Ethical Standards in Sport and Exercise Science Research: 2016 Update

Five-Week, Low-Intensity Blood Flow Restriction Rowing Improves V̇ o2 max in Elite Rowers

ABSTRACT

Held, S, Rappelt, L, Rein, R, Deutsch, J-P, Wiedenmann, T, and Donath, L. Five-week, low-intensity, blood flow restriction rowing improves V̇ o2 max in elite rowers. J Strength Cond Res 38(6): e299-e303, 2024-This controlled intervention study examined the effects of low-intensity rowing with blood flow restriction (BFR) on maximal oxygen uptake (V̇ o2 max), peak power output during ramp testing (PPO), and 2000-m time trial performance (P2k). Eleven, highly elite, male rowers (22.1 ± 1.6 years; 92.6 ± 3.8 kg; 1.93 ± 0.04 m; 7.9. ± 2.2 years rowing experience; 20.4 ± 2.0 h·w -1 training volume; 11.9 ± 1.1 session per week) trained 5 weeks without BFR (Base) followed by a 5-week BFR intervention period. BFR of the lower limb was applied through customized elastic wraps. BFR took place 3 times a week (accumulated net pBFR: 60 min·wk -1 ; occlusion per session: 2 times 10 min·session -1 ) and was used exclusively at low intensities (<2 mmol·L -1 ). V̇ o2 max, PPO, and P2k were examined before, between, and after both intervention periods. Bayesian's credible intervals revealed relevantly increased V̇ o2 max +0.30 L·min -1 (95% credible interval: +0.00 to +0.61 L·min -1 ) adaptations through BFR. By contrast, PPO +14 W (-6 to +34 W) and P2k -5 W (-14 to +3 W) were not noticeably affected by the BFR intervention. This study revealed that 15 sessions of BFR application with a cumulative total BFR load of 5 h over a 5-week macrocycle increased V̇ o2 max remarkably. Thus, pBFR might serve as a promising tool to improve aerobic capacity in highly trained elite rowers.

Muscular fitness profiles in relation to the response in body fat during school-based high-intensity intervention

BACKGROUND

We aimed to assess the equivalence of the muscular fitness (MF) between body fat percentage (BFP) responders (RsBFP) and non-responders (NRsBFP) to school-based high-intensity interval training (HIIT). Adolescents aged 16 (N.=73, 42.5% of males) were identified as RsBFP (N.=45) or NRsBFP (N.=28). MF was assessed based on hand strength (HS), abdominal muscle strength (ABS), and leg power (VJ).

METHODS

Profile analysis showed distinct patterns of MF changes in both response categories. Despite the presence of parallelism (Wilks' Λ=0.979, Pillai's V=0.212, P=0.473), a gradient of increasing changes (HS-ABS-VJ) was found in the RsBFP, while a gradient of decreasing changes was shown in the NRsBFP, and a significant level of inequality (F(1,71)=7.823, P=0.047, partial eta-squared [η2p] 0.041).

RESULTS

One-way analysis showed a significant and moderate effect on VJ (F(1,71)=7.080, P=0.010, η2P=0.091), a close to significant effect on ABS (F(1,71)=3.300, P=0.074, η2P=0.044) and lack of an effect on HS (F(1,71)=0.699, P=0.406, η2P=0.010). The test of equal means across the condition categories (separately for RsBFP and NRsBFP) indicated that there was no multivariate statistically significant within-group effect (F(2, 70)=0.517, P=0.599).

CONCLUSIONS

The findings may help teachers assess the potential and indirect changes in muscle performance after employing a body weight intervention (based on the HIIT program). A more targeted approach to treating adolescents with excessive BF, in parallel with improving MF, can be individually tailored.

The enhancement of explosive power contributes to the development of anaerobic capacity: A comparison of autoregulatory progressive resistance exercise and velocity-based resistance training

Objectives

Due to the character of the taekwondo, the adenosine triphosphate-phosphocreatine system provides the energy for each kick, the glycolytic system supports the repeated execution of kicks, and the aerobic system promotes recovery between these movements and the bout. Therefore, taekwondo athletes require high explosive power and anaerobic capacity in order to carry out sustained and powerful attacks. So, the purpose of this study is to compare the effects of APRE and VBRT on lower-limb explosive power and anaerobic capacity in college taekwondo players.

Methods

A total of 30 taekwondo players completed an 8-week training intervention with autoregulatory progressive resistance exercise (APRE; n = 15) and velocity-based resistance training (VBRT; n = 15). Testing included the one-repetition maximum squat, countermovement jump (CMJ), taekwondo anaerobic intermittent kick test (TAIKT), and 30-s Wingate anaerobic test (WAnT).

Results

(1) Intragroup comparisons revealed significant effects for one-repetition maximum squat, peak power of CMJ (CMJPP), relative peak power of CMJ (CMJRPP), and total number of TAIKT (TAIKTTN) in both the APRE and VBRT groups. The VBRT group exhibited small effect sizes for time at peak power of WAnT (WAnTPPT) and moderate effect sizes for peak power of WAnT (WAnTPP), relative peak power of WAnT (WAnTRPP), and fatigue index of TAIKT (TAIKTFI), whereas the APRE group exhibited small effect sizes for TAIKTFI. (2) Intergroup comparisons revealed no significant effects in any of the results. However, VBRT demonstrated a moderate advantage in WAnTPP and WAnTRPP, whereas APRE had a small advantage in CMJPP and CMJRPP.

Conclusions

These findings suggest that APRE improved explosive power (CMJPP and CMJRPP) more, whereas VBRT improved anaerobic power output (WAnTPP and WAnTRPP) more. Both methods were found to have similar effects in improving the anaerobic endurance (WAnTPPT and TAIKTTN) and fatigue index (power drop of WAnT and TAIKTFI).

Cardiovascular Responses to Eccentric Cycling Based on Perceived Exertion Compared to Concentric Cycling, Effect of Pedaling Rate, and Sex

Interest in eccentric exercises has increased over the last decades due to its efficiency in achieving moderate-high intensity muscular work with reduced metabolic demands. However, individualizing eccentric exercises in rehabilitation contexts remains challenging, as concentric exercises mainly rely on cardiovascular parameters. To overcome this, perceived exertion could serve as an individualization tool, but the knowledge about cardiovascular responses to eccentric cycling based on perceived exertion are still scarce. For this purpose, the cardiorespiratory parameters of 26 participants were assessed during two 5 min bouts of concentric cycling at 30 and 60 rpm and two bouts of eccentric cycling at 15 and 30 rpm matched for rating of perceived exertion. With this method, we hypothesized higher exercise efficiency during eccentric cycling for a same perceived exertion. The results revealed significantly elevated heart rate and cardiac index at higher pedalling rates during concentric (p < 0.001), but not during eccentric cycling (p ≈ 1). Exercise efficiency was higher during concentric cycling (64%), decreasing with pedalling rate, while eccentric cycling exhibited increased work rates (82%), and increased by over 100% with higher pedalling rate. Hence, eccentric cycling, with lower cardiorespiratory work for the same perceived exertion, facilitates higher work rates in deconditioned populations. However, further studies are needed for effective individualization.

Low-intensity climbing with blood flow restriction over 5 weeks increases grip and elbow flexor endurance in advanced climbers: A randomized controlled trial

Grip and elbow flexor strength and endurance are crucial performance surrogates in competitive climbing. Thus, we examined the effects of blood flow restricted (BFR) climbing on grip and elbow flexor performance. Fifteen trained climbers (8 females; 20.8 ± 7.0 yrs; 1.72 ± 0.08 m; 63.0 ± 9.7 kg; 21.7 ± 2.7 IRCRCA grade) were either assigned to the intervention (BFR) or control (noBFR) group, using the minimization method (Strata: age, height, body mass, gender, and IRCRA grade). While BFR was used during low-intensity climbing training (2-times 10 min/session; 3-times/week), noBFR followed identical training protocols without BFR over 5 weeks. BFR of the upper limb was applied via customized pneumatic cuffs (occlusion pressure: 120 ± 23 mmHg, 75%; occlusion pressure). Endurance and strength performances were assessed via one-handed rung pulling (GripSTRENGTH), one-handed bent arm lock off at 90° (ArmSTRENGTH), static-intermitted finger hang (GripENDURANCE), and bent arm hang (ArmENDURANCE). Bayesian credible intervals revealed increased GripENDURANCE (+21 s (95% credible interval: -2 to 43 s)) and ArmENDURANCE +11 s (-5 to 27 s); adaptations via BFR. In contrast, GripSTRENGTH +4 N (-40 to 48 N) and ArmSTRENGTH +4 N (-68 to 75 N) were not affected by the BFR intervention. Fifteen cumulative sessions of BFR application with a cumulative total BFR load of 5 h over a 5 weeks macrocycle remarkably increased grip and elbow flexor endurance. Thus, BFR might serve as a promising means to improve relevant performance surrogates in trained climbers.

Ultrasound and surface electromyography analyses reveal an intensity dependent active stretch-shortening cycle of the vastus lateralis muscle during ergometer rowing

A rowing cycle is characterised by a stretch-shortening cycle (SSC) at the quadriceps femoris muscle-tendon unit (MTU) level. However, due to the associated decoupling between MTU and muscle fascicle length changes, it remains unclear whether a rowing cycle causes active stretch at the muscle level. Fifteen young, sub-elite, male rowers (19.5 ± 1.6 yr; 1.94 ± 0.06 m; 91.9 ± 5.4 kg; rowing experience: 7.5 ± 2.8 yr) performed randomised 60-s rowing intervals using a traditional style at a low (LiR) and high intensity (HiR) and a micro-pause style at a low intensity (MpR). Muscle activity, knee joint angles, and muscle fascicle length changes from the left-sided vastus lateralis (VL) muscle were quantified using surface electromyography, inertial measurement units, and B-mode ultrasound imaging, respectively. All rowing conditions showed active fascicle stretch during late knee flexion (p≤0.001, standardised mean difference (SMD) ≥0.72) and subsequent active fascicle shortening throughout knee extension. Active fascicle stretch duration, amplitude and velocity (rANOVA: p≤0.001, ηp2 = 0.49) were not significantly different (p≥0.174; SMD≤0.26) between LiR and MpR, but were significantly increased during HiR (p≤0.001; SMD≥0.70). The percentage of rowing cycles that involved active fascicle stretch (rANOVA: p≤0.001, ηp2 = 0.95; post-hoc: p≤0.001, SMD≥0.87) was also significantly higher for HiR (98.3 ±12.9%) compared with both LiR (65.0 ± 48.1%) and MpR (68.3 ± 46.9%). In conclusion, rowing involves SSC at the VL muscle fascicle level, but the amount of active stretch differs between rowing intensities, with the longest, largest, and fastest active stretch occurring during HiR. SSC-based mechanisms may therefore contribute more to rowing performance during HiR than LiR or MpR.HighlightsSurface electromyography and ultrasound imaging revealed stretch-shortening cycles (SSCs) of the vastus lateralis muscle fascicles during rowingIncreased active fascicle stretch duration, amplitude and velocity from low- to high-intensity rowing indicate that SSC-based mechanisms likely contribute more to performance during high-intensity rowingThe SSC within the vastus lateralis muscle was independent of the rowing style at the same low rowing intensity.

Positive Effects of Plyometric vs. Eccentric-Overload Training on Performance in Young Male Handball Players

This study aimed to compare the effects of two 8-week in-season strength-training programs on handball players' physical and technical parameters. Thirty-six male athletes were randomly separated into three groups: a control group (n = 12), a plyometric training group (PG, n = 12), and an eccentric-overload training group (EG, n = 12). The PG and EG performed upper- and lower-limb plyometric or eccentric-overload exercises, respectively, three times per week. Control groups performed regular handball training. The athletes were assessed for counter movement jump (CMJ) and Abalakov vertical jump (ABK) height, 15 m linear sprint time, handball-throwing speed (i.e., penalty throw; 3-step running throw; jump throw), and cardiorespiratory endurance through the 20 m shuttle-run test. Heart rate and blood lactate were measured at the end of the endurance test. No baseline differences were noted for dependent variables between groups. The session rating of perceived exertion was similar between the intervention groups (PG = 361 ± 12.2 AU; EG = 370 ± 13.3 AU). The ANOVA revealed significant (p < 0.05; Δ = 5-9%; effect size (ES) = 0.45-1.96). Similar improvements for experimental groups compared to the control group for CMJ, ABK jump, penalty throw, 3-step running throw, and jump throw. However, interventions did not affect 15 m, cardiorespiratory endurance, nor heart rate or blood lactate after the endurance test. In conclusion, an 8-week handball intervention by performing plyometric or eccentric-overload training in-season improves the physical and technical parameters of male players when compared to regular handball practice.

No Difference in Two-Dimensional Kinematic Assessment of a 45-Degree Sidestep Cut Compared to Qualitative Assessment

Background and Purpose

The Expanded Cutting Alignment Scoring Tool (E-CAST) is a two-dimensional qualitative scoring system that has demonstrated moderate inter-rater and good intra-rater reliability for the assessment of trunk and lower extremity alignment during a 45-degree sidestep cut. The primary purpose of this study was to examine the reliability of the quantitative version of the E-CAST among physical therapists and to compare the reliability of the quantitative E-CAST to the original qualitative E-CAST. The hypothesis was that the quantitative version of the E-CAST would demonstrate greater inter-rater and intra-rater reliability compared to the qualitative E-CAST.

Study Design

Observational cohort, repeated measures reliability study.

Methods

Twenty-five healthy female athletes (age 13.8±1.4 years) performed three sidestep cuts with two-dimensional video capturing frontal and sagittal views. Two physical therapist raters independently scored a single trial using both views on two separate occasions. Based on the E-CAST criteria, select kinematic measurements were extracted using a motion analysis phone application. Intraclass correlation coefficients and 95% confident intervals were calculated for the total score, and kappa coefficients were calculated per kinematic variable. Correlations were converted to z-scores and compared to the six original criteria for significance (α<0.05).

Results

Cumulative intra- and inter-rater reliability were both good (ICC=0.821, 95% CI 0.687-0.898 and ICC=0.752, 95% CI 0.565-0.859). Cumulative intra-rater kappa coefficients ranged from moderate to almost perfect, and cumulative inter-rater kappa coefficients ranged from slight to good. No significant differences were observed between the quantitative and qualitative criteria for either inter- or intra-rater reliability (Z_obs(intra)= -0.38, p=0.352 and Z_obs(inter)= -0.30, p=0.382).

Conclusion

The quantitative E-CAST is a reliable tool to assess trunk and lower extremity alignment during a 45-degree sidestep cut. No significant differences were observed in reliability of the quantitative versus qualitative assessment.

Level of evidence

3b.

Low-intensity swimming with blood flow restriction over 5 weeks increases VO2peak: A randomized controlled trial using Bayesian informative prior distribution

Peak oxygen uptake (VO₂peak) and speed at first (LT1, minimal lactate equivalent) and second lactate threshold (LT2 = LT1 +1.5 mmol·L^-1) are crucial swimming performance surrogates. The present randomized controlled study investigated the effects of blood flow restriction (BFR) during low-intensity swimming (LiT) on VO₂peak, LT1, and LT2. Eighteen male swimmers (22.7 ±3.0 yrs; 69.9 ±8.5 kg; 1.8 ±0.1 m) were either assigned to the BFR or control (noBFR) group. While BFR was applied during LiT, noBFR completed the identical LIT without BFR application. BFR of the upper limb was applied via customized pneumatic cuffs (75% of occlusion pressure: 135 ±10 mmHg; 8 cm cuff width). BFR training took place three times a week over 5 weeks (accumulated weekly net BFR training: 60 min·week^-1; occlusion per session: 2-times 10 min·session^-1) and was used exclusively at low intensities. VO₂peak, LT1, and LT2 diagnostics were employed. Bayesian credible intervals revealed notable VO₂peak improvements by +0.29 L·min^-1 kg^-1 (95% credible interval: -0.26 to +0.85 L·min^-1 kg^-1) when comparing BFR vs. noBFR. Speed at LT1 -0.01 m·s^-1 (-0.04 to +0.02 m·s^-1) and LT2 -0.01 m·s^-1 (-0.03 to +0.02 m·s^-1) did not change meaningfully when BFR was employed. Fifteen sessions of LIT swimming (macrocycle of 5 h over 5 weeks) with a weekly volume of 60 min with BFR application adds additional impact on VO₂peak improvement compared to noBFR LIT swimming. Occasional BFR applications should be considered as a promising means to improve relevant performance surrogates in trained swimmers. HighlightsLow-intensity swimming with blood flow restricted (BFR) induced superior peak oxygen consumption adaptations compared to non-restricted swimming training over a 5-week lasting training periodBFR and non-BFR swimming training-induced similar adaptations regarding swimming speed at first and second lactate thresholdIn conclusion, BFR served as a feasible, promising and beneficial complementary training stimuli to traditional swimming training regarding oxygen consumption adaptations.

Jump and Sprint Performance Directly and 24 h After Velocity- vs. Failure-based Training

The combination of plyometric and resistance training (RT) is frequently used to increase power-related adaptations. Since plyometric training is most effective when athletes are in a well-rested state, the acute effect of RT on plyometric performance should be carefully considered. Thus, 15 highly trained males (23.1±3.5 yrs, 1.80±0.06 m, 79.1±7.9 kg) completed a load- and volume-matched velocity-based RT session with 10% velocity loss (VL10) and traditional 1-repetition maximum-based RT session to failure (TRF) in a randomized order. Repeated sprints (5 × 15 m), countermovement jumps (CMJs), and drop jumps (DJs) were measured before, immediately after, and 24 h after both sessions. Lactate, heart rate, and perceived effort (RPE) were measured. Sprint, CMJ, and DJ revealed significant interaction effects (rANOVA p<0.001, η_p ²≥0.63). Immediately afterward, sprint, DJ, and CMJ were less negatively affected (p≤0.03, SMD≥|0.40|) by VL10 vs. TRF. Sprint and CMJ were already recovered 24 h post-testing and showed no significant differences between TRF and VL10 (p≥0.07, SMD≤|0.21|). Twenty-four hours post-testing, DJs were still reduced during TRF but already recovered during VL10 (p=0.01, SMD=|0.70|). TRF resulted in higher lactate, heart rate, and RPE compared to VL10 (p≤0.019, η _p ²≥0.27, SMD≥|0.68|). In conclusion, the non-failure-based VL10 impairs jump and sprint performance less than the failure-based TRF approach, despite matched volume and intensity.

Congruence between Physical Activity Patterns and Dietary Patterns Inferred from Analysis of Sex Differences in Lifestyle Behaviors of Late Adolescents from Poland: Cophylogenetic Approach

Global trends toward physical inactivity and the replacement of healthy dietary behaviors with unhealthy food consumption, particularly in late adolescence, were commonly observed. Thus, the aim of this work was twofold: (1) to examine congruence between PAPs and DPs by identifying sex differences in healthy and unhealthy behaviors and (2) to assess the explanation behind why certain participants were classified into clusters using BMI and fat mass covariates. Late adolescents (19-21 years of age, n = 107) were selected to study. PAPs and DPs were assessed with questionnaires (IPAQ, QEB) and body height, weight, and fat mass percentage were self-reported (the accuracy and reliability of self-reported data were empirically verified). A cophylogenetic approach with several clustering procedures (heatmaps and tanglegrams) was the way to solve the stated problems. Results showed that students achieved the minimal level of physical activity, lower than students from other regions in Poland, Czech Republic, or Germany. There was congruence between PAPs and DPs in some males' and females' behaviors. Significant similarities in sex patterns of behaviors were revealed (Mantel tests-PAPs: r = 0.70, p < 0.001; DPs: r = 0.84, p < 0.001). Similarities in PAPs were related to transportation cycling and school/work activities behaviors. Non-healthy triads in dietary behaviors were found: fast-food, sweetened beverages, and alcoholic drinks in the first, and sweets, fried meals, and yellow cheese in the second. One healthy diad was revealed: vegetables and fruits. Only females' dietary behaviors were reflected in body mass index (F = 3.19, p = 0.049), percentage of body fat (F = 3.87, p = 0.027), and fat mass index (F = 3.83, p = 0.028). The usefulness of the cophenetic approach in patterns study was verified. Sex similarities and specific disparities could help preparing targeted tailored intervention programs that improve healthy habits in late adolescents. This is especially important in relation to females, who more strongly reflected dietary behaviors in body composition.

Acute response of biomarkers in plasma from capillary blood after a strenuous endurance exercise bout

PURPOSE

The present study aims to investigate the acute response of potential exercise-sensitive biomarkers in capillary plasma to an acute incremental running test. In a second step, their concentration was compared to the changes in the venous serum.

METHODS

Thirty-seven active young female and male adults completed a VO_2max ramp test on a treadmill. Before and after exercise, capillary blood from the earlobe and venous blood were taken and synchronized. Concentrations of Interleukin- (IL-) 1β, IL-1ra, IL-6, IL-8, IL-17A, Interferon (IFN)-y, CC-chemokine ligand (CCL)-2, Matrix metallopeptidase (MMP)-9, Secreted protein acidic and rich in cysteine (SPARC), Cluster of differentiation (CD)163, S100 Ca²⁺ -binding protein (S100) A8, S100A9, S100B, Brain-derived neurotrophic factor (BDNF), and Myeloperoxidase (MPO) were determined by magnetic bead-based multiplex assay.

RESULTS

Capillary plasma concentrations of IL-1β, IL-6, IL-8, IL-17A, IFN-y, CCL-2, MMP-9, SPARC, CD163, S100A9, S100B, and BDNF increased after exercise (p < 0.05). Comparing the values from capillary plasma and venous serum, ICCs classified as good were found for IFN-y (post), while the ICCs for IL-1β, IL-8, IL-17A, CCL-2, MMP-9 (post), SPARC, and BDNF (post) were classified as moderate. For all other parameters, only weak ICCs were found.

CONCLUSION

As in the venous serum, there was an increase in most markers in the capillary plasma. However, acceptable to low associations can be found in the concentration levels of these proteins between the compartments. Thus, this source of blood sampling could find some biomarker applications in sports practice.

The Functional Form of the Relationship between Body Height, Body Mass Index and Change of Direction Speed, Agility in Elite Female Basketball and Handball Players

The aim of this study was to assess the functional form of the relationship between two anthropometric measurements-body height (BH) and body mass index (BMI)-and two motor abilities-change of direction speed (CODS) and agility (AG)-in female elite basketball and handball players. It was hypothesized that BH and BMI might be significantly associated with AG and CODS. Two scenarios of the Five-Time Shuttle Run to Gates test (planned and unplanned) were used to evaluate the CODS and AG. Two forms of models were built to assess functional forms of the relationships between CODS and AG vs. BH and BMI: simple linear regression and binomial curvilinear regression for each type of team sport. The results confirmed the relationships between both anthropometric measurements and motor abilities only in HB, whereas in BB only a significant relationship was noted between BH and AG. Moreover, two curvilinear functional forms of the relationship were identified: inverted L-shape and inverted U-shape. Therefore, it was concluded that the first form of function indicated an initially proportional relationship between anthropometric measurement and motor test results and plateau after reaching a certain value of the BH or BMI. Similarly, the second form of function indicated the peak value of the BH or BMI which is threshold for the value of the anthropometric measurement when a progressive effect in the functional feature occurs.

Body composition and grip strength constraints in elite male rink-hockey players of contrasting ethnicity

Rink hockey is a highly specialized and physiological demanding sport with sparse research regarding the game and athletes’ characteristics. A cross-sectional study was developed to characterize the body composition and grip strength of elite male rink hockey players and to establish the relationship between ethnicity on body composition and grip strength. A sample of 100 elite rink-hockey athletes aged 26.59 ± 6.02 participated in the study, comprised of 69 Caucasian male adults aged 27.58 ± 6.44 years and 31 Black African male adults aged 24.39 ± 4.27. Body composition was assessed by anthropometric measurements. Static grip strength was assessed with an adjustable dynamometer. Multiple regression analysis was applied to understand which variables constraints body fat percentage (BF) and grip strength. Body mass showed an average of 76.36 ± 9.18 kg for 175.80 ± 5.87 cm of height and BF% of 10.82 ± 5.07%. Maximal right grip strength was 50.91 ± 6.26 kg and 50.27 ± 6.23 kg for left grip strength. Four predictors accounted for 70.01% of the variance of BF%: abdominal circumference (p < 0.001), right thigh circumference (p < 0.001), right calf circumference (p = 0.001) and ethnicity (p = 0.016). Three predictors accounted for 13.1% of the variance of right grip strength: ethnicity (p = 0.013), chronological age (p = 0.024) and right distal thigh circumference (p = 0.014). Results suggest that elite rink hockey athletes have a specific anthropometric identity, which at the elite level may lead to reduced body fat and greater handgrip strength. Ethnicity seems to predict body fat and grip strength in elite rink hockey athletes.

Analysis of Injury Patterns in Men's Football between the English League and the Spanish League

BACKGROUND

Injuries in professional football lead to reduced team performance and large financial losses. The aim of this study was to analyse injuries in the two best team competitions in the world (LaLiga and Premier League), establishing similarities and differences, as well as determining injury causation patterns.

METHODS

A total of 277 on-field injuries requiring a substitution were analysed (142 in the Spanish league and 135 in the English league). The analysis was performed using traditional statistical tests (frequency analysis, chi-square test) with SPSS 25 and a T-Patterns sequence analysis with THEME 5.0.

RESULTS

In the Spanish league, there were a similar number of injuries in the first part of the season as in the second part of the season, while in the English league, they are more frequent in the first part of the season. In the Spanish league, injuries are more frequent in the first half of the match, while in the English league, they are more frequent in the second half. The type of player most frequently injured was the defender. Most of the injuries occurred without the presence of an opponent. The accumulated minutes during the season affect injuries of the muscular type.

CONCLUSIONS

The most common type of injury in both leagues was a strain, followed by a sprain and a contusion. Although common injury patterns can be established between the two leagues, there are notable differences. One of the factors is determined by the English league calendar (many matches at Christmas). In Spain, there were more muscular injuries that were not caused by the opponent, while in England there were more tackling injuries. Age is a risk factor in the Spanish league. In this league, there is a moderately significant relationship between the number of injuries and the points won.

Neurophysiological Markers for Monitoring Exercise and Recovery Cycles in Endurance Sports

The current study analyzes the suitability and reliability of selected neurophysiological and vegetative nervous system markers as biomarkers for exercise and recovery in endurance sport. Sixty-two healthy men and women, endurance trained and moderately trained, performed two identical acute endurance tests (running trial 1 and running trial 2) followed by a washout period of four weeks. Exercise protocol consisted of an acute running trial lasting 60 minutes. An intensity corresponding to 95% of the heart rate at individual anaerobic threshold for 40 minutes was followed by 20 minutes at 110%. At pre-exercise, post-exercise, three hours post-exercise and 24 hours post-exercise, experimental diagnostics on Brain-derived neurotrophic factor (BDNF), heart rate variability (HRV), Stroop Color and Word Test (SCWT), and Short-Form McGill Pain Questionnaire (SF-MPQ) were performed. Significant changes over time were found for all parameters (p < .05). Furthermore, there was an approached statistical significance in the interaction between gender and training status in BDNF regulation (F₍₃₎ = 2.43; p = 0.06), while gender differences were found only for LF/HF-ratio (3hPoEx, F₍₃₎ = 3.40; p = 0.002). Regarding the reliability, poor ICC-values (< 0.5) were found for BDNF, Stroop sensitivity and pNN50, while all other parameters showed moderate ICC-values (0.5-0.75). Plasma-BDNF, SCWT performance, pain perception and all HRV parameters are suitable exercise-sensitive markers after an acute endurance exercise. Moreover, pain perception, SCWT reaction time and all HRV parameters show a moderate reliability, others rather poor. In summary, a selected neurophysiological and vegetative marker panel can be used to determine exercise load and recovery in endurance sports, but its repeatability is limited due to its vaguely reliability.

The accuracy and reliability of three instruments used to assign school furniture

BACKGROUND: Students spend a high number of hours being seated while at school. In order to find the correct adjustment between school furniture and the anthropometric characteristics, specific knowledge and tools are necessary. OBJECTIVE: The objective of the study is to evaluate the accuracy and reliability of the measurers with different instruments, as well as contrast the differences between the values that were obtained by the different examiners. METHODS: Measurements were taken independently by one expert examiner and two inexperienced teachers from the school. They used a measuring tape, a segmometer and an anthropometer for the anthropometric measurements. The statistical tests conducted: Kolmogorov-Smirnov test, Intraclass Correlation Coefficient, Bland and Altman method, Standard Error of Measurement, Technical Error of Measurement and relative TEM with a level of significance of ρ ≤ 0.05. RESULTS: A total of 108 students (8.87±1.67 years; 40.7% girls) participated in the study. The non-expert measurers had good accuracy and reliability, but they far exceeded the error percentages of the expert, obtaining the worst results in the shoulder measurement. The instrument with the lowest affinity between the inexperienced measurers was the anthropometer CONCLUSIONS: In order to assign furniture in the schools, the experts should continue using the anthropometer. The inexperienced measurers can use more accessible instruments in the school environment such as a measuring tape and segmometer.

Relationship Between Game Load and Player's Performance in Professional Basketball

PURPOSE

The purpose of the study was to examine the relationships between external and internal loads, and their ratio (efficiency index), with game performance between backcourt and frontcourt professional basketball players.

METHODS

Game loads of 14 basketball players were monitored during 6 games. External load variables measured were total distance (TD); distance >18 km·h-1, commonly known as high-speed running (HSR); and number of accelerations (ACC) and decelerations (DEC) >3 m·s-2, whereas the internal load variable measured was average heart rate (HRmean). The ratio between external and internal load variables was calculated and defined through 4 efficiency indexes (TD:HRmean, HSR:HRmean, ACC:HRmean, and DEC:HRmean). Furthermore, basketball performance was quantified using game-related statistics.

RESULTS

TD presented a small association with basketball performance, whereas the other external load variables and the 4 efficiency indexes calculated showed trivial relationships with game-related statistics. Furthermore, HRmean showed the greatest (small) associations with individual performance (P = .01-.02; r = .19 to .22). Regarding specific positions, the only 2 variables that presented significant differences were DEC (P = .01; d = 0.86) and DEC:HRmean (P = .01; d = 0.81), which showed higher values in backcourt players compared with frontcourt players.

CONCLUSIONS

The results suggest that the best performances of basketball players during official competition are not associated with higher game loads. This illustrates the necessity to assess basketball performance from a holistic approach and consider more than just external and internal variables to better understand the players' performance during basketball competition.

Effect of Teaching Method on Exercise Execution in Adolescents' Use of Outdoor Fitness Equipment

The use of outdoor fitness equipment (OFE) is an effective strategy to promote physical activity. The equipment normally includes information panels with phrases and images describing appropriate exercises. However, as using this equipment inappropriately is a potential problem, it is important to find an optimal unsupervised instruction method for correct exercise execution. Our objective in this study was to determine which of several exercise prescription methods, without direct professional supervision, might best instruct adolescents to correctly engage in upper limb motor execution on outdoor flexion-extension equipment. A total of 54 adolescents from a middle socioeconomic level in northwest Spain participated in this descriptive and quasi-experimental study. We randomly assigned members of this convenience sample into three groups who received either video instruction, instruction via images or written panel instructions. We used observational methodology in videographic analysis to evaluate the mistakes participants made in motor execution with each instructional method. We utilized different analytic techniques from observational methodology: statistical analyses (means, standard deviation, confidence intervals, ANOVA, etc.) and detecting T-Patterns with Theme and polar coordinate analysis using HOISAN. Participants who relied on video instructions committed fewer errors than those who relied on panel instructions. The video method prevented loss of information that occurred when instructional images were used. We suggest including a QR code on outdoor fitness equipment in open-air parks to permit users to download an explanatory video to their mobile phones.

Reliability of the Expanded Cutting Alignment Scoring Tool (E-CAST) to Assess Trunk and Limb Alignment During a 45-Degree Side-Step Cut

Background

Current clinical screening tools assessing risky movements during cutting maneuvers do not adequately address sagittal plane foot and ankle evaluations. The Cutting Alignment Scoring Tool (CAST) is reliable in evaluating frontal plane trunk and lower extremity alignment during a 45-degree side-step cut. The Expanded Cutting Alignment Scoring Tool (E-CAST) includes two new sagittal plane variables, knee flexion and ankle plantarflexion angle.

Hypothesis/Purpose

To assess the inter-and intra-rater reliability of the E-CAST to evaluate trunk and lower extremity alignment during a 45-degree side-step cut.

Study Design

Repeated Measures.

Methods

Participants included 25 healthy females (13.8 ± 1.4 years) regularly participating in cutting or pivoting sports. Participants were recorded performing a side-step cut in frontal and sagittal planes. One trial was randomly selected for analysis. Two physical therapists independently scored each video using the E-CAST on two separate occasions, with randomization and a two-week wash-out between rounds. Observed movement variables were awarded a score of "1", with higher scores representing poorer technique. Intraclass correlation coefficients (ICC) and 95% confident intervals (95% CI) were calculated for the total score, and a kappa coefficient (k) was calculated for each variable.

Results

The cumulative intra-rater reliability was good (ICC=0.78, 95% CI 0.59-0.96) and the cumulative inter-rater reliability was moderate (ICC=0.71, 95% CI 0.50-0.91). Intra-rater kappa coefficients ranged from moderate to excellent for all variables (k= 0.50-0.84) and inter-rater kappa coefficients ranged from slight to excellent for all variables (k=0.20-0.90).

Conclusion

The addition of two sagittal plane variables resulted in lower inter-rater ICC compared to the CAST (ICC= 0.81, 95% CI 0.64-0.91). The E-CAST is a reliable tool to evaluate trunk and LE alignment during a 45-degree side-step cut, with good intra-rater and moderate inter-rater reliability.

Level of Evidence

Level 2, Diagnosis.

Comparison of the most demanding scenarios during different in-season training sessions and official matches in professional basketball players

The purpose of this study was to compare physical demands during the most demanding scenarios (MDS) of different training sessions and official matches in professional basketball players across playing positions. Thirteen professional basketball players were monitored over a 9-week competitive season using a local positioning system. Peak physical demands included total distance, distance covered at > 18 km·h^-1, distance and number of accelerations (≥ 2 m∙s^-2) and decelerations (≤ -2 m∙s^-2) over a 60-second epoch. Analysis of variance for repeated measures, Bonferroni post-hoc tests and standardised Cohen's effect size (ES) were calculated. Overall, almost all physical demands during the MDS of training were lower (-6.2% to -35.4%) compared to official matches. The only variable that surpassed competition demands was distance covered at > 18 km·h^-1, which presented moderate (ES = 0.61, p = 0.01) and small (ES = 0.48, p > 0.05) increases during training sessions four and three days before a competition, respectively. Conversely, the two previous practices before match day presented trivial to very large decreases (ES = 0.09-2.66) in all physical demands. Furthermore, centres achieved the lowest peak value in total distance covered during matches, forwards completed the greatest peak distance at > 18 km·h^-1, and guards performed the greatest distance and number of high-intensity accelerations and decelerations. In conclusion, physical demands during the MDS of different training sessions across the microcycle failed to match or surpass peak values during official matches, which should be considered when prescribing a training process intended to optimise the MDS of match play.

Changing Oar Rotation Axis Position Increases Catch Angle During Indoor and In-Field Para-Rowing: A Randomized Crossover Trial Verified by a Repeated Measurement Trial

A long rowing stroke length is crucial for adequate rowing performance. Therefore, the relocation of the oar from traditional “in front” (NORM) to “behind the rotation axis” (GATE) may increase (para) rowing performance. Thus, 15 able-bodied rowers (21.4 ± 3.6 years; 187 ± 8 cm; 85.4 ± 8.2 kg) completed indoor TANK rowing 2 min TimeTrials (2 min-TT) of GATE and NORM in a randomized order. Additionally, one elite Paralympic oarsman (37 years, 185 cm, 67 kg) performed a multiple single case in-field BOAT testing (24x2min-TT of GATE and NORM in a randomized order). GATE revealed significantly larger catch angles during TANK (+97.1 ± 120.4%; p = 0.001, SMD = 0.84) and BOAT (+11.9 ± 3.2%; p < 0.021; SMD = 2.69; Tau-U = 0.70) compared to NORM. While total stroke length, rowing power, and work per stroke increased in GATE during TANK (p < 0.010, SMD > 0.634), no such significant changes of these performance parameters between GATE and NORM were observed during BOAT (p > 0.021; SMD < 0.58; Tau-U < 0.29). Rowing economy-related parameters (power or speed per oxygen uptake) and boat speed also showed no significant differences between GATE und NORM during BOAT (p > 0.61; SMD < 0.31; Tau-U < 0.19). The shape of the force–angle curve (position of peak force and ratio between average and maximal force) remained unaffected from GATE during both TANK (p > 0.73, SMD < 0.1) and BOAT (p > 0.63; SMD < 0.60; Tau-U < 0.27). In conclusion, GATE shifted the entire rowing stroke towards the catch (+6.6 ± 1.8°) without notably affecting relevant performance parameters during BOAT. Particularly during crew rowing, the minimization of detrimental boat movements for perfect synchrony should be aimed for. Accordingly, the combined application of GATE and NORM (for different athletes in crew boats) may be beneficial for rowing synchronization.

Prevalence of Positive Effects on Body Fat Percentage, Cardiovascular Parameters, and Cardiorespiratory Fitness after 10-Week High-Intensity Interval Training in Adolescents

Simple Summary

In this study, we aimed to analyze the prevalence of positive effects of high-intensity interval training (HIIT) on body composition, cardiovascular parameters, and cardiorespiratory fitness among adolescents. We investigated 52 boys and 89 girls from a secondary school, separated into an experimental group (EG) with HIIT intervention and a control group (CG). The measured parameters were body fat % (BFP), resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and fitness index (FI). The results indicate that positive HIIT-induced changes in SBP, DBP, and FI were most common among boys, especially those with low body mass index. Our study also revealed relationships between changes in FI and BFP and BP parameters. The effectiveness of HIIT was confirmed concerning the prevalence of the positive changes in measured parameters. We suggest that HIIT should be implemented in PE lessons, although there is a need to look for a more efficient method for girls.

Abstract

Analysis of the interventions on cardiovascular disease risk factors focuses on quantitative changes, omitting assessment of positive effect frequency in individuals. The aim of this study was to assess the prevalence of positive effects of high-intensity interval training (HIIT) on body composition, cardiovascular parameters, and cardiorespiratory fitness among adolescents. A total of 52 boys and 89 girls from a secondary school were separated into an experimental group (EG) with HIIT and a control group (CG). Body fat % (BFP), resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and fitness index (FI) changes were calculated. We assessed the influence and interaction of three factors: intervention (INT), sex (SEX), and body mass index (BMI_status) on the ratio of individuals with and without positive changes. We used log-linear models for interactions and multivariate correspondence analysis (MCA). The results indicate that HIIT affects the prevalence of positive changes in SBP, DBP, and FI. Interactions between factors suggest boys with low BMI get more benefit from the intervention than girls. The MCA indicates a relationship between FI and BFP and between BP parameters. The effectiveness of HIIT was confirmed concerning the prevalence of the positive changes in measured parameters. We suggest that HIIT should be implemented in PE lessons, although there is a need to look for a more efficient method for girls.

Reliable Peak Power Assessment During Concentric and Flexion-Extension-Cycle Based Rowing Strokes using a Non-Modified Rowing Ergometer

Accurate assessment of peak rowing power is crucial for rowing-specific performance testing. Therefore, within and between day reliability of a non-modified rowing ergometer was examined. 52 trained male rowers (21.0 ± 2.9 years; 1.89 ± 0.05 m; 83.2 ± 8.2 kg; 2,000-m ergometer Time Trial mean power: 369 ± 57 W) performed (two times 4) isolated concentric rowing strokes (DRIVE) and single flexion-extension cycle (FEC-type) rowing strokes (SLIDE-DRIVE) on two separate days (1 week apart). Good to excellent intraclass correlation coefficients (0.94 ≤ ICC ≤ 1.00), low standard error of measurement (≤ 2.7%), low coefficient of variation (≤ 4.9%), and suitable level of agreements (≤ 30W) for DRIVE and SLIDE-DRIVE indicated a high level of (within and between day) reliability. In addition, SLIDE-DRIVE (423 ± 157 W) revealed remarkably higher rowing power (p ≤ 0.001; η_p² = 0.601; SMD = 0.34) compared to DRIVE (370 ± 154 W). The non-modified rowing ergometer is considered to be a reliable tool for the peak power assessment during isolated concentric contraction and FEC-type rowing strokes. Notably higher power outputs (compared to an isolated concentric contraction) during FEC rowing may refer to an underlying stretch shortening cycle.

Impact of match-related contextual variables on weekly training load in a professional soccer team: a full season study

The purpose of this study was to analyse the impact of match-related contextual variables (match location, match outcome and level of the opponent) on the weekly training load in a professional soccer team throughout a full competitive season. Total distance, high-speed running distance (HSRD, > 18 km·h^-1), highmetabolic load distance (HMLD, > 25.5 W·kg^-1), player load and total number of impacts (above 3 G) were collected from training and match sessions in professional soccer players (n = 25) competing in LaLiga123. Comparisons of external load parameters by each match-related contextual variable were examined using a mixed-effect model. Differences between playing positions were found for total distance (p < 0.05; r = 0.11–0.15), HSRD (p < 0.05; r = 0.13–0.19), HMLD (p < 0.05; r = 0.12–0.19), player load (p < 0.05; r = 0.11–0.19) and impacts (p < 0.05; r = 0.15–0.26). However, no significant interaction was observed between match-related contextual variables and playing position for any variable (p > 0.05). In addition, a significant impact of match outcome (p < 0.05; r = 0.11–0.15), opponent level (p < 0.05; r = 0.11–0.17) and match location (p < 0.05; r = 0.14–0.20) on the weekly training load (before and after the match) was observed. In conclusion, match-related contextual variables seem to slightly affect weekly external training load. Thus, coaching and medical departments could consider the influence of these contextual variables when prescribing the training load relative to the match demands.

Effects of combined training on metabolic profile, lung function, stress and quality of life in sedentary adults: A study protocol for a randomized controlled trial

Background

Both physical inactivity and sedentary behavior are considered modifiable risk factors for chronic diseases and all-cause mortality. Adult office-workers spend most of their working day in sedentary behaviors, so they are particularly at high risk of developed chronic diseases (e.g., cardiovascular diseases, metabolic disorders like diabetes mellitus, …). It seems important to promote behavioral changes that could prevent or delay metabolic disease development. Evidence supports the use of exercise programs, however, to date there are several knowledge gaps and inconsistencies in the literature regarding the effects of Combined Training (i.e., aerobic plus resistance training) in sedentary healthy adults. This paper outlines an RCT designed to evaluate the effects of a 16-week combined training program on biochemical and immune markers of metabolic disease, lung function, salivary stress hormones and subjective quality of life (primary outcomes), as well as on body composition and physical fitness (secondary outcomes) in sedentary middle-aged office-workers. Furthermore, we aimed to assess the associations between the changes promoted by the exercise program and the different variables studied.

Methods and design

This is a single-blinded two-arm RCT with parallel groups. A minimum of healthy 40 office-workers aged 40–64 years will be recruited to engage in a 16-week intervention study. After baseline assessments, participants will be randomized to one of the two groups: (1) combined training group or (2) control group. Baseline assessments will be repeated after 8 weeks of intervention (mid-testing) and upon completion of the intervention (post-testing).

Discussion

This RCT involves a multi-disciplinary approach and seems to be a relevant contribution to understanding the potential role of combined training in improving the metabolic profile, lung function, stress, and quality of life in adults. The results can provide important insights for clinical recommendations and for the optimization of strategies to prevent metabolic disorders in adults with sedentary jobs.

Trial registration

This trial is registered with ClinicalTrials.gov (registration number: NCT04868240; date of registration April 30, 2021).

The Mediation Role of Fatness in Associations between Cardiorespiratory Fitness and Blood Pressure after High-Intensity Interval Training in Adolescents

BACKGROUND

Low cardiorespiratory fitness (CRF), elevated blood pressure (BP), and high fatness are cardiovascular disease risk factors. It remains unknown how fatness affects the influence of CRF on BP. Therefore, the aim was to examine whether the associations between baseline CRF and HIIT-postintervention resting BP were mediated through fatness in adolescents.

MATERIAL AND METHODS

The sample (n = 64) comprised 28 boys 36 girls aged 16 years. The analysed factors were fitness index- reflecting CRF, body fat mass (BFM), fat mass index (FMI), and body mass index (BMI). Bootstrapped mediation procedures were performed. The mediation analysis was conducted concerning the sex moderation effect.

RESULTS

The mediation effect of sex was confirmed; therefore, mediations models were designed separately for boys and girls. The results showed a statistically significant inverse relationship between baseline CRF and post-intervention systolic blood pressure (SBP) in both sexes (boys: B = -0.603, p = 0.010; girls: B = -0.394, p = 0.037). The relations between CRF and SBP revealed the mediation effect of the BFM and the FMI only in boys.

CONCLUSIONS

Fatness mediated associations between CRF and SBP in boys. Therefore, both CRF and fatness are necessary to maintain positive results of the BP revealed in normal SBP ranges after HIIT.

Patterns of Injury in the Spanish Football League Players

BACKGROUND

The study of football injuries is a subject that concerns the scientific community. The problem of most of the available research is that it is mainly descriptive. The objective of this study is to discover and analyse the patterns of injury in the Spanish Football League (2016-2017 season).

METHODS

The sample data consisted of 136 given injuries identified by the official physicians of the football clubs. The analysis was performed by using traditional statistic tests, T-pattern detection and polar coordinate analysis.

RESULTS

The analysis revealed several patterns of injury: (a) The defender suffered a rupture of the hamstring muscles after a sprint, (b) knee sprains happened due to a received tackle, (c) fibrillar adductor rupture appeared mostly among defenders and (d) fibrillar ruptures took place mostly throughout the first part.

CONCLUSIONS

There is a marked shift in the tendency regarding the player who gets more injured, from the midfielder to the defender. The most common injury was fibrillar rupture. The most common scenario in which this injury occurred was that in which the player injured himself after a sprint (24%). A week without competing seems to be insufficient as a prevention mechanism for injuries.

Validation of Two Instruments for the Correct Allocation of School Furniture in Secondary Schools to Prevent Back Pain

BACKGROUND

Back pain is common in secondary school students. If we adjust the school furniture to the anthropometric characteristics of the pupils, we will improve their posture and reduce back pain. There is a high degree of mismatch between the furniture used by students and that which should be used. The objectives of this research are to discover the degree of mismatch and validate two instruments that allow a correct allocation of the furniture.

METHODS

The selected sample was 132 secondary students (14.08 ± 1.10 years). An anthropometer was used to determine the ideal height of the chair and table; data were taken from body segments. The recorded values were compared with those obtained by the two measurement instruments to be validated. Inter-measurer and intra-measurer reliability and validation were performed using t-tests and Pearson's coefficient, respectively. Different analysis techniques were used: descriptive, one-way ANOVA, t-test, and effect size. The established level of significance was ρ < 0.05.

RESULTS

The mismatch between the anthropometric dimensions of the students and the existing furniture in the classrooms was 98.5 % for the chairs and 100 % for the tables. The correlational analysis of the instruments to be validated shows an r = 0.993 in the chair and r = 0.996 in the table.

CONCLUSIONS

There is a high degree of mismatch between the furniture and the anthropometric characteristics of the students. The proposed furniture allocation instruments are adequate.

Inter-Individual Variability of a High-Intensity Interval Training With Specific Techniques vs. Repeated Sprints Program in Sport-Related Fitness of Taekwondo Athletes

This study investigated the effect of 4 weeks of high-intensity interval training (HIIT) with specific techniques (TS-G) vs. repeated sprints (RS-G) and analyzed the inter-individual variability [classified into responders (Rs) and non-responders (NRs)] on sport-related fitness in taekwondo (TKD) athletes. Athletes of both genders (n = 12) were randomly assigned into TS-G and RS-G groups. Both groups trained 3 days/week for 4 weeks [two blocks of three rounds of 2 min of activity (4-s of all-out efforts with 28-s dynamical pauses) with 1 min of recovery in between and 5 min between blocks] during their regular training. The related sport fitness assessments included squat jump (SJ), countermovement jump (CMJ), multiple frequency speed of kick test (FSKT_MULT), specifically total kicks and Kick Decrement Index (KDI), and 20-m shuttle run (20MSR). Relevant results indicate a significant effect of the time factor in both groups for SJ performance and a significant decrease for KDI in RS-G. In addition, an improvement in performance according to the effect size analysis in the TS-G in total kicks, KDI, and 20MSR. Complementarily, a higher proportion of athlete Rs was reported in TS-G vs. RS-G for SJ (50% vs. 30.3%, respectively), CMJ, and total kicks (16.6% vs. 0%). In conclusion, the addition to the regular training of a HIIT with specific-techniques and repeated-sprints associated with intervals and similar structure of the combat during 4 weeks of training can improve the concentric characteristics of lower limb performance, although they were not the sufficient stimuli in the other components of TKD-related fitness.

The Mediating Effect of Change of Direction Speed in the Relationship between the Type of Sport and Reactive Agility in Elite Female Team-Sport Athletes

The main aim of this study was to examine the mediating effect of the change of direction speed (CODs) on reactive agility (RA) in female players participating in different team sports (TS). In total, there were 31 elite female players from the Polish national basketball (n = 12, aged 24.98 ± 3.38) and handball (n = 19, aged 27.34 ± 4.68) teams participated in this study. Two experiments using the 'five-time shuttle run to gates' test with similar movement patterns were used to determine the players' RA and CODs. A simple mediation model was utilised to investigate the potential mediation role of CODs and its effect on RA. The results revealed a primary, statistically significant effect of TS on RA (B = 0.796, p = 0.005), which decreased and became statistically insignificant after including the CODs variable into the model of mediation analysis (B = 0.337, p = 0.192). The RA test results were mediated by changes in CODs (B = 0.764, p < 0.001). Likewise, TS affected CODs (B = 0.602, p = 0.016). The general conclusion is that the relationship between TS and RA is not inherent. The direct effect of TS on RA disappears in the presence of the mediator CODs. Study results confirm the relevance of using the mediation analysis to apply in sport training. Identification of the critical ingredients of the athletes' agility performance can improve training programs by focusing on effective components.

Effects of High-Intensity Interval Training With Specific Techniques on Jumping Ability and Change of Direction Speed in Karate Athletes: An Inter-individual Analysis

This study investigated the effect of 4weeks of high-intensity interval training (HIIT) with specific techniques and analyzed inter-individual variability [classified in responders (Rs) and non-responders (NRs)] on jumping ability and change of direction speed (CODS) in youth karate athletes. Athletes of both genders (n=10) were randomly assigned into experimental group (EG; n=5) and the control group (CG; n=5). The EG trained 2-3days per week applying HIIT (three rounds [15 sets of 4s all-out specific efforts with 8s of dynamical pauses] with 3min of recovery between rounds) during their usual training during 4weeks. Assessments included squat jump (SJ) and countermovement jump (CMJ) and CODS by T-test. No significant interaction effect group by time was found. Although, in percentage and effect size (ES) terms increases were reported in both groups for SJ (EG: 15.2%, ES=0.91 vs. CG: 12.4%, ES=0.02) and only in EG for the T-test (-1.7%; ES=-0.35). In turn, a trend toward a higher proportion of Rs was observed in the EG (40% Rs) vs. CG (20% Rs) for SJ and CODS, respectively. In conclusion, the addition to regular training of a HIIT with specific techniques and based on the temporal combat structure after 4weeks was not a sufficient stimulus to increase jumping ability and CODS in karate athletes.

Sport specialization of female figure skaters: cumulative effects on low back injuries

Objective: 1) to determine the proportion of sport specialization among female figure skaters, 2) to compare proportion of low back injuries between specialized female figure skaters and non-specialized female figure skaters, and 3) to identify an independent risk factor(s) for low back injuries in female figure skaters.Methods: A cross-sectional questionnaire study was used. Young female figure skaters were asked questions related to sport specialization and any history of low back injuries. The primary outcome variables were status of sport specialization, weekly training hours, and low back injury. Descriptive statistics, t-test, chi-square analyses, and binary logistic regressions were used.Results: Responses from 132 female figure skaters (mean age: 16.3 ± 2.7 years, age range: 8-22 years) were analyzed. Sixty-two percent (82/132) of figure skaters were specialized. Specialized female figure skaters spent more time in training (11.3 ± 6.5 hours/week) than non-specialized skaters (7.6 ± 4.9 hours/week, p = 0.001). No statistical differences were found in proportion of low back injury history between specialized (25.6%) and non-specialized female figure skaters (24.0%, p = 0.836). Chronological age was also identified as an independent risk factor for low back injuries in female figure skaters (aOR: 1.24, 95%CI: 1.00, 1.54, p = 0.048).Conclusions: The majority of female figure skaters in this cohort were specialized. An association between chronological age and low back injuries, found in the current study, may be a result of cumulative effects of participating in figure skating over time.

The Relationship Between Reactive Agility and Change of Direction Speed in Professional Female Basketball and Handball Players

Assessing the physical ability of players to perform change of direction and the cognitive and motor abilities revealed in reactive agility (RA) is necessary to understand the physical requirements and capabilities of professional players in handball and basketball. The main aim of this study was to determine the differences between professional female basketball and handball players in terms of anthropometric features, change of direction speed (CODS), and the RA task. Moreover, the relationships among anthropometric features, agility, and parameters of perception were determined. Two scenarios of the Five-Time Shuttle Run to Gates test (planned and unplanned) were used to evaluate the CODS and RA. The response time (RT) was also measured in the unplanned scenario. Additionally, the index of reactivity (REAC-INDEX) was specified as the difference between the RA test result and the measurement of CODS. There was a significant difference found in terms of body height, with basketball players being taller than handball players (p = 0.032). Professional female handball players achieved better results than professional female basketball players with regard to RA tasks (p = 0.01) and CODS (p = 0.041). Significant simple correlations between each anthropometric feature (body height, body mass) and values for CODS and RA were observed (r = 0.49-0.53). Applying partial correlation allowed for the assessment of actual relationships among CODS, RA, RT, and REAC-INDEX, without a confounding variable. Detaching the anthropometric parameters from the rest of the relationships resulted in maintenance or changes in r-values and an increased significance in the relationships between each pair: RA vs. RT, RA vs. REAC-INDEX, and RT vs. REAC-INDEX. The strongest associations were related to RT vs. REAC-INDEX (r = 0.97 at detaching body height or body mass, p < 0.001) and CODS vs. RA (r = 0.66 at detaching body height and r = -0.67 at detaching body mass, p < 0.001). It is recommended to use partial correlations in subsequent studies, as simple correlations are not reliable and may not reveal the apparent relationships between the variables. In addition, when determining the CODS and RA, it is suggested to take anthropometric and perception variables into account, such as reaction time or REAC-INDEX.

Reference Curves of Selected Circumferential Parameters for Czech Children Aged 6 to 11 Years

(1) Background/objective: the globally discussed current issue is the increasing body weight of the population. This trend is observed in all age categories. Pediatricians and anthropologists use BMI percentile curves to determine the optimal body weight of children, based on which the child is categorized in the category of underweight, normal weight, overweight, or obese. Medical or anthropological examinations also use some methods to determine the amount of body fat. In addition to evaluating amounts of body fat, it is important to assess its distribution. The distribution of fat in the body, especially in terms of disproportionate distribution, is a risk factor for health complications, especially in terms of metabolic and health risk. Part of monitoring children’s growth is also measuring and evaluating circumferential parameters, such as abdominal circumference, gluteal circumference, and waist circumference. This study aimed to define age- and gender-specific reference curves for waist circumference (WC), abdominal circumference (AbC), and gluteal circumference (GC) in Czech children. (2) Methods: data on children’s circumferential parameters were collected via anthropometric measurements. The research sample consisted of 2093 children aged 6–11 years (boys, n = 1008; girls, n = 1085). Only children with parental informed consent were included. The statistical analysis was performed separately by age and gender using SPSS v. 22. Anthropometric data were summarized by mean and standard deviation. The percentile curves of WC, AbC, and GC were calculated (P3, P10, P25, P50, P75, P90, P97) in R 3.4.2 software (R Foundation for Statistical Computing, Vienna, Austria) using the gamlss package. (3) Results and conclusions: the study developed age- and gender-specific percentile curves of WC, AbC, and GC for Czech children aged 6–11 years. All parameters increased with age in both boys and girls. Generally, the boys had higher WC and AbC than did girls, but girls had higher GC than did boys. Female and male median WC percentiles (M) increased from the age of 6. Both girls’ and boys’ median percentiles showed a continuous increase. We found similar trends in the median GC and AbC percentile curves. All percentile curves showed similar trends in both sexes, but the 90th and 97th WC percentiles in boys were exceptions: from the age of 10, they exceeded the values of girls, reaching their peak at the age of 11 followed by a decrease in the case of the 97th percentile and a plateau in the case of the 90th percentile. This study serves as a reference to enrich the methods of evaluation of somatic and medical status in Czech children. Up–to–date percentile curves would be a practical addition to the BMI percentiles for the screening and evaluation of overweight and obese conditions and the related risks of abdominal obesity in the pediatric population.

l-Glutamine supplementation enhances glutathione peroxidase and paraoxonase-1 activities in HDL of exercising older individuals

BACKGROUND

Oxidative stress is an important factor in the formation of atherosclerotic plaques. High-density lipoprotein (HDL) harbors paraoxonase-1 (PON-1) and glutathione peroxidase (GPx), key enzymes in the protection against the harmful effects of oxidative stress. Although exercise training can increase both HDL-c content and its antioxidant action, and glutamine (Gln) intake also promotes GPx-based defenses, the association between exercise training and Gln in the regulation of PON-1 activity was not explored. Therefore, the objective of this study was to investigate the effects of Gln supplementation on the redox balance and on the total HDL antioxidant capacity by evaluation of the activity of PON-1 and GPx enzymes in physically exercised elderly individuals compared to non-exercised ones.

METHODS

Fifty-one practitioners of a combined exercise training program (CET, age: 71.9 ± 5.7 years) and 32 non-practitioners (NP, age: 73 ± 6.3 years) participated in the study. CET and NP groups were separated into 2 subgroups according to the supplementation: Gln, 0.3 g/kg/day + 10 g maltodextrin (CET-Gln, n = 26; and NP-Gln, n = 16) or placebo, 10 g maltodextrin (CET-PL, n = 25; and NP-PL, n = 16). Blood samples were drawn at baseline and after 30 days after commencement of the supplementation for biochemical and enzyme activity analyses.

RESULTS

Increased HDL-c, total peroxidase (PRx), and GPx activities were found in both CET-Gln and NP-Gln after the supplementation period, compared to baseline, in opposition to CET-PL and NP-PL groups. PON-1 activity increased only in CET-Gln. In both CET-Gln and NP-Gln groups, there was a reduction of the total peroxides/PRx, iron/PRx, and total peroxides/GPX ratios after supplementation. In CET-Gln, thiobarbituric acid-reactive substances (TBARS)/PRx and TBARS/GPx ratios were also lower after supplementation. CET-Gln and CET-PL subgroups had lower glycemia than NP-Gln and NP-PL, either at baseline or after the supplementation periods. The other parameters were unchanged after supplementation [total cholesterol, LDL-c, triglycerides, non-HDL cholesterol, total peroxides, TBARS, iron serum, Trolox-equivalent antioxidant capacity (TEAC), and uric acid].

CONCLUSIONS

Gln supplementation can increase glutathione peroxidase activity regardless the individuals were physically active or sedentary, but the PON-1 activity only increased in physically active individuals. These results show the potential of Gln supplementation in the maintenance of the vascular redox balance, with potential implications for atherogenesis protection.

Valid and Reliable Barbell Velocity Estimation Using an Inertial Measurement Unit

The accurate assessment of the mean concentric barbell velocity (MCV) and its displacement are crucial aspects of resistance training. Therefore, the validity and reliability indicators of an easy-to-use inertial measurement unit (VmaxPro^®) were examined. Nineteen trained males (23.1 ± 3.2 years, 1.78 ± 0.08 m, 75.8 ± 9.8 kg; Squat 1-Repetition maximum (1RM): 114.8 ± 24.5 kg) performed squats and hip thrusts (3–5 sets, 30 repetitions total, 75% 1RM) on two separate days. The MCV and displacement were simultaneously measured using VmaxPro^® and a linear position transducer (Speed4Lift^®). Good to excellent intraclass correlation coefficients (0.91 < ICC < 0.96) with a small systematic bias (p < 0.001; η_p² < 0.50) for squats (0.01 ± 0.04 m·s⁻¹) and hip thrusts (0.01 ± 0.05 m·s⁻¹) and a low limit of agreement (LoA < 0.12 m·s⁻¹) indicated an acceptable validity. The within- and between-day reliability of the MCV revealed good ICCs (0.55 < ICC < 0.91) and a low LoA (<0.16 m·s⁻¹). Although the displacement revealed a systematic bias during squats (p < 0.001; η_p² < 0.10; 3.4 ± 3.4 cm), no bias was detectable during hip thrusts (p = 0.784; η_p² < 0.001; 0.3 ± 3.3 cm). The displacement showed moderate to good ICCs (0.43 to 0.95) but a high LoA (7.8 to 10.7 cm) for the validity and (within- and between-day) reliability of squats and hip thrusts. The VmaxPro^® is considered to be a valid and reliable tool for the MCV assessment.

Influence of Different Small-Sided Game Formats on Physical and Physiological Demands and Physical Performance in Young Soccer Players

ABSTRACT

Castillo, D, Rodríguez-Fernández, A, Nakamura, FY, Sanchez-Sanchez, J, Ramirez-Campillo, R, Yanci, J, Zubillaga, A, and Raya-González, J. Influence of different small-sided game formats on physical and physiological demands and physical performance in young soccer players. J Strength Cond Res 35(8): 2287-2293, 2021-The aim of this study was to quantify the acute impact of bout duration and individual interaction space on physical and physiological demands and on physical performance. Ten young male soccer players (age: 14.8 ± 0.6 years) from the same team playing in the National U-16 Division participated. Physical (total distance [TD]; distance covered at different speeds; and maximum velocity [Velmax]) and physiological (peak [HRpeak] and mean [HRmean] heart rate) parameters were collected for every bout during each small-sided game (SSG) format. Moreover, the effects of SSGs on horizontal jump (HJ) and 30-m sprint performances were evaluated. The SSG formats were composed of 6 players a side (including goalkeepers) and included 4 repetitions of 6 minutes in a space of 100 m2 (SSG1) or 200 m2 (SSG2) and 6 repetitions of 4 minutes in 100 m2 (SSG3) or 200 m2 (SSG4). The TD, the distance covered at different speeds, and Velmax were greater (p < 0.01, effect size [ES] = 1.25-5.95, large) in SSG2 and SSG4 than SSG1 and SSG3, respectively. Furthermore, the HRmean and HRpeak were lower (p < 0.05, ES = 1.53-2.23, large) during SSG3 than other SSGs. In addition, while a significant (p < 0.05, ES = 0.70-2.04, moderate to large) increase in SPR30 time in SSG1 and SSG3 was observed, HJ performance was not affected (p > 0.05, ES = 0.03-0.54, trivial to moderate) by any SSG format. These findings suggest increasing pitch size to induce greater physical demands and to use SSGs with smaller pitch size, and independently of the bout duration, to induce neuromuscular fatigue.

Average Game Physical Demands and the Most Demanding Scenarios of Basketball Competition in Various Age Groups

The purpose of this study was to compare average physical demands and the most demanding 60-s scenarios of basketball match-play between five different age groups. Sixty-four male basketball players from five different age groups were monitored across eight regular-season home games. Physical demands were examined using a local positioning system and included total distance covered, distance >18 km·h^-1, the number of accelerations (≥2 m·s^-2) and decelerations (≤-2 m·s^-2). All four game performance variables increased significantly (58.4 - 639.2%) when calculated with rolling average techniques in comparison to average physical demand values. Furthermore, the current investigation found that while Under-12 presented the highest result in relative total distance covered (p < .001; effect size = 0.58-2.01), they also showed the lowest values in the most demanding scenarios of match play and small-to-moderate effect sizes compared with their older counterparts. Both average physical demands and the most demanding scenarios presented an increasing tendency with age when distance >18 km·h^-1 in basketball players was assessed. More specifically, the Under-12 age group achieved the lowest values and showed significant differences with the other four teams in both game analysis techniques (p < .001; effect size = 0.53 - 1.32). In conclusion, average game demands are shown to remarkably underestimate the most demanding scenarios of basketball match-play, and there are multiple significant differences between particular age groups.

Limitations of Foot-Worn Sensors for Assessing Running Power

Running power as measured by foot-worn sensors is considered to be associated with the metabolic cost of running. In this study, we show that running economy needs to be taken into account when deriving metabolic cost from accelerometer data. We administered an experiment in which 32 experienced participants (age = 28 ± 7 years, weekly running distance = 51 ± 24 km) ran at a constant speed with modified spatiotemporal gait characteristics (stride length, ground contact time, use of arms). We recorded both their metabolic costs of transportation, as well as running power, as measured by a Stryd sensor. Purposely varying the running style impacts the running economy and leads to significant differences in the metabolic cost of running (p < 0.01). At the same time, the expected rise in running power does not follow this change, and there is a significant difference in the relation between metabolic cost and power (p < 0.001). These results stand in contrast to the previously reported link between metabolic and mechanical running characteristics estimated by foot-worn sensors. This casts doubt on the feasibility of measuring running power in the field, as well as using it as a training signal.

High-Protein Energy-Restriction: Effects on Body Composition, Contractile Properties, Mood, and Sleep in Active Young College Students

Background: It is often advised to ensure a high-protein intake during energy-restricted diets. However, it is unclear whether a high-protein intake is able to maintain muscle mass and contractility in the absence of resistance training. Materials and Methods: After 1 week of body mass maintenance (45 kcal/kg), 28 male college students not performing resistance training were randomized to either the energy-restricted (ER, 30 kcal/kg, n = 14) or the eucaloric control group (CG, 45 kcal/kg, n = 14) for 6 weeks. Both groups had their protein intake matched at 2.8 g/kg fat-free-mass and continued their habitual training throughout the study. Body composition was assessed weekly using multifrequency bioelectrical impedance analysis. Contractile properties of the m. rectus femoris were examined with Tensiomyography and MyotonPRO at weeks 1, 3, and 5 along with sleep (PSQI) and mood (POMS). Results: The ER group revealed greater reductions in body mass (Δ -3.22 kg vs. Δ 1.90 kg, p < 0.001, partial η ² = 0.360), lean body mass (Δ -1.49 kg vs. Δ 0.68 kg, p < 0.001, partial η ² = 0.152), body cell mass (Δ -0.85 kg vs. Δ 0.59 kg, p < 0.001, partial η ² = 0.181), intracellular water (Δ -0.58 l vs. Δ 0.55 l, p < 0.001, partial η ² = 0.445) and body fat percentage (Δ -1.74% vs. Δ 1.22%, p < 0.001, partial η ² = 433) compared to the CG. Contractile properties, sleep onset, sleep duration as well as depression, fatigue and hostility did not change (p > 0.05). The PSQI score (Δ -1.43 vs. Δ -0.64, p = 0.006, partial η ² = 0.176) and vigor (Δ -2.79 vs. Δ -4.71, p = 0.040, partial η ² = 0.116) decreased significantly in the ER group and the CG, respectively. Discussion: The present data show that a high-protein intake alone was not able to prevent lean mass loss associated with a 6-week moderate energy restriction in college students. Notably, it is unknown whether protein intake at 2.8 g/kg fat-free-mass prevented larger decreases in lean body mass. Muscle contractility was not negatively altered by this form of energy restriction. Sleep quality improved in both groups. Whether these advantages are due to the high-protein intake cannot be clarified and warrants further study. Although vigor was negatively affected in both groups, other mood parameters did not change.

Meditation Monologue can Reduce Clinical Injection-Related Anxiety: Randomized Controlled Trial

Background.

Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not.

Methods.

A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate.

Results.

There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999).

Conclusion.

Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration:ClinicalTrials.gov NCT02690194

Does the chronotype distribution vary between different level football leagues? Insights gained from Czech elite football players

Chronotype refer to individuals' time-of-day preferences for activities, which can be classified as "morning types = (M-types)", "evening types = (E-types)", and "neither types (N-types)". The primary aim of this study was to compare the chronotype distribution of Czech First League (1L) and Czech National Football League (2L) male elite football players, which was divided into two secondary aims: (i) statistically identify and compare the number (presence) of particular chronotypes in 1L, and (ii) statistically identify and compare the number (presence) of particular chronotypes in 2L. The present cross-sectional study employed a self-reported standardized questionnaire, the Composite Scale of Morningness, to study the chronotype distribution among the male elite football players. The chronotype distribution of 139 (85 from 1L with mean age ± S.D. = 25.5 ± 3.7 years and 54 from 2L age = 24.4 ± 4.5 years) players was assessed. Overall, 61 (71.8%) of the participants from 1L were mainly N-types, followed by M- and E-types. Similarly, 40 (74.1%) participants from 2L were mainly N-types, followed by M- and E-types. The statistical analysis of the 1L players showed a significantly higher presence of N-types compared to M- and E-types (χ²₍₂₎ = 57.62, p < .05, V = .58). The same results were detected in 2L, where the N-type was identified in the majority of football players (χ²₍₂₎ = 57.62, p < .05, V = .58). The statistical comparison of the number of presented chronotypes did not show a significant difference (F = 3.29, p > .05, V = .16) between players of the 1L and 2L. Thus, N-types are dominant among Czech elite football players, and the chronotype distribution of male elite football players from the Czech First League and the Czech National Football League does not vary.

Training in Rhythmic Gymnastics During the Pandemic

The pandemic caused by the COVID 19 Virus creates an unprecedented situation of global confinement altering the development of competition and sports training at all levels of participation and in all sports, including rhythmic gymnastics (RG). To avoid possible effects of physical, technical and psychological detraining, coaches looked for home training alternatives. The objectives of the study were to know how rhythmic gymnastics training developed during the lockdown period (the conditions, type of training, performance monitoring means, and determinants of gymnasts’ participation) and to provide recommendations for a possible future lockdown. Three hundred and two RG coaches from twenty-six different countries throughout the five continents and four professional levels took part in the study: national team (28), international (26), national (172) and regional (75). The data collection tool was a questionnaire consisting of 39 closed questions structured in three dimensions: identification data of the coaches, training data during confinement and gymnast participation data. The independent variable was the gymnasts’ performance levels and the dependent variables organized in four categories: the technical media used to conduct and monitor the training sessions, the type of training done, the mechanisms for monitoring training performance and the aspects that determined participation. Most coaches kept their gymnasts training during confinement, although 76.5% confirm abandonment of any of their gymnasts. The main means used were real-time video conferencing, although at the lower practice levels the media stand out in deferred time. The contents of the training were mainly body technique, physical preparation and body difficulties. For performance monitoring, challenges, physical, and technical tests were predominant. The determinants for the development of training in the confinement vary depending on the level of the gymnasts, connectivity and electronic resources at the highest level, and the availability of spaces and social distancing at lower levels. For future lockdowns, it is necessary to review the content of the trainings, as well as the performance evaluation and the means necessary for it.

Designing a Multicenter Registry of COVID-19 and Other Respiratory Infections in Fars, Iran

Objective:

A year after the emergence of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as a new crisis in respiratory infections, there remain many uncertainties and unknowns about SARS-CoV-2 and the disease it causes, called coronavirus disease (COVID-19). Although COVID-19 is known as a respiratory disease, some atypical manifestations have been seen, different from those seen in other types of viral respiratory infections. This paper aims to describe designing, launching, and implementing a data collection system for all respiratory diseases, with a focus on SARS-CoV-2 from the onset of this pandemic.

Method:

The current registry is designed in compliance with the standard Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, along with the declaration of Helsinki principles.

Results:

A respiratory disease registry, with an emphasis on COVID-19 and other co-infections, was developed. Data consisted of demographic, clinical, and supporting information about SARS-CoV-2 and other respiratory viral diseases.

Conclusion:

It is hoped that the current data registry will facilitate patient evaluation and improve the outcomes of cases of respiratory infection defined by a particular condition, disease, or exposure. Moreover, the registry can harmonize data about the treatment, outcomes, and well-being of patients who receive care over time, and identify best practices.

Reliability of the Cutting Alignment Scoring Tool (CAST) to Assess Trunk and Limb Alignment During a 45-Degree Side-Step Cut

BACKGROUND

Three-dimensional (3D) motion analysis is considered the gold standard for evaluating human movement. However, its clinical utility is limited due to cost, operating expertise, and lengthy data processing time. Numerous qualitative scoring systems have been introduced to assess trunk and lower extremity biomechanics during functional tasks. However, the reliability of qualitative scoring systems to evaluate cutting movements is understudied. Purpose/Hypotheses: To assess the inter-rater and intra-rater reliability of the Cutting Alignment Scoring Tool (CAST) among sports medicine providers and to evaluate rater agreement of each component of the CAST. The hypotheses were: 1) there would be good-to-excellent inter-rater and intra-rater reliability among sports medicine providers, 2) there would be good to almost perfect agreement for cut width and trunk lean variables and moderate to good agreement for valgus variables of the CAST.

STUDY DESIGN

Repeated Measures.

METHODS

Ten videos of a 45-degree side-step cut performed by adolescent athletes were independently rated on two occasions by six raters (2 medical doctors, 2 physical therapists, and 2 athletic trainers). The variables assessed include trunk lean to the opposite direction of the cut, increased cut width, knee valgus at initial load acceptance (static), and knee valgus throughout the task (dynamic). Variables were scored as either present, which were given a score of "1", or not present, which were given a score of "0". Video sequence was randomized in each rating session, and a two-week wash out period was given.

RESULTS

The cumulative inter-rater and intra-rater reliabilities were good (ICC: 0.808 and ICC: 0.753). Almost perfect kappa coefficients were recorded for cut width (k=0.949). Moderate kappa coefficients were found for trunk lean (k= 0.632) and fair kappa coefficients were noted for dynamic and static valgus (k=0.462 and k= 0.533 respectively).

CONCLUSION

These findings suggest that the CAST is a reliable tool to evaluate trunk and LE alignment during a cutting task by sports medicine providers.

LEVEL OF EVIDENCE

Level 2 Diagnosis.