Dryland Performance Tests Are Not Good Predictors of World Aquatics Points in Elite Male and Female Swimmers

Background: Swim performance can be reliant on strength and power. Standardisation of swim performance in different events, distances, and sexes can be completed using World Aquatics points, allowing for ranking of swimmers. The aim of this retrospective cross-sectional study was to assess whether relationships between World Aquatics points and dryland markers of performance existed in male and female elite swimmers separately and combined. Methods: Dryland tests included Optojump® photoelectric cell countermovement jump, countermovement jump reach with a Vertec® system, standing broad jump using a tape measure, repetition maximum testing in the barbell back squat, barbell deadlift, and barbell bench press. Swim performance data and dryland test data on elite male (n = 38) and female (n = 20) Scottish swimmers from 2009-2017 were collected. Swim performance data were converted to World Aquatics federation points, and Bayesian linear regression analyses examined relationships between World Aquatics points and dryland performance tests: countermovement jump height (cm) using an Optojump® photoelectric cells system, countermovement jump height (cm) using a Vertec® device, standing broad jump distance (cm), relative strength (load lifted (kg) per kg of body mass) in the barbell bench press (kg/kg), barbell back squat (kg/kg), barbell deadlift (kg/kg). Results: The Bayesian estimates of change of World Aquatics points for a unit change in jump-based measures were: Optojump®-men = 0.6, women = 0.6, combined = 0.4; Vertec®-men = 4.3, women = -1.6, combined = 2.4; standing broad jump-men = 0, women = 0, combined = 0.4. Strength-based measures were: barbell back squat-men = 2.3, women = 22, combined = -2.5; barbell deadlift-men = -5; barbell bench press-men = 41.8. Conclusions: Dryland performance tests are not good predictors of World Aquatics points and should rather be used for assessing training quality and monitoring injury risks.

Evaluation of multi-directional speed qualities throughout adolescence in youth soccer: The non-linear nature of transfer

Training and assessment of agility is often prioritised by soccer coaches and practitioners aiming to develop multi-directional speed. Although the importance of agility is advocated throughout childhood and adolescence, limited data evidence agility performance at different stages of adolescence. The purpose of this study was to examine differences in multi-directional speed performance in youth soccer players spanning an entire soccer academy. A total of 86 male junior-elite soccer players volunteered to participate. Anthropometric data were collected, alongside performance data from a battery of physical tests including sprinting, jumping, change of direction, reaction time, and agility. Bayesian models using log-likelihoods from posterior simulations of parameter values displayed linear or curvilinear relationships between both chronological and biological age and performance in all tests other than agility and reaction time. For agility and reaction time tests, performance improved until ~14 years of age or the estimated age of peak height velocity whereby arrested development in performance was observed. Our results demonstrate that while most performance skills improve as chronological or biological age increases, measures of agility and reaction time may not. These findings support the notion that agility performance is complex and multifaceted, eliciting unique, challenging physical demands and non-linear development.

The Use of Biofluid Markers to Evaluate the Consequences of Sport-Related Subconcussive Head Impact Exposure: A Scoping Review

BACKGROUND

Amidst growing concern about the safety of sport-related repetitive subconcussive head impacts (RSHI), biofluid markers may provide sensitive, informative, and practical assessment of the effects of RSHI exposure.

OBJECTIVE

This scoping review aimed to systematically examine the extent, nature, and quality of available evidence from studies investigating the effects of RSHI on biofluid markers, to identify gaps and to formulate guidelines to inform future research.

METHODS

PRISMA extension for Scoping Reviews guidelines were adhered to. The protocol was pre-registered through publication. MEDLINE, Scopus, SPORTDiscus, CINAHL, PsycINFO, Cochrane Library, OpenGrey, and two clinical trial registries were searched (until March 30, 2022) using descriptors for subconcussive head impacts, biomarkers, and contact sports. Included studies were assessed for risk of bias and quality.

RESULTS

Seventy-nine research publications were included in the review. Forty-nine studies assessed the acute effects, 23 semi-acute and 26 long-term effects of RSHI exposure. The most studied sports were American football, boxing, and soccer, and the most investigated markers were (in descending order): S100 calcium-binding protein beta (S100B), tau, neurofilament light (NfL), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), phosphorylated tau (p-tau), ubiquitin C-terminal hydrolase L1 (UCH-L1), and hormones. High or moderate bias was found in most studies, and marker-specific conclusions were subject to heterogeneous and limited evidence. Although the evidence is weak, some biofluid markers-such as NfL-appeared to show promise. More markedly, S100B was found to be problematic when evaluating the effects of RSHI in sport.

CONCLUSION

Considering the limitations of the evidence base revealed by this first review dedicated to systematically scoping the evidence of biofluid marker levels following RSHI exposure, the field is evidently still in its infancy. As a result, any recommendation and application is premature. Although some markers show promise for the assessment of brain health following RSHI exposure, future large standardized and better-controlled studies are needed to determine biofluid markers' utility.

Contrasting Characteristics and Outcomes of Sports-Related and Non-Sports-Related Traumatic Brain Injury

Importance

Exposure to traumatic brain injury (TBI) has raised widespread concern over participation in sports, particularly over possible long-term consequences. However, little is known about the outcomes of individuals presenting to hospitals with sports-related TBI.

Objective

To compare the characteristics and outcomes of individuals presenting to hospitals with sports-related and non-sports-related TBI.

Design, Setting, and Participants

The CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) observational cohort study was conducted at hospitals in 18 countries. The study enrolled 4509 patients who had TBI and had an indication for computed tomography (CT), of whom 4360 were 16 years or older. Outcomes were assessed at 3 and 6 months, and groups were compared using regression analyses adjusting for clinical and demographic differences. Data were collected between December 9, 2014, and December 17, 2017, and analyzed from August 2022 to March 2023.

Exposure

Sports-related and non-sports-related TBI with subgroups selected by severity of injury.

Main Outcomes and Measures

The main outcome was the Glasgow Outcome Scale-Extended (GOSE) at 6 months, with secondary outcomes covering postconcussion symptoms, health-related quality of life, and mental health.

Results

A total of 4360 patients were studied, including 256 (6%) with sports-related TBI (mean [SD] age, 38.9 [18.1] years; 161 [63%] male) and 4104 with non-sports-related TBI (mean [SD] age, 51.0 [20.2] years; 2773 [68%] male). Compared with patients with non-sports-related TBI, patients with sports-related TBI were younger, more likely to have tertiary education, more likely to be previously healthy, and less likely to have a major extracranial injury. After adjustment, the groups did not differ in incomplete recovery (GOSE scores <8) at 6 months (odds ratio [OR], 1.27; 95% CI, 0.90-1.78; P = .22 for all patients; OR, 1.20; 95% CI, 0.83-1.73; P = .34 for those with mild TBI; and OR, 1.19; 95% CI, 0.74-1.92; P = .65 for those with mild TBI and negative CT findings). At 6 months, there was incomplete recovery in 103 of 223 patients (46%) with outcomes in the sports-related TBI group, 65 of 168 (39%) in those with mild sports-related TBI, and 30 of 98 (31%) in those with mild sports-related TBI and negative CT findings. In contrast, at 6 months, the sports-related TBI group had lower prevalence of anxiety, depression, posttraumatic stress disorder, and postconcussion symptoms than the non-sports-related group.

Conclusions and Relevance

In this cohort study of 4360 patients with TBI, functional limitations 6 months after injury were common after sports-related TBI, even mild sports-related TBI. Persisting impairment was evident in the sports-related TBI group despite better recovery compared with non-sports-related TBI on measures of mental health and postconcussion symptoms. These findings caution against taking an overoptimistic view of outcomes after sports-related TBI, even if the initial injury appears mild.

Enhanced skeletal muscle contractile function and corticospinal excitability precede strength and architectural adaptations during lower-limb resistance training

PURPOSE

Evolving investigative techniques are providing greater understanding about the early neuromuscular responses to resistance training among novice exercisers. The aim of this study was to investigate the time-course of changes in muscle contractile mechanics, architecture, neuromuscular, and strength adaptation during the first 6-weeks of lower-limb resistance training.

METHODS

Forty participants: 22 intervention (10 males/12 females; 173.48 ± 5.20 cm; 74.01 ± 13.13 kg) completed 6-week resistance training, and 18 control (10 males/8 females; 175.52 ± 7.64 cm; 70.92 ± 12.73 kg) performed no resistance training and maintained their habitual activity. Radial muscle displacement (Dm) assessed via tensiomyography, knee extension maximal voluntary contraction (MVC), voluntary activation (VA), corticospinal excitability and inhibition via transcranial magnetic stimulation, motor unit (MU) firing rate, and muscle thickness and pennation angle via ultrasonography were assessed before and after 2, 4, and 6-weeks of dynamic lower-limb resistance training or control.

RESULTS

After 2-weeks training, Dm reduced by 19-25% in the intervention group; this was before any changes in neural or morphological measures. After 4-weeks training, MVC increased by 15% along with corticospinal excitability by 16%; however, there was no change in VA, corticospinal inhibition, or MU firing rate. After 6-weeks training there was further MVC increase by 6% along with muscle thickness by 13-16% and pennation angle by 13-14%.

CONCLUSION

Enhanced contractile properties and corticospinal excitability occurred before any muscle architecture, neural, and strength adaptation. Later increases in muscular strength can be accounted for by architectural adaptation.

Protocol for a randomised controlled trial to investigate the effects of vitamin K2 on recovery from muscle-damaging resistance exercise in young and older adults-the TAKEOVER study

BACKGROUND

Regular participation in resistance exercise is known to have broad-ranging health benefits and for this reason is prominent in the current physical activity guidelines. Recovery after such exercise is important for several populations across the age range and nutritional strategies to enhance recovery and modulate post-exercise physiological processes are widely studied, yet effective strategies remain elusive. Vitamin K2 supplementation has emerged as a potential candidate, and the aim of the current study, therefore, is to test the hypothesis that vitamin K2 supplementation can accelerate recovery, via modulation of the underlying physiological processes, following a bout of resistance exercise in young and older adults.

METHODS

The current study is a two-arm randomised controlled trial which will be conducted in 80 (40 young (≤40 years) and 40 older (≥65 years)) adults to compare post-exercise recovery in those supplemented with vitamin K2 or placebo for a 12-week period. The primary outcome is muscle strength with secondary outcomes including pain-free range of motion, functional abilities, surface electromyography (sEMG) and markers of inflammation and oxidative stress.

DISCUSSION

Ethical approval has been granted by the College of Medical Veterinary and Life Sciences Ethical Committee at the University of Glasgow (Project No 200190189) and recruitment is ongoing. Study findings will be disseminated through a presentation at scientific conferences and in scientific journals.

TRIAL REGISTRATION

ClinicialTrials.gov NCT04676958. Prospectively registered on 21 December 2020.

The Reliability of Transcranial Magnetic Stimulation-Derived Corticomotor Inhibition as a Brain Health Evaluation Tool in Soccer Players

Background

The suitability of corticomotor inhibition and corticospinal excitability to measure brain health outcomes and recovery of sport-related head impact (concussion and subconcussion) depends on good inter-day reliability, which is evaluated in this study. Transcranial magnetic stimulation (TMS) reliability in soccer players is assessed by comparing soccer players, for whom reliability on this measure may be reduced due to exposure to head impacts, to generally active individuals not engaged in contact sport.

Methods

TMS-derived corticomotor inhibition and corticospinal excitability were recorded from the rectus femoris muscle during two testing sessions, spaced 1–2 weeks apart in 19 soccer players (SOC—age 22 ± 3 years) and 20 generally active (CON—age 24 ± 4 years) healthy volunteers. Inter-day reliability between the two time points was quantified by using intra-class correlation coefficients (ICC). Intra-group reliability and group differences on actual measurement values were also explored.

Results

Good inter-day reliability was evident for corticomotor inhibition (ICC_SOC = 0.61; ICC_CON = 0.70) and corticospinal excitability (ICC_SOC = 0.59; ICC_CON = 0.70) in both generally active individuals and soccer players routinely exposed to sport-related head impacts. Corticomotor inhibition showed lower coefficients of variation than excitability for both groups (Inhib_SOC = 15.2%; Inhib_CON = 9.7%; Excitab_SOC = 41.6%; Excitab_CON = 39.5%). No group differences between soccer players and generally active individuals were found on the corticomotor inhibition value (p > 0.05), but levels of corticospinal excitability were significantly lower in soccer players (45.1 ± 20.8 vs 85.4 ± 6.2%Mmax, p < 0.0001). Corticomotor inhibition also showed excellent inter-rater reliability (ICC = 0.87).

Conclusions

Corticomotor inhibition and corticospinal excitability are stable and maintain good degrees of reliability when assessed over different days in soccer players, despite their routine exposure to head impacts. However, based on intra-group reliability and group differences of the levels of excitability, we conclude that corticomotor inhibition is best suited for the evaluation of neuromuscular alterations associated with head impacts in contact sports.

Longer Neurophysiological vs. Clinical Recovery Following Sport Concussion

Objectives: The objective of this study was to assess if injury-related alterations in the Sport Concussion Assessment Tool-5 (SCAT5) are matched by changes in transcranial magnetic stimulation-derived intracortical inhibition. We hypothesised that neurophysiological measures would take longer to return to normal than recovery assessed by the SCAT5 following sport related concussion (SRC).

Methods: Thirteen male contact sport athletes (20.5 ± 4.5 years), who reported a concussion were recruited from local Rugby and American football clubs. Participants were tested at 4 timepoints throughout the concussion recovery period: within 24 h of concussion (day 0), and at 7, 9, and 11 days after concussion. All participants completed the SCAT5 and underwent TMS to assess cortical silent period duration (CSp), a measure of intracortical inhibition.

Results: After concussion CSp significantly declined from day 0 (122 ± 28 ms) to day 11 (106 ± 15 ms) [F_{(3, 33)} = 7.80, p < 0.001]. SCAT5 measures of symptom number and severity were significantly decreased [symptom number: χ(3)2 = 30.44, p < 0.01; symptom severity: χ(3)2 = 25.75, p < 0.001] between the day 0 timepoint and each of the other timepoints. SCAT5 balance errors (mBESS) decreased significantly [F_{(3, 33)} = 19.55, p < 0.001] between the day 0 timepoint and each of the other timepoints. CSp and SCAT5 recovery patterns were different. SCAT5 domains recovered faster showing no further significant changes after day 7, whilst CSp was still decreasing between days 7 and 9. Due to the small sample size we also used a Bayesian linear model to investigate the recovery of CSp and mBESS. The posterior distribution of our Bayesian model provided evidence that CSp decreased at day 7 and it continued to decrease at day 9, unlike mBESS which decreased at day 7 and then reached a plateau.

Conclusion: There are clinically important discrepancies between clinical and neurophysiological measures of concussion recovery. This finding has important implications for return to play (RTP) protocols and the prevention of complications after sport concussion.

Exercise Referral Instructors' Perspectives on Supporting and Motivating Participants to Uptake, Attend and Adhere to Exercise Prescription: A Qualitative Study

Exercise referral schemes are designed to support people with non-communicable diseases to increase their levels of exercise to improve health. However, uptake and attendance are low. This exploratory qualitative study aims to understand uptake and attendance from the perspectives of exercise referral instructors using semi-structured interviews. Six exercise referral instructors from one exercise referral scheme across four exercise referral sites were interviewed. Four themes emerged: (i) the role that instructors perceive they have and approaches instructors take to motivate participants to take-up, attend exercise referral and adhere to their exercise prescription; (ii) instructors' use of different techniques, which could help elicit behaviour change; (iii) instructors' perceptions of participants' views of exercise referral schemes; and (iv) barriers towards providing an exercise referral scheme. Exercise referral instructors play an important, multifaceted role in the uptake, attendance and adherence to exercise referral. On-going education and peer support for instructors may be useful. Instructors' perspectives help us to further understand how health and leisure services can design successful exercise referral schemes.

Progression from youth to professional soccer: A longitudinal study of successful and unsuccessful academy graduates

To optimize use of available resources, professional academies develop strategies to assess, monitor, and evaluate players as they progress through adolescence toward adulthood. However, few published reports exist using longitudinal study designs to examine performance throughout adolescence and the transition from youth to professional soccer. We examined differences in the age of player recruitment alongside longitudinal performance differences on field-based fitness tests of successful vs. unsuccessful graduates across the entire age spectrum recruited by a professional soccer academy. Altogether, 537 youth soccer players volunteered to participate. We recorded the age of recruitment, biannual fitness test performance, and subsequent success in attaining a senior professional contract at the club across a period of 12 years. Only 53 (10%) of players were successful in obtaining a professional contract, with 68% of players who became professional being recruited at 12 years of age or older. Individuals recruited at an earlier age did not display a higher probability of success in attaining a professional contract. Bayesian regression models reported a consistent interaction between age and group for data on all performance measures. Moreover, "successful" academy graduates only physically outperformed their "unsuccessful" counterparts from age ~13-14 years onward, with either no differences in performance, or performance on physical fitness tests favoring "unsuccessful" players prior to this age. Findings suggest that high achievers during childhood and early adolescence may not develop into successful senior professionals, raising concerns about the predictive utility of talent identification models.

Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities

This study aimed to investigate differences in physical activity (PA) patterns and the associations between objectively measured 24-h movement behaviors and musculoskeletal measures (muscle strength, muscle mass, physical performance, and bone mineral density) in a high-income and a low-income community. This cross-sectional study recruited independent living older adults aged 60-85 years from high-income Scottish (n = 150) and low-income South African (n = 138) settings. Participants completed demographic and health questionnaires, and testing included body composition and bone mineral density (dual energy X-ray absorptiometry), physical performance (grip strength, gait speed), and PA (accelerometry). Participants accumulated similar amounts of weekly total PA, however, the Scottish cohort engaged in more moderate-to-vigorous intensity PA (MVPA) and sedentary behavior (SB), while the South African cohort spent more time sleeping and in light intensity PA (LPA). From compositional data analysis, more time spent in MVPA relative to the other movement behaviors was positively associated with higher muscle mass (p < 0.001) and strength (p = 0.001) in the Scottish cohort. Conversely, more time spent in MVPA was associated with faster gait speed (p < 0.001) and greater hip bone mineral density (p = 0.011) in the South African cohort. Our findings confirm the beneficial role of MVPA in both high- and low-income cohorts, however, the relationship MVPA had with components of musculoskeletal health in older adults differed between settings.

Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Importantly, low and middle-income countries (LMICs) across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities. It is anticipated that alongside the increased prevalence of obesity, these countries will further experience an increase in age-related musculoskeletal diseases such as sarcopenia. The developmental origins of health and disease (DOHaD) approach will allow clinicians and researchers to consider developmental trajectories, and the influence of the environment, for targeting high-risk individuals and communities for treatment and/or prevention-based interventions that are implemented throughout all stages of the life course. Once a valid and reliable diagnostic criterion is developed, we can firstly assess the prevalence and burden of sarcopenic obesity in LMICs in Africa, and secondly, develop appropriate and sustainable interventions that target improved dietary and physical activity behaviors throughout the life course.

Understanding factors associated with sarcopenic obesity in older African women from a low-income setting: a cross-sectional analysis

BACKGROUND

High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting.

METHODS

This cross-sectional study recruited black SA women between the ages of 60-85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m² were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored.

RESULTS

The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8-14.7%, including 0.8-9.8% without obesity and 0-4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001).

CONCLUSIONS

The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.

Food Security, Dietary Intake, and Foodways of Urban Low-Income Older South African Women: An Exploratory Study

This cross-sectional study explored the differences in sociodemographics, dietary intake, and household foodways (cultural, socioeconomic practices that affect food purchase, consumption, and preferences) of food secure and food insecure older women living in a low-income urban setting in South Africa. Women (n = 122) aged 60-85 years old were recruited, a sociodemographic questionnaire was completed, and food security categories were determined. The categories were dichotomised into food secure (food secure and mild food insecurity) and food insecure (moderate and severe). A one-week quantified food frequency questionnaire was administered. Height and weight were measured to calculate body mass index (BMI, kg/m2). Most participants (>90%) were overweight/obese, unmarried/widowed, and breadwinners with a low monthly household income. Food insecure participants (36.9%) more frequently borrowed money for food (57.8% vs. 39.0%, p = 0.04), ate less so that their children could have more to eat (64.4%. vs. 27.3%, p = 0.001), and had higher housing density (1.2 vs. 1.0, p = 0.03), compared to their food-secure counterparts. Overall, <30% of participants met the WHO (Geneva, Switzerland) recommended daily servings of healthy foods (fruits, vegetables, and dairy products), but >60% perceived that they consumed an adequate amount of healthy foods. The overall low-quality diet of our cohort was associated with poor nutritional perceptions and choices, coupled with financial constraints.

Tensiomyography Derived Parameters Reflect Skeletal Muscle Architectural Adaptations Following 6-Weeks of Lower Body Resistance Training

Measurement of muscle specific contractile properties in response to resistance training (RT) can provide practitioners valuable information regarding physiological status of individuals. Field based measurements of such contractile properties within specific muscle groups, could be beneficial when monitoring efficacy of training or rehabilitation interventions. Tensiomyography (TMG) quantifies contractile properties of individual muscles via an electrically stimulated twitch contraction and may serve as a viable option in the aforementioned applications. Thus, aims of this study were; (i) to investigate the potential use of TMG to quantify training adaptations and differences, in response to exercise specific lower limb RT; and (ii) investigate any associations between TMG parameters and accompanying muscle architectural measures. Non-resistance trained male participants (n = 33) were randomly assigned to 1 of 3 single-exercise intervention groups (n = 11 per group); back squat (BS), deadlift (DL), or hip thrust (HT). Participants completed a 6-week linearized training program (2× per week), where the assigned exercise was the sole method of lower body training. Pre- and post-intervention testing of maximal dynamic strength was assessed by one repetition maximum (1RM) of BS, DL, and HT. Radial muscle belly displacement (Dm) and contraction time (Tc) were obtained via TMG from the rectus femoris (RF) and vastus lateralis (VL) pre- and post-intervention, alongside muscle architectural measures (pennation angle and muscle thickness). All three groups displayed significant increases all 1RM strength tests (p < 0.001; pη2 = 0.677-0.753). Strength increases were accompanied by significant overall increases in RF muscle thickness (p < 0.001, pη2 = 0.969), and pennation angle (p = 0.007, pη2 = 0.220). Additionally, an overall reduction in RF Dm (p < 0.001, pη2 = 0.427) was observed. Significant negative relationships were observed between RF Dm and pennation angle (p = 0.003, r = -0.36), and with RF Dm and muscle thickness (p < 0.001, r = -0.50). These findings indicate that TMG is able to detect improved contractile properties, alongside improvements in muscle function within an untrained population. Furthermore, the observed associations between Dm and muscle architecture suggest that TMG contractile property assessments could be used to obtain information on muscle geometry.

Exploring the Efficacy of a Safe Cryotherapy Alternative: Physiological Temperature Changes From Cold-Water Immersion Versus Prolonged Cooling of Phase-Change Material

PURPOSE

To evaluate the effectiveness between cold-water immersion (CWI) and phase-change-material (PCM) cooling on intramuscular, core, and skin-temperature and cardiovascular responses.

METHODS

In a randomized, crossover design, 11 men completed 15 min of 15°C CWI to the umbilicus and 2-h recovery or 3 h of 15°C PCM covering the quadriceps and 1 h of recovery, separated by 24 h. Vastus lateralis intramuscular temperature at 1 and 3 cm, core and skin temperature, heart-rate variability, and thermal comfort were recorded at baseline and 15-min intervals throughout treatment and recovery.

RESULTS

Intramuscular temperature decreased (P < .001) during and after both treatments. A faster initial effect was observed from 15 min of CWI (Δ: 4.3°C [1.7°C] 1 cm; 5.5°C [2.1°C] 3 cm; P = .01). However, over time (2 h 15 min), greater effects were observed from prolonged PCM treatment (Δ: 4.2°C [1.9°C] 1 cm; 2.2°C [2.2°C] 3 cm; treatment × time, P = .0001). During the first hour of recovery from both treatments, intramuscular temperature was higher from CWI at 1 cm (P = .013) but not 3 cm. Core temperature deceased 0.25° (0.32°) from CWI (P = .001) and 0.28°C (0.27°C) from PCM (P = .0001), whereas heart-rate variability increased during both treatments (P = .001), with no differences between treatments.

CONCLUSIONS

The magnitude of temperature reduction from CWI was comparable with PCM, but intramuscular temperature was decreased for longer during PCM. PCM cooling packs offer an alternative for delivering prolonged cooling whenever application of CWI is impractical while also exerting a central effect on core temperature and heart rate.

Understanding the Consequences of Repetitive Subconcussive Head Impacts in Sport: Brain Changes and Dampened Motor Control Are Seen After Boxing Practice

Objectives

The potential effects of exposure to repetitive subconcussive head impacts through routine participation in sport are not understood. To investigate the effects of repetitive subconcussive head impacts we studied boxers following customary training (sparring) using transcranial magnetic stimulation (TMS), decomposition electromyographic (EMG) and tests of memory.

Methods

Twenty amateur boxers performed three 3-min sparring bouts. Parameters of brain function and motor control were assessed prior to sparring and again immediately, 1 h and 24 h post-sparring. Twenty control participants were assessed following mock-sparring.

Results

One hour after sparring boxers showed increased corticomotor inhibition, altered motor unit recruitment strategies, and decreased memory performance relative to controls, with values returning to baseline by the 24 h follow up.

Conclusion

Repetitive subconcussive head impacts associated with sparring resulted in acute and transient brain changes similar to those previously reported in soccer heading, providing convergent evidence that sport-related head impacts produce a GABAergic response. These acute changes in brain health are reminiscent of effects seen following brain injury, and suggest a potential mechanism underlying the damaging long-term effects of routine repetitive head impacts in sport.

Assessment of Skeletal Muscle Contractile Properties by Radial Displacement: The Case for Tensiomyography

Skeletal muscle operates as a near-constant volume system; as such muscle shortening during contraction is transversely linked to radial deformation. Therefore, to assess contractile properties of skeletal muscle, radial displacement can be evoked and measured. Mechanomyography measures muscle radial displacement and during the last 20 years, tensiomyography has become the most commonly used and widely reported technique among the various methodologies of mechanomyography. Tensiomyography has been demonstrated to reliably measure peak radial displacement during evoked muscle twitch, as well as muscle twitch speed. A number of parameters can be extracted from the tensiomyography displacement/time curve and the most commonly used and reliable appear to be peak radial displacement and contraction time. The latter has been described as a valid non-invasive means of characterising skeletal muscle, based on fibre-type composition. Over recent years, applications of tensiomyography measurement within sport and exercise have appeared, with applications relating to injury, recovery and performance. Within the present review, we evaluate the perceived strengths and weaknesses of tensiomyography with regard to its efficacy within applied sports medicine settings. We also highlight future tensiomyography areas that require further investigation. Therefore, the purpose of this review is to critically examine the existing evidence surrounding tensiomyography as a tool within the field of sports medicine.

Reliability and validity of field-based fitness tests in youth soccer players

This study aimed to establish between-day reliability and validity of commonly used field-based fitness tests in youth soccer players of varied age and playing standards, and to discriminate between players without ("unidentified") or with ("identified") a direct route to professional football through their existing club pathway. Three-hundred-and-seventy-three Scottish youth soccer players (U11-U17) from three different playing standards (amateur, development, performance) completed a battery of commonly used generic field-based fitness tests (grip dynamometry, standing broad jump, countermovement vertical jump, 505 (505COD) and T-Drill (T-Test) change of direction and 10/20 m sprint tests) on two separate occasions within 7-14 days. The majority of field-based fitness tests selected within this study proved to be reliable measures of physical performance (ICC = 0.83-0.97; p < .01). However, COD tests showed weaker reliability in younger participants (ICC = 0.57-0.79; p < .01). The field-based fitness testing battery significantly discriminated between the unidentified and identified players; χ² (7) = 101.646, p < .001, with 70.2% of players being correctly classified. We have shown field-based fitness tests to be reliable measures of physical performance in youth soccer players. However, results from the 505COD and T-Test change of direction tests may be more variable in younger players, potentially due to complex demands of these tests and the limited training age established by these players. While the testing battery selected in this study was able to discriminate between unidentified and identified players, findings were inconsistent when attempting to differentiate between individual playing standards within the "identified" player group (development vs. performance).

Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners

BACKGROUND

Core stability training has grown in popularity over 25 years, initially for back pain prevention or therapy. Subsequently, it developed as a mode of exercise training for health, fitness and sport. The scientific basis for traditional core stability exercise has recently been questioned and challenged, especially in relation to dynamic athletic performance. Reviews have called for clarity on what constitutes anatomy and function of the core, especially in healthy and uninjured people. Clinical research suggests that traditional core stability training is inappropriate for development of fitness for heath and sports performance. However, commonly used methods of measuring core stability in research do not reflect functional nature of core stability in uninjured, healthy and athletic populations. Recent reviews have proposed a more dynamic, whole body approach to training core stabilization, and research has begun to measure and report efficacy of these modes training. The purpose of this study was to assess extent to which these developments have informed people currently working and participating in sport.

METHODS

An online survey questionnaire was developed around common themes on core stability training as defined in the current scientific literature and circulated to a sample population of people working and participating in sport. Survey results were assessed against key elements of the current scientific debate.

RESULTS

Perceptions on anatomy and function of the core were gathered from a representative cohort of athletes, coaches, sports science and sports medicine practitioners (n = 241), along with their views on effectiveness of various current and traditional exercise training modes. Most popular method of testing and measuring core function was subjective assessment through observation (43%), while a quarter (22%) believed there was no effective method of measurement. Perceptions of people in sport reflect the scientific debate, and practitioners have adopted a more functional approach to core stability training. There was strong support for loaded, compound exercises performed upright, compared to moderate support for traditional core stability exercises. Half of the participants (50%) in the survey, however, still support a traditional isolation core stability training.

CONCLUSION

Perceptions in applied practice on core stability training for dynamic athletic performance are aligned to a large extent to the scientific literature.

The Effect of Foam Rolling for Three Consecutive Days on Muscular Efficiency and Range of Motion

BACKGROUND

Foam rolling (FR) has been shown to alleviate some symptoms of exercise-induced muscle damage and has been suggested to increase range of motion (ROM) without negatively impacting strength. However, it is unclear what neuromuscular effects, if any, mediate these changes.

METHODS

In a randomized, crossover design, 16 healthy active males completed 2 min of rest or FR of the knee extensors on three consecutive days. Mechanical properties of vastus lateralis (VL) and rectus femoris (RF) were assessed via Tensiomyography. Knee extension maximal voluntary contraction (MVC) and knee flexion ROM were also assessed, and surface electromyography amplitude (RMS) was recorded during a submaximal isometric contraction (50% of MVC). Measures were performed before and after (0, 15, and 30 min) FR or rest.

RESULTS

MVC was reduced on subsequent days in the rest condition compared to FR (p = 0.002, _pη² = 0.04); ROM was not different across time or condition (p = 0.193, _pη² = 0.01). Stiffness characteristics of the VL were different on the third day of FR (p = 0.002, _pη² = 0.03). RMS was statistically reduced 0, 15, and 30 min after FR compared to rest (p = 0.006, _pη² = 0.03; p = 0.003, _pη² = 0.04; p = 0.002, _pη² = 0.04).

CONCLUSIONS

Following FR, MVC was elevated compared to rest and RMS was transiently reduced during a submaximal task. Excitation efficiency of the involved muscles may have been enhanced by FR, which protected against the decline in MVC which was observed with rest.

INFLUENCE OF TOPICALLY APPLIED MENTHOL COOLING GEL ON SOFT TISSUE THERMODYNAMICS AND ARTERIAL AND CUTANEOUS BLOOD FLOW AT REST

BACKGROUND

Topical application of menthol is a popular form of cold therapy and chemically triggers cold receptors and increases cutaneous blood flow. However, although cutaneous blood flow increases, it remains unknown where this increase arises from. Intramuscular temperature assessment may indirectly indicate a change in muscular blood flow.

PURPOSE

To establish intramuscular temperature, blood flow responses and subjective temperature sensation following application of menthol-based cooling gel to the anterior thigh.

STUDY DESIGN

Controlled, randomized cross over interventional study.

METHODS

Twenty (age: 21.4 + 1.7) healthy males were treated on three separate days in random order with ice, a menthol-based gel or placebo gel (participant single blinded) on one anterior thigh. All measurements were taken at baseline and for 80 mins following treatment: 1) Skin, core, and intramuscular temperatures (1 & 3 cm deep); 2) femoral arterial blood flow (duplex ultrasound); 3) cutaneous blood flow (laser Doppler) and 4) subjective cold sensation.

RESULTS

Ice and both gels decreased (p<0.0001, CI (Ice): -5.2 to -6.2 and CI (gels) -1.4 to -2.5) intramuscular temperature by 5.7 and 1.9 °C respectively, but by 80 mins were similar to each other (1.5-2 °C less than pre-treatment). Skin temperature mirrored muscle temperature with 8.8 and 4.2 °C respective decline for ice and gels. Menthol gel increased (p<0.0001) cutaneous blood flow by 0.3 ml/min compared to unaltered flow associated with the placebo gel and a decline of 0.3 ml/min for the ice. Menthol gel cold sensation was subjectively reported to be cooler (p<0.0001) than the other two treatments. Core temperature and arterial flow were unaffected.

CONCLUSION

This is the first study to demonstrate the intramuscular cooling effect of menthol-based gel. However, the likely cause was from evaporative cooling despite menthol-derived increases in cutaneous blood flow and cooling sensation.

LEVEL OF EVIDENCE

Treatment, level 2.

High-threshold motor unit firing reflects force recovery following a bout of damaging eccentric exercise

Exercise-induced muscle damage (EIMD) is associated with impaired muscle function and reduced neuromuscular recruitment. However, motor unit firing behaviour throughout the recovery period is unclear. EIMD impairment of maximal voluntary force (MVC) will, in part, be caused by reduced high-threshold motor unit firing, which will subsequently increase to recover MVC. Fourteen healthy active males completed a bout of eccentric exercise on the knee extensors, with measurements of MVC, rate of torque development and surface electromyography performed pre-exercise and 2, 3, 7 and 14 days post-exercise, on both damaged and control limb. EIMD was associated with decreased MVC (235.2 ± 49.3 Nm vs. 161.3 ± 52.5 Nm; p <0.001) and rate of torque development (495.7 ± 136.9 Nm.s-1 vs. 163.4 ± 163.7 Nm.s-1; p <0.001) 48h post-exercise. Mean motor unit firing rate was reduced (16.4 ± 2.2 Hz vs. 12.6 ± 1.7 Hz; p <0.01) in high-threshold motor units only, 48h post-exercise, and common drive was elevated (0.36 ± 0.027 vs. 0.56 ± 0.032; p< 0.001) 48h post-exercise. The firing rate of high-threshold motor units was reduced in parallel with impaired muscle function, whilst early recruited motor units remained unaltered. Common drive of motor units increased in offset to the firing rate impairment. These alterations correlated with the recovery of force decrement, but not of pain elevation. This study provides fresh insight into the central mechanisms associated with EIMD recovery, relative to muscle function. These findings may in turn lead to development of novel management and preventative procedures.

Reduced firing rates of high threshold motor units in response to eccentric overload

Acute responses of motor units were investigated during submaximal voluntary isometric tasks following eccentric overload (EO) and constant load (CL) knee extension resistance exercise. Ten healthy resistance-trained participants performed four experimental test sessions separated by 5 days over a 20 day period. Two sessions involved constant load and the other two used eccentric overload. EO and CL used both sessions for different target knee eccentric extension phases; one at 2 sec and the other at 4 sec. Maximal voluntary contractions (MVC) and isometric trapezoid efforts for 10 sec at 70% MVC were completed before and after each intervention and decomposed electromyography was used to measure motor unit firing rate. The firing rate of later recruited, high-threshold motor units declined following the 2-sec EO but was maintained following 2sec CL (P < 0.05), whereas MUFR for all motor units were maintained for both loading types following 4-sec extension phases. MVC and rate of force development where maintained following both EO and CL and 2 and 4 sec phases. This study demonstrates a slower firing rate of high-threshold motor units following fast eccentric overload while MVC was maintained. This suggests that there was a neuromuscular stimulus without cost to the force-generating capacity of the knee extensors.

Influence of the "Slingshot" Bench Press Training Aid on Bench Press Kinematics and Neuromuscular Activity in Competitive Powerlifters

Dugdale, JH, Hunter, AM, Di Virgilio, TG, Macgregor, LJ, and Hamilton, DL. Influence of the "Slingshot" bench press training aid on bench press kinematics and neuromuscular activity in competitive powerlifters. J Strength Cond Res 33(2): 327-336, 2019-This study examined the acute effects of the "Slingshot" (SS) on bench press performance, prime mover surface electromyographic (sEMG) amplitude, and barbell velocity during maximal and submaximal bench pressing in competitive male powerlifters. Fifteen male powerlifters (mean ± SD; age: 27.05 ± 5.94 years; mass: 94.15 ± 13.43 kg; 1 repetition maximum [1RM] bench press: 139.7 ± 16.79 kg) participated in the study. Bench press strength, average barbell velocity, and sEMG amplitude of the prime mover muscles (triceps brachii, pectoralis major, and anterior deltoid) were measured during 2 conditions; "Raw" (without use of any assistance) and "SS" (using the "Slingshot" to perform both the weight achieved during "Raw" 1RM testing [Raw max/SS], and absolute 1RM using the "SS"). The results showed that the "SS" significantly increased bench press 1RM performance by a mean ± SD of 20.67 ± 3.4 kg. Barbell velocity and stick point analysis indicate that this improvement is likely driven by an increase in peak and prestick barbell velocity as triceps root mean square (RMS) was lower throughout all rep max phases with the "SS." The "SS" also caused reductions in RMS, specifically of the triceps at all rep ranges but barbell velocity was better maintained in the last reps of all sets. These data indicate that the "SS" specifically deloaded the triceps muscle throughout all rep ranges and provide assistance to maintaining barbell velocity under fatigue during later repetitions of multiple repetition sets. The "SS" training aid could therefore be used in deload phases of bench press training or as an overreaching and velocity training aid.

Fit with good fat? The role of n-3 polyunsaturated fatty acids on exercise performance

N-3 PUFA (n-3) polyunsaturated fatty acids (PUFA) are a family of fatty acids mainly found in oily fish and fish oil supplements. The effects of n-3 PUFA on health are mainly derived from its anti-inflammatory proprieties and its influence on immune function. Lately an increased interest in n-3 PUFA supplementation has reached the world of sport nutrition, where the majority of athletes rely on nutrition strategies to improve their training and performance. A vast amount of attention is paid in increasing metabolic capacity, delaying the onset of fatigue, and improving muscle hypertrophy and neuromuscular function. Nutritional strategies are also frequently considered for enhancing recovery, improving immune function and decreasing oxidative stress. The current review of the literature shows that data regarding the effects of n-3PUFA supplementation are conflicting and we conclude that there is, therefore, not enough evidence supporting a beneficial role on the aforementioned aspects of exercise performance.

Reliability of Trunk Muscle Electromyography in the Loaded Back Squat Exercise

Trunk muscle activation (TMA) has been reported during back squat exercise, however reliability and sensitivity to different loads alongside kinematic measures has not. Hence the aim was to determine the interday reliability and load sensitivity of TMA and kinematics during back squats. 10 males performed 3 test sessions: 1) back squat 1RM, 2) and 3) 3 reps at 65, 75, 85 and 95% of system mass max (SMmax). Kinematics were measured from an electrogoniometer and linear transducer, and surface electromyography (sEMG) recorded 4 muscles of the trunk: rectus abdominis (RA), external oblique (EO), upper lumbar erector spinae (ULES) and lumbar sacral erector spinae (LSES), and a reference leg muscle, the vastus lateralus (VL). sEMG amplitude was root mean squared (RMS). No differences (p>0.05) found between tests for any kinematic and RMS data. CV demonstrated moderate interday reliability (~16.1%) for EO, LSES and ULES but not RA (29.4%) during the velocity-controlled eccentric phase; whereas it was moderately acceptable for just LSES and ULES (~17.8%) but not RA and EO (27.9%) during the uncontrolled concentric phase. This study demonstrated acceptable interday reliability for kinematic data while sEMG for most trunk muscle sites was moderately acceptable during controlled contraction. sEMG responded significantly to load.

Neuromuscular response differences to power vs strength back squat exercise in elite athletes

The study's aim was to establish the neuromuscular responses in elite athletes during and following maximal 'explosive' regular back squat exercise at heavy, moderate, and light loads. Ten elite track and field athletes completed 10 sets of five maximal squat repetitions on three separate days. Knee extension maximal isometric voluntary contraction (MIVC), rate of force development (RFD) and evoked peak twitch force (Pt) assessments were made pre- and post-session. Surface electromyography [root mean square (RMS)] and mechanical measurements were recorded during repetitions. The heavy session resulted in the greatest repetition impulse in comparison to moderate and light sessions (P < 0.001), while the latter showed highest repetition power (P < 0.001). MIVC, RFD, and Pt were significantly reduced post-session (P < 0.01), with greatest reduction observed after the heavy, followed by the moderate and light sessions accordingly. Power significantly reduced during the heavy session only (P < 0.001), and greater increases in RMS occurred during heavy session (P < 0.001), followed by moderate, with no change during light session. In conclusion, this study has shown in elite athletes that the moderate load is optimal for providing a neuromuscular stimulus but with limited fatigue. This type of intervention could be potentially used in the development of both strength and power in elite athletic populations.

Long-term stability of tensiomyography measured under different muscle conditions

Tensiomyography (TMG) is a technique utilised to measure mechanical and contractile properties of skeletal muscle. Aim of this study was to assess long-term stability of TMG across a variety of muscle conditions. Gastrocnemius Medialis of 21 healthy males was measured using TMG in rested conditions, after a warm-up, after a maximal voluntary contraction and after a fatigue protocol. Participants were re-tested on a second occasion 4weeks apart. Among the parameters examined, Contraction Time, Sustain Time and Delay time exhibited a good level of absolute reliability (CV=3.8-9.4%) and poor to excellent level of relative reliability (ICC=0.56-0.92). On the other hand, relative reliability was good to excellent for muscle Displacement (ICC=0.86-0.96), whereas its level of absolute reliability was questionable (CV=8.0-14.8%). Minimum detectable change was less than 20% in most conditions for the aforementioned parameters. Half-relaxation Time yielded overall insufficient reliability. In general, the level of reliability tended to increase after the maximal voluntary contraction and the fatigue protocol were administered, probably because of more controlled conditions preceding the measurement. Information about the long-term stability of TMG across different muscle conditions is essential when intervention studies are undertaken with an exercising population, particularly athletes.

Six weeks of a polarized training-intensity distribution leads to greater physiological and performance adaptations than a threshold model in trained cyclists

This study was undertaken to investigate physiological adaptation with two endurance-training periods differing in intensity distribution. In a randomized crossover fashion, separated by 4 wk of detraining, 12 male cyclists completed two 6-wk training periods: 1) a polarized model [6.4 (±1.4 SD) h/wk; 80%, 0%, and 20% of training time in low-, moderate-, and high-intensity zones, respectively]; and 2) a threshold model [7.5 (±2.0 SD) h/wk; 57%, 43%, and 0% training-intensity distribution]. Before and after each training period, following 2 days of diet and exercise control, fasted skeletal muscle biopsies were obtained for mitochondrial enzyme activity and monocarboxylate transporter (MCT) 1 and 4 expression, and morning first-void urine samples were collected for NMR spectroscopy-based metabolomics analysis. Endurance performance (40-km time trial), incremental exercise, peak power output (PPO), and high-intensity exercise capacity (95% maximal work rate to exhaustion) were also assessed. Endurance performance, PPOs, lactate threshold (LT), MCT4, and high-intensity exercise capacity all increased over both training periods. Improvements were greater following polarized rather than threshold for PPO [mean (±SE) change of 8 (±2)% vs. 3 (±1)%, P < 0.05], LT [9 (±3)% vs. 2 (±4)%, P < 0.05], and high-intensity exercise capacity [85 (±14)% vs. 37 (±14)%, P < 0.05]. No changes in mitochondrial enzyme activities or MCT1 were observed following training. A significant multilevel, partial least squares-discriminant analysis model was obtained for the threshold model but not the polarized model in the metabolomics analysis. A polarized training distribution results in greater systemic adaptation over 6 wk in already well-trained cyclists. Markers of muscle metabolic adaptation are largely unchanged, but metabolomics markers suggest different cellular metabolic stress that requires further investigation.

Evaluation of electromyography normalisation methods for the back squat

The aim of the study was to evaluate maximal isometric (dynamometer based {MVC-NORM} and isometric squat {MIS-NORM}) and sub-maximal EMG normalisation methods (60%-NORM, 70%-NORM, 80%-NORM) for dynamic back squat exercise (DSQ-EX). The absolute reliability (limits of agreement {LOA}, coefficient of variation {CV%}), relative reliability (intra-class correlation coefficient {ICC}) and sensitivity of each method was assessed. Ten resistance-trained males attended four sessions. Session one assessed maximum back squat strength (three repetition maximum {3RM}). In the remaining three sessions Vastus lateralis (VL) and Bicep femoris (BF) EMG were measured whilst participants completed normalisation tasks and DSQ-EX sets at 65%, 75%, 85% and 95% of 3RM. MIS-NORM produced lower intra-participant CV% compared to MVC-NORM. 80%-NORM produced lower intra-participant CV% than other sub-maximal methods for VL and BF during eccentric and concentric phases. 80%-NORM also produced narrower 95% LOA results than all other normalisation methods. The MIS-NORM method displayed higher ICC values for both muscles during eccentric and concentric phases. The 60%-NORM and 70%-NORM methods were the most sensitive for VL and BF during eccentric and concentric phases. Only normalisation methods for the concentric action of the VL enhanced sensitivity compared to unnormalised EMG. Overall, dynamic normalisation methods demonstrated better absolute reliability and sensitivity for reporting VL and BF EMG within the current study compared to maximal isometric methods.

Brain functional changes (QEEG cordance) and worsening suicidal ideation and mood symptoms during antidepressant treatment

OBJECTIVE

Antidepressant medications are efficacious overall; however, some individuals experience worsening mood symptoms and increased suicidal ideation (SI) during treatment. We examined the quantitative electroencephalographic (QEEG) cordance biomarker of brain function biomarker in relation to treatment-emergent symptom worsening.

METHOD

Seventy-two major depressive disorder (MDD) subjects were treated with fluoxetine 20 mg (n = 13), venlafaxine 150 mg (n = 24), or placebo (n = 35) under double-blind conditions. Behavioral ratings determined whether each subject demonstrated worsening of depressed mood, anxiety, or SI during treatment. QEEG cordance data were analyzed to determine whether symptom worsening was associated with neurophysiological changes.

RESULTS

Antidepressant treatment-emergent SI (13.5%) was associated with a large transient decrease in midline-and-right-frontal (MRF) cordance 48 h after start of medication.

CONCLUSION

Hypothesis-generating results suggest a pattern of functional changes in midline and right frontal brain regions associated with antidepressant treatment-emergent SI in MDD.

Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine

The purpose of this study was to determine the reproducibility of limb power outputs and cardiopulmonary responses, to incremental whole-body exercise using a novel swimming training machine. 8 swimmers with a mean age of 23.7 ± 4.6 (yrs), stature 1.77 ± 0.13 (m) and body mass of 74.7 ± 2.8 (kg) gave informed consent and participated in repeat exercise testing on the machine. All subjects performed 2 incremental exercise tests to exhaustion using front crawl movements. From these tests peak oxygen consumption (VO(₂peak)), peak heart rate (HR(peak)), peak power output (W (peak)) and individual limb power outputs were determined. Results showed there were no significant differences between test 1 and 2 for any variable at exhaustion, and the CV% ranged from 2.8 to 3.4%. The pooled mean values were; VO(₂peak) 3.7 ± 0.65 L.min⁻¹, HR (peak) 178.7 ± 6.6 b.min⁻¹ and W (peak) 349.7 ± 16.5 W. The mean contributions to the total power output from the legs and arms were (37.3 ± 4.1% and 62.7 ± 5.1% respectively). These results show that it is possible to measure individual limb power outputs and cardiopulmonary parameters reproducibly during whole-body exercise using this training machine, at a range of exercise intensities.