Sports Medicine最新文献

Inadequate research on female health and performance; the complexity of the research; low menstrual health literacy of athletes, coaches, and support staff; and ethical and cultural sensitivities are all recognized as barriers to effective health monitoring for females in sports. Frameworks have been developed for academics to follow to help improve the quality of female-specific research. However, a similar resource that enables correct terminology, and use of health monitoring techniques has not been provided for sporting organizations, coaches, support staff or athletes. Therefore, this critical commentary presents a new resource, the Menstrual Health Manager. This resource may be used to determine the level of menstrual health monitoring detail that may be used by organisations, coaches or athletes, and specifies what reproductive health details the data will provide. This resource aims to provide organizations and coaches with a means of understanding the data that inform their decisions for female athletes. Utilization of this resource may aid in the consistent use of terminology and methods for female-specific health monitoring in both sports and research.

Background: Traditional electrocardiography (ECG)-derived heart rate variability (HRV) and photoplethysmography (PPG)-derived "HRV" (termed PRV) have been reported interchangeably. Any potential dissociation between HRV and PRV could be due to the variability in pulse arrival time (PAT; time between heartbeat and peripheral pulse).

Objective: This study examined if PRV is equivalent to ECG-derived HRV and if PRV's innate error makes it a high-quality measurement separate from HRV.

Methods: ECG data from 1084 subjects were obtained from the PhysioNet Autonomic Aging dataset, and individual PAT dispersions for both the wrist (n = 42) and finger (n = 49) were derived from Mol et al. (Exp Gerontol. 2020; 135: 110938). A Bayesian simulation was constructed whereby the individual arrival times of the PPG wave were calculated by placing a Gaussian prior on the individual QRS-wave timings of each ECG series. The standard deviation (σ) of the prior corresponds to the PAT dispersion from Mol et al. This was simulated 10,000 times for each PAT σ. The root mean square of successive differences (RMSSD) and standard deviation of N-N intervals (SDNN) were calculated for both HRV and PRV. The Region of Practical Equivalence bounds (ROPE) were set a priori at ± 0.2% of true HRV. The highest density interval (HDI) width, encompassing 95% of the posterior distribution, was calculated for each PAT σ.

Results: The lowest PAT σ (2.0 SD) corresponded to 88.4% within ROPE for SDNN and 21.4% for RMSSD. As the σ of PAT increases, the equivalence of PRV and HRV decreases for both SDNN and RMSSD. The HDI interval width increases with increasing PAT σ, with the HDI width increasing at a higher rate for RMSSD than SDNN.

Conclusions: For individuals with greater PAT variability, PRV is not a surrogate for HRV. When considering PRV as a unique biometric measure, SDNN may have more favorable measurement properties than RMSSD, though both exhibit a non-uniform measurement error.

Background: Our scientific understanding of the mechanistic and practical connections between training session prescriptions, their execution by athletes, and adaptations over time in elite endurance sports remains limited. These connections are fundamental to the art and science of coaching.

Objective: By using successful Norwegian endurance coaches as key informants, the aim of this study is to describe and compare best practice session models across different exercise intensities in Olympic endurance sports.

Methods: Data collection was based on a four-step pragmatic qualitative study design, involving questionnaires, training logs from successful athletes, and in-depth and semi-structured interviews, followed by negotiation among researchers and coaches to assure our interpretations. Twelve successful and experienced male Norwegian coaches from biathlon, cross-country skiing, long-distance running, road cycling, rowing, speed skating, swimming, and triathlon were chosen as key informants. They had been responsible for the training of world-class endurance athletes who altogether have won > 370 medals in international championships.

Results: The duration of low-intensity training (LIT) sessions ranges from 30 min to 7 h across sports, mainly due to modality-specific constraints and load tolerance considerations. Cross-training accounts for a considerable part of LIT sessions in several sports. Moderate (MIT)- and high-intensity training (HIT) sessions are mainly conducted as intervals in specific modalities, but competitions also account for a large proportion of annual HIT in most sports. Interval sessions are characterized by a high accumulated volume, a progressive increase in intensity throughout the session, and a controlled, rather than exhaustive, execution approach. A clear trend towards shorter intervals and lower work: rest ratio with increasing intensity was observed. Overall, the analyzed sports implement considerably more MIT than HIT sessions across the annual cycle.

Conclusions: This study provides novel insights on quantitative and qualitative aspects of training session models across intensities employed by successful athletes in Olympic endurance sports. The interval training sessions revealed in this study are generally more voluminous, more controlled, and less exhaustive than most previous recommendations outlined in research literature.

Background

Anterior cruciate ligament (ACL) injury during contact sports has a high incidence that has not been reduced despite the immense resources devoted to understanding its aetiology. A neurocognitive approach could increase knowledge of the mechanisms contributing to ACL injury enabling practitioners to address and minimise future risk.

Objective

To systematically review the influence of manipulating cognitive demands during motor tasks (i.e. degree of uncertainty) on biomechanical variables associated with ACL injury risk.

Methods

A systematic review was performed according to the Cochrane Handbook for Systematic Reviews of Interventions by searching the major sporting electronic databases. The search strategy included four groups of terms and was conducted by two authors independently. All studies were screened using unique inclusion criteria, with the included studies assessed for risk of bias.

Results

Twenty-five studies were identified from 2031 records and included into the review process. During the experimental conditions where cognitive demands were higher, most biomechanical indicators associated with a greater risk of ACL injury during landing and cutting tasks were significantly enhanced compared with conditions with low or no cognitive demands.

Conclusions

An increase in task complexity through cognitive load significantly leads to changes in mechanisms associated with ACL injury during single-leg landings and cutting movements. Consequently, coaches and exercise professionals should consider inclusion of dual-task paradigms or uncertainty during injury risk assessment scenarios and injury prevention programs to help identify athletes at risk of ACL injury and reduce ACL injury frequency.

Registration

This protocol was registered in the PROSPERO database (https://www.crd.york.ac.uk/PROSPERO) in May 2022, with the registration number CRD42022315795.

Vertical jump height measures our ability to oppose gravity and lower body neuromuscular function in athletes and various clinical populations. Vertical jump tests are principally simple, time-efficient, and extensively used for assessing athletes and generally in sport science research. Using the force platform for jump height estimates is increasingly popular owing to technological advancements and its relative ease of use in diverse settings. However, ground reaction force data can be analyzed in multiple ways to estimate jump height, leading to distinct outcome values from the same jump. In the literature, four equations have been commonly described for estimating jump height using the force platform, where jump height can vary by up to (sim) 15 cm when these equations are used on the same jump. There are advantages and disadvantages to each of the equations according to the intended use. Considerations of (i) the jump type, (ii) the reason for testing, and (iii) the definition of jump height should ideally determine which equation to apply. The different jump height equations can lead to confusion and inappropriate comparisons of jump heights. Considering the popularity of reporting jump height results, both in the literature and in practice, there is a significant need to understand how the different mathematical approaches influence jump height. This review aims to investigate how different equations affect the assessment of jump height using force platforms across various jump types, such as countermovement jumps, squat jumps, drop jumps, and loaded jumps.

Background

Hop testing is widely used by clinicians to monitor rehabilitation and decide when to return to sport following anterior cruciate ligament reconstruction (ACLR); however, the trajectory of long-term hop performance has not been summarised.

Objective

To investigate hop performance change over time after ACLR.

Design

Systematic review with longitudinal meta-analysis.

Data Sources

MEDLINE, EMBASE, CINAHL, Scopus, Cochrane CENTRAL and SPORTDiscus to 28 February 2023.

Eligibility Criteria

Studies with ≥ 50 participants following primary ACLR, with mean participant age of 18–40 years, reporting a quantitative measure of hop performance (e.g. single forward hop distance). Results had to be reported for the ACLR limb and compared with (1) the contralateral limb (within person) and/or (2) an uninjured control limb (between person).

Results

We included 136 studies of 23,360 participants. Performance was similar across different hop tests, with steep initial improvements in within-person symmetry, tailing off after 18–24 months. ACLR limb hop performance was 5–10% lower compared with the contralateral limb at 1 year post-surgery, with largest deficits observed for vertical hop [87.0% contralateral limb (95% CI 85.3–88.8) compared with single forward hop 93.8% (95% CI 92.8–94.9)]. By 3–5 years, results were similar between ACLR and contralateral limbs. There were limited data for between-person comparisons (n = 17 studies). Exploratory analyses showed deficits in all forward hopping tests to be very strongly correlated with each other [e.g. single forward and triple hop rho = 0.96 (95% CI 0.90–0.99)], though there was discordance in the relationship between single forward hop and vertical hop performance [rho = 0.27 (95% CI − 0.53 to 0.79)].

Conclusions

Hop performance is comparable to the uninjured limb by 3–5 years post-ACLR, with the greatest deficits in within-person symmetry present in vertical and side hop tests. Assessment of hopping in multiple planes and comparison with uninjured controls, may provide the most complete evaluation of functional performance.

Introduction

Prolonged strenuous exercise can transiently decrease cardiac function. Other studies have identified three major exercise-induced pulmonary changes: bronchoconstriction, dynamic hyperinflation and pulmonary oedema with reduced alveolar–capillary membrane diffusing capacity. This study investigated whether athletes with one of these pulmonary dysfunctions following a very long-distance triathlon exhibit similar cardiac alterations as those without dysfunctions.

Methods

Sixty trained male triathletes (age 39 ± 9 years) underwent baseline and post-race assessments, including echocardiography (with standard, 2D-strain and myocardial work assessments), spirometry and double-diffusion technique to evaluate alveolar–capillary membrane diffusing capacity for carbon monoxide (DM_CO). Cardiac function in athletes with exercise-induced bronchoconstriction (> 10% decrease FEV₁), dynamic hyperinflation (> 10% decrease inspiratory capacity) or impaired diffusion capacity (> 20% decrease DM_CO/alveolar volume) were compared with those without these dysfunctions.

Results

The race lasted 14 h 20 min ± 1 h 26 min. Both systolic and diastolic cardiac functions declined post-race. Post-race, 18% of athletes had bronchoconstriction, 58% dynamic hyperinflation and 40% impaired diffusing capacity. Right and left ventricular standard and 2D-strain parameters were similar before the race in all subgroups and changed similarly post-race, except E/E′, which decreased in the bronchoconstriction subgroup and increased in those with diffusion impairment. Global constructive work decreased by ~ 19% post-race (2302 ± 226 versus 1869 ± 328 mmHg%, P < 0.001), more pronounced in athletes with diffusion impairment compared with others (− 26 ± 13 versus − 15 ± 9%, P = 0.001) and positively correlated with DM_CO/alveolar volume reduction.

Conclusion

After a very long-distance triathlon, bronchoconstriction and hyperinflation were not associated with significant cardiac changes, whereas impaired alveolar–capillary membrane diffusing capacity was associated with a more significant decline in myocardial function. These findings highlight the complex relationship between pulmonary gas exchange abnormalities and cardiac fatigue following prolonged strenuous exercise.