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Background: In recent years, there has been a large expansion in literature pertaining to the game of Australian football (AF). Furthermore, there have been a number of rule changes that are likely to have changed the demands of the game. Based on these advances and changes, it seemed important to conduct a review assessing the scientific literature surrounding the sport.Objective: The review evaluates the match demands of AF, the qualities required for success, and the impact training and competition have on adaptation, injury and fatigue.Methods: A systematic search of PubMed, CINAHL, SPORTDiscus, Web of Science and Scopus for AF literature was conducted; studies investigating match demands, physical qualities, training practices and injury were included. Weighted means and standard deviations were calculated for match demands and physical and anthropometric profiles across playing standards.Results: A total of 1830 articles were retrieved in the initial search, with 888 removed as duplicates, 626 removed for being non-relevant and a further 152 removed for being AF papers but not relevant to the review. As such, 164 AF papers were included in the review. Due to the intermittent high-intensity nature of match-play, players need a wide range of physical and technical qualities to excel, with speed, aerobic fitness, reactive agility and well-developed lean mass being central to success. Training for AF at the elite level is associated with high workloads, with players engaging in numerous training modalities; even altitude and heat training camps have been utilised by Australian Football League (AFL) teams to further augment fitness improvements. While high chronic workloads can be tolerated and are needed for improving physical qualities, careful planning and monitoring of internal and external workloads is required to minimise sharp spikes in load that are associated with injury.Conclusions: There is a complex interaction between numerous contextual factors that influence the match demands that are discussed in this review. Whilst players must have the physical capacities to cope with the intense physical demands of AF matches, the successful execution of technical skills during match-play is central to success. To develop these skills and attributes, specific and carefully planned and monitored training must be performed over a number of years. [ABSTRACT FROM AUTHOR]

Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most ( n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. [ABSTRACT FROM AUTHOR]

Background: The benefits of physical activity to maintain optimal health and well-being in children and adolescents are undisputed. The school environment offers opportunities for children to be physically active. Objective: The aim of this review is to systematically examine the effects of recess-based interventions on the physical activity (PA) levels of school-aged children and adolescents. Data Sources: A systematic literature search was conducted to identify papers reporting interventions to promote PA during school recess and/or lunchtime periods. The search was conducted in six databases (PubMed, SPORTDiscus™, Web of Science, Proquest, Cochrane and Scopus) for papers published between January 2000 and April 2011. Study Selection: Articles were included in the review if (i) they reported the findings of an intervention targeting PA levels of children and/or adolescents during school recess and/or lunchtime; (ii) have a measure of PA as an outcome variable; (iii) participants were aged between 5 and 18 years; and (iv) were published in English. Methods: Two authors independently searched the literature using the same search strategies to identify papers reporting interventions that promote PA during school recess and lunchtime periods. Methodological quality was assessed using an adapted eight item assessment scale. The effects of the interventions were assessed with a rating system used in a recent review of interventions in youth. Results: The search originally retrieved 2,265 articles. Nine published peer-reviewed journal articles met the inclusion criteria for this review. Eight studies used randomized controlled trials and one was a controlled trial. Three studies demonstrated high methodological quality (33%). None of the studies adequately reported the randomization procedure or used power calculations. Few studies reported potential confounders and three studies had less than a 6 week follow-up. Five studies demonstrated a positive intervention effect on children's PA levels, with four reporting statistically significant increases and two reporting significant decreases in recess PA. The summary of the levels of evidence for intervention effects found inconclusive results for all intervention types, though promising strategies that require further investigation were identified. Limitations: Whilst every effort was made to ensure that this review was as encompassing as possible, it may be limited by its search terms especially if there were studies with unclear titles or abstracts. In addition, only manuscripts published in English were considered, eliminating any possible studies published in other languages. Conclusions: All of the studies used an objective measure to assess PA outcomes, although several criteria were consistently absent from the studies. The levels of evidence were not sufficient to establish conclusive intervention effects on children's recess PA. This could be due to the small number of published studies. There is a need for higher-quality intervention research to strengthen published findings to inform recess PA interventions. Intervention research is needed in adolescents due to the absence of school recess intervention research in this population. [ABSTRACT FROM AUTHOR]

Background and Objective: Hypoxic training techniques are increasingly used by athletes in an attempt to improve performance in normoxic environments. The 'live low-train high (LLTH)' model of hypoxic training may be of particular interest to athletes because LLTH protocols generally involve shorter hypoxic exposures (approximately two to five sessions per week of <3 h) than other traditional hypoxic training techniques (e.g. live high-train high or live high-train low). However, the methods employed in LLTH studies to date vary greatly with respect to exposure times, training intensities, training modalities, degrees of hypoxia and performance outcomes assessed. Whilst recent reviews provide some insight into how LLTH may be applied to enhance performance, little attention has been given to how training intensity/modality may specifically influence subsequent performance in normoxia. Therefore, this systematic review aims to evaluate the normoxic performance outcomes of the available LLTH literature, with a particular focus on training intensity and modality. Data Sources and Study Selection: A systematic search was conducted to capture all LLTH studies with a matched normoxic (control) training group and the assessment of performance under normoxic conditions. Studies were excluded if no training was completed during the hypoxic exposures, or if these exposures exceeded 3 h per day. Four electronic databases were searched (PubMed, SPORTDiscus™, EMBASE and Web of Science) during August 2013, and these searches were supplemented by additional manual searches until December 2013. Results: After the electronic and manual searches, 40 papers were deemed to meet the inclusion criteria, representing 31 separate studies. Within these 31 studies, four types of LLTH were identified: (1) continuous low-intensity training in hypoxia (CHT, n = 16), (2) interval hypoxic training (IHT, n = 4), (3) repeated sprint training in hypoxia (RSH, n = 3) and (4) resistance training in hypoxia (RTH, n = 4). Four studies also used a combination of CHT and IHT. The majority of studies reported no difference in normoxic performance between the hypoxic and normoxic training groups ( n = 19), while nine reported greater improvements in the hypoxic group and three reported poorer outcomes compared with the control group. Selection of training intensity (including matching relative or absolute intensity between normoxic and hypoxic groups) was identified as a key factor in mediating the subsequent normoxic performance outcomes. Five studies included some form of normoxic training for the hypoxic group and 14 studies assessed performance outcomes not specific to the training intensity/modality completed during the training intervention. Conclusion: Four modes of LLTH are identified in the current literature (CHT, IHT, RSH and RTH), with training mode and intensity appearing to be key factors in mediating subsequent performance responses in normoxia. Improvements in normoxic performance appear most likely following high-intensity, short-term and intermittent training (e.g. IHT, RSH). LLTH programmes should carefully apply the principles of training and testing specificity and include some high-intensity training in normoxia. For RTH, it is unclear whether the associated adaptations are greater than those of traditional (maximal) resistance training programmes. [ABSTRACT FROM AUTHOR]

Anterior knee pain is a chronic condition that presents frequently to sport medicine clinics, and can have a long-term impact on participation in physica activity. Conceivably, effective early management may prevent chronicit and facilitate physical activity. Although a variety of nonsurgical interven' tions have been advocated, previous systematic reviews have consistenty been unable to reach conclusions to support their use. Considering a decade has lapsed since publication of the most recent data in these reviews, it is timely to provide an updated synthesis of the literature to assist sports medicine practitioners in making informed, evidence-based decisions. A systematic review and meta-analysis was conducted to evaluate the evidence for non- surgical interventions for anterior knee pain. A comprehensive search strategy was used to search MEDLINE, EM- BASE, CINAHL® and Pre-CINAHL®, PEDro, PubMed, SportDiscus®, Web of Science®, BIOSIS Previews®, and the full Cochrane Library, while reference lists of included papers and previous systematic reviews were hand searched. Studies were eligible for inclusion if they were randomized clinical trials that used a measure of pain to evaluate at least one nonsurgical inter- vention over at least 2 weeks in participants with anterior knee pain. A modified version of the PEDro scale was used to rate methodological quality and risk of bias. Effect size calculation and meta-analyses were based on random effects models. Of 48 suitable studies, 27 studies with low-to-moderate risk of bias were included. There was minimal opportunity for meta-analysis because of heterogeneity of interventions, comparators and follow-up times. Meta- analysis of high-quality clinical trials supports the use of a 6-week multimodal physiotherapy programme (standardized mean difference [SMD] 1.08, 95% CI 0.73, 1.43), but does not support the addition of electromyography bio- feedback to an exercise programme in the short-term (4 weeks: SMD -0.21, 95% CI -0.64,0.21; 8-12 weeks: SMD -0.22,95% CI -0.65, 0.20). Individual study data showed beneficial effects for foot orthoses with and without multimodal physiotherapy (vs flat inserts), exercise (vs control), closed chain exercises (vs open chain exercises), patella taping in conjunction with exercise (vs exercise alone) and acupuncture (vs control). Findings suggest that, in implementing evidence-based practice for the nonsurgical management of anterior knee pain, sports medicine practitioners should prescribe local, proximal and distal components of multimodal physiotherapy in the first instance for suitable patients, and then consider foot orthoses or acupuncture as required. [ABSTRACT FROM AUTHOR]