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Background: Elevated glucose and insulin levels are major risk factors in the development of cardiometabolic disease. Aerobic exercise is widely recommended to improve glycaemic control, yet its acute effect on glycaemia and glucoregulatory hormones has not been systematically reviewed and analysed in healthy adults. Objective: To determine the effect of a single bout of continuous aerobic exercise on circulating glucose, insulin, and glucagon concentrations in healthy adults. Methods: CENTRAL, CINAHL, Embase, Global Health, HMIC, Medline, PubMed, PsycINFO, ScienceDirect, Scopus and Web of Science databases were searched from inception to May 2020. Papers were included if they reported a randomised, crossover study measuring glucose and/or insulin and/or glucagon concentrations before and immediately after a single bout of continuous aerobic exercise (≥ 30 min) compared to a time-matched, resting control arm in healthy adults. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and GRADE approach, respectively. Random-effects meta-analyses were performed for glucose, insulin, and glucagon. Sub-group meta-analyses and meta-regression were performed for categorical (metabolic state [postprandial or fasted], exercise mode [cycle ergometer or treadmill]) and continuous (age, body mass index, % males, maximal aerobic capacity, exercise duration, exercise intensity) covariates, respectively. Results: 42 papers (51 studies) were considered eligible: glucose (45 studies, 391 participants), insulin (38 studies, 377 participants) and glucagon (5 studies, 47 participants). Acute aerobic exercise had no significant effect on glucose concentrations (mean difference: − 0.05 mmol/L; 95% CI, − 0.22 to 0.13 mmol/L; P = 0.589; I2: 91.08%, large heterogeneity; moderate-quality evidence). Acute aerobic exercise significantly decreased insulin concentrations (mean difference: − 18.07 pmol/L; 95% CI, − 30.47 to − 5.66 pmol/L; P = 0.004; I2: 95.39%, large heterogeneity; moderate-quality evidence) and significantly increased glucagon concentrations (mean difference: 24.60 ng/L; 95% CI, 16.25 to 32.95 ng/L; P < 0.001; I2: 79.36%, large heterogeneity; moderate-quality evidence). Sub-group meta-analyses identified that metabolic state modified glucose and insulin responses, in which aerobic exercise significantly decreased glucose (mean difference: − 0.27 mmol/L; 95% CI, − 0.55 to − 0.00 mmol/L; P = 0.049; I2: 89.72%, large heterogeneity) and insulin (mean difference: − 42.63 pmol/L; 95% CI, − 66.18 to − 19.09 pmol/L; P < 0.001; I2: 81.29%, large heterogeneity) concentrations in the postprandial but not fasted state. Meta-regression revealed that the glucose concentrations were also moderated by exercise duration and maximal aerobic capacity. Conclusions: Acute aerobic exercise performed in the postprandial state decreases glucose and insulin concentrations in healthy adults. Acute aerobic exercise also increases glucagon concentrations irrespective of metabolic state. Therefore, aerobic exercise undertaken in the postprandial state is an effective strategy to improve acute glycaemic control in healthy adults, supporting the role of aerobic exercise in reducing cardiometabolic disease incidence. PROSPERO registration number: CRD42020191345. [ABSTRACT FROM AUTHOR]

Background: Among ultra-endurance runners (UER), the mental, behavioral, and physical demands of training/competition can result in maladaptive outcomes. Mental health issues are common in athletes and can impact psychology, physical health, and performance. Objective: To synthesize information regarding the incidence/prevalence and factors associated with mental health issues among UER. Methods: Systematic searches were performed in PubMed, SPORTDiscus, Scopus, Cochrane databases, CINAHL, Web of Science, and Medline Ovid using key terms related to UER (e.g., trail running, road running) and psychological issues (e.g., exercise addiction, depression). Inclusion criteria included original articles published in peer-reviewed journals in English, using qualitative or quantitative approaches. We considered papers reporting incidence/prevalence and associated factors with mental health outcomes in UER of both sexes, all ages, and levels of competition (e.g., elite, nonprofessional runners). The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. Results: A total of 282 studies were identified, and 11 studies were included in the final selection. A total of 3670 UER were included in the studies. The prevalence of mental health issues among UER ranged between 32.0% and 62.5% for eating disorders, from 11.5% to 18.2% for exercise addiction, 18.6% for depressive symptoms, and 24.5% for sleep disturbance. Exercise addiction was not related to weekly volume, but a strong relationship with exercise in an unstructured space, age, and body mass index was shown. Conclusion: Mental health issues among UER are common, especially eating disorders, exercise addiction, sleep disturbances, and depressive symptoms. Further high-quality studies are needed to examine underlying factors and find preventative strategies to protect UER. Registration: The protocol of this systematic review was registered at the PROSPERO—CRD42022338743. [ABSTRACT FROM AUTHOR]

Background: Several studies have utilised isometric, eccentric and downhill walking pre-conditioning as a strategy for alleviating the signs and symptoms of exercise-induced muscle damage (EIMD) following a bout of damaging physical activity. Objectives: This systematic review and meta-analysis examined the effects of pre-conditioning strategies on indices of muscle damage and physical performance measures following a second bout of strenuous physical activity. Data Sources: PubMed, CINAHL and Scopus. Eligibility Criteria: Studies meeting the PICO (population, intervention/exposure, comparison, and outcome) criteria were included in this review: (1) general population or "untrained" participants with no contraindications affecting physical performance; (2) studies with a parallel design to examine the prevention and severity of muscle-damaging contractions; (3) outcome measures were compared using baseline and post-intervention measures; and (4) outcome measures included any markers of indirect muscle damage and muscular contractility measures. Participants: Individuals with no resistance training experiences in the previous 6 or more months. Interventions: A single bout of pre-conditioning exercises consisting of eccentric or isometric contractions performed a minimum of 24 h prior to a bout of damaging physical activity were compared to control interventions that did not perform pre-conditioning prior to damaging physical activity. Study Appraisal: Kmet appraisal system. Synthesis Methods: Quantitative analysis was conducted using forest plots to examine standardised mean differences (SMD, i.e. effect size), test statistics for statistical significance (i.e. Z-values) and between-study heterogeneity by inspecting I2. Results: Following abstract and full-text screening, 23 articles were included in this paper. Based on the meta-analysis, the pre-conditioning group exhibited lower levels of creatine kinase at 24 h (SMD = − 1.64; Z = 8.39; p = 0.00001), 48 h (SMD = − 2.65; Z = 7.78; p = 0.00001), 72 h (SMD = − 2.39; Z = 5.71; p = 0.00001) and 96 h post-exercise (SMD = − 3.52; Z = 7.39; p = 0.00001) than the control group. Delayed-onset muscle soreness was also lower for the pre-conditioning group at 24 h (SMD = − 1.89; Z = 6.17; p = 0.00001), 48 h (SMD = − 2.50; Z = 7.99; p = 0.00001), 72 h (SMD = − 2.73; Z = 7.86; p = 0.00001) and 96 h post-exercise (SMD = − 3.30; Z = 8.47; p = 0.00001). Maximal voluntary contraction force was maintained and returned to normal sooner in the pre-conditioning group than in the control group, 24 h (SMD = 1.46; Z = 5.49; p = 0.00001), 48 h (SMD = 1.59; Z = 6.04; p = 0.00001), 72 h (SMD = 2.02; Z = 6.09; p = 0.00001) and 96 h post-exercise (SMD = 2.16; Z = 5.69; p = 0.00001). Range of motion was better maintained by the pre-conditioning group compared with the control group at 24 h (SMD = 1.48; Z = 4.30; p = 0.00001), 48 h (SMD = 2.20; Z = 5.64; p = 0.00001), 72 h (SMD = 2.66; Z = 5.42; p = 0.00001) and 96 h post-exercise (SMD = 2.5; Z = 5.46; p = 0.00001). Based on qualitative analyses, pre-conditioning activities were more effective when performed at 2–4 days before the muscle-damaging protocol compared with immediately prior to the muscle-damaging protocol, or 1–3 weeks prior to the muscle-damaging protocol. Furthermore, pre-conditioning activities performed using eccentric contractions over isometric contractions, with higher volumes, greater intensity and more lengthened muscle contractions provided greater protection from EIMD. Limitations: Several outcome measures showed high inter-study heterogeneity. The inability to account for differences in durations between pre-conditioning and the second bout of damaging physical activity was also limiting. Conclusions: Pre-conditioning significantly reduced the severity of creatine kinase release, delayed-onset muscle soreness, loss of maximal voluntary contraction force and the range of motion decrease. Pre-conditioning may prevent severe EIMD and accelerate recovery of muscle force generation capacity. [ABSTRACT FROM AUTHOR]

Background: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. Objective: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. Methods: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0–10 m), speed (15–40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. Results: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73–1.08, moderate) and speed (p < 0.05; g = 0.40–0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03–1.81). Conclusions: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration. [ABSTRACT FROM AUTHOR]

Background: Recreational football is an intense, versatile form of exercise with multiple high- and odd-impact actions. Recreational football is therefore hypothesized to be suitable for bone modeling and bone health. Objective: The aim of the present systematic review and meta-analysis was to evaluate the effects of recreational football on bone mineral density (BMD), bone mineral content (BMC) and bone turnover markers (BTM). Design: Systematic review and meta-analysis. Data Sources: MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to September 2021. A manual database search was also performed using the following key terms, either singly or in combination: recreational football/soccer, street football/soccer, recreational small-sided games, effect, influence, impact, bone turnover markers, bone mineral density, bone turnover marker, bone health, osteogenesis, CTX, osteocalcin, P1NP. Eligibility Criteria for Selecting Studies: Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of training intervention or passive control group were included. The primary outcome measures were total BMD, lower limb BMD, total BMC, lower limb BMC, osteocalcin, procollagen type 1N-terminal propeptide (P1NP) and collagen type 1 cross-linked C-telopeptide (CTX). A total of 17 papers met the inclusion criteria and were included. Statistical Analysis: Comprehensive Meta-analysis V.2 software (Biostat, Englewood, New Jersey, USA) was used for the meta-analyses. Risk of Bias: Agreement between the two reviewers was assessed using RoB2 tool and k statistics for full-text screening and rating of relevance and risk of bias. The k agreement rate between reviewers was k = 0.92. Results: The football interventions included were based on studies having a duration of 12–64 weeks with one 5-year follow-up study and with a training frequency of 1–3 sessions/wk. Training sessions were 45–60 min sessions of 3v3 – 7v7 small-sided games. The subjects covered an age span from 9 to 73 years. Five studies examined recreational football effects in females, nine studies in males and three studies included both sexes. Recreational football training produced a statistically significant effect (mean difference = 0.02 g/cm2, 95% confidence interval: 0.00–0.03, P = 0.02) on lower limb BMD and negligible effects for total BMD compared to no-exercise controls. The recreational football effects on total and lower limb BMC, when compared to both no-exercise controls and exercise controls, were negligible. A moderate to large significant increase in osteocalcin, P1NP and CTX was observed for recreational football compared to both no-exercise controls and exercise controls. Conclusion: In conclusion, recreational football training regimes lasting 12–64 weeks have a large osteogenic impact on bone turnover markers in comparison with no-exercise controls as well as exercise controls, and beneficial effects on lower limb BMD compared to no-exercise controls. Short and medium duration recreational football interventions have negligible effects on whole-body BMD and BMC (total and lower limb), with magnitudes similar to those of other exercise modes. [ABSTRACT FROM AUTHOR]

Background: Hamstrings neuromuscular function is a crucial component of functional movement, and changes after anterior cruciate ligament (ACL) injury contribute to risk factors for secondary injury and long-term sequelae. To effectively treat muscular impairments, an accurate understanding of hamstrings neuromuscular function in patients with ACL reconstruction (ACLR) is needed. Objective: A systematic review and meta-analysis were undertaken to describe and quantify hamstrings neuromuscular function in individuals with ACLR compared to controls. Methods: We searched PubMed, Web of Science, SPORTDiscus, CINAHL, and EBSCOhost databases in October of 2020 for studies evaluating the difference between hamstrings electromyography (EMG) between individuals with ACLR and controls. Two independent reviewers assessed each paper for inclusion and quality. Means and standard deviations were extracted from each included study to allow random-effect size (ES) meta-analysis calculations for comparison of results. Results: Thirty-four studies were included for final review. From these, 5 categories of neuromuscular outcomes were identified, and studies were grouped accordingly: (1) muscle activation levels (EMG amplitude), (2) co-activation, (3) onset timing, (4) electromechanical delay, and (5) time-to-peak activity. Moderate to strong evidence indicates that individuals with ACLR demonstrate higher hamstrings EMG amplitude (normalized to % maximum voluntary isometric contraction) and hamstrings-to-quadriceps co-activation during gait and stair ambulation compared to controls. In addition, there was moderate evidence of longer electromechanical delay during knee flexion and greater hamstrings-to-quadriceps co-activation during knee extension compared to controls. Conclusions: Greater hamstrings EMG amplitude and co-activation during gait and ambulation tasks and longer electromechanical delay of the hamstrings in individuals with ACLR align with clinical impairments following ACLR and have implications for re-injury risk and long-term joint health, thus warranting attention in rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Hamstrings muscle morphology is determinant of muscle function (i.e. strength). Among individuals with ACL reconstruction (ACLR), less cross-sectional area (CSA) and volume in the ACLR-limb are associated with muscle weakness, and may contribute to lower rates of return to preinjury activity level and an increased risk for long-term sequelae. Objectives: To effectively treat muscular impairments, an accurate understanding of differences in hamstrings morphology following ACLR is needed. A systematic review and meta-analysis were undertaken to describe the morphology of the hamstring muscle complex after ACLR. Methods: We searched five databases for studies evaluating the difference between hamstrings size and architecture in individuals with ACLR. Two independent reviewers assessed each paper for inclusion and quality. Means and standard deviations were extracted from each included study to allow fixed-effect size meta-analysis calculations for comparison of results. Results: Twenty-four studies were included for final review. Eight categories of morphological outcomes were identified, and studies were grouped accordingly: (1) volume, (2) cross-sectional area (CSA), (3) muscle length, (4) muscle thickness, (5) fascicle length, (6) pennation angle, (7) fiber area, and (8) fiber type. Meta-analysis demonstrated lower hamstrings volume in the ACLR-limb in both contralateral and control group comparisons, and lower CSA, length, and thickness in the ACLR-limb in contralateral comparisons. The semitendinosus and gracilis were most profoundly impacted. Limited moderate evidence demonstrated greater biceps femoris pennation angle in the ACLR-limb. Conclusions: Individuals with ACLR demonstrated large deficits in semitendinosus and gracilis muscle CSA and volume in the ACLR-limb compared contralaterally, with no differences observed in the biceps femoris or semimembranosus. Clinical implications regarding assessment and treatment of individuals with ACLR are discussed. [ABSTRACT FROM AUTHOR]

Background: Microtechnology has allowed sport scientists to understand the locomotor demands of various sports. While wearable global positioning technology has been used to quantify the locomotor demands of sporting activities, microsensors (i.e. accelerometers, gyroscopes and magnetometers) embedded within the units also have the capability to detect sport-specific movements. Objective: The objective of this study was to determine the extent to which microsensors (also referred to as inertial measurement units and microelectromechanical sensors) have been utilised in quantifying sport-specific movements. Methods: A systematic review of the use of microsensors and associated terms to evaluate sport-specific movements was conducted; permutations of the terms used included alternate names of the various technologies used, their applications and different applied environments. Studies for this review were published between 2008 and 2014 and were identified through a systematic search of six electronic databases: Academic Search Complete, CINAHL, PsycINFO, PubMed, SPORTDiscus, and Web of Science. Articles were required to have used athlete-mounted sensors to detect sport-specific movements (e.g. rugby union tackle) rather than sensors mounted to equipment and monitoring generic movement patterns. Results: A total of 2395 studies were initially retrieved from the six databases and 737 results were removed as they were duplicates, review articles or conference abstracts. After screening titles and abstracts of the remaining papers, the full text of 47 papers was reviewed, resulting in the inclusion of 28 articles that met the set criteria around the application of microsensors for detecting sport-specific movements. Eight articles addressed the use of microsensors within individual sports, team sports provided seven results, water sports provided eight articles, and five articles addressed the use of microsensors in snow sports. All articles provided evidence of the ability of microsensors to detect sport-specific movements. Results demonstrated varying purposes for the use of microsensors, encompassing the detection of movement and movement frequency, the identification of movement errors and the assessment of forces during collisions. Conclusion: This systematic review has highlighted the use of microsensors to detect sport-specific movements across a wide range of individual and team sports. The ability of microsensors to capture sport-specific movements emphasises the capability of this technology to provide further detail on athlete demands and performance. However, there was mixed evidence on the ability of microsensors to quantify some movements (e.g. tackling within rugby union, rugby league and Australian rules football). Given these contrasting results, further research is required to validate the ability of wearable microsensors containing accelerometers, gyroscopes and magnetometers to detect tackles in collision sports, as well as other contact events such as the ruck, maul and scrum in rugby union. [ABSTRACT FROM AUTHOR]

An athlete’s pacing strategy is widely recognised as an essential determinant for performance during individual events. Previous research focussed on the importance of internal bodily state feedback, revealed optimal pacing strategies in time-trial exercise, and explored concepts such as teleoanticipation and template formation. Recently, human-environment interactions have additionally been emphasized as a crucial determinant for pacing, yet how they affect pacing is not well understood. Therefore, this literature review focussed on exploring one of the most important human-environment interactions in sport competitions: the interaction among competitors. The existing literature regarding the regulation of exercise intensity and the effect of competition on pacing and performance is critically reviewed in this paper. The PubMed, CINAHL and Web of Science electronic databases were searched for studies about pacing in sports and (interpersonal) competition between January 2000 to October 2017, using the following combination of terms: (1) Sports AND (2) Pacing, resulting in 75 included papers. The behaviour of opponents was shown to be an essential determinant in the regulation of exercise intensity, based on both observational (N = 59) and experimental (N = 16) studies. However, adjustment in the pacing response related to other competitors appears to depend on the competitive situation and the current internal state of the athlete. The findings of this review emphasize the importance of what is happening around the athlete for the outcome of the decision-making process involved in pacing, and highlight the necessity to incorporate human-environment interactions into models that attempt to explain the regulation of exercise intensity in sports and exercise. [ABSTRACT FROM AUTHOR]

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: Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Objectives: Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Methods: Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). Results: A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91 %. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100 % of eligible trials (mean 58 %). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across items were 'reach' 34 % (12-60 %); 'adoption-setting level' 1 % (0-2 %); 'adoption-delivery agent level' 7 % (4-10 %); 'implementation' 36 % (13-63 %) and 'maintenance individual level' 1 % (0-4 %). Conclusion: Information on the specific implementation components of team ball sport IPEPs in published studies is scarce. In particular, major reporting gaps exist regarding the adoption and maintenance of these programmes. The RE-AIM MDIC can be successfully applied to reviewing literature in this context. [ABSTRACT FROM AUTHOR]

Background: The high prevalence of injury amongst cricket fast bowlers exposes a great need for research into the risk factors associated with injury. Both extrinsic (environment-related) and intrinsic (person-related) risk factors are likely to be implicated within the high prevalence of non-contact injury amongst fast bowlers in cricket. Identifying and defining the relative importance of these risk factors is necessary in order to optimize injury prevention efforts. Objective: The objective of this review was to assess and summarize the scientific literature related to the extrinsic and intrinsic factors associated with non-contact injury inherent to adult cricket fast bowlers. Method: A systematic review was performed in compliance with the PRISMA guidelines. This review considered both experimental and epidemiological study designs. Studies that included male cricket fast bowlers aged 18 years or above, from all levels of play, evaluating the association between extrinsic/intrinsic factors and injury in fast bowlers were considered for inclusion. The three-step search strategy aimed at finding both published and unpublished studies from all languages. The searched databases included MEDLINE via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Controlled Trials Register in the Cochrane Library, Physiotherapy Evidence Database (PEDro), ProQuest 5000 International, ProQuest Health and Medical Complete, EBSCO MegaFile Premier, Science Direct, SPORTDiscus with Full Text and SCOPUS (prior to 28 April 2015). Initial keywords used were 'cricket', 'pace', 'fast', 'bowler', and 'injury'. Papers which fitted the inclusion criteria were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Results: A total of 16 studies were determined to be suitable for inclusion in this systematic review. The mean critical appraisal score of the papers included in this study was 6.88 (SD 1.15) out of a maximum of 9. The following factors were found to be associated with injury: bowling shoulder internal rotation strength deficit, compromised dynamic balance and lumbar proprioception (joint position sense), the appearance of lumbar posterior element bone stress, degeneration of the lumbar disc on magnetic resonance imaging (MRI), and previous injury. Conflicting results were found for the association of quadratus lumborum (QL) muscle asymmetry with injury. Technique-related factors associated with injury included shoulder-pelvis flexion-extension angle, shoulder counter-rotation, knee angle, and the proportion of side-flexion during bowling. Bowling workload was the only extrinsic factor associated with injury in adult cricket fast bowlers. A high bowling workload (particularly if it represented a sudden upgrade from a lower workload) increased the subsequent risk to sustaining an injury 1, 3 or 4 weeks later. Conclusion: Identifying the factors associated with injury is a crucial step which should precede the development of, and research into, the effectiveness of injury prevention programs. Once identified, risk factors may be included in pre-participation screening tools and injury prevention programs, and may also be incorporated in future research projects. Overall, the current review highlights the clear lack of research on factors associated with non-contact injury, specifically in adult cricket fast bowlers. Systematic review registration number Johanna Briggs Institute Database of Systematic Reviews and Implementation Reports 1387 (Olivier et al., JBI Database Syst Rev Implement Rep 13(1):3-13. doi:, ). [ABSTRACT FROM AUTHOR]

Background: Soccer is the most popular sport worldwide, with a long history and currently more than 500 million active participants, of whom 300 million are registered football club members. On the basis of scientific findings showing positive fitness and health effects of recreational soccer, FIFA (Fédération Internationale de Football Association) introduced the slogan 'Playing football for 45 min twice a week-best prevention of non-communicable diseases' in 2010. Objective: The objective of this paper was to perform a systematic review and meta-analysis of the literature to determine the effects of recreational soccer on maximal oxygen uptake ( $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ ). Methods: Six electronic databases (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) were searched for original research articles. A manual search was performed to cover the areas of recreational soccer, recreational physical activity, recreational small-sided games and $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ using the following key terms, either singly or in combination: recreational small-sided games, recreational football, recreational soccer, street football, street soccer, effect, maximal oxygen uptake, peak oxygen uptake, cardiorespiratory fitness, $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ . The inclusion criteria were divided into four sections: type of study, type of participants, type of interventions and type of outcome measures. Probabilistic magnitude-based inferences for meta-analysed effects were based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations for baseline fitness. Results: Seventeen studies met the inclusion criteria and were included in the systematic review and meta-analysis. Mean differences showed that $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ increased by 3.51 mL/kg/min (95 % CI 3.07-4.15) over a recreational soccer training programme in comparison with other training models. The meta-analysed effects of recreational soccer on $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ compared with the controls of no exercise, continuous running and strength training were most likely largely beneficial [effect size (ES) = 1.46; 95 % confidence interval (CI) 0.91, 2.01; I = 88.35 %], most likely moderately beneficial (ES = 0.68; 95 % CI 0.06, 1.29; I = 69.13 %) and most likely moderately beneficial (ES = 1.08; 95 % CI −0.25, 2.42; I = 71.06 %), respectively. In men and women, the meta-analysed effect was most likely largely beneficial for men (ES = 1.22) and most likely moderately beneficial for women (ES = 0.96) compared with the controls. After 12 weeks of recreational soccer with an intensity of 78-84 % maximal heart rate (HR), healthy untrained men improved their $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ by 8-13 %, while untrained elderly participants improved their $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ by 15-18 %. Soccer training for 12-70 weeks in healthy women resulted in an improvement in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ of 5-16 %. Significant improvements in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ have been observed in patients with diabetes mellitus, hypertension and prostate cancer. Conclusion: Recreational soccer produces large improvements in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ compared to strength training and no exercise, regardless of the age, sex and health status of the participants. Furthermore, recreational soccer is better than continuous endurance running, albeit the additional effect is moderate. This kind of physical activity has great potential for enhancing aerobic fitness, and for preventing and treating non-communicable diseases, and is ideal for addressing lack of motivation, a key component in physical (in)activity. [ABSTRACT FROM AUTHOR]

Background: Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Objective: Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. Methods: We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. Results: One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. Conclusions: Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains. [ABSTRACT FROM AUTHOR]

Background: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. Objective: To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Study Design: Systematic review. Methods: Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Results: Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. 'Reaching the athlete's pre-injury level' and 'being able to perform full sport activities' were the primary content categories used to define RTP. 'Absence of pain', 'similar strength', 'similar flexibility', 'medical staff clearance', and 'functional performance' were core themes to describe criteria to support the RTP decision after hamstring injury. Conclusion: Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete's pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO systematic review registration number: CRD42015016510. [ABSTRACT FROM AUTHOR]

Background: The adolescent 'growth spurt' results in rapid growth of the skeletal system. It has been theorised that absence of a concomitant increase in muscular adaptations in female athletes may predispose them to an increased risk of anterior cruciate ligament injuries. Objectives: To determine if sex differences exist in landing biomechanics and postural stability of adolescent athletes; with a further objective of determining if such differences are propagated during adolescence. Data sources: The following databases were searched: MEDLINE, EMBASE, CINAHL, PEDro, PubMed, SPORTDiscus and Web of Science. Research papers were identified by including search terms for neuromuscular control, lower limb and pubertal development. Inclusion Criteria: Studies were required to be written in English; report on biomechanical analyses; include landing or postural control tasks; be cross-sectional or longitudinal; and include healthy adolescent/pubertal subjects. Study Appraisal and Synthesis Methods: A modified version of the Strengthening the Reporting of Observational studies in Epidemiology checklist was used to rate methodological quality. Meta-analyses were performed when more than one study reported on an outcome measure. Results: Sixteen articles were included. The overall methodological quality of evaluated studies was low (mean score = 5.75/10 points). Adolescent females exhibited increased knee valgus with increasing maturity. There was no consensus on sex differences in postural stability. Conclusions: With increasing maturation, females are characterized by increased knee valgus during landing tasks. To date, no research has longitudinally investigated postural stability development during adolescence in females, despite the importance of postural control training in injury prevention programmes. Therefore, further research on this topic is warranted. [ABSTRACT FROM AUTHOR]

Background: According to the principle of specific adaptations to imposed demands, training induces specific adaptations that predominantly transfer towards performance tasks of similar physiological and/or biomechanical characteristics. Functional performance improvements secondary to resistance and plyometric training have been hypothesized to be force-vector specific; however, the literature pertaining to this matter appears somewhat equivocal. Objective: The objective of the present systematic review with meta-analysis was to synthesize the available body of literature regarding the performance implications of vertically and horizontally oriented resistance- and plyometric training. Data sources: The review drew from the following sources: PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), SPORTDiscus and Google Scholar. Study Eligibility Criteria: To qualify for inclusion, studies had to compare the efficacy of vertically and horizontally oriented resistance and/or plyometric training, with one or multiple outcome measures related to vertical/horizontal jumping, sprinting and/or change of direction speed (CODS). Study Appraisal and Synthesis: For each outcome measure, an inverse-variance random effects model was applied, with between-treatment effects quantified by the standardized mean difference (SMD) and associated 95% confidence- and prediction intervals. Results: Between-treatment effects were of trivial magnitude for vertical jumping (SMD = − 0.04, P = 0.69) and long-distance (≥ 20 m) sprinting (0.03, P = 0.83), whereas small to moderate effects in favor of horizontal training were observed for horizontal jumping (0.25, P = 0.07), short-distance (≤ 10 m) sprinting (0.72, P = 0.01) and CODS (0.31, P = 0.06), although only the short-distance sprint outcome reached statistical significance. Conclusions: In conclusion, our meta-analysis reveals a potential superiority of horizontally oriented training for horizontal jumping, short-distance sprinting and CODS, whereas vertically oriented training is equally efficacious for vertical jumping and long-distance sprinting. From an applied perspective, the present analysis provides an advanced basis for weighting of vertical and horizontal force-vector exercises as an integrated component for optimizing sport-specific performances. The present systematic review with meta-analysis was not a priori registered. [ABSTRACT FROM AUTHOR]

Background: Motor competence is an integral component of the health and performance of youth. Numerous studies support the hypothesis that motor competence interacts with perceived motor competence and physical fitness during childhood to induce positive (e.g. healthy weight status) or negative (e.g. reduced physical activity engagement) trajectories. Yet, while adolescence is a key period of rapid growth and maturation, no systematic reviews and meta-analyses have examined the association between motor competence and physical activity, physical fitness and psychosocial characteristics solely within adolescents. Objectives: This study aimed to (1) analyse the scientific literature evaluating associations between motor competence and physical activity, physical fitness and/or psychosocial characteristics amongst adolescents; (2) evaluate the associations between motor competence and physical activity, physical fitness characteristics and/or psychosocial characteristics amongst adolescents; and (3) investigate the impact of moderator variables (i.e., age, sex, type of motor competence assessment) on the associations. Methods: A systematic search of electronic databases was conducted, followed by a qualitative synthesis of study methods. Random-effects meta-analyses were performed to establish the magnitude and orientation of pooled correlation coefficients between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents, whilst considering potential moderators (i.e., age, sex, type of motor competence assessment). Results: Sixty-one studies were included, totalling 22,256 adolescents. Twenty-seven different assessments of motor competence were used, with 31 studies utilising product-orientated (i.e. outcome) motor competence assessments. Meta-analyses of 43 studies showed that motor competence was positively associated with physical activity (r = 0.20 to 0.26), some physical fitness characteristics (e.g. muscular strength, cardiovascular endurance; r = 0.03 to 0.60) and psychosocial characteristics (r = 0.07 to 0.34), and inversely associated with weight status (r = − 0.36 to − 0.10), speed (r = − 0.31) and agility (r = − 0.37 to 0.41). Associations with flexibility were unclear. Conclusions: The results of this systematic review and meta-analysis support the hypothesised interactions of motor competence with physical activity (positive), physical fitness (positive except for weight status, speed and agility) and psychosocial characteristics (positive) in adolescence. However, methodological approaches vary considerably (e.g. variety of motor competence assessments utilised), with limitations of the current literature including an inadequate assessment of motor competence, a lack of longitudinal observations and a failure to account for biological maturation. Future research assessing associations between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents should include longitudinal observations of a combined motor competence assessment (i.e. process and product) and account for biological maturation. Improved evaluation using these recommendations could provide more accurate data, leading to more targeted interventions to improve adolescents' physical and psychosocial outcomes. Clinical Trial Registration: CRD42021233441 (PROSPERO ID). [ABSTRACT FROM AUTHOR]

Background: Well programmed strength and conditioning training is an indispensable part of the long-term training process for athletes in individual and team sports to improve performance and prevent injuries. Yet, there is a limited number of studies available that examine the effects of resistance training (RT) on muscular fitness and physiological adaptations in elite female athletes. Objectives: This systematic review aimed to summarize recent evidence on the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. Materials and Methods: A systematic literature search was conducted in nine electronic databases (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until March 2022. Key search terms from the MeSH database such as RT and strength training were included and combined using the operators "AND," "OR," and "NOT". The search syntax initially identified 181 records. After screening for titles, abstracts, and full texts, 33 studies remained that examined the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. Results: Twenty-four studies used single-mode RT or plyometric training and nine studies investigated the effects of combined training programs such as resistance with plyometric or agility training, resistance and speed training, and resistance and power training. The training duration lasted at least 4 weeks, but most studies used ~ 12 weeks. Studies were generally classified as 'high-quality' with a mean PEDro score of 6.8 (median 7). Irrespective of the type or combination of RT with other strength-dominated exercise regimens (type of exercise, exercise duration, or intensity), 24 out of 33 studies reported increases in muscle power (e.g., maximal and mean power; effect size [ES]: 0.23 < Cohen's d < 1.83, small to large), strength (e.g., one-repetition-maximum [1RM]; ES: 0.15 < d < 6.80, small to very large), speed (e.g., sprint times; ES: 0.01 < d < 1.26, small to large), and jump performance (e.g., countermovement/squat jump; ES: 0.02 < d < 1.04, small to large). The nine studies that examined the effects of combined training showed significant increases on maximal strength (ES: 0.08 < d < 2.41, small to very large), muscle power (ES: 0.08 < d < 2.41, small to very large), jump and sprint performance (ES: 0.08 < d < 2.41, small to very large). Four out of six studies observed no changes in body mass or percentage of body fat after resistance or plyometric training or combined training (ES: 0.026 < d < 0.492, small to medium). Five out of six studies observed significant changes in muscle morphology (e.g., muscle thickness, muscle fiber cross-sectional area; ES: 0.23 < d < 3.21, small to very large). However, one study did not find any changes in muscle morphology (i.e., muscle thickness, pennation angle; ES: 0.1 < d < 0.19, small). Conclusion: Findings from this systematic review suggest that RT or combined RT with other strength-dominated exercise types leads to significant increases in measures of muscle power, strength, speed, and jump performance in elite female athletes. However, the optimal dosage of programming parameters such as training intensity and duration necessary to induce large effects in measures of muscular fitness and their physiological adaptations remain to be resolved in female elite athletes. [ABSTRACT FROM AUTHOR]

Background: Tennis is a multidirectional high-intensity intermittent sport for male and female individuals played across multiple surfaces. Although several studies have attempted to characterise the physical demands of tennis, a meta-analysis is still lacking. Objective: We aimed to describe and synthesise the physical demands of tennis across the different court surfaces, performance levels and sexes. Methods: PubMed, Embase, CINAHL and SPORTDiscus were searched from inception to 19 April, 2022. A backward citation search was conducted for included articles using Scopus. The PECOS framework was used to formulate eligibility criteria. Population: tennis players of regional, national or international playing levels (juniors and adults). Exposure: singles match play. Comparison: sex (male/female), court surface (hard, clay, grass). Outcome: duration of play, on-court movement and stroke performance. Study design: cross-sectional, longitudinal. Pooled means or mean differences with 95% confidence intervals were calculated. A random-effects meta-analysis with robust variance estimation was performed. The measures of heterogeneity were Cochrane Q and 95% prediction intervals. Subgroup analysis was used for different court surfaces. Results: The literature search generated 7736 references; 64 articles were included for qualitative and 42 for quantitative review. Mean [95% confidence interval] rally duration, strokes per rally and effective playing time on all surfaces were 5.5 s [4.9, 6.3], 4.1 [3.4, 5.0] and 18.6% [15.8, 21.7] for international male players and 6.4 s [5.4, 7.6], 3.9 [2.4, 6.2] and 20% [17.3, 23.3] for international female players. Mean running distances per point, set and match were 9.6 m [7.6, 12.2], 607 m [443, 832] and 2292 m [1767, 2973] (best-of-5) for international male players and 8.2 m [4.4, 15.2], 574 m [373, 883] and 1249 m [767, 2035] for international female players. Mean first- and second-serve speeds were 182 km·h−1 [178, 187] and 149 km·h−1 [135, 164] for international male players and 156 km·h−1 95% confidence interval [151, 161] and 134 km·h−1 [107, 168] for international female players. Conclusions: The findings from this study provide a comprehensive summary of the physical demands of tennis. These results may guide tennis-specific training programmes. We recommend more consistent measuring and reporting of data to enable future meta-analysts to pool meaningful data. Clinical Trial Registration: The protocol for this systematic review was registered a priori at the Open Science Framework (Registration DOI https://doi.org/10.17605/OSF.IO/MDWFY). [ABSTRACT FROM AUTHOR]

Background: The holistic concept of physical literacy assumes that individuals require adequate cognitive (knowledge and understanding), affective (motivation and confidence), and physical (physical competence) qualities to engage in lifelong physical activity behavior. In recent years, the research field has undergone rapid development and has also yielded an increasing number of interventions that aim to translate the theoretical-philosophical ideas into practical endeavors. Objective: The goal of the present pre-registered systematic review was to (a) provide a general overview of evaluation studies on physical literacy interventions and (b) to quantitatively examine the effectiveness of physical literacy interventions. Methods: Drawing on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched a total of 18 databases for physical literacy interventions. Inclusion criteria were English language, publication by November 2021, and interventions using physical literacy as a theoretical underpinning or evaluation outcome. Articles that met these criteria were analyzed with respect to their basic delivery characteristics, study quality, evaluation approach, and main findings. We additionally ran meta-analyses with all non-randomized and randomized controlled trials to examine and compare the effect of these interventions on five outcome categories: (i) physical competence, (ii) motivation and confidence, (iii) knowledge and understanding, (iv) physical activity behavior, and (v) total physical literacy. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to assess the effects on the different categories. Results: The screening process with two independent raters yielded 48 eligible interventions reported in 51 eligible articles. Quantitative evaluations most frequently addressed physical competence (72.2%), followed by motivation and confidence (47.2%), physical activity behavior (41.7%), and knowledge and understanding (33.3%). The controlled intervention studies (n = 24) exerted significant effects on all five physical literacy categories. Despite meaningful heterogeneity across the subgroups, the strongest effects were found for physical competence (SMD 0.90; 95% CI 0.55–1.25), followed by physical literacy aggregate scores (SMD 0.61; 95% CI 0.20–1.01), knowledge and understanding (SMD 0.54; 95% CI 0.30–0.79), physical activity behavior (SMD 0.39; 95% CI 0.23–0.55), and motivation and confidence (SMD 0.30; 95% CI 0.17–0.44). Conclusions: The present study empirically demonstrated the effectiveness of physical literacy interventions on several outcomes relevant for promoting physical activity and health. To better inform current practices, future studies are advised to identify those program characteristics that significantly influence the effectiveness of physical literacy interventions. Clinical Trial Registration: PROSPERO CRD42020188926. [ABSTRACT FROM AUTHOR]

Background: No previous systematic review has examined the physical health benefits of playing golf or caddying. Objective: To establish the influence of golf participation and physical health in golfers and caddies. More specifically, the review intended to explore the domains of cardiovascular, metabolic and musculoskeletal health, in addition to body composition. Design: Systematic review. Data Sources: Electronic literature searches were conducted using PubMed, SPORTDiscus and CINAHL databases in July 2021. Eligibility Criteria: Experimental (randomised controlled trials, quasi-experiment, pre-post) and non-experimental (case–control, cross-sectional, cohort) articles relating to health and golf, written in English and published in peer-reviewed journals. Results: Of the 572 articles initially identified, 109 full-text articles were assessed for eligibility with 23 meeting the inclusion criteria. Sixteen articles were rated 'good 'and seven 'fair'. The influence of golf on physical health was mixed, although various articles displayed improvements in balance, systolic blood pressure (SBP) and diastolic blood pressure (DBP), high density lipoprotein-cholesterol (HDL-C) and the ratio of HDL to total cholesterol within golfers. Caddies observed improvements in bone mineral density (BMD), stiffness index and strength. Most of the findings indicate that playing golf or caddying does not influence body mass index (BMI); however, playing golf can positively change other body composition markers such as lean and fat mass. Conclusion: This review demonstrated that golf participation may be an effective method for improving musculoskeletal and cardiovascular health, although mixed findings were observed. Moreover, limited longitudinal evidence suggests that playing golf can positively impact metabolic health and the influence on body composition may be parameter dependent. Additionally, the initial evidence suggests that caddying may improve musculoskeletal health. However, the studies included were limited by their methodological inconsistencies such as: study design, participant demographics and intervention prescription. PROSPERO Registration: CRD42021267664. [ABSTRACT FROM AUTHOR]

Background: Exposure to increased mechanical loading during physical training can lead to increased tendon stiffness. However, the loading regimen that maximises tendon adaptation and the extent to which adaptation is driven by changes in tendon material properties or tendon geometry is not fully understood. Objective: To determine (1) the effect of mechanical loading on tendon stiffness, modulus and cross-sectional area (CSA); (2) whether adaptations in stiffness are driven primarily by changes in CSA or modulus; (3) the effect of training type and associated loading parameters (relative intensity; localised strain, load duration, load volume and contraction mode) on stiffness, modulus or CSA; and (4) whether the magnitude of adaptation in tendon properties differs between age groups. Methods: Five databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE) were searched for studies detailing load-induced adaptations in tendon morphological, material or mechanical properties. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated and data were pooled using a random effects model to estimate variance. Meta regression was used to examine the moderating effects of changes in tendon CSA and modulus on tendon stiffness. Results: Sixty-one articles met the inclusion criteria. The total number of participants in the included studies was 763. The Achilles tendon (33 studies) and the patella tendon (24 studies) were the most commonly studied regions. Resistance training was the main type of intervention (49 studies). Mechanical loading produced moderate increases in stiffness (standardised mean difference (SMD) 0.74; 95% confidence interval (CI) 0.62–0.86), large increases in modulus (SMD 0.82; 95% CI 0.58–1.07), and small increases in CSA (SMD 0.22; 95% CI 0.12–0.33). Meta-regression revealed that the main moderator of increased stiffness was modulus. Resistance training interventions induced greater increases in modulus than other training types (SMD 0.90; 95% CI 0.65–1.15) and higher strain resistance training protocols induced greater increases in modulus (SMD 0.82; 95% CI 0.44–1.20; p = 0.009) and stiffness (SMD 1.04; 95% CI 0.65–1.43; p = 0.007) than low-strain protocols. The magnitude of stiffness and modulus differences were greater in adult participants. Conclusions: Mechanical loading leads to positive adaptation in lower limb tendon stiffness, modulus and CSA. Studies to date indicate that the main mechanism of increased tendon stiffness due to physical training is increased tendon modulus, and that resistance training performed at high compared to low localised tendon strains is associated with the greatest positive tendon adaptation. PROSPERO registration no.: CRD42019141299. [ABSTRACT FROM AUTHOR]

Background: The extent of concussion injury in the rugby codes for women is unclear. Objective: Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods: We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women's concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results: The pooled analysis match injury incidence of women's concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women's rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women's rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions: Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women's rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences. [ABSTRACT FROM AUTHOR]

Background: Compression garments are regularly worn during exercise to improve physical performance, mitigate fatigue responses, and enhance recovery. However, evidence for their efficacy is varied and the methodological approaches and outcome measures used within the scientific literature are diverse. Objectives: The aim of this scoping review is to provide a comprehensive overview of the effects of compression garments on commonly assessed outcome measures in response to exercise, including: performance, biomechanical, neuromuscular, cardiovascular, cardiorespiratory, muscle damage, thermoregulatory, and perceptual responses. Methods: A systematic search of electronic databases (PubMed, SPORTDiscus, Web of Science and CINAHL Complete) was performed from the earliest record to 27 December, 2020. Results: In total, 183 studies were identified for qualitative analysis with the following breakdown: performance and muscle function outcomes: 115 studies (63%), biomechanical and neuromuscular: 59 (32%), blood and saliva markers: 85 (46%), cardiovascular: 76 (42%), cardiorespiratory: 39 (21%), thermoregulatory: 19 (10%) and perceptual: 98 (54%). Approximately 85% (n = 156) of studies were published between 2010 and 2020. Conclusions: Evidence is equivocal as to whether garments improve physical performance, with little evidence supporting improvements in kinetic or kinematic outcomes. Compression likely reduces muscle oscillatory properties and has a positive effect on sensorimotor systems. Findings suggest potential increases in arterial blood flow; however, it is unlikely that compression garments meaningfully change metabolic responses, blood pressure, heart rate, and cardiorespiratory measures. Compression garments increase localised skin temperature and may reduce perceptions of muscle soreness and pain following exercise; however, rating of perceived exertion during exercise is likely unchanged. It is unlikely that compression garments negatively influence exercise-related outcomes. Future research should assess wearer belief in compression garments, report pressure ranges at multiple sites as well as garment material, and finally examine individual responses and varying compression coverage areas. [ABSTRACT FROM AUTHOR]

Background: Rapid developments in technology have encouraged the use of smartphones in physical activity research, although little is known regarding their effectiveness as measurement and intervention tools. Objective: This study systematically reviewed evidence on smartphones and their viability for measuring and influencing physical activity. Data Sources: Research articles were identified in September 2013 by literature searches in Web of Knowledge, PubMed, PsycINFO, EBSCO, and ScienceDirect. Study Selection: The search was restricted using the terms (physical activity OR exercise OR fitness) AND (smartphone* OR mobile phone* OR cell phone*) AND (measurement OR intervention). Reviewed articles were required to be published in international academic peer-reviewed journals, or in full text from international scientific conferences, and focused on measuring physical activity through smartphone processing data and influencing people to be more active through smartphone applications. Study Appraisal and Synthesis Methods: Two reviewers independently performed the selection of articles and examined titles and abstracts to exclude those out of scope. Data on study characteristics, technologies used to objectively measure physical activity, strategies applied to influence activity; and the main study findings were extracted and reported. Results: A total of 26 articles (with the first published in 2007) met inclusion criteria. All studies were conducted in highly economically advantaged countries; 12 articles focused on special populations (e.g. obese patients). Studies measured physical activity using native mobile features, and/or an external device linked to an application. Measurement accuracy ranged from 52 to 100 % ( n = 10 studies). A total of 17 articles implemented and evaluated an intervention. Smartphone strategies to influence physical activity tended to be ad hoc, rather than theory-based approaches; physical activity profiles, goal setting, real-time feedback, social support networking, and online expert consultation were identified as the most useful strategies to encourage physical activity change. Only five studies assessed physical activity intervention effects; all used step counts as the outcome measure. Four studies (three pre-post and one comparative) reported physical activity increases (12-42 participants, 800-1,104 steps/day, 2 weeks-6 months), and one case-control study reported physical activity maintenance ( n = 200 participants; >10,000 steps/day) over 3 months. Limitations: Smartphone use is a relatively new field of study in physical activity research, and consequently the evidence base is emerging. Conclusions: Few studies identified in this review considered the validity of phone-based assessment of physical activity. Those that did report on measurement properties found average-to-excellent levels of accuracy for different behaviors. The range of novel and engaging intervention strategies used by smartphones, and user perceptions on their usefulness and viability, highlights the potential such technology has for physical activity promotion. However, intervention effects reported in the extant literature are modest at best, and future studies need to utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better explore the physical activity measurement and intervention capabilities of smartphones. [ABSTRACT FROM AUTHOR]

Lateral ankle sprains (LASs) are among the most common sports-related injuries and a high percentage of individuals who sprain their ankle go on to develop chronic ankle instability (CAI). The condition of CAI is often classified as having pain, loss of function, and a restriction of, or failure to, return to levels of previous activity. Historically, uninjured healthy controls are used as a comparison group to study the biomechanical and neuromuscular consequences of CAI. However, this model is not ideal to determine why a portion of the population experiencing an ankle sprain does not recover. A more appropriate comparison may be individuals who had an ankle sprain, and thus the exposure, but did not go on to develop CAI (i.e., copers). Thus, the purpose of this review was to determine the existing discrepancies and common standards in definitions of, terminology used for, and the inclusionary/exclusionary criteria used to describe copers within the CAI literature. Multiple databases were searched by keywords and specific authors. Potential studies were screened independently by both authors. Inclusion criteria consisted of an explicit definition of copers and explicit inclusionary/exclusionary criteria. A total of 21 studies were included in the current study and had four outcomes extracted: (1) the definition of copers; (2) the terminology used; (3) specific inclusionary/exclusionary criteria; and (4) injury characteristics of the copers. Based on the included operational definitions, it is recommend that future operational definitions of copers include three key components: (1) an initial LAS; (2) subsequent lack of CAI symptoms (i.e., no complaints of disability or giving way); and (3) a time since injury component. The term coper was overwhelming used within the existing literature ( n = 15) and is thus recommended to be used in future studies when describing individuals who have suffered an LAS but failed to develop CAI. Minimal inclusionary criteria should consist of three things: (1) an initial LAS severe enough to warrant either the use of a protective device (e.g., ankle brace) for at least 1 week or immobilization and/or non-weight bearing for at least 3 days, or both; (2) a return to at least moderate levels of weight-bearing physical activity for at least 12 months without recurrent injury, episodes of giving way, and/or feelings of instability; and (3) minimal, if any, level of self-reported disability. Acute head and/or lower extremity injuries that occurred ≤3 months prior to testing, a history of ankle fractures and/or surgeries, and the presence of pain (constant or intermittent) should be used as minimal exclusionary criteria in future investigations dealing with copers. Finally, at least seven items should be reported to better contextualize copers across investigations. These items should include the initial mechanism of injury, the presence of mechanical laxity, number of days immobilized and/or non-weight bearing after the initial ankle sprain, time since the latest ankle sprain, percentage of coper participants with a recurrent ankle sprain or giving way episode, current physical activity levels, and whether copers attended formal rehabilitation for their involved ankle. [ABSTRACT FROM AUTHOR]

Background: The number and magnitude of head impacts have been assessed in-vivo using inertial sensors to characterise the exposure in various sports and to help understand their potential relationship to concussion. Objectives: We aimed to provide a comprehensive review of the field of in-vivo sensor acceleration event research in sports via the summary of data collection and processing methods, population demographics and factors contributing to an athlete's exposure to sensor acceleration events. Methods: The systematic search resulted in 185 cohort or cross-sectional studies that recorded sensor acceleration events in-vivo during sport participation. Results: Approximately 5800 participants were studied in 20 sports using 18 devices that included instrumented helmets, headbands, skin patches, mouthguards and earplugs. Female and youth participants were under-represented and ambiguous results were reported for these populations. The number and magnitude of sensor acceleration events were affected by a variety of contributing factors, suggesting sport-specific analyses are needed. For collision sports, being male, being older, and playing in a game (as opposed to a practice), all contributed to being exposed to more sensor acceleration events. Discussion: Several issues were identified across the various sensor technologies, and efforts should focus on harmonising research methods and improving the accuracy of kinematic measurements and impact classification. While the research is more mature for high-school and collegiate male American football players, it is still in its early stages in many other sports and for female and youth populations. The information reported in the summarised work has improved our understanding of the exposure to sport-related head impacts and has enabled the development of prevention strategies, such as rule changes. Conclusions: Head impact research can help improve our understanding of the acute and chronic effects of head impacts on neurological impairments and brain injury. The field is still growing in many sports, but technological improvements and standardisation of processes are needed. [ABSTRACT FROM AUTHOR]

Background: It is important for sport scientists and health professionals to have estimative methods for energy demand during different physical activities. The metabolic equivalent of task (MET) provides a feasible approach for classifying activity intensity as a multiple of the resting metabolic rate (RMR). RMR is generally assumed to be 3.5 mL of oxygen per kilogram of body mass per minute (mL O2 kg−1 min−1), a value that has been criticized and considered to be overestimated in the older adult population. However, there has been no comprehensive effort to review available RMR estimations, equivalent to 1 MET, obtained in the older adult population. Objective: The aim of this review was to examine the existing evidence reporting measured RMR values in the older adult population and to provide descriptive estimates of 1 MET. Methods: A systematic review was conducted by searching PubMed, Web of Science, Scopus, CINAHL, SPORTDiscus, and Cochrane Library, from database inception to July 2021. To this end, original research studies assessing RMR in adults ≥ 60 years old using indirect calorimetry and reporting results in mL O2 kg−1 min−1 were sought. Results: Twenty-three eligible studies were identified, including a total of 1091 participants (426 men). All but two studies reported RMR values lower than the conventional 3.5 mL O2 kg−1 min−1. The overall weighted average 1 MET value obtained from all included studies was 2.7 ± 0.6 mL O2 kg−1 min−1; however, when considering best practice studies, this value was 11% lower (2.4 ± 0.3 mL O2 kg−1 min−1). Conclusion: Based on the results of this systematic review, we would advise against the application of the standard value of 1 MET (3.5 mL O2 kg−1 min−1) in people ≥ 60 years of age and encourage the direct assessment of RMR using indirect calorimetry while adhering to evidence-based best practice recommendations. When this is not possible, assuming an overall value of 2.7 mL O2 kg−1 min−1 might be reasonable. Systematic review registration: International Prospective Register of Systematic Reviews on 30 September 2020, with registration number CRD42020206440. [ABSTRACT FROM AUTHOR]

Background: The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents. Objective: We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI). Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio. Results: A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r = − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents. Conclusion: This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among 'at risk' groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores. [ABSTRACT FROM AUTHOR]

Background: Running is a popular activity practiced worldwide. It is important to understand how running affects joint health to provide recommendations to sports medicine practitioners and runners. Objective: Our aim was to summarize the influence of running on lower limb cartilage morphology and composition using quantitative magnetic resonance imaging (MRI). Methods: Prospective repeated-measures studies evaluating cartilage using MRI before and after running were included. Data sources included Pubmed, Embase, CINAHL, SportDiscus, Web of Science, and Cochrane Central Registry of Controlled Trials. Qualitative analyses considered the number and methodological quality ratings of studies based on the QualSyst tool, and recommendations were based on the strength of evidence (strong, moderate, limited, or very limited). Quantitative analysis involved meta-analyses, for which effect sizes were calculated as Hedge's g standardized mean differences. Results: We included 43 articles, assessing seven outcomes (lesions, volume, thickness, glycosaminoglycan content, and T1ρ, T2, and T2* relaxation times). Nineteen articles were rated as high quality, 24 were rated as moderate quality, and none were rated as low quality. Qualitative analyses suggest that running may cause an immediate reduction in knee cartilage volume, thickness, as well as T1ρ and T2 relaxation times immediately; however, these changes did not persist. Meta-analyses revealed a small and moderate decrease immediately following a single running bout in T2 relaxation time in the medial femur and tibia, respectively. Qualitative analyses indicated that the influence of repeated exposure to running on cartilage morphology and composition was limited. Despite conflicting evidence regarding pre-existing knee cartilage lesions, moderate evidence suggests that running does not lead to the formation of new lesions. Repeated running exposure did not cause changes to foot and ankle cartilage thickness or composition. Conclusions: Changes to lower limb cartilage following running are transient. Immediate changes to cartilage morphology and composition, which likely reflect natural fluid dynamics, do not persist and were generally not significant when pooled statistically. Results suggest that cartilage recovers well from a single running bout and adapts to repeated exposure. Given that moderate evidence indicates that running does not lead to new lesions, future trials should focus on clinical populations, such as those with osteoarthritis. Trial Registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: The relationship between exercise-induced muscle damage (EIMD) indicators and acute training loads (TL) is yet to be reviewed extensively in semi-elite and elite athlete populations. Objectives: The objectives of this systematic review and meta-analysis were threefold: (1) to evaluate studies of EIMD following the initial period of the preseason in semi-elite and elite athletes: (2) to examine acute physiological and performance responses across two periods of the season with similar TL; and (3) to examine acute physiological and performance responses to acute changes in TL during the season. Methods: The CINAHL, PubMed, Scopus, SPORTDiscus and Web of Science databases were systematically searched for studies that investigated: (1) semi-elite or elite athletes in team or individual sports following a periodised training programme; and (2) measured acute responses to training. Studies were excluded if: (1) conducted in animals; (2) non-English language; or (3) a conference abstract, review or case report. The Kmet Quality Scoring of Quantitative Studies tool was used for study appraisal. Synthesis Methods: Data were quantitatively analysed by generating forest plots to report test statistics for statistical significance and inter-trial heterogeneity. Results: Of the included studies (n = 32), athletes experienced greater creatine kinase (CK) concentrations (Z = 4.99, p < 0.00001, I2 = 74%), inflammatory factors and other indirect measures of muscle damage in the initial phase of the preseason period compared to the off-season; there were no changes in CK (Z = 1.43, p = 0.15, I2 = 74%) across two time points of similar TL; and there were concurrent increases in CK with increases in TL (Z = 4.26, p < 0.0001, I2 = 36%) and vice versa (Z = 4.33, p < 0.0001, I2 = 79%).The qualitative analysis identified that the response of inflammatory factors and other indirect measures of muscle damage to changes in load were inconclusive. Limitations: This review included varying age, sex, sports and competition levels. The group level meta-analysis failed to identify within-athlete or position-specific differences across time. Conclusion: Blood biomarkers of EIMD may not differ across periods of similar TL, however can be considered a sensitive monitoring tool for assessing responses following acute TL changes in semi-elite and elite athletes. [ABSTRACT FROM AUTHOR]

Background: Patients with cervicogenic symptoms following a concussion have shown a disproportionate rate of delayed symptom resolution. However, the prevalence of cervicogenic symptoms in the acute stages following a concussion and the percentage of those patients who continue on to suffer delayed symptom resolution is poorly described in the literature. Objectives: To provide a comprehensive report on the clinical prevalence, diagnostic methods, and potential treatment options for cervicogenic symptoms that are elicited during acute and chronic phases following a concussion. Methods: Electronic searches were conducted in PubMed, SPORTDiscus, ICL, CINAHL and PEDro, from inception to May 2020, to identify original research articles on concussion involving cervicogenic symptoms. We assessed each included article for risk of bias, methodological quality, level of evidence and evidence quality. The articles were categorized into three topics: (1) prevalence of post-concussion cervicogenic symptoms; (2) diagnostic testing for cervicogenic symptoms, and (3) treatment techniques for cervicogenic symptoms. Results: The initial review resulted in 1443 abstracts, of which 103 abstracts met the inclusion criteria of our research. After the review of full text, 80 articles were excluded, which resulted in a total of 23 articles for this systematic review. Prevalence of cervicogenic symptoms in the acute stages ranged from 7 to 69% and increased to 90% in patients experiencing persistent post-concussive symptoms. Neck pain at initial evaluation increased risk of developing persistent post-concussive symptoms (PPCS) by 2.58–6.38 times. Patient-reported outcome measures (e.g., Neck Disability Index, Dizziness Handicap Inventory, and Rivermead Post-Concussion Questionnaire) can identify patients with cervicogenic symptoms that should be further differentiated by clinical testing. Lastly, treatment using graded cervical manual therapy has shown to reduce time to symptom resolution and medical clearance. Conclusions: Cervicogenic symptoms are prevalent in the acute and chronic stages following concussion, which if not diagnosed appropriately increase the likelihood of PPCS. Several clinical tests are available to help differentiate cervicogenic symptoms; however, lack of awareness and hesitation by practitioners limits their use. More randomized controlled trials are necessary to evaluate the effectiveness of cervical specific treatment programs for PPCS. [ABSTRACT FROM AUTHOR]

Background: Netball is the one of the most popular women's sports in the world. Since gaining professional status in 2008 there has been a rapid growth in research in the applied sports science and medicine of the sport. A scoping review of the area would provide practitioners and researchers with an overview of the current scientific literature to support on-court performance, player welfare and reduce injury. Objective: The primary objective was to identify the current research on the applied sports science and medicine of netball. Additionally, the article provides a brief summary of the research in each topic of sports science and medicine in netball and identifies gaps in the current research. Methods: Systematic searches of PubMed, SPORTDiscus, MEDLINE and CINAHL were undertaken from earliest record to Dec 2020 and reference lists were manually searched. The PRISMA-ScR protocol was followed. Studies were eligible for inclusion if they investigated netball as a sport or the applied sport science and medicine of netball athletes. Results: 962 studies were identified in the initial search, 150 of which met the inclusion criteria. Injury was the most highly investigated sport science and medicine topic (n = 45), followed by physical qualities (n = 37), match characteristics (n = 24), biomechanics (n = 15), psychology (n = 13), fatigue and recovery (n = 9), training load (n = 4) and nutrition (n = 3). A range of cohorts were used from school to elite and international standards. All cohorts were female netballers, except for one study. A rapid growth in studies over recent years was demonstrated with 65% of studies published in the last decade. There still remains gaps in the literature, with a low evidence base for nutrition, training load and fatigue and recovery. Conclusion: This scoping review summarises the current evidence base and key findings that can be used in practice to enhance the applied sport science and medical support to netball athletes across a range of playing standards, and support the growth of the sport. It is evident that netball as a sport is still under-researched. [ABSTRACT FROM AUTHOR]

Background: Short-sprint (≤ 20 m) performance is an important quality for success in the football codes. Therefore, developing an evidence base for understanding training methods to enhance short-sprint performance is key for practitioners. However, current systematic reviews are limited by (1) a lack of focus on football code athletes, (2) a lack of consideration of all training modalities and (3) a failure to account for the normal training practices undertaken by intervention groups within their analysis. Therefore, this review aimed to (1) conduct a systematic review of the scientific literature evaluating training interventions upon short-sprint performance within football code athletes, (2) undertake a meta-analysis to assess the magnitude of change of sport-sprint performance following training interventions and (3) identify how moderator variables affect the training response. Methods: A systematic search of electronic databases was conducted. A random-effects meta-analysis was performed to establish standardised mean difference with 95% confidence intervals. This identified the magnitude and direction of the individual training effects of intervention subgroups (primary, secondary, combined-specific, tertiary and combined training methods) on short-sprint performance while considering moderator variables (i.e., football code, sex, age, playing standard, phase of season). Results: 121 studies met the inclusion criteria, totalling 3419 athletes. Significant improvements (small-large) were found between pre- and post-training in short-sprint performance for the combined, secondary, tertiary and combined-specific training methods. No significant effect was found for primary or sport only training. No individual mode was found to be the most effective. Between-subgroup analysis identified that football code, age, playing standard and phase of season all moderated the overall magnitude of training effects. Conclusions: This review provides the largest systematic review and meta-analysis of short-sprint performance development methods and the only one to assess football code athletes exclusively. Practitioners can apply combined, secondary and tertiary training methods to improve short-sprint performance within football code athletes. The application of sport only and primary methods does not appear to improve short-sprint performance. Regardless of the population characteristics, short-sprint performance can be enhanced by increasing either or both the magnitude and the orientation of force an athlete can generate in the sprinting action. Trial Registration: OSF registration https://osf.io/kshqn/. [ABSTRACT FROM AUTHOR]

Background: The acute effects of resistance training (RT) set structure alteration are well established; however, less is known about their effects on chronic training adaptations. Objective: The aim of this systematic review and meta-analysis was to synthesise the available evidence on the effectiveness of traditional (TS), cluster (CS) and rest redistribution (RR) set structures in promoting chronic RT adaptations, and provide an overview of the factors which might differentially influence the magnitude of specific training adaptations between set structure types. Methods: This review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines encompassing the literature search of five databases. Studies in English that compared muscular strength, endurance, and/or hypertrophy adaptations, as well as vertical jump performance, velocity and power at submaximal loads and shifts in the slopes of force–velocity profiles between TS and CS or RR set structures (i.e., alternative set structures) were included. Risk of bias assessment was performed using a modified Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Random-effects meta-analyses and meta-regressions were performed where possible. Results: 17 studies met the inclusion criteria, none had more than one risk of bias item assessed as high risk. Pooled results revealed that none of the set structures were more effective at inducing strength (standardised mean difference (SMD) = − 0.06) or hypertrophy (SMD = − 0.03). TS were more effective at improving muscular endurance compared to alternative set structures (SMD = − 0.38), whereas alternative set structures tended to be more effective for vertical jump performance gains (SMD = 0.13), but this effect was not statistically significant (p = 0.190). Greater velocity and power outputs at submaximal loads (SMD = 0.18) were observed when using alternative set structures compared to TS. In addition, alternative set structures promoted greater shifts of the slope of force–velocity profiles towards more velocity dominant profiles compared to TS (SMD = 0.28). Sub-group analyses controlling for each alternative set structure independently showed mixed results likely caused by the relatively small number of studies available for some outcomes. Conclusion: Modifying TS to an alternative set structure (CS or RR) has a negligible impact on strength and hypertrophy. Using CS and RR can lead to greater vertical jump performance, velocity and power at submaximal loads and shifts to more velocity dominant force–velocity profiles compared to training using TS. However, TS may provide more favourable effects on muscle endurance when compared to CS and RR. These findings demonstrate that altering TS to alternative set structures may influence the magnitude of specific muscular adaptations indicating set structure manipulation is an important consideration for RT program design. Protocol registration: The original protocol was prospectively registered (CRD42019138954) with the PROSPERO (International Prospective Register of Systematic Reviews). [ABSTRACT FROM AUTHOR]

Background: Stretching a muscle not only increases the extensibility or range of motion (ROM) of the stretched muscle or joint but there is growing evidence of increased ROM of contralateral and other non-local muscles and joints. Objective: The objective of this meta-analysis was to quantify crossover or non-local changes in passive ROM following an acute bout of unilateral stretching and to examine potential dose–response relations. Methods: Eleven studies involving 14 independent measures met the inclusion criteria. The meta-analysis included moderating variables such as sex, trained state, stretching intensity and duration. Results: The analysis revealed that unilateral passive static stretching induced moderate magnitude (standard mean difference within studies: SMD: 0.86) increases in passive ROM with non-local, non-stretched joints. Moderating variables such as sex, trained state, stretching intensity, and duration did not moderate the results. Although stretching duration did not present statistically significant differences, greater than 240-s of stretching (SMD: 1.24) exhibited large magnitude increases in non-local ROM compared to moderate magnitude improvements with shorter (< 120-s: SMD: 0.72) durations of stretching. Conclusion: Passive static stretching of one muscle group can induce moderate magnitude, global increases in ROM. Stretching durations greater than 240 s may have larger effects compared with shorter stretching durations. [ABSTRACT FROM AUTHOR]

Background: Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies. Objective: The primary aim of this review was to describe the epidemiology of injury and illness among trail runners. Methods: Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool. Results: Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6–4285.0 injuries per 1000 h of running and 65.0–6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported. Conclusion: Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness. [ABSTRACT FROM AUTHOR]

Background: The importance of achieving an adequate amount of sleep to optimize health and athletic performance is well recognized. Yet, a systematic evidence compilation of the risk for sport-related injury in adult athletic populations due to poor sleep does not exist. Objective: To examine the association between poor sleep and sport and physical training-related injuries in adult athletic populations. Data Sources: Electronic databases were searched using keywords relevant to sleep quantity and quality, and musculoskeletal injury and sport-related concussion (SRC). Eligibility Criteria for Selecting Studies: Studies were included in this systematic review if they were comprised of adult athletic populations, reported measures of sleep quantity or quality, followed participants prospectively for injury, and reported an association between sleep and incidence of sport or physical training-related injury. Study Appraisal: The methodological quality of each study was assessed using the Newcastle–Ottawa Scale for Cohort Studies. Results: From our review of 12 prospective cohort studies, we found limited evidence supporting an association between poor sleep and injury in adult athletic populations. Specifically, there is (a) insufficient evidence supporting the associations between poor sleep and increased risk of injury in specific groups of athletic adults, including professional or elite athletes, collegiate athletes, elite or collegiate dancers, and endurance sport athletes; and (b) limited evidence of an association between poor sleep and increased risk of SRC in collegiate athletes. Conclusions: The current evidence does not support poor sleep as an independent risk factor for increased risk of sport or physical training-related injuries in adult athletic populations. Given the methodological heterogeneity and limitations across previous studies, more prospective studies are required to determine the association between sleep and injury in this population. [ABSTRACT FROM AUTHOR]

Background: Identifying risk factors for lower limb injury is an important step in developing injury risk reduction training and testing for player monitoring. Female athletes are distinct from male athletes, warranting separate investigation into risk factors. Objective: To systematically review the literature and synthesise the evidence for intrinsic risk factors for lower limb injury in female team field and court sports. Methods: Five online databases were searched from inception to April 2020. To be eligible for inclusion, studies were required to be a prospective study presenting intrinsic risk factors for lower limb injury in female team field or court sport athletes. Risk of bias was assessed using the Quality of Prognosis Studies tool. Results: Sixty-nine studies, capturing 2902 lower limb injuries in 14,492 female athletes, and analysing 80 distinct factors met the inclusion criteria. Risk factors for any lower limb injury included greater body mass (standardised mean difference [SMD] = 0.24, 95% confidence interval [95% CI] 0.18–0.29), greater body mass index (BMI) (SMD = 0.22, 95% CI 0.05–040), older age (SMD = 0.20, 95% CI 0.09–0.31), greater star excursion balance test (SEBT) anterior reach distance (SMD = 0.18, 95% CI 0.12–0.24), and smaller single-leg hop distance (SMD = − 0.09, 95% CI − 0.12 to − 0.06). Lower knee injury and osteoarthritis outcome score (KOOS) increased the risk of knee injury. Anterior cruciate ligament (ACL) injury risk factors included prior ACL injury (odds ratio [OR] = 3.94, 95% CI 2.07–7.50), greater double-leg postural sway (SMD = 0.58, 95% CI 0.02–1.15), and greater body mass (SMD = 0.25, 95% CI 0.12–0.39). Ankle injury risk factors included smaller SEBT anterior reach distance (SMD = − 0.13, 95% CI − 0.14 to − 0.13), greater single-leg hop distance asymmetry (OR = 3.67, 95% CI 1.42–9.45), and slower agility course time (OR = 0.20, 95% CI 0.05–0.88). Remaining factors were not associated with injury or had conflicting evidence. Conclusion: Prior injury, older age, greater body mass, and greater BMI are risk factors for lower limb injury in female athletes. Limited evidence showed an association between KOOS, SEBT anterior reach, single-leg hop distance and asymmetry, double-leg postural sway, agility, and lower limb injury. PROSPERO ID: CRD42020171973. [ABSTRACT FROM AUTHOR]

Introduction: Perineal pressure associated with bicycle riding is the cause of several genitourinary pathologies, most notably Alcock's syndrome and subsequent perineal numbness. The possible link between cycling-induced perineal numbness and erectile dysfunction makes the development of strategies for perineal protection in bicycle users critical. Objective: To assess the effectiveness of strategies for reducing the impact of cycling on the perineum in healthy males. Methods: We have conducted a systematic review and a meta-analysis of studies examining various means of reducing the impact of cycling on the perineum under the PRISMA guidelines. Results: Out of 2217 screened studies, 22 met our inclusion criteria, and 6 qualified for meta-analysis. The strategies included various designs of saddles, changes in the cycling position, seat shock absorber, shorts with different padding, using the recumbent bike. Using the no-nose saddle and recumbent bike resulted in a significant reduction of perineal pressure and higher penile oxygen pressure compared with a standard saddle. Indirect evidence supports the protective effect of standing on the pedals every few minutes during cycling. More evidence is needed to support—or dismiss—other strategies. Conclusions: Current evidence supports the use of no-nose saddles as a mean to reduce the negative impact of cycling on the perineum in healthy males at the cost of worse stability and increase of posterior seat pressure. Standing on the pedals every ten minutes might be an effective and potentially widely applicable strategy. The use of a recumbent bike appears to protect the perineum, but several concerns prevent its widespread use. [ABSTRACT FROM AUTHOR]

Background: The alteration of individual sets during resistance training (RT) is often used to allow for greater velocity and power outputs, reduce metabolite accumulation such as lactate and also reduce perceived exertion which can ultimately affect the resultant training adaptations. However, there are inconsistencies in the current body of evidence regarding the magnitude of the effects of alternative set structures (i.e., cluster sets and rest redistribution) on these acute mechanical, metabolic, and perceptual responses during and after RT. Objective: This study aimed to systematically review and meta-analyse current evidence on the differences between traditional and alternative (cluster and rest redistribution) set structures on acute mechanical, metabolic, and perceptual responses during and after RT, and to discuss potential reasons for the disparities noted in the literature. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and five databases were searched until June 2019. Studies were included when they were written in English and compared at least one acute mechanical, metabolic, or perceptual response between traditional, cluster or traditional and rest redistribution set structures in healthy adults. Random-effects meta-analyses and meta-regressions were performed where possible. Results: Thirty-two studies were included. Pooled results revealed that alternative set structures allowed for greater absolute mean [standardized mean difference (SMD) = 0.60] and peak velocity (SMD = 0.41), and mean (SMD = 0.33) and peak power (SMD = 0.38) during RT. In addition, alternative set structures were also highly effective at mitigating a decline in velocity and power variables during (SMD = 0.83–1.97) and after RT (SMD = 0.58) as well as reducing lactate accumulation (SMD = 1.61) and perceived exertion (SMD = 0.81). These effects of alternative set structures on velocity and power decline and maintenance during RT were considerably larger than for absolute velocity and power variables. Sub-group analyses controlling for each alternative set structure independently showed that cluster sets were generally more effective than rest redistribution in alleviating mechanical, metabolic, and perceptual markers of fatigue. Conclusion: Alternative set structures can reduce mechanical fatigue, perceptual exertion, and metabolic stress during and after RT. However, fundamental differences in the amount of total rest time results in cluster sets generally being more effective than rest redistribution in alleviating fatigue-induced changes during RT, which highlights the importance of classifying them independently in research and in practice. Additionally, absolute values (i.e., mean session velocity or power), as well as decline and maintenance of the mechanical outcomes during RT, and residual mechanical fatigue after RT, are all affected differently by alternative set structures, suggesting that these variables may provide distinct information that can inform future training decisions. Protocol Registration: The original protocol was prospectively registered (CRD42019138954) with the PROSPERO (International Prospective Register of Systematic Reviews). [ABSTRACT FROM AUTHOR]

Background: Effects of resistance training on muscle strength and hypertrophy are well established in adults and younger elderly. However, less is currently known about these effects in the very elderly (i.e., 75 years of age and older). Objective: To examine the effects of resistance training on muscle size and strength in very elderly individuals. Methods: Randomized controlled studies that explored the effects of resistance training in very elderly on muscle strength, handgrip strength, whole-muscle hypertrophy, and/or muscle fiber hypertrophy were included in the review. Meta-analyses of effect sizes (ESs) were used to analyze the data. Results: Twenty-two studies were included in the review. The meta-analysis found a significant effect of resistance training on muscle strength in the very elderly [difference in ES = 0.97; 95% confidence interval (CI) 0.50, 1.44; p = 0.001]. In a subgroup analysis that included only the oldest-old participants (80 + years of age), there was a significant effect of resistance training on muscle strength (difference in ES = 1.28; 95% CI 0.28, 2.29; p = 0.020). For handgrip strength, we found no significant difference between resistance training and control groups (difference in ES = 0.26; 95% CI − 0.02, 0.54; p = 0.064). For whole-muscle hypertrophy, there was a significant effect of resistance training in the very elderly (difference in ES = 0 30; 95% CI 0.10, 0.50; p = 0.013). We found no significant difference in muscle fiber hypertrophy between resistance training and control groups (difference in ES = 0.33; 95% CI − 0.67, 1.33; p = 0.266). There were minimal reports of adverse events associated with the training programs in the included studies. Conclusions: We found that very elderly can increase muscle strength and muscle size by participating in resistance training programs. Resistance training was found to be an effective way to improve muscle strength even among the oldest-old. [ABSTRACT FROM AUTHOR]

Background: Reaction time (RT) deficits are reported following concussion, but it is unknown when these deficits normalize to pre-injury status. It is also unclear how factors such as RT measurement technique and participant characteristics influence post-concussion RT. Objective: The purpose of this systematic review and meta-analysis was to (1) characterize acute post-concussion (0–3 days) RT impairments, (2) examine RT recovery over time, and (3) explore moderating factors related to acute RT impairment following concussion. Methods: Database searches (PubMed, CINAHL, EBSCOhost) were conducted according to PRISMA guidelines for articles published in English from January 2002 to March 2019. Studies compared baseline-to-post-injury RT within individuals (within-subject) and/or RT in concussed individuals to non-concussed controls (between-subject). Sixty studies met inclusion criteria, reporting on a total of 9688 participants with 214 discrete RT effects (Hedges' d; between-subject: N = 29, k = 129; within-subject: N = 42, k = 85). Of the 214 effects, 93 occurred in the acute (0–3 days) post-injury timeframe (k = 47 between-subject). Numerous demographic [sex, age, concussion history, population type (athlete, military, and general population), athlete level (high school, college), and sport], and method-based (RT test and measure type, computerized neurocognitive testing platform, concussion definition, and time post-injury) moderators were examined for mean effect influence. Mixed-effects multi-level modeling with restricted-maximum-likelihood estimation was used to account for nested effects and high heterogeneity for the pooled effect size (D+). Results: Significant medium-magnitude RT deficits were observed acutely for between- (D+ = − 0.7279, 95% CI − 0.9919, − 0.4639, I2 = 88.66, p < 0.0001) and within-subject (D+ = − 0.7472, 95% CI − 0.9089, − 0.5855, I2 = 89.21, p < 0.0001) effect models. RT deficits were present at the sub-acute and intermediate-term timeframes for between-subject effects (sub-acute: D+ = − 0.5655, 95% CI − 0.6958, − 0.4352, p < 0.0001; intermediate-term: D+ = − 0.3219, 95% CI − 0.5988, − 0.0450, p = 0.0245). No significant RT mean effect was observed for the between-subject model at the long-term timeframe, indicating RT recovery among concussed participants relative to controls (D+ = 0.3505, 95% CI − 0.4787, 1.1797, p = 0.3639). Sex was a significant moderator for between-subject effects, with every 1% male sample size increase demonstrating − 0.0171 (95% CI − 0.0312, − 0.0029, p = 0.0193) larger RT deficits. Within-subject effect models resulted in RT measure type (simple: [D+ = − 0.9826] vs. mixed: [D+ = − 0.6557], p = 0.0438) and computerized neurocognitive testing platforms (ANAM: [D+ = − 0.3735] vs. HeadMinder CRI: [D+ = − 1.4799] vs. ImPACT: [D+ = − 0.6749], p = 0.0004) having significantly different RT-deficit magnitudes. No other moderators produced significantly different RT-deficit magnitudes (between-subject: [p ≥ 0.0763], within-subject: [p ≥ 0.1723]). Conclusions: Robust RT deficits were observed acutely following concussion. Minimal magnitude differences were noted when comparing between- and within-subject effects, suggesting that pre-injury baselines may not add clinical value in determining post-injury RT impairment. RT deficits persisted up till the intermediate-term (21–59 days post-injury) timeframe and indicate lingering deficits exist. Mean effect size differences were observed between RT measure types and computerized neurocognitive testing platforms; however, all categories displayed negative effects consistent with impaired RT following concussion. Clinical interpretation suggests that measuring RT post-concussion is more important than considering the RT method employed so long as reliable and valid tools are used. PROSPERO Registration #CRD42019119323. [ABSTRACT FROM AUTHOR]

Background: High volume power training (HVPT) involves high volumes of high-velocity resistance training, with the aim to improve repeated high-intensity efforts (RHIEs). Repeat power ability (RPA) is the ability to repeatedly produce maximal or near maximal efforts. Assessments of RPA using external loading may determine the ability to perform repeat RHIEs typical of many sports and, therefore, provide useful information on the effectiveness of training. Objectives: (1) Identify the different HVPT protocols; (2) examine the acute responses and chronic adaptations to different HVPT protocols; (3) identify different lower body RPA assessment protocols and highlight similarities, differences and potential limitations between each protocol, and; (4) describe the reliability and validity of RPA assessments. Methods: An electronic search was performed using SPORTDiscus, PubMed, CINAHL and Embase for studies utilising HVPT protocols and assessments of RPA. Eligible studies included peer-reviewed journal articles published in English. Results: Twenty studies met the inclusion criteria of the final review. Of the eight longitudinal studies, three were rated as fair and five were rated as poor methodological quality, respectively. In contrast, all 12 cross-sectional studies were considered to have a low risk of bias. Preliminary evidence suggests that HVPT can enhance RHIE, RPA, anaerobic capacity, anaerobic power and aerobic performance. HVPT generally consists of 2–3 sessions per week, utilising loads of 30–40% 1 repetition maximum (RM), for 3–5 sets of 10–20 repetitions, with inter-set rest periods of 2–3 min. RPA assessments can be valid and reliable and may provide useful information on an athlete's ability to perform RHIE and the success of HVPT programmes. Conclusions: HVPT can be used to improve a number of physical qualities including RPA and RHIE; while a variety of RPA assessments provide valid and reliable information regarding the athlete's ability to perform RHIEs. Considering the heterogeneity in the HVPT protocols currently used and the relatively low volume and quality of longitudinal publications in this area, further studies are needed to identify the effects of a variety of HVPT methods on RPA, RHIE and other performance outcomes and to identify the most valid and reliable RPA outcomes to use in such studies. [ABSTRACT FROM AUTHOR]

Background: Resistance-training causes changes in the central nervous system (CNS); however, the sites of these adaptations remain unclear. Objective: To determine sites of neural adaptation to resistance-training by conducting a systematic review and meta-analysis on the cortical and subcortical responses to resistance-training. Methods: Evidence from randomized controlled trials (RCTs) that focused on neural adaptations to resistance-training was pooled to assess effect estimates for changes in strength, cortical, and subcortical adaptations. Results: The magnitude of strength gain in 30 RCTs (n = 623) reported a standardised mean difference (SMD) of 0.67 (95% CI 0.41, 0.94; P < 0.001) that measured at least one cortical/subcortical neural adaptation which included: motor-evoked potentials (MEP; 19 studies); silent period (SP; 7 studies); short-interval intracortical inhibition (SICI; 7 studies); cervicomedullary evoked potentials (CMEP; 1 study); transcranial magnetic stimulation voluntary activation (VATMS; 2 studies); H-reflex (10 studies); and V-wave amplitudes (5 studies). The MEP amplitude during voluntary contraction was greater following resistance-training (SMD 0.55; 95% CI 0.27, 0.84; P < 0.001, n = 271), but remained unchanged during rest (SMD 0.49; 95% CI -0.68, 1.66; P = 0.41, n = 114). Both SP (SMD 0.65; 95% CI 0.29, 1.01; P < 0.001, n = 184) and active SICI (SMD 0.68; 95% CI 0.14, 1.23; P = 0.01, n = 102) decreased, but resting SICI remained unchanged (SMD 0.26; 95% CI − 0.29, 0.81; P = 0.35, n = 52). Resistance-training improved neural drive as measured by V-wave amplitude (SMD 0.62; 95% CI 0.14, 1.10; P = 0.01, n = 101), but H-reflex at rest (SMD 0.16; 95% CI − 0.36, 0.68; P = 0.56; n = 57), during contraction (SMD 0.15; 95% CI − 0.18, 0.48; P = 0.38, n = 142) and VATMS (MD 1.41; 95% CI − 4.37, 7.20; P = 0.63, n = 44) remained unchanged. Conclusion: There are subtle neural adaptations following resistance-training involving both cortical and subcortical adaptations that act to increase motoneurone activation and likely contribute to the training-related increase in muscle strength. [ABSTRACT FROM AUTHOR]

Background: Temporal spatial parameters during running are measurable outside of clinical and laboratory environments using wearable technology. Data from wearable technology may be useful for injury prevention, however the association of temporal spatial parameters with overuse injury in runners remains unclear. Objective: To identify the association between overuse injury and temporal spatial parameters during running. Data Sources: Electronic databases were searched using keywords related to temporal spatial parameters, running, and overuse injury, and authors' personal article collections through hand search. Eligibility Criteria for Selecting Studies: Articles included in this systematic review contained original data, and analytically compared at least one temporal spatial parameter (e.g. cadence) between uninjured and retrospectively or prospectively injured groups of runners. Articles were excluded from this review if they did not meet these criteria or measured temporal spatial parameters via survey. Study Appraisal and Synthesis Method: The internal validity of each article was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Meta-analyses were conducted for temporal spatial parameters if data existed from at least three separate cohorts of the same prospective or retrospective design. Data were pooled and analyzed using an inverse variance fixed-effect model. Results: Thirteen articles which tested a total of 24 temporal spatial parameters during running were included in the review. Meta-analyses were conducted on four temporal spatial parameters using data from eleven retrospective studies. Healthy runners and those with a history of overuse injury had a similar average stride time (mean difference: 0.00 s, 95% CI − 0.01 to 0.01 s), contact time (mean difference: 0.00 s, 95% CI 0.00 to 0.01 s), cadence (mean difference: 0.3 steps per minute (spm), 95% CI − 1.8 to 2.5 spm), and stride length (mean difference 0.00 m, 95% CI − 0.05 to 0.05 m) during running. Limitations: Data pooled for meta-analyses were limited to retrospective design studies. Studies included in the systematic review had low methodological consistency. Conclusion: Based on pooled results from multiple studies, stride time, contact time, cadence, and stride length averages are not distinguishable between runners either with or without a history of overuse injury. More prospective studies are required to determine the association of temporal spatial parameters with overuse injury development in runners. Systematic Review Registration Registry and Number: CRD42018112290. [ABSTRACT FROM AUTHOR]

Background: At a young age, high-level youth footballers enter structured practice where they engage in regular training and matches. The academy system is considered fundamental to a young footballer's tactical, technical and physical development. Yet, with regular training and matches, high-level youth footballers may be exposed to the risk of injury. Objective: This systematic review analyses and summarises published scientific information on high-level youth football injury characteristics and calculates the risk of them sustaining an injury over the course of a typical season. Methods: The search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of the 1346 studies found, 23 fulfilled the inclusion criteria. Results: Quality assurance scores for the selected research articles ranged between two and five out of eight. A high degree of heterogeneity between studies was observed. The probability of sustaining a time-loss injury during a high-level youth season ranged between < 1% and 96% for under 9- to under 16-year age groups and 50% and 91% for under 18- to under 21-year age groups. Pooled estimates for total (training and match) incidence per 1000 h was 5.8 for youth players aged under 9 to under 21 years, 7.9 for older players (under 17–under 21 years) and 3.7 for younger aged players (under 9–under 16 years). Training injury incidence rate ranged from 0.69 to 7.9 per 1000 h for all age groups in youth football. Match injury incidence rate for high-level youth players ranged from 0.4 to 80.0 per 1000 h. Close to one-fifth (18%) of all high-level youth football injuries were classified as severe and required > 28 days recovery time. Muscle strain injury accounted for 37% of all injuries reported in youth football. High probabilities (> 90%) of sustaining a time-loss injury over one typical high-level football season were found. Conclusion: High-level youth players lose large portions of the seasonal development to injury, with players seemingly suffering long absences from training and matches, consequently affecting health and well-being and possibly burdening club/parental finances and healthcare systems. [ABSTRACT FROM AUTHOR]

Background: Sedentary behaviour is a risk factor for type 2 diabetes and cardiovascular disease. Objectives: The aims of this work were to systematically review the effects of workplace sedentary behaviour reduction interventions on cardiometabolic risk markers (primary aim) and identify the active behaviour change techniques (BCTs) by which these interventions work (secondary aim). Methods: A systematic search of 11 databases for articles published up to 12 April 2019 yielded a total of 4255 unique titles, with 29 articles being identified for inclusion. Interventions were rated as very promising, quite promising or non-promising based on their effects on cardiometabolic risk markers compared with baseline and/or a comparison arm. Interventions were coded for BCTs used. To assess the relative effectiveness of BCTs, a promise ratio was calculated as the frequency of a BCT appearing in all promising interventions divided by its frequency of appearance in all non-promising interventions. Results: A narrative synthesis included 29 published studies of varying study design and comprised of 30 interventions. Risk of bias was high for blinding and allocation concealment, moderate for random sequence generation, and low for outcome assessment. Nine interventions were very promising, 11 were quite promising, 10 were non-promising, and 10 active control groups did not experience cardiometabolic changes. Significant sedentary behaviour reductions were present in all but five studies where cardiometabolic risk markers improved. The BCTs of social comparison, problem solving, demonstration of the behaviour, goal setting (behaviour), behaviour substitution, and habit reversal, demonstrated moderate to high promise ratios. Conclusions: Workplace interventions show promise for improving cardiometabolic risk markers. The BCTs with the greatest promise of cardiometabolic risk marker improvements included social comparison, those related to individual habits, and behaviour goals. Registration: This systematic review was prospectively registered in PROSPERO (CRD42017072427). [ABSTRACT FROM AUTHOR]

Background: Evidence for the efficacy of low-volume high-intensity interval training (HIIT) for the modulation of body composition is unclear. Objectives: We examined the effect of low-volume HIIT versus a non-exercising control and moderate-intensity continuous training (MICT) on body composition and cardiorespiratory fitness in normal weight, overweight and obese adults. We evaluated the impact of low-volume HIIT (HIIT interventions where the total amount of exercise performed during training was ≤ 500 metabolic equivalent minutes per week [MET-min/week]) compared to a non-exercising control and MICT. Methods: A database search was conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science, SPORTDiscus and Scopus from the earliest record to June 2019 for studies (randomised controlled trials and non-randomised controlled trials) with exercise training interventions with a minimum 4-week duration. Meta-analyses were conducted for between-group (low-volume HIIT vs. non-exercising control and low-volume HIIT vs. MICT) comparisons for change in total body fat mass (kg), body fat percentage (%), lean body mass (kg) and cardiorespiratory fitness. Results: From 11,485 relevant records, 47 studies were included. No difference was found between low-volume HIIT and a non-exercising control on total body fat mass (kg) (effect size [ES]: − 0.129, 95% confidence interval [CI] − 0.468 to 0.210; p = 0.455), body fat (%) (ES: − 0.063, 95% CI − 0.383 to 0.257; p = 0.700) and lean body mass (kg) (ES: 0.050, 95% CI − 0.250 to 0.351; p = 0.744), or between low-volume HIIT and MICT on total body fat mass (kg) (ES: − 0.021, 95% CI − 0.272 to 0.231; p = 0.872), body fat (%) (ES: 0.005, 95% CI − 0.294 to 0.304; p = 0.974) and lean body mass (kg) (ES: 0.030, 95% CI − 0.167 to 0.266; p = 0.768). However, low-volume HIIT significantly improved cardiorespiratory fitness compared with a non-exercising control (p < 0.001) and MICT (p = 0.017). Conclusion: These data suggest that low-volume HIIT is inefficient for the modulation of total body fat mass or total body fat percentage in comparison with a non-exercise control and MICT. A novel finding of our meta-analysis was that there appears to be no significant effect of low-volume HIIT on lean body mass when compared with a non-exercising control, and while most studies tended to favour improvement in lean body mass with low-volume HIIT versus MICT, this was not significant. However, despite its lower training volume, low-volume HIIT induces greater improvements in cardiorespiratory fitness than a non-exercising control and MICT in normal weight, overweight and obese adults. Low-volume HIIT, therefore, appears to be a time-efficient treatment for increasing fitness, but not for the improvement of body composition. [ABSTRACT FROM AUTHOR]