Search

Hamstring injuries constitute the single largest cause of lost playing time in professional football. While restoring high-speed running ability is paramount for rehabilitation from these injuries, little evidence exists regarding the extent of return to sport running performance after hamstring injury in football. We examined medical and match performance data available from a sample of 38 professional soccer players competing in the Qatar Stars League (N = 1426 observations) to describe high-speed running performance during match-play prior and subsequent to a hamstring strain injury. Multivariable-adjusted random-effects generalized additive models estimated post- versus pre-hamstring injury differences in maximal speed (km/h), high-speed running (>20 km/h), and sprinting (>25 km/h) distance. Mean effects and uncertainty (95% confidence interval, CI) were interpreted against the estimated random match-to-match variability in maximal sprinting speed, high-speed running distance, and sprinting running distance of ±1.67 km/h (95% CI, 1.62-1.72 km/h), ±102 m (95% CI, 99-105 m), and ±60 m (95% CI, 58-61 m), respectively. The estimated post- versus pre-hamstring injury mean differences in maximal sprinting speed, high-speed running distance, and sprinting running distance primary outcomes were -0.25 km/h (95% CI, -0.38 to -0.12 km/h), -43 m (95% CI, -56 to -30 m), and -22 m (95% CI, -29 to -16 m). Players returning to football match-play after hamstring strain injury experienced reductions in high-speed match physical performance that were well within normal match-to-match variation in performance.

This study aimed to explore the influence of differences in relative skeletal maturity on performance test outcomes in elite youth soccer players from the Middle East.We integrated skeletal age and performance assessments using mixed-longitudinal data available for 199 outfield players (chronological age range, 11.7 to 17.8 yr) enrolled as academy student-athletes (annual screening range, 1 to 5 visits). Skeletal age was determined as per the Tanner-Whitehouse II protocol. Relative maturity was calculated as the difference (∆) between Tanner-Whitehouse II skeletal age minus chronological age. Performance test outcomes of interest were 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed. Separate random-effects generalized additive models quantified differences in performance test outcomes by relative skeletal maturity. Estimated differences were deemed practically relevant based on the location of the confidence interval (95% CI) against minimal detectable change values for each performance test outcome.For 40-m sprinting, differences of +0.51 s (95% CI, +0.35 to +0.67 s) and +0.62 s (95% CI, +0.45 to +0.78 s) were practically relevant for relative maturity status of ∆ = -1.5 yr versus ∆ = +0.5 and ∆ = +1 yr, respectively. For countermovement jump height, a difference of -8 cm (95% CI, -10 to -5 cm) was practically relevant for ∆ = -1.5 yr versus ∆ = +1 yr relative maturity status comparison. Effects for 10-m sprinting and maximal aerobic speed were unclear.Integration of skeletal age and performance assessments indicated that conventional maturity status classification criteria were inconsistent to inform player development processes in our sample. Between-player differences in test performance may depend on a substantial delay in skeletal maturation (∆ ≤ -1.5 yr) and the performance outcome measure.

PURPOSE To provide the first scrutiny of adult height prediction protocols based on automated Greulich-Pyle and Tanner-Whitehouse (TW) skeletal ages applied to elite youth soccer players from the Middle East. METHODS We examined the application of modified Bayley-Pinneau (BoneXpert®), TW-II, and TW-III protocols using mixed-longitudinal data available for 103 subjects (chronological age range, 19.4 to 27.9 yr) previously enrolled as academy student-athletes (annual screening range, one to six visits). Random-effects generalized additive models quantified the presence of systematic mean differences between actual versus predicted adult height. Effects were deemed practically equivalent based on the location of the confidence interval (95% CI) against a realistic difference value of Δ = ± 1 cm. Each model pooled residual standard deviation described the actual precision of height predictions and was used to calculate a 95% prediction interval. RESULTS The BoneXpert® method overpredicted adult height systematically at chronological ages in the range of approximately 13.5 to 14.5 yr (95% CI range, -1.9 to -1 cm) and Greulich-Pyle skeletal ages between 13.5 and 15 yr (95% CI range, -3.1 to -1 cm). Effects based on TW-II were practically equivalent across the chronological and skeletal age measurement ranges, with this protocol yielding adult height predictions with a precision (standard deviation) of approximately ±2.6 cm. The mean TW-III effects indicated systematic adult height overpredictions until the attainment of 14.5 and 15 yr of chronological age (95% CI range, -3.8 to -1.1 cm) and TW-III skeletal age (95% CI range: -5.2 to -2.3 cm), respectively. CONCLUSIONS Tanner-Whitehouse-II adult height prediction method provided more consistent estimates and can be considered the method of choice for talent development purposes in youth soccer players from the Middle East.

Background and study objectives Adequate sleep is essential to support preparation and recovery processes for training and competition in athletes. A limited number of studies have examined whether adolescents from the Middle-East meet the minimum age-specific recommendations ranging from 8 to 9 h of night sleep based on objective measurements. This study aimed to provide an objective description of routine sleep habits in elite youth football players from the Middle-East. Methods Using wrist-worn actigraphy, we examined objective measures of sleep over a 14-day surveillance period from fifty-nine, male, Middle-Eastern elite youth football players (age range: 12.1 to 16 years). Results The observed median sleep duration was approximately 5.5 to 6 h during weekdays and 6.5 to 7.5 h over weekend days. Sleep intermissions resulting in two or more periods of sleep accounted for 8% and 17% of the data during weekdays and weekends, respectively. Conclusions For the first time, we reported an objective quantification of sleep measures indicating that elite youth athletes from the Middle-East do not meet the age-specific sleep recommendations. Integration of sleep tracking into the routine training monitoring process can be valuable to inform decisions relevant to the adoption of potential multidisciplinary interventions to address sleep insufficiency and disorders in youth athletes.

Purpose: To examine the general perspectives of elite soccer players on the time course of perceived postmatch fatigue and the influence of away matches on subjective perceptions. Methods: Adopting a cross-sectional study design, we invited 371 subjects from 14 top-division European clubs competing in the Belgian First Division A, English Premier League, French Ligue 1, Italian Serie A, Portuguese Primeira Liga, Russian Premier League, and Swiss Premier League to take part in a short survey on general issues relating to postmatch fatigue measurement and tracking in professional soccer. Results: Three hundred male professional soccer players completed the short questionnaire. For perceptions relevant to the time course of postmatch fatigue, two-thirds of respondents (67%) indicated higher postmatch fatigue perceived 2 days (48 h) after an official competition. Among these respondents, a higher proportion of answers was observed in wide midfielders (74%), attackers (74%), and central midfielders (68%). Approximately two-thirds of respondents (63%) indicated more than usual and much more than usual perceived postmatch fatigue following away matches. Conclusions: For the first time, our investigation addressed practical aspects that remained unexplored and fundamental to the definition of an optimal player management process following a competition. From a practical standpoint, perspectives of individual elite soccer players substantiated the notion of implementing processes with dedicated recovery protocols within 48 hours postmatch and highlighted the need for differential strategies addressing the additional burden of away matches and travel.

Objective The aims of this study were to quantify the effects of spinal mobilization on force production, failure point, and muscle activity of the hamstrings during the Nordic hamstring exercise (NHE), and to explore individual differences in responses. Methods In a replicated randomized crossover trial, 24 asymptomatic, recreationally active men (age [mean ± standard deviation]: 27 ± 6 years; body mass: 82 ± 17 kg; height: 181 ± 8 cm) completed 2 standardized intervention trials (L4/5 zygapophyseal mobilizations) and 2 control trials. The failure point of the NHE was determined with 3D motion capture. Peak force, knee flexor torque, and electromyography (EMG) of the biceps femoris were measured. Data analyses were undertaken to quantify mean intervention response and explore any individual response heterogeneity. Results Mean (95% confidence interval) left-limb force was higher in intervention than in control trials by 18.7 (4.6-32) N. Similarly, right-limb force was higher by 22.0 (3.4-40.6) N, left peak torque by 0.14 (0.06-0.22) N • m, and right peak torque by 0.14 (0.05-0.23) N • m/kg. Downward force angle was decreased in intervention vs control trials by 4.1° (0.5°-7.6°) on the side of application. Both peak EMG activity (P = .002), and EMG at the downward force (right; P = .020) increased in the intervention condition by 16.8 (7.1-26.4) and 8.8 (1.5-16.1) mV, respectively. Mean downward acceleration angle changed by only 0.3° (−8.9° to 9.4°) in intervention vs control trials. A clear response heterogeneity was indicated only for right force (Participant × Intervention interaction: P = .044; response heterogeneity standard deviation = 34.5 [5.7-48.4] N). Individual response heterogeneity was small for all other outcomes. Conclusion After spinal mobilization, immediate changes in bilateral hamstring force production and peak torque occurred during the NHE. The effect on the NHE failure point was unclear. Electromyographic activity increased on the ipsilateral side. Response heterogeneity was generally similar to the random trial-to-trial variability inherent in the measurement of the outcomes.

Talent identification (TID) and development (TDE) are large fields in professional soccer and in science. However, TID and TDE processes in youth academies have not been assessed in detail. As such, our aim was to survey professional clubs from around the world about their youth academy TID and TDE processes, with 29 clubs responding to the survey. TID and TDE processes changed as a function of player age. TID processes involved finding the best players locally and regionally, but for older players the search widened to nationally and internationally for the needs of the first team. Clubs used a multidisciplinary approach to TID, but more so with older players. Median number of academy players was 80, 100, and 66 players at 8-11 years, 12-16 years, and 17-21 years, respectively. Annual player turnover in the most recent season (selections/de-selections) was 29% across all age groups, with competition from other clubs cited as a limitation to TID. TDE processes involved weekly matches and 3-5 training sessions per week led by experienced, well-qualified coaches, with most clubs providing players with academic education, residency and transportation services. Our findings extend previous research assessing professional soccer youth academy TID and TDE processes by quantifying worldwide practices.

The purpose of this study was to present reference standards for physical performance test outcomes relevant to elite female soccer players. We analysed mixed-longitudinal data (n = 1715 observations) from a sample of 479 elite youth and senior players as part of the English Football Association's national development programme (age range: 12.7 to 36.0 years). Semi-parametric generalized additive models for location, scale and shape (GAMLSS) estimated age-related reference centiles for 5-m sprinting, 30-m sprinting, countermovement jump (CMJ) height, and Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) performance. The estimated reference centiles indicated that the median of the distribution of physical performance test scores varied non-linearly with advancing chronological age, improving until around 25 years for each performance variable. These are the first reference ranges for performance test outcomes in elite English female soccer players. These data can assist practitioners when interpreting physical test performance outcomes to track an individual's progress over time and support decision-making regarding player recruitment and development.

The youth-to-first team phase presents a number of challenges in the careers of modern football players with stagnation, inconsistent performance and dropout being reported. The aim of this study was to investigate the perception of staff involved in professional academy football clubs around the globe, with a particular focus on youth and first team transition demands, resources as well as transitions barriers and coping among male academy football players. Participants from 29 male youth academies distributed across 29 countries took part in the survey. Our main findings suggested training and match intensity reported as being greater at the senior-level and also pressure from parents. The majority of respondents indicated their clubs having long-term strategy for player development and specific roles supporting successful player transitions. Exposure to different playing styles was deemed important to prepare players for the first team. Likewise, having the academy and the first team training on the same site was perceived to ease the transition, with the majority of respondents indicating that players are able to cope with the pressure of first team training and games. Perceptions on whether staff do not have the skills/resources to prepare players for the changes in environment and culture when players move from youth-to-senior level were unclear. Collectively, our study extends previous transition research on youth football academies suggesting the importance of a club-based playing philosophy to prepare players for the first team demands and challenges.

Talent identification and development programmes have received broad attention in the last decades, yet evidence regarding the predictive utility of physical performance in female soccer players is limited. Using a retrospective design, we appraised the predictive value of performance-related measures in a sample of 228 youth female soccer players previously involved in residential Elite Performance Camps (age range: 12.7 to 15.3 years). With 10-m sprinting, 30-m sprinting, counter-movement jump height, and Yo-Yo Intermittent Recovery Test Level 1 (IR1) distance as primary predictor variables, the Akaike Information Criterion (AIC) assessed the relative quality of four penalised logistic regression models for determining future competitive international squads U17-U20 level selection. The model including Yo-Yo IR1 was the best for predicting career outcome. Predicted probabilities of future selection to the international squad increased with higher Yo-Yo IR1 distances, from 4.5% (95% confidence interval, 0.8 to 8.2%) for a distance lower than 440 m to 64.7% (95% confidence interval, 47.3 to 82.1%) for a score of 2040 m. The present study highlights the predictive utility of high-intensity endurance capacity for informing career progression in elite youth female soccer and provides reference values for staff involved in the talent development of elite youth female soccer players.

Background: \ud After meal ingestion, a series of coordinated hormone responses occur concomitantly with changes in perceived appetite. It is not known whether interindividual variability in appetite exists in response to a meal.\ud \ud Objectives: \ud The aim of this study was to 1) assess the reproducibility of appetite responses to a meal; 2) quantify individual differences in responses; and 3) explore any moderating influence of the fat mass and obesity associated (FTO) gene.\ud \ud Methods: \ud Using a replicated crossover design, 18 healthy men (mean ± SD age: 28.5 ± 9.8 y; BMI: 27.0 ± 5.0 kg/m2) recruited according to FTO genotype (9 AA, 9 TT) completed 2 identical control and 2 identical standardized meal conditions (5025 kJ) in randomized sequences. Perceived appetite and plasma acylated ghrelin, total peptide YY (PYY), insulin, and glucose concentrations were measured before and after interventions as primary outcomes. Interindividual differences were explored using Pearson's product-moment correlations between the first and second replicates of the control-adjusted meal response. Within-participant covariate-adjusted linear mixed models were used to quantify participant-by-condition and genotype-by-condition interactions.\ud \ud Results: \ud The meal suppressed acylated ghrelin and appetite perceptions [standardized effect size (ES): 0.18–4.26] and elevated total PYY, insulin, and glucose (ES: 1.96–21.60). For all variables, SD of change scores was greater in the meal than in the control conditions. Moderate-to-large positive correlations were observed between the 2 replicates of control-adjusted meal responses for all variables (r = 0.44–0.86, P ≤ 0.070). Participant-by-condition interactions were present for all variables (P ≤ 0.056). FTO genotype-by-condition interactions were nonsignificant (P ≥ 0.19) and treatment effect differences between genotype groups were small (ES ≤ 0.27) for all appetite parameters.\ud \ud Conclusions: \ud Reproducibility of postprandial appetite responses is generally good. True interindividual variability is present beyond any random within-subject variation in healthy men but we detected no moderation by the FTO genotype. These findings highlight the importance of exploring individual differences in appetite for the prevention and treatment of obesity. This trial was registered at clinicaltrials.gov as NCT03771690.

Purpose: Using elite youth soccer players’ maximal sprinting speeds collected from a criterion and non-criterion measure, we demonstrate how expert practitioner opinion can be used to determine measurement validity. Methods: Expert soccer practitioners (n = 50) from around the world were surveyed on issues relating to the measurement of maximal sprinting speed and 12 elite youth soccer players performed two maximal 40 m sprints, measured by 10-Hz GPS units (non-criterion) and a 100-Hz Laser (criterion). Setting statistical equivalence bounds as practitioner opinion of the practically acceptable amount of measurement error for maximal sprinting speed, we assessed agreement between GPS and Laser. Results: Survey respondents reported a combination of methods for deriving maximal sprinting speed (tests, training, match) but most did not assess system validity. Median value of the practically acceptable amount of measurement error for maximal sprinting speed was 0.20 m/s. Maximal sprinting speed was 8.79 ± 0.33 m/s (Laser) and 8.75 ± 0.32 m/s (GPS), and the mean difference was 0.04 (90% confidence interval −0.03 to 0.11) m/s. Using the median acceptable amount of measurement error, we set our lower and upper equivalence bounds to −0.10 m/s and +0.10 m/s, respectively. Equivalence testing showed Laser and GPS as likely equivalent measures (probability 93.7%). Conclusion: Using expert-informed equivalence thresholds represents a novel way to assess validity in sports performance research. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Introduction: Valid and informed interpretations of changes in physical performance test data are important within athletic development programmes. At present, there is a lack of consensus regarding a suitable method for deeming whether a change in physical performance is practically relevant or not.\ud \ud Methods: We compared true population variance in mean test scores between those derived from evidence synthesis of observational studies to those derived from practioner opinion (n = 30), and to those derived from a measurement error (minimal detectable change) quantification (n = 140). All these methods can help to obtain ‘target’ change score values for performance variables.\ud \ud Results: We found that the conventional ‘blanket’ target change of 0.2 (between-subjects SD) systematically underestimated practically relevant and more informed changes derived for 5-m sprinting, 30-m sprinting, CMJ, and Yo-Yo Intermittent Recovery Level 1 (IR1) tests in elite female soccer players.\ud \ud Conclusions: For the first time in the field of sport and exercise sciences, we have illustrated the use of a principled approach for comparing different methods for the definition of changes in physical performance test variables that are practically relevant. Our between-method comparison approach provides preliminary guidance for arriving at target change values that may be useful for research purposes and tracking of individual female soccer player’s physical performance.

ObjectivesTo describe age group patterns for injury incidence, severity and burden in elite male youth football.MethodsProspective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13–U18; age range: 11–18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours.ResultsWe included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures.ConclusionInjury patterns differed with age; tailoring prevention programmes may be possible.

McLay et al. (Clin Physiol Funct Imaging (2017); DOI: 10.1111/cpf.12465) recently examined whether the allometric scaling of flow-mediated dilation influenced the mean difference between samples of young and older adults compared with the traditional percentage change approach. They also explored whether a new scaling calculation improved the ability to obtain individually scaled flow-mediated dilation. In our response to their study, we can demonstrate that McLay et al. (Clin Physiol Funct Imaging, 2017) have (i) managed to formulate a new scaling index which does nothing to remove the dependency of that index on baseline diameter and (ii) suggested, incorrectly, that the original allometric approach cannot be used to derive individually-adjusted values of flow-mediated dilation, which can be interpreted in a similar way to a percentage change.

Kyprianou, E, Di Salvo, V, Lolli, L, Al Haddad, H, Villanueva, AM, Gregson, W, and Weston, M. To measure peak velocity in soccer, let the players sprint. J Strength Cond Res 36(1): 273-276, 2022-Expressing externals loads relative to a player's individual capacities has potential to enhance understanding of dose-response. Peak velocity is an important metric for the individualization process and is usually measured during a sprint test. Recently, however, peak velocity was reported to be faster during soccer matches when compared with a 40-m sprint test. With the aim of developing the practice of individualized training prescription and match evaluation, we examined whether the aforementioned finding replicates in a group of elite youth soccer players across a broader range of soccer activities. To do this, we compared the peak velocities of 12 full-time male youth soccer players (age 16.3 ± 0.8 years) recorded during a 40-m sprint test with peak velocity recorded during their routine activities (matches, sprints, and skill-based conditioning drills: small-sided games [SSG], medium-sided games [MSG], large-sided games [LSG]). All activities were monitored with 10-Hz global positioning systems (Catapult Optimeye S5, version 7.32) with the highest speed attained during each activity retained as the instantaneous peak velocity. Interpretation of clear between-activity differences in peak velocity was based on nonoverlap of the 95% confidence intervals for the mean difference between activities with sprint testing. Peak velocity was clearly faster for the sprint test (8.76 ± 0.39 m·s-1) when compared with matches (7.94 ± 0.49 m·s-1), LSG (6.94 ± 0.65 m·s-1), MSG (6.40 ± 0.75 m·s-1), and SSG (5.25 ± 0.92 m·s-1), but not sprints (8.50 ± 0.36 m·s-1). Our data show the necessity for 40-m sprint testing to determine peak velocity.

We aimed to assess the coach-player agreement of subjective soccer training loads via differential ratings of perceived exertion (dRPE). The coach initially underwent quantifiable familiarisation (blackness test) with the Borg CR100 scale. Data were collected from 16 semi-professional soccer players across seven consecutive training sessions. For the measurement of subjective training load, the coach and players provided dRPE (CR100) for legs (RPE-L), breathlessness (RPE-B) and technical exertion (RPE-T). Coach-prescribed dRPE were recorded prior to training, with coach observed and player reported dRPE collected post training. Statistical equivalence bounds for agreement between coach (prescribed and observed) and player reported dRPE scores were 4 arbitrary units on the CR100 and we used a probability outcome of likely (≥75%) to infer realistic equivalence. Following three familiarisation sessions, the coach improved their blackness test score from 39% to 83%. Coach observed and player reported RPE-T scores were likely equivalent, with all other comparisons not realistically equivalent. Since training prescription is coach-led, our data highlight the importance of accurate internal load measurement and feedback in soccer. The improved accuracy and precision of coach intensity estimation after three attempts at the blackness test suggests that this method could be worthwhile to researchers and practitioners employing dRPE.

Training and competition loads have emerged as modifiable composite risk factors of non‐contact injury. Hamstring strains are the most common injuries in football with substantial burden on the individual player and club. Nevertheless, robust evidence of a consistent load‐hamstring injury relationship in professional football is lacking. Using available data from the Qatar Stars League over three competitive seasons, this study investigated the separate and combined effects of perceived exertion and session duration on hamstring injury occurrence in a sample of 30 outfield football players. Load variables were calculated into 7‐day, 14‐day, 21‐day, 28‐day periods of data, and week‐to‐week changes for average ratings of perceived exertion (RPE; au) score and session‐RPE (s‐RPE; session‐duration urn:x-wiley:09057188:media:sms13591:sms13591-math-0001 score), plus the cumulative training and match minutes and s‐RPE, respectively. Conditional logistic regression models estimated load‐injury relationships per 2‐within‐subject standard deviation increments in each candidate variable. Associations were declared practically important based on the location of the confidence interval in relation to thresholds of 0.90 and 1.11 defining small beneficial and harmful effects, respectively. The uncertainty for the corrected odds ratios show that typically high within‐subject increments in each candidate variable were not practically important for training‐ and match‐related hamstring injury (95% confidence intervals range: 0.85 to 1.16). We found limited exploratory evidence regarding the value of perceived exertion and session duration as etiological factors of hamstring injury in Middle‐East professional football. Monitoring remains valuable to inform player load management strategies, but our exploratory findings suggest its role for type‐specific injury risk determination appears empirically unsupported.

Objectives To investigate the impact of physical efforts performed in the period preceding activity as a potential risk factor of muscle injury during match-play within a sample of professional soccer players. Design Observational cohort study. Methods Match load (running [>14.4–19.8 km/h], high-speed running [>19.8–25.2 km/h], sprinting [>25.2 km/h], leading and explosive sprint type) averaged in 1-min and 5-min periods prior to an event or non event for 29 professional outfield soccer players. Conditional logistic and Poisson regression models estimated the relationship between load and injury for a 2 within-subject standard deviation in match load or 1-action increment in the number of sprinting activities, respectively. Associations were deemed beneficial or harmful based on non-overlap of the 95% confidence intervals against thresholds of 0.90 and 1.11, respectively. Results An increment in sprinting distance [+2-SDs = 11 m] covered over a 1-min period (odds ratio [OR]: 1.22, 95%CI, 1.12 to 1.33) increased the odds of muscle injury. Conclusions Our study provides novel exploratory evidence that the volume of sprinting during competitive soccer match-play has a harmful association with muscle injury occurrence.

An important question for researchers and practitioners is whether an individual’s risk of injury increases if they make prior changes to their training load.1 In this field of research, ‘load’ typically refers to in-training distances covered, speed and accelerations.1 Attention has generally focused on whether a person’s acute (eg, 7 day) increase in load, normalised to that person’s prior ‘baseline’ of chronic (eg, 28 day) load, predicts injury.1 To obtain this normalised predictor, acute load is typically divided by chronic load to provide the acute-to-chronic workload ratio (ACWR).1 Fundamentally, simple ratios (Y/X) are formulated to ‘ control for ’ a denominator variable (eg, preceding chronic load) that is perceived to have an important biological influence on the numerator variable (eg, acute load).2 Within this notion of ‘ control for ’,3 it is generally posited that the denominator is a ‘nuisance’ variable that is associated with the numerator of interest.2 Logically, a simple ratio index provides meaningful relative measures for clinical and prognostic purposes only if (1) there is a ‘true’ and ‘proportional’ association between numerator and denominator in the first place, and (2) the ratio normalises for the denominator in a consistent manner for all individuals in the measurement range.2 We have demonstrated recently that the typical practice in the current literature1 of including, …

Left ventricular ejection fraction (EF) is a ratio that is deemed to accurately normalize stroke volume (SV) to end-diastolic volume (EDV). Ratios are now well-recognized for not normalizing the numerator, in this case SV, consistently for the denominator, EDV. We aimed to provide the first allometric-based scrutiny of the conventional assumptions that underpin the EF ratio. We allometrically modelled untransformed SV and EDV measurements from 112 preclinical heart failure patients in the Multi-Ethnic Study of Atherosclerosis (MESA), and 864 chronic heart failure patients in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study. An information-theoretic approach was adopted to assess the relative quality of twelve candidate models for normalizing SV to EDV. None of the conventional underlying assumptions for accurate ratio normalization, for example an allometric exponent ≈1, were upheld for EF. A two-parameter power function with normal, heteroscedastic error was the best model for scaling SV to EDV in both samples. The allometric exponent (95% confidence interval) was 0·776 (0·682 to 0·869) in MESA, and 0·860 (0·857 to 0·864) in TOPCAT. EF was inversely correlated with EDV in MESA (r = -0·67, 95% CI: -0·76 to -0·55) and TOPCAT (r = -0·41, 95% CI: -0·46 to -0·35). Consequently, for fundamental statistical reasons, EF was biased low for people with generally larger EDVs, and vice versa. For the first time, we have demonstrated that EF is an inaccurate statistic for scaling SV to EDV, leading to potential biased inferences for research and individual patients.

The monitoring of training loads is now a much-researched topic in team sports.1 Within this topic, researchers and practitioners are particularly interested in the impact of relatively short (acute) periods of higher training loads normalised for the prior and longer term (chronic) loads. In recent years, a well-established approach for normalising this acute ‘spike’ to chronic load has been by calculating the ‘acute:chronic workload ratio’ (ACWR). Importantly, the term "load" was retained given its common use in this research area. Both this index and chronic load itself have been reported to be independent predictors of training-related injuries.2 It has also been reported, particularly in team sports competitors, that there are associations between acute spikes in training loads (relative to chronic loads) and time-loss injuries.1 The ACWR is usually calculated as the simple ratio of recent (ie, 1 week) to longer term (ie, 4 weeks) training loads.1 While it is important for the numerator and denominator of any ratio to be correlated only through biological mechanisms,3 one aspect of the ACWR calculation is that the acute load also constitutes a substantial …

Maximal oxygen uptake ( $${\dot{\text{V}}\text{O}}$$ 2max) is conventionally normalized to body size as a simple ratio or using an allometric exponent < 1. Nevertheless, the most appropriate body size variable to use for scaling and the value of the exponent are still enigmatic. Studies tend to be based on small samples and can, therefore, lack precision. The objective of this systematic review was to provide a quantitative synthesis of reported static allometric exponents used for scaling $${\dot{\text{V}}\text{O}}$$ 2max to whole body mass and fat-free mass. Eight electronic databases (CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus and Web of Science) were searched for relevant studies published up to January 2016. Search terms included ‘oxygen uptake’, ‘cardiorespiratory fitness’, ‘ $${\dot{\text{V}}\text{O}}$$ 2max’, ‘ $${\dot{\text{V}}\text{O}}$$ 2peak’, ‘scaling’ and all interchangeable terms. Inclusion criteria included human cardiorespiratory fitness data; cross-sectional study designs; an empirical derivation of the exponent; reported precision statistics; and reported information regarding participant sex, age and sports background, $${\dot{\text{V}}\text{O}}$$ 2max protocol, whole body composition protocol and line-fitting methods. A random-effects model was used to quantify weighted pooled exponents and 95% confidence limits (Cls). Heterogeneity was quantified with the tau-statistic (τ). Meta-regression was used to quantify the impact of selected moderator variables on the exponent effect size. A 95% prediction interval was calculated to quantify the likely range of true fat-free mass exponents in similar future studies, with this distribution used to estimate the probability that an exponent would be above theorised universal values of $$\frac{2}{3}\text{and}\frac{3}{4}$$ . Thirty-six studies, involving 6514 participants, met the eligibility criteria. Whole body mass and fat-free mass were used as the scaling denominator in 27 and 15 studies, respectively. The pooled allometric exponent (95% Cls) was found to be 0.70 (0.64 to 0.76) for whole body mass and 0.90 (0.83 to 0.96) for fat-free mass. The between-study heterogeneity was greater for whole body mass (τ = ±0.15) than for fat-free mass (τ = ±0.11). Participant sex explained 30% of the between-study variability in the whole body mass exponent, but the influence on the fat-free mass exponent was trivial. The whole body mass exponent of 0.52 (0.40 to 0.64) for females was substantially lower than the 0.76 (0.70 to 0.83) for males, whereas the fat-free mass exponent was similar for both sexes. The effects of all other moderators were trivial. The 95% PI for fat-free mass ranged from 0.68 to 1.12. The estimated probability of a true fat-free mass exponent in a future study being greater than $$\frac{2}{3}\,\text{or}\,\frac{3}{4}$$ power scaling is 0.98 (very likely) and 0.92 (likely), respectively. In this quantitative synthesis of published studies involving over 6500 humans, the whole body mass exponent was found to be spuriously low and prone to substantial heterogeneity. We conclude that the scaling of $${\dot{\text{V}}\text{O}}$$ 2max in humans is consistent with the allometric cascade model with an estimated prediction interval for the fat-free mass exponent not likely to be consistent with the $$\frac{2}{3}\text{and}\frac{3}{4}$$ power laws.

It has been widely reported that men have a lower ratio of the 2nd and 4th human finger lengths (2D : 4D). Size-scaling ratios, however, have the seldom-appreciated potential for providing biased estimates. Using an information-theoretic approach, we compared 12 candidate models, with different assumptions and error structures, for scaling untransformed 2D to 4D lengths from 154 men and 262 women. In each hand, the two-parameter power function and the straight line with intercept models, both with normal, homoscedastic error, were superior to the other models and essentially equivalent to each other for normalizing 2D to 4D lengths. The conventional 2D : 4D ratio biased relative 2D length low for the generally bigger hands of men, and vice versa for women, thereby leading to an artefactual indication that mean relative 2D length is lower in men than women. Conversely, use of the more appropriate allometric or linear regression models revealed that mean relative 2D length was, in fact, greater in men than women. We conclude that 2D does not vary in direct proportion to 4D for both men and women, rendering the use of the simple 2D : 4D ratio inappropriate for size-scaling purposes and intergroup comparisons.

Background Our recent systematic review showed that prospective studies found contradicting results concerning hamstring-quadriceps (H:Q) strength ratios as a risk factor for ACL injuries. All studies that express hamstring relative to quadriceps strength assume a proportional relationship yet this is not likely. Objective i) To investigate if the H:Q strength relationship is proportional in athlete populations and ii) To evaluate the differences in participant rankings between the traditional way of calculating H:Q ratios and allometrically scaled H:Q ratios. Design Controlled laboratory study. Setting The study was conducted both in a club and biomechanics laboratory setting. Participants 71 male elite football athletes, 55 male recreational athletes and 48 female recreational athletes participated in the study. Assessment of Risk Factors Concentric hamstring and quadriceps strength (Hcon and Qcon), and eccentric hamstring strength (Hecc) were tested in participants9 dominant and non-dominant limbs using isokinetic dynamometry at an angular velocity of 60°/s. Main Outcome Measurements i) Allometric exponents (AE) of the Hcon:Qcon and Hecc:Qcon relationships and ii) Chi-square relationships between population rankings based on the traditional H:Q ratios and the allometrically scaled H:Q ratios. Results i) Linear regression analyses showed that the Hcon:Qcon and Hecc:Qcon relationships were systematically non-proportional (AE ranged between 0.61 and 0.84) and ii) correcting H:Q ratios based on an average allometric exponent (0.65 for Hcon:Qcon and 0.78 for Hecc:Qcon) successfully removed bias from quadriceps strength, and significantly altered population rankings. Conclusions Quadriceps strength meaningfully affects H:Q ratios, causing bias in proportionally scaled H:Q ratios. Unless if quadriceps strength itself is a risk factor, allometrically scaled H:Q ratios are a superior measure of H:Q strength (im)balance for injury risk analyses in athlete populations.

We aimed to provide the first quantitative synthesis of derived static allometric coefficients ( b ) used for scaling maximal oxygen uptake (VO 2max ) to whole-body mass and fat-free mass in human samples. Eight electronic databases were searched for relevant peer-reviewed articles. Inclusion criteria comprised human cardiorespiratory fitness data; cross-sectional study designs; an empirical derivation of the exponent; reported precision statistics; and reported information regarding participant sex, age and sports background, VO 2max protocol, body composition protocol and line-fitting methods. Thirty-seven studies, involving 7,851 participants, met the eligibility criteria and were dichotomized into two main domains relevant to whole-body mass (n=28) and fat-free mass (n=16), respectively. The pooled allometric exponent (95% CL) was found to be 0.71 (0.65 to 0.77) for body mass and 0.91 (0.83 to 0.98) for fat-free mass. The among-studies heterogeneity was substantial for both whole-body mass and fat-free mass (τ =±0.15). Participant sex explained 33% of the between-study variability in the whole body mass exponent, but only 5% of the variability in the fat-free mass exponent. While the body mass exponent was substantially lower in women ( b =0.52; 95% CL: 0.41 to 0.64) than for men ( b =0.77; 95% CL: 0.71 to 0.83), the fat-free mass exponent was similar for both sexes. None of the identified moderator variables was statistically significant. The body mass exponent estimate encompassed both ⅔- and ¾-power laws. Conversely, the fat-free mass exponent was substantially larger and more generalisable due to the heterogeneity of body composition in human samples. We conclude that the scaling of VO 2max in humans is consistent with the allometric cascade model, with an estimated pooled exponent that precludes ⅔- and ¾-power scaling.

Purpose: To assess conventional assumptions that underpin the percentage of mature height index as the simple ratio of screening height (numerator) divided by actual or predicted adult height (denominator). Methods: We examined cross-sectional data from 99 academy youth soccer players (chronological age range, 11.5 to 17.7 y) skeletally immature at the screening time and with adult height measurements available at follow-up. Results: The y-intercept value of −60 cm (95% confidence interval, −115 to −6 cm) from linear regression between screening height and adult height indicated the failure to meet the zero y-intercept assumption. The correlation coefficient between present height and adult height of .64 (95% confidence interval, .50 to .74) was not equal to the ratio of coefficient of variations between these variables (CVx/CVy = 0.46) suggesting Tanner’s special circumstance was violated. The non-zero correlation between the ratio and the denominator of .21 (95% confidence interval, .01 to .39) indicated that the percentage of mature height was biased low for players with generally shorter adult height, and vice versa. Conclusion: For the first time, we have demonstrated that the percentage of mature height is an inconsistent statistic for determining the extent of completed growth, leading to potentially biased inferences for research and applied purposes.