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Abstract Surgical site infections (SSI) cause substantial morbidity and pose a burden to acute healthcare services after surgery. We aimed to investigate whether a smartphone-delivered wound assessment tool can expedite diagnosis and treatment of SSI after emergency abdominal surgery. This single-blinded randomised control trial (NCT02704897) enroled adult emergency abdominal surgery patients in two tertiary care hospitals. Patients were randomised (1:1) to routine postoperative care or additional access to a smartphone-delivered wound assessment tool for 30-days postoperatively. Patient-reported SSI symptoms and wound photographs were requested on postoperative days 3, 7, and 15. The primary outcome was time-to-diagnosis of SSI (Centers for Disease Control definition). 492 patients were randomised (smartphone intervention: 223; routine care: 269). There was no significant difference in the 30-day SSI rate between trial arms: 21 (9.4%) in smartphone vs 20 (7.4%, p = 0.513) in routine care. Among the smartphone group, 32.3% (n = 72) did not utilise the tool. There was no significant difference in time-to-diagnosis of SSI for patients receiving the intervention (−2.5 days, 95% CI: −6.6−1.6, p = 0.225). However, patients in the smartphone group had 3.7-times higher odds of diagnosis within 7 postoperative days (95% CI: 1.02−13.51, p = 0.043). The smartphone group had significantly reduced community care attendance (OR: 0.57, 95% CI: 0.34−0.94, p = 0.030), similar hospital attendance (OR: 0.76, 95% CI: 0.28−1.96, p = 0.577), and significantly better experiences in accessing care (OR: 2.02, 95% CI: 1.17−3.53, p = 0.013). Smartphone-delivered wound follow-up is feasible following emergency abdominal surgery. This can facilitate triage to the appropriate level of assessment required, allowing earlier postoperative diagnosis of SSI.

The purpose of this investigation was to assess the effects of exercise-induced muscle damage (EIMD) on agility and linear sprint running performance. Twelve healthy adults were randomly allocated to a treatment group (n=7; age, 21±1.2 years; height, 1.77±0.11m; body mass, 70.8±8.2 kg) where they completed 100 plyometric jumps, or to a control group (n = 5; age, 24 ± 0.7 years; height, 1.77 ± 0.07 m; body mass, 69.2 ± 8.8 kg). Perceived muscle soreness, isokinetic peak torque of the knee extensors at 60 and 270 deg x s[-1], sprint running time over 5 and 10 m, a timed agility test and ground contact time at the agility turn point were recorded at baseline and then 24, 48 and 168 hours following muscle-damaging exercise. Perceived muscle soreness was significantly increased (p < 0.05) and isokinetic peak torque at 60 and 270 deg x s-1 was significantly decreased (p < 0.05) at 24 and 48 hours in the treatment group following plyometric exercise. Significant increases (p < 0.05) were also observed for 5m (6%) and 10 m (5%) sprint time, agility time (8%) and ground contact time at the agility turn point (21%), peaking at 48 hours in the treatment group. All variables remained unchanged in the control group (p > 0.05). These findings indicate that agility and sprint performance is reduced following EIMD, and provides further evidence that performance of activities requiring rapid generation of force is impaired following muscle-damaging exercise. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the effects of muscle-damaging exercise on the time to peak power during maximal intensity cycling and drop jump performance. Nineteen subjects were randomly assigned to a treatment (n = 10, age 22.6 ± 2.8 years, body mass 70.7 ± 12.9 kg, stature 1.76 ± 0.10 m) or control group (n = 9, age 20.8 ± 2.5 years, body mass 74.2 ± 10.2 kg, stature 1.76 ± 0.07 m) and randomly performed a 10-second cycle ergometer sprint, against a load corresponding to 0.70N·m·kg[-1] for males and 0.67N·m·kg[-1] for females, and a drop jump from a height of 50 cm. Indirect markers of muscle damage (perceived muscle soreness and isokinetic knee extensor torque at 60 and 360 deg·s[-1]) were also assessed. All measures were taken before and at 24, 48, 72 and 168 hours following a plyometric exercise protocol comprised of 10 × 10 maximal countermovement jumps. Repeated measures ANOVA showed significant interactions of time by group on all dependent measures (p < 0.05). Peak power output, time to peak power output, drop jump height, ground contact time during the drop jump, and strength at both joint angular velocities were all adversely affected in the treatment group, with no significant changes in the control group. These results provide further evidence that dynamic muscle performance is compromised in the days following muscledamaging exercise. [ABSTRACT FROM AUTHOR]

Neuroblastoma is the most common extracranial solid tumor diagnosed in children. This inaugural version of the NCCN Guidelines for Neuroblastoma provides recommendations for the diagnosis, risk classification, and treatment of neuroblastoma. The information in these guidelines was developed by the NCCN Neuroblastoma Panel, a multidisciplinary group of representatives with expertise in neuroblastoma, consisting of pediatric oncologists, radiologists, pathologists, surgeons, and radiation oncologists from NCCN Member Institutions. The evidence-based and consensus recommendations contained in the NCCN Guidelines are intended to guide clinicians in selecting the most appropriate treatments for their patients with this clinically heterogeneous disease.

Background: Professional rugby union is a high-intensity contact sport with position-specific high training and match volumes across a season that may lead to periods of fatigue if above a typically experienced threshold. This study assesses the influence of match play and/or training on fatigue levels in rugby union players., Objective: We aimed to perform a systematic review and meta-analysis of measures used to assess fatigue status in male professional rugby union players., Methods: Using electronic databases (PubMed, SPORTDiscus, Web of Science, Cochrane Library, EMBASE, and MEDLINE), a systematic review of fatigue testing in rugby union was conducted on (1) neuromuscular, (2) subjective self-report, (3) biochemical, and (4) heart rate-derived measures., Results: Thirty-seven articles were included in this systematic review, of which 14 were further included in a meta-analysis. The results of the meta-analysis revealed small, yet not significant, decreases in countermovement jump height immediately after (effect size [ES] =  - 0.29; 95% confidence interval [CI] - 0.64 to 0.06), 24 h (ES =  - 0.43; 95% CI - 3.99 to 3.21), and 48 h (ES =  - 0.22; 95% CI - 0.47 to 0.02) after exposure to rugby union match play or training. Reported wellness (ES =  - 0.33; 95% CI - 1.70 to 1.04) and tiredness (ES =  - 0.14; 95% CI - 1.30 to 1.03) declined over a period of a few weeks (however, the results were not-statistically significant), meanwhile muscle soreness increased (ES = 0.91; 95% CI 0.06 to 1.75) within the 96 h after the exposure to rugby union match play or training. Finally, while cortisol levels (ES = 1.87; 95% CI - 1.54 to 5.29) increased, testosterone declined (ES =  - 1.54; 95% CI - 7.16 to 4.08) within the 24 h after the exposure. However, these results were not statistically significant., Conclusions: Subjective measures of muscle soreness can be used to assess fatigue after match play and training in rugby union players. Within-study and between-study variability for countermovement jump height, biochemical markers, and heart rate-derived measures means the utility (practical application) of these measures to assess fatigue in professional rugby union players after matches and training is unclear., Clinical Trial Registration: PROSPERO ID: CRD42020216706., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: The aims of this study were to examine the variability of selected external load metrics within 15-minute intervals during soccer match play and examine their relationship with players' high-intensity intermittent fitness., Methods: A total of 18 male soccer players were monitored for their external load metrics during 26 matches, which included total distance, high-metabolic-load distance, and mechanical work (defined as the sum of accelerations and decelerations >3 m2). Additionally, players completed the 30-15 Intermittent Fitness Test., Results: Total distance had lower coefficients of variation than high-metabolic-load distance and mechanical work (effect size [ES]: 5.2 to 6.4; very large). Within-player Δ-15min showed moderate to large decreases (ES: -0.7 to -1.6) and increases (ES: 0.9 to 1.8) in absolute and coefficient-of-variation values, respectively. Large relationships (r = .55 to .61) were observed between the Intermittent Fitness Test and 15-minmean and 15-minbest in all selected external load metrics. However, small to moderate (0.27 to 0.41) associations were observed between the Intermittent Fitness Test and Δ-15min in selected external load metrics., Conclusions: These findings suggest that players with relatively lower intermittent running capacity might show lower variability during matches, as evidenced by smaller reductions in high-intensity actions during the final 15 minutes. We attribute these observations to players' possessing better pacing strategies.

Purpose: This meta-analysis aimed to (1) provide a comparison of peak changes in indirect markers of exercise-induced muscle damage (EIMD) in youths versus adults and (2) determine if the involved limb moderated this effect., Method: Studies were eligible for inclusion if they (1) provided a human youth versus adult comparison; (2) provided data on muscle strength, soreness, or creatine kinase markers beyond ≥24 hours; and (3) did not provide a recovery treatment. Effect sizes (ES) were presented alongside 95% confidence intervals., Results: EIMD exhibited larger effects on adults than in youths for muscle strength (ES = -2.01; P < .001), muscle soreness (ES = -1.52; P < .001), and creatine kinase (ES = -1.98; P < .001). The random effects meta-regression indicated that the effects of upper- and lower-limb exercise in youths and adults were significant for muscle soreness (coefficient estimate = 1.11; P < .001) but not for muscle strength or creatine kinase (P > .05). As such, the between-group effects for muscle soreness (ES = -2.10 vs -1.03; P < .05) were greater in the upper than lower limbs., Conclusion: The magnitude of EIMD in youths is substantially less than in their adult counterparts, and this effect is greater in upper than lower limbs for muscle soreness. These findings help guide practitioners who may be concerned about the potential impact of EIMD when training youth athletes.

The current study performed a series of online focus groups to understand elite rugby league players' experiences of collision. Eighteen rugby league players comprising different playing positions from four teams were recruited to participate in a series of online focus groups, via the Microsoft Team's platform, facilitated by a moderator. Players were competing in Europe's elite rugby league competition, the European Super League (ESL), during the 2021 season. All focus group data were transcribed, coded and analysed using reflexive thematic analysis guide to ensure robust exploring, interpreting and reporting through pattern-based analysis. The findings are split into five key themes: 1) the three-man tackle - the perceived optimal defensive strategy with simultaneous contact, 2) not all collisions are the same; matchplay events change the collision intensity, 3) bracing and blindsiding - two factors that influence experiences of collision and concussion, 4) coaching philosophies and orientations, 5) psychological readiness for collision. Collision sports have an inherent risk of injury; however, in some players' subjective experiences, there are collision types that have a greater association with risk or intensity (blind-sided collisions or long closing distances). It is essential that future research comprehends the effects of these collision types and the further themes.

Purpose: We examined the movement, physiological and muscle function responses to running with and without (i.e. linear) multiple directional changes to understand which measures of external demands better reflected changes in the internal response. Methods: Twelve team sport athletes completed a linear and multidirectional running trial during which movement characteristics, oxygen consumption ( V ˙ O 2 ), blood lactate (B[La]) and heart rate (HR) were measured. Isometric peak torque of knee extensors and flexors was also assessed before and after each trial. Results: High speed running distance was higher during the linear trial ( p < 0.001), whereas time at high metabolic power ( p = 0.046), number of accelerations ( p < 0.001), summated HR ( p = 0.003) and B[La] ( p = 0.002) were higher during the multidirectional trial. Integrated external to internal ratios of high-speed running: summated HR and high-speed running: total V ˙ O 2 were different between multidirectional and linear trials ( p ≤ 0.001). Conversely, high metabolic power: summated HR and high metabolic power: total V ˙ O 2 were similar ( p ≥ 0.246). Small decrements in knee flexor ( p = 0.003) and extensor torque ( p = 0.004) were observed after both trials. Conclusion: Time at high metabolic power better reflects the increased internal response during running with more directional changes than high speed running.

Purpose: To examine the influence of individual and situational factors on the movement characteristics and internal responses of players to an international Touch tournament., Methods: Using 47 International Touch players (25 men and 22 women), the associations between the movement characteristics and internal responses with individual (sprint, glycolytic test, Yo-Yo intermittent recovery test level 1 [Yo-Yo IR1], jump performance and well-being) and situational (sex, squad, position, competition day, points scored/conceded, result, and opposition rank) factors were examined using linear mixed modelling., Results: Yo-Yo IR1 distance was associated with all movement characteristics and internal responses ( r = -0.29 to 0.37), whilst sprint and glycolytic times only influenced mean heart rate (HR mean ) ( r = 0.15) and high-speed distance ( r = 0.10), respectively. Sex influenced high-speed distance ( r = -0.41), whilst squad was associated with playing time and HR mean ( r = -0.10-0.33). Other associations included: playing position with all movement characteristics ( r = -0.67-0.81); points conceded with relative distance ( r = -0.14); winning with high metabolic power and session RPE ( r = -0.07-0.09), and opposition rank with HR mean and RPE ( r = 0.11-0.35)., Conclusions: Individual and situational factors can influence the movement characteristics and internal responses to Touch and should be considered when developing the characteristics of players and interpreting responses to match-play.

Questions: What is the effect of high-velocity power training (HVPT) compared with traditional resistance training (TRT) on functional performance in older adults? What is the quality of intervention reporting for the relevant literature?, Design: Systematic review and meta-analysis of randomised controlled trials., Participants: Older adults (aged > 60 years), regardless of health status, baseline functional capacity or residential status., Interventions: High-velocity power training with the intent to perform the concentric phase as quickly as possible compared with traditional moderate-velocity resistance training performed with a concentric phase of ≥ 2 seconds., Outcome Measures: Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), five times sit-to-stand test (5-STS), 30-second sit-to-stand test (30-STS), gait speed tests, static or dynamic balance tests, stair climb tests and walking tests for distance. The quality of intervention reporting was assessed with the Consensus on Exercise Reporting Template (CERT) score., Results: Nineteen trials with 1,055 participants were included in the meta-analysis. Compared with TRT, HVPT had a weak-to-moderate effect on change from baseline scores for the SPPB (SMD 0.27, 95% CI 0.02 to 0.53; low-quality evidence) and TUG (SMD 0.35, 95% CI 0.06 to 0.63; low-quality evidence). The effect of HVPT relative to TRT for other outcomes remained very uncertain. The average CERT score across all trials was 53%, with two trials rated high quality and four rated moderate quality., Conclusion: HVPT had similar effects to TRT for functional performance in older adults, but there is considerable uncertainty in most estimates. HVPT had better effects on the SPPB and TUG, but it is unclear whether the benefit is large enough to be clinically worthwhile., (Copyright © 2023 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.)

Purpose: The acute physiological, perceptual and neuromuscular responses to volume-matched running and cycling high intensity interval training (HIIT) were studied in team sport athletes., Methods: In a randomized cross-over design, 11 male team sport players completed 3 × 6 min (with 5 min between sets) repeated efforts of 15 s exercising at 120% speed (s[Formula: see text]O 2max ) or power (p[Formula: see text]O 2max ) at [Formula: see text]O 2max followed by 15 s passive recovery on a treadmill or cycle ergometer, respectively., Results: Absolute mean [Formula: see text]O 2 (ES [95% CI] = 1.46 [0.47-2.34], p < 0.001) and heart rate (ES [95% CI] = 1.53 [0.53-2.41], p = 0.001) were higher in running than cycling HIIT. Total time at > 90% [Formula: see text]O 2max during the HIIT was higher for running compared to cycling (ES [95% CI] = 1.21 [0.26-2.07], p = 0.015). Overall differential RPE (dRPE) (ES [95% CI] = 0.55 [- 0.32-1.38], p = 0.094) and legs dRPE (ES [95% CI] = - 0.65 [- 1.48-0.23], p = 0.111) were similar, whereas breathing dRPE (ES [95% CI] = 1.01 [0.08-1.85], p = 0.012) was higher for running. Maximal isometric knee extension force was unchanged after running (ES [95% CI] = - 0.04 [- 0.80-0.8], p = 0.726) compared to a moderate reduction after cycling (ES [95% CI] = - 1.17 [- 2.02-0.22], p = 0.001)., Conclusion: Cycling HIIT in team sport athletes is unlikely to meet the requirements for improving run-specific metabolic adaptation but might offer a greater lower limb neuromuscular load., (© 2022. The Author(s).)

Purpose: To determine the changes in physical qualities of academy rugby union players over a 10-week unsupervised off-season period., Methods: Body mass, jump height, sprint performance, and intermittent running (30:15 IFT) of 64 academy rugby union players (age = 17.2 ± 0.4 y) were recorded before and after the off-season., Results: Changes in body mass (+1.4 ± 1.3 kg), countermovement jump (-2.2 ± 1.2 cm), squat jump (-1.5 ± 1.8 cm), 10 m sprint (+0.06 ± 0.05 s), 40 m sprint (+0.13 ± 0.11 s) and 30:15 IFT (-0.8 ± 0.8 kmŸh -1 ) were observed ( P < 0.001, d = -1.77 to 0.47). Only changes in body mass were greater in forwards than backs (P = 0.036, d = 0.46). Players with higher end-of-season body mass, squat jump and 30:15 IFT had greater off-season changes ( P = < 0.001 to 0.044; d = 0.63 to 0.94), whilst the pre-post difference in body mass influenced CMJ ( P = 0.005, d = 0.75) and 10 m momentum change ( P < 0.001, d = 1.61)., Conclusion: Understanding the individuality of the changes in physical qualities of academy rugby union players during the off-season is important to ensure players return safely to pre-season training loads.

Background: This study compared the vertical and horizontal force-velocity (FV) profile of academy and senior rugby league players., Methods: Nineteen senior and twenty academy players from one professional club participated in this study. The vertical FV profile was determined using a series of loaded squat jumps (0.4 to 80 kg) with jump height recorded. The horizontal FV profile involved a 30-m over-ground sprint with split times recorded at 5, 10, 15, 20 and 30 m. Theoretical maximal force (F0), velocity (V0) and power (Pmax), optimal F0 and V0, and activity specific variables (e.g., vertical FV imbalance) were determined., Results: Absolute F0 and Pmax from the vertical and horizontal profile were moderately different between groups (standardized mean difference [SMD] = 0.64-1.20, P<0.001-0.026), whilst for V0, differences were small (SMD=0.33-0.41, P=0.149-0.283). Differences in relative F0, Pmax and optimal F0 during both assessments were trivial to moderate (SMD=0.03-0.82, P=0.021-0.907)., Conclusions: These results demonstrate senior and academy players present with different FV profiles and highlight some potential developmental opportunities for senior and academy rugby league players that sport scientists, strength and conditioning and rugby coaches can implement when designing programmes and considering long-term athlete development.

Abstract: Fairbank, M, Highton, J, Twist, C. Passive heat maintenance after an initial warm-up improves high-intensity activity during an interchange rugby league movement simulation protocol. J Strength Cond Res 35(7): 1981-1986, 2021-This study examined using passive heat maintenance (PHM) to maintain core temperature after a warm-up and its effect on simulated first half running performance in rugby players. Thirteen male rugby players completed this randomized crossover study. Tympanic temperature was taken before a warm-up and then after a further 15 minutes of passive recovery either with (PHM) or without (CON) a PHM garment. Subjects then completed 23 minutes of the rugby league movement simulation protocol (RLMSP-i). Differences in tympanic temperature were unclear between CON and PHM before (35.7 ± 1.3 cf. 36.0 ± 1.1° C; effect size [ES] = 0.20) and during exercise (34.5 ± 0.1 cf. 35.2 ± 0.1° C; ES = 0.26-0.35). High-intensity running (ES = 0.27) and peak sprint speed were higher (ES = 0.46-0.56) during the PHM compared with the CON trial. Time spent above 20 W·kg-1 also increased in the first quartile of the PHM compared with the CON trial (ES = 0.18). All other between trial comparisons of performance were unclear. HRmean (ES = 0.38) was higher in PHM compared with CON, while differences in RPEmean (ES = -0.19) were unclear. There are small to large increases in high-intensity activity performed during a playing bout when rugby players wear a PHM garment after a warm-up. Rugby players should consider PHM during extended periods between a warm-up and starting a match., (Copyright © 2019 National Strength and Conditioning Association.)

Aging is anecdotally associated with a prolonged recovery from resistance training, though current literature remains equivocal. This brief review considers the effects of resistance training on indirect markers of muscle damage and recovery (i.e., muscle soreness, blood markers, and muscle strength) in older males. With no date restrictions, four databases were searched for articles relating to aging, muscle damage, and recovery. Data from 11 studies were extracted for review. Of these, four reported worse symptoms in older compared with younger populations, while two have observed the opposite, and the remaining studies (n = 6) proposed no differences between age groups. It appears that resistance training can be practiced in older populations without concern for impaired recovery. To improve current knowledge, researchers are urged to utilize more ecologically valid muscle-damaging bouts and investigate the mechanisms which underpin the recovery of muscle soreness and strength after exercise in older populations.

Abstract: Fernandes, JFT, Lamb, KL, Clark, CCT, Moran, J, Drury, B, Garcia-Ramos, A, and Twist, C. Comparison of the FitroDyne and GymAware rotary encoders for quantifying peak and mean velocity during traditional multijointed exercises. J Strength Cond Res 35(6): 1760-1765, 2021-The FitroDyne and GymAware rotary encoders are being increasingly used in resistance training to monitor movement velocity, but how closely their velocity outcomes agree is unknown. Consequently, this study aimed to determine the level of agreement between the FitroDyne and GymAware for the assessment of movement velocity in 3 resistance training exercises. Fifteen men performed 3 repetitions of bench press, back squat, and bent-over-row exercises at 10% 1 repetition maximum increments (from 20 to 80%). For each repetition, the FitroDyne and GymAware recorded peak and mean barbell velocity (cm·s-1). Although strongly correlated (r = 0.79-1.00), peak velocity values for the GymAware were significantly lower than the FitroDyne for all exercises and loads. Importantly, the random errors between the devices, quantified through Bland and Altman's 95% limits of agreement, were unacceptable, ranging from ±3.8 to 25.9 cm·s-1. Differences in mean velocity were smaller (and nonsignificant for most comparisons) and highly correlated (r = 0.86-1.00) between devices. Notwithstanding smaller random errors than for the peak values, mean values still reflected poor agreement (random errors between ±2.1 and 12.0 cm·s-1). These findings suggest that the FitroDyne and GymAware cannot record peak or mean velocity with acceptable agreement and should neither be used interchangeably nor their data compared., (Copyright © 2018 National Strength and Conditioning Association.)

Purpose: To identify the association between several contextual match factors, technical performance, and external movement demands on the subjective task load of elite rugby league players., Methods: Individual subjective task load, quantified using the National Aeronautics and Space Administration Task Load Index (NASA-TLX), was collected from 29 professional rugby league players from one club competing in the European Super League throughout the 2017 season. The sample consisted of 26 matches (441 individual data points). Linear mixed modeling revealed that various combinations of contextual factors, technical performance, and movement demands were associated with subjective task load., Results: Greater number of tackles (effect size correlation ± 90% confidence intervals; η2 = .18 ± .11), errors (η2 = .15 ± .08), decelerations (η2 = .12 ± .08), increased sprint distance (η2 = .13 ± .08), losing matches (η2 = .36 ± .08), and increased perception of effort (η2 = .27 ± .08) led to most likely-very likely increases in subjective total task load. The independent variables included in the final model for subjective mental demand (match outcome, time played, and number of accelerations) were unclear, excluding a likely small correlation with technical errors (η2 = .10 ± .08)., Conclusions: These data provide a greater understanding of the subjective task load and their association with several contextual factors, technical performance, and external movement demands during rugby league competition. Practitioners could use this detailed quantification of internal loads to inform recovery sessions and current training practices.

Background: This study determined the accuracy of different velocity-based methods when predicting one-repetition maximum (1RM) in young and middle-aged resistance-trained males., Methods: Two days after maximal strength testing, 20 young (age 21.0 ± 1.6 years) and 20 middle-aged (age 42.6 ± 6.7 years) resistance-trained males completed three repetitions of bench press, back squat, and bent-over-row at loads corresponding to 20-80% 1RM. Using reference minimum velocity threshold (MVT) values, the 1RM was estimated from the load-velocity relationships through multiple (20, 30, 40, 50, 60, 70, and 80% 1RM), two-point (20 and 80% 1RM), high-load (60 and 80% 1RM) and low-load (20 and 40% 1RM) methods for each group., Results: Despite most prediction methods demonstrating acceptable correlations ( r = 0.55 to 0.96), the absolute errors for young and middle-aged groups were generally moderate to high for bench press (absolute errors = 8.2 to 14.2% and 8.6 to 20.4%, respectively) and bent-over-row (absolute error = 14.9 to 19.9% and 8.6 to 18.2%, respectively). For squats, the absolute errors were lower in the young group (5.7 to 13.4%) than the middle-aged group (13.2 to 17.0%) but still unacceptable., Conclusion: These findings suggest that reference MVTs cannot accurately predict the 1RM in these populations. Therefore, practitioners need to directly assess 1RM.

Objective: The study was conducted to understand the effects of a short (10 min) and a long (30 min) duration warm-up on subsequent readiness to exercise and movement during simulated rugby league match play. Methods: Using a randomised cross-over design, 13 male rugby players (age: 23.6 ± 4.1 y) completed 10- or 30-min warm-up immediately before 2 × 23 min rugby league movement simulation protocol. Results: Total distance, high- and low speed running and tympanic temperature (ES = 0.56 to 20.8) were all higher in the 30 min warm-up, with differences in relative distance and heart rate unclear (ES = -0.36 to 0.06). Differences in participants' readiness to exercise after the warm-ups were unclear (ES = 0.25). Differences between trials for movement characteristics (ES = -0.13 to -0.32), RPE (ES = -0.13 to 0.04) and B[La] after the simulation were mostly unclear, with only trivial changes in high-speed running (ES = 0.08) and a lower heart rate (ES = -0.26) between the two playing bouts after the 30 min warm-up trial. Conclusion: Practitioners can use warm-ups between 10 or 30 minutes for rugby league interchange players without any implications for subsequent match running performance.

Sclerosing lipogranuloma (SLG) in children is a rare, benign disease of unknown etiology suspected to be due to abnormal fatty tissue reaction. A 13-year-old girl presented with progressively worsening back pain. Cross-sectional imaging identified a retroperitoneal mass compressing the left ureter as well as infrarenal inferior vena cava atresia with extensive venous collaterals and chronic partially occlusive thromboses of the iliac veins. Surgical biopsy was consistent with SLG and it resolved spontaneously. SLG is typically a disease of adulthood but may be seen in children. The association between inferior vena cava atresia with venous thrombosis and development of SLG has not been reported previously., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Dobbin, N, Highton, J, Moss, SL, Hunwicks, R, and Twist, C. Concurrent validity of a rugby-specific Yo-Yo intermittent recovery test (level 1) for assessing match-related running performance. J Strength Cond Res 35(1): 176-182, 2021-This study investigated the concurrent validity of a rugby-specific high-intensity intermittent running test against the internal, external, and perceptual responses to simulated match play. Thirty-six rugby league players (age 18.5 ± 1.8 years; stature 181.4 ± 7.6 cm; body mass 83.5 ± 9.8 kg) completed the prone Yo-Yo Intermittent Recovery Test (Yo-Yo IR1), of which 16 also completed the Yo-Yo IR1, and 2 × ∼20 minute bouts of a simulated match play (rugby league match simulation protocol for interchange players [RLMSP-i]). Most likely reductions in relative total, low-speed and high-speed distance, mean speed, and time above 20 W·kg-1 (high metabolic power [HMP]) were observed between bouts of the RLMSP-i. Likewise, rating of perceived exertion (RPE) and percentage of peak heart rate (%HRpeak) were very likely and likely higher during the second bout. Pearson's correlations revealed a large relationship for the change in relative distance (r = 0.57-0.61) between bouts with both Yo-Yo IR1 tests. The prone Yo-Yo IR1 was more strongly related to the RLMSP-i for change in repeated sprint speed (r = 0.78 cf. 0.56), mean speed (r = 0.64 cf. 0.36), HMP (r = 0.48 cf. 0.25), fatigue index (r = 0.71 cf. 0.63), %HRpeak (r = -0.56 cf. -0.35), RPEbout1 (r = -0.44 cf. -0.14), and RPEbout2 (r = -0.68 cf. -0.41) than the Yo-Yo IR1, but not for blood lactate concentration (r = -0.20 to -0.28 cf. -0.35 to -0.49). The relationships between prone Yo-Yo IR1 distance and measures of load during the RLMSP-i suggest that it possesses concurrent validity and is more strongly associated with measures of training or match load than the Yo-Yo IR1 using rugby league players., (Copyright © 2018 National Strength and Conditioning Association.)

Purpose: To examine responses to a simulated rugby league protocol designed to include more stochastic commands, and therefore require greater vigilance, than traditional team-sport simulation protocols., Methods: Eleven male university rugby players completed 2 trials (randomized and control [CON]) of a rugby league movement simulation protocol, separated by 7 to 10 d. The CON trial consisted of 48 repeated ∼115-s cycles of activity. The stochastic simulation (STOCH) was matched for the number and types of activity performed every 5.45 min in CON but included no repeated cycles of activity. Movement using GPS, heart rate, rating of perceived exertion, and Stroop test performance was assessed throughout. Maximum voluntary contraction peak torque, voluntary activation (in percentage), and global task load were assessed after exercise., Results: The mean mental demand of STOCH was higher than CON (effect size [ES] = 0.56; ±0.69). Mean sprint speed was higher in STOCH (22.5 [1.4] vs 21.6 [1.6] km·h-1, ES = 0.50; ±0.55), which was accompanied by a higher rating of perceived exertion (14.3 [1.0] vs 13.0 [1.4], ES = 0.87; ±0.67) and a greater number of errors in the Stroop test (10.3 [2.5] vs 9.3 [1.4] errors; ES = 0.65; ±0.83). Maximum voluntary contraction peak torque (CON = -48.4 [31.6] N·m and STOCH = -39.6 [36.6] N·m) and voluntary activation (CON = -8.3% [4.8%] and STOCH = -6.0% [4.1%]) was similarly reduced in both trials., Conclusions: Providing more stochastic commands, which requires greater vigilance, might alter performance and associated physiological, perceptual, and cognitive responses to team-sport simulations.

Aim: This study assessed the influence of fat mass to fat-free mass ratio (FM:FFM) on recovery from plyometric exercise., Method: After assessment of body composition, 20 male team sport players (age 20.7 ± 1.1 years; body mass 77.1 ± 11.5 kg) were divided into low- ( n = 10; 0.11 ± 0.03) and normal- ( n = 10; 0.27 ± 0.09) fat groups based on FM:FFM ratio. Thereafter, participants completed measurements of knee extensor torque at 60 and 240°∙s -1 , countermovement jump flight time, plasma creatine kinase (CK) activity and perceived muscle soreness (VAS) before and at 0, 24 and 48 h after 10 × 10 maximal plyometric vertical jumps., Results: Evidence of muscle damage was confirmed by alterations in VAS, peak torque at 60 and 240°∙s -1 and flight time at 0, 24 and 48 h after plyometric exercise ( P < 0.05). CK was increased at 0 and 24 h ( P < 0.05) but returned to baseline values by 48 h. No time by group effects were observed for any of the dependent variables ( P > 0.05)., Conclusion: The current findings indicate that while muscle damage was present after plyometric exercise, the magnitude was similar across the two body composition groups. Applied practitioners can allow for a similar recovery time after plyometric exercise in those with low and normal body fat.

Rabbani, A, Kargarfard, M, and Twist, C. Fitness monitoring in elite soccer players; group vs. individual analyses. J Strength Cond Res 34(11): 3250-3257, 2020-The aims of this study were to (a) examine changes in group and individual HR measures during a submaximal warm-up test, and (b) investigate the relationship between accumulated internal training loads and HR changes during an in-season phase among elite soccer players (n = 14). Before and after an in-season phase (24 days), exercise HR (HRex) and HR recovery (HRR) expressed either as the number of beats recovered (HRR60s) or as the mean HR (HRpost1) during 1 minute of recovery were analyzed. Heart rate measures were expressed as the % of maximal HR. Session rating of perceived exertion (sRPE) was computed for all training/match sessions. Group and individual HR changes were analyzed using magnitude-based inferences. Pearson correlation coefficients were also used to examine the relationships. Group analyses of HR changes revealed there were possibly to likely trivial changes in all HR measures. When analyzing individual data, no substantial change was observed for HRR60s%. However, substantial changes in HRex% and HRpost1% were observed for 4/14 and 5/14 players, respectively. The relationships between HRex% and HRpost1% were nearly perfect (r = 0.90, confidence limits [0.82-0.95]). The associations between changes in HRex% and HRpost1% were also nearly perfect (r = 0.92, 0.80-0.97). A very large inverse correlation was observed between HRex% and accumulated sRPE (r = -0.75, -0.44 to -0.90). This study highlights the value of conducting individual vs. group aerobic fitness monitoring. This study also showed the importance of how HRR is reported when aerobic fitness monitoring of elite soccer players.

Purpose: To examine the within- and between-sexes physical performance, well-being, and neuromuscular function responses across a 4-day international touch rugby (Touch) tournament., Methods: Twenty-one males and 20 females completed measures of well-being (fatigue, soreness, sleep, mood, and stress) and neuromuscular function (countermovement jump height, peak power output, and peak force) during a 4-day tournament with internal, external, and perceptual loads recorded for all matches., Results: Relative and absolute total, low-intensity (females), and high-intensity distance were lower on day 3 (males and females) (effect size [ES] = -0.37 to -0.71) compared with day 1. Mean heart rate was possibly to most likely lower during the tournament (except day 2 males; ES = -0.36 to -0.74), whereas rating of perceived exertion-training load was consistently higher in females (ES = 0.02 to 0.83). The change in mean fatigue, soreness, and overall well-being was unclear to most likely lower (ES = -0.33 to -1.90) across the tournament for both sexes, with greater perceived fatigue and soreness in females on days 3 to 4 (ES = 0.39 to 0.78). Jump height and peak power output were possibly to most likely lower across days 2 to 4 (ES = -0.30 to -0.84), with greater reductions in females (ES = 0.21 to 0.66). Well-being, countermovement jump height, and peak force were associated with changes in external, internal, and perceptual measures of load across the tournament (η2 = -.37 to .39)., Conclusions: Elite Touch players experience reductions in well-being, neuromuscular function, and running performance across a 4-day tournament, with notable differences in fatigue and running between males and females, suggesting that sex-specific monitoring and intervention strategies are necessary.

Purpose: The purpose of this study was to examine the physical match profiles of professional soccer players using 3 and 5 min fixed and rolling averages as well as fixed 1 min averages, with considerations to training prescription. Methods: Twenty-nine professional U23 soccer outfield players competed across 17 competitive matches during the 2017/18 season, equating to a total of 130 separate physical match profiles. Match activities were recorded using global positioning system (GPS) devices with integrated micro-electrical mechanical systems (MEMS), recording total distance (TD), high-speed running (HSR), and metabolic power (MP). For each individual match profile and variable, 1, 3, and 5 min peak, post-peak, and average values were calculated using fixed-time epochs (FIXED) and rolling averages (ROLL). Linear mixed models were employed to examine the differences in the dependent variables as a function of the method of measurement. Results: Results revealed significantly higher peak values, for relative TD, relative HSR and relative MP when employing the ROLL sampling method, in comparison to the FIXED method, for both 3 min and 5 min epoch lengths. Analysis of epoch length revealed significantly higher peak values, across all positions, for relative TD, relative HSR and MP for 1 min epochs, in comparison to 3 min and 5 min epochs. Conclusions: The data offers a novel insight into the appropriate identification of physical demands during youth soccer match-play. Researchers and practitioners should consider the sampling method and epoch length when assessing the physical demands of competitive match-play, as well as when designing and prescribing sport-specific conditioning drills.

Purpose: To determine the utility of running-only and rugby-specific, in-season sprint interval interventions in professional rugby league players., Methods: Thirty-one professional academy rugby players were assigned to a rugby-specific (SITr/s, n = 16) or running-only (SITr, n = 15) sprint interval training group. Measures of speed, power, change of direction ability, prone Yo-Yo Intermittent Recovery Test (Yo-Yo IR1) performance, and heart rate recovery were taken before and after the 2-week intervention as were submaximal responses to the prone Yo-Yo IR1. Internal, external, and perceptual responses were collected during SITr/s and SITr, with well-being and neuromuscular function assessed before each session., Results: Despite contrasting (possible to most likely) internal, external, and perceptual responses to the SIT interventions, possible to most likely within-group improvements in physical characteristics, heart rate recovery, and submaximal responses to the prone Yo-Yo IR1 were observed after both interventions. Between-group analysis favored the SITr/s intervention (trivial to moderate) for changes in 10-m sprint time, countermovement jump, change of direction, and medicine ball throw as well as submaximal (280-440 m) high metabolic power, PlayerLoad™, and acceleration distance during the prone Yo-Yo IR1. Overall changes in well-being or neuromuscular function were unclear., Conclusions: Two weeks of SITr/s and SITr were effective for improving physical characteristics, heart rate recovery, and submaximal responses to the prone Yo-Yo IR1, with no clear change in well-being and neuromuscular function. Between-group analysis favored the SITr/s group, suggesting that the inclusion of sport-specific actions should be considered for in-season conditioning of rugby league players.

The study assesses the test-retest reliability of movement and physiological measures during a simulated rugby match that employed activities performed in a stochastic order. Twenty male rugby players (21.4 ± 2.1 y) completed two trials of a 2 × 23 min rugby movement simulation protocol during which the order of events was performed in a stochastic order, with 7-10 days between trials. Movement characteristics, heart rate (HR), RPE, maximum voluntary contraction (MVC), voluntary activation (VA%) of the quadriceps, Stroop test and subjective task load rating (NASA-TLX) were measured. The most reliable measures of external load was relative distance (typical error [TE] and CV% = 1.5-1.6 m min -1 and 1.4-1.5%, respectively), with all other movement characteristics possessing a CV% <5%. The most reliable measure of internal load, neuromuscular function and perceptual measures were for %HRmax (TE and CV% = 1.4-1.7% and 1.4-2.1%, respectively), MVC before (TE and CV% = 10.8-14.8 N·m and 3.8-4.6%, respectively), and average RPE (TE and CV% = 0.5-0.8 AU and 3.6-5.5%, respectively). The Stroop test, NASA-TLX and blood lactate produced the least reliable measures (CV% >5%). Future studies can confidently examine changes in several perceptual, neuromuscular, physiological and movement measures related to rugby activity using stochastic movements.

Purpose: To assess whether a standardized testing battery can differentiate anthropometric and physical qualities between youth, academy, and senior rugby league players and determine the discriminant validity of the battery., Methods: A total of 729 rugby league players from multiple clubs in England categorized as youth (n = 235), academy (n = 362), and senior (n = 132) players completed a standardized testing battery that included the assessment of anthropometric and physical characteristics during preseason. Data were analyzed using magnitude-based inferences and discriminant analysis., Results: Academy players were most likely taller and heavier than youth players (effect size [ES] = 0.64-1.21), with possibly to most likely superior countermovement jump, medicine-ball throw, and prone Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) performance (ES = 0.23-1.00). Senior players were likely to most likely taller and heavier (ES = 0.32-1.84), with possibly to most likely superior 10- and 20-m sprint times, countermovement jump, change of direction, medicine-ball throw, and prone Yo-Yo IR1 than youth and academy players (ES = -0.60 to 2.06). The magnitude of difference appeared to be influenced by playing position. For the most part, the battery possessed discriminant validity with an accuracy of 72.2%., Conclusion: The standardized testing battery differentiates anthropometric and physical qualities of youth, academy, and senior players as a group and, in most instances, within positional groups. Furthermore, the battery is able to discriminate between playing standards with good accuracy and might be included in future assessments and rugby league talent identification.

Purpose: To investigate the relationship between accumulated global positioning system-accelerometer-based and heart rate-based training metrics and changes in high-intensity intermittent-running capacity during an in-season phase in professional soccer players., Methods: Eleven male professional players (mean [SD] age 27.2 [4.5] y) performed the 30-15 Intermittent Fitness Test (30-15IFT) before and after a 5-wk in-season training phase, and the final velocity (VIFT) was considered their high-intensity intermittent-running capacity. During all sessions, Edwards training impulse (Edwards TRIMP), Banister TRIMP, Z5 TRIMP, training duration, total distance covered, new body load (NBL), high-intensity running performance (distance covered above 14.4 km·h-1), and very-high-intensity running performance (distance covered above 19.8 km·h-1) were recorded., Results: The players' VIFT showed a most likely moderate improvement (+4.3%, 90% confidence limits 3.1-5.5%, effect size 0.70, [0.51-0.89]). Accumulated NBL, Banister TRIMP, and Edwards TRIMP showed large associations (r = .51-.54) with changes in VIFT. A very large relationship was also observed between accumulated Z5 TRIMP (r = .72) with changes in VIFT. Large to nearly perfect within-individual relationships were observed between NBL and some of the other training metrics (ie, Edwards TRIMP, Banister TRIMP, training duration, and total distance) in 10 out of 11 players., Conclusions: Heart rate-based training metrics can be used to monitor high-intensity intermittent-running-capacity changes in professional soccer players. The dose-response relationship is also largely detected using accelerometer-based metrics (ie, NBL) to track changes in high-intensity intermittent-running capacity of professional soccer players.

Purpose: To investigate the factors affecting the anthropometric and physical characteristics of elite academy rugby league players., Methods: One hundred ninety-seven elite academy rugby league players (age = 17.3 [1.0] y) from 5 Super League clubs completed measures of anthropometric and physical characteristics during a competitive season. The interaction between and influence of contextual factors on characteristics was assessed using linear mixed modeling., Results: All physical characteristics improved during preseason and continued to improve until midseason, whereafter 10-m sprint (η2 = .20 cf .25), countermovement jump (CMJ) (η2 = .28 cf .30), and prone Yo-Yo Intermittent Recovery (Yo-Yo IR) test (η2 = .22 cf .54) performance declined. Second (η2 = .17) and third (η2 = .16) -year players were heavier than first-years, whereas third-years had slower 10-m sprint times (η2 = .22). Large positional variability was observed for body mass, 20-m sprint time, medicine-ball throw, CMJ, and prone Yo-Yo IR1. Compared with bottom-ranked teams, top-ranked teams demonstrated superior 20-m (η2 = -.22) and prone Yo-Yo IR1 (η2 = .26) performance, whereas middle-ranked teams reported higher CMJ height (η2 = .26) and prone Yo-Yo IR1 distance (η2 = .20) but slower 20-m sprint times (η2 = .20)., Conclusion: These findings offer practitioners who design training programs for academy rugby league players insight into the relationships between anthropometric and physical characteristics and how they are influenced by playing year, league ranking, position, and season phase.

This study compared the time course of recovery after a squatting exercise in trained young (YG; n = 9; age 22.3 ± 1.7 years) and trained (MT; n = 9; 39.9 ± 6.2 years) and untrained (MU; n = 9; age 44.4 ± 6.3 years) middle-aged males. Before and at 24 and 72 h after 10 × 10 squats at 60% one-repetition maximum (1RM), participants provided measurements of perceived muscle soreness (VAS), creatine kinase (CK), maximal voluntary contraction (MVC), voluntary activation (VA), and resting doublet force of the knee extensors and squatting peak power at 20% and 80% 1RM. When compared to the YG males, the MT experienced likely and very likely moderate decrements in MVC, resting doublet force, and peak power at 20% and 80% 1RM accompanied by unclear differences in VAS, CK, and VA after the squatting exercise. MU males, compared to MT, experienced greater alterations in peak power at 20% and 80% 1RM and VAS. Alterations in CK, MVC, VA, and resting doublet force were unclear at all time-points between the middle-aged groups. Middle-aged males experienced greater symptoms of muscle damage and an impaired recovery profile than young resistance trained males. Moreover, regardless of resistance training experience, middle-aged males are subject to similar symptoms after muscle-damaging lower-body exercise.

Clarke, JS, Highton, J, Close, GL, and Twist, C. Carbohydrate and caffeine improves high-intensity running of elite rugby league interchange players during simulated match play. J Strength Cond Res 33(5): 1320-1327, 2019-The study examined the effects of carbohydrate and caffeine ingestion on simulated rugby league interchange performance. Eight male elite rugby league forwards completed 2 trials of a rugby league simulation protocol for interchange players 7 days apart in a randomized crossover design, ingesting either carbohydrate (CHO; 40 g·h) or carbohydrate and caffeine (CHO-C) (40 g·h + 3 mg·kg) drink. Movement characteristics, heart rate, ratings of perceived exertion (RPE), and countermovement jump (CMJ) height were measured during the protocol. CHO-C resulted in likely to very likely higher mean running speeds (effect size [ES] 0.43-0.75), distance in high-intensity running (ES 0.41-0.64), and mean sprint speeds (ES 0.39-1.04) compared with CHO. Heart rate was possibly to very likely higher (ES 0.32-0.74), and RPE was likely to very likely lower (ES -0.53 to 0.86) with CHO-C. There was a likely trivial to possibly higher CMJ in CHO-C compared with CHO (ES 0.07-0.25). The coingestion of carbohydrate with caffeine has an ergogenic effect to reduce the sense of effort and increase high-intensity running capability that might be used to enhance interchange running performance in elite rugby league players.

Background: To compare load-velocity and load-power relationships among first grade ( n = 26, age 22.9 ± 4.3 years), academy ( n = 23, age 17.1 ± 1.0 years), and scholarship ( n = 16, age 15.4 ± 0.5 years) Super League rugby league players., Methods: Participants completed assessments of maximal upper- and lower-body strength (1RM) and peak velocity and power at 20, 40, 60, and 80 kg during bench press and squat exercises, in a randomised order., Results: Bench press and squat 1RM were highest for first grade players compared with other standards (effect size (ES) = -0.43 to -3.18). Peak velocities during bench and squat were greater in the higher playing standards (ES = -0.39 to -3.72 range), except for the squat at 20 and 40 kg. Peak power was higher in the better playing standards for all loads and exercises. For all three groups, velocity was correlated to optimal bench press power ( r = 0.514 to 0.766), but only 1RM was related to optimal power ( r = 0.635) in the scholarship players. Only squat 1RM in the academy was related to optimal squat power ( r = 0.505)., Conclusions: Peak velocity and power are key physical qualities to be developed that enable progression from junior elite rugby league to first grade level. Resistance training should emphasise both maximal strength and velocity components, in order to optimise upper- and lower-body power in professional rugby league players.