Reply to "Asking the Right Question Is Key to Getting a Valuable Answer".

Author response to the JOSPT Letter to the Editor-in-Chief "Asking the Right Question is Key to Getting a Valuable Answer" J Orthop Sports Phys Ther 2023;53(11):726-727. doi:10.2519/jospt.2023.0204-R.

The Relationship Between Neck Strength and Sports-Related Concussion in Team Sports: A Systematic Review With Meta-analysis.

OBJECTIVE: We aimed to quantify the relationship between neck strength and sports-related concussion (SRC) for athletes participating in team sports. DESIGN: Etiology systematic review with meta-analysis. LITERATURE SEARCH: PubMed, PsycINFO, MEDLINE, CINAHL, CENTRAL, and Scopus were searched on March 17, 2022, and updated on April 18, 2023. STUDY SELECTION CRITERIA: Team sports where an opponent invades the player's territory (eg, football, rugby, basketball) that reported at least 1 measure of neck strength, and 1 measure of SRC incidence, using cohort, case-control, or cross-sectional study designs. The Newcastle-Ottawa scale was used to assess risk of bias; certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. DATA SYNTHESIS: Studies were summarized qualitatively and quantitatively. To understand the relationship between neck strength and future SRC incidence, random-effects meta-analysis was conducted on prospective longitudinal studies. RESULTS: From a total of 1445 search results, eight studies including 7625 participants met the inclusion criteria. Five studies reported a relationship between greater neck strength or motor control and reduced concussion incidence. Pooled results from 4 studies indicated small (r = 0.08-0.14) nonsignificant effects with substantial heterogeneity (I2>90%). The considerable heterogeneity is likely a result of synthesized studies with vastly different sample characteristics, including participant age, playing level, and sports. CONCLUSIONS: There was very low-certainty evidence suggesting a small, nonsignificant relationship between greater neck strength and a lower risk of sustaining a SRC. J Orthop Sports Phys Ther 2023;53(10):1-9. Epub: 10 July 2023. doi:10.2519/jospt.2023.11727.

Comparison of the neuromuscular response to three different Turkish, semi-professional football training sessions typically used within the tactical periodization training model.

This study examined the neuromuscular responses to three typical football (soccer) training sessions and the reliability of peak speed (PS) measured during a submaximal running test (SRT) for identifying neuromuscular fatigue (NMF) status. Jump height (CMJH) and peak velocity (CMJPV) were collected from a CMJ test, while peak speed (PS) was collected during an SRT before and after each training session. Large effect size (ES) decreases were observed in each variable post-training (ES; - 1.42 to - 2.32). Significant differences (> 0.001) were detected between each football session's external load variables. Coefficients of variations were small (< 10%) with moderate (CMJPV; 0.53, PS; 0.44) and strong (CMJH; 0.72) intraclass correlation coefficients between pre-test measures. The demands of each football session aligned with the principles of tactical periodization and were sufficient to produce the fatigue necessary to elicit physiological adaptations. PS was also shown to be a viable measure of monitoring NMF status.

Difference between preferred and non-preferred leg in peak speed, acceleration, and deceleration variables and their relationships with the change-of-direction deficit.

The aim of this study was two-fold: (i) analyze the variation of kinematic measures between using preferred and non-preferred legs while braking during the 5-0-5 change of direction test; and (ii) test the relationships between kinematic measures, and change-of-direction deficit (CODD). A cross-sectional study using twenty adult male soccer players (21.6 ± 2.0 years; 73.2 ± 6.1 kg; 174.8 ± 4.5 cm) was employed. Players performed three repetitions of the 5-0-5 test using each leg during the braking phase. Players have used the Polar Team Pro to obtain the kinematic measures of peak speed, peak acceleration, and peak deceleration. Additionally, the CODD was also obtained using single-beamed photocells. Comparisons revealed a significantly greater peak acceleration (+ 0.22 m/s2; p < 0.001) and deceleration (+ 0.17 m/s2; p = 0.004) for the non-preferred leg. There were no significant correlations were found between CODD and peak accelerations (r = - 0.014, [- 0.193; 0.166]), peak decelerations (r = - 0.052, [- 0.229; 0.128]) or peak speed (r = 0.118, [- 0.063; 0.291]). This study revealed that preferred and non-preferred leg must be analyzed differently since they are different in the kinematic variables. However, CODD seems independent of leg preference and the kinematic measures of a 5-0-5 change of direction test.

What are the odds? Identifying factors related to competitive success in powerlifting.

BACKGROUND: The ability for athletes to gain a competitive advantage over their opponents is well recognised. At times, this advantage may be considered a marginal gain. However, in the context of competition, marginal advantages may be the difference between winning and losing. This investigation explores how competition factors influence the odds of competitive success (i.e. winning) in powerlifting (PL) to assist athletes and coaches in achieving a competitive advantage. METHODS: A cross-sectional, retrospective analysis of competition data from raw/classic, Australian powerlifting competitions 2010-2019 was conducted. Data included 10,599 competition entries (males: n = 6567 [62%], females: n = 4032 [38%]). Independent t-tests were used to compare continuous data between sexes or winners and non-winners at an event. Cohen's d and the 95% confidence interval (d [95% CI]) were calculated. Univariate odds of winning an event based on independent variables (age [irrespective of category], sex, body weight and weight of first lift attempt [regardless of success]), were assessed by separate simple logistic regression. RESULTS: When compared to males, the odds of winning for females were 50% greater (OR [95% CI] 1.500 [1.384, 1.625]; P < 0.001). Athletes who had larger first lift attempts (Squat: + 7.0 kg P < 0.001, Bench Press: + 3.2 kg P < 0.001, and Deadlift: + 6.1 kg P < 0.001and competed for a longer period (winners: 401 vs non-winners: 304 days, P < 0.001) had an increased likelihood winning. Age was associated with increased odds of success for males (OR [95% CI] 1.014 [1.009, 1.019], P < 0.001) per additional year of age for males, but not females (P = 0.509). CONCLUSIONS: Multiple factors appear to contribute to the likelihood of winning a PL competition. These results may help coaches to develop competition and training strategies that optimise athletes' likelihood of competitive success in PL.

Impacts of squat attempt weight selection and success on powerlifting performance.

BACKGROUND: To date, there is no evidence to support the optimal competition strategy for success in powerlifting competitions. The purpose of this study was to analyze powerlifting (PL) competition data to assess the relationship between squat attempts, the success of each lift attempt, and weight increase between attempts, with winning. METHODS: The analysis from 'raw' Powerlifting Australia sanctioned competitions held between 2008 and 2019 included 10,672 individual competition entries (males: N.=6617, females: N.=4055). We reported Cohen's d, statistical significance, 95% confidence intervals and the univariate odds of winning an event. Factors were assessed by separate simple logistic regression and reported as an odds ratio. RESULTS: Overall, first squat attempt weight for those who won was on average 7.0 kg greater (P<0.001, d=0.14 [0.10, 0.18]) than for non-winners. In the total sample, athletes selected opening attempts which were an average of 92% of their achieved maximum on the day with 93.5% of competitors improving on this weight in subsequent attempts. Winners had a 0.5 kg (P<0.001, d=0.10 [0.06, 0.14]) greater absolute increase in weight between first and second lift attempts than non-winners. Overall, ~68% of winners successfully lifted their third attempt weight compared to ~64% of non-winners (P<0.001). CONCLUSIONS: A powerlifting athlete's odds of winning a competition overall are significantly increased by selecting a larger opening squat attempt weight than competitors and completing the attempt successfully. The opening squat may be one of the most important lifts during competition.

Comparison of a Countermovement Jump Test and Submaximal Run Test to Quantify the Sensitivity for Detecting Practically Important Changes Within High-Performance Australian Rules Football.

PURPOSE: To determine the typical variation of variables from a countermovement jump (CMJ) test and a submaximal run test (SRT), along with comparing the sensitivity of each test for the detection of practically important changes within high-performance Australian rules football players. METHODS: A total of 23 professional and semiprofessional Australian rules football players performed 6 CMJs and three 8-second 50-m runs every 30 seconds (SRT), 7 days apart. Absolute and trial-to-trial reliability was represented as a coefficient of variation, CV (±90% confidence intervals). Test-retest reliability was examined using the magnitude of the difference (effect size [±90% confidence interval]) from week 1 to week 2. The smallest worthwhile change was calculated as 0.25 × SD. RESULTS: Good reliability (CVs = 6.6%-9.3%) was determined for all variables except eccentric displacement (CV = 12.8%), with no clear changes observed in any variables between week 1 and week 2. All variables from the SRT possessed a CV less than smallest worthwhile change, indicating an ability to detect practically important changes in performance. Only peak velocity from the CMJ test possessed a CV less than smallest worthwhile change, exhibiting a limitation of this test in detecting practically meaningful changes within this environment. CONCLUSIONS: The results suggest that while all variables possess acceptable reliability, a SRT might offer to be a more sensitive monitoring tool than a CMJ test within high-performance Australian rules football, due to its greater ability for detecting practically important changes in performance.

The effects of fatigue on the running profile of elite team sport athletes. A systematic review and meta-analysis.

INTRODUCTION: With the underlying mechanisms of fatigue shown to be task-specific, gaining an understanding of changes within the running profile due to fatigue may provide a greater task-specific method for monitoring neuromuscular fatigue (NMF) in elite team sport athletes. This review aimed to identify, review and summarize the literature to understand the effects of fatigue on the running profile of elite team sport athletes. EVIDENCE ACQUISITION: MEDLINE, SPORTDiscus, EMBASE and CINAHL were searched. To manage heterogeneity in athlete characteristics and sport demands, studies were limited to elite male field/court team sports, in which changes in running, gait or stride characteristics were assessed. EVIDENCE SYNTHESIS: Thirteen studies were included in the analysis with changes in sprint time, kinematic variables; contact time, center of mass vertical displacement and vertical stiffness, GPS accelerometer vector variables; z and y, and mechanical parameters; velocity and V0, all shown to be sensitive measures of fatigue. Due to having at least three sets of data points, meta-analysis was run for sprint time, with results showing a significant increase immediately postexercise (effect size [ES]±95% confidence interval [CI]; 1.67±1.61, P=0.04), but no change 24 hours postexercise (ES±95% CI; 0.93±3.21, P=0.57). CONCLUSIONS: The findings indicate that fatigue has a negative impact on the running profile in elite team sport athletes, offering an alternative task-specific measure of monitoring NMF in this population. However, due to large discrepancies in protocols, future research is required to allow greater uniformity in variables and methods.