Certainty of Evidence Assessment in Systematic Reviews Published by High-Impact Sports Science Journals: A Meta-epidemiological Study.

BACKGROUND: Assessing certainty of evidence is a key element of any systematic review. The aim of this meta-epidemiology study was to understand the frequency and ways with which certainty of evidence is assessed in contemporary systematic reviews published in high-impact sports science journals. METHODS: We searched PubMed and relevant journal web sites from 1 August 2016 to 11 October 2022 for systematic reviews published in the top-ten highest-impact journals within the 2020 Journal Citation Report for the Sports Sciences category. Pairs of independent reviewers screened items using a priori established criteria. RESULTS: Of 1250 eligible documents, 258 (20.6%) assessed the certainty of evidence, defined as using two or more distinct domains to provide an overall rating of the trustworthiness of findings across studies. Nine methods were cited for assessing certainty, with the most common being the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach (61.6%). The proportion of systematic reviews assessing certainty of evidence appeared to increase over the 6-year timeframe analyzed. Across all reviews analyzed, a large majority addressed the domains of risk of bias, imprecision, and inconsistency of the results. Other certainty domains including indirectness/applicability were less commonly assessed. DISCUSSION: Only one in five recent contemporary systematic reviews in the field of exercise and sports science assessed certainty of evidence. Organizational and institutional education on methods for assessing evidence may help further increase uptake of these methods and improve both the quality and clinical impact of systematic reviews in the field.

The Effects of Intermittent Diet Breaks during 25% Energy Restriction on Body Composition and Resting Metabolic Rate in Resistance-Trained Females: A Randomized Controlled Trial.

The purpose of this study was to examine the effects of intermittent versus continuous energy restriction on body composition, resting metabolic rate, and eating behaviors in resistance-trained females. Thirty-eight resistance-trained females (mean ± standard deviation age: 22.3 ± 4.2 years) were randomized to receive either six weeks of a continuous 25% reduction in energy intake (n = 18), or one week of energy balance after every two weeks of 25% energy restriction (eight weeks total; n = 20). Participants were instructed to ingest 1.8 g protein/kilogram bodyweight per day and completed three weekly supervised resistance training sessions throughout the intervention. There were no differences between groups for changes over time in body composition, resting metabolic rate, or seven of the eight measured eating behavior variables (p > 0.05). However, a significant group-by-time interaction for disinhibition (p < 0.01) from the Three-Factor Eating Questionnaire was observed, with values (± standard error) in the continuous group increasing from 4.91 ± 0.73 to 6.17 ± 0.71, while values in the intermittent group decreased from 6.80 ± 0.68 to 6.05 ± 0.68. Thus, diet breaks do not appear to induce improvements in body composition or metabolic rate in comparison with continuous energy restriction over six weeks of dieting, but may be employed for those who desire a short-term break from an energy-restricted diet without fear of fat regain. While diet breaks may reduce the impact of prolonged energy restriction on measures of disinhibition, they also require a longer time period that may be less appealing for some individuals.

Sex Differences May Exist for Performance Fatigue but Not Recovery After Single-Joint Upper-Body and Lower-Body Resistance Exercise.

ABSTRACT: Lewis, MH, Siedler, MR, Lamadrid, P, Ford, S, Smith, T, SanFilippo, G, Waddell, B, Trexler, ET, Buckner, S, and Campbell, BI. Sex differences may exist for performance fatigue but not recovery after single-joint upper-body and lower-body resistance exercise. J Strength Cond Res 36(6): 1498-1505, 2022-This study evaluated sex differences in performance recovery and fatigue during dynamic exercise. Twenty-eight resistance-trained males (n = 16) and females (n = 12) completed a repeated-measures, randomized, parallel-groups design. The protocol consisted of a baseline assessment, a recovery period (4, 24, or 48 hours), and a postrecovery assessment. The assessments were identical consisting of 4 sets of 10 repetition maximum (10RM) bicep curls and 4 sets of 10RM leg extensions to failure. Recovery was quantified as the number of total repetitions completed in the postrecovery bout. Fatigue was quantified as the number of repetitions completed set to set within the session. For analysis, we set the level of significance at p ≤ 0.05. No sex differences in performance recovery were observed across any of the investigated time periods for either exercise modality. Regarding fatigue, significant effects were observed for set (p < 0.001) and sex (p = 0.031) for bicep curls. Repetitions dropped in later sets, and females generally completed a greater number of repetitions than males (8.8 ± 0.5 vs. 7.2 ± 0.5). For leg extension, a significant sex × set interaction was observed (p = 0.003), but post hoc tests revealed these sex differences as marginal. Our results suggest that in dynamic bicep curls and leg extensions, other factors unrelated to sex may be more impactful on performance recovery. To optimize an athlete's desired adaptations, it may be more important to consider other variables unrelated to sex such as volume, perceived exertion, and training history when formulating training prescriptions for single-joint exercises.

The quality of physical activity guidelines, but not the specificity of their recommendations, has improved over time: a systematic review and critical appraisal.

While numerous guidelines for the prescription of physical activity are released each year, the quality and practicability of these guidelines is unknown. We assessed the quality of 95 guidance documents published since 2000 that included recommendations about physical activity for the promotion of general health and prevention of cardiometabolic disease. We used 3 tools: Appraisal of Guidelines for Research and Evaluation (AGREE II), the National Academy of Medicine's (NAM) Standards for Trustworthy Clinical Practice Guidelines, and the Frequency, Intensity, Time, and Type (FITT) score. Average AGREE II domain scores ranged from 38%-84%, and the portion of criteria fulfilled per NAM domain ranged from 7%-39%. The average FITT score for all recommendations was 2.48 out of 4. While guidelines improved according to both AGREE II and the NAM standards over time, their practicability as assessed by FITT score did not improve. Guidelines produced by governmental agencies or other nonprofit organizations, using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, or fulfilling a higher number of NAM criteria tended to be of higher quality. Organizations producing physical activity guidelines can improve their quality by establishing and reporting processes for public representation, external review, and conflict of interest (COI) management. Future recommendations about physical activity should be more specific and include strategies to improve implementation. Registration no.: PROSPERO CRD42019126364. Novelty: Most physical activity recommendations are not sufficiently specific to be practically implemented. The overall quality of guidelines has improved over time, but the specificity of recommendations has not. Improved public representation, external review, and COI disclosure and management processes would improve guideline quality.