Reliability of lower limb strength assessment in female team sport athletes.

BACKGROUND: Lower limb injury rates have increased dramatically in line with increased female sport participation levels. Muscle strength is a modifiable lower limb injury risk factor, guiding performance monitoring and rehabilitation. OBJECTIVES: The aim of this study was to investigate the test-retest reliability of isokinetic and isometric lower limb peak torque to body mass of muscles acting on the hip, knee, and ankle in female team sport athletes. It was hypothesised the test-retest reliability would be good (intraclass correlation coefficients (ICC) ≥ 0.75). METHODS: Thirty-eight female athletes (Australian Rules Football = 18, netball = 12, soccer = 8) aged 16-35 years participated in this study. Participants performed isokinetic (60°/s and 120°/s) and isometric testing on a Biodex Isokinetic Dynamometer on three separate days. RESULTS: Poor to good reliability was demonstrated for all joint movements (ICC = 0.38-0.88) with small to moderate effect sizes (0.00-0.43) and typical errors (5.65-24.49). CONCLUSION: Differences in peak torque to body mass were observed between sessions one and two and/or one and three, demonstrating a learning effect. Therefore, three testing sessions, and/or the inclusion of a familiarisation session, is recommended for future assessments in populations unfamiliar with dynamometry.

The impact of extreme heat on mass-gathering sporting events: Implications for Australia and other countries.

OBJECTIVES: As temperatures increase across the globe due to climate change, human exposure to extreme heat is a public health challenge. During sporting events, athletes, officials, spectators, and staff are at risk of heat stress and resulting illness. The objective of this review was to explore the impact of heat on the health outcomes of these groups and the wider health system and discuss implications for outdoor mass-gathering sporting events in Australia. DESIGN: A systematic review was undertaken to identify literature published from 2010 to 2023. METHODS: Seven databases were searched: Web of Science, SportDiscus, Scopus, Medline, CINAHL, Emcare, and PsychInfo, for relevant key search terms such as heatwave, heat stress, extreme heat, stadium, arena, sports facilit*, sport, athletic, and Olympic. An inductive thematic analysis was undertaken. Articles were quality checked using Joanna Briggs Institute critical appraisal tools and data were extracted, tabulated, and synthesized. RESULTS: Forty papers were included in the final analysis: 17 quantitative, and 23 descriptive and qualitative (including reviews). Health outcomes explored across the literature included exertional heat illness, exertional heat stroke, hyperthermia, and general heat related illness. Six recommendation themes emerged: planning, mitigation strategies, medical, policy, research, and education. CONCLUSIONS: The impact of heat on health outcomes during sporting events is significant, and should be considered by individuals, coaches, officials, and organizers before, during, and after mass-gathering sporting events. These findings can inform evidence-based preparedness strategies to protect the health of those attending and competing in mass-gathering sporting events now and into the future.

Acute Response to Training after Returning from the Off-Season in Elite Rugby League Athletes.

The purposes of this study were to quantify the physiological response to the initial two-week preseason period in elite male rugby league (RL) athletes, and to determine if a repeated bout effect (RBE) occurs. Eighteen RL players were monitored for the initial two-week preseason period. Blood samples were collected on days (D)1, D2, D4, D5, D8, D9, D11 and D12 to measure creatine kinase (CK). Neuromuscular power was assessed on D1, D5, D8 and D12. During field-based sessions, the external training load was quantified using global positioning system technology, whilst the internal load was quantified using the training impulse and the session rating of perceived exertion. Resistance-based gym session volume was quantified by total repetitions x weight lifted. Perceived measures of fatigue and muscle soreness were assessed on all training days. Two-way (day x week) repeated measures analysis of variance and Bonferroni's corrected post-hoc tests identified significant changes. There were no significant changes in CK activity (649.2 ± 255.0 vs. 673.8 ± 299.1 µL; p = 0.63) or internal training load measures from week 1 to week 2. External training load measures including total distance (4138.1 ± 198.4 vs. 4525.0 ± 169.2 m; p < 0.001) and repeated high-intensity efforts (12.6 ± 1.8 vs. 17.5 ± 1.8 au; p < 0.001) significantly increased in week 2 compared to week 1. Internal training loads and CK activity did not change in response to an increase in external training loads during the initial preseason. The current results provide support for a 'real world' perspective of the RBE phenomenon that may be more applicable for team sport practitioners.

Effects of shift work on sleep quality and cardiovascular function in Taiwanese police officers.

This study aimed to investigate the effects of shift work on sleep quality, cardiovascular function, and physical activity (PA) levels in Taiwanese police officers. Twenty-one male police officers aged 26.9 ± 4.1 years old located in Taipei voluntarily participated in this study. The participants completed the resting heart rate (HR) and hemodynamic variables (e.g. blood pressure, BP) before and after day-time (DTW) and night-time (NTW) shift work phases (5 working days and 2 resting days for each phase). Additionally, an actigraphy was administered to measure PA and sleep patterns in the last 3 working days. The average total sleep time and sleep efficiency were 278.5 ± 79. 6 min and 72.9 ± 10%, respectively, in the NTW phases, which were significantly lower than that in the DTW phases. A comparison of the PA characteristics between the two phases revealed that a lower proportion of moderate-vigorous PA (1.2 ± 0.8%) and a greater proportion of sedentary behaviour PA (74.8 ± 6.4%) was found in the NTW phases. The results of hemodynamic measures demonstrated that the police officers have significantly elevated systolic BP by 3.3% and diastolic BP by 3.9% after the NTW phases. Furthermore, the NTW phases exhibited a significantly higher percentage change ratio of systolic BP and diastolic BP compared to the DTW phases. Compared with the DTW phases, the NTW phase was significantly more likely to report higher decreasing parasympathetic-related HR variability with a range of -5.9% to -7.8%. In conclusion, night-time shift work resulted in negative physiological changes leading to adverse effects on the health and well-being of Taiwanese police officers.

Impact of Spectators, League and Team Ability on Home Advantage in Professional European Basketball.

Our aim in this study was to examine the impact of fans (vs. no fans), geographical location of league, and team ability on home winning percentage (HW%) or home advantage (HA) in professional European basketball. Data were collected from five prestigious professional, national basketball leagues within Europe (Spain, Germany, Italy, Greece and Israel) across 16 regular seasons (2005-2006 to 2020-2021). We conducted comparisons between matches with and without fans, location of leagues, team ability (High, Medium, Low), and combinations of these factors via non-parametric tests (e.g., Mann-Whitney tests, Kruskal-Wallis). We found significantly greater HA during matches with fans for leagues in Germany (p = .001), Italy (p = .012) and Spain (p = .002). For matches with fans, HA and HW% were significantly different between several, but not all, leagues for high (p < .05), medium (p < .05) and low (p < .02) team abilities. In conclusion, HA and HW% were enhanced by spectator attendance, with this phenomenon varying by location/region and team ability. Consideration of these multiple contextual factors may assist coaches and sport organizations to develop key strategies for enhanced team success.

Effects of exercise training on heart rate variability in individuals with lower extremity arterial disease and claudication: A systematic review.

PURPOSE: To perform a systematic review of studies assessing the effects of regular exercise on heart rate variability (HRV) in individuals with lower extremity arterial disease (LEAD) and symptoms of claudication. METHODS: A systematic search in the electronic databases MEDLINE, Embase, and Scielo, was conducted and updated on January 21, 2023. Randomized clinical trials investigating patients with LEAD and IC, assessing ≥ 4 wk of exercise interventions, and reporting at least one HRV measure (e.g., time or frequency domains) at baseline and follow-up were included. Two reviewers independently screened studies for inclusion, performed data extraction, and quality assessment of included studies. RESULTS: Data from 7 trials were included (i.e., 5 walking, 1 resistance, and 1 isometric handgrip training), totaling 327 patients (66% males; range: 61 - 68 yr; ankle brachial index: 0.4 - 0.7). Following exercise training, three studies investigating walking training reported an increase in parasympathetic modulation indices and/or a decrease in sympathetic modulation indices (n = 2) as well as an increase in non-linear indices (n = 1). CONCLUSION: The current evidence is weak, and larger randomized controlled trials are needed to confirm the efficacy of exercise training in improving HRV. Additionally, the high divergence in the methodology of studies indicated the need for standard tools to improve the quality of HRV measurements in exercise trials. It is recommended to use standard procedures in future trials investigating HRV.

Acute effects of prior conditioning activity on change of direction performance. A systematic review and meta-analysis.

We performed a systematic review and meta-analysis on the acute effects of prior conditioning activity (CA) on change of direction (COD) performance. Eligible studies, involving healthy participants undergoing acute CA with at least one measure of COD performance, were analysed across diverse databases. A total of 34 studies were included for systematic review with 19 studies included for the meta-analysis. The intervention condition resulted in significantly faster (Z = 4.39; standard mean difference [SMD] = 0.49; p < 0.05) COD performance compared with the control condition. Both unloaded and light loaded CA resulted in significantly greater (SMD = 0.58-0.59) COD performance compared to the control condition. Moreover, heavy loaded CA demonstrated a significant but small (SMD = 0.24) improvement in COD performance compared to the control condition. Age and study design had no effect on the overall meta-analysis outcomes. Both males and females exhibited similar moderate effects with CA but only males demonstrated significantly greater COD performance compared to control conditions. Our findings indicate that a range of CA protocols can acutely improve COD performance with unloaded and light-loaded CA resulting in the greatest performance enhancements. These findings will assist practitioners with the design and implementation of appropriate acute CA to improve COD performance.

Intra-Session Reliability of Sprint Performance on a Non-Motorised Treadmill for Healthy Active Males and Females.

This study examined the intra-session reliability of sprint performance on a non-motorized treadmill amongst healthy, active male and female adults. One hundred and twenty participants (males n = 77; females n = 45) completed two familiarization sessions, followed by a third session that consisted of three trials (T1, T2, T3) of maximal sprints (4-s), interspersed by three minutes of recovery. Combining males and females exhibited moderate-to-excellent test-retest reliability (intra-class correlation coefficient, ICC), minimal measurement error (coefficient of variation, CV) and trivial differences between trials (effect size, ES) for speed, power, total work and acceleration (ICC = 0.82-0.98, CV = 1.31-8.45%, ES = 0.01-0.22). The measurement error was improved between comparisons of T1 vs. T2 (CV = 1.62-8.45%, ES = 0.12-0.22) to T2 vs. T3 (CV = 1.31-6.56%, ES = 0.01-0.07) and better for females (CV = 1.26-7.94%, ES = 0.001-0.26) than males (CV = 1.33-8.53%, ES = 0.06-0.31). The current study demonstrated moderate-to-excellent reliability and good-moderate measurement error during a 4-s sprint on a non-motorized treadmill. However, sex had a substantial impact with females exhibiting better values. Practitioners should employ at least two separate trials within a session, in addition to multiple familiarization sessions, to achieve reliable non-motorized treadmill sprint performances.

Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease: A Randomized Clinical Trial.

Importance: It is unclear how to effectively promote walking in people with peripheral artery disease (PAD). Objective: To test whether brief counseling delivered by allied health professionals increases step count in participants with PAD. Design, Setting, and Participants: In this randomized clinical trial, participants with symptomatic PAD were recruited from sites in Australia and randomly allocated 1:1 to the counseling intervention or an attention control. Data were collected from January 2015 to July 2021, and data were analyzed from March to November 2022. Interventions: Two 1-hour face-to-face and two 15-minute telephone counseling sessions designed to increase walking. Main Outcomes and Measures: The primary outcome was the between-group difference in change in daily step count estimated by accelerometer recordings over 7 days at baseline and 4 months, using imputation for missing values. Other outcomes at 4, 12, and 24 months included step count, 6-minute walk distance, and disease-specific and generic measures of health-related quality of life. Risk of major adverse limb events was assessed over 24 months. Results: Of 200 included participants, 144 (72.0%) were male, and the mean (SD) age was 69.2 (9.3) years. The planned sample of 200 participants was allocated to the counseling intervention group (n = 102) or attention control group (n = 98). Overall, 198 (99.0%), 175 (87.5%), 160 (80.0%) and 143 (71.5%) had step count assessed at entry and 4, 12, and 24 months, respectively. There was no significant between-group difference in the primary outcome of change in daily step count over 4 months (mean steps, 415; 95% CI, -62 to 893; P = .07). Participants in the counseling group had significantly greater improvement in the secondary outcome of disease-specific Intermittent Claudication Questionnaire score at 4 months (3.2 points; 95% CI, 0.1-6.4; P = .04) and 12 months (4.3 points; 95% CI, 0.5-8.1; P = .03) but not at 24 months (1.2 points; 95% CI, -3.1 to 5.6; P = .57). Findings were similar for mean PAD Quality of Life Questionnaire component assessing symptoms and limitations in physical functioning (4 months: 1.5 points; 95% CI, 0.3-2.8; P = .02; 12 months: 1.8 points; 95% CI, 0.3-3.3; P = .02; 24 months: 1.3 points; 95% CI. -0.5 to 3.1; P = .16). There was no significant effect of the intervention on change in mean 6-minute walking distance (4 months: 9.3 m; 95% CI, -3.7 to 22.3; P = .16; 12 months: 13.8 m; 95% CI, -4.2 to 31.7; P = .13; 24 months: 1.2 m; 95% CI, -20.0 to 22.5; P = .91). The counseling intervention did not affect the rate of major adverse limb events over 24 months (12 [6.0%] in the intervention group vs 11 [5.5%] in the control group; P > .99). Conclusions and Relevance: This randomized clinical trial found no significant effect of brief counseling on step count in people with PAD. Alternate interventions are needed to enable walking. Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12614000592640.

Reliability of the running vertical jump test in female team sport athletes.

Injury rates to the lower limb have increased over the past 40 years, coinciding with increases in female sport participation rates. Sport specific tests such as the running vertical jump (RVJ) are utilised for injury risk profiling, however the test-retest reliability is unknown. OBJECTIVES: The aim of this study was to investigate the test-retest reliability of the thorax, pelvis and lower limb joint angular kinematics and kinetics for the RVJ test in female team sport athletes. DESIGN: Three-dimensional motion capture with force plate integration was utilised as participants performed five trials on each limb on three separate days. SETTING: Testing occurred in a biomechanics laboratory. PARTICIPANTS: Thirty-four females (Australian Rules Football = 15, Netball = 12, Soccer = 7) participated in this study. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICC), effect sizes and typical errors (TE) of segment and joint angular kinematics and kinetics were calculated. RESULTS: Poor to excellent reliability (ICC = -0.12 - 0.92), small to large effect sizes (0.00-0.90) and TE (0.02-289.24) were observed across segment and joint angular kinematics and kinetics. CONCLUSIONS: The RVJ test is recommended when analysing ground reaction forces and joint angular kinematics in female team sport athletes.

Exploring rugby coaches perception and implementation of performance analytics.

Professional coaches commonly rely on performance analysis and metrics to help make decisions regarding their practices, selection and tactics. However, few studies to date have explored coaches' perspectives of performance analysts successful integration into the high-performance environment. The aim of this study was to investigate coaches' philosophies surrounding performance analysis and how they perceived analysts could support and implement these approaches into coaching practices and match preparation. Semi-structured interviews were conducted with five professional elite level Rugby Union coaches to investigate their perceptions of performance analysis, and the contribution of performance analysts to the high-performance environment. Results revealed three main dimensions, including the role, purpose, and desired attributes of a performance analyst. Firstly, the role of the analyst was described in terms of being an information specialist, who collects, filters, and delivers information to stakeholders, and a generalist, who helps coaches utilise technology. Secondly, the purpose of the analyst was described in terms of providing both accountability and support for coaches and players. Finally, the attributes needed of an analyst included the ability to form a close relationship with coaches, communicate complex information in meaningful ways, and who was proactive, innovative, and creative when tasked with delivering information. The findings highlighted the crucial roles, purposes, and attributes of a performance analyst within high-performance Rugby Union identified by coaches and the importance of the coach-analyst relationship to support these dimensions.

Impact of a 5-Week Individualised Training Program on Physical Performance and Measures Associated with Musculoskeletal Injury Risk in Army Personnel: A Pilot Study.

OBJECTIVE: To examine the feasibility and effect of an individualised and force-plate guided training program on physical performance and musculoskeletal injury risk factors in army personnel. DESIGN: Pre-post, randomised control. METHODS: Fourteen male and five female Australian Army soldiers were randomised into two groups and performed 5-weeks of physical training. The control group (n = 9) completed standard, group-designed, physical training whilst the experimental group (n = 8) completed an individualised training program. Physical (push-ups, multi-stage fitness test, three repetition maximum (3RM) for squat, strict press, deadlift and floor press), occupational (weight-loaded march time), and technological assessments (two-leg and one-leg countermovement jumps (CMJ), one-leg balance, one-arm plank) were conducted prior to and following the training period. Comparisons between groups and changes within groups were conducted via Mann-Whitney U tests. RESULTS: Compared to the control group, the experimental group exhibited a significantly smaller improvement for weight-loaded march time (-0.7% ± 4.0% vs. -5.1% ± 3.0%, p = 0.03) and a greater improvement for deadlift-3RM (20.6% ± 11.9% vs. 8.4% ± 6.8%, p = 0.056). All other outcomes were similar between groups. Visually favourable alterations in the two-leg CMJ profile with no reports of injuries were noted for the experimental group. CONCLUSIONS: Individualised physical training was feasible within an army setting and, for the most part, produced similar physical, occupational and technological performances to that of standard, group-designed physical training. These preliminary results provide a foundation for future research to expand upon and clarify the benefits of individualised training programs on long-term physical performance and injury risk/incidence in active combat army personnel.

Acute Fatigue Responses to Occupational Training in Military Personnel: A Systematic Review and Meta-Analysis.

INTRODUCTION: Military personnel are required to undertake rigorous physical training to meet the unique demands of combat, often leading to high levels of physiological stress. Inappropriate recovery periods with these high levels of physical stress may result in sub-optimal training and increased risk of injury in military personnel. However, no reviews have attempted to examine the magnitude of training-induced stress following military training activities. The aim of this systematic review was to assess the magnitude of physiological stress (physical, hormonal, and immunological) following task-specific training activities in military personnel. METHODS: An extensive literature search was conducted within CINAHL, PubMed, Scopus, SportDiscus, and Web of Science databases with 7,220 records extracted and a total of 14 studies eligible for inclusion and evaluation. Study appraisal was conducted using the Kmet scale. Meta-analysis was conducted via forest plots, with standard mean difference (SMD, effect size) and inter-trial heterogeneity (I2) calculated between before (preactivity) and after (12-96 hours postactivity) military-specific activities for biomarkers of physiological stress (muscle damage, inflammation, and hormonal) and physical performance (muscular strength and power). RESULTS: Military training activities resulted in significant levels of muscle damage (SMD = -1.28; P = .003) and significant impairments in strength and power (SMD = 0.91; P = .008) and testosterone levels (SMD = 1.48; P = .05) up to 96 hours postactivity. There were no significant differences in inflammation (SMD = -0.70; P = .11), cortisol (SMD = -0.18; P = .81), or insulin-like growth factor 1 (SMD = 0.65; P = .07) when compared to preactivity measures. CONCLUSIONS: These findings indicate that assessments of muscle damage, anabolic hormones like testosterone, strength, and power are effective for determining the level of acute stress following military-specific activities. With regular monitoring of these measures, appropriate recovery periods may be implemented to optimize training adaptations and occupational performance, with minimal adverse training responses in military personnel.

Operational Insights into Analysing Team and Player Performance in Elite Rugby League: A Narrative Review with Case Examples.

In professional team sports, like Rugby League, performance analysis has become an integral part of operational practices. This has helped practitioners gain deeper insight into phenomena like team and athlete behaviour and understanding how such behaviour may be influenced by various contextual factors. This information can then be used by coaches to design representative practice tasks, inform game principles and opposition strategies, and even support team recruitment practices. At the elite level, the constant evolution of sports technology (both hardware and software) has enabled greater access to information, making the role of the performance analyst even more valuable. However, this increase in information can create challenges regarding which variables to use to help guide decision-making, and how to present it in ways that can be utilised by coaches and other support staff. While there are published works exploring aspects of performance analysis in team sports like Rugby League, there is yet to be a perspective that explores the various operational uses of performance analysis in Rugby League, the addition of which could help guide the practices of emerging performance analysts in elite organisations like the Australian National Rugby League and the European Super League. Thus, this narrative review-with accompanying case examples-explores the various ways performance analysis can help address pertinent operational questions commonly encountered when working in high-performance sport.

Reliability of Force Plate Metrics During Standard Jump, Balance, and Plank Assessments in Military Personnel.

INTRODUCTION: Prevention of musculoskeletal injury is vital to the readiness, performance, and health of military personnel with the use of specialized systems (e.g., force plates) to assess risk and/or physical performance of interest. This study aimed to identify the reliability of one specialized system during standard assessments in military personnel. METHODS: Sixty-two male and ten female Australian Army soldiers performed a two-leg countermovement jump (CMJ), one-leg CMJ, one-leg balance, and one-arm plank assessments using a Sparta Science force plate system across three testing sessions. Sparta Science (e.g., total Sparta, balance and plank scores, jump height, and injury risk) and biomechanical (e.g., average eccentric rate of contraction, average concentric force, and sway velocity) variables were recorded for all sessions. Mean ± SD, intraclass correlation coefficients (ICCs), coefficient of variation, and bias and limits of agreement were calculated for all variables. RESULTS: Mean results were similar between sessions 2 and 3 (P > .05). The relative reliability for the Sparta Science (ICC = 0.28-0.91) and biomechanical variables (ICC = 0.03-0.85) was poor to excellent. The mean absolute reliability (coefficient of variation) for Sparta Science variables was similar to or lower than that of the biomechanical variables during the CMJ (1-10% vs. 3-7%), one-leg balance (4-6% vs. 9-14%), and one-arm plank (5-7% vs. 12-17%) assessments. The mean bias for most variables was small (<5% of the mean), while the limits of agreement varied with most unacceptable (±6-87% of the mean). CONCLUSIONS: The reliability of most Sparta Science and biomechanical variables during standard assessments was moderate to good. The typical variability in metrics documented will assist practitioners with the use of emerging technology to monitor and assess injury risk and/or training interventions in military personnel.

Repeated Bout Effect of Two Resistance Training Bouts on Bowling-Specific Performance in Male Cricketers.

To examine the repeated bout effect (RBE) following two identical resistance bouts and its effect on bowling-specific performance in male cricketers. Male cricket pace bowlers (N = 10), who had not undertaken resistance exercises in the past six months, were invited to complete a familiarisation and resistance maximum testing, before participating in the study protocol. The study protocol involved the collection of muscle damage markers, a battery of anaerobic (jump and sprint), and a bowling-specific performance test at baseline, followed by a resistance training bout, and a retest of physical and bowling-specific performance at 24 h (T24) and 48 h (T48) post-training. The study protocol was repeated 7-10 days thereafter. Indirect markers of muscle damage were lower (creatine kinase: 318.7 ± 164.3 U·L-1; muscle soreness: 3 ± 1), whilst drop jump was improved (~47.5 ± 8.1 cm) following the second resistance training bout when compared to the first resistance training bout (creatine kinase: 550.9 ± 242.3 U·L-1; muscle soreness: 4 ± 2; drop jump: ~43.0 ± 9.7 cm). However, sport-specific performance via bowling speed declined (Bout 1: -2.55 ± 3.43%; Bout 2: 2.67 ± 2.41%) whilst run-up time increased (2.34 ± 3.61%; Bout 2: 3.84 ± 4.06%) after each bout of resistance training. Findings suggest that while an initial resistance training bout reduced muscle damage indicators and improved drop jump performance following a second resistance training bout, this RBE trend was not observed for bowling-specific performance. It was suggested that pace bowlers with limited exposure to resistance training should minimise bowling-specific practice for 1-2 days following the initial bouts of their resistance training program.

Effect of Exercise Training Programs on Physical Fitness Domains in Military Personnel: A Systematic Review and Meta-Analysis.

INTRODUCTION: Physical training is important to prepare soldiers for the intense occupational demands in the military. However, current physical training may not address all fitness domains crucial for optimizing physical readiness and reducing musculoskeletal injury. The effects of nontraditional military physical training on fitness domains have been inconsistently reported, which limits the design of the ideal training program for performance optimization and injury prevention in the military. The aim of this systematic review was to identify the effects of exercise training on various fitness domains (i.e., aerobic fitness, flexibility, muscular endurance, muscular power, muscular strength, and occupationally specific physical performance) that contribute to occupational performance and musculoskeletal injury risk in military personnel. METHODS: An extensive literature search was conducted in January 2021 and was subsequently updated in July 2021 and December 2021. Included studies consisted of comparative groups of healthy military personnel performing traditional and nontraditional military physical training with at least one assessment representative of a fitness domain. Study appraisal was conducted using the PEDro scale. Meta-analysis was conducted via forest plots, standard mean difference (SMD, effect size), and intertrial heterogeneity (I2). RESULTS: From a total of 7,350 records, 15 studies were identified as eligible for inclusion in this review, with a total of 1,613 participants. The average study quality via the PEDro score was good (5.3/10; range 4/10 to 6/10). Nontraditional military physical training resulted in greater posttraining values for muscular endurance (SMD = 0.46; P = .004; I2 = 68%), power (SMD = 1.57; P < .0001; I2 = 90%), strength via repetition maximum testing (SMD = 1.95; P < .00001; I2 = 91%), and occupationally specific physical performance (SMD = 0.54; P = .007; I2 = 66%) compared to the traditional group. There was no significant difference for aerobic fitness (SMD = -0.31; P = .23; I2 = 86%), flexibility (SMD = 0.58; P = .16; I2 = 76%), and muscular strength via maximal voluntary contraction (SMD = 0.18; P = .28; I2 = 66%) between training groups. CONCLUSIONS: The current systematic review identified that nontraditional military physical training had a greater posttraining effect on muscular endurance, power, strength measured via repetition maximum, and occupationally specific physical performance compared to traditional military physical training. Overall, these findings suggest that nontraditional military physical training may be beneficial in optimizing occupational performance while potentially reducing musculoskeletal injury risk.

Acute changes in handgrip strength, lung function and health-related quality of life following cardiac surgery.

BACKGROUND: Handgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients. METHODS: The study was a prospective cohort study that involved 101 patients who completed pre-operative (1-2 days before surgery) and physiotherapy discharge (5-7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis. RESULTS: At the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly (<0.001) reduced compared to their pre-operative values. Significant (<0.001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge. CONCLUSIONS: Undergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.

Relationship between handgrip strength and lung function in adults: a systematic review.

Handgrip strength (HGS) is a functional test that has been directly associated with lung function in some healthy populations; however, inconsistent findings have been reported for populations with chronic diseases. The aim of this study was to identify the relationship between HGS and lung function in both healthy and unhealthy adults. A systematic search was conducted using six databases from their earliest inception to February 29, 2020. Two authors reviewed and assessed methodological quality of eligible studies using the Crowe Critical Appraisal Tool (CCAT). Twenty-five studies met the inclusion criteria with 8 and 17 studies examining healthy and unhealthy populations, respectively. Reported average methodological quality of all included studies using the CCAT was 38-85% with most rated as Good to Excellent. Despite the use of heterogeneous equipment and protocols during HGS and lung function assessments, significant positive and moderate correlations and/or regression coefficients were reported for healthy populations consistently. Conversely, the reported relationships between HGS and lung function for unhealthy counterparts were variable. Handgrip strength was significantly associated with lung function in most healthy adults. Future robust studies are needed to confirm the suitability of HGS to assess lung function for healthy and unhealthy adults.