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Twible BD, Ruggiero L, McNeil CJ, Dalton BH. A Single Bout of On-Ice Training Leads to Increased Interlimb Asymmetry in Competitive Youth Hockey Athletes. J Appl Biomech 2024:1-9. [PMID: 39159926 DOI: 10.1123/jab.2023-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/26/2024] [Accepted: 06/02/2024] [Indexed: 08/21/2024]
Abstract
Interlimb asymmetry (ILA) refers to an anatomical or physiological imbalance between contralateral limbs, which can influence neuromuscular function. Investigating the influence of neuromuscular fatigue on ILA may be critical for optimizing training programs, injury rehabilitation, and sport-specific performance. The purpose of this study was to determine if a single bout of ice hockey-specific exercise creates or exacerbates lower-limb ILA. Before and after an on-ice training session, 33 youth ice-hockey athletes (14.9 [1.7] y; 11 females) performed 3 repetitions of a maximal vertical countermovement jump (CMJ), an eccentric hamstring contraction, and maximal isometric hip adduction and abduction contractions. Force- and power-related variables were analyzed to determine limb-specific neuromuscular function. The on-ice session reduced maximal isometric hip adduction (left: 7.3% [10.3%]; right: 9.5% [9.6%]) and abduction (left: 4.9% [6.9%]; right: 5.0% [8.1%]) force, but did not impair (P ≥ .10) CMJ performance (jump height, relative peak power, braking duration, and total duration). After the on-ice session, ILA was greater for CMJ propulsive impulse (6.3% [2.9%] vs 5.1% [2.6%]), CMJ braking rate of force development (19.3% [7.6%] vs 15.2% [6.4%]), and peak isometric hip adduction force (6.7% [5.5%] vs 6.1% [4.1%]). In conclusion, hockey-specific exercise leads to increased ILA for multiple force-related metrics, which may be a compensatory mechanism to maintain bilateral task performance when fatigued.
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Affiliation(s)
- Bryce D Twible
- Centre for Health Lung and Vascular Health, School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | - Luca Ruggiero
- Department of Sports Science, University of Konstanz, Konstanz, Germany
| | - Chris J McNeil
- Centre for Health Lung and Vascular Health, School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | - Brian H Dalton
- Centre for Health Lung and Vascular Health, School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
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Grainger A, Comfort P, Twist C, Heffernan SM, Tarantino G. Real-World Fatigue Testing in Professional Rugby Union: A Systematic Review and Meta-analysis. Sports Med 2024; 54:855-874. [PMID: 38114782 DOI: 10.1007/s40279-023-01973-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 12/21/2023]
Abstract
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.
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Affiliation(s)
- Adam Grainger
- Kitman Labs, Dublin, Ireland.
- Institute of Sport and Health, University College Dublin, Dublin, Ireland.
| | - Paul Comfort
- University of Salford, Salford, Greater Manchester, UK
- Edith Cowan University, Joondalup, WA, Australia
| | - Craig Twist
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Keogh JAJ, Waddington EE, Masood Z, Mahmood S, Palanisamy AC, Ruder MC, Karsan S, Bishop C, Jordan MJ, Heisz JJ, Kobsar D. Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations-A scoping review. Scand J Med Sci Sports 2023; 33:2125-2148. [PMID: 37551046 DOI: 10.1111/sms.14460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Lower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic biopsychosocial models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes. METHODS A systematic search of MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. Fifty-one articles were included in this review. RESULTS Significant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self-reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self-reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s). CONCLUSION This review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from biopsychosocial modeling. In doing so, this framework of biopsychosocial preventive and prognostic patient-centered practices may provide an actionable means of optimizing health, well-being, and sport performance in competitive athletes.
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Affiliation(s)
- Joshua A J Keogh
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Emma E Waddington
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Zaryan Masood
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Sobia Mahmood
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Anil C Palanisamy
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Matthew C Ruder
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Sameena Karsan
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Chris Bishop
- London Sports Institute, Middlesex University, London, UK
| | - Matthew J Jordan
- Faculty of Kinesiology, Sport Medicine Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer J Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Dylan Kobsar
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
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Golberg E, Pinkoski A, Beaupre L, Rouhani H. Monitoring External Workload With Wearable Technology After Anterior Cruciate Ligament Reconstruction: A Scoping Review. Orthop J Sports Med 2023; 11:23259671231191134. [PMID: 37655252 PMCID: PMC10467401 DOI: 10.1177/23259671231191134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/14/2023] [Indexed: 09/02/2023] Open
Abstract
Background Current sports medicine and rehabilitation trends indicate an increasing use of wearable technology. The ability of these devices to collect, transmit, and process physiological, biomechanical, bioenergy, and environmental data may aid in anterior cruciate ligament reconstruction (ACLR) workload monitoring and return-to-sport decision-making. In addition, their ease of use allows assessments to occur outside the clinical or laboratory settings and across a broader timeline. Purpose To (1) determine how wearable technology can assess external workload deficits between limbs (involved and uninvolved) and between groups (healthy controls vs patients with ACLR) during physical activity (PA) or sport and (2) describe the types of sensors, sensor specifications, assessment protocols, outcomes of interest, and participant characteristics from the included studies. Study Design Scoping review; Level of evidence, 4. Methods In February 2023, a systematic search was performed in the MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, IEEE Xplore, Compendex, and ProQuest Dissertations and Theses Global databases. Eligible studies included assessments of PA or sports workloads via wearable technology after ACLR. Results Twenty articles met eligibility criteria and were included. The primary activity assessed was activities of daily living, although rehabilitation, training, and competition were also represented. Accelerometers, global positioning system units, pedometers, and pressure sensor insoles were worn to collect external workload data, which was quantified as kinetic, kinematic, and temporospatial data. Daily steps (count) and moderate to vigorous PA (min/day or week) were the most common units of measurement. A limited number of studies included outcomes related to between-limb asymmetries. Conclusion The findings of this scoping review highlight the versatility of wearable technologies to collect patients' kinetic, kinematic, and temporospatial data and assess external workload outcomes after ACLR. In addition, some wearable technologies identified deficits in workload compared with healthy controls and between reconstructed and unaffected limbs.
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Affiliation(s)
- Eric Golberg
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Adam Pinkoski
- Epidemiology, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Lauren Beaupre
- Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Hossein Rouhani
- Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada
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The Influence of Injury History on Countermovement Jump Performance and Movement Strategy in Professional Soccer Players: Implications for Profiling and Rehabilitation Foci. J Sport Rehabil 2021; 30:768-773. [PMID: 33494043 DOI: 10.1123/jsr.2020-0243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/09/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Professional soccer players who have sustained a lower limb injury are up to 3× more likely to suffer a reinjury, often of increased severity. Previous injury has been shown to induce compensatory strategies during neuromuscular screening tests, which might mask deficits and lead to misinterpretation of readiness to play based on task outcome measures. OBJECTIVE To investigate the influence of previous injury in professional soccer players on countermovement jump (CMJ) performance and movement strategy. DESIGN Cross-sectional. SETTING Professional soccer club competing in the English Championship (tier 2). Patients (or Other Participants): Outfield players with a minimum of 6 years as a professional. INTERVENTION(S) Players were categorized as previously injured (n = 10) or not injured (n = 10). All players completed double- and single-leg CMJ trials. MAIN OUTCOME MEASURES CMJ performance was quantified as jump height and flight time:contraction time ratio. CMJ movement strategy was quantified as force-time history, differentiating eccentric and concentric phases and CMJ depth. RESULTS Double-leg CMJ was not sensitive to previous injury in performance or movement strategy. In contrast, single-leg CMJ performance was impaired in players with previous injury, who generated significantly lower eccentric and concentric peak force and rate of force development, and a deeper countermovement. Impaired single-leg CMJ performance was also evident in the nonaffected limb of previously injured players, suggesting cross-contamination. Hierarchical ordering revealed that the eccentric phase of the CMJ contributed little to performance in previously injured players. In noninjured players, the eccentric rate of force development and concentric peak force were able to account for up to 89% of the variation in CMJ performance. CONCLUSIONS Single-leg CMJ is advocated for player profiling, being more sensitive to previous injury, and negating the opportunity for interlimb compensation strategies. Movement strategy deficits in previously injured players suggest rehabilitation foci specific to eccentric force development.
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