Illness monitoring in team sports using a Web-based training diary

More than metrics: The role of socio-environmental factors in determining the success of athlete monitoring

The perceived value of athlete monitoring systems (AMS) has recently been questioned. Poor perceptions of AMS are important, because where practitioners lack confidence in monitoring their ability to influence programming, and performance is likely diminished. To address this, researchers have primarily sought to improve factors related to monitoring metrics, e.g., validity rather than socio-environmental factors, e.g., buy-in. Seventy-five practitioners (response rate: n = 30) working with Olympic and Paralympic athletes were invited to take part in a survey about their perceptions of AMS value. Fifty-two per cent (n = 13) was confident in the sensitivity of their athlete self-report measures, but only 64% (n = 16), indicated their monitoring was underpinned by scientific evidence. A scientific base was associated with improved athlete feedback (rS (23) = 0.487, p =0.014*) and feedback correlated with athlete monitoring adherence (rS (22) = 0.675, p =  <0.001**). If athletes did not complete their monitoring, 52% (n = 13) of respondents felt performance might be compromised. However, most respondents 56% (n = 14), had worked with internationally successful athlete(s) who did not complete their monitoring. While AMS can be a useful tool to aid performance optimisation, its potential value is not always realised. Addressing socio-environmental factors alongside metric-factors may improve AMS efficacy.

Effects of 24-week prebiotic intervention on self-reported upper respiratory symptoms, gastrointestinal symptoms, and markers of immunity in elite rugby union players

OBJECTIVES

Elite rugby union players face numerous physiological and psychological stressors which can increase upper respiratory and gastrointestinal illness risk, and in turn can compromise training and competitive performance. This study aimed to investigate the effect of daily prebiotic supplementation on upper respiratory symptoms, gastrointestinal symptoms, and markers of immune function in elite rugby union players.

METHODS

Thirty-three elite rugby union players were randomly assigned to consume a prebiotic (2.8 g/day galactooligosaccharide) or placebo (2.8 g/day maltodextrin), daily for 168 days under double-blind conditions. Participants completed daily and weekly questionnaires for self-reported upper respiratory and gastrointestinal symptoms respectively. Blood and saliva samples were collected at 0, 84, and 168 days for assessment of plasma TNF-α and CRP, and saliva IgA respectively.

RESULTS

The prebiotic group experienced a 2-day reduction in upper respiratory symptom duration (P = 0.045). Gastrointestinal symptom severity and incidence were lower in the prebiotic group compared to the placebo group (P < 0.001, P = 0.041) respectively. Salivary immunoglobulin A secretion rate was 42% greater in the prebiotic group compared to the placebo group at day 168 (P = 0.004), no differences in CRP and TNF-α were found (P > 0.05).

CONCLUSION

A 168-day dietary prebiotic intervention reduced the duration of upper respiratory symptoms and reduced the incidence and severity of gastrointestinal symptoms in elite rugby union players. These findings suggest that seasonal prebiotic interventions may be beneficial for reducing illness in elite rugby union players, improving their availability to train and compete.Key pointsElite athletes are susceptible to upper respiratory symptoms and gastrointestinal symptoms which may impact upon training availability and competition performance.For the first time, this study shows that a dietary prebiotic intervention can reduce the duration of upper respiratory symptoms by 2 days in elite rugby union players.Dietary prebiotic supplementation can improve the incidence and severity of gastrointestinal symptoms experienced by elite rugby union players.Prebiotic supplementation was able to increase salivary IgA secretion after 168 days.These findings can inform practice suggesting that seasonal prebiotic use has the potential to modulate immune function and reduce illness in elite rugby union, which may improve a player's availability to train and compete.The mechanisms by which prebiotics reduce URS and GIS require further research exploration.

Incidence of acute respiratory illnesses in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE

To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Electronic databases: PubMed-Medline, EbscoHost and Web of Science.

ELIGIBILITY CRITERIA

Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15-65 years.

RESULTS

Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3).

SUMMARY/CONCLUSIONS

These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported.

PROSPERO REGISTRATION NUMBER

CRD42020160472.

Exploring the Use of Mobile Athlete Self-report Measures in Elite Gaelic Games: A Qualitative Approach

ABSTRACT

Duignan, CM, Slevin, PJ, Caulfield, BM, and Blake, C. Exploring the use of mobile athlete self-report measures in elite Gaelic games: A qualitative approach. J Strength Cond Res 35(12): 3491-3499, 2021-Athlete self-report measures (ASRMs) are used in research and practice as an accurate, practical, and accessible method of athlete monitoring. Mobile adaptations of constructs from validated ASRM have increasingly been used for athlete monitoring in various sports settings; however, insights on the user experience and perceived value of these systems in the applied team sport setting have been limited. This study aimed to portray the experiences of stakeholders using a pre-existing mobile ASRM (M-ASRM) in elite Gaelic games. Twenty-one stakeholders in elite Gaelic games were recruited for this study (players n = 10, coaches and support staff n = 11). Subjects completed a semistructured interview with the lead researcher regarding their experience of using an M-ASRM in practice. Thematic analysis of the transcripts was conducted using NVivo 12 software. Results were defined under the themes of positive and negative user experience. Positive user experience was portrayed through M-ASRM uses and perceived value: communication and information disclosure, remote player monitoring, decision making and advanced planning, and player education and self-management. Negative user experience was portrayed through M-ASRM challenges: player adherence, player dishonesty, coach time and expertise requirements, and sociotechnical and system factors. Results outline the major uses of M-ASRM in elite Gaelic games and, importantly, highlight the key challenges experienced by stakeholders. These results can be applied by coaches, sports medicine professionals, and sports scientists using or intending to use an M-ASRM, providing key considerations to employ for effective use in team sport.

Illness and infection in elite full-contact football-code sports: A systematic review

OBJECTIVES

Full-contact football-code team sports offer a unique environment for illness risk. During training and match-play, players are exposed to high-intensity collisions which may result in skin-on-skin abrasions and transfer of bodily fluids. Understanding the incidence of all illnesses and infections and what impact they cause to time-loss from training and competition is important to improve athlete care within these sports. This review aimed to systematically report, quantify and compare the type, incidence, prevalence and count of illnesses across full-contact football-code team sports.

DESIGN/METHODS

A systematic search of Cochrane Library, MEDLINE, SPORTDiscus, PsycINFO and CINAHL electronic databases was performed from inception to October 2019; keywords relating to illness, athletes and epidemiology were used. Studies were excluded if they did not quantify illness or infection, involve elite athletes, investigate full-contact football-code sports or were review articles.

RESULTS

Twenty-eight studies met the eligibility criteria. Five different football-codes were reported: American football (n=10), Australian rules football (n=3), rugby league (n=2), rugby sevens (n=3) and rugby union (n=9). One multi-sport study included both American football and rugby union. Full-contact football-code athletes are most commonly affected by respiratory system illnesses. There is a distinct lack of consensus of illness monitoring methodology.

CONCLUSIONS

Full-contact football-code team sport athletes are most commonly affected by respiratory system illnesses. Due to various monitoring methodologies, illness incidence could only be compared between studies that used matching incidence exposure measures. High-quality illness surveillance data collection is an essential component to undertake effective and targeted illness prevention in athletes.

Training-Monitoring Engagement: An Evidence-Based Approach in Elite Sport

PURPOSE

Poor athlete buy-in and adherence to training-monitoring systems (TMS) can be problematic in elite sport. This is a significant issue, as failure to record, interpret, and respond appropriately to negative changes in athlete well-being and training status may result in undesirable consequences such as maladaptation and/or underperformance. This study examined the perceptions of elite athletes to their TMS and their primary reasons for noncompletion.

METHODS

Nine national-team sprint athletes participated in semistructured interviews on their perceptions of their TMS. Interview data were analyzed qualitatively, based on grounded theory, and TMS adherence information was collected.

RESULTS

Thematic analysis showed that athletes reported their main reason for poor buy-in to TMS was a lack of feedback on their monitoring data from key staff. Furthermore, training modifications made in response to meaningful changes in monitoring data were sometimes perceived to be disproportionate, resulting in dishonest reporting practices.

CONCLUSIONS

Perceptions of opaque or unfair decision making on training-program modifications and insufficient feedback were the primary causes for poor athlete TMS adherence. Supporting TMS implementation with a behavioral-change model that targets problem areas could improve buy-in and enable limited resources to be appropriately directed.

Mucosal immunity and illness incidence in elite rugby union players across a season

PURPOSE

To examine the relationship between upper respiratory illness (URI) incidence with changes in mucosal immunity (saliva immunoglobulin A (s-IgA) and saliva lysozyme (s-Lys)) and training load (TL) in a squad of elite rugby union players.

METHODS

Timed resting morning saliva samples were taken from players (n = 31) at preselected time points for 11 months. Weekly illness rates and TL were assessed using a Web-based diary and from medical/coaching staff reports.

RESULTS

No significant correlation was found between absolute s-IgA or s-Lys concentrations and URI incidence. Peaks in URI (December and March) were preceded by periods of increased training intensity and reduced game activity. In 23% of all URI episodes, players reported that presence of an illness either reduced activity (14.4%) or felt the need to go to bed (8.6%). When s-IgA concentration was expressed relative to that when in a URI-free state, a 15% reduction (P = 0.08) was observed in individuals who had present URI symptoms. Decreases in absolute s-IgA (December) and s-Lys (November and February) concentrations were associated with a corresponding increase in saliva cortisol (P < 0.05). Lower s-IgA (P < 0.05) and s-Lys concentrations were consistently observed in backs than forwards, whereas URI incidence also differed for player position (3.4 forwards vs 4.3 backs).

CONCLUSIONS

Regular monitoring of s-IgA and s-Lys may be useful in the assessment of exercise stress and URI risk status in elite team sport athletes. A combination of alterations in training intensity and seasonal influence is a likely contributor to observed peaks in URI incidence. It is probable that stress-induced increases in cortisol release contribute to reductions in mucosal immunity, which, when lowered, predispose rugby players to increased risk of illness.