Relationship of Pre-season Training Load With In-Season Biochemical Markers, Injuries and Performance in Professional Soccer Players

Effects of a Preseason Neuromuscular Training Program vs. an Endurance-Dominated Program on Physical Fitness and Injury Prevention in Female Soccer Players

BACKGROUND

The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players.

METHODS

Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45-60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season.

RESULTS

No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014).

CONCLUSIONS

The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players.

Creatine kinase concentration on the second post-match day is not associated with risk of subsequent muscle injury in professional football players: a four-season cohort study

OBJECTIVE

The objective of this study was to examine the relationship between creatine kinase (CK) concentration following official matches and the risk of subsequent muscle injury in professional male football (soccer) players.

METHODS

Blood samples were collected on the second post-match day for CK analysis over four consecutive seasons in a professional football club. Players were then followed for five days to observe any occurrence of indirect muscle injury (structural or functional in nature). Players exposed to at least 45 minutes in two consecutive matches within seven days were considered valid cases for analysis.

RESULTS

Eighty players participated in the study, generating 1,656 cases eligible for analysis, of which 229 resulted in muscle injuries. The hamstrings were the most frequently injured muscle group (54%), followed by the adductor (21%), triceps surae (19%), quadriceps (5%), and psoas (1%). While CK concentration was higher in muscle injury cases [783 ± 507 U/L (95%CI, 717 to 849; min-max, 105-2,800)] compared with uninjured cases [688 ± 446 U/L (95%CI, 665 to 711; min-max, 100-2,950)], it was not an accurate predictor of subsequent muscle injury risk in professional football players (sensitivity = 56%; specificity = 55%; odds ratio = 1.00; area under curve = 0.557).

CONCLUSION

CK concentration on the second post-match day cannot be used to effectively screen subsequent muscle injury risk in professional male football players.

Well-being fluctuations and injuries during an entire season in male professional soccer players: an observational study

This study aimed to describe and relate the well-being perception and injury incidence of soccer players in an entire soccer season. For 37 weeks, twenty-eight male professional soccer players (25.2 ± 4.3 years old; 22.8 ± 1.4 kg/m2) daily scored (from 1: bad; to 5: perfect) well-being perception (fatigue, sleep, muscle soreness, stress and mood and Hooper Index (HI) as general status). Injuries were also registered. Results showed that players had the lowest well-being perception during Preseason (in terms of HI, fatigue, muscle soreness and stress), being lower than EarlySeason (ps < 0.05, ds > 1.0) and/or InSeason (ps < 0.05, ds > 1.0). The injury incidence was 8.3 ± 9.2/1000 h, being always higher in training compared to competition (35.0 vs 11.1/1000 h). A lower stress perception (worse) correlated with a higher rate of new injuries during PreSeason (r = -0.84), while a greater muscle soreness and fatigue correlated with the new injuries occurring in the following week during the whole season (r = -0.38 and r = -0.39, respectively). As a conclusion, the well-being perception of professional soccer players was especially low during Preseason, with fatigue, muscle soreness and stress as the most affected items that correlated with injury incidence.

Physiological, anthropometric and athletic performance adaptations from completing a 1-month pre-season period. A two-year longitudinal study in female collegiate soccer players

Introduction

Collegiate coaches and integrative support staff often utilize pre-season as a brief and intense training period to prepare athletes technically, tactically, and physiologically, to meet the demands of competition during a soccer season. This study sought to examine the dose-response from performing on-field soccer activities during a four-week pre-season period in female collegiate soccer players, and if the magnitude in response was associated with accumulated exercise stress.

Methods

A total of twenty-seven healthy female soccer players training as part of a collegiate soccer program volunteered to participate in this two-year longitudinal study. Data collection commenced prior to the start of each pre-season period, at the beginning of August, and was completed at the beginning of September, when pre-season ended. Data collection periods were separated by a 31-day period. Indices of cardiovascular function, anthropometry, and athletic performance were examined during each data collection period. Internal and external measures of accumulated exercise stress were recorded using the Polar Team Pro® system.

Results

When comparing the beginning to the end of pre-season, significant improvements were observed in body fat (%) [24.2 ± 6.0 "vs." 23.3 ± 5.6, p = 0.001], heart rate variability (rMSSD) [51.8 ± 25.1 "vs." 67.9 ± 34.6 ms, p = 0.002], resting heart (bpm) [73.8 ± 12.1 "vs." 64.3 ± 8.8, p = 0.001] and cardiorespiratory performance (YoYo IRTL-1) [925.8 ± 272.8 "vs." 1,062.6 ± 223.3 m, p = 0.001]. Significant reductions in musculoskeletal performance were observed through vertical jump height (cm) [24.9 ± 23.7, p = 0.04]. Change in the end of pre-season body weight (kg) was significantly associated with accumulated accelerations and decelerations [r ≥ 0.49, p = 0.01]. End of pre-season change in cardiorespiratory performance was significantly associated with both accumulated training load (au) and TRIMP (au) [r ≥ 0.63, p = 0.01].

Discussion

In conclusion, performing a four-week pre-season period, involving only on-field training, can promote positive and significant adaptations in anthropometry, cardiovascular function, and athletic performance measures in female collegiate soccer players. The magnitudes of these adaptations were associated with both internal and external measures of accumulated exercise stress.

The Association of Serum Calprotectin with Fitness Indicators and Biochemical Markers in High-Level Athletes: A Continuous Dynamic Monitoring during One Competitive Season

The objective was to determine the associations between several biochemical indicators and the dynamics of concentration change across four physical fitness phases over the period of a competitive season. Furthermore, associations between serum calprotectin and biomarkers of inflammation or muscle injury and physical indicators were examined.

SUBJECTS AND METHODS

Twenty professional male water polo players (median age: 28 (22-42)) were included in this study. Serum creatine kinase activity was determined by the automated photometric UV method. The concentrations of calprotectin, C-reactive protein, and myoglobin were measured using an automated immunoturbidimetric method, while an automated immunochemistry method was employed for interleukin-6, troponin I, and cortisol determination. Tests of repeated strength, maximal strength, and static strength were used to evaluate physical activity.

RESULTS

Serum calprotectin concentrations expressed in median and IQR were significantly different: T1: 2.92 g/mL (2.47; 3.86); T2: 2.35 g/mL (1.26; 2.87); T3: 2.27 g/mL (1.60; 3.27); and T4: 1.47 g/mL (1.04; 2.85) (p = 0.004). Cortisol concentration and CK activity showed significant changes among phases (p = 0.049 and p = 0.014, respectively). Each physical activity examined showed a significant seasonal decrease (all p values were 0.001). Calprotectin serum concentration and indicators of muscular injury, inflammation, and physical activity were found to be correlated during particular stages of the seasonal examination.

CONCLUSIONS

Calprotectin values determined throughout one competitive season decreased as training intensity among water polo players increased. Serum calprotectin concentrations and indicators were related to biochemical markers of inflammation and muscle damage.

Training Volume and High-Speed Loads Vary Within Microcycle in Elite North American Soccer Players

ABSTRACT

Ishida, A, Draper, G, Wright, M, Emerson, J, and Stone, MH. Training volume and high-speed loads vary within microcycle in elite North American soccer players. J Strength Cond Res 37(11): 2229-2234, 2023-The purposes of this study were to reduce dimensionality of external training load variables and examine how the selected variables varied within microcycle in elite North American soccer players. Data were collected from 18 players during 2018-2020 in-seasons. Microcycle was categorized as 1, 2, 3, 4, 5 days before match day (MD-1, MD-2, MD-3, MD-4, and MD-5, respectively). Training load variables included total distance, average speed, maximum velocity, high-speed running distance (HSR), average HSR, HSR efforts, average HSR efforts, sprint distance, average sprint distance, sprint efforts, average sprint efforts, total PlayerLoad, and average PlayerLoad. The first principal component (PC) can explain 66.0% of the variances and be represented by "high-speed load" (e.g., HSR and sprint-related variables) with the second PC relating to "volume" (e.g., total distance and PlayerLoad) accounting for 17.9% of the variance. Average sprint distance and total distance were selected for further analysis. Average sprint distance was significantly higher at MD-3 than at MD-2 (p = 0.01, mean difference = 0.36 m•minute-1, 95% confidence intervals [CIs] = 0.07-0.65 m•minute-1) and MD-4 (p = 0.012, mean difference = 0.26 m•minute-1, 95% CIs = 0.10-0.41 m•minute-1). Total distance was significantly higher at MD-3 than at MD-1 (p < 0.001, mean difference = 1,465 m, 95% CIs = 1,003-1926 m), and MD-2 (p < 0.001, mean difference = 941 m, 95% CIs = 523-1,360 m). Principal component analysis may simplify reporting process of external training loads. Practitioners may need to choose "volume" and "high-speed load" variables. Elite North American Soccer players may accumulate higher average sprint distance at MD-3 than at other training days.

Relationships Between Internal and External Load Measures and Fitness Level Changes in Professional Soccer Players

Purpose: Understanding the dose-response relationship between internal and external training load with changes in aerobic fitness and intermittent running capacity, during different periods of the season, may help in optimizing training process. The aim of the present study was to investigate the dose-response relationships between load measures and changes in aerobic fitness and intermittent running capacity among a large cohort of professional soccer players. Methods: Training load, aerobic fitness and intermittent running capacity of 52 male adult professional players from 3 elite teams were monitored across an entire season and analyzed employing linear mixed models, with a significance level set at p≤0.05. Results: Relationships between load measures (training and match duration, sRPE-TL, total distance, high and very high-speed running distances) and changes in physical qualities were stronger during the preparation period (PREP) for both aerobic fitness (d= 0.48 to 0.76, p<0.031) and intermittent running capacity (d= 0.46 to 1.89, p<0.046). The magnitude of the relationships reduced during the first competitive period (d= 0.43 to 0.56) and the relationships became trivial in the second competitive period (d= 0.06 to 0.41, p= 0.063 to 0.846). Conclusion: The moderate to large relationships found between all measures of load and changes in physical capacities suggest that training prescription during the PREP was effective in improving players' fitness. During the competitive phase small changes in aerobic and intermittent running capacities were found, highlighting that coaching staff pursue different aims during the competitive period, such as technical and tactical training and recovery.       .

Effects of preseason training on body composition, running performance, biochemical markers and workload variation in professional rugby union players

Few studies have examined the impact of a preseason training intervention through systematic measures in Pro D2 rugby union (RU). Therefore, this study aimed to describe the effects of 12 weeks of preseason training (three blocks) on body composition, running performance, biochemical markers, and workload (WL) variation in professional RU players. Physiological (physical and biochemical) responses to preseason WL were analyzed by examining changes in anthropometric characteristics, Yo-Yo intermittent recovery level 1 (Yo-Yo IR1) test, blood samples (BS), Hooper index (1-7), the 10-Hz global positioning system (GPS), and session rating of perceived exertion (s-RPE) in nineteen elite male players. Changes throughout the preseason were analyzed using the one-way and mixed-model analysis of variance. Significant (p < 0.01) improvements occurred in anthropometry and Yo-Yo IR1 running performance in forwards and backs. Total distance (p < 0.01) and impact (p < 0.05) during the second block were meaningfully higher than the other two blocks, with backs showing higher values than forwards. As expected, WL decreased significantly (p < 0.01) during the last training block. The WL variations were correlated with changes in biochemical markers over the preseason period. The collected data can be used for i) profiling French Pro D2 rugby championships players, ii) establishing effective training strategies, and iii) setting preseason WL expectations.

Relationships between External, Wearable Sensor-Based, and Internal Parameters: A Systematic Review

Micro electro-mechanical systems (MEMS) are used to record training and match play of intermittent team sport athletes. Paired with estimates of internal responses or adaptations to exercise, practitioners gain insight into players' dose-response relationship which facilitates the prescription of the training stimuli to optimize performance, prevent injuries, and to guide rehabilitation processes. A systematic review on the relationship between external, wearable-based, and internal parameters in team sport athletes, compliant with the PRISMA guidelines, was conducted. The literature research was performed from earliest record to 1 September 2020 using the databases PubMed, Web of Science, CINAHL, and SportDISCUS. A total of 66 full-text articles were reviewed encompassing 1541 athletes. About 109 different relationships between variables have been reviewed. The most investigated relationship across sports was found between (session) rating of perceived exertion ((session-)RPE) and PlayerLoad™ (PL) with, predominantly, moderate to strong associations (r = 0.49-0.84). Relationships between internal parameters and highly dynamic, anaerobic movements were heterogenous. Relationships between average heart rate (HR), Edward's and Banister's training impulse (TRIMP) seem to be reflected in parameters of overall activity such as PL and TD for running-intensive team sports. PL may further be suitable to estimate the overall subjective perception. To identify high fine-structured loading-relative to a certain type of sport-more specific measures and devices are needed. Individualization of parameters could be helpful to enhance practicality.

Biomarkers of post-match recovery in semi-professional and professional football (soccer)

High-level football (soccer) players face intense physical demands that result in acute and residual fatigue, impairing their physical performance in subsequent matches. Further, top-class players are frequently exposed to match-congested periods where sufficient recovery times are not achievable. To evaluate training and recovery strategies, the monitoring of players' recovery profiles is crucial. Along with performance and neuro-mechanical impairments, match-induced fatigue causes metabolic disturbances denoted by changes in chemical analytes that can be quantified in different body fluids such as blood, saliva, and urine, thus acting as biomarkers. The monitoring of these molecules might supplement performance, neuromuscular and cognitive measurements to guide coaches and trainers during the recovery period. The present narrative review aims to comprehensively review the scientific literature on biomarkers of post-match recovery in semi-professional and professional football players as well as provide an outlook on the role that metabolomic studies might play in this field of research. Overall, no single gold-standard biomarker of match-induced fatigue exists, and a range of metabolites are available to assess different aspects of post-match recovery. The use of biomarker panels might be suitable to simultaneously monitoring these broad physiological processes, yet further research on fluctuations of different analytes throughout post-match recovery is warranted. Although important efforts have been made to address the high interindividual heterogeneity of available markers, limitations inherent to these markers might compromise the information they provide to guide recovery protocols. Further research on metabolomics might benefit from evaluating the long-term recovery period from a high-level football match to shed light upon new biomarkers of post-match recovery.

Using global navigation satellite systems for modeling athletic performances in elite football players

This study aims to predict individual Acceleration-Velocity profiles (A-V) from Global Navigation Satellite System (GNSS) measurements in real-world situations. Data were collected from professional players in the Superleague division during a 1.5 season period (2019–2021). A baseline modeling performance was provided by time-series forecasting methods and compared with two multivariate modeling approaches using ridge regularisation and long short term memory neural networks. The multivariate models considered commercial features and new features extracted from GNSS raw data as predictor variables. A control condition in which profiles were predicted from predictors of the same session outlined the predictability of A-V profiles. Multivariate models were fitted either per player or over the group of players. Predictor variables were pooled according to the mean or an exponential weighting function. As expected, the control condition provided lower error rates than other models on average (p = 0.001). Reference and multivariate models did not show significant differences in error rates (p = 0.124), regardless of the nature of predictors (commercial features or extracted from signal processing methods) or the pooling method used. In addition, models built over a larger population did not provide significantly more accurate predictions. In conclusion, GNSS features seemed to be of limited relevance for predicting individual A-V profiles. However, new signal processing features open up new perspectives in athletic performance or injury occurrence modeling, mainly if higher sampling rate tracking systems are considered.

Effects of different training intensities in high-intensity interval training (HIIT) on maximal aerobic velocity, hematological and muscle-damage markers in healthy young adults

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG₁₀₀) while group 2 (n = 10) exercised at 110% MAV (EG₁₁₀). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG₁₁₀ compared to EG₁₀₀ after HIIT (p < 0.01, η_p² = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p < 0.01; 0.02 < η_p² < 0.11) in EG₁₁₀ compared to EG₁₀₀. Moreover, post-hoc tests indicated that LY decreased significantly (p < 0.001, η_p² = 0.21) only for EG₁₁₀. Furthermore, there were significant positive correlations for both EG₁₀₀ and EG₁₁₀ between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG₁₀₀ and EG₁₁₀ between MAV and LY (r = 0.79, p < 0.01; r = 0.72, p < 0.05, respectively). Concerning the relationship between MAV and NE, there was a significant positive correlation (r = 0.66; p < 0.05) only for EG₁₁₀. Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage.

Quantification of Pre-Season and In-Season Training Intensity across an Entire Competitive Season of Asian Professional Soccer Players

The aim of this study was to quantify the training load in two microcycles (Ms) from pre- and another two from in-season and to analyze playing position influences on the load experienced by professional soccer players. Nineteen Asian athletes, including four central defenders, four wide defenders, six central midfielders, three wide midfielders, and two strikers participated in this study. The micro-electromechanical system was used to collect training duration, total distance, and data from Zone 1 (0−3.9 km·h−1), Zone 2 (4−7.1 km·h−1), Zone 3 (7.2−14.3 km·h−1), Zone 4 (14.4−19.7 km·h−1), and Zone 5 (>19.8 km·h−1), heart rate maximum (HRmax), and average (HRavg). The load was reduced on the last day of the Ms, with the exception of Zone 5, in M1, where higher values were found on the last day. Significant differences were observed between central and wide defenders for distance covered in Zone 4 (effect-size: ES = −4.83) in M2 and M4 (ES = 4.96). Throughout all the Ms, a constant HRmax (165−188 bpm) and HRavg (119−145 bpm) were observed. There was a tendency to decrease the load on the last day of the Ms. In general, there were higher external training loads in Ms from the pre-season than in-season. Wide defenders and wide midfielders showed higher distances covered with high-intensity running.

Effects of Vest and Sled Resisted Sprint Training on Sprint Performance in Young Soccer Players: A Systematic Review and Meta-analysis

ABSTRACT

Fernández-Galván, LM, Casado, A, García-Ramos, A, and Haff, GG. Effects of vest and sled resisted sprint training on sprint performance in young soccer players: A systematic review and meta-analysis. J Strength Cond Res XX(X): 000-000, 2022-The aim of the meta-analysis was to determine the effect of resisted sprint training (RST) on sprint performance in young (<20 years) soccer players and to analyze whether the training equipment (sled or vest) and magnitude of the resistive load (above or below 20% of body mass [BM]) influences the long-term adaptations in sprint performance. Resisted sprint training reduced the acceleration phase time [standardized mean difference (SMD) = -0.41], with greater reduction in sprint time occurring in response to applying resistance with a vest (SMD = -0.70) when compared with a sled (SMD = -0.27). Similar reductions were determined for resistive loads <20% (SMD = -0.55) and ≥20% of BM (SMD = -0.31). Full sprint time showed a small reduction after RST (SMD = -0.36), regardless of the training equipment (sled: SMD = -0.44; vest: SMD = -0.26) and resistive load (<20% of BM: SMD = -0.40 ≥ 20% of BM: SMD = -0.21). There was a small and nonsignificant reduction in the maximum-velocity phase after RST (SMD = -0.25), which was comparable when the training was performed with vest (SMD = -0.34) or sled (SMD = -0.22). No significant differences in the changes of the acceleration phase time (SMD = 0.05) or full sprint time (SMD = 0.08) were observed between the experimental (sled or vest RST) and control groups (only soccer or unresisted sprint training). In conclusion, RST is effective to improve sprint performance in young soccer players, but the improvements are not superior to unresisted sprint training.

Understanding load in netball – An analysis of multiple seasons, phases, and teams

Studies of training and competition load in sport are usually based on data that represents a sample of a league and or annual training program. These studies sometimes explore important factors that are affected by load, such as training adaptations and injury risk. The generalisability of the conclusions of these studies, can depend on how much load varies between seasons, training phases and teams. The interpretation of previous load studies and the design of future load studies should be influenced by an understanding of how load can vary across seasons, training phases and between teams. The current study compared training loads (session rating of perceived exertion x session duration) between all (8) teams in an elite Netball competition for multiple (2) season phases and (2) seasons. A total of 29,545 records of athlete session training loads were included in the analysis. Linear mixed models identified differences between seasons and training phases (p < .05). There were also differences between teams and a complex set of interactions between these three factors (season, phase, and team) (p < .05). While the absolute value of the training loads reported here are only relevant to elite netball, these results illustrate that when data is sampled from a broader context, the range and variation in load may increase. This highlights the importance of cautiously interpreting and generalisation of findings from load studies that use limited data sets.

Relationships between Fitness Status and Blood Biomarkers in Professional Soccer Players

Background

Physical conditions are recognized to be optimal after the pre-season (PS) phase in professional sports. Given that blood measures may also reveal variations, which in turn, may present associations with fitness changes.

Objective

The aim of this study is to test the changes of blood markers and physical fitness outcomes at the beginning and following the PS phase. Additionally, we aimed also to analyze the associations of training adaptations between blood markers and the physical fitness measures. Methodology. 25 professional male soccer players (28.1 ± 4.6 years old, 2.0 ± 7.8 kg, and 176.7 ± 4.9 cm) were assessed for hematological and biochemical parameters, and physical fitness measures in the baseline and after the phase of PS.

Results

Increases in platelets were observed after the PS phase (p = 0.001, η2 = 0.39). Regarding the biochemical parameters, significant increases between PS were found for creatinine (Cre) (p = 0.001, η2 = 0.66), alkaline phosphatase (ALP) (p = 0.001, η2 = 0.79), C-Reactive Protein (CRP) (p = 0.001, η2 = 0.74), cortisol (C) (p = 0.001, η2 = 0.63), and testosterone (T) (p = 0.001, η2 = 0.76), whereas significant decreases were found for albumin (Alb) (p = 0.004, η2 = 0.29), and calcium corrected (Ca Corr.) (p = 0.002, η2 = 0.32). Moderate correlations were found between albumin and the 5-meter linear sprint split (r = -0.44 (95%CI: -0.71; -0.05)) and CRP (r = -0.48 (95%CI: -0.74; -0.10)). Moderate correlations were found between VAMEVAL and hemoglobin (r = 0.44 (95%CI: 0.05; 0.71)).

Conclusions

The overall physical fitness measures improved after the PS phase. Also, significant variations (decreases/increases) were observed for the case of biomchemical and hematological outcomes. Coaches should carefully consider the adaptative changes observed in blood parameters as the changes in whole organism and metabolism after specific critical phases as the PS in professional players. Thus, optimal management of stimulus/recovery can be warranted to minimize illness and injury rate and to follow the direction and dynamics of adaptative changes.

Effects of Chronological Age, Relative Age, and Maturation Status on Accumulated Training Load and Perceived Exertion in Young Sub-Elite Football Players

The aims of this study were 1) to analyze the influence of chronological age, relative age, and biological maturation on accumulated training load and perceived exertion in young sub-elite football players and 2) to understand the interaction effects amongst age grouping, maturation status, and birth quartiles on accumulated training load and perceived exertion in this target population. A 6-week period (18 training sessions and 324 observation cases) concerning 60 young male sub-elite football players grouped into relative age (Q1 to Q4), age group (U15, U17, and U19), and maturation status (Pre-peak height velocity (PHV), Mid-PHV, and Post-PHV) was established. External training load data were collected using 18 Hz global positioning system technology (GPS), heart-rate measures by a 1 Hz short-range telemetry system, and perceived exertion with total quality recovery (TQR) and rating of perceived exertion (RPE). U17 players and U15 players were 2.35 (95% CI: 1.25–4.51) and 1.60 (95% CI: 0.19–4.33) times more likely to pertain to Q1 and Q3, respectively. A negative magnitude for odds ratio was found in all four quartile comparisons within maturation status (95% CI: 6.72–0.64), except for Mid-PHV on Q2 (95% CI: 0.19–4.33). Between- and within-subject analysis reported significant differences in all variables on age group comparison measures (F = 0.439 to 26.636, p = 0.000 to 0.019, η2 = 0.003–0.037), except for dynamic stress load (DSL). Between-subject analysis on maturity status comparison demonstrated significant differences for all training load measures (F = 6.593 to 14.424, p = 0.000 to 0.037, η2 = 0.020–0.092). Interaction effects were found for age group x maturity band x relative age (Λ Pillai’s = 0.391, Λ Wilk’s = 0.609, F = 11.385, p = 0.000, η2 = 0.391) and maturity band x relative age (Λ Pillai’s = 0.252, Λ Wilk’s = 0.769, F = 0.955, p = 0.004, η2 = 0.112). Current research has confirmed the effects of chronological age, relative age, and biological maturation on accumulated training load. Perceived exertion does not seem to show any differences concerning age group or maturity status. Evidence should be helpful for professionals to optimize the training process and young football players’ performance.

Biochemical Markers and Wellness Status During a Congested Match Play Period in Elite Soccer Players

OBJECTIVES

To analyze biochemical markers, wellness status, and physical fitness in elite soccer players in relation to changes in training and match exposure during a congested period of match play.

METHODS

Fourteen elite soccer players were evaluated 3 times (T1, T2, and T3) over 12 weeks (T1-T2: 6-wk regular period of match play and T2-T3: 6-wk congested period of match play). Players performed vertical jump tests, repeated shuttle sprint ability test, and the Yo-Yo Intermittent Recovery Test at T1, T2, and T3. Plasma C-reactive protein, creatinine, and creatine kinase were analyzed at T1, T2, and T3. Wellness status was measured daily using the Hopper questionnaire (delayed onset of muscle soreness, stress, fatigue, and sleep quality). Training session rating of perceived exertion was also recorded on a daily basis.

RESULTS

A significant increase was found in stress, fatigue, delayed onset of muscle soreness scores, and Hopper index during the congested period (between T2 and T3) compared with the regular period (between T1 and T2) (.001 < P < .008, 0.8 < ES < 2.3). Between T2 and T3, significant relationships were found between the percentage variations (Δ%) of C-reactive protein, and Δ% of creatine kinase with the Hopper Index, and the Δ% of fatigue score. In addition, the Δ% of fatigue score and Δ% of delayed onset of muscle soreness score correlated with Δ% Yo-Yo Intermittent Recovery Test and Δ% best of repeated shuttle sprint ability test (.49 < r < P < .01).

CONCLUSIONS

An intensive period of congested match play significantly compromised elite soccer players' physical fitness and wellness status. Elite soccer players' wellness status reflects declines in physical fitness during this period while biochemical changes do not.

Variability of External Intensity Comparisons between Official and Friendly Soccer Matches in Professional Male Players

The aims of this study were to compare the external intensity between official (OMs) and friendly matches (FMs), and between first and second halves in the Iranian Premier League. Twelve players participated in this study (age, 28.6 ± 2.7 years; height, 182.1 ± 8.6 cm; body mass, 75.3 ± 8.2 kg). External intensity was measured by total duration, total distance, average speed, high-speed running distance, sprint distance, maximal speed and body load. In general, there was higher intensity in OMs compared with FMs for all variables. The first half showed higher intensities than the second half, regardless of the type of the match. Specifically, OMs showed higher values for total sprint distance (p = 0.012, ES = 0.59) and maximal speed (p < 0.001, ES = 0.27) but lower value for body load (p = 0.038, ES = −0.42) compared to FMs. The first half of FMs only showed lower value for body load (p = 0.004, ES = −0.38) than FMs, while in the second half of OMs, only total distance showed a higher value than FMs (p = 0.013, ES = 0.96). OMs showed higher demands of high intensity, questioning the original assumption of FMs demands. Depending on the period of the season that FMs are applied, coaches may consider requesting higher demands from their teams.

A Practical Approach to Monitoring Biomarkers of Inflammation and Muscle Damage in Youth Soccer Players During a 6-Month Training Cycle

The aim of the study was to determine the effects of a 6-month training cycle on muscle damage and inflammatory markers in youth male soccer players. Twenty-one soccer players were tested four times: at the beginning (T1) and immediately after the pre-season period (T2), in the middle (T3) and at the end of the competitive period (T4). Muscle damage and inflammatory markers were determined in blood taken 36 hours after the match. Throughout the training cycle significant increases (p < 0.05) of creatine kinase (T1: 254.4 U·L^-1; T4: 304.2 U·L^-1) and lactate dehydrogenase (T1: 382.8 U·L^-1; T4: 453.2 U·L^-1) activities were observed. Significant changes (p < 0.05) in platelet count (T1: 210.5·10⁹·L^-1; T4: 234.2·10⁹·L^-1), percentage of lymphocyte (T1: 39.80%; T4: 42.97%), monocyte (T1: 6.88%; T4: 9.99%) and granulocyte (T1: 53.32%; T4: 47.05%) as well as in granulocyte-to-lymphocyte (T1: 1.41; T4: 1.17) and lymphocyte-to-monocyte (T1: 6.21; T4: 4.46) ratios were noted. The correlation analysis revealed statistically significant relationships (p < 0.05) between: myoglobin and the percentage of leukocyte subpopulations and the granulocyte to lymphocyte ratio; lactate dehydrogenase and the percentage of monocyte; lactate and leukocyte count. In conclusion, the reported muscle damage and inflammatory markers in T3 and T4 indicate the need for fatigue status monitoring in youth soccer players, especially in the competitive period. Moreover granulocyte to lymphocyte and lymphocyte to monocyte ratios proved to be sensitive to fatigue changes and therefore can provide coaches and sport scientists with a broader perspective on the biochemical monitoring of training status in soccer players.

Blood Biomarkers Variations across the Pre-Season and Interactions with Training Load: A Study in Professional Soccer Players

Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes after pre-season training. Methodology: Twenty-five professional soccer players were assessed by training load measures (derived from rate of perceived exertion- known as RPE) during the pre-season period. Additionally, blood samples were collected for hematological and biochemical analyses. Results: For hematological parameters, significant increases were found for platelets (PLT) (dif: 6.42; p = 0.006; d = -0.36), while significant decreases were found for absolute neutrophils count (ANC) (dif: -3.98; p = 0.006; d = 0.11), and absolute monocytes count (AMC) (dif: -16.98; p = 0.001; d = 0.78) after the pre-season period. For biochemical parameters, there were significant increases in creatinine (dif: 5.15; p = 0.001; d = -0.46), alkaline phosphatase (ALP) (dif: 12.55; p = 0.001; d = -0.84), C-reactive protein (CRP) (dif: 15.15; p = 0.001; d = -0.67), cortisol (dif: 2.85; p = 0.001; d = -0.28), and testosterone (dif: 5.38; p = 0.001; d = -0.52), whereas there were significant decreases in calcium (dif: -1.31; p = 0.007; d =0.49) and calcium corrected (dif: -2.18; p = 0.015; d = 0.82) after the pre-season period. Moreover, the Hooper Index (dif: 13.22; p = 0.01; d = 0.78), and all derived RPE measures increased after pre-season period. Moderate-to-very large positive and negative correlations (r range: 0.50-0.73) were found between the training load and hematological measures percentage of changes. Moderate-to-large positive and negative correlations (r range: 0.50-0.60) were found between training load and biochemical measures percentage of changes. Conclusions: The results indicated heavy physical loads during the pre-season, leading to a decrease in immune functions. Given the significant relationships between blood and training load measures, monitoring hematological and biochemical measures allow coaches to minimize injury risk, overreaching, and overtraining.

Seasonal Changes and Relationships in Training Loads, Neuromuscular Performance, and Recovery and Stress State in Competitive Female Soccer Players

Background: The purpose of this study was to examine seasonal changes in training load (TL), neuromuscular performance, subjective recovery, and stress state, and to investigate the relationships between acute and chronic TL and neuromuscular performance in competitive female soccer players.

Methods: Nine competitive female soccer players (20.0 ± 1.7 years; 60.3 ± 6.3 kg; 164.0 ± 5.8 cm) completed the Short Recovery and Stress Scale and the countermovement jump (CMJ) with polyvinyl chloride pipe (CMJ0) and 20 kg barbell (CMJ20) at 2–3 h before 1st match (NC₁), 6th match (NC₂), 9th match (C₁), and 15th match (C₂) of the competitive season. TL included total distance, high-speed running, and PlayerLoad. Acute and chronic TL was calculated by using the average of 2 days (D₂), 7 days (D₇), and 21 days (D₂₁) prior to four different match play.

Results: Significant decreases were found from NC₁ to C₁ in D₇ total distance [p = 0.03, Cohen's effect size (d_z) = 1.40]. D₇ total distance and PlayerLoad significantly decreased from NC to C₁ and C₂ (p = 0.001–0.01, d_z = 1.40–1.72). Significant increases were observed from NC₁ to C₁ in CMJ0 jump height (p = 0.03, d_z = 1.40), (p = 0.021, d_z = 1.44), and peak power (p = 0.03, d_z = 1.32). Significant negative correlations were observed for D₇ total distance and CMJ0 jump height (p = 0.02, r = 0.79) and peak power (p = 0.03, r = 0.71) at C₂, while significant positive correlations were observed at C₁ for D₇ PlayerLoad and CMJ0 jump height (p = 0.02, r = 0.80).

Conclusion: Polyvinyl chloride pipe (CMJ0) jump height and peak power may increase from preseason to the midcompetitive season. Seasonal variations may affect the relationships between D₇ TL and CMJ0 performance.

Relative Training Load and Match Outcome: Are Professional Soccer Players Actually Undertrained during the In-Season?

Previous studies examined training/match ratios (TMr) to determine the training load relative to the match load, but the influence of the relative training load (RTL) on success in soccer is still unknown. Therefore, this study aimed to investigate the possible influence of RTL on final match outcome in soccer (win, draw, and loss). Running performances (RP) of soccer players (n = 21) in the Croatian highest national soccer competition were analyzed during the season 2020–2021. Data were measured by the global positioning system in 14 official matches and 67 training sessions. RTL was assessed by TMr, which were calculated as the ratio of RP during training and match in the same week, evaluating the following measures: TDr (total distance ratio), LIDr (low-intensity distance ratio), RDr (running distance ratio), HIDr (high-intensity distance ratio), ACCr (total accelerations ratio), DECr (total decelerations ratio), HI-ACCr (high-intensity accelerations ratio), HI-DECr (high-intensity decelerations ratio). All TMr were examined separately for each training session within in-season microcycles (categorized as days before the match day, i.e., MD minus). Spearman correlations were used to identify association between match outcome and TMr. The results indicated negative associations between match outcome and TDr, LIDr, ACCr and DECr on MD-1 and MD-2). In contrast, positive associations were evidenced between match outcome, and HIDr on MD-3 and TDr, LIDr, ACCr and DECr on MD-5 (p < 0.05; all moderate correlations). These findings demonstrate that final match outcome in soccer was associated with greater RTL of (i) high-intensity running three days before the match, (ii) total and low-intensity running, accelerations and decelerations five days before the match, and (iii) lower RTL of total and low-intensity running, accelerations and decelerations one and two days before the match.

Running Performance of High-Level Soccer Player Positions Induces Significant Muscle Damage and Fatigue Up to 24 h Postgame

This study aimed to determine the impact of a soccer game on the creatine kinase (Ck) response and recovery and the specific Global Positioning System (GPS)-accelerometry-derived performance analysis during matches and comparing playing positions. A sample composed of 118 observations of 24 professional soccer teams of the Brazil League Serie A was recruited and classified according to playing positions, i.e., Left/Right Defenders (D = 30, age: 25.2 ± 5.8 years, height: 187 ± 5.5 cm, weight: 80 ± 5.8 kg), Offensive Midfielders (OM = 44, age: 25.1 ± 0.2 years, height: 177 ± 0.3 cm, weight: 73 ± 1.2 kg), Forwards (F = 9, age: 25.1 ± 0.2 years, height: 176.9 ± 4.3 cm, weight: 74.5 ± 2.1 kg), Left/Right Wingers (M = 23, age: 24.5 ± 0.5 years, height: 175 ± 1.1 cm, weight: 74 ± 4.4 kg), and Strikers (S = 12, age: 28 ± 0.2 years, height: 184 ± 1.0 cm, weight: 80 ± 1.4 kg). Blood Ck concentration was measured pre-, immediately post-, and 24 h postgame, and the GPS-accelerometry parameters were assessed during games. Findings demonstrated that Ck concentrations were higher at all postgame moments when compared with pregame, with incomplete recovery markers being identified up to 24 h after the game (range: 402–835 U/L). Moreover, Midfielders (108.6 ± 5.6 m/min) and Forwards (109.1 ± 8.3 m/min) had a higher relative distance vs. other positions (100.9 ± 10.1 m/min). Strikers [8.2 (8.1, 9.05) load/min] and Defenders [8.45 (8, 8.8) load/min] demonstrated lower load/min than Wingers [9.5 (9.2, 9.8) load/min], Midfielders [10.6 (9.9, 11.67) load/min], and Forwards [11 (10.65, 11, 15) load/min]. These results could be used to adopt specific training programs and recovery strategies after match according to the playing positions.

Hematology, Hormones, Inflammation, and Muscle Damage in Elite and Professional Soccer Players: A Systematic Review with Implications for Exercise

BACKGROUND

Knowledge of the long-term effects of soccer training on hematological, hormonal, inflammatory, and muscle damage markers and physical performance may help to better design strength and conditioning programs for performance development and injury prevention for the individual player and the team.

OBJECTIVES

The aim of this systematic review was to summarize and discuss evidence on the long-term effects of soccer training on selected hematological, hormonal, inflammatory, and muscle damage markers and physical performance in elite and professional soccer players. A second goal was to investigate associations between selected physiological markers and measures of performance.

METHODS

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature search was conducted in four electronic databases (PubMed, ISI Web of Knowledge, Web of Science, and SPORTDiscus) from inception until August 2020 to identify articles related to soccer training effects. To be included in this systematic review, studies had to examine male elite (national level) and/or professional (international level) soccer players aged > 17 years and a soccer training period > 4 weeks, and report outcomes related to hematological, hormonal, inflammatory, muscle damage, and performance markers.

RESULTS

The search syntax initially identified 2420 records. After screening titles, abstracts, and full texts, 20 eligible studies were included in this systematic review, with training durations lasting between 4 and 18 weeks in 15 studies, around 6 months in four studies, and around 1 year in one study. Effects of long-term soccer training revealed parameter-specific increases or decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance. Two studies showed a moderate increase in hematological markers such as hemoglobin (effect size [ES] = 0.67-0.93). Parameter-specific changes were noted for hormonal markers in the form of increases for total testosterone (ES = 0.20-0.67) and free testosterone (FT) (ES = 0.20-0.65) and decreases for cortisol (ES =  - 0.28 to - 1.31). Finally, moderate to very large increases were found for muscle damage markers such as creatine kinase (ES = 0.94-6.80) and physical performance such as countermovement jump (CMJ) height (ES = 0.50-1.11) and squat jump (SJ) height (ES = 0.65-1.28). After long-term periods of soccer training, significant positive correlations were found between percentage change (Δ%) in FT and Δ% in CMJ height (r = 0.94; p = 0.04) and between Δ% in total testosterone/cortisol (TT/C) ratio and Δ% in SJ (r = 0.89; p = 0.03).

CONCLUSIONS

Findings suggest that long-term soccer training induces increases/decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance in male elite and professional soccer players. These fluctuations can be explained by different contextual factors (e.g., training load, duration of training, psychological factors, mood state). Interestingly, the observed changes in hormonal parameters (FT and TT/C) were related to vertical jump performance changes (e.g., CMJ and SJ). Anabolic hormones and TT/C can possibly be used as a tool to identify physical performance alteration after long-term soccer training.

A retrospective study on the combined biomarkers and ratios in serum and pleural fluid to distinguish the multiple types of pleural effusion

Purpose

Pleural effusion (PE) is a common clinical manifestation, and millions of people suffer from pleural disease. Herein, this retrospective study was performed to evaluate the biomarkers and ratios in serum and pleural fluid (PF) for the differential diagnosis of the multiple types of PE and search for a new diagnostic strategy for PE.

Methods

In-patients, who developed tuberculous PE (TPE), malignant PE (MPE), complicated parapneumonic effusion (CPPE), uncomplicated PPE (UPPE), or PE caused by connective tissue diseases (CTDs) and underwent thoracentesis at Peking University People’s Hospital from November 2016 to April 2019, were included in this study. Eleven biomarkers and their ratios in serum and PF were investigated and compared between pairs of the different PE groups, and a decision-tree was developed.

Results

Totally 112 PE cases, including 25 MPE, 33 TPE, 19 CPPE, 27 UPPE, and 8 PE caused by CTDs, were reviewed. Biomarkers and ratios showed good diagnostic performance with high area under the curve values, sensitivities, and specificities for the differential diagnosis of the multiple types of PE. According to the decision-tree analysis, the combination of adenosine deaminase (ADA), serum albumin, serum lactate dehydrogenase, total protein, PF-LDH/ADA, and PF-LDH/TP provided the best predictive capacity with an overall accuracy of 84.8%; the sensitivity and specificity for TPE diagnosis were 100% and 98.7%, respectively.

Conclusion

The biomarkers and ratios showed good diagnostic performance, and a decision-tree with an overall accuracy of 84.8% was developed to differentiate the five types of PE in clinical settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12890-021-01459-w.

Load Measures in Training/Match Monitoring in Soccer: A Systematic Review

In soccer, the assessment of the load imposed by training and a match is recognized as a fundamental task at any competitive level. The objective of this study is to carry out a systematic review on internal and external load monitoring during training and/or a match, identifying the measures used. In addition, we wish to make recommendations that make it possible to standardize the classification and use of the different measures. The systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted through the electronic database Web of Science, using the keywords "soccer" and "football", each one with the terms "internal load", "external load", and "workload". Of the 1223 studies initially identified, 82 were thoroughly analyzed and are part of this systematic review. Of these, 25 articles only report internal load data, 20 report only external load data, and 37 studies report both internal and external load measures. There is a huge number of load measures, which requires that soccer coaches select and focus their attention on the most useful and specific measures. Standardizing the classification of the different measures is vital in the organization of this task, as well as when it is intended to compare the results obtained in different investigations.

Internal and External Training Load in Under-19 versus Professional Soccer Players during the In-Season Period

This study aimed to compare the training load of a professional under-19 soccer team (U-19) to that of an elite adult team (EAT), from the same club, during the in-season period. Thirty-nine healthy soccer players were involved (EAT [n = 20]; U-19 [n = 19]) in the study which spanned four weeks. Training load (TL) was monitored as external TL, using a global positioning system (GPS), and internal TL, using a rating of perceived exertion (RPE). TL data were recorded after each training session. During soccer matches, players' RPEs were recorded. The internal TL was quantified daily by means of the session rating of perceived exertion (session-RPE) using Borg's 0-10 scale. For GPS data, the selected running speed intensities (over 0.5 s time intervals) were 12-15.9 km/h; 16-19.9 km/h; 20-24.9 km/h; >25 km/h (sprint). Distances covered between 16 and 19.9 km/h, > 20 km/h and >25 km/h were significantly higher in U-19 compared to EAT over the course of the study (p = 0.023, d = 0.243, small; p = 0.016, d = 0.298, small; and p = 0.001, d = 0.564, small, respectively). EAT players performed significantly fewer sprints per week compared to U-19 players (p = 0.002, d = 0.526, small). RPE was significantly higher in U-19 compared to EAT (p = 0.001, d = 0.188, trivial). The external and internal measures of TL were significantly higher in the U-19 group compared to the EAT soccer players. In conclusion, the results obtained show that the training load is greater in U19 compared to EAT.

Detrimental Effects of the Off-Season in Soccer Players: A Systematic Review and Meta-analysis

BACKGROUND

The off-season period in soccer leads necessarily to changes in fitness status. However, there is a lack of systematization that allows identifying the magnitude of these changes in groups participating in off-season training programs compared with those subjected to training cessation.

OBJECTIVE

This systematic review with meta-analysis was conducted to assess the effects of training cessation in off-season training programs on men soccer players' body fat, maximal oxygen uptake (VO_2max), yo-yo intermittent recovery test (YYIRT), vertical jump, sprinting time, and repeated-sprint ability.

METHODS

To qualify for inclusion in the systematic review, studies must have included: (1) a detraining period of ≥ 2 weeks; (2) controlled trials or cohorts of healthy men soccer players with no restriction on age; and (3) a pre-post training cessation or off-season training programs measure of body fat (%), VO_2max (mL kg^-1 min^-1), YYIRT performance (meters), vertical jump (height), sprinting (time), and repeated-sprint ability (total time).

RESULTS

The electronic search yielded 563 articles, and 12 were subsequently included. Significant (all p < 0.05) detrimental training cessation effects were noted for body fat (ES = 0.26), VO_2max (ES = - 1.48), YYIRT (ES = - 0.46), vertical jump (ES = - 0.81), and repeated-sprint ability (ES = 0.68). Similarly, significant (all p < 0.05) detrimental off-season training programs effects were noted for body fat (ES = 0.26), VO_2max (ES = - 0.48), vertical jump (ES = - 0.51), and sprinting time (ES = 0.86). When training cessation and off-season training programs effects were compared, greater detrimental effects were noted after training cessation for VO_2max (p = 0.002) and repeated-sprint ability (p < 0.001).

CONCLUSIONS

Detrimental effects on body composition and physical fitness were observed after both training cessation and off-season training programs. However, off-season training programs seem to ameliorate such detrimental effects on VO_2max and repeated-sprint ability to some extent. The results presented here call for the implementation of more effective off-season training programs among male soccer players.

Sports in time of COVID-19: Impact of the lockdown on team activity

The COVID-19 pandemic has affected many sectors of our global society since its detection in Wuhan in December 2019, and team sports have been no stranger to this reality. This special article presents a review of the literature exposing the dangers for athletes of this virus, reporting the effects of the pandemic on competitive sport, and making evidence-based recommendations to avoid the consequences of detraining in confined athletes. Furthermore, we present the results of a survey with 361 answers computed from coaches and different staff members from 26 different countries, representing the activity of more than 4500 athletes from all over the world. The aim was to know more teams’ activity during this cessation period. Finally, the article outlines recommendations based on the answers to help teams if a second outbreak of the virus forces massive confinements again, guiding a safe return to sport at any competitive level.

Workload a-WEAR-ness: Monitoring Workload in Team Sports With Wearable Technology. A Scoping Review

OBJECTIVES

To (1) identify the wearable devices and associated metrics used to monitor workload and assess injury risk, (2) describe the situations in which workload was monitored using wearable technology (including sports, purpose of the analysis, location and duration of monitoring, and athlete characteristics), and (3) evaluate the quality of evidence that workload monitoring can inform injury prevention.

DESIGN

Scoping review.

LITERATURE SEARCH

We searched the CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, HealthSTAR, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science databases.

STUDY SELECTION CRITERIA

We included all studies that used wearable devices (eg, heart rate monitor, inertial measurement units, global positioning system) to monitor athlete workload in a team sport setting.

DATA SYNTHESIS

We provided visualizations that represented the workload metrics reported, sensors used, sports investigated, athlete characteristics, and the duration of monitoring.

RESULTS

The 407 included studies focused on team ball sports (67% soccer, rugby, or Australian football), male athletes (81% of studies), elite or professional level of competition (74% of studies), and young adults (69% of studies included athletes aged between 20 and 28 years). Thirty-six studies of 7 sports investigated the association between workload measured with wearable devices and injury.

CONCLUSION

Distance-based metrics derived from global positioning system units were common for monitoring workload and are frequently used to assess injury risk. Workload monitoring studies have focused on specific populations (eg, elite male soccer players in Europe and elite male rugby and Australian football players in Oceania). Different injury definitions and reported workload metrics and poor study quality impeded conclusions regarding the relationship between workload and injury. J Orthop Sports Phys Ther 2020;50(10):549-563. doi:10.2519/jospt.2020.9753.

Player Monitoring in Professional Soccer: Spikes in Acute:Chronic Workload Are Dissociated From Injury Occurrence

This study aimed to determine whether spikes in acute:chronic workload ratio (ACWR) are associated with injury incidence, and to examine the differences in external load due to greater or lesser exposure to matches and the long-term effects of the load during a chronic seasonal period. Fifteen professional soccer players belonging to the squad of a European Champions League club were enrolled in this study. External training and match load were assessed from all athletes using a global positioning system (GPS). We calculated the uncoupled ACWR for 10 consecutive competitive microcycles. Injuries were identified and determined by the days of absence. The differences in external load were determined using a linear mixed-model approach. In addition to the null hypothesis testing, the effect size was calculated. Thirteen athletes who did not suffer an injury exceeded several times the critical threshold of an ACWR > 1.5. This is equivalent to 1 player exceeding the critical threshold for ACWR in total distance (TD), 2 players for ACWR at distance covered above moderate speed (MSD), 2 players for ACWR at distance covered above high speed (HSD), 2 players for ACWR at distance covered above very high speed (VHSD), and 2 players for ACWR in DC at sprint per week. One athlete experienced a non-contact muscle strain injury and another a contact -injury manifested as a concussion; both athletes document an ACWR <1.5 within the 4 weeks prior to the injury event. Players with lesser participation in official games covered lower TD (-19.6%, very-large ES), MSD (-24.8%, very-large ES), HSD (-25.1%, moderate ES), VHSD (-25.5%, moderate ES), and DC at sprint (-30.6%, moderate ES) over the course of the 10-weeks period in comparison with the players with greater participation in official games. The present study demonstrated that spikes in the ACWR were not related to a subsequent injury occurrence in professional soccer players. Differences in participation in official games caused significant imbalances in the chronic external loads between players in a squad, which should be minimized in training sessions in order to prevent substantial changes in workload for those who usually do not play.

Are Elite Soccer Teams' Preseason Training Sessions Associated With Fewer In-Season Injuries? A 15-Year Analysis From the Union of European Football Associations (UEFA) Elite Club Injury Study

BACKGROUND

Preseason training develops players' physical capacities and prepares them for the demands of the competitive season. In rugby, Australian football, and American football, preseason training may protect elite players against in-season injury. However, no study has evaluated this relationship at the team level in elite soccer.

PURPOSE/HYPOTHESIS

The aim of this study was to investigate whether the number of preseason training sessions completed by elite soccer teams was associated with team injury rates and player availability during the competitive season. It was hypothesized that elite soccer teams who participate in more preseason training will sustain fewer injuries during the competitive season.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

We used the Union of European Football Associations (UEFA) injury dataset to analyze 44 teams for up to 15 seasons (total, 244 team-seasons). Separate linear regression models examined the association between the number of team preseason training sessions and 5 in-season injury measures. Injury-related problems per team were quantified by totals of the following: (1) injury burden, (2) severe injury incidence, (3) training attendance, (4) match availability, and (5) injury incidence.

RESULTS

Teams averaged 30 preseason training sessions (range, 10-51). A greater number of preseason training sessions was associated with less injury load during the competitive season in 4 out of 5 injury-related measures. Our linear regression models revealed that for every 10 additional preseason training sessions that the team performed, the in-season injury burden was 22 layoff days lower per 1000 hours (P = .002), the severe injury incidence was 0.18 severe injuries lower per 1000 hours (P = .015), the training attendance was 1.4 percentage points greater (P = .014), and the match availability was 1.0 percentage points greater (P = .042). As model fits were relatively low (adjusted R² = 1.3%-3.2%), several factors that contribute to in-season injury outcomes were unaccounted for.

CONCLUSION

Teams that performed a greater number of preseason training sessions had "healthier" in-season periods. Many other factors also contribute to in-season injury rates. Understanding the benefit of preseason training on in-season injury patterns may inform sport teams' planning and preparation.