Validity and Efficacy of the Elite HRV Smartphone Application during Slow-Paced Breathing

Slow-paced breathing is a clinical intervention used to increase heart rate variability (HRV). The practice is made more accessible via cost-free smartphone applications like Elite HRV. We investigated whether Elite HRV can accurately measure and augment HRV via its slow-paced breathing feature. Twenty young adults completed one counterbalanced cross-over protocol involving 10 min each of supine spontaneous (SPONT) and paced (PACED; 6 breaths·min-1) breathing while RR intervals were simultaneously recorded via a Polar H10 paired with Elite HRV and reference electrocardiography (ECG). Individual differences in HRV between devices were predominately skewed, reflecting a tendency for Elite HRV to underestimate ECG-derived values. Skewness was typically driven by a limited number of outliers as median bias values were ≤1.3 ms and relative agreement was ≥very large for time-domain parameters. Despite no significant bias and ≥large relative agreement for frequency-domain parameters, limits of agreement (LOAs) were excessively wide and tended to be wider during PACED for all HRV parameters. PACED significantly increased low-frequency power (LF) for Elite HRV and ECG, and between-condition differences showed very large relative agreement. Elite HRV-guided slow-paced breathing effectively increased LF values, but it demonstrated greater precision during SPONT and in computing time-domain HRV.

Reliability of Upper Extremity Functional Performance Tests for the Non-overhead Athlete

Background

While there have been reliability studies conducted on several upper extremity functional performance tests (UEFPT), there are several complicating factors that inhibit the ability to draw definitive consensus about the reliability of the tests in both females and males. Having reliability estimates for UEFPT in the same cohort facilitates direct comparison of their relative and absolute reliability.

Purpose

To establish the test-retest reliability of the closed kinetic chain upper extremity stability test (CKCUEST), seated medicine ball chest pass test (SMBCPT) and hands-release push-up test (HRPUT) in a cohort of males and females with a history of non-overhead sport participation. A secondary purpose was to examine the associations between the three UEFPT.

Study Design

Test-retest reliability, single cohort study.

Methods

Forty adults (20 females, 20 males) with a history of non-overhead sport participation completed three UEFPT during two data collection sessions three to seven days apart. Measures of systematic bias, absolute reliability and relative reliability were computed between the sessions. Additionally, correlational analyses were conducted between the three UEFPT.

Results

Only the UECKCST (both sexes) demonstrated significant (p≤ 0.003) second session performance improvements. All three tests exhibited excellent relative reliability (intraclass correlational coefficients ≥ 0.823) and except for the HRPUT in males, coefficients of variation were all below 8.8%. Except for a significant relationship (r=.691, p=0.001) between the UECKCST and SMBCPT for the females there were no other associations between the three UEFPT.

Conclusion

All three UEFPT demonstrated sufficient reliability. Thus, all three assessments can be used for serial assessments to progress a patient through rehabilitation as well as contribute to the criteria used in making return to sport decisions.

Level of Evidence

3.

Blood alcohol concentration as a measure of risk among pedestrian fatalities in the U.S., 2016-2020

OBJECTIVE

In the United States, deaths among pedestrians have increased dramatically since 2009 relative to other vulnerable road users, with substance use described as an important risk factor. This study aimed to explore blood alcohol concentrations (BAC g/dL) among pedestrian fatalities in the United States between 2016 and 2020. Exploring the presence of alcohol among pedestrian cases will support targeted interventions designed to reduce risk.

METHODS

This study utilized pedestrian fatality and alcohol screening data provided by the Fatality Analysis Reporting System (FARS). Logistic models were examined to identify statistical associations (ORs, 95% CI) by age, race, and sex relative to positive BAC exposure (BAC > 0.0 g/dL), mild exposure (BAC > 0.0 < .079 g/dL), moderate to severe alcohol exposure (BAC 0.08-.299 g/dL), and severe exposure (BAC ≥ 0.30 g/dL).

RESULTS

Between 2016 and 2020, 33,375 pedestrian fatalities were reported to FARS with 75.1% of cases retained for analysis (n = 25,077). Fatalities were more likely to be White (69.3%), male (69.9%), and between 25-64 years of age (67.3%). 74.0% of fatalities were tested for alcohol, with 40.9% screening positive. Females, cases ≥ 75 years of age, and those identified as Asians reported the lowest odds of being positive for alcohol exposure.

CONCLUSIONS

Results suggest an ongoing threat to pedestrians due to alcohol consumption and that exposure odds vary by demographic characteristics. Unfortunately, analytical approaches to understanding the roles played by drugs and alcohol among vulnerable road users tend to be marginalized in the literature. Analytical, evidence-based investigations are needed to curtail the risk of pedestrian fatalities in the U.S.

Reliability of Upper Extremity Functional Performance Tests for Overhead Sports Activities

Background

There is lack of consensus on which tests, particularly upper extremity functional performance tests (FPT) that should be used for clinical decision making to progress a patient through a rehabilitation program or criteria for return to sport (RTS). Consequently, there is a need for tests with good psychometric properties that can be administered with minimal equipment and time.

Purpose

(1) To establish the intersession reliability of several open kinetic chain FPT in healthy young adults with a history of overhead sport participation. (2) To examine the intersession reliability of the limb symmetry indices (LSI) from each test.

Study Design

Test-retest reliability, single cohort study.

Methods

Forty adults (20 males, 20 females) completed four upper extremity FPT during two data collection sessions three to seven days apart: 1) prone medicine ball drop test 90°shoulder abduction (PMBDT 90°), 2) prone medicine ball drop test 90°shoulder abduction/90° elbow flexion (PMBDT 90°-90°), 3) half-kneeling medicine ball rebound test (HKMBRT), 4) seated single arm shot put test (SSASPT). Measures of systematic bias, absolute reliability and relative reliability were computed between the sessions for both the original test scores and LSI.

Results

Except for the SSASPT, all tests demonstrated significant (p ≤ 0.030) improvements in performance during the second session. Generally, for the medicine ball drop/rebound tests, the absolute reliability was the highest (less random error) for the HKMBRT, next the PMBDT 90°followed by PMBDT 90°-90°. Excellent relative reliability existed for the PMBDT 90°, HKMBRT, and SSASPT, whereas fair to excellent relative reliability for the PMBDT 90°-90°. The SSASPT LSI revealed the highest relative and absolute reliability.

Conclusion

Two tests, HKMBRT and SSASPT demonstrated sufficient reliability; therefore, the authors' recommend those tests can be used for serial assessments to advance a patient through a rehabilitation program as well as criteria for progression to RTS.

Level of Evidence

3.

Effects of Kettlebell Load on Joint Kinetics and Global Characteristics during Overhead Swings in Women

This study sought to identify the changes in ankle, knee, and hip joint kinetics with increasing load while performing the kettlebell overhead swing (OHS). Women (n = 18, age: 29.4 ± 5.3 years, 69.7 ± 8.9 kg) with a minimum of 6 months of kettlebell swing training experience performed fifteen repetitions of the kettlebell OHS with three different kettlebell masses (8 kg, 12 kg, 16 kg) in a counterbalanced order. Ankle, knee, and hip joint kinematics were captured within a 12-camera infrared motion capture space, while standing atop two force plates collecting ground reaction force (GRF) data. Post hoc results of statistically significant joint by mass interactions (p < 0.05) of the net joint moment impulse, work, and peak power revealed the hip demonstrating the greatest increase in response to load, followed by the ankle (p < 0.05). The knee joint kinetics changed very little between the masses. Pairwise post hoc comparisons between the joints at each mass level support the kettlebell OHS as being a hip dominant exercise, with the knee making the second largest contribution, despite contributions not changing across kettlebell masses. Collectively, these results provide practitioners with objective evidence regarding the mechanical demands and effects of load changes on the kettlebell OHS.

The Influence of Hip Flexion and Isokinetic Velocity on Hamstrings-Quadriceps Strength Ratios in Healthy Females

Context: Measurements of the concentric hamstrings-quadriceps strength ratio (Hc:Qc) are almost exclusively recorded in the upright, seated position (hip flexion 80-100°) on an isokinetic dynamometer at angular velocities ranging from 30°/s to 360°/s. Further, there is a scarcity of data examining Hc:Qc ratio in females. Objective: To compare the effects of hip-flexion position (0°, 45°, and 90°) and isokinetic velocity (60°/s, 180°/s, and 300°/s) on knee-extension and knee-flexion torques and the Hc:Qc ratio of females. Design: Single-session, repeated measures. Setting: Biomechanics laboratory. Participants: Twenty-seven healthy young female adults. Intervention: Participants completed five repetitions of isokinetic, concentric knee-flexion and knee-extension at hip flexions of 0° (supine), 45° (midrange), and 90° (traditional), at 60°/s, 180°/s, and 300°/s. Main Outcome Measures: Knee extension and flexion average peak torque (PT) and resultant Hc:Qc ratios. Results: Knee-extension average PT was significantly influenced by isokinetic velocity but hip-flexion position was not. Compared to 90°, knee-flexion average PT was significantly greater in the 45° and 0° hip positions, coupled with greater average PT decreases between 60°/s and 180°/s than between 180°/s and 300°/s. Hc:Qc ratios in the 0° position were significantly greater than in the other positions and increased significantly as testing velocity increased. Conclusions: Exclusively using a seated, upright position during knee isokinetic testing on females may misrepresent knee strength at more-functional hip positions. We recommend evaluating isokinetic knee strength using a supine position to better reflect hip positions during daily and sporting activities, throughout movement specific velocities.

Relationships between the seated single arm shot put test and Quick-DASH in patients being discharged from physical therapy

BACKGROUND

Research examining the relationship between patient reported outcomes (PRO) and upper extremity functional performance tests (UEFPT) in patients with shoulder pathology are limited.

OBJECTIVE

To assess the relationship between the seated single arm shot put test (SSASPT) and the PRO Quick-Disabilities of Arm, Shoulder, and Hand (DASH) in patients being discharged from physical therapy after shoulder injury or surgery.

METHODS

Six physical therapists who regularly use the SSASPT and DASH from six different clinical sites provided SSASPT scores and completed Quick-DASH forms on 75 patients being discharged from rehabilitation following shoulder injury or surgery. Patients were grouped according to whether the involved shoulder was the dominant (n = 43) or nondominant (n = 32) limb. Three separate simple linear regression models, whole cohort and two patient groups, were created to determine the magnitude of the relationships (standardized betas) and change (betas) between DASH scores and the SSASPT limb symmetry index (LSI).

RESULTS

Neither whole cohort nor two groups exhibited statistically significant (P > .05) relationships between LSI and Quick-DASH scores based upon the standardized betas (-0.197-0.038). Additionally, neither the standardized betas (z = 1.49, P = .135) nor betas (z = 1.28, P = .200) were statistically different between the two groups.

CONCLUSIONS

The current study revealed no association between SSASPT and the Quick-DASH at discharge from physical therapy following shoulder injury or surgery. Consequently, it may be important to perform a battery of tests that include both subjective PRO and objective UEFPT tests to obtain a comprehensive perspective of the patient's functional and perceived status.

Sleep duration irregularity is associated with elevated blood pressure in young adults

Sleep irregularity (i.e., highly variable sleep patterns) is an emerging risk factor for cardiometabolic disease. Though irregular sleep patterns are common among young adults, the cardiometabolic health (CMH) repercussions of sleep irregularity in this population are unclear. We examined associations between sleep duration and irregularity with measures of CMH in 44 (24 M/20 F, 23 ± 5y, BMI 26 ± 4 kg/m², blood pressure (BP): 125/71 ± 14/9 mmHg) young adults. Participants wore actigraphy monitors for seven-days and sleep duration irregularity was operationalized as the standard deviation of nightly sleep duration (sleep SD). CMH variables of interest included brachial and aortic BP, arterial stiffness (cf-PWV), augmentation index (AIx75), and fasting blood glucose and lipids. Associations between sleep duration and sleep SD with CMH variables were assessed via correlations adjusted for sex and BMI. Sleep duration generally was not associated with CMH indices. However, sleep SD was associated with brachial systolic (r = 0.433, p = .027) and diastolic BP (r = 0.415, p = .035). Similarly, sleep duration SD was associated with aortic systolic BP (r = 0.447, p = .022). Our findings show that sleep irregularity, but not duration, is associated with higher brachial and central BP in young adults.Abbreviations: AIx75: augmentation index at a heart rate of 75 beats per minute; BP: blood pressure; CMH: cardiometabolic health; cf-PWV: carotid-femoral pulse wave velocity; DXA: dual x-ray absorptiometry; mg/dl: milligrams per deciliter; PWA: pulse wave analysis; PWV: pulse wave velocity; sleep duration SD: standard deviation of nightly sleep duration.

Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey

BACKGROUND

The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults.

METHODS

A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire.

RESULTS

Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20).

CONCLUSION

COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.

Biomechanical Differences Between the Bulgarian Split-Squat and Back Squat

The Bulgarian split squat (BSS) is a unilateral lower extremity strength exercise; however, the mechanical demands have not been fully elucidated. The purpose of this study was to compare ankle, knee, and hip joint net joint moment impulse (NJMI), work (NJW), peak net joint moment (NJM) and peak displacement between the BSS and traditional bilateral back squat (BS). Following a practice and 1-repetition maximum (1-RM) session, 2x3 BS (70% 1-RM) and BSS (35% 1-RM) were completed by twenty resistance trained males (24.20 ± 2.50 yrs, 1.76 ± 0.06m, 85.3 ± 13.90 kg). Significant squat type x joint interactions were revealed for NJMI (p < 0.001), NJW (p < 0.001), peak NJM (p < 0.001), and peak displacement (p = 0.011). For both squats, hip NJMI, NJW, and peak NJM was significantly greater than both ankle (d = 5.50-9.40) and knee (d = 7.50-8.50). While knee NJMI (d = 2.80) and peak NJM (d = 2.10) during the BSS was statistically less compared to ankle, during BS knee NJMI was statistically greater than ankle (d = 3.00). Ankle and knee NJW were statistically similar during BSS (d = 0.30), whereas knee NJW was statistically greater than ankle during BS (d = 3.20). Comparing between squat types within each joint demonstrated statistically equal peak displacement for the ankle (d = 0.14) and hip (d = 0.11), whereas knee joint peak displacement was significantly less for the BSS compared to BS (d = 0.82). Both the BSS and BS are hip dominant exercises. The BSS may best be used in circumstances to focus on hip extension while minimizing the knee joint demands, such as the early phases of knee rehabilitation or when addressing isolated hip extension deficiencies.

Reliability and validity of a novel Isokinetic Knee Dynamometer System

PURPOSE

The aim of this work was to determine the intersession reliability and validity of a recently developed prototype Isokinetic Knee Dynamometer to assess isokinetic knee extension and flexion peak moments compared to a Biodex System 4 dynamometer.

METHODS

Thirty- -five healthy participants performed two sessions (48-h separation) of bilateral concentric isokinetic knee extension and flexion on both isokinetic devices at 60 °/s (6 repetitions), 180 °/s (10 repetitions) and 240 °/s (15 repetitions). Dynamometer and limb order were randomized among participants while peak moment of each set was used for data analysis.

RESULTS

The Isokinetic Knee Dynamometer had excellent relative reliability, comparable to the System 4, and both systems displayed acceptable absolute reliability. Proportional biases were observed favoring the System 4 during knee extension of both limbs at 60 °/s and the dominant limb at 180 °/s, and fixed biases favoring the Isokinetic Knee Dynamometer in seven conditions. Relative agreement between systems was good across all test conditions with the majority demonstrating excellent agreement.

CONCLUSIONS

These data support the Isokinetic Knee Dynamometer as a reliable and valid knee isokinetic testing system. Due to its reduced system complexity, space requirements, and production cost, the Isokinetic Knee Dynamometer may increase the clinical utilization of isokinetic knee assessments. Finally, these data fill an existing isokinetics literature void with the results supporting similar and acceptable measurement properties jointly for dominant and non-dominant limbs and at the higher testing velocities considered.

Reliability and validity of a novel Isokinetic Knee Dynamometer System

Purpose: The aim of this work was to determine the intersession reliability and validity of a recently developed prototype Isokinetic Knee Dynamometer to assess isokinetic knee extension and flexion peak moments compared to a Biodex System 4 dynamometer. Methods: Thirty- -five healthy participants performed two sessions (48-h separation) of bilateral concentric isokinetic knee extension and flexion on both isokinetic devices at 60 °/s (6 repetitions), 180 °/s (10 repetitions) and 240 °/s (15 repetitions). Dynamometer and limb order were randomized among participants while peak moment of each set was used for data analysis. Results: The Isokinetic Knee Dynamometer had excellent relative reliability, comparable to the System 4, and both systems displayed acceptable absolute reliability. Proportional biases were observed favoring the System 4 during knee extension of both limbs at 60 °/s and the dominant limb at 180 °/s, and fixed biases favoring the Isokinetic Knee Dynamometer in seven conditions. Relative agreement between systems was good across all test conditions with the majority demonstrating excellent agreement. Conclusions: These data support the Isokinetic Knee Dynamometer as a reliable and valid knee isokinetic testing system. Due to its reduced system complexity, space requirements, and production cost, the Isokinetic Knee Dynamometer may increase the clinical utilization of isokinetic knee assessments. Finally, these data fill an existing isokinetics literature void with the results supporting similar and acceptable measurement properties jointly for dominant and non-dominant limbs and at the higher testing velocities considered.

Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

BACKGROUND

Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVID19) was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional wellbeing.

METHODS

The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online-survey-platform and was promoted by thirty-five research organizations from Europe, North-Africa, Western-Asia and the Americas. All participants were asked for their mental wellbeing (SWEMWS) and depressive symptoms (SMFQ) with regard to "during" and "before" home confinement.

RESULTS

Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental-wellbeing and on mood and feelings. Specifically, a significant decrease (p < .001 and Δ% = 9.4%) in total score of the SWEMWS questionnaire was noted. More individuals (+12.89%) reported a low mental wellbeing "during" compared to "before" home confinement. Furthermore, results from the mood and feelings questionnaire showed a significant increase by 44.9% (p < .001) in SMFQ total score with more people (+10%) showing depressive symptoms "during" compared to "before" home confinement.

CONCLUSION

The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.

Bone Mineral Density and Muscle Mass in Masters Olympic Weightlifters and Runners

The authors examined the musculoskeletal implications of delayed exercise adoption in two distinct cohorts of masters athletes with ∼10 years of training experience: Olympic weightlifters (OWLs) and distance runners (RUNs). Total body and regional bone mineral density (BMD), and dual-energy X-ray absorptiometry-derived lean mass were compared in 51 OWLs and 43 RUNs. Multiple linear regression analyses were conducted on BMD and lean mass with the exercise group (i.e., OWLs vs. RUNs), age, sex, and years of experience as independent variables. Age was associated (p < .05) with less femoral (β = -0.25) and lumbar (β = -0.27) BMD. Total body (β = 0.23), lumbar (β = 0.25), and radial (β = 0.36) BMD were greater (p < .05) in OWLs versus RUNs. Lean mass was greater in OWLs versus RUNs (β = 0.29, p < .01), but did not relate to total body BMD (r = .15; p = .08). Greater total and regional BMD and lean mass in OWLs compared with RUNs may reduce risk for developing osteoporosis and/or sarcopenia and associated downstream health outcomes.

COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction.

METHODS

Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses "before" and "during" confinement conditions.

RESULTS

1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (-58%), friends/neighbors (-44.9%), or entertainment (-46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (-30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology.

CONCLUSION

These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.

Comparison of balance performance between masters Olympic weightlifters and runners

Balance disorders are a common problem among older adults that greatly increase susceptibility for falls and fractures. Aerobically trained older (masters) athletes tend to exhibit superior balance abilities compared to that of healthy age-matched counterparts. Olympic weightlifting involves tremendous power production and motor skill coordination throughout the body which may prompt unique sensory information acquisition and integration adaptations. The purpose of this investigation was to compare a modified clinical test of sensory interaction and balance performance between middle-aged (~40-60 years) masters Olympic weightlifters (OWL, n = 48) and runners (RUN, n = 42). Average mediolateral center of pressure velocity (MLCPV) was computed during completion of 2 double leg trials (30-s) completed on firm (FI) and foam (FO) surfaces with eyes open (EO) and eyes closed (EC). While there were no significant differences between the groups for either the EO-FI (P = .143, d = 0.34) or EO-FO (P = .209, d = 0.26), the OWL demonstrated significantly better balance (lower MLCPV) than the RUN for both the EC-FI (P = .009, d = 0.59) and EC-FO (P = .001, d = 0.70). The most salient result of this investigation was the identification of better balance performance by the OWL, particularly when visual inputs were unavailable (ie, EC), compared to the RUN. These results suggest that Olympic weightlifting may provide a superior training stimulus for somatosensory and vestibular function compared to running in middle-aged adults, a benefit that may help to offset archetypal age-related balance deficits.

Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey

BACKGROUND

Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours.

METHODS

Following a structured review of the literature, the "Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)" Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses "before" and "during" confinement conditions.

RESULTS

1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly.

CONCLUSION

While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.

Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey

BACKGROUND

Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours.

METHODS

Following a structured review of the literature, the "Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)" Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses "before" and "during" confinement conditions.

RESULTS

1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly.

CONCLUSION

While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.

Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey

BACKGROUND

Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours.

METHODS

Following a structured review of the literature, the "Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)" Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses "before" and "during" confinement conditions.

RESULTS

1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly.

CONCLUSION

While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.

Self-reported sleep quality is associated with gut microbiome composition in young, healthy individuals: a pilot study

OBJECTIVES

The microbiota-gut-brain axis is an intricate communication network that is emerging as a key modulator of psychological and physiological wellbeing. Recent pioneering work in the field has suggested a possible link between gut microbiome composition with sleep, an evolutionarily conserved behavior demonstrated to play a critical role in health. This study is the first to address relationships between self-reported sleep habits and gut microbiome composition in young, healthy individuals.

METHODS

A total of 28 young, healthy subjects (17 males/11 females; 29.8 ± 10.4 years) that were free of metabolic or cardiovascular disease, and that did not take sleep medication or antibiotics within the past six months were included in the study. Relationships between self-reported sleep quality, obtained using the Pittsburgh Sleep Quality Index (PSQI), with microbial diversity (Shannon Index), the Firmicutes/Bacteroidetes (F/B) ratio, and select bacterial taxa were assessed.

RESULTS

Alpha diversity (r = -0.50) and F/B ratio (r = -0.47) were inversely associated (P < 0.05) with the PSQI score. Ten bacterial taxa were associated (P < 0.05) with the PSQI score, including genus-level Blautia (r = -0.57), Ruminococcus (r = -0.39), and Prevotella (r = 0.39).

CONCLUSIONS

In young healthy individuals, self-reported sleep quality was positively associated with microbial diversity. We also observed a positive association between sleep quality with F/B ratio, seemingly due to a greater relative abundance of Blautia and Ruminococcus (Firmicutes) and lower proportions of Prevotella (Bacteroidetes) in individuals reporting superior sleep quality. Future studies are encouraged to evaluate mechanistic links between the gut microbiome with sleep, as well as the health implications of this relationship.

Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

BACKGROUND

Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVID19) was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional wellbeing.

METHODS

The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online-survey-platform and was promoted by thirty-five research organizations from Europe, North-Africa, Western-Asia and the Americas. All participants were asked for their mental wellbeing (SWEMWS) and depressive symptoms (SMFQ) with regard to "during" and "before" home confinement.

RESULTS

Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental-wellbeing and on mood and feelings. Specifically, a significant decrease (p < .001 and Δ% = 9.4%) in total score of the SWEMWS questionnaire was noted. More individuals (+12.89%) reported a low mental wellbeing "during" compared to "before" home confinement. Furthermore, results from the mood and feelings questionnaire showed a significant increase by 44.9% (p < .001) in SMFQ total score with more people (+10%) showing depressive symptoms "during" compared to "before" home confinement.

CONCLUSION

The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.

Psychological consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

BACKGROUND

Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily-living. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey (ECLB-COVID19) was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional wellbeing.

METHODS

The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online-survey-platform and was promoted by thirty-five research organizations from Europe, North-Africa, Western-Asia and the Americas. All participants were asked for their mental wellbeing (SWEMWS) and depressive symptoms (SMFQ) with regard to "during" and "before" home confinement.

RESULTS

Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental-wellbeing and on mood and feelings. Specifically, a significant decrease (p < .001 and Δ% = 9.4%) in total score of the SWEMWS questionnaire was noted. More individuals (+12.89%) reported a low mental wellbeing "during" compared to "before" home confinement. Furthermore, results from the mood and feelings questionnaire showed a significant increase by 44.9% (p < .001) in SMFQ total score with more people (+10%) showing depressive symptoms "during" compared to "before" home confinement.

CONCLUSION

The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.

A Biomechanical Analysis of the Effects of Bouncing the Barbell in the Conventional Deadlift

Krajewski, K, LeFavi, R, and Riemann, B. A biomechanical analysis of the effects of bouncing the barbell in the conventional deadlift. J Strength Cond Res 33(7S): S70-S77, 2019-The purpose of this study is to analyze biomechanical differences between the bounce and pause styles of deadlifting. Twenty physically active males performed deadlifts at their 75% one-repetition maximum testing using both pause and bounce techniques in a within-subjects randomized study design. The average peak height the barbell attained from the 3 bounce style repetitions was used to compute a compatible phase for analysis of the pause style repetitions. Net joint moment impulse (NJMI), work, average vertical ground reaction force (vGRF), vGRF impulse, and phase time were computed for 2 phases, liftoff to peak barbell height and the entire ascent. Additionally, the ankle, knee, hip, and trunk angles at the location of peak barbell bounce height were computed. During the liftoff to peak barbell height phase, although each of the joints demonstrated significantly less NJMI and work during the bounce style, the hip joint was impacted the most. The average vGRF was greater for the bounce; however, the vGRF impulse was greater for the pause. The NJMI results for the ascent phase were similar to the liftoff to peak barbell height phase, whereas work was significantly less for the bounce condition compared with the pause condition across all 3 joints. Strength and conditioning specialists using the deadlift should be aware that the bounce technique does not allow the athlete to develop maximal force production in the early portion of the lift. Further analyses should focus on joint angles and potential vulnerability to injury when the barbell momentum generated from the bounce is lost.

Effects of medicine ball mass on the intensity of 90°/90° plyometric throwing exercise

OBJECTIVES

To quantify the effects of medicine ball mass (1 kg, 1.5 kg, 2 kg) on the intensity of 90°/90° plyometric throwing exercise.

STUDY DESIGN

Controlled laboratory study.

SETTING

Biomechanics laboratory.

PARTICIPANTS

Fifteen physically active collegiate aged men.

MAIN OUTCOME MEASURES

Kinematics of the upper extremity were collected during completion of eight to ten repetitions of 90°/90° plyometric throwing exercise with three different mass medicine balls. Four parameters, medicine ball release and contact momentum, time-to-rebound, and contact time, were computed for each selected repetition and used for statistical analysis.

RESULTS

Ball mass did not significantly influence time-to-rebound (P = .718) and had a small (less than 0.05s) effect on ball contact time (P = .039). Ball release momentum was significantly greater (P < .001, 67-123% greater) than ball contact momentum. Medicine ball mass significantly increased both ball release (34-35%) and ball contact (45-67%) momentum however the effect was significantly greater for ball release momentum (P = .005).

CONCLUSIONS

These results document the effects of increasing medicine ball mass during 90°/90° plyometric throwing exercise and provide evidence for designing upper extremity plyometric training programs. Based on ball contact momentum being less than ball release momentum, as well as ball mass having greater influence on ball release velocity, we suggest that 90°/90° plyometric throwing exercise is a safe exercise.

Comparison of 2- and 3-Minute Inter-Repetition Rest Periods on Maximal Jerk Technique and Power Maintenance

Purpose: The aim of this study was to examine the effect of 3- vs. 2-minute inter maximal-repetition rest period (IMRRP) on maintaining jerk technical efficiency and power production during two successive maximal repetitions of Clean & Jerk (C&J). Methods: In a randomized, within subject, repeated measures design, nine elite-weightlifters (age: 24.4 ± 3.6 years, body mass: 77.2 ± 7.1 kg, height 176.0 ± 6.4 cm and 1RM C&J: 170.0 ± 5.0 kg) performed 2-separate testing sessions using 2 (IMRRP-2) and 3 (IMRRP-3) -minute IMRRP, while barbell kinematics and kinetics and joint kinematics were recorded. Results: Statistical analysis showed that one minute longer IMRRP enhanced the maintenance of optimal jerk technique evidenced by reducing declines in peak vertical barbell displacement (2.74%; p = .03), peak barbell velocity (2.89%; p = .03), and peak knee (1.61%; p = .03) and hip extensions (1.59%; p = .03) during the drive phase of the jerk. Additionally, IMRRP-3 led to maintaining optimal lifting strategy by reducing the increase in horizontal displacement during the descending (3.85%; p = .04) and ascending (5.42%; p = .02) phases. Increasing IMRRP from 2min to 3min was also shown to enhance kinetic variables evidenced by prompting higher peak vGRF (2.01%; p = .04) and power (2.55%; p = .04). Conclusion: To better identify an athlete's maximal jerk technique and power maintenance, the results of this study suggest 3min as more appropriate IMRRP during successive C&J at 100% 1RM.

Statistical Primer for Athletic Trainers: Understanding the Role of Statistical Power in Comparative Athletic Training Research

OBJECTIVE

  To describe the concept of statistical power as related to comparative interventions and how various factors, including sample size, affect statistical power.

BACKGROUND

  Having a sufficiently sized sample for a study is necessary for an investigation to demonstrate that an effective treatment is statistically superior. Many researchers fail to conduct and report a priori sample-size estimates, which then makes it difficult to interpret nonsignificant results and causes the clinician to question the planning of the research design.

DESCRIPTION

  Statistical power is the probability of statistically detecting a treatment effect when one truly exists. The α level, a measure of differences between groups, the variability of the data, and the sample size all affect statistical power.

RECOMMENDATIONS

  Authors should conduct and provide the results of a priori sample-size estimations in the literature. This will assist clinicians in determining whether the lack of a statistically significant treatment effect is due to an underpowered study or to a treatment's actually having no effect.

A Bilateral Comparison of the Underlying Mechanics Contributing to the Seated Single-Arm Shot-Put Functional Performance Test

CONTEXT

Functional performance tests (FPTs) are tools used to assess dynamic muscle strength and power. In contrast to the lower extremity, fewer FPTs are available for the upper extremity. The seated single-arm shot put test has the potential to fill the void in upper extremity FPTs; however, the underlying mechanics have not been examined and, therefore, the validity of bilateral comparisons is unknown.

OBJECTIVE

To examine the effects of upper extremity dominance and medicine-ball mass on the underlying mechanics of the seated single-arm shot put.

DESIGN

Crossover study.

SETTING

Biomechanics laboratory.

PATIENTS OR OTHER PARTICIPANTS

Fifteen women (age = 23.6 ± 2.1 years, height = 1.65 ± .07 m, mass = 68.1 ± 11.7 kg) and 15 men (age = 24.3 ± 4.0 years, height = 1.80 ± 0.06 m, mass = 88.1 ± 16.4 kg), all healthy and physically active.

INTERVENTION(S)

Seated single-arm shot-put trials using the dominant and nondominant limbs were completed using three 0.114-m-diameter medicine-ball loads (1 kg, 2 kg, 3 kg).

MAIN OUTCOME MEASURE(S)

Customized touch-sensitive gloves, synchronized with kinematic data of the hands, signaled ball release, so that release height, release angle, and peak anterior and vertical velocity could be quantified for each trial. In addition, the horizontal range from release to first floor impact was recorded.

RESULTS

The dominant-limb horizontal ranges were 7% to 11% greater ( P < .001) than for the nondominant limb for each of the 3 ball masses. No bilateral release-height or -angle differences were revealed ( P ≥ .063). Release velocities were 7.6% greater for the dominant limb than the nondominant limb ( P = .001).

CONCLUSIONS

Our results support the use of the seated single-arm shot put test as a way to compare bilateral upper extremity functional performance. The near-identical release heights and angles between the dominant and nondominant limbs support the interpretation of measured bilateral horizontal-range differences as reflecting underlying strength and power differences.

Effect of 2- vs. 3-Minute Interrepetition Rest Period on Maximal Clean Technique and Performance

Ammar, A, Riemann, BL, Abdelkarim, O, Driss, T, and Hökelmann, A. Effect of 2- vs. 3-minute interrepetition rest period on maximal clean technique and performance. J Strength Cond Res 34(9): 2548-2556, 2020-Currently, it is widely accepted that adopting a long rest period (3-5 minutes) during maximal strength and power exercise is of importance in reducing acute fatigue and maintaining power and technique proficiency. However, despite the fact that weightlifting is an example of maximal strength exercise, only 2 minutes are officially allowed when athletes attempt 2 successive lifts. The purpose of this study was to compare 3- vs. 2-minute intermaximal repetition rest periods (IMRRPs) on performance, rate of perceived exertion (RPE), technical efficiency, and power production during 2 successive maximal repetitions of clean & jerk (C&J). Nine elite weightlifters (age: 24.4 ± 3.6 years, body mass: 77.2 ± 7.1 kg, height 176.0 ± 6.4 cm, and 1 repetition maximum C&J: 170.0 ± 5.0 kg) performed 2 separate testing sessions using 2-minute IMRRP (IMRRP-2) and 3-minute IMRRP (IMRRP-3), in a randomized order, while barbell kinematics and kinetics were recorded. Results showed that the longer IMRRP-3 minutes led to the maintenance of clean technique (from the first to the second repetition) evidenced by a 1.86% lower decline in peak vertical displacement (p = 0.03) and attenuation of increased peak horizontal displacements with a 1.74% (p = 0.03) less backward movement during the first pull, a 3.89% (p = 0.008) less forward movement during the second pull, and a 4.7% (p = 0.005) less backward movement during the catch phase. In addition, attenuation of peak velocity (2.22%; p = 0.02), peak vertical ground reaction force (1.70%; p = 0.03), and peak power (2.14%; p = 0.02) declines were shown using IMRRP-3 compared with IMRRP-2. Increasing IMRRP from 2 to 3 minutes was also shown to decrease RPE values (8.02%; p = 0.008) and to enhance supramaximal C&J performance (1.55%; p = 0.003). The results of this study suggest 3 minutes to be the most advantageous IMRRP in terms of maintaining technical efficiency, power output, reducing fatigue perception, and enhancing performance in elite weightlifters.

Statistical Primer for Athletic Trainers: The Essentials of Understanding Measures of Reliability and Minimal Important Change

OBJECTIVE

  To describe the concepts of measurement reliability and minimal important change.

BACKGROUND

  All measurements have some magnitude of error. Because clinical practice involves measurement, clinicians need to understand measurement reliability. The reliability of an instrument is integral in determining if a change in patient status is meaningful.

DESCRIPTION

  Measurement reliability is the extent to which a test result is consistent and free of error. Three perspectives of reliability-relative reliability, systematic bias, and absolute reliability-are often reported. However, absolute reliability statistics, such as the minimal detectable difference, are most relevant to clinicians because they provide an expected error estimate. The minimal important difference is the smallest change in a treatment outcome that the patient would identify as important.

RECOMMENDATIONS

  Clinicians should use absolute reliability characteristics, preferably the minimal detectable difference, to determine the extent of error around a patient's measurement. The minimal detectable difference, coupled with an appropriately estimated minimal important difference, can assist the practitioner in identifying clinically meaningful changes in patients.

Age related changes in balance performance during self-selected and narrow stance testing

BACKGROUND

Various balance tests have been considered as fall risk screening tools however there is a lot of variability in the methods and outcome measures reported. Based on previous research examining age-related changes in balance and differences between fallers and nonfallers, the purpose of this investigation was to examine age-related balance changes, as reflected in medial-lateral center of pressure (CP) velocity, in community-dwelling/independently living adults (≥60years) during self-selected and narrow stance testing with eyes opened and closed.

METHODS

Two hundred and thirty adults aged 60yrs or older completed one 45s trial under two stances (self-selected, narrow) and two visual conditions (eyes opened, eyes closed). Average medial-lateral CP velocity was computed from the CP data, with preliminary analysis demonstrating positive skewness and association with body height. A sway velocity index (SVI) was created by a natural logarithm transformation and dividing by body height. Multiple linear regression was used to determine the association between age, visual condition, stance, and sex with SVI.

RESULTS

Age, visual condition, stance and sex were all demonstrated to be significant predictors of SVI, with the combination of the predictors explaining 25% of the variance in the SVI.

CONCLUSIONS

These results confirm the balance testing protocol and SVI to be sensitive to age-related changes in balance performance. The results of this study should help future research aimed towards establishing a quick, easy to administer, and readily interpretable instrumented test for assisting with identifying potential balance impairments in older adults who have yet to demonstrate outward deficits.

Intersession reliability of self-selected and narrow stance balance testing in older adults

BACKGROUND

Despite the common practice of using force platforms to assess balance of older adults, few investigations have examined the reliability of postural screening tests in this population.

AIM

We sought to determine the test-retest reliability of self-selected and narrow stance balance testing with eyes open and eyes closed in healthy older adults.

METHODS

Thirty older adults (>65 years) completed 45 s trials of eyes open and eyes closed stability tests using self-selected and narrow stances on two separate days (1.9 ± .7 days). Average medial-lateral center of pressure velocity was computed.

RESULTS

The ICC results ranged from .74 to .86, and no significant systematic changes (P < .05) occurred between the testing sessions for any of the tests. The standard error of measurement ranged from 15.9 to 23.6%.

DISCUSSION

Reliability estimates were similar between the two stances and visual conditions assessed. Slightly higher coefficients were identified for the self-selected stances compared to the narrow stances under both visual conditions; however, there were negligible differences between the sessions. The within subject session-to-session variability provides a basis for further research to consider differences between fallers and non-fallers.

CONCLUSION

Reliability for eyes open and closed balance testing using self-selected and narrow stances in older adults was established which should provide a foundation for the development of fall risk screening tests.

Kinetic and kinematic patterns during high intensity clean movement: searching for optimal load

The aim of the present study was to investigate loading effects on kinematic and kinetic variables among elite-weightlifters in order to identify an optimal training load to maximize power production for clean-movement. Nine elite-weightlifter (age: 24 ± 4years, body-mass: 77 ± 6.5kg, height: 176 ± 6.1cm and 1RM clean: 170 ± 5kg) performed 2 separate repetitions of the clean using 85, 90, 95% and 100%, in a randomized order, while standing on a force platform and being recorded using 3D-capture-system. Differences in kinematics (barbell displacement, velocity and acceleration) and kinetics (power, vertical ground reaction force (vGRF), rate of force development (RFD), and work) across the loads were statistically assessed. Results revealed significant load effects for the majority of the studied parameters (p < 0.01) and showed that typical bar-displacement, greatest bar-velocity and peak-power were achieved at 85 and 90% 1RM (p < 0.001). Additionally greater average power was shown for 90 and 95% (p < 0.01) and greater work and vGRF were shown for 90, 95 and 100% than 85% 1RM (p < 0.05). Load had no significant effect on peak-vGRF and peak-RFD (p > 0.05). The results of this study, suggest 90% 1RM to be the most advantageous load to train explosive-force and to enhance power-outputs while maintaining technical efficiency in elite-weightlifters.

Statistical Primer for Athletic Trainers: Using Confidence Intervals and Effect Sizes to Evaluate Clinical Meaningfulness

OBJECTIVE

To describe confidence intervals (CIs) and effect sizes and provide practical examples to assist clinicians in assessing clinical meaningfulness.

BACKGROUND

As discussed in our first article in 2015, which addressed the difference between statistical significance and clinical meaningfulness, evaluating the clinical meaningfulness of a research study remains a challenge to many readers. In this paper, we will build on this topic by examining CIs and effect sizes.

DESCRIPTION

A CI is a range estimated from sample data (the data we collect) that is likely to include the population parameter (value) of interest. Conceptually, this constitutes the lower and upper limits of the sample data, which would likely include, for example, the mean from the unknown population. An effect size is the magnitude of difference between 2 means. When a statistically significant difference exists between 2 means, effect size is used to describe how large or small that difference actually is. Confidence intervals and effect sizes enhance the practical interpretation of research results.

RECOMMENDATIONS

Along with statistical significance, the CI and effect size can assist practitioners in better understanding the clinical meaningfulness of a research study.

Statistical Primer for Athletic Trainers: The Difference Between Statistical and Clinical Meaningfulness

OBJECTIVE

To explain statistical significance and clinical meaningfulness and to provide guidance in evaluating the clinical meaningfulness of a study.

BACKGROUND

Understanding the results and statistics reported in original research remains a large challenge for many certified athletic trainers, which in turn, may be among the biggest barriers to integrating research into athletic training practice.

DESCRIPTION

Statistical significance reflects the influence of chance on the outcome, whereas clinical meaningfulness reflects the degree to which the differences and relationships reported in a study are relevant to athletic training practice. As consumers of original research, athletic trainers must understand the core factors, most notably sample size, that influence statistical significance.

RECOMMENDATIONS

To assist clinicians in evaluating the clinical meaningfulness of a research study, authors should provide the core elements necessary for interpreting statistical significance and discuss the clinical meaningfulness of statistically significant findings.