• Effect of combined home-based, overground robotic-assisted gait training and usual physiotherapy on clinical functional outcomes in people with chronic stroke: a randomized controlled trial

      Wright, Amy; Stone, Keeron; Martinelli, Louis; Fryer, Simon; Smith, Grace; Lambrick, Danielle; Stoner, Lee; Jobson, Simon; Faulkner, James; University of Winchester; University of Gloucestershire; Hobbs Rehabilitation; University of Gloucestershire; University of Chester; University of Southampton; University of North Carolina; University of Winchester; University of Winchester (SAGE, 2020-12-27)
      Objectives:To assess the effect of a home-based over-ground robotic-assisted gait training program using the AlterG Bionic Leg orthosis on clinical functional outcomes in people with chronic stroke. Design:Randomized controlled trial. Setting:Home. Participants:Thirty-four ambulatory chronic stroke patients who recieve usual physiotherapy. Intervention:Usual physiotherapy plus either (1)10-week over-ground robotic-assisted gait training program (n=16), using the device for 30 minutes per day, or (2)control group (n=18), 30 minutes of physical activity per day. Measurements:The primary outcome was the Six-Minute Walk Test. Secondary outcomes included: Timed-Up-and-Go, Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale. Physical activity and sedentary time were assessed using accelerometry. All measurements were completed at baseline, 10- and 22-weeks after baseline. Results:Significant increases in walking distance were observed for the Six-Minute Walk Test between baseline and 10-weeks for over-ground robotic-assisted gait training (135±81m vs. 158±93m, respectively; P0.001) but not for control (122±92m vs. 119±84m, respectively). Findings were similar for Functional Ambulation Categories, Dynamic Gait Index and Berg Balance Scale (all P0.01). For over-ground robotic-assisted gait training, there were increases in time spent stepping, number of steps taken, number of sit-to-stand transitions, and reductions in time spent sitting/supine between baseline and 10-weeks (all P<.05). The differences observed in all of the aforementioned outcome measures were maintained at 22-weeks, 12 weeks after completing the intervention (all P >.05). Conclusion:Over-ground robotic-assisted gait training combined with physiotherapy in chronic stroke patients led to significant improvements in clinical functional outcomes and physical activity compared to the control group. Improvements were maintained at 22 weeks.
    • Low Body Fat Does Not Influence Recovery after Muscle-Damaging Lower-Limb Plyometrics in Young Male Team Sport Athletes.

      Fernandes, John F T; Lamb, Kevin L; orcid: 0000-0003-4481-4711; Twist, Craig; orcid: 0000-0001-6168-0378 (2020-11-05)
      This study assessed the influence of fat mass to fat-free mass ratio (FM:FFM) on recovery from plyometric exercise. After assessment of body composition, 20 male team sport players (age 20.7 ± 1.1 years; body mass 77.1 ± 11.5 kg) were divided into low- ( = 10; 0.11 ± 0.03) and normal- ( = 10; 0.27 ± 0.09) fat groups based on FM:FFM ratio. Thereafter, participants completed measurements of knee extensor torque at 60 and 240°∙s , countermovement jump flight time, plasma creatine kinase (CK) activity and perceived muscle soreness (VAS) before and at 0, 24 and 48 h after 10 × 10 maximal plyometric vertical jumps. Evidence of muscle damage was confirmed by alterations in VAS, peak torque at 60 and 240°∙s and flight time at 0, 24 and 48 h after plyometric exercise ( < 0.05). CK was increased at 0 and 24 h ( < 0.05) but returned to baseline values by 48 h. No time by group effects were observed for any of the dependent variables ( > 0.05). The current findings indicate that while muscle damage was present after plyometric exercise, the magnitude was similar across the two body composition groups. Applied practitioners can allow for a similar recovery time after plyometric exercise in those with low and normal body fat.
    • Fitness Monitoring in Elite Soccer Players: Group vs. Individual Analyses.

      Rabbani, Alireza; Kargarfard, Mehdi; Twist, Craig (2020-11)
      The aims of this study were to (a) examine changes in group and individual HR measures during a submaximal warm-up test, and (b) investigate the relationship between accumulated internal training loads and HR changes during an in-season phase among elite soccer players (n = 14). Before and after an in-season phase (24 days), exercise HR (HRex) and HR recovery (HRR) expressed either as the number of beats recovered (HRR60s) or as the mean HR (HRpost1) during 1 minute of recovery were analyzed. Heart rate measures were expressed as the % of maximal HR. Session rating of perceived exertion (sRPE) was computed for all training/match sessions. Group and individual HR changes were analyzed using magnitude-based inferences. Pearson correlation coefficients were also used to examine the relationships. Group analyses of HR changes revealed there were possibly to likely trivial changes in all HR measures. When analyzing individual data, no substantial change was observed for HRR60s%. However, substantial changes in HRex% and HRpost1% were observed for 4/14 and 5/14 players, respectively. The relationships between HRex% and HRpost1% were nearly perfect (r = 0.90, confidence limits [0.82-0.95]). The associations between changes in HRex% and HRpost1% were also nearly perfect (r = 0.92, 0.80-0.97). A very large inverse correlation was observed between HRex% and accumulated sRPE (r = -0.75, -0.44 to -0.90). This study highlights the value of conducting individual vs. group aerobic fitness monitoring. This study also showed the importance of how HRR is reported when aerobic fitness monitoring of elite soccer players.
    • Physiological and anthropometric determinants of critical power, W′ and the reconstitution of W′ in trained and untrained male cyclists

      Chorley, Alan; Bott, Richard P; Marwood, Simon; Lamb, Kevin L; University of Chester (Springer, 2020-08-09)
      Abstract Purpose This study examined the relationship of physiological and anthropometric characteristics with parameters of the critical power (CP) model, and in particular the reconstitution of W′ following successive bouts of maximal exercise, amongst trained and untrained cyclists. Methods Twenty male adults (trained nine; untrained 11; age 39 ± 15 year; mass 74.7 ± 8.7 kg; V̇O2max 58.0 ± 8.7 mL kg−1 min−1) completed three incremental ramps (20 W min−1) to exhaustion interspersed with 2-min recoveries. Pearson’s correlation coefficients were used to assess relationships for W′ reconstitution after the first recovery (W′rec1), the delta in W′ reconstituted between recoveries (ΔW′rec), CP and W′. Results CP was strongly related to V̇O2max for both trained (r = 0.82) and untrained participants (r = 0.71), whereas W′ was related to V̇O2max when both groups were considered together (r = 0.54). W′rec1 was strongly related to V̇O2max for the trained (r = 0.81) but not untrained (r = 0.18); similarly, ΔW′rec was strongly related to V̇O2max (r = − 0.85) and CP (r = − 0.71) in the trained group only. Conclusions Notable physiological relationships between parameters of aerobic fitness and the measurements of W′ reconstitution were observed, which differed among groups. The amount of W′ reconstitution and the maintenance of W′ reconstitution that occurred with repeated bouts of maximal exercise were found to be related to key measures of aerobic fitness such as CP and V̇O2max. This data demonstrates that trained cyclists wishing to improve their rate of W′ reconstitution following repeated efforts should focus training on improving key aspects of aerobic fitness such as V̇O2max and CP.
    • Assessment of energy availability and associated risk factors in professional female soccer players

      Moss, Samantha; Randell, Rebecca; Burgess, Darren; Ridley, Stephanie; Ó Cairealláin, Cairbre; Allison, Richard; Rollo, Ian; University of Chester; Gatorade Sports Science Institute, Arsenal Football Club, Tipperary GAA, Melbourne Football Club (Taylor & Francis, 2020-08-06)
      This study aimed to assess energy availability (EA), alongside possible risk factors of reduced or low EA of professional female soccer players during a competitive season. Thirteen players (age: 23.7 ± 3.4 y, stature: 1.69 ± 0.08 m, body mass: 63.7 ± 7.0 kg) engaged in a 5-day (two rest days, one light training, heavy training and match day) monitoring period. Energy intake (EI) and expenditure during exercise (EEE) were measured. EA was calculated and categorised as optimal, reduced or low (≥45, 31-44, ≤30 kcal·kg FFM-1·day-1, respectively). Relationships between EA and bone mineral density, resting metabolic rate (RMR), plasma micronutrient status, biochemical markers and survey data were assessed. EA was optimal for 15%, reduced for 62% and low for 23% of players. Higher EA was observed on rest days compared to others (P<0.05). EA was higher for the light compared to the heavy training day (P<0.001). EEE differed significantly between days (P<0.05). EI (2124 ± 444 kcal), carbohydrate (3.31 ± 0.64 g·kg·day-1) and protein (1.83 ± 0.41 g·kg·day-1) intake remained similar (P>0.05). Survey data revealed 23% scored ≥ 8 on the Low Energy Availability in Females Questionnaire and met criteria for low RMR (ratio <0.90). Relationships between EA and risk factors were inconclusive. Most players displayed reduced EA and did not alter EI or carbohydrate intake to training or match demands. Although cases of low EA were identified, further work is needed to investigate possible long-term effects and risk factors of low and reduced EA separately to inform player recommendations.
    • From public issues to personal troubles: individualising social inequalities in health within local public health partnerships

      Mead, Rebecca; Thurston, Miranda; Bloyce, Daniel; University of Lancaster; Inland Norway University of Applied Sciences; University of Chester (Taylor and Francis, 2020-05-20)
      This paper explores public health policy implementation through partnership working at the local level by examining how local actors from public health and the wider workforce, make sense of and work on social inequalities in health. An ethnographic case study was used to examine policy implementation in one local strategic partnership in north-west England during a period of significant resource constraint. Semi-structured interviews were the primary method of data generation. Sensitising concepts from figurational sociology were used to develop a theoretical account of how local policy implementation directed at narrowing social inequalities in health tended to give rise to relatively fragmented and short-term services, projects and practices, which focused on lifestyle factors and behaviour change. Theorising partnership work as figurations goes some way to explaining the apparent paradox among participants who expressed a relatively detached appreciation of wider social influences, alongside emotional involvement in their work. This process of individualisation explains how local professionals tended to conceptualise health inequality and the social determinants of health as personal troubles. Individualisation meant that the social reality of working in partnerships on difficult issues was simplified. Thus, any scope for working on the social determinants of health tended to be overlooked. The extent to which this was intentional or a matter of struggling to see opportunities, or a mixture of the two, was difficult to discern. Although the policy landscape has changed, the findings give some insight into understanding how local collaborative processes reproduce local public health work underpinned by lifestyle choices.
    • The effects of in-season, low-volume sprint interval training with and without sport-specific actions on the physical characteristics of elite academy rugby league players

      Dobbin, Nick; Highton, Jamie M.; Moss, Samantha; Twist, Craig (Human Kinetics, 2020-05-01)
      Purpose: To determine the utility of a running and rugby-specific, in-season sprint interval interventions in professional rugby league players. Methods: Thirty-one professional academy rugby players were assigned to a rugby-specific (SITr/s, n = 16) or running (SITr, n = 15) sprint interval training group. Measures of speed, power, change of direction (CoD) ability, prone Yo-Yo IR1 performance and heart rate recovery (HRR) were taken before and after the 2-week intervention as were sub-maximal responses to the prone Yo-Yo IR1. Internal, external and perceptual responses were collected during SITr/s/SITr, with wellbeing and neuromuscular function assessed before each session. Results: Despite contrasting (possible to most likely) internal, external and perceptual responses to the SIT interventions, possible to most likely within-group improvements in physical characteristics, HRR and sub-maximal responses to the prone Yo-Yo IR1 were observed after both interventions. Between-group analysis favoured the SITr/s intervention (trivial to moderate) for changes in 10 m sprint time, CMJ, change of direction and medicine ball throw as well as sub-maximal (280-440 m) high metabolic power, PlayerLoad™ and acceleratory distance during the prone Yo-Yo IR1. Overall changes in wellbeing or neuromuscular function were unclear. Conclusion: Two-weeks of SITr/s and SITr was effective for improving physical characteristics, HRR and sub-maximal responses to the prone Yo-Yo IR1, with no clear change in wellbeing and neuromuscular function. Between-group analysis favoured the SITr/s group, suggesting that the inclusion of sport- specific actions should be considered for in-season conditioning of rugby league players.
    • Effects of a four-week touch rugby and self-paced interval running intervention on health markers in active young men.

      Dobbin, Nick; Bloyce, Daniel; Hughes, Stephen; Twist, Craig (Springer, 2020-03-29)
      Background: Modified team sport activity has been proposed as effective exercise modality for promoting markers of health that are comparable or greater than continuous forms of activity. However, research using modified team sports is currently limited to sedentary populations using 2-3 sessions across a minimum of 8 weeks. Aim: To investigate the effects of a four-week touch rugby and self-paced interval running intervention on a range of health markers in active men. Methods: Sixteen participants (age 26.4 ± 6.4 years) were matched for age, demographic and physical activity before completing a single touch rugby (n = 8) or running (n = 8) session per week for four weeks. Measures of systolic and diastolic blood pressure, resting heart rate (RHR), body composition and biochemical status were recorded pre- and post-intervention. Results: ANCOVA analysis revealed between-group differences for impedance (P = 0.027), fat mass (P = 0.008), percentage body fat (P = 0.008) and fat free mass (P = 0.002), with greater changes after touch rugby. Systolic blood pressure decreased for both groups with greater reductions observed after touch rugby (P = 0.002). No between-group difference was observed for RHR, interleukin-6 or C-reactive protein (P > 0.05). Contrasting internal, external and perceptual loads were observed. Conclusion: The results of this study suggest that a single session of touch rugby over a 4-week period elicited greater improvements in body composition and SBP that self-paced running, with both equally beneficial for improving RHR, diastolic blood pressure and improved inflammatory status in active young men.
    • Delivering a sports participation legacy from the London 2012 Olympic and Paralympic Games: evidence from sport development workers in Birmingham and their experiences of a double-bind

      Lovett, Emily; Bloyce, Daniel; Smith, Andy; Edge Hill University; University of Chester (Taylor and Francis, 2020-03-11)
      Legacy promises from London 2012 meant that those working in sport in local, non-host areas in Britain were expected to facilitate more sporting opportunities for local citizens. Legacy preparations occurred in the context of many other constraints that stemmed from Government budget cuts and provision of leisure-time sport and other leisure activities. This paper presents new evidence on a significantly under-researched area of leisure studies, namely: the experiences of those delivering leisure-sport opportunities in a non-host city and how they responded to national legacy promises. Using Elias’s concept of the double-bind, we explain the ‘crisis situation’ in which some local sports workers were enmeshed and how their acceptance of ‘fantasy-laden beliefs’ of expected demonstration effects from mega-events exacerbated their ‘crisis’ (Elias, 2007). We also draw upon participants’ post-Games reflections to consider how future host nations may wish to leverage greater leisure-sporting legacies from a mega-event.
    • Analysis of physical demands during youth soccer match-play: Considerations of sampling method and epoch length

      Doncaster, Greg; Page, Richard; White, Paul; Svenson, Robert; Twist, Craig; Edge HIll University; Stoke City FC; University of Chester (Taylor and Francis, 2019-11-27)
      The purpose of this study was to examine the physical match profiles of professional soccer players using 3 and 5 min fixed and rolling averages as well as fixed 1 min averages, with considerations to training prescription. Twenty-nine, professional U23 soccer outfield players competed across 17 competitive matches during the 2017/18 season, equating to a total of 130 separate physical match profiles. Match activities were recorded using global positioning system (GPS) devices with integrated micro-electrical mechanical systems (MEMS), recording total distance (TD), high-speed running (HSR) and metabolic power (MP). For each individual match profile and variable, 1, 3 and 5 min peak, post-peak, and average values were calculated using fixed-time epochs (FIXED) and rolling averages (ROLL). Linear mixed models were employed to examine the differences in the dependent variables as a function of the method of measurement. Results revealed significantly higher peak values, for relative TD, relative HSR and relative MP when employing the ROLL sampling method, in comparison to the FIXED method, for both 3 min and 5 min epoch lengths. Analysis of epoch length revealed significantly higher peak values, across all positions, for relative TD, relative HSR and MP for 1 min epochs, in comparison to 3 min and 5 min epochs. The data offers a novel insight into the appropriate identification of physical demands during youth soccer match-play. Researchers and practitioners should consider the sampling method and epoch length when assessing the physical demands of competitive match-play, as well as when designing and prescribing sport-specific conditioning drills.
    • To Infinity and Beyond: The Use of GPS Devices within the Football Codes

      Malone, James; Barrett, Stephen; Barnes, Chris; Twist, Craig; Drust, Barry; Liverpool Hope University; Hull City FC; CB Sports Performance; University of Chester; Liverpool John Moores University (Taylor and Francis, 2019-10-17)
      The quantification of external load through global positioning systems (GPS) is now commonplace across the different football codes. Despite this acceptance amongst sports science practitioners, confusion still remains around which are the most appropriate metrics to use when monitoring their athletes. In addition, the translation of the message between the data gathered and the athletes and coaches can often be lost. The aim of this commentary is to provide discussion and recommendations when using GPS for athlete monitoring.
    • Stochastic ordering of simulated rugby match activity produces reliable movements and associated measures of subjective task load, cognitive and neuromuscular function

      Mullen, Thomas; Twist, Craig; Highton, Jamie; University of Chester (Taylor and Francis, 2019-07-31)
      The study assesses the test–retest reliability of movement and physiological measures during a simulated rugby match that employed activities performed in a stochastic order. Twenty male rugby players (21.4 ± 2.1 y) completed two trials of a 2 × 23 min rugby movement simulation protocol during which the order of events was performed in a stochastic order, with 7–10 days between trials. Movement characteristics, heart rate (HR), RPE, maximum voluntary contraction (MVC), voluntary activation (VA%) of the quadriceps, Stroop test and subjective task load rating (NASA-TLX) were measured. The most reliable measures of external load was relative distance (typical error [TE] and CV% = 1.5–1.6 m min−1 and 1.4–1.5%, respectively), with all other movement characteristics possessing a CV% <5%. The most reliable measure of internal load, neuromuscular function and perceptual measures were for %HRmax (TE and CV% = 1.4–1.7% and 1.4–2.1%, respectively), MVC before (TE and CV% = 10.8–14.8 N·m and 3.8–4.6%, respectively), and average RPE (TE and CV% = 0.5–0.8 AU and 3.6–5.5%, respectively). The Stroop test, NASA-TLX and blood lactate produced the least reliable measures (CV% >5%). Future studies can confidently examine changes in several perceptual, neuromuscular, physiological and movement measures related to rugby activity using stochastic movements.
    • Norwegian youngsters’ perceptions of physical education: Exploring the implications for mental health

      Røset, Linda; Green, Ken; Thurston, Miranda; University of Chester (Taylor & Francis, 2019-06-24)
      Improving young people’s mental health has become a priority for policy-makers in Norway as elsewhere. Although the evidence is limited, physical activity has been identified as having a role in mental health promotion with school physical education (PE) typically being presented as a suitable setting. Few studies, however, have explored young people’s perceptions and experiences of PE and the possible consequences for their mental health – the departure point for this paper. We approach this issue sociologically by focusing on the processes through which PE is enacted. Qualitative data were generated by 31 focus groups involving 148 youngsters from the 10th grade (15–16-year-olds) in eight secondary schools in Norway. The overarching theme to emerge was that PE was valued by the students for what it was not as much as what it was. The appeal of PE often lay in being different and a break from ‘normal’ school lessons and, at the same time, an opportunity for informal social interaction and strengthening social bonds. Enjoyment of PE – even among those with limited sporting competence – was understood as giving rise to cathartic benefits and an antidote to their increasingly academic, routinized and performance-oriented school lives. However, processes relating to the organization, delivery and assessment of lessons meant that these benefits were sometimes compromised for some young people. We conclude that as far as the mental health of young people is concerned, the best justificatory defence for PE becomes physical recreation as a solution to (academic) schooling rather than PE as education.
    • A Narrative Review on Female Physique Athletes: The Physiological and Psychological Implications of Weight Management Practices

      Alwan, Nura; Moss, Samantha L.; Elliott-Sale, Kisrty; Davies, Ian; Kevin, Enright; Liverpool John Moores University; University of Chester; Nottingham Trent University (Human Kinetics, 2019-06-13)
      Physique competitions are events in which aesthetic appearance and posing ability are valued above physical performance. Female physique athletes are required to possess high lean body mass and extremely low fat mass in competition. As such, extended periods of reduced energy intake and intensive training regimens are utilised with acute weight loss practices at the end of the pre-competition phase. This represents an increased risk for chronic low energy availability and associated symptoms of Relative Energy Deficiency in Sport, compromising both psychological and physiological health. Available literature suggests that a large proportion of female physique athletes report menstrual irregularities (e.g., amenorrhea and oligomenorrhea), which are unlikely to normalise immediately post-competition. Furthermore, the tendency to reduce intakes of numerous essential micronutrients is prominent among those using restrictive eating patterns. Following competition reduced resting metabolic rate, and hyperphagia, are also a concern for these female athletes, which can result in frequent weight cycling, distorted body image and disordered eating/eating disorders. Overall, female physique athletes are an understudied population and the need for more robust studies to detect low energy availability and associated health effects is warranted. This narrative review aims to define the natural female physique athlete, explore some of the physiological and psychological implications of weight management practices experienced by female physique athletes and propose future research directions.
    • The World Anti-Doping Agency at 20: progress and challenges

      Houlihan, Barrie; Vidar Hanstad, Dag; Loland, Sigmund; Waddington, Ivan (Informa UK Limited, 2019-06-06)
    • Exercise-induced muscle damage and recovery in young and middle-aged males with different resistance training experience

      Fernandes, John; Lamb, Kevin L.; Twist, Craig (MDPI, 2019-05-29)
      This study compared the time course of recovery after a squatting exercise in trained young (YG; n = 9; age 22.3 ± 1.7 years) and trained (MT; n = 9; 39.9 ± 6.2 years) and untrained (MU; n = 9; age 44.4 ± 6.3 years) middle-aged males. Before and at 24 and 72 h after 10 × 10 squats at 60% one-repetition maximum (1RM), participants provided measurements of perceived muscle soreness (VAS), creatine kinase (CK), maximal voluntary contraction (MVC), voluntary activation (VA), and resting doublet force of the knee extensors and squatting peak power at 20% and 80% 1RM. When compared to the YG males, the MT experienced likely and very likely moderate decrements in MVC, resting doublet force, and peak power at 20% and 80% 1RM accompanied by unclear differences in VAS, CK, and VA after the squatting exercise. MU males, compared to MT, experienced greater alterations in peak power at 20% and 80% 1RM and VAS. Alterations in CK, MVC, VA, and resting doublet force were unclear at all time-points between the middle-aged groups. Middle-aged males experienced greater symptoms of muscle damage and an impaired recovery profile than young resistance trained males. Moreover, regardless of resistance training experience, middle-aged males are subject to similar symptoms after muscle-damaging lower-body exercise.
    • Pre-season training responses and their associations with training load in elite rugby league players

      Daniels, Matthew; Highton, Jamie M.; Twist, Craig; St Helens RFC; University of Chester (Taylor and Francis, 2019-05-07)
      Strength, power and endurance characteristics and their association with training load during a 7-week preseason training phase was assessed in elite rugby league players. Twenty-two players (age 23.3 ± 4.4 years) performed bench throw, one repetition maximum (1RM) bench press, squat jumps, three repetition maximum (3RM) squats, prone pull ups and prone Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) before and after the 7-week preseason period. Training was classified into Gym, Field and Wrestle, with training load of each monitored using session rating of perceived exertion (sRPE) multiplied by training duration (sRPE-TL). There were most likely improvements in 3RM back squat, prone pull-ups and Yo-Yo IR1 and likely improvements in bench press, bench throw and squat jump after the 7-week training programme (ES = 0.3 to 1.2). Accumulated sRPE-TL for Gym, Field and Wrestle sessions was 9176 ± 1187, 10906 ± 2162, and 1072 ± 315 AU, respectively. Relationships between mean weekly sRPE-TL and changes in physical qualities was trivial to large (r = -0.67 to 0.34). This study suggests sRPE-TL is unsuitable to detect dose-response relationships between training load and the changes in physical qualities of elite rugby league players during the pre-season period.
    • Influence of Playing Standard on Upper- and Lower-Body Strength, Power, and Velocity Characteristics of Elite Rugby League Players

      Fernandes, John; Daniels, Matthew; Myler, Liam; Twist, Craig (MDPI, 2019-04-17)
      Background: To compare load–velocity and load–power relationships among first grade (n = 26, age 22.9 ± 4.3 years), academy (n = 23, age 17.1 ± 1.0 years), and scholarship (n = 16, age 15.4 ± 0.5 years) Super League rugby league players. Methods: Participants completed assessments of maximal upper- and lower-body strength (1RM) and peak velocity and power at 20, 40, 60, and 80 kg during bench press and squat exercises, in a randomised order. Results: Bench press and squat 1RM were highest for first grade players compared with other standards (effect size (ES) = −0.43 to −3.18). Peak velocities during bench and squat were greater in the higher playing standards (ES = −0.39 to −3.72 range), except for the squat at 20 and 40 kg. Peak power was higher in the better playing standards for all loads and exercises. For all three groups, velocity was correlated to optimal bench press power (r = 0.514 to 0.766), but only 1RM was related to optimal power (r = 0.635) in the scholarship players. Only squat 1RM in the academy was related to optimal squat power (r = 0.505). Conclusions: Peak velocity and power are key physical qualities to be developed that enable progression from junior elite rugby league to first grade level. Resistance training should emphasise both maximal strength and velocity components, in order to optimise upper- and lower-body power in professional rugby league players.
    • The reproducibility and external validity of a modified rugby league movement simulation protocol for interchange players

      Norris, Jonathan; Highton, Jamie M.; Twist, Craig; University of Chester (2019-04-01)
      Purpose: The study assessed the reliability and external validity of a rugby league movement simulation protocol for interchange players that was adapted to include physical contact between participants Methods: Eighteen rugby players performed two trials of a modified rugby league movement simulation protocol for interchange players (RLMSP-i), seven days apart. The simulation was conduced outdoors on artificial turf with movement speeds controlled using an audio signal. Micro-technology was used to measure locomotive and accelerometer (i.e. PlayerLoadTM) metrics for both bouts (~23 min each) alongside heart rate and RPE. Results: Reported for each bout, total distance (102 ± 3 and 101 ± 3 m.min-1), low-speed distance (77 ± 3 and 79 ± 4 m.min-1), high-speed distance (25 ± 3 and 22 ± 4 m.min-1), PlayerLoadTM (10 ± 1 and 10 ± 1 AU.min-1), PlayerLoadTM slow (3.2 ± 0.6 and 3.2 ± 0.6 AU.min-1), PlayerLoadTM 2D (6.0 ± 0.9 and 5.7 ± 0.8 AU.min-1) and heart rate (86 ± 5 and 84 ± 6 %HR max) were similar to match play. The coefficient of variation (%CV) for locomotive metrics ranged from 1.3 to 14.4%, accelerometer CV% 4.4 to 10.0%, and internal load 4.8 to 13.7%. All variables presented a CV% less than the calculated moderate change during one or both bouts of the simulation except high-speed distance (m.min-1), %HRpeak and RPE (AU). Conclusion: The modified RLMSP-i offers a reliable simulation to investigate influences of training and nutrition interventions on the movement and collision activities of rugby league interchange players.
    • Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis

      Kite, Chris; Lahart, Ian; Afzal, Islam; Broom, David; Randeva, Harpal; Kyrou, Ioannis; Brown, James (2019-02-12)
      Background: Typically, management of PCOS focuses on lifestyle changes (exercise and diet), aiming to alleviate symptoms, and lower the associated risk of type 2 diabetes and cardiovascular disease. Our objective was to analyse evidence on the effectiveness of exercise in the management of PCOS, when compared to (i) usual care, (ii) diet alone, and (iii) exercise combined with diet, and also exercise combined with diet, compared to (i) control or usual care and (ii) diet alone. Methods: Relevant databases were searched (June 2017) with no time limit for trial inclusion. Eligible trials employed a randomised or quasi-randomised design to measure the chronic effects of exercise, or exercise and diet in women with PCOS. Results: Searches returned 2390 articles; of those, 27 papers from 18 trials were included. Results are presented as mean difference (MD) and 95% confidence intervals (95% CI). Compared with control, exercise had a statistical effect on change from baseline fasting insulin (MD − 2.44 μIU/mL, 95% CIs − 4.24 to − 0.64; very low-quality evidence), HOMA-IR (− 0.57, − 0.99 to − 0.14; very low-quality evidence), total cholesterol (− 5.88 mg/dL, − 9.92 to − 1.83; low-quality evidence), LDL cholesterol (− 7.39 mg/dL, − 9.83 to − 4.95; low-quality evidence), and triglycerides (− 4.78 mg/dL, − 7.52 to − 2.05; low-quality evidence). Exercise also improved VO2 max (3.84 ml/kg/min, 2.87 to 4.81), waist circumference (− 2.62 cm, − 4.13 to − 1.11), and body fat percentage (− 1.39%, − 2.61 to − 0.18) when compared with usual care. No effect was found for change value systolic/ diastolic blood pressure, fasting glucose, HDL cholesterol (all low-quality evidence), or waist-to-hip ratio. Many favourable change score findings were supported by post-intervention value analyses: fasting insulin (− 2.11 μIU/mL, − 3.49 to − 0.73), total cholesterol (− 6.66 mg/dL, − 11.14 to − 2.17), LDL cholesterol (− 6.91 mg/dL, − 12.02 to − 1.80), and VO2 max (5.01 ml/kg/min, 3.48 to 6.54). Statistically lower BMI (− 1.02 kg/m2, − 1.81 to − 0.23) and resting heart rate (− 3.26 beats/min − 4.93 to − 1.59) were also revealed in post-intervention analysis. Subgroup analyses revealed the greatest improvements in overweight/obese participants, and more outcomes improved when interventions were supervised, aerobic in nature, or of a shorter duration. Based on limited data, we found no differences for any outcome between the effects of exercise and diet combined, and diet alone. It was not possible to compare exercise vs diet or exercise and diet combined vs diet. Conclusion: Statistically beneficial effects of exercise were found for a range of metabolic, anthropometric, and cardiorespiratory fitness-related outcomes. However, caution should be adopted when interpreting these findings since many outcomes present modest effects and wide CIs, and statistical effects in many analyses are sensitive to the addition/removal of individual trials. Future work should focus on rigorously designed, well-reported trials that make comparisons involving both exercise and diet. Systematic review registration: This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Reviews (CRD42017062576)