This study examined the acute training responses of heart rate variability (HRV) and salivary biomarkers (immunoglobulin A and alpha-amylase) following a standardised training bout in Paralympic swimmers. Changes in HRV, sIgA and sAA were documented Monday morning, Monday afternoon and Tuesday morning over a 14-week monitoring period leading into international competition. Magnitude based inferences with effect sizes (ES) were used to assess the practical significance of changes each week. Normal training responses elicited increases in HR, α1, sAA and sIgA, accompanied by decreases in HF(nu), standard deviation of instantaneous RR variability (SD1) and the root mean square of successive differences (RMSSD) from Monday morning to Monday afternoon, and to Tuesday morning with similar week to week responses for most variables. Changes in RMSSD from Monday a.m. to p.m. were likely smaller (less negative) for Week 7 (78/18/3, ES = 0.40) following a competition weekend with similar changes observed from Monday a.m. to Tuesday a.m. (90/5/5, ES = 1.30). In contrast, the change in sAA from Monday a.m. to p.m. was very likely less (more negative) at Week 7 (0/0/99, ES = −2.46), with similar changes observed from Monday a.m. to Tuesday a.m. (0/0/99, ES = −4.69). During the taper period, there were also likely increases in parasympathetic modulations (RMSSD, Weeks 12–14) along with increased immune function (sIgA, Week 13) that demonstrated a favourable state of athlete preparedness. Used together, HRV and sAA provide coaches with valuable information regarding physiological changes in response to training and competition. Full article

Abnormal scapulothoracic mechanics and scapulohumeral rhythm are implicated in shoulder pathologies, including glenohumeral impingement and rotator cuff tears. Upward scapula rotation, specifically asymmetry of scapula motion and associations of patterns through range with injury, was investigated in dominant and non-dominant limbs of nationally ranked junior and Paralympic swimmers during competition season. The static and throughout phases measures of upward scapula rotation were: Phase I (start position, 45°), Phase II (45° to 90°), Phase III (90° to 135°) and Phase IV (135° to max). Injury was assessed with a validated questionnaire. Differences between side (dominant and non-dominant), group (junior and Paralympic), and phase were examined. Significant differences (P < 0.05) between groups were identified for dominant side at rest, 45° and 135°, and in phases II and IV (including range). Scapulohumeral rhythm was higher in the non-dominant limb of Paralympic swimmers but in the dominant limb of junior swimmers. Greatest differences in upward rotation between injured and non-injured swimmers were found in Phase 1: 43.6% (3.3°) Paralympic; 73.1% (8°) junior. Results suggest asymmetry of movement in both limbs, through all phases, and at single points in range, should be investigated for assessing injury and developing preventive strategies and rehabilitation protocols. Full article

The purpose of this study was to compare the throwing kinematics and kinetics of youth catchers and pitchers. It was hypothesized that catchers and pitchers would exhibit differences throughout the throwing motion. Descriptive statistics were used to investigate kinematics during the four events of throwing: foot contact (FC), maximum shoulder external rotation (MER), ball release (BR) and maximum shoulder internal rotation (MIR). Additionally, kinetics were investigated within phases of the events: Phase 1 (cocking; FC to MER), Phase 2 (acceleration; MER to BR) and Phase 3 (deceleration; BR to MIR). Results revealed significant difference in torso flexion, lateral flexion, pelvis lateral flexion and segment velocities between the catchers and pitchers. Based on data from the current study, it appears that the youth catchers execute their throw as they have been instructed. It is unclear if the throwing mechanics displayed by these youth are efficient for a catcher, thus further investigation is needed to determine long-term injury susceptibility. Full article

The current study examined the effects of a six-week lumbopelvic-hip complex (LPHC) strengthening program on muscle activation when performing the shoulder dump exercise. The shoulder dump is a total body exercise that includes overhead arm movements. A pre-post test with a control group was implemented. Twenty-seven graduate students (23.5 ± 1.34 yr; 174.4 ± 11.0 cm; 76.6 ± 16.9 kg) participated. Participants were randomly assigned to a control or intervention group where the intervention group performed LPHC exercises. Two-way analysis of variance (ANOVA) revealed a significant increase in muscle activation of the serratus anterior from pre- and post-LPHC intervention, (t = 6.5, p < 0.001). As presented by these data, incorporation of LPHC exercises may assist in facilitating greater activation in some of the scapula-stabilizing musculature that has traditionally been rehabilitated in prone or side-lying positions. It is, therefore, suggested that LPHC exercises be incorporated in a regular shoulder rehabilitation program. Full article

Athletes with microtrauma or overuse injuries resulting from an accumulation of repeated small forces may differ from athletes with macrotrauma or acute injuries in their psychosocial responses because of the unique challenges presented by these insidious-onset and often chronic injuries. Our purpose was to use narrative inquiry to examine the psychosocial experiences and responses of 10 long-distance runners who had experienced microtrauma injuries. Qualitative data analysis of interview data led to a chronological timeline of the injury experience and an assessment of the meaning attributed to these injury experiences using a variation of Mishler’s core-narrative approach. Participants reported distinct thoughts, feelings, and behaviors during each phase of the injury—pre-injury, injury onset, and outcome. In the pre-injury period, participants indicated specific running-related goals and attributed their injuries to overtraining or a change in training. During the injury onset phase, participants consistently indicated two themes: self-diagnosis and treatment, and not taking time off. Within the outcome phase of injury, participants acknowledged changed training because of the injury, and lessons learned from their injury experiences. The narratives of microtrauma-injured runners revealed psychosocial distress and behavioral tendencies post-injury that have important implications for runners, coaches, and healthcare professionals. Full article

The aim of the present study was to examine and measure high intensity, intermittent upper body performance, in addition to identifying areas of the body that affect the variance in total work done during the 5 × 6 s sprint test. Fifteen males completed an upper body 5 × 6 s sprint test on a modified electro-magnetically braked cycle ergometer, which consisted of five maximal effort sprints, each 6 s in duration, separated by 24 s of passive recovery. A fly wheel braking force corresponding to 5% of the participants’ body weight was used as the implemented resistance level. Body composition was measured using dual-energy X-ray absorptiometry (DEXA). Percent (%) decrement was calculated as 100 − (Total work/ideal work) × 100. Significant (P < 0.05) differences were found between sprints for both absolute and relative (W, W·kg⁻¹, W·kg⁻¹ Lean body mass (LBM) and W·kg⁻¹ Upper body lean body mass (UBLBM)) peak (PP) and mean (MP) power. The % decrement in total work done over the five sprints was 11.4%. Stepwise multiple linear regression analysis revealed that UBLBM accounts for 87% of the variance in total work done during the upper body 5 × 6 s sprint test. These results provide a descriptive analysis of upper body, high intensity intermittent exercise, demonstrating that PP and MP output decreased significantly during the upper body 5 × 6 s sprint test. Full article

The aim of this study was to analyse the effect of forces applied to pedals and cranks on the strain imposed to an instrumented bicycle motocross (BMX) frame. Using results from a finite element analysis to determine the localisation of highest stress, eight strain gauges were located on the down tube, the seat tube and the right chain stay. Before the pedaling tests, static loads were applied to the frame during bench tests. Two pedaling conditions have been analysed. In the first, the rider was in static standing position on the pedals and applied maximal muscular isometric force to the right pedal. The second pedaling condition corresponds to three pedaling sprint tests at submaximal intensities at 150, 300 and 550 W on a cycle-trainer. The results showed that smaller strain was observed in the pedaling condition than in the rider static standing position condition. The highest strains were located in the seat tube and the right chain stay near the bottom bracket area. The maximum stress observed through all conditions was 41 MPa on the right chain stay. This stress was 11 times lower than the yield stress of the frame material (460 MPa). This protocol could help to adapt the frame design to the riders as a function of their force and mechanical power output. These results could also help design BMX frames for specific populations (females) and rider morphology. Full article

While many anterior cruciate ligament (ACL) prevention programs have been published, few have achieved significant reductions in injury rates and improvements in athletic performance indices; both of which may increase compliance and motivation of athletes to participate. A supervised neuromuscular retraining program (18 sessions) was developed, aimed at achieving both of these objectives. The changes in neuromuscular indices were measured after training in 1000 female athletes aged 13–18 years, and the noncontact ACL injury rate in 700 of these trained athletes was compared with that of 1120 control athletes. There were significant improvements in the drop-jump test, (p < 0.0001, effect size [ES] 0.97), the single-leg triple crossover hop (p < 0.0001, ES 0.47), the t-test (p < 0.0001, ES 0.64), the multi-stage fitness test (p < 0.0001, ES 0.57), hamstring strength (p < 0.0001), and quadriceps strength (p < 0.01). The trained athletes had a significant reduction in the noncontact ACL injury incidence rate compared with the controls (1 ACL injury in 36,724 athlete-exposures [0.03] and 13 ACL injuries in 61,244 exposures [0.21], respectively, p = 0.03). The neuromuscular retraining program was effective in reducing noncontact ACL injury rate and improving athletic performance indicators. Full article

Ventilatory equivalents for oxygen and carbon dioxide are physiological measures of breathing efficiency, and are known to be affected by the intensity and mode of exercise. We examined the effect of level running (gradient 0%) and muscle-damaging downhill running (−12%), matched for oxygen uptake, on the ventilatory equivalents for oxygen () and carbon dioxide (). Nine men (27 ± 9 years, 179 ± 7 cm, 75 ± 12 kg, : 52.0 ± 7.7 mL·kg⁻¹·min⁻¹) completed two 40-min running bouts (5 × 8-min with 2-min inter-bout rest), one level and one downhill. Running intensity was matched at 60% of maximal metabolic equivalent. Maximal isometric force of m.quadriceps femoris was measured before and after the running bouts. Data was analyzed with 2-way ANOVA or paired samples t-tests. Running speed (downhill: 13.5 ± 3.2, level: 9.6 ± 2.2 km·h⁻¹) and isometric force deficits (downhill: 17.2 ± 7.6%, level: 2.0 ± 6.9%) were higher for downhill running. Running bouts for level and downhill gradients had , heart rates and respiratory exchange ratio values that were not different indicating matched intensity and metabolic demands. During downhill running, the , (downhill: 29.7 ± 3.3, level: 27.2 ± 1.6) and (downhill: 33.3 ± 2.7, level: 30.4 ± 1.9) were 7.1% and 8.3% higher (p < 0.05) than level running. In conclusion, breathing efficiency appears lower during downhill running (i.e., muscle-damaging exercise) compared to level running at a similar moderate intensity. Full article

Impaired exercise capacity is the core symptom of heart failure with preserved ejection fraction (HFpEF). We assessed effects of exercise training and Crataegus extract WS 1442 in HFpEF and aimed to identify mechanisms of action in an exploratory trial (German Clinical Trials Register DRKS00000259). 140 sedentary HFpEF NYHA II patients on standard treatment received eight weeks of aerobic endurance training and half were randomized to WS 1442 900 mg/day. Symptoms, 2 km walking time (T_2km), parameters of exercise tolerance, cardiac and vascular function, muscular efficiency and skeletal muscular haemoglobin oxygen saturation (SO₂) measured during a treadmill protocol were captured at baseline and after eight weeks. Adverse events were recorded during the trial. Mechanisms of action were explored by correlation and path analyses of changes. Symptoms and exercise capacity improved with training, but correlations between improvements were low and path models were rejected. SO₂ increased, decreased or undulated with increasing exercise intensity in individual patients and was not altered by training. WS 1442 improved T_2km (-12.7% vs. -8.4%, p = 0.019), tended to improve symptoms and to pronounce SO₂-decrease with increasing exercise, an indicator of oxygen utilisation. Endurance training and WS 1442 were safe and well tolerated in combination with standard drug treatment. Full article

Gastrointestinal cancers account for 37% of all cancer deaths worldwide, underlining the need to further investigate modifiable factors for gastrointestinal cancer risk and prognosis. This review summarizes the corresponding evidence for physical activity (PA), including, briefly, possible biological mechanisms. Despite high public health relevance, there is still a scarcity of studies, especially for tertiary prevention. Besides the convincing evidence of beneficial effects of PA on colon cancer risk, clear risk reduction for gastroesophageal cancer was identified, as well as weak indications for pancreatic cancer. Inverse associations were observed for liver cancer, yet based on few studies. Only for rectal cancer, PA appeared to be not associated with cancer risk. With regard to cancer-specific mortality of the general population, published data were rare but indicated suggestive evidence of protective effects for colon and liver cancer, and to a lesser extent for rectal and gastroesophageal cancer. Studies in cancer patients on cancer-specific and total mortality were published for colorectal cancer only, providing good evidence of inverse associations with post-diagnosis PA. Overall, evidence of associations of PA with gastrointestinal cancer risk and progression is promising but still limited. However, the already available knowledge further underlines the importance of PA to combat cancer. Full article

Rugby is a sport that is growing in popularity. A contact sport par excellence, it causes a significant number of injuries. In Rugby Union, there are 30 to 91 injuries per 1000 match hours. This epidemiological review of injuries incurred by rugby players mentions the position and type of injuries, the causes, time during the match and season in which they occur and the players’ positions as well as the length of players’ absences following the injury. Full article

Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC) in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011). The age-bands frequently injured were 10–19 (22%), 40–49 (22%), 30–39 (14%) and 50–59 (13%) years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39). Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton. Full article