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Agreement Between the 2- and 3-Step Methods for Identifying Subtle Menstrual Disturbances

Dionne A. Noordhof, Madison Y. Taylor, Virginia De Martin Topranin, Tina P. Engseth, Øyvind Sandbakk, and John O. Osborne

Recent methodological recommendations suggest the use of the “3-step method,” consisting of calendar-based counting, urinary ovulation testing, and serum blood sampling, for the identification of subtle menstrual disturbances (SMDs). However, the use of the 3-step method is not always feasible, so a less demanding combination of calendar-based counting and urinary ovulation testing, that is, the 2-step method, may be a viable alternative. Purpose: To investigate the agreement between the 2- and 3-step methods for the detection of SMDs. Methods: Menstrual cycles (MCs, 98) of 59 athletes were assessed using the 2- and 3-step methods. Regular-length MCs (ie, ≥21 and ≤35 d) were classified as either having no SMD (luteal phase length ≥10 d, midluteal progesterone concentration ≥16 nmol·L−1, and being ovulatory) or having an SMD (eg, short luteal phase [<10 d], inadequate luteal phase [midluteal progesterone concentration <16 nmol·L−1], or being anovulatory). Method agreement was assessed using the McNemar test and Cohen kappa (κ). Results: Substantial agreement was observed between methods (κ = .72; 95% CI, .53–.91), but the 2-step method did not detect all MCs with an SMD, resulting in evidence of systematic bias (χ 2 = 5.14; P = .023). The 2-step method detected 61.1% of MCs that had an SMD ([51.4, 70.8]), as verified using the 3-step method, and correctly identified 100% of MCs without an SMD. Conclusions: MCs classified as being disturbed using the 2-step method could be considered valid evidence of SMDs. However, MCs classified without SMDs do not definitively confirm their absence, due to the proven underdetection via the 2-step method.

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Gender Equity in Sport-Science Academia: We Still Have a Long Way to Go!

Sabrina Skorski and Silvana Bucher-Sandbakk

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Hemodynamic Effects of Intermittent Pneumatic Compression on Athletes: A Double-Blinded Randomized Crossover Study

Filipe Maia, Marta V.B. Machado, Gustavo Silva, Fábio Yuzo Nakamura, and João Ribeiro

Purpose: There are multiple postexercise recovery technologies available in the market based on the assumption of blood-flow enhancement. Lower-limb intermittent pneumatic compression (IPC) has been widely used, but the available scientific evidence supporting its effectiveness remains scarce, requiring a deeper investigation into its underlying mechanisms. The aim of this study was to assess the hemodynamic effects caused by the use of IPC at rest. Methods: Twenty-two soccer and track and field athletes underwent two 15-minute IPC protocols (moderate- [80 mm Hg] and high-pressure [200 mm Hg]) in a randomized order. Systolic peak velocity, end-diastolic peak velocity, arterial diameter, and heart rate were measured before, during (at the eighth minute), and 2 minutes after each IPC protocol. Results: Significant effects were observed between before and during (eighth minute) the IPC protocol for measures of systolic (P < .001) and end-diastolic peak velocities (P < .001), with the greater effects observed during the high-pressure protocol. Moreover, 2 minutes after each IPC protocol, hemodynamic variables returned to values close to baseline. Arterial diameter presented significant differences between pressures during the IPC protocols (P < .05), while heart rate remained unaltered. Conclusion: IPC effectively enhances transitory blood flow of athletes, particularly when applying high-pressure protocols.

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Kinetics, Kinematics, and Muscle Activity Patterns During Back Squat With Different Contributions of Elastic Resistance

Lin Shi, Mark Lyons, Michael Duncan, Sitong Chen, Dong Han, and Chengbo Yang

Purpose: Performing back squats with elastic bands has been widely used in resistance training. Although research demonstrated greater training effects obtained from adding elastic bands to the back squat, little is known regarding the optimal elastic resistance and how it affects neuromuscular performance. This study aimed to compare the force, velocity, power, and muscle activity during back squats with different contributions of elastic resistance. Methods: Thirteen basketball players performed 3 repetitions of the back squat at 85% of 1-repetition maximum across 4 conditions: (1) total load from free weight and (2) 20%, (3) 30%, and (4) 40% of the total load from elastic band and the remaining load from free weight. The eccentric and concentric phases of the back squat were divided into upper, middle, and bottom phases. Results: In the eccentric phase, mean velocity progressively increased with increasing elastic resistance, and muscle activity of the vastus medialis and rectus femoris significantly increased with the largest elastic resistance in the upper phase (P ≤ .036). In the concentric phase, mean power (P ≤ .021) and rate of force development (P ≤ .002) significantly increased with increasing elastic resistance. Furthermore, muscle activity of the vastus lateralis and vastus medialis significantly improved with the largest elastic resistance in the upper phases (P ≤ .021). Conclusion: Velocity, power, rate of force development, and selective muscle activity increased as the elastic resistance increased in different phases during the back-squat exercise.

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Effect of Beta-Alanine Supplementation on Maximal Intensity Exercise in Trained Young Male Individuals: A Systematic Review and Meta-Analysis

George D. Georgiou, Kyriaki Antoniou, Stephanie Antoniou, Eleni Anna Michelekaki, Reza Zare, Ali Ali Redha, Konstantinos Prokopidis, Efstathios Christodoulides, and Tom Clifford

Beta-alanine is a nonessential amino acid that is commonly used to improve exercise performance. It could influence the buffering of hydrogen ions produced during intense exercise and delay fatigue, providing a substrate for increased synthesis of intramuscular carnosine. This systematic review evaluates the effects of beta-alanine supplementation on maximal intensity exercise in trained, young, male individuals. Six databases were searched on August 10, 2023, to identify randomized, double-blinded, placebo-controlled trials investigating the effect of chronic beta-alanine supplementation in trained male individuals with an age range of 18–40 years. Studies evaluating exercise performance through maximal or supramaximal intensity efforts falling within the 0.5–10 min duration were included. A total of 18 individual studies were analyzed, employing 18 exercise test protocols and 15 outcome measures in 331 participants. A significant (p = .01) result was observed with an overall effect size of 0.39 (95% confidence interval [CI] [0.09, 0.69]), in favor of beta-alanine supplementation versus placebo. Results indicate significant effects at 4 weeks of supplementation, effect size 0.34 (95% CI [0.02, 0.67], p = .04); 4–10 min of maximal effort, effect size 0.55 (95% CI [0.07, 1.04], p = .03); and a high beta-alanine dosage of 5.6–6.4 g per day, effect size 0.35 (95% CI [0.09, 0.62], p = .009). The results provide insights into which exercise modality will benefit the most, and which dosage protocols and durations stand to provide the greatest ergogenic effects. This may be used to inform further research, and professional or recreational training design, and optimization of supplementation strategies.

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How to Equalize High- and Low-Intensity Endurance Exercise Dose

Pekka Matomäki, Olli-Pekka Nuuttila, Olli J. Heinonen, Heikki Kyröläinen, and Ari Nummela

Purpose: Without appropriate standardization of exercise doses, comparing high- (HI) and low-intensity (LI) training outcomes might become a matter of speculation. In athletic preparation, proper quantification ensures an optimized stress-to-recovery ratio. This review aims to compare HI and LI doses by estimating theoretically the conversion ratio, 1:x, between HI and LI: How many minutes, x, of LI are equivalent to 1 minute of HI using various quantification methods? A scrutinized analysis on how the dose increases in relation to duration and intensity was also made. Analysis: An estimation was conducted across 4 categories encompassing 10 different approaches: (1) “arbitrary” methods, (2) physiological and perceptual measurements during exercise, (3) postexercise measurements, and comparison to (4a) acute and (4b) chronic intensity-related maximum dose. The first 2 categories provide the most conservative estimation for the HI:LI ratio (1:1.5–1:10), and the third, slightly higher (1:4–1:11). The category (4a) provides the highest estimation (1:52+) and (4b) suggests 1:10 to 1:20. The exercise dose in the majority of the approaches increase linearly in relation to duration and exponentially in relation to intensity. Conclusions: As dose estimations provide divergent evaluations of the HI:LI ratio, the choice of metric will have a large impact on the research designs, results, and interpretations. Therefore, researchers should familiarize themselves with the foundations and weaknesses of their metrics and justify their choice. Last, the linear relationship between duration and exercise dose is in many cases assumed rather than thoroughly tested, and its use should be subjected to closer scrutiny.

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Athletic Performance Decline Over the Life Span: Cross-Sectional and Longitudinal Analyses of Elite and Masters Track-and-Field Data

Brandon Pfeifer, W. Bradley Nelson, and Robert D. Hyldahl

Purpose : Loss of muscle power has a significant impact on mobility in geriatric populations, so this study sought to determine the extent and time course of performance decline in power-centric events throughout the life span via retrospective analyses of masters and elite track-and-field data. Methods : Four track-and-field events were selected based on maximal power output: the 100-m dash, long jump, high jump, and triple jump. Elite and masters athlete data were gathered from the World Masters Outdoor Championships and the International Amateur Athletic Federation World Athletics Championships (17,945 individual results). Data were analyzed by fitting individual and group results to quadratic and linear models. Results : Average age of peak performance in all events was 27.8 (0.8) years for men and 28.3 (0.8) years for women. Athlete performance decline best matched a linear model for the 5 years following peak performance (mean R 2  = .68 [.20]) and for ages 35–60, but best matched a quadratic model for ages 60–90 and 35–90 (mean R 2  = .75 [.12]). The average rate of decline for the masters data ages 35–60 ranged from 0.55% per year for men’s 100-m dash to 1.04% per year for women’s long jump. A significant age × sex interaction existed between men and women, with men declining faster throughout life in all events except the 100-m dash. Conclusions : Performance decline begins in the early 30s and is linear through middle age. This pattern of decline provides a basis for further research on power-decline pathophysiology and preventive measures starting in the 30s.

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A Change-Point Method to Detect Meaningful Change in Return-to-Sport Progression in Athletes

Kate K. Yung, Ben Teune, Clare L. Ardern, Fabio R. Serpiello, and Sam Robertson

Purpose: To explore how the change-point method can be used to analyze complex longitudinal data and detect when meaningful changes (change points) have occurred during rehabilitation. Method: This design is a prospective single-case observational study of a football player in a professional club who sustained an acute lower-limb muscle injury during high-speed running in training. The rehabilitation program was entirely completed in the football club under the supervision of the club’s medical team. Four wellness metrics and 5 running-performance metrics were collected before the injury and until the player returned to play. Results: Data were collected over 130 days. In the univariate analysis, the change points for stress, sleep, mood, and soreness were located on days 30, 47, 50, and 50, respectively. The change points for total distance, acceleration, maximum speed, deceleration, and high-speed running were located on days 32, 34, 37, 41, and 41, respectively. The multivariate analysis resulted in a single change point for the wellness metrics and running-performance metrics, on days 50 and 67, respectively. Conclusions: The univariate approach provided information regarding the sequence and time point of the change points. The multivariate approach provided a common change point for multiple metrics, information that would benefit clinicians to have a broad overview of the changes in the rehabilitation process. Clinicians may consider the change-point method to integrate and visualize data from multiple sources to evaluate athletes’ progression along the return-to-sport continuum.

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Predicting Future Athletic Performance in Young Female Road Cyclists Based on Aerobic Fitness and Hematological Variables

Dariusz Sitkowski, Jadwiga Malczewska-Lenczowska, Ryszard Zdanowicz, Michał Starczewski, Andrzej Pokrywka, Piotr Żmijewski, and Raphael Faiss

Purpose: This study aimed to determine whether the initial levels of aerobic fitness and hematological variables in young female road cyclists are related to their athletic performance development during their careers. Methods: Results of graded exercise tests on a cycle ergometer and total hemoglobin mass (tHb-mass) measurements were analyzed in 34 female road cyclists (age 18.6 [1.9] y). Among them, 2 groups were distinguished based on their competitive performance (Union Cycliste Internationale world ranking) over the following 8 years. Areas under the curve in receiver-operating-characteristic curves were calculated as indicators of elite-performance prediction. Results: Initial graded exercise test variables (peak power, peak oxygen uptake, and power at 4 mmol/L blood lactate) were not significantly different in elite (n = 13) versus nonelite (n = 21) riders. In contrast, elite riders had higher tHb-mass expressed either in absolute measures (664 [75] vs 596 [59] g, P = .006) or normalized to body mass (11.2 [0.8] vs 10.3 [0.7] g/kg, P = .001) and fat-free mass (14.4 [0.9] vs 13.1 [0.9] g/kg, P < .001). Absolute and relative erythrocyte volumes were significantly higher in elite subjects (P ranged from < .001 to .006). Of all the variables analyzed, the relative tHb-mass had the highest predictive ability to reach the elite level (area under the curve ranged from .82 to .85). Conclusion: Measurement of tHb-mass can be a helpful tool in talent detection to identify young female road cyclists with the potential to reach the elite level in the future.

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Retraction. Pharmacokinetic Profile of Caffeine and Its Two Main Metabolites in Dried Blood Spots After Five Different Oral Caffeine Administration Forms—A Randomized Crossover Study