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Farzin Halabchi, Reza Mazaheri, Khashayar Sabeti, Masoud Yunesian, Zahra Alizadeh, Zahra Ahmadinejad, Seyed Mojtaba Aghili and Zahra Tavakol

Purpose: To compare the severity outcomes of COVID-19 disease between patients with and without regular sports participation. Methods: In a cross-sectional study, the authors investigated all patients who visited the emergency department of Imam Khomeini hospital with signs and symptoms of COVID-19 from February 20 to April 20, 2020. Then the authors assessed all patient outcomes (outpatient vs hospitalization or death). Finally, the authors compared the outcomes between athletes with regular sports participation and others, adjusting for confounding factors of age and sex. Results: Of all 4694 adult patients, 249 individuals (137 males and 112 females with mean [SD] age of 36.45 [9.77] y) had regular participation in different sport disciplines. Overall, 30 (12%) athletes were hospitalized or died (30 and 0, respectively) compared with 957 (21.5%) nonathletes (878 and 79, respectively). Athletes with regular sports participation were 1.49 times less likely to be hospitalized (P = .044). Conclusions: Regular sports participation may positively affect the clinical outcome, regardless of confounding factors of age and sex. The probability of hospitalization in athletes with regular sports participation was 33% lower than nonathletes. However, more longitudinal studies are needed to determine the causal effects.

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Vagner Deuel de Oliveira Tavares, Nicole Leite Galvão-Coelho, Joseph Firth, Simon Rosenbaum, Brendon Stubbs, Lee Smith, Davy Vancampfort and Felipe Barreto Schuch

Purpose: To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA). Methods: Systematic review with meta-analysis. The validity and reliability of SRQs to assess PA in people with mental disorders (January 20, 2020). Random-effects meta-analyses were performed pooling (1) test–retest correlations or (2) the convergent validity between the SRQs and objective measures (eg, accelerometry). Associations were provided in r values with the 95% confidence interval. Methodological quality was assessed. Results: A total of 9 unique studies (N = 1344; 40.5% females) were included. The authors found a moderate correlation test–retest reliability for PA SRQs in the assessment of vigorous PA (r = .69 [.38 to .85]; P = .001), moderate to vigorous PA (r = .63 [.25 to .84]; P = .003), moderate PA (r = .63 [.39 to .79]; P = .001), and good correlation total PA (r = .75 [.37 to .92]; P = .001). The SRQs have moderate correlations with objective measures for moderate to vigorous PA (r = .25 [.18 to .32]; P = .0001) and total PA (r = .47 [.28 to .62]; P = .005), a poor correlation for moderate PA (r = .18 [.03 to .36]; P = .047), and no correlation with vigorous PA (r = .06 [−.10 to .22]; P = .440). Conclusion: Current evidence indicates that SRQs are reliable over time to assess moderate, vigorous, and total PA levels and valid when assessing moderate PA.

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Christopher J. Stevens, Megan L.R. Ross and Roxanne M. Vogel

Menthol is effective at stimulating thermosensitive neurons that evoke pleasant cooling sensations. Internal application of menthol can be ergogenic for athletes, and hence, addition of menthol to sports nutrition products may be beneficial for athletes. The aim of this study was to develop a menthol energy gel for consumption during exercise and to determine acceptability and preferences for gels with different menthol concentrations. With a randomized, crossover, and double-blind placebo-controlled design, 40 endurance athletes (20 females) ingested an energy gel with a menthol additive at a high (0.5%; HIGH) or low concentration (0.1%; LOW), or a mint-flavored placebo (CON), on separate occasions during outdoor endurance training sessions. The athletes rated the gels for cooling sensation, mint flavor intensity, sweetness, and overall experience and provided feedback. Results are reported as median (interquartile range). Both menthol gels successfully delivered a cooling sensation, with a significantly greater response for HIGH (5.0 [4.0–5.0]) compared with LOW (3.5 [3.0–4.0]; p = .022) and CON (1.0 [1.0–2.0]; p < .0005), and LOW compared with CON (p < .0005). Ratings of mint flavor intensity followed the same trend as cooling sensation, while ratings of overall experience were significantly worse for HIGH (2.0 [1.0–3.0]) compared with LOW (4.0 [2.0–4.0]; p = .001) and CON (4.0 [3.0–4.0]; p < .0005). An energy gel with the addition of menthol at 0.1–0.5% provides a cooling sensation for athletes with a dose–response when ingested during exercise. The 0.1% concentration is recommended to maximize the overall experience of the gel.

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Wesley J. Wilson, Ali Brian and Luke E. Kelly

Novice teachers struggle with assessing fundamental motor skills. With growing time constraints, not to mention the current COVID-19 pandemic, professional development needs to be streamlined, asynchronous, and online to meet the needs of current teachers. The purpose of this study was to test the feasibility and efficacy of the Motor Skill Assessment Program (MSAP) in increasing the assessment competency of the underhand roll among physical educators and to examine which factors associated with posttest assessment scores. Twenty-nine physical educators (female = 21, male = 8) completed the program. Paired sample t tests were used to determine the efficacy of the program in improving assessment accuracy from pretest to posttest. Associations between posttest scores assessed which factors predicted success within the program addressing feasibility. Program completion resulted in significantly better posttest assessment scores among participants. Guided practice attempts and average scores on guided practice tests correlated most strongly and positively with posttest scores. The assessment training program increased the assessment competency of physical educators. Guided practice and using practice tests best predicted participant learning. Now that the MSAP results with teacher learning and is feasible, this efficacy trial should be scaled up to feature a control group and more skills.

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Mariana B. Pinto, Patrícia M. Bock, Andressa S.O. Schein, Juliana Portes, Raíssa B. Monteiro, Beatriz D. Schaan and Beatriz D. Schaan

This study evaluated the effects of inspiratory muscle training (IMT) in glucose control and respiratory muscle function in patients with diabetes. It was a randomized clinical trial conducted at the Physiopathology Laboratory of the Hospital de Clínicas de Porto Alegre. Patients with Type 2 diabetes were randomly assigned to IMT or placebo-IMT (P-IMT), performed at 30% and 2% of maximal inspiratory pressure, respectively, every day for 12 weeks. The main outcome measures were HbA1c, glycemia, and respiratory muscle function. Thirty patients were included: 73.3% women, 59.6 ± 10.7 years old, HbA1c 8.7 ± 0.9% (71.6 ± 9.8 mmol/mol), and glycemia 181.8 ± 57.8 mg/dl (10.5 ± 3.2 mmol/L). At the end of the training, HbA1c was 8.2 ±0.3% (66.1 ± 3.3 mmol/mol) and 8.7 ± 0.3% (71.6 ± 3.3 mmol/mol) for the IMT and P-IMT groups, respectively (p = .8). Fasting glycemia decreased in both groups with no difference after training although it was lower in IMT at 8 weeks: 170.0 ± 11.4 mg/dl(9.4 ± 0.6 mmol/L) and 184.4 ± 15.0 mg/dl (10.2 ± 0.8 mmol/L) for IMT and P-IMT, respectively (p < .05). Respiratory endurance time improved in the IMT group (baseline = 325.9 ± 51.1 s and 305.0 ± 37.8 s; after 12 weeks = 441.1 ± 61.7 s and 250.7 ± 39.0 s for the IMT and P-IMT groups, respectively; p < .05). Considering that glucose control did not improve, IMT should not be used as an alternative to other types of exercise in diabetes. Higher exercise intensities or longer training periods might produce better results. The clinical trials identifier is NCT 03191435.

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Yi Wang, Wing K. Lam, Charis K. Wong, Lok Y. Park, Mohammad F. Tan and Aaron K.L. Leung

This study examined the effect of foot orthoses used on ground reaction forces, ankle, and knee kinematics when running at preferred and nonpreferred speeds. Sixteen runners ran on instrumented treadmills at various speeds (90%, 100%, and 110% of preferred speed) when wearing arch-support and flat-control orthoses. Two-way repeated analysis of variance (ANOVA) was performed on the mean and coefficient of variation of all variables. Results indicated that arch-support orthoses experienced larger maximum loading rates than flat-control orthoses (P = .017, 95% CI, 2.22 to 19.53). Slower speed was related to smaller loading rates (preferred: P = .002, 95% CI, −17.02 to −4.20; faster: P = .003, 95% CI, −29.78 to −6.17), shorter stride length (preferred: P < .001, 95% CI, −0.204 to −0.090; faster: P < .001, 95% CI, −0.382 to −0.237), and longer contact time (preferred: P < .001, 95% CI, 0.006–0.021; faster: 95% CI, 0.012–0.042). In arch-support condition, preferred speed induced higher stride length coefficient of variation (P = .046, 95% CI, 0.035–1.117) than faster speed, while displaying no differences in flat-control condition. These findings suggest that the use of arch-support orthoses would influence impact loading, but not spatial-temporal and joint kinematics in recreational runners.

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Iván Peña-González, Alba Roldan, Carlos Toledo, Tomás Urbán and Raúl Reina

Purpose: This study aimed (1) to explore the validity and reliability of a new and specific change-of-direction (COD) test that requires dribbling skills to classify international footballers with cerebral palsy (CP) and compare it with another valid and reliable COD test without ball dribbling and (2) to probe whether both tests can discriminate between the new CP football classes (ie, FT1, FT2, and FT3) established worldwide in 2018. Methods: This study involved 180 international para-footballers with CP from 23 national teams at the 3 regional competitions held in 2018. They performed 2 COD tests, the modified agility test (no dribbling skills) and the dribbling speed test (DST). Results: Reliability was excellent for both the modified agility test (intraclass correlation coefficient [ICC]2,1 = .91, SEM = 5.75%) and the DST (ICC2,1 = .92, SEM = 4.66%). The modified agility test and DST results were highly to very highly correlated to one another for the whole group and considering the sport classes (r = .60–.80; P < .001). A 1-way analysis of variance showed significant differences between sport classes in both tests (P < .001). However, among classes, there were significant differences between FT1 and FT2 and FT3 (P < .01, effect size = large) and low to moderate effect sizes between FT2 and FT3 for either test. Conclusion: The DST appears to be valid and reliable to classify CP football players within the new classification system. Regression analysis revealed that 18.2% of the variance in the new sport classes could be explained by the 2 examined tests.

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Thomas A. Haugen, Felix Breitschädel, Håvard Wiig and Stephen Seiler

Purpose: To quantify possible differences in countermovement jump height across sport disciplines and sex in national-team athletes. Methods: In this cross-sectional study, 588 women (23 [5] y, 66 [8] kg) and 989 men (23 [5] y, 82 [12] kg) from 44 different sport disciplines (including 299 medalists from European Championships, World Championships, and/or Olympic Games) tested a countermovement jump on a force platform at the Norwegian Olympic Training Center between 1995 and 2018. Results: Athletic sprinting showed the highest values among the men (62.7 [4.8] cm) and women (48.4 [6.0] cm), clearly ahead of the long jump/triple jump (mean difference ± 90% CL: 6.5 ± 5.0 and 4.3  ± 4.1; very likely and likely; moderate) and speed skating sprint (11.4 ± 3.1 and 7.5 ± 5.5 cm; most likely and very likely; very large and moderate). These horizontally oriented sports displayed superior results compared with more vertically oriented and powerful sports such as beach volleyball, weightlifting, and ski jumping, both in men (from 2.9 ± 4.7 to 15.6 ± 2.9 cm; small to very large; possibly to most likely) and women (5.9 ± 4.8 to 13.4 ± 3.4 cm; large to very large; very likely to most likely), while endurance sports and precision sports were at the other end of the scale. Overall, the men jumped 33% higher than the women (10.3, ±0.6 cm; most likely; large). Conclusions: This study provides practitioners and scientists with useful information regarding the variation in countermovement jump height among national-team athletes within and across sport disciplines.

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Wigand Poppendieck, Melissa Wegmann, Anne Hecksteden, Alexander Darup, Jan Schimpchen, Sabrina Skorski, Alexander Ferrauti, Michael Kellmann, Mark Pfeiffer and Tim Meyer

Purpose: Cold-water immersion is increasingly used by athletes to support performance recovery. Recently, however, indications have emerged suggesting that the regular use of cold-water immersion might be detrimental to strength training adaptation. Methods: In a randomized crossover design, 11 participants performed two 8-week training periods including 3 leg training sessions per week, separated by an 8-week “wash out” period. After each session, participants performed 10 minutes of either whole-body cold-water immersion (cooling) or passive sitting (control). Leg press 1-repetition maximum and countermovement jump performance were determined before (pre), after (post) and 3 weeks after (follow-up) both training periods. Before and after training periods, leg circumference and muscle thickness (vastus medialis) were measured. Results: No significant effects were found for strength or jump performance. Comparing training adaptations (pre vs post), small and negligible negative effects of cooling were found for 1-repetition maximum (g = 0.42; 95% confidence interval [CI], −0.42 to 1.26) and countermovement jump (g = 0.02; 95% CI, −0.82 to 0.86). Comparing pre versus follow-up, moderate negative effects of cooling were found for 1-repetition maximum (g = 0.71; 95% CI, −0.30 to 1.72) and countermovement jump (g = 0.64; 95% CI, −0.36 to 1.64). A significant condition × time effect (P = .01, F = 10.00) and a large negative effect of cooling (g = 1.20; 95% CI, −0.65 to 1.20) were observed for muscle thickness. Conclusions: The present investigation suggests small negative effects of regular cooling on strength training adaptations.