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Annie C. Jeffries, Lee Wallace, Aaron J. Coutts, Shaun J. McLaren, Alan McCall and Franco M. Impellizzeri

Background: Athlete-reported outcome measures (AROMs) are frequently used in research and practice but no studies have examined their psychometric properties. Objectives: Part 1—identify the most commonly used AROMs in sport for monitoring training responses; part 2—assess risk of bias, measurement properties, and level of evidence, based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Study Appraisal and Synthesis Methods: Methodological quality of the studies, quality of measurement properties, and level of evidence were determined using the COSMIN checklist and criteria. Results: Part 1—from 9446 articles screened for title and abstract, 310 out of 334 full texts were included; 53.9% of the AROMs contained multiple items, while 46.1% contained single items. Part 2—from 1895 articles screened for title and abstract, 71 were selected. Most measurement properties of multiple-item AROMs were adequate, but content validity and measurement error were inadequate. With the exclusion of 2 studies examining reliability and responsiveness, no validity studies were found for single items. Conclusions: The measurement properties of multiple-item AROMs derived from psychometrics were acceptable (with the exclusion of content validity and measurement error). The single-item AROMs most frequently used in sport science have not been validated. Additionally, nonvalidated modified versions of the originally nonvalidated items are common. Until proper validation studies are completed, all conclusions based on these AROMs are questionable. Established reference methods, such as those of clinimetrics, should be used to develop and assess the validity of AROMs.

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Guro S. Solli, Silvana B. Sandbakk, Dionne A. Noordhof, Johanna K. Ihalainen and Øyvind Sandbakk

Purpose: To investigate changes in self-reported physical fitness, performance, and side effects across the menstrual cycle (MC) phases among competitive endurance athletes and to describe their knowledge and communication with coaches about the MC. Methods: The responses of 140 participants (older than 18 y) competing in biathlon or cross-country skiing at the (inter)national level were analyzed. Data were collected via an online questionnaire addressing participants’ competitive level, training volume, MC history, physical fitness, and performance during the MC, MC-related side effects, and knowledge and communication with coaches about the MC and its effects on training and performance. Results: About 50% and 71% of participants reported improved and reduced fitness, respectively, during specific MC phases, while 42% and 49% reported improved and reduced performance, respectively. Most athletes reported their worst fitness (47%) and performance (30%) and the highest number of side effects during bleeding (P < .01; compared with all other phases). The phase following bleeding was considered the best phase for perceived fitness (24%, P < .01) and performance (18%, P < .01). Only 8% of participants reported having sufficient knowledge about the MC in relation to training, and 27% of participants communicated about it with their coach. Conclusions: A high proportion of athletes perceived distinct changes in fitness, performance, and side effects across the MC phases, with their worst perceived fitness and performance during the bleeding phase. Because most athletes indicate a lack of knowledge about the MC’s effect on training and performance and few communicate with coaches on the topic, the authors recommend that more time be devoted to educating athletes and coaches.

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Jesualdo Cuevas-Aburto, Ivan Jukic, Jorge Miguel González-Hernández, Danica Janicijevic, Paola Barboza-González, Luis Javier Chirosa-Ríos and Amador García-Ramos

Purpose: To compare the effects of 2 upper-body strength-training programs differing in set configuration on bench press 1-repetition maximum (BP1RM), bench press throw peak velocity against 30 kg (BPT30), and handball throwing velocity. Methods: Thirty-five men were randomly assigned to a traditional group (TRG; n = 12), rest redistribution group (RRG; n = 13), or control group (n = 10). The training program was conducted with the bench press exercise and lasted 6 weeks (2 sessions per week): TRG—6 sets × 5 repetitions with 3 minutes of interset rest; RRG—1 set × 30 repetitions with 31 seconds of interrepetition rest. The total rest period (15 min) and load intensity (75% 1RM) were the same for both experimental groups. Subjects performed all repetitions at maximal intended velocity, and the load was adjusted on a daily basis from velocity recordings. Results: A significant time × group interaction was observed for both BP1RM and BPT30 (P < .01) due to the higher values observed at posttest compared with pretest for TRG (effect size [ES] = 0.77) and RRG (ES = 0.56–0.59) but not for the control group (ES ≤ 0.08). The changes in BP1RM and BPT30 did not differ between TRG and RRG (ES = 0.04 and 0.05, respectively). No significant differences in handball throwing velocity were observed between the pretest and posttest (ES = 0.16, 0.22, and 0.02 for TRG, RRG, and control group, respectively). Conclusions: Resistance-training programs based on not-to-failure traditional and rest redistribution set configurations induce similar changes in BP1RM, BPT30, and handball throwing velocity.

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Mikkel Oxfeldt, Line B. Dalgaard, Astrid A. Jørgensen and Mette Hansen

Objective: To identify the prevalence of hormonal contraceptive (HC) use, menstrual cycle disturbances, and self-perceived physical and emotional symptoms related to the menstrual cycle/pill cycle in elite female athletes. Methods: One hundred eighty-six Danish elite female athletes completed an online questionnaire to assess menstrual status and history, use of HCs, and self-perceived physical and emotional symptoms related to the menstrual cycle or HC use. Results: Fifty-seven percent of elite female athletes in Denmark use HC, with 74% using combined HCs and 26% using progestin only. Sixty percent of oral contraceptive users reported having manipulated their menstrual cycle by continuous oral contraceptive use. Forty-nine percent of non-HC users had a regular menstrual cycle, while 51% experienced menstrual disturbances, with 1 athlete being primary amenorrheic and 13 athletes having secondary amenorrhea. Menstrual disturbances were experienced by a larger proportion of endurance athletes (69%) compared with athletes performing power and technical disciplines. In endurance athletes amenorrhea was associated with a higher cardiovascular training volume (P < .001). Negative symptoms related to the menstrual/pill cycle were reported by both HC and non-HC users, whereas positive physical symptoms were experienced more often among the non-HC (14%) versus HC users (2%) (P < .01). Notably, 13% of the athletes reported that negative symptoms sometimes/always caused them to not participate in or complete the scheduled training. Conclusion: HC use is common among elite athletes, and continuation of HC is used to manipulate the menstrual cycle in relation to sport competitions. HC use does not abolish dysmenorrhea, but it may reduce emotional-related side effects. Menstrual disturbances are frequent in endurance athletes and are associated with cardiovascular training volume.

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Andrew Renfree, Arturo Casado, Gonzalo Pellejero and Brian Hanley

Purpose: To determine different relationships between, and predictive ability of, performance variables at intermediate distances with finishing time in elite male 10,000-m runners. Methods: Official electronic finishing and 100-m split times of the men’s 10,000-m finals at the 2008 and 2016 Olympic Games and IAAF World Championships in 2013 and 2017 were obtained (125 athlete performances in total). Correlations were calculated between finishing times and positions and performance variables related to speed, position, time to the leader, and time to the runner in front at 2000, 4000, 6000, 8000, and 9900 m. Stepwise linear-regression analysis was conducted between finishing times and positions and these variables across the race. One-way analysis of variance was performed to identify differences between intermediate distances. Results: The SD and kurtosis of mean time, skewness of mean time, and position and time difference to the leader were either correlated with or significantly contributed to predictions of finishing time and position at at least one of the analyzed distances (.81 ≥ r ≥ .30 and .001 ≤ P ≤ .03, respectively). These variables also displayed variation across the race (.001 ≤ P ≤ .05). Conclusions: The ability to undertake a high degree of pace variability, mostly characterized by acceleration in the final stages, is strongly associated with achievement of high finishing positions in championship 10,000-m racing. Furthermore, the adoption and maintenance of positions close to the front of the race from the early stages are important to achieve a high finishing position.

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Matthew D. Wright, Francisco Songane, Stacey Emmonds, Paul Chesterton, Matthew Weston and Shaun J. Mclaren

Purpose: To understand the validity of differential ratings of perceived exertion (dRPE) as a measure of girls’ training and match internal loads. Methods: Using the centiMax scale (CR100), session dRPE for breathlessness (sRPE-B) and leg muscle exertion (sRPE-L) were collected across a season of training (soccer, resistance, and fitness) and matches from 33 players (15 [1] y). Differences and associations between dRPE were examined using mixed and general linear models. The authors’ minimal practical important difference was 8 arbitrary units (AU). Results: Mean (AU [SD] ∼16) sRPE-B and sRPE-L were 66 and 61 for matches, 51 and 49 for soccer, 86 and 67 for fitness, and 45 and 58 for resistance, respectively. Session RPE-B was rated most likely harder than sRPE-L for fitness (19 AU; 90% confidence limits: ±7) and most likely easier for resistance (−13; ±2). Match (5; ±4) and soccer (−3; ±2) differences were likely to most likely trivial. The within-player relationships between sRPE-B and sRPE-L were very likely moderate for matches (r = .44; 90% confidence limits: ±.12) and resistance training (.38; ±.06), likely large for fitness training (.51; ±.22), and most likely large for soccer training (.56; ±.03). Shared variance ranged from 14% to 35%. Conclusions: Practically meaningful differences between dRPE following physical training sessions coupled with low shared variance in all training types and matches suggest that sRPE-B and sRPE-L represent unique sensory inputs in girls’ soccer players. The data provide evidence for the face and construct validity of dRPE as a measure of internal load in this population.

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Amin Daneshfar, Carl J. Petersen, Majid S. Koozehchian and Daniel E. Gahreman

This study aimed to identify the acute effects of caffeinated chewing gum (CAF) on bicycle motocross (BMX) time-trial (TT) performance. In a randomized, placebo-controlled, double-blind cross-over design, 14 male BMX riders (age = 20.0 ± 3.3 years; height = 1.78 ± 0.04 m; body mass = 72 ± 4 kg), consumed either (300 mg; 4.2 ± 0.2 mg/kg) caffeinated (300 mg caffeine, 6 g sugars) or a placebo (0 mg caffeine, 0 g sugars) gum, and undertook three BMX TTs. Repeated-measure analysis revealed that CAF has a large ergogenic effect on TT time, F(1, 14) = 33.570, p = .001, ηp2=.71; −1.5% ± 0.4 compared with the placebo. Peak power and maximal power to weight ratio also increased significantly compared with the placebo condition, F(1, 14) = 54.666, p = .001, ηp2=.79; +3.5% ± 0.6, and F(1, 14) = 57.399, p = .001, ηp2=.80; +3% ± 0.3, respectively. Rating of perceived exertion was significantly lower F(1, 14) = 25.020, p = .001, ηp2=.64 in CAF (6.6 ± 1.3) compared with the placebo (7.2 ± 1.7). Administering a moderate dose (300 mg) of CAF could improve TT time by enhancing power and reducing the perception of exertion. BMX coaches and riders may consider consuming CAF before a BMX race to improve performance and reduce rating of perceived exertion.

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Ade B. Pratama and Tossaporn Yimlamai

Purpose: To compare the effectiveness of 3 recovery protocols on muscle oxygenation, blood lactate, and subsequent performance during a 200-m repeated swim session. Methods: Twelve collegte swimmers completed 3 sessions of 2 consecutive 200-m front-crawl trials separated by 1 of 3 recovery protocols: a 15-minute active recovery (AR), a 15-minute passive recovery (PR), and a combination of 5-minute AR and 10-minute PR (CR) in a counterbalanced design. Tissue saturation index at biceps femoris, blood lactate concentration, arterial oxygen saturation, and heart rate were measured at rest, immediately after the trial, and at 5, 10, and 15 minutes of recovery. Two-way analysis of variance (recovery × time) with repeated measures was used to determine measurement variables. A level of significance was set at P < .05. Results: No significant changes in swimming time were observed between trials (AR: 156.79 [4.09] vs 157.79 [4.23] s, CR: 156.50 [4.89] vs 155.55 [4.86] s, PR: 156.54 [4.70] vs 156.30 [4.52] s) across recovery conditions. Interestingly, tissue saturation index rapidly declined immediately after a 200-m swim and then gradually returned to baseline, with a greater value observed during CR compared with AR and PR after 15-minute recovery (P = .04). These changes were concomitant with significant reductions in blood lactate and heart rate during the recovery period (P = .00). Conclusion: The CR in the present study was more effective in enhancing muscle reoxygenation after a 200-m swim compared with AR and PR, albeit its beneficial effect on subsequent performance warrants further investigation.

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Milos R. Petrovic, Amador García-Ramos, Danica N. Janicijevic, Alejandro Pérez-Castilla, Olivera M. Knezevic and Dragan M. Mirkov

Purpose: To test whether the force–velocity (F–V) relationship obtained during a specific single-stroke kayak test (SSKT) and during nonspecific traditional resistance-training exercises (bench press and prone bench pull) could discriminate between 200-m specialists and longer-distance (500- and 1000-m) specialists in canoe sprint. Methods: A total of 21 experienced male kayakers (seven 200-m specialists and 14 longer-distance specialists) participated in this study. After a familiarization session, kayakers came to the laboratory on 2 occasions separated by 48 to 96 hours. In a randomized order, kayakers performed the SSKT in one session and the bench press and bench pull tests in another session. Force and velocity outputs were recorded against 5 loads in each exercise to determine the F–V relationship and related parameters (maximum force, maximum velocity, F–V slope, and maximum power). Results: The individual F–V relationships were highly linear for the SSKT (r = .990 [.908, .998]), bench press (r = .993 [.974, .999]), and prone bench pull (r = .998 [.992, 1.000]). The F–V relationship parameters (maximum force, maximum velocity, and maximum power) were significantly higher for 200-m specialists compared with longer-distance specialists (all Ps ≤ .047) with large effect sizes (≥0.94) revealing important practical differences. However, no significant differences were observed between 200-m specialists and longer-distance specialists in the F–V slope (P ≥ .477). Conclusions: The F–V relationship assessed during both specific (SSKT) and nonspecific upper-body tasks (bench press and bench pull) may distinguish between kayakers specialized in different distances.

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James A. Betts