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Acute:Chronic Workload Ratio: Conceptual Issues and Fundamental Pitfalls

Franco M. Impellizzeri, Matthew S. Tenan, Tom Kempton, Andrew Novak, and Aaron J. Coutts

The number of studies examining associations between training load and injury has increased exponentially. As a result, many new measures of exposure and training-load-based prognostic factors have been created. The acute:chronic workload ratio (ACWR) is the most popular. However, when recommending the manipulation of a prognostic factor in order to alter the likelihood of an event, one assumes a causal effect. This introduces a series of additional conceptual and methodological considerations that are problematic and should be considered. Because no studies have even tried to estimate causal effects properly, manipulating ACWR in practical settings in order to change injury rates remains a conjecture and an overinterpretation of the available data. Furthermore, there are known issues with the use of ratio data and unrecognized assumptions that negatively affect the ACWR metric for use as a causal prognostic factor. ACWR use in practical settings can lead to inappropriate recommendations, because its causal relation to injury has not been established, it is an inaccurate metric (failing to normalize the numerator by the denominator even when uncoupled), it has a lack of background rationale to support its causal role, it is an ambiguous metric, and it is not consistently and unidirectionally related to injury risk. Conclusion: There is no evidence supporting the use of ACWR in training-load-management systems or for training recommendations aimed at reducing injury risk. The statistical properties of the ratio make the ACWR an inaccurate metric and complicate its interpretation for practical applications. In addition, it adds noise and creates statistical artifacts.

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Additional Clothing Increases Heat Load in Elite Female Rugby Sevens Players

Mitchell J. Henderson, Bryna C.R. Chrismas, Christopher J. Stevens, Andrew Novak, Job Fransen, Aaron J. Coutts, and Lee Taylor

Purpose: To determine whether elite female rugby sevens players are exposed to core temperatures (Tc) during training in the heat that replicate the temperate match demands previously reported and to investigate whether additional clothing worn during a hot training session meaningfully increases the heat load experienced. Methods: A randomized parallel-group study design was employed, with all players completing the same approximately 70-minute training session (27.5°C–34.8°C wet bulb globe temperature) and wearing a standardized training ensemble (synthetic rugby shorts and training tee [control (CON); n = 8]) or additional clothing (standardized training ensemble plus compression garments and full tracksuit [additional clothing (AC); n = 6]). Groupwise differences in Tc, sweat rate, GPS-measured external locomotive output, rating of perceived exertion, and perceptual thermal load were compared. Results: Mean (P = .006, η p 2 = .88 ) and peak (P < .001, η p 2 = .97 ) Tc were higher in AC compared with CON during the training session. There were no differences in external load (F 4,9 = 0.155, P = .956, Wilks Λ = 0.935, η p 2 = .06 ) or sweat rate (P = .054, Cohen d = 1.09). A higher rating of perceived exertion (P = .016, Cohen d = 1.49) was observed in AC compared with CON. No exertional-heat-illness symptomology was reported in either group. Conclusions: Player Tc is similar between training performed in hot environments and match play in temperate conditions when involved for >6 minutes. Additional clothing is a viable and effective method to increase heat strain in female rugby sevens players without compromising training specificity or external locomotive capacity.

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Development and Validation of Single Items for Fatigue and Recovery in Dancers

Annie C. Jeffries, Andrew R. Novak, Aaron J. Coutts, Alan McCall, Shaun J. McLaren, and Franco M. Impellizzeri

Purpose: To examine the construct validity and reliability of 2 single items for fatigue and recovery in dancers. The construct validity was assessed using reference instruments: the fatigue items of the Brunel Mood Scale (BRUMS) and the Short Recovery and Stress Scale (SRSS). A secondary aim was to explore the respondent interpretation of these 2 items using a concept identification approach. Methods: Two hundred forty-three (N = 243) dancers completed single-item fatigue and recovery (unipolar and bipolar), BRUMS, and SRSS once for construct validity. For reliability,  49 dancers completed the questionnaires twice, 1 week apart. Using a concept identification approach, 49 dancers were also asked comprehension and interpretation of fatigue and recovery. Results: The fatigue item correlated with SRSS stress items (r s = .37–.51) and BRUMs fatigue items (r s = .63–.66). The recovery item was only partially confirmed in terms of construct validity, when using the SRSS recovery items as reference (r s = .39–.43). Reliability was confirmed for the single items of fatigue (κ = .77–.78) and recovery (κ = .71–.78). Main responses for the concept of fatigue were tiredness (34.7%), muscle soreness (17.3%), and energy (13.0%). Main responses for the concept of recovery were muscle soreness (43.0%), tiredness (27.9%), and fatigue (24.0%). Conclusion: We provide preliminary confirmation of the validity and reliability of the single item fatigue in dancers. The recovery item was only partially confirmed in terms of construct validity, when using the SRSS recovery items as reference, but did display acceptable reliability and agreement. Further research is warranted further exploring other measurement properties.