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Leslie N. Silk, David A. Greene, and Michael K. Baker

Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardized mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES = 0.644; 95% CI = 0.406–0.883; p < .001), followed by total hip (ES = 0.483, 95% CI= 0.255–0.711, p < .001), femoral neck (ES = 0.402, 95% CI = 0.233–0.570, p = .000) and lumbar spine (ES = 0.306, 95% CI = 0.173–0.440, p < .001). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomized controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.

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Adam Douglas, Michael A. Rotondi, Joseph Baker, Veronica K. Jamnik, and Alison K. Macpherson

Purpose: To compare on-ice external and internal training loads in world-class women’s ice hockey during training and competition. Methods: On-ice training loads were collected during 1 season from 25 world-class ice hockey players via wearable technology. A total of 105 on-ice sessions were recorded, which consisted of 61 training sessions and 44 matches. Paired and unpaired t tests compared training and competition data between and across playing positions. Results: For training data, there was a difference between positions for PlayerLoad (P < .001, effect size [ES] = 0.32), PlayerLoad·minute−1 (P < .001, ES = 0.55), explosive efforts (P < .001, ES = 0.63), and training impulse (P < .001, ES = 0.48). For the competition data, there were also differences between positions for PlayerLoad (P < .001, ES = 0.26), PlayerLoad·minute−1 (P < .001, ES = 0.38), explosive efforts (P < .001, ES = 0.64), and training impulse (P < .001, ES = 1.47). Similar results were found when positions were viewed independently; competition had greater load and intensity across both positions for PlayerLoad, training impulse, and explosive efforts (P < .001, ES = 1.59–2.98) and with PlayerLoad·minute−1 (P = .016, ES = 0.25) for the defense. Conclusions: There are clear differences in the volume and intensity of external and internal workloads between training and competition sessions. These differences were also evident when comparing the playing positions, with defense having lower outputs than forwards. These initial results can be used to design position-specific drills that replicate match demands for ice hockey athletes.

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Michael Sanders, Anton E. Bowden, Spencer Baker, Ryan Jensen, McKenzie Nichols, and Matthew K. Seeley

Context: Foot and ankle injuries are common and often require a nonweight-bearing period of immobilization for the involved leg. This nonweight-bearing period usually results in muscle atrophy for the involved leg. There is a dearth of objective data describing muscle activation for different ambulatory aids that are used during the aforementioned nonweight-bearing period. Objective: To compare activation amplitudes for 4 leg muscles during (1) able-bodied gait and (2) ambulation involving 3 different ambulatory aids that can be used during the acute phase of foot and ankle injury care. Design: Within-subject, repeated measures. Setting: University biomechanics laboratory. Participants: Sixteen able-bodied individuals (7 females and 9 males). Intervention: Each participant performed able-bodied gait and ambulation using 3 different ambulatory aids (traditional axillary crutches, knee scooter, and a novel lower-leg prosthesis). Main Outcome Measure: Muscle activation amplitude quantified via mean surface electromyography amplitude throughout the stance phase of ambulation. Results: Numerous statistical differences (P < .05) existed for muscle activation amplitude between the 4 observed muscles, 3 ambulatory aids, and able-bodied gait. For the involved leg, comparing the 3 ambulatory aids: (1) knee scooter ambulation resulted in the greatest vastus lateralis activation, (2) ambulation using the novel prosthesis and traditional crutches resulted in greater biceps femoris activation than knee scooter ambulation, and (3) ambulation using the novel prosthesis resulted in the greatest gastrocnemius activation (P < .05). Generally speaking, muscle activation amplitudes were most similar to able-bodied gait when subjects were ambulating using the knee scooter or novel prosthesis. Conclusions: Type of ambulatory aid influences muscle activation amplitude. Traditional axillary crutches appear to be less likely to mitigate muscle atrophy during the nonweighting, immobilization period that often follows foot or ankle injuries. Researchers and clinicians should consider these results when recommending ambulatory aids for foot or ankle injuries.