Exploring the Use of Mobile Athlete Self-report Measures in Elite Gaelic Games: A Qualitative Approach.

ABSTRACT: Duignan, CM, Slevin, PJ, Caulfield, BM, and Blake, C. Exploring the use of mobile athlete self-report measures in elite Gaelic games: A qualitative approach. J Strength Cond Res 35(12): 3491-3499, 2021-Athlete self-report measures (ASRMs) are used in research and practice as an accurate, practical, and accessible method of athlete monitoring. Mobile adaptations of constructs from validated ASRM have increasingly been used for athlete monitoring in various sports settings; however, insights on the user experience and perceived value of these systems in the applied team sport setting have been limited. This study aimed to portray the experiences of stakeholders using a pre-existing mobile ASRM (M-ASRM) in elite Gaelic games. Twenty-one stakeholders in elite Gaelic games were recruited for this study (players n = 10, coaches and support staff n = 11). Subjects completed a semistructured interview with the lead researcher regarding their experience of using an M-ASRM in practice. Thematic analysis of the transcripts was conducted using NVivo 12 software. Results were defined under the themes of positive and negative user experience. Positive user experience was portrayed through M-ASRM uses and perceived value: communication and information disclosure, remote player monitoring, decision making and advanced planning, and player education and self-management. Negative user experience was portrayed through M-ASRM challenges: player adherence, player dishonesty, coach time and expertise requirements, and sociotechnical and system factors. Results outline the major uses of M-ASRM in elite Gaelic games and, importantly, highlight the key challenges experienced by stakeholders. These results can be applied by coaches, sports medicine professionals, and sports scientists using or intending to use an M-ASRM, providing key considerations to employ for effective use in team sport.

Mobile Athlete Self-Report Measures and the Complexities of Implementation.

Recent practice in athlete monitoring has seen the development and implementation of customized, digital Athlete Self-Report Measures or Mobile Athlete Self-Report Measures (M-ASRM) across various sport settings, including amateur sports such as Gaelic Games. Successful implementation of M-ASRM requires significant consideration of the use context and limitations therein, an investment of time and expertise by staff and buy-in from key stakeholders, yet there is limited evidence of these considerations being applied in practice. This study aimed to investigate stakeholder perceptions regarding the implementation processes and understanding of a pre-existing M-ASRM in elite Gaelic Games. Semi-structured interviews were conducted with the use of a topic guide to explore the rationale, introduction and use of M-ASRM. Participants were 21 M-ASRM users in elite Gaelic Games (players n = 10, coaches and support staff n = 11), from 15 teams. Thematic analysis was conducted collaboratively by two authors, adopting an inductive approach and coding the transcripts using NVivo 12 software. Four higher-order themes were formed from the data: (1) clarity of purpose; (2) implementation strategies; (3) players perceptions of use and (4) perceived facilitators of M-ASRM use. The results of this study demonstrate a significant underestimation of the practical requirements for successful implementation of an M-ASRM by users in elite Gaelic Games. Recommendations are made for implementation and best practice use, including shared decision-making, evidence-based education strategies, structured feedback channels and improved planning with regards to feasibility and responsibility.

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.

Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries.

Technology in Strength and Conditioning: Assessing Bodyweight Squat Technique With Wearable Sensors.

O'Reilly, MA, Whelan, DF, Ward, TE, Delahunt, E, and Caulfield, BM. Technology in strength and conditioning: assessing bodyweight squat technique with wearable sensors. J Strength Cond Res 31(8): 2303-2312, 2017-Strength and conditioning (S&C) coaches offer expert guidance to help those they work with achieve their personal fitness goals. However, it is not always practical to operate under the direct supervision of an S&C coach and consequently individuals are often left training without expert oversight. Recent developments in inertial measurement units (IMUs) and mobile computing platforms have allowed for the possibility of unobtrusive motion tracking systems and the provision of real-time individualized feedback regarding exercise performance. These systems could enable S&C coaches to remotely monitor sessions and help individuals record their workout performance. One aspect of such technologies is the ability to assess exercise technique and detect common deviations from acceptable exercise form. In this study, we investigate this ability in the context of a bodyweight (BW) squat exercise. Inertial measurement units were positioned on the lumbar spine, thighs, and shanks of 77 healthy participants. Participants completed repetitions of BW squats with acceptable form and 5 common deviations from acceptable BW squatting technique. Descriptive features were extracted from the IMU signals for each BW squat repetition, and these were used to train a technique classifier. Acceptable or aberrant BW squat technique can be detected with 98% accuracy, 96% sensitivity, and 99% specificity when using features derived from all 5 IMUs. A single IMU system can also distinguish between acceptable and aberrant BW squat biomechanics with excellent accuracy, sensitivity, and specificity. Detecting exact deviations from acceptable BW squatting technique can be achieved with 80% accuracy using a 5 IMU system and 72% accuracy when using a single IMU positioned on the right shank. These results suggest that IMU-based systems can distinguish between acceptable and aberrant BW squat technique with excellent accuracy with a single IMU system. Identification of exact deviations is also possible but multi-IMU systems outperform single IMU systems.

2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains.

The Executive Committee of the International Ankle Consortium presents this 2016 position paper with recommendations for information implementation and continued research based on the paradigm that lateral ankle sprain (LAS), and the development of chronic ankle instability (CAI), serve as a conduit to a significant global healthcare burden. We intend our recommendations to serve as a mechanism to promote efforts to improve prevention and early management of LAS. We believe this will reduce the prevalence of CAI and associated sequelae that have led to the broader public health burdens of decreased physical activity and early onset ankle joint post-traumatic osteoarthritis. Ultimately, this can contribute to healthier lifestyles and promotion of physical activity.

Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains.

Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.

Whole body oxygen uptake and evoked torque during subtetanic isometric electrical stimulation of the quadriceps muscles in a single 30-minute session.

OBJECTIVE: To evaluate the time course of fatigue in torque output and oxygen uptake during isometric subtetanic neuromuscular electrical stimulation (NMES) to facilitate the design of NMES-based rehabilitation protocols that can accumulate a defined aerobic exercise volume within a given time period. DESIGN: Single-arm intervention study with within-subject comparisons. SETTING: University research laboratory. PARTICIPANTS: Volunteer sample of healthy men (N=11; mean age, 34.2 ± 11.5 y; range, 19-53 y; body mass, 79.1 ± 11.7 kg; range, 58-100 kg). INTERVENTION: A single 30-minute session of continuous bilateral isometric quadriceps NMES at 4 Hz evoking a mean twitch amplitude of 12% of the maximum voluntary contraction. MAIN OUTCOME MEASURES: Whole body oxygen consumption rate (V˙o2), and evoked torque were measured simultaneously throughout. RESULTS: Mean increment in V˙o2 was 596 ± 238 mL/min, and average exercise intensity during the session was 3 ±.47 metabolic equivalents. The V˙o2 and torque declined slowly at a rate of -.54%±.31% and -.47%±.57% per minute, respectively. CONCLUSIONS: Despite having a higher incremental V˙o2, the observed fatigue rate was considerably less than that previously reported during intermittent isometric tetanic stimulation, suggesting that subtetanic isometric NMES is more sustainable for exercise interventions aimed at accumulating a therapeutic aerobic exercise volume.

Normative adductor squeeze test values in elite junior rugby union players.

OBJECTIVE: To establish normative adductor squeeze test (AST) values in elite junior rugby union players and investigate if differences existed between field position units and categorizations. DESIGN: Cross-sectional study. SETTING: National underage screening camp. PARTICIPANTS: One hundred four healthy players attending an under-19 and under-18 national musculoskeletal and fitness screening camp. Players had no history of surgery, no self-reported history of groin or pelvic pain in either limb and no other lower limb injury in the past 3 months, and no pain reported during the testing procedure. MAIN OUTCOME MEASURES: The AST in 3 positions of hip flexion (0, 45, and 90 degrees), position unit, and categorizations. RESULTS: The highest AST values were observed at 45 degrees of hip flexion in all field position categories. No differences were observed between position units and categorizations. CONCLUSIONS: Normative AST values in an elite junior rugby union population were established in this investigation. Clinically, the sports medicine professional may use these results in making decisions on the management of both symptomatic and asymptomatic players.

Neuromuscular electrical stimulation during recovery from exercise: a systematic review.

The use of subtetanic low-intensity neuromuscular electrical stimulation (NMES) for the purpose of promoting recovery from exercise has increased in recent years. The aim of this systematic review was to assess the effects of NMES on exercise recovery. A computerized database search of PubMed, CINAHL Plus, Sport Discus, and Cochrane Library electronic databases was conducted for the time period of January 1, 1970 to March 8, 2012. Only studies that used healthy uninjured humans and motor threshold electrical stimulation compared with at least one other recovery modality for the purpose of promoting recovery from exercise were eligible for selection. Thirteen studies satisfied the inclusion criteria and were included for analysis (11 randomized crossover trials, 1 randomized control trial [RCT], and 1 classified as other [OTH]). A quality assessment rating of the studies was performed using an extended version of The Cochrane Collaboration's tool for assessing risk of bias. Because of the heterogeneity of the study protocols, a qualitative review (best evidence synthesis) was performed for all outcomes, whereas the results for blood lactate (BLa) were also included in a meta-analysis. Eight studies were classified as high quality, 4 as medium quality, and 1 as low quality. Three studies found a positive outcome for a subjective measure of muscle pain, 3 for BLa, 1 for lowering creatine kinase, and only 1 for a performance parameter. The meta-analysis showed no evidence in favor of NMES vs. active (ACT) and mixed evidence vs. passive (PAS) recovery for BLa. In conclusion, although there may be some subjective benefits for postexercise recovery, evidence is not convincing to support NMES for enhancing subsequent performance.

Whole body oxygen uptake and evoked knee torque in response to low frequency electrical stimulation of the quadriceps muscles: V•O2 frequency response to NMES.

BACKGROUND: There is emerging evidence that isometric Neuromuscular Electrical Stimulation (NMES) may offer a way to elicit therapeutically significant increases in whole-body oxygen uptake in order to deliver aerobic exercise to patients unable to exercise volitionally, with consequent gains in cardiovascular health. The optimal stimulation frequency to elicit a significant and sustained pulmonary oxygen uptake has not been determined. The aim of this study was to examine the frequency response of the oxygen uptake and evoked torque due to NMES of the quadriceps muscles across a range of low frequencies spanning the twitch to tetanus transition. METHODS: Ten healthy male subjects underwent bilateral NMES of the quadriceps muscles comprising eight 4 minute bouts of intermittent stimulation at selected frequencies in the range 1 to 12 Hz, interspersed with 4 minutes rest periods. Respiratory gases and knee extensor torque were simultaneously monitored throughout. Multiple linear regression was used to fit the resulting data to an energetic model which expressed the energy rate in terms of the pulse frequency, the torque time integral and a factor representing the accumulated force developed per unit time. RESULTS: Additional oxygen uptake increased over the frequency range to a maximum of 564 (SD 114) ml min-1 at 12 Hz, and the respiratory exchange ratio was close to unity from 4 to 12 Hz. While the highest induced torque occurred at 12 Hz, the peak of the force development factor occurred at 6 Hz. The regression model accounted for 88% of the variability in the observed energetic response. CONCLUSIONS: Taking into account the requirement to avoid prolonged tetanic contractions and to minimize evoked torque, the results suggest that the ideal frequency for sustainable aerobic exercise is 4 to 5 Hz, which coincided in this study with the frequency above which significant twitch force summation occurred.

A comparison of cutting technique performance in rugby union players.

Rugby union is a dynamic running game requiring players to regularly perform change of direction maneuvers to avoid player opposition. The change of direction/cutting task is characterized by rapid deceleration onto the plant leg (PL) then reacceleration by the push-off leg (POL) into the new direction. Identification of the kinematic characteristics of cutting tasks and their relationship to playing ability may offer practical guidelines for coaches and strength and conditioning staff to design effective agility drills and provide player feedback to improve technique. Therefore, the purpose of this study was to investigate the kinematic and temporal characteristics of cutting tasks and their relationship to performance in rugby union players. Semiprofessional rugby union players from the All-Ireland League were placed in a Starters (N = 13) or Nonstarters (N = 10) group based on whether they were routinely selected in the starting team or were reserve 'bench' players. Each participant was fitted with reflective markers and performed 10 cutting trials (5 left, 5 right) of a single 45° cutting task to collect relevant kinematic data. The directions of the cutting trials were classified as a dominant or nondominant cut based on the participant's dominant leg. All trials were then analyzed to determine the timings, angular displacements, and velocities during key events of the PL and POL in the cutting task. The total time to complete the cutting task was not statistically significant between groups; however, Starters demonstrated significantly shorter contact time of the PL during dominant cuts and initiated knee extension of the POL faster than Nonstarters in dominant and nondominant cuts. This preliminary study demonstrates that components of the cutting task differed between groups and may provide an insight for strength and conditioning professionals to assess change of direction technique.

A valid field test protocol of linear speed and agility in rugby union.

Field testing is a key component to measure player performance in all sports, which provides coaches and strength and conditioning staff information to evaluate player performance and measure desired training effects. Therefore, the purpose of this study was to investigate the reliability and construct validity of a rugby union field test protocol based on analysis of the components of the game. Participants were placed in an Academy (n = 17) or Club (n = 11) group determined by current playing level. Trials of 10- and 30-m linear speed (LS), change of direction speed, and reactive agility speed were measured to evaluate the field test protocol's utility in distinguishing players of different playing abilities. Reliability analysis of each field test demonstrated stable values allowing this field test protocol to be used to compare between groups. Furthermore, the Academy players performed significantly (p < 0.05) faster compared to Club players in all LS and agility components. These results suggest that this field test protocol is appropriate to identify rugby union players of varying playing abilities allowing coaches and strength and fitness staff to measure a player's capability to execute critical aspects of the game and may have application in performance evaluation and talent identification. The results from this study suggest that this test battery is an appropriate measure in identifying the varying playing abilities of rugby union players. This enables coaches and fitness staff to assess a player's capability in executing critical aspects of the game and also may have application in performance evaluation and talent identification.

An investigation into the effects of a simulated effusion in healthy subjects on knee kinematics during jogging and running.

BACKGROUND: Knee joint effusion can lead to changes in the activation of surrounding musculature and result in delayed return to baseline daily and sporting activity following injury. However, the effects of an isolated knee joint effusion on control of movement during cyclical activities such as gait are poorly understood. METHODS: Knee angular displacement and velocity was measured during treadmill jogging (8 km h(-1)) and running (12 km h(-1)) in 12 healthy subjects before and after a simulated knee joint effusion. Two separate pre-effusion recordings were taken to account for test-retest variability in gait measurement techniques. FINDINGS: Subjects demonstrated a small yet significant decrease in peak knee flexion following heel strike at 8 km h(-1) as a result of the effusion (P<0.05). However, there were no significant effects seen at 12 km h(-1). INTERPRETATION: Previous work has suggested that knee joint movement during walking and jump landing is affected by an effusion. However, this work demonstrates that these effects are minimal during jogging and running. Our results suggest that it may be prudent to consider measurement variability in future studies of this nature.

Classification of deadlift biomechanics with wearable inertial measurement units.

The deadlift is a compound full-body exercise that is fundamental in resistance training, rehabilitation programs and powerlifting competitions. Accurate quantification of deadlift biomechanics is important to reduce the risk of injury and ensure training and rehabilitation goals are achieved. This study sought to develop and evaluate deadlift exercise technique classification systems utilising Inertial Measurement Units (IMUs), recording at 51.2Hz, worn on the lumbar spine, both thighs and both shanks. It also sought to compare classification quality when these IMUs are worn in combination and in isolation. Two datasets of IMU deadlift data were collected. Eighty participants first completed deadlifts with acceptable technique and 5 distinct, deliberately induced deviations from acceptable form. Fifty-five members of this group also completed a fatiguing protocol (3-Repition Maximum test) to enable the collection of natural deadlift deviations. For both datasets, universal and personalised random-forests classifiers were developed and evaluated. Personalised classifiers outperformed universal classifiers in accuracy, sensitivity and specificity in the binary classification of acceptable or aberrant technique and in the multi-label classification of specific deadlift deviations. Whilst recent research has favoured universal classifiers due to the reduced overhead in setting them up for new system users, this work demonstrates that such techniques may not be appropriate for classifying deadlift technique due to the poor accuracy achieved. However, personalised classifiers perform very well in assessing deadlift technique, even when using data derived from a single lumbar-worn IMU to detect specific naturally occurring technique mistakes.

Star Excursion Balance Test performance and application in elite junior rugby union players.

OBJECTIVES: To evaluate performance on selected reach directions of the Start Excursion Balance Test (SEBT) in an elite underage rugby union population, and determine if differences exist between the forward and back position units. This information may have implications for the application of this test in player injury prevention and management. DESIGN: Descriptive study. SETTING: Gymnasium at an elite junior rugby union screening camp. PARTICIPANTS: 102 healthy male elite rugby union players (age = 17.9 ± 1.1 years, height = 1.83 ± 0.07 m, body mass = 90.5 ± 11.3 kg). MAIN OUTCOME MEASURES: Participants were assessed on the Anterior (A), Posterior-medial (PM), and Posterior-lateral (PL) reach directions of the SEBT. RESULTS: Normative data for SEBT performance in the A, PM and PL reach directions were established for an elite junior rugby union population. No significant differences in dynamic postural stability were observed between the forward and back position units. CONCLUSIONS: This study provides normative SEBT data on an elite junior rugby union population, which enables clinicians to compare player dynamic postural stability and has implications for use in the prevention and management of player injuries.

A comparison between performance on selected directions of the star excursion balance test and the Y balance test.

CONTEXT: The Star Excursion Balance Test (SEBT) is a widely accepted method of assessing dynamic postural stability. The Y Balance Test (YBT) is a commercially available device for measuring balance that uses 3 (anterior, posteromedial, and posterolateral) of the 8 SEBT directions and has been advocated as a method for assessing dynamic balance. To date, no studies have compared reach performance in these tests in a healthy population. OBJECTIVE: To determine whether any differences exist between reach distance performance for the anterior, posteromedial, and posterolateral directions of the SEBT and the YBT. DESIGN: Descriptive laboratory study. SETTING: University motion analysis laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 20 healthy active male participants (age = 22.50 ± 3.05 years, height = 1.78 ± 0.82 m, weight = 79.48 ± 11.32 kg, body mass index = 24.96 ± 2.56 kg/m²). INTERVENTION(S): Participants carried out 3 trials in each reach direction on each leg on the SEBT and the YBT a minimum of 1 week apart. MAIN OUTCOME MEASURE(S): The means of the 3 trials in each direction on each leg on both tests were calculated. Data were collected after 4 practice trials in each direction. Paired t tests and Bland-Altman plots were used to compare reach distances between the SEBT and the YBT. RESULTS: Participants reached farther in the anterior direction on the SEBT than on the YBT. No differences were observed in the posteromedial and posterolateral directions. CONCLUSIONS: Differing postural-control strategies may be used to complete these tasks. This finding has implications for the implementation and interpretation of these dynamic balance tests.

Effect of subcutaneous fat thickness and surface electrode configuration during neuromuscular electrical stimulation.

The effect of subcutaneous fat thickness, electrode size and inter-electrode distance on the minimum stimulus current necessary for fiber excitation was examined in an attempt to improve the efficacy of neuromuscular electrical stimulation (NMES) in obese populations. A three-dimensional finite element model of the human thigh was developed and used to calculate the potential along a myelinated nerve fiber due to NMES. The activating function was used to examine alterations in the excitation of the fiber due to fat thickness, electrode size and inter-electrode distance. The finite element model was coupled to a neural model to examine the stimulus current required for action potential propagation. The stimulus current required to evoke 10% of the maximum M-wave amplitude was measured experimentally. Both experimental and modeling studies indicated that the stimulus current required to reach the threshold for muscle activation increased with fat thickness, electrode size, and inter-electrode distance. However, as fat thickness increased, the threshold for muscle activation became less sensitive to inter-electrode distance and electrode size. These results suggest that by using larger electrodes above regions of high subcutaneous fat thickness, the efficacy of NMES could be maintained while reducing the current density at the skin and the associated subject discomfort.

The effect of subcutaneous fat thickness on the efficacy of transcutaneous electrical stimulation.

Transcutaneous electrical stimulation is a widely used technique to relieve the symptoms of various neuromuscular disorders and to improve muscle strength. It is currently being investigated in the treatment of obesity to physically enable and encourage increased levels of voluntary exercise. Due to the high resistivity of subcutaneous fat tissue, higher stimulus currents are required to evoke muscle contraction in obese subjects than in subjects of a healthy weight, which can lead to patient discomfort. In this study, a three-dimensional finite element model of the human thigh, including skin, fat, muscle and bone, was developed to examine the relationship between fat thickness and evoked muscle activation. The effects of fat thickness, electrode size and inter-electrode distance on the activating function were investigated during monopolar and bipolar stimulation. The amplitude of the activating function was found to reduce as electrode size increased, however, this effect was relatively less at higher fat thicknesses. The activating function was also less sensitive to inter-electrode distance as fat thickness increased. These results indicate that by increasing electrode size, the current density at the skin surface can be reduced, thereby reducing patient discomfort while maintaining the efficacy of the electrical stimulation in obese patient populations.

What are the electrical stimulation design parameters for maximum VO2 aimed at cardio-pulmonary rehabilitation?

Electrical Stimulation (ES) is increasingly being considered as a means to improve cardio-pulmonary performance in patients with reduced exercise capacity. This short review considers the ES signal parameters and protocols used in studies that have included a measurement of oxygen uptake during the session. It suggests that the tetanic signal parameters normally used for muscle strengthening are not suitable for producing a sustained increase in oxygen uptake. Instead, very low frequencies are preferred, perhaps because there is less fatigue of the type 1 muscle fibers.