Collagen Gene Polymorphisms Previously Associated with Resistance to Soft-Tissue Injury Are More Common in Competitive Runners Than Nonathletes.

ABSTRACT: Dines, HR, Nixon, J, Lockey, SJ, Herbert, AJ, Kipps, C, Pedlar, CR, Day, SH, Heffernan, SM, Antrobus, MR, Brazier, J, Erskine, RM, Stebbings, GK, Hall, ECR, and Williams, AG. Collagen gene polymorphisms previously associated with resistance to soft-tissue injury are more common in competitive runners than nonathletes. J Strength Cond Res 37(4): 799-805, 2023-Single-nucleotide polymorphisms (SNPs) of collagen genes have been associated with soft-tissue injury and running performance. However, their combined contribution to running performance is unknown. We investigated the association of 2 collagen gene SNPs with athlete status and performance in 1,429 Caucasian subjects, including 597 competitive runners (354 men and 243 women) and 832 nonathletes (490 men and 342 women). Genotyping for COL1A1 rs1800012 (C > A) and COL5A1 rs12722 (C > T) SNPs was performed by a real-time polymerase chain reaction. The numbers of "injury-resistant" alleles from each SNP, based on previous literature (rs1800012 A allele and rs12722 C allele), were combined as an injury-resistance score (RScore, 0-4; higher scores indicate injury resistance). Genotype frequencies, individually and combined as an RScore, were compared between cohorts and investigated for associations with performance using official race times. Runners had 1.34 times greater odds of being rs12722 CC homozygotes than nonathletes (19.7% vs. 15.5%, p = 0.020) with no difference in the rs1800012 genotype distribution ( p = 0.659). Fewer runners had an RScore 0 of (18.5% vs. 24.7%) and more had an RScore of 4 (0.6% vs. 0.3%) than nonathletes ( p < 0.001). Competitive performance was not associated with the COL1A1 genotype ( p = 0.933), COL5A1 genotype ( p = 0.613), or RScore ( p = 0.477). Although not associated directly with running performance among competitive runners, a higher combined frequency of injury-resistant COL1A1 rs1800012 A and COL5A1 rs12722 C alleles in competitive runners than nonathletes suggests these SNPs may be advantageous through a mechanism that supports, but does not directly enhance, running performance.

Gene variants previously associated with reduced soft tissue injury risk: Part 1 - independent associations with elite status in rugby.

There is growing evidence of genetic contributions to tendon and ligament pathologies. Given the high incidence and severity of tendon and ligament injuries in elite rugby, we studied whether 13 gene polymorphisms previously associated with tendon/ligament injury were associated with elite athlete status. Participants from the RugbyGene project were 663 elite Caucasian male rugby athletes (RA) (mean (standard deviation) height 1.85 (0.07) m, mass 101 (12) kg, age 29 (7) yr), including 558 rugby union athletes (RU) and 105 rugby league athletes. Non-athletes (NA) were 909 Caucasian men and women (56% female; height 1.70 (0.10) m, mass 72 (13) kg, age 41 (23) yr). Genotypes were determined using TaqMan probes and groups compared using Χ2 and odds ratio (OR). COLGALT1 rs8090 AA genotype was more frequent in RA (27%) than NA (23%; P = 0.006). COL3A1 rs1800255 A allele was more frequent in RA (26%) than NA (23%) due to a greater frequency of GA genotype (39% vs 33%). For MIR608 rs4919510, RA had 1.7 times the odds of carrying the CC genotype compared to NA. MMP3 rs591058 TT genotype was less common in RA (25.1%) than NA (31.2%; P < 0.04). For NID1 rs4660148, RA had 1.6 times the odds of carrying the TT genotype compared to NA. It appears that elite rugby athletes have an inherited advantage that contributes to their elite status, possibly via resistance to soft tissue injury. These data may, in future, assist personalised management of injury risk amongst athletes.Highlights The elite rugby athletes we studied had differing genetic characteristics to non-athletes regarding genetic variants previously associated with soft-tissue injury risk.COLGALT1 rs8090, COL3A1 rs1800255, MIR608 rs4919510, MMP3 rs591058 and NID1 rs4660148 were all associated with elite status in rugby.We propose that elite rugby athletes might possess an inherited resistance to soft tissue injury, which has enabled them to achieve elite status despite exposure to the high-risk environment of elite rugby.

Concussion-Associated Gene Variant COMT rs4680 Is Associated With Elite Rugby Athlete Status.

OBJECTIVE: Concussions are common match injuries in elite rugby, and reports exist of reduced cognitive function and long-term health consequences that can interrupt or end a playing career and produce continued ill health. The aim of this study was to investigate the association between elite rugby status and 8 concussion-associated risk polymorphisms. We hypothesized that concussion-associated risk genotypes and alleles would be underrepresented in elite rugby athletes compared with nonathletes. DESIGN: A case-control genetic association study. SETTING: Institutional (university). PARTICIPANTS: Elite White male rugby athletes [n = 668, mean (SD) height 1.85 (0.07) m, mass 102 (12) kg, and age 29 (7) years] and 1015 nonathlete White men and women (48% men). INTERVENTIONS: Genotype was the independent variable, obtained by PCR of genomic DNA using TaqMan probes. MAIN OUTCOME MEASURE: Elite athlete status with groups compared using χ 2 and odds ratio (OR). RESULTS: The COMT rs4680 Met/Met (AA) genotype, Met allele possession, and Met allele frequency were lower in rugby athletes (24.8%, 74.6%, and 49.7%, respectively) than nonathletes (30.2%, 77.6%, and 54.0%; P < 0.05). The Val/Val (GG) genotype was more common in elite rugby athletes than nonathletes (OR 1.39, 95% confidence interval 1.04-1.86). No other polymorphism was associated with elite athlete status. CONCLUSIONS: Elite rugby athlete status is associated with COMT rs4680 genotype that, acting pleiotropically, could affect stress resilience and behavioral traits during competition, concussion risk, and/or recovery from concussion. Consequently, assessing COMT rs4680 genotype might aid future individualized management of concussion risk among athletes.

Gene variants previously associated with reduced soft-tissue injury risk: Part 2 - Polygenic associations with elite status in Rugby.

Part 1 of this genetic association series highlighted several genetic variants independently associated with elite status in rugby. However, it is highly likely that the genetic influence on elite status is polygenic due to the interaction of multiple genes. Therefore, the aim of the present study was to investigate whether polygenic profiles of elite rugby athletes differed from non-athletes utilising 13 genetic polymorphisms previously associated with tendon/ligament injury. Total genotype score (TGS) was calculated and multifactor dimensionality reduction (MDR) was used to calculate SNP-SNP epistasis interactions. Based on our elite rugby data from Part 1, mean TGS was significantly higher in elite rugby athletes (52.1 ± 10.7) than non-athletes (48.7 ± 10.8). There were more elite rugby athletes (54%) within the upper TGS quartile, and fewer (46%) within the lower quartile, compared to non-athletes (31% and 69%, respectively; P = 5·10-5), and the TGS was able to distinguish between elite rugby athletes and non-athletes (area under the curve = 0.59; 95% confidence interval 0.55-0.63; P = 9·10-7). Furthermore, MDR identified a three-SNP model of COL5A1 rs12722, COL5A1 rs3196378 and MIR608 rs4919510 that was best able to predict elite athlete status, with a greater frequency of the CC-CC-CC genotype combination in elite rugby athletes (9.8%) than non-athletes (5.3%). We propose that elite rugby athletes possess "preferable" musculoskeletal soft-tissue injury-associated polygenic profiles that have helped them achieve success in the high injury risk environment of rugby. These data may, in future, have implications for the individual management of musculoskeletal soft-tissue injury.HighlightsElite rugby athletes have preferable polygenic profiles to non-athletes in terms of genetic variants previously associated with musculoskeletal soft-tissue injury.The total genotype score was able to distinguish between elite rugby athletes and non-athletes.COL5A1 rs12722, COL5A1 rs3196378 and MIR608 rs4919510 produced the best model for predicting elite athlete status.We propose that elite rugby athletes may have an inherited advantage to achieving elite status due to an increased resistance to soft-tissue injury.

Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review.

Increasingly popular, ultra-endurance participation exposes athletes to extremely high levels of functional and structural damage. Ultra-endurance athletes commonly develop acute kidney injury (AKI) and other pathologies harmful to kidney health. There is strong evidence that non-steroidal anti-inflammatory drugs, common amongst ultra-athletes, is linked to increased risk and severity of AKI and potentially ischaemic renal injury, i.e., acute tubular necrosis. Ultra-endurance participation also increases the risk of exertional rhabdomyolysis, exercise-associated hyponatremia, and gastrointestinal symptoms, interlinked pathologies all with potential to increase the risk of AKI. Hydration and fuelling both also play a role with the development of multiple pathologies and ultimately AKI, highlighting the need for individualised nutritional and hydration plans to promote athlete health. Faster athletes, supplementing nitrates, and being female also increase the risk of developing AKI in this setting. Serum creatinine criteria do not provide the best indicator for AKI for ultra-athletes therefore further investigations are needed to assess the practicality and accuracy of new renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL). The potential of recurring episodes of AKI provide need for further research to assess the longitudinal renal health impact of ultra-participation to provide appropriate advice to athletes, coaches, medical staff, and event organisers.

Concussion-Associated Polygenic Profiles of Elite Male Rugby Athletes.

Due to the high-velocity collision-based nature of elite rugby league and union, the risk of sustaining a concussion is high. Occurrence of and outcomes following a concussion are probably affected by the interaction of multiple genes in a polygenic manner. This study investigated whether suspected concussion-associated polygenic profiles of elite rugby athletes differed from non-athletes and between rugby union forwards and backs. We hypothesised that a total genotype score (TGS) using eight concussion-associated polymorphisms would be higher in elite rugby athletes than non-athletes, indicating selection for protection against incurring or suffering prolonged effects of, concussion in the relatively high-risk environment of competitive rugby. In addition, multifactor dimensionality reduction was used to identify genetic interactions. Contrary to our hypothesis, TGS did not differ between elite rugby athletes and non-athletes (p ≥ 0.065), nor between rugby union forwards and backs (p = 0.668). Accordingly, the TGS could not discriminate between elite rugby athletes and non-athletes (AUC ~0.5), suggesting that, for the eight polymorphisms investigated, elite rugby athletes do not have a more 'preferable' concussion-associated polygenic profile than non-athletes. However, the COMT (rs4680) and MAPT (rs10445337) GC allele combination was more common in rugby athletes (31.7%; p < 0.001) and rugby union athletes (31.8%; p < 0.001) than non-athletes (24.5%). Our results thus suggest a genetic interaction between COMT (rs4680) and MAPT (rs10445337) assists rugby athletes in achieving elite status. These findings need exploration vis-à-vis sport-related concussion injury data and could have implications for the management of inter-individual differences in concussion risk.

Nutritional and Non-Nutritional Strategies in Bodybuilding: Impact on Kidney Function.

Bodybuilders routinely engage in many dietary and other practices purported to be harmful to kidney health. The development of acute kidney injury, focal segmental glomerular sclerosis (FSGS) and nephrocalcinosis may be particular risks. There is little evidence that high-protein diets and moderate creatine supplementation pose risks to individuals with normal kidney function though long-term high protein intake in those with underlying impairment of kidney function is inadvisable. The links between anabolic androgenic steroid use and FSGS are stronger, and there are undoubted dangers of nephrocalcinosis in those taking high doses of vitamins A, D and E. Dehydrating practices, including diuretic misuse, and NSAID use also carry potential risks. It is difficult to predict the effects of multiple practices carried out in concert. Investigations into subclinical kidney damage associated with these practices have rarely been undertaken. Future research is warranted to identify the clinical and subclinical harm associated with individual practices and combinations to enable appropriate and timely advice.

The Association Between Interlimb Asymmetry and Athletic Performance Tasks: A Season-Long Study in Elite Academy Soccer Players.

ABSTRACT: Bishop, C, Read, P, Bromley, T, Brazier, J, Jarvis, P, Chavda, S, and Turner, A. The association between interlimb asymmetry and athletic performance tasks: A season-long study in elite academy soccer players. J Strength Cond Res 36(3): 787-795, 2022-The aims of this study were to determine the association between asymmetry and measures of speed and change of direction speed (CODS) performance throughout a competitive soccer season and, determine whether any observed changes in asymmetry were associated with changes in speed and CODS performance. Eighteen elite male under-23 academy soccer players performed unilateral countermovement jumps, unilateral drop jumps (DJ), 10- and 30-m sprints, and 505 CODS tests at pre, mid, and end of season. No significant relationships were evident during preseason or midseason between asymmetry and speed or CODS performance. Significant correlations were shown at the end of season between DJ height asymmetry and 10-m sprint time (ρ = 0.62; p = 0.006) and 505 time on the right limb (ρ = 0.65; p = 0.003). No significant correlations between changes in asymmetry and changes in speed or CODS were evident at any time point. Although numerous studies have reported associations between asymmetry and reduced athletic performance, it seems that these associations with speed and CODS do not track consistently over time. Thus, suggestions for the reduction of asymmetry that may indirectly enhance athletic performance cannot be made.

Magnitude or Direction? Seasonal Variation of Interlimb Asymmetry in Elite Academy Soccer Players.

ABSTRACT: Bishop, C, Read, P, Chavda, S, Jarvis, P, Brazier, J, Bromley, T, and Turner, A. Magnitude or direction? Seasonal variation of interlimb asymmetry in elite academy soccer players. J Strength Cond Res 36(4): 1031-1037, 2022-Previous research has highlighted a distinct lack of longitudinal data for asymmetry. The aims of this study were to provide seasonal variation data for the magnitude and direction of asymmetry. Eighteen elite male academy soccer players (under-23) performed unilateral countermovement jumps (CMJs) and unilateral drop jumps (DJs) during pre-season, mid-season, and end of season time points. Recorded metrics for asymmetry included jump height and concentric impulse for the CMJ, and jump height and reactive strength index for the DJ. The magnitude of asymmetry showed trivial to small changes throughout the season (CMJ effect size [ES] range = -0.43 to 0.05; DJ ES range = -0.18 to 0.41). However, Kappa coefficients showed poor to substantial levels of agreement for the direction of asymmetry during the CMJ (Kappa = -0.06 to 0.77) and DJ (Kappa = -0.10 to 0.78) throughout the season. These data show that when monitoring asymmetry, the magnitude alone may provide a false impression of consistent scores over time. By contrast, monitoring the direction of asymmetry highlights its task and variable nature and is suggested as a useful tool for practitioners who wish to monitor asymmetry over the course of a competitive soccer season.

Seasonal Variation of Physical Performance and Inter-limb Asymmetry in Professional Cricket Athletes.

ABSTRACT: Bishop, C, Weldon, A, Hughes, J, Brazier, J, Loturco, I, Turner, A, and Read, P. Seasonal variation of physical performance and interlimb asymmetry in professional cricket athletes. J Strength Cond Res 35(4): 941-948, 2021-The aims of this study were to: (a) determine the seasonal variation of physical performance in professional cricket players and (b) determine the seasonal variation of interlimb asymmetries in the same cohort of professional players. Fifteen male professional cricket players (age: 20.60 ± 1.59 years; height: 1.82 ± 0.08 m; and body mass: 78.70 ± 11.23 kg) performed unilateral countermovement jumps (CMJs), unilateral drop jumps, 10 m sprints and 505 change of direction (COD) speed tests at pre (March), mid (June), and end (September) of the 2018 season. Interlimb asymmetry was quantified in the unilateral CMJ (jump height and concentric impulse), unilateral drop jump (jump height and reactive strength index [RSI]), and 505 (total time and COD deficit). Significant changes (p < 0.05) were evident for the following tests: unilateral CMJ (effect size [ES] range = 0.67-1.00), 505 on the right leg (ES = 0.70), 10 m (ES range = -1.39 to 0.70), and COD deficit (ES range = 0.70-0.80), with the largest changes evident for 10-m sprint. No significant differences were evident in drop jump performance throughout the season. For the magnitude of asymmetry, significant changes in jump height asymmetry from the unilateral CMJ were evident from mid to end of season (ES = 0.72). For the direction of asymmetry, levels of agreement ranged from poor to substantial in the unilateral CMJ (kappa = -0.21 to 0.72), fair to substantial in the unilateral drop jump (kappa range = 0.33 to 0.74), and slight to moderate during the 505 test (kappa range = 0.06 to 0.44), with RSI showing noticeably better results than other tests or metrics. These data show that the largest changes in performance scores throughout the season came from the 10-m test, which practitioners may wish to consider implementing if not doing so already. Furthermore, both unilateral jump tests showed their use for asymmetry interpretation, which practitioners may wish to consider implementing in to their test batteries. Specifically, jump height asymmetry during the unilateral CMJ was the only metric to exhibit meaningful changes between time points, whereas RSI was the metric that exhibited more consistent limb dominance characteristics for the direction of asymmetry.

Genetic Factors That Could Affect Concussion Risk in Elite Rugby.

Elite rugby league and union have some of the highest reported rates of concussion (mild traumatic brain injury) in professional sport due in part to their full-contact high-velocity collision-based nature. Currently, concussions are the most commonly reported match injury during the tackle for both the ball carrier and the tackler (8-28 concussions per 1000 player match hours) and reports exist of reduced cognitive function and long-term health consequences that can end a playing career and produce continued ill health. Concussion is a complex phenotype, influenced by environmental factors and an individual's genetic predisposition. This article reviews concussion incidence within elite rugby and addresses the biomechanics and pathophysiology of concussion and how genetic predisposition may influence incidence, severity and outcome. Associations have been reported between a variety of genetic variants and traumatic brain injury. However, little effort has been devoted to the study of genetic associations with concussion within elite rugby players. Due to a growing understanding of the molecular characteristics underpinning the pathophysiology of concussion, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose from this review that several genetic variants within or near candidate genes of interest, namely APOE, MAPT, IL6R, COMT, SLC6A4, 5-HTTLPR, DRD2, DRD4, ANKK1, BDNF and GRIN2A, warrant further study within elite rugby and other sports involving high-velocity collisions.

Effects of Interlimb Asymmetries on Acceleration and Change of Direction Speed: A Between-Sport Comparison of Professional Soccer and Cricket Athletes.

ABSTRACT: Bishop, C, Read, P, Brazier, J, Jarvis, P, Chavda, S, Bromley, T, and Turner, A. Effects of interlimb asymmetries on acceleration and change of direction speed: a between-sport comparison of professional soccer and cricket athletes. J Strength Cond Res 35(8): 2095-2101, 2021-The first aim of this study was to quantify and compare asymmetries among professional soccer and cricket athletes. The second aim was to examine the association between asymmetries and performance within both groups. Professional soccer (n = 18) and cricket (n = 23) athletes performed single-leg countermovement jumps, single-leg drop jumps (SLDJs), a 10-m sprint, and 505 change of direction speed (CODS) tests. Interlimb asymmetries were calculated as a standard percentage difference, Mann-Whitney U tests conducted to establish systematic bias between groups, and Spearman's r correlations used to establish the relationship between asymmetry scores and speed and CODS performance. Soccer athletes sprinted faster, jumped higher, and had a greater reactive strength index (RSI) score than cricket athletes (p < 0.05). However, cricketers showed reduced ground contact times compared with footballers during the SLDJ (p < 0.05). The cricket group showed significantly greater jump height (asymmetry = 11.49 vs. 6.51%; p = 0.015) and RSI (asymmetry = 10.37 vs. 5.95%; p = 0.014) asymmetries compared with soccer players. These metrics were also associated with slower 505 times in the cricket group only (r = 0.56 -0.74; p < 0.01). These results show that between-limb asymmetries exhibit no association with speed and CODS in elite soccer players but are associated with reduced CODS in elite cricketers. Thus, the reduction of interlimb asymmetries may be of greater consideration when working with cricket vs. soccer athletes.

Jumping-based Asymmetries are Negatively Associated with Jump, Change of Direction, and Repeated Sprint Performance, but not Linear Speed, in Adolescent Handball Athletes.

The aim of the present study was to determine the association of multi-directional jumping asymmetries with measures of physical performance. Forty-two youth handball athletes (age: 16.0 ± 1.3 years; body height: 174.11 ± 7.3 cm; body mass: 70.49 ± 13.3 kg) performed a mid-season fitness test battery consisting of single leg countermovement, lateral and broad jump tests, two change of direction speed (CODS) tests, an 8 x 10 m repeated sprint test, and a 20 m sprint. The Kappa coefficient showed only 'slight' levels of agreement (K range = -0.05 to 0.15), indicating that asymmetries rarely favoured the same side during each of the jump tests. The single leg countermovement jump showed significantly (p = 0.006) larger asymmetries (11.2 ± 8.4) than the broad jump (6.4 ± 4.6) and significant correlations were present between jumping asymmetries and jump (r = -0.32 to -0.52), CODS (r = 0.31 to 0.32) and repeated sprint (r = 0.35 to 0.40) performance. The findings of the present study highlight the independent nature of jumping asymmetries and associations with measures of physical performance. Practitioners are encouraged to use multiple tests to detect existing side differences and consider appropriate training interventions for the reduction of inter-limb asymmetries.

Anthropometric and Physiological Characteristics of Elite Male Rugby Athletes.

Brazier, J, Antrobus, M, Stebbings, GK, Day, SH, Callus, P, Erskine, RM, Bennett, MA, Kilduff, LP, and Williams, AG. Anthropometric and physiological characteristics of elite male rugby athletes. J Strength Cond Res 34(6): 1790-1801, 2020-This is the first article to review the anthropometric and physiological characteristics required for elite rugby performance within both rugby union (RU) and rugby league (RL). Anthropometric characteristics such as height and body mass, and physiological characteristics such as speed and muscular strength, have previously been advocated as key discriminators of playing level within rugby. This review aimed to identify the key anthropometric and physiological properties required for elite performance in rugby, distinguishing between RU and RL, forwards and backs and competitive levels. There are differences between competitive standards such that, at the elite level, athletes are heaviest (RU forwards ∼111 kg, backs ∼93 kg; RL forwards ∼103 kg, backs ∼90 kg) with lowest % body fat (RU forwards ∼15%, backs ∼12%; RL forwards ∼14%, backs ∼11%), they have most fat-free mass and are strongest (back squat: RU forwards ∼176 kg, backs ∼157 kg; RL forwards ∼188 kg, backs ∼168 kg; bench press: RU forwards ∼131 kg, backs ∼118 kg; RL forwards ∼122 kg, backs ∼113 kg) and fastest (10 m: RU forwards ∼1.87 seconds, backs ∼1.77 seconds; 10 m: RL forwards ∼1.9 seconds, backs ∼1.83 seconds). We also have unpublished data that indicate contemporary RU athletes have less body fat and are stronger and faster than the published data suggest. Regardless, well-developed speed, agility, lower-body power, and strength characteristics are vital for elite performance, probably reflect both environmental (training, diet, etc.) and genetic factors, distinguish between competitive levels, and are therefore important determinants of elite status in rugby.

Tendon and Ligament Injuries in Elite Rugby: The Potential Genetic Influence.

This article reviews tendon and ligament injury incidence and severity within elite rugby union and rugby league. Furthermore, it discusses the biological makeup of tendons and ligaments and how genetic variation may influence this and predisposition to injury. Elite rugby has one of the highest reported injury incidences of any professional sport. This is likely due to a combination of well-established injury surveillance systems and the characteristics of the game, whereby high-impact body contact frequently occurs, in addition to the high intensity, multispeed and multidirectional nature of play. Some of the most severe of all these injuries are tendon and ligament/joint (non-bone), and therefore, potentially the most debilitating to a player and playing squad across a season or World Cup competition. The aetiology of these injuries is highly multi-factorial, with a growing body of evidence suggesting that some of the inter-individual variability in injury susceptibility may be due to genetic variation. However, little effort has been devoted to the study of genetic injury traits within rugby athletes. Due to a growing understanding of the molecular characteristics underpinning the aetiology of injury, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose several single nucleotide polymorphisms within candidate genes of interest; COL1A1, COL3A1, COL5A1, MIR608, MMP3, TIMP2, VEGFA, NID1 and COLGALT1 warrant further study within elite rugby and other invasion sports.

Lower Extremity Stiffness: Considerations for Testing, Performance Enhancement, and Injury Risk.

Brazier, J, Maloney, S, Bishop, C, Read, PJ, and Turner, AN. Lower extremity stiffness: considerations for testing, performance enhancement, and injury risk. J Strength Cond Res 33(4): 1156-1166, 2019-Force-deformation characteristics of the lower limb have been associated with athletic performance and may modulate the risk of injury. Despite these known associations, measurements of lower extremity stiffness are not commonly administered by strength and conditioning coaches. This review provides an overview of the available literature pertaining to the effects of lower extremity stiffness on physical performance and injury risk. Practical methods of monitoring and training stiffness are also discussed. The cumulative body of evidence indicates that increases in lower extremity stiffness are associated with heightened performance in athletic tasks such as hopping, jumping, throwing, endurance running, sprinting, and changing direction. Relationships with injury are less conclusive because both excessive and insufficient limb stiffness have been postulated to increase risk. Thus, the "optimal" level of stiffness seems to be dependent on the anthropometry and physical capabilities of the athlete, in addition to sport-specific activity demands. Training interventions can positively enhance lower extremity stiffness, including isometric, eccentric, and isotonic strength training and plyometrics. Complex training also seems to provide a potent stimulus and may be more effective than the use of singular training modes. For plyometric activities, it is recommended that coaches use a developmental sequence of exercises with increasing eccentric demand to provide an appropriate stimulus based on the training age and technical competency of the athlete.

The validity and reliability of the My Jump 2 app for measuring the reactive strength index and drop jump performance.

BACKGROUND: This is the first study to independently assess the concurrent validity and reliability of the My Jump 2 app for measuring drop jump performance. It is also the first to evaluate the app's ability to measure the reactive strength index (RSI). METHODS: Fourteen male sport science students (age: 29.5±9.9 years) performed three drop jumps from 20 cm and 40 cm (totaling 84 jumps), assessed via a force platform and the My Jump 2 app. Reported metrics included reactive strength index, jump height, ground contact time, and mean power. Measurements from both devices were compared using the intraclass correlation coefficient (ICC), Pearson product moment correlation coefficient (r), Cronbach's alpha (α), coefficient of variation (CV) and Bland-Altman plots. RESULTS: Near perfect agreement was seen between devices at 20 cm for RSI (ICC=0.95) and contact time (ICC=0.99) and at 40 cm for RSI (ICC=0.98), jump height (ICC=0.96) and contact time (ICC=0.92); with very strong agreement seen at 20 cm for jump height (ICC=0.80). In comparison with the force plate the app showed good validity for RSI (20 cm: r=0.94; 40 cm; r=0.97), jump height (20 cm: r=0.80; 40 cm; r=0.96) and contact time (20 cm=0.96; 40 cm; r=0.98). CONCLUSIONS: The results of the present study show that the My Jump 2 app is a valid and reliable tool for assessing drop jump performance.

Physical Characteristics Underpinning Lunging and Change of Direction Speed in Fencing.

Turner, A, Bishop, C, Chavda, S, Edwards, M, Brazier, J, Kilduff, LP. Physical characteristics underpinning lunging and change of direction speed in fencing. J Strength Cond Res 30(8): 2235-2241, 2016-Lunge velocity (LV) and change of direction speed (CODS) are considered fundamental to success during fencing competitions; investigating the physical characteristics that underpin these is the aim of this study. Seventy fencers from the British Fencing National Academy took part and on average (±SD) were 16.83 ± 1.72 years of age, 178.13 ± 8.91 cm tall, 68.20 ± 9.64 kg in mass, and had 6.25 ± 2.23 years fencing experience. The relationship between anthropometric characteristics (height, arm span, and adductor flexibility) and measures of lower-body power (bilateral and unilateral countermovement jump height and reactive strength index) were examined in their ability to influence LV and CODS. In testing the former, fencers lunged (over a self-selected distance) to and from a force plate, where front leg impact and rear leg propulsive force were quantified; the lunging distance was divided by time to establish LV. Change of direction speed was measured over 12 m involving shuttles of between 2 and 4 m. Results revealed that LV and CODS averaged at 3.35 m·s and 5.45 seconds, respectively, and in both cases, standing broad jump was the strongest predictor (r = 0.51 and -0.65, respectively) of performance. Rear leg drive and front leg impact force averaged at 14.61 N·kg and 3 times body weight, respectively, with single leg jumps revealing an asymmetry favoring the front leg of 9 ± 8%. In conclusion, fencers should train lower-body power emphasizing horizontal displacement, noting that this seems to offset any advantage one would expect fencers of a taller stature to have. Also, the commonly reported asymmetry between legs is apparent from adolescence and thus also requires some attention.

Clostridium difficile infection among immunocompromised patients in Rio de Janeiro, Brazil and detection of moxifloxacin resistance in a ribotype 014 strain.

Clostridium difficile is a Gram-positive spore forming anaerobic bacterium, often associated with nosocomial diarrhea and pseudomembranous colitis. The acquisition of this organism occurs primarily in hospitals through accidental ingestion of spores, and its establishment and proliferation in the colon results from the removal of members of the normal intestinal flora during or after antibiotic therapy. In this study, stool samples from patients admitted to the University Hospital Clementino Fraga Filho (HUCCF/UFRJ) were screened for C. difficile toxins with an ELISA test and cultured with standard techniques for C. difficile isolation. A total of 74 stool samples were collected from patients undergoing antibiotic therapy between August 2009 and November 2010, only two (2.7%) were positive in the ELISA test and culture. A third isolate was obtained from a negative ELISA test sample. All cases of CDI were identified in patients with acute lymphoid or myeloid leukemia. Genotypic and phenotypic characterization showed that all strains carried toxins A and B genes, and belonged to PCR-ribotypes 014, 043 and 046. The isolated strains were sensitive to metronidazole and vancomycin, and resistant to ciprofloxacin and levofloxacin. Resistance to moxifloxacin, was present in the strain from PCR-ribotype 014, that showed an amino acid substitution in gyrB gene (Asp 426 â†’ Asn). This is the first time that this mutation in a PCR-ribotype 014 strain has been described in Brazil.