Strain-mode-specific mechanical testing and the interpretation of bone adaptation in the deer calcaneus.

The artiodactyl (deer and sheep) calcaneus is a model that helps in understanding how many bones achieve anatomical optimization and functional adaptation. We consider how the dorsal and plantar cortices of these bones are optimized in quasi-isolation (the conventional view) versus in the context of load sharing along the calcaneal shaft by "tension members" (the plantar ligament and superficial digital flexor tendon). This load-sharing concept replaces the conventional view, as we have argued in a recent publication that employs an advanced analytical model of habitual loading and fracture risk factors of the deer calcaneus. Like deer and sheep calcanei, many mammalian limb bones also experience prevalent bending, which seems problematic because the bone is weaker and less fatigue-resistant in tension than compression. To understand how bones adapt to bending loads and counteract deleterious consequences of tension, it is important to examine both strain-mode-specific (S-M-S) testing (compression testing of bone habitually loaded in compression; tension testing of bone habitually loaded in tension) and non-S-M-S testing. Mechanical testing was performed on individually machined specimens from the dorsal "compression cortex" and plantar "tension cortex" of adult deer calcanei and were independently tested to failure in one of these two strain modes. We hypothesized that the mechanical properties of each cortex region would be optimized for its habitual strain mode when these regions are considered independently. Consistent with this hypothesis, energy absorption parameters were approximately three times greater in S-M-S compression testing in the dorsal/compression cortex when compared to non-S-M-S tension testing of the dorsal cortex. However, inconsistent with this hypothesis, S-M-S tension testing of the plantar/tension cortex did not show greater energy absorption compared to non-S-M-S compression testing of the plantar cortex. When compared to the dorsal cortex, the plantar cortex only had a higher elastic modulus (in S-M-S testing of both regions). Therefore, the greater strength and capacity for energy absorption of the dorsal cortex might "protect" the weaker plantar cortex during functional loading. However, this conventional interpretation (i.e., considering adaptation of each cortex in isolation) is rejected when critically considering the load-sharing influences of the ligament and tendon that course along the plantar cortex. This important finding/interpretation has general implications for a better understanding of how other similarly loaded bones achieve anatomical optimization and functional adaptation.

Roles of collagen cross-links and osteon collagen/lamellar morphotypes in equine third metacarpals in tension and compression tests.

Many bones experience bending, placing one side in net compression and the other in net tension. Because bone mechanical properties are relatively reduced in tension compared with compression, adaptations are needed to reduce fracture risk. Several toughening mechanisms exist in bone, yet little is known of the influences of secondary osteon collagen/lamellar 'morphotypes' and potential interplay with intermolecular collagen cross-links (CCLs) in prevalent/predominant tension- and compression-loaded regions. Paired third metacarpals (MC3s) from 10 adult horses were prepared for mechanical testing. From one MC3/pair, 5 mm cubes were tested in compression at several mid-shaft locations. From contralateral bones, dumbbell-shaped specimens were tested in tension. Hence, habitual/natural tension- and compression-loaded regions were tested in both modes. Data included: elastic modulus, yield and ultimate strength, and energy absorption (toughness). Fragments of tested specimens were examined for predominant collagen fiber orientation (CFO; representing osteonal and non-osteonal bone), osteon morphotype score (MTS, representing osteonal CFO), mineralization, porosity and other histological characteristics. As a consequence of insufficient material from tension-tested specimens, CCLs were only examined in compression-tested specimens (HP, hydroxylysylpyridinoline; LP, lysylpyridinoline; PE, pentosidine). Among CCLs, only LP and HP/LP correlated significantly with mechanical parameters: LP with energy absorption, HP/LP with elastic modulus (both r=0.4). HP/LP showed a trend with energy absorption (r=-0.3, P=0.08). HP/LP more strongly correlated with osteon density and mineralization than CFO or MTS. Predominant CFO more strongly correlated with energy absorption than MTS in both testing modes. In general, CFO was found to be relatively prominent in affecting regional toughness in these equine MC3s in compression and tension.

Validity and Reliability of Force-Time Characteristics Using a Portable Load Cell for the Isometric Midthigh Pull.

ABSTRACT: Pichardo, AW, Neville, J, Tinwala, F, Cronin, JB, and Brown, SR. Validity and reliability of force-time characteristics using a portable load cell for the isometric midthigh pull. J Strength Cond Res 38(1): 185-191, 2024-Many practitioners use the isometric midthigh pull (IMTP) to assess maximal strength in a safe, time-effective manner. However, expensive, stationary force plates are not always practical in a large team setting. Therefore, the purpose of this study was to establish the validity and between-session reliability of peak force, rate of force development (RFD), and impulse during an IMTP using 2 experimental protocols: a traditional fixed bar with a force plate (BarFP) and a flexible chain measured with a force plate (ChainFP) and a load cell (ChainLC). After a familiarization session, 13 resistance-trained men performed 3 trials of the BarFP condition and 3 trials of the chain-based conditions. The identical procedures were replicated twice more, with a week between each testing session. The main findings were (a) no RFD or impulse measures were found to achieve acceptable reliability across all methodological approaches and testing occasions; (b) peak force was reliable across all methods, with coefficient of variation ranging from 4.6 to 8.3%, intraclass correlation coefficient ranging from 0.94 to 0.98, and the least variability associated with the ChainLC condition; and (c) the ChainFP method was found to significantly underrepresent peak force by 4.8% (p < 0.05), with no significant differences between the ChainLC and BarFP methods. Therefore, the ChainLC would seem a valid, reliable, portable, and cost-effective alternative to force plates when assessing maximal isometric strength in the IMTP.

Exploration of the synergistic role of cortical thickness asymmetry ("Trabecular Eccentricity" concept) in reducing fracture risk in the human femoral neck and a control bone (Artiodactyl Calcaneus).

The mechanobiology of the human femoral neck is a focus of research for many reasons including studies that aim to curb age-related bone loss that contributes to a near-exponential rate of hip fractures. Many believe that the femoral neck is often loaded in rather simple bending, which causes net tension stress in the upper (superior) femoral neck and net compression stress in its inferior aspect ("T/C paradigm"). This T/C loading regime lacks in vivo proof. The "C/C paradigm" is a plausible alternative simplified load history that is characterized by a gradient of net compression across the entire femoral neck; action of the gluteus medius and external rotators of the hip are important in this context. It is unclear which paradigm is at play in natural loading due to lack of in vivo bone strain data and deficiencies in understanding mechanisms and manifestations of bone adaptation in tension vs. compression. For these reasons, studies of the femoral neck would benefit from being compared to a 'control bone' that has been proven, by strain data, to be habitually loaded in bending. The artiodactyl (sheep and deer) calcaneus model has been shown to be a very suitable control in this context. However, the application of this control in understanding the load history of the femoral neck has only been attempted in two prior studies, which did not examine the interplay between cortical and trabecular bone, or potential load-sharing influences of tendons and ligaments. Our first goal is to compare fracture risk factors of the femoral neck in both paradigms. Our second goal is to compare and contrast the deer calcaneus to the human femoral neck in terms of fracture risk factors in the T/C paradigm (the C/C paradigm is not applicable in the artiodactyl calcaneus due to its highly constrained loading). Our third goal explores interplay between dorsal/compression and plantar/tension regions of the deer calcaneus and the load-sharing roles of a nearby ligament and tendon, with insights for translation to the femoral neck. These goals were achieved by employing the analytical model of Fox and Keaveny (J. Theoretical Biology 2001, 2003) that estimates fracture risk factors of the femoral neck. This model focuses on biomechanical advantages of the asymmetric distribution of cortical bone in the direction of habitual loading. The cortical thickness asymmetry of the femoral neck (thin superior cortex, thick inferior cortex) reflects the superior-inferior placement of trabecular bone (i.e., "trabecular eccentricity," TE). TE helps the femoral neck adapt to typical stresses and strains through load-sharing between superior and inferior cortices. Our goals were evaluated in the context of TE. Results showed the C/C paradigm has lower risk factors for the superior cortex and for the overall femoral neck, which is clinically relevant. TE analyses of the deer calcaneus revealed important synergism in load-sharing between the plantar/tension cortex and adjacent ligament/tendon, which challenges conventional understanding of how this control bone achieves functional adaptation. Comparisons with the control bone also exposed important deficiencies in current understanding of human femoral neck loading and its potential histocompositional adaptations.

Experimental asynchrony to study self-inflicted lung injury.

Patient self-inflicted lung injury may be associated with worse clinical outcomes and higher mortality. Patient-ventilator asynchrony is associated with increased ventilator days and mortality, and it has been hypothesised as one of the important mechanisms leading to patient self-inflicted lung injury. However, given the observational nature of the key studies in the field so far, the hypothesis that patient-ventilator asynchrony causes patient self-inflicted lung injury has not been supported by evidence yet. Wittenstein and colleagues present a novel approach that enables controlling patient-ventilator asynchrony in a pig model of acute lung injury, to investigate the patient-ventilator asynchrony and patient self-inflicted lung injury causality. Their results suggest that increased patient-ventilator asynchrony associated with poor clinical outcomes reported in observational trials could be a marker, rather than a cause of patient self-inflicted lung injury. These findings on their own are not sufficient to justify a greater tolerance of patient-ventilator asynchrony amongst clinicians, a change for which further experimental work and clinical evidence is needed.

Lower-limb wearable resistance overloads joint angular velocity during early acceleration sprint running.

Lower-limb wearable resistance (WR) facilitates targeted resistance-based training during sports-specific movement tasks. The purpose of this study was to determine the effect of two different WR placements (thigh and shank) on joint kinematics during the acceleration phase of sprint running. Eighteen participants completed maximal effort sprints while unloaded and with 2% body mass thigh- or shank-placed WR. The main findings were as follows: 1) the increase to 10 m sprint time was small with thigh WR (effect size [ES] = 0.24), and with shank WR, the increase was also small but significant (ES = 0.33); 2) significant differences in peak joint angles between the unloaded and WR conditions were small (ES = 0.23-0.38), limited to the hip and knee joints, and <2° on average; 3) aside from peak hip flexion angles, no clear trends were observed in individual difference scores; and, 4) thigh and shank WR produced similar reductions in average hip flexion and extension angular velocities. The significant overload to hip flexion and extension velocity with both thigh- and shank-placed WR may be beneficial to target the flexion and extension actions associated with fast sprint running.

Intersession Variability of Knee Extension Kinetics Using a Strain Gauge Device With Differing Clinically Practical Physical Constraints.

CONTEXT: Intrasession reliabilities of isometric knee extension kinetics via portable strain gauge have been reported across several knee joint angles and constraints. However, intersession variabilities, which are more valuable, have yet to be determined. Therefore, we aimed to quantify the intersession variability of knee extension kinetics over 3 testing sessions using an affordable and portable strain gauge. DESIGN: Participants performed maximum voluntary isometric contractions of the knee extensors over 3 sessions. METHODS: Eleven (6 men and 5 women; 31 [6.4] y) volunteers performed maximum voluntary isometric contractions in constrained (isokinetic setup with thigh and chest straps) and unconstrained (treatment plinth) conditions. Peak force (PF), peak rate of force development, rate of force development (RFD), and impulse (IMP) from 20% to 80% of PF were assessed. Means, SDs, percentage changes, minimal detectable changes, coefficients of variation (CV), and intraclass correlation coefficients (ICC) were calculated and reported. RESULTS: PF had the lowest intersession variability regardless of condition (CV = 5.5%-13.8%, ICC = .67-.93). However, variability of peak rate of force development (CV [range] = 12.2%-24.7%, ICC = .50-.78), RFD (CV = 10.0%-26.8%, ICC = .48-.84), and IMP (CV = 15.2%-35.4%, ICC = .44-.88) was moderate at best. The constrained condition (CV [SD] = 14.1% [4.8%], ICC = .74 [.08]) had lower variability compared with the plinth (CV = 19.8% [7.9%], ICC = .68 [.15]). Variability improved from sessions 1 to 2 (CV = 20.4% [7.7%], ICC = .64 [.14]) and to sessions 2 to 3 (CV = 15.3% [6.4%], ICC = .76 [.10]). CONCLUSIONS: PF can be assessed regardless of setup. However, RFD and IMP changes across sessions should be approached with caution. Backrests and thigh straps improve RFD and IMP variability, and at least 1 familiarization session should be provided before relying on knee-extensor kinetics while utilizing a portable strain gauge.

Mechanical ventilation in COVID-19: A physiological perspective.

NEW FINDINGS: What is the topic of this review? This review presents the fundamental concepts of respiratory physiology and pathophysiology, with particular reference to lung mechanics and the pulmonary phenotype associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent coronavirus disease 2019 (COVID-19) pneumonia. What advances does it highlight? The review provides a critical summary of the main physiological aspects to be considered for safe and effective mechanical ventilation in patients with severe COVID-19 in the intensive care unit. ABSTRACT: Severe respiratory failure from coronavirus disease 2019 (COVID-19) pneumonia not responding to non-invasive respiratory support requires mechanical ventilation. Although ventilation can be a life-saving therapy, it can cause further lung injury if airway pressure and flow and their timing are not tailored to the respiratory system mechanics of the individual patient. The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to a pattern of lung injury in patients with severe COVID-19 pneumonia typically associated with two distinct phenotypes, along a temporal and pathophysiological continuum, characterized by different levels of elastance, ventilation-to-perfusion ratio, right-to-left shunt, lung weight and recruitability. Understanding the underlying pathophysiology, duration of symptoms, radiological characteristics and lung mechanics at the individual patient level is crucial for the appropriate choice of mechanical ventilation settings to optimize gas exchange and prevent further lung injury. By critical analysis of the literature, we propose fundamental physiological and mechanical criteria for the selection of ventilation settings for COVID-19 patients in intensive care units. In particular, the choice of tidal volume should be based on obtaining a driving pressure < 14 cmH2 O, ensuring the avoidance of hypoventilation in patients with preserved compliance and of excessive strain in patients with smaller lung volumes and lower lung compliance. The level of positive end-expiratory pressure (PEEP) should be informed by the measurement of the potential for lung recruitability, where patients with greater recruitability potential may benefit from higher PEEP levels. Prone positioning is often beneficial and should be considered early. The rationale for the proposed mechanical ventilation settings criteria is presented and discussed.

Pathophysiology of coronavirus-19 disease acute lung injury.

PURPOSE OF REVIEW: More than 230 million people have tested positive for severe acute respiratory syndrome-coronavirus-2 infection globally by September 2021. The infection affects primarily the function of the respiratory system, where ∼20% of infected individuals develop coronavirus-19 disease (COVID-19) pneumonia. This review provides an update on the pathophysiology of the COVID-19 acute lung injury. RECENT FINDINGS: In patients with COVID-19 pneumonia admitted to the intensive care unit, the PaO2/FiO2 ratio is typically <26.7 kPa (200 mmHg), whereas lung volume appears relatively unchanged. This hypoxaemia is likely determined by a heterogeneous mismatch of pulmonary ventilation and perfusion, mainly associated with immunothrombosis, endothelialitis and neovascularisation. During the disease, lung weight, elastance and dead space can increase, affecting respiratory drive, effort and dyspnoea. In some severe cases, COVID-19 pneumonia may lead to irreversible pulmonary fibrosis. SUMMARY: This review summarises the fundamental pathophysiological features of COVID-19 in the context of the respiratory system. It provides an overview of the key clinical manifestations of COVID-19 pneumonia, including gas exchange impairment, altered pulmonary mechanics and implications of abnormal chemical and mechanical stimuli. It also critically discusses the clinical implications for mechanical ventilation therapy.

Quantifying cricket fast bowling volume, speed and perceived intensity zone using an Apple Watch and machine learning.

This study examined whether an inertial measurement unit (IMU) and machine learning models could accurately measure bowling volume (BV), ball release speed (BRS), and perceived intensity zone (PIZ). Forty-four male pace bowlers wore a high measurement range, research-grade IMU (SABELSense) and a consumer-grade IMU (Apple Watch) on both wrists. Each participant bowled 36 deliveries, split into two different PIZs (Zone 1 = 70-85% of maximum bowling effort, Zone 2 = 100% of maximum bowling effort). BRS was measured using a radar gun. Four machine learning models were compared. Gradient boosting models had the best results across all measures (BV: F-score = 1.0; BRS: Mean absolute error = 2.76 km/h; PIZ: F-score = 0.92). There was no significant difference between the SABELSense and Apple Watch on the same hand when measuring BV, BRS, and PIZ. A significant improvement in classifying PIZ was observed for IMUs located on the dominant wrist. For all measures, there was no added benefit of combining IMUs on the dominant and non-dominant wrists.

The relationship between bowling intensity and ground reaction force in cricket pace bowlers.

This study examined the relationship between perceived bowling intensity, ball release speed and ground reaction force (measured by peak force, impulse and loading rate) in male pace bowlers. Twenty participants each bowled 36 deliveries, split evenly across three perceived intensity zones: low = 70% of maximum perceived bowling effort, medium = 85%, and high = 100%. Peak force and loading rate were significantly different across the three perceived intensity zones in the horizontal and vertical directions (Cohen's d range = 0.14-0.45, p < 0.01). When ball release speed increased, peak force and loading rate also increased in the horizontal and vertical directions (ηp2 = 0.04-0.18, p < 0.01). Lastly, bowling at submaximal intensities (i.e., low - medium) was associated with larger decreases in peak horizontal force (7.9-12.3% decrease), impulse (15.8-21.4%) and loading rate (7.4-12.7%) compared to decreases in ball release speed (5.4-8.3%). This may have implications for bowling strategies implemented during training and matches, particularly for preserving energy and reducing injury risk.

Variability of Multiangle Isometric Force-Time Characteristics in Trained Men.

ABSTRACT: Oranchuk, DJ, Storey, AG, Nelson, AR, Neville, JG, and Cronin, JB. Variability of multiangle isometric force-time characteristics in trained men. J Strength Cond Res 36(1): 284-288, 2022-Measurements of isometric force, rate of force development (RFD), and impulse are widely reported. However, little is known about the variability and reliability of these measurements at multiple angles, over repeated testing occasions in a homogenous, resistance-trained population. Thus, understanding the intersession variability of multiangle isometric force-time characteristics provides the purpose of this article. Three sessions of isometric knee extensions at 40°, 70°, and 100° of flexion were performed by 26 subjects across 51 limbs. All assessments were repeated on 3 occasions separated by 5-8 days. Variability was qualified by doubling the typical error of measurement (TEM), with thresholds of 0.2-0.6 (small), 0.6-1.2 (moderate), 1.2-2.0 (large), 2.0-4.0 (very large), and >4.0 (extremely large). In addition, variability was deemed large when the intraclass correlation coefficient (ICC) was <0.67 and coefficient of variation (CV) >10%; moderate when ICC >0.67 or CV <10% (but not both); and small when both ICC >0.67 and CV <10%. Small to moderate between-session variability (ICC = 0.68-0.95, CV = 5.2-18.7%, TEM = 0.24-0.49) was associated with isometric peak force, regardless of angle. Moderate to large variability was seen in early-stage (0-50 ms) RFD and impulse (ICC = 0.60-0.80, CV = 22.4-63.1%, TEM = 0.62-0.74). Impulse and RFD at 0-100 ms, 0-200 ms, and 100-200 ms were moderately variable (ICC = 0.71-0.89, CV = 11.8-42.1%, TEM = 0.38-0.60) at all joint angles. Isometric peak force and late-stage isometric RFD and impulse measurements were found to have low intersession variability regardless of joint angle. However, practitioners need to exercise caution when making inferences about early-stage RFD and impulse measures due to moderate-large variability.

Kinetic and Kinematic Effects of Asymmetrical Loading of the Lower Limb During High-Speed Running.

CONTEXT: Light lower-limb wearable resistance has little effect on running biomechanics. However, asymmetrical wearable resistance may potentially alter the kinetics and kinematics of high speed, enabling greater loading or unloading of an injured or rehabilitative lower limb. DESIGN: A cross-sectional study design was used to quantify the influence of asymmetric calf loading on the kinematics and kinetics during 90% maximum sprinting velocity. METHODS: Following a familiarization session, 12 (male = 7 and female = 5) physically active volunteers ran at 90% of maximal velocity. In random order, participants ran with zero (0) wearable resistance and with loads of 300 g (L300) and 600 g (L600) fixed to one shank. A nonmotorized treadmill quantified vertical and horizontal kinetics and step kinematics. The kinetics and kinematics of the loaded (L0, L300, and L600) and unloaded (UL; UL0, UL300, and UL600) limbs were compared. RESULTS: Vertical step ground reaction force of the loaded limb tended to increase between unloaded and 300 and 600 conditions (effect size [ES] = 0.48 to 0.76, all P ≤ .12), while the horizontal step force of the UL tended to decrease (ES = 0.54 to 1.32, all P ≤ .09) with greater external loading. Step length increased in the UL in 0 versus 300 and 600 conditions (ES = 0.60 to 0.70, all P ≤ .06). Step frequency decreased in the ULs in unloaded versus 300 and 600 conditions (ES = 0.73 to 1.10, all P ≤ .03). Mean step velocity tended to be greater in the ULs than the 300 and 600 conditions (ES = 0.52 to 1.01, all P ≤ .10). Only 4 of 16 variables were significantly different between the 300 and 600 conditions. CONCLUSIONS: Asymmetrical shank resistance could be used during high-speed running to reduce or increase the kinetic loading of an injured/rehabilitative limb during return to play protocols. Asymmetrical wearable resistance could also be used to alter step kinematics in runners with known asymmetries. Finally, meaningful alterations in high-speed running biomechanics can be achieved with only 300 g of shank loading.

Resisted sprint training with partner towing improves explosive force and sprint performance in young soccer players - a pilot study.

The purpose of this study was to examine the effects of non-resisted (NRS) and partner-towing resisted (RS) sprint training on legs explosive force, sprint performance and sprint kinematic parameters. Sixteen young elite soccer players (age 16.6 ± 0.2 years, height 175.6 ± 5.7 cm, and body mass 67.6 ± 8.2 kg) were randomly allocated to two training groups: resisted sprint RS (n = 7) and non-resisted sprint NRS (n = 9). The RS group followed a six-week sprint training programme consisting of two "sprint training sessions" per week in addition to their usual soccer training. The NRS group followed a similar sprint training programme, replicating the distances of sprints but without any added resistance. All players were assessed before and after training: vertical and horizontal jumping (countermovement jump (CMJ), squat jump (SJ), and 5-jump test (5JT)), 30 m sprint performance (5, 10, and 20 m split times), and running kinematics (stride length and frequency). In the RS group significant (p < 0.05) changes were: decreased sprint time for 0-5 m, 0-10 m and 0-30 m (-6.31, -5.73 and -2.00%; effect size (ES) = 0.70, 1.00 and 0.41, respectively); higher peak jumping height (4.23% and 3.59%; ES = 0.35 and 0.37, for SJ and CMJ respectively); and 5JT (3.10%; ES = 0.44); and increased stride frequency (3.96%; ES = 0.76). In the NRS group, significant (p < 0.05) changes were: decreased sprint time at 0-30 m (-1.34%, ES = 0.33) and increased stride length (1.21%; ES = 0.17). RS training (partner towing) for six weeks in young soccer players showed more effective performances in sprint, stride frequency and lower-limb explosive force, while NRS training improved sprint performance at 0-30 m and stride length. Consequently, coaches and physical trainers should consider including RS training as part of their sprint training to ensure optimal sprint performance.

Short-term neuromuscular, morphological, and architectural responses to eccentric quasi-isometric muscle actions.

PURPOSE: Eccentric quasi-isometric (EQI) contractions have been proposed as a novel training method for safely exposing the musculotendinous system to a large mechanical load/impulse, with few repetitions. However, understanding of this contraction type is rudimentary. We aimed to compare the acute effects of a single session of isotonic EQIs with isokinetic eccentric (ECC) contractions. METHODS: Fifteen well-trained men performed a session of impulse-equated EQI and ECC knee extensions, with each limb randomly allocated to one contraction type. Immediately PRE, POST, 24/48/72 h, and 7 days post-exercise, regional soreness, quadriceps swelling, architecture, and echo intensity were evaluated. Peak concentric and isometric torque, rate of torque development (RTD), and angle-specific impulse were evaluated at each time point. RESULTS: There were substantial differences in the number of contractions (ECC: 100.8 ± 54; EQI: 3.85 ± 1.1) and peak torque (mean: ECC: 215 ± 54 Nm; EQI: 179 ± 28.5 Nm). Both conditions elicited similar responses in 21/53 evaluated variables. EQIs resulted in greater vastus intermedius swelling (7.1-8.8%, ES = 0.20-0.29), whereas ECC resulted in greater soreness at the distal and middle vastus lateralis and distal rectus femoris (16.5-30.4%, ES = 0.32-0.54) and larger echogenicity increases at the distal rectus femoris and lateral vastus intermedius (11.9-15.1%, ES = 0.26--0.54). Furthermore, ECC led to larger reductions in concentric (8.3-19.7%, ES = 0.45-0.62) and isometric (6.3-32.3%, ES = 0.18-0.70) torque and RTD at medium-long muscle lengths. CONCLUSION: A single session of EQIs resulted in less soreness and smaller reductions in peak torque and RTD versus impulse-equated ECC contractions, yet morphological shifts were largely similar. Long-term morphological, architectural, and neuromuscular adaptations to EQI training requires investigation.

Can an inertial measurement unit (IMU) in combination with machine learning measure fast bowling speed and perceived intensity in cricket?

This study examined whether an inertial measurement unit (IMU), in combination with machine learning, could accurately predict two indirect measures of bowling intensity through ball release speed (BRS) and perceived intensity zone (PIZ). One IMU was attached to the thoracic back of 44 fast bowlers. Each participant bowled 36 deliveries at two different PIZ zones (Zone 1 = 24 deliveries at 70% to 85% of maximum perceived bowling effort; Zone 2 = 12 deliveries at 100% of maximum perceived bowling effort) in a random order. IMU data (sampling rate = 250 Hz) were downsampled to 125 Hz, 50 Hz, and 25 Hz to determine if model accuracy was affected by the sampling frequency. Data were analysed using four machine learning models. A two-way repeated-measures ANOVA was used to compare the mean absolute error (MAE) and accuracy scores (separately) across the four models and four sampling frequencies. Gradient boosting models were shown to be the most consistent at measuring BRS (MAE = 3.61 km/h) and PIZ (F-score = 88%) across all sampling frequencies. This method could be used to measure BRS and PIZ which may contribute to a better understanding of overall bowling load which may help to reduce injuries.

Effects of forearm wearable resistance during accelerated sprints: From a standing start position.

Fusiform weighted garments enable specific loading strategies during sport-specific movements. Loading the arms over during accelerated sprinting from a 2-point start position is pertinent to a variety of sporting performances. Fourteen sprint-trained individuals (age = 20.61 ± 1.16 years; height = 1.73 m ± 3.85 cm; body mass 65.33 ± 4.86 kg; personal best 100-m race time 11.40 ± 0.39 s) performed unloaded/loaded wearable resistance (WR) sprints. Between-condition step kinematics and kinetics were compared over four acceleration phases: steps 1-4, 5-8, 9-12 and 13-16. Sprint performance did not differ between unloaded and loaded WR at 10-m (-1.41%; ES = -0.32), or 30-m (-0.76%; ES = -0.24). Sprinting with forearm WR significantly decreased step frequency during phase two (p < 0.05, -3.42%; ES = -0.81) and three (-3.60%; ES = -0.86) and step velocity during phase four of the 30 m sprinting task (p < 0.05, -3.61%; ES: 0.91) only. There were no significant differences (p ≤ 0.05) between step kinetics amongst the two conditions. Findings indicate that arm-loaded WR may provide specific sprinting overload for 2-point starting positions. This may be relevant to a wider sporting context such as field and team sport performances.

Changes to horizontal force-velocity and impulse measures during sprint running acceleration with thigh and shank wearable resistance.

This study determined the effects of two wearable resistance (WR) placements (i.e. thigh and shank) on horizontal force-velocity and impulse measures during sprint running acceleration. Eleven male athletes performed 50 m sprints either unloaded or with WR of 2% body mass attached to the thigh or shank. In-ground force platforms were used to measure ground reaction forces and determine dependent variables of interest. The main findings were: 1) increases in sprint times and reductions in maximum velocity were trivial to small when using thigh WR (0.00-1.93%) and small to moderate with shank WR (1.56-3.33%); 2) athletes maintained or significantly increased horizontal force-velocity mechanical variables with WR (effect size = 0.32-1.23), except for theoretical maximal velocity with thigh WR, and peak power, theoretical maximal velocity and maximal ratio of force with shank WR; 3) greater increases to braking and vertical impulses were observed with shank WR (2.72-26.3% compared to unloaded) than with thigh WR (2.17-12.1% compared to unloaded) when considering the entire acceleration phase; and, 4) no clear trends were observed in many of the individual responses. These findings highlight the velocity-specific nature of this resistance training method and provide insight into what mechanical components are overloaded by lower-limb WR.

Waveform analysis of shank loaded wearable resistance during sprint running acceleration.

Lower-limb wearable resistance (WR) provides a specific and targeted overload to the musculature involved in sprint running, however, it is unknown if greater impact forces occur with the additional limb mass. This study compared the contact times and ground reaction force waveforms between sprint running with no load and 2% body mass (BM) shank-positioned WR over 30 m. Fifteen male university-level sprint specialists completed two maximum effort sprints with each condition in a randomized order. Sprint running with shank WR resulted in trivial changes to contact times at 5 m, 10 m, and 20 m (effect size [ES] = <0.20, p > 0.05) and a small, significant increase to contact time at 30 m by 1.94% (ES = 0.25, p = 0.03). Significant differences in ground reaction force between unloaded and shank loaded sprint running were limited to the anterior-posterior direction and occurred between 20% and 30% of ground contact at 10 m, 20 m, and 30 m. Shank WR did not result in greater magnitudes of horizontal or vertical forces during the initial impact portion of ground contact. Practitioners can prescribe shank WR training with loads ≤2% BM without concern for increased risk of injurious impact forces.

Psychological distress during the acceleration phase of the COVID-19 pandemic: a survey of doctors practising in emergency medicine, anaesthesia and intensive care medicine in the UK and Ireland.

OBJECTIVE: To quantify psychological distress experienced by emergency, anaesthetic and intensive care doctors during the acceleration phase of COVID-19 in the UK and Ireland. METHODS: Initial cross-sectional electronic survey distributed during acceleration phase of the first pandemic wave of COVID-19 in the UK and Ireland (UK: 18 March 2020-26 March 2020 and Ireland: 25 March 2020-2 April 2020). Surveys were distributed via established specialty research networks, within a three-part longitudinal study. Participants were doctors working in emergency, anaesthetic and intensive medicine during the first pandemic wave of COVID-19 in acute hospitals across the UK and Ireland. Primary outcome measures were the General Health Questionnaire-12 (GHQ-12). Additional questions examined personal and professional characteristics, experiences of COVID-19 to date, risk to self and others and self-reported perceptions of health and well-being. RESULTS: 5440 responses were obtained, 54.3% (n=2955) from emergency medicine and 36.9% (n=2005) from anaesthetics. All levels of doctor seniority were represented. For the primary outcome of GHQ-12 score, 44.2% (n=2405) of respondents scored >3, meeting the criteria for psychological distress. 57.3% (n=3045) had never previously provided clinical care during an infectious disease outbreak but over half of respondents felt somewhat prepared (48.6%, n=2653) or very prepared (7.6%, n=416) to provide clinical care to patients with COVID-19. However, 81.1% (n=4414) either agreed (31.1%, n=2709) or strongly agreed (31.1%, n=1705) that their personal health was at risk due to their clinical role. CONCLUSIONS: Findings indicate that during the acceleration phase of the COVID-19 pandemic, almost half of frontline doctors working in acute care reported psychological distress as measured by the GHQ-12. Findings from this study should inform strategies to optimise preparedness and explore modifiable factors associated with increased psychological distress in the short and long term. TRIAL REGISTRATION NUMBER: ISRCTN10666798.