Doping in Paralympic sport: perceptions, responsibility and anti-doping education experiences from the perspective of Paralympic athletes and parasport coaches.

Introduction: Limited effort has been invested in understanding doping in Paralympic sport. The limited evidence that exists suggests that factors influencing doping in parasport are similar to Olympic sport. However, based on the design and nature of the previous studies, where methods have been mostly limited to qualitative data and prevalence numbers, further research is warranted to extend previous findings. Methods: Informed by current evidence from Paralympic and Olympic sport, we aimed to investigate (1) para-athletes' perceptions of Anti-Doping Rule Violations (ADRVs) and responsibility for them, (2) descriptive norms for doping in parasport (3) perceptions of anti-doping education and legitimacy of anti-doping authorities, and (4) coach engagement in doping prevention and levels of doping confrontation efficacy using a quantitative survey approach. Results: In total, valid survey responses from 126 Paralympic athletes and 35 coaches from four countries (Germany, Austria, Switzerland, UK) were analysed for experience with anti-doping, descriptive norms, anti-doping education, perceived legitimacy, knowledge, and doping confrontation efficacy (coaches only). Across both athletes and coaches, the level of education was generally good and doping willingness was low. Classification cheating was considered a form of doping and seems to be an important issue for athletes and coaches, especially within the UK sample. For 33.3% of the athletes, doping control was their first experience with anti-doping. Coaches' engagement with doping prevention activities and their perceived efficacy to confront doping-related matters appears to be higher compared to Olympic coaches' samples. Discussion: Sport organisations/NADOs in Paralympic sport could use synergies with those organisations in Olympic sport, adopting similar approaches to anti-doping education, also focusing on a balanced communication of doping prevalence numbers and testing figures. Efforts to ensure athletes are educated about anti-doping before they are tested should be upheld. It seems that in para sport, different compared to able-bodied coaches, anti-doping organizations do not have to convince the coaches about their roles (i.e., being responsible for anti-doping education) anymore but can directly build on these resources. Overall, it seems that there are few differences between parasport and able-bodied sports and thus responsible organisations could use the existing programmes in Olympic sport and only adapt special content (e.g., boosting) which is unique to Paralympic athletes.

GRADE IT-A Literacy-Based Assessment Tool for Generating Research-Based Assessment Data to Evidence the ImpacT of Anti-doping Education via Athletes' Capability to Make the Right Decision.

The International Standard for Education (ISE) mandates Code Signatories to plan, deliver, and evaluate anti-doping education. Performance-based evaluation of anti-doping education requires alignment between educational goals, content, and defined outcomes. Based on an existentialist teaching and learning philosophy, we aimed to develop and test an anti-doping impact evaluation tool, to assess the impact of anti-doping education on doping awareness, literacy (DAL), perceived trust, and legitimacy. We propose that the impact of anti-doping education is best captured through assessment of situation-specific (social) cognitive mediators of actions that influence athletes' choices in the context of sport-related goals. In phase one, we aimed to develop and test the Generating Research-based Assessment Data to Evidence the ImpacT of anti-doping education (GRADE IT) evaluation tool that comprised a set of social cognitive components: anti-doping knowledge, DAL, perceived trust, and legitimacy of anti-doping (organizations). In phase two we assessed whether anti-doping education impacts knowledge, the three DAL stages (functional, interactive, and critical literacy), perceived trust and legitimacy. Phase one enrolled 986 junior elite athletes, and we showed that all GRADE IT components performed well. After revision of the tool for phase two, we validated the assumption that anti-doping education impacts the likelihood that athletes will make the "right" choice (based on a new set of data from 1,255 junior elite athletes). Comprehensive education was associated with higher scores for all stages of DAL, as well as perceived trust and legitimacy. Even athletes reporting no education had positive scores for all included outcomes, supporting the assumption that most athletes wish to engage in clean sport behaviors and might need anti-doping education not to prevent them from doping, but rather to reinforce their commitment to clean sport. In conclusion, GRADE IT, which is available in 23 languages, is a suitable tool for application to young, emerging athletes to satisfy the ISE requirement for evaluating anti-doping education programs. Researchers and practitioners alike are advised to collect additional data to further validate the tool for adult athletes, and to apply it longitudinally to identify if changes in doping prevention policies have a delayed effect on DAL, perceived trust, and legitimacy.

The Influence of Environmental Hypoxia on Hemostasis-A Systematic Review.

Humans have been ascending to high altitudes for centuries, with a growing number of professional- and leisure-related sojourns occurring in this millennium. A multitude of scientific reports on hemostatic disorders at high altitude suggest that hypoxia is an independent risk factor. However, no systematic analysis of the influence of environmental hypoxia on coagulation, fibrinolysis and platelet function has been performed. To fill this gap, we performed a systematic literature review, including only the data of healthy persons obtained during altitude exposure (<60 days). The results were stratified by the degree of hypoxia and sub-categorized into active and passive ascents and sojourns. Twenty-one studies including 501 participants were included in the final analysis. Since only one study provided relevant data, no conclusions regarding moderate altitudes (1,500-2,500 m) could be drawn. At high altitude (2,500-5,400 m), only small pathophysiological changes were seen, with a possible impact of increasing exercise loads. Elevated thrombin generation seems to be balanced by decreased platelet activation. Viscoelastic methods do not support increased thrombogenicity, with fibrinolysis being unaffected by high altitude. At extreme altitude (5,400-8,850 m), the limited data showed activation of coagulation in parallel with stimulation of fibrinolysis. Furthermore, multiple confounding variables at altitude, like training status, exercise load, fluid status and mental stress, prevent definitive conclusions being drawn on the impact of hypoxia on hemostasis. Thus, we cannot support the hypothesis that hypoxia triggers hypercoagulability and increases the risk of thromboembolic disorders, at least in healthy sojourners.

The questionable benefit of pectus excavatum repair on cardiopulmonary function: a prospective study.

OBJECTIVES: Since the introduction of the minimally invasive technique for repair of pectus excavatum (MIRPE), increasing numbers of patients are presenting for surgery. However, controversy remains regarding cardiopulmonary outcomes of surgical repair. Therefore, the aim of our prospective study was to investigate cardiopulmonary function, at rest and during exercise before surgery, first after MIRPE and then after pectus bar removal. METHODS: Forty-seven patients were enrolled in a prospective, open-label, single-arm, single-centre clinical trial (Impact of Surgical Treatments of Thoracic Deformation on Cardiopulmonary Function) [NCT02163265] between July 2013 and November 2019. All patients underwent a modified MIRPE technique for surgical correction of pectus excavatum (PE), called Minor Open Videoendoscopically Assisted Repair of Pectus Excavatum. The patients underwent pre- and postoperative chest X-ray, three-dimensional volume-rendering computer tomography thorax imaging, cardiopulmonary function tests at rest and during stepwise cycle spiroergometry (sitting and supine position) and Doppler echocardiography. Daily physical activity questionnaires were also completed. RESULTS: The study was completed by 19 patients (15 males, 4 females), aged 13.9-19.6 years at the time of surgery. The surgical patient follow-up was 5.7 ± 7.9 months after pectus bar removal. No significant differences in cardiopulmonary and exercise parameters were seen after placement of the intrathoracic bar, or after pectus bar removal, compared to presurgery. CONCLUSIONS: Our findings indicate that surgical correction of PE does not impair cardiopulmonary function at rest or during exercise. Therefore, no adverse effects on exercise performance should be expected from surgical treatment of PE via the modified MIRPE technique. CLINICAL TRIAL REGISTRATION NUMBER: clinicaltrials.gov [ClinicalTrials.gov number, NCT02163265].

Geographical heterogeneity of doping-related knowledge, beliefs and attitude among 533 Youth Olympics participants.

OBJECTIVES: Doping-related knowledge, beliefs and attitude influence adolescent athletes' susceptibility to prohibited performance-enhancing substances. They might be modified by different cultural backgrounds. This study's aim was to analyse the geographical heterogeneity of doping-related knowledge, beliefs and attitude among adolescent elite athletes. DESIGN: Cross-sectional study. METHODS: A questionnaire was distributed to athletes participating in the Winter Youth Olympic Games 2020 in Switzerland. Main outcomes ('subjective and actual knowledge', 'beliefs' and 'attitude') were stratified for athletes' region of origin. Geographical heterogeneity was tested with a two-way analysis of variance, and two multiple regression analyses were conducted to assess independent associations of knowledge, age and athletes' geographical region with doping-related beliefs and attitude. RESULTS: 533 athletes (54% females, mean age: 16.0 ±â€¯1.0 years), completed the questionnaire (response rate: 33%). Actual knowledge was moderate-to-good (9.2 ±â€¯2.9 correct answers out of 13), and scores of attitude and beliefs showed favourable patterns. Considerable geographical heterogeneity was found for knowledge (p < 0.001), beliefs (p = 0.004) and attitude (p < 0.001). Higher subjective knowledge and actual knowledge were favourably associated with attitude (ß = -0.096, p = 0.049; ß = -0.316, p < 0.001) and beliefs (ß = 0.120, p = 0.016; ß = 0.212, p < 0.001), independent of age and geographical region. CONCLUSIONS: This study demonstrates considerable geographical heterogeneity of doping-related knowledge, beliefs and attitude, which are three essential target factors of doping prevention in adolescent elite athletes. This evidence should encourage medical doctors and other professionals to change their educative anti-doping approach from teaching knowledge about negative consequences into investigating and forming a young athlete's mind-set.

Effect of Tai Chi on muscle strength, physical endurance, postural balance and flexibility: a systematic review and meta-analysis.

OBJECTIVE: To investigate the impact of Tai Chi training on muscle strength, physical endurance, postural balance and flexibility, as measured by tests commonly used in health-related fitness or competitive sports contexts. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The following databases were searched up to 31 July 2020: CINAHL, Cochrane Library, MEDLINE via PubMed and SPORTDiscus. ELIGIBILITY CRITERIA FOR STUDIES: Inclusion: (1) Randomised controlled trials published in German or English; (2) Tai Chi used as an intervention to improve physical performance; (3) Test methods commonly used in health-related fitness or competitive sports and (4) Participants aged ≥16 years (irrespective of health status). Exclusion: (1) Studies not focusing on Tai Chi or including Tai Chi mixed with other interventions and (2) Modified or less than eight Tai Chi movements. RESULTS: Out of 3817 records, 31 studies were included in the review, 21 of them in the meta-analysis. Significant improvements in handgrip strength (2.34 kg, 95% CI 1.53 to 3.14), walking distance during 6 min (43.37 m, 95% CI 29.12 to 57.63), standing time in single-leg-stance with open eyes (6.41 s, 95% CI 4.58 to 8.24) and thoracolumbar spine flexibility (2.33 cm, 95% CI 0.11 to 4.55) were observed. CONCLUSION: Tai Chi training seems to moderately improve physical fitness when evaluated by tests used in health-related fitness or competitive sports. Moreover, thoracolumbar spine flexibility seems to be a factor in the improvement of postural balance. Further research is needed, including younger healthy participants performing a widely used, standardised form (eg, Peking-style routine) with high-intensity movements (eg, use of lower stances).

Are There Associations Between Submaximal and Maximal Aerobic Power and International Ski Federation World Cup Ranking in Elite Alpine Skiers?

PURPOSE: To analyze the predictive value of parameters of submaximal and maximal cardiopulmonary exercise performance on International Ski Federation (Fédération Internationale de Ski) World Cup ranking (FIS ranking) in elite Austrian Alpine skiers. METHODS: Over 7 World Cup seasons (2012-2018), exercise data (maximal oxygen uptake and maximum power output, lactate threshold 2, and ventilatory threshold 2, based on stepwise cycle spiroergometry) were analyzed to determine whether there was a correlation between world FIS ranking and exercise capacity of male and female elite Alpine skiers. RESULTS: The data of 39 male skiers (age: 27.67 [4.20] y, body mass index: 26.03 [1.25] kg/m2) and 36 female skiers (age: 25.49 [3.18] y, body mass index: 22.97 [1.71] kg/m2) were included in this study. The maximum oxygen uptake and maximum power output ranged from 4.37 to 4.42 W/kg and 53.41 to 54.85 mL/kg/min in men and from 4.17 to 4.30 W/kg and 45.96 to 49.16 mL/kg/min in women, respectively, over the 7 seasons; the yearly mean FIS ranking ranged from 17 to 24 in men and 9 to 18 in women. In a fixed-effects model used for the subsequent panel regression analysis, no statistically significant effect on FIS ranking was found for the exercise parameters of interest. CONCLUSIONS: Neither maximal aerobic tests nor maximum power output significantly predicted competitive performance, as indexed by the FIS ranking. This reinforces the assumption that no single parameter determines competition performance in this complex sport. Therefore, identifying the optimum amount of endurance training remains a major challenge for athletes and coaches, as does identifying and improving the factors that determine performance.

Return to Sports after Anterior Cruciate Ligament Injury: a Matched-Pair Analysis of Repair with Internal Brace and Reconstruction Using Hamstring or Quadriceps Tendons.

PURPOSE: The purpose of this study was to evaluate sports activity before anterior cruciate ligament (ACL) injury and after surgical treatment of ACL rupture comparing ACL repair with an Internal Brace to ACL reconstruction using either a hamstring (HT) or quadriceps tendon (QT) autograft. METHODS: Between 12/2015 and 10/2016, we recruited 69 patients with a mean age of 33.4 years for a matched-pair analysis. Twenty-four patients who underwent Internal Brace reconstruction were matched according to age (±â€Š5 years), gender, Tegner activity scale (±â€Š1), BMI (±â€Š1) and concomitant injuries with 25 patients who had undergone HT reconstruction and 20 patients who had undergone QT reconstruction. The minimum follow-up was 12 months. RESULTS: Overall, the return-to-sports rate was 91.3 %. There were no significant differences (p ≥ 0.05) in the number of sports disciplines and the time before return to sports within or among the groups. Overall and within the groups, the level of sports participation did not change significantly (p ≥ 0.05) postoperatively. The patients' sense of well-being was excellent after either ACL repair with an Internal Brace or ACL reconstruction with autologous HT or QT. CONCLUSION: At short-term follow-up, ACL repair using an Internal Brace enables sports activity and provides a sense of well-being similar to that of classic ACL reconstruction using hamstring or quadriceps tendon autografts in a selected patient population. LEVEL OF EVIDENCE: Level III Retrospective comparative study.

Impact of surgical treatment of pectus carinatum on cardiopulmonary function: a prospective study.

OBJECTIVES: The frequency of sternochondroplasty in cases of pectus carinatum (PC) has increased due to greater surgeon experience and modified surgical techniques. PC deformity does not usually cause cardiopulmonary malfunction or impairment. However, whether cardiopulmonary function changes after surgical repair remains a matter of controversy. The aim of our prospective study was to determine if surgery changes preoperative cardiopulmonary function. METHODS: Nineteen patients (16 males, 3 females) were enrolled in a prospective, open-label, single-arm, single-centre clinical trial (Impact of Surgical Treatments of Thoracic Deformation on Cardiopulmonary Function) (NCT02163265) between July 2013 and January 2017. All patients underwent PC repair via a modified Ravitch procedure and wore a lightweight, patient-controlled chest brace for 8 weeks postoperatively (the Innsbruck protocol). The average follow-up surgical examination was 8.3 months after surgery. In all enrolled patients, before surgery and not before 6 months postoperatively chest X-ray, 3-dimensional volume-rendered computed tomography thorax imaging, cardiopulmonary function tests with stepwise cycle spiroergometry (sitting and supine position) and Doppler echocardiography were performed; questionnaires about daily physical activity were also completed. RESULTS: Fourteen patients (aged 16.3 ± 2.6 years at study entry) completed the study. Changes in submaximal and peak power output were not detected during sitting, or when in the supine position. Also, no clinically relevant postoperative changes in spirometry or echocardiography were noted. CONCLUSIONS: Our findings confirm that surgical correction of PC does not impair cardiopulmonary function at rest or during physical exercise. CLINICAL REGISTRATION NUMBER: clinicaltrials.gov NCT02163265.

An evaluation of prevention initiatives by 53 national anti-doping organizations: Achievements and limitations.

BACKGROUND: One main purpose of the World Anti-Doping Agency was to harmonize anti-doping efforts, including the provision of anti-doping education. A multifaceted approach to doping prevention can play a key role in preventing intentional and unintentional doping. This article aimed to systematically record and evaluate doping prevention approaches in the form of information and education activities of national anti-doping organizations (NADOs) and assess the extent to which a multifaceted doping prevention approach has been realized. METHODS: Data on anti-doping information and education activities of 53 NADOs were collected via a survey and an online search of the NADOs' websites. Prevention activities were classified into knowledge focused, affective focused, social skills, life skills, and ethic- and value- based. The implementation of the prevention activities was assessed by 4 independent raters using a modified visual analogue scale. RESULTS: In total, 59% of the NADOs (n = 38) returned the survey and 70% (n = 45) had information available online. The data were combined for the visual analogue scale assessment. Overall, 58% of the NADOs (n = 37) reported offering activities including elements of all 5 approaches. Results of the raters' assessments indicated that the knowledge-focused approach was best implemented; the implementation of the other 4 approaches was largely unsatisfactory. The most common barriers to implementing doping prevention programs reported by the NADOs were lack of resources (n = 26) and difficulties in collaborating with sports organizations (n = 8). CONCLUSION: Results show a discrepancy between NADOs' self-report data and the implementation assessment. Even though the NADOs indicated otherwise, most of their education-based approaches did not address aspects of the visual analogue scale (e.g., resisting peer pressure) and only a few programs were ongoing. Possible explanations might be found in the reported barriers (e.g., financial). Concrete guidelines defining multifaceted, values-based education, and best practice examples should be developed to indicate how to include all 5 approaches in prevention.

Sex-Related Differences After a Single Bout of Maximal Eccentric Exercise in Response to Acute Effects: A Systematic Review and Meta-analysis.

Morawetz, D, Blank, C, Koller, A, Arvandi, M, Siebert, U, and Schobersberger, W. Sex-related differences after a single bout of maximal eccentric exercise in response to acute effects: a systematic review and meta-analysis. J Strength Cond Res 34(9): 2697-2707, 2020-The most prominent effects after unaccustomed eccentric exercise are muscle damage, muscle soreness, strength loss, and higher concentrations of muscle proteins in the plasma. The aim of this systematic review is to evaluate sex-related differences in these acute effects. A systematic literature search in MEDLINE following the PRISMA guidelines was performed. Inclusion criteria were the difference in absolute outcomes between sexes in eccentric muscle strength, strength loss after eccentric exercise, blood concentrations of creatine kinase (CK), and delayed onset muscle soreness (DOMS). Results for maximal eccentric torque and CK data were pooled using a random-effect meta-analysis. A meta-regression was conducted to explain heterogeneity. Based on the 23 included trials, men showed significantly higher absolute eccentric strength. No sex-related differences were detected when normalizing strength for body mass, cross-sectional area of the muscle, or fat-free mass. Women displayed a tendency toward greater relative strength loss immediately after exercise. The absolute CK concentrations of men were significantly higher after exercise-induced muscle damage. No significant difference was found between sexes in DOMS. Untrained men and women display similar responses in all measures of relative muscle strength and DOMS. Apart from the enzymatic activity after exercise and the levels of absolute eccentric torque, there is no evidence for sex-related differences immediately after eccentric exercise. Therefore, eccentric training might have the same impact on men and women. One potential sex difference with practical relevance would be the possible difference in fatigue pattern immediately after eccentric exercise.

Compliance with needle-use declarations at two Olympic Winter Games: Sochi (2014) and PyeongChang (2018).

OBJECTIVES: We describe compliance with the 'IOC Needle Policy' at two Winter Olympic Games (Sochi and PyeongChang) and compare these findings to those of the Summer Olympic Games of Rio de Janeiro. METHOD: All needle-use declaration(s) (NUD) received during the course of the 2014 and 2018 Olympic Games were reviewed. We recorded socio-demographic data, the nature and purpose of needle use, product(s) injected, and route of administration. Data were analysed descriptively. RESULTS: In total, doctors from 22 National Olympic Committees (NOCs) submitted 122 NUD involving 82 athletes in Sochi; in PyeongChang, doctors from 19 NOCs submitted 82 NUD involving 61 athletes. This represented approximately 2% of all athletes at both Games, and 25% and 20% of all NOCs participating in Sochi and PyeongChang, respectively. No marked differences in the NUD distribution patterns were apparent when comparing the two Winter Olympic Games. The most commonly administered substances were as follows: local anaesthetics, non-steroidal anti-inflammatory drug and glucocorticoids. Physicians submitted multiple NUD for 24% of all athletes who required a NUD. CONCLUSION: A limited number of NOCs submitted NUD suggesting a low incidence of needle use or limited compliance (approximately 2%). A key challenge for the future is to increase the rate of compliance in submitting NUD. More effective education of NOCs, team physicians and athletes regarding the NUD policy, its purpose, and the necessity for NUD submissions, in association with the enforcement of the appropriate sanctions following non-compliance are needed.

Feasibility of Ski Mountaineering for Patients Following a Total Knee Arthroplasty: A Descriptive Field Study.

Background: Total knee arthroplasty (TKA) is socially relevant due to its high prevalence, high incidence and the affected population. A subpopulation of TKA patients exists that strives to be active and also return to sports after total joint replacement. In this context, a further group of TKA patients is interested in high-impact physical activities and want to proceed with such activities even after surgery. Focusing on winter sports, there is still a lack of evidence on whether ski mountaineering is feasible for this subgroup of patients. Therefore, this feasibility study examines the effects of moderate ski mountaineering on strength, balance, functional abilities and mental health in persons following a TKA. Methods: Eight patients (six males, two females; median age, 63 ± Interquartile range 9 years) with TKA were included in this study. The volunteers, who were pre-selected for a 7-day holiday in Sankt Johann (Tyrol, Austria), participated in five guided ski mountaineering tours. Statistical analyses of non-parametric longitudinal data were performed using analysis of variance. For gait parameters and the Feeling Scale, one-factor longitudinal models were used. Statistical significance was set at the level of p < 0.05. Results: A significant decrease in the S3-Check MFT stability index (p = 0.04), a significant increase in general well-being (p = 0.05), and a trend towards a decrease in general stress (p = 0.1) were detected, while all other parameters were unaffected. Conclusion: A 7-day recreational ski mountaineering holiday had no negative effects on ski-experienced patients with TKA and seemed to increase well-being. Further studies should focus on larger groups and use controlled designs. Additionally, long-term effects should be evaluated.

Does Physical Activity during Alpine Vacations increase Tourists' Well-Being?

Physical activities have been proven to have an impact on general well-being in everyday life; however, literature lacks an analysis of the effects of physical activities in vacation settings. Thus, the study aimed at assessing the impacts of physical activity on well-being during vacation by taking a longitudinal approach. We utilized a pre-post within-subject design (n = 101) by testing vacationers prior to, during, and after their vacation in an alpine environment. Therefore, a series of eight linear mixed model analyses of co-variance was performed. The results suggested that the duration of a vacation and the amount of physical activity have a positive impact on the components of well-being, which was expressed by changes in the activation, elation, excitement, and calmness subscales of the Mood Survey Scale. Demographic patterns did not reveal any influences. Physical activity might be a marker for well-being, which influences people's everyday life and leisure time behavior by motivating them to engage in more physical activity. This research extends the existing literature by (1) proving the effects of vacations on well-being, (2) pointing out the effects of demographic predeterminations, and (3) gathering in-depth knowledge about the role of physical activity in changes to well-being.

The effects of 8 weeks of two different training methods on on-sight lead climbing performance.

BACKGROUND: Despite climbing being an increasingly popular sporting pursuit, there have been very few scientific evaluations of appropriate training methods for competitive climbers. The aim of this study was to investigate the effects of an 8-week climbing-specific muscular hypertrophy (MH) or muscular endurance (ME) resistance training program on the on-sight lead climbing performance in a similar setting to a World Cup. METHODS: Twenty-three elite male and female climbers (age: 25.5±6.7 years; height: 1.72±0.08 m; body mass: 63.4±7.7 kg; measured on-sight level: 20.8±2.0 IRCRA [International Rock Climbing Research Association]) participated in 8 weeks' worth of MH (N.=11) or ME (N.=12) training. Before the training (FT1), after 8 weeks of training (FT2), and after a 2-week tapering period (FT3), the participants climbed an on-sight lead route in a similar setting to a world cup. RESULTS: Climbers were able to perform significantly more moves (P=0.019; P<0.001) and climbed significantly harder (P=0.014; P<0.001) with FT2 and FT3 versus FT1. Climbing moves per unit time increased significantly when comparing FT2 to FT1 (P=0.007) and showed a tendency to increase when comparing FT3 to FT1 (P=0.061). However, there was no interaction effect between the groups. CONCLUSIONS: Our findings demonstrated that climbing-specific ME, as well as MH resistance training, improved on-sight lead climbing performance in a similar setting to a world cup. For competing climbers and climbing coaches, we recommend inclusion of the same proportions of climbing-specific ME and MH resistance training in their training programs to enhance on-sight lead climbing performance.

Injuries in Austrian football players: Are they an issue?

PURPOSE AND HYPOTHESIS: With its load characteristics, the team sport of football places high physical demands on players and thus is associated with a high risk of injury. Therefore, the purpose of this study was to collect information about injuries suffered by football players in Austria during training or matches to enable participating clubs to learn about injuries. METHODS: One hundred and forty-five players from seven teams with age ranging from 16 to 38 years participated in this prospective study during the 2015/16 season. Injury surveillance was conducted according to the consensus statement of Fuller et al. (2006). RESULTS: During the period of study, a total of 83 injuries were recorded, which represents an overall incidence of 4.5 injuries/1000 hours (2.3 injuries/1000 hours in training and 14.2 injuries/1000 hours of match play). There was a significant difference for older age in injured players compared to non-injured players (p = 0.019). No differences in BMI were detected (p = 0.427). Ninety-four percent of all injuries occurred in the lower extremity, with the thigh (25.8 %), ankle (19.3 %) and knee (13.3 %) being the major locations of injuries. Muscle tendon injuries were the most common non-contact injuries (78.9 %). CONCLUSION: Lower extremity injuries are the most common injury in Austrian football. The incidence of muscle injuries is high, especially injuries of the posterior thigh. There are promising preventive strategies for the most common injury types. The implementation of these strategies is essential in order to reduce the incidence or recurrence of these football injuries.

Effects of Recreational Ski Mountaineering on Cumulative Muscle Fatigue - A Longitudinal Trial.

Sport is known to have many positive effects on mental and physical health. High-intensity exercise is considered to decrease muscle strength and induce muscle fatigue, which is associated with a higher risk of injury. In recreational alpine skiers, a decrease of eccentric peak hamstring torque, as an indication of muscle fatigue, occurs even after 1 day of skiing. The popularity of ski mountaineering is increasing enormously, but no studies are available on its effects on muscle strength. Therefore, the present study examined the consequences of ski mountaineering on muscle fatigue of the concentric/eccentric quadriceps and/or hamstrings. In addition, a possible role of myofascial foam rolling in reducing muscle fatigue was evaluated. Fifty recreational ski mountaineers (27 males, 23 females) completed five consecutive tours of ski mountaineering within 1 week. After each day of skiing, participants underwent an isokinetic muscle test assessing the concentric and eccentric muscle strength of both thighs. One group completed an additional session of myofascial foam rolling. Right and left concentric quadriceps peak torque, left hamstrings peak torque, left eccentric quadriceps peak torque, as well as right and left hamstring peak torque, were reduced after a single day of ski mountaineering (p ≤ 0.016 for all). However, no cumulative muscle fatigue was detected and we could not demonstrate any effect of myofascial foam rolling. The results show conclusively that a single day of ski mountaineering leads to a significant decrease of concentric and eccentric quadriceps and hamstring strength. Therefore, in order to improve muscle strength for the ski mountaineering season, a physical training program including concentric and eccentric methods can be recommended.

Impact of a single, short morning bright light exposure on tryptophan pathways and visuo- and sensorimotor performance: a crossover study.

BACKGROUND: Bright light (BL) has been shown to be effective in enhancing both cognitive and physical performances. Alterations in nighttime melatonin levels have also been observed. However, evaluations of light-induced changes in the preceding biochemical processes are absent. Therefore, the impact of a single morning BL exposure on sensorimotor and visuomotor performance, as well as tryptophan (trp) and trp metabolites, was evaluated in this study. METHODS: In a crossover design, 33 healthy volunteers were randomly exposed to 30 min of < 150 lx at eye level (office light, OL) and 5000 lx at eye level (bright light, BL) of 6500 K in the morning hours. Trp, sulfatoxymelatonin (aMT6s), and kynurenine (kyn) courses over the morning hours were analyzed, and changes in sensori- and visuomotor measures were examined. RESULTS: Motoric performance increased in both setups, independent of light intensity. aMT6s and kyn decreased equally under both lighting conditions. Trp levels decreased from a mean (95% confidence interval) of 82.0 (77.2-86.9) to 66.5 (62.5-70.1) in the OL setup only. CONCLUSION: These data suggest that BL in the morning hours has a limited effect on visuo- and sensorimotor performance. Nevertheless, trp degradation pathways in the morning show diverse courses after OL and BL exposure. This suggests that trp courses can potentially be altered by BL exposure.

Short Vacation Improves Stress-Level and Well-Being in German-Speaking Middle-Managers-A Randomized Controlled Trial.

Stress in the work place has a detrimental effect on people's health. Sufficient recovery is necessary to counteract severe chronic negative load reactions. Previous research has shown that vacationing for at least seven consecutive days provided an efficient recovery strategy. Yet, thus far, the effects of short vacations and the mode of vacation (whether at home or in a new environment) have rarely been studied. We investigated the immediate and long-term effects of a short vacation (four nights) on well-being and perceived stress and whether the mode of vacation impacted on these results. Data was obtained from 40 middle managers (67.5% men and 32.5% women). The intervention group (n = 20) spent a short vacation in a hotel outside their usual environment. The control group (n = 20) spent their vacation at home. Results indicated that one single short-term vacation, independent of the mode, has large, positive and immediate effects on perceived stress, recovery, strain, and well-being. Strain levels decreased to a greater extent in the intervention group compared to the control group. The effects can still be detected at 30 days (recovery) and 45 days (well-being and strain) post-vacation. Encouraging middle management employees to take short vacations seems to be an efficient health promotion strategy; environmental effects seem to play a minor role.