Statistical heterogeneity in meta-analysis of hypertension and exercise training: A meta-review.

We aim to evaluate the prevalence of reporting and the extent of statistical heterogeneity of systematic reviews with meta-analyses (SRMAs) of exercise training for hypertension and to provide practical recommendations for dealing with statistical heterogeneity. We systematically searched on four databases (from 2002 to September of 2023) for SRMAs comparing exercise interventions vs. a non-exercise control on blood pressure (BP) control in adults with hypertension. Fifty-nine SRMAs, with a median of 14 studies, were analysed. Cochran's Q (41%), I2 (24%), forest plots (44%), and particularly τ2 (54%) and prediction intervals (96.6%) frequently were not reported for the hypertension subgroup. The recalculated prediction intervals were discrepant (i.e., crossed the null effect) of significant 95% confidence intervals of most meta-analyses (systolic BP: 65%; diastolic BP: 92%). This suggests substantial heterogeneity across studies, which was often not acknowledged by authors' conclusions (78%). Consequently, downgrading the certainty of the available evidence may be justified alone due to heterogeneity across studies. Finally, we illustrate areas for improving I2 interpretation and provide practical recommendations on how to address statistical heterogeneity across all stages of a SRMA.

Ecological and Construct Validity of a Repeated Sprint Test in Male Youth Soccer Players.

ABSTRACT: Fernandes-Da-Silva, J, Castagna, C, Teixeira, AS, Carminatti, LJ, Francini, L, Póvoas, SCA, and Antonacci Guglielmo, LG. Ecological and construct validity of a repeated sprint test in male youth soccer players. J Strength Cond Res 35(7): 2000-2009, 2021-This study aimed to examine the relationship between a repeated sprint ability (RSA) test (5 bouts of 30-m sprints interspersed by 30 seconds of recovery) and match-related physical performance in male youth soccer players. Although 60 outfield players were evaluated, only data from players who participated in the full matches (n = 39) were retained (8 central defenders, 7 external defenders, 8 central midfielders, 8 external midfielders, and 8 forwards). To verify the ecological validity of this RSA protocol, the association between the best (RSAbest) and mean (RSAmean) sprint time in the 5 × 30-m and physical match performance during friendly youth soccer games was examined. Physical match demands were assessed using global positioning system technology (10 Hz) considering distance covered in selected arbitrary speed categories. The absolute speed thresholds were the same for all the players. Players were categorized into 2 groups based on the 5 × 30-m performance: RSAmean times below (i.e., faster) and above (i.e., slower) the median value. Players with faster RSAmean times covered significantly more distance sprinting during friendly matches (606 ± 204 m, +47.0%; t = 4.953; effect size = 1.88, 1.24; 2.52, p ≤ 0.001) compared to their slower counterparts (322 ± 145 m). A large negative correlation (r = -0.63, -0.77; -0.44, p ≤ 0.001) was found between RSAbest time (4.59 ± 0.27 seconds) and match sprint distance (457 ± 229 m). Likewise, RSAmean time (4.76 ± 0.25 seconds) was also largely associated (r = -0.60, -0.75; -0.39; p ≤ 0.001) with in-game sprinting performance. The results of this study provided evidence to support the construct and ecological validity of the 5 × 30-m protocol in male youth soccer players. Furthermore, differences in 5 × 30-m performance explained the amount of sprinting activity performed during the match.

Effects of small-sided recreational team handball training on mechanical muscle function, body composition and bone mineralization in untrained young adults-A randomized controlled trial.

Prolonged physical inactivity in young adults may lead to deficiencies in musculoskeletal fitness, and thus a need exists to develop physical activity and exercise programmes that are effective of increasing musculoskeletal fitness. The aim of this study, therefore, was to investigate the effects of small-sided team handball training on lower limb muscle strength, postural balance and body composition in young adults. Twenty-six men and twenty-eight women were stratified for peak oxygen uptake (VO2peak) and body fat percentage and randomly allocated to either 12 wks of small-sided recreational team handball training (THG: 14 men and 14 women, age 24.1±2.6 yrs (mean±SD), VO2peak 39.8±5.9 ml/kg/min and body fat percentage 32.7±8.7%) or serving as non-exercising controls (CON: 12 men and 14 women, age 24.8±3.1 yrs, VO2peak 39.7±5.0 ml/kg/min, body fat percentage 31.7±9.7%). THG trained on average 1.8 times/week for 12 wks. At 0 and 12 wks, lower limb muscle strength, rate of force development (RFD), vertical jump height and power, postural balance, body composition and muscle biopsies were assessed. No training effects were observed for maximal isokinetic or isometric knee extensor strength, maximal vertical jump height or take-off power, fibre type distribution or capillarization. Late phase (RFD) increased (+7.4%, p<0.05) and postural sway excursion length was improved after training (-9%, p<0.05) in THG with no difference from CON (p>0.05). Further, THG demonstrated a decrease in body fat percentage (-3.7%) accompanied by increases in whole-body fat free mass (FFM) (+2.2%), leg FFM (+2.5%), total bone mineral content (BMC) (+1.1%), leg BMC (+1.2%), total hip bone mineral density (+1.6%) and hip T-score (+50%) which differed from CON (all p<0.05). In conclusion, recreational small-sided team handball training appears to effectively improve rapid force capacity, postural balance, lean and fat body mass and bone health in previously untrained young adults. The study was registered at ClinicalTrials.gov (NCT04247724). ClinicalTrials.gov ID number: NCT04247724.

Effects of a Short-Term Recreational Team Handball-Based Programme on Physical Fitness and Cardiovascular and Metabolic Health of 33-55-Year-Old Men: A Pilot Study.

Recreational team handball is an intermittent high-intensity exercise mode with physiological demands in the range of those found to enhance health and physical fitness of sedentary adults. We examined the effects of a short-term team handball-based training programme on physical fitness and metabolic and cardiovascular health of sedentary 33-55-year-old former male team handball players. Twenty-four participants were divided into team handball (THG; n=15) and control groups (CG; n=9) and evaluated at baseline and postintervention. During 12 weeks, THG performed 2-3 60-min recreational team handball matches weekly (average: 2.2 ± 0.7), and CG maintained an inactive lifestyle. Average heart rate (HR) during matches was 80 ± 7%HRmax, with peak values of 91 ± 6%HRmax. A time-by-group interaction was shown in aerobic performance (p=0.016), postural balance (p=0.019), maximum oxygen uptake (VO2max) (p=0.023), resting HR (p<0.001), high-density lipoprotein (HDL) cholesterol (p=0.048), and fasting blood glucose (p=0.052) in favor of THG. THG improved aerobic performance (80%, p<0.001), VO2max (14%, p<0.001), and postural balance (27%, p=0.018). Decreases in resting HR (16%, p<0.001) and fasting blood glucose (7%, p=0.015) and increases in HDL cholesterol (11%, p=0.002) were found in THG. Recreational team handball practice shows positive physical fitness and health-related adaptations, with high attendance, which may contribute to the reduction of the risk of developing lifestyle diseases.

Reliability Characteristics and Applicability of a Repeated Sprint Ability Test in Young Male Soccer Players.

Castagna, C, Lorenzo, F, Krustrup, P, Fernandes-da-Silva, J, Póvoas, SCA, Bernardini, A, and D'Ottavio, S. Reliability characteristics and applicability of a repeated sprint ability test in young male soccer players. J Strength Cond Res 32(6): 1538-1544, 2018-The aim of this study was to examine the usefulness and reliability characteristics of a repeated sprint ability test considering 5 line sprints of 30 m interspersed with 30 seconds of active recovery in nonelite, outfield, young, male soccer players. Twenty-six (age, 14.9 ± 1.2 years; height, 1.72 ± 0.12 cm; body mass, 62.2 ± 5.1 kg) players were tested 48 hours and 7 days apart for 5 × 30-m performance over 5 trials (T1-T5). Short-term (T1-T2) and long-term (T1-T3-T4-T5) reliabilities were assessed with intraclass correlation coefficient (ICC) and with typical error for measurement (TEM). Short- and long-term reliability ICCs and TEMs for total sprint time and best sprint performance were nearly perfect and satisfactory, respectively. Usefulness (as smallest worthwhile change and TEM ratio) resulted acceptable (i.e., = 1) and good (i.e., >1) for total sprint time and best sprint performance, respectively. The present study revealed that the 5 × 30-m sprint test is a reliable field test in short and long terms when the sum of sprint times and the best sprint performance are considered as outcome variables. Sprint performance decrements variables showed large variability across trials.

Physical and Physiological Demands of Recreational Team Handball for Adult Untrained Men.

Lack of motivation to exercise was reported as a major cause of sedentary behavior in adulthood. This descriptive study examines the acute physical and physiological demands of recreational team handball and evaluates whether it could be suggested as an exercise mode for fitness and health enhancement in 33-55-year-old untrained men. Time-motion, heart rate (HR), and blood lactate analyses were obtained from 4 recreational matches. Mean distance covered during the 60 min matches was 6012 ± 428 m. The players changed match activity 386 ± 70 times, of which high-intensity runs and unorthodox movements amounted to 59 ± 18 and 26 ± 26 per match, respectively. The most frequent highly demanding playing actions were jumps and throws. Match average and peak HR were 82 ± 6% and 93 ± 5% HRmax, respectively. Players exercised at intensities between 81 and 90% HRmax for 47% (28 ± 14 min) and >90% HRmax for 24% (14 ± 15 min) of total match time. Match average and peak blood lactate values were 3.6 ± 1.3 and 4.2 ± 1.2 mM, respectively. Recreational team handball is an intermittent high-intensity exercise mode with physical and physiological demands in the range of those found to have a positive effect on aerobic, anaerobic, and musculoskeletal fitness in adult individuals. Training studies considering recreational team handball as a health enhancing intervention are warranted.

Long-Sprint Abilities in Soccer: Ball Versus Running Drills.

PURPOSE: To examine the acute effects of generic drills (running drills [RDs]) and specific (small-sided-games [SSGs]) long-sprint-ability (LSA) drills on internal and external load of male soccer players. METHODS: Fourteen academy-level soccer players (mean ± SD age 17.6 ± 0.61 y, height 1.81 ± 0.63 m, body mass 69.53 ± 4.65 kg) performed four 30-s LSA bouts for maintenance (work:rest 1:2) and production (1:5) with RDs and SSGs. Players' external load was tracked with GPS technology (20-Hz), and heart rate (HR), blood lactate concentration (BLc), and rating of perceived exertion (RPE) were used to characterize players' internal load. Individual peak BLc was assessed with a 30-s all-out test on a nonmotorized treadmill (NMT). RESULTS: Compared with SSGs, the RDs had a greater effect on external load and BLc (large and small, respectively). During SSGs players covered more distance with high-intensity decelerations (moderate to small). Muscular RPE was higher (small to large) in RDs than in SSGs. The production mode exerted a moderate effect on BLc while the maintenance condition elicited higher cardiovascular effects (small to large). CONCLUSION: The results of this study showed the superiority of generic over specific drills in inducing LSA-related physiological responses. In this regard production RDs showed the higher postexercise BLc. Individual peak blood lactate responses were found after the NMT 30-s all-out test, suggesting this drill as a valid option to RDs. The practical physiological diversity among the generic and specific LSA drills here considered enable fitness trainers to modulate prescription of RD and SSG drills for LSA according to training schedule.

Evaluation of the Match External Load in Soccer: Methods Comparison.

PURPOSE: To test the interchangeability of 2 match-analysis approaches for external-load detection considering arbitrary selected speeds and metabolic power (MP) thresholds in male top-level soccer. METHODS: Data analyses were performed considering match physical performance of 60 matches (1200 player cases) of randomly selected Spanish, German, and English first-division championship matches (2013-14 season). Match analysis was performed with a validated semiautomated multicamera system operating at 25 Hz. RESULTS: During a match, players covered 10,673 ± 348 m, of which 1778 ± 208 m and 2759 ± 241 m were performed at high intensity, as measured using speed (≥16 km/h, HI) and metabolic power (≥20 W/kg, MPHI) notations. High-intensity notations were nearly perfectly associated (r = .93, P < .0001). A huge method bias (980.63 ± 87.82 m, d = 11.67) was found when considering MPHI and HI. Very large correlations were found between match total distance covered and MPHI (r = .84, P < .0001) and HI (r = .74, P < .0001). Player high-intensity decelerations (≥-2 m/s2) were very largely associated with MPHI (r = .73, P < .0001). CONCLUSIONS: The speed and MP methods are highly interchangeable at relative level (magnitude rank) but not absolute level (measure magnitude). The 2 physical match-analysis methods can be independently used to track match external load in elite-level players. However, match-analyst decisions must be based on use of a single method to avoid bias in external-load determination.

Technical Actions, Heart Rate, and Locomotor Activity in 7v7 and 8v8 Games for Female Youth Soccer Players.

Ørntoft, C, Larsen, MN, Andersen, TB, Rasmussen, LS, Póvoas, SCA, Randers, MB, and Krustrup, P. Technical actions, heart rate, and locomotor activity in 7v7 and 8v8 games for female youth soccer players. J Strength Cond Res 30(12): 3298-3303, 2016-The purpose of this study was to evaluate technical performance, heart rate (HR), and activity profile in 7v7 and 8v8 soccer games for 9- to 10-year-old girls (U11). A total of 24 female youth players participated in the study, all playing 20-minute 7v7 and 8v8 games with 160 and 223 m per player, respectively. Technical actions, HR, and activity profile were measured during the games using video filming, HR monitors, and 5-Hz Global positioning system (GPS) units. The number of technical actions was higher in 7v7 than in 8v8 games (34 ± 19 vs. 28 ± 14; p = 0.03; d = 0.37), as was the number of successful actions (25 ± 16 vs. 20 ± 12; p = 0.01; d = 0.35), with no difference in success rate for technical actions (70 ± 13 vs. 69 ± 14%; p = 0.63; d = 0.07). No differences were found between 7v7 and 8v8 in total distance covered (1,574 ± 251 and 1,622 ± 281 m; p = 0.66; d = 0.18), peak speed (19.5 ± 2.6 and 20.7 ± 1.5 km·h; p = 0.16; d = 0.56), mean HR values (85 ± 5 and 86 ± 6%HRpeak; p = 0.85; d = 0.18), and time of >90% HRpeak (37 ± 16 and 35 ± 14% of playing time; p = 0.70; d = 0.13). Distance covered at the highest running speeds of >16 km·h was lower in 7v7 than in 8v8 games (34 ± 24 vs. 63 ± 34 m; p = 0.018; d = 0.98), as was the number of entries into this speed zone (8 ± 5 vs. 13 ± 7; p = 0.006; d = 0.82). In conclusion, more technical actions and successful actions were observed in 7v7 than in 8v8 games, but players covered more ground with high-speed running in 8v8 games. This study also revealed that HR values were high in both game formats for U11 adolescent female players, with no difference between formats.

Reliability and validity of Yo-Yo tests in 9- to 16-year-old football players and matched non-sports active schoolboys.

The purpose of this study was to examine the test-retest reliability and construct validity of three age-adapted Yo-Yo intermittent tests in football players aged 9-16 years (n = 70) and in age-matched non-sports active boys (n = 72). Within 7 days, each participant performed two repetitions of an age-related intensity-adapted Yo-Yo intermittent test, i.e. the Yo-Yo intermittent recovery level 1 children's test for 9- to 11-year-olds; the Yo-Yo intermittent endurance level 1 for 12- to 13-year-olds and the Yo-Yo intermittent endurance level 2 test for 14- to 16-year-olds. Peak heart rate (HRpeak) was determined for all tests. The distance covered in the tests was 57% (1098 ± 680 vs. 700 ± 272 m), 119% (2325 ± 778 vs. 1062 ± 285 m) and 238% (1743 ± 460 vs. 515 ± 113 m) higher (p ≤ .016), respectively for football-trained than for non-sports active boys aged 9-11, 12-13 and 14-16 years. The typical errors of measurement for Yo-Yo distance, expressed as a percentage of the coefficient of variation (confidence interval), were 11.1% (9.0-14.7%), 10.1% (8.1-13.7%) and 8.5% (6.7-11.7%) for football players aged 9-11, 12-13 and 14-16 years, respectively, with corresponding values of 9.3% (7.4-12.8%), 10.2% (8.1-14.0%) and 8.5% (6.8-11.3%) for non-sports active boys. Intraclass correlation coefficient values for test-retest were excellent in both groups (range: 0.844-0.981). Relative HRpeak did not differ significantly between the groups in test and retest. In conclusion, Yo-Yo intermittent test performances and HRpeak are reliable for 9- to 16-year-old footballers and non-sports active boys. Additionally, performances of the three Yo-Yo tests were seemingly better for football-trained than for non-sports active boys, providing evidence of construct validity.

Analysis of fatigue development during elite male handball matches.

This study aimed at describing the physiological demands and fatigue development during elite male handball matches. Our hypothesis was that players perform multiple high-intensity activities during periods of the game and develop temporary and end-match neuromuscular fatigue. Time-motion analyses and heart rate (HR) recordings were performed in 40 players during 12 competitive matches. Blood samples were collected, and sprint, jump, and intermittent exercise performance (Yo-Yo Intermittent Endurance level 2 test [YYIE2]) was assessed for 18 players at baseline conditions and after 2 competitive matches, and additional blood sampling and testing were performed for 12 of these players during a friendly match. The time spent with high-intensity running (4.4 ± 2.0 to 3.1 ± 1.7%), the frequency of demanding actions (61 ± 5 to 54 ± 6), and the time with HR above 80% HRmax (62 ± 21 to 41 ± 17%) were lowered from the first to the second half. Average blood lactate during the match was 3.6 ± 2.1 (1.3-8.6) mM. Plasma free fatty acids (FFA), glycerol, glucose, and uric acid increased (p ≤ 0.05) during the first half and plasma FFA and glycerol increased further (p ≤ 0.05) during the second half. After an intense period in the second half, sprint performance was decreased by 3.9 ± 4.9%. After the match, YYIE2 (33.4 ± 8.7%), vertical jump (7.4 ± 6.5%), and 20-m sprint performance (1.6 ± 2.6%) was lower (p ≤ 0.05) than at baseline. This study showed that the intensity is high in certain periods during elite male handball games and that physical performance is impaired both temporarily during and toward the end of games confirming our hypothesis. These findings enables physical trainers and coaches to plan and design proper game-specific training exercises aiming at delaying both temporary and end-game fatigue and strengthen the physiological rationale for the need for substitutions in various stages of match-play.

Physiological demands of elite team handball with special reference to playing position.

This study aimed to analyze the physiological demands of match play for different playing positions in elite male team handball. Time motion (N = 30) and heart rate (HR; N = 70) data were recorded throughout 10 official matches. The mean distance covered by backcourt players (4.96 ± 0.64 km) was greater (p ≤ 0.02) than for wings and pivots (4.23 ± 0.52 and 3.91 ± 0.51 km, respectively). Backcourt players spent less time standing still and walking (∼76%) than wings and pivots (∼80%) (p ≤ 0.03), and wings spent more time sprinting than the other playing positions. Backcourt players (122.9 ± 17.0) and pivots (126.8 ± 33.0) performed more high-demanding actions per game than wings (54.6 ± 15.6) (p = 0.01). The time spent by pivots in high-intensity activities decreased from the first to the second half (4.1 ± 2.4 to 2.7 ± 0.9%; p ≤ 0.01), while backcourt players showed a decrease in high-demanding playing actions (p ≤ 0.05). Backcourt players and pivots had higher mean (84 ± 9 and 83 ± 9% vs. 79 ± 10%; p ≤ 0.03) and peak effective HR, and percentage of total time at intensities >80% maximal HR (HRmax) than wings. The fraction of total time spent at intensities >80% HRmax decreased for all outfield playing positions in the second half (from 39-76 to 30-46%). Competitive team handball involves position-specific differences in the physiological demands. Furthermore, exercise intensity decreases from the first to the second half for all outfield playing positions suggesting that these players experience neuromuscular fatigue. Training of elite handball players should comprise high-intensity position-specific exercises aiming at improving the ability to maintain a high exercise intensity throughout the game.

Physical and physiological demands of elite team handball.

This study aimed to analyze elite team handball physical and physiological demands during match play. Time-motion (N = 30) and heart rate (HR; N = 60) analyses were performed throughout 10 official matches. The defined locomotor categories were standing still, walking, jogging, fast running, sprinting, backwards movement, sideways medium-intensity movement, and sideways high-intensity movement, and playing actions studied were jumps, shots, stops when preceded by high-intensity activities, changes of direction and one-on-one situations. During matches, the mean distances covered were 4,370 ± 702.0 m. Around 80% of the total time was spent standing still (43.0 ± 9.27%) and walking (35.0 ± 6.94%) and only 0.4 ± 0.31% with sprinting. The most frequent high-intensity actions were stops, changes of direction, and one-on-one situations. Effective mean HR was 157 ± 18.0 b·min(-1) (82 ± 9.3% of HRmax), and total HR was 139 ± 31.9 b·min(-1) (72 ± 16.7% of HRmax). The HR, time spent in high-intensity activities, frequency of stops, changes of direction, one-on-one situations, and most intense periods of the game were higher during the first half than during the second half (p ≤ 0.05). The opposite was observed for the number of time outs and the time between each change of activity (p = 0.00). Handball is an intermittent exercise that primarily uses aerobic metabolism, interspersed by high-intensity actions that greatly tax anaerobic metabolism. Additionally, exercise intensity decreases from the first to the second half of the match, suggesting that neuromuscular fatigue may occur during the game. The training of elite handball players should comprise exercises targeting the ability to perform specific high-intensity actions throughout the game and to rapidly recover during the less intense periods.