Exercise Evaluation and Prescription—3rd Edition

Firefighters often complete air management courses (AMC) to assess the ability to tolerate personal protective equipment, appropriately manage the breathing system and assess occupational performance. Little information is known relative to the physiological demands of AMCs, nor how to assess work efficiency in order to characterize occupational performance and evaluate progress. Purpose: To assess the physiological demands of an AMC and examine differences across BMI categories. A secondary aim was to develop an equation to assess work efficiency in firefighters. Methods: Fifty-seven firefighters (Women, n = 4; age: 37.2 ± 8.4 yr.; height: 182.0 ± 6.9 cm; body mass: 90.8 ± 13.1 kg; BMI: 27.8 ± 3.6 kg·m⁻²) completed an AMC per routine evaluation while wearing a department issued self-contained breathing apparatus and full protective gear. Course completion time, starting pounds per square inch (PSI) on the air cylinder, changes in PSI, and distance traveled were recorded. All firefighters were equipped with a wearable sensor integrated with a triaxial accelerometer and telemetry to assess movement kinematics, heart rate, energy expenditure, and training impulse. The AMC consisted of an initial section involving a hose line advance, rescue (body drag), stair climb, ladder raise, and forcible entry. This section was followed by a repeating loop, which consisted of a stair climb, search, hoist, and recovery walk. Firefighters repeated the course loop until the self-contained breathing apparatus air supply pressure reached 200 PSI, at which time they were instructed to lay down until the PSI reached zero. Results: Average completion time was 22.8 ± 1.4 min, with a mean distance of 1.4 ± 0.3 km and an average velocity of 2.4 ± 1.2 m·s⁻¹. Throughout the AMC, the mean heart rate was 158.7 ± 11.5 bpm equating to 86.8 ± 6.3% of the age-predicted max heart rate and a training impulse of 55 ± 3 AU. Mean energy expenditure was 464 ± 86 kcals and work efficiency was 49.8 ± 14.9 km·PSI⁻¹·s. Regression analysis determined that fat-free mass index (R² = 0.315; β = −5.069), body fat percentage (R² = 0.139; β = −0.853), fat-free mass (R² = 0.176; β = −0.744), weight (R² = 0.329; β = −0.681), and age (R² = 0.096; β = −0.571) were significant predictors of work efficiency. Conclusions: The AMC is a highly aerobic task with near-maximal heart rates reached throughout the course. Smaller and leaner individuals achieved a higher degree of work efficiency during the AMC. Full article

This study aimed to investigate the effects of playing position and contextual factors (match outcome, final score difference, match location, travel duration, number of scored and conceded goals) on the internal match load, players’ perceived recovery and players’ well-being. The session-RPE (s-RPE), Perceived Recovery Scale (PRS) and Hooper Index (HI) of 17 male elite water polo players were monitored during all matches (regular season and play-out) of the 2021/22 Italian Serie A1 championship. Three separate, mixed linear models for repeated measures showed significant main effects: drawn compared to won matches led to higher s-RPE values (mean ± SE = 277 ± 17.6 vs. 237.3 ± 20.6), while longer travel duration (estimate = −0.148) and goals scored (estimate = −3.598) led to lower s-RPE values; balanced compared to unbalanced matches led to higher PRS values (mean ± SE = 6.8 ± 0.3 vs. 5.1 ± 0.4), while playing time (estimate = −0.041) and goals scored (estimate = −0.180) led to lower PRS values; higher scores of the HI were registered for regular season compared to the play-out (mean ± SE = 15.6 ± 0.9 vs. 13.5 ± 0.8). This study marks the importance of ecological and non-invasive monitoring tools to assess internal match load, recovery and the well-being of elite water polo players. Full article

Agility is a fitness-skill-related component that should be a part of the standard physiological testing for soccer players and one of the key performance indicators in soccer. The present study aimed to assess the reliability of the CRAST as a research tool in the study of soccer skills. Twenty-one university soccer players (chronological age: 19.3 ± 1.4 years; body mass: 69.6 ± 8.2 kg; stature: 173.5 ± 6.5 cm; federated training experience: 9.7 ± 3.6 years) volunteered for the testing protocol. The CRAST requires players to complete random courses six times as quickly as possible. In addition, the CRAST requires players to control and dribble the markers (four different colors: green, yellow, blue, and red). The soccer players completed three trials, each separated by one week. The first trial accounted for familiarization; the second and third were considered for analysis. The correlation for overall performance was very strong. The reliability of the CRAST was slightly better for total time than that for the penalty score (0.95 vs. 0.93). The TEM and the associated CV range of 7.04%–7.54% were for the penalty score and the total time, respectively. For both measurements, the ICC values also represent excellent reliability, as both values were over 0.900. The CRAST is a reliable protocol for assessing agility in soccer players. Full article

The purpose of this study was to investigate the acute effects of multi-joint resistance exercises (MJRE) with blood flow restriction on hormonal responses. Ten men participated in the study and underwent two experimental protocols in random order: four sets (30, 15, 15, and 15 reps, respectively) of MJRE (half squat and horizontal chest press) were performed with 20% of 1RM and a rest time between sets of 30 s, combined with intermittent blood flow restriction (LI + BFR protocol); and four sets (8, 8, 8, 20 reps, respectively) of the same MJRE performed with 75% of 1RM load (HI protocol), with a 90 s rest between the first three sets and 30 s between the third to the fourth set. Blood samples were collected before (PRE), immediately after (POST), and 15 min after the performance of MJRE (POST15). A time effect was observed for growth hormone (GH) and insulin-like-growth-factor-1-binding-protein-3 (IGFPB-3), but no protocol effects or interactions between protocol and times were observed (p > 0.05). There was no effect of either protocol or time (p > 0.05) on total testosterone, free testosterone, or cortisol concentrations. However, significant (p < 0.05) increases were observed in the GH serum concentrations of 2072.73% and 2278.5%, HI, and LI + BFR protocols, respectively, from the PRE to POST15 test. In addition, there was an increase of 15.30% and 13.29% in the IGFPB-3 concentrations (p < 0.05) from PRE to POST0 times for HI and LI + BFR protocols, respectively. Furthermore, there was a decrease of −6.17% and −11.54%, p = 0.00, between the times POST0 to POST15 in the IGFPB-3 for the HI and LI + BFR protocols, respectively. It is concluded that multi-joint resistance exercises combined with intermittent blood flow restriction seemed to promote acute hormonal responses in a manner similar to traditional exercise with high loads. Future studies may investigate whether chronic use of LI + BFR with MJRE may promote muscle hypertrophy. Full article

Background: Bariatric surgery is the most effective procedure for obesity management, with a greater body weight loss and the remission of several diseases. The aim of this study was to analyze the relationships between the anthropometric profile and postural control outcomes in a group of obese adult women, and the effect of bariatric surgery on postural control. Methods: eighty-eight women candidates for bariatric surgery were recruited. Static balance was measured with the ARGO stabilometric platform under two conditions: open eyes (OE) and closed eyes (CE). Results: Multiple linear regression indicated BMI as the first predictor for postural control in all parameters, except for APO in open eyes, predicted mainly by height. Changes in body weight and BMI showed no statistically significant correlations with modification of postural control parameters (OE), while they appeared to exert an influence under closed eyes conditions. Conclusions: Before surgery, obese patients with a higher BMI showed a better postural control. After surgery, the sway path and antero-posterior oscillation improved under open eyes conditions, while the magnitude of weight loss was negatively correlated with differences in postural control. Full article

The aim of this pilot study was to examine the effectiveness of a CrossFit-based training program to enhance the general and sport-specific physical fitness of 10–12-year-old judokas. The study was conducted between September 2021 and February 2022. The pedagogical research experiment was designed to be one complete, annual macrocycle (September–June). The current study presents mid-point data. Twenty male participants (3 years average sports experience; age = 11 ± 0.64 years) were randomly assigned to one of two groups: CrossFit-based training (experimental, n = 10) and traditional training (control, n = 10). Baseline testing was conducted by the researcher and included tests for motor skills and general physical fitness domains including Sweden wall pull-ups and leg raises, push-ups, long jump, squats, burpees, shuttle run, and forward rolls. Judo-specific tests included O Soto Gari and O Goshi throws. CrossFit-based training was implemented twice per week for 15–20 min in the experimental group after usual training. The control group completed traditional methods of physical fitness training for judokas with the same training load regarding time. Experimental group participants significantly improved on leg raises (p < 0.01), push-ups (p < 0.05), and shuttle run (p < 0.001); the control group improved their shuttle run (p < 0.001). Only the experimental group improved on the O Soto Gari (p < 0.01) and O Goshi throws (p < 0.05). Results showed that the use of CrossFit-based trainings had a positive effect on 10–12-year-old judokas’ speed-strength abilities, speed-strength endurance, and muscular strength. Full article

Exercises for the abdominal muscles are widely used in athletic activities for strength training and prevention of low back disorders. The timing and volume of muscle activation for various movements have not yet been clarified. The purpose of this research was to evaluate the surface electromyographic activity from the upper (RAU) and lower part (RAL) of the rectus abdominis and the external oblique (EO) muscles during eleven abdominal muscle strength training exercises. Thirty-five healthy male university students with a subspecialty in soccer participated in the study. They performed exercises involving isometric, concentric, and eccentric muscle contractions. The electromyographic recordings were amplified by a factor of 1000, rectified, and integrated. Mean integrated values were calculated by dividing the elapsed time for the five repetitions, to provide the mean integrated electromyographic values for each exercise. Leg movements from a long lying position showed higher activity of the rectus abdominis, compared to the EO (p < 0.001). The dynamic sit-ups showed an obvious dominant activity of the EO, compared to the rectus abdominis (p < 0.001). During eccentric exercise, higher activity was found in the RAU, compared to the RAL (p < 0.001). The results could serve as a basis for improving the design and specification of training exercises. Pre-exercises should be performed before testing abdominal muscle strength. Full article

The purpose of the present study was to examine the repeatability of five algorithm-derived motion health screening scores (i.e., readiness, explosiveness, functionality, quality, and dysfunction) obtained from an innovative three-dimensional markerless motion capture system, composed of eight high-definition cameras recording at 60 fps. Thirteen females and six males performed two sets of three motion capture screenings, separated one week apart (six in total). The screenings consisted of 20 body movements performed in sequential order. Each screening within a testing session was separated by a 30 min rest interval to avoid the possible influence of fatigue. A trained research team member, facing the participant and standing outside of the camera capture range, was present to demonstrate each individual movement. The order in which motions were performed was identical across all participants. Repeated measures analysis of variance and intraclass correlation coefficients were used to examine statistically significant differences and measurement agreement across six testing sessions. The findings of the present study revealed no significant differences in algorithm-based motion health screening scores across multiple testing sessions. Moreover, excellent measurement reliability was found for readiness scores (ICC, 95% CI; 0.957, 0.914–0.980), good-to-excellent for functionality (0.905, 0.821–0.959) and explosiveness scores (0.906, 0.822–0.959), and moderate-to-excellent for dysfunction (0.829, 0.675–0.925) and quality scores (0.808, 0.635–0.915). Full article

Looped elastic bands around the thigh are commonly used during squats and result in increased hip activation. Due to the closed kinetic chain nature of the squat exercise, one may expect that placing the elastic band on distal segments, close to the floor contact, may not result in the same increase in hip muscle activation as that achieved with a looped band around the thigh. We analyzed the effects of band position (thigh, lower leg, and forefoot) and band stiffness on the myoelectric activity of the tensor fascia latae, gluteus medius, gluteus maximus, biceps femoris, vastus medialis, and vastus lateralis during squats in 35 healthy subjects (18 men and 17 women). The greatest myoelectric activity of hip muscles was observed when the stiffest band was positioned around the forefeet with an increase in 24% for the tensor fascia latae, 83% for the gluteus medius, and 68% for the gluteus maximus compared to free (without resistance band) squatting. Contrary to previous thinking, the use of elastic bands around the forefeet during squats can elicit increased myoelectric activity of hip muscles, with a magnitude often greater than when the band is placed around the thigh segments. Full article

The purpose of this study was to investigate the acute effects of various loads attached to the forearm on throwing performance, kinematics and electromyography (EMG) activity in overarm throwing. A within-subjects design was used to evaluate thirteen experienced female handball players (age: 22.15 ± 2.82 years; height: 171.62 ± 7.68 cm; body mass: 73.35 ± 11.16 kg) who performed a penalty shot test with various loads attached to their forearms in three conditions: (1) no extra weight, (2) middle weight and (3) high weight. Performance together with 3D kinematics and EMG of eleven muscles were analyzed in Visual 3D (C-motion, Germantown, MD, USA) during the throw. The main findings were that peak velocity was affected (p = 0.004, ηp² = 0.37) but not accuracy (p = 0.47, ηp² = 0.06) when throwing with weights. However, there were no differences between the weights. Furthermore, EMG activity and most kinematics did not change with the added load; only the maximal angular elbow extension velocity increased (p ≤ 0.001, ηp² = 0.67), while the internal shoulder rotation velocity decreased with the load attached. We concluded that changes in throwing velocity were caused by the decrease in maximal angular internal shoulder rotation velocity. The increased maximal elbow extension velocity was probably caused by the increased moment of inertia of the forearm. Between mid and high weights, the load difference was probably too small to observe changes in kinematics due to the lower moment of inertia compared with studies that used heavier balls. Full article

Duration is a rarely investigated marker of exercise prescription. The aim of this study was to test the feasibility of the methodological approach, assessing effects of different duration constant-load exercise (CLE) on physiological responses (internal load) and recovery kinetics. Seven subjects performed an incremental exercise (IE) test, one maximal duration CLE at 77.6 ± 4.8% $\dot{\mathrm{V}}{\mathrm{O}}_{\mathrm{2}\mathrm{m}\mathrm{a}\mathrm{x}}$, and CLE’s at 20%, 40%, and 70% of maximum duration. Heart rate (HR), blood lactate (La), and glucose (Glu) concentrations were measured. Before, 4, 24, and 48 h after CLE’s, submaximal IE tests were performed. HR variability (HRV) was assessed in orthostatic tests (OT). Rating of perceived exertion (RPE) was obtained during all tests. CLE’s were performed at 182 ± 27 W. HR_peak, La_peak, $\dot{\mathrm{V}}{\mathrm{E}}_{\mathrm{peak}}$, and RPE_peak were significantly higher in CLE’s with longer duration. No significant differences were found between CLE’s for recovery kinetics for HR, La, and Glu in the submaximal IE and for HRV or OT. Despite no significant differences, recovery kinetics were found as expected, indicating the feasibility of the applied methods. Maximum tests and recovery tests closer to CLE’s termination are suggested to better display recovery kinetics. These findings are a first step to prescription of exercise by both intensity and duration on an individual basis. Full article

Performance in strike combat sports is mostly evaluated through the values of the net force, acceleration, or speed to improve efficient training procedures and/or to assess the injury. There are limited data on the upper limb striking area, which can be a useful variable for contact pressure assessment. Therefore, the aim of this study was to determine the contact area of the upper limb in three different strike technique positions. A total of 38 men and 38 women (n = 76, 27.3 ± 8.5 years of age, 73.9 ± 13.8 kg of body weight, 173.3 ± 8.4 cm of body height) performed a static simulation of punch with a fist, palm strike, and elbow strike, where three segments of the right upper limb were scanned. The analysis of 684 images showed a correlation (r = 0.634) between weight and punch technique position in men and significant differences in elbow strike (p < 0.001) and palm strike (p < 0.0001) between women and men. In both groups, the palm demonstrated the largest area and the elbow the smallest one. These data may be used to evaluate strike contact pressure in future studies in forensic biomechanics and assessment of injury in combat sports and self-defense. Full article

The ability to maintain a stable single-leg balance stance during a fast change of direction movement is a fundamental aspect both for improving sport-specific skills and for prevention strategies. The aim of this cross-sectional study was to investigate the associations between multidirectional speed performance (MDS), dynamic balance performance (DBP), and chronological age in young and uninjured soccer players. In addition, it was examined whether chronological age and balance can predict variance in speed performance. One-hundred forty-six young male soccer players (age range 11–19) performed the y-balance test (YBT) and the lower extremity functional test (LEFT). Descriptive statistics, Pearson correlation, and multiple regression analysis were executed. The analyses were carried out on the further variables: for the DBP, the YBT composite score % (CS dominant leg/CS non-dominant leg) and limb symmetry index % (LSI) were used; for the MDS, the LEFT time in seconds (s) was used. Findings revealed LEFT scores to have a significant association with chronological age (p = 0.000), CS dominant (p = 0.019) and LSI (p = 0.044) of the YBT. In addition, CS dominant and chronological age explained the variance of the LEFT by 44%, regardless of LSI. To conclude, MDS revealed a strong association with DBP of the dominant side but a small association with LSI. In addition, a small association was found between quick LEFT times and older players. Finally, MDS variance can be predicted from DBP of the dominant side and chronological age in young soccer players. The tests used in this study could be useful screening tools for the detection of performance deficits, the implementation of prevention training programs, and the optimization of selection strategies in soccer academies. Full article

The perception of bar velocity (PV) is a subjective parameter useful in estimating velocity during resistance training. The aim of this study was to investigate if the PV can be improved through specific training sessions, if it differs between the back squat (SQ) and bench press (BP), and if there are differences in perception accuracy in the different intensity zones. Resistance-trained participants were randomly divided in an experimental (EG, n = 16) or a control group (CG, n = 14). After a familiarization trial, both groups were tested before and after 5 weeks of training. The PV was assessed with five blinded loads covering different intensity domains. During the training period, only the EG group received velocity feedback for each repetition. Prior to training, both groups showed a greater PV accuracy in the SQ than in the BP. Post training, the EG showed a significant reduction (p < 0.05) in the delta score (the difference between the real and perceived velocity) for both exercises, while no significant differences were observed in the CG. Prior to training, the perceived velocity was more accurate at higher loads for both exercises, while no difference between loads was observed after training (EG). The results of this study demonstrate that the PV improves with specific training and that differences in the accuracy between loads and exercise modes seen prior to training are leveled off after training. Full article

Introduction: The kinesiotape (KT) method is used to exert a positive effect on muscular, nervous, and organ systems, recognizing the importance of muscle movement. It is widely applied in runners for performance enhancement. However, there is no scientific background to use it as a running speed modulator. Objectives: The purpose of this study was to verify the KT effect on running performance in university-level students while speed is considered. The 1 km run and 40 m shuttle run were investigated. Participants were highly motivated to run as fast as possible since the research was part of the graded fitness test. Students wanted to perform as well as possible to get good marks. Methods: A total of 150 students aged 19.93 ± 0.85 with BMIs of 26.93 ± 0.98 were randomly distributed to the experimental (EG), placebo (PG), and control group (CG). In the EG, 50 students were measured pre-test (no KT) and post-test (KT applied). In the PG, 50 students were measured the same way using the placebo application post-test. In the CG, 50 students were measured without any intervention pre-test or post-test. The application area was the triceps surae muscle bilaterally with KT tension of 75%. The Kruskal–Wallis test and repeated measures ANOVA were used for analysis with a 0.05 level of significance. Results: A statistically significant group effect was reported in the EG (<0.05) in the 1 km run discipline. The time results obtained were significantly shorter than in the PG and the CG. There was no statistically significant difference (0.717) reported in the 40 m shuttle run discipline between the groups. Conclusions: Applying KT with a tension of 75% on the triceps surae muscle bilaterally might be useful to increase the performance of medium or longer distance runs but may not be effective in improving sprinting ability. We recommend applying the KT in the overall muscle and tendon area with a tension of 75% if there is a focus on performance enhancement. Full article

Identifying and measuring soccer playing styles is a very important step toward a more effective performance analysis. Exploring the different game styles that a team can adopt to enable a great performance remains under-researched. To address this challenge and identify new directions in future research in the area, this paper conducted a critical review of 40 research articles that met specific criteria. Following the 22-item Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, this scoping review searched for literature on Google Scholar, Web of Science, and Pub Med databases. The descriptive and thematic analysis found that the objectives of the identified papers can be classified into three main categories (recognition and effectiveness of playing styles and contextual variables that affect them). Critically reviewing the studies, the paper concluded that: (i) factor analysis seems to be the best technique among inductive statistics; (ii) artificial intelligence (AI) opens new horizons in performance analysis, and (iii) there is a need for further research on the effectiveness of different playing styles, as well as on the impact of contextual variables on them. Full article

Literature reports superior performance when focusing one’s attention during a movement on environmental effects of that movement (external focus, EF) compared to focusing on the moving body (internal focus, IF). Nevertheless, IF instructions still play an important role in the daily practice of coaches, trainers, and therapists. The current review compiles evidence for focus-of-attention concepts on movement form corrections and technique training. Reviews on the topic and selected additional papers addressing the effect of attentional focus on movement form or on kinetic, kinematic or muscle activity data were included. Both EF and IF instructions affect movement form. The reviews revealed that IF instructions seem to be better applicable to direct movement form changes than EF instructions. In contrast, EF instructions better facilitate optimization within the whole-body coordination, often resulting in better performance outcomes not directly linked to movement pattern changes. Several studies discuss focus-of-attention effects in the context of the optimal feedback control theory expanding on the constrained action hypothesis. In summary, EF and IF instructions both affect form and performance of movements, however, their relative efficacy is situation dependent. The often-purported superiority of EF over IF instructions cannot be generalized to all application contexts. Full article

Gait recovery is vital for stroke survivors’ ability to perform their activities associated with daily living. Consequently, a gait impairment is a significant target for stroke survivors’ physical rehabilitation. This review aims to identify barriers to gait training among stroke survivors. An integrative review was conducted following Whittemore and Knafl’s methodology. The research was carried out on the electronic databases Scopus, PubMed, and B-on, applying a time span of 2006 to 2022. A total of 4189 articles were initially identified. After selecting and analyzing the articles, twelve studies were included in the sample. This review allowed for the identification of several barriers to gait training among stroke survivors, which can be grouped into three categories: individual, environmental, and rehabilitation workforce-related barriers. These findings highlight that participation in gait training is not solely dependent on the stroke survivor. Instead, the uptake of rehabilitation programs may also depend on environmental and rehabilitation workforce-related factors. Full article