Research and Publications - Department of Kinesiology

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Heat acclimation of an adult female with a large surface area of grafted skin
(Lippincott Williams & Wilkins, 2008-09-01) Wingo, Jonathan E.; Low, David A.; Keller, David M.; Davis, Scott L.; Kowalske, Karen J.; Purdue, Gary F.; Hunt, John L.; Crandall, Craig G.; University of Texas System; University of Texas Southwestern Medical Center Dallas; University of Alabama Tuscaloosa
Grafted skin has impaired blood flow and sweating responses necessary for heat dissipation. Heat acclimation improves temperature regulation in healthy individuals, but it is unknown whether heat acclimation improves temperature regulation of individuals with large areas of grafted skin. A 33-year-old woman with 75% total body surface area grafted skin 14 years postinjury performed upright cycling exercise at 45% peak oxygen uptake (50 W) for seven consecutive days in a climatic chamber set to 40 degrees C and 30% relative humidity. The daily goal was for this patient to exercise 90 minutes (with a 5-minute break at minute 45); however, exercise was stopped when an internal temperature (T.) limit of 39.5 degrees C was reached. The T-c limit was reached during minute 46 of exercise on day 1 of acclimation, but not until minute 65 of exercise oil day 7 of acclimation. The increases in T-c and heart rate during the first 45 minutes of exercise (the minimum duration completed for all acclimation bouts) were progressively mitigated with successive days of heat acclimation. Sweat sensitivity (the increase in sweat rate per 1 degrees C increase in T-c) in an area of uninjured skin increased by similar to 30% oil acclimation clay 7 relative to day 1. Heat acclimation improved thermal tolerance of this patient with a large area of grafted skin, which could increase safety and comfort during thermal stress and/or exercise.
Effect of elevated local temperature on cutaneous vasoconstrictor responsiveness in humans
(American Physiological Society, 2009-02-01) Wingo, Jonathan E.; Low, David A.; Keller, David M.; Brothers, R. Matthew; Shibasaki, Manabu; Crandall, Craig G.; University of Texas System; University of Texas Southwestern Medical Center Dallas; Nara Womens University; University of Alabama Tuscaloosa
Wingo JE, Low DA, Keller DM, Brothers RM, Shibasaki M, Crandall CG. Effect of elevated local temperature on cutaneous vasoconstrictor responsiveness in humans. J Appl Physiol 106: 571-575, 2009. First published December 4, 2008; doi: 10.1152/japplphysiol.91249.2008.-Cutaneous vascular conductance (CVC) increases in response to local skin heating. Although attenuation of vasoconstrictor responsiveness due to local heating has been demonstrated, the mechanism(s) responsible for this attenuation remains unclear. Nitric oxide has been shown to at least partially contribute to this response, but other mechanisms also may be involved. The purpose of this study was to test the hypothesis that local heating diminishes cutaneous vasoconstrictor responsiveness through a nitric oxide-independent mechanism by altering postsynaptic reactivity to norepinephrine. A follow-up protocol tested the hypothesis that local heating attenuates the presynaptic release of neurotransmitters that cause vasoconstriction, also via non-nitric oxide mechanisms. In protocol I, CVC was assessed in eight subjects during administration of increasing doses of norepinephrine (via intradermal microdialysis) at adjacent sites separately heated to 34 degrees C and 40 degrees C. In protocol II, which was identical to, but separate from, protocol I, CVC was assessed in seven subjects during administration of increasing doses of tyramine, which causes release of neurotransmitters from adrenergic nerves. At each site for both protocols, nitric oxide synthesis was inhibited (via microdialysis administration of N-G-nitro-L-arginine methyl ester) and flow was matched (via microdialysis administration of adenosine); therefore, temperature was the only variable that differed between the sites. For both protocols, nonlinear regression analysis revealed no difference (P > 0.05) in the effective drug concentration causing 50% of the vasoconstrictor response. Minimum CVC [6.3 +/- 2.0 and 9.0 +/- 4.0% of peak CVC (mean +/- SD) for protocol 1 and 19.3 +/- 9.3 and 20.5 +/- 11.9% of peak CVC for protocol II at 34 degrees C and 40 degrees C sites, respectively] was not different between sites. Independent of nitric oxide, local skin heating to 40 degrees C does not attenuate adrenergically mediated cutaneous vasoconstriction through pre- or postsynaptic mechanisms.
A Comparison of Energy Expenditure Estimation of Several Physical Activity Monitors
(Lippincott Williams & Wilkins, 2013) Dannecker, Kathryn L.; Sazonova, Nadezhda A.; Melanson, Edward L.; Sazonov, Edward S.; Browning, Raymond C.; Colorado State University; University of Alabama Tuscaloosa; University of Colorado Denver
Introduction: Accurately and precisely estimating free-living energy expenditure (EE) is important for monitoring energy balance and quantifying physical activity. Recently, single and multisensor devices have been developed that can classify physical activities, potentially resulting in improved estimates of EE. Purpose: This study aimed to determine the validity of EE estimation of a footwear-based physical activity monitor and to compare this validity against a variety of research and consumer physical activity monitors. Methods: Nineteen healthy young adults (10 men, 9 women) completed a 4-h stay in a room calorimeter. Participants wore a footwear-based physical activity monitor as well as Actical, ActiGraph, IDEEA, DirectLife, and Fitbit devices. Each individual performed a series of postures/activities. We developed models to estimate EE from the footwear-based device, and we used the manufacturer's software to estimate EE for all other devices. Results: Estimated EE using the shoe-based device was not significantly different than measured EE (mean T SE; 476 T 20 vs 478 +/- 18 kcal, respectively) and had a root-mean-square error of 29.6 kcal (6.2%). The IDEEA and the DirectLlife estimates of EE were not significantly different than the measured EE, but the ActiGraph and the Fitbit devices significantly underestimated EE. Root-mean-square errors were 93.5 (19%), 62.1 kcal (14%), 88.2 kcal (18%), 136.6 kcal (27%), 130.1 kcal (26%), and 143.2 kcal (28%) for Actical, DirectLife, IDEEA, ActiGraph, and Fitbit, respectively. Conclusions: The shoe-based physical activity monitor provides a valid estimate of EE, whereas the other physical activity monitors tested have a wide range of validity when estimating EE. Our results also demonstrate that estimating EE based on classification of physical activities can be more accurate and precise than estimating EE based on total physical activity.
Tracking Changes in Maximal Oxygen Consumption with the Heart Rate Index in Female Collegiate Soccer Players
(Sciendo, 2014) Esco, Michael R.; Snarr, Ronald L.; Flatt, Andrew; Leatherwood, Matthew; Whittaker, Adam; University of Alabama Tuscaloosa; Auburn University
The purpose of this study was to determine if the HRindex Method (VO2max = [6 x HRindex - 5] x 3.5, where HRindex = HRmax/HRrest) was accurate for tracking changes in VO2max following 8-weeks of endurance training among collegiate female soccer players. Predicted VO2max via the HRindex Method and observed VO2max from a maximal exercise test on a treadmill were determined for a group of female soccer athletes (n = 15) before and following an 8-week endurance training protocol. The predicted (pVO(2max)) and observed (aVO(2max)) values were compared at baseline and within 1-week post-training. Change values (i.e., the difference between pre to post) for each variable were also determined and compared. There was a significant difference between aVO(2max) before (43.2 +/- 2.8 ml.kg.min(-1)) and following (46.2 +/- 2.1 ml.kg.min(-1)) the 8-week training program (p < 0.05). However, pVO(2max) did not significantly change following training (pre = 43.4 +/- 4.6 ml.kg.min(-1), post = 42.9 +/- 4.1 ml.kg.min(-1), p = 0.53). Furthermore, the correlation between the change in aVO(2max) and the change in pVO(2max) was trivial and non-significant (r = 0.30, p = 0.28). The HRindex Method does not appear to be suitable for predicting changes in VO2max following 8-weeks of endurance training in female collegiate soccer players.
Dominant-Limb Range-of-Motion and Humeral-Retrotorsion Adaptation in Collegiate Baseball and Softball Position Players
(National Athletic Trainers' Association, 2014) Hibberd, Elizabeth E.; Oyama, Sakiko; Tatman, Justin; Myers, Joseph B.; University of Alabama Tuscaloosa; University of Texas at San Antonio (UTSA); Otterbein University; University of North Carolina; University of North Carolina Chapel Hill
Context: Biomechanically, the motions used by baseball and softball pitchers differ greatly; however, the throwing motions of position players in both sports are strikingly similar. Although the adaptations to the dominant limb from overhead throwing have been well documented in baseball athletes, these adaptations have not been clearly identified in softball players. This information is important in order to develop and implement injury-prevention programs specific to decreasing the risk of upper extremity injury in softball athletes. Objective: To compare range-of-motion and humeral-retrotorsion characteristics of collegiate baseball and softball position players and of baseball and softball players to sex-matched controls. Design: Cross-sectional study. Setting: Research laboratories and athletic training rooms at the University of North Carolina at Chapel Hill. Patients or Other Participants: Fifty-three collegiate baseball players, 35 collegiate softball players, 25 male controls (nonoverhead athletes), and 19 female controls (nonoverhead athletes). Intervention(s): Range of motion and humeral retrotorsion were measured using a digital inclinometer and diagnostic ultrasound. Main Outcome Measure(s): Glenohumeral internal-rotation deficit, external-rotation gain, total glenohumeral range of motion, and humeral retrotorsion. Results: Baseball players had greater glenohumeral internal-rotation deficit, total-range-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, total-range-of-motion, and humeral-retrotorsion difference in softball players and female controls. Conclusions: Few differences were evident between softball players and female control participants, although range-of-motion and humeral-retrotorsion adaptations were significantly different than baseball players. The throwing motions are similar between softball and baseball, but the athletes adapt to the demands of the sport differently; thus, stretching/strengthening programs designed for baseball may not be the most effective programs for softball athletes.
Acute Exercise and Oxidative Stress: CrossFit (TM) vs. Treadmill Bout
(Sciendo, 2015) Kliszczewicz, Brian; Quindry, C. John; Blessing, L. Daniel; Oliver, D. Gretchen; Esco, R. Michael; Taylor, J. Kyle; Kennesaw State University; Auburn University; University of Alabama Tuscaloosa
CrossFit (TM), a popular high-intensity training modality, has been the subject of scrutiny, with concerns of elevated risk of injury and health. Despite these concerns empirical evidence regarding physiologic stresses including acute oxidative stress is lacking. Therefore, the purpose of this investigation was to examine the acute redox response to a CrossFit (TM) bout. Furthermore, these findings were compared to a high-intensity treadmill bout as a point of reference. Ten males 26.4 +/- 2.7 yrs having three or more months of CrossFit (TM) experience participated in the present study. Blood plasma was collected at four time points: Pre-exercise (PRE), immediately-post-exercise (IPE), 1 hr-post (1-HP) and 2 hr-post (2-HP), to examine oxidative damage and antioxidant capacity. Regarding plasma oxidative damage, CrossFit (TM) and Treadmill elicited a time-dependent increase of lipid peroxides 1-HP (CrossFit (TM)=+143%, Treadmill=+115%) and 2-HP (CrossFit (TM) =+256%, Treadmill+167%). Protein Carbonyls were increased IPE in CF only (+5%), while a time-dependent decrease occurred 1-HP (CrossFit (TM)=-16%, Treadmill=-8%) and 2-HP (CF=-16%, TM=-1%) compared to IPE. Regarding antioxidant capacity, Ferric Reducing Antioxidant Power also demonstrated a time-dependent increase within CrossFit (TM) and Treadmill: IPE (CrossFit (TM)=+25%, Treadmill=+17%), 1-HP (CrossFit (TM)=+26%, Treadmill=+4.8%), 2-HP (CrossFit (TM)=+20%, Treadmill=+12%). Total Enzymatic Antioxidant Capacity showed a time-dependent decrease in IPE (CrossFit (TM)=-10%, Treadmill=-12%), 1-HP (CrossFit (TM)=-12%, Treadmill=-6%), 2-HP (CrossFit (TM)=-7%, Treadmill=11%). No trial-dependent differences were observed in any biomarker of oxidative stress. The CrossFit (TM) bout elicited an acute blood oxidative stress response comparable to a traditional bout of high-intensity treadmill running. Results also confirm that exercise intensity and the time course of exercise recovery influence oxidative responses.
Epidemiology of National Collegiate Athletic Association men's and women's swimming and diving injuries from 2009/2010 to 2013/2014
(BMJ, 2015) Kerr, Zachary Y.; Baugh, Christine M.; Hibberd, Elizabeth E.; Snook, Erin M.; Hayden, Ross; Dompier, Thomas P.; Harvard University; Boston Children's Hospital; University of Alabama Tuscaloosa
Background Recent injury data for collegiate-level swimming and diving are limited. This study describes the epidemiology of men's and women's swimming and diving injuries reported by the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) during the 2009/2010 to 2013/2014 academic years. Methods Injuries and athlete-exposure (AE) data reported within 9 men's and 13 women's swimming and diving programmes were analysed. Injury rates, injury rate ratios (IRR), and injury proportions by body site, diagnosis and mechanism were reported with 95% CIs. Results The ISP captured 149 and 208 injuries for men's and women's swimming and diving, respectively, leading to injury rates of 1.54/1000 and 1.71/1000 AEs. Among females, divers had a higher injury rate (2.49/1000 AEs) than swimmers (1.63/1000 AEs; IRR=1.53; 95% CI 1.07 to 2.19). Injury rates for male divers (1.94/1000 AEs) and swimmers (1.48/1000 AEs) did not differ (IRR=1.33; 95% CI 0.85 to 2.31). Most injuries occurred to the shoulder, resulted in strains and were classified as overuse or non-contact. Female swimmers had a higher overuse injury rate (1.04/1000 AEs) than male swimmers (0.66/1000 AEs; IRR=1.58; 95% CI 1.14 to 2.19). Overuse injury rates for female divers (0.54/1000 AEs) and male divers (0.46/1000 AEs) did not differ (IRR= 1.16; 95% CI 0.40 to 3.34). Injury rates in 2012/2013-2013/2014 were lower than those in 2009/2010-2011/2012 for women's swimming (IRR= 0.70; 95% CI 0.52 to 0.95) and diving (IRR= 0.56; 95% CI 0.30 to 1.08), respectively. No time trends existed for men's swimmers or divers. Conclusions Shoulder, strain and overuse injuries were common in collegiate men's and women's swimming and diving. Female swimmers were more likely to suffer an overuse injury than male swimmers. In addition, divers may have higher injury rates than swimmers, although small reported numbers warrant additional research.
Sweat gland density and response during high-intensity exercise in athletes with spinal cord injuries
(Institute of Sports, 2015) Pritchett, R. C.; Al-Nawaiseh, A. M.; Pritchett, K. K.; Nethery, V; Bishop, P. A.; Green, J. M.; Central Washington University; Hashemite University; University of Alabama Tuscaloosa
Sweat production is crucial for thermoregulation. However, sweating can be problematic for individuals with spinal cord injuries (SCI), as they display a blunting of sudomotor and vasomotor responses below the level of the injury. Sweat gland density and eccrine gland metabolism in SCI are not well understood. Consequently, this study examined sweat lactate (S-LA) (reflective of sweat gland metabolism), active sweat gland density (SGD), and sweat output per gland (S/G) in 7 SCI athletes and 8 able-bodied (AB) controls matched for arm ergometry VO(2)peak. A sweat collection device was positioned on the upper scapular and medial calf of each subject just prior to the beginning of the trial, with iodine sweat gland density patches positioned on the upper scapular and medial calf. Participants were tested on a ramp protocol (7 min per stage, 20 W increase per stage) in a common exercise environment (21 +/- 1 degrees C, 45-65% relative humidity). An independent t-test revealed lower (p< 0.05) SGD (upper scapular) for SCI (22.3 +/- 14.8 glands.cm(-2)) vs. AB. (41.0 +/- 8.1 glands.cm(-2)). However, there was no significant difference for S/G between groups. S-LA was significantly greater (p< 0.05) during the second exercise stage for SCI (11.5 +/- 10.9 mmol.l(-1)) vs. AB (26.8 +/- 11.07 mmol.l(-1)). These findings suggest that SCI athletes had less active sweat glands compared to the AB group, but the sweat response was similar (SLA, S/G) between AB and SCI athletes. The results suggest similar interglandular metabolic activity irrespective of overall sweat rate.
Comparison of Upper Extremity Physical Characteristics Between Adolescent Competitive Swimmers and Nonoverhead Athletes
(National Athletic Trainers' Association, 2016) Hibberd, Elizabeth E.; Laudner, Kevin; Berkoff, David J.; Kucera, Kristen L.; Yu, Bing; Myers, Joseph B.; University of Alabama Tuscaloosa; Illinois State University; University of North Carolina; University of North Carolina Chapel Hill
Context: Alterations to upper extremity physical characteristics of competitive swimmers (posture, range of motion [ROM], and subacromial-space distance) are commonly attributed to cumulative training load during a swimmer's competitive career. However, this accepted clinical belief has not been established in the literature. It is important to understand whether alterations in posture and associated physical characteristics occur as a result of sport training or factors other than swimming participation to better understand injury risk and possible interventions. Objective: To compare posture, subacromial-space distance, and glenohumeral external-rotation, internal-rotation, and horizontal-adduction ROM between adolescent competitive swimmers and nonoverhead athletes. Design: Cross-sectional study. Setting: Local swimming pools and high school athletic training rooms. Patients or Other Participants: Forty-four competitive adolescent swimmers and 31 nonoverhead athletes who were not currently experiencing any elbow, shoulder, neck, or back pain that limited their sport activity. Intervention(s): Posture, subacromial-space distance, and glenohumeral ROM were measured using photography, diagnostic ultrasound, and a digital inclinometer, respectively. Main Outcome Measure(s): Forward shoulder posture, forward head posture, normalized subacromial-space distance, internal-rotation ROM, and external-rotation ROM. Results: No clinically significant differences existed between swimmers and nonoverhead athletes for posture, normalized subacromial-space distance, or external-or internal-rotation ROM. Swimmers presented with less horizontal-adduction ROM than nonoverhead athletes. Conclusions: Factors other than swimming participation, such as school and technology use, play important roles in the adaptation of physical characteristics in adolescents. Adolescents, regardless of swimming participation, presented with postural deviations. It is important to consider factors other than swimming participation that contribute to alterations in physical characteristics to understand injury risk and injury-prevention strategies in competitive adolescent swimmers.
Electromyographical Comparison of a Traditional, Suspension Device, and Towel Pull-Up
(De Gruyter, 2017) Snarr, Ronald L.; Hallmark, Ashleigh V.; Casey, Jason C.; Esco, Michael R.; Georgia Southern University; University of Alabama Tuscaloosa
Strengthening muscles of the back may have various implications for improving functions of daily living, aiding in the transfer of power in throwing, and assist in injury prevention of the shoulder complex. While several versions of the pull-up exist, there is currently no literature comparing their differences. The purpose of this investigation was to compare the electromyographical activity of the latissimus dorsi, posterior deltoid, middle trapezius, and biceps brachii while performing three variations of the pull-up. Resistance-trained men and women (n = 15, age = 24.87 +/- 6.52 years) participated in this study by performing traditional pull-ups, suspension device pull-ups, and towel pull-ups in a randomized fashion. Each pull-up was performed for three repetitions with a 1.5 biacromial grip-width for each participant. Normalized (%MVC) electromyographical values were recorded for each muscle group during each pull-up variation. No significant differences existed within the latissimus dorsi, biceps brachii or posterior deltoid between any of the exercises. For the middle trapezius, towel pull-ups provided significantly lower muscle activity than the traditional pull-up, while no differences between suspension pull-ups and the other variations occurred. In conclusion, only one muscular difference existed between the exercise variations and all versions examined provided electromyographical values, determined by current literature, to invoke a sufficient stimulus to promote increases in muscle strength and hypertrophy. Although further research is needed, practitioners can be confident when programming any of the movement variations examined when attempting to elicit adaptations of muscular strength and hypertrophy.
The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009-2010 Through 2014-2015 Academic Years
(National Athletic Trainers' Association, 2017) Kopec, Thomas J.; Hibberd, Elizabeth E.; Roos, Karen G.; Djoko, Aristarque; Dompier, Thomas P.; Kerr, Zachary Y.; Samford University; University of Alabama Tuscaloosa; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina School of Medicine
Context: Deltoid ligament sprains among collegiate studentathletes have not been extensively investigated. Research regarding the mechanisms, participation-restriction time, and recurrence of deltoid ligament sprains in collegiate studentathletes is lacking. Objective: To describe the epidemiology of deltoid ligament sprains in 25 National Collegiate Athletic Association championship sports. Design: Descriptive epidemiology study. Setting: National Collegiate Athletic Association Injury Surveillance Program. Main Outcome Measure(s): We analyzed deltoid ligament sprains recorded in the Injury Surveillance Program for the 2009-2010 through 2014-2015 academic years. Deltoid ligament sprain injury rates, rate ratios, and injury proportion ratios with 95% confidence intervals (CIs) were reported. Results: During the study period, 380 deltoid ligament sprains were reported, resulting in a combined injury rate of 0.79/10 000 athlete-exposures (AEs; 95% CI = 0.71, 0.87). Most deltoid ligament sprains occurred in practices (54.2%, n = 206). However, the competition injury rate was higher than the practice injury rate (rate ratio = 3.74; 95% CI = 3.06, 4.57). The highest deltoid ligament sprain rates were in women's gymnastics (2.30/10 000 AEs; 95% CI = 1.05, 3.55), men's soccer (1.73/10 000 AEs; 95% CI = 1.14, 2.32), women's soccer (1.61/10 000 AEs; 95% CI = 1.13, 2.09), and men's football (1.40/10 000 AEs; 95% CI = 1.18, 1.62). Nearly half of all deltoid ligament sprains (49.7%, n = 189) were due to player contact, and 39.5% (n = 150) were non-time-loss injuries (ie, participation restricted for less than 24 hours). Only 8.2% (n = 31) of deltoid ligament sprains were recurrent. Conclusions: The highest deltoid ligament sprain rates were in women's gymnastics, men's and women's soccer, and men's football. However, the rate for women's gymnastics was imprecise (ie, the CI was wide), highlighting the need for further surveillance of deltoid ligament sprains in the sport. Most deltoid ligament sprains were due to player contact. Future researchers should assess interventions that may prevent deltoid ligament sprains.
Balance, Basic Anthropometrics and Performance in Young Alpine Skiers; Longitudinal Analysis of the Associations During Two Competitive Seasons
(Sciendo, 2017) Lesnik, Blaz; Sekulic, Damir; Supej, Matej; Esco, Michael R.; Zvan, Milan; University of Ljubljana; University of Split; University of Alabama Tuscaloosa
Balance is hypothesized to be important in alpine skiing, while it is known that balance depends on anthropometric indices. The aim of this investigation was to explore the association between balance, anthropometrics and skiing-results over two competitive seasons among youth alpine-skiers. Eighty-one skiers (40 females) participated in this study. The participants were tested twice over two competitive seasons: when they were 12-13 years old (U14) and when they were 14-15 years old (U16). The variables consisted of anthropometrics (body height and body mass) and three balance indexes (medio-lateral-, anterio-posterior- and overall-stability-index). Additionally, skiing results in U14 and U16 were evaluated. The balance status did not change significantly over the observed period of time regardless of the significant changes in body mass and height. The relationships between balance and skiing results were higher in the U14 (Pearson's r = 0.45-0.54) than in the U16 (Pearson's r = 0.05-0.28). The relationships between anthropometrics and competitive results were generally stronger in girls (Pearson's r = 0.39-0.88) than in boys (Pearson's r = 0.26-0.58). After clustering athletes into three achievement groups on a basis of their competitive performance, discriminant canonical analysis showed that relationships between balance and skiing results decreased, while the relationships between anthropometrics and skiing results increased over the two observed seasons. This study highlighted the importance of balance in youth alpine skiing in the age range of 11-14 years.
Adequacy of the Ultra-Short-Term HRV to Assess Adaptive Processes in Youth Female Basketball Players
(Sciendo, 2017) Nakamura, Fabio Y.; Pereira, Lucas A.; Abad, Cesar C. Cal; Cruz, Igor F.; Flatt, Andrew A.; Esco, Michael R.; Loturco, Irineu; Universidade Estadual de Londrina; University of Alabama Tuscaloosa
Heart rate variability has been widely used to monitor athletes' cardiac autonomic control changes induced by training and competition, and recently shorter recording times have been sought to improve its practicality. The aim of this study was to test the agreement between the (ultra-short-term) natural log of the root-mean-square difference of successive normal RR intervals (lnRMSSD - measured in only 1 min post-1 min stabilization) and the criterion lnRMSSD (measured in the last 5 min out of 10 min of recording) in young female basketball players. Furthermore, the correlation between training induced delta change in the ultra-short-term lnRMSSD and the criterion lnRMSSD was calculated. Seventeen players were assessed at rest pre-and post-eight weeks of training. Trivial effect sizes (-0.03 in the pre-and 0.10 in the post-treatment) were found in the comparison between the ultra-short-term lnRMSSD (3.29 +/- 0.45 and 3.49 +/- 0.35 ms, in the pre-and post-, respectively) and the criterion lnRMSSD (3.30 +/- 0.40 and 3.45 +/- 0.41 ms, in the pre-and post-, respectively) (intraclass correlation coefficient = 0.95 and 0.93). In both cases, the response to training was significant, with Pearson's correlation of 0.82 between the delta changes of the ultra-short-term lnRMSSD and the criterion lnRMSSD. In conclusion, the lnRMSSD can be calculated within only 2 min of data acquisition (the 1(st) min discarded) in young female basketball players, with the ultra-short-term measure presenting similar sensitivity to training effects as the standard criterion measure.
Field-Based Performance Tests Are Related to Body Fat Percentage and Fat-Free Mass, But Not Body Mass Index, in Youth Soccer Players
(MDPI, 2018) Esco, Michael R.; Fedewa, Michael, V; Cicone, Zackary S.; Sinelnikov, Oleg A.; Sekulic, Damir; Holmes, Clifton J.; University of Alabama Tuscaloosa; University of Split
The primary aim of this study was to determine the association between body composition and performance outcomes in youth soccer players. Twenty-five competitive male youth soccer players (age = 13.7 +/- 0.8 years, height = 167.4 +/- 9.7 cm, weight = 57.6 +/- 12.1 kg) volunteered to participate in this study. Height and weight were used to calculate body mass index (BMI). Body fat percentage (BF%) and fat-free mass (FFM) were determined with dual-energy X-ray absorptiometry. Each athlete performed the Pacer test, vertical jump, and t-test drill. Participants were predominantly normal weight (20.4 +/- 2.7 kg.m(-2)). The body composition results were 20.3 +/- 4.9% for BF% and 46.5 +/- 8.7 kg for FFM. The results of the performance tests indicated a mean standard deviation (SD) of 1418 +/- 332 m for Pacer, 57.2 +/- 7.4 cm for vertical jump, 11.6 +/- 0.7 s for t-test. Body mass index was not associated with any performance measure (r = 0.02 to -0.21, all p > 0.05). Body fat percentage was associated with the Pacer, vertical jump, and t-test (r = -0.62, -0.57, 0.61, respectively; all p < 0.01) and remained after accounting for BMI. Fat-free mass was only significantly related to t-test (r = -0.43, p < 0.01). However, after controlling for BMI, FFM was related to all three performance tests. Body fat percentage and FFM are associated with performance in youth soccer players, with stronger relationships reported in the former metric. The findings highlight the need for accurate body composition measurements as part of an assessment battery in young athletes.
Rate of Upper Extremity Injury in High School Baseball Pitchers Who Played Catcher as a Secondary Position
(National Athletic Trainers' Association, 2018) Hibberd, Elizabeth E.; Oyama, Sakiko; Myers, Joseph B.; University of Alabama Tuscaloosa; University of Texas at San Antonio (UTSA)
Context: Many high school pitchers play another position after they have finished pitching for the day or on their rest days from pitching. Because of the cumulative demands on the arm, pitchers who also play catcher may have a greater risk of developing a throwing-related shoulder or elbow injury. Objective: To compare the rate of throwing-related upper extremity injuries between high school baseball pitchers who also played catcher as a secondary position and those who did not play catcher. Design: Prospective cohort study. Setting: Field laboratory. Patients or Other Participants: A total of 384 male high school baseball pitchers were recruited from 51 high school teams. Pitchers who reported their secondary position as catcher were classified into the pitcher/catcher group and those who did not report playing catcher as a secondary position were classified into the other group. Main Outcome Measure(s): Participants completed a demographic questionnaire preseason and then athlete participation and injury status were tracked during the subsequent season. Athlete-exposures were monitored and the shoulder and elbow injury proportion rates were calculated. Results: Athlete-exposures did not differ between groups (P = .488). The pitcher/catcher group's risk of shoulder or elbow injury was 2.9 times greater than that of the other pitchers (15% versus 5%; injury proportion rate = 2.9; 95% confidence interval = 1.03, 8.12). Conclusions: Pitchers who reported also playing catcher were at a greater risk of sustaining a throwing-related shoulder or elbow injury than the other pitchers. These findings suggest that pitchers should consider not playing catcher as their secondary position in order to allow adequate time for recovery and to decrease their overall throwing load. Serial physical examinations of pitchers/catchers during the season may be useful in determining if their physical characteristics are changing during the season because of the cumulative throwing load.
Heart Rate Variability Responses to an Undulating Resistance Training Program in Free-Living Conditions: A Case Study in a Collegiate Athlete
(MDPI, 2018) Holmes, Clifton J.; Wind, Stefanie A.; Esco, Michael R.; University of Alabama Tuscaloosa
The purpose of this case study was to evaluate the response in heart rate variability via the parasympathetically-mediated metric of the log-transformed root mean square of successive R-R interval differences (lnRMSSD) to weekly variations in total volume-load (TVL) during an 18-week periodized strength training program in a competitive collegiate hockey athlete. The program consisted of three 60-90 min full-body exercise sessions per week with at least 24-h of rest between each session. Daily lnRMSSD measurements were taken immediately after waking using a validated smartphone application and the pulse-wave finger sensor. The weekly lnRMSSD values were calculated as the mean (lnRMSSD(MEAN)) and the coefficient of variation (lnRMSSD(CV)). A Pearson's bivariate correlation of lnRMSSD(MEAN) and TVL revealed no statistically significant correlation between the two variables; TVL (r = -0.105, p = 0.678). However, significant correlations were found between 1nRMSSD(CV) and both total load (TL) (r = -0.591, p = 0.013) and total volume (TV) (r = 0.765, p < 0.001). Additionally, weekly ratings of perceived exertion (RPE) mean values were statistically significantly correlated to TVL, r = 0.853, p < 0.001. It was concluded that lnRMSSD(CV) increased or decreased proportionally to an increase or decrease in TVL during the periodized resistance training program with TV being the strongest, independent indicator of these changes.
Association between Subjective Indicators of Recovery Status and Heart Rate Variability among Divison-1 Sprint-Swimmers
(MDPI, 2018) Flatt, Andrew A.; Esco, Michael R.; Nakamura, Fabio Y.; University of Alabama Tuscaloosa; G d'Annunzio University of Chieti-Pescara; James Cook University
Heart rate variability (HRV) is a physiological marker of training adaptation among athletes. However, HRV interpretation is challenging when assessed in isolation due to its sensitivity to various training and non-training-related factors. The purpose of this study was to determine the association between athlete-self report measures of recovery (ASRM) and HRV throughout a preparatory training period. Ultra-short natural logarithm of the root mean square of successive differences (LnRMSSD) and subjective ratings of sleep quality, fatigue, muscle soreness, stress and mood were acquired daily for 4 weeks among Division-1 sprint-swimmers (n = 17 males). ASRM were converted to z-scores and classified as average (z-score -0.5-0.5), better than average (z-score > 0.5) or worse than average (z-score < -0.5). Linear mixed models were used to evaluate differences in LnRMSSD based on ASRM classifications. LnRMSSD was higher (p < 0.05) when perceived sleep quality, fatigue, stress and mood were better than average versus worse than average. Within-subject correlations revealed that 15 of 17 subjects demonstrated at least one relationship (p < 0.05) between LnRMSSD and ASRM variables. Changes in HRV may be the result of non-training related factors and thus practitioners are encouraged to include subjective measures to facilitate targeted interventions to support training adaptations.
Physiological and Perceptual Responses to High-Intensity Circuit Training using Body Weight as Resistance: Are There Sex-Specific Differences?
(2019) Clayton, Bethanne C.; Tinius, Rachel A.; Winchester, Lee J.; Menke, Brenna R.; Reece, Michelle C.; Maples, Jill M.; University of Alabama Tuscaloosa
High-intensity circuit training (HICT) using body weight as resistance is a popular fitness trend and an ideal exercise modality in terms of functionality and economy. Given the popularity of HICT, evidence suggests that sex may elicit unique physiological and perceptual responses to this mode of exercise and there is a need for further work in this area. The purpose of this study was to examine physiological and perceptual responses of females and males to HICT using body weight resistance exercise. Forty-five participants (23 females and 22 males) completed baseline testing and a 15-minute HICT exercise bout wearing a portable metabolic analyzer. %VO2max, %HRmax, and RER were monitored during exercise and analyzed at 3 different 5-minute time segments during the HICT (beginning, middle, end). RPE was assessed half-way through the circuit (7.5), immediately upon cessation of exercise (15), and 15-minutes postexercise (Session RPE). There was a significant (p<0.01) time effect on %VO2max, %HRmax, RER, and RPE. At all three time points, %VO2max was significantly (p<0.02) higher among females compared to males. RER values were significantly (p=0.02) higher among females during the last 5-minute segment (i.e. the end) of the exercise bout. However there were no differences in %HRmax (p>0.20). Males reported a higher RPE immediately post-exercise compared to females (p=0.01). Taken together, these data suggest that there are distinct, sex-specific physiological and perceptual responses to HICT; thus, sex-specific exercise prescription considerations are warranted.
Daily Heart Rate Variability before and after Concussion in an American College Football Player
(MDPI, 2019) Flatt, Andrew A.; Wilkerson, Gary B.; Allen, Jeff R.; Keith, Clay M.; Esco, Michael R.; University of Alabama Tuscaloosa; University of Tennessee at Chattanooga
This case report demonstrates the effects of sport-related concussion (SRC) on heart rate variability (HRV) in an American college football player. Daily measures of resting, ultra-short natural logarithm of the root mean square of successive differences (LnRMSSD), subjective wellbeing, and Player Load were obtained each training day throughout a 4-week spring camp and 4 weeks of preseason training. SRC occurred within the first 2 weeks of the preseason. During spring camp and preseason pre-SRC, the athlete demonstrated minimal day-to-day fluctuations in LnRMSSD, which increased post-SRC (LnRMSSD coefficient of variation pre-SRC 3.1%, post-SRC = 5.8%). Moderate decrements in daily-averaged LnRMSSD were observed post-SRC relative to pre-SRC (Effect Size +/- 90% Confidence Interval = -1.12 +/- 0.80), and the 7-day rolling average fell below the smallest worthwhile change for the remainder of the preseason. LnRMSSD responses to SRC appeared similar to trends associated with stress and training fatigue. Therefore, performance and sports medicine staff should maintain regular communication regarding player injury and fatigue status so that HRV can be interpreted in the appropriate context. Detection and monitoring of autonomic dysregulation post-SRC may require near-daily assessment, as LnRMSSD showed greater daily fluctuations rather than chronic suppression following the head injury.
Heart Rate Variability and Stress Recovery Responses during a Training Camp in Elite Young Canoe Sprint Athletes
(MDPI, 2019) Coelho, Andre B.; Nakamura, Fabio Y.; Morgado, Micaela C.; Holmes, Clifton J.; Di Baldassarre, Angela; Esco, Michael R.; Rama, Luis M.; Universidade de Coimbra; G d'Annunzio University of Chieti-Pescara; James Cook University; Universidade do Porto; University of Alabama Tuscaloosa
Training camps are typical in elite Canoeing preparation, during which, the care to assure adaptation to avoid undesired fatigue is not always present. This study aimed identifying a specific sex response in perceived training loads, recovery and stress balance, and cardiac autonomic responses. Twenty-one elite athletes (11 males and 10 females) of the Portuguese Canoeing National team participated in the investigation. The daily HRV (lnRMSSD) was monitored. The (RESTQ-52) questionnaire was used to access the recovery and stress state. The 10-day training camp was composed of two consecutive 5-day periods (P1 and P2). Data analyses were performed using confidence limits, effect size, and magnitude-based inference. In the females, Session rating of perceived exertion (sRPE), lnRMSSD, and its coefficient of variation did not change between P1 and P2. However, in males, lnRMSSD showed a small reduction from P1 to P2. Also, sRPE was higher in males over the training period, with a possibly small difference at P2. Regarding RESTQ-52, total stress most likely increased with large and very large differences in males and moderate differences in females during the training period. Male canoeists undertook higher perceived training loads than females, with a consequent higher level of total perceived stress and lnRMSSD during a 10-day training camp.

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