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The potential effects of exposure to repetitive subconcussive head impacts through routine participation in sport are not understood. To investigate the effects of repetitive subconcussive head impacts we studied boxers following customary training (sparring) using transcranial magnetic stimulation (TMS), decomposition electromyographic (EMG) and tests of memory. Twenty amateur boxers performed three 3-min sparring bouts. Parameters of brain function and motor control were assessed prior to sparring and again immediately, 1 h and 24 h post-sparring. Twenty control participants were assessed following mock-sparring. One hour after sparring boxers showed increased corticomotor inhibition, altered motor unit recruitment strategies, and decreased memory performance relative to controls, with values returning to baseline by the 24 h follow up. Repetitive subconcussive head impacts associated with sparring resulted in acute and transient brain changes similar to those previously reported in soccer heading, providing convergent evidence that sport-related head impacts produce a GABAergic response. These acute changes in brain health are reminiscent of effects seen following brain injury, and suggest a potential mechanism underlying the damaging long-term effects of routine repetitive head impacts in sport.

Exercise-induced muscle damage (EIMD) is associated with impaired muscle function and reduced neuromuscular recruitment. However, motor unit firing behaviour throughout the recovery period is unclear. EIMD impairment of maximal voluntary force (MVC) will, in part, be caused by reduced high-threshold motor unit firing, which will subsequently increase to recover MVC. Fourteen healthy active males completed a bout of eccentric exercise on the knee extensors, with measurements of MVC, rate of torque development and surface electromyography performed pre-exercise and 2, 3, 7 and 14 days post-exercise, on both damaged and control limb. EIMD was associated with decreased MVC (235.2 ± 49.3 Nm vs. 161.3 ± 52.5 Nm; p <0.001) and rate of torque development (495.7 ± 136.9 Nm.s-1 vs. 163.4 ± 163.7 Nm.s-1; p <0.001) 48h post-exercise. Mean motor unit firing rate was reduced (16.4 ± 2.2 Hz vs. 12.6 ± 1.7 Hz; p <0.01) in high-threshold motor units only, 48h post-exercise, and common drive was elevated (0.36 ± 0.027 vs. 0.56 ± 0.032; p< 0.001) 48h post-exercise. The firing rate of high-threshold motor units was reduced in parallel with impaired muscle function, whilst early recruited motor units remained unaltered. Common drive of motor units increased in offset to the firing rate impairment. These alterations correlated with the recovery of force decrement, but not of pain elevation. This study provides fresh insight into the central mechanisms associated with EIMD recovery, relative to muscle function. These findings may in turn lead to development of novel management and preventative procedures.

Background Exercise referral schemes (ERS) aim to tackle non-communicable disease (NCD) by increasing physical activity levels through prescribed exercise. However, there is a sparsity of knowledge upon what exercises are prescribed and if they are targeted towards tackling NCD. Method Mixed methods were employed. Quantitative data was extracted from exercise prescription cards of 50 participants and were assessed for frequency, intensity, type and time of prescribed exercise. Descriptive measures of aggregate data are expressed as median (range: minimum-maximum). Thematic analysis of semi-structured interviews generated qualitative data on exercise referral instructors’ experiences of prescribing exercise. Results Thirty-eight different types of exercise were prescribed. Median prescription was 4 (1–11) exercises per session, at a moderate intensity. Participants were prescribed a median of 35 (5–70) minutes of aerobic exercise per referral session. Exercise referral instructors prescribed exercise to improve activities of daily living, promote independence and autonomy of participants, rather than explicitly targeting the referral condition. Conclusions Knowledge that prescribed exercises are not explicitly targeted to the referral condition provides critical information in understanding the purpose of exercise prescription. Future evaluations of ERS should be mindful of this, that is, perceived outcomes might not match up to what is being prescribed within ERS.

Considering the vast physical and neural developments experienced throughout adolescence, the reliability of physical performance may vary in youth populations. This study aimed to examine the reliability of change of direction (COD) and agility tests in youth soccer players. Altogether, 86 youth soccer players, aged 13.6 ± 2.0 years, volunteered to participate. Data were collected from a modified 505 COD test (m505COD) and the Y-sprint drill in both pre-planned (Y-SprintPRE) and reactive (Y-SprintREACT) conditions during 2 sessions, 7 days apart. Anthropometric data including body mass, standing stature, and sitting height were also collected. COD and agility tests demonstrated good reliability (ICC = 0.81–0.91; CV = 1.2–2.0; d = 0.00–0.31; p < 0.01) for our entire sample. However, we observed a small negative relationship between age and intersession differences for the Y-SprintPRE (r = −0.28; p = 0.04), and moderate negative relationships between both age (r = −0.41; p < 0.01), and maturity offset (r = −0.39; p < 0.01) for the Y-SprintREACT. Although the COD and agility tests adopted within this study possess good intersession reliability, we observed greater intersession differences for younger and less mature individuals. We suggest that while COD and agility tests may provide meaningful objective data for monitoring the development of youth soccer players, these tests should be used with caution when evaluating younger, more immature athletes.

Background Regular participation in resistance exercise is known to have broad-ranging health benefits and for this reason is prominent in the current physical activity guidelines. Recovery after such exercise is important for several populations across the age range and nutritional strategies to enhance recovery and modulate post-exercise physiological processes are widely studied, yet effective strategies remain elusive. Vitamin K2 supplementation has emerged as a potential candidate, and the aim of the current study, therefore, is to test the hypothesis that vitamin K2 supplementation can accelerate recovery, via modulation of the underlying physiological processes, following a bout of resistance exercise in young and older adults. Methods The current study is a two-arm randomised controlled trial which will be conducted in 80 (40 young (≤40 years) and 40 older (≥65 years)) adults to compare post-exercise recovery in those supplemented with vitamin K2 or placebo for a 12-week period. The primary outcome is muscle strength with secondary outcomes including pain-free range of motion, functional abilities, surface electromyography (sEMG) and markers of inflammation and oxidative stress. Discussion Ethical approval has been granted by the College of Medical Veterinary and Life Sciences Ethical Committee at the University of Glasgow (Project No 200190189) and recruitment is ongoing. Study findings will be disseminated through a presentation at scientific conferences and in scientific journals. Trial registration ClinicialTrials.gov NCT04676958. Prospectively registered on 21 December 2020.

Background Amidst growing concern about the safety of sport-related repetitive subconcussive head impacts (RSHI), biofluid markers may provide sensitive, informative, and practical assessment of the effects of RSHI exposure. Objective This scoping review aimed to systematically examine the extent, nature, and quality of available evidence from studies investigating the effects of RSHI on biofluid markers, to identify gaps and to formulate guidelines to inform future research. Methods PRISMA extension for Scoping Reviews guidelines were adhered to. The protocol was pre-registered through publication. MEDLINE, Scopus, SPORTDiscus, CINAHL, PsycINFO, Cochrane Library, OpenGrey, and two clinical trial registries were searched (until March 30, 2022) using descriptors for subconcussive head impacts, biomarkers, and contact sports. Included studies were assessed for risk of bias and quality. Results Seventy-nine research publications were included in the review. Forty-nine studies assessed the acute effects, 23 semi-acute and 26 long-term effects of RSHI exposure. The most studied sports were American football, boxing, and soccer, and the most investigated markers were (in descending order): S100 calcium-binding protein beta (S100B), tau, neurofilament light (NfL), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), phosphorylated tau ( p -tau), ubiquitin C-terminal hydrolase L1 (UCH-L1), and hormones. High or moderate bias was found in most studies, and marker-specific conclusions were subject to heterogeneous and limited evidence. Although the evidence is weak, some biofluid markers—such as NfL—appeared to show promise. More markedly, S100B was found to be problematic when evaluating the effects of RSHI in sport. Conclusion Considering the limitations of the evidence base revealed by this first review dedicated to systematically scoping the evidence of biofluid marker levels following RSHI exposure, the field is evidently still in its infancy. As a result, any recommendation and application is premature. Although some markers show promise for the assessment of brain health following RSHI exposure, future large standardized and better-controlled studies are needed to determine biofluid markers’ utility. Key Points This is the first systematically conducted review focused on scoping biofluid markers in sport-related repetitive subconcussive head impact (RSHI) research, identifying a significant body of evidence not previously featured in relevant systematic reviews. The scoping review identified critical limitations of the current research in the field, including lack of impact monitoring and failure to sufficiently control for confounding variables such as concussion history and the effect of exercise. Findings reveal that the current evidence base is largely heterogeneous, limiting any firm conclusions at this stage. Despite limited and heterogeneous evidence, some markers appeared to show promise in detecting the effects of subconcussive head impacts.

Background: Swim performance can be reliant on strength and power. Standardisation of swim performance in different events, distances, and sexes can be completed using World Aquatics points, allowing for ranking of swimmers. The aim of this retrospective cross-sectional study was to assess whether relationships between World Aquatics points and dryland markers of performance existed in male and female elite swimmers separately and combined. Methods: Dryland tests included Optojump® photoelectric cell countermovement jump, countermovement jump reach with a Vertec® system, standing broad jump using a tape measure, repetition maximum testing in the barbell back squat, barbell deadlift, and barbell bench press. Swim performance data and dryland test data on elite male (n = 38) and female (n = 20) Scottish swimmers from 2009–2017 were collected. Swim performance data were converted to World Aquatics federation points, and Bayesian linear regression analyses examined relationships between World Aquatics points and dryland performance tests: countermovement jump height (cm) using an Optojump® photoelectric cells system, countermovement jump height (cm) using a Vertec® device, standing broad jump distance (cm), relative strength (load lifted (kg) per kg of body mass) in the barbell bench press (kg/kg), barbell back squat (kg/kg), barbell deadlift (kg/kg). Results: The Bayesian estimates of change of World Aquatics points for a unit change in jump-based measures were: Optojump®—men = 0.6, women = 0.6, combined = 0.4; Vertec®—men = 4.3, women = −1.6, combined = 2.4; standing broad jump—men = 0, women = 0, combined = 0.4. Strength-based measures were: barbell back squat—men = 2.3, women = 22, combined = −2.5; barbell deadlift—men = −5; barbell bench press—men = 41.8. Conclusions: Dryland performance tests are not good predictors of World Aquatics points and should rather be used for assessing training quality and monitoring injury risks.

Background High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting. Methods This cross-sectional study recruited black SA women between the ages of 60–85 years ( n  = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of >  30.0 kg/m 2 were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored. Results The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8–14.7%, including 0.8–9.8% without obesity and 0–4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity ( p  = 0.046). A similar profile described women with low BMI-adjusted grip strength ( p  < 0.001). Conclusions The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.

The main objective of this systematic review was to determine if the arterial stiffness remains elevated after 6 weeks post-delivery in women with a history of hypertensive disorders of pregnancy (HDP). A comprehensive systematic literature search was conducted across multiple electronic databases, including Medline, PubMed, Embase, Cochrane Library, Google Scholar, Web of Science, and CINAHL. We included studies assessing arterial stiffness in women with a history of HDP between 43 days and 10 years postdelivery, with participants under 60 years of age. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. We extracted data on arterial stiffness indices, including carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), and heart rate adjusted augmentation index (AIx@75), along with the mean ± standard deviation for each study. A random-effects model was used to pool data, and heterogeneity was explored through sensitivity and subgroup analyses. The Newcastle Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess risk of bias and quality of evidence. Out of 121 identified articles, 12 studies involving a total of 856 women were included in the final review after eliminating duplicates and irrelevant studies. The overall pooled data revealed a significantly elevated AIx and cfPWV among women with a history of HDP. Specifically, the mean difference (MD) in AIx was 11.63 (95% Confidence Interval (CI): [1.72-21.54]), and for cfPWV, the MD was 0.53 (95% CI: [0.27-0.78]). Notably, while AIx showed no significant change in women within 1 year postpartum (MD 14.85, 95% CI [-6.03-35.72]), an elevation was observed in those beyond 1 year post-delivery (MD 9.11, 95% CI [4.20-14.02]). cfPWV was also found to be elevated in HDP patients both within 1 year (MD 0.59, 95% CI [0.32-0.86]) and beyond 1 year (MD 0.45, 95% CI [0.03-0.88]). In cases of early-onset preeclampsia, AIx did not show a significant increase; however, a significant increase in cfPWV was observed, with AIx having an MD of 1.55 (95% CI: [-0.74-3.84]) and cfPWV an MD of 1.86 (95% CI: [0.25-3.47]). For late-onset preeclampsia, there was no significant difference in AIx (MD 2.44, 95% CI: [-8.82-13.70]) or cfPWV (MD 0.10, 95% CI: [-0.42-0.62]). This systematic review and meta-analysis suggest that arterial stiffness may remain elevated beyond 6 weeks postpartum in women with a history of HDP. However, the findings should be interpreted with caution due to heterogeneity across studies and limited number of available studies. Larger and standardized longitudinal studies are needed to confirm these results. In the meantime, regular cardiovascular monitoring for these women is recommended while awaiting more conclusive evidence. https://www.crd.york.ac.uk/PROSPERO/search, CRD42023461867.

Skeletal muscle operates as a near-constant volume system; as such muscle shortening during contraction is transversely linked to radial deformation. Therefore, to assess contractile properties of skeletal muscle, radial displacement can be evoked and measured. Mechanomyography measures muscle radial displacement and during the last 20 years, tensiomyography has become the most commonly used and widely reported technique among the various methodologies of mechanomyography. Tensiomyography has been demonstrated to reliably measure peak radial displacement during evoked muscle twitch, as well as muscle twitch speed. A number of parameters can be extracted from the tensiomyography displacement/time curve and the most commonly used and reliable appear to be peak radial displacement and contraction time. The latter has been described as a valid non-invasive means of characterising skeletal muscle, based on fibre-type composition. Over recent years, applications of tensiomyography measurement within sport and exercise have appeared, with applications relating to injury, recovery and performance. Within the present review, we evaluate the perceived strengths and weaknesses of tensiomyography with regard to its efficacy within applied sports medicine settings. We also highlight future tensiomyography areas that require further investigation. Therefore, the purpose of this review is to critically examine the existing evidence surrounding tensiomyography as a tool within the field of sports medicine.