The workout responses of salivary-free testosterone and cortisol concentrations and their association with the subsequent competition outcomes in professional rugby league

This study assessed the responses of salivary-free testosterone (T) and cortisol (C) concentrations across selected training workouts and their association with the subsequent competition outcomes in professional rugby league. Thirteen rugby league players were assessed for salivary-free T and C concentrations across 5 training workouts performed 3-4 days before a competitive game. The game outcomes included wins and losses and game-ranked performance (1-5) based on the number of points scored, the points differential, and a coach rating. Data were pooled across the winning (n = 3) and losing (n = 2) outcomes. Pooled free T concentrations (absolute and relative changes) were significantly (p < 0.01) elevated across those workouts that preceded winning games, but not the losses, and the relative (percent) T changes were significantly (p < 0.05) higher before winning (30.9%) than before losing (3.4%). Both outcomes were associated with workout decreases in pooled free C concentrations and the relative C changes were not significantly different between wins (222.9%) and losses (225.6%). In conclusion, the free T responses to selected training workouts showed some association with subsequent winning (being elevated) and losing (no change) during a limited number of competitive games in professional rugby league. Speculatively, the free T responses to a midweek workout might provide an early sign of team readiness to compete or to recovery state, thereby providing a novel format for implementing training or management strategies to improve the competition outcomes

The seven step approach to the application of sport science in English professional rugby league: practical considerations in strength and conditioning

This article examines the training and competition loads performed with a full-time professional rugby league team during a Super League season (pre- and in-season). While a logical and evidence-based approach was taken, involving initial planning, delivery, monitoring and evaluation, the idiosyncratic aspects of such a professional environment required a high degree of tacit knowledge and adaptability. The current article will therefore describe the context, outline the broad process and approach, provide some detailed case examples of support work undertaken with associated data, and identify the methods for evaluation. The use of four case studies (i.e., injury audit; hydration in a training week; alternative training strategy; and monitoring) helped review and inform strength and conditioning practice within a professional rugby league club environment

Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19: The RECOVERY-RS Randomized Clinical Trial.

Importance Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been recommended for acute hypoxemic respiratory failure in patients with COVID-19. Uncertainty exists regarding the effectiveness and safety of these noninvasive respiratory strategies. Objective To determine whether either CPAP or HFNO, compared with conventional oxygen therapy, improves clinical outcomes in hospitalized patients with COVID-19-related acute hypoxemic respiratory failure. Design, Setting, and Participants A parallel group, adaptive, randomized clinical trial of 1273 hospitalized adults with COVID-19-related acute hypoxemic respiratory failure. The trial was conducted between April 6, 2020, and May 3, 2021, across 48 acute care hospitals in the UK and Jersey. Final follow-up occurred on June 20, 2021. Interventions Adult patients were randomized to receive CPAP (n = 380), HFNO (n = 418), or conventional oxygen therapy (n = 475). Main Outcomes and Measures The primary outcome was a composite of tracheal intubation or mortality within 30 days. Results The trial was stopped prematurely due to declining COVID-19 case numbers in the UK and the end of the funded recruitment period. Of the 1273 randomized patients (mean age, 57.4 [95% CI, 56.7 to 58.1] years; 66% male; 65% White race), primary outcome data were available for 1260. Crossover between interventions occurred in 17.1% of participants (15.3% in the CPAP group, 11.5% in the HFNO group, and 23.6% in the conventional oxygen therapy group). The requirement for tracheal intubation or mortality within 30 days was significantly lower with CPAP (36.3%; 137 of 377 participants) vs conventional oxygen therapy (44.4%; 158 of 356 participants) (absolute difference, -8% [95% CI, -15% to -1%], P = .03), but was not significantly different with HFNO (44.3%; 184 of 415 participants) vs conventional oxygen therapy (45.1%; 166 of 368 participants) (absolute difference, -1% [95% CI, -8% to 6%], P = .83). Adverse events occurred in 34.2% (130/380) of participants in the CPAP group, 20.6% (86/418) in the HFNO group, and 13.9% (66/475) in the conventional oxygen therapy group. Conclusions and Relevance Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings. Trial Registration isrctn.org Identifier: ISRCTN16912075