Reliability of the running vertical jump test in female team sport athletes

Injury rates to the lower limb have increased over the past 40 years, coinciding with increases in female sport participation rates. Sport specific tests such as the running vertical jump (RVJ) are utilised for injury risk profiling, however the test-retest reliability is unknown. Objectives: The aim of this study was to investigate the test-retest reliability of the thorax, pelvis and lower limb joint angular kinematics and kinetics for the RVJ test in female team sport athletes. Design: Three-dimensional motion capture with force plate integration was utilised as participants performed five trials on each limb on three separate days. Setting: Testing occurred in a biomechanics laboratory. Participants: Thirty-four females (Australian Rules Football = 15, Netball = 12, Soccer = 7) participated in this study. Main Outcome Measures: Intraclass correlation coefficients (ICC), effect sizes and typical errors (TE) of segment and joint angular kinematics and kinetics were calculated. Results: Poor to excellent reliability (ICC = −0.12 – 0.92), small to large effect sizes (0.00–0.90) and TE (0.02–289.24) were observed across segment and joint angular kinematics and kinetics. Conclusions: The RVJ test is recommended when analysing ground reaction forces and joint angular kinematics in female team sport athletes

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Dietary intakes of professional Australian football league women's (AFLW) athletes during a preseason training week

Objectives In 2016 the Australian football league introduced the first women’s league, integrating part-time female athletes into the professional sporting environment. This study aims to assess the dietary intakes of professional Australian football league women’s (AFLW) athletes to highlight key focus areas for nutrition and additionally provide nutrition recommendations for dietitians working with these athletes. Design Cross-sectional study. Methods Dietary intake data was collected from 23 players from the same club competing in the Australian football league women’s, during a preseason week. Dietary intakes were assessed using three day estimated food records. Results Majority of athletes did not meet recommendations for carbohydrate (96%, n = 22), iron (87%, n = 20) and calcium (61%, n = 14). In comparison, majority of athletes met protein (74%, n = 17) and fat (78%, n = 18) recommendations. No significant difference was found in energy intake on main training, light training and recovery days (p > 0.05). Energy and carbohydrate intakes reported by AFLW athletes (1884 ± 457 kcal day−1 and 2.7 ± 0.7 g kg−1 day−1) were consistent with values reported in previous studies that included professional female athletes. Conclusions This research highlights that further exploration of the factors that influence dietary intake is required to support athletes to meet energy and carbohydrate recommendations required for desired training and performance outcomes

Assessing the nutrition knowledge of professional female Australian football (AFLW) athletes

Nutrition education in professional sport may improve athletes’ nutrition knowledge (NK), self-efficacy and food choices. Understanding athletes’ NK can inform development of tailored nutrition education programs. To enhance health and performance, athletes’ dietary intakes must meet their energy and nutritional needs and NK has been identified as a modifiable determinant of dietary intake. This study aimed to assess the NK of Australian football league women’s (AFLW) athletes to provide recommendations for possible dietetic intervention. AFLW athletes (n = 26) were recruited from one Victorian football club. NK was assessed using the validated online Nutrition for Sport Knowledge Questionnaire. AFLW athletes scored ‘average’ overall NK (score: 45.1 ± 12.5, mean accuracy: 50.6 ± 14%). Athletes demonstrated better knowledge in alcohol (5.6 ± 1.9, mean accuracy: 70 ± 23%), macronutrients (18.2 ± 5.0, mean accuracy: 60 ± 17%) and weight management subsections (7.3 ± 2.2, mean accuracy: 57 ± 17%). Athletes performed poorly in the supplements subsection (3.2 ± 2.0, mean accuracy: 23 ± 14%). This study assessed the NK of AFLW athletes and found athletes had average NK, with room for improvement particularly regarding supplement knowledge. Future research should assess the efficacy of online and group education to improve athletes’ NK and dietary intake

Dietary Intakes of Professional and Semi-Professional Team Sport Athletes Do Not Meet Sport Nutrition Recommendations—A Systematic Literature Review

Background: to develop sport-specific and effective dietary advice, it is important to understand the dietary intakes of team sport athletes. This systematic literature review aims to (1) assess the dietary intakes of professional and semi-professional team sport athletes and (2) to identify priority areas for dietetic intervention. Methods: an extensive search of MEDLINE, Sports DISCUS, CINAHL, Web of Science, and Scopus databases in April−May 2018 was conducted and identified 646 studies. Included studies recruited team sport, competitive (i.e., professional or semi-professional) athletes over the age of 18 years. An assessment of dietary intake in studies was required and due to the variability of data (i.e., nutrient and food group data) a meta-analysis was not undertaken. Two independent authors extracted data using a standardised process. Results: 21 (n = 511) studies that assessed dietary intake of team sport athletes met the inclusion criteria. Most reported that professional and semi-professional athletes’ dietary intakes met or exceeded recommendations during training and competition for protein and/or fat, but not energy and carbohydrate. Limitations in articles include small sample sizes, heterogeneity of data and existence of underreporting. Conclusions: this review highlights the need for sport-specific dietary recommendations that focus on energy and carbohydrate intake. Further exploration of factors influencing athletes’ dietary intakes including why athletes’ dietary intakes do not meet energy and/or carbohydrate recommendations is required

Phase-dependent and task-dependent modulation of stretch reflexes during rhythmical hand tasks in humans

Phase-dependent and task-dependent modulation of reflexes has been extensively demonstrated in leg muscles during locomotory activity. In contrast, the modulation of reflex responses of hand muscles during rhythmic movement is poorly documented. The objective of this study was to determine whether comparable reflex modulation occurs in muscles controlling finger motions during rhythmic, fine-motor tasks akin to handwriting. Twelve healthy subjects performed two rhythmic tasks while reflexes were evoked by mechanical perturbations applied at various phases of each task. Electromyograms (EMGs) were recorded from four hand muscles, and reflexes were averaged during each task relative to the movement phase. Stretch reflexes in all four muscles were found to be modulated in amplitude with respect to the phase of the rhythmic tasks, and also to vary distinctly with the tasks being conducted. The extent and pattern of reflex modulation differed between muscles in the same task, and between tasks for the same muscle. Muscles with a primary role in each task showed a higher correlation between reflex response and background EMG than other muscles. The results suggest that the modulation patterns observed may reflect optimal strategies of central–peripheral interactions in controlling the performance of fine-motor tasks. As with comparable studies on locomotion, the phase-dependency of the stretch reflexes implies a dynamically fluctuating role of proprioceptive feedback in the control of the hand muscles. The clear task-dependency is also consistent with a dynamic interaction of sensory feedback and central programming, presumably adapted to facilitate the successful performance of the different fine-motor tasks