Three km Track Time Trial Performance Changes after HIIT in Competitive Cross-Country Skiers

Background: Limited research surrounding sex differences in fatigue and performance after high intensity interval training (HIIT) exists in the field setting. While lab-based protocols provide a controlled environment, physiological mechanisms of fatigue and performance response in competitive athletes are best measured by time-trial (TT). Few studies, however, have investigated fatigue in TT performance while controlling for the menstrual cycle (MC). Objective: The study investigated the influence of sex and MC phase on 3km track TT performance after a HIIT session in Competitive Cross Country (XC) skiers. Methods: A quasi-experimental design was employed and athletes over the age of 16 years (30F, 9M), were recruited from across Canada and completed 3 days of testing/training: a 3km track TT on Day 1 and Day 3; and a HIIT session (4-8x, 800m) on Day 2. MC phase was verified by ovulation testing and salivary hormone samples; athletes were classified as either “Low Hormone” or “High Hormone” for analysis. Results: An overall improvement in performance from pre- to post-HIIT TTs occurred (p<0.01). No significant differences in TT performance after HIIT were observed between sexes (p=0.16) or MC phase (p=0.26). Conclusion: These results indicate that competitive XC skiers will likely experience an improvement in TT performance after a bout of HIIT. Coaches and athletes should plan their workouts prior to testing accordingly to maximize TT performance. These results also suggest that no special adjustments need to be considered for differences in performance after HIIT between sexes and MC phase, although further studies with a greater sample size and repeated testing are warranted

Shoulder Check:Investigating Shoulder Injury Rates, Types, Severity, Mechanisms, and Risk Factors in Canadian Youth Ice Hockey

Objective: To describe shoulder-related injury rates, types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Study Design: Secondary analysis of data from a 5-year prospective cohort study Safeto-Play (2013-2018). Subjects: Overall, 4419 individual players (representing 6585 player-seasons; 3806 males: 613 females) participated. During this period, 118 primary shoulder-related game injuries and 12 practice injuries were reported. Outcome Measures: Injury surveillance data was collected from 2013-2018 (time-loss or medical attention injuries). Descriptive statistics were calculated, and injury rates with 95% CI were estimated using Poisson regression. An exploratory multivariable mixed-effects Poisson regression model (clustering by team and offset by exposure hours) examined risk factors. Results: The shoulder injury rate was 0.70 injuries/1000 game-hours (95% CI 0.371.33) and 0.07 injuries/1000 practice-hours (95% CI 0.04-0.12). Two-thirds of game injuries (n=79, 69%) resulted in &gt;8 days of time-loss, and more than one-third (n=44, 39%) resulted in &gt;28 days of time-loss. An 82% lower rate of shoulder injury was associated with policy prohibiting body checking compared to leagues allowing body checking [IRR=0.18 (95% CI 0.10-0.32)]. A higher shoulder injury rate was seen for those who reported any injury in the last 12-months compared to those with no history [IRR=2.32 (95% CI 1.57-3.41)]. Conclusions: Most shoulder injuries resulted in more than one week of time-loss. Risk factors for shoulder injury included participation in a body checking league and history of injury in the previous 12 months. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey

Shoulder Check:Investigating Shoulder Injury Rates, Types, Severity, Mechanisms, and Risk Factors in Canadian Youth Ice Hockey

Objective: To describe shoulder-related injury rates, types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Study Design: Secondary analysis of data from a 5-year prospective cohort study Safeto-Play (2013-2018). Subjects: Overall, 4419 individual players (representing 6585 player-seasons; 3806 males: 613 females) participated. During this period, 118 primary shoulder-related game injuries and 12 practice injuries were reported. Outcome Measures: Injury surveillance data was collected from 2013-2018 (time-loss or medical attention injuries). Descriptive statistics were calculated, and injury rates with 95% CI were estimated using Poisson regression. An exploratory multivariable mixed-effects Poisson regression model (clustering by team and offset by exposure hours) examined risk factors. Results: The shoulder injury rate was 0.70 injuries/1000 game-hours (95% CI 0.371.33) and 0.07 injuries/1000 practice-hours (95% CI 0.04-0.12). Two-thirds of game injuries (n=79, 69%) resulted in &gt;8 days of time-loss, and more than one-third (n=44, 39%) resulted in &gt;28 days of time-loss. An 82% lower rate of shoulder injury was associated with policy prohibiting body checking compared to leagues allowing body checking [IRR=0.18 (95% CI 0.10-0.32)]. A higher shoulder injury rate was seen for those who reported any injury in the last 12-months compared to those with no history [IRR=2.32 (95% CI 1.57-3.41)]. Conclusions: Most shoulder injuries resulted in more than one week of time-loss. Risk factors for shoulder injury included participation in a body checking league and history of injury in the previous 12 months. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey

Feminae: an international multi-site innovative project for female athletes.

Sufficient high-quality studies in sport science using women as participants are lacking, meaning that our knowledge and understanding of female athletes in relation to their ovarian hormone profiles is limited. Consortia can be used to pool talent, expertise, and data, thus accelerating our learning on a given topic and reducing research waste through collaboration. To this end, we have assembled an international multi-site team, described herein, to investigate the effects of the menstrual cycle and oral contraceptive pill phase on aspects of exercise physiology and sports performance in female athletes. We intend to produce an adequately powered, high-quality dataset which can be used to inform the practices of female athletes. Our approach will also employ research transparency – through the inclusion of a process evaluation - and reproducibility – through a standardised study protocol

The IOC consensus statement: Beyond the female athlete triad-Relative Energy Deficiency in Sport (RED-S)

Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Effects of the menstrual cycle and oral contraceptives on athletic performance

There have been few well-controlled studies to date on the influence of different phases of the menstrual cycle on athletic performance, and information is even more sparse on potential effects of oral contraceptive agents (OCAs) on performance. Many of the earlier studies failed to accurately document the phase of the cycle, or used a variety of different oral contraceptives with higher dosages of estrogens and progestins than those in current usage. Thus, the purpose of this study was to examine the effects of the endogenous hormonal variations of a normal menstrual cycle and the administration of a low-dose triphasic oral contraceptive agent (OCA)on selected measures of athletic performance in a group of elite female athletes. Nineteen eumenorrheic women were studied during the midfollicular (day 5.7 ± 0.5; mean + SE) and midluteal (day 23.3 ± 0.9) phases of a normal menstrual cycle. Cycle phases were confirmed by plasma estradiol and progesterone assays. Following the two menstrual cycle tests, subjects were randomly assigned in a double blind fashion to either a placebo group (n=7, age=28.3 + 1.6 yr, height=168.6 ± 2.0 cm, weight=60.0 ± 3.5 kg) or an OCA group (n=7, age=27.1 ± 1.6 yr, height=168.5 ± 1.9 cm, weight=60.2 ± 1.7 kg). A third test was carried out during the midcycle (day 14.4 ± 0.54) of the second cycle of the placebo/OCA administration. . . . [more text]Education, Faculty ofCurriculum and Pedagogy (EDCP), Department ofGraduat