Workload, fatigue and muscle damage in an U20 rugby union team over an intensified international tournament

Purpose: This study examined the effects of an intensified tournament on workload, perceptual and neuromuscular fatigue and muscle damage responses in an international under-20 rugby union team. Methods: Players were subdivided into two groups according to match-play exposure time: high (HEG, n=13) and low (LEG, n=11). Measures monitored over the 19-day period included training session (n=10) and match (n=5) workload determined via global positioning systems and session ratings of perceived exertion (sRPE). Wellbeing scores, countermovement jump height performance (CMJ) and blood creatine kinase [CK]b concentrations were collected at various time points. Results: Analysis of workload cumulated across the tournament entirety for training and match-play combined showed that high-speed running distance was similar between groups while a very likely larger sRPE load was reported in HEG vs. LEG. In HEG high-speed activity fluctuated across the 5 successive matches albeit with no clear trend for a progressive decrease. No clear tendency for a progressive decrease in wellbeing scores prior to or following matches was observed in either group. In HEG trivial to possibly small reductions in post-match CMJ performance were observed while unclear to most likely moderate increases in pre-match [CK]b concentrations occurred until prior to match 4. Conclusion: The magnitude of match-to-match changes in external workload, perceptual and neuromuscular fatigue and muscle damage was generally unclear or small. These results suggest that irrespective of exposure time to match-play players generally maintained performance and readiness to play across the intensified tournament. These findings support the need for holistic systematic player monitoring programmes

Can we use GPS for assessing sprinting performance in rugby sevens? A concurrent validity and between-device reliability study

Purpose: The purpose of this study was to (1) provide data on maximal sprinting speed (MSS) and maximal acceleration (Amax) in elite rugby sevens players measured with GPS devices, (2) test the concurrent validity of the signal derived from a radar device and a commercially available 16 Hz GPS device, and (2) assess the between-device reliability of MSS and Amax of the same GPS. Methods: Five well-trained rugby players participated. A concurrent validity protocol compared the GPS units and a radar device (Stalker ATS II). The between-device reliability of the GPS signal during maximal sprint running was also assessed using 6 V2 GPS units (Sensoreverywhere, Digital Simulation, Paris, France) attached to a custom-made steel sled and pushed by one athlete who performed 15 linear 40m sprints. Results: CV ranged from 0.5, ±0.1 % for MSS and smoothed MSS to 6.4, ±1.1 % for Amax. TEM was trivial for MSS and smoothed MSS (0.09, ±0.01) and small for Amax and smoothed Amax (0.54, ±0.09 and 0.39, ±0.06 respectively). Mean bias ranged from -1.6, ±1.0% to -3.0, ±1.1 % for smoothed MSS and MSS respectively. TEE were small (2.0, ±0.55 to 1.6, ±0.4%, for MSS and smoothed MSS respectively. Discussion: The main results indicate that the GPS units were highly reliable for assessing MSS and provided acceptable signal to noise ratio for measuring Amax, especially when a smoothing 0.5-s moving average is used. This 16 Hz GPS device provides sport scientists and coaches with an accurate and reliable means to monitor running performance in elite rugby sevens

What is the impact of physical effort on the diagnosis of concussion?

Objective: Sport-related concussion commonly occurs in contact sports such as rugby. To date, diagnosis is based on the realization of clinical tests conducted pitch-side. Yet, the potential effect of prior physical effort on the results of these tests remains poorly understood. The purpose of this study was to determine whether preceding physical effort can influence the outcome of concussion assessments. Design: Prospective observational study. Setting: University Medicine Center Patients: A cohort of 40 subjects (20 rugby players and 20 athletes from a range of sports). Intervention: A concussion assessment was performed immediately following physical activity. Following a period of 6 months and under the same experimental conditions, the same cohort performed the same tests in resting conditions. Main outcome measure: Results of concussion tests. Results: In both cohorts, the comparison for post-exercise and rest assessments demonstrated a most likely moderate-to-very large increase in the number of symptoms, severity of symptoms and BESS score. In the rugby cohort, scores for concentration, delayed memory and SAC, likely-to-most likely decreased following completion of physical activity compared to baseline values. The between-cohort comparison showed a greater impact post-exercise in the rugby players for delayed recall (0.73±0.61, 93/7/1) and SAC score (0.75±0.41, 98/2/0). Conclusion: Physical activity altered the results of concussion diagnostic tests in athletes from a range of sports and notably in rugby players. Therefore, physical efforts prior to the concussion incident should be accounted for during pitch-side assessments and particularly during rugby competition and training

In-match physical performance fluctuations in international rugby sevens competition

It is widely recognised that the physical demands in rugby sevens are high especially in comparison to the 15-aside version. The aim of this study was to assess fluctuations in physical performance (running and contact loads) in international rugby sevens competition. Altogether, 32 matches played by an international team in the HSBC World Sevens Series were analyzed (63 match-observations). Players wore a validated GPS device (SensorEverywhere, France) sampling at 16Hz while an operator coded every contact action (tackles, collisions, mauls, scrums) using video analysis software (SportsCode, USA). Running load was assessed using total distance travelled (m), individually determined high-speed distance (covered at velocities > maximal aerobic speed, m) and very-high speed distance (covered at velocities > 85% maximal sprinting speed, m). The frequency of accelerations (actions > 2.5 m.s-1) and high-intensity actions (HIA, sum of high-velocity runs, accelerations and contact-related actions, n) were also calculated. A magnitude-based inferential approach to statistics was adopted and effect sizes quantified. Findings showed: 1) a small decrease in high speed distance and number of accelerations performed during the second- versus the first-half of play suggesting a decline in running performance. (2) a moderately higher total distance and high-speed distance covered during the first and final 1-min period compared to the average for other 1-min periods, suggesting a specific reverse ‘J-shape’ pacing profile 3) a most likely decrease in total distance, high-speed running, and to a lesser extent the number of accelerations declined following the peak 1-min period of the game. These findings provide pertinent information on changes in running performance over the course of international sevens and have implications for physical conditioning strategies

The travel demands of an elite rugby sevens team: Effects on objective and subjective sleep parameters

Purpose: To explore the effects of travel related to international rugby sevens competition on sleep patterns. Methods: Seventeen international male rugby sevens players participated in this study. Sleep assessments were performed daily during two separate Sevens World Series competition legs (Oceania and America). The duration of each competition leg was subdivided into key periods (pre-tour, pre-competition, tournament 1 and 2, relocation and post-tour) lasting 2 to 7 nights. Linear mixed models in combination with magnitude-based decision were used to assess 1) the difference between pre-season and key periods and 2) the effect of travel direction (eastward or westward). Results: Shorter total sleep time (hh:mm) was observed during tournament 2 (mean ± SD, 06:16 ± 01:08), relocation (06:09 ± 01:09) and pre-tour week (06:34 ± 01:24) compared with pre-season (06:52 ± 01:00). Worse sleep quality (AU) was observed during tournament 1 (6.1 ± 65 2.0) and 2 (5.7 ± 1.2) as well as during the relocation week (6.3 ± 1.5) than during pre-season (6.5 ± 1.8). When traveling eastward compared with westward, earlier fall asleep time was observed during tournament 1 (ES -0.57, 90%CI [-1.12 to -0.01]), relocation week (-0.70 [-1.11 to -0.28]), and post-tour (-0.57 [-0.95 to -0.18]). However, possibly trivial and unclear differences were observed during pre-competition week (0.15 [-0.15 to 0.45]) and tournament 2 (0.81 [-0.29 to 1.91]). Conclusion: Sleep patterns of elite rugby sevens players are robust to the effects of long-haul travel and jet lag. However, staff should consider promoting sleep during the tournament and 73 relocation week

The GPIIIA PlA2 polymorphism is associated with an increased risk of cardiovascular adverse events

<p>Abstract</p> <p>Background</p> <p>The clinical impact of PlA2 polymorphism has been investigated in several diseases, but the definition of its specific role on thrombotic cardiovascular complications has been challenging. We aimed to explore the effect of PlA2 polymorphism on outcome in patients with atherosclerosis.</p> <p>Methods</p> <p>We studied 400 consecutive patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention. A replication study was conducted in 74 hypertensive patients with cerebrovascular events while a group of 100 healthy subjects was included as control population. PlA genotype was determined by PCR-RFLP on genomic DNA from peripheral blood cells. Major adverse cardiac events (MACE), were considered as end points, and recorded at a mean follow up of 24 ± 4.3 months.</p> <p>Results</p> <p>The frequencies of PlA2 polymorphism was similar between groups and genotype distribution was in Hardy-Weinberg equilibrium. In patients with CAD, the presence of PlA2 allele was associated with higher incidence of cardiac death (13.1% vs. 1.5%, p = 0.0001), myocardial infarction (10.7% vs. 2.6%, p = 0.004) and needs of new revascularization (34.8% vs. 17.7%, p = 0.010). Accordingly, the Kaplan-Meier analysis for event free survival in patients harboring the PlA2 allele showed worse long-term outcome for these patients (p = 0.015). Cox regression analysis identified the presence of PlA2 as an independent predictor of cardiac death (OR: 9.594, 95% CI: 2.6 to 35.3, p = 0.002) and overall MACE (OR: 1.829, 95% CI: 1.054 to 3.176, p = 0.032). In the replication study, the PlA2 polymorphism increased the risk of stroke (OR: 4.1, 95% CI: 1.63-12.4, p = 0.02) over TIA and was identified as an independent risk factor for stroke (B:-1.39; Wald: 7.15; p = 0.001).</p> <p>Conclusions</p> <p>Our study demonstrates that in patients with severe atherosclerosis the presence of PlA2 allele is associated with thrombotic cardiovascular complications.</p

Exposure time, running and skill-related performance in international u20 rugby union players during an intensified tournament

Purpose This study investigated exposure time, running and skill-related performance in two international u20 rugby union teams during an intensified tournament: the 2015 Junior World Rugby Championship. Method Both teams played 5 matches in 19 days. Analyses were conducted using global positioning system (GPS) tracking (Viper 2™, Statsports Technologies Ltd) and event coding (Opta Pro®). Results Of the 62 players monitored, 36 (57.1%) participated in 4 matches and 23 (36.5%) in all 5 matches while player availability for selection was 88%. Analyses of team running output (all players completing >60-min play) showed that the total and peak 5-minute high metabolic load distances covered were likely-to-very likely moderately higher in the final match compared to matches 1 and 2 in back and forward players. In individual players with the highest match-play exposure (participation in >75% of total competition playing time and >75-min in each of the final 3 matches), comparisons of performance in matches 4 and 5 versus match 3 (three most important matches) reported moderate-to-large decreases in total and high metabolic load distance in backs while similar magnitude reductions occurred in high-speed distance in forwards. In contrast, skill-related performance was unchanged, albeit with trivial and unclear changes, while there were no alterations in either total or high-speed running distance covered at the end of matches. Conclusions These findings suggest that despite high availability for selection, players were not over-exposed to match-play during an intensified u20 international tournament. They also imply that the teams coped with the running and skill-related demands. Similarly, individual players with the highest exposure to match-play were also able to maintain skill-related performance and end-match running output (despite an overall reduction in the latter). These results support the need for player rotation and monitoring of performance, recovery and intervention strategies during intensified tournaments

Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial

IMPORTANCE: Secretory phospholipase A2(sPLA2) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA2inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. OBJECTIVE: To determine the effects of sPLA2inhibition with varespladib on cardiovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). INTERVENTIONS: Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy measurewas a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. RESULTS: At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA2inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01130246. Copyright 2014 American Medical Association. All rights reserved

Upregulation of pirin expression by chronic cigarette smoking is associated with bronchial epithelial cell apoptosis

BACKGROUND: Cigarette smoke disrupts the protective barrier established by the airway epithelium through direct damage to the epithelial cells, leading to cell death. Since the morphology of the airway epithelium of smokers does not typically demonstrate necrosis, the most likely mechanism for epithelial cell death in response to cigarette smoke is apoptosis. We hypothesized that cigarette smoke directly up-regulates expression of apoptotic genes, which could play a role in airway epithelial apoptosis. METHODS: Microarray analysis of airway epithelium obtained by bronchoscopy on matched cohorts of 13 phenotypically normal smokers and 9 non-smokers was used to identify specific genes modulated by smoking that were associated with apoptosis. Among the up-regulated apoptotic genes was pirin (3.1-fold, p < 0.002), an iron-binding nuclear protein and transcription cofactor. In vitro studies using human bronchial cells exposed to cigarette smoke extract (CSE) and an adenovirus vector encoding the pirin cDNA (AdPirin) were performed to test the direct effect of cigarette smoke on pirin expression and the effect of pirin expression on apoptosis. RESULTS: Quantitative TaqMan RT-PCR confirmed a 2-fold increase in pirin expression in the airway epithelium of smokers compared to non-smokers (p < 0.02). CSE applied to primary human bronchial epithelial cell cultures demonstrated that pirin mRNA levels increase in a time-and concentration-dependent manner (p < 0.03, all conditions compared to controls). Overexpression of pirin, using the vector AdPirin, in human bronchial epithelial cells was associated with an increase in the number of apoptotic cells assessed by both TUNEL assay (5-fold, p < 0.01) and ELISA for cytoplasmic nucleosomes (19.3-fold, p < 0.01) compared to control adenovirus vector. CONCLUSION: These observations suggest that up-regulation of pirin may represent one mechanism by which cigarette smoke induces apoptosis in the airway epithelium, an observation that has implications for the pathogenesis of cigarette smoke-induced diseases