A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations

Background:The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers,practitioners,and the lay public alike.There has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut microbiota.However,compared to other ergogenic aids and dietary supplements,probiotics present unique study challenges.The objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active individuals.Methods:Four databases(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Database of Systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active individuals.An intervention with probiotics and inclusion of a control and/or placebo group were essential.Only peer-reviewed articles in English were considered,and there were no date restrictions.Results were extracted and presented in tabular form to detail study protocols,characteristics,and outcomes.Bias in randomized controlled trials was determined with the RoB 2.0 tool.Results:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over design.Approximately half the studies used a single probiotic and the other half a multi-strain preparation.The probiotic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was between 7 and 150 days.Fewer than half the studies directly assessed gastrointestinal symptoms,gut permeability,or the gut microbiota.The sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated females.Low-level adverse events were reported in only 2 studies,although the methodology of reporting varied widely.The risk of bias was generally low,although details on randomization were lacking in some studies.Conclusion:There is a substantial body of research on the effects of prob iotic supplementation in healthy athletes and physically active individuals.Considerable heterogeneity in probiotic selection and dosage as well as outcome measures has made clinical and mechanistic interpretation challenging for both health care practitioners and researchers.Attention to issues of randomization of participants,treatments and interventions,selection of outcomes,demographics,and reporting of adverse events will facilitate more trustworthy interpretation of probiotic study results and inform evidence-based guidelines.

Is hamstrings-to-quadriceps torque ratio useful for predicting anterior cruciate ligament and hamstring injuries?A systematic and critical review

Background:For the past 30 years,the hamstring(H)-to-quadriceps(Q)(H:Q)torque ratio has been considered an important index of muscle strength imbalance around the knee joint.The purpose of this systematic review was to examine the value of H:Q torque ratio as an independent risk factor for hamstring and anterior cruciate ligament(ACL)injuries.Methods:Database searches were performed to identify all relevant articles in PubMed,MEDLINE,Cochrane Library,and Scopus.Prospective studies evaluating the conventional(concentric H:Q),functional(eccentric H:concentric Q),and mixed(eccentric H at 300/s:concentric Q at2400/s)H:Q ratios as risk factors for occurrence of hamstring muscle strain or ACL injury were considered.Risk of bias was assessed using the Quality In Prognosis Studies tool.Results:Eighteen included studies reported 585 hamstrings injuries in 2945 participants,and 5 studies documented 128 ACL injuries in 2772participants.Best evidence synthesis analysis indicated that there is very limited evidence that H:Q strength ratio is an independent risk factor for hamstring and ACL injury,and this was not different between various ratio types.Methodological limitations and limited evidence for ACL injuries and some ratio types might have influenced these results.Conclusion:The H:Q ratio has limited value for the prediction of ACL and hamstring injuries.Monitoring strength imbalances along with other modifiable factors during the entire competitive season may provide a better understanding of the association between H:Q ratio and injury.

Effects of a school-based karate intervention on academic achievement,psychosocial functioning,and physical fitness:A multi-country cluster randomized controlled trial

Purpose:To examine the effects of a school-based karate intervention on academic achievement,psychosocial functioning,and physical fitness in children aged 7-8 years.Methods:Twenty schools in 5 different European countries(2 second-grade classrooms per school)participated in a cluster randomized controlled trial(Sport at School trial).Participants were assigned to either a control group,which continued with their habitual physical education lessons,or to an intervention group,which replaced these lessons with a 1-year karate intervention(Karate Mind and Movement program).A total of 721 children(344 girls and 377 boys,7.4±0.5 years old,mean±SD)completed the study,of which 333 and 388 were assigned to the control group and intervention group,respectively.Outcomes included academic performance(average grade),psychosocial functioning(Strengths and Difficulties Questionnaire for parents),and different markers of physical fitness(cardiorespiratory fitness,balance,and flexibility).Results:The intervention provided small but significant benefits compared to the control group for academic achievement(d=0.16;p=0.003),conduct problems(d=-0.28;p=0.003),cardiorespiratory fitness(d=0.36;p<0.001),and balance(d=0.24;p=0.015).There was a trend towards significant benefits for flexibility(d=0.24;p=0.056).No significant benefits were observed for other variables,including psychosocial difficulties,emotional symptoms,hyperactivity/inattention,peer problems,or prosocial behaviour(all p>0.05).Conclusion:A 1-year school-based karate intervention was effective in improving academic achievement,conduct problems,and physical fitness in primary school children.The results support the inclusion of karate during physical education lessons.

Team sport, power, and combat athletes are at high genetic risk for coronavirus disease-2019 severity

Dear editor,As government restrictions put in place to slow the acceleration of the coronavirus disease-2019(COVID-19)pandemic start to ease,many people,including elite athletes,will begin to return back to their normal daily activities.Although the majority of risk factors for severe COVID-19-hypertension,respiratory system disease.

Maturity-associated considerations for training load,injury risk,and physical performance in youth soccer:One size does not fit all

Biological maturation can be defined as the timing and tempo of progress to achieving a mature state.The estimation of age of peak height velocity(PHV)or percentage of final estimated adult stature attainment(%EASA)is typically used to inform the training process in young athletes.In youth soccer,maturity-related changes in anthropometric and physical fitness characteristics are diverse among individuals,particularly around PHV.During this time,players are also at an increased risk of sustaining an overuse or growth-related injury.As a result,the implementation of training interventions can be challenging.The purpose of this review was to(1)highlight and discuss many of the methods that can be used to estimate maturation in the applied setting and(2)discuss the implications of manipulating training load around PHV on physical development and injury risk.We have provided key stakeholders with a practical online tool for estimating player maturation status(Supplementary Maturity Estimation Tools).Whilst estimating maturity using predictive equations is useful in guiding the training process,practitioners should be aware of its limitations.To increase the accuracy and usefulness of data,it is also vital that sports scientists implement reliable testing protocols at predetermined time-points.

Principles and practices of training for soccer

The complexity of the physical demands of soccer requires the completion of a multi-component training programme. The development, planning, and implementation of such a programme are difficult due partly to the practical constraints related to the competitive schedule at the top level. The effective planning and organisation of training are therefore crucial to the effective delivery of the training stimulus for both individual players and the team. The aim of this article is to provide an overview of the principles of training that can be used to prepare players for the physical demands of soccer. Information relating to periodisation is supported by an outline of the strategies used to deliver the acute training stress in a soccer environment. The importance of monitoring to support the planning process is also reviewed.

Oral creatine supplementation:A potential adjunct therapy for rheumatoid arthritis patients

Creatine is one of the most popular forms of protein supplements and is known to improve performance in healthy athletic populations via enhanced muscle mass and adenosine triphosphate energy regeneration.Clinical use of creatine may similarly benefit patients with rheumatoid arthritis(RA), an inflammatory condition characterised by generalised muscle loss termed"rheumatoid cachexia". The adverse consequences of rheumatoid cachexia include reduced strength, physical function and, as a consequence, quality of life.Whilst regular high-intensity exercise training has been shown to increase muscle mass and restore function in RA patients, this form of therapy has very low uptake amongst RA patients. Thus, acceptable alternatives are required. The aim of this review is to consider the potential efficacy of creatine as an anabolic and ergonomic therapy for RA patients. To date, only one study has supplemented RA patients with creatine, and the findings from this investigation were inconclusive. However, trials in populations with similar losses of muscle mass and function as RA, including older adults andthose with other muscle wasting conditions, indicate that creatine is an efficacious way of improving muscle mass, strength and physical function, and may offer an easy, safe and cheap means of treating rheumatoid cachexia and its consequences.

Defining Velocity and Acceleration Ranges for Time-Motion Analysis from a 7-Sided Game in U11 Soccer Players Using Global Positioning System Devices:A Case Study

The aims of this study were(1)to define speed and acceleration thresholds from youth match activity of soccer players and(2)to analyze the activity performed by young soccer players during a match using GPS devices and according to these thresholds.Ten U11 soccer players from a professional club participated in a 7-sided match being equipped with global positioning system(GPS)devices(sampling frequency 5 Hz)to measure the speed of each player.The Kernel Density Esti-mate(KDE)was used to observe the occurrences of velocities.The range of velocities was described by a distribution curve,from which the speed and acceleration thresholds for each category of movement were defined and time–motion analysis of the match was made.The model with 4 Gaussian laws was the best when using the Akaike Information Criterion(AIC).In this study,the thresholds defined for each category of movement were:standing(<0.1 km/h),walking(0.1–5.6 km/h),slow running(5.7–7.7 km/h),fast running(7.8–12.7 km/h)and sprint(≥12.8 km/h).Acceleration thresholds were calculated to define movement considered as a sprint for each category of movement:standing(0.3 m/s^(2)),walking(0.66 m/s^(2)),slow running(1.01 m/s^(2))or fast running(0.97 m/s^(2)).All the acceleration thresholds were significantly different from each other(P<0.001)with large effect sizes,excepting the comparison between slow and fast running(P=0.41)with a small effect size.In U-11 soccer players,time–motion analysis may be performed according to five categories of movement.This study has also defined sprint and acceleration thresholds for this category of age.