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BACKGROUND: Understanding the patient perspective of frailty is critical to offering holistic patient-centred care. Rehabilitation strategies for patients with advanced chronic kidney disease (CKD) and frailty are limited in their ability to overcome patient-perceived barriers to participation, resulting in high rates of drop-out and non-adherence. The aim of this study was to explore patient perspectives and preferences regarding experiences with rehabilitation to inform a CKD/Frailty rehabilitation model. METHODS: This qualitative study involved two focus groups, six individual semi-structured interviews and three caregiver semi-structured interviews with lived experience of advanced kidney disease and frailty. Interviews were recorded, transcribed, and coded for meaningful concepts and analysed using inductive thematic analysis using constant comparative method of data analysis employing Social Cognitive Theory. RESULTS: Six major themes emerged including accommodating frailty is an act of resilience, exercise is endorsed for rehabilitation but existing programs have failed to meet end-users' needs. Rehabilitation goals were framed around return to normative behaviours and rehabilitation should have a social dimension, offering understanding for "people like us". Participants reported on barriers and disruptors to frailty rehabilitation in the CKD context. Participants valued peer-to-peer education, the camaraderie of socialisation and the benefit of feedback for maintaining motivation. Patients undertaking dialysis described the commodity of time and the burden of unresolved symptoms as barriers to participation. Participants reported difficulty envisioning strategies for frailty rehabilitation, maintaining a focus on the immediate and avoidance of future uncertainty. CONCLUSIONS: Frailty rehabilitation efforts in CKD should leverage shared experiences, address comorbidity and symptom burden and focus on goals with normative value.

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BACKGROUND: Nutrition guidance for athletes must consider a range of variables to effectively support individuals in meeting energy and nutrient needs. Resistance exercise is a widely adopted training method in athlete preparation and rehabilitation and therefore is one such variable that will influence nutrition guidance. Given its prominence, the capacity to meaningfully quantify resistance exercise energy expenditure will assist practitioners and researchers in providing nutrition guidance. However, the significant contribution of anaerobic metabolism makes quantifying energy expenditure of resistance exercise challenging. OBJECTIVE: The aim of this scoping review was to investigate the methods used to assess resistance exercise energy expenditure. METHODS: A literature search of Medline, SPORTDiscus, CINAHL and Web of Science identified studies that included an assessment of resistance exercise energy expenditure. Quality appraisal of included studies was performed using the Rosendal Scale. RESULTS: A total of 19,867 studies were identified, with 166 included after screening. Methods to assess energy expenditure included indirect calorimetry (n = 136), blood lactate analysis (n = 25), wearable monitors (n = 31) and metabolic equivalents (n = 4). Post-exercise energy expenditure was measured in 76 studies. The reported energy expenditure values varied widely between studies. CONCLUSIONS: Indirect calorimetry is widely used to estimate energy expenditure. However, given its limitations in quantifying glycolytic contribution, indirect calorimetry during and immediately following exercise combined with measures of blood lactate are likely required to better quantify total energy expenditure. Due to the cumbersome equipment and technical expertise required, though, along with the physical restrictions the equipment places on participants performing particular resistance exercises, indirect calorimetry is likely impractical for use outside of the laboratory setting, where metabolic equivalents may be a more appropriate method.

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OBJECTIVES: To describe the incidence rate, frequency, severity, recurrence, and burden of musculoskeletal injury in professional ballet. STUDY DESIGN: Descriptive epidemiological (retrospective). METHODS: Professional dancers (n = 73, 40 females, 33 males) provided consent for retrospective review of musculoskeletal injury data. Medical-attention injuries were reported to and recorded by onsite physiotherapists between January 2018 and December 2021. Time-loss injuries were any injury that prevented a dancer from taking a full part in all dance-related activities for >1 day. Injuries were classified using the OSICS-10.1 system. Injury incidence rates (IIRs; injuries/1000 h), severity, recurrence, and burden were calculated. RESULTS: Nine hundred and fifty-three medical-attention injuries were recorded in 72 (98%) dancers at an IIR of 2.79/1000 h (95% confidence interval [CI], 2.62-2.98). 706 were time-loss injuries, which were reported in 70 dancers at an IIR of 2.07/1000 h (95% CI: 1.92, 2.23). Overuse injuries represented 53% of medical-attention injuries. The most frequently injured body area and tissue/pathology were thoracic facet joint (n = 63/953, 7%) and ankle synovitis/impingement (n = 62/953, 6%). Bone stress injuries (BSIs) were the most severe with the highest median time loss (135 days, interquartile range [IQR] 181) followed by fractures (72.5 days, IQR 132). The injuries with the highest burden were tibial BSIs (13 days lost/1000 h; 95% CI: 13, 14). Jumping and lifting were the most frequently reported injury mechanisms. CONCLUSION: Almost all dancers required medical attention for at least one injury during the surveillance period. Approximately 74% of injuries resulted in time loss. BSIs and ankle synovitis/impingement were of high burden, and a high proportion of BSIs were recurrent. J Orthop Sports Phys Ther 2023;53(11):712-722. Epub 14 September 2023. doi:10.2519/jospt.2023.11858.

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PURPOSE: This study aimed to determine the effects of a field-based priming session on perceptual, physiological, and performance responses in female rugby sevens athletes. METHODS: Thirteen highly trained female rugby sevens players (age: 20.7 [2.0] y; height: 169.3 [4.8] cm; weight: 68.8 [7.9] kg) completed either a 20-minute field-based priming session or a control condition. Perceptual, physiological, and performance variables were collected at baseline (PRE) and 5 (POST5), 30 (POST30), and 120 minutes (POST120) postintervention. Data were analyzed using Bayesian mixed effects models. RESULTS: The priming protocol had a larger increase in mental readiness (maximum a posteriori [MAP] = 20, 95% high-density intervals [HDI] = -4 to 42, probability of direction [PD]% = 95, % in region of practical equivalence [ROPE] = 9.7), physical readiness (MAP = 20.1, 95% HDI = -4.6 to 42.1, PD% = 93, % in ROPE = 10.6), and testosterone (MAP = 14.9, 95% HDI = 0.5 to 27.7, PD% = 98, % in ROPE = 5.6) than the control POST30. Cognitive performance decreased POST120 in the priming condition for congruent (MAP = 0.02, 95% HDI = -0.06 to 0.00, PD% = 95, % in ROPE = 6.4) and incongruent tasks (MAP = 0.00, 95% HDI = -0.07 to 0.00, PD% = 98, % in ROPE = 3.2) when compared with the control. CONCLUSIONS: Perceptual and physiological markers improved POST30 in the priming condition. Findings indicate that perceptual and physiological responses to priming were not coupled with performance improvements. Priming was not accompanied by perceptual, physiological, or performance improvements at POST120.

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INTRODUCTION: Epidemiological evidence supports an association between higher levels of physical activity and improved cancer survival. Trial evidence is now needed to demonstrate the effect of exercise in a clinical setting. The Exercise during CHemotherapy for Ovarian cancer (ECHO) trial is a phase III, randomised controlled trial, designed to determine the effect of exercise on progression-free survival and physical well-being for patients receiving first-line chemotherapy for ovarian cancer. METHODS AND ANALYSIS: Participants (target sample size: n=500) include women with newly diagnosed primary ovarian cancer, scheduled to receive first-line chemotherapy. Consenting participants are randomly allocated (1:1) to either the exercise intervention (plus usual care) or usual care alone, with stratification for recruitment site, age, stage of disease and chemotherapy delivery (neoadjuvant vs adjuvant). The exercise intervention involves individualised exercise prescription with a weekly target of 150 minutes of moderate-intensity, mixed-mode exercise (equivalent to 450 metabolic equivalent minutes per week), delivered for the duration of first-line chemotherapy through weekly telephone sessions with a trial-trained exercise professional. The primary outcomes are progression-free survival and physical well-being. Secondary outcomes include overall survival, physical function, body composition, quality of life, fatigue, sleep, lymphoedema, anxiety, depression, chemotherapy completion rate, chemotherapy-related adverse events, physical activity levels and healthcare usage. ETHICS AND DISSEMINATION: Ethics approval for the ECHO trial (2019/ETH08923) was granted by the Sydney Local Health District Ethics Review Committee (Royal Prince Alfred Zone) on 21 November 2014. Subsequent approvals were granted for an additional 11 sites across Queensland, New South Wales, Victoria and the Australian Capital Territory. Findings from the ECHO trial are planned to be disseminated via peer-reviewed publications and international exercise and oncology conferences. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trial Registry (ANZCTRN12614001311640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367123&isReview=true).

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This double-blind randomised placebo-controlled trial aimed to investigate the effects of α-lactalbumin consumption on sleep quality and quantity in female rugby union athletes during a competition season. Eighteen semi-professional female rugby union players (age 23.8 ± 5.2 y; mean ± SD) wore wrist actigraphy watches for four seven-day blocks corresponding to the pre-season, a home game, a bye week (i.e. no competition game scheduled) and an away game. Participants consumed either an α-lactalbumin (α-LAC), or placebo drink (PLA) every night two hours before bed for the duration of the season. Generalised linear mixed models were used to investigate the effects of the nutritional intervention on sleep variables (total sleep time, sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset) over the duration of the season. There was a significant condition by period interaction effect on SOL (p = 0.01). While similar at baseline (23.3 ± 16.3 and 23.2 ± 18.9 min α-LAC and placebo respectively) and for the home game (22.4 ± 17.6 and 19.3 ± 14.9 min α-LAC and placebo respectively), SOL was reduced in the α-LAC group for the bye (11.6 ± 13.4 min) and away game (17.0 ± 11.5 min; p = 0.045). In comparison, SOL remained unchanged in the PLA group (bye 21.2 ± 17.3 and away 22.5 ± 18.5 min). Pre-sleep α-lactalbumin consumption improved SOL in a semi-professional female team-sport cohort. Thus, α-lactalbumin could be utilised by athletes to support sleep during a competitive season.

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With the recent growth in female sport, practitioners need to be able to provide specific support to female athletes to ensure their sleep, health and athletic performance are optimised. Examine the patterns, duration and quality of sleep among elite female athletes, and consider the impact of situational challenges and their effects on the sleep of elite female athletes. Data was located through a search of SPORTDiscus, MEDLINE and Scopus from inception up to May 2021. Studies needed to be peer-reviewed research reporting quantitative sleep outcomes for female athletes ≥ 18 years of age and competing at a predefined elite level. A meta-analysis was performed on habitual sleep outcomes (e.g. total sleep time [TST] and sleep efficiency [SE]) measured with actigraphy. A total of 38 studies were included. Meta-analysis showed habitual TST (n = 14) was 7.8 h [7.4, 8.2] (mean [95% CI]), and SE was 86.7% [84.7, 88.6], with high variability among studies (I2 = 97.8-98.2%). Subjective sleep complaints are common before a competition, as do post-training sleep disturbances (63% studies report TST decrease), and post-competition sleep disturbances (75% studies report TST decrease). Female athletes achieve satisfactory objective sleep quantity and quality during habitual periods, but experience sleep disturbances pre- and post-situational challenges. There is high variability of objective sleep outcomes, demonstrating the individual nature of habitual female athlete sleep. Overall, future research must focus on optimising the sleep appraisal methods and creating high-quality study designs in a broader number of sports.

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BACKGROUND: To date, there is limited consensus on post-contest recovery recommendations for natural physique athletes. The available literature emphasizes the negative consequences of extreme dieting associated with physique contests, yet offers only speculative suggestions to facilitate physiological recovery post-contest. This scoping review evaluates evidence-based recommendations for recovery in post-physique contests. METHODS: The online search engines and databases Google Scholar, PubMed, and Scopus were searched systematically and 12 peer reviewed journal articles were included in the review. RESULTS: Six key factors were identified that directly impacted on physiological recovery post-contest: (1) body composition, (2) recovery dietary intake, (3) resting metabolic rate (RMR) restoration, (4) endocrine measures recovery, (5) menstrual cycle recovery, and (6) psychological aspects of recovery. CONCLUSIONS: Three dietary strategies have been proposed to facilitate physiological recovery post-contest while bearing in mind body composition and future athlete outcomes; (1) a gradual increase in energy intake to maintenance requirements, (2) ad libitum eating, (3) an immediate return to maintenance energy requirements. Future research is required to determine the timeline in which full physiological recovery occurs post-contest and which strategies best support athlete health and performance during post-contest recovery.

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ABSTRACT: Mason, BRJ, Pumpa, KL, McKune, AJ, Gill, ND, and Ball, NB. A multidisciplinary approach to game day preparation for team sports: A Delphi study with expert consensus. J Strength Cond Res 36(5): 1345-1352, 2022-The aim of this study was to identify game day preparation strategies used by performance staff to improve team sport performance and to determine consensus regarding the application and importance of these strategies. Twenty-five performance staff working in high performance or professional team sports participated in this Delphi study, which implemented 3 survey rounds. The first round sought responses to open-ended questions relating to the use of game day preparation strategies. These responses were developed into statements and recirculated (round-2 survey), with subjects asked to rate their level of agreement with each statement. The third and final survey presented revised versions of statements that did not reach a consensus in the previous round, along with new statements derived from subject responses. A thematic analysis of the open-ended responses in the first survey identified 5 key themes relating to game day preparation strategies: "exercise," "nutrition," "psychological," "technical and tactical," and "other." The round-2 survey included 38 statements across the 5 themes, with 22 reaching the consensus threshold (≥75%) for agreement. The remaining 16 statements did not reach consensus. The final survey included 18 statements (16 revised and 2 new) with 12 reaching the consensus threshold for agreement. Key preparation strategies identified in this study include structured and progressive warm-ups, strength and power-based priming sessions, individualized nutrition plans, and precooling in hot conditions. Performance staff working in similar environments should consider adopting these strategies to improve athlete or team performance.

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ISSUES ADDRESSED: This study aimed to identify risk factors associated with weight gain post a diagnosis of breast cancer in a cohort of Australian women. METHODS: In this retrospective clinical audit, objectively measured weight, age and menopause status, treatment type/s, grade, stage, oestrogen receptor and progesterone receptor (PR) status were extracted for 73 breast cancer patients from an ongoing breast cancer treatment quality assurance project. Weight gain or loss was classified as a body mass increase or decrease of ≥5% of weight at diagnosis. RESULTS: When compared to weight at diagnosis, 57% of patients maintained, 22% gained, and 21% lost weight at 24 months post-diagnosis. Factors associated with weight gain were a diagnosis of grade II (P < .001) or grade III (P < .001) compared to grade I breast cancer, and refusal of radiotherapy (P < .001). Factors associated with weight loss were being postmenopausal compared to premenopausal (P = .033), PR positive compared to PR negative (P < .001), refusal of chemotherapy (P < .001) and radiotherapy recommended (P < .001). CONCLUSIONS: The maintenance of weight in a majority of women in this cohort is a novel finding. Early identification of women at risk of weight gain post a breast cancer diagnosis can assist health professionals identify, and therefore assisting patients in the prevention and management of weight gain and associated sequela. Investigating the weight-related communications between a patient and specialist, their access to allied health professionals and social support may assist in understanding the overall positive changes in this cohort.

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PURPOSE: To compare the habitual sleep of female basketball and soccer athletes to age- and sex-matched controls and to characterize the sleep of basketball and soccer athletes at different competition locations and on the days surrounding competition. METHODS: Using an observational case-control design, 41 female participants were recruited to participate, consisting of 11 basketball athletes (mean [SD]: age = 24.1 [4.9] y), 10 soccer athletes (24.8 [6.4] y), and 20 nonathletic controls (24.2 [2.8] y). Sleep was monitored using actigraphy for four 7-day periods throughout the preseason and subsequent competition season. Generalized linear models were used to analyze the effect of group and competition situation (eg, Home or Away) on sleep. RESULTS: During habitual conditions, basketball athletes had longer sleep durations (7.4 [1.5] h) than soccer athletes (7.0 [1.2] h, P < .001) and controls (7.3 [1.2] h, P = .002). During competition, basketball and soccer athletes had longer sleep durations following home (7.7 [1.7] and 7.2 ± 1.3 h) compared with away games (6.8 [1.8] and 7.0 [1.3] h). In addition, basketballers went to bed earlier (23:49 [01:25]) and woke earlier (07:22 [01:59]) following away games compared with soccer athletes (00:10 [01:45] and 08:13 [01:45]). CONCLUSIONS: Basketballers had longer habitual sleep durations compared with soccer athletes and nonathletic controls. During competition, basketballers had earlier bed and wake times compared with soccer athletes following away games, highlighting the need for individualized sleep strategies.

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PURPOSE: This study aimed to determine the efficacy of α-lactalbumin (A-LAC) supplementation for improving sleep and performance recovery after simulated evening competition in female athletes. METHODS: Sixteen trained women (mean ± SD: age, 27 ± 7 yr; mass, 62 ± 10 kg; stature, 167 ± 8 cm) participated in this randomized double-blind three-arm crossover study. Participants completed a simulated evening competition before consuming either an A-LAC whey protein, whey protein placebo (PLA), or water control (CON) beverage. Sleep was monitored via polysomnography, and participants completed a series of physical, cognitive, and perceptual assessments before, and 14 and 24 h after simulated competition. RESULTS: Non-rapid eye movement stage 2 sleep increased after competition in A-LAC (pre, 199 ± 44 min; post, 212 ± 37 min) but decreased in CON (pre, 228 ± 43 min; post, 195 ± 40 min) and PLA (pre, 224 ± 25 min; post, 211 ± 35 min; P = 0.012). In addition, Yo-Yo Intermittent Recovery Test Level 1 distance improved over time in A-LAC (baseline, 664 ± 332 m; 14 h post, 667 ± 326 m; 24 h post, 781 ± 427 m) compared with CON (baseline, 741 ± 366 m; 14 h post, 648 ± 351 m; 24 h post, 720 ± 407 m) and PLA (baseline, 763 ± 394 m; 14 h post, 636 ± 366 m; 24 h post, 720 ± 396 m; P < 0.001). CONCLUSIONS: The findings indicate that A-LAC supplementation may be useful for retaining some sleep characteristics after evening competition, leading to improved physical performance in female athletes.

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We thank Dunican and Walsh [...].

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BACKGROUND: Quantitative evidence suggests that interventions involving telephone calls and text message are feasible and effective for improving lifestyle intervention adherence and clinical outcomes among adults with obesity. The aim of this article is to provide qualitative insight into the perspectives and experiences of participants who completed a telehealth trial exploring the use of telephone and text support as adjunctive tools to support a community-based obesity management program. METHODS: Focus groups were conducted in order to evaluate program acceptability and overall participant perceptions of the clinical trial. Thematic content analysis was used to analyse the data, aided by the development of a thematic network. RESULTS: The telehealth trial was well received. Participants found the telephone and text message support highly beneficial, providing encouragement, motivation and accountability via a simple and convenient mode of communication. CONCLUSIONS: These findings suggest a high degree of promise for the incorporation of telephone and text support in obesity management.

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Athletes often experience sleep disturbances and poor sleep as a consequence of extended travel, the timing of training and competition (i.e., early morning or evening), and muscle soreness. Nutrition plays a vital role in sports performance and recovery, and a variety of foods, beverages, and supplements purportedly have the capacity to improve sleep quality and quantity. Here, we review and discuss relevant studies regarding nutrition, foods, supplements, and beverages that may improve sleep quality and quantity. Our narrative review was supported by a semi-systematic approach to article searching, and specific inclusion and exclusion criteria, such that articles reviewed were relevant to athletes and sporting environments. Six databases-PubMed, Scopus, CINAHL, EMBASE, SPORTDiscus, and Google Scholar-were searched for initial studies of interest from inception to November 2020. Given the paucity of sleep nutrition research in the athlete population, we expanded our inclusion criteria to include studies that reported the outcomes of nutritional interventions to improve sleep in otherwise healthy adults. Carbohydrate ingestion to improve sleep parameters is inconclusive, although high glycemic index foods appear to have small benefits. Tart cherry juice can promote sleep quantity, herbal supplements can enhance sleep quality, while kiwifruit and protein interventions have been shown to improve both sleep quality and quantity. Nutritional interventions are an effective way to improve sleep quality and quantity, although further research is needed to determine the appropriate dose, source, and timing in relation to training, travel, and competition requirements.

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Gastrointestinal disturbances are one of the most common issues for endurance athletes during training and competition in the heat. The relationship between typical dietary intake or nutritional interventions and perturbations in or maintenance of gut integrity is unclear. Twelve well-trained male endurance athletes (peak oxygen consumption = 61.4 ± 7.0 ml·kg-1·min-1) completed two trials in a randomized order in 35 °C (heat) and 21 °C (thermoneutral) conditions and kept a detailed nutritional diary for eight consecutive days between the two trials. The treadmill running trials consisted of 15 min at 60% peak oxygen consumption, 15 min at 75% peak oxygen consumption, followed by 8 × 1-min high-intensity efforts. Venous blood samples were taken at the baseline, at the end of each of the three exercise stages, and 1 hr postexercise to measure gut integrity and the permeability biomarker concentration for intestinal fatty-acid-binding protein, lipopolysaccharide, and lipopolysaccharide-binding protein. The runners self-reported gut symptoms 1 hr postexercise and 3 days postexercise. The heat condition induced large (45-370%) increases in intestinal fatty-acid-binding protein, lipopolysaccharide-binding protein, and lipopolysaccharide concentrations compared with the baseline, but induced mild gastrointestinal symptoms. Carbohydrate and polyunsaturated fat intake 24 hr preexercise were associated with less lipopolysaccharide translocation. Protein, carbohydrate, total fat, and polyunsaturated fat intake (8 days) were positively associated with the percentage increase of intestinal fatty-acid-binding protein in both conditions (range of correlations, 95% confidence interval = .62-.93 [.02, .98]). Typical nutrition intake partly explained increases in biomarkers and the attenuation of symptoms induced by moderate- and high-intensity exercise under both heat and thermoneutral conditions.

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OBJECTIVES: Determine the extent and underlying causes of post-exercise hyperthermia in athletes with a spinal cord injury following exercise. DESIGN: Observational. METHODS: Thirty-one males (8 with tetraplegia [TP; C5-C8], 7 with high paraplegia [HP; T1-T5], 8 with low paraplegia [LP; T6-L1] and 8 able-bodied [AB]), recovered in 35°C/50%RH for 45min after 30-min of exercise at a metabolic heat production (Hprod) of 4.0W/kg (AB vs TP) or 6.0W/kg (AB vs HP vs LP). Esophageal (Tes), gastrointestinal (Tgi) and skin temperatures, Hprod, local sweat rate (LSR) and mean arterial pressure were measured. RESULTS: TP maintained a higher Tes (38.05°C [95% CI: 37.83°C, 38.28°C], AB: 36.77°C [36.56°C, 36.98°C], p<0.001) and Tgi (TP: 38.36°C [38.15°C, 38.58°C], AB: 37.26°C [37.04°C, 37.47°C], p<0.001), with peak values observed 45min post-exercise. Core temperatures all declined in HP, LP and AB, but HP maintained a higher Tes than AB (p=0.030), and higher Tgi than LP and AB (p=0.019). No differences in post-exercise Hprod were observed between TP and AB (p=0.264), or HP, LP and AB (p=0.124). Evaporative heat loss was estimated to be zero in TP, while back LSR was greater in HP than LP (p=0.009). Minimal dry heat loss occurred in SCI groups (TP: 9W/m2 [6, 12], HP: 4W/m2 [1, 6], LP: 2W/m2 [0, 5]). CONCLUSIONS: Substantial post-exercise hyperthermia is evident in TP (∼1.4°C hotter than AB after 45min of post-exercise recovery) due to minimal evaporation. HP have delayed post-exercise thermoregulatory recovery whereas LP respond similarly to AB.

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Probiotic supplementation may offer team sport athletes a range of benefits beyond the immune and gastrointestinal systems. OBJECTIVES: To examine the effects of a probiotic formulation on perceptual markers of sleep quality and quantity, and muscle soreness, leg heaviness and motivation in elite rugby union athletes. METHODS: A double-blind randomised controlled trial involving 19 elite male rugby athletes was conducted over 17 weeks encompassing both domestic and international competition. Psychometric variables and salivary biomarkers were assessed twice a week. Athletes were assigned either a daily probiotic (Ultrabiotic 60™) and Saccharomyces boulardii (during international competition) or a placebo. Associations between psychometric scores for perceptual and salivary biomarkers of sleep (melatonin) and inflammation C-reactive protein (CRP) were investigated. RESULTS: Muscle soreness was ∼0.5 units lower (F(1, 343)=42.646, p<0.0001) and leg heaviness scores ∼0.7 units lower (F(1, 334)=28.990, p<0.0001) in the probiotic group compared to the placebo group. Across both groups, as self-reported muscle soreness scores and salivary CRP concentrations increased, sleep quantity, quality and motivation scores decreased. Conversely as muscle soreness scores and CRP decreased, sleep quantity and quality, and motivation scores improved. CONCLUSIONS: A long-term programme of probiotic supplementation in international-level rugby union players may yield favourable effects on self-reported muscle soreness and sleep quality associated with muscle soreness during training and competitions.

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Applying heat training interventions in a team sports setting remains challenging. This study investigated the effects of integrating short-term, repeat sprint heat training with passive heat exposure on running performance and general conditioning in team sport players. Thirty male club-level Australian Football players were assigned randomly to: Passive + Active Heat (PAH; n = 10), Active Heat (AH; n = 10) or Control (CON; n = 10) to complete 6 × 40 min high-intensity cycling training sessions over 12 days in 35°C (PAH and AH) or 18°C (CON), 50% RH in parallel with mid-season sports-specific training and games. Players in PAH were exposed to 20 min pre-exercise passive heat. Physiological adaptation and running capacity were assessed via a treadmill submaximal heat stress test followed by a time-to-exhaustion run in 35°C, 50% RH. Running capacity increased by 26% ± 8% PAH (0.88, ±0.23; standardised mean, ± 90% confidence limits), 29% ± 12% AH (1.23, ±0.45) and 10% ± 11% CON (0.45, ±0.48) compared with baseline. Both PAH (0.52, ±0.42; standardised mean, ± 90% confidence limits) and AH (0.35, ±0.57) conditions yielded a greater improvement in running capacity than CON. Physiological and perceptual measures remained relatively unchanged between baseline and post-intervention heat stress tests, within and between conditions. When thermal adaptation is not a direct priority, short-term, repeat effort high-intensity cycling in hot conditions combined with sports-specific training can further enhance running performance in team sport players. Six heat exposures across 12-days should improve running performance while minimising lower limb load and cumulative fatigue for team sports players.

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Purpose: Heat training can be implemented to obtain performance improvements in hot and temperate environments. However, the effectiveness of these interventions for team sports during discrete periods of the season remains uncertain. Methods: We compared the effects of a short pre-season heat training intervention on fitness and thermal tolerance. In a counterbalanced crossover design, eleven state-level male football players undertook 6 × 60 min sessions in HEAT (35°C, 50% RH) and TEMP (18°C, 50% RH) conditions over 12 days. Running performance pre- and post-intervention was assessed via the Yo-Yo Interment Recovery Test Level 1 (YYIR1), and thermal adaptation using a submaximal (4 × 4 min @ 9-13 km·h-1) treadmill heat stress test in 35°C, 50% RH. Results: Running distance increased by 9, ±9% in HEAT (standardized mean, ±90% confidence limits) and 13, ±6% in TEMP, the difference in the mean change between conditions was unclear (0.24, ±0.64 standardized mean, ±90% confidence limits). Irrespective of training interventions, there was an order effect indicated by a substantial 476 ± 168 m increase in running distance between the first and final YYIR1 tests. There were trivial to small reductions in heart rate, blood lactate, RPE and thermal sensation after both interventions. Differences in mean core and skin temperature were unclear. Conclusions: Supplementary conditioning sessions in heat and temperate environments undertaken in addition to sports-specific field-based training were effective in enhancing player fitness during the pre-season. However, few clear differences between HEAT and TEMP conditions indicate conditioning in the heat appeared to offer no additional benefit to that of training in temperate conditions.