A monitoring program is essential in assuring goal attainment and reducing the risk of overtraining or undertraining, establishing long-term athlete development, and ensuring success. This monitoring program needs to be integrated into the training process, developed, and executed by both the sport science and coaching staff. This staff forms the SPEG (sports performance enhancement group), which is athlete centered and coach driven. The purpose of this dissertation was to create an evidence based, or white box approach, to collegiate distance running by identifying key characteristics, utilizing appropriate monitoring tools, and examining the annual plan. Collegiate distance runners took part in a monitoring program through East Tennessee State University, which included vertical jumps, V̇O2max, running economy, anthropometrics, isometric mid-thigh pull, performance results and ultrasound measurements. There were strong correlations between performance results and monitoring data, and there were significant changes that occurred throughout the monitoring program. The results indicate the importance of V̇O2max in collegiate runners and that monitoring variables, including performance, sum of skinfolds, ultrasound and vertical jumps significantly change throughout the competitive season. The results also identify characteristics of a high-level runner and indicate the impact that a strength program can have on monitoring variables and performance. Results further suggest that strength can be a critical component of a training program, can be tracked through systematic monitoring, and is associated with an increase in performance.

The main purpose of this dissertation was to compare performance and physiological outcomes of between a repetition maximum (RM) and a relative intensity using sets-and-repetitions (RISR) resistance training (RT) program in well-trained lifters. Fifteen subjects underwent RT 3 d·wk-1 for 10-weeks in either a RM group (n=8) or RISR group (n=7). The RM group achieved a relative maximum each day while the RISR group trained based on percentages. Testing included percutaneous needle biopsies of the vastus lateralis, ultrasonography, unweighted (g to assess within and between-group alterations. RISR from pre-to-post yielded statistically significant increases in Type I CSA (p=0.018), Type II CSA (p=0.012), ACSA (p=0.002), unweighted (p=0.009) and 20 kg SJ JH (p=0.012), unweighted (p=0.003) and 20kg SJ PPa (p=0.026), IPF (ppSR increased in unweighted (p=0.023) and 20kg SJ JH (p=0.014), and 20kg SJ PPa (p=0.026) from pre-to-post taper. RM yielded statistically significant increases from only pre-to-post taper for 20kg SJ JH (p=0.003) and CMJ JH (p=0.031). Additionally, RM had a statistically significant pre-to-post decrease in RFD from 0-50ms (p=0.018) and 0-100ms (p=0.014). Between-group effect sizes supported RISR for Type I CSA (g=0.48), Type II CSA (g=0.50), ACSA (g=1.03), all MYH isoforms (g=0.31-0.87), all SJ variables (g=0.64-1.07), unweighted and 20kg CMJ JH (g=0.76-0.97), unweighted CMJ PPa (g=0.35), IPFa (g=0.20), and all RFD (g=0.31-1.25) time-points except 0-200ms; with all other effects being of trivial magnitude (gSR training yielded greater improvements in vertical jump, RFD and maximal strength compared RM training. These performances results may, in part, be explained mechanistically by the superior physiological adaptations observed in the RISR group within the skeletal muscle. Taken together, these data support the use of RISR training in well-trained populations.

The purpose of this study was to investigate the kinetic and morphological adaptations that occur during distinct phases of a block periodized training cycle in weightlifters. Monitoring data from nine experienced collegiate weightlifters was examined retrospectively. Isometric mid-thigh pull and ultrasonography results from pre and post three specific training phases within a macrocycle leading up to a competition were compared. Changes in isometric rate of force development and vastus lateralis cross-sectional area reflected the expected adaptations of each training phase.

Competition often requires teams that reside at sea level to compete against opponents whose residence is at a moderate altitude. This may pose a potential competitive disadvantage considering that moderate altitude may cause decrements in VO2max, distance covered, and time to exhaustion in endurance athletes. The purpose of this study was to examine the effect of altitude on game performance measures. Six NCAA Division I female soccer players (20.33 ± 1.21 y; 168 ± 6.45 cm; 62.5 ± 6.03 kg) were retrospectively examined. Comparisons were made between two competitions that were played at sea level (SL) within two weeks of a game played at a moderate altitude (1840 m) on game characteristics including high intensity running (HIR) and total distance covered (TDC). Analysis was performed on these six players who met a threshold of playing sixty or more minutes in each competition. A 10-Hz global positioning system (GPS) was used to measure distance and velocity. The rate of TDC and HIR during the game (m?min-1) and percentage of time at HIR during competition were evaluated. The two games at SL were averaged to establish baseline performance and the mean results were compared with the single game played at altitude. Paired samples t-tests were performed to determine if any mean differences existed between performance at altitude and sea level. Significant differences (p < 0.05) were seen in minutes played between the games at SL (74.23 ± 2.93 min) versus altitude (83.24 ± 5.27 min). The relative distance rate during the game at altitude was lower at altitude (105.77 ± 10.19 m?min-1) than at SL (120.55 ± 8.26 m?min-1). HIR rate was greater at SL (27.65 ± 9.25 m?min-1) compared to altitude (25.07 ± 7.66 m?min-1). The percent of time spent at high intensity was not significantly different (p = 0.064), yet tended to be greater at sea level (10.4 ± 3.3%) than when they performed at altitude (9.1 ±2.2%). Soccer performance at a moderate altitude appears to reduce the rate at which players run throughout the competition, as well as their rate at a high intensity. Results suggest that teams that reside at SL may be at a competitive disadvantage when competing at altitude.

Cross education is the phenomenon by which the untrained limb will experience a gain in strength following a unilateral resistance training program. However, little is known as to the underlying adaptation occurring in the untrained limb. Purpose: To examine the effect of dynamic unilateral resistance training on the strength and neuromuscular adaptations of both the trained and untrained legs. Methods: Eight previously untrained males (22.38±2.92 y, 1.73±0.08 m, 75.26±14.53 kg) completed a four-week unilateral resistance training program, while another eight untrained males (24.00±4.57 y, 1.84±0.05 m, 94.21±16.14 kg) served as controls. Isometric leg extension strength, leg press 1 repetition maximum (1RM), leg extension 1RM, root mean square of the maximal electromyographic amplitude (EMG), submaximal EMG, dynamic neuromuscular economy (NME) and the slope of NME-power output relationship were determined before and after training to assess the changes in strength and neuromuscular adaptations of the vastus lateralis (VL) and rectus femoris (RF) in both the trained and untrained legs. The unilateral resistance training program was conducted on the dominant leg (DOM) in the unilateral resistance training group (URT) and was compared to the dominant leg of the control group (CON). Cross education was measured in the nondominant leg (NON) for both groups. The unilateral resistance training program was completed three days per week for a total of twelve training sessions. Exercises included in the training program were unilateral leg press, unilateral leg extension, bilateral chest press and bilateral low row. All data was analyzed using one-way analysis of covariance of the post-testing values using the pre-testing values as the covariate. Further analysis of the EMG and NME data was performed using magnitude-based inferences. Results: The URT group improved their isometric (DOM:11.03%, NON:4.98%), leg press (DOM:77.63%, NON:64.88%) and leg extension (DOM:46.76%, NON:16.43%) strength after the four weeks of resistance training. There was no difference between the groups in isometric strength in the dominant (p=0.188) or nondominant (p=0.948) leg. For leg extension 1RM, there was a significant difference between groups in the dominant leg (p=0.018), but not the nondominant leg (p=0.482). However, there were significant group differences in both the dominant (p=0.003) and nondominant (p=0.034) leg for leg press 1RM. In terms of maximal EMG, the training groups improved in the vastus lateralis (DOM:29.81%, NON:31.44%) and rectus femoris (DOM:20.71%, NON:6.26%) individually, as well as in total EMG (DOM:24.78%, NON:17.57%). There was a Likely Positive or Very Likely Positive effect of unilateral resistance training on the changes in maximal EMG of the vastus lateralis and rectus femoris in both the dominant and nondominant legs. There was a Likely Positive effect of unilateral resistance training on the submaximal EMG of the dominant vastus lateralis at 75 and 125 watts. Conversely, in the rectus femoris, there was Unclear effects of unilateral resistance training on the submaximal EMG of the dominant leg. There was no consistent effect of unilateral resistance training on submaximal EMG values of the vastus lateralis in the nondominant leg. However, the rectus femoris in the nondominant leg experienced a Likely Positive effect of unilateral resistance training on submaximal EMG. NME improved in the URT group in the VL at 75 (DOM:9.73%, NON:13.42%), 100 (DOM:8.76%, NON:8.21%), and 125(DOM:24.26%, NON:12.8%) watts and in the RF at 75 (DOM:22.25%, NON:15.73%), 100(DOM:24.85%, NON:17.05%) and 125 (DOM:30.99%) watts. In terms of neuromuscular economy, there was a Likely Positive or Very Likely Positive effect of unilateral resistance training on most measures of NME on both the vastus lateralis and rectus femoris in both the dominant and nondominant legs. In terms of NME slope, there was only a Likely Positive effect of unilateral resistance training on the dominant vastus lateralis. Conclusion: Based on these results, it appears that the cross education of strength from unilateral resistance training is modality-specific. Furthermore, the NME of both the vastus lateralis and rectus femoris in both legs appear to improve following unilateral resistance training. However, in the nondominant leg, the improvement in NME appears to be due solely to the increase in maximal EMG, whereas the improved NME in the dominant leg is due to both an increase in maximal EMG and a decrease in submaximal EMG.

Purpose: To examine the effect of three muscle potentiation protocols on changes in muscle architecture and the subsequent effect on jump power performance. Methods: Maximal (1RM) squat strength (Mean SD=178.3 ± 36.6kg), vertical jump power, and muscle architecture were obtained in 12 resistance trained men (25.2±3.6y; 90.67±12.7kg). Participants randomly completed three squatting protocols at 75% (3 x 10 reps), 90% (3 x 3 reps) or 100% (1 x 1) of their 1RM, or no workout (CON), with each protocol being separated by one week. During each testing session ultrasound and vertical jump testing were assessed at baseline (BL), 8min post (8P) and 20min post (20P) workout. Ultrasound measures of the rectus femoris (RF) and vastus lateralis (VL) muscles included; cross sectional area (CSA) and pennation angle (PNG). Following each ultrasound, peak (PVJP) and mean (MVJP) vertical jump power (using hands for maximum jump height) were measured using an accelerometer. Results: Magnitude based inferences analysis indicated that in comparison to CON, 75% resulted in a likely greater change in RF-CSA and VL-CSA (BL-8P and BL–20P), 90% resulted in a likely greater RF-CSA and VL-CSA (BL–20P), and 100% resulted in a very likely or likely decrease in VL-PNG at BL-8P and BL–20P, respectively). Meanwhile, changes in PVJP and MVJP for the 75% trial was likely decreased at BL-8P and BL–20P; and for the 90% trial MVJP was likely decreased at BL-8P and BL–20P. Analysis of the magnitude of the relationships indicated a likely negative relationship between VL-PNG and MVJP (r = -0.35; p < 0.018) at BL-8P, while at BL–20P, a negative relationship was observed between PVJP and RF-CSA (r = - 0.37; p < 0.014). iii Conclusion: Acute increases in muscle size and acute decreases in pennation angle did not result in any potentiation in vertical jump power measures. Although the inverse relationships observed between muscle architecture variables and power suggests a potential effect, the change in position (i.e. movement from standing to supine for ultrasound measures) may negate, as a result of potential fluid shifts or muscle relaxation, the potentiating effects of the exercise. It is also possible that the fatiguing nature of the squat protocols in trained but not competitive participants may have also contributed to the results.

The purpose of this study was to compare the efficacy of two dose levels of L-Alanyl-LGlutamine in a commercially available sports drink to the sports drink only on time to exhaustion, neuromuscular fatigue and physiological measures during prolonged endurance exercise. Twelve endurance-trained males (23.5±3.7 yrs; 175.5±5.4 cm; 70.7±7.6 kg) performed four trials, each consisting of 1 hr treadmill runs at 75% of VO2peak followed by a run to exhaustion at 90% of VO2peak. The trials differed in type of hydration. One trial consisted of no hydration (NHY), another required ingestion of only a sports drink (ET), and two trials required ingestion of a low dose (LD) (300 mg∙500 ml-1) and high dose (HD) of L-Alanyl-L-Glutamine (1 g∙500 ml-1) mixed in the sports drink. During the fluid ingestion trials 250 ml were consumed every 15 min. Plasma glutamine, glucose, electrolytes, and osmolality were measured prior to the run (PRE), and at 30, 45, and 60 min. VO2, RQ, and HR were measured every 15 min and surface electromyography (EMG) of the vastus lateralis and rectus femoris were measured every 10 min during the 1 hr run. Time to exhaustion was significantly longer during the LD and HD trials compared with NHY. Plasma glutamine concentrations were significantly elevated at 45 min in LD and HD trials, and remained elevated at 60 min during HD. Sodium concentrations increased with the beginning of exercise and remained stable for the duration of the 1 hr run. At 60 min plasma sodium was significantly lower in all trials compared with NHY. The results from this study indicated that ingestion of the alanine-glutamine dipeptide at either the low or high dose significantly improved time to exhaustion during high intensity exercise compared to a no hydration trial. These differences were not noted between ET and NHY.

Background. There are roughly 300,000 rib fractures treated for in the United States each year. These represent 10-26% of thoracic trauma injuries and have about a 10% mortality rate. There is a common belief that mortality in rib fracture patients can be contributed to the diagnosis of pneumonia, but this study does not support that claim. Purpose. To determine the predictors of morbidity and mortality in rib fracture patients. Methods. Using a level 1 trauma center patient registry, we retrospectively analyzed all patients that were admitted with at least one rib fracture (n=1,344). All predictors were analyzed with linear regressions. Results. The average age of the patients was 55.48 ± 20.29 years old and ranged between 15 and 98. ISS (OR: 1.0508, p<0.001), bilateral fractures (OR: 1.9495, p = 0.009) and pulmonary contusion (OR: 1.7481, p = 0.022) were all significant predictors of pneumonia. The age of the patient (OR: 1.0467, p < 0.001), ISS (OR: 1.0585, p <0.001), having 6 or more fractured ribs (OR: 3.1450, p < 0.001), the presence of hemothorax (OR: 2.5063, p = 0.048), and the use of mechanical ventilation (OR: 13.2125, p < 0.001) were all significant predictors of mortality. Flail segments (OR: 1.9871, p = 0.067), ISS (OR: 1.1267, p < 0.001), pulmonary contusions (OR: 1.5329, p = 0.047), pneumothorax (OR: 1.4372, p =0.073) and pneumonia (OR: 21.4516, p < 0.001) are all predictors of requiring mechanical ventilation. Conclusion. There are many studies that indicate rib fracture patients who are diagnosed with pneumonia have a higher risk or mortality. With this in mind, the logical course of treatment would be to counteract the complications pneumonia brings as to reduce the risk or mortality. To do this, it is recommend the patient be put on mechanical ventilation. While this has been seen to help with pneumonia patients, this study provides evidence that health care professionals should look for ways to reduce the need for mechanical ventilation instead of using it to combat the pneumonia.

The objectives of this dissertation include 1) to review athlete monitoring strategies and the physical performance demands of female soccer match-play and to provide practical application of athlete monitoring programs, 2) to examine individual and group relationship between training load (TL) and subjective recovery and stress state and neuromuscular performance, and 3) to investigate acute effects of match-play on neuromuscular and subjective recovery and stress state in National Collegiate Association Athlete (NCAA) division I collegiate female soccer. TL was assessed using 10Hz Global Navigation Satellite System units. Subjective recovery and stress state was measured using the Short Recovery and Stress Scale (SRSS) consisting of 8 subscales including Physical Performance Capability (PPC) Mental Performance Capability (MPC), Emotional Balance (EB), Overall Recovery (OR), Muscular Stress (MS), Lack of Activation (LA), Negative Emotional State (NES), and Overall Stress (OS). Neuromuscular performance was assessed using countermovement jump (CMJ) with a polyvinyl chloride pipe (CMJ0) and 20kgs bar (CMJ20). CMJ variables included body mass (BdM), jump height (JH), modified reactive strength index (RSI), peak force (PF), relative peak force (RPP), eccentric impulse (EI), concentric impulse (CI), peak power (PP), relative peak power (RPP), eccentric average peak power (EAP), and concentric average power (CAP). Results of this dissertation showed that 12 individual players demonstrated negative correlations between total distance and MPC (p≤0.05, r=-0.78 to -0.34, number of significant individual correlations [N]=3) and OR (p≤0.05, r=-0.91 to -0.08, N=3). Positive correlations were observed between MS and total distance among all individual players (p≤0.05, r=0.21 to 0.82, N=3) while the group correlations were moderate to large (p≤0.001, r=0.55). Results of this dissertation also demonstrated that significant moderate to large decreases were observed at 12 hours post-match in JH, RSI, CI, PP, RPP, and CPA in CMJ0 and CMJ20 (p

Monitoring external workloads and countermovement jump performance may be useful for coaches. PURPOSE: The purpose of this study was to determine the effects of external load on player performance as measured by a CMJ and specific blood biomarkers throughout the preseason. METHODS:10 female division 1 basketball athletes had PlayerLoadTM (PL) monitored for all mandatory basketball training during six weeks of the preseason and CMJs were performed weekly. Blood biomarkers were collected before preseason and at the end of preseason. Data were analyzed via the Catapult Sport software (Openfield, Catapult, Innovations, Melbourne, VIC, Australia) to quantify all participant movement. Data from CMJs were analyzed via Sparta Science technology (SpartaTrac; SPARTA Performance Science, v1.2.4). Cumulative effect of physical activity (CTPL) was estimated as a sum of total PL up to each jump testing session divided by the number of days. Linear mixed-effects models were used to model data related to the efficacy of PL and CTPL. Athletes (id) and their positions were examined as potential random effects. RESULTS: The best fit model suggested a high-order polynomial pattern between PL and the number of days since the first jump testing session with a random effect for the intercept (marginal R2 = 0.290; conditional R2 = 0.471). The fixed effect for the slope of the first order term was found to be positive. There was a significant negative effect of CTPL on JH (p = 0.0037). The boot strapped model showed a marginal R2 of 0.0183 (95% CI [0.000952, 0.0744]) and a conditional R2 of 0.884 (95% CI [0.762, 0.956]). For RSImod, a significant negative association between RSImod and CTPL (p = 0.0039, 95% CI [-0.0002214, -4.597081e-05]). CONCLUSION: Workloads increase during preseason. CMJ height and RSImod may have limited utility in displaying the effects cumulative workloads. Position played did not impact workload or the impact of that workload on the player. PRACTICAL APPLICATION: Cumulative effect of physical activity may be tracked using CTPL derived from PL. Practitioners may be encouraged to monitor alternative countermovement variables to better understand performance response to the cumulative effect of physical activity.