Latest research in football - week 41 - 2023

As previous literature updates, I have performed a PubCrawler search looking for football articles in NCBI Medline (PubMed) and GenBank databases. 


Following studies were retrieved for this week:

#1 Discrete Hamstring: Quadriceps Strength Ratios Do Not Represent Angle-Specific Ratios in Premier League Soccer Players

Reference: J Strength Cond Res. 2023 Oct 6. doi: 10.1519/JSC.0000000000004574. Online ahead of print.

Authors: David E Lunn, Gareth Nicholson, Mark Cooke, Rubén Crespo, Tom Robinson, Rob J Price, Josh Walker

Summary: This study compared angle-specific hamstring:quadriceps (H:Q) ratios with their discrete counterparts during strength testing in professional male soccer players. Twenty-seven professional English Premier League soccer players were recruited for this study (age: 22 ± 4 years; stature: 1.81 ± 0.08 m; body mass: 74.7 ± 6.5 kg). Isokinetic testing of the knee flexors and extensors was conducted concentrically at two angular velocities (60° and 240°·s-1) and eccentrically (for the knee flexors only) at 30°·s-1. Conventional H:Q ratio was calculated as the ratio between peak joint moment in the flexors and extensors at 60°·s-1. Functional H:Q ratio was calculated as the peak joint moment in the flexors during the eccentric condition and the extensors at 240°·s-1. Discrete conventional and functional H:Q ratios were 0.56 ± 0.06 and 1.28 ± 0.22, respectively. The residual differences between discrete values and angle-specific residual values were 13.60 ± 6.56% when normalized to the magnitude of the discrete value. For the functional ratios, the normalized residual was 21.72 ± 5.61%. Therefore, neither discrete ratio was representative of angle-specific ratios, although the conventional ratio had lower error overall. Therefore, practitioners should consider H:Q ratio throughout the full isokinetic range of motion, not just the discrete ratio calculated from peak joint moments, when designing and implementing training programs or monitoring injury risk, recovery from injury, and readiness to return to play.



#2 Daily energy requirements of male academy soccer players are greater than age-matched non-academy soccer players: A doubly labelled water investigation

Reference: J Sports Sci. 2023 Oct 9:1-13. doi: 10.1080/02640414.2023.2263707. Online ahead of print.

Authors: Reuben G Stables, Marcus P Hannon, Adam D Jacob, Oliver Topping, Nessan B Costello, Lynne M Boddy, Catherine Hambly, John R Speakman, Jazz S Sodhi, Graeme L Close, James P Morton

Summary: This study aimed to test the hypothesis that the total daily energy expenditure (TDEE) of male academy soccer players is greater than players not enrolled on a formalised academy programme. English Premier League academy (ACAD: n = 8, 13 years, 50 ± 6 kg, 88 ± 3% predicted adult stature, PAS) and non-academy players (NON-ACAD: n = 6, 13 years, 53 ± 12 kg, 89 ± 3% PAS) were assessed for TDEE (via doubly labelled water) during a 14-day in-season period. External loading was evaluated during training (ACAD: 8 sessions, NON-ACAD: 2 sessions) and games (2 games for both ACAD and NON-ACAD) via GPS, and daily physical activity was evaluated using triaxial accelerometry. Accumulative duration of soccer activity (ACAD: 975 ± 23 min, NON-ACAD: 397 ± 2 min; p < 0.01), distance covered (ACAD: 54.2 ± 8.3 km, NON-ACAD: 21.6 ± 4.7 km; p < 0.05) and time engaged in daily moderate-to-vigorous (ACAD: 124 ± 17 min, NON-ACAD: 79 ± 18 min; p < 0.01) activity was greater in academy players. Academy players displayed greater absolute (ACAD: 3380 ± 517 kcal · d-1, NON-ACAD: 2641 ± 308 kcal · d-1; p < 0.05) and relative TDEE (ACAD: 66 ± 6 kcal · kg · d-1, NON-ACAD: 52 ± 10 kcal · kg · d-1; p < 0.05) versus non-academy players. Given the injury risk associated with high training volumes during growth and maturation, data demonstrate the requirement for academy players to consume sufficient energy (and carbohydrate) intake to support the enhanced energy cost of academy programmes.



#3 Comparison of the effects of pea protein and whey protein on the metabolic profile of soccer athletes: a randomized, double-blind, crossover trial

Reference: Front Nutr. 2023 Sep 22:10:1210215. doi: 10.3389/fnut.2023.1210215. eCollection 2023.

Authors: Luiz Lannes Loureiro, Tathiany Jéssica Ferreira, Fábio Luiz Candido Cahuê, Victor Zaban Bittencourt, Ana Paula Valente, Anna Paola Trindade Rocha Pierucci

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Summary: Pea protein (PP) concentrate is a plant-based alternative to animal protein sources, such as whey protein (WP). In addition to its valuable amino acid composition, PP has a low environmental impact, making it a sustainable, nutritious, and viable alternative for enhanced sports performance, such as in soccer. PP Therefore, this study aimed to evaluate the effects of PP and WP supplementation on biochemical and metabolic parameters in soccer players. Twelve male under-20 soccer players were included in this double-blind, randomized crossover intervention study. For 10 consecutive days, each participant received either 0.5 g/kg of the PP or WP supplementation after training, starting 7 days before the test game, and continuing until 2 days after. After a 4-day washout period, the athletes switched groups and the intervention was restarted. Blood samples were collected before and after the game, as well as 24 h, 48 h, and 72 h intervals thereafter. Creatine kinase (CK), aspartate transaminase, alanine transaminase (ALT), lactate (LA), urea, creatinine, and uric acid were analyzed using commercial kits. Exploratory metabolic profiling of the serum samples was performed using nuclear magnetic resonance spectroscopy. A comparison of biochemical markers showed that the PP group had lower CK in the post-game moment, 24 h, and 48 h. Lower LA in the post-game moment, and lower ALT in the post-game moment and at 24 h. Of the 48 metabolites analyzed, 22 showed significant differences between the time points, such as amino acids, ketone bodies, and glucose metabolism. Glutamate and lactate levels significantly increased between the pre- and post-game moments in the WP group. After the game, the WP group exhibited reduced levels of metabolites such as arginine and taurine, whereas no such change was observed in the PP group. There was no difference in metabolites 72 h after the game. Despite the slight advantage of the PP group in specific biochemical markers, these differences are not sufficient to justify the choice of a particular type of protein. However, the results highlight the viability of plant protein as a potential alternative to animal protein without compromising athletic performance or recovery.



#4 Does Restricted Ankle Joint Mobility Influence Hamstring Muscle Strength, Work and Power in Football Players after ACL Reconstruction and Non-Injured Players?

Reference: J Clin Med. 2023 Oct 1;12(19):6330. doi: 10.3390/jcm12196330.

Authors: Łukasz Oleksy, Anna Mika, Maciej Kuchciak, Grzegorz Bril, Renata Kielnar, Olga Adamska, Paweł Wolański, Michał Deszczyński

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Summary: This study was aimed at observing how the limitation of ankle dorsiflexion ROM affects hamstring muscle Peak Torque/BW (%), Average Power (W), and Total Work (J), and whether this effect is similar in football players after ACL rupture and reconstruction and in those without injuries. The study included 47 professional football players who were divided into two groups: Group 1 (n = 24) after ACL reconstruction and Group 2 (n = 23) without injuries in the past 3 years. Based on the Weight-Bearing Lunge Test (WBLT), the following subgroups in Groups 1 and 2 were distinguished: N (normal ankle joint dorsiflexion) and R (restricted ankle joint dorsiflexion). The concentric isokinetic test (10 knee flexions and extensions at 60°/s) was performed on both limbs. Significantly lower values of Peak Torque/BW and Average Power were observed in Group 1 compared to Group 2, as well as in subjects with normal and restricted ankle dorsiflexion. However, no significant differences were noted for either group in any of the strength variables comparing subjects with normal and restricted ankle dorsiflexion. A poor and non-significant correlation was exhibited between the ankle joint range of dorsiflexion and all the strength variables. The area under the ROC curve (AUC) for all the evaluated variables in both groups was below 0.5, or very close to this value, indicating that ankle dorsiflexion ROM has no diagnostic accuracy for hamstring muscle strength. Based on the obtained results, it can be assumed that ankle dorsiflexion limitation, which is common in football players, is not a factor in weakening hamstring muscle strength, either in football players after ACL reconstruction or among those without injuries. However, some authors have reported that limited mobility of the ankle joint can have a destructive effect on the work of the lower limbs and may also be a factor in increasing the risk of football injuries in this area. Therefore, we have suggested that hamstring muscle weakness and increased risk of injury may occur due to factors other than limited ankle mobility. These observations may be of great importance in the selection of prevention methods by including a broad spectrum of physical techniques, not just exercises that focus on the improvement of mobility or stability of the lower limbs.



#5 Epidemiology of Injuries in Professional and Amateur Football Men (Part II)

Reference: J Clin Med. 2023 Sep 29;12(19):6293. doi: 10.3390/jcm12196293.

Authors: Tudor Vladimir Gurau, Gabriela Gurau, Carmina Liana Musat, Doina Carina Voinescu, Lucretia Anghel, Gelu Onose, Constantin Munteanu, Ilie Onu, Daniel Andrei Iordan

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Summary: Men's football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men's football game remain the highest of all sports. The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men's football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries-21.13%, contusions-17.86%, and fractures-3.27%, and for amateur football players, the prevalence's were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Football-related injuries have a significant impact on professional and amateur football players and their short- and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries.



#6 Injury Patterns and Incidence in an Elite Youth Football Academy-A Prospective Cohort Study of 138 Male Athletes

Authors: Johannes Weishorn, Ayham Jaber, Severin Zietzschmann, Jan Spielmann, Tobias Renkawitz, Yannic Bangert

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Summary: There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury. A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season. A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7-30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2-41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01). In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention.



#7 Injury incidence in male elite youth football players is associated with preceding levels and changes in training load

Reference: BMJ Open Sport Exerc Med. 2023 Oct 6;9(4):e001638. doi: 10.1136/bmjsem-2023-001638. eCollection 2023.

Authors: Tania Nilsson, Mats Börjesson, Matilda Lundblad, Andreas Ivarsson, Dan Fransson

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Summary: Elite youth football players miss out on a large part of seasonal training due to injury. Limited research suggests an association between external and internal training load (TL) and injury incidence in elite youth football. This study analysed external and internal TL variables and their association with injury incidence in a group of male elite youth football players over four seasons. Measures of external and internal TL and injury incidence of 56 male elite youth football players (age 17-19 years) were collected throughout four seasons. Heart rate, session rating of perceived exertion andGlobal Positioning System (GPS) variables were analysed. Individual players' TL during the 30 days leading up to injury was compared with 30-day injury-free control periods. Change in TL through the periods was also analysed. Eighty-five injuries were included for analysis, showing that for most TL variables, the average levels were significantly lower during the period leading up to injury. Significant increases for the majority of TL variables were also found during the periods leading up to injury, while the control periods did not show any significant change. A lower and/or increasing average TL volume over 30 days might increase the risk of injury in male elite youth football players. Avoiding long-term drops in TL and balance increases in TL might be beneficial to reduce injury risk.



#8 Influence of a football match on landing biomechanics and jump performance in female football players

Reference: Scand J Med Sci Sports. 2023 Oct 12. doi: 10.1111/sms.14518. Online ahead of print.

Authors: Aaron Miralles-Iborra, Jose L L Elvira, Juan Del Coso, Sergio Hernandez-Sanchez, Jose Pino-Ortega, Victor Moreno-Pérez

Summary: This study aimed to assess the acute effect of a competitive football match on jump performance and kinematic parameters during jump landing in semiprofessional female football players. Twenty-two semiprofessional players (20 ± 3 years) underwent a drop jump task for a posterior video analysis of the landing phase. These measurements were obtained at (1) baseline, (2) after, and (3) 48 h after a competitive football match. A one-way ANOVA with repeated measures was employed to detect differences over the time. There was a main effect of time for maximal knee flexion angle during drop landing (p = 0.001). In comparison with baseline, maximal knee flexion angle was reduced immediately post-match and was still reduced 48 h after the match (63.4 ± 8.6 vs 57.0 ± 11.7 vs 48.9 ± 19.1, p ≤ 0.038). There was also a main effect of time for drop jump height (p < 0.001). Drop jump height was reduced immediately post-match and remained low 48 h after the match in comparison with baseline (27.3 ± 3.6 vs 24.5 ± 2.8 ~ 25.5 ± 3.0 cm, p ≤ 0.002). There was a main effect of time on hip flexion angle during landing (p = 0.001), but the pairwise comparison revealed that this variable was not affected immediately post-match but was lower 48 h after the match than at baseline (50.1 ± 10.1 ~ 50.8 ± 13.2 vs 38.1 ± 17.8 °, p ≤ 0.005). A competitive football match worsened jump performance and several landing biomechanical parameters in female football players, which were still decreased in comparison with baseline even 48 h after the match.



#9 Relationship between perceived social support and mental health among Chinese college football athletes: a moderated mediation model

Reference: BMC Psychol. 2023 Oct 11;11(1):329. doi: 10.1186/s40359-023-01357-2.

Authors: Zongyu Liu, Xiuhan Zhao, Liangyu Zhao, Liguo Zhang

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Summary: Previous researches have confirmed that perceived social support has a profound effect on individuals' mental health. However, the effects and potential mechanisms of perceived social support on mental health of college athletes are still largely unknown, especially during and after the COVID-19 pandemic. Thus, the aim of this study was to explore the relationship between perceived social support and mental health in college football athletes, and to evaluate whether hopelessness and psychological pressure affected this relationship. A sample of 672 Chinese college football athletes (37.9% girls; Mage = 20.43 years; SDage = 1.68) were investigated with the Perceived Social Support Scale (PSSS), the Kessler Psychological Distress Scale (K10), the Beck Hopelessness Scale (BHS) and the Perceived Stress Scale (PSS). Surveys were voluntary and anonymous. The findings revealed that, after adjusting for demographic factors, hopelessness mediated the relationship between Chinese college football athletes' perceived social support and their mental health. Furthermore, psychological pressure moderated the negative association between perceived social support and hopelessness, and the association was stronger for them with high-level psychological pressure. These results underline the need for focused strategies in the prevention and treatment of mental health issues among Chinese college football athletes.



#10 Distinct profiles of multisensory processing between professional goalkeepers and outfield football players

Reference: Curr Biol. 2023 Oct 9;33(19):R994-R995. doi: 10.1016/j.cub.2023.08.050.

Authors: Michael Quinn, Rebecca J Hirst, David P McGovern

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Summary: In association football (soccer), the position of goalkeeper is the most specialised position in the sport and has the primary objective of stopping the opposing team from scoring. While previous studies have highlighted differences in physiological and match performance profiles between goalkeepers and outfield players1, surprisingly little research has focused on whether goalkeepers differ in terms of their perceptual-cognitive abilities. Given that goalkeepers use multiple sensory cues and are often required to make rapid decisions based on incomplete multisensory information to fulfil their role2, we hypothesised that professional goalkeepers would display enhanced multisensory temporal processing relative to their outfield counterparts. To test this hypothesis, we measured the temporal binding windows - the time window within which signals from the different senses are integrated into a single percept - of professional goalkeepers, professional outfield players, and a control group with no professional football experience using the sound-induced flash illusion3. Our results indicated a marked difference in multisensory processing between the three groups. Specifically, we found that the goalkeepers displayed a narrower temporal binding window relative to both outfielders and control participants, indicating more precise audiovisual timing estimation. However, this enhanced multisensory temporal processing was accompanied by a general reduction in crossmodal interactions relative to the other two groups that could be attributed to an a priori tendency to segregate sensory signals. We propose that these differences stem from the idiosyncratic nature of the goalkeeping position that puts a premium on the ability of goalkeepers to make quick decisions, often based on partial or incomplete sensory information.



#11 Dark Chocolate Intake Positively Modulates Gut Permeability in Elite Football Athletes: A Randomized Controlled Study

Reference: Nutrients. 2023 Sep 28;15(19):4203. doi: 10.3390/nu15194203.

Authors: Cristina Nocella, Elena Cavarretta, Chiara Fossati, Fabio Pigozzi, Federico Quaranta, Mariangela Peruzzi, Fabrizio De Grandis, Vincenzo Costa, Carwyn Sharp, Massimo Manara, Antonia Nigro, Vittoria Cammisotto, Valentina Castellani, Vittorio Picchio, Sebastiano Sciarretta, Giacomo Frati, Simona Bartimoccia, Alessandra D'Amico, Roberto Carnevale

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Summary: Gut barrier disruption can lead to enhanced intestinal permeability, which allows endotoxins, pathogens, and other proinflammatory substances to move through the intestinal barrier into circulation. Intense exercise over a prolonged period increases intestinal permeability, which can be further worsened by the increased production of reactive oxygen species (ROS) and pro-inflammatory cytokines. The aim of this study was to assess the degree of intestinal permeability in elite football players and to exploit the effect of cocoa polyphenols on intestinal permeability induced by intensive physical exercise. Biomarkers of intestinal permeability, such as circulating levels of zonulin, a modulator of tight junctions, occludin, a tight junction protein, and LPS translocation, were evaluated in 24 elite football players and 23 amateur athletes. Moreover, 24 elite football players were randomly assigned to either a dark chocolate (>85% cocoa) intake (n = 12) or a control group (n = 12) for 30 days in a randomized controlled trial. Biochemical analyses were performed at baseline and after 30 days of chocolate intake. Compared to amateur athletes, elite football players showed increased intestinal permeability as indicated by higher levels of zonulin, occludin, and LPS. After 30 days of dark chocolate intake, decreased intestinal permeability was found in elite athletes consuming dark chocolate. In the control group, no changes were observed. In vitro, polyphenol extracts significantly improved intestinal damage in the human intestinal mucosa cell line Caco-2. These results indicate that chronic supplementation with dark chocolate as a rich source of polyphenols positively modulates exercise-induced intestinal damage in elite football athletes.



#12 Influence of physical fitness on decision-making of soccer referees throughout the match

Reference: Heliyon. 2023 Sep 6;9(9):e19702. doi: 10.1016/j.heliyon.2023.e19702. eCollection 2023 Sep.

Authors: Alfonso Castillo-Rodríguez, Emilio José Alejo-Moya, Antonio Figueiredo, Wanesa Onetti-Onetti, Francisco Tomás González-Fernández

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Summary: The purpose of this study was to analyze the relationships between physical fitness and physical performance in competition and the decision-making (successes and errors). A sample of 22 male national-level soccer referees (weight: 72.7 kg; height: 178.0 cm; age: 23.4 years) participated in this study. Physical fitness was assessed through 6 series of 40 m (velocity) and Yo-yo (aerobic) test in annual exam by Soccer Committee, physical performance was performed through the total distance covered in competition (Experiment 1), and decision-making was registered through a simulated Video Assistant Referee system (VAR) with the consensus of 2 national referees evaluating only warnings (yellow cards), expulsions (red cards), established penalties and obvious goal actions (called and no called) (Experiments 2 and 3). Results showed that physical fitness test was related with total distance (rho = 0.63, p < .01) and success rate percentage (rho = 0.74, p < .05) registered during competition. The success rate percentage, in the first half, was observed 44% successes, and in the second half, 59% successes. The number of events called was related with the physical fitness test score (R2 = 0.71, p = .035; R2 = 0.64, p = .056, respectively). As conclusion, the main finding of this study has provided insight into decision-making behavior in real competitive matches and the physical fitness was the predictor of the successful decision-making being able to determine the permanency, promotion or decrease of category.



#13 The impact of verbal encouragement during the repeated agility speed training on internal intensity, mood state, and physical enjoyment in youth soccer players

Reference: Front Psychol. 2023 Sep 21:14:1180985. doi: 10.3389/fpsyg.2023.1180985. eCollection 2023.

Authors: Okba Selmi, Hilmi Jelleli, Souheir Bouali, Bilel Aydi, Omar Hindawi, Antonella Muscella, Anissa Bouassida, Katja Weiss, Beat Knechtle

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Summary: Verbal encouragement (VE) can be used by coaches to boost morale and commitment during training exercises. This investigation aimed to study the impacts of VE given by coaches on the physiological aspects, players' internal intensity, mood, and perceived enjoyment of youth soccer players during repeated agility speed training (RAS). A total of 17 male youth soccer players (mean ± SD; age: 13.8 ± 0.4 years; body mass: 59.1 ± 6.7 kg; height: 170.0 ± 6.2 cm; training experience: 5.1 ± 0.7 years) participated, in a randomized order, in two experimental training sessions that consisted of a RAS (i.e., the Illinois course) either with VE (RAS-E) or without VE (RAS-NE), with a 7-day interval between the testing sessions. Heart rate (HR) was registered throughout the exercise. The rating of perceived exertion, blood lactate concentration [La], and perceived enjoyment were measured after each training session. The mood state was recorded before and after each protocol. HR mean (Cohen's coefficient d = 0.45, small), %HRmax (d = 0.37, small), HR peak (d = 0.66, moderate), [La] (d = 0.56, small), and the PACES score (d = 2.8, very large) were higher in RAS-E compared to RAS-NE (all, P < 0.001). Compared to the RAS-E trial, the RAS-NE trial showed higher fatigue (P < 0.01), tension (P < 0.05), anger (0.05), total mood score (P < 0.001), and lower vigor (P < 0.001). Coaches may use VE during RAS to improve psychophysiological responses, mood state, and perceived enjoyment in youth soccer players.



#14 Performance Management in Elite Football: A Teamwork Modeling Approach

Reference: International Journal of Sports Physiology and Performance

Authors: Marques J, Chamari K

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Summary: Winning matches and getting 3 competition points is commonly established as a key performance indicator (KPI) for elite football (soccer) teams to achieve their objectives during the season. While winning is the responsibility of the football players, sport-science and -medicine practitioners’ responsibility is to support them by increasing their availability for matches (a key contributing factor to winning the games and ensuring team success). Unfortunately, it is not uncommon to observe sport-science (eg, strength and conditioning coach, physiologist) and -medicine (e.g., physician, physiotherapist) practitioners working in silos in a football setting. As such, we are proposing a teamwork modeling approach for practitioners with elite football teams. Our model comprises specific KPIs to enhance players’ performance while reducing injury risk. This model has the potential to attract the attention of practitioners and researchers aiming to prevent injuries and improving players’ recovery for enhanced football performance.


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