Purpose Session RPE (sRPE) is used to track internal training/competition load in athletes using a metric known as the acute to chronic workload ratio (ACWR). Research that reported on team sports has determined that if the acute load is higher than the chronic load, athletes are likely to sustain injury. No studies, however, have attempted to investigate internal load and injury in a tennis population despite the rigorous training loads. Therefore, the purpose of this study was to investigate if sRPE ACWR is associated with injury in junior tennis players over a 7-month time period. Methods Forty-two junior tennis players were recruited to participate, 26 were included in the final analysis. Players provided a rating of RPE as an estimate of training intensity every day after training/match sessions. sRPE, a measure of internal and external training load was calculated by multiplying the training/match sRPE by the session duration in minutes. Players self-reported all injuries. The ACWR was the primary independent variable. Acute load was determined as the total sRPE for 1 wk, whereas a 4-wk rolling average sRPE represented chronic load. Results Seventeen players sustained injuries. The model indicated that ACWR from the previous week (P < 0.001) and previous injury history (P = 0.003) were significant predictors of injury the following week. In the week preceding injury, the average ACWR was 1.57 (SD, 0.90). Conclusion Injured players had on average 1.5 times more training load in the past week compared with the previous 4 wk. A majority of players who went on to sustain an injury were not prepared for the load endured. These results were similar to previous studies investigating ACWR where an acute increase in load was associated with increased injury risk.

Objective: Although widely used, computerized neurocognitive tests (CNTs) have been criticized because of low reliability and poor sensitivity. A systematic review was published summarizing the reliability of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores; however, this was limited to a single CNT. Expansion of the previous review to include additional CNTs and a meta-analysis is needed. Therefore, our purpose was to analyze reliability data for CNTs using meta-analysis and examine moderating factors that may influence reliability.Data Sources: A systematic literature search (key terms: reliability, computerized neurocognitive test, concussion) of electronic databases (MEDLINE, PubMed, Google Scholar, and SPORTDiscus) was conducted to identify relevant studies.Study Selection: Studies were included if they met all of the following criteria: used a test-retest design, involved at least 1 CNT, provided sufficient statistical data to allow for effect-size calculation, and were published in English.Data Extraction: Two independent reviewers investigated each article to assess inclusion criteria. Eighteen studies involving 2674 participants were retained. Intraclass correlation coefficients were extracted to calculate effect sizes and determine overall reliability. The Fisher Z transformation adjusted for sampling error associated with averaging correlations. Moderator analyses were conducted to evaluate the effects of the length of the test-retest interval, intraclass correlation coefficient model selection, participant demographics, and study design on reliability. Heterogeneity was evaluated using the Cochran Q statistic.Data Synthesis: The proportion of acceptable outcomes was greatest for the Axon Sports CogState Test (75%) and lowest for the ImPACT (25%). Moderator analyses indicated that the type of intraclass correlation coefficient model used significantly influenced effect-size estimates, accounting for 17% of the variation in reliability.Conclusions: The Axon Sports CogState Test, which has a higher proportion of acceptable outcomes and shorter test duration relative to other CNTs, may be a reliable option; however, future studies are needed to compare the diagnostic accuracy of these instruments.

These results indicate that middle-aged adults who are less active may have increased likelihoods of SD. It is important for health care professionals to continue developing methods for increasing PA to decrease the risk of SD.

Clinical Scenario: Dynamic stretching and foam rolling are commonly used by athletes to reduce injury and enhance recovery, thereby improving athletic performance. In contrast to dynamic stretching, little research has been conducted on the acute effects of foam rolling as part of the preexercise warm-up routine. Previously, when researchers implemented foam rolling with static stretching as a warm-up, some found that foam rolling slightly improved flexibility and performance outcomes. More recent research has shown that dynamic stretching is favorable to static stretching when used as a warm-up strategy. Therefore, adding foam rolling to dynamic stretching is hypothesized to create more significant improvements in flexibility and performance compared with adding foam rolling to static stretching. Focused Clinical Question: In active individuals, does foam rolling in addition to dynamic stretching lead to enhanced performance compared with dynamic stretching alone? Summary of Key Findings: Four randomized controlled trials were included. Two studies concluded that the addition of foam rolling to dynamic stretching increased vertical jump height more than dynamic stretching alone, while 2 studies found no difference between these treatment groups. Two studies concluded that the addition of foam rolling increased agility performance compared with dynamic stretching alone, while one study found no difference between treatment groups and one study did not measure agility. All 4 studies reviewed concluded that foam rolling did not improve flexibility more than dynamic stretching alone. Clinical Bottom Line: Foam rolling in conjunction with dynamic stretching may further improve an athlete’s agility and power output; however, little improvement has been observed with foam rolling in regard to athlete flexibility when compared with completing dynamic stretching programs alone. Strength of Recommendation: Inconsistent findings from 4 randomized controlled trials suggest there is Grade C evidence to support the inclusion of foam rolling in a dynamic warm-up.

This finding suggests that avoiding SB may be beneficial for lowering the risk of obesity in adults.