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  1. Hébert-Losier K, Zinner C, Platt S, Stöggl T, Holmberg HC
    Sports Med, 2017 Feb;47(2):319-342.
    PMID: 27334280 DOI: 10.1007/s40279-016-0573-2
    BACKGROUND: Sprint events in cross-country skiing are unique not only with respect to their length (0.8-1.8 km), but also in involving four high-intensity heats of ~3 min in duration, separated by a relatively short recovery period (15-60 min).

    OBJECTIVE: Our aim was to systematically review the scientific literature to identify factors related to the performance of elite sprint cross-country skiers.

    METHODS: Four electronic databases were searched using relevant medical subject headings and keywords, as were reference lists, relevant journals, and key authors in the field. Only original research articles addressing physiology, biomechanics, anthropometry, or neuromuscular characteristics and elite sprint cross-country skiers and performance outcomes were included. All articles meeting inclusion criteria were quality assessed. Data were extracted from each article using a standardized form and subsequently summarized.

    RESULTS: Thirty-one articles met the criteria for inclusion, were reviewed, and scored an average of 66 ± 7 % (range 56-78 %) upon quality assessment. All articles except for two were quasi-experimental, and only one had a fully-experimental research design. In total, articles comprised 567 subjects (74 % male), with only nine articles explicitly reporting their skiers' sprint International Skiing Federation points (weighted mean 116 ± 78). A similar number of articles addressed skating and classical techniques, with more than half of the investigations involving roller-skiing assessments under laboratory conditions. A range of physiological, biomechanical, anthropometric, and neuromuscular characteristics was reported to relate to sprint skiing performance. Both aerobic and anaerobic capacities are important qualities, with the anaerobic system suggested to contribute more to the performance during the first of repeated heats; and the aerobic system during subsequent heats. A capacity for high speed in all the following instances is important for the performance of sprint cross-country skiers: at the start of the race, at any given point when required (e.g., when being challenged by a competitor), and in the final section of each heat. Although high skiing speed is suggested to rely primarily on high cycle rates, longer cycle lengths are commonly observed in faster skiers. In addition, faster skiers rely on different technical strategies when approaching peak speeds, employ more effective techniques, and use better coordinated movements to optimize generation of propulsive force from the resultant ski and pole forces. Strong uphill technique is critical to race performance since uphill segments are the most influential on race outcomes. A certain strength level is required, although more does not necessarily translate to superior sprint skiing performance, and sufficient strength-endurance capacities are also of importance to minimize the impact and accumulation of fatigue during repeated heats. Lastly, higher lean mass does appear to benefit sprint skiers' performance, with no clear advantage conferred via body height and mass.

    LIMITATIONS: Generalization of findings from one study to the next is challenging considering the array of experimental tasks, variables defining performance, fundamental differences between skiing techniques, and evolution of sprint skiing competitions. Although laboratory-based measures can effectively assess on-snow skiing performance, conclusions drawn from roller-skiing investigations might not fully apply to on-snow skiing performance. A low number of subjects were females (only 17 %), warranting further studies to better understand this population. Lastly, more training studies involving high-level elite sprint skiers and investigations pertaining to the ability of skiers to maintain high-sprint speeds at the end of races are recommended to assist in understanding and improving high-level sprint skiing performance, and resilience to fatigue.

    CONCLUSIONS: Successful sprint cross-country skiing involves well-developed aerobic and anaerobic capacities, high speed abilities, effective biomechanical techniques, and the ability to develop high forces rapidly. A certain level of strength is required, particularly ski-specific strength, as well as the ability to withstand fatigue across the repeated heats of sprint races. Cross-country sprint skiing is demonstrably a demanding and complex sport, where high-performance skiers need to simultaneously address physiological, biomechanical, anthropometric, and neuromuscular aspects to ensure success.

  2. Glazier PS, Mehdizadeh S
    Sports Med, 2019 Feb;49(2):171-176.
    PMID: 30511347 DOI: 10.1007/s40279-018-1030-1
    This paper evaluates the effectiveness of, and highlights issues with, conventional paradigms in applied sports biomechanics research and comments on their capacity to optimise techniques of individual athletes. In empirical studies, group-based analyses often mask variability between athletes and only permit probabilistic 'in general' or 'on average' statements that may not be applicable to specific athletes. In individual-based analyses, performance parameters typically exhibit a small range and a flat response over iterative performance trials, making establishing associations between performance parameters and the performance criterion problematic. In theoretical studies, computer simulation modelling putatively enables athlete-specific optimum techniques to be identified, but given each athlete's unique intrinsic dynamics, it is far from certain that these optimum techniques will be attainable, particularly under the often intense psychological pressures of competition, irrespective of the volume of practice undertaken. Sports biomechanists and coaching practitioners are advised to be more circumspect with regard to interpreting the results of applied sports biomechanics research and have greater awareness of their assumptions and limitations, as inappropriate interpretation of results may have adverse consequences for performance and injury.
  3. Goh SL, Persson MSM, Stocks J, Hou Y, Welton NJ, Lin J, et al.
    Sports Med, 2019 May;49(5):743-761.
    PMID: 30830561 DOI: 10.1007/s40279-019-01082-0
    BACKGROUND: Guidelines recommend exercise as a core treatment for osteoarthritis (OA). However, it is unclear which type of exercise is most effective, leading to inconsistency between different recommendations.

    OBJECTIVES: The aim of this systematic review and network meta-analysis was to investigate the relative efficacy of different exercises (aerobic, mind-body, strengthening, flexibility/skill, or mixed) for improving pain, function, performance and quality of life (QoL) for knee and hip OA at, or nearest to, 8 weeks.

    METHODS: We searched nine electronic databases up until December 2017 for randomised controlled trials that compared exercise with usual care or with another exercise type. Bayesian network meta-analysis was used to estimate the relative effect size (ES) and corresponding 95% credibility interval (CrI) (PROSPERO registration: CRD42016033865).

    FINDINGS: We identified and analysed 103 trials (9134 participants). Aerobic exercise was most beneficial for pain (ES 1.11; 95% CrI 0.69, 1.54) and performance (1.05; 0.63, 1.48). Mind-body exercise, which had pain benefit equivalent to that of aerobic exercise (1.11; 0.63, 1.59), was the best for function (0.81; 0.27, 1.36). Strengthening and flexibility/skill exercises improved multiple outcomes at a moderate level. Mixed exercise was the least effective for all outcomes and had significantly less pain relief than aerobic and mind-body exercises. The trend was significant for pain (p = 0.01), but not for function (p = 0.07), performance (p = 0.06) or QoL (p = 0.65).

    CONCLUSION: The effect of exercise varies according to the type of exercise and target outcome. Aerobic or mind-body exercise may be the best for pain and function improvements. Strengthening and flexibility/skill exercises may be used for multiple outcomes. Mixed exercise is the least effective and the reason for this merits further investigation.

  4. Washif JA, Farooq A, Krug I, Pyne DB, Verhagen E, Taylor L, et al.
    Sports Med, 2022 04;52(4):933-948.
    PMID: 34687439 DOI: 10.1007/s40279-021-01573-z
    OBJECTIVE: Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

    METHODS: Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March-June 2020).

    RESULTS: Overall, 85% of athletes wanted to "maintain training," and 79% disagreed with the statement that it is "okay to not train during lockdown," with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered "coaching by correspondence (remote coaching)" to be sufficient (highest amongst world-class athletes). During lockdown, 

  5. Romdhani M, Rae DE, Nédélec M, Ammar A, Chtourou H, Al Horani R, et al.
    Sports Med, 2021 Dec 08.
    PMID: 34878639 DOI: 10.1007/s40279-021-01601-y
    OBJECTIVE: In a convenience sample of athletes, we conducted a survey of COVID-19-mediated lockdown (termed 'lockdown' from this point forward) effects on: (i) circadian rhythms; (ii) sleep; (iii) eating; and (iv) training behaviors.

    METHODS: In total, 3911 athletes [mean age: 25.1 (range 18-61) years, 1764 female (45%), 2427 team-sport (63%) and 1442 elite (37%) athletes] from 49 countries completed a multilingual cross-sectional survey including the Pittsburgh Sleep Quality Index and Insomnia Severity Index questionnaires, alongside bespoke questions about napping, training, and nutrition behaviors.

    RESULTS: Pittsburgh Sleep Quality Index (4.3 ± 2.4 to 5.8 ± 3.1) and Insomnia Severity Index (4.8 ± 4.7 to 7.2 ± 6.4) scores increased from pre- to during lockdown (p 

  6. Tee CCL, Cooke MB, Chong MC, Yeo WK, Camera DM
    Sports Med, 2023 Feb;53(2):327-348.
    PMID: 36441492 DOI: 10.1007/s40279-022-01782-0
    Obesity is a major global health issue and a primary risk factor for metabolic-related disorders. While physical inactivity is one of the main contributors to obesity, it is a modifiable risk factor with exercise training as an established non-pharmacological treatment to prevent the onset of metabolic-related disorders, including obesity. Exposure to hypoxia via normobaric hypoxia (simulated altitude via reduced inspired oxygen fraction), termed hypoxic conditioning, in combination with exercise has been increasingly shown in the last decade to enhance blood glucose regulation and decrease the body mass index, providing a feasible strategy to treat obesity. However, there is no current consensus in the literature regarding the optimal combination of exercise variables such as the mode, duration, and intensity of exercise, as well as the level of hypoxia to maximize fat loss and overall body compositional changes with hypoxic conditioning. In this narrative review, we discuss the effects of such diverse exercise and hypoxic variables on the systematic and myocellular mechanisms, along with physiological responses, implicated in the development of obesity. These include markers of appetite regulation and inflammation, body conformational changes, and blood glucose regulation. As such, we consolidate findings from human studies to provide greater clarity for implementing hypoxic conditioning with exercise as a safe, practical, and effective treatment strategy for obesity.
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