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The aim of this study was to investigate (1) if there are differences in training load and intensity between the different training days within a microcycle and (2) if training load and intensity within the different training days are stable over the course of a season. Data were collected over a full season from a team in the women's premier division in Norway. External load (total distance, high-speed-running distance, sprint distance, and the combined number of accelerations and decelerations [ACCDEC]) was assessed using a 10-Hz GPS system with a built-in accelerometer. Internal load was assessed through session rating of perceived exertion, which was multiplied with session duration (session rating of perceived exertion-load). Training days were classified in relation to their proximity to the upcoming match day (MD): MD − 4, MD − 3, MD − 2, and MD − 1. Contents on these days were standardized according to a weekly periodization model followed by the coaching staff. Differences between training days were analyzed using a linear mixed-effects model. All training days were significantly different from each other across multiple variables. ACCDEC values were highest on MD − 4 (147.5 [13.0] ACCDEC count), and all distance variables were highest on MD − 3. All measures of training load were significantly reduced from MD − 3 to MD − 2 (effect size [ES] = 1.0–4.1) and from MD − 2 to MD − 1 (ES = 1.6-4.3). A significant negative effect across the season was observed for session rating of perceived exertion-load and ACCDEC (ES = 0.8–2.1). These results provide evidence that elite female football teams can be successful in differentiating training load between training days when implementing a weekly periodization approach. [ABSTRACT FROM AUTHOR]

Purpose: To quantify possible differences in countermovement jump height across sport disciplines and sex in national-team athletes. Methods: In this cross-sectional study, 588 women (23 [5] y, 66 [8] kg) and 989 men (23 [5] y, 82 [12] kg) from 44 different sport disciplines (including 299 medalists from European Championships, World Championships, and/or Olympic Games) tested a countermovement jump on a force platform at the Norwegian Olympic Training Center between 1995 and 2018. Results: Athletic sprinting showed the highest values among the men (62.7 [4.8] cm) and women (48.4 [6.0] cm), clearly ahead of the long jump/triple jump (mean difference ± 90% CL: 6.5 ± 5.0 and 4.3 ± 4.1; very likely and likely; moderate) and speed skating sprint (11.4 ± 3.1 and 7.5 ± 5.5 cm; most likely and very likely; very large and moderate). These horizontally oriented sports displayed superior results compared with more vertically oriented and powerful sports such as beach volleyball, weightlifting, and ski jumping, both in men (from 2.9 ± 4.7 to 15.6 ± 2.9 cm; small to very large; possibly to most likely) and women (5.9 ± 4.8 to 13.4 ± 3.4 cm; large to very large; very likely to most likely), while endurance sports and precision sports were at the other end of the scale. Overall, the men jumped 33% higher than the women (10.3, ±0.6 cm; most likely; large). Conclusions: This study provides practitioners and scientists with useful information regarding the variation in countermovement jump height among national-team athletes within and across sport disciplines. [ABSTRACT FROM AUTHOR]

Purpose: To investigate within-player effect, between-player effect, and individual response of external training load from player tracking devices on session rating of perceived exertion training load (sRPE-TL) in elite football players. Methods: The authors collected sRPE-TL from 18 outfield players in 21 training sessions. Total distance, high-speed running distance (>14.4 m/s), very high-speed running distance (>19.8 m/s), PlayerLoad™, PlayerLoad2D™, and high-intensity events (HIE > 1.5, HIE > 2.5, and HIE > 3.5 m/s) were extracted from the tracking devices. The authors modeled within-player and between-player effects of single external load variables on sRPE-TL, and multiple levels of variability, using a linear mixed model. The effect of 2 SDs of external load on sRPE-TL was evaluated with magnitude-based inferences. Results: Total distance, PlayerLoad™, PlayerLoad2D™, and HIE > 1.5 had most likely substantial within-player effects on sRPE-TL (100%–106%, very large effect sizes). Moreover, the authors observed likely substantial between-player effects (12%–19%, small to moderate effect sizes) from the majority of the external load variables and likely to very likely substantial individual responses of PlayerLoad™, high-speed running distance, very high-speed running distance, and HIE > 1.5 (19%–30% coefficient of variation, moderate to large effect sizes). Finally, sRPE-TL showed large to very large between-session variability with all external load variables. Conclusions: External load variables with low intensity-thresholds had the strongest relationship with sRPE-TL. Furthermore, the between-player effect of external load and the individual response to external load advocate for monitoring sRPE-TL in addition to external load. Finally, the large between-session variability in sRPE-TL demonstrates that substantial amounts of sRPE-TL in training sessions are not explained by single external load variables. [ABSTRACT FROM AUTHOR]

Background: To the authors' knowledge, no study has investigated the concurrent repeated, high-intensity (RHIA) and repeated-sprint activity (RSA) of intermittent team-sport competition. Purpose: In this study, they report on the RSA of elite women's football competition. In addition, they describe the nature of RHIA (eg, striding and sprinting activities) that involve a high energy cost and are associated with short (ie, <20 s) recovery periods. Methods: Thirteen elite women soccer players underwent video-based time-motion analysis on 34 occasions during national and international standard matches. RSA and RHIA were defined as successive (ie, 2) sprints or striding and sprinting efforts that occurred with <20 s between efforts. Results: The number of RSA and RHIA bouts performed was similar between the first and second halves of matches. Sprinting and striding/sprinting durations tended to remain relatively stable irrespective of the number of efforts in an RSA or RHIA bout or the period of play. However, recovery duration between efforts increased in the second half, when a greater number of efforts were performed per bout. Conclusion: These findings suggest that first- to second-half reductions in RHIA and RSA do not occur in elite women's soccer competition. However, players increase the amount of low-intensity recovery undertaken between RHIA and RSA efforts, most likely in an attempt to maintain RHIA and RSA performance. These findings emphasize the importance of RSA and RHIA to elite women's soccer and highlight the importance of training this quality to prevent reductions in performance during competitive match play. [ABSTRACT FROM AUTHOR]

It has been clearly established that maximal force and power is lower in the morning compared to noon or afternoon hours. This morning neuromuscular deficit can be diminished by regularly training in the morning hours. However, there is limited and contradictory information upon hypertrophic adaptations to time-of-day-specific resistance training. Moreover, no cellular or molecular mechanisms related to muscle hypertrophy adaptation have been studied with this respect. Therefore, the present study examined effects of the time-of-day-specific resistance training on muscle hypertrophy, phosphorylation of selected proteins, hormonal concentrations and neuromuscular performance. Twenty five previously untrained males were randomly divided into a morning group (n = 11, age 23 ± 2 yrs), afternoon group (n = 7, 24 ± 4 yrs) and control group (n = 7, 24 ± 3 yrs). Both the morning and afternoon group underwent hypertrophy-type of resistance training with 22 training sessions over an 11-week period performed between 07:30-08:30 h and 16:00-17:00 h, respectively. Isometric MVC was tested before and immediately after an acute loading exclusively during their training times before and after the training period. Before acute loadings, resting blood samples were drawn and analysed for plasma testosterone and cortisol. At each testing occasion, muscle biopsies from m. vastus lateralis were obtained before and 60 min after the acute loading. Muscle specimens were analysed for muscle fibre cross-sectional areas (CSA) and for phosphorylated p70S6K, rpS6, p38MAPK, Erk1/2, and eEF2. In addition, the right quadriceps femoris was scanned with MRI before and after the training period. The control group underwent the same testing, except for MRI, between 11:00 h and 13:00 h but did not train. Voluntary muscle strength increased significantly in both the morning and afternoon training group by 16.9% and 15.2 %, respectively. Also muscle hypertrophy occurred by 8.8% and 11.9% (MRI, p < 0.001) and at muscle fibre CSA level by 21% and 18% (p < 0.01) in the morning and afternoon group, respectively. No significant changes were found in controls within these parameters. Both pre- and post-training acute loadings induced a significant (p < 0.001) reduction in muscle strength in all groups, not affected by time of day or training. The post-loading phosphorylation of p70S6Thr421/Ser424 increased independent of the time of day in the pre-training condition, whereas it was significantly increased in the morning group only after the training period (p < 0.05). Phosphorylation of rpS6 and p38MAPK increased acutely both before and after training in a time-of-day independent manner (p < 0.05 at all occasions). Phosphorylation of p70S6Thr389, eEF2 and Erk1/2 did not change at any time point. No statistically significant correlations were found between changes in muscle fibre CSA, MRI and cell signalling data. Resting testosterone was not statistically different among groups at any time point. Resting cortisol declined significantly from pre- to post-training in all three groups (p < 0.05). In conclusion, similar levels of muscle strength and hypertrophy could be achieved regardless of time of the day in previously untrained men. However, at the level of skeletal muscle signalling, the extent of adaptation in some parameters may be time of day dependent. [ABSTRACT FROM AUTHOR]

Background and study aims: Compared with air insufflation, water exchange and carbon dioxide (CO2) insufflation have been shown to reduce colonoscopy discomfort; however, head-to-head studies of the two methods are lacking. We aimed to compare water exchange and CO2 insufflation directly with regard to pain during primary unsedated colonoscopy. Methods: Patients willing to undergo unsedated colonoscopy at three centers in Norway and Poland were randomized 1:1 to water exchange or CO2 insufflation during colonoscope insertion. Patients were blinded to group allocation. The primary end point was the proportion of patients reporting moderate or severe procedural pain on a 4-point verbal rating scale (VRS-4) at discharge. Secondary outcomes included the proportion of patients reporting no pain on the VRS-4. Results: A total of 473 patients were randomized. A discharge pain questionnaire was completed by 226 of 234 patients (97 %) in the water exchange group versus 226 of 239 patients (95 %) in the CO2 group (P=0.37). Moderate or severe pain was reported by 47 of 226 patients (21 %) in the water exchange group versus 60 of 226 patients (27 %) in the CO2 group (P=0.15). No pain was reported by 100 of 226 patients (44 %) and 69 of 226 patients (31 %) in the water exchange and CO2 groups, respectively (P=0.003). On-demand sedation was used in 15 patients (6 %) in each group (P=0.95). Conclusions: There was no significant reduction in moderate or severe pain in a comparison of water exchange with CO2 insufflation. The secondary outcome of no pain was significantly more frequent in the water exchange group. [ABSTRACT FROM AUTHOR]

Background and study aims Some guidelines recommend a minimum standard of 90 % cecal intubation rate (CIR) in routine clinics and 95 % in screening colonoscopy, while others have not made this distinction – both with limited evidence to support either view. This study questions the rationale for making such differentiation. Patients and methods We assessed cecum intubation rates amongst colonoscopies recorded in the Norwegian national quality register Gastronet by 35 endoscopists performing both clinical and screening colonoscopies. Colonoscopies were categorized into primary screening colonoscopy, work-up colonoscopy of screen-positives and clinical colonoscopy or surveillance. Cases with insufficient bowel preparation or mechanical obstruction were excluded. Endoscopists were categorized into “junior” and “senior” endoscopists depending on training and experience. Univariable and multivariable logistic regression analyses were applied. Results During a 2-year period, 10,267 colonoscopies were included (primary screening colonoscopy: 746; work-up colonoscopy of screen-positives: 2,604; clinical colonoscopy or surveillance: 6917). The crude CIR in clinical routine colonoscopy, primary screening colonoscopy and work-up colonoscopy was 97.1 %, 97.1 % and 98.6 %, respectively. In a multiple logistic regression analysis, there were no differences in CIR between the 3 groups. Poor bowel cleansing and female sex were independent predictors for intubation failure. Conclusion Cecal intubation rate in clinical colonoscopies and colonoscopy screening are similar. There is no reason to differentiate between screening and clinical colonoscopy with regard to CIR.