Reliability refers to the reproducibility of values of a test, assay or other measurement in repeated trials on the same individuals. Better reliability implies better precision of single measurements and better tracking of changes in measurements in research or practical settings. The main measures of reliability are within-subject random variation, systematic change in the mean, and retest correlation. A simple, adaptable form of within-subject variation is the typical (standard) error of measurement: the standard deviation of an individual’s repeated measurements. For many measurements in sports medicine and science, the typical error is best expressed as a coefficient of variation (percentage of the mean). A biased, more limited form of within-subject variation is the limits of agreement: the 95% likely range of change of an individual’s measurements between 2 trials. Systematic changes in the mean of a measure between consecutive trials represent such effects as learning, motivation or fatigue; these changes need to be eliminated from estimates of within-subject variation. Retest correlation is difficult to interpret, mainly because its value is sensitive to the heterogeneity of the sample of participants. Uses of reliability include decision-making when monitoring individuals, comparison of tests or equipment, estimation of sample size in experiments and estimation of the magnitude of individual differences in the response to a treatment. Reasonable precision for estimates of reliability requires approximately 50 study participants and at least 3 trials. Studies aimed at assessing variation in reliability between tests or equipment require complex designs and analyses that researchers seldom perform correctly. A wider understanding of reliability and adoption of the typical error as the standard measure of reliability would improve the assessment of tests and equipment in our disciplines. CURRENT OPINION

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Measures of reliability in sports medicine and science.

Minimal measurement error (reliability) during the collection of interval- and ratio-type data is critically important to sports medicine research. The main components of measurement error are systematic bias (e.g. general learning or fatigue effects on the tests) and random error due to biological or mechanical variation. Both error components should be meaningfully quantified for the sports physician to relate the described error to judgements regarding ‘analytical goals’ (the requirements of the measurement tool for effective practical use) rather than the statistical significance of any reliability indicators.

Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine

Muscle fatigue is an exercise-induced reduction in maximal voluntary muscle force. It may arise not only because of peripheral changes at the level of the muscle, but also because the central nervous system fails to drive the motoneurons adequately. Evidence for “central” fatigue and the neural mechanisms underlying it are reviewed, together with its terminology and the methods used to reveal it. Much data suggest that voluntary activation of human motoneurons and muscle fibers is suboptimal and thus maximal voluntary force is commonly less than true maximal force. Hence, maximal voluntary strength can often be below true maximal muscle force. The technique of twitch interpolation has helped to reveal the changes in drive to motoneurons during fatigue. Voluntary activation usually diminishes during maximal voluntary isometric tasks, that is central fatigue develops, and motor unit firing rates decline. Transcranial magnetic stimulation over the motor cortex during fatiguing exercise has revealed focal cha...

Spinal and Supraspinal Factors in Human Muscle Fatigue

Objective:
To present recommendations to optimize the fluid-replacement practices of athletes.


Background:
Dehydration can compromise athletic performance and increase the risk of exertional heat injury. Athletes do not voluntarily drink sufficient water to prevent dehydration during physical activity. Drinking behavior can be modified by education, increasing accessibility, and optimizing palatability. However, excessive overdrinking should be avoided because it can also compromise physical performance and health. We provide practical recommendations regarding fluid replacement for athletes.


Recommendations:
Educate athletes regarding the risks of dehydration and overhydration on health and physical performance. Work with individual athletes to develop fluid-replacement practices that optimize hydration status before, during, and after competition.

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National athletic trainers' association position statement: fluid replacement for athletes.

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of sports dietitians. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins, as well as contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density, may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution, and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and in particular in the United States, a Board Certified Specialist in Sports Dietetics, should provide individualized nutrition direction and advice subsequent to a comprehensive nutrition assessment.

Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance.

The reliability of power in tests of physical performance affects the precision of assessment of athletes, patients, clients and study participants. In this meta-analytic review we identify the most reliable measures of power and the factors affecting reliability. Our measures of reliability were the typical (standard) error of measurement expressed as a coefficient of variation (CV) and the percent change in the mean between trials. We meta-analysed these measures for power or work from 101 studies of healthy adults. Measures and tests with the smallest CV in exercise of a given duration include field tests of sprint running (∼0.9%), peak power in an incremental test on a treadmill or cycle ergometer (∼0.9%), equivalent mean power in a constant-power test lasting 1 minute to 3 hours on a treadmill or cycle ergometer (0.9 to 2.0%), lactate-threshold power (∼1.5%), and jump height or distance (∼2.0%). The CV for mean power on isokinetic ergometers was relatively large (>4%). CV were larger for nonathletes versus athletes (1.3 ×), female versus male nonathletes (1.4 ×), shorter (∼1-second) and longer (∼1-hour) versus 1-minute tests (≤1.6 ×), and respiratory- versus ergometer-based measures of power (1.4 to 1.6 ×). There was no clear-cut effect of time between trials. The importance of a practice trial was evident in studies with >2 trials: the CV between the first 2 trials was 1.3 times the CV between subsequent trials; performance also improved by 1.2% between the first 2 trials but by only 0.2% between subsequent trials. These findings should help exercise practitioners and researchers select or design good measures and protocols for tests of physical performance.

Reliability of Power in Physical Performance Tests

This review suggests that there is little or no effect of elevating pre-exercise muscle glycogen contents above normal resting values on a single exhaustive bout of high-intensity exercise lasting less than 5 minutes. Nor is there any benefit of increasing starting muscle glycogen content on moderate-intensity running or cycling lasting 60 to 90 minutes. In such exercise substantial quantities of glycogen remain in the working muscles at the end of exercise. However, elevated starting muscle glycogen content will postpone fatigue by approximately equal to 20% in endurance events lasting more than 90 minutes. During this type of exercise, exhaustion usually coincides with critically low (25 mmol/kg wet weight) muscle glycogen contents, suggesting the supply of energy from glycogen utilisation cannot be replaced by an increased oxidation of blood glucose. Glycogen supercompensation may also improve endurance performance in which a set distance is covered as quickly as possible. In such exercise, high carbohydrate diets have been reported to improve performance by 2 to 3%.

Carbohydrate-loading and exercise performance. An update.

We examined neuromuscular activity during stochastic (variable intensity) 100-km cycling time trials (TT) and the effect of dietary carbohydrate manipulation. Seven endurance-trained cyclists perfo...

Reduced Neuromuscular Activity and Force Generation During Prolonged Cycling

High retest reliability is desirable in tests used to monitor athletic performance, but the reliability of many popular tests has not been established. The aim of this study was to determine the re...

High reliability of performance of well-trained rowers on a rowing ergometer.

SCHABORT, E. J, S. C. KILLIAN, A. ST CLAIR GIBSON, J. A. HAWLEY, and T. D. NOAKES. Prediction of triathlon race time from laboratory testing in national triathletes. Med. Sci. Sports Exerc., Vol. 32, No. 4, pp. 844–849, 2000.Purpose:Four days after competing in an Olympic-distance National Triathlon

Elske J. Schabort

Papers

Reliability of Power in Physical Performance Tests

Carbohydrate-loading and exercise performance. An update.

Reduced Neuromuscular Activity and Force Generation During Prolonged Cycling

High reliability of performance of well-trained rowers on a rowing ergometer.

Prediction of triathlon race time from laboratory testing in national triathletes.