Category Archives: Monitoring

HRV Case Study of a Powerlifter with Cerebral Palsy Preparing for Competition

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Shortly after my relocation to Alabama, I was given the opportunity  to oversee the competition preparation of a young powerlifter who had been training here at the AUM Human Performance Lab under the care of Dr. Mike Esco and his staff. He was about 5 weeks out from competition at the time of my arrival. Below is a detailed account of the training program with HRV data, training load and sleep score.

The athlete is a 22 year old male with Cerebral Palsy and can therefore only compete in the Bench Press. He competes in the 123lb weight class (actual weight is 121). His best competition lift was 200lbs recorded this past February at his first competition.

After observing a couple of workouts, I could see that Zarius was missing out on some poundage due to technical flaws. The focus of the program was therefore to improve his bench press technique and get him more accustomed to the competition commands. We trained 3x/week and used a full body, undulating approach that enabled us to Bench Press each session to further develop technique.

The original program is below and was followed with only minor adjustments here and there. The chosen sets/reps and percentages were inspired by those outlined Tri-Phasic Training. This allowed for the completion of only quality reps; avoiding failure and saving the grinding for competition. You’ll notice the corresponding rep ranges for each percentage are well below typical capabilities. (i.e. 85%x2 rather than 85%x5-6). Assistance work progressed in weight or reps each week based on performance.

Z_program

Beginning on day one of week one, the athlete recorded HRV each morning with ithlete on his iPod Touch in a seated position. Sleep was rated on a scale of 1-5 on the app. Training load was manually entered based on training intensity to make interpretation easier from the trend in relation to his HRV. Perceived values are not included.

Below is all of the raw data as it appears when exported from the app into Excel followed by a recreation of his 4 week trend. I’ve highlighted high and low HRV days in the respective colors used by ithlete. You’ll note that measurements are missing on two occasions; 4/18 and 5/12.

Z_raw_data

Z_trend

Below are images of his weekly averages of HRV and training load. Training load in this context is simply intended to represent a progressive increase in intensity followed by a deload and then competition.

Z_avg_table

Z_avg_trend

There’s a clear progressive increase in his HRV trend right up until the start of week 3. Week 3 was the highest intensity training week with a slight reduction in volume. It appears that intensity rather than volume created more fatigue. His HRV peaks during the deload week. The deload week included 2 workouts. On Monday we worked up to his opener of 240lb for a single and on Wednesday we worked up to 70% for a few singles with emphasis on the competition commands and pausing.

You can see that the morning of the competition (5/11) there is a small drop in HRV. I attribute this to pre-competition anxiety based on feedback of mood, perception, etc. He appears to have slept well leading up to the meet. HRV remains suppressed until the 3rd day after the competition where it starts to trend back up, however still remains below average. This clearly shows the additional psychological/emotional stress that competing places on the body.

Results

1st Attempt – 240 Good
2nd Attempt – 250 Good
3rd Attempt – 255 Miss at lockout (very debatable)

He added 50lbs to his competition best since February. His next meet will be in October where he’ll be looking to shorten the gap he has to close to fulfill his dreams of qualifying for the Paralympics.

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Individual HRV Responses In Professional Soccer Players During A Competitive Season

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In a team setting environment, athletes are often exposed to similar training loads during practices, training and competition. Monitoring of only the external training load provides coaches with an incomplete picture of how individual athletes may be responding and adapting to the training schedule. Two athletes can in fact respond entirely differently to the same program. A recently published case study by Bara-Filho et al. (2013) demonstrates how HRV, when measured periodically throughout training, can help distinguish these individual differences in professional soccer players exposed to the same training schedule. The following is a brief summary and review of this case study.

Materials and Methods

Subject 1 was a 26 year old Mid-Fielder with 7 years of professional playing experience. Subject 2 was a 19 year old Right Back with only 1 year of professional playing experience.

Over a 3 week period during a competitive season, both subjects participated in training that consisted of small-sided games, simulated matches, strength training, sprint training, and low-intensity aerobic recovery work. Training took place 1-2 times per day, 5 day’s/week culminating in a competition on the 6th day and rest on the 7th. Both subjects were starters in the 3 matches that occurred over the observation period.

HRV was measured on 5 occasions throughout the 3 week period on each Saturday and Monday morning (excluding the last Monday). This allowed for HRV indices to be evaluated both after the weekly training load was accumulated (Saturday) and after recovery (Monday). This is precisely the protocol that I discussed in a recent post entitled Making HRV More Practical for Athletes: Measurement Frequency.

HRV data was collected in the morning with a Polar RS800 watch while the athletes rested in a supine position.

Results

Total weekly TRIMP values were similar in both athletes. After the first measurement (M1) Subject 1 showed an increasing trend in several HRV values (RMSSD, HF, SDNN, SD1) indicating good adaptation to training and quality recovery from competition. Subject 2 showed a progressively decreasing trend in these same HRV values indicating an accumulation of fatigue and insufficient recovery.

Discussion

The authors suggest that subject 2, who saw a decreasing trend in his HRV values, may have been experiencing stressors unrelated to sport that may have contributed to his insufficient recovery. Though subjective measure (questionnaires) were not included, the physical training coach reported that athlete 2 would inform him that he was experiencing disturbed sleep, fatigue during training, and poor recovery.

A lower level of playing experience in subject 2 was reported as another possible explanation for his descending HRV trend. The psychological stressors and anxiety experienced by this younger athlete may have also contributed.

The authors briefly discuss the limitations of a supine measurement only when using HRV to monitor training load in athletes. Essentially, individuals with low resting heart rates appear to be subject to “parasympathetic saturation” in the supine position, possibly skewing the data. Therefore, including measurement performed in the standing position may serve as a resolution to this issue. I discussed this topic in a previous post entitled Supine vs. Standing HRV Measurement.

Finally, the authors conclude that HRV values were useful in monitoring the effects of a competitive training schedule in athletes as these values appear to be sensitive to individual characteristics as well as stress and recovery. A stable or increasing HRV trend appears to be favorable as it indicates quality recovery and adaptation to training. In contrast, a decreasing trend in HRV indicates higher stress and impaired recovery which may necessitate recovery interventions and reductions in training load.

Reference

Bara-Filho, M.G., et al. (2013) Heart rate variability and soccer training: a case study. Motriz: rev. educ. fis. 19(1): 171-77. Free Full-Text

Reaction Test for Athlete Monitoring: Research and Considerations

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Distinguishing functional over-reaching (FOR) from non-function over-reaching (NFOR)can be difficult to do during overload periods; particularly when laboratory measures are inaccessible to the coach or athlete. A common criteria used to determine FOR from NFOR is to assess performance before and after overload training. The fatigue accumulated from the increased training loads will result in expected performance decrements. After an unloading period of 1-2 weeks, performance should return to or exceed pre-overload performance values. An athlete can be considered NFOR if performance remains suppressed after this 2 week period.

Coaches can be proactive in their efforts to avoid NFOR with their athletes by maintaining various monitoring strategies. Keeping tabs on certain variables throughout overload periods allows the coach to detect early warning signs that may indicate excessive fatigue in an athlete(s). Such a metric often discussed is the reaction test. Today I will review some of the available research that investigates the efficacy of the reaction test as a method of potentially determining or indicating NFOR in athletes.

Why The Reaction Test?

The theory behind why the reaction test may serve as a good indicator of overreaching and/or the overtraining syndrome has been postulated by Nederhof et al (2006). Essentially, the overtraining syndrome has several signs and symptoms also seen in chronic fatigue syndrome and major depression. Both chronic fatigue and major depression are associated with slower psychomotor ability. Thus, it is hypothesized that psychomotor speed may be slower in athletes with OTS.

Reaction Test and Overreaching

Nederhof and colleagues (2007) put their theory to the test and evaluated performance, perceived fatigue/mood (RESTQ-sport and POMS) and psychomotor speed (reaction tests) in trained cyclists (n=14) and a control group (n=14). Training load was monitored via sRPE (RPE x session length). Testing was performed at baseline, following a 2 week overload period and once more following a 2 week taper. Of the 14 cyclists, 5 were considered FOR (they fulfilled at least 2 out of the three objective criteria in combination with at least 1 subjective criterion during the second but not during the third exercise test) and 7 were considered well trained (WT) while the remaining 2 were excluded.

Two reaction tests were used. The first described test was the “Finger Pre-Cuing Task” that required the individual to react to a prompt by pressing the correct keys on a computer. The other test was the “Determination Test” that required either manual of pedal reaction in response to visual or auditory stimuli also on a computer. Full descriptions of these tests can be read in the full text here.

The control group and the WT group improved their reaction time at each test. The FOR group however showed increased (slower) reaction time after the overload period but improved reaction time beyond baseline values after the taper. Regarding statistical significance the authors stated; “After high load training the FO group was 20% slower than the control group and 8% slower than theWT group. For comparison, patients with major depression are 20 to 26% slower than healthy controls [21,32] and patients with chronic fatigue syndrome are 15% slower than healthy controls [21]. Thus, although not statistically significant, differences in the present study are meaningful“.

Rietjans et al (2005) aimed to determine if a combination of test parameters could help detect overreaching in 7 well trained male cyclists. Over a 2 week period, training load was doubled while intensity was increased by 15%. Values for the following tests/assessments were collected pre and post training period: Maximal incremental cycle ergometer test with continuous ventilatory measurements and blood lactate values, time trial, basal blood parameter tests, hormones (GH, IGF-1, ACTH, neuro-endocrine stress test, shortened POMS, RPE and a cognitive reaction time test.

The results: “A novel finding was that reaction times increased significantly, indicating that overreaching might adversely affect speed of information processing by the brain, especially for the most difficult conditions. After the intensified training period, neither changes in exercise-induced plasma hormone values, nor SITT values were observed. During the CAPT only cortisol showed a significant decrease after the intensified training period. Hemoglobin showed a significant decrease after the intensified training period whereas hematocrit, red blood cell count (RBC) and MCV tended to decrease. The intensified training had no effect on physical performance (Wmax or time trial), maximal blood lactate, maximal heart rate and white blood cell profile. The most sensitive parameters for detecting overreaching are reaction time performance (indicative for cognitive brain functioning), RPE and to a lesser extend the shortened POMS. This strongly suggests that central fatigue precedes peripheral fatigue. All other systems, including the neuro-endocrine, are more robust and react most likely at a later stage in exhaustive training periods.”

Reaction Test and Perceived Performance 

Nederhof and colleagues (2008) set out to determine if reaction tests are related to perceived performance in rowers. On 5 occasions over the course of a season, reaction tests were performed along with perceived performance measures (“Reduced Sense of Accomplishment” scale from the Athlete Burnout Questionaire) in varsity rowers. The same two reaction tests (Finger Pre-Cueing and the Determination Test) described above were used. The results showed that a significant relationship between the Determination Test and perceived performance. The authors stated; “…rowers who scored higher on the ‘‘Reduced Sense of Accomplishment’’ scale of the Athlete Burnout Questionnaire had longer reaction times on the determination test. For every point the rowers scored higher, their reaction times were 18 ms longer on the action mode and 12 ms on the reaction mode of the determination test. This effect was not found for the finger pre-cueing task.”

Though their hypothesis was supported, the authors affirm that several practical issues require resolution.

My Reaction Test Data Compared to HRV over 4 Different Training Periods

For a much more elaborate discussion on this experiment you can see the original post here. Essentially what I found was that Reaction test average and HRV average mirrored each other at each training period. HRV decreased and Reaction time increased (slower) during High Intensity and again during High Volume training reflecting fatigue. During reduced training loads HRV increased and Reaction time decreased (faster).

Reaction average trend

HRV Avg Trend Reaction Blog

Considerations and Limitations

The reaction test appears to be a test worthy of consideration for coaches looking to incorporate monitoring variables into their training regime. The following is a list of factors to keep in mind regarding this test:

• Caffeine has a well-established effect on reaction time and should therefore be controlled for when implementing reaction testing

• Psychological factors can impact the effectiveness and reliability of the test. Though this is an objective test, the effort put forth by the athlete may not be consistent. Since this test is sensitive to small changes in reaction time, this can obscure data and thus interpretation.

• As with HRV, it is probably best to experiment with a reaction test with a small sample of athletes to determine its usefulness before trying to implement with an entire team.

• Just like any other monitoring variable, reaction time should be considered with other factors when attempting to draw meaningful interpretations from the results.

Reaction time test results appear to respond early to fatigue during overload training. Reaction times (test dependent) may correlate with perceived performance. The simplicity, practicality, affordability and non-invasiveness of a reaction test make it appealing to coaches as a field test.

References

Nederhof, E., et al. (2006) Psychomotor speed: possibly a new marker for overtraining syndrome. Sports Medicine, 36(10): 817-28.

Nederhof, E., Lemmink, K., Zwerver., J. & Mulder, T. (2007) The effect of high load training on psychomotor speed. International Journal of Sports Medicine, 28: 595-601.

Nederhof, E., Visscher, C. & Lemmink, K. (2008) Psychomotor speed is related to perceived performance in rowers. European Journal of Sport Science, 8(5): 259-265

Rietjans, GJ., et al. (2005) Physiological, biochemical and psychological markers of strenuous training induced fatigue. International Journal of Sports Medicine, 26(1): 16-26.

HRV and Reaction Test Data and some updates on our HRV research

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I posted some data a couple of months ago comparing my HRV to my tap test results to see if there was any correlation between the two. You can see that post here if you missed it. It was around that time that I also started using a Reaction Test app. Today I’ll be posting and reviewing my Reaction Test data with my HRV data to see what it might reveal. At the end of the post I’ll provide some brief updates on what’s been happening since I started working in the Human Performance Lab here at Auburn (Montgomery).

HRV: I continue to use ithlete as my main HRV metric. Daily measurements are performed each morning after waking and bladder emptying. All measurements are performed in the standing position with paced breathing. The HRV value provided by ithlete is Ln RMSSD x 20; a time domain measure of parasympathetic tone.

Reaction Test: The reaction test is performed after my HRV test and my Tap test (I’m still doing these but will not include them today). All reaction tests were performed using right index finger. The app functions as follows;

  1. initiate app
  2. Tap target area to start the test
  3. React to stimuli (color change) as fast as possible by tapping the screen
  4. Repeat for a total of 5 reactions (variable time intervals between)

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I used excel to calculate daily average with the reaction test data (plotted on the charts below).

Keep in mind that for a correlation between high HRV and good Reaction Test, we want to see an inverse relationship in the trends. We’re looking for a fast Reaction time (trending down) with a higher HRV score (trending up).

Chart 1 – HRV, Reaction Test Average and Session RPE (secondary axis)  

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For more clarity I’ve also included excel screen shots of the raw data. I’ve sectioned off 4 different areas and noted the goal/purpose of that particular time of training. It works out so that there is a High Intensity section, a Deload section, a High Volume Section, and a Semi-Deload section. The “Semi-Deload” period occurs over the past week that I’ve moved to Alabama. I figured it would be wise to scale intensity and volume back very slightly while I settle in to a new place and new work environment. To give an example, I essentially removed a main working set and stuck with familiar weights. Assistance work was relatively unchanged.

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* I must have forgotten to perform a reaction test or forgot to save it on 03/16 which was a Saturday and therefore it is not included.

I’ve highlighted any score that was +/- 10% from the total average. So for exampme; if HRV was 10% higher than the average of all HRV scores, I would shade that day green. Likewise for Reaction Test. Red shading denotes 10% or greater reduction.

After examining the acute relationship between Reaction Test and HRV I decided to examine the averages for each training block. I’ve shifted my focus lately a little bit more on weekly trend changes vs. daily trend changes. As you can see in the charts below, there is a very strong relationship between HRV AVG and Reaction Test AVG during each training section.

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–          Intensity Section – This section was the last 2 weeks of my 9 week training cycle that I performed after the Christmas break (discussed here). Volume was low but intensity was Maximal. HRV is at it’s lowest average while Reaction Test is at its highest (slowest reaction time) average.

–          Deload – During the deload week HRV average rebounds to peak levels while reaction time improves to near peak levels.

–          High Volume – This marks the start of a new training cycle. HRV drops quite a bit and Reaction Time average increases (slower reaction).

–          Semi-Deload – HRV returns to near peak values while Reaction Test peaks (quickest reaction time average).

From this data set, intensity appeared to have the biggest effect on Reaction Test average and HRV average. High volume work with moderate intensity also had a significant impact on these averages. It should be kept in mind that the Intensity period followed several weeks of training and therefore some fatigue had already been accumulated. I didn’t start using the reaction test until late February.  HRV and Reaction averages improve over periods of reduced training load.

Given that I was able to hit some PR’s in the gym during the Intensity section (under high fatigue), I’m inclined to say at this point, based on this data set, that these tests are not necessarily indicators of performance potential (strength), but rather markers of fatigue. In the future I would like to see how these tests match up with “finer” motor skills in other athletes.

Quick Updates

I made it safely to Montgomery, AL after a nice visit with some family at my folks place in Cincinnati over Easter. Total travel time was about 17.5 hours. We wasted no time in getting to work in the lab. We’ve got 3 projects going on right now (the first two being more health related  as opposed to sports/performance).

  1. I’m helping Dr. Esco complete a study comparing post-exercise HRV recovery after two different modes of exercise (cycling vs. treadmill at same intensity/duration).
  2. We are starting a new study comparing post-exercise HRV in middle aged men after 3 modes or resistance training; Eccentric only; Concentric Only; Traditional Resistance Training
  3. We have put the wheels in motion for a cross-validation study comparing ithlete to EKG. We did some pilot work with about 6 subjects so far and have IRB Forms and Consent Forms about ready for submission. We’ll measure ithlete and EKG simultaneously in about 20 males and 20 females then run the data. This is a very important study to me. In order to improve what we know about HRV and performance, we need more data. Using EKG’s in the field is not practical. What we need to start seeing is data from athletes that are performing measurements at home when they wake up. The device needs to be extremely easy to use and the data needs to be immediately available to the coach. At this time, smart phone app’s are the best way to do this. There are plenty of limitations with this but at the end of the day, if we’re going to apply this stuff in a team setting we need easy to use, affordable tools.
  4. This last project doesn’t exist yet. But I’m hoping to collect data on either the men’s tennis team or the women’s soccer team. I’ll provide more info on this if and when it starts to take shape.

Let me be clear right from the start in saying that Dr. Esco is running the show here. I’ve learned a ton from him already about the research process and anything that I accomplish over the next little while will be because of him.

Lastly, I attended my first Roller Derby which was quite the experience.