Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes

Dalen-Lorentsen, Torstein; Bjørneboe, John; Clarsen, Benjamin; Vagle, Markus; Fagerland, Morten Wang; Andersen, Thor Einar

doi:10.1136/bjsports-2020-103003

Cited by 37 publications

(43 citation statements)

References 69 publications

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“…Until recently, no studies had looked to use load management strategies to prevent injuries from occruing. However, a recent a randomized controlled trial which used the ACWR to manage player load in elite youth soccer teams, demonstrated no difference in health problems between groups [46,53]. This study demonstrates the number of covariates that likely moderate training load and highlights the complexity of the interaction between those covariates in injury [46,50].…”

Section: Why Do We See Such Variation?mentioning

confidence: 73%

Training Load and Injury Risk in Elite Rugby Union: The Largest Investigation to Date

et al. 2020

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Training load monitoring has grown in recent years with the acute:chronic workload ratio (ACWR) widely used to aggregate data to inform decision-making on injury risk. Several methods have been described to calculate the ACWR and numerous methodological issues have been raised. Therefore, this study examined the relationship between the ACWR and injury in a sample of 696 players from 13 professional rugby clubs over two seasons for 1718 injuries of all types and a further analysis of 383 soft tissue injuries specifically. Of the 192 comparisons undertaken for both injury groups, 40% (all injury) and 31% (soft tissue injury) were significant. Furthermore, there appeared to be no calculation method that consistently demonstrated a relationship with injury. Some calculation methods supported previous work for a “sweet spot” in injury risk, while a substantial number of methods displayed no such relationship. This study is the largest to date to have investigated the relationship between the ACWR and injury risk and demonstrates that there appears to be no consistent association between the two. This suggests that alternative methods of training load aggregation may provide more useful information, but these should be considered in the wider context of other established risk factors.

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Section: Why Do We See Such Variation?mentioning

confidence: 73%

Training Load and Injury Risk in Elite Rugby Union: The Largest Investigation to Date

et al. 2020

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“…Through s-RPE, total distance and HSR, the following variables were calculated: (i) TM (mean of training load during the seven days of the week divided by the standard deviation of the training load of the seven days) [ 11 , 17 ], (ii) TS (sum of the training loads for all training sessions during a week multiplied by training monotony) [ 11 , 17 ] and (iii) ACWR (dividing the acute workload, i.e., the 1-week rolling workload data, by the chronic workload, i.e., the rolling 4-week average workload data) [ 18 , 19 , 20 , 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

In-Season Internal and External Workload Variations between Starters and Non-Starters—A Case Study of a Top Elite European Soccer Team

et al. 2021

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Background and Objectives: Interpretation of the load variations across a period seems important to control the weekly progression or variation of the load, or to identify in-micro- and mesocycle variations. Thus, the aims of this study were twofold: (a) to describe the in-season variations of training monotony, training strain and acute:chronic workload ratio (ACWR) through session ratings of perceived exertion (s-RPE), total distance and high-speed running (HSR); and (b) to compare those variations between starters and non-starters. Materials and Methods: Seventeen professional players from a European First League team participated in this study. They were divided in two groups: starters (n = 9) and non-starters (n = 8). The players were monitored daily over a 41-week period of competition where 52 matches occurred during the 2015–2016 in-season. Through the collection of s-RPE, total distance and HSR, training monotony, training strain and ACWR were calculated for each measure, respectively. Data were analyzed across ten mesocycles (M: 1 to 10). Repeated measures ANOVA was used with the Bonferroni post hoc test to compare M and player status. Results: The results revealed no differences between starters vs. non-starters (p > 0.05). M6 had a greater number of matches and displayed higher values for monotony (s-RPE, total distance and HSR), strain (only for total distance) and ACWR (s-RPE, TD and HSR). However, the variation patterns for all indexes displayed some differences. Conclusions: The values of both starters and non-starters showed small differences, thus suggesting that the adjustments of training workloads that had been applied over the season helped to reduce differences according to the player status. Even so, there were some variations over the season (microcycles and mesocycles) for the whole team. This study could be used as a reference for future coaches, staff and scientists.

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“…The survey was conducted in November 2018 as a part of a cluster-RCT investigating the preventive effect of a load management approach on injuries and illnesses in Norwegian elite youth footballers of both sexes. 14 The RCT was cluster randomised on a team level and consisted of a control group and an intervention group. The intervention entailed coaches adapting to an Acute:Chronic Workload theory-based load management programme.…”

Section: Materials and Methods Study Design And Participantsmentioning

confidence: 99%

“…12 13 However, the evidence supporting this practice is limited to observational studies of associations between training load and injuries. In a recent randomised controlled trial (RCT), 14 we found that a common model of training load management using the Acute:Chronic Workload Ratio concept 15 did not reduce the prevalence of health problems (both injuries and illnesses) among elite youth footballers of both sexes. Players' reported compliance with our intervention was 63%.…”

Section: Introductionmentioning

confidence: 91%

Facilitators and barriers for implementation of a load management intervention in football

Dalen-Lorentsen

Ranvik

Bjørneboe

et al. 2021

BMJ Open Sport Exerc Med

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BackgroundIn a recent randomised controlled trial, we found that a commonly used training load management approach was not effective in preventing injuries and illnesses in Norwegian elite youth footballers.AimTo investigate players’ and coaches’ barriers and facilitators to a load management approach to prevent injuries and illnesses and their attitudes and beliefs of load management and injuries and illnesses in general.MethodsWe asked players and coaches about their views on injury risk in football, the benefits and limitations of load management in general and implementation of load management in football. The questionnaires used were based on similar studies using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.ResultsWe recorded answers from 250 players and 17 coaches. Most players (88%) reported that scientific evidence showing improved performance from the intervention measures is a key facilitator to completing the intervention. Similarly, coaches reported that the most important facilitator was scientific evidence that the preventive measures were effective (100%). Players reported that the coach’s attitude to preventive measures was important (86%), and similarly, 88% of coaches reported that the player’s attitude was important.ConclusionsBy having a mutual positive attitude towards the intervention, players and coaches can positively contribute to each other’s motivation and compliance. Both players and coaches reported scientific evidence for load management having injury-preventive and performance-enhancing effect and being time efficient as important facilitators.Trial registration numberTrial registration number

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Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes

Cited by 37 publications

References 69 publications

Training Load and Injury Risk in Elite Rugby Union: The Largest Investigation to Date

Training Load and Injury Risk in Elite Rugby Union: The Largest Investigation to Date

In-Season Internal and External Workload Variations between Starters and Non-Starters—A Case Study of a Top Elite European Soccer Team

Facilitators and barriers for implementation of a load management intervention in football

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