Athlete Monitoring Part II: Methods and Implementation of Monitoring Programs

In our previous post, we explored the "what" and "why" of athlete monitoring, laying the groundwork for understanding its importance. Today, we'll shift our focus to the "how," examining the methods available for monitoring athletes and key considerations for implementing these monitoring programs effectively.

Monitoring methods encompass various tools and technologies designed to track different aspects of an athlete's performance, health, and recovery. The choice of monitoring tool depends on the specific area being targeted, such as physiological, biomechanical, or psychological parameters. When implementing monitoring programs in sports, it's essential to ensure that the methods used are:

• Valid, ensuring they accurately measure what they are intended to measure. If a test lacks validity, the results it produces are meaningless for the specific purpose for which it was intended.[1]

• Reliable, meaning they consistently provide accurate data; This is crucial for tracking progress and making comparisons across different periods.[1]

• Responsive, meaning they can detect small changes in performance or condition. This is particularly important in sports, where small changes in performance can have significant implications;[2]

Validated methods are critical because they provide consistent, accurate, and meaningful data that can be trusted to guide decisions related to athlete performance and health. Without validation, the data collected could be misleading or inaccurate, potentially leading to incorrect conclusions and ineffective interventions.

A Few Examples of Validated Tests in Sports Science:

• VO2 Max Test: Often regarded as the gold standard for measuring aerobic capacity.[3]

• 1RM (One Repetition Maximum) Test: Used to measure maximal strength.[4]

• Wingate Test: A common measure for anaerobic power and capacity.[5]

• OSTRC-H2 (The Oslo Sports Trauma Research Center Questionnaire on Health Problems): A validated tool used to monitor injury and illness in athletes. It is recognized for its reliability in capturing health problem data over time and providing accurate insights into health problem incidence, prevalence and severity. [6,7]

These tests have been validated through extensive research and are widely used in both research and practical settings due to their proven reliability and validity.

To find validated monitoring methods that align with your goals, I recommend consulting a sports scientist (we are available by following e-mail: completeperformance7@gmail.com), or reviewing recent high-quality publications.

Implementation of Monitoring Programs – Compliance: The Key to Success

Once monitoring methods are established, the next critical step is their efficient implementation. Successful implementation depends on several factors, with compliance being one of the most crucial.[8] Compliance, in this context, refers to the extent to which athletes consistently participate in and adhere to the monitoring protocols. High compliance is essential to ensure that the data collected reflects the true status of the athletes, providing a comprehensive view of their health and performance.

Experience from health teams highlight that athletes are more likely to engage with monitoring programs if they perceive a direct benefit to their health and success. If athletes feel that their participation in the program improves their medical care and increases their chances of success, they are more likely to remain compliant over time. This underscores the importance of communicating the value of the program to the athletes and integrating their feedback into the process.

Understanding the Purpose

Before implementing a monitoring program, it’s essential to clarify its purpose. Whether the goal is to protect the athlete's health, enhance performance, or a combination of both, understanding the "why" behind the program will shape its design and execution. For instance, a program aimed at injury prevention might focus more on injury surveillance, biomechanical assessments and workload monitoring, while one centered on performance enhancement might prioritize physiological metrics like heart rate variability or lactate thresholds.

Key Considerations for Effective Implementation

Timeline and Frequency of Monitoring: The timeline and frequency of monitoring must be carefully planned. This involves determining how often data should be collected (e.g., daily, weekly, monthly) and ensuring that these intervals align with the athletes' training and competition schedules. Regular, consistent monitoring allows for the timely identification of trends or issues, but it’s important to strike a balance—too frequent monitoring can lead to data fatigue, while too infrequent monitoring might miss critical changes.

Responsibility for Data Reporting: Clearly defining who is responsible for reporting data is crucial. This could be the athletes themselves, coaches, or support staff. Involving athletes directly in the reporting process can enhance their engagement and ownership of the program, but it’s also important to ensure that the reporting process is simplified and not overly burdensome. Automation, where possible, can help reduce the workload on athletes and staff.

Reporting and Feedback of Gathered Data: The process of providing feedback on the gathered data must be well-structured. Data should not only be collected but also analyzed and interpreted regularly to inform training adjustments or medical interventions. Athletes and their support staff should receive timely and relevant feedback, which can reinforce the importance of their participation and help them understand how the data is being used to enhance their performance and well-being.

Regular Data Analysis and Adjustment

As mentioned above, for a monitoring program to be truly effective, the collected data needs to be regularly analyzed and used to make informed decisions. This could involve adjusting training loads, modifying recovery strategies, or implementing injury prevention measures. The integration of both subjective feedback from athletes and objective data from monitoring tools ensures a holistic approach, enhancing the accuracy and relevance of the interventions.

In summary, the successful implementation of monitoring programs requires careful planning and consideration of several key factors, particularly compliance and feedback. By clearly defining the purpose of the program, ensuring regular and efficient data collection and analysis, and providing athletes with meaningful feedback, athlete monitoring programs can significantly contribute to both the health and performance of athletes.

The key elements of athlete monitoring are:

• Validated Monitoring Methods: Utilization of reliable and responsive methods tailored specifically for surveillance purposes.

• Clear Definitions: Establishment of precise definitions for terms such as injury or exposure to ensure consistency and accuracy.

• Engagement of Medical Personnel: Involvement of medical professionals in the monitoring process to facilitate timely intervention and treatment.

• Timely Feedback: Providing prompt and actionable feedback to athletes and relevant stakeholders to support decision-making and improve outcomes.

In my PhD thesis, I applied these principles by monitoring elite handball players from the first division over a 45-week season. The focus was on capturing a detailed picture of their weekly load across various domains, including training, competition, academic and work commitments, sleep, and injury/illness occurrence. Additionally, we tracked their blood biomarkers to assess hormonal balance and the potential risk for injury or illness. This holistic approach aimed to provide insights into the physical and physiological demands on elite athletes throughout a competitive season. I'll share more about the study and my experiences in the next blog post!

References:

1. Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory  and application. Am J Med. 2006;119:166.e7-16.

2. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53:459–68.

3. Bassett DRJ, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance  performance. Med Sci Sports Exerc. 2000;32:70–84.

4. LeSuer DA, McCormick JH, Mayhew JL, Wasserstein RL, Arnold MD. The Accuracy of Prediction Equations for Estimating 1-RM Performance in the Bench Press, Squat, and Deadlift. J Strength Cond Res [Internet]. 1997;11. Available from: https://journals.lww.com/nsca-jscr/fulltext/1997/11000/the_accuracy_of_prediction_equations_for.1.aspx

5. Bar-Or O. The Wingate anaerobic test. An update on methodology, reliability and validity. Sports Med. 1987;4:381–94.

6. Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire. Br J Sports Med. 2013;47:495–502.

7. Clarsen B, Bahr R, Myklebust G, Andersson SH, Docking SI, Drew M, et al. Improved reporting of overuse injuries and health problems in sport: an update of  the Oslo Sport Trauma Research Center questionnaires. Br J Sports Med. 2020;54:390–6.

8. Plews DJ, Laursen PB, Le Meur Y, Hausswirth C, Kilding AE, Buchheit M. Monitoring training with heart rate-variability: how much compliance is needed  for valid assessment? Int J Sports Physiol Perform. 2014;9:783–90.

Author: Kristina Drole, MSc, PhD candidate