Sports Science & Coaching Volume 5 Number

Transcription

1 Changes in Stress and Recovery as a Result of Participating in a Premier Rugby League Representative Competition by Doug King, Trevor Clark and Michael Kellmann Reprinted from International Journal of Sports Science & Coaching Volume 5 Number

2 International Journal of Sports Science & Coaching Volume 5 Number Changes in Stress and Recovery as a Result of Participating in a Premier Rugby League Representative Competition Doug King 1,2, Trevor Clark 3 and Michael Kellmann 4,5 1 Emergency Department, Hutt Valley District Health Board, Private Bag , Lower Hutt, New Zealand Douglas.King@huttvalleydhb.org.nz 2 Institute of Sports and Recreation Research New Zealand, School of Sport and Recreation, Faculty of Health and Environmental Science, Auckland University of Technology, New Zealand 3 Institute of Food, Nutrition and Human Health, College of Science, Massey University Wellington, Wellington, New Zealand 4 Faculty of Sport Science, Ruhr-University of Bochum, Bochum, Germany 5 School of Human Movement Studies, The University of Queensland, Australia ABSTRACT The aim of this study is to monitor changes in stress and recovery of amateur rugby league players competing in a premier representative competition. A prospective observational cohort design was used in a rugby league match environment over the 2009 representative competition season with 30 registered members in the regional representative rugby league team. Members of the team completed the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) on the first training session following every scheduled match throughout the representative competition season. Injuries were reported as rate per 1,000 match hours. A repeated measure of analysis was used to evaluate differences in the RESTQ-Sport scale scores among the different measure taken. Significant changes were observed in Social Stress between weeks 1 and 4; Fatigue between pre-competition and week 5; and Lack of Energy between week 3 and week 4. The statistical differences observed in the Social Stress scale between weeks 4 and 5 may be related to the programming of the competition. Although the RESTQ-Sport did not predict any future performance or injury of the players, it did reflect how the players were dealing with the effects of amateur participation and the other requirements of life (work, relationships, etc.). Key words: Fatigue, Football, Injury, Overtraining, Player Monitoring, RESTQ-Sport Reviewers: Tim Gabbett (Brisbane Broncos Rugby League Club, Australia) Mike Lambert (University of Cape Town, South Africa)

3 224 Stress and Recovery in Rugby League INTRODUCTION Played internationally, 1 rugby league is a physical contact sport that is played at junior, 2 amateur, 3 sub-elite 4 and elite 5 levels. By nature, rugby league is an intermittent collision sport that requires players to compete with a combination of muscular strength, speed, power, agility, flexibility and aerobic endurance. 6, 7 During a rugby league match, forwards are reported to be involved in an average of 55 physical collisions (39 tackles, 16 as ball carrier) and backs in an average of 29 physical collisions (16 tackles, 13 as ball carrier). 8, 9 There is a risk of musculoskeletal injury occurring from the match environment due to the number of physical collisions and tackles that occur. 3, 10 The risk of injury in rugby league has been reported to increase with inadequate preparation. 11 Players with low speed and maximal aerobic endurance were reported to be at an increased risk of injury. 11 As well, players who completed less than 18 weeks of training before sustaining an initial injury were at a greater risk of sustaining a subsequent injury. 11 Additionally, a study on trained college soccer players highlighted the need for sports participants entering into a regular season competition to be in a trained, but rested state as performance recovery may be difficult to achieve. 12 Although these studies have identified these areas for team sports participants, there are few non-invasive practical tools available for team management to monitor the stress and recovery of the players to enable optimal performance. 13 During the growth and development of rugby league, there have been numerous changes which have had a profound effect on the way the game is played. Perhaps the most dramatic change in the game in the last ten years is the increased fitness levels of the players. Most top-level players today strive to achieve higher levels of fitness to match the demands of the modern game. Maintaining a high level of fitness is considered a pre-requisite to playing in the professional ranks. The past two decades has seen the emergence of science as a potent weapon in the arsenal utilised in the art of coaching. The greatest emphasis in this period has been placed on the application of science to sport specificity. In concise terms, this implies a complete understanding of an individual s potential, and the development of this potential to meet the specific requirements of their sport. 14 Each component of their training programme must relate directly to their specific duties on the field. The challenge for any sports participant and their coach is to identify the level and type of training that enables optimal performance, but at the same time does not induce negative training adaptations. 15 To enable the body to adapt to the demands of the sport, training is usually designed to improve the participant s fitness This is usually undertaken by stressing the body to an increasingly higher stimulus (e.g., training overload). 16, 17 As a result of this, the body adapts to the stimulus to achieve homeostasis enabling fitness enhancement Consequently, when the participant experiences this training overload over a period of time, physiological adaptation occurs. 16 When the same higher stimulus is reintroduced, there is less disruption to the body s reaction to this stressor. This is termed acclimatization. 16, 17 If the participant continues to train above their usual level of effort, then adaptation to the higher level occurs and this then becomes their usual level. 16 This training effort also requires adequate recovery to occur. 16, 17 Recovery enables the body to recuperate from the increased stimulus. Failure to observe the adequate recovery between training stimulus and/or increasing the training stimulus before adequate rest has incurred exposes the participant to vulnerability of overtraining and performance decline The actual point of what is the best balance between training and recovery is difficult to define. 18 Any imbalances between the training stimulus and the recovery period can result in one of two responses: i) inappropriate responses of the participant in training and in

4 International Journal of Sports Science & Coaching Volume 5 Number competition; and ii) overreaching of the participant which can lead onto staleness, burnout or the overtraining syndrome. 18 Alterations in haematological, immunological, biochemical, hormonal and psychological variables have been reported in previous studies with excessive fatigue and overreaching Although these markers show the effects of fatigue and overreaching, there is, to date, no readily available marker as an early warning of impending fatigue. It was not until recently that there was a practical tool available for coaches to monitor the full complexities of stress and recovery states in athletes. The development of the multidimensional Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) allows for the systematic measurement of the recovery and stress of athletes The use of the RESTQ-Sport has been reported in athletes preparing for competition18, 19, 26, 28, 29 and with endurance athletes 13, with all these studies reporting that the RESTQ- Sport was able to recognize changes in training volume and overreaching in sports participants. Despite these studies, there is a paucity of studies reporting the use of the RESTQ-Sport on team based sports participants in competition. Several researchers have reported team-based sports participants being at risk of overreaching during training12, 22 and/or from the demands of competition. 29 There are a few studies 33, 34 that have reported the use of the RESTQ-Sport in a team-based sport. One study 34 utilized a limited period of intensive training to assess the stress and recovery of semi-professional rugby league players. It was found that the RESTQ-Sport followed a dose-response relationship with training strain and endurance performance, and may be a useful tool for monitoring stress and recovery for team-sport athletes. Another study 33 incorporated the RESTQ-Sport as part of the assessment of different recovery strategies from participation following match participation. To date, no study has used the RESTQ-Sport to monitor changes in stress and recovery of team-sport athletes as a result of participation in a competition. Therefore the aim of this study is to monitor changes in stress and recovery of amateur rugby league players competing in a premier representative competition. METHOD PARTICIPANTS A prospective observational study was undertaken on a rugby league regional representative team over the 2009 regional representative season. There were 30 registered members of the team over the duration of the competition. Not all members of the team attended every training session and only those present at the first training sessions following scheduled matches completed the RESTQ-Sport. The mean (±SD) age, height and body mass of the participants was 23.6 (±4.5) years, 1.81 (±0.04) meters and 95.1 (±10.5) kgs. Although the rugby league season lasted from December through to October, the representative season commenced at the completion of the domestic competition with representative games from August through to October. The team participated in the premier division of the regional representative competition comprising of six teams from around New Zealand playing in a home-and-away competition format over an eight week period. All registered players were considered amateur as they derived their main source of income from other means and did not receive match payments. MATCH AND TRAINING EXPOSURE AND INJURY DEFINITIONS Over the duration of the competition, all training and match injuries were recorded. The team medic was a registered comprehensive nurse with tertiary sports medicine qualifications and accredited in injury prevention, assessment and management. Injury data was collected from

5 226 Stress and Recovery in Rugby League all training sessions and competition matches the team participated in. All injuries were recorded on a standardized injury reporting form regardless of severity. 35 All training sessions were 90 minutes in duration and all matches were 80 minutes in duration. The injury definition utilised for this study was any pain or disability that occurs during participation in rugby league match or training activities that is sustained by a player, irrespective of the need for match or training time loss or for first aid or medical attention. An injury that results in a player requiring first aid or medical attention is referred to as a medical attention injury and an injury that results in the player being unable to partake in full part of future training and/or match activities is referred to a time loss injury. 36 The missed match injury definition utilised for this study was any injury that causes a player to be unable to participate in a rugby league training activity or to be selected in a competitive match 36 Injuries were also classified according to the site, nature, and severity of the injury. 37 INSTRUMENTS Developed to measure the frequency of current stress and recovery associated activities, the RESTQ-Sport 27 is a modular constructed questionnaire that includes 12 scales of the general Recovery-Stress Questionnaire (see Table 1). 13, 18, 19 Adding in seven additional scales designed to put more emphasis on stress and recovery in sports, the RESTQ-Sports is sensitive to deficiencies in areas such as Disturbed Breaks, Injury, Personal Accomplishment, Self-Efficacy and Self-Regulation. 13, 27, 38 Table 1. RESTQ-Sport Scales, Scale of Orientation (o), Number of Items (n) and Sample Item 19 No RESTQ-Sport scale o n Example 1 General Stress S 2 I felt down 2 Emotional Stress S 2 I was in a bad mood 3 Social Stress S 2 I was angry with someone 4 Conflicts/Pressure S 2 I felt under pressure 5 Fatigue S 2 I was overtired 6 Lack of Energy S 2 I was unable to concentrate well 7 Physical Complaints S 2 I felt uncomfortable 8 Success R 2 I finished important tasks 9 Social Recovery R 2 I had a good time with my friends 10 Physical Recovery R 2 I felt at ease 11 General Well-Being R 2 I was in a good mood 12 Sleep Quality R 2 I had a satisfying sleep 13 Disturbed Breaks S 4 my coach demanded too much of me during the breaks 14 Emotional Exhaustion S 4 I felt I wanted to quit my sport 15 Injury S 4 my performance drained me physically 16 Being in Shape R 4 I was in good condition physically 17 Personal Accomplishment R 4 I dealt very effectively with my team-mates problems 18 Self-Efficacy R 4 I was convinced that I had trained well 19 Self-Regulation R 4 I prepared myself mentally for performance S = Stress, R = Recovery The Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) is a psychometrically based questionnaire that assesses a participant s recovery-stress state. 18, 19, 26 Consisting of

6 International Journal of Sports Science & Coaching Volume 5 Number twelve basic scales (seven stress subscales: General Stress, Emotional Stress, Social Stress, Conflicts/Pressure, Fatigue, Lack of Energy, Physical Complaints; and five recovery subscales: Social Recovery, Physical Recovery, General Well-Being, Sleep Quality) with seven additional sport-specific scales (three sport-specific stress subscales: Injury, Emotional Exhaustion, Disturbed Breaks; and four sport-specific recovery subscales: Being in Shape, Personal Accomplishment, Self-Regulation, Self-Efficacy) the questionnaire uses a selfreport approach of participants physical, subjective, behavioural, and social aspects of stress and recovery. Each of these scales has items that require the participant s response. Each item is rated according to its frequency on a seven-point Likert scale ranging from 0 (never) to 6 (always). Each item response indicates how often the participant participated in stress- or recovery-associated activities during the previous 72 hours. The mean of each scale indicates either a high or low score in the stress-associated scales and in the recovery-orientated scales. As such, the results of these scores indicate the participant s stress-associated subjective strain for the stress scales and the participant s recovery process for the recovery scales. The internal consistencies and reliability of the RESTQ-Sport have previously been reported with Cronbach s alpha ( ) and the test-retest reliability (r = ). 27 PROCEDURE Members of the team completed the RESTQ-Sport (52 item version) on the first training session following every scheduled match throughout the representative competition season. Not all matches were a week apart with some matches played mid week. The first training session was always two days after the last match was played. Participants always completed the questionnaire before the start of the training session to keep the time schedule comparable. The training cycle for the duration of the rugby league representative competition consisted of activities involving aerobic and anaerobic endurance activities undertaken in a intermittent fashion mimicking the activities of rugby league. 3, 39 As well, rugby league skills, drills and match plan activities were completed throughout the training sessions. As the representative season progressed, the intensity was increased to reflect the ensuing matches the team was programmed to compete in. It was expected that increases in training requirements and harder matches would lead to higher scores in Fatigue, Physical Complaints and Injury scales, respectively. Vice versa, decreases in training requirements and participation in less rigorous matches would lead to lower stress and higher recovery scores, respectively. ANALYSIS All the data collected were entered into a Microsoft Excel spreadsheet and analyzed with SPSS v.16.0 (SPSS Inc, Chicago, Illinois, USA). The statistical significance was set at p < Data are reported as means and standard deviations and with 95% confidence intervals (CI) where appropriate. 40 Repeated measures of analysis were used to evaluate differences in scale scores among the different measure taken. Total recovery and stress scores were obtained by calculating the mean of all recovery and stress scales as previously described. 26 Atwo-tailed paired t-test was used to determine if any significant differences existed. Changes in match and training injuries were compared using a one sample Chisquared (χ 2 ) test. Significant p-values reported in the text are < if they are not specifically stated. RESULTS Over the duration of the representative competition, there were 23 training sessions with 21 (±3.0) players attending training resulting in training exposure hours (see Table 2).

7 228 Stress and Recovery in Rugby League Eight training injuries were recorded over the duration of the competition giving a training injury rate of 12 [95% CI: 4 20] per 1,000 training hours. No missed training injuries were recorded over the duration of the competition. The team participated in six matches (five round robin matches and one semi-final match) resulting in 104 match exposure hours. Table 2. Observed Training and Match Injuries Over the Study Period Training Injuries Match Injuries Total Missed Match Total Injuries Observed Injury rates per 1000 hours (95% CI) 11.0 (5.5 to 22.0) 67.5 (32.2 to 141.5) (398.7 to 679.6) No. Trainings/games played Exposure hrs Hrs per injury (95% CI) (51.2 to 204.6) 14.8 (7.1 to 31.1) 1.9 (1.5 to 2.5) Total No. Injuries per 0.3 (0.2 to 0.7) 1.2 (0.6 to 2.4) 9.0 (6.9 to 11.8) training/game (95% CI) Player appearances per 39.0 (19.5 to 78.0) 11.1 (5.3 to 23.4) 1.4 (1.1 to 1.9) injury (95%CI) Game minutes played (120.0 to 479.9) 68.6 (32.7 to 143.8) 8.9 (6.8 to 11.6) per injury (95%CI) INJURY REGION, TYPE, NATURE, SEVERITY AND PLAYER GROUP The upper limb recorded significantly more training injuries than the chest/back (χ 2 = 4.0, df = 1, p = 0.046) (see Table 3). Strains and contusions (4 [95% CI: 1 to 13] per 1000 training hours) were the most common training injury type. Collisions and over-exertions were the most common injury cause (4 [95% CI: 1 to 13] per 1000 training hours). Forwards recorded more injuries than backs, but these were not significant (RR: 3.0 [95% CI: 0.6 to 14.8]; p = 0.157). All training injuries recorded were transient in nature (11 [95% CI: 6 to 22] per 1000 training hours). The upper (212 [95% CI: 140 to 322] per 1000 playing hours) and lower limb (164 [95% CI: 102 to 264] per 1000 playing hours) recorded significantly more match injuries than the chest/back ((χ 2 = 13, df = 1, p < 0.001; χ 2 = 8, df = 1, p = 0.005). Contusions (251 [95% CI: 171 to 368] per 1000 playing hours) and fracture-dislocations (116 [95% CI: 66 to 204] per 1000 playing hours) were the most common match injury type. There was a significant difference observed that the ball carrier recorded more injuries than the tackler (χ 2 = 9, df = 1, p = 0.002). Forwards recorded significantly more match injuries than backs (RR: 1.8 [95% CI: 1.1 to 3.0]; p = 0.029). Transient injuries were more commonly recorded (87%) than mild (6%), moderate (4%) or major (4%) injury severities. RESTQ-SPORT The mean (±SD) scores of the RESTQ-Sport are shown in Table 4. There were significant differences observed in the stress scale Social Stress between weeks 1 and 4 (F = 4.69, df = 32, p = 0.038), Fatigue between pre-competition and week 5 (F = 5.31, df = 41, p = 0.027) and Lack of Energy between week 3 and week 4 (F = 4.45, df = 32, p = 0.043). There were significant differences observed in the recovery scales in Success between precompetition and week 5 (F = 5.49, df = 41, p = 0.024); Social Recovery between week 1 and 5 (F = 5.80, df = 39, p = 0.021); and General Well-Being between weeks 2 and 3 (F = 4.58, df = 34, p = 0.040). Significant differences were also observed in the sport-specific stress

8 International Journal of Sports Science & Coaching Volume 5 Number Table 3. Injury Region, Type, Nature, Player Group and Severity per 1000 Training or Playing Hours with 95% Confidence Intervals and Percentages No Training Rate a (95% CI) % No Match Rate b (95% CI) % Injury region Head/Neck (0.2 to 9.8) (58.7 to 191.5) 20.4 Upper Limb 4 e 5.5 (2.1 to 14.7) de 212.1(139.6 to 322.1) 40.7 Lower Limb (1.3 to 12.8) ce (101.9 to 263.6) 31.5 Chest/Back 0 c cd 38.6 (14.5 to 102.7) 7.4 Injury Type Contusion (1.3 to 12.8) (170.6 to 368.1) 48.1 Strains (1.3 to 12.8) (26.0 to 128.7) 11.1 Sprains (0.2 to 9.8) (26.0 to 128.7) 11.1 Fracture/dislocations (0.2 to 9.8) (65.7 to 203.7) 22.2 Concussions (1.4 to 68.4) 1.9 Other (9.3 to 89.7) 5.6 Nature of Injury Ball carrier (0.2 to 9.8) (258.4 to 492.3) 68.5 Tackler f (87.2 to 239.8) 27.8 Collision other (1.3 to 12.8) Slip/Trip (0.2 to 9.8) Over-exertion (1.3 to 12.8) (4.8 to 77.1) 3.7 Player Group Forwards (0.9 to 13.9) g (524.8 to ) 64.8 Backs (4.3 to 21.4) (217.0 to 533.3) 35.2 Injury Severity Transient (5.5 to 22.0) (340.4 to 603.0) 87.0 Mild (9.3 to 89.7) 5.6 Moderate (4.8 to 77.1) 3.7 Major (4.8 to 77.1) 3.7 (a) = rate per 1000 training hours; (b) = rate per 1000 playing hours. Significant difference (p < 0.05) than (c) = Upper limb; (d) = Lower Limb; (e) = Chest/Back; (f) = Ball carrier; (g) = Backs

9 230 Stress and Recovery in Rugby League Table 4. Scores in the Different Scales of the RESTQ-Sport Corresponding to the Seven Measures During the Study Period, Players Present at Training, Training Injuries, Total and Missed Match Injuries and Match Results of the 2009 Regional Representative Team Pre-competition Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Scale Mean (±SD) Mean (±SD) Mean (±SD) Mean (±SD) Mean (±SD) Mean (±SD) Mean (±SD) General Stress 1 General Stress 1.20 (±0.88) 1.09 (±0.74) 1.03 (±0.76) 1.21 (±0.80) 0.82 (±0.77) 1.16 (±0.82) 0.88 (±0.78) 2 Emotional Stress 1.63 (±0.60) 1.31 (±0.85) 1.53 (±0.69) 1.58 (±0.73) 1.25 (±0.78) 1.57 (±0.79) 1.45 (±0.76) 3 Social Stress 1.40 (±0.93) e 1.40 (±0.88) 1.06 (±0.63) 1.32 (±0.67) e 0.79 (±0.73) ad 1.25 (±0.90) 1.15 (±0.63) 4 Conflicts/Pressure 2.45 (±1.27) 2.45 (±1.06) 2.09 (±1.17) 2.13 (±1.04) 1.64 (±0.89) 1.80 (±0.73) 1.88 (±1.05) 5 Fatigue 2.58 (±1.10) f 1.81 (±1.17) 2.09 (±1.32) 2.08 (±1.03) 1.93 (±0.92) 1.80 (±1.09) a 1.88 (±1.23) 6 Lack of Energy 1.93 (±0.92) 1.38 (±0.81) 1.59 (±1.08) 1.92 (±0.82) e 1.36 (±0.66) d 1.64 (±0.79) 1.68 (±0.89) 7 Physical Complaints 1.65 (±0.93) 1.06 (±1.06) 1.28 (±1.02) 1.66 (±1.27) 1.21 (±0.78) 1.45 (±1.13) 1.30 (±0.94) General Recovery 8 Success 3.33 (±1.20) f 2.94 (±0.73) 3.44 (±1.03) df 2.82 (±0.69) cg 3.43 (±0.78) f 2.61 (±0.74) aceg 3.30 (±0.77) df 9 Social Recovery 4.13 (±1.12) 4.53 (±1.01) f 4.22 (±1.03) 4.13 (±1.05) 4.00 (±1.13) 3.75 (±0.97) b 4.00 (±1.19) 10 Physical Recovery 2.93 (±0.96) 3.09 (±0.76) 3.19 (±1.00) 2.61 (±0.79) 2.75 (±0.78) 2.66 (±0.76) 2.88 (±0.96) 11 General Well-Being 3.93 (±1.05) 4.00 (±0.86) 4.22 (±0.80) df 3.58 (±0.95) c 3.86 (±1.03) c 3.52 (±0.91) 3.85 (±1.08) 12 Sleep Quality 3.60 (±1.25) 4.03 (±0.85) 3.72 (±1.05) 3.55 (±0.83) 3.75 (±1.03) 3.52 (±0.89) 3.73 (±0.98) Sport Stress 13 Disturbed Breaks 1.60 (±0.75) 1.41 (±0.49) 1.58 (±1.06) 1.58 (±0.79) 1.21 (±0.84) 1.35 (±0.86) 1.41 (±0.85) 14 Emotional Exhaustion 1.60 (±1.11) c 1.25 (±0.79) 0.89 (±0.88) ad 1.74 (±0.89) c 1.36 (±0.89) 1.34 (±0.94) 1.29 (±0.99) 15 Injury 2.46 (±1.10) 2.14 (±0.84) d 2.09 (±1.16) 2.82 (±0.99) b 2.50 (±0.79) 2.56 (±1.10) 2.45 (±1.03) Sport Recovery 16 Being in Shape 3.68 (±1.12) 3.52 (±0.69) 3.70 (±0.98) 3.32 (±0.85) 3.50 (±0.69) 3.42 (±0.72) 3.36 (±0.79) 17 Personal Accomplishment 3.24 (±0.90) 3.03 (±0.81) 3.20 (±0.76) 3.07 (±0.53) 3.23 (±0.75) 3.11 (±0.61) 2.86 (±0.66) 18 Self-Efficacy 3.51 (±0.88) 3.17 (±0.55) 3.64 (±0.75) d 3.13 (±0.70) c 3.34 (±0.72) 3.39 (±0.66) 3.28 (±0.67) 19 Self-Regulation 4.11 (±0.91) g 3.63 (±1.23) 3.64 (±1.43) 3.84 (±0.94) 4.02 (±0.87) 3.77 (±0.83) 3.36 (±0.98)a Mean ±SD Players present at training ±4 23 ± ±1 21 ±1 18 ±1 Training (no.) injuries (per 1000 training hours) 0- (8) 5(19.6) (5)1(5.7) (1)1(34.1) (3) 0- (2) 1(17.9) (2) 0- Total Match injuries (per 1000 playing hours) 0-12(694) 12(694) 8(427) 11(636) 4(231) 7(405) Missed Match injuries (per 1000 playing hours) 0-2(116) 1(58) 0-3(174) 1(58) 0- Results (W = win; L = Loss; H = home; A = Away) - (L) (A) (W) (H) (L) (H) (L) 0-30 (A) (W) (H) (L) (A) SD: Standard deviation; Significant difference (p < 0.05) with (a) pre-competition; (b) week 1; (c) week 2; (d) week 3; (e) week 4; (f) week 5; (g) week 6.

10 International Journal of Sports Science & Coaching Volume 5 Number scales in Emotional Exhaustion between pre-competition and week 2 (F = 4.32, df = 34, p = 0.045) and Injury between weeks 1 and 3 (F = 4.65, df = 34, p = 0.038). CHANGES IN THE RECOVERY-STRESS STATE Significant differences were observed in the total stress score between pre-competition and week 4 (t = 2.05, df = 32, p = 0.048), and in the total recovery score between weeks 2 and 5 (t = 2.10, df = 37, p = 0.043) (see Figure 1). Figure 1. RESTQ Sport Total Stress Score and Total Recovery Score with Standard Deviation over the Duration of the Study DISCUSSION This is the first study to use the RESTQ-Sport to monitor a sporting team during competition matches. Although some studies have undertaken to use the RESTQ-Sport on sports participants in the training environment, 18, 19, 34 and as part of a recovery program, 33 to date, no studies have used the RESTQ-Sport for assessing members of a sporting team over a competition. In a study on rugby union participants, it was identified that the RESTQ-Sport was beneficial for use on an individual basis but not for the team as a group. 41 Individually the RESTQ-Sport was useful for review of lowered performance and to identify the current level of stress and recovery, but it was unable to be used for the prediction of future performance and injury. 41 As well, it was reported that there was a time delay from completing the questionnaire to being able to analyse the results due to the calculation of the results. This finding was similar for the current study. Player s completed the RESTQ-Sport at the first training session following the match but, due to the time requirements to complete the questionnaire analysis any areas identified were unable to be assessed until after the next training session. Despite this, close liaison with the coaching staff of the team was undertaken and, if any concerns were identified, they were contacted directly for immediate follow up.

11 232 Stress and Recovery in Rugby League The statistical differences observed in the Social Stress scale between weeks 4 and 5 may be related to the programming of the competition. Due to adverse weather conditions, week 2 games were cancelled and moved to a mid-week time requiring the players to compete in subsequent matches three days apart. Subsequently players were required to train on different days to allow for a shortened rest period before undertaking another contact match. The statistical differences observed in the Lack of Energy and Success scales may also reflect this increased match requirement. With the shortened recovery period on week 3, the Injury scale was higher than the previous weeks, and was the highest mean score for the duration of the study. Additionally, the team lost the match prior to the week 5 assessment by one point in the last minute and the effects of this may be evident by the lowered Success scale mean score for that assessment. This result may also be reflected in the Fatigue and Social Recovery for the same week. The authors of the RESTQ-Sport 27 recommended that it is best utilized as an individual tool to monitor performance, not for group assessment of participants. Additionally, the authors report that the tool can be used as a likely predictor of future performance and links itself to medical complaints. 27 This was evident in the pre-competition assessment of the cohort of players in this study. As shown in Figure 2, the group mean score for the RESTQ- Sport shows low-scored stress scales (General Stress, Emotional Stress, Social Stress, Conflicts/Pressure, Fatigue, Lack of Energy and Physical Complaints); but, when analyzed by individual players, players A and B recorded higher scores in most, but not all of the stress areas than the group mean. This was similar for sport-specific stress (Disturbed Breaks, Emotional Exhaustion, Injury) with Player A recording the highest score for Injury and Disturbed Breaks for the group. Player B also recorded a higher Disturbed Break and Injury score than the group mean. Conversely, these players recorded lower scores in the recovery (Success, Social Recovery, Physical Recovery, General Well-Being and Sleep Quality) and Figure 2. Pre-Competition RESTQ-Sport Profile for Player A, Player B and Group Mean (with Standard Deviation)

12 International Journal of Sports Science & Coaching Volume 5 Number sport-specific recovery (Being in Shape, Personal Accomplishment, Self-Efficacy and Self- Regulation) aspects of the RESTQ-Sport than the group mean. Given the profile of Players A and B, the future participation in the competition was addressed. Upon individual consultation by the coach and the team medic with the players, Player A withdrew due to bilateral patella tendonitis as this was causing the player concern (Injury score = 4.50). Player B (lumbar strain) continued in the competition undertaking ongoing monitoring (see Figure 3) and, with management of the player by a physiotherapist and the team medic, continued to participate in every match over the competition. As can be seen in Figure 3, the scores for the stress and sport-specific stress reduced (except where he was injured in game 3 of the competition) while his general and sport-related recovery scales increased. The RESTQ-Sport was utilized on the first training session after every match and took approximately minutes for the players to complete. Team management was supportive of this occurring and programmed the time into the training schedule. Despite this, the analysis of the questionnaires was not able to be completed until after the first training session and a conservative approach was required for training on this session. Typically, the first training session was the second day following the match, and was a recovery session with no field-based activities completed. In some cases, this was the only training session conducted due to the frequency of programmed matches. Where there was a subsequent training session programmed before another match, the training intensity was moderated based on the previous RESTQ-Sport results. Some team sport management may not be supportive of allocating this amount of time to player monitoring and other recovery monitoring tools may be more appropriate as an alternative to using the RESTQ-Sport (e.g., Total Quality Recovery (TQR) scale, 42 the Daily Analysis of Life Demands for Athletes (DALDA) scale 43 ) or the Recovery-Cue 44. Figure 3. RESTQ-Sport Results for Player B Pre-Competition, Weeks 1, 3 and 6

13 234 Stress and Recovery in Rugby League Although the RESTQ-Sport did not predict any future performance or injury of the players, it did reflect how the players were dealing with the effects of amateur participation and other requirements in their own life (work, relationships, etc.). While changes of the total stress and recovery scores (Figure 2) may be considered relatively small, they are of applied and practical use. In this context, it needs to be considered that the total stress score averages 10 stress scales, whereas the total recovery score averages nine scales. At the same time, the standard deviation indicates a higher variability within the total stress score and a smaller variability within the total recovery score. However, specifically for the total recovery score this indicates that most of the players score below more often which in turn leaves room to improve recovery activities. The RESTQ-Sport aided in providing some visual feedback to the coaching staff, and individual players, of how this was occurring. By assessing the stress and recovery aspects of the questionnaire results, training sessions and pre-match activities were adjusted to facilitate team recovery and to aid in stress reduction. When viewing the mean score of sports stress by weeks, and comparing this with the following match injury rate, there was a similar peak in the incidence of injuries observed in the match with the previous injury and emotional scale mean scores. For example, on week 3 the mean injury score was recorded at 2.82 (±0.99) and the following match recorded the highest missed match injury rate (174 per 1,000 match hours). But on the subsequent week, when the injury scale score dropped to 2.50 (±0.79), there were no missed match injuries recorded. Further longitudinal studies are warranted to see if in fact the use of the RESTQ-Sport can assist in identification of players at risk of potential injuries in team sports such as rugby league. It is hoped that by undertaking these studies this will assist in identifying the sensitivity surrounding fluctuating score to help predict players at risk of, or be associated with, collision injuries. LIMITATIONS AND DELIMITATIONS Previous studies specifically researching the RESTQ-Sport on the effects of training on stress and recovery have been undertaken on a cohort of participants in a training camp. 18, 19, 26 This study was undertaken on participants who turned up to training, and left at the completion of the training session to return to their own lives outside of rugby league. Activities such as employment, academia and family requirements and stressors were not monitored, nor were they controlled. The recovery process of the participants was always monitored to ensure the best possible recovery was employed to keep players in both a positive physical and psychological state. 45, 46 Another limitation to this study is the frequency of training. Due to adverse weather conditions, matches were postponed necessitating changes in training routines and training venues and time between the RESTQ- Sport. There was no consistent training venue for the duration of the study, nor were there a consistent number of participants present at the trainings. Players not present at the training session when the RESTQ-Sport was conducted were not followed up. However, as the study is set in a real-life situation, the results of this study may be applied to other team sports in an amateur setting. This application indicates a high external validity of the study. The delimitations to this study are that only one team was studied with a limited number of participants. The study was also conducted following the regular season completion for a shorter period of time than the typical rugby league season. CONCLUSION This study used the RESTQ-Sport to assess the stress and recovery of a team-based sport during participation in a short competition. Although the RESTQ-Sport was able to capture

14 International Journal of Sports Science & Coaching Volume 5 Number the relevant information on the stress and recovery of team-based players, further longitudinal studies are warranted to determine whether this tool could become part of a regular season assessment tool for the management of players. REFERENCES 1. Gabbett, T., Incidence of Injury in Junior and Senior Rugby League Players, Sports Medicine, 2004, 34(12), Gabbett, T., Incidence of Injury in Junior Rugby League Players Over Four Competitive Seasons, Journal of Science and Medicine in Sport, 2008, 11(3), King, D. and Gabbett T., Training Injuries in New Zealand Amateur Rugby League Players, Journal of Science and Medicine in Sport, 2008, 11(6), Estell, J., Shenstone, B. and Barnsley, L., Frequency of Injuries in Different Age-Groups in an Elite Rugby League Club, Australian Journal of Science and Medicine in Sport, 1995, 27(4), Gissane, C., Jennings, D., Kerr, K. and White, J., Injury Rates in Rugby League Football: Impact of Change in Playing Season, American Journal of Sports Medicine, 2003, 31(6), Meir, R., Arthur, D. and Forrest, M., Time and Motion Analysis of Professional Rugby League: A Case Study, Strength and Conditioning Coach, 1993, 1(3), Meir, R., Evaluating Players Fitness in Professional Rugby League: Reducing Subjectivity, Strength and Conditioning Coach, 1993, 1(4), Gissane, C., White, J., Kerr, K. and Jennings, D., Physical Collisions in Professional Rugby League: The Demands on Different Player Positions, Cleveland Medical Journal, 2001, 4, Gissane. C., Jennings, D., Jennings, S., White, J. and Kerr, K., Physical Collisions and Injury Rates in Professional Super League Rugby, The Demands of Different Player Positions, Cleveland Medical Journal, 2001, 4, Gabbett T., Incidence, Site, and Nature of Injuries in Amateur Rugby League Over Three Consecutive Seasons, British Journal of Sports Medicine, 2000, 34(2), Gabbett, T. and Domrow, N., Risk Factors For Injury in Subelite Rugby League Players, American Journal of Sports Medicine, 2005, 33(3), Kraemer, W., French, D., Paxton, N., Häkkinen, K., Volek, J., Sebastianelli, W., Putukian, M., Newton, R., Rubin, M., Gómez, A., Vescovi, J., Ratamess, N., Fleck, S., Lynch, J. and Knuttgen, H., Changes in Exercise Performance and Hormonal Concentrations Over A Big Ten Soccer Season in Starters and Nonstarters, Journal of Strength and Conditioning Research, 2004, 18(1), Coutts, A., Wallace, L. and Slattery, K., Monitoring Changes in Performance, Physiology, Biochemistry, and Psychology During Overreaching and Recovery in Triathletes, International Journal of Sports Medicine, 2007, 28(2), Odgers, T., Lannigan, M. and Newton, M., Increased Power: A Program Utilising Light Weights and Infra- Red Timing, Sports Coach, 1992, 15(2), Krieder, R., Fry, A. and O Toole, M., Overtraining in Sport: Terms, Definitions, and Prevalence, in: Kreider, R. Fry, A. and O Toole, M., eds., Overtraining in Sport: Human Kinetics, Champaign, IL, 1998, vii-ix. 16. Adams, J. and Kirkby, R., Exercise Dependence and Overtraining: The Physiological and Psychological Consequences of Excessive Exercise, Sports Medicine and Training Rehabilitation, 2001, 10, Fry, R., Morton, A. and Keast, D., Overtraining in Athletes: An Update, Sports Medicine, 1991, 12(1), Kellmann, M., Altenburg, D., Lormes, W. and Steinacker, J., Assessing Stress and Recovery During Preparation for the World Championships in Rowing, Sports Psychology, 2001, 15, Kellmann, M. and Günther, K-D., Changes in Stress and Recovery in Elite Rowers During Preparation for the Olympic Games, Medicine and Sciecne in Sports and Exercise, 2000, 32(3), Derman, W., Schwellnus, M., Lambert, M., Emms, M., Sinclair-Smith, C., Kirby, P. and Noakes, T., The Worn-Out Athlete : A Clinical Approach to Chronic Fatigue in Athletes, Journal of Sports Sciences, 1997, 15,

15 236 Stress and Recovery in Rugby League 21. Budgett, R., Newsholme, E., Lehmann, M., Sharp, C., Jones, D., Peto, T., Collins, D., Nerurkar, R. and White, P., Redefining the Overtraining Syndrome as the Unexplained Underperformance Syndrome, British Journal of Sports Medicine, 2000, 34(1), Coutts, A., Reaburn, P., Piva, T. and Roswell, G, Monitoring for Overreaching in Rugby League Players, European Journal of Applied Physiology, 2007, 99, Halson, S., Lancaster, G., Jeukendrup, A. and Gleeson, M., Immunological Responses to Overreaching in Cyclists, Medicine and Science in Sports and Exercise, 2003, 35, Urhausen, A. and Kindermann, W., Diagnosis of Overtraining: What Tools Do We Have?, Sports Medicine, 2002, 32, Meeusen, R., Duclos, M., Gleeson, M., Reitjens, G., Steinacker, J. and Urhausen, A., Prevention, Diagnosis and Treatment of the Overtraining Syndrome. ECSS Position Statement Task Force, European Journal of Sport Science, 2006, 6(1), Kellmann, M. and Kallus, K., Mood, Recovery-Stress State, and Regeneration, in: Lehmann, M., Foster, C., Gastmann, U., Keizer, H. and Steinacker, J., eds, Overload: Performance Incompetence and Regeneration in Sport, Kluwer Academic/Plenum Publishers, New York, 1999, Kellmann, M. and Kallus, W., Recovery-Stress Questionnaire for Athletes: User Manual, Human Kinetics, Champaign, IL, Jürimäe, J., Mäestu, J., Purge, P. and Jürimäe, T., Changes in Stress and Recovery After Heavy Training in Rowers, Journal of Science and Medicine in Sport, 2004, 7(3), Filaire, E., Rouviex, M. and Dulcos, M., Training and 24-hr Urinary Catecholamine Excretion, International Journal of Sports Medicine, 2009, 30, Mäestu, J., Jürimäe, J. and Jürimäe, T., Monitoring Performance and Training in Rowing, Sports Medicine, 2005, 35(7), Mäestu, J., Jürimäe, J., Kreegipuu, K. and Jürimäe, T., Changes in Perceived Stress and Recovery During Heavy Training in Highly Trained Male Rowers, Sports Psychology, 2006, 20, González-Boto, R., Salguero, A., Tuero, C., González-Gallego, J. and Marquez, S., Monitoring the Effects of Training Load Changes on Stress and Recovery in Swimmers, Journal of Physiology and Biochemistry, 2008, 64(1), Tessitore, A., Meeusen, R., Pagano, R., Benvenuti, C., Tiberi, M. and Caprancia, L., Effectiveness of Active Versus Passive Recovery Strategies After Futsal Games, Journal of Strength and Conditioning Research, 2008, 22(5), Coutts, A. and Reaburn, P., Monitoring Changes in Rugby League Players Perceived Stress and Recovery During Intensified Training, Perceptual and Motor Skills, 2008, 106(3), King, D. and Gabbett, T., Injuries in the New Zealand Semi-Professional Rugby League Competition, New Zealand Journal of Sports Medicine, 2009, 36(1), King, D., Gabbett, T., Gissane, C. and Hodgson, L., Epidemiological Studies of Injuries in Rugby League: Suggestions for Definitions, Data Collection and Reporting Methods, Journal of Science and Medicine in Sport, 2009, 12(1), King, D., Gabbett, T., Dreyer, C. and Gerrard, D., Incidence of Injuries in the New Zealand National Rugby League Sevens Tournament, Journal of Science and Medicine in Sport, 2006, 9(1-2), Kellmann, M. and Beckmann, J., Research and Intervention in Sport Psychology: New Perspectives for an Inherent Conflict, International Journal of Sport and Exercise Psychology, 2003, 1, Gabbett, T., Training Injuries in Rugby League: An Evaluation of Skill-Based Conditioning Games, Journal of Strength and Conditioning Research, 2002, 16(2), Twellaar, M., Verstappen, F. and Huson, A., Is Prevention of Sports Injuries a Realistic Goal? A Four-Year Prospective Investigation of Sports Injuries Among Physical Education Students, American Journal of Sports Medicine, 1996, 24(4),

16 International Journal of Sports Science & Coaching Volume 5 Number Marshall, J., Measuring Stress and Recovery in Rugby Union, Rugby Football Union Technical Journal, 2004(1st Quarter), 1-14, ssphyscology/stress_and_recovery.ashx, Accessed 20 September Kentta, G. and Hassmen, P., Overtraining and Recovery. A Conceptual Model, Sports Medicine, 1998, 26(1), Rushall B., A Tool for Measuring Stress Tolerance in Elite Athletes, Journal of Applied Sport Psychology, 1990, 2(1), Kellmann, M., Patrick, T., Botterill, C. and Wilson, C., The Recovery-Cue and Its Use in Applied Settings: Practical Suggestions Regarding Assessment and Monitoring of Recovery, in: Kellmann, M., ed., Enhancing Recovery: Preventing Underperformance in Athletes, Human Kinetics, Champaign, IL, 2002, Brown, R., Exercise as an Adjunct to the Treatment of Mental Disorders, in: Morgan, W. and Goldston, S., eds; Exercise and Mental Health, Hemisphere, Washington DC, 1987, Dishman, R., Mental Health, in: Seefeldt, V., ed., Physical Activity and Well Being, American Alliance of Health, Physical Education, Recreation, and Dance, Reston, VA, 1986,

17