Integrating Sport-Specific Comprehensive Training to Upscale Performance in Women and Girls (SUPERGirl)

The overarching objective of the SUPERGirl program is to understand FWG perspectives, develop outcomes and integrated training strategies to optimize performance in FWG athletes. The primary aims of the SUPERGirl program are to:

1. Understand FWG perspectives on sport performance
2. co-design FWG sport-specific performance measures and SUPERGirl training programs
3. Evaluate the association between FWG multidomain outcomes and performance
4. Evaluate the feasibility of and effects of SUPERGirl training on performance
5. Refine the SUPERGirl training program in 11-26 year old FWG athletes.

FWG athletes will complete questionnaires and a cross-sectional survey, multisystem outcomes and performance-based outcomes. These outcomes will be completed following 6 weeks of typical training, after SUPERGirl training and again at the end of the season. At the start of the study, participants will also complete a survey to understand perspectives on performance and at the end of the study, participants will complete a survey to share their experiences with the SUPERGirl program and their recommendations for future iterations of the program. A subset of participants will be purposively sampled to participate in semi-structured interviews.

Aim 1: The researchers will implement a concurrent mixed methods approach using a cross-sectional survey to understand FWG perspectives on sport performance. The survey will include a series of questions related to the participants' perception of contributors to sport performance as well as open-ended questions that inquire about barriers and facilitators to optimal performance guided by the FUEL model.

Aim 2: Co-design FWG sport-specific performance measures and the SUPERGirl training program: The researchers will use a community based participatory research (CBPR) approach guided by a knowledge to action framework. The researcher's pilot work, previous literature, existing sport training, together with the survey output will inform co-design of:

1. meaningful team and individual sport-specific performance measures (e.g. win/loss/tie records, individual technical and/or tactical skills)
2. the SUPERGirl training program. Survey and co-design partners will include interested end-point sport knowledge users with different areas of expertise (e.g. athletes, parents, coaches, technical leads, sport administrators, health care professionals) Potential components of the training protocol include sensorimotor training (SM), mental performance training (MP), mental health (MH), and typical physical training. Additional factors such as growth and development, diet, and sleep, will also be considered and informed from the outputs of the survey.

Performance outcomes: Feasibility, reliability, and validity will be evaluated in a subset of participants.

Training strategies: Based on current literature and the research team's pilot work, it is anticipated that multiple components of sport- and FWG-specific SM training, MP, mental health strategies, nutrition, sleep, etc. will be interwoven into the current physical training programs to co-design the initial SUPERGirl training program.

This co-design process will incorporate the collective local knowledge and guidance of the CAB. We anticipate some aspects will be common to all sports (which will be included as multisport outcomes/training as a basis for other sports to build upon), while other aspects will be sport-specific. Given the pilot nature of this study, the researchers will include an initial convenience sample of 200 ice hockey and 25-50 skeleton athletes (depending on the size of the local Calgary team).

Aim 3: Evaluate the association between FWG multidomain outcomes and performance: A cross-sectional design will be used to evaluate the association between multimodal measures (exposures) and performance (outcome), assessed at the initial timepoint and following the SUPERGirl training in an inclusive sample of participating FWG ice hockey teams and skeleton athletes. Physical, SM, MP, sociocultural, nutrition, mental health, and sport experience will be included as exposures. The initial timepoint will use team/time performance outcomes. Secondary outcomes will include mental health, injury, concussion, and participation rates.

Aim 4: Evaluate the feasibility and efficacy of SUPERGirl training on performance: A quasi-experimental design will be used to evaluate the SUPERGirl training program (intervention) compared to standard training (control season prior to SUPERGirl training) from a feasibility and efficacy standpoint (exploratory outcome). An estimated 6 weeks of SUPERGirl training to be adequate based on current literature, however program parameters (e.g. frequency, duration, intensity) will be adapted based on the needs of the community partners and feedback from the CAB. Weekly coach, trainer and athlete feedback during training will be sought to inform adaptations to training. Components of training will be recorded. The efficacy of SUPERGirl training on multidomain outcomes, mental health, concussion and injury risk will be explored. Injury will be defined as any injury that results in time loss or medical attention. Concussion will be defined as per the Amsterdam International Consensus in Sport.

Aim 5: Refine the SUPERGirl training program: Following SUPERGirl training, a survey will be shared with participants to understand their experience in the SUPERGirl training program. Additionally, results of the first year of the SUPERGirl cohort will be used to refine the initial SUPERGirl training program. Following completion of the SUPERGirl training program, FWG athlete, coach and sport parties will be invited to participate in semi-structured interviews (one-on-one or focus group) to better understand their perspectives on the SUPERGirl training program and the FWG sport experience, particularly performance and specific training factors. A descriptive qualitative approach will be used to inductively analyze the data from the interviews and provide recommendations for future SUPERGirl training.

Outcomes:

Physical:

Knee Extensor Explosive Strength: Knee extensor explosive strength will be assessed using a rigid custom-built dynamometer mounted with a load cell sampling at 1000 Hz. Participants will be positioned in the seat with the centre of the knee joint aligned with the axis of rotation. The backplate will be adjusted to maintain a hip flexion angle of 80° relative to full extension, and the load cell connected to a shank plate will be adjusted to the same position for all participants, approximately 2.5 cm above the lateral malleolus. Testing will be conducted at 80° of knee flexion relative to full extension, verified using a goniometer. Velcro straps will be secured across the shoulders, waist, and thigh to minimize participant movement. The participant's shank will be strapped to an ankle attachment with a Velcro strap. The moment arm, defined as the distance from the knee joint centre to the contact point with the ankle attachment, will be measured using a measuring tape. The seat position and moment arm from the centre of the knee joint to the load cell will be recorded for each participant to ensure that the setup is identical across testing sessions.

Participants will be instructed to hold the sides of the chair for additional stability and to avoid any countermovement action before contraction. Contractions showing a countermovement will be discarded and repeated.

Participants will first complete three maximal voluntary isometric contraction repetitions of knee extension using the right limb. Each contraction will be held for 3 seconds, with a 20-second rest interval between repetitions. Participants will be instructed to achieve maximal voluntary torque "as fast and as hard as possible," with strong verbal encouragement during testing. A computer monitor will provide continuous visual feedback of knee extensor force. Following a 5-minute rest interval, burst contractions will be performed for the right knee extensors. A knee extensor torque target, calculated as 80% of the MVIC knee extensor torque, will be visually displayed on the monitor. Participants will perform 10 burst contraction repetitions lasting 1 second with the aim of reaching the torque target. Participants will be instructed to "create torque as fast as possible," with strong verbal encouragement during testing. Each repetition will be separated by a 15-second rest interval. Participants will then be given a 10-minute rest before performing the same protocol using the left limb.

Lower Limb Explosive Strength: Lower-limb force-velocity testing will be assessed using loaded countermovement jump testing and robotic servomotor leg press maximal voluntary contraction testing. Participants will complete a standardized 10-minute warm-up protocol at a self-selected moderate intensity on a cycle ergometer, followed by four 10-second maximal cycling sprints interspersed with 50 seconds of rest. After warming up, participants will perform five maximal-effort repetitions of countermovement jump testing with no external load, followed by three maximal-effort repetitions with 30% of body mass loaded on a hexagonal trap bar and three maximal-effort repetitions with 60% of body mass loaded on a hexagonal trap bar. Each loading condition will be separated by a 3-5-minute rest period, and each countermovement jump repetition will be separated by 20 seconds of rest.

Participants will then perform three MVCs of isometric, concentric, and eccentric leg press force testing using a robotic servomotor leg press. This will include three MVCs of isokinetic eccentric and concentric leg press actions performed at a constant speed of 0.2 m·s-¹. Each strength test will be separated by a 3-5-minute rest period, and each repetition will be separated by a 10-second rest interval. Strong verbal encouragement will be provided throughout the testing session by a certified exercise physiologist.

MVC leg extensor strength will be measured using a robotic servomotor leg press device sampling at 200 Hz. Three repetitions of MVC eccentric and concentric leg press movements will be performed between 100° and 10° of knee flexion at a constant speed of 0.2 m·s-¹, with a 0.5-second pause between the concentric and eccentric movement phases. Servomotor torque will be converted into force and low-pass filtered using a fourth-order recursive zero-lag Butterworth filter with a 6 Hz cut-off frequency. The acceleration phase of the isokinetic MVCs will be removed using the manufacturer's software to define a stable isokinetic phase across the leg press range of motion. Each force-time curve will be visually inspected to exclude erroneous trials. The repetitions with the highest peak eccentric MVC force, peak concentric MVC force, and maximal isometric MVC force will be used for analysis.

The force-velocity models will be built using vertical take-off velocity from countermovement jump testing and external load normalized to maximal unilateral concentric MVC force converted to kilograms. The countermovement jump repetition with the highest take-off velocity at each loading condition will be plotted with a best-fit least-squares linear regression function to obtain the maximum velocity intercept, Vmax, and the slope of the velocity-load relationship.

Countermovement Jump Stretch-Shortening Cycle Mechanics: Countermovement jump stretch-shortening cycle mechanics will be assessed using a dual force plate system sampling at 1000 Hz. Participants will be instructed to keep their hands firmly placed on their hips during unloaded countermovement jump testing to isolate the contributions of the lower limbs to vertical jump height and body centre of mass power and work production. During loaded countermovement jump testing, participants will hold the hexagonal trap bar and will be instructed to keep their arms straight throughout the entire jumping procedure. Participants will freely determine all other aspects of jump strategy, including their preferred depth, defined as downward body centre of mass displacement. The vertical ground reaction forces of the right and left leg will be measured synchronously and stored for later offline analysis.

Body centre of mass vertical velocity will be obtained by time integration of the instantaneous acceleration signal from the sum of the left and right vertical ground reaction force signals.

Maximal Sprint Speed: Maximal sprint speed (vMax) will be assessed using a 40 m linear sprint with electronic timing gates positioned perpendicular to a flat, non-slip sprinting surface at 10, 20, 30, and 40 m. Over-ground sprint testing across distances of 5-40 m is commonly used to assess sprint ability in youth athletes. Timing gates will be set at a standardized height of 1.0 m from the ground and positioned 1.22 m apart, corresponding to the approximate width of a standard track lane.

Participants will begin from a stationary two-point standing start with the front foot positioned at the 0 m start line. Participants will start when ready and will be instructed to sprint maximally through the 40 m finish line without decelerating before the final timing gate. Each athlete will complete three maximal sprint trials, with 3-5 min of passive recovery between trials. Split times will be recorded at 10, 20, 30, and 40 m. vMax will be calculated from the fastest 10 m split recorded between timing gates, using the 10-20 m, 20-30 m, and 30-40 m intervals. The fastest valid trial will be retained for analysis.

Maximal Aerobic Speed: Maximal aerobic speed (vMAS) was estimated using a 5-minute maximal running time trial performed on an indoor track. Athletes were instructed to cover the greatest possible distance in 5 minutes using an even maximal pacing strategy. Total distance covered was recorded to the nearest meter. The 5-minute running field test was selected because it provides a practical group-administered estimate of vMAS and has demonstrated strong agreement with treadmill-derived vMAS, and the test has also demonstrated strong test-retest reliability in trained men and women.

5-10-5 Change of Direction Test: Change-of-direction speed will be assessed using the standardized 5-10-5 shuttle test. The course consisted of three parallel lines positioned in a straight line, with the centre line serving as the start/finish line and two turn lines positioned 5 yards (4.57 m) to the left and right of centre on a flat, dry, non-slip surface with sufficient space beyond each turn line. This produced a total running distance of 20 yards (18.28 m): 5 yards to the first turn line, 10 yards (9.14 m) to the opposite turn line, and 5 yards back through the finish. Electronic timing gates were positioned at the centre start/finish line, perpendicular to the running direction. Timing gates were set at a standardized height of 1.0 m and positioned consistently for all athletes and across all testing sessions.

Athletes begin in a three-point stance straddling the centre line, with feet placed on either side of the line. The hand in contact with the floor corresponded to the initial direction of travel. Athletes started when ready and were instructed to accelerate maximally to the first turn line, touch the line with the lead foot and hand, change direction and sprint 10 yards to the opposite turn line, touch the line with the lead foot and hand, then change direction again and sprint 5 yards back through the centre finish line.

Each athlete completed trials in both starting directions. Athletes completed 3 maximal trials per direction, with 2-3 minutes of passive recovery between trials. Trials were considered invalid if the athlete failed to touch either turn line with the foot and hand, slipped, fell, deviated from the required path, or failed to sprint maximally through the finish line. The fastest valid trial was retained for analysis. If directional performance was being examined, the fastest valid trial in each starting direction was retained separately.

Sensorimotor: Please see documents section for detail. Cervical Spine outcomes: Cervical Spine range of motion (full/reduced), Cervical Flexor Endurance (CFE), Cervical Flexion Rotation Test (CFRT), Manual Spinal Exam (MSE), Cervical anterolateral flexion strength; Joint Position Sense, Head Perturbation Test (HPT) Vestibulo-ocular reflex (VOR) outcomes: Head thrust test (HTT), dynamic visual acuity, functional video head impulse test (f-vHIT) Quantified Vestibular Ocular Motor Screen (qVOMS): The VOMS with a clinician observed rating of performance on each of the 7 tests.

Additional Vision outcomes: accommodation, Frisby test Dynamic balance: Advanced Functional Gait Assessment (/48) Divided Attention: walking while talking test and timed dual task tandem gait

Ottawa Mental Skills Assessment Tool-3:12 mental skills measure: goal setting, self-confidence, commitment, stress reactions, relaxation, fear control, activation, focusing, imagery, competition planning, mental practice, and refocusing;

Mental health:

Sport Mental Health Assessment Tool (SMHAT) PHQ9, GAD7

Sport Specific Performance:

Ice hockey: Hockey Canada Skills Test: The Transition-Agility Skate course will be set up using four pylons arranged in a square measuring 24 ft × 24 ft (7.32 m × 7.32 m), measured from the centre of each pylon base. The start/finish line will be positioned at the bottom of the circle on the near side of the course, and the designated stop line will be positioned on the opposite side of the course, as shown in Figure 2. Pylon locations, the start/finish line, and the stop line will be measured before testing and marked on the ice using spray paint or tape to ensure consistent placement across athletes and trials. If a pylon is displaced, it will be returned to the marked location before the next trial.

Each player will begin from a stationary hockey-ready T-start position 0.5 m behind the start/finish photocell beam. The lead skate will be oriented toward the first pylon, with the rear skate positioned approximately perpendicular to the lead skate. Athletes may use their preferred lead foot; however, the same lead foot and starting stance must be used across all trials. Right and left directions will be defined from the athlete's perspective at the start position.

The player will skate forward to the far-right side pylon, pivot, and skate backward to the lower-right side pylon. The player will then pivot and skate forward to the far-left side pylon, pivot, and skate backward to the lower-left side pylon. The player will then pivot, skate forward to the designated line, stop completely, and skate back through the start/finish line. Players will complete the test first without a puck and then with a puck.

Timing will be recorded using paired laser photocell timing gates positioned at the start/finish line. The transmitter and receiver will be placed 2.0 m apart, centred on the athlete's intended skating path, with the beam set at 1.0 m above the ice surface. Timing will begin automatically when the athlete crosses the start/finish photocell beam and will stop when the athlete crosses back through the same beam at the end of the trial. The 0.5 m starting distance, photocell height, gate width, and gate location will be kept consistent across all athletes and trials.

For puck trials, the puck will be positioned on the ice directly in front of the athlete's stick blade and fully behind the photocell beam. The athlete, stick blade, and puck will not be permitted to cross or obstruct the beam before trial initiation. Athletes must begin with the puck under control and avoid extending the stick or puck through the timing gate before starting.

Each athlete will complete two valid trials without a puck and two valid trials with a puck. A passive recovery period of 2-3 minutes will be provided between trials. The fastest valid trial from each condition will be retained for analysis.

Athletes will be instructed to complete the course as quickly as possible while following the prescribed skating pattern and maintaining control. A trial will be considered valid only if the player completes the full course in the correct order, skates around the required side of each pylon, performs the required stop at the designated line, maintains the required skating pattern, and crosses the finish line under control.

A trial will be considered invalid and repeated if the athlete misses a pylon, completes the course in the wrong order, skates on the wrong side of a pylon, fails to complete the required stop, falls, stops unintentionally, triggers the timing system early, or fails to skate through the finish line. For puck trials, the trial will also be invalid if the athlete loses control of the puck such that the intended skating pattern or forward progression is disrupted, if the athlete finishes the trial without the puck, or if the athlete, stick, or puck prematurely triggers the photocell beam before trial initiation.

Incidental pylon contact will be permitted if the athlete maintains the correct skating path, retains control, and does not gain an advantage. Knocking over, displacing, or bypassing a pylon will invalidate the trial.

Skeleton: Gold Medal Profile (GMP), National Ranking System (NRS), Individual Race Performances (Percent-Back Calculations): Skeleton sport-specific performance will be assessed using percent back from the race winner. Official race results will be used to extract each athlete's total race time and the winning race time. All race times will be converted to seconds before analysis. Percent back will be calculated as the athlete's race time minus the winning race time, divided by the winning race time, multiplied by 100. This produces a relative race-performance outcome where the race winner receives a value of 0.00%, and higher values represent a greater time deficit from the race winner. Lower percent-back values will therefore indicate better skeleton race performance. Percent back from the leader is used by Bobsleigh Canada Skeleton as a competition performance variable within National Skeleton Program performance evaluation and ranking procedures.

Percent back will be calculated separately for each race before any aggregation across races or competitions. When multiple races are included, each athlete's mean percent-back value will be calculated from their valid race results.

When qualification or cut procedures prevent some athletes from completing additional runs, percent back will be calculated using stage-matched cumulative times. Athletes who do not qualify for subsequent runs will be assigned a percent-back value relative to the leader at the same completed stage of competition. For example, athletes eliminated after Run 1 will be compared with the Run 1 leader, and athletes eliminated after Run 2 will be compared with the leader's cumulative time after Runs 1-2. Final-race percent back will only be calculated for athletes who complete all runs included in the final race classification.

Athletes with no valid official finish time because of "Did not start" (DNS), "Did not finish" (DNF), or "Disqualified" (DSQ) will be excluded from percent-back calculation for that race.