Research in high performance sport - a question of logistics not ethics

Finding good quality research that is of value to enhancing performance in sport is difficult, especially if we look for ecologically valid studies where participants are assembled from an elite group of athletes.  This poses a problem for applied practitioners who want to, as best they can, adopt an evidence based approach to their work.  In the relative absence of such data we find ourselves using research that is within the chosen area of interest however conducted with participants below the standard of athlete with whom we are working.  A common reason cited for the lack of scientific investigation within elite groups is an ethical one; exposing only half of the athletes to a potentially beneficial type of training or intervention may be deemed as unfair.  This of course is a significant deviation from what we consider to be a central tenet of sound scientific investigation, proving the null hypothesis to be true.

Whenever we are interested in the effect of a new treatment (for the purposes of this blog treatment encompasses a new training intervention/modality, nutritional aid or piece of equipment) we should start with the premise that it will be no better than what we currently have access to, representing the null hypothesis.  The aim of the investigation then is to prove this to be true.  Taking this approach turns the ethical question cited above on its head, as it infers no benefit of the new treatment.  If sufficient amounts of data are collected to disprove the null hypothesis then we conclude the alternative hypothesis to be true and can with confidence begin to prescribe the new treatment.  An example may serve to clarify this point.  We would all now accept that training with a reasonable level of volume and intensity is essential if we want to improve our VO2 max or lactate threshold.  This is the result of both anecdotal experience and scientific investigation revealing relatively high volumes of training to be effective in improving these variables.  Recent research however has suggested that intense yet brief efforts, equivalent of 2 minutes duration (4x30s efforts) may elicit similar responses.  This is an exciting finding, especially for those who have limited time to train.  As yet however there is insufficient evidence in elite level athletes to suggest that the null hypothesis (in this instance that brief high intensity training alone is better than high volume training) to be rejected.  As we do not yet know the potential benefits of this type of HIT training in athletes, withholding its use as part of a randomized control trial so that it can be compared to more traditional types of training should not be problematic.

We see similar problems in medical research investigating the effectiveness of drugs.  Ben Goldacre’s recent book ‘Bad Pharma’ highlights the problem with prescription medicines that have yet to be shown more effective than currently available remedies.  Some argue this in unfair as patients are being denied access to drugs that will potentially cure or alleviate their symptoms.  This however, as with our example from sport and exercise is not the case; since there is no evidence that the new drug is more effective patients are no worse off.

Adopting an evidence based approach to sport science provision is difficult, not least because of the dearth of data compiled and collected within this heterogeneous group.  Performing research within elite groups however should not pose an ethical conundrum to the practitioner, instead it represents an opportunity to understand with greater clarity the effect of different and perhaps more effective treatments.  Yes of course there are logistical considerations; however with sound planning and organisation these can be overcome as can the issue of timeframe and competitive advantage.  Institutes and professional teams may not want to publish their data whilst opponents can gain a competitive advantage.  This is understandable however building in a ‘publication threshold’ may solve the problem.  For commonwealth and Olympic sports this may be at the end of the training cycle (every 4 years).  If sport science is to continue as a ‘science’ it must extend the same rigor that exists in academic circles to the applied environment and commit to examining the effectiveness of each type of treatment it adopts to impact upon performance.

So where does this leave us when attempting to innovate within sport science?  Firstly all parties who engage in the physical and mental preparation of elite athletes should commit to performing and publishing research.  In doing this we can start to understand how different treatments work amongst this specific group of people.  We should also feel comfortable with utilising control groups when working with elite athletes enabling the assessment of new treatments against what is currently available or being used.  This approach should ensure we feel comfortable in the veracity of our practices whilst not falling foul of the many gadgets and fads marketed at giving our athletes the ‘edge’ they desire.