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Scapec B, Grgic J, Varovic D, Mikulic P. Caffeine, but not paracetamol (acetaminophen), enhances muscular endurance, strength, and power. J Int Soc Sports Nutr 2024; 21:2400513. [PMID: 39246027 PMCID: PMC11385662 DOI: 10.1080/15502783.2024.2400513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/30/2024] [Indexed: 09/10/2024] Open
Abstract
BACKGROUND Caffeine is one of the most popular ergogenic aids consumed by athletes. Caffeine's ergogenic effect has been generally explained by its ability to bind to adenosine receptors, thus modulating pain and reducing perceived exertion. Another pharmacological agent that may improve performance due to its analgesic proprieties is paracetamol. This study aimed to explore the effects of caffeine, paracetamol, and caffeine + paracetamol consumption on muscular endurance, strength, power, anaerobic endurance, and jumping performance. METHODS In this randomized, crossover, double-blind study, 29 resistance-trained participants (11 men and 18 women) ingested either a placebo, caffeine (3 mg/kg), paracetamol (1500 mg) or caffeine + paracetamol 45 min before the testing sessions. The testing sessions included performing the bench press exercise with 75% of one-repetition maximum to momentary muscular failure, isokinetic knee extension and flexion at angular velocities of 60°/sec and 180°/sec, Wingate, and countermovement jump (CMJ) tests. RESULTS Compared to placebo, isolated caffeine ingestion increased the number of repetitions performed in the bench press (p = 0.005; d = 0.42). Compared to placebo, isolated caffeine ingestion and/or caffeine + paracetamol consumption was ergogenic for strength (torque), muscular endurance (total work), or power in the isokinetic assessment, particularly at slower angular velocities (p = 0.027 to 0.002; d = 0.16 to 0.26). No significant differences between the conditions were observed for outcomes related to the Wingate and CMJ tests. CONCLUSION This study provided novel evidence into the effectiveness of caffeine, paracetamol, and their combination on exercise performance. We found improvements in muscular endurance, strength, or power only when caffeine was consumed in isolation, or in combination with paracetamol. Isolated paracetamol consumption did not improve performance for any of the analyzed outcomes, thus calling into question its ergogenic potential.
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Affiliation(s)
- Bela Scapec
- University of Zagreb Faculty of Kinesiology, Zagreb, Croatia
| | - Jozo Grgic
- National University of Singapore, Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, Singapore
- National University Health System, Centre for Healthy Longevity, Singapore
| | - Dorian Varovic
- University of Zagreb Faculty of Kinesiology, Zagreb, Croatia
| | - Pavle Mikulic
- University of Zagreb Faculty of Kinesiology, Zagreb, Croatia
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BenSalem S, Salem A, Boukhris O, Taheri M, Ammar A, Souissi N, Glenn JM, Trabelsi K, Chtourou H. Acute ingestion of acetaminophen improves cognitive and repeated high intensity short-term maximal performance in well-trained female athletes: a randomized placebo-controlled trial. Eur J Appl Physiol 2024:10.1007/s00421-024-05534-y. [PMID: 38951182 DOI: 10.1007/s00421-024-05534-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/11/2024] [Indexed: 07/03/2024]
Abstract
This study examined the effect of acute acetaminophen (ACTP) ingestion on physical performance during the 5 m shuttle run test (5mSRT), attention, mood states, and the perception of perceived exertion (RPE), pain (PP), recovery (PRS), and delayed onset of muscle soreness (DOMS) in well-trained female athletes. In a randomized, placebo-controlled, double-blind, crossover trial, fifteen well-trained female athletes (age 21 ± 2 years, height 165 ± 6 cm, body mass 62 ± 5 kg) swallowed either 1.5 g of ACTP or 1.5 g of placebo. The profile of mood states (POMS) and digit cancellation (DCT) were assessed 45 min postingestion, and 5mSRT was performed 60 min postingestion. The RPE and PP were determined immediately after each 30-s repetition of the 5mSRT, and the PRS and DOMS were recorded at 5 min and 24 h post-5mSRT. For the 5mSRT, ACTP ingestion improved the greatest distance (+ 10.88%, p < 0.001), total distance (+ 11.33%, p = 0.0007) and fatigue index (+ 21.43%, p = 0.0003) compared to PLA. Likewise, the DCT score was better on the ACTP (p = 0.0007) than on the PLA. RPE, PP, PRS, and DOMS scores were improved after ACTP ingestion (p < 0.01 for all comparisons) compared to PLA. POMS scores were enhanced with ACTP ingestion compared to PLA (p < 0.01). In conclusion, this study indicates that acute acetaminophen ingestion can improve repeated high intensity short-term maximal performance, attention, mood states, and perceptions of exertion, pain, recovery, and muscle soreness in well-trained female athletes, suggesting potential benefits for their overall athletic performance and mood state.
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Affiliation(s)
- Sahar BenSalem
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Atef Salem
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122, Mainz, Germany
- Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia
| | - Omar Boukhris
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia.
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia.
| | - Morteza Taheri
- Department of Behavioral and Cognitive Sciences in Sport, University of Tehran, Tehran, Iran
| | - Achraf Ammar
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122, Mainz, Germany
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Nizar Souissi
- Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia
| | - Jorden M Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia
- SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
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de Oliveira GM, Barcelos Andrade FA, Pereira AB, Viza RS, Gerspacher HF, da Costa Monteiro M, Campos HO, Drummond LR, Rios Leite LH, Celso Coimbra C. Is physical performance affected by non-steroidal anti-inflammatory drugs use? A systematic review and meta-analysis. PHYSICIAN SPORTSMED 2024; 52:207-216. [PMID: 37252825 DOI: 10.1080/00913847.2023.2220439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/29/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aim to analyze the effects of ingesting non-steroidal anti-inflammatory drugs (NSAIDs) on physical performance, muscle strength, and muscle damage in three different moments: immediately, 24 and 48 h after resistance exercise practice. METHODS Relevant studies were researched in three databases (PubMed, Web of Science and SPORTDiscus) in April 2023. After excluding duplicates, the decision to include or exclude studies was made by two independent investigators in the following steps: (I) the study title; (II) the study abstract; and (III) the complete study manuscript. The following characteristics were recorded: (I) first author, (II) year of publication, (III) sample size, (IV) method of NSAIDs administration, (V) exercise protocol, and (VI) analyzed variable results. The studies selected were divided into trials that evaluated the effects of NSAIDs ingestion on performance indices of resistance exercise, endurance exercise and resistance training. RESULTS The meta-analysis, based only on resistance exercises, revealed that both performance and muscle strength were similar between placebo or NSAID treatment immediately and 24 h after resistance exercise practice. An ergolytic effect was found 48 hours after resistance exercise (mean effect size (ES) = -0.42; 95% CI: -0.71, -0.12; p = 0.132), as well as reduced muscle strength (ES = -0.50; 95% CI: -0.83, -0.16; p = 0.072). Additionally, NSAID use did not prevent muscle waste as seen by the unchanged CK plasma concentration at all timetables. CONCLUSION The data of the present meta-analysis indicate that NSAID use is ineffective in improving resistance performance and muscle strength, as well as exercise recovery. When considering the practical application of using NSAIDs to improve exercise capacity and strength gains, the present data supports that consumption of analgesic drugs as an endurance performance enhancer or as a muscle anabolic must not be recommended.
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Affiliation(s)
- Gabriel Moraes de Oliveira
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Fernando Augusto Barcelos Andrade
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - André Bahia Pereira
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Rodrigo Silva Viza
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Henrique Fernandes Gerspacher
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Mateus da Costa Monteiro
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Helton Oliveira Campos
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Departamento de Ciências Biológicas, Universidade do Estado de Minas Gerais - Unidade Carangola, Carangola, MG, Brasil
| | - Lucas Rios Drummond
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Departamento de Educação Física, Universidade do Estado de Minas Gerais - Unidade Divin#x0F3;polis, Divin#x0F3;polis, MG, Brasil
| | - Laura Hora Rios Leite
- Departamento de Fisiologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Cândido Celso Coimbra
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Fehr CM, McEwen G, Robinson C. The Effects of "Physical BEMER® Vascular Therapy" on Work Performed During Repeated Wingate Sprints. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:732-737. [PMID: 35481952 DOI: 10.1080/02701367.2022.2053040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 03/05/2022] [Indexed: 06/14/2023]
Abstract
Purpose: The purpose of this study was to investigate the effects of Bio-Electro-Magnetic-Energy-Regulation (BEMER) on recovery and performance parameters in anaerobic exercise compared to active and passive recovery. Method: Fifteen recreationally active participants completed four sessions separated by 2-5 days between each session. The first visit involved one Wingate Anaerobic Test (WAnT; 30-s cycling sprint on a Monark ergometer) to familiarize participants with testing procedures. The three subsequent sessions involved four repeated WAnTs. Each sprint was followed by 4 min of either passive recovery (laying supine), active recovery (pedaling at 50 rpm at 20% of sprint workload), or BEMER recovery (laying supine on the BEMER body pad at intensity level "5-Plus."). The same recovery method was used within each testing session, and recovery method order was randomized across participants. Results: There was no difference in peak power, average power, fatigue index, or average work performed between recovery conditions. Active recovery resulted in a statistically significant decrease in ratings of pain intensity (M = -0.767, SD = 0.928) and pain unpleasantness (M = -0.608, SD = 0.915), from the first minute to the fourth minute of recovery, compared to both BEMER (Intensity: M = 0.675, SD = 0.745, Unpleasantness: M = 1.125, SD = 0.862) and passive (Intensity: M = 0.542, SD = 0.774, Unpleasantness: M = 1.018, SD = 0.872) recoveries, where pain ratings increased. Conclusions: Although no recovery method resulted in increased performance, active recovery led to a more comfortable exercise experience while still allowing comparable exercise performance.
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Mauger AR, Thomas T, Smith SA, Fennell CRJ. Tramadol is a performance-enhancing drug in highly trained cyclists: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:467-474. [PMID: 37410900 PMCID: PMC10538983 DOI: 10.1152/japplphysiol.00338.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Abstract
Tramadol is a potent narcotic analgesic reportedly used in multiple sports to reduce exertional pain and confer a performance advantage. This study sought to identify whether tramadol enhances performance in time trial cycling. Twenty-seven highly trained cyclists were screened for tramadol sensitivity and then attended the laboratory across three visits. Visit 1 identified maximal oxygen uptake, peak power output, and gas exchange threshold through a ramp incremental test. Participants returned to the laboratory on two further occasions to undertake cycling performance tests following the ingestion of either 100 mg of soluble tramadol or a taste-matched placebo control in a double-blind, randomized, and crossover design. In the performance tests, participants completed a 30 min non-exhaustive fixed intensity cycling task at a heavy exercise intensity (272 ± 42 W), immediately followed by a competitive self-paced 25-mile time trial (TT). Following removal of two outlier data sets, analysis was completed on n = 25. Participants completed the TT significantly faster (d = 0.54, P = 0.012) in the tramadol condition (3758 s ± 232 s) compared with the placebo condition (3808 s ± 248 s) and maintained a significantly higher mean power output (+9 W) throughout the TT (ηp2 = 0.262, P = 0.009). Tramadol reduced perception of effort during the fixed intensity trial (P = 0.026). The 1.3% faster time in the tramadol condition would be sufficient to change the outcomes of a race and is highly meaningful and pervasive in this cohort of highly trained cyclists. The data from this study suggests that tramadol is a performance-enhancing drug.NEW & NOTEWORTHY In the current study, when cycling with tramadol participants completed a time trial on average 50 s faster and at a 9 W higher power output than the placebo control. The study used both a fixed intensity and self-paced time trial exercise tasks to reflect the demands of a stage race. The outcomes from this study were used by the World Anti-Doping Agency to inform their addition of tramadol to the Prohibited List in 2024.
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Affiliation(s)
- Alexis R Mauger
- School of Sport and Exercise Sciences, University of Kent, Canterbury, United Kingdom
| | - Trudy Thomas
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham, United Kingdom
| | - Samuel A Smith
- School of Sport and Exercise Sciences, University of Kent, Canterbury, United Kingdom
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The Effect of Acetaminophen on Running Economy and Performance in Collegiate Distance Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052927. [PMID: 35270624 PMCID: PMC8910038 DOI: 10.3390/ijerph19052927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 12/04/2022]
Abstract
Acetaminophen (ACT) may decrease perception of pain during exercise, which could allow runners to improve running economy (RE) and performance. The aim of this study was to determine the effects of ACT on RE and 3 km time trial (TT) performance in collegiate distance runners. A randomized, double blind, crossover study was employed in which 11 track athletes (9M/2F; age: 18.8 ± 0.6 years; VO2 max: 60.6 ± 7.7 mL/kg/min) completed three intervention sessions. Participants ingested either nothing (baseline, BSL), three gelatin capsules (placebo, PLA), or three 500 mg ACT caplets (ACT). One hour after ingestion, participants completed a graded exercise test consisting of 4 × 5 min steady-state stages at ~55–75% of VO2 max followed by a 3 km TT. There was no influence of ACT on RE in any stage. Similarly, ACT did not favorably modify 3 km TT performance [mean ± SD: BSL = 613 ± 71 s; PLA = 617 ± 70 s; ACT = 618 ± 70 s; p = 0.076]. The results indicate that ACT does not improve RE or TT performance in collegiate runners at the 3 km distance. Those wanting to utilize ACT for performance must understand that ACT’s benefits have yet to be significant amongst well-trained runners. Future studies should examine the effects of ACT on well-trained runners over longer trial distances and under more controlled conditions with appropriate medical oversight.
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Grgic J. What is the Effect of Paracetamol (Acetaminophen) Ingestion on Exercise Performance? Current Findings and Future Research Directions. Sports Med 2022; 52:431-439. [PMID: 35038139 DOI: 10.1007/s40279-021-01633-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/19/2022]
Abstract
In recent years, studies have explored the effects of paracetamol (acetaminophen) ingestion on exercise performance. However, due to the contrasting findings, there is still no consensus on this topic. This article provides an overview of the effects of paracetamol on endurance, sprinting, and resistance exercise performance. Studies have reported that paracetamol ingestion may be ergogenic for endurance performance. These effects occur when paracetamol is ingested 45-60 min before exercise and appear to be more pronounced in time-to-exhaustion versus time-trial tests. Besides endurance, paracetamol ingestion 30 min before exercise increases mean power during repeated cycling sprints in interval training involving repeated 30-s all-out bouts. Preliminary data on paracetamol ingestion also suggest: (a) improved endurance performance in the heat; (b) an improvement in single sprint performance, at least when paracetamol is ingested following exercise-induced fatigue; and (c) attenuation of the decline in muscular strength that occurs with repeated maximum contractions. An ergogenic effect of paracetamol is most commonly observed when a dose of 1500 mg is ingested 30-60 min before exercise. Despite these performance-enhancing effects, the aim of this article is not to promote paracetamol use, as side effects associated with its consumption and ethical aspects need to be considered before utilizing paracetamol as an ergogenic aid. Future research on this topic is still needed, particularly related to paracetamol dosing, timing of ingestion, and the effects of paracetamol in females and elite athletes.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
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de Almeida Azevedo R, Jazayeri D, Yeung ST, Khoshreza R, Millet GY, Murias JM, Aboodarda SJ. The effects of pain induced by blood flow occlusion in one leg on exercise tolerance and corticospinal excitability and inhibition of the contralateral leg in males. Appl Physiol Nutr Metab 2022; 47:632-648. [PMID: 35201916 DOI: 10.1139/apnm-2021-0597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Experiencing pain in one leg can alter exercise tolerance and neuromuscular fatigue (NMF) responses in the contralateral leg; however, the corticospinal modulations to non-local experimental pain induced by blood flow occlusion remain unknown. In three randomized visits, thirteen male participants performed 25% of isometric maximal voluntary contraction (25%IMVC) to task failure with one leg preceded by (i) 6-min rest (CON), (ii) cycling at 80% of peak power output until task failure with the contralateral leg (CYCL) or (iii) CYCL followed by blood flow occlusion (OCCL) during 25%IMVC. NMF assessments (IMVC, voluntary activation [VA] and potentiated twitch [Qtw]) were performed at baseline and task failure. During the 25%IMVC, transcranial magnetic stimulations were performed to obtain motor evoked potential (MEP), silent period (SP), and short intracortical inhibition (SICI). 25%IMVC was shortest in OCCL (105±50s) and shorter in CYCL (154±68s) than CON (219±105s) (P<0.05). IMVC declined less after OCCL (-24±19%) and CYCL (-27±18%) then CON (-35±11%) (P<0.05). Qtw declined less in OCCL (-40±25%) compared to CYCL (-50±22%) and CON (-50±21%) (P<0.05). VA was similar amongst conditions. MEP and SP increased and SICI decreased throughout the task while SP was longer for OCCL compared to CYC condition (P<0.05). The results suggest that pain in one leg diminishes contralateral limb exercise tolerance and NMF development and modulate corticospinal inhibition in males. Novelty: Pain in one leg diminished MVC and twitch force decline in the contralateral limb Experimental pain induced by blood flow occlusion may modulation corticospinal inhibition of the neural circuitries innervating the contralateral exercise limb.
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Affiliation(s)
| | | | | | | | | | - Juan M Murias
- University of Calgary, Faculty of Kinesiology, KNB 434, 2500 University Drive NW, Calgary, Alberta, Canada, T2N1N4;
| | - Saied Jalal Aboodarda
- University of Calgary , Faculty of Kinesiology, 2500 University Drive NW, Calgary, Canada, T2N 1N4;
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Norbury R, Smith SA, Burnley M, Judge M, Mauger AR. The effect of elevated muscle pain on neuromuscular fatigue during exercise. Eur J Appl Physiol 2022; 122:113-126. [PMID: 34586471 PMCID: PMC8748369 DOI: 10.1007/s00421-021-04814-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/15/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE Muscle pain can impair exercise performance but the mechanisms for this are unknown. This study examined the effects of muscle pain on neuromuscular fatigue during an endurance task. METHODS On separate visits, twelve participants completed an isometric time-to-task failure (TTF) exercise of the right knee extensors at ~ 20% of maximum force following an intramuscular injection of isotonic saline (CTRL) or hypertonic saline (HYP) into the vastus lateralis. Measures of neuromuscular fatigue were taken before, during and after the TTF using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation. RESULTS The mean pain intensity was 57 ± 10 in HYP compared to 38 ± 18 in CTRL (P < 0.001). TTF was reduced in HYP (4.36 ± 0.88 min) compared to CTRL (5.20 ± 0.39 min) (P = 0.003). Maximum voluntary force was 12% lower at minute 1 (P = 0.003) and 11% lower at minute 2 in HYP (P = 0.013) compared to CTRL. Voluntary activation was 4% lower at minute 1 in HYP compared to CTRL (P = 0.006) but not at any other time point (all P > 0.05). The TMS silent period was 9% longer at 100 s during the TTF in HYP compared to CTRL (P = 0.026). CONCLUSION Muscle pain reduces exercise performance through the excacerbation of neuromuscular fatigue that is central in origin. This appears to be from inhibitory feedback from group III/IV nociceptors which acts to reduce central motor output.
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Affiliation(s)
- Ryan Norbury
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Samuel A Smith
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Mark Burnley
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Megan Judge
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sports and Exercise Sciences, University of Kent, Chipperfield Building, Canterbury Campus, Canterbury, CT2 7NZ, Kent, UK.
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Bloukh S, Wazaify M, Matheson C. Paracetamol: unconventional uses of a well-known drug. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:527-540. [PMID: 34455434 DOI: 10.1093/ijpp/riab058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To describe and map what is known about unconventional uses of paracetamol through a scoping review of published literature by adopting adopted a PRISMA systematic approach methodology. KEY FINDINGS Four themes for unconventional uses of paracetamol emerged: (a) use of paracetamol in sleep (a-1) positive effect of paracetamol on sleep (n = 9) or (a-2) neutral or negative effect of paracetamol on sleep (n = 9); (b) use of paracetamol in sport (n = 13); (c) mixing paracetamol with drinks, waterpipe and illicit drugs (n = 5); and (d) miscellaneous uses (n = 4). Forty records were reviewed and charted. Available literature supports concern around the potential of harmful or non-medical use of paracetamol, especially among patients with a history of substance use, parents of young children or athletes. SUMMARY Paracetamol (acetaminophen) is one of the most popular and widely used drugs for the treatment of pain and fever. It is considered remarkably safe if used within instructions. However, there is growing evidence that paracetamol, is sometimes used outside approved indications or abused (i.e. used for non-medical reasons). This review highlights the need for enhanced pharmacovigilance and surveillance of non-medical paracetamol use and raising general public awareness of its potential dangers especially in higher than recommended doses.
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Affiliation(s)
- Sarah Bloukh
- School of Pharmacy, The University of Jordan (UJ), Amman, Jordan
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan (UJ), Amman, Jordan
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Kin-Hoo Koo K, Chinoy H, Creaney L, Hayton M. Inflammatory Arthropathy in the Elite Sports Athlete. Curr Sports Med Rep 2021; 20:577-583. [PMID: 34752430 DOI: 10.1249/jsr.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Elite athletes commonly present with joint pains that are attributed to overuse injuries though on occasion it can be due to an inflammatory arthropathy. The diagnostic challenge is that presenting symptoms of benign injuries are similar to inflammatory arthropathies. A holistic review of the athlete can provide clues suggestive of inflammatory arthropathy, before requesting further investigations to confirm the diagnosis. Current imaging modalities are not specific in differentiating inflammatory arthritis with other causes of joint inflammation. Prompt treatment is required to restore the athlete to an optimum level of activity and prevent career ending disability, all in adherence to the regulations of the sporting governing bodies. This review aims to highlight the importance of inflammatory arthropathy in the differentials for an athlete presenting with joint pains.
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Affiliation(s)
- Kenneth Kin-Hoo Koo
- Department of Trauma and Orthopaedics, Salford Royal NHS Foundation Trust, Salford, UNITED KINGDOM
| | - Hector Chinoy
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UNITED KINGDOM
| | - Leon Creaney
- Manchester Institute of Health & Performance (MIHP), Manchester, UNITED KINGDOM
| | - Mike Hayton
- Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wrightington, Wigan, UNITED KINGDOM
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Grgic J, Mikulic P. Effects of Paracetamol (Acetaminophen) Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis. Sports (Basel) 2021; 9:sports9090126. [PMID: 34564331 PMCID: PMC8471630 DOI: 10.3390/sports9090126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
Several studies explored the effects of paracetamol (acetaminophen) ingestion on endurance performance, but their findings are conflicting. Therefore, this review aimed to conduct a meta-analysis examining the effects of paracetamol ingestion on endurance performance. Five databases were searched to find relevant studies. The PEDro checklist was used to assess the methodological quality of the included studies. Data reported in the included studies were pooled in a random-effects meta-analysis. A total of ten studies with good or excellent methodological quality were included in the meta-analysis (pooled n = 141). All included studies had a randomized, double-blind, crossover design. In the main meta-analysis, there was no significant difference between the effects of placebo and paracetamol on endurance performance (Cohen's d = 0.09; 95% confidence interval (CI): -0.04, 0.22; p = 0.172). However, an ergogenic effect was found when we considered only the studies that provided paracetamol 45 to 60 min before exercise (Cohen's d = 0.14; 95% CI: 0.07, 0.21; p < 0.001). In a subgroup analysis that focused on time-to-exhaustion tests, there was a significant ergogenic effect of paracetamol ingestion (Cohen's d = 0.19; 95% CI: 0.06, 0.33; p = 0.006). There was no significant difference between placebo and paracetamol in a subgroup analysis that focused on time trial tests (Cohen's d = 0.05; 95% CI: -0.12, 0.21; p = 0.561). In conclusion, paracetamol ingestion appears to enhance performance (a) in time-to-exhaustion endurance tests and (b) when consumed 45 to 60 min before exercise.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne 3011, Australia
- Correspondence:
| | - Pavle Mikulic
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia;
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13
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Jessen S, Eibye K, Christensen PM, Hostrup M, Bangsbo J. No additive effect of acetaminophen when co-ingested with caffeine on cycling performance in well-trained young men. J Appl Physiol (1985) 2021; 131:238-249. [PMID: 34013747 DOI: 10.1152/japplphysiol.00108.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We investigated the effect of caffeine and acetaminophen on power output during a 6-min performance test, peripheral fatigue, and muscle protein kinase A (PKA) substrate phosphorylation. Fourteen men [age (means ± SD): 26 ± 6 yr; V̇o2max: 63.9 ± 5.0 mL·min-1·kg-1] completed four randomized trials with acetaminophen (1,500 mg), caffeine (5 mg·kg body wt-1), combined caffeine and acetaminophen (caffeine + acetaminophen), or placebo. Mean power output during the 6-min performance test (placebo mean: 312 ± 41 W) was higher with caffeine (+5 W; 95% CI: 1 to 9; P = 0.017) and caffeine + acetaminophen (+6 W; 95% CI: 0 to 12; P = 0.049) than placebo, but not with acetaminophen (+1 W; 95% CI: -4 to 7; P = 0.529). Decline in quadriceps maximal isometric voluntary torque immediately after the performance test was lower (treatment × time; P = 0.035) with acetaminophen (-40 N·m; 95% CI: -53 to -30; P < 0.001) and caffeine + acetaminophen (-44 N·m; 95% CI: -58 to -30; P < 0.001) than placebo (-53 N·m; 95% CI: -71 to -39; P < 0.001) but was similar with caffeine (-54 N·m; 95% CI: -69 to -38; P < 0.001). Muscle phosphocreatine content decreased more during the performance test (treatment × time; P = 0.036) with caffeine + acetaminophen (-55 mmol·kg dry wt-1; 95% CI: -65 to -46; P < 0.001) than placebo (-40 mmol·kg dry wt-1; 95% CI: -52 to -24; P < 0.001). Muscle net lactate accumulation was not different from placebo (+85 mmol·kg dry wt-1; 95% CI: 60 to 110; P < 0.001) for any treatment (treatment × time; P = 0.066), being +75 mmol·kg dry wt-1 (95% CI: 51 to 99; P < 0.001) with caffeine, +76 mmol·kg dry wt-1 (95% CI: 58 to 96; P < 0.001) with acetaminophen, and +103 mmol·kg dry wt-1 (95% CI: 89 to 115; P < 0.001) with caffeine + acetaminophen. Decline in muscle ATP and glycogen content and increase in PKA substrate phosphorylation was not different between treatments (treatment × time; P > 0.1). Thus, acetaminophen provides no additive performance enhancing effect to caffeine during 6-min maximal cycling. In addition, change in PKA activity is likely not a major mechanism of performance improvement with caffeine.NEW & NOTEWORTHY Here, we show that acetaminophen does not provide additive performance improvement to caffeine during a 6-min cycling ergometer performance test, and that acetaminophen does not improve performance on its own. Neither substance affects peripheral fatigue, muscle glycolytic energy production, or phosphorylation of muscle proteins of importance for ion handling. In contrast to previous suggestions, increased epinephrine action on muscle cells does not appear to be a major contributor to the performance enhancement with caffeine.
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Affiliation(s)
- Søren Jessen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Eibye
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Møller Christensen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Team Danmark (Danish Elite Sports Organization), Copenhagen, Denmark
| | - Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Garcia CK, Sheikh LH, Iwaniec JD, Robinson GP, Berlet RA, Mattingly AJ, Murray KO, Laitano O, Clanton TL. Effects of Ibuprofen during Exertional Heat Stroke in Mice. Med Sci Sports Exerc 2021; 52:1870-1878. [PMID: 32175974 DOI: 10.1249/mss.0000000000002329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Intestinal injury is one of the most prominent features of organ damage in exertional heat stroke (EHS). However, whether damage to the intestine in this setting is exacerbated by ibuprofen (IBU), the most commonly used nonsteroidal anti-inflammatory drug in exercising populations, is not well understood. PURPOSE We hypothesized that IBU would exacerbate intestinal injury, reduce exercise performance, and increase susceptibility to heat stroke. METHODS To test this hypothesis, we administered IBU via diet to male and female C57/BL6J mice, over 48 h before EHS. Susceptibility to EHS was determined by assessing exercise response using a forced running wheel, housed inside an environmental chamber at 37.5°C. Core temperature (Tc) was monitored by telemetry. Mice were allocated into four groups: exercise only (EXC); EHS + IBU; EXC + IBU; and EHS only. Exercise performance and Tc profiles were evaluated and stomachs, intestines and plasma were collected at 3 h post-EHS. RESULTS The EHS + IBU males ran approximately 87% longer when Tc was above 41°C (P < 0.03) and attained significantly higher peak Tc (P < 0.01) than EHS-only mice. Histological analyses showed decreased villi surface area throughout the small intestine for both sexes in the EXC + IBU group versus EXC only. Interestingly, though EHS in both sexes caused intestinal injury, in neither sex were there any additional effects of IBU. CONCLUSIONS Our results suggest that in a preclinical mouse model of EHS, oral IBU at pharmacologically effective doses does not pose additional risks of heat stroke, does not reduce exercise performance, and does not contribute further to intestinal injury, though this could have been masked by significant gut injury induced by EHS alone.
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Affiliation(s)
- Christian K Garcia
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
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15
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Zandonai T, Holgado D, Ciria LF, Zabala M, Hopker J, Bekinschtein T, Sanabria D. Novel evidence on the effect of tramadol on self-paced high-intensity cycling. J Sports Sci 2021; 39:1452-1460. [PMID: 33491582 DOI: 10.1080/02640414.2021.1877440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The use of tramadol is a controversial topic in cycling. In order to provide novel evidence on this issue, we tested 29 participants in a pre-loaded cycling time trial (TT; a 20-min TT preceded by 40-min of constant work-rate at 60% of the VO2max) after ingesting 100 mg of tramadol (vs placebo and paracetamol (1.5 g)). Participants performed the Psychomotor Vigilance Task (PVT) at rest and a Sustained Attention to Response Task (SART) during the 60 min of exercise. Oscillatory electroencephalography (EEG) activity was measured throughout the exercise. The results showed higher mean power output during the 20-min TT in the tramadol vs. paracetamol condition, but no reliable difference was reported between tramadol and placebo (nor paracetamol vs. placebo). Tramadol resulted in faster responses in the PVT and higher heart rate during exercise. The main effect of substance was reliable in the SART during the 40-min constant workload (no during the 20-min TT), with slower reaction time, but better accuracy for tramadol and paracetamol than for placebo. This study supports the increased behavioural and neural efficiency at rest for tramadol but not the proposed ergogenic or cognitive (harmful) effect of tramadol (vs. placebo) during self-paced high-intensity cycling.
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Affiliation(s)
- Thomas Zandonai
- Mind, Brain and Behaviour Research Center, Department of Experimental Psychology, Faculty of Psychology, University of Granada, Granada, Spain
| | - Darías Holgado
- Mind, Brain and Behaviour Research Center, Department of Experimental Psychology, Faculty of Psychology, University of Granada, Granada, Spain
| | - Luis F Ciria
- Mind, Brain and Behaviour Research Center, Department of Experimental Psychology, Faculty of Psychology, University of Granada, Granada, Spain
| | - Mikel Zabala
- Department of Physical Education & Sport, University of Granada, Granada, Spain
| | - James Hopker
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Medway, UK
| | | | - Daniel Sanabria
- Mind, Brain and Behaviour Research Center, Department of Experimental Psychology, Faculty of Psychology, University of Granada, Granada, Spain
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16
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Omeragic E, Marjanovic A, Djedjibegovic J, Turalic A, Dedic M, Niksic H, Lugusic A, Sober M. Prevalence of use of permitted pharmacological substances for recovery among athletes. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e54581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives: Food supplements and medicines which are not on the list of prohibited substances of the World Anti-Doping Agency are included in the group of permitted pharmacological agents for athlete’s recovery.
The aim of this study was to describe qualitatively and quantitatively food supplements (FS) and over-the-counter drugs use among athletes in the last six month.
Methods: This was a cross sectional study. Data on food supplements and the over-the-counter drugs, usage were collected during 2018 by self-administered, anonymous questionnaire.
Results: A total of 112 athletes completed the survey. A total of 51.8% (n = 58) athletes reported the use of food supplements. The use of medical supplements was reported by 50.0% (n = 56) of athletes, 26.8% (n = 30) reported using ergogenic supplements, 1.8% (n = 2) using of sports food and 4.5% (n = 5) using other supplements. The use of over-the-counter drugs was reported by 35.7% (n = 40) of athletes. The over-the-counter analgesic drugs were used by 95% (n = 38) of over-the-counter drug users. Concomitant administration two or more over-the-counter drugs was reported by 40% (n = 16) athletes. Doctors and coaches had no advisory role in the use of food supplements or over-the-counter drugs.
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17
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Judge M, Hopker J, Mauger AR. The effect of tDCS applied to the dorsolateral prefrontal cortex on cycling performance and the modulation of exercise induced pain. Neurosci Lett 2020; 743:135584. [PMID: 33352276 DOI: 10.1016/j.neulet.2020.135584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulatory tool purported to enhance endurance performance through reducing fatigue related perceptions, including exercise-induced pain (EIP). We examined whether tDCS of the left DLPFC (1) can reduce EIP during a fixed intensity cycling trial (FI), (2) can improve cycling time trial (TT) performance, and (3) whether this was affected by a bilateral or an extracephalic montage. This investigation was comprised of two parts (study one and two). In both studies, participants completed a 10-minute FI trial and a 15-minute TT after 10 min of 2 mA anodal left DLPFC tDCS, SHAM or no stimulation. In study one, 11 participants received tDCS via a bilateral montage. In study two, 20 participants received tDCS using an extracephalic montage. Pain was recorded throughout the FI and TT trials, with power output (PO) monitored during the TT. Study one saw no significant changes in pain (tDCS 4.3 ± 2.0; SHAM 4.0 ± 1.8; control 3.8 ± 1.4) during the FI trial and no significant differences in distance covered, pain or PO in the TT. In study two there were no differences in pain reported in the FI trial, or distance covered (P = 0.239), pain or PO in the TT. In summary, tDCS of the DLPFC did not induce analgesia and provided no ergogenic effect for TT performance, moreover these observations were consistent across both the extracephalic and bilateral montage. These findings are in line with an increasing number of studies demonstrating the inconsistent effects of tDCS.
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Affiliation(s)
- Megan Judge
- Endurance Research Group, School of Sport and Exercise Science, University of Kent, Chatham, United Kingdom
| | - James Hopker
- Endurance Research Group, School of Sport and Exercise Science, University of Kent, Chatham, United Kingdom
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Science, University of Kent, Chatham, United Kingdom.
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18
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Astokorki A, Flood A, Mauger A. Images depicting human pain increase exercise-induced pain and impair endurance cycling performance. J Sports Sci 2020; 39:138-146. [PMID: 32809900 DOI: 10.1080/02640414.2020.1809162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The current study investigated whether viewing images of others in pain influences exercise-induced pain (EIP) and cycling performance. Twenty-one recreational cyclists attended five laboratory visits. The first two visits involved measuring participants' maximal aerobic capacity and familiarized participants to the fixed power (FP) and 16.1 km cycling time trial (TT) tasks. The FP task required participants to cycle at 70% of their maximal aerobic power for 10-minutes. In the subsequent three visits, participants performed the FP and TT tasks after viewing pleasant, painful or neutral images. Participants rated the subset of painful images as more painful than the pleasant and neutral images; with no difference in the pain ratings of the pleasant and neutral images. In the FP task, EIP ratings were higher following painful compared to pleasant images, while no differences in EIP were observed between any other condition . In the TT, performance did not differ between the pleasant and neutral conditions. However, TT performance was reduced after viewing painful images compared to neutral or pleasant images. HR, B[La], perceived exertion and EIP did not differ between the three conditions. These results suggest that viewing painful images decreases TT performance and increases pain during fixed intensity cycling. Abbreviations: EIP: Exercise Induced Pain; FP: Fixed Power; TT: Time Trial; HR:Heart Rate; B[La]: Blood Lactate; RPE: Rating of Perceived Exertion; IAPS: International Affective Picture System; PO: Power Output.
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Affiliation(s)
- Ali Astokorki
- College of Education-Shaqlawa, Salahaddin University-Erbil , Shaqlawa, Iraq.,Department of Physiotherapy, Faculty of Health Technology, Cihan University-Erbil , Erbil, Iraq.,College of Science, Pathological Analysis, Knowledge University , Erbil, Iraq
| | - Andrew Flood
- Research Institute for Sport & Exercise, University of Canberra , Canberra, Australia.,Centre for Applied Psychology, University of Canberra , Australian Capital Territory, Canberra, Australia
| | - Alexis Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent , Chatham, UK
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19
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Tomazini F, Santos-Mariano A, Andrade-Souza V, Sebben V, De Maria C, Coelho D, Bertuzzi R, Silva-Cavalcante M, Lima-Silva A. Caffeine but not acetaminophen increases 4-km cycling time-trial performance. PHARMANUTRITION 2020. [DOI: 10.1016/j.phanu.2020.100181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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BEJDER JACOB, BREENFELDT ANDERSEN ANDREAS, BONNE THOMASCHRISTIAN, PIIL JACOBFEDER, HAGEN LINNCAMILLAHAUAN, DEHNES YVETTE, EIBYE KASPERHVID, NYBO LARS, NORDSBORG NIKOLAIBAASTRUP. Tramadol Does Not Improve Performance or Impair Motor Function in Trained Cyclists. Med Sci Sports Exerc 2019; 52:1169-1175. [DOI: 10.1249/mss.0000000000002217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Athletes of various skill levels commonly use many different types of medications, often at rates higher than the general population. Common medication classes used in athletes include analgesics such as nonsteroidal anti-inflammatory drugs and acetaminophen, inhalers for asthma and exercise-induced bronchoconstriction, antihypertensives, antibiotics, and insulin. Prescribers must be aware of the unique considerations for each of these medications when using them in patients participating in physical activity. The safety, efficacy, impact on athletic performance, and regulatory restrictions of the most common medications used in athletes are discussed in this article.
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Affiliation(s)
- Benjamin Ferry
- Trident/MUSC Family Medicine Residency Program, Department of Family Medicine, Medical University of South Carolina, 9228 Medical Plaza Drive, Charleston, SC 29406, USA
| | - Alexei DeCastro
- Department of Family Medicine, Medical University of South Carolina, College of Medicine, 9228 Medical Plaza Drive, Charleston, SC 29406, USA
| | - Scott Bragg
- Department of Family Medicine, College of Medicine, College of Pharmacy, Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina, 280 Calhoun Street MSC 140, Charleston, SC 29425, USA.
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22
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Morgan PT, Bailey SJ, Banks RA, Fulford J, Vanhatalo A, Jones AM. Contralateral fatigue during severe-intensity single-leg exercise: influence of acute acetaminophen ingestion. Am J Physiol Regul Integr Comp Physiol 2019; 317:R346-R354. [PMID: 31141387 PMCID: PMC6732432 DOI: 10.1152/ajpregu.00084.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Exhaustive single-leg exercise has been suggested to reduce time to task failure (Tlim) during subsequent exercise in the contralateral leg by exacerbating central fatigue development. We investigated the influence of acetaminophen (ACT), an analgesic that may blunt central fatigue development, on Tlim during single-leg exercise completed with and without prior fatiguing exercise of the contralateral leg. Fourteen recreationally active men performed single-leg severe-intensity knee-extensor exercise to Tlim on the left (Leg1) and right (Leg2) legs without prior contralateral fatigue and on Leg2 immediately following Leg1 (Leg2-CONTRA). The tests were completed following ingestion of 1-g ACT or maltodextrin [placebo (PL)] capsules. Intramuscular phosphorus-containing metabolites and substrates and muscle activation were assessed using 31P-MRS and electromyography, respectively. Tlim was not different between Leg1ACT and Leg1PL conditions (402 ± 101 vs. 390 ± 106 s, P = 0.11). There was also no difference in Tlim between Leg2ACT-CONTRA and Leg2PL-CONTRA (324 ± 85 vs. 311 ± 92 s, P = 0.10), but Tlim was shorter in Leg2ACT-CONTRA and Leg2PL-CONTRA than in Leg2CON (385 ± 104 s, both P < 0.05). There were no differences in intramuscular phosphorus-containing metabolites and substrates or muscle activation between Leg1ACT and Leg1PL and between Leg2ACT-CONTRA and Leg2PL-CONTRA (all P > 0.05). These findings suggest that levels of metabolic perturbation and muscle activation at Tlim are not different during single-leg severe-intensity knee-extensor exercise completed with or without prior fatiguing exercise of the contralateral leg. Despite contralateral fatigue, ACT ingestion did not alter neuromuscular responses, muscle metabolites, or exercise performance.
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Affiliation(s)
- Paul T Morgan
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, United Kingdom
| | - Stephen J Bailey
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, United Kingdom
| | - Rhys A Banks
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, United Kingdom
| | - Jonathan Fulford
- Peninsula Clinical Research Facility, National Institute for Health Research, College of Medicine and Health, Exeter, United Kingdom
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, United Kingdom
| | - Andrew M Jones
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, United Kingdom
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Kuppens K, Feijen S, Roussel N, Nijs J, Cras P, van Wilgen P, Struyf F. Training volume is associated with pain sensitivity, but not with endogenous pain modulation, in competitive swimmers. Phys Ther Sport 2019; 37:150-156. [PMID: 30978601 DOI: 10.1016/j.ptsp.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To investigate the association of pain sensitivity and endogenous analgesia capacity, and training volume in a group of competitive swimmers. DESIGN An observational multi-center study. SETTING Multiple competitive swimming clubs. PARTICIPANTS 102 healthy competitive swimmers. MAIN OUTCOME MEASURES Training volume was estimated using self-reported information. Static and dynamic measures of pain were assessed using pressure pain thresholds (PPTs) and conditioned pain modulation (CPM), the latter as a measure of endogenous pain inhibition. Selected demographic and psychosocial measures were considered as possible confounding factors. RESULTS Moderate positive correlations (0.38 < r < 0.44; p < 0.01) exist between self-reported training volume and PPTs at widespread body areas in competitive swimmers. These results were maintained during linear regression analysis while addressing possible confounding factors such as age and selected psychosocial factors. No associations were found between self-reported training volume and conditioned pain modulation (-0.08 < r < 0.06; p > 0.05). CONCLUSIONS Self-reported swim training volume is associated with pain sensitivity in competitive swimmers. Swimmers who train more show higher pressure pain thresholds, indicating lower pain sensitivity. Swim training volume is not associated with endogenous nociceptive inhibitory capacity as determined using CPM.
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Affiliation(s)
- Kevin Kuppens
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Stef Feijen
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Nathalie Roussel
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jo Nijs
- Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium; Department of Physiotherapy and Rehabilitation, University Hospital Brussels, Belgium
| | - Patrick Cras
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Neurology, University Hospital Antwerp, Belgium
| | - Paul van Wilgen
- Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium; Transcare, Transdisciplinary Pain Management Centre, the Netherlands
| | - Filip Struyf
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
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Morgan PT, Vanhatalo A, Bowtell JL, Jones AM, Bailey SJ. Acetaminophen ingestion improves muscle activation and performance during a 3-min all-out cycling test. Appl Physiol Nutr Metab 2019; 44:434-442. [DOI: 10.1139/apnm-2018-0506] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Acute acetaminophen (ACT) ingestion has been shown to enhance cycling time-trial performance. The purpose of this study was to assess whether ACT ingestion enhances muscle activation and critical power (CP) during maximal cycling exercise. Sixteen active male participants completed two 3-min all-out tests against a fixed resistance on an electronically braked cycle ergometer 60 min after ingestion of 1 g of ACT or placebo (maltodextrin, PL). CP was estimated as the mean power output over the final 30 s of the test and W′ (the curvature constant of the power–duration relationship) was estimated as the work done above CP. The femoral nerve was stimulated every 30 s to measure membrane excitability (M-wave) and surface electromyography (EMGRMS) was recorded continuously to infer muscle activation. Compared with PL, ACT ingestion increased CP (ACT: 297 ± 32 W vs. PL: 288 ± 31 W, P < 0.001) and total work done (ACT: 66.4 ± 6.5 kJ vs. PL: 65.4 ± 6.4 kJ, P = 0.03) without impacting W′ (ACT: 13.1 ± 2.9 kJ vs. PL: 13.6 ± 2.4 kJ, P = 0.19) or the M-wave amplitude (P = 0.66) during the 3-min all-out cycling test. Normalised EMGRMS amplitude declined throughout the 3-min protocol in both PL and ACT conditions; however, the decline in EMGRMS amplitude was attenuated in the ACT condition, such that the EMGRMS amplitude was greater in ACT compared with PL over the last 60 s of the test (P = 0.04). These findings indicate that acute ACT ingestion might increase performance and CP during maximal cycling exercise by enhancing muscle activation.
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Affiliation(s)
- Paul T. Morgan
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Joanna L. Bowtell
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Andrew M. Jones
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Stephen J. Bailey
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
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Morgan PT, Vanhatalo A, Bowtell JL, Jones AM, Bailey SJ. Acute ibuprofen ingestion does not attenuate fatigue during maximal intermittent knee extensor or all-out cycling exercise. Appl Physiol Nutr Metab 2019; 44:208-215. [DOI: 10.1139/apnm-2018-0432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recent research suggests that acute consumption of pharmacological analgesics can improve exercise performance, but the ergogenic potential of ibuprofen (IBP) administration is poorly understood. This study tested the hypothesis that IBP administration would enhance maximal exercise performance. In one study, 13 physically active males completed 60 × 3-s maximal voluntary contractions (MVCs) of the knee extensors interspersed with 2-s passive recovery periods, on 2 occasions, with the critical torque (CT) estimated as the mean torque over the last 12 contractions (part A). In another study, 16 active males completed two 3-min all-out tests against a fixed resistance on an electronically braked cycle ergometer, with the critical power estimated from the mean power output over the final 30 s of the test (part B). All tests were completed 60 min after ingestion of maltodextrin (placebo, PL) or 400 mg of IBP. Peripheral nerve stimulation was administered at regular intervals and electromyography was measured throughout. For part A, mean torque (IBP: 60% ± 13% of pre-exercise MVC; PL: 58% ± 14% of pre-exercise MVC) and CT (IBP: 41% ± 16% of pre-exercise MVC; PL: 40% ± 15% of pre-exercise MVC) were not different between conditions (P > 0.05). For part B, end-test power output (IBP: 292 ± 28 W; PL: 288 ± 31 W) and work done (IBP: 65.9 ± 5.9 kJ; PL: 65.4 ± 6.4 kJ) during the 3-min all-out cycling tests were not different between conditions (all P > 0.05). For both studies, neuromuscular fatigue declined at a similar rate in both conditions (P > 0.05). In conclusion, acute ingestion of 400 mg of IBP does not improve single-leg or maximal cycling performance in healthy humans.
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Affiliation(s)
- Paul T. Morgan
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Joanna L. Bowtell
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Andrew M. Jones
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Stephen J. Bailey
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
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Endurance Performance is Influenced by Perceptions of Pain and Temperature: Theory, Applications and Safety Considerations. Sports Med 2018; 48:525-537. [PMID: 29270865 DOI: 10.1007/s40279-017-0852-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Models of endurance performance now recognise input from the brain, including an athlete's ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use.
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Vlad RA, Hancu G, Popescu GC, Lungu IA. Doping in Sports, a Never-Ending Story? Adv Pharm Bull 2018; 8:529-534. [PMID: 30607326 PMCID: PMC6311632 DOI: 10.15171/apb.2018.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/02/2018] [Accepted: 10/07/2018] [Indexed: 12/14/2022] Open
Abstract
Through doping, we understand the use by athletes of substances prohibited by the antidoping agencies in order to gain a competitive advantage. Since sport plays an important role in physical and mental education and in promoting international understanding and cooperation, the widespread use of doping products and methods has consequences not only on health of the athletes, but also upon the image of sport. Thus, doping in sports is forbidden for both ethical and medical reasons. Narcotics and analgesics, anabolic steroids, hormones, selective androgen receptor modulators are among the most frequently utilized substances. Although antidoping controls are becoming more rigorous, doping and, very importantly, masking doping methods are also advancing, and these are usually one step ahead of doping detection techniques. Depending on the sport practiced and the physical attributes it requires, the athletes will look for one or more of the following benefits of doping: recovering from an injury, increasing body recovery capacity after training, increasing muscle mass and strength, decreasing fat tissue, increasing endurance. Finally, when we look once again at a doping scandal, amazed at how much animosity against those caught can exist; the question is: is it really such a disaster as presented by the media or a silent truth under our eyes, but which many of us have refused to accept?
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Affiliation(s)
- Robert Alexandru Vlad
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu MureŞ, Romania
| | - Gabriel Hancu
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy from Tîrgu MureŞ, Tîrgu MureŞ, Romania
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Lundberg TR, Howatson G. Analgesic and anti-inflammatory drugs in sports: Implications for exercise performance and training adaptations. Scand J Med Sci Sports 2018; 28:2252-2262. [PMID: 30102811 DOI: 10.1111/sms.13275] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/07/2018] [Indexed: 12/22/2022]
Abstract
Over-the-counter analgesics, such as anti-inflammatory drugs (NSAIDs) and paracetamol, are widely consumed by athletes worldwide to increase pain tolerance, or dampen pain and reduce inflammation from injuries. Given that these drugs also can modulate tissue protein turnover, it is important to scrutinize the implications of acute and chronic use of these drugs in relation to exercise performance and the development of long-term training adaptations. In this review, we aim to provide an overview of the studies investigating the effects of analgesic drugs on exercise performance and training adaptations relevant for athletic development. There is emerging evidence that paracetamol might acutely improve important endurance parameters as well as aspects of neuromuscular performance, possibly through increased pain tolerance. Both NSAIDs and paracetamol have been demonstrated to inhibit cyclooxygenase (COX) activity, which might explain the reduced anabolic response to acute exercise bouts. Consistent with this, NSAIDs have been reported to interfere with muscle hypertrophy and strength gains in response to chronic resistance training in young individuals. Although it remains to be established whether any of these observations also translate into detriments in sport-specific performance or reduced training adaptations in elite athletes, the extensive use of these drugs certainly raises practical, ethical, and important safety concerns that need to be addressed. Overall, we encourage greater awareness among athletes, coaches, and support staff on the potential adverse effects of these drugs. A risk-benefit analysis and professional guidance are strongly advised before the athlete considers analgesic medicine for training or competition.
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Affiliation(s)
- Tommy R Lundberg
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK.,Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
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Acute acetaminophen ingestion improves performance and muscle activation during maximal intermittent knee extensor exercise. Eur J Appl Physiol 2018; 118:595-605. [PMID: 29332237 PMCID: PMC5805811 DOI: 10.1007/s00421-017-3794-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 12/19/2017] [Indexed: 01/04/2023]
Abstract
Aim Acetaminophen is a commonly used medicine for pain relief and emerging evidence suggests that it may improve endurance exercise performance. This study investigated some of the physiological mechanisms by which acute acetaminophen ingestion might blunt muscle fatigue development. Methods Thirteen active males completed 60 × 3 s maximum voluntary contractions (MVC) of the knee extensors with each contraction separated by a 2 s passive recovery period. This protocol was completed 60 min after ingesting 1 g of maltodextrin (placebo) or 1 g of acetaminophen on two separate visits. Peripheral nerve stimulation was administered every 6th contraction for assessment of neuromuscular fatigue development, with the critical torque (CT), which reflects the maximal sustainable rate of oxidative metabolism, taken as the mean torque over the last 12 contractions. Surface electromyography was recorded continuously as a measure of muscle activation. Results Mean torque (61 ± 11 vs. 58 ± 14% pre-exercise MVC) and CT (44 ± 13 vs. 40 ± 15% pre-exercise MVC) were greater in the acetaminophen trial compared to placebo (both P < 0.05). Voluntary activation and potentiated twitch declined at a similar rate in both conditions (P > 0.05). However, the decline in electromyography amplitude was attenuated in the acetaminophen trial, with electromyography amplitude being greater compared to placebo from 210 s onwards (P < 0.05). Conclusion These findings indicate that acute acetaminophen ingestion might be ergogenic by increasing CT and preserving muscle activation during high-intensity exercise. Electronic supplementary material The online version of this article (10.1007/s00421-017-3794-7) contains supplementary material, which is available to authorized users.
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Esh CJ, Mauger AR, Palfreeman RA, Al-Janubi H, Taylor L. Acetaminophen (Paracetamol): Use beyond Pain Management and Dose Variability. Front Physiol 2017; 8:1092. [PMID: 29312002 PMCID: PMC5744234 DOI: 10.3389/fphys.2017.01092] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/12/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Christopher J Esh
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, United Kingdom
| | - Roger A Palfreeman
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Exercise and Sports Science Department, Doha, Qatar
| | - Haifa Al-Janubi
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Pharmacy Department, Doha, Qatar
| | - Lee Taylor
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar.,School of Sport, Exercise and Health Sciences. Loughborough University, Loughborough, United Kingdom
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Holgado D, Zandonai T, Zabala M, Hopker J, Perakakis P, Luque-Casado A, Ciria L, Guerra-Hernandez E, Sanabria D. Tramadol effects on physical performance and sustained attention during a 20-min indoor cycling time-trial: A randomised controlled trial. J Sci Med Sport 2017; 21:654-660. [PMID: 29128419 DOI: 10.1016/j.jsams.2017.10.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/19/2017] [Accepted: 10/31/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effect of tramadol on performance during a 20-min cycling time-trial (Experiment 1), and to test whether sustained attention would be impaired during cycling after tramadol intake (Experiment 2). DESIGN Randomized, double-blind, placebo controlled trial. METHODS In Experiment 1, participants completed a cycling time-trial, 120-min after they ingested either tramadol or placebo. In Experiment 2, participants performed a visual oddball task during the time-trial. Electroencephalography measures (EEG) were recorded throughout the session. RESULTS In Experiment 1, average time-trial power output was higher in the tramadol vs. placebo condition (tramadol: 220W vs. placebo: 209W; p<0.01). In Experiment 2, no differences between conditions were observed in the average power output (tramadol: 234W vs. placebo: 230W; p>0.05). No behavioural differences were found between conditions in the oddball task. Crucially, the time frequency analysis in Experiment 2 revealed an overall lower target-locked power in the beta-band (p<0.01), and higher alpha suppression (p<0.01) in the tramadol vs. placebo condition. At baseline, EEG power spectrum was higher under tramadol than under placebo in Experiment 1 while the reverse was true for Experiment 2. CONCLUSIONS Tramadol improved cycling power output in Experiment 1, but not in Experiment 2, which may be due to the simultaneous performance of a cognitive task. Interestingly enough, the EEG data in Experiment 2 pointed to an impact of tramadol on stimulus processing related to sustained attention. TRIAL REGISTRATION EudraCT number: 2015-005056-96.
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Affiliation(s)
- Darías Holgado
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain; Mind, Brain, and Behaviour Research Centre, University of Granada, Spain.
| | - Thomas Zandonai
- Mind, Brain, and Behaviour Research Centre, University of Granada, Spain; Department of Experimental Psychology, Faculty of Psychology, University of Granada, Spain
| | - Mikel Zabala
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - James Hopker
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, UK
| | - Pandelis Perakakis
- Mind, Brain, and Behaviour Research Centre, University of Granada, Spain; Universidad Loyola Andalucía, Departamento de Psicología, Campus de Palmas Altas, Sevilla, España
| | - Antonio Luque-Casado
- Mind, Brain, and Behaviour Research Centre, University of Granada, Spain; Department of Physical Activity and Sport, "San Isidoro" University Center (Pablo de Olavide University), Spain
| | - Luis Ciria
- Mind, Brain, and Behaviour Research Centre, University of Granada, Spain; Department of Experimental Psychology, Faculty of Psychology, University of Granada, Spain
| | | | - Daniel Sanabria
- Mind, Brain, and Behaviour Research Centre, University of Granada, Spain; Department of Experimental Psychology, Faculty of Psychology, University of Granada, Spain.
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Hainline B, Derman W, Vernec A, Budgett R, Deie M, Dvořák J, Harle C, Herring SA, McNamee M, Meeuwisse W, Lorimer Moseley G, Omololu B, Orchard J, Pipe A, Pluim BM, Ræder J, Siebert C, Stewart M, Stuart M, Turner JA, Ware M, Zideman D, Engebretsen L. International Olympic Committee consensus statement on pain management in elite athletes. Br J Sports Med 2017; 51:1245-1258. [DOI: 10.1136/bjsports-2017-097884] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/10/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
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Analgesics and Sport Performance: Beyond the Pain-Modulating Effects. PM R 2017; 10:72-82. [PMID: 28782695 DOI: 10.1016/j.pmrj.2017.07.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/18/2017] [Accepted: 07/25/2017] [Indexed: 11/24/2022]
Abstract
Analgesics are used widely in sport to treat pain and inflammation associated with injury. However, there is growing evidence that some athletes might be taking these substances in an attempt to enhance performance. Although the pharmacologic action of analgesics and their use in treating pain with and without anti-inflammatory effect is well established, their effect on sport performance is debated. The aim of this review was to evaluate the evidence of whether analgesics are capable of enhancing exercise performance and, if so, to what extent. Paracetamol has been suggested to improve endurance and repeated sprint exercise performance by reducing the activation of higher brain structures involved in pain and cognitive/affective processing. Nonsteroidal anti-inflammatory drugs affect both central and peripheral body systems, but investigation on their ergogenic effect on muscle strength development has provided equivocal results. The therapeutic use of glucocorticoids is indubitable, but clear evidence exists for a performance-enhancing effect after short-term oral administration. Based on the evidence presented in this review article, the ergogenic benefit of analgesics may warrant further consideration by regulatory bodies. In contrast to the aforementioned analgesics, there is a paucity of research on the use of opioids such as tramadol on sporting performance. LEVEL OF EVIDENCE III.
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Flood A, Waddington G, Cathcart S. Examining the relationship between endogenous pain modulation capacity and endurance exercise performance. Res Sports Med 2017; 25:300-312. [PMID: 28393555 DOI: 10.1080/15438627.2017.1314291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aim of the current study was to examine the relationship between pain modulatory capacity and endurance exercise performance. Twenty-seven recreationally active males between 18 and 35 years of age participated in the study. Pain modulation was assessed by examining the inhibitory effect of a noxious conditioning stimulus (cuff occlusion) on the perceived intensity of a second noxious stimulus (pressure pain threshold). Participants completed two, maximal voluntary contractions followed by a submaximal endurance time task. Both performance tasks involved an isometric contraction of the non-dominant leg. The main analysis uncovered a correlation between pain modulatory capacity and performance on the endurance time task (r = -.425, p = .027), such that those with elevated pain modulation produced longer endurance times. These findings are the first to demonstrate the relationship between pain modulation responses and endurance exercise performance.
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Affiliation(s)
- Andrew Flood
- a Centre for Applied Psychology, Faculty of Health , University of Canberra , Canberra , Australia.,b University of Canberra Research Institute for Sport and Exercise , University of Canberra , Canberra , Australia
| | - Gordon Waddington
- b University of Canberra Research Institute for Sport and Exercise , University of Canberra , Canberra , Australia.,c Discipline of Physiotherapy, Faculty of Health , University of Canberra , Canberra , Australia
| | - Stuart Cathcart
- a Centre for Applied Psychology, Faculty of Health , University of Canberra , Canberra , Australia.,b University of Canberra Research Institute for Sport and Exercise , University of Canberra , Canberra , Australia
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Hibbert AW, Billaut F, Varley MC, Polman RCJ. No Influence of Transcutaneous Electrical Nerve Stimulation on Exercise-Induced Pain and 5-Km Cycling Time-Trial Performance. Front Physiol 2017; 8:26. [PMID: 28223939 PMCID: PMC5293800 DOI: 10.3389/fphys.2017.00026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/11/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction: Afferent information from exercising muscle contributes to the sensation of exercise-induced muscle pain. Transcutaneous electrical nerve stimulation (TENS) delivers low–voltage electrical currents to the skin, inhibiting nociceptive afferent information. The use of TENS in reducing perceptions of exercise-induced pain has not yet been fully explored. This study aimed to investigate the effect of TENS on exercise-induced muscle pain, pacing strategy, and performance during a 5-km cycling time trial (TT). Methods: On three separate occasions, in a single-blind, randomized, and cross-over design, 13 recreationally active participants underwent a 30-min TENS protocol, before performing a 5-km cycling TT. TENS was applied to the quadriceps prior to exercise under the following conditions; control (CONT), placebo with sham TENS application (PLAC), and an experimental condition with TENS application (TENS). Quadriceps fatigue was assessed with magnetic femoral nerve stimulation assessing changes in potentiated quadriceps twitch force at baseline, pre and post exercise. Subjective scores of exertion, affect and pain were taken every 1-km. Results: During TTs, application of TENS did not influence pain perceptions (P = 0.68, ηp2 = 0.03). There was no significant change in mean power (P = 0.16, ηp2 = 0.16) or TT duration (P = 0.17, ηp2 = 0.14), although effect sizes were large for these two variables. Changes in power output were not significant but showed moderate effect sizes at 500-m (ηp2 = 0.10) and 750-m (ηp2 = 0.10). Muscle recruitment as inferred by electromyography data was not significant, but showed large effect sizes at 250-m (ηp2 = 0.16), 500-m (ηp2 = 0.15), and 750-m (ηp2 = 0.14). This indicates a possible effect for TENS influencing performance up to 1-km. Discussion: These findings do not support the use of TENS to improve 5-km TT performance.
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Affiliation(s)
- Andrew W Hibbert
- Institute of Sport, Exercise, and Active Living, Victoria UniversityMelbourne, VIC, Australia; College of Sport and Exercise Science, Victoria UniversityMelbourne, VIC, Australia
| | - François Billaut
- Institute of Sport, Exercise, and Active Living, Victoria UniversityMelbourne, VIC, Australia; Department of Kinesiology, University LavalQuebec, QC, Canada
| | - Matthew C Varley
- Institute of Sport, Exercise, and Active Living, Victoria University Melbourne, VIC, Australia
| | - Remco C J Polman
- Institute of Sport, Exercise, and Active Living, Victoria UniversityMelbourne, VIC, Australia; Psychology Department, Bournemouth UniversityBournemouth, UK
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Astokorki AHY, Mauger AR. Transcutaneous electrical nerve stimulation reduces exercise-induced perceived pain and improves endurance exercise performance. Eur J Appl Physiol 2017; 117:483-492. [PMID: 28160085 PMCID: PMC5346431 DOI: 10.1007/s00421-016-3532-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/29/2016] [Indexed: 11/21/2022]
Abstract
Purpose Muscle pain is a natural consequence of intense and prolonged exercise and has been suggested to be a limiter of performance. Transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) have been shown to reduce both chronic and acute pain in a variety of conditions. This study sought to ascertain whether TENS and IFC could reduce exercise-induced pain (EIP) and whether this would affect exercise performance. It was hypothesised that TENS and IFC would reduce EIP and result in an improved exercise performance. Methods In two parts, 18 (Part I) and 22 (Part II) healthy male and female participants completed an isometric contraction of the dominant bicep until exhaustion (Part I) and a 16.1 km cycling time trial as quickly as they could (Part II) whilst receiving TENS, IFC, and a SHAM placebo in a repeated measures, randomised cross-over, and placebo-controlled design. Perceived EIP was recorded in both tasks using a validated subjective scale. Results In Part I, TENS significantly reduced perceived EIP (mean reduction of 12%) during the isometric contraction (P = 0.006) and significantly improved participants’ time to exhaustion by a mean of 38% (P = 0.02). In Part II, TENS significantly improved (P = 0.003) participants’ time trial completion time (~2% improvement) through an increased mean power output. Conclusion These findings demonstrate that TENS can attenuate perceived EIP in a healthy population and that doing so significantly improves endurance performance in both submaximal isometric single limb exercise and whole-body dynamic exercise.
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Affiliation(s)
- Ali H Y Astokorki
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, ME4 4AG, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, ME4 4AG, UK.
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Monks MR, Compton CT, Yetman JD, Power KE, Button DC. Repeated sprint ability but not neuromuscular fatigue is dependent on short versus long duration recovery time between sprints in healthy males. J Sci Med Sport 2016; 20:600-605. [PMID: 27825551 DOI: 10.1016/j.jsams.2016.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/01/2016] [Accepted: 10/09/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES During maximal intensity leg cycling sprints, previous research has shown that central and peripheral fatigue development occurs with various (<30s) short-duration recovery periods between sprints. The aim of the current study was to compare the development of neuromuscular fatigue during maximal intensity lower-body sprints interspersed with short and longer duration recovery periods. DESIGN Crossover study. METHODS Ten participants completed 10, 10s sprints interspersed with either 30 or 180s of recovery. Peak power outputs were measured for each sprint. Maximal force, voluntary activation (VA) and evoked contractile properties of the knee extensors were measured at pre-sprint 1, post-sprint 5 and post-sprint 10. Perceived pain was also measured immediately following each sprint. RESULTS Peak power output was significantly lower by 16.1±4.2% (p<0.001) during sprint 10 with 30 compared to 180s of recovery. Irrespective of recovery time, maximal force, VA and potentiated twitch force decreased by 26.7±7.2% (p<0.005), 5.8±1.2% (p=0.025), 38.7±6.1% (p=0.003) respectively, from pre-sprint 1 to post-sprint 10. MVC and PT decreased by 17±4% (p<0.003) and 23±9% (p<0.002) respectively, from pre-sprint 1 to post-sprint 5. CONCLUSIONS Although decreases in peak power and increases in perceived pain were greater when sprints were interspersed with 30 compared to 180s of recovery, the development of neuromuscular fatigue of the knee extensors was similar. The results illustrate that peripheral fatigue developed early whereas central fatigue developed later in the sprint protocol, however the effect of recovery time on neuromuscular fatigue could be task specific.
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Affiliation(s)
- Michael R Monks
- School of Human Kinetics and Recreation, Memorial University, Canada
| | - Chris T Compton
- School of Human Kinetics and Recreation, Memorial University, Canada
| | - Joseph D Yetman
- School of Human Kinetics and Recreation, Memorial University, Canada
| | - Kevin E Power
- School of Human Kinetics and Recreation, Memorial University, Canada; BioMedical Sciences, Faculty of Medicine, Memorial University, Canada
| | - Duane C Button
- School of Human Kinetics and Recreation, Memorial University, Canada; BioMedical Sciences, Faculty of Medicine, Memorial University, Canada.
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Hureau TJ, Romer LM, Amann M. The 'sensory tolerance limit': A hypothetical construct determining exercise performance? Eur J Sport Sci 2016; 18:13-24. [PMID: 27821022 DOI: 10.1080/17461391.2016.1252428] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Neuromuscular fatigue compromises exercise performance and is determined by central and peripheral mechanisms. Interactions between the two components of fatigue can occur via neural pathways, including feedback and feedforward processes. This brief review discusses the influence of feedback and feedforward mechanisms on exercise limitation. In terms of feedback mechanisms, particular attention is given to group III/IV sensory neurons which link limb muscle with the central nervous system. Central corollary discharge, a copy of the neural drive from the brain to the working muscles, provides a signal from the motor system to sensory systems and is considered a feedforward mechanism that might influence fatigue and consequently exercise performance. We highlight findings from studies supporting the existence of a 'critical threshold of peripheral fatigue', a previously proposed hypothesis based on the idea that a negative feedback loop operates to protect the exercising limb muscle from severe threats to homeostasis during whole-body exercise. While the threshold theory remains to be disproven within a given task, it is not generalisable across different exercise modalities. The 'sensory tolerance limit', a more theoretical concept, may address this issue and explain exercise tolerance in more global terms and across exercise modalities. The 'sensory tolerance limit' can be viewed as a negative feedback loop which accounts for the sum of all feedback (locomotor muscles, respiratory muscles, organs, and muscles not directly involved in exercise) and feedforward signals processed within the central nervous system with the purpose of regulating the intensity of exercise to ensure that voluntary activity remains tolerable.
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Affiliation(s)
- Thomas J Hureau
- a Department of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Lee M Romer
- b Centre for Human Performance, Exercise and Rehabilitation, Department of Life Sciences , Brunel University London , UK
| | - Markus Amann
- a Department of Medicine , University of Utah , Salt Lake City , UT , USA
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Flood A, Waddington G, Thompson K, Cathcart S. Increased conditioned pain modulation in athletes. J Sports Sci 2016; 35:1066-1072. [DOI: 10.1080/02640414.2016.1210196] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Patterson SD, Bezodis NE, Glaister M, Pattison JR. The Effect of Ischemic Preconditioning on Repeated Sprint Cycling Performance. Med Sci Sports Exerc 2016; 47:1652-8. [PMID: 25412297 DOI: 10.1249/mss.0000000000000576] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Ischemic preconditioning enhances exercise performance. We tested the hypothesis that ischemic preconditioning would improve intermittent exercise in the form of a repeated sprint test during cycling ergometry. METHODS In a single-blind, crossover study, 14 recreationally active men (mean ± SD age, 22.9 ± 3.7 yr; height, 1.80 ± 0.07 m; and mass, 77.3 ± 9.2 kg) performed twelve 6-s sprints after four 5-min periods of bilateral limb occlusion at 220 mm Hg (ischemic preconditioning) or 20 mm Hg (placebo). RESULTS Ischemic preconditioning resulted in a 2.4% ± 2.2%, 2.6% ± 2.7%, and 3.7% ± 2.4% substantial increase in peak power for sprints 1, 2, and 3, respectively, relative to placebo, with no further changes between trials observed for any other sprint. Similar findings were observed in the first three sprints for mean power output after ischemic preconditioning (2.8% ± 2.5%, 2.6% ± 2.5%, and 3.4% ± 2.1%, for sprints 1, 2, and 3, respectively), relative to placebo. Fatigue index was not substantially different between trials. At rest, tissue saturation index was not different between the trials. During the ischemic preconditioning/placebo stimulus, there was a -19.7% ± 3.6% decrease in tissue saturation index in the ischemic preconditioning trial, relative to placebo. During exercise, there was a 5.4% ± 4.8% greater maintenance of tissue saturation index in the ischemic preconditioning trial, relative to placebo. There were no substantial differences between trials for blood lactate, electromyography (EMG) median frequency, oxygen uptake, or rating of perceived exertion (RPE) at any time points. CONCLUSION Ischemic preconditioning improved peak and mean power output during the early stages of repeated sprint cycling and may be beneficial for sprint sports.
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Affiliation(s)
- Stephen D Patterson
- School of Sport, Health and Applied Science, St Mary's University, Strawberry Hill, Twickenham, UNITED KINGDOM
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Astokorki AHY, Mauger AR. Tolerance of exercise-induced pain at a fixed rating of perceived exertion predicts time trial cycling performance. Scand J Med Sci Sports 2016; 27:309-317. [PMID: 26888740 DOI: 10.1111/sms.12659] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 01/02/2023]
Abstract
To compare the predictive capacity of experimental pain and exercised-induced pain (EIP) on exercise performance. Thirty-two recreationally active male (n = 23) and female (n = 9) participants were recruited. Participants completed measures of pain tolerance by cold pressor test (CPT), pain pressure threshold via algometry (PPT), and EIP tolerance using an RPE clamp trial. A VO2max test provided traditional predictors of performance [VO2max , gas-exchange threshold (GET), peak power output (PPO)]. Finally, participants completed a 16.1-km cycling time trial (TT). No correlation was found between experimental pain measures (CPT, PPT) and TT performance. However, there was a significant correlation between EIP tolerance and TT performance (R = -0.83, P < 0.01). Regression analysis for pain and physiological predictor variables (mean pain in CPT, PPT, EIP tolerance, VO2max , PPO, GET) revealed that a significant model (P < 0.01) emerged when only PPO (Adjusted R2 = 0.739) and EIP tolerance (ΔR2 = 0.075) were used to predict TT performance. These findings suggest that EIP tolerance is an important factor in endurance performance. However, PPT and CPT have limited ability to assess this relationship, and so their use in EIP research should be treated with caution.
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Affiliation(s)
- A H Y Astokorki
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK
| | - A R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK
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Pearcey GE, Bradbury-Squires DJ, Monks M, Philpott D, Power KE, Button DC. Arm-cycling sprints induce neuromuscular fatigue of the elbow flexors and alter corticospinal excitability of the biceps brachii. Appl Physiol Nutr Metab 2016; 41:199-209. [DOI: 10.1139/apnm-2015-0438] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We examined the effects of arm-cycling sprints on maximal voluntary elbow flexion and corticospinal excitability of the biceps brachii. Recreationally trained athletes performed ten 10-s arm-cycling sprints interspersed with 150 s of rest in 2 separate experiments. In experiment A (n = 12), maximal voluntary contraction (MVC) force of the elbow flexors was measured at pre-sprint 1, post-sprint 5, and post-sprint 10. Participants received electrical motor point stimulation during and following the elbow flexor MVCs to estimate voluntary activation (VA). In experiment B (n = 7 participants from experiment A), supraspinal and spinal excitability of the biceps brachii were measured via transcranial magnetic and transmastoid electrical stimulation that produced motor evoked potentials (MEPs) and cervicomedullary motor evoked potentials (CMEPs), respectively, during a 5% isometric MVC at pre-sprint 1, post-sprint 1, post-sprint 5, and post-sprint 10. In experiment A, mean power output, MVC force, potentiated twitch force, and VA decreased 13.1% (p < 0.001), 8.7% (p = 0.036), 27.6% (p = 0.003), and 5.6% (p = 0.037), respectively, from pre-sprint 1 to post-sprint 10. In experiment B, (i) MEPs decreased 42.1% (p = 0.002) from pre-sprint 1 to post-sprint 5 and increased 40.1% (p = 0.038) from post-sprint 5 to post-sprint 10 and (ii) CMEPs increased 28.5% (p = 0.045) from post-sprint 1 to post-sprint 10. Overall, arm-cycling sprints caused neuromuscular fatigue of the elbow flexors, which corresponded with decreased supraspinal and increased spinal excitability of the biceps brachii. The different post-sprint effects on supraspinal and spinal excitability may illustrate an inhibitory effect on supraspinal drive that reduces motor output and, therefore, decreases arm-cycling sprint performance.
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Affiliation(s)
- Gregory E.P. Pearcey
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | | | - Michael Monks
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Devin Philpott
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Kevin E. Power
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Duane C. Button
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
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Coombs GB, Cramer MN, Ravanelli NM, Morris NB, Jay O. Acute acetaminophen ingestion does not alter core temperature or sweating during exercise in hot-humid conditions. Scand J Med Sci Sports 2016; 25 Suppl 1:96-103. [PMID: 25943660 DOI: 10.1111/sms.12336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
Abstract
Acute acetaminophen (ACT) ingestion has been reported to reduce thermal strain during cycling in the heat. In this study, nine active participants ingested 20 mg of ACT per kg of total body mass (ACT) or a placebo (PLA), 60 min prior to cycling at a fixed rate of metabolic heat production (ACT: 8.3 ± 0.3 W/kg; PLA: 8.5 ± 0.5 W/kg), which was equivalent to 55 ± 6% VO2max , for 60 min at 34.5 ± 0.1 °C, 52 ± 1% relative humidity. Resting rectal temperature (Tre ; ACT: 36.70 ± 0.17 °C; PLA: 36.80 ± 0.16 °C, P = 0.24), esophageal temperature (Tes ; ACT: 36.54 ± 0.22 °C; PLA: 36.61 ± 0.17 °C, P = 0.50) and mean skin temperature (Tsk ; ACT: 34.00 ± 0.14 °C; PLA: 33.96 ± 0.20 °C, P = 0.70) were all similar among conditions. At end-exercise, no differences in ΔTre (ACT: 1.12 ± 0.15 °C; PLA: 1.11 ± 0.21 °C, P = 0.92), ΔTes (ACT: 0.90 ± 0.28 °C; PLA: 0.88 ± 0.23 °C, P = 0.84), ΔTsk (ACT: 0.80 ± 0.39 °C; PLA: 0.70 ± 0.46 °C, P = 0.63), mean local sweat rate (ACT: 1.02 ± 0.15 mg/cm(2) /min; PLA: 1.02 ± 0.13 mg/cm(2) /min, P = 0.98) and whole-body sweat loss (ACT: 663 ± 83 g; PLA: 663 ± 77 g, P = 0.995) were evident. Furthermore, ratings of perceived exertion and thermal sensation and thermal comfort were not different between ACT and PLA conditions. In conclusion, ACT ingested 60 min prior to moderate intensity exercise in hot-humid conditions does not alter physiologic thermoregulatory control nor perceived strain.
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Affiliation(s)
- G B Coombs
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Angius L, Hopker JG, Marcora SM, Mauger AR. The effect of transcranial direct current stimulation of the motor cortex on exercise-induced pain. Eur J Appl Physiol 2015; 115:2311-9. [PMID: 26148882 DOI: 10.1007/s00421-015-3212-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/28/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE Transcranial direct current stimulation (tDCS) provides a new exciting means to investigate the role of the brain during exercise. However, this technique is not widely used in exercise science, with little known regarding effective electrode montages. This study investigated whether tDCS of the motor cortex (M1) would elicit an analgesic response to exercise-induced pain (EIP). METHODS Nine participants completed a VO2max test and three time to exhaustion (TTE) tasks on separate days following either 10 min 2 mA tDCS of the M1, a sham or a control. Additionally, seven participants completed 3 cold pressor tests (CPT) following the same experimental conditions (tDCS, SHAM, CON). Using a well-established tDCS protocol, tDCS was delivered by placing the anodal electrode above the left M1 with the cathodal electrode above dorsolateral right prefrontal cortex. Gas exchange, blood lactate, EIP and ratings of perceived exertion (RPE) were monitored during the TTE test. Perceived pain was recorded during the CPT. RESULTS During the TTE, no significant differences in time to exhaustion, RPE or EIP were found between conditions. However, during the CPT, perceived pain was significantly (P < 0.05) reduced in the tDCS condition (7.4 ± 1.2) compared with both the CON (8.6 ± 1.0) and SHAM (8.4 ± 1.3) conditions. CONCLUSION These findings demonstrate that stimulation of the M1 using tDCS does not induce analgesia during exercise, suggesting that the processing of pain produced via classic measures of experimental pain (i.e., a CPT) is different to that of EIP. These results provide important methodological advancement in developing the use of tDCS in exercise.
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Affiliation(s)
- Luca Angius
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - James G Hopker
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - Samuele M Marcora
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK.
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45
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Koziris L(P. Acetaminophen for All-out Power Output. Strength Cond J 2014. [DOI: 10.1519/ssc.0000000000000098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
During prolonged dynamic and rhythmic exercise, muscular pain and discomfort arises as a result of an increased concentration of deleterious metabolites. Sensed by peripheral nociceptors and transmitted via afferent feedback to the brain, this provides important information regarding the physiological state of the muscle. These sensations ultimately contribute to what is termed "exercise-induced pain". Despite being well recognized by athletes and coaches, and suggested to be integral to exercise performance, this construct has largely escaped attention in experimental work. This perspective article highlights the current understanding of pacing in endurance performance, and the causes of exercise-induced pain. A new perspective is described, which proposes how exercise-induced pain may be a contributing factor in helping individuals to regulate their work rate during exercise and thus provides an important construct in pacing.
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Affiliation(s)
- Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK
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47
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Acetaminophen and sport performance: doping or what? Eur J Appl Physiol 2014; 114:881-2. [DOI: 10.1007/s00421-014-2852-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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