Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response

Acute responses and recovery in the femoral cartilage morphology following running and cool-down protocols

This study compared the immediate effects of two common post-exercise cool-down methods to a control condition on subsequent morphologic change in femoral cartilage and vascular response in the posterior tibial artery after running. Sixteen healthy young males (23.6 ± 2.2 years, 172.8 ± 4.9 cm, 72.2 ± 7.1 kg) visited the laboratory during three separate sessions and performed 30-min of treadmill running (7.5 km/h for the initial 5-min, followed 8.5 km/h for 25-min). After running, participants experienced one of three 30-min cool-down protocols: active cool-down, cold application, or control (seated rest with their knee fully extended), in a counterbalanced order. Ultrasonographic assessments of femoral cartilage thickness (intercondylar, lateral, and medial) and posterior tibial artery blood flow were compared. To test condition effects over time, two-way analysis of variances and Tukey tests were used (p < 0.05) with Cohen's d effect sizes (ES). There was no condition by time interaction in femoral cartilage thickness (intercondylar: F30,705 = 0.91, p = 0.61; lateral: F30,705 = 1.24, p = 0.18; medial: F30,705 = 0.49, p = 0.99). Regardless of time (condition effect: F2,705 > 3.24, p < 0.04 for all tests), femoral cartilage in the cold application condition was thicker than the control condition (intercondylar: p = 0.01, ES = 0.16; lateral: p < 0.0001, ES = 0.24; medial: p = 0.04. ES = 0.16). Regardless of condition (time effect: F15,705 > 10.31, p < 0.0001 for all tests), femoral cartilage thickness was decreased after running (intercondylar: p < 0.0001, ES = 1.37; lateral: p < 0.0001, ES = 1.58; medial: p < 0.0001, ES = 0.81) and returned to baseline levels within 40-min (intercondylar: p = 0.09; lateral: p = 0.64; medial: p = 0.26). Blood flow volume was different (condition × time: F30,705 = 2.36, p < 0.0001) that running-induced blood flow volume was maintained for 30-min for the active cool-down condition (p < 0.0001, ES = 1.64), whereas it returned to baseline levels within 10-min for other conditions (cold application: p = 0.67; control: p = 0.62). Neither blood flow nor temperature had a significant impact on the recovery in femoral cartilage after running.

What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials

BACKGROUND

Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes.

OBJECTIVES

To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps.

RESULTS

Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes.

CONCLUSIONS

There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose-response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies.

REGISTRATION

OSF project ( https://osf.io/6auyj/ ) and registration ( https://osf.io/gu8ya ).

Blood Lactate and Heart Rate Responses Between Active and Passive Recovery Modes Over a 15-Minute Recovery Period in Female Dancers After Kathak Dance

Introduction: Dance is physically demanding and results in blood lactate (BL) accumulation and elevated Heart Rate (HR). Researchers recommend using either Active Recovery (AR; eg, low-to-moderate intensity-exercise) or Passive Recovery (PR; eg, complete rest) modes after activity. We compared BL and HR responses between AR or PR over a 15-minute recovery period following a Kathak dance. Methods: Twelve female dancers (31.0 ± 6.0 years; 161.5 ± 4.9 cm; 55.5 ± 5.8 kg) performed 2 dance testing sessions (Day 1 = AR, Day 2 = PR) 48 hours apart. Each session started with a 10-minute warm up followed by dancers performing four 2-minute stages of Kathak dance, with three 1-minute periods between stages where we recorded HR and their Rate of Perceived Exertion (RPE:scale = 6-20) to match the intensity of both sessions. Post-dance, we recorded dancers' BL and HR at 1, 3, 5, 10, and 15 minutes while they recovered via AR or PR. Separate 2(mode) × (time) Repeated-Measures-ANOVA followed by simple-main-effects testing and adjusted Bonferroni-pairwise-comparisons examined differences in BL and HR responses across modes and time(α = .05). Results: Dancers' HR and RPE were similar across sessions. No mode × time interaction existed in BL (F4,8 = 3.6, P = .06). BL levels were similar across modes (F1,2 = 0.5, P = .5). BL levels reduced over time (F4,8 = 6.0, P = .02), but Bonferroni-comparisons did not reveal any pairwise differences. In HR a significant mode*time interaction (F4,36 = 11.0, P = .01, η2 = .55) was observed. Both Active and Passive recovery modes achieved absolute HR levels by 15 minutes, with PR mode stabilizing within 5 minutes. Conclusions: Over a 15-minute recovery period after Kathak dance, dancers' BL and HR responses were similar across time in both AR and PR, with HR being higher in AR. Dancers' HR remained similar from 1 to 3 minute post dance recovery and then dropped over time. Thus, dancers can rest up to 3 minutes and still maintain the same elevated HR. Overall, dancers can choose either AR or PR as their recovery mode based on their individual preferences.

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

OBJECTIVE

This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.

METHODS

Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus.

RESULTS

The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals.

CONCLUSION

In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition.

Comparative Effectiveness of Active Recovery and Static Stretching During Post-Exercise Recovery in Elite Youth Basketball

Purpose: To compare the effectiveness of active recovery (AR) versus static stretching (SS) during post-exercise recovery in basketball. Methods: Using a counterbalanced crossover design, 17 elite youth male players completed two 90-min training sessions, followed by either AR or SS. Differences in jump height (CMJ), heart rate variability (Ln-rMSSD), muscle soreness (VAS), perceived recovery (TQR) and hormonal biomarkers (cortisol, testosterone, testosterone:cortisol ratio) between interventions were assessed at pre-session, post-session (except hormonal biomarkers), post-recovery and 24 h post-session. Differences in Ln-rMSSD were additionally assessed upon awakening on training day, and the following morning. Results: No significant differences were found between interventions at corresponding time points (p > .05). However, the within-intervention time course of recovery differed, as CMJ values were lower at post-recovery, compared with all other time points, in SS only (p < .05, effect size [ES] moderate-to-very large). Additionally, Ln-rMSSD values failed to return to baseline at post-recovery in AR only (p < .05, ES large-to-very large). Similarly, TQR scores were impaired at post-session and post-recovery in AR only (p < .05, ES moderate-to-large). No differences were reported for the remaining variables (p > .05). Conclusion: Differences between AR and SS were probably due to short-term phenomena, indicating that neither strategy was likely superior for improving recovery in the longer term. Overall, neither strategy seemed to significantly improve post-exercise recovery.

ChatGPT Generated Training Plans for Runners are not Rated Optimal by Coaching Experts, but Increase in Quality with Additional Input Information

ChatGPT may be used by runners to generate training plans to enhance performance or health aspects. However, the quality of ChatGPT generated training plans based on different input information is unknown. The objective of the study was to evaluate ChatGPT-generated six-week training plans for runners based on different input information granularity. Three training plans were generated by ChatGPT using different input information granularity. 22 quality criteria for training plans were drawn from the literature and used to evaluate training plans by coaching experts on a 1-5 Likert Scale. A Friedmann test assessed significant differences in quality between training plans. For training plans 1, 2 and 3, a median rating of <3 was given 19, 11, and 1 times, a median rating of 3 was given 3, 5, and 8 times and a median rating of >3 was given 0, 6, 13 times, respectively. Training plan 1 received significantly lower ratings compared to training plan 2 for 3 criteria, and 15 times significantly lower ratings compared to training plan 3 (p < 0.05). Training plan 2 received significantly lower ratings (p < 0.05) compared to plan 3 for 9 criteria. ChatGPT generated plans are ranked sub-optimally by coaching experts, although the quality increases when more input information are provided. An understanding of aspects relevant to programming distance running training is important, and we advise avoiding the use of ChatGPT generated training plans without an expert coach's feedback.

Effects of 12-week full body resistance exercise on vertical jumping with and without military equipment in Slovenian Armed Forces

INTRODUCTION

Jumping ability is one of the most important physical qualities in military personnel. Previous training intervention studies have shown equivocal effects on jumping ability. In this study, we assessed the effect of a 12-week resistance exercise programme on countermovement jump (CMJ) performance with and without military equipment.

METHODS

Ninety-six members of the Slovenian Armed Forces (age range 20-47 years) were allocated to the intervention (n=65) and the control (n=32) group. The intervention group performed 2 sessions of full body resistance exercise per week for 12 weeks, while the control group continued with their regular training routine. Before and after the intervention, CMJ assessment using force plates was conducted with and without military equipment.

RESULTS

CMJ testing with and without equipment both exhibited high to excellent relative and absolute reliability. The intervention elicited statistically significant (p=0.011-0.026; η2=0.05-0.06), but small improvements in CMJ height when performed without equipment (from 28.2±3.8 cm to 29.5±3.3 cm) and with equipment (from 25.3±3.7 cm to 27.1±6.1). Other variables showed even smaller or trivial changes.

CONCLUSIONS

This study suggests that CMJ with equipment could be a reliable tool to assess jumping performance specific to requirements of military work, which would increase the ecological validity of the testing. The present structured full-body training intervention showed modest improvements in jumping ability in both testing conditions.

TRIAL REGISTRATION NUMBER

NCT0341546.

Physical Activity Management for Youth With Type 1 Diabetes: Supporting Active and Inactive Children

Regular physical activity and exercise are important for youth and essential components of a healthy lifestyle. For youth with type 1 diabetes, regular physical activity can promote cardiovascular fitness, bone health, insulin sensitivity, and glucose management. However, the number of youth with type 1 diabetes who regularly meet minimum physical activity guidelines is low, and many encounter barriers to regular physical activity. Additionally, some health care professionals (HCPs) may be unsure how to approach the topic of exercise with youth and families in a busy clinic setting. This article provides an overview of current physical activity research in youth with type 1 diabetes, a basic description of exercise physiology in type 1 diabetes, and practical strategies for HCPs to conduct effective and individualized exercise consultations for youth with type 1 diabetes.

Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation ― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―

Background: The purpose of this study was to investigate the actual conditions of cardiac rehabilitation (CR) for elderly patients with heart failure (HF) in outpatient rehabilitation (OR) facilities using long-term care insurance systems. Methods and Results: This was a cross-sectional web-based questionnaire survey conducted at 1,258 facilities in the Kansai region (6 prefectures) of Japan from October to December 2021. In all, 184 facilities responded to the web-based questionnaire (response rate 14.8%). Of these facilities, 159 (86.4%) accepted patients with HF. Among the patients with HF, 94.3% were aged ≥75 years and 66.7% were classified as New York Heart Association functional class I/II. Facilities treating patients with HF generally provided exercise therapy, patient education, and disease management, which were components of CR. Many facilities not currently treating patients with HF responded positively stating they will accept HF patients in the future. However, a few facilities responded by stating that they are waiting for clearer evidence demonstrating the beneficial effect of OR on patients with HF. Conclusions: The present results show the possibility that outpatient CR can be performed for elderly patients with HF in other than medical insurance.

Assessment of fatigue and recovery in elite cheerleaders prior to and during the ICU World Championships

Introduction

Little is known about the demands of competitive cheerleading. Therefore, the objective of this study was to assess fatigue and recovery during preparation for world championships.

Methods

Fifteen participants from the German senior "All-Girl" and "Coed" national teams (nine males and six women) were recruited. Data were collected during the final preparation (T1 -T7) and competition days (C1 -C2). Heart rate variability (HRV) and resting heart rate (HR) were measured every morning. Data on training load, recovery, and stress (Short Scale for Recovery and Stress) were surveyed after training. Countermovement jump height (CMJ), sit-and-reach, and exercise-induced muscle damage (EMID) scores were taken in the afternoon.

Results

There was a practically relevant decrease in CMJ (T2, T6). A trend for HR to increase (T5-C2) and HRV to decrease (T4, T6-C2) was evident. Through training, recovery decreased and recovered as C1 approached (mental performance: T2-T4 p = 0.004; T2-C1 p = 0.029; T3-T4 p = 0.029; emotional balance: T3-T4 p = 0.023; T3-C1 p = 0.014; general recovery status T1-T3 p = 0.008; T3-T4 p = 0.024; T3-C1 p = 0.041), whereas stress increased during the first days and returned to normal before C1 (emotional dysbalance: T2-T4 p = 0.014; T2-C1 p = 0.009; T3-T4 p = 0.023; T3-C1 p = 0.014). EMID scores increased for the upper and lower body between T3, T5-T7 (p ≤ 0.036) and T3, T6-T7 (p ≤ 0.047), respectively.

Discussion

Pre-competition training led to substantial fatigue, and most markers indicate that athletes do not compete fully recovered. This could possibly be avoided by optimizing the training load or implementing recovery strategies.

Universal Training Precautions: A Review of Evidence and Recommendations for Prevention of Exercise-Related Injury, Illness, and Death in Warfighters and Athletes

Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities.

Training History, Cardiac Autonomic Recovery from Submaximal Exercise and Associated Performance in Recreational Runners

This study investigated the effect of prolonged exertion on cardiac parasympathetic (cPS) reorganization and associated aerobic performance in response to repeated short-lasting submaximal exercise bouts (SSE) performed for 7 days following prolonged exertion. In 19 recreational runners, heart rate (HR) and HR variability (HRV) indices (lnRMSSD, lnHF, and lnLF/HF) were monitored pre- and post-submaximal graded cycling performed on consecutive days following a half-marathon (HM) and compared with the baseline, pre-HM values. Additionally, HR recovery (HRR), aerobic performance, and rate of perceived exertion (RPE) were determined. HR, HRV indices, and HRR were tested for correlation with exercise performance. A significant time effect was found in HR, HRR, and HRV indices as well as in aerobic performance and RPE during the study period. Most of the measured parameters differed from their baseline values only on the same day following HM. However, HRR and HR measured in recovery after SSE were additionally affected one day following the half-marathon yet in opposite directions to those recorded on the same day as the HM. Thus, postSSE HR and HRR exhibited a bivariate time response (postSSE HR: 102 ± 14 bpm; p < 0.001; 82 ± 11 bpm; p = 0.007 vs. 88 ± 11 bpm; HRR in 30 s after SSE cessation: 14.9 ± 4.9 bpm; p < 0.001; 30.1 ± 13.3 bpm; p = 0.006 vs. 24.4 ± 10.8 bpm), potentially indicating a cPS dysfunction phase on the same day and cPS rebound phase one day following HM reflected also in consecutive changes in aerobic power. Correlations were found between the changes in measured cardiac indices with respect to baseline and the changes in aerobic performance indices throughout the study period. The effect of exercise history on cPS reorganization is more pronounced in response to SSE than at rest. Accordingly, we conclude that SSE performed repeatedly on a daily basis following prolonged exertion offers a noninvasive tool to evaluate the impact of training history on cPS recovery and associated aerobic power output in recreational athletes.

Comparison of 4 Different Cooldown Strategies on Lower-Leg Temperature, Blood Lactate Concentration, and Fatigue Perception After Intense Running

CONTEXT

Although active recovery (AR) and cold application is recommended, many people take a shower after exercise. Therefore, a direct comparison between a shower and other recommended methods (AR and/or cold-water immersion) is necessary. To compare immediate effects of 4 postexercise cooldown strategies after running.

DESIGN

A crossover design.

METHODS

Seventeen young, healthy males (23 y; 174 cm; 73 kg) visited on 4 different days and performed a 10-minute intense treadmill run (5 km/h at a 1% incline, then a belt speed of 1 km/h, and an incline of 0.5% were increased every minute). Then, subjects randomly experienced 4 different 30-minute cooldown strategies each session-AR (10-min treadmill walk + 10-min static stretch + 10-min shower), cold-water walk (10-min shower + 20-min walk in cold water), cold-water sit (10-min shower + 20-min sit in cold water), and passive recovery (10-min shower + 20-min passive recovery). Across the cooldown conditions, the water temperatures for immersion and shower were set as 18 °C and 25 °C, respectively. Lower-leg muscle temperature, blood lactate concentration, and fatigue perception were statistically compared (P < .001 for all tests) and effect sizes (ES) were calculated.

RESULTS

The cold-water walk condition (F135,2928 = 69.29, P < .0001) was the most effective in reducing muscle temperature after running (-11.6 °C, ES = 9.46, P < .0001), followed by the cold-water sit (-8.4 °C, ES = 8.61, P < .0001), passive recovery (-4.5 °C, ES = 4.36, P < .0001), and AR (-4.0 °C, ES = 4.29, P < .0001) conditions. Blood lactate concentration (F6,176 = 0.86, P = .52) and fatigue perception (F6,176 = 0.18, P = .98) did not differ among the 4 conditions.

CONCLUSIONS

While the effect of lowering the lower-leg temperature was different, the effect of reducing blood lactate concentration and fatigue perception were similar in the 4 cooldown strategies. We suggest selecting the appropriate method while considering the specific goal, available time, facility, and accessibility.

Breast Cancer Physical Activity Mobile Intervention: Early Findings From a User Experience and Acceptability Mixed Methods Study

BACKGROUND

Physical activity (PA) is the most well-established lifestyle factor associated with breast cancer (BC) survival. Even women with advanced BC may benefit from moderate PA. However, most BC symptoms and treatment side effects are barriers to PA. Mobile health coaching systems can implement functionalities and features based on behavioral change theories to promote healthier behaviors. However, to increase its acceptability among women with BC, it is essential that these digital persuasive systems are designed considering their contextual characteristics, needs, and preferences.

OBJECTIVE

This study aimed to examine the potential acceptability and feasibility of a mobile-based intervention to promote PA in patients with BC; assess usability and other aspects of the user experience; and identify key considerations and aspects for future improvements, which may help increase and sustain acceptability and engagement.

METHODS

A mixed methods case series evaluation of usability and acceptability was conducted in this study. The study comprised 3 sessions: initial, home, and final sessions. Two standardized scales were used: the Satisfaction with Life Scale and the International Physical Activity Questionnaire-Short Form. Participants were asked to use the app at home for approximately 2 weeks. App use and PA data were collected from the app and stored on a secure server during this period. In the final session, the participants filled in 2 app evaluation scales and took part in a short individual interview. They also completed the System Usability Scale and the user version of the Mobile App Rating Scale. Participants were provided with a waist pocket, wired in-ear headphones, and a smartphone. They also received printed instructions. A content analysis of the qualitative data collected in the interviews was conducted iteratively, ensuring that no critical information was overlooked.

RESULTS

The International Physical Activity Questionnaire-Short Form found that all participants (n=4) were moderately active; however, half of them did not reach the recommended levels in the guidelines. System Usability Scale scores were all >70 out of 100 (72.5, 77.5, 95, and 80), whereas the overall user version of the Mobile App Rating Scale scores were 4, 4.3, 4.4, and 3.6 out of 5. The app was perceived to be nice, user-friendly, straightforward, and easy to understand. Recognition of achievements, the possibility of checking activity history, and the rescheduling option were positively highlighted. Technical difficulties with system data collection, particularly with the miscount of steps, could make users feel frustrated. The participants suggested improvements and indicated that the app has the potential to work well for survivors of BC.

CONCLUSIONS

Early results presented in this study point to the potential of this tool concept to provide a friendly and satisfying coaching experience to users, which may help improve PA adherence in survivors of BC.

Effects of a Short-Term Heat Acclimation Protocol in Elite Amateur Boxers

ABSTRACT

Stone, BL, Ashley, JD, Skinner, RM, Polanco, JP, Walters, MT, Schilling, BK, and Kellawan, JM. Effects of a short-term heat acclimation protocol in elite amateur boxers. J Strength Cond Res XX(X): 000-000, 2022-Boxing requires proficient technical and tactical skills coupled with high levels of physiological capacity. Although heat and humidity negatively affect acute exercise performance, short-term exercise training in hot and humid environments can lead to physiological adaptations that enhance exercise performance in both hot and thermoneutral conditions. In highly trained endurance athletes, exercise-induced acclimation can occur in as little as 5 days (known as short-term heat acclimation [STHA]). However, the impact of a 5-day heat acclimation (5-DayHA) in combat athletes, such as elite amateur boxers, is unknown. The aim of the present investigation was to determine whether a 5-DayHA improves aerobic performance in a thermoneutral environment and causes positive physiological adaptations in elite boxers. Seven elite amateur boxers underwent a 5-DayHA protocol, consisting of 60-minute exercise sessions in an environmental chamber at 32 °C and 70% relative humidity. Repeat sprint test (RST) evaluated aerobic performance in a thermoneutral environment 24 hours before and after the 5-DayHA. Presession and postsession hydration status (urine specific gravity) and body mass were assessed. After a 5-DayHA period, boxers significantly improved RST performance (13 ± 7 to 19 ± 7 sprints, d = 0.92, p = 0.03) but not pre-exercise hydration status (1.02 ± 0.01 to 1.01 ± 0.01, d = 0.82, p = 0.07). Therefore, these findings suggest 5-DayHA enhances aerobic performance in elite-level amateur boxers and may provide a viable training option for elite combat athletes.

Evidence‐Based Recovery in Soccer – Low‐Effort Approaches for Practitioners

Strategies to improve recovery are widely used among soccer players at both amateur and professional levels. Sometimes, however, recovery strategies are ineffective, improperly timed or even harmful to players. This highlights the need to educate practitioners and athletes about the scientific evidence of recovery strategies as well as to provide practical approaches to address this issue. Therefore, recent surveys among soccer athletes and practitioners were reviewed to identify the recovery modalities currently in use. Each strategy was then outlined with its rationale, its physiological mechanisms and the scientific evidence followed by practical approaches to implement the modality. For each intervention, practical and particularly low-effort strategies are provided to ensure that practitioners at all levels are able to implement them. We identified numerous interventions regularly used in soccer, i.e., sleep, rehydration, nutrition, psychological recovery, active recovery, foam-rolling/massage, stretching, cold-water immersion, and compression garments. Nutrition and rehydration were classified with the best evidence, while cold-water immersion, compression garments, foam-rolling/massage and sleep were rated with moderate evidence to enhance recovery. The remaining strategies (active recovery, psychological recovery, stretching) should be applied on an individual basis due to weak evidence observed. Finally, a guide is provided, helping practitioners to decide which intervention to implement. Here, practitioners should rely on the evidence, but also on their own experience and preference of the players.

Comparison of Different Recovery Strategies After High-Intensity Functional Training: A Crossover Randomized Controlled Trial

We aimed to determine whether voluntary exercise or surface neuromuscular electrical stimulation (NMES) could enhance recovery after a high-intensity functional training (HIFT) session compared with total rest. The study followed a crossover design. Fifteen male recreational CrossFit athletes (29 ± 8 years) performed a HIFT session and were randomized to recover for 15 min with either low-intensity leg pedaling (“Exercise”), NMES to the lower limbs (“NMES”), or total rest (“Control”). Perceptual [rating of perceived exertion (RPE) and delayed-onset muscle soreness (DOMS) of the lower-limb muscles], physiological (heart rate, blood lactate and muscle oxygen saturation) and performance (jump ability) indicators of recovery were assessed at baseline and at different time points during recovery up to 24 h post-exercise. A significant interaction effect was found for RPE (p = 0.035), and although post hoc analyses revealed no significant differences across conditions, there was a quasi-significant (p = 0.061) trend toward a lower RPE with NMES compared with Control immediately after the 15-min recovery. No significant interaction effect was found for the remainder of outcomes (all p > 0.05). Except for a trend toward an improved perceived recovery with NMES compared with Control, low-intensity exercise, NMES, and total rest seem to promote a comparable recovery after a HIFT session.

Comprehensive Return to Competitive Distance Running: A Clinical Commentary

Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete's psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.

Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence

ABSTRACT

Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.

Immediate and Delayed Effects of Cupping Therapy on Reducing Neuromuscular Fatigue

Cupping therapy has been popular in elite athletes in recent years. However, the effect of cupping therapy on reducing muscle fatigue has not been investigated. The purpose of this study was to investigate the immediate and delayed effects of cupping therapy on reducing biceps brachii fatigue during biceps curls. Twelve healthy untrained participants were recruited for this repeated-measures study. Cupping therapy (–300 mmHg pressure for 5 min) and sham control (no negative pressure for 5 min) were applied after biceps fatigue induced by performing repeated biceps curls at 75% of the 10 repetitions of maximum of the non-dominant hand. Surface electromyography (EMG) with spectral analyses [mean frequency (MNF), median frequency (MDF), and spectral moments ratio (SMR)] were used to assess muscle fatigue during the fatigue task. EMG signals during the first 10 repetitions and the last 10 repetitions of biceps curls were used to assess neuromuscular fatigue. There were significant decreases in MNF and MDF and a significant increase in SMR immediately and 24 h after the sham control (no intervention). When comparing the MNF, MDF, and SMR after cupping therapy to the sham control, there was no significant immediate effect on reducing muscle fatigue. However, there was a significant delayed effect on improving recovery following fatigue for the cupping therapy compared to the sham control (MNF changes: sham 0.87 ± 0.02 vs. cupping 0.91 ± 0.02, p < 0.05; MDF changes sham: 0.85 ± 0.03 vs. cupping: 0.91 ± 0.02, p < 0.05; SMR changes: sham 1.89 ± 0.15 vs. cupping 1.58 ± 0.13, p < 0.05). The findings of this study demonstrate that there is a time effect of cupping therapy for reducing muscle fatigue. Cupping therapy is effective on reducing biceps brachii muscle fatigue after 24 h.

Prone restraint cardiac arrest: A comprehensive review of the scientific literature and an explanation of the physiology

Deaths occurring among agitated or violent individuals subjected to physical restraint have been attributed to positional asphyxia. Restraint in the prone position has been shown to alter respiratory and cardiac physiology, although this is thought not to be to the degree that would cause asphyxia in a healthy, adult individual. This comprehensive review identifies and summarizes the current scientific literature on prone position and restraint, including experiments that assess physiology on individuals restrained in a prone position. Some of these experimental approaches have attempted to replicate situations in which prone restraint would be used. Overall, most findings revealed that individuals subjected to physical prone restraint experienced a decrease in ventilation and/or cardiac output (CO) in prone restraint. Metabolic acidosis is noted with increased physical activity, in restraint-associated cardiac arrest and simulated encounters. A decrease in ventilation and CO can significantly worsen acidosis and hemodynamics. Given these findings, deaths associated with prone physical restraint are not the direct result of asphyxia but are due to cardiac arrest secondary to metabolic acidosis compounded by inadequate ventilation and reduced CO. As such, the cause of death in these circumstances would be more aptly referred to as "prone restraint cardiac arrest" as opposed to "restraint asphyxia" or "positional asphyxia."

Recovery during and after a simulated multi-day tennis tournament: Combining active recovery, stretching, cold-water immersion, and massage interventions

The aim of this study was to investigate the effects of a mixed-method recovery intervention (MMR) consisting of active recovery, stretching, cold-water immersion, and massage on physical, technical, physiological, and perceptual recovery during and after a five-day simulated tennis tournament. Nine competitive male tennis players (age, 24.6±4.2 years) with national ranking positions (German Tennis Federation) and Universal Tennis Ratings between approximately 11-13 participated in two singles tennis tournaments, which were separated by a three-month washout period. During the tournaments, participants played five two-and-a-half-hour competitive singles tennis match on five consecutive days. For the assignment to one of two groups, athletes were matched into homogeneous pairs according to their ranking. Then, within each pair, the players were randomly assigned to one of two groups. The first group performed MMR during the first tournament, whereas the other group used passive recovery (PAS). During the second tournament, recovery conditions were interchanged. Measures of physical and technical performance as well as physiological and perceptual responses (heart rate, blood lactate concentration, perceived exertion) were recorded during match-play sessions. Furthermore, muscle soreness, perceived recovery state, blood markers, countermovement jump height (CMJ), and repeated sprint ability (RSA) were determined before, during, and after the five-day tournament periods. Results showed significant changes over time (P < 0.05) in muscle soreness, perceived recovery state, creatine kinase, c-reactive protein, insulin-like growth factor 1, and countermovement jump height. However, no significant differences or recovery strategy x time interactions were noted either for tennis-specific performance (e.g. number of total points won) or any other of the measured parameters between MMR and PAS (P > 0.05). In conclusion, the repeated use of MMR during and after a five-day tennis tournament did not affect match performance, match load, or recovery from repeated days of tennis match play.

No Time to Lift? Designing Time-Efficient Training Programs for Strength and Hypertrophy: A Narrative Review

Abstract

Lack of time is among the more commonly reported barriers for abstention from exercise programs. The aim of this review was to determine how strength training can be most effectively carried out in a time-efficient manner by critically evaluating research on acute training variables, advanced training techniques, and the need for warm-up and stretching. When programming strength training for optimum time-efficiency we recommend prioritizing bilateral, multi-joint exercises that include full dynamic movements (i.e. both eccentric and concentric muscle actions), and to perform a minimum of one leg pressing exercise (e.g. squats), one upper-body pulling exercise (e.g. pull-up) and one upper-body pushing exercise (e.g. bench press). Exercises can be performed with machines and/or free weights based on training goals, availability, and personal preferences. Weekly training volume is more important than training frequency and we recommend performing a minimum of 4 weekly sets per muscle group using a 6–15 RM loading range (15–40 repetitions can be used if training is performed to volitional failure). Advanced training techniques, such as supersets, drop sets and rest-pause training roughly halves training time compared to traditional training, while maintaining training volume. However, these methods are probably better at inducing hypertrophy than muscular strength, and more research is needed on longitudinal training effects. Finally, we advise restricting the warm-up to exercise-specific warm-ups, and only prioritize stretching if the goal of training is to increase flexibility. This review shows how acute training variables can be manipulated, and how specific training techniques can be used to optimize the training response: time ratio in regard to improvements in strength and hypertrophy.

Graphic Abstract

Injury risk profile of amateur Irish women soccer players and players' opinions on risk factors and prevention strategies

OBJECTIVE

To explore injury profile, opinions on risk factors and injury prevention, among Irish amateur women soccer players.

DESIGN

A cross-sectional online survey.

SETTING

Irish amateur winter league.

PARTICIPANTS

Active players ≤18 years of age.

MAIN OUTCOMES

Differences were found between injured and uninjured groups, and risk factors that significantly predict soccer injury were identified.

RESULTS

168 injuries were reported by 83 respondents during the winter season. An increased prevalence of competition anxiety was observed in (53.8%:n = 85 of respondents) compared to other risk factors. There was a negative association between injuries and players' general health state (OR = 0.820, 95% CI 0.7-0.9, p = 0.007). Players' knowledge about some risk factors including playing position, joint hypermobility, and playing during menses contradicts current evidence. 50%; n = 67 of the respondents had not received any education on injury risk or prevention.

CONCLUSION

This study identified that Irish amateur women soccer players that responded have different characteristics, prevalence of risk factors and injury profiles to women players from different levels and countries. The findings suggest that some players may not be aware of the existing evidence base pertaining to common risk factors for injury. Further research is required to confirm the findings and explore the implementation of injury prevention strategies.

The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Post-exercise (i.e., cool-down) stretching is commonly prescribed for improving recovery of strength and range of motion (ROM) and diminishing delayed onset muscular soreness (DOMS) after physical exertion. However, the question remains if post-exercise stretching is better for recovery than other post-exercise modalities.

Objective: To provide a systematic review and meta-analysis of supervised randomized-controlled trials (RCTs) on the effects of post-exercise stretching on short-term (≤1 h after exercise) and delayed (e.g., ≥24 h) recovery makers (i.e., DOMS, strength, ROM) in comparison with passive recovery or alternative recovery methods (e.g., low-intensity cycling).

Methods: This systematic review followed PRISMA guidelines (PROSPERO CRD42020222091). RCTs published in any language or date were eligible, according to P.I.C.O.S. criteria. Searches were performed in eight databases. Risk of bias was assessed using Cochrane RoB 2. Meta-analyses used the inverse variance random-effects model. GRADE was used to assess the methodological quality of the studies.

Results: From 17,050 records retrieved, 11 RCTs were included for qualitative analyses and 10 for meta-analysis (n = 229 participants; 17–38 years, mostly males). The exercise protocols varied between studies (e.g., cycling, strength training). Post-exercise stretching included static stretching, passive stretching, and proprioceptive neuromuscular facilitation. Passive recovery (i.e., rest) was used as comparator in eight studies, with additional recovery protocols including low intensity cycling or running, massage, and cold-water immersion. Risk of bias was high in ~70% of the studies. Between-group comparisons showed no effect of post-exercise stretching on strength recovery (ES = −0.08; 95% CI = −0.54–0.39; p = 0.750; I² = 0.0%; Egger's test p = 0.531) when compared to passive recovery. In addition, no effect of post-exercise stretching on 24, 48, or 72-h post-exercise DOMS was noted when compared to passive recovery (ES = −0.09 to −0.24; 95% CI = −0.70–0.28; p = 0.187–629; I² = 0.0%; Egger's test p = 0.165–0.880).

Conclusion: There wasn't sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery. Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations. For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims.

Systematic Review Registration: PROSPERO, identifier: CRD42020222091.

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

There has been substantial progress in the knowledge of exercise and type 1 diabetes, with the development of guidelines for optimal glucose management. In addition, an increasing number of people living with type 1 diabetes are pushing their physical limits to compete at the highest level of sport. However, the post-exercise recovery routine, particularly with a focus on sporting performance, has received little attention within the scientific literature, with most of the focus being placed on insulin or nutritional adaptations to manage glycaemia before and during the exercise bout. The post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the rest of the day and overnight. The absence of clear guidance for the post-exercise period means that people with type 1 diabetes should either develop their own recovery strategies on the basis of individual trial and error, or adhere to guidelines that have been developed for people without diabetes. This Review provides an up-to-date consensus on post-exercise recovery and glucose management for individuals living with type 1 diabetes. We aim to: (1) outline the principles and time course of post-exercise recovery, highlighting the implications and challenges for endurance athletes living with type 1 diabetes; (2) provide an overview of potential strategies for post-exercise recovery that could be used by athletes with type 1 diabetes to optimise recovery and adaptation, alongside improved glycaemic monitoring and management; and (3) highlight the potential for technology to ease the burden of managing glycaemia in the post-exercise recovery period.

Repeatability of the Individual Response to the Use of Active Recovery the Day After High-Intensity Interval Training: A Double-Crossover Trial

PURPOSE

To identify whether the use of active recovery (ACT) the day after high-intensity interval training (HIIT) benefits recovery and to assess whether individual responses to ACT are repeatable.

METHODS

Eleven well-trained, male intermittent-sport athletes (age: 25.5 ± 1.8 y) completed 4 HIIT sessions, each separated by a 2-week washout period. Of the 4 sessions, 2 were followed by passive recovery (PAS) and 2 by 60 minutes of moderate biking (ACT) 24 hours postexercise in the following sequences: ACT→PAS→ACT→PAS or PAS→ACT→PAS→ACT. Before and after HIIT and after 24 and 48 hours of recovery, maximal voluntary isometric strength (MVIC), countermovement jump height (CMJ), tensiomyographic markers of muscle fatigue (TMG), serum concentration of creatine kinase (CK), muscle soreness (MS), and perceived stress state (PS) were determined.

RESULTS

A 3-way repeated-measure analysis of variance with a triple-nested random effects model revealed a significant (P < .05) fatigue-related time effect of HIIT on markers of fatigue (MVIC↓; CMJ↓; TMG↑; CK↑; MS↑; PS↑). No significant (P > .05) main effect of recovery strategy was detected. In 9 subjects, the individual results revealed inconsistent and nonrepeatable responses to ACT, while a consistent and repeatable positive or negative response to ACT was found in 2 individuals.

CONCLUSIONS

The repeated failure of ACT to limit the severity of fatigue was found both at the group level and with most individuals. However, a small percentage of athletes may be more likely to benefit repeatedly from either ACT or PAS. Therefore, the use of ACT should be individualized.

Effect of the Cooldown Type on Session Rating of Perceived Exertion

PURPOSE

This study investigated the effect of cooldown modality (active vs passive) and duration (5, 10, and 15 min) on session rating of perceived exertion (sRPE). Secondarily, the possible influence of training sessions' demand on this effect was studied.

METHODS

A total of 16 youth male soccer players (15.7 [0.4] y) completed 2 standardized training sessions per week across 6 weeks. During weeks 1 to 2, 3 to 4, and 5 to 6, cooldown lengths of 15, 10, and 5 minutes were studied, respectively. Using a crossover design, players were randomly assigned to 2 groups and each group performed 1 of 2 different cooldown interventions. Passive and active cooldown interventions based on static stretching and running exercises were studied. Heart rate and sRPE were recorded during all training sessions.

RESULTS

The lowest sRPE was observed when passive cooldown was performed. When the hardest training sessions were considered, a significant main effect of cooldown modality (P < .01) and duration (P < .05) and an interaction effect between these variables (P < .05) on sRPE were obtained. The lowest (P < .01) sRPE was observed during the longest cooldown (15 min).

CONCLUSION

The findings suggest that sRPE may be sensitive to the selected cooldown modality and duration, especially following the most demanding training sessions.

The Impact of Recovery Practices Adopted by Professional Tennis Players on Fatigue Markers According to Training Type Clusters

Introduction: Modern tennis players face congested schedules that force the adoption of various recovery strategies. Thus, recovery must be fine-tuned with an accurate quantification of its impacts, especially with regards to training-induced fatigue. The present study aimed to examine the training type clusters and recovery practices adopted by elite tennis players under ecological training conditions. The respective impacts of training type clusters and recovery techniques on subjective variables, which reflect the players' recovery perceptions, were subsequently determined.

Methods: During 15 consecutive months, a total of 35 elite tennis players filled out questionnaires to report their daily training load, training session content, adopted recovery modalities after training, and perceived recovery.

Results: The hierarchical analysis identified three clusters: “combined tennis and S&C training,” “predominant tennis training” and “predominant S&C training.” Muscle soreness and perceived fatigue were not significantly different among these three clusters (p = 0.07–0.65). Across the 146 recorded training and recovery sessions, players primarily employed a combination of 2 or 3 modalities, with cooling strategies being the most widely used technique (87.6%). Mixed linear models revealed that independent of training clusters, cooling strategies significantly reduced muscle soreness (Δmuscle soreness: β = −1.00, p = 0.02). Among the cooling techniques used, whole-body cryotherapy induced a greater perceived recovery than cold-water immersion (p = 0.02).

Conclusion: These results showed that perceived recovery was not sensitive to training clusters or the associated acute training load. However, cooling strategies were relevant for the alleviation of tennis training-induced soreness. This study represents an initial step toward a periodized approach of recovery interventions, based on the interactions between training load, training contents, and perceived recovery.

Comparison between neurodynamic therapy and foam rolling in cool-down sessions for delayed onset muscle soreness in healthy individuals

BACKGROUND

Delayed onset of muscle soreness (DOMS) is a common finding in trained and untrained individuals post high intensity exercises which can lead to injuries. Foam rolling (FR) and neurodynamic therapy (NDT) are types of active cool-down which provides effective for treatment of DOMS. But their role in reduction of intensity of the same in cool down is not established.

STUDY DESIGN

Crossover study.

METHODOLOGY

Total 60 healthy individuals participated in the study. Pre intervention readings were taken of strength and tightness by Range of motion. Subjects performed both the types of cool-down separated by 4 weeks interval with random allocation. Post intervention readings of hamstring and quadriceps tightness, grade of tenderness and stand to sit VAS score was taken post 24 h and 48 h and strength post 48 h.

RESULTS

Analysis was done for using repeated measures ANOVA and Friedman's test. The difference of values for Straight Leg Raise and Prone knee Flexion between NDT and FR post 24 h were statistically significant (p < 0.05) while that of NDT post 24 h being similar to FR post 48 h (p > 0.05). There was a significant difference between strength, tenderness and VAS in NDT and FR (p < 0.05). With the mean of post 24 h as well as post 48 h being less in the FR intervention.

CONCLUSION

Foam rolling is a better option than Neurodynamic therapy for reduction of intensity of DOMS.

Pilates for low risk pregnant women: Study protocol for a randomized controlled trial

BACKGROUND

Pilates has growing appeal to pregnant women, as a form of exercise and relaxation. It is purported to benefit lumbo-pelvic stability, as well as motor control, strength and endurance. Some suggest that modified Pilates exercises may assist low risk pregnant women to enjoy a healthier pregnancy and prepare for the physical demands of labour and birth. The feasibility and safety of Pilates during pregnancy is poorly understood. We describe the protocol for a feasibility study designed to compare a midwife-led 6-week community-based Pilates intervention with standard antenatal care.

METHODS

A convenience sample of 30 low-risk pregnant women will be recruited from private obstetric clinics in Melbourne, Australia. Participants shall be randomly allocated to a six-week, 1-h weekly Pilates exercises group session or to usual care. The Pilates exercise class will have a warm-up phase, Pilates exercises, breathing exercises, and a cool down phase. Exercises have been designed to prepare for active birth. The primary outcome will be feasibility of implementation, determined by recruitment, retention, adherence and safety. Secondary outcomes include women's health (quality of life, pain, mobility for daily activities, lower extremity performance, abdominal separation, continence) and labour and birth outcomes (duration of first stage and second stage labour, analgesia used, mode of birth). Validated questionnaires will include the Quality of life 12-item short form survey; Pregnancy Mobility Index, and International Consultation on Incontinence Questionnaire. Lower extremity performance and abdominal separation will also be measured.

DISCUSSION

This trial will provide preliminary data regarding the feasibility and safety of Pilates exercise in healthy pregnant women. It will also provide preliminary outcome data used to inform the design of a future large scale, multi-centre RCT.

TRIAL REGISTRATION

This clinical trial has been registered with the Australian and New Zealand Clinical Trials Registry 2016 (ACTRN12616000809437).

Similar Recovery of Maximal Cycling Performance after Ischemic Preconditioning, Neuromuscular Electrical Stimulation or Active Recovery in Endurance Athletes

This study investigated the efficacy of ischemic preconditioning (IPC) on the recovery of maximal aerobic performance and physiological responses compared with commonly used techniques. Nine endurance athletes performed two 5-km cycling time trials (TT) interspersed by 45 minutes of recovery that included either IPC, active recovery (AR) or neuromuscular electrical stimulation (NMES) in a randomized crossover design. Performance, blood markers, arterial O₂ saturation (S_pO₂), heart rate (HR), near-infrared spectroscopy-derived muscle oxygenation parameters and perceptual measures were recorded throughout TTs and recovery. Differences were analyzed using repeated-measures ANOVAs and Cohen's effect size (ES). The decrement in chronometric performance from TT1 to TT2 was similar between recovery modalities (IPC: -6.1 sec, AR: -7.9 sec, NMES: -5.4 sec, p = 0.84, ES 0.05). The modalities induced similar increases in blood volume before the start of TT2 (IPC: 13.3%, AR: 14.6%, NMES: 15.0%, p = 0.79, ES 0.06) and similar changes in lactate concentration and pH. There were negligible differences between conditions in bicarbonate concentration, base excess of blood and total concentration of carbon dioxide, and no difference in S_pO₂, HR and muscle O₂ extraction during exercise (all p > 0.05). We interpreted these findings to suggest that IPC is as effective as AR and NMES to enhance muscle blood volume, metabolic by-products clearance and maximal endurance performance. IPC could therefore complement the athlete's toolbox to promote recovery.

Post-competition recovery strategies in elite male soccer players. Effects on performance: A systematic review and meta-analysis

Aims

The main aim of the present review was to update the available evidence on the value interest of post-competition recovery strategies in male professional or semi-professional soccer players to determine its effect on post-game performance outcomes, physiological markers, and wellness indicators.

Methods

A structured search was carried out following the PRISMA guidelines using six online databases: Pubmed, Scopus, SPORTDiscus, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials. The risk of bias was completed following the Cochrane Collaboration Guidelines. Meta-analyses of randomized controlled trials were conducted to determine the between and within-group effects of different recovery strategies on performance, physiological markers and wellness data. Final meta-analyses were performed using the random-effects model and pooled standardized mean differences (SMD).

Results

Five randomized controlled trials that used Compression Garments (n = 3), Cold Water Immersion (n = 1), and acute Sleep Hygiene Strategy (n = 1) were included. Greater CMJ values at 48h for the intervention group (SMD = 0.70; 95% CI 0.14 to 1.25; p = 0.001; I² = 10.4%) were found. For the 20-m sprint and MVC, the results showed no difference either at 24h or 48h. For physiological markers (CK and CRP) and wellness data (DOMS), small to large SMD were present in favor of the intervention group both at 24h (-0.12 to -1.86) and 48h (-0.21 to -0.85). No heterogeneity was present, except for MVC at 24h (I² = 90.4%; p = 0.0012) and CALF DOMS at 48h (I² = 93.7%; p = 0.013).

Conclusion

The use of recovery strategies offers significant positive effects only in jumping performance (CMJ), with no effects on the 20-m sprint or MVC. Also, the use of recovery strategies offers greater positive effects on muscle damage (physiological markers and wellness data), highlighting the importance of post-match recovery strategies in soccer.

Cardiopulmonary exercise testing during pregnancy

The goal of this review is to examine practical considerations when conducting cardiopulmonary exercise testing during pregnancy. In a clinical and research setting, cardiopulmonary exercise testing during pregnancy is valuable in identifying underlying cardiopulmonary conditions, stratifying the risk of adverse pregnancy outcomes, as well as establishing exercise tolerance/limitations. This review encompasses information regarding the unique physiological adaptations that occur throughout gestation (e.g., changes in resting heart rate, blood pressure, glucose, etc.) and how these adaptations impact the interpretation of physiological measurements. There are also key concerns that are unique to pregnant populations that should be considered when participating in exercise (i.e., fetus, ventilation, thermoregulation, urinary incontinence, low back pain, and pelvic girdle pain). This step-by-step review of cardiopulmonary exercise testing outlines pregnancy related adjustments to standardized methods (i.e., screening/documentation, pre- and post-test measurements, protocol specifics, modality selection, and fetal monitoring) which should be considered for the safety of both the participant and fetus. Currently, pregnancy specific exercise testing guidelines are lacking. Therefore, we will be discussing the limitations of current recommendations such as a safe cut off for resting heart rate and pregnancy specific test termination criteria.

Running coaches and running group leaders' engagement with, and beliefs and perceived barriers to prehabilitation and injury prevention strategies for runners

OBJECTIVES

To identify which pre-and post-run injury risk reduction activities and prehabilitation (prehab) strategies Coaches and Running Group Leaders (Coaches/RGLs) engage in with runners; to explore their beliefs on why runners get injured; to identify Coaches/RGLs confidence providing injury prevention activities, and what they believe are effective for reducing risk of injury; to identify their perceived barriers to including prehab during running coaching/training.

DESIGN

Survey; Participants: UK Coaches/RGLs (N = 100) OUTCOME MEASURES: Online questionnaire with open, closed and Likert scale questions.

RESULTS

Most Coaches/RGLs performed active warm-ups (97%), cool-downs (94%),gave injury prevention advice (91%), and advice on recovery strategies (84%) during training. Fewer coaches/RGLs incorporated prehab (67%). Although they collectively exhibited a wide range of knowledge, individually there was less consistency and confidence providing this. Prehab was rated as very important for injury risk reduction, with supervision recommended to facilitate runner engagement. Coaches/RGLs found conflicting advice, time, environment, and resistance from runners as barriers to incorporating prehab into training.

CONCLUSION

Coaches/RGLs believe prehab is important for runners however lack of confidence and knowledge appeared to limit the wider inclusion of prehab with runners. Coaches/RGLs welcomed reputable information on prehab from evidence-based sources. This may assist in reducing injury.

The effects of general fatigue induced by incremental exercise test and active recovery modes on energy cost, gait variability and stability in male soccer players

The aerobic endurance is considered an important physiological capacity of soccer players which is examined by Incremental Exercise Test (IET). However, it is not clear how general fatigue induced by IET influences physiological and biomechanical gait features in soccer players and how players recover optimally at post-IET. Here, the effect of general fatigue induced by IET on energy cost, gait variability and stability in soccer players was investigated. To identify an optimal recovery mode, the effect of walking at Preferred Walking Speed (PWS), running at Individual Ventilation Threshold (IVT) (two active recovery modes), and Rest (a passive recovery mode) on aforementioned features were studied. Nine male players walked 4-min at PWS on a treadmill prior IET (PreT), which was followed by four 4-min walking trials (PosT-0, 1, 2, and 3) with three 4-min recovery intervals (PWS, IVT, or Rest) between them, in three sessions (one for each recovery mode) in a random order. Energy cost, gait variability and stability were examined at PreT (baseline), and at PosT-0, 1, 2, and 3 (intervals of respectively 0-4, 8-12, 16-20, 24-28 min at post-IET). Gait variability was assessed by the standard deviation of trunk angle and gait stability was assessed by the local dynamic stability of trunk angular velocity. Gait stability was not affected by IET, despite increases in gait variability and energy cost. Different from IVT, PWS and Rest recovery modes reduced energy cost at post-IET. Gait variability and energy cost recovered at PosT-1 and PosT-2, suggesting that 8-12 and 16-20 min recovery intervals, respectively, were required for returning to their baselines. No preference for active over passive recovery was found in terms of gait variability and energy cost.

Active recovery has a positive and acute effect on recovery from fatigue induced by repeated maximal voluntary contractions of the plantar flexors

This study investigated the acute effect of active recovery (AR) following fatigue induced by 80 three-second maximal voluntary isometric plantar flexion contractions (MVICs) in 12 young men. AR consisted of a total of 180 voluntary isometric ramp contractions of the plantar flexors (0.75-s contraction/relaxation) targeting 10% of MVIC torque. MVIC torque, voluntary activation and root mean square values of electromyographic signals for the triceps surae normalized by each peak-to-peak amplitude of compound motor action potential were determined before, and immediately, 10, 20 and 30 min after the fatiguing task. Evoked torques were similarly assessed except for immediately after it. The AR and passive recovery were randomly performed on two days by each participant between 5 min and 10 min after the fatiguing task. For all the parameters other than MVIC torque, there was no significant difference between the conditions at any time point. MVIC torque decreased significantly immediately after the fatiguing task regardless of condition (P < 0.05), and the corresponding decrease in MVIC torque recovered 30 min after the fatiguing task only in AR (P < 0.05). These results suggest an acute positive effect of AR on recovery of neuromuscular function and/or contractile properties after fatigue.

The Training and Development of Elite Sprint Performance: an Integration of Scientific and Best Practice Literature

Despite a voluminous body of research devoted to sprint training, our understanding of the training process leading to a world-class sprint performance is limited. The objective of this review is to integrate scientific and best practice literature regarding the training and development of elite sprint performance. Sprint performance is heavily dependent upon genetic traits, and the annual within-athlete performance differences are lower than the typical variation, the smallest worthwhile change, and the influence of external conditions such as wind, monitoring methodologies, etc. Still, key underlying determinants (e.g., power, technique, and sprint-specific endurance) are trainable. In this review, we describe how well-known training principles (progression, specificity, variation/periodization, and individualization) and varying training methods (e.g., sprinting/running, technical training, strength/power, plyometric training) are used in a sprint training context. Indeed, there is a considerable gap between science and best practice in how training principles and methods are applied. While the vast majority of sprint-related studies are performed on young team sport athletes and focus on brief sprints with maximal intensity and short recoveries, elite sprinters perform sprinting/running over a broad range of distances and with varying intensity and recovery periods. Within best practice, there is a stronger link between choice of training component (i.e., modality, duration, intensity, recovery, session rate) and the intended purpose of the training session compared with the “one-size-fits-all” approach in scientific literature. This review provides a point of departure for scientists and practitioners regarding the training and development of elite sprint performance and can serve as a position statement for outlining state-of-the-art sprint training recommendations and for generation of new hypotheses to be tested in future research.

Optimizing recovery to support multi-evening cycling competition performance

Road criterium and track bicycle racing occur at high speeds, demand repeated high power outputs, last 10-90 min, and offer little chance for recovery after the event. Consecutive evenings of criterium and track racing are respectively known as speed-week or six-day events and take place in evening hours over the course of a week. Given the schedule and timing of these competitions, return to homeostasis can be compromised. No recommendations exist on how to optimize recovery for cyclists participating in these types of repeated evening competitions. Criterium and track cyclists spend considerable time, near and above the individual lactate threshold and therefore mostly utilize carbohydrate as their chief energy substrate. Henceforth, pre - and post-race nutrition and hydration is examined and recommendations are brought forward for carbohydrate, protein, and fluid intake. As evening high-intensity exercise perturbs sleep, strategies to optimize sleep are discussed and recommendations for an optimal sleep environment are given. Active recovery is examined, and the benefits of a short duration low intensity exercise reviewed. Passive recovery methods such as compression garments and cold water immersion are recommended, while evidence for massage, pneumatic compression devices, and neuromuscular electrical stimulation is still lacking. Optimizing recovery strategies will facilitate a return to the resting state following strenuous night competition.

Effects of different recovery strategies following a half-marathon on fatigue markers in recreational runners

Purpose

To investigate the effects of different recovery strategies on fatigue markers following a prolonged running exercise.

Methods

46 recreational male runners completed a half-marathon, followed by active recovery (ACT), cold water immersion (CWI), massage (MAS) or passive recovery (PAS). Countermovement jump height, muscle soreness and perceived recovery and stress were measured 24h before the half-marathon (pre), immediately after the recovery intervention (post_rec) and 24h after the race (post₂₄). In addition, muscle contractile properties and blood markers of fatigue were determined at pre and post₂₄.

Results

Magnitude-based inferences revealed substantial differences in the changes between the groups. At post_rec, ACT was harmful to perceived recovery (ACT vs. PAS: effect size [ES] = −1.81) and serum concentration of creatine kinase (ACT vs. PAS: ES = 0.42), with CWI being harmful to jump performance (CWI vs. PAS: ES = −0.98). It was also beneficial for reducing muscle soreness (CWI vs. PAS: ES = −0.88) and improving perceived stress (CWI vs. PAS: ES = −0.64), with MAS being beneficial for reducing muscle soreness (MAS vs. PAS: ES = −0.52) and improving perceived recovery (MAS vs. PAS: ES = 1.00). At post₂₄, both CWI and MAS were still beneficial for reducing muscle soreness (CWI vs. PAS: ES = 1.49; MAS vs. PAS: ES = 1.12), with ACT being harmful to perceived recovery (ACT vs. PAS: ES = −0.68), serum concentration of creatine kinase (ACT vs. PAS: ES = 0.84) and free-testosterone (ACT vs. PAS: ES = −0.91).

Conclusions

In recreational runners, a half-marathon results in fatigue symptoms lasting at least 24h. To restore subjective fatigue measures, the authors recommend CWI and MAS, as these recovery strategies are more effective than PAS, with ACT being even disadvantageous. However, runners must be aware that neither the use of ACT nor CWI or MAS had any beneficial effect on objective fatigue markers.