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Burden RJ, Biswas A, Hackney AC. Female Athlete Sport Science Versus Applied Practice: Bridging the Gap. Int J Sports Physiol Perform 2024:1-4. [PMID: 39231498 DOI: 10.1123/ijspp.2023-0390] [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: 09/29/2023] [Revised: 05/22/2024] [Accepted: 07/04/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Female-specific science, medicine, and innovation have grown steadily since the turn of the decade as the focus on female sport continues to advance. While this growth is welcome, and despite the best of intentions, it is not always coupled with valuable application. PURPOSE This commentary discusses barriers faced when developing and applying sport-science research and innovation activities in female sport. We offer several practical solutions to help safeguard the progress of female athlete health and performance support. We make 3 suggestions: (1) multicenter studies to increase the number of elite athletes participating in research and enhance statistical power, which is often lacking in sport-science research; (2) further acceptance of case studies in elite sport research, as they can include context alongside athlete data that more traditional research designs perhaps do not; and (3) collaborative, codesigned approaches to research and innovation, wherein researchers, practitioners, and athletes all contribute to balancing scientific rigor with applied "real-world" understanding, which may result in the generation of richer, more meaningful knowledge for the benefit of female athletes and their environments.
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Affiliation(s)
- Richard J Burden
- UK Sports Institute, Manchester, United Kingdom
- Manchester Metropolitan University, Manchester, United Kingdom
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Tabor JB, Penner LC, Galarneau JM, Josafatow N, Cooper J, Ghodsi M, Huang J, Fraser DD, Smirl J, Esser MJ, Yeates KO, Wellington CL, Debert CT, Emery CA. Plasma Biomarkers of Traumatic Brain Injury in Adolescents With Sport-Related Concussion. JAMA Netw Open 2024; 7:e2431959. [PMID: 39235809 DOI: 10.1001/jamanetworkopen.2024.31959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2024] Open
Abstract
Importance Blood-based biomarkers may clarify underlying neuropathology and potentially assist in clinical management of adolescents with sport-related concussion (SRC). Objective To investigate the association between SRC and plasma biomarkers in adolescents. Design, Setting, and Participants Prospective cohort study in Canadian sport and clinic settings (Surveillance in High Schools and Community Sport to Reduce Concussions and Their Consequences study; September 2019 to November 2022). Participants were a convenience sample of 849 adolescent (ages 10-18 years) sport participants with blood samples. Data were analyzed from February to September 2023. Exposures Blood collection and clinical testing preseason (uninjured) and post-SRC follow-ups (ie, ≤72 hours, 1 week, and biweekly until medical clearance to return to play [RTP]). Main Outcomes and Measures Plasma glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase-L1 (UCH-L1), neurofilament light (NfL), and total tau (t-tau) were assayed. Group-level comparisons of biomarker levels were conducted between uninjured and post-SRC intervals (postinjury day [PID] 0-3, 4-10, 11-28, and >28) considering age and sex as modifiers. Secondary analyses explored associations between biomarker concentrations and clinical outcomes (Sport Concussion Assessment Tool, Fifth Edition [SCAT5] symptom scores and time to RTP). Results This study included 1023 plasma specimens from 695 uninjured participants (467 male participants [67.2%]; median [IQR] age, 15.90 [15.13-16.84] years) and 154 participants with concussion (78 male participants [51.0%]; median [IQR] age, 16.12 [15.31-17.11] years). Acute (PID 0-3) differences relative to uninjured levels were found for GFAP (female participants: 17.8% increase; β = 0.164; 95% CI, 0.064 to 0.263; P = .001; male participants: 17.1% increase; β = 0.157; 95% CI, 0.086 to 0.229; P < .001), UCH-L1 (female participants: 43.4% increase; β = 0.361; 95% CI, 0.125 to 0.596; P = .003), NfL (male participants: 19.0% increase; β = 0.174; 95% CI, 0.087 to 0.261; P < .001), and t-tau (female participants: -22.9%; β = -0.260; 95% CI, -0.391 to -0.130; P < .001; male participants: -18.4%; β = -0.203; 95% CI, -0.300 to -0.106; P < .001). Differences were observed for all biomarkers at PID 4 to 10, 11 to 28, and greater than 28 compared with uninjured groups. GFAP, NfL, and t-tau were associated with SCAT5 symptom scores across several PID intervals. Higher GFAP after 28 days post-SRC was associated with earlier clearance to RTP (hazard ratio, 4.78; 95% CI, 1.59 to 14.31; P = .01). Male participants exhibited lower GFAP (-9.7%), but higher UCH-L1 (21.3%) compared with female participants. Age was associated with lower GFAP (-5.4% per year) and t-tau (-5.3% per year). Conclusions and Relevance In this cohort study of 849 adolescents, plasma biomarkers differed between uninjured participants and those with concussions, supporting their continued use to understand concussion neuropathology. Age and sex are critical considerations as these biomarkers progress toward clinical validation.
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Affiliation(s)
- Jason B Tabor
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Linden C Penner
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nik Josafatow
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ghodsi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Johnny Huang
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Douglas D Fraser
- Department of Pediatrics and Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Jonathan Smirl
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Michael J Esser
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Keith Owen Yeates
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantel T Debert
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hackney AC, Prado RCR, Dolan E. Androgenic Steroid Hormones and Endurance Exercise in Athletic Women. ENDOCRINES 2024; 5:252-260. [PMID: 39006054 PMCID: PMC11242914 DOI: 10.3390/endocrines5030018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
This study investigated the impact of intensive endurance exercise on circulating androgenic steroid hormones in women. Fifteen normally menstruating athletic women participated. They completed intensive endurance exercise (treadmill running) until volitional fatigue in their follicular phase, with blood samples collected at pre-exercise, volitional fatigue, 90 min and 24 h into recovery. The steroid hormones (total, free testosterone, dehydroepiandrosterone [DHEA], and DHEA-sulfate [DHEA-S], cortisol) were analyzed in blood sera. Non-parametric statistics were used to assess changes across exercise and recovery. At volitional fatigue, all hormones, except free testosterone, were significantly (p < 0.05) increased compared to pre-exercise levels. Most hormones remained elevated through 90 min of recovery, with DHEA, DHEA-S, and total testosterone changes being significant (p < 0.05). At 24 h of recovery, hormonal levels were reduced; specifically, DHEA, DHEA-S, and total testosterone compared to baseline (p < 0.01 to 0.06). Increases in cortisol levels at volitional fatigue and 90 min of recovery were correlated with reductions in total testosterone, DHEA, and DHEA-S observed at 24 h of recovery (rho > -0.62, p < 0.05). In conclusion, in menstruating women performing intensive endurance exercise during their follicular phase, their androgenic steroid hormones remain elevated during early recovery but are suppressed at 24 h of recovery. The latter finding indicates that establishing a resting endocrine equilibrium requires a longer recovery period than 24 h.
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Affiliation(s)
- Anthony C. Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Raul Cosme Ramos Prado
- School of Physical Education and Sport, University of São Paulo, São Paulo 05508-030, Brazil
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group-Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo 05508-030, Brazil
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Govette A, Gillen JB. At-home bodyweight interval exercise in the fed versus fasted state lowers postprandial glycemia and appetite perceptions in females. Appl Physiol Nutr Metab 2024; 49:1217-1227. [PMID: 38776559 DOI: 10.1139/apnm-2023-0485] [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] [Indexed: 05/25/2024]
Abstract
Limited research has characterized the metabolic health benefits of bodyweight interval exercise (BWE) performed outside of a laboratory setting. Metabolic responses to exercise can also be influenced by meal timing around exercise, but the interactive effects of BWE and nutrition are unknown. This study investigated the effects of BWE performed in the fasted or fed state on postprandial glycemia, post-exercise fat oxidation and appetite perceptions. Twelve females (23 ± 2 years; 22 ± 2 kg/m2) underwent two virtually-monitored trials that involved completing BWE (10 × 1 min, 1 min recovery) 5 min before (FastEX) or beginning BWE 10 min after (FedEX) a standardized breakfast. Heart rate and rating of perceived exertion (RPE) were measured during exercise and capillary glucose concentrations were measured for 2 h postprandial. Following exercise, appetite perceptions were assessed and Lumen expired carbon dioxide percentage (L%CO2) was measured as an index of fat oxidation. Heart rate (85 ± 5%) and RPE (14 ± 2) did not differ between conditions (p > 0.05). Postprandial glucose mean (6.1 ± 0.6 vs. 6.8 ± 0.8 mmol/L, p = 0.03), peak (7.4 ± 1.2 vs. 8.5 ± 1.5 mmol/L, p = 0.01), and area under the curve (AUC) (758 ± 72 vs. 973 ± 82 mmol/L × 2 h, p = 0.004) were lower in FedEX versus FastEX. Appetite perceptions were lower in FedEX versus FastEX (-87.63 ± 58.51 vs. -42.06 ± 34.96 mm, p = 0.029). Post-exercise L%CO2 was transiently decreased 30 min post-exercise in both conditions (4.03 ± 0.38 vs. 4.29 ± 0.34%, p = 0.0023), reflective of increased fat oxidation following BWE. These findings demonstrate that BWE performed in the fed compared to the fasted state lowered postprandial glycemia and appetite perceptions in females.
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Affiliation(s)
- Alexa Govette
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Jenna B Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
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Halson SL, Johnston RD, Pearson M, Minahan C. Menstrual-Cycle Symptoms and Sleep Characteristics in Elite Soccer Players. Int J Sports Physiol Perform 2024; 19:914-920. [PMID: 39048089 DOI: 10.1123/ijspp.2023-0049] [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: 02/09/2023] [Revised: 03/19/2024] [Accepted: 05/13/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. METHODS Sleep was assessed for a minimum of 25 nights (range = 25-31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. RESULTS There was a significant relationship between sleep duration and the day of the menstrual cycle (P = .042) and total symptoms reported that day (P < .001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P = .004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P = .950), wake after sleep onset (P = .217), and subjective sleep quality (P = .080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P = .220), subjective sleep quality (P = .502), or sleep latency (P = .740) but did significantly relate to wake after sleep onset (P < .001), with a significant day × symptom interaction (P < .001). CONCLUSIONS Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics.
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Affiliation(s)
- Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, McAuley at Banyo, Brisbane, QLD, Australia
- Sport Performance Recovery Injury and New Technologies (SPRINT) Research Centre, Faculty of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Rich D Johnston
- School of Behavioural and Health Sciences, Australian Catholic University, McAuley at Banyo, Brisbane, QLD, Australia
- Sport Performance Recovery Injury and New Technologies (SPRINT) Research Centre, Faculty of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Carnegie Applied Rugby Research Centre, School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Madison Pearson
- School of Behavioural and Health Sciences, Australian Catholic University, McAuley at Banyo, Brisbane, QLD, Australia
- Sport Performance Recovery Injury and New Technologies (SPRINT) Research Centre, Faculty of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Clare Minahan
- Griffith Sports Science, Griffith Health, Griffith University, Gold Coast, QLD, Australia
- Australian Institute of Sport, Australian Sports Commission, Canberra, ACT, Australia
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Malcolm D. Some problems of research exploring sex differences in sport-related concussions: a narrative review. Res Sports Med 2024; 32:810-819. [PMID: 37856512 DOI: 10.1080/15438627.2023.2271604] [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: 07/04/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
This narrative review scrutinizes research exploring sex-based differences in experiences of sport-related concussion. The article argues that the limitations of epidemiological studies identifying the greater incidence and severity of concussion among females require that these findings are read with caution. It secondly argues that the dominant explanations for these data are based on and extend historical tendencies to "other" female participation in sport and construct male experiences as the "norm". Finally, the article critiques policy recommendations related to these research findings, arguing that they are likely to embed rather than challenge sex inequality in sport, and that they are both impractical and unethical. While this commentary builds on a broader body of work advocating greater sex/gender equality in sports science research, the prominence of social concerns about concussions in sport makes the broader implications of the focus on sex and sport-related concussion particularly problematic and thus in need of redress.
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Affiliation(s)
- Dominic Malcolm
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Hunter SK, Senefeld JW. Sex differences in human performance. J Physiol 2024; 602:4129-4156. [PMID: 39106346 DOI: 10.1113/jp284198] [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: 10/30/2023] [Accepted: 07/08/2024] [Indexed: 08/09/2024] Open
Abstract
Sex as a biological variable is an underappreciated aspect of biomedical research, with its importance emerging in more recent years. This review assesses the current understanding of sex differences in human physical performance. Males outperform females in many physical capacities because they are faster, stronger and more powerful, particularly after male puberty. This review highlights key sex differences in physiological and anatomical systems (generally conferred via sex steroids and puberty) that contribute to these sex differences in human physical performance. Specifically, we address the effects of the primary sex steroids that affect human physical development, discuss insight gained from an observational study of 'real-world data' and elite athletes, and highlight the key physiological mechanisms that contribute to sex differences in several aspects of physical performance. Physiological mechanisms discussed include those for the varying magnitude of the sex differences in performance involving: (1) absolute muscular strength and power; (2) fatigability of limb muscles as a measure of relative performance; and (3) maximal aerobic power and endurance. The profound sex-based differences in human performance involving strength, power, speed and endurance, and that are largely attributable to the direct and indirect effects of sex-steroid hormones, sex chromosomes and epigenetics, provide a scientific rationale and framework for policy decisions on sex-based categories in sports during puberty and adulthood. Finally, we highlight the sex bias and problem in human performance research of insufficient studies and information on females across many areas of biology and physiology, creating knowledge gaps and opportunities for high-impact studies.
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Affiliation(s)
- Sandra K Hunter
- Movement Science Program, School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathon W Senefeld
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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Noordhof DA, Taylor MY, De Martin Topranin V, Engseth TP, Sandbakk Ø, Osborne JO. Agreement Between the 2- and 3-Step Methods for Identifying Subtle Menstrual Disturbances. Int J Sports Physiol Perform 2024; 19:953-957. [PMID: 39043363 DOI: 10.1123/ijspp.2024-0057] [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: 02/11/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 07/25/2024]
Abstract
Recent methodological recommendations suggest the use of the "3-step method," consisting of calendar-based counting, urinary ovulation testing, and serum blood sampling, for the identification of subtle menstrual disturbances (SMDs). However, the use of the 3-step method is not always feasible, so a less demanding combination of calendar-based counting and urinary ovulation testing, that is, the 2-step method, may be a viable alternative. PURPOSE To investigate the agreement between the 2- and 3-step methods for the detection of SMDs. METHODS Menstrual cycles (MCs, 98) of 59 athletes were assessed using the 2- and 3-step methods. Regular-length MCs (ie, ≥21 and ≤35 d) were classified as either having no SMD (luteal phase length ≥10 d, midluteal progesterone concentration ≥16 nmol·L-1, and being ovulatory) or having an SMD (eg, short luteal phase [<10 d], inadequate luteal phase [midluteal progesterone concentration <16 nmol·L-1], or being anovulatory). Method agreement was assessed using the McNemar test and Cohen kappa (κ). RESULTS Substantial agreement was observed between methods (κ = .72; 95% CI, .53-.91), but the 2-step method did not detect all MCs with an SMD, resulting in evidence of systematic bias (χ2 = 5.14; P = .023). The 2-step method detected 61.1% of MCs that had an SMD ([51.4, 70.8]), as verified using the 3-step method, and correctly identified 100% of MCs without an SMD. CONCLUSIONS MCs classified as being disturbed using the 2-step method could be considered valid evidence of SMDs. However, MCs classified without SMDs do not definitively confirm their absence, due to the proven underdetection via the 2-step method.
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Affiliation(s)
- Dionne A Noordhof
- Department of Neuromedicine and Movement Science, Center for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Madison Y Taylor
- School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Virginia De Martin Topranin
- Department of Neuromedicine and Movement Science, Center for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tina P Engseth
- School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Øyvind Sandbakk
- Department of Neuromedicine and Movement Science, Center for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
- School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - John O Osborne
- School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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MacMillan C, Olivier B, Viljoen C, van Rensburg DCJ, Sewry N. The Association Between Menstrual Cycle Phase, Menstrual Irregularities, Contraceptive Use and Musculoskeletal Injury Among Female Athletes: A Scoping Review. Sports Med 2024:10.1007/s40279-024-02074-5. [PMID: 39215933 DOI: 10.1007/s40279-024-02074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The influence of menstrual cycle phases (MCPs), menstrual irregularities (MI) and hormonal contraceptive (HC) use on injury among female athletes has been scrutinised. Existing systematic reviews investigating the effect of exposures affecting the endogenous reproductive hormone status on sporting injuries are limited in terms of the types of studies included and injuries investigated. OBJECTIVE This scoping review aims to summarise the coverage of the literature related to the extent, nature and characteristics of the influence of MCP, MI and HC use on musculoskeletal injuries among athletes. It also aims to summarise key concepts and definitions in the relevant literature. Observational and experimental studies investigating the effect of MCP, MI, and HC on musculoskeletal injuries among female individuals of reproductive age were included. Studies specifically stating pregnant women, perimenopausal/postmenopausal athletes, or those using medication (other than HC) that affects reproductive hormone profiles or the musculoskeletal system were excluded. METHODS This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping reviews and JBI scoping review guidelines. Published and unpublished studies were sourced from several databases and resources. Initial keywords used included terms related to "menstrual cycle", "hormonal contraception" and "injury." Titles and abstracts of identified citations were screened independently and assessed for eligibility by two independent reviewers. Data from the included studies were extracted using a standard data extraction form. RESULTS The search yielded 10,696 articles, of which 96 met the eligibility criteria. Most studies investigated MI (77%), and 49% included MCP as a contributing injury risk factor. Publications have increased over the last two decades. Collectively, only 16% of research has been conducted in Africa, Asia and Oceania. There were no studies from South America. Seventy-five percent of the studies investigated individual versus team (25%) sport athletes. Most studies only investigated elite or professional (n = 24; 25%) level athletes. The definitions of injury, eumenorrhea and MI differ vastly among studies. Regarding MI, most studies (69%) investigated secondary amenorrhea, followed by oligomenorrhea (51%) and primary amenorrhea (43%). Concerning HC, the influence of oral contraceptive pills was mainly investigated. CONCLUSIONS Research related to MCP, MI and HC as contributing musculoskeletal injury risk factors is increasing; however, several gaps have been identified, including research from countries other than North America and Europe, the study population being non-professional/elite level athletes, athletes participating in team sports and specific injuries related to MCP, MI and HC, respectively. Differences in methodology and terminology of injury, MCP and MI hinder comparative summative research, and future research should consider current published guidelines during the study design. Identifying barriers to following standard guidelines or research investigating the most practical yet accurate methods to investigate the influence of MCP on musculoskeletal health might yield valuable insights for future research designs. CLINICAL TRIAL REGISTRATION Scoping review registration number: Open Science Framework ( https://doi.org/10.17605/OSF.IO/5GWBV ).
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Affiliation(s)
- Candice MacMillan
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, South Street, Pretoria, 0083, Gauteng, South Africa.
- Sport, Exercise Medicine, and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Benita Olivier
- Centre for Healthy Living Research, Oxford Institute of Allied Health Research, Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
- Wits Cricket Research Hub for Science, Medicine and Rehabilitation, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Nicola Sewry
- Sport, Exercise Medicine, and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
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Tomschi F, Ransmann P, Schmidt A, Hilberg T. Exercise induced hypoalgesia after a high intensity functional training: a randomized controlled crossover study. BMC Sports Sci Med Rehabil 2024; 16:182. [PMID: 39198898 PMCID: PMC11351546 DOI: 10.1186/s13102-024-00969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Acute physical activity often induces an acute reduction in pain sensitivity known as exercise induced hypoalgesia (EIH). The aim of this study was to investigate the effects of a high intensity functional training (HIFT) on EIH compared to a control session. METHODS 50 (age: 26.0 ± 2.7; 23 female) participants successfully conducted this study consisting of a pre-experimental test as well as a 12-minute HIFT (body-weight exercises) and a 12-minute control (supervised breathing) session in a randomized crossover design. Pre and post, pressure pain thresholds (PPT) were measured at the ankles, knees, elbows, and forehead. RESULTS The HIFT resulted in a relative maximum and average heart rate of 96.2% (± 3.6%) and 91.1% (± 4.2%), respectively, and maximum and average RPE values of 19.1 (± 1.2) and 16.2 (± 1.4), respectively. Results reveal a significant 'Intervention' × 'Time point' interaction (p < 0.001) for PPT (pooled for one average value) with hypoalgesia observed following the HIFT (p < 0.001; pre: 56.0 ± 16.8, post: 61.6 ± 19.0 [Newton]) and no change following the control (p = 0.067; pre: 56.6 ± 18.4, post: 55.3 ± 18.9 [Newton]). Further, a significant 'Time' × 'Intervention' × 'Landmark' interaction effect (p = 0.024) is observed and all landmarks showed significant hypoalgesia following HIFT (p < 0.01), except for the right elbow and forehead. Following control, no hypoalgesia was observed at any landmark. Analysing male and female participants separately, it was observed that EIH occured only in men. CONCLUSION A HIFT using bodyweight exercises reduces pain sensitivity. Hence, combining strength and aerobically demanding exercises in a short but high intensity manner, as done in HIFT, can be seen as a usable tool to induce hypoalgesia. Yet, these results were observed only in male participants, necessitating future sex-specific research. TRIAL REGISTRATION DRKS00034391, retrospectively registered on the 4th of June 2024.
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Affiliation(s)
- Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.
| | - Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Alexander Schmidt
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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11
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Halioua R, Wasserfurth P, Toepffer D, Claussen MC, Koehler K. Exploring the relationship between low energy availability, depression and eating disorders in female athletes: a cross-sectional study. BMJ Open Sport Exerc Med 2024; 10:e002035. [PMID: 39224200 PMCID: PMC11367324 DOI: 10.1136/bmjsem-2024-002035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This cross-sectional study aimed to investigate the role of low energy availability (LEA) in the interplay between depression and disordered eating/eating disorders (DE/EDs) among female athletes. The International Olympic Committee consensus statement on Relative Energy Deficiency in Sport (REDs) identified depression as both an outcome of LEA and a secondary risk factor for REDs. However, the direct link between LEA and depression has yet to be fully established. Methods We assessed 57 female athletes participating in weight-sensitive sports at different levels of competition training at least four times a week. Assessment was conducted using laboratory analyses, clinical interviews and the Patient Health Questionnaire-9 questionnaire. Participants were recruited through various channels, including German sports clubs, Olympic training centres, social media platforms and the distribution of flyers at competitions. Indicators of LEA were defined if at least two of the following three physiological indicators were present: menstrual disturbances, suppressed resting metabolic rate and suppressed thyroid hormones. Logistic and linear regression analysis were used to examine the relationship between LEA, depression and DE/ED. Results The lifetime prevalence of depressive disorders was 29.6%. 19% of the participants were diagnosed with an ED, and an additional 22.6% exhibited DE.LEA was not significantly associated with either lifetime prevalence of depressive disorders or current depressive symptoms. However, a significant association was found between depression and DE/ED in terms of both lifetime prevalence and current depressive symptoms. DE/ED increased the probability of lifetime prevalence of depressive disorders by 34% (19%-49%) compared with normal eating behaviour. Conclusion We found no evidence that LEA is an independent factor for depression in female athletes. Its association with LEA and REDs appears to occur primarily in the presence of DE/ED.
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Affiliation(s)
- Robin Halioua
- Research Group Sports Psychiatry, Center for Psychiatric Research, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich, University of Zurich, Zurich, Switzerland
- Praxis Liebestrasse, Winterthur, Switzerland
| | - Paulina Wasserfurth
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Désirée Toepffer
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Malte Christian Claussen
- Research Group Sports Psychiatry, Center for Psychiatric Research, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich, University of Zurich, Zurich, Switzerland
- Clinic for Depression and Anxiety, Psychiatric Centre Muensingen, Muensingen, Switzerland
| | - Karsten Koehler
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
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12
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Frazer R, Bowler AL, Condo D, Cox G, Pelly F, Slater G. Commonly Used Indicators of Low Energy Availability Risk Fail to Identify Female Amateur Soccer Players With Measured Low Energy Availability During Preseason. Int J Sport Nutr Exerc Metab 2024:1-10. [PMID: 39209286 DOI: 10.1123/ijsnem.2024-0002] [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: 01/05/2024] [Revised: 06/16/2024] [Accepted: 07/03/2024] [Indexed: 09/04/2024]
Abstract
This study aimed to determine energy availability (EA) and within-day energy balance (WDEB) in female soccer players during preseason and also explored eating disorder risk and athlete food choice. We hypothesized commonly used indicators of low energy availability (LEA) risk would correlate with measured EA and WDEB variables, and that food choice determinants would differ according to EA. Eleven National Premier League female soccer players participated in this observational cross-sectional study over 3 weeks. Assessment of resting metabolic rate and physique traits, including bone mineral density, was conducted during Weeks 1 or 3. During Week 2, dietary intake, energy expenditure, and continuous monitor-derived glucose were measured for 5 days. EA was calculated daily and WDEB calculated hourly with deficits/surpluses carried continuously. Questionnaires were administered throughout the 3 weeks, including the Athlete Food Choice Questionnaire, the Eating Disorders Screen for Athletes, and the Low Energy Availability in Females Questionnaire. Resting metabolic rate ratio, bone mineral density, Low Energy Availability in Females Questionnaire, and Eating Disorders Screen for Athletes scores were used as indicators of LEA risk. EA averaged 30.7 ± 7.5 kcals·kg fat-free mass-1·day-1. Approximately one-third (36%) of athletes were at risk of an eating disorder, while approximately half (45%) were identified at risk of the female athlete triad via Low Energy Availability in Females Questionnaire, compared with approximately one-third (36%) of athletes identified with EA < 30 kcal·kg fat-free mass-1·day-1. No athlete achieved EA >45 kcal·kg fat-free mass-1·day-1, and no indicator of LEA risk was associated with calculated EA or WDEB. However, overnight glycemic variability was positively correlated with measured EA (r = .722, p = .012).
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Affiliation(s)
- Rebekka Frazer
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Amy-Lee Bowler
- Faculty of Health Services and Medicine, Bond University, Robina, QLD, Australia
| | - Dominique Condo
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Gregory Cox
- Faculty of Health Services and Medicine, Bond University, Robina, QLD, Australia
| | - Fiona Pelly
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Gary Slater
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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13
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Ferrer E, Rodas G, Casals G, Trilla A, Balagué-Dobon L, González JR, Ridley K, White R, Burden RJ. The use of saliva and blood progesterone to profile the menstrual cycles of youth professional football players. Front Sports Act Living 2024; 6:1430158. [PMID: 39234531 PMCID: PMC11373522 DOI: 10.3389/fspor.2024.1430158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/30/2024] [Indexed: 09/06/2024] Open
Abstract
Background Understanding individual ovarian hormone cycles and their relationship with health, performance and injuries is highly important to practitioners supporting female athletes. Venous blood sampling is the current gold standard for measuring the ovarian hormones, but the invasive nature of this method presents a major barrier in sport environments. Saliva analysis may offer an alternative method as it is non-invasive, allowing the sample to be collected "in situ", with relative ease, necessary in applied sport environments. Objective The aims of this study were: (i) To compare the concentration of progesterone between capillary blood and saliva, (ii) To assess the efficacy of weekly measurements of progesterone for determining if ovulation has occurred in elite eumenorrheic football players, and (iii) To establish a saliva criteria cut-off for establishing ovulation and assessing the sensitivity, specificity and accuracy values of the method. Methodology Twenty-one professional and semi-professional, Spanish league female football players (18.6 ± 1.5 years, 58.1 ± 6.0 kg, 164.0 ± 4.8 cm) with natural menstrual cycles, completed the study. Capillary blood and saliva samples were collected from each participant on twelve occasions each separated by at least 7 days. All samples were collected in the morning, following an overnight fast. Results According to luteal phase serum progesterone concentrations, 11 out of 21 (52%) players presented with menstrual irregularities (oligomenorrheic n = 6, anovulatory n = 4, amenorrhoeic n = 1). A significant correlation was observed between plasma and saliva progesterone in the estimated eumenorrheic group (r = 0.80, p = <0.001, 95% CI 0.72-0.86). The association between serum and saliva progesterone was weaker in the oligomenorrheic group (r = 0.47, p = <0.001, 95% CI 0.27-0.64) and was not present in the anovulatory or amenorrhoeic groups. Conclusions Salivary measurements of progesterone are well correlated with capillary blood when taken during eumenorrheic menstrual cycles and presents a viable, non-invasive method of establishing characteristic progesterone fluctuations in applied sport settings. The strength of the association appears to be concentration dependent. A luteal phase saliva progesterone (P4) >50 pg/ml and >1.5× follicular baseline has good sensitivity, specificity, and accuracy to indicate ovulation compared to established criteria for serum progesterone.
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Affiliation(s)
- Eva Ferrer
- Sports Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
- Barça Innovation Hub, Health & Wellness Area, Barcelona, Spain
| | - Gil Rodas
- Sports Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
- Barça Innovation Hub, Health & Wellness Area, Barcelona, Spain
- Medical Department of Futbol Club Barcelona, FIFA Medical Center of Excellence, Barcelona, Spain
| | - Gregori Casals
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Antoni Trilla
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Infectious Diseases Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Juan R González
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- CIBER en Epidemiología (CIBERESP), Barcelona, Spain
| | - Katherine Ridley
- Health and Wellness Department, Mint Diagnostics, Sittingbourne, Kent, United Kingdom
| | - Richard White
- Health and Wellness Department, Mint Diagnostics, Sittingbourne, Kent, United Kingdom
- Health and Wellness Department, Sport in Balance, Essex, United Kingdom
| | - Richard J Burden
- Female Athlete Health & Performance Department, UK Sports Institute, Manchester, United Kingdom
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
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14
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Krajcigr M, Kutáč P, Elavsky S, Jandačka D, Zimmermann M. Comparison of bone mineral density of runners with inactive males: A cross-sectional 4HAIE study. PLoS One 2024; 19:e0306715. [PMID: 39121106 PMCID: PMC11315333 DOI: 10.1371/journal.pone.0306715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/23/2024] [Indexed: 08/11/2024] Open
Abstract
The purpose of the study was to determine whether running is associated with greater bone mineral density (BMD) by comparing the BMD of regularly active male runners (AR) with inactive nonrunner male controls (INC). This cross-sectional study recruited 327 male AR and 212 male INC (aged 18-65) via a stratified recruitment strategy. BMD of the whole body (WB) and partial segments (spine, lumbar spine (LS), leg, hip, femoral neck (FN), and arm for each side) were measured by dual-energy x-ray absorptiometry (DXA) and lower leg dominance (dominant-D/nondominant-ND) was established by functional testing. An ANCOVA was used to compare AR and INC. The AR had greater BMD for all segments of the lower limb (p<0.05), but similar BMD for all segments of the upper limb (p>0.05) compared with INC. Based on the pairwise comparison of age groups, AR had greater BMD of the ND leg in every age group compared with INC (p<0.05). AR had grater BMD of the D leg in every age group except for (26-35 and 56-65) compare with INC (p<0.05). In the youngest age group (18-25), AR had greater BMD in every measured part of lower extremities (legs, hips, femoral necks) compared with INC (p<0.05). In the 46-55 age group AR had greater BMD than INC (p < 0.05) only in the WB, D Leg, D neck, and ND leg. In the 56-65 age group AR had greater BMD than INC (p<0.05) only in the ND leg. Overall, AR had greater BMD compared with INC in all examined sites except for the upper limbs, supporting the notion that running may positively affect bone parameters. However, the benefits differ in the skeletal sites specifically, as the legs had the highest BMD difference between AR and INC. Moreover, the increase in BMD from running decreased with age.
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Affiliation(s)
- Miroslav Krajcigr
- Department of Human Movement Science, University of Ostrava, Ostrava, Czech Republic
| | - Petr Kutáč
- Department of Human Movement Science, University of Ostrava, Ostrava, Czech Republic
| | - Steriani Elavsky
- Department of Human Movement Science, University of Ostrava, Ostrava, Czech Republic
| | - Daniel Jandačka
- Department of Human Movement Science, University of Ostrava, Ostrava, Czech Republic
| | - Matthew Zimmermann
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
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15
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Vigh-Larsen JF, Junge N, Cialdella-Kam L, Tomás R, Young L, Krustrup P, Mohr M, Nybo L. Testing in Intermittent Sports-Importance for Training and Performance Optimization in Adult Athletes. Med Sci Sports Exerc 2024; 56:1505-1537. [PMID: 39004796 DOI: 10.1249/mss.0000000000003442] [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: 07/16/2024]
Abstract
ABSTRACT Performance in intermittent sports relies on the interplay between multiple physiological systems determining the capacity to perform short explosive efforts as well as repeated intense actions with limited recovery over the course of an entire game. Testing should reflect these demands to allow for sport- and position-specific capacity analyses that eventually may translate into optimized training and improved performance. This may include individual load management and optimized training prescription, intensity targeting for specific positions or individual athletes, as well as benchmarking for monitoring of training progression and enhanced engagement of athletes. This review provides an overview of available tests in different exercise domains identified as relevant (from assessment of single explosive actions to intermittent endurance capacity), forming the basis for recommendations on how to compose a comprehensive yet feasible test battery that may be integrated into the seasonal competition and training plan. The test procedures should cover the performance spectrum of relevance for the individual athlete-also in team sports to account for positional differences. We emphasize the benefits of sport-specific tests, highlight parameters of importance for test standardization, and discuss how the applied test battery may be supplemented with secondary tests directed toward specific energy systems to allow for more in-depth analyses when required (e.g., in terms of an underperforming athlete). The synergy between testing and tracking of match performance (utilizing time-motion or global positioning systems) is highlighted, and although tracking cannot substitute for testing, combining the tools may provide a comprehensive overview of the physiological demands and performance during competition contextualized to the athletes' maximal exercise capacity.
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Affiliation(s)
| | - Nicklas Junge
- Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, DENMARK
| | - Lynn Cialdella-Kam
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | - Rita Tomás
- Portugal Football School, Federação Portuguesa de Futebol Avenida das Seleções, Oeiras, PORTUGAL
| | - Laura Young
- American College of Sports Medicine, Indianapolis, IN
| | | | | | - Lars Nybo
- Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, DENMARK
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16
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Brown GA, Jones M, Cole B, Shawdon A, Duffield R. Self-Reported Menstrual Health, Symptomatology, and Perceived Effects of the Menstrual Cycle for Elite Junior and Senior Football Players. Int J Sports Physiol Perform 2024:1-9. [PMID: 39089677 DOI: 10.1123/ijspp.2023-0522] [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: 12/14/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE To describe the self-reported menstrual health, symptomatology, and perceived effects of the menstrual cycle on athletic performance for national and international Australian football (soccer) players. METHODS Players from national and domestic teams were invited to complete an online questionnaire regarding menstrual health, use of hormonal contraceptives (HCs), negative symptomatology, and perceived disruption of the menstrual cycle to performance. Descriptive statistics and binomial regressions with odds ratios (OR) were used to report the relationship of menstrual-related variables with perceived performance disruption. RESULTS A total of 199 players (20.9 [5.1] y) completed the questionnaire, with 18% of players reporting using HCs. One primary amenorrhea case was detected, and 26% of players reported menarche at age ≥15 years. For non-HC users, the prevalence of secondary amenorrhea was 2%, oligomenorrhea was 19%, and heavy menstrual bleeding was 11%. Ninety-seven percent of players reported experiencing physical or affective menstrual symptoms (5 [1.3] per player), and 40% of all players reported that menstrual symptoms impacted their ability to work, study, train, or compete. Furthermore, 40% of players perceived their training or performance to be disrupted by the menstrual cycle. Increasing number of menstrual symptoms (OR = 1.43; 95% CI, 1.28-1.62; P < .001), heavy menstrual bleeding (OR = 12.73; 95% CI, 3.4-82.8; P < .001), and pelvic pain (OR = 3.40; 95% CI, 1.7-7.2; P < .001) increased the likelihood of perceiving the menstrual cycle to disrupt performance. CONCLUSION Heavy menstrual bleeding and HC use were low among this cohort of national and international footballers, whereas amenorrhea and oligomenorrhoea were comparable with other football populations. Nearly all players reported menstrual symptoms, and increased symptomatology was associated with greater perceived effects on performance.
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Affiliation(s)
- Georgia A Brown
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Football Australia, Sydney, NSW, Australia
| | - Mark Jones
- Football Australia, Sydney, NSW, Australia
| | | | - Anik Shawdon
- Australian Professional Leagues, Sydney, NSW, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Football Australia, Sydney, NSW, Australia
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17
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Sanchez BN, Volek JS, Kraemer WJ, Saenz C, Maresh CM. Sex Differences in Energy Metabolism: A Female-Oriented Discussion. Sports Med 2024; 54:2033-2057. [PMID: 38888855 DOI: 10.1007/s40279-024-02063-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 06/20/2024]
Abstract
The purpose of this review is to delineate aspects of energy metabolism at rest and during exercise that may be subject to sex differences and the potential underlying mechanisms involved. It focuses on distinct aspects of female physiology with an oriented discussion following the reproductive life stages of healthy, eumenorrheic females, including premenopausal time frames, pregnancy, perimenopause, and menopause. Finally, this review aims to address methodological challenges surrounding sexual dimorphism in energy metabolism investigations and confounding factors in this field. During resting conditions, females tend to have higher rates of non-oxidative free fatty acid clearance, which could contribute to lower respiratory exchange ratio measures. At the same time, carbohydrate energy metabolism findings are mixed. In general, females favor lipid energy metabolism during moderate-intensity exercise, while men favor carbohydrate energy metabolism. Factors such as age, dietary intake, genetics, and methodological decisions confound study findings, including properly identifying and reporting the menstrual cycle phase when female subjects are eumenorrheic. Pregnancy presents a unique shift in physiological systems, including energy metabolism, which can be observed at rest and during exercise. Changes in body composition and hormonal levels during the post-menopausal period directly impact energy metabolism, specifically lipid metabolism. This change in physiological state factors into the evidence showing a reduction in our understanding of sex differences in lipid metabolism during exercise in older adults. This review reveals a need for a focused understanding of female energy metabolism that could help exercise and nutrition professionals optimize female health and performance across the lifespan.
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Affiliation(s)
- Barbara N Sanchez
- Exercise Science, Department of Health Sciences, College of Education, Nursing and Health Professions, University of Hartford, 200 Bloomfield Avenue, West Hartford, CT, USA.
| | - Jeff S Volek
- Exercise Science, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - William J Kraemer
- Exercise Science, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Catherine Saenz
- Exercise Science, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Carl M Maresh
- Exercise Science, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
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18
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Guisado-Cuadrado I, Romero-Parra N, Elliott-Sale KJ, Sale C, Díaz ÁE, Peinado AB. Influence of Menstrual Cycle and Oral Contraceptive Phases on Bone (re)modelling Markers in Response to Interval Running. Calcif Tissue Int 2024:10.1007/s00223-024-01259-4. [PMID: 39066926 DOI: 10.1007/s00223-024-01259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Abstract
To explore how sex hormone fluctuations may affect bone metabolism, this study aimed to examine P1NP and β-CTX-1 concentrations across the menstrual and oral contraceptive (OC) cycle phases in response to running. 17β-oestradiol, progesterone, P1NP and β-CTX-1 were analysed pre- and post-exercise in eight eumenorrheic females in the early-follicular, late-follicular, and mid-luteal phases, while 8 OC users were evaluated during the withdrawal and active pill-taking phases. The running protocol consisted of 8 × 3min treadmill runs at 85% of maximal aerobic speed. 17β-oestradiol concentrations (pg·ml-1) were lower in early-follicular (47.22 ± 39.75) compared to late-follicular (304.95 ± 235.85;p = < 0.001) and mid-luteal phase (165.56 ± 80.6;p = 0.003) and higher in withdrawal (46.51 ± 44.09) compared to active pill-taking phase (10.88 ± 11.24;p < 0.001). Progesterone (ng·ml-1) was higher in mid-luteal (13.214 ± 4.926) compared to early-follicular (0.521 ± 0.365; p < 0.001) and late-follicular phase (1.677 ± 2.586;p < 0.001). In eumenorrheic females, P1NP concentrations (ng·ml-1) were higher in late-follicular (69.97 ± 17.84) compared to early-follicular (60.96 ± 16.64;p = 0.006;) and mid-luteal phase (59.122 ± 11.77;p = 0.002). β-CTX-1 concentrations (ng·ml-1) were lower in mid-luteal (0.376 ± 0.098) compared to late-follicular (0.496 ± 0.166; p = 0.001) and early-follicular phase (0.452 ± 0.148; p = 0.039). OC users showed higher post-exercise P1NP concentrations in withdrawal phase (61.75 ± 8.32) compared to post-exercise in active pill-taking phase (45.45 ± 6;p < 0.001). Comparing hormonal profiles, post-exercise P1NP concentrations were higher in early-follicular (66.91 ± 16.26;p < 0.001), late-follicular (80.66 ± 16.35;p < 0.001) and mid-luteal phases (64.57 ± 9.68;p = 0.002) to active pill-taking phase. These findings underscore the importance of studying exercising females with different ovarian hormone profiles, as changes in sex hormone concentrations affect bone metabolism in response to running, showing a higher post-exercise P1NP concentrations in all menstrual cycle phases compared with active pill-taking phase of the OC cycle.
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Affiliation(s)
- Isabel Guisado-Cuadrado
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science, Universidad Politécnica de Madrid, Calle de Martín Fierro, 7, 28040, Madrid, Spain.
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science, Universidad Politécnica de Madrid, Calle de Martín Fierro, 7, 28040, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine. Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Craig Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Ángel E Díaz
- Laboratorio Clínico. S.G. Ciencias del Deporte. Consejo Superior de Deportes, Madrid, Spain
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance. Faculty of Physical Activity and Sport Science, Universidad Politécnica de Madrid, Calle de Martín Fierro, 7, 28040, Madrid, Spain
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Hackney AC. Exercise and Neuroendocrinology. Curr Top Behav Neurosci 2024. [PMID: 39039359 DOI: 10.1007/7854_2024_491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
The intent of this chapter is to provide a basic overview and explanation of the neuroendocrine system responses to an exercise session in healthy adults. Specifically, the physiologic mechanisms for inducing the hormonal responses of this system and the scope of such responses are addressed. Additionally, factors that augment or attenuate exercise hormonal responses are presented as well as issues related to sex differences, and exercise-related hormonal dysfunction.
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20
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Oleka CT, Anderson T, Ackerman KE, Elliott-Sale KJ, Kraus E, Casey E, Stellingwerff T, Donaldson AT, Finnoff JT, Post EG, Adams WM. An update to terminology describing abnormal uterine bleeding in female athletes: facilitating cross-disciplinary health care. Br J Sports Med 2024:bjsports-2024-108261. [PMID: 39025663 DOI: 10.1136/bjsports-2024-108261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Chimsom T Oleka
- Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Falls Church, Virginia, USA
- Women's Health Task Force, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
| | - Travis Anderson
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Kathryn E Ackerman
- Women's Health Task Force, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- Wu Tsai Female Athlete Program, Boston Children's Hospital; Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Emily Kraus
- Women's Health Task Force, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- Stanford Female Athlete Science and Translational Research (FASTR) Program, Department of Orthopaedic Surgery, Stanford, California, USA
| | - Ellen Casey
- Women's Health Task Force, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- Hospital for Special Surgery, New York, New York, USA
| | - Trent Stellingwerff
- Canadian Sport Institute - Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Amber T Donaldson
- Women's Health Task Force, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Jonathan T Finnoff
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Eric G Post
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
- School of Health, Exercise and Sport Sciences, Loughborough University, Leicestershire, UK
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Tan R, Merrill C, Riley CF, Hammer MA, Kenney RT, Riley AA, Li J, Zink AC, Karl ST, Price KM, Sharabidze LK, Rowland SN, Bailey SJ, Stiemsma LT, Pennell A. Acute inorganic nitrate ingestion does not impact oral microbial composition, cognitive function, or high-intensity exercise performance in female team-sport athletes. Eur J Appl Physiol 2024:10.1007/s00421-024-05552-w. [PMID: 39017740 DOI: 10.1007/s00421-024-05552-w] [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: 06/10/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024]
Abstract
The purpose of this study was to investigate the effects of acute nitrate (NO3-)-rich beetroot juice ingestion on explosive and high-intensity exercise performance, oral microbiota composition, and cognitive flexibility (i.e., function), before and after maximal intermittent running exercise. Fifteen women team-sport athletes were assigned in a randomized, double-blind, crossover design to consume concentrated NO3--depleted beetroot juice (PL; 0.1 mmol NO3-) and NO3--rich beetroot juice (BR; 12.0 mmol NO3-) 2.5 h prior to performing a battery of exercise performance tasks and cognitive testing before and after the Yo-Yo intermittent recovery level 1 (YYIR1) running test. Resting plasma [NO3-] and plasma nitrite ([NO2-]) were elevated following BR (P < 0.001). BR did not impact global composition or relative abundance of taxa in the oral microbiome (P > 0.05) or cognitive flexibility before or after exercise (P > 0.05). There was no significant difference in performance during 20-m (PRE, PL: 4.38 ± 0.27 vs. BR: 4.38 ± 0.32 s; POST, PL: 4.45 ± 0.29 vs. BR: 4.43 ± 0.35 s) and 10-m sprints (PRE, PL 2.78 ± 0.15 vs. BR 2.79 ± 0.18 s; POST, PL: 2.82 ± 0.16 vs. BR: 2.81 ± 0.19 s), isokinetic handgrip dynamometry, medicine ball throw, horizontal countermovement jump, or YYIR1 (PL: 355 ± 163 m vs. BR: 368 ± 184 m) between BR and PL (P > 0.05). These findings indicate that acute dietary NO3- may not influence the oral microbiome, explosive and high-intensity exercise performance, or cognitive function in women team-sport athletes.
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Affiliation(s)
- Rachel Tan
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA.
| | - Courtney Merrill
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Chandler F Riley
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Maya A Hammer
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Ryan T Kenney
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Alyssa A Riley
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Jeffrey Li
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Alexandra C Zink
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Sean T Karl
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Katherine M Price
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Luka K Sharabidze
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Samantha N Rowland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Leah T Stiemsma
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
| | - Adam Pennell
- Natural Science Division, Pepperdine University, Malibu, CA, 90263, USA
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22
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Tucker JAL, McCarthy SF, Bornath DPD, Khoja JS, Hazell TJ. The Effect of the Menstrual Cycle on Energy Intake: A Systematic Review and Meta-analysis. Nutr Rev 2024:nuae093. [PMID: 39008822 DOI: 10.1093/nutrit/nuae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Abstract
CONTEXT Energy intake may differ across the menstrual cycle, with some studies identifying greater energy intake in the luteal phase (LP) compared with the follicular phase (FP) and others finding no clear differences. To date, no study has systematically synthesized the available data to draw more definite conclusions while considering any methodological inconsistencies between studies. OBJECTIVE The aim was to conduct a systematic review/meta-analysis in an effort to determine if there are differences in energy intake between the FP and LP. DATA SOURCES A systematic search strategy was developed and the search was conducted in 5 databases for studies that investigated any changes in energy intake across menstrual phases. DATA EXTRACTION Using Covidence, studies were identified and included if they contained individuals between the ages of 18 and 45 years, maintained an average body mass index (BMI) of 18.5-25 kg/m2, had no history of disordered eating, and included energy intake and menstrual cycle measurements in the FP and LP. DATA ANALYSIS Effect sizes were calculated for each study and a random-effects model was used to pool the results of each study. RESULTS Fifteen datasets were included consisting of 330 female participants with a mean age of 26 ± 4 years and mean BMI of 22.4 ± 2.3 kg/m2. Overall, there was a statistically significant difference (standardized mean difference = 0.69; P = .039) with increased energy intake in the LP compared with the FP (crude 168 kcal⋅d-1 average difference between phases). CONCLUSION Energy intake was found to be greater in the LP compared with the FP, providing insight into the effect of the menstrual cycle on energy intake. However, there were repeated methodological inconsistencies and future work should strive to utilize best practices for both energy intake measurement and menstrual phase specification.
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Affiliation(s)
- Jessica A L Tucker
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Seth F McCarthy
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Derek P D Bornath
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Jenna S Khoja
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
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23
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Ihalainen JK, Mikkonen RS, Ackerman KE, Heikura IA, Mjøsund K, Valtonen M, Hackney AC. Beyond Menstrual Dysfunction: Does Altered Endocrine Function Caused by Problematic Low Energy Availability Impair Health and Sports Performance in Female Athletes? Sports Med 2024:10.1007/s40279-024-02065-6. [PMID: 38995599 DOI: 10.1007/s40279-024-02065-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/13/2024]
Abstract
Low energy availability, particularly when problematic (i.e., prolonged and/or severe), has numerous negative consequences for health and sports performance as characterized in relative energy deficiency in sport. These consequences may be driven by disturbances in endocrine function, although scientific evidence clearly linking endocrine dysfunction to decreased sports performance and blunted or diminished training adaptations is limited. We describe how low energy availability-induced changes in sex hormones manifest as menstrual dysfunction and accompanying hormonal dysfunction in other endocrine axes that lead to adverse health outcomes, including negative bone health, impaired metabolic activity, undesired outcomes for body composition, altered immune response, problematic cardiovascular outcomes, iron deficiency, as well as impaired endurance performance and force production, all of which ultimately may influence athlete health and performance. Where identifiable menstrual dysfunction indicates hypothalamic-pituitary-ovarian axis dysfunction, concomitant disturbances in other hormonal axes and their impact on the athlete's health and sports performance must be recognized as well. Given that the margin between podium positions and "losing" in competitive sports can be very small, several important questions regarding low energy availability, endocrinology, and the mechanisms behind impaired training adaptations and sports performance have yet to be explored.
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Affiliation(s)
- Johanna K Ihalainen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014, Jyväskylä, Finland.
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland.
| | - Ritva S Mikkonen
- Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014, Jyväskylä, Finland
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, Vuokatti, Finland
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ida A Heikura
- Canadian Sport Institute-Pacific, Victoria, BC, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Katja Mjøsund
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
- National Olympic Training Centre Helsinki, Helsinki, Finland
| | - Maarit Valtonen
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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24
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Kubica C, Ketelhut S, Nigg CR. Polarized running training adapted to versus contrary to the menstrual cycle phases has similar effects on endurance performance and cardiovascular parameters. Eur J Appl Physiol 2024:10.1007/s00421-024-05545-9. [PMID: 38977510 DOI: 10.1007/s00421-024-05545-9] [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: 11/14/2023] [Accepted: 06/16/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE This study compared the effects of polarized running training adapted to the menstrual cycle (MC) phases versus polarized training adapted contrary to the MC on endurance performance and cardiovascular parameters. METHODS Thirty-three naturally menstruating, moderately trained females (age: 26 ± 4 years; BMI: 22.3 ± 3.2 kg/m2; V ˙ O2max/rel: 40.35 ± 4.61 ml/min/kg) were randomly assigned to a control (CON) and intervention (INT) group. Both groups participated in a load-matched eight-week running training intervention. In the INT, high-intensity sessions were aligned with the mid and late follicular phase, low-intensity sessions with the early and mid-luteal phase, and recovery with the late luteal and early follicular phase. In the CON, high-intensity sessions were matched to the late luteal and early follicular phase, and recovery to the mid and late follicular phase. Endurance performance and cardiovascular parameters were assessed at baseline and after the intervention. RESULTS Twenty-six females completed the intervention. A repeated measures ANOVA determined no time × group interaction effect for any parameter. A significant time effect was found for maximal oxygen uptake (F(1,12) = 18.753, p = 0.005, ηp2 = 0.630), the velocity at the ventilatory threshold one (F(1,12) = 10.704, p = 0.007, ηp2 = 0.493) and two (F(1,12) = 7.746, p = .018, ηp2 = .413). CONCLUSION The training intervention improved endurance performance in both groups, with no further benefit observed from the MC-adapted polarized training in a group-based analysis. Replications with an extended intervention period, a larger sample size, and a more reliable MC determination are warranted.
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Affiliation(s)
- Claudia Kubica
- Health Science Department, University of Bern, Bern, Switzerland.
| | - Sascha Ketelhut
- Health Science Department, University of Bern, Bern, Switzerland
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25
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Lim AH, Varghese C, Sebaratnam GH, Schamberg G, Calder S, Gharibans AA, Andrews CN, Foong D, Ho V, Ishida S, Imai Y, Wise MR, O'Grady G. Effect of menstrual cycle and menopause on human gastric electrophysiology. Am J Physiol Gastrointest Liver Physiol 2024; 327:G47-G56. [PMID: 38713629 PMCID: PMC11211038 DOI: 10.1152/ajpgi.00216.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/09/2024]
Abstract
Chronic gastroduodenal symptoms disproportionately affect females of childbearing age; however, the effect of menstrual cycling on gastric electrophysiology is poorly defined. To establish the effect of the menstrual cycle on gastric electrophysiology, healthy subjects underwent noninvasive Body Surface Gastric Mapping (BSGM; 8x8 array) with the validated symptom logging App (Gastric Alimetry, New Zealand). Participants included were premenopausal females in follicular (n = 26) and luteal phases (n = 18) and postmenopausal females (n = 30) and males (n = 51) were controls. Principal gastric frequency (PGF), body mass index (BMI) adjusted amplitude, Gastric Alimetry Rhythm Index (GA-RI), Fed:Fasted Amplitude Ratio (ff-AR), meal response curves, and symptom burden were analyzed. Menstrual cycle-related electrophysiological changes were then transferred to an established anatomically accurate computational gastric fluid dynamics model (meal viscosity 0.1 Pas) to predict the impact on gastric mixing and emptying. PGF was significantly higher in the luteal versus follicular phase [mean 3.21 cpm, SD (0.17) vs. 2.94 cpm, SD (0.17), P < 0.001] and versus males [3.01 cpm, SD (0.2), P < 0.001]. In the computational model, this translated to 8.1% higher gastric mixing strength and 5.3% faster gastric emptying for luteal versus follicular phases. Postmenopausal females also exhibited higher PGF than females in the follicular phase [3.10 cpm, SD (0.24) vs. 2.94 cpm, SD (0.17), P = 0.01], and higher BMI-adjusted amplitude [40.7 µV (33.02-52.58) vs. 29.6 µV (26.15-39.65), P < 0.001], GA-RI [0.60 (0.48-0.73) vs. 0.43 (0.30-0.60), P = 0.005], and ff-AR [2.51 (1.79-3.47) vs. 1.48 (1.21-2.17), P = 0.001] than males. There were no differences in symptoms. These results define variations in gastric electrophysiology with regard to human menstrual cycling and menopause.NEW & NOTEWORTHY This study evaluates gastric electrophysiology in relation to the menstrual cycle using a novel noninvasive high-resolution methodology, revealing substantial variations in gastric activity with menstrual cycling and menopause. Gastric slow-wave frequency is significantly higher in the luteal versus follicular menstrual phase. Computational modeling predicts that this difference translates to higher rates of gastric mixing and liquid emptying in the luteal phase, which is consistent with previous experimental data evaluating menstrual cycling effects on gastric emptying.
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Affiliation(s)
- Alexandria H Lim
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Chris Varghese
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | | | - Gabriel Schamberg
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry, Ltd., Auckland, New Zealand
| | - Stefan Calder
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry, Ltd., Auckland, New Zealand
| | - Armen A Gharibans
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry, Ltd., Auckland, New Zealand
| | | | - Daphne Foong
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Vincent Ho
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Shunichi Ishida
- Graduate School of Engineering, Kobe University, Kobe, Japan
| | - Yohsuke Imai
- Graduate School of Engineering, Kobe University, Kobe, Japan
| | - Michelle R Wise
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Greg O'Grady
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry, Ltd., Auckland, New Zealand
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26
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Wyatt HE, Sheerin K, Hume PA, Hébert-Losier K. Prevalence and Risk Factors for Musculoskeletal Pain when Running During Pregnancy: A Survey of 3102 Women. Sports Med 2024; 54:1955-1964. [PMID: 38319589 PMCID: PMC11258093 DOI: 10.1007/s40279-024-01994-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Musculoskeletal pain while running is a concern to women during pregnancy and can lead to running cessation. To support women who wish to run during pregnancy, it is essential to understand the sites, severities and personal risk factors associated with musculoskeletal pain. OBJECTIVE The aim was to investigate prevalence and risk factors for musculoskeletal pain when running during pregnancy. METHODS An online survey was completed by women who had a child in the past 5 years and ran prior to and during pregnancy. Pain frequency informed prevalence rates by body site, and logistic regression odds ratios (ORs) and 95% confidence intervals were calculated. RESULTS A total of 3102 women of 23 ethnicities from 25 countries completed the survey. Women were 22-52 years old when they gave birth and ran 2-129 km/week during the 0.5-35 years before the birth of their youngest child. Women ran significantly less distance and less often during pregnancy than before pregnancy. Most women (86%) experienced pain while running during pregnancy (59% pelvis/sacroiliac joint, 52% lower back, 51% abdomen, 44% breast, 40% hip). The highest prevalence of severe-to-worst pain was at the pelvis/sacroiliac joint (9%). Women at greatest risk of pain while running during pregnancy had a previous injury (OR = 3.44) or were older (OR = 1.04). Women with a previous child were less likely to experience breast pain (OR = 0.76) than those running during their first pregnancy. CONCLUSION Healthcare practices to reduce pain should focus on regions of greatest musculoskeletal change during pregnancy, specifically the pelvis, lower back and abdomen. Efforts to support women to run for longer throughout pregnancy should focus on pain at the pelvis and breasts.
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Affiliation(s)
- Hannah E Wyatt
- Faculty of Health, University of Canterbury, Christchurch, New Zealand.
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.
| | - Kelly Sheerin
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Patria A Hume
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Mindaroo Tech & Policy Lab, Law School, The University of Western Australia, Perth, Australia
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health University of Waikato, Tauranga, New Zealand
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27
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Merrell LH, Perkin OJ, Bradshaw L, Collier‐Bain HD, Collins AJ, Davies S, Eddy R, Hickman JA, Nicholas AP, Rees D, Spellanzon B, James LJ, McKay AKA, Smith HA, Turner JE, Koumanov F, Maher J, Thompson D, Gonzalez JT, Betts JA. Myths and Methodologies: Standardisation in human physiology research-should we control the controllables? Exp Physiol 2024; 109:1099-1108. [PMID: 38763158 PMCID: PMC11215472 DOI: 10.1113/ep091557] [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: 09/28/2023] [Accepted: 02/05/2024] [Indexed: 05/21/2024]
Abstract
The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants' habitual diets, yet a self-report and replication method can be flawed by under-reporting. Researchers may also need to consider standardisation of physical activity, whether it be through familiarisation trials, wash-out periods, or guidance on levels of physical activity to be achieved before trials. In terms of pharmacological agents, the ethical implications of standardisation require researchers to carefully consider how medications, caffeine consumption and oral contraceptive prescriptions may affect the study. For research in females, it should be considered whether standardisation between- or within-participants in regards to menstrual cycle phase is most relevant. The timing of measurements relative to various other daily events is relevant to all physiological research and so it can be important to standardise when measurements are made. This review summarises the areas of standardisation which we hope will be considered useful to anyone involved in human physiology research, including when and how one can apply standardisation to various contexts.
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Affiliation(s)
- Lucy H. Merrell
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Oliver J. Perkin
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Louise Bradshaw
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | | | - Adam J. Collins
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Sophie Davies
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Rachel Eddy
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - James A. Hickman
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Anna P. Nicholas
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Daniel Rees
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Bruno Spellanzon
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Lewis J. James
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Alannah K. A. McKay
- Mary MacKillop Institute for Health ResearchAustralian Catholic UniversityMelbourneAustralia
| | - Harry A. Smith
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - James E. Turner
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | | | - Jennifer Maher
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | - Dylan Thompson
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
| | | | - James A. Betts
- Centre for Nutrition, Exercise and MetabolismUniversity of BathBathUK
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28
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Rodriguez LA, Casey E, Crossley E, Williams N, Dhaher YY. The hormonal profile in women using combined monophasic oral contraceptive pills varies across the pill cycle: a temporal analysis of serum endogenous and exogenous hormones using liquid chromatography with tandem mass spectroscopy. Am J Physiol Endocrinol Metab 2024; 327:E121-E133. [PMID: 38775726 DOI: 10.1152/ajpendo.00418.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 07/18/2024]
Abstract
Oral contraceptive pills, of all types, are used by approximately 151 million women worldwide; however, a clear understanding of the concentrations of endogenous and exogenous hormones across a 28-day combination monophasic oral contraceptive pill pack is not well described. In our study of 14 female participants taking various combination monophasic oral contraceptive pills, we found significant fluctuations in endogenous and exogenous hormone levels throughout the pill cycle. Our analysis revealed significantly greater levels of ethinyl estradiol on the 20th and 21st days of active pill ingestion, compared with days 1-2 (active) and days 27-28 (inactive pill ingestion). Conversely, estradiol concentrations decreased during active pill consumption, while progestin and progesterone levels remained stable. During the 7 days of inactive pill ingestion, estradiol levels rose sharply and were significantly higher at days 27-28 compared with the mid and late active phase time points, while ethinyl estradiol declined and progestin did not change. These findings challenge the previous assumption that endogenous and exogenous hormones are stable throughout the 28-day pill cycle.NEW & NOTEWORTHY The results from this study have wide-ranging implications for research and treatment in women's health including considerations in research design and interpretation for studies including women taking oral contraceptives, the potential for more precise and personalized methods of dosing to reduce unwanted side effects and adverse events, and the potential treatment of a variety of disorders ranging from musculoskeletal to neurological with exogenous hormones.
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Affiliation(s)
- Luis A Rodriguez
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, United States
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York, United States
| | - Eric Crossley
- Department of Biochemistry, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Noelle Williams
- Department of Biochemistry, UT Southwestern Medical Center, Dallas, Texas, United States
| | - Yasin Y Dhaher
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, United States
- Department of Physiatry, Hospital for Special Surgery, New York, New York, United States
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, United States
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29
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Kuikman MA, McKay AKA, Minahan C, Harris R, Elliott-Sale KJ, Stellingwerff T, Smith ES, McCormick R, Tee N, Skinner J, Ackerman KE, Burke LM. Effect of Menstrual Cycle Phase and Hormonal Contraceptives on Resting Metabolic Rate and Body Composition. Int J Sport Nutr Exerc Metab 2024; 34:207-217. [PMID: 38653456 DOI: 10.1123/ijsnem.2023-0193] [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: 09/10/2023] [Revised: 01/17/2024] [Accepted: 02/29/2024] [Indexed: 04/25/2024]
Abstract
The cyclical changes in sex hormones across the menstrual cycle (MC) are associated with various biological changes that may alter resting metabolic rate (RMR) and body composition estimates. Hormonal contraceptive (HC) use must also be considered given their impact on endogenous sex hormone concentrations and synchronous exogenous profiles. The purpose of this study was to determine if RMR and dual-energy X-ray absorptiometry body composition estimates change across the MC and differ compared with HC users. This was accomplished during a 5-week training camp involving naturally cycling athletes (n = 11) and HC users (n = 7 subdermal progestin implant, n = 4 combined monophasic oral contraceptive pill, n = 1 injection) from the National Rugby League Indigenous Women's Academy. MC phase was retrospectively confirmed via serum estradiol and progesterone concentrations and a positive ovulation test. HC users had serum estradiol and progesterone concentrations assessed at the time point of testing. Results were analyzed using general linear mixed model. There was no effect of MC phase on absolute RMR (p = .877), relative RMR (p = .957), or dual-energy X-ray absorptiometry body composition estimates (p > .05). There was no effect of HC use on absolute RMR (p = .069), relative RMR (p = .679), or fat mass estimates (p = .766), but HC users had a greater fat-free mass and lean body mass than naturally cycling athletes (p = .028). Our findings suggest that RMR and dual-energy X-ray absorptiometry body composition estimates do not significantly differ due to changes in sex hormones in a group of athletes, and measurements can be compared between MC phases or with HC usage without variations in sex hormones causing additional noise.
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Affiliation(s)
- Megan A Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Clare Minahan
- Griffith Sports Science, Griffith University, Gold Coast, QLD, Australia
- Female Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT, Australia
| | - Rachel Harris
- Female Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT, Australia
- Perth Orthopaedic and Sports Medicine Research Institute, West Perth, WA, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Pacific Institute for Sport Excellence, Victoria, BC, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Ella S Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Rachel McCormick
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Nicolin Tee
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | | | - Kathryn E Ackerman
- Female Athlete Program, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Wilson LJ, Curtis C. Running Event, Age, and Competitive Level as Predictors of Dual-Energy X-Ray Absorptiometry-Derived Body Composition and Bone Health Markers in Female Runners. J Strength Cond Res 2024; 38:e366-e372. [PMID: 38595277 DOI: 10.1519/jsc.0000000000004773] [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: 04/11/2024]
Abstract
ABSTRACT Wilson, LJ and Curtis, C. Running event, age, and competitive level as predictors of dual-energy X-ray absorptiometry-derived body composition and bone health markers in female runners. J Strength Cond Res 38(7): e366-e372, 2024-The aim of this study was to assess the impact of running discipline, competitive level (COMP), and age on body composition measures in female athletes. A total of n = 51 female runners (age: 30.9 ± 5.7 years, stature: 166.7 ± 5.7 cm, and body mass (BM): 57.1 ± 8.2 kg) completed a full-body dual-energy x-ray absorptiometry (DXA) scan in a cross-sectional design. One-way ANOVA or Kruskal-Wallis was used to identify differences in DXA measures and independent variables. Stepwise regression determined the contribution of independent variables on DXA measures. Body fat percentage (BF%) and fat mass (FM) differed based on COMP (BF%: H (2) = 17.451; FM: H (2) = 17.406, both p ≤ 0.0001). Competitive level modestly predicted BF% and FM (BF%: R2adj = 0.316, F (1,50) = 22.660; FM: R2adj = 0.300, F (1,50) = 21.029, both p ≤ 0.0001). Bone mineral density (BMD) and BMD Z-score (BMD Z ) did not differ between age, running discipline, or COMP (age: BMD: F (2,50) = 2.825, BMD Z : F (2,50) = 2.215; running discipline: BMD: F (3,50) = 1.145, BMD Z : F (3,50) = 1.474; COMP: BMD: F (2,50) = 0.074, BMD Z : F (2,50) = 1.297, all p ≤ 0.05). Age and running discipline modestly predicted BMD and BMD Z (BMD: R2adj = 0.179, F (1,50) = 5.264; BMD Z : R2adj = 0.173, F (1,50) = 4.545, both p ≤ 0.05). These findings indicate COMP may be a predictor of BF% and FM. Age and running discipline appear predictors of bone health markers. Such findings may enable medical and sport science practitioners to tailor interventions relating to realization of training adaptations, performance, and health.
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Affiliation(s)
- Laura Jane Wilson
- London Sport Institute, Middlesex University, London, United Kingdom; and
| | - Christopher Curtis
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
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de Oliveira NG, de Oliveira LF, da Silva RP, Oliveira TN, Möller GB, Murasaki J, Ramires MA, Azevedo RDA, Artioli GG, Roschel H, Gualano B, Saunders B. Trehalose Improved 20-min Cycling Time-Trial Performance After 100-min Cycling in Amateur Cyclists. Int J Sport Nutr Exerc Metab 2024; 34:199-206. [PMID: 38458180 DOI: 10.1123/ijsnem.2023-0241] [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: 11/08/2023] [Revised: 01/10/2024] [Accepted: 01/30/2024] [Indexed: 03/10/2024]
Abstract
Carbohydrate (CHO) supplementation during endurance exercise can improve performance. However, it is unclear whether low glycemic index (GI) CHO leads to differential ergogenic and metabolic effects compared with a standard high GI CHO. This study investigated the ergogenic and metabolic effects of CHO supplementation with distinct GIs, namely, (a) trehalose (30 g/hr), (b) isomaltulose (30 g/hr), (c) maltodextrin (60 g/hr), and (d) placebo (water). In this double-blind, crossover, counterbalanced, placebo-controlled study, 13 male cyclists cycled a total of 100 min at varied exercise intensity (i.e., 10-min stages at 1.5, 2.0, and 2.5 W/kg; repeated three times plus two 5-min stages at 1.0 W/kg before and after the protocol), followed by a 20-min time trial on four separated occasions. Blood glucose and lactate (every 20 min), heart rate, and ratings of perceived exertion were collected throughout, and muscle biopsies were taken before and immediately after exercise. The results showed that trehalose improved time-trial performance compared with placebo (total work done 302 ± 39 vs. 287 ± 48 kJ; p = .01), with no other differences between sessions (all p ≥ .07). Throughout the 100-min protocol, blood glucose was higher with maltodextrin compared with the other supplements at all time points (all p < .05). Heart rate, ratings of perceived exertion, muscle glycogen content, blood glucose, and lactate were not different between conditions when considering the 20-min time trial (all p > .05). Trehalose supplementation throughout endurance exercise improved cycling performance and appears to be an appropriate CHO source for exercise tasks up to 2 hr. No ergogenic superiority between the different types of CHO was established.
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Affiliation(s)
- Nathan Gobbi de Oliveira
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Luana Farias de Oliveira
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Rafael Pires da Silva
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Tamires Nunes Oliveira
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Gabriella Berwig Möller
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Juliana Murasaki
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Manoel Antônio Ramires
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Rafael de Almeida Azevedo
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Guilherme Giannini Artioli
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
- Food Research Center, University of São Paulo, Sao Paulo, SP, Brazil
| | - Bryan Saunders
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
- Institute of Orthopaedics and Traumatology, Faculty of Medicine FMUSP, University of São Paulo, Sao Paulo, SP, Brazil
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Santabarbara KL, Helms ER, Stewart TI, Armour MJ, Harris NK. Menstrual cycle patterns and their relationship with measures of well-being and perceived performance metrics in competitive and recreational resistance-trained athletes. J Sports Med Phys Fitness 2024; 64:694-706. [PMID: 38916093 DOI: 10.23736/s0022-4707.24.15752-0] [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: 06/26/2024]
Abstract
BACKGROUND There is mixed evidence on how the menstrual cycle (MC) affects sports performance, with many studies showing variations in performance during different phases of the MC, while other evidence shows that the MC's effects on performance may be trivial. Therefore, this exploratory longitudinal monitoring study was designed to investigate MC characteristics and symptoms in a resistance-trained (RT) population to look for associations between measures of well-being and perceived performance metrics across the MC. METHODS RT females reported their workout habits, perceived performance metrics, and measures of well-being while tracking their MC with detailed methods via daily check-ins in an app. RESULTS Most MC characteristics and symptoms in the present RT population aligned with previous research on the general population. However, the frequency of irregular cycles was higher than in previous research on the general population. The amount of individual variation and within-subject cycle-to-cycle variation in MC characteristics and MC symptoms was also high. All measures of well-being were significantly associated with specific days of the MC, demonstrating a change in well-being based on the timing of the MC. Several perceived performance metrics were significantly associated with changes across the MC, while others were not. CONCLUSIONS Overall, with the current evidence as it stands, a highly individualized approach should be taken for any training or performance considerations surrounding the MC due to the high levels of individual variation.
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Affiliation(s)
- Kimberly L Santabarbara
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand -
- Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, USA -
| | - Eric R Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
- Department of Exercise Science and Health Promotion, Florida Atlantic University, Laboratory of Muscle Physiology, Boca Raton, FL, USA
| | - Tom I Stewart
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
| | - Mike J Armour
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington, New Zealand
| | - Nigel K Harris
- Human Potential Center, Auckland University of Technology, Auckland, New Zealand
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Roffler A, Fleddermann MT, de Haan H, Krüger K, Zentgraf K. Menstrual cycle tracking in professional volleyball athletes. Front Sports Act Living 2024; 6:1408711. [PMID: 39005625 PMCID: PMC11239427 DOI: 10.3389/fspor.2024.1408711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction The menstrual cycle may affect well-being and physical performance of elite female athletes by interfering with the function of multiple physiological systems. The aim of this study was to characterize the symptoms of the menstrual cycle and their frequency in elite female volleyball players. Methods Twenty professional female volleyball players were instructed to track their menstrual symptoms over the course of the first German national league season using the FitrWoman® tracking app. The app recorded the cycle length, duration, and intensity of the period as well as the occurrence and frequency of frequent cycle symptoms. The reported symptoms were then categorized into four categories (frequently, sometimes, rare, never) in order to create an individual Menstrual Symptom index (MSi) for each athlete. Results The most frequently occurring symptoms among all players without hormonal contraception (non-HC; n = 15) were "stomach cramps" (n = 15), "sleep disturbances" (n = 11), and "tiredness" (n = 11). The average number of symptoms counted per cycle was 11.8 (±17.7) and the average calculated MSi within the team was 12.9 (±10.7) points for non-HC users. The HC players (n = 4) also regularly experienced symptoms such as "sleep disturbances" or "tendered breasts". The most common symptoms "stomach cramps" and "disturbed sleep" occurred more frequently during menstruation, while symptoms such as "bloating", "cravings" or "tendered breasts" did also peak before menstruation. Discussion Menstrual cycle symptoms can be highly individual within a professional sports team. The calculation of the MSi seems to be a simple and accessible method to describe and overview the intensity and prevalence of symptoms in top female athletes in sports games.
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Affiliation(s)
- Andrea Roffler
- Department of Movement Science and Training in Sports, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Marie-Therese Fleddermann
- Department of Movement Science and Training in Sports, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Hanna de Haan
- Department of Performance Psychology, German Sport University Cologne, Köln, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig University Giessen, Giessen, Germany
| | - Karen Zentgraf
- Department of Movement Science and Training in Sports, Institute of Sport Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
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Belamjahad A, Tourny C, Jebabli N, Clark CCT, Laher I, Hackney AC, Granacher U, Zouhal H. Effects of a Preseason Neuromuscular Training Program vs. an Endurance-Dominated Program on Physical Fitness and Injury Prevention in Female Soccer Players. SPORTS MEDICINE - OPEN 2024; 10:76. [PMID: 38922502 PMCID: PMC11208342 DOI: 10.1186/s40798-024-00731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/16/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players. METHODS Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45-60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season. RESULTS No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014). CONCLUSIONS The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players.
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Affiliation(s)
- Ali Belamjahad
- CETAPS UR 3832 (Research Center of Sport Science), University of Rouen Normandy, Rouen, France
| | - Claire Tourny
- CETAPS UR 3832 (Research Center of Sport Science), University of Rouen Normandy, Rouen, France
| | - Nidhal Jebabli
- High Institute of Sport and Physical Education of Kef, UR22JS01, University of Jendouba, Kef, Tunisia
| | - Cain C T Clark
- Institute for Health and Wellbeing, Coventry University, Coventry, CV1 5FB, UK
- College of Life Sciences, Birmingham City University, B15 3TN, Birmingham, UK
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Anthony C Hackney
- CETAPS UR 3832 (Research Center of Sport Science), University of Rouen Normandy, Rouen, France.
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany.
| | - Hassane Zouhal
- Université Rennes, M2S (Laboratoire Mouvement, Sport, Rennes, Santé, France.
- Institut International des Sciences du Sport (2I2S), 35850, Irodouer, France.
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Badenhorst CE. The Menstrual Health Manager (MHM): A Resource to Reduce Discrepancies Between Science and Practice in Sport and Exercise. Sports Med 2024:10.1007/s40279-024-02061-w. [PMID: 38904920 DOI: 10.1007/s40279-024-02061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/22/2024]
Abstract
Inadequate research on female health and performance; the complexity of the research; low menstrual health literacy of athletes, coaches, and support staff; and ethical and cultural sensitivities are all recognized as barriers to effective health monitoring for females in sports. Frameworks have been developed for academics to follow to help improve the quality of female-specific research. However, a similar resource that enables correct terminology, and use of health monitoring techniques has not been provided for sporting organizations, coaches, support staff or athletes. Therefore, this critical commentary presents a new resource, the Menstrual Health Manager. This resource may be used to determine the level of menstrual health monitoring detail that may be used by organisations, coaches or athletes, and specifies what reproductive health details the data will provide. This resource aims to provide organizations and coaches with a means of understanding the data that inform their decisions for female athletes. Utilization of this resource may aid in the consistent use of terminology and methods for female-specific health monitoring in both sports and research.
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Affiliation(s)
- Claire E Badenhorst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
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Cabre HE, Gould LM, Redman LM, Smith-Ryan AE. Effects of the Menstrual Cycle and Hormonal Contraceptive Use on Metabolic Outcomes, Strength Performance, and Recovery: A Narrative Review. Metabolites 2024; 14:347. [PMID: 39057670 PMCID: PMC11278889 DOI: 10.3390/metabo14070347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
The effects of female sex hormones on optimal performance have been increasingly recognized as an important consideration in exercise and sport science research. This narrative review explores the findings of studies evaluating the effects of menstrual cycle phase in eumenorrheic women and the use of hormonal contraception (oral contraceptives and hormonal intrauterine devices) on metabolism, muscular strength, and recovery in active females. Ovarian hormones are known to influence metabolism because estrogen is a master regulator of bioenergetics. Importantly, the menstrual cycle may impact protein synthesis, impacting skeletal muscle quality and strength. Studies investigating muscular strength in eumenorrheic women report equivocal findings between the follicular phase and luteal phase with no differences compared to oral contraceptive users. Studies examining recovery measures (using biomarkers, blood lactate, and blood flow) do not report clear or consistent effects of the impact of the menstrual cycle or hormonal contraception use on recovery. Overall, the current literature may be limited by the evaluation of only one menstrual cycle and the use of group means for statistical significance. Hence, to optimize training and performance in females, regardless of hormonal contraception use, there is a need for future research to quantify the intra-individual impact of the menstrual cycle phases and hormonal contraceptive use in active females.
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Affiliation(s)
- Hannah E. Cabre
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | | | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Abbie E. Smith-Ryan
- Human Movement Sciences Curriculum, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
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Burden RJ, Altini M, Ferrer E, Flood TR, Lewin G, Nimphius S, Phillips SM, Elliott-Sale KJ. Measure do not guess: a call to action to end assumed and estimated menstrual cycle phases in research. BMJ Open Sport Exerc Med 2024; 10:e002095. [PMID: 38895644 PMCID: PMC11184199 DOI: 10.1136/bmjsem-2024-002095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
- Richard J Burden
- UK Sports Institute, Manchester, UK
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Marco Altini
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Eva Ferrer
- Barça Innovation Hub of Football Club Barcelona, Barcelona, Spain
- Sports and Exercise Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
| | - Tessa R Flood
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Gary Lewin
- Arsenal Women’s Football Club, London, UK
| | - Sophia Nimphius
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
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Tuma C, Thomas A, Braun H, Thevis M. Development of an LC-HRMS/MS Method for Quantifying Steroids and Thyroid Hormones in Capillary Blood: A Potential Tool for Assessing Relative Energy Deficiency in Sport (RED-S). Metabolites 2024; 14:328. [PMID: 38921463 PMCID: PMC11205421 DOI: 10.3390/metabo14060328] [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: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Relative energy deficiency in sport (RED-S) is a condition that arises from persistent low energy availability (LEA), which affects the hypothalamic-pituitary axis and results in alterations of several hormones in both male and female athletes. As frequent blood hormone status determinations using venipuncture are rare in sports practice, microsampling offers promising possibilities for preventing and assessing RED-S. Therefore, this study aimed at developing a liquid chromatography-high-resolution tandem mass spectrometry (LC-HRMS/MS) method for quantifying relevant steroids and thyroid hormones in 30 μL of capillary blood obtained using Mitra® devices with volumetric absorptive microsampling technology (VAMS®). The results of the study showed that all validation criteria were met, including a storage stability of more than 28 days in a frozen state (-18 °C) and 14 days at room temperature (20 °C). The validated assay provided precise (<12%) and accurate (<13%) results for all the target analytes. Furthermore, as a proof of concept, autonomously collected VAMS® samples from 50 female and male, healthy, active adults were analyzed. The sensitivity of all analytes was adequate to quantify the decreased hormone concentrations in the RED-S state, as all authentic samples could be measured accordingly. These findings suggest that self-collected VAMS® samples offer a practical opportunity for regular hormone measurements in athletes and can be used for early RED-S assessment and progress monitoring during RED-S recovery.
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Affiliation(s)
- Chiara Tuma
- Institute of Biochemistry, Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Andreas Thomas
- Institute of Biochemistry, Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany
| | - Hans Braun
- Institute of Biochemistry, Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany
- German Research Centre of Elite Sports (Momentum), German Sport University Cologne, 50933 Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry, Center of Preventive Doping Research, German Sport University Cologne, 50933 Cologne, Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA), 50933 Cologne, Germany
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De Larochelambert Q, Hamri I, Chassard T, Meignié A, Storme F, Dupuit M, Diry A, Toussaint JF, Louis PY, Coulmy N, Antero JDS. Exploring the effect of the menstrual cycle or oral contraception on elite athletes' training responses when workload is not objectively quantifiable: the MILS approach and findings from female Olympians. BMJ Open Sport Exerc Med 2024; 10:e001810. [PMID: 38882205 PMCID: PMC11177701 DOI: 10.1136/bmjsem-2023-001810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Objectives Develop the Markov Index Load State (MILS) model, based on hidden Markov chains, to assess athletes' workload responses and investigate the effects of menstrual cycle (MC)/oral contraception (OC), sex steroids hormones and wellness on elite athletes' training. Methods On a 7-month longitudinal follow-up, daily training (volume and perceived effort, n=2200) and wellness (reported sleep quality and quantity, fitness, mood, menstrual symptoms, n=2509) data were collected from 24 female rowers and skiers preparing for the Olympics. 51 MC and 54 OC full cycles relying on 214 salivary hormone samples were analysed. MC/OC cycles were normalised, converted in % from 0% (first bleeding/pill withdrawal day) to 100% (end). Results MILS identified three chronic workload response states: 'easy', 'moderate' and 'hard'. A cyclic training response linked to MC or OC (95% CI) was observed, primarily related to progesterone level (p=8.23e-03 and 5.72e-03 for the easy and hard state, respectively). MC athletes predominantly exhibited the 'easy' state during the cycle's first half (8%-53%), transitioning to the 'hard' state post-estimated ovulation (63%-96%). OC users had an increased 'hard' state (4%-32%) during pill withdrawal, transitioning to 'easy' (50%-60%) when on the pill. Wellness metrics influenced the training load response: better sleep quality (p=5.20e-04), mood (p=8.94e-06) and fitness (p=6.29e-03) increased the likelihood of the 'easy' state. Menstrual symptoms increased the 'hard' state probability (p=5.92e-02). Conclusion The MILS model, leveraging hidden Markov chains, effectively analyses cumulative training load responses. The model identified cyclic training responses linked to MC/OC in elite female athletes.
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Affiliation(s)
- Quentin De Larochelambert
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
- French Rowing Federation, Nogent-sur-Marne, France
- Scientific Department, Fédération Française de Ski, Annecy, France
- Institut de Mathématiques de Bourgogne, UMR 5584, CNRS & Université de Bourgogne, F-21000 Dijon, France, Dijon, France
| | - Imad Hamri
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Tom Chassard
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Alice Meignié
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Florent Storme
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Marine Dupuit
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Allison Diry
- French Rowing Federation, Nogent-sur-Marne, France
| | - Jean-François Toussaint
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
- CIMS, Hôtel-Dieu, AP-HP, Paris, France
| | - Pierre Yves Louis
- Institut de Mathématiques de Bourgogne, UMR 5584, CNRS & Université de Bourgogne, F-21000 Dijon, France, Dijon, France
- Université Bourgogne Franche-Comté, Institut Agro, Université de Bourgogne, INRAE, UMR PAM 1517, 21000 Dijon, France
| | - Nicolas Coulmy
- Scientific Department, Fédération Française de Ski, Annecy, France
| | - Juliana da Silva Antero
- Institut de Recherche bioMédicale et d'Epidemiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
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Johnson KA, Shields RK. Influence of the Menstrual Cycle and Training on the Performance of a Perturbed Single-Leg Squatting Task in Female Collegiate Athletes. Orthop J Sports Med 2024; 12:23259671241251720. [PMID: 38831876 PMCID: PMC11146038 DOI: 10.1177/23259671241251720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 06/05/2024] Open
Abstract
Background Anterior cruciate ligament (ACL) injuries often occur when an athlete experiences an unexpected disruption, or perturbation, during sports. ACL injury rates may also be influenced by the menstrual cycle. Purpose To determine whether training adaptations to knee control and muscle activity during a perturbed single-leg squatting (SLS) task depend on menstrual cycle phase in female athletes. Study Design Controlled laboratory study. Methods A total of 21 healthy female collegiate athletes (current or former [<3 years]) who competed in 9 different sports performed an SLS task in which they attempted to match their knee position (user signal) to a target signal. The protocol consisted of a 9-condition pretest, 5 sets of 3 training trials, and a 9-condition posttest. One perturbation was delivered in each condition by altering the resistance of the device. Sagittal knee control (absolute error between the target signal and user signal) was assessed using a potentiometer. Muscle activity during perturbed squat cycles was normalized to maximal activation and to corresponding muscle activity during unperturbed squat cycles (%unperturbed) within the same test condition. Athletes performed the protocol during a distinct menstrual cycle phase (early follicular [EF], late follicular [LF], midluteal [ML]). Two-way mixed analysis of variance was used to determine the effects of the menstrual cycle and training on knee control and muscle activity during task performance. Venous blood was collected for hormonal analysis, and a series of health questionnaires and anthropometric measures were also assessed to determine differences among the menstrual cycle groups. Results After training, athletes demonstrated better knee control during the perturbed squat cycles (lower absolute error, P < .001) and greater soleus feedback responses to the perturbation (%unperturbed, P = .035). Better knee control was demonstrated in the ML phase versus the EF phase during unperturbed and perturbed squat cycles (P < .039 for both). Quadriceps activation was greater in the ML phase compared with the EF and LF phases, both immediately before and after the perturbation (P < .001 for all). Conclusion Athletes learned to improve knee control during the perturbed performance regardless of menstrual cycle phase. The best knee control and greatest quadriceps activation during the perturbed squatting task was found in the ML phase. Clinical Relevance These findings may correspond to a lower incidence of ACL injury in the luteal phase and alterations in exercise performance across the menstrual cycle.
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Affiliation(s)
- Kristin A. Johnson
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Richard K. Shields
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
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Barlow A, Blodgett JM, Williams S, Pedlar CR, Bruinvels G. Injury Incidence, Severity, and Type Across the Menstrual Cycle in Female Footballers: A Prospective Three Season Cohort Study. Med Sci Sports Exerc 2024; 56:1151-1158. [PMID: 38227488 DOI: 10.1249/mss.0000000000003391] [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: 01/17/2024]
Abstract
PURPOSE The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity, and type in elite female professional footballers over three seasons. METHODS Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorized into four phases using a standardized model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and premenstrual phase (phase 4; P4). Injury incidence rates (IIR) and ratios (IIRR) were calculated for overall injuries, injury severity, type, contact vs noncontact, and game/training. RESULTS A total of 593 cycles across 13,390 d were tracked during the study, and 74 injuries from 26 players were eligible for analysis. When comparing IIR between phases (reference: P1), overall injury rates were highest in P4 (IIRR, 2.30 (95% confidence interval, 0.99-5.34; P = 0.05)). When examining rates by injury severity and type, IIR values were also highest in P4 for ≤7 d' time-loss (4.40 (0.93-20.76; P = 0.06)), muscle-specific (6.07 (1.34-27.43; P = 0.02)), and noncontact (3.05 (1.10-8.50; P = 0.03)) injuries. Muscle-specific (IIRR P3/P1, 5.07 (1.16-22.07; P = 0.03)) and ≤7 d' time-loss (4.47 (1.01-19.68; P = 0.05)) injury risk was also significantly higher in P3. Muscle injuries were the most prevalent subtype ( n = 41). No anterior cruciate ligament injuries were recorded across the monitoring period. CONCLUSIONS Injury risk was significantly elevated during the luteal phase of the menstrual cycle (P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.
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Affiliation(s)
- Ally Barlow
- Centre for Health, and Injury & Illness Prevention in Sport, Department for Health, University of Bath, Bath, UNITED KINGDOM
| | - Joanna M Blodgett
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, University College London, UNITED KINGDOM
| | - Sean Williams
- Centre for Health, and Injury & Illness Prevention in Sport, Department for Health, University of Bath, Bath, UNITED KINGDOM
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Ronca F, Blodgett JM, Bruinvels G, Lowery M, Raviraj M, Sandhar G, Symeonides N, Jones C, Loosemore M, Burgess PW. Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: Potential implications for female sport. Neuropsychologia 2024:108909. [PMID: 38762068 DOI: 10.1016/j.neuropsychologia.2024.108909] [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: 02/02/2024] [Revised: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual cycle. A separate body of work suggests that spatial cognition might also fluctuate in a similar manner. Changes in spatial cognition could, in theory, be a contributing risk factor for injury, especially in fast-paced sports that require precise, millisecond accuracy in interactions with moving objects in the environment. However, existing theories surrounding causes for increased injury risk in menstruating females largely focus on biomechanical mechanisms, with little consideration of possible cognitive determinants of injury risk. Therefore, the aim of this proof-of-principle study was to explore whether menstruating females exhibit fluctuations in cognitive processes throughout their cycle on a novel sport-oriented cognitive test battery, designed to measure some of the mental processes putatively involved in these sporting situations. A total of 394 participants completed an online cognitive battery, a mood scale and a symptom questionnaire twice, 14 days apart. After exclusions, 248 eligible participants were included in the analyses (mean: 28 ± 6 years) (male = 96, female(menstruating) = 105, female(contraception) = 47). Cycle phase for menstruating females was based on self-reported information. The cognitive battery was designed to measure reaction times, attention, visuospatial functions (including 3D mental rotation) and timing anticipation. Three composite scores were generated using factor analysis with varimax rotation (Errors, Reaction Time, Intra-Individual Variability). Mixed model ANOVAs and repeated measures ANOVAs were performed to test for between and within-subject effects. There was no group difference in reaction times and accuracy between males and females (using contraception and not). However, within subject analyses revealed that regularly menstruating females performed better during menstruation compared to being in any other phase, with faster reaction times (10ms c.ca, p < 0.01), fewer errors (p < 0.05) and lower dispersion intra-individual variability (p < 0.05). In contrast they exhibited slower reaction times (10ms c.ca, p < 0.01) and poorer timing anticipation (p < 0.01) in the luteal phase, and more errors in the predicted ovulatory phase (p < 0.01). Self-reported mood, cognitive and physical symptoms were all worst during menstruation (p < 0.01), and a significant proportion of females felt that their symptoms were negatively affecting their cognitive performance during menstruation on testing day, which was incongruent with their actual performance. These findings suggest that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase. If these extend to associations between phase-specific cognitive performance and injury incidence, they would support a cognitive theory of determinants of injury risk in cycling female athletes, opening an opportunity to develop mitigation strategies where appropriate.
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Affiliation(s)
- F Ronca
- Institute of Sport, Exercise and Health, University College London, London, UK.
| | - J M Blodgett
- Institute of Sport, Exercise and Health, University College London, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - G Bruinvels
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - M Lowery
- Institute of Sport, Exercise and Health, University College London, London, UK; Sport and Wellbeing Analytics Limited, Swansea, UK
| | - M Raviraj
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - G Sandhar
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - N Symeonides
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - C Jones
- Institute of Sport, Exercise and Health, University College London, London, UK; Sport and Wellbeing Analytics Limited, Swansea, UK
| | - M Loosemore
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - P W Burgess
- Institute of Cognitive Neuroscience, University College London, London, UK
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Hardaker N, King D, Hume PA, Stewart T, Sims S, Basu I, Shilton B, Selfe J. Female RNA concussion (FeRNAC) study: assessing hormone profiles and salivary RNA in females with concussion by emergency departments in New Zealand: a study protocol. BMC Neurol 2024; 24:149. [PMID: 38698312 PMCID: PMC11064333 DOI: 10.1186/s12883-024-03653-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Females of reproductive age with concussion report a greater number of symptoms that can be more severe and continue for longer than age matched males. Underlying mechanisms for sex differences are not well understood. Short non-coding Ribonucleic Acids (sncRNAs) are candidate salivary biomarkers for concussion and have been studied primarily in male athletes. Female sex hormones influence expression of these biomarkers, and it remains unclear whether a similar pattern of sncRNA expression would be observed in females following concussion. This study aims to evaluate recovery time, the ratio of salivary sncRNAs and symptom severity across different hormone profiles in females presenting to emergency departments (ED) with concussion and, to investigate the presence of low energy availability (LEA) as a potential modifier of concussion symptoms. METHODS This prospective cohort study recruits participants from New Zealand EDs who are biologically female, of reproductive age (16-50 years) and with a confirmed diagnosis of concussion from an ED healthcare professional. Participants are excluded by ED healthcare professionals from study recruitment as part of initial routine assessment if they have a pre-diagnosed psychiatric condition, neurological condition (i.e., epilepsy, cerebral palsy) or more than three previously diagnosed concussions. Participants provide a saliva sample for measurement of sncRNA's, and online survey responses relating to hormone profile and symptom recovery at 7-day intervals after injury until they report a full return to work/study. The study is being performed in accordance with ethical standards of the Declaration of Helsinki with ethics approval obtained from the Health and Disability Ethics Committee (HDEC #2021 EXP 11655), Auckland University of Technology Ethics Committee (AUTEC #22/110) and locality consent through Wellington hospital research office. DISCUSSION If saliva samples confirm presence of sncRNAs in females with concussion, it will provide evidence of the potential of saliva sampling as an objective tool to aid in diagnosis of, and confirmation of recovery from, concussion. Findings will determine whether expression of sncRNAs is influenced by steroid hormones in females and may outline the need for sex specific application and interpretation of sncRNAs as a clinical and/or research tool. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) registration number ACTRN12623001129673.
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Affiliation(s)
- Natalie Hardaker
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand.
| | - Doug King
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Department of Sport and Exercise Sciences, Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Patria A Hume
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Technology and Policy Lab - Law School, The University of Western Australia, Perth, Australia
| | - Tom Stewart
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
| | - Stacy Sims
- Faculty of Health and Environmental Science, Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand Wellington, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
| | | | | | - James Selfe
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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McCubbin AJ, Irwin C. The effect of pre-exercise oral hyperhydration on endurance exercise performance, heart rate, and thermoregulation: a meta-analytical review. Appl Physiol Nutr Metab 2024; 49:569-583. [PMID: 38198662 DOI: 10.1139/apnm-2023-0384] [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] [Indexed: 01/12/2024]
Abstract
This study aimed to determine the effect of pre-exercise hyperhydration on endurance performance (primary outcome), heart rate, thermoregulation, and perceptual responses (secondary outcomes). Six academic databases were searched to February 2023. Only studies reporting differences in hydration between intervention and placebo/control were included. Meta-analysis determined overall effect size (Hedges' g), and meta-regression the influence of independent moderators (ambient temperature, hyperhydration agent, exercise mode, extent of hyperhydration). Overall, 10 publications generating 19 effect estimates for primary outcomes, and 11 publications reporting 48 effect estimates for secondary outcomes, were included. A small-to-moderate improvement in time-to-exhaustion (TTE) (Hedges' g = 0.31, 95% CI: 0.13-0.50, p = 0.001) and time trial (TT) (g = 0.25, 95% CI: 0.002-0.51, p = 0.049) but not total work (TW) tasks (p = 0.120) was found following hyperhydration. No moderating effects were observed. No effect of hyperhydration was found for heart rate following steady state (SS) exercise (p = 0.069) or the performance task (p = 0.072), nor for body temperature post-SS (p = 0.132) or post-performance task (p = 0.349), but meta-regression of sodium versus glycerol showed lower body temperature post-performance task with sodium (g = 0.80, t (5) = 2.65, p = 0.046). No effects were found for perceived exertion or thermal comfort. Study heterogeneity was low, lacking representation of elite and female athletes, and weight-bearing (i.e., running) exercise modalities. These results suggest pre-exercise hyperhydration provides a small-to-moderate benefit to endurance performance in TTE and TT, but not TW performance tasks. While no moderating effects were observed, lack of heterogeneity makes it difficult to generalise these findings.
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Affiliation(s)
- Alan J McCubbin
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Christopher Irwin
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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45
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Alvar B, O'Bryan SJ, Harris DM. Considerations for assessing sex differences in performance fatiguability. J Physiol 2024; 602:1889-1891. [PMID: 38606983 DOI: 10.1113/jp285951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Brooke Alvar
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
| | - Steven J O'Bryan
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dale M Harris
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
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46
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Flood TR, Clausen E, Kuikman MA, Smith E, McKay AKA, Burke LM, Elliott-Sale KJ. Auditing the representation of hormonal contraceptives in studies assessing exercise performance in women. J Sports Sci 2024; 42:825-839. [PMID: 38896557 DOI: 10.1080/02640414.2024.2368762] [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: 12/19/2023] [Accepted: 06/09/2024] [Indexed: 06/21/2024]
Abstract
Hormonal contraceptive (HC) users have a different ovarian hormonal profile compared to eumenorrheic women. Due to the prevalence of HC use amongst sportswomen, there has been increased research efforts to understand their impact on exercise performance. The aim was to audit this research. Studies identified were assessed for HC type, athlete calibre, performance outcome, study design, and quality of methodological control regarding ovarian hormonal profiles. Sixty-eight different HCs were reported across 61 studies. Monophasic combined oral contraceptive (OCP) pills represented 60% of HCs, followed by other pills [34%, phasic-combined, progestogen-only, and un-specified], phasic and long acting reversible contraceptives [5%, vaginal ring, patch, implant, injection, intrauterine system] and unspecified HCs (1%). Eleven percent of participants using HCs were classified as highly trained or elite/international with no participants being classed as world class. Whilst the number of studies involving HCs has increased two-fold over the past decade, the number of studies ranked as gold standard has not increased (HC; 2003-57%, 2011-55%, 2022-43%. OCP; 2003-14%, 2011-17%, 2022-12%). Future research assessing HCs and exercise performance should adopt high-quality research designs and include a broader range of HCs in highly trained to world-class populations to increase the reach and impact of research in this area.
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Affiliation(s)
- Tessa R Flood
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Emma Clausen
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Megan A Kuikman
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ella Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Science, Manchester Metropolitan University Institute of Sport, Manchester, UK
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Beníčková M, Gimunová M, Paludo AC. Effect of circadian rhythm and menstrual cycle on physical performance in women: a systematic review. Front Physiol 2024; 15:1347036. [PMID: 38720785 PMCID: PMC11076705 DOI: 10.3389/fphys.2024.1347036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
The literature has extensively investigated potential factors influencing women's performance, including the menstrual cycle and the circadian rhythm. However, review articles exploring the combined influence of both factors remain lacking in the literature. The study aimed to systematically review the literature on the relationship between the circadian rhythm and menstrual cycle on physical performance in women. The review followed the PRISMA guidelines. The search was performed on the Web of Science, PubMed, Scopus, SPORTDiscus, and Google Scholar databases. Of the 1205 records identified, four articles met the inclusion criteria. From four articles, two studies found a significant interaction between the time of day and phase of the menstrual cycle with physical performance. The isometric strength increased in the afternoon in the mid-luteal phase (versus the morning in the mid-luteal phase, p < 0.05), and the maximum cycling power was higher in the afternoon in the mid-follicular phase (versus the morning in the mid-follicular phase, p < 0.01). Our findings suggest that the time of day and the menstrual cycle phase affect physical performance, with the daytime potentially having a more significant influence. However, the results should be interpreted cautiously due to the limited studies and diverse methodologies used to monitor the menstrual cycle phase. This review reinforces the need for further investigation to understand better the combined effects of the circadian rhythm and menstrual cycle on women's physical performance. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=380965, identifier CRD42022380965.
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Affiliation(s)
- Michaela Beníčková
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Marta Gimunová
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Ana Carolina Paludo
- Department of Sport Performance and Exercise Testing, Faculty of Sports Studies, Masaryk University, Brno, Czechia
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Selvamoorthy R, Macgregor LJ, Donald N, Hunter AM. Dryland Performance Tests Are Not Good Predictors of World Aquatics Points in Elite Male and Female Swimmers. Sports (Basel) 2024; 12:104. [PMID: 38668572 PMCID: PMC11053844 DOI: 10.3390/sports12040104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
Background: Swim performance can be reliant on strength and power. Standardisation of swim performance in different events, distances, and sexes can be completed using World Aquatics points, allowing for ranking of swimmers. The aim of this retrospective cross-sectional study was to assess whether relationships between World Aquatics points and dryland markers of performance existed in male and female elite swimmers separately and combined. Methods: Dryland tests included Optojump® photoelectric cell countermovement jump, countermovement jump reach with a Vertec® system, standing broad jump using a tape measure, repetition maximum testing in the barbell back squat, barbell deadlift, and barbell bench press. Swim performance data and dryland test data on elite male (n = 38) and female (n = 20) Scottish swimmers from 2009-2017 were collected. Swim performance data were converted to World Aquatics federation points, and Bayesian linear regression analyses examined relationships between World Aquatics points and dryland performance tests: countermovement jump height (cm) using an Optojump® photoelectric cells system, countermovement jump height (cm) using a Vertec® device, standing broad jump distance (cm), relative strength (load lifted (kg) per kg of body mass) in the barbell bench press (kg/kg), barbell back squat (kg/kg), barbell deadlift (kg/kg). Results: The Bayesian estimates of change of World Aquatics points for a unit change in jump-based measures were: Optojump®-men = 0.6, women = 0.6, combined = 0.4; Vertec®-men = 4.3, women = -1.6, combined = 2.4; standing broad jump-men = 0, women = 0, combined = 0.4. Strength-based measures were: barbell back squat-men = 2.3, women = 22, combined = -2.5; barbell deadlift-men = -5; barbell bench press-men = 41.8. Conclusions: Dryland performance tests are not good predictors of World Aquatics points and should rather be used for assessing training quality and monitoring injury risks.
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Affiliation(s)
- Ragul Selvamoorthy
- Physiology, Exercise and Nutrition Research Group, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (R.S.); (L.J.M.)
| | - Lewis J. Macgregor
- Physiology, Exercise and Nutrition Research Group, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (R.S.); (L.J.M.)
| | - Neil Donald
- Sportscotland: Institute of Sport, Stirling FK9 4LA, UK;
| | - Angus M. Hunter
- Physiology, Exercise and Nutrition Research Group, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; (R.S.); (L.J.M.)
- Department of Sport Science, Sport, Health and Performance Enhancement (SHAPE) Research Centre, Nottingham Trent University, Nottingham NG11 8NS, UK
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49
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McKay AKA, Minahan C, Harris R, McCormick R, Skinner J, Ackerman KE, Burke LM. Female Athlete Research Camp: A Unique Model for Conducting Research in High-Performance Female Athletes. Med Sci Sports Exerc 2024; 56:706-716. [PMID: 38109054 DOI: 10.1249/mss.0000000000003354] [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: 12/19/2023]
Abstract
PURPOSE The purpose of this study is to describe the implementation of a novel research protocol for conducting research with highly trained female athletes, including characterizing menstrual cycle (MC) function, hormonal profiles and symptoms of the participating athletes. METHODS Twenty-four Australian First Nation female Rugby League athletes completed this study, which involved 11 wk of cycle tracking, followed by attendance at a 5-wk training camp. Throughout the study, athletes completed a daily survey, reporting their MC function and any associated symptoms. During the training camp, athletes reported to the laboratory on three occasions and provided a venous blood sample, which was analyzed for reproductive hormones. For naturally cycling athletes (athleteNC, n = 11), this included phase 1, 2, and 4 of the menstrual cycle, whereas athletes using hormonal contraception (athleteHC; n = 13) were tested at three equally spaced time points in which consistent exogenous hormone provision occurred. RESULTS In the athleteNC cohort, just one athlete reached criteria for classification as eumenorrheic, with five athletes showing evidence of MC dysfunction. The prevalence of symptoms on any given day was similar between athleteNC (33.7%) and athleteHC (22.9%; P = 0.376); however, more symptoms were reported in athleteNC, suggesting that they were more likely to report multiple symptoms. Regardless of MC function, there was a significant, positive association between bleeding and symptoms ( P < 0.001), where athletes were more likely to report one or more symptoms on bleeding (50.1%) compared with nonbleeding days (22.0%). CONCLUSIONS We describe an innovative strategy to investigate the effect of MC function and MC phase in a high-performance sport environment, including approaches to address the challenges of undertaking research with female athletes with MC variability and those using exogenous hormonal therapies.
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Affiliation(s)
- Alannah K A McKay
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AUSTRALIA
| | | | | | - Rachel McCormick
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AUSTRALIA
| | | | - Kathryn E Ackerman
- Female Athlete Program, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, AUSTRALIA
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50
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Donelon TA, Edwards J, Brown M, Jones PA, O'Driscoll J, Dos'Santos T. Differences in Biomechanical Determinants of ACL Injury Risk in Change of Direction Tasks Between Males and Females: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:29. [PMID: 38561438 PMCID: PMC10984914 DOI: 10.1186/s40798-024-00701-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. OBJECTIVE The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. METHODS Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021-June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18-40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. RESULTS This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098-0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299-1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134-0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: -0.454, 95% CI 0.151-0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally applied KJLs. All retrieved studies failed to control for strength, resistance training or skill history status. CONCLUSION No differences were observed in KJLs between males and females despite females displaying greater knee abduction at IC and less peak knee flexion during the stance phase of CODs, which are visual characteristics of non-contact ACL injury. Further research is required to examine if this translates to a similar injury risk, considering morphological differences in strain characteristics of the ACL between males and females. This observation may in part explain the disproportionate ACL injury incidence in female multidirectional athletes. Further higher quality controlled research is required whereby participants are matched by skill training history, resistance training history and strength status to ensure an appropriate comparison between males and females.
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Affiliation(s)
- Thomas A Donelon
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK.
| | - Jamie Edwards
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Mathew Brown
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Paul A Jones
- School of Health Sciences, C702 Allerton Building, University of Salford, Salford, M6 6PU, UK
| | - Jamie O'Driscoll
- Section of Sport Section of Sport, Exercise and Rehabilitation Sciences, School of Human and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1Q, UK
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences | Manchester Metropolitan University, 2.01 Institute of Sport, 99 Oxford Road, Manchester, M1 7EL, UK
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