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de Oliveira GM, Barcelos Andrade FA, Pereira AB, Viza RS, Gerspacher HF, da Costa Monteiro M, Campos HO, Drummond LR, Rios Leite LH, Celso Coimbra C. Is physical performance affected by non-steroidal anti-inflammatory drugs use? A systematic review and meta-analysis. PHYSICIAN SPORTSMED 2024; 52:207-216. [PMID: 37252825 DOI: 10.1080/00913847.2023.2220439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/29/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aim to analyze the effects of ingesting non-steroidal anti-inflammatory drugs (NSAIDs) on physical performance, muscle strength, and muscle damage in three different moments: immediately, 24 and 48 h after resistance exercise practice. METHODS Relevant studies were researched in three databases (PubMed, Web of Science and SPORTDiscus) in April 2023. After excluding duplicates, the decision to include or exclude studies was made by two independent investigators in the following steps: (I) the study title; (II) the study abstract; and (III) the complete study manuscript. The following characteristics were recorded: (I) first author, (II) year of publication, (III) sample size, (IV) method of NSAIDs administration, (V) exercise protocol, and (VI) analyzed variable results. The studies selected were divided into trials that evaluated the effects of NSAIDs ingestion on performance indices of resistance exercise, endurance exercise and resistance training. RESULTS The meta-analysis, based only on resistance exercises, revealed that both performance and muscle strength were similar between placebo or NSAID treatment immediately and 24 h after resistance exercise practice. An ergolytic effect was found 48 hours after resistance exercise (mean effect size (ES) = -0.42; 95% CI: -0.71, -0.12; p = 0.132), as well as reduced muscle strength (ES = -0.50; 95% CI: -0.83, -0.16; p = 0.072). Additionally, NSAID use did not prevent muscle waste as seen by the unchanged CK plasma concentration at all timetables. CONCLUSION The data of the present meta-analysis indicate that NSAID use is ineffective in improving resistance performance and muscle strength, as well as exercise recovery. When considering the practical application of using NSAIDs to improve exercise capacity and strength gains, the present data supports that consumption of analgesic drugs as an endurance performance enhancer or as a muscle anabolic must not be recommended.
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Affiliation(s)
- Gabriel Moraes de Oliveira
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Fernando Augusto Barcelos Andrade
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - André Bahia Pereira
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Rodrigo Silva Viza
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Henrique Fernandes Gerspacher
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Mateus da Costa Monteiro
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Helton Oliveira Campos
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Departamento de Ciências Biológicas, Universidade do Estado de Minas Gerais - Unidade Carangola, Carangola, MG, Brasil
| | - Lucas Rios Drummond
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
- Departamento de Educação Física, Universidade do Estado de Minas Gerais - Unidade Divin#x0F3;polis, Divin#x0F3;polis, MG, Brasil
| | - Laura Hora Rios Leite
- Departamento de Fisiologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Cândido Celso Coimbra
- Laborat#x0F3;rio de Endocrinologia e Metabolismo, Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Roberts BM, Geddis AV, Ciuciu A, Reynoso M, Mehta N, Varanoske AN, Kelley AM, Walker RJ, Munoz R, Kolb AL, Staab JS, Naimo MA, Tomlinson RE. Acetaminophen influences musculoskeletal signaling but not adaptations to endurance exercise training. FASEB J 2024; 38:e23586. [PMID: 38568858 DOI: 10.1096/fj.202302642r] [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: 12/22/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
Acetaminophen (ACE) is a widely used analgesic and antipyretic drug with various applications, from pain relief to fever reduction. Recent studies have reported equivocal effects of habitual ACE intake on exercise performance, muscle growth, and risks to bone health. Thus, this study aimed to assess the impact of a 6-week, low-dose ACE regimen on muscle and bone adaptations in exercising and non-exercising rats. Nine-week-old Wistar rats (n = 40) were randomized to an exercise or control (no exercise) condition with ACE or without (placebo). For the exercise condition, rats ran 5 days per week for 6 weeks at a 5% incline for 2 min at 15 cm/s, 2 min at 20 cm/s, and 26 min at 25 cm/s. A human equivalent dose of ACE was administered (379 mg/kg body weight) in drinking water and adjusted each week based on body weight. Food, water intake, and body weight were measured daily. At the beginning of week 6, animals in the exercise group completed a maximal treadmill test. At the end of week 6, rats were euthanized, and muscle cross-sectional area (CSA), fiber type, and signaling pathways were measured. Additionally, three-point bending and microcomputer tomography were measured in the femur. Follow-up experiments in human primary muscle cells were used to explore supra-physiological effects of ACE. Data were analyzed using a two-way ANOVA for treatment (ACE or placebo) and condition (exercise or non-exercise) for all animal outcomes. Data for cell culture experiments were analyzed via ANOVA. If omnibus significance was found in either ANOVA, a post hoc analysis was completed, and a Tukey's adjustment was used. ACE did not alter body weight, water intake, food intake, or treadmill performance (p > .05). There was a treatment-by-condition effect for Young's Modulus where placebo exercise was significantly lower than placebo control (p < .05). There was no treatment by condition effects for microCT measures, muscle CSA, fiber type, or mRNA expression. Phosphorylated-AMPK was significantly increased with exercise (p < .05) and this was attenuated with ACE treatment. Furthermore, phospho-4EBP1 was depressed in the exercise group compared to the control (p < .05) and increased in the ACE control and ACE exercise group compared to placebo exercise (p < .05). A low dose of ACE did not influence chronic musculoskeletal adaptations in exercising rodents but acutely attenuated AMPK phosphorylation and 4EBP1 dephosphorylation post-exercise.
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Affiliation(s)
- Brandon M Roberts
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Alyssa V Geddis
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Alexandra Ciuciu
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Marinaliz Reynoso
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Nikhil Mehta
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alyssa N Varanoske
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - Alyssa M Kelley
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Raymond J Walker
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Rigoberto Munoz
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Alexander L Kolb
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Jeffery S Staab
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Marshall A Naimo
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Ryan E Tomlinson
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Franco-Alvarenga PE, Cechetti MDS, Barcelos D, Canestri R, Brietzke C, Vinicius Í, Goethel MF, Ferreira GA, Pires FO. Ice Massage on the Calf Improves 4-km Running Time Trial Performance in a Normothermic Environment. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:1126-1132. [PMID: 36121708 DOI: 10.1080/02701367.2022.2120948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
Purpose: Local cooling with ice massage is a practical and inexpensive technique to decrease perceptual stress and improve motor performance in hot environments. However, it is unknown whether local cooling with ice massage reduces perceptual responses to exercise and improves performance in a normothermic environment. Thus, we investigated whether ice massage on the calf muscles before a 4 km running time trial (TT4km) reduced the ratings of perceived exertion (RPE) and perceived muscle pain, thereby improving exercise performance in a normothermic environment. Methods: After familiarizations, fourteen recreationally endurance-trained men (age = 21.3 ± 1.2 years; body weight = 67.5 ± 9.2 kg; height = 173.0 ± 5.0 cm) underwent two TT4km on a 400 m track in normothermic conditions with or without ice massage before the trial. The time of running, RPE, and pain perception were recorded every 400 m throughout the TT4km. Results: The local cooling with ice massage increased the mean speed (~ 5.2%, p = 0.03) and decreased the time to complete the TT4km (~ 5.5%, p = 0.03). Accordingly, ice massage also reduced the exercise-derived pain perception (p = 0.028), although no effect has been found in the RPE during the TT4km (p = 0.32). Conclusion: Together, these results showed that local cooling with ice massage before the exercise reduced the exercise-derived pain perception, enabling runners to increase the speed for a comparable RPE during exercise, thereby improving the TT4km performance in a normothermic environment.
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Corbett J, Young JS, Tipton MJ, Costello JT, Williams TB, Walker EF, Lee BJ, Stevens CE. Molecular biomarkers for assessing the heat-adapted phenotype: a narrative scoping review. J Physiol Sci 2023; 73:26. [PMID: 37848829 DOI: 10.1186/s12576-023-00882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
Heat acclimation/acclimatisation (HA) mitigates heat-related decrements in physical capacity and heat-illness risk and is a widely advocated countermeasure for individuals operating in hot environments. The efficacy of HA is typically quantified by assessing the thermo-physiological responses to a standard heat acclimation state test (i.e. physiological biomarkers), but this can be logistically challenging, time consuming, and expensive. A valid molecular biomarker of HA would enable evaluation of the heat-adapted state through the sampling and assessment of a biological medium. This narrative review examines candidate molecular biomarkers of HA, highlighting the poor sensitivity and specificity of these candidates and identifying the current lack of a single 'standout' biomarker. It concludes by considering the potential of multivariable approaches that provide information about a range of physiological systems, identifying a number of challenges that must be overcome to develop a valid molecular biomarker of the heat-adapted state, and highlighting future research opportunities.
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Affiliation(s)
- J Corbett
- Extreme Environments Laboratory, School of Sport Health and Exercise Sciences, University of Portsmouth, Portsmouth, UK.
| | - J S Young
- National Horizons Centre, Teesside University, Darlington, UK
| | - M J Tipton
- Extreme Environments Laboratory, School of Sport Health and Exercise Sciences, University of Portsmouth, Portsmouth, UK
| | - J T Costello
- Extreme Environments Laboratory, School of Sport Health and Exercise Sciences, University of Portsmouth, Portsmouth, UK
| | - T B Williams
- Extreme Environments Laboratory, School of Sport Health and Exercise Sciences, University of Portsmouth, Portsmouth, UK
| | - E F Walker
- Defence Science and Technology Laboratory, Porton Down, Salisbury, UK
| | - B J Lee
- Occupational and Environmental Physiology Group, Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - C E Stevens
- Extreme Environments Laboratory, School of Sport Health and Exercise Sciences, University of Portsmouth, Portsmouth, UK
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Effect of Acetaminophen on Endurance Cycling Performance in Trained Triathletes in Hot and Humid Conditions. Int J Sports Physiol Perform 2022; 17:917-925. [PMID: 35240576 DOI: 10.1123/ijspp.2021-0475] [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: 10/12/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The effect of acetaminophen (ACT, also known as paracetamol) on endurance performance in hot and humid conditions has been shown previously in recreationally active populations. The aim of this study was to determine the effect of ACT on physiological and perceptual variables during steady-state and time-trial cycling performance of trained triathletes in hot and humid conditions. METHODS In a randomized, double-blind crossover design, 11 triathletes completed ∼60 minutes steady-state cycling at 63% peak power output followed by a time trial (7 kJ·kg body mass-1, ∼30 min) in hot and humid conditions (∼30°C, ∼69% relative humidity) 60 minutes after consuming either 20 mg·kg body mass-1 ACT or a color-matched placebo. Time-trial completion time, gastrointestinal temperature, skin temperature, thermal sensation, thermal comfort, rating of perceived exertion, and fluid balance were recorded throughout each session. RESULTS There was no difference in performance in the ACT trial compared with placebo (P = .086, d = 0.57), nor were there differences in gastrointestinal and skin temperature, thermal sensation and comfort, or fluid balance between trials. CONCLUSION In conclusion, there was no effect of ACT (20 mg·kg body mass-1) ingestion on physiology, perception, and performance of trained triathletes in hot and humid conditions, and existing precooling and percooling strategies appear to be more appropriate for endurance cycling performance in the heat.
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The Effect of Acetaminophen on Running Economy and Performance in Collegiate Distance Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052927. [PMID: 35270624 PMCID: PMC8910038 DOI: 10.3390/ijerph19052927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 12/04/2022]
Abstract
Acetaminophen (ACT) may decrease perception of pain during exercise, which could allow runners to improve running economy (RE) and performance. The aim of this study was to determine the effects of ACT on RE and 3 km time trial (TT) performance in collegiate distance runners. A randomized, double blind, crossover study was employed in which 11 track athletes (9M/2F; age: 18.8 ± 0.6 years; VO2 max: 60.6 ± 7.7 mL/kg/min) completed three intervention sessions. Participants ingested either nothing (baseline, BSL), three gelatin capsules (placebo, PLA), or three 500 mg ACT caplets (ACT). One hour after ingestion, participants completed a graded exercise test consisting of 4 × 5 min steady-state stages at ~55–75% of VO2 max followed by a 3 km TT. There was no influence of ACT on RE in any stage. Similarly, ACT did not favorably modify 3 km TT performance [mean ± SD: BSL = 613 ± 71 s; PLA = 617 ± 70 s; ACT = 618 ± 70 s; p = 0.076]. The results indicate that ACT does not improve RE or TT performance in collegiate runners at the 3 km distance. Those wanting to utilize ACT for performance must understand that ACT’s benefits have yet to be significant amongst well-trained runners. Future studies should examine the effects of ACT on well-trained runners over longer trial distances and under more controlled conditions with appropriate medical oversight.
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Grgic J. What is the Effect of Paracetamol (Acetaminophen) Ingestion on Exercise Performance? Current Findings and Future Research Directions. Sports Med 2022; 52:431-439. [PMID: 35038139 DOI: 10.1007/s40279-021-01633-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/19/2022]
Abstract
In recent years, studies have explored the effects of paracetamol (acetaminophen) ingestion on exercise performance. However, due to the contrasting findings, there is still no consensus on this topic. This article provides an overview of the effects of paracetamol on endurance, sprinting, and resistance exercise performance. Studies have reported that paracetamol ingestion may be ergogenic for endurance performance. These effects occur when paracetamol is ingested 45-60 min before exercise and appear to be more pronounced in time-to-exhaustion versus time-trial tests. Besides endurance, paracetamol ingestion 30 min before exercise increases mean power during repeated cycling sprints in interval training involving repeated 30-s all-out bouts. Preliminary data on paracetamol ingestion also suggest: (a) improved endurance performance in the heat; (b) an improvement in single sprint performance, at least when paracetamol is ingested following exercise-induced fatigue; and (c) attenuation of the decline in muscular strength that occurs with repeated maximum contractions. An ergogenic effect of paracetamol is most commonly observed when a dose of 1500 mg is ingested 30-60 min before exercise. Despite these performance-enhancing effects, the aim of this article is not to promote paracetamol use, as side effects associated with its consumption and ethical aspects need to be considered before utilizing paracetamol as an ergogenic aid. Future research on this topic is still needed, particularly related to paracetamol dosing, timing of ingestion, and the effects of paracetamol in females and elite athletes.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
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Starving Your Performance? Reduced Preexercise Hunger Increases Resistance Exercise Performance. Int J Sports Physiol Perform 2021; 17:458-464. [PMID: 34872065 DOI: 10.1123/ijspp.2021-0166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/01/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Preexercise food intake enhances exercise performance due, in part, to the provision of exogenous carbohydrate. Food intake also suppresses hunger, but the specific influence of hunger on exercise performance has not been investigated. This study aimed to manipulate hunger by altering preexercise meal viscosity to examine whether hunger influences performance. METHODS Sixteen resistance-trained males completed 2 experimental trials ingesting either high viscosity semisolid (SEM) and low viscosity liquid (LIQ) carbohydrate-containing meals 2 hours before performing 4 sets of back squat (85 [22] kg) and bench press (68 [13] kg) to failure at 90% 10-repetition maximum. Subjective hunger/fullness as well as plasma concentrations of glucose, insulin, ghrelin, and peptide tyrosine-tyrosine were measured before and periodically after the meal. Repetitions completed in sets were used to determine exercise performance. RESULTS Hunger was lower, and fullness was greater during SEM compared with LIQ immediately before and during exercise (P < .05). Total repetitions completed for back squat were approximately 10% greater in SEM (SEM 57 [9]; LIQ 51 [7] repetitions; P = .001) with no difference in bench press repetitions (SEM 48 [11]; LIQ 48 [10] repetitions; P = .621). Postprandial glucose concentrations were greater during LIQ (12% increase in peak glucose) but were similar throughout exercise. CONCLUSION This study demonstrates that exercise performance in back squat was increased in the SEM trial concomitant to a reduction in hunger. Therefore, this study provides novel data that suggest that exercise performance might be influenced by hunger, at least for resistance exercise.
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Bloukh S, Wazaify M, Matheson C. Paracetamol: unconventional uses of a well-known drug. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:527-540. [PMID: 34455434 DOI: 10.1093/ijpp/riab058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To describe and map what is known about unconventional uses of paracetamol through a scoping review of published literature by adopting adopted a PRISMA systematic approach methodology. KEY FINDINGS Four themes for unconventional uses of paracetamol emerged: (a) use of paracetamol in sleep (a-1) positive effect of paracetamol on sleep (n = 9) or (a-2) neutral or negative effect of paracetamol on sleep (n = 9); (b) use of paracetamol in sport (n = 13); (c) mixing paracetamol with drinks, waterpipe and illicit drugs (n = 5); and (d) miscellaneous uses (n = 4). Forty records were reviewed and charted. Available literature supports concern around the potential of harmful or non-medical use of paracetamol, especially among patients with a history of substance use, parents of young children or athletes. SUMMARY Paracetamol (acetaminophen) is one of the most popular and widely used drugs for the treatment of pain and fever. It is considered remarkably safe if used within instructions. However, there is growing evidence that paracetamol, is sometimes used outside approved indications or abused (i.e. used for non-medical reasons). This review highlights the need for enhanced pharmacovigilance and surveillance of non-medical paracetamol use and raising general public awareness of its potential dangers especially in higher than recommended doses.
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Affiliation(s)
- Sarah Bloukh
- School of Pharmacy, The University of Jordan (UJ), Amman, Jordan
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan (UJ), Amman, Jordan
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Grgic J, Mikulic P. Effects of Paracetamol (Acetaminophen) Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis. Sports (Basel) 2021; 9:sports9090126. [PMID: 34564331 PMCID: PMC8471630 DOI: 10.3390/sports9090126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
Several studies explored the effects of paracetamol (acetaminophen) ingestion on endurance performance, but their findings are conflicting. Therefore, this review aimed to conduct a meta-analysis examining the effects of paracetamol ingestion on endurance performance. Five databases were searched to find relevant studies. The PEDro checklist was used to assess the methodological quality of the included studies. Data reported in the included studies were pooled in a random-effects meta-analysis. A total of ten studies with good or excellent methodological quality were included in the meta-analysis (pooled n = 141). All included studies had a randomized, double-blind, crossover design. In the main meta-analysis, there was no significant difference between the effects of placebo and paracetamol on endurance performance (Cohen's d = 0.09; 95% confidence interval (CI): -0.04, 0.22; p = 0.172). However, an ergogenic effect was found when we considered only the studies that provided paracetamol 45 to 60 min before exercise (Cohen's d = 0.14; 95% CI: 0.07, 0.21; p < 0.001). In a subgroup analysis that focused on time-to-exhaustion tests, there was a significant ergogenic effect of paracetamol ingestion (Cohen's d = 0.19; 95% CI: 0.06, 0.33; p = 0.006). There was no significant difference between placebo and paracetamol in a subgroup analysis that focused on time trial tests (Cohen's d = 0.05; 95% CI: -0.12, 0.21; p = 0.561). In conclusion, paracetamol ingestion appears to enhance performance (a) in time-to-exhaustion endurance tests and (b) when consumed 45 to 60 min before exercise.
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Affiliation(s)
- Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne 3011, Australia
- Correspondence:
| | - Pavle Mikulic
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia;
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An Abductive Inference Approach to Assess the Performance-Enhancing Effects of Drugs Included on the World Anti-Doping Agency Prohibited List. Sports Med 2021; 51:1353-1376. [PMID: 33811295 DOI: 10.1007/s40279-021-01450-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 12/18/2022]
Abstract
Some have questioned the evidence for performance-enhancing effects of several substances included on the World Anti-Doping Agency's Prohibited List due to the divergent or inconclusive findings in randomized controlled trials (RCTs). However, inductive statistical inference based on RCTs-only may result in biased conclusions because of the scarcity of studies, inter-study heterogeneity, too few outcome events, or insufficient power. An abductive inference approach, where the body of evidence is evaluated beyond considerations of statistical significance, may serve as a tool to assess the plausibility of performance-enhancing effects of substances by also considering observations and facts not solely obtained from RCTs. Herein, we explored the applicability of an abductive inference approach as a tool to assess the performance-enhancing effects of substances included on the Prohibited List. We applied an abductive inference approach to make inferences on debated issues pertaining to the ergogenic effects of recombinant human erythropoietin (rHuEPO), beta2-agonists and anabolic androgenic steroids (AAS), and extended the approach to more controversial drug classes where RCTs are limited. We report that an abductive inference approach is a useful tool to assess the ergogenic effect of substances included on the Prohibited List-particularly for substances where inductive inference is inconclusive. Specifically, a systematic abductive inference approach can aid researchers in assessing the effects of doping substances, either by leading to suggestions of causal relationships or identifying the need for additional research.
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Garcia CK, Sheikh LH, Iwaniec JD, Robinson GP, Berlet RA, Mattingly AJ, Murray KO, Laitano O, Clanton TL. Effects of Ibuprofen during Exertional Heat Stroke in Mice. Med Sci Sports Exerc 2021; 52:1870-1878. [PMID: 32175974 DOI: 10.1249/mss.0000000000002329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Intestinal injury is one of the most prominent features of organ damage in exertional heat stroke (EHS). However, whether damage to the intestine in this setting is exacerbated by ibuprofen (IBU), the most commonly used nonsteroidal anti-inflammatory drug in exercising populations, is not well understood. PURPOSE We hypothesized that IBU would exacerbate intestinal injury, reduce exercise performance, and increase susceptibility to heat stroke. METHODS To test this hypothesis, we administered IBU via diet to male and female C57/BL6J mice, over 48 h before EHS. Susceptibility to EHS was determined by assessing exercise response using a forced running wheel, housed inside an environmental chamber at 37.5°C. Core temperature (Tc) was monitored by telemetry. Mice were allocated into four groups: exercise only (EXC); EHS + IBU; EXC + IBU; and EHS only. Exercise performance and Tc profiles were evaluated and stomachs, intestines and plasma were collected at 3 h post-EHS. RESULTS The EHS + IBU males ran approximately 87% longer when Tc was above 41°C (P < 0.03) and attained significantly higher peak Tc (P < 0.01) than EHS-only mice. Histological analyses showed decreased villi surface area throughout the small intestine for both sexes in the EXC + IBU group versus EXC only. Interestingly, though EHS in both sexes caused intestinal injury, in neither sex were there any additional effects of IBU. CONCLUSIONS Our results suggest that in a preclinical mouse model of EHS, oral IBU at pharmacologically effective doses does not pose additional risks of heat stroke, does not reduce exercise performance, and does not contribute further to intestinal injury, though this could have been masked by significant gut injury induced by EHS alone.
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Affiliation(s)
- Christian K Garcia
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
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Omeragic E, Marjanovic A, Djedjibegovic J, Turalic A, Dedic M, Niksic H, Lugusic A, Sober M. Prevalence of use of permitted pharmacological substances for recovery among athletes. PHARMACIA 2021. [DOI: 10.3897/pharmacia.68.e54581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives: Food supplements and medicines which are not on the list of prohibited substances of the World Anti-Doping Agency are included in the group of permitted pharmacological agents for athlete’s recovery.
The aim of this study was to describe qualitatively and quantitatively food supplements (FS) and over-the-counter drugs use among athletes in the last six month.
Methods: This was a cross sectional study. Data on food supplements and the over-the-counter drugs, usage were collected during 2018 by self-administered, anonymous questionnaire.
Results: A total of 112 athletes completed the survey. A total of 51.8% (n = 58) athletes reported the use of food supplements. The use of medical supplements was reported by 50.0% (n = 56) of athletes, 26.8% (n = 30) reported using ergogenic supplements, 1.8% (n = 2) using of sports food and 4.5% (n = 5) using other supplements. The use of over-the-counter drugs was reported by 35.7% (n = 40) of athletes. The over-the-counter analgesic drugs were used by 95% (n = 38) of over-the-counter drug users. Concomitant administration two or more over-the-counter drugs was reported by 40% (n = 16) athletes. Doctors and coaches had no advisory role in the use of food supplements or over-the-counter drugs.
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14
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Tomazini F, Santos-Mariano A, Andrade-Souza V, Sebben V, De Maria C, Coelho D, Bertuzzi R, Silva-Cavalcante M, Lima-Silva A. Caffeine but not acetaminophen increases 4-km cycling time-trial performance. PHARMANUTRITION 2020. [DOI: 10.1016/j.phanu.2020.100181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Athletes of various skill levels commonly use many different types of medications, often at rates higher than the general population. Common medication classes used in athletes include analgesics such as nonsteroidal anti-inflammatory drugs and acetaminophen, inhalers for asthma and exercise-induced bronchoconstriction, antihypertensives, antibiotics, and insulin. Prescribers must be aware of the unique considerations for each of these medications when using them in patients participating in physical activity. The safety, efficacy, impact on athletic performance, and regulatory restrictions of the most common medications used in athletes are discussed in this article.
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Affiliation(s)
- Benjamin Ferry
- Trident/MUSC Family Medicine Residency Program, Department of Family Medicine, Medical University of South Carolina, 9228 Medical Plaza Drive, Charleston, SC 29406, USA
| | - Alexei DeCastro
- Department of Family Medicine, Medical University of South Carolina, College of Medicine, 9228 Medical Plaza Drive, Charleston, SC 29406, USA
| | - Scott Bragg
- Department of Family Medicine, College of Medicine, College of Pharmacy, Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina, 280 Calhoun Street MSC 140, Charleston, SC 29425, USA.
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16
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A comparison of different methods to analyse data collected during time-to-exhaustion tests. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00585-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Purpose
Despite their widespread use in exercise physiology, time-to-exhaustion (TTE) tests present an often-overlooked challenge to researchers, which is how to computationally deal with between- and within-subject differences in exercise duration. We aimed to verify the best analysis method to overcome this problem.
Methods
Eleven cyclists performed an incremental test and three TTE tests differing in workload as preliminary tests. The TTEs were used to derive the individual power–duration relationship needed to set the workload (corresponding to an estimated TTE of 1200 s) for four identical experimental TTE tests. Within individuals, the four tests were subsequently rank ordered by performance. Physiological and psychological variables expected to change with performance were analysed using different methods, with the main aim being to compare the traditional “group isotime” method and a less-used “individual isotime” method.
Results
The four tests, ranked from the best to the worst, had a TTE of 1526 ± 332, 1425 ± 313, 1295 ± 325, and 1026 ± 265 s. Ratings of perceived exertion, minute ventilation, respiratory frequency, and affective valence were sensitive to changes in performance when their responses were analysed with the “individual isotime” method (P < 0.022, ηp2 > 0.144) but not when using the “group isotime” method, because the latter resulted in partial data loss.
Conclusions
The use of the “individual isotime” method is strongly encouraged to avoid the misinterpretation of the phenomenon under study. Important implications are not limited to constant-workload exercise, but extend to incremental exercise, which is another commonly used test of exercise tolerance.
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17
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Husmann F, Bruhn S, Mittlmeier T, Zschorlich V, Behrens M. Dietary Nitrate Supplementation Improves Exercise Tolerance by Reducing Muscle Fatigue and Perceptual Responses. Front Physiol 2019; 10:404. [PMID: 31068827 PMCID: PMC6491676 DOI: 10.3389/fphys.2019.00404] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/22/2019] [Indexed: 12/27/2022] Open
Abstract
The present study was designed to provide further insight into the mechanistic basis for the improved exercise tolerance following dietary nitrate supplementation. In a randomized, double-blind, crossover design, twelve recreationally active males completed a dynamic time-to-exhaustion test of the knee extensors after 5 days of consuming both nitrate-rich (NITRATE) and nitrate-depleted beetroot juice (PLACEBO). Participants who improved their time-to-exhaustion following NITRATE performed a time-matched trial corresponding to the PLACEBO exercise duration with another 5 days of dietary nitrate supplementation. This procedure was performed to obtain time-matched exercise trials with (NITRATEtm) and without dietary nitrate supplementation (PLACEBO). Neuromuscular tests were performed before and after each time-matched condition. Muscle fatigue was quantified as percentage change in maximal voluntary torque from pre- to post-exercise (ΔMVT). Changes in voluntary activation (ΔVA) and quadriceps twitch torque (ΔPS100) were used to quantify central and peripheral factors of muscle fatigue, respectively. Muscle oxygen saturation, quadriceps muscle activity as well as perceptual data (i.e., perception of effort and leg muscle pain) were recorded during exercise. Time-to-exhaustion was improved with NITRATE (12:41 ± 07:18 min) compared to PLACEBO (09:03 ± 04:18 min; P = 0.010). NITRATEtm resulted in both lower ΔMVT and ΔPS100 compared to PLACEBO (P = 0.002; P = 0.001, respectively). ΔVA was not different between conditions (P = 0.308). NITRATEtm resulted in reduced perception of effort and leg muscle pain. Our findings extend the mechanistic basis for the improved exercise tolerance by showing that dietary nitrate supplementation (i) attenuated the development of muscle fatigue by reducing the exercise-induced impairments in contractile muscle function; and (ii) lowered the perception of both effort and leg muscle pain during exercise.
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Affiliation(s)
- Florian Husmann
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Sven Bruhn
- Institute of Sport Science, University of Rostock, Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand and Reconstructive Surgery, University Medicine Rostock, Rostock, Germany
| | | | - Martin Behrens
- Institute of Sport Science, University of Rostock, Rostock, Germany
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18
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Kuppens K, Feijen S, Roussel N, Nijs J, Cras P, van Wilgen P, Struyf F. Training volume is associated with pain sensitivity, but not with endogenous pain modulation, in competitive swimmers. Phys Ther Sport 2019; 37:150-156. [PMID: 30978601 DOI: 10.1016/j.ptsp.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To investigate the association of pain sensitivity and endogenous analgesia capacity, and training volume in a group of competitive swimmers. DESIGN An observational multi-center study. SETTING Multiple competitive swimming clubs. PARTICIPANTS 102 healthy competitive swimmers. MAIN OUTCOME MEASURES Training volume was estimated using self-reported information. Static and dynamic measures of pain were assessed using pressure pain thresholds (PPTs) and conditioned pain modulation (CPM), the latter as a measure of endogenous pain inhibition. Selected demographic and psychosocial measures were considered as possible confounding factors. RESULTS Moderate positive correlations (0.38 < r < 0.44; p < 0.01) exist between self-reported training volume and PPTs at widespread body areas in competitive swimmers. These results were maintained during linear regression analysis while addressing possible confounding factors such as age and selected psychosocial factors. No associations were found between self-reported training volume and conditioned pain modulation (-0.08 < r < 0.06; p > 0.05). CONCLUSIONS Self-reported swim training volume is associated with pain sensitivity in competitive swimmers. Swimmers who train more show higher pressure pain thresholds, indicating lower pain sensitivity. Swim training volume is not associated with endogenous nociceptive inhibitory capacity as determined using CPM.
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Affiliation(s)
- Kevin Kuppens
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Stef Feijen
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Nathalie Roussel
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jo Nijs
- Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium; Department of Physiotherapy and Rehabilitation, University Hospital Brussels, Belgium
| | - Patrick Cras
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Neurology, University Hospital Antwerp, Belgium
| | - Paul van Wilgen
- Department of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium; Transcare, Transdisciplinary Pain Management Centre, the Netherlands
| | - Filip Struyf
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
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19
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Morgan PT, Vanhatalo A, Bowtell JL, Jones AM, Bailey SJ. Acetaminophen ingestion improves muscle activation and performance during a 3-min all-out cycling test. Appl Physiol Nutr Metab 2019; 44:434-442. [DOI: 10.1139/apnm-2018-0506] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Acute acetaminophen (ACT) ingestion has been shown to enhance cycling time-trial performance. The purpose of this study was to assess whether ACT ingestion enhances muscle activation and critical power (CP) during maximal cycling exercise. Sixteen active male participants completed two 3-min all-out tests against a fixed resistance on an electronically braked cycle ergometer 60 min after ingestion of 1 g of ACT or placebo (maltodextrin, PL). CP was estimated as the mean power output over the final 30 s of the test and W′ (the curvature constant of the power–duration relationship) was estimated as the work done above CP. The femoral nerve was stimulated every 30 s to measure membrane excitability (M-wave) and surface electromyography (EMGRMS) was recorded continuously to infer muscle activation. Compared with PL, ACT ingestion increased CP (ACT: 297 ± 32 W vs. PL: 288 ± 31 W, P < 0.001) and total work done (ACT: 66.4 ± 6.5 kJ vs. PL: 65.4 ± 6.4 kJ, P = 0.03) without impacting W′ (ACT: 13.1 ± 2.9 kJ vs. PL: 13.6 ± 2.4 kJ, P = 0.19) or the M-wave amplitude (P = 0.66) during the 3-min all-out cycling test. Normalised EMGRMS amplitude declined throughout the 3-min protocol in both PL and ACT conditions; however, the decline in EMGRMS amplitude was attenuated in the ACT condition, such that the EMGRMS amplitude was greater in ACT compared with PL over the last 60 s of the test (P = 0.04). These findings indicate that acute ACT ingestion might increase performance and CP during maximal cycling exercise by enhancing muscle activation.
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Affiliation(s)
- Paul T. Morgan
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Joanna L. Bowtell
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Andrew M. Jones
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
| | - Stephen J. Bailey
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter EX1 2LU, UK
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20
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Morgan PT, Vanhatalo A, Bowtell JL, Jones AM, Bailey SJ. Acute ibuprofen ingestion does not attenuate fatigue during maximal intermittent knee extensor or all-out cycling exercise. Appl Physiol Nutr Metab 2019; 44:208-215. [DOI: 10.1139/apnm-2018-0432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recent research suggests that acute consumption of pharmacological analgesics can improve exercise performance, but the ergogenic potential of ibuprofen (IBP) administration is poorly understood. This study tested the hypothesis that IBP administration would enhance maximal exercise performance. In one study, 13 physically active males completed 60 × 3-s maximal voluntary contractions (MVCs) of the knee extensors interspersed with 2-s passive recovery periods, on 2 occasions, with the critical torque (CT) estimated as the mean torque over the last 12 contractions (part A). In another study, 16 active males completed two 3-min all-out tests against a fixed resistance on an electronically braked cycle ergometer, with the critical power estimated from the mean power output over the final 30 s of the test (part B). All tests were completed 60 min after ingestion of maltodextrin (placebo, PL) or 400 mg of IBP. Peripheral nerve stimulation was administered at regular intervals and electromyography was measured throughout. For part A, mean torque (IBP: 60% ± 13% of pre-exercise MVC; PL: 58% ± 14% of pre-exercise MVC) and CT (IBP: 41% ± 16% of pre-exercise MVC; PL: 40% ± 15% of pre-exercise MVC) were not different between conditions (P > 0.05). For part B, end-test power output (IBP: 292 ± 28 W; PL: 288 ± 31 W) and work done (IBP: 65.9 ± 5.9 kJ; PL: 65.4 ± 6.4 kJ) during the 3-min all-out cycling tests were not different between conditions (all P > 0.05). For both studies, neuromuscular fatigue declined at a similar rate in both conditions (P > 0.05). In conclusion, acute ingestion of 400 mg of IBP does not improve single-leg or maximal cycling performance in healthy humans.
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Affiliation(s)
- Paul T. Morgan
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Joanna L. Bowtell
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Andrew M. Jones
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Stephen J. Bailey
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Heavitree Road, Exeter, EX1 2LU, UK
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21
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Endurance Performance is Influenced by Perceptions of Pain and Temperature: Theory, Applications and Safety Considerations. Sports Med 2018; 48:525-537. [PMID: 29270865 DOI: 10.1007/s40279-017-0852-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Models of endurance performance now recognise input from the brain, including an athlete's ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use.
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22
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Lundberg TR, Howatson G. Analgesic and anti-inflammatory drugs in sports: Implications for exercise performance and training adaptations. Scand J Med Sci Sports 2018; 28:2252-2262. [PMID: 30102811 DOI: 10.1111/sms.13275] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/07/2018] [Indexed: 12/22/2022]
Abstract
Over-the-counter analgesics, such as anti-inflammatory drugs (NSAIDs) and paracetamol, are widely consumed by athletes worldwide to increase pain tolerance, or dampen pain and reduce inflammation from injuries. Given that these drugs also can modulate tissue protein turnover, it is important to scrutinize the implications of acute and chronic use of these drugs in relation to exercise performance and the development of long-term training adaptations. In this review, we aim to provide an overview of the studies investigating the effects of analgesic drugs on exercise performance and training adaptations relevant for athletic development. There is emerging evidence that paracetamol might acutely improve important endurance parameters as well as aspects of neuromuscular performance, possibly through increased pain tolerance. Both NSAIDs and paracetamol have been demonstrated to inhibit cyclooxygenase (COX) activity, which might explain the reduced anabolic response to acute exercise bouts. Consistent with this, NSAIDs have been reported to interfere with muscle hypertrophy and strength gains in response to chronic resistance training in young individuals. Although it remains to be established whether any of these observations also translate into detriments in sport-specific performance or reduced training adaptations in elite athletes, the extensive use of these drugs certainly raises practical, ethical, and important safety concerns that need to be addressed. Overall, we encourage greater awareness among athletes, coaches, and support staff on the potential adverse effects of these drugs. A risk-benefit analysis and professional guidance are strongly advised before the athlete considers analgesic medicine for training or competition.
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Affiliation(s)
- Tommy R Lundberg
- Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK.,Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
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23
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MacRae BA, Annaheim S, Spengler CM, Rossi RM. Skin Temperature Measurement Using Contact Thermometry: A Systematic Review of Setup Variables and Their Effects on Measured Values. Front Physiol 2018. [PMID: 29441024 DOI: 10.3389/fphys.2018.00029, 10.3389/fpls.2018.00029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Skin temperature (Tskin) is commonly measured using Tskin sensors affixed directly to the skin surface, although the influence of setup variables on the measured outcome requires clarification. Objectives: The two distinct objectives of this systematic review were (1) to examine measurements from contact Tskin sensors considering equilibrium temperature and temperature disturbance, sensor attachments, pressure, environmental temperature, and sensor type, and (2) to characterise the contact Tskin sensors used, conditions of use, and subsequent reporting in studies investigating sports, exercise, and other physical activity. Data sources and study selection: For the measurement comparison objective, Ovid Medline and Scopus were used (1960 to July 2016) and studies comparing contact Tskin sensor measurements in vivo or using appropriate physical models were included. For the survey of use, Ovid Medline was used (2011 to July 2016) and studies using contact temperature sensors for the measurement of human Tskinin vivo during sport, exercise, and other physical activity were included. Study appraisal and synthesis methods: For measurement comparisons, assessments of risk of bias were made according to an adapted version of the Cochrane Collaboration's risk of bias tool. Comparisons of temperature measurements were expressed, where possible, as mean difference and 95% limits of agreement (LoA). Meta-analyses were not performed due to the lack of a common reference condition. For the survey of use, extracted information was summarised in text and tabular form. Results: For measurement comparisons, 21 studies were included. Results from these studies indicated minor (<0.5°C) to practically meaningful (>0.5°C) measurement bias within the subgroups of attachment type, applied pressure, environmental conditions, and sensor type. The 95% LoA were often within 1.0°C for in vivo studies and 0.5°C for physical models. For the survey of use, 172 studies were included. Details about Tskin sensor setup were often poorly reported and, from those reporting setup information, it was evident that setups widely varied in terms of type of sensors, attachments, and locations used. Conclusions: Setup variables and conditions of use can influence the measured temperature from contact Tskin sensors and thus key setup variables need to be appropriately considered and consistently reported.
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Affiliation(s)
- Braid A MacRae
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland.,Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Simon Annaheim
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - René M Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
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24
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MacRae BA, Annaheim S, Spengler CM, Rossi RM. Skin Temperature Measurement Using Contact Thermometry: A Systematic Review of Setup Variables and Their Effects on Measured Values. Front Physiol 2018; 9:29. [PMID: 29441024 PMCID: PMC5797625 DOI: 10.3389/fphys.2018.00029] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Skin temperature (Tskin) is commonly measured using Tskin sensors affixed directly to the skin surface, although the influence of setup variables on the measured outcome requires clarification. Objectives: The two distinct objectives of this systematic review were (1) to examine measurements from contact Tskin sensors considering equilibrium temperature and temperature disturbance, sensor attachments, pressure, environmental temperature, and sensor type, and (2) to characterise the contact Tskin sensors used, conditions of use, and subsequent reporting in studies investigating sports, exercise, and other physical activity. Data sources and study selection: For the measurement comparison objective, Ovid Medline and Scopus were used (1960 to July 2016) and studies comparing contact Tskin sensor measurements in vivo or using appropriate physical models were included. For the survey of use, Ovid Medline was used (2011 to July 2016) and studies using contact temperature sensors for the measurement of human Tskinin vivo during sport, exercise, and other physical activity were included. Study appraisal and synthesis methods: For measurement comparisons, assessments of risk of bias were made according to an adapted version of the Cochrane Collaboration's risk of bias tool. Comparisons of temperature measurements were expressed, where possible, as mean difference and 95% limits of agreement (LoA). Meta-analyses were not performed due to the lack of a common reference condition. For the survey of use, extracted information was summarised in text and tabular form. Results: For measurement comparisons, 21 studies were included. Results from these studies indicated minor (<0.5°C) to practically meaningful (>0.5°C) measurement bias within the subgroups of attachment type, applied pressure, environmental conditions, and sensor type. The 95% LoA were often within 1.0°C for in vivo studies and 0.5°C for physical models. For the survey of use, 172 studies were included. Details about Tskin sensor setup were often poorly reported and, from those reporting setup information, it was evident that setups widely varied in terms of type of sensors, attachments, and locations used. Conclusions: Setup variables and conditions of use can influence the measured temperature from contact Tskin sensors and thus key setup variables need to be appropriately considered and consistently reported.
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Affiliation(s)
- Braid A. MacRae
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Simon Annaheim
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Christina M. Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - René M. Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
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25
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Acute acetaminophen ingestion improves performance and muscle activation during maximal intermittent knee extensor exercise. Eur J Appl Physiol 2018; 118:595-605. [PMID: 29332237 PMCID: PMC5805811 DOI: 10.1007/s00421-017-3794-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 12/19/2017] [Indexed: 01/04/2023]
Abstract
Aim Acetaminophen is a commonly used medicine for pain relief and emerging evidence suggests that it may improve endurance exercise performance. This study investigated some of the physiological mechanisms by which acute acetaminophen ingestion might blunt muscle fatigue development. Methods Thirteen active males completed 60 × 3 s maximum voluntary contractions (MVC) of the knee extensors with each contraction separated by a 2 s passive recovery period. This protocol was completed 60 min after ingesting 1 g of maltodextrin (placebo) or 1 g of acetaminophen on two separate visits. Peripheral nerve stimulation was administered every 6th contraction for assessment of neuromuscular fatigue development, with the critical torque (CT), which reflects the maximal sustainable rate of oxidative metabolism, taken as the mean torque over the last 12 contractions. Surface electromyography was recorded continuously as a measure of muscle activation. Results Mean torque (61 ± 11 vs. 58 ± 14% pre-exercise MVC) and CT (44 ± 13 vs. 40 ± 15% pre-exercise MVC) were greater in the acetaminophen trial compared to placebo (both P < 0.05). Voluntary activation and potentiated twitch declined at a similar rate in both conditions (P > 0.05). However, the decline in electromyography amplitude was attenuated in the acetaminophen trial, with electromyography amplitude being greater compared to placebo from 210 s onwards (P < 0.05). Conclusion These findings indicate that acute acetaminophen ingestion might be ergogenic by increasing CT and preserving muscle activation during high-intensity exercise. Electronic supplementary material The online version of this article (10.1007/s00421-017-3794-7) contains supplementary material, which is available to authorized users.
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Esh CJ, Mauger AR, Palfreeman RA, Al-Janubi H, Taylor L. Acetaminophen (Paracetamol): Use beyond Pain Management and Dose Variability. Front Physiol 2017; 8:1092. [PMID: 29312002 PMCID: PMC5744234 DOI: 10.3389/fphys.2017.01092] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/12/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Christopher J Esh
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, Chatham, United Kingdom
| | - Roger A Palfreeman
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Exercise and Sports Science Department, Doha, Qatar
| | - Haifa Al-Janubi
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Pharmacy Department, Doha, Qatar
| | - Lee Taylor
- Aspetar - Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar.,School of Sport, Exercise and Health Sciences. Loughborough University, Loughborough, United Kingdom
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Hainline B, Derman W, Vernec A, Budgett R, Deie M, Dvořák J, Harle C, Herring SA, McNamee M, Meeuwisse W, Lorimer Moseley G, Omololu B, Orchard J, Pipe A, Pluim BM, Ræder J, Siebert C, Stewart M, Stuart M, Turner JA, Ware M, Zideman D, Engebretsen L. International Olympic Committee consensus statement on pain management in elite athletes. Br J Sports Med 2017; 51:1245-1258. [DOI: 10.1136/bjsports-2017-097884] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/10/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
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Analgesics and Sport Performance: Beyond the Pain-Modulating Effects. PM R 2017; 10:72-82. [PMID: 28782695 DOI: 10.1016/j.pmrj.2017.07.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/18/2017] [Accepted: 07/25/2017] [Indexed: 11/24/2022]
Abstract
Analgesics are used widely in sport to treat pain and inflammation associated with injury. However, there is growing evidence that some athletes might be taking these substances in an attempt to enhance performance. Although the pharmacologic action of analgesics and their use in treating pain with and without anti-inflammatory effect is well established, their effect on sport performance is debated. The aim of this review was to evaluate the evidence of whether analgesics are capable of enhancing exercise performance and, if so, to what extent. Paracetamol has been suggested to improve endurance and repeated sprint exercise performance by reducing the activation of higher brain structures involved in pain and cognitive/affective processing. Nonsteroidal anti-inflammatory drugs affect both central and peripheral body systems, but investigation on their ergogenic effect on muscle strength development has provided equivocal results. The therapeutic use of glucocorticoids is indubitable, but clear evidence exists for a performance-enhancing effect after short-term oral administration. Based on the evidence presented in this review article, the ergogenic benefit of analgesics may warrant further consideration by regulatory bodies. In contrast to the aforementioned analgesics, there is a paucity of research on the use of opioids such as tramadol on sporting performance. LEVEL OF EVIDENCE III.
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Foster J, Mauger A, Thomasson K, White S, Taylor L. Effect of Acetaminophen Ingestion on Thermoregulation of Normothermic, Non-febrile Humans. Front Pharmacol 2016; 7:54. [PMID: 27014068 PMCID: PMC4789353 DOI: 10.3389/fphar.2016.00054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 02/26/2016] [Indexed: 12/31/2022] Open
Abstract
In non-febrile mouse models, high dose acetaminophen administration causes profound hypothermia. However, this potentially hazardous side-effect has not been confirmed in non-febrile humans. Thus, we sought to ascertain whether an acute therapeutic dose (20 mg⋅kg lean body mass) of acetaminophen would reduce non-febrile human core temperature in a sub-neutral environment. Ten apparently healthy (normal core temperature, no musculoskeletal injury, no evidence of acute illness) Caucasian males participated in a preliminary study (Study 1) to determine plasma acetaminophen concentration following oral ingestion of 20 mg⋅kg lean body mass acetaminophen. Plasma samples (every 20 min up to 2-hours post ingestion) were analyzed via enzyme linked immunosorbent assay. Thirteen (eight recruited from Study 1) apparently healthy Caucasian males participated in Study 2, and were passively exposed to 20°C, 40% r.h. for 120 min on two occasions in a randomized, repeated measures, crossover design. In a double blind manner, participants ingested acetaminophen (20 mg⋅kg lean body mass) or a placebo (dextrose) immediately prior to entering the environmental chamber. Rectal temperature, skin temperature, heart rate, and thermal sensation were monitored continuously and recorded every 10 min. In Study 1, the peak concentration of acetaminophen (14 ± 4 μg/ml) in plasma arose between 80 and 100 min following oral ingestion. In Study 2, acetaminophen ingestion reduced the core temperature of all participants, whereas there was no significant change in core temperature over time in the placebo trial. Mean core temperature was significantly lower in the acetaminophen trial compared with that of a placebo (p < 0.05). The peak reduction in core temperature in the acetaminophen trial was reached at 120 min in six of the thirteen participants, and ranged from 0.1 to 0.39°C (average peak reduction from baseline = 0.19 ± 0.09°C). There was no significant difference in skin temperature, heart rate, or thermal sensation between the acetaminophen and placebo trials (p > 0.05). The results indicate oral acetaminophen reduces core temperature of humans exposed to an environment beneath the thermal neutral zone. These results suggest that acetaminophen may inhibit the thermogenic mechanisms required to regulate core temperature during exposure to sub-neutral environments.
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Affiliation(s)
- Josh Foster
- Applied Sport and Exercise Physiology Research Group, Institute of Sport and Physical Activity Research, Department of Sport Science and Physical Activity, University of Bedfordshire Bedfordshire, UK
| | - Alexis Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent Chatham, UK
| | - Katie Thomasson
- Applied Sport and Exercise Physiology Research Group, Institute of Sport and Physical Activity Research, Department of Sport Science and Physical Activity, University of Bedfordshire Bedfordshire, UK
| | - Stephanie White
- Applied Sport and Exercise Physiology Research Group, Institute of Sport and Physical Activity Research, Department of Sport Science and Physical Activity, University of Bedfordshire Bedfordshire, UK
| | - Lee Taylor
- Applied Sport and Exercise Physiology Research Group, Institute of Sport and Physical Activity Research, Department of Sport Science and Physical Activity, University of BedfordshireBedfordshire, UK; ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research CentreDoha, Qatar
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Astokorki AHY, Mauger AR. Tolerance of exercise-induced pain at a fixed rating of perceived exertion predicts time trial cycling performance. Scand J Med Sci Sports 2016; 27:309-317. [PMID: 26888740 DOI: 10.1111/sms.12659] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 01/02/2023]
Abstract
To compare the predictive capacity of experimental pain and exercised-induced pain (EIP) on exercise performance. Thirty-two recreationally active male (n = 23) and female (n = 9) participants were recruited. Participants completed measures of pain tolerance by cold pressor test (CPT), pain pressure threshold via algometry (PPT), and EIP tolerance using an RPE clamp trial. A VO2max test provided traditional predictors of performance [VO2max , gas-exchange threshold (GET), peak power output (PPO)]. Finally, participants completed a 16.1-km cycling time trial (TT). No correlation was found between experimental pain measures (CPT, PPT) and TT performance. However, there was a significant correlation between EIP tolerance and TT performance (R = -0.83, P < 0.01). Regression analysis for pain and physiological predictor variables (mean pain in CPT, PPT, EIP tolerance, VO2max , PPO, GET) revealed that a significant model (P < 0.01) emerged when only PPO (Adjusted R2 = 0.739) and EIP tolerance (ΔR2 = 0.075) were used to predict TT performance. These findings suggest that EIP tolerance is an important factor in endurance performance. However, PPT and CPT have limited ability to assess this relationship, and so their use in EIP research should be treated with caution.
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Affiliation(s)
- A H Y Astokorki
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK
| | - A R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK
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Coombs GB, Cramer MN, Ravanelli NM, Morris NB, Jay O. Acute acetaminophen ingestion does not alter core temperature or sweating during exercise in hot-humid conditions. Scand J Med Sci Sports 2016; 25 Suppl 1:96-103. [PMID: 25943660 DOI: 10.1111/sms.12336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
Abstract
Acute acetaminophen (ACT) ingestion has been reported to reduce thermal strain during cycling in the heat. In this study, nine active participants ingested 20 mg of ACT per kg of total body mass (ACT) or a placebo (PLA), 60 min prior to cycling at a fixed rate of metabolic heat production (ACT: 8.3 ± 0.3 W/kg; PLA: 8.5 ± 0.5 W/kg), which was equivalent to 55 ± 6% VO2max , for 60 min at 34.5 ± 0.1 °C, 52 ± 1% relative humidity. Resting rectal temperature (Tre ; ACT: 36.70 ± 0.17 °C; PLA: 36.80 ± 0.16 °C, P = 0.24), esophageal temperature (Tes ; ACT: 36.54 ± 0.22 °C; PLA: 36.61 ± 0.17 °C, P = 0.50) and mean skin temperature (Tsk ; ACT: 34.00 ± 0.14 °C; PLA: 33.96 ± 0.20 °C, P = 0.70) were all similar among conditions. At end-exercise, no differences in ΔTre (ACT: 1.12 ± 0.15 °C; PLA: 1.11 ± 0.21 °C, P = 0.92), ΔTes (ACT: 0.90 ± 0.28 °C; PLA: 0.88 ± 0.23 °C, P = 0.84), ΔTsk (ACT: 0.80 ± 0.39 °C; PLA: 0.70 ± 0.46 °C, P = 0.63), mean local sweat rate (ACT: 1.02 ± 0.15 mg/cm(2) /min; PLA: 1.02 ± 0.13 mg/cm(2) /min, P = 0.98) and whole-body sweat loss (ACT: 663 ± 83 g; PLA: 663 ± 77 g, P = 0.995) were evident. Furthermore, ratings of perceived exertion and thermal sensation and thermal comfort were not different between ACT and PLA conditions. In conclusion, ACT ingested 60 min prior to moderate intensity exercise in hot-humid conditions does not alter physiologic thermoregulatory control nor perceived strain.
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Affiliation(s)
- G B Coombs
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Foster J, Mauger AR, Chrismas BCR, Thomasson K, Taylor L. Is prostaglandin E2 (PGE2) involved in the thermogenic response to environmental cooling in healthy humans? Med Hypotheses 2015; 85:607-11. [PMID: 26253311 DOI: 10.1016/j.mehy.2015.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/20/2015] [Accepted: 07/25/2015] [Indexed: 12/12/2022]
Abstract
Prostaglandin E2 (PGE2) is an eicosanoid derived from cyclooxygenase, an enzyme responsible for the cyclisation and oxygenation of arachidonic acid. In response to bacterial infection, PGE2 binds to EP3 receptors on a population of GABAergic neurons in the pre-optic area. Activation of the EP3 receptor decreases the intracellular cyclic adenosine monophosphate (cAMP) concentrations of these neurons, and the resulting dis-inhibition activates spinal motor outputs responsible for shivering thermogenesis, tachycardia, and brown adipose tissue activation. These involuntary responses increase core body temperature to varying degrees depending on the magnitude of infection; an immune response which is crucial for the survival of the host. However, evidence in animal and human models, primarily through the use of cyclooxygenase inhibitors (which block the production of PGE2), suggests that PGE2 may also be an important molecule for the defence of core temperature against body cooling and cold stress (in the absence of fever). In this paper, evidence within human and animal models is discussed which supports the hypothesis that the eicosanoid PGE2 has a role in maintaining human core temperature during environmental cooling. Given that over-the-counter PGE2 inhibiting drugs [i.e. Non-Steroidal Anti Inflammatory Drugs (NSAIDS)] are frequently used worldwide, it is possible that the use of such medication during environmental cooling could impair one's ability to thermoregulate. Support for such findings could have major implications in the pathology of hypothermia, thus, we suggest that future researchers investigate this specific hypothesis in vivo, using healthy human models. Suggestions for the implementation of such experiments are provided in the present work.
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Affiliation(s)
- Josh Foster
- Applied Sport and Exercise Physiology (ASEP) Research Group, Institute of Sport and Physical Activity Research (ISPAR), Department of Sport and Exercise Sciences, University of Bedfordshire, Bedford, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, University of Kent, Chatham Maritime, UK
| | - Bryna C R Chrismas
- Applied Sport and Exercise Physiology (ASEP) Research Group, Institute of Sport and Physical Activity Research (ISPAR), Department of Sport and Exercise Sciences, University of Bedfordshire, Bedford, UK
| | - Katie Thomasson
- Applied Sport and Exercise Physiology (ASEP) Research Group, Institute of Sport and Physical Activity Research (ISPAR), Department of Sport and Exercise Sciences, University of Bedfordshire, Bedford, UK
| | - Lee Taylor
- Applied Sport and Exercise Physiology (ASEP) Research Group, Institute of Sport and Physical Activity Research (ISPAR), Department of Sport and Exercise Sciences, University of Bedfordshire, Bedford, UK.
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Angius L, Hopker JG, Marcora SM, Mauger AR. The effect of transcranial direct current stimulation of the motor cortex on exercise-induced pain. Eur J Appl Physiol 2015; 115:2311-9. [PMID: 26148882 DOI: 10.1007/s00421-015-3212-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/28/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE Transcranial direct current stimulation (tDCS) provides a new exciting means to investigate the role of the brain during exercise. However, this technique is not widely used in exercise science, with little known regarding effective electrode montages. This study investigated whether tDCS of the motor cortex (M1) would elicit an analgesic response to exercise-induced pain (EIP). METHODS Nine participants completed a VO2max test and three time to exhaustion (TTE) tasks on separate days following either 10 min 2 mA tDCS of the M1, a sham or a control. Additionally, seven participants completed 3 cold pressor tests (CPT) following the same experimental conditions (tDCS, SHAM, CON). Using a well-established tDCS protocol, tDCS was delivered by placing the anodal electrode above the left M1 with the cathodal electrode above dorsolateral right prefrontal cortex. Gas exchange, blood lactate, EIP and ratings of perceived exertion (RPE) were monitored during the TTE test. Perceived pain was recorded during the CPT. RESULTS During the TTE, no significant differences in time to exhaustion, RPE or EIP were found between conditions. However, during the CPT, perceived pain was significantly (P < 0.05) reduced in the tDCS condition (7.4 ± 1.2) compared with both the CON (8.6 ± 1.0) and SHAM (8.4 ± 1.3) conditions. CONCLUSION These findings demonstrate that stimulation of the M1 using tDCS does not induce analgesia during exercise, suggesting that the processing of pain produced via classic measures of experimental pain (i.e., a CPT) is different to that of EIP. These results provide important methodological advancement in developing the use of tDCS in exercise.
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Affiliation(s)
- Luca Angius
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - James G Hopker
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - Samuele M Marcora
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK
| | - Alexis R Mauger
- Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham Maritime, Kent, ME4 4AG, UK.
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Ultra-endurance exercise: unanswered questions in redox biology and immunology. Biochem Soc Trans 2014; 42:989-95. [DOI: 10.1042/bst20140120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ultra-endurance races are extreme exercise events that can take place over large parts of a day, several consecutive days or over weeks and months interspersed by periods of rest and recovery. Since the first ultra-endurance races in the late 1970s, around 1000 races are now held worldwide each year, and more than 100000 people take part. Although these athletes appear to be fit and healthy, there have been occasional reports of severe complications following ultra-endurance exercise. Thus there is concern that repeated extreme exercise events could have deleterious effects on health, which might be brought about by the high levels of ROS (reactive oxygen species) produced during exercise. Studies that have examined biomarkers of oxidative damage following ultra-endurance exercise have found measurements to be elevated for several days, which has usually been interpreted to reflect increased ROS production. Levels of the antioxidant molecule GSH (reduced glutathione) are depleted for 1 month or longer following ultra-endurance exercise, suggesting an impaired capacity to cope with ROS. The present paper summarizes studies that have examined the oxidative footprint of ultra-endurance exercise in light of current thinking in redox biology and the possible health implications of such extreme exercise.
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Reply to letter: Acetaminophen and sport performance: doping or what? Eur J Appl Physiol 2014; 114:883-4. [PMID: 24563095 DOI: 10.1007/s00421-014-2853-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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Acetaminophen and sport performance: doping or what? Eur J Appl Physiol 2014; 114:881-2. [DOI: 10.1007/s00421-014-2852-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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