Renal and liver functions and muscle injuries during training and after competition in Thai boxers

Disentangling the dynamic interplay between muscle damage and energetics in male boxers during a short training block

Boxing is a combat sport linked to muscle damage (e.g., soreness, rising creatine kinase [CK]) and energetic biomarkers (e.g., urea, glucose). These factors have not, however, been examined dynamically in terms of day-to-day, lagged and reciprocal effects during normal training. This study investigated the dynamic interplay between muscle damage and energetics in male boxers during a short training block. Thirteen amateur boxers were monitored over 16 consecutive days during early-season training. The participants were assessed each morning for plasma CK, urea, glucose, and creatinine (days 1 and 16 only) concentrations, before self-reporting muscle soreness (1-10 scale). Within-person contemporaneous (lag-0) and temporal (lag-1) networks were estimated using multilevel vector autoregression. Muscle soreness, CK, urea, and glucose presented different trajectories with training, but with some heterogeneity reflecting within-person variances (47% to 78%). The contemporaneous network yielded a significant positive edge (or correlation) between CK and soreness (r = 0.44), along with negative CK-glucose and glucose-urea edges. More significant edges emerged in the temporal network, with soreness linked to CK (r = 0.19), glucose (r = -0.28) and urea (r = 0.22), whilst the CK-glucose edge sign switched. In summary, daily fluctuations in muscle damage and energetic activity, which presented in a normal physiological range, were highly variable among boxers during early-season training. Within-person networks indicated some interrelatedness between CK, soreness, urea, and glucose, although the nature and presence of these relationships were contingent on temporal ordering. These inconsistences reflect the pleiotropy of energetic biomarkers in training and recovery.

Energy demands in high-intensity intermittent taekwondo specific exercises

Background

Taekwondo is an intermittent Olympic combat sport, which shows an aerobic predominance in matches and high participation of alactic metabolism for actions that determine competitive success. However, there is no information on energetic contribution systems in different high-intensity intermittent exercises for metabolic conditioning with specific movements. The study aimed to measure the physiological demands, mainly the energy expenditure, in taekwondo-specific high-intensity intermittent exercises (HIIE).

Methods

This study recruited ten male black belt athletes with a mean age of 20.2 ± 4 years, body mass of 62.8 ± 10.5 kg and height of 170.6 ± 7.8 cm, and total practice time of 11.8 ± 5.4 years. Subjects performed an incremental specific test and three different HIIE protocols on nonconsecutive days, and all comprised three 2-min rounds and 1 min of recovery between rounds. Heart rate, oxygen consumption, and blood lactate were measured. Energetic expenditure of aerobic, alactic, and lactic metabolisms was estimated through oxygen consumption, excess post-exercise oxygen consumption, and peak blood lactate after each round.

Results

For the mean of the three rounds, the TKDtest100 resulted in higher absolute and relative contribution from the aerobic metabolism (52.4 ± 4%; p = 0.01) and lower than the 35:5 relative alactic contribution (48.7 ± 5.4%; p = 0.03).

Conclusion

The mean of the three rounds for 35:5 and 15:10:5 presented similar absolute and relative contributions of aerobic and alactic metabolisms, whereas the TKDtest100 was a predominantly aerobic activity. We emphasize that aerobic metabolism was predominant from the second round in the 15:10:5 and 100%TKDtest protocols and in the last round of the 35:5 protocol.

Seasonal evaluation of skeletal muscle damage and hematological and biochemical parameters of Greco-Roman wrestlers from the Kyrgyzstan National Team before the 2016 Summer Olympic Games

BACKGROUND

Regular exercise activities affect blood cells.

OBJECTIVE

The purpose of this study was to evaluate the seasonal evaluation of some hematological and biochemical parameters of the Olympic Greco-Roman wrestlers.

METHODS

A total of three measurements were performed on wrestlers: immediately before the training period, three months and six months after the training session. Hematological and biochemical parameters were analyzed by taking sufficient blood samples from the athletes before and after exercise.

RESULTS

The total leukocyte, lymphocyte, and neutrophil values were found to be significantly higher (p< 0.05) in all three measures (beginning, 3rd and 6th months) in comparison with the values before exercise. When biochemical analyses were examined, blood glucose levels were significantly decreased after exercise in all three measures compared to before exercise. Post-exercise HDL cholesterol concentrations significantly increased (p< 0.05) while LDL cholesterol concentrations significantly decreased (p< 0.05).

CONCLUSION

On all three measures fatigue exercise has significantly increased the total leukocyte, lymphocyte and neutrophil values of wrestlers, while other, hematological parameters were not affected evenly. Fatigue exercise also significantly reduced blood glucose levels and LDL cholesterol concentrations, while HDL cholesterol concentrations were increased. The six-month period training did not have a significant effect on both hematologic and biochemical parameters in all three measurements.

Deceleration, Acceleration, and Impacts Are Strong Contributors to Muscle Damage in Professional Australian Football

Gastin, PB, Hunkin, SL, Fahrner, B, and Robertson, S. Deceleration, acceleration, and impacts are strong contributors to muscle damage in professional Australian football. J Strength Cond Res 33(12): 3374-3383, 2019-The purpose of this study was to investigate the relationships between serum creatine kinase [CK], an indirect marker of muscle damage, and specific indices of match load in elite Australian football. Twenty-six professional players were assessed during a competitive Australian Football League (AFL) season. [CK] was collected 24-36 hours before match and 34-40 hours after match during 8 in-season rounds. An athlete-tracking technology was used to quantify match load. Generalized estimating equations and random forest models were constructed to determine the extent to which match-load indices and pre-match [CK] explained post-match [CK]. There was a 129 ± 152% increase in [CK] in response to AFL competition. Generalized estimating equations found that number of impacts >3g (p = 0.004) and game time (p = 0.016) were most strongly associated with post-match [CK]. Random forest, with considerably lower errors (130 vs. 316 U·L), found deceleration, acceleration, impacts >3g, and sprint distance to be the strongest predictors. Pre-match [CK] accounted for 11% of post-match [CK], and considerable interindividual and intraindividual variability existed in the data. Creatine kinase, an indicator of muscle damage, was considerably elevated as a result of AFL competition. Parametric and machine-learning analysis techniques found several indices of physical load associated with muscle damage during competition, with impacts >3g and high-intensity running variables as the strongest predictors. [CK] may be used as a global measure of muscle damage in field team sports such as AF, yet with some caution given cost, invasiveness, and inherent variability. Quantifying physical load and the responses to that load can guide athlete management decision-making and is best undertaken within a suite of practical, sport-specific measures, where data are interpreted individually and with an understanding of the limitations.

Effects of Boxing Matches on Metabolic, Hormonal, and Inflammatory Parameters in Male Elite Boxers

Background and objectives: Boxing is a popular combat sport that requires high intensity and cooperation. However, there are limited data about the influence of boxing matches on blood parameters. The purpose of the present study was to investigate the match-induced changes in the metabolic, hormonal, and inflammatory status in male elite boxers. Materials and methods: High-level 20 male boxers with more than 5 years experience in boxing voluntarily participated in this study. Venous blood samples of the boxers, before and after combat, were taken for determination of the plasma parameters. Results: Our results indicated that a 9-min boxing match caused significant increases in plasma energy fuels (glucose and lactate), metabolic hormones (insulin, adrenocorticotropic hormone (ACTH), cortisol, and growth hormone), inflammatory markers (interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α)), muscle damage indicators (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), and oxidative stress marker (SOD). A decrease in total oxidant status (TOS) was also considered. However, there were no significant alterations in the plasma levels of androgenic hormone (free and total testosterone), anabolic hormone (IGF-1), lipids (total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL)), kidney function markers (creatinine and urea), and minerals (iron (Fe) and magnesium (Mg)). Conclusion: Elevations in the level of energy fuels and metabolic hormones of the boxers could be taken as a reflection of high-energy turnover during combat performance. The increases in inflammatory and tissue damage indicators may possibly be an indication of traumatic injury. Understanding the biochemical changes that occur during boxing match could be valuable to optimize the performance improvement of the athletes.

Evaluation of Muscle Damage Marker after Mixed Martial Arts Matches

The aim of this paper is to identify predictors of serum muscle damage marker (MDM) response following mixed martial arts (MMA) matches. Creatine kinase activity (CK) and myoglobin concentration (Mb) were measured in ten male elite MMA fighters (aged 28±5.7 years) prior to, 2 h, 24 h, and 96 h following 9 different MMA matches. The number of performed upright punches and kicks (UKF) that failed the opponent, the number of obtained hits to the upper and lower body (LBH), as well as the total fight duration (TFD) were evaluated as potential predictors from video recordings. CK peaked 24 h (829±753 U/L(-1)) and Mb peaked 2 h (210±122 µg/L(-1)) post matches. Almost 80% of the peak CK variance could be explained by LBH and UKF, whereas 87% of the Mb variation was explained by TFD and LBH. MMA result in a significant skeletal muscle damage, which largely depends on LBH. Furthermore, eccentric contractions to decelerate kicks that missed the opponent and the TFD seem to contribute to the MDM response.

Alanine aminotransferase-old biomarker and new concept: a review

Measurement of serum alanine aminotransferase (ALT) is a common, readily available, and inexpensive laboratory assay in clinical practice. ALT activity is not only measured to detect liver disease, but also to monitor overall health. ALT activity is influenced by various factors, including viral hepatitis, alcohol consumption, and medication. Recently, the impact of metabolic abnormalities on ALT variation has raised concern due to the worldwide obesity epidemic. The normal ranges for ALT have been updated and validated considering the metabolic covariates in the various ethnic districts. The interaction between metabolic and demographic factors on ALT variation has also been discussed in previous studies. In addition, an extremely low ALT value might reflect the process of aging, and frailty in older adults has been raised as another clinically significant feature of this enzyme, to be followed with additional epidemiologic investigation. Timely updated, comprehensive, and systematic introduction of ALT activity is necessary to aid clinicians make better use of this enzyme.

Metabolic markers in sports medicine

Physical exercise induces adaptations in metabolism considered beneficial for health. Athletic performance is linked to adaptations, training, and correct nutrition in individuals with genetic traits that can facilitate such adaptations. Intense and continuous exercise, training, and competitions, however, can induce changes in the serum concentrations of numerous laboratory parameters. When these modifications, especially elevated laboratory levels, result outside the reference range, further examinations are ordered or participation in training and competition is discontinued or sports practice loses its appeal. In order to correctly interpret commonly used laboratory data, laboratory professionals and sport physicians need to know the behavior of laboratory parameters during and after practice and competition. We reviewed the literature on liver, kidney, muscle, heart, energy, and bone parameters in athletes with a view to increase the knowledge about clinical chemistry applied to sport and to stimulate studies in this field. In liver metabolism, the interpretation of serum aminotransferases concentration in athletes should consider the release of aspartate aminotransferase (AST) from muscle and of alanine aminotransferase (ALT) mainly from the liver, when bilirubin can be elevated because of continuous hemolysis, which is typical of exercise. Muscle metabolism parameters such as creatine kinase (CK) are typically increased after exercise. This parameter can be used to interpret the physiological release of CK from muscle, its altered release due to rhabdomyolysis, or incomplete recovery due to overreaching or trauma. Cardiac markers are released during exercise, and especially endurance training. Increases in these markers should not simply be interpreted as a signal of cardiac damage or wall stress but rather as a sign of regulation of myocardial adaptation. Renal function can be followed in athletes by measuring serum creatinine concentration, but it should be interpreted considering the athlete's body-mass index (BMI) and phase of the competitive season; use of cystatin C could be a reliable alternative to creatinine. Exercise and training induce adaptations in glucose metabolism which improve glucose utilization in athletes and are beneficial for reducing insulin insensitivity in nonathletes. Glucose metabolism differs slightly for different sports disciplines, as revealed in laboratory levels. Sport activities induce a blood lipid profile superior to that of sedentary subjects. There are few reports for a definitive conclusion, however. The differences between athletes and sedentary subjects are mainly due to high-density lipoprotein cholesterol (HDLC) concentrations in physically active individuals, although some differences among sport disciplines exist. The effect of sports on serum and urinary markers for bone metabolism is not univocal; further studies are needed to establish the real and effective influence of sport on bone turnover and especially to establish its beneficial effect.

Biochemical markers of muscular damage

Muscle tissue may be damaged following intense prolonged training as a consequence of both metabolic and mechanical factors. Serum levels of skeletal muscle enzymes or proteins are markers of the functional status of muscle tissue, and vary widely in both pathological and physiological conditions. Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and carbonic anhydrase CAIII are the most useful serum markers of muscle injury, but apoptosis in muscle tissues subsequent to strenuous exercise may be also triggered by increased oxidative stress. Therefore, total antioxidant status can be used to evaluate the level of stress in muscle by other markers, such as thiobarbituric acid-reactive substances, malondialdehyde, sulfhydril groups, reduced glutathione, oxidized glutathione, superoxide dismutase, catalase and others. As the various markers provide a composite picture of muscle status, we recommend using more than one to provide a better estimation of muscle stress.

[Liver and sport]

The liver is a vital organ and plays a central role in energy exchange, protein synthesis as well as the elimination of waste products from the body. Acute and chronic injury may disturb a variety of liver functions to different degrees. Over the last three decades, the effects of physical activity and competitive sport on the liver have been described by various investigators. These include viral hepatitis and drug-induced liver disorders. Herein, we review acute and chronic liver diseases potentially caused by sport. Team physicians, trainers and others, responsible for the health of athletes, should be familiar with the risk factors, clinical features, and consequences of liver diseases that occur in sports.

Relation between serum creatinine and body mass index in elite athletes of different sport disciplines

OBJECTIVES

To document the relation between serum creatinine concentration and body mass index in elite athletes from five different sports, and to study potential differences among athletes performing different sports with different features and requirements.

METHODS

Before the start of the competitive season, serum creatinine was measured in 151 elite athletes from five different sports: rugby (n = 44), soccer (n = 27), alpine skiing (n = 34), sailing (n = 22), cycling (n = 24). Pearson's correlation analysis was used to evaluate the relation between serum creatinine and body mass index (BMI). Analysis of variance and unpaired Student's t test were used to compare creatinine concentration and BMI in different sport disciplines.

RESULTS

In the whole group of athletes, a positive correlation between serum creatinine and BMI was found (r = 0.48, p<0.001). Significant differences in creatinine concentration and BMI were found between athletes competing in different sports: their mean (SD) values were respectively 1.31 (0.12) mg/dl and 28.83 (2.41) for rugby players, 1.27 mg/dl (0.10) and 23.10 (1.01) for soccer players, 1.15 (0.11) mg/dl and 25.8 (1.50) for skiers, 1.08 (0.11) mg/dl and 26.93 (2.36) for sailors, and 0.91 (0.07)mg/dl and 21.33 (1.21) for cyclists.

CONCLUSIONS

There is a correlation between creatinine concentration and BMI in elite athletes competing in different sports characterised by different kinds of training, competitive season, and involvement of aerobic and anaerobic metabolism. Interpretation of creatinine concentrations in male athletes should consider professional status as well as the specific sport performed. All athletes should be monitored with consecutive creatinine assessments, using as the baseline the concentration determined before the start of training and the competitive season, but taking into consideration the specific sport performed and the BMI until equations that include creatinine and factors that affect its concentration are used.

Muscular damage and intravascular haemolysis during an 18 hour subterranean exploration in a cave of 700 m depth

OBJECTIVE

To verify presence and severity of muscular and/or intravascular damage during a subterranean exploration of long duration.

METHODS

We measured serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) as markers of muscular damage. We also measured haptoglobin as a marker of intravascular haemolysis, and platelets and leucocytes as markers of inflammation.

RESULTS

We found in all the participants an increase in CK, LDH, and platelets and leucocytes (mainly due to neutrophilia and monocytosis), and a decrease in the level of haptoglobin and circulating lymphocytes.

CONCLUSIONS

The observed data suggest that continuous effort during long alpine subterranean explorations, environmental conditions, sleep deprivation, multiple impacts on rocks, and compression caused by bindings of the caving harness cause muscle damage, intravascular haemolysis, inflammation response, and immunological changes.

Serum alanine aminotransferase in skeletal muscle diseases

Although elevation of the levels of serum alanine aminotransferase (ALT) following liver injury is well known, confusion exists concerning skeletal muscle injury as the cause of this rise. We reviewed the records of 16 patients who had muscle necrosis without evidence of liver disease. The patients were divided into three groups: extreme exercise, polymyositis, and seizures. All patients exhibited markedly elevated creatine kinase and lactate dehydrogenase levels consistent with muscle injury. In acute cases, aspartate aminotransferase (AST) and ALT were both elevated, and the AST/ALT ratio was greater than 3, but this ratio approached 1 after a few days because of a faster decline in AST. In conclusion, this difference in half-life accounts for the comparable AST and ALT levels in our cases with chronic muscle injury.

A 16 year study of injuries to professional kickboxers in the state of Victoria, Australia

OBJECTIVES

To determine the rate and type of injuries occurring to registered professional kickboxers in Victoria, Australia over a 16 year period.

METHODS

Data describing all fight outcomes and injuries sustained during competition for the period August 1985 to August 2001 were obtained from the Victorian Professional Boxing and Combat Sports Board.

RESULTS

A total of 382 injuries were recorded from 3481 fight participations, at an injury rate of 109.7 injuries per 1000 fight participations. The most common body region injured was the head/neck/face (52.5%), followed by the lower extremities (39.8%). Specifically, injuries to the lower leg (23.3%), the face (19.4%), and intracranial injury (17.2%) were the most common. Over 64% of the injuries were superficial bruising or lacerations.

CONCLUSION

The nature of kickboxing, whereby kicking the opponent is the prime movement and the head a prime target, is reflected in the distributions of body regions most commonly injured by participants. Further research into injury patterns in different styles of kickboxing and the mechanism of injury occurrence is required. Exposure adjusted prospective studies are needed to monitor injury rates over time.

Injury and injury rates in Muay Thai kick boxing

OBJECTIVE

To determine the type and number of injuries that occur during the training and practice of Muay Thai kick boxing and to compare the data obtained with those from previous studies of karate and taekwondo.

METHODS

One to one interviews using a standard questionnaire on injuries incurred during training and practice of Muay Thai kick boxing were conducted at various gyms and competitions in the United Kingdom and a Muay Thai gala in Holland.

RESULTS

A total of 152 people were questioned, 132 men and 20 women. There were 19 beginners, 82 amateurs, and 51 professionals. Injuries to the lower extremities were the most common in all groups. Head injuries were the second most common in professionals and amateurs. Trunk injuries were the next most common in beginners. The difference in injury distribution among the three groups was significant (p< or =0.01). Soft tissue trauma was the most common type of injury in the three groups. Fractures were the second most common in professionals, and in amateurs and beginners it was sprains and strains (p< or =0.05). Annual injury rates were: beginners, 13.5/1000 participants; amateurs, 2.43/1000 participants; professionals, 2.79/1000 participants. For beginners, 7% of injuries resulted in seven or more days off training; for amateurs and professionals, these values were 4% and 5.8% respectively.

CONCLUSIONS

The results are similar to those found for karate and taekwondo with regard to injury distribution, type, and rate. The percentage of injuries resulting in time off training is less.