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Hiroshige Y, Watanabe H, Tomiyama S, Kato H. Epidemiological Study of Track-and-Field Meets On-Field Medical Care. J Sport Rehabil 2024:1-7. [PMID: 39379015 DOI: 10.1123/jsr.2023-0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND Most epidemiological studies on track-and-field meets have been limited to the Olympics and world championships. These are meets in which only high-performance athletes participate at a certain time of the year. In contrast, epidemiological studies on athletes of various ages and across different seasons may provide health care providers with valuable insights into injury prevention and on-field medical care. The study aims to determine the trends and locations of injuries during track-and-field meets in athletes of various ages and seasons based on on-field medical care records. METHODS The number and incidence of injuries requiring on-field medical care during or after the event were obtained from 39 track-and-field meets. Injuries were defined as cases that required on-field medical care. The incidence was defined as the number of injuries per 1000 athlete exposures wherein 1 athlete exposure is the athlete's participation in one event. We also recorded the number of injuries at each location and whether transportation to a medical station was required. RESULTS A total of 191 injuries were reported. This study identified a population with a high incidence of injury (middle- and long-distance events, combined events, and athletes over the age of 19), areas within the stadium where injuries were more likely to occur (finish line and first turn), and a high rate of transport to the medical station (approximately 70%); most of them were transported to wheelchairs. CONCLUSION The results provide insights into the trends, locations, and transport of injured athletes during track-and-field meets. Professionals will better understand the injuries occurring during track-and-field meets and can improve the efficiency of on-field medical care activities. They will also assist organizers in track-and-field meets to improve the safety of their meet operations.
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Affiliation(s)
- Yosuke Hiroshige
- Institute of Sports Science and Medicine, Teikyo University, Hachioji, Tokyo, Japan
| | - Hodaka Watanabe
- Tsukuba Sports Medicine and Health Science Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | | | - Hajime Kato
- Faculty of Medical Technology, Department of Sport and Medical Science, Teikyo University, Hachioji,Tokyo, Japan
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Racinais S, Ihsan M, Grant ME, Dablainville V, Rousse Y, Schobersberger W, Budgett R, Engebretsen L. Ice challenge in recent summer olympic games. Br J Sports Med 2024; 58:943-945. [PMID: 39054047 DOI: 10.1136/bjsports-2024-108664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Affiliation(s)
- Sebastien Racinais
- CREPS Montpellier Font-Romeu, Environmental Stress Unit, Montpellier University, Montpellier, Occitanie, France
- DMEM, UMR 866 INRAE / University of Montpellier, Montpellier, France
| | - Mohammed Ihsan
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Valentin Dablainville
- DMEM, UMR 866 INRAE / University of Montpellier, Montpellier, France
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Yohan Rousse
- CREPS Montpellier Font-Romeu, Environmental Stress Unit, Montpellier University, Montpellier, Occitanie, France
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Périard JD, Wilson MG, Tebeck ST, Stanley J, Girard O. Health status and heat preparation at a UCI World Tour multistage cycling race. J Sci Med Sport 2024:S1440-2440(24)00491-2. [PMID: 39242327 DOI: 10.1016/j.jsams.2024.08.206] [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: 04/10/2024] [Revised: 08/14/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES To assess health status and heat preparation of cyclists at the 2019 Tour Down Under and determine the alignment of heat mitigation strategies with current recommendations. DESIGN Cohort study. METHODS Twenty-three (17 % participation rate) male World Tour cyclists from five teams and 10 countries completed a pre-competition questionnaire evaluating exertional heat illness (EHI) history, pre-race health status, and heat mitigation and recovery strategies use. Associations between arrival days pre-competition, years as professional, nationality, team, history of EHI symptoms and diagnosis on heat mitigation and recovery strategy utilisation were assessed. RESULTS 65 % of cyclists reported previously experiencing one or more EHI symptom (cramping: 48 %) and 22 % a diagnosis of heat stroke. In the 10 days preceding the race, 26 % experienced one or more illness symptoms. 65 % trained in the heat (acclimatisation 8-25 days; acclimation: 3-7 days), which was associated with team (P = 0.047, ϕc = 0.61), nationality (P = 0.009, ϕc = 0.86) and EHI symptoms history (P = 0.058, ϕ = 0.43). All cyclists had a hydration plan, with links to team (0.5-1.0 L·h-1, P = 0.043, ϕc = 0.68) and EHI symptom history (1.0-1.5 L·h-1, P = 0.048, ϕ = 0.476). Most had pre-cooling (87 %) and mid-cooling (83 %) strategies, most commonly cold beverages (75 %) and neck collars (78 %), respectively. All cyclists planned on using at least one recovery strategy (massage: 87 %). CONCLUSIONS Our data indicate good alignment with current recommendations for competing in the heat, particularly for hydration, cooling and recovery strategies. Whilst the proportion of cyclists engaging in heat acclimation/acclimatisation is encouraging, greater awareness on adapting and implementing heat training is required.
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Affiliation(s)
- J D Périard
- Research Institute for Sport and Exercise, University of Canberra, Australia.
| | - M G Wilson
- Institute of Sport, Exercise and Health, University College London, UK; Aspetar Orthopaedic and Sports Medicine Hospital, Qatar
| | - S T Tebeck
- Department of Sports Science, South Australian Sports Institute of Sport, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia
| | - J Stanley
- Department of Sports Science, South Australian Sports Institute of Sport, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia; Australian Cycling Team, Auscycling, Gepps Cross, Australia
| | - O Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia
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4
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Convit L, Kelly MK, Jardine WT, Périard JD, Carr AJ, Warmington S, Bowe SJ, Snipe RMJ. Influence of acute heat mitigation strategies on core temperature, heart rate and aerobic performance in females: A systematic literature review. J Sports Sci 2024; 42:1491-1511. [PMID: 39262133 DOI: 10.1080/02640414.2024.2396225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 08/17/2024] [Indexed: 09/13/2024]
Abstract
This review examined the effect of acute heat mitigation strategies on physiological strain and exercise performance in females exercising in the heat. Three databases were searched for original research with an acute heat mitigation (intervention) and control strategy in active females and reporting core temperature, heart rate and/or aerobic exercise performance/capacity with ≥ 24°C wet bulb globe temperature. Hedges' g effect sizes were calculated to evaluate outcomes. Thirteen studies (n = 118) were included. Most studies that applied an acute heat mitigation strategy to females did not reduce thermal (9/10) or cardiovascular (6/6) strain or improve exercise performance/capacity (8/10). The most effective strategies for attenuating thermal strain were pre-cooling with ice-slurry (effect size = -2.2 [95% CI, -3.2, -1.1]) and ice-vests (-1.9 [-2.7, -1.1]), and pre- and per-cooling with an ice-vest (-1.8 [-2.9, -0.7]). Only pre-cooling with an ice-vest improved running performance (-1.8 [-2.9, -0.7]; ~0.43 min) whilst sodium hyperhydration improved cycling capacity at 70% V O2peak (0.8 [0.0, 1.6]; ~20.1 min). There is currently limited research on acute heat mitigation strategies in females, so the evidence for the efficacy is scarce. Some studies show beneficial effects with ice-slurry, ice-vests and sodium hyperhydration, which can guide future research to support female exercise performance in the heat.
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Affiliation(s)
- Lilia Convit
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Monica K Kelly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - William T Jardine
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Bruce, Australia
| | - Amelia J Carr
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Stuart Warmington
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Steven J Bowe
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Rhiannon M J Snipe
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
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Leslie E, Erram J, Cannon DT. Heat stress and the velocity-duration relationship in amateur runners. Physiol Rep 2024; 12:e70013. [PMID: 39152681 PMCID: PMC11329748 DOI: 10.14814/phy2.70013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024] Open
Abstract
Tolerance to high-intensity constant power exercise can be characterized by the hyperbolic power-duration (or velocity-duration) relationship. The hyperbola is defined by the asymptote (critical power or velocity) and the curvature constant (W' or D'). The effects of thermoregulatory stress on middle-distance running performance are equivocal-possibly due to the complexities of the hyperbolic velocity-duration relationship for these relatively short duration events. We aimed to measure the effects of heat stress on the velocity-duration relationship in amateur runners. Fifteen participants (23 ± 6 years) completed a series of constant-velocity running bouts to intolerance in three heat indices (MILD: 20°C, VERY HOT: 38°C, EXTREME: 55°C). Critical velocity (CV) in MILD (3.52 ± 0.86 m/s) was higher than VERY HOT (3.39 ± 0.82 m/s) and EXTREME (3.29 ± 1.05 m/s; F[2.28] = 3.80, p < 0.035) with no effect of thermal stress on D' (F[2.28] = 2.48, p = 0.11). In amateur competitive/recreational runners, heat stress of ≥38°C heat index negatively affected CV. Thus, even during relatively short events, such as middle-distance running where fluid loss is not a primary concern, heat stress may negatively impact performance.
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Affiliation(s)
- Eric Leslie
- School of Exercise & Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Jyotika Erram
- School of Exercise & Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Daniel T. Cannon
- School of Exercise & Nutritional SciencesSan Diego State UniversitySan DiegoCaliforniaUSA
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Bandiera D, Racinais S, Garrandes F, Adami PE, Bermon S, Pitsiladis YP, Tessitore A. Heat-related risk at Paris 2024: a proposal for classification and review of International Federations policies. Br J Sports Med 2024; 58:860-869. [PMID: 38950917 DOI: 10.1136/bjsports-2024-108310] [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] [Accepted: 06/07/2024] [Indexed: 07/03/2024]
Abstract
Several International Federations (IFs) employ specific policies to protect athletes' health from the danger of heat. Most policies rely on the measurement of thermal indices such as the Wet Bulb Globe Temperature (WBGT) to estimate the risk of heat-related illness. This review summarises the policies implemented by the 32 IFs of the 45 sports included in the Paris 2024 Olympic Games. It provides details into the venue type, measured parameters, used thermal indices, measurement procedures, mitigation strategies and specifies whether the policy is a recommendation or a requirement. Additionally, a categorisation of sports' heat stress risk is proposed. Among the 15 sports identified as high, very high or extreme risk, one did not have a heat policy, three did not specify any parameter measurement, one relied on water temperature, two on air temperature and relative humidity, seven on WBGT (six measured on-site and one estimated) and one on the Heat Stress Index. However, indices currently used in sports have been developed for soldiers or workers and may not adequately reflect the thermal strain endured by athletes. Notably, they do not account for the athletes' high metabolic heat production and their level of acclimation. It is, therefore, worthwhile listing the relevance of the thermal indices used by IFs to quantify the risk of heat stress, and in the near future, develop an index adapted to the specific needs of athletes.
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Affiliation(s)
- David Bandiera
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
| | - Sebastien Racinais
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
- UMR 866 INRAE Université de Montpellier, Montpellier, France
| | | | | | | | - Yannis P Pitsiladis
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, Kowloon, Hong Kong
| | - Antonio Tessitore
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
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Bongers CCWG, James LJ, Périard JD. From Tokyo through Paris to Los Angeles and beyond - Preparing athletes to face the heat of a warming world. J Sci Med Sport 2024:S1440-2440(24)00256-1. [PMID: 39107225 DOI: 10.1016/j.jsams.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024]
Affiliation(s)
- C C W G Bongers
- HAN University of Applied Sciences, School of Sport and Exercise, the Netherlands; Radboud University Medical Center, Department of Medical Biosciences, the Netherlands.
| | - L J James
- Loughborough University, National Centre for Sport and Exercise Medicine, School of Sport and Exercise Sciences, UK. https://twitter.com/LJJ_nutrition
| | - J D Périard
- University of Canberra, Research Institute for Sport and Exercise, Australia. https://twitter.com/DrJPeriard
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8
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Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme Heat and Occupational Health Risks. Annu Rev Public Health 2024; 45:315-335. [PMID: 38166501 DOI: 10.1146/annurev-publhealth-060222-034715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace.
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Affiliation(s)
- Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Stella Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | | | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
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Kelly MK, Smith ES, Brown HA, Jardine WT, Convit L, Bowe SJ, Condo D, Guy JH, Burke LM, Périard JD, Snipe RMJ, Snow RJ, Carr AJ. Auditing the Representation of Females Versus Males in Heat Adaptation Research. Int J Sport Nutr Exerc Metab 2024; 34:111-121. [PMID: 38211577 DOI: 10.1123/ijsnem.2023-0186] [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: 08/31/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 01/13/2024]
Abstract
The aim of this audit was to quantify female representation in research on heat adaptation. Using a standardized audit tool, the PubMed database was searched for heat adaptation literature from inception to February 2023. Studies were included if they investigated heat adaptation among female and male adults (≥18-50 years) who were free from noncommunicable diseases, with heat adaptation the primary or secondary outcome of interest. The number and sex of participants, athletic caliber, menstrual status, research theme, journal impact factor, Altmetric score, Field-Weighted Citation Impact, and type of heat exposure were extracted. A total of 477 studies were identified in this audit, including 7,707 participants with ∼13% of these being female. Most studies investigated male-only cohorts (∼74%, n = 5,672 males), with ∼5% (n = 360 females) including female-only cohorts. Of the 126 studies that included females, only 10% provided some evidence of appropriate methodological control to account for ovarian hormone status, with no study meeting best-practice recommendations. Of the included female participants, 40% were able to be classified to an athletic caliber, with 67% of these being allocated to Tier 2 (i.e., trained/developmental) or below. Exercise heat acclimation was the dominant method of heat exposure (437 interventions), with 21 studies investigating sex differences in exercise heat acclimation interventions. We recommend that future research on heat adaptation in female participants use methodological approaches that consider the potential impact of sexual dimorphism on study outcomes to provide evidence-based guidelines for female athletes preparing for exercise or competition in hot conditions.
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Affiliation(s)
- Monica K Kelly
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Ella S Smith
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Harry A Brown
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | - William T Jardine
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Lilia Convit
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Steven J Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
- Faculty and School of Health, Victoria University of Wellington, Kelburn, Wellington, New Zealand
| | - Dominique Condo
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
| | - Joshua H Guy
- School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Julien D Périard
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
| | | | - Rodney J Snow
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
| | - Amelia J Carr
- Centre for Sport Research, Deakin University, Burwood, VIC, Australia
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Tan XR, Stephenson MC, Alhadad SB, Loh KWZ, Soong TW, Lee JKW, Low ICC. Elevated brain temperature under severe heat exposure impairs cortical motor activity and executive function. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:233-244. [PMID: 37678507 PMCID: PMC10980903 DOI: 10.1016/j.jshs.2023.09.001] [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: 03/01/2023] [Revised: 05/27/2023] [Accepted: 07/20/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Excessive heat exposure can lead to hyperthermia in humans, which impairs physical performance and disrupts cognitive function. While heat is a known physiological stressor, it is unclear how severe heat stress affects brain physiology and function. METHODS Eleven healthy participants were subjected to heat stress from prolonged exercise or warm water immersion until their rectal temperatures (Tre) attained 39.5°C, inducing exertional or passive hyperthermia, respectively. In a separate trial, blended ice was ingested before and during exercise as a cooling strategy. Data were compared to a control condition with seated rest (normothermic). Brain temperature (Tbr), cerebral perfusion, and task-based brain activity were assessed using magnetic resonance imaging techniques. RESULTS Tbr in motor cortex was found to be tightly regulated at rest (37.3°C ± 0.4°C (mean ± SD)) despite fluctuations in Tre. With the development of hyperthermia, Tbr increases and dovetails with the rising Tre. Bilateral motor cortical activity was suppressed during high-intensity plantarflexion tasks, implying a reduced central motor drive in hyperthermic participants (Tre = 38.5°C ± 0.1°C). Global gray matter perfusion and regional perfusion in sensorimotor cortex were reduced with passive hyperthermia. Executive function was poorer under a passive hyperthermic state, and this could relate to compromised visual processing as indicated by the reduced activation of left lateral-occipital cortex. Conversely, ingestion of blended ice before and during exercise alleviated the rise in both Tre and Tbr and mitigated heat-related neural perturbations. CONCLUSION Severe heat exposure elevates Tbr, disrupts motor cortical activity and executive function, and this can lead to impairment of physical and cognitive performance.
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Affiliation(s)
- Xiang Ren Tan
- Health and Social Sciences, Singapore Institute of Technology, Singapore 138683, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Mary C Stephenson
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore
| | - Sharifah Badriyah Alhadad
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - Kelvin W Z Loh
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - Tuck Wah Soong
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
| | - Jason K W Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117510, Singapore; N.1 Institute for Health, National University of Singapore, Singapore 117456, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore.
| | - Ivan C C Low
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore.
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11
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van de Kerkhof TM, Bongers CCWG, Périard JD, Eijsvogels TMH. Performance Benefits of Pre- and Per-cooling on Self-paced Versus Constant Workload Exercise: A Systematic Review and Meta-analysis. Sports Med 2024; 54:447-471. [PMID: 37803106 PMCID: PMC10933154 DOI: 10.1007/s40279-023-01940-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Exercise in hot environments impairs endurance performance. Cooling interventions can attenuate the impact of heat stress on performance, but the influence of an exercise protocol on the magnitude of performance benefit remains unknown. This meta-analytical review compared the effects of pre- and per-cooling interventions on performance during self-paced and constant workload exercise in the heat. METHODS The study protocol was preregistered at the Open Science Framework ( https://osf.io/wqjb3 ). A systematic literature search was performed in PubMed, Web of Science, and MEDLINE from inception to 9 June, 2023. We included studies that examined the effects of pre- or per-cooling on exercise performance in male individuals under heat stress (> 30 °C) during self-paced or constant workload exercise in cross-over design studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized trials. RESULTS Fifty-nine studies (n = 563 athletes) were identified from 3300 records, of which 40 (n = 370 athletes) used a self-paced protocol and 19 (n = 193 athletes) used a constant workload protocol. Eighteen studies compared multiple cooling interventions and were included more than once (total n = 86 experiments and n = 832 paired measurements). Sixty-seven experiments used a pre-cooling intervention and 19 used a per-cooling intervention. Average ambient conditions were 34.0 °C [32.3-35.0 °C] and 50.0% [40.0-55.3%] relative humidity. Cooling interventions attenuated the performance decline in hot conditions and were more effective during a constant workload (effect size [ES] = 0.62, 95% confidence interval [CI] 0.44-0.81) compared with self-paced exercise (ES = 0.30, 95% CI 0.18-0.42, p = 0.004). A difference in performance outcomes between protocols was only observed with pre-cooling (ES = 0.74, 95% CI 0.50-0.98 vs ES = 0.29, 95% CI 0.17-0.42, p = 0.001), but not per-cooling (ES = 0.45, 95% CI 0.16-0.74 vs ES = 0.35, 95% CI 0.01-0.70, p = 0.68). CONCLUSIONS Cooling interventions attenuated the decline in performance during exercise in the heat, but the magnitude of the effect is dependent on exercise protocol (self-paced vs constant workload) and cooling type (pre- vs per-cooling). Pre-cooling appears to be more effective in attenuating the decline in exercise performance during a constant workload compared with self-paced exercise protocols, whereas no differences were found in the effectiveness of per-cooling.
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Affiliation(s)
- Tessa M van de Kerkhof
- Department of Physiology (392), Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Coen C W G Bongers
- Department of Physiology (392), Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- School of Sports and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Canberra, ACT, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology (392), Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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12
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Ristanović L, Cuk I, Villiger E, Stojiljković S, Nikolaidis PT, Weiss K, Knechtle B. The pacing differences in performance levels of marathon and half-marathon runners. Front Psychol 2023; 14:1273451. [PMID: 38187410 PMCID: PMC10771621 DOI: 10.3389/fpsyg.2023.1273451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Many studies indicate a considerable impact of optimal pacing on long-distance running performance. Given that the amount of carbohydrates in metabolic processes increases supralinearly with the running intensity, we may observe differences between the pacing strategies of two long-distance races and different performance levels of runners. Accordingly, the present study aimed to examine the differences in pacing strategies between marathon and half-marathon races regarding the performance levels of runners. Methods The official results and split times from a total of 208,760 (marathon, N = 75,492; half-marathon, N = 133,268) finishers in the "Vienna City Marathon" between 2006 and 2018 were analyzed. The percentage of the average change of speed for each of the five segments (CS 1-5), as well as the absolute change of speed (ACS) were calculated. The CS 1-5 for the marathon are as follows: up to the 10th km, 10th - 20th km, 20th - 30th km, 30th - 40th km, and from the 40th km to the 42.195 km. For the half-marathon, the CS 1-5 are half of the marathon values. Four performance groups were created as quartiles of placement separately for sexes and races: high-level (HL), moderate to high-level (MHL), moderate to low-level (MLL), and low-level (LL). Results Positive pacing strategies (i.e., decrease of speed) were observed in all performance groups of both sex and race. Across CS 1-5, significant main effects (p < 0.001) were observed for the segment, performance level, and their interaction in both sex and race groups. All LL groups demonstrated higher ACS (men 7.9 and 6.05%, as well as women 5.83 and 5.49%, in marathon and half-marathon, respectively), while the HL performance group showed significantly lower ACS (men 4.14 and 2.97%, as well as women 3.16 and 2.77%, in marathon and half-marathon, respectively). Significant main effects (p < 0.001) for the race were observed but with a low effect size in women (ŋ2 = 0.001). Discussion Better runners showed more even pacing than slower runners. The half-marathoners showed more even pacing than the marathoners across all performance groups but with a trivial practical significance in women.
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Affiliation(s)
- Ljubica Ristanović
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Ivan Cuk
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Elias Villiger
- Klinik für Allgemeine Innere Medizin, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Pantelis T. Nikolaidis
- Exercise Physiology Laboratory, Nikaia, Greece
- School of Health and Caring Sciences, University of West Attica, Athens, Greece
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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Galan-Lopez N, Esh CJ, Leal DV, Gandini S, Lucas R, Garrandes F, Bermon S, Adami PE, Kajeniene A, Hosokawa Y, Chrismas BCR, Stevens CJ, Taylor L. Heat Preparation and Knowledge at the World Athletics Race Walking Team Championships Muscat 2022. Int J Sports Physiol Perform 2023:1-12. [PMID: 37279899 DOI: 10.1123/ijspp.2022-0446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE To assess elite racewalkers' preparation strategies, knowledge, and general practices for competition in the heat and their health status during the World Athletics Race Walking Teams Championships (WRW) Muscat 2022. METHODS Sixty-six elite racewalkers (male: n = 42; mean age = 25.8 y) completed an online survey prior to WRW Muscat 2022. Athletes were grouped by sex (males vs females) and climate (self-reported) they live/trained in (hot vs temperate/cold), with differences/relationships between groups assessed. Relationships between ranking (medalist/top 10 vs nonmedalist/nontop 10) and precompetition use of heat acclimation/acclimatization (HA) were assessed. RESULTS All surveyed medalists (n = 4) implemented, and top 10 finishers were more likely to report using (P = .049; OR = 0.25; 95% CI, 0.06%-1%), HA before the championships. Forty-three percent of athletes did not complete specific HA training. Females (8% [males 31%]) were less likely to have measured core temperature (P = .049; OR = 0.2; 95% CI, 0.041-0.99) and more likely to not know expected conditions in Muscat (42% vs 14%; P = .016; OR = 4.3; 95% CI, 1%-14%) or what wet bulb globe temperature is (83% vs 55%; P = .024; OR = 4.1; 95% CI, 1%-14%). CONCLUSIONS Athletes who implemented HA before the championships tended to place better than those who did not. Forty-three percent of athletes did not prepare for the expected hot conditions at the WRW Muscat 2022, primarily attributed to challenges in accessing and/or cost of equipment/facilities for HA strategies. Further efforts to bridge the gap between research and practice in this elite sport are needed, particularly in female athletes.
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Affiliation(s)
- Natalia Galan-Lopez
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
| | - Chris J Esh
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
- Aspetar, Orthopedic and Sports Medicine Hospital, FIFA Medical Center of Excellence, Doha,Qatar
| | - Diogo Vaz Leal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia,Portugal
| | - Silvia Gandini
- Centro Studi-Federazione Italiana di Atletica Leggera, Rome,Italy
| | | | - Frederic Garrandes
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Stephane Bermon
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Alma Kajeniene
- Department of Sports Medicine, Lithuanian University of Health Sciences, Kaunas,Lithuania
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Shinjuku-ku,Japan
| | | | - Christopher J Stevens
- Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, Coffs Harbour, NSW,Australia
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Moore Park, NSW,Australia
- Human Performance Research Center, University of Technology Sydney (UTS), Sydney, NSW,Australia
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14
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Choo HC, Lee M, Yeo V, Poon W, Ihsan M. The effect of cold water immersion on the recovery of physical performance revisited: A systematic review with meta-analysis. J Sports Sci 2023; 40:2608-2638. [PMID: 36862831 DOI: 10.1080/02640414.2023.2178872] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
This review evaluated the effect of CWI on the temporal recovery profile of physical performance, accounting for environmental conditions and prior exercise modality. Sixty-eight studies met the inclusion criteria. Standardised mean differences were calculated for parameters assessed at <1, 1-6, 24, 48, 72 and ≥96 h post-immersion. CWI improved short-term recovery of endurance performance (p = 0.01, 1 h), but impaired sprint (p = 0.03, 1 h) and jump performance (p = 0.04, 6h). CWI improved longer-term recovery of jump performance (p < 0.01-0.02, 24 h and 96 h) and strength (p < 0.01, 24 h), which coincided with decreased creatine kinase (p < 0.01-0.04, 24-72 h), improved muscle soreness (p < 0.01-0.02, 1-72 h) and perceived recovery (p < 0.01, 72 h). CWI improved the recovery of endurance performance following exercise in warm (p < 0.01) and but not in temperate conditions (p = 0.06). CWI improved strength recovery following endurance exercise performed at cool-to-temperate conditions (p = 0.04) and enhanced recovery of sprint performance following resistance exercise (p = 0.04). CWI seems to benefit the acute recovery of endurance performance, and longer-term recovery of muscle strength and power, coinciding with changes in muscle damage markers. This, however, depends on the nature of the preceding exercise.
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Affiliation(s)
- Hui Cheng Choo
- Sport Physiology Department, Sport Science and Medicine Centre, Singapore Sport Institute, Singapore
| | - Marcus Lee
- Sports Science, National Youth Sports Institute, Singapore
| | - Vincent Yeo
- Sport Physiology Department, Sport Science and Medicine Centre, Singapore Sport Institute, Singapore
| | - Wayne Poon
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Mohammed Ihsan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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15
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Heatherly AJ, Caputo JL, Johnson SL, Fuller DK. Heat Acclimation Knowledge among Recreational Runners. Sports (Basel) 2023; 11:sports11020049. [PMID: 36828334 PMCID: PMC9965591 DOI: 10.3390/sports11020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Heat acclimation (HA) is the foremost method of preventing exertional heat illness during exercise in hot and humid environments. However, the prevalence of HA training and its associated knowledge is not currently known in recreational running populations. The purpose of this study was to determine the knowledge of recreational runners toward HA. A survey consisting of 38 questions that required approximately 10-15 min to complete was disseminated to running clubs throughout the Southeastern United States. Questions were designed to collect data on participant demographics, yearly training habits, and HA knowledge. Recreational runners (N = 125) demonstrated a lack of knowledge toward proper HA training and its associated benefits. Participants largely received HA advice from their peers (31.2%) and reported no professional guidance in their training (79.2%). Finally, participants' beliefs toward proper HA training differed among training groups with moderate and high groups perceiving greater frequency, miles/wk, and min/wk as appropriate for HA compared to the low group (p ≤ 0.05). Due to the warmer temperatures and higher relative humidity experienced in the southeastern, southwestern, and mid-Atlantic locations of the United States and throughout certain regions of the European Union, governing bodies in sport and exercise science should develop more educational initiatives to convey the importance and advantages of HA, especially when runners are training for major marathons that are typically held in the late spring and early fall seasons.
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Affiliation(s)
| | - Jennifer L. Caputo
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN 37132, USA
| | - Samantha L. Johnson
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN 37132, USA
| | - Dana K. Fuller
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN 37132, USA
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16
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Racinais S, Hosokawa Y, Akama T, Bermon S, Bigard X, Casa DJ, Grundstein A, Jay O, Massey A, Migliorini S, Mountjoy M, Nikolic N, Pitsiladis YP, Schobersberger W, Steinacker JM, Yamasawa F, Zideman DA, Engebretsen L, Budgett R. IOC consensus statement on recommendations and regulations for sport events in the heat. Br J Sports Med 2023; 57:8-25. [PMID: 36150754 PMCID: PMC9811094 DOI: 10.1136/bjsports-2022-105942] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 01/07/2023]
Abstract
This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor environmental conditions before and during an event; to provide sufficient ice, shading and cooling; and to work with the IF to remove regulatory and logistical limitations. The second section summarises recommendations that are directly associated with athletes' behaviours, which include the role and methods for heat acclimation; the management of hydration; and adaptation to the warm-up and clothing. The third section explains the specific medical management of exertional heat stroke (EHS) from the field of play triage to the prehospital management in a dedicated heat deck, complementing the usual medical services. The fourth section provides an example for developing an environmental heat risk analysis for sport competitions across all IFs. In summary, while EHS is one of the leading life-threatening conditions for athletes, it is preventable and treatable with the proper risk mitigation and medical response. The protection of athletes competing in the heat involves the close cooperation of the local organising committee, the national and international federations, the athletes and their entourages and the medical team.
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Affiliation(s)
- Sebastien Racinais
- Research and Scientific Support Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | | | - Xavier Bigard
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | - Douglas J Casa
- Korey Stringer Institiute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Andrew Grundstein
- Department of Geography, University of Georgia, Athens, Georgia, USA
| | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andrew Massey
- Medical Department, Federation Internationale de Football Association, Zurich, Switzerland
| | | | | | | | | | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine & Health Tourism (ISAG), UMIT Tirol – Private University for Health Sciences and technology, Hall, Austria,University Hospital/Tirol Kliniken, Innsbruck, Austria
| | | | | | - David Anthony Zideman
- International Olympic Committee Medical and Scientific Games Group, Pinner, Middlesex, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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17
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Derman W, Runciman P, Eken M, Boer PH, Blauwet C, Bogdos M, Idrisova G, Jordaan E, Kissick J, LeVan P, Lexell J, Mohammadi F, Patricio M, Schwellnus M, Webborn N, Willick SE, Yagishita K. Incidence and burden of illness at the Tokyo 2020 Paralympic Games held during the COVID-19 pandemic: a prospective cohort study of 66 045 athlete days. Br J Sports Med 2022; 57:bjsports-2022-106312. [PMID: 36588431 DOI: 10.1136/bjsports-2022-106312] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To describe the incidence and burden of illness at the Tokyo 2020 Paralympic Games, which was organised with strict COVID-19 countermeasures. METHODS Daily illnesses were recorded via the web-based injury and illness surveillance system (teams with their own medical staff; n=81), and local polyclinic services (teams without their own medical staff; n=81). Illness proportion, incidence and burden were reported for all illnesses and in subgroups by sex, age, competition period, sports and physiological system. RESULTS 4403 athletes (1853 female and 2550 male) from 162 countries were monitored for the 15-day period of the Tokyo Paralympic Games (66 045 athlete days). The overall incidence of illnesses per 1000 athlete days was 4.2 (95% CI 3.8 to 4.8; 280 illnesses). The highest incidences were in wheelchair tennis (7.1), shooting (6.1) and the new sport of badminton (5.9). A higher incidence was observed in female compared with male athletes (5.1 vs 3.6; p=0.005), as well as during the precompetition versus competition period (7.0 vs 3.5; p<0.0001). Dermatological and respiratory illnesses had the highest incidence (1.1 and 0.8, respectively). Illness burden was 4.9 days per 1000 athlete days and 23% of illnesses resulted in time loss from training/competition>1 day. CONCLUSION The incidence of illness at the Tokyo 2020 Paralympic Games was the lowest yet to be recorded in either the summer or winter Paralympic Games. Dermatological and respiratory illnesses were the most common, with the burden of respiratory illness being the highest, largely due to time loss associated with COVID-19 cases. Infection countermeasures appeared successful in reducing respiratory and overall illness, suggesting implementation in future Paralympic Games may mitigate illness risk.
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Affiliation(s)
- Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- IOC Research Center, Pretoria, South Africa
| | - Phoebe Runciman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Maaike Eken
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Pieter-Henk Boer
- Department of Human Movement Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Manos Bogdos
- Alzheimer's Disease Center, Nestor Psychogeriatric Society, Athens, Greece
| | - Guzel Idrisova
- Sport and Health, Lesgaft National State University of Physical Education, St. Petersburg, Russian Federation
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - James Kissick
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Philipe LeVan
- Pôle Médical, Institut National des Sports de l'Expertise et de la Performance, Paris, France
| | - Jan Lexell
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | - Fariba Mohammadi
- Department of Sport Medicine, Sport Sciences Research Institute, Tehran, Iran (the Islamic Republic of)
| | - Marcelo Patricio
- Trauma Observatory, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil
| | - Martin Schwellnus
- IOC Research Center, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nick Webborn
- School of Sport and Health Sciences, Loughborough University, Loughborough, UK
| | - Stuart E Willick
- Physical Medicine and Rehabilitation, University of Utah Orthopaedic Center, Salt Lake City, Utah, USA
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Yanaoka T, Iwahashi M, Hasegawa H. Effects of mixed-method cooling between exercise bouts on thermoregulation and cycling time-trial performance in the heat. J Therm Biol 2022; 109:103329. [DOI: 10.1016/j.jtherbio.2022.103329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/01/2022] [Accepted: 09/11/2022] [Indexed: 11/30/2022]
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Périard JD, DeGroot D, Jay O. Exertional heat stroke in sport and the military: epidemiology and mitigation. Exp Physiol 2022; 107:1111-1121. [PMID: 36039024 PMCID: PMC9826288 DOI: 10.1113/ep090686] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
NEW FINDINGS What is the topic of this review? Exertional heat stroke epidemiology in sport and military settings, along with common risk factors and strategies and policies designed to mitigate its occurrence. What advances does it highlight? Individual susceptibility to exertional heat stroke risk is dependent on the interaction of intrinsic and extrinsic factors. Heat policies in sport should assess environmental conditions, as well as the characteristics of the athlete, clothing/equipment worn and activity level of the sport. Exertional heat stroke risk reduction in the military should account for factors specific to training and personnel. ABSTRACT Exertional heat illness occurs along a continuum, developing from the relatively mild condition of muscle cramps, to heat exhaustion, and in some cases to the life-threatening condition of heat stroke. The development of exertional heat stroke (EHS) is associated with an increase in core temperature stemming from inadequate heat dissipation to offset the rate of metabolically generated heat. Susceptibility to EHS is linked to the interaction of several factors including environmental conditions, individual characteristics, health conditions, medication and drug use, behavioural responses, and sport/organisational requirements. Two settings in which EHS is commonly observed are competitive sport and the military. In sport, the exact prevalence of EHS is unclear due to inconsistent exertional heat illness terminology, diagnostic criteria and data reporting. In contrast, exertional heat illness surveillance in the military is facilitated by standardised case definitions, a requirement to report all heat illness cases and a centralised medical record repository. To mitigate EHS risk, several strategies can be implemented by athletes and military personnel, including heat acclimation, ensuring adequate hydration, cold-water immersion and mandated work-to-rest ratios. Organisations may also consider developing sport or military task-specific heat stress policies that account for the evaporative heat loss requirement of participants, relative to the evaporative capacity of the environment. This review examines the epidemiology of EHS along with the strategies and policies designed to reduce its occurrence in sport and military settings. We highlight the nuances of identifying individuals at risk of EHS and summarise the benefits and shortcomings of various mitigation strategies.
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Affiliation(s)
- Julien D. Périard
- Research Institute for Sport and ExerciseUniversity of CanberraCanberraAustralia
| | - David DeGroot
- Army Heat CenterMartin Army Community HospitalFort BenningGAUSA
| | - Ollie Jay
- Thermal Ergonomics LaboratoryHeat and Health Research IncubatorFaculty of Medicine and HealthUniversity of SydneyCamperdownAustralia
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Heat Adaptation and Nutrition Practices: Athlete and Practitioner Knowledge and Use. Int J Sports Physiol Perform 2022; 17:1011-1024. [PMID: 35338104 DOI: 10.1123/ijspp.2021-0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To survey elite athletes and practitioners to identify (1) knowledge and application of heat acclimation/acclimatization (HA) interventions, (2) barriers to HA application, and (3) nutritional practices supporting HA. METHODS Elite athletes (n = 55) and practitioners (n = 99) completed an online survey. Mann-Whitney U tests (effect size [ES; r]) assessed differences between ROLE (athletes vs practitioners) and CLIMATE (hot vs temperate). Logistic regression and Pearson chi-square (ES Phi [ϕ]) assessed relationships. RESULTS Practitioners were more likely to report measuring athletes' core temperature (training: practitioners 40% [athletes 15%]; P = .001, odds ratio = 4.0, 95% CI, 2%-9%; competition: practitioners 25% [athletes 9%]; P = .020, odds ratio = 3.4, 95% CI, 1%-10%). Practitioners (55% [15% athletes]) were more likely to perceive rectal as the gold standard core temperature measurement site (P = .013, ϕ = .49, medium ES). Temperate (57% [22% hot]) CLIMATE dwellers ranked active HA effectiveness higher (P < .001, r = .30, medium ES). Practitioners commonly identified athletes' preference (48%), accessibility, and cost (both 47%) as barriers to HA. Increasing carbohydrate intake when training in the heat was more likely recommended by practitioners (49%) than adopted by athletes (26%; P = .006, 95% CI, 0.1%-1%). Practitioners (56% [28% athletes]) were more likely to plan athletes' daily fluid strategies, adopting a preplanned approach (P = .001; 95% CI, 0.1%-1%). CONCLUSIONS Practitioners, and to a greater extent athletes, lacked self-reported key HA knowledge (eg, core temperature assessment/monitoring methods) yet demonstrated comparatively more appropriate nutritional practices (eg, hydration).
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21
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Marathon Performance and Pacing in the Doha 2019 Women's IAAF World Championships: Extreme Heat, Suboptimal Pacing, and High Failure Rates. Int J Sports Physiol Perform 2022; 17:1119-1125. [PMID: 35580843 DOI: 10.1123/ijspp.2022-0020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The Doha 2019 women's World Championship marathon took place in extreme hot (32 °C), humid conditions (74% relative humidity) culminating in unprecedented (41%) failure rates. We explored whether extreme heat or suboptimal pacing was responsible for diminished performance against a temperate "control" (London 2017: 19 °C, 59% relative humidity) and whether physical characteristics (eg, body surface area, estimated maximal oxygen uptake, habitual heat exposure) explained performance. METHOD Five-kilometer-pace (km·h-1) data underwent repeated-measures analyses of hot (Doha, n = 40) versus temperate pacing and performance (London, n = 78) within and between marathon pacing (finisher quartiles normalized against personal best; n = 10 per group) and within hot marathon finishers versus nonfinishers (up to 10 km; normalized data). Possible predictors (multiple regression) of hot marathon pacing were explored. Tests to .05 alpha level, partial eta squared (ηp2) indicates effect size. RESULTS Mean (SD) of Doha (14.82 [0.96] km·h-1) pace was slower (London: 15.74 [0.96] km·h-1; P = .00; ηp2=.500). In hot conditions, athletes finishing in positions 1 to 10 (group 1) started more conservatively (93.7% [2.1%] of personal best) than slower runners (groups 3 and 4; 96.6% [2.8%] of personal best; P < .05, ηp2=.303). Groups were not different at 15 km and then slowed immediately (groups 3 and 4) or after 20 km (group 2). Finishers and nonfinishers adopted similar pace up to 10 km (P > .05, ηp2=.003). World ranking predicted (P = .00; r2 = .248) average pace in Doha. CONCLUSION Extreme hot conditions reduced performance. Top 10 athletes adopted a conservative initial pace, whereas lower-placing athletes adopted a faster, aggressive start. Pacing alone does not explain high failure rates in nonfinishers. Athletes competing in the heat should initially pace conservatively to optimize performance.
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22
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Carr AJ, Vallance BS, Rothwell J, Rea AE, Burke LM, Guy JH. Competing in Hot Conditions at the Tokyo Olympic Games: Preparation Strategies Used by Australian Race Walkers. Front Physiol 2022; 13:836858. [PMID: 35399272 PMCID: PMC8983867 DOI: 10.3389/fphys.2022.836858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction The Tokyo 2021 Olympic Games was anticipated to expose athletes to the most challenging climatic conditions experienced in the history of the modern Olympic Games. This study documents strategies executed by Australian endurance athletes during the team holding camp and Olympic Games experiences, including (1) baseline physiological data, training data, and heat acclimation/acclimatization practices; (2) pre- and in-race cooling and nutritional strategies, and (3) Olympic Games race performance data. Methods Six athletes (three males, three females; age 24 ± 4 years; VO2max 63.2 ± 8.7 mL⋅kg–1⋅min–1; sum of 7 skinfolds 53.1 ± 23.4 mm) were observed prior to and during the team holding camp held in Cairns, QLD, Australia. Athletes completed 6–7 weeks of intermittent heat acclimation training, utilizing a combination of 2–4 passive and active acclimation sessions per week. Active acclimation was systematically increased via exposure time, exercise intensity, temperature, and humidity. In the team holding camp, athletes undertook a further 23 heat acclimatization training sessions over 18 days in a continuous fashion. Hyperhydration (using sodium and glycerol osmolytes), and internal and external pre-and in-race cooling methods were also utilized. A low energy availability intervention was implemented with two athletes, as a strategy to periodize ideal race body composition. Race performance data and environmental conditions from the 2021 Olympic Games were also documented. Results The highest values for aerobic capacity were 63.6 mL⋅kg–1⋅min–1 for female race walkers and 73.7 mL⋅kg–1⋅min–1 for males. Training volume for the six athletes was the highest in the second week of the team holding camp, and training intensity was lowest in the first week of the team holding camp. Performance outcomes included 6th place in the women’s 20 km event (1:30:39), which was within 2% of her 20 km personal best time, and 8th place in the men’s 50 km event (3:52:01), which was a personal best performance time. Conclusion Periodized training, heat acclimation/acclimatization, cooling and nutritional strategies study may have contributed to the race outcomes in Olympic Games held hot, humid conditions, for the race walkers within this observational study.
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Affiliation(s)
- Amelia J. Carr
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
- *Correspondence: Amelia J. Carr,
| | - Brent S. Vallance
- Athletics Australia, Melbourne, VIC, Australia
- Exercise and Nutrition Research Program, Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Jessica Rothwell
- Athletics Australia, Melbourne, VIC, Australia
- Victorian Institute of Sport, Melbourne, VIC, Australia
| | - Anna E. Rea
- School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Louise M. Burke
- Exercise and Nutrition Research Program, Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Joshua H. Guy
- School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, QLD, Australia
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23
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Responses to a 5-Day Sport-Specific Heat Acclimatization Camp in Elite Female Rugby Sevens Athletes. Int J Sports Physiol Perform 2022; 17:969-978. [PMID: 35303714 DOI: 10.1123/ijspp.2021-0406] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the physiological (resting core temperature, exercising heart rate, and sweat rate) and psychophysical (rating of perceived exertion, thermal sensation, and thermal comfort) responses to a short-term heat acclimatization (HA) training camp in elite female rugby sevens athletes. METHODS Nineteen professional female rugby sevens athletes participated in a 5-day HA camp in Darwin, Australia (training average: 32.2°C and 58% relative humidity). Training involved normal team practice prescribed by appropriate staff. Markers of physiological and psychophysical adaptations to HA were collected at various stages during the camp. Partial eta-squared effect sizes (from linear mixed-effects models), rank-biserial correlations (from Freidman tests), and P values were used to assess changes across the protocol. RESULTS Resting core temperature did not significantly change. Exercising heart rate showed a large and significant reduction from day 1 to day 5 (175 [13] vs 171 [12] beats·min-1), as did sweat rate (1.1 [0.3] vs 1.0 [0.2] L·h-1). Thermal sensation showed a large and significant reduction between day 1 and day 5 (median [interquartile range] = 5 [5-5.5] vs 4.5 [4-5]). Changes in rating of perceived exertion and thermal comfort were unclear. CONCLUSIONS Beneficial cardiovascular adaptations were observed simultaneously across a full squad of elite female rugby sevens players (without expensive facilities/equipment or modifying training content). However, beneficial changes in resting core temperature, sweat rate, and thermal/effort perceptions likely require a greater thermal impulse. These data contribute to the development of evidence-informed practice for minimal effective HA doses in female team-sport athletes, who are underrepresented in the current research.
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24
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Racinais S, Havenith G, Aylwin P, Ihsan M, Taylor L, Adami PE, Adamuz MC, Alhammoud M, Alonso JM, Bouscaren N, Buitrago S, Cardinale M, van Dyk N, Esh CJ, Gomez-Ezeiza J, Garrandes F, Holtzhausen L, Labidi M, Lange G, Lloyd A, Moussay S, Mtibaa K, Townsend N, Wilson MG, Bermon S. Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships. Br J Sports Med 2022; 56:439-445. [PMID: 35165084 PMCID: PMC8995810 DOI: 10.1136/bjsports-2021-104569] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 12/14/2022]
Abstract
Purpose To determine associations between thermal responses, medical events, performance, heat acclimation and health status during a World Athletics Championships in hot-humid conditions. Methods From 305 marathon and race-walk starters, 83 completed a preparticipation questionnaire on health and acclimation. Core (Tcore; ingestible pill) and skin (Tskin; thermal camera) temperatures were measured in-competition in 56 and 107 athletes, respectively. 70 in-race medical events were analysed retrospectively. Performance (% personal best) and did not finish (DNF) were extracted from official results. Results Peak Tcore during competition reached 39.6°C±0.6°C (maximum 41.1°C). Tskin decreased from 32.2°C±1.3°C to 31.0°C±1.4°C during the races (p<0.001). Tcore was not related to DNF (25% of starters) or medical events (p≥0.150), whereas Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were (p≤0.029). A third of the athletes reported symptoms in the 10 days preceding the event, mainly insomnia, diarrhoea and stomach pain, with diarrhoea (9% of athletes) increasing the risk of in-race medical events (71% vs 17%, p<0.001). Athletes (63%) who performed 5–30 days heat acclimation before the competition: ranked better (18±13 vs 28±13, p=0.009), displayed a lower peak Tcore (39.4°C±0.4°C vs 39.8°C±0.7°C, p=0.044) and larger in-race decrease in Tskin (−1.4°C±1.0°C vs −0.9°C±1.2°C, p=0.060), than non-acclimated athletes. Although not significant, they also showed lower DNF (19% vs 30%, p=0.273) and medical events (19% vs 32%, p=0.179). Conclusion Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were important indicators of heat tolerance. While heat-acclimated athletes ranked better, recent diarrhoea represented a significant risk factor for DNF and in-race medical events.
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Affiliation(s)
- Sebastien Racinais
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Polly Aylwin
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Mohammed Ihsan
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Paolo Emilio Adami
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Maria-Carmen Adamuz
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Marine Alhammoud
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Juan Manuel Alonso
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Nicolas Bouscaren
- Inserm CIC1410, CHU Reunion, La Réunion, Réunion.,Interuniversity Laboratory of Human Movement Biology-EA 7424, Université Jean Monnet Saint-Etienne, Saint-Etienne, France
| | | | - Marco Cardinale
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Nicol van Dyk
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Chris J Esh
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,School of Sport Exercise and Health Sciences, Loughborough, UK
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Frederic Garrandes
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Louis Holtzhausen
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Section Sports Medicine, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Mariem Labidi
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | | | - Alexander Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Sebastien Moussay
- Unicaen, Inserm, Comete, GIP Cyceron, Normandie Universite, Caen, France
| | - Khouloud Mtibaa
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Nathan Townsend
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Mathew G Wilson
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Stephane Bermon
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
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25
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Abstract
In recent years, there has been a significant expansion in female participation in endurance (road and trail) running. The often reported sex differences in maximal oxygen uptake (VO2max) are not the only differences between sexes during prolonged running. The aim of this narrative review was thus to discuss sex differences in running biomechanics, economy (both in fatigue and non-fatigue conditions), substrate utilization, muscle tissue characteristics (including ultrastructural muscle damage), neuromuscular fatigue, thermoregulation and pacing strategies. Although males and females do not differ in terms of running economy or endurance (i.e. percentage VO2max sustained), sex-specificities exist in running biomechanics (e.g. females have greater non-sagittal hip and knee joint motion compared to males) that can be partly explained by anatomical (e.g. wider pelvis, larger femur-tibia angle, shorter lower limb length relative to total height in females) differences. Compared to males, females also show greater proportional area of type I fibres, are more able to use fatty acids and preserve carbohydrates during prolonged exercise, demonstrate a more even pacing strategy and less fatigue following endurance running exercise. These differences confer an advantage to females in ultra-endurance performance, but other factors (e.g. lower O2 carrying capacity, greater body fat percentage) counterbalance these potential advantages, making females outperforming males a rare exception. The present literature review also highlights the lack of sex comparison in studies investigating running biomechanics in fatigue conditions and during the recovery process.
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26
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Fenemor SP, Gill ND, Driller MW, Mills B, Casadio JR, Beaven CM. The relationship between physiological and performance variables during a hot/humid international rugby sevens tournament. Eur J Sport Sci 2021; 22:1499-1507. [PMID: 34429018 DOI: 10.1080/17461391.2021.1973111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To characterise physiological responses to competing in an international rugby sevens tournament played in hot/humid conditions, core temperature (Tc) and Tc predictors were collected from 11 elite men's rugby sevens athletes competing in the Oceania sevens tournament in Suva, Fiji. Tc, body mass change, sweat electrolytes, playing minutes, total running distance, high speed running distance (HSD), psychrometric wet bulb temperature and exertional heat illness symptoms were collected pre, during and post games. Linear mixed-models were used to assess the effect of Tc predictors on post-game Tc, along with differences in Tc across measurement periods. Compared to baseline on both tournament days, mean Tc was higher during all between game (recovery) measures (all d >1.30, p <0.01). On both tournament days, eight athletes reached a post-game Tc >39.0°C, with several athletes reaching >39.0°C during warm-ups. Mean post-game Tc was related to playing minutes, total running distance, HSD, and post warm-up Tc (all p < 0.01). The Tc during warm-ups and games regularly exceeded those demonstrated to be detrimental to repeated sprint performance (> 39°C). Warm-up Tc represents the easiest predictor of post-game Tc to control via time/intensity modulation and the use of appropriate pre- and per-cooling strategies. Practitioners should be prepared to modulate warm-ups and other heat preparation strategies based on likely environmental conditions during hot/humid tournaments.
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Affiliation(s)
- Stephen P Fenemor
- Te Huataki Waiora School of Health, University of Waikato Adams Centre for High Performance, Mt Maunganui, New Zealand.,High Performance Sport New Zealand, Auckland, New Zealand
| | - N D Gill
- Te Huataki Waiora School of Health, University of Waikato Adams Centre for High Performance, Mt Maunganui, New Zealand.,New Zealand Rugby Union, Wellington, New Zealand
| | - M W Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - B Mills
- New Zealand Rugby Union, Wellington, New Zealand
| | - J R Casadio
- High Performance Sport New Zealand, Auckland, New Zealand
| | - C M Beaven
- Te Huataki Waiora School of Health, University of Waikato Adams Centre for High Performance, Mt Maunganui, New Zealand
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27
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McIntyre RD, Zurawlew MJ, Oliver SJ, Cox AT, Mee JA, Walsh NP. A comparison of heat acclimation by post-exercise hot water immersion and exercise in the heat. J Sci Med Sport 2021; 24:729-734. [DOI: 10.1016/j.jsams.2021.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/01/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
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28
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Hollander K, Klöwer M, Richardson A, Navarro L, Racinais S, Scheer V, Murray A, Branco P, Timpka T, Junge A, Edouard P. Apparent temperature and heat-related illnesses during international athletic championships: A prospective cohort study. Scand J Med Sci Sports 2021; 31:2092-2102. [PMID: 34333808 DOI: 10.1111/sms.14029] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
International outdoor athletics championships are typically hosted during the summer season, frequently in hot and humid climatic conditions. Therefore, we analyzed the association between apparent temperature and heat-related illnesses occurrence during international outdoor athletics championships and compared its incidence rates between athletics disciplines. Heat-related illnesses were selected from illness data prospectively collected at seven international outdoor athletics championships between 2009 and 2018 using a standardized methodology. The Universal Thermal Climate Index (UTCI) was calculated as a measure of the apparent temperature based on weather data for each day of the championships. Heat-related illness numbers and (daily) incidence rates were calculated and analyzed in relation to the daily maximum UTCI temperature and between disciplines. During 50 championships days with UTCI temperatures between 15℃ and 37℃, 132 heat-related illnesses were recorded. Average incidence rate of heat-related illnesses was 11.7 (95%CI 9.7 to 13.7) per 1000 registered athletes. The expected daily incidence rate of heat-related illnesses increased significantly with UTCI temperature (0.12 more illnesses per 1000 registered athletes/°C; 95%CI 0.08-0.16) and was found to double from 25 to 35°C UTCI. Race walkers (RR = 45.5, 95%CI 21.6-96.0) and marathon runners (RR = 47.7, 95%CI 23.0-98.8) had higher heat-related illness rates than athletes competing in short-duration disciplines. Higher UTCI temperatures were associated with more heat-related illnesses, with marathon and race walking athletes having higher risk than athletes competing in short-duration disciplines. Heat-related illness prevention strategies should predominantly focus on marathon and race walking events of outdoor athletics championships when high temperatures are forecast.
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Affiliation(s)
- Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Milan Klöwer
- Atmospheric, Oceanic and Planetary Physics, University of Oxford, Oxford, UK
| | - Andy Richardson
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, England
| | | | - Sébastien Racinais
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Volker Scheer
- Ultra Sports Science Foundation, Pierre-Bénite, France
| | - Andrew Murray
- Knowledge Translation Team, Sport and Exercise, University of Edinburgh, Edinburgh, Scotland.,Public Health and Medical Team, Fife, UK
| | - Pedro Branco
- European Athletics Medical & Anti-Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Linköping, Sweden
| | - Astrid Junge
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany.,Swiss Concussion Center, Schulthess Klinik, Zürich, Switzerland
| | - Pascal Edouard
- European Athletics Medical & Anti-Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland.,Inter-university Laboratory of Human Movement Sciences (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Department of Clinical and Exercise Physiology, Sports Medicine Unit, Faculty of Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France
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29
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Ihsan M, Abbiss CR, Allan R. Adaptations to Post-exercise Cold Water Immersion: Friend, Foe, or Futile? Front Sports Act Living 2021; 3:714148. [PMID: 34337408 PMCID: PMC8322530 DOI: 10.3389/fspor.2021.714148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
In the last decade, cold water immersion (CWI) has emerged as one of the most popular post-exercise recovery strategies utilized amongst athletes during training and competition. Following earlier research on the effects of CWI on the recovery of exercise performance and associated mechanisms, the recent focus has been on how CWI might influence adaptations to exercise. This line of enquiry stems from classical work demonstrating improved endurance and mitochondrial development in rodents exposed to repeated cold exposures. Moreover, there was strong rationale that CWI might enhance adaptations to exercise, given the discovery, and central role of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in both cold- and exercise-induced oxidative adaptations. Research on adaptations to post-exercise CWI have generally indicated a mode-dependant effect, where resistance training adaptations were diminished, whilst aerobic exercise performance seems unaffected but demonstrates premise for enhancement. However, the general suitability of CWI as a recovery modality has been the focus of considerable debate, primarily given the dampening effect on hypertrophy gains. In this mini-review, we highlight the key mechanisms surrounding CWI and endurance exercise adaptations, reiterating the potential for CWI to enhance endurance performance, with support from classical and contemporary works. This review also discusses the implications and insights (with regards to endurance and strength adaptations) gathered from recent studies examining the longer-term effects of CWI on training performance and recovery. Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy.
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Affiliation(s)
- Mohammed Ihsan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris R Abbiss
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Robert Allan
- School of Sport and Health Sciences, University of Central Lancashire, Preston, United Kingdom
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30
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Muniz-Pardos B, Angeloudis K, Guppy FM, Tanisawa K, Hosokawa Y, Ash GI, Schobersberger W, Grundstein AJ, Yamasawa F, Racinais S, Casa DJ, Pitsiladis YP. Ethical dilemmas and validity issues related to the use of new cooling technologies and early recognition of exertional heat illness in sport. BMJ Open Sport Exerc Med 2021; 7:e001041. [PMID: 33927884 PMCID: PMC8048013 DOI: 10.1136/bmjsem-2021-001041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 12/21/2022] Open
Abstract
The Tokyo 2020 Olympic Games is expected to be among the hottest Games in modern history, increasing the chances for exertional heat stroke (EHS) incidence, especially in non-acclimatised athletes/workers/spectators. The urgent need to recognise EHS symptoms to protect all attendees' health has considerably accelerated research examining the most effective cooling strategies and the development of wearable cooling technology and real-time temperature monitoring. While these technological advances will aid the early identification of EHS cases, there are several potential ethical considerations for governing bodies and sports organisers. For example, the impact of recently developed cooling wearables on health and performance is unknown. Concerning improving athletic performance in a hot environment, there is uncertainty about this technology's availability to all athletes. Furthermore, the real potential to obtain real-time core temperature data will oblige medical teams to make crucial decisions around their athletes continuing their competitions or withdraw. Therefore, the aim of this review is (1) to summarise the practical applications of the most novel cooling strategies/technologies for both safety (of athletes, spectators and workers) and performance purposes, and (2) to inform of the opportunities offered by recent technological developments for the early recognition and diagnosis of EHS. These opportunities are presented alongside several ethical dilemmas that require sports governing bodies to react by regulating the validity of recent technologies and their availability to all.
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Affiliation(s)
- Borja Muniz-Pardos
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | | | - Fergus M Guppy
- Centre for Stress and Age Related Disease, University of Brighton, Brighton, UK.,School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Garrett I Ash
- Center for Medical Informatics, Yale School of Medicine, New Haven, Connecticut, USA.,Pain Research, Informatics, Multi-morbidities, and Education (PRIME), VA Connecticut Healthcare System, West haven, CT, USA
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism, Tirol Kliniken Innsbruck and UMIT Tirol, Hall, Austria
| | | | | | - Sebastien Racinais
- Athlete Health and Performance Research Centre, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Yannis P Pitsiladis
- Centre for Stress and Age Related Disease, University of Brighton, Brighton, UK.,Centre for Exercise Sciences and Sports Medicine, FIMS Collaborating Centre of Sports Medicine, Rome, Italy.,International Federation of Sports Medicine (FIMS), Lausanne, Switzerland.,European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
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31
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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32
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Roussey G, Bernard T, Fontanari P, Louis J. Heat acclimation training with intermittent and self-regulated intensity may be used as an alternative to traditional steady state and power-regulated intensity in endurance cyclists. J Therm Biol 2021; 98:102935. [PMID: 34016357 DOI: 10.1016/j.jtherbio.2021.102935] [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: 09/07/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
The study aimed to determine the effects of self-regulated and variable intensities sustained during short-term heat acclimation training on cycling performance. Seventeen competitive-level male athletes performed a 20-km cycling time trial before (TT-PRE), immediately after (TT-POST1) and one week after (TT-POST2) a 5-day acclimation training program, including either RPE-regulated intermittent (HA-HIT, N = 9) or fixed and low-intensity (HA-LOW, N = 8) training sessions in the heat (39 °C; 40% relative humidity). Total training volume was 23% lower in HA-HIT compared to HA-LOW. Physiological responses were evaluated during a 40-min fixed-RPE cycling exercise performed before (HST-PRE) and immediately after (HST-POST) heat acclimation. All participants in HA-LOW group tended to improve mean power output from TT-PRE to TT-POST1 (+8.1 ± 5.2%; ES = 0.55 ± 0.23), as well as eight of the nine athletes in HA-HIT group (+4.3 ± 2.0%; ES = 0.29 ± 0.31) without difference between groups, but TT-POST2 results showed that improvements were dissipated one week after. Similar improvements in thermal sensation and lower elevations of core temperature in HST-POST following HA-LOW and HA-HIT training protocols suggest that high intensity and RPE regulated bouts could be an efficient strategy for short term heat acclimation protocols, for example prior to the competition. Furthermore, the modest impact of lowered thermal sensation on cycling performance confirms that perceptual responses of acclimated athletes are dissociated from physiological stress when exercising in the heat.
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Affiliation(s)
- Gilles Roussey
- Laboratoire Motricité Humaine, Education, Sport, Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Thierry Bernard
- Laboratoire Motricité Humaine, Education, Sport, Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Pierre Fontanari
- Laboratoire Motricité Humaine, Education, Sport, Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Liverpool, Byrom Street, L3 3AF, United Kingdom.
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Postexercise Hot-Water Immersion Does Not Further Enhance Heat Adaptation or Performance in Endurance Athletes Training in a Hot Environment. Int J Sports Physiol Perform 2021; 16:480-488. [DOI: 10.1123/ijspp.2020-0114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022]
Abstract
Purpose: Hot-water immersion (HWI) after training in temperate conditions has been shown to induce thermophysiological adaptations and improve endurance performance in the heat; however, the potential additive effects of HWI and training in hot outdoor conditions remain unknown. Therefore, this study aimed to determine the effect of repeated postexercise HWI in athletes training in a hot environment. Methods: A total of 13 (9 female) elite/preelite racewalkers completed a 15-day training program in outdoor heat (mean afternoon high temperature = 34.6°C). Athletes were divided into 2 matched groups that completed either HWI (40°C for 30–40 min) or seated rest in 21°C (CON), following 8 training sessions. Pre–post testing included a 30-minute fixed-intensity walk in heat, laboratory incremental walk to exhaustion, and 10,000-m outdoor time trial. Results: Training frequency and volume were similar between groups (P = .54). Core temperature was significantly higher during immersion in HWI (38.5 [0.3]) than CON (37.8°C [0.2°C]; P < .001). There were no differences between groups in resting or exercise rectal temperature or heart rate, skin temperature, sweat rate, or the speed at lactate threshold 2, maximal O2 uptake, or 10,000-m performance (P > .05). There were significant (P < .05) pre–post differences for both groups in submaximal exercising heart rate (∼11 beats·min−1), sweat rate (0.34–0.55 L·h−1) and thermal comfort (1.2–1.5 arbitrary units), and 10,000-m racewalking performance time (∼3 min). Conclusions: Both groups demonstrated significant improvement in markers of heat adaptation and performance; however, the addition of HWI did not provide further enhancements. Improvements in adaptation appeared to be maximized by the training program in hot conditions.
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Additional Clothing Increases Heat Load in Elite Female Rugby Sevens Players. Int J Sports Physiol Perform 2021; 16:1424-1431. [PMID: 33771940 DOI: 10.1123/ijspp.2020-0620] [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: 06/23/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether elite female rugby sevens players are exposed to core temperatures (Tc) during training in the heat that replicate the temperate match demands previously reported and to investigate whether additional clothing worn during a hot training session meaningfully increases the heat load experienced. METHODS A randomized parallel-group study design was employed, with all players completing the same approximately 70-minute training session (27.5°C-34.8°C wet bulb globe temperature) and wearing a standardized training ensemble (synthetic rugby shorts and training tee [control (CON); n = 8]) or additional clothing (standardized training ensemble plus compression garments and full tracksuit [additional clothing (AC); n = 6]). Groupwise differences in Tc, sweat rate, GPS-measured external locomotive output, rating of perceived exertion, and perceptual thermal load were compared. RESULTS Mean (P = .006, ηp2=.88) and peak (P < .001, ηp2=.97) Tc were higher in AC compared with CON during the training session. There were no differences in external load (F4,9 = 0.155, P = .956, Wilks Λ = 0.935, ηp2=.06) or sweat rate (P = .054, Cohen d = 1.09). A higher rating of perceived exertion (P = .016, Cohen d = 1.49) was observed in AC compared with CON. No exertional-heat-illness symptomology was reported in either group. CONCLUSIONS Player Tc is similar between training performed in hot environments and match play in temperate conditions when involved for >6 minutes. Additional clothing is a viable and effective method to increase heat strain in female rugby sevens players without compromising training specificity or external locomotive capacity.
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Bouscaren N, Faricier R, Millet GY, Racinais S. Heat Acclimatization, Cooling Strategies, and Hydration during an Ultra-Trail in Warm and Humid Conditions. Nutrients 2021; 13:1085. [PMID: 33810371 PMCID: PMC8065615 DOI: 10.3390/nu13041085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the history of exertional heat illness (EHI), heat preparation, cooling strategies, heat related symptoms, and hydration during an ultra-endurance running event in a warm and humid environment. This survey-based study was open to all people who participated in one of the three ultra-endurance races of the Grand Raid de la Réunion. Ambient temperature and relative humidity were 18.6 ± 5.7 °C (max = 29.7 °C) and 74 ± 17%, respectively. A total of 3317 runners (56% of the total eligible population) participated in the study. Overall, 78% of the runners declared a history of heat-related symptoms while training or competing, and 1.9% reported a previous diagnosis of EHI. Only 24.3% of study participants living in temperate climates declared having trained in the heat before the races, and 45.1% of all respondents reported a cooling strategy during the races. Three quarter of all participants declared a hydration strategy. The planned hydration volume was 663 ± 240 mL/h. Fifty-nine percent of the runners had enriched their food or drink with sodium during the race. The present study shows that ultra-endurance runners have a wide variability of hydration and heat preparation strategies. Understandings of heat stress repercussions in ultra-endurance running need to be improved by specific field research.
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Affiliation(s)
- Nicolas Bouscaren
- Inserm CIC1410, CHU Réunion, 97448 Saint Pierre, France
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Robin Faricier
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Guillaume Y. Millet
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
- Institut Universitaire de France (IUF), 75231 Paris, France
| | - Sébastien Racinais
- Research and Scientific Support Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha 29222, Qatar;
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36
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Xu M, Wu Z, Dong Y, Qu C, Xu Y, Qin F, Wang Z, Nassis GP, Zhao J. A Mixed-Method Approach of Pre-Cooling Enhances High-Intensity Running Performance in the Heat. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:26-34. [PMID: 33707983 DOI: 10.52082/jssm.2021.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023]
Abstract
We investigated whether single or combined methods of pre-cooling could affect high-intensity exercise performance in a hot environment. Seven male athletes were subjected to four experimental conditions for 30 min in a randomised order. The four experimental conditions were: 1) wearing a vest cooled to a temperature of 4 ℃ (Vest), 2) consuming a beverage cooled to a temperature of 4 ℃ (Beverage), 3) simultaneous usage of vest and consumption of beverage (Mix), and 4) the control trial without pre-cooling (CON). Following those experimental conditions, they exercised at a speed of 80% VO2max until exhaustion in the heat (38.1 ± 0.6 ℃, 55.3 ± 0.3% RH). Heart rate (HR), rectal temperature (Tcore), skin temperature (Tskin), sweat loss (SL), urine specific gravity (USG), levels of sodium (Na+) and potassium (K+), rating of perceived exertion (RPE), thermal sensation (TS), and levels of blood lactic acid ([Bla]) were monitored. Performance was improved using the mixed pre-cooling strategy (648.43 ± 77.53 s, p = 0.016) compared to CON (509.14 ± 54.57 s). Tcore after pre-cooling was not different (Mix: 37.01 ± 0.27 ℃, Vest: 37.19 ± 0.33 ℃, Beverage: 37.03 ± 0.35 ℃) in all cooling conditions compared to those of CON (37.31 ±0.29 ℃). A similar Tcore values was achieved at exhaustion in all trials (from 38.10 ℃ to 39.00 ℃). No difference in the level of USG was observed between the conditions. Our findings suggest that pre-cooling with a combination of cold vest usage and cold fluid intake can improve performance in the heat.
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Affiliation(s)
- Minxiao Xu
- School of Kinesiology, Shanghai University of Sports, Shanghai, China.,Exercise Biological Center, China Institute of Sport Science, Beijing, China
| | - Zhaozhao Wu
- Exercise Biological Center, China Institute of Sport Science, Beijing, China.,Physical Education Department, Northwest University, Xi'an, China
| | - Yanan Dong
- Beijing Institute of Sport Science, Beijing, China
| | - Chaoyi Qu
- Exercise Biological Center, China Institute of Sport Science, Beijing, China.,School of Sport Science, Beijing Sport University, Beijing, China
| | - Yaoduo Xu
- Physical Education Department, Northwestern Poly-technical University, Xi'an, China
| | - Fei Qin
- Exercise Biological Center, China Institute of Sport Science, Beijing, China.,School of Physical Education, Jinan University, Guangzhou, China
| | - Zhongwei Wang
- School of Kinesiology, Shanghai University of Sports, Shanghai, China.,Exercise Biological Center, China Institute of Sport Science, Beijing, China
| | - George P Nassis
- Physical Education Department-(CEDU), United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| | - Jiexiu Zhao
- Exercise Biological Center, China Institute of Sport Science, Beijing, China
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37
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Racinais S, Ihsan M, Taylor L, Cardinale M, Adami PE, Alonso JM, Bouscaren N, Buitrago S, Esh CJ, Gomez-Ezeiza J, Garrandes F, Havenith G, Labidi M, Lange G, Lloyd A, Moussay S, Mtibaa K, Townsend N, Wilson MG, Bermon S. Hydration and cooling in elite athletes: relationship with performance, body mass loss and body temperatures during the Doha 2019 IAAF World Athletics Championships. Br J Sports Med 2021; 55:1335-1341. [PMID: 33579722 PMCID: PMC8606454 DOI: 10.1136/bjsports-2020-103613] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 11/09/2022]
Abstract
Purpose To characterise hydration, cooling, body mass loss, and core (Tcore) and skin (Tsk) temperatures during World Athletics Championships in hot-humid conditions. Methods Marathon and race-walk (20 km and 50 km) athletes (n=83, 36 women) completed a pre-race questionnaire. Pre-race and post-race body weight (n=74), Tcore (n=56) and Tsk (n=49; thermography) were measured. Results Most athletes (93%) had a pre-planned drinking strategy (electrolytes (83%), carbohydrates (81%)) while ice slurry was less common (11%; p<0.001). More men than women relied on electrolytes and carbohydrates (91%–93% vs 67%–72%, p≤0.029). Drinking strategies were based on personal experience (91%) rather than external sources (p<0.001). Most athletes (80%) planned pre-cooling (ice vests (53%), cold towels (45%), neck collars (21%) and ice slurry (21%)) and/or mid-cooling (93%; head/face dousing (65%) and cold water ingestion (52%)). Menthol usage was negligible (1%–2%). Pre-race Tcore was lower in athletes using ice vests (37.5°C±0.4°C vs 37.8°C±0.3°C, p=0.024). Tcore (pre-race 37.7°C±0.3°C, post-race 39.6°C±0.6°C) was independent of event, ranking or performance (p≥0.225). Pre-race Tsk was correlated with faster race completion (r=0.32, p=0.046) and was higher in non-finishers (did not finish (DNF); 33.8°C±0.9°C vs 32.6°C±1.4°C, p=0.017). Body mass loss was higher in men than women (−2.8±1.5% vs −1.3±1.6%, p<0.001), although not associated with performance. Conclusion Most athletes’ hydration strategies were pre-planned based on personal experience. Ice vests were the most adopted pre-cooling strategy and the only one minimising Tcore, suggesting that event organisers should be cognisant of logistics (ie, freezers). Dehydration was moderate and unrelated to performance. Pre-race Tsk was related to performance and DNF, suggesting that Tsk modulation should be incorporated into pre-race strategies.
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Affiliation(s)
- Sebastien Racinais
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Mohammed Ihsan
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
- Human Potential Translational Research Program, NUS Yong Loo Lin School of Medicine, Singapore
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Marco Cardinale
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | | | - Juan Manuel Alonso
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | | | | | - Chris J Esh
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa
| | | | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Mariem Labidi
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Gunter Lange
- Health and Science Department, World Athletics, Monaco
| | - Alexander Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Sebastien Moussay
- Normandie Univ, UNICAEN, INSERM, COMETE, CYCERON, CHU Caen, Caen, Normandie, France
| | - Khouloud Mtibaa
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Nathan Townsend
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Ad Dawhah, Qatar
| | - Mathew G Wilson
- Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Stephane Bermon
- Health and Science Department, World Athletics, Monaco
- Human Motricity Laboratory Expertise Sport Health, Cote d'Azur University, Nice, Provence-Alpes-Côte d'Azu, France
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38
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Maloy W, Hulsopple C. Novel Use of Water Immersion in the Management of Exertional Heat Stress. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Barnes JN, Charkoudian N. Integrative cardiovascular control in women: Regulation of blood pressure, body temperature, and cerebrovascular responsiveness. FASEB J 2020; 35:e21143. [PMID: 33151577 DOI: 10.1096/fj.202001387r] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022]
Abstract
Over the past several decades, it has become increasingly clear that women have distinct cardiovascular profiles compared to men. In this review, our goal is to provide an overview of the literature regarding the influences of female sex and reproductive hormones (primarily estradiol) on mechanisms of cardiovascular control relevant to regulation of blood pressure, body temperature, and cerebral blood flow. Young women tend to have lower resting blood pressure compared with men. This sex difference is reversed at menopause, when women develop higher sympathetic nerve activity and the risk of systemic hypertension increases sharply as postmenopausal women age. Vascular responses to thermal stress, including cutaneous vasodilation and vasoconstriction, are also affected by reproductive hormones in women, where estradiol appears to promote vasodilation and heat dissipation. The influence of reproductive hormones on cerebral blood flow and sex differences in the ability of the cerebral vasculature to increase its blood flow (cerebrovascular reactivity) are relatively new areas of investigation. Sex and hormonal influences on integrative blood flow regulation have further implications during challenges to physiological homeostasis, including exercise. We propose that increasing awareness of these sex-specific mechanisms is important for optimizing health care and promotion of wellness in women across the life span.
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Affiliation(s)
- Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Nisha Charkoudian
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
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40
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Malgoyre A, Siracusa J, Tardo-Dino PE, Garcia-Vicencio S, Koulmann N, Charlot K. A basal heat stress test to detect military operational readiness after a 14-day operational heat acclimatization period. Temperature (Austin) 2020; 7:277-289. [PMID: 33123621 DOI: 10.1080/23328940.2020.1742572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A basal heat stress test (HST) to predict the magnitude of adaptive responses during heat acclimatization (HA) would be highly useful for the armed forces. The aim was to identify physiological markers assessed during a HST (three 8-min running sets at 50% of the speed at VO2max) performed just before a 14-day HA period that would identify participants still at "risk" at the end of HA. Individuals that responded poorly (large increases in rectal temperature [Trec] and heart rate [HR]) during the initial HST were more likely to respond favorably to HA (large reductions in Trec and HR). However, they were also more likely to exhibit lower tolerance to HST at D15. Basal Trec was found to efficiently discriminate participants showing a Trec > 38.5°C after HA, who are considered to be "at risk". Finally, participants were classified by quartiles based on basal Trec and HR at the end of the HST and physiological strain index (PSI). Most of the participants "at risk" were among the upper quartile (i.e. the least tolerant) of Trec and PSI (p = 0.011 for both). Overall, these results show that the individuals who are less tolerant to a basal HST are very likely to benefit the most from HA but they also remain less tolerant to heat at the end of HA than those who better tolerated the basal HST. A basal HST could therefore theoretically help the command to select the most-ready personnel in hot conditions while retaining those who are less tolerant 6.
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Affiliation(s)
- Alexandra Malgoyre
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Julien Siracusa
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Pierre-Emmanuel Tardo-Dino
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Sebastian Garcia-Vicencio
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Nathalie Koulmann
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France.,Ecole du Val-de-Grâce, Paris, France
| | - Keyne Charlot
- Département Environnements Opérationnels, Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Institut de Recherche Biomédicale des Armées, France Bretigny-Sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
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41
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Epidemiology of exertional heat illnesses in organised sports: A systematic review. J Sci Med Sport 2020; 23:701-709. [DOI: 10.1016/j.jsams.2020.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 11/21/2022]
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42
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Bongers CCWG, de Korte JQ, Eijsvogels T. Infographic. Keep it cool and beat the heat: cooling strategies for exercise in hot and humid conditions. Br J Sports Med 2020; 55:bjsports-2020-102294. [PMID: 32561517 DOI: 10.1136/bjsports-2020-102294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Coen C W G Bongers
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, The Netherlands
| | - Johannus Q de Korte
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, The Netherlands
| | - Thijs Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, The Netherlands
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43
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Abstract
Respiratory and gastrointestinal infections limit an athlete's availability to train and compete. To better understand how sick an athlete will become when they have an infection, a paradigm recently adopted from ecological immunology is presented that includes the concepts of immune resistance (the ability to destroy microbes) and immune tolerance (the ability to dampen defence yet control infection at a non-damaging level). This affords a new theoretical perspective on how nutrition may influence athlete immune health; paving the way for focused research efforts on tolerogenic nutritional supplements to reduce the infection burden in athletes. Looking through this new lens clarifies why nutritional supplements targeted at improving immune resistance in athletes show limited benefits: evidence supporting the old paradigm of immune suppression in athletes is lacking. Indeed, there is limited evidence that the dietary practices of athletes suppress immunity, e.g. low-energy availability and train- or sleep-low carbohydrate. It goes without saying, irrespective of the dietary preference (omnivorous, vegetarian), that athletes are recommended to follow a balanced diet to avoid a frank deficiency of a nutrient required for proper immune function. The new theoretical perspective provided sharpens the focus on tolerogenic nutritional supplements shown to reduce the infection burden in athletes, e.g. probiotics, vitamin C and vitamin D. Further research should demonstrate the benefits of candidate tolerogenic supplements to reduce infection in athletes; without blunting training adaptations and without side effects.
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Yanovich R, Ketko I, Charkoudian N. Sex Differences in Human Thermoregulation: Relevance for 2020 and Beyond. Physiology (Bethesda) 2020; 35:177-184. [PMID: 32293229 DOI: 10.1152/physiol.00035.2019] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The participation of women in physically strenuous athletic and occupational tasks has increased substantially in the past decade. Female sex steroids have influences on thermoregulatory processes that could impact physical performance in the heat. Here, we summarize and evaluate the current literature regarding sex differences in thermoregulation and provide recommendations for heat-illness risk-mitigation strategies.
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Affiliation(s)
- R Yanovich
- The Institute of Military Physiology, Israel Defense Forces, Medical Corps, Tel-Hashomer, Israel
- Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - I Ketko
- The Institute of Military Physiology, Israel Defense Forces, Medical Corps, Tel-Hashomer, Israel
- Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - N Charkoudian
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachussetts
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Ganse B, Degens H. Skin Temperature in Master Long-Distance Runners-Results From a Field Study at the 2018 World Master Athletics Championships. Front Sports Act Living 2020; 2:31. [PMID: 33345023 PMCID: PMC7739730 DOI: 10.3389/fspor.2020.00031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 03/13/2020] [Indexed: 11/13/2022] Open
Abstract
Older people and athletes show impairments in thermoregulation, but this has not yet been studied during a running competition. The aim of the study was to assess (1) whether there are age-related differences in skin temperature during the last stage of a race in well-trained master athletes and (2) to what extent such differences are related to running speed and sex. To investigate this, we used thermography to measure maximum skin temperatures of the head, legs and hands of participants of the 2018 World Master Athletics (WMA) Championships when they were approximately 9,600 m into a 10,000-m road race. Of the 813 runners, 404 were analyzed (142 women, 262 men) including athletes of age groups 35 to 85. All ≥70-year-old athletes completed the race; all 16 non-finishers were younger. The hand temperature was lower than that of the head and legs (p < 0.001). Stepwise regression revealed that head ( R adj 2 = 0.143; p < 0.001) and hand temperature decreased with increasing speed ( R adj 2 = 0.092; p < 0.001). Sex was the most important determinant of leg skin temperature ( R adj 2 = 0.054; p < 0.001), men having higher leg temperatures than women, with a small negative contribution of speed ( R adj 2 increased to 0.069). In conclusion, higher running speed is associated with lower skin temperatures, and leg skin temperature is lower in women than men. The absence of an age effect on skin temperature suggests that there is no impairment in heat dissipation in well-trained older athletes.
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Affiliation(s)
- Bergita Ganse
- Department of Life Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Hans Degens
- Department of Life Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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Henderson MJ, Chrismas BCR, Stevens CJ, Coutts AJ, Taylor L. Changes in Core Temperature During an Elite Female Rugby Sevens Tournament. Int J Sports Physiol Perform 2020; 15:571-580. [PMID: 32023538 DOI: 10.1123/ijspp.2019-0375] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/30/2019] [Accepted: 07/29/2019] [Indexed: 10/27/2023]
Abstract
PURPOSE To characterize player core temperature (Tc) across a World Rugby Women's Sevens Series tournament day (WRWSS) and determine the efficacy of commonly employed cold-water-immersion (CWI) protocols. METHODS Tc was measured in 12 elite female rugby sevens athletes across 3 games (G1-3) from day 1 of the Sydney WRWSS tournament. Symptoms of exertional heat illness, perceptual scales, CWI details, playing minutes, external-load data (measured by global positioning systems), and wet-bulb globe temperature (range 18.5°C-20.1°C) were also collected. Linear mixed models and magnitude-based inferences were used to assess differences in Tc between periods (G1-3 and warm-ups [WU]). RESULTS Average Tc was "very likely" lower (effect size; ±90% confidence limit -0.33; ±0.18) in G1 than in G2. Peak Tc was "very likely" (0.71; ±0.28) associated with increased playing time. CWI did not remove the accumulated Tc due to WU and match-play activity (∼1°C-2°C rise in Tc still present compared with Tc at WU onset for players ≥6-min match play). CONCLUSIONS Elite WRWSS athletes experienced high Tc during WU (Tc peak 37.9-39.0°C) and matches (Tc peak 37.9-39.8°C), a magnitude known to reduce intermittent high-intensity physical performance (≥39°C). The CWI protocol resulted in players (≥6-min match play) with ∼1°C to 2°C raised Tc compared with Tc at WU onset.
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Gamage PJ, Finch CF, Fortington LV. Document analysis of exertional heat illness policies and guidelines published by sports organisations in Victoria, Australia. BMJ Open Sport Exerc Med 2020; 6:e000591. [PMID: 32342949 PMCID: PMC7173990 DOI: 10.1136/bmjsem-2019-000591] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives To conduct a document and content analysis of exertional heat illness (EHI)-related documents published by sports organisations in Victoria, Australia, in order to determine their scope and evidence base against current international best practice recommendations. Methods A qualitative document and content analysis. Official documents relating to EHI were identified through a search of 22 Victorian sport organisation websites, supplemented by a general internet search. The content of these documents was evaluated against recommendations presented in three current international position statements on prevention and management of EHI. Results A range of document types addressing EHI were identified (n=25), including specific heat policies, match day guides, rules and regulations. Recommendations about prevention measures were the most common information presented, but these were largely focused on event modification/cancellation guidelines only (n=22; 88%). Most documents provided information on hydration as a preventive measure (n=20; 80%), but the emphasis on the importance of cooling strategies (n=7; 28%) and heat acclimatisation (n=5; 20%) was inadequate. Details on EHI, including its definition, symptoms/signs to look out for, and common risk factors (beyond humidity/high temperatures) were lacking in most documents. Conclusion There is considerable variation in formal documents with regard to their content and quality of information. Continued efforts to bridge the evidence to practice gap in sports safety are therefore important. This study highlights the challenge for community sport, which relies on high-level policy and governance, across settings and populations that can differ substantially in their needs.
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Affiliation(s)
- Prasanna J Gamage
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Caroline F Finch
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lauren V Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Racinais S, Nichols D, Travers G, Moussay S, Belfekih T, Farooq A, Schumacher YO, Périard JD. Health status, heat preparation strategies and medical events among elite cyclists who competed in the heat at the 2016 UCI Road World Cycling Championships in Qatar. Br J Sports Med 2020; 54:1003-1007. [DOI: 10.1136/bjsports-2019-100781] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 11/03/2022]
Abstract
PurposeAssess the health status and heat preparation strategies of athletes competing in a World Cycling Championships held in hot ambient conditions (37°C, 25% relative humidity, wet-bulb-globe-temperature 27°C) and monitor the medical events arising during competition.Methods69 cyclists (~9% of the world championships participants) completed a pre-competition questionnaire. Illnesses and injuries encountered by the Athlete Medical Centre (AMC) were extracted from the race reports.Results22% of respondents reported illness symptoms in the 10 days preceding the Championships. 57% of respondents had previously experienced heat-related symptoms (cramping most commonly) while 17% had previously been diagnosed with exertional heat illness. 61% of the respondents had undergone some form of heat exposure prior to the Championships, with 38% acclimating for 5 to 30 days. In addition, several respondents declared to live in warm countries and all arrived in Qatar ~5 days prior to their event. 96% of the respondents used a pre-cooling strategy for the time trials and 74% did so before the road race (p<0.001), with ice vests being the most common. The AMC assessed 46 injuries and 26 illnesses in total, with three cyclists diagnosed with heat exhaustion.ConclusionsThe prevalence of previous heat illness in elite cyclists calls for team and event organisation doctors to be trained on heat illness management, including early diagnosis and rapid on-site cooling. Some cyclists had been exposed to the heat prior to the Championships, but few had a dedicated plan, calling for additional education on the importance of heat acclimation. Pre-cooling was widely adopted.
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Heathcote SL, Hassmén P, Zhou S, Taylor L, Stevens CJ. How Does a Delay Between Temperate Running Exercise and Hot-Water Immersion Alter the Acute Thermoregulatory Response and Heat-Load? Front Physiol 2019; 10:1381. [PMID: 31824325 PMCID: PMC6886377 DOI: 10.3389/fphys.2019.01381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/21/2019] [Indexed: 11/13/2022] Open
Abstract
Hot-water immersion following exercise in a temperate environment can elicit heat acclimation in endurance-trained individuals. However, a delay between exercise cessation and immersion is likely a common occurrence in practice. Precisely how such a delay potentially alters hot-water immersion mediated acute physiological responses (e.g., total heat-load) remains unexplored. Such data would aid in optimizing prescription of post-exercise hot-water immersion in cool environments, relative to heat acclimation goals. Twelve male recreational runners (mean ± SD; age: 38 ± 13 years, height: 180 ± 7 cm, body mass: 81 ± 13.7 kg, body fat: 13.9 ± 3.5%) completed three separate 40-min treadmill runs (18°C), followed by either a 10 min (10M), 1 h (1H), or 8 h (8H) delay, prior to a 30-min hot-water immersion (39°C), with a randomized crossover design. Core and skin temperatures, heart rate, sweat, and perceptual responses were measured across the trials. Mean core temperature during immersion was significantly lower in 1H (37.39 ± 0.30°C) compared to 10M (37.83 ± 0.24°C; p = 0.0032) and 8H (37.74 ± 0.19°C; p = 0.0140). Mean skin temperature was significantly higher in 8H (32.70 ± 0.41°C) compared to 10M (31.93 ± 0.60°C; p = 0.0042) at the end of the hot-water immersion. Mean and maximal heart rates were also higher during immersion in 10M compared to 1H and 8H (p < 0.05), despite no significant differences in the sweat or perceptual responses. The shortest delay between exercise and immersion (10M) provoked the greatest heat-load during immersion. However, performing the hot-water immersion in the afternoon (8H), which coincided with peak circadian body temperature, provided a larger heat-load stimulus than the 1 h delay (1H).
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Affiliation(s)
- Storme L Heathcote
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.,Laboratory for Athlete Development, Experience and Performance, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Peter Hassmén
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Shi Zhou
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.,Faculty of Health, Sport and Exercise Discipline Group, University of Technology Sydney, Sydney, NSW, Australia.,Human Performance Research Centre, University of Technology Sydney, Sydney, NSW, Australia.,ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar
| | - Christopher J Stevens
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.,Laboratory for Athlete Development, Experience and Performance, Southern Cross University, Coffs Harbour, NSW, Australia
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Gibson OR, James CA, Mee JA, Willmott AG, Turner G, Hayes M, Maxwell NS. Heat alleviation strategies for athletic performance: A review and practitioner guidelines. Temperature (Austin) 2019; 7:3-36. [PMID: 32166103 PMCID: PMC7053966 DOI: 10.1080/23328940.2019.1666624] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 12/19/2022] Open
Abstract
International competition inevitably presents logistical challenges for athletes. Events such as the Tokyo 2020 Olympic Games require further consideration given historical climate data suggest athletes will experience significant heat stress. Given the expected climate, athletes face major challenges to health and performance. With this in mind, heat alleviation strategies should be a fundamental consideration. This review provides a focused perspective of the relevant literature describing how practitioners can structure male and female athlete preparations for performance in hot, humid conditions. Whilst scientific literature commonly describes experimental work, with a primary focus on maximizing magnitudes of adaptive responses, this may sacrifice ecological validity, particularly for athletes whom must balance logistical considerations aligned with integrating environmental preparation around training, tapering and travel plans. Additionally, opportunities for sophisticated interventions may not be possible in the constrained environment of the athlete village or event arenas. This review therefore takes knowledge gained from robust experimental work, interprets it and provides direction on how practitioners/coaches can optimize their athletes' heat alleviation strategies. This review identifies two distinct heat alleviation themes that should be considered to form an individualized strategy for the athlete to enhance thermoregulatory/performance physiology. First, chronic heat alleviation techniques are outlined, these describe interventions such as heat acclimation, which are implemented pre, during and post-training to prepare for the increased heat stress. Second, acute heat alleviation techniques that are implemented immediately prior to, and sometimes during the event are discussed. Abbreviations: CWI: Cold water immersion; HA: Heat acclimation; HR: Heart rate; HSP: Heat shock protein; HWI: Hot water immersion; LTHA: Long-term heat acclimation; MTHA: Medium-term heat acclimation; ODHA: Once-daily heat acclimation; RH: Relative humidity; RPE: Rating of perceived exertion; STHA: Short-term heat acclimation; TCORE: Core temperature; TDHA: Twice-daily heat acclimation; TS: Thermal sensation; TSKIN: Skin temperature; V̇O2max: Maximal oxygen uptake; WGBT: Wet bulb globe temperature.
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Affiliation(s)
- Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER), Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, UK
| | - Carl A. James
- Institut Sukan Negara (National Sports Institute), Kuala Lumpur, Malaysia
| | - Jessica A. Mee
- School of Sport and Exercise Sciences, University of Worcester, Worcester, UK
| | - Ashley G.B. Willmott
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Gareth Turner
- Bisham Abbey National High-Performance Centre, English Institute of Sport, EIS Performance Centre, Marlow, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
| | - Neil S. Maxwell
- Environmental Extremes Laboratory, School of Sport and Service Management, University of Brighton, Eastbourne, UK
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