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Mougin L, Bougault V, Racinais S, Mountjoy ML, Stephenson B, Carter S, James LJ, Mears SA, Taylor L. Environmental challenges facing athletes, stakeholders and spectators at Paris 2024 Olympic and Paralympic Games: an evidence-based review of mitigation strategies and recommendations. Br J Sports Med 2024; 58:870-881. [PMID: 38955507 DOI: 10.1136/bjsports-2024-108281] [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: 06/11/2024] [Indexed: 07/04/2024]
Abstract
The upcoming Paris 2024 Olympic and Paralympic Games could face environmental challenges related to heat, air quality and water quality. These challenges will pose potential threats to athletes and impact thousands of stakeholders and millions of spectators. Recognising the multifaceted nature of these challenges, a range of strategies will be essential for mitigating adverse effects on participants, stakeholders and spectators alike. From personalised interventions for athletes and attendees to comprehensive measures implemented by organisers, a holistic approach is crucial to address these challenges and the possible interplay of heat, air and water quality factors during the event. This evidence-based review highlights various environmental challenges anticipated at Paris 2024, offering strategies applicable to athletes, stakeholders and spectators. Additionally, it provides recommendations for Local Organising Committees and the International Olympic Committee that may be applicable to future Games. In summary, the review offers solutions for consideration by the stakeholders responsible for and affected by the anticipated environmental challenges at Paris 2024.
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Affiliation(s)
- Loïs Mougin
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | | | - Sébastien Racinais
- Environmental Stress Unit, CREPS Montpellier Font-Romeu, Montpellier, France
- DMEM, UMR 866 INRAE / University of Montpellier, Montpellier, France
| | - Margo L Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ben Stephenson
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- UK Sports Institute, Loughborough, UK
| | - Sarah Carter
- Faculty of Health, Exercise and Sports Science, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Stephen A Mears
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
- University of Technology Sydney, Sydney, New South Wales, Australia
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Cinca-Morros S, Álvarez-Herms J. The Importance of Maintaining and Improving a Healthy Gut Microbiota in Athletes as a Preventive Strategy to Improve Heat Tolerance and Acclimatization. Microorganisms 2024; 12:1160. [PMID: 38930542 PMCID: PMC11205789 DOI: 10.3390/microorganisms12061160] [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: 04/17/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Exposure to passive heat (acclimation) and exercise under hot conditions (acclimatization), known as heat acclimation (HA), are methods that athletes include in their routines to promote faster recovery and enhance physiological adaptations and performance under hot conditions. Despite the potential positive effects of HA on health and physical performance in the heat, these stimuli can negatively affect gut health, impairing its functionality and contributing to gut dysbiosis. Blood redistribution to active muscles and peripheral vascularization exist during exercise and HA stimulus, promoting intestinal ischemia. Gastrointestinal ischemia can impair intestinal permeability and aggravate systemic endotoxemia in athletes during exercise. Systemic endotoxemia elevates the immune system as an inflammatory responses in athletes, impairing their adaptive capacity to exercise and their HA tolerance. Better gut microbiota health could benefit exercise performance and heat tolerance in athletes. This article suggests that: (1) the intestinal modifications induced by heat stress (HS), leading to dysbiosis and altered intestinal permeability in athletes, can decrease health, and (2) a previously acquired microbial dysbiosis and/or leaky gut condition in the athlete can negatively exacerbate the systemic effects of HA. Maintaining or improving the healthy gut microbiota in athletes can positively regulate the intestinal permeability, reduce endotoxemic levels, and control the systemic inflammatory response. In conclusion, strategies based on positive daily habits (nutrition, probiotics, hydration, chronoregulation, etc.) and preventing microbial dysbiosis can minimize the potentially undesired effects of applying HA, favoring thermotolerance and performance enhancement in athletes.
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Affiliation(s)
- Sergi Cinca-Morros
- Microfluidics Cluster UPV/EHU, Analytical Microsystems & Materials for Lab-on-a-Chip (AMMa-LOAC) Group, Analytical Chemistry Department, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain
- Microfluidics Cluster UPV/EHU, BIOMICs Microfluidics Group, Lascaray Research Center, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Jesús Álvarez-Herms
- Physiology and Molecular Laboratory (Phymolab), 40170 Collado Hermoso, Spain;
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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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Henderson MJ, Grandou C, Chrismas BCR, Coutts AJ, Impellizzeri FM, Taylor L. Core Body Temperatures in Intermittent Sports: A Systematic Review. Sports Med 2023; 53:2147-2170. [PMID: 37526813 PMCID: PMC10587327 DOI: 10.1007/s40279-023-01892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Hyperthermia (and associated health and performance implications) can be a significant problem for athletes and teams involved in intermittent sports. Quantifying the highest thermal strain (i.e. peak core body temperature [peak Tc]) from a range of intermittent sports would enhance our understanding of the thermal requirements of sport and assist in making informed decisions about training or match-day interventions to reduce thermally induced harm and/or performance decline. OBJECTIVE The objective of this systematic review was to synthesise and characterise the available thermal strain data collected in competition from intermittent sport athletes. METHODS A systematic literature search was performed on Web of Science, MEDLINE, and SPORTDiscus to identify studies up to 17 April 2023. Electronic databases were searched using a text mining method to provide a partially automated and systematic search strategy retrieving terms related to core body temperature measurement and intermittent sport. Records were eligible if they included core body temperature measurement during competition, without experimental intervention that may influence thermal strain (e.g. cooling), in healthy, adult, intermittent sport athletes at any level. Due to the lack of an available tool that specifically includes potential sources of bias for physiological responses in descriptive studies, a methodological evaluation checklist was developed and used to document important methodological considerations. Data were not meta-analysed given the methodological heterogeneity between studies and therefore were presented descriptively in tabular and graphical format. RESULTS A total of 34 studies were selected for review; 27 were observational, 5 were experimental (2 parallel group and 3 repeated measures randomised controlled trials), and 2 were quasi-experimental (1 parallel group and 1 repeated measures non-randomised controlled trial). Across all included studies, 386 participants (plus participant numbers not reported in two studies) were recruited after accounting for shared data between studies. A total of 4 studies (~ 12%) found no evidence of hyperthermia, 24 (~ 71%) found evidence of 'modest' hyperthermia (peak Tc between 38.5 and 39.5 °C), and 6 (~ 18%) found evidence of 'marked' hyperthermia (peak Tc of 39.5 °C or greater) during intermittent sports competition. CONCLUSIONS Practitioners and coaches supporting intermittent sport athletes are justified to seek interventions aimed at mitigating the high heat strain observed in competition. More research is required to determine the most effective interventions for this population that are practically viable in intermittent sports settings (often constrained by many competing demands). Greater statistical power and homogeneity among studies are required to quantify the independent effects of wet bulb globe temperature, competition duration, sport and level of competition on peak Tc, all of which are likely to be key modulators of the thermal strain experienced by competing athletes. REGISTRATION This systematic review was registered on the Open Science Framework ( https://osf.io/vfb4s ; https://doi.org/10.17605/OSF.IO/EZYFA , 4 January 2021).
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Affiliation(s)
- Mitchell J Henderson
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia.
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia.
| | - Clementine Grandou
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia
| | - Bryna C R Chrismas
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Aaron J Coutts
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia
| | - Franco M Impellizzeri
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia
| | - Lee Taylor
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, Australia
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Jerram ML, Baker D, Smith TB, Healey P, Taylor L, Black K. A 0.1% L-Menthol Mouth Swill in Elite Male Rugby Players Has Different Effects in Forwards and Backs. Int J Sports Physiol Perform 2023; 18:909-917. [PMID: 36689991 DOI: 10.1123/ijspp.2022-0191] [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: 05/12/2022] [Revised: 09/20/2022] [Accepted: 10/26/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Menthol mouth swills can improve endurance performance in the heat, which is attributed to attenuations in nonthermally derived thermal sensation (TS) and perception of effort. However, research in elite team-sport athletes is absent. Therefore, this study investigated the performance and TS responses to a 0.1% menthol mouth rinse (MR) or placebo (PLA) among elite male rugby union players. METHOD Twenty-seven (15 Forwards and 12 Backs) elite male Super Rugby players completed two 3-minute 15-a-side rugby-specific conditioning blocks, with MR or PLA provided at the start of training (baseline), at the start of each 3-minute block (swill 1 [S1] and swill 2 [S2]), and at the end of training (swill 3 [S3]). TS was assessed using the American Society of Heating, Refrigerating and Air-Conditioning Engineers 9-point Analog Sensation Scale after each swill and at baseline (preconditioning block). Acceptability was measured after baseline swill and S3 using a 5-question Likert scale. Physical performance was measured throughout training using global positioning system metrics. RESULTS MR attenuated TS from baseline to S1 (P = .003, SD = 1.01) and S2 (P = .002, SD = 1.09) in Forwards only, compared with PLA. Acceptability was higher only for Forwards in MR versus PLA at baseline (P = .003, SD = 1.3) and S3 (P = .004, SD = 0.75). MR had no effect on physical performance metrics (P > .05). CONCLUSION MR attenuated the rise in TS with higher acceptability at S1 and S3 (in Forwards only) with no effect on selected physical performance metrics. Longer-duration exercise (eg, a match) in hot-humid conditions eliciting markedly increased body temperatures could theoretically allow favorable changes in TS to enhance performance-these postulations warrant experimental investigation.
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Affiliation(s)
- Marcia L Jerram
- Department of Human Nutrition, University of Otago, Dunedin,New Zealand
| | - Dane Baker
- Department of Human Nutrition, University of Otago, Dunedin,New Zealand
| | | | - Phil Healey
- Blues Super Rugby Franchise, Auckland,New Zealand
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
- Human Performance Research Centre, University of Technology Sydney (UTS), Sydney, NSW,Australia
- Sport & Exercise Discipline Group, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW,Australia
| | - Katherine Black
- Department of Human Nutrition, University of Otago, Dunedin,New Zealand
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Zhang W, Ren S, Zheng X. Effect of 3 min whole-body and lower limb cold water immersion on subsequent performance of agility, sprint, and intermittent endurance exercise. Front Physiol 2022; 13:981773. [PMID: 36299255 PMCID: PMC9589280 DOI: 10.3389/fphys.2022.981773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to investigate the effects of whole-body cold-water immersion (WCWI) and lower-limb cold-water immersion (LCWI) employed during a 15-min recovery period on the subsequent exercise performance as well as to determine the physiological and perceptual parameters in the heat (39°C). Eleven males performed team-sports-specific tests outdoors. The exercise program consisted of two identical exercise protocols (1 and 2) separated by a 15-min recovery period. The participants completed the same tests in each exercise protocol, in the following order: agility t test (t-test), 20-m sprint test (20M-ST), and Yo-Yo Intermittent Endurance Test Level 1 (Yo-Yo). During the recovery period, a 3-min recovery intervention of a passively seated rest (control, CON), WCWI, or LCWI was performed. The t-test and 20M-ST for the CON group were significantly longer during exercise protocol 2, but they were not significantly different between the two exercise protocols for the WCWI and LCWI groups. The completed Yo-Yo distance for the CON and LCWI groups was shorter during exercise protocol 2, but it was not significantly different between the two exercise protocols for the WCWI group. The chest temperature (Tchest), upper arm temperature (Tarm), thigh temperature (Tthigh), mean skin temperature (Tskin), and thermal sensation (TS) values were lower for the WCWI group than for the CON group; but only the Tthigh, Tskin, and TS values were lower for the LCWI group compared to the CON group. The Tchest, Tarm, Tskin, and TS values after the intervention were lower for the WCWI group than for the LCWI group. None of the three intervention conditions affected the core temperature (Tcore), heart rate (HR), or rating of perceived exertion (RPE). These results suggest that WCWI at 15°C for 3 min during the 15-min recovery period attenuates the impairment of agility, sprint, and intermittent-endurance performance during exercise protocol 2, but LCWI only ameliorates the reduction of agility and sprint performance. Furthermore, the ergogenic effects of WCWI and LCWI in the heat are due, at least in part, to a decrease of the Tskin and improvement of perceived strain.
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Affiliation(s)
- Wei Zhang
- Department of Sports Training, Shenyang Sport University, Shengyang, China
| | - Shoupeng Ren
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
| | - Xinyan Zheng
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
- *Correspondence: Xinyan Zheng,
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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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de Korte JQ, Bongers CCWG, Hopman MTE, Eijsvogels TMH. Exercise Performance and Thermoregulatory Responses of Elite Athletes Exercising in the Heat: Outcomes of the Thermo Tokyo Study. Sports Med 2021; 51:2423-2436. [PMID: 34396493 PMCID: PMC8514392 DOI: 10.1007/s40279-021-01530-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
Objective We examined the impact of simulated Tokyo 2020 environmental condition on exercise performance, thermoregulatory responses and thermal perception among Dutch elite athletes. Methods 105 elite athletes from different sport disciplines performed two exercise tests in simulated control (15.9 ± 1.2 °C, relative humidity (RH) 55 ± 6%) and Tokyo (31.6 ± 1.0 °C, RH 74 ± 5%) environmental conditions. Exercise tests consisted of a 20-min warm-up (70% HRmax), followed by an incremental phase until volitional exhaustion (5% workload increase every 3 min). Gastrointestinal temperature (Tgi), heart rate, exercise performance and thermal perception were measured. Results Time to exhaustion was 16 ± 8 min shorter in the Tokyo versus the control condition (− 26 ± 11%, whereas peak power output decreased with 0.5 ± 0.3 W/kg (16 ± 7%). Greater exercise-induced increases in Tgi (1.8 ± 0.6 °C vs. 1.5 ± 0.5 °C, p < 0.001) and higher peak Tgi (38.9 ± 0.6 °C vs. 38.7 ± 0.4 °C, p < 0.001) were found in the Tokyo versus control condition. Large interindividual variations in exercise-induced increase in Tgi (range 0.7–3.5 °C) and peak Tgi (range 37.6–40.4 °C) were found in the Tokyo condition, with greater Tgi responses in endurance versus mixed- and skill-trained athletes. Peak thermal sensation and thermal comfort scores deteriorated in the Tokyo condition, with aggravated responses for power versus endurance- and mixed-trained athletes. Conclusion Large performance losses and Tgi increases were found among elite athletes exercising in simulated Tokyo conditions, with a substantial interindividual variation and significantly different responses across sport disciplines. These findings highlight the importance of an individual approach to optimally prepare athletes for safe and maximal exercise performance during the Tokyo Olympics. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01530-w.
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Affiliation(s)
- Johannus Q de Korte
- Department of Physiology (392), Radboud University Medical Centre, 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 Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Physiology (392), Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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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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10
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Limiting Rise in Heat Load With an Ice Vest During Elite Female Rugby Sevens Warm-Ups. Int J Sports Physiol Perform 2021; 16:1684-1691. [PMID: 34021092 DOI: 10.1123/ijspp.2020-0833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/01/2021] [Accepted: 01/25/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the effect of wearing a phase-change cooling vest in elite female rugby sevens athletes during (1) a simulated match-day warm-up in hot conditions prior to a training session and (2) a prematch warm-up during a tournament in cool conditions. METHODS This study consisted of 2 randomized independent group designs (separated by 16 d) where athletes completed the same 23- to 25-minute match-day warm-up (1) in hot conditions (range = 28.0°C to 35.1°C wet bulb globe temperature [WBGT]) prior to training and (2) in cool conditions (range = 18.8°C to 20.1°C WBGT) prior to a World Rugby Women's Sevens Series match. In both conditions, athletes were randomly assigned to wearing either (1) the standardized training/playing ensemble (synthetic rugby shorts and training tee/jersey) or (2) the standardized training/playing ensemble plus a commercial phase-change athletic cooling vest. Group-wise differences in core temperature rise from baseline, global positioning system-measured external locomotive output, and perceptual thermal load were compared. RESULTS Core temperature rise during a match warm-up was lower in the hot condition only (-0.65°C [95% confidence interval = -1.22°C to -0.08°C], ηp2=.23 [95% confidence interval = .00 to .51], P = .028). No differences in various external-load variables were observed. CONCLUSIONS Phase-change cooling vests can be worn by athletes prior to, and during, a prematch warm-up in hot conditions to limit excess core temperature rise without adverse effects on thermal perceptions or external locomotion output.
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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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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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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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