1
|
Ruuskanen O, Valtonen M, Waris M, Luoto R, Heinonen OJ. Sport and exercise during viral acute respiratory illness-Time to revisit. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:663-665. [PMID: 38072364 DOI: 10.1016/j.jshs.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Olli Ruuskanen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku 20521, Finland.
| | - Maarit Valtonen
- Finnish Institute of High Performance Sport KIHU, Jyväskylä 40700, Finland
| | - Matti Waris
- Institute of Biomedicine, University of Turku and Department of Clinical Virology, Turku University Hospital, Turku 20520, Finland
| | - Raakel Luoto
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku 20521, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku 20520, Finland
| |
Collapse
|
2
|
Agustiningsih D, Wibawa T. Demystifying roles of exercise in immune response regulation against acute respiratory infections: A narrative review. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:139-153. [PMID: 38708320 PMCID: PMC11067861 DOI: 10.1016/j.smhs.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 05/07/2024] Open
Abstract
The benefits of physical activity and exercise, especially those classified as moderate-to-vigorous activity (MVPA), have been well-established in preventing non-communicable diseases and mental health problems in healthy adults. However, the relationship between physical activity and exercise and the prevention and management of acute respiratory infection (ARI), a global high-burden disease, has been inconclusive. There have been debates and disagreements among scientific publications regarding the relationship between exercise and immune response against the causative agents of ARI. This narrative review aims to explore the theory that sufficiently explains the correlation between exercise, immune response, and ARI. The potential root causes of discrepancies come from research associated with the "open window" hypothesis. The studies have several limitations, and future improvements to address them are urgently needed in the study design, data collection, exercise intervention, subject recruitment, biomarkers for infection and inflammation, nutritional and metabolism status, and in addressing confounding variables. In conclusion, data support the clinical advantages of exercise have a regulatory contribution toward improving the immune response, which in turn potentially protects humans fromARI. However, the hypothesis related to its negative effect must be adopted cautiously.
Collapse
Affiliation(s)
- Denny Agustiningsih
- Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Tri Wibawa
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| |
Collapse
|
3
|
Escalona T, Okamura AR. Nasal Injuries and Issues in Athletes. Curr Sports Med Rep 2024; 23:7-15. [PMID: 38180070 DOI: 10.1249/jsr.0000000000001130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
ABSTRACT Nasal injuries and issues are widespread in athletic populations and can adversely affect training, performance, and overall well-being. Causes can typically be understood as cellular (allergic, nonallergic, and infectious rhinitis) or structural (static vs dynamic obstruction, trauma), and diagnosis and management differ accordingly. Upper respiratory tract infections, a subtype of infectious rhinitis, remain the most common illnesses among athletes. Here, the authors review the research surrounding the complex relationship between exercise, immunology, and susceptibility to infection. Furthermore, the authors provide an updated understanding of the current literature surrounding rhinitis and nasal trauma management and synthesize practical treatment considerations for providers caring for athletes at all levels.
Collapse
Affiliation(s)
- Tomas Escalona
- Resident, University of New Mexico Albuquerque, 1 University of New Mexico, Albuquerque, NM
| | - Anthony Robert Okamura
- University of New Mexico Albuquerque, Pediatric Sports Medicine, 1 University of New Mexico, Albuquerque, NM
| |
Collapse
|
4
|
Turpin VRG, Parr SK, Hammond ST, White ZJ, Tickner PJ, Chisam CE, Goerl KV, Drezner JA, Ade CJ. Cardiac changes in collegiate athletes following SARS-CoV-2 infection and quarantine: a prospective Case-Control study. Ann Med 2023; 55:2269586. [PMID: 37883807 PMCID: PMC10836285 DOI: 10.1080/07853890.2023.2269586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Athletes are susceptible to acute respiratory tract infections, including SARS-CoV-2, which can affect cardiovascular function. We aimed to evaluate the impact of COVID-19 infection and quarantine on cardiac function in male and female collegiate athletes. METHODS We conducted a single-center, prospective, case-control study and performed transthoracic echocardiography in a diverse group of convalescent SARS-CoV-2-positive athletes following a 10-14-day quarantine, matched to non-SARS-CoV-2 athletes. Data collection occurred from August 1, 2020, to May 31, 2021. RESULTS We evaluated 61 SARS-CoV-2-positive athletes (20 ± 1 years, 39% female) and 61 controls (age 20 ± 2 years, 39% female). Echocardiography in SARS-CoV-2-positive athletes was performed on average 40 ± 38 days after infection diagnosis. All SARS-CoV-2-positive athletes had clinically normal systolic left ventricular function (LVEF > 50%). However, SARS-CoV-2-positive athletes exhibited mildly lower LVEF compared to controls (65 ± 6% vs. 72 ± 8%, respectively, p < 0.001), which remained significant when evaluated separately for female and male athletes. Sub-analysis revealed these differences occurred only when imaging occurred within a mean average of 27 days of infection, with a longer recovery period (≥27 days) resulting in no differences. SARS-CoV-2-positive male athletes exhibited higher left ventricular end-diastolic volume and mitral filling velocities compared to male controls. CONCLUSION Our study reveals unique sex-specific cardiac changes in collegiate athletes following SARS-CoV-2 infection and quarantine compared to controls. Despite a mild reduction in LVEF, which was only observed in the first weeks following infection, no clinically significant cardiac abnormalities were observed. Further research is required to understand if the changes in LVEF are directly attributed to the infection or indirectly through exercise restrictions resulting from quarantine.
Collapse
Affiliation(s)
- Vanessa-Rose G Turpin
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Shannon K Parr
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Stephen T Hammond
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Zachary J White
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Preston J Tickner
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Chloe E Chisam
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
| | - Kyle V Goerl
- Lafene Health Center, Kansas State University, Manhattan, KS, USA
| | - Jonathan A Drezner
- Department of Family Medicine, Center for Sports Cardiology, University of WA, Seattle, WA, USA
| | - Carl J Ade
- Department of Kinesiology, College of Health and Human Sciences, KS State University, Manhattan, KS, USA
- Physician Associate Studies, College of Health and Human Sciences, Kansas State University, Manhattan, KS, USA
- Johnson Cancer Center, Kansas State University, Manhattan, KS, USA
| |
Collapse
|
5
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
6
|
Schwellnus M, Adami PE, Bougault V, Budgett R, Clemm HH, Derman W, Erdener U, Fitch K, Hull JH, McIntosh C, Meyer T, Pedersen L, Pyne DB, Reier-Nilsen T, Schobersberger W, Schumacher YO, Sewry N, Soligard T, Valtonen M, Webborn N, Engebretsen L. International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 1: acute respiratory infections. Br J Sports Med 2022; 56:bjsports-2022-105759. [PMID: 35863871 DOI: 10.1136/bjsports-2022-105759] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/04/2022]
Abstract
Acute illnesses affecting the respiratory tract are common and form a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. Acute respiratory illness (ARill) can broadly be classified as non-infective ARill and acute respiratory infections (ARinf). The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to ARinf in athletes. The International Olympic Committee (IOC) Medical and Scientific Commission appointed an international consensus group to review ARill (non-infective ARill and ARinf) in athletes. Six subgroups of the IOC Consensus group were initially established to review the following key areas of ARill in athletes: (1) epidemiology/risk factors for ARill, (2) ARinf, (3) non-infective ARill including ARill due to environmental exposure, (4) acute asthma and related conditions, (5) effects of ARill on exercise/sports performance, medical complications/return-to-sport and (6) acute nasal/vocal cord dysfunction presenting as ARill. Several systematic and narrative reviews were conducted by IOC consensus subgroups, and these then formed the basis of sections in the consensus documents. Drafting and internal review of sections were allocated to 'core' members of the consensus group, and an advanced draft of the consensus document was discussed during a meeting of the main consensus core group in Lausanne, Switzerland on 11 to 12 October 2021. Final edits were completed after the meeting. This consensus document (part 1) focusses on ARinf, which accounts for the majority of ARill in athletes. The first section of this consensus proposes a set of definitions and classifications of ARinf in athletes to standardise future data collection and reporting. The remainder of the consensus paper examines a wide range of clinical considerations related to ARinf in athletes: epidemiology, risk factors, pathology/pathophysiology, clinical presentation and diagnosis, management, prevention, medical considerations, risks of infection during exercise, effects of infection on exercise/sports performance and return-to-sport guidelines.
Collapse
Affiliation(s)
- Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco, Monaco Principality
| | - Valerie Bougault
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Hege Havstad Clemm
- Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Wayne Derman
- International Olympic Committee Research Centre, Pretoria, South Africa
- Institute of Sport and Exercise Medicine (ISEM), Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Uğur Erdener
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Ken Fitch
- School of Human Science; Sports, Exercise and Health, University of Western Australia, Perth, Western Australia, Australia
| | - James H Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
- Institute of Sport, Exercise and Health (ISEH), University College London (UCL), London, UK
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Lars Pedersen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Tonje Reier-Nilsen
- The Norwegian Olympic Sports Centre, Oslo, Norway
- Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine & Health Tourism (ISAG), University Hospital - Tirol Kliniken Innsbruck and Private University UMIT Tirol, Hall, Austria
| | | | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | | | - Nick Webborn
- Centre for Sport and Exercise Science and Medicine, University of Brighton, Brighton, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|