Diagnosing Overtraining Syndrome: A Scoping Review

Health-Related Quality of Life in Rugby Athletes: The Role of Dietary Supplements and Their Consumption

This study investigates dietary supplement use among rugby players and their general health, focusing on prevalence and underlying motivations. Involving 92 athletes, it examines the relationship between supplement usage, motivations, and health outcomes using the 36-item Short Form Health Survey and a 24-item ad hoc questionnaire. Findings reveal a high frequency of supplement usage, motivated by desires to enhance performance, appearance, and mood. Significant differences in health-related quality of life are found between users and non-users, particularly in mental health, social functioning, and emotional stability. Motivations like performance enhancement and body shape manipulation were linked to altered health perceptions, indicating the psychosocial impacts of supplementation. This study emphasizes the need to consider the holistic effects of supplements on athlete well-being, advocating for a balanced approach prioritizing both physical and mental health. It calls for increased awareness among athletes, coaches, and sports professionals about the potential risks and benefits of supplement use and the importance of informed decision-making. Additionally, it highlights the need for further research to understand the mechanisms of supplement use and its impact on athlete health, aiming to enhance sports science and promote overall athlete well-being in competitive environments.

The structural validity and latent profile characteristics of the Abbreviated Profile of Mood States among Chinese athletes

BACKGROUND

This study examines the structural validity of the Chinese version of the Abbreviated Profile of Mood States (POMS) among Chinese athletes and analyzes potential profiles to provide evidence for its effective use and recommendations for its application.

METHODS

A total of 340 Chinese athletes completed the Chinese version of the Abbreviated POMS. Initially, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to identify and verify the extractable dimensions of the Abbreviated POMS. Subsequently, the fit of the six-factor and seven-factor models of POMS was tested directly based on their theoretical structures. Finally, latent profile analysis was used to examine profiles based on the four-factor model derived from the factor analysis, six-factor model, and seven-factor model.

RESULTS

The Abbreviated POMS was refined to a four-factor model, consisting of 27 items across four factors: positive mood, anger, fatigue, and confusion. The hypothesized six-factor and seven-factor models did not demonstrate satisfactory fit, suggesting that the seven dimensions function better as independent subscales. Iceberg and inverse iceberg profiles were observed across the four-factor model, six-factor model, and seven-factor model.

CONCLUSION

The Abbreviated POMS does not support its initial hypothesized structure among Chinese athletes. Caution is advised when using the Abbreviated POMS with athletes; it is recommended to use the four-factor model or evaluate each emotion as an independent subscale. The iceberg and inverse iceberg profiles can be used to categorize athletes' emotional characteristics.

Risk Factors for Injury in Border Collies Competing in Agility Competitions

Border Collies are the most common breed in agility and their reported injury rate is much higher than that of other breeds. We aimed to identify demographic, training, and competition variables associated with the injury risk for this breed. We hypothesized that higher jump heights and competition at national/international levels would increase the injury risk. Data were collected from an internet-based survey. A logistic regression model was built using backward selection. There were 934 Border Collies in the sample, with 488 reporting an injury. The jump height relative to the shoulder height was associated with injury, with dogs jumping noticeably above or below shoulder height more likely to report a history of injury. Other identified risk factors included the number of weekends spent competing/year, the number of competitions at the national level, the age when starting elbow height jumps and backside jumps, the acquisition of the dog from a breeder, and the age of the handler. Factors associated with prolonged injury (>3-month duration) were the age when starting elbow height jumps and having a veterinary assistant as a handler. Border Collies jumping above shoulder height had an increased risk of injury. However, those jumping below shoulder height were also at a higher risk, which could have been due to reverse causality. Similarly, the observed associations regarding differences based on the number of trial weekends/year may have been impacted by reverse causality as well. The increased risk of injury with elbow height jump training at <10 months of age may indicate that the repetitive impact of jump training prior to skeletal maturity negatively influences musculoskeletal development. These data provide valuable information for further prospective studies.

The combined effects of temperature and posture on regional blood flow and haemodynamics

Under simultaneous ambient temperature and postural stressors, integrated regional blood flow responses are required to maintain blood pressure and thermoregulatory homeostasis. The aim of the present study was to assess the effect of ambient temperature and body posture on regional regulation of microvascular blood flow, specifically in the arms and legs. Participants (N = 11) attended two sessions in which they experienced transient ambient conditions, in a climatic chamber. During each 60-min trial, ambient temperature increased from 15.7 (0.6) °C to 38.9 (0.6) °C followed by a linear decrease, and the participants were either standing or in a supine position throughout the trial; relative humidity in the chamber was maintained at 25.9 (6.6) %. Laser doppler flowmetry of the forearm (SkBFarm) and calf (SkBFcalf), and haemodynamic responses (heart rate, HR; stroke volume, SV; cardiac output, CO; blood pressure, BP), were measured continuously. Analyses of heart rate variability and wavelet transform were also conducted. SkBFarm increased significantly at higher ambient temperatures (p = 0.003), but not SkBFcalf. The standing posture caused lower overall SkBF in both regions throughout the protocol, regardless of temperature (p < 0.001). HR and BP were significantly elevated, and SV significantly lowered, in response to separate and combined effects of higher ambient temperatures and a standing position (all p < 0.05); CO remained unchanged. Mechanistic analyses identified greater sympathetic nerve activation, and higher calf myogenic activation at peak temperatures, in the standing condition. Mechanistically and functionally, arm vasculature responds to modulation from both thermoregulation and baroreceptor activity. The legs, meanwhile, are more sensitive to baroreflex regulatory mechanisms.

Association between eHealth literacy and health outcomes in German athletes using the GR-eHEALS questionnaire: a validation and outcome study

BACKGROUND

Athletes face various sports-related stressors, which may increase their risk for physical and mental health symptoms. With the internet as an important source of (health) information, it is important for athletes to have eHealth literacy, i.e. the ability to access, understand and use electronic health information and services. However, it is presently uncertain whether eHealth literacy of athletes is linked to better health outcomes such as reduced injury frequency and behaviours like decreased substance abuse.

METHODS

A cross-sectional study was conducted with N = 373 German athletes (229 females) from different types of sport (e.g., ball sports and water sports) who were included in the statistical analyses. The survey included medical, socio-demographic, eHealth- and sports-related data as well as the eHealth Literacy Scale (GR-eHEALS) questionnaire, which measures eHealth literacy. Confirmatory factor analyses and correlational analyses were performed to determine the convergent and discriminant (compared to the 8-item Impulsive Behavior-8 Scale) validity of the GR-eHEALS and to assess the relation between eHealth literacy scores and health outcomes.

RESULTS

The more frequently athletes had sustained minor or moderate injuries in the past, the higher the level of eHealth literacy they reported. Furthermore, consumption frequency of painkillers (r = .18, p = .002), sedatives (r = .12, p = .040), and cannabis (r = .29, p = .000) was significantly correlated with eHealth literacy scores. The confirmatory factor analysis of the GR-eHEALS showed an acceptable model fit with a 2-factor solution (information seeking and information appraisal). The GR-eHEALS showed good discriminant (r = - .09, p = .21) and convergent validity (digital confidence; r = .28, p < .001).

CONCLUSION

The GR-eHEALS is a valid instrument to assess eHealth literacy within the cohort of German athletes. Potential dangers of dealing with injury and psychological strain without reaching out for professional help should be considered.

Myalgic encephalomyelitis/chronic fatigue syndrome from current evidence to new diagnostic perspectives through skeletal muscle and metabolic disturbances

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a demanding medical condition for patients and society. It has raised much more public awareness after the COVID-19 pandemic since ME/CFS and long-COVID patients share many clinical symptoms such as debilitating chronic fatigue. However, unlike long COVID, the etiopathology of ME/CFS remains a mystery despite several decades' research. This review moves from pathophysiology of ME/CFS through the compelling evidence and most interesting hypotheses. It focuses on the pathophysiology of skeletal muscle by proposing the hypothesis that skeletal muscle tissue offers novel opportunities for diagnosis and treatment of this syndrome and that new evidence can help resolve the long-standing debate on terminology.

The function of previously unappreciated exerkines secreted by muscle in regulation of neurodegenerative diseases

The initiation and progression of neurodegenerative diseases (NDs), distinguished by compromised nervous system integrity, profoundly disrupt the quality of life of patients, concurrently exerting a considerable strain on both the economy and the social healthcare infrastructure. Exercise has demonstrated its potential as both an effective preventive intervention and a rehabilitation approach among the emerging therapeutics targeting NDs. As the largest secretory organ, skeletal muscle possesses the capacity to secrete myokines, and these myokines can partially improve the prognosis of NDs by mediating the muscle-brain axis. Besides the well-studied exerkines, which are secreted by skeletal muscle during exercise that pivotally exert their beneficial function, the physiological function of novel exerkines, e.g., apelin, kynurenic acid (KYNA), and lactate have been underappreciated previously. Herein, this review discusses the roles of these novel exerkines and their mechanisms in regulating the progression and improvement of NDs, especially the significance of their functions in improving NDs' prognoses through exercise. Furthermore, several myokines with potential implications in ameliorating ND progression are proposed as the future direction for investigation. Elucidation of the function of exerkines secreted by skeletal muscle in the regulation of NDs advances the understanding of its pathogenesis and facilitates the development of therapeutics that intervene in these processes to cure NDs.

Nonlinear, Multicomponent Physical Exercise With Heart Rate Variability-Guided Prescription in Women With Breast Cancer During Treatment: Feasibility and Preliminary Results (ATOPE Study)

OBJECTIVE

The purpose of this study was to examine the feasibility, safety, adherence, and preliminary efficacy of the ATOPE program during radiotherapy (RT) or chemotherapy (CT) for women with breast cancer.

METHODS

This single-blind, pretest-posttest feasibility study included 38 women with breast cancer at the beginning of their treatment. The ATOPE program consisted of 12 to 18 sessions of a multimodal physical exercise program, prescribed based on daily heart rate variability and clinimetric assessments using the ATOPE+ mHealth system. Overall health was assessed with quality of life, autonomous balance, and body composition, whereas health-related fitness was measured through functional capacity, physical activity levels, and upper and lower limb strength.

RESULTS

The rates of recruitment, retention, and adherence were 52.35, 73.68, and 84.37%, respectively, and the satisfaction rating was 9.2 out of a possible 10 points. The perceived health status change score was 3.83 points, scored on a -5 to 5 point scale. No adverse effects were found. Compliance results showed that the ATOPE+ mHealth system was used on 73.38% of the days, and the Fitbit bracelet (Google, Mountain View, CA, USA) was used on 84.91% of the days. Women stayed physically active 55% of days. Regarding preliminary results, for overall health, the percentage of body fat in the RT group decreased by 1.93%, whereas it increased by 5.03% in the CT group. Lower limb strength increased in the RT group, specifically knee extensor isometric strength (6.07%), isokinetic knee flexors 180 degree/second (1.53%), and isokinetic knee extensors 300 degree/second (4.53%), in contrast with the reductions found in the CT group (11.07, 18.67, and 14.89%, respectively).

CONCLUSION

The ATOPE program, through nonlinear prescription based on daily monitoring with the ATOPE+ mHealth system, is feasible and safe for application during breast cancer treatment. The results suggest that the overall health can be maintained or even improved regarding most variables.

IMPACT

This study focused on the feasibility, safety, and completion of a physical therapist-led program at early diagnosis for adults with breast cancer. The multimodal, supervised, tailored, nonlinear physical exercise program is feasible and safe, showed a good completion rate, and was able to prevent the quality-of-life deficits that are often triggered by systemic breast cancer treatment. This study highlights the importance of daily morning assessments using the ATOPE+ mHealth system in patients with breast cancer to prescribe nonlinear physical exercise.

Effects of Exercise Intensity on Cardiometabolic Parameters of Ovariectomized Obese Mice

The aim of this study was to compare the effects of continuous-moderate vs. high-intensity interval aerobic training on cardiovascular and metabolic parameters in ovariectomized high-fat-fed mice. C57BL/6 female ovariectomized were divided into four groups (n=8): low-fat-fed sedentary (SLF); high-fat-fed sedentary (SHF); high-fat-fed moderate-intensity continuous trained (MICT-HF); and high-fat-fed high-intensity interval aerobic trained (HIIT-HF). The high-fat diet lasted 10 weeks. Ovariectomy was performed in the fourth week. The exercise training was carried out in the last four weeks of protocol. Fasting glycemia, oral glucose tolerance, arterial pressure, baroreflex sensitivity, and cardiovascular autonomic modulation were evaluated. Moderate-intensity continuous training prevented the increase in arterial pressure and promoted a reduction in HR at rest, associated with an improvement in the sympathovagal balance in MICT-HF vs. SHF. The high-intensity interval training reduced blood glucose and glucose intolerance in HIIT-HF vs. SHF and MICT-HF. In addition, it improved sympathovagal balance in HIIT-HF vs. SHF. Moderate-intensity continuous training was more effective in promoting cardiovascular benefits, while high-intensity interval training was more effective in promoting metabolic benefits.

The Association between Training Frequency, Symptoms of Overtraining and Injuries in Young Men Soccer Players

Overtraining is a prevalent issue among young men soccer players, particularly those who are driven to enhance their skills. While an intense training volume and effort might contribute to athletic growth, it can also have negative implications, including injury. The current study aimed at examining the association between training frequency, symptoms of overtraining and injuries in young men soccer players. A path analysis approach was used to examine the causal relationships between variables. The sample consisted of 189 young men soccer players aged 13-17 years old (age = 14.81, SD = 1.37). Participants reported that they were training, on average, 5.77 days (SD = 1.53) per week. Athletes were competing at a regional (n = 100) or national (n = 89) level. Concerning injuries, participants indicated, on average, 2.03 (SD = 1.16) injuries since they started practicing soccer. The results displayed a significant association, as theoretically expected, namely: (i) training frequency was significantly associated with overtraining symptoms (β = 0.15 [IC95% = 0.01, 0.29]); (ii) overtraining symptoms were significantly associated with the number of injuries (β = 0.19 [IC95% = 0.02, 0.35]). An indirect effect between training frequency and injuries was also observed (β = 0.15 [IC95% = 0.01, 0.29]). Thus, there is preliminary evidence that overtraining symptoms could play a mediating role. In conclusion, investigating the links between overtraining symptoms and injury in young men soccer players is critical, as it can assist in identifying overtraining warning signs, promote young players' health and safety, customize training regimens to individual needs, and contribute to a better understanding of sports-related injuries.

Longitudinal Training and Workload Assessment in Young Friesian Stallions in Relation to Fitness: Part 1

Friesian stallions have to complete a 10-week studbook approval test (70-day test) consisting of dressage and driving training for acceptance as a breeding stallion. Training response of the horses to this approval program was evaluated. External workload (EW) of 16 stallions (3.2 ± 0.4 years old) was registered during the 9 weeks preceding the 70-day test (preparation period) and during 70-day test. Ridden indoor standardized exercise tests (SET), measuring heart rate (HR) and plasma lactate concentration (LA) at walk, trot and canter, were performed in week 1 (SET-I), 6 (SET-II) and 10 (SET-III) of the 70-day test. Linear mixed effect models were used to analyze HR and LA related to SETs and EW related to the phase of the study, using Akaike's information criterion for model reduction. EW was higher in the 70-day test compared to the preparation period, with longer duration of training sessions. Compared to SET-I, horses showed increased HR and LA after canter in SET-II and SET-III, indicating that they were more fatigued. The fact that the fitness of these Friesian stallions decreased during the 70-day test suggests overtraining. To optimize training effects and welfare of these horses, the workload of the training program needs to be adjusted.

Longitudinal Training and Workload Assessment in Young Friesian Stallions in Relation to Fitness, Part 2-An Adapted Training Program

Young Friesian stallions have to complete a 10-week training program (70-day test) for acceptance as a breeding stallion. Part one of this study showed that the 70-day test was too intense and led to reduced fitness. In the present (part two) study, the effects of an adapted training program were studied. Training frequency and minutes of cantering per week were lowered compared with part one. The external workload (EW) of sixteen stallions (3.4 ± 0.8 years) was monitored during the 6-weeks before testing (preparation period) as well as during the 70-day test. Standardized exercise tests (SETs) were performed in week 1 (SET-I), 6 (SET-II), and 10 (SET-III) of the 70-day test, measuring heart rate (HR) and plasma lactate concentration (LA). Linear mixed effect models were used to analyze the EW, and the HR and LA related to the SETs. The EW increased from the preparation period to the 70-day test; this increase in the EW was lower compared with the original training program. The horses showed lower HR and LA levels in SET-III compared with SET-I. The young Friesian horses were at risk to be overtrained in part one, but the adapted training program resulted in increased fitness. This study shows that a carefully chosen program is necessary to improve the performance and welfare of (young) horses.

High-Intensity Interval Training Combined with Different Types of Exercises on Cardiac Autonomic Function. An Analytical Cross-Sectional Study in CrossFit® Athletes

It is well established that endurance exercise has positive effects on cardiac autonomic function (CAF). However, there is still a dearth of information about the effects of regular high-intensity interval training combined with different types of exercises (HIITCE) on CAF.

OBJECTIVE

The aim of this study is to compare CAF at rest, its reactivity, and reactivation following maximal exercise testing in HIITCE and endurance athletes.

METHODS

An observational study was conducted with 34 male athletes of HIITCE (i.e., CrossFit^®) [HG: n = 18; 30.6 ± 4.8 years] and endurance athletes (i.e., triathlon) [TG.: n = 16; 32.8 ± 3.6 years]. We analyzed 5 min of frequency-domain indices (TP, LF, HF, LFn, HFn, and LF/HF ratio) of heart rate variability (HRV) in both supine and orthostatic positions and its reactivity after the active orthostatic test. Post-exercise heart rate recovery (HRR) was assessed at 60, 180, and 300 s. Statistical analysis employed a non-parametric test with a p-value set at 5%.

RESULTS

The HG showed reduced HFn and increased LFn modulations at rest (supine). Overall cardiac autonomic modulation (TP) at supine and all indices of HRV at the orthostatic position were similar between groups. Following the orthostatic test, the HG showed low reactivity for all HRV indices compared to TG. After the exercise, HRR does not show a difference between groups at 60 s. However, at 180 and 300 s, an impairment of HRR was observed in HG than in TG.

CONCLUSION

At rest (supine), the HG showed reduced parasympathetic and increased sympathetic modulation, low reactivity after postural change, and impaired HRR compared to TG.

Cardiorespiratory coupling strength in athletes and non-athletes

PURPOSE

Despite the relevant presence of nonlinear components on heart period (HP) likely due to cardiorespiratory coupling (CRC), the HP is frequently analyzed in absence of concomitant recordings of respiratory movements (RESP). This study aims to assess the cardiovascular dynamics and CRC during postural challenge in athletes and non-athletes via joint symbolic analysis (JSA).

METHODS

A cross-sectional study was conducted in 50 men, aged between 20 and 40 yrs, divided into athletes (n = 25) and non-athletes (n = 25) groups. The electrocardiogram, blood pressure and RESP signals were recorded during 15 min in both supine position (REST) and after active postural maneuver (STAND). From the beat-to-beat series of HP, systolic arterial pressure (SAP) and RESP, we computed the time and frequency domain indexes and baroreflex sensitivity. The JSA was based on the definition of symbolic HP and RESP patterns and on the evaluation of the rate of their simultaneous occurrence in both HP and RESP series.

RESULTS

The JSA analysis was able to identify higher CRC strength at REST in athletes. Moreover, the response of CRC to STAND depended on the time scales of the analysis and was much more evident in athletes than in non-athletes, thus indicating a more reactive autonomic control in athletes.

CONCLUSION

Assessing CRC in athletes via JSA provides additional information compared to standard linear time and frequency domain tools likely due to the more relevant presence of nonlinearities in HP-RESP variability relationship.