Futureproofing triathlon: expert suggestions to improve health and performance in triathletes

Ultra culture-ultra reality: a content analysis of YouTube depictions of ultra endurance sport and comparisons to scientific literature

Introduction

Interest in ultra endurance sport (UES) is increasing, with relevant events growing in popularity. However, these activities may encompass more complex characteristics and demands that do not correspond to scientifically validated correlations between physical activity and improved health. It is unknown whether high volume training for UES can have adverse implications, although certain sociocultural aspects of western society, such as an emphasis on autonomy and self-directed success, may encourage participation as a representation of personal achievement. As media depictions of UES can be highly influential, we aimed to explore prominent messages to better comprehend the values and aspirations of established and aspiring ultra endurance athletes (UEA).

Methods

Using qualitative, conventional content analysis techniques, we evaluated n = 15 popular YouTube videos on various UES to synthesize the most common themes. A YouTube search was conducted, and videos were selected based on sport and relevance. Subsequently, videos were analyzed and coded to discern the most frequently repeated themes.

Results

Five recurring themes were identified: discussion of the mental aspects of UES participation; the adoption of folk-tale storytelling; dietary habits of UEA; a focus on pain and suffering; the use of words associated with mental illness as a colloquial descriptor of UES/UEA.

Discussion

YouTube depictions of UES participation appear to accentuate suffering and co-occurring phenomena as attractive qualities. These resonate with sociocultural ideologies in western contexts, which emphasize fitness and personal success, but appear inconsistent with evidence around potentially adverse health-related implications of UES.

Conclusion

Discrepancies between popular portrayals of UES and scientific evidence suggest a need for greater community education and information sharing about sport-specific risk factors for physical and mental health conditions and appropriate training protocols. Further research is also required to better define the relationship between motivations for UES participation and overall health using interdisciplinary approaches.

The Low Energy Availability in Females Questionnaire (LEAF-Q) as a Useful Tool to Identify Female Triathletes at Risk for Menstrual Disorders Related to Low Energy Availability

BACKGROUND

Nutrition in sport is a priority; it is the basis for maintaining optimal health and a prerequisite for the high performance necessary for competitions. The aim of this study was to assess low energy availability and its possible consequences among female triathletes by using the Low Energy Availability in Females Questionnaire (LEAF-Q).

METHODS

The study involved 30 female triathetes. The LEAF-Q was used in the study. An analysis of the body composition was carried out with the seca device mBCA 515 medical Body Composition Analyzer.

RESULTS

Of the 30 female triathletes studied, 23.3% had a monthly cycle disorder, defined as an amenorrhea state for more than 90 days. No differences were found in injury rates or training days lost to injury due to menstrual disturbances. Menstruation changes were significantly greater due to increases in exercise intensity, frequency, and duration in the group experiencing menstrual disturbances (85.7 [95% CIs: 42.1-99.6] vs. 8.7 [95% CIs: 1.1-28.0]). The menstrual disorder group had a greater incidence of their periods stopping for more than 3 months than the group without menstrual disturbances.

CONCLUSIONS

The female triathletes did not show abnormalities in body weight or composition, and these were not related to the incidence of menstrual disturbances. However, 20% of the triathletes either had, at the time of the study, or had had in the past monthly cycle disorders that could indicate an immediate risk of low energy availability. The LEAF-Q identified 10% of the triathletes as at risk (score > 8) of low energy availability and the physiological and performance consequences related to relative energy deficiency in sports (RED-S).

Exercise Mode in Heart Failure: A Systematic Review and Meta-Analysis

BACKGROUND

Optimising exercise prescription in heart failure (HF) with a preserved (HFpEF) or reduced (HFrEF) ejection fraction is clinically important. As such, the aim of this meta-analysis was to compare traditional moderate intensity training (MIT) against combined aerobic and resistance training (CT) and high-intensity interval training (HIIT) for improving aerobic capacity (VO₂), as well as other clinically relevant parameters.

METHODS

A comprehensive systematic search was performed to identify randomised controlled trials published between 1990 and May 2021. Research trials reporting the effects of MIT against CT or HIIT on peak VO₂ in HFpEF or HFrEF were considered. Left-ventricular ejection fraction (LVEF) and various markers of diastolic function were also analysed.

RESULTS

Seventeen studies were included in the final analysis, 4 of which compared MIT against CT and 13 compared MIT against HIIT. There were no significant differences between MIT and CT for peak VO₂ (weighted mean difference [WMD]: 0.521 ml min^-1 kg^-1, [95% CI] =  - 0.7 to 1.8, P_fixed = 0.412) or LVEF (WMD: - 1.129%, [95% CI] =  - 3.8 to 1.5, P_fixed = 0.408). However, HIIT was significantly more effective than MIT at improving peak VO₂ (WMD: 1.62 ml min^-1 kg^-1, [95% CI] = 0.6-2.6, P_random = 0.002) and LVEF (WMD: 3.24%, [95% CI] = 1.7-4.8, P_random < 0.001) in HF patients. When dichotomized by HF phenotype, HIIT remained significantly more effective than MIT in all analyses except for peak VO₂ in HFpEF.

CONCLUSIONS

HIIT is significantly more effective than MIT for improving peak VO₂ and LVEF in HF patients. With the exception of peak VO₂ in HFpEF, these findings remain consistent in both phenotypes. Separately, there is no difference in peak VO₂ and LVEF change following MIT or CT, suggesting that the addition of resistance exercise does not inhibit aerobic adaptations in HF.

Mood profiles of amateur triathletes: Implications for mental health and performance

Moods have been shown to be predictive of athletic performance and a reflection of mental health status. The aims of our study were (a) to compare pre-race mood scores of triathletes with population norms; (b) to compare pre-race mood scores of triathletes grouped by gender and age bands; (c) to explore whether six distinct mood profile clusters reported in the literature were evident among triathletes and their respective prevalence; (d) to determine if pre-race mood scores predicted triathlon performance; and (e) to interpret our findings in terms of the risk of mental health issues for triathletes. Participants were 592 age-group triathletes (also referred to as recreational or amateur triathletes) who completed the Brunel Mood Scale pre-race and recorded their time goal for the race. Mean mood scores deviated significantly from population norms, with Tension and Vigor scores at the 55th and 54th percentile, respectively, and Depression, Anger, Fatigue, and Confusion scores between the 42nd and 46th percentile. Females reported higher Tension scores than males (p < 0.001), and those in the 18-25  years and 26-35 years age bands reported higher Tension scores than those in the 46-55 years age band (p < 0.008). Using k-means cluster analysis, six distinct mood profiles were identified, the distribution of which approximated the general population, except for a low prevalence of very negative profiles. Mean scores for Depression and Anger were exceptionally low and only 1.5% of triathletes, compared to the normal prevalence of ~5%, reported an "inverse Everest" profile, which is associated with elevated risk of psychopathology. Mood scores did not predict triathlon performance, assessed by finish time as a percentage of time goal. Results showed an association between triathlon participation and psychological well-being. Findings will inform future investigations of mood responses among triathletes and provide a relevant point of reference for applied practitioners who work with triathletes.

Reliability and concurrent validity of TRAZER compared to three-dimensional motion capture

BACKGROUND

Efficient neural processing of visuospatial and proprioceptive input appears to be crucial for avoidance of sport injury. As such, clinically-feasible tests are needed to identify deficiencies found by advanced neuroimaging and electrophysiological tests. Three-dimensional motion capture in a laboratory setting is currently the gold standard for measurement of human movement parameters but is costly and requires extensive training. Non-immersive virtual reality systems with body motion tracking, such as TRAZER, may provide a clinically-feasible and portable means of acquiring similar variables. Test-retest reliability and concurrent validity of these systems are currently lacking.

AIM

The aim of the study was to assess the concurrent validity of the TRAZER single-camera system with 3D motion capture system and to assess the test-retest reliability of TRAZER's whole-body reactive agility metrics.

METHODS

Participants - For validity, 13 healthy individuals (24.8±3.1 years, 170.0±7.7 cm, 70.0±14.2 kg); for reliability, 18 healthy individuals (23.3±2.5 years, 168.2±11.2 cm, 78.2±17.8 kg). Design - Validity was a single-session cross-sectional study. Reliability was a 3 consecutive day test-retest study. Setting-Controlled laboratory study. Intervention - Assessments utilized randomized movements in eight directions for forty total repetitions as designated by the TRAZER system. TRAZER protocol was simultaneously tracked by Vicon Motion Capture and the TRAZER system. Reliability data were captured on three consecutive days by the TRAZER system. Main Outcome Measures - Maximum acceleration, maximum velocity, and total distance were recorded for validation. In addition to these measures, maximum deceleration, average velocity, average acceleration, average deceleration, and average reaction time were collected for reliability.

RESULTS

Overall, a lack of agreement exists between maximum outputs for TRAZER and 3D motion capture (velocity r=0.808, acceleration r=-0.090), but total distance correlation was high (r =.961). ICC values between days 1-2-3 for average measures were high (average velocity=0.847, average acceleration=0.919, and average deceleration=0.948) with the exception of average reaction time being fair (ICC=0.536). ICCs for maximum measures showed a much smaller correlation between days (velocity=0.654, acceleration=0.171, and deceleration=0.416).

CONCLUSIONS

Even though there is a lack of strong concurrent validity between measures obtained from TRAZER and 3D motion capture systems, there is strong test-retest reliability of the TRAZER system. The applicability of these findings makes TRAZER clinically relevant in scenarios requiring pre- and post-testing for return to play decisions, or monitoring of a training regimen where demonstration of validation to a gold standard measurement is not relevant.

RELEVANCE FOR PATIENTS

When test-retest capability is desired, such as in return-to-play protocols following an injury, Trazer is a reliable option.