Muscular fatigue in response to different modalities of CrossFit sessions

Acute Effects of 30 g Cyclodextrin Intake during CrossFit® Training on Performance and Fatigue

The main objective of this study was to investigate the influence of carbohydrate intake (cyclodextrin) on performance during the performance of two consecutive workouts of the day (WODs) lasting 20 min each. Twenty-one male CrossFit (CF) athletes (29.5 ± 4.3 years; 72.81 ± 12.85 kg; 1.74 ± 0.06 m; 3.41 ± 1.21 years of experiences) participated in a crossover, randomized, and double-blind study. The effect of supplementation with 30 g of cyclodextrin (SG) (Cluster Dextrin®) or placebo (PG) (Bolero Advanced Hydration®) was evaluated on the performance of two specific WOD. Additionally, the effect on handgrip maximum strength, countermovement jump (CMJ), Wingate test, and 1 RM bench press test was evaluated. The effect on blood glucose and lactate was also evaluated. No differences were found in time, height, and power (W/Kg) in CMJ. However, there was a percentage improvement in CMJ jump power (W) (p < 0.05) between the groups, assuming an improvement in performance due to the intervention. Moreover, both conditions experimented differences in execution speed between sets (p < 0.05) in pre-WOD, and differences in post-WOD only in the placebo group, as well as decreases in this variable per repetition across the set (p < 0.01) in both conditions. However, no differences were found in the rest of the variables. Supplementation with 30 g of cyclodextrin did not have any metabolic or performance effects in CF tests. Although some differences between groups were observed in CMJ and power tests for bench press, the data are not conclusive and further research is needed in this regard.

Assessment of Cardiorespiratory and Metabolic Contributions in an Extreme Intensity CrossFit® Benchmark Workout

Our purpose was to characterize the oxygen uptake kinetics (VO2), energy systems contributions and total energy expenditure during a CrossFit® benchmark workout performed in the extreme intensity domain. Fourteen highly trained male CrossFitters, aged 28.3 ± 5.4 years, with height 177.8 ± 9.4 cm, body mass 87.9 ± 10.5 kg and 5.6 ± 1.8 years of training experience, performed the Isabel workout at maximal exertion. Cardiorespiratory variables were measured at baseline, during exercise and the recovery period, with blood lactate and glucose concentrations, including the ratings of perceived exertion, measured pre- and post-workout. The Isabel workout was 117 ± 10 s in duration and the VO2 peak was 47.2 ± 4.7 mL·kg-1·min-1, the primary component amplitude was 42.0 ± 6.0 mL·kg-1·min-1, the time delay was 4.3 ± 2.2 s and the time constant was 14.2 ± 6.0 s. The accumulated VO2 (0.6 ± 0.1 vs. 4.8 ± 1.0 L·min-1) value post-workout increased substantially when compared to baseline. Oxidative phosphorylation (40%), glycolytic (45%) and phosphagen (15%) pathways contributed to the 245 ± 25 kJ total energy expenditure. Despite the short ~2 min duration of the Isabel workout, the oxygen-dependent and oxygen-independent metabolism energy contributions to the total metabolic energy release were similar. The CrossFit® Isabel requires maximal effort and the pattern of physiological demands identifies this as a highly intensive and effective workout for developing fitness and conditioning for sports.

Influence of HIIRT With Fixed and Self-Selected Recovery Intervals on Physiological, Affective, and Enjoyment Responses

Purpose: Recovery-interval strategies may influence physiological and psychological responses during highintensity interval resistance training (HIIRT). This study compared the intensity, performance, and psychological outcomes during all-out effort HIIRT performed with fixed (FRI) and self-selected (SSRI) recovery intervals. Methods: Sixteen trained males (27.2 ± 4.1 years; 84.5 ± 8.9 kg; 55.8 ± 7.1 mL.kg-1.min-1) performed HIIRT bouts interspersed with FRI (10 s) and SSRI (15.3 ± 7.9 s). Results: Relative heart rate (%HRmax) and oxygen uptake (%VO2Peak), number of repetitions, and psychological responses (affection: Feeling ScaleFS; Felt Arousal ScaleFAS; enjoyment: Physical Activity Enjoyment ScalePACES) were assessed. FRI and SSRI elicited similar relative average intensity (p > .05) (%HRmax: 88.1 ± 3.5% vs. 87.6 ± 3.0%; %VO2Peak: 55.3 ± 7.4% vs. 54.1 ± 8.1%, respectively). The number of repetitions similarly decreased in SSRI and FRI from rounds 1 to 4 (~15%; p < .006), with no difference of total volume across conditions (FRI: 358.6 ± 32 reps vs. SSRI:357.5 ± 28.2; p = .89). In each round, no difference between FRI and SSRI (p > .05) was found for FS (3- to 3.5 vs. 2- to 4, respectively) or FAS (2- to 4 vs. 2- to 4, respectively), while PACES was lower in FRI than SSRI (102.8 ± 15.8 vs. 109.2 ± 13.2; p = .04). Conclusion: In conclusion, relative intensity, total repetitions, and affective perception were not influenced by the strategy of recovery intervals. On the other hand, overall enjoyment was favored in SSRI vs. FRI.

Taurine supplementation enhances anaerobic power in elite speed skaters: A double-blind, randomized, placebo-controlled, crossover study

Taurine (2-aminoethanesulfonic acid) is a semi-essential sulphur-containing amino acid abundant in skeletal muscle. Taurine supplementation is popular among athletes and has been purported to enhance exercise performance. This study aimed to investigate the ergogenic effects of taurine supplementation on anaerobic (Wingate; WanT) performance, blood lactate, ratings of perceived exertion (RPE), and countermovement vertical jump (CMJ) in elite athletes. For this study, randomized, double-blind, placebo-controlled crossover designs were used. Thirty young male speed skaters were randomly assigned to either taurine (TAU; single dose of 6 g) or placebo (PLAC; single dose of 6 g) 60 minutes before testing. Following a 72-hour washout, period participants completed the opposite condition. TAU improved peak (Δ% = 13.41, p < 0.001, d = 1.71), mean (Δ% = 3.95, p = 0.002, d = 1.04), and minimum power output (Δ% = 7.89, p = 0.034, d = 0.48) compared to placebo. Further, RPE (Δ% = -10.98, p = 0.002, d = 0.46) was significantly lower following the WanT in the TAU condition compared to placebo. There were no differences between conditions for the countermovement vertical jump. In conclusion, acute TAU supplementation augments anaerobic performance in elite speed skaters.

Trunk, Mass Grasp, Knee, and Hip Muscle Performance in CrossFit Participants: Reference Values According to Participants' Sex and Limb Dominance

Background

CrossFit is characterized by a diverse range of exercises recruiting different muscles and requiring different muscle functions. A characterization of muscular performance parameters in this population is needed.

Purpose

To determine reference values for various aspects of muscular performance of muscles of the trunk, thigh, hip, and mass grasp in CrossFit participants. Also, this investigation aimed to compare the strength measures between male and female CrossFit participants, as well as between dominant and non-dominant limbs.

Design

Descriptive, Cross-sectional.

Setting

Laboratory.

Methods

Isometric strength of trunk extensors (TE) and mass grasp was measured with handheld and Jamar dynamometer respectively. An isokinetic dynamometer was used to assess the muscle performance of the knee flexors (KF) and extensors (KE) (at 60º/s and 300º/s), and hip flexors (HF), extensors (HE), and abductors (HA) (60º/s and 240º/s ). Reference values for torque, work, power, fatigue, flexor:extensor ratio for the knee (hamstring:quadriceps - H:Q) and hip (HF:HE) joints were calculated. The torque and work values were normalized by the body mass. Mixed multivariate and univariate analyses of variance and independent t-tests were used for statistical analyses to compare between sexes and limbs.

Results

Participants included 111 individuals (58 males and 53 females) with at least one year of experience in CrossFit. Normative data are provided for the outcome variables. Males had greater values of muscular performance parameters than females in most variables (p<0.05). Also, the dominant limb had greater mass grasp strength (p<0.002), greater KE power at 60º/s (p=0.015), lower H:Q ratio at 60º/s (p=0.021) and 300º/s (p=0.008), and lower KE fatigue (p=0.002).

Conclusion

This study provides reference values for the trunk extensors, mass grasp, knee, and hip muscle performance in male and female CrossFit practitioners. Their muscle performance profile was characterized by few inter-limb asymmetries, and males demonstrated greater muscular performance outcomes than females, even after normalization by body mass. These reference values can be used for comparisons in research and clinical settings.

Level of Evidence

3b.

CrossFit®: 'Unknowable' or Predictable?-A Systematic Review on Predictors of CrossFit® Performance

The functional fitness training program CrossFit^® is experiencing fast-growing and widespread popularity with day-to-day varying 'Workouts of the Day' (WOD). Even among tactical athletes, the training program is widely applied. Nevertheless, there is a lack of data on which parameters influence CrossFit^® performance. For this reason, the purpose of this study is to conduct a systematic review of the existing literature to identify and summarize predictors of CrossFit^® performance and performance enhancement. In accordance with the PRISMA guidelines, a systematic search of the following databases was conducted in April 2022: PubMed, SPORTDiscus, Scopus, and Web of Science. Using the keyword 'CrossFit', 1264 entries are found, and 21 articles are included based on the eligibility criteria. In summary, the studies show conflicting results, and no specific key parameter was found that predicts CrossFit^® performance regardless of the type of WOD. In detail, the findings indicate that physiological parameters (in particular, body composition) and high-level competitive experience have a more consistent influence than specific performance variables. Nevertheless, in one-third of the studies, high total body strength (i.e., CrossFit^® Total performance) and trunk strength (i.e., back squat performance) correlate with higher workout scores. For the first time, this review presents a summary of performance determinants in CrossFit^®. From this, a guiding principle for training strategies may be derived, suggesting that a focus on body composition, body strength, and competition experience may be recommended for CrossFit^® performance prediction and performance enhancement.

Physiological effects of regular CrossFit® training and the impact of the COVID-19 pandemic—A systematic review

CrossFit® is a functional fitness training program known for its day-to-day varying “Workouts of the Day” (WOD). In accordance with the ‘CrossFit® Level 1 Training Guide’, regular CrossFit® training sessions consist of Warm-up, Mobility, Skill/Power training, WOD, and Cool-down. Despite the fast-growing and widespread popularity, data on the practical implementation of the training program based on scientific evidence are rare. Therefore, the purpose of this study is to systematically review the existing literature on the physiological effects of regular CrossFit® training in full extent instead of stand-alone WODs and to examine the impact of the COVID-19 pandemic on the training behavior of CrossFit® athletes. A systematic search was conducted following the PRISMA guidelines in April 2022 and updated in July 2022 using the following databases: PubMed, SPORTDiscus, Scopus, and Web of Science. Using the keyword “CrossFit”, 1,264 records were found. Based on the eligibility criteria, 12 studies are included and separated by topics: acute-short term physiological response (n = 8), and impact of the COVID-19 pandemic (n = 4). The results show that studies of regular training sessions were rarely conducted and contradicted the existing knowledge of the physiological demands [e.g., heart rate (HR)] of CrossFit®. In detail, included studies demonstrate that training sessions last 30–60 min and provide a progressive increase in cardiovascular load up to maximal effort activity (&gt;90% HRmax), differing from stand-alone WODs exclusively at high-intensity. Also, scarce research exists on COVID-19-pandemic-induced effects on training behavior, and studies are of moderate to low quality. There is still a lack of comprehensive analyses on the acute physiological effects of regular training sessions and the consequences of the COVID-19 pandemic in the scientific literature. Moreover, the inconsistent terminology used in CrossFit® research complicates generalized conclusions. Therefore, future research on the training methodology of CrossFit® needs to overcome terminological inequalities and examine scientifically the implementation of the concept by considering regular training sessions under practical settings.

Effects of Different Recovery Modalities on Delayed Onset Muscle Soreness, Recovery Perceptions, and Performance Following a Bout of High-Intensity Functional Training

The purpose of this study was to investigate the effects of the foam rolling technique and static stretching on perceptual and neuromuscular parameters following a bout of high-intensity functional training (HIFT), which consisted of 100 pull-ups, 100 push-ups, 100 sit-ups, and 100 air squats (Angie benchmark) in recreationally trained men (n = 39). Following baseline measurements (Feeling Scale, Visual Analogue Scale, Total Quality Recovery, Sit-and-Reach, Countermovement Jump, and Change-of-Direction t-test), the volunteers performed a single bout of HIFT. At the end of the session, participants were randomly assigned to one of three distinct groups: control (CONT), foam rolling (FR), or static stretching (SS). At the 24 h time-point, a second experimental session was conducted to obtain the post-test values. The level of significance was set at p < 0.05. Regarding power performance, none of the three groups reached pretest levels at 24 h point of the intervention. However, the CONT group still showed a greater magnitude of effect at the 24 h time-point (ES = 0.51, p ≥ 0.05). Flexibility presented the same recovery pattern as power performance (post × 24 h CONT = ES = 0.28, FR = ES = 0.21, SS = ES = 0.19). At 24 h, all groups presented an impaired performance in the COD t-test (CONT = ES = 0.24, FR = ES = 0.65, SS = ES = 0.56 p ≥ 0.05). The FR protocol resulted in superior recovery perceptions (pre × 24 h TQR = ES = 0.32 p ≥ 0.05). The results of the present study indicate that the use of FR and SS exercises may not be indicated when aiming to restore neuromuscular performance following a single bout of HIFT. The use of the FR technique during the cooldown phase of a HIFT session may be helpful in improving an individual's perception of recovery.

Acute physiological outcomes of high-intensity functional training: a scoping review

Background

Systematic reviews and meta-analyses related to high-intensity functional training (HIFT) have been conducted. However, due to a restricted pool of available research, these investigations are often limited in scope. As such, a scoping review investigating the present literature surrounding the acute physiological response to HIFT-based exercise was chosen as a more appropriate structured review.

Methodology

A scoping review was conducted following Arksey and O'Malley's framework. Three large scale databases were searched to reveal any article pertaining to HIFT and related exercise terminology.

Results

A total of 2,241 articles were found during the initial search. Following this, titles, then abstracts, and full-texts were reviewed to determine inclusion eligibility. A total of 60 articles which investigated a combined total of 35 unique HIFT workouts were included within this review.

Conclusions

A variety of physiological parameters and HIFT workouts have been examined. Markers of intensity (e.g., blood lactate concentrations, heart rate) have been most consistently assessed across all studies, and these support the idea that HIFT workouts are typically performed at high-intensity. In contrast, the inclusion of most other measures (e.g., hormonal, markers of inflammation and damage, energy expenditure, performance) has been inconsistent and has thus, limited the possibility for making generalized conclusions. Differences in study methodologies have further impacted conclusions, as different studies have varied in sample population characteristics, workouts assessed, and time points. Though it may be impossible to comprehensively research all possible HIFT workouts, consistent adoption of population definitions and workload quantification may overcome this challenge and assist with future comparisons.

Influence of Beetroot Juice Ingestion on Neuromuscular Performance on Semi-Professional Female Rugby Players: A Randomized, Double-Blind, Placebo-Controlled Study

PURPOSE

Beetroot juice (BRJ) is considered an ergogenic aid with good to strong evidence for improving human performance in sport modalities with similar demands to rugby. However, most of the studies were realized in male athletes with limited evidence in female athletes. Thus, the aim of this study was to explore the acute ingestion of BRJ in female rugby players.

METHODS

Fourteen semi-professional female rugby players (25.0 ± 3.7 years) belonging to a team from the First Spanish Female Rugby Division participated in this study. Participants were randomly divided into two groups that realized a neuromuscular battery after BRJ (140mL, 12.8 mmol NO₃^-) or placebo (PLAC, 140 mL, 0.08 mmol NO₃^-) ingestion on two different days separated by one week between protocols. The neuromuscular test battery consisted of a countermovement jump (CMJ), isometric handgrip strength (i.e., dominant), 10-m and 30-m sprint, agility t-test and Bronco test. Afterwards, participants reported a rate of perception scale (6-20 points) and side effects questionnaire associated with BRJ or PLAC ingestion.

RESULTS

Statistically significant improvements were observed in CMJ (7.7%; p = 0.029; ES = 0.62), while no differences were reported in dominant isometric handgrip strength (-1.7%; p = 0.274; ES = -0.20); 10-m and 30-m sprint (0.5-0.8%; p = 0.441-0.588; ES = 0.03-0.18); modified agility t-test (-0.6%; p = 0.503; ES = -0.12) and Bronco test (1.94%; p = 0.459; ES = 0.16).

CONCLUSIONS

BRJ ingestion could improve neuromuscular performance in the CMJ test, while no differences in sprint (10-m and 30-m sprint test), agility, isometric handgrip strength and endurance performance (i.e., Bronco test) were reported.

Neuromuscular Fatigue and Metabolic Stress during the 15 Minutes of Rest after Carrying Out a Bench Press Exercise Protocol

Background: Velocity loss (VL) at 1 m·s−1 can help to determine neuromuscular fatigue after performing an exercise protocol. The aim of this study was to analyse muscle fatigue and metabolic stress during the 15 min that follow the execution of a bench press (BP) exercise protocol. Methods: Forty-four healthy male students of sports science performed two exercise sessions separated by one week of rest. In the first week, the participants carried out a test with progressive loads in the (BP) exercise until reaching the one-repetition maximum (1RM) in order to obtain the load−velocity relationship of each participant. In the second week, each participant conducted three BP exercise sets at an intensity of 70% of 1RM, determining this load through the mean propulsive velocity (MPV) obtained from the individual load−velocity relationship, with the participants performing the maximum number of repetitions (MNR) to muscle failure. Two minutes of rest were allocated between sets. MPV at 1 m·s−1 and blood lactate concentrations were recorded before executing the exercise and at minute 0, 5, 10 and 15 after performing the exercise protocol. Results: A two-factor repeated measures ANOVA was performed. MPV at 1 m·s−1 in minute 0 post-exercise was −33.3% (p < 0.05), whereas in minute 10 and 15 post-exercise, it was ≈−9% (p > 0.05). Regarding the blood lactate levels, significant differences were observed in all measurements before and after the exercise protocol (p < 0.001), obtaining ≈7 mmol·L−1 at minute 10 post-exercise and 4.3 mmol·L−1 after 15 min of recovery. Conclusions: MPV with medium or moderate loads shows a certain recovery from minute 10 of rest. However, the blood lactate levels are still high (>5 mmol·L−1). Therefore, although there seem to be certain conditions to reach a similar maximum MPV peak, the residual fatigue at the neuromuscular level and the non-recovery of metabolic homeostasis would hinder the reproduction of these protocols, both at the level of applied stimulus and from a methodological perspective, since a long recovery time would be required between sets and exercises.

Time Course of Recovery Following CrossFit® Karen Benchmark Workout in Trained Men

The establishment of fatigue following the acute exercise stimulus is a complex and multi-factorial process, that might arise due to a range of distinct physiological mechanisms. However, a practical method of assessing CrossFit^® athletes’ recovery status has been neglected entirely in real-world sporting practice. The study describes the acute and delayed time course of recovery following the CrossFit^® Benchmark Workout Karen. Eight trained men (28.4 ± 6.4 years; 1RM back squat 139.1 ± 26.0 kg) undertook the Karen protocol. The protocol consists of 150 Wall Balls (9 kg), aiming to hit a target 3 m high. Countermovement jump height (CMJ), creatine kinase (CK), and perceived recovery status scale (PRS) (general, lower and upper limbs) were assessed pre, post-0h, 24, 48 and 72 h after the session. The creatine kinase concentration 24 h after was higher than pre-exercise (338.4 U/L vs. 143.3 U/L; p = 0.040). At 48h and 72 h following exercise, CK concentration had returned to baseline levels (p > 0.05). The general, lower and upper limbs PRS scores were lower in the 24-h post-exercise compared to pre-exercise (general PRS: 4.7 ± 1.5 and 7.7 ± 1.7; p = 0.013; upper limbs PRS: 6.6 ± 1.3 and 7.5 ± 1.3; p = 0.037; lower limbs PRS: 3.9 ± 2.5 and 7.3 ± 0.1; p = 0.046). Our findings provide insights into the fatigue profile and recovery in acute CrossFit^® and can be useful to coaches and practitioners when planning training programs. Moreover, recovery status can be useful to optimize training monitoring and to minimize the potential detrimental effects associated with the performance of repeated high-intensity sessions of CrossFit^®.

Physiological Responses at 15 Minutes of Recovery after a Session of Functional Fitness Training in Well-Trained Athletes

Background: the aim of this study was to analyse muscle fatigue and metabolic stress at 15 min of recovery after performing two independent sessions of functional fitness training (FFT): a session of strength functional fitness training (FFTstrength) and a session of endurance functional fitness training (FFTendurance). Methods: eighteen well-trained men conducted two protocols, separated by one week of rest: FFTstrength (3 sets of 21, 15 and 9 repetitions of Thruster with bar + Pull ups) and FFTendurance (3 sets × (30 kcal rowing + 15 kcal assault air bike)). Neuromuscular fatigue and metabolic stress were measured right before, right after and at 10 and 15 min after completing the FFT workout, as well as the mean heart rate (HRmean) and the rating of perceived exertion (RPE) at the end of the FFT. Results: FFTendurance recovered the velocity loss values after 15 min of recovery. On the other hand, FFTstrength only recovered velocity in the 1 m·s⁻¹ Tests in squat (SQ), since the velocity levels were 7% lower in the 1 m·s⁻¹ Tests in military press exercise (MP) after 15 min. Conclusions: These data indicate that there are specific recovery patterns not only as a function of the exercise and the body regions involved, but also regarding the recovery of neuromuscular and metabolic factors, since both FFT workouts obtained high blood lactate concentrations.

Acute effects of beetroot juice and caffeine co-ingestion during a team-sport-specific intermittent exercise test in semi-professional soccer players: a randomized, double-blind, placebo-controlled study

BACKGROUND

Beetroot juice (BJ) and caffeine (CAF) are considered as ergogenic aids among athletes to enhance performance, however, the ergogenic effects of BJ and CAF co-ingestion are unclear during team-sport-specific performance. This study aimed to investigate the acute effects of BJ and CAF co-ingestion on team-sport-specific performance, compared with placebo (PL), BJ, and CAF alone.

METHOD

Sixteen semi-professional male soccer players (age: 19.8 ± 2.2 years, body mass: 69.2 ± 6.1 kg, height: 177.3 ± 6.0 cm) completed four experimental trials using a randomized, double-blind study design: BJ + CAF, CAF + PL, BJ + PL, and PL + PL. Countermovement jump with arm swing (CMJAS) performance and cognitive function by Stroop Word-Color test were evaluated before and after the Yo-Yo Intermittent Recovery Test level 1 (YYIR1). Also, rate of perceived exertion (RPE), heart rate, and gastrointestinal (GI) discomfort were measured during each session.

RESULTS

No significant differences were shown between test conditions for total distance covered in YYIR1 (BJ + CAF: 1858 ± 455 m, CAF + PL: 1798 ± 422 m, BJ + PL: 1845 ± 408 m, PL + PL 1740 ± 362 m; p = 0.55). Moreover, CMJAS performance, cognitive function, and RPE during the YYIR1 were not significantly different among conditions (p > 0.05). However, the average heart rate during the YYIR1 was higher in CAF + PL compared to PL + PL (by 6 ± 9 beats/min; p < 0.05), and GI distress was greater in BJ + CAF compared to PL + PL (by 2.4 ± 3.6 a.u.; p < 0.05).

CONCLUSION

These results suggest, neither acute co-ingestion of BJ + CAF nor BJ or CAF supplementation alone significantly affected team-sport-specific performance compared to the PL treatment.

Comparison of Different Recovery Strategies After High-Intensity Functional Training: A Crossover Randomized Controlled Trial

We aimed to determine whether voluntary exercise or surface neuromuscular electrical stimulation (NMES) could enhance recovery after a high-intensity functional training (HIFT) session compared with total rest. The study followed a crossover design. Fifteen male recreational CrossFit athletes (29 ± 8 years) performed a HIFT session and were randomized to recover for 15 min with either low-intensity leg pedaling (“Exercise”), NMES to the lower limbs (“NMES”), or total rest (“Control”). Perceptual [rating of perceived exertion (RPE) and delayed-onset muscle soreness (DOMS) of the lower-limb muscles], physiological (heart rate, blood lactate and muscle oxygen saturation) and performance (jump ability) indicators of recovery were assessed at baseline and at different time points during recovery up to 24 h post-exercise. A significant interaction effect was found for RPE (p = 0.035), and although post hoc analyses revealed no significant differences across conditions, there was a quasi-significant (p = 0.061) trend toward a lower RPE with NMES compared with Control immediately after the 15-min recovery. No significant interaction effect was found for the remainder of outcomes (all p > 0.05). Except for a trend toward an improved perceived recovery with NMES compared with Control, low-intensity exercise, NMES, and total rest seem to promote a comparable recovery after a HIFT session.

Injury in CrossFit®: A Systematic Review of Epidemiology and Risk Factors

OBJECTIVE

To review the characteristics of the injuries among CrossFit® practitioners, including prevalence and incidence, nature, location, and risk factors.

METHODS

PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and SPORTDiscus databases were searched from inception through August 2020, and English-language articles reporting on CrossFit®-related injuries were included. Data including sample (sex, age, and demographics) and injuries' characteristics (prevalence, incidence rate, nature, location, percentage of injuries requiring surgery and risk factors) were extracted.

RESULTS

Overall, twenty-five studies involving a total of 12,079 CrossFit® practitioners met the inclusion criteria. The mean prevalence of injuries among the included studies was 35.3%, with an incidence rate varying between 0.2 and 18.9 per 1000 hours of training. The most injured areas were shoulder (26%), spine (24%), and knee (18%). Among the studies that reported the injuries requiring surgery, the mean percentage was 8.7%. Regarding the risk factors associated with injuries, older age, male sex, a greater body mass index, the existence of previous injuries, the lack of coach supervision, the experience on CrossFit® and the participation in competitions were reported by the studies.

CONCLUSIONS

CrossFit® training has an injury incidence rate similar to weightlifting and powerlifting. Findings from the studies suggest that the most affected areas are shoulder, spine, and knee. The limited quality of the studies prevents us from drawing solid conclusions about injury risk factors.

Effects of Introducing Rest Intervals in Functional Fitness Training

Background: Functional Fitness Training (FFT) is a new exercise modality prioritizing functional multi-joint movements executed at high intensity as a circuit. Objective: To examine the impacts of introducing rest intervals in a FFT workout compared to “rounds for time” (RFT) FFT. Materials and Methods: Participants were 25 resistance-trained adults who completed two FFT workouts 1 week apart. The study design was crossover such that in a given session half the participants completed the standard and the other half the adapted FFT (FFTadapted). The workouts consisted of the same exercises (circuit of four rounds of exercises), but one (FFTadapted) included preset rest intervals (three sets of 1 min after each completed round). Before and after the workouts, countermovement jump ability and blood lactate were measured. Heart rate (HR) and ratings of perceived exertion (RPE) were measured post-exercise. Results: For both the standard and adapted protocols, mean HR was 90% age-predicted maximum. Final RPE was also similar for both workouts (~15–15.5) and indicated a “hard” work intensity. Both FFTs took the same time to complete (~13 min). Furthermore, no significant differences were observed in jump ability between FFTs. In contrast, lactate (15.11 ± 3.64 vs. 13.48 ± 3.64 mmol·L−1, p < 0.05), measured 3 min post-exercise, was significantly lower in FFTadapted. Conclusions: In FFTadapted, there was a significant reduction in RPE and blood lactate concentrations after exercise, while there were no significant differences in either HR or jumping ability, compared to a FFT workout in RFT methodology.

Muscle Recovery after a Single Bout of Functional Fitness Training

Background: Functional fitness training (FFT) is a new exercise modality that targets functional multi-joint actions via both muscle-strengthening exercises and aerobic training intervals. The aim of the study was to examine muscle recovery over a 20 min period after an FFT workout in trained adults. Materials and methods: Participants were 28 healthy trained subjects. In a single session, a countermovement jump (CMJ) was performed to determine several mechanical variables (jump height, maximum velocity, power) before (preFFT) and 4, 10, and 20 min after the FFT workout (postFFT). In parallel, capillary blood lactate concentrations were measured pre- and 3 min postFFT. Heart rate was also measured before and after the workout, and perceived exertion was measured postFFT. Results: Significant differences between the time points preFFT and 4 min and 10 min postFFT, respectively, were produced in jump height (p = 0.022, p = 0.034), maximum velocity (p = 0.016, p = 0.005), average power relative (p = 0.018, p = 0.049), and average power total (p = 0.025, p = 0.049). No differences were observed in any of the variables recorded preFFT and 20 min postFFT. Conclusions: While mechanical variables indicating muscle fatigue were reduced 4 and 10 min postFFT, pre-exercise jump ability only really started to recover 20 min after FFT although not reaching pre-exercise levels. This means that ideally intervals of around 20 min of rest should be implemented between training bouts.

Physical and Physiological Predictors of FRAN CrossFit® WOD Athlete's Performance

CrossFit^® training is one of the fastest-growing fitness activities in the world due to its varied functional movement and competition experience. The performance is present in almost every workout of the day (WOD); however, there is a lack of knowledge in the science that did not allow us to fully understand the performance determinants of CrossFit WOD’s like we do for other individual or team sports. The purpose of this study was to analyze the physical and physiological variables of recreational trained CrossFit athletes during one of the most famous WOD, FRAN, and to identify which variables best determine performance. Methods: Fifteen CrossFit practitioners performed, alone on separate days, 1RM and a maximum of repetitions of pull-ups test, 1RM and a maximum of repetitions of thrusters with 95 lb/43.2 kg, FRAN CrossFit WOD, and 2K Row test. Results: Blood lactate concentrate, HR_max, HR_av, and RPE achieved higher values for 2K Row and maximum repetitions of thrusters. Maximum repetition of thrusters and pull-ups, 1RM of thrusters, and 2K Row resulted in moderate to strong correlation with FRAN performance (r = −0.78; r = −0.58; r = −0.67; r = 0.63, respectively). Conclusions and practical applications: FRAN performance was strongly related to maximal and endurance strength training of thrusters, which should be prioritized.

Predicting the Unknown and the Unknowable. Are Anthropometric Measures and Fitness Profile Associated with the Outcome of a Simulated CrossFit® Competition?

The main objective of this research was to find associations between the outcome of a simulated CrossFit^® competition, anthropometric measures, and standardized fitness tests. Ten experienced male CrossFit^® athletes (age 28.8 ± 3.5 years; height 175 ± 10.0 cm; weight 80.3 ± 12.5 kg) participated in a simulated CrossFit^® competition with three benchmark workouts ("Fran", "Isabel", and "Kelly") and underwent fitness tests. Participants were tested for anthropometric measures, sit and reach, squat jump (SJ), countermovement jump (CMJ), and Reactive Strength Index (RSI), and the load (LOAD) corresponding to the highest mean power value (POWER) in the snatch, bench press, and back squat exercises was determined using incremental tests. A bivariate correlation test and k-means cluster analysis to group individuals as either high-performance (HI) or low performance (LO) via Principal Component Analysis (PCA) were carried out. Pearson's correlation coefficient two-tailed test showed that the only variable correlated with the final score was the snatch LOAD (p < 0.05). Six performance variables (SJ, CMJ, RSI, snatch LOAD, bench press LOAD, and back squat LOAD) explained 74.72% of the variance in a k = 2 means cluster model. When CrossFit^® performance groups HI and LO were compared to each other, t-test revealed no difference at a p ≤ 0.05 level. Snatch maximum power LOAD and the combination of six physical fitness tests partially explained the outcome of a simulated CrossFit competition. Coaches and practitioners can use these findings to achieve a better fit of the practices and workouts designed for their athletes.

Reliability and Validity of the Polar V800 Sports Watch for Estimating Vertical Jump Height

This study aimed to assess the reliability and validity of the Polar V800 to measure vertical jump height. Twenty-two physically active healthy men (age: 22.89 ± 4.23 years; body mass: 70.74 ± 8.04 kg; height: 1.74 ± 0.76 m) were recruited for the study. The reliability was evaluated by comparing measurements acquired by the Polar V800 in two identical testing sessions one week apart. Validity was assessed by comparing measurements simultaneously obtained using a force platform (gold standard), high-speed camera and the Polar V800 during squat jump (SJ) and countermovement jump (CMJ) tests. In the test-retest reliability, high intraclass correlation coefficients (ICCs) were observed (mean: 0.90, SJ and CMJ) in the Polar V800. There was no significant systematic bias ± random errors (p > 0.05) between test-retest. Low coefficients of variation (<5%) were detected in both jumps in the Polar V800. In the validity assessment, similar jump height was detected among devices (p > 0.05). There was almost perfect agreement between the Polar V800 compared to a force platform for the SJ and CMJ tests (Mean ICCs = 0.95; no systematic bias ± random errors in SJ mean: -0.38 ± 2.10 cm, p > 0.05). Mean ICC between the Polar V800 versus high-speed camera was 0.91 for the SJ and CMJ tests, however, a significant systematic bias ± random error (0.97 ± 2.60 cm; p = 0.01) was detected in CMJ test. The Polar V800 offers valid, compared to force platform, and reliable information about vertical jump height performance in physically active healthy young men.

Six weeks of Jilin ginseng root supplementation attenuates drop jump-related muscle injury markers in healthy female college students

BACKGROUND

Eccentric muscle contraction is an inherent component of numerous sporting movements but can result in muscle fatigue and injury, especially when engaging in unfamiliar exercise, which requires pharmacological intervention. Jilin ginseng root (GS) has been used to protect muscles and reduce the risk of exercise injury.

AIM OF THE STUDY

In this study, we sought to examine and demonstrate the effectiveness of using GS in preventing muscle stiffness and reducing the risk of exercise injury in women.

METHODS

Twenty females were randomly assigned to GS and placebo groups. Body composition, serum biochemistry index, kinematics, and endurance exercise tests were measured at two time point presupplementation and 6 weeks after supplementation. The major compounds of GS were characterized using a high-performance liquid chromatograph with a gradient delivery system (HPLC).

RESULTS

After 6 weeks of supplementation, the GS group exhibited significant increases in the serum levels of free fatty acids and glucose as well as greater maximum oxygen consumption (VO2 max, mL min-1 kg-1) compared with the placebo group in an exhaustive biking test. Following drop jump tests, the jump height and reactive strength index were increased in the GS group after completing 70 DJs. In addition, subjects in the GS group also showed decreased knee and ankle stiffness in DJs, leading to reduced fatigue associated with eccentric movement.

CONCLUSIONS

GS supplementation leads to ameliorates drop jump muscle stiffness and fatigue in females and is to be used as a nutrient supplement to reduce the risk of musculoskeletal system injuries when performing drop jumps.

Effect of three fitness programs on strength, speed, flexibility and muscle power on sedentary subjects

BACKGROUND

The aim of this study was to research and compare the effect of Crossfit® (CF), LesMills® (LM) and traditional resistance (TRAD) training program on short performances.

METHODS

Participants were assigned randomly into 3 groups and followed the training sessions allocated at the rate of 5 sessions/week for 16 weeks. A battery of tests including anthropometric and performance measures were carried out over three sessions: before training (T0), after eight weeks (T1) and sixteen weeks of training (T2).

RESULTS

Findings indicated that strength tests demonstrated a significant time effect (p<0.001, ηp 2=0.6), the results showed that CF and TRAD groups improved strength every 8 weeks while LM group only at T2, The speed test demonstrated also a significant time effect (p<0.001 , ηp 2=0.5) the results showed an improvement in speed every 8 weeks for LM, at T2 for CF and no change for TRAD, for flexibility, all tests demonstrated a main time effect (p<0.001 , ηp 2=0.46 - 0.7) CF was the best in shoulder range of motion and LM in trunk and lower limb flexibility, all power tests also demonstrated a significant time effect (p<0.001 , ηp 2=0.76 - 0.9) the improvement for all groups was every 8 weeks.

CONCLUSIONS

Based on these findings, we recommend TRAD and CF as valuable trainings for strength development, LM for flexibility and all three trainings for power improvement.

Effects of Nutritional Supplements on Judo-Related Performance: A Review

The potential ergogenic effect of nutritional supplements depends on their dosage and the type of exercise executed. Aiming at reviewing the research literature regarding sport supplements utilized in judo in order to improve performance, a literature search was performed at the following databases: Dialnet, PubMed, Scielo, Scopus and SportDiscus. A total of 11 articles met the inclusion criteria and were selected. Evidence revised indicates that supplementation with caffeine, β-alanine, sodium bicarbonate, creatine, and β-hydroxy-β-methylbutyrate has a positive effect on judo-related performance. Moreover, there is evidence suggesting that combining some of these nutritional supplements may produce an additive effect.

A Systematic Review of CrossFit® Workouts and Dietary and Supplementation Interventions to Guide Nutritional Strategies and Future Research in CrossFit®

CrossFit® is a high-intensity functional training method consisting of daily workouts called "workouts of the day." No nutritional recommendations exist for CrossFit® that are supported by scientific evidence regarding the energetic demands of this type of activity or dietary and supplement interventions. This systematic review performed in accordance with PRISMA guidelines aimed to identify studies that determined (a) the physiological and metabolic demands of CrossFit® and (b) the effects of nutritional strategies on CrossFit® performance to guide nutritional recommendations for optimal recovery, adaptations, and performance for CrossFit® athletes and direct future research in this emerging area. Three databases were searched for studies that investigated physiological responses to CrossFit® and dietary or supplementation interventions on CrossFit® performance. Various physiological measures revealed the intense nature of all CrossFit® workouts of the day, reflected in substantial muscle fatigue and damage. Dietary and supplementation studies provided an unclear insight into effective strategies to improve performance and enhance adaptations and recovery due to methodological shortcomings across studies. This systematic review showed that CrossFit® is a high-intensity sport with fairly homogenous anaerobic and aerobic characteristics, resulting in substantial metabolic stress, leading to metabolite accumulation (e.g., lactate and hydrogen ions) and increased markers of muscle damage and muscle fatigue. Limited interventional data exist on dietary and supplementation strategies to optimize CrossFit® performance, and most are moderate to very low quality with some critical methodological limitations, precluding solid conclusions on their efficacy. High-quality work is needed to confirm the ideal dietary and supplemental strategies for optimal performance and recovery for CrossFit® athletes and is an exciting avenue for further research.

The effects of acute consumption of carbohydrate-protein supplement in varied ratios on CrossFit athletes' performance in two CrossFit exercises: a randomized cross-over trial

BACKGROUND

CrossFit is becoming popular over the past few years, and various supplementation ways have been utilized by exercise physiologists to enhance CrossFit athletes' performance. This study aimed to evaluate the effects of consuming preworkout carbohydrate-protein supplements on CrossFit athletes' performance.

METHODS

Well-trained CrossFit athletes (8 men; 25.62±3.02 years) were randomized to a single-blind, placebo controlled, crossover design (7-day washout) to performed six bouts of two CrossFit workouts: Fight Gone Bad (FGB) and Cindy (CI). One hour and immediately before the onset of each bout, the subjects consumed carbohydrate-protein supplement in two ratios (2:2 or 3:1) or placebo (P): FGB+2:2, FGB+3:1, FGB+P, CI+2:2, CI+3:1, and CI+P. To value the differentiation in performances, the performed each subject repetitions in FGB and CI were recorded in the bouts.

RESULTS

Repeated measure analysis of variance was used to analyze the data, and the level of significance set for the study was P≤0.05. No significant difference was observed in the total number of repetitions performed in FGB (P=0.275) or CI (P=0.789) workouts in supplements and placebo groups.

CONCLUSIONS

These results indicate that acute consumption of preworkout carbohydrate-protein supplement may not enhance the CrossFit athletes' performance in FGB and CI workouts.

Acute leucocyte, muscle damage, and stress marker responses to high-intensity functional training

BACKGROUND

High-intensity functional training (HIFT) has become more popular, and the number of practitioners has increased; however, it remains unclear whether perturbations in the immune parameters occur, even after one single bout. Our aim was to examine acute leucocyte, muscle damage, and stress marker responses following a single 'Cindy' workout session, and compare the results between novice and experienced participants.

MATERIAL AND METHODS

Twenty-three HIFT practitioners (age 31.0 ± 1.0 years) completed the 'Cindy' workout. They were categorized as novice (3-8 months of experience; n = 10) and experienced (≥18 months; n = 13). White blood cell (WBC) count, plasma creatine kinase (CK) activity, blood cortisol level, and lactate concentration were measured. Blood analysis was performed before (pre-ex), immediately after (post-ex), 30 min after (post-30 min), and 24 h after (post-24 h) a single 'Cindy' workout session.

RESULTS

WBC count was higher post-ex (6.8 to 11.8x103/μL) and returned to baseline values within post-30 min (p<0.01). Neutrophil (3.3 to 4.5x103/μL) and lymphocyte levels (2.8 to 5.9x103/μL) were higher post-ex and returned to baseline values after post-24 h, yet lymphocytopoenia (2.2x103/μL) was observed at post-30 min (p<0.01). CK increased post-ex (174.9 to 226.7 U.L-1) and remained elevated post-24 h. Cortisol (14.7 to 17.0 μg/dL) and lactate (1.9 to 13.5 mmol.l-1) responses increased post-ex, but only the lactate level was reduced at post-30 min (p<0.01). The experienced participants had higher WBC, lymphocyte, and cortisol concentrations post-ex than the novice ones (p<0.01).

CONCLUSIONS

A single HIFT session elicited significant acute perturbations in WBC count, stress markers, and muscle tissue, which is like other similar regimens. Importantly, the experienced participants showed greater lymphocyte and cortisol responses than the novice ones.

CrossFit® Training Strategies from the Perspective of Concurrent Training: A Systematic Review

In the basic principles of CrossFit®, the goal is to improve fitness, related to the simultaneous development of strength and endurance. This is also the main idea of concurrent training, which has been researched since the 1980s. This article aimed to analyze the acute and chronic effects of CrossFit® and to assess the relevance of using the concurrent training methodology. The findings show that CrossFit® is an intense form of exercise that affects the function of the endocrine, immune, and central nervous systems. It also has potential in the development of strength and endurance parameters. These conclusions were compared with relevant concurrent training studies. Although the CrossFit® interventions (workouts of the day) have much in common with concurrent training, methodological recommendations can only be partially transferred. The approach for training and athlete development must be based on the originality of this sport.

Prevalence of Female Urinary Incontinence in Crossfit Practitioners and Associated Factors: An Internet Population-Based Survey

OBJECTIVES

CrossFit comprises a set of high-intensity, high-impact exercises that includes movements that may increase intra-abdominal pressure and cause involuntary loss of urine. There is scant literature about the prevalence of urinary incontinence (UI) in female crossfitters, as well as its associated factors.

METHODS

A population-based Internet survey stored in a website created with information on the benefits and risks of CrossFit for women's health (https://crosscontinencebr.wixsite.com/crosscontinencebr) invited female crossfitters. In total, 551 women answered an online questionnaire, and the demographic variables (age, marital status, and parity), anthropometric data (weight, height, and body mass index), and the presence of UI during exercises were also investigated. The prevalence of UI and its associated factors were calculated using a logistic regression model. The significance level was set at 5%.

RESULTS

The overall prevalence of UI during CrossFit exercises was 29.95%, and most women with UI reported loss of urine during at least one exercise (16.70%). Women with UI were older (33.77 ± 8.03 years) than those without UI (30.63 ± 6.93 years; P < 0.001). Double under (20.15%) and single under (7.99%) were the exercises that were most frequently associated with UI and also the only variables that remained in the final model that caused UI. The duration of CrossFit practice, number of days per week practicing CrossFit, daily time practice, previous vaginal delivery, and mean birth weight were not statistically associated with UI.

CONCLUSIONS

One-third of female crossfitters presented with UI during exercise. Double under was the exercise that was the most associated with UI.

Understanding the effects of beetroot juice intake on CrossFit performance by assessing hormonal, metabolic and mechanical response: a randomized, double-blind, crossover design

BACKGROUND

Acute beetroot juice (BJ) intake has shown to enhance aerobic and anaerobic performance. However, no studies have evaluated the effects of BJ intake on CrossFit (CF) performance by linking hormonal, metabolic, and mechanical responses. The purpose of this study was to determine the causal physiological association between hormonal, metabolic and mechanical responses, and CF workouts performance after acute BJ intake.

METHODS

Twelve well-trained male practitioners undertook a CF workout after drinking 140 mL of BJ (~ 12.8 mmol NO3-) or placebo. The two experimental conditions (BJ or placebo) were administered using a randomized, double-blind, crossover design. The CF workout consisted of repeating the same exercise routine twice: Wall ball (WB) shots plus full back squat (FBS) with 3-min rest (1st routine) or without rest (2nd routine) between the two exercises. A 3-min rest was established between the two exercise routines.

RESULTS

An interaction effect was observed in the number of repetitions performed (p = 0.04). The Bonferroni test determined a higher number of repetitions after BJ than placebo intake when a 3-min rest between WB and FBS (1st routine) was established (p = 0.007). An interaction effect was detected in cortisol response (p = 0.04). Cortisol showed a higher increase after BJ compared to placebo intake (76% vs. 36%, respectively). No interaction effect was observed in the testosterone and testosterone/cortisol ratio (p > 0.05). A significant interaction effect was found in oxygen saturation (p = 0.01). A greater oxygen saturation drop was observed in BJ compared to placebo (p <  0.05). An interaction effect was verified in muscular fatigue (p = 0.03) with a higher muscular fatigue being observed with BJ than placebo (p = 0.02).

CONCLUSIONS

BJ intake improved anaerobic performance only after the recovery time between exercises. This increase in performance in the first routine probably generated greater hypoxia in the muscle mass involved, possibly conditioning post-exercise performance. This was observed with a fall in oxygen saturation and in muscle fatigue measured at the end of the CF workout. The greatest perceived changes in cortisol levels after BJ intake could be attributed to the nitrate-nitrite-nitric oxide pathway.

Characterization of Hormonal, Metabolic, and Inflammatory Responses in CrossFit® Training: A Systematic Review

Background: CrossFit® training is a high-intensity functional training program that aims to increase physical functional performance through biochemical responses, i.e., hormonal, metabolic, and inflammatory responses. Most hormonal, metabolic, and inflammatory changes induced by CrossFit® training have been reported in isolated clinical studies. The purpose of this review was to systematically explore the existing literature on characterization of hormonal, metabolic, and inflammatory responses resulting from CrossFit® training. Methods: A systematic search of the literature was conducted in PubMed, Web of Science and Scopus from August 2019 to October 2019. Studies were selected through critical review of the content. Using specific keywords, 623 articles were found, of which 597 were excluded for ineligibility, and 25 were eligible. The papers were separated according to subject area: hormonal (n = 8), metabolic (n = 19), and inflammatory (n = 6) changes. All were published between 2015 and 2019. Results: This review reveals potential effects of CrossFit® training on hormonal, metabolic, and inflammatory responses. However, studies had low levels of evidence and reliability due to methodological limitations. Conclusion: In summary, the results showed a greater volume and intensity of workouts accentuate the responses, that are of paramount importance for improving understanding of the effects of CrossFit® training and serve as a basis for prescribing future exercise protocols.

Session Rating of Perceived Exertion Is a Superior Method to Monitor Internal Training Loads of Functional Fitness Training Sessions Performed at Different Intensities When Compared to Training Impulse

Despite its increase in popularity, little is known about how to best quantify internal training loads from functional fitness training (FFT) sessions. The purpose of this study was to assess which method [training impulse (TRIMP) or session rating of perceived exertion (sRPE)] is more accurate to monitor training loads in FFT. Eight trained males (age 28.1 ± 6.0 years) performed an ALL-OUT FFT session and an intensity-controlled session (RPE of six out of 10). Internal load was determined via Edward's TRIMP (eTRIMP), Bannister's TRIMP (bTRIMP), and sRPE. Heart rate was measured continuously during the session, while blood lactate and rate of perceived exertion were measured at baseline, and immediately and 30 min after the sessions. ALL-OUT blood lactate and RPE were significantly higher immediately and 30 min after the session compared to the RPE6 condition. ALL-OUT training load was significantly different between conditions using bTRIMP (61.1 ± 10.6 vs. 55.7 ± 12.4 AU) and sRPE (91.7 ± 30.4 vs. 42.6 ± 14.9 AU), with sRPE being more sensitive to such differences [p = 0.045, effect size (ES) = 0.76 and p = 0.002, ES = 1.82, respectively]. No differences in the training loads of the different sessions were found using eTRIMP (93.1 ± 9.5 vs. 84.9 ± 13.7 AU, p = 0.085). Only sRPE showed a significant correlation with lactate 30 min post session (p = 0.015; p = 0.596, large). sRPE was more accurate than both TRIMP methods to represent the overall training load of the FFT sessions. While the use of sRPE is advised, further research is necessary to establish its ability to reflect changes in fitness, fatigue, and performance during a period of training.

Prevalence of Injuries in Exercise Programs Based on Crossfit®, Cross Training and High-Intensity Functional Training Methodologies: A Systematic Review

Current literature shows studies that question the safety of the practices carried out in high-intensity training modalities such as CrossFit®, Cross Training or High-Intensity Functional Training, which may lead to a greater risk in the prevalence of injuries. The aim of this study was to analyze in detail the prevalence of injuries occurring in training based on the CrossFit®, Cross Training or High-Intensity Functional Training modalities, through a systematic review, as well as evaluating the methodological quality of the included studies. We used the recommendations of the PRISMA protocol. For the quality analysis of the studies, we applied the tool proposed by the National Institute of Health (United States). The areas that mainly present a higher risk of injury during CrossFit, Cross Training or High-Intensity Functional Training practices are shoulders, knees and back. Additionally, 11 of the 12 included studies displayed a poor methodological quality according to the quality tool used.

Interquartile differences in biomechanical parameters in CrossFit® athletes during deep squats with submaximal load until fatigue

BACKGROUND

CrossFit^® exercises are demanding and require high power outputs sustained over time, therefore the daily workouts (WOD) could provoke considerable fatigue and lead to injury in a subsequent exercise session. To improve performance and prevent injury, the effect of pacing strategies has to be studied, by observing how fatigue modifies movement biodynamics until muscle failure. Thus, the present study aimed to analyze the interquartile differences in biomechanical parameters in CrossFit^® athletes during deep squats with submaximal load until fatigue.

METHODS

This is a comparative and descriptive applied research study using electromyographic analysis. Twenty CrossFit^® competition athletes participated in this study (age 27±6 years; training experience 14.4±7.7 months; weight 80±11 kg; height 175±7 cm; BMI 26±3 kg/m²).

RESULTS

The mean time until fatigue was 14±8 minutes. Pairwise comparisons confirmed fatigue by using the lactate results (pre=1.80 mg/dL, post=12.60 mg/dL; P=0.0001). Significant differences were noted among quartiles (Pillai's trace F=3.99; P=0.001) on the composite variable.

CONCLUSIONS

The results supported the hypothesis of self-regulation and showed higher velocity associated with higher maximal power. Concentric muscular recruitment was associated to the detriment of the eccentric phase during progressive fatigue. Coaches and athletes can apply the results of the present study when establishing WOD strategies during training and competition.

Mixed Modal Training to Help Older Adults Maintain Postural Balance

OBJECTIVE

Older adults have poorer balance compared with younger adults, but exercise may slow this age-related loss. Although the best type of exercise to optimize balance gains remains unclear, it is likely that a training regimen incorporating several different types of exercise, termed mixed modality training (MMT) (popularized by CrossFit), would be effective. Accordingly, this study aims to assess whether regular MMT leads to improved balance in older adults.

METHODS

Ten trained young (28 ± 4 years, minimum of 1 year MMT) and 22 older (67 ± 6 years) adults participated in this study. Older adults were divided into 2 groups: trained (minimum of 1 year MMT) and untrained. An electronic baropodometer was used to assess baseline postural balance using the postural sway (both open and closed eyes) test.

RESULTS

Compared with untrained older adults, those who trained performed similarly to young trained adults in the postural sway test. In addition, with eyes closed, trained older adults demonstrated better center of pressure total displacement area than untrained older adults.

CONCLUSION

These data suggest that regular MMT can lead to a level of postural control in older adults similar to that observed in young adults. The favorable effects of MMT on postural control in older adults may be attributable to improvements in both muscle strength and proprioception.

48-hour recovery of biochemical parameters and physical performance after two modalities of CrossFit workouts

CrossFit is high-intensity interval training involving routines called 'workouts of the day' (WOD). The aim of the present study is to analyse biochemical parameters and physical performance after two modalities of CrossFit WODs, and to evaluate 48-hour recovery. Twelve trained CrossFit practitioners (age: 30.4 ± 5.37 years; VO2max: 47.8 ± 3.63 ml/min/kg; 1RM Power Clean: 93.2 ± 7.62 kg) participated in the study. A crossover design was applied, and participants completed two modalities of WODs on separate days: WOD1 (as many rounds as possible) and WOD2 (rounds for time). Blood lactate, ratings of perceived exertion and heart rate were measured to determine the intensity of training sessions. Biochemical parameters and physical performance were evaluated before, immediately after, 24 hours after and 48 hours after exercise. There were significant differences in intensity between WOD1 and WOD2 (lactate: 13.3±1.87 vs. 18.38±2.02 mmol/L, heart rate mean: 127.6±11.1 vs. 159.8±12.1 bpm), and blood glucose concentrations were significantly higher after WOD2 (135.4 ± 19.6 vs. 167.4±19.6 mg/dL). After exercise, WOD1 and WOD2 caused significant increases of hepatic transaminases, creatine phosphokinase and blood glucose, as well as a large decrease in the physical performance evaluated by the plank test. All these values returned to baseline by 48 hours after exercise. Both WODs caused metabolic and muscular stress, as well as a decrease in physical performance. All the levels recovered at 48 hours, so the stress caused by CrossFit WODs did not induce a pathological state.

Gender Differences in Chronic Hormonal and Immunological Responses to CrossFit®

This study was designed to analyze the chronical responses of the hormonal and immune systems after a CrossFit^® training period of six months as well as to compare these results between genders. Twenty-nine CrossFit^® practitioners (35.3 ± 10.4 years, 175.0 ± 9.2 cm, 79.5 ± 16.4 kg) with a minimum CrossFit^® experience of six months were recruited, and hormonal and immune responses were verified every two months during training. The training was conducted in five consecutive days during the week, followed by two resting days. Testosterone (T) values were significantly higher at the last measurement time (T6 = 346.0 ± 299.7 pg·mL^-1) than at all the other times (p < 0.002) and were higher in men than in women (p < 0.001). Cortisol (C) levels were lower at all times compared to the initial level before training, and differences were observed between men and women, with men having a lower value (T0: p = 0.028; T2: p = 0.013; T4: p = 0.002; and T6: p = 0.002). The TC ratio in women was lower at all times (p < 0.0001) than in men. Significant effects on CD8 levels at different times (F_(3.81) = 7.287; p = 0.002; η_p² = 0.213) and between genders (F_(1.27) = 4.282; p = 0.048; η_p² = 0.137), and no differences in CD4 levels were observed. CrossFit^® training changed the serum and basal levels of testosterone and cortisol in men (with an increase in testosterone and a decrease in cortisol).

Is Perceived Exertion a Useful Indicator of the Metabolic and Cardiovascular Responses to a Metabolic Conditioning Session of Functional Fitness?

The purpose of this study was to assess whether the self-regulation of training intensity based on rating of perceived exertion (RPE) is a reliable method to control the intensity during metabolic conditioning sessions of functional fitness. In addition, the relationship between RPE and the changes in heart rate, number of repetitions, and lactate responses was also analyzed. Eight male participants (age 28.1 ± 5.4 years; body mass 77.2 ± 4.4 kg; VO₂ max: 52.6 ± 4.6 mL·(kg·min)⁻¹ completed two sessions (five to seven days apart), in a randomized order, under different conditions, as follows: (1) all-out (ALL), or (2) self-regulation of intensity based on an RPE of six (hard) on the Borg CR-10 scale (RPE6). The rating of perceived exertion, lactate (LAC), and heart rate (HR) response were measured before, during, and immediately after the sessions. The RPE and LAC during the all-out sessions were higher (p < 0.0005) than the RPE6 session for all of the analyzed time points during the session. There was no difference in the HR area under the curve for the all-out and RPE6 sessions. The average number of repetitions performed was lower (p ≤ 0.009) for the RPE6 session (190.5 ± 12.5 repetitions) when compared to the all-out session (214.4 ± 18.6 repetitions). There was a significant correlation between the RPE and LAC (p = 0.005; r = 0.66; large) and number of repetitions during the session (p = 0.026; r = 0.55; large). No correlation was observed between the RPE and HR (p = 0.147; r = 0.380). These results indicate that the self-regulation of intensity of effort based on the RPE may be a useful tool to control the exercise intensity during a metabolic conditioning session of functional fitness.

The Multimodal Nature of High-Intensity Functional Training: Potential Applications to Improve Sport Performance

Training for sports performance requires the development of multiple fitness components within the same program. In this context, training strategies that have the potential to concomitantly enhance metabolic and musculoskeletal fitness are of great value for athletes and coaches. The purpose of this manuscript is to review the current studies on high-intensity functional training (HIFT) and to assess how HIFT could be utilized in order to improve sport-specific performance. Studies on untrained and recreationally-active participants have led to positive results on aerobic power and anaerobic capacity, and muscular endurance, while results on muscular strength and power are less clear. Still, HIFT sessions can elicit high levels of metabolic stress and resistance training exercises are prescribed with parameters that can lead to improvements in muscular endurance, hypertrophy, strength, and power. As similar training interventions have been shown to be effective in the athletic population, it is possible that HIFT could be a time-efficient training intervention that can positively impact athletes’ performances. While the potential for improvements in fitness and performance with HIFT is promising, there is a clear need for controlled studies that employ this training strategy in athletes in order to assess its effectiveness in this population.

Acute caffeine supplementation in combat sports: a systematic review

Caffeine used as a supplement has been shown to improve physical and cognitive performance in several sport modalities due to its effects on the central nervous system. This review assesses the direct effects of caffeine supplementation on performance in combat sports. Using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, relevant studies were identified through the Medline, Scopus and SPORTDiscus databases. Of 1053 search results, only 9 articles fulfilled the inclusion criteria. Of these, three studies detected no ergogenic effect of caffeine supplementation, while six studies did observe a significant positive effect. Supplementation with 3-6 mg/kg of caffeine was found to increase the glycolytic contribution to energy metabolism during the execution of real or simulated combats, as indicated by elevated blood lactate concentrations. Caffeine intake was also noted to improve levels of strength, power and upper arm muscular endurance. These effects were not paralleled by an increase in the exertion perceived by the athlete.

Cardiometabolic and Muscular Fatigue Responses to Different CrossFit® Workouts

CrossFit® consists of workouts of the day (WODs) in which different exercises are conducted at high intensity with minimal or no rest periods. This study sought to quantify exercise intensity and muscular fatigue in the three CrossFit® session modalities: gymnastics (G), metabolic conditioning (M) and weightlifting (W). Thirty two, young, strength-trained, healthy men completed the three WODs: G ("Cindy"), M (double skip rope jumps) and W (power cleans). The variables measured in the sessions were: mean heart rate (HR), rate of perceived exertion (RPE), blood lactate [lactate], and jump height (H), average power (AP) and maximum take-off velocity (V_max) in a counter movement jump test. In all three WODs, elevated HR values (≥90% of the theoretical HR_max) were recorded at the time points mid-session and end-session. Mean RPEs were 17.6 ± 1.6 (G WOD), 16.0 ± 2.3 (M WOD), and 15.7 ± 2.0 (W WOD). Postexercise [lactate] was higher than 10 mmol·L^-1 for the three WODs. Following the G ("Cindy") and W (power cleans) WODs, respectively, significant muscular power losses were observed in H (7.3% and 8.1%), V_max (13.8% and 3.3%), AP relative (4.6% and 8.3%) and AP total (4.2% and 8.2%) while losses in the M WOD were not significant (p > 0.05). A vigorous intensity of exercise was noted in all three WODs, with greater mean HRs detected in the "Cindy" and skip rope WODs than power clean WOD. Muscular fatigue was produced in response to the "Cindy" and power clean WODs but not the skip rope WOD.

Are extreme conditioning programmes effective and safe? A narrative review of high-intensity functional training methods research paradigms and findings

Extreme conditioning programmes (ECPs, eg, CrossFit, Insanity and Gym Jones) are a growing fitness regimen characterised by functional movements performed at high-intensity and with constantly varying movements. While the popularity and number of practitioners of ECPs are growing, a debate has been established between what is observed in the scientific literature and anecdotal reports from athletes, coaches and physicians about safety (incidence and prevalence of injuries and rhabdomyolysis) and benefits (physical and mental health). In this article, we review the prevalence and incidence of injuries, rhabdomyolysis, physiological responses and chronic adaptations to ECPs. The majority of the available evidence confirm that the estimated injury rate among athletes participating in ECPs is similar to that in weightlifting and most other recreational activities. Additionally, ECP sessions resulted in increased acute oxidative, metabolic and cardiovascular stress, and depending on the stimulus (intensity, duration and non-usual exercise) and training status of the practitioner, an ECP session may precipitate rhabdomyolysis. In the scientific literature, the current chronic effects of ECPs showed little or no effects on body composition and improvements in physical fitness and psychological parameters; however, further studies are important.

Effects of Beetroot Juice Supplementation on Performance and Fatigue in a 30-s All-Out Sprint Exercise: A Randomized, Double-Blind Cross-Over Study

As a nitric oxide precursor, beetroot juice (BJ) is known to enhance high-intensity exercise performance (80⁻100% VO2max) yet its impacts on higher intensity sprint exercise (>100% VO2max) remain to be established. This study sought to examine the effects of BJ supplementation on performance and subsequent fatigue during an all-out sprint exercise. Using a randomized cross-over, double-blind, placebo-controlled design, 15 healthy resistance-trained men (22.4 ± 1.6 years) ingested 70 mL of either BJ or placebo. Three hours later, participants undertook a 30-s all-out Wingate test. Before and after the sprint exercise and at 30 s and 180 s post-exercise, three countermovement jumps (CMJ) were performed and blood lactate samples were obtained. Compared to placebo, BJ consumption improved peak (placebo vs. BJ, 848 ± 134 vs. 881 ± 135 W; p = 0.049) and mean (641 ± 91 vs. 666 ± 100 W; p = 0.023) power output and also reduced the time taken to reach Wpeak in the Wingate test (8.9 ± 1.4 vs. 7.3 ± 0.9 s; p = 0.003). No differences were detected in the fatigue index. In addition, while over time CMJ height and power diminished (ANOVA p < 0.001) and blood lactate levels increased (ANOVA p < 0.001), no supplementation effect was observed. Our findings indicate that while BJ supplementation improved performance at the 30-s cycling sprint, this improvement was not accompanied by differences in fatigue during or after this type of exercise.

Profiling the Isokinetic Muscle Strength of Athletes Involved in Sports Characterized by Constantly Varied Functional Movements Performed at High Intensity: A Cross-Sectional Study

BACKGROUND

Constantly varied functional movements performed at high intensity (FMHI) is a type of strength and general conditioning program that has gained widespread popularity in recent years. The very intense exercises performed with lower and upper limbs may create muscular asymmetry or imbalance between agonist and antagonist muscles, and therefore the characterization of isokinetic muscle strength, side-to-side difference, and balance ratios for lower and upper limbs may contribute to a better understanding of the modality characteristics.

OBJECTIVE

To evaluate the knee and shoulder strength of FMHI athletes of both sexes.

DESIGN

Cross-sectional study.

SETTING

Exercise physiology laboratory.

PARTICIPANTS

Sixty FMHI athletes (30 M/30 W) with more than 2 years' experience.

METHODS

Athletes performed isokinetic tests in both lower and upper limbs: concentrically at 60°/s and 240°/s and eccentrically at 240°/s.

MAIN OUTCOME MEASUREMENTS

Isokinetic peak torque of knee flexor and extensor and shoulder internal and external rotator muscles. Conventional and functional strength balance ratios and side-to-side strength difference.

RESULTS

Concentric peak torque values relative to total body mass for shoulder and knee joints were higher in men than women on both sides. Eccentric peak torque values for knee flexor-dominant and extensor-nondominant limbs showed no difference between the sexes. The knee conventional strength balance ratio for dominant and nondominant sides in women (51.5% ± 7.0% and 51.0% ± 7.1%, respectively) and for dominant and nondominant sides in men (54.4% ± 15.2% and 51.5% ± 9.9%, respectively) were no different between the sexes or limbs. The shoulder conventional strength balance ratio was higher in women (78.1 ± 13.2%) than in men (67.6% ± 10.9%) on the nondominant side. Knee and shoulder functional strength balance ratios in nondominant limbs were higher for women than men. Both sexes presented no side-to-side difference for knee joints or muscles, or for shoulder IR muscles, but ER was stronger in dominant limbs.

CONCLUSIONS

These data from highly trained FMHI athletes can be compared to that of other athletes to help determine individual weaknesses, strengths, and imbalances, and may be useful for designing training programs.

LEVEL OF EVIDENCE

III.

Testosterone and Cortisol Responses to Five High-Intensity Functional Training Competition Workouts in Recreationally Active Adults

To determine the salivary steroid response to high-intensity functional training (HIFT) competition workouts, saliva samples were collected from ten recreationally trained male and female competitors during a 5-week (WK1–WK5) international competition. Competitors arrived at their local affiliate and provided samples prior to (PRE) their warm-up, immediately (IP), 30-min (30P), and 60-min (60P) post-exercise. Samples were analyzed for concentrations of testosterone (T), cortisol (C), and their ratio (TC). Generalized linear mixed models with repeated measures revealed significant main effects for time (p < 0.001) for T, C, and TC. Compared to PRE-concentrations, elevated (p < 0.05) T was observed at IP on WK2–WK5 (mean difference: 135–511 pg·mL⁻¹), at 30P on WK3 (mean difference: 81.0 ± 30.1 pg·mL⁻¹) and WK5 (mean difference: 56.6 ± 22.7 pg·mL⁻¹), and at 60P on WK3 (mean difference: 73.5 ± 29.7 pg·mL⁻¹) and WK5 (mean difference: 74.3 ± 28.4 pg·mL⁻¹). Compared to PRE-concentrations, elevated (p < 0.05) C was noted on all weeks at IP (mean difference: 9.3–15.9 ng·mL⁻¹) and 30P (mean difference: 6.0–19.9 ng·mL⁻¹); significant (p < 0.006) elevations were noted at 60P on WK1 (mean difference: 9.1 ± 3.0 ng·mL⁻¹) and WK5 (mean difference: 12.8 ± 2.9 ng·mL⁻¹). Additionally, TC was significantly reduced from PRE-values by 61% on WK1 at 60P (p = 0.040) and by 80% on WK5 at 30P (p = 0.023). Differences in T, C, and TC were also observed between weeks at specific time points. Although each workout affected concentrations in T, C, and/or the TC ratio, changes appeared to be modulated by the presence of overload and workout duration. During periods of elevated training or competition, athletes and coaches may consider monitoring these hormones for consistency and as a means of assessing workout difficulty.

Effects of β-alanine supplementation during a 5-week strength training program: a randomized, controlled study

BACKGROUND

β-Alanine (BA) is a non-essential amino acid that has been shown to enhance exercise performance. The purpose of this investigation was to determine if BA supplementation improved the adaptive response to five weeks of a resistance training program.

METHODS

Thirty healthy, strength-trained individuals were randomly assigned to the experimental groups placebo (PLA) or BA. Over 5 weeks of strength training, subjects in BA took 6.4 g/day of BA as 8 × 800 mg doses each at least 1.5 h apart. The training program consisted of 3 sessions per week in which three different leg exercises were conducted as a circuit (back squat, barbell step ups and loaded jumping lunges). The program started with 3 sets of 40 s of work per exercise and rest periods between sets of 120 s in the first week. This training volume was then gradually built up to 5 sets of 20 s work/60 s rest in the fifth week. The work load during the program was set by one of the authors according to the individual's perceived effort the previous week. The variables measured were average velocity, peak velocity, average power, peak power, and load in kg in a back squat, incremental load, one-repetition maximum (1RM) test. In addition, during the rest period, jump ability (jump height and power) was assessed on a force platform. To compare data, a general linear model with repeated measures two-way analysis of variance was used.

RESULTS

Significantly greater training improvements were observed in the BA group versus PLA group (p = 0.045) in the variables average power at 1RM (BA: 42.65%, 95% CI, 432.33, 522.52 VS. PLA: 21.07%, 95% CI, 384.77, 482.19) and average power at maximum power output (p = 0.037) (BA: 20.17%, 95% CI, 637.82, 751.90 VS. PLA; 10.74%, 95% CI, 628.31, 751.53). The pre- to post training average power gain produced at 1RM in BA could be explained by a greater maximal strength gain, or load lifted at 1RM (p = 0.014) (24 kg, 95% CI, 19.45, 28.41 VS. 16 kg, 95% CI, 10.58, 20.25) and in the number of sets executed (p = 0.025) in the incremental load test (BA: 2.79 sets, 95% CI, 2.08, 3.49 VS. PLA: 1.58 sets, 95% CI, 0.82, 2.34).

CONCLUSIONS

β-Alanine supplementation was effective at increasing power output when lifting loads equivalent to the individual's maximal strength or when working at maximum power output. The improvement observed at 1RM was explained by a greater load lifted, or strength gain, in response to training in the participants who took this supplement.

Tabata protocol: a review of its application, variations and outcomes

PURPOSE

The great popularity of the Tabata Protocol is accompanied by an uncomfortable lack of consistency and criteria in its use, which results in many controversies in the results obtained from its utilization. The purpose of this study was to analyse the studies that based their interventions on the Tabata Protocol and to provide a critical analysis of its use.

METHODS

A systematic literature search was conducted in PubMed and Scopus. All articles published between 1996 and October 2017 that cited at least one of the original studies of Tabata et al. were considered. Inclusion criteria were as follows: original articles, human trials and English language.

RESULTS

Thirty studies were included for analysis. Almost 37% of the studies (n = 11) used a variation of the Tabata Protocol on a cycle ergometer. Only five studies stated the use of the original Tabata Protocol. Exercise intensity was controlled by percentage of i V ˙ O₂ max (n = 8) or i V ˙ O₂ peak (n = 3), number of bouts performed (n = 3), all out (n = 10), rate of perceived exertion (n = 1), self-perception of paces (n = 1), maximal power output (n = 1), aerobic power (n = 1) and other forms (n = 2).

CONCLUSION

Based on our results, variations of the Tabata Protocol seem to be indicated to provide increases in aerobic power that are similar to traditional aerobic training while being less time consuming. These adaptations seem to be mainly due to peripheral adaptations. Moreover, the use of Tabata Protocols to promote weight loss is not substantiated by the reviewed studies.

Influence of Football on Physiological Cardiac Indexes in Professional and Young Athletes

Background: After long-term intensive training, considerable morphological and functional heart changes occur in professional athletes. Such changes arise progressively and regress upon interruption of the physical activity. Morphological and functional alterations on heart are known as “Athlete's heart” condition.

Objective: This study aims to compare echocardiographic parameters in two different groups of professional athletes. Furthermore, a prospective study is performed analyzing the echocardiographic changes occurring in 12 professional players in 3 years of follow-up.

Materials and Methods: 78 football players were examined from July 2011 to May 2016 (40 enrolled in Group A and 38 in Group B). Twelve players of GROUP A were followed for 3 consecutive seasons. The general clinical examination, the cardiopulmonary evaluation, the ECG, the ergometer stress test, the spirometric examination and the standard cardiac eco color doppler test were recorded.

Results: Left ventricle dimensions, left atrium dimensions, and interventricular septum dimensions were higher in A players than in B players. Moreover, following up 12 players for 3 years, a statistically significant increase of such values was observed.

Discussion: In A players, higher dimensions of the left chambers and the interventricular septum were observed, compared to B players. No statistically significant difference was found regarding the ejection fraction. The 3 years follow-up showed a statistically significant increase of both left chambers and interventricular septum dimensions, particularly in the second and third year.

Conclusions: These findings demonstrated that A players have higher echocardiographic parameters respect to B players. The results of this study support the scientific theory that long-term intensive training influences heart function, inducing “athlete's heart” with morphological adaptations. No significant echocardiographic variation within the examined sample was observed for different roles (goalkeeper, defender, midfielder, or attacker) or skills of individual players.