Training and illness characteristics of cross-country skiers transitioning from junior to senior level

COVID-19 in Female and Male Athletes: Symptoms, Clinical Findings, Outcome, and Prolonged Exercise Intolerance-A Prospective, Observational, Multicenter Cohort Study (CoSmo-S)

BACKGROUND

An infection with SARS-CoV-2 can lead to a variety of symptoms and complications, which can impair athletic activity.

OBJECTIVE

We aimed to assess the clinical symptom patterns, diagnostic findings, and the extent of impairment in sport practice in a large cohort of athletes infected with SARS-CoV-2, both initially after infection and at follow-up. Additionally, we investigated whether baseline factors that may contribute to reduced exercise tolerance at follow-up can be identified.

METHODS

In this prospective, observational, multicenter study, we recruited German COVID elite-athletes (cEAs, n = 444) and COVID non-elite athletes (cNEAs, n = 481) who tested positive for SARS-CoV-2 by PCR (polymerase chain reaction test). Athletes from the federal squad with no evidence of SARS-CoV-2 infection served as healthy controls (EAcon, n = 501). Questionnaires were used to assess load and duration of infectious symptoms, other complaints, exercise tolerance, and duration of training interruption at baseline and at follow-up 6 months after baseline. Diagnostic tests conducted at baseline included resting and exercise electrocardiogram (ECG), echocardiography, spirometry, and blood analyses.

RESULTS

Most acute and infection-related symptoms and other complaints were more prevalent in cNEA than in cEAs. Compared to cEAs, EAcon had a low symptom load. In cNEAs, female athletes had a higher prevalence of complaints such as palpitations, dizziness, chest pain, myalgia, sleeping disturbances, mood swings, and concentration problems compared to male athletes (p < 0.05). Until follow-up, leading symptoms were drop in performance, concentration problems, and dyspnea on exertion. Female athletes had significantly higher prevalence for symptoms until follow-up compared to male. Pathological findings in ECG, echocardiography, and spirometry, attributed to SARS-CoV-2 infection, were rare in infected athletes. Most athletes reported a training interruption between 2 and 4 weeks (cNEAs: 52.9%, cEAs: 52.4%), while more cNEAs (27.1%) compared to cEAs (5.1%) had a training interruption lasting more than 4 weeks (p < 0.001). At follow-up, 13.8% of cNEAs and 9.9% of cEAs (p = 0.24) reported their current exercise tolerance to be under 70% compared to pre-infection state. A persistent loss of exercise tolerance at follow-up was associated with persistent complaints at baseline, female sex, a longer break in training, and age > 38 years. Periodical dichotomization of the data set showed a higher prevalence of infectious symptoms such as cough, sore throat, and coryza in the second phase of the pandemic, while a number of neuropsychiatric symptoms as well as dyspnea on exertion were less frequent in this period.

CONCLUSIONS

Compared to recreational athletes, elite athletes seem to be at lower risk of being or remaining symptomatic after SARS-CoV-2 infection. It remains to be determined whether persistent complaints after SARS-CoV-2 infection without evidence of accompanying organ damage may have a negative impact on further health and career in athletes. Identifying risk factors for an extended recovery period such as female sex and ongoing neuropsychological symptoms could help to identify athletes, who may require a more cautious approach to rebuilding their training regimen.

TRIAL REGISTRATION NUMBER

DRKS00023717; 06.15.2021-retrospectively registered.

Annual Volume and Distribution of Physical Training in Norwegian Female Cross-Country Skiers and Biathletes: A Comparison Between Sports, Competition Levels, and Age Categories-The FENDURA Project

PURPOSE

To describe and compare the annual physical training characteristics between Norwegian female cross-country (XC) skiers and biathletes across competition levels and age categories.

METHODS

Daily training sessions for 1 year were recorded for 45 XC skiers and 26 biathletes, comprising international/national team (inter[national]) and nonnational/regional team members (nonnational) of both junior and senior age. Endurance, strength, flexibility, speed, and power training sessions were recorded. Data included exercise modality, intensity, and duration. Data were analyzed using linear mixed-effects models.

RESULTS

The total annual physical training volume consisted of ∼90% endurance training for both groups, although XC skiers had significantly higher total volumes (∼10%; P = .003; d = 0.78) than biathletes. Senior XC skiers performed more training hours of skiing and/or roller skiing compared with biathletes over the season. However, biathletes compensated for this lower volume by more skating and a higher proportion of endurance training as skiing (81% [17%]) compared with XC skiers (68% [16%]; P < .001; d = 0.94). Overall, (inter)national-level athletes completed a higher annual training volume than non-national-level athletes (740 [90] h vs 649 [95] h; P = .004;d = 0.81). Although juniors reported less endurance volume than seniors, they maintained a relatively stable level of endurance training across the preparatory and competition period, unlike senior athletes.

CONCLUSIONS

The higher annual physical training volume by XC skiers compared with biathletes is likely caused by the different demands of the 2 sports; XC skiing necessitates training for 2 skiing styles, while biathlon requires additional shooting practice. However, biathletes compensate with a higher proportion of ski training, particularly in the skating technique.

From juniors to seniors: changes in training characteristics and aerobic power in 17 world-class cross-country skiers

Purpose: To compare training characteristics and aerobic power (VO2max) between the most successful junior and senior seasons of world-class cross-country (XC) skiers and to identify differences between sexes and among sprint and distance skiers. Methods: Retrospective analysis was conducted on self-reported training and VO2max tests of ten male and seven female world-class XC-skiers, collectively holding 38 Olympic medals. Training was categorized by form (endurance, strength, speed, other) and mode (specific, unspecific) and was divided into low- (LIT), moderate- (MIT), and high-intensity training (HIT). Results: Total training increased by 203 ± 130 h (35% ± 31%, p < .001, large effect) and 78 ± 69 sessions (21% ± 24%, p < .001, very large effect). Junior training volume (658 ± 107 h) did not correlate with senior volume (861 ± 74 h) but correlated negatively with changes in volume (r = -.822, p < .001). No sex differences were observed related to total volume, but distance skiers increased their total volume more than sprint skiers (p = .037, large effect). Endurance training increased by 197 ± 117 h (p < .001; large effect) tied to increased low-intensity training (186 ± 115 h, p < .001; large effect) and moderate-intensity training (13 ± 7 h, p < .001; large effect). Training intensity distribution (% LIT/MIT/HIT) was 91/3/6 in junior and 92/4/4 in senior season. Women demonstrated greater increase of unspecific modes (100 ± 58 vs. 37 ± 44 h, p = .022; large effect) and strength training (25 ± 23 vs. -3 ± 17 h, p = .010, large effect). Men improved absolute (8% ± 5%; p = .009; large effect) and relative VO2max (6% ± 4%; p = .016; large effect) from junior to senior, while women only increased relative VO2max (7% ± 5%, p = .012; large effect). Conclusion: This study provides novel information regarding changes in training characteristics and aerobic power from junior to senior age in world-class XC-skiers. Overall, the enhanced training volume during this transition was primarily driven by increased LIT and MIT and the exceptionally high relative VO2max at junior age further increased in both sexes.

School's out for summer-Differences in training characteristics between adolescent biathletes of different performance levels

The purpose of this study was to retrospectively describe the longitudinal changes of training variables in adolescent biathletes based on performance level. Thirty biathletes (15 men and 15 women) were included in the study and categorized as either national level biathletes (NLB, n = 21) or national team biathletes (NTB, n = 9). Retrospective training data was collected from training diary covering the biathletes' four years (Y1-Y4) as student-athletes at upper secondary school. Training data was divided into physical and shooting training variables. A linear mixed-effect model was used for comparing the difference of the performance group and year of upper secondary school on training characteristics. The NTB group achieved a greater annual training volume than the NLB group, especially during Y4 (594±71 h·y-1 vs 461±127 h·y-1, p < 0.001), through an increase in duration of each session and by completing more weekly training volume during the general phase (13.7±4.6 vs 10.0±4.9 h·w-1, p = 0.004). No difference was observed in relative training intensity distribution between the groups. The total number of shots fired was also greater for the NTB (9971±4716 vs 7355±2812 shots·y-1, p = 0.003). There was an equal frequency in illness and injury for both the NLB and NTB. Accordingly, the results of the present study describe longitudinal changes of biathlon training in adolescent biathletes that also may affect performance development.

Health problems in national team cross-country skiers over a competitive season: a 17-week prospective cohort study

OBJECTIVE

Few long-term prospective studies have investigated health problems in elite competitive cross-country (XC) skiers. Hence, our objective was to compare the prevalence of health problems in national team XC skiers over a competitive season.

METHODS

Forty national team XC skiers participated in this prospective, observational study. Two groups were characterised according to performance level: senior (n=18, ~26 years old, 9 women) and development (n=22, ~21 years old, 9 women). The skiers reported all and substantial injuries and illnesses weekly for 17 consecutive weeks throughout the 2019/2020 competitive season using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.

RESULTS

The average weekly prevalence of all and substantial health problems was 19% (95% CI: 16% to 22%) and 12% (95% CI: 9% to 15%), respectively, and was similar between senior and development level skiers (p>0.05). The injury prevalence was higher in senior versus development level skiers (12%, 95% CI: 9% to 15% vs 5%, 95% CI: 3% to 7%; p<0.001), while illnesses were less common (8%, 95% CI: 3% to 13% vs 13%, 95% CI: 9% to 17%, respectively; p=0.031). Illnesses accounted for 72% of all problems. The prevalence of all health problems was higher in female than in male skiers (23%, 95% CI: 19% to 27% vs 15%, 95% CI: 11% to 19%; p<0.003).

CONCLUSIONS

Health problems, especially illnesses, were relatively common, with approximately one in five skiers (19%) reporting at least one problem in any given week. Both performance level and sex influenced the prevalence of different types of health problems.

Anthropometric, Physiological, and Performance Developments in Cross-country Skiers

PURPOSE

This study aimed to describe changes in laboratory-assessed anthropometric and physiological characteristics, training volumes, and competitive performance in national development-team cross-country skiers over a 25-month period, and to analyze whether changes in competitive performance could be predicted by changes in laboratory-assessed qualities and training volumes.

METHODS

Data collected over 25 months from 30 national development-team cross-country skiers (14 women, 16 men; age, 18-23 yr) were analyzed retrospectively using multivariate statistics. Anthropometric and physiological characteristics were assessed via dual-energy x-ray absorptiometry and incremental roller-ski treadmill tests, respectively. Total training volumes and distributions of low- and high-intensity training were analyzed from online training diaries, and competitive performance was determined by International Ski Federation (FIS) distance and sprint points.

RESULTS

Whole- and upper-body lean mass increased in the full cohort of skiers (n = 30; both P < 0.05), whereas lower-body lean mass, whole-body fat mass, speed and oxygen uptake (V˙O2) at a blood lactate concentration (BLa) of 2 and 4 mmol·L-1, as well as time-trial completion time, power output, and peak V˙O2, improved in the women only (all P < 0.05). Valid predictive models were identified for female skiers' best FIS distance points (R2 = 0.81/Q2 = 0.51) and changes in FIS distance points (R2 = 0.83/Q2 = 0.54), with body mass, fat mass, lean mass, V˙O2peak, and speed at a BLa of 4 mmol·L-1 identified as consistently important variables for projection.

CONCLUSIONS

The valid prediction of competitive performance was achieved for women only in distance events. This study suggests that improvements in body composition and aerobic capacity may be more beneficial for elite female development-level skiers than for their male counterparts. These results have implications for athlete selection and performance development.