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

Assessment of Anabolic Androgenic Steroids Use Among Professional CrossFit® Athletes: Motives, Perception, and Safety

BACKGROUND

Anabolic androgenic steroids (AAS) are traditionally used for the treatment/control of various diseases; however, they are being used for non-therapeutic and indiscriminate purposes to enhance sports performance and physical appearance. This study aimed to assess the prevalence and associated factors of AAS use among professional CrossFit® competitors.

METHODS

We conducted an observational cross-sectional survey in which an anonymous questionnaire was applied to professional CrossFit® athletes.

RESULTS

The prevalence of AAS usage was 33.3%. Most users were male (74.2%), aged between 30 and 39 years (51.6%), with completed higher education (83.9%), and had been training for more than 5 years (77.4%); the primary motivation for AAS use was performance enhancement (77.4%). Individuals who were older (p < 0.05) and more experienced in competitions (p < 0.01) are more likely to use AAS. Testosterone was the most employed AAS (71.0%); CrossFit® athletes typically used an average of 2 different AAS. The majority of users had notably sought advice from a physician (74.2%), and AAS were acquired from either drugstores (80.6%) or through illicit channels (29.0%). Moreover, 61.3% of AAS users reported experiencing adverse effects.

CONCLUSIONS

Our results demonstrated a higher prevalence of AAS users among professional competitors in CrossFit® compared to the general population; older age and greater experience in official competitions were decisive factors for a greater inclination toward AAS use. A significant percentage of athletes seek drugs through illegal channels. Despite the majority of users experiencing adverse effects, athletes report satisfaction with use, believing that the benefits still outweigh the drawbacks.

Effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes: A systematic review

This study aims to analyse the effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes.

METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search of electronic databases was also conducted, including EBSCOhost, Scopus, PubMed, Web of Science, CNKI, Google Scholar, and Wanfang. The Physiotherapy Evidence Database (PEDro) scale was an effective indicator to evaluate the quality of studies included in the systematic review.

RESULTS

This systematic review included 474 participants aged 8-24 years old. The intervention period for most studies was 12 weeks. Among the included studies, 6 focused on muscle strength, 4 on jumping performance, and 11 on functional movement screen.

CONCLUSION

These articles have been analysed, and the positive impact of functional training interventions on muscle strength, jumping, and functional movement screen of wushu athletes has been verified.

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.

Do Men and Women Differ in Hematological Adaptations to 24 Weeks of Crossfit® Training?

Regular exercise can modulate the immune system functioning through changes in the number and function of leukocytes as well as in red blood cells and other typical blood markers. High intensity exercise promotes increases in cytotoxic activity, phagocytic capacity, chemotaxis and cell apoptosis. The aim of the study was to compare the chronic effects of a 24-week training program using CrossFit® methodology on hematological variables of men vs. women. Twenty-nine CrossFit® athletes (35.3 ± 10.4 years, 175.0 ± 9.2 cm, 79.5 ± 16.4 kg) participated in the study. The blood count, the lipid profile and glucose markers were measured every two months during the study period. The erythrocyte count and hemoglobin concentrations increased in months 4 and 6 in men and women, respectively. Hematocrit levels increased in men in months 2, 4 and 6, while in women only in month 6. Red cell distribution width increased in men in month 6 when compared to the value in month 2. Segmented neutrophils increased in men in month 6 and eosinophil levels increased in women in month 6. Differences between the two sexes were observed in monocytes levels at baseline, as well as in months 2, 4 and 6. Cross-Fit® training increased red cell count indicators in both sexes, which may be related to increased erythropoiesis. Some white blood cell counts were altered and these differed between sexes. The number of lymphocytes remained stable throughout the experiment.

A Preliminary Investigation into the Frequency Dose Effects of High-Intensity Functional Training on Cardiometabolic Health

The objective of this study was to explore the effects of three weekly frequency doses of high-intensity functional training (HIFT) on an array of cardiometabolic markers in adults with metabolic syndrome (MetS). Twenty-one men and women, randomized into one (HIFT1), two (HIFT2), or three (HIFT3) days per week of HIFT, completed 3-weeks of familiarization plus a 12-week progressive training program. Pre- and post-intervention, several cardiometabolic, body composition, oxygen consumption, metabolic syndrome severity, and perceptions of fitness measurements were assessed. Additionally, an exercise enjoyment survey was administered post-intervention. A Cohen's d was used to demonstrate within-group change effect size. Although this study was not fully powered, a one-way and two-way ANOVA were used to compare the dose groups to provide provisional insights. No differences were found when frequency dose groups were compared. Many cardiometabolic, body composition, and fitness improvements were seen within each group, with clinically meaningful improvements in the metabolic syndrome severity score (MSSS) (HIFT1: -0.105, d = 0.28; HIFT2: -0.382, d = 1.20; HIFT3: -0.467, d = 1.07), waist circumference (HIFT1: -4.1cm, d = 3.33; HIFT2: -5.4cm, d = 0.89; HIFT3: -0.7cm, d = 0.20), and blood glucose (HIFT1: -9.5mg/dL, d = 0.98; HIFT2: -4.9mg/dL, d = 1.00; HIFT3: -1.7mg/dL, d = 0.23). All three groups similarly reported high exercise enjoyment and likeliness to continue after the intervention. In conclusion, HIFT performed once, twice, or thrice a week elicits improvements in MetS and is considered enjoyable. HIFT, even at a low weekly dose, therefore represents a potential strategy to reduce the global MetS burden.

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.

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.

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Time-course effects of functional fitness sessions performed at different intensities on the metabolic, hormonal, and BDNF responses in trained men

Background

To investigate the time-course effects of a self-regulated training session (performed at an rating perceived exertion of 6/10), all-out session, and a control session on the metabolic, hormonal, and brain derived neurotrophic factor (BDNF) responses in Functional-Fitness (FFT) participants.

Methods

In a randomized, crossover fashion, eight healthy males (age 28.1 ± 5.4 years old; body mass 77.2 ± 4.4 kg; VO_2max: 52.6 ± 4.6 mL.(kg.min)⁻¹; 2000 m rowing test 7.35 ± 0.18 min; 1RM back squat 135.6 ± 21.9 kg) performed a FFT session under two different conditions: all-out, or with the intensity controlled to elicit an rating perceived exertion (RPE) of 6 in the Borg 10-point scale (RPE6). A control session (no exercise) was also completed. Metabolic (lactate and creatine kinase), hormonal (testosterone and cortisol), and BDNF responses were assessed pre, post-0 h, 1 h, 2 h and 24 h after the sessions.

Results

Creatine kinase concentrations were significantly higher (p ≤ 0.05) after 24 h for both training sessions. Total and free testosterone concentrations were lower post-2 h for all-out when compared to the RPE6 session (p ≤ 0.05). Serum cortisol concentration increased post-0 h (p = 0.011) for RPE6 and post-0 h (p = 0.003) and post-1 h (p = 0.030) for all-out session when comparing to baseline concentrations. BDNF was significantly higher (p = 0.002) post-0 h only for the all-out session when compared to baseline. A positive correlation between blood lactate concentrations and BDNF (r = 0.51; p = 0.01) was found for both effort interventions.

Conclusions

A single FFT session when performed in all-out format acutely increases the concentrations of serum BDNF. However, physiological stress markers show that the all-out session requires a longer recovery period when compared to the RPE6 protocol. These findings can be helpful to coaches and practitioners design FFT session.

Comparison of Physiological Responses and Training Load between Different CrossFit® Workouts with Equalized Volume in Men and Women

The purpose of the present study was to compare the heart rate (HR), blood lactate and training load between different CrossFit^® workouts, with equalized total work volumes in men and women. The study included 23 individuals (13 men and 10 women) experienced in CrossFit^® training, who performed two workouts with different training types (as many reps as possible (AMRAP) and ‘for time’) but an equalized volume. Measurements of lactate, HR and rating of perceived exertion (RPE) were performed. The results show that there was no HR interaction between workout time and sex (p = 0.822; η² = 0.006) and between workout type and sex (p = 0.064, η² = 0.803). The HR significantly differed during each workout type (p < 0.001, η² = 0.621), but not between the two workout types (p = 0.552, η² = 0.017). Lactate showed no difference between the workout types (p = 0.474, η² = 0.768), although the training load was higher (p = 0.033, η² = 0.199) in women when they performed AMRAP. Altogether, the HR was not significantly different between training types or sex, while RPE, lactate and training load showed statistically significant differences depending on the group (women or men) or workout type (AMRAP or ‘for time’).