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Zhang Q, Zhao W, Li S, Ding Y, Wang Y, Ji X. Intermittent Hypoxia Conditioning: A Potential Multi-Organ Protective Therapeutic Strategy. Int J Med Sci 2023; 20:1551-1561. [PMID: 37859700 PMCID: PMC10583178 DOI: 10.7150/ijms.86622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023] Open
Abstract
Severe hypoxia can induce a range of systemic disorders; however, surprising resilience can be obtained through sublethal adaptation to hypoxia, a process termed as hypoxic conditioning. A particular form of this strategy, known as intermittent hypoxia conditioning hormesis, alternates exposure to hypoxic and normoxic conditions, facilitating adaptation to reduced oxygen availability. This technique, originally employed in sports and high-altitude medicine, has shown promise in multiple pathologies when applied with calibrated mild to moderate hypoxia and appropriate hypoxic cycles. Recent studies have extensively investigated the protective role of intermittent hypoxia conditioning and its underlying mechanisms using animal models, demonstrating its potential in organ protection. This involves a range of processes such as reduction of oxidative stress, inflammation, and apoptosis, along with enhancement of hypoxic gene expression, among others. Given that intermittent hypoxia conditioning fosters beneficial physiological responses across multiple organs and systems, this review presents a comprehensive analysis of existing studies on intermittent hypoxia and its potential advantages in various organs. It aims to draw attention to the possibility of clinically applying intermittent hypoxia conditioning as a multi-organ protective strategy. This review comprehensively discusses the protective effects of intermittent hypoxia across multiple systems, outlines potential procedures for implementing intermittent hypoxia, and provides a brief overview of the potential protective mechanisms of intermittent hypoxia.
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Affiliation(s)
- Qihan Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wenbo Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Sijie Li
- Beijing Key Laboratory of Hypoxic Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Emergency Department, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Yuan Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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Albertus-Cámara I, Rochel-Vera C, Lomas-Albaladejo JL, Ferrer-López V, Martínez-González-Moro I. Ventilatory Pattern Influences Tolerance to Normobaric Hypoxia in Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4935. [PMID: 36981844 PMCID: PMC10049086 DOI: 10.3390/ijerph20064935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Tolerance to breathing in conditions with a decreased oxygen ratio is subject-specific. A normobaric hypoxia tolerance test (NHTT) is performed to assess the ability of each individual, as this may be influenced by genetic or personal factors such as age or gender. The aim of this study is to test the influence of deep breathing on hypoxia tolerance time. MATERIAL AND METHODS A total of 45 subjects (21 parachutists and 24 students) performed two NHTTs at 5050 m altitude (iAltitude). Arterial (SatO2) and muscle (SmO2) oxygen saturation were monitored with the Humon Hex® device. The first NHTT was performed with free breathing, without any instructions; and the second NHTT was performed with wide, slow, diaphragmatic breathing. The NHTT was terminated at the end of 10 min or when a value of less than 83% was obtained. RESULTS The first NHTT was completed by 38.1% of parachutist and 33.3% of students while the second NHTT was completed by 85.7% and 75%, respectively. In the second NHTT, both parachutists and students had a significantly (p = 0.001) longer duration compared to the first NHTT. SmO2 and SatO2 values also increased significantly (p < 0.001) in both groups (p < 0.05). CONCLUSION Performing controlled diaphragmatic breathing is successful in increasing hypoxia tolerance time and/or SatO2 values.
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Park HY, Kim SW, Jung WS, Kim J, Lim K. Hypoxic Therapy as a New Therapeutic Modality for Cardiovascular Benefit: A Mini Review. Rev Cardiovasc Med 2022; 23:161. [PMID: 39077598 PMCID: PMC11273974 DOI: 10.31083/j.rcm2305161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 07/31/2024] Open
Abstract
Cardiovascular diseases (CVDs) are recognized as one of the major causes of morbidity and mortality worldwide. Generally, most CVDs can be prevented by addressing behavioral risk factors, including smoking, unhealthy diet and obesity, lack of physical activity, and alcohol abuse. Therefore, it is important to have a healthy lifestyle by performing regular physical activity to improve cardiovascular health and diseases. However, a majority of adults worldwide do not meet the minimum recommendations for regular aerobic exercise, and overweight and obesity ratio continues to rise. In addition, obese individuals, with a high prevalence of CVDs, have a lower participation rate for exercise because of the strain on the musculoskeletal system. Hypoxic therapy, including exposure or exercise intervention under hypoxia, has been utilized as a new therapeutic modality for cardiovascular benefit and amelioration of CVDs. Hypoxic therapy shows various physiological and pathophysiological properties, including increased appetite suppression and dietary intake reduction, increased energy consumption, improved glycogen storage, enhanced fatty acid oxidation, improved myocardial angiogenesis or ventricular remodeling, augmentation of blood flow within the skeletal muscle vascular beds, and reduction of the burden on the musculoskeletal system making it applicable to patients with CVDs and obesity with attenuated cardiovascular function. In particular, hypoxic therapy is very effective in improving cardiovascular benefits and preventing CVDs by enhancing arterial function, vascular endothelial function, and hemorheological properties. These observations indicate that hypoxic therapy may be an important and essential strategy for improving cardiovascular health and reducing cardiovascular morbidity and mortality.
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Affiliation(s)
- Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 05029 Seoul, Republic of Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, 05029 Seoul, Republic of Korea
| | - Sung-Woo Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 05029 Seoul, Republic of Korea
| | - Won-Sang Jung
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 05029 Seoul, Republic of Korea
| | - Jisu Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 05029 Seoul, Republic of Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, 05029 Seoul, Republic of Korea
| | - Kiwon Lim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 05029 Seoul, Republic of Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, 05029 Seoul, Republic of Korea
- Department of Physical Education, Konkuk University, 05029 Seoul, Republic of Korea
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Nowak-Lis A, Nowak Z, Gabrys T, Szmatlan-Gabrys U, Batalik L, Knappova V. The Use of Vibration Training in Men after Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063326. [PMID: 35329010 PMCID: PMC8951545 DOI: 10.3390/ijerph19063326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 02/07/2023]
Abstract
The aim of the study was to evaluate the effects of the applied whole-body vibration training (WBV) as additional training to standard rehabilitation programme on exercise tolerance, evaluated through an exercise test, blood lipid profile, and the changes in selected echocardiographic parameters of patients after myocardial infarction. The study involved 63 males. The subjects were divided into two groups: standard—ST (27) and with vibration training—ST + WBV (36). All the subjects had undergone angioplasty with stent implantation. The standard and with vibration training group carried out a 24-day improvement program comprising 22 training units. Each session consisted of endurance, general stamina, and resistance training. Instead of resistance training, the experimental group performed exercises on the vibration platform. Statistically significant changes in both groups were observed in the parameters of the echocardiographic exercise test, such as test duration (p < 0.001), distance covered (p < 0.001), MET (p < 0.001), VO2max (p < 0.001), and HRrest (p < 0.01). The echocardiographic test revealed significant improvement of Left Ventricular Ejection Fraction in both groups (ST + WBV group p = 0.024, ST group p = 0.005). There were no statistically significant changes in blood lipid profile and body mass and composition.
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Affiliation(s)
- Agata Nowak-Lis
- Department of Physiotherapy, Jerzy Kukuczka’s Academy of Physical Education, 40-065 Katowice, Poland;
- Correspondence: ; Tel.: +48-501-773-925
| | - Zbigniew Nowak
- Department of Physiotherapy, Jerzy Kukuczka’s Academy of Physical Education, 40-065 Katowice, Poland;
| | - Tomasz Gabrys
- Department of Physical Education and Sport Science, Faculty of Pedagogy, University of West Bohemia, 30100 Pilsen, Czech Republic; (T.G.); (V.K.)
| | - Urszula Szmatlan-Gabrys
- Department Anathomy, Faculty of Rehabilitation, University of Physical Education, 31-571 Krakow, Poland;
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic;
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Vera Knappova
- Department of Physical Education and Sport Science, Faculty of Pedagogy, University of West Bohemia, 30100 Pilsen, Czech Republic; (T.G.); (V.K.)
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Bestavashvili A, Glazachev O, Bestavashvili A, Suvorov A, Zhang Y, Zhang X, Rozhkov A, Kuznetsova N, Pavlov C, Glushenkov D, Kopylov P. Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile. Biomedicines 2022; 10:biomedicines10030566. [PMID: 35327372 PMCID: PMC8945352 DOI: 10.3390/biomedicines10030566] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to evaluate efficacy and applicability of the “intermittent hypoxic-hyperoxic exposures at rest” (IHHE) protocol as an adjuvant method for metabolic syndrome (MS) cardiometabolic components. A prospective, single-center, randomized controlled clinical study was conducted on 65 patients with MS subject to optimal pharmacotherapy, who were randomly allocated to IHHE or control (CON) groups. The IHHE group completed a 3-week, 5 days/week program of IHHE, each treatment session lasting for 45 min. The CON group followed the same protocol, but was breathing room air through a facial mask instead. The data were collected 2 days before, and at day 2 after the 3-week intervention. As the primary endpoints, systolic (SBP) and diastolic (DBP) blood pressure at rest, as well as arterial stiffness and hepatic tissue elasticity parameters, were selected. After the trial, the IHHE group had a significant decrease in SBP and DBP (Cohen’s d = 1.15 and 0.7, p < 0.001), which became significantly lower (p < 0.001) than in CON. We have failed to detect any pre-post IHHE changes in the arterial stiffness parameters (judging by the Cohen’s d), but after the intervention, cardio-ankle vascular indexes (RCAVI and LCAVI) were significantly lowered in the IHHE group as compared with the CON. The IHHE group demonstrated a medium effect (0.68; 0.69 and 0.71 Cohen’s d) in pre-post decrease of Total Cholesterol (p = 0.04), LDL (p = 0.03), and Liver Steatosis (p = 0.025). In addition, the IHHE group patients demonstrated a statistically significant decrease in pre-post differences (deltas) of RCAVI, LCAVI, all antropometric indices, NTproBNP, Liver Fibrosis, and Steatosis indices, TC, LDL, ALT, and AST in comparison with CON (p = 0.001). The pre-post shifts in SBP, DBP, and HR were significantly correlated with the reduction degree in arterial stiffness (ΔRCAVI, ΔLCAVI), liver fibrosis and steatosis severity (ΔLFibr, ΔLS), anthropometric parameters, liver enzymes, and lipid metabolism in the IHHE group only. Our results suggested that IHHE is a safe, well-tolerated intervention which could be an effective adjuvant therapy in treatment and secondary prevention of atherosclerosis, obesity, and other components of MS that improve the arterial stiffness lipid profile and liver functional state in MS patients.
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Affiliation(s)
- Afina Bestavashvili
- Department of Cardiology, Functional and Ultrasound Diagnostics, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (N.K.); (P.K.)
- Correspondence: ; Tel.: +7-916-338-3595
| | - Oleg Glazachev
- Department of Normal Physiology, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (O.G.); (X.Z.)
| | - Alexander Bestavashvili
- Department of Therapy, General Practice and Nuclear Medicine, Pirogov Russian National Research Medical University, 117997 Moscow, Russia;
| | - Alexander Suvorov
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (A.S.); (A.R.)
| | - Yong Zhang
- The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education, Department of Pharmacology, TbalHarbin Medical University, Harbin 150081, China;
| | - Xinliang Zhang
- Department of Normal Physiology, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (O.G.); (X.Z.)
| | - Andrey Rozhkov
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (A.S.); (A.R.)
| | - Natalia Kuznetsova
- Department of Cardiology, Functional and Ultrasound Diagnostics, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (N.K.); (P.K.)
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (A.S.); (A.R.)
| | - Chavdar Pavlov
- Department of Therapy of the Institute of Professional Education, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia;
- Botkinskaya Hospital, 125284 Moscow, Russia
| | - Dmitriy Glushenkov
- Department of Internal Medicine, Gastroenterology and Hepatology, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia;
| | - Philippe Kopylov
- Department of Cardiology, Functional and Ultrasound Diagnostics, N.V. Sklifosovsky Institute of Clinical Medicine, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (N.K.); (P.K.)
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (A.S.); (A.R.)
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Gloc D, Nowak Z, Nowak-Lis A, Gabryś T, Szmatlan-Gabrys U, Valach P, Pilis A. Indoor cycling training in rehabilitation of patients after myocardial infarction. BMC Sports Sci Med Rehabil 2021; 13:151. [PMID: 34844646 PMCID: PMC8628460 DOI: 10.1186/s13102-021-00379-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Standard endurance training used from the second stage of cardiac rehabilitation has many common features with indoor cycling training which is used in fitness clubs. In the study, an attempt was made to evaluate the usefulness of this form of training in a 24-day rehabilitation program for patients after myocardial infarction. The study examined a group of 64 patients (51.34 ± 8.02 years) who were divided into two groups: the IC group (32 patients aged 53.40 ± 4.31 years) with indoor cycling training instead of standard endurance training; and the ST group (32 patients aged 55.31 ± 6.45 years) performing standard training. The level of exercise tolerance (cardiopulmonary exercise testing on a treadmill-Bruce's protocol), hemodynamic indicators of the left ventricle (echocardiography) and blood lipid profile (laboratory test) were assessed. RESULTS In the IC group there was a significant increase in the test duration (9.21 ± 2.02 vs 11.24 ± 1.26 min; p < 0.001), the MET value (9.16 ± 1.30 vs 10.73 ± 1.23; p = 0.006) and VO2max (37.27 ± 3.23 vs 39.10 ± 3.17 ml/kg/min; p < 0.001). Parallel changes were observed in the ST group, where the following parameters improved: the test duration (9.41 ± 0.39 vs 10.91 ± 2.22; p < 0.001), MET value (8.65 ± 0.25 vs 9.86 ± 1.12; p = 0.002) and VO2max (36.89 ± 6.22 vs 38.76 ± 3.44; p < 0.001). No statistically significant changes were found in the hemodynamic indices of the left ventricle and the lipid profile. Also, the intergroup analysis did not show any statistical significance. CONCLUSION Based on the research results, it was found that indoor cycling training in the second phase of cardiac rehabilitation is a safe form of therapy and therefore may be an interesting alternative method to the classic bicycle ergometer exercise in the stage of early cardiac rehabilitation.
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Affiliation(s)
- Dagmara Gloc
- Silesian Center for Rehabilitation and Prevention, 43-450 Ustron, Poland
| | - Zbigniew Nowak
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Agata Nowak-Lis
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Tomasz Gabryś
- Sport Centrum Faculty of Pedagogy, University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - Urszula Szmatlan-Gabrys
- Department of Anatomy, Faculty of Rehabilitation, University of Physical Education, 31-571 Kraków, Poland
| | - Peter Valach
- Sport Centrum Faculty of Pedagogy, University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - Anna Pilis
- Faculty of Health Science, Jan Dlugosz University, 42-200 Czestochowa, Poland
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Karabiyik H, Eser MC, Guler O, Yasli BC, Ertetik G, Sisman A, Koz M, Gabrys T, Pilis K, Karayigit R. The Effects of 15 or 30 s SIT in Normobaric Hypoxia on Aerobic, Anaerobic Performance and Critical Power. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083976. [PMID: 33918866 PMCID: PMC8069352 DOI: 10.3390/ijerph18083976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/16/2022]
Abstract
Sprint interval training (SIT) is a concept that has been shown to enhance aerobic-anaerobic training adaptations and induce larger effects in hypoxia. The purpose of this study was to examine the effects of 4 weeks of SIT with 15 or 30 s in hypoxia on aerobic, anaerobic performance and critical power (CP). A total of 32 male team players were divided into four groups: SIT with 15 s at FiO2: 0.209 (15 N); FiO2: 0.135 (15 H); SIT with 30 s at FiO2: 0.209 (30 N); and FiO2: 0.135 (30 H). VO2max did not significantly increase, however time-to-exhaustion (TTE) was found to be significantly longer in the post test compared to pre test (p = 0.001) with no difference between groups (p = 0.86). Mean power (MPw.kg) after repeated wingate tests was significantly higher compared to pre training in all groups (p = 0.001) with no difference between groups (p = 0.66). Similarly, CP was increased in all groups with 4 weeks of SIT (p = 0.001) with no difference between groups (p = 0.82). This study showed that 4 weeks of SIT with 15 and 30 s sprint bouts in normoxia or hypoxia did not increased VO2max in trained athletes. However, anerobic performance and CP can be increased with 4 weeks of SIT both in normoxia or hypoxia with 15 or 30 s of sprint durations.
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Affiliation(s)
- Hakan Karabiyik
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
| | - Mustafa Can Eser
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
| | - Ozkan Guler
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
| | - Burak Caglar Yasli
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
- Department of Physical Education and Sports, Iğdır University, Iğdır 76410, Turkey
| | - Goktug Ertetik
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
- Faculty of Sport Sciences, Kastamonu University, Kastamonu 37000, Turkey
| | - Aysegul Sisman
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
- Faculty of Sport Sciences, Muğla Sıtkı Koçman University, Muğla 48000, Turkey
| | - Mitat Koz
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
| | - Tomasz Gabrys
- Sport Centrum Faculty of Pedagogy, University of West Bohemia, 301 00 Pilsen, Czech Republic;
| | - Karol Pilis
- Faculty of Health Science, Jan Dlugosz University, 42-200 Czestochowa, Poland;
| | - Raci Karayigit
- Faculty of Sport Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (H.K.); (M.C.E.); (O.G.); (B.C.Y.); (G.E.); (A.S.); (M.K.)
- Correspondence: ; Tel.: +90-312-600-0100
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