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Cold Water Immersion as a Strategy for Muscle Recovery in Professional Basketball Players During the Competitive Season. J Sport Rehabil 2021; 29:301-309. [PMID: 30676280 DOI: 10.1123/jsr.2018-0301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/03/2018] [Accepted: 12/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Despite prior studies that have addressed the recovery effects of cold-water immersion (CWI) in different sports, there is a lack of knowledge about longitudinal studies across a full season of competition assessing these effects. OBJECTIVE To analyze the CWI effects, as a muscle recovery strategy, in professional basketball players throughout a competitive season. DESIGN A prospective cohort design. SETTING Elite basketball teams. PARTICIPANTS A total of 28 professional male basketball players divided into 2 groups: CWI (n = 12) and control (n = 16) groups. MAIN OUTCOME MEASURES Muscle metabolism serum markers were measured during the season in September-T1, November-T2, March-T3, and April-T4. Isokinetic peak torque strength and ratings of perceived exertion were measured at the beginning and at the end of the season. CWI was applied immediately after every match and after every training session before matches. RESULTS All serum muscular markers, except myoglobin, were higher in the CWI group than the control group (P < .05). The time course of changes in muscle markers over the season also differed between the groups (P < .05). In the CWI group, ratings of perceived exertion decreased significantly from the beginning (T1-T2) to the end (T3-T4). Isokinetic torque differed between groups at the end of the season (60°/s peak torque: P < .001 and ηp2=.884; and 180°/s peak torque: P < .001 and ηp2=.898) and had changed significantly over the season in the CWI group (P < .05). CONCLUSIONS CWI may improve recovery from muscle damage in professional basketball players during a regular season.
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Factors influencing post-exercise proteinuria after marathon and ultramarathon races. Biol Sport 2019; 37:33-40. [PMID: 32205908 PMCID: PMC7075229 DOI: 10.5114/biolsport.2020.89939] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/03/2019] [Accepted: 11/03/2019] [Indexed: 11/26/2022] Open
Abstract
Post-exercise proteinuria is one of the most common findings observed after short and intensive physical activity, but is observed also after long runs with low intensity. The aim of this study was to analyze factors influencing proteinuria after marathon runs. Two groups of male amateur runners were studied. The results of 20 marathon finishers (42.195 m), with a mean age of 49.3 ± 6.85 years; and 17 finishers of a 100-km ultramarathon with a mean age of 40.18±4.57 years were studied. Urine albumin to creatinine ratio (ACR) was calculated before and after both races. The relationship between ACR and run pace, metabolites (lactate, beta hydroxybutyrate), markers of inflammation (CRP, IL-6) and insulin was studied. The significant increase in ACR was observed after both marathon races. ACR increased from 6.41 to 21.96 mg/g after the marathon and from 5.37 to 49.64 mg/g after the ultramarathon (p<0.05). The increase in ACR was higher after the ultramarathon that after the marathon. There was no correlation between run pace and proteinuria. There was no correlation between ACR and glucose, free fatty acids, lactate, beta-hydroxybutyrate and insulin levels. There was significant negative correlation between ACR and interleukin 6 (IL-6) (r =-0.59, p< 0.05) after ultramarathon. Proteinuria is a common finding after physical exercise. After very long exercises it is related to duration but not to intensity. There is no association between metabolic and hormonal changes and ACR after marathon runs. The role on inflammatory cytokines in albuminuria is unclear.
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Yamamoto T, Fujita M, Oda Y, Todani M, Hifumi T, Kondo Y, Shimazaki J, Shiraishi S, Hayashida K, Yokobori S, Takauji S, Wakasugi M, Nakamura S, Kanda J, Yagi M, Moriya T, Kawahara T, Tonouchi M, Yokota H, Miyake Y, Shimizu K, Tsuruta R. Evaluation of a Novel Classification of Heat-Related Illnesses: A Multicentre Observational Study (Heat Stroke STUDY 2012). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091962. [PMID: 30205551 PMCID: PMC6165559 DOI: 10.3390/ijerph15091962] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 01/09/2023]
Abstract
The Japanese Association for Acute Medicine Committee recently proposed a novel classification system for the severity of heat-related illnesses. The illnesses are simply classified into three stages based on symptoms and management or treatment. Stages I, II, and III broadly correspond to heat cramp and syncope, heat exhaustion, and heat stroke, respectively. Our objective was to examine whether this novel severity classification is useful in the diagnosis by healthcare professionals of patients with severe heat-related illness and organ failure. A nationwide surveillance study of heat-related illnesses was conducted between 1 June and 30 September 2012, at emergency departments in Japan. Among the 2130 patients who attended 102 emergency departments, the severity of their heat-related illness was recorded for 1799 patients, who were included in this study. In the patients with heat cramp and syncope or heat exhaustion (but not heat stroke), the blood test data (alanine aminotransferase, creatinine, blood urea nitrogen, and platelet counts) for those classified as Stage III were significantly higher than those of patients classified as Stage I or II. There were no deaths among the patients classified as Stage I. This novel classification may avoid underestimating the severity of heat-related illness.
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Affiliation(s)
- Takahiro Yamamoto
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Motoki Fujita
- Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Yasutaka Oda
- Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Masaki Todani
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
| | - Toru Hifumi
- Emergency and Critical Care medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
| | - Yutaka Kondo
- Department of Emergency Medicine and Critical Care Medicine, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan.
| | - Junya Shimazaki
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Shinichiro Shiraishi
- Department of Emergency and Critical Care Medicine, Aizu Chuo Hospital, 1-1 Tsuruga-machi, Aizuwakamatsu, Fukushima 965-8611, Japan.
| | - Kei Hayashida
- Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
| | - Shuhei Takauji
- Department of Emergency Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan.
| | - Masahiro Wakasugi
- Emergency and Critical Care Center, Toyama University Hospital, 2630, Sugitani, Toyama City, Toyama 930-0152, Japan.
| | - Shunsuke Nakamura
- Department of Emergency Medicine, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama City, Wakayama 640-8505, Japan.
| | - Jun Kanda
- Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
| | - Masaharu Yagi
- Department of Emergency and Critical Care Medicine, Urasoe General Hospital, 4-16-1 Iso, Urasoe, Okinawa 901-2132, Japan.
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama City, Saitama 330-8503, Japan.
| | - Takashi Kawahara
- Japan Sport Council, 2-8-35 Kita-Aoyama, Minato-ku, Tokyo 107-0061, Japan.
| | - Michihiko Tonouchi
- Japan Meteorological Business Support Center, To-nen Bld, 3-17 Kanda-Nishikicho, Chiyoda-ku, Tokyo 101-0054, Japan.
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
| | - Yasufumi Miyake
- Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
| | - Keiki Shimizu
- Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan.
| | - Ryosuke Tsuruta
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
- Department of Acute and General Medicine, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
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Manspeaker S, Henderson K, Riddle D. Treatment of exertional rhabdomyolysis in athletes: a systematic review. ACTA ACUST UNITED AC 2018; 14:117-47. [PMID: 27532656 DOI: 10.11124/jbisrir-2016-001879] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Exertional rhabdomyolysis (ER) is the breakdown of skeletal muscle tissue following intense physical activity that results in impairment of the cell membrane, which allows intracellular contents to be released into the bloodstream. Signs and symptoms include myalgia, myoglobinuria and increased creatine kinase (CK) levels. Athletes are vulnerable to this condition due to their increased level of physical activity. The severity and effects of this condition vary between individuals; however, all athletes are at risk of significant muscle damage, renal failure and perhaps death if not recognized and treated quickly. Effective methods for treatment and return to activity following this condition should be established. OBJECTIVES The objective of this review was to identify effective treatment methods associated with ER in athletes. INCLUSION CRITERIA TYPES OF PARTICIPANTS Adult and adolescent patients (15 years of age and older) in the athletic population who have been diagnosed with ER. TYPES OF INTERVENTIONS Fluid resuscitation/replacement or other treatment methods that aim to improve CK levels and decrease myoglobinuria and treat ER. TYPES OF STUDIES Due to the absence of randomized control trials, the quantitative component of the review considered descriptive studies, case series and individual case reports for inclusion. OUTCOMES PRIMARY OUTCOMES CK and myoglobinuria levels. SECONDARY OUTCOMES length of hospital stay; length of time from diagnosis to premorbid levels of physical activity. SEARCH STRATEGY A comprehensive search of the following databases with no date limitation was conducted: CINAHL, PubMed, ProQuest, Embase, SPORTDiscus and Physical Education Index. Results were limited to those available in English. METHODOLOGICAL QUALITY Two independent reviewers evaluated the retrieved articles for methodological quality using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics and Review Instruments. DATA EXTRACTION Data were extracted from the articles by two independent reviewers using the standardized Joanna Briggs Institute extraction tool. DATA SYNTHESIS Narrative and tabular synthesis. RESULTS Fourteen studies with a combined total of 53 participants were included. Aggressive intravenous (IV) fluid resuscitation was found to be the most commonly utilized treatment method for decreasing CK levels and resolving myoglobinuria. The addition of compounds within the IV fluid varied between studies. CONCLUSION Due to the types of included studies and variation in reported treatment methods and outcomes for ER among athletes, effectiveness of treatment could not be determined. The limited evidence available indicates that IV fluid replacement, specifically normal saline, is the most commonly reported treatment for decreasing CK levels and myoglobinuria following ER. It appears that normal saline may be combined with other compounds including sodium bicarbonate, sodium chloride or potassium chloride to achieve reduction of CK levels and myoglobinuria. Clinically, early IV fluid replacement appears to be delivered at a rate of approximately 400 ml/hour, with adjustments ranging between 200 and 1000 ml/hour, depending on severity and volume states. Hospitalization time varies, depending on severity of condition, and return to activity is widely inconsistent among the athletic population.
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Affiliation(s)
- Sarah Manspeaker
- 1Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA 2Texas Christian University Center for Evidence-based Practice and Research: a Collaborating Center of the Joanna Briggs Institute, Fort Worth, Texas, USA 3Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, Florida, USA 4Nursing, Texas Christian University: a Collaborating Center of the Joanna Briggs Institute, Fort Worth, Texas, USA
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Magrini D, Khodaee M, San-Millán I, Hew-Butler T, Provance AJ. Serum creatine kinase elevations in ultramarathon runners at high altitude. PHYSICIAN SPORTSMED 2017; 45:129-133. [PMID: 28075653 DOI: 10.1080/00913847.2017.1280371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Creatine kinase (CK) is a sensitive enzyme marker for muscle damage in athletes. Elevated CK levels have been reported in many endurance physical activities. The consequence and possible long-term sequela of the CK elevation in athletes is unknown. There is a paucity of literature stating actual numerical values of CK associated with competing in an ultramarathon with extreme environmental conditions. Our hypothesis was that the serum CK levels increase significantly as a result of running a 161 km ultramarathon at high altitude. METHODS This was a prospective observational study of participants of the Leadville 100 ultramarathon race in Leadville, Colorado at high altitude (2800-3840 m) in August 2014. We collected blood samples from sixty-four volunteer runners before and eighty-three runners immediately after the race. RESULTS Out of 669 athletes who started the race, 352 successfully completed the race in less than the 30-hour cut-off time (52%). The majority of runners were male (84%). We were able to collect both pre- and post-race blood samples from 36 runners. Out of these 36 runners, the mean pre-race CK was increased from 126 ± 64 U/L to 14,569 ± 14,729 U/L (p < 0.001). There was a weak linear correlation between lower sodium levels and higher CK levels post-race (p = 0.003; R2 = 0.10). Using a multiple regression model, other than a negative correlation between sodium and CK levels (p = 0.001), there were no statistically significant correlations between post-race CK levels and athletes' age, BMI, or finishing time. CONCLUSIONS Significant elevation of CK level occurs as a result of running ultramarathons. The majority of athletes with significantly elevated CK levels were asymptomatic and required no major medical attention.
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Affiliation(s)
- Danielle Magrini
- a Division of Orthopedics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Morteza Khodaee
- b Department of Family Medicine, Division of Sports Medicine , University of Colorado School of Medicine , Denver , CO , USA
| | - Iñigo San-Millán
- c Department of Physical Medicine and Rehabilitation, Division of Sports Medicine , University of Colorado School of Medicine , Aurora , CO , USA
| | - Tamara Hew-Butler
- d Exercise Science Program, Oakland University School of Health Sciences , Rochester , MI , USA
| | - Aaron J Provance
- e Department of Orthopedics, Division of Sports Medicine , University of Colorado School of Medicine , Aurora , CO , USA
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Yang Y, Carter LP, Cook RE, Paul E, Schwartz KR. A Case of Exertional Rhabdomyolysis: A Cheer for Standardizing Inpatient Management and Prevention. Hosp Pediatr 2016; 6:753-756. [PMID: 27909094 DOI: 10.1542/hpeds.2016-0082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
| | - Lindsay P Carter
- Department of Pediatrics, and.,Divisions of Pediatric Hospital Medicine
| | - Rebecca E Cook
- Department of Pediatrics, and.,Divisions of Pediatric Hospital Medicine
| | - Elahna Paul
- Department of Pediatrics, and.,Pediatric Nephrology, and
| | - Kevin R Schwartz
- Department of Pediatrics, and.,Divisions of Pediatric Hospital Medicine.,Pediatric Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Kim J, Lee J. The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions. J Exerc Nutrition Biochem 2015; 19:123-9. [PMID: 26244131 PMCID: PMC4523802 DOI: 10.5717/jenb.2015.15061910] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 06/08/2015] [Accepted: 06/19/2015] [Indexed: 11/06/2022] Open
Abstract
[Purpose] The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise. [Methods] Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise. [Results] The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index. [Conclusion] CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.
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Affiliation(s)
- Jooyoung Kim
- College of Physical Education, Kookmin University, Seoul, Republic of Korea
| | - Joohyung Lee
- College of Physical Education, Kookmin University, Seoul, Republic of Korea
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