Evaluating the role of nitric oxide in myogenesis in vitro

Skeletal muscle injury activates satellite cells to proliferate as myoblasts and migrate, differentiate and fuse with existing fibres at the site of injury. Nitric oxide (NO), a free radical produced by NO synthase, is elevated and supports healing after in vivo injury. NOS-independent elevation of NO levels in vitro is possible via donors such as molsidomine (SIN-1). We hypothesized that alterations in NO levels may directly influence myogenic processes critical for skeletal muscle wound healing. This study aimed to clarify the role of NO in myoblast proliferation, migration and differentiation. Baseline NO levels were established in vitro, whereafter NO levels were manipulated during myogenesis using l-NAME (NOS inhibitor) or SIN-1. Baseline NO levels generated by myoblasts in proliferation media did not change 1 h after stimulation. Addition of a pro-proliferative dose of HGF slightly elevated NO levels 1 h post-stimulation, whereas cell numbers assessed 24 h later increased significantly; l-NAME reduced the HGF-driven increase in NO and proliferation, reducing wound closure over 16 h. In differentiation media, NO levels increased significantly within 24 h, returning to baseline over several days. Regular addition of l-NAME to differentiating cells significantly reduced NO levels and fusion. SIN-1 increased NO levels in a dose-dependent manner, reaching maximal levels 16 h post-treatment. SIN-1, added at 0, 2 and 4 days, significantly increased myofiber area (26 ± 1.8% vs 18.6 ± 3.4% in control at 5 day, p < 0.0001), without affecting proliferation or migration. In conclusion, this study demonstrates that, during skeletal muscle regeneration, increased NO specifically stimulates myoblast differentiation.

Rheumatoid cachexia: the underappreciated role of myoblast, macrophage and fibroblast interplay in the skeletal muscle niche

Although rheumatoid arthritis affects 1% of the global population, the role of rheumatoid cachexia, which occurs in up to a third of patients, is relatively neglected as research focus, despite its significant contribution to decreased quality of life in patients. A better understanding of the cellular and molecular processes involved in rheumatoid cachexia, as well as its potential treatment, is dependent on elucidation of the intricate interactions of the cells involved, such as myoblasts, fibroblasts and macrophages. Persistent RA-associated inflammation results in a relative depletion of the capacity for regeneration and repair in the satellite cell niche. The repair that does proceed is suboptimal due to dysregulated communication from the other cellular role players in this multi-cellular environment. This includes the incomplete switch in macrophage phenotype resulting in a lingering pro-inflammatory state within the tissues, as well as fibroblast-associated dysregulation of the dynamic control of the extracellular matrix. Additional to this endogenous dysregulation, some treatment strategies for RA may exacerbate muscle wasting and no multi-cell investigation has been done in this context. This review summarizes the most recent literature characterising clinical RA cachexia and links these features to the roles of and complex communication between multiple cellular contributors in the muscle niche, highlighting the importance of a targeted approach to therapeutic intervention.

Delayed wound healing and dysregulation of IL6/STAT3 signalling in MSCs derived from pre-diabetic obese mice

Metabolic dysfunction that occurs in obesity and Type 2 diabetes results in a low-level inflammatory state which impacts on mesenchymal stem cells (MSCs) capacity to promote wound healing. The ability of either recombinant Interleukin-6 (rIL6) or pioglitazone to modulate MSC migration, essential for wound healing, by targeting the inflammation-modulated IL6/STAT3 signalling pathway was therefore investigated in bone marrow-derived MSCs from control (C57BL/6J) and pre-diabetic obese mice (B6. Cg-Lepob/J). The population doubling time, in vitro wound closure and mRNA expression profile of 84 genes involved in the IL6/STAT3 signalling pathway were assessed. IL6/STAT3 signalling dysregulation, caused by IL6 deficiency, resulted in skewing of the immune modulatory properties of MSCs to favour a pro-inflammatory profile. This could be nullified by addition of either rIL6 or conventional diabetes treatment. Therapies to improve diabetic wound healing should therefore focus on the cellular changes induced by the pathological inflammatory micro-environment.

Acute change of titin at mid-sarcomere remains despite 8 wk of plyometric training

The purpose of this study was to investigate skeletal muscle changes induced by an acute bout of plyometric exercise (PlyEx) both before and after PlyEx training, to understand if titin is affected differently after PlyEx training. Healthy untrained individuals ( N = 11) completed the 1stPlyEx (10 × 10 squat-jumps, 1-min rest). Thereafter, six subjects completed 8 wk of PlyEx, while five controls abstained from any jumping activity. Seven days after the last training session, all subjects completed the 2ndPlyEx. Blood samples were collected before and 6 h and 1, 2, 3, and 4 days after each acute bout of PlyEx, and muscle biopsies 4 days before and 3 days after each acute bout of PlyEx. The 1stPlyEx induced an increase in circulating myoglobin concentration. Muscle sample analysis revealed Z-disk streaming, a stretch or a fragmentation of titin (immunogold), and increased calpain-3 autolysis. After training, 2ndPlyEx did not induce Z-disk streaming or calpain-3 activation. The previously observed post-1stPlyEx positional change of the titin COOH terminus was still present pre-2ndPlyEx, in all trained and all control subjects. Only two controls presented with Z-disk streaming after 2ndPlyEx, while calpain-3 activation was absent in all controls. Eccentric explosive exercise induced a stretch or fragmentation of titin, which presented as a positional change of the COOH terminus. Calpain-3 activation does not occur when titin is already stretched before explosive jumping. Enzymatic digestion results in titin fragmentation, but since an increase in calpain-3 autolysis was visible only after the 1stPlyEx acute bout, fragmentation cannot explain the prolonged positional change.

Greater performance impairment of black runners than white runners when running in hypoxia

This study aimed to compare the response of performance-matched black and white runners during maximal and sub-maximal running in normoxic and hypoxic conditions. 14 well-trained runners (8 black, 6 white) performed 2 incremental maximal exercise tests and 2 fatigue resistance tests at 21% O2 (normoxia) or 14% O2 (hypoxia). Respiratory parameters, heart rate (HR), lactate concentration ([La(-)]) as well as arterial saturation (SpO2) were measured. Enzyme activities and myosin heavy chain content (MHC) were also measured. White runners reached a significantly greater peak treadmill speed and a higher HRmax than black runners in hypoxia (p<0.05). Additionally, White runners achieved a greater time to fatigue than black runners (p<0.05), with black runners displaying a greater decline in performance in hypoxia compared to normoxia (20.3% vs. 13.4%, black vs. white, respectively). However, black runners presented lower [La(-)] and higher SpO2 than white runners in hypoxia (p<0.05). Black runners had a higher proportion of MHC IIa and higher lactate dehydrogenase activity (p<0.05). The greater performance impairment observed in black runners in hypoxia suggests a greater performance sensitivity to this condition, despite the maintenance of physiological variables such as SpO2 and [La (-) ] within a smaller range than white runners.

Variable inflammation and intramuscular STAT3 phosphorylation and myeloperoxidase levels after downhill running

Individual responses in creatine kinase (CK) release after eccentric exercise are divergent. This study aimed to identify whether this could be related to selected humoral or intramuscular inflammatory factors. Twenty-three subjects were divided into non-exercising (n = 5) and downhill run (DHR; n = 18) groups (12 × 5 min, 10% decline at 15 km/h). Blood samples were analyzed for white blood cell differential count, CK, myoglobin, tumor necrosis factor-α, granulocyte colony-stimulating factor, interleukin (IL)-1β, IL-6, and IL-10. Muscle biopsies were analyzed for signal transducer and activator of transcription-3 (STAT3), IκBα, and myeloperoxidase (MPO). DHR participants clustered as early (DHR1) recovery, biphasic response (DHR2), or classic delayed exaggerated CK response (DHR3), with a delayed CK peak (4784 ± 1496 U/L) on day 4. For DHR1 and DHR2, CK peaked on day 1 (DHR1: 1198 ± 837 U/L) or on day 1 and day 4 (DHR2: 1583 ± 448 U/L; 1878 ± 427 U/L), respectively. Immediately post-DHR, IL-6 increased in DHR2 and DHR3 whereas IL-10 increased in all DHR groups. STAT3 signaling increased for DHR1 and DHR2 at 4 h, but MPO at day 2 only in DHR2. Objective cluster analysis uncovered a group of subjects with a characteristic biphasic CK release after DHR. The second elevation was related to their early cytokine response. The results provide evidence that early responses following eccentric exercise are indicative of later variation.

Cytokine and satellite cell responses to muscle damage: interpretation and possible confounding factors in human studies

It is plausible that multiple muscle biopsies following a muscle damaging intervention can exacerbate the inflammatory and subsequent satellite cell responses. To elucidate confounding effects of muscle biopsy procedure on satellite cell number, indirect markers of damage and the inflammatory response following acute downhill running (DHR) were investigated. 10 healthy male participant were divided into a non-exercising control (n = 4) and DHR (12 × 5min bouts, 10 % decline at 85 % VO(2)max) (n = 6) group. Blood samples were taken pre, post and every 24 h for 9 days. Serum was analysed for creatine kinase (CK), myoglobin (Mb), lactate dehydrogenase (LDH), TNF-α, IL-6 and IL-10. Muscle biopsies taken on days 1 and 2 post intervention from opposing legs were analysed for Pax7(+) satellite cells. In the DHR group, Mb (536 ± 277 ng mL(-1)), IL-6 (12.6 ± 4.7 pg mL(-1)) and IL-10 (27.3 ± 11.5 pg mL(-1)) peaked immediately post DHR, while CK (2651 ± 1911 U L(-1)), LDH (202 ± 47 U L(-1)) and TNF-α (25.1 ± 8.7 pg mL(-1)) peaked on day 1. A 30 % increase in Pax7(+) satellite cells on day 1 in the DHR group was no longer apparent on day 2. H&E staining show evidence of phagocytosis in the DHR group. No significant changes over time were observed in the control group for any of the variables measured. Events observed in the DHR group were as a result of the intervention protocol and subsequent muscle damage. The relationship between SC proliferation and pro-inflammatory cytokine release appears to be complex since the IL-6/IL-10 response time differs significantly from the TNF-α response.

Satellite cell count, VO(2max) , and p38 MAPK in inactive to moderately active young men

Satellite cells (SCs) are responsible for muscle repair following strenuous exercise or injury. SC responses to intervention have been studied, but most studies do not discuss or take into account the substantial variability in SC number among young individuals. We hypothesized that an active lifestyle reflected in higher VO(2max) may be associated with greater SC number. As training alters basal p38-mitogen-activated protein kinase (MAPK) activity, which is associated with SC proliferation, SC count may also correlate with this stress signaling kinase. Muscle biopsies from vastus lateralis of eight male participants were analyzed for fiber type, myogenin, and p38/phospho-p38 MAPK using SDS-PAGE and Western blotting. Immunofluorescence was used to detect Pax7(+) SCs. Two weeks following the biopsy, subjects underwent an incremental treadmill test to determine VO(2max) . A strong positive correlation (P = 0.0087) was found between the number of Pax7(+) nuclei and VO(2max) . Pax7(+) cell number correlated negatively with phospho-p38/p38 MAPK (P = 0.0006), but had no correlation with fiber type or myogenin. SC number is proportional to VO(2max) , and hence it can be postulated that higher levels of physical activity activate SC proliferation but not fusion, underlining the relevance of exercise in stimulating SC pool size even without injury.

Illuminating the interrelated immune and endocrine adaptations after multiple exposures to short immobilization stress by in vivo blocking of IL-6

Intermittent psychological stress was induced in adult rats by 2 h/day of immobilization stress for 4 days, with or without blocking the function of IL-6 by using an anti-IL-6 antibody. Basal concentrations of serum corticosterone, IL-1β, IL-6, and TNF-α were assessed 24 h after the last intervention, as were levels of glucocorticoid receptors (GR) and activities of glucocorticoid-inducible enzymes (tyrosine aminotransferase and glutamine synthetase) in muscle and liver. Whole blood cultures were used to assess both spontaneous and LPS-induced reactivity of peripheral blood mononuclear cells. Stress increased corticosterone concentration in a manner partially modulated by IL-6. Serum IL-1β concentration was downregulated during stress when IL-6 was blocked ( P < 0.01). LPS-induced IL-6 secretion by peripheral blood mononuclear cells in vitro correlated positively with serum IL-1β concentration in antibody-treated groups, independently of stress ( R = 0.70 in nonstressed and R = 0.78 in stressed rats; both P < 0.05), whereas serum corticosterone concentration correlated positively with LPS-induced secretion of IL-6 only in control rats ( R = 0.66; P < 0.05). Reductions in liver GR levels indicated independent effects of stress (34.5%) and anti-IL-6 antibody (16.7%) and additive effects for both (62.5%). Similar results are reported for vastus muscle. Conversely, stress increased tyrosine aminotransferase and glutamine synthetase activities in muscle and liver with a significant ( P < 0.05) effect of anti-IL-6 antibody only seen in stressed livers. In conclusion, IL-6 plays a role in maintaining circulating IL-1β concentration after multiple exposures to stress, thus promoting a continued elevation of corticosterone release; in peripheral tissues, IL-6 antagonizes the effects of glucocorticoids, especially at the level of GR concentration.

Endocrine and immune effects of dexamethasone in unilateral total knee replacement

The effect of acute pre-surgery dexamethasone treatment on the inflammatory immune and endocrine responses to orthopaedic surgery was investigated. Whole blood samples were obtained before and 5 days after surgery for immune analysis, and serum was obtained before and 6 h, 3 days and 5 days after surgery for endocrine assessment. Dexamethasone did not affect the post-surgery granulocyte response, but inhibited the increase in monocyte count (an average increase of 38.5% was seen in the control group). Peak C-reactive protein concentration (3 days after surgery) was 51.4% lower in the dexamethasone group than in the control group. Dexamethasone had a major effect on cortisol concentrations and the cortisol:testosterone and cortisol:dehydroepiandrosterone ratios, but no effect on anabolic hormone concentrations. In conclusion, acute pre-surgery dexamethasone treatment may have beneficial effects in the post-surgery period, by limiting the extent of systemic inflammation and the cortisol response.

Mountain bike racing - the influence of prior glycogen-inducing exercise and glutamine supplementation on selected stress and immune parameters

Objective. To investigate the effect of pre-exercise glutamine supplementation and the influence of a prior acute bout of glycogen-reducing exercise on the general stress and immune response to acute high-intensity cycling. Design. Randomised, double-blind, cross-over supplementation study. Setting and intervention. Subjects performed a series of 4 simulated mountain-bike races lasting ≈60 minutes each on separate days 1 week apart, with/ without prior glycogen- reducing exercise on a known outdoor course with/ without pre-exercise glutamine supplementation. Blood samples were collected pre- and immediately post-exercise after each race. Main outcome measures. Circulating concentrations of cortisol (COR) and dehydroepiandrosterone-sulphate (DHEAS) were assessed at all time points, as well as changes in white blood cell (WBC) subpopulation distribution. Results. COR was elevated in all groups post-exercise (p < 0.0001), but neither glycogen reduction, nor glutamine supplementation had any effect. DHEAs increased post-exercise (p < 0.05), with a greater relative increase in glutamine-supplemented subjects (p = 0.07). Total WBC and neutrophil counts in all groups were elevated after exercise (both p < 0.0005). Glutamine supplementation had no effect on differential WBC counts or distribution, but total WBC (p = 0.06) and monocyte (p < 0.05) counts showed greater increases after glycogen reduction. Gluta- mine supplementation was associated with greater postexercise decreases in CD4+ count (p = 0.07) and CD4+: CD8+ ratio (p = 0.01) after glycogen-reducing exercise. Conclusions. We conclude that pre-exercise glutamine supplementation may have an anticortisol effect by enhancing the DHEAS response to exercise stress. The suppressive effect of glutamine supplementation on CD4+: CD8+ ratio and its positive effect on monocyte count after repeated bouts of exercise warrants further investigation. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 122-128

The effect of a professional cricket match schedule on selected immune parameters

Objective. The impact of a professional cricket match schedule on white blood cell (WBC) distribution and lymphocyte activation (CD69 expression) was investigated. Methods. After a 3-month pre-season training period, physical and immune parameters were determined in 14 male cricketers before (B) and after (A) an intensive 5- week match schedule. Results. Exercise test results were unchanged from B to A. Total WBC counts were similar, but total lymphocyte and lymphocyte subpopulation counts decreased significantly. The CD4:CD8 ratio did not change. After in vitro stimulation, percentage CD4+CD69+ cells increased (B: 54.4 ± 9.7%, A: 64.0 ± 8.5%, p < 0.01), but absolute CD4+CD69+ cell counts did not change from B to A. In contrast, both the %CD8+CD69+ cells and absolute CD8+CD69+ cell count remained similar. Conclusion. A strenuous, interregional, professional cricket match schedule resulted in a decreased number of lymphocytes, but relatively increased in vitro reactivity of CD4+ cells, thus maintaining the absolute capacity of the CD4+ cells to become activated on stimulation. In cricketers who suffered upper respiratory tract symptoms during the match schedule (N = 7), none of the immune parameters investigated differed significantly from the others at B or A. SA Sports Medicine Vol.16(2) 2004: 22-27

The effect of a professional cricket match schedule on selected immune parameters

Objective. The impact of a professional cricket match schedule on white blood cell (WBC) distribution and lymphocyte activation (CD69 expression) was investigated. Methods. After a 3-month pre-season training period, physical and immune parameters were determined in 14 male cricketers before (B) and after (A) an intensive 5- week match schedule. Results. Exercise test results were unchanged from B to A. Total WBC counts were similar, but total lymphocyte and lymphocyte subpopulation counts decreased significantly. The CD4:CD8 ratio did not change. After in vitro stimulation, percentage CD4+CD69+ cells increased (B: 54.4 ± 9.7%, A: 64.0 ± 8.5%, p < 0.01), but absolute CD4+CD69+ cell counts did not change from B to A. In contrast, both the %CD8+CD69+ cells and absolute CD8+CD69+ cell count remained similar. Conclusion. A strenuous, interregional, professional cricket match schedule resulted in a decreased number of lymphocytes, but relatively increased in vitro reactivity of CD4+ cells, thus maintaining the absolute capacity of the CD4+ cells to become activated on stimulation. In cricketers who suffered upper respiratory tract symptoms during the match schedule (N = 7), none of the immune parameters investigated differed significantly from the others at B or A. SA Sports Medicine Vol.16(2) 2004: 22-27

Prolonged suppression of the innate immune system in the horse following an 80 km endurance race

REASONS FOR PERFORMING STUDY

An increased susceptibility to bacterial and viral infections of the respiratory tract, which results in a loss of performance, has been reported in racehorses. Much research has focused on the influence of high-intensity exercise of a short duration on immune system function in horses, but scant attention has been given to prolonged endurance exercise as an immune modulator.

OBJECTIVES

The objective of this study was to evaluate the effect of an 80 km endurance race on the monocyte and neutrophil oxidative burst, serum cortisol, glutamine and plasma glucose concentrations in 8 endurance-trained horses (mean +/- s.d. age 9.4 +/- 2.2 years).

METHODS

Blood samples were drawn from the horses prior to and following an 80 km ride.

RESULTS

Mean time for completion of the 80 km race was 306 +/- 40 mins. Immediately post race mean serum cortisol concentration, blood monocyte and neutrophil counts were higher and blood lymphocyte counts and plasma glucose concentration were lower compared with prerace values (P < 0.05). Neutrophil and monocyte oxidative burst activity decreased following the race and had not regained prerace values after 3 days of rest (P < 0.05).

CONCLUSIONS

The present study indicates that long duration exercise in horses has a negative impact on the function of the innate immune system that lasts several days post race. Precise mechanisms instigating the fall in innate immune system function are unclear and multifactorial, but may be attributed, at least in part, to a high serum cortisol response during very prolonged exercise.

POTENTIAL CLINICAL RELEVANCE

A prolonged bout of exercise results in a long-term suppression of the innate immune system function in horses which may, in part, account for the observed increase of infectious episodes in horses during training.

Plasma lactate concentrations for self-selected maximal effort lasting 1 h

PURPOSE

We determined the plasma lactate concentrations for 11 well-trained endurance cyclists or triathletes during a laboratory trial to measure maximal distance cycled in 1 h.

METHODS

Subjects performed three distance trials, cycling as far as possible in 1 h. Blood samples were taken from a forearm vein every 10 min during the third trial (T). Samples were analyzed by spectrophotometer for plasma lactate concentrations ([La]).

RESULTS

During T, subjects cycled 40.8+/-2.2 km at an average of 83+/-4% of their predicted maximum heart rate (HRmax). Minimum and maximum [La] for each subject was noted for minutes 10, 20, 30, 40, and 50. Minimum [La] ranged between 2.8 and 10.3 mmol x L(-1), and maximum [La] ranged between 5.8 and 13.6 mmol x L(-1). The average [La] from minute 10 to 50 was calculated for each subject and ranged from 5.0 to 12.3 mmol x L(-1). This did not correlate with performance (distance covered in 1 h). Therefore, there was a wide range of individual plasma lactate responses to the same laboratory test that simulated an actual race. The overall average [La] for all subjects was 7.6+/-2.1 mmol x L(-1).

CONCLUSIONS

These data indicate first that the value of 4 mmol x L(-1), commonly referred to as OBLA, may often underestimate the upper limit of tolerance to lactate during a maximal endurance performance test lasting approximately 1 h. Second, during this type of work, intersubject differences in average plasma lactate concentration do not correlate with performance.

Oral creatine supplementation decreases plasma markers of adenine nucleotide degradation during a 1-h cycle test

We investigated the effect of oral creatine supplementation (20 g d(-1) for 7 days) on metabolism during a 1-h cycling performance trial. Twenty endurance-trained cyclists participated in this double-blind placebo controlled study. Five days after familiarization with the exercise test, the subjects underwent a baseline muscle biopsy. Thereafter, a cannula was inserted into a forearm vein before performing the baseline maximal 1-h cycle (test 1 (T1)). Blood samples were drawn at regular intervals during exercise and recovery. After creatine (Cr) loading, the muscle biopsy, 1-h cycling test (test 2 (T2)) and blood sampling were repeated. Resting muscle total creatine (TCr), measured by high performance liquid chromatography, was increased (P < 0.001) in the creatine group from 123.0 +/- 3.8 - 159.8 +/- 7.9 mmol kg(-1) dry wt, but was unchanged in the placebo group (126.7 +/- 4.7 - 127.5 +/- 3.6 mmol kg(-1) dry wt). The extent of Cr loading was unrelated to baseline Cr levels (r=0.33, not significant). Supplementation did not significantly improve exercise performance (Cr group: 39.1 +/- 0.9 vs. 39.8 +/- 0.8 km and placebo group: 39.3 +/- 0.8 vs. 39.2 +/- 1.1 km) or change plasma lactate concentrations. Plasma concentrations of ammonia (NH(3)) (P < 0.05) and hypoxanthine (Hx) (P < 0.01) were lower in the Cr group from T1 to T2. Our results indicate that Cr supplementation alters the metabolic response during sustained high-intensity submaximal exercise. Plasma data suggest that nett intramuscular adenine nucleotide degradation may be decreased in the presence of enhanced intramuscular TCr concentration even during submaximal exercise.

The relationship between functional capacity, muscle size and strength in chronic ACL deficient and ACL reconstructed individuals

Aim: The aim of this study was to assess the relationship between the quadriceps muscle atrophy and strength deficits caused by chronic ACL deficiency, and to ascertain whether these deficits were rectified in subjects who had undergone ACL reconstruction.Methods: Thirteen ACL deficient subjects (ACLD) and eight subjects who had undergone ACL reconstruction (ACLR) participated in the study. Functional capacity, lean thigh volume (LTV), and isokinetic peak torque of the quadriceps and hamstrings muscles were assessed.Results: The ACLD group had a significantly lower score for episodes of giving way compared to the ACLR group (7.4 +/- 3.8 vs. 18.0 +/- 3.7; p < 0.01) and a lower score for inability to perform jumping/twisting activities (1.8 +/- 0.8 vs. 3.6 +/- 1.1; p <0.01; ACLD vs. ACLR) suggesting decreased functional capacity. However, there was no significant difference between the ACLD group and ACLR group for LTV differences (416.0 +/- 276.5 vs. 238.3 +/- 224.4 cc) and quadriceps eccentric peak torque differences (38.1 +/- 13.7 vs. 23.7 +/- 18.3 Nm) between involved and uninvolved limbs. The relationship between LTV and quadriceps isokinetic peak torque was r = 0.59 (p < 0.05) for the ACLD group and r = 0.50 (NS) for the ACLR group.Conclusion: Quadriceps strength deficits are present in ACL deficient subjects, particularly during eccentric contractions. ACL reconstruction improved subjective function and reduced the episodes of giving way, but did not prevent eccentric quadriceps muscle weakness. A low correlation exists between reported function and LTV and eccentric peak torque activity, and between LTV and eccentric peak torque in both ACLD and ACLR groups. These findings suggest that factors other than muscle atrophy are responsible for the functional changes described, in ACL deficient and. ACL reconstructed groups.

Running economy of African and Caucasian distance runners

PURPOSE

Anecdotal evidence suggests an advantageous physiological endowment of the African endurance athlete. Higher fractional utilization of VO2max has been suggested but not measured directly, and investigations of running economy have been inconclusive. The aim of the current study was to measure a) running economy and b) fractional utilization of VO2max, in African and Caucasian 10-km runners of similar body mass.

METHODS

Eight African and eight Caucasian runners had no significant difference in mean race time (32.8 +/- 2.8, 32.0 +/- 2.5 min, respectively), body mass (61.4 +/- 7.0, 64.9 +/- 3.0 kg), age, body fat, or lean thigh volume. Caucasian runners were 6 cm taller (P < 0.05). Subjects completed a progressive treadmill VO2peak test. On a separate day, subjects completed two 6-min workloads (16.1 km x h(-1) and 10-km race pace) separated by 5 min.

RESULTS

Mean VO2peak was 13% lower in the Africans (61.9 +/- 6.9, 69.9 +/- 5.4 mL x kg(-1) x min(-1), P = 0.01). At 16.1 km x h(-1), the Africans were 5% more economical (47.3 +/- 3.2, 49.9 +/- 2.4 mL x kg(-1) x min(-1), P < 0.05). This difference increased to 8% (P < 0.01) when standardized per kg(0.66). At race pace, the Africans utilized a higher %VO2peak (92.2 +/- 3.7, 86.0 +/- 4.8%, P < 0.01) and had higher HR (185 +/- 9, 174 +/- 11 b x min(-1), P < 0.05) and plasma [ammonia] (113.2 +/- 51, 60.3 +/- 16.9 micromol x L(-1), P < 0.05). Despite the higher relative workload, the plasma [lactate] was not different (5.2 +/- 2.0, 4.2 +/- 1.7 mmol x L(-1), NS).

CONCLUSIONS

This study indicates greater running economy and higher fractional utilization of VO2peak in African distance runners. Although not elucidating the origin of these differences, the findings may partially explain the success of African runners at the elite level.

The effect of polyethylene glycol on the mechanics and ATPase activity of active muscle fibers

We have used polyethylene glycol (PEG) to perturb the actomyosin interaction in active skinned muscle fibers. PEG is known to potentiate protein-protein interactions, including the binding of myosin to actin. The addition of 5% w/v PEG (MW 300 or 4000) to active fibers increased fiber tension and decreased shortening velocity and ATPase activity, all by 25-40%. Variation in [ADP] or [ATP] showed that the addition of PEG had little effect on the dissociation of the cross-bridge at the end of the power stroke. Myosin complexed with ADP and the phosphate analog V(i) or AlF(4) binds weakly to actin and is an analog of a pre-power-stroke state. PEG substantially enhances binding of these states both in active fibers and in solution. Titration of force with increasing [P(i)] showed that PEG increased the free energy available to drive the power stroke by about the same amount as it increased the free energy available from the formation of the actomyosin bond. Thus PEG potentiates the binding of myosin to actin in active fibers, and it provides a method for enhancing populations of some states for structural or mechanical studies, particularly those of the normally weakly bound transient states that precede the power stroke.

Decreased resting metabolic rate in ballet dancers with menstrual irregularity

We studied 21 ballet dancers aged 19.4 +/- 1.4 years, hypothesizing that undernutrition was a major factor in menstrual irregularity in this population. Menstrual history was determined by questionnaire. Eight dancers had always been regular (R). Thirteen subjects had a history of menstrual irregularity (HI). Of these, 2 were currently regularly menstruating, 3 had short cycles, 6 were oligomenorrheic, and 2 were amenorrheic. Subjects completed a weighed dietary record and an Eating Attitudes Test (EAT). The following physiological parameters were measured: body composition by anthropometry, resting metabolic rate (RMR) by open-circuit indirect calorimetry, and serum thyroid hormone concentrations by radioimmunoassay. R subjects had significantly higher RMR than HI subjects. Also, HI subjects had lower RMR than predicted by fat-free mass, compared to the R subjects. Neither reported energy intake nor serum thyroid hormone concentrations were different between R and HI subjects. EAT scores varied and were not different between groups. We concluded that in ballet dancers, low RMR is more strongly associated with menstrual irregularity than is current reported energy intake or serum thyroid hormone concentrations.

African runners exhibit greater fatigue resistance, lower lactate accumulation, and higher oxidative enzyme activity

Nine African and eight Caucasian 10-km runners resident at sea level volunteered. Maximal O2 consumption and peak treadmill velocity (PTV) were measured by using a progressive test, and fatigue resistance [time to fatigue (TTF)] was measured by using a newly developed high-intensity running test: 5 min at 72, 80, and 88% of individual PTV followed by 92% PTV to exhaustion. Skeletal muscle enzyme activities were determined in 12 runners and 12 sedentary control subjects. In a comparison of African and Caucasian runners, mean 10-km race time, maximal O2 consumption, and PTV were similar. In African runners, TTF was 21% longer (P < 0.01), plasma lactate accumulation after 5 min at 88% PTV was 38% lower (P < 0.05), and citrate synthase activity was 50% higher (27.9 +/- 7.5 vs. 18.6 +/- 2.1 micromol. g wet wt-1. min-1, P = 0.02). Africans accumulated lactate at a slower rate with increasing exercise intensity (P < 0.05). Among the entire group of runners, a higher citrate synthase activity was associated with a longer TTF (r = 0.70, P < 0.05), a lower plasma lactate accumulation (r = -0.73, P = 0.01), and a lower respiratory exchange ratio (r = -0.63, P < 0.05). We conclude that the African and Caucasian runners in the present study differed with respect to oxidative enzyme activity, rate of lactate accumulation, and their ability to sustain high-intensity endurance exercise.

Long-term restoration of deficits in bone mineral density is inadequate in premenopausal women with prior menstrual irregularity

OBJECTIVE

To investigate change in bone mineral density (BMD) in premenopausal women (age, 29-46 years), some of whom were marathon runners with a history of menstrual irregularity.

DESIGN

Longitudinal follow-up.

SETTING

University medical school.

PARTICIPANTS

We investigated 8 sedentary controls (SC) and 19 marathon runners (12 with regular menses (R) and 7 with a history of irregularity (OA) 11.7 +/- 7.9 years before follow-up).

MAIN OUTCOME MEASURES

BMD (g/cm2) of lumbar spine (LS) and proximal femur were determined at baseline and follow-up (3-5 years later). We calculated a menstrual history index (MHI) (estimated periods/year since age 13).

RESULTS

Body mass, age at menarche, and femoral BMD were not statistically different. Follow-up LS BMD (g/cm2) was lower (p < 0.01) in OA (0.936 +/- 0.060) than in R (1.043 +/- 0.103) and SC (1.094 +/- 0.077), even when covarying for age or both age and mass. No group changed BMD significantly with time. Current MHI was lower (p < 0.001) in OA (9.7 +/- 1.4) than in R (11.3 +/- 0.5) and SC (11.8 +/- 0.4). MHI for the teenage years was lower in OA than in SC but not in R. OA had significantly lower MHI than did R and SC for the third and fourth decades. Only MHI during the third decade correlated significantly with LS BMD for all subjects.

CONCLUSIONS

Restoration of LS BMD deficit in women with prior menstrual irregularity aged over 30 is slow and may never reach the same level as age-related controls; secondly, this may be the result of both bone loss in the third decade of life and reduced acquisition during adolescence.

Training techniques to improve fatigue resistance and enhance endurance performance

Despite their best efforts, sports scientists have found it difficult to persuade elite athletes to experiment with their training regimens. Thus, until recently, exercise physiologists have had limited impact on the training practices of successful athletes, with most of the innovations in the training patterns of the best athletes coming from the empirical observations of top-level coaches. One form of training recognized by sports scientists and used by athletes for several decades in interval/transition training. Such training consists of a number of exercise bouts alternated with short rest intervals of more slowly paced activity and is thought to improve the fatigue resistance of the active muscles by exposing them to sustained, high-intensity exercise at the athlete's maximal steady-state pace. Few scientific studies, however, have examined the effects of transition training on the performances of competitive athletes. This paper identifies the physiological factors associated with successful endurance performance, and summarizes the results of investigations on competitive endurance cyclists which examined the time-course of changes in performance in response to a sustained, high-intensity interval training programme.

Response of compressed skinned skeletal muscle fibers to conditions that simulate fatigue

During fatigue, muscles become weaker, slower, and more economical at producing tension. Studies of skinned muscle fibers can explain some but not all of these effects, and, in particular, they are less economical in conditions that simulate fatigue. We investigated three factors that may contribute to the different behavior of skinned fibers. 1) Skinned fibers have increased myofilament lattice spacing, which is reversible by osmotic compression. 2) A myosin subunit becomes phosphorylated during fatigue. 3) Inosine 5'-monophosphate (IMP) accumulates during fatigue. We tested the response of phosphorylated and unphosphorylated single skinned fibers (isometric tension, contraction velocity, and adenosinetriphosphatase activity) to changes in lattice spacing (0-5% dextran) and IMP (0-5 mM) in the presence of altered concentrations of P(i) (3-25 mM), H+ (pH 7-6.2), and ADP (0-5 mM). The response of maximally activated skinned fibers to the direct metabolites of ATP hydrolysis is not altered by osmotic compression, phosphorylating myosin subunits, or increasing IMP concentration. These factors, therefore, do not explain the discrepancy between intact and skinned fibers during fatigue.

Metabolic and performance adaptations to interval training in endurance-trained cyclists

This study examined the effects of sustained high-intensity interval training (HIT) on the athletic performances and fuel utilisation of eight male endurance-trained cyclists. Before HIT, each subject undertook three baseline peak power output Wpeak tests and two simulated 40-km time-trial cycling performance (TT40) tests, of which the variabilities were 1.5 (1.3)% and 1.0 (0.5)%, respectively [mean (SD)]. Over 6 weeks, the cyclists then replaced 15 (2)% of their 300 (66) km.week-1 endurance training with 12 HIT sessions, each consisting of six to nine 5-min rides at 80% of Wpeak, separated by a l-min recovery. HIT increased Wpeak from 404 (40) to 424 (53) W (P < 0.01) and improved TT40 speeds from 42.0 (3.6) to 43.0 (4.2) km.h-1 (P < 0.05). Faster TT40 performances were due to increases in both the absolute work rates from 291 (43) to 327 (51) W (P < 0.05) and the relative work rates from 72.6 (5.3)% of pre-HIT Wpeak to 78.1 (2.8)% of post-HIT Wpeak (P < 0.05). HIT decreased carbohydrate (CHO) oxidation, plasma lactate concentration and ventilation when the cyclists rode at the same absolute work rates of 60, 70 and 80% of pre-HIT Wpeak (P < 0.05), but not when they exercised at the same relative (% post-HIT Wpeak) work rates. Thus, the ability of the cyclists to sustain higher percentages of Wpeak in TT40 performances after HIT was not due to lower rates of CHO oxidation. Higher relative work rates in the TT40 rides following HIT increased the estimated rates of CHO oxidation from approximately 4.3 to approximately 5.1 g.min-1.

Skeletal muscle buffering capacity and endurance performance after high-intensity interval training by well-trained cyclists

Skeletal muscle buffering capacity (beta m), enzyme activities and exercise performance were measured before and after 4 weeks of high-intensity, submaximal interval training (HIT) undertaken by six well-trained competitive cyclists [mean maximal oxygen consumption (VO2max) = 66.2 ml.kg-1.min-1]. HIT replaced a portion of habitual endurance training and consisted of six sessions, each of six to eight repetitions of 5 min duration at 80% of peak sustained power output (PPO) separated by 1 min of recovery. beta m increased from 206.6 (17.9) to 240.4 (34.1) mumol H+.g muscle dw-1.pH-1 after HIT (P = 0.05). PPO, time to fatigue at 150% PPO (TF150) and 40-km cycle time trial performance (TT40) all significantly improved after HIT (P < 0.05). In contrast, there was no change in the activity of either phosphofructokinase or citrate synthase. In addition, beta m correlated significantly with TT40 performance before HIT (r = -0.82, P < 0.05) and the relationship between change in beta m and change in TT40 was close to significance (r = -0.74). beta m did not correlate with TF150. These results indicate that beta m may be an important determinant of relatively short-duration (< 60 min) endurance cycling activity and responds positively to just six sessions of high-intensity, submaximal interval training.

Improved athletic performance in highly trained cyclists after interval training

This study determined whether a 4-wk high-intensity interval training program (HIT) would improve the 40-km time trial performances (TT40) of 8 competitive cyclists (peak O2 uptake 5.2 +/- 0.4 I.min-1) with a background of moderate-intensity endurance training (BASE). Before intervention, all cyclists were tested on at least three separate occasions to ensure that their baseline performances were stable. In these tests, peak sustained power output (PPO) was measured during a progressive exercise test, muscular resistance to fatigue was determined during a timed ride to exhaustion at 150% of PPO (TF150), and a TT40 was performed on a cycle-simulator. The coefficient of variation for all baseline tests was < 1.7 +/- 1.3% (mean +/- SD). Cyclists then replaced 15 +/- 2% of their approximately 300 km.wk-1 BASE training with HIT, which took place on 6 d and consisted of six to eight 5-min repetitions at 80% of PPO, with 60-s recovery between work bouts. HIT significantly improved TT40 (56.4 +/- 3.6 vs 54.4 +/- 3.2 min; P < 0.0001), PPO (416 +/- 32 vs 434 +/- 34 W; P < 0.01) and TF150 (60.5 +/- 9.3 vs 72.5 +/- 7.6 s; P < 0.01). The faster TT40 was due to a significant increase in both the cyclists' absolute (301 +/- 42 vs 326 +/- 43 W; P < 0.0001) and relative (72.1 +/- 5.6 vs 75.0 +/- 6.8% of PPO; P < 0.05) power output after HIT. These results indicate that a 4-wk program of HIT increased the PPO and fatigue resistance of competitive cyclists and improved their 40-km time trial performances.

Skeletal muscle buffering capacity is higher in the superficial vastus than in the soleus of spontaneously running rats

Skeletal muscle buffering capacity (beta mtitr) was determined in soleus (type I) and superficial vastus (type II) muscles of 16 Long-Evans rats with differing levels of spontaneous activity and in 11 sedentary control rats. beta mtitr was 24% higher (P < 0.001) in superficial vastus muscle than in soleus muscle (268 +/- 50 vs. 216 +/- 30 mumol H+ g muscle dry wt-1 pH unit-1) (mean +/- SD). There was no relationship between beta mtitr and mean weekly running distance amongst spontaneously running rats, nor was beta mtitr any greater in these rats than in a group of sedentary control rats. Protein to wet wt ratio was 31% higher (P < 0.0001) in the superficial vastus muscle when compared with soleus muscle (22.04 +/- 3.74 vs. 16.77 +/- 3.00 mg protein, 100 mg wet wt muscle-1), but there was no relationship between protein to wet wt ratio and running distance. Initial muscle homogenate pH (pHi) was lower in superficial vastus muscle compared with soleus muscle (6.36 +/- 0.25 vs. 6.63 +/- 0.16). Running rats had a significantly lower pHi in both soleus and superficial vastus than sedentary controls. There was an exponential relationship between weekly running distance and pHi in both the superficial vastus muscle (r = -0.86. P < 0.001) and the soleus muscle (r = -0.73, P < 0.01). Citrate synthase activity correlated with weekly running distance in superficial vastus muscle (r = 0.66, P < 0.01) but not in soleus muscle. The results confirm a higher beta mtitr in the type II superficial vastus muscle when compared with the predominantly type I soleus muscle. We suggest that this may be partly the result of a higher protein concentration in type II muscle. Future studies measuring beta mtitr in mixed muscle (e.g. human vastus lateralis) should report fibre type composition.

Nucleotide turnover rate measured in fully relaxed rabbit skeletal muscle myofibrils

Steady state measurements of the ATP turnover rate of myosin crossbridges in relaxed living mammalian muscle or in in vitro systems are complicated by other more rapid ATPase activities. To surmount these problems we have developed a technique to measure the nucleotide turnover rate of fully relaxed myosin heads in myofibrils using a fluorescent analogue of ATP (mant-ATP). Rabbit myofibrils, relaxed in 1.6 mM ATP, were rapidly mixed with an equal volume of solution containing 80 microM mant-ATP and injected into a fluorimeter. As bound ADP is released, a fraction of the myosin active sites bind mant-ATP and fluorescence emission rises exponentially, defining a rate of nucleotide turnover of 0.03 +/- 0.001 s-1 at 25 degrees C (n = 17). This rate was approximately equal to one half that of purified myosin. The turnover rates for myosin and myofibrils increased between 5 degrees and 42 degrees C, reaching 0.16 +/- 0.04 s-1 and 0.06 +/- 0.005 s-1, respectively, at 39 degrees C, the body temperature of the rabbit. If the rate observed for purified myosin occurred in vivo, it would generate more heat than is observed for resting living muscle. When myosin is incorporated into the myofilament lattice, its ATPase activity is inhibited, providing at least a partial explanation for the low rate of heat production by living resting muscle.

Bone mineral density in mature, premenopausal ultramarathon runners

We measured bone mineral density (BMD) in 25 premenopausal ultramarathon (56 km) runners aged 29-39 yr and related risk factors for decreased BMD with actual BMD. Fifteen runners who had never had oligo/amenorrhea (R) were compared with 10 runners (OA): 4 oligomenorrheic, 2 amenorrheic, and 4 with prior oligo/amenorrhea. Menstrual, dietary and training data were obtained. BMD of the lumbar spine (LS) and proximal femur (F) were measured by dual energy x-ray densitometry. Both groups had similar body mass (58 +/- 8 vs 57 +/- 8 kg), running and dietary histories. F BMD was not different (P = 0.07) and correlated only with BMI (P < 0.05; r = 0.43). LS BMD was lower in OA (0.946 +/- 0.098 g.cm-2) than R (1.088 +/- 0.069 g.cm-2; P < 0.001). Menstrual History Index (MHI), (estimated periods.yr-1 since age 13), was higher in R (11.6 +/- 0.6) than OA (9.4 +/- 2.1; P < 0.01). LS BMD correlated with MHI (P < 0.0005; r = 0.67) and years oligomenorrheic (P < 0.01; r = -0.58) but not years amenorrheic, parity, breastfeeding, diet, or training. In conclusion, in mature women distance runners low LS BMD is related to a history of oligo/amenorrhea regardless of resumption of regular menstrual cycles in some subjects. Not only amenorrhea, but also prolonged oligomenorrhea may negatively influence peak adult bone mass.

Age-related differences in cross-sectional geometry of the forearm bones in healthy women

Men exhibit age-related adaptive changes in long bone geometry, namely, endosteal resorption and periosteal apposition of bone, that help to preserve bone strength. It is not clear whether women undergo similar adaptive responses. To address this question, we assessed the bone mineral density and cross-sectional geometry of the radius and ulna at the one-third distal site by single photon absorptiometry and computed tomography (CT) in healthy young (n = 21, age 20-30 years) and older (n = 22, age 63-84 years) women. We used the CT data to compute the total subperiosteal, medullary, and cortical areas, as well as the maximum, minimum, and polar moments of inertia. We normalized the geometric parameters for bone length and performed comparisons using both the original and size-corrected data. Radial and ulnar bone mineral content and density were 20-30% lower in the older women (P < 0.0001). Ulnar width, total area, medullary area, and maximum and polar moment of inertia were greater in the older than in the younger women. Although we observed similar trends when we examined the radius data that were corrected for bone size, age-related differences in radial geometry were less pronounced and were not significant. We conclude that women undergo endosteal resorption and periosteal apposition of the ulna with age, thereby exhibiting an adaptive pattern that helps to preserve bone strength. The different behavior of these two bones suggests that local, rather than systemic, factors underlie this adaptation.

Low bone mineral density at axial and appendicular sites in amenorrheic athletes

Amenorrheic athletes have low axial bone-mineral density (BMD, g.cm-2). We compared 12 amenorrheic and 9 eumenorrheic women athletes to determine whether athletes with amenorrhea have lower BMD in other skeletal regions, including weight-bearing lower limbs. BMD was measured by dual energy x-ray and single photon absorptiometry. Both groups had similar age, body mass, and exercise quantity. Women with amenorrhea missed 86.3 +/- 58.3 menstrual periods since menarche. BMD was lower in the amenorrheic vs eumenorrheic subjects for the lumbar spine (0.928 +/- 0.056 vs 1.050 +/- 0.110, P < 0.005), whole body (1.032 +/- 0.05 vs 1.09 +/- 0.06, P < 0.05), most regions of the whole body (P < 0.05-0.001), all areas of the proximal femur (P < 0.005), and at the femoral mid-shaft (1.333 +/- 0.109 vs 1.491 +/- 0.088, P < 0.005). No significant differences were detected at the mid-radius and tibial shaft. The best predictors of BMD were years of regular menstruation for lumbar spine; and years of amenorrhea for hip, femoral mid-shaft, and whole body. We conclude that low BMD in athletes with amenorrhea is not limited to the axial skeleton but is also present in other regions including appendicular weight-bearing bones.

Influence of recreational activity and muscle strength on ulnar bending stiffness in men

Bone bending stiffness (modulus of elasticity [E] x moment of inertia [I]), a measure of bone strength, is related to its mineral content (BMC) and geometry and may be influenced by exercise. We evaluated the relationship of habitual recreational exercise and muscle strength to ulnar EI, width, and BMC in 51 healthy men, 28-61 yr of age. BMC and width were measured by single photon absorptiometry and EI by mechanical resistance tissue analysis. Maximum biceps strength was determined dynamically (1-RM) and grip strength isometrically. Subjects were classified as sedentary (S) (N = 13), moderately (M) (N = 18), or highly active (H) (N = 20) and exercised 0.2 +/- 0.2; 2.2 +/- 1.3; and 6.8 +/- 2.3 h.wk-1 (P < 0.001). H had greater biceps (P < 0.0005) and grip strength (P < 0.05), ulnar BMC (P < 0.05), and ulnar EI (P = 0.01) than M or S, who were similar. Amount of activity correlated with grip and biceps strength (r = 0.47 and 0.49; P < 0.001), but not with bone measurements, whereas muscle strength correlated with both EI and BMC (r = 0.40-0.52, P < 0.005). EI also correlated significantly with both BMC and ulnar width (P < 0.0001). Ulnar width and biceps strength were the only independent predictors of EI (r2 = 0.67, P < 0.0001). We conclude that levels of physical activity sufficient to increase arm strength influence ulnar bending stiffness.

In vivo assessment of forearm bone mass and ulnar bending stiffness in healthy men

The cross-sectional bending stiffness EI of the ulna was measured in vivo by mechanical resistance tissue analysis (MRTA) in 90 men aged 19-89 years. MRTA measures the impedance response of low-frequency vibrations to determine EI, which is a reflection of elastic modulus E and moment of inertia I for the whole ulna. EI was compared to conventional estimates of bone mineral content (BMC), bone width (BW), and BMC/BW, which were all measured by single-photon absorptiometry. Results obtained from the nondominant ulna indicate that BW increases (r = 0.27, p = 0.01) and ulnar BMC/BW decreases (r = -0.31, p < or = 0.005) with age. Neither BMC nor EI declined with age. The single best predictor of EI was BW (r2 = 0.47, p = 0.0001), and further small but significant contributions were made by BMC (r2 = 0.53, p = 0.0001) and grip strength (r2 = 0.55, p = 0.0001). These results suggest that the resistance of older men to forearm fracture is related to age-associated changes in the moment of inertia achieved by redistributing bone mineral farther from the bending axis. We conclude that the in vivo assessment of bone geometry offers important insights to the comprehensive evaluation of bone strength.

Are Risk Factors for Menstrual Dysfunction Cumulative?

In brief That so many factors are associated with menstrual dysfunction JMBJ in athletes makes management difficult. This study compares the number and prevalence of risk factors in ultramarathon runners who had menstrual dysfunction with those in matched controls who had no history of menstrual dysfunction. Both groups had statistically similar prevalences of the risk factors analyzed, but the runners with menstrual dysfunction had significantly more risk factors. Also, significantly more of them had three or more risk factors. The results indicate that no single factor is critical and suggest that management should focus on reducing the number of risk factors.

Metabolic rate, not percent dehydration, predicts rectal temperature in marathon runners

This study was designed to determine the factors predicting the post-race rectal temperature in marathon runners. Post-race rectal temperatures of 30 recreational runners (maximum oxygen consumption (VO2max) = 58.3 +/- 5.9 ml O2.kg-1.min-1; mean +/- SD) who completed a 42.2 km marathon at 75.8% (+/- 9.3%) VO2max were measured and related to their levels of dehydration (percent mass loss), their running velocities (km.h-1), and their estimated absolute metabolic rates (1 O2.min-1) for different segments of the 42.2 km race. The influence of certain anthropometric variables was also determined. Percent mass loss during the race (2.5 +/- 1.4%), post-race rectal temperatures (38.9 +/- 0.6 degrees C), and rates of sweat loss (1.0 +/- 0.3 1.h-1) were low. There was no statistical relationship between percent mass loss and post-race rectal temperature. Post-race rectal temperatures were significantly related to the metabolic rates for the full 42.2 km and for the last 21.1 and 6 km of the race, and to the average running velocity for the last 6 km (P less than 0.05 and P less than 0.01). Average sweat rates were related to metabolic rates for 42.2 km and for the last 6 km of the race (P less than 0.05) but were unrelated to running velocity. We conclude that metabolic rate sustained during the latter section of the race, and not the level of dehydration, is the principal determinant of the post-race rectal temperature in marathon runners.

Low bone density is an etiologic factor for stress fractures in athletes

OBJECTIVE

To determine whether low bone density and other risk factors for osteoporosis are associated with stress fractures in athletes.

DESIGN

Case-control study.

SETTING

Institutional sports injury clinic with primary and secondary care.

PARTICIPANTS

Twenty-five athletes (nineteen women) with scintigraphically confirmed stress fractures matched for sex, age, weight, height, and exercise history with 25 control athletes with no history of bone injury.

MEASUREMENTS AND MAIN RESULTS

Bone mineral density measured by dual-energy x-ray absorptiometry was significantly lower in athletes with fractures than in control athletes: In the spine, bone mineral density was 1.01 +/- 0.14 g/cm2 in athletes with fractures and 1.11 +/- 0.13 g/cm2 in control athletes (P = 0.02). In the femoral neck, it was 0.84 +/- 0.09 g/cm2 in athletes with fractures and 0.90 +/- 0.11 g/cm2 in control athletes (P = 0.005). It was also significantly lower in the Ward triangle (P = 0.01) and the greater trochanter (P = 0.01). Eight athletes with fractures and no control athletes had less than 90% of predicted age-related spine density (P = 0.01), and three athletes with fractures had bone mineral densities that were 2 SDs or more below this predicted level. More athletes with fractures than control athletes had current menstrual irregularity (amenorrhea or oligomenorrhea) (P less than 0.005). Fewer athletes with fractures were using oral contraceptives (P less than 0.05). Seven-day diet records indicated similar energy and nutrient intakes, except athletes with fractures had lower calcium intakes (697 +/- 242 mg/d compared with 832 +/- 309 mg/d; P = 0.02). Dairy product intake was lower in athletes with fractures since leaving high school (P less than 0.05). The incidence of a family history of osteoporosis was similar in both groups.

CONCLUSIONS

In athletes with similar training habits, those with stress fractures are more likely to have lower bone density, lower dietary calcium intake, current menstrual irregularity, and lower oral contraceptive use.

Plasma volume and renal function during and after ultramarathon running

Plasma volume (PV) and renal function were studied in eight subjects for 3 d prior to and 6 d after a 56 km footrace. Immediately following the race, PV, creatinine clearance, and urine flow were unchanged from pre-race values. Over the subsequent 3 d, PV increased due initially to a 17 g influx of serum albumin and an associated increase in plasma sodium content, which persisted throughout the study period. A reduction in urine sodium secretion occurred during the race day. Creatinine clearance increased after the race and remained elevated for 48 h. Increases serum enzyme activities, C-reactive protein concentration, serum uric acid content, and plasma creatinine concentration and production suggest muscle damage. We suggested the following. First, the persistent post-exercise plasma volume expansion is initiated by an influx of albumin into the intravascular space with an associated increase in plasma sodium content. A decrease in urine sodium excretion during the race day would contribute to the latter. Second, the interpretation of post-race changes in serum constituents must take account of changes in plasma volume. Third, there is an increase in creatinine clearance, indicating an increase in glomerular filtration rate, after both standard and ultramarathon running. This may be caused by the products of muscle cell damage although the physiologic mechanism for this is unclear.

Skeletal muscle limits the exercise tolerance of renal transplant recipients: effects of a graded exercise training program

Sixteen renal transplant recipients were studied before and after they had participated in a 24-week exercise training program to determine (1) the nature of the factors explaining their impaired exercise tolerance, and (2) their adaptative responses to exercise training. During progressive treadmill exercise to exhaustion prior to training, renal transplant recipients stopped exercising at lower peak rates of oxygen consumption (VO2max) (29.0 +/- 7.8 47.9 +/- 9.1 mL O2.kg-1.min-1; P less than 0.001) and ventilation (55.9 +/- 13.2 v 124.0 +/- 22.2 L.min-1; P less than 0.0001), and at lower peak heart rates (169 +/- 22 v 196 +/- 9 beats.min-1; P less than 0.05) and peak blood lactate concentrations (5.0 +/- 2.1 v 11.5 +/- 4.0 mmol.L-1; P less than 0.001) than did controls. None showed a plateau in oxygen consumption with increasing workload. Exercise time to exhaustion was also significantly shorter in renal transplant recipients (9.5 +/- 1.8 v 16.0 +/- 1.3 min; P less than 0.0001). After training, exercise time to exhaustion (12.0 +/- 2.0 min; P less than 0.001), VO2max (37.5 +/- 4.8 mL O2.kg-1.min-1; P less than 0.05), maximum ventilation rate (68.5 +/- 14.0 L.min-1; P less than 0.05), peak blood lactate concentrations (7.8 +/- 1.8 mmol-L-1; P less than 0.001), and the rate of oxygen consumption at a blood lactate concentration of 2.0 mmol.L-1 (22.5 +/- 2.5 v 16.5 +/- 2.2 mL O2.kg-1.min-1; P less than 0.001) had all increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Peak treadmill running velocity during the VO2 max test predicts running performance

Twenty specialist marathon runners and 23 specialist ultra-marathon runners underwent maximal exercise testing to determine the relative value of maximum oxygen consumption (VO2max), peak treadmill running velocity, running velocity at the lactate turnpoint, VO2 at 16 km h-1, % VO2max at 16 km h-1, and running time in other races, for predicting performance in races of 10-90 km. Race time at 10 or 21.1 km was the best predictor of performance at 42.2 km in specialist marathon runners and at 42.2 and 90 km in specialist ultra-marathon runners (r = 0.91-0.97). Peak treadmill running velocity was the best laboratory-measured predictor of performance (r = -0.88(-)-0.94) at all distances in ultra-marathon specialists and at all distances except 42.2 km in marathon specialists. Other predictive variables were running velocity at the lactate turnpoint (r = -0.80(-)-0.92); % VO2max at 16 km h-1 (r = 0.76-0.90) and VO2max (r = 0.55(-)-0.86). Peak blood lactate concentrations (r = 0.68-0.71) and VO2 at 16 km h-1 (r = 0.10-0.61) were less good predictors. These data indicate: (i) that in groups of trained long distance runners, the physiological factors that determine success in races of 10-90 km are the same; thus there may not be variables that predict success uniquely in either 10 km, marathon or ultra-marathon runners, and (ii) that peak treadmill running velocity is at least as good a predictor of running performance as is the lactate turnpoint. Factors that determine the peak treadmill running velocity are not known but are not likely to be related to maximum rates of muscle oxygen utilization.

The influence of inborn athletic potential on choice of profession and exercise habits of paramedical students

Twenty physiotherapy and 15 pharmacology students from the 2nd-year paramedical class were studied to determine whether inborn athletic potential had influenced their choice of profession. Each subject completed a questionnaire and performed a graded treadmill test to exhaustion to determine maximum oxygen consumption (VO2max), peak treadmill running velocity and ventilation threshold (VT). No difference was found between physiotherapy and pharmacy students in body mass, VO2max or running speed at VT, but physiotherapy students reached a higher peak treadmill velocity (P less than 0.01). Fewer pharmacy students participated in sport at university. To determine factors influencing participation in sport, students from both groups who exercised were compared with non-exercisers. Students who exercised had significantly higher VO2max, peak treadmill running velocity and VT, but differences were less than could be explained purely on the basis of superior genetic endowment. It is concluded: (i) that physiotherapy students do not have greater inborn athletic potential than pharmacy students; (ii) that exercising students show physiological adaptations compatible with a higher level of 'fitness', and (iii) that whereas lack of inborn athletic potential is not the reason why some students do not exercise regularly at university, inborn athletic potential may determine those who will exercise competitively.