Psychophysiological Adaptations to Exercise Training in COVID-19 Patients: A Systematic Review

Introduction

Many COVID-19 patients display adverse symptoms, such as reduced physical ability, poor quality of life, and impaired pulmonary function. Therefore, this systematic review is aimed at evaluating the effectiveness of physical exercise on various psychophysiological indicators among COVID-19 patients who may be at any stage of their illness (i.e., critically ill, hospitalized, postdischarge, and recovering).

Methods

A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from 2019 to 2021. Twenty-seven studies, which assessed a total of 1525 patients, were included and analysed.

Results

Overall, data revealed significant improvements in the following parameters: physical function, dyspnoea, pulmonary function, quality of life (QOL), lower limb endurance and strength, anxiety, depression, physical activity level, muscle strength, oxygen saturation, fatigue, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-α), lymphocyte, leukocytes, and a fibrin degradation product (D-dimer).

Conclusions

Physical training turns out to be an effective therapy that minimises the severity of COVID-19 in the intervention group compared to the standard treatment. Therefore, physical training could be incorporated into conventional treatment of COVID-19 patients. More randomized controlled studies with follow-up evaluations are required to evaluate the long-term advantages of physical training. Future research is essential to establish the optimal exercise intensity level and assess the musculoskeletal fitness of recovered COVID-19 patients. This trial is registered with CRD42021283087.

Ultra-Cycling- Past, Present, Future: A Narrative Review

BACKGROUND

Ultra-endurance events are gaining popularity in multiple exercise disciplines, including cycling. With increasing numbers of ultra-cycling events, aspects influencing participation and performance are of interest to the cycling community.

MAIN BODY

The aim of this narrative review was, therefore, to assess the types of races offered, the characteristics of the cyclists, the fluid and energy balance during the race, the body mass changes after the race, and the parameters that may enhance performance based on existing literature. A literature search was conducted in PubMed, Scopus, and Google Scholar using the search terms 'ultracycling', 'ultra cycling', 'ultra-cycling', 'ultra-endurance biking', 'ultra-bikers' and 'prolonged cycling'. The search yielded 948 results, of which 111 were relevant for this review. The studies were classified according to their research focus and the results were summarized. The results demonstrated changes in physiological parameters, immunological and oxidative processes, as well as in fluid and energy balance. While the individual race with the most published studies was the Race Across America, most races were conducted in Europe, and a trend for an increase in European participants in international races was observed. Performance seems to be affected by characteristics such as age and sex but not by anthropometric parameters such as skin fold thickness. The optimum age for the top performance was around 40 years. Most participants in ultra-cycling events were male, but the number of female athletes has been increasing over the past years. Female athletes are understudied due to their later entry and less prominent participation in ultra-cycling races. A post-race energy deficit after ultra-cycling events was observed.

CONCLUSION

Future studies need to investigate the causes for the observed optimum race age around 40 years of age as well as the optimum nutritional supply to close the observed energy gap under consideration of the individual race lengths and conditions. Another research gap to be filled by future studies is the development of strategies to tackle inflammatory processes during the race that may persist in the post-race period.

Analysis of over 1 million race records shows runners from East African countries as the fastest in 50-km ultra-marathons

The 50-km ultra-marathon is a popular race distance, slightly longer than the classic marathon distance. However, little is known about the country of affiliation and age of the fastest 50-km ultra-marathon runners and where the fastest races are typically held. Therefore, this study aimed to investigate a large dataset of race records for the 50-km distance race to identify the country of affiliation and the age of the fastest runners as well as the locations of the fastest races. A total of 1,398,845 50-km race records (men, n = 1,026,546; women, n = 372,299) were analyzed using both descriptive statistics and advanced regression techniques. This study revealed significant trends in the performance of 50-km ultra-marathoners. The fastest 50-km runners came from African countries, while the fastest races were found to occur in Europe and the Middle East. Runners from Ethiopia, Lesotho, Malawi, and Kenya were the fastest in this race distance. The fastest 50-km racecourses, providing ideal conditions for faster race times, are in Europe (Luxembourg, Belarus, and Lithuania) and the Middle East (Qatar and Jordan). Surprisingly, the fastest ultra-marathoners in the 50-km distance were found to fall into the age group of 20-24 years, challenging the conventional belief that peak ultra-marathon performance comes in older age groups. These findings contribute to a better understanding of the performance models in 50-km ultra-marathons and can serve as valuable insights for runners, coaches, and race organizers in optimizing training strategies and racecourse selection.

Personality of marathon runners: a narrative review of recent findings

Participation in marathons has dramatically increased over the last few years. Marathon running has many proven beneficial effects, especially on cardiovascular health and fitness. Most research has focused on physiologic and pathophysiologic adaptations in connection with endurance exercise. Nevertheless, marathon running also has a major impact on psychological aspects and positively influences mental health, which has only recently attracted research interest. The present narrative review aimed to review the personality traits of marathon runners with an emphasis on recent literature. Marathon runners show a distinct personality and highly characteristic personality traits needed to successfully finish such a demanding race, i.e., a strong sense of vigor, self-sufficiency, and intelligence as well as low scores in anger, fatigue, tension, and depression. Furthermore, personality differences are detectable between runners of different sexes, ages, and performance level groups. This has significant clinical implications for athletes, coaches and competition organizers, as these groups show different patterns of personality traits. Future studies should focus on changes in cognition and mood states pre-, during, and post-endurance events, as well as during training periods. Large-scale studies comparing personality differences by sex, age, and performance are also important for better clinical guidance. See also the graphical abstract(Fig. 1).

Fear of failure in Brazilian runners

This study aims to investigate the fear or failure (FoF) in Brazilian runners of both sex, performance levels and age categories, as well as to verify the relationship between FoF and socioeconomic status (SES). Sample size as composed by 916. Age, sex, body height, body weight, SES, and running pace were self-reported. The Multidimensional Questionnaire of FoF was applied in an online platform. Running pace, and SES were categorized and processed through multivariate analysis and Spearman correlations, with the p-value set at 0.05. Female runners with better performance (2.13 ± 0.74) and younger (2.16 ± 0.80), as a well as male runners with worse performance (2.04 ± 0.69) and older (2.04 ± 0.89) presented the highest values of FoF. Among women, SES was negatively associated with FoF (r = -0.144; p = 0.006), while a positive association between running pace and SES was observed among men (r = 0.290; p < 0.001). Non-professional Brazilian runners presented low values of FoF.

Sedentarism in Recreational Marathon Runners

Aim

Although it has been previously observed that sedentary behavior (SB) was not related to training duration in marathon runners, little information existed about the relationship of SB with training, anthropometric and physiological characteristics in this population. This study aimed to investigate the prevalence of SB and its correlation with performance parameters (such as body fat percentage, maximal oxygen uptake and weekly training volume) as well as its variation by sex and day (ie, weekdays versus weekend) in recreational marathon runners.

Methods

A total of 151 finishers (women, n = 29; men, n = 122; age 43.1 (8.7) years, mean (standard deviation)) in the Athens marathon 2017 performed a series of anthropometric and physiological tests, and completed the Multi-context sitting time questionnaire.

Results

SB did not correlate with anthropometric and physiological characteristics and no difference in these characteristics was shown between low and high sedentary participants (p > 0.05). SB did not differ between women and men (p > 0.05), but differed between working and non-working days (p < 0.05).

Conclusion

In contrast to previous findings on the general population indicating an association of a high SB with a low cardiorespiratory and muscular fitness, our finding of no correlation between SB and physical fitness in marathon runners suggested that endurance exercise might offset the negative effects of SB.

The pacing differences in performance levels of marathon and half-marathon runners

Introduction

Many studies indicate a considerable impact of optimal pacing on long-distance running performance. Given that the amount of carbohydrates in metabolic processes increases supralinearly with the running intensity, we may observe differences between the pacing strategies of two long-distance races and different performance levels of runners. Accordingly, the present study aimed to examine the differences in pacing strategies between marathon and half-marathon races regarding the performance levels of runners.

Methods

The official results and split times from a total of 208,760 (marathon, N = 75,492; half-marathon, N = 133,268) finishers in the "Vienna City Marathon" between 2006 and 2018 were analyzed. The percentage of the average change of speed for each of the five segments (CS 1-5), as well as the absolute change of speed (ACS) were calculated. The CS 1-5 for the marathon are as follows: up to the 10th km, 10th - 20th km, 20th - 30th km, 30th - 40th km, and from the 40th km to the 42.195 km. For the half-marathon, the CS 1-5 are half of the marathon values. Four performance groups were created as quartiles of placement separately for sexes and races: high-level (HL), moderate to high-level (MHL), moderate to low-level (MLL), and low-level (LL).

Results

Positive pacing strategies (i.e., decrease of speed) were observed in all performance groups of both sex and race. Across CS 1-5, significant main effects (p < 0.001) were observed for the segment, performance level, and their interaction in both sex and race groups. All LL groups demonstrated higher ACS (men 7.9 and 6.05%, as well as women 5.83 and 5.49%, in marathon and half-marathon, respectively), while the HL performance group showed significantly lower ACS (men 4.14 and 2.97%, as well as women 3.16 and 2.77%, in marathon and half-marathon, respectively). Significant main effects (p < 0.001) for the race were observed but with a low effect size in women (ŋ2 = 0.001).

Discussion

Better runners showed more even pacing than slower runners. The half-marathoners showed more even pacing than the marathoners across all performance groups but with a trivial practical significance in women.

An analysis of the São Silvestre race between 2007-2021: An increase in participation but a decrease in performance

This study aimed to investigate the trends of finishers in the São Silvestre race in Brazil, taking into account sex, age, and performance levels. A total of 31 ​775 runners (women, n ​= ​13 ​847; men, n ​= ​17 ​928), aged (45.2 ​± ​16.8) years, finishers in the São Silvestre race between 2007 and 2021, were considered in the present analysis. Data (event year, date of birth, sex, and race times) were downloaded from the official race website. The man-Whitney U test, Spearman correlation, and robust regression model were computed. Participation increased over time for both sexes. Regarding age groups, "31-40 years" (women) and "> 60 years" (men) were those with the highest number of finishers. We found a decrease in performance across the years (β ​= ​2.45; p ​< ​0.005), as well as significant differences in race times for both sexes (U ​= ​42.844; p ​< ​0.001), with men presenting better performances than women. Over time, it was observed an increase in the performance gap between the sexes, but in general, the performance decreased (β ​= ​1.76; p ​< ​0.001). Stakeholders should consider improving the strategies to improve women and young people's participation in running events.

Effects of twelve weeks of dance Exergames on the quality-of-life variables of elderly Brazilian women enrolled in a community program

BACKGROUND AND PURPOSE

Exercise-based interventions can be a safe alternative to improve and maintain physical and mental health during the aging process. The aim of the present study was to evaluate the effects of a 12-week training program with Dance Exergames on the mood and functional fitness profile of elderly women.

METHODS

The sample (n = 22) was divided into Exergames (EG, n = 9, 70.6 ± 1.6 years) and Control Groups (CG, n = 13, 73.6 ± 2.2 years). Evaluations were carried out before and after the interventions. Each participant played, in pairs, the electronic game Dance Central 3, with the XBOX 360 Kinect console (Slim, Microsoft, USA). The EG trained for 12 weeks (24 sessions), with two weekly sessions of 50 min and the CG performed manual activities workshops.

RESULTS

In functional fitness, both exercise training with exergame (EG) and the intervention model for the CG did not produce significant effects regarding interaction (group*time). Mood state presented significant effect of time intervention regarding tension (p = <0.001), depression (p = 0.001), anger (p = 0.030), fatigue (p = 0.001), and mental confusion (p = 0.004).

CONCLUSION

Twelve weeks of training with a dance exergame (for, EG) and manual activities (for, CG) is enough to promote improvements in the mood state of healthy elderly women. This is an interesting result, as it shows that social interaction is as important a component as improving functional capacity.

Sleep in marathon and ultramarathon runners: a brief narrative review

Introduction

Sleep is considered a fundamental biological function in humans necessary for recovery from daily physical activities. Considering the increasing popularity of long-distance running and participation in races such as marathons and ultramarathons, the aim of the present study was to review the relationship of such strenuous physical activities with sleep.

Methods

A search of Scopus was performed on 24/6/2023 using the syntax [ABS (sleep) AND ABS (marathon)] to identify relevant papers, the references of which were hand-searched to find additional sources.

Results

Optimal sleep has been shown to affect injury prevention and susceptibility to infection positively. In turn, participation in a marathon race may influence nocturnal autonomic modulation and disturb homeostasis. Ultramarathon races may have such a long duration that results in sleep deprivation even for several days, where sleep duration is quite below the physiological range. It seems that for ultramarathons of short duration, continuous running and sleep deprivation are beneficial for performance. In contrast, for races longer than 200 miles, it is necessary to develop sleep strategies to sustain performance.

Conclusion

In summary, the longer the distance of a running race, the greater the importance of an optimal sleep for race performance as well as the impact of a race on sleep.

Comparing the Performance Gap Between Males and Females in the Older Age Groups in IRONMAN® 70.3: An Internet-Based Cross-Sectional Study of More Than 800,000 Race Records

BACKGROUND

The sex difference in the three split disciplines (swimming, cycling, and running) and overall race times in triathlon races has mainly been investigated for the Olympic distance and IRONMAN® triathlon formats, but not for the half IRONMAN® distance, i.e., the IRONMAN® 70.3. The aim of the present study was to investigate the sex differences in IRONMAN® 70.3 by age group in 5-year intervals for the split disciplines of this race. Data from 823,459 records (625,393 males and 198,066 females) of all age group finishers (in 5-year intervals) competing in all official IRONMAN® 70.3 races held worldwide between 2004 and 2020 were analyzed, and sex differences by age group and split disciplines were evaluated.

RESULTS

Males were faster than females in all split disciplines and all age groups. The sex difference was lower in swimming than in cycling and running and less pronounced for triathletes between 20 and 50 years of age. After the age of 60 years, females were able to reduce the sex difference to males in swimming and cycling, but not in running, where the reduction in the sex difference started after the age of 70 years. The lowest sex difference was in the age group 75 + years for swimming and cycling and in the age group 30-34 years for running. Across age groups, the sex difference was U-shaped in swimming and running, with an increase after 18-24 years in swimming and after 40-44 years in running. In contrast, the sex difference decreased continuously with the increasing age for cycling.

CONCLUSIONS

In conclusion, the study found that the sex difference in performance decreases with age in the IRONMAN® 70.3 race distance. However, females did not outperform males at older ages. Notably, sex differences were observed across different disciplines, with swimming displaying lower differences compared to cycling and running. These findings underscore the complex interplay between age, sex, and performance in endurance sports, emphasizing the need for additional research to understand the factors influencing these differences.

Performance and pacing of professional IRONMAN triathletes: the fastest IRONMAN World Championship ever-IRONMAN Hawaii 2022

Pacing during cycling and running in an IRONMAN triathlon has been investigated in only one study with elite IRONMAN triathletes. We have, however, no knowledge of how professional triathletes pace during an IRONMAN World Championship. To investigate the split-by-split speed, pacing strategies and pacing variability in professional female and male IRONMAN World Championship participants in the fastest IRONMAN World Championship ever in IRONMAN Hawaii 2022. For both cycling and running, 25 specific split times were recorded in each discipline. The best 30 men and 30 women overall were chosen from the official IRONMAN website database for further analysis. They were divided into three performance groups: Top 10, 11-20th place, and 21st-30th place. Mean speed, individual linear regressions with the corresponding correlation coefficients, and coefficient of variation were calculated to assess split-by-split speed, pacing strategies, and pacing variability, respectively. In both men's and women's cycling and running segments, the top ten participants exhibited faster split times compared to the slower performance groups. Notably, no discernible differences existed between the 11-20th and 21st-30th place in men's cycling and women's running times. Conversely, in men's running and women's cycling segments, those in the 11-20th place displayed quicker times than those in the 21st-30th place. In the cycling segment across all groups, men demonstrated a more negative pacing pattern (indicating an increase in speed), whereas women exhibited more consistent pacing. In the running segment, the top 10 men and all women's groups showcased relatively similar slightly positive pacing profiles. However, men ranking 11-20th and 21st-30th displayed more pronounced positive pacing strategies, implying a more significant decline in speed over time. In terms of cycling, the variability in pacing remained relatively consistent across the three performance groups. Conversely, during the running segment, the top ten male triathletes and those in the 11-20th place displayed lower pacing variability than their counterparts in the 21st-30th position place and all women's groups. In summary, performance and pacing were examined in professional male and female IRONMAN World Championship participants during IRONMAN Hawaii 2022. Top performers showed faster cycling and running split times, with differences in pacing strategies between sexes. The pacing was more consistent in cycling, while running pacing varied more, particularly among male triathletes in different performance groups.

Elderly female ultra-marathoners reduced the gap to male ultra-marathoners in Swiss running races

Recent studies showed that female runners reduced the performance gap to male runners in endurance running with increasing age and race distance. However, the investigated samples were generally small. To investigate this further, the present study examined sex differences by age across various race distances (5, 10 km, half-marathon, marathon, and ultra-marathon) using a large dataset of over 1,100,000 race records from Switzerland over two decades (1999-2019). The study explored performance and participation disparities between male and female runners by employing diverse methods, such as descriptive statistics, histograms, scatter and line plots, correlations, and a predictive machine learning model. The results showed that female runners were more prevalent in shorter races (5, 10 km, half-marathon) and outnumbered male runners in 5 km races. However, as the race distance increased, the male-to-female ratio declined. Notably, the performance gap between sexes reduced with age until 70 years, after which it varied depending on the race distance. Among participants over 75 years old, ultra-marathon running exhibited the smallest sex difference in performance. Elderly female ultra-marathoners (75 years and older) displayed a performance difference of less than 4% compared to male ultra-marathoners, which may be attributed to the presence of highly selected outstanding female performers.

Match Running Performance Profile and Heart Rate Response in Amputee Soccer Players

INTRODUCTION

The purpose of this study was (a) to create a profile of the running performances of male amputee soccer players in different speed zones, (b) to investigate the relationship between heart rate (HR) and running distance in two soccer matches, and (c) to study the effect of the level of amputation on the running distance covered during a match.

MATERIAL AND METHODS

The participants were male amputee soccer players (n = 10, Greek, n = 5; Belgian, n = 5) who played two international, friendly matches. Distances were measured using a global positioning system, and HRs were recorded using a Polar Team Pro.

RESULTS

No differences in the distances covered were observed between participants with different levels of amputation (p > 0.05). Nevertheless, there was a trend that participants with a below-the-knee amputation tended to cover longer distances in total (difference +262.3 m, Cohen's d = 0.40) and in zones 2 (+324.4 m, d = 0.79), 3 (+ 7.1 m, d = 0.65), 4 (+22.7 m, d = 0.43), and 5 (+0.4 m, d = 0.20) and less distance in zone 1 (-207.2 m, d = 0.88). They also tended to perform more accelerations (+3.9, d = 0.89) and decelerations (+4.2, d = 0.87) and had a higher mean HR (+8.4%, d = 2.04) than those with an above-the-knee amputation. Moreover, the mean HR corresponded to 83.3% of the HRmax and did not correlate with distance in any speed zone.

CONCLUSIONS

It was concluded that the level of amputation might influence running performance and acute physiological response during a soccer match.

The birthplace and relative age effects in Brazilian olympic athletes: a cross-national comparison

Purpose

Our purpose was to verify the existence of birthplace and relative age effect (RAE), as well as the association between birthplace effect and RAE among Brazilian athletes competing in the Olympic Games.

Methods

Data included information about Brazilian Summer Olympic athletes from 1920 to 2021. To investigate RAE, athletes' birthdate was distributed into birth quartiles (Q1: Jan-Mar; Q2: Apr-Jun; Q3: Jul-Sep; Q4: Oct-Dec), while birthplace effect was assessed considering the state and the region (Southeast; Northeast; South; North; and Midwest) of birth. The Chi-square test (χ²) was used to verify differences between the birthplace effect and RAE.

Results

The sample consisted of 388 Brazilian athletes of both sexes, distributed in 38 sports modalities from 23 Brazilian states (Southeast = 66.5%; South = 14.4%; Northeast = 12.1%; North = 1.5%; Midwest = 5.4%). For both sexes, most of the athletes were from the São Paulo state (37.4%), followed by Rio de Janeiro (18.3%), both from the Southeast region. For birthdate distribution according to birthplace, it was observed that the North region presented the highest frequency of athletes born in Q1 (50%), followed by the Northeast and Southeast regions. No significant differences were found for the birthplace effect (χ² = 5.69, value of p = 0.128) and RAE between sexes (χ² = 0.530, value of p = 0.912), nor was shown an association between the birthplace effect and RAE.

Conclusion

Most Brazilian Olympic athletes are from the Southeast region, but no RAE was established regarding their birthplace. Results from the present study can guide sports public policies in Brazilian regions, especially in the Midwest, North, and Northeast regions, which are underrepresented in Brazilian high-performance sports.

Where are the fastest master butterfly swimmers competing in the FINA World Masters Championships from?

While the butterfly stroke has received considerable attention in sports science, the origin of the fastest master butterfly swimmers remains unknown. The present study investigated which geographical locations produce the top-performing master butterfly swimmers within their age groups and gender. A total of 26,512 master butterfly swimmers (11,288 women and 15,224 men) competed in 50 m, 100 m and 200 m races in World Masters Championships held between 1986 and 2019. From each swimmer, the year of competition, first name, last name, age group and distance were recorded. Descriptive data were presented using mean, standard deviation, maximum and minimum values, and/or confidence intervals. The top 10 race times for master butterfly swimming and gender were identified for descriptive purposes. Nationalities were then grouped into six categories: the top five nationalities with the most appearances in the top 10 fastest times in butterfly swimming by distance each year and one group consisting of all other nationalities. In the event of a tie, the nationality with the most participants overall was selected. Generalized linear models (GLMs) with a gamma probability distribution and log link function were used to assess the effect of age groups and gender on swimming time. In summary, Germany had the fastest women butterfly master swimmers across all distances, while the USA had the fastest men butterfly master swimmers for all distances. Men covered all distances faster than women and younger swimmers were quicker than older swimmers. The results of this study can be utilized to determine the countries that produce the most successful master butterfly swimmers, providing a foundation for further research to explore the factors that lead to their success.

Sports Physiology in Adolescent Track-and-Field Athletes: A Narrative Review

The present study aimed to review the physiological aspects of adolescent track-and-field (TAF) athletes. A search of Scopus on 27/12/2022 using the syntax ABS (track-and-field) AND ABS (children) OR ABS (adolescent) showed 121 documents, and 45 were considered for further analysis. In addition, handsearching was conducted to identify Russian literature missing in Scopus. Differences were shown in performance characteristics among disciplines, especially between throwers and the other athletes. The sex difference in performance (ie, a better performance in boys than in girls) started in early adolescence. A relative age effect was more pronounced in athletes under 13 years old. Despite the wide use of nutritional supplements, an insufficient intake of vitamins has been found. The age of training onset and body weight were identified as risk factors for problems with menarche. The inclusion of track-and-field training programs in physical education was beneficial for health and physical fitness. The need to collaborate closely with parents and coaches was identified, especially, regarding education in topics such as the age of training onset, relative age effect, and doping. In conclusion, the existence of many disciplines with different anthropometric and physiological characteristics highlighted the need for a discipline-specific approach.

Predictors of half-marathon performance in male recreational athletes

Few research has been conducted on predictors of recreational runners' performance, especially in half-marathon running. The purpose of our study was (a) to investigate the relationship of half-marathon race time with training, anthropometry and physiological characteristics, and (b) to develop a formula to predict half-marathon race time in male recreational runners. Recreational runners (n=134, age 44.2±8.7 years; half-marathon race time 104.6±16.2 min) underwent a physical fitness battery consisting of anthropometric and physiological tests. The participants were classified into five performance groups (fast, 73-92 min; above average, 93-99 min; average 100-107 min; below average, 108-117 min; slow group, 118-160 min). A prediction equation was developed in an experimental group (EXP, n=67), validated in a control group (CON, n=67) and prediction bias was estimated with 95 % confidence intervals (CI). Performance groups differed in half-marathon race time, training days, training distance, age, weight, (body mass index) BMI, body fat (BF) and maximum oxygen uptake (VO2max) (p≤0.001, η2≥0.132), where faster groups had better scores than the slower groups. Half-marathon race time correlated with physiological, anthropometric and training characteristics, with the faster the runner, the better the score in these characteristics (e.g., VO2max, r=0.59; BMI, r=-0.55; weekly running distance, r=-0.53, p<0.001). Race time in EXP might be calculated (R2=0.63, standard error of the estimate=9.9) using the equation 'Race time (min)=80.056+2.498×BMI-0.594×VO2max-0.191×weekly training distance in km'. Validating this formula in CON, no bias was shown (difference between observed and predicted value 2.3±12.8 min, 95 % CI -0.9, 5.4, p=0.153). Half-marathon race time was related to and could be predicted by BMI, VO2max and weekly running distance. Based on these relationships, a prediction formula for race time was developed providing a practical tool for recreational runners and professionals working with them.

Effects of moderate- vs. high-intensity interval training on physical fitness, enjoyment, and affective valence in overweight/obese female adolescents: a pre-/post-test study

OBJECTIVE

The aim of this study was to compare the effects of 12-week moderate-intensity interval training (MIIT) vs. high-intensity interval training (HIIT) on body composition, physical fitness, and psychological valence in overweight/obese (OW/OB) female adolescents.

PATIENTS AND METHODS

Thirty-eight OW/OB female students were randomized into HIIT (n=13), MIIT (n=13) or control (n=12) groups. The participants underwent a 12-week interval-training program at 100% to 110% and 60% to 75% of maximal aerobic speed for HIIT and MIIT, respectively. The control group kept their usual physical activity without completing the training program. Pre- and post-training measurements were performed to assess body composition, aerobic capacity, and anaerobic performance (using selected tests evaluating speed, jumping ability, and strength). Ratings of perceived exertion and the feeling scale were evaluated every three weeks. Enjoyment was measured at the end of the program. A two-way analysis of variance with repeated measurements was applied to test for "group×time" interactions for body composition, physical fitness, and affective variables.

RESULTS

Significant "group×time" interactions were detected for aerobic and anaerobic performance, body composition indices, and the feeling scale. HIIT resulted in more noticeable improvements in body composition and physical performance than MIIT, while no significant changes were found in the control group. Throughout the program, the feeling score has progressively increased in the MIIT group but decreased in the HIIT group. Ratings of the perceived exertion have increased in both groups, more noticeably in the HIIT group. At the end of the program, the MIIT group showed a higher enjoyment score.

CONCLUSIONS

Despite offering better body composition improvement and physical fitness enhancement, HIIT offered lesser enjoyment and affective valence than MIIT in OW/OB female adolescents. MIIT might be an alternative time-efficient protocol for improving health in this population.

Low-Carbohydrate Diet and Human Health

Low-carbohydrate diets were initially recommended as a therapeutic dietary scheme for epilepsy, while increasing evidence suggests their potential application in the management of several other pathologies, such as diabetes, neoplasms, gastrointestinal and lung diseases, diseases of the cardiovascular system, as well as obesity [...].

[Ice Swimming]

Ice Swimming Abstract: Just a few years ago, no one could imagine that ice swimming could evolve into a competitive sport. In the past, people swimming in ice-cold water were called madmen and, at best, were studied as scientific objects. Today regular competitions in ice swimming over different distances (ice mile, ice km, and shorter distances such as 50m, 100m, and 200m), and different disciplines are organized (freestyle, breaststroke, backstroke, butterfly). National championships, as well as continental and world championships, are also held, with new records set regularly. In this overview, we summarize the historical development of ice swimming up to a competitive sport and explore the risks in this nascent sports discipline.

Skinfold thickness variation and associations with cardiorespiratory fitness in male soccer players of different ages

OBJECTIVE

The aim of the present study was to examine skinfold thickness (SKF) distribution in youth and adult male soccer players regarding cardiorespiratory fitness (CRF) and the role of age.

PATIENTS AND METHODS

Participants were youth [n=83, age 16.2 (1.0) years, mean (standard deviation)] and adult male soccer players [n=121, 23.2 (4.3) years], who were tested for SKF on 10 anatomical sites and Conconi test was used to assess velocity at maximal oxygen uptake (vVO2max).

RESULTS

A between-within-subjects analysis of variance revealed a small interaction between the anatomical site and age group on SKF (p=0.006, η2=0.022), where adolescents had larger cheek (+0.7 mm; p=0.022; 95% confidence intervals - CI  - 0.1, 1.3), triceps (+0.9 mm; p=0.017; 95% CI 0.2, 1.6) and calf (+0.9 mm; p=0.014; 95% CI 0.2, 1.5) SKF, while adults had larger chin (+0.5 mm; p=0.007; 95% CI 0.1, 0.8) SKF, and no difference was observed for the rest of the anatomical sites. No difference between adolescent and adult age groups was observed in average SKF (SKFavg) [9.0 (2.7) vs. 9.1 (2.5) mm; difference -0.1 mm; 95% CI, -0.8, 0.6; p=0.738]. Compared to adults, adolescents had a lower SKF coefficient of variation (SKFcv) [0.34 (0.10) vs. 0.37 (0.09); difference-0.03; 95% CI, -0.06, -0.01; p=0.020] and subscapular-to-triceps ration (STR) [1.08 (0.28) vs. 1.29 (0.37); difference-0.21; 95% CI, -0.31, -0.12; p<0.001]. The largest Pearson moment correlation coefficient between vVO2max and SKF was shown in the subscapular (r=-0.411; 95% CI, -0.537, -0.284; p<0.001) and the smallest in the patellar anatomical site (r=-0.221; 95% CI, -0.356, -0.085; p=0.002). In addition, vVO2max correlated moderately with SKFavg (r=-0.390; 95% CI, -0.517, -0.262; p<0.001) and SKFcv (r=-0.334; 95% CI, -0.464, -0.203; p<0.001).

CONCLUSIONS

In summary, CRF was related to the thickness of specific SKF and the magnitude of thickness variation by the anatomical site (i.e., the smaller the variation, the better the CRF). Considering the relevance of specific SKF for CRF, their further use would be recommended for monitoring physical fitness in soccer players.

The Relative Importance of Training and Social Support for Runners' Performance: A Cross-Sectional Study

BACKGROUND

Running participation/performance is a complex system. Understanding the variables associated with these behaviors may help to increase population physical activity and improve performance. This study aimed to investigate social and training variables important for running performance using a network approach.

METHODS

This cross-sectional study sampled 1151 non-professional Brazilian runners of both sexes (women, 38.2%; men, 61.7%). A questionnaire was available for eligible participants using an online platform, and information regarding training (volume and running pace) and social variables (participation in a running event, participation in a running group, influence on running, runners in the family, and childhood sport) related to runners' performance was obtained. The Chi-square test and network model were estimated by sex.

RESULTS

Training characteristics tend to be clustered. For both sexes, the training volume node presented the highest expected influence in the network (1.69 for women and 2.16 for men). Centrality indicators of social variables show that sports childhood participation and the presence of runners in the family were the most important nodes of network connection for women and men, respectively.

CONCLUSION

Based on these findings, it was concluded that sports participation during childhood and the practice of running by other family members were important factors to connect variables in the network. These findings have practical applications for health policymakers, highlighting the need to develop educational programs to increase sports participation during childhood and within families.

A Machine Learning Approach to Finding the Fastest Race Course for Professional Athletes Competing in Ironman® 70.3 Races between 2004 and 2020

Our purpose was to find the fastest race courses for elite Ironman® 70.3 athletes, using machine learning (ML) algorithms. We collected the data of all professional triathletes competing between 2004 and 2020 in Ironman 70.3 races held worldwide. A sample of 16,611 professional athletes originating from 97 different countries and competing in 163 different races was thus obtained. Four different ML regression models were built, with gender, country of origin, and event location considered as independent variables to predict the final race time. For all the models, gender was the most important variable in predicting finish times. Attending to the single decision tree model, the fastest race times in the Ironman® 70.3 World Championship of around ~4 h 03 min would be achieved by men from Austria, Australia, Belgium, Brazil, Switzerland, Germany, France, the United Kingdom, South Africa, Canada, and New Zealand. Considering the World Championship is the target event for most professional athletes, it is expected that training is planned so that they attain their best performance in this event.

Effects of Biological Age on Athletic Adaptations to Combined Plyometric and Sprint with Change of Direction with Ball Training in Youth Soccer Players

There is evidence for the effectiveness of youth combined plyometric and sprint with change of direction (COD) training. However, the evidence is not well-known regarding the in-season effects of biological age (peak height velocity—PHV) on the motor adaptive processes following combined plyometric and COD with ball training (P-CODBT) in youth soccer players. This study aimed to examine the in-season effects of P-CODBT (8 weeks and twice a week) on the athletic performances of male youth soccer players, circa- and post-PHV. In a randomized controlled training study with pre-to-post measurements, forty-eight male players were assigned into two experimental (performing P-CODBT; n = 12 × circa-PHV and n = 12 × post-PHV) and two control groups (CONG; n = 12 × circa-PHV and n = 12 × post-PHV). The pre- and post-training participants were assessed for their anthropometric, linear sprinting with and without a ball, COD speed with and without a ball, vertical jump, dynamic balance, and endurance-intensive performances. After the intervention, the experimental condition induced significant (all p < 0.0001) and small to large effect size (ES = 0.263−3.471) additional gains only on explosive measures compared to CONG. Both the experimental (all p < 0.0001; ES = 0.338−1.908) and control (p = 0.011−0.0001; ES = 0.2−1.8) groups improved their athletic performances over the training period. The improvements generated by p-CODBT were not affected by biological age. In-season short-term P-CODBT (twice a week) could be safe way to generate benefits in explosive performances in youth soccer players, which are relevant components of match-winning actions in soccer.

How to end up on the podium after running a 6-days-run with type 1 diabetes mellitus - A case study and literature review

BACKGROUND

An increasing number of people living with type 1 diabetes mellitus (T1DM) are pushing their physical limits to compete at the sport's highest level. Muscle, liver, and glycogen metabolism can be normal in athletes with diabetes with good glucose management, and modifications to insulin dose and nutrition can facilitate exercise performance.

CASE PRESENTATION

We report on a 66-year-old runner with insulin-dependent T1DM. He has run over 90 marathons and ultra-marathons. Thanks to an insulin pump and continuous glucose monitoring, he has completed forty-eight 24-hour runs with an average performance of 133.8 km. Over the years, the runner increased his monthly running volume significantly and decreased his glycated Hemoglobin type A1C (hba1c) levels. Meanwhile, a significant association between monthly running kilometers and hba1c levels could be shown. At the age of 66 years, he finished his sixth 6-day-run in third place overall by covering a total distance of 467.424 km.

CONCLUSIONS

These findings show that it is possible to participate in ultra-endurance events while suffering from T1DM without glucose derailing. With a good understanding of the disease and its impact on an individual's body, we can curtail the preparation and execution phases of ultra-endurance events to allow athletes to compete with minimal risk.

The Effects of Sex, Age and Performance Level on Pacing in Ultra-Marathon Runners in the ‘Spartathlon’

Background

Pacing has been investigated in different kinds of ultra-marathon races, but not in one of the toughest ultra-marathons in the world, the ‘Spartathlon’.

Objective

The aim of the present study was to analyse the pacing of female and male finishers competing in the ‘Spartathlon’ in regards to their age and performance groups.

Methods

A total of 2598 runners (2255 men and 343 women) finishing ‘Spartathlon’ between 2011 and 2019 were analysed. We selected 10 checkpoints with split times corresponding to important race sections. Average running speed was calculated for each participant and the average checkpoint running speed for each of the 10 race checkpoints. Furthermore, to assess the pacing strategy of each runner, the percentage of change in checkpoint speed (CCS) in relation to the average race speed was calculated (for each of 10 checkpoints). Finally, the average change in checkpoint speed (ACCS) was calculated for each participant as a mean of the 10 CCSs.

Results

Both women and men slowed down through the first 7 checkpoints but increased running speed towards the end of the race (reverse J-shaped pacing). Men showed a significantly greater CCS in the first and second checkpoint (p < 0.01 and p < 0.05, respectively), whereas women showed a more significant change in CCS in the last checkpoint (p < 0.05). Furthermore, age and sex showed no effect on ACCS, whereas ACCS differed between the performance groups. In particular, the slowest and the fastest runners showed a more minor change in ACCS than the two medium groups of both men and women (p < 0.01).

Conclusions

In summary, successful finishers in ‘Spartathlon’ showed a reverse J-shaped pacing curve with a decrease in running speed from the start to the 7th checkpoint and an increase in running speed thereafter. This strategy was most probably due to the profile of the race course. Men showed a more significant change in checkpoint speed in the first two checkpoints, whereas women showed a more substantial change in the last checkpoint. Age and sex did not affect average checkpoint speed, whereas this speed was different between the different performance groups. The slowest and the fastest runners showed fewer changes in average checkpoint speed than the two medium groups in men and women.

Performance improvement in sport through vitamin D - a narrative review

OBJECTIVE

It is well known that vitamin D deficiency can lead to various health problems. However, it is not common knowledge among athletes and doctors that vitamin D deficiency is prevalent in sports. This deficiency can severely impact performance, while vitamin D supplementation can alleviate this effect and potentially improve performance.

MATERIALS AND METHODS

This narrative review aims to compile the current state of knowledge about the importance of vitamin D in increasing performance for active people. To this end, we searched the 'Scopus' and 'PubMed' databases for the terms 'vitamin D - athlete - performance' with an end date of 30 June 2022.

RESULTS

Study results indicated that the therapeutic impact of vitamin D on aerobic capacity, recovery, strength and sprint performance remains controversial.

CONCLUSIONS

Based on the previous findings on recovery, strength and performance, 4,000-5,000 IU of vitamin D per day may be a safe dose that can improve athletic performance.

Biophysical characterization of the first ultra-cyclist in the world to break the 1,000 km barrier in 24-h non-stop road cycling: A case report

A plethora of factors determine elite cycling performance. Those include training characteristics, pacing strategy, aerodynamics, nutritional habits, psychological traits, physical fitness level, body mass composition, and contextual features; even the slightest changes in any of these factors can be associated with performance improvement or deterioration. The aim of the present case report is to compare the performances of the same ultra-cyclist in achieving two world records (WR) in 24 h cycling. We have analyzed and compared the distance covered and speed for each WR. The 24 h period was split into four-time intervals (0–6 h; > 6–12 h; > 12–18 h; > 18–24 h), and we compared the differences in the distance covered and speed between the two WRs. For both WRs, a strong negative correlation between distance and speed was confirmed (r = –0.85; r = –0.89, for old and new WR, respectively). Differences in speed (km/h) were shown between the two WRs, with the most significant differences in 12–18 h (Δ = 6.50 km/h). For the covered distance in each block, the most significant differences were observed in the last part of the cycling (Δ = 38.54 km). The cyclist effective surface area (ACd) was 0.25 m² less and 20% more drag in the new WR. Additionally, the mechanical power was 8%, the power to overcome drag was 31%, and the power-weight ratio was 8% higher in the new WR. The mechanical efficiency of the cyclist was 1% higher in the new WR. Finally, the heart rate (HR) presented significant differences for the first 6 h (Old WR: 145.80 ± 5.88 bpm; New WR: 139.45 ± 5.82 bpm) and between the 12 and 18 h time interval (Old WR: 133.19 ± 3.53 bpm; New WR: 137.63 ± 2.80 bpm). The marginal gains concept can explain the performance improvement in the new WR, given that the athlete made some improvements in technical specifications after the old WR.

EXERCISE SCIENCE IN HIGH SCHOOL BIOLOGY TEXTBOOKS

ABSTRACT The content of high school textbooks related to physical activity and exercise is of utmost importance because physical activity and exercise are considered important tools in maintaining and improving health. Our objective was to analyze the presence and quality of exercise science content in high school biology textbooks approved by the National Textbook Plan. A guiding document was developed to enable the analysis of the textbooks. The topics investigated were: I) the extent of content related to exercise science; II) misconceptions about exercise science; III) health benefits attributed to exercise. The academic qualifications of the textbook authors were also analyzed. All analyzed textbooks (n = 9) featured some degree of exercise science content. In addition, ~67% of textbooks analyzed had at least one misconception regarding exercise science, the most common being related to biochemistry and muscle physiology. Also, 93.8% of the authors had undergraduate degrees in biological sciences; 43.8% had doctoral degrees. In conclusion, all high school biology textbooks presented content related to exercise science; however, most of them presented at least one misconception regarding exercise science. Thus, we suggest that the Brazilian National Textbook Plan should improve the criteria for analyzing biology textbooks. Level of Evidence III; Economic and decision analyses - Development of an economic or decision model.

Factors associated with perceived performance drops and musculoskeletal injuries in Brazilian recreational triathletes

OBJECTIVE

The aim of the study was to investigate sleep characteristics, use of supplements, and training volume of recreational triathletes, and to verify possible associations with perceived performance drops and occurrence of injuries.

MATERIALS AND METHODS

Recreational triathletes (n=942) answered a questionnaire inquiring about their demographic characteristics, performance, injuries and training volume.

RESULTS

When comparing athletes who slept more (9-10 hours) with those who slept less, less sleep was associated with a higher prevalence of perceived performance drops. Regarding difficulties in initiating sleep, the absence of initiating difficulties (p<0.001) was a protective factor against perceived performance drops. Regarding weekly training volume, compared to those who trained more than 20 hours, training less than 3 hours (p<0.001), 3-5 hours (p<0.001), or 12-14 hours (p<0.001) were protective factors against perceived performance drops. Concerning training volume and injuries, we found that compared to those who trained more than 20 hours, training 18-20 hours (p<0.001), 15-17 hours (p<0.001), 12-14 hours (p<0.001), 6-8 hours (p<0.001), or 3-5 hours (p<0.001) were protective factors against injuries.

CONCLUSIONS

Triathletes with a lower sleep quantity and those who have difficulties initiating sleep frequently experience drops in performance. Training volumes can influence both performance and the likelihood of injuries.

Comment on Eschweiler et al. Anatomy, Biomechanics, and Loads of the Wrist Joint. Life 2022, 12, 188

We have read 'Anatomy, biomechanics and loads of the wrist joint' [...].

Body Composition of Female Air Force Personnel: A Comparative Study of Aircrew, Airplane, and Helicopter Pilots

This research aimed to analyze the body composition (BC) of different groups of women aircrew units in the Spanish Air Forces for a better understanding and improvement of their operability. Specifically, 184 female aircrew members were analyzed and classified into specialties (38 airplane pilots, age: 32.8 ± 10.8; 26 helicopter pilots, age: 32.0 ± 9.18; and 120 transport aircrew, age: 36.9 ± 8.18). The women’s BC was analyzed with an InBody720 bioimpedance device previously used in the military population. There were differences in the BC among specialties, although there were similarities between airplane and helicopter pilots. Airplane (24.0% ± 10.4%) and helicopter pilots (22.6 ± 6.32%) had a smaller percentage of body fat mass than transport aircrew (26.3 ± 7.51%), but there was uniformity among groups in skeletal muscle mass and soft lean mass. We found no differences in body water among specialties. Differences in BCs were previously reported for men in the air force, and these results in women showed similarities for different job entry requirements, different training needs, and different occupational behaviors among units in the Air Force. These results help to deepen the previous knowledge of women’s BC standards in military units. Although pilots are primarily responsible for the aircraft, healthy habits should be encouraged to keep fit and improve the performance of all aircrew members both in flight and when they are deployed.

Differences in pacing during cycling and running in ultra-triathlons - The example of 'Swissultra'

OBJECTIVE

The knowledge of the most predictive split discipline and the pacing during a triathlon race is of utmost importance for planning an ultra-triathlon race. This study aimed at investigating the pacing during cycling and running splits in three different multi-stage ultra-triathlon race formats (i.e., Quintuple, Deca, and Double Deca Iron ultra-triathlon with 5x, 10x and 20x the daily distance of a full Ironman-distance triathlon).

SUBJECTS AND METHODS

A total of 48 male ultra-triathletes competing in Quintuple (n=14), Deca (n=25), and Double Deca (n=9) Iron ultra-triathlon "swissultra" between 2016 and 2019 in Switzerland were analyzed. For each race day, we calculated the total performance (sum of all laps time), average individual performance (average of all laps time within a race day) and pacing variation (coefficient of variation of race laps time) for cycling and running. Discipline (cycling and running) and race distance (Quintuple, Deca, and Double Deca Iron ultra-triathlon) were used as independent parameters. The primary outcome variables were the time performance (daily and total) and the pacing variation. We applied two general linear models (GLM): the first model was a one-way ANOVA comparing total and daily performance by race distance, and the second model was a two-way ANOVA (race distance´ discipline) using pacing variation (average pace oscillation) as a dependent variable.

RESULTS

The first GLM identified a significant race distance effect for total performance in both cycling (F = 375.6; p < 0.001; ηp2 = 0.943) and running (F = 267.8; p < 0.001; ηp2 = 0.922) with Double Deca Iron ultra-triathlon being the fastest and Quintuple Iron ultra-triathlon the slowest. The GLM for daily average performance showed no significant effect of race distance on cycling performance (F = 0.171; p = 0.843; ηp2 = 0.008), but on running performance (F = 6.408; p = 0.004; ηp2 = 0.222). The two-way GLM comparing pacing variation showed a significant effect for race distance (F = 11.81; p<0.001; ηp2 = 0.344) with Deca presenting larger pace variation than Quintuple and Double Deca Iron ultra-triathlon in both cycling and running, but not for discipline (F = 0.067; p=0.797; ηp2 = 0.001), nor for interaction (F = 1.469; p=0.241; ηp2 = 0.061).

CONCLUSIONS

Athletes achieved a stable cycling performance independent of the length of the race, and the cycling split had an influence on the subsequent running split depending upon the length of the race.

Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers

In hypertonic muscles of patients with upper motor neuron syndrome (UMNS), investigation with surface electromyography (EMG) with the muscle in a shortened position and during passive muscle stretch allows to identify two patterns underlying hypertonia: spasticity and spastic dystonia. We recently observed in Para swimmers that the effect of fatigue on hypertonia can be different from subject to subject. Our goal was, therefore, to understand whether this divergent behavior may depend on the specific EMG pattern underlying hypertonia. We investigated eight UMNS Para swimmers (five men, mean age 23.25 ± 3.28 years), affected by cerebral palsy, who presented muscle hypertonia of knee flexors and extensors. Muscle tone was rated using the Modified Ashworth Scale (MAS). EMG patterns were investigated in rectus femoris (RF) and biceps femoris (BF) before and after two fatiguing motor tasks of increasing intensity. Before the fatiguing tasks, two subjects (#2 and 7) had spasticity and one subject (#5) had spastic dystonia in both RF and BF. Two subjects (#3 and 4) showed spasticity in RF and spastic dystonia in BF, whereas one subject (#1) had spasticity in RF and no EMG activity in BF. The remaining two subjects (#6 and 8) had spastic dystonia in RF and no EMG activity in BF. In all the 16 examined muscles, these EMG patterns persisted after the fatiguing tasks. Spastic dystonia increased (p &lt; 0.05), while spasticity did not change (p &gt; 0.05). MAS scores increased only in the muscles affected by spastic dystonia. Among the phenomena possibly underlying hypertonia, only spastic dystonia is fatigue-dependent. Technical staff and medical classifiers should be aware of this specificity, because, in athletes with spastic dystonia, intense and prolonged motor activity could negatively affect competitive performance, creating a situation of unfairness among Para athletes belonging to the same sports class.

The Key Role of Nutritional Elements on Sport Rehabilitation and the Effects of Nutrients Intake

Adequate nutrition is of utmost importance for athletes, especially during rehabilitation after injury in order to achieve fast healing and return to sports. The aim of this narrative review is to define the proper nutritional elements for athletes to meet their needs and facilitate their fast return to sports after surgery or injury, as well as determine the effects of specific nutrients intake. Studies on antioxidants, which are substances that protect against free radicals, for the injured athlete are few and unclear, yet poly-phenols and especially flavonoids might improve healing and inflammation following an injury. Benefits of vitamin C or E on muscle damage are disputable in relevant studies, while optimal levels of vitamin D and calcium contribute to bone healing. Minerals are also essential for athletes. Other supplements suggested for muscle damage treatment and protein synthesis include leucine, creatine, and hydroxymethylbutyrate. Diets that include high-quality products, rich in micronutrients (like vitamins, minerals, etc.) bio-active compounds and other nutritional elements (like creatine) are suggested, while an individualized nutrition program prescribed by a trained dietitian is important. Further studies are needed to clarify the underlying mechanisms of these nutritional elements, especially regarding injury treatment.

Association between lowering restriction levels during the coronavirus outbreak and physical activity among adults: a longitudinal observational study in Brazil

OBJECTIVE

The COVID-19 pandemic has had significant consequences on public health and lifestyle and has negatively affected mental health and the level of physical activity worldwide. This study examined the impact of reopening fitness centers and nonessential services and introducing flexible measures to ensure social distancing on physical activity and mental health.

MATERIALS AND METHODS

This was a longitudinal study. A self-administered questionnaire, including personal, behavioral, physical activity, perception of health, and mood state disorder information, was answered by 128 Brazilians in June 2020 (during severe restrictive measures) and again in April 2021 (after fitness centers and nonessential services were reopened).

RESULTS

The restriction level adopted in April 2021 was significantly lower than that in June 2020 (p<0.001). The level of physical activity (p<0.001) and health status perception (p<0.001) decreased from June 2020 to April 2021. The median values for depression and anxiety did not differ across the study period.

CONCLUSIONS

The level of physical activity was reduced during the COVID-19 pandemic, and anxiety and depression were not improved following less restrictive social distancing measures and the reopening of fitness centers. Thus, the return to a prepandemic level of physical activity and mental health status may not be automatic. The results presented herein suggest that the decrease in physical activity observed in the population may be challenging in the postpandemic period.

Comparison of sleep characteristics during the first and second period of restrictive measures due to COVID-19 pandemic in Greece

OBJECTIVE

The first wave of coronavirus pandemic and concomitant restrictive measures affected sleep. We slept more than usual, but the quality was worse. As the pandemic continues, a second period of restrictive measures was initiated, and no data exist about their impact on sleep. The aim of this study was to compare quantity and quality of sleep between the two periods of restrictive measures, due to the Coronavirus Disease-19 (COVID-19) pandemic in Greece.

MATERIALS AND METHODS

A web-based survey using a short 13-item questionnaire was created and was distributed online. This included information about demographic and professional data, quantitative and qualitative characteristics of sleep, degree of abidance in lockdown measures, and data about COVID-19 infection or close contact with active confirmed cases.

RESULTS

A total of 1,078 questionnaires were evaluated (first period, n=963; second period, n=115). Sleep duration was shorter during the second lockdown (mean difference -0.51h; 95% confidence interval, (CI), -0.82, -0.19, p=0.002). Compared to usual habits, sleep increased in first wave (mean difference +0.37h; 95% CI, 0.26, 0.47; p<0.001) and decreased in second wave (mean difference -0.35h; 95% CI, -0.60, -0.09; p=0.009). Regarding quality of sleep, less participants reported good quality of sleep during the second wave compared to the first (p=0.006). Finally, compliance to restriction measures was lower and the prevalence of confirmed illness or close contact with COVID-19 cases among participants was higher during the second period than during the first one (p<0.001 and p=0.028, respectively).

CONCLUSIONS

Our data showed that sleep duration increased during the first lockdown and decreased in the second one, when compared to usual habits. Moreover, sleep quality progressively deteriorated, as the restrictive measures due to coronavirus pandemic continued.

The Sex Difference in 6-h Ultra-Marathon Running—The Worldwide Trends from 1982 to 2020

Background and Objectives: The 6-h ultra-marathon is the shortest time-limited ultra-marathon race, but little has been investigated regarding this race format. Previously, only the age of peak performance in the context of longer time-limited ultra-marathons was determined. The purpose of this study was to investigate the trends in 6-h ultra-marathon races from 1982 to 2020 for female and male ultra-runners, the participation and performance by countries, the age of peak performance, and the differences in performance regarding countries. Materials and Methods: The sample included 23,203 female ultra-runners, aged 18–83 years, and 87,264 male ultra-runners, aged 18–85 years, who were finishers in a 6-h ultra-marathon held between 1982 and 2020. The age of peak performance was tested using the Kruskal–Wallis test, followed by the Bonferroni Correction. The difference in performance by countries was verified using a linear regression model with the fastest runners from Russia in women, and Tunisia in men, used as reference. Results: Over the years, the men-to-women ratio decreased. The mean age was 43.20 ± 9.30 years for female and 46.09 ± 10.17 years for male runners. Athletes in younger age groups were faster than athletes in older age groups. Most female and male participants originated from Germany. Women from Russia (10.01 ± 1.28 km/h) and men from Tunisia (12.16 ± 1.46 km/h) were the fastest. Conclusions: In summary, in 6-h ultra-marathons held between 1982 and 2020, the participation for both women and men increased, while the men-to-women ratio decreased. The mean age was higher in men compared to women. Most female and male runners originated from Germany, but the fastest women were from Russia, and the fastest men from Tunisia. Future studies need to investigate whether Russian women and Tunisian men are also the best in other distance-limited ultra-marathon races, such as 12-h and 24-h.

Adolescent female handball players present greater bone mass content than soccer players: A cross-sectional study

BACKGROUND

Osteoporosis is a systemic disease affecting half of women over the age of 50 years. Considering that almost 90% of peak of bone mass is achieved until the second decade of life, ensuring a maximal bone mineral content acquisition may compensate for age-associated bone loss. Among several other factors, physical activity has been recommended to improve bone mass acquisition. However, it is unknown whether athletes involved with sports with different impact loading characteristics differ in regards to bone mass measurements.

AIM

To compare the bone mass content, bone mass density and lean mass of young female soccer players (odd-impact loading exercise), handball players (high-impact loading exercises) and non-athletes.

METHODS

A total of 115 female handball players (15.5 ± 1.3 years, 165.2 ± 5.6 cm and 61.9 ± 9.3 kg) and 142 soccer players (15.5 ± 1.5 years, 163.7 ± 6.6 cm and 56.5 ± 7.7 kg) were evaluated for body composition using a dual-emission X-ray absorptiometry system, and 136 female non-athletes (data from NHANES) (15.1 ± 1.32 years, 163.5 ± 5.8 cm and 67.2 ± 19.4 kg) were considered as the control.

RESULTS

Handball players presented higher bone mass content values than soccer players for upper limbs (294.8 ± 40.2 g and 270.7 ± 45.7 g, p < 0.001), lower limbs (1011.6 ± 145.5 g and 967.7 ± 144.3 g, p = 0.035), trunk (911.1 ± 182.5 g and 841.6 ± 163.7 g, p = 0.001), ribs (312.4 ± 69.9 g and 272.9 ± 58.0 g, p < 0.001), spine (245.1 ± 46.8 g and 222.0 ± 45.1 g, p < 0.001) and total bone mass (2708.7 ± 384.1 g and 2534.8 ± 386.0 g, p < 0.001). Moreover, non-athletes presented lower bone mass content for lower limbs (740.6 ± 132.3 g, p < 0.001), trunk (539.7 ± 98.6 g, p < 0.001), ribs (138.2 ± 29.9 g, p < 0.001), pelvis (238.9 ± 54.6 g, p < 0.001), spine (152.8 ± 26.4 g, p < 0.001) and total bone mass (1987.5 ± 311.3 g, p < 0.001) than both handball and soccer players. Handball players also presented higher bone mass density values than soccer players for trunk, ribs and spine (p < 0.05) and handball and soccer players presented higher bone mass density than non-athletes for all measurements (p < 0.005). Finally, the non-athletes' lower limb lean mass was lower than soccer and handball players values (p < 0.05).

CONCLUSION

Adolescent females engaged in handball training for at least one year present higher bone mass contents than those who are engaged in soccer training, which, in turn, present higher bone mass contents than non-athletes. These results might be used by physicians and healthcare providers to justify the choice of a particular sport to enhance bone mass gain in female adolescents.

Age and Training-Related Changes on Body Composition and Fitness in Male Amateur Cyclists

Master athletes are considered as a model of healthy aging because they can limit the age-related decline of physiological abilities compared to sedentary individuals. The main objective of this study is to analyze age-related changes and annual training on body composition (BC) and cardiorespiratory fitness (CRF) parameters. The participants in this retrospective cross-sectional study were 176 male cyclists, aged 40-60 years. BC was evaluated through anthropometric measurements and CRF was determined by an incremental cycle ergometer test to exhaustion. A comparative study between age groups was carried out through a one-way ANOVA test and the associations between the variables were assessed by Spearman's correlation coefficients and multiple regression analysis to estimate the performance. Training was generally associated with a decrease in both body weight and body fat (p < 0.05). A decrease in resting heart rate was observed as a vagal effect of kilometers cycled per year (p < 0.05). Kilometers cycled per year were associated with an increase in peak power output, which was larger in the master 40 group (p < 0.05) with a non-significant upward in VO2max (p > 0.05). In the performance prediction model, the included variables explained 52% of the variance. In summary, the changes induced by age were minimal in BC and negligible in CRF, whereas HR decreased with age. Training load was generally associated with a decrease in body weight, BMI and body fat percentage that was particularly notable in the abdominal skin folds. A decrease in HRrest was observed as a vagal effect due to kilometers cycled per year, and age did not seem to have a significant effect. The annual cycling kilometers were associated with to high PPO that is greater in the M40 group and a non-significant upward trend in VO2max.

Development and Validation of Prediction Formula of Wingate Test Peak Power From Force-Velocity Test in Male Soccer Players

Peak power of the Wingate anaerobic test (WAnT), either in W (Ppeak) or in W.kg^–1 (rPpeak), has been widely used to evaluate the performance of soccer players; however, its relationship with force–velocity (F-v) test (e.g., whether these tests can be used interchangeably) has received little scientific attention so far. The aim of this work was to develop and validate a prediction equation of Ppeak and rPpeak from F-v characteristics in male soccer players. Participants were 158 adult male soccer players (sport experience 11.4 ± 4.5 years, mean ± standard deviation, approximately five weekly training units, age 22.6 ± 3.9 years, body mass 74.8 ± 7.8 kg, and height 178.3 ± 7.8 cm) who performed both WAnT and F-v test. An experimental (EXP, n = 79) and a control group (CON, n = 79) were used for development and validation, respectively, of the prediction equation of Ppeak and rPpeak from F-v test. In EXP, Ppeak correlated very largely with body mass (r = 0.787), fat-free mass (r = 0.765), largely with maximal power of F-v test (P_max; r = 0.639), body mass index (r = 0.603), height (r = 0.558), moderately with theoretical maximal force (F₀; r = 0.481), percentage of body fat (r = 0.471), fat mass (r = 0.443, p < 0.001); rPpeak correlated with rPmax (largely; r = 0.596, p < 0.001), theoretical maximal velocity (v₀; moderately; r = 0.341, p = 0.002), F₀ (small magnitude; r = 0.280, p = 0.012), BF (r = −0.230, p = 0.042), and fat mass (r = −0.242, p = 0.032). Ppeak in EXP could be predicted using the formula “44.251 + 7.431 × body mass (kg) + 0.576 × P_max (W) – 19.512 × F₀” (R = 0.912, R² = 0.833, standard error of estimate (SEE) = 42.616), and rPpeak from “3.148 + 0.218 × rPmax (W.kg^–1) + v0 (rpm)” (R = 0.765, R² = 0.585, SEE = 0.514). Applying these formulas in CON, no bias was observed between the actual and the predicted Ppeak (mean difference 2.5 ± 49.8 W; 95% CI, −8.7, 13.6; p = 0.661) and rPpeak (mean difference 0.05 ± 0.71 W.kg^–1; 95% CI, −0.11, 0.21, p = 0.525). These findings provided indirect estimates of Ppeak of the WAnT, especially useful in periods when this test should not be applied considering the fatigue it causes; in this context, the F-v test can be considered as an alternative of exercise testing for estimating the average Ppeak of a group of soccer players rather than for predicting individual scores when the interindividual variation of performance is small.

Interval Training with Different Intensities in Overweight/Obese Adolescent Females

To compare the effects of 12 weeks of high-intensity interval training (HIIT) versus moderate-intensity interval training (MIIT) on hematological and inflammatory markers in youth females, 38 overweight/obese females (16.4±1.0 yrs.) were randomly assigned to HIIT (2×6-8 repetitions of 30 s at 100-110% maximal aerobic speed (MAS), with 30 s active recovery between repetitions at 50% MAS; n=13), MIIT (2×6-8 repetitions of 30 s at 70-80% MAS, with 30 s active recovery between repetitions at 50% MAS; n=13), and a control group (CG, no intervention; n=12). Body composition, blood pressure, maximal heart rate, hematological and inflammatory markers (C-reactive protein [CRP], and erythrocyte sedimentation rate [ESR]) markers were assessed in all groups before and following the training program. Results revealed a significant (P<0.05) interaction effect for body composition, systolic blood pressure (SBP), MAS, maximal heart rate, and CRP. Within-group analyses for the HIIT and MIIT groups showed significant improvements in body mass (P=0.009 and P=0.025, respectively), BMI Z-score (P=0.011 and P=0.028, respectively), and MAS (P<0.001 and P=0.011, respectively). The HIIT program showed a significant decrease in body fat (P=0.002), waist circumference (P=0.002), maximal heart rate (P=0.003), SBP (P=0.001), and plasma CRP (P=0.004). In both groups, no significant changes were observed in ESR and hematological markers after intervention. No variable changed in CG. HIIT was the effective method to manage cardiometabolic health and inflammatory disorders in obese youth.

The Effect of Simulation-based Training on Athletic Performances among Female Basketball Players

Background:

The effectiveness of simulation-based training has been examined in various sports. However, considering the effect of gender and sport on training, it would be interesting to evaluate simulation-based training in female basketball.

Objective:

The purpose of the study was to examine the effect of simulation-based training on physical fitness and performance indices in female basketball players.

Methods:

Sixteen female semi-professional basketball players were randomly assigned to experimental (n=8; age, 25±2 years; weight, 62±9 kg; height, 167±8 cm) or control (n=8; age, 24±1 years; weight, 57±9 kg; height, 170±8 cm) groups. The experimental group participated in a six week basketball simulation training program including running with different speeds (jogging to sprinting), agility, jumping, and shuffling. Both groups performed the Cooper 12 min run, line drill, an adjusted T-test, 20 ms print, the Sargent vertical jump and basketball exercise simulation test before and after six weeks of the study period. Control and experimental groups performed typical basketball training, three times weekly. The overall training volume was similar for both groups.

Results:

The perceived exertion was higher in the simulation-based training than control (p<0.05) group. The findings of this study indicated a significant increase in VO2 max (p=0.001), anaerobic power (p=0.009), explosive leg strength (p=0.036), and total distance covered in basketball exercise simulation test (p=0.001) and decrease of the meantime of one round of basketball exercise simulation test (p=0.001) in the simulation training compared to the control group.

Conclusion:

Generally incorporation of the simulation-based training in conditioning programs is recommended for improving aerobic, anaerobic and leg explosive strength of basketball players.

A Sociodemographic Profile of Mask Use During the COVID-19 Outbreak Among Young and Elderly Individuals in Brazil: Online Survey Study

BACKGROUND

Sociodemographic variables may impact decision making regarding safety measures. The use and selection of adequate face masks is a safety and health measure that could help minimize the spread of COVID-19 infection.

OBJECTIVE

This study aims to examine sociodemographic variables and factors relating to COVID-19 that could impact decision making or the choice to use or not use face masks in the prevention and care of a possible COVID-19 infection among a large sample of younger and older Brazilian people.

METHODS

An online survey composed of 14 closed-ended questions about sociodemographic variables and COVID-19 was used. A total of 2673 participants consisted of Brazilian people (aged ≥18 years) from different states of Brazil and were grouped according to age (≤59 years and ≥60 years). To compare the variables of interest (associated with wearing a face mask or not), chi-square and likelihood ratio tests were used (with P<.05 being significant).

RESULTS

Most of the participants in both groups were women from the southeast region who had postgraduate degrees. Approximately 61% (1452/2378) of individuals aged ≤59 years and 67.8% (200/295) of those aged ≥60 years were not health professionals. In the group aged ≤59 years, 83.4% (1983/2378) did not show COVID-19 signs and symptoms, and 97.3% (2314/2378) were not diagnosed with COVID-19. In the older adult group, 92.5% (273/295) did not show signs and symptoms of COVID-19, and 98.3% (290/295) were not diagnosed with the disease. The majority of the participants in both groups reported using face masks, and their decision to use face masks was influenced by the level of education and their occupation as a health professional.

CONCLUSIONS

Younger and older adults have worn face masks during the COVID-19 outbreak. It is difficult to measure how much of a positive impact this attitude, habit, and behavior could have on the degree of infection and spread of the disease. However, it can be a positive indicator of adherence to the population's security and safety measures during the pandemic.

Ghrelin Response to Acute and Chronic Exercise: Insights and Implications from a Systematic Review of the Literature

BACKGROUND

Ghrelin is a peptide hormone predominantly produced by the stomach. It exerts a wide range of functions including stimulating growth hormone release and regulating appetite, food intake, and glucose and lipid metabolism. Since physical exercise affects all these aspects, a particular interest is accorded to the relationship between ghrelin and exercise. This systematic review aimed to summarize the current available data on the topic for a better understanding of the relationship.

METHODS

An extensive computerized search was performed in the PubMed and SPORTDiscus databases for retrieving relevant articles. The search contained the following keywords: ghrelin, appetite-related peptides, gastrointestinal peptides, gastrointestinal hormones, exercise, acute exercise, chronic exercise, training, and physical activity. Studies investigating the effects of acute/chronic exercise on circulating forms of ghrelin were included.

RESULTS

The initial search identified 840 articles. After screening, 80 articles were included. Despite a heterogeneity of studies and a variability of the findings, the review suggests that acute exercise suppresses acyl ghrelin production regardless of the participants and the exercise characteristics. Long- and very long-term exercise training programs mostly resulted in increased total and des-acyl ghrelin production. The increase is more noticeable in overweight/obese individuals, and is most likely due to weight loss resulting from the training program.

CONCLUSION

The review suggests that exercise may impact ghrelin production. While the precise mechanisms are unclear, the effects are likely due to blood flow redistribution and weight loss for acute and chronic exercise, respectively. These changes are expected to be metabolically beneficial. Further research is needed for a better understanding of the relationship between ghrelin and exercise.