Anabolic-androgenic steroids (AAS) encompass a broad group of natural and synthetic androgens. AAS misuse is highly prevalent on a global scale, with the lifetime prevalence of AAS misuse in males being estimated to be around 6%, with 15 to 25% of male gym attendees using it at any one time. AAS are associated with sudden cardiac death, neuropsychiatric manifestations, and infertility. The average AAS user is unlikely to voluntarily declare their usage to a physician, with around 1 in 10 actively engaging in unsafe injection techniques. The aim of this paper is to review the current evidence base on AAS with emphasis on mechanisms of action, adverse effects, and user profiles that are most likely to engage in AAS misuse. This paper also reviews terminologies and uses methods specific to the AAS user community.
Introduction: Endurance running performance is dependent upon hematological, physiological, anthropometrical, diet, genetic, and training characteristics. Increased oxygen transport and efficiency of tissue in extracting oxygen are the major determinants to competitions that require endurance. Thus, altitude training is often employed to increase blood oxygen-carrying capacity to improve sea-level endurance performance. This study aimed to compare hematological parameters of endurance runners' training at different clubs with different altitudes (Guna Athletics Sport Club at Guna (3100 meter above sea level) and Ethiopian Youth Sport Academy at Addis Ababa (2400 meter above sea level)).
Methods: A comparative cross-sectional study was conducted at GASC and EYSA. Data were collected from a total of 102 eligible study subjects (26 runners and 25 controls at Guna and 26 runners and 25 controls at Addis Ababa) from May to October 2019. About 3 ml of the venous blood was drawn from the antecubital vein by aseptic procedure and analyzed using a hematology analyzer (DIRUI BCC-3000B, China). One-way ANOVA and independent-sample t-tests were used to compare means.
Result: Male runners in Guna had significantly higher hemoglobin (Hgb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and white blood cell (WBC) count than male runners in Addis Ababa. Besides, female runners in Guna had significantly higher MCH and MCHC than female runners in Addis Ababa. However, there were no significant differences between Guna and Addis Ababa runners in red blood cell (RBC) count, Hct, MCV, and platelet count in both sexes, while Hgb and WBC count in females.
Conclusion: Decisively, Guna Athletics Sport Club endurance runners had significantly higher hematological parameters than Ethiopian Youth Sport Academy endurance runners. This provides invaluable information for coaches and sport physicians to monitor the hematological profile and the health status of an athlete living and training at different altitudes.
Background: The COVID-19 pandemic has had a profound effect on all aspects of life, including physical fitness and well-being of the general population. In the present study, we assessed the effect of the pandemic on the subjective and objective fitness of high-level nonelite runners.
Methods: The MASTERS Athletic Study is an ongoing survey of training and health habits of high-level nonelite runners, the majority of whom compete in marathons and other extreme endurance events. We invited participants to a web-based questionnaire regarding training and fitness during the COVID-19 pandemic. Comparisons were made between subjective and objective fitness as well as well as the relationship of prepandemic training volume and history of COVID-19 on change in fitness during the pandemic, using Mann-Whitney rank-sum tests and chi-square tests for nonparametric and categorical variables, respectively.
Results: A total of 189 runners completed the survey, of whom 26 (13.8%) reported prior diagnosis with COVID-19. In terms of the subjective sense of fitness compared to before the pandemic, 49 (25.9%) reported they were less fit, 55 (29.1%) reported they were more fit, and 85 (45.0%) reported their fitness was unchanged. These assessments correlated well with objective measurement of training volume in MET-min/week. Runners with improved fitness at present had a lower calculated training volume before the pandemic versus those who reported unchanged or worsened fitness. There was no relationship between the report of prior COVID-19 and either subjective or objective measures of fitness.
Conclusion: The COVID-19 pandemic has had a variable effect on the fitness of high-level nonelite runners. We found an inverse relationship between baseline training volume and the likelihood of runners reporting improved fitness and no relationship between a history of COVID-19 and change in fitness through the pandemic. Understanding the effect of the COVID-19 pandemic on athletic fitness will help guide strategies to maintain physical health and wellness through future public health crises.
Background: Single-modality, high-intensity interval training (HIIT) using traditional cardiorespiratory exercise selection has been found to provide similar and sometimes superior cardiometabolic effects compared with moderate-intensity continuous training. However, little is known regarding the cardiometabolic and psychosocial effects of HIIT using resistance training modalities. Therefore, this study aims to compare the effects of HIIT using rowing (R-HIIT) and multimodal HIIT (MM-HIIT) using resistance training on liver enzymes, cardiometabolic risk factors, and psychosocial outcomes.
Method: Recreationally active females with a body mass index <30 kg/m2 (N = 16, 23.0 ± 5.9 years) were randomized into a MM-HIIT or R-HIIT group and completed a 12-week HIIT intervention (ClinicalTrials.gov registration number: https://clinicaltrials.gov/ct2/show/NCT03093441) using principles of social cognitive theory (SCT). Participants completed pre- and postintervention measurements on anthropometrics, resting heart rate, blood pressure, blood measures (lipids, liver enzymes, and glucose), exercise self-efficacy, and perceived wellness. Analysis of covariance was used to examine differences in postintervention measures between groups after controlling for baseline values, waist circumference, and waist-to-height ratio.
Results: R-HIIT group had significantly decreased alanine aminotransferase (mean difference = 13.16, P=0.013, effect size (ES) = 0.44, confidence interval (CI) = 3.40 to 22.92) and aspartate aminotransferase (mean difference = 10.79, P=0.024, ES = 0.38, CI = 1.67 to 19.90) levels compared with the M-HIIT group, and the whole group had improved wellness scores (14.72 ± 2.6 to 16.89 ± 2.76, P=0.002).
Conclusion: R-HIIT may be an effective preventative method for improving liver health in females without obesity. When using principles of SCT, HIIT may enhance overall well-being.
Although sleep disturbance is a common complaint in overtrained athletes, the role of sleep in the overtraining process is not clear. This study aimed (i) to compare sleep efficiency/quantity at the start of a competition phase in elite adolescent sprinters who adapted to prior training with that in those who maladapt and (ii) to examine the influence of prior training, fatigue, and sleep on performance through a moderated mediation model. Fatigue (via Profile of Mood State) and internal training load (via session rating of perceived exertion and duration of training as volume) were measured in 20 sprinters (mean age: 15.9 ± 1.7 years) across 4 mesocycles (baseline (T1); preparatory (T2); precompetitive (T3); and competitive (T4) phases), over 26 weeks. Performances were assessed during the competitive period (T3, T4), while sleep was monitored (via actigraphy) for a week during T4. It was inferred that sprinters who had increasingly greater fatigue and concomitant decrements in performance (35%) were maladapted to training and the remaining sprinters who improved fatigue and performance (65%) were adapted to training. Sleep efficiency (91 ± 3% vs. 82 ± 3%, p < 0.001) and quantity (425 ± 33 min vs. 394 ± 20 min, p < 0.001) at the start of T4 were significantly greater in sprinters who adapted. Moreover, higher prior training volume (mean of T1 to T3 training volume) was associated with lower sleep efficiency at the start of T4 (R 2 = 0.55, p < 0.001) which was associated with poorer performance (R 2 = 0.82, p < 0.001). Fatigue moderated the indirect effect of prior training volume on performance through its moderation of the effect of sleep efficiency on performance (R 2 = 0.89, p < 0.001). Impaired sleep as a result of greater prior training volume may be related to performance decrements through fatigue. Athletes should improve sleep during periods of higher training volume to reduce fatigue for better adaptation to training.
High-intensity eccentric exercise can cause a delayed onset of muscle soreness (DOMS), a short-term condition characterized by muscle damage and tenderness that might hold up recovery and jeopardize exercise routine. Previous studies indicated that hydrogen-rich water (HRW) might be a helpful topical intervention to boost recovery in musculoskeletal medicine, yet no data are available concerning the effectiveness and safety of whole-body bathing with supersaturated HRW after DOMS-inducing exercise. This study evaluates the effects of a single-session bathing with HRW on biochemical markers of muscular damage in healthy young men. The six volunteers who were exposed to DOMS-inducing eccentric exercise were assigned to either supersaturated HRW or control whole-body bathing in a double-blind crossover design. Immediately after an exercise session, the participants were immersed up to the neck into a 200 L bathtub with supersaturated HRW (8 mg of H2 per L) or control water (no hydrogen) for 30 min. Blood biomarkers of inflammation and muscular damage and Visual Analogue Scale (VAS) scores for muscle soreness were assessed at baseline (before exercise) and at 24-hour follow-up. Two-way ANOVA revealed a significant difference between two groups in serum creatine kinase (CK) response over the period of intervention (P=0.04). A single-session bathing in HRW prevented a rise in circulating biomarkers of muscular damage induced by exercise at 24-hour follow-up, retaining the levels of all biomarkers similar to the baseline values (P > 0.05). On the other hand, serum CK, aldolase, and aspartate transaminase were significantly elevated at 24-hour follow-up as compared to the baseline levels after the control bath (342 ± 309 U/L vs. 465 ± 295 U/L; P > 0.05). HRW bath also induced a significant drop in VAS scores for muscle soreness in comparison with control water, both immediately after an intervention (32.7 ± 8.6% vs. 20.0 ± 12.8%; P=0.02) and at 24-hour follow-up (31.6 ± 24.3% vs. 22.4 ± 27.5%; P=0.03), respectively. No participants reported any major side effects during the trial. This pilot study suggests that the whole-body bathing in supersaturated HRW is a safe procedure that attenuates muscular damage and can ease sore muscles after high-intensity eccentric exercise.
Skeletal muscle injuries occur often in athletics and in daily life. In minor injuries, muscles are able to regenerate completely and recover their functional capabilities. However, in the case of severe injuries, the injured muscle cannot recover to a functional level because of the formation of fibrous scar tissue. The physical barrier of scars is significantly challenged in both research and clinical treatment. Fibrous scar tissue not only limits cells' migration, but also contributes to normal tissue biomechanical properties. This scar formation creates an unsuitable environment for tissue structure resulting in frequent pain. Antifibrosis treatment is one of the major strategies used to augment muscle regeneration and accelerate its functional recovery. This review will discuss the currently available methods for improving muscle regeneration with a specific focus on antifibrosis applications. We also discussed several novel hypotheses and clinical applications in muscle fibrosis treatment currently in practice.
Assessment of hematological parameters is common in sports medicine. Although physical exercise is an important preanalytical variable, data about acute hematological changes after high-intensity intermittent exercise are scarce. This study aimed to examine floorball as a potential preanalytical variable for hematological parameters used in health assessment and antidoping testing. Twenty-three professional male floorball players participated in a floorball game. Hematological parameters including hemoglobin, erythrocyte count and erythrocyte indices, reticulocytes, white blood cells (WBC), platelets, reticulocytes, and OFF-hr score were assessed at baseline, immediately postgame, and at 2 h postgame. Median hemoglobin concentration decreased significantly from 146 g/L pregame to 141 g/L immediately postgame (p < 0.001). WBC count increased from 7.2 × 109/L pregame to 10.1 × 109/L 2 h postgame (p < 0.001). The median OFF-hr score decreased from 99.5 to 94.2 immediately postgame and remained significantly lower than baseline at 2 h postgame (94.4, p=0.030). Looking at individual results, the highest OFF-hr score increased from 120 at baseline to 124 at 2 h postgame. Our findings suggest that participation in a floorball game affects several hematological parameters and consequently can affect health assessment and antidoping testing.
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