Journal of Sports Medicine最新文献

Objectives: Overtraining syndrome (OTS), a common dysfunction among elite athletes, causes decreased performance and fatigue and has no standardized diagnostic criteria. The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study identified more than 45 potential biomarkers of OTS. In the present study, we hypothesized that combinations of these biomarkers could be an accurate diagnostic tool for OTS.

Methods: We selected parameters with largest difference and fewest overlapping results compared to healthy athletes and highest feasibility and reproducibility. Among the multiple combinations attempted, we chose those that did not show overlapping results, according to the objective.

Results: We included 11 clinical parameters, 4 basal hormones, and 5 hormonal responses in Insulin Tolerance Test (ITT). The three selected diagnostic tools were the (i) EROS-CLINICAL, with only clinical parameters, which was suitable as an initial assessment for athletes suspected of OTS; (ii) EROS-SIMPLIFIED, with clinical parameters and basal hormones, when the EROS-CLINICAL was inconclusive; and (iii) EROS-COMPLETE, with basal and hormonal responses to stimulation tests, which was valuable for population-based screening, research purposes, and unusual presentations of OTS.

Conclusion: We identified innovative tools with 100% accuracy for the diagnosis of OTS, without the need to exclude confounding disorders.

The aim of the study was to describe the changes in kidney parameters induced by 10 days of tapering (TP) during a training camp (TC), where the players were preparing for a group competition, in 15 female handball team members of a Division 1 Amateur of Benin, in the sub-Saharan environment. Measures were taken in all the players before and after the intensive training (IT) and tapering (TP) phases in an intervention study. The estimated glomerular filtration rate (eGFR) with the CKD-EPI 4-level race formula, the fractional excretions of sodium (FeNa) and potassium (FeK), the urine potassium-to-sodium ratio (Na/K urine), and the hemoglobin rate [Hb] were determined for all participants. At the end of IT, eGFR and FeNa increased, respectively, by 22.39% (P < 0.01) and 143.85% (P < 0.01), but the variation of FeK is not significant (P > 0.05). The number of abnormally low eGFR values (<90 mL/min/1.73 m²) was reduced from 11 to 5 (P < 0.05). At the end of TP, the eGFR and urine Na-to-K ratio remained on average constant (P > 0.05) but FeNa decreased by 96.32% (P < 0.001) and FeK increased by 144.41% (P < 0.001). The [Hb] rate increased by 9.80% (P < 0.001), and players had inadequate hydration practice. The results suggested that in addition to its already known effects, TP preserves the positive effects of IT on glomerular function in athletes preparing for a competition that presents a major challenge.

Lumbar spondylolysis is a unilateral or bilateral defect of the pars interarticularis, an isthmus of bone connecting the superior and inferior facet surfaces in the lumbar spine at a given level. Spondylolysis is common in young athletes participating in sports, particularly those requiring repetitive hyperextension movements. The majority of young athletes are able to return to full sport participation following accurate diagnosis and conservative management, including a structured treatment program. Surgical intervention for isolated pars injuries is seldom necessary. A progressive physical therapy (PT) program is an important component of recovery after sustaining an acute pars fracture. However, there is a paucity of literature detailing PT programs specific to spondylolysis. Here, we provide an overview of the epidemiology, natural history, radiographic evaluation, and management of pars fractures in young athletes. In addition, a detailed description of a physiotherapy program for this population that was developed at a spine center within an academic medical center is provided.

Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p < 0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p < 0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25-50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10-15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13-19-year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.

Many studies have validated the use of bioimpedance analysis (BIA) to quantify body fat percentage (BF%). However, it is unknown if some model types (i.e., hand to hand, foot to foot, and hand to foot) are differing in their validity depending on hip and waist circumferences. The purpose of this study was to compare the difference in BF% between three BIA models (i.e., hand to hand, foot to foot, and hand to foot) against the Bod Pod across different hip and waist circumferences. A total of 92 people aged 19-72 years were recruited in this study. After following the pretesting procedures recommended for BIA measures, BF% was estimated using three BIA models and the Bod Pod. Hip and waist circumferences were obtained using standard procedures and tertiles were computed. The Bland-Altman was plotted and 1-sample T-test as well as correlation between the average measure and the difference between the two measures was tested. Within the entire sample, across all BIA models, the Bland-Altman analysis showed significant difference compared to 0 and a significant difference for the proportional. However, when stratified by tertiles, the two measurements were only significant for the highest tertiles of hip and waist for all BIA apparatus (all p <0.01) and the proportional bias was nonsignificant for all tertiles and across all BIA apparatus. For the highest tertile of waist and hip, the average difference was between 1.67% and 3.29% compared with the Bod Pod estimation. In conclusion, the three BIA models offer a BF% measurement agreeing with the estimation obtained with the Bod Pod with the exception of people having a greater waist or greater hip.

Purpose: This study compared gender differences in eating disorder risk among NCAA Division I cross country and track distance running student-athletes.

Methods: Six hundred thirty-eight male and female student-athletes competing at distances of 800m or greater completed the Eating Disorder Screen for Primary Care (ESP). Scores on the ESP were used as the risk of eating disorders.

Results: Females screened positive at higher rates for risk of eating disorders than males on the ESP at a cutoff of 2 (sensitivity 90-100%, specificity 71%) with rates of 45.95% ± 3.03 and 13.66% ± 1.80, respectively. Females were also screened positive at higher rates than males at a stricter cutoff of 3 (sensitivity 81%, specificity 92%), with rates of 21.69% ± 2.50 compared to 4.64% ± 1.10, respectively.

Conclusion: This study highlights that, among distance runners, both males and females are at risk of eating disorders, with females being at higher risk. It also emphasizes the need for screening for risk of eating disorders in this population.

Background: Several anthropometric equations that estimate skeletal muscle mass (SMM) have been published, but their applicability and accuracy among athletes are still uncertain.

Purpose: To assess the accuracy of different anthropometric equations that estimate SMM in professional male soccer players, as compared to dual-energy X-ray absorptiometry (DXA) as the reference method.

Methods: In this cross-sectional study, we evaluated 179 professional male soccer players aged between 18 and 37 years. Anthropometric measurements (height, body weight, skinfold thicknesses, and girths) and a DXA whole body scan were performed the same day for each participant, and SMM was estimated with nine anthropometric equations (Heymsfield, Martin, Doupe, Kerr, Drinkwater, Lee, De Rose, and two equations published by Kuriyan). To determine differences between SMM estimated with anthropometric equations and SMM evaluated with DXA, a Kruskal-Wallis test was performed using Dunn's test as post hoc. The significance level was set at p < 0.05. We calculated the mean difference and 95% limits of agreement for the analyzed equations (Equation - DXA).

Results: Only Heymsfield's and Lee's equations showed no significant differences with DXA. Heymsfield's equation had the smallest mean difference (-0.17 kg), but wider limits of agreement with DXA (-6.61 to 6.94 kg). Lee's equation had a small mean difference (1.10 kg) but narrower limits of agreement with DXA (-1.83 to 4.03 kg).

Conclusions: In this study, the prediction equation published by Lee et al. showed the best agreement with DXA and is able to estimate SMM accurately in professional male soccer players.

Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career. These flow limitations are due to extreme hemodynamic stress which may result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair. However, current diagnostic techniques have unsatisfactory sensitivity and cannot be applied during exercise. Near-infrared spectroscopy (NIRS) has shown great diagnostic potential in peripheral vascular disease and might bring a solution since it measures tissue oxygenation in real time during and after exercise. This report describes the first experiences of the application of NIRS in the vastus lateralis muscle during and after maximal graded cycling exercise in ten healthy participants and in three patients with flow limitations due to (1) subtle functional kinking, (2) an intravascular lesion, and (3) severe functional kinking. The results are put into perspective based on an empirically fitted model. Delayed recovery, showing clearly different types of patterns of tissue reoxygenation after exercise, was found in the affected athletes compared with the healthy participants. In the patients that had kinking of the arteries, tissue reoxygenation was clearly more delayed if NIRS was measured in provocative position with flexed hip. In this pilot experiment, clearly distinctive reoxygenation patterns are observed during recovery consistent with severity of flow limitation, indicating that NIRS is a promising diagnostic tool to detect and grade arterial flow limitations in athletes. Our findings may guide research and optimization of NIRS for future clinical application.

Background/objective: Not only but particularly due to their time efficiency, High-Intensity Interval Training (HIIT) is becoming increasingly popular in fitness-oriented endurance sports. The purpose of this study was to determine the effect of a HIIT running program versus a Moderate Intensity Continuous Exercise (MICE) training running program (16 weeks each) on lactate kinetics in untrained males.

Methods: 65 healthy but untrained males (30-50 years, BMI: 27.2 ± 3.7kg/m²) were randomly assigned to either an HIIT (n=33) or a waiting-control/MICE group (n=32). HIIT consisted of intervals and intense continuous running bouts at or above the individual anaerobic threshold (IANS, 95-110% of IANS-HR), while MICE focused on continuous running at 70-82.5% IANS-HR. Both programs were adjusted for "total workload". Study endpoints were time to IANS and time from IANS till "time to exhaustion" (TTE) as assessed by stepwise treadmill test.

Results: In both exercise groups time to reach IANS (MICE: 320 ± 160 s versus HIIT: 198 ± 118 s) increased significantly (p<.001), with the groups differing significantly (p<.001). Time from IANS until TTE was prolonged significantly among the HIIT group (27 ± 66s, p=.030), while among the MICE group a significant reduction of time from IANS until TTE (59 ± 109s; p=.017) was determined. Between-group difference is significant (p=.003) for this parameter. In both groups TTE increased significantly (HIIT: 27.2 ± 17.7% versus MICE: 29.0 ± 19.4%, both p<.001) at a similar level (p=.279).

Conclusion: HIIT and MICE protocols, when adjusted for total workload, similarly increased running performance in untrained male subjects; however, the underlying mechanisms differ fundamentally. Due to its effects on aerobic and anaerobic performance improvement, HIIT can be recommended for untrained individuals as a time-efficient alternative or complementary training method to MICE. However, our protocol did not confirm the general superiority of HIIT versus MICE on the key endurance parameter "time to exhaustion" that has been reported by other comparative exercise studies.

Introduction: The goal of this study was to describe the echocardiographic parameters of soccer referees and to examine the changes in these parameters after a period of intensive physical exercise.

Methods and patients: We conducted a prospective study that included Beninese soccer referees. The study of the geometry and function of the left ventricle (LV) was made at the beginning and end of the national Division 1 championship, which was held during the course of 10 weeks.

Results: There were 37 referees included in this study; 20 at the national level (G1: 27.8 ± 6.6 years) and 17 at the international level (G2: 32.1 ± 6.4 years). Dimensions of the LV were normal for all the referees. At the beginning of the championship, 51.3% of the referees had a normal LV geometry, 37.8% had concentric remodelling, 2.7% had concentric hypertrophy, and 8.1% had eccentric hypertrophy. In the group of referees with normal LV geometry, a modification in concentric remodelling at the end of the championship was seen in 30% of the referees in G1, 33.3% of the referees in G2, and 31.6% of the whole sample. In the group of subjects who presented concentric LV remodelling, a modification in the normal geometry was observed in 37.5% of those in G1, in 0% of those in G2, and in 21.4% of the whole sample. The cases of LV hypertrophy showed no change regardless of the group considered. An LV ejection fraction of more than 50% and an E/E' ratio less than 8 were found in all referees.

Conclusion: All the referees studied had normal cardiac morphology and function. The intensity of the physical load was insufficient to impact this morphology.