Sports Medicine and Health Science最新文献

Decreased mechanical loading after orthopaedic surgery predisposes patients to develop muscle atrophy. The purpose of this review was to assess whether the evidence supports oral protein supplementation can help decrease postoperative muscle atrophy and/or improve patient outcomes following orthopaedic surgery. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). PubMed (MEDLINE), Embase, Scopus, and Web of Science were searched for randomized controlled trials that assessed protein or amino acid supplementation in patients undergoing orthopaedic surgery. Two investigators independently conducted the search using relevant Boolean operations. Primary outcomes included functional or physiologic measures of muscle atrophy or strength. Fourteen studies including 611 patients (224 males, 387 females) were analyzed. Three studies evaluated protein supplementation after ACL reconstruction (ACLR), 3 after total hip arthroplasty (THA), 5 after total knee arthroplasty (TKA), and 3 after surgical treatment of hip fracture. Protein supplementation showed beneficial effects across all types of surgery. The primary benefit was a decrease in muscle atrophy compared to placebo as measured by muscle cross sectional area. Multiple authors also demonstrated improved functional measures and quicker achievement of rehabilitation benchmarks. Protein supplementation has beneficial effects on mitigating muscle atrophy in the postoperative period following ACLR, THA, TKA, and surgical treatment of hip fracture. These effects often correlate with improved functional measures and quicker achievement of rehabilitation benchmarks. Further research is needed to evaluate long-term effects of protein supplementation and to establish standardized population-specific regimens that maximize treatment efficacy in the postoperative period.

Little is known about the prevalent nationalities among the best-placed athletes participating in “Ironman Hawaii.” Moreover, the age at which athletes achieve their best performances remains unclear. The present study aimed to compare the prevalent nationalities among the athletes, their respective placement among the top five, and the performance difference between the different age groups in ‘Ironman Hawaii’ from 2003 to 2019. A total of 30 354 amateur triathletes were selected from the Obsessed Triathlete (OBSTRI) website. A “TOP 5” division filter was applied for further analysis, resulting in 1 851 athletes being included in this study. Among the male runners, Americans participated the most in Ironman events (39%), followed by Germans (10%). Among female runners, Americans participated the most (54%), followed by Australian runners (8%). Male Americans also featured most among the top five (30%), followed by Germans (16%). Female Americans were the most prevalent among the top five (47%), followed by Australian Americans (10%). There were no significant performance differences (p ​> ​0.05) between the 25–29 and 40–44 age groups for either sex. The 45–49 age group presented significantly worse performance than the 35–39 age group for both sexes (p ​< ​0.001). North Americans were the most performant and frequent participants in “Ironman Hawaii.” The expected performance decline due to aging was observed after 45 years in both sexes.

Muscle atrophy exacerbates disease outcomes and increases mortality, whereas the preservation of skeletal muscle mass and function play pivotal roles in ensuring long-term health and overall quality-of-life. Muscle atrophy represents a significant clinical challenge, involving the continued loss of muscle mass and strength, which frequently accompany the development of numerous types of cancer. Cancer cachexia is a highly prevalent multifactorial syndrome, and although cachexia is one of the main causes of cancer-related deaths, there are still no approved management strategies for the disease. The etiology of this condition is based on the upregulation of systemic inflammation factors and catabolic stimuli, resulting in the inhibition of protein synthesis and enhancement of protein degradation. Numerous necessary cellular processes are disrupted by cachectic pathology, which mediate intracellular signalling pathways resulting in the net loss of muscle and organelles. However, the exact underpinning molecular mechanisms of how these changes are orchestrated are incompletely understood. Much work is still required, but structured exercise has the capacity to counteract numerous detrimental effects linked to cancer cachexia. Primarily through the stimulation of muscle protein synthesis, enhancement of mitochondrial function, and the release of myokines. As a result, muscle mass and strength increase, leading to improved mobility, and quality-of-life. This review summarises existing knowledge of the complex molecular networks that regulate cancer cachexia and exercise, highlighting the molecular interplay between the two for potential therapeutic intervention. Finally, the utility of mass spectrometry-based proteomics is considered as a way of establishing early diagnostic biomarkers of cachectic patients.

Poor cardiorespiratory fitness may mediate vascular impairments at rest and following an acute bout of exercise in young healthy individuals. This study aimed to compare flow mediated dilation (FMD) and vascular augmentation index (AIx75) between young adults with low, moderate, and high levels of cardiorespiratory fitness before and after an acute bout of aerobic exercise. Forty-three participants (22 men; 21 women) between 18 and 29 years of age completed the study. Participants were classified into low, moderate, and high health-related cardiorespiratory fitness groups according to age- and sex-based relative maximal oxygen consumption ($\dot{V}$O₂ max) percentile rankings. FMD was performed using Doppler ultrasound and AIx75 was performed using pulse wave analysis at baseline and 60-min after a 30-min bout of treadmill running at 70% $\dot{V}$O₂ max. A significant interaction (p ​= ​0.047; η_p² ​= ​0.142) was observed, with the moderate fitness group exhibiting a higher FMD post-exercise compared with baseline ([6.7% ​± ​3.1%] vs. [8.5% ​± ​2.8%], p ​= ​0.028; d ​= ​0.598). We found a significant main effect of group for AIx75 (p ​= ​0.023; η_p² ​= ​0.168), with the high fitness group exhibiting lower AIx75 compared to low fitness group ([−10% ​± ​10%] vs. [2% ​± ​10%], respectively, p ​= ​0.019; g ​= ​1.07). This was eliminated after covarying for body fat percentage (p ​= ​0.489). Our findings suggest that resting FMD and AIx75 responses are not significantly influenced by cardiorespiratory fitness, but FMD recovery responses to exercise may be enhanced in individuals with moderate cardiorespiratory fitness levels.

Oxygen uptake ($\dot{V}$ O₂) was measured during a non-exhaustive high-intensity intermittent cross-exercise (HIICE) protocol consisting of four alternating bouts of 20 ​s running (R) and three bouts of bicycle exercise (BE) at ∼160% and ∼170% maximal oxygen uptake ($\dot{V}$ O₂max), respectively, with 10 ​s between-bout rests (sequence R-BE-R-BE-R-BE-R). The $\dot{V}$ O₂ during the last BE ([52.2 ​± ​5.0] mL·kg⁻¹·min⁻¹) was significantly higher than the $\dot{V}$ O₂max of the BE ([48.0 ​± ​5.4] mL·kg⁻¹·min⁻¹, n ​= ​30) and similar to that of running. For clarifying the underlying mechanisms, a corresponding HIICE-protocol with BE and arm cranking ergometer exercise (AC) was used (sequence AC-AC-BE-AC-BE-AC-AC-BE). In some experiments, thigh blood flow was occluded by a cuff around the upper thigh. Without occlusion, the $\dot{V}$ O₂ during the AC ([39.2 ​± ​7.1] mL·kg⁻¹·min⁻¹ [6^th bout]) was significantly higher than the $\dot{V}$ O₂max of AC ([30.2 ​± ​4.4] mL·kg⁻¹·min⁻¹, n ​= ​7). With occlusion, the corresponding $\dot{V}$ O₂ ([29.8 ​± ​3.9] mL·kg⁻¹·min⁻¹) was reduced to that of the $\dot{V}$ O₂max of AC and significantly less than the $\dot{V}$ O₂ without occlusion. These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise, probably because it is a summation of the $\dot{V}$ O₂ for the ongoing exercise plus excess post-oxygen consumption (EPOC) produced by the previous exercise with a higher $\dot{V}$ O₂max.

A 23-year-old professional distance runner with several years of exertional calf pain was diagnosed with a unique mixed type III and functional popliteal artery entrapment syndrome (PAES). Surgical reduction of the obstructing tissue allowed her to return to professional running. This case highlights the importance of including PAES in the differential for chronic intermittent lower extremity claudication and outlines the work-up required to diagnose this vascular obstruction in younger athletes.

Chronic neck pain (CNP) is a worldwide health problem with several risk factors. One of the most widely used treatments for managing this condition is therapeutic exercise, which could generate a response called exercise-induced hypoalgesia (EIH). There is no consensus on the best exercise modality to induce hypoalgesia. Therefore, this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP. We included articles on EIH and CNP in patients older than 18 years, with pain for more than three months, where the EIH response was measured. Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded. The studies reviewed reported variable results. Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity; however, in people with chronic pain, the response is variable. Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity, others found no clinical response, and some even reported EIH with decreased pain and increased sensitivity. EIH is an identifiable, stimulable, and helpful therapeutic response in people with pain. More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon. In addition, it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

To explore the reasons for low levels of physical activity in obese/overweight children and adolescents and to propose appropriate strategies to promote their physical activity (PA). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by searching and analyzing the literature of studies related to physical activity in obese/overweight children and adolescents published between January 2003 and January 2023 in Web of Science, Scopus, and PubMed databases. A total of 31 relevant studies were included for analysis, of which 16 were quantitative and 15 qualitative. According to these studies, the PA of obese/overweight children and adolescents is mainly constrained by negative factors: Individual, interpersonal, and environmental. Among these factors, low levels of individual motivation and psychological sensitivity and vulnerability, lack of family support, negative social feedback, insufficient protection from government policies, and inadequate support from the built environment are the main reasons that constrain their PA. The promotion of PA in obese/overweight children and adolescents, who are subject to more constraints at all levels, requires a system of security that involves the government, the community, the school, and the family to address the problems they encounter and enhance the sustainability of engagement in PA.