Wellness, fatigue and physical performance acclimatisation to a 2-week soccer camp at 3600 m (ISA3600)

Performance variables and nutritional status analysis from Moroccan professional and adolescent football players during the competition period: a descriptive study

Introduction

Nutrition plays an integral role in optimizing football players' performance during training sessions and matches and maintaining their overall health throughout the season. This study aimed to evaluate how well the dietary practices of professional and adolescent football players in Morocco during the competitive period met international macronutrient recommendations, and to explore the relationship between their nutritional status and aerobic performance, as measured by the Yo-Yo IRL1 test.

Methods

A total of 277 footballers from Morocco's professional league, "Botola-Pro", were monitored over a seven-day (training microcycle) during the competitive period. The dietary intake was assessed through self-reported methods and 24-hour recalls. Relevant body composition was measured with bioelectrical impedance (BI), and aerobic performance was evaluated using the Yo-Yo IR test.

Results

The results indicated significant variations in performance and nutritional status across different categories and age groups. The nutritional status of the players didn't match the UEFA recommendations (p < 0.001). We found that higher intake levels of carbohydrates and proteins were positively correlated with the total distance covered by the players (p < 0.001, r = 0.63, R2 = 0.4 for carbohydrates; p < 0.001, r = 0.59, R2 = 0.35 for proteins). Conversely, a higher proportion of energy derived from fats in the diet was negatively correlated with the distance covered (p < 0.001, r = -0.64, R2 = 0.41).

Conclusion

These findings suggest that optimizing carbohydrates and protein intake while managing fat consumption is crucial for enhancing sporting performance. This information is essential for tailoring training programs and nutritional regimens based on the competition level.

Effects of 8 weeks pre-season training on physical fitness, heart rate variability and cognition in women soccer players

The aim of this study was to explore the variations (pre-post) of (i) Anthropometric measures: weight, body mass index, lean and muscle mass, (ii) Physical fitness: countermovement jump (CMJ) and VO2max, (iii) heart rate variability (HRV) (recumbent and sitting): mean RR, RMSSD, NN50 and NN50 %, (iv) Psychomotor Vigilance Task, and v) SART: ACC Go, ACC NoGo and reaction times in semi-professional women soccer players from the second division of the Spanish League. The analysis indicated that lean mass improved after the observation period (p = .05, d = -0.38), while no other significant changes in anthropometric measures were observed. Additionally, CMJ and aerobic power were also improved (p<.01, d>0.50). The RMSSD [recumbent (d = -0.73) and sitting (d = -0.52)] and NN50 [recumbent (d = -0.69) and sitting (d = -0.70)] increased after the period of observation (p < .05). Reaction time also significantly improved after the period of observation [PVT (d = 0.42) and SART (d = -0.89)]. Correlations performed between measures revealed that smaller body mass and body mass index were largely associated with greater NN50 (r < 0.83, p = .001). Additionally, greater CMJ and aerobic fitness were associated with greater HRV [recumbent (r = -51, p = .001) and sitting (r = -0.60, p = .01). The main findings of this study were that there was no relationship between cognitive performance and physical fitness, but HRV was related to body composition and physical fitness during the pre-season in women soccer players.

Study on the dynamic effects of plateau hypoxic and cold environment on the thermal adaptation of short-term sojourners in Xizang

The plateau hypoxic environment can affect the thermoregulation process of the human body, and due to the different acclimatization ability to the hypoxic environment, the thermal requirements among the people who enter Xizang at different times may be different. Accordingly, this study aims to clarify how plateau hypoxic environments influence the physiological and subjective responses of people entering Xizang at different times. And field experiments were conducted in Xi'an and Lhasa, respectively, to compare the thermal responses and oxygen responses of the subjects under different temperature conditions on the plain, the first day of entering Xizang and the 15th day of entering Xizang. The results showed that under the hypoxic environment, the thermal sensation of the subjects decreased. With the extension of the time entering Xizang, the influence of the hypoxic environment on thermal comfort was gradually weakened, but under the low temperature environment, the effect of hypoxia on thermal response was not significantly reduced. The results of this study can help to reveal how plateau hypoxic environments affect human thermal comfort and provide a theoretical basis for the design of indoor thermal environment parameters suitable for sojourners entering Xizang at different times.

Submaximal Fitness Test in Team Sports: A Systematic Review and Meta-Analysis of Exercise Heart Rate Measurement Properties

BACKGROUND

Submaximal fitness tests (SMFT) are a pragmatic approach for evaluating athlete's physiological state, due to their time-efficient nature, low physiological burden and relative ease of administration in team sports settings. While a variety of outcome measures can be collected during SMFT, exercise heart rate (HRex) is the most popular. Understanding the measurement properties of HRex can support the interpretation of data and assist in decision making regarding athlete's current physiological state and training effects.

OBJECTIVES

The aims of our systematic review and meta-analysis were to: (1) establish meta-analytic estimates of SMFT HRex reliability and convergent validity and (2) examine the moderating influence of athlete and protocol characteristics on the magnitude of these measurement properties.

METHODS

We conducted a systematic literature search with MEDLINE, Scopus and Web of Science databases for studies published up until January 2022 since records began. Studies were considered for inclusion when they  included team sports athletes and the reliability and/or convergent validity of SMFT HRex was investigated. Reliability statistics included the group mean difference (MD), typical error of measurement (TE) and intraclass correlation coefficient (ICC) derived from test-retest(s) designs. Pearson's correlation coefficient (r) describing the relationship between SMFT HRex and a criterion measure of endurance performance was used as the statistic for convergent validity. Qualitative assessment was conducted using risk of bias assessment tool for non-randomised studies. Mixed-effects, multilevel hierarchical models combined with robust variance estimate tests were performed to obtain pooled measurement property estimates, effect heterogeneity, and meta-regression of modifying effects.

RESULTS

The electronic search yielded 21 reliability (29 samples) and 20 convergent validity (29 samples) studies that met the inclusion criteria. Reliability meta-analysis indicated good absolute (MD = 0.5 [95% CI 0.1 to 0.9] and TE = 1.6 [95% CI 1.4 to 1.9] % points), and high relative (ICC = 0.88 [95% CI 0.84 to 0.91]) reliability. Convergent validity meta-analysis indicated an inverse, large relationship (r = - 0.58 [95% CI - 0.62 to - 0.54]) between SMFT HRex and endurance tests performance. Meta-regression analyses suggested no meaningful influence of SMFT protocol or athlete characteristics on reliability or convergent validity estimates.

CONCLUSIONS

Submaximal fitness test HRex is a reliable and valid proxy indicator of endurance performance in team sport athletes. Athlete and SMFT protocol characteristics do not appear to have a meaningful effect on these measurement properties. Practitioners may implement SMFT HRex for monitoring athlete's physiological state by using our applied implications to guide the interpretation of data in practice. Future research should examine the utility of SMFT HRex to track within-athlete changes in aerobic capacity, as well as any further possible effects of SMFT protocols design elements or HRex analytical methods on measurement properties. Registration Protocol registration can be found in Open Science Framework and available through https://doi.org/10.17605/OSF.IO/9C2JV .

Psychophysiological Responses to a Preseason Training Camp in High-Level Youth Soccer Players

PURPOSE

This study aimed to examine the responsiveness of commonly used measurement instruments to a short training camp by examining the time course of psychophysiological responses in high-level youth soccer players.

METHODS

Monitoring was carried out in 14 U15 male soccer players of 1 professional youth academy. Players provided data 3 days prior to (D - 3), during (D2-D4), and 1 (D + 1) and 4 days (D + 4) after the camp: 4 items for the Short Recovery and Stress Scale (SRSS), a countermovement jump (CMJ), and a submaximal run to assess exercise heart rate and heart-rate recovery. Training load during the camp followed an alternating low-high pattern, with lower training loads on D1 and D3 and higher training loads on D2 and D4.

RESULTS

Changes in SRSS physical performance capability, emotional balance, overall recovery, muscular stress, and overall stress were small to moderate on D3 and moderate to large on D + 1, while changes were trivial on D + 4. Some CMJ parameters related to the eccentric phase were slightly improved on D3, and these parameters were slightly impaired on D4. Changes in CMJ parameters were trivial on D + 1 and D + 4. After a moderate decrease in exercise heart rate on D3, there was a small decrease on D + 4 and a moderate increase in heart-rate recovery.

CONCLUSION

Measurement instruments such as the SRSS and submaximal runs can be used to monitor acute psychophysiological responses to load, while the CMJ may provide little insight during periods of intensified training load.

Remote ischemic preconditioning enhances aerobic performance by accelerating regional oxygenation and improving cardiac function during acute hypobaric hypoxia exposure

Remote ischemic preconditioning (RIPC) may improve exercise performance. However, the influence of RIPC on aerobic performance and underlying physiological mechanisms during hypobaric hypoxia (HH) exposure remains relatively uncertain. Here, we systematically evaluated the potential performance benefits and underlying mechanisms of RIPC during HH exposure. Seventy-nine healthy participants were randomly assigned to receive sham intervention or RIPC (4 × 5 min occlusion 180 mm Hg/reperfusion 0 mm Hg, bilaterally on the upper arms) for 8 consecutive days in phases 1 (24 participants) and phase 2 (55 participants). In the phases 1, we measured the change in maximal oxygen uptake capacity (VO₂max) and muscle oxygenation (SmO₂) on the leg during a graded exercise test. We also measured regional cerebral oxygenation (rSO₂) on the forehead. These measures and physiological variables, such as cardiovascular hemodynamic parameters and heart rate variability index, were used to evaluate the intervention effect of RIPC on the changes in bodily functions caused by HH exposure. In the phase 2, plasma protein mass spectrometry was then performed after RIPC intervention, and the results were further evaluated using ELISA tests to assess possible mechanisms. The results suggested that RIPC intervention improved VO₂max (11.29%) and accelerated both the maximum (18.13%) and minimum (53%) values of SmO₂ and rSO₂ (6.88%) compared to sham intervention in hypobaric hypoxia exposure. Cardiovascular hemodynamic parameters (SV, SVRI, PPV% and SpMet%) and the heart rate variability index (Mean RR, Mean HR, RMSSD, pNN50, Lfnu, Hfnu, SD1, SD2/SD1, ApEn, SampEn, DFA1and DFA2) were evaluated. Protein sequence analysis showed 42 unregulated and six downregulated proteins in the plasma of the RIPC group compared to the sham group after HH exposure. Three proteins, thymosin β4 (Tβ4), heat shock protein-70 (HSP70), and heat shock protein-90 (HSP90), were significantly altered in the plasma of the RIPC group before and after HH exposure. Our data demonstrated that in acute HH exposure, RIPC mitigates the decline in VO₂max and regional oxygenation, as well as physiological variables, such as cardiovascular hemodynamic parameters and the heart rate variability index, by influencing plasma Tβ4, HSP70, and HSP90. These data suggest that RIPC may be beneficial for acute HH exposure.

Etiology and Recovery of Neuromuscular Function Following Academy Soccer Training

Aim: To profile the etiology and recovery time-course of neuromuscular function in response to a mixed-content, standard training week in professional academy soccer players. We concurrently examined physical performance, cognitive function, and perceptual measures of mood and wellness states to identify a range of simple tests applied practitioners could use in the field as surrogate measures of neuromuscular function.

Methods: Sixteen professional academy soccer players completed a range of neuromuscular, physical, perceptual, mood, and cognitive function tests at baseline and after a strenuous training day (pitch and gym), with retest at 24, 48, and 72 h, and further pitch and gym sessions after 48 h post-baseline. Maximal voluntary contraction force (MVC) and twitch responses to electrical stimulation (femoral nerve) during isometric knee-extensor contractions and at rest were measured to assess central nervous system (voluntary activation, VA) and muscle contractile (potentiated twitch force, Q_tw,pot) function.

Results: Strenuous training elicited decrements in MVC force post-session (−11%, p = 0.001) that remained unresolved at 72 h (−6%, p = 0.03). Voluntary activation (motor nerve stimulation) was reduced immediately post-training only (−4%, p = 0.03). No change in muscle contractile function (Q_tw,pot) was observed post-training, though was reduced at 24 h (−13%, p = 0.01), and had not fully recovered 72 h after (−9%, p = 0.03). Perceptions of wellness were impaired post-training, and recovered by 24 h (sleepiness, energy) and 48 h (fatigue, muscle soreness, readiness to train). Countermovement jump performance declined at 24 h, while RSI (Reactive Strength Index) decrements persisted at 48 h. No changes were evident in adductor squeeze, mood, or cognitive function.

Conclusion: Elite youth soccer training elicits substantial decrements in neuromuscular function, which are still present 72 h post-strenuous exercise. Though central processes contribute to post-exercise neuromuscular alterations, the magnitude and prolonged presence of impairments in contractile function indicates it is the restitution of muscular function (peripheral mechanisms) that explains recovery from strenuous training in academy soccer players.

Monitoring Acclimatization and Training Responses Over 17–21 Days at 1,800 m in Elite Cross-Country Skiers and Biathletes

Objective

To monitor the daily variations and time course of changes in selected variables during a 17–21-day altitude training camp at 1,800 m in a group of elite cross-country skiers (9 women, 12 men) and biathletes (7 women, 4 men).

Methods

Among other variables, resting peripheral oxygen saturation (SpO_2rest), resting heart rate (HR_rest) and urine specific gravity (USG) were monitored daily at altitude, while illness symptoms were monitored weekly. Before and after the camp, body composition (i.e., lean and fat mass) and body mass were assessed in all athletes, while roller-skiing speed at a blood lactate concentration of 4 mmol·L⁻¹ (Speed_@4mmol) was assessed in the biathletes only.

Results

Neither SpO_2rest, HR_rest nor USG changed systematically during the camp (p > 0.05), although some daily time points differed from day one for the latter two variables (p < 0.05). In addition, body composition and body mass were unchanged from before to after the camp (p > 0.05). Eleven out of 15 illness episodes were reported within 4 days of the outbound or homebound flight. The five biathletes who remained free of illness increased their Speed_@4mmol by ~ 4% from before to after the camp (p = 0.031).

Conclusions

The present results show that measures typically recommended to monitor acclimatization and responses to altitude in athletes (e.g., SpO_2rest and HR_rest) did not change systematically over time. Further research is needed to explore the utility of these and other measures in elite endurance athletes at altitudes typical of competition environments.

Submaximal Fitness Tests in Team Sports: A Theoretical Framework for Evaluating Physiological State

Team-sports staff often administer non-exhaustive exercise assessments with a view to evaluating physiological state, to inform decision making on athlete management (e.g., future training or recovery). Submaximal fitness tests have become prominent in team-sports settings for observing responses to a standardized physical stimulus, likely because of their time-efficient nature, relative ease of administration, and physiological rationale. It is evident, however, that many variations of submaximal fitness test characteristics, response measures, and monitoring purposes exist. The aim of this scoping review is to provide a theoretical framework of submaximal fitness tests and a detailed summary of their use as proxy indicators of training effects in team sports. Using a review of the literature stemming from a systematic search strategy, we identified five distinct submaximal fitness test protocols characterized in their combinations of exercise regimen (continuous or intermittent) and the progression of exercise intensity (fixed, incremental, or variable). Heart rate-derived indices were the most studied outcome measures in submaximal fitness tests and included exercise (exercise heart rate) and recovery (heart rate recovery and vagal-related heart rate variability) responses. Despite the disparity between studies, these measures appear more relevant to detect positive chronic endurance-oriented training effects, whereas their role in detecting negative transient effects associated with variations in autonomic nervous system function is not yet clear. Subjective outcome measures such as ratings of perceived exertion were less common in team sports, but their potential utility when collected alongside objective measures (e.g., exercise heart rate) has been advocated. Mechanical outcome measures either included global positioning system-derived locomotor outputs such as distance covered, primarily during standardized training drills (e.g., small-sided games) to monitor exercise performance, or responses derived from inertial measurement units to make inferences about lower limb neuromuscular function. Whilst there is an emerging interest regarding the utility of these mechanical measures, their measurement properties and underpinning mechanisms are yet to be fully established. Here, we provide a deeper synthesis of the available literature, culminating with evidence-based practical recommendations and directions for future research.

Upper respiratory tract symptom risk in elite field hockey players during a dry run for the Tokyo Olympics

ABSTRACTThe primary aim of this study was to examine if biomarker and/or self-reported data could predict upper respiratory tract symptom (URTS) risk in elite field hockey players. The secondary aim was to investigate the effect of the additional stressor 'repeated heat exposure' on measures of thermoregulation and immunity. A prospective cohort repeated measures study design was used to collect URTS, household illness, self-reported wellness, biomarker and thermoregulatory data from elite male field hockey players (n = 19), during an 8-week training and competition period that simulated the preparatory and competition phases of the 2020 Tokyo Olympics. Heat response testing (HRT) was performed at the beginning of the study period, following heat acclimation (HA) and following an intensified competition period (ICP) played in hot and humid conditions (27-37°C and 53-80% relative humidity). Univariate frailty analysis demonstrated that illness in players' households (Hazard ratio (HR: 4.90; p < 0.001)) and self-reported stress (HR: 0.63; p = 0.043) predicted players' risk for URTS. Additionally, low baseline resting salivary secretory immunoglobulin A (SIgA) concentration predicted players' "potential" URTS risk (p = 0.021). The additional stressor "repeated heat exposure" was found to facilitate partial thermoregulatory adaptation without attenuating resting immune functions. In conclusion, lifestyle and behavioural factors (i.e. household illness and stress) influenced players risk for URTS more so than sport-related stressors. Furthermore, repeated heat exposure did not appear to compromise players resting immunity. To assess athletes' risk for URTS, baseline screening of SIgA concentration and regular monitoring of self-reported lifestyle and behavioural data are recommended.

Sex differences in sleep and influence of the menstrual cycle on women's sleep in junior endurance athletes

Previous research shows that female athletes sleep better according to objective parameters but report worse subjective sleep quality than male athletes. However, existing sleep studies did not investigate variations in sleep and sleep stages over longer periods and have, so far, not elucidated the role of the menstrual cycle in female athletes' sleep. To address these methodological shortcomings, we investigated sex differences in sleep and sleep stages over 61 continuous days in 37 men and 19 women and examined the role of the menstrual cycle and its phases in 15 women. Sleep was measured by a non-contact radar, and menstrual bleeding was self-reported. Associations were investigated with multilevel modeling. Overall, women tended to report poorer subjective sleep quality (p = .057), but objective measurements showed that women obtained longer sleep duration (p < .001), more light (p = .013) and rapid eye movement sleep (REM; hours (h): p < .001, %: p = .007), shorter REM latency (p < .001), and higher sleep efficiency (p = .003) than men. R2 values showed that sleep duration, REM and REM latency were especially affected by sex. Among women, we found longer time in bed (p = .027) and deep sleep (h: p = .036), and shorter light sleep (%: p = .021) during menstrual bleeding vs. non-bleeding days; less light sleep (h: p = .040), deep sleep (%: p = .013) and shorter REM latency (p = .011) during the menstrual than pre-menstrual phase; and lower sleep efficiency (p = .042) and more deep sleep (%: p = .026) during the follicular than luteal phase. These findings indicate that the menstrual cycle may impact the need for physiological recovery, as evidenced by the sleep stage variations. Altogether, the observed sex differences in subjective and objective sleep parameters may be related to the female athletes' menstrual cycle. The paper provides unique data of sex differences in sleep stages and novel insights into the role of the menstrual cycle in sleep among female athletes.

Predictors of upper respiratory tract symptom risk: Differences between elite rugby union and league players

This study examined possible predictors of upper respiratory tract symptom (URTS) episodes in elite rugby union and league players (n = 51) during intensive pre-season training. Baseline saliva and blood samples were collected in the first week of pre-season training for analysis of salivary secretory immunoglobulin A (SIgA) and cytomegalovirus. Thereafter, SIgA, URTS, internal training load and self-reported wellness data were repeatedly measured throughout a 10-week pre-season training period. Univariate frailty model analysis, which included 502 observations, was performed for each rugby code for the following independent predictor variables: SIgA concentration, internal training load, total wellness, sleep quantity, sleep quality and stress. Rugby union and league players experienced a similar number of URTS episodes; however, predictors of URTS episodes differed between the codes. No biomarkers or self-reported measures significantly predicted URTS risk in rugby union players, while reductions in self-reported total wellness (HR: 0.731, p = 0.004) and sleep quality (HR: 0.345, p = 0.001) predicted increased URTS risk in rugby league players. The findings from this study highlight that factors influencing URTS risk are perhaps sport specific and this may be attributed to different sporting demands and/or different management of players by team-practitioners.

The Use of Pulse Oximetry in the Assessment of Acclimatization to High Altitude

Background: Finger pulse oximeters are widely used to monitor physiological responses to high-altitude exposure, the progress of acclimatization, and/or the potential development of high-altitude related diseases. Although there is increasing evidence for its invaluable support at high altitude, some controversy remains, largely due to differences in individual preconditions, evaluation purposes, measurement methods, the use of different devices, and the lacking ability to interpret data correctly. Therefore, this review is aimed at providing information on the functioning of pulse oximeters, appropriate measurement methods and published time courses of pulse oximetry data (peripheral oxygen saturation, (SpO₂) and heart rate (HR), recorded at rest and submaximal exercise during exposure to various altitudes. Results: The presented findings from the literature review confirm rather large variations of pulse oximetry measures (SpO₂ and HR) during acute exposure and acclimatization to high altitude, related to the varying conditions between studies mentioned above. It turned out that particularly SpO₂ levels decrease with acute altitude/hypoxia exposure and partly recover during acclimatization, with an opposite trend of HR. Moreover, the development of acute mountain sickness (AMS) was consistently associated with lower SpO₂ values compared to individuals free from AMS. Conclusions: The use of finger pulse oximetry at high altitude is considered as a valuable tool in the evaluation of individual acclimatization to high altitude but also to monitor AMS progression and treatment efficacy.

Household illness is the strongest predictor of upper respiratory tract symptom risk in elite rugby union players

OBJECTIVES

To identify periods of increased risk for upper respiratory tract symptom (URTS) episodes, and examine whether biomarkers and/or self-reported lifestyle and wellness data can predict URTS risk in elite rugby union players.

DESIGN

Prospective, longitudinal and repeated-measures study.

METHODS

Salivary secretory immunoglobulin A (SIgA), salivary cortisol, URTS, internal training load and self-reported lifestyle and wellness data including household illness, stress, mood, fatigue, muscle soreness and sleep quality were repeatedly measured in elite Southern hemisphere rugby union players (n=28) throughout a season. Univariate frailty model analysis, which included 495 observations, was used to determine predictors of URTS risk.

RESULTS

Surprisingly, the highest incidence of URTS occurred after rest weeks, namely the Christmas break and bye weeks (i.e., no scheduled trainings or matches); whereas URTS risk was reduced during weeks involving international travel (Hazard ratio (HR): 0.43, p<0.001)). Household illness was the strongest predictor of URTS risk; players were almost three-fold more at risk for an URTS episode when illness in the household was present (HR: 2.90, p=0.002). A non-significant, but potentially important trend for an inverse association between SIgA concentration and URTS incidence was also observed (HR: 0.99, p=0.070).

CONCLUSIONS

Rest weeks were identified as periods of increased risk for URTS; while international travel did not appear to increase players risk for URTS. Incidence of household illness and SIgA concentration independently predicted URTS risk, with household illness being the strongest predictor. These findings can assist practitioners monitoring and management of athletes to potentially reduce URTS risk.

Fitness Monitoring in Elite Soccer Players: Group vs. Individual Analyses

Rabbani, A, Kargarfard, M, and Twist, C. Fitness monitoring in elite soccer players; group vs. individual analyses. J Strength Cond Res 34(11): 3250-3257, 2020-The aims of this study were to (a) examine changes in group and individual HR measures during a submaximal warm-up test, and (b) investigate the relationship between accumulated internal training loads and HR changes during an in-season phase among elite soccer players (n = 14). Before and after an in-season phase (24 days), exercise HR (HRex) and HR recovery (HRR) expressed either as the number of beats recovered (HRR60s) or as the mean HR (HRpost1) during 1 minute of recovery were analyzed. Heart rate measures were expressed as the % of maximal HR. Session rating of perceived exertion (sRPE) was computed for all training/match sessions. Group and individual HR changes were analyzed using magnitude-based inferences. Pearson correlation coefficients were also used to examine the relationships. Group analyses of HR changes revealed there were possibly to likely trivial changes in all HR measures. When analyzing individual data, no substantial change was observed for HRR60s%. However, substantial changes in HRex% and HRpost1% were observed for 4/14 and 5/14 players, respectively. The relationships between HRex% and HRpost1% were nearly perfect (r = 0.90, confidence limits [0.82-0.95]). The associations between changes in HRex% and HRpost1% were also nearly perfect (r = 0.92, 0.80-0.97). A very large inverse correlation was observed between HRex% and accumulated sRPE (r = -0.75, -0.44 to -0.90). This study highlights the value of conducting individual vs. group aerobic fitness monitoring. This study also showed the importance of how HRR is reported when aerobic fitness monitoring of elite soccer players.

Reciprocal Associations Between Sleep, Mental Strain, and Training Load in Junior Endurance Athletes and the Role of Poor Subjective Sleep Quality

The importance of adequate sleep for athletic functioning is well established. Still, the literature shows that many athletes report sleep of suboptimal quality or quantity. To date, no research has investigated how bidirectional variations in mental and physiological states influence sleep patterns. The present study, therefore, investigates reciprocal associations between sleep, mental strain, and training load by utilizing a prospective, observational design. In all, 56 junior endurance athletes were followed over 61 consecutive days. Unobtrusive, objective measurements of sleep with novel radar technology were obtained, and subjective daily reports of mental strain and training load were collected. The role of subjective sleep quality was investigated to identify whether the reciprocal associations between sleep, mental strain, and training load depended on being a good versus poor sleeper. Multilevel modeling with Bayesian estimation was used to investigate the relationships. The results show that increases in mental strain are associated with decreased total sleep time (TST, 95% CI = −0.12 to −0.03), light sleep (95% CI = −0.08 to −0.00), and sleep efficiency (95% CI = −0.95 to −0.09). Further, both mental strain and training load are associated with subsequent deceased rapid eye movement (REM, respectively, 95% CI = −0.05 to −0.00 and 95% CI = −0.06 to −0.00) sleep. Increases in TST, light, deep, and REM sleep are all associated with subsequent decreased training load (respectively, 95% CI = −0.09 to −0.03; 95% CI = −0.10 to −0.01; 95% CI = −0.22 to −0.02; 95% CI = −0.18 to −0.03). Finally, among poor sleepers, increases in sleep onset latency are associated with increases in subsequent mental strain (95% CI = 0.09–0.46), and increases in deep sleep are associated with decreases in subsequent training load (95% CI = −67.65 to 11.43). These results offer novel insight into the bidirectional associations between sleep, mental strain, and training load in athletes and demonstrate the detrimental effects of mental strain on sleep, likely caused by mental activation incompatible with sleep. An increased need for recovery, suggested by increased TST and time in different sleep stages, is associated with subsequent self-regulatory reduction of training loads by the athletes. In poor sleepers, increases in deep sleep may suggest an elevated need for physiological recovery.

Alterations in acid-base balance and high-intensity exercise performance after short-term and long-term exposure to acute normobaric hypoxic conditions

This investigation assessed the course of renal compensation of hypoxia-induced respiratory alkalosis by elimination of bicarbonate ions and impairments in anaerobic exercise after different durations of hypoxic exposure. Study A: 16 participants underwent a resting 12-h exposure to normobaric hypoxia (3,000 m). Blood gas analysis was assessed hourly. While blood pH was significantly increased, PO2, PCO2, and SaO2 were decreased within the first hour of hypoxia, and changes remained consistent. A substantial reduction in [HCO3-] levels was observed after 12 h of hypoxic exposure (- 1.35 ± 0.29 mmol/L, p ≤ 0.05). Study B: 24 participants performed in a randomized, cross-over trial portable tethered sprint running (PTSR) tests under normoxia and after either 1 h (n = 12) or 12 h (n = 12) of normobaric hypoxia (3,000 m). No differences occurred for PTSR-related performance parameters, but the reduction in blood lactate levels was greater after 12 h compared with 1 h (- 1.9 ± 2.2 vs 0.0 ± 2.3 mmol/L, p ≤ 0.05). These results indicate uncompensated respiratory alkalosis after 12 h of hypoxia and similar impairment of high-intensity exercise after 1 and 12 h of hypoxic exposure, despite a greater reduction in blood lactate responses after 12 h compared with 1 h of hypoxic exposure.

Changes in Continuous, Long-Term Heart Rate Variability and Individualized Physiological Responses to Wellness and Vacation Interventions Using a Wearable Sensor

There are many approaches to maintaining wellness, including taking a simple vacation to attending highly structured wellness retreats, which typically regulate the attendee's personal time and activities. In a healthy English-speaking cohort of 112 women and men (aged 30–80 years), this study examined the effects of participating in either a 6-days intensive wellness retreat based on Ayurvedic medicine principles or unstructured 6-days vacation at the same wellness center setting. Heart rate variability (HRV) was monitored continuously using a wearable ECG sensor patch for up to 7 days prior to, during, and 1-month following participation in the interventions. Additionally, salivary cortisol levels were assessed for all participants at multiple times during the day. Continual HRV monitoring data in the real-world setting was seen to be associated with demographic [HRV_ALF: β_Age = 0.98 (95% CI = 0.96–0.98), false discovery rate (FDR) < 0.001] and physiological characteristics [HRV_PLF: β = 0.98 (95% CI = 0.98–1), FDR =0.005] of participants. HRV features were also able to quantify known diurnal variations [HRV_LF/HF: β_{ACT:night vs. early−morning} = 2.69 (SE = 1.26), FDR < 0.001] along with notable inter- and intraperson heterogeneity in response to intervention. A statistically significant increase in HRV_ALF [β = 1.48 (SE = 1.1), FDR < 0.001] was observed for all participants during the resort visit. Personalized HRV analysis at an individual level showed a distinct individualized response to intervention, further supporting the utility of using continuous real-world tracking of HRV at an individual level to objectively measure responses to potentially stressful or relaxing settings.

Contemporary Periodization of Altitude Training for Elite Endurance Athletes: A Narrative Review

Since the 1960s there has been an escalation in the purposeful utilization of altitude to enhance endurance athletic performance. This has been mirrored by a parallel intensification in research pursuits to elucidate hypoxia-induced adaptive mechanisms and substantiate optimal altitude protocols (e.g., hypoxic dose, duration, timing, and confounding factors such as training load periodization, health status, individual response, and nutritional considerations). The majority of the research and the field-based rationale for altitude has focused on hematological outcomes, where hypoxia causes an increased erythropoietic response resulting in augmented hemoglobin mass. Hypoxia-induced non-hematological adaptations, such as mitochondrial gene expression and enhanced muscle buffering capacity may also impact athletic performance, but research in elite endurance athletes is limited. However, despite significant scientific progress in our understanding of hypobaric hypoxia (natural altitude) and normobaric hypoxia (simulated altitude), elite endurance athletes and coaches still tend to be trailblazers at the coal face of cutting-edge altitude application to optimize individual performance, and they already implement novel altitude training interventions and progressive periodization and monitoring approaches. Published and field-based data strongly suggest that altitude training in elite endurance athletes should follow a long- and short-term periodized approach, integrating exercise training and recovery manipulation, performance peaking, adaptation monitoring, nutritional approaches, and the use of normobaric hypoxia in conjunction with terrestrial altitude. Future research should focus on the long-term effects of accumulated altitude training through repeated exposures, the interactions between altitude and other components of a periodized approach to elite athletic preparation, and the time course of non-hematological hypoxic adaptation and de-adaptation, and the potential differences in exercise-induced altitude adaptations between different modes of exercise.

Are Functional Movement Screen Tests Performed at the Right Time, if It Is an Injury Risk Predictor?

CONTEXT

Sports injuries are more common when players are fatigued and occur more frequently at the end of matches; therefore, determining the right time for employing an injury screening test is important.

OBJECTIVE

To determine the role of timing (prematch vs postmatch fatigue) on the functional movement screen (FMS) scores, a frequently used injury risk screening method.

DESIGN

Cross-sectional study.

SETTING

Field.

PARTICIPANTS

Twenty-four women soccer players from a professional team were included.

MAIN OUTCOME MEASURES

The players were evaluated with a visual analog scale for perceived fatigue and with the FMS. Assessments were conducted before and after a 60-minute match.

RESULTS

The subtest scores for deep squat, hurdle line, in-line lunge, trunk stability push-up, and the total FMS scores showed a significant decrease following the match (P < .05). Compared with prematch, the number of players who could achieve the highest score of 3/3 postmatch was lower for all subtests except right shoulder mobility.

CONCLUSIONS

Our results suggest a negative relationship between perceived fatigue level and performance on the deep squat, hurdle line, in-line lunge, and trunk stability push-up subtest scores and in the total FMS score. Therefore, the authors suggest that screening tests such as the FMS should be employed following a match when players present with fatigue.

Keeping Athletes Healthy at the 2020 Tokyo Summer Games: Considerations and Illness Prevention Strategies

Keeping athletes healthy will be important for optimal athletic performance at the 2020 Tokyo Summer Olympic and Paralympic Games. Athletes will be exposed to several stressors during the preparatory and competition phases of the Summer Games that have the potential to depress immunity and increase illness risk. This mini-review provides an overview on effective and practical stressor-specific illness prevention strategies that can be implemented to maintain and protect the health of Olympic and Paralympic athletes.

Training to Compete at Altitude:Natural Altitude or Simulated Live High:Train Low?

PURPOSE

To compare the effects of natural altitude training (NAT) and simulated (SIM) live high:train low altitude training on road-race walking performance (min), as well as treadmill threshold walking speed (km·h^-1) at 4 mmol·L^-1 and maximal oxygen consumption, at 1380 m.

METHODS

Twenty-two elite-level male (n = 15) and female (n = 7) race walkers completed 14 d of NAT at 1380 m (n = 7), SIM live high:train low at 3000:600 m (n = 7), or control conditions (600-m altitude; CON, n = 8). All preintervention and postintervention testing procedures were conducted at 1380 m and consisted of an incremental treadmill test, completed prior to a 5 × 2-km road-race walking performance test. Differences between groups were analyzed via mixed-model analysis of variance and magnitude-based inferences, with a substantial change detected with >75% likelihood of exceeding the smallest worthwhile change.

RESULTS

The improvement in total performance time for the 5 × 2-km test in NAT was not substantially different from SIM but was substantially greater (85% likely) than CON. The improvement in percentage decrement in the 5 × 2-km performance test in NAT was greater than in both SIM (93% likely) and CON (93% likely). The increase in maximal oxygen consumption was substantially greater (91% likely) in NAT than in SIM. Improvement in threshold walking speed was substantially greater than CON for both SIM (91% likely) and NAT (90% likely).

CONCLUSIONS

Both NAT and SIM may allow athletes to achieve reasonable acclimation prior to competition at low altitude.

Preparation for Endurance Competitions at Altitude: Physiological, Psychological, Dietary and Coaching Aspects. A Narrative Review

It was the Summer Olympic Games 1968 held in Mexico City (2,300 m) that required scientists and coaches to cope with the expected decline of performance in endurance athletes and to establish optimal preparation programs for competing at altitude. From that period until now many different recommendations for altitude acclimatization in advance of an altitude competition were proposed, ranging from several hours to several weeks. Those recommendations are mostly based on the separate consideration of the physiology of acclimatization, psychological issues, performance changes, logistical or individual aspects, but there is no review considering all these aspects in their entirety. Therefore, the present work primarily focusses on the period of altitude sojourn prior to the competition at altitude based on physiological and psychological aspects complemented by nutritional and sports practical considerations.

Heart Rate Monitoring in Team Sports-A Conceptual Framework for Contextualizing Heart Rate Measures for Training and Recovery Prescription

A comprehensive monitoring of fitness, fatigue, and performance is crucial for understanding an athlete's individual responses to training to optimize the scheduling of training and recovery strategies. Resting and exercise-related heart rate measures have received growing interest in recent decades and are considered potentially useful within multivariate response monitoring, as they provide non-invasive and time-efficient insights into the status of the autonomic nervous system (ANS) and aerobic fitness. In team sports, the practical implementation of athlete monitoring systems poses a particular challenge due to the complex and multidimensional structure of game demands and player and team performance, as well as logistic reasons, such as the typically large number of players and busy training and competition schedules. In this regard, exercise-related heart rate measures are likely the most applicable markers, as they can be routinely assessed during warm-ups using short (3–5 min) submaximal exercise protocols for an entire squad with common chest strap-based team monitoring devices. However, a comprehensive and meaningful monitoring of the training process requires the accurate separation of various types of responses, such as strain, recovery, and adaptation, which may all affect heart rate measures. Therefore, additional information on the training context (such as the training phase, training load, and intensity distribution) combined with multivariate analysis, which includes markers of (perceived) wellness and fatigue, should be considered when interpreting changes in heart rate indices. The aim of this article is to outline current limitations of heart rate monitoring, discuss methodological considerations of univariate and multivariate approaches, illustrate the influence of different analytical concepts on assessing meaningful changes in heart rate responses, and provide case examples for contextualizing heart rate measures using simple heuristics. To overcome current knowledge deficits and methodological inconsistencies, future investigations should systematically evaluate the validity and usefulness of the various approaches available to guide and improve the implementation of decision-support systems in (team) sports practice.

Seasonal Training Load and Wellness Monitoring in a Professional Soccer Goalkeeper

The purpose of this investigation was to (1) quantify the training load practices of a professional soccer goalkeeper and (2) investigate the relationship between the training load observed and the subsequent self-reported wellness response. One male goalkeeper playing for a team in the top league of the Netherlands participated in this case study. Training load data were collected across a full season using a global positioning system device and session-RPE (rating of perceived exertion). Data were assessed in relation to the number of days to a match (MD- and MD+). In addition, self-reported wellness response was assessed using a questionnaire. Duration, total distance, average speed, PlayerLoad™, and load (derived from session-RPE) were highest on MD. The lowest values for duration, total distance, and PlayerLoad™ were observed on MD-1 and MD+1. Total wellness scores were highest on MD and MD-3 and were lowest on MD+1 and MD-4. Small to moderate correlations between training load measures (duration, total distance covered, high deceleration efforts, and load) and the self-reported wellness response scores were found. This exploratory case study provides novel data about the physical load undertaken by a goalkeeper during 1 competitive season. The data suggest that there are small to moderate relationships between training load indicators and self-reported wellness response. This weak relation indicates that the association is not meaningful. This may be due to the lack of position-specific training load parameters that practitioners can currently measure in the applied context.

Monitoring Athletic Training Status Through Autonomic Heart Rate Regulation: A Systematic Review and Meta-Analysis

BACKGROUND

Autonomic regulation of heart rate (HR) as an indicator of the body's ability to adapt to an exercise stimulus has been evaluated in many studies through HR variability (HRV) and post-exercise HR recovery (HRR). Recently, HR acceleration has also been investigated.

OBJECTIVE

The aim of this systematic literature review and meta-analysis was to evaluate the effect of negative adaptations to endurance training (i.e., a period of overreaching leading to attenuated performance) and positive adaptations (i.e., training leading to improved performance) on autonomic HR regulation in endurance-trained athletes.

METHODS

We searched Ovid MEDLINE, Embase, CINAHL, SPORTDiscus, PubMed, and Academic Search Premier databases from inception until April 2015. Included articles examined the effects of endurance training leading to increased or decreased exercise performance on four measures of autonomic HR regulation: resting and post-exercise HRV [vagal-related indices of the root-mean-square difference of successive normal R-R intervals (RMSSD), high frequency power (HFP) and the standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) only], and post-exercise HRR and HR acceleration.

RESULTS

Of the 5377 records retrieved, 27 studies were included in the systematic review and 24 studies were included in the meta-analysis. Studies inducing increases in performance showed small increases in resting RMSSD [standardised mean difference (SMD) = 0.58; P < 0.001], HFP (SMD = 0.55; P < 0.001) and SD1 (SMD = 0.23; P = 0.16), and moderate increases in post-exercise RMSSD (SMD = 0.60; P < 0.001), HFP (SMD = 0.90; P < 0.04), SD1 (SMD = 1.20; P = 0.04), and post-exercise HRR (SMD = 0.63; P = 0.002). A large increase in HR acceleration (SMD = 1.34) was found in the single study assessing this parameter. Studies inducing decreases in performance showed a small increase in resting RMSSD (SMD = 0.26; P = 0.01), but trivial changes in resting HFP (SMD = 0.04; P = 0.77) and SD1 (SMD = 0.04; P = 0.82). Post-exercise RMSSD (SMD = 0.64; P = 0.04) and HFP (SMD = 0.49; P = 0.18) were increased, as was HRR (SMD = 0.46; P < 0.001), while HR acceleration was decreased (SMD = -0.48; P < 0.001).

CONCLUSIONS

Increases in vagal-related indices of resting and post-exercise HRV, post-exercise HRR, and HR acceleration are evident when positive adaptation to training has occurred, allowing for increases in performance. However, increases in post-exercise HRV and HRR also occur in response to overreaching, demonstrating that additional measures of training tolerance may be required to determine whether training-induced changes in these parameters are related to positive or negative adaptations. Resting HRV is largely unaffected by overreaching, although this may be the result of methodological issues that warrant further investigation. HR acceleration appears to decrease in response to overreaching training, and thus may be a potential indicator of training-induced fatigue.

Athletes at High Altitude

CONTEXT

Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes.

EVIDENCE ACQUISITION

A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar.

STUDY DESIGN

Clinical review.

LEVEL OF EVIDENCE

Level 3.

RESULTS

AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks.

CONCLUSION

Individualized and appropriate acclimatization is an essential component of injury and illness prevention.

Impact of Altitude on Power Output during Cycling Stage Racing

PURPOSE

The purpose of this study was to quantify the effects of moderate-high altitude on power output, cadence, speed and heart rate during a multi-day cycling tour.

METHODS

Power output, heart rate, speed and cadence were collected from elite male road cyclists during maximal efforts of 5, 15, 30, 60, 240 and 600 s. The efforts were completed in a laboratory power-profile assessment, and spontaneously during a cycling race simulation near sea-level and an international cycling race at moderate-high altitude. Matched data from the laboratory power-profile and the highest maximal mean power output (MMP) and corresponding speed and heart rate recorded during the cycling race simulation and cycling race at moderate-high altitude were compared using paired t-tests. Additionally, all MMP and corresponding speeds and heart rates were binned per 1000 m (<1000 m, 1000-2000, 2000-3000 and >3000 m) according to the average altitude of each ride. Mixed linear modelling was used to compare cycling performance data from each altitude bin.

RESULTS

Power output was similar between the laboratory power-profile and the race simulation, however MMPs for 5-600 s and 15, 60, 240 and 600 s were lower (p ≤ 0.005) during the race at altitude compared with the laboratory power-profile and race simulation, respectively. Furthermore, peak power output and all MMPs were lower (≥ 11.7%, p ≤ 0.001) while racing >3000 m compared with rides completed near sea-level. However, speed associated with MMP 60 and 240 s was greater (p < 0.001) during racing at moderate-high altitude compared with the race simulation near sea-level.

CONCLUSION

A reduction in oxygen availability as altitude increases leads to attenuation of cycling power output during competition. Decrement in cycling power output at altitude does not seem to affect speed which tended to be greater at higher altitudes.

Relative Match Intensities at High Altitude in Highly-Trained Young Soccer Players (ISA3600)

To compare relative match intensities of sea-level versus high-altitude native soccer players during a 2-week camp at 3600 m, data from 7 sea-level (Australian U17 National team, AUS) and 6 high-altitude (a Bolivian U18 team, BOL) native soccer players were analysed. Two matches were played at sea-level and three at 3600 m on Days 1, 6 and 13. The Yo-Yo Intermittent recovery test (vYo-YoIR1) was performed at sea-level, and on Days 3 and 10. Match activity profiles were measured via 10-Hz GPS. Distance covered >14.4 km.h(-1) (D>14.4 km·h(-1)) and >80% of vYo-YoIR1 (D>80%vYo-YoIR1) were examined. Upon arrival at altitude, there was a greater decrement in vYo-YoIR1 (Cohen's d +1.0, 90%CL ± 0.8) and D>14.4 km·h(-1) (+0.5 ± 0.8) in AUS. D>14.4 km.h(-1) was similarly reduced relative to vYo-YoIR1 in both groups, so that D>80%vYo-YoIR1 remained similarly unchanged (-0.1 ± 0.8). Throughout the altitude sojourn, vYo-YoIR1 and D>14.4 km·h(-1) increased in parallel in AUS, so that D>80%vYo-YoIR1 remained stable in AUS (+6.0%/match, 90%CL ± 6.7); conversely D>80%vYo-YoIR1 decreased largely in BOL (-12.2%/match ± 6.2). In sea-level natives competing at high-altitude, changes in match running performance likely follow those in high-intensity running performance. Bolivian data confirm that increases in 'fitness' do not necessarily translate into greater match running performance, but rather in reduced relative exercise intensity. Key pointsWhen playing at high-altitude, players may alter their activities during matches in relation to their transient maximal physical capacities, possibly to maintain a 'tolerable' relative exercise intensity.While there is no doubt that running performance per se in not the main determinant of match outcomes (Carling, 2013), fitness levels influence relative match intensity (Buchheit et al., 2012, Mendez-Villanueva et al., 2013), which in-turn may impact on decision making and skill performance (Rampinini et al., 2008).In the context of high-altitude competitions, it is therefore recommended to arrive early enough (i.e., ~2 weeks) to allow (at least partial) acclimatisation, and in turn, allow sea-level native players to regulate their running activities in relation to both actual game demands and relative match intensity.

Predicting changes in high-intensity intermittent running performance with acute responses to short jump rope workouts in children

The aims of the present study were to 1) examine whether individual HR and RPE responses to a jump rope workout could be used to predict changes in high-intensity intermittent running performance in young athletes, and 2) examine the effect of using different methods to determine a smallest worthwhile change (SWC) on the interpretation of group-average and individual changes in the variables. Before and after an 8-week high-intensity training program, 13 children athletes (10.6 ± 0.9 yr) performed a high-intensity running test (30-15 Intermittent Fitness Test, VIFT) and three jump rope workouts, where HR and RPE were collected. The SWC was defined as either 1/5(th) of the between-subjects standard deviation or the variable typical error (CV). After training, the large ~9% improvement in VIFT was very likely, irrespective of the SWC. Standardized changes were greater for RPE (very likely-to-almost certain, ~30-60% changes, ~4-16 times >SWC) than for HR (likely-to-very likely, ~2-6% changes, ~1-6 times >SWC) responses. Using the CV as the SWC lead to the smallest and greatest changes for HR and RPE, respectively. The predictive value for individual performance changes tended to be better for HR (74-92%) than RPE (69%), and greater when using the CV as the SWC. The predictive value for no-performance change was low for both measures (<26%). Substantial decreases in HR and RPE responses to short jump rope workouts can predict substantial improvements in high-intensity running performance at the individual level. Using the CV of test measures as the SWC might be the better option. Key pointsDecreased HR and RPE responses to short jump rope workouts can be confidently used to track improvements in high-intensity intermittent running performance in children familiarized with this exercise mode. Rope jumping is a particularly convenient exercise, since it can be performed in a restricted space and allows the testing of a large number of athletes simultaneously.We recommend using the CV of the measures (i.e., 3 and 4% for HR and RPE (OMNI scale) responses, respectively) as the SWC.

Stage racing at altitude induces hemodilution despite an increase in hemoglobin mass

Plasma volume (PV) can be modulated by altitude exposure (decrease) and periods of intense exercise (increase). Cycle racing at altitude combines both stimuli, although presently no data exist to document which is dominant. Hemoglobin mass (Hbmass), hemoglobin concentration ([Hb]), and percent reticulocytes (%Retics) of altitude (ALT; n = 9) and sea-level (SL; n = 9) residents were measured during a 14-day cycling race, held at 1,146–4120 m, as well as during a simulated tour near sea level (SIM; n = 12). Hbmass was assessed before and on days 9 and 14 of racing. Venous blood was collected on days 0, 3, 6, 10, and 14. PV was calculated from Hbmass and [Hb]. A repeated-measures ANOVA was used to assess the impact of racing at altitude over time, within and between groups. [Hb] decreased significantly in all groups over time ( P < 0.0001) with decreases evident on the third day of racing. %Retics increased significantly in SL only ( P < 0.0001), with SL values elevated at day 6 compared with prerace ( P = 0.02), but were suppressed by the end of the race ( P = 0.0002). Hbmass significantly increased in SL after 9 ( P = 0.0001) and 14 ( P = 0.008) days of racing and was lower at the end of the race than midrace ( P = 0.018). PV increased in all groups ( P < 0.0001). Multiday cycle racing at altitude induces hemodilution of a similar magnitude to that observed during SL racing and occurs in nonacclimatized SL residents, despite an altitude-induced increase in Hbmass. Osmotic regulatory mechanisms associated with intense exercise appear to supersede acute enhancement of oxygen delivery at altitude.

Methods of the international study on soccer at altitude 3600 m (ISA3600)

Background

We describe here the 3-year process underpinning a multinational collaboration to investigate soccer played at high altitude—La Paz, Bolivia (3600 m). There were two main aims: first, to quantify the extent to which running performance would be altered at 3600 m compared with near sea level; and second, to characterise the time course of acclimatisation of running performance and underlying physiology to training and playing at 3600 m. In addition, this project was able to measure the physiological changes and the effect on running performance of altitude-adapted soccer players from 3600 m playing at low altitude.

Methods

A U20 Bolivian team (‘The Strongest’ from La Paz, n=19) played a series of five games against a U17 team from sea level in Australia (The Joeys, n=20). 2 games were played near sea level (Santa Cruz 430 m) over 5 days and then three games were played in La Paz over the next 12 days. Measures were (1) game and training running performance—including global positioning system (GPS) data on distance travelled and velocity of movement; (2) blood—including haemoglobin mass, blood volume, blood gases and acid–base status; (3) acclimatisation—including resting heart rate variability, perceived altitude sickness, as well as heart rate and perceived exertion responses to a submaximal running test; and (4) sleep patterns.

Conclusions

Pivotal to the success of the project were the strong professional networks of the collaborators, with most exceeding 10 years, the links of several of the researchers to soccer federations, as well as the interest and support of the two head coaches.

Changes in blood gas transport of altitude native soccer players near sea-level and sea-level native soccer players at altitude (ISA3600)

Objectives

The optimal strategy for soccer teams playing at altitude is not known, that is, ‘fly-in, fly-out’ versus short-term acclimatisation. Here, we document changes in blood gas and vascular volumes of sea-level (Australian, n=20) and altitude (Bolivian, n=19) native soccer players at 3600 m.

Methods

Haemoglobin-oxygen saturation (Hb-sO₂), arterial oxygen content (CaO₂), haemoglobin mass (Hbmass), blood volume (BV) and blood gas concentrations were measured before descent (Bolivians only), together with aerobic fitness (via Yo-YoIR1), near sea-level, after ascent and during 13 days at 3600 m.

Results

At baseline, haemoglobin concentration [Hb] and Hbmass were higher in Bolivians (mean±SD; 18.2±1.0 g/dL, 12.8±0.8 g/kg) than Australians (15.0±0.9 g/dL, 11.6±0.7 g/kg; both p≤0.001). Near sea-level, [Hb] of Bolivians decreased to 16.6±0.9 g/dL, but normalised upon return to 3600 m; Hbmass was constant regardless of altitude. In Australians, [Hb] increased after 12 days at 3600 m to 17.3±1.0 g/dL; Hbmass increased by 3.0±2.7% (p≤0.01). BV decreased in both teams at altitude by ∼400 mL. Arterial partial pressure for oxygen (PaO₂), Hb-sO₂ and CaO₂ of both teams decreased within 2 h of arrival at 3600 m (p≤0.001) but increased over the following days, with CaO₂ overcompensated in Australians (+1.7±1.2 mL/100 mL; p≤0.001). Yo-YoIR1 was lower on the 3rd versus 10th day at altitude and was significantly related to CaO₂.

Conclusions

The marked drop in PaO₂ and CaO₂ observed after ascent does not support the ‘fly-in, fly-out’ approach for soccer teams to play immediately after arrival at altitude. Although short-term acclimatisation was sufficient for Australians to stabilise their CaO₂ (mostly due to loss of plasma volume), 12 days appears insufficient to reach chronic levels of adaption.

The impact of altitude on the sleep of young elite soccer players (ISA3600)

Background

Altitude training is used by elite athletes to improve sports performance, but it may also disrupt sleep. The aim of this study was to examine the effects of 2 weeks at high altitude on the sleep of young elite athletes.

Methods

Participants (n=10) were members of the Australian under-17 soccer team on an 18-day (19-night) training camp in Bolivia, with six nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was monitored using polysomnography during a baseline night at 430 m and three nights at 3600 m (immediately after ascent, 1 week after ascent and 2 weeks after ascent). Data were analysed using effect size statistics.

Results

All results are reported as comparisons with baseline. Rapid eye movement (REM) sleep was likely lower immediately upon ascent to altitude, possibly lower after 1 week and similar after 2 weeks. On all three nights at altitude, hypopneas and desaturations were almost certainly higher; oxygen saturation was almost certainly lower; and central apnoeas, respiratory arousals and periodic breathing were very likely higher. The effects on REM sleep were common to all but one participant, but the effects on breathing were specific to only half the participants.

Conclusions

The immediate effects of terrestrial altitude of 3600 m are to reduce the amount of REM sleep obtained by young elite athletes, and to cause 50% of them to have impaired breathing during sleep. REM sleep returns to normal after 2 weeks at altitude, but impaired breathing does not improve.

The sleep of elite athletes at sea level and high altitude: a comparison of sea-level natives and high-altitude natives (ISA3600)

BACKGROUND

Altitude exposure causes acute sleep disruption in non-athletes, but little is known about its effects in elite athletes. The aim of this study was to examine the effects of altitude on two groups of elite athletes, that is, sea-level natives and high-altitude natives.

METHODS

Sea-level natives were members of the Australian under-17 soccer team (n=14). High-altitude natives were members of a Bolivian under-20 club team (n=12). Teams participated in an 18-day (19 nights) training camp in Bolivia, with 6 nights at near sea level in Santa Cruz (430 m) and 13 nights at high altitude in La Paz (3600 m). Sleep was assessed on every day/night using activity monitors.

RESULTS

The Australians' sleep was shorter, and of poorer quality, on the first night at altitude compared with sea level. Sleep quality returned to normal by the end of the first week at altitude, but sleep quantity had still not stabilised at its normal level after 2 weeks. The quantity and quality of sleep obtained by the Bolivians was similar, or greater, on all nights at altitude compared with sea level. The Australians tended to obtain more sleep than the Bolivians at sea level and altitude, but the quality of the Bolivians' sleep tended to be better than that of the Australians at altitude.

CONCLUSIONS

Exposure to high altitude causes acute and chronic disruption to the sleep of elite athletes who are sea-level natives, but it does not affect the sleep of elite athletes who are high-altitude natives.

Predicting sickness during a 2-week soccer camp at 3600 m (ISA3600)

Objectives

To examine the time course of changes in wellness and health status markers before and after episodes of sickness in young soccer players during a high-altitude training camp (La Paz, 3600 m).

Methods

Wellness and fatigue were assessed daily on awakening using specifically-designed questionnaires and resting measures of heart rate and heart rate variability. The rating of perceived exertion and heart rate responses to a submaximal run (9 km/h) were also collected during each training session. Players who missed the morning screening for at least two consecutive days were considered as sick.

Results

Four players met the inclusion criteria. With the exception of submaximal exercise heart rate, which showed an almost certain and large increase before the day of sickness (4%; 90% confidence interval 3 to 6), there was no clear change in any of the other psychometric or physiological variables. There was a very likely moderate increase (79%, 22 to 64) in self-reported training load the day before the heart rate increase in sick players (4 of the 4 players, 100%). In contrast, training load was likely and slightly decreased (−24%, −78 to −11) in players who also showed an increased heart rate but remained healthy.

Conclusions

A >4% increased heart rate during submaximal exercise in response to a moderate increase in perceived training load the previous day may be an indicator of sickness the next day. All other variables, that is, resting heart rate, heart rate variability and psychometric questionnaires may be less powerful at predicting sickness.

Monitoring training status with HR measures: do all roads lead to Rome?

Measures of resting, exercise, and recovery heart rate are receiving increasing interest for monitoring fatigue, fitness and endurance performance responses, which has direct implications for adjusting training load (1) daily during specific training blocks and (2) throughout the competitive season. However, these measures are still not widely implemented to monitor athletes' responses to training load, probably because of apparent contradictory findings in the literature. In this review I contend that most of the contradictory findings are related to methodological inconsistencies and/or misinterpretation of the data rather than to limitations of heart rate measures to accurately inform on training status. I also provide evidence that measures derived from 5-min (almost daily) recordings of resting (indices capturing beat-to-beat changes in heart rate, reflecting cardiac parasympathetic activity) and submaximal exercise (30- to 60-s average) heart rate are likely the most useful monitoring tools. For appropriate interpretation at the individual level, changes in a given measure should be interpreted by taking into account the error of measurement and the smallest important change of the measure, as well as the training context (training phase, load, and intensity distribution). The decision to use a given measure should be based upon the level of information that is required by the athlete, the marker's sensitivity to changes in training status and the practical constrains required for the measurements. However, measures of heart rate cannot inform on all aspects of wellness, fatigue, and performance, so their use in combination with daily training logs, psychometric questionnaires and non-invasive, cost-effective performance tests such as a countermovement jump may offer a complete solution to monitor training status in athletes participating in aerobic-oriented sports.

Yin and yang, or peas in a pod? Individual-sport versus team-sport athletes and altitude training

The question of whether altitude training can enhance subsequent sea-level performance has been well investigated over many decades. However, research on this topic has focused on athletes from individual or endurance sports, with scant number of studies on team-sport athletes. Questions that need to be answered include whether this type of training may enhance team-sport athlete performance, when success in team-sport is often more based on technical and tactical ability rather than physical capacity per se. This review will contrast and compare athletes from two sports representative of endurance (cycling) and team-sports (soccer). Specifically, we draw on the respective competition schedules, physiological capacities, activity profiles and energetics of each sport to compare the similarities between athletes from these sports and discuss the relative merits of altitude training for these athletes. The application of conventional live-high, train-high; live-high, train-low; and intermittent hypoxic training for team-sport athletes in the context of the above will be presented. When the above points are considered, we will conclude that dependent on resources and training objectives, altitude training can be seen as an attractive proposition to enhance the physical performance of team-sport athletes without the need for an obvious increase in training load.

Position statement--altitude training for improving team-sport players' performance: current knowledge and unresolved issues

Despite the limited research on the effects of altitude (or hypoxic) training interventions on team-sport performance, players from all around the world engaged in these sports are now using altitude training more than ever before. In March 2013, an Altitude Training and Team Sports conference was held in Doha, Qatar, to establish a forum of research and practical insights into this rapidly growing field. A round-table meeting in which the panellists engaged in focused discussions concluded this conference. This has resulted in the present position statement, designed to highlight some key issues raised during the debates and to integrate the ideas into a shared conceptual framework. The present signposting document has been developed for use by support teams (coaches, performance scientists, physicians, strength and conditioning staff) and other professionals who have an interest in the practical application of altitude training for team sports. After more than four decades of research, there is still no consensus on the optimal strategies to elicit the best results from altitude training in a team-sport population. However, there are some recommended strategies discussed in this position statement to adopt for improving the acclimatisation process when training/competing at altitude and for potentially enhancing sea-level performance. It is our hope that this information will be intriguing, balanced and, more importantly, stimulating to the point that it promotes constructive discussion and serves as a guide for future research aimed at advancing the bourgeoning body of knowledge in the area of altitude training for team sports.

Soccer activity profile of altitude versus sea-level natives during acclimatisation to 3600 m (ISA3600)

OBJECTIVES

We investigated the effect of high altitude on the match activity profile of elite youth high altitude and sea level residents.

METHODS

Twenty Sea Level (Australian) and 19 Altitude-resident (Bolivian) soccer players played five games, two near sea level (430 m) and three in La Paz (3600 m). Match activity profile was quantified via global positioning system with the peak 5 min period for distance ((D₅(peak)) and high velocity running (>4.17 m/s, HIVR₅(peak)); as well as the 5 min period immediately subsequent to the peak for both distance (D₅(sub)) and high-velocity running (HIVR₅(sub)) identified using a rolling 5 min epoch. The games at 3600 m were compared with the average of the two near sea-level games.

RESULTS

The total distance per minute was reduced by a small magnitude in the first match at altitude in both teams, without any change in low-velocity running. There were variable changes in HiVR, D₅(peak) and HiVR₅(peak) from match to match for each team. There were within-team reductions in D₅(peak) in each game at altitude compared with those at near sea level, and this reduction was greater by a small magnitude in Australians than Bolivians in game 4. The effect of altitude on HiVR₅(peak) was moderately lower in Australians compared with Bolivians in game 3. There was no clear difference in the effect of altitude on maximal accelerations between teams.

CONCLUSIONS

High altitude reduces the distance covered by elite youth soccer players during matches. Neither 13 days of acclimatisation nor lifelong residence at high altitude protects against detrimental effects of altitude on match activity profile.