Monitoring and Titrating Symptoms

Psychological Assessment and Intervention at the Boston Marathon

The Boston Marathon is a highly regarded event in the running world, not just for its prestige and challenging course, but also for its implementation of a psychology team to support runners. The 2013 Boston Marathon bombings underscored the essential role that mental health support plays at this event, prompting the development and expansion of its innovative care model. This review critically outlines, evaluates, and analyzes the approach and effectiveness of the psychological care model provided to runners on race day as part of the Boston Marathon medical team, including the standard of care, how it functions, and best practices for other marathons. The implications for this review contribute to the increasing trend of providing psychological care in marathon and other athletic settings, and to provide a framework for standardizing assessment and intervention procedures for both elite and novice runners.

Analysis of a Submaximal Cycle Test to Monitor Adaptations to Training: Implications for Optimizing Training Prescription

ABSTRACT

Capostagno, B, Lambert, MI, and Lamberts, RP. Analysis of a submaximal cycle test to monitor adaptations to training: Implications for optimizing training prescription. J Strength Cond Res 35(4): 924-930, 2021-The Lamberts and Lambert Submaximal Cycle Test (LSCT) was developed to monitor training adaptation to optimize the training prescription of cyclists. However, it is not known which of the variables within the LSCT are most closely associated with changes in training status. The aim of this study was to retrospectively analyze the LSCT data of cyclists (n = 15) who completed a 2-week high-intensity interval training intervention. The cyclists were retrospectively allocated to 1 of 2 groups based on the change in their 40-km time trial (40-km TT) performance. The "adapters" (n = 7) improved their 40-km TT performance, while the "nonadapters" (n = 8) failed to improve their 40-km TT performance. The variables measured in the LSCT were analyzed to determine which measures tracked the improvements in 40-km TT performance the best. Heart rate recovery increased significantly during the training period in the "adapters" group, but decreased in the "nonadapters" group. Mean power output in stage 2 of the LSCT tended to increase during the high-intensity interval training period in the "adapters" group and was unchanged in the "nonadapters" group. The findings of this study suggest that heart rate recovery and mean power output during stage 2 are the most sensitive markers to track changes in training status within the LSCT.

Age-Predicted Maximal Heart Rate in Recreational Marathon Runners: A Cross-Sectional Study on Fox's and Tanaka's Equations

Age-based prediction equations of maximal heart rate (HR_max), such as the popular formulas Fox's 220-age, or Tanaka's 208-0.7 × age, have been widely used in various populations. Surprisingly, so far these equations have not been validated in marathon runners, despite the importance of the role of HR_max for training purposes in endurance running. The aim of the present study was to examine the validity of Fox and Tanaka equations in a large sample of women and men recreational marathon runners. Participants (n = 180, age 43.2 ± 8.5 years, VO_2max 46.8 mL/min/kg, finishers in at least one marathon during the last year) performed a graded exercise test on a treadmill, where HR_max was measured. Measured HR_max correlated largely with age in the total sample (r = −0.50, p < 0.001), women (r = −0.60, p < 0.001) and men (r = −0.53, p < 0.001). In women, a large main effect of method on HR_max (p = 0.001, η² = 0.294) was shown with measured HR_max lower than Fox-HR_max (−4.8 bpm; −8.4, −1.3) and Tanaka-HR_max (−4.9 bpm; −8.1, −1.8). In men, a moderate effect of assessment method on HR_max was found (p = 0.001, η² = 0.066) with measured HR_max higher than Fox-HR_max (+2.8; 1.0, 4.6), Tanaka-HR_max higher than Fox-HR_max (+1.2; 0.7, 1.7). Based on these findings, it was concluded that Fox and Tanaka' formulas overestimated HR_max by ~5 bpm in women, whereas Fox underestimated HR_max in men by ~3 bpm. Thus, we recommend the further use of Tanaka's formula in men marathon runners. In addition, exercise physiologists and sport scientists should consider the observed differences among various assessment methods when performing exercise testing or prescribing training program relying on HR.

Relationships between training load, salivary cortisol responses and performance during season training in middle and long distance runners

Purpose

Monitoring training from a multifactorial point of view is of great importance in elite endurance athletes. This study aims to analyze the relationships between indicators of training load, hormonal status and neuromuscular performance, and to compare these values with competition performance, in elite middle and long-distance runners.

Method

Fifteen elite middle and long-distance runners (12 men, 3 women; age = 26.3±5.1 yrs) were measured for training volume, training zone and session rate of perceived exertion (RPE) (daily), countermovement jump (CMJ) and salivary free cortisol (weekly) for 39 weeks (i.e., the whole season). Competition performance was also observed throughout the study, registering the season best and worst competitions.

Results

Season average salivary free cortisol concentrations correlate significantly with CMJ (r = −0.777) and RPE (r = 0.551). Also, weekly averages of CMJ significantly correlates with RPE (r = −0.426), distance run (r = −0.593, p<0.001) and training zone (r = 0.437, p<0.05). Finally, it was found that the CMJ (+8.5%, g = 0.65) and the RPE (−17.6%, g = 0.94) measured the week before the best competition performance of the season were significantly different compared with the measurement conducted the week before the season’s worst competition performance.

Conclusions

Monitoring weekly measurements of CMJ and RPE could be recommended to control training process of such athletes in a non-invasive, field-based, systematic way.

Standardized versus customized high-intensity training: effects on cycling performance

PURPOSE

To determine whether a submaximal cycling test could be used to monitor and prescribe high-intensity interval training (HIT).

METHODS

Two groups of male cyclists completed 4 HIT sessions over a 2-wk period. The structured-training group (SG; n = 8, VO2max = 58.4 ± 4.2 mL · min-1 · kg-1) followed a predetermined training program while the flexible-training group (FG; n = 7, VO2max = 53.9 ± 5.0 mL · min-1 · kg-1) had the timing of their HIT sessions prescribed based on the data of the Lamberts and Lambert Submaximal Cycle Test (LSCT).

RESULTS

Effect-size calculations showed large differences in the improvements in 40-km time-trial performance after the HIT training between SG (8 ± 45 s) and FG (48 ± 42 s). Heart-rate recovery, monitored during the study, tended to increase in FG and remain unchanged in SG.

CONCLUSIONS

The results of the current study suggest that the LSCT may be a useful tool for coaches to monitor and prescribe HIT.

Exercise in the Prevention and Treatment of Adolescent Depression: A Promising but Little Researched Intervention

Despite a dramatic increase in the number of treatment studies for adolescent major depressive disorder in the past 15 years, the majority being clinical trials of medications and cognitive behavioral therapy, response rates have been modest and remission rates low. Moreover, most positive responders posttreatment have many residual symptoms, significant functional impairment, and high rates of relapse. There is a need for the development of new, more effective interventions to treat this severe, chronic condition that usually persists into adulthood with poor long-term outcomes. Findings from preliminary treatment studies suggest that exercise may have the potential to be efficacious as a monotherapy or as part of a combined treatment for adolescent major depressive disorder. This review summarizes the findings and analyzes the design flaws of randomized trials of exercise to treat adolescent depression, offering recommendations on how to design more methodologically sound studies with an emphasis on subject selection criteria; issues related to control conditions, types of diagnostic interviews, and measures needed to establish the diagnosis of depression; types of exercise treatments; and appropriate outcome measures. Future studies of exercise to treat and prevent adolescent major depressive disorder need to be comparable to state-of-the-art treatment studies of pharmacotherapy and cognitive behavioral therapy in this population to more accurately determine its efficacy and potential public health benefits.

The psychology of the marathoner : of one mind and many

The unique physiological attributes of marathoners have long been recognised, but until the pioneering research of Morgan and Pollock (1977) little was known about their psychological characteristics. Their work revealed marathoners have significantly better mental health compared with non-athletes, with desirable mental health variables being most pronounced in elite competitors. It was also found that during competition, elite marathoners typically utilise a unique cognitive strategy labelled 'association', whereby they regulate pace based upon bodily sensations including pain and effort. More recent research indicates there are considerable individual differences in the psychological responses of marathoners to the stressors associated with training and competition, and in some cases negative emotions traditionally presumed to be harmful actually benefit performance. This brief review will highlight findings of psychological research involving marathoners and other endurance athletes, distinguishing between characteristics common among groups (i.e. nomothetic) with those particular to individuals (i.e. ideographic) or sub-groups of elite and non-elite competitors.