Can neuromuscular fatigue explain running strategies and performance in ultra-marathons?: the flush model

Continuous vertical jump test is a reliable alternative to wingate anaerobic test and isokinetic fatigue tests in evaluation of muscular fatigue resistance in endurance runners

BACKGROUND

Endurance athletes face the challenge of sustaining performance while managing cumulative fatigue during half marathons and ultra-marathons while the evaluation of muscular fatigue resistance in endurance runners is essential to optimize training and race-day performance. This study aimed to assess the validity of total work measured during the continuous vertical jump test (CVJT) as an alternative to Wingate anaerobic power test (WAnT) and isokinetic fatigue test (ISO FAT) for evaluating muscular fatigue resistance and to test whether these measures correlated to race performance during half marathon (HM) and ultra marathon (UM) races.

METHODS

Twenty-two male recreational distance runners (age: 35.23 ± 21.12 years, height: 171.13 ± 21.35 cm, weight: 69.49 ± 11.25 kg) were recruited in this study. Anthropometrics, WAnT, ISO FAT, and CVJT were interspersed 24 h of recovery, within 7 weeks.

RESULTS

Total work during WAnT was highly associated with the measures of ISO FAT and CVJT both pre-race and post-race conditions (p < 0.001). Bland Altman limits of agreement (LOA) revealed that total work measures of ISO FAT and CVJT both during baseline and following HM and UM races (Hedge's g: 0.411; 0.353; 0.428; 0.435) were lower than WAnT while their 95% LOA represented 23.46%, 32.81%, 35.02%, and 36.79% of WAnT, respectively.

CONCLUSION

Strong internal consistency and reproducibility in total work measures and the magnitude of the difference among tests suggests that CVJT, WAnT, and ISO FAT warrant interchangeability in assessing muscular fatigue resistance. These findings offer important implications and highlight the utility and feasibility of CVJT as an alternative to WAnT and ISO FAT for training load assessment.

Tracking of time-dependent changes in concentric and eccentric quadriceps and hamstring torques and powers after a half-marathon

The increasing participation in running events, particularly half-marathons, has been noteworthy in recent decades. However, the time course of recovery of muscle performance after a half-marathon running remains largely unclear. This study aimed to investigate changes in concentric and eccentric quadriceps and hamstring peak torques and mean powers, as well as hamstring to quadriceps torque and power ratios, after a half-marathon. Thirty-eight recreational runners participated in this study. Isokinetic dynamometry was used to measure peak torque and mean power at four time points: pre (baseline), immediately post (within 5 min), 1 day post and 2 days post half-marathon running. Compared with baseline measurements, reductions were observed in concentric and eccentric quadriceps and hamstring peak torques (p < 0.001) and mean powers (p < 0.001), reductions in eccentric hamstring to concentric quadriceps torque ratios (p < 0.001) and power ratios (p = 0.033). Most measured parameters recovered to baseline within 1 day, except concentric quadriceps peak torques and mean powers, which were restored within 2 days. By the second day, we also observed supercompensation in concentric hamstring and eccentric quadriceps peak torques and mean powers. These findings suggest that recreational runners should avoid high-intensity exercise within 2 days after a half-marathon to minimize injury risk.

Could the perception of effort help us unravel the potential of "living low-training high"? A perspective article

Living low-training high may promote favourable physiological adaptations and improvement of exercise performance in normoxia following training at altitudes above 1500 m. Whether and how physiological adaptations to training high interact with the perception of effort remains unknown. This perspective article aims to carve out potential contributory effects of the perception of effort on performance changes following living low-training high interventions. It is based on two unique case reports, findings on known physiological adaptations to living low-training high, and integration of current knowledge on the neurophysiology of effort perception. Considering the current state of knowledge on the effect of exercising in hypoxia on perceived effort, we propose that the hypoxia exposure associated with living low-training high protocols interact with the perception of effort and its rating, by inducing adaptations that i) slow the development of neuromuscular fatigue and associated compensatory increase in motor command, ii) alter the functioning of the anterior cingulate cortex and/or the motor areas, and iii) alter the interaction with other psychological responses to the exercise. In the proposed framework using a psychophysiological approach, changes in the participants' report of their perceived effort would reflect underlying neurophysiological and psychological adaptations to hypoxia exposure.

No sex differences in performance and perceived fatigability during a self-paced endurance exercise performed under moderate hypoxia

This study examined potential sex differences in performance and perceived fatigability during a whole body endurance exercise performed under normoxia or moderate hypoxia. Nine males and eight females cyclists performed a 4-km cycling time trial under normoxia or hypoxia conditions. Performance fatigability and its central and peripheral determinants were measured via pre- to post-exercise changes in maximal voluntary isometric contraction (IMVC), voluntary activation (VA), and potentiated twitch force (TwPt) of knee extensors, respectively. Perceived fatigability was characterized via a rating of perceived exertion (RPE). Time to complete the trial was longer in hypoxia than normoxia in females (482 ± 24 vs. 465 ± 21 s) and males (433 ± 30 vs. 408 ± 31 s) (P = 0.039). There was no effect of sex or condition (P ≥ 0.370) for the magnitude of decrease in IMVC (female: normoxia = -14.3 ± 4.4%, hypoxia = -11.8 ± 5.2% vs. male: normoxia = -13.1 ± 9.4%, hypoxia = -12.9 ± 9.8%), TwPt (female: normoxia = -34.4 ± 11.4%, hypoxia = -31.8 ± 18.9% vs. male: normoxia = -30.5 ± 17.9%, hypoxia = -31.9 ± 20.9%), and VA (female: normoxia = -0.5 ± 2.3%, hypoxia = -1.6 ± 1.6% vs. male: normoxia = 0.8 ± 2.2%, hypoxia = -0.5 ± 1.3%). RPE was higher in hypoxia than in normoxia for both groups (P = 0.002). In conclusion, moderate hypoxia similarly impairs performance and perceived fatigability development in females and males during a 4-km cycling time trial.NEW & NOTEWORTHY In this study, we showed that females and males develop a similar hypoxia-induced impairment in endurance performance, perceived and performance fatigability during a 4-km cycling time trial. These novel findings indicate that females and males regulate their power output similarly during a 4-km cycling time trial under moderate hypoxia, likely to avoid prematurely exacerbating metabolic disturbances and thereby reaching comparable levels of performance fatigability by the end of the task.

Biomechanical Changes and the Time Course of Recovery in Lower Extremities of Recreational Runners Following a Simulated Treadmill Half-Marathon

BACKGROUND

Providing runners with injury prevention suggestions from a biomechanical perspective is crucial in light of the increased incidence of running-related injuries forecasted with the rising popularity of the half-marathon. Previous research has demonstrated associations between running injuries and patterns of lower extremity biomechanics, as well as indicating that inadequate rest between training sessions can result in injuries and underperformance. However, whether half-marathon running elicits lower extremity biomechanical changes and the recovery time remains largely unclear. This study aimed to investigate the acute changes (pre-run and immediately post-run) and the time course of recovery (pre-run, day 1, and day 2) in neuromuscular function, landing strategies, and lower extremity joint mechanics of recreational runners following a simulated half-marathon protocol on a treadmill.

RESULTS

Compared to pre-half-marathon measurements, we observed significant reductions in concentric (Flexors: Pre: 1.49 ± 0.50Nm/kg, Post: 1.34 ± 0.54Nm/kg, p < 0.001; Extensors: Pre: 2.19 ± 0.73Nm/kg, Post: 2.00 ± 0.82Nm/kg, p < 0.001) and eccentric (Flexors: Pre: 1.67 ± 0.68Nm/kg, Post: 1.34 ± 0.62Nm/kg, p < 0.001; Extensors: Pre: 2.44 ± 0.13Nm/kg, Post: 1.96 ± 0.12Nm/kg, p < 0.001) torques of the knee flexors and extensors, reductions in eccentric knee flexor to concentric knee extensor torque ratios (Pre: 0.78 ± 0.27, Post: 0.68 ± 0.22, p < 0.001), and impaired knee (Pre: 1.6 ± 0.1°, Post: 3.0 ± 0.2°, p < 0.001) and hip (Pre: 1.5 ± 0.2°, Post: 2.6 ± 0.2°, p < 0.001) joint position sense immediately post running. Additionally, we observed an increase in contact time (p = 0.006), decreases in peak vertical ground reaction force (p < 0.001) and impulse (p < 0.001), and changes in lower extremity joint kinematics and kinetics during the stance phase of running immediately after the half-marathon. Most measured parameters recovered within one day, except hip joint position sense, which was restored within two days. By the second day, we also observed super-compensation in thigh muscle torques.

CONCLUSION

The study revealed that simulated treadmill half-marathon induces alterations to neuromuscular function, impacts landing strategies, and elicits changes in lower extremity joint mechanics. However, these effects are temporary and resolve within two days post-run. These findings provide valuable insights to optimize training responses and prevent overtraining in recreational runners.

Influence of deception of task duration on the sex-specific physiological responses to RPE-clamp cycle ergometry

PURPOSE

The purpose of this study was to examine the sex-specific influence of expected exercise duration on the physiological responses to RPE-clamp exercise anchored to RPE 15 with participants being deceived into believing the RPE-clamp exercise would last for 20-, 30-, or 40-min, but all trials were 30-min.

METHODS

Twelve males and 12 females completed a graded exercise test followed by randomly ordered RPE-clamp trials at RPE15 on the Borg 6-20 scale where subjects were deceived into expecting exercise to last for either 20-, 30-, or 40-min, but the actual duration for each trial was 30-min. Separate 2 (Sex [Male vs. Female]) × 3 (Deception [20-min, 30-min, 40-min]) × 11 (Time [0, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30 min]) mixed model analyses of variance (ANOVAs) with appropriate follow-up ANOVAs, and Bonferroni-corrected pairwise comparisons, were used to examine changes in volume of oxygen uptake (V ˙ O 2 ), heart rate (HR), respiration rate (RR), power output, and muscle oxygen saturation (%SmO2).

RESULTS

Females, but not males, demonstrated lower power outputs when expected duration was 40-min compared to 20-min after approximately half of the exercise bout.V ˙ O 2 , regardless of Sex, was also lower when expected duration was 40-min (62.47 ± 5.59%V ˙ O 2 max ) compared to 20-min (66.35 ± 5.79%V ˙ O 2 max ). There was no effect of expected duration on HR, RR, or %SmO2, but females demonstrated significantly higher HR (86.06 ± 5.93%HRmax) and RR (74.81 ± 7.26%RRmax) compared to males (79.52 ± 4.96%HRmax; 62.31 ± 5.80%RRmax).

CONCLUSIONS

RPE-clamp exercise performance in females, but not males, may be influenced by the expectation of exercise duration.

Infrared Thermography Sensor in the Analysis of Acute Metabolic Stress Response during Race Walking Competition

Introduction: Due to the possible impact of the thermoregulatory process on sports performance, it is necessary to explore the existing relationships between kinetic, mechanical, and physiological variables. The objective of this study was to evaluate metabolic stress using thermography in the lower limb after the Spanish Championship 2023 walk. Method: A descriptive study was carried out on national and international race walkers before and after the 2023 Spanish Championships. The participants performed different tests within the same circuit. Five walkers completed the long-distance race of 35 km, four walkers completed the middle-distance race of 20 km and finally, two walkers completed the short-distance race of 10 km. Result: Statistically significant changes were observed in the lower limbs of the walkers after completing the test. We observed a decrease in skin temperature in all the anatomical regions analyzed, except for the back of the leg. More specifically, the decrease was in the hip (-1.92 °C: p = 0.004), quadriceps, hamstrings (-1.23 °C: p = 0.002), and tibia (-1.23 °C: p = 0.030). However, in the posterior region of the leg, a significant increase in temperature was observed (+0.50 °C: p = 0.011) following the competition. Discussion and Conclusions: The findings in this descriptive investigation support the notion that thermography may serve as a useful tool in the acute analysis of muscle functional activation and metabolic response in professional marching athletes. Moreover, the results confirmed that the change in skin temperature is the result of a variation in acute metabolic and functional activation in the lower extremities of race walkers during competition, with infrared thermography representing an instrument capable of detecting such a change in a rapid and non-invasive manner.

Enhancing endurance performance with combined imagined and actual physical practice

PURPOSE

The perception of effort exerts influence in determining task failure during endurance performance. Training interventions blending physical and cognitive tasks yielded promising results in enhancing performance. Motor imagery can decrease the perception of effort. Whether combining motor imagery and physical training improves endurance remains to be understood, and this was the aim of this study.

METHODS

Participants (24 ± 3 year) were assigned to a motor imagery (n = 16) or a control (n = 17) group. Both groups engaged in physical exercises targeting the knee extensors (i.e., wall squat, 12 training sessions, 14-days), with participants from the motor imagery group also performing motor imagery. Each participant visited the laboratory Pre and Post-training, during which we assessed endurance performance through a sustained submaximal isometric knee extension contraction until task failure, at either 20% or 40% of the maximal voluntary contraction peak torque. Perceptions of effort and muscle pain were measured during the exercise.

RESULTS

We reported no changes in endurance performance for the control group. Endurance performance in the motor imagery group exhibited significant improvements when the intensity of the sustained isometric exercise closely matched that used in training. These enhancements were less pronounced when considering the higher exercise intensity. No reduction in perception of effort was observed in both groups. There was a noticeable decrease in muscle pain perception within the motor imagery group Post training.

CONCLUSION

Combining motor imagery and physical training may offer a promising avenue for enhancing endurance performance and managing pain in various contexts.

Rating of Perceived Exertion: A Large Cross-Sectional Study Defining Intensity Levels for Individual Physical Activity Recommendations

BACKGROUND

Physical inactivity is a growing risk factor worldwide, therefore getting people into sports is necessary. When prescribing physical activity, it is essential to recommend the correct training intensities. Cardiopulmonary exercise testing (CPX) enables precise determination of individuals' training intensities but is unavailable for a broad population. Therefore, the Borg scale allows individuals to assess perceived exertion and set their intensity easily and cost-efficiently. In order to transfer CPX to rating of perceived exertion (RPE), previous studies investigated RPE on specific physiological anchors, e.g. blood lactate (bLa) concentrations, but representativeness for a broad population is questionable. Some contradictory findings regarding individual factors influencing RPE occur, whereas univariable analysis has been performed so far. Moreover, a multivariable understanding of individual factors influencing RPE is missing. This study aims to determine RPE values at the individual anaerobic threshold (LT2) and defined bLa concentrations in a large cohort and to evaluate individual factors influencing RPE with multivariable analysis.

METHODS

CPX with bicycle or treadmill ergometer of 6311 participants were analyzed in this cross-sectional study. RPE values at bLa concentrations 2 mmol/l, 3 mmol/l, 4 mmol/l, and LT2 (first rise in bLa over baseline + 1.5 mmol/l) were estimated by spline interpolation. Multivariable cumulative ordinal regression models were performed to assess the influence of sex, age, type of ergometry, VO2max, and duration of exercise testing on RPE.

RESULTS

Median values [interquartile range (IQR)] of the total population were RPE 13 [11; 14] at 2 mmol/l, RPE 15 [13; 16] at 3 mmol/l, RPE 16 [15; 17] at 4 mmol/l, and RPE 15 [14; 16] at LT2. Main influence of individual factors on RPE were seen especially at 2 mmol/l: male sex (odds ratio (OR) [95%-CI]: 0.65 [0.587; 0.719]), treadmill ergometry (OR 0.754 [0.641; 0.886]), number of stages (OR 1.345 [1.300; 1.394]), age (OR 1.015 [1.012; 1.018]), and VO2max (OR 1.023 [1.015; 1.030]). Number of stages was the only identified influencing factor on RPE at all lactate concentrations/LT2 (3 mmol/l: OR 1.290 [1.244; 1.336]; 4 mmol/l: OR 1.229 [1.187; 1.274]; LT2: OR 1.155 [1.115; 1.197]).

CONCLUSION

Our results suggest RPE ≤ 11 for light intensity, RPE 12-14 for moderate intensity, and RPE 15-17 for vigorous intensity, which slightly differs from the current American College of Sports Medicine (ACSM) recommendations. Additionally, we propose an RPE of 15 delineating heavy and severe intensity domain. Age, sex, type of ergometry, duration of exercise, and cardiopulmonary fitness should be considered when recommending individualized intensities with RPE, primarily at lower intensities. Therefore, this study can be used as a new guideline for prescribing individual RPE values in the clinical practice, predominantly for endurance type exercise.

Effects of ibuprofen during 42-km trail running on oxidative stress, muscle fatigue, muscle damage and performance: a randomized controlled trial

Up to 75% of marathon runners ingest non-steroidal anti-inflammatory drugs (NSAIDs) during competition. Despite the doubt whether or not they contribute to performance, the effect of NSAID in endurance sports is unclear. We evaluated the effect of ibuprofen (IBU) use on oxidative stress, muscle damage, physical performance, and vertical jump of runners participating in a 42-km-trail running. The sample consisted of 12 men randomly divided into 2 groups: a placebo group (placebo) and an ibuprofen group (IBG). A 400-mg IBU capsule was administered to the IBG 15 min prior to the start of the trial and during the course after 5 h. In the intergroup analysis, placebo 70.1% increase (p < 0.0001; Cohen's d = 4.77) of the thiobarbituric acid reactive substances (TBARS); the IBG exhibited a 31.46% increase of the sulphhydryl groups (SH) (p = 0.024, Cohen's d = 0.27), 55% of squat jump (SJ) (p < 0.01; Cohen's d = 1.41) with no significant effect on creatine kinase (CK), pace, speed, and finish time. In summary, IBU had positive evidence on oxidative stress and muscle fatigue, but had no effect on physical performance and muscle damage.

Limits of Ultra: Towards an Interdisciplinary Understanding of Ultra-Endurance Running Performance

Ultra-endurance running (UER) poses extreme mental and physical challenges that present many barriers to completion, let alone performance. Despite these challenges, participation in UER events continues to increase. With the relative paucity of research into UER training and racing compared with traditional endurance running distance (e.g., marathon), it follows that there are sizable improvements still to be made in UER if the limitations of the sport are sufficiently understood. The purpose of this review is to summarise our current understanding of the major limitations in UER. We begin with an evolutionary perspective that provides the critical background for understanding how our capacities, abilities and limitations have come to be. Although we show that humans display evolutionary adaptations that may bestow an advantage for covering large distances on a daily basis, these often far exceed the levels of our ancestors, which exposes relative limitations. From that framework, we explore the physiological and psychological systems required for running UER events. In each system, the factors that limit performance are highlighted and some guidance for practitioners and future research are shared. Examined systems include thermoregulation, oxygen delivery and utilisation, running economy and biomechanics, fatigue, the digestive system, nutritional and psychological strategies. We show that minimising the cost of running, damage to lower limb tissue and muscle fatigability may become crucial in UER events. Maintaining a sustainable core body temperature is critical to performance, and an even pacing strategy, strategic heat acclimation and individually calculated hydration all contribute to sustained performance. Gastrointestinal issues affect almost every UER participant and can be due to a variety of factors. We present nutritional strategies for different event lengths and types, such as personalised and evidence-based approaches for varying types of carbohydrate, protein and fat intake in fluid or solid form, and how to avoid flavour fatigue. Psychology plays a vital role in UER performance, and we highlight the need to be able to cope with complex situations, and that specific long and short-term goal setting improves performance. Fatigue in UER is multi-factorial, both physical and mental, and the perceived effort or level of fatigue have a major impact on the ability to continue at a given pace. Understanding the complex interplay of these limitations will help prepare UER competitors for the different scenarios they are likely to face. Therefore, this review takes an interdisciplinary approach to synthesising and illuminating limitations in UER performance to assist practitioners and scientists in making informed decisions in practice and applicable research.

Acute Neuromuscular Alterations of Ankle Evertors Induced by Short Trail Running: Sex-Related Considerations

Ravier, G, Dury, J, Grevillot, J, Girard, B, Bouzigon, R, and Michel, F. Acute neuromuscular alterations of ankle evertors induced by short trail running: sex-related considerations. J Strength Cond Res 37(10): 2008–2015, 2023—This study investigated the exercise-induced effects on the neuromuscular function of ankle evertors, balance control associated with trail running, and sex-related interactions. Fourteen male and 14 female medium-level runners completed a 16-km (400 D+) course. At rest and immediately after running, maximal voluntary isometric contraction (MVC) and rate of force development (RFD) for knee extension and ankle eversion, electromyographic (EMG) activity of peroneus muscles during MVC plateau (EMG) and the first 200 ms (EMG200), ankle angular velocity ( INV) during 20 weight-bearing inversion movements, and balance control during destabilizing single-leg task were evaluated. Repeated measures ANOVA-revealed changes in knee and ankle MVC (ankle: P = 0.0004, −12%) and RFD (ankle: P < 0.0001, −19%), EMG (P < 0.0001, −17%), EMG200 (P < 0.0001, −19%), and ankle INV (P < 0.0001, +35%) in response to trail running. Single-leg balance was not impaired. Sex-related differences were observed in EMG and EMG200 with higher values in men than in women. MVC and RFD were greater in men when expressed in absolute values, but not different relative to body mass. Single-leg balance and ankle INV did not differ between men and women. Finally, none of these variables showed any sex-related difference when considering pre-exercise to postexercise changes. This study demonstrated impairment in neuromuscular function of evertor muscles and ability in braking inversion in response to trail running. Sex-related differences were observed in neuromuscular activity but not in fatigability. These data suggest that coaches might implement strength exercises specifically designed for ankle lateral stability into their training program.

Sleep in marathon and ultramarathon runners: a brief narrative review

Introduction

Sleep is considered a fundamental biological function in humans necessary for recovery from daily physical activities. Considering the increasing popularity of long-distance running and participation in races such as marathons and ultramarathons, the aim of the present study was to review the relationship of such strenuous physical activities with sleep.

Methods

A search of Scopus was performed on 24/6/2023 using the syntax [ABS (sleep) AND ABS (marathon)] to identify relevant papers, the references of which were hand-searched to find additional sources.

Results

Optimal sleep has been shown to affect injury prevention and susceptibility to infection positively. In turn, participation in a marathon race may influence nocturnal autonomic modulation and disturb homeostasis. Ultramarathon races may have such a long duration that results in sleep deprivation even for several days, where sleep duration is quite below the physiological range. It seems that for ultramarathons of short duration, continuous running and sleep deprivation are beneficial for performance. In contrast, for races longer than 200 miles, it is necessary to develop sleep strategies to sustain performance.

Conclusion

In summary, the longer the distance of a running race, the greater the importance of an optimal sleep for race performance as well as the impact of a race on sleep.

Concussed Neural Signature is Substantially Different than Fatigue Neural Signature in Non-concussed Controls

Traumatic brain injuries can result in short-lived and long-lasting neurological impairment. Identifying the correct recovery timeframe is challenging, as balance-based metrics may be negatively impacted if testing is performed soon after exercise. Thirty-two healthy controls and seventeen concussed individuals performed a series of balance challenges, including virtual reality optical flow perturbation. The control group completed a backpacking protocol to induce moderate fatigue. Concussed participants had lower spectral power in the motor cortex and central sulcus when compared to fatigued controls. Moreover, concussed participants experienced a decrease in overall theta band spectral power while fatigued controls showed an increase in theta band spectral power. This neural signature may be useful to distinguish between concussed and non-concussed fatigued participants in future assessments.

Perceived Exertion: Revisiting the History and Updating the Neurophysiology and the Practical Applications

The perceived exertion construct creation is a landmark in exercise physiology and sport science. Obtaining perceived exertion is relatively easy, but practitioners often neglect some critical methodological issues in its assessment. Furthermore, the perceived exertion definition, neurophysiological basis, and practical applications have evolved since the perceived exertion construct's inception. Therefore, we revisit the careful work devoted by Gunnar Borg with psychophysical methods to develop the perceived exertion construct, which resulted in the creation of two scales: the rating of perceived exertion (RPE) and the category-ratio 10 (CR10). We discuss a contemporary definition that considers perceived exertion as a conscious perception of how hard, heavy, and strenuous the exercise is, according to the sense of effort to command the limbs and the feeling of heavy breathing (respiratory effort). Thus, other exercise-evoked sensations would not hinder the reported perceived exertion. We then describe the neurophysiological mechanisms involved in the perceived exertion genesis during exercise, including the influence of the peripheral feedback from the skeletal muscles and the cardiorespiratory system (i.e., afferent feedback) and the influence of efferent copies from the motor command and respiratory drive (i.e., corollary discharges), as well as the interaction between them. We highlight essential details practitioners should consider when using the RPE and CR10 scales, such as the perceived exertion definition, the original scales utilization, and the descriptors anchoring process. Finally, we present how practitioners can use perceived exertion to assess cardiorespiratory fitness, individualize exercise intensity prescription, predict endurance exercise performance, and monitor athletes' responses to physical training.

Differences in time to task failure and fatigability between children and young adults: A systematic review and meta-analysis

The transition from childhood to adulthood is characterized by many physiological processes impacting exercise performance. Performance fatigability and time to task failure are commonly used to capture exercise performance. This review aimed to determine the differences in fatigability and TTF between youth (including both children and adolescents) and young adults, and to evaluate the influence of exercise modalities (i.e., exercise duration and type of exercise) on these differences. Medline, SPORTDiscus and Cochrane Library were searched. Thirty-four studies were included. The meta-analyses revealed that both children (SMD −1.15; p &lt; 0.001) and adolescents (SMD −1.26; p = 0.022) were less fatigable than adults. Additional analysis revealed that children were less fatigable during dynamic exercises (SMD −1.58; p &lt; 0.001) with no differences during isometric ones (SMD –0.46; p = 0.22). Children (SMD 0.89; p = 0.018) but not adolescents (SMD 0.75; p = 0.090) had longer TTF than adults. Additional analyses revealed 1) that children had longer TTF for isometric (SMD 1.25; p &lt; 0.001) but not dynamic exercises (SMD −0.27; p = 0.83), and 2) that TTF differences between children and adults were larger for short- (SMD 1.46; p = 0.028) than long-duration exercises (SMD 0.20; p = 0.64). Children have higher endurance and are less fatigable than adults. These differences are influenced by the exercise modality, suggesting distinct physiological functioning during exercise between children and adults. The low number of studies comparing these outcomes between adolescents versus children and adults prevents robust conclusions and warrants further investigations in adolescent individuals.

Global trends and hot topics in electrical stimulation of skeletal muscle research over the past decade: A bibliometric analysis

Background

Over the past decade, numerous advances have been made in the research on electrical stimulation of skeletal muscle. However, the developing status and future direction of this field remain unclear. This study aims to visualize the evolution and summarize global research hot topics and trends based on quantitative and qualitative evidence from bibliometrics.

Methods

Literature search was based on the Web of Science Core Collection (WoSCC) database from 2011 to 2021. CiteSpace and VOSviewer, typical bibliometric tools, were used to perform analysis and visualization.

Results

A total of 3,059 documents were identified. The number of literature is on the rise in general. Worldwide, researchers come primarily from North America and Europe, represented by the USA, France, Switzerland, and Canada. The Udice French Research Universities is the most published affiliation. Millet GY and Maffiuletti NA are the most prolific and the most co-cited authors, respectively. Plos One is the most popular journal, and the Journal of Applied Physiology is the top co-cited journal. The main keywords are muscle fatigue, neuromuscular electrical stimulation, spinal cord injury, tissue engineering, and atrophy. Moreover, this study systematically described the hotspots in this field.

Conclusion

As the first bibliometric analysis of electrical stimulation of skeletal muscle research over the past decade, this study can help scholars recognize hot topics and trends and provide a reference for further exploration in this field.

Does Neuromuscular Fatigue Generated by Trail Running Modify Foot-Ground Impact and Soft Tissue Vibrations?

The purpose of the study was to assess the influence of a preceding mountain ultramarathon on the impact between the foot and the ground and the resulting soft tissue vibrations (STV). Two sessions of measurements were performed on 52 trail runners, before and just after mountain trail running races of various distances (from 40 to 171 km). Triaxial accelerometers were used to quantify the foot--ground impact (FGI) and STV of both gastrocnemius medialis (GAS) and vastus lateralis (VL) muscles during level treadmill running at 10 km·h^-1. A continuous wavelet transform was used to analyze the acceleration signals in the time-frequency domain, and the maps of coefficients as well as the frequency and damping properties of STV were computed. Fatigue was assessed from isometric maximal voluntary contraction force loss of knee extensors (KE) and plantar flexors (PF) after each race. Statistical nonParametric Mapping and linear mixed models were used to compare the means between the data obtained before and after the races. FGI amplitude and GAS STV were not modified after the race, while VL STV amplitude, frequency and damping significantly decreased whatever the running distance. A significant force loss was observed for the PF (26 ± 14%) and KE (27 ± 16%), but this was not correlated to the changes observed in STV. These results might reveal a protection mechanism of the muscles, indicating that biomechanical and/or physiological adaptations may occur in mountain ultramarathons to limit STV and muscle damage of knee extensors.Trial registration: ClinicalTrials.gov identifier: NCT04025138..

Effects of Central and Peripheral Fatigue on Impact Characteristics during Running

Fatigue and impact can represent an injury risk factor during running. The objective of this study was to compare the impact transmission along the locomotor system between the central and peripheral fatigued states during running. Tibial and head acceleration as well as shock attenuation in the time- and frequency-domain were analyzed during 2-min of treadmill running in the pre- and post-fatigue state in eighteen male popular runners (N = 18). The impact transmission was measured before and after a 30-min central fatigue protocol on the treadmill or a peripheral fatigue protocol in the quadricep and hamstring muscles using an isokinetic dynamometer. The time-domain acceleration variables were not modified either by peripheral or central fatigue (p > 0.05). Nevertheless, central fatigue increased the maximum (p = 0.006) and total (p = 0.007) signal power magnitude in the high-frequency range in the tibia, and the attenuation variable in the low- (p = 0.048) and high-frequency area (p = 0.000), while peripheral fatigue did not cause any modifications in the frequency-domain variables (p > 0.05). Furthermore, the attenuation in the low (p = 0.000)- and high-frequency area was higher with central fatigue than peripheral fatigue (p = 0.003). The results demonstrate that central fatigue increases the severity of impact during running as well as the attenuation of low and high components.

Performance Determinants in Trail-Running Races of Different Distances

PURPOSE

While the physiological determinants of road running have been widely studied, there is a lack of research in trail-running racing performance. The aim of our study was to determine the physiological predictors of trail-running performance in races of different distances in similar terrain and weather conditions.

METHODS

Seventy-five trail runners participating in one of the races of the Ultra-Trail du Mont-Blanc were recruited. Previous to the race, each runner was evaluated with (1) an incremental treadmill test to determine maximal oxygen uptake, ventilatory thresholds, cost of running, and substrate utilization; (2) a power-force-velocity profile on a cycle ergometer; (3) maximal voluntary contractions of the knee extensors and plantar flexors; and (4) anthropometric characteristics. Neuromuscular fatigue was evaluated after the races. Twenty-four runners finished a SHORT (<55 km), 16 finished a MEDIUM (101 km), and 14 finished a LONG (>145 km) race. Correlations and multiple linear regressions were used to find the determinants of performance in each race distance.

RESULTS

Performance in SHORT was explained by maximal oxygen uptake and lipid utilization at 10 km/h (r2 = .825, P < .001). Performance in MEDIUM was determined by maximal oxygen uptake, maximal isometric strength, and body fat percentage (r2 = .917, P < .001). A linear model could not be applied in LONG, but performance was correlated to peak velocity during the incremental test.

CONCLUSIONS

Performance in trail running is mainly predicted by aerobic capacity, while lipid utilization also influences performance in races <60 km and performance in approximately 100 km is influenced by muscle strength and body composition.

The effects of pain induced by blood flow occlusion in one leg on exercise tolerance and corticospinal excitability and inhibition of the contralateral leg in males

Experiencing pain in one leg can alter exercise tolerance and neuromuscular fatigue (NMF) responses in the contralateral leg; however, the corticospinal modulations to non-local experimental pain induced by blood flow occlusion remain unknown. In three randomized visits, thirteen male participants performed 25% of isometric maximal voluntary contraction (25%IMVC) to task failure with one leg preceded by (i) 6-min rest (CON), (ii) cycling at 80% of peak power output until task failure with the contralateral leg (CYCL) or (iii) CYCL followed by blood flow occlusion (OCCL) during 25%IMVC. NMF assessments (IMVC, voluntary activation [VA] and potentiated twitch [Qtw]) were performed at baseline and task failure. During the 25%IMVC, transcranial magnetic stimulations were performed to obtain motor evoked potential (MEP), silent period (SP), and short intracortical inhibition (SICI). 25%IMVC was shortest in OCCL (105±50s) and shorter in CYCL (154±68s) than CON (219±105s) (P<0.05). IMVC declined less after OCCL (-24±19%) and CYCL (-27±18%) then CON (-35±11%) (P<0.05). Qtw declined less in OCCL (-40±25%) compared to CYCL (-50±22%) and CON (-50±21%) (P<0.05). VA was similar amongst conditions. MEP and SP increased and SICI decreased throughout the task while SP was longer for OCCL compared to CYC condition (P<0.05). The results suggest that pain in one leg diminishes contralateral limb exercise tolerance and NMF development and modulate corticospinal inhibition in males. Novelty: Pain in one leg diminished MVC and twitch force decline in the contralateral limb Experimental pain induced by blood flow occlusion may modulation corticospinal inhibition of the neural circuitries innervating the contralateral exercise limb.

Concurrent Evolution of Biomechanical and Physiological Parameters With Running-Induced Acute Fatigue

Understanding the influence of running-induced acute fatigue on the homeostasis of the body is essential to mitigate the adverse effects and optimize positive adaptations to training. Fatigue is a multifactorial phenomenon, which influences biomechanical, physiological, and psychological facets. This work aimed to assess the evolution of these three facets with acute fatigue during a half-marathon. 13 recreational runners were equipped with one inertial measurement unit (IMU) on each foot, one combined global navigation satellite system-IMU-electrocardiogram sensor on the chest, and an Android smartphone equipped with an audio recording application. Spatio-temporal parameters for the running gait, along with the heart rate, its variability and complexity were computed using validated algorithms. Perceived fatigability was assessed using the rating-of-fatigue (ROF) scale at every 10 min of the race. The data was split into eight equal segments, corresponding to at least one ROF value per segment, and only level running parts were retained for analysis. During the race, contact time, duty factor, and trunk anteroposterior acceleration increased, and the foot strike angle and vertical stiffness decreased significantly. Heart rate showed a progressive increase, while the metrics for heart rate variability and complexity decreased during the race. The biomechanical parameters showed a significant alteration even with a small change in perceived fatigue, whereas the heart rate dynamics altered at higher changes. When divided into two groups, the slower runners presented a higher change in heart rate dynamics throughout the race than the faster runners; they both showed similar trends for the gait parameters. When tested for linear and non-linear correlations, heart rate had the highest association with biomechanical parameters, while the trunk anteroposterior acceleration had the lowest association with heart rate dynamics. These results indicate the ability of faster runners to better judge their physiological limits and hint toward a higher sensitivity of perceived fatigue to neuromuscular changes in the running gait. This study highlights measurable influences of acute fatigue, which can be studied only through concurrent measurement of biomechanical, physiological, and psychological facets of running in real-world conditions.

Sex Differences in Endurance Running

In recent years, there has been a significant expansion in female participation in endurance (road and trail) running. The often reported sex differences in maximal oxygen uptake (VO_2max) are not the only differences between sexes during prolonged running. The aim of this narrative review was thus to discuss sex differences in running biomechanics, economy (both in fatigue and non-fatigue conditions), substrate utilization, muscle tissue characteristics (including ultrastructural muscle damage), neuromuscular fatigue, thermoregulation and pacing strategies. Although males and females do not differ in terms of running economy or endurance (i.e. percentage VO_2max sustained), sex-specificities exist in running biomechanics (e.g. females have greater non-sagittal hip and knee joint motion compared to males) that can be partly explained by anatomical (e.g. wider pelvis, larger femur-tibia angle, shorter lower limb length relative to total height in females) differences. Compared to males, females also show greater proportional area of type I fibres, are more able to use fatty acids and preserve carbohydrates during prolonged exercise, demonstrate a more even pacing strategy and less fatigue following endurance running exercise. These differences confer an advantage to females in ultra-endurance performance, but other factors (e.g. lower O₂ carrying capacity, greater body fat percentage) counterbalance these potential advantages, making females outperforming males a rare exception. The present literature review also highlights the lack of sex comparison in studies investigating running biomechanics in fatigue conditions and during the recovery process.

The effect of fatigue on first stance phase kinetics during acceleration sprint running in professional football players

Nineteen professional football players (Age: 26±5 years; Height: 1.84±0.08 m; Mass: 83.4±8.9 kg) completed three x 30 m maximal acceleration sprints from a standing start before completing the Yo-Yo intermittent recovery test level 1. Three x 30 m maximal acceleration sprints were then repeated post-fatigue. Light gates recorded sprint times from 0-5 m, 0-10 m, 0-15 m and 0-30 m. Force platforms collected ground reaction force of the first stance phase of the sprint run. Differences between pre- and post-fatigue were observed in the sprint times over 0-15 m (P = 0.015; CI [0.007, 0.110]) and 0-30 m (P = 0.004; CI [0.056, 0.234]). Peak medial-lateral ground reaction force was lower (P = 0.045; CI [-0.146, -0.005]) post- than pre-fatigue. The ratio of force were significantly different between pre- and post-fatigue for the medial-lateral and anterior-posterior comparison (P = 0.017; CI [-0.063, -0.010]), and the medial-lateral and vertical comparison (P = 0.012; CI [-0.036, -0.007]). Football players altered their sprint mechanics to reduce medial-lateral loading and orient the force in an increased anteroposterior and vertical direction in order to maintain 0-10 m sprint performance. Practitioners should observe medial-lateral force contributions and improve sprint technical efficacy.

The Exercising Brain: An Overlooked Factor Limiting the Tolerance to Physical Exertion in Major Cardiorespiratory Diseases?

“Exercise starts and ends in the brain”: this was the title of a review article authored by Dr. Bengt Kayser back in 2003. In this piece of work, the author highlights that pioneer studies have primarily focused on the cardiorespiratory-muscle axis to set the human limits to whole-body exercise tolerance. In some circumstances, however, exercise cessation may not be solely attributable to these players: the central nervous system is thought to hold a relevant role as the ultimate site of exercise termination. In fact, there has been a growing interest relative to the “brain” response to exercise in chronic cardiorespiratory diseases, and its potential implication in limiting the tolerance to physical exertion in patients. To reach these overarching goals, non-invasive techniques, such as near-infrared spectroscopy and transcranial magnetic stimulation, have been successfully applied to get insights into the underlying mechanisms of exercise limitation in clinical populations. This review provides an up-to-date outline of the rationale for the “brain” as the organ limiting the tolerance to physical exertion in patients with cardiorespiratory diseases. We first outline some key methodological aspects of neuromuscular function and cerebral hemodynamics assessment in response to different exercise paradigms. We then review the most prominent studies, which explored the influence of major cardiorespiratory diseases on these outcomes. After a balanced summary of existing evidence, we finalize by detailing the rationale for investigating the “brain” contribution to exercise limitation in hitherto unexplored cardiorespiratory diseases, an endeavor that might lead to innovative lines of applied physiological research.

Sex Differences in Neuromuscular Fatigue and Changes in Cost of Running after Mountain Trail Races of Various Distances

INTRODUCTION

Women have been shown to experience less neuromuscular fatigue than men in knee extensors (KE) and less peripheral fatigue in plantar flexors (PF) after ultratrail running, but it is unknown if these differences exist for shorter trail running races and whether this may impact running economy. The purpose of this study was to characterize sex differences in fatigability over a range of running distances and to examine possible differences in the postrace alteration of the cost of running (Cr).

METHODS

Eighteen pairs of men and women were matched by performance after completing different races ranging from 40 to 171 km, divided into SHORT versus LONG races (<60 and >100 km, respectively). Neuromuscular function and Cr were tested before and after each race. Neuromuscular function was evaluated on both KE and PF with voluntary and evoked contractions using electrical nerve (KE and PF) and transcranial magnetic (KE) stimulation. Oxygen uptake, respiratory exchange ratio, and ventilation were measured on a treadmill and used to calculate Cr.

RESULTS

Compared with men, women displayed a smaller decrease in maximal strength in KE (-36% vs -27%, respectively, P < 0.01), independent of race distance. In SHORT only, women displayed less peripheral fatigue in PF compared with men (Δ peak twitch: -10% vs -24%, respectively, P < 0.05). Cr increased similarly in men and women.

CONCLUSIONS

Women experience less neuromuscular fatigue than men after both "classic" and "extreme" prolonged running exercises but this does not impact the degradation of the energy Cr.

The Consequences of Training and Competition to the Musculoskeletal System in Ultramarathon Runners: A Narrative Review

Ultramarathons are becoming increasingly popular every year, leading to more and more publications focusing on athletes of these endurance events. This paper summarizes the current state of knowledge on the effects of ultramarathons on the motor system. Various studies have attempted to answer questions about negative and positive effects on the musculoskeletal system, common injuries, optimal strategies, and regeneration. Considering the increasing number of ultramarathon athletes, the discoveries may have practical applications for a multitude of experts in the field of sports medicine, as well as for the athletes themselves. Acute locomotor system changes in runners as assessed by locomotor biomarkers are reversible and may be asymptomatic or painful. Injuries suffered by runners largely allow them to finish the competition and are usually overlooked. Regeneration, including regular massage and the use of supporting techniques, allows for faster convalescence. This publication is meant to be a source of knowledge for people associated with this discipline.

Fatigue Measured in Dynamic Versus Isometric Modes After Trail Running Races of Various Distances

PURPOSE

Fatigue has previously been investigated in trail running by comparing maximal isometric force before and after the race. Isometric contractions may not entirely reflect fatigue-induced changes, and therefore dynamic evaluation is warranted. The aim of the present study was to compare the magnitude of the decrement of maximal isometric force versus maximal power, force, and velocity after trail running races ranging from 40 to 170 km.

METHODS

Nineteen trail runners completed races shorter than 60 km, and 21 runners completed races longer than 100 km. Isometric maximal voluntary contractions (IMVCs) of knee extensors and plantar flexors and maximal 7-second sprints on a cycle ergometer were performed before and after the event.

RESULTS

Maximal power output (Pmax; -14% [11%], P < .001), theoretical maximum force (F0; -11% [14%], P < .001), and theoretical maximum velocity (-3% [8%], P = .037) decreased significantly after both races. All dynamic parameters but theoretical maximum velocity decreased more after races longer than 100 km than races shorter than 60 km (P < .05). Although the changes in IMVCs were significantly correlated (P < .05) with the changes in F0 and Pmax, reductions in IMVCs for knee extensors (-29% [16%], P < .001) and plantar flexors (-26% [13%], P < .001) were larger (P < .001) than the reduction in Pmax and F0.

CONCLUSIONS

After a trail running race, reductions in isometric versus dynamic forces were correlated, yet they are not interchangeable because the losses in isometric force were 2 to 3 times greater than the reductions in Pmax and F0. This study also shows that the effect of race distance on fatigue measured in isometric mode is true when measured in dynamic mode.

Effect of race distance on performance fatigability in male trail and ultra-trail runners

The etiology of changes in lower-limb neuromuscular function, especially to the central nervous system, may be affected by exercise duration. Direct evidence is lacking as few studies have directly compared different race distances. This study aimed to investigate the etiology of deficits in neuromuscular function following short versus long trail-running races. Thirty-two male trail runners completed one of five trail-running races as LONG (>100 km) or SHORT (<60 km). Pre- and post-race, maximal voluntary contraction (MVC) torque and evoked responses to electrical nerve stimulation during MVCs and at rest were used to assess voluntary activation and muscle contractile properties of knee-extensor (KE) and plantar-flexor (PF) muscles. Transcranial magnetic stimulation (TMS) was used to assess evoked responses and corticospinal excitability in maximal and submaximal KE contractions. Race distance correlated with KE MVC (ρ = -0.556) and twitch (ρ = -0.521) torque decreases (p ≤ .003). KE twitch torque decreased more in LONG (-28 ± 14%) than SHORT (-14 ± 10%, p = .005); however, KE MVC time × distance interaction was not significant (p = .073). No differences between LONG and SHORT for PF MVC or twitch torque were observed. Maximal voluntary activation decreased similarly in LONG and SHORT in both muscle groups (p ≥ .637). TMS-elicited silent period decreased in LONG (p = .021) but not SHORT (p = .912). Greater muscle contractile property impairment in longer races, not central perturbations, contributed to the correlation between KE MVC loss and race distance. Conversely, PF fatigability was unaffected by race distance.

Quantification of Neuromuscular Fatigue: What Do We Do Wrong and Why?

Neuromuscular fatigue (NMF) is usually assessed non-invasively in healthy, athletic or clinical populations with the combination of voluntary and evoked contractions. Although it might appear relatively straightforward to magnetically or electrically stimulate at different levels (cortical/spinal/muscle) and to measure mechanical and electromyographic responses to quantify neuromuscular adjustments due to sustained/repeated muscle contractions, there are drawbacks that researchers and clinicians need to bear in mind. The aim of this opinion paper is to highlight the pitfalls inevitably faced when NMF is quantified. The first problem might arise from the definition of fatigue itself and the parameter(s) used to measure it; for instance, measuring power vs. isometric torque may lead to different conclusions. Another potential limitation is the delay between exercise termination and the evaluation of neuromuscular function; the possible underestimation of exercise-induced neural and contractile impairment and misinterpretation of fatigue etiology will be discussed, as well as solutions recently proposed to overcome this problem. Quantification of NMF can also be biased (or not feasible) because of the techniques themselves (e.g. results may depend on stimulation intensity for transcranial magnetic stimulation) or the way data are analyzed (e.g. M wave peak-to-peak vs first phase amplitude). When available, alternatives recently suggested in the literature to overcome these pitfalls are considered and recommendations about the best practices to assess NMF (e.g. paying attention to the delay between exercise and testing, adapting the method to the characteristics of the population to be tested and considering the limitations associated with the techniques) are proposed.

Heat Acclimatization, Cooling Strategies, and Hydration during an Ultra-Trail in Warm and Humid Conditions

The aim of this study was to assess the history of exertional heat illness (EHI), heat preparation, cooling strategies, heat related symptoms, and hydration during an ultra-endurance running event in a warm and humid environment. This survey-based study was open to all people who participated in one of the three ultra-endurance races of the Grand Raid de la Réunion. Ambient temperature and relative humidity were 18.6 ± 5.7 °C (max = 29.7 °C) and 74 ± 17%, respectively. A total of 3317 runners (56% of the total eligible population) participated in the study. Overall, 78% of the runners declared a history of heat-related symptoms while training or competing, and 1.9% reported a previous diagnosis of EHI. Only 24.3% of study participants living in temperate climates declared having trained in the heat before the races, and 45.1% of all respondents reported a cooling strategy during the races. Three quarter of all participants declared a hydration strategy. The planned hydration volume was 663 ± 240 mL/h. Fifty-nine percent of the runners had enriched their food or drink with sodium during the race. The present study shows that ultra-endurance runners have a wide variability of hydration and heat preparation strategies. Understandings of heat stress repercussions in ultra-endurance running need to be improved by specific field research.

Physiological Determinants of Ultramarathon Trail-Running Performance

CONTEXT

The physiological determinants of ultramarathon success have rarely been assessed and likely differ in their contributions to performance as race distance increases.

PURPOSE

To examine predictors of performance in athletes who completed either a 50-, 80-, or 160-km trail race over a 20-km loop course on the same day.

METHODS

Measures of running history, aerobic fitness, running economy, body mass loss, hematocrit alterations, age, and cardiovascular health were examined in relation to race-day performance. Performance was defined as the percentage difference from the winning time at a given race distance, with 0% representing the fastest possible time.

RESULTS

In the 50-km race, training volumes, cardiovascular health, aerobic fitness, and a greater loss of body mass during the race were all related to better performance (all P < .05). Using multiple linear regression, peak velocity achieved in the maximal oxygen uptake test (β = -11.7, P = .002) and baseline blood pressure (β = 3.1, P = .007) were the best performance predictors for the men's 50-km race (r = .98, r2 = .96, P < .001), while peak velocity achieved in the maximal oxygen uptake test (β = -13.6, P = .001) and loss of body mass (β = 12.8, P = .03) were the best predictors for women (r = .94, r2 = .87, P = .001). In the 80-km race, only peak velocity achieved in the maximal oxygen uptake test predicted performance (β = -20.3, r = .88, r2 = .78, P < .001). In the 160-km race, there were no significant performance determinants.

CONCLUSIONS

While classic determinants of running performance, including cardiovascular health and running fitness, predict 50-km trail-running success, performance in longer-distance races appears to be less influenced by such physiological parameters.

To Be a Champion of the 24-h Ultramarathon Race. If Not the Heart ... Mosaic Theory?

This comprehensive case analysis aimed to identify the features enabling a runner to achieve championship in 24-h ultramarathon (UM) races. A 36-year-old, multiple medalist of the World Championships in 24-h running, was assessed before, one and 10 days after a 24-h run. Results of his extensive laboratory and cardiological diagnostics with transthoracic echocardiography (TTE) and a one-time cardiopulmonary exercise test (CPET) were analyzed. After 12 h of running (approximately 130 km), the athlete experienced an increasing pain in the right knee. His baseline clinical data were within the normal range. High physical efficiency in CPET (VO₂max 63 mL/kg/min) was similar to the average achieved by other ultramarathoners who had significantly worse results. Thus, we also performed genetic tests and assessed his psychological profile, body composition, and markers of physical and mental stress (serotonin, cortisol, epinephrine, prolactin, testosterone, and luteinizing hormone). The athlete had a mtDNA haplogroup H (HV0a1 subgroup, belonging to the HV cluster), characteristic of athletes with the highest endurance. Psychological studies have shown high and very high intensity of the properties of individual scales of the tools used mental resilience (62–100% depending on the scale), openness to experience (10th sten), coherence (10th sten), positive perfectionism (100%) and overall hope for success score (10th sten). The athlete himself considers the commitment and mental support of his team to be a significant factor of his success. Body composition assessment (%fat 13.9) and the level of stress markers were unremarkable. The tested athlete showed a number of features of the champions of ultramarathon runs, such as: inborn predispositions, mental traits, level of training, and resistance to pain. However, none of these features are reserved exclusively for “champions”. Team support’s participation cannot be underestimated. The factors that guarantee the success of this elite 24-h UM runner go far beyond physiological and psychological explanations. Further studies are needed to identify individual elements of the putative “mosaic theory of being a champion”.

Prior Upper Body Exercise Impairs 4-km Cycling Time-Trial Performance Without Altering Neuromuscular Function

Purpose: This study investigated the effects of previous exhaustive upper body exercise on performance and neuromuscular fatigue following a 4-km cycling time-trial (4-km TT). Methods: Eight recreational cyclists performed a 4-km TT with (ARM_PRE) or without (CONTR) a previous arm-crank maximal incremental test. In each experimental session, neuromuscular fatigue was evaluated with a series of electrically evoked and maximal voluntary isometric contractions (MVC). Oxygen uptake ( V ˙ O₂), heart rate, electromyographic muscle activity (EMG_RMS) and rating of perceived exertion (RPE) were also recorded throughout the 4-km TT. Results: The average power output during the 4-km TT was reduced (P = .027) for the ARM_PRE (299 ± 59 W) group, compared with CONTR (310 ± 59 W) and overall performance in 4-km TT was impaired (P = .021) in ARM_PRE (382 ± 28 s) compared with CONTR (376 ± 27 s). The decrease observed in MVC (P = .033) and potentiated peak twitch force (P = .004) at post-TT were similar between the ARM_PRE and CONTR conditions (P = .739 and P = .493, respectively). There was no (P = .619) change in voluntary activation at post-TT between conditions. V ˙ O₂, EMG_RMS and RPE measured throughout the 4-km TT were not significantly different between the conditions (P = .558, P = .558 and P = .940, respectively). The rate of RPE change relative to power output average and heart rate was higher (P = .030 and P = .013, respectively) in ARM_PRE (0.031 ± 0.018 AU/W and 168 ± 8 bpm) than CONTR (0.022 ± 0.010 AU/W and 161 ± 7 bpm). Conclusion: These results suggest that impaired performance in ARM_PRE was mostly due to pronounced perception of effort rather than neuromuscular fatigue.

Fatigue development and perceived response during self-paced endurance exercise: state-of-the-art review

Performance in self-paced endurance exercises results from continuous fatigue symptom management. While it is suggested that perceived responses and neuromuscular fatigue development may determine variations in exercise intensity, it is uncertain how these fatigue components interact throughout the task. To address the fatigue development in self-paced endurance exercises, the following topics were addressed in the present review: (1) fatigue development during constant-load vs. self-paced endurance exercises; (2) central and peripheral fatigue and perceived exertion interconnections throughout the self-paced endurance exercises; and (3) future directions and recommendations. Based on the available literature, it is suggested (1) the work rate variations during a self-paced endurance exercise result in transitions between exercise intensity domains, directly impacting the end-exercise central and peripheral fatigue level when compared to constant-load exercise mode; (2) central and peripheral fatigue, as well as perceived exertion response contribute to exercise intensity regulation at the different stages of the trial. It seems that while neuromuscular fatigue development might be relevant at beginning of the trial, the perceived exertion might interfere in the remaining parts to achieve maximal values only at the finish line; (3) future studies should focus on the mechanisms underpinning fatigue components interactions throughout the task and its influence on exercise intensity variations.

Neuromuscular responses to fatiguing locomotor exercise

Over the last two decades, an abundance of research has explored the impact of fatiguing locomotor exercise on the neuromuscular system. Neurostimulation techniques have been implemented prior to and following locomotor exercise tasks of a wide variety of intensities, durations, and modes. These techniques have allowed for the assessment of alterations occurring within the central nervous system and the muscle, while techniques such as transcranial magnetic stimulation and spinal electrical stimulation have permitted further segmentalization of locomotor exercise-induced changes along the motor pathway. To this end, the present review provides a comprehensive synopsis of the literature pertaining to neuromuscular responses to locomotor exercise. Sections of the review were divided to discuss neuromuscular responses to maximal, severe, heavy and moderate intensity, high-intensity intermittent exercise, and differences in neuromuscular responses between exercise modalities. During maximal and severe intensity exercise, alterations in neuromuscular function reside primarily within the muscle. Although post-exercise reductions in voluntary activation following maximal and severe intensity exercise are generally modest, several studies have observed alterations occurring at the cortical and/or spinal level. During prolonged heavy and moderate intensity exercise, impairments in contractile function are attenuated with respect to severe intensity exercise, but are still widely observed. While reductions in voluntary activation are greater during heavy and moderate intensity exercise, the specific alterations occurring within the central nervous system remain unclear. Further work utilizing stimulation techniques during exercise and integrating new and emerging techniques such as high-density electromyography is warranted to provide further insight into neuromuscular responses to locomotor exercise.

Do Sex Differences in Physiology Confer a Female Advantage in Ultra-Endurance Sport?

Ultra-endurance has been defined as any exercise bout that exceeds 6 h. A number of exceptional, record-breaking performances by female athletes in ultra-endurance sport have roused speculation that they might be predisposed to success in such events. Indeed, while the male-to-female performance gap in traditional endurance sport (e.g., marathon) remains at ~ 10%, the disparity in ultra-endurance competition has been reported as low as 4% despite the markedly lower number of female participants. Moreover, females generally outperform males in extreme-distance swimming. The issue is complex, however, with many sports-specific considerations and caveats. This review summarizes the sex-based differences in physiological functions and draws attention to those which likely determine success in extreme exercise endeavors. The aim is to provide a balanced discussion of the female versus male predisposition to ultra-endurance sport. Herein, we discuss sex-based differences in muscle morphology and fatigability, respiratory-neuromechanical function, substrate utilization, oxygen utilization, gastrointestinal structure and function, and hormonal control. The literature indicates that while females exhibit numerous phenotypes that would be expected to confer an advantage in ultra-endurance competition (e.g., greater fatigue resistance, greater substrate efficiency, and lower energetic demands), they also exhibit several characteristics that unequivocally impinge on performance (e.g., lower O₂-carrying capacity, increased prevalence of GI distress, and sex-hormone effects on cellular function/injury risk). Crucially, the advantageous traits may only manifest as ergogenic in the extreme endurance events which, paradoxically, are those that females less often contest. The title question should be revisited in the coming years, when/if the number of female participants increases.

Fatigue development and perceived response during self-paced endurance exercise: state-of-the-art review

Performance in self-paced endurance exercises results from continuous fatigue symptom management. While it is suggested that perceived responses and neuromuscular fatigue development may determine variations in exercise intensity, it is uncertain how these fatigue components interact throughout the task. To address the fatigue development in self-paced endurance exercises, the following topics were addressed in the present review: (1) fatigue development during constant-load vs. self-paced endurance exercises; (2) central and peripheral fatigue and perceived exertion interconnections throughout the self-paced endurance exercises; and (3) future directions and recommendations. Based on the available literature, it is suggested (1) the work rate variations during a self-paced endurance exercise result in transitions between exercise intensity domains, directly impacting the end-exercise central and peripheral fatigue level when compared to constant-load exercise mode; (2) central and peripheral fatigue, as well as perceived exertion response contribute to exercise intensity regulation at the different stages of the trial. It seems that while neuromuscular fatigue development might be relevant at beginning of the trial, the perceived exertion might interfere in the remaining parts to achieve maximal values only at the finish line; (3) future studies should focus on the mechanisms underpinning fatigue components interactions throughout the task and its influence on exercise intensity variations.

Downhill Running: What Are The Effects and How Can We Adapt? A Narrative Review

Downhill running (DR) is a whole-body exercise model that is used to investigate the physiological consequences of eccentric muscle actions and/or exercise-induced muscle damage (EIMD). In a sporting context, DR sections can be part of running disciplines (off-road and road running) and can accentuate EIMD, leading to a reduction in performance. The purpose of this narrative review is to: (1) better inform on the acute and delayed physiological effects of DR; (2) identify and discuss, using a comprehensive approach, the DR characteristics that affect the physiological responses to DR and their potential interactions; (3) provide the current state of evidence on preventive and in-situ strategies to better adapt to DR. Key findings of this review show that DR may have an impact on exercise performance by altering muscle structure and function due to EIMD. In the majority of studies, EIMD are assessed through isometric maximal voluntary contraction, blood creatine kinase and delayed onset muscle soreness, with DR characteristics (slope, exercise duration, and running speed) acting as the main influencing factors. In previous studies, the median (25th percentile, Q1; 75th percentile, Q3) slope, exercise duration, and running speed were - 12% (- 15%; - 10%), 40 min (30 min; 45 min) and 11.3 km h-1 (9.8 km h-1; 12.9 km h-1), respectively. Regardless of DR characteristics, people the least accustomed to DR generally experienced the most EIMD. There is growing evidence to suggest that preventive strategies that consist of prior exposure to DR are the most effective to better tolerate DR. The effectiveness of in-situ strategies such as lower limb compression garments and specific footwear remains to be confirmed. Our review finally highlights important discrepancies between studies in the assessment of EIMD, DR protocols and populations, which prevent drawing firm conclusions on factors that most influence the response to DR, and adaptive strategies to DR.

The role of peripheral muscle fatigability on exercise intolerance in COPD

INTRODUCTION

Exercise limitation in chronic obstructive pulmonary disease (COPD) is multi-factorial; however, growing evidence indicates that muscle dysfunction may contribute in some patients.

AREAS COVERED

This work outlines current evidence for and against increased peripheral muscle fatigability in COPD through a comprehensive review of relevant literature available on PubMed/MEDLINE until May 2020. The authors first discuss key methodological issues relative to muscle fatigue assessment by non-volitional techniques, particularly magnetic stimulation. The authors then provide a detailed discussion of critical studies to have objectively measured skeletal muscle fatigue in individuals with COPD.

EXPERT OPINION

Current evidence indicates that localized (knee extension) and cycling exercise are associated with increased quadriceps fatigability in most COPD patients. Increased fatigability, however, has not been consistently found in response to walking, likely reflecting the tendency of 'central' respiratory constraints to overshadow potential functional impairments in the appendicular muscles in this form of exercise. Thus, addressing skeletal muscle abnormalities may be critical to translate improvements in lung mechanics (e.g., due to bronchodilator therapy) into better exercise tolerance. The positive effects of pulmonary rehabilitation on muscle fatigability are particularly encouraging and suggest a role for these measurements to test the efficacy of emerging adjunct training strategies focused on the peripheral muscles.

Inspiratory and Lower-Limb Strength Importance in Mountain Ultramarathon Running. Sex Differences and Relationship with Performance

The study was aimed at comparing lower-limb strength and respiratory parameters between male and female athletes and their interaction with performance in a 107 km mountain ultramarathon. Forty seven runners (29 males and 18 females; mean ± SD age: 41 ± 5 years) were enrolled. Lower-limb strength assessment comprised a squat jump test, an ankle rebound test, and an isometric strength test. Respiratory assessment included pulmonary function testing and the measurement of maximal inspiratory pressure. Male athletes performed largely better in the squat jump (26 ± 4 vs. 21 ± 3 cm; p < 0.001; d = 1.48), while no sex differences were found in the other two lower-limb tests. Concerning the respiratory parameters, male athletes showed largely greater values in pulmonary expiratory variables: forced vital capacity (5.19 ± 0.68 vs. 3.65 ± 0.52 L; p < 0.001; d = 2.53), forced expiratory volume in 1 s (4.24 ± 0.54 vs. 2.97 ± 0.39 L; p < 0.001; d = 2.69), peak expiratory flow (9.9 ± 1.56 vs. 5.89 ± 1.39 L/min; p < 0.001; d = 2.77) and maximum voluntary ventilation in 12 s (171 ± 39 vs. 108 ± 23 L/min; p < 0.001; d = 1.93); while no sex differences were identified in maximal inspiratory pressure. Race time was associated with ankle rebound test performance (r = −0.390; p = 0.027), isometric strength test performance (r = −0.349; p = 0.049) and maximal inspiratory pressure (r = −0.544; p < 0.001). Consequently, it seems that athletes competing in mountain ultramarathons may benefit from improving lower-limb isometric strength, ankle reactive strength and inspiratory muscle strength. Nevertheless, further interventional studies are required to confirm these exploratory results. In addition, the fact that the magnitude of the sex difference for isometric strength was minor, as compared with the other strength tests, could represent one of the factors explaining why the performance gap between males and females is reduced in ultramarathons.

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue

The study aimed at assessing the acute physiological effects of running a 65-km vs a 107-km mountain ultramarathon. Nineteen athletes (15 males and 4 females) from the shorter race and forty three athletes (26 males and 17 females) from the longer race were enrolled. Body weight, respiratory and lower limb strength were assessed before and after the race. Blood samples were obtained before, after and 24-h post-race. Body weight loss did not differ between races. A decrease in squat jump height (p<0.01; d = 1.4), forced vital capacity (p<0.01; d = 0.5), forced expiratory volume in 1 s (p<0.01; d = 0.6), peak inspiratory flow (p<0.01; d = 0.6) and maximal inspiratory pressure (p<0.01; d = 0.8) was observed after the longer race; while, after the shorter race only maximal inspiratory pressure declined (p<0.01; d = 0.5). Greater post-race concentrations of creatine kinase (p<0.01; d = 0.9) and C-reactive protein (p<0.01; d = 2.3) were observed following the longer race, while high-sensitivity cardiac troponin was higher after the shorter race (p<0.01; d = 0.3). Sodium decreased post-competition only after the shorter race (p = 0.02; d = 0.6), while creatinine increased only following the longer race (p<0.01; d = 1.5). In both groups, glomerular filtration rate declined at post-race (longer race: p<0.01, d = 2.1; shorter race: p = 0.01, d = 1.4) and returned to baseline values at 24 h post-race. In summary, expiratory and lower-limb fatigue, and muscle damage and inflammatory response were greater following the longer race; while a higher release of cardiac troponins was observed after the shorter race. The alteration and restoration of renal function was similar after either race.

Different race pacing strategies among runners covering the 2017 Berlin Marathon under 3 hours and 30 minutes

The purposes of this study were 1) to analyse the different pacing behaviours based on athlete's performance and 2) to determine whether significant differences in each race split and the runner's performance implied different race profiles. A total of 2295 runners, which took part in Berlin's marathon (2017), met the inclusion criteria. 4 different groups were created based on sex and performance. Men: Elite (<02:19:00 h), Top 1 (<02:30:00 h), Top 2 (<02:45:00 h) and Top 3 (<03:00:00 h); women: Elite (02:45:00 h), Top 1 (<03:00:00 h), Top 2 (<03:15:00 h), Top 3 (<03:30:00 h). With the aim of comparing the pacing between sex and performance the average speed was normalized. In men, no statistically significant changes were found between performance group and splits. A large number of significant differences between splits and groups were found amongst women: 5-10 km Top 2 vs Top 3 (P = 0.0178), 10-15 km Top1 vs Top 2 (P = 0.0211), 15-20 km Top1 vs Top 2 (P = 0.0382), 20-21.1 km Elite vs Top 2 (P = 0.0129); Elite vs Top 3 (P = 0.0020); Top1 vs Top 2 (P = 0.0233); Top 1 vs Top 3 (P = 0.0007), 25-30 km Elite vs Top 2 (P = 0.0273); Elite vs Top 3 (P = 0.0156), 30-35 km Elite vs Top 2 (P = 0.0096); Top 1 vs Top 2 (P = 0.0198); Top2 vs Top3 (P = 0.0069). In men there were little significant differences based on athletes' performance which implied a similar pacing behaviour. Women presented numerous differences based on their performance which suggested different pacing behaviours.

The Advantage of Supine and Standing Heart Rate Variability Analysis to Assess Training Status and Performance in a Walking Ultramarathon

Cardiac autonomic modulation of heart rate, assessed by heart rate variability (HRV), is commonly used to monitor training status. HRV is usually measured in athletes after awakening in the morning in the supine position. Whether recording during standing reveals additional information compared to supine remains unclear. We aimed to evaluate the association between short-duration HRV, assessed both in the supine and standing position, and a low-intensity long-duration performance (walking ultramarathon), as well as training experience. Twenty-five competitors in a 100 km walking ultramarathon underwent pre-race supine (12 min) and standing (6 min) HR recordings, whereas performance and subjective training experience were assessed post-race. There were no significant differences in both supine and standing HRV between finishers (n = 14) and non-finishers (n = 11, mean distance 67 km). In finishers, a slower race velocity was significantly correlated with a higher decrease in parasympathetic drive during position change [larger decrease in High Frequency power normalized units (HF_nu: r = −0.7, p = 0.01) and higher increase in the detrended fluctuation analysis alpha 1 index (DFA1: r = 0.6, p = 0.04)]. Highly trained athletes accounted for higher HF_nu during standing compared to poorly trained competitors (+11.5, p = 0.01). Similarly, greater training volume (total km/week) would predict higher HF_nu during standing (r = 0.5, p = 0.01). HRV assessment in both supine and standing position may provide additional information on the dynamic adaptability of cardiac autonomic modulation to physiologic challenges and therefore be more valuable for performance prediction than a simple assessment of supine HRV. Self-reported training experience may reliably associate with parasympathetic drive, therefore indirectly predicting long-term aerobic performance in ultramarathon walking races.

Mechanism of Fatigue Induced by Different Cycling Paradigms With Equivalent Dosage

Leg cycling is one of the most common modes of exercise used in athletics and rehabilitation. This study used a novel cycling setting to elucidate the mechanisms, central vs. peripheral fatigue induced by different resistance with equivalent works (watt∗min). Twelve male adults received low and relatively high resistance cycling fatigue tests until exhausted (RPE > 18) in 2 weeks. The maximal voluntary contraction, voluntary activation level, and twitch forces were measured immediately before and after cycling to calculate General (GFI), central (CFI), and peripheral (PFI) fatigue indices of knee extensors, respectively. The results showed that the CFI (high: 92.26 ± 8.67%, low: 78.32 ± 11.77%, p = 0.004) and PFI (high: 73.76 ± 17.32%, low: 89.63 ± 11.01%, p < 0.017) were specific to the resistance of fatigue protocol. The GFI is influenced by the resistance of cycling to support the equivalent dosage. This study concluded that the mechanism of fatigue would be influenced by the resistance of fatigue protocol although the total works had been controlled.

Marques M. Effects of Knowing the Task's Duration on Soccer Players' Positioning and Pacing Behaviour During Small-Sided Games

The study aimed to identify how the manipulation of knowledge regarding a training task duration constrains the pacing and tactical behaviour of soccer players when playing small-sided games (SSG). Twenty professional and experienced soccer players participated in a cross-sectional field study using three conditions: not informed on the duration of the SSG, which ended after 20 min (Unknown Condition); briefed about playing the SSG for 10 min, but after they completed the 10-min game, they were requested to complete another 10 min (Partial Condition) and informed before that they would play for 20 min (Known Condition). A global positioning system was used to measure the total distance covered and distances of different exercise training zones (walking to sprinting) and to access the dynamic players positioning through the distance from each player to all the teammates and opponents. Additionally, approximate entropy was measured to identify the regularity pattern of each gathered individual variable. The results indicate that the first 10 min of each scenario presented a higher physical impact independently of the initial information. During this time, the tactical behaviour also revealed higher variability. An increase in the distance of the teammates during the second period of 10-min for the Known scenario was also found, which may result from a lower pacing strategy. This study showed that the prior knowledge of the task duration led to different physical and tactical behaviours of the players. Furthermore, the relationship between the physical impact and the regularity of team game patterns should be well analysed by the coach, because the physical impact may be harmful to the development of the collective organization of the team.

Incorporating methods and findings from neuroscience to better understand placebo and nocebo effects in sport

Placebo and nocebo effects are a factor in sports performance. However, the majority of published studies in sport science are descriptive and speculative regarding mechanisms. It is therefore not unreasonable for the sceptic to argue that placebo and nocebo effects in sport are illusory, and might be better explained by variations in phenomena such as motivation. It is likely that, in sport at least, placebo and nocebo effects will remain in this empirical grey area until researchers provide stronger mechanistic evidence. Recent research in neuroscience has identified a number of consistent, discrete and interacting neurobiological and physiological pathways associated with placebo and nocebo effects, with many studies reporting data of potential interest to sport scientists, for example relating to pain, fatigue and motor control. Findings suggest that placebos and nocebos result in activity of the opioid, endocannabinoid and dopamine neurotransmitter systems, brain regions including the motor cortex and striatum, and measureable effects on the autonomic nervous system. Many studies have demonstrated that placebo and nocebo effects associated with a treatment, for example an inert treatment presented as an analgesic or stimulant, exhibit mechanisms similar or identical to the verum or true treatment. Such findings suggest the possibility of a wide range of distinct placebo and nocebo mechanisms that might influence sports performance. In the present paper, we present some of the findings from neuroscience. Focussing on fatigue as an outcome and caffeine as vehicle, we propose three approaches that researchers in sport might incorporate in their studies in order to better elucidate mechanisms of placebo/nocebo effects on performance.