Hormonal responses to striking combat sports competition: a systematic review and meta-analysis

Hormonal response during official bouldering competition

BACKGROUND

Sports competitions present a highly stressful environment for the athletes. The stress that is produced because of physiological or psychological demands could influence athletes' performance. This study aimed to understand the dynamics of stress biomarkers during official national bouldering climbing competition.

METHODS

Twelve sport climbers ([6 females] average age: 20.3±5.21 years, body height: 174.0±10.27 cm, body mass: 64.7±10.80 kg, training age: 10.3±2.40 years) took part in this study. Their saliva cortisol (C) and alpha-amylase (AA) were sampled during the official climbing competition (qualification and final).

RESULTS

The results showed that C had higher values post- (qualification, 1.02±0.43 µg/dL; final, 0.46±0.27 µg/dL) than precompetition (0.45±0.24 µg/dL; 0.29±0.68 µg/dL, respectively). A similar trend can be observed in AA, with higher values post- (qualification, 156.07±133.24 U/dL; final, 199.09±51.24 U/dL) than precompetition (88.18±80.24 U/dL; 88.72±51.24 U/dL, respectively). Furthermore, C had a significantly higher response prequalification (0.45±0.24 µg/dL) than prefinal (0.29±0.19 µg/dL), with the same response post both competition rounds (qualification, 1.02±0.43 µg/dL; final, 0.46±0.27 µg/dL).

CONCLUSIONS

Overall, the results showed a strong endocrine and nervous system response. These findings lead to the conclusion that sports climbing competitions present a highly stressful environment for athletes, both physically and psychologically.

Levels of Stress in Volleyball Referees During Official Matches-The Influence of the Referee Role and Level of Competition

Volleyball referees, as athletes and staff members, are exposed to different stress levels which can be determined by measuring pre- and post-match levels of salivary cortisol (C) and alpha-amylase (AA). This study aimed to determine the dynamics of stress biomarkers in referees during official volleyball matches and the connection to the roles or level of competition. The participants in this study were nine international volleyball referees (three females and six males) with a mean chronological age of 48.23 ± 2.31 years. In this study, saliva samples were collected during 24 official matches during the European championship for senior women's teams (Eurovolley 2021). The AA activity and C concentrations were determined from saliva samples. When the referees' roles were assessed in line with their duties, the first referees' salivary C levels showed a significant increase between the pre- and post-match measurements (p = 0.01), while in the second referees remained low. The reserve and challenge referees demonstrated a significant drop in their C concentrations (p = 0.00 and p = 0.02, respectively). Additionally, when assessing AA which accounts for the responsibilities of referees and the intensity of competition, the first (p = 0.06 and p = 0.07) and second referees (p = 0.01 and p = 0.00) showed an increase between the pre- and post-match measurements, respectively. At the same time, the AA activity did not show any significant change concerning the reserve and challenge referees. Our results indicate that referees' roles and the level of competition may cause higher responses in "active referee roles"-mainly the first and second referees-while reserve and challenge referees showed no increase or even a decrease in the measured biomarkers. The observed changes in the stress markers can be explained by psychological or emotional effects and are dependent on the level of competition and the role referees are fulfilling.

Interactions between Stress Levels and Hormonal Responses Related to Sports Performance in Pro Women's Basketball Team

The testosterone to cortisol ratio (T:C ratio) is a measure of whether elite athletes are recovering from their training. This study described this hormone balance stress in elite women's basketball. (1) Objectives: to analyse the fluctuation of T:C ratio over a 16-week period and explore itis relation to their athletic performance. The participants characteristics were: (height: 177.6 ± 6.4 cm; body mass: 77.808 ± 12.396 kg age: 26.0 ± 5.9 years; and a playing experience of 14.7 ± 2.9 years with 5.0 ± 1.2 years at the elite level. The T:C ratio at Time 1 is: 4.0 ± 2.4 (n = 12); and at Time 2 is: 5.1 ± 4.3 (n = 12). (2) Methods: during 16 weeks of competition, participants underwent analysis of blood samples to assess various biochemical parameters including hormone levels. In addition, their athletic performance was assessed with the following tests: jumping (SJ, CMJ, ABK, DJ); throwing test with a medicine ball (3 kg); Illinois COD agility test; sprint repeatability with change of direction; 20-m speed test without change of direction; and Yo-yo intermittent endurance test IET (II). (3) Results: The main alterations observed were an increase in T levels (1.687%) and a decrease in C levels (-7.634%) between moments, with an improvement (26.366%) in the T:C ratio. Improvements were also observed in some of the tests developed, such as jumping (SJ: 11.5%, p = 0.029; CMJ: 10.5%, p = 0.03; DJ: 13.0%, p = 0.01), upper body strength (MBT: 5.4%, p = 0.03), translation ability (20 m: -1.7%), repeated sprint ability (RSA: -2.2%), as well as intermittent endurance test (Yy (IET): 63.5%, p = 0.01), with significant changes in some of the performance tests. (4) Conclusions: T:C ratio may differ in a manner unrelated to training volume, showing some variation. These results may be attributed to the accumulation of psychophysiological stress during the season.

A comparative analysis of the physical fitness profile of Korean women's national amateur boxers by weight category

The purpose of this study was to examine the differences in specific physical fitness of the national amateur women's boxer. The Korean women's national amateur boxers were classified into the lightweight category (LWC, n=21) and middleweight category (MWC, n=13), and body composition (percentage body fat and body mass index) and specific physical fitness (maximal muscle strength, anaerobic power, isokinetic muscle strength, cardiopulmonary endurance) were measured. The Mann-Whitney U-test was conducted to determine the differences in the body composition and specific physical fitness in women's boxers. The percentage body fat (P=0.004) and body mass index (P<0.001) were significantly higher in the LWC compared to MWC. In addition, LWC showed significantly higher isokinetic muscle strength (P<0.001), upper anaerobic mean power (P=0.002), maximal muscle strength (P=0.003), and maximal heart rate at anaerobic threshold (P=0.029), maximal oxygen consumption (P<0.001) and the 20-m shuttle-run exercise (P=0.004) compared to MWC. In conclusion, the body fat percentage and body mass index levels among body composition were significantly higher in the MWC than in the LWC, and the constant muscle strength, maximum muscle strength, and cardiopulmonary endurance levels were significantly higher in the LWC than in the MWC. The results of this study are expected to provide useful data for planning future strategies for efficient and scientific training programs for each weight category.

Sex differences in mood, hormone and immune response to combatives training in West Point Cadets

Hand-to-hand combat training, known as combatives, instructs Soldiers in close-quarters combat techniques and how to cope with stress, understand controlled physical aggression, and develop self-confidence when engaged in such activities. Limited research in combat sports suggests men and women may respond to combatives stress differently. Given the increasing integration of women into close combat roles in the military, investigation of sex differences in the physiological and psychological response to combatives among military-trained personnel is warranted.

PURPOSE

This study was designed to identify sex differences in stress and gonadal hormones, mucosal immunity, and mood states in a military combatives training course.

METHODS

U.S. Military Academy Cadets (men = 144, women = 37) enrolled in a 2-month Combat Applications Course at West Point completed the Profile of Mood States and Competitive State Anxiety Inventory-2 and provided salivary samples at baseline prior to the course, and immediately prior to their midterm and final combat matches. Combat matches were gender- and weight-matched. Additional salivary samples were collected immediately following the first midterm and final matches. Salivary cortisol, testosterone, secretory immunoglobulin A (SIgA) and estradiol (women only) were measured via immunoassay. Men and women were compared over time with linear mixed effects models.

RESULTS

In both men and women, confusion, tension, anger, cognitive anxiety, somatic anxiety, and self-confidence increased throughout the course whereas friendliness and SIgA secretion rate decreased (all p < 0.05). Compared to women, men had a greater acute increase in cortisol from pre- to post-match (p = 0.043). Prior to the final match, women displayed higher ratings of tension (20.5 ± 9.3 vs. 16.0 ± 8.6) and cortisol (0.6 ± 0.3 vs. 0.4 ± 0.3 µg/dL) than men (all p < 0.05). After controlling for previous combative experience, ratings of tension did not differ by sex but remained elevated prior to midterm and final compared to baseline.

CONCLUSION

Combatives training elicited significant psychological and physiological stress and decreased mucosal immunity in both men and women. Women exhibited higher tension at the final match, likely due to lack of previous combative experience. Self-confidence increased from baseline suggesting that the skills learned may help Cadets prepare for combatives and other activities that require controlled aggression.

Drawbacks and Unexpected Advantages of the Response to Modeling Posttraumatic Stress Disorder in Old Wistar Rats

In modeling post-traumatic stress disorder (PTSD), old Wistar rats exhibit the same general signs of a PTSD-like condition as young rats do. The ratio of testosterone to corticosterone levels was assessed as a new index and proved to provide a guideline for dividing the rat population into low- and high-anxiety groups when modeling PTSD. Several features were observed in behavior, psycho-emotional manifestations, hormone levels, and myocardial state in old rats. A sharp rise in circulating testosterone was for the first time shown to occur in old, but not young, rats in stress, contributing to a more rapid decision as to where to move in the labyrinth space. Priority data were obtained on dysfunctional accumulation of mitochondria in the myocardium in intact and stressed old rats. The information obtained may be useful in developing drugs against harmful consequences of PTSD and senile changes in the myocardium.

RECOVERY FROM MUSCLE INJURIE AFTER HIGH-INTENSITY TRAINING IN TABLE TENNIS

ABSTRACT Introduction High-intensity training is an important point in table tennis training. Due to the high muscle load, occasional injuries may occur during the practice of this activity, requiring the intervention of dedicated physical rehabilitation. Objective Explore the rehabilitation process of muscle injuries caused by high-intensity training in table tennis athletes. Methods Thirty-one student table tennis athletes with indications for rehabilitation due to muscle injuries caused by high-intensity training were volunteers for this research. Data pertinent to the research were collected before and after the intervention. Muscle strength, tank test, lifting test, flexor and extensor group peak torque at 60°/s speed, and flexor and extensor group peak torque at 60°/s speed were analyzed, and data were stored and analyzed in statistical software. The results were analyzed and checked against the updated scientific literature. Results The research shows that a good recovery method can relieve muscle pain and reduce psychological problems caused by pain and speed up joint motion gain. Conclusion The protocol analyzed in this paper can improve the athletes’ sporting level both from the physiological and psychological point of view, besides promoting faster recovery and being suitable for daily practical application. Level of evidence II; Therapeutic studies - investigation of treatment results.

Psychological readiness to return to sports practice and risk of recurrence: Case studies

Returning to sport after the sports injury is a difficult decision because it's multicausal and the fact that a rash decision can result in numerous negative consequences. Given the importance of psychological variables for the correct rehabilitation of the injured athlete and his or her optimal return to sports practice, there seems to be little information on this subject. In this sense, the objective is to determine the relationship between the subjective psychological disposition of the athlete in the process of Return to Play (RTP) with the type of mood profile and his mental health. This is based on the fact that each athlete evaluates his or her recovery differently and has different levels of anxiety, depression, and stress. For this purpose, four athletes participated in the study. Two males and two females from the sports of indoor soccer and soccer, who had just returned to sports after a moderate or severe injury. The average age was 24.25 years. Various measurements were taken after practices and after matches, to assess mood, psychological readiness, anxiety, stress, and depression. The results confirm Morgan's iceberg profile and the influence that subjective psychological perceptions and assessed emotional states have on athletes' incorporation into their sports practice with a guarantee of success.

RELATIONSHIP BETWEEN COMPETITION SIMULATION AND TRAINING ON STRENGTH AND DAMAGE INDICATORS IN JIU-JITSU

ABSTRACT Background: The relationship between training and competition is very important and aims at a more specific and adequate preparation in Jiu-Jitsu. Problem and objective: To evaluate the relationship between training and competition through indications of injury and muscle strength. Methods: The study sample included nine subjects (22.54 ± 2.77 years of age) who were submitted to the following two conditions: 1) training simulation and 2) competition simulation. Results: There were no significant differences in the countermovement jump (CMJ) test. However, 48 hours after training there was an indication of values higher than the post-competition ones. Creatine kinase (CK) indicated significant differences in muscle damage after competition in relation to the other conditions and moments (p <0.01) with a high effect. Lactate dehydrogenase (LDH) showed differences in the moments before, during, and after both competition and training conditions (p <0.05) with a high effect. The power of the upper limbs (PUL) showed a medium correlation at 24h (> 0.55) and 48h (0.47) after the intervention. There was high correlation (> 0.70) for all conditions in the squat jump (SJ). LDH showed a high correlation (> 0.70) at 48 hours. Conclusion: There was a good correlation between training and competition simulation, which tends to indicate that the training model used in the study properly prepare Jiu-Jitsu athletes for the demands of competition. Level of evidence I; High-quality randomized clinical trial with or without a statistically significant difference, but with narrow confidence intervals.

The prevalence of pre-conditioning and recovery strategies in senior elite and non-elite amateur boxing

OBJECTIVES

A variety of acute strategies around competition are used to prepare and promote physical and mental restoration in athletes. However, to date, no research exists on the prevalence of such methods in amateur boxing. Therefore, this study aimed to 1) examine the prevalence of pre-conditioning and recovery strategies in amateur boxing; 2) ascertain whether this was discriminated against at competitor level.

METHODS

This study surveyed 101 senior amateur boxers (Senior Elite SEB n = 59; Senior Development SDB n = 42), on their application and perceptions of pre-conditioning and recovery strategies.

RESULTS

The reported findings determined a significantly greater number of SEB performed resistance priming activity up to 48 hours prior to competition (11, 19% vs 2, 5%; P = 0.040), and post-activation performance enhancement (PAPE) activity in the pre-competition warm-up (18, 31% vs 1, 2%; P < 0.001), compared to SDB. Likewise, SEB reported they were also significantly more likely to utilize massage (SEB 35, 59%, SDB 11, 29%, P = 0.001) and cold-water immersion (CWI) (SEB 28, 47%, SDB 10, 29%, P = 0.016) as recovery modes, compared to their SDB counterparts.

CONCLUSIONS

This study was the first to provide data on the use of PAPE, priming and recovery methods around amateur boxing bouts. Increased access to multi-disciplinary staff could be expected in SEB, possibly explaining the greater prevalence of evidence-based methods around competition. Once athlete responsiveness to PAPEand longer-term priming methods are initially assessed, these strategies could be implemented to improve punch-specific performance, though more research is needed on their efficacy. Likewise, boxers could utilize evidence-based recovery modes where possible, with increased importance during repeat-bout scenarios, such as domestic tournaments. Coaches and practitioners may use this data to implement pre-conditioning and recovery strategies, to optimize performance and reduce the risk of injury of amateur boxers.

Uric Acid and Cortisol Levels in Plasma Correlate with Pre-Competition Anxiety in Novice Athletes of Combat Sports

Pre-competition anxiety is very prevalent in novice athletes, causing stress and drastic decreases in their performances. Cortisol plays a central role in the psychosomatic responses to stress and also in the physiology of strenuous exercise. Growing evidence links uric acid, an endogenous antioxidant, with oxidative stress and anxiety, as observed in many depressive-related disorders. We here compared anxiety inventory scores (BAI and CSAI-2), cortisol and biomarkers of oxidative stress in the plasma of novice combat athletes (white and blue belts) before and after their first official national competition, when levels of stress are presumably high. Although the novice fighters did not reveal high indexes of anxiety on questionnaires, significant correlations were confirmed between cortisol and cognitive anxiety (Pearson’s r = 0.766, p-value = 0.002, and a ‘strong’ Bayesian inference; BF10 = 22.17) and between pre-post changes of plasmatic uric acid and somatic anxiety (r = 0.804, p < 0.001, and ‘very strong’ inference; BF10 = 46.52). To our knowledge, this is the first study to report such strong correlations between uric acid and pre-competition anxiety in novice combat athletes. The cause-consequence association between these indexes cannot be directly inferred here, although the interplay between uric acid and anxiety deserves further investigation.

The Acute Physiological, Endocrine, Biochemical and Performance Responses Associated with Amateur Boxing: A Systematic Review with Meta-analysis

AbstractPrevious research has explored the demands of amateur boxing-specific activity; however, no holistic review of the acute responses to such activity currently exists. This systematic review aimed to provide a synthesis of the available literature on the acute physiological, endocrine, biochemical and neuromuscular responses to amateur boxing-specific activity. Following a search of EBSCOhost, SportDiscus, PubMed and Google Scholar databases, 25 studies were identified as meeting the inclusion criteria for the review. Methodological quality of the included studies were assessed via a modified Downs and Black checklist. Random-effects meta-analysis of standardised mean differences (SMD) revealed large (SMD = 4.62) increases in pre-post blood lactate (BLa), cortisol (SMD = 1.33), myoglobin (Mb) (SMD = 1.43) and aspartate transaminase (AST) (SMD = 1.37), in addition to moderate increases in creatine kinase (CK) (SMD = 0.65) and alanine aminotransferase (ALT) (SMD = 0.97). Small pre-post increases in counter-movement jump (CMJ) height (SMD = 0.33) were observed. Consistently greater pre-post alterations were observed in competitive bouts, followed by sparring, when compared with boxing-specific simulations. Considerable physiological, endocrine and biochemical responses are elicited following amateur boxing. Interestingly, neuromuscular and task-specific performance may not deteriorate following boxing-specific activity. The findings of the review may assist in the designing and periodising of boxing-specific training, dependent on the desired physical adaptations, training phase and recovery status of the amateur boxer.

Training vs. Competition in Sport: State Anxiety and Response of Stress Hormones in Young Swimmers

This study was aimed to assess the neuroendocrine response to stress induced by different sports environments (a regular training session and a competitive event), to define the contribution of psychological and physical stress, and to check the possible relationship between state-anxiety and stress hormones responses to competitive and non-competitive sports practices. Twelve young national-level male swimmers participated in this investigation. Endorphins, adrenocorticotropin, and prolactin plasma levels were measured at baseline conditions (t0), before a regular swimming training session (t1), and before and after real swimming competition consisting of 100 m freestyle (t2 and t3, respectively). Moreover, state-anxiety was evaluated in all assessment time-points. The results showed no differences in endorphin, adrenocorticotropin, prolactin and state-anxiety between t0 and t1; however, significant increases in endorphins (142%), prolactin (137%) and state-anxiety (13%) were observed in t2. Huge stress response was observed in t3 (increases of 354%, 387%, and 250% for endorphins, adrenocorticotropin, and prolactin, respectively) although state-anxiety decreased slightly. Lastly, a lack of the relationship between stress hormones and state-anxiety was found in all conditions. Mental and especially physical stress associated with sports competition induces a significant release of stress hormones which is not relevant for the regular training session.

Cortisol, Temperament and Serotonin in Karate Combats: An Evolutionary Psychobiological Perspective

Objectives

There is evidence suggesting that in martial arts competitions athletes characterized by higher anxiety and harm avoidance may be more likely to lose a fight. This psychological profile has been hypothesized to explain in part the observation that cortisol is higher in losers before and in response to a competition. An important research target that needs further exploration is the identification of phenotypic traits that can be helpful in predicting athletes’ performance. Here we present a brief description of the theoretical bases that drives our research in the evolutionary psychobiology of sports and illustrate preliminary data on the relationship between the 5HTTLPR genotype, salivary cortisol, temperament and competition.

Methods

Sixty-five healthy male non-professional athletes provided saliva samples 10 min before and after a kumite session and filled out the Tridimensional Personality Questionnaire.

Results

Salivary cortisol levels 10 min before the competition were higher in losers and in athletes with the S allele. Temperament was associated with competition outcome and cortisol: losers were characterized by higher scores of harm avoidance and harm avoidance was positively correlated with cortisol levels.

Conclusions

The results confirm previous findings linking temperamental traits, pre-and post- competition physiological stress response with competition outcome in kumite fight. Moreover, they indicate an association between the 5HTTLPR polymorphism and pre-competition salivary cortisol, thus providing a preliminary but non-conclusive evidence on the role played by the 5HTTLPR genotype as a vulnerability factor in sport competition.

The association between competitor level and the physical preparation practices of amateur boxers

Physical training, testing, and monitoring are three key constitutes of athlete physical performance; however, there is a currently a lack of information on the prevalence of such methods in amateur boxing. This study aimed to explore the physical preparation practices of senior elite (SEB) and senior development (SDB) amateur boxers, and to determine whether these practices were discriminated by competitor level. One hundred and one amateur boxers (SEB n = 59, SDB n = 42) were surveyed on their understanding, perceptions and application of physical training, monitoring, and testing practices. SEB were associated with strength/power training (SEB 78%, SDB 50%, P = 0.005), monitor of training intensities (SEB 68%, SDB 40%, P = 0.006), and performing regular fitness testing (SEB 76%, SDB 50%, P = 0.006), compared to SDB. Likewise, SEB were twice as likely (56%) to have their physical preparation managed by a strength and conditioning (S&C) coach or sport scientist, compared to SDB (26%; P = 0.005). For the first time, these data demonstrate the extent to which competitor level is associated with preparatory practices in amateur boxing. Cost was identified as the main barrier in implementing several forms of scientific support in SDB. These data serve as a framework to enhance preparatory practices across different competitor levels in amateur boxing. This might include boxer and coach education on the benefits to a more scientific approach, and the use of cost-effective methods to develop, monitor and assess amateur boxers physical performance. This may be of particular importance where boxers are not funded, such as the SDB in the current study. However, this work may also be used to emphasise the importance of strength/power training, physical fitness testing and monitoring at the elite level of amateur boxing.

Acute Effects of Supervised Making Weight on Health Markers, Hormones and Body Composition in Muay Thai Fighters

Making weight is a practice often used in combat sports. This consists of a rapid weight loss (RWL) and a subsequent rapid weight gain (RWG) in the days preceding competition. However, this practice is often carried out based on anecdotal information provided by ex-athletes or non-professionals, which has led to several adverse events. This study aimed to assess the acute effects of a supervised nutritional period of RWL/RWG on health markers, hormone concentrations, and body composition. We performed a single-arm repeated-measures (baseline, after RWL and after RWG) clinical trial with twenty-one (8F:16M) Italian Muay Thai fighters. Body mass was significantly lower after the RWL (-4.1%) while there was a significantly higher glucose availability after RWL and RWG. Blood urea nitrogen, lipid profile, and creatinine were within the normal range after RWL/RWG. Testosterone decrease significantly after RWL and RWG in the men group. Male fighters had a significant reduction in thyroid-stimulating hormone concentration after the RWL and RWG intervention, but no change was found in women at pre-competition. Bioelectrical parameters were almost fully restored after RWG. An evidence-based and individualized nutrition methodology reduces the adverse events after an RWL and RWG practice, although the impact on the hormonal profile is inevitable.

Redox Homeostasis and Inflammation Responses to Training in Adolescent Athletes: a Systematic Review and Meta-analysis

Background

Several studies have highlighted the substantial role of the athlete’s redox and inflammation status during the training process. However, many factors such as differences in testing protocols, assays, sample sizes, and fitness levels of the population are affecting findings and the understanding regarding how exercise affects related biomarkers in adolescent athletes.

Objectives

To search redox homeostasis variables’ and inflammatory mediators’ responses in juvenile athletes following short- or long-term training periods and examine the effect size of those variations to training paradigms.

Methods

A PRISMA-compliant systematic review and meta-analysis were conducted. The entire content of PubMed (MEDLINE), Scopus, and Science Direct were systematically searched until December 2019. Studies with outcomes including (1) a group of adolescent athletes from any individual or team sport, (2) the assessment of redox and/or inflammatory markers after a short- (training session or performance testing) or longer training period, and (3) variables measured in blood were retained. The literature search initially identified 346 potentially relevant records, of which 36 studies met the inclusion criteria for the qualitative synthesis. From those articles, 27 were included in the quantitative analysis (meta-analysis) as their results could be converted into common units.

Results

Following a short training session or performance test, an extremely large increase in protein carbonyls (PC) (ES 4.164; 95% CI 1.716 to 6.613; Z = 3.333, p = 0.001), a large increase in thiobarbituric acid reactive substances (TBARS) (ES 1.317; 95% CI 0.522 to 2.112; Z = 3.247, p = 0.001), a large decrease in glutathione (GSH) (ES − 1.701; 95% CI − 2.698 to − 0.705; Z = − 3.347, p = 0.001), and a moderate increase of total antioxidant capacity (TAC) level (ES 1.057; 95% CI − 0.044 to 2.158; Z = 1.882, p = 0.060) were observed. Following more extended training periods, GSH showed moderate increases (ES 1.131; 95% CI 0.350 to 1.913; Z = 2.839, p = 0.005) while TBARS displayed a small decrease (ES 0.568; 95% CI − 0.062 to 1.197; Z = 1.768, p = 0.077). Regarding cytokines, a very large and large increase were observed in IL-6 (ES 2.291; 95% CI 1.082 to 3.501; Z = 3.713, p = 0.000) and IL-1 receptor antagonist (ra) (ES 1.599; 95% CI 0.347 to 2.851; Z = 2.503, p = 0.012), respectively, following short-duration training modalities in juvenile athletes.

Conclusions

The results showed significant alterations in oxidative stress and cytokine levels after acute exercise, ranging from moderate to extremely large. In contrast, the variations after chronic exercise ranged from trivial to moderate. However, the observed publication bias and high heterogeneity in specific meta-analysis advocate the need for further exploration and consistency when we deal with the assessed variables to ascertain the implications of structured training regimes on measured variables in order to develop guidelines for training, nutritional advice, and wellbeing in young athletes.

Trial Registration

PROSPERO CRD42020152105

Physical activity as an adjunct treatment for erectile dysfunction

Increasing data are available to suggest that physical activity and lifestyle modification in general can benefit erectile function, with effect sizes comparable with established treatment options such as testosterone therapy and phosphodiesterase type 5 inhibitors. Despite this evidence, primary-care physicians are rarely afforded critical information on the underlying mechanisms through which physical activity works as a treatment, severely hampering treatment credibility for both physician and patient. Physical activity is associated with psychological and metabolic adaptations that are compatible with the adaptations required for the treatment of erectile dysfunction (ED). These adaptations include increased expression and activity of nitric oxide synthase, strengthened endothelial function, acute rises in testosterone, decreased stress and anxiety, and improved body image. Use of physical activity as a first-line treatment option for ED is limited, and explicit physical activity guidelines for the treatment of ED are required. Such guidelines should include not only a suggested exercise programme but also guidelines for physician-patient communication that might enhance patient receptivity and therapy continuation. An understanding of how physical activity affects erectile function, as well as its effectiveness in treating ED compared with other established treatments, can benefit urologists and primary-care physicians searching for noninvasive treatment options for men presenting with poor erectile function.