Blood Biomarker Profiling and Monitoring for High-Performance Physiology and Nutrition: Current Perspectives, Limitations and Recommendations

Thermal relations in sled dogs before and after exercise

Regulation of internal body temperature (Tb), or thermoregulation, is an evolutionarily conserved trait that places demand on basal metabolic rate of endothermic animals. Across species, athletes generate increased quantities of heat in comparison to their nonathletic counterparts and, therefore, must mediate physiological unbalance by upregulating the effectiveness of their heat dissipation abilities. Canine athletes are no exception to this phenomenon, however, with literature denoting body temperatures lower than nonathletic canines, it is clear they must possess adaptations to mitigate this demand. With VO2 max measurements of more than 200 mL/kg/min in sled dogs with mild training to 300 mL/kg/min in highly trained animals, sled dogs are a prime example of athleticism in canines. Seeking to determine correlations between Tear and body mass, morphology, and age of canine athletes, core body temperature (Tb) was measured with an instant ear thermometer, using Tear as a correlate before and after a 2-mile run. In addition, we employed thermal imaging analysis to capture body-wide heat dissipation patterns in sled dogs, and focused on thermal variation of mouth (Tmouth), nose (Tnose), and eyes (Teye). Furthermore, we looked at correlations between thermal variability across these four tissues and head morphology of each dog. Tear was consistently the highest temperature across all tissues measured, with a 1.5°C increase between pre- to postexercise (p < 0.001). Thermal imaging revealed significant positive correlations between Tmouth and body mass 15 min postexercise (p = 0.0023) as well as significantly negative correlations between Tnose and body mass at before exercise (p = 0.0468), Teye and nose length after run (p = 0.0076), and Tmouth and nose length after run (p = 0.0110). As body temperature rises during exercise, it becomes increasingly important to regulate blood flow throughout the body to supply working tissues with oxygen. This demand is offset by the role of the snout in evaporative cooling through panting, functioning as a prime location for heat dissipation and therefore maintaining significant relationships with many other vascularized tissues.

The association between blood biological age at rehabilitation admission and physical activity during rehabilitation in geriatric inpatients: RESORT

Geriatric rehabilitation inpatients have high levels of sedentary behaviour (SB) and low levels of physical activity (PA). Biological age predicted by blood biomarkers is indicative of adverse outcomes. The objective was to determine the association between blood biological age at rehabilitation admission and levels of SB and PA during rehabilitation in geriatric inpatients. Inpatients admitted to geriatric rehabilitation wards at the Royal Melbourne Hospital (Melbourne, Australia) from October 22, 2019, to March 29, 2020, in the REStORing health of acute unwell adulTs (RESORT) observational cohort were included. Blood biological age was predicted using SenoClock-BloodAge, a hematological ageing clock. Patients wore an inertial sensor to measure SB and PA. Logistic regression analyses were conducted. A total of 111 patients (57.7% female) with mean age 83.3 ± 7.5 years were included in the analysis. The mean blood biological age was 82.7 ± 8.4 years. Patients with 1-year higher blood biological age had higher odds of having high SB measured as non-upright time greater than 23 h/day (odds ratio (OR): 1.050, 95% confidence interval (CI): 1.000-1.102). Individuals having 1-year higher age deviation trended towards lower odds of having high levels of PA measured as stepping time greater than 7.4 min/day (OR: 0.916, CI: 0.836-1.005) and as greater than 19.5 sit-to-stand transitions/day (OR: 0.915, CI: 0.836-1.002). In conclusion, higher biological age was associated with higher levels of SB and trended towards lower PA. Incorporating blood biological age could facilitate resource allocation and the development of more tailored rehabilitation plans.

Advancing athletic assessment by integrating conventional methods with cutting-edge biomedical technologies for comprehensive performance, wellness, and longevity insights

In modern athlete assessment, the integration of conventional biochemical and ergophysiologic monitoring with innovative methods like telomere analysis, genotyping/phenotypic profiling, and metabolomics has the potential to offer a comprehensive understanding of athletes' performance and potential longevity. Telomeres provide insights into cellular functioning, aging, and adaptation and elucidate the effects of training on cellular health. Genotype/phenotype analysis explores genetic variations associated with athletic performance, injury predisposition, and recovery needs, enabling personalization of training plans and interventions. Metabolomics especially focusing on low-molecular weight metabolites, reveal metabolic pathways and responses to exercise. Biochemical tests assess key biomarkers related to energy metabolism, inflammation, and recovery. Essential elements depict the micronutrient status of the individual, which is critical for optimal performance. Echocardiography provides detailed monitoring of cardiac structure and function, while burnout testing evaluates psychological stress, fatigue, and readiness for optimal performance. By integrating this scientific testing battery, a multidimensional understanding of athlete health status can be achieved, leading to personalized interventions in training, nutrition, supplementation, injury prevention, and mental wellness support. This scientifically rigorous approach hereby presented holds significant potential for improving athletic performance and longevity through evidence-based, individualized interventions, contributing to advances in the field of sports performance optimization.

Exercise testing for young athletes

With increasing competitiveness across the sporting landscape, there is a need for more research into monitoring and managing the young athlete, as the needs of a young athlete are vastly different to those of an older athlete who is already established in their respective sport. As the age of sports specialisation seems to decrease, exercise testing in the younger cohort of athletes is crucial for safety and long-term success. This article provides a comprehensive summary of available testing and monitoring methods that can be used to assist young athletes as they mature and attempt to excel in their chosen sport.

Building Bridges Instead of Putting Up Walls: Connecting the "Teams" to Improve Soccer Players' Support

The increase in the economic value of soccer occurred in parallel with an increase in competing demands. Therefore, clubs and federations evolved to greater specialization (e.g., state-of-the-art facilities and high-profile expertise staff) to support players' performance and health. Currently, player preparation is far from exclusively club or national team centered, and the lack of control in each player's environment can be more prevalent than expected. For example, an elite group of professional players faces disruptions in the season club-oriented planification due to involvement in national teams. Moreover, as elite players' financial resources grow, it is common for them to employ specialized personal staff (e.g., strength and conditioning, nutritionist, and sports psychologist) to assist in their preparation, resulting in complex three-fold relationships (i.e., club, player's staff, national team). Although efforts have been made to improve communication with and transition from the club to the national team supervision, this new reality (club-players' staff) may generate serious compound role-related problems and difficulties in monitoring load and training adaptation and having a unified message. Therefore, efforts must be implemented to ensure a more informed management of the players' performance environment, where the existence and impact of these various personal staff are considered to avoid a long-term non-zero sum for all intervening parties. If left unchecked, current professional thinking may collide or overlap, potentially triggering conflict escalation and impairing athletic performance or health, especially if effective communication routes are not adequately established. Moreover, diluted personal responsibility regarding performance may ensue, resulting in decreased productivity from all involved, which may cause more harm than benefits for the player's overall health and performance. This emerging reality calls for developing a joint working framework (i.e., between the player's personalized support team and the clubs' team) and better managing of a player-centered process.

Blood-Based Biomarkers for Managing Workload in Athletes: Perspectives for Research on Emerging Biomarkers

At present, various blood-based biomarkers have found their applications in the field of sports medicine. This current opinion addresses biomarkers that warrant consideration in future research for monitoring the athlete training load. In this regard, we identified a variety of emerging load-sensitive biomarkers, e.g., cytokines (such as IL-6), chaperones (such as heat shock proteins) or enzymes (such as myeloperoxidase) that could improve future athlete load monitoring as they have shown meaningful increases in acute and chronic exercise settings. In some cases, they have even been linked to training status or performance characteristics. However, many of these markers have not been extensively studied and the cost and effort of measuring these parameters are still high, making them inconvenient for practitioners so far. We therefore outline strategies to improve knowledge of acute and chronic biomarker responses, including ideas for standardized study settings. In addition, we emphasize the need for methodological advances such as the development of minimally invasive point-of-care devices as well as statistical aspects related to the evaluation of these monitoring tools to make biomarkers suitable for regular load monitoring.

Blood Profiling of Athletes after COVID-19: Differences in Blood Profiles of Post-COVID-19 Athletes Compared to Uninfected Athletic Individuals-An Exploratory Analysis

Blood profiling data in athletic populations and their respective responses to SARS-CoV-2 infection are lacking. Thus, this exploratory pilot study aimed to analyze and compare clinical blood markers in previously infected trained athletes (ATH; 30 m/29 f) and a not previously infected healthy athletic control group (HC; 12 m/19 f). The ATH group undertook a sports medical examination which included extended blood analyses. Blood profiles with a total of 74 variables were assessed (blood counts, pro-/inflammatory and immunological markers, and micronutrients), and the ATH group was compared to the age-matched, vaccinated HC group with comparable athletic back grounds, though without previous SARS-CoV-2-infections. The ATH group showed lower IgG, Troponin-T levels, and they had a lower complement/acute-phase protein activation. Furthermore, Vitamin D levels were lower and electrolyte/micronutrient concentrations were higher in ATH. Soluble transferrin receptor as a marker of erythrocyte turnover was decreased whereas PTT as a coagulation marker was increased. Subgroup analyses according to sex revealed more differences between the women of the ATH and HC groups (for 25 different variables) than between the men (for 5 different variables), especially for immunological and metabolic variables. In particular, the immune system and electrolyte/micronutrient status should be observed frequently and sex-specifically in this athletic cohort.

Blood-Based Biomarkers for Managing Workload in Athletes: Considerations and Recommendations for Evidence-Based Use of Established Biomarkers

Blood-based biomarkers can provide an objective individualized measure of training load, recovery, and health status in order to reduce injury risk and maximize performance. Despite enormous potentials, especially owing to currently evolving technology, such as point-of-care testing, and advantages, in terms of objectivity and non-interference with the training process, there are several pitfalls in the use and interpretation of biomarkers. Confounding variables such as preanalytical conditions, inter-individual differences, or an individual chronic workload can lead to variance in resting levels. In addition, statistical considerations such as the detection of meaningful minimal changes are often neglected. The lack of generally applicable and individual reference levels further complicates the interpretation of level changes and thus load management via biomarkers. Here, the potentials and pitfalls of blood-based biomarkers are described, followed by an overview of established biomarkers currently used to support workload management. Creatine kinase is discussed in terms of its evidence for workload management to illustrate the limited applicability of established markers for workload management to date. We conclude with recommendations for best practices in the use and interpretation of biomarkers in a sport-specific context.

Optimizing human performance in extreme environments through precision medicine: From spaceflight to high-performance operations on Earth

Humans operating in extreme environments often conduct their operations at the edges of the limits of human performance. Sometimes, they are required to push these limits to previously unattained levels. As a result, their margins for error in execution are much smaller than that found in the general public. These same small margins for error that impact execution may also impact risk, safety, health, and even survival. Thus, humans operating in extreme environments have a need for greater refinement in their preparation, training, fitness, and medical care. Precision medicine (PM) is uniquely suited to address the needs of those engaged in these extreme operations because of its depth of molecular analysis, derived precision countermeasures, and ability to match each individual (and his or her specific molecular phenotype) with any given operating context (environment). Herein, we present an overview of a systems approach to PM in extreme environments, which affords clinicians one method to contextualize the inputs, processes, and outputs that can form the basis of a formal practice. For the sake of brevity, this overview is focused on molecular dynamics, while providing only a brief introduction to the also important physiologic and behavioral phenotypes in PM. Moreover, rather than a full review, it highlights important concepts, while using only selected citations to illustrate those concepts. It further explores, by demonstration, the basic principles of using functionally characterized molecular networks to guide the practical application of PM in extreme environments. At its core, PM in extreme environments is about attention to incremental gains and losses in molecular network efficiency that can scale to produce notable changes in health and performance. The aim of this overview is to provide a conceptual overview of one approach to PM in extreme environments, coupled with a selected suite of practical considerations for molecular profiling and countermeasures.

Measurement of Energy Intake Using the Principle of Energy Balance Overcomes a Critical Limitation in the Assessment of Energy Availability

Prolonged low energy availability, which is the underpinning aetiology of the Relative Energy Deficiency in Sport and the Female and Male Athlete Triad frameworks, can have unfavourable impacts on both health and performance in athletes. Energy availability is calculated as energy intake minus exercise energy expenditure, expressed relative to fat free mass. The current measurement of energy intake is recognized as a major limitation for assessing energy availability due to its reliance on self-report methods, in addition to its short-term nature. This article introduces the application of the energy balance method for the measurement of energy intake, within the context of energy availability. The energy balance method requires quantification of the change in body energy stores over time, with concurrent measurement of total energy expenditure. This provides an objective calculation of energy intake, which can then be used for the assessment of energy availability. This approach, the Energy Availability - Energy Balance (EA_EB) method, increases the reliance on objective measurements, provides an indication of energy availability status over longer periods and removes athlete burden to self-report energy intake. Implementation of the EA_EB method could be used to objectively identify and detect low energy availability, with implications for the diagnosis and management of Relative Energy Deficiency in Sport and the Female and Male Athlete Triad.

Body Composition and Bone Health Status of Jockeys: Current Findings, Assessment Methods and Classification Criteria

Jockeys are unlike other weight-making athletes as the sport of horse racing requires strict weight management to meet the racing stipulations, protracted working hours and an extended racing season with limited downtime. Several studies have reported on the body composition and bone status of male and female professional and retired jockeys, yet the variety of assessment techniques, lack of standardised testing protocols and classification inconsistency make interpretation and comparison between studies problematic. This review aimed to appraise the existing body composition and bone health evidence in jockeys and evaluate the assessment methods and classification criteria used. Dual-energy X-ray absorptiometry (DXA) has been used most frequently in jockey research to assess body composition and bone status, while various generic skinfold equations have been used to predict body fat percentage. Evidence indicates flat jockeys are now taller and heavier than the data reported in earlier studies. Absolute fat mass has steadily increased in male jockeys in the last decade. The bone status of male jockeys remains a concern as constant low bone density (BMD) is evident in a large percentage of young and experienced professional jockeys. Due to limited studies and variations in assessment methods, further research is required to investigate bone turnover markers in male and female jockeys. A standardised testing protocol using internationally recognised assessment guidelines is critical for the accurate interpretation and evaluation of body composition and bone health measurements. Furthermore, establishing jockey-specific BMD and bone turnover reference ranges should be considered using existing and future data.

Assessment of Changes in Physiological Markers in Different Body Fluids at Rest and after Exercise

Physiological and biological markers in different body fluids are used to measure the body’s physiological or pathological status. In the field of sports and exercise medicine, the use of these markers has recently become more popular for monitoring an athlete’s training response and assessing the immediate or long-term effects of exercise. Although the effect of exercise on different physiological markers using various body fluids is well substantiated, no article has undertaken a review across multiple body fluids such as blood, saliva, urine and sweat. This narrative review aims to assess various physiological markers in blood, urine and saliva, at rest and after exercise and examines physiological marker levels obtained across similar studies, with a focus on the population and study methodology used. Literature searches were conducted using PRISMA guidelines for keywords such as exercise, physical activity, serum, sweat, urine, and biomarkers, resulting in an analysis of 15 studies for this review paper. When comparing the effects of exercise on physiological markers across different body fluids (blood, urine, and saliva), the changes detected were generally in the same direction. However, the extent of the change varied, potentially as a result of the type and duration of exercise, the sample population and subject numbers, fitness levels, and/or dietary intake. In addition, none of the studies used solely female participants; instead, including males only or both male and female subjects together. The results of some physiological markers are sex-dependent. Therefore, to better understand how the levels of these biomarkers change in relation to exercise and performance, the sex of the participants should also be taken into consideration.

Comprehensive training load monitoring with biomarkers, performance testing, local positioning data, and questionnaires - first results from elite youth soccer

Load management, i.e., prescribing, monitoring, and adjusting training load, is primarily aimed at preventing injury and maximizing performance. The search for objective monitoring tools to assess the external and internal load of athletes is of great interest for sports science research. In this 4-week pilot study, we assessed the feasibility and acceptance of an extensive monitoring approach using biomarkers, neuromuscular performance, and questionnaires in an elite youth soccer setting. Eight male players (mean ± SD: age: 17.0 ± 0.6 years, weight: 69.6 ± 8.2 kg, height: 177 ± 7 cm, VO_2max: 62.2 ± 3.8 ml/min/kg) were monitored with a local positioning system (e.g., distance covered, sprints), biomarkers (cell-free DNA, creatine kinase), questionnaires, neuromuscular performance testing (counter-movement jump) and further strength testing (Nordic hamstring exercise, hip abduction and adduction). Feasibility was high with no substantial impact on the training routine and no adverse events such as injuries during monitoring. Adherence to the performance tests was high, but adherence to the daily questionnaires was low, and decreased across the study period. Occasional significant correlations were observed between questionnaire scores and training load data, as well as between questionnaire scores and neuromuscular performance. However, due to the small sample size, these findings should be treated with caution. These preliminary results highlight the feasibility of the approach in elite soccer, but also indicate that modifications are needed in further large-scale studies, particularly in relation to the length of the questionnaire.

Neurophysiological Markers for Monitoring Exercise and Recovery Cycles in Endurance Sports

The current study analyzes the suitability and reliability of selected neurophysiological and vegetative nervous system markers as biomarkers for exercise and recovery in endurance sport. Sixty-two healthy men and women, endurance trained and moderately trained, performed two identical acute endurance tests (running trial 1 and running trial 2) followed by a washout period of four weeks. Exercise protocol consisted of an acute running trial lasting 60 minutes. An intensity corresponding to 95% of the heart rate at individual anaerobic threshold for 40 minutes was followed by 20 minutes at 110%. At pre-exercise, post-exercise, three hours post-exercise and 24 hours post-exercise, experimental diagnostics on Brain-derived neurotrophic factor (BDNF), heart rate variability (HRV), Stroop Color and Word Test (SCWT), and Short-Form McGill Pain Questionnaire (SF-MPQ) were performed. Significant changes over time were found for all parameters (p < .05). Furthermore, there was an approached statistical significance in the interaction between gender and training status in BDNF regulation (F₍₃₎ = 2.43; p = 0.06), while gender differences were found only for LF/HF-ratio (3hPoEx, F₍₃₎ = 3.40; p = 0.002). Regarding the reliability, poor ICC-values (< 0.5) were found for BDNF, Stroop sensitivity and pNN50, while all other parameters showed moderate ICC-values (0.5-0.75). Plasma-BDNF, SCWT performance, pain perception and all HRV parameters are suitable exercise-sensitive markers after an acute endurance exercise. Moreover, pain perception, SCWT reaction time and all HRV parameters show a moderate reliability, others rather poor. In summary, a selected neurophysiological and vegetative marker panel can be used to determine exercise load and recovery in endurance sports, but its repeatability is limited due to its vaguely reliability.

Biochemical Properties of Atranorin-Induced Behavioral and Systematic Changes of Laboratory Rats

Atranorin (ATR) is a secondary metabolite of lichens. While previous studies investigated the effects of this substance predominantly in an in vitro environment, in our study we investigated the basic physicochemical properties, the binding affinity to human serum albumin (HSA), basic pharmacokinetics, and, mainly, on the systematic effects of ATR in vivo. Sporadic studies describe its effects during, predominantly, cancer. This project is original in terms of testing the efficacy of ATR on a healthy organism, where we can possibly attribute negative effects directly to ATR and not to the disease. For the experiment, 24 Sprague Dawley rats (Velaz, Únetice, Czech Republic) were used. The animals were divided into four groups. The first group (n = 6) included healthy males as control intact rats (♂INT) and the second group (n = 6) included healthy females as control intact rats (♀INT). Groups three and four (♂ATR/n = 6 and ♀ATR/n = 6) consisted of animals with daily administered ATR (10mg/kg body weight) in an ethanol-water solution per os for a one-month period. Our results demonstrate that ATR binds to HSA near the binding site TRP214 and acts on a systemic level. ATR caused mild anemia during the treatment. However, based on the levels of hepatic enzymes in the blood (ALT, ALP, or bilirubin levels), thiobarbituric acid reactive substances (TBARS), or liver histology, no impact on liver was recorded. Significantly increased creatinine and lactate dehydrogenase levels together with increased defecation activity during behavioral testing may indicate the anabolic effect of ATR in skeletal muscles. Interestingly, ATR changed some forms of behavior. ATR at a dose of 10 mg/kg body weight is non-toxic and, therefore, could be used in further research.

Relationships between Fitness Status and Blood Biomarkers in Professional Soccer Players

Background

Physical conditions are recognized to be optimal after the pre-season (PS) phase in professional sports. Given that blood measures may also reveal variations, which in turn, may present associations with fitness changes.

Objective

The aim of this study is to test the changes of blood markers and physical fitness outcomes at the beginning and following the PS phase. Additionally, we aimed also to analyze the associations of training adaptations between blood markers and the physical fitness measures. Methodology. 25 professional male soccer players (28.1 ± 4.6 years old, 2.0 ± 7.8 kg, and 176.7 ± 4.9 cm) were assessed for hematological and biochemical parameters, and physical fitness measures in the baseline and after the phase of PS.

Results

Increases in platelets were observed after the PS phase (p = 0.001, η2 = 0.39). Regarding the biochemical parameters, significant increases between PS were found for creatinine (Cre) (p = 0.001, η2 = 0.66), alkaline phosphatase (ALP) (p = 0.001, η2 = 0.79), C-Reactive Protein (CRP) (p = 0.001, η2 = 0.74), cortisol (C) (p = 0.001, η2 = 0.63), and testosterone (T) (p = 0.001, η2 = 0.76), whereas significant decreases were found for albumin (Alb) (p = 0.004, η2 = 0.29), and calcium corrected (Ca Corr.) (p = 0.002, η2 = 0.32). Moderate correlations were found between albumin and the 5-meter linear sprint split (r = –0.44 (95%CI: –0.71; –0.05)) and CRP (r = –0.48 (95%CI: –0.74; –0.10)). Moderate correlations were found between VAMEVAL and hemoglobin (r = 0.44 (95%CI: 0.05; 0.71)).

Conclusions

The overall physical fitness measures improved after the PS phase. Also, significant variations (decreases/increases) were observed for the case of biomchemical and hematological outcomes. Coaches should carefully consider the adaptative changes observed in blood parameters as the changes in whole organism and metabolism after specific critical phases as the PS in professional players. Thus, optimal management of stimulus/recovery can be warranted to minimize illness and injury rate and to follow the direction and dynamics of adaptative changes.

Olympic Cycle Comparison of the Nutritional and Cardiovascular Health Status of an Elite-Level Female Swimmer: Case Study Report from Slovenia

Monitoring the many aspects that are crucial to an athlete’s performance progress is vital for further training planning and for the development of performance and the sport. We evaluated a four-year change (2018 vs. 2022) in the current nutritional and cardiovascular health status of the most successful elite-level female swimmer in Slovenia. Body composition and dietary intake were assessed using dual-energy X-ray absorptiometry and a standardized food questionnaire. The concentration of blood lipids, blood pressure, and serum micronutrients (B₁₂, 25(OH)D), potassium, calcium, phosphorus, magnesium, and iron) were measured. The four-year comparison showed an improved body composition status (i.e., increased body mass and decreased body fat (percentage and mass), increased lean soft tissue and total bone mineral density (BMD) (i.e., significantly decreased BMD of a left femoral neck and increased BMD of a spine and head)). We also measured an improvement in the cardiovascular health status of some markers (i.e., decreased total cholesterol, triglycerides, and blood pressure but increased low-density lipoprotein cholesterol), most likely due to the differences in assessed dietary intake (i.e., lower carbohydrate intake, higher total and saturated fat intake, and lower sodium intake). Notably, nutrient intakes that are generally of concern (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin B₁₂ and D, calcium, iron, and zinc (except for fiber intake)) were all within recommended ranges. However, the athlete’s vitamin K and potassium intake were not adequate. Furthermore, in 2018, the athlete did not consume dietary supplements, while she now regularly uses several dietary supplements, including EPA and DHA omega-3, vitamin D, multivitamins, carbohydrate powder, and sports drink. Moreover, from the micronutrient serum, only iron levels deviated from the reference values (37 μmol/L vs. 10.7–28.6 μmol/L). The presented screening example using valid, sensitive, and affordable methods and with rapid organizational implementation may be a viable format for regular monitoring.

Diagnostics of tissue involved injury occurrence of top-level judokas during the competition: suggestion for prevention

Background

Judo, as a high-intensity contact sport, may lead to the occurrence of injuries, especially in competitions. This work aims to assess the likelihood of soft and hard tissue injuries in top-level judokas during competition with defining factors that determine the probability of injury occurrence.

Methods

The injuries that occurred in 123 official international competitions from 2005-2019 were recorded by the European Judo Union (EJU) Medical Commission as a survey that was a part of the EJU Injury Registration form with internal consistency shown by a Crombach Alpha of 0.69. This survey data identified factors such as: sex, anatomical localisation of injury, type of injury, tissue involved and mechanisms of the injury. A total of 650 tissue injuries were reported correctly in terms of tissue injury definition.

Results

The most frequent soft tissue injury (STI) reported was a ligament STI (48.15%), closely followed by skin STI (12.15%) and muscles STI (11.38%). In turn, the most frequent hard tissue injury occurred in bones (8.56%). The highest rates of injuries occurred during the fight in the standing position (78%). Injuries in the standing position mainly occurred while executing a throw (25.85%) and followed by the attempt to throw, i.e., the action of reaching the throwing position (22.30%), grip fighting (15.07%), and during falls (14.77%). Opposite to this, fight in groundwork reached only 18.30% soft and hard tissue injuries combined. The ongoing registration of injuries during judo combat and training and the early diagnosis of risk factors for injuries are the basis for the development of effective strategies for injury prevention and further treatment.

Methodological Considerations for Investigating Iron Status and Regulation in Exercise and Sport Science Studies

Iron deficiency is a common health issue in active and athlete populations. Accordingly, research into iron status, regulation, absorption, and iron deficiency treatment strategies is increasing at a rapid rate. However, despite the increase in the quantity of research, various methodological issues need to be addressed as we progress our knowledge in this area. The purpose of this review is to highlight specific considerations for conducting iron-related research in active and athlete populations. First, we discuss the methodological importance of assessment and interpretation of iron status, with reference to blood collection protocols, participant screening procedures, and biomarker selection. Next, we consider numerous variables that should be accounted for in the design of iron-related research studies, such as the iron regulatory hormone hepcidin and its interaction with exercise, in addition to an examination of female physiology and its impact on iron metabolism. Subsequently, we explore dietary iron and nutrient interactions that impact iron regulation and absorption, with recommendations made for optimal methodological control. Consideration is then given to key features of long-term study designs, such as the monitoring of training load, oral iron supplementation, dietary analysis, and general lifestyle factors. Finally, we conclude our recommendations with an exploration of stable iron isotope tracers as a methodology to measure iron absorption. Ultimately, it is our intention that this review can be used as a guide to improve study design, biomarker analysis, and reporting of findings, to maximize the quality of future research outputs in iron-related research focused on active and athlete populations.

The Effect of Two Acute Bouts of Exercise on Oxidative Stress, Hematological, and Biochemical Parameters, and Rectal Temperature in Trained Canicross Dogs

Canicross is a sport discipline that connects human and canine athletes in running. Changes in physiological, hematological, and biochemical parameters, and exercise-induced oxidative stress have not been thoroughly characterized in canicross dogs. The aim of our study was the assessment of the health status of trained canicross dogs that were subjected to two acute bouts of exercise with their owners during the training season. Health status was assessed by measuring the rectal temperature, hematological and biochemical parameters, as well as blood oxidative stress parameters (plasma malondialdehyde, lipid peroxidation marker; whole blood glutathione peroxidase and erythrocyte superoxide dismutase1, antioxidant enzymes) before and during a two-day canicross training session and after a 24-h rest period. Seven trained canicross dogs (three females/four males) aged 12–120 months were included in the study. Blood samples were collected before and immediately after the first acute bout of exercise (day 1), after the second acute bout of exercise (day 2), and after 24 h of rest (day 3). Rectal temperature was measured at the same time as blood sample collection. The majority of hematological and biochemical parameters remained within reference ranges at all sampling times. Rectal temperature was significantly higher after training on days 1 and 2 compared to resting temperature on day 3. Hematological parameters did not change significantly; however, there were significant differences in urea, creatinine, creatine kinase, and triglycerides between specific sampling times. Despite significant changes, these biochemical parameters remained within reference ranges. Significant changes in biochemical parameters seem to reflect the dogs' physiological response to each acute bout of exercise, considering all biochemical parameters and rectal temperature returned to pre-exercise values after a 24-h rest period (day 3). No significant differences in oxidative stress parameters were found between any sampling times. Relatively high erythrocyte superoxide dismutase1 activity at all sampling times may indicate that the canicross dogs are adapted to training by an increased expression of antioxidant enzymes. Based on our results, we can conclude that the trained canicross dogs included in our study were healthy, in good physical condition, and fit for the two acute bouts of field exercise.

Changes in Body Composition, Energy Metabolites and Electrolytes During Winter Survival Training in Male Soldiers

The aim of this study was to examine changes in body composition, energy metabolites and electrolytes during a 10-day winter survival training period. Two groups of male soldiers were examined: the REC group (n = 26; age 19.7 ± 1.2 years; BMI 23.9 ± 2.7) had recovery period between days 6 and 8 in the survival training, whereas the EXC group (n = 42; age 19.6 ± 0.8 years; BMI 23.1 ± 2.8) did not. The following data were collected: body composition (bioimpedance), energy balance (food diaries, heart rate variability measurements), and biomarkers (blood samples). In survival training, estimated energy balance was highly negative: −4,323 ± 1,515 kcal/d (EXC) and −4,635 ± 1,742 kcal/d (REC). Between days 1 and 10, body mass decreased by 3.9% (EXC) and 3.0% (REC). On day 6, free fatty acid and urea levels increased, whereas leptin, glucose and potassium decreased in all. Recovery period temporarily reversed some of the changes (body mass, leptin, free fatty acids, and urea) toward baseline levels. Survival training caused a severe energy deficit and reductions in body mass. The early stage of military survival training seems to alter energy, hormonal and fluid metabolism, but these effects disappear after an active recovery period.

A New Biomarker of Fecal Bacteria for Non-Invasive Diagnosis of Colorectal Cancer

Background

The intestinal flora is correlated with the occurrence of colorectal cancer. We evaluate a new predictive model for the non-invasive diagnosis of colorectal cancer based on intestinal flora to verify the clinical application prospects of the intestinal flora as a new biomarker in non-invasive screening of colorectal cancer.

Methods

Subjects from two independent Asian cohorts (cohort I, consisting of 206 colorectal cancer and 112 healthy subjects; cohort II, consisting of 67 colorectal cancer and 54 healthy subjects) were included. A probe-based duplex quantitative PCR (qPCR) determination was established for the quantitative determination of candidate bacterial markers.

Results

We screened through the gutMEGA database to identify potential non-invasive biomarkers for colorectal cancer, including Prevotella copri (Pc), Gemella morbillorum (Gm), Parvimonas micra (Pm), Cetobacterium somerae (Cs), and Pasteurella stomatis (Ps). A predictive model with good sensitivity and specificity was established as a new diagnostic tool for colorectal cancer. Under the best cutoff value that maximizes the sum of sensitivity and specificity, Gm and Pm had better specificity and sensitivity than other target bacteria. The combined detection model of five kinds of bacteria showed better diagnostic ability than Gm or Pm alone (AUC = 0.861, P < 0.001). These findings were further confirmed in the independent cohort II. Particularly, the combination of bacterial markers and fecal immunochemical test (FIT) improved the diagnostic ability of the five bacteria (sensitivity 67.96%, specificity 89.29%) for patients with colorectal cancer.

Conclusion

Fecal-based colorectal cancer-related bacteria can be used as new non-invasive diagnostic biomarkers of colorectal cancer. Simultaneously, the molecular biomarkers in fecal samples are similar to FIT, have the applicability in combination with other detection methods, which is expected to improve the sensitivity of diagnosis for colorectal cancer, and have a promising prospect of clinical application.

Blood Biomarkers Variations across the Pre-Season and Interactions with Training Load: A Study in Professional Soccer Players

Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes after pre-season training. Methodology: Twenty-five professional soccer players were assessed by training load measures (derived from rate of perceived exertion- known as RPE) during the pre-season period. Additionally, blood samples were collected for hematological and biochemical analyses. Results: For hematological parameters, significant increases were found for platelets (PLT) (dif: 6.42; p = 0.006; d = -0.36), while significant decreases were found for absolute neutrophils count (ANC) (dif: -3.98; p = 0.006; d = 0.11), and absolute monocytes count (AMC) (dif: -16.98; p = 0.001; d = 0.78) after the pre-season period. For biochemical parameters, there were significant increases in creatinine (dif: 5.15; p = 0.001; d = -0.46), alkaline phosphatase (ALP) (dif: 12.55; p = 0.001; d = -0.84), C-reactive protein (CRP) (dif: 15.15; p = 0.001; d = -0.67), cortisol (dif: 2.85; p = 0.001; d = -0.28), and testosterone (dif: 5.38; p = 0.001; d = -0.52), whereas there were significant decreases in calcium (dif: -1.31; p = 0.007; d =0.49) and calcium corrected (dif: -2.18; p = 0.015; d = 0.82) after the pre-season period. Moreover, the Hooper Index (dif: 13.22; p = 0.01; d = 0.78), and all derived RPE measures increased after pre-season period. Moderate-to-very large positive and negative correlations (r range: 0.50-0.73) were found between the training load and hematological measures percentage of changes. Moderate-to-large positive and negative correlations (r range: 0.50-0.60) were found between training load and biochemical measures percentage of changes. Conclusions: The results indicated heavy physical loads during the pre-season, leading to a decrease in immune functions. Given the significant relationships between blood and training load measures, monitoring hematological and biochemical measures allow coaches to minimize injury risk, overreaching, and overtraining.

Beyond the Finish Line: The Impact and Dynamics of Biomarkers in Physical Exercise-A Narrative Review

The research of biomarkers continues to emerge as a developing academic field which is attracting substantial interest. The study of biomarkers proves to be useful in developing and implementing new screening methods for a wide variety of diseases including in the sports area, whether for leisure activities or professional sports. Novel research has brought into question the immune system and the limitations it may impose on sports practicing. As the well-being of athletes is a priority, the state of their immune function offers valuable information regarding their health status and their ability to continue training. The assessment of various biomarkers may contribute to a more accurate risk stratification and subsequent prevention of some invalidating or even fatal pathologies such as the sudden cardiac death. Therefore, we have reviewed several studies that included sports-related pathology or specific morphofunctional alterations for which some immune biomarkers may represent an expression of the underlying mechanism. These include the defensins, immunoglobulin A (IgA), interleukin-6 (IL-6), the tumoral necrosis factor α (TNF-α), and the white blood cells (WBC) count. Similarly, also of significant interest are various endocrine biomarkers, such as cortisol and testosterone, as well as anabolic or catabolic markers, respectively. Literature data highlight that these values are greatly influenced not only by the duration, but also by the intensity of the physical exercise; moderate training sessions actually enhance the immune function of the body, while a significant increase in both duration and intensity of sports activity acts as a deleterious factor. Therefore, in this paper we aim to highlight the importance of biomarkers’ evaluation in connection with sports activities and a subsequent more adequate approach towards personalized training regimens.

Transferring clinically established immune inflammation markers into exercise physiology: focus on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index

Over the last decades the cellular immune inflammation markers neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII = NLR × platelets) have emerged in clinical context as markers of disease-related inflammation and are now widely appreciated due to their integrative character. Transferring these clinically established inflammation markers into exercise physiology seems highly beneficial, especially due to the low temporal, financial and infrastructural resources needed for assessment and calculation. Therefore, the aim of this review is to summarize evidence on the value of the integrative inflammation markers NLR, PLR and SII for depiction of exercise-induced inflammation and highlight potential applications in exercise settings. Despite sparse evidence, multiple investigations revealed responsiveness of the markers to acute and chronic exercise, thereby opening promising avenues in the field of exercise physiology. In performance settings, they might help to infer information for exercise programming by reflecting exercise strain and recovery status or periods of overtraining and increased infection risk. In health settings, application involves the depiction of anti-inflammatory effects of chronic exercise in patients exhibiting chronic inflammation. Further research should, therefore, focus on establishing reference values for these integrative markers in athletes at rest, assess the kinetics and reliability in response to different exercise modalities and implement the markers into clinical exercise trials to depict anti-inflammatory effects of chronic exercise in different patient collectives.

Temporal changes in blood oxidative stress biomarkers across the menstrual cycle and with oral contraceptive use in active women

PURPOSE

To examine the temporal changes in blood oxidative stress biomarkers in recreationally-trained women that were naturally-cycling (WomenNC) or using oral contraceptives (WomenOC) across one month.

METHODS

Blood samples were acquired at three timepoints of the menstrual cycle (1: early-follicular, 2: late-follicular and 3: mid-luteal) and oral contraceptive packet (1: InactiveOC, 2: Mid-activeOC and 3: Late-activeOC) for determination of estradiol, progesterone, oxidative stress, C-reactive protein (CRP) and other cardiometabolic biomarkers in plasma and serum.

RESULTS

There was a Group by Time effect on estradiol (p < 0.001, partial η² = 0.64) and progesterone (p < 0.001, partial η² = 0.77). Malondialdehyde, lipid hydroperoxides and CRP concentrations were higher in WomenOC during Late-activeOC compared to InactiveOC (+ 96%, + 23% and + 104%, respectively, p < 0.05). However, there were no changes in these biomarkers across the menstrual cycle in WomenNC (p > 0.05). At all timepoints (i.e., 1, 2 and 3), WomenOC had elevated lipid hydroperoxides (+ 28, + 48% and + 50%) and CRP (+ 71%, + 117% and + 130%) compared to WomenNC (p < 0.05, partial η² > 0.25). There was no Group by Time effect on non-enzymatic antioxidants or glutathione peroxidase; however, glutathione peroxidase was lower in WomenOC, i.e., main effect of group (p < 0.05, partial η² > 0.20).

CONCLUSION

These findings demonstrate that WomenOC not only have higher oxidative stress and CRP than WomenNC, but also a transient increase across one month of habitual oral contraceptive use. Since changes in oxidative stress and CRP often relate to training stress and recovery, these outcomes may have implications to workload monitoring practices in female athletes.

Acute Effects of Training Loads on Muscle Damage Markers and Performance in Semi-elite and Elite Athletes: A Systematic Review and Meta-analysis

BACKGROUND

The relationship between exercise-induced muscle damage (EIMD) indicators and acute training loads (TL) is yet to be reviewed extensively in semi-elite and elite athlete populations.

OBJECTIVES

The objectives of this systematic review and meta-analysis were threefold: (1) to evaluate studies of EIMD following the initial period of the preseason in semi-elite and elite athletes: (2) to examine acute physiological and performance responses across two periods of the season with similar TL; and (3) to examine acute physiological and performance responses to acute changes in TL during the season.

METHODS

The CINAHL, PubMed, Scopus, SPORTDiscus and Web of Science databases were systematically searched for studies that investigated: (1) semi-elite or elite athletes in team or individual sports following a periodised training programme; and (2) measured acute responses to training. Studies were excluded if: (1) conducted in animals; (2) non-English language; or (3) a conference abstract, review or case report. The Kmet Quality Scoring of Quantitative Studies tool was used for study appraisal.

SYNTHESIS METHODS

Data were quantitatively analysed by generating forest plots to report test statistics for statistical significance and inter-trial heterogeneity.

RESULTS

Of the included studies (n = 32), athletes experienced greater creatine kinase (CK) concentrations (Z = 4.99, p < 0.00001, I² = 74%), inflammatory factors and other indirect measures of muscle damage in the initial phase of the preseason period compared to the off-season; there were no changes in CK (Z = 1.43, p = 0.15, I² = 74%) across two time points of similar TL; and there were concurrent increases in CK with increases in TL (Z = 4.26, p < 0.0001, I² = 36%) and vice versa (Z = 4.33, p < 0.0001, I² = 79%).The qualitative analysis identified that the response of inflammatory factors and other indirect measures of muscle damage to changes in load were inconclusive.

LIMITATIONS

This review included varying age, sex, sports and competition levels. The group level meta-analysis failed to identify within-athlete or position-specific differences across time.

CONCLUSION

Blood biomarkers of EIMD may not differ across periods of similar TL, however can be considered a sensitive monitoring tool for assessing responses following acute TL changes in semi-elite and elite athletes.

Recovery-Stress Response of Blood-Based Biomarkers

The purpose of this study was to investigate blood-based biomarkers and their regulation with regard to different recovery-stress states. A total of 35 male elite athletes (13 badminton, 22 soccer players) were recruited, and two venous blood samples were taken: one in a ‘recovered’ state (REC) after a minimum of one-day rest from exercise and another one in a ‘non-recovered’ state (NOR) after a habitual loading microcycle. Overall, 23 blood-based biomarkers of different physiologic domains, which address inflammation, muscle damage, and tissue repair, were analyzed by Luminex assays. Across all athletes, only creatine kinase (CK), interleukin (IL-) 6, and IL-17A showed higher concentrations at NOR compared to REC time points. In badminton players, higher levels of CK and IL-17A at NOR were found. In contrast, a higher value for S100 calcium-binding protein A8 (S100A8) at REC was found in badminton players. Similar differences were found for BDNF in soccer players. Soccer players also showed increased levels of CK, and IL-6 at NOR compared to REC state. Several molecular markers were shown to be responsive to differing recovery-stress states, but their suitability as biomarkers in training must be further validated.

The Physical Activity-Dependent Hematological and Biochemical Changes in School Horses in Comparison to Blood Profiles in Endurance and Race Horses

Blood testing is one of the most important ways to improve performance, facilitate recovery and monitor the training of endurance and race horses. However, little is known about the physical activity-dependent changes of blood parameters in horses used for pleasure and in riding schools. This study aimed to perform routine blood tests for training monitoring of sport horses in three different horse types of use. Then the values of blood indicators were compared between school, endurance and race horses to find similarities in the physical activity-dependent profile. The study was carried out on 15 endurance, 15 race and 15 school healthy horses who underwent the typical effort for their disciplines. The hemogram parameters, creatine phosphokinase (CPK), aspartate aminotransferase (AST), blood lactate (LAC), and total serum protein (TSP) concentrations were measured using the same protocol and equipment. Measurements of main hematological and biochemical physical activity-dependent parameters were conducted before, immediately after and 30 min after training. In school horses, the physical activity-dependent increase of WBC (40.9%) and CPK (76.4%) was similar to endurance horses, whereas an increase of RBC (19.1%), HGB (18.6%) and HCT (19.4%) were more similar to race horses. The moderate effort-dependent increase of LAC concentration (2775%) was lower than in race horses (7526%) and higher than in endurance horses (390%). Limiting the training or work monitoring assessment of school horses to only the endurance or racing blood profile may result in the omission of significant changes in hematological and biochemical parameters.

[Musculoskeletal laboratory diagnostics in competitive sport]

Hintergrund

Die labordiagnostische Untersuchung stellt eine wichtige Möglichkeit zur Beurteilung und Optimierung der Leistungs- und Regenerationsfähigkeit professioneller Athleten dar. Ferner ist sie für die Prävention, Diagnostik und Rehabilitation von Verletzungen und Überbelastungen von Bedeutung.

Fragestellung

Ziel dieser Arbeit ist die Darstellung muskuloskelettaler laborchemischer Parameter, die relevante Erkenntnisse für die medizinische Betreuung von Leistungssportlern liefern.

Material und Methoden

Literaturrecherche und narratives Review.

Ergebnisse

Die Bestimmung des Vitamin-D-, Calcium- und Knochenstoffwechsels stellt die laborchemische Basisdiagnostik im Rahmen der Beurteilung des Skelettstatus mit zusätzlichem präventivem Nutzen bezüglich muskuloskelettaler Verletzungen dar. Ferner können muskuläre Serummarker, z. B. Laktatdehydrogenase (LDH), Kreatinkinase (CK), Myoglobin und Aspartat-Aminotransferase (ASAT), helfen, eine metabolische Adaptation an das physische Training festzustellen und Aussagen über die muskuläre Arbeitslast und mögliche Schädigungen zu gewinnen. Die Energieverfügbarkeit kann durch eine entsprechende Bilanzierung sowie die laborchemische Bestimmung der Makro- und Mikronährstoffe eingeschätzt und optimiert werden.

Schlussfolgerungen

Die labordiagnostische Untersuchung besitzt in der Betreuung von Athleten eine sportartenübergreifende klinische Relevanz. Sie dient der Erreichung einer höchstmöglichen Leistungsfähigkeit sowie optimalen Prävention von Knochen- und Muskelverletzungen, wobei sämtliche Mangelzustände (z. B. Vitamin D) ausgeglichen werden sollten. Durch eine Periodisierung der laborchemischen Untersuchungen, mit zumindest zwei Labordiagnostiken im Jahr, und Aufstellung individueller Variabilitäts- und Referenzbereiche kann ferner eine bessere Beurteilbarkeit erreicht werden.

Iron status in athletic females, a shift in perspective on an old paradigm

Iron deficiency is a common nutrient deficiency within athletes, with sport scientists and medical professionals recognizing that athletes require regular monitoring of their iron status during intense training periods. Revised considerations for athlete iron screening and monitoring have suggested that males get screened biannually during heavy training periods and females require screening biannually or quarterly, depending on their previous history of iron deficiency. The prevalence of iron deficiency in female athletes is higher than their male counterparts and is often cited as being a result of the presence of a menstrual cycle in the premenopausal years. This review has sought to revise our current understanding of female physiology and the interaction between primary reproductive hormones (oestrogen and progesterone) and iron homoeostasis in females. The review highlights an apparent symbiotic relationship between iron metabolism and the menstrual cycle that requires additional research as well as identifying areas of the menstrual cycle that may be primed for nutritional iron supplementation.

Screening of Potential Stress Biomarkers in Sweat Associated with Sports Training

BACKGROUND

Intense and continuous physical training in sports is related with psychological and physiological stress, affecting the health and well-being of athletes. The development of non-invasive sampling methodologies is essential to consider sweat as a potential biological fluid for stress biomarker assessment. In the current work, the identification in sweat samples of potential molecules that may be used as stress biomarkers was pursued.

METHODS

A sweat pool sample from football players after a 90-min intense training game was studied.

RESULTS

An analysis method using liquid chromatography with detection by tandem mass spectrometry (LC-MSMS) to attain a screening profile of sweat composition is presented. The major focus was on neurotransmitters (e.g. monoamines and metabolites) and other biological molecules related with physical training, such as precursors of biogenic amines (phenylaniline, tyrosine, etc.).

CONCLUSIONS

This study allowed the identification of small biomolecules, neurotransmitters and other related molecules in sweat that are potentially associated with stress conditions. The developed methodology intends to contribute to the assessment and study of physical and psychological stress biomarkers related with intense sports using non-invasive methods.

Biomarkers Correlate With Body Composition and Performance Changes Throughout the Season in Women's Division I Collegiate Soccer Players

The purpose of this study was to evaluate the effects of a competitive soccer season on biomarkers and performance metrics in order to determine the correlation between changes in biomarkers, body composition, and performance outcomes. Twenty-one Division 1 female collegiate soccer players were monitored throughout the 16-week season. Player workload was measured using heart rate and Global Position Satellite systems at all practices and games. Performance testing, including vertical jump, VO_2max, and 3-repetition maximum testing for bench press, squat and deadlift, occurred prior to pre-season and immediately post-season. Blood draws occurred prior to preseason and every 4-weeks thereafter, following a game. Body composition was assessed prior to the start of season (week 0) and weeks 6, 10, 14, and 17 (post-season). Delta area under the curve was calculated for biomarkers and body composition variables to account for seasonal changes adjusted for baseline. Pearson-product moment correlations were used to assess relationships with significance set at p < 0.05. Trends were considered p ≤ 0.10. No significant time main effects were seen for anabolic biomarkers (p > 0.05). Significant time effects were seen for catabolic biomarkers throughout the season (p = 0.001). No changes in body weight, VO_2max, vertical jump, and deadlift occurred. Squat and bench press improved (p = 0.01 and p = 0.02, respectively) with a decline in percent body fat (p = 0.03) and a trend for increased fat free mass (p = 0.09). Additionally, total cortisol (TCORT) negatively correlated with fat free mass (r = −0.48; p = 0.03) and positively correlated with VO_2max (r = 0.47; p = 0.04). A trend was shown for a positive correlation between both TCORT and free cortisol (FCORT) and percent body fat (r = 0.39; r = 0.40; p = 0.08, respectively). IGF-1 and growth hormone positively correlated to deadlift (r = 0.57; P = 0.02 and r = 0.59; p = 0.03), whereas creatine kinase showed a trend for a positive correlation with deadlift (r = 0.49; p = 0.06). IL-6 negatively correlated with bench press (r = −0.53; p = 0.03). These findings support a relationship between biomarkers, performance outcomes, and body composition. Biomarker monitoring may be useful to detect individual player's physiological response to an athletic season and may help provide insights in efforts to optimize performance outcomes.

Autoregulation in Resistance Training: Addressing the Inconsistencies

Autoregulation is a process that is used to manipulate training based primarily on the measurement of an individual's performance or their perceived capability to perform. Despite being established as a training framework since the 1940s, there has been limited systematic research investigating its broad utility. Instead, researchers have focused on disparate practices that can be considered specific examples of the broader autoregulation training framework. A primary limitation of previous research includes inconsistent use of key terminology (e.g., adaptation, readiness, fatigue, and response) and associated ambiguity of how to implement different autoregulation strategies. Crucially, this ambiguity in terminology and failure to provide a holistic overview of autoregulation limits the synthesis of existing research findings and their dissemination to practitioners working in both performance and health contexts. Therefore, the purpose of the current review was threefold: first, we provide a broad overview of various autoregulation strategies and their development in both research and practice whilst highlighting the inconsistencies in definitions and terminology that currently exist. Second, we present an overarching conceptual framework that can be used to generate operational definitions and contextualise autoregulation within broader training theory. Finally, we show how previous definitions of autoregulation fit within the proposed framework and provide specific examples of how common practices may be viewed, highlighting their individual subtleties.

Reliability and suitability of physiological exercise response and recovery markers

There is currently insufficient evidence about the reliable quantification of exercise load and athlete's recovery management for monitoring training processes. Therefore, this test-retest study investigated the reliability of various subjective, muscle force, and blood-based parameters in order to evaluate their suitability for monitoring exercise and recovery cycles. 62 subjects completed two identical 60-min continuous endurance exercise bouts intermitted by a four-week recovery period. Before, immediately after, three, and 24 h after each exercise bout, analysis of parameters were performed. Significant changes over time were found for rating of perceived exertion (RPE), multidimensional mood state questionnaire (MDMQ), maximum voluntary contraction parameters (MVCs), and blood-based biomarkers (p < 0.05). Excellent reliability was calculated for MVCs, mean corpuscular volume and 5-bound distance (ICC > 0.90). A good reliability was found for thiobarbituric acid reactive substances (TBARS) (ICC = 0.79) and haematological markers (ICC = 0.75-0.86). For RPE, MDMQ, interleukin (IL-) 1RA, IL-6, IL-8, IL-15, cortisol, lactate dehydrogenase (LDH), creatine kinase (CK) only moderate reliability was found (ICC < 0.75). Significant associations for IL1-RA and CK to MVC were found. The excellent to moderate reliability of TBARS, LDH, IL-1RA, six measured haematological markers, MVCs and MDMQ implicate their suitability as physiological exercise response and recovery markers for monitoring athletes' load management.

Lacrosse Athletes Load and Recovery Monitoring: Comparison between Objective and Subjective Methods

Both objective (OM) and subjective (SM) methods are used in athletic studies, regardless of sport type, to identify and analyze load and recovery status of athletes. As little information exists about the comparison of these two methodologies, the aim of this study is to compare and contrast information that defines the relationship between both methods. Twelve international male lacrosse athletes participated in this study over the course of which participants heart-rate-variability and questionnaire-data were collected. Statistical analysis was performed to evaluate changes over time and correlations between used methods. Comparison between baseline values and competition showed a reduction in root-mean-square of successive differences (RMSSD) (p < 0.01) and the proportion of beat-intervals (NN) that differ by more than 50 ms divided by total number of NNs (pNN50) (p < 0.01). Further, RMSSD values showed differences during competition with large effects (p = 0.02; η² = 0.24). SM (p < 0.01) showed different progression during competition. Correlation was found for used SM and OM, when considered separately. No evidence for a reliable prediction of OM values using SM could be found. According to these findings, we recommend using a combination of SM and OM data to quantify the physiological stress of training and competition, respectively.