Exercise-Induced Transient Oxidative Stress Is Mitigated in Down Syndrome: Insights About Redox Balance and Muscle Strength

ABSTRACT

Reis, AL, Deus, LA, Neves, RVP, Corrêa, HL Reis, TL, Aguiar, LS Honorato, FS, Barbosa, JMS, Araújo, TB, Palmeira, TRC, Simões, HG, Prestes, J, Sousa, CV, Ide, BN, and Rosa, TdS. Exercise-induced transient oxidative stress is mitigated in Down syndrome: insights about redox balance and muscle strength. J Strength Cond Res 38(3): e125-e34, 2024-This study aimed to evaluate the acute effects of a session of resistance exercise (RE) performed with elastic tubes on the redox balance and inflammatory profile in individuals with Down syndrome (DS). Subjects ( n = 23) were allocated into 2 groups: individuals with DS (DS; n = 11) and individuals without DS (WDS; n = 12), who performed an acute RE session. Diagnostic assessment included medical history, anthropometric measures (body height, body mass, body mass index, and body composition assessment), biological collections, muscle strength assessments (handgrip and maximal voluntary isometric contraction tests), and exercises. The redox balance and inflammatory profile were assessed in urine and saliva samples before and after an acute RE session. There were no differences between WDS and DS groups for body composition ( p > 0.05). The DS group presented higher values pre and post an acute RE session with elastic tubes for oxidative and proinflammatory markers compared with WDS ( p < 0.05). Uric acid values increased from pre-acute RE session to post-acute RE session for WDS ( p < 0.0001). No differences were identified within groups for the delta analysis ( p > 0.05). Inverse correlations were found between total force and F2-isoprostane, 8OHdG, uric acid, allantoin, IL-6, TNF-α, and the TNF-α:IL-10 ratio. A positive correlation was found between IL-10 and total force. The DS group presented increased peak force in the knee extension and elbow flexion exercises (∼25 and 12%, respectively) but decreases in handgrip strength of ∼7%. The WDS group showed higher peak force values for knee extension, elbow flexion, and handgrip (∼16, 10, and 14%, respectively). The DS group had lower transient elevation of oxidative stress after an acute RE session compared with WDS. Oxidative stress and inflammation responses of DS to an acute RE session with elastic tubes may be insufficient to induce health adaptations for the same relative load compared with WDS.

Systemic Sirtuin 1 as a Potential Target to Mediate Interactions Between Body Fat and Testosterone Concentration in Master Athletes

Evidence indicates that master athletes have higher concentration of Sirtuin 1 (Sirt1), lower body fat (BF), and greater activity of the hypothalamic-pituitary-gonadal axis in comparison to untrained peers. However, no published data have demonstrated possible mediation effect of Sirt1 in the interaction of BF and testosterone in this population. Therefore, this study compared and verified possible associations between Sirt1, BF, fat mass index (FMI), testosterone, luteinizing hormone (LH), and testosterone/luteinizing hormone (T/LH) ratio in middle-aged master athletes (n = 54; 51.22 ± 7.76 years) and control middle-aged peers (n = 21; 47.76 ± 8.47 years). Venous blood was collected for testosterone, LH, and Sirt1. BF was assessed through skinfold protocol. Although LH concentration did not differ between groups, master athletes presented higher concentration of Sirt1, testosterone, and T/LH ratio, and lower BF and FMI in relation to age-matched nonathletes. Moreover, Sirt1 correlated positively with testosterone and T/LH ratio, negatively with BF, and was not significantly correlated with LH (mediation analysis revealed the effect of BF on testosterone is mediated by Sirt1 and vice versa; R2 = .1776; p = .032). In conclusion, master athletes have higher testosterone, T/LH ratio, and Sirt1, and lower BF and FMI in relation to untrained peers. Furthermore, Sirt1 was negatively associated with BF and positively associated with testosterone and T/LH ratio. These findings suggest that increased circulating Sirt1, possibly due to the master athlete's training regimens and lifestyle, exhibits a potential mediation effect on the interaction between endocrine function and body composition.

Age- and sex-specific normative values for muscle mass parameters in 18,625 Brazilian adults

Background

The present study aimed to provide age- and sex-specific normative values for muscle mass parameters in Brazilian adults.

Methods

Data pertaining to Brazilian adults (18+ years) who attended a nutritional clinical between January 2018 and July 2022 were analyzed. Muscle mass parameters were assessed using a bioimpedance digital scale (InBody 230, GBC BioMed NZ). Assessments were conducted under standard conditions, with participants refraining from physical exercise for 96 h and from eating or drinking (including water) for 8 h before evaluations.

Results

A total of 18,625 Brazilian adults were analyzed. Normative values for absolute and relative (height, m2) muscle mass and appendicular muscle mass (ASM) were calculated. In addition, specific age-related changes in muscle mass parameters were observed. In women, muscle mass peaked between the ages of 40-49 before gradually declining at an average rate of 5.7% per decade from the sixth decade of life onwards. ASM reached its peak earlier, during the third decade of life, and started to decline later, from 50 to 59 years. In contrast, absolute and ASM peaked at 40-49 years and declined from the sixth decade of life in men. Both sexes displayed a slightly greater decline in ASM than in muscle mass (13 vs. 12%).

Conclusions

The present study provides normative values for absolute and relative muscle mass and ASM in Brazilian adults. Furthermore, important specific age-related changes in muscle mass parameters were observed. These data have public health implications and might serve as a reference tool to guide health professionals.

An analysis of the São Silvestre race between 2007-2021: An increase in participation but a decrease in performance

This study aimed to investigate the trends of finishers in the São Silvestre race in Brazil, taking into account sex, age, and performance levels. A total of 31 ​775 runners (women, n ​= ​13 ​847; men, n ​= ​17 ​928), aged (45.2 ​± ​16.8) years, finishers in the São Silvestre race between 2007 and 2021, were considered in the present analysis. Data (event year, date of birth, sex, and race times) were downloaded from the official race website. The man-Whitney U test, Spearman correlation, and robust regression model were computed. Participation increased over time for both sexes. Regarding age groups, "31-40 years" (women) and "> 60 years" (men) were those with the highest number of finishers. We found a decrease in performance across the years (β ​= ​2.45; p ​< ​0.005), as well as significant differences in race times for both sexes (U ​= ​42.844; p ​< ​0.001), with men presenting better performances than women. Over time, it was observed an increase in the performance gap between the sexes, but in general, the performance decreased (β ​= ​1.76; p ​< ​0.001). Stakeholders should consider improving the strategies to improve women and young people's participation in running events.

Pacing Variation in Multistage Ultramarathons: Internet-Based Cross-Sectional Study

BACKGROUND

Ultramarathon running is the most popular ultraendurance competition in terms of the number of races and runners competing annually worldwide; however, no study has compared pacing and performance over a long period.

OBJECTIVE

This study analyzes the pacing of successful finishers and nonfinishers in multistage ultramarathons worldwide.

METHODS

A total of 4079 athletes (men=3288; women=791) competing in 99 multistage ultramarathon events from 1983 to 2021 were analyzed, including the number of participants, age, gender, rank, and running speed of successful finishers.

RESULTS

The results showed a significant increase in the number of events (n=338) and a significant increase in the number of finishers and nonfinishers (n=5575) in the ultramarathons worldwide during this period. The general linear models (GLMs) of pacing variation showed nonsignificant effects for gender (F1,36.2=2.5; P=.127; ηp2=0.063) and age group (F10,10=0.6; P=.798; ηp2=0.367), but it showed a significant interaction (gender × age) effect (F10,2689=2.3; P=.008; ηp2=0.009). Post hoc analyses showed that men have a higher pacing variation than women in the under 30 years (U30), U35, U45, and U50 groups. Additionally, the fastest women's age group (U35) had the lowest pacing variation. The GLM of pacing variation by gender and event distance showed significant effects for both gender (F1,3=18.5; P<.001; ηp2=0.007) and distance (F2,3=20.1; P<.001; ηp2=0.015). Post hoc analyses showed a growing pacing variation with increasing race distance for both men and women. In addition, men had a higher variation in long events. Furthermore, there was a significant main effect for both genders (F1,3=33.7; P<.001; ηp2=0.012) and rank (F1,3=136.6; P<.001; ηp2=0.048) on performance, with men being faster than women. Pacing varied greatly due to gender (F1,3=4.0; P=.047; ηp2=0.001), with a lower (ie, more even) pacing variation for male athletes in the top 3 finishers. Male nonfinishers showed a higher performance than female nonfinishers (F1,1340=25.6; P<.001), and no difference was identified for pacing variation (F1,789=1.5; P=.228) based on gender. In addition, a weak but significant correlation (r=-0.130; P<.001) was identified between the average running speed and pacing variation for both female and male nonfinishers.

CONCLUSIONS

In summary, multistage ultramarathon competitions showed an increasing number of competitors and a higher performance challenge. Men have a higher pacing (ie, less even) variation than women, especially observed in longer events. A higher pacing variation was associated with lower performance for men, women, and nonfinishers.

Relationship of Testosterone, LH, Estradiol, IGF-1, and SHBG with Physical Performance of Master Athletes

Purpose: The aim of this study was to investigate and compare the levels of luteinizing hormone (LH), testosterone (T), estradiol (ES), sex hormone-binding globulin (SHBG), and insulin-like growth factor 1 (IGF-1) in master sprint (MS) and master endurance (ME) athletes. Additionally, the possible associations between these hormones, body composition, and lipid profile with athletic performance (% of performance in relation to the current world record) were analyzed. Materials and Methods: The participants were all men: (i) 34 MS (51.0 ± 6.8 years); and (ii) 32 ME (51.7 ± 9.4 years). Student's t-tests for independent samples were performed to compare all variables between groups. Results: MS had a significantly higher (p = .008) average IGF-1 (154.78 ± 29.85 ng/mL) when compared to ME (129.92 ± 25.48 ng/mL). Performance was significantly correlated with IGF-1 (r = 0.424). The MS group had a moderately lower body fat than ME athletes (MS 12.54 ± 4.07 vs. ME 14.60 ± 4.12; p = .078; d = 0.503). Conclusions: Thus, strength/power training exercise/sport seems to be more beneficial for obtaining a higher IGF-1 compared to aerobic/distance exercise/sport. In addition, LH, T, ES, and SHBG were similar between the two groups of athletes and were comparable to the reference values of younger adults.

Predicting overall performance in Ironman 70.3 age group triathletes through split disciplines

Knowing which discipline contributes most to a triathlon performance is important to plan race pacing properly. To date, we know that the running split is the most decisive discipline in the Olympic distance triathlon, and the cycling split is the most important discipline in the full-distance Ironman^® triathlon. However, we have no knowledge of the Ironman^® 70.3. This study intended to determine the most crucial discipline in age group athletes competing from 2004 to 2020 in a total of 787 Ironman^® 70.3 races. A total of 823,459 athletes (198,066 women and 625,393 men) from 240 different countries were analyzed and recorded in 5-year age groups, from 18 to 75 + years. Correlation analysis, multiple linear regression, and two-way ANOVA were applied, considering p < 0.05. No differences in the regression analysis between the contributions of the swimming, cycling, and running splits could be found for all age groups. However, the correlation analysis showed stronger associations of the cycling and running split times than the swimming split times with overall race times and a smaller difference in swimming performance between males and females in age groups 50 years and older. For age group triathletes competing in Ironman^® 70.3, running and cycling were more predictive than swimming for overall race performance. There was a progressive reduction in the performance gap between men and women aged 50 years and older. This information may aid triathletes and coaches in planning their race tactics in an Ironman^® 70.3 race.

Participation and performance trends in short-, medium, and long-distance duathlon

Participation and performance trends of male and female athletes have been thoroughly analyzed in various endurance sports. Knowing these trends can help coaches and athletes prepare for competitions and may influence their training strategy and career planning. However, duathlon events-consisted of two splits of running (Run1 and Run2) interspersed by a split of cycling (Bike)-have not been thoroughly studied, unlike other endurance sports. The present study aimed to compare participation and performance trends in duathletes who competed in duathlon races hosted by World Triathlon or affiliated National Federations between 1990 and 2021. A total of 25,130 results of age group finishers who competed in run-bike-run duathlon races of varying distances were analyzed with different general linear models. Races were divided into three distances: short-distance (up to 5.5 km run, 21 km bike, 5 km run), medium-distance (5-10 km run, 30-42 km bike, 7-11 km run) and long-distance (at least 14 km run, 60 km bike, 25 km run). On average, women represented 45.6% of all finishers in short-distance, 39.6% in medium-distance and 24.9% in long-distance duathlon races. Throughout the years, men were consistently faster than women in all three race legs (Run 1, Bike, and Run 2) in all three distances across all age groups, and women could not reduce the performance gap. Concerning the age of peak performance, duathletes of the age group 30-34 finished most often in the top three in short- and medium-distance duathlons, whereas male duathletes of the age group 25-29 and female duathletes of the age group 30-34 finished most often in the top three in long-distance duathlons. Women participated less, especially in longer distances, and were constantly slower than men. Duathletes of the age group 30-34 finished most often in the top three. Future studies should analyze participation and performance trends in further subgroups (e.g., elite athletes) and pacing behaviours.

Active Video Game Interventions Targeting Physical Activity Behaviors: Systematic Review and Meta-analysis

BACKGROUND

Research on digital games designed to increase physical activity (PA), also known as exergames or active video games (AVGs), has proliferated over the past 2 decades. As a result, reviews of literature in this field can become outdated, revealing the need for updated high-quality reviews that identify overarching insights. Furthermore, given the significant heterogeneity in AVG research, study inclusion criteria may significantly influence conclusions. To the best of our knowledge, no prior systematic review or meta-analysis has specifically focused on studies of longitudinal AVG interventions targeting increases in PA behaviors.

OBJECTIVE

The aim of this study was to obtain insights into when and why longitudinal AVG interventions are more or less successful for sustained increases in PA, especially for public health.

METHODS

Six databases (PubMed, PsycINFO, SPORTDiscus, MEDLINE, Web of Science, and Google Scholar) were reviewed until December 31, 2020. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, randomized controlled trials had to prominently (>50% of intervention) feature AVG technology, involve repeated AVG exposure, and target changes in PA behavior. Experimental designs had to include ≥2 within- or between-participant conditions with ≥10 participants per condition.

RESULTS

A total of 25 studies published in English between 1996 and 2020 were identified, with 19 studies providing sufficient data for inclusion in the meta-analysis. Our findings indicated that AVG interventions had a moderately positive effect, thereby increasing overall PA (Hedges g=0.525, 95% CI 0.322-0.728). Our analysis showed substantial heterogeneity (I²=87.7%; Q=154.1). The main findings were consistent across all subgroup analyses. The comparison between PA assessment type groups showed a moderate effect for objective measures (Hedges g=0.586, 95% CI 0.321-0.852) and a small effect for subjective measures (Hedges g=0.301, 95% CI 0.049-0.554) but no significant difference between the groups (P=.13). The platform subgroup analysis indicated a moderate effect for stepping devices (Hedges g=0.303, 95% CI 0.110-0.496), combination of handheld and body-sensing devices (Hedges g=0.512, 95% CI 0.288-0.736), and other devices (Hedges g=0.694, 95% CI 0.350-1.039). The type of control group showed a wide range of effects sizes, ranging from a small effect size (Hedges g=0.370, 95% CI 0.212-0.527) for the passive control group (nothing) to a moderate effect size for the conventional PA intervention group (Hedges g=0.693, 95% CI 0.107-1.279) and ultimately to a large effect size for sedentary game as control groups (Hedges g=0.932, 95% CI 0.043-1.821). There was no significant difference among the groups (P=.29).

CONCLUSIONS

AVGs represent a promising tool for PA promotion among the general population and clinical subpopulations. However, significant variabilities in AVG quality, study design, and impact were also detected. Suggestions for improving AVG interventions and related research will be discussed.

TRIAL REGISTRATION

PROSPERO CRD42020204191; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204191.

Effects of moderate- vs. high-intensity interval training on physical fitness, enjoyment, and affective valence in overweight/obese female adolescents: a pre-/post-test study

OBJECTIVE

The aim of this study was to compare the effects of 12-week moderate-intensity interval training (MIIT) vs. high-intensity interval training (HIIT) on body composition, physical fitness, and psychological valence in overweight/obese (OW/OB) female adolescents.

PATIENTS AND METHODS

Thirty-eight OW/OB female students were randomized into HIIT (n=13), MIIT (n=13) or control (n=12) groups. The participants underwent a 12-week interval-training program at 100% to 110% and 60% to 75% of maximal aerobic speed for HIIT and MIIT, respectively. The control group kept their usual physical activity without completing the training program. Pre- and post-training measurements were performed to assess body composition, aerobic capacity, and anaerobic performance (using selected tests evaluating speed, jumping ability, and strength). Ratings of perceived exertion and the feeling scale were evaluated every three weeks. Enjoyment was measured at the end of the program. A two-way analysis of variance with repeated measurements was applied to test for "group×time" interactions for body composition, physical fitness, and affective variables.

RESULTS

Significant "group×time" interactions were detected for aerobic and anaerobic performance, body composition indices, and the feeling scale. HIIT resulted in more noticeable improvements in body composition and physical performance than MIIT, while no significant changes were found in the control group. Throughout the program, the feeling score has progressively increased in the MIIT group but decreased in the HIIT group. Ratings of the perceived exertion have increased in both groups, more noticeably in the HIIT group. At the end of the program, the MIIT group showed a higher enjoyment score.

CONCLUSIONS

Despite offering better body composition improvement and physical fitness enhancement, HIIT offered lesser enjoyment and affective valence than MIIT in OW/OB female adolescents. MIIT might be an alternative time-efficient protocol for improving health in this population.

A Machine Learning Approach to Finding the Fastest Race Course for Professional Athletes Competing in Ironman® 70.3 Races between 2004 and 2020

Our purpose was to find the fastest race courses for elite Ironman® 70.3 athletes, using machine learning (ML) algorithms. We collected the data of all professional triathletes competing between 2004 and 2020 in Ironman 70.3 races held worldwide. A sample of 16,611 professional athletes originating from 97 different countries and competing in 163 different races was thus obtained. Four different ML regression models were built, with gender, country of origin, and event location considered as independent variables to predict the final race time. For all the models, gender was the most important variable in predicting finish times. Attending to the single decision tree model, the fastest race times in the Ironman® 70.3 World Championship of around ~4 h 03 min would be achieved by men from Austria, Australia, Belgium, Brazil, Switzerland, Germany, France, the United Kingdom, South Africa, Canada, and New Zealand. Considering the World Championship is the target event for most professional athletes, it is expected that training is planned so that they attain their best performance in this event.

How much did it cost to develop and implement an eHealth intervention for a minority children population that overlapped with the COVID-19 pandemic?

BACKGROUND

eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions.

OBJECTIVES

We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19.

METHODS

We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs.

RESULTS

The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant completing the RCT (79 participants/237 visits) was $24,403 (Direct: $15,543; Indirect: $8860). Due to no-shows and cancellations (198 visits) and dropouts before study completion (61 visits; 56 participants), 496 visits had to be scheduled to ensure complete data collection on 79 participants. If all 496 visits were from participants completing the three-visit protocol, that would correspond to 165 participants, bringing the average cost per participant down to $11,684 (Direct: $7442; Indirect: $4242). Of the subcategories, intervention material development accounted for the largest portion, followed by personnel salaries. While the direct COVID-19-specific cost constituted <1% of the entire budget, the indirect effects were much larger and significantly impacted the trial.

CONCLUSION

RCTs typically involve significant resources, even more so during a pandemic. Future eHealth intervention investigators should budget and plan accordingly to prepare for unexpected costs such as recruitment challenges to increase flexibility while maximizing the intervention efficacy.

The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games

Narratives are pervasive in video games and have been found to increase physical activity in active video games. However, the effect of incorporating narrative elements has seldom been examined in fully immersive virtual reality games. We investigated the effect of narrative element incorporation (between-subject: narrative vs. no narrative) in active virtual reality and sedentary virtual reality games (within-subject) and examined between- and within-subject effects on physical activity behavior, game experience, and physical activity engagement. We randomized 36 sedentary college students to either the narrative or the non-narrative group. All participants played an active virtual reality and a sedentary virtual reality game in counter-balanced order. Before each game session, they either watched a 5-min narrative video (narrative) or directly played the original virtual reality games without narratives (non-narrative). We collected participants' physical activity data using wrist-worn accelerometers; we obtained their game experience and physical activity engagement via questionnaires. The narrative group spent a greater proportion of time in moderate-to-vigorous physical activity (%) and had less non-movement time during the active virtual reality gameplay than the non-narrative group (all p values < .05). The active virtual reality sessions induced a greater positive affect and greater physical activity engagement ratings than the sedentary virtual reality sessions. The incorporation of narrative elements in active virtual reality increased the relative time spent in moderate-to-vigorous physical activity and reduced non-movement time, compared to the non-narrative group. Active virtual reality encouraged more activity by participants and offered them a more enjoyable gaming experience in which they engaged more. Active virtual reality is a feasible physical activity promotion option among sedentary adults; the incorporation of narrative elements in active virtual reality helps increase relative moderate-to-vigorous physical activity and should be further explored for its efficacy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10055-023-00754-7.

A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance

OBJECTIVE

To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms.

DATA SOURCE

Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020.

STUDY SELECTION

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition.

DATA EXTRACTION

Three reviewers independently performed data extraction and assessed the risk of bias.

DATA SYNTHESIS

129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, M_age=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753).

CONCLUSIONS

AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.

Biophysical characterization of the first ultra-cyclist in the world to break the 1,000 km barrier in 24-h non-stop road cycling: A case report

A plethora of factors determine elite cycling performance. Those include training characteristics, pacing strategy, aerodynamics, nutritional habits, psychological traits, physical fitness level, body mass composition, and contextual features; even the slightest changes in any of these factors can be associated with performance improvement or deterioration. The aim of the present case report is to compare the performances of the same ultra-cyclist in achieving two world records (WR) in 24 h cycling. We have analyzed and compared the distance covered and speed for each WR. The 24 h period was split into four-time intervals (0–6 h; > 6–12 h; > 12–18 h; > 18–24 h), and we compared the differences in the distance covered and speed between the two WRs. For both WRs, a strong negative correlation between distance and speed was confirmed (r = –0.85; r = –0.89, for old and new WR, respectively). Differences in speed (km/h) were shown between the two WRs, with the most significant differences in 12–18 h (Δ = 6.50 km/h). For the covered distance in each block, the most significant differences were observed in the last part of the cycling (Δ = 38.54 km). The cyclist effective surface area (ACd) was 0.25 m² less and 20% more drag in the new WR. Additionally, the mechanical power was 8%, the power to overcome drag was 31%, and the power-weight ratio was 8% higher in the new WR. The mechanical efficiency of the cyclist was 1% higher in the new WR. Finally, the heart rate (HR) presented significant differences for the first 6 h (Old WR: 145.80 ± 5.88 bpm; New WR: 139.45 ± 5.82 bpm) and between the 12 and 18 h time interval (Old WR: 133.19 ± 3.53 bpm; New WR: 137.63 ± 2.80 bpm). The marginal gains concept can explain the performance improvement in the new WR, given that the athlete made some improvements in technical specifications after the old WR.

Autoimmune hepatitis in monozygotic twins - a case report

OBJECTIVE

Autoimmune hepatitis is a chronic liver disease caused by a dysfunctional immune system. It is widely believed that autoimmune hepatitis accumulates in families. We found that autoimmune hepatitis does accumulate in monozygotic twins.

CASE REPORT

We present middle-aged monozygotic female twins developing autoimmune hepatitis consecutively within two years. Both twins had developed Graves' disease and were treated with carbimazole before the onset of autoimmune hepatitis. Both were cigarette smokers. The twins were treated with budesonide and azathioprine, which normalised liver parameters.

CONCLUSIONS

This case report supports the hypothesis that a genetic factor might be of great importance in the aetiology of autoimmune hepatitis.

Differences in pacing during cycling and running in ultra-triathlons - The example of 'Swissultra'

OBJECTIVE

The knowledge of the most predictive split discipline and the pacing during a triathlon race is of utmost importance for planning an ultra-triathlon race. This study aimed at investigating the pacing during cycling and running splits in three different multi-stage ultra-triathlon race formats (i.e., Quintuple, Deca, and Double Deca Iron ultra-triathlon with 5x, 10x and 20x the daily distance of a full Ironman-distance triathlon).

SUBJECTS AND METHODS

A total of 48 male ultra-triathletes competing in Quintuple (n=14), Deca (n=25), and Double Deca (n=9) Iron ultra-triathlon "swissultra" between 2016 and 2019 in Switzerland were analyzed. For each race day, we calculated the total performance (sum of all laps time), average individual performance (average of all laps time within a race day) and pacing variation (coefficient of variation of race laps time) for cycling and running. Discipline (cycling and running) and race distance (Quintuple, Deca, and Double Deca Iron ultra-triathlon) were used as independent parameters. The primary outcome variables were the time performance (daily and total) and the pacing variation. We applied two general linear models (GLM): the first model was a one-way ANOVA comparing total and daily performance by race distance, and the second model was a two-way ANOVA (race distance´ discipline) using pacing variation (average pace oscillation) as a dependent variable.

RESULTS

The first GLM identified a significant race distance effect for total performance in both cycling (F = 375.6; p < 0.001; ηp2 = 0.943) and running (F = 267.8; p < 0.001; ηp2 = 0.922) with Double Deca Iron ultra-triathlon being the fastest and Quintuple Iron ultra-triathlon the slowest. The GLM for daily average performance showed no significant effect of race distance on cycling performance (F = 0.171; p = 0.843; ηp2 = 0.008), but on running performance (F = 6.408; p = 0.004; ηp2 = 0.222). The two-way GLM comparing pacing variation showed a significant effect for race distance (F = 11.81; p<0.001; ηp2 = 0.344) with Deca presenting larger pace variation than Quintuple and Double Deca Iron ultra-triathlon in both cycling and running, but not for discipline (F = 0.067; p=0.797; ηp2 = 0.001), nor for interaction (F = 1.469; p=0.241; ηp2 = 0.061).

CONCLUSIONS

Athletes achieved a stable cycling performance independent of the length of the race, and the cycling split had an influence on the subsequent running split depending upon the length of the race.

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students

BACKGROUND

Active video games are a new method for increasing physical activity (PA). Fully immersive virtual reality (VR) is a hardware device on which an active video game can run. Active (video games in) VR (AVR), might increase immersion, game engagement, and moderate-to-vigorous PA (MVPA), thereby yielding greater exercise-related benefits, e.g., cognitive performance.

METHODS

We examined the induction of MVPA via an AVR and a sedentary VR (SVR) as well as the effects of VR play on cognitive performance, which was monitored using 2 different methods. Each of 29 sedentary college students attended three 20-min laboratory sessions (AVR, SVR, or control) in a randomized order; during the control session, they sat quietly doing nothing. A fully immersive headset was used for the 2 video game sessions. We monitored and computed participants' PA using hip-worn accelerometers (wGT3x-bt; ActiGraph, Pensacola, FL, USA) and a heart rate band (Polar H7; Polar, Kempele, Finland). After each session, the participants completed a mnemonic similarity test (MST) to measure recognition memory. They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire.

RESULTS

The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method. AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion, challenge, and positive affect than did SVR. The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session.

CONCLUSION

AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.

[A Distal Radius Fracture Is Not Simply a Distal Radius Fracture]

A Distal Radius Fracture Is Not Simply a Distal Radius Fracture Abstract. We report on a 57-year-old female patient with a distal extra-articular radius fracture. The family doctor's suspicion was an osteoporosis-associated fracture, and an interdisciplinary investigation was initiated. In addition to DXA measurement differential diagnoses for secondary osteoporosis were considered. In our case, secondary osteoporosis was diagnosed as part of Graves' disease and insufficiency of vitamin D leading to a radius fracture.

The beginning of success: Performance trends and cut-off values for junior and the U23 triathlon categories

Background

This study sought to determine cut-off values for each triathlon discipline to achieve podium in Junior (short distance; 750 m swim, 20 km cycle and 5 km run) and U23 (standard/Olympic distance; 1.5 km swim, 40 km cycle and 10 km run) triathlon events. Additionally, we aimed to investigate which discipline has the largest relationship with overall Junior and U23 triathlon performance, and the effect of sex and time in performance trends.

Methods

We included all data from Junior and U23 official races (International Triathlon Federation; ITU) of Junior (n = 3,314 finishes) and U23 (n = 5,092 finishes) categories held from 1999 to 2018.

Results

Men were significantly faster than women in both Junior (11.13%) and U23 (12.28%) categories. Swimming and cycling times were faster in 2009-2018 than in the 1999-2008 decade for men (3.36%; 6.49%), women junior (6.50%; 7.09%), men (0.15%; 3.46%) and women U23 (1.61%; 3.31%) respectively. Cycling was the discipline with the greatest influence on overall triathlon performance in Junior and U23 categories, regardless of sex or rank position. The cut-off values for the Junior category were (men/women): swimming, 9.2/9.4 min; cycling, 31.9/38.2 min; running, 16.8/18.9 min. U23's cut-off values were (men/women): swim, 18.0/19.4 min, cycling: 63.4/70.1 min; run, 33.9/38.7 min.

Conclusion

Cycling was the discipline with the greatest influence on overall performance for both men and women in Junior and U23 categories. Moreover, swimming and cycling performances increased over the years for both sexes.

Changes in Sex Difference in Time-Limited Ultra-Cycling Races from 6 Hours to 24 Hours

Background and objective: Existing research shows that the sex differences in distance-limited ultra-cycling races decreased with both increasing race distance and increasing age. It is unknown, however, whether the sex differences in time-limited ultra-cycling races will equally decrease with increasing race distance and age. This study aimed to examine the sex differences regarding performance for time-limited ultra-cycling races (6, 12, and 24 h). Methods: Data were obtained from the online database of the Ultra-Cycling Marathon Association (UMCA) of time-limited ultra-cycling races (6, 12, and 24 h) from the years 1983–2019. A total of 18,241 race results were analyzed to compare cycling speed between men and women by calendar year, age group (<29; 30–39; 40–49; 50–59; 60–69; >70 years), and race duration. Results: The participation of both men (85.1%) and women (14.9%) increased between 1983 and 2019. The age of peak performance was between 40 and 59 years for men and between 30 and 59 years for women. Between 2000 and 2019, more men (63.1% of male participants and 52.2% of female participants) competed in 24 h races. In the 24 h races, the sex difference decreased significantly in all age groups. Men cycled 9.6% faster than women in the 12 h races and 4% faster in the 24 h races. Both women and men improved their performance significantly across the decades. Between 2000 and 2019, the improvement in the 24 h races were 15.6% for men and 21.9% for women. Conclusion: The sex differences in cycling speed decreased between men and women with increasing duration of ultra-cycling races and with increasing age. Women showed a greater performance improvement than men in the last 20 years. The average cycling speed of men and women started to converge in the 24 h races.

What Type of Body Shape Moves Children? An Experimental Exploration of the Impact of Narrative Cartoon Character Body Shape on Children's Narrative Engagement, Wishful Identification, and Exercise Motivation

Background

The incorporation of narratives helps to enhance children’s engagement in active video games (AVGs), thus increasing moderate-to-vigorous physical activity (MVPA). Specific narrative elements, such as the visual representation of the characters’ body shape, have been rarely manipulated to explore their role in modulating children’s narrative engagement (NE) and exercise motivation.

Objective

To investigate the effects of character body shape manipulation (overweight/obese, average, or athletic slim) on children’s narrative immersion (NI), NE, wishful identification (WI), as well as their mediating effect on AVG and PA motivation.

Methods

Children ages 8–12 years old (N = 87) were randomly assigned to watch a 15-min animated video (designed for an existing AVG) in which the main characters had an overweight/obese, or average^∗, or athletic slim body shape (all other elements were identical). Children’s NI, NE, WI, and AVG and physical activity (PA) motivation were then assessed.

Results

Controlling for social desirability, the analysis indicated that participants with a BMI of greater than the 75th percentile had a significantly higher NI, NE, WI, and PA motivation when video characters were set to the overweight/obese condition, than they did for video characters set to the average or athletic slim conditions. On the other hand, children of equal or less than the 75th percentile exposed to the average character body condition had a greater NE, WI, and PA motivation than overweight/obese or athletic slim conditions. A mediation analysis with structural equation modeling indicated that NE mediated the effect between character body shape and AVG and PA motivation.

Conclusion

Narrative cartoon characters that mirror the target participant’s body shape can increase NE, which in turn mediates AVG and PA motivation. Content producers should identify optimal strategies in character body shape design to encourage children of different weight status to participate in PA with engaging stories to maximize health narratives’ persuasive potentials.

^∗The term average in this sense is not in reference to the national average body weight, but rather an average of the body weights represented in conditions A and C.

Increased Participation and Decreased Performance in Recreational Master Athletes in "Berlin Marathon" 1974-2019

The aspect of participation and performance trends in marathon running has been investigated mainly in marathons held in the United States of America (e.g., “New York City Marathon,” “Boston Marathon”), but not for the fastest course in the world, the “Berlin Marathon” held in Berlin, Germany. This study aimed to examine trends in participation and performance in the “Berlin Marathon” on all its previous 46 editions from 1974 to 2019, the largest dataset ever studied in this event with 696,225 finishers (after data cleaning). Athletes in all age groups increased their participation, except for male athletes aged 20–49 years and athletes of both sexes above 79 years of age. This overall increase in participation was more pronounced in women, but still, there are more men than women participating in “Berlin Marathon” nowadays. All age group athletes decreased their performance across years overall, whereas the top ten recreational athletes improved their performance over the years. Our findings improved the knowledge about the evolution of male and female marathoners across calendar years, especially for the fastest marathon race in the world, the “Berlin Marathon.”

Influence of Anthropometric Characteristics on Ice Swimming Performance-The IISA Ice Mile and Ice Km

Ice swimming following the rules of IISA (International Ice Swimming Association) is a recent sports discipline starting in 2009. Since then, hundreds of athletes have completed an Ice Mile or an Ice Km in water colder than 5 °C. This study aimed to expand our knowledge about swimmers completing an Ice Mile or an Ice Km regarding the influence of anthropometric characteristics (i.e., body mass, body height, and body mass index, BMI) on performance. We analyzed data from 957 swimmers in the Ice Km (590 men and 367 women) and 585 swimmers in the Ice Mile (334 men and 251 women). No differences were found for anthropometric characteristics between swimmers completing an Ice Mile and an Ice Km although water temperatures and wind chill were lower in the Ice Km than in the Ice Mile. Men were faster than women in both the Ice Mile and Ice Km. Swimming speed decreased significantly with increasing age, body mass, and BMI in both women and men in both the Ice Mile and Ice Km. Body height was positively correlated to swimming speed in women in the Ice Km. Air temperature was significantly and negatively related to swimming speed in the Ice Km but not in the Ice Mile. Water temperature was not associated with swimming speed in men in both the Ice Mile and Ice Km but significantly and negatively in women in Ice Km. In summary, swimmers intending to complete an Ice Mile or an Ice Km do not need to have a high body mass and/or a high BMI to swim these distances fast.

Relationship between inflammatory biomarkers and testosterone levels in male master athletes and non-athletes

BACKGROUND

Aging is often associated with low-grade systemic inflammation and reduced anabolic hormone levels. To investigate whether lifelong exercise training can decrease the age-related low-grade inflammation and anabolic hormone levels, we examined hormonal and inflammatory parameters among highly-trained male masters athletes and age-matched non-athletes.

METHODS

From 70 elite power and endurance master athletes - EMA (51.3 ± 8.0 yr), 32 young controls - YC (23.7 ± 3.9 yr) and 24 untrained age-matched controls - MAC (47.2 ± 8.0 yr) venous blood was drawn to measure inflammatory parameters (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α] and interleukin-10 [IL-10]) and circulating hormones (luteinizing hormone [LH], total testosterone, estradiol, sex hormone-binding globulin [SHBG] and free androgen index [FAI]).

RESULTS

EMA showed a better anti-inflammatory status than MAC (higher IL-10 and IL-10/IL-6 ratio and lower IL-6), but a lower anti-inflammatory status than YC (higher TNF-α) (p < 0.05). The MAC group had lower testosterone levels compared to the YC and EMA group (p < 0.05), and lower estradiol levels and testosterone/LH ratio compared to YC (p < 0.05). In the control groups (MAC and YC), testosterone correlated negatively with age and proinflammatory parameters, and positively with anti-inflammatory parameters.

CONCLUSION

Elite master athletics elevated levels of anti-inflammatory cytokines above that seen in non-athlete peers and mitigated the age-related reduction in testosterone levels.

The Role of Environmental Conditions on Master Marathon Running Performance in 1,280,557 Finishers the 'New York City Marathon' From 1970 to 2019

Aim: This study investigated the influence of weather conditions on running performance in female and male age group runners in the largest marathon in the world, the “New York City Marathon.”

Methods: The analysis included data from 1,280,557 finishers the “New York City Marathon” from the years 1970 to 2019. Linear mixed models for men and women finishers with race time (min) as dependent variable and 5-year age groups, temperature, wind and relative humidity tertiles (low, medium, high) as independent factors and finisher as random intercept was performed. Additional models with an interaction between age groups and one weather variable each were performed.

Results: Temperature was positively associated with race time while wind speed and humidity were negatively associated (p < 0.001). Men were significantly greater affected wind speed and humidity than women (p < 0.001 for interaction) but not by temperature (p = 0.17 for interaction). With an average of 8 min longer race time, high temperature had the greatest effect on race time. The effect of high humidity on race time was significantly increased in 40–59 years old men and 25–65 years old women. High temperatures had an increased effect on race time in 30–64 years old men and 40–64 years old women. The inverse association between race time and high wind speed was pronounced in finishers with younger age.

Conclusion: Performance was lower on days with high temperature, low humidity and low wind speed. Men seemed to benefit more from higher humidity and wind speed than women. Aged (70 +) finishers were not greater affected by high temperatures.

What Is the Best Discipline to Predict Overall Triathlon Performance? An Analysis of Sprint, Olympic, Ironman® 70.3, and Ironman® 140.6

Objective: To analyze the proportion of dedication in each triathlon discipline (swimming, cycling, and running) and the importance of each separate discipline to predict overall performance of elite triathletes across different triathlon distances.

Methods: Data from 2015 to 2020 (n = 16,667) from official races and athletes in Sprint, Olympic distance, IM 70.3 (Half-Ironman distance), and IM 140.6 (Full-Ironman distance) competitions were included. The proportion of each discipline was calculated individually and compared using general linear models by event distance, sex, and performance level. Automatic linear regression models were applied for each distance considering overall performance as the dependent variable.

Results: A within-distance analysis showed that the best predictor for Sprint is cycling, for Olympic is swimming, for IM 70.3 is cycling, and for IM 140.6 is running. A between-distance analysis revealed that swimming is a better predictor in Olympic distance than in other triathlon distances. Cycling is a poor predictor for overall performance in IM 140.6, and the importance of running to predict overall performance is the highest in IM 140.6 and diminishes with decreasing race distance.

Conclusion: Each discipline represents a different relative portion and importance to predict overall performance depending on the triathlon distance. Swimming is the most important predictor discipline in Sprint- and Olympic-distance triathlon, cycling in IM 70.3, and running in IM 140.6.

Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial

BACKGROUND

Sarcopenia and chronic kidney disease (CKD) have been associated with negative outcomes in older people, including inflammatory profile and anemia biomarkers.

AIMS

To investigate the effects of pre-dialysis resistance training (RT) on sarcopenia, inflammatory profile, and anemia biomarkers in older patients with CKD.

METHODS

A total of 107 patients with CKD (65.4 ± 3.7 years) were randomly allocated into four groups: sarcopenic RT (n = 37), non-sarcopenic RT (n = 20), sarcopenic control (n = 28), and non-sarcopenic control (n = 22). DXA and handgrip strength were used to classify sarcopenia according to EWGSOP-2. Treatment groups underwent a 24-week intervention with RT before each dialysis session, three times per week. Blood sample analysis for ferritin, hepcidin, iron availability, and inflammatory profile (TNFα, IL-6, and IL-10) was conducted. All-cause mortality was recorded over 5 years.

RESULTS

Sarcopenic RT group increased iron availability after the intervention, while their counterparts decreased. Ferritin and hepcidin significantly decreased in sarcopenic RT group. RT elicited a reduction in both TNFα and IL-6, while increasing IL-10 in both intervention groups. The rate of sarcopenic subjects substantially decreased after the intervention period (from 37 to 17 in the RT group; p = 0.01). The proportion of deaths was higher (P = 0.033) for sarcopenic subjects (Controls 35.7% vs RT 29.7%) when compared to non-sarcopenic subjects (Controls 18% vs RT 10%). The proportion of deaths decreased according to the randomization group (X2 = 8.704; P < 0.1).

CONCLUSIONS

The 24-week RT intervention elicited a better sarcopenia status, better inflammatory profile, and improved anemia biomarkers. Sarcopenia was associated with higher mortality rate in older patients with CKD.

Improving the prognosis of renal patients: The effects of blood flow-restricted resistance training on redox balance and cardiac autonomic function

NEW FINDINGS

What is the central question of this study? Can resistance training with and without blood flow restriction improve redox balance and positively impact the autonomic cardiac modulation in chronic kidney disease patients? What is the main finding and its importance? Resistance training with and without blood flow restriction improved antioxidant defence (paraoxonase 1), decreased the pro-oxidative myeloperoxidase, improved cardiac autonomic function and slowed the decrease in renal function. We draw attention to the important clinical implications for the management of redox balance and autonomic cardiac function in chronic kidney disease patients.

ABSTRACT

Patients with chronic kidney disease (CKD) are prone to cardiovascular diseases secondary to abnormalities in both autonomic cardiac function and redox balance [myeloperoxidase (MPO) to paraoxonase 1 (PON1) ratio]. Although aerobic training improves both autonomic balance and redox balance in patients with CKD, the cardioprotective effects of resistance training (RT), with and without blood flow restriction (BFR), remain unknown. We aimed to compare the effects of RT and RT+BFR on antioxidant defence (PON1), pro-oxidative status (MPO), cardiac autonomic function (quantified by heart rate variability analysis) and renal function. Conservative CKD (stages 1 to 5 who do not need hemodialysis) patients (n = 105, 33 female) of both sexes were randomized into three groups: control (CTL; 57.6 ± 5.2 years; body mass index, 33.23 ± 1.62 kg/m² ), RT (58.09 ± 6.26 years; body mass index 33.63 ± 2.05 kg/m² ) and RT+BFR (58.06 ± 6.47 years; body mass index, 33.32 ± 1.87 kg/m² ). Patients completed 6 months of RT or RT+BFR on three non-consecutive days per week under the supervision of strength and conditioning professionals. Training loads were adjusted every 2 months. Heart rate variability was recorded with a Polar-RS800 and data were analysed for time and frequency domains using Kubios software. The redox balance markers were PON1 and MPO, which were analysed in plasma samples. Renal function was estimated as estimated glomerular filtration rate. The RT and RT+BFR decreased pro-oxidative MPO (RT, ∼34 ng/ml and RT+BFR, ∼27 ng/ml), improved both antioxidant defence (PON1: RT, ∼23 U/L and RT+BFR, ∼31 U/L) and cardiac autonomic function (R-R interval: RT, ∼120.4 ms and RT+BFR, ∼117.7 ms), and slowed the deterioration of renal function (P < 0.0001). Redox balance markers were inversely correlated with heart rate variability time-domain indices. Our data indicated that both training models were effective as non-pharmacological tools to increase the antioxidant defences, decrease oxidative stress and improve the cardiac autonomic function of CKD patients.

Rapid component of excess post-exercise oxygen consumption of children of different weight status after playing active video games

BACKGROUND

Excess post-exercise oxygen consumption (EPOC) of children could indicate the potential of an exercise therapy to treat or prevent obesity. However, EPOC as a result of playing active video games (AVG) has been poorly investigated. Therefore, we aimed to investigate the rapid component of EPOC of children with healthy weight and overweight/obesity (according to their BMI percentile) after playing AVGs that feature predominately upper body (UB) and whole-body (WB) movement.

METHODS

Twenty-one children with healthy weight (BMI percentile < 85%) and with overweight/obesity (BMI percentile ≥ 85%) randomly underwent two 10-min AVG sessions (UB and WB). The heart rate (HR), minute ventilation (VE), oxygen consumption (VO2) and carbon dioxide production (VCO2) were recorded during exercise and post-exercise recovery period. For the rapid component of EPOC in each AVG session, measurements were recorded every 15 s for 5-min of post-exercise recovery. The rate of perceived exertion (RPE) was also measured immediately before and after each AVG play.

RESULTS

Children with overweight/obesity had a higher average of absolute VE, VO2, and VCO2 than their healthy-weight counterparts (BMI percentile < 85%; n = 21) during post-exercise recovery. RPE, HR, and HR% were not different between the game sessions and weight groups. Children with overweight/obesity showed a higher absolute VO2 during EPOC than healthy-weight children in both game sessions, but relative VO2 was higher in healthy-weight children during EPOC. No differences were observed for EPOC between UB and WB sessions.

CONCLUSIONS

Children with overweight/obesity had a greater EPOC than healthy-weight children after AVG sessions in terms of absolute oxygen values, whereas healthy-weight children have higher EPOC considering relative VO2 when controlling for body mass. UB and WB AVGs induced a similar EPOC among children with healthy weight and overweight/obesity. As UB and WB AVGs induce the rapid component of EPOC in children regardless their weight status, AVGs could be used as an exercise method to treat and prevent child obesity.

Pacing in World-Class Age Group Swimmers in 200 and 400 m Individual Medley

The present research investigated pacing for world-class age group swimmers competing in individual medley in 200 m and 400 m. Data on 3,242 unique finishers (1,475 women and 1,767 men) competing in four Master World Championships [XV FINA WMC held in Montreal (Canada) in 2014, the XVI FINA WMC held in Kazan (RUS) in 2015, the FINA WMC held in Budapest (HUN) in 2017, and the XVIII FINA WMC held in Gwangju (KOR] in 2019) were analyzed. Men were faster than women among all age groups in both 200 and 400 m. Additionally, differences were found between almost all adjacent age groups, with the exception (p > 0.05) of age groups 25-29 to 30-34, 35-39 to 40-44 years in 200 m races and 25-29 to 30-34, 30-34 to 35-39, 35-39 to 40-44, and 45-49 to 50-54 years in 400 m races. Men showed a higher pacing variation in 200 m among all male age groups and all female age groups up to 69 years. Pace-variation pairwise comparisons between men and women showed no consistencies throughout age groups, with the exception of a higher variation in men in age groups ≥55-year-old. Men were faster for all splits and strokes in both 200 and 400 m, and significant changes were identified for each split and stroke for both men and women in both 200 and 400 m. Front crawl (freestyle, 4th split) was the fastest butterfly (1st split), backstroke (2nd split), and breaststroke (3rd split). In summary, men were faster than women for all age groups in both 200 and 400 m. Men showed a higher pacing variation in 200 m in all age groups, where women had a higher variation in age groups up to 69 years. The fastest stroke for the final spurt was front crawl, followed by butterfly, backstroke, and breaststroke. Based on these findings, coaches should advise their master athletes to focus on the final spurt in both 200 and 400 m individual medley for a fast final race time.

Cut-Off Values in the Prediction of Success in Olympic Distance Triathlon

Cut-off points and performance-related tools are needed for the development of the Olympic distance triathlon. The purposes of the present study were (i) to determine cut-off values to reach the top three positions in an Olympic distance triathlon; (ii) to identify which discipline present the highest influence on overall race performance and if it has changed over the decades. Data from 1989 to 2019 (n = 52,027) from all who have competed in an official Olympic distance triathlon events (World Triathlon Series and Olympics) were included. The cut-off value to achieve a top three position was calculated. Linear regressions were applied for performance trends overall and for the top three positions of each race. Men had cut-off values of: swimming = 19.5 min; cycling = 60.7 min; running = 34.1 min. Women's cut-off values were: swimming = 20.7 min; cycling = 71.6 min; running = 38.1 min. The running split seemed to be the most influential in overall race time regardless of rank position or sex. In conclusion, cut-offs were established, which can increase the chances of achieving a successful rank position in an Olympic triathlon. Cycling is the discipline with the least influence on overall performance for both men and women in the Olympic distance triathlon. This influence pattern has not changed in the last three decades.

What is the exercise intensity of Pilates? An analysis of the energy expenditure, blood lactate, and intensity of apparatus and mat Pilates sessions

BACKGROUND

Pilates is a form of exercise commonly used in rehabilitation settings that improves muscular fitness and flexibility. However, it is unknown whether the energy expenditure (EE) from Pilates sessions could also lead to the intensity suggested by health organizations to improve physical fitness. This study aimed to quantify and compare the intensity and the EE of two different Pilates sessions (mat and apparatus).

METHODS

18 healthy females (age: 22 ± 3 years; height: 1.6 ± 0.1m; body mass: 61.0 ± 10.0 kg; body mass index: 21 ± 3 kg/m²) performed two different sessions. Each session involved the performance of 15 exercises. Oxygen consumption (V˙O₂) was measured continuously and then converted to EE in Kcal/min. Blood lactate, heart rate (HR), and blood pressure (BP) were also measured. A repeated measures two-way ANOVA (time X group) determined differences between sessions. Bonferroni's post hoc analysis was used to identify significant differences between measures.

RESULTS

The Reformer apparatus and Mat sessions presented an EE of 2.59 ± 0.53 and 1.93 ± 0.26 kcal/min, respectively. V˙O₂ was higher for the Reformer session (8.67 ± 1.15 ml/kg/min) when compared to Mat (6.44 ± 0.73 ml/kg/min). There was no significant increase in blood lactate, HR, and BP for either session above resting values.

CONCLUSION

The Pilates sessions analyzed in this study elicit low cardiovascular stress, leading to low EE levels. However, a typical session performed on the Reformer apparatus presented a higher EE, V˙O_2, and HR compared to the Mat Pilates session.

Cold Water Swimming-Benefits and Risks: A Narrative Review

Cold water swimming (winter or ice swimming) has a long tradition in northern countries. Until a few years ago, ice swimming was practiced by very few extreme athletes. For some years now, ice swimming has been held as competitions in ice-cold water (colder than 5 °C). The aim of this overview is to present the current status of benefits and risks for swimming in cold water. When cold water swimming is practiced by experienced people with good health in a regular, graded and adjusted mode, it appears to bring health benefits. However, there is a risk of death in unfamiliar people, either due to the initial neurogenic cold shock response or due to a progressive decrease in swimming efficiency or hypothermia.

Even Pacing Is Associated with Faster Finishing Times in Ultramarathon Distance Trail Running-The "Ultra-Trail du Mont Blanc" 2008-2019

In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. This study investigated the effects of age, sex, and performance level on pacing in the UTMB^® (Ultra-trail du Mont Blanc) and aimed to verify previous findings obtained in the research on other running disciplines and other ultramarathon races. Data from the UTMB^® from 2008 to 2019 for 13,829 race results (12,681 men and 1148 women) were analyzed. A general linear model (two-way analysis of variance (ANOVA)) was applied to identify a sex, age group, and interaction effect in pace average and pace variation. A univariate model (one-way ANOVA) was used to identify a sex effect for age, pace average, and pace variation for the fastest men and women. In our study, pace average and a steadier pace were positively correlated. Even pacing throughout the UTMB^® correlated with faster finishing times. The average pace depended significantly on sex and age group. When considering the top five athletes in each age group, sex and age group also had significant effects on pace variation. The fastest women were older than the fastest men, and the fastest men were faster than the fastest women. Women had a higher pace variation than men. In male competitors, younger age may be advantageous for a successful finish of the UTMB^®. Faster male runners seemed to be younger in ultramarathon trail running with large changes in altitude when compared to other distances and terrains.

The impact of narratives and active video games on long-term moderate-to-vigorous physical activity: A randomized controlled trial protocol

BACKGROUND

Although physical activity (PA) has been shown in helping prevent and treat obesity, current PA interventions are still not effective in ameliorating the obesity epidemic. Additional forms of PA need to be investigated to improve PA engagement and outcomes. We hypothesize that pairing a narrative (i.e., story) with an active video game (AVG), a less traditional form of PA, will increase participant engagement in PA. This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes.

OBJECTIVE

This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes.

METHODS/DESIGN

The Active Video Game Study is a six-month randomized controlled single-blind trial projected to include 210 participants. The intervention strategy will pair a narrative to an active video game (AVG). Participants will be randomized into 3 groups: condition A [Narrative + AVG], condition B [AVG Only], and condition C [Control]. Participants will undergo three in-person data collection visits over the course of six months. Inclusion criteria are that children are between the ages of 8-12 and have a BMI ≥ 85%. The primary outcome is change in moderate to vigorous physical activity (MVPA). Secondary outcome measures include change in BMI percentile, fasting insulin and glucose, lipid panel, C-reactive protein, and cognitive function. A pilot trial of n = 6 was conducted to help develop procedures and address problems that could arise in the main trial.

DISCUSSION

Successful completion of this study will provide the empirical basis for novel intervention and design strategies to enhance the impact of AVGs on long-term MVPA.

Pacing strategy of a wheelchair athlete in a 5x and 10x Ironman ultra triathlon: a case study

OBJECTIVE

For disabled athletes such as wheelchair athletes, there is no knowledge about competing and pacing during a long-distance triathlon such as an Ironman triathlon. This study aimed to investigate the pacing strategy of a paraplegic wheelchair athlete competing and finishing a Quintuple Iron ultra-triathlon (i.e., five times 3.8 km swimming, 180 km handbike cycling and 42.195 km wheelchair racing in five days) and a Deca Iron ultra-triathlon (10 times the same distance in 10 days).

METHODS

Data from an ultra-distance triathlon race (Swissultra) covering 5x and 10x Ironman distance were collected. Official performance data were acquired from the race organizer's website and athlete's personal information from the athlete through online interviews. The athlete is a man born in 1962, the races analysed in this study were held in the summer of 2017 (5x) and 2019 (10x). The split times for swimming, cycling and running, the overall race times for each Ironman and the lap times in cycling (handbike) and running (wheelchair) were analysed.

RESULTS

The athlete finished the Quintuple Iron ultra-triathlon in an overall race time of 66:28:31 h:min:s and the Deca Iron ultra-triathlon in 137:03:20 h:min:s. He adopted an even pacing in both races in split disciplines and for overall race time.

CONCLUSION

The paraplegic wheelchair athlete was able to finish both a Quintuple and a Deca Iron ultra-triathlon by adopting an even pacing in all split disciplines and for overall race time.IMPLICATIONS FOR REHABILITATIONTriathlon is a growing sport among athletes with spinal cord injury.Ultra-triathlons are ultra-endurance events and pacing is a key aspect to a successful race regardless the athlete's category.An athlete with a spinal cord injury finished a 5x and 10x Ironman ultra-triathlon applying an even pacing strategy.

Can the Performance Gap between Women and Men be Reduced in Ultra-Cycling?

This study examined a large dataset of ultra-cycling race results to investigate the sex difference in ultra-cycling performance (100 to 500 miles) according to age and race distance. Data from the time period 1996-2018 were obtained from online available database of the ultra-cycling marathon association (UMCA), including distance-limited ultra-cycling races (100, 200, 400, and 500 miles). A total of 12,716 race results were analyzed to compare the performance between men and women by calendar year, age group (18-34, 35-44, 45-59, and 60+ years), and race distance. Men were faster than women in 100 and 200 mile races, but no sex differences were identified for the 400 and 500 mile races. The performance ratio (average cycling speed_men/average cycling speed_women) was smaller in the 200 mile races compared to the 100 mile races and remained stable in the 400 and 500 mile races. In all race distances, the difference in average cycling speed between women and men decreased with increasing age. The gender gap in performance was closed in several distance-limited ultra-cycling races, such as the 400 and 500 mile races.

The Effect of Narrative on Physical Activity via Immersion During Active Video Game Play in Children: Mediation Analysis

BACKGROUND

Active video games (AVGs) can increase physical activity (PA) and help produce higher physiological expenditure. Animated narrative videos (NVs) possess unique immersive and motivational properties. When added to AVGs, they have been found to increase moderate-to-vigorous physical activity (MVPA) as opposed to the original no video condition. However, there is no evidence of whether that was due to the NV or the addition of an animated video to an AVG.

OBJECTIVE

This study aimed to investigate the differential effect of adding an NV versus a nonnarrative video (NNV) to an AVG on PA parameters and physiological responses and to explore the mediating role of immersion.

METHODS

A total of 22 children aged 8 to 12 years were randomly assigned to the NV or NNV condition. They were instructed to play an AVG (on Xbox Kinect) for as long as they wanted. We used accelerometers to estimate the time spent (in minutes) in MVPA. Heart rate (HR) and rate of perceived exertion (RPE) were measured before, during, and after the AVG play session. The participants then reported their experience of narrative immersion via a questionnaire.

RESULTS

The NV group had significantly higher narrative immersion (mean 3.50, SD 0.55 vs mean 2.91, SD 0.59; P=.03) and MVPA (mean 19.46, SD 13.31 vs mean 7.85, SD 5.83; P=.02) than the NNV group. Narrative immersion was positively correlated with MVPA (r=0.52; P=.01) and average HR during AVG (r=0.43; P=.05). Mediation analysis indicated that narrative immersion mediated the effect of NV (NV vs NNV) on MVPA (direct effect: beta=7.51; P=.01). The indirect effect was that NV was positively correlated with the mediator variable narrative immersion (beta=.59; P=.03), which was itself marginally associated with MVPA (beta=6.95; P=.09); when narrative immersion was included in the model, the regression coefficient was attenuated.

CONCLUSIONS

AVG with added narratives elicits more narrative immersion, resulting in more minutes in MVPA. Narrative immersion served as a mediator between NV and MVPA via its elicitation of an elevated HR without increasing RPE. The inclusion of immersive narratives in AVG could be helpful for inducing MVPA, to enhance AVG engagement without additional exertion.

Participation and Performance Trends in the Oldest 100-km Ultramarathon in the World

Participation and performance trends in ultramarathon running have been investigated for large datasets and long period of times with an increase in participants and an improvement in performance. However, the analysis of ultramarathons across many decades is missing. We analyzed these trends for 96,036 athletes (88,286 men and 7750 women) from 67 countries competing between 1956 and 2019 in ‘100 km Lauf Biel’ in Switzerland, the oldest 100-km ultramarathon in the world. More men than women participated in all years. The number of male participants reached a peak at around 1985 and a decline in participation occurred thereafter. Women started competing in 1962. Men were always faster than women and both women and men reduced their race times over years. After about 1985, both overall women and men and both female and male winners were not able to improve race times. For men, athletes from all age groups below the age of 49 years old reached a peak of participation in the 1980s, and showed a decrease since then. Regarding age groups, the decrease first started in age group 20–29 years, followed by 30–39, 40–49, 50–59, and 60–69 years. For athletes in age groups 70–79 and 80–89 years, no decrease occurred. For women, age group athletes in age groups 40–49, 50–59, and 60–69 years increased their participation, whereas age groups 20–29 and 30–39 peaked in the late 1980s and started to decrease or stabilize, respectively. Switzerland, Germany, and France were the countries with the highest numbers of participants throughout the history of the race. In men, race times increased after about 1990 for most nationalities; only runners from Germany seemed to stabilize their performance. In women, runners from Italy, France, and Austria improved their performance over the years. In summary, the analysis of the oldest 100-km ultramarathon in the world showed a decrease in participation and an impairment in performance in the last 60 years. These changes were due to a decrease in the number of male ultramarathoners in around the 1980s, where mainly the number of age group runners younger than 70 years decreased.

Pacing and Performance Analysis of the World's Fastest Female Ultra-Triathlete in 5x and 10x Ironman

The aim of the present case study was to analyse the performance data of the world’s best female ultra-triathlete setting a new world record in a Quintuple (5xIronman) and Deca Iron (10xIronman) ultra-triathlon, within and between race days, and between disciplines (cycling and running) and races (Quintuple and Deca Iron ultra-triathlon). The subject was an elite female triathlete (52 kg, 169 cm) born in 1983. At the time of her world record in Quintuple Iron ultra-triathlon she had an age of 35 years and at the time of the world record in Deca Iron ultra-triathlon 36 years old. The distribution of time spent in each discipline and transitions was 8.48% in swimming, 51.67% cycling, 37.91% running, and 1.94% transitions. There was no difference between the race days of the average speed neither in cycling nor running. The running pace had a within-day variation larger than the cycling pace, and also varied more between race days. In conclusion, the world’s best female ultra-triathlete adopted a steady (even) pacing strategy for both cycling and running, without substantial variations within- or between race days, for both the world record in a Quintuple and a Deca Iron ultra-triathlon.

Faster and Healthier: Relationship between Telomere and Performance in Master Athletes

Aging is associated with increased oxidative stress, chronic inflammation, and decreased telomere length (TL). However, the lifestyle of master athletes can lead to a reduced risk of these conditions, and thus attenuates aging and performance deterioration. We aimed to analyze the relationships between TL and relative performance (RP), and their relation to adiposity, oxidative stress, and inflammation in endurance (END) and sprint/power (SPW) master athletes (MAs). Twenty-two world-class MAs visited the laboratory for anamnesis, anthropometrics, and blood sampling. Inflammatory and oxidative stress parameters were assessed using commercial kits. Relative TL was determined in leukocytes through qPCR analyses. A positive association was observed between RP and TL in both groups (SPW: r=0.641; END: r=0.685) and the whole sample (r=0.594). The IL6/IL10 ratio presented an inverse correlation with RP in the whole sample (r=–0.580). Body mass index also demonstrated a negative correlation with TL for the END group (r=–0.690) and the whole sample analysis (r=–0.455). Moreover, the IL6/IL10 ratio was negatively associated with strength/power training hours (r=–0.464), whereas the CAT/TBARS ratio was negatively associated with aerobic training hours (r=–0.482). In conclusion, TL of MAs was associated with RP regardless of the training model (endurance or sprint/power), and inflammation and adiposity were associated with shorter telomeres.

Ultra-triathlon-Pacing, performance trends, the role of nationality, and sex differences in finishers and non-finishers

Ultra-triathlons are defined as triathlons longer than the traditional Ironman distance and became more popular in the last two decades; however, scarce scientific evidence of these events are available. Therefore, we aimed to investigate the trends of performance, pacing, nationality, sex differences, and rate of non-finishers in ultra-triathlons. Data from 1985 to 2018 were collected including Double Iron, Triple Iron, Quintuple Iron, and Deca Iron ultra-triathlons. Different pacing patterns by event and sex were observed (P < .05); athletes spent less %time in swimming and cycling, and more %time in running as the distance of event was longer; women spent more %time in cycling and less% time in running in Double and Triple. Performance analysis showed a negative trend over time for men and women since 1985. Switzerland, France, and Germany were the fastest nations in ultra-triathlons. The frequency of North Americans competing in Europe was very low (<5%), whereas Europeans often competed in North America (~25%). The rate of non-finishers between sexes was similar in all races with the exception of Deca Iron ultra-triathlon, which was much greater (~20%) for women. Non-finishers had slower race times in swimming and cycling splits than finishers. In conclusion, ultra-triathletes should redistribute their energy among swimming, cycling, and running depending on their sex and distance of race. Performance in ultra-triathlons has been decreasing in men and women over the years, but sex difference in performance remained. Europeans were the fastest ultra-triathletes and compete in Europe and North America. Additionally, non-finishers were slower swimmers and cyclists than finishers.

American Masters Road Running Records-The Performance Gap Between Female and Male Age Group Runners from 5 Km to 6 Days Running

Recent studies investigating elite and master athletes in pool- and long-distance open-water swimming showed for elite swimmers that the fastest women were able to outperform the fastest men, and for master athletes that elderly women were able to achieve a similar performance to elderly men. The present study investigating age group records in runners from 5 km to 6 days aimed to test this hypothesis for master runners. Data from the American Master Road Running Records were analyzed, for 5 km, 8 km, 10 km, 10 miles, 20 km, half-marathon, 25 km, 30 km, marathon, 50 km, 50 miles, 100 km, 100 miles, 12 h, 24 h, 48 h and 144 h, for athletes in age groups ranging from 40 to 99 years old. The performance gap between men and women showed higher effects in events lengthening from 5 km to 10 miles (d = 0.617) and lower effects in events lengthening from 12 to 144 h (d = 0.304) running. Both other groups showed similar effects, being 20 km to the marathon (d = 0.607) and 50 km to 100 miles (d = 0.563). The performance gap between men and women showed higher effects in the age groups 85 years and above (d = 0.953) followed by 55 to 69 years (d = 0.633), and lower effects for the age groups 40 to 54 years (d = 0.558) and 70 to 84 years (d = 0.508). In summary, men are faster than women in American road running events, however, the sex gap decreases with increasing age but not with increasing event length.