Selective cortical adaptations associated with neural efficiency in visuospatial tasks - the comparison of electroencephalographic profiles of expert and novice artists

Visuospatial cognition encapsulates an individual's ability to efficiently navigate and make sense of the multimodal cues from their surroundings, and therefore has been linked to expert performance across multiple domains, including sports, performing arts, and highly skilled tasks, such as drawing (Morrone and Minini, 2023). As neural efficiency posits a task-specific functional reorganization facilitated by long-term training, the present study employs a visuospatial construction task as a means of investigating the neurophysiological adaptations associated with expert visuospatial cognitive performance. Electroencephalogram (EEG) data acquisitions were used to evaluate the event-related changes (ER%) and statistical topographic maps of nine expert versus nine novice artists. The expert artists displayed overall higher global ER% compared to the novices within task-active intervals. Significant increases in relative ER% were found in the theta (t (10) = 3.528, p = 0.003, CI = [27.3,120.9]), lower-alpha (t (10) = 3.751, p = 0.002, CI = [28.2,110.5]), upper-alpha (t (10) = 3.829, p = 0.002, CI = [50.2,189.8]), and low beta (t (10) = 4.342, p < 0.001, CI = [37.0,114.9]) frequency bands, when comparing the experts to the novice participants. These results were particularly found in the frontal (t (14) = 2.014, p = 0.032, CI = [7.7,245.4]) and occipital (t (14) = 2.647, p = 0.010, CI = [45.0,429.7]) regions. Further, a significant decrease in alpha ER% from lower to upper activity (t (8) = 4.475, p = 0.001, CI = [21.0, 65.8]) was found across cortical regions in the novice group. Notably, greater deviation between lower and upper-alpha activity was found across scalp locations in the novice group, compared to the experts. Overall, the findings demonstrate potential local and global EEG-based indices of selective cortical adaptations within a task requiring a high degree of visuospatial cognition, although further work is needed to replicate these findings across other domains.

Injury Incidence, Severity, and Type Across the Menstrual Cycle in Female Footballers: A Prospective Three Season Cohort Study

PURPOSE

The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity, and type in elite female professional footballers over three seasons.

METHODS

Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorized into four phases using a standardized model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and premenstrual phase (phase 4; P4). Injury incidence rates (IIR) and ratios (IIRR) were calculated for overall injuries, injury severity, type, contact vs noncontact, and game/training.

RESULTS

A total of 593 cycles across 13,390 d were tracked during the study, and 74 injuries from 26 players were eligible for analysis. When comparing IIR between phases (reference: P1), overall injury rates were highest in P4 (IIRR, 2.30 (95% confidence interval, 0.99-5.34; P = 0.05)). When examining rates by injury severity and type, IIR values were also highest in P4 for ≤7 d' time-loss (4.40 (0.93-20.76; P = 0.06)), muscle-specific (6.07 (1.34-27.43; P = 0.02)), and noncontact (3.05 (1.10-8.50; P = 0.03)) injuries. Muscle-specific (IIRR P3/P1, 5.07 (1.16-22.07; P = 0.03)) and ≤7 d' time-loss (4.47 (1.01-19.68; P = 0.05)) injury risk was also significantly higher in P3. Muscle injuries were the most prevalent subtype ( n = 41). No anterior cruciate ligament injuries were recorded across the monitoring period.

CONCLUSIONS

Injury risk was significantly elevated during the luteal phase of the menstrual cycle (P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.

The association of range of motion, lower limb strength, and load during jump landings in professional ballet dancers

This study aimed to investigate the associations between peak plantarflexion ankle joint moments and vertical ground reaction forces (vGRF) during jump landings, and static ankle dorsiflexion range of motion (ROM), three-dimensional ankle excursions, and lower extremity strength in professional ballet dancers. Twenty-seven professional ballet dancers volunteered to participate (men = 14, women = 13). Participants attended one data collection session to measure dorsiflexion ROM and isometric lower extremity strength. Two further sessions were used to establish ankle mechanics and vGRFs during countermovement jump landings in seven foot positions, via a seven-camera motion capture system and piezoelectric force platform. Two linear mixed-effects models were used to investigate associations between the target variables and strength, dorsiflexion ROM, and ankle excursions. Dancer identification, sex, and foot position were entered as random effects. Model fit, when considered independent of random effects, was generally poor with the predictor variables explaining little of the variance of peak plantarflexion ankle joint moments (R2 = 0.02) or vGRF (R2 = 0.01). Model fit improved when random effects were considered (R2 = 0.65 & 0.34). Frontal plane ankle excursion was the only predictor variable with a significant negative association with peak plantarflexion ankle joint moments (p = .016), although coefficient estimates were small. Strength, static ankle dorsiflexion ROM, and three-dimensional ankle excursions are poor predictors of load experienced at a joint and system level in professional ballet dancers. Differences between individuals, sex, and foot position may be better indicators of the load experienced during jump landings.

Exercise-induced β2-adrenergic receptor activation enhances the anti-leukemic activity of expanded γδ T-Cells via DNAM-1 upregulation and PVR/Nectin-2 recognition

Exercise mobilizes cytotoxic lymphocytes to blood which may allow superior cell products to be manufactured for cancer therapy. Gamma-Delta (γδ) T-cells have shown promise for treating solid tumors, but there is a need to increase their potency against hematologic malignancies. Here, we show that human γδ T-cells mobilized to blood in response to just 20-minutes of graded exercise have surface phenotypes and transcriptomic profiles associated with cytotoxicity, adhesion, migration and cytokine signaling. Following 14-days ex vivo expansion with zoledronic acid and interleukin (IL)-2, exercise mobilized γδ T-cells had surface phenotypes and transcriptomic profiles associated with enhanced effector functions, and demonstrated superior cytotoxic activity against multiple hematologic tumors in vitro, and in vivo in leukemia bearing xenogeneic mice. Infusing humans with the β1+β2-agonist isoproterenol and administering β1 or β1+β2 antagonists prior to exercise revealed these effects to be β2-adrenergic receptor (AR) dependent. Antibody blocking of DNAM-1 on expanded γδ T-cells, as well as the DNAM-1 ligands PVR and Nectin-2 on leukemic targets, abolished the enhanced anti-leukemic effects of exercise. These findings provide a mechanistic link between exercise, β2-AR activation, and the manufacture of superior γδ T-cell products for adoptive cell therapy against hematological malignancies.

EEG-based neurophysiological indices for expert psychomotor performance - a review

A primary objective of current human neuropsychological performance research is to define the physiological correlates of adaptive knowledge utilization, in order to support the enhanced execution of both simple and complex tasks. Within the present article, electroencephalography-based neurophysiological indices characterizing expert psychomotor performance, will be explored. As a means of characterizing fundamental processes underlying efficient psychometric performance, the neural efficiency model will be evaluated in terms of alpha-wave-based selective cortical processes. Cognitive and motor domains will initially be explored independently, which will act to encapsulate the task-related neuronal adaptive requirements for enhanced psychomotor performance associating with the neural efficiency model. Moderating variables impacting the practical application of such neuropsychological model, will also be investigated. As a result, the aim of this review is to provide insight into detectable task-related modulation involved in developed neurocognitive strategies which support heightened psychomotor performance, for the implementation within practical settings requiring a high degree of expert performance (such as sports or military operational settings).

Jumping Asymmetries and Risk of Injuries in Preprofessional Ballet

BACKGROUND

Preprofessional ballet dancers are exposed to the risk of injuries, primarily in the lower extremities, with most injuries occurring during jumping and landing activities. Interlimb asymmetry during jumping and landing activities has been associated with the injury risk in adolescent athletes, but this has not been examined in dancers.

PURPOSE

To investigate associations between interlimb asymmetry during a double-leg countermovement jump (DL-CMJ) and single-leg jump (SLJ) and the injury risk in adolescent preprofessional ballet dancers.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

Adolescent preprofessional ballet dancers (N = 255) performed 3 DL-CMJs and 3 SLJs on force plates during annual screening. Absolute and directional (separate values for left and right limb dominance) asymmetries in a set of kinetic variables during a DL-CMJ and in jump height during an SLJ were calculated. Each variable was characterized as having "high" or "normal" asymmetry according to the percentage of asymmetry (greater than or less than or equal to, respectively, the mean ± 0.5 SD) based on the present sample. Risk ratios (RRs) and 95% CIs were calculated based on the injury incidence in the subsequent academic year.

RESULTS

Of the 242 dancers that satisfied the inclusion criteria, 128 injuries were observed in the subsequent academic year. In the whole sample, 3 absolute, 7 left limb-dominant, and 1 right limb-dominant kinetic asymmetry in the eccentric, concentric, and landing phases of the DL-CMJ as well as left limb-dominant jump height asymmetry in the SLJ were associated with a significant (P < .001) increase in the injury risk (RR, 1.28-1.69 [95% CI, 1.02-2.37]). Separating by sex, asymmetries in the eccentric and landing phase of the DL-CMJ were not significant in boys, while in girls, RRs for asymmetries in the eccentric and landing phase of the DL-CMJ increased, and SLJ jump height asymmetry was not significant.

CONCLUSION

Higher asymmetries in certain kinetic variables during the DL-CMJ and in jump height during the SLJ were associated with an elevated risk of injuries in elite preprofessional ballet dancers with some sex-specific differences. Associations were mainly identified for high left limb-dominant asymmetry in the takeoff phase, suggesting that the injury risk may be specific to a relative right limb deficit.

COVID-19 vaccination produces exercise-responsive SARS-CoV-2 specific T-cells regardless of infection history

BACKGROUND

The mobilization and redistribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific T-cells and neutralizing antibodies (nAbs) during exercise is purported to increase immune surveillance and protect against severe coronavirus disease 2019 (COVID-19). We sought to determine if COVID-19 vaccination would elicit exercise-responsive SARS-CoV-2 T-cells and transiently alter nAb titers.

METHODS

Eighteen healthy participants completed a 20-min bout of graded cycling exercise before and/or after receiving a COVID-19 vaccine. All major leukocyte subtypes were enumerated before, during, and after exercise by flow cytometry, and immune responses to SARS-CoV-2 were determined using whole blood peptide stimulation assays, T-cell receptor (TCR)-β sequencing, and SARS-CoV-2 nAb serology.

RESULTS

COVID-19 vaccination had no effect on the mobilization or egress of major leukocyte subsets in response to intensity-controlled graded exercise. However, non-infected participants had a significantly reduced mobilization of CD4+ and CD8+ naive T-cells, as well as CD4+ central memory T-cells, after vaccination (synthetic immunity group); this was not seen after vaccination in those with prior SARS-CoV-2 infection (hybrid immunity group). Acute exercise after vaccination robustly mobilized SARS-CoV-2 specific T-cells to blood in an intensity-dependent manner. Both groups mobilized T-cells that reacted to spike protein; however, only the hybrid immunity group mobilized T-cells that reacted to membrane and nucleocapsid antigens. nAbs increased significantly during exercise only in the hybrid immunity group.

CONCLUSION

These data indicate that acute exercise mobilizes SARS-CoV-2 specific T-cells that recognize spike protein and increases the redistribution of nAbs in individuals with hybrid immunity.

Acute and long-term sleep measurements produce opposing results on sleep quality in 8 and 12 hour shift patterns in law enforcement officers

The occupational demands of law enforcement increase the risk of poor-quality sleep, putting officers at risk of adverse physical and mental health. This cross-sectional study aimed to characterise sleep quality in day workers, 8 and 12 h rotating shift pattern workers. One hundred eighty-six officers volunteered for the study (37 female, age: 41 ± 7). Sleep quality was assessed using the Pittsburgh sleep quality index, actigraphy and the Leeds sleep evaluation questionnaire. The maximal aerobic capacity (VO2max ) was measured on a treadmill via breath-by-breath analysis. There was a 70% overall prevalence of poor sleepers based on Pittsburgh sleep quality index scores, where 8 h shifts exhibited the worst prevalence (92%, p = 0.029), however, there was no difference between age, gender, or role. In contrast, 12 h shifts exhibited the poorest short-term measures, including awakening from sleep (p = 0.039) and behaviour following wakefulness (p = 0.033) from subjective measures, and poorer total sleep time (p = 0.024) and sleep efficiency (p = 0.024) from the actigraphy. High VO2max predicted poorer wake after sleep onset (Rsq = 0.07, p = 0.05) and poorer sleep latency (p = 0.028). There was no relationship between the Pittsburgh sleep quality index scores and any of the short-term measures. The prevalence of poor sleepers in this cohort was substantially higher than in the general population, regardless of shift pattern. The results obtained from the long- and short-term measures of sleep quality yielded opposing results, where long-term perceptions favoured the 12 h pattern, but short-term subjective and objective measures both favoured the 8 h pattern.

Sleep Health, Individual Characteristics, Lifestyle Factors, and Marathon Completion Time in Marathon Runners: A Retrospective Investigation of the 2016 London Marathon

Despite sleep health being critically important for athlete performance and well-being, sleep health in marathoners is understudied. This foundational study explored relations between sleep health, individual characteristics, lifestyle factors, and marathon completion time. Data were obtained from the 2016 London Marathon participants. Participants completed the Athlete Sleep Screening Questionnaire (ASSQ) along with a brief survey capturing individual characteristics and lifestyle factors. Sleep health focused on the ASSQ sleep difficulty score (SDS) and its components. Linear regression computed relations among sleep, individual, lifestyle, and marathon variables. The analytic sample (N = 943) was mostly male (64.5%) and young adults (66.5%). A total of 23.5% of the sample reported sleep difficulties (SDS ≥ 8) at a severity warranting follow-up with a trained sleep provider. Middle-aged adults generally reported significantly worse sleep health characteristics, relative to young adults, except young adults reported significantly longer sleep onset latency (SOL). Sleep tracker users reported worse sleep satisfaction. Pre-bedtime electronic device use was associated with longer SOL and longer marathon completion time, while increasing SOL was also associated with longer marathon completion. Our results suggest a deleterious influence of pre-bedtime electronic device use and sleep tracker use on sleep health in marathoners. Orthosomnia may be a relevant factor in the relationship between sleep tracking and sleep health for marathoners.

Amenorrhea and oligomenorrhea risk related to exercise training volume and intensity: Findings from 3705 participants recruited via the STRAVA™ exercise application

OBJECTIVES

To investigate associations between self-reported exercise training habits and amenorrhea/oligomenorrhea among physically active women.

DESIGN

A cross-sectional survey was completed by 3705 women (median age = 40 years [quartile 1, quartile 3: 30, 45], body mass index = 22.1 kg/m2 [20.5, 24.2]) representing multiple nationalities and sports via the STRAVA™ exercise application. Respondents selected the amount of time they participated in low intensity, moderate intensity, and high intensity exercise training per week. Amenorrhea/oligomenorrhea was defined as self-reporting ≤10 menses in the last year.

METHODS

Associations between weekly exercise volume for low intensity training, moderate intensity training, and high intensity training and amenorrhea/oligomenorrhea were modeled with univariate logistic regression models, followed by adjustment for age and body mass index.

RESULTS

Amenorrhea/oligomenorrhea prevalence was 16 % (n = 576/3705), with no difference by country of origin or most sport modes. In adjusted models, participating in low intensity training ≥7 h/week or moderate intensity training ≥6 h/week was associated with 1.43 (95 % confidence interval: 1.04-1.96) and 1.46 (1.10-1.95) greater odds of amenorrhea/oligomenorrhea compared to 2 to 3 h/week, respectively. Similarly, high intensity training ≥5 h/week was associated with 1.41 (1.03-1.92) greater odds of amenorrhea/oligomenorrhea compared to 1 to 2 h/week. Participating in low intensity training for ≤30 min/week compared to 2 to 3 h/week was associated with reduced amenorrhea/oligomenorrhea odds (0.65 [0.44-0.94]).

CONCLUSIONS

Taken together, these associations suggest greater weekly exercise volume, irrespective of intensity, may increase amenorrhea/oligomenorrhea risk among physically active women.

Reliability of ankle mechanics during jump landings in turned-out and parallel foot positions in professional ballet dancers

This study aimed to determine the within- and between-session reliability of ankle mechanics and vertical ground reaction forces (vGRF) during jump landings in turned-out and parallel foot positions in professional ballet dancers. Twenty-four professional ballet dancers (men = 13, women = 11) attended two data collection sessions where they completed five maximal countermovement jumps in each foot position. The ankle joint mechanics and vGRF of the right limb were recorded via a seven-camera motion capture system and one force platform. Within- and between-session intraclass correlation coefficients (ICC), coefficients of variation (CV), standard error of measurement, and minimal detectable change were calculated for three-dimensional ankle excursion, peak ankle angle, ankle joint velocity, moment, and power, as well as peak landing vGRF, time to peak landing vGRF, loading rate, and jump height. Across both foot positions, within- (ICC: 0.17-0.96; CV: 1.4-82.3%) and between-session (ICC: 0.02-0.98; CV:1.3-57.1%) reliability ranged from poor to excellent, with ankle excursion, peak ankle angle, and jump height demonstrating the greatest ICC values (ICC: 0.65-0.96; CV: 1.4-57%). Jump landings in a turned-out foot position demonstrated better within-session reliability compared to a parallel position, however, no difference in between-session reliability across the foot positions was observed. Most ankle mechanics provide adequate between-session, but not within-session, reliability during jump landings in professional ballet dancers.

The development and validation of an open-source accelerometery algorithm for measuring jump height and frequency in ballet

The aim was to determine the validity of an open-source algorithm for measuring jump height and frequency in ballet using a wearable accelerometer. Nine professional ballet dancers completed a routine ballet class whilst wearing an accelerometer positioned at the waist. Two investigators independently conducted time-motion analysis to identify time-points at which jumps occurred. Accelerometer data were cross-referenced with time-motion data to determine classification accuracy. To determine the validity of the measurement of jump height, five participants completed nine jetés, nine sautés and three double tour en l'air from a force plate. The jump height predicted by the accelerometer algorithm was compared to the force plate jump height to determine agreement. Across 1440 jumps observed in time-motion analysis, 1371 true positives, 34 false positives and 69 false negatives were identified by the algorithm, resulting in a sensitivity of 0.98, a precision of 0.95 and a miss rate of 0.05. For all jump types, mean absolute error was 2.6 cm and the repeated measures correlation coefficient was 0.97. Bias was 1.2 cm and 95% limits of agreement were -4.9 to 7.2 cm. The algorithm may be used to manage jump load, implement periodization strategies, or plan return-to-jump pathways for rehabilitating athletes.

A bespoke sleep monitoring and sleep hygiene intervention improves sleep in an U18 professional football player: A case study

This case study reports on a professional football player (age: 17.6 years) who was referred for sleep monitoring and intervention after reporting excessive night-time awakenings. The player undertook a series of subjective sleep assessments and objective sleep monitoring (activity monitor). Based on the data presented, a sleep hygiene intervention was prescribed. Numerical comparisons were made between pre-intervention (Pre) and post-intervention (Post) values. Objective values were also compared to reference data from a similarly aged professional cohort from the same club (n = 11). Wake episodes per night (Pre: 7.9 ± 3, Post: 4.5 ± 1.9; -43%) and wake after sleep onset (WASO; Pre: 74.3 ± 31.8 mins, Post: 50.0 ± 22.8 mins, -33%) were improved from Pre to Post. Compared to the reference data, mean wake episodes per night (Pre: 7.9 ± 3.0, reference: 4.6 ± 2.6; -42%) and WASO (Pre: 74.3 ± 31.8 mins, reference: 44.3 ± 36.5 mins; -40%) were all lower compared to Pre levels. Whilst causality cannot be proven, we observed multiple sleep metrics improving following an intervention. This provides a potential framework for practitioners looking to provide targeted sleep assessment and intervention.

Objective Measures of Strain and Subjective Muscle Soreness Differ Between Positional Groups and Season Phases in American College Football

PURPOSE

To assess objective strain and subjective muscle soreness in "Bigs" (offensive and defensive line), "Combos" (tight ends, quarterbacks, line backers, and running backs), and "Skills" (wide receivers and defensive backs) in American college football players during off-season, fall camp, and in-season phases.

METHODS

Twenty-three male players were assessed once weekly (3-wk off-season, 4-wk fall camp, and 3-wk in-season) for hydroperoxides (free oxygen radical test [FORT]), antioxidant capacity (free oxygen radical defense test [FORD]), oxidative stress index (OSI), countermovement-jump flight time, Reactive Strength Index (RSI) modified, and subjective soreness. Linear mixed models analyzed the effect of a 2-within-subject-SD change between predictor and dependent variables.

RESULTS

Compared to fall camp and in-season phases, off-season FORT (P ≤ .001 and <.001), FORD (P ≤ .001 and <.001), OSI (P ≤ .001 and <.001), flight time (P ≤ .001 and <.001), RSI modified (P ≤ .001 and <.001), and soreness (P ≤ .001 and <.001) were higher for "Bigs," whereas FORT (P ≤ .001 and <.001) and OSI (P = .02 and <.001) were lower for "Combos." FORT was higher for "Bigs" compared to "Combos" in all phases (P ≤ .001, .02, and .01). FORD was higher for "Skills" compared with "Bigs" in off-season (P = .02) and "Combos" in-season (P = .01). OSI was higher for "Bigs" compared with "Combos" (P ≤ .001) and "Skills" (P = .01) during off-season and to "Combos" in-season (P ≤ .001). Flight time was higher for "Skills" in fall camp compared with "Bigs" (P = .04) and to "Combos" in-season (P = .01). RSI modified was higher for "Skills" during off-season compared with "Bigs" (P = .02) and "Combos" during fall camp (P = .03), and in-season (P = .03).

CONCLUSION

Off-season American college football training resulted in higher objective strain and subjective muscle soreness in "Bigs" compared with fall camp and during in-season compared with "Combos" and "Skills" players.

Collagen Gene Polymorphisms Previously Associated with Resistance to Soft-Tissue Injury Are More Common in Competitive Runners Than Nonathletes

ABSTRACT

Dines, HR, Nixon, J, Lockey, SJ, Herbert, AJ, Kipps, C, Pedlar, CR, Day, SH, Heffernan, SM, Antrobus, MR, Brazier, J, Erskine, RM, Stebbings, GK, Hall, ECR, and Williams, AG. Collagen gene polymorphisms previously associated with resistance to soft-tissue injury are more common in competitive runners than nonathletes. J Strength Cond Res 37(4): 799-805, 2023-Single-nucleotide polymorphisms (SNPs) of collagen genes have been associated with soft-tissue injury and running performance. However, their combined contribution to running performance is unknown. We investigated the association of 2 collagen gene SNPs with athlete status and performance in 1,429 Caucasian subjects, including 597 competitive runners (354 men and 243 women) and 832 nonathletes (490 men and 342 women). Genotyping for COL1A1 rs1800012 (C > A) and COL5A1 rs12722 (C > T) SNPs was performed by a real-time polymerase chain reaction. The numbers of "injury-resistant" alleles from each SNP, based on previous literature (rs1800012 A allele and rs12722 C allele), were combined as an injury-resistance score (RScore, 0-4; higher scores indicate injury resistance). Genotype frequencies, individually and combined as an RScore, were compared between cohorts and investigated for associations with performance using official race times. Runners had 1.34 times greater odds of being rs12722 CC homozygotes than nonathletes (19.7% vs. 15.5%, p = 0.020) with no difference in the rs1800012 genotype distribution ( p = 0.659). Fewer runners had an RScore 0 of (18.5% vs. 24.7%) and more had an RScore of 4 (0.6% vs. 0.3%) than nonathletes ( p < 0.001). Competitive performance was not associated with the COL1A1 genotype ( p = 0.933), COL5A1 genotype ( p = 0.613), or RScore ( p = 0.477). Although not associated directly with running performance among competitive runners, a higher combined frequency of injury-resistant COL1A1 rs1800012 A and COL5A1 rs12722 C alleles in competitive runners than nonathletes suggests these SNPs may be advantageous through a mechanism that supports, but does not directly enhance, running performance.

Rehearsal and Performance Volume in Professional Ballet: A Five-Season Cohort Study

INTRODUCTION

Few studies have published data concerning the longitudinal rehearsal and performance demands experienced by professional ballet dancers. We aimed to describe the rehearsal and performance volumes undertaken across five professional ballet seasons and identify factors associated with inter-dancer and inter-production variation in dance hours.

METHODS

Scheduling data were collected from 123 dancers over five seasons at The Royal Ballet. Linear mixed effects models were used to evaluate differences in: 1. weekly dance hours and seasonal performance counts across sexes, company ranks, and months; and 2. factors associated with the variation in rehearsal hours required to stage different productions.

RESULTS

On average across the five seasons, a peak in performance volume was observed in December, whereas rehearsal hours peaked in October and November and between January and April. Differences in weekly dance hours were observed between company ranks (p < 0.001, range in means: 19.1 to 27.5 hours per week). Seasonal performance counts varied across company ranks (p < 0.001), ranging from 28 (95% CI: 22, 35) in principals to 113 (95% CI: 108, 118) in the rank of artist. Rehearsal durations were considerably greater in preparation for newly created ballets compared with existing ballets (77.8 vs. 37.5 hours). Rehearsal durations were also greater in preparation for longer ballets, with each additional minute of running time associated with a 0.43 hour increase in rehearsal duration (p < 0.001). Full-length ballets, however, were consistently the most time-efficient to stage due to their long performance runs compared with shorter ballets (16.2 vs. 7.4 performances).

CONCLUSIONS

Training principles such as progressive overload and periodization should be implemented in professional ballet companies to manage the high and variable rehearsal and performance loads.

Compression Garments for Recovery from Muscle Damage: Evidence and Implications of Dose Responses

ABSTRACT

The use of compression garments (CG) has been associated with improved recovery following exercise-induced muscle damage. The mechanisms responsible are not well established, and no consensus exists regarding the effects of compression pressure (i.e., the "dose"), which until recently was seldom reported. With the increasing prevalence of studies reporting directly measured pressures, the present review aims to consolidate current evidence on optimal pressures for recovery from exercise-induced muscle damage. In addition, recent findings suggesting that custom-fitted garments provide greater precision and experimental control are discussed. Finally, biochemical data from human trials are presented to support a theoretical mechanism by which CG enhance recovery, with recommendations for future research. The effects of compression on adaptation remain unexplored. More studies are required to investigate the relationship between compression pressure and the recovery of performance and physiological outcomes. Furthermore, improved mechanistic understanding may help elucidate the optimal conditions by which CG enhance recovery.

Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people

Athletes are advised to receive the COVID-19 vaccination to protect themselves from SARS-CoV-2 infection during major competitions. Despite this, many athletes are reluctant to get the COVID-19 vaccine due to concerns that symptoms of vaccinosis may impair athletic performance. This study aimed to determine the effects of COVID-19 vaccination on the physiological responses to graded exercise. Healthy physically active participants completed a 20-min bout of graded cycling exercise at intensities corresponding to 50%, 60%, 70%, and 80% of the predetermined V̇O2max before and ∼21 days after receiving the COVID-19 vaccine (2-dose Pfizer mRNA or 1-dose Johnson & Johnson). Vaccination had no effect on a large number of physiological responses to exercise measured in blood (e.g., lactate, epinephrine, and cortisol) and by respiratory gas exchange (e.g., oxygen uptake, CO2 production, ventilation, respiratory exchange ratio, predicted V̇O2max, and ventilatory threshold) (P > 0.05). We did, however, find significant elevations in heart rate (∼5 beats/min) and norepinephrine (P = 0.006 and 0.04, respectively) in response to vigorous (i.e., 70%-80% V̇O2max) intensity exercise after vaccination, particularly in those who received the two-shot Pfizer mRNA vaccine regimen. These findings held true when compared with demographically matched controls who completed identical bouts of exercise several weeks apart without receiving a vaccine; delta values for heart rate (P = 0.03) and norepinephrine (P = 0.01) were elevated in the second trial for those who received the Pfizer mRNA vaccine compared with the controls at the 70% and 80% V̇O2max stages, respectively. Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people. The small elevations in cardiovascular and neuroendocrine responses to exercise after the Pfizer mRNA vaccine regimen could have implications for athletes at the elite level and warrants investigation.NEW & NOTEWORTHY Recent COVID-19 vaccination does not affect a large number of physiological responses to graded exercise, indicating that vaccination is unlikely to impair exercise capacity in normal healthy people. Heart rate and norepinephrine levels were elevated in response to exercise after the two-dose Pfizer mRNA vaccination compared to controls. Small elevations in cardiovascular and neuroendocrine responses to exercise after recent COVID-19 vaccination could have implications for exercise performance in elite athletes and warrants investigation.

Rehearsal and Performance Volume in Professional Ballet: A Five-Season Cohort Study

Introduction: Few studies have published data concerning the longitudinal rehearsal and performance demands experienced by professional ballet dancers. We aimed to describe the rehearsal and performance volumes undertaken across five professional ballet seasons and identify factors associated with inter-dancer and inter-production variation in dance hours. Methods: Scheduling data were collected from 123 dancers over five seasons at The Royal Ballet. Linear mixed effects models were used to evaluate differences in: 1. weekly dance hours and seasonal performance counts across sexes, company ranks, and months; and 2. factors associated with the variation in rehearsal hours required to stage different productions. Results: On average across the five seasons, a peak in performance volume was observed in December, whereas rehearsal hours peaked in October and November and between January and April. Differences in weekly dance hours were observed between company ranks (p < 0.001, range in means: 19.1 to 27.5 hours per week). Seasonal performance counts varied across company ranks (p < 0.001), ranging from 28 (95% CI: 22, 35) in principals to 113 (95% CI: 108, 118) in the rank of artist. Rehearsal durations were considerably greater in preparation for newly created ballets compared with existing ballets (77.8 vs. 37.5 hours). Rehearsal durations were also greater in preparation for longer ballets, with each additional minute of running time associated with a 0.43 hour increase in rehearsal duration (p < 0.001). Full-length ballets, however, were consistently the most time-efficient to stage due to their long performance runs compared with shorter ballets (16.2 vs. 7.4 performances).Conclusions: Training principles such as progressive overload and periodization should be implemented in professional ballet companies to manage the high and variable rehearsal and performance loads.

Acute exercise increases immune responses to SARS CoV-2 in a previously infected man

Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.

Cardiac effects of detraining in athletes: A narrative review

BACKGROUND

Routine physical activity stimulates numerous morphologic and functional adaptations of the cardiac system, which are commonly referred to as exercise-induced cardiac remodeling (EICR). EICR has been well documented in elite and recreational athletes, but comparatively little is known about the "reverse" cardiac adaptations during detraining in an athletic population.

OBJECTIVE

To assess the morphologic and functional cardiac effects of detraining in athletes.

METHODS

Eligible studies were identified in PubMed from inception to May 2020. Studies were included if they assessed the cardiac effects of detraining periods in athletes.

RESULTS

A total of 16 studies from the literature search were identified and included in this review. These studies included athletes from multiple different sporting disciplines and detraining periods ranged from 3 weeks to 13 years. Detraining periods led to significantly decreased right ventricular and left (LV) ventricular dimensions, LV mass, and LV wall thickness, but only limited changes in systolic and diastolic functional parameters were observed.

CONCLUSIONS

From the limited data available in this population, cardiac atrophy has been observed with short periods of detraining (1-8 weeks) but often spares systolic and diastolic heart function. Supplemental exercise training during times of rehabilitation to combat cardiac regression has not been vigorously studied in athletes, so the ideal frequency, intensity, and modality of exercise needed to maintain EICR remains unclear.

Dance Exposure, Individual Characteristics, and Injury Risk over Five Seasons in a Professional Ballet Company

PURPOSE

This study aimed to describe the relationships between dance exposure, dancer characteristics, and injury risk across five seasons in a professional ballet company.

METHODS

Dance exposure time and clinician-reported time-loss and medical attention injury data were prospectively collected from 118 professional dancers of The Royal Ballet between 2015/2016 and 2019/2020. Cox proportional hazards and shared frailty models were fitted to overuse and traumatic injuries; individualized robust Z-scores for 7- and 28-d accumulated exposure, and week-to-week change in exposure, age, sex, company rank, and injury history were included as time-varying covariates.

RESULTS

Across 381,710 h of exposure, 1332 medical attention and 427 time-loss injuries were observed. Positive relationships were observed between week-to-week change in exposure and overuse time-loss (+1 Z-score hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.06-1.53) and medical attention injury risk (+1 Z-score HR, 1.17; 95% CI, 1.06-1.28). A negative relationship was observed between 7-d accumulated exposure and overuse medical attention injury risk (+1 Z-score HR, 0.74; 95% CI, 0.66-0.84). Overuse time-loss injury risk was greater in soloists compared with the corps de ballet (HR, 1.47; 95% CI, 1.01-2.15) and in dancers with a higher previous injury rate (+1 injury per 1000 h HR, 1.06; 95% CI, 1.02-1.10). Only age was associated with traumatic time-loss (+1-yr HR, 1.05; 95% CI, 1.01-1.09) or medical attention injury risk (+1-yr HR, 1.04; 95% CI, 1.01-1.07).

CONCLUSIONS

Professional ballet companies should implement training principles such as periodization and progression, particularly in the case of senior-ranking dancers, older dancers, and dancers with high rates of previous injury. These findings provide a basis for future prospective investigations into specific causal injury pathways.

Modelling menstrual cycle length in athletes using state-space models

The ability to predict an individual's menstrual cycle length to a high degree of precision could help female athletes to track their period and tailor their training and nutrition correspondingly. Such individualisation is possible and necessary, given the known inter-individual variation in cycle length. To achieve this, a hybrid predictive model was built using data on 16,524 cycles collected from a sample of 2125 women (mean age 34.38 years, range 18.00-47.10, number of menstrual cycles ranging from 4 to 53). A mixed-effect state-space model was fitted to capture the within-subject temporal correlation, incorporating a Bayesian approach for process forecasting to predict the duration (in days) of the next menstrual cycle. The modelling procedure was split into three steps (1) a time trend component using a random walk with an overdispersion parameter, (2) an autocorrelation component using an autoregressive moving-average model, and (3) a linear predictor to account for covariates (e.g. injury, stomach cramps, training intensity). The inclusion of an overdispersion parameter suggested that [Formula: see text] [Formula: see text] of cycles in the sample were overdispersed. The random walk standard deviation for a non-overdispersed cycle is [Formula: see text] [1.00, 1.09] days while under an overdispersed cycle, the menstrual cycle variance increase in 4.78 [4.57, 5.00] days. To assess the performance and prediction accuracy of the model, each woman's last observation was used as test data. The root mean square error (RMSE), concordance correlation coefficient and Pearson correlation coefficient (r) between the observed and predicted values were calculated. The model had an RMSE of 1.6412 days, a precision of 0.7361 and overall accuracy of 0.9871. In conclusion, the hybrid model presented here is a helpful approach for predicting menstrual cycle length, which in turn can be used to support female athlete wellness.

Medical encounters at community-based physical activity events (parkrun) in the UK

OBJECTIVE

To determine the incidence, clinical correlates and exposure risk of medical encounters during community-based physical activity events in the UK.

METHODS

An analysis of medical data from weekly, community-based physical activity events (parkrun) at 702 UK locations over a 6-year period (29 476 294 participations between 2014 and 2019) was conducted in order to define the incidence and clinical correlates of serious life-threatening, non-life-threatening and fatal medical encounters.

RESULTS

84 serious life-threatening encounters (overall incidence rate=0.26/100 000 participations) occurred including 18 fatalities (0.056/100 000 participations). Statistical modelling revealed that the probabilities of serious life-threatening encounters were exceptionally low, however, male sex, increasing age, slower personal best parkrun time and less prior running engagement/experience (average number of runs per year and number of years as a parkrun participant) were associated with increased probability of serious life-threatening encounters. These were largely accounted for by cardiac arrest (48/84, 57%) and acute coronary syndromes (20/84, 24%). Non-life-threatening medical encounters were mainly attributed to tripping or falling, with a reported incidence of 39.2/100 000 participations.

CONCLUSIONS

Serious life-threatening and fatal medical encounters associated with parkrun participation are extremely rare. In the context of a global public health crisis due to inactivity, this finding underscores the safety and corollary public health value of community running/walking events as a strategy to promote physical activity.

Jumping in Ballet: A Systematic Review of Kinetic and Kinematic Parameters

AIMS

Understanding the biomechanics of jumping in ballet dancers provides an opportunity to optimize performance and mitigate injury risk. This systematic review aimed to summarize research investigating kinetics and kinematics of jumping in ballet dancers.

METHODS

PubMed (MEDLINE), SPORTDiscus, and Web of Science were systematically searched for studies published before December 2020. Studies were required to investigate dancers specializing in ballet, assess kinetics or kinematics during take-off or landing, and be published in English.

RESULTS

A total of 3,781 articles were identified, of which 29 met the inclusion criteria. Seven studies investigated take-off (kinetics: n = 6; kinematics: n = 4) and 23 studies investigated landing (kinetics: n = 19; kinematics: n = 12). Included articles were categorized into six themes: Activity Type (n = 10), Environment and Equipment (n = 10), Demographics (n = 8), Physical Characteristics (n = 3), Injury Status (n = 2), and Skill Acquisition and Motor Control (n = 1). Peak landing vertical ground reaction force (1.4-9.6 times body weight) was most commonly reported. Limited evidence suggests greater ankle involvement during the take-off of ballet jumps compared to countermovement jumps. There is also limited evidence indicating greater sagittal plane joint excursions upon landing in ballet dancers compared to non-dancers, primarily through a more extended lower extremity at initial contact. Only 4 articles investigated male ballet dancers, which is a notable gap in the literature.

CONCLUSIONS

The findings of this review can be used by dance science and medicine practitioners to improve their understanding of jumping in ballet dancers.

The effect of custom-fitted compression garments worn overnight for recovery from judo training in elite athletes

This study investigated the effects of custom-fitted compression garments (CG) worn during recovery over a multi-day training camp in elite judo players (judoka). A single blind, placebo-controlled study was carried out in 11 elite judoka, using a two-way crossover design. Two three-day training camps were completed in CG and placebo conditions in a random order. Changes in performance and physiological markers were compared between conditions. Judoka were assessed before training for (maximal) isometric knee extension and grip strength, countermovement jump performance and bench-press velocity, alongside soreness, limb circumferences, plasma creatine kinase activity (CK) and perceived bruising. Measurements were repeated after 12, 36 and 43 h of training, whereupon judoka rated the effectiveness of each intervention. Knee extension and bench-press performance demonstrated significant familiarization (p < 0.001), and were excluded from subsequent analysis. Jump performance was unaffected by training (p > 0.05). Grip strength declined throughout training (p < 0.001), with peak decrements of -9.7% indicating mild muscle damage. Increases in bruising, CK and soreness demonstrated highly variable, if significant (p < 0.001) responses. Although CG were perceived as significantly more effective than placebo for recovery (p = 0.046), no effects were observed for any other outcome (p > 0.05). Compression conferred no statistically significant impact upon recovery markers in elite judoka throughout training. Muscle damage responses were inconsistent in this population. Individual athletes would be advised to monitor habitually-used performance measures while using CG to ascertain whether perceptual benefits translate into enhanced recovery. HighlightsCompression garments were perceived as more effective for recovery than placebo by elite judoka.However, no measures of performance or muscle damage were enhanced by CG.Randori was associated with inconsistent muscle damage responses in elite judoka, while lower-body performance was not impaired.Individual athletes would be advised to monitor habitually-used performance measures while using CG to ascertain whether perceptual benefits translate into enhanced recovery.

COVID-19-Considerations for the Female Athlete

The SARS CoV-2 virus (COVID-19) caused the whole sporting calendar to be paused. As we embark on the challenge of navigating through the return to play (RTP) process, there is a necessity to consider the needs of all athletes. This commentary specifically considers recommendations and requirements for the female athlete with a physiological emphasis during and following the COVID-19 pandemic, however, it will be relevant for any similar future scenarios that may present. It is important to acknowledge that there remain many unknowns surrounding COVID-19 and the female athlete both in the short- and long-term.

Hormonal Contraceptive Use in Football Codes in Australia

The recent launch of the new National elite women's football competitions in Australia has seen a 20-50% increase in grassroots female participation. With the growing participation across grassroots to elite competitions, understanding the health of female athletes should be prioritized. In elite level athletes, hormonal contraceptive (HC) use is common (~50%), however, little is known about the prevalence and reasons for use and disuse of HC in elite female football athletes. As such, the impact of HC use is often not considered when monitoring the health of female footballers. This study involved a subset of data collected as part of a larger questionnaire investigating menstrual cycle function, hormonal contraception use, and the interaction with training load volume and perceived performance in elite female football code athletes. A total of 177 participants completed the questionnaire across three football codes within Australia (rugby league, rugby union/sevens, Australian football). One third (n = 58) of athletes were currently using HC, predominately in the form of an oral contraceptive pill (OC, n = 47). Reasons for use included: to avoid pregnancy (71%); to control/regulate cycle (38%); and to reduce menstrual pain (36%). However, most athletes using an OC (89%) could not identify the type of pill used (e.g., mono-, bi-, or triphasic). The main reason for disuse was due to the negative side effects (n = 23), such as mood swings, weight gain, and depression/anxiety. Comparing HC users and non-users, there were no statistical differences in the number of reported menstrual symptoms, use of medication to relieve menstrual pain, or frequency for needing to adapt training due to their menstrual cycle (p > 0.05). Since most athletes were unaware of the type of OC they used, female football athletes require further education about the different types of HC, and specifically OC, available to them. Similarities in the symptoms experienced, pain management, and training adaptation requirements between groups suggests that HC use may not have the intended outcome for certain athletes. As such, greater awareness of athlete's personal experiences with the menstrual cycle, how HC may influence their experience, and acknowledgment of non-pharmacological methods to help manage menstrual cycle related symptoms are warranted.

A comparison of methods to generate adaptive reference ranges in longitudinal monitoring

In a clinical setting, biomarkers are typically measured and evaluated as biological indicators of a physiological state. Population based reference ranges, known as 'static' or 'normal' reference ranges, are often used as a tool to classify a biomarker value for an individual as typical or atypical. However, these ranges may not be informative to a particular individual when considering changes in a biomarker over time since each observation is assessed in isolation and against the same reference limits. To allow early detection of unusual physiological changes, adaptation of static reference ranges is required that incorporates within-individual variability of biomarkers arising from longitudinal monitoring in addition to between-individual variability. To overcome this issue, methods for generating individualised reference ranges are proposed within a Bayesian framework which adapts successively whenever a new measurement is recorded for the individual. This new Bayesian approach also allows the within-individual variability to differ for each individual, compared to other less flexible approaches. However, the Bayesian approach usually comes with a high computational cost, especially for individuals with a large number of observations, that diminishes its applicability. This difficulty suggests that a computational approximation may be required. Thus, methods for generating individualised adaptive ranges by the use of a time-efficient approximate Expectation-Maximisation (EM) algorithm will be presented which relies only on a few sufficient statistics at the individual level.

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

Blood test data were traditionally confined to the clinic for diagnostic purposes, but are now becoming more routinely used in many professional and elite high-performance settings as a physiological profiling and monitoring tool. A wealth of information based on robust research evidence can be gleaned from blood tests, including: the identification of iron, vitamin or energy deficiency; the identification of oxidative stress and inflammation; and the status of red blood cell populations. Serial blood test data can be used to monitor athletes and make inferences about the efficacy of training interventions, nutritional strategies or indeed the capacity to tolerate training load. Via a profiling and monitoring approach, blood biomarker measurement combined with contextual data has the potential to help athletes avoid injury and illness via adjustments to diet, training load and recovery strategies. Since wide inter-individual variability exists in many biomarkers, clinical population-based reference data can be of limited value in athletes, and statistical methods for longitudinal data are required to identify meaningful changes within an athlete. Data quality is often compromised by poor pre-analytic controls in sport settings. The biotechnology industry is rapidly evolving, providing new technologies and methods, some of which may be well suited to athlete applications in the future. This review provides current perspectives, limitations and recommendations for sports science and sports medicine practitioners using blood profiling and monitoring for nutrition and performance purposes.

Variations in strength-related measures during the menstrual cycle in eumenorrheic women: A systematic review and meta-analysis

OBJECTIVES

To systematically review the current body of research that has investigated changes in strength-related variables during different phases of the menstrual cycle in eumenorrheic women.

DESIGN

Systematic review and meta-analysis.

METHODS

A literature search was conducted in Pubmed, SPORTDiscus and Web of Science using search terms related to the menstrual cycle and strength-related measures. Two reviewers reached consensus that 21 studies met the criteria for inclusion. Methodological rigour was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Random effects meta-analyses were used to compare the early-follicular, ovulatory and mid-luteal phases for maximal voluntary contraction, isokinetic peak torque, and explosive strength.

RESULTS

The assessment of study quality showed that a high level of bias exists in specific areas of study design. Non-significant and small or trivial effect sizes (p≥0.26, Hedges g≤0.35) were identified for all strength-related variables in each comparison between phases. 95% confidence intervals for each comparison suggested the uncertainty associated with each estimate extends to a small effect on strength performance with unclear direction (-0.42≤g≤0.48). The heterogeneity for each comparison was also small (p≥0.83, I²=0%).

CONCLUSIONS

Strength-related measures appear to be minimally altered (g≤0.35) by the fluctuations in ovarian sex hormones that occur during the menstrual cycle. This finding should be interpreted with caution due to the methodological shortcomings identified by the quality assessment.

The Validity of the Session Rating of Perceived Exertion Method for Measuring Internal Training Load in Professional Classical Ballet Dancers

The aim of this study was to investigate the convergent validity of session rating of perceived exertion (s-RPE) with objective measures of internal training load (TL) in professional classical ballet dancers. Heart rate and s-RPE data were collected in 22 professional classical ballet dancers across a total of 218 ballet class or rehearsal sessions. Eleven participants completed at least 9 sessions, and were therefore included in analyses of individual relationships between s-RPE and objective measures. To calculate s-RPE, the session duration was multiplied by the RPE, measured using the modified Borg CR-10 scale. The Edwards summated heart rate zones (Edwards TRIMP) and Banister training impulse (Banister TRIMP) methods were used as criterion measures of internal TL. Pearson product-moment correlation coefficients were used to determine intra-individual relationships between s-RPE and objective measures. Repeated measures correlations were used to identify intra-individual relationships common across the cohort. Positive linear relationships were seen between s-RPE and objective measures across all session types [Edwards TRIMP: r_{rm (195)} = 0.81, p < 0.001; Banister TRIMP: r_{rm (195)} = 0.79, p < 0.001], in ballet class [Edwards TRIMP: r_{rm (58)} = 0.64, p < 0.001; Banister TRIMP: r_{rm (58)} = 0.59, p < 0.001], and in rehearsals [Edwards TRIMP: r_{rm (119)} = 0.82, p < 0.001; Banister TRIMP: r_{rm (119)} = 0.80, p < 0.001], as well as across both males [Edwards TRIMP: r_{rm (136)} = 0.82, p < 0.001; Banister TRIMP: r_{rm (136)} = 0.80, p < 0.001], and females [Edwards TRIMP: r_{rm (57)} = 0.80, p < 0.001; Banister TRIMP: r_{rm (57)} = 0.78, p < 0.001]. Intra-individual correlation coefficients ranged from 0.46–0.96 [Edwards TRIMP: mean r = 0.81 ± 0.11, p = 0.051 – < 0.001; Banister TRIMP: mean r = 0.78 ± 0.14, p = 0.13– < 0.001]. These results demonstrate that s-RPE is a valid and practical method for measuring internal TL in professional classical ballet dancers.

Are There Benefits from the Use of Fish Oil Supplements in Athletes? A Systematic Review

Despite almost 25 y of fish oil supplementation (FS) research in athletes and widespread use by the athletic community, no systematic reviews of FS in athletes have been conducted. The objectives of this systematic review are to: 1) provide a summary of the effect of FS on the athlete's physiology, health, and performance; 2) report on the quality of the evidence; 3) document any side effects as reported in the athlete research; 4) discuss any risks associated with FS use; and 5) provide guidance for FS use and highlight gaps for future research. Electronic databases (PubMed, Embase, Web of Science, Google Scholar) were searched up until April 2019. Only randomized placebo-controlled trials (RCTs) in athletes, assessing the effect of FS on a health, physiological/biochemical, or performance variable were included. Of the 137 papers identified through searches, 32 met inclusion criteria for final analysis. Athletes varied in classification from recreational to elite, and from Olympic to professional sports. Mean age for participants was 24.9 ± 4.5 y, with 70% of RCTs in males. We report consistent effects for FS on reaction time, mood, cardiovascular dynamics in cyclists, skeletal muscle recovery, the proinflammatory cytokine TNF-α, and postexercise NO responses. No clear effects on endurance performance, lung function, muscle force, or training adaptation were evident. Methodological quality, applying the Physiotherapy Evidence Database (PEDro) scale, ranged from 6 to a maximum of 11, with only 4 RCTs reporting effect sizes. Few negative outcomes were reported. We report various effects for FS on the athlete's physiology; the most consistent findings were on the central nervous system, cardiovascular system, proinflammatory cytokines, and skeletal muscle. We provide recommendations for future research and discuss the potential risks with FS use.

The Association of Parental Genetic, Lifestyle, and Social Determinants of Health with Offspring Overweight

INTRODUCTION

In the UK, the number of comorbidities seen in children has increased along with the worsening obesity rate. These comorbidities worsen into adulthood. Genome-wide association studies have highlighted single nucleotide polymorphisms associated with the weight status of adults and offspring individually. To date, in the UK, parental genetic, lifestyle, and social determinants of health have not been investigated alongside one another as influencers of offspring weight status. A comprehensive obesity prevention scheme would commence prior to conception and involve parental intervention including all known risk factors. This current study aims to identify the proportion of overweight that can be explained by known parental risk factors, including genetic, lifestyle, and social determinants of health with offspring weight status in the UK.

METHODS

A cross-sectional study was carried out on 123 parents. Parental and offspring anthropometric data and parental lifestyle and social determinants of health data were self-reported. Parental genetic data were collected by use of GeneFiX saliva collection vials and genotype were assessed for brain-derived neurotrophic factor (BDNF) gene rs6265, melanocortin 4 receptor (MC4R) gene rs17782313, transmembrane protein 18 (TMEM18) gene rs2867125, and serine/threonine-protein kinase (TNN13K) gene rs1514175. Associations were assessed between parental data and the weight status of offspring.

RESULTS

Maternal body mass index modestly predicted child weight status (p < 0.015; R2 = 0.15). More mothers of overweight children carried the MC4R rs17782313 risk allele (77.8%; p = 0.007) compared to mothers of normal-weight children. Additionally, fathers who were not Caucasian and parents who slept for <7 h/night had a larger percentage of overweight children when compared to their counterparts (p = 0.039; p = 0.014, respectively).

CONCLUSION

Associations exist between the weight status of offspring based solely on parental genetic, lifestyle, and social determinants of health data. Further research is required to appropriately address future interventions based on genetic and lifestyle risk groups on a pre-parent cohort.

Systemic β-Adrenergic Receptor Activation Augments the ex vivo Expansion and Anti-Tumor Activity of Vγ9Vδ2 T-Cells

TCR-gamma delta (γδ) T-cells are considered important players in the graft-vs.-tumor effect following allogeneic hematopoietic cell transplantation (alloHCT) and have emerged as candidates for adoptive transfer immunotherapy in the treatment of both solid and hematological tumors. Systemic β-adrenergic receptor (β-AR) activation has been shown to mobilize TCR-γδ T-cells to the blood, potentially serving as an adjuvant for alloHCT and TCR-γδ T-cell therapy. We investigated if systemic β-AR activation, using acute dynamic exercise as an experimental model, can increase the mobilization, ex vivo expansion, and anti-tumor activity of TCR-γδ T-cells isolated from the blood of healthy humans. We also sought to investigate the β-AR subtypes involved, by administering a preferential β1-AR antagonist (bisoprolol) and a non-preferential β1 + β2-AR antagonist (nadolol) prior to exercise as part of a randomized placebo controlled cross-over experiment. We found that exercise mobilized TCR-γδ cells to blood and augmented their ex vivo expansion by ~182% compared to resting blood when stimulated with IL-2 and ZOL for 14-days. Exercise also increased the proportion of CD56+, NKG2D+/CD62L-, CD158a/b/e+ and NKG2A- cells among the expanded TCR-γδ cells, and increased their cytotoxic activity against several tumor target cells (K562, U266, 221.AEH) in vitro by 40-60%. Blocking NKG2D on TCR-γδ cells in vitro eliminated the augmented cytotoxic effects of exercise against U266 target cells. Furthermore, administering a β1 + β2-AR (nadolol), but not a β1-AR (bisoprolol) antagonist prior to exercise abrogated the exercise-induced enhancement in TCR-γδ T-cell mobilization and ex vivo expansion. Furthermore, nadolol completely abrogated while bisoprolol partially inhibited the exercise-induced increase in the cytotoxic activity of the expanded TCR-γδ T-cells. We conclude that acute systemic β-AR activation in healthy donors markedly augments the mobilization, ex vivo expansion, and anti-tumor activity of TCR-γδ T-cells and that some of these effects are due to β2-AR signaling and phenotypic shifts that promote a dominant activating signal via NKG2D. These findings highlight β-ARs as potential targets to favorably alter the composition of allogeneic peripheral blood stem cell grafts and improve the potency of TCR-γδ T-cell immune cell therapeutics.

Effects of Strength Training on Postpubertal Adolescent Distance Runners

PURPOSE

Strength training activities have consistently been shown to improve running economy (RE) and neuromuscular characteristics, such as force-producing ability and maximal speed, in adult distance runners. However, the effects on adolescent (<18 yr) runners remains elusive. This randomized control trial aimed to examine the effect of strength training on several important physiological and neuromuscular qualities associated with distance running performance.

METHODS

Participants (n = 25, 13 female, 17.2 ± 1.2 yr) were paired according to their sex and RE and randomly assigned to a 10-wk strength training group (STG) or a control group who continued their regular training. The STG performed twice weekly sessions of plyometric, sprint, and resistance training in addition to their normal running. Outcome measures included body mass, maximal oxygen uptake (V˙O2max), speed at V˙O2max, RE (quantified as energy cost), speed at fixed blood lactate concentrations, 20-m sprint, and maximal voluntary contraction during an isometric quarter-squat.

RESULTS

Eighteen participants (STG: n = 9, 16.1 ± 1.1 yr; control group: n = 9, 17.6 ± 1.2 yr) completed the study. The STG displayed small improvements (3.2%-3.7%; effect size (ES), 0.31-0.51) in RE that were inferred as "possibly beneficial" for an average of three submaximal speeds. Trivial or small changes were observed for body composition variables, V˙O2max and speed at V˙O2max; however, the training period provided likely benefits to speed at fixed blood lactate concentrations in both groups. Strength training elicited a very likely benefit and a possible benefit to sprint time (ES, 0.32) and maximal voluntary contraction (ES, 0.86), respectively.

CONCLUSIONS

Ten weeks of strength training added to the program of a postpubertal distance runner was highly likely to improve maximal speed and enhances RE by a small extent, without deleterious effects on body composition or other aerobic parameters.

Cardiovascular response to prescribed detraining among recreational athletes

Exercise-induced cardiac remodeling (EICR) and the attendant myocardial adaptations characteristic of the athlete’s heart may regress during periods of exercise reduction or abstinence. The time course and mechanisms underlying this reverse remodeling, specifically the impact of concomitant plasma volume (PV) contraction on cardiac chamber size, remain incompletely understood. We therefore studied recreational runners ( n = 21, age 34 ± 7 yr; 48% male) who completed an 18-wk training program (~7 h/wk) culminating in the 2016 Boston Marathon after which total exercise exposure was confined to <2 h/wk (no single session >1 h) for 8 wk. Cardiac structure and function, exercise capacity, and PV were assessed at peak fitness (10–14 days before) and at 4 wk and 8 wk postmarathon. Mixed linear modeling adjusting for age, sex, V̇o2peak, and marathon finish time was used to compare data across time points. Physiological detraining was evidenced by serial reductions in treadmill performance. Two distinct phases of myocardial remodeling and hematological adaptation were observed. After 4 wk of detraining, there were significant reductions in PV (Δ −6.0%, P < 0.01), left ventricular (LV) wall thickness (Δ −8.1%, <0.05), LV mass (Δ −10.3%, P < 0.001), and right atrial area (Δ −8.2%, P < 0.001). After 8 wk of detraining, there was a significant reduction in right ventricle chamber size (end-diastolic area Δ = −8.0%, P < 0.05) without further concomitant reductions in PV or LV wall thickness. Abrupt reductions in exercise training stimulus result in a structure-specific time course of reverse cardiac remodeling that occurs largely independently of PV contraction.

NEW & NOTEWORTHY Significant reverse cardiac remodeling, previously documented among competitive athletes, extends to recreational runners and occurs with a distinct time course. Initial reductions in plasma volume and left ventricular (LV) mass, driven by reductions in wall thickness, are followed by contraction of the right ventricle. Consistent with data from competitive athletes, LV chamber volumes appear less responsive to detraining and may be a more permanent adaptation to sport.

Iron balance and iron supplementation for the female athlete: A practical approach

Maintaining a positive iron balance is essential for female athletes to avoid the effects of iron deficiency and anaemia and to maintain or improve performance. A major function of iron is in the production of the oxygen and carbon dioxide carrying molecule, haemoglobin, via erythropoiesis. Iron balance is under the control of a number of factors including the peptide hormone hepcidin, dietary iron intake and absorption, environmental stressors (e.g. altitude), exercise, menstrual blood loss and genetics. Menstruating females, particularly those with heavy menstrual bleeding are at an elevated risk of iron deficiency. Haemoglobin concentration [Hb] and serum ferritin (sFer) are traditionally used to identify iron deficiency, however, in isolation these may have limited value in athletes due to: (1) the effects of fluctuations in plasma volume in response to training or the environment on [Hb], (2) the influence of inflammation on sFer and (3) the absence of sport, gender and individually specific normative data. A more detailed and longitudinal examination of haematology, menstrual cycle pattern, biochemistry, exercise physiology, environmental factors and training load can offer a superior characterisation of iron status and help to direct appropriate interventions that will avoid iron deficiency or iron overload. Supplementation is often required in iron deficiency; however, nutritional strategies to increase iron intake, rest and descent from altitude can also be effective and will help to prevent future iron deficient episodes. In severe cases or where there is a time-critical need, such as major championships, iron injections may be appropriate.