Preseason Symptom Reporting and Cognition in Middle School Athletes with Past Concussions

This study examined the association between past concussions and current preseason symptom reporting and cognitive performance in 9,257 youth ages 11–13. Participants completed neurocognitive testing prior to participating in a school sports between 2009 and 2019. We stratified the sample by gender and number of prior concussions and assessed group differences on the Post-Concussion Symptom Scale total score and the ImPACT cognitive composite scores. Those with≥2 prior concussions reported more symptoms than those with 0 concussions (d=0.43–0.46). Multiple regressions examining the contribution of concussion history and developmental/health history to symptom reporting showed the most significant predictors of symptoms scores were (in descending order): treatment for a psychiatric condition, treatment for headaches, history of learning disability (in boys only), history of attention-deficit/hyperactivity disorder, and age. Concussion history was the weakest statistically significant predictor in boys and not significant in girls. Cognitively, boys with 1 prior concussion had worse speed those with 0 concussions (d=0.11), and girls with≥2 prior concussions had worse verbal/visual memory than girls with 0 concussions (ds=0.38–0.39). In summary, youth with≥2 prior concussions reported more symptoms than those with no concussions. Boys with multiple concussions performed similarly on cognitive testing, while girls had worse memory scores.

Determination of second lactate threshold using near-infrared spectroscopy in elite cyclists

The use of near-infrared spectroscopy could be an interesting alternative to other invasive or expensive methods to estimate the second lactate threshold. Our objective was to compare the intensities of the muscle oxygen saturation breakpoint obtained with the Humon Hex and the second lactate threshold in elite cyclists. Ninety cyclists performed a maximal graded exercise test. Blood capillary lactate was obtained at the end of steps and muscle oxygenation was continuously monitored. There were no differences (p>0.05) between muscle oxygen oxygenation breakpoint and second lactate threshold neither in power nor in heart rate, nor when these values were relativized as a percentage of maximal aerobic power or maximum heart rate. There were also no differences when men and women were studied separately. Both methods showed a highly correlation in power (r=0.914), percentage of maximal aerobic power (r=0.752), heart rate (r=0.955), and percentage of maximum heart rate (r=0.903). Bland-Altman resulted in a mean difference of 0.05±0.27 W·kg–1, 0.91±4.93%, 0.63±3.25 bpm, and 0.32±1.69% for power, percentage of maximal aerobic power, heart rate and percentage of maximum heart rate respectively. These findings suggest that Humon may be a non-invasive and low-cost alternative to estimate the second lactate threshold intensity in elite cyclists.

Temporal trends in the physical fitness of Hong Kong adolescents between 1998 and 2015

Low physical fitness in adolescence is linked with increased cardiometabolic risk and early all-cause mortality. This study aimed to estimate temporal trends in the physical fitness of Hong Kong adolescents aged 12–17 years between 1998 and 2015. Physical fitness (9-min run/walk, sit-ups, push-ups, and sit-and-reach) and body size data in a total of 28,059 adolescents tested across five population-representative surveys of Hong Kong secondary school pupils, were reported. Temporal trends in means were estimated at the gender-age level by best-fitting sample-weighted linear regression, with national trends estimated by a post-stratified population-weighting procedure. Overall, there were small declines in 9-min run/walk (effect size (ES) = 0.29 (95%CI: 0.32, 0.26)) and sit-ups performance (ES = 0.24 (95%CI: 0.27, 0.21)), with negligible changes in push-ups and sit-and-reach performance. There were small concurrent increases in both mean height and body mass, with a negligible increase in sum of skinfolds. Trends in mean physical fitness and body size/ were not always uniform across the population distribution. The small declines in mean 9-min run/walk and sit-ups performance for Hong Kong adolescents are suggestive of corresponding declines in cardiorespiratory fitness and abdominal/core endurance, respectively. Increased national health promotion strategies are required to improve existing fitness trends.

Individual-based Creatine Kinase Reference Values in Response to Soccer Match-play

The aim of the present study was to determine the creatine kinase reference limits for professional soccer players based on their own normal post-match response. The creatine kinase concentration was analyzed in response to official matches in 25 players throughout a 3-year period. Samples were obtained between 36–43 hours following 70 professional soccer matches and corresponded to 19.1±12.1 [range: 6–49] samples per player. Absolute reference limits were calculated as 2.5th and 97.5th percentile of the samples collected. Creatine kinase values were also represented as a percentage change from the individual’s season mean and represented by 90th, 95th and 97.5th percentiles. The absolute reference limits for creatine kinase concentration calculated as 97.5th and 2.5th percentiles were 1480 U.L−1 and 115.8 U.L−1, respectively. The percentage change from the individual’s season mean was 97.45±35.92% and players were in the 90th, 95th and 97.5th percentiles when the percentages of these differences were 50.01, 66.7, and 71.34% higher than player’s season mean response, respectively. The data allowed us to determine whether the creatine kinase response is typical or if it is indicative of a higher than normal creatine kinase elevation and could be used as a practical guide for detection of muscle overload, following professional soccer match-play.

The Effects of Match Congestion on Physical Performance in Football Referees

We examined the changes in performance during congested (two matches within a 7-day interval) and non-congested (one match within≥7-day interval) fixtures in 17 elite football (soccer) referees during 181 official matches. External demands comprised 20 GPS-based metrics. Internal load was assessed by heart rate and rating of perceived exertion. Compared to non-congested fixtures, referees decreased their running distance at 21–24 km·h−1 (p=0.027, effect size [ES]=0.41) and > 24 km·h−1 (p=0.037, ES=0.28), the number of sprints (p=0.012, ES=0.29), and distance sprinting (p=0.022, ES=0.29) in congested matches. Most play metrics were lower in congested versus non-congested fixtures with low-to-moderate ES. During the 2nd half of non-congested fixtures, referees covered larger distances at low-speed running (p=0.025, ES=0.47). Match congestion due to officiating two matches less than a week apart caused a notable decrease in match running activity in professional football referees, especially at above 21 km·h−1. These data reiterate the need for specific conditioning and post-match recovery strategies in high-level referees to ensure optimal judgment performance favouring the quality of the competition. Governing bodies should take these outcomes into account when designating referees for a match.

Type and Intensity as Key Variable of Exercise in Metainflammation diseases: A Review

Monocyte and lymphocyte subpopulations exhibit functions that vary between the anti- and pro-inflammatory spectrum, such as classic CD16- and non-classical CD16+ monocytes, as well as T helper 2 lymphocytes (Th2), the Th1/Th17 lymphocytes ratio, and T regulatory lymphocytes (Treg). Metabolic disease-associated inflammation is accompanied by an imbalance in monocyte and lymphocyte phenotypes and functionality, as well as a stronger proportion of inflammatory subpopulations. These changes appear to be important for the development and progression of diseases like diabetes and cardiovascular disease. On the other hand, the regular practice of physical exercise is an important tool to restore the functionality of monocytes and lymphocytes, and to balance the subtypes ratio. However, key variables regarding exercise prescription, such as the type of exercise, intensity, and volume differentially impact on the acute and chronic immune response in individuals diagnosed with meta inflammation diseases. Here, we discuss the impact of different physical exercise protocols, acutely and chronically, on monocytes and lymphocytes of individuals with metabolic disease-associated inflammation. In this review, we focus on the best effects of different exercise protocols to dose the “exercise pill” in different inflammatory status.

Plyometric Training in Normobaric Hypoxia improves Jump Performance

Strength training in hypoxia has been shown to enhance hypertrophy and function of skeletal muscle, however, the effects of plyometric training in hypoxia is relatively unknown. Therefore, this study aimed to examine the effects of plyometric training in hypoxia compared to normoxia on body composition, sprint and jump parameters. Twenty-three male physical education students (20.4±2.0 years, mean±SD) participated in the study and were divided into a plyometric training in hypoxia (PTH, n=8), plyometric training in normoxia (PTN, n=7) or control group (C, n=8). The PTH group trained in normobaric hypoxia (approximately 3536 m) 3 days/week for 8 weeks, while the PTN trained in normoxia. PTH induced significant improvements from baseline to post-testing in countermovement-jump (37.8±6.7 cm, 43.4±5.0 cm, p<0.05), squat-jump (35.4±6.2 cm, 41.1±5.7 cm, p<0.05), drop-jump height (32.8±6 cm, 38.1±6 cm, p<0.05) and 20-m sprint performance (3257.1±109.5 ms, 3145.8±83.6 ms, p<0.05); whereas PTN produced significant improvement only in countermovement-jump (37.3±4.8 cm, 40.5±4.5 cm, p<0.05) and 20-m sprint performance (3209.3±76.1 ms, 3126.6±100.4 ms, p<0.05). Plyometric training under hypoxic conditions induces greater improvement in some jump measures (drop-jump and squat-jump) compared to similar training in normoxia.

A Personal Biography of a Physiological Misnomer: The Anaerobic Threshold

In 1973 Wasserman, Whipp, Koyal, and Beaver published a groundbreaking study titled “Anaerobic threshold and respiratory gas analysis during exercise”. At that time, respiratory gas analysis and laboratory computers had evolved such that more advanced respiratory exercise physiology studies were possible. The initial publications from this group on the onset of anaerobic metabolism in cardiac patients, the first breath-by-breath VO2 system, the first description of the anaerobic threshold, and then later new methods to detect the anaerobic threshold have been and continue to be highly cited. In fact, their 1973 anaerobic threshold paper is the sixth and their 1986 paper is the second most cited paper ever published in the Journal of Applied Physiology. The anaerobic threshold concept has also generated>5500 publications with the rates increasing over time. The publication of two papers that help to refute the “anaerobic” explanation for this phenomenon had no effect on the rates of citations of the original anaerobic threshold papers or the number of anaerobic threshold papers published since. Thus, despite now substantial evidence refuting the proposed anaerobic mechanisms underlying this phenomenon, these papers continue to be highly influential in the discipline of exercise physiology and, perhaps even more explicitly, clinical exercise physiology.

Changes in pulmonary function after long-duration adventure racing in adolescent athletes

The present study investigated the acute effects of a mixed-modality, long-duration adventure race on pulmonary function in adolescent athletes. Twenty male adolescents aged 14 to 17 years volunteered to participate in a wilderness adventure race of 68.5-km. Expiratory function was evaluated before, immediately after, and 24 h after race completion. Measurements included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF). Maximal inspiratory and expiratory mouth static pressures (MIP and MEP, respectively) were also measured using a portable hand-held mouth pressure meter across the same time points. The mean completion time of the race was 05:38 ± 00:20 hours. A significant post-race decrease in FVC was observed immediately after the race (-5.2%, p = 0.01). However, no significant changes were observed for FEV1, PEF and the FEV1/FVC and FEV1/PEF ratios. In addition, estimates of respiratory muscle strength (MIP and MEP) were unaffected by the race. The long-duration adventure race induced no marked reduction in expiratory pulmonary function and this response was associated with no apparent respiratory muscle fatigue. Therefore, the pulmonary system of trained adolescent athletes was sufficiently robust to sustain the mixed-modality, long-duration adventure race of ∽5-6 h.

Regulation of the Effect of Physical Activity Through MicroRNAs in Breast Cancer

Physical activity and exercise can induce beneficial molecular and biological regulations that have been associated with an incidence of various diseases, including breast cancer. Recent studies demonstrated that the potential links between physical activity-induced circulating microRNAs (miRNAs) and cancer risk and progression. Here, we investigated whether altered miRNAs by exercise could influence breast cancer progression. After primary searching in PubMed and reviewing the full-text papers, candidate miRNAs altered by exercise in breast cancer were identified. Analysis of expression profiles and clinical outcomes of altered miRNAs using The Cancer Genome Atlas datasets showed altered miRNAs expressions were significantly associated with the patient's prognosis, whereas prognostic values of each miRNA varied in different stages and subtypes. In addition, altered miRNAs profiles regulated various target genes and key signaling pathways in tumorigenesis, including pathways in cancer and the PI3K-Akt signaling pathway; however, miRNAs regulated the expression of target genes differently according to tumor stages and subtypes. These results indicate that circulating miRNAs are promising noninvasive stable biomarkers for early detection, diagnosis, prognosis, and monitoring the response to clinical therapies of breast cancer. Moreover, stages and subtype-stratified approaches for breast cancer progression would be needed to evaluate the prognostic value of miRNAs for biomarkers and therapeutic targets.