Neuromuscular electrical stimulation during maximal voluntary contraction: a Delphi survey with expert consensus.

PURPOSE: The use of electrical stimulation to assess voluntary activation of muscle/s is a popular method employed in numerous exercise science and health research settings. This Delphi study aimed to collate expert opinion and provide recommendations for best practice when using electrical stimulation during maximal voluntary contractions. METHODS: A two-round Delphi study was undertaken with 30 experts who completed a 62-item questionnaire (Round 1) comprising of open- and closed-ended questions. Consensus was assumed if ≥ 70% of experts selected the same response; such questions were removed from the subsequent Round 2 questionnaire. Responses were also removed if they failed to meet a 15% threshold. Open-ended questions were analysed and converted into closed-ended questions for Round 2. It was assumed there was no clear consensus if a question failed to achieve a ≥ 70% response in Round 2. RESULTS: A total of 16 out of 62 (25.8%) items reached consensus. Experts agreed that electrical stimulation provides a valid assessment of voluntary activation in specific circumstances, such as during maximal contraction, and this stimulation can be applied at either the muscle or the nerve. Experts recommended using doublet stimuli, self-adhesive electrodes, a familiarisation session, real-time visual or verbal feedback during the contraction, a minimum current increase of + 20% to ensure supramaximal stimulation, and manually triggering stimuli. CONCLUSION: The results of this Delphi consensus study can help researchers make informed decisions when considering technical parameters when designing studies involving electrical stimulation for the assessment of voluntary activation.

The role of exercise and hypoxia on glucose transport and regulation.

Muscle glucose transport activity increases with an acute bout of exercise, a process that is accomplished by the translocation of glucose transporters to the plasma membrane. This process remains intact in the skeletal muscle of individuals with insulin resistance and type 2 diabetes mellitus (T2DM). Exercise training is, therefore, an important cornerstone in the management of individuals with T2DM. However, the acute systemic glucose responses to carbohydrate ingestion are often augmented during the early recovery period from exercise, despite increased glucose uptake into skeletal muscle. Accordingly, the first aim of this review is to summarize the knowledge associated with insulin action and glucose uptake in skeletal muscle and apply these to explain the disparate responses between systemic and localized glucose responses post-exercise. Herein, the importance of muscle glycogen depletion and the key glucoregulatory hormones will be discussed. Glucose uptake can also be stimulated independently by hypoxia; therefore, hypoxic training presents as an emerging method for enhancing the effects of exercise on glucose regulation. Thus, the second aim of this review is to discuss the potential for systemic hypoxia to enhance the effects of exercise on glucose regulation.

Increased footwear comfort is associated with improved running economy - a systematic review and meta-analysis.

Footwear with or without custom foot orthotics have the potential to improve comfort, but the link with running performance needs further investigation. We systematically reviewed the association of footwear comfort on running economy in recreational runners. Nine electronic databases were searched from inception to March 2020. Eligible studies investigated both direct outcome measures of running performance (e.g. running speed) and/or physiological measures (e.g. running economy (RE)) alongside comfort for each footwear condition tested. Methodological quality was assessed using the "Effective Public Health Practice Project" (EPHPP). RE during submaximal running was the most common physiological outcome reported in 4 of the 6 eligible studies. The absolute difference in RE between the most and least comfortable footwear condition was computed, and meta-analysis was conducted using a random effect model. The most comfortable footwear is associated with a reduction in oxygen consumption (MD: -2.06 mL.kg-1.min-1, 95%CI: -3.71, -0.42, P = 0.01) while running at a set submaximal speed. There was no significant heterogeneity (I2 = 0%, P = 0.82). EPHPP quality assessment demonstrated weak quality of the studies, due to reporting bias and failing to disclose the psychometric properties of the outcome measures. It can be concluded with moderate certainty that improved RE in recreational athletes is associated with wearing more comfortable footwear compared to less comfortable footwear.HighlightsThis systematic review reports on the association of footwear comfort with running economy in recreational runners.Running economy during constant submaximal running is likely improved in recreational runners wearing more comfortable compared to less comfortable footwear.This finding is based on a meta-analysis, including four studies, showing a small but statistically significant decreased oxygen consumption at steady state speeds while wearing the most comfortable footwear.

How does multi-set high-load resistance exercise impact neuromuscular function in normoxia and hypoxia?

This study examined whether hypoxia during multi-set, high-load resistance exercise alters neuromuscular responses. Using a single-blinded (participants), randomised crossover design, eight resistance-trained males completed five sets of five repetitions of bench press at 80% of one repetition maximum in moderate normobaric hypoxia (inspiratory oxygen fraction = 0.145) and normoxia. Maximal isometric bench press trials were performed following the warm-up, after 10 min of altitude priming and 5 min post-session (outside, inside and outside the chamber, respectively). Force during pre-/post-session maximal voluntary isometric contractions and bar velocity during exercise sets were measured along with surface electromyographic (EMG) activity of the pectoralis major, anterior deltoid and lateral and medial triceps muscles. Two-way repeated measures ANOVA (condition×time) were used. A significant time effect (p = 0.048) was found for mean bar velocity, independent of condition (p = 0.423). During sets of the bench press exercise, surface EMG amplitude of all studied muscles remained unchanged (p > 0.187). During maximal isometric trials, there were no main effects of condition (p > 0.666) or time (p > 0.119), nor were there any significant condition×time interactions for peak or mean forces and surface EMG amplitudes (p > 0.297). Lower end-exercise blood oxygen saturation (90.9 ± 1.8 vs. 98.6 ± 0.6%; p < 0.001) and higher blood lactate concentration (5.8 ± 1.4 vs. 4.4 ± 1.6 mmol/L; p = 0.007) values occurred in hypoxia. Acute delivery of systemic normobaric hypoxia during multi-set, high-load resistance exercise increased metabolic stress. However, only subtle neuromuscular function adjustments occurred with and without hypoxic exposure either during maximal isometric bench press trials before versus after the session or during actual exercise sets.HighlightsPerforming multi-set, high-load bench press resistance exercise in hypoxia accentuates metabolic stress, as evidenced by lower arterial oxygen saturation and higher blood lactate concentration, compared to normoxia.Acute hypoxic exposure doesn't alter neuromuscular responses during the execution of the sets since mean bar velocity dropped similarly in both conditions from set 2 to set 5 with no difference in peak velocity and surface EMG amplitude of the prime movers during the bench press.Only subtle adjustments in peak or mean force and accompanying surface EMG activity occur with and without hypoxic exposure during maximal isometric bench press trials after a 10-min hypoxic priming period and 5 min after the session in reference to post-warm-up.

Effects of graded hypoxia during exhaustive intermittent cycling on subsequent exercise performance and neuromuscular responses.

PURPOSE: This study examined the effect of graded hypoxia during exhaustive intermittent cycling on subsequent exercise performance and neuromuscular fatigue characteristics in normoxia. METHODS: Fifteen well-trained cyclists performed an exhaustive intermittent cycling exercise (EICE 1; 15 s at 30% of anaerobic power reserve interspersed with 45 s of passive recovery) at sea level (SL; FiO2 ~ 0.21), moderate (MH; FiO2 ~ 0.16) and severe hypoxia (SH; FiO2 ~ 0.12). This was followed, after 30 min of passive recovery in normoxia, by an identical exercise bout in normoxia (EICE 2). Neuromuscular function of the knee extensors was assessed at baseline, after EICE 1 (post-EICE 1), and EICE 2 (post-EICE 2). RESULTS: The number of efforts completed decreased with increasing hypoxic severity during EICE 1 (SL: 39 ± 30, MH: 22 ± 13, SH: 13 ± 6; p ≤ 0.02), whereas there was no difference between conditions during EICE 2 (SL: 16 ± 9, MH: 20 ± 14, SH: 24 ± 17; p ≥ 0.09). Maximal torque (p = 0.007), peripheral (p = 0.02) and cortical voluntary activation (p < 0.001), and twitch torque (p < 0.001) decreased from baseline to post-EICE 1. Overall, there were no significant difference in any neuromuscular parameters from post-EICE 1 to post-EICE 2 (p ≥ 0.08). CONCLUSION: Increasing hypoxia severity during exhaustive intermittent cycling hampered exercise capacity, but did not influence performance and associated neuromuscular responses during a subsequent bout of exercise in normoxia performed after 30 min of rest.

Sensitivity of the Inhomogeneous Magnetization Transfer Imaging Technique to Spinal Cord Damage in Multiple Sclerosis.

BACKGROUND AND PURPOSE: The inhomogeneous magnetization transfer technique has demonstrated high specificity for myelin, and has shown sensitivity to multiple sclerosis-related impairment in brain tissue. Our aim was to investigate its sensitivity to spinal cord impairment in MS relative to more established MR imaging techniques (volumetry, magnetization transfer, DTI). MATERIALS AND METHODS: Anatomic images covering the cervical spinal cord from the C1 to C6 levels and DTI, magnetization transfer/inhomogeneous magnetization transfer images at the C2/C5 levels were acquired in 19 patients with MS and 19 paired healthy controls. Anatomic images were segmented in spinal cord GM and WM, both manually and using the AMU40 atlases. MS lesions were manually delineated. MR metrics were analyzed within normal-appearing and lesion regions in anterolateral and posterolateral WM and compared using Wilcoxon rank tests and z scores. Correlations between MR metrics and clinical scores in patients with MS were evaluated using the Spearman rank correlation. RESULTS: AMU40-based C1-to-C6 GM/WM automatic segmentations in patients with MS were evaluated relative to manual delineation. Mean Dice coefficients were 0.75/0.89, respectively. All MR metrics (WM/GM cross-sectional areas, normal-appearing and lesion diffusivities, and magnetization transfer/inhomogeneous magnetization transfer ratios) were observed altered in patients compared with controls (P < .05). Additionally, the absolute inhomogeneous magnetization transfer ratio z scores were significantly higher than those of the other MR metrics (P < .0001), suggesting a higher inhomogeneous magnetization transfer sensitivity toward spinal cord impairment in MS. Significant correlations with the Expanded Disability Status Scale (ρ = -0.73/P = .02, ρ = -0.81/P = .004) and the total Medical Research Council scale (ρ = 0.80/P = .009, ρ = -0.74/P = .02) were observed for inhomogeneous magnetization transfer and magnetization transfer ratio z scores, respectively, in normal-appearing WM regions, while weaker and nonsignificant correlations were obtained for DTI metrics. CONCLUSIONS: With inhomogeneous magnetization transfer being highly sensitive to spinal cord damage in MS compared with conventional magnetization transfer and DTI, it could generate great clinical interest for longitudinal follow-up and potential remyelinating clinical trials. In line with other advanced myelin techniques with which it could be compared, it opens perspectives for multicentric investigations.

Psycho-physiological responses to perceptually-regulated interval runs in hypoxia and normoxia.

We investigated whether perceptually-regulated high-intensity intervals in hypoxia are associated with slower running velocities versus normoxia, when physiological responses and exercise-related sensations remain the same. Nineteen trained runners (33.4 ±â€¯9.1 years) completed a high-intensity interval running protocol (4 × 4-min intervals at a clamped perceived rating exertion of 16 on the 6-20 Borg scale, 3-min passive recoveries) in either hypoxic (HYP; FiO2 15.0%) or normoxic (NOR; FiO2 20.9%) conditions. Participants adjusted to a progressively slower running velocity from interval 1-4 (-7.0%), and more so in HYP vs. NOR for intervals 2, 3 and 4 (-4.6%, -6.4% and - 7.9%, respectively; p < .01). Heart rate increased from interval 1-4 (+4.8%; p < .01), independent of condition. Arterial oxygen saturation was lower in HYP vs. NOR (86.0% vs. 94.8%; p < .01). Oxyhemoglobin (-23.7%) and total hemoglobin (-77.0%) decreased, whilst deoxyhemoglobin increased (+44.9%) from interval 1-4 (p < .01), independent of condition. Perceived recovery (-41.6%) and motivation (-21.8%) were progressively lower from interval 1-4, and more so in HYP vs. NOR for intervals 2, 3 and 4 (recovery: -8.8%, -24.2% and - 29.3%; motivation: -5.3%, -20.3% and - 22.4%, respectively; p < .01). Perceived breathlessness (+18.6%), limb discomfort (+44.0%) and pleasure (-32.2%) changed from interval 1-4, with significant differences (+21.8%, +11.3% and - 31.3%, respectively) between HYP and NOR (p < .01). Slower interval running velocities in hypoxia achieve similar heart rate and muscle oxygenation responses to those observed in normoxia when perceptually-regulated, yet at the expense of less favourable exercise-related sensations.

Validating the sensitivity of inhomogeneous magnetization transfer (ihMT) MRI to myelin with fluorescence microscopy.

Inhomogeneous Magnetization Transfer (ihMT) is a development from the MT MRI technique. IhMT can be considered as a dipolar order relaxation time (T1D) weighted imaging modality whose signal has shown an enhanced selectivity for myelin-rich structures. However, a formal validation of the ihMT sensitivity relative to a gold standard myelin density measurement has not yet been reported. To address this need, we compared ihMT MRI with green fluorescence protein (GFP) microscopy, in a study performed on genetically-modified plp-GFP mice, considered as a reference technique for myelin-content assessment. Various ihMT protocols consisting of variable T1D-filtering and radiofrequency power temporal distributions, were used for comparison with fluorescence microscopy. Strong and significant linear relationships (r2 (0.87-0.96), p < 0.0001) were found between GFP and ihMT ratio signals across brain regions for all tested protocol variants. Conventional MT ratios showed weaker correlations (r2 (0.24-0.78), p ≤ 0.02) and a much larger signal fraction unrelated to myelin, hence corresponding to a much lower specificity for myelin. T1D-filtering reduced the ihMT signal fraction not attributed to myelin by almost twofold relative to zero filtering suggesting that at least half of the unrelated signal has a substantially shorter T1D than myelin. Overall, these results strongly support the sensitivity of ihMT to myelin content.

Low duty-cycle pulsed irradiation reduces magnetization transfer and increases the inhomogeneous magnetization transfer effect.

Intense off-resonant RF irradiation can lead to saturation of the macromolecular pool magnetization and enhance bound pool dipolar order responsible for the inhomogeneous magnetization transfer (ihMT) effect, but the intensity of RF power in human imaging studies is limited by safety constraints on RF heating. High RF intensities can still be achieved if applied in short pulses with low duty-cycle. Here we investigate the benefits of low duty-cycle irradiation for MT and ihMT studies with both theoretical and experimental methods. Solutions for pulsed irradiation of a two-pool model including dipolar order effects were implemented. Experiments were conducted at 3 T in the brain and through the calf of healthy human subjects. 2D echo planar images were acquired following a preparation of RF irradiation with a 2 s train of 5 ms pulses repeated from between 10 to 100 ms for duty-cycles (DCs) of 50% to 5%, and at varying offset frequencies, and time averaged RF powers. MT and ihMT data were measured in regions of interest within gray matter, white matter and muscle, and fit to the model. RF irradiation effects on signal intensity were reduced at 5% relative to 50% DCs. This reduced RF effect was much larger for single than dual frequency irradiation. 5% DC irradiation reduced single and dual frequency MT ratios but increased ihMT ratios up to 3 fold in brain tissues. Muscle ihMT increased by an even larger factor, depending on the frequency and applied power. The model predicted these changes with duty-cycle. The model fit the data well and constrained model parameters. Low duty-cycle pulsed irradiation reduces MT effects and markedly increases dipolar order effects. This approach is an attractive method to enhance ihMT signal-to-noise ratio and demonstrates a measurable ihMT effect in muscle tissue at 3 T under acceptable specific absorption rates. The effects of duty-cycle changes demonstrated in a separate MT/ihMT preparation provide a route for new applications in magnetization-prepared MRI sequences.

Preventing musculoskeletal complaints in music students: a randomized controlled trial.

BACKGROUND: Musculoskeletal complaints in music students are common. Little is known about effectiveness of interventions. AIMS: To assess whether a biopsychosocial prevention course is better at reducing disability due to musculoskeletal disorders compared with physical activity promotion. METHODS: This was a multicentre randomized controlled trial with intention-to-treat analysis. Participants were first- and second-year students from five conservatories, randomized to experimental or control groups. The experimental group participated in 11 classes on body posture playing the instrument according to postural exercise therapy, and performance-related psychosocial aspects. The control group participated in five classes promoting physical activity according to national guidelines. The primary outcome was disability using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, including the performing arts module. Secondary outcomes were pain, quality of life, playing-related musculoskeletal disorders and health behaviour. Outcomes were assessed at six points, from baseline until 2-year follow-up. RESULTS: One hundred and seventy participants were randomized to experimental (n = 84) or control (n = 86) groups. Loss to follow-up was 40% during the trial and 69% at 2-year follow-up. The dropout rate was equal in both groups. Overall, there were no significant differences between groups for any outcome adjusted for baseline characteristics: percentage disability, odds ratio was 1.31, 95% confidence interval (CI) 0.69-2.51; general DASH, ß = -0.57, 95% CI -3.23 to 2.09; and performing arts module, ß = -0.40, 95% CI 5.12-4.32. CONCLUSIONS: A biopsychosocial prevention course tailored for musicians was not superior to physical activity promotion in reducing disability. Large numbers lost to follow-up warrant cautious interpretation.

Evaluation of the Sensitivity of Inhomogeneous Magnetization Transfer (ihMT) MRI for Multiple Sclerosis.

BACKGROUND AND PURPOSE: Inhomogeneous magnetization transfer is a new endogenous MR imaging contrast mechanism that has demonstrated high specificity for myelin. Here, we tested the hypothesis that inhomogeneous magnetization transfer is sensitive to pathology in a population of patients with relapsing-remitting MS in a way that both differs from and complements conventional magnetization transfer. MATERIALS AND METHODS: Twenty-five patients with relapsing-remitting MS and 20 healthy volunteers were enrolled in a prospective MR imaging research study, whose protocol included anatomic imaging, standard magnetization transfer, and inhomogeneous magnetization transfer imaging. Magnetization transfer and inhomogeneous magnetization transfer ratios measured in normal-appearing brain tissue and in MS lesions of patients were compared with values measured in control subjects. The potential association of inhomogeneous magnetization transfer ratio variations with the clinical scores (Expanded Disability Status Scale) of patients was further evaluated. RESULTS: The magnetization transfer ratio and inhomogeneous magnetization transfer ratio measured in the thalami and frontal, occipital, and temporal WM of patients with MS were lower compared with those of controls (P < .05). The mean inhomogeneous magnetization transfer ratio measured in lesions was lower than that in normal-appearing WM (P < .05). Significant (P < .05) negative correlations were found between the clinical scores and inhomogeneous magnetization transfer ratio measured in normal-appearing WM structures. Weaker nonsignificant correlation trends were found for the magnetization transfer ratio. CONCLUSIONS: The sensitivity of the inhomogeneous magnetization transfer technique for MS was highlighted by the reduction in the inhomogeneous magnetization transfer ratio in MS lesions and in normal-appearing WM of patients compared with controls. Stronger correlations with the Expanded Disability Status Scale score were obtained with the inhomogeneous magnetization transfer ratio compared with the standard magnetization transfer ratio, which may be explained by the higher specificity of inhomogeneous magnetization transfer for myelin.

Adaptations in muscle oxidative capacity, fiber size, and oxygen supply capacity after repeated-sprint training in hypoxia combined with chronic hypoxic exposure.

In this study, we investigate adaptations in muscle oxidative capacity, fiber size and oxygen supply capacity in team-sport athletes after six repeated-sprint sessions in normobaric hypoxia or normoxia combined with 14 days of chronic normobaric hypoxic exposure. Lowland elite field hockey players resided at simulated altitude (≥14 h/day at 2,800-3,000 m) and performed regular training plus six repeated-sprint sessions in normobaric hypoxia (3,000 m; LHTLH; n = 6) or normoxia (0 m; LHTL; n = 6) or lived at sea level with regular training only (LLTL; n = 6). Muscle biopsies were obtained from the m. vastus lateralis before (pre), immediately after (post-1), and 3 wk after the intervention (post-2). Changes over time between groups were compared, including likelihood of the effect size (ES). Succinate dehydrogenase activity in LHTLH largely increased from pre to post-1 (~35%), likely more than LHTL and LLTL (ESs = large-very large), and remained elevated in LHTLH at post-2 (~12%) vs. LHTL (ESs = moderate-large). Fiber cross-sectional area remained fairly similar in LHTLH from pre to post-1 and post-2 but was increased at post-1 and post-2 in LHTL and LLTL (ES = moderate-large). A unique observation was that LHTLH and LHTL, but not LLTL, improved their combination of fiber size and oxidative capacity. Small-to-moderate differences in oxygen supply capacity (i.e., myoglobin and capillarization) were observed between groups. In conclusion, elite team-sport athletes substantially increased their skeletal muscle oxidative capacity, while maintaining fiber size, after only 14 days of chronic hypoxic residence combined with six repeated-sprint training sessions in hypoxia. NEW & NOTEWORTHY Our novel findings show that elite team-sport athletes were able to substantially increase the skeletal muscle oxidative capacity in type I and II fibers (+37 and +32%, respectively), while maintaining fiber size after only 14 days of chronic hypoxic residence combined with six repeated-sprint sessions in hypoxia. This increase in oxidative capacity was superior to groups performing chronic hypoxic residence with repeated sprints in normoxia and residence at sea level with regular training only.

Repeated maximal-intensity hypoxic exercise superimposed to hypoxic residence boosts skeletal muscle transcriptional responses in elite team-sport athletes.

AIM: To determine whether repeated maximal-intensity hypoxic exercise induces larger beneficial adaptations on the hypoxia-inducible factor-1α pathway and its target genes than similar normoxic exercise, when combined with chronic hypoxic exposure. METHODS: Lowland elite male team-sport athletes underwent 14 days of passive normobaric hypoxic exposure [≥14 h·day-1 at inspired oxygen fraction (Fi O2 ) 14.5-14.2%] with the addition of six maximal-intensity exercise sessions either in normobaric hypoxia (Fi O2 ~14.2%; LHTLH; n = 9) or in normoxia (Fi O2 20.9%; LHTL; n = 11). A group living in normoxia with no additional maximal-intensity exercise (LLTL; n = 10) served as control. Before (Pre), immediately after (Post-1) and 3 weeks after (Post-2) the intervention, muscle biopsies were obtained from the vastus lateralis. RESULTS: Hypoxia-inducible factor-1α subunit, vascular endothelial growth factor, myoglobin, peroxisome proliferator-activated receptor-gamma coactivator 1-α and mitochondrial transcription factor A mRNA levels increased at Post-1 (all P ≤ 0.05) in LHTLH, but not in LHTL or LLTL, and returned near baseline levels at Post-2. The protein expression of citrate synthase increased in LHTLH (P < 0.001 and P < 0.01 at Post-1 and Post-2, respectively) and LLTL (P < 0.01 and P < 0.05 at Post-1 and Post-2, respectively), whereas it decreased in LHTL at Post-1 and Post-2 (both P < 0.001). CONCLUSION: Combined with residence in normobaric hypoxia, repeated maximal-intensity hypoxic exercise induces short-term post-intervention beneficial changes in muscle transcriptional factors that are of larger magnitude (or not observed) than with similar normoxic exercise. The decay of molecular adaptations was relatively fast, with most of benefits already absent 3 weeks post-intervention.

Acute and Residual Soccer Match-Related Fatigue: A Systematic Review and Meta-analysis.

BACKGROUND: Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses. OBJECTIVES: (1) To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs. 11) and match simulations. METHODS: A first screening phase consisted of a systematic search on PubMed (MEDLINE) and SportDiscus databases until March 2016. Inclusion criteria were: longitudinal study with soccer players; match or validated protocol; duration > 45 min; and published in English. RESULTS: A total of 77 eligible studies (n = 1105) were used to compute 1196 effect sizes (ES). Half-time assessments revealed small to large alterations in immunological parameters (e.g. leukocytes, ES = 1.9), a moderate decrement in insulin concentration (ES = - 0.9) and a small to moderate impairment in lower-limb muscle function (ES = - 0.5 to - 0.7) and physical performance measures (e.g. linear sprint, ES = - 0.3 to - 1.0). All the systematically analyzed fatigue-related markers were substantially altered at post-match. Hamstrings force production capacity (ES = - 0.7), physical performance (2-4%, ES = 0.3-0.5), creatine kinase (CK, ES = 0.4), well-being (ES = 0.2-0.4) and delayed onset muscle soreness (DOMS, ES = 0.6-1.3) remained substantially impaired at G + 72 h. Compared to simulation protocols, 11 vs. 11 match format (CK, ES = 1.8) induced a greater magnitude of change in muscle damage (i.e. CK, ES = 1.8 vs. 0.7), inflammatory (IL-6, ES = 2.6 vs. 1.1) and immunological markers and DOMS (ES = 1.5 vs. 0.7) than simulation protocols at post-assessments. Neuromuscular performances at post-match did not differ between protocols. CONCLUSION: While some parameters are fully recovered (e.g. hormonal and technical), our systematic review shows that a period of 72 h post-match play is not long enough to completely restore homeostatic balance (e.g. muscle damage, physical and well-being status). The extent of the recovery period post-soccer game cannot consist of a 'one size fits all approach'. Additionally, the 'real match' (11 vs. 11 format) likely induces greater magnitudes of perceptual (DOMS) and biochemical alterations (e.g. muscle damage), while neuromuscular alterations were essentially similar. Overall, coaches must adjust the structure and content of the training sessions during the 72-h post-match intervention to effectively manage the training load within this time-frame.

Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations: a systematic review.

Normobaric hypoxic conditioning (HC) is defined as exposure to systemic and/or local hypoxia at rest (passive) or combined with exercise training (active). HC has been previously used by healthy and athletic populations to enhance their physical capacity and improve performance in the lead up to competition. Recently, HC has also been applied acutely (single exposure) and chronically (repeated exposure over several weeks) to overweight and obese populations with the intention of managing and potentially increasing cardio-metabolic health and weight loss. At present, it is unclear what the cardio-metabolic health and weight loss responses of obese populations are in response to passive and active HC. Exploration of potential benefits of exposure to both passive and active HC may provide pivotal findings for improving health and well being in these individuals. A systematic literature search for articles published between 2000 and 2017 was carried out. Studies investigating the effects of normobaric HC as a novel therapeutic approach to elicit improvements in the cardio-metabolic health and weight loss of obese populations were included. Studies investigated passive (n = 7; 5 animals, 2 humans), active (n = 4; all humans) and a combination of passive and active (n = 4; 3 animals, 1 human) HC to an inspired oxygen fraction ([Formula: see text]) between 4.8 and 15.0%, ranging between a single session and daily sessions per week, lasting from 5 days up to 8 mo. Passive HC led to reduced insulin concentrations (-37 to -22%) in obese animals and increased energy expenditure (+12 to +16%) in obese humans, whereas active HC lead to reductions in body weight (-4 to -2%) in obese animals and humans, and blood pressure (-8 to -3%) in obese humans compared with a matched workload in normoxic conditions. Inconclusive findings, however, exist in determining the impact of acute and chronic HC on markers such as triglycerides, cholesterol levels, and fitness capacity. Importantly, most of the studies that included animal models involved exposure to severe levels of hypoxia ([Formula: see text] = 5.0%; simulated altitude >10,000 m) that are not suitable for human populations. Overall, normobaric HC demonstrated observable positive findings in relation to insulin and energy expenditure (passive), and body weight and blood pressure (active), which may improve the cardio-metabolic health and body weight management of obese populations. However, further evidence on responses of circulating biomarkers to both passive and active HC in humans is warranted.

Optimization of inhomogeneous magnetization transfer (ihMT) MRI contrast for preclinical studies using dipolar relaxation time (T1D ) filtering.

A pulsed inhomogeneous magnetization transfer (ihMT)-prepared fast imaging sequence was implemented at 11.75 T for preclinical studies on mouse central nervous system. A strategy based on filtering the ihMT signal originating from short dipolar relaxation time (T1D ) components is proposed. It involves increasing the repetition time of consecutive radiofrequency (RF) pulses of the dual saturation and allows improved signal specificity for long T1D myelinated structures. Furthermore, frequency offset, power and timing saturation parameters were adjusted to optimize the ihMT sensitivity. The optimization of the ihMT sensitivity, whilst preserving the strong specificity for the long T1D component of myelinated tissues, allowed measurements of ihMT ratios on the order of 4-5% in white matter (WM), 2.5% in gray matter (GM) and 1-1.3% in muscle. This led to high relative ihMT contrasts between myelinated tissues and others (~3-4 between WM and muscle, and ≥2 between GM and muscle). Conversely, higher ihMT ratios (~6-7% in WM) could be obtained using minimal T1D filtering achieved with short saturation pulse repetition time or cosine-modulated pulses for the dual-frequency saturation. This study represents a first stage in the process of validating ihMT as a myelin biomarker by providing optimized ihMT preclinical sequences, directly transposable and applicable to other preclinical magnetic fields and scanners. Finally, ihMT ratios measured in various central nervous system areas are provided for future reference.

Changes in running mechanics over 100-m, 200-m and 400-m treadmill sprints.

PURPOSE: Compare alterations in running mechanics during maximal treadmill sprints of different distances. METHODS: Eleven physically active males performed short (100-m), medium (200-m) and long (400-m) running sprints on an instrumented treadmill. Continuous measurement of running kinetics/kinematics and spring-mass characteristics were recorded and values subsequently averaged over every 50-m distance intervals for comparison. RESULTS: Compared with the initial 50m, running velocity decreased (P<0.001) by 8±2%, 20±4% and 39±7% at the end of the 100, 200 and 400-m, respectively. All sprint distances (except for step length in the 100-m) induced significantly longer (P<0.05) contact times (+7±4%, +22±8% and +36±13%) and lower step lengths (-1±4%, -5±5% and -41±2%) and frequencies (-6±3%, -13±7% and -22±8%) at the end of the 100-m, 200-m and 400-m, respectively. Larger reductions in ground reaction forces occurred in horizontal versus vertical direction, with greater changes with increasing sprinting distance (P<0.05). Similarly, the magnitude of decrement in vertical stiffness increased with sprint distance (P<0.05), while leg stiffness decreases were smaller and limited to 200-m and 400-m runs. Overall, we observed earlier and larger alterations for the 400-m compared with other distances. CONCLUSIONS: The magnitude of changes in running velocity and mechanics over short (100-m), medium (200-m) and long (400-m) treadmill sprints increases with sprint distance. The alterations in stride mechanics occur relatively earlier during the 400-m compared with the 100-m and 200-m runs.

Interpretation of magnetization transfer from inhomogeneously broadened lines (ihMT) in tissues as a dipolar order effect within motion restricted molecules.

Comparison of off-resonance saturation with single and dual frequency irradiation indicates a contribution of inhomogeneously broadened lines to magnetization transfer in tissues. This inhomogeneous magnetization transfer (ihMT) phenomenon can be exploited to produce images that highlight tissues containing myelin, in vivo. Here, a model for ihMT is described that includes dipolar order effects from magnetization associated with motion-restricted macromolecules. In this model, equal irradiation at positive and negative frequency offsets eliminates dipolar order and achieves greater saturation than irradiation at a single offset frequency using the same power. Fitting of mouse and human volunteer brain data at different irradiation powers and offset frequencies was performed to assess the relevance of the model and approximate tissue parameters. A key parameter in determining ihMT signal was found to be the relaxation time T1D associated with the dipolar order reservoir and the fraction f of the semi-solid, bound magnetization that possessed a nonzero T1D. Indeed, better fits of myelinated tissue were achieved when assuming f≠1. From such fits, estimated T1Ds of mice in the white matter, (34±14) ms, were much longer than in muscle, T1D=(1±1) ms and the average f from white matter volunteer data was 2.2 times greater than that in grey matter. The combination of f and longer T1Ds was primarily responsible for the much higher ihMT in myelinated tissues, and provided explanation for the species variation. This dipolar order ihMT model should help guide future research, pulse sequence optimization, and clinical applications.

Consensus recommendations on training and competing in the heat.

Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.

Consensus recommendations on training and competing in the heat.

Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat.