Urinary Incontinence in Female Athletes: A Systematic Review on Prevalence and Physical Therapy Approaches.

Urinary incontinence (UI) is an involuntary leakage of urine and is classified as stress, mixed, or urge. It is more common in females due to anatomical and physiological body differences. Moreover, the literature remarks an evident presence of UI with high-intensity physical activities. Therefore, the present integrative systematic review focused on the studies aimed at investigating the prevalence of UI in nulliparous sportswomen, studies illustrating sport-specific prevalence of UI, and studies demonstrating the impact of physical therapy intervention on UI. A literature search was carried out systematically on electronic databases consisting of Cochrane and Google Scholar databases from 2018 to December 2023. The keywords utilized to perform the literature search and include relevant articles consisted of "urinary incontinence," AND "nulliparous," AND "sportswomen," OR "female athletes," AND "physical therapy". A total of nine studies were included in the present systematic review. The quality assessment of the studies was performed by using a measurement tool to assess systematic reviews (AMSTAR 2) scale, and the Mixed Methods Appraisal Tool was used for cross-sectional and randomized controlled trial studies. The data extracted included first author and year of publication, study design, sample or number of individuals involved in the study, age range of the participants, type of UI, type of sports involved, purpose of the study, methodological part, outcome measures derived, conclusion, and quality assessment of the studies. The review concluded that nulliparous athletes, especially those participating in high-impact activities, have a significant prevalence of UI. In addition, the physical therapy intervention consisting of pelvic floor muscle training (PFMT) along with education about pertinent pelvic anatomy was mostly performed on female athletes for the prevention and management of UI.

Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes.

INTRODUCTION AND HYPOTHESIS: This study was aimed at identifying the prevalence and experience of urinary incontinence (UI) among elite female Gaelic sports athletes in Ireland. METHODS: A cross-sectional study comprising an anonymous online survey of elite Gaelic sports (Camogie and Ladies Gaelic Football) players. Players were asked about their background information, knowledge of the pelvic floor and practice of pelvic floor muscle training (PFMT), as well as their experiences of UI. The prevalence and severity of UI was assessed using the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI-SF) questionnaire. Logistic regression was used to evaluate risk factors. RESULTS: A total of 185 players responded (25 ± 5 years) and 95.3% (n = 176) were nulliparous. Forty-one percent (n = 75) of players had learned about PFMT and 13% (n = 24) had performed PFMT within the last 4 weeks. The ICIQ-UI-SF was completed by 159 players, with UI reported by 61.6% (n = 98), 52% (n = 51) of whom experienced stress urinary incontinence (SUI). A significant association was found between UI and longer weekly sporting activity time (OR 1.05, 95% CI 1.002 to 1.008). Parous players were more likely to experience UI (p = 0.025). Jumping and sprinting activities were the most commonly reported triggers, with pre-voiding and wearing protection (liners, pads) the most commonly adopted UI management strategies. Only ten players reported receiving treatment for UI. CONCLUSIONS: Urinary incontinence is prevalent among this cohort of elite female Gaelic sports athletes. Many players used strategies to manage their UI whereas few sought help for what is a treatable condition. Findings suggest the need for education of players regarding pelvic floor health and treatment options available.

Energy expenditure of international female rugby union players during a major international tournament: a doubly labelled water study.

The purpose of this study was to quantify the total energy expenditure (TEE) of international female rugby union players. Fifteen players were assessed over 14 days throughout an international multi-game tournament, which represented two consecutive one-match microcycles. Resting metabolic rate (RMR) and TEE were assessed by indirect calorimetry and doubly labelled water, respectively. Physical activity level (PAL) was estimated (TEE:RMR). Mean RMR, TEE, and PAL were 6.60 ± 0.93 MJ·day-1 (1578 ± 223 kcal·day-1), 13.51 ± 2.28 MJ·day-1 (3229 ± 545 kcal·day-1), and 2.0 ± 0.3 AU, respectively. There was no difference in TEE (13.74 ± 2.31 (3284 ± 554 kcal·day-1) vs. 13.92 ± 2.10 MJ·day-1 (3327 ± 502 kcal·day-1); p = 0.754), or PAL (2.06 ± 0.26 AU vs. 2.09 ± 0.23 AU; p = 0.735) across microcycles, despite substantial decreases in training load (total distance: -8088 m, collisions: -20 n, training duration: -252 min). After correcting for body composition, there was no difference in TEE (13.80 ± 1.74 (3298 ± 416 adj. kcal·day-1) vs. 13.16 ± 1.97 (3145 ± 471 adj. kcal·day-1) adj. MJ·day-1, p = 0.190), RMR (6.49 ± 0.81 (1551 ± 194 adj. kcal·day-1) vs. 6.73 ± 0.83 (1609 ± 198 adj. kcal·day-1) adj. MJ·day-1, p = 0.633) or PAL (2.15 ± 0.14 vs. 1.87 ± 0.26 AU, p = 0.090) between forwards and backs. For an injured participant (n = 1), TEE reduced by 1.7 MJ·day-1 (-401 kcal·day-1) from pre-injury. For participants with illness (n = 3), TEE was similar to pre-illness (+0.49 MJ·day-1 (+117 kcal·day-1)). The energy requirements of international female rugby players were consistent across one-match microcycles. Forwards and backs had similar adjusted energy requirements. These findings are critical to inform the dietary guidance provided to female rugby players.

World Athletics regulations unfairly affect female athletes with differences in sex development.

World Athletics have introduced regulations preventing female athletes with certain differences in sex development from competing in the female category. We argue these regulations are not justified and should be removed. Firstly, we examine the reasoning and evidence underlying the position that these athletes have a substantial mean difference in performance from other female athletes such that it constitutes an advantage, and argue it is not sufficient. Secondly, if an advantage does exist, it needs to be demonstrated it is unfair. We argue the advantage would not be unfair because to say otherwise relies on a presupposition about whether these athletes are female, which involves contradictory and inconsistent definitions of sex. Thirdly, we contend that even if it is established that there is an advantage and it is unfair, the response of requiring athletes to take testosterone-suppressing medication is not appropriate and is unfair.

Effect of Off-Season Iron Supplementation on Aerobic Capacity of Female Handball Player: A Randomized, Double-Blinded, Placebo-Controlled Study.

Background: Iron supplementation, especially in female athletes, is 1 of the influential factors in aerobic capacity, and its deficiency can lead to significant problems related to reduced aerobic capacity. Objectives: This study aimed to investigate the effect of 3 wk of iron supplementation on the aerobic capacity of female handball players. Methods: In this randomized, double-blinded, and placebo control trial, 14 elite handball players (age: 21.6 ± 5.68 y; height: 169.5 ± 4.9 cm; weight: 62.2 ± 9.25 kg; body mass index (in kg/m2): 21.5 ± 2.9) randomly divided into 2 supplement groups (receiving a 100 mg/d of poly-maltose tri hydroxide iron complex in the form of tablets) and the placebo group (receiving a tablet containing 100 mg/d starch which is the same color and shape as iron tablets). The supplementation protocol was performed for 3 wk during the off-season. Maximal oxygen consumption (VO2max), amounts of carbon dioxide at the first ventilatory threshold, amounts of carbon dioxide at the second ventilatory threshold, time to exhaustion (TTE), pulmonary ventilation (VE), ventilatory equivalents for oxygen, amounts of oxygen at the first ventilatory threshold, amounts of oxygen at the second ventilatory threshold, time to reach first ventilatory threshold, end-tidal partial pressure of oxygen at the first ventilatory threshold, end-tidal partial pressure of carbon dioxide at the first ventilatory threshold and ventilatory equivalents for carbon dioxide were measured using the Bruce test and gas analyzer in 2 pretest and posttest stages. Results: There were significant improvements in oxygen at the first ventilatory threshold, time to reach first ventilatory threshold, and end-tidal partial pressure of carbon dioxide at the first ventilatory threshold and a significant decrease in end-tidal partial pressure of oxygen at the first ventilatory threshold (P < 0.05). Also, no significant changes were found in VO2max, carbon dioxide at the first ventilatory threshold, carbon dioxide at the second ventilatory threshold, oxygen at the second ventilatory threshold, TTE, VE, ventilatory equivalents for oxygen, and ventilatory equivalents for carbon dioxide after 3 wk of iron supplementation (P > 0.05). Conclusions: The study found that 3 wk of off-season iron supplementation positively impacted female handball players' aerobic capacity; however, it did not significantly improve their VO2max.

Morning-evening differences of short-term maximal performance and psychological variables in female athletes.

The aim of this study was to examine the effect of time of day on short-term maximal performance and psychological variables in young females. Fifteen active women participated in the study (age: 22 ± 3 years) and completed Hooper and the POMS-F questionnaires subsequently. In a randomized order, they performed a maximum of 30 s cycling exercise at two different times of day: in the morning at 07:00 h and in the afternoon at 16:00 h with a recovery period of 48 h. The digit cancellation test, countermovement jump (CMJ), squat jump (SJ) test, and the lower quarter Y balance test were performed at the beginning and at the end of each session. Our results showed that only peak power and mean power (p < 0.01) during the maximum 30 s cycling, reaching distances during the Y-balance (p < 0.05), Jump height in CMJ and SJ (p < 0.01) as well as attention, vigor, and stress scores (all p < 0.01) were higher in the afternoon than in the morning. Our results indicated a daily diurnal variation in short-term maximal performance and mood states in young athletic women with better performance observed during the afternoon.

The impact of intermittent fasting during Ramadan on psychomotor and cognitive skills in adolescent athletes.

Introduction: Intermittent fasting (IF) represents a dietary intervention similar to caloric restriction, characterized by the strategic limitation of food consumption. Among the diverse array of practices for IF, Ramadan IF (RIF), a religious observance in Islam, mandates that healthy adult Muslims abstain from both food and drinks during daylight hours. In sports, researchers have extensively studied IF effects on health, including sleep and physical performance, but its impact on cognitive functions during RIF remains understudied. Therefore, this study was conducted to evaluate the influence of RIF on psychomotor and cognitive performance among young female athletes. Methods: To achieve this purpose, a cohort of 23 female handball players, aged 17.2 ± 0.5 years, participated in a series of six testing sessions: one conducted prior to Ramadan (R0), and others during the first (R1), second (R2), third (R3), and fourth (R4) weeks of Ramadan, followed by a session in the week after Ramadan (R5). Each session involved assessments using a Simple Reaction Time Test (SRT), Choice Reaction Time Test (CRT), Vigilance Test (VT), and Mental Rotation Test (MRT). Additionally, dietary intake, body composition, and Pittsburgh Sleep Quality Index (PSQI) scores were evaluated during these periods. Results and discussion: The obtained data illustrated that there was a decrease in SRT, CRT, VT, and MRT performances during R1 in comparison to R0 (all p < .001). This reduction was also observed in R2, R3, R4, and R5. Notably, during the fourth week of Ramadan (R4), these cognitive and psychomotor parameters were significantly lower than during the earlier weeks (R1, R2, R3; all p < .001). Furthermore, a gradual decrease in total PSQI scores, sleep quality, and sleep duration was observed throughout the Ramadan period, reaching the lowest levels during R4. These findings illustrate that RIF has a significantly detrimental impact on neuromuscular and cognitive abilities as well as sleep quality in young female athletes. The study also highlights a fluctuating pattern in cognitive function across the four weeks of Ramadan, with the most pronounced decline observed during the final week of fasting illustrating the importance of conducting similar studies on normal individuals from both genders with larger sample size.

Postural Control During Single-Leg Landing in Female Athletes After Anterior Cruciate Ligament Reconstruction.

Background: Secondary anterior cruciate ligament (ACL) injury is a complication of ACL reconstruction (ACLR), which may result from altered neuromuscular control affecting anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) required for maintaining balance during movement. However, it remains unclear how APAs and CPAs differ in single-leg landings post-ACLR compared to healthy subjects. Purpose: The purpose of this study was to clarify the differences in muscle activities of APAs and CPAs, lower limb kinematics, and kinetics between athletes with a history of ACLR and healthy athletes during single-leg landing. Study design: Cross-sectional study. Methods: Eighteen female athletes were recruited and divided into ACLR (n = 9) and control groups (n = 9). The experimental task involved a single-leg landing from a 30 cm box. Joint angles and moments were determined using a 3-dimensional motion analysis system, while muscle activity was assessed using surface electromyography. Analysis intervals were divided into two phases: the APA phase (-150 ms to 50 ms) and the CPA phase (50 ms to 250 ms), with initial contact (0 ms) as the reference point. Muscle activity onset time was defined as the time when the baseline exceeded by the sum of mean values and 2 standard deviations. Results: No significant differences were observed in muscle activity or onset time between the ACLR and control groups. However, an increased hip external rotation moment was observed during the CPA phase in the ACLR group. Conclusion: These findings suggest that APAs and CPAs of athletes who returned to sports more than 1 year post-ACLR may be similar. The increased hip external rotation moment in the ACLR group during the CPA phase could represent a specific compensatory strategy to decrease the hip internal rotation angle post-ACLR. Level of Evidence: III.

Small-Sided Games vs. High-Intensity Interval Training on Body Composition of Female Handball Players / Juegos Reducidos vs Entrenamiento Interválico de Alta Intensidad sobre la Composición Corporal de Jugadoras de Balonmano

SUMMARY: The purpose of this study was to compare the effects of different training programs based on small-sided games (SSG) and high-intensity interval training (HIIT) on the body composition of female handball players. A total of 45 female handball players (age: 16.13±0.89 years; training experience: 6.18±1.33 years) were assigned to three groups: game group (GG; N = 15), running group (RG; N = 15), and control group (CON; N = 15). The training programs lasted eight weeks, with two training sessions per week. The GG performed three vs. three small-sided games on a 20 m x 20 m court; the RG performed 15 s HIIT running followed by 15 s of active recovery; the CON group maintained regular handball training. Regardless of the group assignment, all participants were measured for each of the following variables: Body height, body mass, fat-free mass, fat mass, muscle mass, intracellular water, and extracellular water. The results demonstrate significant differences (p0.01) in muscle mass. The GG showed significant (p<0.001) greater improvement in these body composition variables than RG and CON. Body composition variables improved with GG, moving from 2.04 % in fat mass to 1.3 % in extracellular water. In the RG, results show significant improvements (p<0.001) only in intra- and extracellular water. The CON shows improvements in fat-free mass, muscle mass, intracellular water, and extracellular water. To conclude, eight weeks of SSG in handball provide better changes in body composition compared to HIIT 15 s - 15 s and handball training alone.

El propósito de este estudio fue comparar los efectos de diferentes programas de entrenamiento basados en juegos reducidos (SSG) y entrenamiento interválico de alta intensidad (HIIT) sobre la composición corporal de jugadoras de balonmano. Un total de 45 jugadoras de balonmano (edad: 16,13 ± 0,89 años; experiencia de entrenamiento: 6,18 ± 1,33 años) fueron asignadas a tres grupos: grupo de juego (GG; N = 15), grupo de carrera (RG; N = 15) y grupo de control (CON; N = 15). Los programas de formación duraron ocho semanas, con dos sesiones de formación por semana. El GG realizó partidos reducidos de tres contra tres en una cancha de 20 x 20 m; el RG realizó 15 s de carrera HIIT seguidos de 15 s de recuperación activa; El grupo CON mantuvo un entrenamiento regular de balonmano. Independientemente de la asignación de grupo, a todos los participantes se les midió cada una de las siguientes variables: altura corporal, masa corporal, masa libre de grasa, masa grasa, masa muscular, agua intracelular y agua extracelular. Los resultados demuestran diferencias significativas (p0,01) en la masa muscular. El GG mostró una mejora significativa (p<0,001) mayor en estas variables de composición corporal que RG y CON. Las variables de composición corporal mejoraron con GG, pasando de un 2,04 % en masa grasa a un 1,3 % en agua extracelular. En el RG, los resultados mostraron mejoras significativas (p<0,001) sólo en el agua intra y extracelular. El CON indicó mejoras en la masa magra, la masa muscular, el agua intracelular y el agua extracelular. En conclusión, ocho semanas de SSG en balonmano proporcionan mejores cambios en la composición corporal en comparación con el HIIT de 15 s - 15 s y el entrenamiento de balonmano solo.

Habitual Nocturnal Sleep, Napping Behavior, and Recovery Following Training and Competition in Elite Water Polo: Sex-Related Effects.

PURPOSE: To examine nocturnal sleep patterns, napping behaviors, and subjective wellness responses of elite water polo players within an in-season week and to identify whether sleeping patterns differ between men and women. METHODS: Sleep characteristics of 10 male and 17 female professional water polo players were objectively assessed during 1 week of the in-season period, including 5 training days, 1 match day, and 1 day of rest. Internal load (rating of perceived exertion × duration of training or match) was assessed 30 minutes posttraining or postmatch, and the total quality of recovery was recorded every morning. A series of multilevel models were used to analyze the data. RESULTS: Time in bed and wake-up time were earlier on both training (P < .001) and rest days (P < .001) than on the day of the match. Internal workload did not predict any of the players' sleeping patterns. Midday naps predicted less time in bed (P = .03) and likely less sleep time (P = .08). The total quality of recovery was predicted only by the total sleep time (P < .01). Women exhibited higher sleep efficiency (P < .001), less waking after sleep onset (P = .01), and a lower number of awakenings (P = .02) than men. CONCLUSIONS: The current results indicate that the nocturnal sleep patterns of elite water polo players are not associated with internal load and that women display better nocturnal sleep quality compared with men. As long naps interfere with nocturnal sleep, and total nocturnal sleep time predicts total quality of recovery, we suggest that athletes follow hygiene sleep strategies to facilitate adequate nocturnal sleep and next-day recovery.

Differences in bone mineral density and associated factors in dancers and other female athletes.

Dancers are susceptible to relative energy deficiency in sport (RED-S), specifically low bone mineral density (BMD). Little is known about how dancers' BMD compares to other athletic populations. The objective of this study was to examine the association between participant characteristics and total body areal BMD (aBMD) among female pre-professional dancers compared to other female athletes. Two hundred sixty-nine females (132 pre-professional dancers (17.6 (3.2) years) and 137 sport participants (22.8 (2.6) years) were included in this study. aBMD (g/cm2) was estimated using dual X-ray absorptiometry. Multivariable linear regression was used to examine the association between height-adjusted z-scores of total body aBMD (aBMD-Z) and age (years), body mass index (BMI) (z-score), supplement intake, history of stress fracture, irregular menses, MRI/bone scan, 1-year injury history, oral contraceptives, and activity (dance/sport). Total body aBMD and aBMD-Z were lower in dancers than athletes (dancers: aBMD = 1.03 g/cm2 (95% CI: 1.01, 1.05); aBMD-Z = -0.28 (-0.43, -0.12) (p < 0.001); athletes: aBMD = 1.14 g/cm2 (95% CI: 1.12, 1.16); aBMD-Z = 0.41 (0.25, 0.57) (p < 0.001)). aBMD-Z increased with age (ß = 0.054, 95% CI: 0.017, 0.092; p = 0.004) and BMI (ß = 0.221, 95% CI: 0.006, 0.415; p = 0.043). Activity type modified the relationship between BMI and aBMD-Z (ß = 0.323, 95% CI: 0.025, 0.621; p < 0.033) with a stronger positive association in dancers, compared to other female athletes. Dancers had lower total body aBMD and aBMD-Z than other female athletes. aBMD-Z increases with age in female pre-professional dancers and other female athletes. A stronger association exists between aBMD-Z and BMI in dancers than athletes. Future studies should consider changes in aBMD-Z during adolescence and associations with increased risk of bone injury.

The effect of last meal "Suhoor" timing on diurnal variations in cognitive performance during Ramadan fasting among female athletes.

The present study aimed to investigate the effect of the timing of the last meal, "Suhoor", on diurnal variation in cognitive performance during Ramadan intermittent fasting (RIF). In a randomized order, 26 adolescent female athletes (aged 15.9 ± 0.9 y) were tested in three sessions at 7:00 a.m., 12:00 p.m., and 5:00 p.m. across four different conditions: the 10 days preceding Ramadan (PR); the final 12 days of Ramadan (RO): two different conditions: Early Suhoor (SEarly), and Late Suhoor (SLate); and, ultimately, the 10 days immediately after Ramadan (AR) with an in-between recovery period of ≥24 h. During each test session, the oral temperature (OT), simple reaction time test (SRT), choice reaction time test (CRT), attention test (ATT), and mental rotation test (MRT) were evaluated. The Pittsburgh Sleep Quality Index (PSQI) and daily diary intake were assessed across the three periods. Compared to PR, the sleep parameters assessed by the PSQI were significantly lower during the RO and AR periods. However, neither total dietary intake nor OT showed any changes due to RIF. Compared to PR, the afternoon performances of SRT, CRT, ATT, and MRT significantly declined under both the SEarly and SLate conditions. Notably, midday performance decreased only during SLate, while morning performance remained unaffected in both conditions. Additionally, compared to SEarly, these performances were better during SLate in the afternoon and at midday. In summary, nutrient intake timing had a significant effect on the diurnal fluctuations in cognitive functions during Ramadan fasting, particularly around noon and in the afternoon. Our results illustrate the benefits of a late last meal (Suhoor) in preserving optimal morning cognitive abilities and preventing any impairment during the fasted state at midday or in the afternoon, which could affect overall athletic performance.

Strength Training Frequency and Athletic Performance in High School Girls Basketball Players.

This study investigated the effects of a six-week strength training intervention on the physical fitness of female high school athletes, with a focus on training frequency. Twenty-three female high school basketball athletes were recruited and split into two groups: one group participated in strength training once per week (S1), while the other participated in two training sessions per week (S2). The groups were not random as training sessions were voluntary, and some participants were only able to train once per week. Participants were tested before and after the intervention, and the data included: age, body height, body mass, body fat percentage, grip strength, leg/back dynamometer (LBD) strength, a seated medicine ball throw (MBT), a vertical jump (VJ), 505 tests from each foot, 0-5, 0-10, and 0-20 sprint times, and multistage fitness test shuttles. Data were analyzed by a two (time) x two (group) repeated measures analysis of variance (ANOVA; p < 0.05). When significant F ratios were detected in any ANOVA calculations, post hoc pairwise comparisons were conducted using the Bonferroni adjustment procedure. There were significant main effects for time that indicated the following: increased body height, body mass, grip strength, LBD strength, MBT distance, and VJ height, faster 505 times, and slower 0-5 and 0-10 m sprint times (p ≤ 0.021). There were no significant time by group ANOVAs or between-group main effects. These performance changes occurred irrespective of training frequency. High school girls who participate in at least one strength training session per week can improve their strength (grip, LBD), power (MBT, VJ), and change-of-direction speed (505).

Female patients have greater improvement in pain symptoms and physical activity after fasciotomy for treatment of chronic exertional compartment syndrome of the lower leg.

PURPOSE: The purpose of this study was to identify sex differences in postoperative outcomes and return-to-sport rates after fasciotomy for treatment of chronic exertional compartment syndrome (CECS) of the lower leg. It was hypothesised that male CECS patients would have a higher rate of return to sport than female CECS patients. METHODS: A retrospective cohort study was conducted involving patients who underwent primary fasciotomy of one to four leg compartments for treatment of CECS at a single centre from 2010 to 2020. Each affected leg was treated as a separate subject. Postoperative outcomes included CECS pain frequency and severity, return to sport and Tegner activity level. Multivariable regression was used to determine if sex was an independent predictor of outcomes after adjusting for demographic and clinical covariates. p < 0.05 were considered significant. RESULTS: Eighty-one legs (44 M, 37 F) of 47 unique patients (34 of whom had bilateral symptoms) were included with a mean follow-up time of 51.5 ± 31.4 months. Male subjects were older (p < 0.001) and had higher body mass index (p < 0.001) compared to female subjects. Most subjects (84.0%) underwent two- or four-compartment fasciotomies. Female sex was found to be predictive of lower overall postoperative pain severity (p = 0.007), higher odds of return to sport (p = 0.04) and higher postoperative Tegner score (p = 0.005). However, female sex was not predictive of postoperative pain frequency, odds of reoperation or odds of return to sport to at least the presymptomatic level (all p < 0.05). CONCLUSION: Female sex is independently predictive of reduced overall pain severity, higher odds of return to sport and higher postoperative improvement in Tegner score following fasciotomy for treatment of lower-limb CECS. LEVEL OF EVIDENCE: III.

Saliva as a Diagnostic Tool for Early Detection of Exercise-Induced Oxidative Damage in Female Athletes.

Although blood still remains the most commonly utilized medium to detect increased levels of oxidative damage induced by exercise, saliva diagnostics have gained increasing popularity due to their non-invasive nature and athlete-friendly collection process. Given that the contribution of various phases of the menstrual cycle to the levels of oxidative damage may differ, the aim of this study was to evaluate an agreement between salivary and plasmatic levels of lipid peroxidation products in female swimmers in both the follicular (F) and luteal (L) phases of the menstrual cycle at rest and following exercise. Twelve well-trained female swimmers aged 19.6 ± 1.1 years old were examined. We measured diene conjugates (DCs), triene conjugates (TCs), and Schiff bases (SBs) in lipids immediately after their extraction from both saliva and blood plasma. All female swimmers were studied two times each, in the two different phases of one menstrual cycle, before and after high-intensity interval exercise (HIIE). Salivary and plasmatic levels of DCs, TCs, and SBs significantly increased post-exercise compared to pre-exercise, in both the F and L phases. A high positive correlation was observed between the concentrations of DCs, TCs, and SBs in the saliva and blood plasma of participants in the F and L phases, both at rest and following HIIE. Ordinary least products regression analysis indicates that there was no proportional and differential bias in the data. The Bland-Altman method also declares that there was no differential bias, since the line of equality was within the 95% confidence interval of the mean difference between salivary and plasmatic levels of DCs, TCs, and SBs in female swimmers, in both the F and L phases, before and after HIIE. There was also no proportional bias in the Bland-Altman plots. Thus, this is the first study to report a high agreement between the quantifications of DCs, TCs, and SBs in the saliva and blood plasma of female swimmers in both the F and L phases, at rest and following HIIE.

Effect of Menstrual Cycle Phase and Hormonal Contraceptives on Resting Metabolic Rate and Body Composition.

The cyclical changes in sex hormones across the menstrual cycle (MC) are associated with various biological changes that may alter resting metabolic rate (RMR) and body composition estimates. Hormonal contraceptive (HC) use must also be considered given their impact on endogenous sex hormone concentrations and synchronous exogenous profiles. The purpose of this study was to determine if RMR and dual-energy X-ray absorptiometry body composition estimates change across the MC and differ compared with HC users. This was accomplished during a 5-week training camp involving naturally cycling athletes (n = 11) and HC users (n = 7 subdermal progestin implant, n = 4 combined monophasic oral contraceptive pill, n = 1 injection) from the National Rugby League Indigenous Women's Academy. MC phase was retrospectively confirmed via serum estradiol and progesterone concentrations and a positive ovulation test. HC users had serum estradiol and progesterone concentrations assessed at the time point of testing. Results were analyzed using general linear mixed model. There was no effect of MC phase on absolute RMR (p = .877), relative RMR (p = .957), or dual-energy X-ray absorptiometry body composition estimates (p > .05). There was no effect of HC use on absolute RMR (p = .069), relative RMR (p = .679), or fat mass estimates (p = .766), but HC users had a greater fat-free mass and lean body mass than naturally cycling athletes (p = .028). Our findings suggest that RMR and dual-energy X-ray absorptiometry body composition estimates do not significantly differ due to changes in sex hormones in a group of athletes, and measurements can be compared between MC phases or with HC usage without variations in sex hormones causing additional noise.

Effects of Hypopressive Exercise on Dynamic Neuromuscular Control in Female Roller-Skaters.

The effects of hypopressive exercise (HE) on dynamic balance have never been studied. We aimed to study the effects of a HE program on dynamic balance, posterior chain kinematics and expiratory peak flow on female competitive roller skaters over a 6-week training period. Twenty competitive female roller-skaters (13-22 years of age, SD 2.25) performed a 30-minute HE session once weekly before the regular roller-skating practice for 6 weeks. The HE program consisted of breathing and postural awareness exercises in addition to 5 basic HE poses performed three times each. Dynamic neuromuscular control was assessed with the Y-Balance Test (YBT), posterior back chain kinematics with the sit and reach test and peak expiratory flow rate with a digital spirometer. Paired t-test revealed significant differences between the measurement periods for all YBT leg directions and composite score (p ≤ 0.01). Significant differences were also revealed between baseline and after the intervention for the sit and reach test (p ≤ 0.01) and peak expiratory flow (p = 0.01). No differences in forced expiratory volume in the first second were found (p = 0.04). These preliminary findings suggest that a 6-week HE program could be a feasible neuromuscular option for training dynamic balance, posterior back chain kinematics and peak expiratory flow in female roller-skaters.

Lower-Body Strength Relationships with Sprint, Jump, and Sport-Specific Skill Performance in High School Girls Softball Players.

Softball athletes require multiple fitness traits (e.g., strength, speed, power) and sport-specific skills (e.g., hitting, throwing) for success. Lower-body strength could underpin these qualities; this has received little analysis among high school female athletes. This research investigated correlations between absolute and relative lower-body strength with age, linear speed, lower-body power, and throwing and hitting velocity in high school girls softball athletes. Archival data collected from 34 high school girls softball players (age=14.91±1.00 years; height=1.66±0.07 m; body mass=63.21±9.59 kg) from a private strength and conditioning facility was analyzed. The data included: age, height, and body mass; 0-9.14 and 0-18.29 m sprint interval times; standing broad jump (SBJ) distance (lower-body power); batted ball exit (i.e., hitting) and throwing velocity; and absolute and relative three-repetition maximum (3RM) front squat and hexagonal bar deadlift (HBD). Pearson's correlations (p<0.05) derived relationships between absolute and relative strength with the fitness and sport-specific tests. The results indicated significant relationships between the 3RM HBD with age (r=0.389) and hitting velocity (r=0.418). The 3RM front squat related to the SBJ (r=0.422) and hitting velocity (r=0.457). Relative 3RM HBD correlated with the 0-18.29 m sprint interval (r=-0.349). These results suggested that a strength and conditioning program that improves the lower-body strength of high school girls softball players could contribute to faster sprinting speed, further horizontal jumps, and greater hitting velocity. The results from this study highlights the value of strength enhancement in high school girls softball athletes and provides support for strength and conditioning program provision for these individuals.

Effects of Various Caffeine Doses on Cognitive Abilities in Female Athletes with Low Caffeine Consumption.

Caffeine (CAF), a prevalent psychoactive stimulant, is believed to potentially enhance cognitive ability. However, studies on the effects of various doses are limited and yield inconsistent results, particularly in female athletes. Therefore, we aimed to assess the association between three different dosages of CAF intake (low, moderate, and high) and cognitive skills in female athletes with low CAF consumption. This study had a randomized, crossover, double-blind design in which each athlete performed four experimental sessions after ingesting either a placebo (PLAC), 3 mg·kg-1 of CAF (3 mg of CAF), 6 mg·kg-1 of CAF (6 mg of CAF), or 9 mg·kg-1 of CAF (9 mg of CAF) with an in-between washout period of at least 72 h. Following a 60 min window post-capsule consumption, fourteen female athletes (age: 17.4 ± 0.8 years) were assessed through various cognitive tests, namely, simple reaction time (SRT), choice reaction time (CRT), and attentional task (AT) tests, along with the mental rotation test (MRT). Additionally, they were required to complete a questionnaire about the undesirable side effects of CAF. Our results indicated that, compared to those of PLAC, the SRT, CRT, and AT performance were significantly improved following the administration of both 3 mg of CAF and 6 mg of CAF. While the greatest enhancement was observed after consuming 3 mg of CAF, no significant differences were found between the effects of 3 mg and 6 mg of CAF. Interestingly, MRT performance did not improve with any of the CAF dosages. Moreover, the ingestion of 9 mg of CAF did not enhance cognitive skills and was linked to the highest occurrence of CAF-related side effects. In conclusion, our results highlight the recommendation for a low CAF dosage of 3 mg·kg-1, in contrast to a higher dose of 6 mg·kg-1 or 9 mg·kg-1 of CAF, to enhance various aspects of cognitive performance in female athletes with low CAF consumption without adverse side effects.