A global view on how local muscular fatigue affects human performance.

There is a growing interest in scientific literature on identifying how and to what extent interventions applied to a specific body region influence the responses and functions of other seemingly unrelated body regions. To investigate such a construct, it is necessary to have a global multivariate model that considers the interaction among several variables that are involved in a specific task and how a local and acute impairment affects the behavior of the output of such a model. We developed an artificial neural network (ANN)-based multivariate model by using parameters of motor skills obtained from kinematic, postural control, joint torque, and proprioception variables to assess the local fatigue effects of the abductor hip muscles on the functional profile during a single-leg drop landing and a squatting task. Findings suggest that hip abductor muscles' local fatigue produces a significant effect on a general functional profile, built on different control systems. We propose that expanded and global approaches, such as the one used in this study, have great applicability and have the potential to serve as a tool that guarantees ecological validity of future investigations.

Reliability of the Heartbeat Tracking Task to Assess Interoception.

Interoception refers to the competence in perceiving and interpreting internal sensations emerging from the body. The most common approach to assess interoception is through cardiac interoceptive tests like the heartbeat tracking task (HTT), which measures the accuracy on perceive and counting heartbeats during a period. However, the literature is scarce in providing adequate reliability evidence for this measure so that the interoception assessment may be threaten. In addition to HTT accuracy, it is possible to determine sensibility (self-reported confidence) and interoceptive awareness (correspondence between accuracy and sensibility). Thus, we measured the test-retest reliability of HTT and also investigated the behavior of HTT outcomes along the task. Therefore, 31 healthy adults (16 males) with 27.8 (9.4) years old performed two consecutive HTT interspersed by one day. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable difference (MD) analyzes showed 'Good' relative reliability for interoceptive accuracy (ICC = 0.880; SEM = 0.263; MD = 0.728; p < 0.001) and 'Moderate' for sensibility (ICC = 0.617; SEM = 0.648; MD = 1.797; p < 0.001) and awareness (ICC = 0.593; SEM = 0.227; MD = 0.628; p < 0.001). The absolute reliability shows low threshold values for observing true effects in HTT outcomes. The results also showed that reducing the number of HTT blocks did not impact the outcomes. The HTT showed to be reliable in determine the interoceptive competences in healthy adults.

The placebo effect of a pink non-caloric, artificially sweetened solution on strength endurance performance and psychological responses in trained individuals.

Background: The pink color enhances the perceived sweetness, increasing the individuals' expectation of the presence of sugar/carbohydrate in a beverage. Hence, it is plausible to speculate that providing a pink solution during exercise could induce an ergogenic benefit through a potential placebo effect. Aim: We examined whether ingesting a pink non-caloric, artificially sweetened solution can improve endurance strength exercise performance and psychological responses. Methods: Eighteen strength-trained individuals (34 ± 7 y; 1.74 ± 0.06 m; 79.86 ± 10.91 kg) completed three experimental trials in a randomized, single-blind, crossover counterbalanced fashion. In each trial, participants performed a 5-set strength endurance test at 70% of the one-repetition maximum in the bench press exercise, interspersed by 2 min. Before each set, participants ingested either a pink (PINK) or a transparent (TRANSP) non-caloric, artificially sweetened solution. A session without ingestion (CON) was also completed. Total number of repetitions and psychological responses such as motivation, emotional arousal, affect, and ratings of perceived exertion were obtained throughout the exercise protocol. Results: Total repetitions improved in PINK (60 ± 12 reps) compared to TRANSP (p = 0.03; 56 ± 10 reps; ES = 0.22; ±3.8%) and CON (p = 0.01; 56 ± 9 reps; ES = 0.33; ±6.6%), but no difference occurred between TRANSP and CON (p = 0.84; ES = 0.12; ±2.4%). Comparable responses were observed in motivation, emotional arousal, affect, and ratings of perceived exertion in PINK, TRANSP, and CON trials (all, p > 0.05), despite the greater total physical work performed in PINK trial. Conclusion: Ingesting a pink non-caloric, artificially sweetened solution improved strength endurance performance with comparable psychological responses. These results have implications for future nutritional studies and performance assessments in real-world sports scenarios.

The reward for placebos: mechanisms underpinning placebo-induced effects on motor performance.

Different from the most popular thinking, the placebo effect is not a purely psychological phenomenon. A body of knowledge from multidisciplinary fields has shown that the expectation of a potential benefit when receiving a treatment induces a cascade of neurochemical-electrophysiological alterations in brain reward areas, including motor-related ones. Alterations in the dopamine, opioid, and glutamate metabolism are the neural representation converting reward-derived declarative forms into an attractive and wanted behavior, thereby changing the activation in reward subcortical and cortical structures involved in motor planning, motor execution, and emotional-cognitive attributes of decision-making. We propose that the expectation of receiving a treatment that is beneficial to motor performance triggers a cascade of activations in brain reward areas that travels from motor planning and motor command areas, passing through corticospinal pathways until driving the skeletal muscles, therefore facilitating the motor performance. Although alternative explanations cannot be totally ruled out, this mechanistic route is robust in explaining the results of placebo-induced effects on motor performance and could lead to novel insights and applications in the exercise sciences. Factors such as sex differences in reward-related mechanisms and aversion-induced nocebo effects should also be addressed.

Caffeine effects on VO2max test outcomes investigated by a placebo perceived-as-caffeine design.

BACKGROUND: Ergogenic effects of caffeine (CAF) ingestion have been observed in different cycling exercise modes, and have been associated with alterations in ratings of perceived exertion (RPE). However, there has been little investigation of maximal oxygen uptake (VO2MAX) test outcomes. AIM: This study aimed to verify whether CAF may reduce RPE, thereby improving maximal incremental test (MIT) outcomes such as VO2MAX, time to exhaustion and peak power output (WPEAK). METHODS: Nine healthy individuals performed three MITs (25 W/min until exhaustion) in a random, counterbalanced fashion after ingestion of CAF, placebo perceived as caffeine (PLA), and no supplementation (baseline control). VO2 was measured throughout the test, while RPE was rated according to overall and leg effort sensations. The power output corresponding to submaximal (RPE = 14 according to the 6-20 Borg scale) and maximal RPE was recorded for both overall (O-RPE14 and O-RPEMAX) and leg RPE (L-RPE14 and L-RPEMAX). RESULTS: VO2MAX did not change significantly between MITs; however, CAF and PLA increased time to exhaustion (↑ ∼18.7% and ∼17.1%, respectively; p < .05) and WPEAK (↑ ∼13.0% and ∼11.8%, respectively; p < .05) when compared with control. When compared with control, CAF ingestion reduced submaximal and maximal overall and leg RPEs, the effect being greater in maximal (likely beneficial in O-RPEMAX and L-RPEMAX) than submaximal RPE (possibly beneficial in O-RPE14 and L-RPE14). Similar results were found when participants ingested PLA. CONCLUSIONS: Compared with control, CAF and PLA improved MIT performance outcomes such as time to exhaustion and WPEAK, without altering VO2MAX values. CAF effects were attributed to placebo.

Carbohydrate mouth rinse improves performance of mentally fatigued cyclists despite null effects on psychological responses.

Mental fatigue reduces exercise performance through an impaired psychological response such as increased perceived exertion. Carbohydrate (CHO) mouth rinses improve exercise performance and perceived exertion likely due to an improved activation in cerebral reward areas, then we investigated if the CHO mouth rinse-improved exercise performance in mentally fatigued individuals was associated with ameliorated reward-related psychological responses. We hypothesised that CHO mouth rinse would be beneficial for mentally fatigued cyclists mainly in high-metabolic disturbance intensities. After familiarization and baseline sessions, well trained cyclists (n = 20) performed a maximal incremental test (MIT) after mental fatigue induction. They completed the MIT either without mouth rinse (MF) or rinsing their mouth with CHO (MF+CHO) or placebo (FM+PLA) solutions at every 25 % of the MIT. Psychological responses such as ratings of perceived exertion (RPE), affective valence, emotional arousal, and motivation were assessed throughout the MIT, while performance was assessed as peak power output and time of exercise. Mental fatigue reduced MIT performance (P < 0.05), but CHO mouth rinse was effective to counteract this deleterious mental fatigue effect (P < 0.05). However, we found null effects of CHO mouth rinses in psychological responses above the VT2 (P > 0.05) such as RPE, affective valence, emotional arousal, and motivation. Correlational analysis showed a significant, but moderate negative correlation between motivation and time of exercise above the VT2 when participants used CHO mouth rinse. In conclusion, the ergogenic CHO mouth rinse effects on MIT performance of mentally fatigued cyclists were irrespective of ameliorated psychological responses to exercise.

No Evidence of Postactivation Performance Enhancement on Endurance Exercises: A Comprehensive Systematic Review and Meta-analysis.

PURPOSE: Narrative reviews have suggested that postactivation induced by warm-up routines is effective to increase endurance exercise performance in real-world scenarios. However, systematic reviews with meta-analysis rather than narrative ones are required to provide an up-to-date summary of the evidence and provide directions for practical decisions. Therefore, we systematically reviewed peer-reviewed and gray literature to determine the certainty of evidence and the relative effects of postactivation performance enhancement (PAPE) in endurance exercises. METHODS: The effects of PAPE on endurance performance were meta-analyzed as a standardized mean difference (SMD) from control conditions within a random-effects model considering polled data and subgroups (PAPE strategies, endurance test modalities, and V̇O 2max -based endurance level). RESULTS: Eligible studies ( n = 35) showed a high risk of bias due to methodological flaws in randomization and blinding procedures. A meta-analysis including 57 comparisons (432 participants) revealed a significant but very small PAPE effect on endurance performance ( Z = 2.49, SMD = 0.15-very small, 95% confidence interval = 0.03 to 0.28) due to exceptional effect sizes reported by two studies (SMD of 2.85 and 2.14). We also observed that neither PAPE strategies nor endurance test modalities or V̇O 2max -based endurance levels influenced the PAPE effects on endurance performance. Meta-regression showed that PAPE effects were correlated neither with the time interval between conditioning routines and endurance exercise nor with endurance exercise duration. We found a very low certainty of evidence that PAPE potentiates endurance performance. CONCLUSIONS: Based on the analyses of bias and certainty of evidence, we found no support to recommend PAPE strategies to improve endurance exercise performance. Significant but very small PAPE effects on endurance performance were due to two exceptional effect sizes.

Carbohydrate mouth rinse failed to reduce central fatigue, lower perceived exertion, and improve performance during incremental exercise.

We examined if carbohydrate (CHO) mouth rinse may reduce central fatigue and perceived exertion, thus improving maximal incremental test (MIT) performance. Nine recreational cyclists warmed up for 6 min before rinsing a carbohydrate (CHO) or placebo (PLA) solution in their mouth for 10 s in a double-blind, counterbalanced manner. Thereafter, they performed the MIT (25 W·min-1 increases until exhaustion) while cardiopulmonary and ratings of perceived exertion (RPE) responses were obtained. Pre- to post-MIT alterations in voluntary activation (VA) and peak twitch torque (Tw) were determined. Time-to-exhaustion (p = 0.24), peak power output (PPO; p = 0.45), and V̇O2MAX (p = 0.60) were comparable between conditions. Neither treatment main effect nor time-treatment interaction effect were observed in the first and second ventilatory threshold when expressed as absolute or relative V̇O2 (p = 0.78 and p = 0.96, respectively) and power output (p = 0.28 and p = 0.45, respectively) values, although with moderate-to-large effect sizes. RPE increased similarly throughout the tests and was comparable at the ventilatory thresholds (p = 0.56). Despite the time main effect revealing an MIT-induced central and peripheral fatigue as indicated by the reduced VA and Tw, CHO mouth rinse was ineffective in attenuating both fatigues. Hence, rinsing the mouth with CHO was ineffective in reducing central fatigue, lowering RPE, and improving MIT performance expressed as PPO and time-to-exhaustion. However, moderate-to-large effect sizes in power output values at VT1 and VT2 may suggest some beneficial CHO mouth rinse effects on these MIT outcomes.

Music Alters Conscious Distance Monitoring without Changing Pacing and Performance during a Cycling Time Trial.

Athletes use their own perception to monitor distance and regulate their pace during exercise, avoiding premature fatigue before the endpoint. On the other hand, they may also listen to music while training and exercising. Given the potential role of music as a distractor, we verified if music influenced the athletes' ability to monitor the distance covered during a 20-km cycling time trial (TT20km). We hypothesized that music would elongate cyclists' perceived distance due to reduced attentional focus on exercise-derived signals, which would also change their ratings of perceived exertion (RPE). We also expected that the motivational role of music would also be beneficial in pacing and performance. After familiarization sessions, ten recreational cyclists performed an in-laboratory TT20km while either listening to music or not (control). They reported their RPE, associative thoughts to exercise (ATE), and motivation when they each perceived they had completed 2-km. Power output and heart rate (HR) were continuously recorded. Cyclists elongated their distance perception with music, increasing the distance covered for each perceived 2 km (p = 0.003). However, music reduced the error of conscious distance monitoring (p = 0.021), pushing the perceived distance towards the actual distance. Music increased the actual distance-RPE relationship (p = 0.004) and reduced ATE (p < 0.001). However, music affected neither performance assessed as mean power output (p = 0.564) and time (p = 0.524) nor psychophysiological responses such as HR (p = 0.066), RPE (p = 0.069), and motivation (p = 0.515). Cyclists elongated their distance perception during the TT20km and changed the actual distance-RPE relationship, which is likely due to a music-distractive effect. Although there was a reduced error of conscious distance monitoring, music affected neither pacing nor performance.

Ice Massage on the Calf Improves 4-km Running Time Trial Performance in a Normothermic Environment.

Purpose: Local cooling with ice massage is a practical and inexpensive technique to decrease perceptual stress and improve motor performance in hot environments. However, it is unknown whether local cooling with ice massage reduces perceptual responses to exercise and improves performance in a normothermic environment. Thus, we investigated whether ice massage on the calf muscles before a 4 km running time trial (TT4km) reduced the ratings of perceived exertion (RPE) and perceived muscle pain, thereby improving exercise performance in a normothermic environment. Methods: After familiarizations, fourteen recreationally endurance-trained men (age = 21.3 ± 1.2 years; body weight = 67.5 ± 9.2 kg; height = 173.0 ± 5.0 cm) underwent two TT4km on a 400 m track in normothermic conditions with or without ice massage before the trial. The time of running, RPE, and pain perception were recorded every 400 m throughout the TT4km. Results: The local cooling with ice massage increased the mean speed (~ 5.2%, p = 0.03) and decreased the time to complete the TT4km (~ 5.5%, p = 0.03). Accordingly, ice massage also reduced the exercise-derived pain perception (p = 0.028), although no effect has been found in the RPE during the TT4km (p = 0.32). Conclusion: Together, these results showed that local cooling with ice massage before the exercise reduced the exercise-derived pain perception, enabling runners to increase the speed for a comparable RPE during exercise, thereby improving the TT4km performance in a normothermic environment.

A Narrative Review of Current Concerns and Future Perspectives of the Carbohydrate Mouth Rinse Effects on Exercise Performance.

Previous systematic reviews have confirmed that carbohydrate (CHO) mouth rinse may boost physical exercise performance, despite some methodological aspects likely affecting its ergogenic effect. In this review, we discussed if the exercise mode, pre-exercise fasting status, CHO solutions concentration, CHO solutions temperature, mouth rinse duration, and CHO placebo effects may potentially reduce the CHO mouth rinse ergogenic effect, suggesting possible solutions to manage these potential confounders. The effectiveness of CHO mouth rinse as a performance booster is apparently related to the origin of the exercise-induced neuromuscular fatigue, as CHO mouth rinse unequivocally potentiates endurance rather than sprint and strength exercises performance. Furthermore, ergogenic effects have been greater in fasting than fed state, somehow explaining the varied magnitude of the CHO mouth rinse effects in exercise performance. In this regard, the CHO solution concentration and temperature, as well as the mouth rinse duration, may have increased the variability observed in CHO mouth rinse effects in fasting and fed state. Finally, placebo effects have challenged the potential of the CHO mouth rinse as an ergogenic aid. Therefore, we suggest that future studies should consider methodological controls such as sample size and sample homogeneity, proper familiarization with experimental procedures, and the use of alternative placebo designs to provide unbiased evidence regarding the potential of the CHO mouth rinse as an ergogenic aid.

Effects of experimentally induced muscle pain on endurance performance: A proof-of-concept study assessing neurophysiological and perceptual responses.

Pain arising from exercise potentiates fatigue and impairs the performance of endurance exercise. We assessed neurophysiological and perceptual responses to endurance exercise performed under experimentally induced muscle pain by a model that separates muscle pain from muscle fatigue. After a series of pilot studies investigating different hypertonic saline volumes, 17 healthy males performed a preliminary VO2PEAK test before performing a familiarization of the cycling time-to-exhaustion exercise (80% of the peak power output in the VO2PEAK test). Participants, performed a baseline exercise session before the sessions with hypertonic and isotonic saline injections in the vastus lateralis of both legs, in a crossover and counterbalanced design. Neurophysiological and perceptual responses such as electroencephalography (EEG) in frontal, prefrontal, parietal, and motor cortex, electromyography (EMG) of the vastus lateralis and biceps femoris muscles, ratings of perceived exertion (RPE), pain sensation, and affective valence were measured at rest and during exercise. The hypertonic injection reduced the resting EEG alpha-beta ratio in the frontal and prefrontal cortex. When compared to exercise performed after the isotonic injection (430.5 ± 152.6 s), hypertonic injection shortened the time-to-exhaustion (357.5 ± 173.0 s), reduced the EMG of the assessed muscles, and increased the muscle co-contraction during exercise. The hypertonic injection also reduced the EEG alpha-beta ratio in the prefrontal and parietal cortex, increased RPE and pain sensation, and reduced affective valence during exercise. This proof-of-concept study showed that hypertonic injection-induced muscle pain reduced endurance performance, promoting centrally mediated alterations in motor command and cortical activation, as well as an interplay of perceptual responses.

Proof-of-Concept and Test-Retest Reliability Study of Psychological and Physiological Variables of the Mental Fatigue Paradigm.

This study provided a proof-of-concept and test-retest reliability of measures frequently used to assess a mental fatigue paradigm. After familiarization, 28 healthy men performed (40-min) the Rapid Visual Information Processing (RVP) test in a test-retest design, having mental fatigue sensation, motivation, emotional arousal, total mood disturbance, and electroencephalography (EEG) in the prefrontal cortex measured before and after the test. EEG was recorded during a 3-min rest so that the power spectral density of theta (3-7 Hz) and alpha (8-13 Hz) bands was calculated. Pre-to-post RVP test changes in psychological and physiological domains were compared (paired-T tests), and absolute (standard error of measurement (SEM) and minimal difference (MD)) and relative reliability (intraclass correlation coefficient (ICC)) were calculated. The RVP test induced an increase (p < 0.05) in mental fatigue sensation (120.9% (109.4; 132.4)) and total mood disturbance (3.5% (-6.3; 13.3)), and a decrease in motivation (-7.1% (-9.2; -5.1)) and emotional arousal (-16.2% (-19.1; -13.2)). Likewise, EEG theta (59.1% (33.2; 85.0); p < 0.05), but not alpha band, increased due to RVP test. All psychophysiological responses showed poor-to-moderate relative reliability. Changes in mental fatigue sensation and motivation were higher than SEM and MD, but changes in EEG theta band were higher only than SEM. Mental fatigue sensation, motivation, and EEG theta band were sensitive to distinguish a mental fatigue paradigm despite true mental fatigue effects on theta activity may be trivial.

Carbohydrate Mouth Rinse Mitigates Mental Fatigue Effects on Maximal Incremental Test Performance, but Not in Cortical Alterations.

Detrimental mental fatigue effects on exercise performance have been documented in constant workload and time trial exercises, but effects on a maximal incremental test (MIT) remain poorly investigated. Mental fatigue-reduced exercise performance is related to an increased effort sensation, likely due to a reduced prefrontal cortex (PFC) activation and inhibited spontaneous behavior. Interestingly, only a few studies verified if centrally active compounds may mitigate such effects. For example, carbohydrate (CHO) mouth rinse potentiates exercise performance and reduces effort sensation, likely through its effects on PFC activation. However, it is unknown if this centrally mediated effect of CHO mouth rinse may mitigate mental fatigue-reduced exercise performance. After a proof-of-principle study, showing a mental fatigue-reduced MIT performance, we observed that CHO mouth rinse mitigated MIT performance reductions in mentally fatigued cyclists, regardless of PFC alterations. When compared to placebo, mentally fatigued cyclists improved MIT performance by 2.24-2.33% when rinsing their mouth with CHO during MIT. However, PFC and motor cortex activation during MIT in both CHO and placebo mouth rinses were greater than in mental fatigue. Results showed that CHO mouth rinse mitigated the mental fatigue-reduced MIT performance, but challenged the role of CHO mouth rinse on PFC and motor cortex activation.

Caffeine Increased Muscle Endurance Performance Despite Reduced Cortical Activation and Unchanged Neuromuscular Efficiency and Corticomuscular Coherence.

The central and peripheral effects of caffeine remain debatable. We verified whether increases in endurance performance after caffeine ingestion occurred together with changes in primary motor cortex (MC) and prefrontal cortex (PFC) activation, neuromuscular efficiency (NME), and electroencephalography-electromyography coherence (EEG-EMG coherence). Twelve participants performed a time-to-task failure isometric contraction at 70% of the maximal voluntary contraction after ingesting 5 mg/kg of caffeine (CAF) or placebo (PLA), in a crossover and counterbalanced design. MC (Cz) and PFC (Fp1) EEG alpha wave and vastus lateralis (VL) muscle EMG were recorded throughout the exercise. EEG-EMG coherence was calculated through the magnitude squared coherence analysis in MC EEG gamma-wave (CI > 0.0058). Moreover, NME was obtained as the force-VL EMG ratio. When compared to PLA, CAF improved the time to task failure (p = 0.003, d = 0.75), but reduced activation in MC and PFC throughout the exercise (p = 0.027, d = 1.01 and p = 0.045, d = 0.95, respectively). Neither NME (p = 0.802, d = 0.34) nor EEG-EMG coherence (p = 0.628, d = 0.21) was different between CAF and PLA. The results suggest that CAF improved muscular performance through a modified central nervous system (CNS) response rather than through alterations in peripheral muscle or central-peripheral coupling.

Correction to: Effects of Carbohydrate Mouth Rinse on Cycling Time Trial Performance: A Systematic Review and Meta-Analysis.

Section 3.2, Fig. 2: The wording on the x-axis which previously read.

Caffeine improved cycling trial performance in mentally fatigued cyclists, regardless of alterations in prefrontal cortex activation.

PURPOSE: To verify whether caffeine (CAF) could increase the prefrontal cortex (PFC) activation and improve 20 km cycling time trial (TT20km) performance in mentally fatigued cyclists. METHODS: After preliminary TT20km, twelve recreational cyclists (VO2MAX of 58.9 ±â€¯6.2 mL kg min-1) performed a familiarization with a cognitive test to induce mental fatigue (MF) and psychological scales. Thereafter, they performed: 2) a baseline TT20km; 3) a mentally fatigued TT20km (MF); 4 and 5) a mentally fatigued TT20km after CAF (MF + CAF) or placebo (MF + PLA) ingestion, in a double-blind, counterbalanced design. Performance and psychological responses were obtained throughout the TT20km, while PFC electroencephalography (EEG) theta wave was obtained before and after the mental fatigue test. RESULTS: The mental fatigue-induced increase in EEG theta wave (↑ ~ 4.8%) was reverted with CAF (↓ 8.8%) and PLA ingestion (↓ 4.8%). CAF improved TT20km performance in mentally fatigued cyclists by reducing time (p = .00; ↓ ~ 1.7%) and increasing WMEAN (p = .00; ↑ ~ 3.6%), when compared to MF + PLA. The RPE-power output ratio was lower (p = .01), but affect (p = .018), motivation (p = .033) and emotional arousal (p = .001) were greater throughout the TT20km in MF + CAF than in MF + PLA. CONCLUSIONS: CAF ingestion improved TT20km performance and psychological responses in mentally fatigued cyclists, despite the unaltered PFC activation.

Effects of Carbohydrate Mouth Rinse on Cycling Time Trial Performance: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite the growing number of studies reporting carbohydrate mouth rinse effects on endurance performance, no systematic and meta-analysis review has been conducted to elucidate the level of evidence of carbohydrate mouth rinse effects on cycling trial performance such as time-, work-, and distance-based trials. OBJECTIVES: The objective of this study were to establish the effect of a carbohydrate mouth rinse on cycling performance outcomes such as mean power output and time to complete a trial, together with the risk of bias in the cycling-carbohydrate mouth rinse literature. METHODS: We systematically reviewed randomized placebo-controlled trials that assessed carbohydrate mouth rinse effects on mean power output and time to complete the trial. A random-effects meta-analysis assessed the standardized mean difference between carbohydrate and placebo mouth rinses. RESULTS: Thirteen studies (16 trials) were qualitatively (systematic review) and quantitatively (meta-analysis) analyzed with regard to mean power output (n = 175) and time to complete the trial (n = 151). Overall, the reviewed studies showed a low risk of bias and homogeneous results for mean power output (I2 = 0%) and time to complete the trial (I2 = 0%). When compared with placebo, the carbohydrate mouth rinse improved mean power output (standardized mean difference = 0.25; 95% confidence interval 0.04-0.46; p = 0.02), but not the time to complete the trial (standardized mean difference = - 0.13; 95% confidence interval - 0.36 to 0.10; p = 0.25). CONCLUSION: The present systematic and meta-analytic review supports the notion that a carbohydrate mouth rinse has the potential to increase mean power output in cycling trials, despite showing no superiority over placebo in improving time to complete the trials.

Prefrontal cortex asymmetry and psychological responses to exercise: A systematic review.

BACKGROUND: Studies have shown a relationship between prefrontal cortex (PFC) activation asymmetry and psychological responses to exercise, so that a higher rest activation in left rather than right PFC has been associated with positive psychological responses to exercise such as an improved affect, anxiety and multidimensional arousal states. PURPOSE: To review: 1) evidence that PFC activation asymmetry before exercise is associated with psychological responses to exercise; 2) protocols of PFC asymmetry determination. METHODS: A systematic review (SR) was performed on studies retrieved from the PubMed and Web of Science database up to 04-30-2019. Eligibility criteria were: 1) studies investigating participants submitted to aerobic exercises; 2) including cerebral activation measures through electroencephalography (EEG) before the exercise bout; 3) and psychological measures during or after the exercise bout; 4) original studies. RESULTS: A number of 1901 studies was retrieved from the databases and 1 study was manually inserted. Thereafter, 1858 studies were excluded during the screening stage so that 30 studies remained for the SR. After full reading, 22 studies were excluded and 8 studies composed the final SR. Methodological assessment revealed that 62.5% of the studies showed a low risk of bias, while 34.37% and 3.12% showed either an unclear or a high risk of bias, respectively. Protocols of PFC activation asymmetry used EEG at F3-F4-P3-P4 (3 studies), F3-F4 (2 studies), F3-F4-T3-T4 (1 study), F3-F4-F7-F8-T5-T6-P3-P4 (1 study) and Fp1-Fp2-Fz-F3-F4-F7-F8-Cz-C3-C4-T3-T4-T5-T6-Pz-P3-P4-Oz-O1-O2 (1 study) positions. Most studies (75%) found a higher left PFC activation associated with a greater affect (n = 2), energetic arousal (n = 2), lower anxiety (n = 2) as well as calmness and tired arousal, simultaneously (n = 1). CONCLUSIONS: Although the heterogeneity of PFC asymmetry protocols, reviewed studies showed a low risk of bias, suggesting that a higher left PFC activation is associated with a positive psychological response to exercise.

Carbohydrate Mouth Rinse Fails to Improve Four-Kilometer Cycling Time Trial Performance.

We investigated if a carbohydrate (CHO) mouth rinse may attenuate global fatigue and improve 4-km cycling time trial (TT4km) performance. After a preliminary session, cyclists (n = 9) performed a TT4km after a CHO or placebo (PLA) mouth rinse. Mean power output, time, and ratings of perceived exertion (RPE) were recorded throughout the TT4km. Twitch interpolation responses (%VA; voluntary activation and ∆Tw; delta peak twitch torque) were compared pre and post TT4km with traditional statistics and effect size (ES) analysis. Time-to-complete the 4 km and mean power output were comparable between CHO (386.4 ± 28.0 s) and PLA (385.4 ± 22.4 s). A lower central (p = 0.054) and peripheral (p = 0.02) fatigue in CHO than in PLA were suggested by an extremely-large ES in %VA (manipulation main effect: p = 0.052, d = 1.18; manipulation-by-time interaction effect: p = 0.08, d = 1.00) and an extremely, very-large ES in ∆Tw (manipulation main effect: p = 0.07, d = 0.97; time-by-manipulation interaction effect: p = 0.09, d = 0.89). The RPE increased slower in CHO than in PLA (p = 0.051; d = 0.7). The apparent reduction in global fatigue (central and peripheral) and RPESLOPE with only one CHO mouth rinse were not translated into improved TT4km performance. Further tests may be required to verify if these likely differences in global fatigue might represent an edge in the short-lasting cycling time trial performance.