Results from phase 1 of the MANIFEST clinical trial to evaluate the safety and tolerability of pelabresib in patients with myeloid malignancies.

Pelabresib (CPI-0610), a BET protein inhibitor, is in clinical development for hematologic malignancies, given its ability to target NF-κB gene expression. The MANIFEST phase 1 study assessed pelabresib in patients with acute leukemia, high-risk myelodysplastic (MDS) syndrome, or MDS/myeloproliferative neoplasms (MDS/MPNs) (NCT02158858). Forty-four patients received pelabresib orally once daily (QD) at various doses (24-400 mg capsule or 225-275 mg tablet) on cycles of 14 d on and 7 d off. The most frequent drug-related adverse events were nausea, decreased appetite, and fatigue. The maximum tolerated dose (MTD) was 225 mg tablet QD. One patient with chronic myelomonocytic leukemia (CMML) showed partial remission. In total, 25.8% of acute myeloid leukemia (AML) patients and 38.5% of high-risk MDS patients had stable disease. One AML patient and one CMML patient showed peripheral hematologic response. The favorable safety profile supports the ongoing pivotal study of pelabresib in patients with myelofibrosis using the recommended phase 2 dose of 125 mg tablet QD.CLINICAL TRIAL REGISTRATION: NCT02158858.

Flexibility and Strength Effects of Adapted Nordic Walking and Myofascial Exercises Practice in Breast Cancer Survivors and Analysis of Differences.

Breast cancer treatments can elicit negative kinesiological side effects concerning both the posture and functional status of breast cancer survivors. As our body is functionally organized in myofascial meridians, physical exercise practice should favor a whole-body approach rather than a local one. The aim of the study was to investigate and compare the effects of two whole-body disciplines, i.e., adapted Nordic Walking and myofascial exercise, on the flexibility and strength performances in BCS. One hundred and sixty breast cancer survivors were trained three times per week for 12 weeks through adapted Nordic Walking or myofascial exercise. Handgrip, sit and reach, back scratch, and single leg back bridge tests and body composition were assessed at the beginning and completion of the training period. Linear mixed models showed no significant changes in body composition, whereas flexibility (p < 0.001), strength (p < 0.001), and muscle quality index (p = 0.003) changed independently from the treatment. When data modification has been analyzed according to sub-sample membership, no significant differences have been observed. Age, radiation therapy, and chemotherapy seem to have independent effects on several investigated variables. Twelve weeks of adapted myofascial exercise and Nordic Walking led to significant changes in flexibility, strength, and muscle quality in breast cancer survivors, with no apparent superiority of one approach over the other.

In-Season Longitudinal Hydration/Body Cell Mass Ratio Changes in Elite Rugby Players.

BACKGROUND: Hydration status has a direct role in sports performance. Bioelectrical Impedance Vector Analysis (BIVA) and Urine Specific Gravity (USG) are commonly used to assess hydration. The study aims to identify the sensitivity and relationship between BIVA and USG in a field sports setting. METHODS: BIVA and USG measurements were conducted five times throughout one rugby season. 34 elite male rugby players (25.1 ± 4.4 years; 184.0 ± 7.8 cm; 99.9 ± 13.4 kg) were enrolled. Differences over time were tested using one-way repeated measures ANOVA, and Bonferroni's post-hoc test was applied in pairwise comparisons. Resistance-reactance graphs and Hotelling's T2 test were used to characterize the sample and to identify bioelectrical changes. A repeated measures correlation test was conducted for BIVA-USG associations. RESULTS: Two clear trends were seen: (1) from July to September, there was a vector shortening and an increase of the phase angle (p < 0.001); and (2) from December to April, there was a vector lengthening and a decrease of the phase angle (p < 0.001). USG reported neither changes nor correlation with BIVA longitudinally (p > 0.05). Vector variations indicated a body fluid gain (especially in the intracellular compartment) and a body cell mass increase during the preseason, suggesting a physical condition and performance improvement. During the last months of the season, the kinetic was the opposite (fluid loss and decreased body cell mass). CONCLUSIONS: Results suggested that BIVA is sensitive to physiological changes and a better option than USG for assessing hydration changes during a rugby sports season.

Psychopharmacology of eating disorders: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: The concurrent assessment of weight and affective psychopathology outcomes relevant to the psychopharmacology of major eating disorders (EDs), namely anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), warrants systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: PubMed, Scopus, and ClinicalTrials.gov were inquired from inception through August 31st, 2022, for RCTs documenting any psychopharmacological intervention for EDs diagnosed according to validated criteria and reporting weight and psychopathology changes. Adopted keywords were: "anorexia nervosa," "bulimia nervosa," "binge eating disorder," "antidepressant," "antipsychotic," and "mood stabilizer." No language restriction applied. RESULTS: 5122 records were identified, and 203 full-texts were reviewed. Sixty-two studies entered the qualitative synthesis (AN = 22, BN = 23, BED = 17), of which 22 entered the meta-analysis (AN = 9, BN = 10, BED = 3). Concerning BMI increase in AN, olanzapine outperformed placebo (Hedges'g = 0.283, 95%C·I. = 0.051-0.515, I2 = 0 %; p = .017), whereas fluoxetine failed (Hedges'g = 0.351, 95%C.I. = -0.248 to 0.95, I2 = 63.37 %; p = .251). Fluoxetine not significantly changed weight (Hedges'g = 0.147, 95%C.I. = -0.157-0.451, I2 = 0 %; p = .343), reducing binging (Hedges'g = 0.203, 95%C.I. = 0.007-0.399, I2 = 0 %; p = .042), and purging episodes (Hedges'g = 0.328, 95%C.I. = -0.061-0.717, I2 = 58.97 %; p = .099) in BN. Lisdexamfetamine reduced weight (Hedges'g = 0.259, 95%C.I. = 0.071-0.446, I2 = 0 %; p = .007) and binging (Hedges'g = 0.571, 95%C.I. = 0.282-0.860, I2 = 53.84 %; p < .001) in BED. LIMITATIONS: Small sample size, short duration, and lack of reliable operational definitions affect most of the included sponsored RCTs. CONCLUSIONS: The efficacy of different drugs varies across different EDs, warranting additional primary studies recording broad psychopathological and cardiometabolic outcomes besides weight, especially against established psychotherapy interventions.

Dual career experiences of elite coaches enrolled at university level.

The lifelong education of coaches is one of the priorities of the European Union. Therefore, the purpose of this study was to investigate Italian elite coaches' motivation to engage in a sport-related academic education, and its demands, barriers, support, and relocation issues in relation to their dual career (DC) path. Sixteen Italian elite coaches (e.g., certified fourth-level national team coaches, senior team coaches) enrolled in a specifically tailored Bachelor's degree in sports sciences at the University of Rome Foro Italico (Italy) volunteered for this study. A qualitative approach integrating inductive and deductive reasoning, and thematic analysis was applied to participants' responses to an open-ended item survey. Independently from relocation, student-coaches' DC perceptions resulted in 15 lower-order themes further organized in 5 high-er-order themes (e.g., Benefit, Challenge, Expectation, Organization, and Support), each related to the contexts (e.g., Personal, Academic, Sport), the DC dimension (e.g., micro, meso, macro, and policy), and the DC push (e.g., facilitating) /pull (e.g., hindering) factors. The elite coaches' insights emphasize the complexity of the coach lifelong education at university level, and provide valuable information for promoting European and National (e.g., Italian) DC recommendations for elite sportspersons through a cooperation between sport bodies and higher educational institutions.

Competition Between Desired Competitive Result, Tolerable Homeostatic Disturbance, and Psychophysiological Interpretation Determines Pacing Strategy.

Scientific interest in pacing goes back >100 years. Contemporary interest, both as a feature of athletic competition and as a window into understanding fatigue, goes back >30 years. Pacing represents the pattern of energy use designed to produce a competitive result while managing fatigue of different origins. Pacing has been studied both against the clock and during head-to-head competition. Several models have been used to explain pacing, including the teleoanticipation model, the central governor model, the anticipatory-feedback-rating of perceived exertion model, the concept of a learned template, the affordance concept, the integrative governor theory, and as an explanation for "falling behind." Early studies, mostly using time-trial exercise, focused on the need to manage homeostatic disturbance. More recent studies, based on head-to-head competition, have focused on an improved understanding of how psychophysiology, beyond the gestalt concept of rating of perceived exertion, can be understood as a mediator of pacing and as an explanation for falling behind. More recent approaches to pacing have focused on the elements of decision making during sport and have expanded the role of psychophysiological responses including sensory-discriminatory, affective-motivational, and cognitive-evaluative dimensions. These approaches have expanded the understanding of variations in pacing, particularly during head-to-head competition.

Effectiveness of Different Modalities of Remote Online Training in Young Healthy Males.

Since 2020 there has been an increase in demand for home workouts. Therefore, different ways of delivering distance training have been proposed to promote "stay active at home." This study aimed to compare the effectiveness of three different training programs consisting of a total of 15 workouts (three sessions per week): supervised livestreaming (LS), unsupervised following a video recording (VR), and unsupervised following a written program (WP). Changes in anthropometric and cardiovascular variables, muscle fitness, and physical activity levels were evaluated. To provide a meaningful analysis for significant comparisons between small groups, mean differences (∆), 95% confidence interval (95% C.I.), and Cohen's effect sizes (E.S.) were also calculated. The three training modalities increased physical activity levels, with an adherence rate of LS = 93.3%, VR = 86%, and WP = 74%. Although there was no reduction in body weight, waist circumference decreased by 1.3 cm (95% C.I. = −2.1, −0.5; E.S. = 0.170; p < 0.004). Furthermore, where LS, VR, and WP resulted in improvements in muscle fitness, only LS showed changes in cardiovascular variables, such as resting heart rate (∆ = −7.3 bpm; 95% C.I. = −11.9, −2.7; E.S. = 1.296; p < 0.001) and Ruffier's index (∆ = −2.1bpm; 95% C.I. = −3.5, −0.8; E.S. 1.099; p < 0.001). Remote online training proved its effectiveness over a short period of time. However, supervised training proved to be the most effective, highlighting the importance of an experienced trainer.

The Effect of a Combined Exercise Program on Postural Control and Fine Motor Skills in Parkinson's Disease: Study Design.

Parkinson's disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim to evaluate the effect a of postural and fine motor skills training program in older adults with PD. PD individuals, with mild to moderate stage PD, aged between 65 to 80 years, will be voluntary selected from the Nursing Home Residences and Rehabilitation Centers. Subsequently, they will be randomly assigned to intervention group (PD) to receive a combined training program (postural control and fine motor skills exercises) or to the Control group (CON) to receive a stretching program. Before (PRE) and after (POST) a 12-week program both groups will perform wobble board (WB) and grooved pegboard (GPT) tests. Different performances between groups will be expected: (1) no significant differences between PD and CON group for WB and GPT test values before the beginning of the training intervention (PRE); (2) significantly better WB and GPT test values in PD subjects after the training intervention (POST) when compared to the base values (PRE); and (3) no significant differences in WB and GPT test values in CON subjects after the training intervention (POST) when compared to the base values (PRE). The findings of the present study protocol could be used for future studies investigating clinical populations, such as PD, and the effects of different rehabilitative interventions aiming to improve postural control and fine motor skills performances assessed by WB and GPT tests.

Effectiveness of muscle energy technique in patients with nonspecific low back pain: a systematic review with meta-analysis.

INTRODUCTION: Low back pain (LBP) is a major cause of physical disability in the world. The origin of this condition can be due to differents causes, with a specific cause or of unknown mechanical origin,being characterized as unspecific. In this case a physical therapy treatment approach with manual therapy is relevant, which includes the muscle energy technique (MET) classified as a common conservative treatment for pathologies of the spine, mainly in LBP and disability. This study assessed the effectiveness of the muscle energy technique on nonspecific low back pain. EVIDENCE ACQUISITION: Patients with acute, subacute or chronic non-specific low back pain. The primary outcomes were pain and disability. This study was designed by a systematic review and meta-analysis, registered in PROSPERO (CRD42020219295). For the report and methodological definitions of this study, the recommendations of the PRISMA protocol and the Cochrane collaboration, were followed, respectively. EVIDENCE SYNTHESIS: The search yielded 164 citations, which 19 were eligible randomised trials were included in the review (N.=609 patients with low back pain). The methodological quality of the studies averaged 4.2 points, with an interval of 2 to 7 points. Three RCTs showed satisfactory methodological quality (PEDro Score ≥6). For patients with chronic LBP, a significant result on pain (but with a small and clinically unimportant effect) in favor of MET versus other (MD=-0.51 [95% CI,-0.93 to -0.09] P=0.02, N.=376, studies=11, I2=80%). In patients with subacute LBP, MET enabled a significant and moderate effect to reduce pain intensity when compared to the control group (MD=-1.32 [95% CI,-2.57 to -0.06] P=0.04, N.=120, studies=3, I2=88%). No significant effects were observed for the disability. CONCLUSIONS: MET is not considered an efficient treatment to improve the incapacity of the lumbar spine, but it may be beneficial in reducing the intensity of LBP, although showing a small clinical effect in chronic LBP and a moderate effect in subacute LBP.

Efficacy and safety of a colostrum- and Aloe vera-based oral care protocol to prevent and treat severe oral mucositis in patients undergoing hematopoietic stem cell transplantation: a single-arm phase II study.

Oral mucositis is one of the worst effects of the conditioning regimens given to patients undergoing hematopoietic stem cell transplantation. It is characterized by dry mouth, erythema, mucosal soreness, ulcers, and pain, and it may impact patient outcomes. Bovine colostrum and Aloe vera contain a wide variety of biologically active compounds that promote mucosal healing. A non-randomized phase II study was designed to assess the safety and efficacy of a combined bovine colostrum and Aloe vera oral care protocol to prevent and to treat severe oral mucositis in transplant patients. Two commercially available products were given to patients in addition to the standard protocol: Remargin Colostrum OS® mouthwash and Remargin Colostrum Gastro-Gel® taken orally. Forty-six (78.0%) patients experienced oral mucositis, 40 (67.8%) developed mild-moderate forms, and 6 (10.2%) severe ones. Comparing the study group's outcomes with those of a homogeneous historical control group, severe oral mucositis decreased significantly (10.2% vs. 28.4%; P < 0.01), as did its duration (0.5 ± 1.9 vs. 1.5 ± 3.0 days; P < 0.01). Febrile neutropenia episodes (69.5% vs. 95.1%; P < 0.01) and duration (4.0 ± 4.7 vs. 6.2 ± 4.5 days; P < 0.01) also decreased. These findings show that the experimental protocol seems effective in preventing severe forms of oral mucositis. However, a randomized controlled trial is necessary to confirm this.

COVID-19 Lockdown: A Global Study Investigating the Effect of Athletes' Sport Classification and Sex on Training Practices.

PURPOSE: To investigate differences in athletes' knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification. METHODS: Athletes (12,526; 66% male; 142 countries) completed an online survey (May-July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed. RESULTS: During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%-49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%-28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%). CONCLUSIONS: Changes in athletes' training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.

Simple Approach to Defining Training Intensity in Endurance Runners.

Training intensity distribution is important to training program design. The zones 1 to 2 boundary can be defined by the Talk Test and the rating of perceived exertion. The zones 2 to 3 boundary can be defined by respiratory gas exchange, maximal lactate steady state, or, more simply, by critical speed (CS). The upper boundary of zone 3 is potential defined by the velocity at maximum oxygen uptake (vVO2max), although no clear strategy has emerged to categorize this intensity. This is not normally definable outside the laboratory. PURPOSE: This study predicts vVO2max from CS, determined from 1 (1.61 km) and 2 (3.22 km) citizen races in well-trained runners. METHODS: A heterogeneous group of well-trained runners (N = 22) performed 1- and 2-mile races and were studied during submaximal and maximal treadmill running to measure oxygen uptake, allowing computation of vVO2max. This vVO2max was compared with CS. RESULTS: vVO2max (4.82 [0.53] m·s-1) was strongly correlated with CS (4.37 [0.49] m·s-1; r = .84, standard error of estimate [SEE] = 0.132 m·s-1), 1-mile speed (5.09 [0.51] m·s-1; r = .84, SEE = 0.130 m·s-1), and 2-mile speed (4.68 [0.49] m·s-1; r = .86, SEE = 0.120 m·s-1). CONCLUSIONS: CS, calculated from 2 citizen races (or even training time trials), can be used to make reasonable estimates of vVO2max, which can be used in the design of running training programs.

Stem cell transplantation patients receiving a novel oral care protocol for oral mucositis prevention and treatment: patient-reported outcomes and quality of life.

BACKGROUND: Oral mucositis (OM) is one of the most debilitating effects of toxicity due to hematopoietic stem cell transplantation (HSCT) conditioning regimens. The aim of this secondary analysis of the data of a phase II study designed to assess the efficacy of a novel oral care protocol containing bovine colostrum and aloe vera to prevent oral mucositis was to compare outcomes reported by patients with those collected by healthcare professionals (HCPs). METHOD: Data on oral mucositis severity, duration, time of onset and related pain were collected from patients using the Oral Mucositis Daily Questionnaire (OMDQ). HCPs assessed the same outcomes using the World Health Organization oral mucositis scale and pain numerical rating scale. Quality of life was assessed with the 3-level EuroQol-5 dimensions. RESULTS: Fifty-nine autologous/allogeneic graft patients were recruited, 46 of whom (78.0%) experienced OM. Mean onset was 9.1 (SD ± 3.5) days after conditioning initiation, mean duration was 10.4 (SD ± 4.3) days, and the average maximum pain score was 3.7 (SD ± 2.7). Self-administration of the OMDQ detected oral symptoms at least 1 day sooner compared to objective assessments (p = 0.025). Significant differences were observed between the patient-reported and the HCP-assessment data on oral mucositis severity grading distribution (p < 0.0001) and highest pain score (p < 0.0001). Quality of life score variations were correlated with changes in oral mucositis severity during patients' hospital stay. CONCLUSIONS: Further studies are necessary to improve the understanding of these findings; a randomised controlled trial is being set up at our institution.

Home-Based Physical Activity as a Healthy Aging Booster before and during COVID-19 Outbreak.

The role of physical activity in improving overall aspects of health regardless of age is well documented. Due to the coronavirus disease 2019 outbreak, preventive measures to limit airborne infection have been introduced, with people, especially older adults, advised to stay at home, thus increasing sedentary lifestyle and the risk of chronic diseases. As one of the few possible ways to stay active is home-based training, this review aims to provide evidence on alternative and feasible home-based activity programs as a tool to improve the fitness level in older adults, especially when preventive measures are needed to ensure isolation and limit interpersonal contacts. During quarantine, older adults, especially those with chronic diseases, are recommended to regularly exercise. Combined balance and muscle-strengthening training has proven to be particularly useful in limiting falls and mobility limitations. In addition, the use of virtual reality systems seems to be a potential strategy in remaining physically active, reducing physical inactivity time and significantly increasing the compliance of the older adults with physical activity programs. In conclusion, home-based programs induce improvements in physical functions in general and quality of life in older people with or without co-morbidities, and it can be considered in the future as one of the feasible and economic ways to increase physical well-being. This may be of unique importance in the setting of coronavirus disease 2019 enforced limitations in out-of-home activity.

Evidence That Rating of Perceived Exertion Growth During Fatiguing Tasks is Scalar and Independent of Exercise Mode.

INTRODUCTION: The relationship between the percentage of a fatiguing ambulatory task completed and rating of perceived exertion (RPE) appears to be linear and scalar, with a relatively narrow "window." Recent evidence has suggested that a similar relationship may exist for muscularly demanding tasks. METHODS: To determine whether muscularly demanding tasks fit within this "ambulatory window," we tested resistance-trained athletes performing bench press and leg press with different loadings predicted to allow 5, 10, 20, and 30 repetitions and measured RPE (category ratio scale) at the end of the concentric action for each repetition. RESULTS: There was a regular, and strongly linear, pattern of growth of RPE for both bench press (r = .89) and leg press (r = .90) during the tasks that allowed 5.2 (1.2), 11.6 (1.9), 22.7 (2.0), and 30.8 (3.2) repetitions for bench press and 5.5 (1.5), 11.4 (1.6), 20.2 (3.0), and 32.4 (4.2) repetitions for leg press, respectively. CONCLUSIONS: The path of the RPE growth versus percentage task fit within the window evident for ambulatory tasks. The results suggest that the RPE versus percentage task completed relationship is scalar, relatively linear, and apparently independent of exercise mode.

Relationship Between External and Internal Load Measures in Youth Beach Handball.

PURPOSE: Assessing the relationship between external load (EL) and internal load (IL) in youth male beach handball players. METHODS: A total of 11 field players from the Lithuanian U17 beach handball team were monitored across 14 training sessions and 7 matches. The following EL variables were assessed by means of inertial movement units: PlayerLoad™, accelerations, decelerations, changes of direction, and jumps and total of inertial movements. IL was assessed objectively and subjectively using the summated heart rate zones and training load calculated via session rating of perceived exertion, respectively. Spearman correlations (ρ) were used to assess the relationship between EL and IL. The interindividual variability was investigated using linear mixed models with random intercepts with IL as dependent variable, PlayerLoad™ as the independent variable, and players as random effect. RESULTS: The lowest significant (P < .05) relationship was for high jumps with objective (ρ = .56) and subjective (ρ = .49) IL. The strongest relationship was for PlayerLoad™ with objective (ρ = .9) and subjective (ρ = .84) IL. From the linear mixed model, the estimated SD of the random intercepts was 19.78 arbitrary units (95% confidence interval, 11.75-33.31); SE = 5.26, and R2 = .47 for the objective IL and 6.03 arbitrary units (95% confidence interval, 0.00-7330.6); SE = 21.87; and R2 = .71 for the subjective IL. CONCLUSIONS: Objective and subjective IL measures can be used as a monitoring tool when EL monitoring is not possible. Coaches can predict IL based on a given EL by using the equations proposed in this study.

Training During the COVID-19 Lockdown: Knowledge, Beliefs, and Practices of 12,526 Athletes from 142 Countries and Six Continents.

OBJECTIVE: Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March-June 2020). RESULTS: Overall, 85% of athletes wanted to "maintain training," and 79% disagreed with the statement that it is "okay to not train during lockdown," with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered "coaching by correspondence (remote coaching)" to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for "general fitness and health maintenance" during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification. CONCLUSIONS: COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to "maintain" training and the greatest opposition to "not training" during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered "coaching by correspondence" as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes' physical capacities and were also likely detrimental to athletes' mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).