Renal Function Recovery Strategies Following Marathon in Amateur Runners.

Long distance races have a physiological impact on runners. Up to now, studies analyzing these physiological repercussions have been mainly focused on muscle and cardiac damage, as well as on its recovery. Therefore, a limited number of studies have been done to explore acute kidney failure and recovery after performing extreme exercises. Here, we monitored renal function in 76 marathon finishers (14 females) from the day before participating in a marathon until 192 h after crossing the finish line (FL). Renal function was evaluated by measuring serum creatinine (sCr) and the glomerular filtration rate (GFR). We randomly grouped our cohort into three intervention groups to compare three different strategies for marathon recovery: total rest (REST), continuous running at their ventilatory threshold 1 (VT1) intensity (RUN), and elliptical workout at their VT1 intensity (ELLIPTICAL). Interventions in the RUN and ELLIPTICAL groups were performed at 48, 96, and 144 h after marathon running. Seven blood samples (at the day before the marathon, at the FL, and at 24, 48, 96, 144, and 192 h post-marathon) and three urine samples (at the day before the marathon, at the finish line, and at 48 h post-marathon) were collected per participant. Both heart rate monitors and triaxial accelerometers were used to control the intensity effort during both the marathon race and the recovery period. Contrary to our expectations, the use of elliptical machines for marathon recovery delays renal function recovery. Specifically, the ELLIPTICAL group showed a significantly lower ∆GFR compared to both the RUN group (p = 4.5 × 10-4) and the REST group (p = 0.003). Hence, we encourage runners to carry out an active recovery based on light-intensity continuous running from 48 h after finishing the marathon. In addition, full resting seems to be a better strategy than performing elliptical workouts.

Ultra Trail Performance is Differently Predicted by Endurance Variables in Men and Women.

The study aimed to assess the relationship between peak oxygen uptake, ventilatory thresholds and maximal fat oxidation with ultra trail male and female performance. 47 athletes (29 men and 18 women) completed a cardiopulmonary exercise test between 2 to 4 weeks before a 107-km ultra trail. Body composition was also analyzed using a bioelectrical impedance weight scale. Exploratory correlation analyses showed that peak oxygen uptake (men: r=-0.63, p=0.004; women: r=-0.85, p < 0.001), peak speed (men: r=-0.74, p < 0.001; women: r=-0.69, p=0.009), speed at first (men: r=-0.49, p=0.035; women: r=-0.76, p=0.003) and second (men: r=-0.73, p < 0.001; women: r=-0.76, p=0.003) ventilatory threshold, and maximal fat oxidation (men: r=-0.53, p=0.019; women: r=-0.59, p=0.033) were linked to race time in male and female athletes. Percentage of fat mass (men: r=0.58, p=0.010; women: r=0.62, p= 0.024) and lean body mass (men: r=-0.61, p=0.006; women: r=-0.61, p=0.026) were also associated with performance in both sexes. Subsequent multiple regression analyses revealed that peak speed and maximal fat oxidation together were able to predict 66% of male performance; while peak oxygen uptake was the only statistically significant variable explaining 69% of the variation in women's race time. These results, although exploratory in nature, suggest that ultra trail performance is differently predicted by endurance variables in men and women.

Muscle Cramping in the Marathon: Dehydration and Electrolyte Depletion vs. Muscle Damage.

ABSTRACT: Martínez-Navarro, I, Montoya-Vieco, A, Collado, E, Hernando, B, Panizo, N, and Hernando, C. Muscle Cramping in the marathon: Dehydration and electrolyte depletion vs. muscle damage. J Strength Cond Res 36(6): 1629-1635, 2022-Our aim was to compare dehydration variables, serum electrolytes, and muscle damage serum markers between runners who suffered exercise-associated muscle cramps (EAMC) and runners who did not suffer EAMC in a road marathon. We were also interested in analyzing race pacing and training background. Nighty-eight marathoners took part in the study. Subjects were subjected to a cardiopulmonary exercise test. Before and after the race, blood and urine samples were collected and body mass (BM) was measured. Immediately after the race EAMC were diagnosed. Eighty-eight runners finished the marathon, and 20 of them developed EAMC (24%) during or immediately after the race. Body mass change, post-race urine specific gravity, and serum sodium and potassium concentrations were not different between crampers and noncrampers. Conversely, runners who suffered EAMC exhibited significantly greater post-race creatine kinase (464.17 ± 220.47 vs. 383.04 ± 253.41 UI/L, p = 0.034) and lactate dehydrogenase (LDH) (362.27 ± 72.10 vs. 307.87 ± 52.42 UI/L, p = 0.002). Twenty-four hours post-race also values of both biomarkers were higher among crampers (CK: 2,438.59 ± 2,625.24 vs. 1,166.66 ± 910.71 UI/L, p = 0.014; LDH: 277.05 ± 89.74 vs. 227.07 ± 37.15 UI/L, p = 0.021). The difference in the percentage of runners who included strength conditioning in their race training approached statistical significance (EAMC: 25%, non-EAMC: 47.6%; p = 0.074). Eventually, relative speed between crampers and noncrampers only differed from the 25th km onward (p < 0.05). Therefore, runners who suffered EAMC did not exhibit a greater degree of dehydration and electrolyte depletion after the marathon but displayed significantly higher concentrations of muscle damage biomarkers.

Pacing and Body Weight Changes During a Mountain Ultramarathon: Sex Differences and Performance.

The study was aimed at comparing pacing adopted by males and females in a 107-km mountain ultramarathon and assessing whether pacing-related variables were associated with intracompetition body weight changes and performance. Forty-seven athletes (29 males; 18 females) were submitted to a cardiopulmonary exercise test before the race. Athletes were also weighted before the start of the race, at three midpoints (33 km, 66 km and 84 km) and after the race. Pacing was analyzed using absolute and relative speeds and accelerometry-derived sedentary time spent during the race. Results showed that females spent less sedentary time (4.72 ± 2.91 vs. 2.62 ± 2.14%; p = 0.035; d = 0.83) and displayed a smaller body weight loss (3.01 ± 1.96 vs. 4.37 ± 1.77%; p = 0.048; d = 0.77) than males. No significant sex differences were revealed for speed variability, absolute and relative speed. In addition, finishing time was correlated with: speed variability (r = 0.45; p = 0.010), index of pacing (r = -0.63; p < 0.001) and sedentary time (r = 0.64; p < 0.001). Meanwhile, intracompetition body weight changes were related with both the absolute and relative speed in the first and the last race section. These results suggest that females, as compared with males, take advantage of shorter time breaks at aid stations. Moreover, performing a more even pacing pattern may be positively associated with performance in mountain ultramarathons. Finally, intracompetition body weight changes in those races should be considered in conjunction with running speed fluctuations.

Influence of Female Sex Hormones on Ultra-Running Performance and Post-Race Recovery: Role of Testosterone.

In recent years, increasing numbers of women have participated in extremely long races. In adult males, there is a clear association between physiological levels of endogenous sex hormones and physical performance. However, the influence of plasmatic sex hormones and the effects of different types of hormonal contraception (HC) on the modulation of physical performance in adult females remain to be fully clarified. Eighteen female ultra-endurance athletes were recruited to participate in the study. Different variables were studied, including hematological parameters, body mass index, and body composition. Strength measurements were obtained using the squat-jump and hand-grip test. A repeated-measures analysis demonstrated significant differences in hematological values of CK and LDH pre-race as compared to immediately post-race and after 24/48 h. Furthermore, statistical differences were found in squat-jump and hand-grip test results after the ultramarathon. Testosterone, estradiol, and the testosterone/estrogen ratio were significantly correlated with muscle fatigue and were found to be indirect markers of muscle damage. A multivariate analysis demonstrated the protective role of testosterone against muscle damage and severe fatigue. Fluctuations in endogenous testosterone levels were correlated with greater fatigability and muscle damage after the competition. Adjusting the menstrual cycle with HC would not provide any further benefit to the athlete's competitive capacity.

Impact of Plasma Oxidative Stress Markers on Post-race Recovery in Ultramarathon Runners: A Sex and Age Perspective Overview.

Oxidative stress has been widely studied in association to ultra-endurance sports. Although it is clearly demonstrated the increase in reactive oxygen species and free radicals after these extreme endurance exercises, the effects on the antioxidant defenses and the oxidative damage to macromolecules, remain to be fully clarified. Therefore, the aim of this study was to elucidate the impact of an ultramarathon race on the plasma markers of oxidative stress of 32 runners and their post-race recovery, with especial focused on sex and age effect. For this purpose, the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GR) activity, as well as the lipid peroxidation product malondialdehyde (MDA) and the carbonyl groups (CG) content were measured before the race, in the finish line and 24 and 48 h after the race. We have reported an increase of the oxidative damage to lipids and proteins (MDA and CG) after the race and 48 h later. Moreover, there was an increase of the GR activity after the race. No changes were observed in runners' plasma GPx activity throughout the study. Finally, we have observed sex and age differences regarding damage to macromolecules, but no differences were found regarding the antioxidant enzymes measured. Our results suggest that several basal plasma markers of oxidative stress might be related to the extent of muscle damage after an ultraendurance race and also might affect the muscle strength evolution.

Inflammation, muscle damage and postrace physical activity following a mountain ultramarathon.

BACKGROUND: The study aimed at exploring whether muscle membrane disruption, as a surrogate for muscle damage, and inflammation recovery following a mountain ultramarathon (MUM) was related with race performance and postrace physical activity. METHODS: Blood samples were obtained from thirty-four athletes (29 men and 5 women) before a 118-km MUM, immediately after and three- and seven-days postrace. Creatine kinase (CK), lactate dehydrogenase (LDH) and C-reactive protein (CRP) were compared between faster (FR) and slower (SR) runners. Physical activity performed during the week following the MUM was objectively analyzed using accelerometers and compared between FR and SR. RESULTS: CK was significantly higher in FR at 3 days postrace (P<0.012, d=1.17) and LDH was significantly higher in FR at 3- and 7-days postrace (P=0.005, d=1.01; P<0.015, d=1.05 respectively), as compared to SR. No significant differences were identified in postrace physical activity levels between FR and SR. Significant relationships were found between race time and CK and LDH concentrations at 3 days postrace (rs=-0.41, P=0.017; rs=-0.52, P=0.002 respectively) and 7 days postrace (rs=-0.36, P=0.039; rs=-0.46. P=0.007 respectively). However, postrace physical activity was not associated with muscle damage and inflammation recovery, except for light intensity and CRP at 3 days postrace (rs=-0.40, P=0.025). CONCLUSIONS: Race time appeared to have a higher influence on muscle damage recovery than the intensity of physical activities performed in the week after running a MUM. Inflammatory activity takes longer to normalize than muscle damage following a MUM, it is not related with race time and lightly related with postrace physical activity.

Effects of wearing a full body compression garment during recovery from an ultra-trail race.

In sport disciplines with high levels of muscle damage such as an ultra-trail competition, full body compression garments (FBCG) may have an ergogenic effect during the recovery process. The aim of the study was to assess the influence of FBCG worn for 24 h immediately after a 107-km ultra-trail on delayed onset muscle soreness (DOMS), muscle damage, inflammatory and renal response. Thirty-two athletes (19 males and 13 females; VO2peak: 54.1 ± 5.2 ml O2/kg/min) participated in the study. The following blood markers were analysed before, immediately after, at 24 and 48 h post-race: lactate dehydrogenase, creatine kinase, C-reactive protein and creatinine. The glomerular filtration rate was also calculated. Delayed onset muscle soreness was evaluated before, immediately after and at 24 h post-race. On arrival at the finishing line, athletes were randomised into one of two recovery groups (FBCG and control group). The results showed that wearing FBCG did not influence the evolution of any of the blood markers up to 48 h after the race (p > .05). However, FBCG group presented a lower increase in posterior leg DOMS (11.0 ± 46.2% vs 112.3 ± 170.4%, p = .03, d = 0.8). Therefore, although FBCG is not useful for reducing muscle damage and inflammatory response after an ultra-trail race, its use may still be recommended as a recovery method to reduce muscle soreness.Trial registration: ClinicalTrials.gov identifier: NCT03990259.

Recovery of Inflammation, Cardiac, and Muscle Damage Biomarkers After Running a Marathon.

ABSTRACT: Bernat-Adell, MD, Collado-Boira, EJ, Moles-Julio, P, Panizo-González, N, Martínez-Navarro, I, Hernando-Fuster, B, and Hernando-Domingo, C. Recovery of inflammation, cardiac and muscle damage biomarkers after running a marathon. J Strength Cond Res 35(3): 626-632, 2021-Physical endurance sports conditions the increase of blood biomarkers responsible for the acute inflammatory response. The purpose of this study was to observe the impact of intense physical exercise on these biomarkers and detect their recovery pattern. This is an experimental study of repeated measures (pre-post marathon). The biomarkers lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity troponin T (hs-TNT), and C-reactive protein (CRP) were analyzed in a total of 86 runners, 24 hours before the marathon, immediately after finishing the race and at 24, 48, 96, and 144 postrace hours. The comparative analyses were performed using the Friedman and Wilcoxon tests. The correlations between dependent and independent variables were analyzed using Spearman correlations. The data were processed through the IBM SPSS package, version 23. Significant value was p ≤ 0.05. The LDH increased and showed significant differences (p ≤ 0.001) for all times, compared with the initial LDH value, normalizing after 192 hours (p = 0.667) (effect size [ES], r = 0.807). The CK increased and showed significant differences (p ≤ 0.001) (ES, r = 0.975) up to 96 hours afterward, normalizing after 144 hours. The hs-TNT presented an increase and showed significant differences (p ≤ 0.001) between the pre-post race times, 24 and 48 hours, normalizing after 96 hours, although it showed a new significant value at 192 hours (p ≤ 0.001) (ES, r = 0.519). The CRP increased and showed significant differences (p ≤ 0.001) between the pre-post race times, at 24, 48, 96, 144, and 192 hours after race. The recovery after alterations produced by the marathon varies according to the biomarker. Blood levels of biomarkers decrease with longer race times. Greater energy expenditure increases the blood levels of LDH, CK, and hs-TNT.

Pulmonary and Inspiratory Muscle Function Response to a Mountain Ultramarathon.

The study aimed to provide within-race data on the time course of pulmonary function during a mountain ultramarathon (MUM). Additionally, we wanted to assess possible sex differences regarding pre- to post-race change in pulmonary and inspiratory muscle function. Lastly, we were interested in evaluating whether changes in respiratory function were associated with relative running speed and due to general or specific fatigue. 47 athletes (29 males and 18 females; 41 ± 5 years) were submitted to a cardiopulmonary exercise test (CPET) before a 107-km MUM. Spirometric variables: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF); maximal inspiratory pressure (MIP); squat jump (SJ) and handgrip strength (HG) were assessed before and after the race. Additionally PEF was measured at three aid stations (33rd, 66th and 84th km) during the race. PEF declined from the 33rd to the 66th km (p = 0.004; d = 0.72) and from the 84th km to the finish line (p = 0.003; d = 0.90), while relative running speed dropped from the first (0-33 km) to the second (33-66 km) race section (p < 0.001; d = 1.81) and from the third (66-84 km) to the last race section (p < 0.001; d = 1.61). Post-race, a moderate reduction was noted in FVC (-13%; p < 0.001; d = 0.52), FEV1 (-19.5%; p < 0.001; d = 0.65), FEV1/FVC (-8.4%; p = 0.030; d = 0.59), PEF (-20.3%; p < 0.001; d = 0.58), MIP (-25.3%; p < 0.001; d = 0.79) and SJ (-31.6%; p < 0.001; d = 1.42). Conversely, HG did not change from pre- to post-race (-1.4%; p = 0.56; d = 0.05). PEF declined during the race in parallel with running speed drop. No sex differences were noted regarding post-race respiratory function, except that FEV1/FVC decay was significantly greater among women. The magnitude of pre- to post-race respiratory function decline was uncorrelated with relative running speed.

120 min/week of neuromotor multicomponent training are enough to improve executive function and functional fitness in older women.

PURPOSE: The study aimed at comparing the effects of a neuromotor multicomponent training program (MCTP) on executive function, functional fitness, blood pressure, body composition and health-related quality of life (HRQOL), compared with a concurrent strength and endurance exercise training program (CONTROL-EXE) and a cognitive training program (CONTROL-COG). METHODS: 56 older women (73 ± 6 years) completed the 30-weeks intervention. The three groups attended two 60-min sessions per week and they were assessed before and after the intervention. RESULTS: MCTP showed a moderate improvement in Stroop C condition (28 ± 7 vs 32 ± 8 correct items; p = 0.001; d = 0.53) and Stroop interference score (-7.4 ± 7.3 vs -3.7 ± 6.1; p = 0.035; d = 0.55), while no changes were observed among control groups. MCTP showed a small to moderate improvement in Timed Up and Go test (TUGT) (5.85 ± 0.58 vs 5.46 ± 0.56 s; p < 0.001; d = 0.71) and Chair-Stand test (CST) (18 ± 4 vs 19 ± 4 repetitions; p < 0.001; d = 0.47); while CONTROL-EXE only improved moderately at TUGT (7.02 ± 1.1 vs 6.44 ± 0.91 s; p = 0.005; d = 0.59) and CONTROL-COG showed a moderate to small worsening in TUGT, CST and handgrip strength. Additionally, MCTP enhanced body composition and HRQOL. Lastly, both exercise groups showed lowered blood pressure values. CONCLUSIONS: Our results suggest that a neuromotor MCTP could be considered as a highly suitable training to enhance executive function, functional fitness, HRQOL and body composition in older women.

Inspiratory and Lower-Limb Strength Importance in Mountain Ultramarathon Running. Sex Differences and Relationship with Performance.

The study was aimed at comparing lower-limb strength and respiratory parameters between male and female athletes and their interaction with performance in a 107 km mountain ultramarathon. Forty seven runners (29 males and 18 females; mean ± SD age: 41 ± 5 years) were enrolled. Lower-limb strength assessment comprised a squat jump test, an ankle rebound test, and an isometric strength test. Respiratory assessment included pulmonary function testing and the measurement of maximal inspiratory pressure. Male athletes performed largely better in the squat jump (26 ± 4 vs. 21 ± 3 cm; p < 0.001; d = 1.48), while no sex differences were found in the other two lower-limb tests. Concerning the respiratory parameters, male athletes showed largely greater values in pulmonary expiratory variables: forced vital capacity (5.19 ± 0.68 vs. 3.65 ± 0.52 L; p < 0.001; d = 2.53), forced expiratory volume in 1 s (4.24 ± 0.54 vs. 2.97 ± 0.39 L; p < 0.001; d = 2.69), peak expiratory flow (9.9 ± 1.56 vs. 5.89 ± 1.39 L/min; p < 0.001; d = 2.77) and maximum voluntary ventilation in 12 s (171 ± 39 vs. 108 ± 23 L/min; p < 0.001; d = 1.93); while no sex differences were identified in maximal inspiratory pressure. Race time was associated with ankle rebound test performance (r = -0.390; p = 0.027), isometric strength test performance (r = -0.349; p = 0.049) and maximal inspiratory pressure (r = -0.544; p < 0.001). Consequently, it seems that athletes competing in mountain ultramarathons may benefit from improving lower-limb isometric strength, ankle reactive strength and inspiratory muscle strength. Nevertheless, further interventional studies are required to confirm these exploratory results. In addition, the fact that the magnitude of the sex difference for isometric strength was minor, as compared with the other strength tests, could represent one of the factors explaining why the performance gap between males and females is reduced in ultramarathons.

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue.

The study aimed at assessing the acute physiological effects of running a 65-km vs a 107-km mountain ultramarathon. Nineteen athletes (15 males and 4 females) from the shorter race and forty three athletes (26 males and 17 females) from the longer race were enrolled. Body weight, respiratory and lower limb strength were assessed before and after the race. Blood samples were obtained before, after and 24-h post-race. Body weight loss did not differ between races. A decrease in squat jump height (p<0.01; d = 1.4), forced vital capacity (p<0.01; d = 0.5), forced expiratory volume in 1 s (p<0.01; d = 0.6), peak inspiratory flow (p<0.01; d = 0.6) and maximal inspiratory pressure (p<0.01; d = 0.8) was observed after the longer race; while, after the shorter race only maximal inspiratory pressure declined (p<0.01; d = 0.5). Greater post-race concentrations of creatine kinase (p<0.01; d = 0.9) and C-reactive protein (p<0.01; d = 2.3) were observed following the longer race, while high-sensitivity cardiac troponin was higher after the shorter race (p<0.01; d = 0.3). Sodium decreased post-competition only after the shorter race (p = 0.02; d = 0.6), while creatinine increased only following the longer race (p<0.01; d = 1.5). In both groups, glomerular filtration rate declined at post-race (longer race: p<0.01, d = 2.1; shorter race: p = 0.01, d = 1.4) and returned to baseline values at 24 h post-race. In summary, expiratory and lower-limb fatigue, and muscle damage and inflammatory response were greater following the longer race; while a higher release of cardiac troponins was observed after the shorter race. The alteration and restoration of renal function was similar after either race.

The effect of long-term ultra-endurance exercise and SOD2 genotype on telomere shortening with age.

Telomere shortening, a well-known biomarker of aging, is a complex process influenced by several intrinsic and lifestyle factors. Although habitual exercise may promote telomere length maintenance, extreme endurance exercise has been also associated with increased oxidative stress-presumed to be the major cause of telomere shortening. Therefore, the pace of telomere shortening with age may also depend on antioxidant system efficiency, which is, in part, genetically determined. In this study, we aimed to evaluate the impact of ultra-endurance exercise and oxidative stress susceptibility (determined by the rs4880 polymorphism in the superoxide dismutase 2 (SOD2) gene) on telomere length. Genomic DNA was obtained from 53 sedentary individuals (34 females, 19-67 yr) and 96 ultra-trail runners (31 females, 23-58 yr). Indeed, blood samples before and after finishing a 107-km-trail race were collected from 69 runners to measure c-reactive protein (CRP) levels and, thus, analyze whether acute inflammation response is modulated by the SOD2 rs4880 polymorphism. Our results revealed that telomere length was better preserved in ultra-trail runners compared with controls, especially in elderly runners who have been regularly training for many years. Carrying the SOD2 rs4880*A allele was significantly associated with having shorter telomeres, as well as with having increased CRP levels after the ultra-trail race. In conclusion, habitual ultra-endurance exercise had a beneficial effect on telomere length maintenance, especially at older ages. This study also suggested that the SOD2 rs4880 polymorphism may also have an impact on acute and chronic oxidative-related damage (inflammatory response and telomere length) after an ultra-trail race.NEW & NOTEWORTHY Habitual ultra-endurance exercise seems to promote telomere length maintenance, especially at older ages. In addition, the beneficial effect of ultra-endurance training on biological aging is higher in ultra-trail runners who have been engaged to ultra-endurance training during many years. Finally, and for the first time, this study shows that the SOD2 rs4880 polymorphism has a significant impact on telomere length, as well as on acute inflammatory response to a 107-km trail race.

Using Accelerometry for Evaluating Energy Consumption and Running Intensity Distribution Throughout a Marathon According to Sex.

The proportion of females participating in long-distance races has been increasing in the last years. Although it is well-known that there are differences in how females and males face a marathon, higher research may be done to fully understand the intrinsic and extrinsic factors affecting sex differences in endurance performance. In this work, we used triaxial accelerometer devices to monitor 74 males and 14 females, aged 30 to 45 years, who finished the Valencia Marathon in 2016. Moreover, marathon split times were provided by organizers. Several physiological traits and training habits were collected from each participant. Then, we evaluated several accelerometry- and pace-estimated parameters (pacing, average change of speed, energy consumption, oxygen uptake, running intensity distribution and running economy) in female and male amateur runners. In general, our results showed that females maintained a more stable pacing and ran at less demanding intensity throughout the marathon, limiting the decay of running pace in the last part of the race. In fact, females ran at 4.5% faster pace than males in the last kilometers. Besides, their running economy was higher than males (consumed nearly 19% less relative energy per distance) in the last section of the marathon. Our results may reflect well-known sex differences in physiology (i.e., muscle strength, fat metabolism, VO2max), and in running strategy approach (i.e., females run at a more conservative intensity level in the first part of the marathon compared to males). The use of accelerometer devices allows coaches and scientific community to constantly monitor a runner throughout the marathon, as well as during training sessions.

Immediate and 24-h post-marathon cardiac troponin T is associated with relative exercise intensity.

PURPOSE: We aimed at exploring whether cardiopulmonary fitness, echocardiographic measures and relative exercise intensity were associated with high-sensitivity cardiac troponin T (hs-TNT) rise and normalization following a marathon. METHODS: Nighty-eight participants (83 men, 15 women; 38.72 ± 3.63 years) were subjected to echocardiographic assessment and a cardiopulmonary exercise test (CPET) before the race. hs-TNT was measured before, immediately after and at 24, 48, 96, 144 and 192 h post-race. Speed and mean heart rate (HR) during the race were relativized to CPET values: peak speed (%VVMAX), peak HR (HR%MAX), speed and HR at the second ventilatory threshold (HR%VT2 and %VVT2). RESULTS: Hs-TNT increased from pre- to post-race (5.74 ± 5.29 vs. 50.4 ± 57.04 ng/L; p < 0.001), seeing values above the Upper Reference Limit (URL) in 95% of the participants. At 24 h post-race, 39% of the runners still exceeded the URL (High hs-TNT group). hs-TNT rise was correlated with marathon speed %VVT2 (r = 0.22; p = 0.042), mean HR%VT2 (r = 0.30; p = 0.007), and mean HR%MAX (r = 0.32; p = 0.004). Moreover, the High hs-TNT group performed the marathon at a higher Speed %VVT2 (88.21 ± 6.53 vs. 83.49 ± 6.54%; p = 0.002) and Speed %VVMAX (72 ± 4.25 vs. 69.40 ± 5.53%; p = 0.009). hs-TNT showed no significant associations with cardiopulmonary fitness and echocardiographic measures, except for a slight correlation with left ventricular end systolic diameter (r = 0.26; p = 0.018). CONCLUSION: Post-race hs-TNT was above the URL in barely all runners. Magnitude of hs-TNT rise was correlated with exercise mean HR; whereas, its normalization kept relationship with marathon relative speed.

Estimation of energy consumed by middle-aged recreational marathoners during a marathon using accelerometry-based devices.

As long-distance races have substantially increased in popularity over the last few years, the improvement of training programs has become a matter of concern to runners, coaches and health professionals. Triaxial accelerometers have been proposed as a one of the most accurate tools to evaluate physical activity during free-living conditions. In this study, eighty-eight recreational marathon runners, aged 30-45 years, completed a marathon wearing a GENEActiv accelerometer on their non-dominant wrist. Energy consumed by each runner during the marathon was estimated based on both running speed and accelerometer output data, by applying the previously established GENEActiv cut-points for discriminating the six relative-intensity activity levels. Since accelerometry allowed to perform an individualized estimation of energy consumption, higher interpersonal differences in the number of calories consumed by a runner were observed after applying the accelerometry-based approach as compared to the speed-based method. Therefore, pacing analyses should include information of effort intensity distribution in order to adjust race pacing appropriately to achieve the marathon goal time. Several biomechanical and physiological parameters (maximum oxygen uptake, energy cost of running and running economy) were also inferred from accelerometer output data, which is of great value for coaches and doctors.

Cardiac Damage Biomarkers and Heart Rate Variability Following a 118-Km Mountain Race: Relationship with Performance and Recovery.

This study aimed to assess the release of cardiac damage biomarkers jointly with cardiac autonomic modulation after a mountain ultramarathon. Such knowledge and the possible relationship of these markers with race time is of primary interest to establish possible recommendations upon athletes' recovery and return to training following these competitions. Forty six athletes enrolled in the Penyagolosa Trails CSP115 race (118 km and a total positive elevation of 5439 m) took part in the study. N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive cardiac troponin T (hs-TNT) concentrations as well as linear and nonlinear heart rate variability (HRV) were evaluated before and after the race. NT-proBNP and hs-TNT significantly increased post-race; fifty percent of the finishers surpassed the Upper Reference Limit (URL) for hs-TNT while 87% exceeded the URL for NT-proBNP. Overall and vagally-mediated HRV were diminished and cardiac autonomic modulation became less complex and more predictable following the race. More pronounced vagal modulation decreases were associated with higher levels of postexertional NT-proBNP. Moreover, rise in hs-TNT and NT-proBNP was greater among faster runners, while pre-race overall and vagally-mediated HRV were correlated with finishing time. Participation in a 118-km ultratrail induces an acute release of cardiac damage biomarkers and a large alteration of cardiac autonomic modulation. Furthermore, faster runners were those who exhibited a greater rise in those cardiac damage biomarkers. In light of these findings, an appropriate recovery period after ultraendurance races appears prudent and particularly important among better performing athletes. At the same time, HRV analysis is shown as a promising tool to assess athletes' readiness to perform at their maximum level in an ultraendurance race.

Quick Recovery of Renal Alterations and Inflammatory Activation after a Marathon.

PURPOSE: We evaluated the incidence of acute kidney injury in a cohort of marathon participants. METHODS: We conducted a prospective observational study focused on evaluating the incidence of kidney damage after a marathon, and its evolution in the first 48 h after the marathon in 88 runners who completed the Valencia Marathon. RESULTS: From the 88 participants, 42 (48.28%) presented with acute kidney injury, mainly grade 1 (95.20%). Microscopic haematuria was observed in 29 runners (33%). Levels of interleukin 6, leukocytes, and neutrophils were markedly increased at the marathon's finish line. CONCLUSIONS: Our results confirmed that there are slight transient changes in glomerular filtration rate and inflammatory activation after a marathon.

Establishing cut-points for physical activity classification using triaxial accelerometer in middle-aged recreational marathoners.

The purpose of this study was to establish GENEA (Gravity Estimator of Normal Everyday Activity) cut-points for discriminating between six relative-intensity activity levels in middle-aged recreational marathoners. Nighty-eight (83 males and 15 females) recreational marathoners, aged 30-45 years, completed a cardiopulmonary exercise test running on a treadmill while wearing a GENEA accelerometer on their non-dominant wrist. The breath-by-breath V̇O2 data was also collected for criterion measure of physical activity categories (sedentary, light, moderate, vigorous, very vigorous and extremely vigorous). GENEA cut-points for physical activity classification was performed via Receiver Operating Characteristic (ROC) analysis. Spearman's correlation test was applied to determine the relationship between estimated and measured intensity classifications. Statistical analysis were done for all individuals, and separating samples by sex. The GENEA cut-points established were able to distinguish between all six-relative intensity levels with an excellent classification accuracy (area under the ROC curve (AUC) values between 0.886 and 0.973) for all samples. When samples were separated by sex, AUC values were 0.881-0.973 and 0.924-0.968 for males and females, respectively. The total variance in energy expenditure explained by GENEA accelerometer data was 78.50% for all samples, 78.14% for males, and 83.17% for females. In conclusion, the wrist-worn GENEA accelerometer presents a high capacity of classifying the intensity of physical activity in middle-aged recreational marathoners when examining all samples together, as well as when sample set was separated by sex. This study suggests that the triaxial GENEA accelerometers (worn on the non-dominant wrist) can be used to predict energy expenditure for running activities.