Exercise Professionals Improve Their Poor Skills in Contracting Pelvic-Floor Muscles: A Randomized Controlled Trial.

A quick, well-timed pelvic-floor muscle contraction during physical effort is recommended for active women to prevent urine leakage. PURPOSE: We address two research questions: how well do future female exercise professionals contract the pelvic-floor muscles, and whether the biofeedback session is necessary to train them to contract pelvic-floor muscles? METHOD: Participants were 84 nulliparous future exercise professionals (age 23 ± 3 years, mean ± SD), randomly allocated into biofeedback (n = 27), usual-advice (n = 26), and control (no advice, n = 21) groups. Contraction of pelvic-floor muscles on a 4-point scale (1 = incorrect through 4 = correct) was assessed in all groups by surface electromyography (sEMG) with a vaginal probe before and after 6 weeks of intervention. RESULTS: In pretest, almost one in five participants (17%) could not activate the pelvic floor and less than half of them (45%) presented correct technique. The technique score for the three groups was 3.1 ± 1.1 (mean ± SD). After training, both intervention groups presented better technique score by 0.6 (90% confidence limits ± 0.5) relative to the control group, and two-thirds (65%) of the intervention groups presented the correct technique. CONCLUSIONS: Future exercise professionals displayed poor skills in contracting pelvic-floor muscles. Both training interventions (with and without biofeedback) were effective for this study group.

Effect of Flavonoids on Upper Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis.

Previous research on animals indicates flavonoid compounds have immunomodulatory properties; however, human research remains inconclusive. The aim of this systematic review was to assess the efficacy of dietary flavonoids on upper respiratory tract infections (URTIs) and immune function in healthy adults. A created search strategy was run against Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and EMBASE classic, CINAHL, and AMED. The returned studies were initially screened, and 2 reviewers independently assessed the remaining studies for eligibility against prespecified criteria. Fourteen studies, of 387 initially identified, were included in this review, and the primary outcome measure was the effect of flavonoids on URTI incidence, duration, and severity. Of the included studies, flavonoid supplementation ranged from 0.2 to 1.2 g/d. Overall, flavonoid supplementation decreased URTI incidence by 33% (95% CI: 31%, 36%) compared with control, with no apparent adverse effects. Sick-day count was decreased by 40% with flavonoid supplementation, although unclear. Differences in bio-immune markers (e.g., interleukin-6, tumor necrosis factor-α, interferon-γ, neutrophils) were trivial between the intervention and control groups during the intervention and after exercise when a postintervention exercise bout was included. These findings suggest that flavonoids are a viable supplement to decrease URTI incidence in an otherwise healthy population.

Impact of Dietary Antioxidants on Sport Performance: A Review.

Many athletes supplement with antioxidants in the belief this will reduce muscle damage, immune dysfunction and fatigue, and will thus improve performance, while some evidence suggests it impairs training adaptations. Here we review the effect of a range of dietary antioxidants and their effects on sport performance, including vitamin E, quercetin, resveratrol, beetroot juice, other food-derived polyphenols, spirulina and N-acetylcysteine (NAC). Older studies suggest vitamin E improves performance at altitude, with possible harmful effects on sea-level performance. Acute intake of vitamin E is worthy of further consideration, if plasma levels can be elevated sufficiently. Quercetin has a small beneficial effect for exercise of longer duration (>100 min), but it is unclear whether this benefits athletes. Resveratrol benefits trained rodents; more research is needed in athletes. Meta-analysis of beetroot juice studies has revealed that the nitrate component of beetroot juice had a substantial but unclear effect on performance when averaged across athletes, non-athletes and modes of exercise (single dose 1.4 ± 2.0%, double dose 0.5 ± 1.9%). The effect of addition of polyphenols and other components to beetroot juice was trivial but unclear (single dose 0.4 ± 3.2%, double dose -0.5 ± 3.3%). Other food-derived polyphenols indicate a range of performance outcomes from a large improvement to moderate impairment. Limited evidence suggests spirulina enhances endurance performance. Intravenous NAC improved endurance cycling performance and reduced muscle fatigue. On the basis of vitamin E and NAC studies, acute intake of antioxidants is likely to be beneficial. However, chronic intakes of most antioxidants have a harmful effect on performance.

Does hydrotherapy help or hinder adaptation to training in competitive cyclists?

PURPOSE: Cold water immersion (CWI) may be beneficial for acute recovery from exercise, but it may impair long-term performance by attenuating the stimuli responsible for adaptation to training. We compared effects of CWI and passive rest on cycling performance during a simulated cycling grand tour. METHODS: Thirty-four male endurance-trained competitive cyclists were randomized to CWI for four times per week for 15 min at 15°C or control (passive recovery) groups for 7 d of baseline training, 21 d of intensified training, and an 11-d taper. Criteria for completion of training and testing were satisfied by 10 cyclists in the CWI group (maximal aerobic power, 5.13 ± 0.21 W·kg; mean ± SD) and 11 in the control group (5.01 ± 0.41 W·kg). Each week, cyclists completed a high-intensity interval cycling test and two 4-min bouts separated by 30 min. CWI was performed four times per week for 15 min at 15°C. RESULTS: Between baseline and taper, cyclists in the CWI group had an unclear change in overall 4-min power relative to control (2.7% ± 5.7%), although mean power in the second effort relative to the first was likely higher for the CWI group relative to control (3.0% ± 3.8%). The change in 1-s maximum mean sprint power in the CWI group was likely beneficial compared with control (4.4% ± 4.2%). Differences between groups for the 10-min time trial were unclear (-0.4% ± 4.3%). CONCLUSION: Although some effects of CWI on performance were unclear, data from this study do not support recent speculation that CWI is detrimental to performance after increased training load in competitive cyclists.

Effects of dietary antioxidants on training and performance in female runners.

Exercise-induced oxidative stress is implicated in muscle damage and fatigue which has led athletes to embark on antioxidant supplementation regimes to negate these effects. This study investigated the intake of vitamin C (VC) (1 g), blackcurrant (BC) juice (15 mg VC, 300 mg anthocyanins) and placebo in isocaloric drink form on training progression, incremental running test and 5-km time-trial performance. Twenty-three trained female runners (age, 31 ± 8 y; mean ± SD) completed three blocks of high-intensity training for 3 wks and 3 days, separated by a washout (~3.7 wks). Changes in training and performance with each treatment were analysed with a mixed linear model, adjusting for performance at the beginning of each training block. Markers of oxidative status included protein carbonyl, malondialdehyde (in plasma and in vitro erythrocytes), ascorbic acid, uric acid and erythrocyte enzyme activity of superoxide dismutase, catalase and glutathione peroxidase were analysed. There was a likely harmful effect on mean running speed during training when taking VC (1.3%; 90% confidence limits ±1.3%). Effects of the two treatments relative to placebo on mean performance in the incremental test and time trial were unclear, but runners faster by 1 SD of peak speed demonstrated a possible improvement on peak running speed with BC juice (1.9%; ±2.5%). Following VC, certain oxidative markers were elevated: catalase at rest (23%; ±21%), protein carbonyls at rest (27%; ±38%) and superoxide dismutase post-exercise (8.3%; ±9.3%). In conclusion, athletes should be cautioned about taking VC chronically, however, BC may improve performance in the elite.

Effect of dietary antioxidants, training, and performance correlates on antioxidant status in competitive rowers.

UNLABELLED: The beneficial effects of exercise and a healthy diet are well documented in the general population but poorly understood in elite athletes. Previous research in subelite athletes suggests that regular training and an antioxidant-rich diet enhance antioxidant defenses but not performance. PURPOSE: To investigate whether habitual diet and/or exercise (training status or performance) affect antioxidant status in elite athletes. METHODS: Antioxidant blood biomarkers were assessed before and after a 30-min ergometer time trial in 28 male and 34 female rowers. The antioxidant blood biomarkers included ascorbic acid, uric acid, total antioxidant capacity (TAC), erythrocyte- superoxide dismutase, glutathione peroxidase (GPx), and catalase. Rowers completed a 7-d food diary and an antioxidant-intake questionnaire. Effects of diet, training, and performance on resting biomarkers were assessed with Pearson correlations, and their effect on exercise-induced changes in blood biomarkers was assessed by a method of standardization. RESULTS: With the exception of GPx, there were small to moderate increases with exercise for all markers. Blood resting TAC had a small correlation with total antioxidant intake (correlation .29; 90% confidence limits, ±.27), and the exercise-induced change in TAC had a trivial to small association with dietary antioxidant intake from vitamin C (standardized effect .19; ±.22), vegetables (.20; ±.23), and vitamin A (.25; ±.27). Most other dietary intakes had trivial associations with antioxidant biomarkers. Years of training had a small inverse correlation with TAC (-.32; ±.19) and a small association with the exercise-induced change in TAC (.27; ±.24). CONCLUSION: Training status correlates more strongly with antioxidant status than diet does.

Effects of acute carbohydrate supplementation on endurance performance: a meta-analysis.

UNLABELLED: Research on the performance effects of acute carbohydrate supplementation is comprehensive. Here we present the first meta-analytic review of this research. METHODS: Eighty-eight randomized crossover studies in which carbohydrate supplements were consumed with or without protein before and/or during exercise provided 155 estimates for performance effects in time-to-exhaustion tests or in time trials with or without a preload. For the mixed-model meta-analysis, all effects were converted into percentage changes in mean power in a non-preloaded time trial and weighted using percentage standard errors derived from exact p-values (in a minority of studies) or from estimated errors of measurement (in all other studies). Publication bias was assessed with a plot of t-values for the random-effect solutions versus standard errors. Probabilistic inferences were derived with reference to thresholds for small, moderate and large effects on performance of 0.5, 1.5 and 2.7%. RESULTS: Publication bias was reduced by excluding studies with a standard error >1.25%. In the remaining 73 studies and 122 estimates, the meta-analysed performance effects of carbohydrate supplements ranged from clear large improvements of ∼6% to clear moderate impairments of ∼2%. The best supplement inferred from the analysis consisted of a ∼3-10% carbohydrate-plus-protein drink providing ∼0.7 g/kg/h glucose polymers, ∼0.2 g/kg/h fructose and ∼0.2 g/kg/h protein. Substantial increases in the benefit of a supplement were probably small with an additional 9-hour fast and with the inclusion of ∼0.2 g/kg/h of protein, probably small to moderate with ingesting the first bolus not at the start of exercise but 1-4 hours before exercise, and possibly small with increasing the frequency of ingestion by three boluses per hour. Substantial reductions in the benefit of a supplement were possibly moderate with a supplement providing >0.25 g/kg/h fructose, and possibly small with an increase in ambient temperature of 10°C. The effect in subjects with maximal oxygen consumption higher by 10 mL/kg/min was probably trivial, and the effects of exercise duration were dependent on the concentration of carbohydrate plus protein in the supplement. The effect of including salt was unexpectedly trivial, and the effect of gender was unclear. CONCLUSIONS: Carbohydrate supplements with an appropriate composition and administration regimen can have large benefits on endurance performance. More research and better reporting are required to investigate the moderating effects of gender and salt.

Effectiveness of 1% diclofenac gel in the treatment of wrist extensor tenosynovitis in long distance kayakers.

Anecdotally many athletes use non-steroidal anti-inflammatory gels during competition to allow continued participation. To determine if this clinical practice is useful a randomised placebo-controlled study was conducted at the 5-day 2004 Red Cross Murray River Marathon. Forty-two kayakers presented with wrist extensor tenosynovitis while competing in the single and double kayak events. All subjects received standard treatment of ice, stretches and massage for wrist tenosynovitis before being randomised into a placebo or 1% diclofenac gel group. Evaluation was done by using a visual analogue scale (0-10) for pain and by clinical grading (0-3). The main outcome measurements were reduction in pain and clinical grading, the requirement for a rescue medication (paracetamol or diclofenac tablets) and effect on performance times. Both groups had similar pain scores and clinical grading on the first and fifth days of pain. On the second to fourth days of pain there was clearly no benefit and possibly a detrimental effect on pain with diclofenac gel relative to placebo. However, diclofenac tablets were possibly beneficial for pain relative to paracetamol tablets. The effects of pain and the various treatments on performance time were either trivial (<0.5%) or small, but none was particularly clear. We conclude that standard treatment appears to be sufficient for the management of wrist extensor tenosynovitis during competition.

The effect of attempted ballistic training on the force and speed of movements.

Athletes in sports requiring explosive movements might benefit from a unique form of training in which a limb is restrained while the athlete attempts ballistic (explosive) movements. We investigated the effects of such ballistic training and conventional resistance training on force and speed of front kicks, side kicks, and palm strikes of martial artists. We assigned subjects randomly to an experimental group (n = 13) or a control (normal martial art training) group (n = 9). Conventional resistance training produced a gain of 12% (95% likely limits +/- 13%) in front kick force relative to the control group. Overall ballistic training and conventional resistance training decreased side kick force by 15% (+/-14%), but movement speeds increased by 11-21% (+/-13-17%). Responses to ballistic training were generally more marked in more highly skilled athletes. Attempted ballistic training may be a beneficial adjunct to resistance training for skilled athletes in sports where speed rather than force is critical.