Images: "Too much heat for my non-24-hour sleep-wake disorder!" A case report.

The non-24-hour sleep-wake disorder (N24SWD) is a rare condition, sometimes associated with blindness or with suprachiasmatic nuclei lesions, resulting in a free-running rhythm or hypernycthemeral syndrome. Synchronizers, such as light, when light perception remains, melatonin, food intakes, physical activity, social interactions, and temperature, play a key role in the treatment of N24SWD. In this report, we describe a case illustrating the impact of outdoor temperature in a 34-year-old man with N24SWD effectively treated through a combination of chronotherapy interventions. During 3 consecutive heat waves, he experienced a recurrence of his natural 25.5-hour free-running rhythm, with a consistent bedtime phase delay caused by temperature, resulting in the discontinuation of chronotherapy. After these heat waves, he was able again to resynchronize his rhythms with the combination of chronotherapeutics. This case report highlights that patients with N24SWD may be particularly at risk of relapse during heat waves, with direct implications for monitoring and reinforcing chronotherapies. CITATION: Garrivet J, d'Ortho M-P, Frija-Masson J, et al. "Too much heat for my non-24-hour sleep-wake disorder!" A case report. J Clin Sleep Med. 2024;20(2):329-333.

Prevalence of dietary supplement use among male Brazilian recreational triathletes: a cross-sectional study.

BACKGROUND AND RATIONALE: The literature shows that the prevalence of dietary supplements is high and guidance by a nutritionist or specialized professional is low in professional triathletes. It is reasonable to assume that in recreational triathletes, the prevalence of dietary supplements will also be high and that a significant portion of the sampled population will use supplements without any guidance from a qualified professional. The present study investigated dietary supplement use among Brazilian male recreational triathletes. METHODS: A total of 724 Brazilian male recreational triathletes (age: 38.00 [10.00] years and body mass index: 24.16 [3.02] kg/m2) took part in this study. All participants answered an online questionnaire containing questions about their demographic characteristics and the nutritional aspects of their diet. RESULTS: The results showed that ~ 90% (n = 653) of the interviewed participants reported using at least one dietary supplement. Surprisingly, ~ 25% did not receive supplement advice from a professional nutritionist. CONCLUSION: The prevalence of dietary supplements in male recreational triathletes was high, and a substantial part of the sample did not receive professional recommendations. This situation is worrisome because dietary supplements should be prescribed by a professional nutritionist. PRACTICAL IMPLICATIONS: Our results suggest the need for an appropriate attitude and guidance by health professionals who deal with this population, especially nutritionists, to promote safe practices.

Are the Dietary-Nutritional Recommendations Met? Analysis of Intake in Endurance Competitions.

BACKGROUND: In recent decades the number of endurance events has increased, as well as the number of athletes participating in them. Adequate nutritional and water planning is essential to maintain optimal sports performance and to reduce the incidence of gastrointestinal problems. The main objective of this study is to determine the dietary intake and compliance with nutritional recommendations of athletes in two endurance competitions, as well as to assess the incidence of gastrointestinal complaints. METHODS: An observational and cross-sectional study was carried out on the consumption of liquids, food, and supplements in 42 triathletes and mountain runners (MRs) participating in a Vi-Half-Gasteiz triathlon and the Ultra Sierra de Cazorla trail run. At the completion of the trials, participants completed a validated questionnaire (NIQEC). RESULTS: The mean caloric intake during the test of the participants in this study was 192.17 kcal/h, while the mean carbohydrate intake was 43.67 g/h, the mean sodium intake was 267.43 mg/h, and the mean caffeine intake was 15.53 mg/h, with no significant differences between the two sports. The amount of liquids consumed by the participants was 421.21 mL/h, with no significant differences between the triathletes and MRs. As for gastrointestinal problems, it was observed that the participants presented gastrointestinal discomfort in 61.9% of the cases. CONCLUSIONS: The intakes of energy, carbohydrates, water, sodium, and caffeine were lower than the current recommendations. There were no differences in the energy, carbohydrate, water, sodium, and caffeine intakes between the triathletes and mountain runners. Gastrointestinal problems showed a high prevalence in these athletes.

A Combination of Soy Isoflavone and L-Carnitine Improves Running Endurance in Mice.

The present study aimed to investigate the effect of APIC, a mixture containing soy isoflavone and L-carnitine on running endurance. Male C57BL/6 mice were orally administered APIC for 8 weeks. The APIC group exhibited a significant increase in treadmill running time until exhaustion compared to the control group. The respiratory exchange ratio in the APIC group was lower, indicating an enhancement in fatty acid oxidative metabolism. Furthermore, APIC supplementation increased the proportion of oxidative myofibers. Biochemical parameters associated with endurance capacity were also affected by APIC, as evidenced by increased muscle ATP levels and decreased levels of muscle triglycerides and blood lactate. qPCR and immunoblot analysis of C2C12 myotubes and gastrocnemius muscles indicated that APIC treatment stimulated AMPK signaling, mitochondrial biogenesis, and fatty acid metabolism. Additionally, treatment with APIC led to an increased oxygen consumption rate in C2C12 myotubes. Collectively, these findings suggest that APIC supplementation enhances mitochondrial biogenesis, promotes a switch from glycolytic to oxidative fiber types, and improves fatty acid metabolism through the activation of the AMPK signaling pathway in murine skeletal muscle. Ultimately, these effects contribute to the enhancement of running endurance.

Runners' responses to a biofeedback intervention aimed to reduce tibial acceleration differ within and between individuals.

An increment in peak tibial acceleration (PTA) may be related to an increased risk of running-rated injury. Many authors believe that reducing PTA through improved shock-absorption could, therefore, help prevent injury. The aim of the current study was, therefore, to investigate the individual responses of participants to a biofeedback intervention aimed at reducing PTA.11 participants (two females, nine males; 43 ±â€¯10 years; stature: 1.74 ±â€¯0.07 m; body mass: 74 ±â€¯11 kg; distance running a week: 19 ±â€¯14 km; 5 km time: 24 ±â€¯3 min) received an intervention of six sessions of multisensory biofeedback aimed at reducing PTA. Mean PTA and kinematic patterns were measured at baseline, directly after the feedback intervention and a month after the end of the intervention. Group as well as single-subject analyses were performed to quantify differences between the sessions. A significant decrease of 26 per cent (effect size: Hedges' g = 0.94) in mean PTA was found a month after the intervention. No significant changes or large effect sizes were found for any group differences in the kinematic variables. However, on an individual level, shock-absorbing solutions differed both within and between participants. The data suggest participants did not learn a specific solution to reduce PTA but rather learned the concept of reducing PTA. These results suggest future research in gait retraining should investigate individual learning responses and focus on the different strategies participants use both between and within sessions. For training purposes, participants should not focus on learning one running strategy, but they should explore several strategies.

Sports Physiology in Adolescent Track-and-Field Athletes: A Narrative Review.

The present study aimed to review the physiological aspects of adolescent track-and-field (TAF) athletes. A search of Scopus on 27/12/2022 using the syntax ABS (track-and-field) AND ABS (children) OR ABS (adolescent) showed 121 documents, and 45 were considered for further analysis. In addition, handsearching was conducted to identify Russian literature missing in Scopus. Differences were shown in performance characteristics among disciplines, especially between throwers and the other athletes. The sex difference in performance (ie, a better performance in boys than in girls) started in early adolescence. A relative age effect was more pronounced in athletes under 13 years old. Despite the wide use of nutritional supplements, an insufficient intake of vitamins has been found. The age of training onset and body weight were identified as risk factors for problems with menarche. The inclusion of track-and-field training programs in physical education was beneficial for health and physical fitness. The need to collaborate closely with parents and coaches was identified, especially, regarding education in topics such as the age of training onset, relative age effect, and doping. In conclusion, the existence of many disciplines with different anthropometric and physiological characteristics highlighted the need for a discipline-specific approach.

Study on acute respiratory infection in children aged 1 year to 5 years-A hospital-based cross-sectional study.

Background: Acute respiratory infections (ARIs) are the single greatest cause of death among children throughout the world. They are responsible every year for the deaths of 4.3 million children under 5 years of age worldwide. Community- or hospital-based surveys for finding out the prevalence and various factors associated with ARI are very few, especially in urban areas. Also, surveys to study the use of vaccines in preventing ARIs are scarce. Hence, we studied ARI in children aged 1 year to 5 years in a tertiary care hospital in Kerala. The aim was to determine the frequency of ARIs in the last 1 year in children aged 1 year to 5 years, attending the immunization clinic at Lourdes Hospital, Kochi, and assess the selected epidemiological, socio-demographic, nutritional and immunization factors associated with ARIs in the study group. Methods: Children attending the immunization clinic at a tertiary care hospital, Kochi, in the age group of 1 year to 5 years were selected. A brief introduction was given to the mother/caregiver of the child regarding the purpose of the study and was asked to fill out the questionnaire. Informed consent was taken. For the study, ARI is defined as the presence of one or more of the following: cough, running nose, blocked nose, sore throat, difficulty breathing, or ear problems; with or without fever. Results were analyzed. Results: Mother was the caregiver in 67% of the cases. When the caregiver was the mother, ARI is found to be less. Among those mothers who had no formal education, 100% of their children got ARI. Children whose caregivers were 30 years and older had lesser ARI. The proportion of children with ARIs was more with a history of respiratory infection among family members (parents/siblings) compared to those with no such history. The occurrence of ARI was more frequent in rural compared to urban areas. There is a significant proportion of ARI in non-exclusively breastfed infants, bottle feeding, and early initiation of complementary feeding. Children with a history of exposure to cigarette smoke had an increased occurrence of ARI. Similar results followed for exposure to biomass fuel and exposure to cold and rain. Children who were not immunized to vaccines-pneumococcal, Hib, measles, vitamin A, showed a higher occurrence of ARI compared to immunization. Conclusion: The studies regarding factors influencing ARI are relatively rare in an urban setting, thus this calls for more studies in urban areas. Health education can change the healthcare-seeking behavior and attitude of parents for preventing ARI-related deaths. Family physicians can play a significant role by educating caregivers of children and giving timely services. Promoting and ensuring exclusive breastfeeding practices, timely weaning after 6 months, and avoidance of bottle feeds can dramatically decrease the episodes of ARI.

The effects of L-Citrulline and Glutathione on Endurance performance in young adult trained males.

BACKGROUND: Citrulline may amplify the effects of L-arginine and nitric oxide concentration, which may augment vasodilation and blood flow, thereby enhancing aerobic exercise performance. The purpose of this randomized, double-blind, placebo-controlled crossover study was to investigate effects of L-citrulline + Glutathione on aerobic exercise performance and blood flow in well-trained men. METHODS: Twenty-five males (Mean ± SD; Age: 22.2 ± 2.4 yrs; Height: 177.0 ± 4.8 cm; Weight: 75.3 ± 6.9 kg) were randomly assigned to the L-citrulline + Glutathione (Setria Performance Blend: SPB; L-citrulline [2 g] + glutathione [200 mg], 6 capsules) or placebo (PL; 3.1 g cellulose, 6 capsules) group. Participants performed a maximal oxygen consumption treadmill test to determine peak velocity (PV) and returned after eight days of ingesting either PL or SPB. Three timed treadmill runs to exhaustion (TTE) were performed at 90%, 100%, and 110% PV. Brachial artery blood flow and vessel diameter were assessed using ultrasound at 1-hr prior to exercise (1hrPrEX), after each exercise bout, immediately post-exercise (immediate PEX), and 30 minutes post exercise (30minPEX) at visits 2 and 4. Blood analytes were assessed via venous blood draws at visit 1, visit 3, and 1hrPEX, immediate PEX, and 30minPEX at visits 2 and 4. After a 14-day washout, participants repeated the same procedures, ingesting the opposite treatment. Separate repeated measures ANOVAs were performed for TTE, vessel diameter, blood flow, and blood analytes. RESULTS: Blood flow was significantly augmented 30minPEX (p = 0.04) with SPB in comparison with PL. L-citrulline and L-arginine plasma concentrations were significantly elevated immediately PEX (p = 0.001) and 30-minPEX (p = 0.001) following SPB in comparison to PL. CONCLUSION: Acute ingestion of SPB after eight days may enhance blood flow, L-citrulline, and L-arginine plasma concentrations after high-intensity exercise, which may enhance performance. CLINICAL TRIAL REGISTRATION: [https://clinicaltrials.gov/ct2/show/nct04090138], identifier [NCT04090138].

Impact of Pilates mat-based exercises on knee kinematics during running.

INTRODUCTION: Core strengthening, balance, and flexibility programs such as Pilates have been advocated to positively impact running mechanics and prevent lower extremity injuries. The purpose of this study was to assess the effects of a 12-week mat-based Pilates exercise program on dynamic knee valgus alignment in runners. METHODS: Thirty-four novice runners, including young male and female adults performed a running protocol at baseline. The protocol consisted of the participants running on a treadmill at a constant five miles per hour (mph) for 4 min. Post-examination, participants were randomly assigned to a Pilates or control group (n = 16 and n = 18, respectively). A certified Pilates instructor gave the Pilates group a 12-week home-based program. To ensure participants in the Pilates group performed exercises correctly, the Pilates instructor conducted the first session, and provided feedback to each participant. Participants in both groups performed the same running testing protocol every four weeks. Knee valgus was measured as the medial displacement of the knee joint center during the running stance phase. Repeated measures Analysis of Variance (RepANOVA) was calculated at baseline and 4-, 8-, and 12-weeks post examinations to compare knee valgus during running. RESULTS: Although a reduction in dynamic knee valgus was observed within the Pilates group, the RepANOVA analysis revealed this change was not statistically significant. CONCLUSIONS: Pilates mat-based exercises may improve knee valgus after 12 weeks but a larger sample size, longer intervention duration, or a supervised program should be considered for future research to evaluate its effectiveness.

Are the Consumption Patterns of Sports Supplements Similar among Spanish Mountain Runners?

BACKGROUND: The use of sports supplements (SS) to improve sports performance is widespread in all types of athletes, however, the specific characteristics of mountain races may require the use of certain SS. Despite being a sport where the consumption of SS seems widespread, few studies have been conducted in this regard. The objective of this study is to analyze the pattern of SS consumption of mountain runners in relation to the degree of scientific evidence, sex, and level of competition. METHODS: Descriptive and cross-sectional study on the consumption and habitual use of SS of 357 federated mountain runners in Spain. Data were collected through a validated questionnaire. RESULTS: From the total sample, 93.84% of the athletes stated that they consumed SS, with no differences observed based on the competitive level or in terms of sex; however, there were significant differences according to the competitive level in terms of the number of SS consumed, with consumption being greater at a higher competitive level (p = 0.009). The most consumed SS were sports bars (66.1%), sports drinks (60.5%), sports gels (52.9%), and caffeine (46.2%). CONCLUSIONS: The consumption of SS in mountain races is high, and the number of SS consumed is higher as the competition level increases. The four SS most consumed by the participants in this study were all included in category A in the classification of the Australian Institute of Sport (AIS), this category is the one with the greatest scientific evidence.

L-menthol administration facilitates breathing comfort during exhaustive endurance running and improves running capacity in well-trained runners: A randomized crossover study.

ABSTRACTThis study aimed to clarify the contribution of L-menthol administration to endurande exercise capacity. Thirteen male runners (age, 35.8 ± 7.8 years; peak oxygen uptake, 62.7 ± 6.8 mL kg-1 min-1) ran on treadmills at fixed intensities of their anaerobic thresholds to exhaustion. All participants underwent three trials-water ingestion (W-IG), L-menthol mouth rinsing (M-MR), and L-menthol ingestion (M-IG)- in a random order every 5 min while running. Breathing comfort (BC) was measured immediately after fluid intake. Dyspnea threshold against external inspiratory resistance was examined before and after the running test. The running time with M-IG (1683.9 ± 520.3 s) was longer than that with W-IG (1410.2 ± 465.9 s, effect size [ES] = 0.55). BC with M-IG (2.00 ± 0.74) was higher than that with W-IG (0.42 ± 0.79) at exhaustion (ES > 2.00). The dyspnea threshold after running decreased to 19.2 ± 7.6 cm H2O L-1 s-1 with W-IG, whereas that with M-MR (26.2 ± 6.5 cm H2O L-1 s-1) and M-IG (29.2 ± 2.8 cm H2O L-1 s-1) remained high (p for interaction < 0.001). M-IG facilitated BC during running, improved endurance capacity, and prevented decreases in the dyspnea threshold against external inspiratory resistance after exhaustive running.HighlightsL-menthol ingestion facilitated breathing comfort during high intensity endurance running and improved exhaustive endurance running capacity.Even after exhaustion, L-menthol solution relieved dyspnea sensitivity against external inspiratory resistance.L-menthol ingestion might help athletes improve their endurance running capacity.

Omega-3 index and AA/EPA ratio as biomarkers of running-related injuries: An observational study in recreational runners.

ABSTRACTThe aim of this study was to examine the association between biomarkers of polyunsaturated fatty acids (PUFA), such as omega-3 (ω-3) index and arachidonic acid (AA; 20:4 ω-6)/eicosapentaenoic acid (EPA; 20:5ω-3) ratio (AA/EPA), and the prevalence of running-related injuries (RRI) in a cohort of recreational runners. We performed a retrospective, observational study of 275 non-elite runners (mean age: 41.20 ± 12.47 years) who were not supplemented with ω-3 fatty acids. The training characteristics and RRI were recorded over a period of 12 months through a self-reported questionnaire. Using whole blood samples collected by finger prick, PUFA were quantified by gas chromatography and ω-3 index and AA/EPA ratio measured. A total of 191 RRI cases were reported, with an injury prevalence rate of 50.9% in the overall population. The injured runners ran a significantly greater weekly distance than uninjured subjects (53.54 ± 25.27 km/week; p = 0.007). In a multivariate regression analysis, the lowest number of RRI was associated with higher values of ω-3 index (ß = - 0.237; 95% CI - 0.308 to - 0.164; R2 = 0.172; p < 0.0001), while a higher AA/EPA ratio was correlated with higher number of RRI (ß = 0.019; 95% CI 0.007-0.031; R2 = 0.038; p = 0.003). This study identifies ω-3 index and AA/EPA ratio as potential parameters associated with the risk of RRI. Future research is needed to confirm these results and apply specific nutritional strategies to successfully modify these biochemical variables.Trial registration: ISRCTN.org identifier: ISRCTN12847156..

Epigenetic regulation of IPF fibroblast phenotype by glutaminolysis.

OBJECTIVE: Excessive extra-cellular-matrix production and uncontrolled proliferation of the fibroblasts are characteristics of many fibrotic diseases, including idiopathic pulmonary fibrosis (IPF). The fibroblasts have enhanced glutaminolysis with up-regulated glutaminase, GLS1, which converts glutamine to glutamate. Here, we investigated the role of glutaminolysis and glutaminolysis-derived metabolite α-ketoglutarate (α-KG) on IPF fibroblast phenotype and gene expression. METHODS: Reduced glutamine conditions were carried out either using glutamine-free culture medium or silencing the expression of GLS1 with siRNA, with or without α-KG compensation. Cell phenotype has been characterized under these different conditions, and gene expression profile was examined by RNA-Seq. Specific profibrotic genes (Col3A1 and PLK1) expression were examined by real-time PCR and western blots. The levels of repressive histone H3K27me3, which demethylase activity is affected by glutaminolysis, were examined and H3K27me3 association with promoter region of Col3A1 and PLK1 were checked by ChIP assays. Effects of reduced glutaminolysis on fibrosis markers were checked in an animal model of lung fibrosis. RESULTS: The lack of glutamine in the culture medium alters the profibrotic phenotype of activated fibroblasts. The addition of exogenous and glutaminolysis-derived metabolite α-KG to glutamine-free media barely restores the pro-fibrotic phenotype of activated fibroblasts. Many genes are down-regulated in glutamine-free medium, α-KG supplementation only rescues a limited number of genes. As α-KG is a cofactor for histone demethylases of H3K27me3, the reduced glutaminolysis alters H3K27me3 levels, and enriches H3K27me3 association with Col3A1 and PLK1 promoter region. Adding α-KG in glutamine-free medium depleted H3K27me3 association with Col3A1 promoter region but not that of PLK1. In a murine model of lung fibrosis, mice with reduced glutaminolysis showed markedly reduced fibrotic markers. CONCLUSIONS: This study indicates that glutamine is critical for supporting pro-fibrotic fibroblast phenotype in lung fibrosis, partially through α-KG-dependent and -independent mechanisms, and supports targeting fibroblast metabolism as a therapeutic method for fibrotic diseases.

Ecosystem-level effects of re-oligotrophication and N:P imbalances in rivers and estuaries on a global scale.

Trends and ecological consequences of phosphorus (P) decline and increasing nitrogen (N) to phosphorus (N:P) ratios in rivers and estuaries are reviewed and discussed. Results suggest that re-oligotrophication is a dominant trend in rivers and estuaries of high-income countries in the last two-three decades, while in low-income countries widespread eutrophication occurs. The decline in P is well documented in hundreds of rivers of United States and the European Union, but the biotic response of rivers and estuaries besides phytoplankton decline such as trends in phytoplankton composition, changes in primary production, ecosystem shifts, cascading effects, changes in ecosystem metabolism, etc., have not been sufficiently monitored and investigated, neither the effects of N:P imbalance. N:P imbalance has significant ecological effects that need to be further investigated. There is a growing number of cases in which phytoplankton biomass have been shown to decrease due to re-oligotrophication, but the potential regime shift from phytoplankton to macrophyte dominance described in shallow lakes has been documented only in a few rivers and estuaries yet. The main reasons why regime shifts are rarely described in rivers and estuaries are, from one hand the scarcity of data on macrophyte cover trends, and from the other hand physical factors such as peak flows or high turbidity that could prevent a general spread of submerged macrophytes as observed in shallow lakes. Moreover, re-oligotrophication effects on rivers may be different compared to lakes (e.g., lower dominance of macrophytes) or estuaries (e.g., limitation of primary production by N instead of P) or may be dependent on river/estuary type. We conclude that river and estuary re-oligotrophication effects are complex, diverse and still little known, and in some cases are equivalent to those described in shallow lakes, but the regime shift is more likely to occur in mid to high-order rivers and shallow estuaries.

Case report: Diagnosis and intervention of a non-24-h sleep-wake disorder in a sighted child with a psychiatric disorder.

Circadian rhythm sleep-wake disorders (CRSWD) are sleep dysfunctions related to circadian functioning. They are characterized by symptoms of insomnia or excessive sleepiness that occur because the intrinsic circadian pacemaker is not entrained to a 24-h light/dark cycle. Affected individuals with a free-running disorder or hypernycthemeral syndrome (N24SWD) have a longer sleep-wake cycle that produces a sleep pattern that typically delays each day. The disorder is seen in 70% of blind people, and among people with healthy vision, it is a rare pathology. Among sighted cases, 80% are young men and 28% have a psychiatric disorder. The patient was a 14-year-old boy with a psychiatric pathology diagnosed with a PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococci), a sudden acute and debilitating onset of intense anxiety and mood lability accompanied by obsessive compulsive-like issues and/or tics, in association with a streptococcal A infection that occurs immediately prior to the symptoms. As a comorbidity, he exhibited severe insomnia due to an irregular sleep pattern that strongly delayed his sleep schedule day to day. It affected his daily routines, as he was not going to school, and aggravated, furthermore, the psychiatric symptoms. He was referred for sleep consultation, where the case was explored by ambulatory circadian monitoring (ACM) using the novel system Kronowise® (Chronolab, University of Murcia) and diagnosed with a non-24-h sleep-wake disorder (N24SWD). The first treatment approach for the patient was focused on improving symptoms during the acute infection and psychiatric symptoms. Additionally, sleep pathology was treated by light therapy and melatonin. After 8 months and different trials, it was possible to establish a treatment to normalize the symptoms and fix his sleep rhythm in a normal schedule as well as to reduce anxious symptoms during the day. The association of PANDAS and N24SWD has not previously been reported in the literature.

Sport kinesiology based on the concept of health and fitness / Cinesiologia esportiva baseada no conceito de saúde e aptidão física / Kinesiología deportiva basada en el concepto de salud y aptitud física

ABSTRACT Introduction: Exercise is the most effective way to improve physical fitness. One can achieve the effect of wellness and fitness through scientific exercise. Running is a relatively common method of physical exercise. It plays a significant role in improving physical fitness. Objective: This study aimed to investigate the characteristics of lower extremity movements during running. The results of this study may provide better exercise planning for runners. Methods: This paper selects several runners as the research subject. The subjects started running after attaching a motion detector sensor patch to their body. Then, this paper collected kinematic data. The kinematic data includes the joint angles and range of motion (ROM) of the hip, knee, and ankle joints. Results: There was no significant difference in the distribution of peak tibial acceleration, plantar pressure, and maximum pressure of athletes under different track materials (P>0.05). There was a significant age difference between the hip and knee joints of the athletes in the overhead stage (P<0.05). Conclusion: There may not be a necessary connection between ground and lower limb impact in running athletes. Through its adjustment, the human body can dampen the load effect of the foot contact surface. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O exercício físico é a forma mais eficaz de melhorar a aptidão física. Pode-se alcançar o efeito do bem-estar e da boa forma física por meio da prática de exercícios físicos. A corrida é um método relativamente comum de exercício físico. Ele desempenha um papel significativo na melhora da aptidão física. Objetivo: Este estudo teve como objetivo investigar as características dos movimentos das extremidades inferiores durante a corrida. Os resultados deste estudo podem proporcionar melhores planejamentos de exercícios para os corredores. Métodos: Este trabalho seleciona vários corredores como o objeto de pesquisa. Os sujeitos começaram a correr após anexar um adesivo com sensor detector de movimento em seu corpo. Em seguida, este trabalho coletou dados cinemáticos. Os dados cinemáticos incluem os ângulos articulares e a amplitude de movimento (ROM) das articulações do quadril, joelho e tornozelo. Resultados: Não houve diferença significativa na distribuição do pico de aceleração tibial, pressão plantar e pressão máxima dos atletas sob diferentes materiais de pista (P>0,05). Houve uma diferença de idade significativa entre as articulações do quadril e do joelho dos atletas na etapa aérea (P<0,05). Conclusão: Pode não haver uma conexão necessária entre o solo e o impacto dos membros inferiores em atletas de corrida. Através de seu ajuste, o corpo humano pode amortecer o efeito de carga da superfície de contato com o pé. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El ejercicio físico es la forma más eficaz de mejorar la forma física. Se puede conseguir el efecto de bienestar y de puesta en forma a través del ejercicio físico. Correr es un método de ejercicio físico relativamente común. Desempeña un papel importante en la mejora de la condición física. Objetivo: Este estudio tiene como objetivo investigar las características de los movimientos de las extremidades inferiores durante la carrera. Los resultados de este estudio pueden proporcionar una mejor planificación del ejercicio para los corredores. Métodos: Este trabajo selecciona a varios corredores como objeto de investigación. Los sujetos empezaron a correr tras colocarse un parche sensor de movimiento en el cuerpo. A continuación, este trabajo recogió datos cinemáticos. Los datos cinemáticos incluyen los ángulos articulares y la amplitud de movimiento (ROM) de las articulaciones de la cadera, la rodilla y el tobillo. Resultados: No hubo diferencias significativas en la distribución de la aceleración tibial máxima, la presión plantar y la presión máxima de los atletas con diferentes materiales de pista (P>0,05). Hubo una diferencia de edad significativa entre las articulaciones de la cadera y la rodilla de los atletas en la etapa de sobrecarga (P<0,05). Conclusión: Puede que no exista una conexión necesaria entre el impacto en el suelo y en las extremidades inferiores en los atletas que corren. Mediante su ajuste, el cuerpo humano puede amortiguar el efecto de carga de la superficie de contacto del pie. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

A nutritional intervention for moderate altitude endurance preparation: A case report.

Background: Moderate altitudes carry physiological and metabolic changes that can dampen exercise performance. Fortunately, these changes can be modulated by an optimal nutritional intervention. This case study represents the first nutritional intervention of a moderate altitude athlete. These results may help to establish well-designed nutritional guidelines for moderate altitude sports athletes. Case presentation: This case study examined the effects of a 11-week nutritional intervention on body composition, muscle strength, cardiorespiratory fitness, resting and exercise nutrient oxidation, and subjective sleep quality, in a male high-level moderate altitude athlete with a very light non-exercise activity thermogenesis. During the 11-week of nutritional intervention, 2800-3500 kcal/day, 6.8-8.9 g/kg/day of carbohydrates, 1.2-1.7 g/kg/day of protein, and 1-2.5 g/kg/day of fat were prescribed. Different specific considerations were also included, such as: iron supplementation, antioxidants increment in different phases, and ergogenic aids (i.e. creatine and beta-alanine). Our results demonstrated a decrease in adiposity and an increase in fat-free mass. In parallel, the athlete improved muscle strength, and therefore endurance adaptations after a maximal effort test (i.e. enhancement of the heart rate recovery). After the intervention, the athlete not only increased the carbohydrate oxidation during exercise and resting conditions but also improved his subjective sleep quality. Conclusions: Our results suggest that a nutritional intervention based on the endurance nutritional recommendations and adapted to the altitude physiological peculiarities can induce body re-composition, improve physiological adaptations to effort, and upgrade the substrate oxidation in a moderate altitude high-level athletes.

Improved Oxygen Uptake Efficiency Parameters Are Not Correlated with VO2peak or Running Economy and Are Not Affected by Omega-3 Fatty Acid Supplementation in Endurance Runners.

Peak oxygen uptake (VO2peak) is one of the most reliable parameters of exercise capacity; however, maximum effort is required to achieve this. Therefore, alternative, and repeatable submaximal parameters, such as running economy (RE), are needed. Thus, we evaluated the suitability of oxygen uptake efficiency (OUE), oxygen uptake efficiency plateau (OUEP) and oxygen uptake efficiency at the ventilatory anaerobic threshold (OUE@VAT) as alternatives for VO2peak and RE. Moreover, we evaluated how these parameters are affected by endurance training and supplementation with omega-3 fatty acids. A total of 26 amateur male runners completed a 12-week endurance program combined with omega-3 fatty acid supplementation or medium-chain triglycerides as a placebo. Before and after the intervention, the participants were subjected to a treadmill test to determine VO2peak, RE, OUE, OUEP and OUE@VAT. Blood was collected at the same timepoints to determine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes. OUE correlated moderately or weakly with VO2peak (R2 = 0.338, p = 0.002) and (R2 = 0.226, p = 0.014) before and after the intervention, respectively. There was a weak or no correlation between OUEP, OUE@VAT, VO2peak and RE despite steeper OUE, increased OUEP and OUE@VAT values in all participants. OUE parameters cannot be treated as alternative parameters for VO2peak or RE and did not show changes following supplementation with omega-3 fatty acids in male amateur endurance runners.

Increased Plasma L-Arginine Levels and L-Arginine/ADMA Ratios after Twelve Weeks of Omega-3 Fatty Acid Supplementation in Amateur Male Endurance Runners.

It is not fully understood how supplementation with omega-3 fatty acids affects the metabolism of amino acids required for the bioavailability/synthesis of NO, i.e., L-arginine (L-arg), asymmetric dimethylarginine (ADMA), their metabolites, and the L-arg/ADMA ratio and their impact on running economy (RE) in runners. Thus, 26 male amateur endurance runners completed a twelve-week study in which they were divided into two supplemented groups: the OMEGA group (n = 14; 2234 mg and 916 mg of eicosapentaenoic and docosahexaenoic acid daily) or the MCT group (n = 12; 4000 mg of medium-chain triglycerides daily). At the same time, all participants followed an endurance training program. Before and after the 12-week intervention, blood was collected from participants at two time points (at rest and immediately post-exercise) to determine EPA and DHA in red blood cells (RBCs) and plasma levels of L-arg, ADMA, and their metabolites. RBC EPA and DHA significantly increased in the OMEGA group (p < 0.001), which was related to the resting increase in L-arg (p = 0.001) and in the L-arg/ADMA ratio (p = 0.005) with no changes in the MCT group. No differences were found in post-exercise amino acid levels. A total of 12 weeks of omega-3 fatty acid supplementation at a dose of 2234 mg of EPA and 916 mg of DHA daily increased levels of L-arg and the L-arg/ADMA ratio, which indirectly indicates increased bioavailability/NO synthesis. However, these changes were not associated with improved RE in male amateur endurance runners.

Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials.

OBJECTIVE: To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. RESULTS: Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 -3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55-1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: -4.96 to -0.90). CONCLUSION: There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO REGISTRATION NUMBER: CRD42020150630.