Psychological Stress Triggers a Hyperammonemia Episode in Patient with Ornithine Transcarbamylase Deficiency.

An 18-year-old male motorcycle racer, who was a participant in the FIM Road Racing World Championship and had a history of Ornithine Transcarbamylase deficiency, developed nausea and dizziness while driving his motorcycle and became unconscious right after he stopped at the box. He was rapidly attended to by the medical personnel of the circuit, and once he recovered consciousness, he was taken to the local hospital where the blood analysis showed hyperammonemia (307 µg/dL) and excess alkalosis. The patient was properly following the prescribed treatment, and there were no environmental stressors. Hence, psychological stress and its somatization due to the risky task that the patient was performing could have triggered the episode. Stress must be considered as a potential cause, triggering strenuous metabolic stress that leads to hyperammonemia.

The Impact of Nationality on the Psychophysiological Stress Response and Academic Fulfilment in the Final Degree Dissertation.

The aims of this study were: i. to analyze the effect of nationality on the psychophysiological stress response of physiotherapy last year students in their final degree dissertations; and ii. to analyze the relationship between the stress response and academic results according to nationality. We evaluated the autonomic stress response, cortical arousal, distress subjective perception, and objective and subjective academic fulfilment in Spanish, Italian, and French physiotherapy students during their final degree dissertation. Results showed a large anticipatory anxiety response before the dissertation in the three student groups. Only the Spanish group showed an increased tendency in the habituation process, reducing the psychophysiological stress response during the dissertation, while the Italian and French groups maintained a large sympathetic activation until the end of the dissertation. Cortical arousal and subjective perception of distress were similar in the three nationalities. In addition, no correlation between academic fulfilment and autonomic modulation was found. We concluded that there was no nationality effect in the psychophysiological stress response of physiotherapy last year students in their final degree dissertation, all of them showing a large anticipatory anxiety response.

Effects of Beetroot Juice Ingestion on Physical Performance in Highly Competitive Tennis Players.

Beetroot juice (BJ) contains high levels of inorganic nitrate (NO3-) and its intake has good evidence in increasing blood nitrate/nitrite concentrations. The ingestion of BJ has been associated with improvements in physical performance of endurance sports, however the literature in intermittent sports is scarce. The aim of this study was to investigate whether BJ could improve physical performance in tennis players. Thirteen well-trained tennis players (25.4 ± 5.1 years) participated in the study during their preparatory period for the tennis season. Subjects were randomly divided into two groups and performed a neuromuscular test battery after either BJ or placebo (PLA) consumption. Both trials were executed on two separate days, in randomized order, with one week of wash out period. The test battery consisted of serve velocity test (SVT), countermovement jump (CMJ), isometric handgrip strength (IHS), 5-0-5 agility test (5-0-5), and 10 m sprint (10-m). No significant differences were found in SVT (1.19%; p = 0.536), CMJ (0.96%; p = 0.327), IHS (4.06%; p = 0.069), 5-0-5 dominant and nondominant side (1.11-2.02%; p = 0.071-0.191) and 10-m (1.05%; p = 0.277) when comparing BJ and PLA ingestion. Thus, our data suggest that low doses of BJ (70 mL) consumption do not enhance tennis physical performance.

The acute effect of match-play on hip range of motion and isometric strength in elite tennis players.

BACKGROUND: Groin injuries are some of the most common injuries tennis players suffer. Several factors (e.g., post-match decrease in hip adductor (ADD) strength) have been proposed as possible mechanisms for increasing the incidence of this type of injury. However, the risk factors of developing groin injuries after a tennis match have not yet been delineated. OBJECTIVE: The aim of this study was to determine the effect of tennis match-play on isometric ADD and abductor (ABD) strength and passive hip range of motion (ROM). METHODS: Twenty-six male tennis players (20.30 ± 4.98 years) took part in this study. Participants completed an evaluation of strength and flexibility hip measurements before and after a simulated tennis match. Dominant and non-dominant passive hip ROM, ADD and ABD isometric strength, and the ADD/ABD strength ratio were measured before and immediately post-match. A global positioning system (GPS) and a session rating of perceived exertion (RPE) were used to assess the locomotive demands and internal match load. RESULTS: Isometric dominant ADD strength (17.8%, p ≤ 0.01) and ADD/ABD strength ratio (11.6%, p = 0.04) were lower post-match compared to the pre-match values. No between-limbs differences were observed for isometric ADD strength, ABD strength, and passive hip ROM tests. RPE showed an expected increase between pre- vs. post-match (pre- vs. post-warming-up, 3.42 ± 2.08 vs. 5.62 ± 2.29, p < 0.01). In addition, a significant relationship between ADD strength and the volume of tennis practice per week was found, stablishing that tennis players with lower volume of training per week suffered a reduction in ADD strength in their dominant limb after match-play (r = 0.420, p = 0.04). CONCLUSION: The assessment of ADD strength and the ADD/ABD strength ratio in the dominant limb may be considered a post-match tool that can be used to identify players who require rest and additional recovery strategies before competing again.

Acute effects of a single tennis match on passive shoulder rotation range of motion, isometric strength and serve speed in professional tennis players.

Shoulder pain has been associated with glenohumeral internal rotation deficit (GIRD) and a reduction in external rotation (ER) strength; however, in tennis players, there is scarce evidence regarding the impact of a single match on shoulder range of motion (ROM), strength and serve speed. The aim of this study was to determine the acute effect of a single tennis match on shoulder rotation ROM, isometric strength and serve speed. Twenty-six professional tennis players participated in the study (20.4±4.4 years; 10.5±3.2 years tennis expertise; 20.5±5.4 h/week training). Passive shoulder external (ER-ROM) and internal rotation ROM (IR-ROM), ER and IR isometric strength were measured before and after a single tennis match (80.3±21.3 min) in both shoulder´s. Moreover, the total arc of motion (TAM) and ER/IR strength ratio were calculated. Video analysis was used to assess the number of serves and groundstrokes, while a radar gun was utilized to measure maximal ball speed. In the dominant shoulder, compared to pre-match levels, IR-ROM was significantly reduced (-1.3%; p = 0.042), while ER-ROM (5.3%; p = 0.037) and TAM (3.1%; p = 0.050) were significantly increased. In the non-dominant shoulder, ER-ROM (3.7%; p = 0.006) was increased. Furthermore, in the dominant shoulder, the isometric ER strength was significantly reduced after the match (-4.8%; p = 0.012), whereas serve speed was not significantly reduced after match (-1.16%; p = 0.197). A single tennis match leads to significant reductions in shoulder ROM (e.g., IR of the dominant shoulder) and isometric strength (e.g., ER of the dominant shoulder). This study reveals the importance of recovery strategies prescription aiming at minimize post-match alteration in the shoulders.

Validity and Reliability of Ventilatory and Blood Lactate Thresholds in Well-Trained Cyclists.

PURPOSE: The purpose of this study was to determine, i) the reliability of blood lactate and ventilatory-based thresholds, ii) the lactate threshold that corresponds with each ventilatory threshold (VT1 and VT2) and with maximal lactate steady state test (MLSS) as a proxy of cycling performance. METHODS: Fourteen aerobically-trained male cyclists ([Formula: see text] 62.1±4.6 ml·kg-1·min-1) performed two graded exercise tests (50 W warm-up followed by 25 W·min-1) to exhaustion. Blood lactate, [Formula: see text] and [Formula: see text] data were collected at every stage. Workloads at VT1 (rise in [Formula: see text];) and VT2 (rise in [Formula: see text]) were compared with workloads at lactate thresholds. Several continuous tests were needed to detect the MLSS workload. Agreement and differences among tests were assessed with ANOVA, ICC and Bland-Altman. Reliability of each test was evaluated using ICC, CV and Bland-Altman plots. RESULTS: Workloads at lactate threshold (LT) and LT+2.0 mMol·L-1 matched the ones for VT1 and VT2, respectively (p = 0.147 and 0.539; r = 0.72 and 0.80; Bias = -13.6 and 2.8, respectively). Furthermore, workload at LT+0.5 mMol·L-1 coincided with MLSS workload (p = 0.449; r = 0.78; Bias = -4.5). Lactate threshold tests had high reliability (CV = 3.4-3.7%; r = 0.85-0.89; Bias = -2.1-3.0) except for DMAX method (CV = 10.3%; r = 0.57; Bias = 15.4). Ventilatory thresholds show high reliability (CV = 1.6%-3.5%; r = 0.90-0.96; Bias = -1.8-2.9) except for RER = 1 and V-Slope (CV = 5.0-6.4%; r = 0.79; Bias = -5.6-12.4). CONCLUSIONS: Lactate threshold tests can be a valid and reliable alternative to ventilatory thresholds to identify the workloads at the transition from aerobic to anaerobic metabolism.

Acute psychological and behavioral effect of COVID-19 confinement measures in Spanish population / Efecto psicológico y conductual agudo de las medidas de confinamiento del COVID-19 en población española

Objective: The COVID-19 pandemic is now a major global health issue and quarantine is being applicated worldwide as asuppression measure. The aim of this study was to analyse the psychological and behavioural modifications associated withthe first phase of the confinement period in Spanish population.Material and method: Variables of anxiety, sleep quality, motivation, food intake and physical activity habits and body weightwere analysed in ninety-one participants (35.7±10.4 years old) at the beginning of the quarantine, after three days, one week,two weeks and three weeks of the confinement decreed in Spain.Results: A significant (P<0.05) increase of 20% prevalence was found in the number of participants that started to exercise.Despite this, anxiety levels increased throughout the confinement, being significant after 2 weeks of isolation compared tothe initial moment. None of the other variables significantly presented modifications. Correlation analysis showed that anxietylevels were positively related to the number of daily food intakes and negatively to sleep quality. On the other hand, the timededicated to aerobic exercise was negatively related to body weight and the number of intakes, and positively to the timededicated to anaerobic exercise (p <0.05 for all correlations).Conclusion: We found how first phase of confinement period in the COVID-19 pandemic in Spain produced a significantincrease in anxiety levels, and subjects that started to exercise, do not significantly affecting body weight, food intakes, sleepquality and motivation of subjects. Higher food ingestions per day positively correlated with anxiety and negatively withsleep quality.(AU)

Objetivo: La pandemia de COVID-19 es ahora un importante problema de salud mundial y la cuarentena se está aplicandoen todo el mundo como medida de supresión. El objetivo de este estudio fue analizar las modificaciones psicológicas yconductuales asociadas a la primera fase del período de encierro en población española.Material y método: Se analizaron variables de ansiedad, calidad del sueño, motivación, ingesta alimentaria y hábitos deactividad física y peso corporal en noventa y un participantes (35,7 ± 10,4 años) al inicio de la cuarentena, después de tresdías, una semana, dos semanas y tres semanas del confinamiento decretado en España.Resultados: Se encontró un aumento significativo (P <0,05) del 20% de prevalencia en el número de participantes quecomenzaron a hacer ejercicio. A pesar de ello, los niveles de ansiedad aumentaron a lo largo del confinamiento, siendosignificativo a las 2 semanas de aislamiento respecto al momento inicial. Ninguna de las otras variables estudiadas presentómodificaciones significativas. El análisis de correlaciones mostró que los niveles de ansiedad se relacionaron positivamentecon el número de ingestas de comida diaria y negativamente con la calidad del sueño. Por otro lado, el tiempo dedicado aejercicio aeróbico se relacionó negativamente con el peso corporal y el número de ingestas, y positivamente con el tiempodedicado a ejercicio anaeróbico (p<0,05 para todas las correlaciones).Conclusión: Encontramos cómo la primera fase del período de encierro en la pandemia de COVID-19 en España produjo unaumento significativo en los niveles de ansiedad, y los sujetos que comenzaron a hacer ejercicio, no afectaron significativa-mente el peso corporal, la ingesta de alimentos, la calidad del sueño y la motivación de los sujetos. La mayor ingesta diariade alimentos se correlacionó positivamente con la ansiedad y negativamente con la calidad del sueño.(AU)

Aerobic Exercise Training Increases Muscle Water Content in Obese Middle-Age Men.

PURPOSE: The objective of this study is to determine whether muscle water content (H2Omuscle) expands with training in deconditioned middle-age men and the effects of this expansion in other muscle metabolites. METHODS: Eighteen obese (BMI = 33 ± 3 kg⁻¹·m⁻²) untrained (V˙O2peak = 29 ± 7 mL⁻¹·kg⁻¹·min⁻¹) metabolic syndrome men completed a 4-month aerobic cycling training program. Vastus lateralis muscle biopsies were collected before and 72 h after the completion of the last training bout. Water content, total protein, glycogen concentration, and citrate synthase activity were measured in biopsy tissue. Body composition was assessed using dual-energy X-ray absorptiometry, and cardiometabolic fitness was measured during an incremental cycling test. RESULTS: Body weight and fat mass were reduced -1.9% and -5.4%, respectively (P < 0.05), whereas leg fat free mass increased with training (1.8%, P = 0.023). Cardiorespiratory fitness (i.e., V˙O2peak), exercise maximal fat oxidation (i.e., FOmax), and maximal cycling power (i.e., Wmax) improved with training (11%, 33%, and 10%, respectively; P < 0.05). After 4 months of training, H2Omuscle increased from 783 ± 18 to 799 ± 24 g·kg⁻¹ wet weight (ww) (2%, P = 0.011), whereas muscle protein concentration decreased 11% (145 ± 15 to 129 ± 13 g·kg⁻¹ ww, P = 0.007). Citrate synthase activity (proxy for mitochondrial density) increased by 31% (17 ± 5 to 22 ± 5 mmol·min⁻¹·kg⁻¹ ww, P = 0.024). Muscle glycogen concentration increased by 14% (22 ± 7 to 25 ± 7 g·kg⁻¹ ww) although without reaching statistical significance when expressed as per kilogram of wet weight (P = 0.15). CONCLUSIONS: Our findings suggest that aerobic cycling training increases quadriceps muscle water although reduces muscle protein concentration in obese metabolic syndrome men. Reduced protein concentration coexists with increased leg lean mass suggestive of a water dilution effect that however does not impair increased cycling leg power with training.

Comparison of glucose tolerance tests to detect the insulin sensitizing effects of a bout of continuous exercise.

The aim of the present study was to determine which of the available glucose tolerance tests (oral (OGTT) vs. intravenous (IVGTT)) could more readily detect the insulin sensitizing effects of a bout of continuous exercise. Ten healthy moderately fit young men (V̇O2peak of 45.4 ± 1.8 mL·kg(-1)·min(-1); age 27.5 ± 2.7 yr) underwent 4 OGTT and 4 IVGTT on different days following a standardized dinner and overnight fast. One test was performed immediately after 55 min of cycle-ergometer exercise at 60% V̇O2peak. Insulin sensitivity index was determined during a 50 min IVGTT according to Tura (CISI) and from a 120 min OGTT using the Matsuda composite index (MISI). After exercise, MISI improved 29 ± 10% without reaching statistical significance (p = 0.182) due to its low reproducibility (coefficient of variation 16 ± 3%; intra-class reliability 0.846). However, CISI significantly improved (50 ± 4%; p < 0.001) after exercise showing better reproducibility (coefficient of variation 13 ± 4%; intra-class reliability 0.955). Power calculation revealed that 6 participants were required for detecting the effects of exercise on insulin sensitivity when using IVGTT, whereas 54 were needed when using OGTT. The superior response of CISI compared with MISI suggests the preferential use of IVGTT to assess the effects of exercise on insulin sensitivity when using a glucose tolerance test.

Increased blood cholesterol after a high saturated fat diet is prevented by aerobic exercise training.

A high saturated fatty acids diet (HSFAD) deteriorates metabolic and cardiovascular health while aerobic training improves them. The aim of this study was to investigate in physically inactive and overweight people if 2 weeks of HSFAD leads to hyperlipemia or insulin resistance and if concurrent aerobic exercise training counteracts those effects. Fourteen overweight (body mass index, 27.5 ± 0.6 kg·m(-2)), healthy, young individuals (aged 24.8 ± 1.8 years) were randomly assigned to a diet (D) or a diet plus exercise (D + E) group. During 14 consecutive days both groups increased dietary saturated fatty acids from 31 ± 10 to 52 ± 14 g·day(-1) (p < 0.001) while maintaining total fat intake. Concurrent to the diet, the D + E group underwent 11 cycle-ergometer sessions of 55 min at 60% peak oxygen uptake (V˙O(2peak)). Before and after intervention, insulin sensitivity and body composition were estimated, and blood lipids, resting blood pressure, and VO(2peak) were measured. Body weight and composition, plasma free fatty acids composition and concentration, and insulin sensitivity remained unchanged in both groups. However, post-intervention total cholesterol (T(C)) and low-density lipoprotein cholesterol (LDL-C) increased above pre-intervention values in the D group (147 ± 8 to 161 ± 9 mg·dL(-1), p = 0.018 and 71 ± 10 to 82 ± 10 mg·dL(-1), p = 0.034, respectively). In contrast, in the D + E group, T(C) and LDL-C remained unchanged (153 ± 20 to 157 ± 24 mg·dL(-1) and 71 ± 21 to 70 ± 25 mg·dL(-1)). Additionally, the D + E group lowered systolic blood pressure (6 ± 2 mm Hg, p = 0.029) and increased VO(2peak) (6 ± 2 mL·kg(-1)·min(-1), p = 0.020). Increases in T(C) and LDL-C concentration induced by 14 days of HSFAD can be prevented by concurrent aerobic exercise training, which, in addition, improves cardiorespiratory fitness.