Effects of a nighttime melatonin ingestion on dynamic postural balance and muscle strength the following morning in people living with multiple sclerosis: A preliminary study.

BACKGROUND: Decreased endogenous melatonin concentrations in people with multiple sclerosis (PwMS) are associated with fatigue and pain that impair postural balance and muscle strength. Melatonin ingestion had analgesic and anti-fatigue effects. However, the acute effect of exogenous melatonin on dynamic postural stability and muscle strength has not been studied yet in PwMS. This study aimed to investigate the safety and the efficacy of a nighttime melatonin intake on dynamic postural balance and lower-extremity muscle strength the following morning in PwMS. METHODS: Fourteen PwMS (28.36 ± 6.81 years) were assessed (8 a.m.) pre- and post-acute intake of melatonin or placebo (6mg, 30 minutes before nocturnal bedtime). Evaluated parameters included dynamic postural balance (force platform), lower-extremity muscle strength [Five-Repetition Sit-To-Stand Test (5-STST)], hand dexterity (Nine-Hole Peg Test), nociceptive pain [Visual Analogue Scale (VAS)], neuropathic pain [Neuropathic Pain 4 Questions (DN4)], sleep quality and fatigue perception [Hooper Index (HI)]. RESULTS: In the frontal plane, melatonin reduced the center of pressure (CoP) path length (CoPL), CoPL in the anteroposterior axis (CoPLY) and CoP sway area (CoPAr) compared with placebo by 7.56% (p=0.02, Cohens'd (d)=1.24), 19.27% (p<0.001, d=2.60) and 13.82% (p<0.001, d=2.02), respectively. Melatonin induced a higher decrease in these posturographic parameters compared with placebo in the sagittal plane [CoPL: 9.10% (p=0.005, d=1.02), CoPLY: 4.29% (p=0.025, d=1.07) and CoPAr: 7.45% (p=0.038, d=0.74)]. Melatonin decreased 5-STST duration as well as VAS, DN4, HI-fatigue and HI-sleep scores compared with placebo by 8.19% (p=0.008, d=1.19), 5.74% (p=0.04, d=0.82), 27.30% (p=0.023, d=0.98), 40.15% (p=0.044, d=0.85) and 30.16% (p=0.012, d=1.10), respectively. CONCLUSION: This preliminary study, among PwMS, showed that acute melatonin ingestion was safe and efficient for improving dynamic postural stability and lower-extremity muscle strength probably through its analgesic and anti-fatigue effects.

Sensor-Based Assessment of Time-of-Day-Dependent Physiological Responses and Physical Performances during a Walking Football Match in Higher-Weight Men.

Monitoring key physiological metrics, including heart rate and heart rate variability, has been shown to be of value in exercise science, disease management, and overall health. The purpose of this study was to investigate the diurnal variation of physiological responses and physical performances using digital biomarkers as a precise measurement tool during a walking football match (WFM) in higher-weight men. Nineteen males (mean age: 42.53 ± 12.18 years; BMI: 33.31 ± 4.31 kg·m-2) were engaged in a WFM at two different times of the day. Comprehensive evaluations of physiological parameters (e.g., cardiac autonomic function, lactate, glycemia, and oxygen saturation), along with physical performance, were assessed before, during, and after the match. Overall, there was a significant interaction (time of day x WFM) for mean blood pressure (MBP) (p = 0.007) and glycemia (p = 0.039). Glycemia decreased exclusively in the evening after WFM (p = 0.001), while mean blood pressure did not significantly change. Rating of perceived exertion was significantly higher in the evening than in the morning (p = 0.04), while the heart rate recovery after 1 min (HRR60s) of the match was lower in the evening than in the morning (p = 0.048). Overall, walking football practice seems to be safe, whatever the time of day. Furthermore, HRR60, glycemia, and (MBP) values were lower in the evening compared to the morning, suggesting that evening exercise practice could be safer for individuals with higher weight. The utilization of digital biomarkers for monitoring health status during WFM has been shown to be efficient.

Nocturnal Melatonin Ingestion Improves Soccer Players' Short-Term Maximal Performances on the Following Day.

Purpose: Exogenous melatonin has been proven to have beneficial effects on sleep. A good sleep quality promotes recovery and improves physical performance. In this sense, the present study aimed to explore the potential effect of nocturnal melatonin ingestion on psycho-cognitive and short-term maximal performances, in the following morning. Method: Twelve professional soccer players (22.9 ± 1.3 years, 1.80 ± 0.05 m, and 72.0 ± 8.8 kg) volunteered to perform two separate testing sessions after either nocturnal melatonin or placebo ingestion. The next morning, participants performed the following psycho-cognitive and physical tests: Hooper's index, reaction time, vigilance, handgrip strength (HG), squat jump (SJ), modified agility T-test (MAT) and Wingate anaerobic test (WanT). Rating of perceived exertion (RPE) and blood lactate [La] were recorded, respectively, immediately and 3 min after the WanT. Blood glucose [GL] was measured before and 3 min after WanT. Results: Compared with placebo, melatonin improved subjective sleep quality, short-term maximal performances (HG and SJ), reaction-time, as well as peak and mean WanT powers and decreased fatigue index and RPE scores. However, [La] and [GL] were not affected by melatonin ingestion. Conclusion: Nocturnal melatonin intake before sleep has beneficial effects on cognitive and physical performances the following day.

Is moderate-intensity interval training more tolerable than high-intensity interval training in adults with obesity?

Interval training (IT) has been shown to be a time-effective alternative to traditional training programmes in the management of obesity. Nevertheless, studies comparing the effects of different IT intensities on inflammation, muscle and liver damage, and perceptual responses in people with obesity are relatively scarce. This study aimed to compare the acute effects of two different IT protocols matched by the mean load and duration on biochemical and perceptual responses in sedentary adults with obesity. Twenty-two volunteers (age = 33.40 ± 10.01 years, BMI = 38.29 ± 7.09 kg/m²) were randomized to perform two conditions: moderate-intensity IT (MIIT) 5 × 3 min (70% of peak power output (PPO))/2 min (45%PPO) and high-intensity IT (HIIT) 8 × 1 min (90%PPO)/2 min (45%PPO). Blood samples were drawn before and after exercise for biochemical and haematological measurements. Rating of perceived exertion (RPE) was assessed during and after exercise. Perceptual pain was evaluated before, throughout and after exercise. C-reactive protein, white blood cells and neutrophils increased only after HIIT (p < 0.001, for all). Aspartate aminotransferase, alanine aminotransferase, creatine kinase and lactate dehydrogenase increased in both HIIT and MIIT (p < 0.001, for all), without any difference between sessions. HIIT induced a greater increase of blood lactate compared to MIIT (p < 0.05). Pain and RPE scores were higher during HIIT vs. MIIT (p < 0.001 and p < 0.01, respectively). MIIT induced fewer immune system perturbations and less muscle pain and was perceived as more tolerable compared to HIIT session. Therefore, MIIT could be used as a first step to promote body adaptations before starting a HIIT programme in sedentary people with obesity.

Intervention Based on Psychomotor Rehabilitation in Children with Autism Spectrum Disorder ASD: Effect on Postural Control and Sensory Integration.

Postural stability and control are essential motor skills for successfully performing various activities of daily living. However, children with autism spectrum disorder (ASD) exhibit significant sensorimotor impairments. The aim of this study was to investigate the efficacy of psychomotricity training on postural control (PC) of children with ASD. We recruited thirty children (age = 8.01 ± 1.2; weight = 31.66 ± 8.1 kg; height = 129.7 ± 10.8 cm) diagnosed with ASD (intellectual quotient > 50) to participate in this study. They were divided into two groups: the experimental group (n = 16) and control group (n = 14). Children in the experimental group were trained with psychomotor activities two times a week for nine weeks. Statistic postural balance was assessed before and after intervention and on different vision conditions. The results showed that the psychomotor training significantly improved PC in standing position under different conditions when compared to the control group, in all parameters (CoPA; CoPLX; CoPLy) (p < 0.01). Our preliminary findings suggest the usefulness of the psychomotor training in children with ASD on static PC.

Nap improved game-related technical performance and physiological response during small-sided basketball game in professional players.

The effect of 40-min nap (NAP) opportunity on psycho-physiological outcomes and technical performance during small-sided basketball game (SSG) was examined in ten professional basketball players. Nocturnal sleep and naps were monitored by actigraphic recording and sleep diaries. Nocturnal total sleep time (TST), time in bed (TIB), sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset (WASO) were analyzed. Subjective sleep quality was assessed with visual analogue scale (VAS). Profile of mood state (POMS) and simple reaction time (SRT) were measured before and after Nap and no-nap (CON) conditions. During both test sessions, participants played 10-min SSG. Technical and tactical performances were assessed using Team Sport Assessment Procedure. Volume of play (VP), attack with ball (AB), efficiency index (EI) and performance score (PS) were determined. Heart rate (HR) was measured during SSG, and rating of perceive excretion (RPE) after. Lower HR (p ≤ 0.03, d ≥ 0.78) and RPE (p = 0.007, d = 1.11) were obtained in NAP compared to CON. There was no significant difference in TIB, TST, SE, WASO and VAS between CON and NAP conditions. AB, EI and PS were higher in NAP compared to CON (0.0002 ≤ p ≤ 0.001, 1.3 ≤ d ≤ 1.8). A significant reduction was observed in POMS' fatigue (p = 0.005, d = -1.16, Δ = -53.6%), anxiety (p = 0.02, d = -0.9, Δ = -32.1%), anger (p = 0.01, d = -0.94, Δ = -30.3%), and an improvement in vigor (p = 0.01, d = 0.99, Δ = + 23.8%); which may reflect better readiness after nap and more concentration to start a game-situation. In summary, NAP reduced fatigue, anger, anxiety and enhanced vigor, allowing better technical and tactical performances during basketball SSG.

Monitoring training load in youth soccer players: effects of a six-week preparatory training program and the association between external and internal loads.

This study examined the effects of a six-week preparatory training program on physical performance and physiological adaptations in junior soccer players. Additionally, we investigated whether a relationship existed between external and internal loads. Youth soccer players (aged 16 years old) from a youth football academy participated in six weeks of pre-conditioning training. Wireless Polar Team Pro and Polar heart rate sensors (H10) were used to monitor physical performance indicators (sprint and acceleration scores, covered distance, maximum and average speed and duration), physiological responses (maximum and average heart rate [HR] and R-R interval, time in HR zones 4+5, and heart rate variability [HRV]), and training load score. Additionally, muscle status and rating of perceived exertion (RPE) scores were measured using digital questionnaires. Significant increases were observed in the majority of physical performance indicators [i.e., sprints (p = 0.015, ES = 1.02), acceleration (p = 0.014, ES = 1), total distance (p = 0.02, ES = 0.87), as well as maximum speed (p = 0.02, ES = 0.87)]. A trend towards improvement was observed in the remaining performance indicators (i.e., distance/min and avg speed; ES = 0.6), training load (ES = 0.2), muscle status (ES = 0.3)), and all physiological responses parameters (ES = 0.1 to 0.6). Significant correlations were found between the majority of external load parameters (i.e., performance indicators) and objective (i.e., physiological responses) and subjective (i.e., RPE, muscle status) internal load parameters (p < 0.001). The highest number of moderate-large correlations were registered between performance indicators and time in HR zone 4+5 (0.58 < r < 0.82), training load (0.53 < r < 0.83), average HR (0.50 < r < 0.87), maximal HR (0.51 < r < 0.54) and average R-R interval (0.58 < r < 0.76). HR zone 4+5, average and maximal HR, average R-R interval, and training load score may help control training parameters and reduce the risk of under- or over-training in youth soccer players. However, these conclusions should be confirmed and replicated in future studies with more diverse subject populations.

Effectiveness of Ramadan diurnal intermittent fasting and concurrent training in the management of obesity: is the combination worth the weight?

BACKGROUND AND AIMS: We investigated, in men with obesity, the efficacy of the combination of two strategies (Ramadan diurnal intermittent fasting 'RDIF' strategy vs RDIF plus concurrent training program 'RDIF-CT' strategy) known for their positive impact on body composition and then we explored the possible impact on metabolic and inflammatory biomarkers. METHODS AND RESULTS: Twenty obese men, age: 31.8 ± 7.05 years, BMI: 33.1 ± 4.2 kg m-2, performing regularly RDIF, were randomized into two groups: RDIF-CT (n = 10) and RDIF without training (RDIF-NCT) (n = 10). The RDIF-CT group participated in High intensity interval training (HIIT) program combined with resistance exercises for 4 weeks. Body composition, blood glucose, lipid profile, liver biomarkers and inflammation were assessed before and after 4-week RDIF. Both groups showed a significant decrease in weight, fat mass (FM), fat percentage (Fat%) and waist circumference (WC) and an improvement in blood glucose, lipid profile and inflammation. Fat free mass decreased significantly in RDIF-NCT (p < 0.05) while remaining unchanged in RDIF-CT. However, RDIF-CT induced greater improvements in body composition (i.e., weight, FM, Fat% and WC (p < 0.05, p < 0.01, p < 0.01 and p < 0.05; respectively)) as well as greater decrease in lipid biomarkers (i.e., TC, TG and LDL (p < 0.01 for all)), inflammation (i.e., CRP (p < 0.05)), and liver damage (i.e., ASAT, ALAT and Gamma-GT (p < 0.01, p < 0.05 and p < 0.001; respectively)) compared to RDIF-NCT group pre-post intervention. CONCLUSIONS: Our results suggest that a combination of RDIF and CT induces greater changes in body composition, lipid profile, inflammation and liver biomarkers compared to RDIF strategy alone. CLINICAL TRIAL REGISTER: PACTR202203475387226.

Dietary Intake and Body Composition During Ramadan in Athletes: A Systematic Review and Meta-Analysis With Meta-Regression.

The aim of this research was to evaluate the effect of Ramadan observance on dietary intake and body composition in adult athletes. This was a systematic review and meta-analysis. Data sources used were PubMed, Web of Science, Scopus, and Taylor and Francis. Eligibility criteria for selecting studies were as follows: single-group, pre-/post-Ramadan, with or without control group, conducted in athletes aged ≥19 years training at least twice a week, and published in any language before August 25, 2021. Studies assessing dietary intake and/or body composition were deemed eligible. The methodological quality of studies was assessed using QualSyst. Nine studies evaluated dietary intake; 4 of these were rated as strong quality and the remaining as moderate. Of the 17 selected studies evaluating body composition, 7 were of strong quality and the remaining 10 were rated as moderate. Compared to pre-Ramadan, energy (number of studies, K = 7; number of participants, N = 78; g = -0.781; 95% confidence interval [CI], -1.416 to -0.145; p = 0.016), carbohydrate (K = 5; N = 50; g = -1.643; 95% CI, -2.949 to -0.336; p = 0.014), and water (K = 4; N = 39; g = -1.081; 95% CI, -1.371 to -0.790; p = 0.000) intakes decreased during Ramadan. However, fat (K = 5; N = 50; g = -0.472; 95% CI, -1.085 to 0.140; p = 0.131) and protein (K = 5; N = 60; g = -0.574; 95% CI, -1.213 to -0.066; p = 0.079) intakes remained unchanged. Compared to pre-Ramadan, body mass (K = 16; N = 131; g = -0.262; 95% CI, -0.427 to -0.097; p = 0.002) and body fat percentage (K = 8; N = 81; g = -0.197; 95% CI, -0.355 to -0.040; p = 0.014) decreased in the fourth week of Ramadan. Lean body mass did not change during Ramadan (K = 4; N = 45; g = -0.047; 95% CI, -0.257 to 0.162; p = 0.658). Carbohydrate and total water intake decreased with the observance of Ramadan, but fat and protein intake were unchanged. Continued training of athletes during Ramadan was associated with a decreased body mass and body fat percentage, but not lean body mass, toward the end of the fasting month.Key pointsRamadan fasting decreases body mass and body fat percentage of athletes, but not lean body mass.Longer durations of fasting could provoke more pronounced decrements in body mass.Carbohydrate and total water intake decreased during Ramadan in athletes.Future studies, with greater methodological rigor, are required to better discern changes in dietary intake and body composition during Ramadan.Supplemental data for this article is available online at https://doi.org/10.1080/07315724.2021.2000902 .

Physiological response and physical performance after 40 min and 90 min daytime nap opportunities.

This study aimed to examine the impact of 40-min and 90-min naps on performance in the 5-m shuttle run test (5mSRT) and on various physiological and perceptual measures. Sixteen male athletes (20 ± 3 years, 173 ± 7 cm, 67 ± 7 kg) performed the 5mSRT after a 40-min nap (N40), after a 90-min nap (N90), and in a no-nap, control condition (N0). The 5mSRT involves six repetitions of 30 s of all-out exercise. Total distance (in the six repetitions) and highest distance (in a single repetition) in the 5mSRT were greater after naps than in N0 (p < 0.001), and the total distance, which reflects the anaerobic capacity, was greater in N90 than in N40 (p < 0.05). Physiological and perceptual responses were favourable in both nap conditions (p < 0.01), more so in N90 than in N40 (p < 0.05). Together, the results support the contention that physiological/perceptual responses after napping contribute to improved exercise performance and that longer naps are more effective.

40-min nap opportunity attenuates heart rate and perceived exertion and improves physical specific abilities in elite basketball players.

The effect of a 40-min nap opportunity on physiological responses and specific abilities was investigated. Twelve high-level professional basketball players (26.33±5.2 years; 193.17±7.1 m; 87.48±11.2 kg) undertook randomly 40-min nap opportunity (NAP) and control condition (CON). Wellness (Hooper Index) and Epworth Sleepiness Scale (ESS) were measured before and after both conditions. Defensive (DA) and offensive (OA) agility and upper body power (UBP) were assessed after both conditions. Shooting skill (SST) performance was evaluated prior and after a fatiguing task (FT). Heart rate (HR) and rating of perceived exertion (RPE) were recorded during SST-test, FT and SST-retest. ESS, Hooper's stress and fatigue score were significantly lower after nap compared to those before nap (0.009 ≤ p ≤ 0.03). Better performance was obtained in NAP compared to CON condition for DA, OA and UBP (0.0005 ≤ p ≤ 0.02). SST performance was significantly higher in NAP compared to CON in the retest session (p = 0.003, Δ = 20.2%).         The improved performance was associated with significant lower HRpeak (p = 0.01, Δ = 5.25%) and RPE (p = 0.003, Δ = 15.12%). In conclusion, NAP reduced sleepiness and stress and fatigue and enhances physical outcomes of specific skills in elite basketball players.

Melatonin Ingestion Prevents Liver Damage and Improves Biomarkers of Renal Function Following a Maximal Exercise.

Background: While the promotion of the beneficial effects of melatonin (MEL) ingestion on the modulation of oxidative stress is widespread, less attention is given to the biological influence that it could exert on the results of hematology and clinical chemistry parameters. This study was undertaken to assess the effects of acute MEL ingestion on these parameters during a maximal running exercise. Methods: In double blind randomized design, 12 professional soccer players [age: 17.54 ± 0.78 yrs, body mass: 70.31 ± 3.86 kg, body height: 1.8 ± 0.08 m; maximal aerobic speed (MAS): 16.85 ± 0.63 km/h; mean ± standard deviation], all males, performed a diurnal (17:00 h ± 30 h) running exercise test (RET) at 100% of their MAS following either MEL or placebo ingestion. Blood samples were obtained at rest and following the RET. Results: Compared to placebo, MEL intake decreased post-exercise biomarkers of liver damage (aspartate aminotransferase, p<0.001; alanine aminotransferase, p<0.001; gamma-glutamyltransferase; p<0.05) and improved post-exercise renal function markers (i.e., creatinine, p<0.001). However, lipid profile, glucose, lactate and leukocyte were not affected by MEL ingestion. Regarding the time to exhaustion, no difference was found between MEL (362.46 ± 42.06 s) and PLA (374.54 ± 57.97 s) conditions. Conclusion: The results of this investigation clearly attest that MEL ingestion before a maximal running exercise might protect athletes from liver damage and perturbation in renal function biomarkers. However, this study comprises an acute MEL supplementation and no assessment on chronic effects or circadian rhythm the day before was done.

Benefits and risks of napping in older adults: A systematic review.

A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim of this systematic review was to (i) determine how studies evaluated napping behavior in older adults (frequency, duration and timing); (ii) explore how napping impacts perceptual measures, cognitive and psychomotor performance, night-time sleep and physiological parameters in the elderly (PROSPERO CRD42022299805). A total of 738 records were screened by two researchers using the PICOS criteria. Fifteen studies met our inclusion criteria with a mean age ranging from 60.8 to 78.3 years and a cumulative sample size of n = 326. Daytime napping had an overall positive impact on subjective measures (i.e., sleepiness and fatigue), psychomotor performances (i.e., speed and accuracy) and learning abilities (i.e., declarative and motor learning). Additionally, studies showed (i) consistency between nap and control conditions regarding sleep duration, efficiency and latency, and proportion of sleep stages, and (ii) increase of 24 h sleep duration with nap compared to control condition. Based on the findings of the present review, there is minimal evidence to indicate that napping is detrimental for older adults' nighttime sleep. Future studies should consider involving repeated naps during a micro-cycle in order to investigate the chronic effect of napping on older adults. Systematic review registration: identifier: CRD42022299805.

The effect of caffeine, nap opportunity and their combination on biomarkers of muscle damage and antioxidant defence during repeated sprint exercise.

To investigate the effect of 20 min nap opportunity (N20), 5 mg · kg-1 of caffeine (CAF) and their combination (CAF+N20) on the biochemical response (energetic biomarkers, biomarkers of muscle damage and enzymatic antioxidants) to the running-based anaerobic sprint test. Fourteen highly trained male athletes completed in a double-blind, counterbalanced and randomized order four test sessions: no nap with placebo (PLA), N20, CAF and CAF+N20. Compared to PLA, all treatments enhanced maximum and mean powers. Minimum power was higher [(mean difference) 58.6 (95% confidence interval = 1.31-116) Watts] after CAF and [102 (29.9-175) Watts] after CAF+N20 compared to N20. Also, plasma glucose was higher after CAF [0.81 (0.18-1.45) mmol · l-1] and CAF+N20 [1.03 (0.39-1.64) mmol · l-1] compared to N20. However, plasma lactate was higher [1.64 (0.23-3.03) mmol · l-1] only after N20 compared to pre-exercise, suggesting a higher anaerobic glycolysis during N20 compared to PLA, CAF and CAF+N20. Caffeine ingestion increased post-exercise creatine kinase with [54.3 (16.7-91.1) IU · l-1] or without napping [58.9 (21.3-96.5) IU · l-1] compared to PLA. However, superoxide dismutase was higher after napping with [339 (123-554) U · gHB-1] or without caffeine [410 (195-625) U · gHB-1] compared to PLA. Probably because of the higher aerobic glycolysis contribution in energy synthesis, caffeine ingestion resulted in better repeated sprint performance during CAF and CAF+N20 sessions compared to N20 and PLA. Caffeine ingestion resulted in higher muscle damage, and the short nap enhanced antioxidant defence with or without caffeine ingestion.

Melatonin supplementation alleviates cellular damage and physical performance decline induced by an intensive training period in professional soccer players.

Melatonin has been proved to have positive effects on cellular damage and metabolic regulation. The aim of the study was to determine the effect of melatonin supplementation during an intensive training period on physical performance decline, oxidative stress and cellular damage state. The investigation was conducted on 20 soccer players who participated in an exhaustive six-day training schedule associated with daily 5 mg oral melatonin or placebo ingestion. Resting blood samples and physical performance were measured before and after the training period. The mixed 2-way ANOVA (group x training camp) showed that compared to placebo, melatonin intake prevented an increase in advanced oxidation protein products (p>0.05) and increased the antioxidant enzyme activity (i.e., superoxide dismutase; p<0.001). In addition, melatonin prevented an increase of biomarkers of renal function (e.g., creatinine; p>0.05) and biomarkers of muscle (e.g., creatine kinase; p>0.05) and liver (e.g., gamma-glutamyltransferase; p>0.05) damage. Furthermore, melatonin alleviated the deterioration in physical performance (countermovement jump, five-jump test and 20-m sprint; p>0.05). In conclusion, the obtained data showed increased oxidative stress and renal, muscle and liver damage in professional soccer players during an exhaustive training schedule. Melatonin intake during the training period exerts beneficial effects on physical performance and protects tissues against the deleterious effects of reactive oxygen species and cellular damage.

Lockdown Duration and Training Intensity Affect Sleep Behavior in an International Sample of 1,454 Elite Athletes.

Objective: To investigate the effect of 1) lockdown duration and 2) training intensity on sleep quality and insomnia symptoms in elite athletes. Methods: 1,454 elite athletes (24.1 ± 6.7 years; 42% female; 41% individual sports) from 40 countries answered a retrospective, cross-sectional, web-based questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: 1) Pittsburgh sleep quality index (PSQI); 2) Insomnia severity index (ISI); bespoke questions about 3) napping; and 4) training behaviors. The association between dependent (PSQI and ISI) and independent variables (sleep, napping and training behaviors) was determined with multiple regression and is reported as semi-partial correlation coefficient squared (in percentage). Results: 15% of the sample spent < 1 month, 27% spent 1-2 months and 58% spent > 2 months in lockdown. 29% self-reported maintaining the same training intensity during-lockdown whilst 71% reduced training intensity. PSQI (4.1 ± 2.4 to 5.8 ± 3.1; mean difference (MD): 1.7; 95% confidence interval of the difference (95% CI): 1.6-1.9) and ISI (5.1 ± 4.7 to 7.7 ± 6.4; MD: 2.6; 95% CI: 2.3-2.9) scores were higher during-compared to pre-lockdown, associated (all p < 0.001) with longer sleep onset latency (PSQI: 28%; ISI: 23%), later bedtime (PSQI: 13%; ISI: 14%) and later preferred time of day to train (PSQI: 9%; ISI: 5%) during-lockdown. Those who reduced training intensity during-lockdown showed higher PSQI (p < 0.001; MD: 1.25; 95% CI: 0.87-1.63) and ISI (p < 0.001; MD: 2.5; 95% CI: 1.72-3.27) scores compared to those who maintained training intensity. Although PSQI score was not affected by the lockdown duration, ISI score was higher in athletes who spent > 2 months confined compared to those who spent < 1 month (p < 0.001; MD: 1.28; 95% CI: 0.26-2.3). Conclusion: Reducing training intensity during the COVID-19-induced lockdown was associated with lower sleep quality and higher insomnia severity in elite athletes. Lockdown duration had further disrupting effects on elite athletes' sleep behavior. These findings could be of relevance in future lockdown or lockdown-like situations (e.g., prolonged illness, injury, and quarantine after international travel).

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

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

Ramadan Observance Exacerbated the Negative Effects of COVID-19 Lockdown on Sleep and Training Behaviors: A International Survey on 1,681 Muslim Athletes.

Objective: Disrupted sleep and training behaviors in athletes have been reported during the COVID-19 pandemic. We aimed at investigating the combined effects of Ramadan observance and COVID-19 related lockdown in Muslim athletes. Methods: From an international sample of athletes (n = 3,911), 1,681 Muslim athletes (from 44 countries; 25.1 ± 8.7 years, 38% females, 41% elite, 51% team sport athletes) answered a retrospective, cross-sectional questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: (i) Pittsburgh sleep quality index (PSQI); (ii) insomnia severity index (ISI); (iii) bespoke questions about training, napping, and eating behaviors, and (iv) questions related to training and sleep behaviors during-lockdown and Ramadan compared to lockdown outside of Ramadan. The survey was disseminated predominately through social media, opening 8 July and closing 30 September 2020. Results: The lockdown reduced sleep quality and increased insomnia severity (both p < 0.001). Compared to non-Muslim (n = 2,230), Muslim athletes reported higher PSQI and ISI scores during-lockdown (both p < 0.001), but not pre-lockdown (p > 0.05). Muslim athletes reported longer (p < 0.001; d = 0.29) and later (p < 0.001; d = 0.14) daytime naps, and an increase in late-night meals (p < 0.001; d = 0.49) during- compared to pre-lockdown, associated with lower sleep quality (all p < 0.001). Both sleep quality (χ2 = 222.6; p < 0.001) and training volume (χ2 = 342.4; p < 0.001) were lower during-lockdown and Ramadan compared to lockdown outside of Ramadan in the Muslims athletes. Conclusion: Muslim athletes reported lower sleep quality and higher insomnia severity during- compared to pre-lockdown, and this was exacerbated by Ramadan observance. Therefore, further attention to Muslim athletes is warranted when a circadian disrupter (e.g., lockdown) occurs during Ramadan.