Prediction of Functional Overreaching From Subjective Fatigue and Readiness to Train After Only 3 Days of Cycling.

PURPOSE: To investigate whether monitoring of easily measurable stressors and symptoms can be used to distinguish early between acute fatigue (AF) and functional overreaching (FOR). METHODS: The study included 30 subjects (11 female, 19 male; age 40.8 ± 10.8 y, VO2max 51.8 ± 6.3 mL · kg-1 · min-1) who participated in an 8-d cycling event over 1300 km with 18,500 climbing meters. Performance was measured before and after the event using a maximal incremental test. Subjects with decreased performance after the event were classified as FOR, others as AF. Mental and physical well-being, internal training load, resting heart rate, temperature, and mood were measured daily during the event. Differences between AF and FOR were analyzed using mixed-model ANOVAs. Logistic regression was used to determine the best predictors of FOR after 3 and 6 d of cycling. RESULTS: Fifteen subjects were classified as FOR and 14 as AF (1 excluded). Although total group changes were observed during the event, no differences between AF and FOR were found for individual monitoring parameters. The combination of questionnaire-based changes in fatigue and readiness to train after 3 d cycling correctly predicted 78% of the subjects as AF or FOR (sensitivity = 79%, specificity = 77%). CONCLUSIONS: Monitoring changes in fatigue and readiness to train, using simple visual analog scales, can be used to identify subjects likely to become FOR after only 3 d of cycling. Hence, we encourage athlete support staff to monitor not only fatigue but also the subjective integrated mental and physical readiness to perform.

Effect of latissimus dorsi flap breast reconstruction on the strength profile of the upper extremity.

OBJECTIVE: Dissection of the latissimus dorsi (LD) flap may have a distinct impact on upper extremity function and strength. To date, insufficient differentiation has been made between loss of muscular strength and shoulder function by dissection of the LD muscle per se and loss of function resulting from all excisional surgery, radiation therapy, and reconstructive procedures at the donor site and the recipient site that may have been combined near the shoulder region. METHODS: This study determines the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions. The Biodex System 3 Pro (Biodex Medical Systems, New York, NY) was used in 12 patients at a mean of 3.5 years after surgery, and in 20 matched controls. Because loss of LD muscle may not result in significant impairment of activities of daily live (ADL) even in cases where objective measurements are decreased, this study simultaneously assessed the subjective function by use of the standardised Disability of Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: This study observed a significant long-term loss of 8.8 Nm or 19% LD torque strength in synergistic movement directions after transplantation of the LD muscle. This loss correlated significantly with an increase of the mean DASH score among the patients. CONCLUSIONS: Because no significant loss of contra-movement torque strength was observed, it was concluded that the loss of synergistic torque strength appears to result from the loss of LD function per se.