Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points - A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes.

The study aimed to evaluate the immediate effects of a dry needling (DN) therapy session on biomechanical properties, muscle power, perfusion, and pressure pain threshold of the gastrocnemius muscle with latent trigger points. Twenty mixed martial arts athletes (MMA) were randomly divided into two groups: experimental (eDN, n = 10) and sham (qDN, n = 10) to undergo one session of DN either with a real or a qazi needle. The measurements were taken at rest, 1-5 minutes after the DN (Post1-5min) and 24h after the DN (Post24h). DN significantly increased the muscle perfusion (Post1-5min and Post24h, p < 0.001), reduced its tone (Post1-5min and Post24h, p < 0.001) and stiffness (Post1-5min, p < 0.05; Post24 h, p < 0.001), and improved its elasticity (Post1-5min and Post24h, p < 0.001). DN also caused a significant increase in pressure pain threshold (Post1-5min, p < 0.001; Post24h, p < 0.05) and in muscle power (Post24h, p < 0.01). The DN session increased the blood perfusion and improved the biomechanical properties of the gastrocnemius muscle, which led to improved muscle power. The DN also had an analgesic effect. These effects were maintained at 24 h, which suggests that DN could facilitate muscle recovery in a post-exercise period of MMA athletes.

Influence of the breathing pattern on the pulmonary function of endurance-trained athletes.

Proper functioning of the respiratory system is one of the most important determinants of human health. According to current knowledge, the diaphragmatic breathing pattern seems to be the most favourable. However, recent reports indicate that athletes often have dysfunctional breathing patterns, which may be associated with an increased risk of musculoskeletal injuries. The influence of the type of breathing pattern on the mechanical airways in athletes has not been investigated. The aim of the present study was to determine the characteristics and relationships between breathing patterns and respiratory function in athletes. This study included 69 Polish elite endurance athletes (♂40, ♀29) in different sports disciplines and 44 (♂17, ♀27) healthy nonathletes as a control group. All participants underwent pulmonary function tests (spirometry, plethysmography, diffusion capacity for carbon monoxide) with assessment of breathing patterns by the Hi-Lo test. Inspiratory and expiratory resistance (R) and reactance (X) of the respiratory system at a given frequency (5 Hz, 11 Hz, and 19 Hz) were measured by a noninvasive forced oscillation technique. In this study, almost half of the athletes (44.92%) had dysfunctional breathing patterns, although at a lower rate than that in the control group. Diaphragmatic breathing patterns were characterized by higher spirometric, plethysmographic and DLCO values compared to thoracic or abdominal breathing patterns. Similarly, lower inspiratory reactance at 5 Hz (X5%pred.) was observed in the diaphragmatic pattern compared to the thoracic pattern. A diaphragmatic breathing pattern is associated with better pulmonary function test results. However, this study revealed a dysfunctional breathing pattern in almost half of the athletes. These results suggest that the assessment of breathing patterns and the implementation of breathing exercises in athletes are essential to promote proper breathing patterns.

The Effects of Omega-3 Fatty Acid Supplementation on the Lipid Profile and Cardiovascular Markers Following Downhill Running in Long-Distance Runners.

Exercise-induced injury may intensify inflammatory response and reduce the cardiovascular protection mechanisms of omega 3 polyunsaturated fatty acids (ω 3 PUFA). Therefore, this study aimed to determine the erythrocyte content of fatty acids (ω 3 and ω 6), the levels of cardiac damage markers (CKMB, hsTnT, H - FABP), the concentration of inflammation mediators (IL-6, TNF α) in long distance runners supplemented with ω 3 PUFA. Twenty-four male long distance runners, who were randomly assigned to a placebo group (GrP) or a group supplemented (GrSuppl) with a daily dose of 3,000 mg of ω 3 PUFA for three weeks, participated in the study. Participants performed a downhill running exercise test. Blood samples were collected at rest and after the exercise protocol to analyse the levels of cardiac markers and inflammatory cytokines. The erythrocyte membrane content of EPA and DHA in the GrSuppl at the 3rd week of supplementation was significantly higher than at the baseline (p < 0.001). The erythrocyte membrane content of ω 3 PUFA in the GrSuppl was significantly higher at the completion of supplementation (p < 0.001). Supplementation with ω 3 PUFA improved blood lipid profiles and reduced the concentration of inflammation mediators measured after the eccentric exercise tests. The increased ω 3 PUFA content in the erythrocyte membrane and lower blood concentrations of cardiac damage markers and inflammation mediators in distance runners supplemented for three weeks with ω 3 PUFA suggest that the cardiovascular function has been improved.

The Effect of High-Intensity Interval Exercise on Short-Term Glycaemic Control, Serum Level of Key Mediator in Hypoxia and Pro-Inflammatory Cytokines in Patients with Type 1 Diabetes-An Exploratory Case Study.

Type 1 diabetes (T1D) is associated with hyperglycaemia-induced hypoxia and inflammation. This study assessed the effects of a single bout of high-intensity interval exercise (HIIE) on glycaemia (BG) and serum level of pro-inflammatory cytokines, and an essential mediator of adaptive response to hypoxia in T1D patients. The macronutrient intake was also evaluated. Nine patients suffering from T1D for about 12 years and nine healthy individuals (CG) were enrolled and completed one session of HIIE at the intensity of 120% lactate threshold with a duration of 4 × 5 min intermittent with 5 min rests after each bout of exercise. Capillary and venous blood were withdrawn at rest, immediately after and at 24 h post-HIIE for analysis of BG, hypoxia-inducible factor alpha (HIF-1α), tumour necrosis factor alpha (TNF-α) and vascular-endothelial growth factor (VEGF). Pre-exercise BG was significantly higher in the T1D patients compared to the CG (p = 0.043). HIIE led to a significant decline in T1D patients' BG (p = 0.027) and a tendency for a lower BG at 24 h post-HIIE vs. pre-HIIE. HIF-1α was significantly elevated in the T1D patients compared to CG and there was a trend for HIF-1α to decline, and for VEGF and TNF-α to increase in response to HIIE in the T1D group. Both groups consumed more and less than the recommended amounts of protein and fat, respectively. In the T1D group, a tendency for a higher digestible carbohydrate intake and more frequent hyperglycaemic episodes on the day after HIIE were observed. HIIE was effective in reducing T1D patients' glycaemia and improving short-term glycaemic control. HIIE has the potential to improve adaptive response to hypoxia by elevating the serum level of VEGF. Patients' diet and level of physical activity should be screened on a regular basis, and they should be educated on the glycaemic effects of digestible carbohydrates.

The effect of swimming on the body posture, range of motion and musculoskeletal pain in elite para and able-bodied swimmers.

BACKGROUND: Elite swimmers may be predisposed to disturbances in the range of motion (ROM) of hip joints and spinal curvatures, which are a factor that induces body's compensatory mechanisms that may have an impact on sports training, athletic performance and health. This study aimed to identify compensatory mechanisms in body posture of elite Para and able-bodied swimmers (spinal curvatures, ROM), to indicate the dominant locations of the compensatory mechanisms in the groups of Para and able-bodied athletes, and to identify and compare the prevalence and location of musculoskeletal pain from the last week and the last six months in the context of compensatory mechanisms. METHODS: Thirty-five (nF = 8; nM = 27; age = 20.51 ± 4.24) elite Para and able-bodied swimmers from the Polish national team took part in the study and were divided into: study group (SG) of Para swimmers and control group (CG) of able-bodied swimmers. Depth of the anteroposterior spinal curvatures and sagittal spinal mobility testing were evaluated with a Medi Mouse device. The prevalence and locations of musculoskeletal pain were assessed with a Nordic Musculoskeletal Questionnaire for the last seven days (NMQ-7) and the last six months (NMQ-6). RESULTS: In both groups lumbar hypolordosis, anterior pelvic tilt and pain in the shoulders, lower back and hips/thighs (NMQ-7) were reported the most frequent. In SG several significant relationships were found between duration of sport-specific training experience (years) and depth of angle the lumbar lordosis, the depth of the angle of pelvic inclination the ROM in the lumbar spine and thoracic spine, what was not reported in CG. CONCLUSIONS: Extrinsic compensatory mechanism was identified in both study groups, however only in SG it occurred as structural (depth of the angle of lumbar lordosis and pelvic inclination) and functional changes (ROM in the thoracic and lumbar spine) in the body posture. Internal compensatory mechanism was identified in SG, however external compensation showed only partially suppressive character regarding to internal compensation. The locations of the musculoskeletal complaints seems to result from both internal compensatory mechanism (SG) and continuous overload of the anatomy trains as a result of swimming training (SG, CG).

Determinants of daily physical activity limitation in patients with idiopathic pulmonary fibrosis.

The purpose of the study was to determine the level of physical fitness assessed based on the physiological parameters and intensity of daily physical activity (PA) of patients with idiopathic pulmonary fibrosis (IPF). Additionally, we aimed to determine the intensity and duration of exercise that would bring beneficial modifications in the cardio-respiratory system of the patients with IPF. Eighteen patients with IPF (61.7 ± 4.3 years) and fifteen healthy volunteers performed a graded exercise test to exhaustion on a treadmill (Bruce protocol). Spirometry, dyspnea (mMRC, Borg scale) and fatigue (FAS) were measured. Total daily PA (kcal/day, MET) was monitored for seven days. The linear regression of PA (kcal/day) vs. peak oxygen uptake (%pred. peakVO2) was used to determine the intensity of daily PA that should be used in the rehabilitation of the patients with IPF. The average energy expenditure of daily PA of patients with IPF was 147.9 ± 86.4 kcal/day and it was significantly lower compared to healthy individuals. The linear regression indicated that the predicted energy expenditure of daily PA (PAEE) is 280.0 kcal/day, estimated based on VO2peak 100%pred. Therefore, the patients should add about 30 min of exercise of the intensity of 4.5 ± 0.2 kcal (calculated at the anaerobic threshold) or about 3700 steps/day to their daily PA. Diffusion for carbon monoxide and physiological variables of aerobic capacity seem to be the most important determinants of PA limitation in patients with IPF. The method of estimating PAEE should be used to plan training loads in IPF rehabilitation.

Prediction of injuries, traumas and musculoskeletal pain in elite Olympic and Paralympic volleyball players.

The study aimed to identify the prevalence and location of injuries, traumas, and musculoskeletal complaints in Paralympic and Olympic volleyball players with different impairments and initial playing positions (sitting/standing); and to identify the predictors of the abovementioned variables using a multivariate CRT model. Seventy-five elite volleyball players from seven countries took part in the study. They were divided into three study groups: (SG1)-lateral amputee Paralympic volleyball players, (SG2)-able-bodied Paralympic volleyball players, (SG3)-able-bodied Olympic volleyball players. The prevalence and location of the analyzed variables were assessed with surveys quessionaires, while game-related statistics was interpreted based on the CRT analysis. Regardless of the impairment or initial playing position, both the humeral and knee joints were found to be the most frequent locations of musculoskeletal pain and/or injuries in all studied groups, followed by LBP. Players from SG1 and SG3 were characterized by an almost identical prevalence of reported musculoskeletal pain and injuries, what was not noted in SG2. Extrinsic compensatory mechanism (playing position) may be a crucial variable for prediction of musculoskeletal pain and injuries in volleyball players. Lower limb amputation seems to impact the prevalence of musculoskeletal complaints. Training volume may predict the prevalence of LBP.

Impact of physical functional capacity on quality of life in patients with interstitial lung diseases.

This study aimed to investigate the physical functioning predictors for health-related quality of life (HRQL) decline in patients with idiopathic interstitial fibrosis (IPF), sarcoidosis and other interstitial lung disease (ILD). The study enrolled 52 patients with ILD and 16 healthy individuals. Participants' HRQL was assessed using the 36-item Short-Form Health Survey questionnaire. Spirometry, physical performance, and daily physical activity (PA) were monitored. Patients with IPF showed significantly lower PA compared to patients with other ILD (p = 0.002)and sarcoidosis (p = 0.01). The type of disease aetiology had no significant effect on aerobic capacity, HRQL and fatigue. Patients with ILD showed significant greater fatigue, lower physical functioning and greater physical aspects scores compared to the control group (F=6.0; p = 0.018; F=12.64; p = 0.001, respectively). A significant positive correlation was observed between 6-minute walking distance (6MWD) and the physical domain of HRQL (r = 0.35, p = 0.012) and PA and the physical aspects of HRQL (r = 0.37, p = 0.007). This study revealed that the key predictors for HRQL decline were lower lung function, lower PA and physical performance.

Three Weeks of Pulmonary Rehabilitation Do Not Influence Oscillometry Parameters in Postoperative Lung Cancer Patients.

Background: Thoracic surgery is a recommended treatment option for non-small cell lung cancer patients. An important part of a patient's therapy, which helps to prevent postoperative complications and improve quality of life, is pulmonary rehabilitation (PR). The aim of this study was to assess whether the implementation of physical activity has an influence on forced oscillation technique (FOT) values in patients after thoracic surgery due to lung cancer. Methods: In this observational study, we enrolled 54 patients after thoracic surgery due to lung cancer, 49 patients with idiopathic interstitial fibrosis (IPF), and 54 patients with chronic obstructive pulmonary disease/asthma−COPD overlap (COPD/ACO). All patients were subjected to three weeks of in-hospital PR and assessed at the baseline as well as after completing PR by FOT, spirometry, grip strength measurement, and the 6-min walk test (6MWT). Results: We observed differences between FOT values under the influence of physical activity in studied groups, mostly between patients after thoracic surgery and COPD/ACO patients; however, no significant improvement after completing PR among FOT parameters was noticed in any group of patients. Improvements in the 6MWT distance, left hand strength, and right hand strength after PR were noticed (p < 0.001, 0.002, and 0.012, respectively). Conclusions: Three weeks of pulmonary rehabilitation had no impact on FOT values in patients after thoracic surgery due to lung cancer. Instead, we observed improvements in the 6MWT distance and the strength of both hands. Similarly, no FOT changes were observed in IPF and COPD/ACO patients after completing PR.

Handcycling Training in Men with Spinal Cord Injury Increases Tolerance To High Intensity Exercise.

Individuals with spinal cord injury are characterised by reduced physical capacity as compared to able-bodied persons, and are at risk of developing cardiovascular disease. The study aimed to evaluate the differences in physiological responses to an exercise test in handcycling-trained vs. able-bodied-trained and non-trained men. Eight males with spinal cord injury who were trained in handcycling, eighteen able-bodied males who were trained in powerlifting, and fourteen physically active non-athletes performed a graded arm crank ergometer test. The following physiological indices were measured before and during the test: heart rate, oxygen uptake, and blood lactate concentrations. Aerobic capacity was significantly higher in athletes with spinal cord injury compared to able-bodied athletes (p<0.01) and the control group (p<0.01). The heart rate achieved by handcycling-trained athletes was significantly lower as compared to powerlifters (p<0.01), however, the oxygen pulse was significantly higher (p<0.05). Handcycling-trained athletes reached significantly higher peak power (Pmax) during the graded arm exercise in comparison with powerlifters, and significantly higher post exercise blood lactate concentration (p<0.05). The lactate threshold was observed at a significantly higher P in individuals with spinal cord injury compared to able-bodied-trained (p<0.05) and non-trained men (p<0.001). Athletes with spinal cord injury were found to have excellent aerobic capacity and better physiological adaptation to the maximal graded exercise test as compared to able-bodied-trained men. These findings emphasize the importance of regular physical exercise and its potential therapeutic role in the prevention of cardiovascular disease in patients with spinal cord injury.

Effect of Apnea-Induced Hypoxia on Cardiovascular Adaptation and Circulating Biomarkers of Oxidative Stress in Elite Breath-Hold Divers.

Given the previous evidence that breath-hold diving is a cause of physiological stress, this study aimed to determine whether a combination static and dynamic apnea would affect total oxidant status, nitric oxide, heat shock proteins and cardiovascular parameters in elite freedivers. Thirteen finalists of the World and European championships in swimming pool breath-hold diving participated in the study. Whole-body plethysmography and electrocardiography was performed to determine the cardiorespiratory variables at baseline and during the simulation static apnea. An assessment of the heart rate, blood oxygen saturation and biochemical variables was performed before and in response to a combination of a static followed by a dynamic apnea. Static and dynamic breath-holding had a significant effect on oxidative stress, as evidenced by an increase in the total oxidant status/capacity (p < 0.001). The post apnea concentrations of heat shock proteins 27 (HSP27) were significantly elevated (p < 0.03, but total antioxidant status (TAS), HSP90, HSP70, and nitric oxide (NO) changes were not significant. levels under the influence of the static and dynamic breath-hold protocol. A significant positive correlation between HSPs and TAS (r = 0.63; p < 0.05) as well as NO levels was associated with beneficial cardiovascular adaptation. An increase in serum HSP27 levels mediated in nitric oxide levels could explain its important role in improving cardiovascular functions in elite freedivers. Further studies are necessary to explain the exact mechanisms of breath holds training of cardiovascular adaptation responsible for maintaining adequate oxygen supply in elite divers.

Effect of an Acute Resistance Training Bout and Long-Term Resistance Training Program on Arterial Stiffness: A Systematic Review and Meta-Analysis.

Resistance training (RT) and exercise is useful for preventing cardiovascular disease, systolic hypertension and stroke, which are associated with the stiffening of the larger central arterial system. The aim of this systematic review was to (a) understand the changes in arterial stiffness (AS) in various parts of the body measurement after acute RT bout and long-term RT, and (b) to determine the impact of exercise intensity on these changes in healthy individuals. A systematic computerized search was performed according to the PRISMA in PubMed, Scopus and Google Scholar with final selection of 23 studies. An acute RT bout led to a temporary increase in pulse wave velocity (PWV) regardless of the measurement method or intensity. A long-term RT at above an 80% repetition maximum (RM) have an ambiguous effect on PWV. A low-intensity RT or whole-body vibration training program decreased carotid-femoral PWV and brachial-ankle PWV (d = 1.02) to between 0.7 ± 1.4 ms-1 (p < 0.05) and 1.3 ± 1.07 ms-1 (p < 0.05) and improved other cardiac functions. A long-term RT of moderate (60-80% 1RM) or low intensity (<60% one-repetition maximum (1RM)) can decrease AS. Low and moderate intensity RT is beneficial to reduce high AS to prevent cardiovascular diseases.

Strenuous 12-h run elevates circulating biomarkers of oxidative stress, inflammation and intestinal permeability in middle-aged amateur runners: A preliminary study.

Given the solid evidence that prolonged strenuous exercise is a cause of metabolic stress, this study sought to determine whether a 12-h run would affect total oxidant status (TOS), total oxidant capacity (TOC), total antioxidant status (TAS), high-sensitivity C-reactive protein (hs-CRP) and the biomarkers of intestinal permeability (protein fatty acid-binding proteins (I-FABP) and zonulin) in middle-aged male subjects. Ten amateur long-distance runners (aged 52.0 ± 6.2 years, body height 176.9 ± 4.9 cm, body mass 73.9 ± 6.0 kg) were enrolled in the study. The venous blood samples were collected 1 hour before and right after the run and were analyzed for the levels of TAS, TOS/TOC, hs-CRP, I-FABP and zonulin. The post-run concentrations of TOS/TOC were significantly elevated (p < 0.001), but TAS changes were not significant. Pearson's correlation coefficients calculated for the post run values of TAS and TOS/TOC were statistically significant and negative (r = -0.750, p < 0.05). Significant increases in the concentrations of hs-CRP (p < 0.001), I-FABP (p < 0.05) and zonulin (p < 0.01) were noted. The results indicate that a strenuous 12-h run disturbs the prooxidant-antioxidant balance in middle-aged men, as well as promoting inflammation and impairing intestinal permeability.

The effects of exercise training on lipid profile in patients with sarcoidosis.

This study aimed to determine the use of lipid profiling to assess the effects of moderate intensity exercise training (ET) on patients with sarcoidosis. Fourteen patients with sarcoidosis (mean age, 46.0 ± 9.6 years) were examined before and after 3-week of ET programme in hospital settings. Symptoms (fatigue: FAS, dyspnoea: MRC), lung function tests and physical function tests (6 MWT, muscle force) were measured before and after ET. Proton nuclear magnetic resonance (NMR) spectroscopy combined with orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to determine lipid profile before and after ET. Twenty-five NMR signals from lipid compounds were selected for further analysis as well as serum lipid and inflammatory markers. Three weeks of ET results in improvement of symptoms (FAS: 27.5 vs. 21.0; p < 0.001, MRC: 0.86 vs. 0.14; p = 0.002) and physical function (6MWT: 508.43 vs. 547.29; p = 0.039). OPLS-DA analysis of the lipid profiles of patients with sarcoidosis revealed differences among the samples before and after ET, including decreases in fatty acids (p < 0.017), triglycerides (p < 0.022) and total cholesterol (p < 0.020). Other changes included shifts in fatty acids oxidation products and triacylglycerol esters. A short-time, in-hospital exercise training benefits patients with sarcoidosis by enhancing their physical function. Additionally, positive effect on lipid profile was observed also in this study. It is suggested that lipid profiling could become a new prognostic method to assess effects of pulmonary rehabilitation in patients with sarcoidosis.

Is body mass index (BMI) or body adiposity index (BAI) a better indicator to estimate body fat and selected cardiometabolic risk factors in adults with intellectual disabilities?

BACKGROUND: The BMI index cannot always be used in people with intellectual disabilities due to neuromuscular coordination disorders and psychological barriers that may hinder conventional body weight measurement. The study aimed to assess the usefulness of BMI and BAI in estimating obesity and body fat in people with intellectual disabilities. METHODS: The first stage of the research involved 161 people with profound intellectual disabilities. Somatic parameters (BM, BH, WC, HC) were measured and BMI, BAI, WHR were calculated. Fifty seven persons with above-normal BMI and BAI were included in the second stage of the study and biochemical parameters were determined (TC, LDL-cholesterol, HDL-cholesterol, TG, GL). RESULTS: According to both BMI and BAI classifications, most people were overweight or obese. A high correlation of %BF with BMI and BAI indices was observed (r = 0.78). The sensitivity of both indices was 95.65%. In groups with above-normal BMI and BAI, an upward trend was found for mean values of TC, LDL, TG, and GL, with a simultaneous downward trend for HDL. Statistically significant intergroup differences were recorded for TG and GL (p < 0.05) for both indices (BMI and BAI). CONCLUSIONS: Our research demonstrated that BAI is complementary to BMI and can be recommended for the estimation of body fat and cardiometabolic risks in people with intellectual disabilities. Due to the ease of measurement, BAI has high utility value.

The Effect of Omega-3 Fatty Acid Supplementation on Serum Adipocytokines, Lipid Profile and Biochemical Markers of Inflammation in Recreational Runners.

BACKGROUND: The study aimed to evaluate the effects of a 3-week ω-3 PUFA supplementation on serum adipocytokines (i.e., adiponectin, leptin), neuregulin-4 (NRG4) and erythrocyte omega-3 (ω-3) fatty acid content, as well as the blood antioxidant defense capacity in non-elite endurance runners. METHODS: Twenty-four runners were randomized into two groups: the supplemented group, who received omega free fatty acids extract containing 142 mg of EPA, 267 mg of DHA, 12 mg of vitamin E and 5 µg of vitamin D, each administrated at a dose of six capsules twice a day for three weeks, or the placebo group. Venous blood samples were withdrawn at the start and at the end of the study protocols to estimate serum biochemical variables. RESULTS: A significantly higher ω-3 index and lower AA/EPA ratio was observed after ω-3 PUFA compared to pre-supplementation levels (p < 0.001 and p < 0.001, respectively). An increase in baseline adiponectin and NRG4 levels, as well as a decrease of leptin concentration and lipid profile improvement, were observed in subjects after a ω-3 PUFA diet. The increased ω-3 index had a significant effect on TNFα levels and a serum marker of antioxidant defense. CONCLUSIONS: The ω-3 PUFA extract with added vitamin E and D supplementation may have a positive effect on the function of the adipocyte tissue, as well as the ability to prevent cardiovascular complications in athletes.

Circulating Inflammatory Biomarkers and Endocrine Responses to Exercise in Female Soccer Players.

The objective of the study to determine the effects of graded exercise on the cytokines and insulin-like growth factor-1 (IGF-1), growth hormone (hGH), testosterone (T), and cortisol (C) concentrations in the peripheral blood of female soccer players, and to evaluate if increased inflammatory biomarkers were related to these hormones and performance variables. Sixteen female soccer players (N = 16, age 19.3 ± 2.3 years) participated in this study. Blood samples were collected at three time points: pre-exercise, post-exercise, and in the 15th minute of recovery, to evaluate morphological and biochemical variables. The relative expression of IL-6 (interleukin 6) and serum concentrations of the cytokines were increased in the recovery period compared to pre-exercise levels (p = 0.03 and p=0.005, respectively). There was a significant effect of exercise on serum hGH level (p " 0.001), T/C ratio (p = 0.001), and C level (p=0.02). Positive correlations were found between: post-exercise IL-1ß (interleukin 1 beta) and IL-6 (R = 0.84, p = 0.000), and the IL-6 and TNF-α (tumor necrosis factor alpha) gene expression during recovery (R = 0.65, p = 0.009), and serum IL-1ß post-exercise and maximal power (R = 0.68; p = 0.004). Exercise-induced serum C levels positively correlated with IGF-1 levels (R = 0.52 p = 0.05). Negative associations were revealed between post-exercise T/C ratio and IGF-1 (R = - 0.58, p = 0.03) and serum free T and IL- ß (R = -0.56, p = 0.04) levels. The low level of pre-exercise genes and protein of the IL-1ß, IL-6 and TNF-α indicate a lack of inflammation signs in the female soccer players. This study shows significant effects of exercise on hormone levels and pro-inflammatory markers, which could be used to identify the role of female sex steroids on the immune function.

Moderate intensity exercise in hypoxia increases IGF-1 bioavailability and serum irisin in individuals with type 1 diabetes.

AIM: This study aimed to determine the effect of moderate intensity continuous exercise (Ex) and hypoxia (Hyp) on serum brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and its binding protein-3 (IGFBP-3), irisin and cytokines levels in patients with type 1 diabetes (T1D). METHODS: A total of 14 individuals with T1D (age: 28.7 ± 7.3 years) and 14 healthy adults (age: 27.1 ± 3.9 years) performed 40-min continuous Ex at moderate intensity (50% lactate threshold) on a cycle ergometer in normoxia (Nor) and Hyp (FiO2 = 15.1%) Biochemical factors, glucose concentrations and physiological variables were measured at rest, immediately and up to 24 h after both Ex protocols. RESULTS: Patients with T1D had significantly lower pre-Ex serum concentrations of BDNF (p < 0.05, p < 0.01), and total IGF-1 (p < 0.001, p < 0.05) and significantly higher irisin levels (p < 0.05, p < 0.01) in Nor and Hyp, compared with healthy subjects. Ex significantly increased in T1D group serum BDNF (in Nor only p < 0.05) and total IGF-1 levels in Nor and Hyp (p < 0.001 and p < 0.01, respectively). Immediately after Ex in Hyp, freeIGF-1 (p < 0.05) and irisin levels (p < 0.001) were significantly higher compared with the levels induced by Ex alone. Free IGF-1 and irisin serum levels remained elevated in 24 h post-Ex in Hyp. In T1D, significant blood glucose (BG) decrease was observed immediately after Ex in Hyp (p < 0.001) and in 24 h recovery (p < 0.001) compared with pre-Ex level. CONCLUSION: The study results suggest that moderate intensity continuous Ex has beneficial effect on BDNF and IGF-1 levels. Ex in hypoxic conditions may be more effective in increasing availability of IGF-1. The alterations in the post-Ex irisin levels and IGF-1 system may be contributing to more effective glycaemia control in patients with T1D.

Chest pain in an elite master ultra-marathon runner: a case report with a follow-up on his subsequent athletic activity.

Ultra-marathon running has enjoyed increasing popularity, with the number of master ultra-marathon runners growing annually. This study presents a case of a 51-year-old highly experienced long-distance runner (body mass: 65.1 kg, body height: 168 cm), who took part in a 48-h ultra-marathon race held in 2010, but dropped out of the competition due to acute cardiac problems manifested after 16 h of running and having completed a distance of 129 km. Two weeks following the race, intense cardiac examination was performed to explain the drop-out due to chest pain. A 12­lead electrocardiogram, a 2D transthoracic echocardiography in 3 apical projections of the left ventricle, a computed tomography of the chest, an invasive coronary angiography and a maximal oxygen uptake (VO2max) test were performed. The 12-lead ECG revealed a negative T wave in III and aVF without morphological abnormalities. The echocardiographic examinations presented a normal size and function of the heart chambers, and a normal valvar structure and function (only trivial mitral and tricuspid regurgitation was observed). The invasive coronary arteriography - due to an increased calcium score in the CT scan - showed only a non-significant systolic dynamic narrowing in the eighth segment of the left anterior descending artery due to a muscle bridge. The physical performance characteristics of the athlete and a follow-up history of his athletic activity showed that the cardiac problems he had experienced during the ultra-marathon race did not prevent him from being active in sport. Int J Occup Med Environ Health. 2020;33(4):523-34.

The effect of vitamin D supplementation on serum total 25(OH) levels and biochemical markers of skeletal muscles in runners.

BACKGROUND: The beneficial adaptation of skeletal muscle function to strenuous exercise is partially attributable to the improvement of vitamin D status. The present study aimed to evaluate the effects of a 3-week vitamin D supplementation on serum 25(OH)D levels and skeletal muscle biomarkers (i.e. troponin, myoglobin, creatine kinase and lactic dehydrogenase) of endurance runners. METHODS: A double-blind placebo-controlled study design was used and vitamin D supplementation was compared to a non-treatment control group. Twenty-four runners, competitors of the ultra-marathons held during the National Running Championships, were randomly assigned into two groups supplemented with the dose of 2000 IU vitamin D or placebo for three weeks. All subjects participated in three exercise protocols: (a) incremental exercise test (to determine the maximum oxygen uptake and the intensity of eccentric exercise), (b) eccentric exercise before and (c) after two dietary protocols. Venous blood samples were drawn at rest, immediately after the exercise and after 1 h and 24 h of recovery in order to estimate serum 25(OH)D levels, skeletal muscle biomarkers, proinflammatory cytokines and tumor necrosis factor-alpha (TNF-α) levels. A two-way ANOVA was used to test main effects and their interactions and Pearson correlation coefficients were analyzed to determine the effects of inter-variable relationships. RESULTS: Significant differences between pre- and post-intervention in baseline 25(OH)D levels were observed (34.9 ± 4.7 versus 40.3 ± 4.9 ng/ml, p = 0.02) in supplemented group. A higher post intervention 25(OH)D level was observed after vitamin D diet compared to placebo (40.3 ± 4.9 versus 31.8 ± 4.2 ng/mL, respectively; p < 0.05). The vitamin D supplementation decreased post-exercise (TN max) and 1 h post-exercise troponin (p = 0.004, p = 0.03, respectively), 1 h post-exercise myoglobin concentration (p = 0.01) and TNF-α levels(p < 0.03). 24 h post exercise creatine kinase activity was significantly lower in supplemented group compared to placebo (p < 0.05). A negative correlation was observed between post exercise 25(OH)D levels and myoglobin levels (r = - 0.57; p = 0.05), and 25(OH)D levels and TNFα (r = - 0.58; p = 0.05) in vitamin D supplemented group. CONCLUSIONS: Three weeks of vitamin D supplementation had a positive effect on serum 25(OH)D levels in endurance trained runners and it caused a marked decrease in post-exercise biomarkers levels. We concluded that vitamin D supplementation might play an important role in prevention of skeletal muscle injuries following exercise with eccentric muscle contraction in athletes.