Global practitioner assessment and management of mental fatigue and mental recovery in high-performance sport: A need for evidence-based best-practice guidelines.

BACKGROUND: Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high-performance sport are necessary. OBJECTIVE: To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high-performance sport. METHODS: A mixed-methods survey approach obtained information from 156 multi-disciplinary high-performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon-signed rank analysis. Thematic analysis interpreted open-text responses. RESULTS: Only 11.5% and 5.1% of respondents indicated they were "very" knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete-buy in, time-availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi-disciplinary in nature. CONCLUSION: Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence-based assessment and management practices in high-performance sport.

Compression socks and the effects on coagulation and fibrinolytic activation during marathon running.

PURPOSE: Compression socks are frequently used in the treatment and prevention of lower-limb pathologies; however, when combined with endurance-based exercise, the impact of compression socks on haemostatic activation remains unclear. OBJECTIVES: To investigate the effect of wearing compression socks on coagulation and fibrinolysis following a marathon. METHODS: Sixty-seven participants [43 males (mean ± SD: age: 46.7 ± 10.3 year) and 24 females (age: 40.0 ± 11.0 year)] were allocated into a compression (SOCK, n = 34) or control (CONTROL, n = 33) group. Venous blood samples were obtained 24 h prior to and immediately POST-marathon, and were analyzed for thrombin-anti-thrombin complex (TAT), tissue factor (TF), tissue factor pathway inhibitor (TFPI), and D-Dimer. RESULTS: Compression significantly attenuated the post-exercise increase in D-Dimer compared to the control group [median (range) SOCK: + 9.02 (- 0.34 to 60.7) ng/mL, CONTROL: + 25.48 (0.95-73.24) ng/mL]. TF increased following the marathon run [median (range), SOCK: + 1.19 (- 7.47 to 9.11) pg/mL, CONTROL: + 3.47 (- 5.01 to 38.56) pg/mL] in all runners. No significant post-exercise changes were observed for TAT and TFPI. CONCLUSIONS: While activation of coagulation and fibrinolysis was apparent in all runners POST-marathon, wearing compression socks was shown to reduce fibrinolytic activity, as demonstrated by lower D-Dimer concentrations. Compression may reduce exercise-associated haemostatic activation when completing prolonged exercise.

The impact of a simulated grand tour on sleep, mood, and well-being of competitive cyclists.

AIM: Professional cycling is considered one of the most demanding of all endurance sports. The three major professional cycling stages races (i.e. Tour de France, Giro d'Italia and Vuelta a España) require cyclists to compete daily covering between ~150-200 km for three consecutive weeks. Anecdotal evidence indicates that such an event has a significant effect on the sleep, mood, and general well-being of cyclists, particularly during the latter stages of the event. The primary aim of this study was to simulate a grand tour and determine the impact a grand tour has on the sleep, mood, and general well-being of competitive cyclists. METHODS: Twenty-one male cyclists (M±SD, age 22.2±2.7 years) were examined for 39 days across three phases (i.e. baseline, simulated grand tour, and recovery). Sleep was assessed using sleep diaries and wrist activity monitors. Mood and general well-being were assessed using the Brunel Mood Scale (BRUMS) and Visual Analogue Scales (VAS). RESULTS: The amount and quality of sleep as assessed by the wrist activity monitors declined during the simulated grand tour. In contrast, self-reported sleep quality improved throughout the study. Cyclists' mood and general well-being as indicated by vigour, motivation, physical and mental state declined during the simulated tour. CONCLUSION: Future investigations should examine sleep, mood and well-being during an actual grand tour. Such data could prove instrumental toward understanding the sleep and psychological changes that occur during a grand tour.

Leukocyte heat shock protein expression before and after intensified training.

The purpose of the current research was to test the hypothesis that exercise induced leukocyte heat shock protein (HSP) expression is increased during periods of intensified exercise training. Seven male endurance cyclists carried out tests of maximal oxygen consumption and endurance capacity. These standard exercise tests were carried out prior to and following 6 days of prescribed intensified training. Sampled leukocytes were examined for Hsp27 and Hsp70 expression using a Fluorescence Activated Cell Scanner (EPICS XL, Coulter). During a period of overreaching, as signified by a drop in time to fatigue following the intensified training period (p = 0.02), the number of extracellular Hsp27 positive granulocytes increased in response to the VO(2)max test. Acute, intracellular HSP responses were observed in both baseline and overreached conditions. The present study showed that a period of intensified training caused adaptations in the acute heat shock protein exercise response, reflected by a greater increase of cell surface HSP positive leukocytes following heavy training.

Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state.

The aim of this study was to determine whether consumption of a diet containing 8.5 g carbohydrate (CHO) x kg(-1) x day(-1) (high CHO; HCHO) compared with 5.4 g CHO x kg(-1) x day(-1) (control; Con) during a period of intensified training (IT) would result in better maintenance of physical performance and mood state. In a randomized cross-over design, seven trained runners [maximal O(2) uptake (Vo(2 max)) 64.7 +/- 2.6 ml x kg(-1) x min(-1)] performed two 11-day trials consuming either the Con or the HCHO diet. The last week of both trials consisted of IT. Performance was measured with a preloaded 8-km all-out run on the treadmill and 16-km all-out runs outdoors. Substrate utilization was measured using indirect calorimetry and continuous [U-(13)C]glucose infusion during 30 min of running at 58 and 77% Vo(2 max). Time to complete 8 km was negatively affected by the IT: time significantly increased by 61 +/- 23 and 155 +/- 38 s in the HCHO and Con trials, respectively. The 16-km times were significantly increased (by 8.2 +/- 2.1%) during the Con trial only. The Daily Analysis of Life Demands of Athletes questionnaire showed significant deterioration in mood states in both trials, whereas deterioration in global mood scores, as assessed with the Profile of Mood States, was more pronounced in the Con trial. Scores for fatigue were significantly higher in the Con compared with the HCHO trial. CHO oxidation decreased significantly from 1.7 +/- 0.2 to 1.2 +/- 0.2 g/min over the course of the Con trial, which was completely accounted for by a decrease in muscle glycogen oxidation. These findings indicate that an increase in dietary CHO content from 5.4 to 8.5 g CHO x kg(-1)x day(-1) (41 vs. 65% total energy intake, respectively) allowed better maintenance of physical performance and mood state over the course of training, thereby reducing the symptoms of overreaching.