Quantitative relationship between physical activity and antihypertensives in elderly women / Relación cuantitativa entre actividad física y antihipertensivos en ancianas / Relação quantitativa entre atividade física e anti-hipertensivos em idosas

ABSTRACT Introduction: Physical activity is an important tool to manage systemic arterial hypertension. However, less is known about the relationship of physical activity with the number of antihypertensive drugs used by older adults. Objective: The aim of this study was to compare the number of antihypertensive drugs used by older female adults (aged ≥ 60 years) with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. Methods: Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants who presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected. Results: The number of prescribed antihypertensive drugs was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets prescribed (p>0.05). Although there was no statistical difference, a higher proportion of participants from the lower physical activity group used more than two antihypertensive drugs. Conclusion: The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive elderly women. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMEN Introducción: La actividad física es una herramienta importante para el manejo de la hipertensión arterial sistémica. Sin embargo, se sabe poco sobre la relación de la actividad física con la cantidad de medicamentos antihipertensivos utilizados por las ancianas. Objetivo: El objetivo de este estudio fue hacer una comparación entre el número de medicamentos antihipertensivos utilizados por mujeres adultas mayores (≥ 60 años) y bajo nivel de actividad física con el número utilizado por aquellas con alto nivel de actividad física, y verificar cuántas de las participantes usaron más de dos medicamentos antihipertensivos. Métodos: Veintiocho ancianas físicamente activas con hipertensión arterial sistémica que participaron en un programa de actividad física para mujeres adultas mayores residentes en la comunidad fueran divididas en dos grupos: las participantes que presentaron niveles más bajos de actividad física habitual se ubicaron en el grupo 1 y las participantes que presentaron los mayores niveles de actividad física se ubicaron en el grupo 2, según el cuestionario de Baecke. Además, se recogió el número de medicamentos antihipertensivos utilizados por las participantes. Resultados: El número de comprimidos antihipertensivos prescritos fue de 2,0 (mediana) para ambos grupos investigados. No hubo diferencia significativa entre los grupos en cuanto al número de medicamentos antihipertensivos prescritos (p>0,05). Aunque no hubo diferencia estadística, una mayor proporción de participantes del grupo de menor actividad física usó más de dos medicamentos antihipertensivos. Conclusión: El nivel de actividad física habitual no afectó el número de comprimidos antihipertensivos utilizados por las ancianas hipertensas. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

RESUMO Introdução: A atividade física é uma importante ferramenta no manejo da hipertensão arterial sistêmica. No entanto, pouco se sabe sobre a relação entre a atividade física e a quantidade de anti-hipertensivos usados por idosos. Objetivo: O objetivo deste estudo foi realizar uma comparação entre o número de anti-hipertensivos usados por idosas (≥ 60 anos) com baixo nível de atividade física com o número usado por aquelas com alto nível de atividade física, verificando quantas participantes usaram mais de dois anti-hipertensivos. Métodos: Vinte e oito idosas fisicamente ativas com hipertensão arterial sistêmica que participavam de um programa de atividade física para idosas da comunidade foram divididas em dois grupos: as participantes que apresentaram níveis mais baixos de atividade física habitual foram colocadas no grupo 1 e as participantes que apresentaram maiores níveis de atividade física foram colocados no grupo 2, de acordo com o questionário de Baecke. Ademais, coletou-se o número de medicamentos anti-hipertensivos utilizados pelas participantes. Resultados: O número de fármacos anti-hipertensivos prescritos foi de 2,0 (mediana) para ambos os grupos investigados. Não houve diferença significativa entre os grupos quanto ao número de comprimidos anti-hipertensivos prescritos (p>0,05). Embora não tenha havido diferença estatística, uma maior proporção de participantes entre o grupo de menor atividade física utilizava mais de dois anti-hipertensivos. Conclusão: O nível de atividade física habitual não afetou a quantidade de comprimidos anti-hipertensivos utilizados pelas idosas hipertensas. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.

Force-Velocity Relationship in Cycling and Arm Cranking: A Comparison of Men and Women.

This study was aimed at comparing the force-velocity relationship during cycling and arm cranking in males and females. Thirty-two male and twenty-two female healthy volunteers performed a force-velocity test on a cycle ergometer and a cranking ergometer in a randomly selected order. The theoretical values of the maximum force at zero speed (F0) and the maximum velocity at zero braking force (v0) for the lower and upper limbs were determined, and the maximum anaerobic power (Pmax) was calculated from the individual force-velocity relationship. The Pmax and F0 of the upper limbs related to the lower limbs correspond to 78.2 ± 14.3% and 80.1 ± 17.3% in men and 65.5 ± 12.5% and 74.5 ± 6.5% in women, respectively. The theoretical maximum velocity v0 of the upper limbs to the lower limbs attained 129.1 ± 29.0% in men and 127.4 ± 26.4% in women. The results of the study can serve as reference data for the force-velocity characteristics of the upper and lower limbs of male and female athletes. The results can be used both in training and rehabilitation programs, where the starting point is the objectification of possible strength deficits in various areas of the force-velocity characteristic spectrum of the muscles of the upper and lower limbs.

Pacing Variation in Multistage Ultramarathons: Internet-Based Cross-Sectional Study.

BACKGROUND: Ultramarathon running is the most popular ultraendurance competition in terms of the number of races and runners competing annually worldwide; however, no study has compared pacing and performance over a long period. OBJECTIVE: This study analyzes the pacing of successful finishers and nonfinishers in multistage ultramarathons worldwide. METHODS: A total of 4079 athletes (men=3288; women=791) competing in 99 multistage ultramarathon events from 1983 to 2021 were analyzed, including the number of participants, age, gender, rank, and running speed of successful finishers. RESULTS: The results showed a significant increase in the number of events (n=338) and a significant increase in the number of finishers and nonfinishers (n=5575) in the ultramarathons worldwide during this period. The general linear models (GLMs) of pacing variation showed nonsignificant effects for gender (F1,36.2=2.5; P=.127; ηp2=0.063) and age group (F10,10=0.6; P=.798; ηp2=0.367), but it showed a significant interaction (gender × age) effect (F10,2689=2.3; P=.008; ηp2=0.009). Post hoc analyses showed that men have a higher pacing variation than women in the under 30 years (U30), U35, U45, and U50 groups. Additionally, the fastest women's age group (U35) had the lowest pacing variation. The GLM of pacing variation by gender and event distance showed significant effects for both gender (F1,3=18.5; P<.001; ηp2=0.007) and distance (F2,3=20.1; P<.001; ηp2=0.015). Post hoc analyses showed a growing pacing variation with increasing race distance for both men and women. In addition, men had a higher variation in long events. Furthermore, there was a significant main effect for both genders (F1,3=33.7; P<.001; ηp2=0.012) and rank (F1,3=136.6; P<.001; ηp2=0.048) on performance, with men being faster than women. Pacing varied greatly due to gender (F1,3=4.0; P=.047; ηp2=0.001), with a lower (ie, more even) pacing variation for male athletes in the top 3 finishers. Male nonfinishers showed a higher performance than female nonfinishers (F1,1340=25.6; P<.001), and no difference was identified for pacing variation (F1,789=1.5; P=.228) based on gender. In addition, a weak but significant correlation (r=-0.130; P<.001) was identified between the average running speed and pacing variation for both female and male nonfinishers. CONCLUSIONS: In summary, multistage ultramarathon competitions showed an increasing number of competitors and a higher performance challenge. Men have a higher pacing (ie, less even) variation than women, especially observed in longer events. A higher pacing variation was associated with lower performance for men, women, and nonfinishers.

Predicting overall performance in Ironman 70.3 age group triathletes through split disciplines.

Knowing which discipline contributes most to a triathlon performance is important to plan race pacing properly. To date, we know that the running split is the most decisive discipline in the Olympic distance triathlon, and the cycling split is the most important discipline in the full-distance Ironman® triathlon. However, we have no knowledge of the Ironman® 70.3. This study intended to determine the most crucial discipline in age group athletes competing from 2004 to 2020 in a total of 787 Ironman® 70.3 races. A total of 823,459 athletes (198,066 women and 625,393 men) from 240 different countries were analyzed and recorded in 5-year age groups, from 18 to 75 + years. Correlation analysis, multiple linear regression, and two-way ANOVA were applied, considering p < 0.05. No differences in the regression analysis between the contributions of the swimming, cycling, and running splits could be found for all age groups. However, the correlation analysis showed stronger associations of the cycling and running split times than the swimming split times with overall race times and a smaller difference in swimming performance between males and females in age groups 50 years and older. For age group triathletes competing in Ironman® 70.3, running and cycling were more predictive than swimming for overall race performance. There was a progressive reduction in the performance gap between men and women aged 50 years and older. This information may aid triathletes and coaches in planning their race tactics in an Ironman® 70.3 race.

Participation and performance trends in short-, medium, and long-distance duathlon.

Participation and performance trends of male and female athletes have been thoroughly analyzed in various endurance sports. Knowing these trends can help coaches and athletes prepare for competitions and may influence their training strategy and career planning. However, duathlon events-consisted of two splits of running (Run1 and Run2) interspersed by a split of cycling (Bike)-have not been thoroughly studied, unlike other endurance sports. The present study aimed to compare participation and performance trends in duathletes who competed in duathlon races hosted by World Triathlon or affiliated National Federations between 1990 and 2021. A total of 25,130 results of age group finishers who competed in run-bike-run duathlon races of varying distances were analyzed with different general linear models. Races were divided into three distances: short-distance (up to 5.5 km run, 21 km bike, 5 km run), medium-distance (5-10 km run, 30-42 km bike, 7-11 km run) and long-distance (at least 14 km run, 60 km bike, 25 km run). On average, women represented 45.6% of all finishers in short-distance, 39.6% in medium-distance and 24.9% in long-distance duathlon races. Throughout the years, men were consistently faster than women in all three race legs (Run 1, Bike, and Run 2) in all three distances across all age groups, and women could not reduce the performance gap. Concerning the age of peak performance, duathletes of the age group 30-34 finished most often in the top three in short- and medium-distance duathlons, whereas male duathletes of the age group 25-29 and female duathletes of the age group 30-34 finished most often in the top three in long-distance duathlons. Women participated less, especially in longer distances, and were constantly slower than men. Duathletes of the age group 30-34 finished most often in the top three. Future studies should analyze participation and performance trends in further subgroups (e.g., elite athletes) and pacing behaviours.

Changes in pacing variation with increasing race duration in ultra-triathlon races.

Despite the increasing scientific interest in the relationship between pacing and performance in endurance sports, little information is available about pacing and pacing variation in ultra-endurance events such as ultra-triathlons. Therefore, we aimed to investigate the trends of pacing, pacing variation, the influence of age, sex, and performance level in ultra-triathlons of different distances. We analysed 969 finishers (849 men, 120 women) in 46 ultra-triathlons longer than the original Ironman® distance (e.g., Double-, Triple-, Quintuple- and Deca Iron ultra-triathlons) held from 2004 to 2015. Pacing speed was calculated for every cycling and running lap. Pacing variation was calculated as the coefficient of variation (%) between the average speed of each lap. Performance level (i.e., fast, moderate, slow) was defined according to the 33.3 and 66.6 percentile of the overall race time. A multivariate analysis (two-way ANOVA) was applied for the overall race time as the dependent variable with 'sex' and 'age group' as independent factors. Another multivariate model with 'age' and 'sex' as covariates (two-way ANCOVA) was applied with pacing variation (cycling and running) as the dependent variable with 'race' and 'performance level' as independent factors. Different pacing patterns were observed by event and performance level. The general pacing strategy applied was a positive pacing. In Double and Triple Iron ultra-triathlon, faster athletes paced more evenly with less variation than moderate or slower athletes. The variation in pacing speed increased with the length of the race. There was no significant difference in pacing variation between faster, moderate, and slower athletes in Quintuple and Deca Iron ultra-triathlon. Women had a slower overall performance than men. The best overall times were achieved at the age of 30-39 years. Successful ultra-triathlon athletes adapted a positive pacing strategy in all race distances. The variation in pacing speed increased with the length of the race. In shorter ultra-triathlon distances (i.e., Double and Triple Iron ultra-triathlon), faster athletes paced more evenly with less variation than moderate or slower athletes. In longer ultra-triathlon distances (i.e., Quintuple and Deca Iron ultra-triathlon), there was no significant difference in pacing variation between faster, moderate, and slower athletes.

Shoulder Internal Rotator Strength as Risk Factor for Shoulder Pain in Volleyball Players.

The aim of this study was to identify the intrinsic factors that could increase risk of shoulder pain in adolescent volleyball players. Twenty-eight young male volleyball players (between 14 and 18 years old) participated in this study. Athletes were submitted to: isokinetic muscle strength assessment of shoulder rotator muscles, ball service speed assessment, anterior and posterior drawer test, apprehension test, groove sign and scapular dyskinesia test. Athletes were followed for 16 weeks to monitor the presence of shoulder pain. All athletes were submitted to the same training protocol. During the 16 weeks, 28.5% of the athletes (n=8) experienced shoulder pain in the dominant limb higher than 3 according to Numerical Rating Scale criteria; 71.5% of the athletes (n=20) did not experience pain, or pain equal or lower than 3. The main result of our study was that the odds of feeling pain higher than 3 was significantly higher among players who presented higher values for internal rotation peak torque (OR=1.113, CI 95%=1.006 to 1.232 and p=0.038). The odds of feeling pain increased by 11% for every N·m of the internal rotator muscles. Pre-season isokinetic rotator strength assessments can help identify adolescent volleyball players at increased risk of a shoulder injury.

Participation and performance characteristics in half-marathon run: a brief narrative review.

Half-marathon (HM) is a running sport of increasing popularity in both sexes and in all age groups worldwide during the last years. Many studies have examined several aspects of HM, such as performance and participation trends, sex and age differences, physiological correlates, and training; however, no comprehensive review has ever been contacted to summarize the recently accumulated knowledge. Therefore, the aim of the present study was to review all previous research in this sport, focusing on participation and performance aspects. It was shown that HM runners had similar anthropometric and physiological characteristics as full-marathon runners which should be attributed to the affinity of these two races in terms of metabolic demands. Performance in HM was related with superior scores in aerobic capacity (maximal oxygen uptake, anaerobic threshold and running economy) and training characteristics (sport experience, weekly distance, training speed, frequency of sessions and long single endurance run distance), and lower scores in adiposity-related scores (e.g. body mass, body mass index, body fat percentage and skinfold thickness). Considering the popularity of HM race and the lack of many original studies (compared to FM race), this is an exciting field for scientific research with a large potential for practical applications, since the majority of HM runners are amateur runners in need of sex-, age- and performance-tailored exercise prescription.

Is there stability in the performance of elite half-marathoners?

The purpose of this study was to investigate the performance stability of elite half-marathoners of both sexes. The study was composed of 24 elite athletes (12 female and 12 male), ranked among the Senior World TOP20 half-marathoners, who completed a half-marathon race for at least three consecutive years. Tracking was tested using autocorrelations and Kappa Cohen. Autocorrelation revealed a significant association, but a decrease in correlation among the years in both sexes. The overall weighted kappa showed lower stability in performance for both sexes (K â€‹= â€‹0.191 and K â€‹= â€‹-0.245) than for males. These findings suggest that both female and male elite half-marathoners showed low stability in performance during three events. Besides that, athletes with a better performance tended to present the highest performance stability. It is recommended that coaches track the developmental trajectories of the athletes to comprised the changes in performance across the years, as to provide environmental characteristics that can influence performance.

Correction: Russians are the fastest 100-km ultra-marathoners in the world.

[This corrects the article DOI: 10.1371/journal.pone.0199701.].

Effects of congested match periods on acceleration and deceleration profiles in professional soccer.

The aim of the present study was to analyse the influence of congested periods of matches on the acceleration (Acc) and deceleration (Dec) profiles of elite soccer players. Twenty-three elite male professional soccer players participated in the study across 31 official matches. Assessed periods included: (i) congested periods (three to four days between games), and (ii) non-congested periods (more than four days between games). Physical activity during matches was recorded during games using a 10Hz global positioning system device, coupled with a 100 Hz accelerometer, and was analysed according to the periods. Maximal Acc- (73.2 ± 20.3 vs. 84.918.5 m), high Acc- (244.0 ± 49.5 vs. 267.0 ± 37.8 m), maximal Dec- (139.0 ± 44.8 vs. 152.039.3 m) and the total decelerating- distance (5132 ± 690 vs. 5245 ± 552 m) were lower in congested than in non-congested periods (p < 0.05, effect size 0.31-0.70). Neither a main effect of playing position nor a period*playing position interaction on Acc and Dec were observed (p > 0.05). It was concluded that Acc and Dec match activities were significantly affected during congested periods compared to non-congested highlighting a possible fatigue accumulation being responsible for the observed decrement in physical activity. Monitoring Acc and Dec metrics throughout particular periods of congested fixtures amongst professional soccer teams is advised and may be a way to assess physical and fatigue status.

Pacing strategy of a wheelchair athlete in a 5x and 10x Ironman ultra triathlon: a case study.

OBJECTIVE: For disabled athletes such as wheelchair athletes, there is no knowledge about competing and pacing during a long-distance triathlon such as an Ironman triathlon. This study aimed to investigate the pacing strategy of a paraplegic wheelchair athlete competing and finishing a Quintuple Iron ultra-triathlon (i.e., five times 3.8 km swimming, 180 km handbike cycling and 42.195 km wheelchair racing in five days) and a Deca Iron ultra-triathlon (10 times the same distance in 10 days). METHODS: Data from an ultra-distance triathlon race (Swissultra) covering 5x and 10x Ironman distance were collected. Official performance data were acquired from the race organizer's website and athlete's personal information from the athlete through online interviews. The athlete is a man born in 1962, the races analysed in this study were held in the summer of 2017 (5x) and 2019 (10x). The split times for swimming, cycling and running, the overall race times for each Ironman and the lap times in cycling (handbike) and running (wheelchair) were analysed. RESULTS: The athlete finished the Quintuple Iron ultra-triathlon in an overall race time of 66:28:31 h:min:s and the Deca Iron ultra-triathlon in 137:03:20 h:min:s. He adopted an even pacing in both races in split disciplines and for overall race time. CONCLUSION: The paraplegic wheelchair athlete was able to finish both a Quintuple and a Deca Iron ultra-triathlon by adopting an even pacing in all split disciplines and for overall race time.IMPLICATIONS FOR REHABILITATIONTriathlon is a growing sport among athletes with spinal cord injury.Ultra-triathlons are ultra-endurance events and pacing is a key aspect to a successful race regardless the athlete's category.An athlete with a spinal cord injury finished a 5x and 10x Ironman ultra-triathlon applying an even pacing strategy.

The beginning of success: Performance trends and cut-off values for junior and the U23 triathlon categories.

BACKGROUND: This study sought to determine cut-off values for each triathlon discipline to achieve podium in Junior (short distance; 750 m swim, 20 km cycle and 5 km run) and U23 (standard/Olympic distance; 1.5 km swim, 40 km cycle and 10 km run) triathlon events. Additionally, we aimed to investigate which discipline has the largest relationship with overall Junior and U23 triathlon performance, and the effect of sex and time in performance trends. METHODS: We included all data from Junior and U23 official races (International Triathlon Federation; ITU) of Junior (n = 3,314 finishes) and U23 (n = 5,092 finishes) categories held from 1999 to 2018. RESULTS: Men were significantly faster than women in both Junior (11.13%) and U23 (12.28%) categories. Swimming and cycling times were faster in 2009-2018 than in the 1999-2008 decade for men (3.36%; 6.49%), women junior (6.50%; 7.09%), men (0.15%; 3.46%) and women U23 (1.61%; 3.31%) respectively. Cycling was the discipline with the greatest influence on overall triathlon performance in Junior and U23 categories, regardless of sex or rank position. The cut-off values for the Junior category were (men/women): swimming, 9.2/9.4 min; cycling, 31.9/38.2 min; running, 16.8/18.9 min. U23's cut-off values were (men/women): swim, 18.0/19.4 min, cycling: 63.4/70.1 min; run, 33.9/38.7 min. CONCLUSION: Cycling was the discipline with the greatest influence on overall performance for both men and women in Junior and U23 categories. Moreover, swimming and cycling performances increased over the years for both sexes.

The Effect of Muscle Strength on Marathon Race-Induced Muscle Soreness.

BACKGROUND: Muscle soreness after a competition or a training session has been a concern of runners due to its harmful effect on performance. It is not known if stronger individuals present a lower level of muscle soreness after a strenuous physical effort. The aim of this study was to investigate whether the pre-race muscle strength or the V˙O2max level can predict muscle soreness 24, 48 and 72 h after a full marathon in men. METHODS: Thirty-one marathon runners participated in this study (age, 40.8 ± 8.8 years old; weight, 74.3 ± 10.4 kg; height, 174.2 ± 7.6 cm; maximum oxygen uptake, V˙O2max, 57.7 ± 6.8 mL/kg/min). The isokinetic strength test for thigh muscles and the V˙O2max level was performed 15-30 days before the marathon and the participants were evaluated for the subjective feeling of soreness before, 24, 48 and 72 h after the marathon. RESULTS: The participants presented more pain 24 h after the race (median = 3, IQR = 1) than before it (median = 0, IQR = 0) (p < 0.001), and the strength values for the knee extensor muscles were significantly associated with muscle soreness assessed 24 h after the race (p = 0.028), but not 48 (p = 0.990) or 72 h (p = 0.416) after the race. The V˙O2max level was not associated with the muscle pain level at any moment after the marathon. CONCLUSIONS: Marathon runners who presented higher muscular strength for the knee extensor muscles presented lower muscle soreness 24 h after the race, but not after 48 h or 72 h after the race. Therefore, the muscle soreness level 3 days after a marathon race does not depend on muscle strength.

Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020.

BACKGROUND: The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo. METHODS: A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male). RESULTS: The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52-0.80]) or insufficiently active [aPR: 0.39 (0.18-0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35-0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40-0.79)]. CONCLUSIONS: A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

Knowledge and Prevalence of Supplements Used by Brazilian Resistance Training Practitioners Before Coronavirus Outbreak.

INTRODUCTION: The use of dietary supplements and ergogenic aids (DSEA) is popular among physical activity enthusiasts. Particularly, resistance training (RT) practitioners represent important DSEA consumers due to its easy access and the appeal of claims related to muscle hypertrophy, aesthetics, and physical performance improvements. METHODS: Our aim was to study knowledge, prevalence, and profile of DSEA used by Brazilian recreational RT practitioners. For this, RT practitioners of both sexes (n=129, female=58 and male=71) answered a paper-based questionnaire. The questionnaire was specifically created for the studied population to assess different aspects of the DSEA used and sociodemographic variables. RESULTS: Seventy-seven percent of the participants (n=99) declared that they had already used DSEA. The majority (53%) searched the internet to obtain information about DSEA. Whey protein (66%) was the most used followed by branched chain amino acids (48%). CONCLUSION: The use of DSEA, before coronavirus outbreak, was popular among RT practitioners; protein and amino acids were the most used DSEA. Most users used internet to obtain information about DSEA. The results suggest the need for appropriate attitude and guidance by health professionals who deal with this population, especially dietitians, nutritionists, and physical training professionals in order to promote best and security practices.

From Athens to Sparta-37 Years of Spartathlon.

(1) Background: Recent studies analyzed the participation and performance trends of historic races such as the oldest ultra-marathon (Comrades) or the oldest 100-km ultra-marathon (Biel). One of the toughest and historic ultra-marathons in the world is the 'Spartathlon' (246-km ultra-marathon from Athens to Sparta). The present study aimed to analyze the trends in participation and performance of this race. (2) Methods: Different general linear models were applied as follows: the first model was a two-way ANOVA (Decade × Sex), with separate models for all participants and for only the top five finishers in each race; the second model was a two-way ANOVA (Age Group × Sex); the third model was a two-way ANOVA (Nationality × Sex). (3) Results: Between 1982 and 2019, 3504 ultra-marathoners (3097 men and 407 women) officially finished the Spartathlon at least once. Athletes from Japan were the majority with 737 participants, followed by far by runners from Germany (n = 393), Greece (n = 326), and France (n = 274). The nations with the highest numbers of athletes amongst the top five performers were Japan (n = 71), followed by Germany (n = 59), and Great Britain (n = 31). Runners from the USA were the fastest in men, and runners from Great Britain were the fastest in women. Female and male runners improved performance across the decades. The annual five fastest women and men improved their performance over time. Runners achieved their best performance earlier in life (20-29 and 30-39 years) than female runners (30-39 and 40-49 years). Runners in age group 30-39 years were the fastest for all nationalities, except for Greece. (4) Conclusions: Successful finishers in the Spartathlon improved performance in the last four decades and male runners achieved their best performance ~10 years earlier in life than female runners.

Setting Objective Clinical Assessment Tools for Circadian Rhythm Sleep-Wake Disorders - A Community-Based Cross-Sectional Epidemiological Study.

INTRODUCTION: Circadian rhythm sleep-wake disorder (CRSWD) is an often-misdiagnosed group of sleep disturbances with limited data concerning diagnostic and therapeutic algorithms in the general population. Therefore, reported prevalence varies in the literature due to different case definitions, methodological, and environmental factors. OBJECTIVES: The purpose of our cross-sectional study was to estimate the prevalence of CRSWD in the general population of Cyprus and to suggest clinical parameters for the assessment of atypical sleep schedules. The estimation was carried out by introducing normal preset sleep time limits, according to the imposed local environment and by administering well-established questionnaires for symptoms and consequence dysfunction, as objective evaluation tools. METHODS: In a nationwide epidemiological survey, 4118 Cypriot adult participants, selected and stratified to represent the general population, were interviewed on sleep habits and complaints by computer-assisted telephone interviewing (CATI). In the second stage, 250 adults were randomly selected from the initial representative sample, for a CRSWD assessment. According to the proposed diagnostic criteria, patients were interviewed about sleepiness and/or insomnia, and daytime dysfunction (fatigue, anxiety, and depression). They were also assessed by a weekly sleep diary for sleep schedules. Finally, all participants underwent a Type III Sleep Study, to rule out obstructive sleep apnea. RESULTS: From 195 enrolled participants (response rate 78%), 25 individuals (12.8%) met the criteria for CRSWD. The two most prevalent disorders were delayed sleep-wake phase disorder (DSWPD) (10pts, 5.1%) and shift work sleep disorder (SWD) (13, 6.7%). Less prevalent disorders included irregular sleep-wake rhythm disorder (ISWRD) (1, 0.5%) and advanced sleep-wake phase disorder (ASWPD) (1, 0.5%). CONCLUSIONS: According to our data, CRSWDs are common in the general population of Cyprus, especially DSWPD and SWD. Affected individuals usually suffer from sleep deprivation and complain about insomnia, sleepiness and depression.