Systemic Sirtuin 1 as a Potential Target to Mediate Interactions Between Body Fat and Testosterone Concentration in Master Athletes.

Evidence indicates that master athletes have higher concentration of Sirtuin 1 (Sirt1), lower body fat (BF), and greater activity of the hypothalamic-pituitary-gonadal axis in comparison to untrained peers. However, no published data have demonstrated possible mediation effect of Sirt1 in the interaction of BF and testosterone in this population. Therefore, this study compared and verified possible associations between Sirt1, BF, fat mass index (FMI), testosterone, luteinizing hormone (LH), and testosterone/luteinizing hormone (T/LH) ratio in middle-aged master athletes (n = 54; 51.22 ± 7.76 years) and control middle-aged peers (n = 21; 47.76 ± 8.47 years). Venous blood was collected for testosterone, LH, and Sirt1. BF was assessed through skinfold protocol. Although LH concentration did not differ between groups, master athletes presented higher concentration of Sirt1, testosterone, and T/LH ratio, and lower BF and FMI in relation to age-matched nonathletes. Moreover, Sirt1 correlated positively with testosterone and T/LH ratio, negatively with BF, and was not significantly correlated with LH (mediation analysis revealed the effect of BF on testosterone is mediated by Sirt1 and vice versa; R2 = .1776; p = .032). In conclusion, master athletes have higher testosterone, T/LH ratio, and Sirt1, and lower BF and FMI in relation to untrained peers. Furthermore, Sirt1 was negatively associated with BF and positively associated with testosterone and T/LH ratio. These findings suggest that increased circulating Sirt1, possibly due to the master athlete's training regimens and lifestyle, exhibits a potential mediation effect on the interaction between endocrine function and body composition.

Exercise-Induced Transient Oxidative Stress Is Mitigated in Down Syndrome: Insights About Redox Balance and Muscle Strength.

ABSTRACT: Reis, AL, Deus, LA, Neves, RVP, Corrêa, HL Reis, TL, Aguiar, LS Honorato, FS, Barbosa, JMS, Araújo, TB, Palmeira, TRC, Simões, HG, Prestes, J, Sousa, CV, Ide, BN, and Rosa, TdS. Exercise-induced transient oxidative stress is mitigated in Down syndrome: insights about redox balance and muscle strength. J Strength Cond Res 38(3): e125-e34, 2024-This study aimed to evaluate the acute effects of a session of resistance exercise (RE) performed with elastic tubes on the redox balance and inflammatory profile in individuals with Down syndrome (DS). Subjects ( n = 23) were allocated into 2 groups: individuals with DS (DS; n = 11) and individuals without DS (WDS; n = 12), who performed an acute RE session. Diagnostic assessment included medical history, anthropometric measures (body height, body mass, body mass index, and body composition assessment), biological collections, muscle strength assessments (handgrip and maximal voluntary isometric contraction tests), and exercises. The redox balance and inflammatory profile were assessed in urine and saliva samples before and after an acute RE session. There were no differences between WDS and DS groups for body composition ( p > 0.05). The DS group presented higher values pre and post an acute RE session with elastic tubes for oxidative and proinflammatory markers compared with WDS ( p < 0.05). Uric acid values increased from pre-acute RE session to post-acute RE session for WDS ( p < 0.0001). No differences were identified within groups for the delta analysis ( p > 0.05). Inverse correlations were found between total force and F2-isoprostane, 8OHdG, uric acid, allantoin, IL-6, TNF-α, and the TNF-α:IL-10 ratio. A positive correlation was found between IL-10 and total force. The DS group presented increased peak force in the knee extension and elbow flexion exercises (∼25 and 12%, respectively) but decreases in handgrip strength of ∼7%. The WDS group showed higher peak force values for knee extension, elbow flexion, and handgrip (∼16, 10, and 14%, respectively). The DS group had lower transient elevation of oxidative stress after an acute RE session compared with WDS. Oxidative stress and inflammation responses of DS to an acute RE session with elastic tubes may be insufficient to induce health adaptations for the same relative load compared with WDS.

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.

Relationship of Testosterone, LH, Estradiol, IGF-1, and SHBG with Physical Performance of Master Athletes.

Purpose: The aim of this study was to investigate and compare the levels of luteinizing hormone (LH), testosterone (T), estradiol (ES), sex hormone-binding globulin (SHBG), and insulin-like growth factor 1 (IGF-1) in master sprint (MS) and master endurance (ME) athletes. Additionally, the possible associations between these hormones, body composition, and lipid profile with athletic performance (% of performance in relation to the current world record) were analyzed. Materials and Methods: The participants were all men: (i) 34 MS (51.0 ± 6.8 years); and (ii) 32 ME (51.7 ± 9.4 years). Student's t-tests for independent samples were performed to compare all variables between groups. Results: MS had a significantly higher (p = .008) average IGF-1 (154.78 ± 29.85 ng/mL) when compared to ME (129.92 ± 25.48 ng/mL). Performance was significantly correlated with IGF-1 (r = 0.424). The MS group had a moderately lower body fat than ME athletes (MS 12.54 ± 4.07 vs. ME 14.60 ± 4.12; p = .078; d = 0.503). Conclusions: Thus, strength/power training exercise/sport seems to be more beneficial for obtaining a higher IGF-1 compared to aerobic/distance exercise/sport. In addition, LH, T, ES, and SHBG were similar between the two groups of athletes and were comparable to the reference values of younger adults.

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.

Active Video Game Interventions Targeting Physical Activity Behaviors: Systematic Review and Meta-analysis.

BACKGROUND: Research on digital games designed to increase physical activity (PA), also known as exergames or active video games (AVGs), has proliferated over the past 2 decades. As a result, reviews of literature in this field can become outdated, revealing the need for updated high-quality reviews that identify overarching insights. Furthermore, given the significant heterogeneity in AVG research, study inclusion criteria may significantly influence conclusions. To the best of our knowledge, no prior systematic review or meta-analysis has specifically focused on studies of longitudinal AVG interventions targeting increases in PA behaviors. OBJECTIVE: The aim of this study was to obtain insights into when and why longitudinal AVG interventions are more or less successful for sustained increases in PA, especially for public health. METHODS: Six databases (PubMed, PsycINFO, SPORTDiscus, MEDLINE, Web of Science, and Google Scholar) were reviewed until December 31, 2020. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, randomized controlled trials had to prominently (>50% of intervention) feature AVG technology, involve repeated AVG exposure, and target changes in PA behavior. Experimental designs had to include ≥2 within- or between-participant conditions with ≥10 participants per condition. RESULTS: A total of 25 studies published in English between 1996 and 2020 were identified, with 19 studies providing sufficient data for inclusion in the meta-analysis. Our findings indicated that AVG interventions had a moderately positive effect, thereby increasing overall PA (Hedges g=0.525, 95% CI 0.322-0.728). Our analysis showed substantial heterogeneity (I2=87.7%; Q=154.1). The main findings were consistent across all subgroup analyses. The comparison between PA assessment type groups showed a moderate effect for objective measures (Hedges g=0.586, 95% CI 0.321-0.852) and a small effect for subjective measures (Hedges g=0.301, 95% CI 0.049-0.554) but no significant difference between the groups (P=.13). The platform subgroup analysis indicated a moderate effect for stepping devices (Hedges g=0.303, 95% CI 0.110-0.496), combination of handheld and body-sensing devices (Hedges g=0.512, 95% CI 0.288-0.736), and other devices (Hedges g=0.694, 95% CI 0.350-1.039). The type of control group showed a wide range of effects sizes, ranging from a small effect size (Hedges g=0.370, 95% CI 0.212-0.527) for the passive control group (nothing) to a moderate effect size for the conventional PA intervention group (Hedges g=0.693, 95% CI 0.107-1.279) and ultimately to a large effect size for sedentary game as control groups (Hedges g=0.932, 95% CI 0.043-1.821). There was no significant difference among the groups (P=.29). CONCLUSIONS: AVGs represent a promising tool for PA promotion among the general population and clinical subpopulations. However, significant variabilities in AVG quality, study design, and impact were also detected. Suggestions for improving AVG interventions and related research will be discussed. TRIAL REGISTRATION: PROSPERO CRD42020204191; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204191.

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.

The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games.

Narratives are pervasive in video games and have been found to increase physical activity in active video games. However, the effect of incorporating narrative elements has seldom been examined in fully immersive virtual reality games. We investigated the effect of narrative element incorporation (between-subject: narrative vs. no narrative) in active virtual reality and sedentary virtual reality games (within-subject) and examined between- and within-subject effects on physical activity behavior, game experience, and physical activity engagement. We randomized 36 sedentary college students to either the narrative or the non-narrative group. All participants played an active virtual reality and a sedentary virtual reality game in counter-balanced order. Before each game session, they either watched a 5-min narrative video (narrative) or directly played the original virtual reality games without narratives (non-narrative). We collected participants' physical activity data using wrist-worn accelerometers; we obtained their game experience and physical activity engagement via questionnaires. The narrative group spent a greater proportion of time in moderate-to-vigorous physical activity (%) and had less non-movement time during the active virtual reality gameplay than the non-narrative group (all p values < .05). The active virtual reality sessions induced a greater positive affect and greater physical activity engagement ratings than the sedentary virtual reality sessions. The incorporation of narrative elements in active virtual reality increased the relative time spent in moderate-to-vigorous physical activity and reduced non-movement time, compared to the non-narrative group. Active virtual reality encouraged more activity by participants and offered them a more enjoyable gaming experience in which they engaged more. Active virtual reality is a feasible physical activity promotion option among sedentary adults; the incorporation of narrative elements in active virtual reality helps increase relative moderate-to-vigorous physical activity and should be further explored for its efficacy. Supplementary Information: The online version contains supplementary material available at 10.1007/s10055-023-00754-7.

A Machine Learning Approach to Finding the Fastest Race Course for Professional Athletes Competing in Ironman® 70.3 Races between 2004 and 2020.

Our purpose was to find the fastest race courses for elite Ironman® 70.3 athletes, using machine learning (ML) algorithms. We collected the data of all professional triathletes competing between 2004 and 2020 in Ironman 70.3 races held worldwide. A sample of 16,611 professional athletes originating from 97 different countries and competing in 163 different races was thus obtained. Four different ML regression models were built, with gender, country of origin, and event location considered as independent variables to predict the final race time. For all the models, gender was the most important variable in predicting finish times. Attending to the single decision tree model, the fastest race times in the Ironman® 70.3 World Championship of around ~4 h 03 min would be achieved by men from Austria, Australia, Belgium, Brazil, Switzerland, Germany, France, the United Kingdom, South Africa, Canada, and New Zealand. Considering the World Championship is the target event for most professional athletes, it is expected that training is planned so that they attain their best performance in this event.

A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance.

OBJECTIVE: To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms. DATA SOURCE: Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020. STUDY SELECTION: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition. DATA EXTRACTION: Three reviewers independently performed data extraction and assessed the risk of bias. DATA SYNTHESIS: 129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, Mage=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753). CONCLUSIONS: AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.

How much did it cost to develop and implement an eHealth intervention for a minority children population that overlapped with the COVID-19 pandemic?

BACKGROUND: eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions. OBJECTIVES: We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19. METHODS: We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs. RESULTS: The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant completing the RCT (79 participants/237 visits) was $24,403 (Direct: $15,543; Indirect: $8860). Due to no-shows and cancellations (198 visits) and dropouts before study completion (61 visits; 56 participants), 496 visits had to be scheduled to ensure complete data collection on 79 participants. If all 496 visits were from participants completing the three-visit protocol, that would correspond to 165 participants, bringing the average cost per participant down to $11,684 (Direct: $7442; Indirect: $4242). Of the subcategories, intervention material development accounted for the largest portion, followed by personnel salaries. While the direct COVID-19-specific cost constituted <1% of the entire budget, the indirect effects were much larger and significantly impacted the trial. CONCLUSION: RCTs typically involve significant resources, even more so during a pandemic. Future eHealth intervention investigators should budget and plan accordingly to prepare for unexpected costs such as recruitment challenges to increase flexibility while maximizing the intervention efficacy.

Age- and sex-specific normative values for muscle mass parameters in 18,625 Brazilian adults.

Background: The present study aimed to provide age- and sex-specific normative values for muscle mass parameters in Brazilian adults. Methods: Data pertaining to Brazilian adults (18+ years) who attended a nutritional clinical between January 2018 and July 2022 were analyzed. Muscle mass parameters were assessed using a bioimpedance digital scale (InBody 230, GBC BioMed NZ). Assessments were conducted under standard conditions, with participants refraining from physical exercise for 96 h and from eating or drinking (including water) for 8 h before evaluations. Results: A total of 18,625 Brazilian adults were analyzed. Normative values for absolute and relative (height, m2) muscle mass and appendicular muscle mass (ASM) were calculated. In addition, specific age-related changes in muscle mass parameters were observed. In women, muscle mass peaked between the ages of 40-49 before gradually declining at an average rate of 5.7% per decade from the sixth decade of life onwards. ASM reached its peak earlier, during the third decade of life, and started to decline later, from 50 to 59 years. In contrast, absolute and ASM peaked at 40-49 years and declined from the sixth decade of life in men. Both sexes displayed a slightly greater decline in ASM than in muscle mass (13 vs. 12%). Conclusions: The present study provides normative values for absolute and relative muscle mass and ASM in Brazilian adults. Furthermore, important specific age-related changes in muscle mass parameters were observed. These data have public health implications and might serve as a reference tool to guide health professionals.

An analysis of the São Silvestre race between 2007-2021: An increase in participation but a decrease in performance.

This study aimed to investigate the trends of finishers in the São Silvestre race in Brazil, taking into account sex, age, and performance levels. A total of 31 â€‹775 runners (women, n â€‹= â€‹13 â€‹847; men, n â€‹= â€‹17 â€‹928), aged (45.2 â€‹± â€‹16.8) years, finishers in the São Silvestre race between 2007 and 2021, were considered in the present analysis. Data (event year, date of birth, sex, and race times) were downloaded from the official race website. The man-Whitney U test, Spearman correlation, and robust regression model were computed. Participation increased over time for both sexes. Regarding age groups, "31-40 years" (women) and "> 60 years" (men) were those with the highest number of finishers. We found a decrease in performance across the years (ߠ​= â€‹2.45; p â€‹< â€‹0.005), as well as significant differences in race times for both sexes (U â€‹= â€‹42.844; p â€‹< â€‹0.001), with men presenting better performances than women. Over time, it was observed an increase in the performance gap between the sexes, but in general, the performance decreased (ߠ​= â€‹1.76; p â€‹< â€‹0.001). Stakeholders should consider improving the strategies to improve women and young people's participation in running events.

Biophysical characterization of the first ultra-cyclist in the world to break the 1,000 km barrier in 24-h non-stop road cycling: A case report.

A plethora of factors determine elite cycling performance. Those include training characteristics, pacing strategy, aerodynamics, nutritional habits, psychological traits, physical fitness level, body mass composition, and contextual features; even the slightest changes in any of these factors can be associated with performance improvement or deterioration. The aim of the present case report is to compare the performances of the same ultra-cyclist in achieving two world records (WR) in 24 h cycling. We have analyzed and compared the distance covered and speed for each WR. The 24 h period was split into four-time intervals (0-6 h; > 6-12 h; > 12-18 h; > 18-24 h), and we compared the differences in the distance covered and speed between the two WRs. For both WRs, a strong negative correlation between distance and speed was confirmed (r = -0.85; r = -0.89, for old and new WR, respectively). Differences in speed (km/h) were shown between the two WRs, with the most significant differences in 12-18 h (Δ = 6.50 km/h). For the covered distance in each block, the most significant differences were observed in the last part of the cycling (Δ = 38.54 km). The cyclist effective surface area (ACd) was 0.25 m2 less and 20% more drag in the new WR. Additionally, the mechanical power was 8%, the power to overcome drag was 31%, and the power-weight ratio was 8% higher in the new WR. The mechanical efficiency of the cyclist was 1% higher in the new WR. Finally, the heart rate (HR) presented significant differences for the first 6 h (Old WR: 145.80 ± 5.88 bpm; New WR: 139.45 ± 5.82 bpm) and between the 12 and 18 h time interval (Old WR: 133.19 ± 3.53 bpm; New WR: 137.63 ± 2.80 bpm). The marginal gains concept can explain the performance improvement in the new WR, given that the athlete made some improvements in technical specifications after the old WR.

[A Distal Radius Fracture Is Not Simply a Distal Radius Fracture]. / Eine distale Radiusfraktur ist nicht einfach eine distale Radiusfraktur.

A Distal Radius Fracture Is Not Simply a Distal Radius Fracture Abstract. We report on a 57-year-old female patient with a distal extra-articular radius fracture. The family doctor's suspicion was an osteoporosis-associated fracture, and an interdisciplinary investigation was initiated. In addition to DXA measurement differential diagnoses for secondary osteoporosis were considered. In our case, secondary osteoporosis was diagnosed as part of Graves' disease and insufficiency of vitamin D leading to a radius fracture.

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.

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students.

BACKGROUND: Active video games are a new method for increasing physical activity (PA). Fully immersive virtual reality (VR) is a hardware device on which an active video game can run. Active (video games in) VR (AVR), might increase immersion, game engagement, and moderate-to-vigorous PA (MVPA), thereby yielding greater exercise-related benefits, e.g., cognitive performance. METHODS: We examined the induction of MVPA via an AVR and a sedentary VR (SVR) as well as the effects of VR play on cognitive performance, which was monitored using 2 different methods. Each of 29 sedentary college students attended three 20-min laboratory sessions (AVR, SVR, or control) in a randomized order; during the control session, they sat quietly doing nothing. A fully immersive headset was used for the 2 video game sessions. We monitored and computed participants' PA using hip-worn accelerometers (wGT3x-bt; ActiGraph, Pensacola, FL, USA) and a heart rate band (Polar H7; Polar, Kempele, Finland). After each session, the participants completed a mnemonic similarity test (MST) to measure recognition memory. They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire. RESULTS: The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method. AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion, challenge, and positive affect than did SVR. The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session. CONCLUSION: AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.

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.

Are Resistance Training-Induced BDNF in Hemodialysis Patients Associated with Depressive Symptoms, Quality of Life, Antioxidant Capacity, and Muscle Strength? An Insight for the Muscle-Brain-Renal Axis.

BACKGROUND: Hemodialysis patients are suffering from depressive symptoms. Brain-derived neurotrophic factor (BDNF) levels are negatively associated with depressive symptoms and decrease during a single hemodialysis session. Resistance training (RT) might be an additional non-pharmacological tool to increase BDNF and promote mental health. METHODS: Two randomized groups of hemodialysis patients: control (CTL, n = 76/F36; 66.33 ± 3.88 years) and RT (n = 81/F35; 67.27 ± 3.24 years). RT completed six months of training thrice a week under the supervision of strength and conditioning professional immediately before the dialysis session. Training loads were adjusted using the OMNI rating of perceived exertion. The total antioxidant capacity (TROLOX), glutathione (GSH), thiobarbituric acid reactive substance (TBARS), and BDNF levels were analyzed in serum samples. Quality of life (assessed through Medical Outcomes-SF36), and Beck Depression Inventory was applied. RESULTS: RT improved handgrip strength (21.17 ± 4.38 vs. 27.17 ± 4.34; p = 0.001) but not for CTL (20.09 ± 5.19 vs. 19.75 ± 5.54; p = 0.001). Post-training, RT group had higher values as compared to CTL related to TROLOX (RT,680.8 ± 225.2 vs. CTL,589.5 ± 195.9; p = 0.001) and GSH (RT, 9.33 ± 2.09 vs. CTL,5.00 ± 2.96; p = 0.001). RT group had lower values of TBARS as compared to CTL at post-training (RT, 11.06 ± 2.95 vs. CTL, 13.66 ± 2.62; p = 0.001). BDNF increased for RT (11.66 ± 5.20 vs. 19.60 ± 7.23; p = 0.001), but decreased for CTL (14.40 ± 4.99 vs. 10.84 ± 5.94; p = 0.001). Quality of life and mental health increased (p = 0.001) for RT, but did not change for CTL (p = 0.001). BDNF levels were associated with emotional dimensions of SF36, depressive symptoms, and handgrip (p = 0.001). CONCLUSIONS: RT was effective as a non-pharmacological tool to increased BDNF levels, quality of life, temper the redox balance and decrease depressive symptoms intensity in hemodialysis patients.