Factors Associated with Fatigue in COVID-19 ICU Survivors.

PURPOSE: Approximately 30% of people infected with COVID-19 require hospitalization and 20% of them are admitted to an intensive care unit (ICU). Most of these patients experience symptoms of fatigue weeks post-ICU, so understanding the factors associated with fatigue in this population is crucial. METHODS: Fifty-nine patients [38-78 yr] hospitalized in ICU for COVID-19 infection for 32 [6-80] days including 23 [3-57] days of mechanical ventilation, visited the laboratory on two separate occasions. The first visit occurred 52 ± 15 days after discharge and was dedicated to questionnaires, blood sampling and cardiopulmonary exercise testing, while measurements of the knee extensors neuromuscular function and performance fatigability were performed in the second visit 7 ± 2 days later. RESULTS: Using the FACIT-F questionnaire, 56% of patients were classified as fatigued. Fatigued patients had worse lung function score than non- fatigued (i.e. 2.9 ± 0.8 L vs 3.6 ± 0.8 L; 2.4 ± 0.7 l vs 3.0 ± 0.7 L for forced vital capacity and forced expiratory volume in one second, respectively) and forced vital capacity was identified as a predictor of being fatigued. Maximal voluntary activation was lower in fatigued patients than non-fatigued patients (82 ± 14% vs 91 ± 3%) and was the only neuromuscular variable that discriminated between fatigued and non-fatigued patients. Patient-reported outcomes also showed differences between fatigued and non-fatigued patients for sleep, physical activity, depression and quality of life (p < 0.05). CONCLUSIONS: COVID-19 survivors showed altered respiratory function 4 to 8 weeks after discharge, that was further deteriorated in fatigued patients. Fatigue was also associated with lower voluntary activation and patient-reported impairments (i.e. sleep satisfaction, quality of life or depressive state). The present study reinforces the importance of exercise intervention and rehabilitation to counteract cardiorespiratory and neuromuscular impairments of COVID-19 patients admitted in ICU, especially individuals experiencing fatigue.

Reliability of Corticospinal and Motoneuronal Excitability Evaluation During Unfatiguing and Fatiguing Cycling Exercise.

INTRODUCTION: Central nervous system excitability depends on the task performed, muscle group solicited, and contraction type. However, little is known on corticospinal and motoneuronal excitability measured during locomotor exercise. This study aimed at determining the reliability of motor-evoked potentials (MEP) and thoracic motor-evoked potentials (TMEP) in dynamic mode during unfatiguing and fatiguing cycling exercise. METHODS: Twenty-two participants completed four visits. Visit 1 comprised familiarization and a maximal incremental test to determine maximal power output (Wmax). The remaining visits encompassed unfatiguing evaluations, which included 8 brief bouts of moderate (50% Wmax) and high intensity cycling (80% Wmax). In each bout, a set of two TMEPs, five MEPs and one M-max were obtained. Subsequently, a fatiguing exercise to exhaustion at 80% Wmax was performed, with four sets of measurements 3 min through the exercise and 4 additional sets at exhaustion, both measured at 50% Wmax. RESULTS: Intraclass correlation coefficients (ICCs) for 5, 10, 15 and 20 MEP·Mmax-1 revealed excellent reliability at both intensities and during fatiguing exercise (ICC ≥ 0.92). TMEP·Mmax-1 showed ICCs ≥0.82 for moderate and high intensity, and it was not affected by fatigability. Overall standard error of measurement was 0.090 [0.083, 0.097] for MEP·Mmax-1 and 0.114 [0.105, 0.125] for TMEP·Mmax-1. A systematic bias associated to the number of stimulations, especially at high intensity, suggested the evaluation itself may be influenced by fatigability. A mean reduction of 8% was detected in TMEP·Mmax-1 at exhaustion. CONCLUSIONS: Motoneuronal and corticospinal excitability measured in dynamic mode presented good to excellent reliability in unfatiguing and fatiguing exercise. Further studies inducing greater fatigability must be conducted to assess the sensitivity of central nervous system excitability during cycling.

Reliability and measurement error of a maximal voluntary toe plantarflexion measurement process.

Despite the growing interest, information regarding the psychometric properties of maximal voluntary isometric toe plantarflexion force and rate of force development (RFD) is lacking. Hence, we investigate the test-retest reliability and measurement error of these outcome measurement instruments measured with a custom-built dynamometer. Twenty-six healthy adults participated in a crossed design with four sessions separated by 5-7 days. RFD was quantified using manual onset and calculating the impulse and the slope in the following time windows: 0-50 ms, 0-100 ms, 0-150 ms, 0-200 ms, 0-250 ms. We estimated the systematic bias of the mean, the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) from the agreement and consistency models. The ICC and the SEM agreement for maximal voluntary isometric toe plantarflexion force along the perpendicular axis were respectively 0.87 (95%CI: 0.76, 0.93) and 27 N (22, 32), while along the resultant of the perpendicular and anterior posterior axis they were 0.85 (0.73, 0.92) and 29 N (23, 35). The results of the consistency model were similar as the estimated variance for session was closer to zero. A systematic bias of the mean between session 1 and 3 was found. For the RFD variables, the ICC agreement ranged from 0.35 to 0.65. The measurement process was found to be reliable to assess maximal voluntary isometric toe plantarflexion force but not RFD. However, a familiarization session is mandatory and these results need to be confirmed in less coordinated (e.g. aging population) individuals.

Sleep and Ultramarathon: Exploring Patterns, Strategies, and Repercussions of 1,154 Mountain Ultramarathons Finishers.

BACKGROUND: Sleep and physical performance are strongly related and mutually influence each other. Athletes, particularly in disciplines like offshore sailing and ultra-endurance sports, often suffer from sleep deprivation due to factors like irregular training times, travel, and the extended duration of events like 100-mile mountain races. Despite growing interest in sleep's role in sports science, few studies have specifically investigated the sleep patterns of ultramarathon runners. This study aimed to investigate sleep patterns and sleep management strategies in ultramarathons, and the repercussions of sleep deprivation during and after races. METHODS: This cross-sectional study using e-survey was conducted on 1154 runners from two ultramarathons (a 165 km race with 9,576 m positive elevation; 2018 finish time [23:18:48-66:04:00], and a 111 km race with 6,433 m elevation; [15:34:56 - 41:54:16]). RESULTS: The results revealed that 58% of the runners reported implementing sleep management strategies before or during the race. Most runners began the race with some level of sleep debt (-50 min a week before the race). During the races, 77% of runners slept, with the cumulative sleep duration varying based on race duration and the number of nights spent on the race (76 min at 165 km and 27 min at 111 km). Short naps lasting less than 30 min were the most popular strategy. The prevalence of symptoms attributed to sleep deprivation during the race was high (80%), with reported falls and hallucinations. After the race, runners reported recovering a normal state of wakefulness relatively quickly (within two days); 22% believed that sleep deprivation during the race increased the risk of accidents in everyday life. CONCLUSION: This study provides valuable insights into sleep patterns and strategies in ultramarathon running and emphasizes the importance of adequate sleep management for performance and post-race recovery.

Limits of Ultra: Towards an Interdisciplinary Understanding of Ultra-Endurance Running Performance.

Ultra-endurance running (UER) poses extreme mental and physical challenges that present many barriers to completion, let alone performance. Despite these challenges, participation in UER events continues to increase. With the relative paucity of research into UER training and racing compared with traditional endurance running distance (e.g., marathon), it follows that there are sizable improvements still to be made in UER if the limitations of the sport are sufficiently understood. The purpose of this review is to summarise our current understanding of the major limitations in UER. We begin with an evolutionary perspective that provides the critical background for understanding how our capacities, abilities and limitations have come to be. Although we show that humans display evolutionary adaptations that may bestow an advantage for covering large distances on a daily basis, these often far exceed the levels of our ancestors, which exposes relative limitations. From that framework, we explore the physiological and psychological systems required for running UER events. In each system, the factors that limit performance are highlighted and some guidance for practitioners and future research are shared. Examined systems include thermoregulation, oxygen delivery and utilisation, running economy and biomechanics, fatigue, the digestive system, nutritional and psychological strategies. We show that minimising the cost of running, damage to lower limb tissue and muscle fatigability may become crucial in UER events. Maintaining a sustainable core body temperature is critical to performance, and an even pacing strategy, strategic heat acclimation and individually calculated hydration all contribute to sustained performance. Gastrointestinal issues affect almost every UER participant and can be due to a variety of factors. We present nutritional strategies for different event lengths and types, such as personalised and evidence-based approaches for varying types of carbohydrate, protein and fat intake in fluid or solid form, and how to avoid flavour fatigue. Psychology plays a vital role in UER performance, and we highlight the need to be able to cope with complex situations, and that specific long and short-term goal setting improves performance. Fatigue in UER is multi-factorial, both physical and mental, and the perceived effort or level of fatigue have a major impact on the ability to continue at a given pace. Understanding the complex interplay of these limitations will help prepare UER competitors for the different scenarios they are likely to face. Therefore, this review takes an interdisciplinary approach to synthesising and illuminating limitations in UER performance to assist practitioners and scientists in making informed decisions in practice and applicable research.

Age-Related Differences between Old and Very Old Men in Performance and Fatigability Are Evident after Cycling but Not Isometric or Concentric Single-Limb Tasks.

PURPOSE: This study aimed to compare performance and fatigability between young (n = 13; 18-30 yr), old (n = 13; 60-80 yr), and very old (n = 12; >80 yr) men during a single-joint isometric (ISO) and concentric (CON) task performed on an isokinetic dynamometer and a cycling (BIKE) task. METHODS: Participants randomly performed incremental tasks consisting of stages of 75 contractions (i.e., 120 s, 0.8 s on/0.8 s off) for ISO and CON and 120 s at 37.5 rpm (similar duty cycle) for BIKE. Increments were set as a percentage of body weight. Knee extensor maximal force, voluntary activation, and twitch amplitude were measured at baseline, after each stage, and at task failure (five out of eight contractions below the target force or 6 s in a row at a cadence <37.5 rpm). RESULTS: Compared with young men, performance (number of stages) was 24% and 40% lower in old and very old men in ISO, 54% and 59% lower in CON, and 36% and 60% lower in BIKE (all P < 0.05). Performance of old and very old differed only in BIKE (P < 0.01). For the last common stages performed, compared with young, force loss was greater for very old men in ISO and for old and very old men in BIKE (all P < 0.05). Overall, for the last common stage performed and task failure, old and very old men presented similar force loss, alterations in voluntary activation, and twitch amplitude. CONCLUSIONS: Our findings reveal that, with workloads relative to body weight, differences in performance between old and very old men could only be observed during BIKE (i.e., the more ecologically valid task). Results from isometric or concentric conditions might not be transferable to dynamic exercise with large muscle masses.

A Comprehensive Evaluation of Multiple Sclerosis-Related Fatigue with a Special Focus on Fatigability.

INTRODUCTION: Fatigue is the most common and disabling symptom in multiple sclerosis (MS), being reported by 55% to 78% of patients with MS (PwMS). Etiology of MS-related fatigue remains poorly understood, but an increased neuromuscular fatigability (i.e., greater loss of torque during exercise) could contribute to this phenomenon. This study aimed to characterize the correlates of MS-related fatigue in PwMS using a comprehensive group of physiological and psychosocial measures, with a particular focus on fatigability. METHODS: Forty-two relapsing-remitting PwMS and 20 healthy subjects were recruited. PwMS were assigned in two groups (high (HF) and low (LF) fatigue) based on two fatigue questionnaires (Fatigue Severity Scale and Modified Fatigue Impact Scale). The main outcomes of this study are derived from incremental cycling completed to task failure (i.e., inability to pedal around 60 rpm). Maximal voluntary contraction (MVC), rating of perceived exertion, and central and peripheral parameters measured using transcranial magnetic and peripheral nerve stimulation were assessed in the knee extensor muscles before, during, and after the fatiguing task. Other potential correlates of fatigue were also tested. RESULTS: MVC torque decreased to a greater extent for the HF group than LF group after the third common stage of the incremental fatiguing exercise (-15.7% ± 6.6% vs -5.9% ± 13.0%, P < 0.05), and this occurred concurrently with a higher rating of perceived exertion for HF (11.8 ± 2.5 vs 9.3 ± 2.6, P < 0.05). Subjective parameters (depression, quality of life) were worse for HF compared with LF and healthy subjects ( P < 0.001). Moreover, MVC torque loss at the final common stage and maximal heart rate explained 29% of the variance of the Modified Fatigue Impact Scale. CONCLUSIONS: These results provide novel insight into the relationship between MS-related fatigue and fatigability among PwMS. The HF group exhibited greater performance fatigability, likely contributing to a higher perceived exertion than the LF group when measured during a dynamic task.

Elite vs. Experienced Male and Female Trail Runners: Comparing Running Economy, Biomechanics, Strength, and Power.

ABSTRACT: Besson, T, Pastor, FS, Varesco, G, Berthet, M, Kennouche, D, Dandrieux, P-E, Rossi, J, and Millet, GY. Elite vs. experienced male and female trail runners: comparing running economy, biomechanics, strength, and power. J Strength Cond Res 37(7): 1470-1478, 2023-The increased participation in trail running (TR) races and the emergence of official international races have increased the performance level of the world best trail runners. The aim of this study was to compare cost of running (Cr) and biomechanical and neuromuscular characteristics of elite trail runners with their lower level counterparts. Twenty elite (10 females; ELITE) and 21 experienced (10 females; EXP) trail runners participated in the study. Cr and running biomechanics were measured at 10 and 14 km·h-1 on flat and at 10 km·h-1 with 10% uphill incline. Subjects also performed maximal isometric voluntary contractions of knee and hip extensors and knee flexors and maximal sprints on a cycle ergometer to assess the power-torque-velocity profile (PTVP). Athletes also reported their training volume during the previous year. Despite no differences in biomechanics, ELITE had a lower Cr than EXP (p < 0.05). Despite nonsignificant difference in maximal lower-limb power between groups, ELITE displayed a greater relative torque (p < 0.01) and lower maximal velocity (p < 0.01) in the PTVP. Females displayed shorter contact times (p < 0.01) compared with males, but no sex differences were observed in Cr (p > 0.05). No sex differences existed for the PTVP slope, whereas females exhibited lower relative torque (p < 0.01) and velocity capacities (p < 0.01) compared with males. Although not comprehensively assessing all determining factors of TR performance, those data evidenced level and sex specificities of trail runners in some factors of performance. Strength training can be suggested to lower level trail runners to improve Cr and thus TR performance.

2022 French Report Card on Physical Activity and Sedentary Behaviors in Children and Youth: From Continuous Alarming Conclusions to Encouraging Initiatives.

BACKGROUND: Scientific evidence and public health reports keep highlighting the continuous and alarming worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from the 2022 French Report Card (RC) on physical activity for children and youth and compares them to the 2016, 2018, and 2020 RCs. METHODS: The 2022 edition of the French RC follows the standardized methodology established by the Active Healthy Kids Global Matrix. Ten physical activity indicators have been evaluated and graded based on the best available evidence coming from national surveys, peer-reviewed literature, government and nongovernment reports, and online information. The evaluation was also performed in children and adolescents with disabilities. Indicators were graded from A (high level of evidence) to F (very low level of evidence) or INC for incomplete. RESULTS: The evaluated indicators received the following grades: overall physical activity: D-; organized sport participation and physical activity: C; active play: F; active transportation: C; sedentary behaviors: D-; family and peers: D; physical fitness: C; school: C-; community and the built environment: F; government: B. CONCLUSIONS: While this 2022 French RC shows progression for 7 out of the 10 indicators considered, it also underlines the continuous need for actions at the local, regional, and national levels to develop better surveillance systems and favor a long-term improvement of youth movement behaviors.

Different ramp-incremental slopes elicit similar V̇o2max and fatigability profiles in females and males despite differences in peak power output.

The aim of this article is to investigate the effects of different ramp-incremental (RI) slopes on fatigability and its recovery in females and males. Ten females and 11 males performed RI tests with distinct slopes, in separated and randomized sessions, 15 (RI15), 30 (RI30), and 45 (RI45) W·min-1. Performance fatigability was assessed by femoral nerve electrical stimuli evoked during and after isometric maximal voluntary contraction (IMVC) of knee extensors at baseline and after task failure at min 0.5, 1.5, 2.5, 5, and 10. Maximal oxygen uptake (V̇o2max) and peak power output (POpeak) were also measured. There were significant and similar declines from pre- to post-RI test in RI15, RI30, and RI45 for IMVC (-23%; -25%; -25%, respectively; P < 0.05) and potentiated single twitch (-46%; -47%; -49%; P < 0.05), whereas voluntary activation did not change (-1%; -1%; 0%; P > 0.05). There were no RI condition effects, nor time × condition interaction for IMVC, potentiated single twitch and voluntary activation (all P > 0.05). V̇o2max was not different among RI15, RI30, and RI45 conditions (3.30, 3.29, and 3.26 L·min-1, respectively; P = 0.717), but POpeak was (272, 304, and 337 W, respectively; P < 0.001). Overall, performance fatigability profiles were similar between sexes after the RI tests and during recovery. In addition, during recovery, high-frequency doublets and single twitch recovered faster after RI30 and RI45 compared with RI15, regardless of sex (all P > 0.05 for sex differences). In conclusion, RI tests of different slopes that elicited similar V̇o2max but different POpeak did not affect the profile of performance fatigability at task failure in females and males.NEW & NOTEWORTHY It was unknown whether performance fatigability and its recovery are affected by different slopes in a ramp incremental (RI) test. It was also uncertain if females and males would respond differently. Performance fatigability was the same regardless of the RI slope adopted and the sex of the population, which was accompanied by similar maximal oxygen uptake but different power output achieved. The recovery of contractile function was similar between sexes but delayed after slower RI slopes.

Measuring objective fatigability and autonomic dysfunction in clinical populations: How and why?

Fatigue is a major symptom in many diseases, often among the most common and severe ones and may last for an extremely long period. Chronic fatigue impacts quality of life, reduces the capacity to perform activities of daily living, and has socioeconomical consequences such as impairing return to work. Despite the high prevalence and deleterious consequences of fatigue, little is known about its etiology. Numerous causes have been proposed to explain chronic fatigue. They encompass psychosocial and behavioral aspects (e.g., sleep disorders) and biological (e.g., inflammation), hematological (e.g., anemia) as well as physiological origins. Among the potential causes of chronic fatigue is the role of altered acute fatigue resistance, i.e. an increased fatigability for a given exercise, that is related to physical deconditioning. For instance, we and others have recently evidenced that relationships between chronic fatigue and increased objective fatigability, defined as an abnormal deterioration of functional capacity (maximal force or power), provided objective fatigability is appropriately measured. Indeed, in most studies in the field of chronic diseases, objective fatigability is measured during single-joint, isometric exercises. While those studies are valuable from a fundamental science point of view, they do not allow to test the patients in ecological situations when the purpose is to search for a link with chronic fatigue. As a complementary measure to the evaluation of neuromuscular function (i.e., fatigability), studying the dysfunction of the autonomic nervous system (ANS) is also of great interest in the context of fatigue. The challenge of evaluating objective fatigability and ANS dysfunction appropriately (i.e.,. how?) will be discussed in the first part of the present article. New tools recently developed to measure objective fatigability and muscle function will be presented. In the second part of the paper, we will discuss the interest of measuring objective fatigability and ANS (i.e. why?). Despite the beneficial effects of physical activity in attenuating chronic fatigue have been demonstrated, a better evaluation of fatigue etiology will allow to personalize the training intervention. We believe this is key in order to account for the complex, multifactorial nature of chronic fatigue.

Acute effects of conventional versus wide-pulse neuromuscular electrical stimulation on quadriceps evoked torque and neuromuscular function.

PURPOSE: The effectiveness of a neuromuscular electrical stimulation (NMES) program is proportional to the level of evoked torque, which can be achieved with either conventional or wide-pulse stimulations. The aim of this study was to compare evoked torque, objective fatigability, and related peripheral and central alterations, as well as changes in central nervous system (CNS) excitability induced by an acute session of conventional versus wide-pulse NMES. METHODS: Seventeen young men underwent three 20-min NMES sessions: conventional (0.2 ms/50 Hz), wide-pulse at 50 Hz (1 ms/50 Hz), and wide-pulse at 100 Hz (1 ms/100 Hz). Neuromuscular measurements (i.e., maximal voluntary contraction, voluntary activation, evoked responses to femoral nerve stimulation, and CNS excitability) were performed on the right quadriceps femoris muscle before and after each NMES session. CNS excitability was measured using transcranial magnetic, thoracic, and transcutaneous spinal cord stimulations. RESULTS: The level of evoked torque was not significantly different between conventional and wide-pulse protocols applied at the maximal tolerable current intensity. All NMES protocols induced objective fatigability (~14% decrease in maximal voluntary contraction torque, p < 0.001) associated with peripheral (decrease in doublet torque and potentiated M-wave amplitude, p = 0.002 and p < 0.001, respectively) but not central (unchanged voluntary activation, p = 0.79) alterations. However, these acute changes did not differ between NMES protocols and none of the NMES protocols modified markers of CNS excitability. CONCLUSION: These results may allow to conjecture that chronic effects and treatment effectiveness could be comparable between conventional and wide-pulse NMES.

Running Endurance in Women Compared to Men: Retrospective Analysis of Matched Real-World Big Data.

BACKGROUND AND OBJECTIVE: To determine whether the gap in endurance performance between men and women is reduced as distances increase, i.e. if there is a sex difference in endurance, one can analyse the performance of elite runners, all participants, or one can pair women and men during short-distance events and examine the difference over longer distances. The first two methods have caveats, and the last method has never been performed with a large dataset. This was the goal of the present study. METHODS: A dataset including 38,860 trail running races from 1989 to 2021 in 221 countries was used. It provided information on 1,881,070 unique runners, allowing 7251 pairs of men and women with the same relative level of performance to be obtained, i.e. the same percentage of the winner time of the considered race on short races (25-45 km-effort) that were compared during longer races (45-260 km-effort). The effect of distance on sex differences in average speed was determined using a gamma mixed model. RESULTS: The gap between sexes decreased as distance increases, i.e. men's speed decreased by 4.02% (confidence interval 3.80-4.25) for every 10 km-effort increase, whereas it decreased by 3.25% (confidence interval 3.02-3.46) for women. The men-women ratio decreases from 1.237 (confidence interval 1.232-1.242) for a 25 km-effort to 1.031 (confidence interval 1.011-1.052) for a 260 km-effort. This interaction was modulated by the level of performance, i.e. the greater the performance level of the runner, the lower the difference in endurance between sexes. CONCLUSIONS: This study shows for the first time that the gap between men and women shrinks when trail running distance increases, which demonstrates that endurance is greater in women. Although women narrow the performance gap with men as race distance increases, top male performers still outperform the top women.

Wide-pulse electrical stimulation of the quadriceps allows greater maximal evocable torque than conventional stimulation.

PURPOSE: The effectiveness of a neuromuscular electrical stimulation (NMES) program has been shown to be proportional to the maximal evocable torque (MET), which is potentially influenced by pulse characteristics such as duration and frequency. The aim of this study was to compare MET between conventional and wide-pulse NMES at two different frequencies. METHODS: MET-expressed as a percentage of maximal voluntary contraction (MVC) torque-and maximal tolerable current intensity were quantified on 71 healthy subjects. The right quadriceps was stimulated with three NMES protocols using different pulse duration/frequency combinations: conventional NMES (0.2 ms/50 Hz; CONV), wide-pulse NMES at 50 Hz (1 ms/50 Hz; WP50) and wide-pulse NMES at 100 Hz (1 ms/100 Hz; WP100). The proportion of subjects reaching the maximal stimulator output (100 mA) before attaining maximal tolerable current intensity was also quantified. RESULTS: The proportion of subjects attaining maximal stimulator output was higher for CONV than WP50 and WP100 (p < 0.001). In subjects who did not attain maximal stimulator output in any protocol, MET was higher for both WP50 and WP100 than for CONV (p < 0.001). Maximal tolerable current intensity was lower for both WP50 and WP100 than for CONV and was also lower for WP100 than for WP50 (p < 0.001). CONCLUSION: When compared to conventional NMES, wide-pulse protocols resulted in greater MET and lower maximal tolerable current intensity. Overall, this may lead to better NMES training/rehabilitation effectiveness and less practical issues associated with maximal stimulator output limitations.

VO2max and Velocity at VO2max Play a Role in Ultradistance Trail-Running Performance.

PURPOSE: Previous research has shown that maximal oxygen uptake (VO2max) significantly influences performance in trail-running races up to 120 km but not beyond. Similarly, the influence of running economy on performance in ultratrail remains unclear. The aim of our study was, therefore, to determine the physiological predictors of performance in a 166-km trail-running race. METHODS: Thirty-three experienced trail runners visited the laboratory 4 to 8 weeks before the race to undergo physiological testing including an incremental treadmill test and strength assessments. Correlations and regression analyses were used to determine the physiological variables related to performance. RESULTS: Average finishing time was 37:33 (5:52) hours. Performance correlated significantly with VO2max (r = -.724, P < .001), velocity at VO2max (r = -.813, P < .001), lactate turn point expressed as percentage of VO2max (r = -.510, P = .018), cost of running (r = -.560, P = .008), and body fat percentage (r = .527, P = .012) but was not related to isometric strength. Regression analysis showed that velocity at VO2max predicted 65% of the variability in performance (P < .001), while a model combining VO2max and cost of running combined predicted 62% of the variability (P = .008). CONCLUSION: This is the first study to show that VO2max and velocity at VO2max are significant predictors of performance in a 166-km trail-running race. This suggests that ultratrail runners should focus on the development of these 2 qualities to optimize their race performance.

Increasing Shoe Longitudinal Bending Stiffness Is Not Beneficial to Reduce Energy Cost During Graded Running.

PURPOSE: Carbon plates have been used to increase running shoes' longitudinal bending stiffness (LBS), leading to reductions in the energy cost of level running (Cr). However, whether or not this is true during uphill (UH) running remains unknown. The aim of our study was to identify the effect of LBS on Cr during UH running. METHODS: Twenty well-trained male runners participated in this study. Cr was determined using gas exchange during nine 4-minute bouts performed using 3 different LBS shoe conditions at 2.22 and 4.44 m/s on level and 2.22 m/s UH (gradient: + 15%) running. All variables were compared using 2-way analyses of variance (LBS × speed/grade effects). RESULTS: There was no significant effect of LBS (F = 2.04; P = .14, ηp2=.11) and no significant LBS × grade interaction (F = 0.31; P = .87, ηp2=.02). Results were characterized by a very large interindividual variability in response to LBS changes. CONCLUSIONS: The current study contributes to a growing body of literature reporting no effect of LBS on Cr during level and UH running. Yet, the very large interindividual differences in response to changes in LBS suggest that increasing shoe LBS may be beneficial for some runners.

Elite Road vs. Trail Runners: Comparing Economy, Biomechanics, Strength, and Power.

ABSTRACT: Sabater Pastor, FS, Besson, T, Berthet, M, Varesco, G, Kennouche, D, Dandrieux, P-E, Rossi, J, and Millet, GY. Elite road vs. trail runners: comparing economy, biomechanics, strength, and power. J Strength Cond Res 37(1): 181-186, 2023-The purpose of this study was to determine the differences between road (ROAD) vs. trail (TRAIL) elite runners in terms of force-velocity profile (FVP), running biomechanics, lower-limb maximal isometric strength, cost of running (Cr), and training. Seventeen male elite athletes (10 TRAIL and 7 ROAD) participated in this study. Force-velocity profile was measured using a 2-sprint test on a cycle ergometer. Strength was assessed with a dynamometer measuring isometric maximum voluntary torque of the knee extensors and knee flexors. Biomechanics parameters (running kinematics and stiffness) were measured, and Cr was calculated at 10 and 14 km·h-1 at 0% slope and at 10 km·h-1 on a 10% slope on a treadmill. Athletes also reported their training duration during the previous year. Theoretical maximal torque (F0) and maximal power (Pmax) in the FVP were higher for TRAIL vs. ROAD (122 ± 13 vs. 99 ± 7 N·m, p = 0.001; and 726 ± 89 vs. 626 ± 44 W; p = 0.016). Cost of running was higher for TRAIL compared with ROAD on flat at 14 km·h-1 (4.32 ± 0.22 vs. 4.06 ± 0.29 J·kg-1·m-1; p = 0.047) but similar at 10 km·h-1 and uphill. No differences were found in maximal isometric strength or running biomechanics. ROAD spent 81% more time training than TRAIL (p = 0.0003). The specific training (i.e., "natural" resistance training) performed during graded running in trail runners and training on level surface at high speed may explain our results. Alternatively, it is possible that trail running selects stronger athletes because of the greater strength requirements of graded running.

Changes in Cost of Locomotion Are Higher after Endurance Cycling Than Running When Matched for Intensity and Duration.

INTRODUCTION: Cost of locomotion (C L ) has been shown to increase after endurance running and cycling bouts. The main purpose of this study was to compare, in the same participants, the effect of both modalities on C L when matched for relative intensity and duration. METHODS: Seventeen recreational athletes performed two incremental tests in running and cycling to determine the first ventilatory threshold then two 3-h bouts of exercise at 105% of threshold, with gas exchange measurements taken for 10 min at the start, middle and end of the 3 h to calculate C L . Neuromuscular fatigue during isometric knee extensor contractions and force-velocity profile on a cycle ergometer were assessed before and immediately after the 3-h trials. RESULTS: C L significantly increased at mid (+3.7%, P = 0.006) and end (+7.4%, P < 0.001) of exercise for cycling compared with start, whereas it did not change with time for running. Cardio-respiratory and metabolic variables changed similarly for cycling and running, therefore not explaining the time-course differences in C L between modalities. Changes in C L during cycling correlated significantly with loss of maximal force extrapolated from the force-velocity profile ( r = 0.637, P = 0.006) and changes in cadence ( r = 0.784, P < 0.001). CONCLUSIONS: The type of locomotion influences the effects of exercise on energy cost because 3 h of exercise at the same relative intensity caused a significant increase of cycling C L , and no changes in running C L . The changes in C L in cycling are likely due, at least in part, to fatigue in the locomotor muscles.

Does neuromuscular fatigue generated by trail running modify foot-ground impact and soft tissue vibrations?

The purpose of the study was to assess the influence of a preceding mountain ultramarathon on the impact between the foot and the ground and the resulting soft tissue vibrations (STV). Two sessions of measurements were performed on 52 trail runners, before and just after mountain trail running races of various distances (from 40 to 171 km). Triaxial accelerometers were used to quantify the foot-ground impact (FGI) and STV of both gastrocnemius medialis (GAS) and vastus lateralis (VL) muscles during level treadmill running at 10 km·h-1. A continuous wavelet transform was used to analyze the acceleration signals in the time-frequency domain, and the maps of coefficients as well as the frequency and damping properties of STV were computed. Fatigue was assessed from isometric maximal voluntary contraction force loss of knee extensors (KE) and plantar flexors (PF) after each race. Statistical nonParametric Mapping and linear mixed models were used to compare the means between the data obtained before and after the races. FGI amplitude and GAS STV were not modified after the race, while VL STV amplitude, frequency and damping significantly decreased whatever the running distance. A significant force loss was observed for the PF (26 ± 14%) and KE (27 ± 16%), but this was not correlated to the changes observed in STV. These results might reveal a protection mechanism of the muscles, indicating that biomechanical and/or physiological adaptations may occur in mountain ultramarathons to limit STV and muscle damage of knee extensors.Trial registration: ClinicalTrials.gov identifier: NCT04025138..

Trail running races with distances from 40 to 171 km induced the same alterations of soft-tissue vibrations. Due to the hilly characteristics of trail running, only the vastus lateralis soft-tissue vibrations were affected by the races.Vastus lateralis vibration amplitude, frequency and damping coefficient were reduced after trail running races. These modifications can arise from a protection mechanism and/or modification in the muscle properties.Neuromuscular fatigue quantified with loss of maximal isometric force production is not predictive of soft-tissue vibration modifications.

The repeated bout effect influences lower-extremity biomechanics during a 30-min downhill run.

The repeated bout effect in eccentric-biased exercises is a well-known phenomenon, wherein a second bout of exercise results in attenuated strength loss and soreness compared to the first bout. We sought to determine if the repeated bout effect influences changes in lower-extremity biomechanics over the course of a 30-min downhill run. Eleven male participants completed two bouts of 30-min downhill running (DR1 and DR2) at 2.8 m.s-1 and -11.3° on an instrumented treadmill. Three-dimensional kinematics and ground reaction forces were recorded and used to quantify changes in spatiotemporal parameters, external work, leg stiffness, and lower extremity joint-quasi-stiffness throughout the 30-min run. Maximum voluntary isometric contraction (MVIC) and perceived quadriceps pain were assessed before-after, and throughout the run, respectively. DR2 resulted in attenuated loss of MVIC (P = 0.004), and perceived quadriceps pain (P < 0.001) compared to DR1. In general, participants ran with an increased duty factor towards the end of each running bout; however, increases in duty factor during DR2 (+5.4%) were less than during DR1 (+8.8%, P < 0.035). Significant reductions in leg stiffness (-11.7%, P = 0.002) and joint quasi-stiffness (up to -25.4%, all P < 0.001) were observed during DR1 but not during DR2. Furthermore, DR2 was associated with less energy absorption and energy generation than DR1 (P < 0.004). To summarize, the repeated bout effect significantly influenced lower-extremity biomechanics over the course of a downhill run. Although the mechanism(s) underlying these observations remain(s) speculative, strength loss and/or perceived muscle pain are likely to play a key role.HighlightsA 30-min downhill running bout increased contact time and reduced flight time transitioning to an increased duty factor.Lower-extremity stiffness also decreased and mechanical energy absorption increased over the course of the first 30-min downhill running bout.When the same bout of 30-min downhill running was performed three weeks later, the observed changes to lower extremity biomechanics were significantly attenuated.The findings from this study demonstrated, for this first time, a repeated bout effect for lower extremity biomechanics associated with downhill running.