Impact of menstrual cycle or combined oral contraception on elite female cyclists' training responses through a clustering analysis of training sessions.

Objectives: (i) To classify training sessions of elite female cyclists according to an intensity index based on a longitudinal follow-up using multiparametric data collected in situ (ii) to measure the effect of estimated menstrual cycle (MC) phases and oral contraceptive pills (OC) phases on the athletes' training responses on each type of training identified. Method: Thirteen elite French cyclists were followed up over 30 months and 5,190 training sessions were collected and 81 MC/OCs full cycles analyzed. Power sensors and position devices captured training data in situ, which was summarized into 14 external load variables. Principal Component Analysis and K-means clustering were used to identify cycling sessions according to an intensity load index. The clusters were then verified and categorized through the analysis of heart rate and rate of perceived effort. A calendar method was used to estimate 3 phases of the MC: menstruation, mid-cycle phase (MP) and late-cycle phase (LP). Two phases were defined among monophasic OC users: pills' taking/withdrawal. Results: Four main types of training effort were identified: Intensive, Long, Medium and Light. In the MC group (n = 7; 52 cycles), the intensity index is 8% higher during the mid-cycle (vs. menstrual phase, p = 0.032) in the Intensive effort sessions. No differences were observed in Long, Medium or Light effort, nor between the phases of pills' taking/withdrawal among OC users. Conclusion: The clustering analyses developed allows a training classification and a robust method to investigate the influence of the MC/OC in situ. A better training response during the mid-cycle when the sessions are the most intense suggest an impact of the MC when the athletes approach their maximal capacity.

Individual In-Situ GPS-Derived Acceleration-Speed Profiling: Toward Automatization and Refinement in Male Professional Rugby Union Players.

BACKGROUND: Recently a proof-of-concept was proposed to derive the soccer players' individual in-situ acceleration-speed (AS) profile from global positioning system (GPS) data collected over several sessions and games. The present study aimed to propose an automatized method of individual GPS-derived in-situ AS profiling in a professional rugby union setting. METHOD: AS profiles of forty-nine male professional rugby union players representing 61.5 million positions, from which acceleration was derived from speed during 51 training sessions and 11 official games, were analyzed. A density-based clustering algorithm was applied to identify outlier points. Multiple AS linear relationships were modeled for each player and session, generating numerous theoretical maximal acceleration (A0), theoretical maximal running speed (S0) and AS slope (ASslope, i.e., overall orientation of the AS profile). Each average provides information on the most relevant value while the standard deviation denotes the method accuracy. In order to assess the reliability of the AS profile within the data collection period, data were compared over two 2-week phases by the inter-class correlation coefficient. A0 and S0 between positions and type of sessions (trainings and games) were compared using ANOVA and post hoc tests when the significant threshold had been reached. RESULTS: All AS individual profiles show linear trends with high coefficient of determination (r2 > 0.81). Good reliability (Inter-class Correlation Coefficient ranging from 0.92 to 0.72) was observed between AS profiles, when determined 2 weeks apart for each player. AS profiles depend on players' positions, types of training and games. Training and games data highlight that highest A0 are obtained during games, while greatest S0 are attained during speed sessions. CONCLUSIONS: This study provides individual in-situ GPS-derived AS profiles with automatization capability. The method calculates an error of measurement for A0 and S0, of paramount importance in order to improve their daily use. The AS profile differences between training, games and playing positions open several perspectives for performance testing, training monitoring, injury prevention and return-to-sport sequences in professional rugby union, with possible transferability to other sprint-based sports. KEY POINTS: AS profiles computed from rugby union GPS data provide positional benchmarks during training and competition. This study provides automatic detection of atypical data and the computation of error measurement of theoretical maximal acceleration and speed components. This refinement constitutes a step forward for a daily use of ecological data by considering data collection and method reliabilities. This easy-to-implement approach may facilitate its use to the performance management process (talent identification, training monitoring and individualization, return-to-sport).

On-Field Methodological Approach to Monitor the Menstrual Cycle and Hormonal Phases in Elite Female Athletes.

OBJECTIVES: Currently, there are no guidelines for implementing the monitoring of menstrual status, including the natural menstrual cycle (NC) or oral contraception (OC), in a sport setting. We aimed to provide a feasible, on-field methodological approach for monitoring NC and OC in female athletes. METHODS: We developed a smartphone app with daily questionnaires to monitor both NC and OC phases in 19 elite female soccer players (23.7 [4.4] y) over 7 months. Adherence and compliance were evaluated. The NC and OC phases were based on calendar data to establish an individual menstrual profile for each athlete. RESULTS: The initial questionnaire revealed that the vast majority of female players (80%) were interested in monitoring their menstrual status. The online monitoring yielded high athlete adherence (87.0% [14.2%]) with a slight decrease over the winter break and at the end of the championship, which necessitated adaptations to promote compliance. Monitoring identified the specific menstrual pattern of each athlete and highlighted large interindividual variability. CONCLUSION: This study assesses, for the first time, the interest of female players in monitoring their menstrual status. It provides a new methodological approach, as well as guidelines for optimizing on-field monitoring. It also anticipates some obstacles sport staff may encounter when trying to implement such follow-up. It is essential to better understand the menstrual profile of athletes and determine its potential impacts on well-being and performance.

Medical withdrawals in elite tennis in reference to playing standards, court surfaces and genders.

OBJECTIVES: To examine the relationships between medical withdrawals, playing standards, court surfaces and genders in tennis players participating in all elite tours. DESIGN: Descriptive epidemiology study. METHODS: Medical withdrawals of men and women tennis players from Association of Tennis Professionals, Women Tennis Association, Challengers and International Tennis Federation Futures tours' matches have been identified considering the court surfaces (fast vs. slow). Proportion comparison and the binomial regression model were used to determine the influence of playing standards, court surfaces and genders on tennis players' likelihoods to withdraw. RESULTS: A higher proportion of withdrawals was found for men in Challengers and Futures vs. Association of Tennis Professionals (4.8 %, 5.9 % vs 3.4 %; p < 0.001), but without difference between court surfaces (0.1 %, p > 0.05) whatever the playing standards. Women reported higher proportion of medical withdrawals sustained on slow surfaces (0.4 %, p < 0.001), but without different withdrawal rates between playing standards (3.9 %, p > 0.05). After adjustment, the odds of medical withdrawals were higher for Challengers (1.18, p < 0.001) and Futures (1.34, p < 0.001), with a higher likelihood to withdraw (1.04, p < 0.001) when playing on slow surfaces and with a gender-dependent effect indicating higher odds (1.29, p < 0.001) to withdraw for medical reasons in men in reference to women. CONCLUSIONS: These findings demonstrated a gender-dependent effect on medical withdrawals from an elite tennis tournament with higher likelihood for men participating in Challengers/Futures tours and for women playing on slow surfaces.

Impact of COVID-19 Vaccination on Short-Term Perceived Change in Physical Performance among Elite Athletes: An International Survey.

COVID-19 vaccination raised concerns about its potential effects on physical performance. To assess the impact of COVID-19 vaccination on the perceived change in physical performance, we conducted an online survey among elite athletes from Belgium, Canada, France and Luxembourg, with questions about socio-demographics, COVID-19 vaccination, perceived impact on physical performance and perceived pressure to get vaccinated. Full vaccination was defined as two doses of mRNA or vector vaccine or a heterologous vaccine scheme. Among 1106 eligible athletes contacted, 306 athletes answered the survey and were included in this study. Of these, 72% perceived no change in their physical performance, 4% an improvement and 24% a negative impact following full COVID-19 vaccination. For 82% of the included athletes, the duration of the negative vaccine reactions was ≤3 days. After adjustment for potential confounding variables, practicing an individual sport, a duration of vaccine reactions longer than 3 days, a high level of vaccine reaction and the perceived pressure to get vaccinated were independently associated with a perceived negative impact on physical performance of more than 3 days after the vaccination. The perceived pressure to get vaccinated appears to be a parameter associated with the negative perceived change in the physical performance and deserves further consideration.

Corrective adjustment methods for relative age effects on French young swimmers' performances.

BACKGROUND: This study aimed to identify a Relative Age Effect (RAE) among French young swimmers and apply corrective adjustment procedures to rebalance performances according to categories and events. METHODS: 5,339,351 performances of French swimmers aged 10 to 18 were collected between 2000 and 2019. Birth quarters distribution was examined according to competitiveness level ('All', 'Top50%', 'Top25%' and 'Top10%'), event and age category. A linear relationship between the distribution of performances and calendar days provides a calibration coefficient allowing to rebalance performances by considering the effect of RAE for each event. Then, adjusted performances are recalculated using this coefficient, the initial performance and the relative age. RESULTS: Proportion of swimmers born in the first quarter was higher than the proportion of those born in the last quarter for all events and strokes (p < 0.01). RAE increases with the competitiveness level for all events. Indeed, among 'All' 12 years old 50m freestyle swimmers, the proportion born in the first quarter is 30.9% vs 19.2% in the fourth quarter, while among the "Top10%", 47.5% were born in the first quarter vs 10.3% in the last one. (p-value < 0.01). In average, each day represents a gap of 0.008 second, resulting in a difference of almost 3 seconds over a year. This tool is validated by comparing swimmers who have performed at least twice in a season. It provides a day by day rebalancing method for all swimming events and age categories. CONCLUSIONS: Relative age effect is present among French young male and female swimmers, and is strengthened by competitiveness level. A new corrective adjustment procedure to rebalance performances considering categories and events is proposed and validated. By applying such a tool, we are able to reveal the full potential of swimmers and make it possible to compare them at the same relative age.

Menstrual cycle and hormonal contraceptive phases' effect on elite rowers' training, performance and wellness.

Objectives: To investigate the effect of menstrual cycle (MC) and hormonal contraception (HC) phases in elite rowers training, performance and wellness monitoring. Methods: Twelve French elite rowers were follow-up for 4,2 cycles on average in their final preparation for the Olympics and Paralympics Games in Tokyo 2021 through an on-site longitudinal study based on repeated measures. Daily self-reported evaluation using Likert rating scales of wellness (sleep quality, fitness, mood, injuries' pain), menstrual symptoms and training parameters (perceived exertion and self-assessment of performance) were collected (n = 1,281) in parallel to a coach evaluation of rowers' performance (n = 136), blinded to theirs MC and HC phases. Salivary samples of estradiol and progesterone were collected in each cycle to help to classify the MC into 6 phases and HC into 2-3 phases depending on the pills' hormone concentration. A chi-square test normalized by each rower was used to compare the upper quintile scores of each studied variable across phases. A Bayesian ordinal logistic regression was applied to model the rowers' self-reported performance. Results: Rowers with a natural cycle, n = 6 ( + 1 amenorrhea) evaluate their performance and wellness with significant higher score indices at the middle of their cycle. Top assessments are rarer at the premenstrual and menses phases, when they more frequently experience menstrual symptoms which are negatively correlated with their performance. The HC rowers, n = 5, also better evaluate their performance when taking the pills and more frequently experience menstrual symptoms during the pill withdrawal. The athletes self-reported performance is correlated with their coach's evaluation. Conclusion: It seems important to integrate MC and HC data in the wellness and training monitoring of female athletes since these parameters vary across hormonal phases affecting training perception of both athlete and coach.

Training load and intensity distribution for sprinting among world-class track cyclists.

BACKGROUND: Only few studies analyzed real training programs of sprinters while that should be a valuable step in the understanding of sprint training. The present study aimed at characterizing track cycling sprinter training by training load and intensity distribution. METHODS: Twenty-nine weeks of prechampionship training data were retrospectively analyzed for 6 world-class athletes. Training load was measured by the ratio of volume completed to maximal volume and categorized by five intensity zones (endurance: zones1-2; sprinting: zones3-5) and exercise type (on-bike or resistance). Intra-week (training monotony) and inter-week (acute-chronic workload ratio) variation was also studied. RESULTS: On-bike training represented 77.4±15.3% of total training load; resistance training, 22.6±15.2% (note high standard deviation). Total weekly training load significantly varied (P=0.0002) with high acute-chronic workload ratio (12.0±3.2 weeks >1.5 or <0.8), but low intra-week variations (training monotony, 1.81±0.20). Zone4 and zone5 made up 74.4±16.9% of total training load; zone1, 15.8±11%. Training load was seldom in zone2 (6.4±5.3%) or zone3 (3.3±4.2%). From the first to the second half of the period, zone3-4 training load decreased (39.3±3.3 to 27.4±1.7%; P=0.01), while zone5 increased (34.9±2.4 to 50±3.7%; P=0.002). CONCLUSIONS: In this reduced group of elite athletes, training appeared to mainly consist of on-bike exercises within the highest intensity zones. As demonstrated by monotony and acute-chronic workload ratio overloading and unloading are based on high variations over weeks, not days. Essentially, this study describes a polarized intensity distribution on the highest intensities which increased with world championships approach.

Does maternity during sports career jeopardize future athletic success in elite marathon runners?

The impact of maternity (Mat) on subsequent athletic performance is not well known. This study aims to investigate the impact of maternity among elite marathoners on their overall performance progression. For each runner listed in the top 150 female marathoners, who had experienced a mid-career maternity, performance development was reconstituted throughout the career. Maternity data and career break time span (Ttotal) were collected from publicly available informations. Performances were modelled according to the known age-performance relationship and the impact of maternity was added into the model. Linear mixed effect model was used to study the influence of maternity on the overall career. Among this sample, 37 runners had at least 1 child during her career. Among them, 14 had 2 children. Eleven runners (29.72%) made their personal best performance before Mat, which occurred at an average age of 28.40 ± 4.00 years. Twenty-six runners (70.28%) establish their best performances after Mat, at an average age of 32.20 ± 4.28. The age-performance relationship model explains 92% of the performance variability during the career's progression. When age is considered, maternity does not have significant impact on performance development. World's most competitive marathoners can still perform at their best level after pregnancy. The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance during career development.HighlightsMid-career maternity does not have a significant impact on overall progression in high level runners, who return to official races.The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance.Age is the variable that explains most of performance progression, independently of mid-career maternity occurrence(s).

ChAd155-RSV vaccine is immunogenic and efficacious against bovine RSV infection-induced disease in young calves.

Respiratory syncytial virus (RSV) infection causes a substantial lower-respiratory-tract disease burden in infants, constituting a global priority for vaccine development. We evaluated immunogenicity, safety and efficacy of a chimpanzee adenovirus (ChAd)-based vaccine candidate, ChAd155-RSV, in a bovine RSV (bRSV) challenge model. This model closely reproduces the pathogenesis/clinical manifestations of severe pediatric RSV disease. In seronegative calves, ChAd155-RSV elicits robust neutralizing antibody responses against human RSV. Two doses protect calves from clinical symptoms/lung pathological changes, and reduce nasal/lung virus loads after both a short (4-week) and a long (16-week) interval between last immunization and subsequent bRSV challenge. The one-dose regimen confers near-complete or significant protection after short-term or long-term intervals before challenge, respectively. The presence of pre-existing bRSV-antibodies does not affect short-term efficacy of the two-dose regimen. Immunized calves present no clinical signs of enhanced respiratory disease. Collectively, this supports the development of ChAd155-RSV as an RSV vaccine candidate for infants.

Dealing with menstrual cycle in sport: stop finding excuses to exclude women from research.

The current literature is mostly male-based, limiting evidence-based recommendations for training individualization for female athletes. Recently, studies have relied on recent findings showing a potential effect of the menstrual cycle to exclude female athletes from their samples. We highlight that the arguments usually put forward to this action are not acceptable. Our discussion aims to elucidate that female physiological parameter can be confounding variables in the same way than other parameters (temperature, nutrition, fatigue, etc.). Those are usually well handled in most studies. This is important to bridge the current sex data gap and promote research on female athletes. Specially, as we approach the next Olympic Games, were, for the first time, there will be full gender parity in terms of athlete numbers at the Olympic Games Paris 2024.

Echocardiographic Assessment of Left Ventricular Function 10 Years after the Ultra-Endurance Running Event Eco-Trail de Paris® 2011.

Background: Regular and moderate physical activity is beneficial for physical and mental health, resulting in an increase in life expectancy for both sexes. From a cardiovascular point of view, although the benefits of regular moderate physical exercise have been established, the long-term effects of repeated ultra-endurance running events are still unknown. Hypothesis: The aim of our study is to evaluate the 10-year evolution of the parameters of the left ventricular systolic and diastolic functions of amateur subjects regularly practising ultra-endurance running events using resting echocardiography. Study design: Cross-sectional study. Level of evidence: Level 3-non-randomized controlled cohort/follow-up study. Methods: The 66 participants who participated in the 2011 edition of the Eco-Trail de Paris® were contacted by e-mail. Demographic data, sports practice, and the results of an echocardiography scan carried out during the year 2021 evaluating left ventricular systolic and diastolic function variables were collected. Echographic variables from 2011 and 2021 were compared using the paired Student's t-test. Results: Forty-six (70%) participants responded positively. Twenty (30%) participants could not be reached and were not analysed. Of the 46 respondents, 42 (91%) provided data from a trans-thoracic cardiac ultrasound performed in 2021. Over the past 10 years, the participants reported having completed an average of 4 ± 2 ultra-trails per year. No significant differences were observed between left ventricular diastolic and systolic echocardiographic parameters between the years 2011 and 2021. Conclusions: Among amateur participants, long-distance running is not associated with an alteration in the echocardiographic parameters of resting left ventricular systolic and diastolic function after 10 years of practice. Clinical relevance: Long-term long-distance running practice is not associated with left ventricular cardiac function alteration. These results suggest a potential adaptation role of the cardiovascular system to regular and moderate long-distance running practice.

Relationship between Exercise Intensity and IL-6 Increase during an 80 km Long-Distance Running Race.

Background: IL-6 plasma concentration (IL-6PC) reflects the systemic inflammation related to exercise intensity level. This study aims to describe the IL-6PC kinetics during a long-distance running race. IL-6PC was measured in 20 male runners before (0 km), at each refreshment point (at 21 and 53 km, i.e., k21 and k53, respectively) and at the end of an 80 km long-distance run (k80). Methods: IL-6PC variations (absolute and relative values in each of the three sections (S)) were calculated over S1 (0_k21), S2 (k21_k53) and S3 (k53_k80) and compared with the exercise intensity (duration*race speed) within each section. Results: The mean IL-6PC increased during the run: 2.1 ± 0.6 ng.L-1 at 0 km, 21.0 ± 11.3 ng.L-1 at k21, 38.9 ± 13.0 ng.L-1 at k53 and 49.8 ± 11.9 ng.L-1 at k80. Exercise intensity increased between S1 (24.2 ± 0.5) and S2 (51.9 ± 3.2) (p = 0.04) but not between S2 and S3 (67.4 ± 4.5) (p = 0.69). IL-6PC variation was associated with exercise intensity within S1 (p = 0.03) and S2 (p = 2 × 10-3) and showed at least a trend within S3 (p = 0.06). Conclusions: IL-6PC increases that occur during the early stages of a long-distance run are associated with the running intensity, and then IL-6PC remain stable after the reduction in intensity related to the decrease in running speed.

Postlockdown Performance in French Swimming Championships.

PURPOSE: To measure the proportion of French swimmers that progressed, stagnated, or regressed during the 2020 national championship compared with previous ones. METHOD: Individual best performances were collected at the French national championships from 2000 to 2020. Yearly proportions of swimmers who improved, stagnated, or regressed in performances were compared with their previous performances. RESULTS: In 2020, the proportion of swimmers with performance regression has significantly increased (33% vs 17% in 2019). Women showed a higher proportion of performance regression (41%) than men (26%, P < .0001) in 2020. Only 39% of women and 53% of men experienced progression in 2020 (vs 60.8% [3.7%] and 66.7% [5.2%], respectively, in the previous years). Only the 2008 and 2009 championships showed a regression proportion that did not increase with age. The 2010 championship (the year of swimsuits ban) showed a higher proportion of regressing athletes than these previous years. Long-distance events showed higher proportion of performance regression (36.2% [0.5%]) for 400-, 800-, and 1500-m races than for short-distance ones (32.1% [3.2%]; 50-, 100-, and 200-m events). Breaststroke events showed higher regression (42.4%) than other styles (30.5% [2.1%]). Younger swimmers more often improved their performance than older ones (61.9% [8.5%] for swimmers less than 18 y of age vs 20.0% [10.8%] for those 25 y and older). CONCLUSION: A high proportion of swimmers experienced performance regression during the 2020 French national championships. A higher impact was observed among female, long-distance, and breaststroke swimmers. Eight weeks of lockdown without training may have led to poorer swimming performances.

Exercise Dose Equalization in High-Intensity Interval Training: A Scoping Review.

Based on comparisons to moderate continuous exercise (MICT), high-intensity interval training (HIIT) is becoming a worldwide trend in physical exercise. This raises methodological questions related to equalization of exercise dose when comparing protocols. The present scoping review aims to identify in the literature the evidence for protocol equalization and the soundness of methods used for it. PubMed and Scopus databases were searched for original investigations comparing the effects of HIIT to MICT. A total of 2041 articles were identified, and 169 were included. Of these, 98 articles equalized protocols by utilizing energy-based methods or exercise volume (58 and 31 articles, respectively). No clear consensus for protocol equalization appears to have evolved over recent years. Prominent equalization methods consider the exercise dose (i.e., energy expenditure/production or total volume) in absolute values without considering the nonlinear nature of its relationship with duration. Exercises resulting from these methods induced maximal exertion in HIIT but low exertion in MICT. A key question is, therefore, whether exercise doses are best considered in absolute terms or relative to individual exercise maximums. If protocol equalization is accepted as an essential methodological prerequisite, it is hypothesized that comparison of program effects would be more accurate if exercise was quantified relative to intensity-related maximums.

Digital phenotyping in young breast cancer patients treated with neoadjuvant chemotherapy (the NeoFit Trial): protocol for a national, multicenter single-arm trial.

BACKGROUND: Breast cancer (BC) has particular characteristics in young women, with diagnosis at more advanced stages, a poorer prognosis and highly aggressive tumors. In NeoFit, we will use an activity tracker to identify and describe various digital profiles (heart rate, physical activity, and sleep patterns) in women below the age of 45 years on neoadjuvant chemotherapy for BC. METHODS: NeoFit is a prospective, national, multicenter, single-arm open-label study. It will include 300 women below the age of 45 years treated with neoadjuvant chemotherapy for BC. Participants will be asked to wear a Withing Steel HR activity tracker round the clock for 12 months. The principal assessments will be performed at baseline, at the end of neoadjuvant chemotherapy and at 12 months. We will evaluate clinical parameters, such as toxicity and the efficacy of chemotherapy, together with quality of life, fatigue, and parameters relating to lifestyle and physical activity. The women will complete REDCap form questionnaires via a secure internet link. DISCUSSION: In this study, the use of an activity tracker will enable us to visualize changes in the lifestyle of young women on neoadjuvant chemotherapy for BC, over the course of a one-year period. This exploratory study will provide crucial insight into the digital phenotypes of young BC patients on neoadjuvant chemotherapy and the relationship between these phenotypes and the toxicity and efficacy of treatment. This trial will pave the way for interventional studies involving sleep and physical activity interventions. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT05011721 . Registration date: 18/08/2021.