A Cardiopulmonary Exercise Testing for Prescribing High-Intensity Interval Training Sessions with Elastic Resistance.

This study aims to analyze the agreement of cardiopulmonary variables between a cardiopulmonary exercise test with elastic resistance (CPxEL) and high-intensity interval exercise with elastic resistance (EL-HIIE). METHODS: Twenty-two physically independent participants were recruited. Visit one consisted of conducting a health survey and anthropometric assessment. On visit two, the participants performed CPxEL. After seven days, on visit three, the participants performed EL-HIIE. The CPxEL was carried out on a rubber mat demarcated by lines representing eight stages. The test consisted of alternating back and forth steps against elastic resistance. The increments were performed at a rate of one stage per minute, following a cadence controlled by a metronome calibrated by beats per minute (bpm). The EL-HIIE was performed at the stage corresponding to an intensity of ~85% VO2max, as determined by CPxEL. The EL-HIIE consisted of 10 × 1 min (work):1 min (passive rest), with a cadence of 200 bpm. Cardiopulmonary parameters, heart rate (HR), and oxygen consumption (VO2) were measured during exercise. Bland-Altman was applied to analyze the agreement between the HR and VO2 found in EL-HIIE and the values prescribed by CPxEL (~85-90% VO2max). RESULTS: The HRpeak and VO2peak in the EL-HIIE showed good agreement with the VO2CPxEL and HRCPxEL values, showing an average difference of (-1.7 mL·kg-1·min-1) and (0.3 bpm). CONCLUSIONS: The results of the present study demonstrate the agreement of cardiopulmonary variables between the CPxEL and the EL-HIIE. Therefore, for a more specific prescription of EL-HIIE intensity, CPxEL can be used.

SARS-CoV-2 promotes microglial synapse elimination in human brain organoids.

Neuropsychiatric manifestations are common in both the acute and post-acute phase of SARS-CoV-2 infection, but the mechanisms of these effects are unknown. In a newly established brain organoid model with innately developing microglia, we demonstrate that SARS-CoV-2 infection initiate neuronal cell death and cause a loss of post-synaptic termini. Despite limited neurotropism and a decelerating viral replication, we observe a threefold increase in microglial engulfment of postsynaptic termini after SARS-CoV-2 exposure. We define the microglial responses to SARS-CoV-2 infection by single cell transcriptomic profiling and observe an upregulation of interferon-responsive genes as well as genes promoting migration and synapse engulfment. To a large extent, SARS-CoV-2 exposed microglia adopt a transcriptomic profile overlapping with neurodegenerative disorders that display an early synapse loss as well as an increased incident risk after a SARS-CoV-2 infection. Our results reveal that brain organoids infected with SARS-CoV-2 display disruption in circuit integrity via microglia-mediated synapse elimination and identifies a potential novel mechanism contributing to cognitive impairments in patients recovering from COVID-19.

Time Course of Recovery Following CrossFit® Karen Benchmark Workout in Trained Men.

The establishment of fatigue following the acute exercise stimulus is a complex and multi-factorial process, that might arise due to a range of distinct physiological mechanisms. However, a practical method of assessing CrossFit® athletes' recovery status has been neglected entirely in real-world sporting practice. The study describes the acute and delayed time course of recovery following the CrossFit® Benchmark Workout Karen. Eight trained men (28.4 ± 6.4 years; 1RM back squat 139.1 ± 26.0 kg) undertook the Karen protocol. The protocol consists of 150 Wall Balls (9 kg), aiming to hit a target 3 m high. Countermovement jump height (CMJ), creatine kinase (CK), and perceived recovery status scale (PRS) (general, lower and upper limbs) were assessed pre, post-0h, 24, 48 and 72 h after the session. The creatine kinase concentration 24 h after was higher than pre-exercise (338.4 U/L vs. 143.3 U/L; p = 0.040). At 48h and 72 h following exercise, CK concentration had returned to baseline levels (p > 0.05). The general, lower and upper limbs PRS scores were lower in the 24-h post-exercise compared to pre-exercise (general PRS: 4.7 ± 1.5 and 7.7 ± 1.7; p = 0.013; upper limbs PRS: 6.6 ± 1.3 and 7.5 ± 1.3; p = 0.037; lower limbs PRS: 3.9 ± 2.5 and 7.3 ± 0.1; p = 0.046). Our findings provide insights into the fatigue profile and recovery in acute CrossFit® and can be useful to coaches and practitioners when planning training programs. Moreover, recovery status can be useful to optimize training monitoring and to minimize the potential detrimental effects associated with the performance of repeated high-intensity sessions of CrossFit®.

Detection and isolation of airborne SARS-CoV-2 in a hospital setting.

Transmission mechanisms for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are incompletely understood. In particular, aerosol transmission remains unclear, with viral detection in air and demonstration of its infection potential being actively investigated. To this end, we employed a novel electrostatic collector to sample air from rooms occupied by COVID-19 patients in a major Swedish hospital. Electrostatic air sampling in conjunction with extraction-free, reverse-transcriptase polymerase chain reaction (hid-RT-PCR) enabled detection of SARS-CoV-2 in air from patient rooms (9/22; 41%) and adjoining anterooms (10/22; 45%). Detection with hid-RT-PCR was concomitant with viral RNA presence on the surface of exhaust ventilation channels in patients and anterooms more than 2 m from the COVID-19 patient. Importantly, it was possible to detect active SARS-CoV-2 particles from room air, with a total of 496 plaque-forming units (PFUs) being isolated, establishing the presence of infectious, airborne SARS-CoV-2 in rooms occupied by COVID-19 patients. Our results support circulation of SARS-CoV-2 via aerosols and urge the revision of existing infection control frameworks to include airborne transmission.

Time-course effects of functional fitness sessions performed at different intensities on the metabolic, hormonal, and BDNF responses in trained men.

BACKGROUND: To investigate the time-course effects of a self-regulated training session (performed at an rating perceived exertion of 6/10), all-out session, and a control session on the metabolic, hormonal, and brain derived neurotrophic factor (BDNF) responses in Functional-Fitness (FFT) participants. METHODS: In a randomized, crossover fashion, eight healthy males (age 28.1 ± 5.4 years old; body mass 77.2 ± 4.4 kg; VO2max: 52.6 ± 4.6 mL.(kg.min)-1; 2000 m rowing test 7.35 ± 0.18 min; 1RM back squat 135.6 ± 21.9 kg) performed a FFT session under two different conditions: all-out, or with the intensity controlled to elicit an rating perceived exertion (RPE) of 6 in the Borg 10-point scale (RPE6). A control session (no exercise) was also completed. Metabolic (lactate and creatine kinase), hormonal (testosterone and cortisol), and BDNF responses were assessed pre, post-0 h, 1 h, 2 h and 24 h after the sessions. RESULTS: Creatine kinase concentrations were significantly higher (p ≤ 0.05) after 24 h for both training sessions. Total and free testosterone concentrations were lower post-2 h for all-out when compared to the RPE6 session (p ≤ 0.05). Serum cortisol concentration increased post-0 h (p = 0.011) for RPE6 and post-0 h (p = 0.003) and post-1 h (p = 0.030) for all-out session when comparing to baseline concentrations. BDNF was significantly higher (p = 0.002) post-0 h only for the all-out session when compared to baseline. A positive correlation between blood lactate concentrations and BDNF (r = 0.51; p = 0.01) was found for both effort interventions. CONCLUSIONS: A single FFT session when performed in all-out format acutely increases the concentrations of serum BDNF. However, physiological stress markers show that the all-out session requires a longer recovery period when compared to the RPE6 protocol. These findings can be helpful to coaches and practitioners design FFT session.

Incremental and decremental cardiopulmonary exercise testing protocols produce similar maximum oxygen uptake in athletes.

The aim of the study was to evaluate and compare the maximal oxygen uptake ([Formula: see text]O2max) achieved during incremental and decremental protocols in highly trained athletes. Nineteen moderate trained runners and rowers completed, on separate days, (i) an initial incremental [Formula: see text]O2max test (INC) on a treadmill, followed by a verification phase (VER); (ii) a familiarization of a decremental test (DEC); (iii) a tailored DEC; (iv) a test with decremental and incremental phases (DEC-INC); (v) and a repeated incremental test (INCF). During each test [Formula: see text]O2, carbon dioxide production, ventilation, heart and breath rates and ratings of perceived exertion were measured. No differences were observed in [Formula: see text]O2max between INC (61.3 ± 5.2 ml kg-1 min-1) and DEC (61.1 ± 5.1 ml kg-1 min-1; average difference of ~ 11.58 ml min-1; p = 0.831), between INC and DEC-INC (60.9 ± 5.3 ml kg-1 min-1; average difference of ~ 4.8 ml min-1; p = 0.942) or between INC and INCF (60.7 ± 4.4 ml kg-1 min-1; p = 0.394). [Formula: see text]O2max during VER (59.8 ± 5.1 ml kg-1 min-1) was 1.50 ± 2.20 ml kg-1 min-1 lower (~ 2.45%; p = 0.008) compared with values measured during INC. The typical error in the test-to-test changes for evaluating [Formula: see text]O2max over the five tests was 2.4 ml kg-1 min-1 (95% CI 1.4-3.4 ml kg-1 min-1). Decremental tests do not elicit higher [Formula: see text]O2max than incremental tests in trained runners and rowers, suggesting that a plateau in [Formula: see text]O2 during the classic incremental and verification tests represents the maximum ceiling of aerobic power.

Session Rating of Perceived Exertion Is a Superior Method to Monitor Internal Training Loads of Functional Fitness Training Sessions Performed at Different Intensities When Compared to Training Impulse.

Despite its increase in popularity, little is known about how to best quantify internal training loads from functional fitness training (FFT) sessions. The purpose of this study was to assess which method [training impulse (TRIMP) or session rating of perceived exertion (sRPE)] is more accurate to monitor training loads in FFT. Eight trained males (age 28.1 ± 6.0 years) performed an ALL-OUT FFT session and an intensity-controlled session (RPE of six out of 10). Internal load was determined via Edward's TRIMP (eTRIMP), Bannister's TRIMP (bTRIMP), and sRPE. Heart rate was measured continuously during the session, while blood lactate and rate of perceived exertion were measured at baseline, and immediately and 30 min after the sessions. ALL-OUT blood lactate and RPE were significantly higher immediately and 30 min after the session compared to the RPE6 condition. ALL-OUT training load was significantly different between conditions using bTRIMP (61.1 ± 10.6 vs. 55.7 ± 12.4 AU) and sRPE (91.7 ± 30.4 vs. 42.6 ± 14.9 AU), with sRPE being more sensitive to such differences [p = 0.045, effect size (ES) = 0.76 and p = 0.002, ES = 1.82, respectively]. No differences in the training loads of the different sessions were found using eTRIMP (93.1 ± 9.5 vs. 84.9 ± 13.7 AU, p = 0.085). Only sRPE showed a significant correlation with lactate 30 min post session (p = 0.015; p = 0.596, large). sRPE was more accurate than both TRIMP methods to represent the overall training load of the FFT sessions. While the use of sRPE is advised, further research is necessary to establish its ability to reflect changes in fitness, fatigue, and performance during a period of training.

Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-PCR.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is commonly diagnosed by reverse transcription polymerase chain reaction (RT-PCR) to detect viral RNA in patient samples, but RNA extraction constitutes a major bottleneck in current testing. Methodological simplification could increase diagnostic availability and efficiency, benefitting patient care and infection control. Here, we describe methods circumventing RNA extraction in COVID-19 testing by performing RT-PCR directly on heat-inactivated or lysed samples. Our data, including benchmarking using 597 clinical patient samples and a standardised diagnostic system, demonstrate that direct RT-PCR is viable option to extraction-based tests. Using controlled amounts of active SARS-CoV-2, we confirm effectiveness of heat inactivation by plaque assay and evaluate various generic buffers as transport medium for direct RT-PCR. Significant savings in time and cost are achieved through RNA-extraction-free protocols that are directly compatible with established PCR-based testing pipelines. This could aid expansion of COVID-19 testing.

Obese elderly with diabetes experience more pain and reduced quality of life compared to obese elderly with hypertension.

BACKGROUND AND AIM: Growth of elderly population is a worldwide phenomenon that impacts public health. The objective of this study was to compare the pain levels, strength, and quality of life among elderly obese with diabetes or hypertension. MATERIALS AND METHODS: The study cohort comprised 52 obese elderly subjects with hypertension (n = 35) and diabetes (n = 17). The parameters measured were anthropometric features, handgrip strength, visual analog scale for pain, and quality of life using the World Health Organization questionnaire. RESULTS: The level of pain reported by obese hypertensive elderly subjects (5.3 ± 3.4) was lower than reported by obese diabetic elderly subjects (7.4 ± 2.4). Obese hypertensive elderly scored higher on quality of life (sensory functioning and past, present, and future [PPF] activities) than obese diabetic elderly. No differences were observed for the other parameters. Strength, pain, anthropometrics, and hemodynamics were not correlated to quality of life. CONCLUSIONS: Obese elderly diabetics exhibit worse pain scores, sensorial abilities, and PPF activities than obese hypertensive elderly individuals. RELEVANCE FOR PATIENTS: The difference in pain and quality of life aspects between obese elderly individuals with hypertension and diabetes should be accounted for in health-care programs designed for these individuals.

Kerker Conditions upon Lossless, Absorption, and Optical Gain Regimes.

The directionality and polarization of light show peculiar properties when the scattering by a dielectric sphere can be described exclusively by electric and magnetic dipolar modes. Particularly, when these modes oscillate in phase with equal amplitude, at the so-called first Kerker condition, the zero optical backscattering condition emerges for nondissipating spheres. However, the role of absorption and optical gain in the first Kerker condition remains unexplored. In this work, we demonstrate that either absorption or optical gain precludes the first Kerker condition and, hence, the absence of backscattered radiation light, regardless of the particle's size, incident wavelength, and incoming polarization. Finally, we derive the necessary prerequisites of the second Kerker condition of the zero forward light scattering, finding that optical gain is a compulsory requirement.

Operative and Technical Modifications to the Coriolis® µ Air Sampler That Improve Sample Recovery and Biosafety During Microbiological Air Sampling.

Detecting infectious aerosols is central for gauging and countering airborne threats. In this regard, the Coriolis® µ cyclonic air sampler is a practical, commercial collector that can be used with various analysis methods to monitor pathogens in air. However, information on how to operate this unit under optimal sampling and biosafety conditions is limited. We investigated Coriolis performance in aerosol dispersal experiments with polystyrene microspheres and Bacillus globigii spores. We report inconsistent sample recovery from the collector cone due to loss of material when sampling continuously for more than 30 min. Introducing a new collector cone every 10 min improved this shortcoming. Moreover, we found that several surfaces on the device become contaminated during sampling. Adapting a high efficiency particulate air-filter system to the Coriolis prevented contamination without altering collection efficiency or tactical deployment. A Coriolis modified with these operative and technical improvements was used to collect aerosols carrying microspheres released inside a Biosafety Level-3 laboratory during simulations of microbiological spills and aerosol dispersals. In summary, we provide operative and technical solutions to the Coriolis that optimize microbiological air sampling and improve biosafety.

A fieldable electrostatic air sampler enabling tuberculosis detection in bioaerosols.

Tuberculosis (TB) infects about 25% of the world population and claims more human lives than any other infectious disease. TB is spread by inhalation of aerosols containing viable Mycobacterium tuberculosis expectorated or exhaled by patients with active pulmonary disease. Air-sampling technology could play an important role in TB control by enabling the detection of airborne M. tuberculosis, but tools that are easy to use and scalable in TB hotspots are lacking. We developed an electrostatic air sampler termed the TB Hotspot DetectOR (THOR) and investigated its performance in laboratory aerosol experiments and in a prison hotspot of TB transmission. We show that THOR collects aerosols carrying microspheres, Bacillus globigii spores and M. bovis BCG, concentrating these microparticles onto a collector piece designed for subsequent detection analysis. The unit was also successfully operated in the complex setting of a prison hotspot, enabling detection of a molecular signature for M. tuberculosis in the cough of inmates. Future deployment of this device may lead to a measurable impact on TB case-finding by screening individuals through the aerosols they generate.

Effects of Pre-exhaustion Versus Traditional Resistance Training on Training Volume, Maximal Strength, and Quadriceps Hypertrophy.

BACKGROUND: The pre-exhaustion (PreEx) method is used as a resistance training (RT) method to increase muscle mass, yet the chronic effects of this method are poorly understood. OBJECTIVE: Although readily prescribed as a RT method for promotion of muscle hypertrophy, few researches give light to gains made after chronic PreEx RT. Therefore, we compared the effects of traditional versus PreEx RT programs on muscle strength, body composition, and muscular hypertrophy in adult males. METHODS: Untrained subjects (age: 31.37 ± 6.83 years; height: 175.29 ± 5.52 cm; body mass: 82.04 ± 13.61 kg; 1RM leg press: 339.86 ± 61.17 kg; 1RM leg extension: 121.71 ± 11.93 kg) were submitted to 9 weeks of RT with weekly sessions. Traditional (TRT) group (n = 12) performed three sets at 45° of leg press exercise at 75% of 1RM, PreEx group (n = 12) completed a set to failure on a leg extension machine prior to the leg press, and the control (CON) group (n = 7) did not train. Maximum strength, muscle thickness, and body composition were analyzed. RESULTS: PreEx group increased in maximal strength on leg press (16 ± 8%) and leg extension (17 ± 11%), while the TRT group improved by 15 ± 9 and 11 ± 4%, respectively. The thickness of the quadriceps muscles increased for both intervention groups. Specifically, the post-training thickness of the vastus lateralis was significantly higher for PreEx (55%) compared to the CON group. The TRT group presented a greater loss of total and thigh fat mass when compared with the PreEx method. These results were found in the presence of a lower training load for the PreEx group. CONCLUSION: The PreEx training can decrease the total training volume while maintaining results in strength and hypertrophy when comparing to TRT. However, TRT may be optimal if the goal is to decrease fat mass.

Time-Course of Changes in Physiological, Psychological, and Performance Markers following a Functional-Fitness Competition.

Functional Fitness Training (FFT) programs are characterized by utilizing a high volume of training and using a variety of high intensity exercises. While FFT are growing in the number of practitioners and popularity, the relationship between physiological biomarkers and subjective scales in the specific context of FFT has not yet been evaluated in the literature. The purpose of the present study was to monitor the time-course response of cytokines (IL-10 and 1L-1ß), immune variables (C-reactive protein -CRP and immunoglobulin A-IgA), hormonal milieu (cortisol-C, total testosterone-TT, free testosterone-FT and testosterone/cortisol-T/C ratio), creatine kinase-CK, muscle performance (countermovement jump height) and perceived well-being (WB) following a functional fitness competition. Nine amateur male athletes (age 27.1 ± 4.1 years; training experience 2.2 ± 1.3 years) completed five workouts over three consecutive days of FFT-competition. All variables were measured before, 24 h, 48 h, and 72 h following the last day of competition. The FFT-competition induced a decrease in IL10/IL1ß ratio approximately 5% after 24h, 21% after 48h and 31% after 72h. Delta T/C ratio remained unchanged during the post-competition period. IgA displayed a significant increase 24h and 72h post FFT-competition. The WB status score was higher 72h after the FFT-competition as compared with pre-competition. The present findings suggest that FFT-competition induces transient changes in some inflammatory and hormonal biomarkers, and perceived well-being seems to be efficient to detect changes in muscle performance.

Is Perceived Exertion a Useful Indicator of the Metabolic and Cardiovascular Responses to a Metabolic Conditioning Session of Functional Fitness?

The purpose of this study was to assess whether the self-regulation of training intensity based on rating of perceived exertion (RPE) is a reliable method to control the intensity during metabolic conditioning sessions of functional fitness. In addition, the relationship between RPE and the changes in heart rate, number of repetitions, and lactate responses was also analyzed. Eight male participants (age 28.1 ± 5.4 years; body mass 77.2 ± 4.4 kg; VO2 max: 52.6 ± 4.6 mL·(kg·min)-1 completed two sessions (five to seven days apart), in a randomized order, under different conditions, as follows: (1) all-out (ALL), or (2) self-regulation of intensity based on an RPE of six (hard) on the Borg CR-10 scale (RPE6). The rating of perceived exertion, lactate (LAC), and heart rate (HR) response were measured before, during, and immediately after the sessions. The RPE and LAC during the all-out sessions were higher (p < 0.0005) than the RPE6 session for all of the analyzed time points during the session. There was no difference in the HR area under the curve for the all-out and RPE6 sessions. The average number of repetitions performed was lower (p ≤ 0.009) for the RPE6 session (190.5 ± 12.5 repetitions) when compared to the all-out session (214.4 ± 18.6 repetitions). There was a significant correlation between the RPE and LAC (p = 0.005; r = 0.66; large) and number of repetitions during the session (p = 0.026; r = 0.55; large). No correlation was observed between the RPE and HR (p = 0.147; r = 0.380). These results indicate that the self-regulation of intensity of effort based on the RPE may be a useful tool to control the exercise intensity during a metabolic conditioning session of functional fitness.

Acute Effects of the New Method Sarcoplasma Stimulating Training Versus Traditional Resistance Training on Total Training Volume, Lactate and Muscle Thickness.

Background: Trained subjects have difficulty in achieving continued results following years of training, and the manipulation of training variables through advanced resistance training (RT) methods is widely recommended to break through plateaus. Objective: The purpose of the present study was to compare the acute effects of traditional RT (TRT) versus two types of sarcoplasma stimulating training (SST) methods on total training volume (TTV), lactate, and muscle thickness (MT). Methods: Twelve trained males (20.75 ± 2.3 years; 1.76 ± 0.14 meters; body mass = 79.41 ± 4.6 kg; RT experience = 4.1 ± 1.8 years) completed three RT protocols in a randomly sequenced order: TRT, SST contraction type (SST-CT), or SST rest interval variable (SST-RIV) with 7 days between trials in arm curl (elbow flexors) and triceps pulley extension (elbow extensors) performed on the same day. Results: The SST groups displayed greater acute biceps and triceps brachii (TB) MT versus the TRT session, with no difference in lactate levels between them. The SST-CT resulted in greater biceps and TB MT versus the SST-RIV session. The TTV was greater for the TRT session versus the SST sessions, except in the case of the elbow flexors (no difference was observed between TRT and SST-CT), and higher for the SST-CT versus the SST-RIV. Conclusion: Trained subjects may benefit from using the SST method as this method may offer a superior MT stimulus and reduced training time, even with a lower TTV.

Strength and Muscular Adaptations After 6 Weeks of Rest-Pause vs. Traditional Multiple-Sets Resistance Training in Trained Subjects.

Prestes, J, Tibana, RA, de Araujo Sousa, E, da Cunha Nascimento, D, de Oliveira Rocha, P, Camarço, NF, Frade de Sousa, NM, and Willardson, JM. Strength and muscular adaptations after 6 weeks of rest-pause vs. traditional multiple-sets resistance training in trained subjects. J Strength Cond Res 33(7S): S113-S121, 2019-The purpose of this study was to compare the longitudinal effects of 6 weeks of rest-pause vs. traditional multiple-set resistance training (RT) on muscle strength, hypertrophy, localized muscular endurance, and body composition in trained subjects. Eighteen trained subjects (mean ± SD; age = 30.2 ± 6.6 years; weight = 74.8 ± 17.2 kg; height = 171.4 ± 10.3 cm) were randomly assigned to either a traditional multiple-set group (n = 9; 7 men and 2 women; 3 sets of 6 repetitions with 80% of 1-repetition maximum (1RM) and 2-minute rest intervals between sets) or a rest-pause group (n = 9; 7 men and 2 women). The results showed no significant differences (p > 0.05) between groups in 1RM strength (rest-pause: 16 ± 11% for bench press, 25 ± 17% for leg press and 16 ± 10% for biceps curl vs. traditional multiple-set: 10 ± 21% for BP, 30 ± 20% for LP and 21 ± 20% for BC). In localized muscular endurance, the rest-pause group displayed significantly greater (p < 0.05) repetitions, only for the LP exercise (rest pause: 27 ± 8% vs. traditional multiple-set: 8 ± 2%). In muscle hypertrophy, the rest-pause group displayed significantly greater (p < 0.05) thickness, only for the thigh (rest-pause: 11 ± 14% vs. traditional multiple-set: 1 ± 7%). In conclusion, RT performed with the rest-pause method resulted in similar gains in muscle strength as traditional multiple-set training. However, the rest-pause method resulted in greater gains in localized muscular endurance and hypertrophy for the thigh musculature.

Are extreme conditioning programmes effective and safe? A narrative review of high-intensity functional training methods research paradigms and findings.

Extreme conditioning programmes (ECPs, eg, CrossFit, Insanity and Gym Jones) are a growing fitness regimen characterised by functional movements performed at high-intensity and with constantly varying movements. While the popularity and number of practitioners of ECPs are growing, a debate has been established between what is observed in the scientific literature and anecdotal reports from athletes, coaches and physicians about safety (incidence and prevalence of injuries and rhabdomyolysis) and benefits (physical and mental health). In this article, we review the prevalence and incidence of injuries, rhabdomyolysis, physiological responses and chronic adaptations to ECPs. The majority of the available evidence confirm that the estimated injury rate among athletes participating in ECPs is similar to that in weightlifting and most other recreational activities. Additionally, ECP sessions resulted in increased acute oxidative, metabolic and cardiovascular stress, and depending on the stimulus (intensity, duration and non-usual exercise) and training status of the practitioner, an ECP session may precipitate rhabdomyolysis. In the scientific literature, the current chronic effects of ECPs showed little or no effects on body composition and improvements in physical fitness and psychological parameters; however, further studies are important.