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OBJECTIVES: The aim of this study is to analyse the adaptations of the autonomic nervous system after a musculoskeletal injury, obtained by measuring heart rate variability in athletes. It was hypothesized that there is an alteration in heart rate variability after a musculoskeletal injury. STUDY DESIGN: Cohort study. SUBJECTS: 15 semi-professional soccer players from three football teams, aged between 21 and 33 (mean age: 29.4 ± 3.31 years), with a recent musculoskeletal injury. METHODS: Heart rate variability was collected using the Polar m200 and the chest strap H10 in two moments: within 72 h after the injury and between 5 and 7 days after full return-to-play. RESULTS: Results show differences between T1 and T2 (p ≤ 0.05) in low-frequency power (n.u.) (p = 0.001) and high-frequency power (n.u.) (p = 0.001), in low-frequency/high-frequency ratio (p = 0.001) and in high-frequency power (ms2) (p = 0.017) measures. No statistical differences were found in low-frequency power (ms2) (p = 0.233). The low frequency power (n.u.) was significantly lower after injury compared with LF power (n.u.) values after full return-to-play. In high-frequency power there was a significant difference between both moments with high values after injury. CONCLUSIONS: The use of heart rate variability therefore seems to be promising to detect an imbalance in the autonomic nervous system and help clinical departments to identify a possible non-traumatic musculoskeletal injury. Further research should be performed considering a wide range of musculoskeletal injuries and to establish baseline values of the athletes.

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In 2019, three regulations of the Minister of Health regarding sports medicine examinations in children, adolescents and young athletes came into force. The publication presents in detail the current scope of tests and the frequency of required medical examinations necessary to obtain medical certificates qualify- ing patients to practice sports. The publication also presents the Regulation of the Minister of Health on the required qualifications of doctors authorized to issue medical certificates to athletes. It is very important to properly assess the health of potential and current athletes to ensure their safety while participating in sports competitions. There are diseases that increase the risk of sudden cardiac death which doctors should keep in mind when qualifying athletes for competition. The publication draws attention to the underestimated role of echocardiography and electrocardiographic stress testing.

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In-season management of anterior shoulder instability in athletes is a complex problem. Athletes often wish to play through their current season, though recurrent instability rates are high, particularly in contact sports. Athletes are generally considered safe to return to play when they are relatively pain-free, and their strength and range of motion match the uninjured extremity. If an athlete is unable to progress toward recovering strength and range of motion, surgical management is an option, though this is often a season-ending decision.

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INTRODUCTION: In soccer, most studies evaluate metabolic profile changes in male athletes, often using data from a single match. Given the current landscape of women's soccer and the effects of biological sex on the physiological response and adaptation to exercise, more studies targeting female athletes and analyzing pre- and post-game moments throughout the season are necessary. OBJECTIVES: To describe the metabolomics profile of female soccer athletes from an elite team in Brazil. The study observed the separation of groups in three pre- and post-game moments and identified the discriminating metabolites. METHODS: The study included 14 female soccer athletes. Urine samples were collected and analyzed using Nuclear Magnetic Resonance in pre-game and immediate post-game moments over three national championship games. The metabolomics data were then used to generate OPLS-DA and VIP plots. RESULTS: Forty-three metabolites were identified in the samples. OPLS-DA analyses demonstrated a progressive separation between pre-post conditions, as supported by an increasing Q2 value (0.534, 0.625, and 0.899 for games 1, 2 and 3, respectively) and the first component value (20.2% and 19.1% in games 1 and 2 vs. 29.9% in game 3). Eight out of the fifteen most discriminating metabolites appeared consistently across the three games: glycine, formate, citrate, 3-hydroxyvalerate, glycolic acid, trimethylamine, urea, and dimethylglycine. CONCLUSION: The main difference between the three games was the increasing separation between groups throughout the championship. Since the higher VIP-scores metabolites are linked to energy and protein metabolism, this separation may be attributed several factors, one being the accumulation of fatigue.

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The objective of the current study was to examine the prevalence of eating disorder behaviours among student-athletes at a small, non-NCAA (Canadian) university, while evaluating the influence of gender, type of sport, and perceived social support. Two hundred participants (130 female, 70 male) completed an online survey that assessed participants eating disorder behaviours (EAT-26), behaviours consistent with the Adonis Complex (ACQ) and perceived social support (modified MPSS). The results revealed significant differences in eating disorder behaviour between female and male athletes, with females scoring significantly higher; yet no differences were found between how female and male athletes scored on the Adonis Complex Questionnaire. Significant differences were found between lean-sport and non-lean sport athletes, with lean sport athletes exhibiting more eating disorder behaviours. Furthermore, non-lean sport male athletes were found to score significantly higher than lean-sport male athletes for the Adonis Complex. Perceived social support was found to be negatively correlated to eating disorder behaviours and when considering gender and type of sport, accounted for unique variance in eating disorder behaviour. These results suggest that student-athletes are susceptible to negative mental health outcomes, even within the context of a smaller (and non-NCAA) university context, and eating behaviours vary among athlete and sport type. The results highlight the importance of continued research in this area and of having support systems in place for student-athletes and increasing awareness of athletic staff and coaches as to the seriousness and prevalence of eating disorder behaviours.

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Determining an athlete's maximal peak power (MPP) is crucial in profiling endurance sports participants. While short (3 to 6 seconds) all-out efforts have been validated for MPP assessment, prior studies mainly involved non-endurance trained athletes. This study aimed to assess the intra- and inter-day reliability of a 6-second Wingate test for MPP determination in endurance athletes. Endurance-trained participants (22 males, 5 females) completed nine 6-second Wingate tests over four days (3 trials at baseline, 2 trials on each subsequent day). Analysis revealed no systematic differences in MPP (F(4.09, 106.3) = 1.88, p = 0.117) or time to peak power (χ2 (8) = 5.23, p = 0.732) across the trials. Reliability, assessed through the intraclass correlation coefficient (ICC) and standard error of measurement (SEM), was excellent across all trials (ICC = 0.95, SEM = 40.0W, SEM% = 3.7%). Absolute reliability improved when selecting the average or the best MPP values from each day (SEM% = 2.7% and 2.9%, respectively). Within-day reliability was consistently rated as excellent, with the best values on the 4th day of tests. No significant differences in MPP values occurred between the first and second 6-second Wingate tests on days 1 to 3, with both trials demonstrating similar reliability values (SEM%: 3.2% vs 2.8%, for the first and second trials, respectively). The test also demonstrated a good sensitivity to detect a meaningful change in MPP values. In conclusion, the 6-second Wingate test proves reliable for determining MPP in endurance-trained athletes. Two trials are recommended on the first day of testing, with a single MPP likely sufficient to determine the athlete's MPP on subsequent days.

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We investigated the effect of repeated sessions of anodal transcranial direct current stimulation (a-tDCS) on subjective and objective measures of recovery, cognitive and sport-specific performance in professional soccer players following a soccer match simulation (SMS). Sixteen soccer players participated in this randomized, crossover, and sham-controlled study. They completed baseline assessments of well-being, total quality recovery (TQR), electromyographic activity (EMG) of the thigh muscles, countermovement jump (CMJ), and cognitive and Loughborough soccer passing test (LSPT) skills. Then, the participants engaged in an SMS routine (2 × 45 min, 15-min intervals). There was no significant difference in rating of perceived exertion (RPE) during the SMS in the anodal (17.25 ± 0.85) and sham (16.93 ± 0.92) conditions (p = 0.19). Following the SMS, the participants were randomized to receive three sessions of a-tDCS (2 mA, 20 min, +F3/-F4) targeting the left dorsolateral prefrontal cortex (DLPFC) or sham immediately after, 24 h, and 48 h after the SMS. Finally, the same outcome measures were evaluated 24 and 48 h following the SMS. A two-way repeated-measures ANOVA showed that a-tDCS stimulation improved passing skills (decreased time to perform the LSPT and number of errors; all ps < 0.01; d = 0.56-2.9) and increased the feeling of well-being (p = 0.02; d = 2.8), with no effect on TQR, cognitive performance, CMJ performance, and EMG. Therefore, the results of the present study indicate, for the first time, that repeated a-tDCS could be used as an adjunct method to accelerate soccer players' well-being and technical performance recovery, particularly after congested matches and/or training sessions. These findings may also be applicable to other team sports with characteristics similar to soccer (e.g., futsal, handball, basketball, etc.).

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30 min of moderate-intensity aerobic exercise per day is recommended, but the response and adaptation of endothelial function (EF) to this exercise remains controversial. The purpose of this study was to determine the changes in EF in endurance trained and untrained individuals before and after this exercise and to compare the differences between trained and untrained individuals. Twelve endurance-trained male college athletes (trained group) and 12 untrained male college students (untrained group) performed a 30-min run at an intensity of 60% VO2max. Brachial artery flow-mediated dilation (FMD) was measured before exercise, 30 min and 60 min after exercise, and the following morning. Resting diameter and maximum diameter showed large time effects (p < 0.001, η2 = 0.533; p < 0.001, η2 = 0.502). Resting diameters at 30 and 60 min after exercise were higher than before exercise in both the untrained and trained groups (p < 0.05), and maximum diameters at 30 min after exercise were higher than before exercise in both the untrained and trained groups (p < 0.01). Resting diameter and maximum diameter also exhibited some group effects (p = 0.055, η2 = 0.157; p = 0.041, η2 = 0.176). Resting diameters and maximum diameters were higher in the trained group than in the untrained group before exercise (p < 0.05). FMD (%) showed no time, group, or time-group interaction effects. 30 min of moderate-intensity aerobic exercise can increase resting and maximal arterial diameters in both trained and untrained young men, but has no effect on FMD. Long-term endurance training has the potential to increase resting and maximal arterial diameters in young men, but not necessarily FMD.

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BACKGROUND: Supraventricular extra beats (SVEB) are frequently observed in athletes but data on significance, prognostic role and correlation with cardiac remodeling are contrasting. It is uncertain whether SVEB may indicate the development of more complex arrhythmias and the need for closer monitoring is undetermined. The aim was to assess the prevalence and clinical significance of BESV in Olympic athletes of different sporting disciplines, evaluating potential correlations with cardiac remodeling and clinical features. METHODS: We enrolled athletes who participated at 2012-2022 Olympic Games, submitted to physical examination, blood tests, echocardiography and exercise tests, categorized into power, skills, endurance and mixed disciplines. RESULTS: We studied 1492 elite athletes: 56% male individuals, mean age 25.8 ±â€Š5.1 years; 29.5% practiced power, 12.3% skills, 21% endurance and 37.2% mixed disciplines. At exercise-stress tests, 6.2% had SVEB, mostly single beats. SVEB were not influenced by anthropometrics or blood test results. They were more common in male individuals (77.4 vs. 54.6%, P < 0.0001) and older athletes (27.1 ±â€Š5.7 vs. 25.7 ±â€Š5.1, P = 0.01). In male athletes with SVEB, higher left atrial volumes were observed (24.2 ±â€Š7.3 vs. 22.2 ±â€Š7.1 ml/m2, P = 0.03). No differences were found in terms of sporting discipline: despite larger left atrial dimensions in aerobic disciplines, SVEB rates were similar in different sporting disciplines (6.1% endurance, 6.3% mixed, 5.2% power and 8.7% skills; P = 0.435). CONCLUSION: SVEB were more common in older, male athletes and associated with higher left atrial volume (especially in male individuals) regardless of sport practiced. Athletes with greater left atrial volume and SVEB are supposed to have higher risk, in middle age, of developing more complex arrhythmias.

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OBJECTIVES: To compare the pre-competition nutrition practices of Lithuanian elite international-level (IL) and national-level (NL) bodybuilders. METHODS: Sixteen male bodybuilders (n=8 per group) were enrolled. The IL group comprised individuals achieving 1st to 4th place in the World and European Championships organized by the IFBB, whereas the NL group ranked between 1st and 6th place in the national championships. Body mass and diet data were obtained via a questionnaire. A repeated-measures ANOVA was performed using time as a within factor and group as a between factor. RESULTS: Both groups experienced a reduction in body mass during the pre-competition phase (p<0.001), which was slower in the IL than in the NL group (p=0.048). Both groups exhibited a reduction in caloric (p<0.001), carbohydrate (p<0.001), and fat (p=0.006) intake relative to body mass, but not in protein intake. Nevertheless, the IL group had a higher intake of calories (p=0.015), protein (p<0.001), but not carbohydrates relative to body mass vs. the NL group. CONCLUSIONS: The Lithuanian IL and NL bodybuilders both reduced calories by cutting fat and carbohydrates during pre-competition. The IL group maintained higher calorie and protein intake, resulting in similar body mass loss but at a slower rate than the NL group.

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To investigate: (1) the injury epidemiology in an Australian academy; (2) how athletes transition through the high-performance sport (HPS) pathway; and (3) why athletes leave this HPS program. This retrospective cohort study was conducted at an Australian HPS academy over a 4-year period. Medical attention injuries were prospectively recorded. Injury incidence rates (IIR) and burden were calculated per 365 athlete-days, according to sport, sex, and pathway level. Athlete pathway levels were mapped to the Foundations, Talent, Elite, and Mastery (FTEM) framework. Reasons for athletes transitioning out were reported. Four hundred and eighty-one injuries were reported across 124 athletes at an IIR of 2.09 injuries per 365 athlete-days (95% CI = 1.91-2.29). Most athletes (103, 83.1%) were injured at least once over the 4-year period. IIRs increased (IRR = 1.17, 95% CI = 1.06-1.29, p = 0.001) as athletes progressed through the pathway. The most common reason for athlete attrition was deselection due to performance (n = 18), with 55.6% of these athletes sustaining an injury in the season prior to deselection. Injury burden was highest at E2 (119.5 days absence per 365 athlete-days (95% CI = 62.18-229.67)) and lowest at T4 (30.47 days absence per 365 athlete-days (95% CI = 21.98-42.24)). Injury occurrence is common across HPS, with IIRs increasing as athletes progressed to higher talent levels. Deselection due to poor performance was the main attrition factor, with more than half the deselected athletes impacted by injury prior to deselection. This study highlights an increased risk of deselection, following injury, and indicates the need for further development of prevention strategies targeting pathway athletes.

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