Exercise Addiction in the Sports Context: What Is Known and What Is Yet to Be Known

Exercise addiction (EA) involves excessive concerns for exercise routines, an abusive practice, and the inability to control one’s own behavior, as well as the presence of psychological processes that are typical of behavioral addictions such as abstinence. EA is further associated with an alteration of the individual’s personal, social, and professional functioning and a higher risk for several pathologies, including physical injury, psychological distress, and eating disorders. The present work presents a narrative scoping review of the state of the art and the main findings of the research on EA, with a focus in the athletic population. The prevalence of EA risk, between 1 and 52% and up to 80% when co-occurring with eating disturbances, is also reviewed. Additionally, some of the explanatory models proposed to date and their power and limitations in terms of their capacity for a consensual operationalization and characterization of EA, and thus for the optimal exploration and management of this condition, are discussed. Finally, some deficiencies in the research on EA are noted which are to be addressed to successfully respond to the intervention and prevention needs that occur both in the general context of exercise-sports practice and the specific context of competitive athletes.

Resistance Training Recommendations to Maximize Muscle Hypertrophy in an Athletic Population: Position Stand of the IUSCA

Hypertrophy can be operationally defined as an increase in the axial cross-sectional area of a muscle fiber or whole muscle, and is due to increases in the size of pre-existing muscle fibers. Hypertrophy is a desired outcome in many sports. For some athletes, muscular bulk and, conceivably, the accompanying increase in strength/power, are desirable attributes for optimal performance. Moreover, bodybuilders and other physique athletes are judged in part on their muscular size, with placings predicated on the overall magnitude of lean mass. In some cases, even relatively small improvements in hypertrophy might be the difference between winning and losing in competition for these athletes. This position stand of leading experts in the field synthesizes the current body of research to provide guidelines for maximizing skeletal muscle hypertrophy in an athletic population. The recommendations represent a consensus of a consortium of experts in the field, based on the best available current evidence. Specific sections of the paper are devoted to elucidating the constructs of hypertrophy, reconciliation of acute vs long-term evidence, and the relationship between strength and hypertrophy to provide context to our recommendations.

Blood pressure, heart rate, and rate pressure product behavior during interval and continuous aerobic exercise (Comportamiento de la presión arterial, frecuencia cardíaca y doble producto durante el ejercicio aeróbico a intervalos y continuo)

The purpose of the present study was to compare the blood pressure, heart rate, and rate pressure product behavior during interval and continuous aerobic exercise in physically active women. Eight physically active women with prior indoor cycling experience were recruited for the present study. Participants visited the laboratory for three sessions, the first visit was used for familiarization and the remaining two visits were to perform the experimental protocols in a randomized order: 1) Twenty-one minutes of continuous indoor cycling at 70% of maximum heart rate (CONT), and 2) Twenty-one minutes of interval indoor cycling, alternating one minute at 90% and two minutes at 60% of maximum heart rate (INT). To assess the hemodynamic behavior, blood pressure, heart rate, and rate pressure product were also measuring at 6-minute (During-6), 12-minute (During-12), 18-minute (During-18), and 21-minute (During-21) intervals. Both protocols (continuous and interval) showed significant increases in blood pressure, heart rate, and rate pressure product in three out of four moments (During-6, During-12, and During-21), with the interval protocol showing higher values compared to the continuous protocol. The results of this study have practical implications for both prescription and cardiac rehabilitation and may be used in an athletic and non-athletic population, since a hypotension effect and lower cardiac workload is advantageous to one’s fitness. Resumen. El propósito del presente estudio fue comparar lo comportamiento de la presión arterial, la frecuencia cardíaca y doble producto durante el ejercicio aeróbico continuo y a intervalos en mujeres físicamente activas. Para el presente estudio se reclutaron ocho mujeres físicamente activas con experiencia previa en ciclismo indoor. Los participantes visitaron el laboratorio durante tres sesiones, la primera visita se utilizó para familiarizarse y les das visitas restantes fueron para realizar los protocolos experimentales en un orden aleatorio: 1) Veintiún minutos de ciclismo indoor continuo al 70% de la frecuencia cardíaca máxima (CONT), y 2) Veintiún minutos de ciclismo indoor a intervalos, alternando un minuto al 90% y dos minutos al 60% de la frecuencia cardíaca máxima (INT). Para evaluar el comportamiento de la presión arterial, la frecuencia cardíaca y doble producto también se midieron a los 6 minutos (Durante-6), 12 minutos (Durante-12), 18 minutos (Durante-18) y 21 minutos (durante-21) durante la actividad. Ambos los protocolos (CONT y INT) mostraron aumentos significativos en la presión arterial, la frecuencia cardíaca, y el doble producto en tres de cuatro momentos (Durante-6, Durante-12 y durante-21), con el protocolo INT que muestra los valores más altos en comparación al protocolo CONT. Los resultados de este estudio tienen implicaciones prácticas tanto para la prescripción médica como para la rehabilitación cardíaca y pueden usarse en una población atlética y no atlética, ya que un efecto de hipotensión y una menor carga de trabajo cardíaco son ventajosos para la aptitud física.

Sagittal Integral Morphotype of Competitive Amateur Athletes and Its Potential Relation with Recurrent Low Back Pain

Athletes have higher thoracic and lumbar curvature in standing than the reference values of the non-athletic population. The sagittal integral morphotype method (SIM) assessment has not previously been applied to competitive amateur athletes (CAA). The propose of the present study was to determine the SIM of CAA treated at a sports-medicine center and to identify spinal misalignments associated with recurrent low back pain (LBP). An observational analysis was developed to describe the SIM in 94 CAA. The thoracic and lumbar curvatures of the CAA were measured in standing, sitting, and trunk forward flexion. Association analysis (Pearson’s chi-square and Cramér’s V tests) was then performed to identify the SIM misalignments associated with LBP. Effect size was analyzed based on Hedges’ g. The most common thoracic SIMs in CAA were total hyperkyphosis (male = 59.02%; female = 42.42%) and static hyperkyphosis (male = 11.48%; female = 6.06%). Hyperlordotic attitude (female = 30.30%; male = 4.92%), static-functional hyperkyphosis (male = 16.39%; female = 3.03%), and structured hyperlordosis (female = 21.21%; male = 1.64%) were the most common lumbar SIMs. Hyperlordotic attitude, static functional lumbar hyperkyphosis, and structured hyperlordosis were associated with LBP in male and female athletes.

Normative PROMIS Scores in Healthy Collegiate Athletes: Establishing a Target for Return to Function in the Young Adult Athlete

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) computer-adaptive testing (CAT) has been shown to be a valid and reliable means of assessing patient-reported outcomes. However, normal scores and distributions for a subset of a healthy young athletic population have not been established. Purpose: To establish normative PROMIS scores for the domains of Physical Function (PF-CAT), Mobility (M-CAT), Upper Extremity Function (UE-CAT), and Pain Interference (PI-CAT) and determine the frequency of floor and ceiling effects in a population of healthy collegiate athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Healthy collegiate athletes (18-23 years of age) were prospectively enrolled to complete the 4 PROMIS CAT domains. Additionally, the athletes provided information regarding their age, sex, and sport(s). Mean scores (±SD) and identification of ceiling or floor effects were calculated. Ceiling and floor effects were considered significant if >15% of the participants obtained the highest or lowest possible score on a domain. Results: A total of 194 healthy athletes (mean age, 19.1 years) were included in the study: 118 (60.8%) men and 76 (39.2%) women. Mean scores were 62.9 ± 6.7 for PF-CAT, 58.2 ± 4.1 for M-CAT, 57.4 ± 5.8 for UE-CAT, and 43.2 ± 6.2 for PI-CAT. Distributions of scores for M-CAT and UE-CAT indicated strong ceiling effects by 77.3% and 66.0% of the participants, respectively. In healthy athletes, the PF-CAT differed most from the expected population-based mean score (50), with the mean being >1 SD above (62.9), without a ceiling effect observed. There were no significant sex- or age-based differences on any of the PROMIS domain scores. Conclusion: Healthy collegiate athletes scored nearly 1 SD from population-based means for all of the domains tested. M-CAT and UE-CAT demonstrated ceiling effects in more than two-thirds of healthy athletes, which may limit their utility in this population. The PF-CAT did not demonstrate floor or ceiling effects and demonstrated differences in a young adult athletic population from the population mean. The mean PF-CAT score of 62.9 can represent a target for return of function in injured athletes.

Athletes’ Self-Assessment of Urine Color Using Two Color Charts to Determine Urine Concentration

Our objective was to determine self-reported accuracy of an athletic population using two different urine color (Uc) charts (8-color vs. 7-color Uc chart). After approval by the Institutional Review Board, members of an athletic population (n = 189, 20 (19–22) year old student- or tactical athletes and coaches, with n = 99 males and n = 90 females) scored their Uc using two charts. To determine the diagnostic value of Uc, results were compared with urine concentration (osmolality and urine specific gravity, USG). Uc was scored slightly darker with the 8-color vs. 7-color Uc chart (2.2 ± 1.2 vs. 2.0 ± 1.2, respectively, p < 0.001), with a moderate correlation between charts (r = 0.76, 95% CI: 0.69–0.81). Bland-Altman analysis showed a weak reporting bias (r = 0.15, p = 0.04). The area under the curve for correct urine sample classification ranged between 0.74 and 0.86. Higher accuracy for both methods was found when Uc scores were compared to USG over osmolality, indicated by 4.8–14.8% range in difference between methods. The optimal Uc cut-off value to assess a low vs. a high urine concentration for both Uc charts varied in this study between 1 and ≤2 while accuracy for charts was similar up to 77% when compared to USG.

Study of Prevalence of Neuromuscular Dysfunctions Especially Trunk Dysfunction among the Athletic Population of Rocket, Team and Water Sports

Background: The high prevalence of injury in sports necessitates the use of screening tests and injury prevention programs. Dysfunctions in the neuromuscular control of the trunk or TD (Trunk Dysfunction) are directly related to athletic performance and injury. The present study aims to study the prevalence of neuromuscular dysfunctions especially TD among the athletic population of rocket, team and water sports.Results: For data analysis, it’s used the analysis of variance of (ANOVA) and also the Chi-square tests. The ANOVA test did not show a significant difference between tuck jump test scores among the three sports; the Chi-square test, on the other hand, demonstrated people with and without TD. The number of people with TD was 12 (40%) in table tennis, 6 (20%) in cycling, and 9 (30%) in swimming respectively.Conclusions: It can be concluded that the most and the least people with TD were table tennis and cycling, respectively. According to the direct relationship between TD and sports injury, it’s possible to reduce the risk of injury by an accurate and timely screening and assessing of TD in future athletes, by this, it seems that the quality level and the implementation strategies of techniques, the skills and the activities of athletes can be improved.

Influence of Cognitive Performance on Musculoskeletal Injury Risk: A Systematic Review

Background: While a large number of studies have investigated the anatomic, hormonal, and biomechanical risk factors related to musculoskeletal (MSK) injury risk, there is growing evidence to suggest that cognition is an important injury contributor in the athletic population. A systematic review of the available evidence regarding the influence of cognitive performance on MSK injury risk has yet to be published in the sports medicine literature. Purpose/Hypothesis: The purpose was to determine the effects of cognition on (1) MSK biomechanics during sports-specific tasks and (2) MSK injury occurrence in the athletic population. It was hypothesized that athletes with lower cognitive performance would demonstrate biomechanical patterns suggestive of MSK injury risk and that injured athletes would perform worse on baseline measures of cognition as compared with their noninjured counterparts. Study Design: Systematic review. Methods: PubMed and SPORTDiscus were searched from January 2000 to January 2020. Manual searches were performed on the reference lists of the included studies. A search of the literature was performed for studies published in English that reported MSK biomechanics as a function of cognitive performance and MSK injury occurrence after baseline measures of cognition. Two independent reviewers extracted pertinent study data in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines and assessed study quality using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies from the National Institutes of Health. A meta-analysis was not performed, owing to the heterogeneous nature of the study designs. Results: Ten studies met inclusion criteria: 4 cognition–MSK biomechanics studies and 6 cognition–MSK injury studies. All 4 cognition–MSK biomechanics studies demonstrated that worse performance on measures of cognition was associated with lower extremity MSK biomechanical patterns suggestive of greater risk for MSK injury. The majority of the cognition–MSK injury studies demonstrated that injured athletes significantly differed on baseline cognition measures versus matched controls or that cognitive performance was a significant predictor for subsequent MSK injury. Conclusion: Although the literature exploring cognitive contributions to MSK injury risk is still in its infancy, it is suggested that sports medicine personnel conduct baseline assessments of cognition—in particular, reaction time and working memory—to identify which athletes may be at elevated risk for future MSK injury.