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Shear wave elastography (SWE) allows assessment of muscle and tendon stiffness and can be used to diagnose soft tissue pathologies such as tendinopathies. In sports medicine, SWE may have the potential to uncover structural changes early on before they lead to functional impairment. To systematically analyze possible differences in tendon and muscle stiffness of the lower limb between professional (PG) and semiprofessional female athletes (SG) using SWE and to compile reference values for developing preventive medicine approaches for professional athletes. Standardized SWE of both lower limb tendons and muscles (Achilles tendon [AT], soleus muscle insertion [SM], patellar tendon [PT], quadriceps tendon [QT], vastus medialis muscle [VM]) in the longitudinal plane was performed with the tendons in relaxed position in 24 healthy professional female athletes (PG) in comparison with 24 healthy semiprofessional female athletes (SG). Median tendon and muscle stiffness was significantly higher in professional athletes (AT:PG, 11.12 m/s vs SG, 7.33 m/s, P< .001; SM: 1.77 m/s vs 1.14 m/s, P< .001; VM: 1.63 m/s vs 0.87 m/s, P< .001; QT: 3.31 m/s vs 2.61 m/s, P< .05). There was no significant difference in patellar tendon stiffness between PG and SG (PT: 2.57 m/s vs 3.21, P= .25). Professional female athletes have higher stiffness values than semiprofessional female athletes in lower limb muscles and tendons, except for the patellar tendon. Knowledge of such differences is necessary for diagnosing tendinopathy and injuries. Musculoskeletal SWE could offer great benefits in sports medicine as well as in rehabilitation and preventive medicine.

Legerlotz, K, Kittelmann, J, Dietzel, M, Wolfarth, B, and Böhlke, N. Ice hockey-specific repeated shuttle sprint test performed on ice should not be replaced by off-ice testing. J Strength Cond Res36(4): 1071–1076, 2022—Although the importance of sport-specific testing has been stated in various studies, the application of standard tests that are little related to the requirements in competition is still widespread in performance diagnostics. Furthermore, the actual exercise mode in testing often deviates from the exercise mode in competition. The aim of this study was therefore to investigate how the performance in an ice hockey mimicking repeated sprint shuttle test conducted off-ice (RSS) differs from the on-ice performance (RISS). The two performance tests were completed by 21 male junior ice hockey players within one week. Anaerobic fatigue was significantly larger in RISS and did not correlate with RSS, whereas best run, mean run, total run time, turn and fly time, and total times in all three shifts correlated moderately. Although the best and mean run times did not differ, these times were achieved with different strategies depending on the test condition, indicated by significantly different split times. Aerobic fatigue in shift 3 was the only parameter where the off-ice measurement correlated strongly with the on-ice measurement. Our results imply that an off-ice test does not predict on-ice performance with sufficient precision, strongly advocating performance testing in the exercise mode used in competition.

To promote physical activity, the Borg Scale (6–20) is an easy and accessible tool for the recommendation of training intensities.Our results suggest RPE ≤ 11 for light intensity, RPE 12–14 for moderate intensity, and RPE 15–17 for vigorous intensity, and RPE 15 delineating heavy and severe intensity domain.In clinical routine, physicians and therapists should consider age, sex, type of ergometry, duration of exercise, and cardiopulmonary fitness as factors influencing RPE, especially with lower intensities.

The 2005 update of the human gene map for physical performance and health related fitness phenotypes are presented. It is shown that little progress is made in the 12 months with respect to the genetic basis of human variation in performance and health-related fitness.

ABSTRACTObjectivesTo prevent the occurrence of injury in a sport, exact knowledge of injury patterns is needed. To synthesize sport-specific injuries in track and field comparing elite and recreational level athletes, as well as gender. Furthermore, analyze the time loss due to injury and reduction in athletic performance.MethodsInjury type-specific frequencies were recorded according to discipline, gender and performance level. Injury severity was assessed by time loss duration and performance reduction.Results64% of athletes suffered at least one injury. In the top 10 ranking, 83% (n = 524) were located in the lower extremities. A muscle strain of the thigh had the highest prevalence in sprint (34%, n = 41), jump (15%, n = 15) and middle-distance running (16%, n = 6). More injuries occurred during training (75%, n = 165) as compared to competition (25%, n = 56). The longest time loss was documented in throwing with a downtime of 36 weeks after a ligament injury of the elbow and 39 weeks after a muscle injury of the elbow. The injury with the highest number of athletes with a reduced level of performance was the foot ligament injury in sprint athletes at 100%.ConclusionAssessing time loss and performance reduction in athletics, there are discipline-specific injury patterns. This study points out the high prevalence of training injuries, highlighting the need for future investigations to adapt training management, improve medical care and rehabilitation with respect to every discipline.

Leistungssportlerinnen und Leistungssportler sind hohen physischen und psychischen Anforderungen ausgesetzt, um optimale Ergebnisse zu erzielen. Dafür ist auch die Funktion der Regenerationsphase wichtig, zu der maßgeblich ein erholsamer Schlaf beiträgt. Es gibt jedoch Hinweise, dass bei Leistungssportlerinnen und Leistungssportlern aufgrund verschiedener Belastungen im Rahmen des Trainings und der Wettkämpfe gehäuft eine Insomniesymptomatik auftreten kann. Zur objektiven Untersuchung der Schlafstruktur, Schlafqualität und Funktion des kardialen autonomen Tonus wurden Leistungssporttreibende (LS) und eine Gruppe ebenfalls gesunder Kontrollen (GK) mit einer vereinfachten ambulanten Schlafmessung untersucht.

This article reviews current research on the relationship between human genetics and physical fitness levels. An analysis of cardiorespiratory endurance, muscle strength, gene mutation, and body composition measurements is presented.

This article describes a human gene map used to help identify genetic differences related to physical performance and health. Traits such as endurance, muscular strength, metabolism, hemodynamic characteristics, and body composition are analyzed as genetic variables related to athletic ability and general health.

The alpha 2a-adrenoreceptor gene shows a weak association with high levels of endurance in athletes. Variation in this gene or a location near it may be a significant factor in athletes' abilities to maintain an endurance training regimen designed to produce maximal aerobic power.

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ABSTRACTIn this study, the development of routine duration (RD) in artistic gymnastics was investigated. Because of fundamental rule changes in 2006, the difference between the periods 1997–2005 and 2006–2019 and between the Olympic cycles (OC) over the entire period was examined. Therefore, 1387 routines were evaluated using video recordings. The results were: I) RD increased from 1997–2005 to 2006–2019 on pommel horse (36.0 to 44.0 s; p = 0.00), still rings (SR) (42.0 to 53.0 s; p = 0.00), parallel bars (PB) (35.0 to 50.0 s; p = 0.00), high bar (37.0 to 50.0 s; p = 0.00), uneven bars (UB) (32.5 to 36.0 s; p = 0.00), balance beam (83.0 to 85.0 s; p = 0.08) and floor female (87.0 to 89.0 s; p = 0.00), whereas floor male (67.0 vs. 67.0 s; p = 0.96) shows no differences; II) RD increase on SR from OC 2008 to OC 2012 (p = 0.00), at PB from OC 2012 to OC 2016 (p = 0.00), and reduced from OC 2012 to OC 2016 (p = 0.00) at UB. The increase of RD must be considered by coaches in order to prepare their athletes specifically for competitions.

This article provides an overview of the potentials and vast areas of digital applications in the field of sports medicine.Digital transformation is becoming increasingly common in modern life and sports medicine, like many other medical disciplines, it is strongly influenced and impacted by this rapidly changing field. This review aims to give a brief overview of the potential that digital technologies can have for health care providers and patients in the clinical practice of sports medicine. We will focus on mobile applications, wearables, smart devices, intelligent machines, telemedicine, artificial intelligence, big data, system interoperability, virtual reality, augmented reality, exergaming, or social networks. While some technologies are already used in current medical practice, others still have undiscovered potential. Due to the diversity and ever changing nature of this field, we will briefly review multiple areas in an attempt to give readers some general exposure to the landscape instead of a thorough, deep review of one topic. Further research will be necessary to show how digitalization applications could best be used for patient treatments.

Rapid advances in technologies in the field of genomics such as high throughput DNA sequencing, big data processing by machine learning algorithms and gene-editing techniques are expected to make precision medicine and gene-therapy a greater reality. However, this development will raise many important new issues, including ethical, moral, social and privacy issues. The field of exercise genomics has also advanced by incorporating these innovative technologies. There is therefore an urgent need for guiding references for sport and exercise genomics to allow the necessary advancements in this field of sport and exercise medicine, while protecting athletes from any invasion of privacy and misuse of their genomic information. Here, we update a previous consensus and develop a guiding reference for sport and exercise genomics based on a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. This SWOT analysis and the developed guiding reference highlight the need for scientists/clinicians to be well-versed in ethics and data protection policy to advance sport and exercise genomics without compromising the privacy of athletes and the efforts of international sports federations. Conducting research based on the present guiding reference will mitigate to a great extent the risks brought about by inappropriate use of genomic information and allow further development of sport and exercise genomics in accordance with best ethical standards and international data protection principles and policies. This guiding reference should regularly be updated on the basis of new information emerging from the area of sport and exercise medicine as well as from the developments and challenges in genomics of health and disease in general in order to best protect the athletes, patients and all other relevant stakeholders.

The most significant articles in exercise, fitness, and performance genomics and a brief overview of the first genome-wide association study of the genetic differences between exercisers and nonexercisers are reported. The findings recommended an urgent need to prioritize high-quality research designs and replication studies with large sample sizes.

A study investigates the Epstein-Barr virus (EBV) serostatus in an athletic endurance population, especially the prevalence of complex aberrant EBV antibody patterns, and determines whether serology in athletes is more complex than in the general population. No evidence is found for the assumption that endurance athletes are more susceptible to EBV infections than the general population and no differences are indicated with respect to serological classical and aberrant complicated patterns between athletes and the control group.

A subset of the 2004 update of the human gene map project focueses on physical performance and health-related fitness phenotypes. Information on peer-reviewed papers on this topic published in 2004 is presented. The genes and markers for sedentary people, people beginning sports training and very seasoned athletes are discusses. These genes and markers are positioned on the genetic map of all autosomes and the X chromosome.

The 2003 update of the human gene map for physical performance and health-related fitness phenotypes is presented. It is based on pear-reviewed papers published by the end of 2003 and includes association studies with candidate genes, genome-wide scans with polymorphic markers, and single-gene defects causing exercise intolerance to variable degrees.

This article summarizes the number of genes and markers, identified until year 2002, that are known to exhibit an association or linkage on the X chromosome with a performance or fitness phenotype in sedentary or active subjects enganging in exercise.

The purpose of the study was to determine whether total hemoglobin mass (tHM) and total blood volume are influenced by training, chronic altitude exposure and possibly by the combination of both conditions. In endurance athletes who are native to moderate altitude, tHB and BV were synergistically influenced be training and by altitude exposure, which is probably one important reason for their high performance.

White matter integrity and cognition have been found to decline with advancing adult age. Aerobic exercise may be effective in counteracting these declines. Generally, white matter integrity has been quantified using a volumetric measure (WMV) and with tensor-based parameters, such as fractional anisotropy (FA) and mean diffusivity (MD), the validity of which appears to be compromised in the presence of crossing fibers. Fixel-based analysis techniques claim to overcome this problem by yielding estimates of fiber density (FD), cross-section (FC), and their product (FDC) in multiple directions per voxel. In a sample of 61 healthy older adults (63–76 years old), we quantified changes in white matter integrity following an aerobic exercise intervention with the commonly used volumetric and tensor-based metrics (WMV, FA, MD) and with fixel-based metrics (FD, FC, FDC). We investigated the associations of changes in these white matter parameters with changes in cardiovascular fitness and Digit Symbol Substitution task (DSST) performance, a marker of perceptual speed. In line with previous findings, we observed maintained WMV in the corpus callosum of exercisers, and positive change-change correlations between WMV and fitness, and between WMV and perceptual speed. For FA and MD, group differences in change opposite to those hypothesized were found in the corpus callosum, posterior corona radiata, and superior longitudinal fasciculus at an uncorrected significance threshold. Likewise, regions in superficial WM in the prefrontal cortex showed group differences in FD and FDC change, uncorrected, with more positive change in controls and more negative change in exercisers. Finally, changes in FD and FDC were found to be inversely correlated to changes in fitness and DSST performance. The present results corroborate previous findings of WMV changes, but cast doubt on current physiological interpretations of both tensor-based and fixel-based indicators of white matter properties in the context of exercise intervention studies.

Background: Correction for body composition is recommended for appropriate interpretation of equivocally altered cardiac dimensions. We sought to investigate the impact of body composition on athletés heart.Methods: Left ventricular mass (LVM), septal wall thickness (SWT) and end-diastolic diameter (LVEDD) were measured by echocardiography in 1051 elite athletes (26% female, aged 18–40 years) and in 338 sedentary controls matched for age, gender and body size. Body fat was determined by skinfold thickness measurements.Results: Normative ranges are provided for LVM, LVEDD and SWT scaled to body surface area (BSA), height, height2.7and fat-free mass (FFM). The strongest correlation was found for FFM (r = 0.70; 0.64; 0.49; p < 0.001 each). LVM, LVEDD and SWT differed significantly (p < 0.05) between athletes of low, moderate and high dynamic disciplines. Correcting LVEDD for height2.7eliminated these differences (p > 0.05), whereas LVM and SWT remained significantly increased in high dynamic athletes despite correction for body size. Gender differences were consistently eliminated by scaling LVEDD to FFM0.33and SWT to BSA, but scaled LVM remained significantly increased in male athletes. Compared to sedentary controls, significant differences in LVEDD and SWT disappeared after correction for height2.7and FFM, but LVM again remained significantly higher in athletes.Conclusions: Adaptation of left ventricular dimensions to exercise training is closely related to body composition, in particular to FFM. The normative ranges for LVEDD, SWT and LVM scaled to body size aid interpretation of equivocal alterations in elite athletes. However, the increase of LVM in particular reveals exercise-induced adaptations beyond these associations.

Die Anti-Doping-Vorgaben sind von zunehmender Bedeutung in der praktischen Sportmedizin. Die Tatsache, dass diese Vorgaben von Jahr zu Jahr modifiziert werden, erfordert eine stetige Weiterbildung für den betreuenden Arzt im Hochleistungssport. Neben der Kenntnis des Inhalts der jeweils aktuellen Anti-Doping-Verbotsliste müssen die administrativen Vorgaben für die Beantragung anmeldepflichtiger Substanzen eingehalten werden. Um Fehler mit fatalen Folgen für die Sportler zu vermeiden, muss der betreuende Arzt im Leistungssport jederzeit die notwendigen Informationen zu Anti-Doping-Vorgaben parat haben und insbesondere die Ansprechpartner/Adressen der jeweils zuständigen Anti-Doping-Behörden kennen.

WOLFARTH, B., M. A. RIVERA, J-M. OPPERT, M. R. BOULAY, F. T. DIONNE, M. CHAGNON, J. GAGNON, Y. CHAGNON, L. PÉRUSSE, J. KEUL, and C. BOUCHARD. A polymorphism in the alpha2a-adrenoceptor gene and endurance athlete status. Med. Sci. Sports Exerc.,Vol. 32, No. 10, pp. 1709–1712, 2000.

Several studies have reported that the insertion (I) allele of the angiotensin-converting enzyme (ACE) I/deletion (D) polymorphism is associated with enhanced responsiveness to endurance training and is more common in endurance athletes than in sedentary controls. We tested the latter hypothesis in a cohort of 192 male endurance athletes with maximal oxygen uptake ≥75 ml ⋅ kg−1⋅ min−1and 189 sedentary male controls. The ACEID polymorphism in intron 16 was typed with the three-primer polymerase chain reaction method. Both the genotype (P= 0.214) and allele (P= 0.095) frequencies were similar in the athletes and the controls. Further analyses in the athletes revealed no excess of the I allele among the athletes within the highest quartile (> 80 ml ⋅ kg−1⋅ min−1) or decile (>83 ml ⋅ kg−1⋅ min−1) of maximal oxygen uptake. These data from the GENATHLETE cohort do not support the hypothesis that the ACEID polymorphism is associated with a higher cardiorespiratory endurance performance level.

The purpose of this study was to investigate the association between elite endurance athlete (EEA) status and two restriction fragment length polymorphisms (RFLPs) at the muscle-specific creatine kinase (CKMM) gene locus. Genomic DNA was extracted from white blood cells or lymphoblastoid cell lines of 124 unrelated Caucasian male EEA (VO2max>73 mL·kg-1·min-1) and 115 unrelated Caucasian sedentary male controls (SCON). The genetic polymorphism at the CKMM locus was detected by the polymerase chain reaction and DNA digestion with theNcoIand TaqIrestriction endonucleases. The allelic frequencies for the NcoIand TaqIRFLPs were not different(P> 0.05) between EEA and SCON subjects. The three expected genotypes for CKMM-NcoI(1170/1170 bp, 1170/985 + 185 bp, and 985 + 185/985 + 185 bp) and CKMM-TaqI(1170/1170 bp, 1170/1020 + 150 bp, and 1020 + 50/1020 + 150 bp) were observed in the EEA and SCON groups. These genotype frequencies were in Hardy-Weinberg equilibrium, but they were not significantly (P> 0.05) different between the EEA and SCON. A strong (P< 0.001) linkage disequilibrium was detected among theNcoIand TaqIRFLPs in both EEA and SCON. These findings indicate that the skeletal muscle CK-NcoIand CK-TaqIgene polymorphisms are not associated with the elite endurance athlete status.

This study examined the associations between elite endurance athlete (EEA) status and three mitochondrial DNA (mtDNA) restriction fragment length polymorphisms (RFLPs) in the subunit 5 of the NADH dehydrogenase (MTND5) locus and one in the D-loop region. A group of 125 Caucasian male EEA well endowed with the phenotypic expression of VO2max(78.9 ± 3.8 mL·kg-1·min-1, mean ± SD) and 65 sedentary controls (SCON: VO2max= 39.8 ± 8.2 mL·kg-1·min-1) participated in the study.VO2maxwas determined during an incremental exercise test on a cycle ergometer or a motor-driven treadmill. mtDNA was extracted from white blood cells or lymphoblastoid cell lines and specific regions were amplified by the polymerase chain reaction. The Pearson Chi-square statistic test and Fisher exact test revealed no significant association (P> 0.05) between any of the three mtDNA RFLPs and EEA status. The MTND5-BamHIRFLP at bp 13,470 (morph 3) was found in 12.8% of the EEA and 12.3% of the SCON (χ2= 0.009, P= 0.92). The prevalence of the MTND5-NciIRFLP at bp 13,364 (morph 2) was 12.9% and 14% for the EEA and SCON, respectively (χ2= 0.043, P= 0.83). The D-loop-KpnIRFLP at bp 16,133 (morph 1) was found in 5.8% of the EEA and in 1.6% of the SCON (Fisher exact test = 1.80, P= 0.18). The MTND5-HincII RFLP at bp 12,406 (morph 1) was not present in this study sample. These results indicate no evidence for a difference in the frequency of two polymorphic restriction sites in the subunit 5 of the NADH dehydrogenase gene of mtDNA and one in the D-loop region between elite endurance athletes and sedentary controls.

The article offers information on genetic findings related to sporting performance, which requires athletes to have a synergy of physiological and behavioural factors. Topics discussed include the link between single nucleotide polymorphisms (SNPs) and performance- and fitness-related traits, the use of genetic methods such as estimating heritability and gene association analysis, and a table showing the genetics of the performance of an elite athlete.