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Introduction: Sitting volleyball is a widely practiced paralympic sport. A correct and standardized physical evaluation helps coaches to plan and manage the training. It is also important to evaluate physical fitness accurately and adopt standardized protocols to compare and normalize the data. The aim of the study was to evaluate physical fitness evaluation methods adopted in sitting volleyball and to eventually propose standard operating procedures. Evidence acquisition: English-written and peer-reviewed original articles were included in this review. The population studied was composed only of athletes practicing sitting volleyball. Articles were searched on the electronic databases PubMed, Web of Science, and Scopus using keywords matched with Boolean operators. Two independent investigators collected and screened the studies against the eligibility criteria. Data were analyzed narratively. Evidence synthesis: Only 7 studies were eligible and included in this review, but a wide testing methodology exists. There are some tests commonly adopted in the studies included and these are the handgrip test, the agility t-test, the speed, and endurance test. These tests with the 2-site skinfold thickness evaluation, the modified push-ups, the shoulder-stretch test, the chest throw test and the simple reaction time task were included in the standard operating procedure. Conclusions: The literature on the topic is poor and standardization of the testing procedure to evaluate the physical fitness of people practicing SV has been provided.

Many studies reported various relationships between 2000-m rowing performance and anthropometric as well as metabolic variables, however, little is known about 60-s mean power in elite youth athletes. The aim of this study was to develop different regression models to predict 2000-m rowing indoor performance time (t2000) using anthropometric variables, maximal oxygen uptake (VO2max) and mean power established during a 60-s all-out test (W60) in national elite youth rowers. Fifteen youth male Italian rowers (age: 15.7 ± 2.0 years; body height: 176.0 ± 8.0 cm; body mass: 71.2 ± 10.0 kg) performed an incremental maximal test, a 60-s all-out test and a 2000-m race simulation using a Concept2 rowing ergometer to assess VO2max, W60 and t2000, respectively. The relationships of all variables with t2000 were investigated through Pearson’s correlation. Multiple regression analyses were used to verify the best prediction model of 2000-m indoor rowing performance. The reliability of these models was expressed by R2 and the standard error of estimate. The results showed that t2000 was significantly correlated with all the examined variables, except for VO2max/body mass and age, and exhibited the significantly highest relationship with W60 (r = -0.943). The combination of anthropometric, VO2max and W60 variables was found to be the most reliable equation to predict t2000 (R2 = 0.94, SEE = 6.4). W60 measure should be considered when monitoring the rower’s capability to perform high-intensity phases, important during the race’s fast start and end. Not requiring expensive equipment and long duration, a 60-s all-out test could be considered a valuable tool for predicting 2000-m performance of elite youth rowers.

Sitting volleyball is a widely practiced Paralympic Sport. A correct and standardized physical evaluation helps coaches to plan and manage the training. It is also important to evaluate physical fitness accurately and adopt standardized protocols to compare and normalize the data. The objective of the study was to evaluate physical fitness evaluation methods adopted in sitting volleyball and to eventually propose Standard Operating Procedures.English-written and peer-reviewed original articles were included in this review. The population studied was composed only of athletes practicing sitting volleyball. Articles were searched on the electronic databases PubMed, Web of Science, and Scopus using keywords matched with Boolean operators. Two independent investigators collected and screened the studies against the eligibility criteria. Data were analyzed narratively.Only 7 studies were eligible and included in this review but a wide testing methodology exists. There are some tests commonly adopted in the studies included and these are the handgrip test, the agility t-test, the speed and endurance test. These tests with the 2-site skinfold thickness evaluation, the modified push-ups, the shoulder-stretch test, the chest throw test and the simple reaction time task were included in the standard operating procedure.The literature on the topic is poor and standardization of the testing procedure to evaluate the physical fitness of people practicing SV has been provided.

This retrospective cohort study aimed to analyze the effect of a 9-week detraining caused by COVID-19 lock-down on the maximal aerobic speed (MAS) of youth soccer players. The study included twenty-two under-16 male players competing at the national league level (15.4 ± 0.7 years old) who were analyzed pre and post the detraining period. The MAS was estimated using the Bronco’s test. Moreover, the self-regulated physical exercise performed by the players during the lockdown was monitored using a questionnaire. Considering the training volume per week, the players were grouped into those working more (>180 min/week) and those working less (

Background: Although a knee valgus position is related to the increase in injury risk in volleyball players, there is a lack of studies on the relationship between knee valgus and vertical jump (VJ) performance. Hence, the aim of this study was to investigate the effects of a postural exercise program on VJ height in young female volleyball players with knee valgus. Methods: This pilot study included 19 young female volleyball players divided into the following groups: the Valgus Experimental Group (VEG); the Valgus Control Group (VCG); and the Neutral Control Group (NCG). All three groups carried out the same volleyball training program. In addition, only the VEG underwent a 3-month postural exercise program of 30–45 min/session, twice/week. VJ performance was measured through the Sargent test before (T0), at 6 weeks (T1), and at 12 weeks (T2). Results: A significant effect from T0 to T1 (p = 0.0017) and from T0 to T2 (p = 0.0001) was found in the VEG. No significant differences were found over time in the VCG and in the NCG. Conclusion: An integrated postural exercise program might lead to a more balanced muscle efficiency inducing athletes to obtain a higher VJ performance.

Background: Research on biomechanics in rowing has mostly focused on the lumbar spine. However, injuries can also affect other body segments. Thus, the aim of this pilot study was to explore any potential variations in the kinematics of the cervical spine during two different stroke rates on the rowing ergometer in young rowers. Methods: Twelve young rowers of regional or national level were recruited for the study. The experimental protocol consisted of two separate test sessions (i.e., a sequence of 10 consecutive strokes for each test session) at different stroke rates (i.e., 20 and 30 strokes/min) on an indoor rowing ergometer. Kinematics of the cervical spine was assessed using an inertial sensor capable of measuring joint ROM (angle of flexion, angle of extension, total angle of flexion–extension). Results: Although there were no differences in the flexion and total flexion–extension movements between the test sessions, a significant increase in the extension movement was found at the highest stroke rate (p = 0.04, d = 0.66). Conclusion: Young rowers showed changes in cervical ROM according to stroke rate. The lower control of the head during the rowing stroke cycle can lead to a higher compensation resulting in an augmented effort, influencing sports performance, and increasing the risk of injury.

Digital media are widespread among school-age children, and their incorrect use may lead to an increase in sedentary levels and the consequences associated with it. There are still few studies that have investigated whether physical activity levels could be increased through their use. The aim of this study was to systematically review the scientific literature in order to identify whether digital strategies and technologies are capable of increasing the level of physical activity. A literature search was performed using the following databases: Pubmed, Scopus, and Web of Science. The main outcomes evaluated the increase in physical activity levels, the number of steps, and the reduction of sedentary behaviors. Two trained researchers independently assessed eligible studies against eligibility criteria, extracted data, and assessed the risk of bias. The Downs and Black checklist was used to assess the quality of the included studies. A total of 15 studies (1122 children) were included in this systematic review, with a mean age of 8.45 ± 0.70 years. Quality assessment of the studies observed a “moderate quality” of the included records. The results of this systematic review highlight that digital media can be applied as a way to improve the levels of physical activity in children to contrast a sedentary lifestyle. The main limitations of the study are the heterogeneity within the exercise protocols and the paucity of studies involving school-age children. More research is needed to confirm our findings also due to continuing technological progress.

Background Goalball is a Paralympic sport for visually impaired athletes. Although it is widely practiced, a great variety of tests are adopted to evaluate athletes' physical fitness. Therefore, the objective was to identify the physical fitness tests adopted in this sport to find the common aspects between them and, eventually, to propose a standard operating procedure. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adopted. The studies were extracted from PubMed, Web of Science, and Scopus. A selection process by title, abstract, and full-text, according to the inclusion and exclusion criteria, was performed. The results were discussed with narrative synthesis. Results A total of 7 papers and 222 participants were included. A wide variety of tests were adopted and the Brockport Physical Fitness Test (BPFT) was the only battery included to evaluate general athletes' well-being. Conclusions Although few literature exists on Goalball, the BPFT could be the battery for evaluating Goalball athletes though the test battery should be standardized to the characteristics of this sport., Public health; Quality of life; Disability; Physical activity; Aging and life course; Visually impaired people; Health-related evaluation; Standard operating procedure

Background: Congenital hypothyroidism (CH) is an endocrine disease with a precocious significant impairment of growth and neuromotor development. Thyroid hormones are essential for central nervous system development, maturation, and myelination. Furthermore, thyroid hormone deficiency affects the function of several systems, including the musculoskeletal system. The disease has a significant incidence in the general population (1:3000–1:2000 newborns in Italy). The aim of the present study was to evaluate any differences in upper and lower limb strength, body sway, and plantar loading distribution in children with CH compared to healthy children. Methods: In this study, the case group was composed of children with CH (CHG), while the control group included healthy children (CG). Both groups comprised 19 children (CHG: female = 12; CG: female = 9). The maximum isometric handgrip strength and explosive-elastic lower limb strength were assessed with the handgrip test and the Sargent test, respectively. The stabilometric and baropodometric analyses were used to measure the Center of Pressure displacements and the plantar loading distribution between feet, respectively. The differences between groups were analyzed by a univariate analysis of covariance using as covariates weight and height with the significant level set at < 0.05. Results: We found that CHG children were shorter and thinner than CG ones (p < 0.05). No significant difference in the upper and lower limb strength was found between groups. CHG exhibited a significant greater Sway Path Length (p < 0.01) and Ellipse Surface (p < 0.05) than CG. Moreover, CHG displayed an asymmetric plantar loading distribution with a significant lower percentage in the right than in the left foot (p < 0.05). Moreover, a significant lower plantar loading percentage in the right foot of CHG than in the right foot of CG was observed (p < 0.05). Conclusions: These findings seem to suggest that CH does not affect muscle strength in early treated children. However, these patients show poor postural control ability and asymmetric plantar loading distribution. Increasing the physical activity in these children could improve their body posture.

Previous research has reported that children with idiopathic short stature (ISS) showed functional and cognitive impairments. The purpose of this study was to compare muscle strength and body posture between children with ISS treated with growth hormone (GH) and healthy peers (healthy children, HC), and to analyze whether these parameters were affected by physical exercise. Eighteen children for the ISS group (mean age: 10.96 ± 1.68 years) and 26 children for the HC group (mean age: 10.19 ± 1.06 years) were recruited for the study. All participants performed the following assessments: handgrip and Sargent test for the muscle strength evaluation; baropodometric and stabilometric test for the posturographic measures. Data were analyzed with analysis of covariance (ANCOVA) using height and weight as covariate. Groups were then stratified into active and inactive and independent t-tests were used to determine differences between variables. Significance level was set to p < 0.05. Our results showed a significantly lower performance for both hands (p < 0.01) and a greater difference of plantar loading distribution between feet in the ISS compared to the HC groups (p < 0.01). In relation to physical exercise, the HC active group showed the highest handgrip strength values for both hands among the analyzed groups and, moreover, handgrip strength of both ISS active and inactive groups was significantly lower than corresponding CH peers for both hands. Although ISS and HC inactive groups reported an unequal plantar loading distribution between feet (p < 0.05), this asymmetry was not present in both ISS and HC active groups. We assume that GH therapy integrated with physical exercise in young patients with ISS could be suggested to increase muscle strength and body posture improving their quality of life.

This prospective cohort study aimed to evaluate whether COVID-19 lockdown caused biological, psychological, and/or physical performance variations in footballers. We compared the 2018/2019 and 2019/2020 seasons evaluating the plasma volume, hematological parameters, iron/ferritin, creatine kinase, vitamin D, cortisol, testosterone, and physiological state of players of the Italian football major league (Serie A). Measurements were performed before the preparatory period (T0), at the beginning (T1) and in the middle (T2) of the championship, and in March (T3) and at the end of season (T4). The results showed that in the 2019/2020 season affected by the lockdown, the weight, BMI, and fat mass percentage were higher than in the previous season. Hematocrit, hemoglobin, red blood cells, and ferritin decreased during both seasons, more significantly than in the regular season. During both seasons, creatine kinase increased from T2 whilst iron concentrations decreased in T3. Testosterone increased in both seasons from T0 to T3 and returned to initial levels at T4; cortisol increased in T2 and T3 during the 2018/2019 season but not during the COVID-19 season. Physical performance tests revealed differences associated with lockdown. Thus, although from a medical point of view, none of the evaluated changes between the two seasons were clinically relevant, training at home during lockdown did not allow the players to maintain the jumping power levels typical of a competitive period.

Background: In contact sports, such as martial arts, protection from oral injuries is generally recommended. Several authors have focused on the effects of wearing such oral protective gear on sports performances and, in particular, occlusal devices. Although many studies have shown improvements in athletic performance, especially in maximal isometric strength, to date there is still no consensus on the issue. Objectives: The aim of our study was to evaluate differences in isometric handgrip before and after the application of an occlusal splint (OS) in martial arts athletes. Methods: A repeated measures within-subjects design was adopted for the study. Twenty-five young martial arts athletes, specifically of taekwondo (n = 9), ju-jitsu (n = 10) and karate (n = 6), were enrolled in order to study the effects on handgrip peak force while wearing an occlusal splint under two different handgrip test conditions (OS: with occlusal splint vs. NO OS: without occlusal splint), testing both dominant and non-dominant hands. Results: For the dominant hand, comparisons showed a significant increase in handgrip strength under the OS condition (P = 0.01), whereas no significant differences were found for the non-dominant hand for the whole sample. The differences between the OS and NO OS conditions for the dominant hand were present in taekwondo (+8.33%), ju-jitsu (+1.05%) and karate (+2.97%). However, Bonferroni post hoc test showed statistical significance (P = 0.04) only for the taekwondo group. Conclusions: The benefits found with the occlusal splint were statistically significant only during dominant-hand handgrip tasks. Therefore, realignment of the temporomandibular joint (TMJ) via occlusal splints could play a significant role in increasing handgrip peak force only for the dominant hand.

Air pollution is a major problem worldwide, which could be even more serious for athletes who train in urban environments. Exercise increases minute ventilation and exposure to pollutants, but the literature on the effects of air pollution in athletes is relatively scarce, with the exception of chlorine exposure in athletes of aquatic sports and air pollution secondary to ice resurfacing in athletes performing in ice arenas. Although air pollution may exert detrimental effects on athletic performance, little has been published on this topic. The largest body of information regards the impact of air pollution during urban active transport, i.e., walking and cycling in cities, due to the potential risk of air pollution in citizens and the need to rethink urban transportation strategies accordingly. In healthy subjects, the benefits of physical activity largely outweigh the disadvantages of exposure to air pollutants. In susceptible individuals, however, such as patients with cardiac or respiratory disease and children, detrimental effects have been demonstrated. Improvement in air quality, individual protective behaviors, and prompt communication to the population of dangerous air quality may help to limit the negative effects of air pollution on respiratory health.

This pilot study aims to investigate if specific training protocol can improve the quality of life in people with multiple sclerosis through the improvement of some impaired ability like the balance. We enrolled in our project 20 subjects (age: 34,88 ± 4,45; height: 168,25 ± 8,66 cm; weight: 72,31 ± 17,28 kg) but only 5 completed the study. A proprioceptive training was administered for 12 weeks, 2 times a week, an hour for each session. At the beginning (T0) and at the end of the study (T1), static and dynamic balance parameters were tested. Statistical analyzes were performed using IBM SPSS Statistics 22.Changes in balance and strength between T0, T1 were evaluated using t Student test for paired data. Pearson linear correlation coefficient was used to investigate the correlations between all parameters analyzed. As regards static baropodometry, there was a statistic significant different between left forefoot load (T0 54,25 ± 2,5 % and T1 59,5± 1,73%; P

Introduction Falls are the leading cause of injury-related mortality and morbidity in the elderly. Physical activity plays a key role in the prevention of falls and stimulates postural control. The aim of this study was to compare a general physical activity program for the elderly with a Pilates program to evaluate the effects on balance and on reducing the risk of falling. Materials and methods Forty-six subjects were enrolled in this study, but only 41 were included in the study. The subjects were divided into 2 groups: Pilates group (P-G) and a group following a nonspecific program of physical activity (Pa-G). Each subject underwent the hand grip test, Berg balance scale test, and posturographic analysis. Results Spearman correlation coefficient showed correlations between the following parameters: BBS versus hand grip test (r = 0.68); BBS versus ellipse surface area (r = -0.75). There were significant differences between groups after the exercise program: both groups showed an improvement in performance but the P-G recorded significantly better results than the Pa-G. Discussion and conclusions This study confirmed that physical activity improves both balance and strength. However, our data show that Pilates has a greater effect on these physical abilities than a general physical activity program.

High-level young athletes need to face a wide spectrum of stressors on their journey to élite categories. The aims of the present study are (i) to evaluate session rate of perceived exertion (sRPE) at different training impulse (TRIMP) categories and the correlations between these two variables and, (ii) evaluate the correlations between sRPE, fluid loss, and carbohydrate consumption during exercise. Data on Edward’s TRIMP, sRPE, body mass loss pre- and post- exercise (∆), and carbohydrate consumption (CHO/h) during exercise have been acquired from eight male junior cyclists during a competitive season. One-way ANOVA and correlation analysis with linear regression have been performed on acquired data. sRPE resulted in a significant difference in the three TRIMP categories (p &lt, 0.001). sRPE resulted in being very largely positively associated with TRIMP values (p &lt, 0.001, R = 0.71). ∆ as well as CHO/h was largely negatively related with sRPE in all TRIMP categories (p &lt, 0.001). The results confirmed the role of fluid balance and carbohydrate consumption on the perception of fatigue and fatigue accumulation dynamics independently from the training load. Young athletes’ training load monitoring and nutritional-hydration support represent important aspects in athlete’s exercise-induced fatigue management.

Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling. The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region. Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear −60 ± 21 dB; Left ear −61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination. A linear regression analysis has shown a regression coefficient (R2) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation. Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls.

Relationships between heart rate recovery after exercise (HRR, baseline heart rate variability measures (HRV), and time to perform a 10Km running trial (t10Km) were evaluated in "master" athletes of endurance to assess whether the measured indexes may be useful for monitoring the training status of the athletes. Ten “master” athletes of endurance, aged 40-60 years, were recruited. After baseline measures of HRV, the athletes performed a graded maximal test on treadmill and HRR was measured at 1 and 2 minutes from recovery. Subsequently they performed a 10Km running trial and t10Km was related to HRV and HRR indexes. The time to perform a 10Km running trial was significantly correlated with baseline HRV indexes. No correlation was found between t10Km and HRR. Baseline HRV measures, but not HRR, were significantly correlated with the time of performance on 10km running in “master” athletes. The enhanced parasympathetic function at rest appears to be a condition to a better performance on 10km running. HRV can be simple and useful measurements for monitoring the training stratus of athletes and their physical condition in proximity of a competition.

We previously reported that responsiveness to methacholine (Mch) in the absence of deep inspiration (DI) decreased in healthy subjects after a short course of exercise training. We assessed whether a similar beneficial effect of exercise on airway responsiveness could occur in asthmatics. Nine patients (male/female: 3/6; mean age ± SD: 24 ± 2 yr) with mild untreated asthma [forced expiratory volume in 1 s (FEV1): 100 ± 7.4% pred; FEV1/vital capacity (VC): 90 ± 6.5%] underwent a series of single-dose Mch bronchoprovocations in the absence of DI in the course of a 10-wk training rowing program (6 h/wk of submaximal and maximal exercise), at baseline ( week 0), and at week 5 and 10. The single-dose Mch was established as the dose able to induce ≥15% reduction in inspiratory vital capacity (IVC) and was administered to each subject at every challenge occasion. Five asthmatics (male/female: 1/4; mean age ± SD: 26 ± 3 yr) with similar baseline lung function (FEV1: 102 ± 7.0% predicted; FEV1/VC: 83 ± 6.0%; P = 0.57 and P = 0.06, respectively) not participating in the exercise training program served as controls. In the trained group, the Mch-induced reduction in IVC from baseline was 22 ± 10% at week 0, 13 ± 11% at week 5 ( P = 0.03), and 11 ± 8% at week 10 ( P = 0.028). The Mch-induced reduction in FEV1 did not change with exercise ( P = 0.69). The reduction in responsiveness induced by exercise was of the same magnitude of that previously obtained in healthy subjects (50% with respect to pretraining). Conversely, Mch-induced reduction in IVC in controls remained unchanged after 10 wk (%reduction IVC at baseline: 21 ± 20%; after 10 wk: 29 ± 14%; P = 0.28). This study indicates that a short course of physical training is capable of reducing airway responsiveness in mild asthmatics.

Background: Performing complex motor skills, such as the ones performed by karate athletes, requires a great sense of balance. Because the posturo-kinetic performance seems to be improved by sport practice, especially by sports involving a lot of posturokinetic activities, the aim of this review was to critically analyse the scientific literature in order to appraise whether any positive correlation between karate and improved postural control is scientifically supported. Material/Methods: The online search engines Scirus and Medline were used for generating the data. A comprehensive literature search was conducted based on the following keywords: “karate”, “postural control” and “body sway”. Results were collected and filtered manually. Results: Four articles were identified related to karate practice and postural control, covering a period between 1998 and 2009. Although different experimental approaches were used to investigate this concept, overall the results of these studies confirm the effectiveness of karate in improving postural control. Conclusions: Practicing karate seems to elicit long term improvements in postural control. However, a much deeper approach to this fighting sport, which would take into account its technical specificities (e.g. kata & kumite), is required in order to increase our understanding of the posture-kinetic impact of this relatively unexplored sport activity.

Am J Physiol Regul Integr Comp Physiol. 2005 Nov;289(5):R1496-503. Epub 2005 Jul 14. Supramaximal exercise mobilizes hematopoietic progenitors and reticulocytes in athletes. Morici G, Zangla D, Santoro A, Pelosi E, Petrucci E, Gioia M, Bonanno A, Profita M, Bellia V, Testa U, Bonsignore MR. SourceDepartment of Experimental Medicine, University of Palermo, Italy. Abstract Marathon runners show increased circulating CD34+ cell counts and postexercise release of interleukin-6 (IL-6), granulocyte-colony stimulating factor (G-CSF) and flt3-ligand (Bonsignore MR, Morici G, Santoro A, Pegano M, Cascio L, Bonnano A, Abate P, Mirabella F, Profita M, Insalaco G, Gioia M, Vignola AM, Majolino I, Testa U, and Hogg JC. J Appl Physiol 93: 1691-1697, 2002). In the present study we hypothesized that supramaximal ("all-out") exercise may acutely affect circulating progenitors and reticulocytes and investigated possible mechanisms involved. Progenitor release was measured by flow cytometry (n = 20) and clonogenic assays (n = 6) in 20 young competitive rowers (13 M, 7 F, age +/- SD: 17.1 +/- 2.1 yr, peak O2 consumption: 56.5 +/- 11.4 ml.min(-1).kg(-1)) at rest and shortly after 1,000 m "all-out." Release of reticulocytes, cortisol, muscle enzymes, neutrophil elastase, and several cytokines/growth factors was measured. Supramaximal exercise doubled circulating CD34+ cells (rest: 7.6 +/- 3.0, all-out: 16.3 +/- 9.1 cells/mul, P < 0.001), and increased immature reticulocyte fractions; AC133+ cells doubled, suggesting release of angiogenetic precursors. Erythrocyte burst forming units and colony forming units for granulocytes-monocytes and all blood series increased postexercise by 3.4-, 5.5-, and 4.8-fold, respectively (P < 0.01 for all). All-out rowing acutely increased plasma cortisol, neutrophil elastase, flt3-ligand, hepatocyte growth factor, VEGF, and transforming growth factor-beta1, and decreased erythropoietin; K-ligand, stromal-derived factor-1, IL-6, and G-CSF were unchanged. Therefore, all-out exercise is a physiological stimulus for progenitor release in athletes. Release of reticulocytes and proangiogenetic cells and mediators suggests tissue hypoxia as possibly involved in progenitor mobilization. PMID:16020520[PubMed - indexed for MEDLINE]

In the last ten years, the effects of exercise on bronchial epithelial cells and inflammatory cells in the airways have been studied in detail, and such new information has been combined with previous knowledge on bronchial reactivity and asthma evoked by exercise in asthmatic patients and athletes. The resulting picture is very complex, and the potential clinical consequences are often contradictory, suggesting the opportunity to define different phenotypes of exercise-associated airway changes (Lee & Anderson, 1985; Haahtela et al., 2008; Moreira et al., 2011a). Studies in asthmatic athletes in the 90’ had began to explore the possibility that airway inflammation might be involved in exercise-associated respiratory symptoms. However, studies in non-asthmatic athletes also found increased number of inflammatory cells not only at rest, but also after strenuous endurance exercise (Bonsignore et al., 2001). It was therefore hypothesized that endurance exercise may physiologically cause influx of inflammatory cells into the airways, associated with low or absent inflammatory activation (Bonsignore et al., 2003a). Subsequent studies in athletes and animal models have extended these finding, but the mechanisms of inflammatory cell recruitment into the airways and the tight control of inflammatory activation physiologically associated with exercise remain poorly understood. Exercise is a known cause of bronchoconstriction in asthmatic patients (Cabral et al., 1999) and athletes (Parsons & Mastronarde, 2005). A large number of asthmatic elite athletes participate to international top-level competitions, and guidelines regarding management of asthmatic athletes (Fitch et al., 2008) and rules on the use of anti-asthmatic drugs have been issued (World Anti-Doping Agency, WADA, Oct. 18 2010 report). However, exercise is a powerful physiologic stimulus for bronchodilatation, and some reports underlined that exercise training may actually downmodulate bronchial reactivity in normal subjects (Scichilone et al., 2005, 2010), asthmatic children (Bonsignore et al., 2008) and animal models of asthma (Hewitt et al., 2010). This chapter will summarize the changes induced by acute exercise and training in bronchial reactivity and airway cells in both humans and animal models. It will also discuss the changing paradigm regarding the impact of physical activity in patients with bronchial asthma, and the new perspectives of exercise-based rehabilitation in patients with respiratory diseases such as chronic obstructive pulmonary disease (COPD).

J Appl Physiol. 2010 Aug;109(2):288-94. Epub 2010 Jun 10. Effects of exercise training on airway responsiveness and airway cells in healthy subjects. Scichilone N, Morici G, Zangla D, Chimenti L, Davì E, Reitano S, Paternò A, Santagata R, Togias A, Bellia V, Bonsignore MR. SourceDept. of Internal Medicine, Div. of Pulmonology (DIBIMIS Univ. of Palermo, "Villa Sofia-Cervello" Hospital, Via Trabucco 180, 90146 Palermo, Italy. n.scichilone@libero.it Abstract Airway responsiveness to methacholine (Mch) in the absence of deep inspirations (DIs) is lower in athletes compared with sedentary individuals. In this prospective study, we tested the hypothesis that a training exercise program reduces the bronchoconstrictive effect of Mch. Ten healthy sedentary subjects (M/F: 3/7; mean + or - SD age: 22 + or - 3 yr) entered a 10-wk indoor rowing exercise program on rowing ergometer and underwent Mch bronchoprovocation in the absence of DIs at baseline, at weeks 5 and 10, as well as 4-6 wk after the training program was completed. Exercise-induced changes on airway cells and markers of airway inflammation were also assessed by sputum induction and venous blood samples. Mean power output during the 1,000 m test was 169 + or - 49 W/stroke at baseline, 174 + or - 49 W/stroke at 5 wk, and 200 + or - 60 W/stroke at 10 wk of training (P < 0.05). The median Mch dose used at baseline was 50 mg/ml (range 25-75 mg/ml) and remained constant per study design. At the pretraining evaluation, the percent reduction in the primary outcome, the inspiratory vital capacity (IVC) after inhalation of Mch in the absence of DIs was 31 +/- 13%; at week 5, the Mch-induced reduction in IVC was 22 + or - 19%, P = 0.01, and it further decreased to 15 + or - 11% at week 10 (P = 0.0008). The percent fall in IVC 4-6 wk after the end of training was 15 + or - 11% (P = 0.87 vs. end of training). Changes in airway cells were not associated with changes in airway responsiveness. Our data show that a course of exercise training can attenuate airway responsiveness against Mch inhaled in the absence of DIs in healthy subjects and suggest that a sedentary lifestyle may favor development of airways hyperresponsiveness. Comment in J Appl Physiol. 2010 Aug;109(2):267-8. PMID:20538849[PubMed - in process]

Med Sci Sports Exerc. 2004 Oct;36(10):1723-9. Airway cell composition at rest and after an all-out test in competitive rowers. Morici G, Bonsignore MR, Zangla D, Riccobono L, Profita M, Bonanno A, Paternò A, Di Giorgi R, Mirabella F, Chimenti L, Benigno A, Vignola AM, Bellia V, Amato G, Bonsignore G. SourceDepartment of Experimental Medicine Italian National Research Council (CNR), Palermo, Italy. Abstract PURPOSES: This study was designed to assess: a) whether rowing affects airway cell composition, and b) the possible relationship between the degree of ventilation during exercise and airway cells. SUBJECTS AND METHODS: In nine young, nonasthmatic competitive rowers (mean age +/- SD: 16.2 +/- 1.0 yr), induced sputum samples were obtained at rest and shortly after an all-out rowing test over 1000 m (mean duration: 200 +/- 14 s), during which ventilatory and metabolic variables were recorded breath-by-breath (Cosmed K4b, Italy). RESULTS: At rest, induced sputum showed prevalence of neutrophils (60%) over macrophages (40%); after exercise, total cell and bronchial epithelial cell (BEC) counts tended to increase. In the last minute of exercise, mean VE was 158.0 +/- 41.5 L x min(-1), and VO2 x kg(-1) 62 +/- 11 mL x min(-1). Exercise VE correlated directly with postexercise total cell (Spearman rho: 0.75, P < 0.05) an dmacrophage (rho: 0.82, P < 0.05) counts. A similar trend was observed for exercise VE and changes in BEC counts from baseline to postexercise (rho: 0.64, P = 0.11). Exercise VE did not correlate with airway neutrophil counts at rest or after exercise. Expression of adhesion molecules by airway neutrophils, macrophages, and eosinophils decreased after the all-out test. CONCLUSION: Similar to endurance athletes, nonasthmatic competitive rowers showed increased neutrophils in induced sputum compared with values found in sedentary subjects. The trend toward increased BEC postexercise possibly reflected the effects of high airflows on airway epithelium. Airway macrophages postexercise were highest in rowers showing tile most intense exercise hyperpnea, suggesting early involvement of these cells during exercise. However, the low expression of adhesion molecules by all airway cell types suggests that intense short-lived exercise may be associated with a blunted response of airway cells in nonasthmatic well-trained rowers. PMID:15595293[PubMed - indexed for MEDLINE]