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Aim: There is limited evidence showing a relationship with age in the incidence of sudden cardiac arrest during exercise, which can be lethal at times., Methods: To examine the incidence by age group in sudden cardiac arrest, we prospectively observed cases of sudden cardiac arrest in full marathons certified by the Japan Association of Athletics Federations held between April 2011 and March 2019. Sudden cardiac arrest was defined as collapse during or 1 h after the race requiring chest compressions or the use of an automatic electrical defibrillation., Results: 4.1 million persons ran in 516 marathons. Of the participants, 78.6 % were men. By age group, 37.4 %, 34.7 %, 19.6 %, and 8.3 % belonged to the < 40 s, 40 s, 50 s, and ≥ 60 s groups, respectively. During the study period, 69 sudden cardiac arrests (1.7 per 100,000 participants, 95 % confidence interval [CI]: 1.3-2.1) were observed, of which 66 were men. The incidence per 100,000 runners of sudden cardiac arrest was 0.9 (95 % CI: 0.4, 1.4), 0.9 (95 % CI: 0.4, 1.4), 2.6 (95 % CI: 1.5, 3.8), and 5.5 (95 % CI: 2.9, 8.2) for those in their under 40 s, 40 s, 50 s, and over 60 s, respectively, with higher rates for older age groups. Compared to men, the cases of SCA among women were less common (only three cases), and the incidence did not differ by age group., Conclusions: Men, unlike women, had a higher incidence of sudden cardiac arrest during marathons according to age. Identification of this high-risk population could be important information in encouraging marathoners pre-participation self-screening., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: All branches of the U.S. Military have a running component of their physical readiness testing battery. Running-related musculoskeletal injuries affect 20 to 40% of DoD Service Members each year. Running form has not historically been addressed with military running-related injuries. To assess the utility of a structured gait retaining protocol designed to treat the onset of running-related pain and/or injury by correcting identified biomechanical risk factors for injury and improve clinical outcomes., Study Design: Case series., Materials and Methods: A total of 160 Active Duty Service Members (ADSMs) with running-related lower-body musculoskeletal injuries were referred by a physical therapist for a multisession gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike). Run with CLASS utilized various drills to emphasize impact progression, proximal strengthening, and proprioception and spatial awareness., Results: Results revealed that the implemented gait retraining protocol significantly improved running parameters following lower-body injury as evidenced by increased cadence, improved functional assessment scores, and a marked transition from predominantly heel strike to forefoot strike patterns during running., Conclusions: A 3-week supervised gait retraining program focused on the gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike) was successful in altering biomechanics of self-selected running gait by increasing cadence and transitioning ADSMs to a forefoot foot strike. Additionally, ADSMs reported significant improvements on the self-reported functional scores on the University of Wisconsin Running Injury and Recovery Index and Single Assessment Numerical Evaluation., Level of Evidence: 4., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

The association between built environment and physical activity has been recognized. However, how and to what extent microscale streetscapes are related to running activity remains underexplored, partly due to the lack of running data in large urban areas. Moreover, few studies have examined the interactive effects of macroscale built environment and microscale streetscapes. This study examines the main and interactive effects of the two-level environments on running intensity, using 9.73 million fitness tracker data from Keep in Shanghai, China. Results of spatial error model showed that: 1) the explanatory power of microscale streetscapes was higher than that of macroscale built environment with R 2 of 0.245 and 0.240, respectively, which is different from the prior finding that R 2 is greater for macroscale built environment than for microscale streetscape; 2) sky and green view indexes were positively associated with running intensity, whereas visual crowdedness had a negative effect; 3) there were negative interactions of land use Herfindahl-Hirschman index with sky and green view indexes, while a positive interaction was observed for visual crowdedness. To conclude, greener, more open and less visually crowded streetscapes, can promote running behavior and enhance the benefits of land use mix as well. The findings highlight the importance of streetscapes in promoting running behavior, instead of a supplement to macroscale built environment., (© 2024. The Author(s).)

Background: Long-distance runs with equipment are practised in military training establishments to develop physical stamina and prepare for battles. A study was planned to quantify and compare the physiological and mental workloads of the early and late finishers of a military endurance run through the jungle terrain of north-eastern India in hot and humid conditions., Methods: Twenty-five soldiers of the Indian Army completed a 15 km run through a rural and jungle track with 6.5 kg of equipment. Twelve participants who finished the race before 130 min were categorised as 'early finishers', and 13 were categorised as 'late finishers' who finished the race after 130 min. Physiological parameters, viz., heart rate (HR), breathing rate (BR), estimated core temperature (ECT), peak acceleration (PAC), and physiological intensity (PHYI) and mechanical intensity (MECHI) were recorded using BioHarness V.3 (Zephyr Technologies, USA) and NASA Task Load Index scores were obtained to assess mental workload. Mann-Whitney U test was applied to assess the level of significance at a p value of <0.05., Results: HR, ECT and PAC were significantly higher (167.9 and 156.0 beats/min, 39.0℃ and 38.4℃, and 1.1 and 1.0 g, respectively) for the first group compared with the second group. The second group expressed higher BR and subjective responses ('total scores' were 76.5 and 82.5, respectively) than the first. The PHYI was significantly higher (from 7.2 to 6.3) for the first group, whereas the MECHI was similar in both groups., Conclusion: The successful completion by the first group can be attributed to their motivation to continue heavy work in an adverse environment, and their ability to negotiate with natural obstacles was reflected through controlled subjective responses. Adoption of a possible safe and stable approach to the same task might have led the second group to take a longer duration, exert higher mental effort and demand lower physiological cost., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Context: Bone-stress injury (BSI) is common in collegiate athletes. Injury rates and health care use in running athletes are not well documented., Objective: To describe the rate and classification of injury and associated health care use in collegiate cross-country runners with BSI., Design: Descriptive epidemiology study., Setting: Sports medicine facilities participating in the Pac-12 Health Analytics Program., Patients or Other Participants: Pac-12 Conference collegiate cross-country athletes., Main Outcome Measure(s): Counts of injury and health care resources used for each injury. Injury rates were calculated based on athlete-seasons., Results: A total of 168 BSIs were reported over 4 seasons from 80 team-seasons (34 men's and 46 women's team-seasons) and 1220 athlete-seasons, resulting in 1764 athletic training services and 117 physician encounters. Bone-stress injuries represented 20% of all injuries reported by cross-country athletes. The average BSI rate was 0.14 per athlete-season. Injury rates were higher in female (0.16) than male (0.10) athletes and higher in the 2019-2020 season (0.20) than the 2020-2021 (0.14), 2018-2019 (0.12), and 2021-2022 (0.10) seasons. Most BSIs occurred in the lower leg (23.8%) and the foot (23.8%). The majority of injuries were classified as overuse and time loss (72.6%) and accounted for most of the athletic training services (75.3%) and physician encounters (72.6%). We found a mean of 10.89 athletic training services per overuse and time-loss injury and 12.20 athletic training services per overuse and non-time-loss injury. Mean occurrence was lower for physician encounters (0.70), prescription medications (0.04), tests (0.75), procedures (0.01), and surgery (0.02) than for athletic training services (10.50)., Conclusions: Bone-stress injuries are common in collegiate cross-country runners and require considerable athletic training resources. Athletic trainers should be appropriately staffed for this population, and suspected BSIs should be confirmed with a medical diagnosis. Future investigators should track treatment codes associated with BSI to determine best-practice patterns., (© by the National Athletic Trainers' Association, Inc.)

Introduction: Anterior cruciate ligament (ACL) rupture is frequently encountered in athletes as well as in military personnel. In civilian population, many studies have looked at the return to sport, but return to duty in Army is a topic that requires further research.The purpose of this study was to determine through annual military fitness tests in real conditions, the return to sport in soldiers after ACL reconstruction and factors influencing failure., Materials and Methods: This was a retrospective comparative study. Patients were all soldiers and had followed up in a Military Hospital. The SUCCESS group was military personnel who obtained a result of the specific aptitude test greater than or equal to this same test carried out before reconstruction of the ACL, the FAILURE group comprised the others. Results of the annual specific aerobic fitness tests were collected before and after ACL reconstruction. Preoperative epidemiological data, intraoperative information, and isokinetic test results were collected., Results: One hundred forty four soldiers were included between January 2011 and December 2017 (94.9% of men with a median age of 27.6 years); 40.3% obtained a result greater than or equal to the preoperative fitness test after ACL reconstruction. Among the soldiers who did not regain their performance, 24.3% were declared unfit or discharged. In the FAILURE group, we found patients with a higher body mass index (25.5 vs. 24.4; P = .04), less patients with isokinetic deficit < 30% on the knee flexors and extensors (26.6% vs. 62.9%; P < .01), more long sick leave (39.5% vs. 13.7%; P < .01), and late resumption of military activities (10.5 vs. 8.9 months; P < .01)., Conclusion: Rupture of ACL has a significant impact on the operational capacity of the French army. The proportion of return to the same level in annual specific fitness tests after ACL reconstruction is 40% among soldiers. Several variables are important to consider in the follow-up of these patients to optimize their recovery of sports performance and therefore their operational capacity., (© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Current methods of small animal exercise involve either voluntary (wheel running) or forced (treadmill running) protocols. Although commonly used, each have several drawbacks which cause hesitancy to adopt these methods. While mice will instinctively run on a wheel, the distance and time spent running can vary widely. Forced exercise, while controllable, puts animals in stressful environments in which they are confined and often shocked for "encouragement." Additionally, both methods require expensive equipment and software, which limit these experiments to well-funded laboratories. To counter these issues, we developed a non-invasive mouse running device aimed to reduce handler-induced stress, provide time- and distance-based stopping conditions, and enable investigators with limited resources to easily produce and use the device. The Lockable Open-Source Training-Wheel (LOST-Wheel) was designed to be 3D printed on any standard entry-level printer and assembled using a few common tools for around 20 USD. It features an on-board screen and is capable of tracking distances, running time, and velocities of mice. The LOST-Wheel overcomes the largest drawback to voluntary exercise, which is the inability to control when and how long mice run, using a servo driven mechanism that locks and unlocks the running surface according to the protocol of the investigator. While the LOST-Wheel can be used without a computer connection, we designed an accompanying application to provide scientists with additional analyses. The LOST-Wheel Logger, an R-based application, displays milestones and plots on a user-friendly dashboard. Using the LOST-Wheel, we implemented a timed running experiment that showed distance-dependent decreases in serum myostatin as well as IL-6 gene upregulation in muscle. To make this device accessible, we are releasing the designs, application, and manual in an open-source format. The implementation of the LOST-Wheel and future iterations will improve upon existing murine exercise equipment and research., Competing Interests: The authors have declared that no competing interests exist.

As a key modulator of training adaptations and racing performance, nutrition plays a critical role in endurance runners' success, and the training/racing behaviors of runners are potentially affected by their diet types. The present study aimed to investigate whether distance runners with a vegan diet (i.e., devoid of foods or ingredients from animal sources), vegetarian diet (i.e., devoid of meat and flesh foods), and omnivorous diet (i.e., a mixed diet with no restriction on food sources) have different training and racing patterns in general and based on race distance subgroups. A total of 3835 recreational runners completed an online survey. Runners were assigned to dietary (omnivorous, vegetarian, and vegan) and race distance (<21 km, half-marathon, and marathon/ultra-marathon) groups. In addition to sociodemographic information, a complete profile of data sets focusing on running and racing behaviors/patterns was evaluated using a questionnaire-based epidemiological approach. There were 1272 omnivores (47% females), 598 vegetarians (64% females), and 994 vegans (65% females). Compared to vegans and vegetarians, omnivorous runners prepared for a longer time period for running events, had a higher number of half-marathons and marathons completed with a better finish time, and had more reliance on training under supervision ( p < 0.05). The present findings indicate an important association of diet types with patterns of training and racing amongst endurance runners that may be related to different motives of omnivorous, vegetarian, and vegan runners for participating in events.

Nutrient deficiency is a common cause of underperformance in endurance athletes, and supplement intake is frequently considered compensatory for vegan and vegetarian athletes specifically. This study aimed to investigate the patterns of supplement intake among vegan, vegetarian, and omnivorous distance (>10 km) runners and its association with age, sex, and race distance. From a total of 317 runners who participated in an online survey, 220 distance runners (mean age: 38.5 years; mean BMI: 21.75 kg/m 2 ) were selected for the final sample after data clearance and assigned to 100 omnivores, 40 vegetarians, or 80 vegans. Sociodemographic information, racing experience, and patterns of supplement intake, including type, frequency, dosage, etc., were collected using a questionnaire. Macronutrient intake was assessed using a food frequency questionnaire. ANOVA and logistic regression were used for data analysis. The prevalence of supplement intake was 51% for total runners and 72% among vegan runners. Age, sex, and race distance had no significant effect on the type of supplement intake ( p > 0.05). Compared to omnivores and vegetarians, vegan runners reported consuming more vitamin (but not carbohydrate/protein or mineral) supplements ( p < 0.05). Vitamin B 12 , magnesium, and multivitamin had the most prevalent use amongst micronutrient supplements. This study points to a central role for supplementary nutritional strategies in different groups of distance runners. The present findings may help future investigations by design to identify specific requirements of endurance runners when adhering to specific kinds of diet particularly plant-based diets.

Background: The Wet-Bulb Globe Temperature (WBGT) index is a common tool to screen for heat stress for sporting events. However, the index has a number of limitations. Rational indices, such as the physiological equivalent temperature (PET) and Universal Thermal Climate Index (UTCI), are potential alternatives., Aim: To identify the thermal index that best predicts ambulance-required assistances and collapses during a city half marathon., Methods: Eight years (2010-2017) of meteorological and ambulance transport data, including medical records, from Gothenburg's half-marathon were used to analyse associations between WBGT, PET and UTCI and the rates of ambulance-required assistances and collapses. All associations were evaluated by Monte-Carlo simulations and leave-one-out-cross-validation., Results: The PET index showed the strongest correlation with both the rate of ambulance-required assistances (R 2 =0.72, p=0.008) and collapses (R 2 =0.71, p=0.008), followed by the UTCI (R 2 =0.64, p=0.017; R 2 =0.64, p=0.017) whereas the WBGT index showed substantially poorer correlations (R 2 =0.56, p=0.031; R 2 =0.56, p=0.033). PET stages of stress, match the rates of collapses better that the WBGT flag colour warning. Compared with the PET, the WBGT underestimates heat stress, especially at high radiant heat load. The rate of collapses increases with increasing heat stress; large increase from the day before the race seems to have an impact of the rate of collapses., Conclusion: We contend that the PET is a better predictor of collapses during a half marathon than the WBGT. We call for further investigation of PET as a screening tool alongside WBGT., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To determine if running biomechanics and bone mineral density (BMD) were independently associated with bone stress injury (BSI) in a cohort of National Collegiate Athletic Association Division I cross country runners., Methods: This was a prospective, observational study of 54 healthy collegiate cross country runners over three consecutive seasons. Whole body kinematics, ground reaction forces (GRFs) and BMD measures were collected during the preseason over 3 years via motion capture on an instrumented treadmill and total body densitometer scans. All medically diagnosed BSIs up to 12 months following preseason data collection were recorded. Generalised estimating equations were used to identify independent risk factors of BSI., Results: Univariably, step rate, centre of mass vertical excursion, peak vertical GRF and vertical GRF impulse were associated with BSI incidence. After adjusting for history of BSI and sex in a multivariable model, a higher step rate was independently associated with a decreased risk of BSI. BSI risk decreased by 5% (relative risk (RR): 0.95; 95% CI 0.91 to 0.98) with each one step/min increase in step rate. BMD z-score was not a statistically significant risk predictor in the final multivariable model (RR: 0.93, 95% CI 0.85 to 1.03). No other biomechanical variables were found to be associated with BSI risk., Conclusion: Low step rate is an important risk factor for BSI among collegiate cross country runners and should be considered when developing comprehensive programmes to mitigate BSI risk in distance runners., Competing Interests: Competing interests: SAK is currently an associate editor for BJSM., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To investigate the proportion of individuals who practice running, its temporal trend, and to describe the runners' characteristics., Design: Population-based repeated cross-sectional study., Methods: The data from the Protective and Risk Factors for Chronic Diseases by Telephone Survey (Vigitel) from Brazil were used. Telephone interviews were conducted with adults from the Brazilian capitals (27 cities) between 2006-2017. The interviewer read the questions and recorded the participants' responses immediately in a questionnaire. Data analyses were conducted using a Bayesian approach., Results: The Vigitel database consisted of 625,460 Brazilian participants composed of 295,681 exercisers and within them 15,529 runners. The mean yearly proportion of runners was about 2.45% (95% Bayesian credible interval [CrI] 1.93 to 3.11) and 5.32% (95%CrI 4.29 to 6.54) in the entire study population and within exercisers, respectively. The absolute increase in the proportion of runners per year over the 12-year period was 0.13% and 0.17% in the entire study population and within exercisers, respectively. Runners were more likely to be younger, men, within normal body mass index, highly educated, moderate alcohol drinkers, non-smokers, less exposed to TV, living near physical activity/sports facilities and less exposed to health conditions such as arterial hypertension, diabetes and dyslipidaemia., Conclusion: There was a 95% probability that the yearly proportion of runners lies between 1.93% and 3.11% in the population of the 27 Brazilian capitals, and between 4.29% and 6.54% within exercisers. There has been an increase in the proportion of runners over time. Runners were associated with healthier characteristics compared to non-runners and non-exercisers., (Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Abstract: Running is a popular form of exercise that is easily accessible to various populations; endurance running, defined as distances beyond 5 km, continues to grow within the sport. Endurance running-related injuries are common in the lower extremities and are primarily overuse related. A multitude of risk factors for injury exist, including extrinsic factors, such as running distance and frequency, and intrinsic factors, such as biomechanics and nutrition status. Training and rehabilitation techniques vary with a general focus on strengthening and gradual increase in activity, but evidence is mixed, and it is difficult to generalize programs across different running populations. Management of specific running groups, including youth runners, is an area in which additional research is needed. New treatments, such as orthobiologics and wearable technology, have promising potential to optimize performance and recovery and minimize injury. However, they need to be further evaluated with high-quality studies., (Copyright © 2021 by the American College of Sports Medicine.)

Objectives: To determine predictors for return to previous level of sports after anterior cruciate ligament reconstruction (ACLR)., Design: Cross-sectional; SETTING: Athletic teams., Participants: Ninety-one athletes who had ACLR with hamstring-tendon autograft within 1-5 years participated in this study. Athletes indicated their sport participation levels, injury profile, rehabilitation duration, and time to start sport-related activities (running, cutting-pivoting) after ACLR. Athletes answered whether they returned to the same previous level of frequency, duration, and intensity of sports., Main Outcome Measures: Athletes' characteristics, injury and surgical factors, duration of post-operative rehabilitation program, and time to start sport-related activities after ACLR were evaluated by univariate logistic regression to determine predictors for return to previous level of sports., Results: Nine athletes (10%) returned to their self-described previous level of sports. Predictors for returning to previous level of sports were rehabilitation duration >4 months (OR:6.78; p = .011), time to start running ≤4 months (OR:8.62; p = .047) and cutting-pivoting <6 months after surgery (OR:5.02; p = .030)., Conclusion: Longer post-operative rehabilitation duration and time to start sport-related activities after ACLR predicted return to previous level of sports. Spending adequate time in post-operative rehabilitation program and time-based resumption of sports-related activities after ACLR might be key factors for returning to previous sports level., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The aims of this study were to: (1) identify the representative external load profile of match-play in Spanish professional soccer players by principal components analysis (PCA), and (2) analyse the effect of match location (home vs away), match outcome (win vs draw vs loss) and length of the microcycle (5 vs 6 vs 7 vs 8 vs 9 days) on the external load profile. Data were collected during one season consisting of 42 matches in LaLiga 123 and 11 external load variables were selected after the PCA. TD, total distance covered; DIS 0-6 : distance from 0 to 6 km/h; DIS 21-24 : distance from 21 to 24 km/h; HSRD: high-speed running distance above 21 km/h; HSRA: total of high-speed running actions above 21 km/h; V MAX : maximum speed in km/h; Sprints: total of actions above 24 km/h; ACC: total of accelerations; ACC G-avg : average accelerometer G-force; ACC MAX : maximum acceleration (m/s2); DEC MAX : maximum deceleration (m/s 2 ). Match location had an impact on HSRD ( p  < 0.01; ES = 0.05), DIS 0-6 ( p  < 0.01; ES = 0.05), and ACC MAX ( p  < 0.01; ES = 0.05). Match outcome had a relation to TD ( p  < 0.01; ES = 0.05), DIS 0-6 ( p  < 0.01; ES = 0.05) and HSRD ( p  < 0.01; ES = 0.05). Length of the microcycle had an impact on TD ( p  < 0.01; ES = 0.05), DIS 0-6 ( p  < 0.01; ES = 0.11), ACC ( p  < 0.01; ES = 0.04) and V MAX ( p  < 0.01; ES = 0.04). This study provides coaches a selection of variables for match-play analysis, which could represent two-thirds of external load profile. Then, professionals should consider that these contextual variables could have an impact on the external load profile.

Background: The use of analgesics is prevalent in runners, with an associated potential for serious harm. More information is needed regarding runners' practices and the factors that may influence their use of analgesics, to identify potential sources of misuse or abuse., Objectives: To describe South Africa (SA)-based runners' practices regarding use of analgesics, focusing on the types used, sources of information, and factors predicting use., Methods: This study had a descriptive, cross-sectional design. SA-based runners aged ≥18 years, who had run at least one race during the year preceding the study, were included. Participants were recruited via social media and SA running clubs. They completed an online survey that included demographic information, training and competition history, and analgesic usage practices., Results: Data from 332 participants (196 females, 136 males) were analysed. There was a high rate of analgesic use (64%), with 17% of users reporting concomitant use of more than one type of analgesic. The highest rate of analgesic use was after a run (80%). Non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently used analgesics before (71%), during (50%) and after a run (74%). Importantly, NSAIDs and a combination NSAID-containing analgesic were the most common analgesics used concomitantly (19%). Most participants (90%) used over-the-counter analgesics, 41% of them receiving no input from any health professional. Sustaining a running-related injury increased the likelihood of analgesic use almost three-fold (Exp(B)=2.6; 95% confidence interval 1.59 - 2.41; p=0.0001)., Conclusions: A large percentage of runners in our study displayed unsafe practices regarding analgesic use during training and competition, predominantly for perceived injury management. Importantly, the lack of education and recommendations regarding analgesics from health professionals is very concerning, as there is a risk of potentially life-threatening analgesic-induced adverse effects, especially as a high percentage were using two NSAIDs concomitantly. Knowledge of these practices, gained through this study, could allow for the development and implementation of corrective strategies to promote education and safe practice of analgesic use in runners.

Purpose: This study aimed to determine how the speed-distance relationship, described by critical speed (CS) and distance prime (D'), is altered with aging., Methods: Official race data from the past eight World Masters Athletics Indoor Track and Field World Championships were used for this study. CS and D' were calculated for female and male athletes (35-90 yr of age) who registered times for the 800-, 1500-, and 3000-m runs during a single championship to determine the relationship between age and CS and D'. Twenty-six athletes completed sufficient races in multiple championships to retrospectively assess the change in CS and D' over time., Results: Cross-sectional data indicated that CS continuously decreases after age 35 yr in a curvilinear manner with advancing age (R2 = 0.73, P < 0.001, n = 187), with even greater decreases in CS occurring after ~70 yr of age. D' also changed in a curvilinear manner with age (R2 = 0.45, P < 0.001, n = 103), such that decreases were observed between 35 and 70 yr, followed by an increase in D' thereafter. Retrospective, longitudinal data, with an average follow-up of 6.38 ± 1.73 yr, support these findings, indicating that the annual decrease in CS grows with advancing age (e.g., ~1% vs ~3% annual decrease in CS at age 55 vs 80 yr, respectively) and that D' shifts from an annual decrease (e.g., ~2.5% annual decrease at 55 yr) to an annual increase (e.g., ~2.5% annual increase at 80 yr) around 70 yr of age. Importantly, the relationship between CS and race pace was unaffected by age, supporting the relevance of CS throughout aging., Conclusion: Even among world-class athletes, CS decreases and D' changes with aging. These adaptations may contribute to the diminished exercise ability associated with aging., (Copyright © 2020 by the American College of Sports Medicine.)

Recently, we proposed the hypothesis that weekly running volume and preferred running pace may play a role in preserving ankle joint kinetics in middle-age runners as ankle joint kinetics were generally similar in young and middle-aged runners with similar running volume and preferred pace. To further address this hypothesis, we compared lower extremity joint kinetics between high and low training volume runners in both young and middle-aged groups. Joint kinetics calculated from 3D kinematic and ground reaction force data during over-ground running at 2.7 m·s -1 from young and middle-aged runners who ran low or high weekly volume were analyzed. A two-factor analysis of variance was used to compare joint kinetics between age and running volume groups. Positive hip work was greater in middle-aged compared to young runners (P = .005). Plantarflexor torque (P = .009) and positive ankle work (P = .042) were greater in young compared to middle-aged runners. Positive ankle work was also greater in the high compared to the low volume group (P = .021). Finally, age by volume interactions were found for knee extensor torque (P = .024), negative knee work (P = .018), and positive knee work (P = .019) but not for ankle and hip joint kinetics. These findings suggest less distal-to-proximal difference in positive joint work with high running volume in both young and middle-aged runners as a result of greater power generation at the ankle. Given the age main effects, our findings are also the first to suggest the age-related distal-to-proximal shift in joint kinetics appears in middle-aged runners., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The purpose of this study was to cross-sectionally estimate the prevalence of recreational running in Portugal and describe characteristics of adult recreational runners. A random representative sample of 1068 Portuguese adults was selected. Socio-demographic information, physical activity habits and running behavior were assessed. Recreational runners' training habits, motivations, barriers, vitality and flow were also assessed. The prevalence of recreational running in Portugal was 10.6%. It was higher in men (14.6% vs. 6.6%, p = .024) and in younger runners (13.6% vs. 7.7%, p = .026). Participants ran on average 3 times, 20 kilometers and 3 hours per week. General health orientation (88%), self-esteem (63%), and life meaning (57%) were the most predominant motives for running, while time was the most prevalent barrier (43%). This first Portuguese running prevalence representative study, indicates that almost 11% of adults ran regularly, and describes correlates of running, which can inform future running promotion interventions., Competing Interests: The authors have declared that no competing interests exist.

Background and objectives : The COVID-19 outbreak has become a major health and economic crisis. The World Health Organization declared it a pandemic in March 2020, and many sporting events were canceled. Materials and Methods : We examined the effects of the COVID-19 pandemic on endurance and ultra-endurance running (UER) and analyzed finishes and events during the COVID-19 pandemic (observation period March 2020-October 2020) to the same time period pre-COVID-19 outbreak (March 2019-October 2019). Results: Endurance finishes decreased during the pandemic (459,029 to 42,656 (male: 277,493 to 25,582; female 181,536 to 17,074; all p < 0.001). Similarly, the numbers of endurance events decreased (213 vs. 61 events; p < 0.001). Average marathon finishing times decreased during the pandemic in men (5:18:03 ± 0:16:34 vs. 4:43:08 ± 0:25:08 h:min:s ( p = 0.006)) and women (5:39:32 ± 0:19:29 vs. 5:14:29 ± 0:26:36 h:min:s ( p = 0.02)). In UER, finishes decreased significantly (580,289 to 110,055; p < 0.001) as did events (5839 to 1791; p < 0.001). Popular event locations in United States, France, UK, and Germany decreased significantly ( p < 0.05). All distance and time-limited UER events saw significant decreases ( p < 0.05). Conclusions : The COVID-19 pandemic has had a significant effect on endurance and UER, and it is unlikely that running activities return to pre-pandemic levels any time soon. Mitigation strategies and safety protocols should be established.

The aim of the present study was to examine the number of finishers and performance trends in 10 km, half-marathon and marathon races in Oslo. Data (total 115,725 finishers; women, n = 50,595; men, n = 65,130) from 10 km, half-marathon and marathon races in Oslo from 2008 to 2018 were analysed considering number, sex, age and running speed of finishers. The total men-to-women ratio was the smallest in the 10 km race (0.60) and the largest in the marathon (3.86) ( p < 0.01, φ = 0.28). In both women and men, the slowest running speed was shown in the older age groups ( p < 0.01). Based on the findings of the present study, it was concluded that relatively more women finished a 10 km and less a half-marathon and a marathon. Our results indicated that the sex difference in performance was attenuated in the longer race distances and older age groups.

Objectives: Back squat mean concentric velocity (MV) and countermovement jump (CMJ) performance were examined in sub-elite rugby league players post-match to monitor changes in neuromuscular status (NMS) from baseline. Relationships between changes in back squat MV and CMJ performance variables were used to compare back squat MV to an established method to monitor NMS., Design: Longitudinal observational design., Methods: 18 male sub-elite rugby league players (mean±SD, 20.5±2.4 yr; 180.0±6.7cm; 93.3±11.2kg) performed 3 repetitions of CMJ and back squat with an individualised, pre-determined load at -2h (baseline), +30min, +24h, and +48h in relation to a match. Back squat MV, CMJ height, CMJ peak power, and CMJ peak velocity were measured with a linear position transducer., Results: Significant (p<0.05), small to large decreases (ES=0.52-1.24) were observed in back squat MV up to +48h post-match. Significant (p<0.05), small to moderate decreases (ES=0.52-0.70) in CMJ height were also observed up to +24h post-match, returning to baseline at +48h. CMJ peak power and peak velocity post-match changes were not significant compared to baseline (p>0.05). Significant positive correlations were found between changes in back squat MV and CMJ height at +30min (r=0.59; p=0.009) and +48h (r=0.51; p=0.03)., Conclusions: These findings suggest back squat MV may be a suitable alternative or addition to CMJ testing for monitoring NMS in rugby league players., (Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objective: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in endurance running and by elite athletes. We examined the pattern of use of NSAIDs, the purpose of use and knowledge of the adverse effects of NSAID use in a population of recreational runners at Parkrun UK., Methods: An online observational non-interventional cross-sectional survey of Parkrun UK participants being over the age of 18, on Parkrun UK's mailing list, and residing in the UK., Key Findings: Runners (n = 806) had a high use of NSAIDs in the past 12 months (87.8%). The average age of respondents was 48.39 years. There was a significant association between those taking an oral NSAID in the last twelve months and those with a sporting injury (χ 2  = 10.89, df = 1, n = 797, P = 0.001). Ibuprofen was the most commonly used NSAID (81.1%). A third of runners had experienced an adverse drug reaction associated with NSAIDs, usually gastrointestinal. Half of runners used NSAIDs with no advice, and patient information leaflets were the most common source for those that had advice. Ninety-four per cent of runners would like more information on the harms and benefits of NSAIDs., Conclusions: Some recreational runners have a high use of NSAIDs, which is chronic in nature and a potential health risk. Recreational runners want more information on the harms and benefits of NSAIDs. Race event organizers should provide evidence-based advice on the use of NSAIDs., (© 2020 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.)

Introduction: The 1.5-mile best-effort run is used in the British Army to assess the fitness of all recruits and trained service personnel by means of the physical fitness assessment (PFA). The 1.5-mile run is a basic measure of fitness and slower times have been associated with an increased risk of musculoskeletal injury (MSkI), particularly during this early stage of training. The aim of this study was to establish whether 1.5-mile run times were associated with subsequent MSkIs among female recruits during their 14-week basic training., Method: Retrospective data were analysed from female recruits who had undertaken basic military training between June 2016 and October 2017. This included retrieving the results of their week 1 PFA; recording the type, cause and week of MSkI if they had sustained one; and noting down their outcome from basic training. Run times were statistically analysed in relation to MSkI occurrence of 227 female recruits using binomial logistic regression with an accepted alpha level of p value <0.05., Results: 1.5-mile run time predicted risk of MSkI (χ 2 (1)=12.91, p<0.0005) in female recruits. The mean run time for injury-free recruits was faster than for injured recruits (12 min 13 s compared with 12 min 43 s). Every 10 s increase in run time was associated with an 8.3% increase in risk of injury., Conclusion: Slower 1.5-mile best-effort run time, as a surrogate of aerobic fitness, is associated with increased risk of MSkI in female recruits during basic training., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The top 10 athletes in the International Association of Athletic Federations in 100-m and 400-m ranking for each sex were assessed for their history of race times before achieving their personal record (PR). The main goal of this study was to create a new method for optimal performance improvement rate assessment for coaches and athletes aiming the World Record., Methods: The difference between PR ('current' season) and the best race time in the last season was defined as the first season improvement rate (1-SIR), whereas the average improvement rate in the last and preceding seasons was the multi-season improvement rate (M-SIR). 1-SIR and M-SIR were calculated for each athlete., Results: The sex comparison for the 100 m event showed a significant difference in the M-SIR in favor of women. No statistical differences were identified for the 400 m event, with a trivial effect in both 1-SIR and M-SIR., Conclusions: As a practical applicability, graph plots were designed to help verifying the improvement rate of athletes and to evaluate whether a long-term training strategy induced an acceptable performance improvement or whether some adjustments needed and check within the plots if the improvement rate is within the average of the top-10 athletes of their event.

Our primary aim was to explore the development of player load throughout match time (i.e., the pattern) using moving 5-min windows in an elite soccer team and our secondary aim was to compare player load patterns between different positions within the same team. The dataset included domestic home matches (n = 34) over three seasons for a Norwegian Elite League team. Player movements (mean ± SD age 25.5 ± 4.2 years, height 183.6 ± 6.6 cm, body mass 78.9 ± 7.4 kg) were recorded at 20 Hz using body-worn sensors. Data for each variable (player load, player load per meter, total distance, accelerations, decelerations, sprint distance, high-intensity running distance) were averaged within positions in each match, converted to z-scores and averaged across all matches, yielding one time series for each variable for each position. Pattern similarity between positions was assessed with cross-correlations. Overall, we observed a distinct pattern in player load throughout match time, which also occurred in the majority of individual matches. The pattern shows peaks at regular intervals (~15 min), each followed by a period of lower load, declining until the next peak. The same pattern was evident in player load per meter. The cross-correlation analyses support the visual evidence, with correlations ranging 0.88-0.97 (p < .001) in all position pairs. In contrast, no specific patterns were discernible in total distance, accelerations, decelerations, sprint distance and high-intensity running distance, with cross-correlations ranging 0.65-0.89 (p < .001), 0.32-0.64 (p < .005), 0.18-0.65 (p < .005 in nine position pairs), 0.02-0.38 (p < .05 in three pairs) and 0.01-0.52 (p < .05 in three pairs), respectively. This study demonstrated similarity in player load patterns between both matches and positions in elite soccer competition, which could indicate a physical "pacing pattern" employed by the team., Competing Interests: The commercial affiliation (Rosenborg FC) does not alter our adherence to all PLOS ONE policies on sharing data and materials by including the following statement: "This does not alter our adherence to PLOS ONE policies on sharing data and materials.”

Working as a team with patients who are also recreational runners and managing a running school in the City of Mostar had made us thinking on how recreational running affects the mental health in individuals. Previous literature is pretty old dated, so we found this even more interesting. We have wondered why there is no more recent literature on this subject. So, while working on this mini review and discussing on this subjects we came up with an idea on a research about self esteem and life quality of individuals pre and post running school experience. Previous studies show that consistent running results in a number of positive psychological changes among diverse populations. In a study of Kenneth E.C. ordinary nonprofessional runners were surveyed about the psychological aspects of running. Many of the respondents had started running to improve their health, and almost all noted mental and emotional benefits including relief of tension, improved self-image, and better mood. Considering therapeutic effects of running Greist et al. define running as not expensive, and unlike sorne other treatments, it has beneficiai physical side effects. Their results compare favorably with those of patients in psychotherapy and have persisted for at !east one year in follow-up. Taking in mind all of the previously published research it can be concluded that running can be a therapeutic tool for a sereies of negative psychological conditions, such ass depression, anxieta, tension, mood changes, low self esteem etc. Although, these research are a few decades old there is still no recipe or dosage for running, especially in the area of physical ilness prevention. There is much to research and to be discovered in this field.

The aim of this novel research was to compare the amount of systematic training and the different training activities undertaken by elite-standard long-distance runners during their first seven years of systematic training. Participants were divided into three performance groups: world-class Kenyans ( N  = 19), European-standard Spanish athletes ( N  = 18), and Spanish national-standard athletes ( N  = 18). Performance and training data were obtained for two-year periods using retrospective recall (including training diaries) from the time the athletes began systematic training, until the seventh year after. These activities included high-intensity training sessions considered deliberate practice (DP) and easy runs. There was no evidence that starting systematic training at a younger age was advantageous, and easy runs (a non-DP activity) were the most used by participants as a proportion of overall running distance. As part of an overall higher accumulation of distance run ( P  < 0.001, d  ≥ 1.35), the Kenyans completed more tempo runs and short-interval training than the other groups ( P  < 0.001, d  ≥ 1.38), but did not complete more long intervals or races. There were few differences between the European- and national-standard athletes except for easy runs, which highlights the value of these easy runs but also the need for higher-intensity training to compete with world-class performers. When planning for training overload and progression, long-distance running coaches should consider increasing the volume of tempo runs and short intervals, in addition to easier runs that develop cardiovascular conditioning.

Abstract Even pacing within the marathon has been associated with faster marathon performance times, however, little literature has investigated the association between pacing ability during a marathon and a recreational marathoner's training characteristics and previous experiences. N  = 139 participants completed an online questionnaire concerning training history in relation to a 2017 marathon and previous long-distance running experiences. Online databases were used to collect split times of the participants after successfully completing a 2017 marathon, identifying the percentage slowdown in pace between the first half and second half of the marathon, used for correlational analyses. The strongest correlates for pacing ability were marathon finishing time and previous distance race personal best finishing times (i.e. marathon, half-marathon, 10 and 5 km). There were many weaker, however significant correlates for training history characteristics and previous long-distance running experience. The current findings demonstrate that greater accrued long-distance running experiences and higher weekly training volumes are strongly associated with smaller declines in pace during the second half of the marathon in comparison to the first half and less variability in pace during the marathon.

Though there are exhaustive data about participation, performance trends, and sex differences in performance in different running disciplines and races, no study has analyzed these trends in stair climbing and tower running. The aim of the present study was therefore to investigate these trends in tower running. The data, consisting of 28,203 observations from 24,007 climbers between 2014 and 2019, were analyzed. The effects of sex and age, together with the tower characteristics (i.e., stairs and floors), were examined through a multivariable statistical model with random effects on intercept, at climber's level, accounting for repeated measurements. Men were faster than women in each age group ( p < 0.001 for ages ≤69 years, p = 0.003 for ages > 69 years), and the difference in performance stayed around 0.20 km/h, with a minimum of 0.17 at the oldest age. However, women were able to outperform men in specific situations: (i) in smaller buildings (<600 stairs), for ages between 30 and 59 years and >69 years; (ii) in higher buildings (>2200 stairs), for age groups <20 years and 60-69 years; and (iii) in buildings with 1600-2200 stairs, for ages >69 years. In summary, men were faster than women in this specific running discipline; however, women were able to outperform men in very specific situations (i.e., specific age groups and specific numbers of stairs).

Introduction: Triathlon is one of the fastest growing sports in the United Kingdom. However, in recent years several deaths have occurred. The intention of this study is to identify these cases and examine the role cardiovascular disease played in these deaths., Methods: An extensive online search was performed to identify triathlon-related deaths (TRDs) in the United Kingdom and UK citizens who died during or as a result of competing in triathlons abroad. British Triathlon provided the number of participants who took part in UK-based events. Coroners provided information on all those who died., Results: Between 2009 and 2015, 991,186 participants took part in British Triathlon-sanctioned events. Five TRDs in the United Kingdom were identified. The mortality rate was 0.5 per 100,000 participants. Deaths occurred during or after the swim (3), cycle (1), and run (1) events. During the same period, 5 TRDs were identified among UK citizens competing abroad. These deaths occurred during or after the swim (2), cycle (1), and run (2) events. Cardiovascular pathology was cited as a cause or contributing factor in half of the fatalities. Four deaths were referred to a specialist cardiac pathology service for autopsy., Conclusions: Cardiovascular disease was found to be the most common cause of TRD. Further research is needed to determine the underlying cardiac pathology that triggers TRDs. With this information it may be possible to develop screening tools that can prevent similar fatalities from occurring in the future., (Copyright © 2019. Published by Elsevier Inc.)

Fitzgerald, CF and Jensen, RL. A Comparison of the National Football League's annual National Football League combine 1999-2000 to 2015-2016. J Strength Cond Res 34(3): 771-781, 2020-The purpose of this study was to determine if elite football players are becoming bigger, faster, and stronger over the past decade by analyzing individual performances at the National Football League's (NFL) Combine. This study was conducted with (N = 1,263) subjects from the 1999-2000 (99-00) NFL Combines (n = 635) and the 2015-2016 (15-16) NFL Combines (n = 628) separated by position. Data were collected for height, body mass, 40-yd (36.58 m) dash, NFL 225 lb. (102.06 kg) repetitions test, vertical jump (VJ), broad jump (BJ), pro-agility shuttle, and 3-cone drill. Statistical significance between the years for all subjects participating in the NFL Combine was found for the 40-yd dash (99-00: mean ± SD = 4.85 ± 3.2; 15-16: 4.80 ± 3.5; p = 0.002) and VJ (99-00 = 82.04 ± 10.36 and 83.46 ± 10.59; p = 0.028) at the alpha p < 0.05 level. Statistical significance was also found for BJ (99-00 = 111.37 ± 8.81; 15-16: 115.03 ± 9.22; p < 0.001) and the 3-cone drill (99-00 = 7.41 ± 0.42; 15-16: 7.29 ± 4.1; p < 0.001) at the alpha p < 0.001 level. There were no statistically significant findings (p > 0.05) for mass or height found across all subjects by combine years. Results indicate that elite football players have improved their performance, when comparing results from 1999-2000 to 2015-2016. These finding may be beneficial to NFL franchises in their prospective player assessments.

Knowledge of spatial movement patterns in soccer occurring on a regular basis can give a soccer coach, analyst or reporter insights in the playing style or tactics of a group of players or team. Furthermore, it can support a coach to better prepare for a soccer match by analysing (trained) movement patterns of both his own as well as opponent players. We explore the use of the Qualitative Trajectory Calculus (QTC), a spatiotemporal qualitative calculus describing the relative movement between objects, for spatial movement pattern recognition of players movements in soccer. The proposed method allows for the recognition of spatial movement patterns that occur on different parts of the field and/or at different spatial scales. Furthermore, the Levenshtein distance metric supports the recognition of similar movements that occur at different speeds and enables the comparison of movements that have different temporal lengths. We first present the basics of the calculus, and subsequently illustrate its applicability with a real soccer case. To that end, we present a situation where a user chooses the movements of two players during 20 seconds of a real soccer match of a 2016-2017 professional soccer competition as a reference fragment. Following a pattern matching procedure, we describe all other fragments with QTC and calculate their distance with the QTC representation of the reference fragment. The top-k most similar fragments of the same match are presented and validated by means of a duo-trio test. The analyses show the potential of QTC for spatial movement pattern recognition in soccer., Competing Interests: The authors have declared that no competing interests exist.

Nikolaidis, PT and Knechtle, B. Do fast older runners pace differently from fast younger runners in the "New York City Marathon"? J Strength Cond Res 33(12): 3423-3430, 2019-Although pacing strategies in the marathon and generally in endurance running have been well studied with regard to the effects of age group and performance level, little is known for their interaction. Thus, the aim of this was to examine whether fast runners of different age differ for pacing. Finishers (women, n = 117,595; men, n = 180,487) in the "New York City" Marathon between 2006 and 2016 were analyzed in 5-year age groups. To examine the effect of performance, we created performance groups according to quartiles of average race speed (Q1-the fastest, Q2, Q3, and Q4-the slowest). A large main effect of split on race speed was observed in women and men with the fastest speed in the 5-10-km split and the slowest in the 35-40-km. Compared with the other performance groups, the slowest group had the largest percentage decrease in speed at 5, 10, 15, and 20 km but the largest percentage increase in speed at 35 and 40 km. The fastest group had the least decrease during the race and the least increase at 40 km. A trivial split × age group interaction on race speed was observed for all performance groups in both sexes. This interaction was more pronounced in Q4. Based on these findings, coaches should advise their slow master runners to adopt age-tailored pacing strategy, whereas their fast master runners should adopt similar pacing as the younger fast runners.

Background: Information about how much time adults spend cycling, walking and running can be used for planning and evaluating initiatives for active, healthy societies. The objectives of this study were to describe how much time adult Copenhageners cycle, walk, run, stand and spend sedentary using accelerometers, and to describe differences between population groups., Methods: In the fifth examination of the Copenhagen City Heart Study, 2335 individuals gave consent to wear accelerometers (skin-attached; right thigh and iliac crest; 24 h/day, 7 consecutive days) of which 1670 fulfilled our inclusion criteria (≥16 h/day for ≥5 days; median wear time: 23.8 h/day). Daily time spent cycling, walking, running, standing and sedentary was derived from accelerometer-based data using the Acti4 software, and differences between sex, age groups, level of education and BMI were investigated using Kruskal-Wallis rank sum tests., Results: Among those cycling (61%), the median cycling time was 8.3 min/day. The median time walking, running, standing and sedentary was 82.6, 0.1, 182.5 and 579.1 min/day, respectively. About 88% walked fast (i.e., ≥100 steps/min) ≥30 min/day. The shortest duration and lowest prevalence of cycling, walking and running were found among older individuals, those with a low level of education, and individuals being overweight or obese., Conclusions: We found a long duration and high prevalence of cycling and walking, but also that many adult Copenhageners spent much time sedentary. Population groups with low participation in physical activities such as cycling and walking should be targeted in future initiatives towards an active, healthy society.

Background: Pre-race determinants influencing performance and finishing of one of the largest transcontinental multistage ultramarathons were investigated., Methods: Forty-four participants of the TransEurope FootRace 2009 (TEFR), running 4486 km in 64 stages (average 70.1 km daily) were analyzed regarding training and running history. This included years of regular endurance running (PRY), number of finished marathons, ultramarathons (UM) and multistage ultramarathons (MSUM), pre-race records (PRR) for marathon and specific UM races and the extent of pre-race training (PRT) in the last year before TEFR: volume (km/week), duration (h/week) and intensity (km/h)., Results: Mean total running speed during TEFR was 8.25 km/h.Seventy-one percent of subjects finished the race. The mean PRT-volume extends 5500 km. Finishers and non-finishers of the TEFR did not show significant difference in any tested pre-race determinants. There was no association between PRY, number of finished marathons, UM, and MSUM and TEFR performance. There was very strong positive correlation between PRT-intensity and TEFR performance. PRT volume correlated with a medium effect size to TEFR performance. PRR in specific ultra-races (6-hour, 50-km, 100-km races) showed a high correlation to TEFR performance. Performance in ultramarathon correlates inversely with age., Conclusions: Like in other endurance disciplines with shorter distances, in ultra-long multistage endurance running the athletes also need a stage-specific pre-race experience, training and adaptation if he wants to end up with a good performance. But dropping out of a MSUM seems not to be consistent with regard to specific pre-race experience. Further research results of TEFR project may reveal potential risk factors for non-finishing a transcontinental footrace.

BackgroundIn the Netherlands, obstacle, mud and survival runs are increasingly popular. Although outbreaks of gastroenteritis have been reported following these events, associated health risks have not been systematically assessed.AimTo investigate the incidence of acute gastrointestinal infections (AGI), skin infections (SI) and respiratory infections (RI) among obstacle run participants, as well as risk factors.MethodsBetween April and October 2017, we conducted a retrospective cohort study among 2,900 participants of 17 obstacle runs in the Netherlands. Demographic, symptomatic and behavioural data were collected from participants via an online questionnaire 1 week after participation in an obstacle run. Stool specimens were obtained from respondents for microbiological tests. Adjusted relative risks (aRR) and 95% confidence intervals (CI) using multilevel binomial regression analysis were calculated.ResultsOf 2,646 respondents (median age: 33 years; 53% male), 76 had AGI after the obstacle run; ingesting mud was associated with AGI (aRR: 1.7; 95% CI: 1.2-4.9) and 38 respondents had AGI during or in the week before the obstacle run. Overall, 103 respondents reported SI and 163 RI. Rinsing off in a hot tub was associated with SI (aRR: 2.2; 95% CI: 1.7-2.8). Of 111 stool specimens, 13 tested positive for six different pathogens. No clusters were found.ConclusionThe reported incidence of AGI, SI and RI was low. Risk of these infections could be decreased by informing participants on preventive measures, e.g. showering vs rinsing in the hot tub, avoiding ingesting mud and not participating with symptoms of AGI.

Objectives: We examined the overall association as well as the dose-response relationship between leisure-time running and incident type 2 diabetes., Methods: Participants were 19,347 adults aged 18-100 years who were free of cardiovascular disease, cancer, and diabetes at baseline, and who received at least 2 extensive preventive medical examinations between 1974 and 2006. Running and other types of aerobic physical activity were assessed by self-reported leisure-time activities. Type 2 diabetes was defined as fasting glucose ≥126 mg/dL (7.0 mmol/L), physician diagnosis, or insulin use., Results: During an average follow-up of 6.5 years, 1015 adults developed type 2 diabetes. Approximately 29.5% of adults participated in leisure-time running at baseline. Runners had a 28% (hazard ratio [HR] 0.72; 95% confidence interval [CI], 0.62-0.84) lower risk of developing type 2 diabetes compared with nonrunners during follow-up. The HRs (95% CIs) of type 2 diabetes were 0.98 (0.75-1.28), 0.69 (0.51-0.92), 0.62 (0.45-0.85), 0.78 (0.59-1.04), and 0.57 (0.42-0.79) across quintiles of running time (minutes/week) compared with nonrunners after adjusting for potential confounders, including levels of nonrunning aerobic physical activity. Similar dose-response relationships between running distance (miles/week), frequency (times/week), total amount (MET-minutes/week), and speed (mph) were also observed., Conclusions: Participating in leisure-time running is associated with a lower risk of developing type 2 diabetes in adults. Consistent linear dose-response relationships were observed between various running parameters and incident type 2 diabetes, supporting the prescription of running to prevent type 2 diabetes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Black, GM, Gabbett, TJ, Naughton, G, Cole, MH, Johnston, RD, and Dawson, B. The influence of contextual factors on running performance in female Australian football match-play. J Strength Cond Res 33(9): 2488-2495, 2019-Given the recent growth of the professional status among multiple female football codes, the aim of this study is to investigate the effects of contextual factors on activity profiles and pacing strategies in female Australian football (AF) players. Thirty-five female AF players participated in this study. Global positioning system analysis was completed over 1 competitive season. Matches were separated into eight 10-minute periods. Greater distances were covered during the first half irrespective of playing position (effect size [ES] = 0.39-0.50, Likelihood ≥90%). Throughout a number of periods half-backs (defensive players) covered greater distances during losses (ES ≥ 0.74, Likelihood ≥92%) and against top 3 opponents (ES ≥ 1.0, Likelihood ≥97%). Midfielders and half-backs covered greater distances (ES ≥ 0.49, Likelihood ≥89%) in the final match period in winning compared with losing matches. A reduction in player work rate is evident during the second half of matches. The influence of contextual factors varied across positional groups. However, it is clear that coaches could use player rotation both early in the match in an attempt to delay the effect of fatigue and more frequently during the second half to increase running intensity.

"A Mile in Her Shoes" is a volunteer-led charity which provides running groups for homeless women. The objective of this study was to explore the experiences of homeless women attending these running groups and to establish how participation in a supported running group impacted their lives. This exploratory qualitative study was carried out across two sites in London UK during February and April 2017. All regular attenders of the running groups were invited to participate in the study; subsequently, a self-selected sample of 11 women consented to being interviewed. Data were collected by female interviewers on a one-to-one basis, steered by a semi-structured topic guide. All interviews were digitally recorded, transcribed verbatim, and analysed using thematic analysis. Themes were cross-referenced by the research team and findings were supported by direct quotes. Five main themes emerged from the findings: the positive impact of the charity; homeless women's motivations and barriers to participating in running groups; the benefits of participating on physical and mental health; the importance and value of social support from the group; and the value of being provided with quality running kit. This study concludes that volunteer-led running groups are valued by homeless women by helping them take control of their health. It provides insight into their engagement in physical activity, thus potentially helping prevent injury or illness, and aiding recovery and rehabilitation. One implication of this study is that gathering homeless women's views helps to steer how community-based physical activity programmes can benefit their wellbeing. However, this small-scale study may have limited generalisability, with the topic warranting further research., (© 2019 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.)

Schneider, AL, Nikolaidis, PT, and Knechtle, B. Improved performance in master runners competing in the European championships between 1978 and 2014. J Strength Cond Res 33(9): 2559-2569, 2019-The performance trends in elite runners have been well investigated, but we have no knowledge about performance trends and the difference between the sexes in elderly runners competing at a high level in varying distances. The purpose of this study was to investigate the performance of these age groups. Data from 17 European Championships held between 1978 and 2014 were analyzed for various race distances (i.e., 100, 200, 400, 800, 1,500, 5,000, 10,000 m, and marathon). Running speed for the top 8 female and male finalists for each age group (35-99 years, split into 5-year gaps) and each race distance were included. A 2-way analysis of variance compared the effects of sex, race distance, age group and calendar year on speed. Subsequent comparisons between race distances, age groups, or calendar years were performed using a post hoc Bonferroni's test. Our analysis shows that men were faster than women in all distances, and the difference between the sexes was greater in the shorter distances. Speed was higher for shorter distances than for longer distances. Younger participants were faster than older ones, and the effect of age group was the largest for the 200 m. There was a minor effect of calendar year on speed in the 100, 20, 1,500, 10,000 m and marathon, and a minor calendar year × sex interaction on running speed was shown for the 200 m. For athletes and coaches, the current study demonstrates that both male and female athletes improved their running performance over time and that the sex gap may have reached its limit.

Background: Physical inactivity is associated with chronic disease and premature death, but excessive exercise can also lead to injury. Ultramarathon running is popular among adults but has not been assessed in children. To analyze ultramarathon participation in children and to determine if they continue running ultramarathons into adulthood provide some evidence of associated health risks., Methods: Race results databases were used to identify ultramarathon finishers under the age of 19 between 1960-2017. Participation trends across calendar years, age groups and different race distances were analyzed and continued participation into adulthood examined., Results: A total of 7775 finishes by 5418 individual children were recorded worldwide with an increase in ultramarathon finishers over time (P<0.0001), with the greatest number among older age groups (>16 years) and the 50 and 100 km race distances. Less than 25% of childhood ultramarathon runners continued running ultramarathons into adulthood and approximately 12% continued beyond 20 years., Conclusions: Childhood participants has been growing exponentially over the last 20 years. While few of those children continue to complete ultramarathons into adulthood, the finding that some have continued well into adulthood suggests there is no obligate serious adverse physical impairment resulting from childhood ultramarathon participation.

Terrorist incidents that target hospitals magnify morbidity and mortality. Before a real or perceived terrorist mass casualty incident threatens a hospital and its providers, it is essential to have protocols in place to minimize damage to the infrastructure, morbidity, and mortality. In the years following the Boston Marathon bombings, much has been written about the heroic efforts of survivors and responders. Far less has been published about near misses due to lack of experience responding to a mass casualty incident resulting from terrorism. After an extensive review of the medical literature and published media in English, Spanish, and Hebrew, we were unable to identify a similar event. To the best of our knowledge, this is the first reported experience of a bomb threat caused evacuation of an emergency department in the United States while actively responding to multiple casualty terrorist incidents. We summarized the chronology of the events that led to a bomb threat being identified and the subsequent evacuation of the emergency department. We then reviewed the problematic nature of our response and described evidence-based policy changes based on data from health care, law enforcement, and counterterrorism. (Disaster Med Public Health Preparedness. 2019;13:791-798).

In this study, we propose a novel three-criteria performance score to semiquantitatively classify the running style, the degree of involvement and compliance and the validity of electric shock count for rats exercising on a treadmill. Each score criterion has several style-marks that are based on the observational registry of male Sprague-Dawley rats running for 4-7 weeks. Each mark was given a score value that was averaged throughout a session-registry and resulting in a session score for each criterion, ranging from "0" score for a hypothetical "worst runner", to score "1" for a hypothetical "perfect runner" rat. We found significant differences throughout a training program, thus providing evidence of sufficient sensitivity of this score to reflect the individual evolution of performance improvement in exercise capacity due to training. We hypothesize that this score could be correlated with other physiological or metabolic parameters, thus refining research results and further helping researchers to reduce the number of experimental subjects., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Breaking the sub-2-h marathon in an official event has attracted growing interest in recent times with commercial and international momentum building. Here it is shown that predicting how likely and when the sub-2-h barrier will be broken are statistically coupled considerations., Methods: Using a nonlinear limiting exponential model and calculating prediction intervals, a statistical timetable for the sub-2-h event is produced over a range of likelihoods., Results: At the benchmark odds level (1 in 10, or 10% likely), the expected sub-2-h arrival time is found to be May 2032. By estimating the model for male and female world record progressions, I find that limiting marathon times for males and females (at 1 in 10) are 1 h 58 min 5 s and 2 h 5 min 31 s, respectively. These times equate to a performance gap of 2.9% and 8.6%, respectively. The male estimate has remarkable similarity (~7 s) to Joyner's 1991 limiting human physiological estimate. Finally, I provide an estimate of the equivalent "sub-2-h" threshold for females and argue that a threshold of 130 min ("sub-130") could be an appropriate choice., Conclusion: The study is the first to address all three related aspects of world record marathon performance (sub-2 h, limits, gender equivalence) in a single, unified modeling framework and provides many avenues for further exploration and insight.

Clark, KP, Rieger, RH, Bruno, RF, and Stearne, DJ. The NFL combine 40-yard dash: how important is maximum velocity? J Strength Cond Res 33(6): 1542-1550, 2019-This investigation analyzed the sprint velocity profiles for athletes who completed the 40-yard (36.6 m) dash at the 2016 National Football League (NFL) Combine. The purpose was to evaluate the relationship between maximum velocity and sprint performance, and to compare acceleration patterns for fast and slow athletes. Using freely available online sources, data were collected for body mass and sprint performance (36.6 m time with split intervals at 9.1 and 18.3 m). For each athlete, split times were used to generate modeled curves of distance vs. time, velocity vs. time, and velocity vs. distance using a monoexponential equation. Model parameters were used to quantify acceleration patterns as the ratio of maximum velocity to maximum acceleration (vmax/amax, or τ). Linear regression was used to evaluate the relationship between maximum velocity and sprint performance for the entire sample. In addition, athletes were categorized into fast and slow groups based on maximum velocity, with independent t-tests and effect size statistics used to evaluate between-group differences in sprint performance and acceleration patterns. Results indicated that maximum velocity was strongly correlated with sprint performance across 9.1, 18.3, and 36.6 m (r of 0.72, 0.83, and 0.94, respectively). However, both fast and slow groups accelerated in a similar pattern relative to maximum velocity (τ = 0.768 ± 0.068 seconds for the fast group and τ = 0.773 ± 0.070 seconds for the slow group). We conclude that maximum velocity is of critical importance to 36.6 m time, and inclusion of more maximum velocity training may be warranted for athletes preparing for the NFL Combine.

Introduction: Excessive physical exercise may evolve into physical exercise addiction, a recently identified entity with many yet unclear aspects, such as global prevalence and variability according to different types of physical exercise., Methods: We systematically reviewed the current literature up to June 2018 to collect all studies screening exercise addiction with two of the most frequently used screening scales: the Exercise Addiction Inventory (EAI) and the Exercise Dependence Scale (EDS)., Results: We detected forty-eight studies (20 using the EAI, 26 the EDS, and 2 both scales) reporting variable point prevalence of exercise addiction risk, depending on the target population and the investigated sport. The EAI identifies a higher proportion of people at risk for physical exercise addiction among endurance athletes (14,2%) followed by ball games (10,4%), fitness centre attendees (8,2%) and power disciplines (6,4%), while a frequency of 3,0% was reported in the general population. Studies using the EDS found discrepant results., Discussion: This systematic review suggests that sport disciplines are associated with different vulnerability for physical exercise addiction. Besides the different addictive potential of each sport, the heterogeneity of results may be also due to socio-demographic and cultural characteristics of the target populations. The EAI and the EDS identify different proportions of individuals at risk for exercise addiction both in general population and in specific sport categories. As the EAI screens a higher proportion of subjects at risk, especially in endurance disciplines, it could be more appropriate for early detection of at-risk subjects and/or disciplines., Conclusion: Tailored prevention strategies for each discipline could help better preserving benefits of sports. More precision in research methods and the use of the most appropriate scale are required to allow a better comparability of prevalence among physical exercise disciplines and in general population., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background and Aims: This study examines exercise addiction (EA) in amateur runners from a multidimensional approach, including demographics (age, sex, educational attainment, and financial situation), training factors (duration of running activity, weekly time spent running, mean workout distance per session, other sports activities, and childhood physical activity), psychological features (perceived health, life satisfaction, loneliness, stress, anxiety, depression, body shape, and eating disorders), and anthropometrics (body mass index) that might predict EA., Methods: The well-validated Exercise Dependence Scale (EDS) was applied to evaluate the prevalence of EA in amateur runners. A multinomial logistic regression was performed to find explanatory variables of risk of EA using the SPSS 24.0 statistical software., Results: A total of 257 runners (48.9% females, M age  = 40.49, SD  = 8.99 years) with at least 2 years running activity participated in an anonymous questionnaire survey. About 53.6% of respondents were characterized as non-dependent symptomatic and 37.8% as non-dependent asymptomatic. About 8.6% had prevalence of being at risk of EA. The logistic regression model displayed five variables that significantly predicted the risk of EA: (a) anxiety, (b) loneliness, (c) weekly time spent running, (d) childhood physical activity, and (e) education level., Discussion and Conclusions: Findings indicate that loneliness and anxiety may lead to withdrawal and uncontrolled behavior that in turn leads to increased amount of exercise in amateur runners. Lower level of education attainment is also a likely risk of EA development, and childhood sports activity is a predictor.