Does low volume high-intensity interval training elicit superior benefits to continuous low to moderate-intensity training in cancer survivors?

AIM To determine the impact of low volume high-intensity interval training (LVHIIT) and continuous low to moderate- intensity exercise training (CLMIT) on cardiovascular disease (CVD) risk and health outcomes in cancer survivors. METHODS Sedentary cancer survivors (n = 75, aged 51 ± 12 year) within 24 months of diagnosis, were randomised into three groups for 12 wk of LVHIIT (n = 25), CLMIT (n = 25) or control group (n = 25). The exercise intervention involved 36 sessions (three sessions per week). The LVHIIT group performed 7 × 30 s intervals (≥ 85% predicted maximal heart rate) with a 60 s rest between intervals, and the CLMIT group performed continuous aerobic training for 20 min (≤ 55% predicted maximal heart rate) on a stationary bike. Outcome variables were measured at baseline and at 12 weeks and analysed using a 3 × 2 (group × time) repeated measures ANCOVA to evaluate main and interaction effects. RESULTS Significant improvements (time) were observed for seven of the 22 variables (ES 0.35-0.97, P ≤ 0.05). There was an interaction effect (P < 0.01) after 12 wk in the LVHIIT group for six-minute walk test (P < 0.01; d = 0.97; 95%CI: 0.36, 1.56; large), sit to stand test (P < 0.01; d = -0.83; 95%CI: -1.40, -0.22; large ) and waist circumference reduction (P = 0.01; d = -0.48; 95%CI: -1.10, 0.10; medium). An interaction effect (P < 0.01) was also observed for quality of life in both the LVHIIT (d = 1.11; 95%CI: 0.50, 1.72; large) and CLMIT (d = 0.57; 95%CI: -0.00, 1.20; moderate) compared with the control group (d = -0.15; 95%CI: -0.95, 0.65; trivial). CONCLUSION Low-volume high-intensity training shows promise as an effective exercise prescription within the cancer population, showing greater improvements in cardiorespiratory fitness, lower body strength and waist circumference compared with traditional CLMIT and control groups. Both LVHIIT and CLMIT improved quality of life. A proposed benefit of LVHIIT is the short duration (3 min) of exercise required, which may entice more cancer survivors to participate in exercise, improving health outcomes and lowing the risk of CV

Exercise during chemotherapy for ovarian cancer (ECHO) trial : design and implementation of a randomised controlled trial

Introduction Epidemiological evidence supports an association between higher levels of physical activity and improved cancer survival. Trial evidence is now needed to demonstrate the effect of exercise in a clinical setting. The Exercise during CHemotherapy for Ovarian cancer (ECHO) trial is a phase III, randomised controlled trial, designed to determine the effect of exercise on progression-free survival and physical well-being for patients receiving first-line chemotherapy for ovarian cancer. Methods and analysis Participants (target sample size n=500) include women with newly diagnosed primary ovarian cancer, scheduled to receive first-line chemotherapy. Consenting participants are randomly allocated (1:1) to either the exercise intervention (plus usual care) or usual care alone, with stratification for recruitment site, age, stage of disease and chemotherapy delivery (neoadjuvant vs adjuvant). The exercise intervention involves individualised exercise prescription with a weekly target of 150 minutes of moderate-intensity, mixed-mode exercise (equivalent to 450 metabolic equivalent minutes per week), delivered for the duration of first-line chemotherapy through weekly telephone sessions with a trial-trained exercise professional. The primary outcomes are progression-free survival and physical well-being. Secondary outcomes include overall survival, physical function, body composition, quality of life, fatigue, sleep, lymphoedema, anxiety, depression, chemotherapy completion rate, chemotherapy-related adverse events, physical activity levels and healthcare usage. Ethics and dissemination Ethics approval for the ECHO trial (2019/ETH08923) was granted by the Sydney Local Health District Ethics Review Committee (Royal Prince Alfred Zone) on 21 November 2014. Subsequent approvals were granted for an additional 11 sites across Queensland, New South Wales, Victoria and the Australian Capital Territory. Findings from the ECHO trial are planned to be disseminated via peer-reviewed publications and international exercise and oncology conferences

International Society of Sports Nutrition Position Stand: Probiotics.

Position statement: The International Society of Sports Nutrition (ISSN) provides an objective and critical review of the mechanisms and use of probiotic supplementation to optimize the health, performance, and recovery of athletes. Based on the current available literature, the conclusions of the ISSN are as follows: 1)Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host (FAO/WHO).2)Probiotic administration has been linked to a multitude of health benefits, with gut and immune health being the most researched applications.3)Despite the existence of shared, core mechanisms for probiotic function, health benefits of probiotics are strain- and dose-dependent.4)Athletes have varying gut microbiota compositions that appear to reflect the activity level of the host in comparison to sedentary people, with the differences linked primarily to the volume of exercise and amount of protein consumption. Whether differences in gut microbiota composition affect probiotic efficacy is unknown.5)The main function of the gut is to digest food and absorb nutrients. In athletic populations, certain probiotics strains can increase absorption of key nutrients such as amino acids from protein, and affect the pharmacology and physiological properties of multiple food components.6)Immune depression in athletes worsens with excessive training load, psychological stress, disturbed sleep, and environmental extremes, all of which can contribute to an increased risk of respiratory tract infections. In certain situations, including exposure to crowds, foreign travel and poor hygiene at home, and training or competition venues, athletes' exposure to pathogens may be elevated leading to increased rates of infections. Approximately 70% of the immune system is located in the gut and probiotic supplementation has been shown to promote a healthy immune response. In an athletic population, specific probiotic strains can reduce the number of episodes, severity and duration of upper respiratory tract infections.7)Intense, prolonged exercise, especially in the heat, has been shown to increase gut permeability which potentially can result in systemic toxemia. Specific probiotic strains can improve the integrity of the gut-barrier function in athletes.8)Administration of selected anti-inflammatory probiotic strains have been linked to improved recovery from muscle-damaging exercise.9)The minimal effective dose and method of administration (potency per serving, single vs. split dose, delivery form) of a specific probiotic strain depends on validation studies for this particular strain. Products that contain probiotics must include the genus, species, and strain of each live microorganism on its label as well as the total estimated quantity of each probiotic strain at the end of the product's shelf life, as measured by colony forming units (CFU) or live cells.10)Preclinical and early human research has shown potential probiotic benefits relevant to an athletic population that include improved body composition and lean body mass, normalizing age-related declines in testosterone levels, reductions in cortisol levels indicating improved responses to a physical or mental stressor, reduction of exercise-induced lactate, and increased neurotransmitter synthesis, cognition and mood. However, these potential benefits require validation in more rigorous human studies and in an athletic population

Complementary and alternative medicine use among elite Australian athletes and the efficacy of selected complementary and alternative medicines in the prevention and treatment of delayed onset muscle soreness and muscle damage in well trained males

The use of complementary and alternative medicines and therapies (CAM) in Australia and across the world is becoming increasingly prevalent. The most recent survey conducted by MacLennon et al. in 2004 [2] identified that more than half the general Australian population had used some form of CAM in the previous 12 months before the survey was conducted.[2-4] Up until now, the prevalence of CAM use among elite Australian athletes was unknown. As athletes are constantly looking to gain an advantage over their competitors through physical or psychological interventions or through the application of new technologies, it was hypothesised that the use of CAM in this group would be higher in athletes than in the general population. After surveying 497 elite Australian athletes we found that 93% of this specific population utilised at least one CAM within their lifetime. The 10 CAM (as defined by the Therapeutics Goods Administration) used most frequently were sports drinks, massage, sports bars, cereal bars, multivitamins, aloe vera, sports gels, Pilates, caffeine and yoga. There were no significant differences identified between specific sporting groups- football codes, court sports, field sports, water sports and others, with all groups reporting high usage. Sports physicians, family, coaches and friends were identified as the main sources for product information, with health food shops, sports dieticians and sports physicians being the predominant providers of the actual product. Four CAM sold on the Australian market which purported to decrease the symptoms of delayed onset muscle soreness (DOMS), or reported anti-inflammatory properties which could impact of the inflammatory response associated with DOMS were studied. Lyprinol® (an anti-inflammatory agent), topical Arnica (for symptomatic relief of soft tissue trauma), Tienchi Ginseng (proposed to relieve symptoms of DOMS) and Devil’s Claw (an analgesic and anti-inflammatory agent) were the chosen CAM. Four separate randomised, double blind placebo controlled studies comprising of 20 subjects per study were carried out with the same DOMS inducing methodology (downhill treadmill running) employed. All subjects in each of the four studies had their performance (counter movement and squat jump, maximal force), pain (visual analogue scale and muscle tenderness) and blood parameters (high sensitivity C-reactive protein, interleukin-1A, interleukin-6, tumour necrosis factor-K, creatine kinase and myoglobin) analysed seven times over five days. Lyprinol® did not affect performance, pain or blood markers of muscle damage and inflammation analysed in this study. Despite Lyprinol® being marketed as having “potent anti-inflammatory” properties, Lyprinol® did not demonstrate any antiinflammatory properties in our sample group at a dose of 200mg daily for two months, and did not alter any of the markers of inflammation after a downhill running protocol. A significant difference was identified in quadriceps muscle tenderness between the topical Arnica and placebo groups 72 hours after the downhill running protocol. This indicated that the topical Arnica group experienced less quadriceps pain at this time point, though this was not reflected in the quadriceps visual analogue scale results. There were significant differences identified between the topical Arnica and placebo groups for muscle tenderness in the gastrocnemius and tumour necrosis factor-K concentration at baseline. Further statistical analysis assessing relative changes from baseline did not demonstrate any statistically significant differences between the groups for either of these parameters. We therefore conclude that the symptomatic relief of soft tissue trauma claimed from a topical Arnica product sold in Australia was not conclusively demonstrated in this study. The single, isolated significant difference identified in quadriceps tenderness does not conclusively, from this study, indicate efficacy for the use of this topical Arnica for the relief of soft tissue trauma. Tienchi Ginseng demonstrated the most promising outcomes, with statistically significant differences identified in performance and inflammatory markers in favour of Tienchi Ginseng. Though it cannot be conclusively deemed beneficial for DOMS from this study alone, Tienchi Ginseng warrants further research with larger sample sizes and a similar muscle damage protocol. Finally, Devil’s Claw did not demonstrate beneficial outcomes in regards to DOMS within this study. It actually demonstrated some, perhaps detrimental effects, upon analysis of performance and inflammatory markers. We are unsure of the mechanisms behind these findings, particularly when considering the proposed anti-inflammatory effects of Devil’s Claw. From the literature, Devil’s Claw appears to be beneficial in chronic musculoskeletal conditions however it does not seem to impact on muscle damage and pain resulting from DOMS inducing exercise. The questionnaire study has demonstrated that there is a high usage of CAM among elite Australian athletes, an area up until now that has been unexplored. The onset of CAM use within the Australian athletic population, and the prevalence of CAM use by other professional Australian athletes would be an area to explore in the future. In regards to products which specifically claim to benefit athletes suffering soft tissue trauma such as DOMS, convincing evidence for specific product use was not demonstrated in these studies. Further research involving greater sample sizes may reveal more definitive outcomes, specifically in regards to the use of Tienchi Ginseng

The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well-trained males: A double blind randomised controlled trial

Objectives: The aim of the study was to determine if Panax notoginseng is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improve performance in well trained males who underwent a bout of eccentric exercise designed to induce delayed onset muscle soreness (DOMS). Design: A double blind randomised placebo controlled trial. Setting: Twenty well trained male volunteers, matched by maximum aerobic capacity were randomly assigned to consume a regime of 4000. mg of P. notoginseng capsules or an indistinguishable placebo before and after a downhill treadmill running episode designed to induce DOMS. Main outcome measures: Performance measures (Kin-Com, counter movement and squat jump), pain assessments (visual analogue scale (VAS), algometer) and blood analyses (interleukin-1, interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), C-reactive protein, myoglobin, creatine kinase) were assessed at 7 time points over 5 days (pre, post, 4, 24, 48, 72 and 96. h after the downhill run). Results: The placebo group demonstrated a significant decrease in squat jump performance immediately post the downhill run, with a mean change. ±. 95% confidence interval (CI) of 0.8. cm (-3.53 to 1.93). The placebo group also experienced increased pain in the quadriceps 96. h after the downhill run, with a mean VAS change. ±. 95% CI of -0.32. cm (-0.34 to 0.98).The serum concentration of IL-6 and TNF-α were significantly lower in the placebo group 24. h after the downhill run. Mean IL-6 change. ±. 95% CI of 0.50. pg/mL (-1.59 to 0.59), and mean TNF-α change. ±. 95% CI was 0.98. pg/mL (-2.04 to 0.09). No other significant differences were identified between the groups for any other outcome measure. Conclusion: Considering all data from this study, P. notoginseng did not convincingly have an effect on performance, muscular pain or assessed blood markers in well-trained males after an intense bout of eccentric exercise that induced DOMS

Physical and Physiological Characteristics of Various-Sided Games in Elite Women's Soccer

Purpose:To investigate the physical and physiological response to different formats of various-sided games.Methods:Eighteen elite women’s soccer players wore 15-Hz global positioning system devices and heart-rate (HR) monitors during various-sided games (small, 4 vs 4 and 5 vs 5; medium, 6 vs 6 and 7 vs 7; large, 8 vs 8 and 9 vs 9).Results:Players covered more relative sprinting distance during large-sided games than in small-sided (P &lt; .001, d = 0.69) and medium-sided (P &lt; .001, d = 0.54) games. In addition, a greater proportion of total acceleration efforts that had a commencement velocity &lt;1 m/s were observed in small-sided games (44.7% ± 5.5%) than in large-sided games (36.7% ± 10.6%) (P = .018, d = 0.94). This was accompanied by a greater proportion of acceleration efforts with a final velocity equivalent to the sprint threshold in large-sided games (15.4% ± 7.7%) than in small-sided games (5.2% ± 2.5%) (P &lt; .001, d = 1.78). The proportion of time spent in HR zone 4 (&gt;85% maximum HR) was greater during small-sided games (69.8% ± 2.5%) than in medium- (62.1% ± 2.8%, d = 2.90) and large-sided games (54.9% ± 3.1%) (P &lt; .001, d = 5.29).Conclusions:The results from this study demonstrate that coaches can use small-sided games as an aerobic conditioning stimulus and to develop players’ explosiveness and repeat-sprint ability over short durations. Large-sided games can be used to maintain aerobic capacity and develop maximum speed over longer distances.</jats:sec

The effects of Lyprinol® on delayed onset muscle soreness and muscle damage in well trained athletes: a double-blind randomised controlled trial

Objectives: The aim of the study was to determine if Lyprinol ® is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improving performance in well trained athletes suffering from delayed onset muscle soreness (DOMS).