Cardiac autonomic and salivary responses to a repeated training bout in elite swimmers

This study examined the acute training responses of heart rate variability (HRV) and salivary biomarkers (immunoglobulin A and alpha-amylase) following a standardised training bout in Paralympic swimmers. Changes in HRV, sIgA and sAA were documented Monday morning, Monday afternoon and Tuesday morning over a 14-week monitoring period leading into international competition. Magnitude based inferences with effect sizes (ES) were used to assess the practical significance of changes each week. Normal training responses elicited increases in HR, 1, sAA and sIgA, accompanied by decreases in HF(nu), standard deviation of instantaneous RR variability (SD1) and the root mean square of successive differences (RMSSD) from Monday morning to Monday afternoon, and to Tuesday morning with similar week to week responses for most variables. Changes in RMSSD from Monday a.m. to p.m. were likely smaller (less negative) for Week 7 (78/18/3, ES = 0.40) following a competition weekend with similar changes observed from Monday a.m. to Tuesday a.m. (90/5/5, ES = 1.30). In contrast, the change in sAA from Monday a.m. to p.m. was very likely less (more negative) at Week 7 (0/0/99, ES = -2.46), with similar changes observed from Monday a.m. to Tuesday a.m. (0/0/99, ES = -4.69). During the taper period, there were also likely increases in parasympathetic modulations (RMSSD, Weeks 12-14) along with increased immune function (sIgA, Week 13) that demonstrated a favourable state of athlete preparedness. Used together, HRV and sAA provide coaches with valuable information regarding physiological changes in response to training and competition

Beyond Peak, a Simple Approach to Assess Rowing Power and the Impact of Training: A Technical Report

International Journal of Exercise Science 12(6): 233-244, 2019. Recently, rowing power has been shown to be a key determinant of rowing performance. However, rowing power testing can vary greatly, and is not standardized. Here we sought to evaluate rowing power over a 15 sec rowing test utilizing a stroke-by-stroke analysis before and after 4 weeks of training in youth rowers. Methods: 18 adolescent male rowers were assigned to complete either 4 weeks of plyometric training (PLYO, n=9), or steady state cycling (Control, n=9), for 30 minutes before on water training three days/week. Each group was matched for training volume. Peak power (PP) was assessed via a 15 sec maximal rowing ergometer test. Using the Ergdata mobile app, PP, peak force (PF), average force (AF), drive speed (DS), and stroke at which PP was achieved (PPstroke) were measured and recorded for later offline analysis. Results: Before training PP, PF, AF and DS did not differ between groups. After training, PP trended towards a significant difference between groups PLYO and CON (569±75 v. 629±51 Watts, control v. PLYO, p=0.08). Stroke-by-stroke analysis indicated more power was produced over the test following training (p\u3c0.05), but no group differences existed. There was also a trend towards PLYO achieving PP earlier in the test (7.7±0.9 to 6.9±0.9 strokes, p=0.08). Finally, DS during the test was significantly increased for PLYO after training (p\u3c0.05). Conclusion: This novel method of evaluating rowing power was able to detect changes in rowing power indices, providing coaches with a cost effective method of evaluating responses to rowing training

The Effect of Concurrent Plyometric Training Versus Submaximal Aerobic Cycling on Rowing Economy, Peak Power, and Performance in Male High School Rowers

BACKGROUND: Plyometric training has been shown to increase muscle power, running economy, and performance in athletes. Despite its use by rowing coaches, it is unknown whether plyometrics might improve rowing economy or performance. The purpose was to determine if plyometric training, in conjunction with training on the water, would lead to improved rowing economy and performance. METHODS: Eighteen male high school rowers were assigned to perform 4 weeks of either plyometric training (PLYO, n = 9) or steady-state cycling below ventilatory threshold (endurance, E, n = 9), for 30 min prior to practice on the water (matched for training volume) 3 days per week. Rowing performance was assessed through a 500-m rowing time trial (TT) and peak rowing power (RP), while rowing economy (RE) was assessed by measuring the oxygen cost over four work rates (90, 120, 150, and 180 W). RESULTS: Rowing economy was improved in both PLYO and E (p \u3c 0.05). The 500-m TT performance improved significantly for PLYO (from 99.8 ± 9 s to 94.6 ± 2 s, p \u3c 0.05) but not for E (from 98.8 ± 6 s to 98.7 ± 5 s, p \u3e 0.05). Finally, RP was moderately higher in the PLYO group post-training (E 569 ± 75 W, PLYO 629 ± 51 W, ES = 0.66) CONCLUSIONS: In a season when the athletes performed no rowing sprint training, 4 weeks of plyometric training improved the 500-m rowing performance and moderately improved peak power. This increase in performance may have been mediated by moderate improvements in rowing power, but not economy, and warrants further investigation

Protein-pacing caloric-restriction enhances body composition similarly in obese men and women during weight loss and sustains efficacy during long-term weight maintenance

Short-Term protein-pacing (P; ~6 meals/day, >30% protein/day) and caloric restriction (CR, ~25% energy deficit) improves total (TBF), abdominal (ABF) and visceral (VAT) fat loss, energy expenditure, and biomarkers compared to heart healthy (HH) recommendations (3 meals/day, 15% protein/day) in obese adults. Less is known whether obese men and women respond similarly to P-CR during weight loss (WL) and whether a modified P-CR (mP-CR) is more efficacious than a HH diet during long-term (52 week) weight maintenance (WM). The purposes of this study were to evaluate the efficacy of: (1) P-CR on TBF, ABF, resting metabolic rate (RMR), and biomarkers between obese men and women during WL (weeks 0–12); and (2) mP-CR compared to a HH diet during WM (weeks 13–64). During WL, men (n = 21) and women (n = 19) were assessed for TBF, ABF, VAT, RMR, and biomarkers at weeks 0 (pre) and 12 (post). Men and women had similar reductions (p < 0.01) in weight (10%), TBF (19%), ABF (25%), VAT (33%), glucose (7%–12%), insulin (40%), leptin (>50%) and increase in % lean body mass (9%). RMR (kcals/kg bodyweight) was unchanged and respiratory quotient decreased 9%. Twenty-four subjects (mP-CR, n = 10; HH, n = 14) completed WM. mP-CR regained significantly less body weight (6%), TBF (12%), and ABF (17%) compared to HH (p < 0.05). Our results demonstrate P-CR enhances weight loss, body composition and biomarkers, and maintains these changes for 52-weeks compared to a traditional HH diet

Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices

Background The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge. Methods We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study. Results Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children. Conclusions Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected childre

The epidemiology of adolescents living with perinatally acquired HIV: A cross-region global cohort analysis

Background Globally, the population of adolescents living with perinatally acquired HIV (APHs) continues to expand. In this study, we pooled data from observational pediatric HIV cohorts and cohort networks, allowing comparisons of adolescents with perinatally acquired HIV in “real-life” settings across multiple regions. We describe the geographic and temporal characteristics and mortality outcomes of APHs across multiple regions, including South America and the Caribbean, North America, Europe, sub-Saharan Africa, and South and Southeast Asia. Methods and findings Through the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER), individual retrospective longitudinal data from 12 cohort networks were pooled. All children infected with HIV who entered care before age 10 years, were not known to have horizontally acquired HIV, and were followed up beyond age 10 years were included in this analysis conducted from May 2016 to January 2017. Our primary analysis describes patient and treatment characteristics of APHs at key time points, including first HIV-associated clinic visit, antiretroviral therapy (ART) start, age 10 years, and last visit, and compares these characteristics by geographic region, country income group (CIG), and birth period. Our secondary analysis describes mortality, transfer out, and lost to follow-up (LTFU) as outcomes at age 15 years, using competing risk analysis. Among the 38,187 APHs included, 51% were female, 79% were from sub-Saharan Africa and 65% lived in low-income countries. APHs from 51 countries were included (Europe: 14 countries and 3,054 APHs; North America: 1 country and 1,032 APHs; South America and the Caribbean: 4 countries and 903 APHs; South and Southeast Asia: 7 countries and 2,902 APHs; sub-Saharan Africa, 25 countries and 30,296 APHs). Observation started as early as 1982 in Europe and 1996 in sub-Saharan Africa, and continued until at least 2014 in all regions. The median (interquartile range [IQR]) duration of adolescent follow-up was 3.1 (1.5–5.2) years for the total cohort and 6.4 (3.6–8.0) years in Europe, 3.7 (2.0–5.4) years in North America, 2.5 (1.2–4.4) years in South and Southeast Asia, 5.0 (2.7–7.5) years in South America and the Caribbean, and 2.1 (0.9–3.8) years in sub-Saharan Africa. Median (IQR) age at first visit differed substantially by region, ranging from 0.7 (0.3–2.1) years in North America to 7.1 (5.3–8.6) years in sub-Saharan Africa. The median age at ART start varied from 0.9 (0.4–2.6) years in North America to 7.9 (6.0–9.3) years in sub-Saharan Africa. The cumulative incidence estimates (95% confidence interval [CI]) at age 15 years for mortality, transfers out, and LTFU for all APHs were 2.6% (2.4%–2.8%), 15.6% (15.1%–16.0%), and 11.3% (10.9%–11.8%), respectively. Mortality was lowest in Europe (0.8% [0.5%–1.1%]) and highest in South America and the Caribbean (4.4% [3.1%–6.1%]). However, LTFU was lowest in South America and the Caribbean (4.8% [3.4%–6.7%]) and highest in sub-Saharan Africa (13.2% [12.6%–13.7%]). Study limitations include the high LTFU rate in sub-Saharan Africa, which could have affected the comparison of mortality across regions; inclusion of data only for APHs receiving ART from some countries; and unavailability of data from high-burden countries such as Nigeria. Conclusion To our knowledge, our study represents the largest multiregional epidemiological analysis of APHs. Despite probable under-ascertained mortality, mortality in APHs remains substantially higher in sub-Saharan Africa, South and Southeast Asia, and South America and the Caribbean than in Europe. Collaborations such as CIPHER enable us to monitor current global temporal trends in outcomes over time to inform appropriate policy responses

Eligibility Classification as a Factor in Understanding Student-Athlete Responses to Collegiate Volleyball Competition

The current study examined differences in heart rate variability (HRV) across student-athletes of different eligibility classifications and analyzed differences in HRV when competing at home or away. Fourteen female collegiate volleyball players volunteered for the study. Data collection encompassed an entire collegiate season, with comparisons in HRV made between home and away games, as well as pre-gameday, gameday, and post-gameday recordings for the whole squad. Comparisons were also made between student-athlete eligibility classification, with self-reported measures of sleep quality, fatigue, muscle soreness, stress, and mood recorded at the time of HRV measurement. Freshman athletes reported a significantly (p &lt; 0.05, η2 = 0.17) lower HRV (80.3 ± 9.7) compared to sophomore (85.7 ± 7.2), junior (91.2 ± 8.3), and senior (86.5 ± 7.2) athletes, while junior athletes had a significantly higher HRV when compared to sophomore and senior athletes. All athlete classifications reported similar HRV for home and away games, and there was no difference in HRV for any athlete classification group when comparing pre-gameday, gameday, and post-gameday measures. Freshman athletes reported significantly (p &lt; 0.05, η2 = 0.23) worse mood states compared to the other eligibility classifications, while self-reported stress was significantly (p &lt; 0.05) worse in junior and senior athletes. Results suggest that monitoring the workload of student-athletes based on their eligibility classification holds merit. Collegiate coaching and support staff should be aware of the academic and competitive demands placed on their student-athletes. In particular, freshman athletes adjusting to the increased demands placed on them as collegiate student-athlete may warrant additional support

The Impact of a Ballet and Modern Dance Performance on Heart Rate Variability in Collegiate Dancers

Heart rate (HR) variability (HRV) is a useful tool for assessing cardiac autonomic function and identifying potential readiness to perform in athletic populations, but has yet to be investigated in dance populations. As such, HRV may be able to provide valuable insight into the preparedness of dancers and the demands of performance in a collegiate dance population. 29 female dancers were monitored leading up to and following a dance performance. Analysis of HRV focused on the square root of the mean squared differences of the successive RR intervals (RMSSD). A one-way ANOVA, with Bonferroni post-hoc, paired with magnitude-based-inferences (MBI) with effect sizes (ES) were used to analyze changes during the Winter Dance Concert, while the Recovery-Stress Questionnaire for Athletes (REST-Q Sport) measured the frequency of stress of dancers. When compared to baseline (69.8 &plusmn; 1.7 bpm), mean (HR) was increased at both pre-show recordings (76.5 &plusmn; 2.1 bpm and 75.6 &plusmn; 1.8 bpm). In contrast, RMSSD was significantly diminished (p &lt; 0.05) at both pre-show recordings (40.6 &plusmn; 28.4 ms and 40.5 &plusmn; 21.8 ms) as compared to baseline (70.3 &plusmn; 38.4 ms). Dancers reported increased (p &lt; 0.05) self-efficacy before the second show and at 36 h post-concert. As expected, Dance Exposure (DE) increased significantly (p &lt; 0.05), while Academic Exposure (AE) was similar, during the week leading up to the dance concert. The results suggest dancers responded to concert dance performances similarly to other athletic populations approaching intense competition by exhibiting decreased parasympathetic activity prior to the dance performances, which returned to baseline values 36 h after their performances. Given the increase in self-efficacy, these fluctuations may indicate a readiness to a performance comparable to athletes

Effect of chronic training on heart rate variability, salivary IgA and salivary alpha-amylase in elite swimmers with a disability

The purpose of this study was to a) determine the heart rate variability (HRV) and saliva markers of immunity (salivary immunoglobulin A; sIgA) and stress (salivary alpha-amylase; sAA) responses to chronic training in elite swimmers with a disability; and b) identify the relationships between HRV, sIgA, sAA and training volume. Eight members of a high performance Paralympic swimming program were monitored for their weekly resting HRV, sIgA and sAA levels in the 14 weeks leading up to a major international competition. The 14 week training program included aerobic, anaerobic, power and speed, and taper training phases, while also incorporating two swimming step tests and two swimming competitions. Specific time (root mean square of the successive differences; RMSSD) and frequency (high frequency normalized units [HFnu]) domain measures, along with non-linear indices (standard deviation of instantaneous RR variability; SD1 and short term fractal scaling exponent; α1) of HRV were used for all analyses with effects examined using magnitude-based inferences. Relationships between HRV and saliva markers were identified by Spearman rank rho (ρ) correlation coefficients. Compared with week 1, SD1 was very likely lower (96/4/0, ES = -2.21), while sAA was very likely elevated (100/0/0, ES = 2.32) at the beginning of week 7 for all athletes. The training program did not alter HRV or saliva whereas competition did. There were also no apparent differences observed for HRV, sIgA and sAA between each of the training phases during the 14 week swimming program. Correlations were observed between sAA and SD1 (ρ = -0.212, p<0.05), along with sAA and mean HR (ρ = 0.309, p<0.05). These results show that high level national competition influences depresses HRV (SD1) and increases saliva biomarkers of stress (sAA). It appears that a well-managed and periodised swimming program can maintain these indices within normal baseline levels. The study also highlighted the parasympathetic nervous system influence on sAA

Daily heart rate variability of Paralympic gold medallist swimmers: A 17-week investigation

Objectives: Heart rate variability (HRV) can be a simple, non-invasive method of gauging cardiac autonomic nervous system fluctuations across periodised training workloads and taper in elite athlete populations. The purpose of these three case studies was to examine daily cardiac autonomic variations in Paralympic athletes leading in to the Paralympic games. Methods: Three Paralympic gold medallist swimmers were monitored daily for their resting HRV over a 17-week monitoring period leading up to the Paralympic games. Specific time- and frequency-domain measures, along with non-linear indices of HRV were calculated for all analyses. All HRV data were analysed individually using daily values, weekly average values, and average values for rest and training phases. Results: A significant difference in HRV was seen for all variables between athlete 1 and athletes 2 and 3 (amputee disabilities) during the entire monitoring period. Conclusion: Despite minimal long-term changes, both swimming classification and disability type significantly influence HRV during athlete monitoring. An increased understanding of individual responses to training, travel, and other outside influences affecting Paralympic athletes could potentially lead to improved management and monitoring of training workloads for enhanced performance