Importance of fatiguing, overtraining and chronic fatigue in athletes

Piesik Adam, Dryja Monika, Zawadka-Kunikowska Monika, Slomko Joanna, Kozakiewicz Mariusz, Tafil‑Klawe Małgorzata, Klawe Jacek J., Zalewski Paweł. Importance of fatiguing, overtraining and chronic fatigue in athletes. Journal of Education, Health and Sport. 2017;7(9):203-216. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.893319 http://ojs.ukw.edu.pl/index.php/johs/article/view/4829 https://pbn.nauka.gov.pl/sedno-webapp/works/831622 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.08.2017. Revised: 10.09.2017. Accepted: 10.09.2017. Importance of fatiguing, overtraining and chronic fatigue in athletes Adam Piesik1, Monika Dryja1, Monika Zawadka-Kunikowska1, Joanna Slomko1, Mariusz Kozakiewicz3, Małgorzata Tafil-Klawe2, Jacek J. Klawe1, Paweł Zalewski1 1 Department of Hygiene, Epidemiology, and Ergonomics Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy UMK w Toruniu, Polska 2 Department of Physiology Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy UMK w Toruniu, Polska 3 Department of Chemistry of Foodstuffs Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy UMK w Toruniu, Polska Correspondence: Adam Piesik, Department of Ergonomics and Exercise Physiology, ul. M. Curie Skłodowskiej 9, 85-094 Bydgoszcz, [email protected], tel./fax 52 585-35-89 Abstract Each training that requires achieving a higher heart rate limit and/or increased concentration in time may cause fatigue, considered to be a natural defence mechanism of a body. In the case of excessive fatigue and insufficient time designated for rest and regeneration, an overtraining syndrome (OTS) may develop. The main symptom of overtraining is increased fatigue that fails to become reversed in normal conditions of regeneration. Although authors are familiar with the overtraining syndrome and associated symptoms, as of today no diagnostic tool has been developed that may form a basis for a final diagnosis, and the diagnosis itself is frequently based on a subjective assessment of the athlete. Possible causes of the band overtraining syndrome are disorders of sodium, inflammatory processes resulting from physical activity and / or disorders of the autonomic nervous system. Key words: OTS, elite sportsmen, supercompensatio

Relationship between Cardiopulmonary, Mitochondrial and Autonomic Nervous System Function Improvement after an Individualised Activity Programme upon Chronic Fatigue Syndrome Patients

Background: The therapeutic effects of exercise from structured activity programmes have recently been questioned; as a result, this study examines the impact of an Individualised Activity Program (IAP) on the relationship with cardiovascular, mitochondrial and fatigue parameters. Methods: Chronic fatigue syndrome (CFS) patients were assessed using Chalder Fatigue Questionnaire (CFQ), Fatigue Severity Score (FSS) and the Fatigue Impact Scale (FIS). VO(2)peak, VO(2)submax and heart rate (HR) were assessed using cardiopulmonary exercise testing. Mfn1 and Mfn2 levels in plasma were assessed. A Task Force Monitor was used to assess ANS functioning in supine rest and in response to the Head-Up Tilt Test (HUTT). Results: Thirty-four patients completed 16 weeks of the IAP. The CFQ, FSS and FIS scores decreased significantly along with a significant increase in Mfn1 and Mfn2 levels (p = 0.002 and p = 0.00005, respectively). The relationships between VO2 peak and Mfn1 increase in response to IAP (p = 0.03) and between VO2 at anaerobic threshold and ANS response to the HUTT (p = 0.03) were noted. Conclusions: It is concluded that IAP reduces fatigue and improves functional performance along with changes in autonomic and mitochondrial function. However, caution must be applied as exercise was not well tolerated by 51% of patients

COVID-19 pandemic year in a sample of Polish myasthenia gravis patients: an observational study

Aim of the study: Coronavirus disease 2019 (COVID-19) incidence, mortality, recovery and hospitalisation rates vary in different countries. This study aimed to present the clinical characteristics of a sample of unvaccinated Polish myasthenia gravis (MG) patients during the first year of the COVID-19 pandemic, taking into account the number of MG exacerbations, a detailed description of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection course, and the need to modify immunosuppressive therapies. Clinical rationale for the study: To assess the impact of the first COVID-19 pandemic year on MG course in a sample of unvaccinated patients. Materials and methods: A retrospective observational study involving 30 unvaccinated Polish MG patients consulted in a neurological outpatient clinic on 11-31 March, 2020 (baseline) and 11-31 March, 2021 (endpoint). Results: During the period of evaluation, exacerbation of MG requiring hospitalisation was reported in 11 patients. Among them, four were treated with intravenous immunoglobulin and another six required plasma exchange. In the study group, COVID-19 was identified in 10 patients. Of them, seven experienced a mild course of SARSCoV-2 infection with spontaneous recovery. In the remaining three patients, both MG exacerbation and SARS-CoV-2 infection were reported. These patients experienced MG exacerbation in the preceding month or concurrently with COVID-19 and were aged over 50 years. Due to the SARS-CoV-2 infection, they required antibiotic and oxygen therapy, and hospitalisation was necessary in the case of two obese patients. None of the patients died due to COVID-19, and nor did any require discontinuation of immunosuppressive therapies during the study period. In total, 12 patients in the study group experienced neither MG exacerbation nor SARS-CoV-2 infection. Conclusions: In the presented sample of Polish MG patients, favourable outcomes of COVID-19 were observed. Further studies are needed to evaluate the reliable course of COVID-19 taking into account international differences, the types of treatment applied, and the ratio of vaccinated to unvaccinated MG patients

Early Clinical Features, Time to Secondary Progression, and Disability Milestones in Polish Multiple Sclerosis Patients

Background and Objectives: Determining the clinical course of multiple sclerosis (MS) and prediction of long-term disability can be a big challenge. To determine early clinical features of MS, their influence on long-term disability progression, and time to transition from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS), a cohort of Polish patients was studied. Materials and Methods: We retrospectively evaluated 375 Polish MS patients based on data from available medical records. We assessed early clinical MS features and the relationship between demographics and time from disease onset to attainment of 4 and 6 points on the Expanded Disability Status Scale (EDSS), as well as time to conversion from RRMS to SPMS. Results: The differences between initial MS variants were significantly associated with gender, age at disease onset, number and type of the first symptoms, and rate of the disability accrual. Mean times from disease onset to attainment of EDSS 4 and 6 were significantly influenced by the disease variant, age at onset, gender, degree of recovery from the initial symptoms, and first inter-bouts interval. The mean time to secondary progression was significantly influenced by the number and type of the first symptoms of RRMS. Conclusions: Early clinical features of MS are important in determining the disease variant, the time to transition from RRMS to SPMS, as well as predicting the disability accumulation of patients. Despite the small differences regarding the first MS symptoms, the disability outcomes in the cohort of Polish patients are similar to other regions of the world

Cardiac Autonomic Modulation Is Different in Terms of Clinical Variant of Multiple Sclerosis

This study evaluates whether the cardiac autonomic response to head-up tilt test (HUTT) differs between patients with relapsing-remitting multiple sclerosis (RRMS) and those with progressive MS (PMS) as compared to healthy controls (HC). Baroreflex sensitivity, cardiac parameters, heart rate (HRV) and blood pressure variability (BPV) were compared between 28 RRMS, 21PMS and 25 HC during HUTT. At rest, PMS patients had higher values of the sympathovagal ratio, a low-frequency band HRV (LFnu-RRI) and lower values of parasympathetic parameters (HFnu-RRI, HF-RRI) compared to RRMS and HC. Resting values of cardiac parameters were significantly lower in RRMS compared to PMS patients. No intergroup differences were observed for post-tilt cardiac and autonomic parameters, except for delta HF-RRI with lower values in the PMS group. The MS variant corrected for age, sex and Expanded Disability Status Scale (EDSS) score was an independent predictor of changes in the sympathovagal ratio as measured by HRV. Furthermore, a higher overall EDDS score was related to a higher sympathovagal ratio, lower parasympathetic parameters at rest, and decrease post-tilt changes of the sympathovagal ratio of sBP BPV. Autonomic imbalance is markedly altered in the MS patient group compared to control changes were most pronounced in the progressive variant of MS disease. The MS variant appeared to have a potential influence on cardiac autonomic imbalance at rest

Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery

Repeat surgery is often required to treat brain tumor recurrences. Here, we compared the functional state and rehabilitation of patients undergoing initial and repeat surgery for brain tumors to establish their individual risks that might impact management. In total, 835 patients underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. The Karnofsky performance status, Barthel index, and the modified Rankin scale were used to assess functional status, and the gait index was used to assess gait efficiency. Motor skills, postoperative complications, and length of hospital stay were recorded. Patients were classified into two groups: first surgery (n = 103) and repeat surgery (n = 30). Eighteen percent of patients required reoperations, and these patients required prolonged postoperative rehabilitation as often as those operated on for the first time. Rehabilitation was more often complicated in the repeat surgery group (p = 0.047), and the complications were more severe and persistent. Reoperated patients had significantly worse motor function and independence in activities of daily living before surgery and at discharge, but the deterioration after surgery affected patients in the first surgery group to a greater extent according to all metrics (p < 0.001). The length of hospital stay was similar in both groups. These results will be useful for tailoring postoperative rehabilitation during a hospital stay on the neurosurgical ward as well as planning discharge requirements after leaving the hospital

Association between Daytime Sleepiness, Fatigue and Autonomic Responses during Head-Up Tilt Test in Multiple Sclerosis Patients

We aimed to assess dynamic changes in hemodynamic and autonomic function in response to the head-up tilt test (HUTT) in patients with multiple sclerosis (MS) compared to healthy controls (HCs) and evaluate its relationship with the patients’ reported daytime sleepiness and fatigue symptoms. A total of 58 MS patients and 30 HCs were included in the analysis. Fatigue and sleepiness were evaluated using the Chalder Fatigue Scale (CFQ) and the Epworth Sleepiness Scale (ESS), respectively. Hemodynamic response, baroreflex sensitivity, heart rate variability, and systolic and diastolic blood pressure (BP) variability (SBPV, DBPV) parameters were calculated at rest, and in response to the HUTT. The MS patients displayed attenuated BP responses coupled with a more pronounced decrease in cardiac index as well as a reduced increase in the low frequency (LFnu) of DBPV (p = 0.021) and the sympathovagal ratio (p = 0.031) in the latter-phase orthostatic challenge compared to HCs. In MS patients, the ESS score showed no correlation with CFQ or clinical disease outcomes, but exhibited a moderate correlation with LFnu of BPVrest. Fatigue and disease variants predicted blood pressure response to HUTT. These findings underscore the importance of subjective daytime sleepiness and fatigue symptoms and their role in blood pressure regulation in MS patients

Cognitive Function and Postural Control Strategies in Relation to Disease Progression in Patients with Parkinson’s Disease

Aim: This study assessed the influence of performing an additional cognitive task on center of pressure (COP) displacement in the early and advanced stages of patients with Parkinson’s disease (PD) compared to age-matched healthy controls (HCs). Methods: The study included 40 HCs and 62 patients with PD: early PD (n = 38) and advanced PD (n = 24). COP parameters were determined by static posturography during quiet standing with open eyes (ST, single task) and simultaneous performance of a cognitive task (DT, dual task). Cognitive functioning was examined with a Mini Mental State Examination, number-counting-backward test, and number of enunciated words during DT. Results: In the advanced-PD group, DT significantly reduced the sway radius (p = 0.009), area of stabilogram (p = 0.034), medio-lateral length (p = 0.027), and velocity (p = 0.033) compared to ST. In HCs, DT showed a significant increase in the sway radius (p = 0.006), total length (p = 0.039), sway velocity (p = 0.037), anterior–posterior length, and sway velocity. Both PD groups showed worse cognitive performance compared to HCs. Conclusions: Both early and advanced patients with PD showed significant delay in cognitive performance associated with executive function compared to the HCs. During additional cognitive tasks, patients with advanced stages of PD may reduce stabilographic parameters in medio-lateral direction, and this is probably an adaptive strategy to restore balance

Importance of fatiguing, overtraining and chronic fatigue in athletes

Each training that requires achieving a higher heart rate limit and/or increased concentration in time may cause fatigue, considered to be a natural defence mechanism of a body. In the case of excessive fatigue and insufficient time designated for rest and regeneration, an overtraining syndrome (OTS) may develop. The main symptom of overtraining is increased fatigue that fails to become reversed in normal conditions of regeneration. Although authors are familiar with the overtraining syndrome and associated symptoms, as of today no diagnostic tool has been developed that may form a basis for a final diagnosis, and the diagnosis itself is frequently based on a subjective assessment of the athlete. Possible causes of the band overtraining syndrome are disorders of sodium, inflammatory processes resulting from physical activity and / or disorders of the autonomic nervous system