To optimize performance, coaches and athletes are always looking for the right balance between training load and recovery. Therefore, closely monitoring of athletes is important. Heart rate recovery (HRR) after standardized sub maximal exercise has been proposed as a useful variable to monitor (Lamberts et al., 2004). However, it is well known that heart rate, next to biological variability, is influenced by several factors such as training load and psychosocial stress. So, the purpose was to look at individual variability in HRR from one week to another using the heart rate interval monitoring system (HIMS). Methods Eight elite Dutch female indoor hockey players (age: 23.9±3.91yr, length: 155.0±7.01cm, weight: 56.6±6.16kg) completed the HIMS two weeks in a row (Lamberts et al., 2004). The heart rate at the end of the last stage (HRend) was determined and the HRR was calculated one minute after the end of the last stage. Furthermore, training load and psychosocial stress and recovery were monitored using the Foster-method (1998) and the RESTQ-Sport (Nederhof et al., 2008), respectively. Results A strong correlation was found between the HRend from one week to the other (r=0.984 p.
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BackgroundRoutine outpatient care of patients with coronary artery disease (CAD) lacks a simple measure of physical fitness and risk of mortality. Heart rate recovery (HRR) is noninvasive and easily obtainable in outpatient settings. Prior studies have suggested that delayed postexercise HRR in the first minutes is associated withmortality in several types of populations. However, a comprehensive overview of the prognostic value of delayed HRR for time to mortality specifically in CAD patients is not available. The purpose of the current meta-analysis is to evaluate the prognostic value of delayed HRR in CAD patients.MethodsWe conducted a systematic search in OVID MEDLINE and OVID EMBASE to identify studies reporting on HRR and risk of incident cardiovascular events or mortality in CAD patients. Hazard ratios for delayed versus nondelayed HRR were pooled using random-effects meta-analysis.Results Four studies were included, comprising 2,428 CAD patients. The study quality of the included studies was rated moderate (n = 2) to high (n = 2). Delayed HRR was defined by ≤12 to ≤21 beat/min in the recovery period. During follow-up (range 2.0-9.8 years), 151 patients died (6.2% [range 2.5%-19.5%]). Only data on mortality could be pooled. Heterogeneity was limited (I² = 32%; P = .23); pooled unadjusted hazard ratio for mortality, based on 3 studies, was 5.8 (95% CI 3.2-10.4).CoclusionsIn CAD patients, delayed HRR is significantly associated with all-cause mortality. As exercise testing is performed routinely in CAD patients, HRR can be considered in monitoring exercise; still, further research must investigate the addition of HRR in current risk scores.
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The aim of the present study was to find early markers for overreaching that are applicable in sport practice. In a group of elite soccer players aged 15–18, the stress–recovery balance and reaction times before and after exercise were assessed. Overreaching was indicated by an elevated submaximal heart rate during a sport-specific field test. Submaximal changes in heart rate were prospectively monitored by means of monthly Interval Shuttle Run Tests during two competitive seasons. Out of 94 players, seven players with an elevated heart rate of at least one month could be included in the study, together with seven controls, matched for age, body composition, training and performance level. The stress–recovery balance was assessed with the Dutch version of the Recovery Stress Questionnaire (RESTQ-Sport). The soccer players with an elevated heart rate reported a disturbed stress–recovery balance (Mann–Whitney test, P<0.05). An ANOVA for repeated measures of reaction times revealed a significant main effect of time (F 1,12=13.87, P<0.01) indicating an improvement of psychomotor speed. No differences between groups were found. We conclude that soccer players with an elevated submaximal heart rate of at least one month share a disturbed stress–recovery balance, but they could not be distinguished from controls based on reaction time after strenuous exercise.
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The purpose was to investigate perceived stress and recovery related to cycling performance of female athletes over one full year. 20 female athletes (age, 27±8 years; E2max, 50.3±4.6 mL·kg-1·min-1) were measured 8 times in one year to determine perceived stress and recovery (RESTQ-Sport) in relation to cycling performance (Lamberts and Lambert Submaximal Cycle Test (LSCT)). All 19 RESTQ-Sport scales were calculated and scores of the 4 main categories were determined (i. e., general stress, general recovery, sport-specific stress and sport-specific recovery). A balance score of total stress and recovery was calculated by recovery-stress. Power at the second stage (P80), third stage (P90) and heart rate recovery (HRR60 s) of the LSCT were determined as performance parameters. 110 RESTQ-Sports and LSCTs were analysed using a multilevel approach (random intercepts model). Higher self-efficacy was related to improvement of all performance parameters. Higher total recovery stress, and lower emotional stress were related to improvement of P90 and HRR60 s. Higher sport-specific recovery was related to P80, higher general stress, fatigue and physical complaints were related to decreased P90 and higher social stress and injury were related to decreased HRR60 s. Improved perceived recovery and stress contributed to an improved performance. Relevant information could be provided by monitoring changes in perceived stress and recovery of female athletes.
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The emergence of wearable sensor technology may provide opportunities for automated measurement of psychophysiological markers of mental and physical fitness, which can be used for personalized feedback. This study explores to what extent within-subject changes in resting heart rate variability (HRV) during sleep predict the perceived mental and physical fitness of military personnel on the subsequent morning. Participants wore a Garmin wrist-worn wearable and filled in a short morning questionnaire on their perceived mental and physical fitness during a period of up to 46 days. A custom-built smartphone app was used to directly retrieve heart rate and accelerometer data from the wearable, on which open-source algorithms for sleep detection and artefact filtering were applied. A sample of 571 complete observations in 63 participants were analyzed using linear mixed models. Resting HRV during sleep was a small predictor of perceived physical fitness (marginal R 2 = .031), but not of mental fitness. The items on perceived mental and physical fitness were strongly correlated (r = .77). Based on the current findings, resting HRV during sleep appears to be more related to the physical component of perceived fitness than its mental component. Recommendations for future studies include improvements in the measurement of sleep and resting HRV, as well as further investigation of the potential impact of resting HRV as a buffer on stress-related outcomes.
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Consumer wearables health data may reflect the impact of pancreatic cancer and its treatment on cardiorespiratory fitness and the subsequent recovery after treatment. The patient is a 65-year-old male treated for borderline resectable pancreatic cancer. Treatment consisted of four courses of FOLFIRINOX neoadjuvant chemotherapy, a Whipple procedure with a right hemicolectomy and venous segment resection, and eight courses of adjuvant FOLFIRINOX chemotherapy. Physical activity and moderate to vigorous physical activity declined after the onset of symptoms, increased in the weeks before surgery, declined after surgery and then gradually recovered during and after adjuvant chemotherapy. Estimated VO 2max remained stable during neoadjuvant chemotherapy, sharply decreased after surgery and then gradually recovered. Heart rate at rest increased and heart rate variability decreased after the onset of symptoms reaching their highest and lowest values after surgery. Both gradually returned to baseline seven months after the last course of chemotherapy. The physical impact of pancreatic cancer and its treatment and recovery was in this case reflected on consumer wearable health data. Seven months after the last chemotherapy recovery was close to baseline values.
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Physical and psychosocial stress and recovery are important performance determinants. A holistic approach that monitors these performance determinants over a longer period of time is lacking. Therefore this study aims to investigate the effect of a player’s physical and psychosocial stress and recovery on field-test performance. In a prospective non-experimental cohort design 10 female Dutch floorball players were monitored over 6 months. To monitor physical and psychosocial stress and recovery, daily training-logs and three-weekly the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) were filled out respectively. To determine field-test performance 6 Heart rate Interval Monitoring System (HIMS) and 4 Repeated Modified Agility T-test (RMAT) measurements were performed. Multilevel prediction models were applied to account for within-players and between-players field-test performance changes. The results show that more psychosocial stress and less psychosocial recovery over 3 to 6 weeks before testing decrease HIMS performance (p≤0.05). More physical stress over 6 weeks before testing improves RMAT performance (p≤0.05). In conclusion, physical and psychosocial stress and recovery affect submaximal interval-based running performance and agility up to 6 weeks before testing. Therefore both physical and psychosocial stress and recovery should be monitored in daily routines to optimize performance.
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Background To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR guideline, as it includes several novel topics. Methods A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based interventions during all CR phases in patients with CHD. Evidence was graded (1–4) according the Dutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assessment, treatment and evaluation. Results Recommendations for exercise-based CR were formulated covering the following topics: preoperative physiotherapy, mobilisation during the clinical phase, aerobic exercise, strength training, and relaxation therapy during the outpatient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation. Conclusions There is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementation of this guideline in clinical practice needs further evaluation as well as the maintenance of an active lifestyle after supervised rehabilitation. LinkedIn: https://www.linkedin.com/in/tinusjongert/
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Among runners, there is a high drop-out rate due to injuries and loss of motivation. These runners often lack personalized guidance and support. While there is much potential for sports apps to act as (e-)coaches to help these runners to avoid injuries, set goals, and maintain good intentions, most available running apps primarily focus on persuasive design features like monitoring, they offer few or no features that support personalized guidance (e.g., personalized training schemes). Therefore, we give a detailed description of the working mechanism of Inspirun e-Coach app and on how this app uses a personalized coaching approach with automatic adaptation of training schemes based on biofeedback and GPS-data. We also share insights into how end-users experience this working mechanism. The primary conclusion of this study is that the working mechanism (if provided with accurate data) automatically adapts training sessions to the runners’ physical workload and stimulates runners’ goal perception, motivation, and experienced personalization. With this mechanism, we attempted to make optimal use of the potential of wearable technology to support the large group of novice or less experienced runners and that by providing insight in our working mechanisms, it can be applied in other technologies, wearables, and types of sports.
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Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.
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