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Training-induced muscle adaptations during competitive preparation in elite female rowers

Training-induced adaptations in muscle morphology, including their magnitude and individual variation, remain relatively unknown in elite athletes. We reported changes in rowing performance and muscle morphology during the general and competitive preparation phases in elite rowers. Nineteen female rowers completed 8 weeks of general preparation, including concurrent endurance and high-load resistance training (HLRT). Seven rowers were monitored during a subsequent 16 weeks of competitive preparation, including concurrent endurance and resistance training with additional plyometric loading (APL). Vastus lateralis muscle volume, physiological cross-sectional area (PCSA), fascicle length, and pennation angle were measured using 3D ultrasonography. Rowing ergometer power output was measured as mean power in the final 4 minutes of an incremental test. Rowing ergometer power output improved during general preparation [+2 ± 2%, effect size (ES) = 0.22, P = 0.004], while fascicle length decreased (−5 ± 8%, ES = −0.47, P = 0.020). Rowing power output further improved during competitive preparation (+5 ± 3%, ES = 0.52, P = 0.010). Here, morphological adaptations were not significant, but demonstrated large ESs for fascicle length (+13 ± 19%, ES = 0.93), medium for pennation angle (−9 ± 15%, ES = −0.71), and small for muscle volume (+8 ± 13%, ES = 0.32). Importantly, rowers showed large individual differences in their training-induced muscle adaptations. In conclusion, vastus lateralis muscles of elite female athletes are highly adaptive to specific training stimuli, and adaptations largely differ between individual athletes. Therefore, coaches are encouraged to closely monitor their athletes' individual (muscle) adaptations to better evaluate the effectiveness of their training programs and finetune them to the athlete's individual needs.

Intra-assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet-based ultrasound machine

Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest.

Anabolic competence: assessment and integration of the multimodality interventional approach in disease-related malnutrition

Serial exercise testing in children, adolescents and young adults with Senning repair for transposition of the great arteries

Background: Patients with Senning repair for complete transposition of the great arteries (d-TGA) show an impaired exercise tolerance. Our aim was to investigate changes in exercise capacity in children, adolescents and adults with Senning operation. Methods: Peak oxygen uptake (peak VO2), oxygen pulse and heart rate were assessed by cardiopulmonary exercise tests (CPET) and compared to normal values. Rates of change were calculated by linear regression analysis. Right ventricular (RV) function was assessed by echocardiography. Results: Thirty-four patients (22 male) performed 3.5 (range 3–6) CPET with an interval of ≥ 6 months. Mean age at first assessment was 16.4 ± 4.27 years. Follow-up period averaged 6.8 ± 2 years. Exercise capacity was reduced (p<0.0005) and the decline of peak VO2 (−1.3 ± 3.7 %/year; p=0.015) and peak oxygen pulse (−1.4 ± 3.0 %/year; p=0.011) was larger than normal, especially before adulthood and in female patients (p<0.01). During adulthood, RV contractility changes were significantly correlated with the decline of peak oxygen pulse (r= −0.504; p=0.047). Conclusions: In patients with Senning operation for d-TGA, peak VO2 and peak oxygen pulse decrease faster with age compared to healthy controls. This decline is most obvious during childhood and adolescence, and suggests the inability to increase stroke volume to the same extent as healthy peers during growth. Peak VO2 and peak oxygen pulse remain relatively stable during early adulthood. However, when RV contractility decreases, a faster decline in peak oxygen pulse is observed

Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. EACPR/AHA Joint Scientific Statement

From an evidence-based perspective, cardiopulmonary exercise testing (CPX) is a well-supported assessment technique in both the United States (US) and Europe. The combination of standard exercise testing (ET) [i.e. progressive exercise provocation in association with serial electrocardiograms (ECGs), haemodynamics, oxygen saturation, and subjective symptoms] and measurement of ventilatory gas exchange amounts to a superior method to: (i) accurately quantify cardiorespiratory fitness (CRF), (ii) delineate the physiologic system(s) underlying exercise responses, which can be applied as a means to identify the exercise-limiting pathophysiological mechanism(s) and/or performance differences, and (iii) formulate function-based prognostic stratification. Cardiopulmonary ET certainly carries an additional cost as well as competency requirements and is not an essential component of evaluation in all patient populations. However, there are several conditions of confirmed, suspected, or unknown aetiology where the data gained from this form of ET is highly valuable in terms of clinical decision making.1

Self-infusion of prophylaxis: evaluating the quality of its performance and time needed

Prophylactic replacement therapy is the cornerstone of treatment in severe haemophilia. Regular infusions with clotting factor concentrate have been proven effective to prevent bleeding, subsequent (joint) damage, and positively affect the impact of haemophilia on daily life [1]. Patients or parents of younger patients learn to infuse clotting factor concentrate in a peripheral vein (i.v.) or a central venous access device (CVAD) [2].