Mid Sweden University

Bakgrund Ansträngningsutlöst bronkkonstriktion (EIB) innebär en övergående luftvägsobstruktion i samband med ansträngning och definieras som en minskning med ≥ 10% av den forcerade utandningen under första sekunden (FEV1). EIB är vanligt bland elitskidåkare. Referenstestet för diagnostik är torrluftsprovokation men ansträngningstest (ECT) i fält anses ha högre representativitet och sensitivitet men är svårt att standardisera. ECT i köldkammare kombinerar en idrottspecifik provokation med en standardiserad miljö men har aldrig använts för att undersöka förekomsten av EIB bland vinteridrottare. Målet med studien var att kartlägga prevalensen av EIB hos elitskidåkare med hjälp av ECT i kyla. Material och metod De 31 deltagarna (16 kvinnor) var ett slumpmässigt urval av de 174 längdskidåkare och skidskyttar från Sveriges riksidrottsgymnasium och nationella idrottsutbildningar som vintern 2022 deltog i en web-enkät om luftvägssymtom, träning och astma. Sex (19%) deltagare hade använt astmamediciner för en läkardiagnostiserad astma de senaste 12 månaderna. ECT i en köldkammare utfördes (8 min löpning i -14,7 °C, Rh 77% på 85% av beräknad maxpuls) med spirometri före och 5-30 minuter efter. Resultat EIB detekterades hos 7 (23%) av deltagarna, 5 av 25 utan astma och 2 av 6 med astma. En deltagare sjönk >15% på FEV1 och hade ingen tidigare känd astma. Kön, ålder, träningstimmar, allergi, FeNO och förekomst av pip/väs från luftvägarna med andnöd de senaste 12 månaderna skiljde sig inte åt mellan deltagarna med och utan EIB. Slutsats ECT i kyla påvisar en hög förekomst av EIB hos unga, friska, svenska elitskidåkare, redan tidigt i karriären och oavsett tidigare känd astma. Att förekomsten av EIB hos skidåkarna med astma inte var högre skulle kunna vara ett resultat av deras antiinflammatoriska astmaläkemedel eller överdiagnostik.

Maximal exercise capacity is reduced at altitude or during hypoxia at sea level. It has been suggested that this might reflect increased right ventricular afterload due to hypoxic pulmonary vasoconstriction. We have shown previously that the pulmonary vascular sensitivity to hypoxia is enhanced by sustained isocapnic hypoxia, and inhibited by intravenous iron. In this study, we tested the hypothesis that elevated pulmonary artery pressure contributes to exercise limitation during acute hypoxia. Twelve healthy volunteers performed incremental exercise tests to exhaustion breathing 12% oxygen, before and after sustained (8-h) isocapnic hypoxia at sea level. Intravenous iron sucrose (n = 6) or saline placebo (n = 6) was administered immediately before the sustained hypoxia. In the placebo group, there was a substantial (12.6 ± 1.5 mmHg) rise in systolic pulmonary artery pressure (SPAP) during sustained hypoxia, but no associated fall in maximal exercise capacity breathing 12% oxygen. In the iron group, the rise in SPAP during sustained hypoxia was markedly reduced (3.4 ± 1.0 mmHg). There was a small rise in maximal exercise capacity following sustained hypoxia within the iron group, but no overall effect of iron, compared with saline. These results do not support the hypothesis that elevated SPAP inhibits maximal exercise capacity during acute hypoxia in healthy volunteers.

BACKGROUND: This study used metabolic phenotyping to explore the responses of highly-trained cross-country skiers to a standardized exercise test, which was part of the athletes' routine testing, and determine whether metabolic phenotyping could discriminate specific physiological, performance, and illness characteristics.

METHODS: Twenty-three highly-trained cross-country skiers (10 women and 13 men) participated in this study. Capillary whole-blood samples were collected before (at rest) and 2.5 min after (post-exercise) a roller-ski treadmill test consisting of 5-6 × 4-min submaximal stages followed by a self-paced time trial (~ 3 min) and analyzed using mass spectrometry. Performance level was defined by International Ski Federation distance and sprint rankings. Illness data were collected prospectively for 33 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. Orthogonal partial least squares-discriminant analyses (OPLS-DA) followed by enrichment analyses were used to identify metabolic phenotypes of athlete groups with specific physiological, performance, and illness characteristics.

RESULTS: Blood metabolite phenotypes were significantly different after the standardized exercise test compared to rest for metabolites involved in energy, purine, and nucleotide metabolism (all OPLS-DA p < 0.001). Acute changes in the metabolic phenotype from rest to post-exercise could discriminate athletes with: (1) higher vs. lower peak blood lactate concentrations; (2) superior vs. inferior performance levels in sprint skiing, and (3) ≥ 2 vs. ≤ 1 self-reported illness episodes in the 33-week study period (all p < 0.05). The most important metabolites contributing to the distinction of groups according to (1) post-exercise blood lactate concentrations, (2) sprint performance, and (3) illness frequency were: (1) inosine, hypoxanthine, and deoxycholic acid, (2) sorbitol, adenosine monophosphate, and 2-hydroxyleuroylcarnitine, and (3) glucose-6-phosphate, squalene, and deoxycholic acid, respectively.

CONCLUSION: Metabolic phenotyping discriminated between athlete groups with higher vs. lower post-exercise blood lactate concentrations, superior vs. inferior sprint skiing performance, and more vs. less self-reported illnesses. While the biological relevance of the identified biomarkers requires validation in future research, metabolic phenotyping shows promise as a tool for routine monitoring of highly-trained endurance athletes.

The International Olympic Committee's (IOC) consensus statement on 'methods for recording and reporting of epidemiological data on injury and illness in sport' recommended standardising methods to advance data collection and reporting consistency. However, additional aspects need to be considered when these methods are applied to specific sports settings. Therefore, we have developed a snow sports-specific extension of the IOC statement to promote the harmonisation of injury and illness registration methods among athletes of all levels and categories in the different disciplines governed by the International Ski and Snowboard Federation (FIS), which is also applicable to other related snow sports such as biathlon, ski mountaineering, and to some extent, para snow sports. The panel was selected with the aim of representing as many different areas of expertise/backgrounds, perspectives and diversity as possible, and all members were assigned to thematic subgroups based on their profiles. After panel formation, all members were provided with an initial draft of this extension, which was used as a basis for discussion of aspects specific to the discipline, application context, level and sex within their snow sports subgroup topic. The outcomes were then aligned with the IOC's existing consensus recommendations and incorporated into a preliminary manuscript draft. The final version of this snow sports-specific extension was developed and approved in two iterative rounds of manuscript revisions by all consensus panel members and a final meeting to clarify open discussion points. This snow sports-specific extension of the IOC statement is intended to guide researchers, international and national sports governing bodies, and other entities recording and reporting epidemiological data in snow sports to help standardise data from different sources for comparison and future research.

: The aim of this study was to investigate effects of a single infrared sauna (IRS) session on postexercise recovery of neuromuscular performance, autonomic nervous system function, subjective sleep quality, and muscle soreness. Male basketball players (n = 16) performed two trials consisting of a complex resistance exercise protocol (maximal strength with plyometrics), followed by either 20 min passive recovery (PAS) or IRS (temperature 43±5°C), in a randomized crossover design, with trials separated by one week. Recovery of neuromuscular performance was assessed using 20 m maximal sprint, maximal countermovement-jump (CMJ), and isometric leg press tests, performed 14 hours after exercise. Heart rate (HR), heart rate variability (HRV), sleep diary, muscle soreness, and indirect muscle damage markers were measured pre and post exercise. The decrease in CMJ performance from pre- to post-exercise was attenuated after IRS compared to PAS (p < 0.01). The IRS session resulted in higher HR and lower root mean square of successive differences between normal heartbeats (RMSSD), and high and low frequency power, compared to PAS (p < 0.002). Post-exercise night-time HR and HRV did not differ following IRS vs. PAS. Muscle soreness was less severe, and perceived recovery was higher after IRS compared to PAS (p < 0.01). Post-exercise IRS attenuated the drop in explosive performance and decreased subjective muscle soreness after resistance training, which may enhance mood, readiness, and physical performance of an athlete. A single IRS session had no detrimental effects on recovery of the autonomic nervous system.

Background and Aims: Winter endurance athletes have a high prevalence of exercise-induced bronchoconstriction (EIB) and asthma, probably due to repeated and prolonged inhalation of cold and dry air. Heat- and moisture-exchanging devices (HME) warm and humidify inhaled air and prevent EIB. The aim of this study was to share cross-country skiers and biathletes' experiences of training and competition in low temperatures, views on temperature limits, usage of HME, and consequences of cold exposure on their health. Methods: Eleven Swedish World Championship or Olympic medalists in cross-country skiing and biathlon were interviewed and transcripts were analyzed using qualitative content analysis. Results: Participants described how cold temperatures predominantly affected the airways, face, and extremities. During training, extreme cold was managed by choosing warmer clothing, modification of planned sessions, use of HME, delaying training, or changing location. In competition, participants described limited possibility for such choices and would prefer adjustment of existing rules (i.e., more conservative temperature limits), especially since they understood elite skiing in low temperatures to present an occupational hazard to their health. Participants had at times used HMEs during training in cold environments but described mixed motives for their use—that HMEs warm and humidify cold inhaled air but introduce additional resistance to breathing and can cause problems due to mucus and ice build-up. Skiers also perceived that they had become more sensitive to cold during the latter part of their careers. Conclusions: The present study gives a unique insight into the “cold” reality of being an elite athlete in skiing and biathlon. Cold exposure results in negative health consequences that are preventable, which means that rules must be followed, and organizers should acknowledge responsibility in protecting athletes from occupational hazards. Development of evidence-based guidelines for protection of athletes' respiratory health should be a focus for future translational research.