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Kadhiresan R. Murugappan, Ariel Mueller, Daniel P. Walsh, Shahzad Shaefi, Akiva Leibowitz, and Todd Sarge

Rapid weight loss or “weight cutting” is a common but potentially harmful practice used in mixed martial arts competition. Following the official weigh-in, competitors refeed and rehydrate themselves in a process known as rapid weight gain (RWG) to realize a potential competitive advantage. While data from surveys and small series have indicated the majority of mixed martial arts athletes engage in rapid weight loss, there is a lack of officially collected data from sanctioning organizations describing its prevalence. The present investigation represents a summary of the data collected between December 2015 and January 2018 by the California State Athletic Commission. In total, 512 professional mixed martial artists (455 males and 57 females) were included. Of these, 503 (98%) athletes gained body mass between weigh-in and their bouts. Total RWG between weigh-in and competition was 5.5 ± 2.5 kg, corresponding to an 8.1% ± 3.6% body mass increase. Total RWG was 5.6 ± 2.5 kg (8.1% ± 3.6%) for males and 4.5 ± 2.3 kg (8.0% ± 3.8%) for females. More than one quarter of men and one third of women gained >10% body mass between weigh-in and competition. Athletes from leading international promotions gained more absolute, but not relative, body mass than those from regional promotions. Our findings indicate RWG is nearly ubiquitous in professional , with a similar prevalence in male and female athletes. Trends based on promotion suggest a larger magnitude of RWG in presumably more experienced and/or successful mixed martial artists from leading international promotions.

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Konstantinos Papanikolaou, Panagiotis Tsimeas, Angeliki Anagnostou, Alexandros Varypatis, Christos Mourikis, Theofanis Tzatzakis, Dimitrios Draganidis, Dimitrios Batsilas, Theodoros Mersinias, Georgios Loules, Athanasios Poulios, Chariklia K. Deli, Alexios Batrakoulis, Athanasios Chatzinikolaou, Magni Mohr, Athanasios Z. Jamurtas, and Ioannis G. Fatouros

Purpose: To examine the recovery kinetics of exercise-induced muscle damage (EIMD), neuromuscular fatigue, and performance following small-sided games (SSGs) of different densities in soccer. Methods: Ten male players randomly completed 3 trials: a control trial (no SSGs), 4v4 SSGs (62.5 m2/player), and 8v8 SSGs (284.4 m2/player). External and internal load were monitored using GPS technology, heart-rate monitors, and rating of perceived exertion. Delayed-onset muscle soreness (DOMS), creatine kinase (CK), isokinetic strength, countermovement jump (CMJ), and sprint were determined at baseline, as well as at 24, 48, and 72 hours post-SSGs. Neuromuscular fatigue was assessed at baseline and at 1, 2, and 3 hours post-SSGs. Results: DOMS increased (P < .05) in 4v4 for 72 hours and in 8v8 for 24 hours with that of knee flexors being more pronounced than that of extensors. CK increased (P < .05) in 4v4 for 72 hours and in 8v8 for 24 hours. Neuromuscular fatigue increased (P < .05) in 4v4 for 2 hours and in 8v8 for 3 hours. Strength declined (P < .05) in 4v4 for 48 hours and in 8v8 for 72 hours. CMJ decreased (P < .05) in 4v4 for 24 hours and in 8v8 for 48 hours. Sprint decreased (P < .05) for 48 hours in 4v4 and for 72 hours in 8v8. Conclusions: SSGs are associated with a prolonged rise of EIMD and induce short-term neuromuscular fatigue and slow recovery kinetics of strength, jump, and sprinting performance. The time for complete recovery is longer for SSGs of lower density.

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Gabriel Barreto, Luana Farias de Oliveira, Tiemi Saito, Rafael Klosterhoff, Pedro Perim, Eimear Dolan, Rosa Maria R. Pereira, Patrícia Campos-Ferraz, Fernanda R. Lima, and Bryan Saunders

Purpose: Women’s professional cycling has grown in popularity, and this increase is also apparent in Brazil, which has increased its female cycling calendar in recent years. The aim of this observational study was to (1) determine training and competition loads of a top-level Brazilian female cycling team, (2) evaluate nutrition and clinical health, and (3) measure whether exercise capacity changed throughout the season. Methods: Training and competition data were collected over the season using global positioning system monitors, while laboratory-based physiological and performance measures (incremental cycling test, 30-s Wingate, 4-km time trial) and clinical and nutritional analyses were performed at time points throughout the season. Results: Total distance covered over the year was 11,124 (2895) km (7382–14,698 km). Endurance capacity was reduced over the season (P = .005) but not anaerobic power (all P > .05). Nutrition and stress markers remained largely unchanged throughout the season, although there were some individual fluctuations in some measures, and testosterone concentration was low for some. Median estimated energy availability ranged between 32.3 and 56.8 kcal·kgLBM−1·d−1 during training and 26.4 and 53.8 kcal·kgLBM−1·d−1 during competition. Percentage of training spent in optimal estimated energy availability was generally low, with 3 athletes spending <35% within the optimal intake. Conclusions: Substantial training and competition loads of the monitored professional Brazilian female cyclists may have reduced exercise capacity toward the end of the season, indicative of a grueling yearlong schedule. Several athletes may have had suboptimal energy availability during the season, potentially affecting testosterone concentration. These data demonstrate the difficulties in maintaining optimal nutrition, health, and performance throughout a season in professional female cycling and highlight the need for quality sport-science support for this type of top-level athlete.

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Haresh T. Suppiah, Richard Swinbourne, Jericho Wee, Vanes Tay, and Paul Gastin

Purpose: Elite athletes experience chronic sleep insufficiency due to training and competition schedules. However, there is little research on sleep and caffeine use of elite youth athletes and a need for a more nuanced understanding of their sleep difficulties. This study aimed to (1) examine the differences in sleep characteristics of elite youth athletes by individual and team sports, (2) study the associations between behavioral risk factors associated with obstructive sleep apnea and caffeine use with sleep quality, and (3) characterize the latent sleep profiles of elite youth athletes to optimize the sleep support strategy. Methods: A group (N = 135) of elite national youth athletes completed a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and questions pertaining to obstructive sleep apnea, napping behavior, and caffeine use. K-means clustering was used to characterize unique sleep characteristic subgroups based on PSQI components. Results: Athletes reported 7.0 (SD = 1.2) hours of sleep. Out of the total group, 45.2% of the athletes had poor quality sleep (PSQI global >5), with team-sport athletes reporting significantly poorer sleep quality than individual-sport athletes. Multiple logistic regression analysis indicated that sport type significantly correlated with poor sleep quality. The K-means clustering algorithm classified athletes’ underlying sleep characteristics into 4 clusters to efficiently identify athletes with similar underlying sleep issues to enhance interventional strategies.Conclusion: These findings suggest that elite youth team-sport athletes are more susceptible to poorer sleep quality than individual-sport athletes. Clustering methods can help practitioners characterize sleep-related problems and develop efficient athlete support strategies.

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Gemma N. Parry, Lee C. Herrington, Ian G. Horsley, and Ian Gatt

Context: Maximal power describes the ability to immediately produce power with the maximal velocity at the point of release, impact, and/or take off—the greater an athlete’s ability to produce maximal power, the greater the improvement of athletic performance. In reference to boxing performance, regular consistent production of high muscular power during punching is considered an essential prerequisite. Despite the importance of upper limb power to athletic performance, presently, there is no gold standard test for upper limb force development performance. Objective: To investigate the test–retest reliability of the force plate–derived measures of countermovement push-up in elite boxers. Design: Test–retest design. Setting: High Performance Olympic Training Center. Participants: Eighteen elite Olympic boxers (age = 23 [3] y; height = 1.68 [0.39] m; body mass = 70.0 [17] kg). Intervention: Participants performed 5 repetitions of countermovement push-up trials on FD4000 Forcedeck dual force platforms on 2 separate test occasions 7 days apart. Main Outcome Measures: Peak force, mean force, flight time, rate of force development, impulse, and vertical stiffness of the bilateral and unilateral limbs from the force–time curve. Results: No significant differences between the 2 trial occasions for any of the derived bilateral or unilateral performance measures. Intraclass correlation coefficients indicated moderate to high reliability for performance parameters (intraclass correlation coefficients = .68–.98) and low coefficient of variation (3%–10%) apart from vertical stiffness (coefficient of variation = 16.5%–25%). Mean force demonstrated the greatest reliability (coefficient of variation = 3%). In contrast, no significant differences (P < .001) were noted between left and right limbs (P = .005–.791), or between orthodox or southpaw boxing styles (P = .19–.95). Conclusion: Force platform–derived kinetic bilateral and unilateral parameters of countermovement push-up are reliable measures of upper limb power performance in elite-level boxers; results suggest unilateral differences within the bilateral condition are not the norm for an elite boxing cohort.

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Julian Martinez, Autumn E. Decker, Chi C. Cho, Aiden Doherty, Ann M. Swartz, John Staudenmayer, and Scott J. Strath

Purpose: To assess the convergent validity of body-worn wearable camera still images (IMGs) for determining posture compared with activPAL (AP) classifications. Methods: The participants (n = 16, mean age 46.7 ± 23.8 years, 9 F) wore an Autographer wearable camera and an AP during three 2-hr free-living visits. IMGs were on average 8.47 s apart and were annotated with output consisting of events, transitory states, unknown, and gaps. The events were annotations that matched AP classifications (sit, stand, and move), consisting of at least three IMGs; the transitory states were posture annotations fewer than three IMGs; the unknowns were IMGs that could not be accurately classified; and the gaps were the time between annotations. For the analyses, the annotation and AP output were converted to 1-s epochs. The total and average length of visits and events were reported in minutes. Bias and 95% confidence intervals for event posture times from IMGs to AP were calculated to determine accuracy and precision. Confusion matrices using total AP posture times were computed to determine misclassification. Results: Forty-three visits were analyzed, with a total visit and event time of 5,027.73 and 4,237.23 min, respectively, and the average visit and event lengths being 116.92 and 98.54 min, respectively. Bias was not statistically significant for sitting, but was significant for standing and movement (0.84, −6.87, and 6.04 min, respectively). From confusion matrices, IMGs correctly classified sitting, standing, and movement (85.69%, 54.87%, and 69.41%, respectively) of total AP time. Conclusion: Wearable camera IMGs provide a good estimation of overall sitting time. Future work is warranted to improve posture classifications and examine the validity of IMGs in assessing activity-type behaviors.

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Cheryl Cooky

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Henning T. Langer, Agata A. Mossakowski, Suraj Pathak, Mark Mascal, and Keith Baar

Cannabidiol (CBD) has proven clinical benefits in the treatment of seizures, inflammation, and pain. The recent legalization of CBD in many countries has caused increased interest in the drug as an over-the-counter treatment for athletes looking to improve recovery. However, no data on the effects of CBD on the adaptive response to exercise in muscle are available. To address this gap, we eccentrically loaded the tibialis anterior muscle of 14 rats, injected them with a vehicle (n = 7) or 100 mg/kg CBD (n = 7), and measured markers of injury, inflammation, anabolic signaling, and autophagy 18 hr later. Pro-inflammatory signaling through nuclear factor kappa B (NF-kB) (Ser536) increased with loading in both groups; however, the effect was significantly greater (36%) in the vehicle group (p < .05). Simultaneously, anabolic signaling through ribosomal protein S6 kinase beta-1 (S6K1) (Thr389) increased after eccentric contractions in both groups with no difference between vehicle and CBD (p = .66). The ribosomal protein S6 phosphorylation (240/244) increased with stimulation (p < .001) and tended to be higher in the CBD group (p = .09). The ubiquitin-binding protein p62 levels were not modulated by stimulation (p = .6), but they were 46% greater in the CBD compared with the vehicle group (p = .01). Although liver weight did not differ between the groups (p = .99) and levels of proteins associated with stress were similar, we did observe serious side effects in one animal. In conclusion, an acute dose of CBD decreased pro-inflammatory signaling in the tibialis anterior without blunting the anabolic response to exercise in rats. Future research should determine whether these effects translate to improved recovery without altering adaptation in humans.

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Elif Inan-Eroglu, Bo-Huei Huang, Leah Shepherd, Natalie Pearson, Annemarie Koster, Peter Palm, Peter A. Cistulli, Mark Hamer, and Emmanuel Stamatakis

Background: Thigh-worn accelerometers have established reliability and validity for measurement of free-living physical activity-related behaviors. However, comparisons of methods for measuring sleep and time in bed using the thigh-worn accelerometer are rare. The authors compared the thigh-worn accelerometer algorithm that estimates time in bed with the output of a sleep diary (time in bed and time asleep). Methods: Participants (N = 5,498), from the 1970 British Cohort Study, wore an activPAL device on their thigh continuously for 7 days and completed a sleep diary. Bland–Altman plots and Pearson correlation coefficients were used to examine associations between the algorithm derived and diary time in bed and asleep. Results: The algorithm estimated acceptable levels of agreement with time in bed when compared with diary time in bed (mean bias of −11.4 min; limits of agreement −264.6 to 241.8). The algorithm-derived time in bed overestimated diary sleep time (mean bias of 55.2 min; limits of agreement −204.5 to 314.8 min). Algorithm and sleep diary are reasonably correlated (ρ = .48, 95% confidence interval [.45, .52] for women and ρ = .51, 95% confidence interval [.47, .55] for men) and provide broadly comparable estimates of time in bed but not for sleep time. Conclusions: The algorithm showed acceptable estimates of time in bed compared with diary at the group level. However, about half of the participants were outside of the ±30 min difference of a clinically relevant limit at an individual level.