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Daniel J. Davies, Kenneth S. Graham and Chin Moi Chow

Purpose:

The use of daytime napping as a recovery tool following exercise is virtually unexplored. The objective of this study was to assess the quality of daytime nap sleep following endurance training in an athletic population, and to appraise the optimal circadian timing of the nap and the time interval between training and the nap.

Methods:

Six physically trained male subjects (22.5 ± 2.4 y) performed four separate standardized 90-min endurance training sessions followed by a 90-min daytime nap either 1 or 2 h after training (time interval), commencing at either 10:30 or 11:30 (circadian timing). During the nap, sleep was monitored using polysomnography. Subjective measurements of sleep quality, alertness and preparedness to train following a nap were recorded using a visual analog scale.

Results:

The duration of slow wave sleep (SWS) was significantly greater during the 11:30 naps (13.7 ± 9.0 min) compared with the 10:30 naps (6.9 ± 8.8 min) (P = .049). There was no significant difference in SWS duration between a 1-h (10.6 ± 10.2 min) or 2-h (10.0 ± 9.0 min) time interval between training and the nap (P = .82). No other sleep variables differed significantly according to circadian timing or time interval.

Conclusion:

Recovery naps commenced later in the morning contain more SWS than earlier naps. The data imply that daytime naps have a potential role as a valuable recovery tool following endurance exercise, given the suggested energy restorative functions of SWS.

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Jason R. Karp, Jeanne D. Johnston, Sandra Tecklenburg, Timothy D. Mickleborough, Alyce D. Fly and Joel M. Stager

Nine male, endurance-trained cyclists performed an interval workout followed by 4 h of recovery, and a subsequent endurance trial to exhaustion at 70% VO2max, on three separate days. Immediately following the first exercise bout and 2 h of recovery, subjects drank isovolumic amounts of chocolate milk, fluid replacement drink (FR), or carbohydrate replacement drink (CR), in a single-blind, randomized design. Carbohydrate content was equivalent for chocolate milk and CR. Time to exhaustion (TTE), average heart rate (HR), rating of perceived exertion (RPE), and total work (WT) for the endurance exercise were compared between trials. TTE and WT were significantly greater for chocolate milk and FR trials compared to CR trial. The results of this study suggest that chocolate milk is an effective recovery aid between two exhausting exercise bouts.

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John K. Malone, Catherine Blake and Brian Caulfield

Purpose:

To investigate the use of neuromuscular electrical stimulation (NMES) during acute recovery between 2 bouts of maximal aerobic exercise.

Methods:

On 3 separate days, 19 trained male cyclists (28 ± 7 y, 76.4 ± 10.4 kg, power output at maximal aerobic power [pVo2max] 417 ± 44 W) performed a 3-min maximal cycling bout at 105% PVo2max before a 30-min randomly assigned recovery intervention of passive (PAS: resting), active (ACT: 30% PVo2max), or NMES (5 Hz, 4 pulses at 500 μs). Immediately afterward, a cycle bout at 95% PVo2max to exhaustion (TLIM) was performed. Heart rate (HR) and blood lactate (BLa) were recorded at designated time points. Data were analyzed using repeated-measures ANOVA with a Tukey honestly significantly different post hoc test. Statistical significance threshold was P < .05.

Results:

The TLIM was significantly shorter for NMES than for ACT (199.6 ± 69.4 s vs 250.7 ± 105.5 s: P = .016) but not PAS recovery (199.6 ± 69.4 s vs 216.4 ± 77.5 s: P = .157). The TLIM was not significantly different between ACT and PAS (250.7 ± 105.5 s vs 216.4 ± 77.5 s: P = .088). The decline in BLa was significantly greater during ACT than NMES and PAS recovery (P < .001), with no difference between NMES and PAS. In addition, HR was significantly higher during ACT than NMES and PAS recovery (P < .001), with no difference between NMES and PAS.

Conclusions:

NMES was less effective than ACT and comparable to PAS recovery when used between 2 bouts of maximal aerobic exercise in trained male cyclists.

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Ian M. Wilcock, John B. Cronin and Wayne A. Hing

Purpose:

To assess the effect that post exercise immersion in water has on subsequent exercise performance.

Methods:

A literary search and review of water-immersion and performance studies was conducted.

Results:

Seven articles were examined. In 2, significant benefits to performance were observed. Those 2 articles revealed a small to large effect on jump performance and isometric strength.

Practical Application and Conclusions:

It is possible that water immersion might improve recovery from plyometric or muscle-damaging exercise. Such a statement needs to be verified, however, because of the scarcity of research on water immersion as a recovery strategy.

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Mindy Millard-Stafford, Gordon L. Warren, Leah Moore Thomas, J. Andrew Doyle, Teresa Snow and Kristen Hitchcock

Post-exercise nutrition is critical to facilitate recovery from training. To determine if added protein (P) or increased carbohydrate (CHO) differentially improves recovery, eight runners ingested: 6% CHO (CHO6), 8% CHO + 2% protein (CHOP), and isocaloric 10% CHO (CHO10) following a 21-km run plus treadmill run to fatigue (RTF) at 90% VO2max. RTF was repeated after 2 h recovery. After 24 h, a 5 km time trial was performed. Insulin and blood glucose were higher (P < 0.05) following CHO10 compared to CHO-P and CHO6, but did not affect improvement from the first to second RTF (29.6% ± 6, 40.5% ± 8.8, 40.5% ± 14.5) or 5 km time (1100 ± 36.3, 1110 ± 37.3, 1118 ± 36.5 s). CK was not different, but perceived soreness with CHO-P (2.1 ± 0.5) was lower than CHO10 (5.2 ± 0.7). Additional calories from CHO or P above that provided in sports drinks does not improve subsequent performance after recovery; but less soreness suggests benefits with CHO-P.

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Justin M. Stanek

Clinical Scenario:

The popularity of compression socks has increased substantially among athletes, particularly those participating in endurance events such as running and triathlon. Companies are increasingly marketing compression stockings to runners, triathletes, and other endurance athletes for the benefits of improved performance and/or decreased recovery time. Originally developed for the treatment of deep-vein thrombosis, compression socks are now marketed as a tool to improve venous return, thus believed to improve both performance and recovery in athletes. The use of compression socks during training aims to help the skeletal-muscle pump, increase deep venous velocity, and/or decrease blood pooling in the calf veins and alleviate delayed-onset muscle soreness. The scenario is a 28-y-old recreational triathlete seeking your advice while training for her first half-Ironman. She occasionally complains of tightness in the calves both during and after running. She wants your opinion on the effectiveness of using compression socks to help her performance and recovery.

Focused Clinical Question:

What is the effectiveness of using graduated compression socks for improving athletic performance and decreasing recovery time in healthy endurance athletes?

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Ricardo J.S. Costa, Robert Walters, James L.J. Bilzon and Neil P. Walsh

The purpose of the study was to determine the effects of carbohydrate (CHO) intake, with and without protein (PRO), immediately after prolonged strenuous exercise on circulating bacterially stimulated neutrophil degranulation. Twelve male runners completed 3 feeding interventions, 1 week apart, in randomized order after 2 hr of running at 75% VO2max. The feeding interventions included a placebo solution, a CHO solution equal to 1.2 g CHO~/kg body mass (BM), and a CHO-PRO solution equal to 1.2 g CHO/kg BM and 0.4 g PRO/kg BM (CHO+PRO) immediately postexercise. All solutions were flavor and water-volume equivalent (12 ml/kg BM). Circulating leukocyte counts, bacterially stimulated neutrophil degranulation, plasma insulin, and cortisol were determined from blood samples collected preexercise, immediately postexercise, and every 30 min until 180 min postexercise. The immediate postexercise circulating leukocytosis, neutrophilia, and lymphocytosis (p < .01 vs. preexercise) and the delayed lymphopenia (90 min postexercise, p < .05 vs. preexercise) were similar on all trials. Bacterially stimulated neutrophil degranulation decreased during recovery in control (23% at 180 min, p < .01 vs. preexercise) but remained above preexercise levels with CHO and CHO+PRO. In conclusion, CHO ingestion, with or without PRO, immediately after prolonged strenuous exercise prevented the decrease in bacterially stimulated neutrophil degranulation during recovery.

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Dylan Thompson, Clyde Williams, Stephen J. McGregor, Ceri W. Nicholas, Frank McArdle, Malcolm J. Jackson and Jonathan R. Powell

The aim of the present study was to investigate whether 2 weeks of vitamin C supplementation affects recovery from an unaccustomed bout of exercise. Sixteen male subjects were allocated to either a placebo (P; n = 8) or vitamin C group (VC; n = 8). The VC group consumed 200 mg of ascorbic acid twice a day, whereas the P group consumed identical capsules containing 200 mg of lactose. Subjects performed a prolonged (90-min) intermittent shuttle-running test 14 days after supplementation began. Post-exercise serum creatine kinase activities and myoglobin concentrations were unaffected by supplementation. However, vitamin C supplementation had modest beneficial effects on muscle soreness, muscle function, and plasma concentrations of malondialdehyde. Furthermore, although plasma interleukin-6 increased immediately after exercise in both groups, values in the VC group were lower than in the P group 2 hours after exercise (p < .05). These results suggest that prolonged vitamin C supplementation has some modest beneficial effects on recovery from unaccustomed exercise.

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Andreas M. Kasper, S. Andy Sparks, Matthew Hooks, Matthew Skeer, Benjamin Webb, Houman Nia, James P. Morton and Graeme L. Close

, affecting everyday function, and can last several days postgame and remain throughout the entire season ( Fletcher et al., 2016 ). Players and support staff, therefore, constantly strive to improve recovery strategies and reduce pain with an emerging method being the use of cannabidiol (CBD). It is

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Rennae Williams Stowe

This review presents a framework for understanding the role of social support in athletic injury prevention and recovery. The stress-injury model is presented, which is the theoretical basis for many studies on psychosocial factors related to injury in sport. In addition, we discuss the definition of social support, types and sources of social support for the athlete, and strategies supporting others can use to show their support. Finally, using social support as a rehabilitation strategy and gender differences will be presented.