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Recovery During Successive 120-min Football Games: Results from the 120-min Placebo/Carbohydrate Randomized Controlled Trial.
Ermidis, G, Mohr, M, Jamurtas, AZ, Draganidis, D, Poulios, A, Papanikolaou, K, Vigh-Larsen, J, Loules, G, Sovatzidis, A, Nakopoulou, T, et al
Medicine and science in sports and exercise. 2024
Abstract
PURPOSE To examine the recovery kinetics (i.e. time-dependent changes) of performance-related variables between two 120-min male football games performed three days apart with and without carbohydrate (CHO) supplementation. METHODS 20 male players (20 ± 1 years; body fat: 14.9 ± 5.1%; VO2max: 59.4 ± 3.7 mL•kg-1•min-1) participated in two 120-min football games (G1, G2) according to a randomized, two-trial, repeated measures, cross-over, double-blind design. Participants received carbohydrate/Placebo supplements during recovery between games. Field activity was monitored during the games. Performance testing and blood sampling were performed before, at 90- and 120-min of each game. Muscle biopsies were collected at baseline, 90- and 120-min of G1 and pre-G2. RESULTS Compared to G1, G2 was associated with reduced total distance (10,870 vs. 10,685 m during 90-min and 3,327 vs. 3,089 m during extra 30-min; p = 0.007-0.038), average (6.7 vs. 6.2 m•s-1 during extra 30-min match-play; p = 0.007) and maximal speed (32.2 vs. 30.2 m•s-1 during 90-min and 29.0 vs. 27.9 m•s-1 during extra 30-min; p < 0.05), accelerations/decelerations (p < 0.05) and mean HR (p < 0.05). Repeated sprint ability (p < 0.001), jumping (p < 0.05) and strength (p < 0.001) performance were compromised before and during G2. Muscle glycogen was not restored at G2-baseline (p = 0.005). Extended game-play reduced lymphocyte, erythrocyte counts, hematocrit, hemoglobin, reduced glutathione (p < 0.05) and increased DOMS, creatine kinase activity, blood glycerol and ammonia (p < 0.05) and protein carbonyls (p < 0.05) before and during G2. Pax7+ (p = 0.004) and MyoD+ cells (p = 0.019) increased at baseline-G2. Carbohydrate supplementation restored performance and glycogen, reduced glycerol and DOMS responses, and increased leukocyte counts and Pax7+ and MyoD+ cells. CONCLUSIONS Results suggest that extended football games induce a prolonged recovery of performance which may be facilitated by carbohydrate supplementation during a congested game fixture.
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The angiotensin-converting enzyme I/D polymorphism does not impact training-induced adaptations in exercise capacity in patients with stable coronary artery disease.
Sjúrðarson, T, Kristiansen, J, Nordsborg, NB, Gregersen, NO, Lydersen, LN, Grove, EL, Kristensen, SD, Hvas, AM, Mohr, M
Scientific reports. 2023;(1):18300
Abstract
Systematic exercise training effectively improves exercise capacity in patients with coronary artery disease (CAD), but the magnitude of improvements is highly heterogeneous. We investigated whether this heterogeneity in exercise capacity gains is influenced by the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene. Patients with CAD (n = 169) were randomly assigned to 12 weeks of exercise training or standard care, and 142 patients completed the study. The ACE polymorphism was determined for 128 patients (82% males, 67 ± 9 years). Peak oxygen uptake was measured before and after the 12-week intervention. The ACE I/D polymorphism frequency was n = 48 for D/D homozygotes, n = 61 for I/D heterozygotes and n = 19 for I/I homozygotes. Baseline peak oxygen uptake was 23.3 ± 5.0 ml/kg/min in D/D homozygotes, 22.1 ± 5.3 ml/kg/min in I/D heterozygotes and 23.1 ± 6.0 ml/kg/min in I/I homozygotes, with no statistical differences between genotype groups (P = 0.50). The ACE I/D polymorphism frequency in the exercise group was n = 26 for D/D, n = 21 for I/D and n = 12 for I/I. After exercise training, peak oxygen uptake was increased (P < 0.001) in D/D homozygotes by 2.6 ± 1.7 ml/kg/min, in I/D heterozygotes by 2.7 ± 1.9 ml/kg/min, and in I/I homozygotes by 2.1 ± 1.3 ml/kg/min. However, the improvements were similar between genotype groups (time × genotype, P = 0.55). In conclusion, the ACE I/D polymorphism does not affect baseline exercise capacity or exercise capacity gains in response to 12 weeks of high-intensity exercise training in patients with stable CAD.Clinical trial registration: www.clinicaltrials.gov (NCT04268992).
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Robust arm and leg muscle adaptation to training despite ACE inhibition: a randomized placebo-controlled trial.
Sjúrðarson, T, Bejder, J, Breenfeldt Andersen, A, Bonne, TC, Kyhl, K, Thomassen, M, Prats, J, Oddmarsdóttir Gregersen, N, Skoradal, MB, Weihe, P, et al
European journal of applied physiology. 2023;(2):325-337
Abstract
PURPOSE Angiotensin-converting enzyme (ACE) inhibitor treatment is widely applied, but the fact that plasma ACE activity is a potential determinant of training-induced local muscular adaptability is often neglected. Thus, we investigated the hypothesis that ACE inhibition modulates the response to systematic aerobic exercise training on leg and arm muscular adaptations. METHODS Healthy, untrained, middle-aged participants (40 ± 7 yrs) completed a randomized, double-blinded, placebo-controlled trial. Participants were randomized to placebo (PLA: CaCO3) or ACE inhibitor (ACEi: enalapril) for 8 weeks and completed a supervised, high-intensity exercise training program. Muscular characteristics in the leg and arm were extensively evaluated pre and post-intervention. RESULTS Forty-eight participants (nACEi = 23, nPLA = 25) completed the trial. Exercise training compliance was above 99%. After training, citrate synthase, 3-hydroxyacyl-CoA dehydrogenase and phosphofructokinase maximal activity were increased in m. vastus lateralis in both groups (all P < 0.05) without statistical differences between them (all time × treatment P > 0.05). In m. deltoideus, citrate synthase maximal activity was upregulated to a greater extent (time × treatment P < 0.05) in PLA (51 [33;69] %) than in ACEi (28 [13;43] %), but the change in 3-hydroxyacyl-CoA dehydrogenase and phosphofructokinase maximal activity was similar between groups. Finally, the training-induced changes in the platelet endothelial cell adhesion molecule-1 protein abundance, a marker of capillary density, were similar in both groups in m. vastus lateralis and m. deltoideus. CONCLUSION Eight weeks of high-intensity whole-body exercise training improves markers of skeletal muscle mitochondrial oxidative capacity, glycolytic capacity and angiogenesis, with no overall effect of pharmacological ACE inhibition in healthy adults.
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Extended Match Time Exacerbates Fatigue and Impacts Physiological Responses in Male Soccer Players.
Mohr, M, Ermidis, G, Jamurtas, AZ, Vigh-Larsen, JF, Poulios, A, Draganidis, D, Papanikolaou, K, Tsimeas, P, Batsilas, D, Loules, G, et al
Medicine and science in sports and exercise. 2023;(1):80-92
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Abstract
PURPOSE This study evaluated how extended match time (90 + 30 min) affected physiological responses and fatigue in male soccer players. METHODS Twenty competitive players (mean ± SD: age, 20 ± 1 yr; maximal oxygen uptake, 59 ± 4 mL·min -1 ·kg -1 ) completed an experimental match with their activity pattern and heart rate assessed throughout the game, whereas countermovement jump performance and repeated sprint ability were tested and quadriceps muscle biopsies and venous blood samples were taken at baseline and after 90 and 120 min of match play. RESULTS Less high-intensity running (12%) was performed in extra time in association with fewer intense accelerations and decelerations per minute compared with normal time. Peak sprint speed was 11% lower in extra time compared with normal time, and fatigue also manifested in impaired postmatch repeated sprint ability and countermovement jump performance (all P < 0.05). Muscle glycogen declined from 373 ± 59 mmol·kg -1 dry weight (dw) at baseline to 266 ± 64 mmol·kg -1 dw after 90 min, with a further decline to 186 ± 56 mmol·kg -1 dw after extra time ( P < 0.05) and with single-fiber analyses revealing depleted or very low glycogen levels in ~75% of both slow and fast twitch fibers. Blood glucose did not change during the first 90-min but declined ( P < 0.05) to 81 ± 8 mg·dL -1 after extra time. Plasma glycerol and ammonia peaked at 236 ± 33 mg·dL -1 and 75 ± 21 μmol·L -1 after the extra period. CONCLUSIONS These findings demonstrate exacerbated fatigue after extra time compared with normal time, which seems to be associated with muscle glycogen depletion, reductions in blood glucose levels, and hyperammonemia. Together, this points to metabolic disturbances being a major part of the integrated and multifaceted fatigue response during extended soccer match play.
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The Role of Muscle Glycogen Content and Localization in High-Intensity Exercise Performance: A Placebo-Controlled Trial.
Vigh-Larsen, JF, Ørtenblad, N, Nielsen, J, Emil Andersen, O, Overgaard, K, Mohr, M
Medicine and science in sports and exercise. 2022;(12):2073-2086
Abstract
PURPOSE We investigated the coupling between muscle glycogen content and localization and high-intensity exercise performance using a randomized, placebo-controlled, parallel-group design with emphasis on single-fiber subcellular glycogen concentrations and sarcoplasmic reticulum Ca 2+ kinetics. METHODS Eighteen well-trained participants performed high-intensity intermittent glycogen-depleting exercise, followed by randomization to a high- (CHO; ~1 g CHO·kg -1 ·h -1 ; n = 9) or low-carbohydrate placebo diet (PLA, <0.1 g CHO·kg -1 ·h -1 ; n = 9) for a 5-h recovery period. At baseline, after exercise, and after the carbohydrate manipulation assessments of repeated sprint ability (5 × 6-s maximal cycling sprints with 24 s of rest), neuromuscular function and ratings of perceived exertion during standardized high-intensity cycling (~90% Wmax ) were performed, while muscle and blood samples were collected. RESULTS The exercise and carbohydrate manipulations led to distinct muscle glycogen concentrations in CHO and PLA at the whole-muscle (291 ± 78 vs 175 ± 100 mmol·kg -1 dry weight (dw), P = 0.020) and subcellular level in each of three local regions ( P = 0.001-0.046). This was coupled with near-depleted glycogen concentrations in single fibers of both main fiber types in PLA, especially in the intramyofibrillar region (within the myofibrils). Furthermore, increased ratings of perceived exertion and impaired repeated sprint ability (~8% loss, P < 0.001) were present in PLA, with the latter correlating moderately to very strongly ( r = 0.47-0.71, P = 0.001-0.049) with whole-muscle glycogen and subcellular glycogen fractions. Finally, sarcoplasmic reticulum Ca 2+ uptake, but not release, was superior in CHO, whereas neuromuscular function, including prolonged low-frequency force depression, was unaffected by dietary manipulation. CONCLUSIONS Together, these results support an important role of muscle glycogen availability for high-intensity exercise performance, which may be mediated by reductions in single-fiber levels, particularly in distinct subcellular regions, despite only moderately lowered whole-muscle glycogen concentrations.
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Feasibility and impact of whole-body high-intensity interval training in patients with stable coronary artery disease: a randomised controlled trial.
Kristiansen, J, Sjúrðarson, T, Grove, EL, Rasmussen, J, Kristensen, SD, Hvas, AM, Mohr, M
Scientific reports. 2022;(1):17295
Abstract
Exercise training reduces cardiovascular mortality and improves quality of life in CAD patients. We investigated the feasibility and impact of 12 weeks of low-volume high-intensity interval training (HIIT) in CAD-patients. Patients with stable CAD were randomized 1:1 to supervised HIIT or standard care. HIIT sessions were completed three times weekly for 12 weeks on a rowing ergometer. Before and after the 12-week intervention, patients completed a physiological evaluation of cardiorespiratory performance and quality of life questionnaires. Mixed model analysis was used to evaluate differences between and within groups. A total of 142 patients (67 ± 9 years, nHIIT = 64, nStandard care = 78) completed the trial. Training adherence was 97% (range 86-100%). Six patients dropped out because of non-fatal adverse events. Weekly training duration was 54 min with an average power output of 138 W. HIIT increased peak oxygen uptake by 2.5 mL/kg/min (95% CI 2.1-3.0), whereas no change was observed in standard care (0.2 mL/kg/min, 95% CI - 0.2-0.6, P < 0.001). In addition, HIIT improved markers of quality of life, including physical functioning, limitations due to physical illness, general health and vitality (P < 0.05). Twelve weeks of low-volume whole-body HIIT increased cardiorespiratory capacity and improved quality of life in patients with stable CAD compared to standard care. In addition, our study demonstrates that the applied vigorous training regime is feasible for this patient group.Clinical trial registration: www.clinicaltrials.gov . Identification number: NCT04268992.
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Effects of Postdischarge High-Protein Oral Nutritional Supplements and Resistance Training in Malnourished Surgical Patients: A Pilot Randomized Controlled Trial.
Patursson, P, Møller, G, Thomsen, BB, Olsen, E, Mortensen, J, Andorsdóttir, G, Mohr, M, Andersen, JR
Nutrients. 2022;(13)
Abstract
The presence of malnutrition is increasingly becoming a postdischarge problem in surgical patients. We aimed to investigate whether oral nutritional supplements combined with resistance training could minimize skeletal muscle atrophy in surgical patients after discharge. This randomized controlled study was conducted at the Department of Surgery, National Hospital of Faroe Islands from 2018 to 2020. A total of 45 patients aged 37−74 years participated and were allocated to one of three groups: diet (DI; n = 13), exercise and diet (EX + DI; n = 16), or control (CON; n = 16). The intervention period lasted 8 weeks. The intervention groups received individual dietary counselling and a protein-rich oral nutritional supplement twice a day containing 22 g of protein/day. Patients in the EX + DI group were assigned to resistance training sessions. Patients in the CON group received standard care. The primary outcome was change in lean body mass (LBM). Secondary outcomes were change in body weight, handgrip strength, quality of life, surgery-related side effects, energy and protein intake, length of stay and one-year mortality. To estimate within-group changes, linear mixed models including group−time interactions as fixed effects and patients as random effects were fitted. Within-group change in LBM was 233, 813 and 78 g in the DI, EX + DI and CON groups, respectively, with no significant between-group difference (p > 0.05). Pain score declined more (p = 0.04) in the EX + DI group compared with the CON group. Body weight, handgrip strength, quality of life and surgery-related side effects did not differ between groups. At the end of study, mean cumulative weight change in the DI and EX + DI groups was 0.4% and 1.6%, respectively, whereas the CON group experienced a weight loss of −0.6%. No significant difference in primary outcome between groups was noted. However, our results indicate some benefits from exercise and nutrition for malnourished surgical patients.
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Four Weeks of Intensified Training Enhances On-Ice Intermittent Exercise Performance and Increases Maximal Oxygen Consumption of Youth National-Team Ice Hockey Players.
Sommer Jeppesen, J, Vigh-Larsen, JF, Oxfeldt, MS, Laustsen, NM, Mohr, M, Bangsbo, J, Hostrup, M
International journal of sports physiology and performance. 2022;(10):1507-1515
Abstract
PURPOSE We investigated whether 4 weeks of intensified training consisting of speed endurance training (SET) enhanced high-intensity exercise performance in youth national-team ice hockey players. METHODS Utilizing a randomized crossover design, we subjected 17 players to 4 weeks of SET, comprising 6 to 10 × 20 seconds at maximal effort (>95% maximum ice skating speed) with 120-second recovery performed 3 times weekly, or maintenance of regular training (control period). Before and after each period, players completed ice-hockey-specific tests on ice, including a Yo-Yo Intermittent Recovery Level 1 test, a 30-m sprint test, and an agility test. On a separate day, players were assessed for body composition with dual-energy X-ray absorptiometry and performed countermovement jump, maximal voluntary isometric knee extensor contraction, a 15-second maximal sprint test, and a submaximal and incremental test on a bike ergometer in which pulmonary oxygen consumption was determined. RESULTS Yo-Yo Intermittent Recovery Level 1 test performance increased (P < .001) by 14% (95% CI, 201-496 m) during the SET period. Maximal pulmonary oxygen consumption (P < .05) and time to exhaustion (P < .05) were 4.8% and 6.5% higher, respectively, after the SET period than before. Fat-free mass increased (P < .01) during the SET period by 1.7 kg (95% CI, 1.0-2.5), whereas fat mass remained unchanged. These effects were superior to the control period. CONCLUSIONS These findings underpin the effectiveness of SET for improving on-ice high-intensity performance and highlight that elite ice hockey players can benefit from implementing SET.
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Skeletal muscle phenotype and game performance in elite women football players.
Mohr, M, Fatouros, IG, Jamurtas, AZ, Draganidis, D, Thomassen, M, Ørntoft, C, Ermidis, G, Loules, G, Batsilas, D, Poulios, A, et al
Scandinavian journal of medicine & science in sports. 2022;:39-53
Abstract
We combined game activity analyses with skeletal muscle phenotypes and comprehensive physiological testing to elucidate factors of importance for physical performance in elite women's football. GPS-data from an experimental game, sprint and endurance testing, and muscle tissue analysis of metabolic enzyme activity, protein expression and fiber type composition were completed for international top-level women players (n = 20; age; 23 ± 4 yrs, height; 166 ± 10 cm, weight; 60 ± 8 kg; VO2max ; 51 ± 6 ml/min/kg). Muscle monocarboxylate transporter 4 (MCT4) protein expression explained 46% of the variance in total game distance, while the ability to maintain high-intensity running (HIR) during the final 15 min of the game correlated to myosin heavy chain 1 (MHCI) and Na+ -K+ ATPase β1, FXYD1 (phospholemman) and superoxide dismutase 2 (SOD2) protein expression (range: r = 0.51-0.71; all p < 0.05). Total HIR distance correlated with (MHCIIa) protein expression (r = 0.51; p < 0.05), while muscle Na+ /H+ exchanger 1 (NHE1) protein explained 36% of the variance in game sprint distance (p < 0.05). Total game accelerations (actions >4 m/s2 ) correlated with platelet endothelial cell adhesion molecule (PECAM-1) protein expression (r = 0.51; p < 0.05), while concentric knee flexor strength explained 42-62% of the variance in intense decelerations (>4 m/s2 ). In conclusion, for elite women players' game endurance performance and resistance to end-game fatigue were affected by monocarboxylate transporter expression and myosin heavy chain profile. HIR was also correlated to ion transporter expression and muscle antioxidative capacity. Finally, the importance of functional strength and measures of muscle vascularization in relation to total game decelerations and accelerations, respectively, illustrates the complex physiological demands in elite women's football.
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Haemostasis and fibrinolysis after regular high-intensity interval training in patients with coronary artery disease: a randomised controlled trial.
Kristiansen, J, Grove, EL, Sjúrðarson, T, Rasmussen, J, Mohr, M, Kristensen, SD, Hvas, AM
Open heart. 2022;(2)
Abstract
UNLABELLED IntroductionPatients with coronary artery disease (CAD) have prothrombotic changes compared with healthy individuals. Regular exercise reduces cardiovascular mortality in patients with stable CAD. However, the underlying mechanism for the beneficial effect is unknown. We investigated whether regular exercise would inhibit platelet aggregation and thrombin generation and increase fibrinolysis in patients with CAD. MATERIALS AND METHODS Patients with CAD were randomised 1:1 to a supervised high-intensity exercise training programme or standard care for 12 weeks. Blood samples were obtained at baseline and after 6 and 12 weeks. Platelet aggregation was evaluated with the Multiplate Analyser, thrombin generation using the calibrated automated thrombogram and fibrinolysis employing a clot lysis assay. RESULTS A total of 169 stable patients with CAD were randomised, and 142 patients (67±9 years, 83% males) completed the study; 64 in the exercise group and 78 in the standard care group. All but one patients received single antiplatelet therapy. From baseline to 12 weeks postintervention (Δ), no significant between-group differences were found in adenosine diphosphate-induced platelet aggregation (Δ-15 aggregation units (AU), AU×min, 95% CI -70 to 40 in the exercise group and Δ-26 AU×min, 95% CI -77 to 26 in the standard care group, p=0.44); endogenous thrombin potential (medians: Δ-5%, 95% CI -12 to 3 in the exercise group and Δ-6%, 95% CI -13 to 1 in the standard care group, p=0.26); nor in 50% clot lysis time (medians: Δ-9%, 95% CI -23 to 7 in the exercise group and Δ-17%, 95% CI -29 to -3 in the standard care group, p=0.60). CONCLUSIONS Twelve weeks of high-intensity whole-body endurance exercise did not affect platelet aggregation, thrombin generation or fibrinolysis in patients with stable CAD. TRIAL REGISTRATION NUMBER NCT04268992.