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Scarce research has examined the links between stress, anxiety, and gastrointestinal (GI) symptoms during competition, despite that they are positively correlated in the general population. A total of 186 endurance athletes completed the Perceived Stress Scale (PSS)-14, Anxiety Sensitivity Index (ASI)-3, and State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) before races. Afterwards, they reported the severity of in-race GI symptoms. Associations between high levels of stress and anxiety (defined as the top tertile) and GI distress (≥3 on a 0-10 scale) were examined using logistic regression. Athletes with high PSS-14 scores did not have greater odds of GI symptoms, except nausea (odds ratio [OR] = 2.21, 95% confidence interval [CI] 1.02-4.78). High scores on the STICSA-trait were associated with nausea (OR = 3.43, 95% CI 1.57-7.50) and regurgitation/reflux (OR = 3.31, 95% CI 1.26-8.73). Among a sub-sample of 125 participants that completed STICSA-state questionnaires, higher anxiety was associated with nausea (OR = 5.57, 95% CI 1.96-15.83), regurgitation/reflux (OR = 3.75, 95% CI 1.17-12.00), fullness (OR = 2.98, 95% CI 1.05-8.49), and cramping (OR = 3.99, 95% CI 1.36-11.68). The ORs remained relatively stable after adjusting for age, gender, experience, body mass index, type of race, and race duration. ASI-3 scores were not associated with symptoms. Individuals with higher levels of anxiety, especially on the morning of a race, may be prone GI distress, particularly nausea, regurgitation/reflux, and cramping.

Objective: To develop a novel muscle cramp scale (MCS) to assess frequency, severity and clinically meaningful information related to cramps among patients with amyotrophic lateral sclerosis (ALS). Methods: This new scale comprises four 5-point subdomains: (1) triggering factors, (2) frequency, (3) location, (4) severity, and (5) the degree to which cramps affect overall daily living. Thirty patients with ALS, who experienced at least 5 cramps per week, participated in a randomized test-retest study. An additional 26 patients participated in a second study assessing cramp changes over 4 weeks using the MCS and a detailed cramp diary. Results: To establish internal reliability of the scale, a Cronbach's coefficient value of 0.75 or higher was considered acceptable. Test/retest evaluations comparing in-person and telephone administration were assessed using paired t -tests and Cohen's kappa statistics. Non-significant differences were identified, and the results revealed moderate to high agreement for each item (range 0.60 to 0.95, p  < 0.0001). Scale construct validity against the cramp diary was acceptable. There were essentially no significant mean differences in muscle cramps over 4 weeks measured using the MCS and diary, respectively. Conclusions: The MCS is a valid, simple, and quick measure for the assessment of muscle cramps in patients with ALS. It can be reliably administered either in person or by telephone and provides richer information than the routinely utilized cramp diary.

Introduction: Muscle cramping may increase peripheral nervous system excitability. It is unknown if, and how long, cramp susceptibility is affected by previous cramping. We tested whether volitionally induced muscle cramps (VIMCs) lowered cramp threshold frequency (TF c ) and how long TF c was affected post-VIMC., Methods: Fifteen cramp-prone participants volitionally induced a flexor hallucis brevis (FHB) cramp on 4 separate days. FHB TF c was measured before VIMC (i.e., baseline) and 5, 30, and 60 min post-VIMC. VIMC electromyography (EMG) amplitude, VIMC duration, and perceived VIMC intensity were measured to ensure consistency of VIMC between days., Results: VIMC EMG amplitude, duration, and perceived intensity were similar between days (P > 0.05). VIMC lowered TF c ; baseline TF c (18 ± 6 Hz) was higher than 5-min (14 ± 6 Hz), 30-min (14 ± 5 Hz), and 60-min TF c (14 ± 5 Hz; P < 0.05)., Discussion: Acute VIMCs increase cramp susceptibility. Clinicians should apply treatments for at least 60 min postcramp to decrease the probability of cramp recurrence. Muscle Nerve 56: E95-E99, 2017., (© 2017 Wiley Periodicals, Inc.)