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Study objective Long COVID patients can experience high levels of impairment in their cognitive function and mental health Using a parallel randomized control trial we evaluated the effectiveness of a neuro meditation program to reduce cognitive impairment in patients with long COVID Methods A total of 34 patients with long COVID were randomized to an intervention group G Int n 17 or a control group G Con n 17 and 15 healthy participants were constitutive of a normative group G Nor The intervention consisted of ten 30 min sessions of Rebalance over a period of five weeks Each session included sound therapy and coach guided meditation associated with light stimulations i e chromotherapy Primary outcomes were performance on five computerized cognitive tasks choice response time pattern comparison Simon pursuit rotor task and Corsi block tapping task mental and physical fatigue Chalder fatigue scale perceived stress perceived stress scale and mood profiles of mood states Secondary outcomes were anxiety and depressive symptoms hospital anxiety and depression scale muscular pain joint pain and headaches using visual analog scales VAS as well as sleep quality Spiegel sleep questionnaire Assessments were conducted at baseline and at 1 2 and 7 8 days of follow up Results Compared to healthy subjects long COVID patients showed significant differences at baseline on all the self report questionnaires and a Rebalance program improved all the subjective reports as well as cognitive performances especially on reaction time based tasks In particular only the G Int group revealed shortened reaction times in the choice reaction time RTbaseline 593 121 ms vs RTpost2 521 86 ms p 0 001 Simon RTbaseline 539 123 ms vs RTpost2 494 134 ms p 0 01 and pattern comparison tasks RTbaseline 1244 315 ms vs RTpost2 1079 213 ms p 0 001 Conclusions Initial evidence suggests that neuro meditation reduces cognitive impairment and improves physical and mental fatigue muscle and joint pain symptoms of

Using a parallel randomised control trial to demonstrate the effectiveness of 10 sessions of a Triple Combined Intervention (TCI, far-infrared, negative air ions and light therapy) in reducing stress-related symptoms in workers and detoxify the body. Twenty-one participants were randomly assigned to the experimental group (Gexp, N = 11) or the control group (Gcon, N = 10). The Gexp completed 10 × 20 min sessions using the MLX i3Dome over a 4-week period. Subjective questionnaires were assessed for sleep and psychological disturbances. Trace elements, toxic metals, cortisol, white blood count, muscular and joint soreness level (SL), body weight, resting blood pressure and well-being were also measured. Systolic blood pressure was lower after the 4-week period for Gexp participants only. Sleep improved for Gexp participants and insomnia index decrease significantly. The increase in zinc and copper concentrations were associated with a decrease in the level of lead, mercury and cortisol in the blood following the 10-session programme. An increase in lymphocyte count was reported in the Gexp only. Initial evidence suggests that a triple combined intervention (i.e. MLX i3Dome) reduces excessive stress, improves perceived sleep quality, increases general well-being, enhances body detoxification.

This study evaluated the effectiveness of an innovative strategy which combined low-frequency ultra sound (LOFU) with high-intensity interval training (HIIT) to improve physical fitness and promote body fat loss in overweight sedentary women. A placebo controlled, parallel group randomized experimental design was used to investigate the efficacy of a 2-week combined LOFU and HIIT program (3 sessions per week). Participants were allocated into either the Experimental HIIT group (HIITEXP, n = 10) or Placebo HIIT group (HIITPLA, n = 10). Baseline exercise testing (maximal oxygen uptake, lower limb strength and substrate oxidation test), dietary assessment, anthropometric measures and blood sampling were completed in week 1 and repeated in week 4 to determine changes following the program (Post-HIIT). During each training session, the HIITEXP and HIITPLA groups wore a non-thermal diffuse ultrasound belt. However, the belt was only switched on for the HIITEXP group. Delta change scores were calculated for body weight, body fat percentage (Fat%), muscle mass, V.O2max, hip and waist circumferences, and all lipid variables from Baseline to Post-HIIT. Statistical analysis was completed using a repeated-measures factorial analysis of variance by group (HIITPLA and HIITEXP) and time (Baseline and Post-HIIT). Results showed significant improvements in maximal oxygen uptake (HIITEXP; Baseline 24.7 ± 5.4 mL kg–1 min–1, Post-HIIT 28.1 ± 5.5 mL kg–1 min–1 and HIITPLA; Baseline 28.4 ± 5.9 mL kg–1 min–1, Post-HIIT 31.4 ± 5.5 mL kg–1 min–1) for both groups. Significant decreases in Fat% (HIITEXP; Baseline 32.7 ± 3.2%, Post-HIIT 28.9 ± 3.5% and HIITPLA; Baseline 28.9 ± 3.5%, Post-HIIT 28.9 ± 3.4% kg), waist circumference (HIITEXP; Baseline 95.8 ± 9.6 cm, Post-HIIT 89.3 ± 8.9 cm and HIITPLA; Baseline 104.3 ± 3.5 cm, Post-HIIT 103.6 ± 3.4 cm) and triglycerides (HIITEXP; −29.2%, HIITPLA; −6.7%) were observed in the HIITEXP group only. These results show that HIIT combined with LOFU was an

© 2018 Human Kinetics, Inc. Purpose: To determine the effect of high- versus low-intensity training in the heat and ensuing taper period in the heat on endurance performance. Methods: In total, 19 well-trained triathletes undertook 5 days of normal training and a 1-wk taper including either low- (heat acclimation [HA-L], n = 10) or high-intensity (HA-H, n = 9) training sessions in the heat (30°C, 50% relative humidity). A control group (n = 10) reproduced their usual training in thermoneutral conditions. Indoor 20-km cycling time trials (35°C, 50% relative humidity) were performed before (Pre) and after the main heat exposure (Mid) and after the taper (Post). Results: Power output remained stable in the control group from Pre to Mid (effect size: −0.10 [0.26]) and increased from Mid to Post (0.18 [0.22]). The HA-L group demonstrated a progressive increase in performance from Pre to Mid (0.62 [0.33]) and from Mid to Post (0.53 [0.30]), alongside typical physiological signs of HA (reduced core temperature and heart rate and increased body-mass loss). While the HA-H group presented similar adaptations, increased perceived fatigue and decreased performance at Mid (−0.35 [0.26]) were evidenced and reversed at Post (0.50 [0.20]). No difference in power output was reported at Post between the HA-H and control groups. Conclusion: HA-H can quickly induce functional overreaching in nonacclimatized endurance athletes. As it was associated with a weak subsequent performance supercompensation, coaches and athletes should pay particular attention to training monitoring during a final preparation in the heat and reduce training intensity when early signs of functional overreaching are identified.

© 2017 Human Kinetics, Inc. Purpose: Faster heart-rate recovery (HRR) after high to maximal exercise (>90% of maximal heart rate) has been reported in athletes suspected of functional overreaching (f-OR). This study investigated whether this response would also occur at lower exercise intensity. Methods: Responses of HRR and rating of perceived exertion (RPE) were compared during an incremental intermittent running protocol to exhaustion in 20 experienced male triathletes (8 control subjects and 13 overload subjects led to f-OR) before and immediately after an overload training period and after a 1-wk taper. Results: Both groups demonstrated an increase in HRR values immediately after the training period, but this change was very likely to almost certainly larger in the f-OR group at all running intensities (large to very large differences, eg, +16 ± 7 vs +3 ± 5 beats/min, in the f-OR and control groups at 11 km/h, respectively). The highest between-groups differences in changes in HRR were reported at 11 km/h (13 ± 4 beats/min) and 12 km/h (10 ± 6 beats/min). A concomitant increase in RPE at all intensities was reported only in the f-OR group (large to extremely large differences, +2.1 ± 1.5 to +0.7 ± 1.5 arbitrary units). Conclusion: These findings confirm that faster HRR does not systematically predict better physical performance. However, when interpreted in the context of the athletes’ fatigue state and training phase, HRR after submaximal exercise may be more discriminant than HRR measures taken after maximal exercise for monitoring f-OR. These findings may be applied in practice by regularly assessing HRR after submaximal exercise (ie, warm-up) for monitoring endurance athletes’ responses to training.

© 2016 Human Kinetics, Inc. Purpose: To describe the effect of the initial perceptual experience from heat familiarization on the pacing profle during a freepaced endurance time trial (TT) compared with temperate conditions. Methods: Two groups of well-trained triathletes performed two 20-km TTs in either hot (35°C and 50% relative humidity [RH], n = 12) or temperate (21°C and 50% RH, n = 22) conditions, after standardization of training for each group before both trials. To ensure no physiological acclimation differences between conditions, the TTs for both groups were separated by 11 ± 4 d. Results: Performance improvement in the heat (11 ± 24 W) from the 1st to 2nd trial appeared comparable to that in temperate conditions (8 ± 14 W, P =.67). However, the specifc alteration in pacing profle in the heat was markedly different than temperate conditions, with a change from "positive" to an "even" pacing strategy. Conclusions: Altered perceptions of heat during heat familiarization, rather than physiological acclimatization per se, may mediate initial changes in pacing and TT performance in the heat. These results highlight the need for athletes without time for suffcient heat acclimatization to familiarize themselves with hot conditions to reduce the uncertainty from behavior-based outcomes that may impede performance.

Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.

© 2015 Aubry et al This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Purpose: The aim of the study was to investigate whether heart rate recovery (HRR) may represent an effective marker of functional overreaching (f-OR) in endurance athletes. Methods and Results: Thirty-one experienced male triathletes were tested (10 control and 21 overload subjects) before (Pre), and immediately after an overload training period (Mid) and after a 2-week taper (Post). Physiological responses were assessed during an incremental cycling protocol to exhaustion, including heart rate, catecholamine release and blood lactate concentration. Ten participants from the overload group developed signs of f-OR at Mid (i.e. -2.1 ± 0.8% change in performance associated with concomitant high perceived fatigue). Additionally, only the f-OR group demonstrated a 99% chance of increase in HRR during the overload period (+8 ± 5 bpm, large effect size). Concomitantly, this group also revealed a >80% chance of decreasing blood lactate (-11 ± 14%, large), plasma norepinephrine (-12 ± 37%, small) and plasma epinephrine peak concentrations (-51 ± 22%, moderate). These blood measures returned to baseline levels at Post. HRR change was negatively correlated to changes in performance, peak HR and peak blood metabolites concentrations. Conclusion: These findings suggest that i) a faster HRR is not systematically associated with improved physical performance, ii) changes in HRR should be interpreted in the context of the specific training phase, the athletes perceived level of fatigue and the performance response; and, iii) the faster HRR associated with f-OR may be induced by a decreased central command and by a lower chemoreflex activity.

PURPOSE: This study aimed to examine whether (i) objective markers of sleep quantity and quality are altered in endurance athletes experiencing overreaching in response to an overload training program and (ii) potential reduced sleep quality would be accompanied with a higher prevalence of upper respiratory tract infections in this population. METHODS: Twenty-seven trained male triathletes were randomly assigned to either overload (n = 18) or normal (CTL, n = 9) training groups. Respective training programs included a 1-wk moderate training phase followed by a 3-wk period of overload or normal training, respectively, and then a subsequent 2-wk taper. Maximal aerobic power and oxygen uptake (V̇O 2max) from incremental cycle ergometry were measured after each phase, whereas mood states and incidences of illness were determined from questionnaires. Sleep was monitored every night of the 6 wk using wristwatch actigraphy. RESULTS: Of the 18 overload training group subjects, 9 were diagnosed as functionally overreached (F-OR) after the overload period, as based on declines in performance and V̇O2max with concomitant high perceived fatigue (P < 0.05), whereas the other 9 overload subjects showed no decline in performance (AF, P > 0.05). There was a significant time-group interaction for sleep duration (SD), sleep efficiency (SE), and immobile time (IT). Only the F-OR group demonstrated a decrease in these three parameters (-7.9% ± 6.7%,-1.6% ± 0.7%, and-7.6% ± 6.6% for SD, SE, and IT, respectively, P < 0.05), which was reversed during the subsequent taper phase. Higher prevalence of upper respiratory tract infections were also reported in F-OR (67%, 22%, and 11% incidence rate for F-OR, AF, and CTL, respectively). CONCLUSION: This study confirms sleep disturbances and increased illness in endurance athletes who present with symptoms of F-OR during periods of high volume training. © 2014 by the American college of Sports Medicine.

PURPOSE: The purpose of this study is to examine whether performance supercompensation during taper is maximized in endurance athletes after experiencing overreaching during an overload training (OT) period. METHODS: Thirty-three trained male triathletes were assigned to either OT (n = 23) or normal training groups (n = 10, CTL) during 8 wk. Cycling performance and maximal oxygen uptake (V̇O2max) were measured after 1 wk of moderate training, a 3-wk period of OT, and then each week during 4-wk taper. RESULTS: Eleven of the 23 subjects from the OT group were diagnosed as functionally overreached (F-OR) after the overload period (decreased performance with concomitant high perceived fatigue), whereas the 12 other subjects were only acutely fatigued (AF) (no decrease in performance). According to qualitative statistical analysis, the AF group demonstrated a small to large greater peak performance supercompensation than the F-OR group (2.6% ± 1.1%) and the CTL group (2.6% ± 1.6%). V̇O2max increased significantly from baseline at peak performance only in the CTL and AF groups. Of the peak performances, 60%, 83%, and 73% occurred within the two first weeks of taper in CTL, AF, and OR, respectively. Ten cases of infection were reported during the study with higher prevalence in F-OR (70%) than that in AF (20%) and CTL (10%). CONCLUSION: This study showed that 1) greater gains in performance and V̇O2max can be achieved when higher training load is prescribed before the taper but not in the presence of F-OR; 2) peak performance is not delayed during taper when heavy training loads are completed immediately prior; and 3) F-OR provides higher risk for training maladaptation, including increased infection risks. © 2014 by the American College of Sports Medicine.

The aim of this study was to examine the effects of cool water immersion (20 °C; CWI) while wearing a cooling jacket (Cryovest;V) and a passive control (PAS) as recovery methods on physiological and thermoregulatory responses between 2 exercise bouts in temperate conditions. Nine well-trained male cyclists performed 2 successive bouts of 45 min of endurance cycling exercise in a temperate environment (20 °C) separated by 25 min of the respective recovery interventions. Capillary blood samples were obtained to measure lactate (La -), sodium (Na +), bicarbonate (HCO3 -) concentrations and pH, whilst body mass loss (BML), core temperature (T core), skin temperature (T skin), heart rate (HR), oxygen uptake, and minute ventilation were measured before (Pre), immediately after the first exercise bout (Ex1), the recovery (R), and after the second exercise bout (Ex2). V and CWI both resulted in a reduction of T skin at R (-2.1 ± 0.01 °C and -11.6 ± 0.01 °C, respectively, p < 0.01). Despite no difference in final values post-Ex2 (p > 0.05), V attenuated the rise in HR, minute ventilation, and oxygen uptake from Ex1 to Ex2, while T core and T skin were significantly lower following the second session (p < 0.05). Further, CWI was also beneficial in lowering T core, T skin, and BML, while a rise in Na + was observed following Ex2 (p < 0.05). Overall results indicate that cooling interventions (V and CWI) following exercise in a temperate environment provide a reduction in thermal strain during ensuing exercise bouts.

Purpose: The aims of this study were i) to evaluate changes in leg-spring behavior during an exhaustive run in elite triathletes and ii) to determine whether these modifications were related to an increase in the energy cost of running (Cr). Methods: Nine elite triathletes ran to exhaustion on an indoor track at a constant velocity corresponding to 95% of the velocity associated with the maximal oxygen uptake (mean ± SD = 5.1 ± 0.3 m·s−1, time to exhaustion = 10.7 ± 2.6 min). Vertical and horizontal ground reaction forces were measured every lap (200 m) by a 5-m-long force platform system. Cr was measured from pulmonary gas exchange using a breath-by-breath portable gas analyzer. Results: Leg stiffness (−13.1%, P < 0.05) and peak vertical (−9.2%, P < 0.05) and propulsive (−7.5%, P < 0.001) forces decreased significantly with fatigue, whereas vertical stiffness did not change significantly. Leg and vertical stiffness changes were positively related with modifications of aerial time (R2 = 0.66, P < 0.01 and R2 = 0.72, P < 0.01, respectively) and negatively with contact time (R2 = 0.71, P < 0.01 and R2 = 0.74, P < 0.01, respectively). Alterations of vertical forces were related with the decrease of the angle of velocity vector at toe off (R2 = 0.73, P < 0.01). When considering mean values of oxygen uptake, no change was observed from 33% to 100% of the time to exhaustion. However, between one-third and two-thirds of the fatiguing run, negative correlations were observed between oxygen consumption and leg stiffness (R2 = 0.83, P < 0.001) or vertical stiffness (R2 = 0.50, P < 0.03). Conclusions: During a constant run to exhaustion, the fatigue induces a stiffness adaptation that modifies the stride mechanical parameters and especially decreases the maximal vertical force. This response to fatigue involves greater energy consumption.

In order to investigate the effectiveness of diVerent techniques of water immersion recovery on maximal strength, power and the post-exercise inflammatory response in elite athletes, 41 highly trained (Football, Rugby, Volleyball) male subjects (age = 21.5 ± 4.6 years, mass = 73.1 ± 9.7 kg and height = 176.7 ± 9.7 cm) performed 20 min of exhaustive, intermittent exercise followed by a 15 min recovery intervention. The recovery intervention consisted of diVerent water immersion techniques, including: Temperate water immersion (36°C; TWI), cold water immersion (10°C; CWI), contrast water temperature (10-42°C; CWT) and a passive recovery (PAS). Performances during a maximal 30-s rowing test (P30 s), a maximal vertical countermovement jump (CMJ) and a maximal isometric voluntary contraction (MVC) of the knee extensor muscles were measured at rest (Pre-exercise), immediately after the exercise (Post-exercise), 1 h after (Post 1 h) and 24 h later (Post 24 h). Leukocyte proWle and venous blood markers of muscle damage (creatine kinase (CK) and lactate dehydrogenase (LDH)) were also measured Preexercise, Post 1 h and Post 24 h. A signiWcant time eVect was observed to indicate a reduction in performance (Pre-exercise vs. Post-exercise) following the exercise bout in all conditions (P < 0.05). Indeed, at 1 h post exercise, a signiWcant improvement in MVC and P30 s was respectively observed in the CWI and CWT groups compared to pre-exercise. Further, for the CWI group, this result was associated with a comparative blunting of the rise in total number of leucocytes at 1 h post and of plasma concentration of CK at 24 h post. The results indicate that the practice of cold water immersion and contrast water therapy are more eVective immersion modalities to promote a faster acute recovery of maximal anaerobic performances (MVC and 30" all-out respectively) after an intermittent exhaustive exercise. These results may be explained by the suppression of plasma concentrations of marker