Abstract：
BACKGROUND: Relative energy deficiency in sport (REDs) is a condition that is associated with negative health and performance outcomes in athletes. Insufficient energy intake relative to exercise energy expenditure, resulting in low energy availability, is the underlying cause, which triggers numerous adverse physiological consequences including several associated with musculoskeletal (MSK) health and neuromuscular performance.
OBJECTIVE: This commentary aims to (1) discuss the health and performance implications of REDs on the skeletal and neuromuscular systems and (2) examine the role that MSK training (ie, strength and plyometric training) during treatment and return to performance following REDs might have on health and performance in athletes, with practical guidelines provided.
CONCLUSIONS: REDs is associated with decreases in markers of bone health, lean body mass, maximal and explosive strength, and muscle work capacity. Restoration of optimal energy availability, mainly through an increase in energy intake, is the primary goal during the initial treatment of REDs with a return to performance managed by a multidisciplinary team of specialists. MSK training is an effective nonpharmacological component of treatment for REDs, which offers multiple long-term health and performance benefits, assuming the energy needs of athletes are met as part of their recovery. Supervised, prescribed, and gradually progressive MSK training should include a combination of resistance training and high-impact plyometric-based exercise to promote MSK adaptations, with an initial focus on achieving movement competency. Progressing MSK training exercises to higher intensities will have the greatest effects on bone health and strength performance in the long term.
OBJECTIVE: This commentary aims to (1) discuss the health and performance implications of REDs on the skeletal and neuromuscular systems and (2) examine the role that MSK training (ie, strength and plyometric training) during treatment and return to performance following REDs might have on health and performance in athletes, with practical guidelines provided.
CONCLUSIONS: REDs is associated with decreases in markers of bone health, lean body mass, maximal and explosive strength, and muscle work capacity. Restoration of optimal energy availability, mainly through an increase in energy intake, is the primary goal during the initial treatment of REDs with a return to performance managed by a multidisciplinary team of specialists. MSK training is an effective nonpharmacological component of treatment for REDs, which offers multiple long-term health and performance benefits, assuming the energy needs of athletes are met as part of their recovery. Supervised, prescribed, and gradually progressive MSK training should include a combination of resistance training and high-impact plyometric-based exercise to promote MSK adaptations, with an initial focus on achieving movement competency. Progressing MSK training exercises to higher intensities will have the greatest effects on bone health and strength performance in the long term.
摘要：
背景：运动中的相对能量不足（REDs）是一种与运动员的负面健康和表现结果相关的疾病。相对于运动能量消耗的能量摄入不足，导致能源可用性低，是根本原因，这会引发许多不利的生理后果，包括与肌肉骨骼（MSK）健康和神经肌肉表现相关的一些后果。
目的：本评论旨在（1）讨论REDs对骨骼和神经肌肉系统的健康和性能影响，以及（2）检查MSK训练的作用（即，力量和屈光度训练）在治疗期间，并在REDs可能对运动员的健康和表现有影响后恢复表现，提供实用指南。
结论：REDs与骨骼健康标志物的减少有关，瘦体重,最大和爆炸强度，和肌肉工作能力。恢复最佳能源可用性，主要是通过增加能量摄入，是REDs初始治疗期间的主要目标，并恢复由多学科专家团队管理的绩效。MSK训练是治疗REDs的有效非药物组成部分，它提供了多种长期健康和性能益处，假设运动员的能量需求得到满足作为他们恢复的一部分。被监督,处方,逐步推进的MSK训练应包括阻力训练和基于强冲击力的塑形运动相结合，以促进MSK适应，最初的重点是实现运动能力。从长远来看，将MSK训练练习提高到更高的强度将对骨骼健康和力量表现产生最大的影响。
目的：本评论旨在（1）讨论REDs对骨骼和神经肌肉系统的健康和性能影响，以及（2）检查MSK训练的作用（即，力量和屈光度训练）在治疗期间，并在REDs可能对运动员的健康和表现有影响后恢复表现，提供实用指南。
结论：REDs与骨骼健康标志物的减少有关，瘦体重,最大和爆炸强度，和肌肉工作能力。恢复最佳能源可用性，主要是通过增加能量摄入，是REDs初始治疗期间的主要目标，并恢复由多学科专家团队管理的绩效。MSK训练是治疗REDs的有效非药物组成部分，它提供了多种长期健康和性能益处，假设运动员的能量需求得到满足作为他们恢复的一部分。被监督,处方,逐步推进的MSK训练应包括阻力训练和基于强冲击力的塑形运动相结合，以促进MSK适应，最初的重点是实现运动能力。从长远来看，将MSK训练练习提高到更高的强度将对骨骼健康和力量表现产生最大的影响。
