Some studies showed that a single session of transcranial direct current stimulation (tDCS) has the potential of modulating motor performance in healthy and athletes. To our knowledge, previously published systematic reviews have neither comprehensively investigated the effects of tDCS on athletic performance in both physical and psychological parameters nor investigated the effects of tDCS on high-level athletes. We examined all available research testing a single session of tDCS on strength, endurance, sport-specific performance, emotional states and cognitive performance for better application in competition and pre-competition trainings of national- or international-level athletes. A systematic search was conducted in PubMed, Web of Science, EBSCO, Embase, and Scopus up until to June 2023. Studies were eligible when participants had sports experience at a minimum of state and national level competitions, underwent a single session of tDCS without additional interventions, and received either sham tDCS or no interventions in the control groups. A total of 20 experimental studies (224 participants) were included from 18 articles. The results showed that a single tDCS session improved both physical and psychological parameters in 12 out of the 18 studies. Of these, six refer to the application of tDCS on the motor system (motor cortex, premotor cortex, cerebellum), five on dorsolateral prefrontal cortex and two on temporal cortex. The most sensitive to tDCS are strength, endurance, and emotional states, improved in 67%, 75%, and 75% of studies, respectively. Less than half of the studies showed improvement in sport-specific tasks (40%) and cognitive performance (33%). We suggest that tDCS is an effective tool that can be applied to competition and pre-competition training to improve athletic performance in national- or international-level athletes. Further research would explore various parameters (type of sports, brain regions, stimulation protocol, athlete level, and test tasks) and neural mechanistic studies in improving efficacy of tDCS interventions. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022326989, identifier CRD42022326989.

Emotional regulation is an indispensable capacity for human beings, so that alterations in it can lead to the appearance of psychological, social and/or cognitive disorders. Therefore, possessing adequate emotional strategies is intimately related to the quality of life that a person presents. In this sense, high-level athletes suffer constant setbacks and frustrations due to the performance of their sporting activity, in addition to continuous modifications of their daily life activities. Thus, the objective of this research is to explore the emotional regulation and self-perceived quality of life of high-level athletes in mountain sports, analyzing the possible influences of gender, demographic location, body mass index and age. Fifty-four athletes belonging to the High Performance Technification Center of Cáceres (Extremadura, Spain) completed a sociodemographic questionnaire, as well as the Cognitive Emotion Regulation Questionnaire and the WHOQOL-BREF. The Shapiro-Wilkins test was used to analyze the normality of the variables collected and nonparametric statistics were used since the assumption was not met. Both gender and demographic location showed significant differences in the dimensions of the two questionnaires. Likewise, age was associated with the dimensions of both scales, but not body mass index, which was only associated with self-perceived quality of life. In addition, the stepwise linear regression model predicted self-perceived quality of life with a value of 60% across self-culpability, gender body mass index and planning. Therefore, it appears that gender, demographic location, age and body mass index could exert modifications on the levels of emotional regulation and self-perceived quality of life of high-level mountain athletes.

In this study, we aimed to assess sprinting using a developed instrument encompassing an inertial measurement unit (IMU) in order to analyze athlete performance during the sprint, as well as to determine the number of steps, ground contact time, flight time, and step time using a high-speed camera as a reference. Furthermore, we correlated the acceleration components (XYZ) and acceleration ratio with the performance achieved in each split time obtained using photocells. Six athletes (four males and two females) ran 40 m with the IMU placed on their fifth lumbar vertebra. The accuracy was measured through the mean error (standard deviation), correlation (r), and comparison tests. The device could identify 88% to 98% of the number of steps. The GCT, flight time, and step time had mean error rates of 0.000 (0.012) s, 0.010 (0.011) s, and 0.009 (0.009) s when compared with the high-speed camera, respectively. The step time showed a correlation rate of r = 0.793 (p = 0.001) with no statistical differences, being the only parameter with high accuracy. Additionally, we showed probable symmetries, and through linear regression models identified that higher velocities result in the maximum anteroposterior acceleration, mainly over 0-40 m. Our device based on a Wi-Fi connection can determine the step time with accuracy and can show asymmetries, making it essential for coaches and medical teams. A new feature of this study was that the IMUs allowed us to understand that anteroposterior acceleration is associated with the best performance during the 40 m sprint test.

In this study, we aimed to assess the countermovement jump (CMJ) using a developed instrument encompassing an off-the-shelf Inertial Measurement Unit (IMU) in order to analyze performance during the contraction phase, as well as to determine the jump height and the modified reactive strength index (RSImod), using force plate (FP) data as reference. Eight athletes (six males and two females) performed CMJs with the IMU placed on their fifth lumbar vertebra. Accuracy was measured through mean error (standard deviation), correlation, and comparison tests. The results indicated high accuracy, high correlation (r), and no statistical differences between the IMU and the FP for contraction time (r = 0.902; ρ < 0.001), negative impulse phase time (r = 0.773; ρ < 0.001), flight time (r = 0.737; ρ < 0.001), jump time (r = 0.708; ρ < 0.001), RSImod (r = 0.725; ρ < 0.001), nor minimum force (r = 0.758; ρ < 0.001). However, the values related to the positive impulse phase did not have the expected accuracy, as we used different devices and positions. Our results demonstrated that our developed instrument could be utilized to identify the contraction phase, jump height, RSImod, and minimum force in the negative impulse phase with high accuracy, obtaining a signal similar to that of an FP. This information can help coaches and athletes with training monitoring and control, as the device has simpler applicability making it more systematic.

The present study aimed to examine the effects of spirulina supplementation on pro/antioxidant status, inflammation and skeletal muscle damage markers immediately and 24 h after exhaustive exercise in elite rugby players.
Seventeen elite male Rugby Union players were randomly assigned to a spirulina (SPI: n = 9) or placebo (PLA: n = 8) group in a double-blind design. Subjects were supplemented with Spirulina platensis (5.7 g day-1 ) or placebo (isoproteic and caloric) for 7 weeks. At baseline and after 7 weeks of supplementation, blood samples were obtained before (T0), immediately after (T1) and 24 h after (T2) exhaustive exercise. The Yoyo Intermittent Recovery Test Level 2 was used as an exhaustive exercise to induce oxidative stress (OS), inflammation and skeletal muscle damage. The studied parameters included pro/antioxidant status markers (superoxide dismutase, glutathione peroxidase, reduced glutathione/glutathione disulphide ratio, oxidised low-density lipoprotein and F2α-isoprostanes [F2-Isop]), inflammation markers (myeloperoxidase and C-reactive protein [CRP]) and skeletal muscle damage markers (lactate dehydrogenase and creatine kinase [CK]).
Our results showed that F2-Isop, CRP and CK levels significantly increased at T1 only in the PLA group (p < 0.05, p < 0.05 and p < 0.001, respectively) with no change in the SPI group, which reflects the effect of spirulina to prevent lipid peroxidation, inflammation and skeletal muscle damage induced by exhaustive exercise. Moreover, spirulina supplementation accelerated the return to baseline values given that F2-Isop, CRP and CK levels at T2 were significantly lower than at T0 in the SPI group (p < 0.05, p < 0.01 and p < 0.001, respectively).
Based on the markers used in the present study, our results show that spirulina supplementation potentially prevents exercise-induced lipid peroxidation, inflammation and skeletal muscle damage, and may also accelerate the recovery of some of these markers. Based on our findings, we recommend spirulina supplementation especially for those athletes who do not achieve the recommended antioxidant dietary intake and who perform a high training load aiming to reduce the magnitude of OS, inflammation and skeletal muscle damage, which could help to reduce performance losses and accelerate recovery after training/competitions throughout the season.

High-level athletes (HLAs) have been shown to have better short-term outcomes than nonathletes (NAs) after hip arthroscopy.
(1) To report midterm outcomes of HLAs after primary hip arthroscopy and (2) to compare their results with a propensity-matched cohort of NA patients.
Cohort study; Level of evidence, 3.
Data were prospectively collected and retrospectively reviewed between February 2008 and November 2015 for HLAs (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLAs were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sports-Specific Subscale (HOS-SSS). Radiographic and intraoperative findings, surgical procedures, patient-reported outcomes (PROs), patient acceptable symptomatic state (PASS), minimal clinically important difference (MCID), and return to sport were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison.
A total 65 HLA patients (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLAs showed significant improvement in all PROs recorded, achieved high rates of MCID and PASS for mHHS (74.6% and 79.4%, respectively) and HOS-SSS (67.7% and 66.1%, respectively), and returned to sport at high rates (80.4%). When compared with the propensity-matched NA control group, HLAs reported higher baseline but comparable postoperative scores for the mHHS and NAHS. HLA patients achieved MCID and PASS for mHHS at similar rates as NA patients, but the HLA patients achieved PASS for HOS-SSS at higher rates that trended toward statistical significance (66.1% vs 48.4%; P = .07). NA patients underwent revision arthroscopic surgery at similar rates as HLA patients (14.9% vs 9.0%, respectively; P = .424).
Primary hip arthroscopy results in favorable midterm outcomes in HLAs. When compared with a propensity-matched NA control group, HLAs demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up.

OBJECTIVE: To determine if generic off-ice physical fitness tests can provide useful predictions of ice hockey players\' match performance.
METHODS: Approximately 40 to 60 defenders and 70 to 100 forwards from the Norwegian male upper ice hockey league were tested for strength (1-repetition maximum in squat and bench press), power (40-m sprint and countermovement jump), and endurance (hanging sit-ups, chins, and 3000-m run) annually at the end of every preseason period between 2008 and 2017. Measures of match performance were each player\'s season mean counts per match of assists, points, goals, penalty minutes, and plus-minus score.
RESULTS: Overall, match performance measures displayed trivial to small correlations with the fitness tests. More specifically, points per game had at most small correlations with measures of strength (range, approximately -0.2 to 0.3), speed (approximately -0.2 to 0.3), and endurance (approximately -0.1 to 0.3). After adjustments for age that showed moderate to large correlations with player match performance, multiple-regression analyses of each test measure still provided some predictability among players of the same age. However, players selected for the national team had substantially better mean scores for most tests and match performance measures than those not selected, with a moderate to large difference for age, 1-repetition maximum squat, and 1-repetition maximum bench press.
CONCLUSIONS: Fitness tests had only marginal utility for predicting match performance in Norwegian hockey players, but those selected into the national team had better general fitness.

This review aimed to synthesize evidence regarding interventions based on heart rate variability (HRV)-guided training for VO2max improvements in endurance athletes and address the issues that impact this performance enhancement. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL Complete, the Web of Science Core Collection, Global Health, Current Contents Connect, and the SciELO citation index were searched. Inclusion criteria were: randomized controlled trials; studies with trained athletes enrolled in any regular endurance training; studies that recruited men, women, and both sexes combined; studies on endurance training controlled by HRV; studies that measured performance with VO2max. A random-effects meta-analysis calculating the effect size (ES) was used. Moderator analyses (according to the athlete\'s level and gender) and metaregression (according to the number of participants in each group) were undertaken to examine differences in ES. HRV-guided training and control training enhanced the athletes\' VO2max (p < 0.0001), but the ES for the HRV-guided training group was significantly higher (p < 0.0001; ESHRVG-CG = 0.187). The amateur level and female subgroup reported better and significant results (p < 0.0001) for VO2max. HRV-guided training had a small (ES = 0.402) but positive effect on endurance athlete performance (VO2max), conditioned by the athlete\'s level and sex.

The management of Achilles tendon rupture continues to be controversial in the everyday athlete; however, there is strong evidence indicating that surgical intervention is preferred in elite athletes due to the return of greater strength and peak torque. We review the published literature, as well as our operative technique and post-operative protocol in the management of Achilles tendon injuries in elite athletes.

Elite athletes in varied sports typically combine ergogenic strategies in the hope of enhancing physiological responses and competitive performance, but the scientific evidence for such practices is very scarce. The peculiar characteristics of speed skating contribute to impede blood flow and exacerbate deoxygenation in the lower limbs (especially the right leg). We investigated whether combining preconditioning strategies could modify muscular oxygenation and improve performance in that sport. Using a randomized, single-blind, placebo-controlled, crossover design, seven male elite long-track speed skaters performed on-ice 600-m time trials, preceded by either a combination of preconditioning strategies (COMBO) or a placebo condition (SHAM). COMBO involved performing remote ischemic preconditioning (RIPC) of the upper limbs (3 × 5-min compression at 180 mmHg and 5-min reperfusion) over 3 days (including an acute treatment before trials), with the addition of an inspiratory muscle warm-up [IMW: 2 × 30 inspirations at 40% maximal inspiratory pressure (MIP)] on the day of testing. SHAM followed the same protocol with lower intensities (10 mmHg for RIPC and 15% MIP). Changes in tissue saturation index (TSI), oxyhemoglobin-oxymyoglobin ([O2HbMb]), deoxyhemoglobin-deoxymyoglobin ([HHbMb]), and total hemoglobin-myoglobin ([THbMb]) in the right vastus lateralis muscle were monitored by near-infrared spectroscopy (NIRS). Differences between COMBO and SHAM were analyzed using Cohen\'s effect size (ES) and magnitude-based inferences. Compared with SHAM, COMBO had no worthwhile effect on performance time while mean Δ[HHbMb] (2.7%, ES 0.48; -0.07, 1.03) and peak Δ[HHbMb] (1.8%, ES 0.23; -0.10, 0.57) were respectively likely and possibly higher in the last section of the race. These results indicate that combining ischemic preconditioning and IMW has no practical ergogenic impact on 600-m speed-skating performance in elite skaters. The low-sitting position in this sport might render difficult enhancing these physiological responses.