Morning versus Evening Intake of Creatine in Elite Female Handball Players.
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ABSTRACT:
SUBMITTER: Jurado-Castro JM
PROVIDER: S-EPMC8744932 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe aging population is associated with increased multimorbidity and polypharmacy. Older adults are at a higher risk of adverse events and reduced therapeutic response. This phenomenon is partially explained by drug interactions and treatment adherence. Most randomized clinical trials have found no significant differences between morning and evening levothyroxine (LT4) administration in young adults, but there is little evidence regarding alternative LT4 regimens in older populations. Thus, the MONIALE trial aims to test an alternative schedule for LT4 administration in older adults.Methods/designThis randomized crossover clinical trial will include participants aged 60 years or older with primary hypothyroidism. The trial groups will consist of morning LT4 intake (60 min before breakfast) or evening LT4 intake (60 min after supper). The primary outcome will be variation in serum thyrotropin (TSH) levels after 24 weeks of the LT4 protocol. The secondary outcomes will be the prevalence of drugs that potentially interact with LT4 and hypothyroidism control according to interaction status. The sample size was calculated to detect a minimum mean difference of 1 mUI/L in serum TSH level between the groups with 80% power and a 5% probability of type I error, resulting in 91 patients per group. The project was approved by the Hospital de Clínicas de Porto Alegre Ethics Committee.DiscussionConsidering the aging population, the increased prevalence of multimorbidity and polypharmacy, as well as potential drug interactions and treatment adherence difficulties, an alternative LT4 protocol could be useful for hypothyroidism treatment in the elderly. Prior studies comparing alternative LT4 administration protocols have mainly included young adult populations and have not addressed potential drug interactions.Trial registrationClinicalTrials.gov, NCT03614988. Registered 30 July 2018.
| S-EPMC6918562 | biostudies-literature
Project description:BackgroundHandball is a strenuous body-contact team sport that places high loads on the knee joint. Anterior cruciate ligament (ACL) tear is one of the most devastating injuries that any handball player can suffer, and female athletes are at particular risk due to their intrinsic anatomical, hormonal, neuromuscular and biomechanical characteristics. The purpose of this study was to analyze the horizontal jumping biomechanics of female elite handball players with or without previous ACL reconstruction.MethodsTwenty-one female participants (6 with previous ACL reconstruction and 15 uninjured controls) were recruited. Two horizontal hopping tasks were evaluated using inertial sensor unit (ISU)-based technology to assess jumping biomechanics through a direct mechanics-based approach.ResultsThe athletes with previous ACL reconstruction demonstrated a significant (P < 0.05) reduction in the unilateral triple hop for distance compared with the healthy controls. Furthermore, during the initial propulsive phase of the unilateral cross-over hop, the control participants generated significantly (P < 0.05) higher force values in the mediolateral direction (the X axis) with their dominant limb compared with the ACL-reconstructed (ACL-R) limb of previously injured participants.ConclusionsThree-dimensional horizontal jumping biomechanics analyses using ISU-based technologies could provide clinicians with more accurate information regarding the horizontal jumping biomechanical patterns among elite handball female athletes. Furthermore, several mechanical alterations could still be observed among those players who had undergone previous ACL reconstruction, even when several years have passed since the original ACL injury.
| S-EPMC6859617 | biostudies-literature
Project description:BackgroundVariation in blood pressure levels display circadian rhythms. The morning surge in blood pressure is known to increase the risk of myocardial events in the first several hours post awakening. A systematic review of the administration-time-related-effects of evening versus morning dosing regimen of antihypertensive drugs in the management of patients with primary hypertension has not been conducted.ObjectivesTo evaluate the administration-time-related-effects of antihypertensive drugs administered as once daily monotherapy in the evening versus morning administration regimen on all cause mortality, cardiovascular morbidity and reduction of blood pressure in patients with primary hypertension.Search strategyWe searched Cochrane CENTRAL on Ovid (4th Quarter 2009), Ovid MEDLINE (1950 to October 2009), EMBASE (1974 to October 2009), the Chinese Biomedical literature database (1978 to 2009) and the reference lists of relevant articles. No language restrictions were applied.Selection criteriaRandomized controlled trials comparing the administration-time-related effects of evening with morning dosing monotherapy regimens in patients with primary hypertension were included. Patients with known secondary hypertension, shift workers or white coat hypertension were excluded.Data collection and analysisTwo authors independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Data synthesis and analysis were done using RevMan 5.1. Random effects meta-analysis and sensitivity analysis were conducted.Main results21 randomized controlled trials (RCTs) in 1,993 patients with primary hypertension met the inclusion criteria for this review - ACEIs (5 trials), CCBs (7 trials), ARBs (6 trials), diuretics (2 trials), alpha-blockers (1 trial), and beta-blockers (1 trial). Meta-analysis showed significant heterogeneity across trials.No RCT reported on all cause mortality, cardiovascular mortality, cardiovascular morbidity and serious adverse events.There was no statistically significant difference for overall adverse events (RR=0.78, 95%CI: 0.37 to 1.65) and withdrawals due to adverse events (RR=0.53, 95%CI: 0.26 to 1.07).No significant differences were noted for morning SBP (-1.62 mm Hg, 95% CI: -4.19 to 0.95) and morning DBP (-1.21 mm Hg, 95% CI: -3.28 to 0.86); but 24-hour BP (SBP: -1.71 mm Hg, 95% CI: -2.78 to -0.65; DBP: -1.38 mm Hg, 95% CI: -2.13 to -0.62) showed a statistically significant difference.Authors' conclusionsNo RCT reported on clinically relevant outcome measures - all cause mortality, cardiovascular morbidity and morbidity. There were no significant differences in overall adverse events and withdrawals due to adverse events among the evening versus morning dosing regimens. In terms of BP lowering efficacy, for 24-hour SBP and DBP, the data suggests that better blood pressure control was achieved with bedtime dosing than morning administration of antihypertensive medication, the clinical significance of which is not known.
| S-EPMC9040377 | biostudies-literature
Project description:Stroboscopic training enhances perceptual cognition and motor skills; however, neurophysiological mechanisms underlying this adaptation are not fully understood. This study aimed to investigate the effects of a six-week stroboscopic training program on the conductivity of the visual pathway in elite handball players, specifically related to their visual processing of retinal location and viewing conditions. The study included 22 handball players who were randomly assigned to an experimental or a control group. Both groups performed handball-specific in-situ tasks, but only the experimental group underwent stroboscopic training. Participants were assessed three times using visually evoked potential recordings measured by P100 implicit time and amplitude under three viewing conditions (dominant eye, non-dominant eye, and binocular) and two retinal locations (extra-foveal and foveal vision) before and after the six-week training period, and again four weeks later. The results showed a significant TIME vs. GROUP effect of P100 implicit time for the dominant eye in extra-foveal vision (F2,40 = 5.20, p = 0.010, ηp2 = 0.206), extra-foveal binocular viewing (F2,40 = 3.32, p = 0.046, ηp2 = 0.142), and dominant eye foveal vision (F2,40 = 4.07, p = 0.025, ηp2 = 0.169). Stroboscopic training significantly improved early visual processing by reducing the P100 implicit time for the dominant eye and binocular vision, particularly in extra-foveal vision. The improvements were more noticeable in the short compared to the long term.
| S-EPMC10875695 | biostudies-literature
Project description:ObjectiveStudies suggest that bedtime dosing of an angiotensin-converting enzyme (ACE)-inhibitor or angiotensin receptor blocker shows a more sustained and consistent 24-h antihypertensive profile, including greater night-time blood pressure (BP) reduction. We compared the antihypertensive effects of morning (a.m.) and evening (p.m.) dosing of valsartan on 24-h BP.MethodsThis 26-week, multicentre, randomized, double-blind study evaluated the efficacy and safety of valsartan 320 mg, dosed a.m. or p.m., versus lisinopril 40 mg (a.m.), a long-acting ACE-inhibitor, in patients with grade 1-2 hypertension and at least one additional cardiovascular risk factor. Patients (n = 1093; BP = 156 ± 11/91 ± 8 mmHg; 62 years, 56% male, 99% white) received (1 : 1 : 1) valsartan 160 mg a.m. or p.m. or lisinopril 20 mg a.m. for 4 weeks, then force-titrated to double the initial dose for 8 weeks. At Week 12, hydrochlorothiazide (HCTZ) 12.5 mg was added for 14 weeks if office BP was more than 140/90 mmHg and/or ambulatory BP more than 130/80 mmHg.ResultsMean 24-h ambulatory SBP change from baseline to Weeks 12 and 26 was comparable between valsartan a.m. (-10.6 and -13.3 mmHg) and p.m. (-9.8 and -12.3 mmHg) and lisinopril (-10.7 and -13.7 mmHg). There was no benefit of valsartan p.m. versus a.m. on night-time BP, early morning BP and morning BP surge. Evening dosing also did not improve BP lowering in patients requiring add-on HCTZ or in nondippers at baseline. All treatments were well tolerated.ConclusionOnce-daily dosing of valsartan 320 mg results in equally effective 24-h BP efficacy, regardless of dosing time.Trial registrationClinicalTrials.gov Identifier: NCT00241124.
| S-EPMC4284009 | biostudies-literature
Project description:The purpose of this study is to identify lower-extremity (LE) musculoskeletal characteristics of elite female soccer players and to determine whether differences between dominant and nondominant extremities exist with respect to strength, flexibility, and range of motion. Physical data were collected from 26 female professional soccer players. Core control, hip and knee passive range of motion (PROM), LE flexibility, hip abductor strength, and dynamic functional alignment were assessed for each LE. Of 26 subjects, 21 scored 2/5 or less on core control. Mean hip internal rotation and external rotation were 33 degrees (+/-8 degrees) and 25 degrees (+/-6.7 degrees), respectively. All subjects had shortened two-joint hip flexors with an average knee flexion angle of 50 degrees (+/-11 degrees) and increased femoral anteversion. Forty one of 48 dominant limbs and 42 of 48 nondominant limbs demonstrated deviations from neutral alignment during step down or single-leg squat. Of 25 subjects, 15 demonstrated a stiff-knee landing and/or takeoff. All subjects demonstrated limitations in hip external rotation PROM and hip flexor length. There was no difference between dominant and nondominant LEs in all variables including hip abductor strength. Additional research is needed to determine if there is a correlation between the musculoskeletal characteristics, LE biomechanics, and potential risk for injury.IV.
| S-EPMC2744746 | biostudies-other
Project description:Protein requirements for athletes are affected by various factors, including distribution and quality (i. e., amino acid composition) of protein ingestion throughout the day. However, little is known about the protein requirements of elite female athletes engaging in team sports. This study aimed to determine the nitrogen balance and distribution of protein and amino acid intake in elite female handball athletes during training camp. In observational study design, 11 female Japanese national handball players (age 26.9 ± 4.9 years) participated in a 5-days experiment. Nitrogen balance was calculated from the daily protein intake assessed by dietary records and urinary nitrogen excretion. Amino acid intake amounts were organized based on six eating occasions. The average and population-safe protein intake for zero nitrogen balance were estimated as 1.57 and 1.93 g/kg/day, respectively. The protein intake at breakfast, lunch, and dinner and the leucine intake in the three main meals and the morning snack were higher than is recommended by current guidelines for maximizing muscle protein synthesis. The population-safe protein intake in elite female handball athletes was within the range of the current recommendations for athletes (1.2-2.0 g/kg/day). Our results show that it may be possible to improve the distribution and quality of protein ingestion after exercise and before sleep.
| S-EPMC7236612 | biostudies-literature
Project description:BackgroundThe relevance of body composition (BC) to performance in sport has long been appreciated with special concern on the total and regional proportion of fat and muscle. Dual-energy X-ray absorptiometry (DXA) is able to accurately measure BC, but it may not be easily available in practice; anthropometry has long been used as a simple and inexpensive field method to objectively assess BC. The aim of this study was twofold: first, to develop and validate a sport-specific anthropometric predictive equation for total body fat mass (FM) and lean mass components in female handball players to be used in the sport setting; second, to cross-validate in female team handball players several independently developed, predictive equations for BC in female athletes.MethodsA total of 85 female team handball players (30 wings, 31 backs, 14 pivots, 10 goalkeepers) of different competitive levels underwent anthropometry and a whole-body DXA scan. Multiple linear regression analysis was used to develop predictive equations in a derivation sample (n = 60) of randomly selected players using demographic and anthropometric variables. The developed equations were used to predict DXA outcomes in an independent validation sample (n = 25).ResultsStatistically significant (P < 0.001) models were developed for total body FM (adjusted R 2 = 0.943, standard error of the estimate, SEE = 1,379 g), percentage FM (adjusted R 2 = 0.877, SEE = 2.00%), fat-free soft tissue mass (FFSTM) (adjusted R 2 = 0.834, SEE = 2,412 g), fat-free mass (FFSTM + bone mineral content; adjusted R 2 = 0.829, SEE = 2,579 g). All models were robust to collinearity. Each developed equation was successfully validated in the remaining 25 players using correlation analysis, mean signed difference, t-test, and Bland-Altman plot. The whole dataset of team handball players (n = 85) was used to cross-validate several predictive equations independently developed by others in female athletes. Equations significantly (P < 0.001 for all; t-test) over- or underestimated the corresponding DXA measurements.DiscussionIt is concluded that in team female handball players the anthropometric equations presented herein are able to estimate body fat and FFSTM with accuracy. Several BC predictive anthropometric equations developed in different female athletic populations revealed inaccurate when tested in team handball players. These results should be of use for coaches, physical trainers, and nutritionists when evaluating the physical status of female team handball players.
| S-EPMC6266933 | biostudies-literature
Project description:This study explored the anthropometric and body composition characteristics of elite female rugby union players, comparing between and within different playing positions. Thirty elite female rugby union players (25.6 ± 4.3 y, 171.3 ± 7.7 cm, 83.5 ± 13.9 kg) from New Zealand participated in this study. Physical characteristics were assessed using anthropometric (height, body mass, skinfolds) and body composition (dual-energy X-ray absorptiometry) measures. Forwards were significantly taller (p < 0.01; d = 1.34), heavier (p < 0.01; d = 2.19), and possessed greater skinfolds (p < 0.01; d = 1.02) than backs. Forwards also possessed significantly greater total (p < 0.01; d = 1.83-2.25) and regional (p < 0.01; d = 1.50-2.50) body composition measures compared to backs. Healthy bone mineral density values were observed in both forwards and backs, with significantly greater values observed at the arm (p < 0.01; d = 0.92) and femoral neck (p = 0.04; d = 0.77) sites for forwards. Tight-five players were significantly heavier (p = 0.02; d = 1.41) and possessed significantly greater skinfolds (p < 0.01; d = 0.97) than loose-forwards. Tight-five also possessed significantly greater total body composition measures (p < 0.05; d = 0.97-1.77) and significantly greater trunk lean mass (p = 0.04; d = 1.14), trunk fat mass (p < 0.01; d = 1.84), and arm fat mass (p = 0.02; d = 1.35) compared to loose-forwards. Specific programming and monitoring for forwards and backs, particularly within forward positional groups, appear important due to such physical characteristic differences.
| S-EPMC7557873 | biostudies-literature
Project description:BackgroundAn athlete who returns to sport after an anterior cruciate ligament (ACL) injury has a substantially high risk of sustaining a new secondary ACL injury. Because ACL injuries most frequently occur during cutting maneuvers, such movements should be at the center of research attention.PurposeTo investigate whether knee biomechanical parameters during side-step cutting maneuvers differ between female elite athletes with and without a history of ACL injury and to evaluate whether such parameters are associated with future secondary ACL injury.Study designCohort study; Level of evidence, 2.MethodsA total of 756 female elite handball and soccer players, of whom 76 had a history of ACL injury, performed a sport-specific cutting task while 3-dimensional kinematics and kinetics were measured. ACL injuries were registered prospectively over an 8-year follow-up period. Seven knee-specific biomechanical variables were the basis for all analyses. Two-way analyses of variance were applied to assess group differences, whereas logistic regression models served to evaluate associations between the knee-specific variables and future secondary ACL injury.ResultsWhen players with a previous ACL injury performed the cutting maneuver with their ipsilateral leg, they exhibited lower knee abduction angles (mean difference [MD], 1.4°-1.5°; 95% CI, 0.2°-2.9°), lower peak knee flexion moments (MD, 0.33 N·m/kg-1; 95% CI, 0.18-0.48 N·m/kg-1), lower peak knee abduction moments (MD, 0.27 N·m/kg-1; 95% CI, 0.12-0.41 N·m/kg-1), and lower peak knee internal rotation moments (MD, 0.06 N·m/kg-1; 95% CI, 0.01-0.12 N·m/kg-1) compared with injury-free players. When players performed the cut with their contralateral leg, no differences were evident (P < .05). None of the 7 knee-specific biomechanical variables was associated with future secondary ACL injury in players with an ACL injury history (P < .05).ConclusionApproximately 4 years after ACL injury, female elite team-ball athletes still unloaded their ipsilateral knee during cutting maneuvers, yet contralateral knee loading was similar to that of injury-free players. Knee biomechanical characteristics were not associated with future secondary ACL injury.
| S-EPMC10986153 | biostudies-literature