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BACKGROUND: Coaches usually reduce the training load (tapering) before competition to improve performance; however, in paralympic athletes this strategy had not yet been tested and we did not know which variables are associated with improved performance. Therefore, the objective was to compare the sleep, mood, sports performance, and reaction time (RT) of paralympic swimmers (PS) during tapering and to investigate whether there is a relationship between the variables during this training phase. METHODS: Eight PS were monitored for 17 days before the main competition, with an actigraphy to record sleep in 16 days. Evaluations were performed on Mondays (Evaluation 1 = E1) and Fridays (E2) during the first and second weeks (E3 and E4), and on Tuesday (E5) of the third week, the day traveling to the competition. Brunel Mood Scale, RT (Psychomotor Vigilance Test), and sports performance (50 m in the pool) were assessed before training on each assessment day. Internal training load (ITL) was evaluated using ratings of perceived exertion. RESULTS: ITL decreased gradually between assessments. Performance and RT were better on E5 than on E1. Fatigue was higher on E1 and E2 than on E4 and E5. Sleep parameters (total sleep time [TST], awakenings after sleep onset, and sleep efficiency) improved in the second week compared with the first week. Furthermore, TST from the previous night was correlated with RT, and RT and fatigue correlated with sports performance. CONCLUSIONS: The increase in TST and the reduction in fatigue just before competition achieved by tapering correlated with the improvement in RT and sports performance. In addition, the tapering improved sports performance, RT, sleep parameters, and decreased fatigue.

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CONTEXT: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. OBJECTIVES: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. EVIDENCE ACQUISITION: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. EVIDENCE SYNTHESIS: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). CONCLUSIONS: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.

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CONTEXT: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. OBJECTIVES: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. EVIDENCE ACQUISITION: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. EVIDENCE SYNTHESIS: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). CONCLUSIONS: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.

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PURPOSE: This study investigated the effects of both an active warm-up and the time-of-day variation on repeated-sprint performance. A second objective was to compare the post-exercise recovery between the experimental conditions. METHODS: Eleven male participants performed ten maximal cycling sprints (6 s each, with a 30-s interval between them) in the morning and late afternoon, either after a warm-up or control condition. The warm-up consisted of cycling for 10 min at 50% of the peak aerobic power. RESULTS: Rest measurements of rectal, muscle, and skin temperatures were higher in the afternoon compared to the morning (p < 0.05), with no significant differences in heart rate (p = 0.079) and blood lactate concentration (p = 0.300). Warm-up increased muscle temperature, heart rate, and lactate, and reduced skin temperature (all p < 0.001), though no significant differences were observed for rectal temperature (p = 0.410). The number of revolutions (p = 0.034, ηp2 = 0.375), peak (p = 0.034, ηp2 = 0.375), and mean (p = 0.037, ηp2 = 0.365) power of the first sprint (not the average of ten sprints) were higher in the afternoon compared to the morning, regardless of warm-up. However, beneficial performance effects of warming up were evident for the first (p < 0.001) and the average of ten sprints (p < 0.05), regardless of time of day. More remarkable changes during the 60-min post-exercise were observed for rectal temperature (p = 0.005) and heart rate (p = 0.010) in the afternoon than in the morning. CONCLUSION: Warming-up and time-of-day effects in enhancing muscular power are independent. Although warm-up ensured further beneficial effects on performance than the time-of-day variation, a faster post-exercise recovery was observed in the late afternoon.

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ABSTRACT: Santiago, LCS, Lyra, MJ, Germano-Soares, AH, Lins-Filho, OL, Queiroz, DR, Prazeres, TMP, Mello, MT, Pedrosa, RP, Falcão, APST, and Santos, MAM. Effects of strength training on sleep parameters of adolescents: a randomized controlled trial. J Strength Cond Res 36(5): 1222-1227, 2022-This study aimed to examine the effects of 12 weeks of strength training (ST) on sleep quality and daytime sleepiness in adolescents with sleep complaints. Thirty adolescents were randomly assigned to 2 groups: ST group (ST, n = 18) and control group (CG, n = 12). Anthropometric, body composition, one-repetition maximum test, and sleep parameters (Pittsburgh Sleep Quality Index [PSQI] and Epworth Sleepiness Scale [ESS]) were evaluated. Training consisted of 55 min·d-1 (3 times a week, for 12 weeks), 3 sets of 10-12 repetitions with a 1-minute rest interval between sets and exercises. Baseline and postintervention differences were analyzed using Generalized Estimating Equations and the effect size (ES) with Cohen's d coefficient. Significance was set at (p < 0.05). After 12 weeks of ST, a significant decrease in the PSQI score (7.3 ± 0.7 vs. 5.1 ± 0.6; ES = 4.10) was observed in the ST group, but not in the CG (6.3 ± 0.8 vs. 7.4 ± 0.7; ES = 1.53). A significant decrease in ESS score was found in the ST group (10.1 ± 0.7 vs. 8.2 ± 0.7; ES = 3.08), without differences in the CG (10.7 ± 0.8 vs. 11.0 ± 0.7; ES = 0.56). The ST group presented increased total sleep duration (h·min-1) (6.2 ± 0.2 vs. 6.9 ± 0.2; ES = 3.60), but not the CG (7.0 ± 0.2 vs. 6.8 ± 0.1; ES = 1.32). Individual analyses showed ≈67% of adolescents experienced a reduction in PSQI (8.3; confidence interval [CI] 95% 6.8-10.1) and ESS (8.3; CI 95% 6.7-9.9) scores after ST, whereas only ≈17% of control subjects presented reduced scores (PSQI [11.1; CI 95% 9.5-12.9] and ESS [11.0; CI 95% 9.4-12.6]). Strength training improved sleep quality and increased total sleep duration.

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Abstract Aim: This study aims to compare the sleep parameters in Paralympic powerlifting athletes during days with and without training, and to analyze the relationship between the training load and sleep on the same day and the relationship between the previous night's sleep and the training load of the following day. Methods: Actigraphy was used to analyze the sleep parameters of 11 Paralympic powerlifting athletes for 14 days (7 days without and with training), whereas Ratings of Perceived Exertion (RPE) analysis was used to assess training load. In addition, the Horne and östberg chronotype questionnaire and the Epworth Sleepiness Scale were applied. Results: Athletes show morning and indifferent chronotype and low daytime sleepiness. We found that on training days, sleep onset latency (SOL) was lower (average 5.3 min faster), whereas total sleep time (TST) and sleep efficiency (SE) were higher (TST averaged 169 min and SE 7% higher) compared to non-training days. In addition, the TST of the night before the training days correlated positively with the RPE of the following day, and the training volume correlated negatively with the SE of the same day. Conclusion: Our findings show that Paralympic powerlifting training had positive effects in increasing TST and SE and decreasing SOL on training days. These results show the positive effects of this type of training in improving sleep in athletes with physical disabilities. In addition, a good night's sleep the day before training can make it possible to put more effort into the next day's training. Therefore, guiding athletes to sleep more before training with more intense loads is recommended.

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PURPOSE: To investigate the relationship between sleep quality and quantity and injuries in elite soccer players and to compare sleep-wake variables and injury characteristics. METHODS: The current investigation was a prospective cohort study of 23 elite male soccer players competing for 2 teams over 6 mo in the highest-level Brazilian competition. The players' sleep behavior was monitored for 10 d in the preseason using self-reporting sleep diaries and wrist activity monitors to determine sleep duration and quality. Furthermore, injuries were recorded by the respective club's medical teams into a specific database. Details of injuries recorded included the type, location, and severity of each injury. The results were expressed as descriptive statistics, and the significance level was set at 5%. The Mann-Whitney U test was performed to compare the sleep variables between groups. Spearman correlation coefficient and linear-regression analysis were used. RESULTS: The results indicated a moderate negative correlation between sleep efficiency and particular injury characteristics, including absence time, injury severity, and amount of injuries. The linear-regression analysis indicated that 44% of the total variance in the number of injuries can be explained by sleep efficiency, 24% of the total variance in the absence time after injury (days) can be explained by sleep efficiency, and 47% of the total variance in the injury severity can be explained by sleep efficiency. CONCLUSIONS: Soccer players who exhibit lower sleep quality or nonrestorative sleep show associations with increased number and severity of musculoskeletal injuries.

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Asthma-obesity is a multifactorial disease with specific asthma phenotypes that aggravate due to overweight and an unbalanced diet. Furthermore, obese asthmatic patients are corticotherapy-resistant. Therefore, the aims of the present study were to evaluate the effects of an interdisciplinary intervention on food consumption, body composition, lung function and adipokines in asthmatic and non-asthmatic obese adolescents and to investigate the influence of nutrients on lung function. Obese non-asthmatic (n 42) and obese asthmatic (n 21) adolescents of both sexes were enrolled in the present study. Food intake, adipokine levels, body composition, asthma symptoms and lung function were assessed across the study. After the intervention of 1 year, there was a reduction (P ≤ 0·01) in BMI, body fat percentage, visceral and subcutaneous fat and an increase (P ≤ 0·01) in lean mass and all lung function variables in both groups, except the relation between forced expiratory volume in 1 s and forced vital capacity (FEV1:FVC) in non-asthmatic patients. Moreover, both groups decreased lipid and cholesterol consumption (P ≤ 0·01). The highest energy consumption (ß = -0·021) was associated with lower values of FVC. Similarly, carbohydrate consumption (ß = -0·06) and cholesterol were negative predictors (ß = -0·05) in FEV1:FVC. However, the consumption of Ca (ß = 0·01), fibres (ß = 1·34) and vitamin A (ß = 0·01) were positive predictors of FEV1:FVC. Asthma-obesity interdisciplinary treatment promoted an improvement on food consumption and lung function in adolescents and demonstrated that the consumption of nutrients influenced an increase in lung function.

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Objective: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. Methods: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. Results: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. Conclusion: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. Clinical trial registration: NCT01571115

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OBJECTIVE: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. METHODS: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. RESULTS: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. CONCLUSION: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. CLINICAL TRIAL REGISTRATION: NCT01571115.

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