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BACKGROUND: Body temperature is often assessed in the core and the skin. Infrared thermography has been used to measure skin temperature (Tsk) in sport research and clinical practice. This study aimed to explore the information reported to date on the use of infrared thermography to detect short-term Tsk responses to endurance exercise and to identify the methodological considerations and knowledge gaps, and propose future directions. METHOD: A web search (PubMed, Science Direct, Google Scholar, and Web of Science) was conducted following systematic review guidelines, and 45 out of 2921 studies met the inclusion criteria (endurance sports, since 2000, English, full text available). RESULTS: A total of 45 publications were extracted, in which most of the sample were runners (n = 457, 57.9%). Several differences between IRT imaging protocols and ROI selection could lead to potential heterogeneity of interpretations. These particularities in the methodology of the studies extracted are widely discussed in this systematic review. CONCLUSIONS: More analyses should be made considering different sports, exercise stimuli and intensities, especially using follow-up designs. Study-derived data could clarify the underlying thermo physiological processes and assess whether Tsk could be used a reliable proxy to describe live thermal regulation in endurance athletes and reduce their risk of exertional heat illness/stroke. Also more in-depth analyses may elucidate the Tsk interactions with other tissues during exercise-related responses, such as inflammation, damage, or pain.

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BACKGROUND: This study aimed to globally assess heat strain, dehydration, and mechanical load as acute kidney injury (AKI) indicators in amateur endurance trail athletes during a 35.3 km run. METHODS: Thirty amateur experienced trail runners completed an endurance trail run (total positive ascend 1815 m). The following assessments were performed at four measurement time points (pre-, during, immediately post [-post0h], and after 24 h of the finish of the run [-post24h]): serum test (creatinine, blood ureic nitrogen, albumin, creatine kinase, blood ureic nitrogen: creatinine ratio, creatinine clearance, and glomerular filtration rate), mechanical load (impacts and Player Load), heat strain and dehydration (hematocrit, urine solids, body weight and urine specific gravity), pain and exertion perception (rate of perceived exertion, lumbar and bipodal, and one-leg squat pain), and urinalysis (pH, protein, glucose, erythrocytes, and urine specific gravity). RESULTS: There were pre vs. post0h changes in all serum biomarkers (F = 5.4-34.45, p < 0.01). The change in these biomarkers correlated with an increase in mechanical load indicators (r = 0.47-59, p < 0.05). A total of 40% and 23.4% of participants presented proteinuria and hematuria, respectively. Pain and perceived exertion increased significantly due to effort made during the endurance trail running (F = 4.2-176.4, p < 0.01). CONCLUSIONS: Endurance trail running may lead to an increase in blood and urine indicators of transitional AKI. The difference in blood and urine markers was significantly related to the mechanical load during running, suggesting potential kidney overload and cumulative mechanical load.

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The increase of wide-spread participation in endurance events in sports such as open water swimming, cycling, running and triathlons, has given rise to a concern about potential implications for renal function and kidney health. This study aimed to delve into the findings on exertional rhabdomyolysis (ER) and acute kidney injury (AKI) in endurance sports, emphasizing the diagnostic criteria used, physical and environmental contextual conditions in which ER and AKI are reported. Following PRISMA guidelines for systematic reviews and meta-analysis, topic related studies were searched digital sources (from 2009 to 2020). Studies with biomarkers of ER and AKI reported in endurance or ultra-endurance events were included. A total of 43 publications (sample = 813) were extracted, and 345 (43.5%) individuals were diagnosed with ER (creatinine kinase > 5000 UI/L) and 130 (16.39%) with ER + AKI (creatinine ≥ 1.88 mg/dL). Out of the total cases of ER + AKI, 96.92% were in ultra-endurance runners. There were inconsistences between studies in diagnosis criteria for ER and AKI, which represented a difficulty in the interpretation of the data. Increased levels of muscle and kidney injury immediately after endurance events were reported, but after 5.86 days these levels usually returned to baseline. There is a lack of knowledge around the potential of repeated ER and AKI predisposing to long-term chronic kidney disease. More accurate markers for subclinical and functional AKI diagnosis are needed in the analysis of kidney health after endurance events. ER and AKI are serious clinical problems with significant morbidity. Further research may be in order to help define future prevention strategies.

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Background and objectives: The purpose of this study was to explore which urinary markers could indicate acute kidney injury (AKI) during prolonged trail running in outpatient settings. Materials and Methods: Twenty-nine experienced trail runners (age 39.1 ± 8.8 years, weight 71.9 ± 11 kg, height 171.9 ± 8.3 cm) completed a 35 km event (cumulative positive ascend of 1815 m, altitude = 906 to 1178 m.a.s.l.) under a temperature of 25.52 ± 1.98 °C and humidity of 79.25 ± 7.45%). Two participant groups (AKI = 17 and No-AKI = 12) were made according to AKI diagnosis criteria based on pre- and post-race values of serum creatinine (sCr) (an increase of 1.5 times from baseline). Blood and urinalysis were performed immediately pre- and post-race. Results: Pre- vs. post-race differences in sCr and sBUN were found in both AKI and No-AKI groups (p < 0.01). Differences in post-race values were found between groups (p = 0.03). A total of 52% of AKI runners presented significant increases in proteinuria (χ2 = 0.94, p = 0.01) and 47% in bilirubinuria (χ2 = 0.94, p = 0.04). Conversely, No-AKI participants presented no significant increases in urine markers. Conclusions: These study's findings may suggest the potential use of urinalysis as an accessible alternative in the outpatient setting to early identify transitional AKI until a clinical confirmation is performed.

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ABSTRACT Introduction: The traditional hypoxic training program used by endurance athletes was included in the training of team and/or racquet sports players. Objective: The aim of this study is to analyse the effect of a new lower dose of repeated-sprint training in hypoxia (RSH) as compared with previous studies on short and long-term physical performance of team sports players. Methods: Tests were performed before and after four weeks of supervised specific training and after two weeks of detraining. Twenty-four team-sport players voluntarily participated in the study (age: 22.73±2.87 years; weight: 70.20±3.42 kg; height: 176.95±1.63 cm; BMI: 22.42±2.26 kg/m2); the participants were randomly assigned to the RSH training group (n=8; FiO2= 14.6%), to the normoxia group (RSN) (n=8; FiO2= 20.9%) or to a third control group (CON) (n=8). The participants performed eight training sessions of two sets of five 10-second repeated sprints, with a recovery period of 20 seconds between sprints and a recovery period of 10 minutes at 120 W between sets. Body composition was measured following standard anthropometric evaluation procedures. The Wingate Test, Repeated-Sprint Ability Test, SJ, CMJ and Yo-Yo Intermittent Recovery Test were used to evaluate aerobic and anaerobic outcomes. Results: In the hypoxia group, maximal power increased by 14.96% and the total number of sprints performed increased by 20.36%, both with a large effect size (ES=0.78 and ES = 0.71, respectively). Conclusion: A lower dose of repeated-sprint training in hypoxia produces improvements in maximal power and number of sprints in the hypoxia group, in team sports players, as shown by the large effect size in both cases. Level of evidence II; Comparative prospective study.

RESUMO Introdução: O tradicional programa de treinamento em hipóxia utilizado pelos atletas de endurance foi incluído no treinamento dos jogadores de esportes coletivos e/ou de raquete. Objetivo: O objetivo do presente estudo consiste em analisar o efeito de uma nova dose menor de treinamento de sprints repetidos em hipóxia (SRH), em comparação com estudos anteriores sobre o desempenho físico de curto e longo prazo dos jogadores de esportes coletivos. Métodos: Os testes foram realizados antes e após quatro semanas de treinamento específico supervisionado e após duas semanas de destreinamento. Vinte e quatro jogadores de esporte coletivo participaram voluntariamente no estudo (idade: 22,73±2,87 anos; peso: 70,20±3,42 kg; estatura: 176,95±1,63 cm; IMC: 22,42 ±2,26 kg/m2); os participantes foram aleatoriamente designados para o grupo de treinamento SRH (n=8; FiO2=14,6%) ou para o grupo de normóxia (SRN) (n=8; FiO2=20,9%) ou para um terceiro grupo controle (CON) (n=8). Os participantes realizaram oito sessões de treinamento de duas séries de cinco sprints repetidos de 10 segundos com período de recuperação de 20 segundos entre os sprints e de 10 minutos a 120 W entre as séries. A composição corporal foi medida seguindo os procedimentos padrão de avaliação antropométrica. Para avaliar os desfechos aeróbicos e anaeróbicos, os testes de Wingate, teste de habilidade de sprints repetidos, SJ, CMJ e Yo-Yo teste de recuperação intermitente foram utilizados. Resultados: No grupo hipóxia, a potência máxima aumentou em 14,96% e o número total de sprints realizado aumentou em 20,36%, ambos apresentaram grande tamanho de efeito (ES = 0,78 e ES = 0,71, respectivamente). Conclusão: Uma dose menor de treinamento de sprints repetidos em hipóxia leva a melhorias na potência máxima e no número de sprints no grupo hipóxia em jogadores de esportes coletivos, conforme demonstrado através do grande tamanho de efeito em ambos os casos. Nível de evidência II; Estudo prospectivo comparativo.

RESUMEN Introducción: El tradicional programa de entrenamiento en hipoxia utilizado por los atletas de endurance fue incluido en el entrenamiento de los jugadores de deportes colectivos y/o de raqueta. Objetivo: El objetivo del presente estudio consiste en analizar el efecto de una nueva dosis menor de entrenamiento de sprints repetidos en hipoxia (SRH), en comparación con estudios anteriores sobre el desempeño físico de corto y largo plazo de los jugadores de deportes colectivos. Métodos: Los tests fueron realizados antes y después de cuatro semanas de entrenamiento específico supervisado y después de dos semanas de desentrenamiento. Veinticuatro jugadores de deporte colectivo participaron voluntariamente en el estudio (edad: 22,73±2,87 años; peso: 70,20±3,42 kg; estatura: 176,95±1,63 cm; IMC: 22,42 ±2,26 kg/m2); los participantes fueron aleatoriamente designados para el grupo de entrenamiento SRH (n=8; FiO2=14,6%) o para el grupo de normoxia (SRN) (n=8; FiO2=20,9%) o para un tercer grupo control (CON) (n=8). Los participantes realizaron ocho sesiones de entrenamiento de dos series de cinco sprints repetidos de 10 segundos con período de recuperación de 20 segundos entre los sprints y de 10 minutos a 120 W entre las series. La composición corporal fue medida siguiendo los procedimientos estándar de evaluación antropométrica. Para evaluar los resultados aeróbicos y anaeróbicos, fueron utilizados los tests de Wingate, test de habilidad de sprints repetidos, SJ, CMJ y Yo-Yo test de recuperación intermitente. Resultados: En el grupo hipoxia, la potencia máxima aumentó en 14,96% y el número total de sprints realizado aumentó en 20,36%, ambos presentaron gran tamaño de efecto (ES = 0,78 y ES = 0,71, respectivamente). Conclusión: Una dosis menor de entrenamiento de sprints repetidos en hipoxia lleva a mejoras en la potencia máxima y en el número de sprints en el grupo hipoxia en jugadores de deportes colectivos, conforme fuera demostrado a través del gran tamaño de efecto en ambos casos. Nivel de evidencia II; Estudio prospectivo comparativo.

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(1) Background: This study aimed to explore wearable sensors' potential use to assess cumulative mechanical kidney trauma during endurance off-road running. (2) Methods: 18 participants (38.78 ± 10.38 years, 73.24 ± 12.6 kg, 172.17 ± 9.48 cm) ran 36 k off-road race wearing a Magnetic, Angular Rate and Gravity (MARG) sensor attached to their lower back. Impacts in g forces were recorded throughout the race using the MARG sensor. Two blood samples were collected immediately pre- and post-race: serum creatinine (sCr) and albumin (sALB). (3) Results: Sixteen impact variables were grouped using principal component analysis in four different principal components (PC) that explained 90% of the total variance. The 4th PC predicted 24% of the percentage of change (∆%) of sCr and the 3rd PC predicted the ∆% of sALB by 23%. There were pre- and post-race large changes in sCr and sALB (p ≤ 0.01) and 33% of participants met acute kidney injury diagnosis criteria. (4) Conclusions: The data related to impacts could better explain the cumulative mechanical kidney trauma during mountain running, opening a new range of possibilities using technology to better understand how the number and magnitude of the g-forces involved in off-road running could potentially affect kidney function.

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Muscle and kidney injury in endurance athletes is worrying for health, and its relationship with physical external workload (eWL) needs to be explored. This study aimed to analyze which eWL indexes have more influence on muscle and kidney injury biomarkers. 20 well-trained trail runners (age = 38.95 ± 9.99 years) ran ~35.27 km (thermal-index = 23.2 ± 1.8 °C, cumulative-ascend = 1815 m) wearing inertial measurement units (IMU) in six different spots (malleolus peroneus [MPleft/MPright], vastus lateralis [VLleft/VLright], lumbar [L1-L3], thoracic [T2-T4]) for eWL measuring using a special suit. Muscle and kidney injury serum biomarkers (creatin-kinase [sCK], creatinine (sCr), ureic-nitrogen (sBUN), albumin [sALB]) were assessed pre-, -post0h and post24h. A principal component (PC) analysis was performed in each IMU spot to extract the main variables that could explain eWL variance. After extraction, PC factors were inputted in multiple regression analysis to explain biomarkers delta change percentage (Δ%). sCK, sCr, sBUN, sALB presented large differences (p < 0.05) between measurements (pre < post24h < post0h). PC's explained 77.5-86.5% of total eWL variance. sCK Δ% was predicted in 40 to 47% by L1-L3 and MPleft; sCr Δ% in 27% to 45% by L1-L3 and MPleft; and sBUN Δ% in 38%-40% by MPright and MPleft. These findings could lead to a better comprehension of how eWL (impacts, player load and approximated entropy) could predict acute kidney and muscle injury. These findings support the new hypothesis of mechanical kidney injury during trail running based on L1-L3 external workload data.

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OBJECTIVES: The main objective of this study was to compare two cold water immersion protocols, continuous or intermittent, on recovery in basketball players. METHODS: Ten male basketball players (age: 14 ± 0.4 years, body mass: 65.4 ± 9.1 kg, height: 175 ± 7.3 cm, body fat %: 10.3 ± 4) were included in the study. After three 90-minute training sessions (avg. heart rate 158 ± 11.92, 156 ± 7.06 and 151 ± 10.44 bpm), participants were grouped into a continuous immersion (12 min at 12 ± 0.4°C) group, intermittent immersion (4 x 2 min immersion at 12 ± 0.4 °C + 1 min out of water) group and a control group (CG). Countermovement jump (CMJ), muscle pain and thigh volume were measured. RESULTS: Both cold water immersion protocols were effective in reducing the pain 24 and 48 hours after training compared with the CG (F (3.54) = 2.91, p = 0.016, ηp2 = .24). Concerning CMJ change, % differences occurred at 24 (Z = 11.04, p = 0.004) and 48 hours (Z = 14.01, p < 0.001) in comparison with the CG. Regarding the muscle volume, the statistical analysis did not report a significant interaction (F (3.54) = 2.42, p = 0.058). CONCLUSION: Both cold water immersion CWI protocols are effective in improving recovery in basketball players.

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