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Physical exercise has been shown to alter sensory functions, such as sensory detection or perceived pain. However, most contributing studies rely on the assessment of single thresholds, and a systematic testing of the sensory system is missing. This randomised, controlled cross-over study aims to determine the sensory phenotype of healthy young participants and to assess if sub-maximal endurance exercise can impact it. We investigated the effects of a single bout of sub-maximal running exercise (30 min at 80% heart rate reserve) compared to a resting control in 20 healthy participants. The sensory profile was assessed applying quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain. QST comprises a broad spectrum of thermal and mechanical detection and pain thresholds. It was applied to the forehead of study participants prior and immediately after the intervention. Time between cross-over sessions was one week. Sub-maximal endurance exercise did not significantly alter thermal or mechanical sensory function (time × group analysis) in terms of detection and pain thresholds. The sensory phenotypes did not indicate any clinically meaningful deviation of sensory function. The alteration of sensory thresholds needs to be carefully interpreted, and only systematic testing allows an improved understanding of mechanism. In this context, sub-maximal endurance exercise is not followed by a change of thermal and mechanical sensory function at the forehead in healthy volunteers.
Background: Handball referees play an important role during a handball match. Surprisingly, not much is known about their sports-related injuries and resulting pain, therefore the purpose of our study was to focus on injuries and sports-related pain in referees in German handball leagues. Methods: During the 2018/19 national German handball season, referees of the German Federation of Handball (DHB) were contacted and asked to complete an injury and pain questionnaire on the penultimate matchday of the first and the second round of the season. Results: Seventy referees participated in the study. One in three referees reported an injury during the last year and perceived some form of pain. Of those suffering from pain, 16.7% referees reported chronic pain disorders. During the season, 31.4% of referees incurred an injury and the majority of the 70 referees officiated despite pain (n = 43). Prospectively-enrolled data suggested an incidence of 11.6 (95% CI: 10.3 to 13.0) injuries per 1000 match hours, and 19.0 (95% CI: 16.8 to 21.3) sports-related pain events per 1000 match hours. The most common injuries were foot and knee injuries and a substantial number of the referees (n = 25) reported taking analgesics for the pain. Conclusion: German handball referees are at risk of sports-related injuries with subsequent pain. Considering the injury profile, the incidence of sports-related pain events, and the high physiological demands of refereeing, it appears that prevention programs should be developed and integrated into the routine of the referee.
Background: Associations between age, concerns or history of falling, and various gait parameters are evident. Limited research, however, exists on how such variables moderate the age-related decline in gait characteristics. The purpose of the present study was to investigate the moderating effects of concerns of falling (formerly referred to as fear of falling), history of falls & diseases, and sociodemographic characteristics on changes in gait characteristics with increasing age in the elderly. Methods: In this individual participant level data re-analysis, data from 198 participants (n = 125 females) from 60 to 94 years of age were analysed (mean 73.9, standard deviation 7.7 years). Dependent variables were major spatiotemporal gait characteristics, assessed using a capacitive force measurement platform (zebris FDM-T). Age (independent variable) and the moderating variables concerns of falling (FES-I), gender/sex, history of falls and fall-related medical records, number of drugs daily taken, and body mass index were used in the statistical analysis. Hierarchical linear mixed moderation models (multilevel analysis) with stepwise (forward) modelling were performed. Results: Decreases of gait speed (estimate = −.03, equals a decrease of 0.03 m/s per year of ageing), absolute (− 1.4) and gait speed-normalized (−.52) stride length, step width (−.08), as well as increases in speed normalized cadence (.65) and gait speed variability (.15) are all age-related (each p < .05). Overall and specific situation-related concerns of falling (estimates: −.0012 to −.07) were significant moderators. History of potentially gait- and/or falls-affecting diseases accelerated the age-related decline in gait speed (−.002) and its variability (.03). History of falls was, although non-significant, a relevant moderator (in view of increasing the model fit) for cadence (.058) and gait speed (−.0027). Sociodemographics and anthropometrics showed further moderating effects (sex moderated the ageing effect on stride length, .08; height moderated the effect on the normalised stride length, .26; BMI moderated the effects on step width, .003). Conclusion: Age-related decline in spatiotemporal gait characteristics is moderated by concerns of falling, (non-significantly) by history of falls, significantly by history of diseases, and sociodemographic characteristics in 60–94 years old adults. Knowing the interactive contributions to gait impairments could be helpful for tailoring interventions for the prevention of falls. Trial registration: Re-analysis of [21–24].
Investigation of the sympathetic regulation in delayed onset muscle soreness: results of an RCT
(2021)
Sports-related pain and injury is directly linked to tissue inflammation, thus involving the autonomic nervous system (ANS). In the present experimental study, we disable the sympathetic part of the ANS by applying a stellate ganglion block (SGB) in an experimental model of delayed onset muscle soreness (DOMS) of the biceps muscle. We included 45 healthy participants (female 11, male 34, age 24.16 ± 6.67 years [range 18–53], BMI 23.22 ± 2.09 kg/m2) who were equally randomized to receive either (i) an SGB prior to exercise-induced DOMS (preventive), (ii) sham intervention in addition to DOMS (control/sham), or (iii) SGB after the induction of DOMS (rehabilitative). The aim of the study was to determine whether and to what extent sympathetically maintained pain (SMP) is involved in DOMS processing. Focusing on the muscular area with the greatest eccentric load (biceps distal fifth), a significant time × group interaction on the pressure pain threshold was observed between preventive SGB and sham (p = 0.034). There was a significant effect on pain at motion (p = 0.048), with post hoc statistical difference at 48 h (preventive SGB Δ1.09 ± 0.82 cm VAS vs. sham Δ2.05 ± 1.51 cm VAS; p = 0.04). DOMS mediated an increase in venous cfDNA -as a potential molecular/inflammatory marker of DOMS- within the first 24 h after eccentric exercise (time effect p = 0.018), with a peak at 20 and 60 min. After 60 min, cfDNA levels were significantly decreased comparing preventive SGB to sham (unpaired t-test p = 0.008). At both times, 20 and 60 min, cfDNA significantly correlated with observed changes in PPT. The 20-min increase was more sensitive, as it tended toward significance at 48 h (r = 0.44; p = 0.1) and predicted the early decrease of PPT following preventive stellate blocks at 24 h (r = 0.53; p = 0.04). Our study reveals the broad impact of the ANS on DOMS and exercise-induced pain. For the first time, we have obtained insights into the sympathetic regulation of pain and inflammation following exercise overload. As this study is of a translational pilot character, further research is encouraged to confirm and specify our observations.