Exercise Immunology Applied to Pediatric Sport and the Importance of Monitoring Stages of Puberty and Biological Maturation.

CONTEXT: Exercise immunology is aimed at understanding how exercise sessions can affect the immune system in athletic subjects of different age groups. The objective of the current study was to discuss in which stage of biological maturation (BM) young athletes may be more vulnerable in relation to the immune system, and whether there is a BM range in which it is safer to perform sports training with strenuous exercise loads. EVIDENCE ACQUISITION: Evidence from scientific research from several scientific disciplines (eg, immunology, sport immunology, pediatrics, sports medicine, human development) was gathered to holistically examine the main particularities of exercise immunology as applied to pediatric sport. STUDY DESIGN: Narrative review. LEVEL OF EVIDENCE: Level 5. RESULTS: In pediatric patients, lymphoid tissue expands during puberty and involutes after puberty until it returns to pre-expansion values. This suggests that there is a specific period in which the immune system may be stronger, which may provide opportunities for strenuous exercise in pediatric athletes. However, the chronological period when puberty occurs will be determined by BM, which is the rate at which the biological systems of the human body improves. This may affect the period of lymphoid tissue expansion and, consequently, the behavior of the immune system in pediatric subjects of the same age category. CONCLUSION: During puberty, there is a significant increase in the proinflammatory profile; to compensate for this, there is an expansion of lymphoid tissue that may favor the efficiency of the immune system. The period in which puberty is reached may vary according to the stages of BM. Therefore, in exercise immunology applied to pediatric sports, in addition to external and internal training loads, it is necessary to consider BM and puberty, which have been shown to be safer biomarkers than chronological age for determining immune system behavior in pediatric athletes. STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT): Evidence B level 3.

Physiological mechanisms of muscle strength and power are dependent on the years post obtaining peak height velocity in elite juniors rowers: A cross-sectional study.

BACKGROUND: It is not yet known whether the years after peak height velocity (PHV) are associated with the physiological mechanisms of muscle strength and power in Juniors rowers. OBJECTIVE: To identify the association between years post PHV (YPPHV) with muscle power and strength in Juniors rowers. METHODS: We tested 235 Brazilian rowing athletes (male: 171, female: 64, Juniors category). We measured: power (indoor rowing over 100-m, 500-m, 2,000-m and 6,000-m) and muscle strength (one repetition maximum (1RM) test in squat, deadlift, bench press and bent row on the bench). Biological maturation was index by age of PHV. The sample was divided into groups considering YPPHV recent (2.5 to 3.9), median (2.51 to 4.9) and veteran (>4.9). We use a Baysian approach to data handling. RESULTS: When compared to their peers in the recent and median post PHV groups, the male veteran group were superior in muscle power (Absolute: 100-m (BF10: 2893.85), 500-m (BF10: 553.77) and 6,000-m (BF10: 22.31). Relative: (100-m (BF10: 49.9)) and strength (BF10≥10.0 in squat, bench press and deadlift), and in the female the veteran group were superior in test time (500-m, BF10: 88.4). CONCLUSION: In elite Juniors rowers the increasing YPPHV are associated with muscle power performance in both sexes and muscle strength performance in males.

Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis.

CONTEXT: Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. OBJECTIVES: To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. DATA SOURCES: CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. STUDY SELECTION: Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. RESULTS: Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. CONCLUSION: In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.

Are there differences in anaerobic relative muscle power between upper and lower limbs in adolescent swimmers: A blinded study.

Success in speed swimming depends on the efficiency of the anaerobic system for the production of cellular energy, especially during muscle power production. In the adolescent athletes much is unknown with regards to the relationships between relative power of upper and lower limbs with speed swimming performance. The aim the present study was to identify differences in relative muscle power of upper and lower limbs in adolescent swimmers and relate these to speed swimming performances. Sixty adolescents, of both sexes (50% female, 50% male, 30 swimmers and 30 controls), were recruited. The relative upper limb power (ULP[W/kg]) was assessed by a medicine ball test and the relative lower limbs power (LLP[W/kg]) by a jump test on a jumping platform. Lean mass of the upper and lower limbs was assessed by dual-energy X-ray absorptiometry (DXA) (g). Sport performance was assessed during national level competition (50-m swimming time [in seconds]). Biological maturation (BM) was indexed by years from attainment of peak height velocity. ULP(W/kg) was higher than LLP(W/kg) in both groups (p â€‹< â€‹0.05). Upper and lower limb lean mass (g) correlated significantly with ULP(W/kg) and LLP(W/kg) in both groups (p â€‹< â€‹0.05). ULP(W/kg) and LLP(W/kg) correlated with 50-m swimming performance (s), in both sexes (p â€‹< â€‹0.05). Advanced BM was associated with ULP(W/kg) and LLP(W/kg) in both groups (p â€‹< â€‹0.05), and with 50-m swimming performance (s) in both sexes (p â€‹< â€‹0.05). We concluded that ULP(W/kg) is higher than LLP (W/kg) in adolescent swimmers. Upper and lower limb lean mass and BM were both positively associated with increased ULP (W/kg) and LLP (W/kg).

Influence of Advancing Biological Maturation on Aerobic and Anaerobic Power and on Sport Performance of Junior Rowers: A Longitudinal Study.

Background: Researches are linking Biological Maturation (BM) with the performance of adolescent rowers from both genders. Despite this, there is still not enough information about the influence of BM advancement correlating to sports, aerobic and anaerobic performance in adolescent athletes at the sport modality rowing. Objective: Investigate the influence of Biological Maturation on sports performance and aerobic and anaerobic power in adolescent rowing athletes. Methods: A longitudinal observational study, developed over 3 years, with a sample of 52 adolescents, rowing athletes, of both genders (61% male and 39% female) mean age of 16.0 ± 0.5 years old at the start and 18.4 ± 0.5 years old at the end of the study. Analysis was performed once a year. BM was evaluated through maturational groups generated from Age Peak Height Velocity; maximum aerobic power [VO2Max (ml/kg/min)] and mean anaerobic power (Watts) through the ergometer test (indoor rowing); peak anaerobic power (Watts) through a mathematical model derived from competition time, to determine sports performance analyzed the race time during world championship tryouts. Results: The advancement of BM influenced the reduction of the test time and increase of the mean anaerobic power (Watts) in indoor rowing (η2p > 0.36, p < 0.05), as well as an improvement in performance in sports competition (η2p > 0.35, p < 0.05). However, the advancement of BM did not affect VO2Max (ml/kg/min) in young elite rowing athletes of both sexes (p > 0.05). Conclusion: Advances in biological maturation have been shown to influence the anaerobic and sports performance (reduction of the execution time in 2,000-m) of adolescent rowing athletes of both genders.

Reliability of biological maturation analyses performed by equations predicting skeletal age and peak height velocity with hand and wrist X-ray results.

BACKGROUND: Hand-wrist radiography is the gold standard for the assessment of skeletal age (SA) and the assignment of biological maturation (BM) status. However, its practical use in the field is questioned, prompting the development of anthropometric equations to estimate BM. However, there is no consensus on the reliability of these equations in relation to hand-wrist X-rays. OBJECTIVE: To test the reliability of the BM estimated from predictive equations with the results of hand-wrist X-rays. METHODS: One-hundred forty-four young athletes (38%-males, 62%-females; 12.3 ± 1.4 years) were recruited. SA was assessed by analyzing X-rays of the hand-wrist using the Greulich-Pyle protocol. SA was predicted using the anthropometric equations of Cabral and Macêdo. By subtracting chronological age from SA, a measure of BM or biological age (BA) was computed. In addition, a BA of years from peak height velocity (PHV) was predicted using the anthropometric equations of Mirwald and Moore. RESULTS: Relative to X-ray, Cabral's equations showed high reliability in estimating BM in both sexes (p < .0001) while Macêdo's equations showed substantial reliability or males (p < .0001) only. Mirwald and Moore's equations showed weak reliability (p < .05 and p = .043, respectively). CONCLUSION: The prediction of SA using anthropometric equations was found to be reliable in categorizing individuals as late, synchronized, and/or early maturers in both sexes. However, the predictive equations of years from PHV only reliably categorized late and synchronized maturation stages in males and the synchronized maturers in females.

Pre-exhaustion Training, a Narrative Review of the Acute Responses and Chronic Adaptations.

Pre-exhaustion (PE) is a popular resistance training strategy that involves performing a single-joint exercise followed by a multi-joint exercise with minimal recovery between the transition. This approach is widely used by bodybuilding athletes and resistance training (RT) enthusiasts with the aim of enhancing muscle strength and hypertrophy. The present paper aimed to provide a narrative review as to the effects of the PE method on different acute and chronic outcomes, and discuss relevant practical applications. When considering the body of literature as a whole, we conclude that current evidence does not support a benefit to the PE method compared to traditional RT models regarding chronic improvements in strength, hypertrophy and body composition. However, the heterogeneous study designs confound the ability to draw strong conclusions on the topic. Further investigations are warranted with strict control of study variables to better elucidate what, if any, benefits may be obtained by the PE method.

Effect of Training and Detraining in the Components of Physical Fitness in People Living With HIV/AIDS.

The aim of the study was to evaluate the effect of training and detraining on the physical fitness components of people living with HIV/AIDS (PLHA). The study was characterized as experimental with a sample composed of 21 people divided into two groups: 11 volunteers (PLHA, 46.9 ± 8.0 years, 63.8 ± 12.7 kg, 161.7 ± 8.7 cm, 7 men, and 4 women), using antiretroviral therapy (ART) and 10 people without HIV/AIDS in the control group (CG, 43.8 ± 13.8 years, 75.2 ± 11.2 kg, 163.3 ± 7.8 cm, 3 men, and 7 women), with the same average age and level of physical activity. The intervention, applied to both groups, consisted of combined training for 15 weeks, followed by detraining for 5 weeks. Before and after the training and detraining period the following parameters were evaluated: body composition by dual energy radiological absorptiometry (DXA), cardiorespiratory fitness by ergospirometer, and strength of upper and lower limbs by isometric dynamometer. The results show the effect of the intervention moments on the strength and oxygen consumption variables (time factor), considering the two study groups. Regarding the analysis of the interaction (group vs. time), there was a significant effect on the isometric extension strength of the left (p = 0.019) and right (p = 0.030) knees, with training (left: 10.4%; right: 12.4%) and detraining (left: -10.8%; right: -12.1%) effect in PLHA, when compared with the control group (left: 8.1 and 3.9%, respectively; right: 11.5 and -0.2%, respectively). In addition, there was a significant interaction on ventilatory threshold 1 (p = 0.002), indicating a significantly greater increase with training (27.3%) and decrease with detraining (-22.7%) in the PLHA group compared with the Control group (19.9 and -6.7%, respectively). In conclusion, combined training and the subsequent period of detraining caused similar responses in body composition, isometric strength, and cardiorespiratory fitness of PLHA and CG, except for the extensor strength of the lower limbs and ventilatory threshold 1, which presented positive effects on training and negative effects on detraining for PLHA. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03075332.

Influence of Healthy Habits Counseling on Biochemical and Metabolic Parameters in Children and Adolescents with HIV: Longitudinal Study.

We analyze the influence of dietary counseling and physical activity on biochemical and metabolic parameters in children and adolescents with HIV. A longitudinal experimental study, including three analyses: At the beginning, 4th month, and 8th month. A sample of 18 subjects with HIV of both sexes, mean age 10.4 ± 4.50 years. Usual food intake (24 h recall and food intake marker), level of habitual physical activity, biochemical parameters, resting metabolic rate, as well as body composition (dual-energy X-ray absorptiometry), biological maturation, and anamnesis with clinical data and socioeconomic were evaluated. There was an effect of time on the reduction of blood glucose and triglycerides and the resting metabolic rate. There was a significant increase in fruit consumption throughout the study. The consumption of soft drinks decreased when comparing analysis periods 1 and 2, however, it increased again in analysis period 3. There was no significant effect of time on the set of variables related to a food recall. Counseling healthy habits and regular clinical follow-up were relevant for improving biochemical parameters (glucose, triglyceride, HDL cholesterol), maintaining the resting metabolic rate, increasing fruit consumption, and decreasing the consumption of soft drinks, in part of the time, of children and adolescents with HIV. Finally, we emphasize that counseling positively influenced healthy habits, and these, in turn, improved health-related parameters.

Comparison of Muscle Strength, Aerobic Capacity and Body Composition between Healthy Adolescents and Those Living with HIV: A Systematic Review and Meta-Analysis.

Background: The adverse effects of antiretroviral therapy associated with complications generated by human immunodeficiency virus (HIV) promote impairments in physical fitness in adolescents. Objective: To analyze the aerobic capacity, muscle strength, and body composition of adolescents living with HIV compared with a healthy population of the same age. Methods: Searches were performed in the MEDLINE, Embase, Web of Science, Scopus and SportDiscus databases until September 2019 and updated in April 2020. Eligibility Criteria: adolescents of both sexes in the age group from 10 to 19 years; living with HIV; cross-sectional, case-control, cohort studies; comparing with a healthy population. Mean differences and 95% Confidence intervals (CIs) were calculated using RevMan (software for systematic reviews). Results: Five articles were included, involving 197 adolescents living with HIV (16 to 18 years) and 185 without infection (13 to 18 years), with the sample in each study ranging from 15 to 65 adolescents. Aerobic capacity and muscle strength were reduced in adolescents with HIV, and body mass index was also significantly lower in this group. Conclusion: Adolescents living with HIV have impaired cardiorespiratory fitness, muscle strength, and body composition when compared to their uninfected peers. However, this systematic review provides limited evidence on the differences between the physical fitness outcomes of adolescents living with HIV compared to healthy adolescents.

Impact of curcumin on energy metabolism in HIV infection: A case study.

Prolonged use of antiretroviral therapy (ART) has been associated with dyslipidemia and impaired energy substrate oxidation (SOxi). Curcumin is a natural bioactive compound, which interacts with molecular targets and holds important metabolic properties. The aim of this study was to evaluate the effect of curcumin supplementation on energetic metabolism of an adult female with HIV/AIDS and under ART. The intervention was performed with 500 mg/day of curcumin for 27 days. Glycemic and lipid profile and SOxi at rest were evaluated before and after intervention. After intervention, improvement of lipid profile and insulin sensibility was observed. Moreover, there was a positive modulation of SOxi at rest. Oral curcumin supplementation can positively modulate the energy metabolism of people living with HIV/AIDS using the ART. However, clinical studies are required in order to confirm our findings in a representative sample.

[Contribution of anthropometric characteristics to pubertal stage prediction in young male individuals]. / Contribuição das características antropométricas na predição dos estádios de maturação puberal de jovens do sexo masculino.

OBJECTIVE: To identify the contribution of anthropometric variables to predict the maturational stage in young males. METHODS: Cross-sectional study that enrolled 190 male subjects aged between eight and 18 years, randomly selected from public and private schools in Natal, Northeast Brazil. Thirty-two anthropometric variables were measured following the recommendations of the International Society for the Advancement of Kineanthropometry (ISAK). The assessment of sexual maturation was based on the observation of two experienced experts, who identified the pubertal development according to Tanner guidelines (1962). RESULTS: The anthropometric variables showed a significant increase of their values during the advancement of pubertal development (p<0.05). The following variables showed the best value for prediction of maturational groups: sitting height, femoral biepicondylar diameter, forearm girth, triceps skinfold, tibiale laterale and acromiale-radiale bone lenghts. These variables were able to estimate the pubertal stages in 76.3% of the sujects. CONCLUSION: The anthropometric characteristics showed significant differences between the moments of maturational stages, being found, representatively, seven variables that best predict the stages of sexual maturation.

Relationship between dietary intake and use of protease inhibitors with anthropometric and biochemical parameters of lipodystrophy in people living with hiv.

The lipodystrophy syndrome is characterized by redistribution of body fat and disorders of glicidic and lipid metabolism. Although its etiology is related to infection and drug therapy, there is little evidence regarding the nutritional disturbances on this association. This study aimed to assess the relationship between dietary intake and use of protease inhibitors (PIs) with anthropometric and biochemical parameters in HIV positive patients. The study included 50 patients. A questionnaire about socioeconomic status, lifestyle and infection history was taken. In addition, it was conducted the evaluation of dietary intake (frequency questionnaire), anthropometric parameters (body mass index, waist circumference, triceps skinfold, corrected arm muscle area) and biochemistry tests (glycemia and lipid profile). Only 37% of the sample was classified as "good food consumption", 54% were overweight or obese and 66% presented high waist circumference. The group with good food consumption had higher HDL-C (p=0.04) levels than the group with poor food consumption. Patients taking PIs presented VLDL-C (p=0.023) and triglycerides (p=0.024) levels significantly higher. These results indicated the necessity for continuous monitoring of HIV-positive patients and non-pharmacological interventions such as nutrition education and practice of physical exercises.

La lipodistrofia se caracteriza por la redistribución de la grasa corporal y los trastornos de la glucosa y el metabolismo de los lípidos. Su etiología está relacionada con la infección y la terapia de drogas, sin embargo, hay poca evidencia sobre el papel de la nutrición en estos cambios . Este estudio tuvo como objetivo evaluar la relación entre el consumo alimenticio y el uso de inhibidores de la proteasa con parâmetros antropométricos y bioquímicos en las personas que viven con el VIH. La muestra estuvo constituida por 50 pacientes. Se recogieron Preguntas sobre la situación socioeconómica, el estilo de vida, y antecedentes de infección. Además, se celebró evaluar el consumo de alimentos (cuestionario de frecuencia), antropométricos (índice de masa corporal, circunferencia de la cintura, espesor del pliegue cutáneo del tríceps y el área muscular del brazo corregida) y bioquímicos (niveles de glucosa y lípidos). Sólo el 37 % de la muestra se clasifica como buena consumo de alimentos, 54 % tenían sobrepeso o eran obesos y 66 % tienen alta circunferencia de la cintura. El grupo de consumo de alimentos clasificados como " buenos" presentaram mejores valores de HDLc cuando comparados com el grupo clasidicado del "malo" del los pacientes que usan IP mostró valores de VLDL -C y triglicéridos significativamente más altos. Estos resultados indican la necesidad de un seguimiento continuado de estos pacientes y las intervenciones no farmacológicas, como la educación en nutrición y ejercicio físico.