Safety and efficacy of a probiotic cocktail containing P. acidilactici and L. plantarum for gastrointestinal discomfort in endurance runners: randomized double-blinded crossover clinical trial.

Probiotics are increasingly used to treat conditions associated with gastrointestinal injury and permeability, including exercise-induced gastrointestinal discomfort. This study assessed safety and efficacy of a probiotic in altering the intestinal milieu and mitigating gastrointestinal symptoms (GIS) in endurance runners. In a double blind, crossover study, 16 runners were randomized to 4 weeks of daily supplementation with a probiotic cocktail containing Pediococcus acidilactici bacteria and Lactobacillus plantarum or placebo. Fasting blood and stool samples were collected for measurement of gut permeability markers, immune parameters, and microbiome analyses. Treadmill run tests were performed before and after treatment; participants ran at 65%-70% of VO2max at 27 °C for a maximum of 90 min or until fatigue/GIS developed. A blood sample was collected after the treadmill run test. In healthy individuals, 4 weeks of probiotic supplementation did not alter health parameters, although a marginal reduction in aspartate aminotransferase levels was observed with probiotic treatment only (p = 0.05). GIS, gut permeability-associated parameters (intestinal fatty acid binding protein, lipopolysaccharide binding protein, zonulin, and cytokines), and intestinal microbial content were not altered by the probiotic supplementation. Post-run measurements of GIS and gut-associated parameters did not differ between groups; however, the observed lack of differences is confounded by an absence of measurable functional outcome as GIS was not sufficiently induced during the run. Under the current study conditions, the probiotic was safe to use, and did not affect gut- or immune-associated parameters, or intestinal symptoms in a healthy population. The probiotic might reduce tissue damage, but more studies are warranted.

Gender differences on the age-related distal-to-proximal shift in joint kinetics during running.

The increased running participation in women and men over 40 years has contributed to scientific interest on the age-related and gender differences in running performance and biomechanics over the last decade. Gender differences in running biomechanics have been studied extensively in young runners, with inconsistent results. Understanding how gender influences the age-related differences in running mechanics could help develop population-specific training interventions or footwear to address any potential different mechanical demands. The purpose of this study was to assess gender and age effects on lower limb joint mechanics while running. Middle-aged men (57 ± 5 years) and women (57 ± 8 years) and young men (28 ± 6 years) and women (30 ± 6 years) completed five overground running trials at a set speed of 2.7 m/s while lower limb kinematics and ground reaction forces were collected. Lower limb joint kinetics were computed, normalized to body mass and compared between age and gender groups using two-factor analyses of variance. Women reported slower average running paces than men and middle-aged runners reported slower running paces than young runners. We confirmed that young runners run with more ankle, but less hip positive work and peak positive power compared to middle-aged runners (i.e., age-related distal-to-proximal shift in joint kinetics). We also present a novel finding that women run with more ankle, but less hip peak positive power compared to men suggesting an ankle dominant strategy in women at a preferred and comfortable running pace. However, the age-related distal-to-proximal shift in joint kinetics was not different between genders.

External loading of common training drills: Ranking drills to design progressive return-to-run programs.

Return-to-run protocols following lower extremity injuries commonly include a gradual training and loading progression to allow positive adaptation of musculoskeletal tissue. Before full return to running, training drills designed to provide a low to high external loading progression (i.e., vertical forces) may therefore minimize the risks of re-injury. However, the magnitude of external loading among various training drills has not yet been quantified. OBJECTIVES: The purpose of this study was to quantify peak vertical forces of multiple common training drills and rank each of them in order from lowest to highest peak vertical force. DESIGN: /Participants: 11 experienced runners completed five trials of 46 training drills while in-shoe vertical reaction force (vRF) was measured with wireless force insoles. MAIN OUTCOME MEASURES: Average peak vRF was calculated for each drill across all participants. Drills were also grouped by vRF into four categories intended for use by clinicians as stages of rehabilitation. RESULTS: 46 training drills were ranked in order from least to greatest vRF. The drill with the highest average peak vRF was "Ladder Single Leg Hop Forward", at 2.80 BW. The drill with the lowest average peak vRF was "Squat Mini Jump", at 1.02 BW. CONCLUSIONS: These data provide valuable information for clinicians, coaches and pelvic floor practitioners when programming rehabilitation and return-to-run training progressions for runners coming back from lower extremity or pelvic injuries.