Effects of acute exercise and training status on glucocorticoid-induced leucine zipper (GILZ) expression in human skeletal muscle.

Interactions between statin therapy and physical exercise complicate effective cardiovascular prevention. Emerging evidence suggests that muscle strain related changes in the expression of the glucocorticoid-induced leucine zipper (GILZ) may be involved. Therefore, we measured GILZ mRNA expression levels in M. vastus lateralis samples of 32 healthy individuals before and after a standardized bout of strength or endurance exercise. Overall, we found a highly significant downregulation of GILZ after exercise training (p < 0.001). Within-subgroup changes were statistically significant only after strength training, supporting the role of muscle (as opposed to cardiocirculatory) strain. If confirmed, this may help fitting training recommendations and medication.

Assessment of myocardial function and cardiac performance using left ventricular global longitudinal strain in athletes after COVID-19: a follow-up study.

Background: It has not yet been conclusively determined whether reduced left ventricular global longitudinal strain (LV GLS) after COVID-19 contributes to a reduction in exercise capacity. Our own studies showed a possible mild myocardial involvement in the form of reduced LV GLS in athletes after COVID-19 compared with healthy athletes. The aims of this prospective follow-up study were to investigate the development of LV GLS over a 3-month period in athletes after COVID-19 and the possible relationship between LV GLS and physical performance. Methods: LV GLS was determined in four-, two-, and three-chamber views and assessed offline by a blinded investigator in 96 recreational athletes (mean age 33.15 ± 12.40 years, 53 male, peak VO2 38.82 ± 11.14 ml/min/kg) at a median of two (t0) and five months (t1) after COVID-19. Cardiopulmonary exercise testing (CPET) was performed on a bicycle ergometer on both examination dates. Results: LV GLS improved significantly between t0 and t1 (t0 -18.82 ± 2.02 vs. t1 -19.46 ± 2.05, p < 0.001). Echocardiographic and spiroergometric parameters were within the normal clinical reference range. Maximum power increased significantly from t0 to t1 (t0 283.17 ± 83.20 vs. t1 286.24 ± 85.22 Watt, p = 0.009) and there was a trend toward increased peak oxygen uptake (t0 36.82 ± 11.14 vs. t1 38.68 ± 10.26 ml/min/kg, p = 0.069). We found no correlation between LV GLS and performance parameters, except for the respiratory exchange ratio (RER) [ρ -0.316, (-0.501; -0.102), p < 0.050]. Conclusions: Significant improvement in LV GLS approximately five months after COVID-19 may be due to mild myocardial involvement during or shortly after COVID-19, which seems to recover. There was no correlation between LV GLS and performance parameters, except for an inverse correlation of LV GLS and RER, suggesting insufficient exercise intolerance at lower GLS values. Further studies on the development of GLS in athletes or in the general population with moderate and severe disease courses would be informative as well as the comparison of pre-COVID-19 with post-COVID-19 echocardiography to evaluate the effects of COVID-19 on cardiac function.

Testing anabolic activity, potency and mechanisms of action of the phyto-derived beta 2 agonist higenamine.

Higenamine (Hige), a plant derived alkaloid is classified as ß2 agonist by the World Anti-Doping Agency (WADA). However, pharmacologic mechanisms of its performance-enhancing activity have not been investigated so far. Therefore, we investigate the anabolic activity and associated molecular mechanisms of Hige in C2C12 myotubes. In differentiated C2C12 cells dose-dependent effects of Hige on myotube size were analyzed. The mRNA expression of genes involved in hypertrophy was measured. For mechanistic studies, ß2-adrenoceptor (ADRB2), androgen receptor (AR), and estrogen receptor (ER) inhibitors and dexamethasone (Dexa) were co-incubated and myotube diameter was evaluated. The interaction of Hige with the AR and ER was investigated. Hige treatment significantly increased myotube diameters and stimulated the mRNA expression of hypertrophy-involved genes. In contrast to the ADRB2 inhibitor (ICI 118551), the ER inhibitor ZK 191703, the AR inhibitor Flutamide (Flu), and treatment with Dexa were able to antagonize the Hige-induced increase of myotube diameter. Hige has antagonistic activity in the AR and ER yeast transactivation assay. Our results demonstrate that Hige induces anabolic effects in C2C12 cells but not via the ADRB2. There are indications for a cross talk between Hige and the AR and ER. Future studies are necessary to investigate the involved molecular mechanisms.

Combinatory in vitro effects of the ß2-agonists salbutamol and formoterol in skeletal muscle cells.

ß2-agonists are used for the treatment of bronchoconstriction, but also abused in doping. Beside an ergogenic activity ß2-agonists may have also anabolic activity. Therefore, we investigated the anabolic activity and associated molecular mechanisms of Salbutamol (SAL) and Formoterol (FOR) alone, as well as in combination in C2C12 myotubes. In differentiated C2C12 cells, dose-dependent effects of SAL and FOR (alone/in combination) on myotube diameter, myosin heavy chain (MHC) protein expression and the mRNA expression of genes involved in hypertrophy were analyzed. ß2-adrenoceptor 2 (ADRB2), androgen receptor (AR) and estrogen receptor (ER) inhibitors, as well as dexamethasone (Dexa) were co-incubated with the ß2-agonists and myotube diameter was determined. SAL and FOR treatment significantly induced hypertrophy and increased MHC expression and the mRNA expression of Igf1, mTOR, PIk3r1 and AMpKa2. In contrast to an ER inhibitor, the ADRB2 and AR inhibitors, as well as Dexa antagonized FOR and SAL induced hypertrophy. Combined treatment with SAL and FOR resulted in significant additive effects on myotube diameter and MHC expression. Future clinical studies are needed to prove this effect in humans and to evaluate this finding with respect to antidoping regulations.

High inter-observer reliability in standardized ultrasound measurements of subcutaneous adipose tissue in children aged three to six years.

BACKGROUND: A procedure to measure subcutaneous adipose (SAT) using brightness-mode ultrasound has recently been standardized and applied to various groups of adults including underweight, overweight and obese adults. High reliability of this procedure was found in each of the examined groups. The purpose of this study was to determine inter-observer reliability of the standardized brightness-mode ultrasound measurement of uncompressed SAT in three to six-year-old children. METHODS: Three experienced observers independently captured the ultrasound images at the eight standardized measurement sites in each of the 20 children and evaluated their images using an interactive software that detects the SAT contour and automatically measures multiple thicknesses in each image; the mean of these represents SAT thickness at a given site. The children were aged 4.9 ± 1.0 years; their body mass index ranged from 13.6-17.7 kgm- 2. Sound speed was set to 1450 ms- 1 for SAT. RESULTS: SAT thickness sums with fibrous structures included (DI) ranged from 25.7-86.4 mm, mean DI was 48.1 ± 15.5 mm. For DI, resulting from 160 measurements by each observer, the intra-class correlation coefficient was 0.998 (95% confidence interval 0.980-0.999), standard error of the estimate was 1.1 mm, and 95% limits of agreement were within ±2.1 mm. The median difference in DI was 0.8 mm, i.e. about 1.9% of mean DI. CONCLUSIONS: Inter-observer results in children are comparable to previously described high reliability in adults. This method, which provides a technical thickness measurement accuracy of about 0.1 to 0.2 mm, enables monitoring of subcutaneous adipose tissue in children with a similarly high reliability as was obtained in adults previously. TRIAL REGISTRATION: German Institute of Medical Documentation and Information, German Clinical Trials Register (DRKS) ID: DRKS00010089; Date 24/02/2016.

Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people.

BACKGROUND: The aim of this study was to assess the effect of day of the week and wearing a device (reactivity) on objectively measured physical activity (PA) in older people. METHODS: Walking duration as a measure for PA was recorded from 1333 German community-dwelling older people (≥65 years, 43.8% women) over 5 days using accelerometers (activPAL). Least-square means of PA with 95%-confidence intervals (95%-CI) from multi-level analysis were calculated for each day of the week and each measurement day (days after sensor attachment). RESULTS: Walking duration on Sundays was significantly lower compared to working days (Sunday vs. Monday-Friday: - 12.8 min (95%-CI: - 14.7; - 10.9)). No statistically significant difference compared to working days was present for Saturdays. The linear slope for measurement day and walking duration was marginal and not statistically significant. CONCLUSIONS: Studies using PA sensors in older people should assess Sundays and working days to adequately determine the activity level of the participants.

Genotyping of circulating tumor DNA in cholangiocarcinoma reveals diagnostic and prognostic information.

Diagnosis of Cholangiocarcinoma (CCA) is difficult, thus a noninvasive approach towards (i) assessing and (ii) monitoring the tumor-specific mutational profile is desirable to improve diagnosis and tailor treatment. Tumor tissue and corresponding ctDNA samples were collected from patients with CCA prior to and during chemotherapy and were subjected to deep sequencing of 15 genes frequently mutated in CCA. A set of ctDNA samples was also submitted for 710 gene oncopanel sequencing to identify progression signatures. The blood/tissue concordance was 74% overall and 92% for intrahepatic tumors only. Variant allele frequency (VAF) in ctDNA correlated with tumor load and in the group of intrahepatic CCA with PFS. 63% of therapy naive patients had their mutational profile changed during chemotherapy. A set of 76 potential progression driver genes was identified among 710 candidates. The molecular landscape of CCA is accessible via ctDNA. This could be helpful to facilitate diagnosis and personalize and adapt therapeutic strategies.

Objectively assessed physical activity and weight status of primary school children in Germany with and without migration backgrounds.

OBJECTIVES: Many children are insufficiently active, and children with a migration background appear to be even less active and at a higher risk of developing obesity. This study evaluated the weight status, and the frequencies and intensities of objectively assessed physical activity (PA) of children with and without a migration background. STUDY DESIGN: Cross-sectional study. METHODS: PA was assessed objectively for 6 days in 273 children (aged 7.1 ± 0.6 years). In total, 74 children (27%) were classified as having a migration background. PA was grouped in light and moderate-to-vigorous (MVPA) intensities. Body mass index (BMI) percentiles (BMIPCT) were determined. RESULTS: Children without a migration background spent more time in MVPA compared with children with a migration background (138.2 ± 62.6 vs 121.7 ± 54.9 min, respectively; P < 0.01). On weekends, time in MVPA decreased significantly for all children (112.3 ± 66.0 min, P < 0.01), especially for children with a migration background (97.7 ± 56.7 min, P < 0.01). Children with a migration background displayed significantly higher BMIPCT than children without a migration background (55.7 ± 29.6 vs 44.3 ± 26.8, respectively; P < 0.01) and were significantly more often overweight and/or obese (13.5% vs 8.5%, respectively; P < 0.02). CONCLUSIONS: Children with a migration background are less physically active and more often overweight, resulting in higher risks of developing secondary diseases. The results of this study should be considered when designing interventions to increase PA in children with a migration background. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), DRKS-ID: DRKS00000494.

Moderate intensity continuous training reverses the detrimental effects of ovariectomy on RyR1 phosphorylation in rat skeletal muscle.

High 17ß-Estradiol (E2) concentrations in isolated ventricular myocytes as well as a lack of ovarian hormones in cardiac muscle of ovariectomized (OVX) rodents has been shown to lead to arrhythmogenic effects by inducing post-translational modifications, including phosphorylation of the sarcoplasmic reticulum (SR) Ca2+ release channel ryanodine receptor-2 (RyR2). The effects of estrogens on the phosphorylation status of the RyR1 in skeletal muscle have not been investigated before. Furthermore, while high intensity exercise has been shown to increase RyR phosphorylation, there is no data on the effects of moderate intensity continuous training (MICT). The aims of the study were to investigate the effects of a 3-day treatment with low (1 nM, moderate (5 nM) and high (10 nM, 100 nM) E2 concentrations on RyR1 mRNA and protein expression and phosphorylation status (pRyRSer2844) in cultured C2C12 myotubes and to study the effects of OVX on RyR1 expression and phosphorylation in rat skeletal muscle in combination with 3 weeks of MICT. Treatment with low, physiological E2 concentrations reduced dihydropyridine receptor (DHPR) and RyR1 mRNA content in C2C12 myotubes compared to untreated control cells, whereas RyR1 protein phosphorylation (pRyRSer2844) was significantly increased after treatment with high, non-physiological E2 concentrations (p ≤ 0.05). RyR1 protein content (p ≤ 0.05) and pRyRSer2844 (p ≤ 0.05) were significantly elevated in skeletal muscle of OVX vs. sham-operated rats. Importantly, pRyRSer2844 levels were similar to sham-operated controls in OVX rats after MICT (OVX vs. OVX + MICT, p ≤ 0.05). Our results indicate, that one of the actions of estrogens is to alter skeletal muscle Ca2+ homeostasis by modulating the expression and phosphorylation of the RyR1 in skeletal muscle. Notably, regular MICT was able to counteract RyR1 phosphorylation in skeletal muscle of OVX rats.

[Sports cardiology : Overview of relevant clinical topics]. / Sportkardiologie : Überblick über relevante klinische Themen.

Physical activity is nowadays an established therapeutic principle concerning primary and secondary prevention of cardiovascular diseases; therefore, in internal sports medicine various aspects go beyond basic cardiological knowledge and require special medical expertise (sports cardiology). Acute cardiac risk is increased during physical activity; therefore, physical activity should be individually phased under consideration of the whole clinical situation. Physical training results in a functional adaptation of the cardiovascular system. Moreover, a structural adaptation can also be observed in competitive athletes but a differentiation between athlete's heart and cardiomyopathy is sometimes challenging. Preparticipation screening verifiably reduces the incidence of sudden cardiac death in athletes. Respective recommendations for the required diagnostics have been published and statutory health insurances are increasingly more willing to bear the incurred costs. Statistically, doping is more frequent in performance-orientated leisure time sports than in competitive sports. Drugs which are relevant for doping have partially irreversible cardiac side effects.

Attenuated heart rate recovery predicts risk of incident diabetes: insights from a meta-analysis.

AIMS: To assess the association between attenuated heart rate recovery, a non-invasive measure of autonomic dysfunction, and risk of diabetes in the general population. METHODS: Databases were searched for cohort studies up to May 2017 that reported the association of heart rate recovery with the risk of diabetes. The overall hazard ratios for slowest vs fastest heart rate recovery (the referent) and for every 10-beats-per-min decrement in heart rate recovery were calculated using a random effects meta-analysis model. RESULTS: Four cohort studies with 430 incident cases of diabetes among a total of 9113 participants during a mean follow-up period of 8.1 years were included. Results showed that the slowest heart rate recovery was associated with a higher risk of diabetes (hazard ratio 1.66, 95% CI 1.16 to 2.38) vs the fastest heart rate recovery, and the hazard ratio of risk of diabetes for every 10-beats-per-min decrement in heart rate recovery was 1.29 (95% CI 1.13 to 1.48). No significant interaction effect was observed regarding the efficacy of 1-min and 2-min heart rate recovery in predicting risk of diabetes (both Pfor interaction >0.60); however, a linear dose-response relationship existed for overall studies and for studies using 1-min heart rate recovery as the exposure (both P >0.60 for non-linearity). CONCLUSIONS: Attenuated heart rate recovery is associated with an increased risk of diabetes in a dose-dependent manner, and measurement of heart rate recovery is worth recommending as part of diabetes risk assessment in clinical routines.

The role of sex, adiposity, and gonadectomy in the regulation of irisin secretion.

A sexual dimorphism has been reported for the adipo-myokine irisin at rest and in response to exercise. The effects of male and female sex, adiposity, and gonadectomy on irisin secretion have not been investigated before. The objective of this study was to elucidate the effects of sex, adiposity, and gonadectomy in the regulation of irisin secretion as well as PGC-1α/FNDC5 mRNA and protein expression. We hypothesized that a lack of female sex hormones by ovariectomy reduces irisin levels and inhibits skeletal muscle expression of PGC-1α and FNDC5. Circulating irisin was measured in vivo in serum samples of healthy and obese men and women at rest and in response to acute exercise. The effects of gonadectomy on serum irisin, PGC-1α and FNDC5 muscle mRNA, and protein expression were investigated in ovariectomized (OVX) and orchiectomized (ORX) Wistar rats. Serum irisin at rest was not significantly different between men and women (lean or obese). However, in response to acute aerobic exercise, irisin levels increased significantly more in lean women versus men (p ≤ 0.05). In obese individuals, resting irisin concentrations were significantly higher compared to lean subjects (p ≤ 0.001) and the irisin response to acute exercise was blunted. Only the lack of gonadal hormones in OVX but not ORX rats increased serum irisin levels (p ≤ 0.01) and resulted in significantly increased body weight (p ≤ 0.01), adipose tissue content (p ≤ 0.05), muscle FNDC5 mRNA (p ≤ 0.05), and protein (p ≤ 0.01) expression without altering PGC-1α expression. Testosterone treatment in ORX rats leads to increased PGC-1α mRNA content and reduced PGC-1α protein content without affecting FDNC5 expression or serum irisin levels. We show that a sexual dimorphism exists for the acute irisin response to exercise in normal-weight but not in obese subjects. OVX, which is associated with increased adiposity and insulin insensitivity, increases basal FNDC5 expression and serum irisin, without altering PGC-1α expression. This may be an early sign for metabolic disturbances associated with menopause, such as a developing irisin resistance or an attempt of the organism to improve glucose metabolism.

Pedometer intervention and weight loss in overweight and obese adults with Type 2 diabetes: a meta-analysis.

AIM: Although pedometer intervention is effective in increasing physical activity among adults with Type 2 diabetes, its impact on weight loss remains unclear. This meta-analysis was aimed to assess whether pedometer intervention promotes weight loss. METHODS: Three different databases were searched for randomized controlled trials (RCTs) published in English up to April 2015. Studies were included if they investigated the effects of pedometer intervention on weight loss, as measured by BMI or weight. Effect sizes were aggregated using a random-effects model. Subgroup and meta-regression analyses were used to identify potential moderators. Eleven RCTs with 1258 participants were included. All enrolled participants were overweight or obese. RESULTS: Pedometer intervention led to significantly decreased BMI [weighted mean difference (WMD) -0.15 kg/m(2) , 95% confidence interval (CI) -0.29 to -0.02 kg/m(2) ] and reduced weight (WMD -0.65 kg, 95% CI -1.12 to -0.17 kg). Dietary counselling seemed to be a key predictor of the observed changes. However, none of the following variables had a significant influence: step goal setting, baseline age, BMI, weight, sex distribution, disease duration, intervention duration, and baseline values or change scores for total or moderate-to-vigorous physical activity. After completion of the pedometer intervention, non-significant declines in BMI and weight were observed during the follow-up periods. CONCLUSIONS: Pedometer intervention promotes modest weight loss, but its association with physical activity requires further clarification. Future studies are also required to document dietary and sedentary behaviour changes to facilitate the use of pedometers for weight loss in overweight and obese adults with Type 2 diabetes.

[Atrial fibrillation and physical activity. An overview]. / Vorhofflimmern und körperliche Aktivität. Eine Übersicht.

A training-induced increase in vagal tone, left atrial enlargement and high atrial volume load due to exercise can theoretically favor induction and continuation of atrial fibrillation (AF) in (endurance) athletes. However, there is currently no evidence for a higher occurrence of AF in young endurance athletes in comparison to an age-matched normal population. The correlate of long-term endurance training results in proarrhythmogenic atrial remodeling in a rat model. The results of some studies also suggest that there may be atrial remodeling in humans, which might be an explanation for the comparatively higher incidence of AF in veteran athletes, whereby the relative risk might have been overestimated due to methodological problems, e.g. due to insufficient consideration of "new" AF risk factors. To date, there are no indications for an increased risk of AF due to normal physical activity: on the contrary, moderate physical activity seems to decrease the risk for AF. For an individual evaluation of sports participation of patients with AF, the overall cardiac situation, atrioventricular conduction during exercise, a possible oral anticoagulation as well as the sport and training intensity practiced are important. Well-adapted training for patients with AF has to be considered as safe and effective in terms of the overall positive effects of physical activity in patients with cardiovascular problems, for example due to a positive influence on cardiovascular risk factors.

The supportive effect of supplementation with α-keto acids on physical training in type 2 diabetes mellitus.

The maintenance of physical activity is crucial for the prevention and management of type 2 diabetes (T2D), and exercise induced changes including production of metabolites like ammonia can result in fatigue and exercise intolerance. Nutritional supplements may serve as an effective measure in supporting patients undergoing physical training by acting on their metabolism. This study investigates the effects of supplementation with α-keto acids (KAS) on exercise tolerance and glucose control in T2D patients. In a double-blind, placebo-controlled, randomized study 28 T2D patients underwent 6 weeks training on a cycle ergometer while they were supplemented with either a placebo or KAS (0.2 g kg(-1) body weight each day). The weekly training volume, power output at maximum and lactic threshold, leg muscle torque, the plasma concentration and 8 h urinary discharge of glucose, ammonia and urea were determined before and after the training as well as after one week of recovery. With KAS the patients did significantly more voluntary exercise (213 vs. 62 min, P < 0.01), reached a higher VO2max (27.3 vs. 24.8 ml min(-1) kg(-1)), higher power output (224 vs. 193 watts, P < 0.05) and greater endurance capacity (108 vs. 96 watts at lactic threshold, P < 0.05). Although the patients without KAS improved their glucose control after the training (P < 0.05), this effect could not be maintained after recovery as it was in the KAS group, where there was a prolonged benefit in glucose control. KAS also affected the ammonia and urea metabolism. KAS delivered supportive effects on the physical training along with a prolonged benefit in glucose control in T2D patients.

Correlates of habitual physical activity and organized sports in German primary school children.

OBJECTIVES: The increased prevalence of childhood obesity has also been attributed to low physical activity (PA) levels. Understanding factors affecting child PA levels is especially important considering the benefits PA offers to youth. STUDY DESIGN: This study therefore examined different correlates affecting habitual PA and sports participation in primary school children. METHODS: Height and weight were measured during a school visit in 1714 children (7.1 ± .6 years). PA and behavioural correlates were assessed by parental questionnaire. The effect of various correlates on PA as well as participation in organized sports was assessed using logistic regression analysis. RESULTS: Significant correlates of PA and sports participation were engagement in sporting activities outside of clubs and children's weight status. Playing outdoors for more than 60 min/day was significant for PA, having well educated parents and being male. Participation in sports was influenced by children's media consumption, active travel to school and having active parents. No influence was found for migration, income, parental weight status and health consciousness. CONCLUSION: In this study, a multiplicity of independent correlates of PA and sports participation, which require a broad approach to promote an active lifestyle, have been considered. Understanding these factors might support the development of effective health-promoting interventions.

Impact of insidious gastrointestinal blood loss on endurance performance in an elite rower.

Gastrointestinal (GI) blood loss is a possible reason for anemia in athletes. To quantify the impact on endurance performance, we present data of a world-class rower who developed anemia due to GI blood loss but maintained his training volume. Eight months after recording four normal hematological values over 6 months, an anemic state was detected. Total hemoglobin mass (tHbmass) was reduced from 1267 g to 917 g (-28%) and [Hb] was reduced from 176 g/L to 122 g/L (-31%). Blood volume (BV) remained largely unchanged at 8162 mL and 8261 mL, respectively. VO2max was decreased from 5.8 L/min to 4.8 L/min (-17%), but remained ~0.4 L/min higher than calculated from tHbmass. Power at [lactate] 2 mmol/L (P2) and 4 mmol/L (P4) decreased by 12% and 14%, respectively. Ten months after detection of the anemic state, the athlete had recovered and tHbmass (9%) as well as VO2max (3%), P2 (7%) and P4 (5%) were higher than before anemia. GI blood loss was most likely caused by the intake of non steroidal anti-inflammatory drugs and/or a bleeding Meckel's diverticulum, the latter been diagnosed and surgically removed 3 years later after two rapid bleedings had occurred. Data demonstrate the impact of a tHbmass reduction leading to a substantial but mitigated decrease in submaximal performance and VO2max in an elite athlete. 10 months later, higher levels of tHbmass, VO2max, and endurance performance were observed. However, the underlying mechanisms for the apparent increase in tHbmass remain unclear.

Total haemoglobin mass, maximal and submaximal power in elite rowers.

Elite rowers are highly endurance trained and present with a large lean body mass (LBM), which is closely related to total haemoglobin mass (tHbmass), a major determinant of blood O2-transport. This study aims to determine the magnitude of tHbmass in elite rowers and its relation to performance parameters that are common in rowing worldwide. 13 rowers (3 lightweight) performed a 2000 m test to evaluate maximal performance on the rowing ergometer (P2k) and an incremental test to evaluate power output at lactate 2 and 4 mmol/l (N=15). tHbmass was measured by CO-rebreathing. tHbmass amounted to 1285±123 g (open weight) and 1059±48 g (lightweight). Coefficients of correlation between tHbmass and power output increased with intensity, being highest for P2k (r=0.80). An increase of 100 g tHbmass is associated with an increase of 24 W in P2k between subjects. The ratio between tHbmass/LBM amounted to approximately 16 g/kg. Absolute tHbmass in elite rowers of open weight class is very high. In relation to body mass or LBM, data is similar to other endurance athletes. The relation between P2k performance and tHbmass is very large. However, it is partly mediated by body composition.

[Development and implementation of a state-wide "train the trainer" model of the school-based prevention programme "Join the Healthy Boat - Primary School"]. / Entwicklung und Implementierung eines landesweiten Multiplikatorensystems zur flächendeckenden Umsetzung des schulbasierten Präventionsprogramms "Komm mit in das gesunde Boot - Grundschule"

STUDY AIM: This paper shows how a state-wide health-promotion intervention at primary schools can be implemented by considering the example of the programme "Join the Healthy Boat - Primary School". Additionally, it is illustrated how quality control throughout the whole process can be incorporated. METHODS: To operate long-term and target-group orientated in the whole state of Baden-Württemberg, the school-based prevention programme "Join the Healthy Boat" uses a "train the trainer" model. The trainers are teachers who were instructed by the project team. In the school year 2009/10, these trainers offered quadrinominal training courses for further teachers. Every urban and rural district is covered by 1 trainer. The trainers evaluated the 6 preparatory training courses they had been given using questionnaires. The following 4 training courses the trainers offered to the teachers were reviewed by the trainers as well as the teachers using questionnaires, too. Additionally, at the end of the school year 2009/10, the teachers completed a questionnaire about their satisfaction regarding the programme itself and the work with the trainer. RESULTS: During the school year 2009/10, 453 teachers were trained by 32 trainers. According to indications on the questionnaires about the preparatory training courses, all trainers felt themselves "very well" or "well" prepared for their task. The teachers evaluated the expertise of the respective trainer, the quality of the training courses and the satisfaction with the programme itself throughout highly. CONCLUSION: Based on the excellent results of the process evaluation and the programme's wide coverage, an adoption of a "train the trainer" model seems worthwhile for other school-based prevention programmes, as well.

A test for determining endurance capacity in fencers.

Until now endurance in fencers has been tested by non-specific ergometer tests even though the movement patterns during fencing are considerably different. The aim of the study was to evaluate a newly developed fencing-specific endurance test (FET). 2 studies were carried out: 28 fencers were tested by FET with fencing-specific footwork and incremental tests on cycle (CE) and treadmill ergometer (TM) in a random order. Afterwards fencing bouts (BOU) were conducted to determine specific physical load. Blood lactate and heart rates were measured. In a second study another group of 18 international and 20 national level fencers conducted FET to explore differences between groups. Comparison of CE, TM, FET and BOU revealed a significant correlation between FET and BOU (r=0.80, p<0.01), heart rates during CE and TM were significantly lower than in bouts (p<0.01). Performance at CE and TM hardly correlated with FET (r=0.30, p<0.05; r=0.31, p<0.05). Elite-fencers showed significantly better performance than non-elite fencers in FET (p<0.01). FET was suitable for determining specific endurance in fencers, allows a better assessment of physical demands during bouts than conventional ergometry and can be used to distinguish between fencers of different levels.