From Protecting the Heart to Improving Athletic Performance – the Benefits of Local and Remote Ischaemic Preconditioning

This review was also finally published. This is the second output of the last collaboration we setup with the Olympic Medical Institute before its closure. With colleagues from the Hatter Institute in UCL we started questioning the protocols employed in the clinical setting and in the sport setting for remote ischaemic preconditioning. Our first paper was a pilot study to look at the dose-response of common methods, this one is a comprehensive review on this topic with the hope that more and better studies are designed to define safe and effective protocols.
The abstract is below, you can access the article online here.

Cardiovasc Drugs Ther. 2015 Oct 19. [Epub ahead of print]

From Protecting the Heart to Improving Athletic Performance – the Benefits of Local and Remote Ischaemic Preconditioning.

Abstract

Remote Ischemic Preconditioning (RIPC) is a non-invasive cardioprotective intervention that involves brief cycles of limb ischemia and reperfusion. This is typically delivered by inflating and deflating a blood pressure cuff on one or more limb(s) for several cycles, each inflation-deflation being 3-5 min in duration. RIPC has shown potential for protecting the heart and other organs from injury due to lethal ischemia and reperfusion injury, in a variety of clinical settings. The mechanisms underlying RIPC are under intense investigation but are just beginning to be deciphered. Emerging evidence suggests that RIPC has the potential to improve exercise performance, via both local and remote mechanisms. This review discusses the clinical studies that have investigated the role of RIPC in cardioprotection as well as those studying its applicability in improving athletic performance, while examining the potential mechanisms involved.

KEYWORDS: 

Acute kidney injury; CABG; Cardioprotection; Exercise performance; Ischemia-reperfusion injury; PCI; Perconditioning; Postconditioning; Remote ischemic preconditioning; Sports
PMID:

 

26477661

 

[PubMed – as supplied by publisher]

New systematic review and meta-analysis

I realised I have not written much on this blog since our activities started at Aspire Academy. This is clearly a sign that we have been very busy at work but also that the only time I had to write it has been spent writing scientific work. As a department we are doing very well not only because our service provision improves on a daily basis but also because we are starting to produce a lot of applied scientific papers which I hope can help the coaching and sports science community Worldwide in improving the support to athletes. We have quite a good number of articles already published, a few in press and many submitted which means that by the end of 2015 we might be able to make a significant contribution to our willingness to learn more and share the learning.

The most recent effort is an extensive systematic review and meta-analysis on the topic of cold baths in adolescent athletes. This was triggered by the fact that many coaches and sports scientists working with young athletes tend to replicate processes and procedures observed in senior athletes without questioning appropriateness and effectiveness. Our conclusions are pretty clear: there is no evidence of benefits of such interventions in adolescent athletes and there are a lot of unanswered questions when it comes to the implications for such recovery practice to negatively affect training adaptations. So as usual, there is a need for more and better studies to understand this with all the limitations of conducting studies in a youth population.

The article is free and completely accessible online. The abstract is below.
If you are interested in reading it, just click here and download the PDF.

Abstract

Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e.g. heats/finals). In recent years, a lot of emphasis has been put on recovery modalities. In particular, emphasis has been placed on the need to reduce the delayed onset of muscle soreness (DOMS) typically evident following training and competitive activities inducing a certain degree of muscle damage. One of the most used recovery modalities consists of cold-water immersion and/or ice/cold applications to muscles affected by DOMS. While the scientific literature has provided a rationale for such modalities to reduce pain in athletes and recreationally active adults, it is doubtful if this rationale is appropriate to aid training with adolescent athletes. In particular, since these methods have been suggested to potentially impair the muscle remodeling process leading to muscle hypertrophy. While this debate is still active in the literature, many coaches adopt such practices in youth populations, simply transferring what they see in elite sportspeople directly; without questioning the rationale, safety or effectiveness as well as the potential for such activity to reduce the adaptive potential of skeletal muscle remodeling in adolescent athletes. The aim of this review was to assess the current knowledge base on the use of ice/cold applications for recovery purposes in adolescent athletes in order to provide useful guidelines for sports scientists, medical practitioners, physiotherapists and coaches working with such populations as well as developing research questions for further research activities in this area. Based on the current evidence, it seems clear that evidence for acute benefits of such interventions are scarce and more work is needed to ascertain the physiological implications on a pre or peri-pubertal population.
Keywords: 

Recovery; Ice; Cold; Youth; Adolescent; Athlete; Elite

New season new activities

So, here we are again, after the summer break the new sporting season is about to start in Doha. The development of activities at Aspire academy is now moving faster than ever. We are starting an exciting project with the Qatar Athletics Federation to work closely together to develop talents as well as establish a sustainable structure to integrate coaching, science and medicine. Since September all QAF athletes and coaches will be training at Aspire and we will be working together to realize this vision and be ready for Doha 2019 and beyond. This project really excites me as I can see this being a true legacy project for the state of Qatar and I am proud to be part of it. We are also contributing to the international community with a conference, which has now become an annual event. In fact, after the success of last year’s conference we have organized another event on coaching young athletes with some excellent speakers and are looking forward to welcome all our coaches, and many coaches from around the World to attend as well. The details of the conference are available here. It is a very exciting time for the academy as two of our former students are participating in the World Championships in Beijing and one of them can hopefully bring home a medal (fingers crossed Mutaz and coach Stan!).


Our service delivery to Aspire athletes and coaches keeps improving and we are introducing more detailed monitoring and reporting activities to be able to influence practice and document the coaching approaches being used in our sports. The centralized database has now been implemented and more minimally invasive and wearable technologies  are being developed and deployed to understand more about coaching young athletes. Our applied research activities are continuing and we plan to submit more papers to describe our work as well as challenge current practice on young athletes. I promise to use to blog to keep everyone up to date as well as working with Aspire to communicate through our social media/website channels a bit more about the activities we conduct.

On the science front, we have also decided to make sure we have an annual scientific conference after the success of the Talent ID one we organized last year. This year our focus is on training monitoring and we have some amazing speakers confirmed as well as a great-exciting programme. The conference is completely free and all details are available here.

This is a great opportunity to learn and network as well as a excellent chance to come to visit us, see our wonderful facilities and possibly talk about collaborations and/or bringing your athletes in Doha for training camps.

So, as you can probably gather from my writing, I am looking forward to this sporting season and I hope to meet/see many of you in Doha at one of our events and/or at one of the many international competitions hosted by the state of Qatar.