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      Non-steroidal Anti-inflammatory Drug Consumption in a Multi-Stage and a 24-h Mountain Bike Competition

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          Abstract

          Purpose: Excessive or inappropriate non-steroidal anti-inflammatory drug (NSAID) use during ultra-endurance events could cause potential risk to athletes’ health. Reports on NSAID consumption in mountain bikers or ultra-mountain bikers are scarce. Therefore, the aim of this study was to investigate the prevalence of NSAID consumption immediately before, during and immediately after a mountain bike (MTB) race and to compare NSAID consumption in two different MTB competitions.

          Methods: This observational study took place at a three-stage MTB race (SMTB) ( n = 63) and at a 24-h MTB race (24MTB) ( n = 68), both held in the Czechia in 2017. NSAID consumption was evaluated via self-reported electronic questionnaires.

          Results: Of all finishers ( n = 131), fourteen (10%) consumed NSAID at least once during the competition day (immediately before, during or immediately after the race). The number of NSAID consumers was the same in both competitions. Nevertheless, only three athletes (2%), all of them from the 24MTB, consumed NSAID during the race and 5% of all mountain bikers reported consumption after the race. In contrast to the SMTB, the intake reported by the 24MTB participants was quite homogeneous in terms of the timing of NSAID consumption. The NSAID users were older ( p = 0.043) than the non-users. Ibuprofen was most commonly used by 79% of all consumers.

          Conclusion: The prevalence of NSAID use was higher in the older participants and seems to be lower in comparison with results from studies about runners, ultra-runners and triathletes suggesting that it is determined by the discipline (i.e., cycling). On the other hand, the timing of NSAID consumption was probably affected by the competition character (e.g., MTBS or 24MTB). Future studies should focus on a larger sample size of cyclists from various disciplines.

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          Most cited references25

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          Factors related to successful completion of a 161-km ultramarathon.

          Despite increased 161-km ultramarathon participation in recent years, little is known about those who pursue such an activity. This study surveyed entrants in two of the largest 161-km trail ultramarathon runs in North America to explore demographic characteristics and issues that affected race performance. All entries of the 2009 Western States Endurance Run and the Vermont 100 Endurance Race were invited to complete a postrace questionnaire. There were 500 respondents among the 701 race entries (71.3% response). Finish time was found to have a significant (P ≤ .01) negative association with training volume and was generally directly associated with body mass index. Among nonfinishers, the primary reason for dropping out was nausea and/or vomiting (23.0%). Finishers compared with nonfinishers were more likely (P ≤ .02) to report blisters (40.1% vs 17.3%), muscle pain (36.5% vs 20.1%), and exhaustion (23.1% vs 13.7%) as adversely affecting race performance, but nausea and/or vomiting was similar between groups (36.8% vs 39.6%). Nausea and/or vomiting was no more common among those using nonsteroidal anti-inflammatory drugs (NSAIDs), those participating in the event with higher ambient temperatures, those with a lower training volume, or those with less experience at finishing 161-km races. Overall use of NSAIDs was high, and greater (P = .006) among finishers (60.5%) than nonfinishers (46.4%). From this study, we conclude that primary performance-limiting issues in 161-km ultramarathons include nausea and/or vomiting, blisters, and muscle pain, and there is a disturbingly high use of NSAIDs in these events.
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            Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015.

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              Muscle damage is linked to cytokine changes following a 160-km race.

              Muscle damage and perceived soreness following the 160-km Western States Endurance Run were related to changes in plasma cytokines and use of nonsteroidal anti-inflammatory drugs (NSAIDS). Subjects included 60 ultramarathoners (mean+/-SE, age 45.3 +/- 1.1 years) who finished the race in under 30 h (26.3 +/- 0.4 h). Blood samples were collected the morning prior to and immediately following the race, and subjects recorded muscle soreness during the week following the race using a 10-point Likert scale (DOMS). Seven plasma cytokines were measured including IL-6, IL-10, IL-8, IL-1ra, granulocyte colony-stimulating factor (G-CSF), monocyte chemotactic protein 1 (MCP-1), and macrophage inflammatory protein 1beta (MIP-1beta). Cytokine changes were compared between NSAID users and nonusers, and correlated with creatine phosphokinase (CPK) and DOMS. Significant increases were measured for all seven cytokines, with the greatest fold increases seen for IL-6 (125x), IL-10 (24x), and G-CSF (12x). CPK was correlated with changes in IL-6, G-CSF, IL-10, IL-1ra, and MCP-1 (r = .49-.68), (P < .001), but not IL-8 or MIP-1beta. DOMS averaged 7.1 +/- 0.3 the day after the race, and 5.0 +/- 0.3, 2.5 +/- 0.2, and 1.6 +/- 0.1 3 days, 5 days, and 7 days post-race, respectively, and each was correlated with CPK (r = .40-.63, P < .001) and changes in IL-6, G-CSF, IL-10, and MCP-1 (r = .28-.77, P < .05). A comparison of NSAID users (72% of athletes) and nonusers showed no differences in CPK or DOMS, but did reveal greater increases in five of seven cytokines in the NSAID users (P < .05). In conclusion, muscle damage in athletes competing in a 160-km race was significantly correlated with post-race DOMS and increases in five of seven cytokines. NSAID users did not experience a reduction in muscle damage or DOMS, but did have higher post-race plasma levels in five of seven cytokines.
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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                10 September 2018
                2018
                : 9
                : 1272
                Affiliations
                [1] 1Centre of Sports Activities, Brno University of Technology , Brno, Czechia
                [2] 2Department of Biomedical Engineering, Brno University of Technology , Brno, Czechia
                [3] 3Exercise Physiology Laboratory , Nikaia, Greece
                [4] 4Institute of Primary Care, University of Zurich , Zurich, Switzerland
                Author notes

                Edited by: Hassane Zouhal, University of Rennes 2 – Upper Brittany, France

                Reviewed by: Martin Burtscher, Universität Innsbruck, Austria; Giovanni Messina, University of Foggia, Italy

                *Correspondence: Beat Knechtle, beat.knechtle@ 123456hispeed.ch

                These authors have contributed equally to this work

                This article was submitted to Exercise Physiology, a section of the journal Frontiers in Physiology

                Article
                10.3389/fphys.2018.01272
                6139357
                30246809
                3956c82a-448e-4175-8364-71bd2c5cbdc5
                Copyright © 2018 Chlíbková, Ronzhina, Nikolaidis, Rosemann and Knechtle.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 22 March 2018
                : 21 August 2018
                Page count
                Figures: 1, Tables: 7, Equations: 0, References: 28, Pages: 8, Words: 0
                Categories
                Physiology
                Original Research

                Anatomy & Physiology
                mountain bikers,endurance,anti-inflammatory drug consumption,ibuprofen,pain relief

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