An imbalance between the overall strain experienced during exercise training and the athlete's tolerance of such effort may induce overreaching or overtraining syndrome. Overtraining syndrome is characterised by diminished sport-specific physical performance, accelerated fatiguability and subjective symptoms of stress. Overtraining is feared by athletes yet there is a lack of objective parameters suitable for its diagnosis and prevention. In addition to the determination of substrates (e.g. lactate, ammonia and urea) and enzymes (e.g. creatine kinase), the possibilities for monitoring of training by measuring hormonal levels in blood are currently being investigated. Endogenous hormones are essential for physiological reactions and adaptations during physical work and influence the recovery phase after exercise by modulating anabolic and catabolic processes. Testosterone and cortisol are playing a significant role in metabolism of protein as well as carbohydrate metabolism. Both are competitive agonists at the receptor level of muscular cells. The testosterone/cortisol ratio is used as an indication of the anabolic/catabolic balance. This ratio decreases in relation to the intensity and duration of physical exercise, as well as during periods of intense training or repetitive competition, and can be reversed by regenerative measures. Correlations have been noted with the training-induced changes of strength. However, it seems more likely that the testosterone/cortisol ratio indicates the actual physiological strain in training, rather than overtraining syndrome. The sympatho-adrenergic system might be involved in the pathogenesis of overtraining. Overtraining appears as a disturbed autonomic regulation, which in its parasympathicotonic form shows a diminished maximal secretion of catecholamines, combined with an impaired full mobilisation of anaerobic lactic reserves. This is supposed to lead to decreased maximal blood lactate levels and maximal performance. Free plasma adrenaline (epinephrine) and noradrenaline (norepinephrine) may provide additional information for the monitoring of endurance training. While prolonged aerobic exercise conducted at intensities below the individual anaerobic threshold lead to a moderate rise of sympathetic activity, workloads exceeding this threshold are characterised by a disproportionate increase in the levels of catecholamines. In addition, psychological stress during competitive events is characterised by a higher catecholamines to lactate ratio in comparison with training exercise sessions. Thus, the frequency of training sessions with higher anaerobic lactic demands or of competition, should be carefully limited in order to prevent overtraining syndrome. In the state of overtraining syndrome and overreaching, respectively, an intraindividually decreased maximum rise of pituitary hormones (corticotrophin, growth hormone), cortisol and insulin has been found after a standardised exhaustive exercise test performed with an intensity of 10% above the individual anaerobic thresho...

Mononuclear phagocytes play a major role in the development of vascular lesions in atherogenesis. The goal of our study was to characterize circulating blood monocyte subpopulations as potential cellular markers of systemic immunological abnormalities in hypercholesterolemia. In normal subjects, three-parameter immunophenotyping of whole blood revealed that 61.3 +/- 6.0% of monocytes showed "bright" expression of the lipopolysaccharide receptor (LPSR: CD14) and Fc gamma receptor I (RI: CD64) without expression of Fc gamma-RIII (CD16). Other monocyte subsets (populations 2, 3, 4, and 5) were characterized by the simultaneous expression of both Fc gamma-R's (25.6 +/- 5.0%), isolated expression of Fc gamma-RIII (9.4 +/- 1.7%), or high expression of CD33 (3.7 +/- 1.1%) with only dim expression of CD14, respectively. The smallest subset of monocytes (population 5: 2.1 +/- 0.8%) differed from the predominant population of CD14brightCD64+CD16- monocytes by additional expression of neural cell adhesion molecule (N-CAM: CD56). In a group of hypercholesterolemic patients (n = 19), high density lipoprotein cholesterol levels were negatively correlated to the population size of CD64-CD16+ monocytes. In both healthy subjects (n = 55) and hypercholesterolemic patients, the rare apolipoprotein E3/E4 and E4/E4 phenotypes were associated with a tendency toward a larger population of CD64-CD16+ monocytes. Expression of the variant activation antigen CD45RA by peripheral blood mononuclear phagocytes showed a positive correlation to plasma levels of the atherogenic lipoproteins low density lipoprotein and lipoprotein(a). These data suggest that systemic abnormalities in mononuclear phagocyte subpopulations may play a role in the pathogenesis of atherosclerosis.

Haemophilia is characterized by intra-articular bleeding, often requiring immobilization, which may result in muscle atrophy and impaired proprioception. The aim of the study was to investigate differences in proprioceptive performance and isometric muscular strength of the lower limbs in haemophilic subjects compared with control subjects. Twelve subjects with severe haemophilia (11 haemophilia A; one haemophilia B) vs. 12 control subjects were matched for anthropometric data and tested for differences of proprioception (one-leg-stand, posturomed, angle-reproduction, and tuning fork tests) and isometric strength (leg press, knee extensor). The static proprioceptive performance of the haemophilic group, as measured by the one-leg-stand test (on hard or soft ground, with open or closed eyes; P < 0.05) was demonstrably impaired (by 41-363%). In contrast, the dynamic proprioceptive performance measured by the posturomed test did not show any difference between the groups. The local proprioceptive performance (angle-reproduction test) of the knee, (the most commonly affected joint in haemophiliacs) showed a trend to impaired function but was not distinctly different from that of controls. The quantitative sensory function (tuning fork) showed significant (P < 0.05) impairment of 9-10% in the haemophilic subjects. Additionally, the isometric muscular strength of the leg extensor was weaker (32-38%) in the haemophilic group when the limbs were tested individually as well as bilaterally (P < 0.05). In conclusion, the results suggest that global proprioceptive performance is impaired and that the isometric strength of the leg extensors is weaker in the haemophilic subjects. Therefore, specialized training for global proprioception would be helpful in order to compensate for proprioceptive deficits. This exercise regimen should also include safe strength-training for an optimal stabilization of the joints, but must be adapted to the individual needs and situations of the haemophilic subjects.p

The aim of the present prospective longitudinal study was to investigate the hormonal response in overtrained athletes at rest and during exercise consisting of a short-term exhaustive endurance test on a cycle ergometer at an intensity 10% above the individual anaerobic threshold. Over a period of 19+/-1 months, 17 male endurance athletes (cyclists and triathletes; age 23.4+/-1.6 yr; VO2max. 61.2+/-1.8 mL x min(-1) x kg(-1); means+/-SEM) were examined five times on two separate days under standardized conditions. Short-term overtraining states (OT, N=15) were primarily induced by an increase of frequency of high-intensive bouts of exercise or competitions without increase of the total amount of training. OT was compared with normal training states intraindividually (NS, N=62). During OT, the time to exhaustion of the exercise test was significantly decreased by 27% on average. At rest and during exercise, the concentrations in plasma and the nocturnal excretion in urine of free epinephrine and norepinephrine were not significantly changed during OT. At physical rest, the concentrations of (free) testosterone, cortisol, luteinizing hormone, follicle-stimulating hormone, adrenocorticotropic hormone, growth hormone, and insulin during OT were comparable with those during NS. A significantly (P < 0.025) lower maximal exercise-induced increase of the adrenocorticotropic hormone and growth hormone, as well as a trend for a decrease of cortisol (P=0.060) and insulin (P=0.036), was measured. The response of free catecholamines as well as the ergometric performance of an all-out 30-s test was unchanged. Serum urea, uric acid, ferritin, and activity of creatine kinase showed no differences between conditions. In conclusion, the results confirm the hypothesis of a hypothalamo-pituitary dysregulation during OT expressed by an impaired response of pituitary hormones to exhaustive short-endurance exercise.

In a moderately to highly endurance-trained group, the percentages of VO2max and HRmax vary considerably in relation to the IAT. As most physiological responses to exercise are intensity dependent, reliance on these parameters alone without considering the IAT is not sufficient.