In June 2017 a group of experts in anthropology, biology, kinesiology, neuroscience, physiology, and psychology convened in Canterbury, UK, to address questions relating to the placebo effect in sport and exercise. The event was supported exclusively by Quality Related (QR) funding from the Higher Education Funding Council for England (HEFCE). The funder did not influence the content or conclusions of the group. No competing interests were declared by any delegate. During the meeting and in follow-up correspondence, all delegates agreed the need to communicate the outcomes of the meeting via a brief consensus statement. The two specific aims of this statement are to encourage researchers in sport and exercise science to 1. Where possible, adopt research methods that more effectively elucidate the role of the brain in mediating the effects of treatments and interventions. 2. Where possible, adopt methods that factor for and/or quantify placebo effects that could explain a percentage of inter-individual variability in response to treatments and intervention.

Performance in endurance sports relies on athletes’ drive, which is the sum of all factors pushing athletes to exert effort during exercise. Mental fatigue can influence endurance performance by decreasing athletes’ drive to exercise. From a psychological point of view, mental fatigue has two separate components: it can affect drive by increasing the perceived effort necessary for a given task (“I cannot do this, I am too exhausted”), or by decreasing the perceived value of the reward that can be obtained (“I do not want to do this, it is not worth it”). Neurophysiological theories confirm this dual nature of mental fatigue. It is suggested that mental fatigue can activate the inhibition centers of the brain, increasing perceived effort for a given task, hence decreasing drive and willingness to act. On the other hand, it may also deactivate facilitative brain centers (normally responsible for motivated behavior and increased drive toward a reward), also resulting in decreased drive. In this Perspective we will adopt a multidimensional approach, describing how mental fatigue interacts with drive and performance in endurance exercise. We aim to show how mental fatigue affects endurance performance via two main mechanisms: perceived effort and reward. We will study the interaction between mental fatigue and other factors impacting on drive, such as perceived exertion and motivation, and examine how these factors combined result in athletes’ exercise behavior (such as pacing) and performance. This will provide researchers, coaches, and athletes with useful tools in order to understand, influence and enhance athletes’ drive in exercise, which is of high relevance in elite endurance sports, where mental fatigue, motivation, and stakes all are of the highest level.

Small and large airway dysfunction poorly associate with asthma symptoms in our patients. However, deteriorations in small airway dysfunction are strongly related to an increase in dyspnea during bronchial provocation with methacholine. Small airway dysfunction contributes also independently to the clinical expression of asthma, as reflected by the severity of BHR.

Elite athletes have invested many years in training and competition to reach the elite level. One very important factor on the road to elite performance is the decision-making process regarding the regulation of effort over time, termed as pacing behavior. The regulation of effort is vital for optimal athletic performance during a single race and over a longer period of time (e.g., a competitive season) as an inadequate regulation could result in a higher risk of injuries, overtraining, and drop-out. Despite this, there is limited knowledge on how young athletes learn and develop the abilities related to pacing. Pacing behavior of athletes develops from childhood throughout adolescence and is thought to be closely connected to physical maturation, the development of pre-frontal cortical related (meta-) cognitive functions, as well as the gathering of experience with exercise tasks. The motivation of an athlete can critically influence how an athlete paces a single race, but also how they distribute their effort over a longer period of time. Coaches are advised to closely monitor the development of pacing behavior during adolescence (e.g., by gathering split times, and related physiological measurement, during training and competition), as well as the underlying factors including physical maturation (meta-) cognitive development and the motivation of young athletes. Furthermore, pacing behavior development could be aided by providing training in which the task, individual, and environment are manipulated. Hereby, presenting athletes with the opportunity to gain experience in situations which closely resemble the perceptual-motor conditions of upcoming competitions.

Endurance sports are booming, with sports passionates of varying skills and expertise battering city streets and back roads on their weekly or daily exercise rounds. The investments required for performing in endurance exercise are nevertheless considerable, and passion for their sport might explain the efforts endurance athletes are willing to make. Passion may be defined as a strong motivational force and as such might be related to the neurophysiological basis underlying the drive to exercise. A complex relationship between the brain and other systems is responsible for athletes' exercise behavior and thus performance in sports. We anticipate important consequences of athletes' short term choices, for example concerning risk taking actions, on long term outcomes, such as injuries, overtraining and burnout. We propose to consider athletes' type of passion, in combination with neurophysiological parameters, as an explanatory factor inunderstanding the apparent disparity in the regulation of exercise intensity during endurance sports. Previous research has demonstrated that athletes can be passionate toward their sport in either a harmonious or an obsessive way. Although both lead to considerable investments and therefore often to successful performances, obsessive passion may affect athlete well-being and performance on the long run, due to the corresponding inflexible exercise behavior. In this perspective we will thus examine the influence of passion in sport on athletes' short term and long term decision-making and exercise behavior, in particular related to the regulation of exercise intensity, and discuss the expected long term effects of both types of passion for sport.

No abstract

BackgroundSmall airways dysfunction (SAD) contributes to the clinical expression of asthma. The identification of patients who suffer from SAD is important from a clinical perspective, as targeted therapy may improve patients’ well-being and treatment efficacy.AimsWe aimed to realize the first step in the development of a simple small airways dysfunction tool (SADT) that may help to identify asthma patients having SAD.MethodsAsthma patients with and without SAD were interviewed. Patients were selected to participate in this study based on FEF50% and R5-R20 values from spirometry and impulse oscillometry respectively.ResultsTen in depth interviews and two focus groups revealed that patients with and without SAD perceived differences in symptoms and signs, habits and health related issues. For example, patients with SAD reported to wheeze easily, were unable to breathe in deeply, mentioned more symptoms related to bronchial hyperresponsiveness, experienced more pronounced exercise-induced symptoms and more frequently had allergic respiratory symptoms after exposure to cats and birds. Based on these differences, 63 items were retained to be further explored for the SADT.ConclusionsThe first step of the development of the SADT tool shows that there are relevant differences in signs and respiratory symptoms between asthma patients with and without SAD. The next step is to test and validate all items in order to retain the most relevant items to create a short and simple tool, which should be useful to identify asthma patients with SAD in clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0155-7) contains supplementary material, which is available to authorized users.

No abstract