Assessment of Fatigue and Recovery in Sport: Narrative Review

Abstract

Fatigue is a phenomenon associated with decreases in both physical and cognitive performances and increases in injury occurrence. Competitive athletes are required to complete demanding training programs with high workloads to elicit the physiological and musculoskeletal adaptations plus skill acquisition necessary for performance. High workloads, especially sudden rapid increases in training loads, are associated with the occurrence of fatigue. At present, there is limited evidence elucidating the underlying mechanisms associating the fatigue generated by higher workloads and with an increase in injury risk. The multidimensional nature and manifestation of fatigue have led to differing definitions and dichotomies of the term. Consequently, a plethora of physiological, biochemical, psychological and performance markers have been proposed to measure fatigue and recovery. Those include self-reported scales, countermovement jump performance, heart rate variability, and saliva and serum biomarker analyses. The purpose of this review is to provide an overview of fatigue and recovery plus methods of assessments.

Key words

fatigue - injury - recovery - marker - workload

Publikationsverlauf

Eingereicht: 24. Juni 2021

Angenommen: 25. April 2022

Accepted Manuscript online:
25. April 2022

Artikel online veröffentlicht:
15. Juni 2022

• References

• 1 Michael DJ, Daugherty S, Santos A. et al. Fatigue biomarker index: An objective salivary measure of fatigue level. Accid Anal Prev 2012; 45: 68-73
• 2 Santamaria LJ, Webster KE. The effect of fatigue on lower-limb biomechanics during single-limb landings: A systematic review. J Orthop Sports Phys Ther 2010; 40: 464-473
• 3 Wilson EL, Madigan ML. Effects of fatigue and gender on peroneal reflexes elicited by sudden ankle inversion. J Electromyogr Kinesiol 2007; 17: 160-166
• 4 McIntosh AS. Risk compensation, motivation, injuries, and biomechanics in competitive sport. Br J Sports Med 2005; 39: 2-3
• 5 Taimela S, Kujala UM, Osterman K. Intrinsic risk factors and athletic injuries. Sports Med 1990; 9: 205-215
• 6 Abbiss CR, Laursen PB. Is part of the mystery surrounding fatigue complicated by context?. J Sci Med Sport 2007; 10: 277-279
• 7 Enoka R, Duchateau J. Muscle fatigue: What, why and how it influences muscle function. J Physiol 2008; 586: 11-23
• 8 Halson SL. Monitoring training load to understand fatigue in athletes. Sports Med 2014; 44: 139-147
• 9 Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: Proposal for a unified taxonomy. Neurology 2013; 80: 409-416
• 10 Marino FE, Gard M, Drinkwater EJ. The limits to exercise performance and the future of fatigue research. Br J Sports Med 2011; 45: 65-67
• 11 Micklewright D, Gibson ASC, Gladwell V. et al. Development and validity of the rating-of-fatigue scale. Sports Med 2017; 47: 2375-2393
• 12 Taylor K, Chapman D, Cronin J. et al. Fatigue monitoring in high performance sport: a survey of current trends. JASC 2012; 20: 12-23
• 13 Mehta RK, Parasuraman R. Effects of mental fatigue on the development of physical fatigue: a neuroergonomic approach. Hum Factors 2014; 56: 645-656
• 14 DeLuca J. Fatigue: its definition, its study, and its future. In: Deluca J, eds. Fatigue as a Window to the Brain. Cambridge, MA: MIT Press; 2005: 319-325
• 15 Rodrigues KA, Soares RJ, Tomazini JE. The influence of fatigue in evertor muscles during lateral ankle sprain. Foot 2019; 40: 98-104
• 16 Jones CM, Griffiths PC, Mellalieu SD. Training load and fatigue marker associations with injury and illness: A systematic review of longitudinal studies. Sports Med 2017; 47: 943-974
• 17 Chiu LZ, Barnes JL. The fitness-fatigue model revisited: Implications for planning short-and long-term training. Strength Cond J 2003; 25: 42-51
• 18 Noakes TDO. Fatigue is a brain-derived emotion that regulates the exercise behavior to ensure the protection of whole body homeostasis. Front Physiol 2012; 3: 82
• 19 Shen J, Barbera J, Shapiro CM. Distinguishing sleepiness and fatigue: Focus on definition and measurement. Sleep Med Rev 2006; 10: 63-76
• 20 Xu Y, Xiao D, Zhang H. et al. A prospective study on peptide mapping of human fatigue saliva markers based on magnetic beads. Exp Ther Med 2019; 17: 2995-3002
• 21 Knicker AJ, Renshaw I, Oldham AR. et al. Interactive processes link the multiple symptoms of fatigue in sport competition. Sports Med 2011; 41: 307-328
• 22 Cormack SJ, Newton RU, McGuigan MR. et al. Neuromuscular and endocrine responses of elite players during an Australian rules football season. Int J Sports Physiol Perform 2008; 3: 439-453
• 23 Giannesini B, Cozzone PJ, Bendahan D. Non-invasive investigations of muscular fatigue: metabolic and electromyographic components. Biochimie 2003; 85: 873-883
• 24 Liederbach M, Schanfein L, Kremenic IJ. What is known about the effect of fatigue on injury occurrence among dancers. J Dance. Med Sci 2013; 17: 101-108
• 25 Reilly T. Physiological aspects of soccer. Biol Sport 1994; 11: 3-20
• 26 Waldron M, Highton J. Fatigue and pacing in high-intensity intermittent team sport: An update. Sports Med 2014; 44: 1645-1658
• 27 Allen DG, Lamb GD, Westerblad H. Skeletal muscle fatigue: Cellular mechanisms. Physiol Rev 2008; 88: 287-332
• 28 Schijve J. Fatigue of Structures and Materials. Springer Science & Business Media; 2001
• 29 Ellyin F. Fatigue Damage, Crack Growth and Life Prediction. Springer Science & Business Media; 2012
• 30 Zhu S-P, Huang H-Z, Wang Z-L. Fatigue life estimation considering damaging and strengthening of low amplitude loads under different load sequences using fuzzy sets approach. Int J Damage Mech 2011; 20: 876-899
• 31 Kwofie S. An exponential stress function for predicting fatigue strength and life due to mean stresses. Int J Fatigue 2001; 23: 829-836
• 32 Riley RD, Hayden JA, Steyerberg EW. et al. Prognosis Research Strategy (PROGRESS) 2: prognostic factor research. PLoS Med 2013; 10: e1001380
• 33 Millet G, Millet G, Lattier G. et al. Alteration of neuromuscular function after a prolonged road cycling race. Int J Sports Med 2003; 24: 190-194
• 34 Behm DG, Power K, Drinkwater E. Comparison of interpolation and central activation ratios as measures of muscle inactivation. Muscle Nerve 2001; 24: 925-934
• 35 Hirshkowitz M. Fatigue, sleepiness, and safety: Definitions, assessment, methodology. Sleep Med Clin 2013; 8: 183-189
• 36 Van der Linden D, Frese M, Meijman TF. Mental fatigue and the control of cognitive processes: Effects on perseveration and planning. Acta Psychol (Amst) 2003; 113: 45-65
• 37 Phillips RO. A review of definitions of fatigue – And a step towards a whole definition. Transp Res F: Traffic Psychol Behav 2015; 29: 48-56
• 38 Pageaux B, Lepers R. The effects of mental fatigue on sport-related performance. Prog Brain Res 2018; 240: 291-315
• 39 Boksem MA, Tops M. Mental fatigue: costs and benefits. Brain Res Rev 2008; 59: 125-139
• 40 Boksem MA, Meijman TF, Lorist MM. Mental fatigue, motivation and action monitoring. Biol Psychol 2006; 72: 123-132
• 41 Schiphof-Godart L, Roelands B, Hettinga FJ. Drive in sports: How mental fatigue affects endurance performance. Front Psychol 2018; 9: 1383
• 42 Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol (1985) 2009; 106: 857-864
• 43 Dantzer R, Heijnen CJ, Kavelaars A. et al. The neuroimmune basis of fatigue. Trends Neurosci 2014; 37: 39-46
• 44 MacMahon C, Schücker L, Hagemann N. et al. Cognitive fatigue effects on physical performance during running. J Sport Exerc Psychol 2014; 36: 375-381
• 45 Emanuel P, Sousa J, Silva M. et al. Prior acute mental exertion in exercise and sport. Clin Pract Epidemiol Ment Health 2016; 12: 94-107
• 46 McMorris T, Barwood M, Hale BJ. et al. Cognitive fatigue effects on physical performance: A systematic review and meta-analysis. Physiol Behav 2018; 188: 103-107
• 47 Martin K, Meeusen R, Thompson KG. et al. Mental fatigue impairs endurance performance: A physiological explanation. Sports Med 2018; 48: 2041-2051
• 48 Lal SK, Craig A. A critical review of the psychophysiology of driver fatigue. Biol Psychol 2001; 55: 173-194
• 49 Boyas S, Guével A. Neuromuscular fatigue in healthy muscle: underlying factors and adaptation mechanisms. Ann Phys Rehabil Med 2011; 54: 88-108
• 50 Davis JM. Central and peripheral factors in fatigue. J Sports Sci 1995; 13: 49-53
• 51 Gibson H, Edwards R. Muscular exercise and fatigue. Sports Med 1985; 2: 120-132
• 52 Tanaka M, Ishii A, Watanabe Y. Neural mechanisms underlying chronic fatigue. Rev Neurosci 2013; 24: 617-628
• 53 Abbiss CR, Peiffer JJ, Meeusen R. et al. Role of ratings of perceived exertion during self-paced exercise: what are we actually measuring?. Sports Med 2015; 45: 1235-1243
• 54 Marcora SM. Perception of effort during exercise is independent of afferent feedback from skeletal muscles, heart, and lungs. J Appl Physiol (1985) 2009; 106: 2060-2062
• 55 Smirmaul BdPC. Sense of effort and other unpleasant sensations during exercise: clarifying concepts and mechanisms. Br J Sports Med 2012; 46: 308-311
• 56 Swart J, Lindsay TR, Lambert MI. et al. Perceptual cues in the regulation of exercise performance–physical sensations of exercise and awareness of effort interact as separate cues. Br J Sports Med 2012; 46: 42-48
• 57 Vetter RE, Symonds ML. Correlations between injury, training intensity, and physical and mental exhaustion among college athletes. J Strength Cond Res 2010; 24: 587-596
• 58 Van Oosterwijck J, Nijs J, Meeus M. et al. Pain inhibition and postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: an experimental study. J Intern Med 2010; 268: 265-278
• 59 Gribble PA, Hertel J, Denegar CR. et al. The effects of fatigue and chronic ankle instability on dynamic postural control. J Athl Train 2004; 39: 321-329
• 60 Rozzi S, Yuktanandana P, Pincivero D. et al. Role of fatigue on proprioception and neuromuscular control. In: Lephart S, Fu F, Eds. Proprioception and Neuromuscular Control in Joint Stability. Champaign, IL: Human Kinetics; 2000: 375-383
• 61 Takeda K, Mani H, Hasegawa N. et al. Adaptation effects in static postural control by providing simultaneous visual feedback of center of pressure and center of gravity. J Physiol Anthropol 2017; 36: 31
• 62 Winter DA. Biomechanics and Motor Control of Human Movement. John Wiley & Sons; 2009
• 63 Gribble PA, Hertel J. Effect of hip and ankle muscle fatigue on unipedal postural control. J Electromyogr Kinesiol 2004; 14: 641-646
• 64 Gribble PA, Hertel J. Effect of lower-extremity muscle fatigue on postural control. Arch Phys Med Rehab 2004; 85: 589-592
• 65 Johnston RD, Gabbett TJ, Jenkins DG. et al. Influence of physical qualities on post-match fatigue in rugby league players. J Sci Med Sport 2015; 18: 209-213
• 66 Lundin TM, Feuerbach JW, Grabiner MD. Effect of plantar flexor and dorsiflexor fatigue on unilateral postural control. J Appl Biomech 1993; 9: 191-201
• 67 Miller PK, Bird AM. Localized muscle fatigue and dynamic balance. Percept Mot Skills 1976; 42: 135-138
• 68 Nardone A, Tarantola J, Giordano A. et al. Fatigue effects on body balance. Electroencephalogr Clin Neurophysiol 1997; 105: 309-320
• 69 Ochsendorf DT, Mattacola CG, Arnold BL. Effect of orthotics on postural sway after fatigue of the plantar flexors and dorsiflexors. J Athl Train 2000; 35: 26-30
• 70 Sirois-Leclerc G, Remaud A, Bilodeau M. Dynamic postural control and associated attentional demands in contemporary dancers versus non-dancers. PLoS One 2017; 12: e0173795
• 71 Hanson C, Klimovitch, Lofthus G. Effects of fatigue and laterality on fractionated reaction time. J Mot Behav 1978; 10: 177-184
• 72 Morris AF. Effects of fatiguing isometric and isotonic exercise on resisted and unresisted reaction time components. Eur J Appl Physiol Occup Physiol 1977; 37: 1-11
• 73 Willems T, Witvrouw E, Delbaere K. et al. Intrinsic risk factors for inversion ankle sprains in females – a prospective study. Scan J Med Sci Sports 2005; 15: 336-345
• 74 Sparto PJ, Parnianpour M, Reinsel TE. et al. The effect of fatigue on multijoint kinematics, coordination, and postural stability during a repetitive lifting test. J Ortho Sports Phys Ther 1997; 25: 3-12
• 75 Parnianpour M, Nordin M, Kahanovitz N. et al. The triaxial coupling of torque generation of trunk muscles during isometric exertions and the effect of fatiguing isoinertial movements on the motor output and movement patterns. Spine 1988; 13: 982-992
• 76 Skinner H, Wyatt M, Hodgdon J. et al. Effect of fatigue on joint position sense of the knee. J Orthop Res 1986; 4: 112-118
• 77 Gabbett TJ. Incidence, site, and nature of injuries in amateur rugby league over three consecutive seasons. Br J Sports Med 2000; 34: 98-103
• 78 Jackson ND, Gutierrez GM, Kaminski T. The effect of fatigue and habituation on the stretch reflex of the ankle musculature. J Electromyogr Kinesiol 2009; 19: 75-84
• 79 Pinto M, Kuhn JE, Greenfield M. et al. Prospective analysis of ice hockey injuries at the Junior A level over the course of one season. Clin J Sport Med 1999; 9: 70-74
• 80 Woods C, Hawkins R, Hulse M. et al. The Football Association Medical Research Programme: an audit of injuries in professional football: an analysis of ankle sprains. Br J Sports Med 2003; 37: 233-238
• 81 Yaggie JA, McGregor SJ. Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehab 2002; 83: 224-228
• 82 Ekstrand J, Hägglund M, Waldén M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med 2011; 45: 553-558
• 83 Mohr M, Krustrup P, Bangsbo J. Match performance of high-standard soccer players with special reference to development of fatigue. J Sports Sci 2003; 21: 519-528
• 84 Gabbett TJ. Incidence of injury in semi-professional rugby league players. Br J Sports Med 2003; 37: 36-44
• 85 Tropp H, Odenrick P. Postural control in single-limb stance. J Orthop Res 1988; 6: 833-839
• 86 Greig M. The influence of soccer-specific fatigue on peak isokinetic torque production of the knee flexors and extensors. Am J Sports Med 2008; 36: 1403-1409
• 87 Small K, McNaughton L, Greig M. et al. The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. J Sci Med Sport 2010; 13: 120-125
• 88 Rahnama N, Reilly T, Lees A. et al. Muscle fatigue induced by exercise simulating the work rate of competitive soccer. J Sports Sci 2003; 21: 933-942
• 89 Ekdahl C. Postural control, muscle function and psychological factors in rheumatoid arthritis: Are there any relations?. Scand J Rheumatol 1992; 21: 297-301
• 90 Bangsbo J. The physiology of soccer – with special reference to intense intermittent exercise. Acta Physiol Scand Suppl 1994; 619: 1-155
• 91 Kernell D, Monster A. Motoneurone properties and motor fatigue Experimental Brain Research. Exp Brain Res 1982; 46: 197-204
• 92 Macefield G, Hagbarth K-E, Gorman R. et al. Decline in spindle support to alpha-motoneurones during sustained voluntary contractions. J Physiol 1991; 440: 497-512
• 93 Green H. Neuromuscular aspects of fatigue. Can J Sports Sci 1987; 12: 7s-19s
• 94 Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise. Sports Med 2008; 38: 633-646
• 95 Bellenger CR, Fuller JT, Thomson RL. et al. Monitoring athletic training status through autonomic heart rate regulation: a systematic review and meta-analysis. Sports Med 2016; 46: 1461-1486
• 96 Buchheit M, Simpson M, Al Haddad H. et al. Monitoring changes in physical performance with heart rate measures in young soccer players. Eur J Appl Physiol 2012; 112: 711-723
• 97 Meeusen R, Duclos M, Foster C. et al. European College of Sport Science; American College of Sports Medicine. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc 2013; 45: 186-205
• 98 Smith DJ, Norris SR. Changes in glutamine and glutamate concentrations for tracking training tolerance. Med Sci Sports Exerc 2000; 32: 684-689
• 99 Steinacker JM, Lormes W, Reissnecker S. et al. New aspects of the hormone and cytokine response to training. Eur J Appl Physiol 2004; 91: 382-391
• 100 Urhausen A, Gabriel H, Kindermann W. Blood hormones as markers of training stress and overtraining. Sports Med 1995; 20: 251-276
• 101 Gabriel H, Urhausen A, Valet G. et al. Overtraining and immune system: a prospective longitudinal study in endurance athletes. Med Sci Sports Exerc 1998; 30: 1151-1157
• 102 Meyer T, Faude O, Urhausen A. et al. Different effects of two regeneration regimens on immunological parameters in cyclists. Med Sci Sports Exerc 2004; 36: 1743-1749
• 103 Kellmann M. Preventing overtraining in athletes in high-intensity sports and stress/recovery monitoring. Scand J Med Sci Sports 2010; 20: 95-102
• 104 Kaikkonen P, Rusko H, Martinmäki K. Post-exercise heart rate variability of endurance athletes after different high-intensity exercise interventions. Scand J Med Sci Sports 2008; 18: 511-519
• 105 Buchheit M. Monitoring training status with HR measures: do all roads lead to Rome?. Front Physiol 2014; 5: 73
• 106 Hecksteden A, Skorski S, Schwindling S. et al. Blood-borne markers of fatigue in competitive athletes – results from simulated training camps. PLoS One 2016; 11: e0148810
• 107 Faria EW, Parker DL, Faria IE. The Science of Cycling. Sports Med 2005; 35: 285-312
• 108 Gleeson M. Biochemical and immunological markers of over-training. J Sports Sci Med 2002; 1: 31-41
• 109 Ballard HJ. ATP and adenosine in the regulation of skeletal muscle blood flow during exercise. Acta Physiol Sin 2014; 66: 67-78
• 110 Vizi É, Huszár É, Csoma Z. et al. Plasma adenosine concentration increases during exercise: a possible contributing factor in exercise-induced bronchoconstriction in asthma. J Allergy Clin Immunol 2002; 109: 446-448
• 111 Koyas A, Tucer S, Kayhan M. et al. Interleukin-7 protects CD8+T cells from adenosine-mediated immunosuppression. Sci Signal 2021; 14 eabb1269
• 112 Wlodarczyk M, Kusy K, Slominska E. et al. Changes in blood concentration of adenosine triphosphate metabolism biomarkers during incremental exercise in highly trained athletes of different sport specializations. J Strength Cond Res 2019; 33: 1192-1200
• 113 Ramakers B, Pickkers P, Deussen A. et al. Measurement of the endogenous adenosine concentration in humans in vivo: Methodological considerations. Curr Drug Metab 2008; 9: 679-685
• 114 Beneke R, Leithäuser RM, Ochentel O. Blood lactate diagnostics in exercise testing and training. Int J Sports Physiol Perform 2011; 6: 8-24
• 115 Rowbottom DG, Keast D, Morton AR. The emerging role of glutamine as an indicator of exercise stress and overtraining. Sports Med 1996; 21: 80-97
• 116 Halson SL, Lancaster GI, Jeukendrup AE. et al. Immunological responses to overreaching in cyclists. Med Sci Sports Exerc 2003; 35: 854-861
• 117 Walsh NP, Blannin AK, Robson PJ. et al. Glutamine, exercise and immune function. Sports Med 1998; 26: 177-191
• 118 Castell L, Newsholme E. The relation between glutamine and the immunodepression observed in exercise. Amino Acids 2001; 20: 49-61
• 119 Mackinnon LT, Hooper SL. Plasma glutamine and upper respiratory tract infection during intensified training in swimmers. Med Sci Sports Exerc 1996; 28: 285-290
• 120 Greenhaff P, Gleeson M, Maughan R. The influence of an alteration in diet composition on plasma and muscle glutamine levels in man. Clin Sci 1988; 74: 20
• 121 Fukuda S, Nojima J, Motoki Y. et al. A potential biomarker for fatigue: Oxidative stress and anti-oxidative activity. Biol Psychol 2016; 118: 88-93
• 122 Wadley AJ, van Zanten JJV, Paine NJ. et al. Underlying inflammation has no impact on the oxidative stress response to acute mental stress. Brain Behav Immun 2014; 40: 182-190
• 123 Margonis K, Fatouros IG, Jamurtas AZ. et al. Oxidative stress biomarkers responses to physical overtraining: implications for diagnosis. Free Radic Biol Med 2007; 43: 901-910
• 124 Ikegami K, Ogyu S, Arakomo Y. et al. Urinary 8-hydroxydeoxyguanosine levels and psychological reactions after sleep deprivation. J UOEH 2010; 32: 1-10
• 125 Wimalawansa SJ. Vitamin D deficiency: effects on oxidative stress, epigenetics, gene regulation, and aging. Biology (Basel) 2019; 8: 30
• 126 Ryan ZC, Craig TA, Folmes CD. et al. 1α, 25-Dihydroxyvitamin D3 regulates mitochondrial oxygen consumption and dynamics in human skeletal muscle cells. J Biol Chem 2016; 291: 1514-1528
• 127 Bouillon R, Verstuyf A. Vitamin D, mitochondria, and muscle. J Clin Endocrinol Metab 2013; 98: 961-963
• 128 Sarsour EH, Kumar MG, Chaudhuri L. et al. Redox control of the cell cycle in health and disease. Antioxid Redox Signal 2009; 11: 2985-3011
• 129 Shuler FD, Wingate MK, Moore GH. et al. Sports health benefits of vitamin D. Sports Health 2012; 4: 496-501
• 130 Bartoszewska M, Kamboj M, Patel DR. Vitamin D, muscle function, and exercise performance. Pediatr Clin 2010; 57: 849-861
• 131 Ceglia L. Vitamin D and its role in skeletal muscle. Curr Opin Clin Nutr Metab Care 2009; 12: 628-633
• 132 Ceglia L. Vitamin D and skeletal muscle tissue and function. Mol Aspects Med 2008; 29: 407-414
• 133 Dirks-Naylor AJ, Lennon-Edwards S. The effects of vitamin D on skeletal muscle function and cellular signaling. J Steroid Biochem Mol Biol 2011; 125: 159-168
• 134 Hamilton B. Vitamin D and human skeletal muscle. Scand J Med Sci Sports 2010; 20: 182-190
• 135 Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med 2008; 29: 361-368
• 136 Nicoll JX, Hatfield DL, Melanson KJ. et al. Thyroid hormones and commonly cited symptoms of overtraining in collegiate female endurance runners. Eur J Appl Physiol 2018; 118: 65-73
• 137 Loucks AB, Heath EM. Induction of low-T3 syndrome in exercising women occurs at a threshold of energy availability. Am J Physiol 1994; 266: R817-R823
• 138 Loucks AB, Callister R. Induction and prevention of low-T3 syndrome in exercising women. Am J Physiol 1993; 264: R924-R930
• 139 Harber VJ, Petersen SR, Chilibeck PD. Thyroid hormone concentrations and muscle metabolism in amenorrheic and eumenorrheic athletes. Can J Appl Physiol 1998; 23: 293-306
• 140 Tornberg ÅB, Melin A, Koivula FM. et al. Reduced neuromuscular performance in amenorrheic elite endurance athletes. Med Sci Sports Exerc 2017; 49: 2478-2485
• 141 Cioffi F, Senese R, Lanni A. et al. Thyroid hormones and mitochondria: with a brief look at derivatives and analogues. Mol Cell Endocrinol 2013; 379: 51-61
• 142 Baylor L, Hackney A. Resting thyroid and leptin hormone changes in women following intense, prolonged exercise training. Eur J Appl Physiol 2003; 88: 480-484
• 143 Morgan WP, Costill DL, Flynn MG. et al. Mood disturbance following increased training in swimmers. Med Sci Sports Exerc 1988; 21: 107-114
• 144 Lehmann M, Foster C, Dickhuth H-H. et al. Autonomic imbalance hypothesis and overtraining syndrome. Med Sci Sports Exerc 1998; 30: 1140-1145
• 145 Eichner ER. Overtraining: consequences and prevention. J Sports Sci 1995; 13: 41-48
• 146 Hagen J, Gott N, Miller DR. Reliability of saliva hormone tests. J Am Pharm Assoc 2003; 43: 724-726
• 147 Vining RF, McGinley RA, Symons RG. Hormones in saliva: mode of entry and consequent implications for clinical interpretation. Clin Chem 1983; 29: 1752-1756
• 148 Cormack SJ, Newton RU, McGuigan MR. Neuromuscular and endocrine responses of elite players to an Australian rules football match. Int J Sports Physiol Perform 2008; 3: 359-374
• 149 Elloumi M, Maso F, Michaux O. et al. Behaviour of saliva cortisol [C], testosterone [T] and the T/C ratio during a rugby match and during the post-competition recovery days. Eur J Appl Physiol 2003; 90: 23-28
• 150 West DJ, Finn CV, Cunningham DJ. et al. Neuromuscular function, hormonal, and mood responses to a professional rugby union match. J Strength Cond Res 2014; 28: 194-200
• 151 Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med 2005; 35: 339-361
• 152 Crewther BT, Cook C, Cardinale M. et al. Two emerging concepts for elite athletes. Sports Med 2011; 41: 103-123
• 153 Daly W, Seegers C, Rubin D. et al. Relationship between stress hormones and testosterone with prolonged endurance exercise. Eur J Appl Physiol 2005; 93: 375-380
• 154 Doerr P, Pirke KM. Cortisol-induced suppression of plasma testosterone in normal adult males. J Clin Endocrinol Metab 1976; 43: 622-629
• 155 Roe G, Till K, Darrall-Jones J. et al. Changes in markers of fatigue following a competitive match in elite academy rugby union players. SA J Sports Med 2016; 28: 2-5
• 156 Cunniffe B, Hore AJ, Whitcombe DM. et al. Time course of changes in immuneoendocrine markers following an international rugby game. Eur J Appl Physiol 2010; 108: 113-122
• 157 Jones MR, West DJ, Harrington BJ. et al. Match play performance characteristics that predict post-match creatine kinase responses in professional rugby union players. BMC Sports Sci Med Rehabil 2014; 6: 38
• 158 McLean BD, Coutts AJ, Kelly V. et al. Neuromuscular, endocrine, and perceptual fatigue responses during different length between-match microcycles in professional rugby league players. Int J Sports Physiol Perform 2010; 5: 367-383
• 159 Garrett J. The proper role of nerves in salivary secretion: a review. J Dent Res 1987; 66: 387-397
• 160 Proctor GB, Carpenter GH. Regulation of salivary gland function by autonomic nerves. Auton Neurosci 2007; 133: 3-18
• 161 Klein LC, Corwin EJ. Seeing the unexpected: how sex differences in stress responses may provide a new perspective on the manifestation of psychiatric disorders. Curr Psychiatry Rep 2002; 4: 441-448
• 162 Twist C, Highton J. Monitoring fatigue and recovery in rugby league players. Int J Sports Physiol Perform 2013; 8: 467-474
• 163 Mackinnon LT. Exercise and Immunology. Champaign, Il: Human Kinetics;; 1998
• 164 Parry-Billings M, Budgett R, Koutedakis Y. et al. Plasma amino acid concentrations in the overtraining syndrome: possible effects on the immune system. Med Sci Sports Exerc 1992; 24: 1353-1358
• 165 Blannin AK, Chatwin LJ, Cave R. et al. Effects of submaximal cycling and long-term endurance training on neutrophil phagocytic activity in middle aged men. Br J Sports Med 1996; 30: 125-129
• 166 Keen P, McCarthy D, Passfield L. et al. Leucocyte and erythrocyte counts during a multi-stage cycling race (‘the Milk Race’). Br J Sports Med 1995; 29: 61-65
• 167 Mackinnon LT. Exercise, immunoglobulin and antibody. Exerc Immunol Rev 1996; 2: 1-35
• 168 Khansari DN, Murgo AJ, Faith RE. Effects of stress on the immune system. Immunol Today 1990; 11: 170-175
• 169 Noakes T. Lore of Running. 2nd ed. Cape Town: Oxford University Press; 1992
• 170 Rushall BS. A tool for measuring stress tolerance in elite athletes. J Appl Sport Psychol 1990; 2: 51-66
• 171 Buchheit M. Sensitivity of monthly heart rate and psychometric measures for monitoring physical performance in highly trained young handball players. Int J Sports Med 2015; 36: 351-356
• 172 Raglin J, Morgan W. Development of a scale for use in monitoring training-induced distress in athletes. Int J Sports Med 1994; 15: 84-88
• 173 Thorpe RT, Atkinson G, Drust B. et al. Monitoring fatigue status in elite team-sport athletes: implications for practice. Int J Sports Physiol Perform 2017; 12: 27-34
• 174 Coutts AJ, Cormack S. Monitoring the training response. In: Joyce D, Lewindon D, Eds. High-performance Training for Sports. Champaign, Il: Human Kinetics Publishers; 2014: 71-84
• 175 Kenttä G, Hassmén P. Overtraining and recovery. A conceptual model. Sports Med 1998; 26: 1-16
• 176 Nässi A, Ferrauti A, Meyer T. et al. Psychological tools used for monitoring training responses of athletes. Perform Enhanc Health 2017; 5: 125-133
• 177 McNair DM, Lorr M, Droppleman LF. Manual Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service; 1971
• 178 Kölling S, Schaffran P, Bibbey A. et al. Validation of the acute recovery and stress scale (ARSS) and the short recovery and stress scale (srss) in three english-speaking regions. J Sports Sci 2020; 38: 130-139
• 179 Kellmann M, Kallus KW. Recovery-Stress Questionnaire for Athletes: User manual. Human Kinetics. 2001
• 180 Jeffries AC, Wallace L, Coutts AJ. et al. Athlete-reported outcome measures for monitoring training responses: A systematic review of risk of bias and measurement property quality according to the COSMIN guidelines. Int J Sports Physiol Perform 2020; 15: 1203-1215
• 181 Duignan C, Doherty C, Caulfield B. et al. Single-item self-report measures of team-sport athlete wellbeing and their relationship with training load: a systematic review. J Athl Train 2020; 55: 944-953
• 182 Gallo TF, Cormack SJ, Gabbett TJ. et al. Self-reported wellness profiles of professional Australian football players during the competition phase of the season. J Strength Cond Res 2017; 31: 495-502
• 183 Gastin PB, Meyer D, Robinson D. Perceptions of wellness to monitor adaptive responses to training and competition in elite Australian football. J Strength Cond Res 2013; 27: 2518-2526
• 184 Twist C, Waldron M, Highton J. et al. Neuromuscular, biochemical and perceptual post-match fatigue in professional rugby league forwards and backs. J Sports Sci 2012; 30: 359-367
• 185 Van Dongen H. Comparison of mathematical model predictions to experimental data of fatigue and performance. Aviat Space Environ Med 2004; 75: 15-36
• 186 Caldwell JA, Mallis MM, Caldwell JL. et al. Fatigue countermeasures in aviation. Aviat Space Environ Med 2009; 80: 29-59
• 187 Coyne JO, Haff GG, Coutts AJ. et al. The current state of subjective training load monitoring—a practical perspective and call to action. Sports Med Open 2018; 4: 58
• 188 Saw AE, Main LC, Gastin PB. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. Br J Sports Med 2016; 50: 281-291
• 189 Meeusen R, Duclos M, Gleeson M. et al. Prevention, diagnosis and treatment of the overtraining syndrome: ECSS position statement ‘task force’. Eur J Sport Sci 2006; 6: 1-14
• 190 Ndlec M, McCall A, Carling C. et al. Recovery in Soccer: Part I-post-match fatigue and time course of recovery. Sports Med 2012; 42: 997-1015
• 191 Plews DJ, Laursen PB, Kilding AE. et al. Heart rate variability in elite triathletes, is variation in variability the key to effective training? A case comparison. Eur J Appl Physiol 2012; 112: 3729-3741
• 192 Kuipers H. Training and Overtraining. Philadelphia, PA, USA: Lippincott Williams & Wilkins; 1998
• 193 Hopkins WG. Quantification of training in competitive sports. Sports Med 1991; 12: 161-183
• 194 Bagger M, Petersen P, Pedersen P. Biological variation in variables associated with exercise training. Int J Sports Med 2003; 24: 433-440
• 195 Daanen HA, Lamberts RP, Kallen VL. et al. A systematic review on heart-rate recovery to monitor changes in training status in athletes. Int J Sports Physiol Perform 2012; 7: 251-260
• 196 Shetler K, Marcus R, Froelicher VF. et al. Heart rate recovery: validation and methodologic issues. J Am Coll Cardiol 2001; 38: 1980-1987
• 197 Uusitalo A, Uusitalo A, Rusko H. Exhaustive endurance training for 6–9 weeks did not induce changes in intrinsic heart rate and cardiac autonomic modulation in female athletes. Int J Sports Med 1998; 19: 532-540
• 198 Plews DJ, Laursen PB, Stanley J. et al. Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring. Sports Med 2013; 43: 773-781
• 199 Hautala AJ, Kiviniemi AM, Tulppo MP. Individual responses to aerobic exercise: the role of the autonomic nervous system. Neurosci Biobehav Rev 2009; 33: 107-115
• 200 Kiviniemi AM, Hautala AJ, Kinnunen H. et al. Endurance training guided individually by daily heart rate variability measurements. Eur J Appl Physiol 2007; 101: 743-751
• 201 Kiviniemi AM, Hautala AJ, Kinnunen H. et al. Daily exercise prescription on the basis of HR variability among men and women. Med Sci Sports Exerc 2010; 42: 1355-1363
• 202 Hedelin R, Wiklund U, Bjerle P. et al. Cardiac autonomic imbalance in an overtrained athlete. Med Sci Sports Exerc 2000; 32: 1531-1533
• 203 Hynynen E, Uusitalo A, Konttinen N. et al. Cardiac autonomic responses to standing up and cognitive task in overtrained athletes. Int J Sports Med 2008; 29: 552-558
• 204 Uusitalo A, Uusitalo A, Rusko H. Heart rate and blood pressure variability during heavy training and overtraining in the female athlete. Int J Sports Med 2000; 21: 45-53
• 205 Hynynen E, Uusitalo A, Konttinen N. et al. Heart rate variability during night sleep and after awakening in overtrained athletes. Med Sci Sports Exerc 2006; 38: 313-317
• 206 Hedelin R, Kenttä G, Wiklund U. et al. Short-term overtraining: effects on performance, circulatory responses, and heart rate variability. Med Sci Sports Exerc 2000; 32: 1480-1484
• 207 Buchheit M, Laursen PB, Al Haddad H. et al. Exercise-induced plasma volume expansion and post-exercise parasympathetic reactivation. Eur J Appl Physiol 2009; 105: 471-481
• 208 Al Haddad H, Laursen P, Chollet D. et al. Reliability of resting and postexercise heart rate measures. Int J Sports Med 2011; 32: 598-605
• 209 Kennedy R, Drake D. The effect of acute fatigue on countermovement jump performance in rugby union players during preseason. J Sports Med Phys Fitness 2017; 57: 1261-1266
• 210 Bigland-Ritchie B, Woods J. Changes in muscle contractile properties and neural control during human muscular fatigue. Muscle Nerve 1984; 7: 691-699
• 211 McLellan CP, Lovell DI, Gass GC. Markers of postmatch fatigue in professional rugby league players. J Strength Cond Res 2011; 25: 1030-1039
• 212 Gathercole R, Sporer B, Stellingwerff T. et al. Alternative countermovement-jump analysis to quantify acute neuromuscular fatigue. Int J Sports Physiol Perform 2015; 10: 84-92
• 213 Komi PV. Stretch-shortening cycle: a powerful model to study normal and fatigued muscle. J Biomech 2000; 33: 1197-1206
• 214 Kallerud H, Gleeson N. Effects of stretching on performances involving stretch-shortening cycles. Sports Med 2013; 43: 733-750
• 215 Avela J, Kyrolainen H, Komi PV. et al. Reduced reflex sensitivity persists several days after long-lasting stretch-shortening cycle exercise. J Appl Physiol (1985) 1999; 86: 1292-1300
• 216 Nicol C, Avela J, Komi PV. The stretch-shortening cycle. Sports Med 2006; 36: 977-999
• 217 Thorlund JB, Aagaard P, Madsen K. Rapid muscle force capacity changes after soccer match play. Int J Sports Med 2009; 30: 273-278
• 218 Edwards T, Spiteri T, Piggott B. et al. Monitoring and managing fatigue in basketball. Sports (Basel) 2018; 6: 19
• 219 Bishop PA, Jones E, Woods AK. Recovery from training: a brief review: brief review. Strength Cond Res 2008; 22: 1015-1024
• 220 Worrell TW, Perrin DH. Hamstring muscle injury: the influence of strength, flexibility, warm-up, and fatigue. J Orthop Sports Phys Ther 1992; 16: 12-18