Beat Knechtle

Bio: Beat Knechtle is an academic researcher from University of Zurich. The author has contributed to research in topics: Medicine & Athletes. The author has an hindex of 46, co-authored 659 publications receiving 9786 citations. Previous affiliations of Beat Knechtle include University of St. Gallen & Kantonsspital St. Gallen.

Physiology and Pathophysiology in Ultra-Marathon Running

Abstract: In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10-20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35-45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold) or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In longer ultra-marathons, ~50-60% of the participants experience musculoskeletal problems. The most common injuries in ultra-marathoners involve the lower limb, such as the ankle and the knee. An ultra-marathon can lead to an increase in creatine-kinase to values of 100,000-200,000 U/l depending upon the fitness level of the athlete and the length of the race. Furthermore, an ultra-marathon can lead to changes in the heart as shown by changes in cardiac biomarkers, electro- and echocardiography. Ultra-marathoners often suffer from digestive problems and gastrointestinal bleeding after an ultra-marathon is not uncommon. Liver enzymes can also considerably increase during an ultra-marathon. An ultra-marathon often leads to a temporary reduction in renal function. Ultra-marathoners often suffer from upper respiratory infections after an ultra-marathon. Considering the increased number of participants in ultra-marathons, the findings of the present review would have practical applications for a large number of sports scientists and sports medicine practitioners working in this field.

Reduced level of physical activity during COVID-19 pandemic is associated with depression and anxiety levels: an internet-based survey.

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a strong negative impact on economic and social life worldwide. It has also negatively influenced people’s general health and quality of life. The aim of the present study was to study the impact of social distancing on physical activity level, and the association between mood state (depression and anxiety level) or sex with actual physical activity levels, the change in physical activity caused by social distancing period, the adhesion level to social distancing, the adoption time of social distancing, family income and age. A self-administered questionnaire with personal, quarantine, physical activity, and mood state disorders information’s was answered by 2140 Brazilians of both sex who were recruited through online advertising. The physical activity level adopted during the period of social distancing (2.9 ± 1.1) was lower than that adopted prior to the pandemic period (3.5 ± 0.8, p < 0.001). Thirty percent of the participants presented symptoms of moderate/severe depression and 23.3% displayed moderate/severe anxiety symptoms. A greater presence of symptoms related to anxiety and depression were associated with low physical activity levels, low family monthly income, and younger age. A higher percentage of men who had no mood disorders was observed among those who were very active than among those less active. The COVID-19 pandemic has a negative impact on physical activity. Those who reduced their level of physical activity had the highest levels of mood disorders. Therefore, physical activity programs should be encouraged, while respecting the necessary social distancing to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2.

Age-related changes in 100-km ultra-marathon running performance

Abstract: The aims of this study were (1) to investigate the participation and performance trends at the '100 km Lauf Biel' in Switzerland from 1998 to 2010, and (2) to compare the age-related changes in 100-km running performance between males and females. For both sexes, the percent of finishers significantly (P < 0.01) decreased for the 18-29 and the 30-39-year age groups, while it significantly (P < 0.01) increased for the 40-49 and the 50-59-year age groups over the studied period. From 1998 to 2010, the mean age of the top ten finishers increased by 0.4 years per annum for both females (P = 0.02) and males (P = 0.003). The running time for the top ten finishers remained stable for females, while it significantly (P = 0.001) increased by 2.4 min per annum for males. There was a significant (P < 0.001) age effect on running times for both sexes. The best 100-km running times was observed for the age comprised between 30 and 49 years for males, and between 30 and 54 years for females, respectively. The age-related decline in running performance was similar until 60-64 years between males and females, but was greater for females compared to males after 65 years. Future studies should investigate the lifespan from 65 to 75 years to better understand the performance difference between male and female master ultra-marathoners.

Participation and performance trends in ultra‐triathlons from 1985 to 2009

Abstract: We examined the changes in participation and performance trends in ultra-triathlons, from the Double Iron (7.6 km swimming, 360 km cycling, 84.4 km running) to the Deca Iron (38 km swimming, 1800 km cycling, 422 km running), between 1985 (first year of a Double Iron) and 2009 (25 years). The mean finish rate for all distances and races was 75.8%. Women accounted for ∼8-10% of the ultra-triathlons starters. For Double and Triple Iron, the number of finishers per year increased, from 17 to 98 and from 7 to 41, respectively. In the Deca Iron, the finishers per race have remained <20 since the first event was held, up to 2009. Concerning World best performances, the men were ∼19% faster than the women in both the Double and Triple Iron, and ∼30% faster in a Deca Iron. With the increasing length of ultra-triathlons, the best women became relatively slower compared with the best men. Further investigations are required to understand why this gender difference in total performance time increased with the distance in ultra-triathlons.

Fat oxidation in men and women endurance athletes in running and cycling.

Abstract: Recent studies showed that the maximal fat oxidation seems to be different in men and women and that it can be influenced by type and intensity of exercise. Nineteen endurance trained male (V.O (2)peak 61.3 +/- 4.4 ml x kg (-1) x min (-1)) and 17 female (V.O (2)peak 52.8 +/- 4.5 ml x kg (-1) x min (-1)) athletes were studied over 30 min at 55, 65 and 75 % V.O (2)peak on a treadmill and a cycling ergometer in order to find the intensity and kind of exercise with the highest absolute fat oxidation. For women, normalised (per body weight) fat oxidation was higher at 75 % V.O (2)peak than at 55 % V.O (2)peak for both running (p = 0.02) and cycling (p = 0.01). Women also oxidised a significantly higher percentage of fat with regard to total energy expenditure than men in running (p = 0.02) and cycling (p = 0.004). Normalised carbohydrate oxidation was significantly higher for men at each tested intensity (p < 0.05) and compared to kind of exercise in men (p = 0.006) and women (p = 0.002) in cycling than in running. Men and women showed a significantly higher normalised fat oxidation for running compared to cycling (p = 0.01). Cycling produced in men (p = 0.06) and women (p = 0.001) significantly more lactate than running. In summary, we found at 75 % V.O (2)peak a higher fat oxidation rate than at 65 % V.O (2)peak and 55 % V.O (2)peak for men and women in cycling and running. This is coincident with lactate threshold in men and women in cycling but not in running, where lactate threshold is higher than 75 % V.O (2)peak.

Using Multivariate Statistics

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Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury

Abstract: Acute kidney injury (AKI) is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research. We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI. Members representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI participated in a two day conference in Amsterdam, The Netherlands, in September 2005 and were assigned to one of three workgroups. Each group's discussions formed the basis for draft recommendations that were later refined and improved during discussion with the larger group. Dissenting opinions were also noted. The final draft recommendations were circulated to all participants and subsequently agreed upon as the consensus recommendations for this report. Participating societies endorsed the recommendations and agreed to help disseminate the results. The term AKI is proposed to represent the entire spectrum of acute renal failure. Diagnostic criteria for AKI are proposed based on acute alterations in serum creatinine or urine output. A staging system for AKI which reflects quantitative changes in serum creatinine and urine output has been developed. We describe the formation of a multidisciplinary collaborative network focused on AKI. We have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.

Reliability and validity

Abstract: Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs? Issues: Selection, maturation, history, mortality, testing, regression towrd the mean, selection by maturation, treatment by mortality, treatment by testing, measured treatment variables Increase: Eliminate the threats, above all do experimental manipulations, random assignment, and counterbalancing.

Human MotivationThe Mind in Action: A Study of Motives and Values. A. Campbell Garnett

Abstract: In his Preface the author' says that he started out to review all the more important theories upon the topics ordinarily discussed under human motivation but soon found himself more and more limited to the presentation of his own point of view. This very well characterizes the book. It is a very personal product. It is an outline with some defense of the author's own thinking about instincts and appetites and sentiments and how they function in human behavior. And as the author draws so heavily upon James and McDougall, especially the latter, the book may well be looked upon as a sort of sequel to their efforts. There is a thought-provoking distinction presented between instinct and appetite. An instinct is said to be aroused always by something in the external situation; and, correspondingly, an appetite is said to be aroused by sensations from within the body itself. This places, of course, a heavy emphasis upon the cognitive factor in all instinctive behaviors; and the author prefers to use the cognitive factor, especially the knowledge of that end-experience which will satisfy, as a means of differentiating one instinct from another. In this there is a recognized difference from McDougall who placed more emphasis for differentiation upon the emotional accompaniment. The list of instincts arrived at by this procedure is much like that of McDougall, although the author is forced by his criteria to present the possibility of food-seeking and sex and sleep operating both in the manner of an appetite and also as an instinct. The Shand-McDougall concept of sentiment is taken over and used in the explanation of moral motivation. There is the development within each personality of a sentiment for some moral principle. But this sentiment is not a very powerful motivating factor. It is reinforced by social pressures and by religion, which is treated as an effort of finite man to live in harmony with the infinite reality. Those whose psychological thinking is largely in terms of McDougall will doubtless find this volume a very satisfying expansion; but those who are at all inclined to support their psychological thinking by reference to experimental studies will not be so well pleased. The James-Lange theory, for example, is discussed without mention of the many experimental studies which it has provoked. Theoretical sources appear in general to be preferred to experimental investigations.