Abstract
This study investigated the effect of open-placebo on cycling time-trial (TT) performance. Twenty-eight trained female cyclists completed a 1-km cycling TT following a control session or an open-placebo intervention. The intervention consisted of an individual presentation, provided by a medic, in which the concept of open-placebo was explained to the participant, before she ingested two red and white capsules containing flour; 15 min later, they performed the TT. In the control session, the participant sat quietly for 20 min. Heart rate and ratings of perceived exertion (RPE) were monitored throughout exercise, while blood lactate was determined pre- and post-exercise. Post-exercise questionnaires were employed to gain insight into the perceived influence of the supplement on performance. Open-placebo improved time-to-completion (P = 0.039, 103.6±5.0 vs. 104.4±5.1 s, -0.7±1.8 s, -0.7±1.7%) and mean power output (P = 0.01, 244.8±34.7 vs. 239.7±33.2, +5.1±9.5 W) during the TT. Individual data analysis showed that 11 individuals improved, 13 remained unchanged and 4 worsened their performance with open-placebo. Heart rate, RPE and blood lactate were not different between sessions (all P>0.05). Positive expectation did not appear necessary to induce performance improvements, suggesting unconscious processes occurred, although a lack of an improvement appeared to be associated with a lack of belief. Open-placebo improved 1-km cycling TT performance in trained female cyclists. Although the intervention was successful for some individuals, individual variation was high, and some athletes did not respond or even performed worse. Thus, open-placebo interventions should be carefully considered by coaches and practitioners, while further studies are warranted.
Highlights
A beneficial effect arising from the belief that one has received a positive intervention is known as the placebo effect [1]
Clinical studies investigating the effect of open-placebo, where participants are deliberately informed that they would receive placebo pills, have shown significant improvements in symptoms for patients with irritable bowel syndrome [7], chronic low back pain, [8], allergic rhinitis [9, 10], depression [11] and cancer-related fatigue [12]
Of the 13 individuals who showed no change in performance, there were similar reports of an inability to notice any differences (#11, #29, #15, #18) and a lack of expectancy regarding the supplement (#20, #4, #12, #22) there were a few reports of positive expectation (#13, #23) and mental imaging (#25). This is the first study to show that exercise performance can be improved on average when athletes are openly administered a placebo supplement compared to a control session, providing evidence that the use of a placebo in a non-deceptive way can be ergogenic
Summary
A beneficial effect arising from the belief that one has received a positive intervention is known as the placebo effect [1]. The placebo effect is a powerful tool that can be used to modify subjective feelings, such as fatigue and disease symptoms, as well as objective measures of tolerance to pain [2, 3]. These responses can be variable, and are determined by environmental, psychological and neurobiological factors including verbal cues, expectancy, desire, positivity, beliefs and conditioning [4, 5]. No study has investigated the effect of open-placebo on exercise performance
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