Ultramarathon Race Research Articles

The Ultramarathon of Gene Therapy Development for Rare Diseases: How Can We Cross the Finish Line Together?

The promising developments in gene and cell therapy bring an array of hope to the >7000 rare disease patient communities, of which 90% to 95% are still working toward a treatment. However, the pace of gene and cell therapy development pathways often resembles ultramarathon relay races that potentially span decades. It is a pace that is incongruent to the sprint that most individuals with rare diseases and their families are living and working in pursuit of life-saving treatments. It is also challenging for the medical professionals, academic researchers, and pharmaceutical partners working tirelessly to bring a treatment to reality. Gene and cell therapy development programs can have many parallels to an ultramarathon, including extensive training and preparation leading up to clinical trials, selecting inclusion and exclusion criteria, supporting trial participants, and creating support teams. All aspects of the development course carry the greatest hope that as many treatments as possible can cross the finish line. Drawing on this analogy, perspectives and insights from a patient family member and rare disease advocacy leader in a community that has experienced its first clinical trial of gene therapy is shared. Bringing attention to these experiences, challenges, barriers, and potential learnings from a patient family perspective will likely encourage continued improvements in development of patient-driven gene and cell drug and therapy for the rare disease community.

Emotional Intelligence in Ultra-Marathon Runners: Implications for Recovery Strategy and Stress Responses during an Ultra-Endurance Race.

The aim of this research was to investigate the role of trait emotional intelligence (EI) in recovery stress states in a mountain ultra-marathon (MUM) race. Recovery stress states of 13 finishers were assessed before, during, and immediately after the end of an extreme MUM, whereas emotional intelligence was assessed 2 days before the MUM race. Temporal evolutions of recovery stress states were examined. Stress states increased after the race whereas recovery states decreased in all participants. In addition, recovery states were influenced by the trait EI level assessed before the competition. Results supported the hypothesis that trait EI tends to have a positive effect by boosting recovery strategies. In this perspective, trait EI could have a protective role against stress and improve pre-competition mental preparation. High scores of trait EI (in comparison to low scores of trait EI) could have helped athletes to increase recovery states in order to improve their psychological adaptation to one of the most difficult races in the world.

Sex-Specific Physiological Responses to Ultramarathon.

Despite a growing body of literature on the physiological responses to ultramarathon, there is a paucity of data in females. This study assessed the female physiological response to ultramarathon and compared the frequency of perturbations to a group of race- and time-matched males. Data were collected from 53 contestants of an ultramarathon trail race at the Ultra-Trail du Mont-Blanc (UTMB®) in 2018/19. Before and within 2 h of the finish, participants underwent physiological assessments, including blood sampling for biomarkers (creatine kinase-MB isoenzyme [CK-MB], cardiac troponin I [cTnI], brain natriuretic peptide [BNP], and creatinine [Cr]), pulmonary function testing (spirometry, exhaled NO, diffusing capacities, and mouth pressures), and transthoracic ultrasound (lung comet tails, cardiac function). Data from eight female finishers (age = 36.6 ± 6.9 yr; finish time = 30:57 ± 11:36 h:min) were compared with a group of eight time-matched males (age = 40.3 ± 8.3 yr; finish time = 30:46 ± 10:32 h:min). Females exhibited significant pre- to postrace increases in BNP (25.8 ± 14.6 vs 140.9 ± 102.7 pg·mL -1 ; P = 0.007) and CK-MB (3.3 ± 2.4 vs 74.6 ± 49.6 IU·L -1 ; P = 0.005), whereas males exhibited significant pre- to postrace increases in BNP (26.6 ± 17.5 vs 96.4 ± 51.9 pg·mL -1 ; P = 0.002), CK-MB (7.2 ± 3.9 vs 108.8 ± 37.4 IU·L -1 ; P = 0.002), and Cr (1.06 ± 0.19 vs 1.23 ± 0.24 mg·dL -1 ; P = 0.028). Lung function declined in both groups, but males exhibited additional reductions in lung diffusing capacities (DL CO = 34.4 ± 5.7 vs 29.2 ± 6.9 mL⋅min -1 ⋅mm Hg -1 , P = 0.004; DL NO = 179.1 ± 26.2 vs 152.8 ± 33.4 mL⋅min -1 ⋅mm Hg -1 , P = 0.002) and pulmonary capillary blood volumes (77.4 ± 16.7 vs 57.3 ± 16.1 mL; P = 0.002). Males, but not females, exhibited evidence of mild postrace pulmonary edema. Pooled effect sizes for within-group pre- to postrace changes, for all variables, were generally larger in males versus females ( d = 0.86 vs 0.63). Ultramarathon negatively affects a range of physiological functions but generally evokes more frequent perturbations, with larger effect sizes, in males compared to females with similar race performances.

The Effects of Sex, Age and Performance Level on Pacing in Ultra-Marathon Runners in the ‘Spartathlon’

BackgroundPacing has been investigated in different kinds of ultra-marathon races, but not in one of the toughest ultra-marathons in the world, the ‘Spartathlon’.ObjectiveThe aim of the present study was to analyse the pacing of female and male finishers competing in the ‘Spartathlon’ in regards to their age and performance groups.MethodsA total of 2598 runners (2255 men and 343 women) finishing ‘Spartathlon’ between 2011 and 2019 were analysed. We selected 10 checkpoints with split times corresponding to important race sections. Average running speed was calculated for each participant and the average checkpoint running speed for each of the 10 race checkpoints. Furthermore, to assess the pacing strategy of each runner, the percentage of change in checkpoint speed (CCS) in relation to the average race speed was calculated (for each of 10 checkpoints). Finally, the average change in checkpoint speed (ACCS) was calculated for each participant as a mean of the 10 CCSs.ResultsBoth women and men slowed down through the first 7 checkpoints but increased running speed towards the end of the race (reverse J-shaped pacing). Men showed a significantly greater CCS in the first and second checkpoint (p < 0.01 and p < 0.05, respectively), whereas women showed a more significant change in CCS in the last checkpoint (p < 0.05). Furthermore, age and sex showed no effect on ACCS, whereas ACCS differed between the performance groups. In particular, the slowest and the fastest runners showed a more minor change in ACCS than the two medium groups of both men and women (p < 0.01).ConclusionsIn summary, successful finishers in ‘Spartathlon’ showed a reverse J-shaped pacing curve with a decrease in running speed from the start to the 7th checkpoint and an increase in running speed thereafter. This strategy was most probably due to the profile of the race course. Men showed a more significant change in checkpoint speed in the first two checkpoints, whereas women showed a more substantial change in the last checkpoint. Age and sex did not affect average checkpoint speed, whereas this speed was different between the different performance groups. The slowest and the fastest runners showed fewer changes in average checkpoint speed than the two medium groups in men and women.

Effect of an Ultra-Endurance Event on Cardiovascular Function and Cognitive Performance in Marathon Runners

BackgroundUltra-marathon running participation has become increasingly more popular in recent years; however, there is inconclusive evidence concerning the effects of participation on cognition and cardiovascular function. The purpose of this study was to examine alterations in cardiovascular function and cognitive performance and their association in ultra-marathon runners prior to and following an ultra-endurance event.MethodsIn total, 24 runners (19 males and 5 females) participated in an ultra-marathon race (FatDog120) held in British Columbia, Canada. Participants competed in varying races distances [48 km (n = 2), 80 km (n = 7), 113 km (n = 3), and 193 km (n = 12)]. Cognition was assessed prior to and upon race completion using simple reaction time, choice reaction time, discrimination reaction time, and recognition memory (% correct). Cardiovascular function was assessed prior to and upon race completion using radial applanation tonometry for diastolic pulse contour examination.ResultsCognitive performance displayed significantly (p < 0.001) slower reaction times post-race for simple (30.2%), discrimination (22.7%), and choice reaction time (30.5%), as well as a significant (p < 0.05) reduction in memory test performance (−8.2%). A significant association between systemic vascular resistance and choice reaction time was observed post-race (r = 0.41, p < 0.05). Significant changes in post-race cardiovascular function were observed in resting heart rate (31.5%), cardiac output (27.5%), mean arterial blood pressure (−5.6%), total systemic resistance (−17.6%), systolic blood pressure (−7.0%), pulse pressure (−11.2%), and rate pressure product (22.4%). There was evidence of enhanced cardiovascular function being associated with improved cognitive performance before and after the ultra-endurance event.ConclusionUltra endurance running is associated with marked impairments in cognitive performance that are associated (at least in part) with changes in cardiovascular function in healthy adults.

The Sex Difference in 6-h Ultra-Marathon Running-The Worldwide Trends from 1982 to 2020.

Background and Objectives: The 6-h ultra-marathon is the shortest time-limited ultra-marathon race, but little has been investigated regarding this race format. Previously, only the age of peak performance in the context of longer time-limited ultra-marathons was determined. The purpose of this study was to investigate the trends in 6-h ultra-marathon races from 1982 to 2020 for female and male ultra-runners, the participation and performance by countries, the age of peak performance, and the differences in performance regarding countries. Materials and Methods: The sample included 23,203 female ultra-runners, aged 18–83 years, and 87,264 male ultra-runners, aged 18–85 years, who were finishers in a 6-h ultra-marathon held between 1982 and 2020. The age of peak performance was tested using the Kruskal–Wallis test, followed by the Bonferroni Correction. The difference in performance by countries was verified using a linear regression model with the fastest runners from Russia in women, and Tunisia in men, used as reference. Results: Over the years, the men-to-women ratio decreased. The mean age was 43.20 ± 9.30 years for female and 46.09 ± 10.17 years for male runners. Athletes in younger age groups were faster than athletes in older age groups. Most female and male participants originated from Germany. Women from Russia (10.01 ± 1.28 km/h) and men from Tunisia (12.16 ± 1.46 km/h) were the fastest. Conclusions: In summary, in 6-h ultra-marathons held between 1982 and 2020, the participation for both women and men increased, while the men-to-women ratio decreased. The mean age was higher in men compared to women. Most female and male runners originated from Germany, but the fastest women were from Russia, and the fastest men from Tunisia. Future studies need to investigate whether Russian women and Tunisian men are also the best in other distance-limited ultra-marathon races, such as 12-h and 24-h.

The Acute Effects of an Ultramarathon on Atrial Function and Supraventricular Arrhythmias in Master Athletes.

Background. Endurance sports practice has significantly increased over the last decades, with a growing proportion of master athletes. However, concerns exist regarding the potential proarrhythmic effects induced by ultra-endurance sports. This study aimed to analyse the acute effects of an ultramarathon race on atrial remodelling and supraventricular arrhythmias in a population of master athletes. Methods. Master athletes participating in an ultramarathon (50 km, 600 m of elevation gain) with no history of heart disease were recruited. A single-lead ECG was recorded continuously from the day before to the end of the race. Echocardiography and 12-lead resting ECG were performed before and immediately at the end of the race. Results. The study sample consisted of 68 healthy non-professional master athletes. Compared with baseline, P wave voltage was higher after the race (p < 0.0001), and more athletes developed ECG criteria for right atrial enlargement (p < 0.0001). Most of the athletes (97%) had ≥1 premature atrial beats (PAB) during the 24-h monitoring, also organised in triplets (17%) and non-sustained supraventricular tachycardias (NSSVTs) (19%). In contrast, exercise-induced PABs, triplets, and NSSVTs were rare. One athlete developed acute atrial fibrillation during the race. After the race, no significant differences were found in biatrial dimensions. Biatrial function, estimated by peak atrial longitudinal and contraction strains, were normal both before and after the race. Conclusions. In master athletes running an ultramarathon, acute exercise-induced atrial dysfunction was not detected, and exercise-induced supraventricular arrhythmias were uncommon. These results did not confirm the hypothesis of an acute atrial dysfunction induced by ultra-endurance exercise.

The Effect of an Ultradistance Foot Race on Thyroid, Stress Hormone Levels and the Immune System

The aim of the present research is to investigate the effect of an ultra-marathon race on the levels of thyroid, immune and stress system hormones. Moreover, to explore a potential correlation of the above-mentioned hormones with stress hormones.

Effect of performance standard and sex on 24 h ultra-marathon pacing profiles

The purpose of the present study was to examine the effect of sex and performance standard on pacing profiles in a 24 h ultra-marathon race. Performance data of 283 participants (237 men and 46 women) from the last decade’s versions (2011 until 2020, with the exception of the 2017 version) of the International Ultramarathon Festival held in Athens-Hellinikon, Greece, were analyzed and pacing profiles were evaluated based on performance standard and sex. Relative speed for every hour and % distance covered in 6 h and 12 h segments and coefficient of variation (CV) were calculated. Mean distance ran was 159.99±36.04 km. Runners followed a reverse J-shaped race pace (p &lt; 0.001). Sex did not seem to interact with pacing (p &gt; 0.05 in every case), while performance standard interacted significantly with pacing (p &lt; 0.001). CV was negatively correlated with total distance covered and total running time (–0.761, p &lt; 0.001 and –0.753, p &lt; 0.001, respectively). In conclusion, the overall pacing profile adopted by runners in a 24 h ultra-marathon race was a reverse J-shaped model, with better runners following a more even pacing than slower runners, with lower velocity variability.

Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII

ABSTRACT Objectives To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an increased risk of race-day medical encounters (MEs). Methods Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 – history of chronic medical conditions/prescription medication use) were collected in 133641 Comrades Marathon race entrants (2014–2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI’s). Results Pre-race medical screening questions identified race entrants with a history of chronic medical conditions and/or prescription medication use (6.9%) and allergies (7.4%). The % entrants with risk factors for cardiovascular disease (CVD) was 30% and being older (>45 years) or male (27.5%) were the most frequent CVD risk factors. 0.3% of entrants reported existing CVD. The overall incidence of MEs was 20/1000 race starters. MEs were significantly higher in race entrants reporting a ‘yes’ to Q1 (allergies) (IR = 1.3; 1.1–1.5) (p = 0.014) or Q2 (chronic medical conditions and/or prescription medication use) (IR = 1.3; 1.1–1.5) (p = 0.0006). Conclusions Voluntary completion of two open-ended questions identified chronic medical conditions and/or prescription medication use in 6.9% and allergies in 7.4% of ultramarathon race entrants. This is lower than that reported for other races that implemented compulsory completion of a more comprehensive pre-screening questionnaire. Despite potential under-reporting, a pre-race self-reported history of chronic medical conditions and allergies was associated with a higher risk of race-day MEs.

Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon

The incidence of acute kidney injury (AKI) associated with ultramarathon running is varied partially because onsite measurement of serum creatinine concentration (Cr) is rarely performed at races due to logistical challenges. We conducted a prospective observational study using blood samples from volunteer athletes before and immediately after the Leadville Trail 100 Run in August 2014. The goals of our study were to determine the incidence of those meeting the AKI criteria immediately following the ultramarathon race and to evaluate the utility of using medical equations to back-calculate creatinine levels for runners without known baseline creatinine levels and to identify possible risk factors for developing AKI. We were able to collect pre-race and post-race blood samples on 64 and 84 volunteers, respectively. AKI was defined as a Cr increase (≥1.5 times or ≥0.3 mg/dl from baseline). Of the 37 runners for whom we had both pre- and post-race blood samples, 18 (49%) met the criteria for AKI. Using two different methods of back-calculating baseline estimated creatinine (a fixed eGFR [estimated glomerular filtration rate] and an aged-based eGFR), 6 (16%) and 22 (59%) of 37 runners met the criteria for AKI, respectively. We found that there is no accurate way to estimate baseline Cr in this population.

Lessons Learned from the Tragedy during the 100 km Ultramarathon Race in Baiyin, Gansu Province on 22 May 2021

Twenty-one runners died of hypothermia during the 100 km Ultramarathon Mountain race in Baiyin, Gansu Province on 22 May 2021. The hypothermia was caused by a combination of low temperatures, precipitation, and high winds associated with a typical large-scale cold front passing by the race site that morning. Based on historical hourly records of 13 meteorological surface stations over the past six years, temperature (3.0°C) and apparent temperature (−5.1°C) at 1200 LST as well as gust wind speed (11.2 m s−1) at 1100 LST on the day of the tragedy were found to be within the top or bottom 5th percentile for the month of May. The precipitation was only moderate at this time, but when temperature lower than 3.0°C, gust wind speed greater than 11.2 m s−1, and precipitation greater than 0.1 mm for any adjacent three hours were combined together, 1200 LST 22 May fell within the top 0.1% of cases. The European Centre for Medium-range Weather Forecasting model produced reasonably good forecasts of the low temperature and high wind one day and seven days before the event, respectfully. Based on this study, lessons that can be learned from this tragedy are summarized from an academic perspective: Hazard and impact forecasts of high-impact weather events should be developed to increase the value of weather forecasts. Probability forecasts should be issued by government weather agencies and communicated well to the public. And more importantly, knowledge of how to evaluate the impact of weather should be delivered to the public in the future.We would like to extend our deepest condolences to the families and loved ones of the people who lost their lives in this tragedy, including 21 runners and one officer. May our efforts honor those who lost their lives by highlighting the value of weather forecasting and calling for greater action in the future.

Ankle joint mechanical contribution in running is reduced after mountain ultramarathon races of different distances

Running mechanics have been shown to be altered by mountain ultramarathon (MUM) racing (Degache et al., 2016), resulting in a ‘smoother’ running pattern. Yet, due to the complexity of setting up la...

Circulating microRNAs after a 24-h ultramarathon run in relation to muscle damage markers in elite athletes.

Ultra-endurance sports are growing in popularity but can be associated with adverse health effects, such as exercise-induced muscle damage (EIMD), which can lead to exertional rhabdomyolysis. Circulating microRNAs (miRNAs) may be useful to approach the degree of EIMD. We aimed to (1) investigate the relevance of circulating miRNAs as biomarkers of muscle damage and (2) examine the acute response of skeletal/cardiac muscle and kidney biomarkers to a 24-h run in elite athletes. Eleven elite athletes participated in the 24-h run World Championships. Counter-movement jump (CMJ), creatine kinase (CK), myoglobin (Mb), creatinine (Cr), high-sensitive cardiac troponin T (hs-cTnT), and muscle-specific miRNA (myomiR) levels were measured before, immediately after, and 24 and 48h after the race. CMJ height was reduced immediately after the race (-84.0±25.2%, p<0.001) and remained low at 24h (-43.6±20.4%, p=0.002). We observed high CK activity (53239±63608 U/L, p<0.001) immediately after the race, and it remained elevated 24h after (p<0.01). Circulating myomiR levels (miR-1-3p, miR-133a-3p, miR-133b, miR-208a-3p, miR-208b-3p, and miR-499a-5p) were elevated immediately after the 24-h run (fold changes: 18-124,723, p<0.001) and significantly (p<0.05) correlated or tended to significantly (p<0.07) correlate with the reduction in CMJ height at 24h. We found no significant correlation between CMJ height loss at 24h and CK (p=0.23) or Mb (p=0.41) values. All elite ultramarathon runners included in our study were diagnosed with exertional rhabdomyolysis after the 24-h ultramarathon race. MyomiR levels may be useful to approach the degree of muscle damage.

Impact of a 246 Km ultra-marathon running race on heart: Insights from advanced deformation analysis

ABSTRACT Although previous studies suggest that prolonged intense exercise such as marathon running transitorily alters cardiac function, there is little information regarding ultramarathon races. Aim of this study was to investigate the acute impact of ultra-endurance exercise (UEE) on heart, applying advanced strain imaging. Echocardiographic assessment was performed the day before and at the finish line of “Spartathlon”: A 246 Km ultra-marathon running race. 2D speckle-tracking echocardiography was performed in all four chambers, evaluating longitudinal strain (LS) for both ventricles and atria. Peak strain values and temporal parameters adjusted for heart rate were extracted from the derived curves. Out of 60 participants initially screened, 27 athletes (19 male, age 45 ± 7 years) finished the race in 33:34:27(28:50:38-35:07:07) hours. Absolute values of right (RV) and left ventricular (LV) LS (RVLS −22.9 ± 3.6 pre- to −21.2 ± 3.0% post-, p=0.04 and LVLS −20.9 ± 2.3 pre- to −18.8 ± 2.0 post-, p=0.009) slightly decreased post-race, whereas atrial strain did not change. RV and LV LS decrease was caused mainly by strain impairment of basal regions with apical preservation. Inter-chamber relationships assessed through RV/LV, LV/LA, RV/RA and RA/LA peak values' ratios remained unchanged from pre to post-race. Finally, UEE caused an extension of the systolic phase of cardiac cycle with concomitant diastole reduction (p<0.001 for all strain curves). Conclusively, ventricular LS strain as well as effective diastolic period slightly decreased, whereas atrial strain and inter-chamber relationships remained unchanged after running a 246-km-ultra-marathon race. These changes may be attributed to concomitant pre- and afterload alterations following UEE.

Contribution of Solid Food to Achieve Individual Nutritional Requirement during a Continuous 438 km Mountain Ultramarathon in Female Athlete.

Background: Races and competitions over 100 miles have recently increased. Limited information exists about the effect of multiday continuous endurance exercise on blood glucose control and appropriate intake of food and drink in a female athlete. The present study aimed to examine the variation of blood glucose control and its relationship with nutritional intake and running performance in a professional female athlete during a 155.7 h ultramarathon race with little sleep. Methods: We divided the mountain course of 438 km into 33 segments by timing gates and continuously monitored the participant’s glucose profile throughout the ultramarathon. The running speed in each segment was standardized to the scheduled required time-based on three trial runs. Concurrently, the accompanying runners recorded the participant’s food and drink intake. Nutrient, energy, and water intake were then calculated. Results: Throughout the ultramarathon of 155.7 h, including 16.0 h of rest and sleep, diurnal variation had almost disappeared with the overall increase in blood glucose levels (25–30 mg/dL) compared with that during resting (p < 0.0001). Plasma total protein and triglyceride levels were decreased after the ultramarathon. The intake of protein and fat directly or indirectly contributed to maintaining blood glucose levels and running speed as substrates for gluconeogenesis or as alternative sources of energy when the carbohydrate intake was at a lower recommended limit. The higher amounts of nutrient intakes from solid foods correlated with a higher running pace compared with those from liquids and gels to supply carbohydrates, protein, and fat. Conclusion: Carbohydrate, protein, and fat intake from solid foods contributed to maintaining a fast pace with a steady, mild rise in blood glucose levels compared with liquids and gels when female runner completed a multiday continuous ultramarathon with little sleep.

The acute effects of an ultramarathon on biventricular function and ventricular arrhythmias in master athletes

Abstract Funding Acknowledgements Type of funding sources: None. Background. Endurance sports practice has significantly increased over the last decades, with a growing proportion of participants older than 40 years. Although the benefits of moderate regular exercise are well known, concerns exist regarding the potential negative effects induced by extreme endurance sport. The aim of this study was to analyze the acute effects of an ultramarathon race on the ECG, biventricular function and ventricular arrhythmias in a population of master athletes. Methods. Master athletes participating in an ultramarathon (50 km, 600 meters of elevation gain) with no history of heart disease were recruited. A single-lead ECG was recorded continuously from the day before to the end of the race. Echocardiography and 12-lead resting ECG were performed before and at the end of the race. Results. The study sample consisted of 68 healthy non-professional master athletes. Compared with baseline, R-wave amplitude in V1 and QTc duration were higher after the race (p &amp;lt; 0.001). Exercise-induced isolated premature ventricular beats were observed in 7% of athletes; none showed non-sustained ventricular tachycardia before or during the race. Left ventricular ejection fraction, global longitudinal strain (GLS) and twisting did not significantly differ before and after the race. After the race, no significant differences were found in right ventricular inflow and outflow tract dimensions, fractional area change, s’ and GLS. Conclusions. In master endurance athletes running an ultra-marathon, exercise-induced ventricular dysfunction or relevant ventricular arrhythmias were not detected. These results did not confirm the hypothesis of a detrimental acute effect of strenuous exercise on the heart. Abstract Figure.

Arterial Function after a 246 km Ultra-marathon Running Race.

There is little research about the effects of ultra-endurance exercise on arterial morphological and functional properties. The aim was to assess the acute changes of the carotid-femoral pulse wave velocity and carotid doppler-derived parameters following an ultra-marathon race as well as the intima-media thickness of the carotid artery in ultra-marathon runners. Twenty athletes were examined at baseline and within 10 mins after a 246 km running race. Measurements included carotid-femoral pulse wave velocity, peak-systolic and end-diastolic velocities of carotid artery blood flow, pulsatility and resistivity indices and blood biochemical parameters. The intima-media thickness of the right and left carotid artery was measured before the race. Arterial stiffness and carotid artery intima media thickness at rest remained within known normal limits. The ultra-marathon race significantly increased carotid-femoral pulse wave velocity by 22.6% and pulsatility index by 10.2%. There was a decrease in body weight by 3.35% and an increase of all biochemical markers of muscle damage after the race. Additionally, C-reactive protein was correlated with both pulsatility and resistivity indices post-race. This study shows that immediately after a 246 km ultra-marathon running race, acute increase of arterial stiffness and vascular resistance were evident. The carotid artery thickness of ultra-marathon runners was within normal range.

Risk factors for not finishing an ultramarathon: 4-year study in 23,996 race starters, SAFER XXI.

Limited data support prerace medical screening to identify risk factors for not finishing an endurance running race. The aim of the study was to determine risk factors associated with not finishing an ultramarathon. A prospective, cross-sectional study of Two Oceans ultramarathon (56 km) race starters who completed a prerace medical screening questionnaire. Race day environmental conditions were recorded on race day. Univariate analyses of risk factors associated with the did-not-finish (DNF) included race day factors and prerace medical screening history. Risk factors for DNF amongst 23,996 starters during the 56 km race included older age and females (P<0.0001). After adjusting for age and sex, the following were significant univariate risk factors: fewer years of running (P<0.0001), less previous race experience (P<0.0001), less training/racing per week (P=0.0002), lower average weekly training distance (P=0.0016), slower race vs. training speed (P<0.0001), lack of allergies (P=0.0100) and average wet-bulb globe temperature (P<0.0001). Females, older age, training-related factors (less training/racing, average weekly training distance, race vs. training speed) and average wet-bulb temperature, were risk factors for not finishing an ultramarathon. The results may not only assist runners and coaches in race preparation, but also have clinical implications for the medical planning prior to races.

Influence of Psychological Factors on the Success of the Ultra-Trail Runner

The aim of this study was to analyze the psychological variables of runners of ultra-trail mountain races and their association with athletic performance and success. The sample was made up of 356 mountain runners, 86.7% men and 13.2% women, with a mean age of 42.7 years and 5.7 years of experience. Using pre- and post-race questionnaires, data were collected regarding mental toughness, resilience, and passion. The performance of each runner in the race was also recorded. The results showed very high values in the psychological variables analyzed compared with other sports disciplines. Completion of the race (not withdrawing) and the elite quality of the runners were presented as the most relevant indicators in the processes of resilience, mental toughness, and obsessive passion. Differences were noted between the pre- and post-race results, suggesting that the competition itself is a means of training those psychological factors that are essential to this sports discipline. It can be concluded that psychological factors are decisive to athletic performance and race completion in mountain ultra-marathon races.