Table 7 Training or race-related illness and injury
Study | Participants | Measures | Design | Evidence quality | Major findings | |||
|---|---|---|---|---|---|---|---|---|
Hoffman & Krishnan [52] | 1,212 active ultramarathon athletes (32% female, 68% male). Median age 42.3 years (range 18–81 years) | 12-month incidence of exercise-related injury and stress fractures | Cohort study | Low | No sex differences in rate of exercise-related injuries over 12-month period. Stress fractures were more common among females, compared with males (p < 0.001) | |||
Khodaee et al (Abstract only) [57] | 308 athletes who completed a 100 mile ultramarathon. Sex split not reported | Race-related injuries requiring medical attention post-race | Cross-sectional | Low | No sex differences in incidence of race-related injuries requiring medical attention | |||
Krabak et al.[53] | 396 athletes (20.8% females, 79.2% males) who completed a 250Â km 7-day trail ultramarathon | Rate of medical illness and injury | Cohort study | Low | Females were 16% more likely to encounter medical illness when adjusted for age and race hours No difference in overall injury/illness rates, skin problems, or MSK injuries | |||
Lipman et al.[54] | 128 athletes (28% females and 72% males) who competed in a 250 km multi-stage ultramarathon | Changes in serum creatinine, cumulative incidence and prevalence of AKI | Cohort study | Low | Overall cumulative incidence of AKI was 41.4%. Odds ratio for females and AKI was 4.64 (95% CI 2.07–10.37, p < 0.001) | |||
Hoffman et al.[58] | 201 athletes who completed a 161Â km ultramarathon. Sex split not reported | Plasma sodium, incidence of EAH | Cohort study | Low | Overall EAH incidence was 6%. No sex differences in incidence of EAH | |||
Rust et al.[59] | 46 athletes (19 females and 27 males) who completed a 100 km ultramarathon | Body mass, plasma and urinary electrolytes, Hct, plasma volume, fluid, energy, and electrolyte intake | Cohort study | Low | 5% (n = 1) of females and 11% of males (n = 3) developed EAH. Significant decrease in Hct in females (-1.2%, p > 0.05) but not in males (-1.1%, p < 0.05). No sex differences in electrolyte changes | |||
Hoffman et al.[62] | 47 athletes (Sex split not reported) who completed a 161 km ultramarathon | Serum sodium | Cohort study | Low | Overall EAH incidence was 30% Females made up 28.6% of hyponatraemic group and 18.2% of normonatraemic group (significant > 0.05) | |||
Chlibkova et al.[60] | 113 athletes (25 females and 88 males) who completed an ultramarathon | Serum sodium | Cohort study | Low | No sex differences in the incidence of hyponatraemia | |||
Costa et al.[61] | 74 athletes (28 females and 46 males) who completed a 225 km multi-stage ultramarathon Mean age 41 years | Fluid and sodium intake, serum sodium and osmolality, plasma volume, urine osmolality | Cohort study | Low | Females had a higher water intake (daily and during running) when corrected for body mass (p < 0.001). No significant sex differences in sodium intake, serum sodium, plasma volume, serum osmolality | |||
Khodaee et al.[63] | 84 athletes (15 females and 69 males) who competed in a 100 mile high altitude ultramarathon in Colorado | Serum sodium, post-race survey | Cohort study | Low | 15.9% of males had EAH, compared with 40% of females (p = 0.66) | |||
Schwellnus et al.[56] | 49 athletes who completed a 56Â km ultramarathon | Incidence of EAMC | Cohort study | Low | No sex differences of EAMC incidence during, or within 6Â h of an ultramarathon | |||
Bouscaren et al.[55] | 3126 athletes (525 females and 2601 males) who competed in a trail ultramarathon on Reunion Island. Mean age 42.2 years | Pre- and post-race survey | Cohort study | Low | History of HRI: 79.9% of males vs 70.2% of females (p < 0.001) History of muscle cramps: 40.9% of males vs 22.5% of females (p < 0.001). No significant sex differences in history of digestive issues, headaches, or collapse Experienced heat-related symptoms during race: 56.5% of males vs 46.8% of females (p = 0.002) | |||