The enriched study design provides a method of determining the efficacy and safety of nabiximols in a way that more closely reflects proposed clinical practice, by limiting exposure to those patients who are likely to benefit from it. Hence, the difference between active and placebo should be a reflection of efficacy and safety in the population intended for treatment.

The influence of extremely low temperatures on the human body and physiological reactions are not fully recognized. It has been postulated that cryostimulation could modify immunological reactions, leukocytes mobilization and levels of cytokines. The aim of this research was to estimate the influence of a ten sessions 3-min-long exposures to cryogenic temperature (-130 degrees C) on the white blood cell (WBC) count, level of IL6 and the total oxidative and antioxidative status in 15 young, clinically healthy men. Blood samples were obtained in the morning before cryostimulation, again 30 min after treatment and the next day in the morning, both during the first and tenth session. The WBC count, level of IL6 and total lipid peroxides as the total oxidative status and the total antioxidative status (TAS), were measured. After completing a total of ten whole-body therapy sessions a significant increase in WBC count, especially lymphocytes and monocytes was noted. There was an increase in level of IL6 after first and the last cryostimulation the most pronounced after tenth session. On the contrary the TAS level decreased significant after the treatment. It was concluded that repeated expositions to extremely low temperatures use in cryostimulation have mobilization effect on immunological system.

Track cyclists are required to perform short- and long-term efforts during sprint and endurance race events, respectively. The 200 m flying sprint races require maximal power output and anaerobic capacity, while the 4,000 m pursuit cyclists demand a high level of aerobic capacity. Our goal was to investigate spatial changes in morphological and mechanical properties displayed using 3D topographical maps of the quadriceps muscle and tendons after 200 m flying start and 4,000 m individual pursuit race in elite track cyclists. We hypothesized a non-uniform distribution of the changes in the quadriceps muscle stiffness (QMstiff), and acute alterations in quadriceps tendon (QTthick) and patellar tendon (PTthick) thickness. Fifteen men elite sprint and 15 elite men endurance track cyclists participated. Sprint track cyclists participated in a 200 m flying start, while endurance track cyclists in 4,000 m individual pursuit. Outcomes including QTthick (5–10–15 mm proximal to the upper edge of the patella), PTthick (5–10–15–20 mm inferior to the apex of the patella)—using ultrasonography evaluation, QMstiff, and quadriceps tendon stiffness (QTstiff) were measured according to anatomically defined locations (point 1–8) and patellar tendon stiffness (PTstiff)—using myotonometry, measured in a midway point between the patella distal and the tuberosity of tibial. All parameters were assessed before and after (up to 5 min) the 200 m or 4,000 m events. Sprint track cyclists had significantly larger QTthick and PTthick than endurance track cyclists. Post-hoc analysis showed significant spatial differences in QMstiff between rectus femoris, vastus lateralis, and vastus medialis in sprint track cyclists. At before race, sprint track cyclists presented significantly higher mean QTthick and PTthick, and higher QMstiff and the QTstiff, as compared with the endurance track cyclists. The observed changes in PTThick and QTThick were mostly related to adaptation-based vascularity and hypertrophy processes. The current study suggests that assessments using both ultrasonography and myotonometry provides crucial information about tendons and muscles properties and their acute adaptation to exercise. Higher stiffness in sprint compared with endurance track cyclists at baseline seems to highlight alterations in mechanical properties of the tendon and muscle that could lead to overuse injuries.

Background: Kickboxing is a combat sport where athletes require constant supervision of a coach. The outbreak of the pandemic caused by SARS-CoV-2 has led to a crisis in many sectors, including sport. Global efforts to limit the spread of the pathogen resulted in temporary lockdowns that limited sporting activity, thus deteriorating athletes’ physical fitness. Methods: The participants included 20 kickboxers competing at the international level. Their physical fitness was evaluated based on the test developed by the International Committee on the Standardization of Physical Fitness Test (ICSPFT) and their body build was assessed using Tanita BC601 body composition monitor and a body height meter. Differences between physical fitness before the COVID-19 outbreak and during the pandemic after re-opening sports facilities were evaluated. Results: Temporary closing of sports clubs has led to the increase in body mass of the participants by 2.65 kg on average and significantly deteriorated physical fitness. Conclusions: Temporary closing of sports clubs and restrictions on physical activity aimed at containing the spread of COVID-19 caused a significant reduction in physical fitness and increased body mass of the participants. This is likely to cause worse performance in the nearest competitions and have a negative impact on the athletes’ health status and immunity to diseases.

The influence of extremely low temperatures on the human body and physiological reactions is not fully understood. The aim of this research was to estimate the influence of a single exposure to cryogenic temperature (-130 degrees C), without subsequent kinesiotherapy, on the activity of the most crucial antioxidant enzymes in erythrocytes: superoxide dismutase (SOD), catalase (CAT), glutathione reductase (R-GSSG), glutathione peroxidase (GPx) and glutathione transferase (T-GSH). In the plasma, the concentrations of glutathione, uric acid, albumins and extra-erythrocyte haemoglobin as components of the non-enzymatic antioxidant system were evaluated. The subjects were 10 healthy young men. Blood was sampled in the morning on the day of cryostimulation, 30 min after cryostimulation and the next morning. The enzymatic response of the antioxidant defence to the influence of the extremely low temperature resulted in an immediate, significant, increase in GPx and R-GSSG activities, but a decrease in CAT and T-GSH activities. We observed an increase in the concentrations of all the examined non-enzymatic antioxidants, especially extra-erythrocyte haemoglobin and uric acid, which had both increased further the day after cryostimulation. The results indicate that a single stimulation with cryogenic temperatures results in oxidative stress in a healthy body, but that the level of stress is not very high. It seems that in this case the most significant role in the antioxidant mechanisms is played by peroxidase.