The Transeurope Footrace Project: longitudinal data acquisition in a cluster randomized mobile MRI observational cohort study on 44 endurance runners at a 64-stage 4,486km transcontinental ultramarathon

Abstract

BackgroundThe TransEurope FootRace 2009 (TEFR09) was one of the longest transcontinental ultramarathons with an extreme endurance physical load of running nearly 4,500 km in 64 days. The aim of this study was to assess the wide spectrum of adaptive responses in humans regarding the different tissues, organs and functional systems being exposed to such chronic physical endurance load with limited time for regeneration and resulting negative energy balance. A detailed description of the TEFR project and its implemented measuring methods in relation to the hypotheses are presented.MethodsThe most important research tool was a 1.5 Tesla magnetic resonance imaging (MRI) scanner mounted on a mobile unit following the ultra runners from stage to stage each day. Forty-four study volunteers (67% of the participants) were cluster randomized into two groups for MRI measurements (22 subjects each) according to the project protocol with its different research modules: musculoskeletal system, brain and pain perception, cardiovascular system, body composition, and oxidative stress and inflammation. Complementary to the diverse daily mobile MR-measurements on different topics (muscle and joint MRI, T2*-mapping of cartilage, MR-spectroscopy of muscles, functional MRI of the brain, cardiac and vascular cine MRI, whole body MRI) other methods were also used: ice-water pain test, psychometric questionnaires, bioelectrical impedance analysis (BIA), skinfold thickness and limb circumference measurements, daily urine samples, periodic blood samples and electrocardiograms (ECG).ResultsThirty volunteers (68%) reached the finish line at North Cape. The mean total race speed was 8.35 km/hour. Finishers invested 552 hours in total. The completion rate for planned MRI investigations was more than 95%: 741 MR-examinations with 2,637 MRI sequences (more than 200,000 picture data), 5,720 urine samples, 244 blood samples, 205 ECG, 1,018 BIA, 539 anthropological measurements and 150 psychological questionnaires.ConclusionsThis study demonstrates the feasibility of conducting a trial based centrally on mobile MR-measurements which were performed during ten weeks while crossing an entire continent. This article is the reference for contemporary result reports on the different scientific topics of the TEFR project, which may reveal additional new knowledge on the physiological and pathological processes of the functional systems on the organ, cellular and sub-cellular level at the limits of stress and strain of the human body.Please see related articles: http://www.biomedcentral.com/1741-7015/10/76 and http://www.biomedcentral.com/1741-7015/10/77

Substantial and reversible brain gray matter reduction but no acute brain lesions in ultramarathon runners: experience from the TransEurope-FootRace Project

“…What really distinguishes participants of TEFR09 from leisure athletes normally participating in marathon events is the amount of training they undertake: the TEFR09 participants had run a mean of 5,523 km (SD 1,874 km, range 2,500 km to 11,440 km) in the last year with a training volume of 106.3 km per week (SD 35.3 km/week, range 50 km to 200 km/week) [2]. This reflects a much more extensive training and pre-race running experience compared to participants of normal (half-) marathon distances (for example, average weekly workload of 14 km of a cohort in a previous study on (half-)marathon runners [55]).…”

“…Two scanners were located at our university. The third was a mobile MRI unit mounted on a truck escorting the runners [2]. The sequence parameters are given in Table 2, resulting in an isotropic resolution of 1 × 1 × 1 mm for the volumetric data.…”

“…It was the second European transcontinental multistage ultramarathon race and covered the distance from the south of Italy (Bari) to the North Cape [1,2]. A group of 67 endurance athletes with a mean age of 50.7 years ranging from 26 to 74 and encompassing 11 women and 56 men from 12 nations met the challenge.…”

Use of Cardiac Magnetic Resonance and Echocardiography in Population-Based Studies

“…IGT and LV mass Strong Heart 34 (n=1343) IGT was associated with increased LV mass in men (P=0.05) and women (P=0.002) and increased posterior wall thickness in men (P=0.002) and women (P=0.001) MESA 35 (n=588) IGT was associated with increased LV mass in women (P=0.001) and increased posterior wall thickness in men and women (both P=0.001) Systolic BP and LV mass Cardia study 36 (n=5115) r=0.37-0.65 depending on race and sex MESA study 37 have a high accuracy for cardiac chamber measurements, 7,8 based on excellent spatial and contrast resolution that allows reproducible delineation of endo-and epicardial borders and the free, but standardized choice of imaging planes not limited by ultrasound windows. In contrast, the original echocardiographic technique (M mode) used in the Framingham Heart study had high temporal resolution 48 but limited reproducibility.…”

“…On a worldwide basis, much population research is currently being performed in the process of epidemiological transition, as developing countries develop disease burdens in degenerative and man-made diseases, rather than infectious disease, malnutrition, and more simple chronic disease, such as hypertension. 6 Although mobile MR scanners have been used for on-site imaging in Europe, 7 most of these environments in the developing world are unsuitable for CMR, both regarding the availability of the scanners and the infrastructure to support them.…”