title: Diagnosing overtraining in athletes using the two-bout exercise protocol.
abstract: OBJECTIVE
  In this work, whether a two-bout exercise protocol can be used to make an objective, immediately available distinction between non-functional over reaching (NFO) and overtraining syndrome (OTS) was studied.
  
  
  METHODS
  Underperforming athletes who were diagnosed with the suspicion of NFO or OTS were included in the study. Recovery of the athletes was monitored by a sports physician to retrospectively distinguish NFO from OTS.
  
  
  METHODS
  Sports medicine laboratory
  
  
  METHODS
  The protocol was started and completed by 10 underperforming athletes. NFO was retrospectively diagnosed in five athletes, and OTS was diagnosed in five athletes.
  
  
  METHODS
  A two-bout maximal exercise protocol was used to measure physical performance and stressinduced hormonal reactions.
  
  
  METHODS
  Exercise duration, heart rate and blood lactate concentration were measured at the end of both exercise tests. Venous concentrations cortisol, adrenocorticotrophic hormone (ACTH), prolactin and growth hormone were measured both before and after both exercise tests.
  
  
  RESULTS
  Maximal blood lactate concentration was lower in OTS compared with NFO, while resting concentrations of cortisol, ACTH and prolactin concentrations were higher. However, sensitivity of these measures was low. The ACTH and prolactin reactions to the second exercise bout were much higher in NFO athletes compared with OTS and showed the highest sensitivity for making the distinction.
  
  
  CONCLUSIONS
  NFO might be distinguished from OTS based on ACTH and prolactin reactions to a two-bout exercise protocol. This protocol could be a useful tool for diagnosing NFO and OTS; however, more data should be collected before this test can be used as the gold standard.
authors.affiliation: Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium. rmeeusen@vub.ac.be
authors.forename: R
authors.initials: R
authors.lastname: Meeusen
authors.forename: E
authors.initials: E
authors.lastname: Nederhof
authors.forename: L
authors.initials: L
authors.lastname: Buyse
authors.forename: B
authors.initials: B
authors.lastname: Roelands
authors.forename: G
authors.initials: G
authors.lastname: de Schutter
authors.forename: M F
authors.initials: MF
authors.lastname: Piacentini
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis*; D012090:Cumulative Trauma Disorders / Q000175:diagnosis*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006728:Hormones / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D006728:Hormones; D019344:Lactic Acid