Endurance Training

Statins lower low-density lipoprotein cholesterol (LDL-C) and help prevent atherosclerotic cardiovascular disease, but some users develop statin-associated muscle symptoms (SAMS) such as soreness, stiffness, weakness, or elevated creatine kinase (CK). These symptoms may be more noticeable during exercise. Regular long-distance running improves cardiopulmonary fitness-VO₂max, aerobic threshold (AT), and respiratory compensation point (RCP)-mainly through mitochondrial and metabolic adaptations. Prior studies suggest that lipophilic statins like simvastatin may blunt these adaptations, while hydrophilic statins such as rosuvastatin may have a smaller impact. However, prospective data in habitual endurance runners are limited. This randomized controlled trial will examine how rosuvastatin affects cardiopulmonary fitness improvements and muscle tolerance in individuals who run at least three times per week and meet clinical criteria for statin therapy. After informed consent and baseline cardiopulmonary exercise testing (CPET), participants will be randomized to rosuvastatin 10 mg daily or no statin therapy for three months. Both groups will maintain their usual training routines, and training load will be recorded using heart-rate-based TRIMP. CPET will be repeated monthly to assess changes in VO₂max, AT, and RCP, and muscle enzymes and SAMS will be evaluated at each visit. The study aims to clarify whether rosuvastatin influences endurance-related physiological adaptations or increases muscle symptoms in regular long-distance runners.

Finding the optimal training, i.e. the training that enables the athlete to achieve the best performance while preserving their physical and psychological integrity, is a multi-factorial issue. Each individual's background and training capacity are very different, hence the need for personalised training. The availability of data combined with advances in Artificial Intelligence (data modelling and analysis sciences, big data, machine learning, deep learning, etc.) offer the opportunity to refine our understanding of training and adapt recommendations according to the runner's profile for a given objective (achieving a time over a distance, completing an event, etc.). The strategy that the investigators wish to evaluate as part of this trial could make it possible to recommend an optimal training load, as well as the distribution of intensities (as a percentage of the aerobic threshold, anaerobic threshold, VVO2max, etc). The two features are (i) the personalisation will be based on training history, the level of the runner, age and gender, and the runner can focus on training, and (ii) the strategy will be adaptive, i.e. the algorithm will update the training load in real time based on contextual data about the athlete (level of fatigue via heart rate variability, feedback on recent training sessions, feelings of stress).

Athletes need plyometric training as well as endurance training to enhance their speed, strength and agility in the field. Plyometric exercise involves stretching the muscle immediately before making a rapid concentric contraction. The combined action is commonly called a stretch-shortening cycle (SSC). Similar gains of maximal strength have been reported with traditional strength and plyometric training, but the latter approach appears to induce greater gains in muscle power. The combination of balance and muscle strength/power exercises seems to be an appropriate possibility, since both modalities induced adaptation on the neuromuscular level. A blocked combination of balance and muscle strength exercises effectively improve physical performance, and improvements in performance are more pronounced if balance exercises are followed by strength exercises than vice versa.