One of the difficulties in diagnosing OTS is that this should be based on “exclusion criteria”.1 18 Although, in recent years, the knowledge of central pathomechanisms of the OTS has significantly increased, there is still a strong demand for relevant tools for the early diagnosis of OTS. By calculating sensitivity for detection of NFO and OTS, a good indication of the value of the different measures for the diagnosis of unexplainable underperformance is obtained (table 2).

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Chronic stress and the subsequent chronic peripheral glucocorticoid secretion plays an important role in the desensitisation of higher brain centre response during acute stressors because it has been shown that in acute (and also chronic) immobilisation, the responsiveness of hypothalamic corticotrophin-releasing hormone (CRH) neurons rapidly falls.26 These adaptation mechanisms could be the consequence of changes in neurotransmitter release, depletion of CRH and/or desensitisation of hypothalamic hormonal release to afferent neurotransmitter input.26 Indeed, concentrations of CRH are elevated, the number of CRH-secreting neurons in the limbic brain regions is increased and the number of CRH binding sites in the frontal cortex is reduced secondary to increased CRH concentrations following chronic stress.25
Dietary nitrate supplementation increases circulating nitrite concentration, and the subsequent reduction of nitrite to nitric oxide is promoted in hypoxic environments. Given that PO2 is lower in Type II compared with Type I muscle, this article examines the hypothesis that the ergogenicity of nitrate supplementation is linked to specific effects on vascular, metabolic, and contractile function in Type II muscle.
Alert: Companies strictly follow their exercise rules and deadlines, and courts tend to side with them. See, for example, Deal v. Consumer Programs, Inc. (2006), decided by the 8th Circuit Court of Appeals. The court ruled that the mere submission of a written notice to exercise stock options may be insufficient when the grant agreement states that the notice must be "accompanied by full payment of the purchase price of the shares."
Exclusion criteria included major diseases or conditions such as severe heart disease, uncontrolled hypertension, obesity, osteoarticular pathology, and neurological disease. Criteria were evaluated on the basis of clinical history, resting ECG, and physical examination. Participants maintained their lifestyles and were instructed not to take part in any other physical programs throughout the study. At the time of the initial design, the study consisted of a 12-week randomized controlled trial with a frequency of 3 times a week, 36 sessions in all, ending with a new assessment of their wellness and the potential persistence of the results on functional/physical capacities.