{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:43:29Z","timestamp":1788389009111,"version":"build-2803163510"},"reference-count":47,"publisher":"Georg Thieme Verlag KG","issue":"12","funder":[{"DOI":"10.13039\/501100003756","name":"Biomedicum\n                        Helsinki-s\u00e4\u00e4ti\u00f6","doi-asserted-by":"crossref","award":["20220044"],"award-info":[{"award-number":["20220044"]}],"id":[{"id":"10.13039\/501100003756","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Sports Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Overtraining syndrome (OTS) is characterised by persistent fatigue and\n                    performance decline, but it currently lacks specific diagnostic criteria and\n                    medical coding. Diagnosis is primarily based on a decline in maximal performance\n                    and a subjective feeling of \u2018staleness', after ruling out other medical\n                    conditions. This study aimed to identify physiological and self-reported\n                    predictors of OTS by comparing individuals diagnosed with OTS (n=110;\n                    2008\u20132022) with a healthy control group (n=447; 2005\u20132023). Both groups\n                    consisted of athletes and recreational exercisers assessed at the Helsinki\n                    Sports and Exercise Medicine Clinic (HULA). Data were collected through\n                    questionnaires and spiroergometric testing and subsequently analysed using\n                    logistic regression, adjusting for age and sex. The results of this study\n                    suggest that fatigue, dizziness and shortness of breath, along with decreased\n                    maximum oxygen uptake (V\u0307O2max), peak blood lactate value\n                        (Lamax) and oxygen uptake at both ventilatory thresholds\n                        (V\u0307O2VT1 and V\u0307O2VT2), are significant predictors of\n                    OTS (p&lt;0.05\/54). Among reported health conditions, asthma, allergy,\n                    anaemia and mental health issues were statistically significant predictors of\n                    OTS at the 0.05 level, but not after Bonferroni correction. In conclusion,\n                    regular spiroergometric testing and symptom monitoring may support earlier\n                    diagnosis and improved management of OTS in athletes and recreational\n                    exercisers.<\/jats:p>","DOI":"10.1055\/a-2611-3598","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T12:35:36Z","timestamp":1752064536000},"page":"898-907","source":"Crossref","is-referenced-by-count":7,"title":["A Comprehensive Analysis of Overtraining Syndrome in Athletes and\n                    Recreational Exercisers"],"prefix":"10.1055","volume":"46","author":[{"given":"Rauha Lucia","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, University of Helsinki\n                    Faculty of Medicine, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadwiga","family":"Buchwald","sequence":"additional","affiliation":[{"name":"Helsinki Institute of Life Science (HiLIFE), Institute\n                    for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki,\n                    Finland"},{"name":"Department of Public Health, Biostatistics Unit,\n                    University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, University of Helsinki\n                    Faculty of Medicine, Helsinki, Finland"},{"name":"Helsinki Sports and Exercise Medicine Clinic, Foundation for Sports and\n                    Exercise Medicine (HULA), Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha E.","family":"Peltonen","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, University of Helsinki\n                    Faculty of Medicine, Helsinki, Finland"},{"name":"Clinical Physiology and Nuclear Medicine, Diagnostic\n                    Center, Helsinki University Central Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arja L.T.","family":"Uusitalo","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, University of Helsinki\n                    Faculty of Medicine, Helsinki, Finland"},{"name":"Helsinki Sports and Exercise Medicine Clinic, Foundation for Sports and\n                    Exercise Medicine (HULA), Helsinki, Finland"},{"name":"Clinical Physiology and Nuclear Medicine, Helsinki\n                    University Central Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1249\/MSS.0b013e318279a10a","article-title":"Prevention, diagnosis, and treatment of the overtraining syndrome: Joint\n                    consensus statement of the European College of Sport Science and the American\n                    College of Sports Medicine","volume":"45","author":"R Meeusen","year":"2013","journal-title":"Med Sci Sports Exer"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1249\/MSS.0b013e318207f87b","article-title":"Prevalence of nonfunctional overreaching\/overtraining in young English\n                    athletes","volume":"43","author":"N F Matos","year":"2011","journal-title":"Med Sci Sports Exer"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"967","DOI":"10.2165\/00007256-200434140-00003","article-title":"Does overtraining exist? 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Med"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1249\/JSR.0000000000000027","article-title":"Overtraining syndrome in the athlete: Current clinical practice","volume":"13","author":"D G Carfagno","year":"2014","journal-title":"Curr Sports Med Rep"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00005768-200001000-00012","article-title":"Limiting factors for maximum oxygen uptake and determinants of endurance\n                    performance","volume":"32","author":"D R Bassett","year":"2000","journal-title":"Med Sci Sports Exercise"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1152\/ajpcell.00143.2022","article-title":"Physiological basis of brief, intense interval training to enhance maximal\n                    oxygen uptake: a mini-review","volume":"323","author":"M J Gibala","year":"2022","journal-title":"Am J Physiol Cell Physiol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s40279-020-01322-8","article-title":"An examination and critique of current methods to determine exercise\n                    intensity","volume":"50","author":"N A Jamnick","year":"2020","journal-title":"Sports Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1249\/mss.0b013e318060f17d","article-title":"Autonomic recovery after exercise in trained athletes: Intensity and duration\n                    effects","volume":"39","author":"S Seiler","year":"2007","journal-title":"Med Sci Sports Exercise"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1111\/sms.14007","article-title":"The importance of ventilatory thresholds to define aerobic exercise intensity in\n                    cardiac patients and healthy subjects","volume":"31","author":"F Anselmi","year":"2021","journal-title":"Scand J Med Sci Sports"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1097\/00005768-199809000-00001","article-title":"The case history of an elite ultra-endurance cyclist who developed chronic\n                    fatigue syndrome","volume":"30","author":"D G Rowbottom","year":"1998","journal-title":"Med Sci Sports Exercise"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1097\/00005768-200008000-00017","article-title":"Short-term overtraining: Effects on performance, circulatory responses, and\n                    heart rate variability","volume":"32","author":"R Hedelin","year":"2000","journal-title":"Med Sci Sports Exercise"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1186\/s12872-024-04081-w","article-title":"Cardiopulmonary exercise testing in long covid shows the presence of\n                    dysautonomia or chronotropic incompetence independent of subjective exercise\n                    intolerance and 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