A new method to individualize monitoring of muscle recovery in athletes

Purpose: Assessment of muscle recovery is essential for the daily fine-tuning of training load in competitive sports, but individual differences may limit the diagnostic accuracy of group-based reference ranges. This article reports an attempt to develop individualized reference ranges using a Bayesian approach comparable to that developed for the Athlete Biological Passport. Methods: Urea and creatine kinase (CK) were selected as indicators of muscle recovery. For each parameter, prior distributions and repeated-measures SDs were characterized based on data of 883 squad athletes (1758 data points, 1-8 per athlete, years 2013-2015). Equations for the individualization procedure were adapted from previous material to allow for discrimination of 2 physiological states (recovered vs nonrecovered). Evaluation of classificatory performance was carried out using data from 5 consecutive weekly microcycles in 14 elite junior swimmers and triathletes. Blood samples were collected every Monday (recovered) and Friday according to the repetitive weekly training schedule over 5 wk. On the group level, changes in muscle recovery could be confirmed by significant differences in urea and CK and validated questionnaires. Group-based reference ranges were derived from that same data set to avoid overestimating the potential benefit of individualization. Results: For CK, error rates were significantly lower with individualized classification (P vs group-based: test-pass error rate P = .008; test-fail error rate P < .001). For urea, numerical improvements in error rates failed to reach significance. Conclusions: Individualized reference ranges seem to be a promising tool to improve accuracy of monitoring muscle recovery. Investigating application to a larger panel of indicators is warranted