Background
Ultramarathon
The race
No | race: date | route | total distance | days, stages | mean stage distance | star -tera
| fin-ishera
|
---|---|---|---|---|---|---|---|
1. | 1928: 4 March - 24 May | Los Angeles - New York | 5,509 km 3,423 miles | 84 | 65.6 km/d 40.8 miles/d | 199 | 55 28% |
2. | 1929: 21 March - 8 June | New York - Los Angeles | 5,509 km 3,423 miles | 84 | 65.6 km/d 40.8 miles/d | 80 | 31 39% |
3. | 1992: 20 June - 22 August | Huntington Beach - New York | 4,722 km 2,935 miles | 64 | 73.8 km/d 45.9 miles/d | 28 | 13 46% |
4. | 1993: 19 June - Aug.21 | Huntington Beach - New York | 4,686 km 2,912 miles | 64 | 73.8 km/d 45.9 miles/d | 13 | 6 46% |
5. | 1994: June 18 - 20 August | Huntington Beach - New York | 4,708 km 2,926 miles | 64 | 73.6 km/d 45.7 miles/d | 14 | 5 36% |
6. | 1995: 17 June 17 - 19 August | Huntington Beach - New York | 4,676 km 2,906 miles | 64 | 73.1 km/d 45.4 miles/d | 14 | 10 71% |
Trans Australia Foot Race 2001
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7. | 2001: 6 January - 11 March | Perth - Canberra | 4,109 km 2,553 miles | 63 | 67.8 km/d 42.1 miles/d | 24 | 14 58% |
Run Across America 2002
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8. | 2002: 15 June - 24 August | New York - Huntington Beach | 4,961 km 3,084 miles | 71 | 68.9 km/d 42.8 miles/d | 11 | 8 73% |
10. | 2004: 15 June - 24 August | Huntington Beach - New York | 4,961 km 3,084 miles | 71 | 68.9 km/d 42.8 miles/d | 10 | 6 60% |
9. | 2003: 19 April - 21 June | Lisbon, Portugal - Moscow | 5,020 km 3,119 miles | 64 | 79.5 km/d 49.4 miles/d | 44 | 22 50% |
11. | 2009: 19 April - 21 June | Bari, Italy - North Cape | 4,486 km 2,787 miles | 64 | 70.1 km/d 43.6 miles/d | 67 | 46 69% |
Run Across America 2011: LANY (Los Angeles to New York)
| |||||||
12. | 2011: 19 June - 27 August | Huntington Beach - New York | 5,157 km 3,205 miles | 70 | 73.7 km/d 45.8 miles/d | 14 | 8 57% |
The project
Project module I: musculoskeletal system
Pre-race injuries and deformation
Joints
Soft tissues of the leg
Bones
Project module II: brain, mind and pain perception
Brain volume
Brain lesions
Pain perception, mind and mental stress
Project module III: cardiovascular system
Heart
Arteries
Project module IV: body composition
Purpose
Methods
Mobile MRI
Study participants
Investigators
Pre-race
Field studies
MR measurements
MRI in module I: Musculoskeletal System |
---|
ankle/foot (PP: FFS, supine): |
• TIRM 2D sag; PM: FA 140, TE 60; TR 11320, IR 120, ST 2, SBS 2.4, FOV 900, MS 512*512, PS 0.586 iso, PB 130; IAT: 5:37 |
• PDw TSE fs 2D tra; PM: FA 150, TE 32, TR 5830, ST 4, SBS 4.4, FOV 256, MS 384*384, PS 0.4167 iso, PB: 150; IAT: 3:46 |
• syngo™ MapIt FLASH 2D sag: T2*w GRE; PM: FA 60, TE 4.5, TR 1010, ST 2.5, SBS 2.75, FOV 182.25, MS 320*320; PS 0.421875 iso, PB: 250, IN: 12; IAT: 4:15 |
knee (PP: FFS, supine): |
• TIRM 2D sag; PM: FA 140, TE 50, TR: 4010, TI 150, ST 3, SBS 3.3, FOV 289, MS 256*256, PS 0.664 iso, PB 180; IAT: 3:31 |
• PDw TSE fs 2D cor; PM: FA 150, TE 31, TR 4400, ST 3, SBS 3.3, FOV 289, MS 512*512, PS 0.332 iso, PB 100; IAT: 4:11 |
• syngo™ MapIt FLASH 2D tra/sag: T2*w GRE; PM: FA 60, TE 4.18, TR 889/1120, ST 3, SBS 3.3, FOV 289, MS 512*512; PS 0.332 iso, PB: 250, IN: 12; IAT: 4:21/3:58 |
Hip (PP: FFS): |
• TIRM 2D cor; PM: FA 150, TE 61, TR 6230, TI 145, ST 3.5, SBS 3.85, FOV 1444, MS 384*384, PS 0.9896 iso, PB 130; IAT: 03:38 |
upper/lower leg (PP: FFS, supine): |
• T1w SE 2D tra, PM: FA 90, TE 13, TR 626, ST 5, SBS 5, FOV 1050/722, MS 512*336/256, PS 0.78125/0.7422 iso, PB 115; IAT: 1:54/1:30 |
• TIRM 2D tra; PM: FA 140, TE 62; TR 12530, TI 130, ST 3, SBS 3.9, FOV 512, MS 384*192, PS 0.833 iso, PB 180; IAT: 2:08 |
• PDw TSE fs 2D tra; PM: FA 150, TE 39, TR 6730, ST 3, SBS 3.9, FOV 512, MS 320*160, PS 1.0 iso, PB: 150; IAT: 2:14 |
• DWI (with ADC): SPAIR epi b-value 0-800, 2D tra; PM: FA 90, TE 75, TR 5100, ST 10, SBS 10, FOV 1300/1173.25, MS 128*104, PS 3.125/2.96875 iso, PB 1030; IAT: 2:32/3:01 |
MRI in module II: Brain and Pain
|
Brain (PP: HFS, supine): |
• (turbo) FLASH 3D sag: T1 mpr; PM: FA 15, TE 4.75, TR 2100, ST 1, FOV 614.4, MS 240*256, PS 1.0 iso, PB130; IAT: 8:37 |
• T2w fs FLAIR 2D cor: TIRM; PM: FA 150, TE 120, TR 9000, TI 2500, ST 5, SBS 5.5, FOV, MS 288*384, PS 0.599 iso, PB 150; IAT: 4:43 |
• DWI (with ADC): SPAIR epi b-value 0-1000, 2D tra; PM: FA 90, TE 98, TR 3700, ST 5, SBS 6, FOV 529, MS 256*256, PS 0, 89844 iso, PB 1000; IAT: 0:49 |
functional MRI (fMRI) for pain perception: Epi 2d: epi2d_bold; PM: Fa 90, TE 60, TR 2600, ST 5, SBS 6, FOV, MS 384*384 (Start fMRI: 16*16), PS 3.59375, PB 2440; IAT: ~15:20 in total |
MRI in module III: Cardiovascular System
|
Cardiac cine-MRI (PP: HFS, supine), IAT: ~25:00 in total |
• Cine SSFP, 2D: GRE cine with retrospective 2d cardiac triggering; PM: FA 80, TE var, TR var, ST 6, SBS 6, FOV 1156/1089, MS 192*192/156, PS 1.771/1.71875 iso, PB 930, IN: 30 |
• Phase contrast acquisition 2D; PM: venc 150, FA 30, TE 2.33var, TR 41.1var, ST 6, FOV, MS 180*192, PS 1.875 iso, PB 555, IN:25 |
• Cine-tagging SSFP, 2D: GRE cine with retrospective 2d cardiac triggering; PM: FA 20, TE var, TR var, ST 6, SBS 18, FOV 1073.25, MS 212*256, PS 1.40625 iso, PB 500, IN: 21 |
Vascular cine-MRI (PP: HFS, supine), IAT: ~25:00 var in total |
• Carotid artery: FLASH 2D tra: T2*w gradient-spoiled GRE cine with prospective 2d cardiac triggering; PM: FA 15, TE ~5.45 var, TR ~34.75 var, ST 6, FOV 289, MS 320 × 320, PS 0.53125 iso, PB 250, IN: 50/RR-cycle; IAT: ~5:30 var |
• Femoral artery: FLASH 2D tra: see carotid artery; PM: FA 15, TE 5.00 var, TR 26.80 var, ST 6, FOV 768, MS 512 × 384, PS 0.625 iso, PB 250, IN: 50/RR-cycle; IAT: ~4:20 var |
• Aortic flow prox./dist.: FLASH 2D tra: PM: FA 20, TE 2.75 var, TR 11.55 var, ST 5, FOV 768, MS 256*192, PS 1.25 iso, PB 590, IN: 100; IAT: ~4:10 |
MRI in module IV: Morphometry, Body Composition
|
whole body MRI (PP: HFP/FFP, prone): T1w TSE 2D tra; PM: FA 180, TE 12, TR 490, ST 10, SBS 20, FOV 1991, MS 256*196, PS 1.9922 iso, PB 120, IN: 90-120 var; IAT: appr. 20:00 |
MR spectroscopy (PP: FFS, supine) for evaluation of intramyocellular lipids (IMCL): Single-voxel STEAM, TE 20, TR 2000, voxel of interest 11 × 11 × 20 mm3, 40 acq., IAT: appr. 10:00 |
MRI of feet
MRI of knees
MRI of hips/pelvis
MRI of upper/lower legs
Cerebral MRI, functional MRI
Cardiac cine MRI
Vascular cine MRI
Whole body MRI
MR-spectroscopy
Focused supplementary sequences
Anthropometric and cardiovascular physical measurements
Lab samples
Post-race/follow-up
Statistical analysis
Results
Race conditions
Changes of study plan due to hazards in TEFR
No. | stage | location (Figure 1) | event (Figure 3) | MR down time |
---|---|---|---|---|
1
| 0 | Bari, Southern Italy | Defect of MRI table. | 24 hours |
2
| 12 | Lugo to Alberone, Northern Italy | Truck collision on bridge over the river Po. | - |
3
| 33 | Bad Segeberg, Nothern Germany | Roof damage on MRI trailer. | - |
4
| 36 | Göteborg to Sjövik, Southern Sweden | Total system breakdown, damage of one compressor. | 16 hours |
5
| 38 | Kristinehamn, Central Sweden | Truck sunken in football sand-field. | 5 hours |
6
| 45 | Hackas, Central Sweden | Severe ankle fracture of MRI assistant. | 16 hours |
7
| 56 | Svapparaava, Northern Sweden | Total rupture of tractor to trailer cables. | 2 hours |
8
| after race | nearby Gällivare, Northern Sweden | Reindeer collision on the way back from North Cape: total damage of material van. | - |
Baseline characteristics and performances of subjects
all subjects | MR group 1 | MR group 2 | |
---|---|---|---|
number (%) | number (%) | number (%) | |
total | 44 | 22 (50.0) | 22 (50) |
men | 40 (90.9) | 20 (90.9) | 20 (90.9) |
women | 4 (9.1) | 2 (9.1) | 2 (9.1) |
Finisher (F) | 30 (68.2) | 19 (86.4) | 11 (50.0) |
Non-finisher (NF) | 14 (31.8) | 3 (13.6) | 11 (50.0) |
mean/median (SD) | mean/median (SD) | mean/median (SD) | |
age (years) | 49.7 (10.5) | 50.3 (9.6) | 49.1 (11.5) |
prerace history: | |||
years of regular endurance running | 17.9 (7.5) | 19.1 (7.5) | 17.1 (7.4) |
finished marathons | 91.7 (168.6) | 62.0 (93.4) | 121.47 (218.8) |
finished ultra-marathons | 85.4 (63.6) | 81.1 (59.0) | 89.8 (69.0) |
finished multistage ultra-marathons | 5.7 (3.6) | 5.1 (4.1) | 6.3 (2.9) |
anthropometry: | |||
height (cm) | 175 (8) | 175 (6) | 174 (9) |
BMI (kg/m2) | 23.1 (2.2) | 22.8 (1.8) | 23.4 (2.6) |
body fat percentage, BIA (%) | 11.2 (4.3) | 11.0 (4.1) | 11.4 (4.5) |
body fat percentage, calculateda (%) | 16.6 (4.2) | 15.5 (3.2) | 16.6 (5.0) |
body fat percentage, MRI (%) | - | - | 22.7 (6.0) |
muscle percentage, calculatedb (%) | 49.8 (5.1) | 49.7 (4.7) | 50.0 (5.7) |
somatic lean tissue, MRI (%) | - | - | 65.0 (5.3) |
active range of hip motion (°) | |||
flexion, 121 (26)c
| 123 (27) | 122 (26) | 124 (27) |
extension, 19 (16)c
| 24 (17) | 25 (17) | 21 (16) |
abduction, 42 (22)c
| 43 (23) | 43 (22) | 42 (24) |
internal rotation, 31 (16)c
| 31 (16) | 30 (16) | 32 (16) |
external rotation, 32 (18)c
| 34 (19) | 33 (18) | 34 (19) |
active range of knee motion (°): | |||
flexion, 132 (20)c
| 134 (19) | 135 (20) | 133 (19) |
lower limb alignment: | - | - | |
LL difference [mm], 6 (95th: 11)d
| 2 (3.3), 95th: 9) | ||
FTR, 1.26 (0.05)d
| 1.17 (0.04) | ||
FTA [°], m: 178 (174-182)e
| 178 (175-182) | ||
w: 181 (177-185)e
| |||
FTA difference | 1 (0.8) | ||
MAD (mm), 10 (4-16)e
| 10 (4-17) |
affected region | pathology | subjects (number = 14, 31.8%) | all (number = 21, 31.3%) |
---|---|---|---|
Soft tissues of legs: | 10 (71.4%) | 14 (66.7%) | |
lower legs: | shin splint: myofasciitis, tenditis | 5 (35.7%) | 7 (33.3%) |
Achillodynia | - | 1 (4.8%) | |
upper legs: | myo-tendino-fasciitis, perineuritis | 5 (35.7%) | 6 (28.6%) |
Bone/joint of lower body: | stress fractures: tibia, pelvis | 2 (14.3%) | 2 (9.5%) |
bunion (arthritis) | 1 (7.1%) | 1 (4.8%) | |
Upper extremities: | Phlegmon of the hand | 1 (7.1%) | 1 (4.8%) |
Gastrointestinal (GIT): | upper GIT-bleeding (NSAID) | - | 1 (4.8%) |
GIT infection | - | 1 (4.8%) | |
Mental problems: | Intolerance of crowded small halls at night | - | 1 (4.8%) |