Key result
Blood-based biomarkers for managing athlete workload require careful consideration of confounding variables, appropriate measurement timing, and statistical analysis to ensure correct interpretation.
Why the study?
Despite the potential of blood-based biomarkers to guide athlete workload management, pitfalls in use, confounding variables, statistical challenges, and a lack of reference levels complicate their interpretation.
Evidence-based use of established blood-based biomarkers in athletes requires careful consideration of confounding variables, individual reference levels, and appropriate statistical analysis.
Clinicians must account for preanalytical confounders when interpreting athlete biomarkers; leaves open their standardized use for training optimization.
Blood-based biomarkers can provide an objective individualized measure of training load, recovery, and health status in order to reduce injury risk and maximize performance. Despite enormous potentials, especially owing to currently evolving technology, such as point-of-care testing, and advantages, in terms of objectivity and non-interference with the training process, there are several pitfalls in the use and interpretation of biomarkers. Confounding variables such as preanalytical conditions, inter-individual differences, or an individual chronic workload can lead to variance in resting levels. In addition, statistical considerations such as the detection of meaningful minimal changes are often neglected. The lack of generally applicable and individual reference levels further complicates the interpretation of level changes and thus load management via biomarkers. Here, the potentials and pitfalls of blood-based biomarkers are described, followed by an overview of established biomarkers currently used to support workload management. Creatine kinase is discussed in terms of its evidence for workload management to illustrate the limited applicability of established markers for workload management to date. We conclude with recommendations for best practices in the use and interpretation of biomarkers in a sport-specific context.
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Haller et al. (2023) conducted a review in Workload management and recovery in athletes. Blood-based biomarkers (e.g., creatine kinase, lactate, urea, myoglobin, WBC, CRP) was evaluated. Blood-based biomarkers for managing athlete workload require careful consideration of confounding variables, appropriate measurement timing, and statistical analysis to ensure correct interpretation.
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