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Diagnosing Overtraining Syndrome: A Scoping Review.

Justin Carrard1, Anne-Catherine Rigort1, Christian Appenzeller-Herzog2

  • 1Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.

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|September 9, 2021
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Summary

Overtraining syndrome (OTS) is difficult to diagnose, but various biomarkers and tools show promise. The EROS scores, combining hormonal, metabolic, and psychological factors, are potential diagnostic aids for OTS.

Keywords:
athletesbiomarkersdiagnosisovertraining syndrometools

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Area of Science:

  • Sports Medicine
  • Exercise Physiology
  • Biomarkers

Background:

  • Overtraining syndrome (OTS) is a condition of prolonged performance decline due to training-recovery imbalance.
  • Currently, OTS is a diagnosis of exclusion due to the absence of a definitive diagnostic test.

Purpose of the Study:

  • To systematically review and map potential diagnostic biomarkers and tools for overtraining syndrome (OTS).

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Web of Science, and SPORTDiscus.
  • Eligibility criteria included studies on athletes with likely OTS and reported diagnostic biomarkers or tools.
  • A scoping review methodology was employed, following PRISMA-ScR guidelines.

Main Results:

  • 39 studies met eligibility criteria from over 5500 initial results.
  • Three diagnostic scores (EROS-CLINICAL, EROS-SIMPLIFIED, EROS-COMPLETE) were identified.
  • Various biomarkers and tools were reported, including hormone levels, neurotransmitters, metabolites, psychological questionnaires, exercise tests, heart rate variability, and immunological parameters.

Conclusions:

  • Multiple biomarkers and tools, reflecting OTS's multisystemic nature, show potential for diagnosis.
  • Combinations of variables, such as those in the EROS scores, may be necessary for accurate OTS diagnosis.
  • Further validation of these scores in larger cohorts, including female athletes, is recommended.