<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mes</journal-id><journal-title-group><journal-title xml:lang="ru">Экстремальная биомедицина</journal-title><trans-title-group xml:lang="en"><trans-title>Extreme Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-8964</issn><issn pub-type="epub">3033-8972</issn><publisher><publisher-name>Centre for Strategic Planning of the Federal Medical and Biological Agency</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47183/mes.2026-549</article-id><article-id custom-type="elpub" pub-id-type="custom">mes-549</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ГЛАВНАЯ ТЕМА: ПРИКЛАДНЫЕ АСПЕКТЫ СПОРТИВНОЙ МЕДИЦИНЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>MAIN TOPIC: APPLIED ASPECTS OF SPORTS MEDICINE</subject></subj-group></article-categories><title-group><article-title>Маркеры перетренированности спортсменов: систематический обзор и оценка согласованности результатов исследований</article-title><trans-title-group xml:lang="en"><trans-title>Overtraining markers in athletes: A systematic review and assessment of study consistency</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8981-7583</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мавлиев</surname><given-names>Ф. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mavliev</surname><given-names>F. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мавлиев Фанис Азгатович, канд. биол. наук</p><p>Казань</p></bio><bio xml:lang="en"><p>Fanis A. Mavliev, Cand. Sci. (Biol.)</p><p>Kazan </p></bio><email xlink:type="simple">Fanis16rus@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4971-7822</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдрахманова</surname><given-names>А. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdrakhmanova</surname><given-names>A. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абдрахманова Аделя Шамилевна</p><p>Казань</p></bio><bio xml:lang="en"><p>Adelia Sh. Abdrakhmanova</p><p>Kazan </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-0253-8707</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карфик</surname><given-names>В. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Karfik</surname><given-names>V. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карфик Владислав Рафаэльевич</p><p>Казань</p></bio><bio xml:lang="en"><p>Vladislav R. Karfik</p><p>Kazan </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-3169-1453</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сабиров</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sabirov</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сабиров Тимур Васильевич</p><p>Казань</p></bio><bio xml:lang="en"><p>Timur V. Sabirov</p><p>Kazan </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8711-8807</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зотова</surname><given-names>Ф. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Zotova</surname><given-names>F. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зотова Фируза Рахматулловна, д-р пед. наук, профессор</p><p>Казань</p></bio><bio xml:lang="en"><p>Firuza R. Zotova, Dr. Sci. (Ed.), Professor</p><p>Kazan </p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Поволжский государственный университет физической культуры, спорта и туризма</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Volga Region State University of Physical Culture, Sport and Tourism</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Республиканская спортивная школа олимпийского резерва по фехтованию</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Sports School of Olympic Reserve in Fencing</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Поволжский государственный университет физической культуры, спорта и туризма; Казанский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Volga Region State University of Physical Culture, Sport and Tourism; Kazan Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>11</day><month>09</month><year>2026</year></pub-date><volume>28</volume><issue>3</issue><fpage>346</fpage><lpage>358</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мавлиев Ф.А., Абдрахманова А.Ш., Карфик В.Р., Сабиров Т.В., Зотова Ф.Р., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Мавлиев Ф.А., Абдрахманова А.Ш., Карфик В.Р., Сабиров Т.В., Зотова Ф.Р.</copyright-holder><copyright-holder xml:lang="en">Mavliev F.A., Abdrakhmanova A.S., Karfik V.R., Sabirov T.V., Zotova F.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.extrememedicine.ru/jour/article/view/549">https://www.extrememedicine.ru/jour/article/view/549</self-uri><abstract><sec><title>Введение</title><p>Введение. Состояние перетренированности у спортсменов представляет собой дезадаптацию функциональных систем организма, следствием которой является снижение работоспособности. Отсутствие единой методики оценки перетренированности и однозначных маркеров для его определения приводит к противоречивости результатов исследований, что обусловливает необходимость разработки надежных и валидных методов и маркеров диагностики данного состояния.</p></sec><sec><title>Цель</title><p>Цель. Оценка согласованности результатов исследований маркеров перетренированности спортсменов.</p></sec><sec><title>Методы</title><p>Методы. Проведен систематический обзор 1976 публикаций, из которых было отобрано 22 полнотекстовых исследования за 2006– 2026 гг. c помощью поисковой системы Google Scholar, а также в библиографических базах PubMed/MEDLINE, РИНЦ/eLIBRARY, КиберЛенинка. Синтез данных был выполнен по методике «синтез без метаанализа» (SWiM) с использованием метода подсчета голосов (Vote Counting) и графиков направления эффекта (Effect Direction Plot). Риск систематической ошибки оценивали по шкале Risk Of Bias In Non-randomized Studies — of Interventions (ROBINS-I). Достоверность доказательств оценивали по методологии GRADE.</p></sec><sec><title>Результаты</title><p>Результаты. Проанализировано 30 маркеров, сгруппированных в 5 групп: биохимические и эндокринные, физиологические, психометрические и субъективные, морфологические, молекулярно-генетические и иммунологические маркеры. Полная согласованность (100%) отмечена для психометрических и субъективных шкал (опросник профиля состояний настроения (POMS) — 6 из 6 исследований, опросник восстановления-стресса для спортсменов (RESTQ-Sport) — 3 из 3 исследований, показатель воспринимаемого напряжения (RPE) — 3 из 3 исследований). Согласованность ряда маркеров была достигнута только по одному исследованию (n = 1 для 11 маркеров из 30) либо в рамках одного исследовательского проекта (проект EROS, n = 3 для показателей «скелетно-жировая масса» и «базальный метаболизм», n = 2 для показателя «нейтрофилы/лимфоциты»), что снижает возможность обобщения выводов. Изолированные маркеры продемонстрировали меньшую согласованность по сравнению с комбинированными индексами: кортизол — 4 из 9 исследований (44,4%), креатинфосфокиназа — 3 из 4 (75%), тестостерон — 5 из 8 (62,5%), лактат при нагрузке — 3 из 4 (75%), максимальное потребление кислорода — 1 из 3 (33,3%). Среди комбинированных индексов наибольшую согласованность показали: индекс анаболизма — 4 из 5 (80%) и отношение частоты сердечных сокращений к уровню лактата (ЧССмакс/лактатмакс) — 4 из 4 (100%). По уровню риска систематической ошибки исследования распределились так: 81,8% — умеренный риск, 13,6% — высокий, 4,5% — низкий. Уровень достоверности маркеров был оценен достаточно низко (умеренный — 40%, низкий — 30%, очень низкий — 30%) из-за этических ограничений (рассматривались наблюдательные исследования), малых выборок и неконтролируемых факторов.</p></sec><sec><title>Выводы</title><p>Выводы. Полученные данные показывают потенциальную ценность маркеров для диагностирования состояния перетренированности, но ряд факторов требует сдержанной интерпретации: ограниченная достоверность по GRADE, недостаточное число исследований в случае отдельных маркеров, а также получение части данных в одном и том же единственном проекте. Для выявления состояния перетренированности необходим комплексный подход, позволяющий учесть дезадаптационные изменения в работе функциональных систем организма. Для раннего выявления в полевых условиях признаков перетренированности могут быть применены психометрические и скоростно-силовые тесты, в лабораторных условиях для более глубокой и точной оценки целесообразно применять комбинированные индексы. Дальнейшие исследования должны быть связаны со стандартизацией диагностических протоколов, проведением проспективных исследований с большей выборкой, участием женщин, спортсменов элитного уровня, а также оценкой диагностической точности маркеров с учетом вклада внешних факторов (режим сна, психоэмоциональный стресс, характер питания).</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Athletic overtraining represents a maladaptation of the body’s functional systems that leads to decreased performance. The evaluation of this state is hindered by the lack of a unified assessment framework and definitive markers, resulting in inconsistent research findings. This ambiguity underscores the need to develop reliable and valid diagnostic tools.</p></sec><sec><title>Objective</title><p>Objective. To assess the consistency of research findings on overtraining markers in athletes.</p></sec><sec><title>Methods</title><p>Methods. A systematic review of 1976 publications was conducted; a total of 22 full-text studies published between 2006 and 2026 were selected using the Google Scholar search engine, as well as the PubMed/MEDLINE, RSCI/eLIBRARY, and CyberLeninka bibliographic databases. Data synthesis was guided by the Synthesis Without Meta-Analysis (SWiM) approach, incorporating the vote-counting method and effect direction plots. The risk of bias was assessed using the Risk of Bias in Non-randomized Studies — of Interventions (ROBINS-I) tool. The certainty of evidence was evaluated according to the GRADE methodology.</p></sec><sec><title>Results</title><p>Results. Thirty markers were analyzed and grouped into five categories: biochemical and endocrine, physiological, psychometric and subjective, morphological, and molecular genetic and immunological markers. Full consistency (100%) was observed for psychometric and subjective scales: the Profile of Mood States questionnaire (POMS; 6/6 studies), the Recovery Stress Questionnaire for Athletes (RESTQ-Sport; 3/3 studies), and the rating of perceived exertion (RPE; 3/3 studies). The consistency scores for several markers were derived only from a single study (n = 1 for 11/30 markers) or a single research project (the EROS project: n = 3 for skeletal muscle and fat mass and basal metabolism; n = 2 for the neutrophil-to-lymphocyte ratio), which limits the generalizability of the conclusions. Isolated markers demonstrated lower consistency compared to composite metrics: 44.4% for cortisol (4/9 studies), 75% for creatine kinase (3/4 studies), 62.5% for testosterone (5/8 studies), 75% for lactate during exercise (3/4 studies), and 33.3% for maximal oxygen uptake (1/3 studies). Among the composite metrics, the highest consistency was observed for the anabolic index (4/5 studies; 80%) and the ratio of maximal heart rate to maximal lactate level (4/4 studies; 100%). In terms of the risk of bias, 81.8% of studies showed a moderate risk, 13.6% a high risk, and 4.5% a low risk. The certainty of evidence for the markers was assessed as relatively low (moderate: 40%; low: 30%; very low: 30%) due to ethical constraints (restricting research to observational designs), small sample sizes, and uncontrolled factors.</p></sec><sec><title>Conclusions</title><p>Conclusions. While the findings indicate the potential value of these markers for diagnosing overtraining, a cautious interpretation is advised due to the limited GRADE certainty, the insufficient number of studies for certain markers, and the fact that some data were derived from a single research project. Identifying overtraining requires a comprehensive approach that accounts for maladaptive changes in the body’s functional systems. Psychometric and speed-strength tests can be applied for the early detection of overtraining signs in field conditions; in laboratory settings, composite metrics are advisable for a more in-depth and precise assessment. Further research should focus on standardizing diagnostic protocols, conducting prospective studies with larger sample sizes, recruiting female athletes and elite-level athletes, and evaluating the diagnostic accuracy of markers while accounting for the influence of external factors (sleep patterns, psychological stress, and dietary habits).</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>маркеры</kwd><kwd>перетренированность</kwd><kwd>синдром перетренированности</kwd><kwd>спортсмены</kwd><kwd>индекс анаболизма</kwd><kwd>ЧСС/лактат</kwd><kwd>POMS</kwd><kwd>RESTQ-Sport</kwd><kwd>дезадаптация</kwd><kwd>функциональные тесты</kwd><kwd>мониторинг</kwd></kwd-group><kwd-group xml:lang="en"><kwd>markers</kwd><kwd>overtraining</kwd><kwd>overtraining syndrome</kwd><kwd>athletes</kwd><kwd>anabolic index</kwd><kwd>HR/lactate</kwd><kwd>POMS</kwd><kwd>RESTQ-Sport</kwd><kwd>maladaptation</kwd><kwd>functional tests</kwd><kwd>monitoring</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено за счет гранта Российского научного фонда и Академии наук Республики Татарстан по проекту № 26-25-20055.</funding-statement><funding-statement xml:lang="en">The study was supported by a grant from the Russian Science Foundation and the Tatarstan Academy of Sciences (Project No. 26-25-20055).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Armstrong LE, Bergeron MF, Lee EC, Mershon JE, Armstrong EM. Overtraining syndrome as a complex systems phenomenon. Frontiers in Network Physiology. 2022;1:794392. https://doi.org/10.3389/fnetp.2021.794392</mixed-citation><mixed-citation xml:lang="en">Armstrong LE, Bergeron MF, Lee EC, Mershon JE, Armstrong EM. Overtraining syndrome as a complex systems phenomenon. Frontiers in Network Physiology. 2022;1:794392. https://doi.org/10.3389/fnetp.2021.794392</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Carrard J, Rigort AC, Appenzeller-Herzog C, Colledge F, Königstein K, Hinrichs T, et al. Diagnosing overtraining syndrome: A scoping review. Sports Health. 2022;14(5):665–73. https://doi.org/10.1177/19417381211044739</mixed-citation><mixed-citation xml:lang="en">Carrard J, Rigort AC, Appenzeller-Herzog C, Colledge F, Königstein K, Hinrichs T, et al. Diagnosing overtraining syndrome: A scoping review. Sports Health. 2022;14(5):665–73. https://doi.org/10.1177/19417381211044739</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Varlet-Marie E, Mercier J, Brun JF. Is plasma viscosity a predictor of overtraining in athletes? Clinical Hemorheology and Microcirculation. 2006;35(1-2):329–32. PMID: 16899952</mixed-citation><mixed-citation xml:lang="en">Varlet-Marie E, Mercier J, Brun JF. Is plasma viscosity a predictor of overtraining in athletes? Clinical Hemorheology and Microcirculation. 2006;35(1-2):329–32. PMID: 16899952</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Brel YI, Faschenko YI, Melnik SN. Overtraining syndrome: peculiarities and perspectives of diagnostics. Opera Medica et Physiologica. 2023;10(3):5–22. https://doi.org/10.24412/2500-2295-2023-3-5-22</mixed-citation><mixed-citation xml:lang="en">Brel YI, Faschenko YI, Melnik SN. Overtraining syndrome: peculiarities and perspectives of diagnostics. Opera Medica et Physiologica. 2023;10(3):5–22. https://doi.org/10.24412/2500-2295-2023-3-5-22</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Weakley J, Halson SL, Mujika I. Overtraining syndrome symptoms and diagnosis in athletes: where is the research? A systematic review. International Journal of Sports Physiology and Performance. 2022;17(5):675–81. https://doi.org/10.1123/ijspp.2021-0448</mixed-citation><mixed-citation xml:lang="en">Weakley J, Halson SL, Mujika I. Overtraining syndrome symptoms and diagnosis in athletes: where is the research? A systematic review. International Journal of Sports Physiology and Performance. 2022;17(5):675–81. https://doi.org/10.1123/ijspp.2021-0448</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Valdesalici A, Sella E, Domenicucci R, Ghisi M, Borella E. Effects of non-functional overreaching and overtraining syndrome on psychological and cognitive functioning in elite athletes: A Systematic review. Psychology of Sport and Exercise. 2026;84:103079. https://doi.org/10.1016/j.psychsport.2026.103079</mixed-citation><mixed-citation xml:lang="en">Valdesalici A, Sella E, Domenicucci R, Ghisi M, Borella E. Effects of non-functional overreaching and overtraining syndrome on psychological and cognitive functioning in elite athletes: A Systematic review. Psychology of Sport and Exercise. 2026;84:103079. https://doi.org/10.1016/j.psychsport.2026.103079</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Lipka A, Luthardt C, Tognaccioli T, Cairo B, Abreu RMD. Heart rate variability and overtraining in soccer players: A systematic review. Physiological Reports. 2025;13:e70357. https://doi.org/10.14814/phy2.70357</mixed-citation><mixed-citation xml:lang="en">Lipka A, Luthardt C, Tognaccioli T, Cairo B, Abreu RMD. Heart rate variability and overtraining in soccer players: A systematic review. Physiological Reports. 2025;13:e70357. https://doi.org/10.14814/phy2.70357</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Nowicka I, Łuniewski B, Macko A, Łuniewska M, Turek PR. Possible hormonal biomarkers in the diagnosis of overtraining syndrome (OTS)-a literature review. Quality in Sport. 2026;50:68113. https://doi.org/10.12775/QS.2026.50.68113</mixed-citation><mixed-citation xml:lang="en">Nowicka I, Łuniewski B, Macko A, Łuniewska M, Turek PR. Possible hormonal biomarkers in the diagnosis of overtraining syndrome (OTS)-a literature review. Quality in Sport. 2026;50:68113. https://doi.org/10.12775/QS.2026.50.68113</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Будко АН, Рыбина ИЛ. Биохимические аспекты перетренированности у спортсменов в конькобежном спорте. Прикладная спортивная наука. 2016;1(3):44–9. EDN: WITJTR</mixed-citation><mixed-citation xml:lang="en">Budko AN, Rybina IL. Biochemical aspects of overtraining in speed skating athletes. Applied Sports Science. 2016;1(3):44–9 (In Russ.). EDN: WITJTR</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Аллахярова КЭ, Невзорова ЕВ, Гулин АВ. Оценка интенсивности физической нагрузки и расчет индекса анаболизма как критерия перетренированности. Вестник Тамбовского университета. Серия: естественные и технические науки. 2017;22(2):382–6. https://doi.org/10.20310/1810-0198-2017-22-2-382-386</mixed-citation><mixed-citation xml:lang="en">Allakhyarova KE, Nevzorova EV, Gulin AV. Assessment of physical activity intensity and calculation of anabolism index as a criterion of overtraining. Bulletin of Tambov State University. Natural Sciences. 2017;22(2):382–6 (In Russ.). https://doi.org/10.20310/1810-0198-2017-22-2-382-386</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Buchwald RL, Buchwald J, Lehtonen E, Peltonen JE, Uusitalo AL. A comprehensive analysis of overtraining syndrome in athletes and recreational exercisers. International Journal of Sports Medicine. 2025;46(12):898–907. https://doi.org/10.1055/a-2611-3598</mixed-citation><mixed-citation xml:lang="en">Buchwald RL, Buchwald J, Lehtonen E, Peltonen JE, Uusitalo AL. A comprehensive analysis of overtraining syndrome in athletes and recreational exercisers. International Journal of Sports Medicine. 2025;46(12):898–907. https://doi.org/10.1055/a-2611-3598</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Kajaia Y, Maskhulia L, Chelidze K, Akhalkatsi V, Kakhabrishvili Z. The effects of non-functional overreaching and overtraining on autonomic nervous system function in highly trained Georgian athletes. Georgian Medical News. 2017;3(264):97–103. PMID: 28480859.</mixed-citation><mixed-citation xml:lang="en">Kajaia Y, Maskhulia L, Chelidze K, Akhalkatsi V, Kakhabrishvili Z. The effects of non-functional overreaching and overtraining on autonomic nervous system function in highly trained Georgian athletes. Georgian Medical News. 2017;3(264):97–103. PMID: 28480859.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Grant CC, Janse Van Rensburg DC, Collins R, Wood PS, Du Toit PJ. The Profile of Mood State (POMS) questionnaire as an indicator of Overtraining Syndrome (OTS) in endurance athletes. African Journal for Physical, Health Education, Recreation and Dance. 2012;18(1):23–32.</mixed-citation><mixed-citation xml:lang="en">Grant CC, Janse Van Rensburg DC, Collins R, Wood PS, Du Toit PJ. The Profile of Mood State (POMS) questionnaire as an indicator of Overtraining Syndrome (OTS) in endurance athletes. African Journal for Physical, Health Education, Recreation and Dance. 2012;18(1):23–32.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Ranahan AM, Pignanelli C, Thompson KM, Burr JF, Coates AM. Alterations in glycemic control and glucose tolerance following overtraining in endurance athletes. Applied Physiology, Nutrition, and Metabolism. 2025;50:1–10. https://doi.org/10.1139/apnm-2025-0278</mixed-citation><mixed-citation xml:lang="en">Ranahan AM, Pignanelli C, Thompson KM, Burr JF, Coates AM. Alterations in glycemic control and glucose tolerance following overtraining in endurance athletes. Applied Physiology, Nutrition, and Metabolism. 2025;50:1–10. https://doi.org/10.1139/apnm-2025-0278</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Fatouros IG, Destouni A, Margonis K, Jamurtas AZ, Vrettou C, Kouretas D, et al. Cell-free plasma DNA as a novel marker of aseptic inflammation severity related to exercise overtraining. Clinical Chemistry. 2006;52(9):1637–45. https://doi.org/10.1373/clinchem.2006.070417</mixed-citation><mixed-citation xml:lang="en">Fatouros IG, Destouni A, Margonis K, Jamurtas AZ, Vrettou C, Kouretas D, et al. Cell-free plasma DNA as a novel marker of aseptic inflammation severity related to exercise overtraining. Clinical Chemistry. 2006;52(9):1637–45. https://doi.org/10.1373/clinchem.2006.070417</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Noce F, Costa VT, Szmuchrowski LA, Soares DS, De Mello MT. Psychological indicators of overtraining in high level judo athletes in pre-and post-competition periods. Archives of Budo. 2014;10:281–6.</mixed-citation><mixed-citation xml:lang="en">Noce F, Costa VT, Szmuchrowski LA, Soares DS, De Mello MT. Psychological indicators of overtraining in high level judo athletes in pre-and post-competition periods. Archives of Budo. 2014;10:281–6.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Cadegiani FA, Kater CE. Body composition, metabolism, sleep, psychological and eating patterns of overtraining syndrome — results of the EROS study (EROS-PROFILE). Journal of Sports Sciences. 2018;36(16):1902–10. https://doi.org/10.1080/02640414.2018.1424498</mixed-citation><mixed-citation xml:lang="en">Cadegiani FA, Kater CE. Body composition, metabolism, sleep, psychological and eating patterns of overtraining syndrome — results of the EROS study (EROS-PROFILE). Journal of Sports Sciences. 2018;36(16):1902–10. https://doi.org/10.1080/02640414.2018.1424498</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Cadegiani FA, Kater CE. Hypothalamic-pituitary-adrenal (HPA) axis functioning in overtraining syndrome — findings from endocrine and metabolic responses on overtraining syndrome (EROS) — EROS-HPA study. Sports Medicine — Open. 2017;3(1):45. https://doi.org/10.1186/s40798-017-0113-0</mixed-citation><mixed-citation xml:lang="en">Cadegiani FA, Kater CE. Hypothalamic-pituitary-adrenal (HPA) axis functioning in overtraining syndrome — findings from endocrine and metabolic responses on overtraining syndrome (EROS) — EROS-HPA study. Sports Medicine — Open. 2017;3(1):45. https://doi.org/10.1186/s40798-017-0113-0</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Cadegiani FA, Kater CE. Hormonal response to a non-exercise stress test in athletes with overtraining syndrome: results from the Endocrine and metabolic Responses on Overtraining Syndrome (EROS)—EROS-STRESS. Journal of Science and Medicine in Sport. 2018;21(7):648–53. https://doi.org/10.1016/j.jsams.2017.10.033</mixed-citation><mixed-citation xml:lang="en">Cadegiani FA, Kater CE. Hormonal response to a non-exercise stress test in athletes with overtraining syndrome: results from the Endocrine and metabolic Responses on Overtraining Syndrome (EROS)—EROS-STRESS. Journal of Science and Medicine in Sport. 2018;21(7):648–53. https://doi.org/10.1016/j.jsams.2017.10.033</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Cadegiani FA, Kater CE. Inter-correlations among clinical, metabolic, and biochemical parameters and their predictive value in healthy and overtrained male athletes: the EROSCORRELATIONS study. Frontiers in Endocrinology. 2019;10:534. https://doi.org/10.3389/fendo.2019.00858</mixed-citation><mixed-citation xml:lang="en">Cadegiani FA, Kater CE. Inter-correlations among clinical, metabolic, and biochemical parameters and their predictive value in healthy and overtrained male athletes: the EROSCORRELATIONS study. Frontiers in Endocrinology. 2019;10:534. https://doi.org/10.3389/fendo.2019.00858</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Cadegiani FA, Kater CE, Gazola M. Clinical and biochemical characteristics of high-intensity functional training (HIFT) and overtraining syndrome — findings from the EROS study (The EROS-HIFT). Sports Medicine Open. 2019;27(11):1296–307. https://doi.org/10.1080/02640414.2018.1555912</mixed-citation><mixed-citation xml:lang="en">Cadegiani FA, Kater CE, Gazola M. Clinical and biochemical characteristics of high-intensity functional training (HIFT) and overtraining syndrome — findings from the EROS study (The EROS-HIFT). Sports Medicine Open. 2019;27(11):1296–307. https://doi.org/10.1080/02640414.2018.1555912</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Fagundes LHS, Costa ITD, Reis CP, Pinheiro GDS, Costa VT. Monitoring of overtraining and motivation in elite soccer players. Motriz: Revista de Educação Física. 2021;27:e102100109. https://doi.org/10.1590/S1980-65742021022221</mixed-citation><mixed-citation xml:lang="en">Fagundes LHS, Costa ITD, Reis CP, Pinheiro GDS, Costa VT. Monitoring of overtraining and motivation in elite soccer players. Motriz: Revista de Educação Física. 2021;27:e102100109. https://doi.org/10.1590/S1980-65742021022221</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Slivka DR, Hailes WS, Cuddy JS, Ruby BC. Effects of 21 days of intensified training on markers of overtraining. Journal of Strength &amp; Conditioning Research. 2010;24(10):2604–12. https://doi.org/10.1519/JSC.0b013e3181e8a4eb</mixed-citation><mixed-citation xml:lang="en">Slivka DR, Hailes WS, Cuddy JS, Ruby BC. Effects of 21 days of intensified training on markers of overtraining. Journal of Strength &amp; Conditioning Research. 2010;24(10):2604–12. https://doi.org/10.1519/JSC.0b013e3181e8a4eb</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Anderson T, Haake S, Lane AR, Hackney AC. Changes in resting salivary testosterone, cortisol and interleukin-6 as biomarkers of overtraining. Baltic Journal of Sport and Health Sciences. 2016;101(2):2–7. PMID: 29708232</mixed-citation><mixed-citation xml:lang="en">Anderson T, Haake S, Lane AR, Hackney AC. Changes in resting salivary testosterone, cortisol and interleukin-6 as biomarkers of overtraining. Baltic Journal of Sport and Health Sciences. 2016;101(2):2–7. PMID: 29708232</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Nicoll JX, Fry AC, Mosier EM, Olsen LA, Sontag SA. MAPK, androgen, and glucocorticoid receptor phosphorylation following high-frequency resistance exercise non-functional overreaching. European Journal of Applied Physiology. 2019;119(10):2237–53. https://doi.org/10.1007/s00421-019-04200-y</mixed-citation><mixed-citation xml:lang="en">Nicoll JX, Fry AC, Mosier EM, Olsen LA, Sontag SA. MAPK, androgen, and glucocorticoid receptor phosphorylation following high-frequency resistance exercise non-functional overreaching. European Journal of Applied Physiology. 2019;119(10):2237–53. https://doi.org/10.1007/s00421-019-04200-y</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Tian Y, He Z. Monitoring overtraining in women wrestlers. International Journal of Wrestling Science. 2013;3(2):51–7. https://doi.org/10.1080/21615667.2013.10878988</mixed-citation><mixed-citation xml:lang="en">Tian Y, He Z. Monitoring overtraining in women wrestlers. International Journal of Wrestling Science. 2013;3(2):51–7. https://doi.org/10.1080/21615667.2013.10878988</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Kargarfard M, Amiri E, Shaw I, Shariat A, Shaw BS. Salivary testosterone and cortisol concentrations, and psychological overtraining scores as indicators of overtraining syndromes among elite soccer players. Revista de Psicología del Deporte. 2018;27(1):155–60. https://doi.org/10.1136/bjsm.2002.000254</mixed-citation><mixed-citation xml:lang="en">Kargarfard M, Amiri E, Shaw I, Shariat A, Shaw BS. Salivary testosterone and cortisol concentrations, and psychological overtraining scores as indicators of overtraining syndromes among elite soccer players. Revista de Psicología del Deporte. 2018;27(1):155–60. https://doi.org/10.1136/bjsm.2002.000254</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Gasser BA, Vogel R, Wehrlin J. Effects of a 6-week additional work on performance capacity — Hints for a parasympathetic overtraining? Journal of Human Sport and Exercise. 2022;17(3):690–702. https://doi.org/10.14198/jhse.2022.173.12</mixed-citation><mixed-citation xml:lang="en">Gasser BA, Vogel R, Wehrlin J. Effects of a 6-week additional work on performance capacity — Hints for a parasympathetic overtraining? Journal of Human Sport and Exercise. 2022;17(3):690–702. https://doi.org/10.14198/jhse.2022.173.12</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Le Meur YL, Hausswirth C, Natta F, Couturier A, Bignet F, Vidal PP. A multidisciplinary approach to overreaching detection in endurance trained athletes. Journal of Applied Physiology. 2013;114(3):411–20. https://doi.org/10.1152/japplphysiol.01254.2012</mixed-citation><mixed-citation xml:lang="en">Le Meur YL, Hausswirth C, Natta F, Couturier A, Bignet F, Vidal PP. A multidisciplinary approach to overreaching detection in endurance trained athletes. Journal of Applied Physiology. 2013;114(3):411–20. https://doi.org/10.1152/japplphysiol.01254.2012</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Hackney AC, Kallman A, Hosick KP, Rubin DA, Battaglini CL. Thyroid hormonal responses to intensive interval versus steady-state endurance exercise sessions. Hormones. 2012;11(1):54–60. https://doi.org/10.1007/BF03401537</mixed-citation><mixed-citation xml:lang="en">Hackney AC, Kallman A, Hosick KP, Rubin DA, Battaglini CL. Thyroid hormonal responses to intensive interval versus steady-state endurance exercise sessions. Hormones. 2012;11(1):54–60. https://doi.org/10.1007/BF03401537</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Brini S, Clark CC, Ouergui I, Delextrat A, Yagin FH, Muscella A, et al. Plasma and salivary measures of testosterone and cortisol levels in basketball players under various games/training conditions, and nutritional strategies: an updated systematic review. Frontiers in Physiology. 2025;16:1678971. https://doi.org/10.3389/fphys.2025.1678971</mixed-citation><mixed-citation xml:lang="en">Brini S, Clark CC, Ouergui I, Delextrat A, Yagin FH, Muscella A, et al. Plasma and salivary measures of testosterone and cortisol levels in basketball players under various games/training conditions, and nutritional strategies: an updated systematic review. Frontiers in Physiology. 2025;16:1678971. https://doi.org/10.3389/fphys.2025.1678971</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Lopes TR, Pereira HM, Silva BM. Perceived exertion: Revisiting the history and updating the neurophysiology and the practical applications. International Journal of Environmental Research and Public Health. 2022;19(21):14439. https://doi.org/10.3390/ijerph192114439</mixed-citation><mixed-citation xml:lang="en">Lopes TR, Pereira HM, Silva BM. Perceived exertion: Revisiting the history and updating the neurophysiology and the practical applications. International Journal of Environmental Research and Public Health. 2022;19(21):14439. https://doi.org/10.3390/ijerph192114439</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
