Metabolic and thermodynamic responses to dehydration-induced reductions in muscle blood flow in exercising humans

Effects of massage on limb and skin blood flow after quadriceps exercise

PURPOSE

At present, there is little scientific evidence that postexercise manual massage has any effect on the factors associated with the recovery process. The purpose of this study was to compare the effects of massage against a resting control condition upon femoral artery blood flow (FABF), skin blood flow (SKBF), skin (SKT), and muscle (MT) temperature after dynamic quadriceps exercise.

METHODS

Thirteen male volunteers participated in 3 x 2-min bouts of concentric quadriceps exercise followed by 2 x 6-min bouts of deep effleurage and pétrissage massage or a control (rest) period of similar duration in a counterbalanced fashion. Measures of FABF, SKBF, SKT, MT, blood lactate concentration (BLa), heart rate (HR), and blood pressure (BP) were taken at baseline, immediately after exercise, as well as at the midpoint and end of the massage/rest periods. Data were analyzed by two-way ANOVA.

RESULTS

Significant main effects were found for all variables over time due to effects of exercise. Massage to the quadriceps did not significantly elevate FABF (end-massage 760 +/- 256 vs end-control 733 +/- 161 mL x min(-1)), MT, BL, HR, and BP over control values (P < 0.05). SKBF (end-massage 150 +/- 49 vs end control 6 +/- 4 au) SKT (end-massage 32.2 +/- 0.9 vs end-control 31.1 +/- 1.3degreesC) were elevated after the application of massage compared with the control trial (P < 0.05).

CONCLUSION

From these data it is proposed that without an increase in arterial blood flow, any increase in SKBF is potentially diverting flow away from recovering muscle. Such a response would question the efficacy of massage as an aid to recovery in postexercise settings.

Cerebral perturbations provoked by prolonged exercise

This review addresses cerebral metabolic and neurohumoral alterations during prolonged exercise in humans with special focus on associations with fatigue. Global energy turnover in the brain is unaltered by the transition from rest to moderately intense exercise, apparently because exercise-induced activation of some brain regions including cortical motor areas is compensated for by reduced activity in other regions of the brain. However, strenuous exercise is associated with cerebral metabolic and neurohumoral alterations that may relate to central fatigue. Fatigue should be acknowledged as a complex phenomenon influenced by both peripheral and central factors. However, failure to drive the motorneurons adequately as a consequence of neurophysiological alterations seems to play a dominant role under some circumstances. During exercise with hyperthermia excessive accumulation of heat in the brain due to impeded heat removal by the cerebral circulation may elevate the brain temperature to >40 degrees C and impair the ability to sustain maximal motor activation. Also, when prolonged exercise results in hypoglycaemia, perceived exertion increases at the same time as the cerebral glucose uptake becomes low, and centrally mediated fatigue appears to arise as the cerebral energy turnover becomes restricted by the availability of substrates for the brain. Changes in serotonergic activity, inhibitory feed-back from the exercising muscles, elevated ammonia levels, and alterations in regional dopaminergic activity may also contribute to the impaired voluntary activation of the motorneurons after prolonged and strenuous exercise. Furthermore, central fatigue may involve depletion of cerebral glycogen stores, as signified by the observation that following exhaustive exercise the cerebral glucose uptake increases out of proportion to that of oxygen. In summary, prolonged exercise may induce homeostatic disturbances within the central nervous system (CNS) that subsequently attenuates motor activation. Therefore, strenuous exercise is a challenge not only to the cardiorespiratory and locomotive systems but also to the brain.

The effect of prolonged submaximal exercise on gas exchange kinetics and ventilation during heavy exercise in humans

This study compared ventilation, gas exchange (oxygen uptake, VO(2)) and the surface electromyogram (EMG) activity of four major lower limb muscles during heavy exercise before (Pre-Ex) and after (Post-Ex) a sustained 90-min cycling exercise at 60% VO(2peak). The 90-min exercise was incorporated under the hypothesis that sustained exercise would alter substrate availability in the second exercise bout causing differences in fibre recruitment patterns, gas exchange and ventilation. Nine trained male subjects [VO(2peak)=60.2 (1.7) ml.kg(-1).min(-1)] completed two identical 6-min bouts of cycling performed at high intensity [approximately 90% VO(2peak); 307 (6) W, mean (SE)]. Ventilation and gas exchange were measured breath-by-breath and the EMG was recorded during the last 12 s of each minute of the two 6-min bouts. EMG signals were analysed to determine integrated EMG (iEMG) and mean power frequency (MPF). VO(2) at min 3 and min 6 in Post-Ex were significantly higher (i.e., +201 and 141 ml.min(-1), respectively, P<0.05) than in Pre-Ex but there was a approximately 25% decrease of the slow component, taken as the difference between min 6 and min 3 [187 (27) vs 249 (35) ml.min(-1), respectively, P<0.05]. The greater whole-body VO(2) after 3 min of exercise in Post-Ex was not accompanied by clear alterations in the iEMG and MPF of the examined leg muscles. Ventilation and heart rate were elevated (approximately 12-16 l.min(-1) and approximately 10 beats.min(-1), respectively, P<0.05) as were the ratios V(E)/O(2) and V(E)/VCO(2) in the Post-Ex tests. It was concluded that the VO(2) and ventilation responses to high-intensity exercise can be altered following prolonged moderate intensity exercise in terms of increased amplitude without associated major changes in either iEMG or MPF values among conditions.

Cerebral changes during exercise in the heat

This review focuses on cerebral changes during combined exercise and heat stress, and their relation to fatigue. Dynamic exercise can elevate the core temperature rapidly and high internal body temperatures seem to be an independent cause of fatigue during exercise in hot environments. Thus, in laboratory settings, trained participants become exhausted when they reach a core temperature of approximately 40 degrees C. The observation that exercise-induced hyperthermia reduces the central activation percentage during maximal isometric muscle contractions supports the idea that central fatigue is involved in the aetiology of hyperthermia-induced fatigue. Thus, hyperthermia does not impair the ability of the muscles to generate force, but sustained force production is lowered as a consequence of a reduced neural drive from the CNS. During ongoing dynamic exercise in hot environments, there is a gradual slowing of the electroencephalogram (EEG) whereas hyperthermia does not affect the electromyogram. The frequency shift of the EEG is highly correlated with the participants' perception of exertion, which furthermore may indicate that alterations in cerebral activity, rather than peripheral fatigue, are associated with the hyperthermia-induced development of fatigue. Cerebral blood flow is reduced by approximately 20% during exercise with hyperthermia due to hyperventilation, which causes a lowering of the arterial CO(2) pressure. However, in spite of the reduced blood flow, cerebral glucose and oxygen uptake does not seem to be impaired. Removal of heat from the brain is also an important function of the cerebral blood flow and the lowered perfusion of the brain during exercise and heat stress appears to reduce heat removal by the venous blood. Heat is consequently stored in the brain. The causal relationship between the circulatory changes, the EEG changes and the hyperthermia-induced central fatigue is at the present not well understood and future studies should focus on this aspect.

Reductions in systemic and skeletal muscle blood flow and oxygen delivery limit maximal aerobic capacity in humans

BACKGROUND

A classic, unresolved physiological question is whether central cardiorespiratory and/or local skeletal muscle circulatory factors limit maximal aerobic capacity (VO2max) in humans. Severe heat stress drastically reduces VO2max, but the mechanisms have never been studied.

METHODS AND RESULTS

To determine the main contributing factor that limits VO2max with and without heat stress, we measured hemodynamics in 8 healthy males performing intense upright cycling exercise until exhaustion starting with either high or normal skin and core temperatures (+10 degrees C and +1 degrees C). Heat stress reduced VO2max, 2-legged VO2, and time to fatigue by 0.4+/-0.1 L/min (8%), 0.5+/-0.2 L/min (11%), and 2.2+/-0.4 minutes (28%), respectively (all P<0.05), despite heart rate and core temperature reaching similar peak values. However, before exhaustion in both heat stress and normal conditions, cardiac output, leg blood flow, mean arterial pressure, and systemic and leg O2 delivery declined significantly (all 5% to 11%, P<0.05), yet arterial O2 content and leg vascular conductance remained unchanged. Despite increasing leg O2 extraction, leg VO2 declined 5% to 6% before exhaustion in both heat stress and normal conditions, accompanied by enhanced muscle lactate accumulation and ATP and creatine phosphate hydrolysis.

CONCLUSIONS

These results demonstrate that in trained humans, severe heat stress reduces VO2max by accelerating the declines in cardiac output and mean arterial pressure that lead to decrements in exercising muscle blood flow, O2 delivery, and O2 uptake. Furthermore, the impaired systemic and skeletal muscle aerobic capacity that precedes fatigue with or without heat stress is largely related to the failure of the heart to maintain cardiac output and O2 delivery to locomotive muscle.

Factors affecting the rate of phosphocreatine resynthesis following intense exercise

Within the skeletal muscle cell at the onset of muscular contraction, phosphocreatine (PCr) represents the most immediate reserve for the rephosphorylation of adenosine triphosphate (ATP). As a result, its concentration can be reduced to less than 30% of resting levels during intense exercise. As a fall in the level of PCr appears to adversely affect muscle contraction, and therefore power output in a subsequent bout, maximising the rate of PCr resynthesis during a brief recovery period will be of benefit to an athlete involved in activities which demand intermittent exercise. Although this resynthesis process simply involves the rephosphorylation of creatine by aerobically produced ATP (with the release of protons), it has both a fast and slow component, each proceeding at a rate that is controlled by different components of the creatine kinase equilibrium. The initial fast phase appears to proceed at a rate independent of muscle pH. Instead, its rate appears to be controlled by adenosine diphosphate (ADP) levels; either directly through its free cytosolic concentration, or indirectly, through its effect on the free energy of ATP hydrolysis. Once this fast phase of recovery is complete, there is a secondary slower phase that appears almost certainly rate-dependent on the return of the muscle cell to homeostatic intracellular pH. Given the importance of oxidative phosphorylation in this resynthesis process, those individuals with an elevated aerobic power should be able to resynthesise PCr at a more rapid rate than their sedentary counterparts. However, results from studies that have used phosphorus nuclear magnetic resonance ((31)P-NMR) spectroscopy, have been somewhat inconsistent with respect to the relationship between aerobic power and PCr recovery following intense exercise. Because of the methodological constraints that appear to have limited a number of these studies, further research in this area is warranted.

Thermoregulatory-induced compromise of muscle blood flow in ponies during intense exercise in the heat: a contributor to the onset of fatigue?

Cardiac output (Q) and tissue blood flows (BF) were measured in four ponies at rest, after 30 min of moderate exercise (ME) (approximately 30% VO2max) and following moderately intense exercise (M-IE) (approximately 65%) until fatigue, in a mildly hot (MH) environment (dry bulb temperature = 41 degrees C, wet bulb temperature = 27.5 degrees C). Exercise at both intensities resulted in increases in Q (15.6 +/- 1.7 [rest] vs. 35.8 +/- 2.6 [ME] vs. 48.6 +/- 3.9 [M-IE] l/min) and VO2 (4.7 +/- 0.9 vs. 24.5 +/- 1.2 vs. 55.8 +/- 5.8 ml/kg/min). When compared to ME, M-IE resulted in decreases in BF to the skin (approximately 15%), nonworking muscle (46%), fat (93%), gut (56%), kidneys (57%), CNS (31-66%) and an increase in BF to respiratory (68%), limb (98.5%) and cardiac (50%) muscles. In contrast, BF to working muscle during ME in thermoneutral (TN) conditions (McConaghy et al. 2002) was higher than found during ME in MH. We calculated that limb BF was approximately 25% lower for ME in MH vs. ME in TN. Similarly, we estimated that limb BF during M-IE in MH was approximately 25% lower than for M-IE in TN. Attenuation of the increases in muscle BF during exercise in the heat may be a determinant of the onset of fatigue.

Perceptual versus physiological heat strain during exercise-heat stress

PURPOSE

The physiological strain index (PSI) has been proposed as a universally applicable measure of exercise-heat strain. Unknown is whether this index, based on normalized increases in core temperature and heart rate, is matched by its perceptual analog.

METHODS

By using a similar mathematical construct to the PSI, the perceptions of thermal sensation and perceived exertion were combined, and the resultant index, PeSI, was compared with its physiological counterpart, denoted as PhSI, for the exercise-heat stress specific to this study. Twenty-six young and healthy subjects wore semi-impermeable clothing and walked (3.5 km.h(-1)) under hot conditions (40 degrees C and 30% RH) until exhaustion or when their core temperature reached 39.5 degrees C. Subjects were divided into two fitness groups [endurance trained (T) and untrained (U)] comprised of 10 men and 3 women each. U subjects had a higher level of body fatness (mean +/- SD 18.1 +/- 5.3 vs 12.6 +/- 4.5%; P=0.010) and a lower level of aerobic fitness ((.)VO(2max)= 43.6 +/- 3.8 +/- vs 59.0 +/- 6.2 mL.min(-1).kg(-1); P<0.001).

RESULTS

During the first hour of exposure, there was no group difference in PhSI, yet T perceived their physiological strain (PeSI) lower than U (P=0.002). Further, the indices were not different for U whereas PhSI was higher than PeSI for T (P=0.008). At the end of the exposure, T had a higher value of PhSI than U (8.23 +/- 0.72 vs 6.74 +/- 1.47; = 0.002), but there was no group difference in PeSI. Although the indices were again not different for U, PhSI at the end was higher than PeSI for T (6.14 +/- 1.68; P<0.001).

CONCLUSION

T underestimated and U consistently perceived their physiological strain, as defined by PhSI, in accordance with the measured increases in core temperature and heart rate throughout an exposure to uncompensable exercise-heat stress.

Heat stress increases muscle glycogen use but reduces the oxidation of ingested carbohydrates during exercise

The aim of the present study was to test the hypothesis that the oxidation rate of ingested carbohydrate (CHO) is impaired during exercise in the heat compared with a cool environment. Nine trained cyclists (maximal oxygen consumption 65 +/- 1 ml x kg body wt(-1) x min(-1)) exercised on two different occasions for 90 min at 55% maximum power ouptput at an ambient temperature of either 16.4 +/- 0.2 degrees C (cool trial) or 35.4 +/- 0.1 degrees C (heat trial). Subjects received 8% glucose solutions that were enriched with [U-13C]glucose for measurements of exogenous glucose, plasma glucose, liver-derived glucose and muscle glycogen oxidation. Exogenous glucose oxidation during the final 30 min of exercise was significantly (P < 0.05) lower in the heat compared with the cool trial (0.76 +/- 0.06 vs. 0.84 +/- 0.05 g/min). Muscle glycogen oxidation during the final 30 min of exercise was increased by 25% in the heat (2.07 +/- 0.16 vs. 1.66 +/- 0.09 g/min; P < 0.05), and liver-derived glucose oxidation was not different. There was a trend toward a higher total CHO oxidation and a lower plasma glucose oxidation in the heat although this did not reach statistical significance (P = 0.087 and P = 0.082, respectively). These results demonstrate that the oxidation rate of ingested CHO is reduced and muscle glycogen utilization is increased during exercise in the heat compared with a cool environment.

Thermoregulation and marathon running: biological and environmental influences

The extreme physical endurance demands and varied environmental settings of marathon footraces have provided a unique opportunity to study the limits of human thermoregulation for more than a century. High post-race rectal temperatures (Tre) are commonly and consistently documented in marathon runners, yet a clear divergence of thought surrounds the cause for this observation. A close examination of the literature reveals that this phenomenon is commonly attributed to either biological (dehydration, metabolic rate, gender) or environmental factors. Marathon climatic conditions vary as much as their course topography and can change considerably from year to year and even from start to finish in the same race. The fact that climate can significantly limit temperature regulation and performance is evident from the direct relationship between heat casualties and Wet Bulb Globe Temperature (WBGT), as well as the inverse relationship between record setting race performances and ambient temperatures. However, the usual range of compensable racing environments actually appears to play more of an indirect role in predicting Tre by acting to modulate heat loss and fluid balance. The importance of fluid balance in thermoregulation is well established. Dehydration-mediated perturbations in blood volume and blood flow can compromise exercise heat loss and increase thermal strain. Although progressive dehydration reduces heat dissipation and increases Tre during exercise, the loss of plasma volume contributing to this effect is not always observed for prolonged running and may therefore complicate the predictive influence of dehydration on Tre for marathon running. Metabolic heat production consequent to muscle contraction creates an internal heat load proportional to exercise intensity. The correlation between running speed and Tre, especially over the final stages of a marathon event, is often significant but fails to reliably explain more than a fraction of the variability in post-marathon Tre. Additionally, the submaximal exercise intensities observed throughout 42 km races suggest the need for other synergistic factors or circumstances in explaining this occurrence. There is a paucity of research on women marathon runners. Some biological determinants of exercise thermoregulation, including body mass, surface area-to-mass ratio, sweat rate, and menstrual cycle phase are gender-discrete variables with the potential to alter the exercise-thermoregulatory response to different environments, fluid intake, and exercise metabolism. However, these gender differences appear to be more quantitative than qualitative for most marathon road racing environments.

Fluid and electrolyte balance in ultra-endurance sport

It is well known that fluid and electrolyte balance are critical to optimal exercise performance and, moreover, health maintenance. Most research conducted on extreme sporting endeavour (>3 hours) is based on case studies and studies involving small numbers of individuals. Ultra-endurance sportsmen and women typically do not meet their fluid needs during exercise. However, successful athletes exercising over several consecutive days come close to meeting fluid needs. It is important to try to account for all factors influencing bodyweight changes, in addition to fluid loss, and all sources of water input. Increasing ambient temperature and humidity can increase the rate of sweating by up to approximately 1 L/h. Depending on individual variation, exercise type and particularly intensity, sweat rates can vary from extremely low values to more than 3 L/h. Over-hydration, although not frequently observed, can also present problems, as can inappropriate fluid composition. Over-hydrating or meeting fluid needs during very long-lasting exercise in the heat with low or negligible sodium intake can result in reduced performance and, not infrequently, hyponatraemia. Thus, with large rates of fluid ingestion, even measured just to meet fluid needs, sodium intake is vital and an increased beverage concentration [30 to 50 mmol/L (1.7 to 2.9 g NaCl/L) may be beneficial. If insufficient fluids are taken during exercise, sodium is necessary in the recovery period to reduce the urinary output and increase the rate of restoration of fluid balance. Carbohydrate inclusion in a beverage can affect the net rate of water assimilation and is also important to supplement endogenous reserves as a substrate for exercising muscles during ultra-endurance activity. To enhance water absorption, glucose and/or glucose-containing carbohydrates (e.g. sucrose, maltose) at concentrations of 3 to 5% weight/volume are recommended. Carbohydrate concentrations above this may be advantageous in terms of glucose oxidation and maintaining exercise intensity, but will be of no added advantage and, if hyperosmotic, will actually reduce the net rate of water absorption. The rate of fluid loss may exceed the capacity of the gastrointestinal tract to assimilate fluids. Gastric emptying, in particular, may be below the rate of fluid loss, and therefore, individual tolerance may dictate the maximum rate of fluid intake. There is large individual variation in gastric emptying rate and tolerance to larger volumes. Training to drink during exercise is recommended and may enhance tolerance.

Influence of aerobic fitness and body fatness on tolerance to uncompensable heat stress

This study examined the independent and combined importance of aerobic fitness and body fatness on physiological tolerance and exercise time during weight-bearing exercise while wearing a semipermeable protective ensemble. Twenty-four men and women were matched for aerobic fitness and body fatness in one of four groups (4 men and 2 women in each group). Aerobic fitness was expressed per kilogram of lean body mass (LBM) to eliminate the influence of body fatness on the expression of fitness. Subjects were defined as trained (T; regularly active with a peak aerobic power of 65 ml x kg LBM(-1) x min(-1)) or untrained (UT; sedentary with a peak aerobic power of 53 ml x kg LBM(-1) x min(-1)) with high (High; 20%) or low (Low; 11%) body fatness. Subjects exercised until exhaustion or until rectal temperature reached 39.5 degrees C or heart rate reached 95% of maximum. Exercise times were significantly greater in T(Low) (116 +/- 6.5 min) compared with their matched sedentary (UT(Low); 70 +/- 3.6 min) or fatness (T(High); 82 +/- 3.9 min) counterparts, indicating an advantage for both a high aerobic fitness and low body fatness. However, similar effects were not evident between T(High) and UT(High) (74 +/- 4.1 min) or between the UT groups (UT(Low) and UT(High)). The major advantage attributed to a higher aerobic fitness was the ability to tolerate a higher core temperature at exhaustion (the difference being as great as 0.9 degrees C), whereas both body fatness and rate of heat storage affected the exercise time as independent factors.

Perceived exertion is associated with an altered brain activity during exercise with progressive hyperthermia

The present study tested the hypothesis that perceived exertion during prolonged exercise in hot environments is associated with changes in cerebral electrical activity rather than changes in the electromyogram (EMG) of the exercising muscles. Therefore, electroencephalogram (EEG) in three positions (frontal, central, and occipital cortex), EMG, rating of perceived exertion (RPE), and core temperature were measured in 14 subjects during submaximal exercise in normal (18 degrees C, control) and hot (40 degrees C, hyperthermia) environments. RPE increased from 11 +/- 1 units at 5 min to 20 +/- 0 units at exhaustion (50 +/- 3 min) in the trial with progressive hyperthermia, whereas exercise in the control trial was maintained with a stable core temperature for 1 h without exhausting the subjects. Altered EEG activity was observed in all electrode positions, and stepwise forward-regression analysis identified core temperature and a frequency index of the EEG over the frontal cortex as the best predictors of RPE. In contrast, there were no significant correlations between RPE and any of the measured EMG parameters (median spectral frequency, root mean square, or amplitude), and the EMG parameters were not different in hyperthermia compared with control. Thus hyperthermia does not seem to affect the activation pattern of the muscles. Rather, the linear correlation among core temperature, EEG frequency index, and RPE indicates that alterations in cerebral activity may be associated with the hyperthermia-induced development of fatigue during prolonged exercise in hot environments.

No effect of mild heat stress on the regulation of carbohydrate metabolism at the onset of exercise

To investigate the influence of heat stress on the regulation of skeletal muscle carbohydrate metabolism, six active, but not specifically trained, men performed 5 min of cycling at a power output eliciting 70% maximal O2 uptake in either 20 degrees C (Con) or 40 degrees C (Heat) after 20 min of passive exposure to either environmental condition. Although muscle temperature (T(mu)) was similar at rest when comparing trials, 20 min of passive exposure and 5 min of exercise increased (P < 0.05) T(mu) in Heat compared with Con (37.5 +/- 0.1 vs. 36.9 +/- 0.1 degrees C at 5 min for Heat and Con, respectively). Rectal temperature and plasma epinephrine were not different at rest, preexercise, or 5 min of exercise between trials. Although intramuscular glycogen phosphorylase and pyruvate dehydrogenase activity increased (P < 0.05) at the onset of exercise, there were no differences in the activities of these regulatory enzymes when comparing Heat with Con. Accordingly, glycogen use in the first 5 min of exercise was not different when comparing Heat with Con. Similarly, no differences in intramuscular concentrations of glucose 6-phosphate, lactate, pyruvate, acetyl-CoA, creatine, phosphocreatine, or ATP were observed at any time point when comparing Heat with Con. These results demonstrate that, whereas mild heat stress results in a small difference in contracting T(mu), it does not alter the activities of the key regulatory enzymes for carbohydrate metabolism or glycogen use at the onset of exercise, when plasma epinephrine levels are unaltered.

Hyperthermia and central fatigue during prolonged exercise in humans

The present study investigated the effects of hyperthermia on the contributions of central and peripheral factors to the development of neuromuscular fatigue. Fourteen men exercised at 60% maximal oxygen consumption on a cycle ergometer in hot (40 degrees C; hyperthermia) and thermoneutral (18 degrees C; control) environments. In hyperthermia, the core temperature increased throughout the exercise period and reached a peak value of 40.0 +/- 0.1 degrees C (mean +/- SE) at exhaustion after 50 +/- 3 min of exercise. In control, core temperature stabilized at approximately 38.0 +/- 0.1 degrees C, and exercise was maintained for 1 h without exhausting the subjects. Immediately after the cycle trials, subjects performed 2 min of sustained maximal voluntary contraction (MVC) either with the exercised legs (knee extension) or with a "nonexercised" muscle group (handgrip). The degree of voluntary activation during sustained maximal knee extensions was assessed by superimposing electrical stimulation (EL) to nervus femoralis. Voluntary knee extensor force was similar during the first 5 s of contraction in hyperthermia and control. Thereafter, force declined in both trials, but the reduction in maximal voluntary force was more pronounced in the hyperthermic trial, and, from 30 to 120 s, the force was significantly lower in hyperthermia compared with control. Calculation of the voluntary activation percentage (MVC/MVC + EL) revealed that the degree of central activation was significantly lower in hyperthermia (54 +/- 7%) compared with control (82 +/- 6%). In contrast, total force of the knee extensors (MVC + force from EL) was not different in the two trials. Force development during handgrip contraction followed the same pattern of response as was observed for the knee extensors. In conclusion, these data demonstrate that the ability to generate force during a prolonged MVC is attenuated with hyperthermia, and the impaired performance is associated with a reduction in the voluntary activation percentage.

Middle cerebral artery blood velocity is reduced with hyperthermia during prolonged exercise in humans

1. In the present study we examined the effect of hyperthermia on the middle cerebral artery mean blood velocity (MCA V(mean)) during prolonged exercise. We predicted that the cerebral circulation would be impaired when hyperthermia is present during exercise and assumed that this could be observed as a reduced MCA V(mean). 2. Eight endurance trained men (maximum oxygen uptake (V(O2,max)) 70 +/- 1 ml min(-1) kg(-1) (mean +/- S.E.M.)) performed two exercise trials at 57 % of V(O2,max) on a cycle ergometer in a hot (40 degrees C; hyperthermic trial) and in a thermoneutral environment (18 degrees C; control trial). In the hyperthermic trial, the oesophageal temperature increased throughout the exercise period reaching a peak value of 40.0 +/- 0.1 degrees C at exhaustion after 53 +/- 4 min of exercise. In the control trial, exercise was maintained for 1 h without any signs of fatigue and with core temperature stabilised at 37.8 +/- 0.1 degrees C after approximately 15 min of exercise. 3. Concomitant with the development of hyperthermia, MCA V(mean) declined by 26 +/- 3 % from 73 +/- 4 cm s(-1) at the beginning of exercise to 54 +/- 4 cm s(-1) at exhaustion (P < 0.001). In contrast, MCA V(mean) remained unchanged at 70-72 cm s(-1) throughout the 1 h control trial. 4. When individually determined regression lines for MCA V(mean) and arterial carbon dioxide pressure (P(a,CO2)) obtained during preliminary exercise tests were used to account for the differences in P(a,CO2) between the hyperthermic and control trial, it appeared that more than half of the reduction in MCA V(mean) (56 +/- 8 %) was related to a hyperventilation-induced drop in P(a,CO2). Declining cardiac output and arterial blood pressure accounted for the remaining part of the hyperthermia-induced reduction in MCA V(mean). 5. The present results demonstrate that the development of hyperthermia during prolonged exercise is associated with a marked reduction in MCA V(mean).

Alterations in energy metabolism during exercise and heat stress

Much of the research that has examined the interaction between metabolism and exercise has been conducted in comfortable ambient conditions. It is clear, however, that environmental temperature, particularly extreme heat, is a major practical issue one must consider when examining muscle energy metabolism. When exercise is conducted in very high ambient temperatures, the gradient for heat dissipation is significantly reduced which results in changes to thermoregulatory mechanisms designed to promote body heat loss. This can ultimately impact upon hormonal and metabolic responses to exercise which act to alter substrate utilisation. In general, the literature examining metabolic responses to exercise and heat stress has demonstrated a shift towards increased carbohydrate use and decreased fat use. Although glucose production appears to be augmented during exercise in the heat, glucose disposal and utilisation appears to be unaltered. In contrast, glycogen use has been consistently demonstrated to be augmented during exercise in the heat. This increase in glycogenolysis is observed via both aerobic and anaerobic pathways. Although several hypotheses have been proposed as mechanisms for the substrate shift towards greater carbohydrate metabolism during exercise and heat stress, recent work suggests that an augmented sympatho-adrenal response and intramuscular temperature may be responsible for such a phenomenon.

Hydration effects on thermoregulation and performance in the heat

During exercise, sweat output often exceeds water intake, producing a water deficit or hypohydration. The water deficit lowers both intracellular and extracellular fluid volumes, and causes a hypotonic-hypovolemia of the blood. Aerobic exercise tasks are likely to be adversely effected by hypohydration (even in the absence of heat strain), with the potential affect being greater in hot environments. Hypohydration increases heat storage by reducing sweating rate and skin blood flow responses for a given core temperature. Hypertonicity and hypovolemia both contribute to reduced heat loss and increased heat storage. In addition, hypovolemia and the displacement of blood to the skin make it difficult to maintain central venous pressure and thus cardiac output to simultaneously support metabolism and thermoregulation. Hyperhydration provides no advantages over euhydration regarding thermoregulation and exercise performance in the heat.

The importance of aerobic fitness in determining tolerance to uncompensable heat stress

When protective clothing is worn that restricts evaporative heat loss, it is not valid to assume that the higher sweat rates associated with improvements in aerobic fitness will increase heat tolerance. An initial study compared thermoregulatory and cardiovascular responses to both compensable and uncompensable heat stress before and after 8 weeks of endurance training in previously sedentary males. Despite a 15% improvement in VO2peak, and lower heart rates and rectal temperature (T(re)) responses while wearing combat clothing, no changes were noted when subjects wore a protective clothing ensemble. Tolerance times were unchanged at approximately 50 min. A subsequent short-term training model that used daily 1-h exercise sessions for 2 weeks also failed to show any benefit when the protective clothing was worn in the heat. Cross-sectional comparisons between groups of high and low aerobic fitness, however, have revealed that a high aerobic fitness is associated with extended tolerance time when the protective clothing is worn. The longer tolerance time is a function of both a lower starting T(re) and a higher T(re) tolerated at exhaustion. Improvements in cardiovascular function with long-term training may allow higher core temperatures to be reached prior to exhaustion. Conversely, elevations in core temperature that occur with normal training sessions may familiarize the more fit subjects to the discomforts of exercise in the heat. Other factors such as differences in body fatness may account for a faster increase in tissue temperature at a given metabolic rate for less fit individuals.

Effects of marked hyperthermia with and without dehydration on VO(2) kinetics during intense exercise

This study determined whether marked hyperthermia alone or in combination with dehydration reduces the initial rate of rise in O(2) consumption (VO(2) on-kinetics) and the maximal rate of O(2) uptake (VO(2 max)) during intense cycling exercise. Six endurance-trained male cyclists completed four maximal cycle ergometer exercise tests (402 +/- 4 W) when euhydrated or dehydrated (4% body wt) with normal (starting esophageal temperature, 37.5 +/- 0.2 degrees C; mean skin temperature, approximately 31 degrees C) or elevated (+1 and +6 degrees C, respectively) thermal strain. In the euhydrated and normal condition, subjects reached VO(2 max) (4.7 +/- 0.2 l/min) in 228 +/- 34 s, with a mean response time of 42 +/- 2 s, and fatigued after 353 +/- 39 s. Hyperthermia alone or in combination with dehydration reduced mean response time (17-23%), VO(2 max) (16%), and performance time (51-53%) (all P < 0.01) but did not alter the absolute response time (i.e., the time to reach 63% response in the control trial, 3.2 +/- 0.1 l/min, 42 s). Reduction in VO(2 max) was accompanied by proportional decline in O(2) pulse and significantly elevated maximal heart rate (195 vs. 190 beats/min for hyperthermia vs. normal). Preventing hyperthermia in dehydrated subjects restored VO(2 max) and performance time by 65 and 50%, respectively. These results demonstrate that impaired high-intensity exercise performance with marked skin and internal body hyperthermia alone or in combination with dehydration is not associated with a diminished rate of rise in VO(2) but decreased VO(2 max).

Effect of temperature on post-tetanic potentiation in human dorsiflexor muscles

The effect of temperature on post-tetanic potentiation (PTP) has been examined in the muscles of small mammals but not in human skeletal muscle. We examined PTP in the ankle dorsiflexor muscles of 10 young men by evoking twitches before and after a 7-second tetanus at 100 Hz in a control (room air ~21°C) condition and after immersion of the lower leg in warm (45°C) and cold (10°C) water baths for 30 min. Exposure to cold decreased tetanus and pre-tetanus twitch peak torque, but increased rise time, half-relaxation time, and muscle action potential (M-wave) amplitude; exposure to warm water had little effect. PTP was smallest in cold exposure 5 s post-tetanus, but persisted throughout the 12 min test period, whereas PTP had subsided by 6 min post-tetanus in control and warm exposures. M-wave amplitude initially decreased after exposure to warm water, recovered, then decreased again by 11 min post-tetanus. In contrast, exposure to cold had no initial effect but did increase the M-wave amplitude during the last half of the 12 min test period, similar to that seen in the control. The greatest immediate decrease in rise time and half-relaxation time was observed in the control; however, by 12 min post-tetanus warm exposure showed the greatest increase in rise time and half-relaxation time above pre-tetanus values. The decrease in the unpotentiated twitch torque with cooling in human dorsiflexors is typical for muscles with a predominance of type I (slow) fibres. The effect of cold on PTP is similar to that seen previously in mammalian muscles with a predominance of type II (fast) fibres, although the underlying mechanism of the cooling effect appears to differ.Key words: contraction, muscle, twitch.

Prolonged exercise after diuretic-induced hypohydration: effects on substrate turnover and oxidation

To determine the influence of a diuretic-induced reduction in plasma volume (PV) on substrate turnover and oxidation, 10 healthy young males were studied during 60 min of cycling exercise at 61% peak oxygen uptake on two separate occasions > or =1 wk apart. Exercise was performed under control conditions (CON; placebo), and after 4 days of diuretic administration (DIU; Novotriamazide; 100 mg triamterene and 50 mg hydrochlorothiazide). DIU resulted in a calculated reduction of PV by 14.6 +/- 3.3% (P < 0.05). Rates of glucose appearance (R(a)) and disappearance (R(d)) and glycerol R(a) were determined by using primed constant infusions of [6,6-(2)H]glucose and [(2)H(5)]glycerol, respectively. No differences in oxygen uptake during exercise were observed between trials. Main effects for condition (P < 0.05) were observed for plasma glucose and glycerol, such that the values observed for DIU were higher than for CON. No differences were observed in plasma lactate and serum free fatty acid concentrations either at rest or during exercise. Hypohydration led to lower (P < 0.05) glucose R(a) and R(d) at rest and at 15 and 30 min of exercise, but by 60 min, the effects were reversed (P < 0. 05). Hypohydration had no effect on rates of whole body lipolysis or total carbohydrate or fat oxidation. A main effect for condition (P < 0.05) was observed for plasma glucagon concentrations such that larger values were observed for DIU than for CON. A similar decline in plasma insulin occurred with exercise in both conditions. These results indicate that diuretic-induced reductions in PV decreases glucose kinetics during moderate-intensity dynamic exercise in the absence of changes in total carbohydrate and fat oxidation. The specific effect on glucose kinetics depends on the duration of the exercise.

Skeletal muscle substrate metabolism during exercise: methodological considerations

The aim of the present article is to evaluate critically the various methods employed in studies designed to quantify precisely skeletal muscle substrate utilization during exercise. In general, the pattern of substrate utilization during exercise can be described well from O2 uptake measurements and the respiratory exchange ratio. However, if the aim is to quantify limb or muscle metabolism, invasive measurements have to be carried out, such as the determination of blood flow, arterio-venous (a-v) difference measurements for O2 and relevant substrates, and biopsies of the active muscle. As many substrates and metabolites may be both taken up and released by muscle at rest and during exercise, isotopes can be used to determine uptake and/or release and also fractional uptake can be accounted for. Furthermore, the use of isotopes opens up further possibilities for the estimation of oxidation rates of various substrates. There are several methodological concerns to be aware of when studying the metabolic response to exercise in human subjects. These concerns include: (1) the muscle mass involved in the exercise is largely unknown (bicycle or treadmill). Moreover, whether the muscle sample obtained from a limb muscle and the substrate and metabolite concentrations are representative can be a problem; (2) the placement of the venous catheter can be critical, and it should be secured so that the blood sample represents blood from the active muscle with a minimum of contamination from other muscles and tissues; (3) the use of net limb glycerol release to estimate lipolysis is probably not valid (triacylglycerol utilization by muscle), since glycerol can be metabolized in skeletal muscle; (4) the precision of blood-borne substrate concentrations during exercise measured by a-v difference is hampered since they become very small due to the high blood flow. Recommendations are given in order to obtain more quantitative and conclusive data in studies investigating the regulatory mechanisms for substrate choice by muscle.