Aerobic high-intensity intervals improve VO2max more than moderate training

Benefits and interval training in individuals with spinal cord injury: A thematic review

BACKGROUND

Arm crank ergometry (ACE), functional electrical stimulation leg cycling exercise (FES-LCE), and the combination of the two (FES hybrid exercise) have all been used as activities to help improve the fitness-related health of individuals with spinal cord injury (SCI). More recently, high-intensity interval training (HIIT) has become popular in the non-disabled community due to its ability to produce greater aerobic fitness benefits or equivalent benefits with reduced time commitment.

OBJECTIVE

This thematic review of the literature sought to determine the potential benefits and practicality of using ACE, FES-LCE, and FES hybrid exercise in an interval training format for individuals with SCI.

METHODS

Systematic literature searches were conducted in May 2020 and March 2021 focusing on interval training in individuals with SCI. Pre-defined nested search terms were used to narrow the available literature from 4273 citations to 1362 articles. The titles and abstracts were then reviewed to determine the appropriateness of the articles ending with fifteen articles.

RESULTS

The literature was limited to fifteen articles with low participant numbers (n = 1-20). However, in each article, HIIT protocols either demonstrated a greater improvement in cardiovascular, metabolic, or practicality scores compared to moderate intensity continuous training (MICT) protocols, or improvement during relatively brief time commitments.

CONCLUSION

The available literature lacked sufficient numbers of randomized control trials. However, the available evidence is encouraging concerning the potential benefits and practicality of using HIIT (ACE, FES-LCE, or FES hybrid exercise) to improve aerobic and anaerobic capacity and decrease cardiometabolic risk after SCI.

Exercise Dose Equalization in High-Intensity Interval Training: A Scoping Review

Based on comparisons to moderate continuous exercise (MICT), high-intensity interval training (HIIT) is becoming a worldwide trend in physical exercise. This raises methodological questions related to equalization of exercise dose when comparing protocols. The present scoping review aims to identify in the literature the evidence for protocol equalization and the soundness of methods used for it. PubMed and Scopus databases were searched for original investigations comparing the effects of HIIT to MICT. A total of 2041 articles were identified, and 169 were included. Of these, 98 articles equalized protocols by utilizing energy-based methods or exercise volume (58 and 31 articles, respectively). No clear consensus for protocol equalization appears to have evolved over recent years. Prominent equalization methods consider the exercise dose (i.e., energy expenditure/production or total volume) in absolute values without considering the nonlinear nature of its relationship with duration. Exercises resulting from these methods induced maximal exertion in HIIT but low exertion in MICT. A key question is, therefore, whether exercise doses are best considered in absolute terms or relative to individual exercise maximums. If protocol equalization is accepted as an essential methodological prerequisite, it is hypothesized that comparison of program effects would be more accurate if exercise was quantified relative to intensity-related maximums.

Affective Valence and Enjoyment in High- and Moderate-High Intensity Interval Exercise. The Tromsø Exercise Enjoyment Study

Introduction

Exercise at high intensity may cause lower affective responses toward exercise compared with moderate intensity exercise. We aimed to elucidate affective valence and enjoyment in high- and moderate-high interval exercise.

Methods

Twenty recreationally active participants (9 females, 11 males, age range: 20-51 years) underwent three different treadmill running exercise sessions per week over a 3-week period, in randomized order; (1) CE70: 45 min continuous exercise at 70% of heart rate maximum (HR_max), (2) INT80: 4 × 4 min intervals at 80% of HR_max, (3) INT90: 4 × 4 min intervals at 90% of HR_max. Pre-tests included graded submaximal steady state intensities and a test to exhaustion for determining peak oxygen uptake and HR_max. Affective valence (pleasure/displeasure) was measured before, during and after the sessions using the Feeling Scale (FS). Enjoyment was assessed before and after the sessions applying the Physical Activity Enjoyment Scale (PACES) and during the sessions using the Exercise Enjoyment Scale (EES).

Results

The participants felt lower pleasure (between-sessions effect: p = 0.02, _p η²: 0.13) during INT90 sessions (FS: 1.08, 95% CI: 0.35-1.92) compared with INT80 (FS: 2.35, 95% CI: 1.62-3.08, p = 0.052) and CE70 sessions (FS: 2.45, 95% CI: 1.72-3.18, p = 0.03), with no differences between INT80 and CE70 sessions (p = 1.00). There were higher enjoyment after INT80 sessions (PACES: 101.5, 95% CI: 95.7-107.3) versus CE70 sessions (PACES: 91.3 95% CI: 85.5-97.1, p = 0.046), and no differences between INT90 (PACES: 98.2, 95% CI: 92.4-103.4) and CE70 (p = 0.29) or INT80 (p = 1.00). For enjoyment during exercise, CE70 were perceived more enjoyable, and INT80 and INT90 less enjoyable in week 2 (EES: week x session: p = 0.01, _p η²: 0.11; CE70: 4.3, 95% CI: 3.6-4.9, INT80: 4.6, 95% CI: 3.9-5.2, INT90: 4.0, 95% CI: 3.4-4.7) and 3 (EES: CE70: 4.2, 95% CI: 3.7-4.8, INT80: 4.8, 95% CI: 4.2-5.3, INT90: 4.3, 95% CI: 3.8-4.9) than in week 1 (EES: CE70: 3.5, 95% CI: 3.0-4.0, INT80: 5.0, 95% CI: 4.5-5.5, INT90: 4.5, 95% CI: 4.0-5.0).

Conclusion

The negative affective consequences associated with high intensity interval exercise can be alleviated by keeping the intensity at or around 80% of HR_max while preserving the beneficial enjoyment responses associated with interval exercise.

Changes in spatiotemporal parameters, joint and CoM kinematics and leg stiffness in novice runners during a high-intensity fatigue protocol

Even though running enjoys growing popularity, the effects of fatigue on the running kinematics of novices have rarely been studied. This is surprising, given the risk of running-related injuries when detrimental movement patterns are adopted. Therefore, the goal of the present study was to characterize the effects of fatigue induced by a high-intensity running protocol on spatiotemporal and stiffness parameters as well as on joint kinematics and center of mass (CoM) motion in novice runners. 14 participants performed a standardized treadmill familiarization and ran at 13 km/h until voluntary exhaustion. Kinematics were captured using a 3D motion capture system. Spatiotemporal and stiffness parameters as well as the range of motion (RoM) of the joints and CoM were compared by use of paired t-tests. Time series of the joint angles and CoM motion were analyzed by the statistical parametric mapping method. The results revealed that novice runners did not change spatiotemporal or stiffness parameters, but showed adaptations in joint kinematics, e.g. decreased dorsiflexion and increased pronation in the ankle joint during the swing phase. The findings of this study underline the importance of strengthening the ankle joint to prevent excessive pronation and increase its stability in novice runners.

The effect of aquatic High Intensity Interval Training on cardiometabolic and physical health markers in women: A systematic review and meta-analysis

Background

We performed a meta-analysis of randomized controlled trials (RCTs) assessing the effect of Aquatic High Intensity Interval Training (AHIIT) on cardiometabolic and physical health markers in women.

Methods

Systematic search used 7 databases (MEDLINE, PubMed, SPORTDiscus, Cochrane, Embase, CINAL complete, PsycINFO). The Physiotherapy Evidence Database (PEDro) score was used to evaluate the methodological quality of the studies. Clinical trials compared AHIIT with a control group that receive no exercise training. We integrated randomized controlled trials published in English, and participants were women aged ≥18 years. The outcome of interest was the change in cardiometabolic and physical health markers.

Results

Among 242 articles screened, 18 articles (13 trials) were included in this meta-analysis comparing AHIIT (n = 261) with a control group (n = 215). The median PEDro score was 5.5 out of 10 (range, 4–8). AHIIT significantly improved peak oxygen uptake (Hedges' g 0.610; 95% CI 0.277–0.943; P < 0.001), reduced resting heart rate (Hedges' g −0.495; 95% CI -0.866 to −0.124; P < 0.05), as well as chair to stand test. (Hedges’ g 0.548; 95% CI 0.019 to 1.077; P < 0.05).

Conclusion

AHIIT has a moderate effect in improving cardiometabolic and physical health markers in women.

Changes in the Second Ventilatory Threshold Following Individualised versus Standardised Exercise Prescription among Physically Inactive Adults: A Randomised Trial

The second ventilatory threshold (VT2) is established as an important indicator of exercise intensity tolerance. A higher VT2 allows for greater duration of higher intensity exercise participation and subsequently greater reductions in cardiovascular disease (CVD) risk. This study aimed to compare the efficacy of standardised and individualised exercise prescription on VT2 among physically inactive adults. Forty-nine physically inactive male and female participants (48.6 ± 11.5 years) were recruited and randomised into a 12-week standardised (n = 25) or individualised (n = 24) exercise prescription intervention. The exercise intensity for the standardised and individualised groups was prescribed as a percentage of heart rate reserve (HRR) or relative to the first ventilatory threshold (VT1) and VT2, respectively. Participants were required to complete a maximal graded exercise test at pre-and post-intervention to determine VT1 and VT2. Participants were categorised as responders to the intervention if an absolute VT2 change of at least 1.9% was attained. Thirty-eight participants were included in the analysis. A significant difference in VT2 change was found between individualised (pre vs. post: 70.6% vs. 78.7% maximum oxygen uptake (VO2max)) and standardised (pre vs. post: 72.5% vs. 72.3% VO2max) exercise groups. Individualised exercise prescription was significantly more efficacious (p = 0.04) in eliciting a positive response in VT2 (15/19, 79%) when compared to the standardised exercise group (9/19, 47%). Individualised exercise prescription appears to be more efficacious than standardised exercise prescription in eliciting a positive VT2 change among physically inactive adults. Increasing VT2 allows for greater tolerance to higher exercise intensities and therefore greater cardiovascular health outcomes.

Prefrontal cortex hemodynamic response to acute high intensity intermittent exercise during executive function processing

We investigated prefrontal cortex (PFC) hemodynamic response, through functional near infrared spectroscopy (fNIRS) during executive function (EF) processing in response to acute high intensity intermittent exercise (HIIE) in young adults. We also assessed the associated sex differences in the cognitive scores and related PFC hemodynamic functions in response to HIIE. 49 young healthy adult participants (32 women, 17 men) were randomly assigned to either control or HIIE intervention groups. HIIE group participants performed 4 × 4 minutes of HIIE on cycle ergometer with 3 minutes of active recovery between the bouts; control group relaxed for the time equivalent to intervention. fNIRS data was collected during the performance of the EF tests including Color Word Stroop Test (CWST) and Trail Making Test (TMT) in pre and post sessions in both the groups. Results indicated a significant change in the hemodynamic response in the form of increased oxygenated and decreased deoxygenated hemoglobin in the PFC areas specific to the EF tasks, with improved CWST and TMT scores in response to HIIE intervention. PFC activation was different in men and women in response to HIIE, however similar scores of task performance were observed in men and women during the performance of executive functions in response to HIIE. The study concludes that an acute HIIE session improves executive function which is associated with an increase activation of PFC. Sex differences exist in the activation of PFC in response to HIIE during EF processing. Our study adds to the current evidence regarding exercise and cognition.

The Acute Physiological and Perceptual Responses Between Bodyweight and Treadmill Running High-Intensity Interval Exercises

Objective

The purpose of this study was to compare the acute physiological, perceptual, and enjoyment responses between bodyweight high-intensity interval exercise (BW-HIIE) and treadmill running high-intensity interval exercise HIIE (RUN-HIIE).

Methods

Twelve adults [age: 29.5 ± 5.3 years; weight: 70.9 ± 15.0 kg; height: 167.9 ± 8.9 cm; peak oxygen consumption (VO2 peak): 48.7 ± 6.5 ml min−1·kg−1] performed both RUN-HIIE and BW-HIIE. RUN-HIIE consisted of two sets of 5, 60-s (s) run intervals at 100% of the speed achieved during VO2 peak testing followed by 60s of walking at 4.02 km/h. BW-HIIE consisted of two sets of 5, 60s ‘all-out’ effort calisthenic exercises followed by 60s of marching in place at 100 steps per minute. Oxygen consumption (VO2), blood lactate (Blac), heart rate (HR), and rating of perceived exertion (RPE) were measured during exercise. Physical activity enjoyment (PACES) was assessed post-exercise. Creatine Kinase (CK) was measured before exercise and 48-h post-exercise. Muscle soreness was assessed before exercise, post-exercise, and 48-h post-exercise.

Results

Oxygen consumption relative to VO2 peak was higher (p &lt; 0.001) during RUN-HIIE (88 ± 3%) compared to BW-HIIE (77 ± 4%). HR relative to HRpeak was higher (p = 0.002) for RUN-HIIE (93 ± 1%) compared to BW-HIIE (88 ± 2%). Blac was higher (p &lt; 0.001) after BW-HIIE (11.2 ± 3.2 mmol/l) compared to RUN-HIIE (6.9 ± 2.0 mmol/l). Average RPE achieved was higher (p = 0.003) during BW-HIIE (16 ± 2) than RUN-HIIE (14 ± 2). PACES was similar for RUN-HIIE and BW-HIIE (p &gt; 0.05). No differences (p &gt; 0.05) in CK were observed between RUN-HIIE and BW-HIIE.

Conclusion

Our results indicate ‘all-out’ calisthenic exercise can elicit vigorous cardiorespiratory, Blac, and RPE responses. Implementing this style of exercise into training requires minimal space, no equipment, and may elicit cardiometabolic adaptations seen with traditional forms of high-intensity exercise.

State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions

For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.

The Use of Fitness-Fatigue Models for Sport Performance Modelling: Conceptual Issues and Contributions from Machine-Learning

The emergence of the first Fitness-Fatigue impulse responses models (FFMs) have allowed the sport science community to investigate relationships between the effects of training and performance. In the models, athletic performance is described by first order transfer functions which represent Fitness and Fatigue antagonistic responses to training. On this basis, the mathematical structure allows for a precise determination of optimal sequence of training doses that would enhance the greatest athletic performance, at a given time point. Despite several improvement of FFMs and still being widely used nowadays, their efficiency for describing as well as for predicting a sport performance remains mitigated. The main causes may be attributed to a simplification of physiological processes involved by exercise which the model relies on, as well as a univariate consideration of factors responsible for an athletic performance. In this context, machine-learning perspectives appear to be valuable for sport performance modelling purposes. Weaknesses of FFMs may be surpassed by embedding physiological representation of training effects into non-linear and multivariate learning algorithms. Thus, ensemble learning methods may benefit from a combination of individual responses based on physiological knowledge within supervised machine-learning algorithms for a better prediction of athletic performance.

In conclusion, the machine-learning approach is not an alternative to FFMs, but rather a way to take advantage of models based on physiological assumptions within powerful machine-learning models.

Molecular Mechanisms of Exercise and Healthspan

Healthspan is the period of our life without major debilitating diseases. In the modern world where unhealthy lifestyle choices and chronic diseases taper the healthspan, which lead to an enormous economic burden, finding ways to promote healthspan becomes a pressing goal of the scientific community. Exercise, one of humanity's most ancient and effective lifestyle interventions, appears to be at the center of the solution since it can both treat and prevent the occurrence of many chronic diseases. Here, we will review the current evidence and opinions about regular exercise promoting healthspan through enhancing the functionality of our organ systems and preventing diseases.

Comparison of the lymphocyte response to interval exercise versus continuous exercise in recreationally trained men

The purpose of this investigation was to compare changes in circulating lymphocyte subset cell counts between high-intensity interval exercise (HIIE), sprint interval exercise (SIE), and moderate-intensity continuous exercise (MICE). Recreationally active men (n ​= ​11; age: 23 ​± ​4 ​yr; height: 179.9 ​± ​4.5 ​cm; body mass: 79.8 ​± ​8.7 ​kg; body fat %:12.6 ​± ​3.8%; V̇O2max: 46.6 ​± ​3.9 ​ml⋅kg-1⋅min-1) completed a maximal graded exercise test to determine maximal oxygen uptake (V̇O2max) and three duration-matched cycling trials (HIIE, SIE, and MICE) in a randomized, counterbalanced fashion. HIIE consisted of fifteen 90-s bouts at 85% V̇O2max interspersed with 90-s active recovery periods. SIE consisted of fifteen 20-s bouts at 130% maximal power and 160-s active recovery periods. MICE was a continuous bout at 65% V̇O2max. Total exercise duration was 53 ​min in all three trials, including warm-up and cool-down. Blood was collected before, immediately post, 30 ​min, 2 ​h, 6 ​h, and 24 ​h post-exercise. Changes in lymphocyte subset counts, and surface expression of various markers were analyzed via flow cytometry. Changes were assessed using mixed model regression analysis with an autoregressive first order repeated measures correction. Significant decreases were observed in absolute counts of CD56dim NK cells, CD19+ B cells, CD4+ T cells, and CD8+ T cells 30 ​min and 24-h post-exercise in all three trials. Despite resulting in greater total work and oxygen consumption, MICE elicited similar changes in lymphocyte subset counts and receptor expression compared to both SIE and HIIE. Similarly, while the two interval trials resulted in differing oxygen consumption and total work, no differences in the lymphocyte response were observed. Though both forms of exercise resulted in declines in circulating lymphocyte cell counts, neither exercise type provides an immune-related advantage when matched for duration.

Relationships Between Maximal Aerobic Speed, Lactate Threshold, and Double Poling Velocity at Lactate Threshold in Cross-Country Skiers

Purpose

To investigate the relationships between maximal aerobic speed (MAS), lactate threshold in per cent of peak oxygen uptake (LT) and velocity at LT (LT_v) in cross-country skiers. Secondly, we aimed to explore the fit of an equation previously used in cyclists and runners in a cohort of well-trained, competitive cross-country skiers for calculation of LT_v. Thirdly, we aimed to investigate if a new LT_v could still be calculated after a period of regular training only by providing a new MAS.

Methods

Ninety-five competitive cross-country skiers (65 males and 30 females) were tested for maximal oxygen uptake (VO_2max), peak oxygen uptake in double poling (DP-VO_2peak), oxygen cost of double poling (C_DP), LT, and LT_v. Thirty-five skiers volunteered to be tested 3 months later to evaluate potential changes in LT and LT_v.

Results

Velocity at LT was mainly determined by MAS (r = 0.88, p < 0.01). LT did not show a significant impact on LT_v. The product of MAS·LT precisely predicted LT_v at baseline (r = 0.99, SEE = 2.4%), and by only measuring MAS, a new LT_v could be accurately calculated (r = 0.92, SEE = 6.8%) 3 months later in a sub-set of the initial 95 skiers (n = 35).

Conclusion

The results suggest that LT has minor impact on LT_v in DP tested in a laboratory. LT_v seemed to be predominantly determined by MAS, and we suggest to put more focus on MAS and less on LT and LT_v in regular testing to evaluate aerobic performance capacity in DP.

Modification in Psychophysiological Stress Parameters of Soldiers after an Integral Operative Training Prior to a Real Mission

(1) Background. Military personel could be defined as “Tactical Athletes”. However, experimental evidence about the effects of new HIIT trainings in comparison with traditional training schedules is lacking. The aim of this study was to experimentally analyze the modifications on psycho-physiological and performance response of soldiers after completing experimental integral operative training. (2) Methods. A total of 43 male subjects of a special unit force of the Spanish armed forces were randomly selected and assigned into the experimental and control groups assessed after training and after deploying in a real operation area. The experimental group underwent an integral operative pre-mission 6-week training (IOT), and the control group, the 6-week traditional training. (3) Results. HIIT-based integral operative training significantly improved combat performance (melee combat score) and the psychophysiological stress response, as measured by heart rate variability indexes. (4) Conclusion. This study provides experimental evidence supporting a new integral operative effective for improved autonomic regulation, reduced perceived stress, melee and close-quarter combat techniques, in addition to aerobic and anaerobic performance and lower body strength in comparison with the traditional training.

Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial

Background

Aerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity.

Methods

This was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM).

Results

73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6–21) points and 11 (95% CI 5–17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups.

Conclusions

Patients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity.

Trials registration

Regional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01940-y.

How Do the Effects of an 8-Week Intervention Influence Subsequent Performance Development in Cross-Country Skiers?

PURPOSE

To investigate how the effects of increased low- versus high-intensity endurance training in an 8-week intervention influenced the subsequent development of performance and physiological indices in cross-country skiers.

METHODS

Forty-four (32 men and 12 women) junior cross-country skiers were randomly assigned into a low-intensity training group (LITG, n = 20) or high-intensity training group (HITG, n = 24) for an 8-week intervention followed by 5 weeks of standardized training with similar intensity distribution, and thereafter 14 weeks of self-chosen training. Performance and physiological indices in running and in roller-ski skating were determined preintervention, after the intervention, and after the standardized training period. Roller-ski skating was also tested after the period of self-chosen training.

RESULTS

No between-groups changes from preintervention to after the standardized training period were found in peak speed when incremental running and roller-ski skating (P = .83 and .51), although performance in both modes was improved in the LITG (2.4% [4.6%] and 3.3% [3.3%], P < .05) and in roller-ski skating for HITG (2.6% [3.1%], P < .01). While improvements in maximal oxygen consumption running and peak oxygen uptake roller-ski skating were greater in HITG than in LITG from preintervention to after the intervention, no between-groups differences were found from preintervention to after the standardized training period (P = .50 and .46), although peak oxygen uptake in roller-ski skating significantly improved in HITG (5.7% [7.0%], P < .01). No changes either within or between groups were found after the period of self-chosen training.

CONCLUSIONS

Differences in adaptations elicited by a short-term intervention focusing on low- versus high-intensity endurance training had little or no effect on the subsequent development of performance or physiological indices following a period of standardized training in cross-country skiers.

Transferability of Cardiopulmonary Parameters between Treadmill and Cycle Ergometer Testing in Male Triathletes—Prediction Formulae

Cardiopulmonary exercise testing (CPET) on a treadmill (TE) or cycle ergometry (CE) is a common method in sports diagnostics to assess athletes’ aerobic fitness and prescribe training. In a triathlon, the gold standard is performing both CE and TE CPET. The purpose of this research was to create models using CPET results from one modality to predict results for the other modality. A total of 152 male triathletes (age = 38.20 ± 9.53 year; BMI = 23.97 ± 2.10 kg·m⁻²) underwent CPET on TE and CE, preceded by body composition (BC) analysis. Speed, power, heart rate (HR), oxygen uptake (VO₂), respiratory exchange ratio (RER), ventilation (VE), respiratory frequency (fR), blood lactate concentration (LA) (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured. Random forests (RF) were used to find the variables with the highest importance, which were selected for multiple linear regression (MLR) models. Based on R² and RF variable selection, MLR equations in full, simplified, and the most simplified forms were created for VO_2AT, HR_AT, VO_2RCP, HR_RCP, VO_2max, and HR_max for CE (R² = 0.46–0.78) and TE (R² = 0.59–0.80). By inputting only HR and power/speed into the RF, MLR models for practical HR calculation on TE and CE (both R² = 0.41–0.75) were created. BC had a significant impact on the majority of CPET parameters. CPET parameters can be accurately predicted between CE and TE testing. Maximal parameters are more predictable than submaximal. Only HR and speed/power from one testing modality could be used to predict HR for another. Created equations, combined with BC analysis, could be used as a method of choice in comprehensive sports diagnostics.

No Change in Inhibitory Control or P3 Following Different High-Intensity Interval Exercise Modalities

Acute aerobic high-intensity interval exercise (HIIE) has demonstrated positive effects on inhibitory control and P3 event-related potential (ERP) in young adults. However, the evidence is not well established regarding the effects of different HIIE modalities that incorporate aerobic-resistance training on these cognitive and neurocognitive outcomes. The purpose of this investigation was to examine the transient effects of HIIE-aerobic and HIIE-aerobic/resistance on P3 and Flanker task performance. Participants (n = 24; 18–25 years old) completed the Flanker task at two time points (30 min and 85 min) following 9 min of HIIE-aerobic (intermittent bouts of walking and running at 90% of maximal heart rate), HIIE-aerobic/resistance (intermittent bouts of walking and high-intensity calisthenics), and seated rest on three separate counterbalanced days. Results revealed no changes in Flanker performance (i.e., reaction time and response accuracy) or P3 (latency and mean amplitude) following either HIIE conditions compared to seated rest. Together, these data suggest inhibitory control and neuroelectric underpinnings are not affected by different modalities of HIIE at 30 min and 85 min post-exercise. Such findings reveal that engaging in short bouts of different HIIE modalities for overall health neither improves nor diminishes inhibitory control and brain function for an extended period throughout the day.

Adherence, Efficacy, and Safety of Wearable Technology-Assisted Combined Home-Based Exercise in Chinese Patients With Ankylosing Spondylitis: Randomized Pilot Controlled Clinical Trial

Background

Clinical practice guidelines recommend that exercise is essential in the self-management of ankylosing spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be difficult and patients may decline participation, whereas effective home-based exercise interventions that do not require regular medical center visits are likely to be more accessible for AS patients.

Objective

The goal of the research was to investigate the adherence, efficacy, and safety of a wearable technology–assisted combined home-based exercise program in AS.

Methods

This was a 16-week investigator-initiated, assessor-blinded, randomized, pilot controlled trial conducted at Chinese People’s Liberation Army General Hospital. We enrolled patients with AS who had no regular exercise habits and had been stable in drug treatment for the preceding month. Patients were randomly assigned (1:1) using a computer algorithm. An exercise program consisting of moderate-intensity aerobic exercise and functional exercise was given to the patients in the intervention group. The exercise intensity was controlled by a Mio FUSE Heart Rate Monitor wristband, which uses photoplethysmography to measure heart rate. Patients in the control group received usual care. The primary outcome was the difference in the Ankylosing Spondylitis Disease Activity Score (ASDAS). The secondary outcomes were patient global assessment (PGA), physician global assessment (PhGA), total pain, nocturnal pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BAS Functional Index (BASFI), BAS Metrology Index (BASMI), Spondyloarthritis International Society Health Index (ASAS HI), 36-item Short Form Survey (SF-36), maximal oxygen uptake (VO₂) max, body composition, range of motion of joints, and muscle endurance tests. Retention rate, adherence rate, barriers to being active, and adverse events were also assessed.

Results

A total of 77 patients were screened, of whom 55 (71%) patients were enrolled; 2% (1/55) withdrew without treatment after randomization. Patients were assigned to the intervention (n=26) or control group (n=28). The median adherence rate of the prescribed exercise protocol was 84.2% (IQR 48.7%-97.9%). For the primary outcome, between-group difference of ASDAS was significant, favoring the intervention (–0.2, 95% CI –0.4 to 0.02, P=.03). For the secondary outcomes, significant between-group differences at 16 weeks were detected in PGA, PhGA, total pain, BASDAI, BASDAI-fatigue, BASDAI–spinal pain, BASDAI–morning stiffness intensity, BASFI, and BASMI. Moreover, the frequency of difficulty in ASAS HI-motivation at 16 weeks was less in the intervention group (P=.03). Between-group difference for change from baseline were also detected in VO₂ max, SF-36, back extensor endurance test, and the range of motion of cervical lateral flexion at 16 weeks. Lack of time, energy, and willpower were the most distinct barriers to being active. Incidences of adverse events were similar between groups (P=.11).

Conclusions

Our pilot study suggests that this technology-assisted combined home-based exercise program can improve the clinical outcomes of patients with AS who have no exercise habit, with good adherence and safety profile.

Trial Registration

Chinese Clinical Trial Registry ChiCTR1900024244; http://www.chictr.org.cn/showproj.aspx?proj=40176

Effect of Interval Training on the Factors Influencing Maximal Oxygen Consumption: A Systematic Review and Meta-Analysis

BACKGROUND

The maximal rate of oxygen consumption (VO_2max) is an important measure in exercise science as it is an indicator of cardiorespiratory fitness. Individual studies have identified central and peripheral adaptions to interval training that may underlie improvements in VO_2max, but there is no compilation of results.

OBJECTIVE

We aimed to systematically review the adaptive responses to high-intensity interval training (HIIT) and sprint interval training (SIT) on the central and peripheral factors influencing VO_2max in healthy individuals.

DATA SOURCES

SPORTDiscus and MEDLINE (up to and including 13 June, 2020) were explored to conduct the literature search.

STUDY SELECTION

Reviewed studies met the following criteria: (1) were in the English language; (2) prospective in nature; (3) included at least three interval sessions or were at least 1 week in duration; (4) contained HIIT or SIT; (5) involved participants between the ages of 18 and 65 years; and (6) included at least one of the following central (blood volume, plasma volume, hemoglobin mass, left ventricular mass, maximal stroke volume, maximal cardiac output) or peripheral factors (capillary density, maximal citrate synthase activity, mitochondrial respiration associated with VO_2max).

RESULTS

Thirty-two studies (369 participants, 49 were female) were included in the quantitative analyses, consisting of both HIIT (n = 18) and SIT (n = 17) interventions. There were only statistically significant changes in hematological measures (plasma volume) following HIIT. There was a significant increase in left ventricular mass following HIIT (7.4%, p < 0.001) and SIT (5.3%, p = 0.007) in inactive individuals, though the change following SIT may be misleading. There was only a significant increase in maximal stroke volume (14.1%, p = 0.015) and maximal cardiac output (12.6%, p = 0.002) following HIIT. In addition to central factors, there was a significant increase in capillary density (13.8%, p < 0.001) following SIT in active individuals. With respect to maximal citrate synthase activity, there were improvements following HIIT (20.8%, p < 0.001) and SIT (15.7%, p < 0.001, I² = 97%) in active individuals. The results for mitochondrial respiration suggested that there was no statistically significant improvement following HIIT (5.0%, p = 0.585).

CONCLUSIONS

Improvements in the central and peripheral factors influencing VO_2max were dependent on the interval type. Only HIIT led to a statistically significant improvement in cardiac function. Both HIIT and SIT increased maximal citrate synthase activity, while changes in other peripheral measures (capillary density, mitochondrial respiration) only occurred with SIT.

Effects of different exercise programs on cardiorespiratory fitness and body composition in college students

Objective

The cardiorespiratory fitness (CRF) of college students is showing a downward trend, this study aimed to explore the effects of three exercise programs on CRF and body composition indicators in college students.

Methods

A total of 50 non-smoking, healthy and physically inactive students were recruited from campus in Beijing, China, and randomly assigned to 4 groups: low-intensity continuous training with blood flow restriction (LICT-BFR, n = 13), moderate-intensity continuous training (MICT, n = 13), high-intensity interval training (HIIT, n = 12), and no exercise control (n = 12), the intervention continued for 8 weeks. Body composition and aerobic capacity were measured before and after the intervention.

Results

Exercise groups reached significant improvements in maximal oxygen uptake (VO₂max, p < 0.01) and a decrease in body fat percentage (p < 0.05) comparing to the control group. The fat mass and visceral fat area reduced significantly (p < 0.05) with a muscle mass growth (p < 0.05) in the LICT-BFR and MICT groups comparing to the control group. Changes of fat and muscle mass were trivial in the HIIT group (p = 0.842, p = 0.247).

Conclusion

All three exercise programs can improve the CRF of college students, with LICT-BFR has the most profound effects, and MICT is more beneficial for body composition improvement than other programs. From an overall perspective, LICT-BFR should be the ideal choice, however, due to limited equipment, college students can choose MICT or HIIT according to their situations.

High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO2max: A randomized controlled trial

INTRODUCTION

High-intensity interval training (HIIT) may improve cardiorespiratory fitness (CRF) and mental health. The current observer-blinded RCT investigates the sparsely studied efficiency of HIIT in reducing psychotic and non-psychotic symptoms in schizophrenia and complements previous studies by investigating whether symptom reduction following HIIT is associated with, putatively partly mediated by, increased VO₂max.

METHODS

Participants (outpatients meeting diagnostic criteria for schizophrenia) were randomized to HIIT (n = 43) or a comparison group performing low-intensity active video gaming (AVG) to control for social interaction (n = 39). Both interventions consisted of two supervised sessions/week for 12 weeks and a 4 months follow-up. Effects on overall symptoms and symptom domains [PANSS (0-6 scale), five-factor model] were estimated using mixed-effects models (intention-to-treat, n = 82). Underlying mechanisms were analyzed using moderated mediation analyses (n = 66). We anticipated that HIIT would reduce overall symptoms, particularly depressive symptoms, more than AVG, and symptom reduction would be associated with, putatively mediated through, improved VO₂max.

RESULTS

Depressive symptoms (baseline score 3.97, 95% CI: 3.41, 4.52), were -1.03 points more reduced in HIIT than AVG at post-intervention (95% CI: -1.71, -0.35, p = 0.003), corresponding to a small to moderate effect size (d = 0.37) and persisting at follow-up. There was a small reduction in overall symptoms, but no significant between-group differences were observed. Change in VO₂max correlated negatively with the change in depressive symptoms. Mediation analysis showed a significant effect of change in VO₂max on change in depressive symptoms within HIIT. The total effect was moderated by group, and depressive symptoms were more reduced in HIIT. Direct effects, not mediated through VO₂max, were non-significant. Indirect effects, mediated through VO₂max, were non-significant, but the moderated mediation test indicated a non-significant trend of 0.4 points (95% CI: -1.188, 0.087) and a larger reduction in depressive symptoms through VO₂max in HIIT.

CONCLUSION

HIIT reduced depressive symptoms more than AVG, which persisted at follow-up. HIIT may serve as a complementing treatment option targeting these symptoms in individuals with schizophrenia, even before they reach clinical depression. Depressive symptoms are important to prevent, stabilize, and treat due to their negative implications for psychological wellbeing and long-term functional outcome. Reduction in depressive symptoms was associated with improved VO₂max, and non-significant trends in the data supported that improved VO₂max may be part of the complex mechanisms underlying the anti-depressive effect of HIIT.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [NCT02205684].

Acute Effects of Strength and Endurance Training on Bone Turnover Markers in Young Adults and Elderly Men

CONTEXT

Exercise is recognized as an important strategy to prevent bone loss, but its acute effects on bone turnover markers (BTMs) and related markers remain uncertain.

OBJECTIVE

To assess the acute effects of two different exercise modes on BTMs and related markers in young adults of both sexes and elderly men.

DESIGN SETTING PARTICIPANTS

This was a three-group crossover within-subjects design study with a total of 53 participants-19 young women (aged 22-30), 20 young men (aged 21-30 years), and 14 elderly men (aged 63-74 years)-performing two different exercise sessions [strength training (ST) and high-intensity interval training (HIIT)] separated by 2 weeks, in a supervised laboratory setting.

MAIN OUTCOME MEASURES

Plasma volume-corrected serum measurements of the BTMs C-terminal telopeptide of type 1 collagen (CTX-I) and procollagen of type 1 N-terminal propeptide (P1NP), total osteocalcin (OC), sclerostin, and lipocalin-2 (LCN2) at baseline, immediately after, and 3 and 24 h after each of the two exercise modes were performed.

RESULTS AND CONCLUSION

Analyses revealed sex- and age-dependent differences in BTMs and related bone markers at baseline and time-, sex-, and age-dependent differences in response to exercise. No differences between exercise modes were observed for BTM response except for sclerostin in young men and LCN2 in elderly men. An acute, transient, and uniform increase in P1NP/CTX-1 ratio was found in young participants, demonstrating that beneficial skeletal effects on bone metabolism can be attained through both aerobic endurance and resistance exercise, although this effect seems to be attenuated with age. The acute effects of exercise on bone-related biomarkers were generally blunted after 24 h, suggesting that persistent alterations following prolonged exercise interventions should be assessed at later time points.

Effects of self-paced high-intensity interval training and moderate-intensity continuous training on the physical performance and psychophysiological responses in recreationally active young adults

This study aimed to compare the effects of 8-week self-paced high-intensity interval training (HIIT) vs. self-paced moderate-intensity continuous training (MICT) on the physical performance and psychophysiological responses of young adults. Twenty-eight recreationally active young adults (age: 21.1 ± 1.6 years) were randomly assigned to either the self-paced HIIT (n = 14) or the MICT (n = 14) group training protocol. The HIIT consisted of two 12-24 x 30 seconds of high-intensity runs interspersed by 30 seconds of recovery. The MICT completed 24-48 minutes of continuous running. Before and after the 8-week interventions the following tests were completed: maximum oxygen consumption (V̇O_2max) estimated from the Yo-Yo Intermittent Recovery Test level 1 (YYIRTL-1), repeated sprint ability (RSA), 10-30-m sprint test, change of direction test (T-drill), countermovement jump (CMJ) and squat jump (SJ), and triple hop distance test (THD). Training rating of perceived exertion (RPE) and physical activity enjoyment scale (PACES) were assessed during the training programme. The HIIT resulted in greater improvement in YYIRTL-1, V̇O_2max, RSA and T-drill performances compared to the MICT. Furthermore, RPE and PACES values were higher in the HIIT than the MICT. This study suggested that self-paced HIIT may be a more effective training regime to improve aerobic fitness with greater physical enjoyment in recreationally active young adults.

HIIT vs. SIT: What Is the Better to Improve V˙O2max? A Systematic Review and Meta-Analysis

Lack of time is seen as a barrier to maintaining a physically active lifestyle. In this sense, interval training has been suggested as a time-efficient strategy for improving health, mainly due to its potential to increase cardiorespiratory fitness. Currently, the most discussed interval training protocols in the literature are the high-intensity interval training (HIIT) and the sprint interval training (SIT). Objective: We investigated, through a systematic review and meta-analysis, which interval training protocol, HIIT or SIT, promotes greater gain in cardiorespiratory fitness (V˙O2max/peak). The studies were selected from the PubMed (MEDLINE), Scopus and Web of Science databases. From these searches, a screening was carried out, selecting studies that compared the effects of HIIT and SIT protocols on V˙O2max/peak. A total of 19 studies were included in the final analysis. Due to the homogeneity between studies (I2 = 0%), fixed-effects analyses were performed. There was no significant difference in the V˙O2max/peak gains between HIIT and SIT for the standardized mean difference (SMD = 0.150; 95% CI = -0.038 to 0.338; p = 0.119), including studies that presented both measurements in mL·kg-1·min-1 and l·min-1; and raw mean differences (RMD = 0.921 mL·kg-1·min-1; 95% CI = -0.185 to 2.028; p = 0.103) were calculated only with data presented in mL·kg-1·min-1. We conclude that the literature generates very consistent data to confirm that HIIT and SIT protocols promote similar gains in cardiorespiratory fitness. Thus, for this purpose, the choice of the protocol can be made for convenience.

Training responsiveness of cardiorespiratory fitness and arterial stiffness following moderate-intensity continuous training and high-intensity interval training in adults with intellectual and developmental disabilities

BACKGROUND

Cardiorespiratory fitness (CRF) prompts antiatherogenic adaptations in vascular function and structure. However, there is an extraordinary interindividual variability in response to a standard dose of exercise, wherein a substantial number of adults with intellectual and developmental disabilities (IDD) do not improve CRF. We (1) evaluated the effects of 12-month of moderate-intensity continuous training (MICT) on CRF and arterial stiffness and (2) tested whether an additional 3-month of high-intensity interval training (HIIT) would add to improvements in CRF responsiveness and arterial stiffness.

METHODS

Fifteen adults with mild-to-moderate IDD (male adults = 9, 30.1 ± 7.5 years old) met 3 days per week for 30 min MICT for 12 months, after which the incidence of CRF responsiveness was calculated (≥5.0% change in absolute peak VO₂ ). Thereafter, responders and non-responders started HIIT for 3 months with identical daily training load/frequency. Peak VO₂ , local and regional indices of arterial stiffness were assessed prior to and after each period.

RESULTS

Sixty per cent of the participants were non-responders following MICT, but the incidence dropped to 20% following HIIT (P = 0.03). Absolute peak VO₂ values reached significant difference from pre-intervention (+0.38 ± 0.08 L min^-1 , P = 0.001) only when HIIT was added. Lower limb pulse wave velocity (PWV) decreased following MICT (-0.8 ± 1.1 m s^-1 , P = 0.049), whereas central PWV only decreased following HIIT (-0.8 ± 0.9 m s^-1 , P = 0.013).

CONCLUSIONS

Cardiorespiratory fitness responsiveness and reductions in PWV to a 12-month MICT period in adults with IDD improved following a period of HIIT programme inducing higher metabolic stress.

Superior On-Ice Performance After Short-Interval vs. Long-Interval Training in Well-Trained Adolescent Ice Hockey Players

ABSTRACT

Rønnestad, BR, Haugen, OC, and Dæhlin, TE. Superior on-ice performance after short-interval vs long-interval training in well-trained adolescent ice hockey players. J Strength Cond Res 35(12S): S76-S80, 2021-The purpose of this study was to compare the effects of 9 weeks with 3 weekly sessions of short intervals (SIs) against long intervals (LIs) on endurance performance in well-trained adolescent ice hockey players. Eighteen male adolescent ice hockey players volunteered to participate and were randomly allocated to perform SIs (n = 9; 3 series with 13 × 30 seconds work intervals) or LIs (n = 7; 4 series of 5 minutes work intervals). Subjects completed a skating multistage aerobic test (SMAT), maximal oxygen consumption, maximal power output, and maximal isokinetic knee-extensor strength tests before and after the intervention, and changes in performance were assessed using analysis of variance (p ≤ 0.05). Short intervals improved SMAT performance more from pretest to post-test than LIs (13.9 ± 8.1% vs. 3.7 ± 5.2%, respectively; p = 0.030, effect size [ES] = 1.48). No significant differences were observed between SIs and LIs in change of maximal oxygen uptake (SI: 3.8 ± 6.1% vs. LI: -0.4 ± 10.2%; p = 0.30) or 60 seconds maximal power output (SI: 1.0 ± 4.9% vs. LI: -3.7 ± 4.1%; p = 0.053). However, ESs were moderate (ES = 0.55) and large (ES = 1.07), respectively, in favor of SI for these dependent variables. There were no changes in isokinetic knee-extension strength (p > 0.05). The present SI protocol induced superior improvements in on-ice endurance performance compared with the LI protocol. Practitioners seeking to improve ice hockey players' on-ice endurance performance should consider including SI in their conditioning protocol.

Physiological profile comparison between high intensity functional training, endurance and power athletes

INTRODUCTION

High intensity functional trainings (HIFT), a recent development of high intensity trainings, includes in the same training session components of endurance exercises, elements of Olympic weightlifting and powerlifting, gymnastics, plyometrics and calisthenics exercises. Therefore, subjects practicing this type of activity are supposed to show physiological features that represent a combination of both endurance and power athletes. The aim of this study was to compare the physiological profile of three groups of age-matched endurance, HIFT and power athletes.

METHODS

A total of 30 participants, 18 to 38-year-old men were enrolled in the study. Participants were divided in three groups: HIFT (n = 10), endurance (END, n = 10), and power (POW, weightlifters, n = 10) athletes. All were evaluated for anthropometric characteristics, VO_2peak, handgrip, lower limb maximal isometric and isokinetic strength, countermovement vertical jump and anaerobic power through a shuttle run test on the field.

RESULTS

VO_2peak/kg was higher in END and HIFT than POW athletes (p = 0.001 and p = 0.007, respectively), but there were no significant differences between the first two. POW and HIFT athletes showed significant greater strength at the handgrip, countermovement jump and leg extension/flexion tests than END athletes. HIFT athletes showed highest results at the dynamic isokinetic test, while there were no significant differences at the shuttle run test among groups.

CONCLUSIONS

As HIFT reach aerobic levels similar to END athletes and power and strength output similar to POW athletes, it appears that HIFT programs are effective to improve both endurance-related and power-related physical fitness components.

Effect of Exercise on Brain Health: The Potential Role of Lactate as a Myokine

It has been well established in epidemiological studies and randomized controlled trials that habitual exercise is beneficial for brain health, such as cognition and mental health. Generally, it may be reasonable to say that the physiological benefits of acute exercise can prevent brain disorders in late life if such exercise is habitually/chronically conducted. However, the mechanisms of improvement in brain function via chronic exercise remain incompletely understood because such mechanisms are assumed to be multifactorial, such as the adaptation of repeated acute exercise. This review postulates that cerebral metabolism may be an important physiological factor that determines brain function. Among metabolites, the provision of lactate to meet elevated neural activity and regulate the cerebrovascular system and redox states in response to exercise may be responsible for exercise-enhanced brain health. Here, we summarize the current knowledge regarding the influence of exercise on brain health, particularly cognitive performance, with the underlying mechanisms by means of lactate. Regarding the influence of chronic exercise on brain function, the relevance of exercise intensity and modality, particularly high-intensity interval exercise, is acknowledged to induce “metabolic myokine” (i.e., lactate) for brain health.

Association of Innate and Acquired Aerobic Capacity With Resilience in Healthy Adults: Protocol for a Randomized Controlled Trial of an 8-Week Web-Based Physical Exercise Intervention

BACKGROUND

Physical activity alleviates chronic stress. The latest research suggests a relationship between resilience and physical fitness. Beneficial adaptations of the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, endocannabinoid system, and tryptophan pathway, which are induced by an active lifestyle, are considered to be conducive to resilience. However, detailed knowledge on the molecular link between the effects of acute and chronic physical exercise and improved resilience to stress in humans is missing. Moreover, the relationship between innate and acquired aerobic capacity and resilience is poorly understood.

OBJECTIVE

The aim of this study is to implement a human exercise intervention trial addressing the following main hypotheses: a high innate aerobic capacity is associated with high resilience to stress, and web-based physical exercise training improves aerobic capacity of physically inactive adults, which is accompanied by improved resilience. In this setting, we will analyze the relationship between resilience parameters and innate and acquired aerobic capacity as well as circulating signaling molecules.

METHODS

A total of 70 healthy, physically inactive (<150 minutes/week of physical activity) adults (aged 18-45 years) will be randomly assigned to an intervention or control group. Participants in the intervention group will receive weekly training using progressive endurance and interval running adapted individually to their remotely supervised home training performance via web-based coach support. A standardized incremental treadmill exercise test will be performed before and after the intervention period of 8 weeks to determine the innate and acquired aerobic capacity (peak oxygen uptake). Before and after the intervention, psychological tests and questionnaires that characterize parameters implicated in resilience will be applied. Blood and saliva will be sampled for the analysis of cortisol, lactate, endocannabinoids, catecholamines, kynurenic acid, and further circulating signal transducers. Statistical analysis will provide comprehensive knowledge on the relationship between aerobic capacity and resilience, as well as the capacity of peripheral factors to mediate the promoting effects of exercise on resilience.

RESULTS

The study was registered in October 2019, and enrollment began in September 2019. Of the 161 participants who were initially screened via a telephone survey, 43 (26.7%) fulfilled the inclusion criteria and were included in the study. Among the 55% (17/31) of participants in the intervention group and 45% (14/31) of participants in the control group who completed the study, no serious adverse incidents were reported. Of 43 participants, 4 (9%) withdrew during the program (for individual reasons) and 8 (19%) have not yet participated in the program; moreover, further study recruitment was paused for an indeterminate amount of time because of the COVID-19 pandemic.

CONCLUSIONS

Our study aims to further define the physiological characteristics of human resilience, and it may offer novel approaches for the prevention and therapy of mental disorders via an exercise prescription.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/29712.

High-intensity interval training in high-school physical education classes: Study protocol for a randomized controlled trial

Background

School and Physical Education classes (PEC) are privileged spaces, promoters of positive changes for the rest of life. High-Intensity Interval Training (HIIT) is presented as a time-efficient alternative to aerobic training, as it leverages the number of exercise participants, resulting in improvements in health outcomes. Despite the widespread interest in the advantages that the HIIT methodology reveals, there is a lack of randomized controlled studies investigating the impact on adolescents, mainly adressing adolescents’ environment, such as schools. This study aims to evaluate the utility of a HIIT program integrated into high-school PEC, as a strategy that allows students to improve their Physical Fitness, Physical Activity (PA) level, and Motivation for Exercise.

Methods

This study is a two-arm randomized controlled trial design with adolescents from the 10th to 12th grades (15–17 years). The trial will aim to recruit 300 students from 1 secondary school. The HIIT sessions will be applied in the first 10–15 min of each PEC, twice a week, for 16 weeks, ranged from 14 to 20 all-out bouts intervals, adopting a 2:1 work to rest ratio. A cut-point of ≥ 90% of maximal heart rate will be a criterion for satisfactory compliance to high-intensity exercise. A rated perceived exertion scale will be measured in each exercise session to estimate effort, fatigue, and training load. The control group will continue the usual programmed PEC. Study outcomes will be measured at baseline and after the HIIT program. Cardiorespiratory fitness is the primary outcome. Secondary outcomes include: muscular fitness, PA and motivation for exercise.

Discussion

HIIT protocols presents wide applicability in PEC and great adaptation to the facilities. The authors aim to provide novel HIIT protocols for schools.

Effect of Cycle-Based High-Intensity Interval Training and Moderate to Moderate-Intensity Continuous Training in Adolescent Soccer Players

Cardiorespiratory fitness, anaerobic power, and lower extremity strength are essential for soccer players at all levels. An effective program should be developed to improve physical strength for adolescent soccer players who need to combine academic and technical training. This study analyzed the impact of short-term high intensity interval training (HIIT) training and traditional moderate intensity continuous training (MICT) on adolescent soccer players. Participants included 56 adolescent soccer players who were divided into HIIT and MICT groups. The training program was conducted 3 times a week for 4 weeks using cycle ergometer. Each session included the same resistance training program, and the characteristics of HIIT and MICT were applied to improve cardiorespiratory fitness and anaerobic power. Body composition analysis, graded exercise test for peak oxygen uptake (VO₂ peak), Wingate anaerobic power test, and isokinetic knee strength test were performed. VO₂ peak was improved in HIIT and MICT, but anaerobic threshold and heart rate recovery significantly improved in the HIIT group. Wingate anaerobic peak power had increased significantly in sets 1, 2, and 3 in the HIIT group, but showed significant improvement only in set 1 in the MICT group. The isokinetic strength improved significantly in the HIIT group at 60°/s and in the MICT group at 240°/s. There was no significant change in body composition in either group. In conclusion, short-term HIIT administered to adolescent soccer players effectively improved cardiorespiratory fitness in HIIT and MICT groups. While HIIT increased anaerobic threshold and power, MICT effectively improved muscle endurance. Short-term intensive training can be considered a time-efficient training strategy.

Effect of high-intensity interval training protocols on VO2max and HbA1c level in people with type 2 diabetes: A systematic review and meta-analysis

BACKGROUND

The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM).

OBJECTIVE

This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VO₂max and glycated hemoglobin (HbA1c) level in patients with T2DM.

METHODS

The search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups.

RESULTS

A total of 20 studies (738 participants) were included. Overall, HIIT increased VO₂max by 5.09 mL/kg/min (95% CI 2.99; 7.19, I² = 80.89) versus the control and by 1.9 mL/kg/min (95% CI 0.81; 2.98, I² = 25.62) versus MICT. HIIT promoted a significant reduction in HbA1c level of -0.8% (95% CI -1.06; -0.49, I² = 77.31) versus the control but with no difference versus MICT. Moderate-interval, high-volume and long-term training promoted a greater increase in VO₂max. A long interval and moderate volume and period conferred a greater increase in VO₂max versus MICT. A short interval and moderate volume and period conferred a greater reduction in HbA1c level versus the control. No publication bias was detected, as evaluated by a funnel chart and Egger's test (p > 0.05).

CONCLUSIONS

As compared with MICT, HIIT had better effect on VO₂max and a similar effect on HbA1C level. Interval protocols, moderate to long training period and moderate to high volume may maximize the HIIT effect in patients with T2DM.

Central and Peripheral Oxygen Distribution in Two Different Modes of Interval Training

In high-intensity interval training the interval duration can be adjusted to optimize training results in oxygen uptake, cardiac output, and local oxygen supply. This study aimed to compare these variables in two interval trainings (long intervals HIIT3m: 3 min work, 3 min active rest vs. short intervals HIIT30s: 30 s work, 30 s active rest) at the same overall work rate and training duration. 24 participants accomplished both protocols, (work: 80% power output at VO₂peak, relief: 85% power output at gas exchange threshold) in randomized order. Spirometry, impedance cardiography, and near-infrared spectroscopy were used to analyze the physiological stress of the cardiopulmonary system and muscle tissue. Although times above gas exchange threshold were shorter in HIIT3m (HIIT3m 1669.9 ± 310.9 s vs. HIIT30s 1769.5 ± 189.0 s, p = 0.034), both protocols evoked similar average fractional utilization of VO₂peak (HIIT3m 65.23 ± 4.68% VO₂peak vs. HIIT30s 64.39 ± 6.78% VO₂peak, p = 0.261). However, HIIT3m resulted in higher cardiovascular responses during the loaded phases (VO₂p < 0.001, cardiac output p < 0.001). Local hemodynamics were not different between both protocols. Average physiological responses were not different in both protocols owning to incomplete rests in HIIT30s and large response amplitudes in HIIT3m. Despite lower acute cardiovascular stress in HIIT30s, short submaximal intervals may also trigger microvascular and metabolic adaptions similar to HIIT3m. Therefore, the adaption of interval duration is an important tool to adjust the goals of interval training to the needs of the athlete or patient.

Airflow restriction mask induces greater central fatigue after a non-exhaustive high-intensity interval exercise

The airflow restriction mask (ARM) is a practical and inexpensive device for respiratory muscle training. Wearing an ARM has recently been combined with high-intensity interval exercise (HIIE), but its effect on neuromuscular fatigue is unknown. The present study investigated the effects of ARM wearing on neuromuscular fatigue after an HIIE session. Fourteen healthy men performed two HIIE sessions (4x4min at 90% HRmax, 3min recovery at 70% HRmax) with or without an ARM. Neuromuscular fatigue was quantified via pre- to post-HIIE changes in maximal voluntary contraction (MVC), voluntary activation (VA, central fatigue), and potentialized evoked twitch force at 100, 10, and 1 Hz (peripheral fatigue). Blood pH and lactate were measured before and after the HIIE session, while HR, SpO₂ , dyspnea, physical sensation of effort (P-RPE), and Task Effort and Awareness (TEA) were recorded every bout. The exercise-induced decrease in MVC was higher (p<0.05) in the ARM (-28±12%) than in the control condition (-20±11%). The VA decreased (p<0.05) in the ARM (-11±9%) but not in the control condition (-4±5%, p>0.05). Pre- to post-HIIE declines in evoked twitch at 100, 10, and 1 Hz were similar (p>0.05) between ARM and control conditions (ARM: -18±10, -43±11 and -38±12%; Control: -18±14, -43±12 and -37±17%). When compared with the control, the HIIE bout wearing ARM was marked by higher heart rate, plasma lactate concentration, dyspnea, P-RPE and TEA, as well as lower SpO₂ and blood pH. In conclusion, ARM increases perceptual and physiological stress during a HIIE, which may lead to a greater post-exercise central fatigue.

Effects of High-Intensity Interval Training and Moderate-Intensity Continuous Training on Cardiometabolic Risk Factors in Overweight and Obesity Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials

Background: The purpose of this review was to compare the effectiveness of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiometabolic risk factors of obese children and adolescents. Methods: Relevant studies published in PubMed, MEDLINE and Web of Science databases were searched. Only randomized controlled trials (RCTs) that examined the effect of HIIT and MICT on children and adolescents with obesity were included. Meta-analyses were conducted to determine the effect of HIIT on cardiometabolic risk factors using STATA software and potential moderators were explored (i.e., study duration, training modalities, work/rest ratio and work duration time). Results: Twelve RCTs involving 325 participants were included in the meta-analysis. HIIT showed more positive effects on maximal oxygen uptake (VO_2max; SMD = 0.87, 95% CI: 0.39 to 1.35, p = 0.000) and systolic blood pressure (SBP; SMD = −0.64, 95% CI: −1.05 to −0.22, p = 0.003) than MICT. However, when compared with MICT, HIIT caused no significant differences in body weight, body mass index, body fat percentage, diastolic blood pressure and glycolipid metabolism markers. Furthermore, subgroup analysis showed that the effects of HIIT on VO_2max and SBP were significantly different regarding protocol factors, such as modality, duration, training time, training settings, work/rest ratio and work duration. Conclusions: HIIT has a positive role in promoting cardiometabolic risk factors in obese children and adolescents. Moreover, when compared with MICT, HIIT had a more significant effect on improving cardiorespiratory fitness and systolic blood pressure. The factors of HIIT protocol had an important influence on the intervention effects of childhood obesity.

Changes in white matter microstructure and MRI-derived cerebral blood flow after 1-week of exercise training

Exercise is beneficial for brain health, inducing neuroplasticity and vascular plasticity in the hippocampus, which is possibly mediated by brain-derived neurotrophic factor (BDNF) levels. Here we investigated the short-term effects of exercise, to determine if a 1-week intervention is sufficient to induce brain changes. Fifteen healthy young males completed five supervised exercise training sessions over seven days. This was preceded and followed by a multi-modal magnetic resonance imaging (MRI) scan (diffusion-weighted MRI, perfusion-weighted MRI, dual-calibrated functional MRI) acquired 1 week apart, and blood sampling for BDNF. A diffusion tractography analysis showed, after exercise, a significant reduction relative to baseline in restricted fraction-an axon-specific metric-in the corpus callosum, uncinate fasciculus, and parahippocampal cingulum. A voxel-based approach found an increase in fractional anisotropy and reduction in radial diffusivity symmetrically, in voxels predominantly localised in the corpus callosum. A selective increase in hippocampal blood flow was found following exercise, with no change in vascular reactivity. BDNF levels were not altered. Thus, we demonstrate that 1 week of exercise is sufficient to induce microstructural and vascular brain changes on a group level, independent of BDNF, providing new insight into the temporal dynamics of plasticity, necessary to exploit the therapeutic potential of exercise.

Interval Training with Different Intensities in Overweight/Obese Adolescent Females

To compare the effects of 12 weeks of high-intensity interval training (HIIT) versus moderate-intensity interval training (MIIT) on hematological and inflammatory markers in youth females, 38 overweight/obese females (16.4±1.0 yrs.) were randomly assigned to HIIT (2×6-8 repetitions of 30 s at 100-110% maximal aerobic speed (MAS), with 30 s active recovery between repetitions at 50% MAS; n=13), MIIT (2×6-8 repetitions of 30 s at 70-80% MAS, with 30 s active recovery between repetitions at 50% MAS; n=13), and a control group (CG, no intervention; n=12). Body composition, blood pressure, maximal heart rate, hematological and inflammatory markers (C-reactive protein [CRP], and erythrocyte sedimentation rate [ESR]) markers were assessed in all groups before and following the training program. Results revealed a significant (P<0.05) interaction effect for body composition, systolic blood pressure (SBP), MAS, maximal heart rate, and CRP. Within-group analyses for the HIIT and MIIT groups showed significant improvements in body mass (P=0.009 and P=0.025, respectively), BMI Z-score (P=0.011 and P=0.028, respectively), and MAS (P<0.001 and P=0.011, respectively). The HIIT program showed a significant decrease in body fat (P=0.002), waist circumference (P=0.002), maximal heart rate (P=0.003), SBP (P=0.001), and plasma CRP (P=0.004). In both groups, no significant changes were observed in ESR and hematological markers after intervention. No variable changed in CG. HIIT was the effective method to manage cardiometabolic health and inflammatory disorders in obese youth.

Effects of Taekwondo Training on Body Composition: A Systematic Review and Meta-Analysis

Background: The purpose of this study is to investigate the effect of Taekwondo training on body composition and to evaluate the magnitude of the effect. Methods: Databases were used to select studies related to the effectiveness of Taekwondo training, and the inclusion criteria were as follows. Results: Thirty-seven studies were selected. We found statistically significant differences from the control group in weight, body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR), body fat mass, body fat percentage, lean mass, and muscle mass. Also, the age group was statistically significant in control variables on weight, BMI, and body fat percentage. Conclusions: Taekwondo training had a positive effect on body composition, and these results suggest that Taekwondo training is an effective exercise method to lower obesity.

Acute Effects of Different Exercise Intensities on Executive Function and Oculomotor Performance in Middle-Aged and Older Adults: Moderate-Intensity Continuous Exercise vs. High-Intensity Interval Exercise

A wealth of evidence has shown that a single bout of aerobic exercise can facilitate executive function. However, none of current studies on this topic have addressed whether the magnitude of the acute-exercise benefit on executive function and oculomotor performance is influenced by different aerobic exercise modes. The present study was thus aimed toward an investigation of the acute effects of high-intensity interval exercise (HIIE) vs. moderate-intensity continuous exercise (MICE) on executive-related oculomotor performance in healthy late middle-aged and older adults. Using a within-subject design, twenty-two participants completed a single bout of 30 min of HIIE, MICE, or a non-exercise-intervention (REST) session in a counterbalanced order. The behavioral [e.g., reaction times (RTs), coefficient of variation (CV) of the RT], and oculomotor (e.g., saccade amplitude, saccade latency, and saccadic peak velocity) indices were measured when participants performed antisaccade and prosaccade tasks prior to and after an intervention mode. The results showed that a 30-min single-bout of HIIE and MICE interventions shortened the RTs in the antisaccade task, with the null effect on the CV of the RT in the late middle-aged and older adults. In terms of oculomotor metrics, although the two exercise modes could not modify the performance in terms of saccade amplitudes and saccade latencies, the participants’ saccadic peak velocities while performing the oculomotor paradigm were significantly altered only following an acute HIIE intervention. The present findings suggested that a 30-min single-bout of HIIE and MICE interventions modulated post-exercise antisaccade control on behavioral performance (e.g., RTs). Nevertheless, the HIIE relative MICE mode appears to be a more effective aerobic exercise in terms of oculomotor control (e.g., saccadic peak velocities) in late middle-aged and older adults.

Smartphone-Assisted High-Intensity Interval Training in Inflammatory Rheumatic Disease Patients: Randomized Controlled Trial

BACKGROUND

Patients with inflammatory rheumatic diseases (IRDs) experience disease-related barriers to physical training. Compared with the general population, IRD patients are reported to have reduced maximal oxygen uptake (VO2max) and physical activity levels. Supervised high-intensity interval training (HIIT) is documented to counteract the reduced VO2max and poor cardiovascular health associated with IRDs. However, supervised HIIT is resource demanding.

OBJECTIVE

This study sought to investigate if self-administered 4×4-min HIIT guided by a smartphone app (Myworkout GO) could yield similar HIIT-induced effects as standard 4×4-min HIIT performed under the guidance and supervision of health care professionals. The effects studied were on VO2max and health-related quality of life (HRQoL).

METHODS

Forty patients (33 female patients, mean age 48 years, SD 12 years; 7 male patients, mean age 52 years, SD 11 years) diagnosed with rheumatoid arthritis, spondyloarthritis, or systemic lupus erythematosus were randomized to a supervised group (SG) or an app group (AG). Both groups were instructed to perform 4×4-min intervals with a rate of perceived exertion of 16 to 17, corresponding to 85% to 95% of the maximal heart rate, twice a week for 10 weeks. Treadmill VO2max and HRQoL measured using RAND-36 were assessed before and after the exercise period.

RESULTS

VO2max increased (P<.001) in both groups after 10 weeks of HIIT, with improvements of 3.6 (SD 1.3) mL/kg/min in the SG and 3.7 (SD 1.5) mL/kg/min in the AG. This was accompanied by increases in oxygen pulse in both groups (P<.001), with no between-group differences apparent for either measure. Improvements in the HRQoL dimensions of bodily pain, vitality, and social functioning were observed for both groups (P<.001 to P=.04). Again, no between-group differences were detected.

CONCLUSIONS

High-intensity 4×4-min interval training increased VO2max and HRQoL, contributing to patients' reduced cardiovascular disease risk, improved health and performance, and enhanced quality of life. Similar improvements were observed following HIIT when IRD patients were guided using perceived exertion by health care professionals or the training was self-administered and guided by the app Myworkout GO. Utilization of the app may help reduce the cost of HIIT as a treatment strategy in this patient population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04649528; https://clinicaltrials.gov/ct2/show/NCT04649528.

Health-related physical fitness in patients with complaints of hand, wrist, forearm and elbow: an exploratory study

Objectives

Little is known about the physical fitness of patients with complaints of hand, wrist, forearm and/or elbow and its possible determinants. Aims were to assess health-related physical fitness (HRPF) in these patients, to compare HRPF with reference values of healthy persons, and to explore whether HRPF was correlated with symptom severity, upper limb function (ULF) and physical activity (PA).

Methods

Cardiorespiratory fitness, handgrip strength and body composition, self-reported symptom severity, ULF and PA were assessed in adult outpatients with complaints of hand, wrist, forearm and/or elbow diagnosed as CANS.

Results

Measurements were completed in 25 subjects (8 males) aged 46.1±14.5 years, of which 44% had specific CANS and 56% had non-specific CANS.

Peak oxygen consumption (VO₂peak) of men was 2978±983 mL/min and of women was 1978±265 mL/min. Handgrip strength of men was 47.0±11.1 kgf and of women was 32.4±6.3 kgf. Body mass index (BMI) of men was 24.2±2.6 kg/m² and of women was 27.4±6.1 kg/m².

VO₂peak of the study sample was lower than that of healthy adults (−414±510 mL/min, p<0.001). Handgrip strength and BMI were similar to reference values.

VO₂peak was correlated with PA (r=0.58, p=0.004); BMI was correlated with disability (r=0.48, p=0.022). Other correlations between HRPF and symptom severity and ULF were non-significant.

Conclusions

Patients with CANS have lower cardiorespiratory fitness, but similar handgrip strength and body composition, compared with the healthy population. Cardiorespiratory fitness was correlated with PA and BMI was correlated with disability, no other correlations were observed with symptom severity and ULF.

Effects of Increased Load of Low- Versus High-Intensity Endurance Training on Performance and Physiological Adaptations in Endurance Athletes

PURPOSE

To compare the effects of increased load of low- versus high-intensity endurance training on performance and physiological adaptations in well-trained endurance athletes.

METHODS

Following an 8-week preintervention period, 51 (36 men and 15 women) junior cross-country skiers and biathletes were randomly allocated into a low-intensity (LIG, n = 26) or high-intensity training group (HIG, n = 25) for an 8-week intervention period, load balanced using the overall training impulse score. Both groups performed an uphill running time trial and were assessed for laboratory performance and physiological profiling in treadmill running and roller-ski skating preintervention and postintervention.

RESULTS

Preintervention to postintervention changes in running time trial did not differ between groups (P = .44), with significant improvements in HIG (-2.3% [3.2%], P = .01) but not in LIG (-1.5% [2.9%], P = .20). There were no differences between groups in peak speed changes when incremental running and roller-ski skating to exhaustion (P = .30 and P = .20, respectively), with both modes being significantly improved in HIG (2.2% [3.1%] and 2.5% [3.4%], both P < .01) and in roller-ski skating for LIG (1.5% [2.4%], P < .01). There was a between-group difference in running maximal oxygen uptake changes (P = .04), tending to improve in HIG (3.0% [6.4%], P = .09) but not in LIG (-0.7% [4.6%], P = .25). Changes in roller-ski skating peak oxygen uptake differed between groups (P = .02), with significant improvements in HIG (3.6% [5.4%], P = .01) but not in LIG (-0.1% [0.17%], P = .62).

CONCLUSION

There was no significant difference in performance adaptations between increased load of low- versus high-intensity training in well-trained endurance athletes, although both methods improved performance. However, increased load of high-intensity training elicited better maximal oxygen uptake adaptations compared to increased load of low-intensity training.

Relationship Between the 20-m Multistage Fitness Test and 2.4-km Run in Law Enforcement Recruits

ABSTRACT

Lockie, RG, Dawes, JJ, Moreno, MR, Cesario, KA, Balfany, K, Stierli, M, Dulla, JM, and Orr, RM. Relationship between the 20-m multistage fitness test and 2.4-km run in law enforcement recruits. J Strength Cond Res 35(10): 2756-2761, 2021-In the United States, the 2.4-km run is arguably the most common law enforcement aerobic assessment. Potential limitations are that recruits use an internal pacing strategy, the test requires fewer direction changes, and less-fit recruits run for longer. The 20-m multistage fitness test (20MSFT) is commonly used internationally to assess aerobic fitness in law enforcement recruits and provides an external pacing strategy. This study documented sex differences between the 2.4-km run and 20MSFT in law enforcement recruits, and between-test relationships. Retrospective analysis on 8 academy classes (463 men and 87 women) from 1 agency was conducted. The 20MSFT was completed before academy and the 2.4-km run in the first week. Between-sex comparisons in the 2.4-km run and 20MSFT were conducted with independent-samples t-tests and effect sizes. Estimated V̇o2max from the tests was compared with paired-samples t-tests. Correlations and linear regression calculated 2.4-km run and 20MSFT relationships. There were significant between-sex differences for the 2.4-km run and 20MSFT (p < 0.01), with moderate (d = 0.9) and small (d = 0.4) effects, respectively. Estimated 2.4-km run V̇o2max was greater than that from the 20MSFT (p < 0.01). The 2.4-km run had significant relationships with the 20MSFT (r = -0.6), although the regression equations were low (r2 = 0.30-0.37). Between-sex differences in the 20MSFT seemed less than for those in the 2.4-km run. Nonetheless, even with significant relationships between the tests, the 20MSFT induces a higher running intensity and direction changes. This may limit transferability with the 2.4-km run in law enforcement recruits.