Aerobic high-intensity intervals improve VO2max more than moderate training

Playing around the anaerobic threshold during COVID-19 pandemic: advantages and disadvantages of adding bouts of anaerobic work to aerobic activity in physical treatment of individuals with obesity

INTRODUCTION

Obesity is a condition that generally limits work capacity and predisposes to a number of comorbidities and related diseases, the last being COVID-19 and its complications and sequelae. Physical exercise, together with diet, is a milestone in its management and rehabilitation, although there is still a debate on intensity and duration of training. Anaerobic threshold (AT) is a broad term often used either as ventilatory threshold or as lactate threshold, respectively, detected by respiratory ventilation and/or respiratory gases (VCO₂ and VO₂), and by blood lactic acid.

AIMS AND METHODOLOGY

This review outlines the role of AT and of the different variations of growth hormone and catecholamine, in subjects with obesity vs normal weight individuals below and beyond AT, during a progressive increase in exercise training. We present a re-evaluation of the effects of physical activity on body mass and metabolism of individuals with obesity in light of potential benefits and pitfalls during COVID-19 pandemic. Comparison of a training program at moderate-intensity exercise (< AT) with training performed at moderate intensity (< AT) plus a final bout of high-intensity (> AT) exercise at the end of the aerobic session will be discussed.

RESULTS

Based on our data and considerations, a tailored strategy for individuals with obesity concerning the most appropriate intensity of training in the context of rehabilitation is proposed, with special regard to potential benefits of work program above AT.

CONCLUSION

Adding bouts of exercise above AT may improve lactic acid and H⁺ disposal and improve growth hormone. Long-term aerobic exercise may improve leptin reduction. In this way, the propensity of subjects with obesity to encounter a serious prognosis of COVID-19 may be counteracted and the systemic and cardiorespiratory sequelae that may ensue after COVID-19, can be overcome. Individuals with serious comorbidities associated with obesity should avoid excessive exercise intensity.

High-Intensity Interval Training for Knee Osteoarthritis: A Pilot Study

OBJECTIVE

To assess the feasibility and changes in outcomes of a 12-week high-intensity interval training (HIIT) program in individuals with symptomatic knee osteoarthritis (OA).

METHODS

The single-arm trial included 29 participants (mean ± SD age 63 ± 7 years; 66% women; 66% obese). Measures of participant flow, adherence, and tolerability were collected. Pain, function, and balance were assessed at baseline, 6 weeks, and 12 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index, 20-m fast-paced walk test, 30-second chair-stand test, stair-climb test, timed up and go test, and single leg stance. Cardiorespiratory fitness, strength, and body composition were evaluated using peak oxygen consumption (VO2 peak), isometric knee extensor/flexor strength, and dual-energy x-ray absorptiometry, respectively. HIIT was completed two times/week (cycling or treadmill) and consisted of 10 repetitions of 1-minute bouts at 90% VO2 peak, with 1-minute rest periods. Separate multivariable-adjusted linear mixed models were fit for each outcome with fixed effects of time, age, sex, body mass index, and random effects of baseline values to estimate mean changes and 95% confidence intervals (CIs) between baseline and 12-week assessments.

RESULTS

Recruitment aligned with the anticipated enrollment rate, adherence was 70%, and no adverse events were reported. At 12 weeks, improvements were observed for most outcomes, with notable mean changes for the 20-m fast-paced walk (-1.13 [95% CI -1.61 to -0.64] seconds), 30-second chair-stand (2.6 [1.8-3.4] stands), and VO2 peak (0.14 [0.03-0.24] liters/minute).

CONCLUSION

In this 12-week pilot study, HIIT improved multiple aspects of health in individuals with knee OA; larger studies are needed.

Bladder cancer and exeRcise trAining during intraVesical thErapy-the BRAVE trial: a study protocol for a prospective, single-centre, phase II randomised controlled trial

INTRODUCTION

Non-muscle invasive bladder cancer (NMIBC) accounts for about 75% of newly diagnosed bladder cancers. The treatment for NMIBC involves surgical removal of the tumour followed by 6 weekly instillations of immunotherapy or chemotherapy directly into the bladder (ie, intravesical therapy). NMIBC has a high rate of recurrence (31%-78%) and progression (15%). Moreover, bladder cancer and its treatment may affect patient functioning and quality of life. Exercise is a safe and effective intervention for many patient with cancer groups, however, no studies have examined exercise during intravesical therapy for NMIBC. The primary objective of the Bladder cancer and exeRcise trAining during intraVesical thErapy (BRAVE) trial is to examine the safety and feasibility of an exercise intervention in patients with bladder cancer undergoing intravesical therapy. The secondary objectives are to investigate the preliminary efficacy of exercise on health-related fitness and patient-reported outcomes; examine the social cognitive predictors of exercise adherence; and explore the potential effects of exercise on tumour recurrence and progression.

METHODS AND ANALYSIS

BRAVE is a phase II randomised controlled trial that aims to include 66 patients with NMIBC scheduled to receive intravesical therapy. Participants will be randomly assigned to the exercise intervention or usual care. The intervention consists of three supervised, high-intensity interval training sessions per week for 12 weeks. Feasibility will be evaluated by eligibility, recruitment, adherence and attrition rates. Preliminary efficacy will focus on changes in cardiorespiratory fitness and patient-reported outcomes from baseline (prior to intravesical therapy) to pre-cystoscopy (3 months). Cancer outcomes will be tracked at 3 months, and 1-year follow-up by cystoscopy. Analysis of covariance will compare between-group differences at post-intervention (pre-cystoscopy) for all health-related fitness and patient-reported outcomes.

ETHICS AND DISSEMINATION

The study was approved by the Health Research Ethics Board of Alberta-Cancer Committee (#20-0184). Dissemination will include publication and presentations at scientific conferences and public channels.

TRIAL REGISTRATION NUMBER

NCT04593862; Pre-results.

Cognitive effectiveness of high-intensity interval training for individuals with methamphetamine dependence: a study protocol for randomised controlled trial

INTRODUCTION

Cognitive deficit is a common syndrome of methamphetamine (MA) dependence. It is related to decision-making, control ability, and social functioning. High-intensity interval training (HIIT) is a training technique that requires people to work out at full intensity during a short period. Many studies have already shown the potential effects of HIIT on cognitive functions. The purpose of this trial is to evaluate the cognitive effects of HIIT on individuals with MA dependence.

METHODS AND ANALYSIS

A total of 240 individuals with MA dependence will be randomly assigned to the HIIT group, moderate-intensity continuous training (MICT) group and control (CON) group. HIIT will consist of a 24-min HIIT exercise on a treadmill. MICT will consist of a 1-h body-mind exercise. CON will be their traditional intervention. The experimental period will be 12 months with 3 interventions weekly for the first 6 months and follow-up for the next 6 months. All subjects will be given cognitive tests at baseline, after intervention and at follow-up. Cognitive performances will be compared by a mixed-model analysis for repeated measures.

DISCUSSION

HIIT training may reduce illicit drug cravings amongst individuals with MA dependence; hence, HIIT may have a good effect on the cognitive functions, such as memory and executive function, of individuals with MA dependence.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2000032492 . Registered on April 30, 2020 ( http://www.chictr.org.cn/edit.aspx?pid=52127&htm=4 ).

One-Year Committed Exercise Training Reverses Abnormal Left Ventricular Myocardial Stiffness in Patients With Stage B Heart Failure With Preserved Ejection Fraction

BACKGROUND

Individuals with left ventricular (LV) hypertrophy and elevated cardiac biomarkers in middle age are at increased risk for the development of heart failure with preserved ejection fraction. Prolonged exercise training reverses the LV stiffening associated with healthy but sedentary aging; however, whether it can also normalize LV myocardial stiffness in patients at high risk for heart failure with preserved ejection fraction is unknown. In a prospective, randomized controlled trial, we hypothesized that 1-year prolonged exercise training would reduce LV myocardial stiffness in patients with LV hypertrophy.

METHODS

Forty-six patients with LV hypertrophy (LV septum >11 mm) and elevated cardiac biomarkers (N-terminal pro-B-type natriuretic peptide [>40 pg/mL] or high-sensitivity troponin T [>0.6 pg/mL]) were randomly assigned to either 1 year of high-intensity exercise training (n=30) or attention control (n=16). Right-heart catheterization and 3-dimensional echocardiography were performed while preload was manipulated using both lower body negative pressure and rapid saline infusion to define the LV end-diastolic pressure-volume relationship. A constant representing LV myocardial stiffness was calculated from the following: P=S×[Exp {a (V-V₀)}-1], where "P" is transmural pressure (pulmonary capillary wedge pressure - right atrial pressure), "S" is the pressure asymptote of the curve, "V" is the LV end-diastolic volume index, "V₀" is equilibrium volume, and "a" is the constant that characterizes LV myocardial stiffness.

RESULTS

Thirty-one participants (exercise group [n=20]: 54±6 years, 65% male; and controls (n=11): 51±6 years, 55% male) completed the study. One year of exercise training increased max by 21% (baseline 26.0±5.3 to 1 year later 31.3±5.8 mL·min^-1·kg^-1, P<0.0001, interaction P=0.0004), whereas there was no significant change in max in controls (baseline 24.6±3.4 to 1 year later 24.2±4.1 mL·min^-1·kg^-1, P=0.986). LV myocardial stiffness was reduced (right and downward shift in the end-diastolic pressure-volume relationship; LV myocardial stiffness: baseline 0.062±0.020 to 1 year later 0.031±0.009), whereas there was no significant change in controls (baseline 0.061±0.033 to 1 year later 0.066±0.031, interaction P=0.001).

CONCLUSIONS

In patients with LV hypertrophy and elevated cardiac biomarkers (stage B heart failure with preserved ejection fraction), 1 year of exercise training reduced LV myocardial stiffness. Thus, exercise training may provide protection against the future risk of heart failure with preserved ejection fraction in such patients. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03476785.

Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity

Exercise based cardiac rehabilitation (CR) is recognized internationally as a class 1 clinical practice recommendation for patients with select cardiovascular diseases and heart failure with reduced ejection fraction. Over the past decade, several meta-analyses have generated debate regarding the effectiveness of exercise-based CR for reducing all-cause and cardiovascular mortality. A common theme highlighted in these meta-analyses is the heterogeneity and/or lack of detail regarding exercise prescription methodology within CR programs. Currently there is no international consensus on exercise prescription for CR, and exercise intensity recommendations vary considerably between countries from light-moderate intensity to moderate intensity to moderate-vigorous intensity. As cardiorespiratory fitness [peak oxygen uptake (VO₂peak)] is a strong predictor of mortality in patients with coronary heart disease and heart failure, exercise prescription that optimizes improvement in cardiorespiratory fitness and exercise capacity is a critical consideration for the efficacy of CR programming. This review will examine the evidence for prescribing higher-intensity aerobic exercise in CR, including the role of high-intensity interval training. This discussion will highlight the beneficial physiological adaptations to pulmonary, cardiac, vascular, and skeletal muscle systems associated with moderate-vigorous exercise training in patients with coronary heart disease and heart failure. Moreover, this review will propose how varying interval exercise protocols (such as short-duration or long-duration interval training) and exercise progression models may influence central and peripheral physiological adaptations. Importantly, a key focus of this review is to provide clinically-relevant recommendations and strategies to optimize prescription of exercise intensity while maximizing safety in patients attending CR programs.

Fidelity, tolerability and safety of acute high-intensity interval training after hospitalisation for COVID-19: a randomised cross-over trial

OBJECTIVES

Many patients with COVID-19 suffer from persistent symptoms, many of which may potentially be reversed by high-intensity interval training (HIIT). Yet, the safety and tolerability of HIIT after COVID-19 is controversial. This study aimed to investigate the fidelity, tolerability and safety of three different HIIT protocols in individuals that had recently been hospitalised due to COVID-19.

METHODS

The study was a randomised cross-over trial. We compared three supervised HIIT protocols (4×4, 6×1, 10-20-30) in 10 individuals recently discharged after hospitalisation for severe COVID-19. Each HIIT protocol had a duration of 38 min and was performed with a 1-week washout between them. Outcomes included adverse events, exercise training intensity and tolerability assessed by the Likert scale (1-10).

RESULTS

All 10 participants aged 61 (mean, SD 8) years (5 males) completed all three HIIT protocols with no adverse events. High intensities were achieved in all three protocols, although they differed in terms of time spent with a heart rate ≥85% of maximum (mean (SD); 4×4: 13.7 (6.4) min; 10-20-30: 12.1 (3.8) min; 6×1: 6.1 (5.6) min; p=0.03). The three protocols were all well tolerated with similar Likert scale scores (mean (SD); 4×4: 8 (2), 10-20-30: 8 (2), 6×1: 9 (2), p=0.72).

CONCLUSION

Our findings indicate that recently hospitalised individuals for severe COVID-19 may safely tolerate acute bouts of supervised HIIT as per protocol. This warrants future studies testing the potential of regular HIIT as a rehabilitation strategy in this context.

Responders and non-responders to aerobic exercise training: beyond the evaluation of V˙O2max

The evaluation of the maximal oxygen uptake ( V ˙ O 2 max ) following exercise training is the classical assessment of training effectiveness. Research has lacked in investigating whether individuals that do not respond to the training intervention ( V ˙ O 2 max ), also do not improve in other health-related parameters. We aimed to investigate the cardiovascular and metabolic adaptations (i.e., performance, body composition, blood pressure, vascular function, fasting blood markers, and resting cardiac function and morphology) to exercise training among participants who showed different levels of V ˙ O 2 max responsiveness. Healthy sedentary participants engaged in a 6-week exercise training program, three times a week. Our results showed that responders had a greater increase in peak power output, second lactate threshold, and microvascular responsiveness, whereas non-responders had a greater increase in cycling efficiency. No statistical differences were observed in body composition, blood pressure, fasting blood parameters, and resting cardiac adaptations. In conclusion, our study showed, for the first time, that in addition to the differences in the V ˙ O 2 max , a greater increase in microvascular responsiveness in responders compared to non-responders was observed. Additionally, responders and non-responders did not show differences in the adaptations on metabolic parameters. There is an increasing need for personalized training prescription, depending on the target clinical outcome.

Physiological and performance responses of sprint interval training and endurance training in Gaelic football players

PURPOSE

While ideal for developing aerobic capacity, traditional endurance training (ET) is extremely time-consuming and may lack the specificity to maintain indices of speed and power in team sport athletes. In contrast, low-volume short-duration sprint interval training (SIT) has been shown to improve [Formula: see text]O2max to a similar extent as ET. However, to date, few studies have compared the effects of running-based SIT and ET, on aerobic capacity and indices of speed and power of trained team sport athletes.

METHODS

Club level male Gaelic football players were randomly assigned to SIT (n = 13; 26.5 ± 4.87 years) or ET (n = 12; 25.4 ± 2.58 years) groups. Participants trained 3 days week-1 for 6 weeks. [Formula: see text]O2max, RE, v[Formula: see text]O2max, blood lactate concentrations, Wingate test performance, running speed, jump performance and intermittent endurance performance (IEP) were measured at baseline and after 6 weeks.

RESULTS

An increase in [Formula: see text]O2max (p < 0.05), v[Formula: see text]O2max (p < 0.001) and IEP (p < 0.001) following 6 weeks of both SIT and ET was observed. Wingate mean power (p < 0.001), peak power (p < 0.001) and fatigue index (p < 0.005) were all significantly improved following training in both groups. Velocity at LT was significantly higher and performance in the 20-m running speed and VJ tests were significantly reduced post training in the ET group (all p < 0.005).

CONCLUSION

Despite the large difference in total training time, a running-based protocol of SIT is a time efficient training method for improving aerobic capacity and IEP while maintaining indices of lower body power and running speed in team-sport players.

Jumping into a Healthier Future: Trampolining for Increasing Physical Activity in Children

OBJECTIVES

Physical activity in children and adolescents has positive effects on cardiopulmonary function in this age group as well as later in life. As poor cardiopulmonary function is associated with higher mortality and morbidity, increasing physical activity especially in children needs to become a priority. Trampoline jumping is widely appreciated in children. The objective was to investigate its use as a possible training modality.

METHODS

Fifteen healthy children (10 boys and 5 girls) with a mean age of 8.8 years undertook one outdoor incremental running test using a mobile cardiopulmonary exercise testing unit. After a rest period of at least 2 weeks, a trampoline test using the mobile unit was realized by all participants consisting of a 5-min interval of moderate-intensity jumping and two high-intensity intervals with vigorous jumping for 2 min, interspersed with 1-min rests.

RESULTS

During the interval of moderate intensity, the children achieved [Formula: see text]-values slightly higher than the first ventilatory threshold (VT1) and during the high-intensity interval comparable to the second ventilatory threshold (VT2) of the outdoor incremental running test. They were able to maintain these values for the duration of the respective intervals. The maximum values recorded during the trampoline test were significantly higher than during the outdoor incremental running test.

CONCLUSION

Trampoline jumping is an adequate tool for implementing high-intensity interval training as well as moderate-intensity continuous training in children. As it is a readily available training device and is greatly enjoyed in this age group, it could be implemented in exercise interventions.

Effects of Plyometric Training on Soft and Hard Surfaces for Improving Running Economy

The present study investigated the effects of plyometric jump training on hard and soft surfaces on running economy (RE), maximal oxygen uptake (VO_2max), running performance and the rate of force development in orienteers. Nineteen orienteers (11 women and 8 men, body mass 61.1 ± 7.3 kg, age 21 ± 5.8 yrs) were randomly stratified based on sex, age, VO_2max and RE to plyometric jumping training (8 sessions over 4 weeks) on either a hard or a soft surface. RE, VO_2max and running performance were assessed on a treadmill and outdoor on- and off-trail loops. Moreover, ground reaction forces and force development were assessed during a one leg drop-jump test. The training intervention led to an overall 2-7% improvement in treadmill and off-trail RE, independent of the jumping surface and running velocity assessed. These improvements were not explained by force development during drop jump tests, which remained unchanged following the intervention. The changes in time-trial performance were associated with changes in RE. Plyometric training improved RE with no difference between the hard or the soft training surface and improved RE was also independent of the running speed assessed. Furthermore, improved running performance was associated with changes in RE after the intervention.

Promoting Exercise and Healthy Diet Among Primary Care Patients: Feasibility, Preliminary Outcomes, and Lessons Learned From a Pilot Trial With High Intensity Interval Exercise

Physical activity and healthy diet are recognized as effective approaches for disease prevention. Controlled laboratory clinical trials support these approaches, yet minimal data exists supporting implementation of exercise as medicine within a healthcare setting.

Objectives: To understand perception and barriers to exercise and nutrition from patients and physicians from a family medicine clinic (FMC) to inform the implementation of a laboratory-based exercise and nutrition lifestyle intervention (Phase I), and to determine the feasibility, adherence, and preliminary outcomes of implementing this lifestyle intervention into a FMC (Phase II).

Methods: In phase I 10 patients and 5 physicians were interviewed regarding perceptions of exercise and nutrition practices. In phase II patients at risk for cardiovascular disease were enrolled into a lifestyle intervention (n = 16), within a FMC, manipulating diet and exercise. Cardiorespiratory fitness (CRF), body composition, and metabolic blood markers were completed at baseline, after the 12-week intervention, and at 24 weeks. Feasibility was defined by patients who completed the intervention and number of sessions vs. total available.

Results: Prescribing high-intensity interval training and a meal replacement for 12 weeks in patients with at least one risk factor for cardiovascular disease, was shown to have moderate feasibility with 62.5% (n = 10) for patients completing the 12 week intervention, and poor feasibility for assessing effects 12 weeks after cessation of the intervention, with 50% (n = 5) participants returning. Tracking exercise electronically via FitBit had moderate fidelity (n = 9), with hardcopy logs yielding poor compliance (n = 6). This pilot study demonstrated preliminary effectiveness of this home-based approach for improving cardiorespiratory fitness with an average 4.31 ± 5.67 ml·kg·min⁻¹ increase in peak oxygen consumption. Blood triglycerides and insulin were improved in 70% and 60% of the patients, respectively.

Conclusions: Despite moderate feasibility, a home-based exercise and nutrition has the potential to be used as an effective approach for managing and mitigating cardiovascular disease risk factors. There were key lessons learned which will help to develop and adapt a larger scale lifestyle intervention into a clinical setting.

Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/study/NCT02482922, identifier NCT02482922.

Neurophysiological Stress Response and Mood Changes Induced by High-Intensity Interval Training: A Pilot Study

This pilot study, conducted in advance of a future definitive randomized controlled trial, aimed to investigate the feasibility of using a HIIT-based intervention to induce neurophysiological stress responses that could be associated with possible changes in mood. Twenty-five active male college students with an average age of 21.7 ± 2.1 years, weight 72.6 ± 8.4 kg, height 177 ± 6.1 cm, and BMI: 23.1 ± 1.4 kg/m² took part in this quasi-experimental pilot study in which they were evaluated in two different sessions. In the first session, subjects performed a graded exercise test to determine the cycling power output corresponding to VO_2peak. The second session consisted of (a) pre-intervention assessment (collection of blood samples for measuring plasma corticotropin and cortisol levels, and application of POMS questionnaire to evaluate mood states); (b) exercise intervention (10 × 1-min of cycling at VO_2peak power output); (c) post-intervention assessment, and (d) 30-min post-intervention evaluation. Significant post-exercise increases in corticotropin and cortisol plasma levels were observed whereas mood states decreased significantly at this assessment time-point. However, a significant increase in mood was found 30-min after exercise. Finally, significant relationships between increases in stress hormones concentrations and changes in mood states after intense exercise were observed. In conclusion, our HIIT-based intervention was feasible to deliver and acceptable to participants. A single bout of HIIT induced acute changes in mood states that seems to be associated with hypothalamic-pituitary-adrenal axis activation.

Alterations in Circulating MicroRNAs and the Relation of MicroRNAs to Maximal Oxygen Consumption and Intima-Media Thickness in Ultra-Marathon Runners

The impact of long-term training on cardiovascular disease (CVD) is not clear. Carotid intima-media thickness (CIMT) test is recommended as a useful measure to diagnose the early stages of atherosclerosis. MicroRNAs (miRNAs) are altered due to endurance exercise and can be promising biomarkers of pathophysiological changes. We aimed to evaluate the association of circulating miRNAs with physical fitness and markers of atherosclerosis in ultra-marathon runners. Ultra-marathon runners had 28-fold upregulation of miR-125a-5p expressions compared to control individuals (p = 0.002), whereas let-7e and miR-126 did not differ statistically between ultra-marathon runners and controls. In the ultra-marathon runners' group, negative correlations were observed between VO₂max/kg and relative expression of miR-125a-5p and miR-126 (r = -0.402, p = 0.028; r = -0.438, p = 0.032, respectively). Positive correlations were observed between CIMT and miR-125a-5p and miR-126 (r = 0.388, p = 0.050; r = 0.504, p = 0.023, respectively) in ultra-marathon runners. Individuals with the highest quartile of VO₂max/kg had 23-fold lower miR-126 expression in comparison to subgroups with lower VO₂max/kg (p = 0.017). Our results may indicate that both miRNAs may serve as a biomarker for early pathological changes leading to atherosclerosis burden in athletes. Furthermore, the association between miRNAs and traditional risk factors for CVD indicate a possible use of these molecules as early biomarkers of future cardiovascular health.

Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective

Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a "near maximal" or "all-out" effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided.

Targeting Diet Quality at the Workplace: Influence on Cardiometabolic Risk

The American Heart Association criteria for cardiovascular health include overall diet quality (DQ). The present study evaluated the effect of a workplace health promotion program targeting DQ and physical activity on features of cardiometabolic risk (CMR). Before and after the 3-month intervention, 2260 employees (1462 men and 798 women) completed a health and fitness evaluation including assessment of DQ using a validated food-based questionnaire. After the 3-month lifestyle modification program, DQ increased significantly in both sexes (p < 0.0001) as well as physical activity level (p < 0.0001). A reduction in waist circumference (p < 0.0001) and improved lipid levels were also observed. Significant associations were found between changes in DQ index and changes in CMR variables in both men (standardized regression coefficients ranged from −0.19 (95% confidence interval: −0.26 to −0.12) to −0.29 (95% confidence interval: −0.34 to −0.25)) and women (standardized regression coefficients ranged from −0.18 (95% confidence interval: −0.25 to −0.11) to −0.27 (95% confidence interval: −0.41 to −0.13)). Multiple linear regression analyses showed a significant contribution of changes in the DQ index to the variation in some CMR variables, independent from changes in physical activity level and cardiorespiratory fitness. This study provides evidence that targeting DQ at the workplace is relevant to improve cardiometabolic health.

Upper and lower limb resistance training program versus high-intensity interval training on oxidative stress markers in university athletes

Highly-intensive exercise occurs in reactive oxygen species which leads to cellular damage as a result of increased oxidative stress markers. An appropriate program design incorporating volume, intensity, and types of exercise may produce different effects amid oxidative status in athletes. Therefore, this study aimed to investigate the outcomes of resistance training (RT) and high-intensity interval training (HIIT) on oxidative stress markers, and physical performance in university athlete subjects. The effect of two different protocol types (RT and HIIT) on oxidative stress and antioxidant status were also compared. Seventy-two university athletes, were recruited and divided into control, RT, and HIIT groups (n=22/group). The RT group were undertaken a resistance exercise training program of the upper and lower body. The HIIT group performed their exercise training on a cycle ergometer. The training program was 30 min/day, 3 days/wk, continuously over 8 weeks. We observed that long-term RT and HIIT improved blood glutathione and glutathione disulfide redox ratio in all athletes. The results demonstrated that only RT training significantly decreased plasma malondialdehyde. Another finding was that RT and HIIT resulted in similar elicitation of physical performance in the post-compared with pretraining exercise. This study revealed that RT and HIIT programs improved antioxidants and physical performance in university sports athletes. However, oxidative markers were only improved following the RT program. This study suggests that RT program is superior to HIIT in improving oxidative stress markers in sport athletes.

Effects of Individual Changes in Training Distribution on Maximal Aerobic Capacity in Well-Trained Cross-Country Skiers: A Follow-Up Study

The purpose of this study was to evaluate individual changes in training distribution and the subsequent effects on maximal oxygen uptake (VO_2max). The participants were well-trained cross-country skiers who had performed a year with no substantial changes in training prior to this study. Six cross-country skiers, who were participants in a larger previous study, volunteered for a follow-up study. All skiers performed self-motivated changes in training distribution for a new preparation period in this follow-up, generally by more high-intensity training (HIT). All training characteristics were registered from training diaries. During the follow-up period, all skiers performed an incremental VO_2max test in February 2020 and August 2020. Training were categorized into three different training periods; (1) February 2019 to February 2020 (P₁) representing the training performed prior to the follow-up, (2) February 2020 to July 2020 (P₂), and (3) July 2020 to August 2020 (P₃). On average, the skiers increased their VO_2max by 5.8 ± 5.0% (range: −1.8 to + 10.2%) during the follow-up study compared with the average VO_2max during the preceding year. Total training volume increased on average by 10.0 and 25.7% in P₂ and P₃, respectively, compared with P₁. The average volume of HIT was similar between P₁ and P₂ but increased 62.8% in P₃. However, large individual differences in training changes were observed. In conclusion, the present study revealed that individual changes in training distribution generated an increased VO_2max in four out of six already well-trained cross-country skiers. Reduced total training volume (three out of six) and increased (four out of six) HIT volume were the most marked changes.

Effects of High-Intensity Interval Training After Stroke (The HIIT Stroke Study) on Physical and Cognitive Function: A Multicenter Randomized Controlled Trial

OBJECTIVE

To assess the effects of high-intensity interval training (HIIT) on physical, mental, and cognitive functioning after stroke.

DESIGN

The HIIT Stroke Study was a single-blind, multicenter, parallel-group randomized controlled trial.

SETTING

Specialized rehabilitation units at 3 Norwegian hospitals.

PARTICIPANTS

Adult stroke survivors (N=70) 3 months to 5 years after a first-ever stroke. Mean age was 57.6±9.2 years and 58.7±9.2 years in the intervention and control groups, respectively.

INTERVENTIONS

Participants were randomized to standard care in combination with 4×4 minutes of treadmill HIIT at 85%-95% of peak heart rate or standard care only.

OUTCOMES

Outcomes were measured using physical, mental, and cognitive tests and the FIM and Stroke Impact Scale. Linear mixed models were used to analyze differences between groups at posttest and 12-month follow-up.

RESULTS

The intervention group showed a significant treatment effect (95% confidence interval [CI]) from baseline to posttest on a 6-minute walk test of 28.3 (CI, 2.80-53.77) meters (P=.030); Berg Balance Scale 1.27 (CI, 0.17-2.28) points (P=.025); and Trail Making Test Part B (TMT-B; -24.16 [CI, -46.35 to -1.98] s, P=.033). The intervention group showed significantly greater improvement on TMT-B at the 12-month follow-up (25.44 [CI, -49.01 to -1.87] s, P=.035). The control group showed significantly greater improvement in total Functional Independence Measure score with a treatment effect of -2.37 (CI, -4.30 to -0.44) points (P=.016) at 12-month follow-up. No significant differences were identified between groups on other outcomes at any time point.

CONCLUSIONS

HIIT combined with standard care improved walking distance, balance, and executive function immediately after the intervention compared with standard care only. However, only TMT-B remained significant at the 12-month follow-up.

Effect of Different Endurance Training Protocols During Cardiac Rehabilitation on Quality of Life

BACKGROUND

This study aimed to assess the effect of different types of endurance training during outpatient cardiac rehabilitation on patients' health-related quality of life (HRQL).

METHODS

The MacNew Heart Disease HRQL questionnaire and the Hospital Anxiety and Depression Scale were used to assess changes in HRQL in 66 patients before and after 6 weeks of cardiac rehabilitation. Patients were randomized to 1 of 3 types of supervised endurance training: continuous endurance training, high-intensity interval training, and pyramid training. Two-way analysis of variance for repeated measure and chi-square test were used to analyze changes before and after rehabilitation.

RESULTS

Attendance rate during the 6 weeks of exercise training was 99.2%. Physical work capacity increased from 136.1 to 165.5 watts (+22.9%; P < .001), and there were no statistical differences between training protocols. Fully completed questionnaires at both time points were available in 46 patients (73.9%; 61.3±11.6 years, 34 males, 12 females). Regardless of the type of supervised endurance training, there was significant improvement during rehabilitation in each of the categories of the MacNew questionnaire (ie, emotion, physical, social, global; all P < .05) and the Hospital Anxiety and Depression Scale (anxiety: P = .05; depression: P = .032), without significant differences between protocols.

CONCLUSIONS

All 3 types of endurance training led to significant and well comparable increases in physical work capacity, which was associated with an increase in HRQL independent of the type of training. Our findings support further individualization of training regimes, which could possibly lead to better compliance during life-long home-based exercise training.

Exercise Intensity and Technical Involvement in U9 Team Handball: Effect of Game Format

The purpose of this study was to quantify the exercise intensity and technical involvement of U9 boys’ and girls’ team handball during different game formats, and the differences between genders. Locomotor activity (total distance, distance in speed zones, accelerations, and decelerations), heart rate (HR), and technical involvement (shots, goals, and duels) metrics were collected during various 15 min game formats from a total of 57 Danish U9 players (37 boys and 20 girls). Game formats were a small size pitch (20 × 13 m) with 3 vs. 3 players and offensive goalkeepers (S3 + 1) and 4 vs. 4 players (S4), a medium size pitch (25.8 × 20 m) with 4 vs. 4 (M4) and 5 vs. 5 (M5) players, and a large size pitch (40 × 20 m) with 5 vs. 5 (L5) players. Boys and girls covered a higher total distance (TD) of high-speed running (HSR) and sprinting during L5 games compared to all other game formats (p < 0.05; ES = (−0.9 to −2.1), (−1.4 to −2.8), and (−0.9 to −1.3) respectively). Players covered the highest amount of sprinting distance in L5 games compared to all other game formats (p < 0.01; ES = 0.8 to 1.4). In all the game formats, players spent from 3.04 to 5.96 min in 180–200 bpm and 0.03 min to 0.85 min in >200 bpm of the total 15 min. In addition, both genders had more shots in S3 + 1 than M5 (p < 0.01; ES = 1.0 (0.4; 1.7)) and L5 (p < 0.01; ES = 1.1 (0.6; 2.2)). Team handball matches have high heart rates, total distances covered, and high-intensity running distances for U9 boys and girls irrespective of the game format. Locomotor demands appeared to be even higher when playing on larger pitches, whereas the smaller pitch size and fewer players led to elevated technical involvement.

Aerobic and Anaerobic Speed Predicts 800-m Running Performance in Young Recreational Runners

The main aim was to investigate the impact of maximal aerobic speed (MAS), maximal anaerobic speed (MANS), and time to exhaustion (TTE) at 130% MAS, on 800-m running time performance (800TT). A second aim was to investigate the impact of anaerobic speed reserve (ASR), i.e., the relative difference between MAS and MANS, on TTE. A total of 22 healthy students classified as recreational runners participated in a cross-sectional study. They were tested for maximal oxygen consumption (VO_2max), oxygen cost of running (C_R), time performance at 100 m (100TT), time performance at 800 m (800TT), and TTE. MAS was calculated as VO_2max × C_R^–1, and MANS was calculated as 100TT velocity. Both MAS and MANS correlated individually with 800TT (r = –0.74 and –0.67, respectively, p < 0.01), and the product of MAS and MANS correlated strongly (r = –0.82, p < 0.01) with 800TT. TTE did not correlate with 800TT. Both ASR and % MANS correlated strongly with TTE (r = 0.90 and –0.90, respectively, p < 0.01). These results showed that 800TT was first and foremost dependent on MAS and MANS, and with no impact from TTE. It seemed that TTE was merely a product of each runner’s individual ASR. We suggest a simplified model of testing and training for 800TT, namely, by focusing on VO_2max, C_R, and short sprint velocity, i.e., MAS and MANS.

Twelve weeks of sprint interval training increases peak cardiac output in previously untrained individuals

INTRODUCTION

Sprint interval training (SIT), characterized by brief bouts of 'supramaximal' exercise interspersed with recovery periods, increases peak oxygen uptake ([Formula: see text]) despite a low total exercise volume. Per the Fick principle, increased [Formula: see text] is attributable to increased peak cardiac output ([Formula: see text]) and/or peak arterio-venous oxygen difference (a-vO_2diff). There are limited and equivocal data regarding the physiological basis for SIT-induced increases in [Formula: see text], with most studies lasting ≤ 6 weeks.

PURPOSE

To determine the effect of 12 weeks of SIT on [Formula: see text], measured using inert gas rebreathing, and the relationship between changes in [Formula: see text] and [Formula: see text].

METHODS

15 healthy untrained adults [6 males, 9 females; 21 ± 2 y (mean ± SD)] performed 28 ± 3 training sessions. Each session involved a 2-min warm-up at 50 W, 3 × 20-s 'all-out' cycling bouts (581 ± 221 W) interspersed with 2-min of recovery, and a 3-min cool-down at 50 W.

RESULTS

Measurements performed before and after training showed that 12 weeks of SIT increased [Formula: see text] (17.0 ± 3.7 vs 18.1 ± 4.6 L/min, p = 0.01, partial η² = 0.28) and [Formula: see text] (2.63 ± 0.78 vs 3.18 ± 1.1 L/min, p < 0.01, partial η² = 0.58). The changes in these two variables were correlated (r² = 0.46, p < 0.01). Calculated peak a-vO_2diff also increased after training (154 ± 22 vs 174 ± 23 ml O₂/L; p < 0.01) and was correlated with the change in [Formula: see text] (r² = 0.33, p = 0.03). Exploratory analyses revealed an interaction (p < 0.01) such that [Formula: see text] increased in male (+ 10%, p < 0.01) but not female participants (+ 0.6%, p = 0.96), suggesting potential sex-specific differences.

CONCLUSION

Twelve weeks of SIT increased [Formula: see text] by 6% in previously untrained participants and the change was correlated with the larger 21% increase in [Formula: see text].

A systematic review of small sided games within rugby: Acute and chronic effects of constraints manipulation

Small-sided games is a commonly used training method to develop technical, tactical and physical qualities concurrently. However, a review of small-sided games in rugby football codes (e.g. rugby union, rugby league) is not available. This systematic review aims to investigate the acute responses and chronic adaptations of small-sided games within rugby football codes considering the constraints applied. Four electronical databases were systematically searched until August 2020. Acute and chronic studies investigating rugby football codes small-sided games, with healthy amateur and professional athletes were included. Twenty studies were eventually included: 4 acute and 1 chronic in rugby union, 13 acute and 2 chronic in rugby league. Acute studies investigated task and individual constraints. Chronic studies showed that small-sided games would be an effective training method to improve physical performance. Current research in rugby football codes is heavily biased towards investigating how manipulating constraints can affect the physical characteristics of small-sided games, with limited literature investigating the effect on technical skills, and no studies investigating tactical behaviour. Future research is needed to evidence the effects of constraint manipulation on technical and tactical behaviour of rugby football players in small-sided games, in addition to physical characteristics.

Competition-Based Heart Rate, Training Load, and Time Played Above 85% Peak Heart Rate in NCAA Division I Women's Basketball

ABSTRACT

Sanders, GJ, Boos, B, Rhodes, J, Kollock, RO, and Peacock, CA. Competition-based heart rate, training load, and time played above 85% peak heart rate in NCAA division I women's basketball. J Strength Cond Res 35(4): 1095-1102, 2021-Basketball athletes frequently engage in intensities ≥85% HRpeak throughout competition. Knowing the time spent competing at intensities ≥85% HRpeak can improve training protocols. The purpose of the study was to assess heart rate responses across 4-quarter games (N = 31) in an NCAA Division I women's basketball season. Ten female athletes were tested and monitored with heart rate-based wearable microsensor devices. Before the season, HRpeak was recorded through a peak metabolic test (V̇o2peak). Average (HRavg) and HRpeak were recorded for each game, and time spent in 5 heart rate zones (HRZones) were recorded: HRZone1 = 50-60% HRpeak, HRZone2 = 60-70% HRpeak, HRZone3 = 70-76% HRpeak, HRZone4 = 77-84% HRpeak, and HRZone5 = 85-100% HRpeak. Training load was calculated with the summated-heart-rate-zone model (SHRZmod). There was a main effect of position (p ≤ 0.019) and quarter (p ≤ 0.005) on SHRZmod and on time spent in HRZone1-5. Athletes accumulated the most time in HRZone4 and HRZone5 and in the fourth quarter, and SHRZmod was the greatest in the fourth quarter. There was no main effect for HRavg and HRpeak (p ≥ 0.110). Athletes averaged 34.5 minutes per game competing in HRZone5 or ≥85% HRpeak with nearly one-third of those minutes accumulated in the fourth quarter. Although there were no differences in HRavg and HRpeak from quarter to quarter, SHRZmod increased from the first to fourth quarter. Utilizing time spent in heart rate zones and training load with SHRZmod can provide valuable information to practitioners regarding the intensity and physiological demands of competitive basketball games.

Effect of High-Intensity Interval Training Versus Sprint Interval Training on Time-Trial Performance: A Systematic Review and Meta-analysis

BACKGROUND

Two forms of interval training commonly discussed in the literature are high-intensity interval training (HIIT) and sprint interval training (SIT). HIIT consists of repeated bouts of exercise that occur at a power output or velocity between the second ventilatory threshold and maximal oxygen consumption (VO_2max). SIT is performed at a power output or velocity above those associated with VO_2max.

OBJECTIVE

The primary objective of this study is to systematically review published randomized and pair-matched trials to determine which mode of interval training, HIIT versus SIT, leads to a greater improvement in TT performance in active and trained individuals. The second objective of this review is to perform a subgroup analysis to determine if there is a distinction between HIIT programs that differ in work-bout duration.

DATA SOURCES

SPORTDiscus (1800-present) and Medline with Full Text (1946-present) were used to conduct a systematic literature search.

STUDY SELECTION

Studies were selected for the review if they met the following criteria: (1) individuals (males and females) who were considered at least moderately trained (~ 3-h per week of activity) as specified by the authors of the included studies; (2) between the ages of 18 and 45 years; (3) randomized or pair-matched trials that included a HIIT and a SIT group; (4) provided detailed information about the interval training program; (5) were at least 2 weeks in duration; (6) included a TT test that required participants to complete a set distance.

RESULTS

A total of 6 articles met the inclusion criteria for the subjective and objective analysis. The pooled analysis was based on a random-effects model. There was no difference in the change in TT performance when comparing all HIIT versus SIT (0.9%; 90% CI - 1.2-1.9%, p = 0.18). However, subgroup analysis based on duration of work interval indicated a 2% greater improvement in TT performance following long-HIIT (≥ 4 min) when compared to SIT. There was no difference in change in VO_2max/_peak oxygen consumption (VO_2peak) between groups. There was a moderate effect (ES = 0.70) in favor of HIIT over SIT in maximal aerobic power (MAP) or maximal aerobic velocity (MAV).

CONCLUSION

The results of the meta-analysis indicate that long-HIIT may be the optimal form of interval training to augment TT performance. Additional research that directly compares HIIT exercise differing in work-bout duration would strengthen these results and provide further insight into the mechanisms behind the observed benefits of long-HIIT.

Individual cardiovascular responsiveness to work-matched exercise within the moderate- and severe-intensity domains

Purpose

We investigated the cardiovascular individual response to 6 weeks (3×/week) of work-matched within the severe-intensity domain (high-intensity interval training, HIIT) or moderate-intensity domain (moderate-intensity continuous training, MICT). In addition, we analyzed the cardiovascular factors at baseline underlying the response variability.

Methods

42 healthy sedentary participants were randomly assigned to HIIT or MICT. We applied the region of practical equivalence-method for identifying the levels of responders to the maximal oxygen uptake (V̇O_2max) response. For investigating the influence of cardiovascular markers, we trained a Bayesian machine learning model on cardiovascular markers.

Results

Despite that HIIT and MICT induced significant increases in V̇O_2max, HIIT had greater improvements than MICT (p < 0.001). Greater variability was observed in MICT, with approximately 50% classified as “non-responder” and “undecided”. 20 “responders”, one “undecided” and no “non-responders” were observed in HIIT. The variability in the ∆V̇O_2max was associated with initial cardiorespiratory fitness, arterial stiffness, and left-ventricular (LV) mass and LV end-diastolic diameter in HIIT; whereas, microvascular responsiveness and right-ventricular (RV) excursion velocity showed a significant association in MICT.

Conclusion

Our findings highlight the critical influence of exercise-intensity domains and biological variability on the individual V̇O_2max response. The incidence of “non-responders” in MICT was one third of the group; whereas, no “non-responders” were observed in HIIT. The incidence of “responders” was 11 out of 21 participants in MICT, and 20 out of 21 participants in HIIT. The response in HIIT showed associations with baseline fitness, arterial stiffness, and LV-morphology; whereas, it was associated with RV systolic function in MICT.

Blood Volume, Hemoglobin Mass, and Peak Oxygen Uptake in Older Adults: The Generation 100 Study

Purpose: To investigate the association between blood volume, hemoglobin mass (Hb_mass), and peak oxygen uptake (VO_2peak) in healthy older adults.

Methods: Fifty fit or unfit participants from the prospective randomized Generation 100 Study (n = 1,566) were included (age- and sex-specific VO_2peak above or below average values). Blood, plasma, and erythrocyte volume and Hb_mass were tested using the carbon monoxide rebreathing method within 1 week after VO_2peak testing.

Results: Mean age, BMI, Hb_mass, blood volume, and VO_2peak were 73.0 ± 2.1 years, 24.8 ± 3.3 kg·m², 10.0 ± 1.7 g·kg⁻¹, 76.4 ± 11.8 mL·kg⁻¹, and 33.5 ± 8.4 mL·kg⁻¹·min⁻¹. VO_2peak in fit and unfit participants and women and men were 38.6 ± 6.5 and 25.8 ± 3.8 mL·kg⁻¹·min⁻¹, 30.7 ± 7.6 mL·kg⁻¹·min⁻¹, and 35.5 ± 8.5 mL·kg⁻¹·min⁻¹, respectively. Women were shorter (Δ14 cm), leaner (Δ13 kg), and with less muscle mass (Δ9%) than men (P < 0.05). Relative erythrocyte volume and Hb_mass were lower in women, and blood and erythrocyte volume and Hb_mass were higher in the fit participants (P < 0.05). Hb_mass and erythrocyte volume explained 40 and 37%, respectively, of the variability in VO_2peak, with a limited effect of physical-activity adjustment (40 and 38%, respectively). Blood and plasma volume explained 15 and 25%, respectively, of VO_2peak variability, and the association was strengthened adjusting for physical activity (25 and 31%, respectively), indicating a training-dependent adaptation in plasma but not erythrocyte volume (p ≤ 0.006).

Conclusions: Blood and plasma volumes were moderately associated with VO_2peak in healthy older men and women, and the association was strengthened after adjustment for physical activity. Hb_mass and erythrocyte volume were strongly associated with VO_2peak but unrelated to physical activity.

Superior Physiological Adaptations After a Microcycle of Short Intervals Versus Long Intervals in Cyclists

PURPOSE

To compare the effects of a 1-week high-intensity aerobic-training shock microcycle composed of either 5 short-interval sessions (SI; n = 9, 5 series with 12 × 30-s work intervals interspersed with 15-s recovery and 3-min recovery between series) or 5 long-interval sessions (LI; n = 8, 6 series of 5-min work intervals with 2.5-min recovery between series) on indicators of endurance performance in well-trained cyclists.

METHODS

Before and following 6 days with standardized training loads after the 1-week high-intensity aerobic-training shock microcycle, both groups were tested in physiological determinants of endurance performance.

RESULTS

From pretraining to posttraining, SI achieved a larger improvement than LI in maximal oxygen uptake (5.7%; 95% confidence interval, 1.3-10.3; P = .015) and power output at a blood lactate concentration of 4 mmol·L-1 (3.8%; 95% confidence interval, 0.2-7.4; P = .038). There were no group differences in changes of fractional use of maximal oxygen uptake at a workload corresponding to a blood lactate concentration of 4 mmol·L-1, gross efficiency, or the 1-minute peak power output from the maximal-oxygen-uptake test.

CONCLUSION

The SI protocol may induce superior changes in indicators of endurance performance compared with the LI protocol, indicating that SI can be a good strategy during a 1-week high-intensity aerobic-training shock microcycle in well-trained cyclists.

Intensity Paradox-Low-Fit People Are Physically Most Active in Terms of Their Fitness

Depending on their cardiorespiratory fitness (CRF), people may perceive the exertion of incident physical activity (PA) differently. Therefore, the use of relative intensity thresholds based on individual fitness have been proposed to evaluate the accumulation of PA at different intensity levels. A subsample of the FinFit2017-study, 1952 adults (803 men and 1149 women) aged 20–69 years, participated in this study. Their maximal oxygen uptake (VO₂max) was predicted with a 6 min walk test, and they were instructed to wear a triaxial hip-worn accelerometer for one week. The participants were divided into CRF tertiles by five age groups and sex. Raw acceleration data were analyzed with the mean amplitude deviation method in 6 s epochs. Additionally, the data were smoothed with 1 min and 6 min exponential moving averages. The absolute intensity threshold for moderate activity was 3.0 metabolic equivalent (MET) and for vigorous 6.0 MET. Correspondingly, the relative thresholds were 40% and 60% of the oxygen uptake reserve. Participants in the lowest CRF tertile were the most active with relative thresholds, and participants in the highest CRF tertile were the most active with absolute thresholds. High-fit people easily reached the absolute thresholds, while people in the lowest CRF tertile had to utilize most of their aerobic capacity on a daily basis simply to keep up with their daily chores or peers.

Temporal Location of High-Intensity Interval Training in Cycling Does Not Impact the Time Spent Near Maximal Oxygen Consumption

PURPOSE

To examine the influence of temporal location of high-intensity interval training (HIIT) within a cycling session on the time spent ≥90% of maximal oxygen consumption and physiological and perceptual responses.

METHODS

In a randomized, crossover design, 16 trained cyclists (male, n = 13 and female, n = 3) completed three 90-minute cycling sessions with HIIT placed at the beginning, middle, or end of the session (13, 36, and 69 min, respectively). Intervals consisted of three 3-minute efforts at 90% of the power output associated with maximal oxygen consumption interspersed with 3 minutes of recovery. Oxygen consumption, minute ventilation, respiratory rate, and heart rate were recorded continuously during work intervals. Rate of perceived exertion was recorded at the end of work intervals, and sessional rate of perceived exertion was collected 20 minutes after session completion.

RESULTS

No differences were observed for mean oxygen consumption (P = .479) or time spent ≥90% maximal oxygen consumption (P = .753) between condition. The mean rate of perceived exertion of all intervals were greater in the Middle (P < .01, effect size = 0.83) and End (P < .05, effect size = 0.75) compared with Beginning conditions. Mean minute ventilation was greater in the End compared with Beginning condition (P = .015, effect size = 0.63). However, no differences in mean respiratory rate were observed between conditions (P = .297).

CONCLUSIONS

Temporal location of HIIT has no impact on oxygen consumption or cardiovascular stress within a cycling session. However, HIIT performed later in the session resulted in higher ventilation, which may indicate the need for greater anaerobic contribution to these intervals.

High-intensity interval training and active video gaming improve neurocognition in schizophrenia: a randomized controlled trial

There is a need for treatments targeting neurocognitive dysfunctions in schizophrenia. The aim of this study was to investigate the neurocognitive effect of aerobic high-intensity interval training (HIIT). A comparison group performed sport simulating active video gaming (AVG). We anticipated that HIIT would improve neurocognition beyond any effect of AVG, due to engagement in higher intensity cardiorespiratory demands. Recent research on the beneficial neurocognitive effect of AVG challenges this expectation but added new relevance to comparing the two interventions. This is an observer-blinded randomized controlled trial. Eighty-two outpatients diagnosed with schizophrenia were allocated to HIIT (n = 43) or AVG (n = 39). Both groups received two supervised sessions per week for 12 weeks. The attrition rate was 31%, and 65% of the participants were defined as protocol compliant study completers. Intention-to-treat analyses showed significant improvements in the neurocognitive composite score from baseline to post-intervention and from baseline to 4 months follow-up in the total sample. The same pattern of results was found in several subdomains. Contrary to our hypothesis, we found no interaction effects of time and group, indicating equal effects in both groups. Separate within-group analysis unexpectedly showed trends of differential effects in the learning domain, as HIIT showed post-intervention improvement in verbal but not visual learning, while AVG showed improvement in visual but not verbal learning. HIIT and AVG improve neurocognition equally, suggesting that both interventions may be applied to target neurocognition in schizophrenia. Future research should investigate trends towards possible differential effects of exercise modes on neurocognitive subdomains. NCT02205684, 31.07.14.

Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis

PURPOSE

We aimed to investigate differences between high-intensity interval exercise (HIIE, including high-intensity interval training and sprint interval training) and moderate-intensity continuous training (MICT) on physical fitness, body composition, blood pressure, blood lipids, insulin and glucose metabolism, inflammation, and endothelial function.

METHODS

Differences between HIIE and MICT were summarized using a random-effects meta-analysis on the effect size (Cohen's d). A meta-regression was conducted using the following subgroups: population, age, training duration, men ratio, exercise type, baseline values (clinical relevant ranges), and type of HIIE. Studies were included if at least one of the following outcomes were reported: maximal oxygen uptake (V˙O2max), flow-mediated dilation (FMD), body mass index (BMI), body mass, percent body fat, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, total cholesterol, C-reactive protein (CRP), fasting glucose and insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR). A total of 55 studies were included.

RESULTS

Overall, HIIE was superior to MICT in improving V˙O2max (d = 0.40, P < 0.001) and FMD (d = 0.54, P < 0.05). Oppositely, MICT was superior to HIIE in improving HbA1c (d = -0.27, P < 0.05). No differences were observed in BMI (d = -0.02), body mass (d = -0.05), percent body fat (d = 0.04), systolic blood pressure (d = -0.04), diastolic blood pressure (d = 0.03), HDL (d = -0.05), LDL (d = 0.08), triglycerides (d = 0.03), total cholesterol (d = 0.14), CRP (d = -0.11), fasting insulin (d = 0.02), fasting glucose (d = 0.02), and HOMA-IR (d = -0.04). Moderator analyses indicated that the difference between HIIE and MICT was affected by different subgroups.

CONCLUSION

Overall, HIIE showed to be more effective in improving cardiovascular health and cardiorespiratory fitness, whereas MICT was superior in improving long-term glucose metabolism. In the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.

Cardiorespiratory Responses to Constant and Varied-Load Interval Training Sessions

PURPOSE

To compare the cardiorespiratory responses of a traditional session of high-intensity interval training session with that of a session of similar duration and average load, but with decreasing workload within each bout in cyclists and runners.

METHODS

A total of 15 cyclists (maximal oxygen uptake [V˙O2max] 62 [6] mL·kg-1·min-1) and 15 runners (V˙O2max 58 [4] mL·kg-1·min-1) performed both sessions at the maximal common tolerable load on different days. The sessions consisted of four 4-minute intervals interspersed with 3 minutes of active recovery. Power output was held constant for each bout within the traditional day, whereas power started 40 W (2 km·h-1) higher and finished 40 W (2 km·h-1) lower than average within each bout of the decremental session.

RESULTS

Average oxygen uptake during the high-intensity intervals was higher in the decremental session in cycling (89 [4]% vs 86 [5]% of V˙O2max, P = .002) but not in running (91 [4]% vs 90 [4]% of V˙O2max, P = .38), as was the time spent >90% of V˙O2max and the time spent >90% of peak heart rate. Average heart rate (P < .001), pulmonary ventilation (P < .001), and blood lactate concentration (P < .001) were higher during the decremental sessions in both cycling and running.

CONCLUSIONS

Higher levels of physiological perturbations were achieved during decremental sessions in both cycling and running. These differences were, however, more prominent in cycling, thus making cycling a more attractive modality for testing the effects of a training intervention.

The dose-response relationship between interval-training and VO2max in well-trained endurance runners: A systematic review

Success in endurance running is primarily determined by maximal aerobic power (VO_2max), fractional utilization, and running economy (RE). Within the literature, two training modalities have been identified to improve VO_2max; continuous training (CT) and interval-training (IT). The efficacy of IT to improve VO_2max in well-trained runners remains equivocal, as does whether a dose-response relationship exists between the IT training load performed and changes in VO_2max. A keyword search was performed in five electronic databases. Seven studies met the inclusion criteria for this systematic review. The training impulse (TRIMP) was calculated to analyse relationships between training load and changes in VO_2max, by calculating the time accumulated in certain intensity domains throughout a training intervention. Non-significant (P>0.05) improvements in VO_2max were reported in six studies, with only one study reporting a significant (P<0.05) improvement following the IT interventions. A relationship between the training session impulse of the interval-training performed (IT S_TRIMP) and VO_2max improvements were observed. The efficacy of IT to improve VO_2max in well-trained runners remains equivocal, nevertheless, the novel method of training-load analysis demonstrates a relationship between the IT S_TRIMP and VO_2max improvements. This provides practical application for the periodization of IT within the training regime of well-trained distance runners.

Validation and Practical Applications of Performance in a 6-Min Rowing Test in the Danish Armed Forces

Personnel of the Danish Armed Forces must complete a yearly basic physical fitness test consisting of a Cooper’s 12-min run test (CRT) and four strength-related bodyweight exercises. However, there is no validated alternative to the CRT allowing injured or sailing personnel to conduct the yearly basic physical fitness test. Therefore, the aim of this study was to validate performance in a 6-min rowing ergometer test (6MRT) against CRT performance. Thirty-one individuals (M/F: 20/11, age: 34 ± 12 years) employed at the Danish Armed Forces completed testing on two independent days; (I) the CRT on an outdoor track and (II) a 6MRT with pulmonary measurements of breath-by-breath oxygen uptake. In addition, 5 participants (M/F: 4/1, age: 40 ± 10 years) completed re-testing of the 6MRT. No difference was observed between VO_2max estimated from the CRT and measured during the 6MRT. Absolute VO_2max correlated strongly (r = 0.95; p < 0.001) to performance in the 6MRT, and moderately (r = 0.80; p < 0.001) to performance in the CRT. Bodyweight (BW) and fat free mass (FFM) correlated stronger to performance in the 6MRT compared to the CRT. 6MRT re-testing yielded similar performance results. The 6MRT is a valid and reliable alternative to the CRT, allowing injured or sailing personnel of the Danish Armed Forces to complete the basic physical fitness test as required, albeit 6MRT performance demands must be made relative to bodyweight.

Adiposity and Physical Activity as Risk Factors for Developing Psoriatic Arthritis: Longitudinal Data From a Population-Based Study in Norway

OBJECTIVE

Adiposity is prevalent among patients with psoriatic arthritis (PsA). However, the temporal relation is unclear. The present study was undertaken to investigate whether adiposity and body fat distribution are related to the risk of developing PsA, and whether physical activity could modify the possible risk.

METHODS

We included 36,626 women and men from the Norwegian Nord-Trøndelag Health Study without diagnosed PsA at baseline from 1995 to 1997. Cox regression analysis was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) of incident PsA at follow-up from 2006 to 2008.

RESULTS

During follow-up, 185 new cases of PsA were reported. Increases of 1 SD in body mass index (BMI) (4.2 and 3.5 kg/m² for women and men, respectively) and waist circumference (10.8 and 8.6 cm, respectively) were associated with HRs of 1.40 (95% CI 1.24, 1.58) and 1.48 (95% CI 1.31, 1.68), respectively. Compared to individuals of normal weight, obese individuals had an HR of 2.46 (95% CI 1.65, 3.68), and overweight individuals had an HR of 1.41 (95% CI 1.00, 1.99). Comparing extreme quartiles of waist circumference yielded an HR of 2.63 (95% CI 1.73, 3.99). In analyses of combined effects using a BMI of <25 kg/m² and high physical activity as reference, a BMI of ≥25 kg/m² was associated with HRs of 2.06 (95% CI 1.18, 3.58) and 1.53 (95% CI 0.80, 2.91) among those with low and high physical activity levels, respectively. Corresponding HRs for high waist circumference and physical activity were 2.25 (95% CI 1.40, 1.63) and 1.85 (95% CI 0.95, 3.50).

CONCLUSION

The results suggest that adiposity, particularly central obesity, is associated with increased risk of incident PsA. Although there was no clear modifying effect of physical activity, high levels of physical activity reduced the risk of PsA, regardless of BMI.

Hormonal Contraceptive Use Does Not Affect Strength, Endurance, or Body Composition Adaptations to Combined Strength and Endurance Training in Women

ABSTRACT

Myllyaho, MM, Ihalainen, JK, Hackney, AC, Valtonen, M, Nummela, A, Vaara, E, Häkkinen, K, Kyröläinen, H, and Taipale, RS. Hormonal contraceptive use does not affect strength, endurance, or body composition adaptations to combined strength and endurance training in women. J Strength Cond Res 35(2): 449-457, 2021-This study examined the effects of a 10-week period of high-intensity combined strength and endurance training on strength, endurance, body composition, and serum hormone concentrations in physically active women using hormonal contraceptives (HCs, n = 9) compared with those who had never used hormonal contraceptives (NHCs, n = 9). Training consisted of 2 strength training sessions and 2 high-intensity running interval sessions per week. Maximal bilateral isometric leg press (Isom), maximal bilateral dynamic leg press (one repetition maximum [1RM]), countermovement jump (CMJ), a 3,000-m running test (3,000 m), body composition, and serum hormone levels were measured before and after training between days 1-5 of each subject's menstrual cycle. Both groups increased 1RM and CMJ: HC = 13.2% (p < 0.001) and 9.6% (p < 0.05), and NHC = 8.3% (p < 0.01) and 8.5% (p < 0.001). Hormonal contraceptive improved 3,000 m by 3.5% (p < 0.05) and NHC by 1% (n.s.). Never used hormonal contraceptive increased lean mass by 2.1% (p < 0.001), whereas body fat percentage decreased from 23.9 ± 6.7 to 22.4 ± 6.0 (-6.0%, p < 0.05). No significant changes were observed in body composition in HC. No significant between-group differences were observed in any of the performance variables. Luteinizing hormone concentrations decreased significantly (p < 0.05) over 10 weeks in NHC, whereas other hormone levels remained statistically unaltered in both groups. It seems that the present training is equally appropriate for improving strength, endurance, and body composition in women using HC as those not using HC without disrupting hypothalamic-pituitary-gonadal axis function.

Effect of Aerobic Exercise Intensity on Energy Expenditure and Weight Loss in Severe Obesity-A Randomized Controlled Trial

OBJECTIVE

This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure.

METHODS

This was a single-center randomized controlled trial of patients with severe obesity allocated to a 24-week moderate-intensity continuous training (MICT) program or a combined MICT with high-intensity interval training (HIIT/MICT) program. The primary outcome was energy expenditure during exercise (EEDE). Secondary outcomes included resting metabolic rate, cardiorespiratory fitness, and body composition.

RESULTS

A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per-protocol analysis showed that EEDE increased by 10% (95% CI: 3%-17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%-10%) in the MICT group (n = 24), with no differences between groups. In the 8- to 16- week per-protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively.

CONCLUSIONS

Patients completing a 24-week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24-week MICT program. The HIIT/MICT group experienced, on average, a 3-kg-larger weight loss than the MICT group.

The Effect of High-Intensity Intermittent Training on the Acute Gait Plantar Pressure in Healthy Young Adults

High-intensity intermittent training (HIIT) has been successfully applied in various sports activities, as HIIT was considered as one of the most efficient training methods of exercise for improving physical performance and reducing the weight of overweight individuals. However, its acute effects of HIIT on gait and balance performance were not addressed. Thus, in this study we examined the acute effects of HIIT on dynamic postural control compared with steady-state training (SST) by analyzing plantar pressure parameters. In this study, sixteen healthy male adults were examined in 3 days. After exhaustive ramp-like cycle ergometer testing, the maximal heart rate (HRmax) of each participant was determined on the first day, then either a 20 minutes HIIT at 80–90% of HRmax or a 20 minutes SST at 60% of HRmax was randomly performed on the second and third day, respectively. Plantar pressure parameters were collected at comfortable walking velocity immediately after HIIT and SST respectively, and compared with the baseline data of plantar pressure gathered before maximal ramp test on the first day. The results showed significant differences in the plantar pressure in these three conditions of gait. Compared to pre-intervention and pre-SST, peak pressure and maximum force in the middle and lateral metatarsal increased significantly in post-HIIT. Meanwhile, the foot balance data indicate that post-HIIT exhibits more foot pronation than baseline. The center of pressure (COP) trajectory was medially shifted during the stance phase in post-SST, and noticeably in post-HIIT. The displacement and velocity of medial-lateral COP in the initial contact phase were greater in post-HIIT; while during the forefoot contact phase, post-HIIT showed fewer time percentages and greater velocity of medial-lateral COP. In conclusion, a single high-intensity intermittent training session adversely affected the acute dynamic postural control than steady-state training in healthy male adults.

Physiological Adaptations to High-Intensity Interval and Continuous Training in Kayak Athletes

Papandreou, A, Philippou, A, Zacharogiannis, E, and Maridaki, M. Physiological adaptations to high-intensity interval and continuous training in kayak athletes. J Strength Cond Res 34(8): 2258-2266, 2020-High-intensity interval training (HIIT) seems to be more effective than continuous training (CT) for the improvement of physical condition and sports performance. This study compared physiological adaptations with HIIT and CT in flat water kayak athletes. Twenty-four national-class kayakists were divided into 3 groups (n = 8 per group), 2 of which participated in an 8-week CT or HIIT program, whereas the third one served as control (C). An incremental maximum oxygen uptake (V[Combining Dot Above]O2max), a maximal anaerobic Wingate-type, as well as 1,000-m (T1,000 m) and 200-m (T200 m) time test were performed before and after the training period on a kayak ergometer, to determine changes in V[Combining Dot Above]O2max, peak blood lactate ([La]peak), paddling speed at V[Combining Dot Above]O2max ((Equation is included in full-text article.)), heart rate at V[Combining Dot Above]O2max (HRpeak), paddling economy speed (PEs; speed at 75% of V[Combining Dot Above]O2max), paddling speed at anaerobic ventilatory threshold (PSVT2), maximal paddling speed (PSpeak), and reduction of PSpeak (PSR). V[Combining Dot Above]O2max, [La]peak, HRpeak, and PSR did not change after the 8-week training compared with baseline in either training group (p > 0.05). However, significant changes were found in PSVT2 and T200 m (HIIT), (Equation is included in full-text article.), PEs, PSpeak, and T1,000 m (CT and HIIT) (p < 0.05-0.0001) as compared to baseline. Moreover, percent changes were different between the training groups in PEs, and between control and training groups in PSpeak and (Equation is included in full-text article.)(p < 0.05-0.01). Both training programs improved physiological and performance variables; however, HIIT resulted in significant changes of PSVT2 and T200 m and higher improvement of PEs with 15 times less training time compared with CT. Thus, HIIT seems more time-efficient than CT for improving paddling economy of kayaking performance.

Aerobic but not thermoregulatory gains following a 10-day moderate-intensity training protocol are fitness level dependent: A cross-adaptation perspective

Moderate‐intensity exercise sessions are incorporated into heat‐acclimation and hypoxic‐training protocols to improve performance in hot and hypoxic environments, respectively. Consequently, a training effect might contribute to aerobic performance gains, at least in less fit participants. To explore the interaction between fitness level and a training stimulus commonly applied during acclimation protocols, we recruited 10 young males of a higher (more fit‐MF, peak aerobic power [VO_2peak]: 57.9 [6.2] ml·kg⁻¹·min⁻¹) and 10 of a lower (less fit‐LF, VO_2peak: 41.7 [5.0] ml·kg⁻¹·min⁻¹) fitness level. They underwent 10 daily exercise sessions (60 min@50% peak power output [W_peak]) in thermoneutral conditions. The participants performed exercise testing on a cycle ergometer before and after the training period in normoxic (NOR), hypoxic (13.5% F_iO₂; HYP), and hot (35°C, 50% RH; HE) conditions in a randomized and counterbalanced order. Each test consisted of two stages; a steady‐state exercise (30 min@40% NOR W_peak to evaluate thermoregulatory function) followed by incremental exercise to exhaustion. VO_2peak increased by 9.2 (8.5)% (p = .024) and 10.2 (15.4)% (p = .037) only in the LF group in NOR and HE, respectively. W_peak increases were correlated with baseline values in NOR (r = −.58, p = .010) and HYP (r = −.52, p = .018). MF individuals improved gross mechanical efficiency in HYP. Peak sweat rate increased in both groups in HE, whereas MF participants activated the forehead sweating response at lower rectal temperatures post‐training. In conclusion, an increase in VO_2peak but not mechanical efficiency seems probable in LF males after a 10‐day moderate‐exercise training protocol.

High-Intensity Shoulder Abduction Exercise in Subacromial Pain Syndrome

Subacromial pain syndrome (SAPS) defined as pain of nontraumatic origin localized around the acromion, is a debilitating, common, and often chronic condition. Among many proposed underlying causes of SAPS, hypoperfusion and hypoxic conditions in and around the tendons may be an intrinsic cause of SAPS.

PURPOSE

This study aimed to determine if adding high-intensity aerobic interval training (HIIT) of the rotator cuff to usual care was feasible in SAPS and improved shoulder endurance more than usual care alone, as well as to examine the influence on shoulder pain and disability and the response of tendinous microcirculation after HIIT.

METHODS

Twenty-one subjects with chronic SAPS were randomized to two groups: experimental group (EG; n = 13) receiving HIIT in addition to treatment as usual and control group (CG; n = 8) receiving treatment as usual. Before and after 8 wk of exercise therapy, endurance performance was assessed by an incremental abduction exercise of the arm to exhaustion (TTE). Pain and disability was assessed by the shoulder pain and disability index (SPADI). Contrast-enhanced ultrasound of the musculus supraspinatus and tendon was utilized to indicate tendon blood flow.

RESULTS

Endurance in the TTE test improved by an estimated 233 s more on average in EG than in CG (P = 0.001; 95% confidence interval, 102 to 363). The SPADI score was reduced 22 points more on average in EG (P = 0.017; 95% confidence interval, -40 to -5). The change from pretest to posttest was significant in EG for both TTE test and SPADI improvement (P < 0.001). EG also experienced less pain during exercise after the intervention compared with CG (P < 0.001). Contrast-enhanced ultrasound indicated an increase in tendinous blood flow in EG (P = 0.019).

CONCLUSIONS

HIIT rotator cuff exercise seems to be a feasible intervention in SAPS, increasing endurance performance more than usual care alone.