Muscle phosphocreatine and pulmonary oxygen uptake kinetics in children at the onset and offset of moderate intensity exercise

The Influence of Acute Hypoxia on Oxygen Uptake and Muscle Oxygenation Kinetics During Cycling Exercise in Prepubertal Boys

PURPOSE

To examine the effect of normobaric hypoxia on pulmonary oxygen uptake (V˙O2) and muscle oxygenation kinetics during incremental and moderate-intensity exercise in children.

METHODS

Eight prepubertal boys (9-11 y) performed incremental cycle tests to exhaustion in both normoxia and hypoxia (fraction of inspired O2 of 15%) followed by repeat 6-minute transitions of moderate-intensity exercise in each condition over subsequent visits.

RESULTS

Maximal oxygen uptake (V˙O2max) was reduced in hypoxia compared with normoxia (1.69 [0.20] vs 1.87 [0.26] L·min-1, P = .028), although the gas exchange threshold was not altered in absolute terms (P = .33) or relative to V˙O2max (P = .78). During moderate-intensity exercise, the phase II V˙O2 time constant (τ) was increased in hypoxia (18 [9] vs 24 [8] s, P = .025), with deoxyhemoglobin τ unchanged (17 [8] vs 16 [6], P ≥ .28).

CONCLUSIONS

In prepubertal boys, hypoxia reduced V˙O2max and slowed V˙O2 phase II kinetics during moderate-intensity exercise, despite unchanged deoxyhemoglobin kinetics. These data suggest an oxygen delivery dependence of V˙O2max and moderate-intensity V˙O2 kinetics under conditions of reduced oxygen availability in prepubertal boys.

Longitudinal alterations of pulmonary V.O2 on-kinetics during moderate-intensity exercise in competitive youth cyclists are related to alterations in the balance between microvascular O2 distribution and muscular O2 utilization

Purpose

The main purpose of the current study was to investigate the dynamic adjustment of pulmonary oxygen uptake (V.O2) in response to moderate-intensity cycling on three occasions within 15 months in competitive youth cyclists. Furthermore, the muscle Δdeoxy[heme] on-kinetics and the Δdeoxy[heme]-to-V.O2 ratio were modeled to examine possible mechanistic basis regulating pulmonary V.O2 on-kinetics.

Methods

Eleven cyclists (initial age, 14.3 ± 1.6 y; peak V.O2, 62.2 ± 4.5 mL.min−1.kg−1) with a training history of 2–5 years and a training volume of ~10 h per week participated in this investigation. V.O2 and Δdeoxy[heme] responses during workrate-transitions to moderate-intensity cycling were measured with breath-by-breath spirometry and near-infrared spectroscopy, respectively, and subsequently modeled with mono-exponential models to derive parameter estimates. Additionally, a normalized Δdeoxy[heme]-to-V.O2 ratio was calculated for each participant. One-way repeated-measures ANOVA was used to assess effects of time on the dependent variables of the responses.

Results

The V.O2 time constant remained unchanged between the first (~24 s) and second visit (~22 s, P > 0.05), whereas it was significantly improved through the third visit (~13 s, P = 0.006–0.013). No significant effects of time were revealed for the parameter estimates of the Δdeoxy[heme] response (P > 0.05). A significant Δdeoxy[heme]-to-V.O2 ratio “overshoot” was evident on the first (1.09 ± 0.10, P = 0.006) and second (1.05 ± 0.09, P = 0.047), though not the third (0.97 ± 0.10, P > 0.05), occasion. These “overshoots” showed strong positive relationships with the V.O2 time constant during the first (r = 0.66, P = 0.028) and second visit (r = 0.76, P = 0.007). Further, strong positive relationships have been observed between the individual changes of the fundamental phase τp and the Δdeoxy[heme]-to-V.O2 ratio “overshoot” from occasion one to two (r = 0.70, P = 0.017), and two to three (r = 0.74, P = 0.009).

Conclusion

This suggests that improvements in muscle oxygen provision and utilization capacity both occurred, and each may have contributed to enhancing the dynamic adjustment of the oxidative “machinery” in competitive youth cyclists. Furthermore, it indicates a strong link between an oxygen maldistribution within the tissue of interrogation and the V.O2 time constant.

Oxygen Uptake Kinetics in Endurance Trained Youth and Adult Cyclists

Previous studies reported faster pulmonary oxygen uptake kinetics at the onset of exercise in untrained youth compared with adults. Whether or not these differences are identical for trained groups have not been examined. The purpose of this study was to compare ˙VO₂ kinetics of youth and adult cyclists at moderate and heavy-intensity exercise. Thirteen adult (age: 23.2 ± 4.8 years; ˙VO_2peak 68.4 ± 6.8 mL·min^-1.kg^-1) and thirteen youth cyclists (age: 14.3 ± 1.5 years; ˙VO_2peak 61.7 ± 4.3 mL·min^-1.kg^-1) completed a series of 6-min square wave exercises at moderate and heavy-intensity exercise at 90 rev·min^-1. A two-way repeated-measure ANOVA was conducted to identify differences between groups and intensities. The time constant, time delay and the mean response time were not significantly different between youth and adult cyclists (p > 0.05). We found significant differences between intensities, with a faster time constant during moderate than heavy-intensity exercise in youth (24.1 ± 7.0 s vs. 31.8 ± 5.6 s; p = 0.004) and adults (22.7 ± 5.6 s vs. 28.6 ± 5.7 s; p < 0.001). The present data suggest that the effect of training history in adult cyclists compensate for the superior primary response of the oxygen uptake kinetics typically seen in youth compared to adults. Furthermore, the ˙VO₂ response is dependent of work rate intensity in trained youth and adult cyclists.

Oxygen uptake kinetics during treadmill walking in adolescents with clinically stable cystic fibrosis

Background: Oxygen uptake (V̇O₂) kinetics have been shown to be slowed in adolescents with cystic fibrosis (CF) during heavy-intensity cycling and maximal exercise testing.Objectives: This study investigated V̇O₂ kinetics in adolescents with CF compared to control adolescents (CON) during a treadmill-walking exercise.Methods: Eight adolescents with CF and mild-to-moderate pulmonary obstruction (5 girls; 13.1 ± 2.5 years; FEV₁ 67.8 ± 21.4%) and 18 CON adolescents (10 girls; 13.8 ± 1.8 years) were recruited. Pulmonary gas exchange and ventilation were measured during a single transition of 10 min of treadmill walking and a 5 min seated recovery period. Participant's walking speed was determined during a one-minute self-paced walking task along a 50-m corridor. A six-parameter, non-linear regression model was used to describe the changes in V̇O₂ function during the treadmill walking and recovery, with monoexponential curve fitting used to describe the mean response time (MRT₁) at the onset of exercise, and the half-life (T_1/2V̇O₂) at the offset of exercise. V̇O₂ baseline and amplitude, minute ventilation and respiratory equivalents were recorded.Results: V̇O₂ kinetics were slower in CF group compared to CON group during the treadmill walking with a greater MRT₁ (32 ± 14 s vs 21 ± 16 s; p = .04, effect size = 0.75). The T_1/2V̇O2 was prolonged during recovery in CF group compared to CON group (86 ± 24 s vs 56 ± 22 s; p = .04, effect size = 1.31). The mean VE/V̇CO₂ during exercise was the only parameter significantly greater in CF group compared to CON group (32.9 ± 2.3 vs 29.0 ± 2.4; p < .01, effect size = 1.66). Conclusion: V̇O₂ kinetics were found to be slowed in adolescents with CF during treadmill walking.

Relationship between (non)linear phase II pulmonary oxygen uptake kinetics with skeletal muscle oxygenation and age in 11-15 year olds

NEW FINDINGS

What is the central question of this study? Do the phase II parameters of pulmonary oxygen uptake ( V ̇ O 2 ) kinetics display linear, first-order behaviour in association with alterations in skeletal muscle oxygenation during step cycling of different intensities or when exercise is initiated from an elevated work rate in youths. What is the main finding and its importance? Both linear and non-linear features of phase II V ̇ O 2 kinetics may be determined by alterations in the dynamic balance between microvascular O₂ delivery and utilization in 11-15 year olds. The recruitment of higher-order (i.e. type II) muscle fibres during 'work-to-work' cycling might be responsible for modulating V ̇ O 2 kinetics with chronological age.

ABSTRACT

This study investigated in 19 male youths (mean age: 13.6 ± 1.1 years, range: 11.7-15.7 years) the relationship between pulmonary oxygen uptake ( V ̇ O 2 ) and muscle deoxygenation kinetics during moderate- and very heavy-intensity 'step' cycling initiated from unloaded pedalling (i.e. U → M and U → VH) and moderate to very heavy-intensity step cycling (i.e. M → VH). Pulmonary V ̇ O 2 was measured breath-by-breath along with the tissue oxygenation index (TOI) of the vastus lateralis using near-infrared spectroscopy. There were no significant differences in the phase II time constant ( τ V ̇ O 2 p ) between U → M and U → VH (23 ± 6 vs. 25 ± 7 s; P = 0.36); however, the τ V ̇ O 2 p was slower during M → VH (42 ± 16 s) compared to other conditions (P < 0.001). Quadriceps TOI decreased with a faster (P < 0.01) mean response time (MRT; i.e. time delay + τ) during U → VH (14 ± 2 s) compared to U → M (22 ± 4 s) and M → VH (20 ± 6 s). The difference (Δ) between the τ V ̇ O 2 p and MRT-TOI was greater during U → VH compared to U → M (12 ± 7 vs. 2 ± 7 s, P < 0.001) and during M → VH (23 ± 15 s) compared to other conditions (P < 0.02), suggesting an increased proportional speeding of fractional O₂ extraction. The slowing of the τ V ̇ O 2 p during M → VH relative to U → M and U → VH correlated positively with chronological age (r = 0.68 and 0.57, respectively, P < 0.01). In youths, 'work-to-work' transitions slowed microvascular O₂ delivery-to-O₂ utilization with alterations in phase II V ̇ O 2 dynamics accentuated between the ages of 11 and 15 years.

Oxygen Uptake Kinetics in Youth: Characteristics, Interpretation, and Application

Pulmonary oxygen uptake ( V˙O2 ) kinetics, which describes the aerobic response to near instantaneous changes in metabolic demand, provides a valuable insight into the control and coordination of oxidative phosphorylation during exercise. Despite their applicability to the highly sporadic habitual physical activity and exercise patterns of children, relatively little is known regarding the influence of internal and external stimuli on the dynamic V˙O2 response. Although insufficient evidence is available during moderate-intensity exercise, an age-related slowing of the phase 2 time constant (τ) and augmentation of the V˙O2 slow component appears to manifest during heavy-intensity exercise, which may be related to changes in the muscle phosphate controllers of oxidative phosphorylation, muscle oxygen delivery and utilization, and/or muscle fiber type recruitment patterns. Similar to findings in adults, aerobic training is associated with a faster phase 2 τ and smaller V˙O2 slow component in youth, independent of age or maturity, indicative of an enhanced oxidative metabolism. However, a lack of longitudinal or intervention-based training studies limits our ability to attribute these changes to training per se. Further, methodologically rigorous studies are required to fully resolve the interaction(s) between age, sex, biological maturity, and external stimuli, such as exercise training and exercise intensity and the dynamic V˙O2 response at the onset and offset of exercise.

The efficacy of a discontinuous graded exercise test in measuring peak oxygen uptake in children aged 8 to 10 years

As children's natural activity patterns are highly intermittent in nature, and characterised by rapid changes from rest to vigorous physical activity, discontinuous exercise tests may be considered ecologically valid for this population group. This study compared the peak physiological responses from a discontinuous and continuous graded exercise test (GXT_D, GXT_C, respectively) during treadmill exercise in children. Twenty-one healthy children (9.6 ± 0.6 y) completed GXT_D and GXT_C in a randomised order, separated by 72-hours. Following each GXT, and after a 15-minute recovery, participants completed a verification test at 105% of the velocity attained at peak oxygen consumption (VO2peak). There were no differences in VO2peak (55.3 ± 8.2 cf. 54.4 ± 7.6 mL·kg-1·min-1) or maximal heart rate (202 ± 10 cf. 204 ± 8 b·min-1) between GXT_C and GXT_D, respectively (P>.05). Peak running speed (10.7 ± 0.9 cf. 12.1 ± 1.3 km·h-1) and respiratory exchange ratio (1.04 ± 0.05 cf. 0.92 ± 0.05) were however different between tests (P<.001). Although similar peak physiological values were revealed between GXT_C and the corresponding verification test (P>.05), VO2peak (53.3 ± 7.3 mL·kg-1·min-1) and heart rate (197 ± 13 b·min-1) were significantly lower in the GXT_D verification test (P<.05). In conclusion, a discontinuous GXT is an accurate measure of VO2peak in children aged 8 to 10 years and may be a valid alternative to a continuous GXT, despite its longer duration.

Muscle metabolism changes with age and maturation: How do they relate to youth sport performance?

AIM

To provide an evidence-based review of muscle metabolism changes with sex-, age- and maturation with reference to the development of youth sport performance.

METHODS

A narrative review of data from both invasive and non-invasive studies, from 1970 to 2015, founded on personal databases supported with computer searches of PubMed and Google Scholar.

RESULTS

Youth sport performance is underpinned by sex-, age- and maturation-related changes in muscle metabolism. Investigations of muscle size, structure and metabolism; substrate utilisation; pulmonary oxygen uptake kinetics; muscle phosphocreatine kinetics; peak anaerobic and aerobic performance; and fatigue resistance; determined using a range of conventional and emerging techniques present a consistent picture. Age-related changes have been consistently documented but specific and independent maturation-related effects on muscle metabolism during exercise have proved elusive to establish. Children are better equipped for exercise supported primarily by oxidative metabolism than by anaerobic metabolism. Sexual dimorphism is apparent in several physiological variables underpinning youth sport performance. As young people mature there is a progressive but asynchronous transition into an adult metabolic profile.

CONCLUSIONS

The application of recent developments in technology to the laboratory study of the exercising child and adolescent has both supplemented existing knowledge and provided novel insights into developmental exercise physiology. A sound foundation of laboratory-based knowledge has been established but the lack of rigorously designed child-specific and sport-specific testing environments has clouded the interpretation of the data in real life situations. The primary challenge remains the translation of laboratory research into the optimisation of youth sports participation and performance.

The effect of priming exercise on O2 uptake kinetics, muscle O2 delivery and utilization, muscle activity, and exercise tolerance in boys

This study used priming exercise in young boys to investigate (i) how muscle oxygen delivery and oxygen utilization, and muscle activity modulate oxygen uptake kinetics during exercise; and (ii) whether the accelerated oxygen uptake kinetics following priming exercise can improve exercise tolerance. Seven boys that were aged 11.3 ± 1.6 years completed either a single bout (bout 1) or repeated bouts with 6 min of recovery (bout 2) of very heavy-intensity cycling exercise. During the tests oxygen uptake, muscle oxygenation, muscle electrical activity and exercise tolerance were measured. Priming exercise most likely shortened the oxygen uptake mean response time (change, ±90% confidence limits; -8.0 s, ±3.0), possibly increased the phase II oxygen uptake amplitude (0.11 L·min(-1), ±0.09) and very likely reduced the oxygen uptake slow component amplitude (-0.08 L·min(-1), ±0.07). Priming resulted in a likely reduction in integrated electromyography (-24% baseline, ±21% and -25% baseline, ±19) and a very likely reduction in Δ deoxyhaemoglobin/Δoxygen uptake (-0.16, ±0.11 and -0.09, ±0.05) over the phase II and slow component portions of the oxygen uptake response, respectively. A correlation was present between the change in tissue oxygenation index during bout 2 and the change in the phase II (r = -0.72, likely negative) and slow component (r = 0.72, likely positive) oxygen uptake amplitudes following priming exercise, but not for muscle activity. Exercise tolerance was likely reduced (change -177 s, ±180) following priming exercise. The altered phase II and slow component oxygen uptake amplitudes in boys following priming exercise are linked to an improved localised matching of muscle oxygen delivery to oxygen uptake and not muscle electrical activity. Despite more rapid oxygen uptake kinetics following priming exercise, exercise tolerance was not enhanced.

Changes in phosphocreatine concentration of skeletal muscle during high-intensity intermittent exercise in children and adults

PURPOSE

The aim of the present study was to test the hypotheses that a greater oxidative capacity in children results in a lower phosphocreatine (PCr) depletion, a faster PCr resynthesis and a lower muscle acidification during high-intensity intermittent exercise compared to adults.

METHODS

Sixteen children (9.4 ± 0.5 years) and 16 adults (26.1 ± 0.3 years) completed a protocol consisting of a dynamic plantar flexion (10 bouts of 30-s exercise at 25 % of one repetition maximum separated by 20-s recovery), followed by 10 min of passive recovery. Changes of PCr, ATP, inorganic phosphate, and phosphomonoesters were measured by means of (31)Phosphorous-magnetic resonance spectroscopy during and post-exercise.

RESULTS

Average PCr (percentage of [PCr] at initial rest (%[PCr]i)) at the end of the exercise (adults 17 ± 12 %[PCr]i, children 38 ± 17 %[PCr]i, P < 0.01) and recovery periods (adults 37 ± 14 %[PCr]i, children 57 ± 17 %[PCr]i, P < 0.01) was significantly lower in adults compared to children, induced by a stronger PCr decrease during the first exercise interval (adults -73 ± 10 %[PCr]i, children -55 ± 15 %[PCr]i, P < 0.01). End-exercise pH was significantly higher in children compared to adults (children 6.90 + 0.20, -0.14; adults 6.67 + 0.23, -0.15, P < 0.05).

CONCLUSIONS

From our results we suggest relatively higher rates of oxidative ATP formation in children's muscle for covering the ATP demand of high-intensity intermittent exercise compared to adults, enabling children to begin each exercise interval with significantly higher PCr concentrations and leading to an overall lower muscle acidification.

A comparison of the oxygen cost and physiological responses to running in children with and without Developmental Coordination Disorder

The aim of this study was to compare the oxygen cost of running in boys with and without Developmental Coordination Disorder (DCD). Fourteen boys with DCD (9.1 ± 1.4 yr) and 16 typically developing (TD) controls (9.4 ± 1.3 yr) were tested on two separate occasions at least a week apart. On the first visit, motor proficiency, body composition and maximal aerobic capacity were established. On the second visit, oxygen consumption was determined via indirect calorimetry while participants ran at three submaximal speeds (7.2 km/h, 8.0 km/h and 8.8 km/h) on a motorised treadmill for 4 min each. Additional physiological responses such as blood lactate, respiratory exchange ratio (RER), heart rate, salivary alpha amylase and pain threshold were monitored at baseline and after each submaximal effort. Although there were no differences in the oxygen cost of running at all three speeds, the boys with DCD had higher blood lactate concentration (7.2 km/h, p=0.05; 8.0 km/h p=0.019), heart rate (p ≤ 0.001), RER (8.0 km/h, p=0.019; 8.8 km/h, p=0.001), salivary alpha amylase (8.0 km/h, p=0.023; 8.8 km/h, p=0.020) and a lower pain threshold (p<0.01). The higher overall metabolic cost of running in boys with DCD as indicated by the higher RER, heart rate and blood lactate concentrations, together with the higher levels of sympathoadrenal medullary activity and sensitivity to pain, may be deterring factors for participation in physical activity in this population.

Pulmonary oxygen uptake and muscle deoxygenation kinetics during recovery in trained and untrained male adolescents

Previous studies have demonstrated faster pulmonary oxygen uptake (VO2) kinetics in the trained state during the transition to and from moderate-intensity exercise in adults. Whilst a similar effect of training status has previously been observed during the on-transition in adolescents, whether this is also observed during recovery from exercise is presently unknown. The aim of the present study was therefore to examine VO2 kinetics in trained and untrained male adolescents during recovery from moderate-intensity exercise. 15 trained (15 ± 0.8 years, VO2max 54.9 ± 6.4 mL kg(-1) min(-1)) and 8 untrained (15 ± 0.5 years, VO2max 44.0 ± 4.6 mL kg(-1) min(-1)) male adolescents performed two 6-min exercise off-transitions to 10 W from a preceding "baseline" of exercise at a workload equivalent to 80% lactate threshold; VO2 (breath-by-breath) and muscle deoxyhaemoglobin (near-infrared spectroscopy) were measured continuously. The time constant of the fundamental phase of VO2 off-kinetics was not different between trained and untrained (trained 27.8 ± 5.9 s vs. untrained 28.9 ± 7.6 s, P = 0.71). However, the time constant (trained 17.0 ± 7.5 s vs. untrained 32 ± 11 s, P < 0.01) and mean response time (trained 24.2 ± 9.2 s vs. untrained 34 ± 13 s, P = 0.05) of muscle deoxyhaemoglobin off-kinetics was faster in the trained subjects compared to the untrained subjects. VO2 kinetics was unaffected by training status; the faster muscle deoxyhaemoglobin kinetics in the trained subjects thus indicates slower blood flow kinetics during recovery from exercise compared to the untrained subjects.

The extent of aerobic system activation during continuous and interval exercise protocols in young adolescents and men

This study assessed the extent of aerobic system activation in young adolescents and men during heavy continuous (HC), short-interval (SI), and long-interval (LI) aerobic exercise protocols, and compared this response between the 2 age groups in the 3 protocols. Ten young adolescents (aged 13.2 ± 0.3 years) and 10 men (aged 21.0 ± 1.6 years) completed a maximal incremental test, an HC exercise protocol (83% of maximal aerobic velocity; MAV), an SI exercise protocol (30 s at 110% MAV with 30 s at 50%), and an LI exercise protocol (3 min at 95% MAV with 3 min at 35%). Oxygen consumption and heart rate were measured continuously, and blood samples were obtained for lactate determination. Men completed more runs and distance in the SI protocol (p < 0.05) than adolescents; however, there were no age differences in the number of LI runs and in the duration of HC protocol. In both age groups, more time was spent above 90% and 95% of maximal oxygen consumption (p < 0.05), and a higher percentage of maximal oxygen consumption was reached in the LI compared with the HC and SI protocols, with no differences between the HC and SI protocols. Although within each protocol the percentage of maximal oxygen consumption achieved and time spent above 90% and 95% of maximal oxygen consumption was not different between age groups, the time spent at 80% maximal oxygen consumption was longer for adolescents than men in the HC protocol, and longer for men than boys in the SI protocol (p < 0.05). In conclusion, all protocols elicited high levels of aerobic activation in both age groups. The LI protocol taxed the aerobic system at 90%–100% of maximal oxygen consumption for a longer time when compared with the HC and SI protocols in young adolescents and in men. However, differences were observed between groups in taxing the aerobic system at 80% maximal oxygen consumption: in young adolescents, the HC protocol allowed longer running time than the LI and SI protocols, while in men there were no differences among protocols.

The influence of priming exercise on oxygen uptake, cardiac output, and muscle oxygenation kinetics during very heavy-intensity exercise in 9- to 13-yr-old boys

The present study examined the effect of priming exercise on O2 uptake (V̇o2) kinetics during subsequent very heavy exercise in eight 9- to 13-yr-old boys. We hypothesised that priming exercise would 1) elevate muscle O2 delivery prior to the subsequent bout of very heavy exercise, 2) have no effect on the phase II V̇o2 τ, 3) elevate the phase II V̇o2 total amplitude, and 4) reduce the magnitude of the V̇o2 slow component. Each participant completed repeat 6-min bouts of very heavy-intensity cycling exercise separated by 6 min of light pedaling. During the tests V̇o2, muscle oxygenation (near infrared spectroscopy), and cardiac output (Q̇) (thoracic impedance) were determined. Priming exercise increased baseline muscle oxygenation and elevated Q̇ at baseline and throughout the second exercise bout. The phase II V̇o2 τ was not altered by priming exercise ( bout 1: 22 ± 7 s vs. bout 2: 20 ± 4 s; P = 0.30). However, the time constant describing the entire V̇o2 response from start to end of exercise was accelerated ( bout 1: 43 ± 8 s vs. bout 2: 36 ± 5 s; P = 0.002) due to an increased total phase II V̇o2 amplitude ( bout 1: 1.73 ± 0.33 l/min vs. bout 2: 1.80 ± 0.59 l/min; P = 0.002) and a reduced V̇o2 slow component amplitude ( bout 1: 0.18 ± 0.08 l/min vs. bout 2: 0.12 ± 0.09 l/min; P = 0.048). These results suggest that phase II V̇o2 kinetics in young boys is principally limited by intrinsic muscle metabolic factors, whereas the V̇o2 total phase II and slow component amplitudes may be O2 delivery sensitive.

Age- and sex-related differences in muscle phosphocreatine and oxygenation kinetics during high-intensity exercise in adolescents and adults

The aim of this investigation was to examine the adaptation of the muscle phosphates (e.g. phosphocreatine (PCr) and ADP) implicated in regulating oxidative phosphorylation, and oxygenation at the onset of high intensity exercise in children and adults. The hypotheses were threefold: primary PCr kinetics would be faster in children than adults; the amplitude of the PCr slow component would be attenuated in children; and the amplitude of the deoxyhaemoglobin/myoglobin (HHb) slow component would be reduced in children. Eleven children (5 girls, 6 boys, 13 +/- 1 years) and 11 adults (5 women, 6 men, 24 +/- 4 years) completed two to four constant work rate exercise tests within a 1.5 T MR scanner. Quadriceps muscle energetics during high intensity exercise were monitored using (31)P-MRS. Muscle oxygenation was monitored using near-infrared spectroscopy. The time constant for the PCr response was not significantly different in boys (31 +/- 10 s), girls (31 +/- 10 s), men (44 +/- 20 s) or women (29 +/- 14 s, main effects: age, p = 0.37, sex, p = 0.25). The amplitude of the PCr slow component relative to end-exercise PCr was not significantly different between children (23 +/- 23%) and adults (17 +/- 13%, p = 0.47). End-exercise [PCr] was significantly lower, and [ADP] higher, in females (18 +/- 4 mM and 53 +/- 16 microM) than males (23 +/- 4 mM, p = 0.02 and 37 +/- 11 microM, p = 0.02), but did not differ with age ([PCr]: p = 0.96, [ADP]: p = 0.72). The mean response time for muscle tissue deoxygenation was significantly faster in children (22 +/- 4 s) than adults (27 +/- 7 s, p = 0.01). The results of this study show that the control of oxidative metabolism at the onset of high intensity exercise is adult-like in 13-year-old children, but that matching of oxygen delivery to extraction is more precise in adults.

Early oxygen uptake recovery following exercise testing in children with chronic chest diseases

The value of exercise testing as an objective measure of disease severity in patients with chronic chest diseases (CCD) is becoming increasingly recognized. The aim of this study was to investigate changes in oxygen uptake (VO2) during early recovery following maximal cardiopulmonary exercise testing (CPXT) in relation to functional capacity and markers of disease severity. Twenty-seven children with CCD (age 12.7 +/- 3.1 years; 17 female) [19 children with Cystic fibrosis (CF) (age 13.4 +/- 3.1 years; 10 female) and 8 with other stable non-CF chest diseases (NON-CF) (age 11.1 +/- 2.2 years; 7 female)] and 27 healthy controls (age 13.2 +/- 3.3 years; 17 female) underwent CPXT on a cycle ergometer. On-line respiratory gas analysis measured VO2 before and during CPXT to peak VO2) (VO2(peak)), and during the first 10 min of recovery. Early VO2 recovery was quantified by the time (sec) to reach 50% of the VO2 (peak) value. Early VO2 recovery was correlated against spirometry [forced expiratory volume in 1 sec (FEV(1)) and forced expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75))] and aerobic fitness (VO2)(peak)) as a measure of functional capacity. Disease severity was graded in the CF patients by the Shwachman score (SS). Compared to controls, children with CCD demonstrated a significantly reduced VO2(peak) (P = 0.011), FEV(1) (P < 0.001), FEF(25-75) (P < 0.001), and a significantly prolonged early (VO2) recovery (P = 0.024). In the CF patients the SS was significantly correlated with early VO2 recovery (r = -0.63, P = 0.004), FEV(1) (r = 0.72, P = 0.001), and FEF(25-75) (r = 0.57, P = 0.011). In the children with CCD, FEV(1), FEF(25-75), and BMI were not significantly correlated with VO2(peak) or early VO2 recovery. Lung function does not necessarily reflect aerobic fitness and the ability to recover from exercise in these patients. A significant relationship was found between VO2(peak) and early VO2 recovery (r = -0.39, P = 0.044) in the children with CCD, showing that a greater aerobic fitness corresponded with a faster recovery.

Muscle phosphocreatine kinetics in children and adults at the onset and offset of moderate-intensity exercise

The splitting of muscle phosphocreatine (PCr) plays an integral role in the regulation of muscle O2 utilization during a "step" change in metabolic rate. This study tested the hypothesis that the kinetics of muscle PCr would be faster in children compared with adults both at the onset and offset of moderate-intensity exercise, in concert with the previous demonstration of faster phase II pulmonary O2 uptake kinetics in children. Eighteen peri-pubertal children (8 boys, 10 girls) and 16 adults (8 men, 8 women) completed repeated constant work-rate exercise transitions corresponding to 80% of the Pi/PCr intracellular threshold. The changes in quadriceps [PCr], [Pi], [ADP], and pH were determined every 6 s using 31P-magnetic resonance spectroscopy. No significant (P>0.05) age- or sex-related differences were found in the PCr kinetic time constant at the onset (boys, 21+/-4 s; girls, 24+/-5 s; men, 26+/-9 s; women, 24+/-7 s) or offset (boys, 26+/-5 s; girls, 29+/-7 s; men, 23+/-9 s; women 29+/-7 s) of exercise. Likewise, the estimated theoretical maximal rate of oxidative phosphorylation (Qmax) was independent of age and sex (boys, 1.39+/-0.20 mM/s; girls, 1.32+/-0.32 mM/s; men, 2.36+/-1.18 mM/s; women, 1.51+/-0.53 mM/s). These results are consistent with the notion that the putative phosphate-linked regulation of muscle O2 utilization is fully mature in peri-pubertal children, which may be attributable to a comparable capacity for mitochondrial oxidative phosphorylation in child and adult muscle.