The Effects of Hyperoxia on Sea-Level Exercise Performance, Training, and Recovery: A Meta-Analysis. Sports Med. 2018;48:153-175. [PMID: 28975517 DOI: 10.1007/s40279-017-0791-2]

Repeated Short-Term Bouts of Hyperoxia Improve Aerobic Performance in Acute Hypoxia

ABSTRACT

Faulhaber, M, Schneider, S, Rausch, LK, Dünnwald, T, Menz, V, Gatterer, H, Kennedy, MD, and Schobersberger, W. Repeated short-term bouts of hyperoxia improve aerobic performance in acute hypoxia. J Strength Cond Res 37(10): 2016-2022, 2023-This study aimed to test the effects of repeated short-term bouts of hyperoxia on maximal 5-minute cycling performance under acute hypoxic conditions (3,200 m). Seventeen healthy and recreationally trained individuals (7 women and 10 men) participated in this randomized placebo-controlled cross-over trial. The procedures included a maximal cycle ergometer test and 3 maximal 5-minute cycling time trials (TTs). TT1 took place in normoxia and served for habituation and reference. TT2 and TT3 were conducted in normobaric hypoxia (15.0% inspiratory fraction of oxygen). During TT2 and TT3, the subjects were breathing through a face mask during five 15-second periods. The face mask was connected through a nonrebreathing T valve to a 300-L bag filled with 100% oxygen (intermittent hyperoxia) or ambient hypoxic air (placebo). The main outcome was the mean power output during the TT. Statistical significance level was set at p < 0.05. The mean power output was higher in the intermittent hyperoxia compared with the placebo condition (255.5 ± 49.6 W vs. 247.4 ± 48.2 W, p = 0.001). Blood lactate concentration and ratings of perceived exertion were significantly lower by about 9.7 and 7.3%, respectively, in the intermittent hyperoxia compared with the placebo condition, whereas heart rate values were unchanged. IH application increased arterial oxygen saturation (82.9 ± 2.6% to 92.4 ± 3.3%, p < 0.001). Repeated 15-second bouts of hyperoxia, applied during high-intensity exercise in hypoxia, are sufficient to increase power output. Future studies should focus on potential dose-response effects and the involved mechanisms.

Does Hyperbaric Oxygenation Improve Athletic Performance?

ABSTRACT

Šet, V, and Lenasi, H. Does hyperbaric oxygenation improve athletic performance? J Strength Cond Res 37(2): 482-493, 2023-Hyperbaric oxygen (HBO) has been suggested to affect oxygen availability and performance, and delay the onset of fatigue. Many mechanisms of HBO-induced alterations have been proposed, including modulation of various metabolic pathways, and the antioxidant defense mechanisms. As exercise per se affects similar aspects, it is tempting to speculate that simultaneous application of both, exercise and HBO might have synergistic effects. The aim of this review was to search through the currently available literature and evaluate the effect of acute exposure to HBO on exercise performance, potential effects of a combination of HBO and physical training, and to elucidate some possible mechanisms behind. We conducted searches in the PubMed and Scopus databases (search term: "hyperbaric" AND "oxygen" AND "exercise") and in relevant hyperbaric textbook and assessed potentially eligible full texts for details. Meta-analysis could not be performed because of a few available and rather heterogeneous studies. Twenty-seven studies were included in the final assessment (14 on exercise during HBO, 9 on exercise following HBO, 4 on applying HBO during recovery and rest between exercise bouts, and 3 on a combination of HBO and training). The results are contradictory, showing either positive or none ergogenic effects. There is some risk of bias and placebo effect. Discrepant findings of the available studies might partly be explained by different protocols applied, both regarding HBO and exercise intensity and regimen. There is a need for further research with well-designed trials to evaluate the effect of HBO on performance before recommending it to routine use in athletes.

Ginseng Pectin WGPA Alleviates Exercise-Induced Fatigue by Enhancing Gluconeogenesis

With the development of medicine and sport science, growing attention has been paid to the recovery of exercise-induced fatigue. Ginseng pectin has been shown to be important for a variety of biological functions. Although many studies suggest that ginseng pectin plays an important role in the alleviation of exercise-induced fatigue, the underlying mechanism still remains unclear. In this study, C57BL/6J mice were subjected to a wheel apparatus for exhaustive exercise and fed with ginseng pectin WGPA (acidic fraction of water-soluble ginseng polysaccharides) afterwards. Subsequently, a series of physiological and biochemical indexes, such as blood lactic acid, blood glucose, muscle glycogen, insulin, and glucagon, is evaluated. Meanwhile, enzymatic activity and mRNA level of key enzymes involved in hepatic gluconeogenesis are analyzed. Our results demonstrate that the treatment of ginseng pectin WGPA can result in enhanced gluconeogenesis and decreased insulin and in turn facilitate the recovery of exercise-induced fatigue. In response to WGPA treatment, both phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6 phosphatase (G6Pase) activity were upregulated, indicating that these two enzymes play a critical role in WGPA-induced upregulation in gluconeogenesis. Moreover, mRNA level of G6Pase, but not PEPCK, was increased upon WGPA treatment, suggesting that G6Pase expression is regulated by WGPA. Importantly, the presence of WGPA downregulated insulin both in vivo and in vitro, suggesting the upregulation in gluconeogenesis may be due to alterations in insulin. Together, we provide evidence that ginseng pectin WGPA is able to alleviate exercise-induced fatigue by reducing insulin and enhancing gluconeogenesis.

Adaptive Responses to Hypoxia and/or Hyperoxia in Humans

Significance: Oxygen is indispensable for aerobic life, but its utilization exposes cells and tissues to oxidative stress; thus, tight regulation of cellular, tissue, and systemic oxygen concentrations is crucial. Here, we review the current understanding of how the human organism (mal-)adapts to low (hypoxia) and high (hyperoxia) oxygen levels and how these adaptations may be harnessed as therapeutic or performance enhancing strategies at the systemic level. Recent Advances: Hyperbaric oxygen therapy is already a cornerstone of modern medicine, and the application of mild hypoxia, that is, hypoxia conditioning (HC), to strengthen the resilience of organs or the whole body to severe hypoxic insults is an important preparation for high-altitude sojourns or to protect the cardiovascular system from hypoxic/ischemic damage. Many other applications of adaptations to hypo- and/or hyperoxia are only just emerging. HC-sometimes in combination with hyperoxic interventions-is gaining traction for the treatment of chronic diseases, including numerous neurological disorders, and for performance enhancement. Critical Issues: The dose- and intensity-dependent effects of varying oxygen concentrations render hypoxia- and/or hyperoxia-based interventions potentially highly beneficial, yet hazardous, although the risks versus benefits are as yet ill-defined. Future Directions: The field of low and high oxygen conditioning is expanding rapidly, and novel applications are increasingly recognized, for example, the modulation of aging processes, mood disorders, or metabolic diseases. To advance hypoxia/hyperoxia conditioning to clinical applications, more research on the effects of the intensity, duration, and frequency of altered oxygen concentrations, as well as on individual vulnerabilities to such interventions, is paramount. Antioxid. Redox Signal. 37, 887-912.

Oxygen-enriched Air Decreases Ventilation during High-intensity Fin-swimming Underwater

Oxygen-enriched air is commonly used in the sport of SCUBA-diving and might affect ventilation and heart rate, but little work exists for applied diving settings. We hypothesized that ventilation is decreased especially during strenuous underwater fin-swimming when using oxygen-enriched air as breathing gas. Ten physically-fit divers (age: 25±4; 5 females; 67±113 open-water dives) performed incremental underwater fin-swimming until exhaustion at 4 m water depth with either normal air or oxygen-enriched air (40% O ₂ ) in a double-blind, randomized within-subject design. Heart rate and ventilation were measured throughout the dive and maximum whole blood lactate samples were determined post-exercise. ANOVAs showed a significant effect for the factor breathing gas (F(1, 9)=7.52; P=0.023; η ²_p =0.455), with a lower ventilation for oxygen-enriched air during fin-swimming velocities of 0.6 m·s ⁻¹ (P=0.032) and 0.8 m·s ⁻¹ (P=0.037). Heart rate, lactate, and time to exhaustion showed no significant differences. These findings indicate decreased ventilation by an elevated oxygen fraction in the breathing gas when fin-swimming in shallow-water submersion with high velocity (>0.5 m·s ⁻¹ ). Applications are within involuntary underwater exercise or rescue scenarios for all dives with limited gas supply.

The Acute Effect of Hyperoxia on Onset of Blood Lactate Accumulation (OBLA) and Performance in Female Runners during the Maximal Treadmill Test

The objective of this study was to analyze the acute effect of hyperoxia during the maximal treadmill test (MTT) of runners. Participants included 10 female street runners who performed the MTT under two different conditions: hyperoxia (HYPX), inhaling oxygen (60% O₂) every 3 min; and normoxia (NORM), without additional oxygen inhalation. Both groups performed the MTT with increases in the slope of the run every 3 min until voluntary exhaustion. The variables of lactate concentration, the onset of blood lactate accumulation (OBLA), peripheral oxygen saturation (SpO₂), heart rate (HR), and Borg scale were evaluated. It was verified after the comparison (HYPX vs. NORM) that stage 3 (p = 0.012, Cohen’s d = 1.76) and stage 4 (p < 0.001; Cohen’s d = 5.69) showed a reduction in lactate under the HYPX condition. OBLA under the HYPX condition was identified at a later stage than NORM. There were no differences in Borg scale, SpO₂, and HR between the different conditions. It was concluded that the HYPX condition contributed to a reduction in lactate concentration and delayed OBLA in runners.

Exercise intervention under hypoxic condition as a new therapeutic paradigm for type 2 diabetes mellitus: A narrative review

This review aims to summarize the health benefits of exposure to hypoxic conditions during exercise in patients with type 2 diabetes mellitus (T2DM). Exposure to hypoxic conditions during exercise training positively changes the physiological response in healthy subjects. Exposure to hypoxic conditions during exercise could markedly increase skeletal muscle glucose uptake compared to that in normoxic conditions. Furthermore, post-exercise insulin sensitivity of T2DM patients increases more when exercising under hypoxic than under normoxic conditions. Regular exercise under short-term hypoxic conditions can improve blood glucose control at lower workloads than in normoxic conditions. Additionally, exercise training under short-term hypoxic conditions can maximize weight loss in overweight and obese patients. Previous studies on healthy subjects have reported that regular exercise under hypoxic conditions had a more positive effect on vascular health than exercising under normoxic conditions. However, currently, evidence indicating that exposure to hypoxic conditions could positively affect T2DM patients in the long-term is lacking. Therefore, further evaluations of the beneficial effects of exercise under hypoxic conditions on the human body, considering different cycle lengths, duration of exposures, sessions per day, and the number of days, are necessary. In this review, we conclude that there is evidence that exercise under hypoxic conditions can yield health benefits, which is potentially valuable in terms of clinical care as a new intervention for T2DM patients.

Is Structured Exercise Performed with Supplemental Oxygen a Promising Method of Personalized Medicine in the Therapy of Chronic Diseases?

Aim: This systematic review aimed to explore the literature to identify in which types of chronic diseases exercise with supplemental oxygen has previously been utilized and whether this type of personalized therapy leads to superior effects in physical fitness and well-being. Methods: Databases (PubMed/MEDLINE, CINHAL, EMBASE, Web of knowledge and Cochrane Library) were searched in accordance with PRISMA. Eligibility criteria included adult patients diagnosed with any type of chronic diseases engaging in supervised exercise training with supplemental oxygen compared to normoxia. A random-effects model was used to pool effect sizes by standardized mean differences (SMD). Results: Out of the identified 4038 studies, 12 articles were eligible. Eleven studies were conducted in chronic obstructive pulmonary disease (COPD), while one study included coronary artery disease (CAD) patients. No statistical differences were observed for markers of physical fitness and patient-reported outcomes on well-being between the two training conditions (SMD −0.10; 95% CI −0.27, 0.08; p = 0.26). Conclusions: We found that chronic exercise with supplemental oxygen has mainly been utilized for COPD patients. Moreover, no superior long-term adaptations on physical fitness, functional capacity or patient-reported well-being were found, questioning the role of this method as a personalized medicine approach. Prospero registration: CRD42018104649.

Effects of hyperoxia on dynamic muscular endurance are associated with individual whole-body endurance capacity

Low-intensity training involving high repetitions is recommended to enhance muscular endurance. Hyperoxic conditions could increase the number of repetitions until exhaustion and thereby improve the results of muscular endurance training. This study aimed to investigate the acute effects of hyperoxia on dynamic muscular endurance, and determine individual factors that may be related to these effects. A single-blinded, counterbalanced crossover design was used. Twenty-five young men performed repetitions of the one-arm preacher curl at 30% of their 1-repetition maximum until exhaustion under hyperoxic and normoxic conditions. The maximum number of repetitions was recorded as an index of muscular endurance. Electromyogram (EMG) and near-infrared spectroscopy parameters were measured in the biceps brachii. The maximum number of repetitions was greater (P < 0.001) under hyperoxic conditions (132 ± 59 repetitions) than under normoxic conditions (114 ± 40 repetitions). The root mean square amplitude of EMG and oxygenated hemoglobin concentration for the last five repetitions under normoxic conditions were greater than those under hyperoxic conditions (P = 0.015 and P = 0.003, respectively). The percent change in the maximum number of repetitions between hyperoxic and normoxic conditions had significant positive correlations with individual maximal oxygen uptake measured using an incremental cycle ergometer test (r = 0.562, 95% confidence intervals [CI] = 0.213-0.783, P = 0.003), but not with muscle strength (τ = -0.124, 95% CI = -0.424-0.170, P = 0.387). The 95% CI for the correlation coefficient between the percent change in the maximum number of repetitions and muscular endurance included 0 (τ = 0.284, 95% CI = -0.003-0.565, P = 0.047); this indicated no significant correlation between the two parameters. The results suggest that hyperoxia can acutely enhance dynamic muscular endurance, with delayed elevation of EMG amplitude due to fatigue, and the effects are associated with individual whole-body endurance capacity.

Can Hyperoxic Preconditioning in Normobaric Hypoxia (3500 m) Improve All-Out Exercise Performance in Highly Skilled Skiers? A Randomized Crossover Study

BACKGROUND

The altering effects of hypoxia on aerobic/anaerobic performance are well documented and form the basis of this study. Application of hyperoxic gases (inspiratory fraction of oxygen [FiO2] > 0.2095) prior to competition or training (hyperoxic preconditioning) can compensate for the negative influence of acute hypoxia.

PURPOSE

To investigate whether oxygen supplementation immediately prior to exercise (FiO2 = 1.0) improves all-out exercise performance in normobaric hypoxia (3500 m) in highly skilled skiers.

METHODS

In this single-blind, randomized, crossover study, 17 subjects performed a 60-second constant-load, all-out test in a normobaric hypoxic chamber. After a short period of adaptation to hypoxia (60 min), they received either pure oxygen or chamber air for 5 minutes prior to the all-out test (hyperoxic preconditioning vs nonhyperoxic preconditioning). Capillary blood was collected 3 times, and muscle oxygenation was assessed with near-infrared spectroscopy.

RESULTS

Absolute and relative peak power (P = .073 vs P = .103) as well as mean power (P = .330 vs P = .569) did not significantly differ after the hyperoxic preconditioning phase. PaO2 increased from 51.3 (3) to 451.9 (89.0) mm Hg, and SaO2 increased from 88.2% (1.7%) to 100% (0.2%) and dropped to 83.8% (4.2%) after the all-out test. Deoxygenation (P = .700) and reoxygenation rates (P = .185) did not significantly differ for both preconditioned settings.

CONCLUSIONS

Therefore, the authors conclude that hyperoxic preconditioning did not enhance 60-second all-out exercise performance in acute hypoxia (3500 m).

Acute Low-Dose Hyperoxia during a Single Bout of High-Intensity Interval Exercise Does Not Affect Red Blood Cell Deformability and Muscle Oxygenation in Trained Men-A Randomized Crossover Study

Recent technological developments provide easy access to use an artificial oxygen supply (hyperoxia) during exercise training. The aim of this study was to assess the efficacy of a commercially available oxygen compressor inducing low-dose hyperoxia, on limiting factors of endurance performance. Thirteen active men (age 24 ± 3 years) performed a high-intensity interval exercise (HIIE) session (5 × 3 min at 80% of W_max, separated by 2 min at 40% W_max) on a cycle ergometer, both in hyperoxia (4 L∙min⁻¹, 94% O₂, HYP) or ambient conditions (21% O₂, NORM) in randomized order. The primary outcome was defined as red blood cell deformability (RBC-D), while our secondary interest included changes in muscle oxygenation. RBC-D was expressed by the ratio of shear stress at half-maximal deformation (SS¹/₂) and maximal deformability (EI_max) and muscle oxygenation of the rectus femoris muscle was assessed by near-infrared spectroscopy. No statistically significant changes occurred in SS¹/₂ and EI_max in either condition. The ratio of SS¹/₂ to EI_max statistically decreased in NORM (p < 0.01; Δ: −0.10; 95%CI: −0.22, 0.02) but not HYP (p > 0.05; Δ: −0.16; 95%CI: −0.23, −0.08). Muscle oxygenation remained unchanged. This study showed that low-dose hyperoxia during HIIE using a commercially available device with a flow rate of only 4 L·min⁻¹ may not be sufficient to induce acute ergogenic effects compared to normoxic conditions.

The effect of the fraction of inspired oxygen on the NIRS-derived deoxygenated hemoglobin "breakpoint" during ramp-incremental test

During ramp-incremental (RI) exercise to exhaustion, the near-infrared spectroscopy-derived deoxygenated hemoglobin ([HHb]) signal in the vastus lateralis muscle shows a linear increase up to a point at which a plateau-like response is manifested ([HHb]_bp). This study investigated if 1) the [HHb]_bp is affected by different fractions of inspired O₂ (FIO2) [hypoxia (16%; HYPO); normoxia (21%; NORM); hyperoxia (30%; HYPER)]; and 2) an abrupt change to hyperoxic-inspired gas just before the occurrence of the [HHb]_bp (HYPER_SWITCH) would affect the [HHb] plateau-like response. Ten physically active male participants reported to the laboratory on four separate occasions to perform an RI test to exhaustion in NORM, HYPO, and HYPER and an RI test to exhaustion with an abrupt increase in FIO2 (30%; HYPER_SWITCH) 15 W before the power output (PO) associated with [HHb]_bp in normoxia. PO, [HHb], tissue O₂ (StO2), and pulse O₂ saturation (SpO2) were recorded continuously. Peak PO was significantly lower in HYPO (290 ± 21 W) and higher in HYPER (321 ± 22 W) and HYPER_SWITCH (320 ± 19 W) compared with NORM (311 ± 18 W). The PO associated with [HHb]_bp was not different between NORM and HYPER (246 ± 23 vs. 247 ± 24 W), but it was lower in HYPO (198 ± 31 W) than NORM and HYPER. The PO associated with the [HHb]_bp in HYPER_SWITCH (240 ± 23) was not different compared with NORM. HYPER and HYPER_SWITCH resulted in greater StO2 and SpO2 compared with NORM. These results suggest that the [HHb]_bp response is not dependent of O₂ driving pressure and that other physiological mechanisms might determine its occurrence.

Influence of Hyperoxic-Supplemented High-Intensity Interval Training on Hemotological and Muscle Mitochondrial Adaptations in Trained Cyclists

Background: Hyperoxia (HYPER) increases O₂ carrying capacity resulting in a higher O₂ delivery to the working muscles during exercise. Several lines of evidence indicate that lactate metabolism, power output, and endurance are improved by HYPER compared to normoxia (NORM). Since HYPER enables a higher exercise power output compared to NORM and considering the O₂ delivery limitation at exercise intensities near to maximum, we hypothesized that hyperoxic-supplemented high-intensity interval training (HIIT) would upregulate muscle mitochondrial oxidative capacity and enhance endurance cycling performance compared to training in normoxia. Methods: 23 trained cyclists, age 35.3 ± 6.4 years, body mass 75.2 ± 9.6 kg, height 179.8 ± 7.9 m, and VO₂max 4.5 ± 0.7 L min^-1 performed 6 weeks polarized and periodized endurance training on a cycle ergometer consisting of supervised HIIT sessions 3 days/week and additional low-intensity training 2 days/week. Participants were randomly assigned to either HYPER (F_IO₂ 0.30; n = 12) or NORM (F_IO₂ 0.21; n = 11) breathing condition during HIIT. Mitochondrial respiration in permeabilized fibers and isolated mitochondria together with maximal and submaximal VO₂, hematological parameters, and self-paced endurance cycling performance were tested pre- and posttraining intervention. Results: Hyperoxic training led to a small, non-significant change in performance compared to normoxic training (HYPER 6.0 ± 3.7%, NORM 2.4 ± 5.0%; p = 0.073, ES = 0.32). This small, beneficial effect on the self-paced endurance cycling performance was not explained by the change in VO₂max (HYPER 1.1 ± 3.8%, NORM 0.0 ± 3.7%; p = 0.55, ES = 0.08), blood volume and hemoglobin mass, mitochondrial oxidative phosphorylation capacity (permeabilized fibers: HYPER 27.3 ± 46.0%, NORM 16.5 ± 49.1%; p = 0.37, ES = 3.24 and in isolated mitochondria: HYPER 26.1 ± 80.1%, NORM 15.9 ± 73.3%; p = 0.66, ES = 0.51), or markers of mitochondrial content which were similar between groups post intervention. Conclusions: This study showed that 6 weeks hyperoxic-supplemented HIIT led to marginal gain in cycle performance in already trained cyclists without change in VO₂max, blood volume, hemoglobin mass, mitochondrial oxidative phosphorylation capacity, or exercise efficiency. The underlying mechanisms for the potentially meaningful performance effects of hyperoxia training remain unexplained and may raise ethical questions for elite sport.

Effects of mild whole body hypothermia on self-paced exercise performance

This study examined self-paced, high-intensity exercise during mild hypothermia and whether hyperoxia might offset any potential impairment. Twelve trained males each completed 15-km time trials in three environmental conditions: Neutral (23°C, [Formula: see text] 0.21), Cold (0°C, [Formula: see text] 0.21), and Cold+Hyper (0°C, [Formula: see text] 0.40). Cold and Cold+Hyper trials occurred after a 0.5°C drop in rectal temperature. Rectal temperature was higher ( P ≤ 0.016) throughout Neutral compared with Cold and Cold+Hyper; Cold had a higher ( P ≤ 0.035) rectal temperature than Cold+Hyper from 2.5 to 7.5 km, and hyperoxia did not alter thermal sensation or comfort. Oxyhemoglobin saturation decreased from ~98% to ~94% with Neutral and Cold, but was maintained at ~99% in Cold+Hyper ( P < 0.01). Cerebral tissue oxygenation index (TOI) was higher in Neutral than in Cold throughout the time trial (TT) ( P ≤ 0.001), whereas Cold+Hyper were unchanged ( P ≥ 0.567) from Neutral by 2.5 km. Muscle TOI was maintained in Cold+Hyper compared with Neutral and was higher ( P ≤ 0.046) than Cold throughout the entire TT. Power output during Cold (246 ± 41 W) was lower than Neutral (260 ± 38 W) at all 2.5-km intervals ( P ≤ 0.012) except at 12.5 km. Power output during Cold+Hyper (256 ± 42 W) was unchanged ( P ≥ 0.161) from Neutral throughout the TT, and was higher than Cold from 7.5 km onward. Average cadence was higher in Neutral (93 ± 8 rpm) than in either Cold or Cold+Hyper (Cold: 89 ± 7 and Cold+Hyper: 90 ± 8 rpm, P = 0.031). In conclusion, mild hypothermia reduced self-paced exercise performance; hyperoxia during mild hypothermia restored performance to thermoneutral levels, likely due to maintenance of oxygen availability rather than any thermogenic benefit. NEW & NOTEWORTHY We examined self-paced, high-intensity exercise with 0.5°C rectal temperature decreases in a 0°C ambient environment, along with whether hyperoxia could offset any potential impairment. During a 15-km time trial, power output was lower with hypothermia than with thermoneutral. However, with hypothermia, hyperoxia of [Formula: see text] = 0.40 restored power output despite there being no thermophysiological improvement. Hypothermia impairs exercise performance, whereas hyperoxia likely restored performance due to maintenance of oxygen availability rather than any thermogenic benefit.

The effects of beetroot juice supplementation on exercise economy, rating of perceived exertion and running mechanics in elite distance runners: A double-blinded, randomized study

Purpose

Nitrate-rich beetroot juice supplementation has been extensively used to increase exercise economy in different populations. However, its use in elite distance runners, and its potential effects on biomechanical aspects of running have not been properly investigated. This study aims to analyze the potential effects of 15 days of beetroot juice supplementation on physiological, psychological and biomechanical variables in elite runners.

Methods

Twelve elite middle and long-distance runners (age = 26.3 ± 5.1yrs, VO₂Max = 71.8±5.2 ml*kg^-1*min^-1) completed an incremental running test to exhaustion on a treadmill before and after a 15-days supplementation period, in which half of the group (EG) consumed a daily nitrate-rich beetroot juice and the other group (PG) consumed a placebo drink. Time to exhaustion (TEx), running economy, vastus lateralis oxygen saturation (SmO₂), leg stiffness and rate of perceived exertion (RPE) were measured at 15, 17.1 and 20 km/h during the incremental test.

Results

Likely to very likely improvements in EG were observed for the RPE (Standardized mean difference (SMD) = -2.17, 90%CI = -3.23, -1.1), SmO₂ (SMD = 0.72, 90%CI = 0.03, 1.41) and TEx (SMD = 1.18, 90%CI = -0.14, 2.5) in comparison with PG. No other physiological or biomechanical variable showed substantial improvements after the supplementation period.

Conclusions

Fifteen days of nitrate-rich beetroot juice supplementation produced substantial improvements in the time to exhaustion in elite runners; however, it didn’t produce meaningful improvements in running economy, VO₂Max or mechanical parameters.

High-intensity interval training and hyperoxia during chemotherapy: A case report about the feasibility, safety and physical functioning in a colorectal cancer patient

INTRODUCTION

We conducted a case study to examine the feasibility and safety of high-intensity interval training (HIIT) with increased inspired oxygen content in a colon cancer patient undergoing chemotherapy. A secondary purpose was to investigate the effects of such training regimen on physical functioning.

CASE PRESENTATION

A female patient (51 years; 49.1 kg; 1.65 m; tumor stage: pT3, pN2a (5/29), pM1a (HEP), L0, V0, R0) performed 8 sessions of HIIT (5 × 3 minutes at 90% of Wmax, separated by 2 minutes at 45% Wmax) with an increased inspired oxygen fraction of 30%. Patient safety, training adherence, cardiorespiratory fitness (peak oxygen uptake and maximal power output during an incremental cycle ergometer test), autonomous nervous function (i.e., heart rate variability during an orthostatic test) as well as questionnaire-assessed quality of life (EORTC QLQ-C30) were evaluated before and after the intervention.No adverse events were reported throughout the training intervention and a 3 months follow-up. While the patient attended all sessions, adherence to total training time was only 51% (102 of 200 minutes; mean training time per session 12:44 min:sec). VO2peak and Wmax increased by 13% (from 23.0 to 26.1 mL min kg) and 21% (from 83 to 100 W), respectively. Heart rate variability represented by the root mean squares of successive differences both in supine and upright positions were increased after the training by 143 and 100%, respectively. The EORTC QLQ-C30 score for physical functioning (7.5%) as well as the global health score (10.7%) improved, while social function decreased (17%).

CONCLUSIONS

Our results show that a already short period of HIIT with concomitant hyperoxia was safe and feasible for a patient undergoing chemotherapy for colon cancer. Furthermore, the low overall training adherence of only 51% and an overall low training time per session (∼13 minutes) was sufficient to induce clinically meaningful improvements in physical functioning. However, this case also underlines that intensity and/or length of the HIIT-bouts might need further adjustments to increase training compliance.