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Hellsten Y, Gliemann L. Peripheral limitations for performance: Muscle capillarization. Scand J Med Sci Sports 2024; 34:e14442. [PMID: 37770233 DOI: 10.1111/sms.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 10/03/2023]
Abstract
Sufficient delivery of oxygen and metabolic substrates, together with removal of waste products, are key elements of muscle performance. Capillaries are the primary site for this exchange in skeletal muscle and the degree of muscle capillarization affects diffusion conditions by influencing mean transit time, capillary surface area and diffusion distance. Muscle capillarization may thus represent a limiting factor for performance. Exercise training increases the number of capillaries per muscle fiber by about 10%-20% within a few weeks in untrained subjects, whereas capillary growth progresses more slowly in well-trained endurance athletes. Studies show that capillaries are tortuous, situated along and across the length of the fibers with an arrangement related to muscle fascicles. Although direct data is lacking, it is possible that years of training not only enhances capillary density but also optimizes the positioning of capillaries, to further improve the diffusion conditions. Muscle capillarization has been shown to increase oxygen extraction during exercise in humans, but direct evidence for a causal link between increased muscle capillarization and performance is scarce. This review covers current knowledge on the implications of muscle capillarization for oxygen and glucose uptake as well as performance. A brief overview of the process of capillary growth and of physical factors, inherent to exercise, which promote angiogenesis, provides the foundation for a discussion on how different training modalities may influence muscle capillary growth. Finally, we identify three areas for future research on the role of capillarization for exercise performance.
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Affiliation(s)
- Ylva Hellsten
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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2
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Liu Y, Christensen PM, Hellsten Y, Gliemann L. Effects of Exercise Training Intensity and Duration on Skeletal Muscle Capillarization in Healthy Subjects: A Meta-analysis. Med Sci Sports Exerc 2022; 54:1714-1728. [PMID: 35522254 DOI: 10.1249/mss.0000000000002955] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate the effect of intensity and duration of continuous and interval exercise training on capillarization in skeletal muscle of healthy adults. METHODS PubMed and Web of Science were searched from inception to June 2021. Eligibility criteria for studies were endurance exercise training >2 wk in healthy adults, and the capillary to fiber ratio (C:F) and/or capillary density (CD) reported. Meta-analyses were performed, and subsequent subgroup analyses were conducted by the characteristics of participants and training scheme. RESULTS Fifty-seven trials from 38 studies were included (10%/90%, athletic/sedentary). C:F was measured in 391 subjects from 47 trials, whereas CD was measured in 428 subjects from 50 trials. Exercise training increased C:F (mean difference, 0.33 (95% confidence interval, 0.30-0.37)) with low heterogeneity ( I2 = 45.08%) and CD (mean difference, 49.8 (36.9-62.6) capillaries per millimeter squared) with moderate heterogeneity ( I2 = 68.82%). Compared with low-intensity training (<50% of maximal oxygen consumption (V̇O 2max )), 21% higher relative change in C:F was observed after continuous moderate-intensity training (50%-80% of V̇O 2max ) and 54% higher change after interval training with high intensity (80%-100% of V̇O 2max ) in sedentary subjects. The magnitude of capillary growth was not dependent on training intervention duration. In already trained subjects, no additional increase in capillarization was observed with various types of training. CONCLUSIONS In sedentary subjects, continuous moderate-intensity training and interval training with high intensity lead to increases in capillarization, whereas low-intensity training has less effect. Within the time frame studied, no effect on capillarization was established regarding training duration in sedentary subjects. The meta-analysis highlights the need for further studies in athlete groups to discern if increased capillarization can be obtained, and if so, which combination is optimal (time vs intensity).
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Affiliation(s)
| | | | - Ylva Hellsten
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
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3
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Interindividual Differences in Trainability and Moderators of Cardiorespiratory Fitness, Waist Circumference, and Body Mass Responses: A Large-Scale Individual Participant Data Meta-analysis. Sports Med 2022; 52:2837-2851. [PMID: 35781787 DOI: 10.1007/s40279-022-01725-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
Although many studies have assumed variability reflects variance caused by exercise training, few studies have examined whether interindividual differences in trainability are present following exercise training. The present individual participant data (IPD) meta-analysis sought to: (1) investigate the presence of interindividual differences in trainability for cardiorespiratory fitness (CRF), waist circumference, and body mass; and (2) examine the influence of exercise training and potential moderators on the probability that an individual will experience clinically important differences. The IPD meta-analysis combined data from 1879 participants from eight previously published randomized controlled trials. We implemented a Bayesian framework to: (1) test the hypothesis of interindividual differences in trainability by comparing variability in change scores between exercise and control using Bayes factors; and (2) compare posterior predictions of control and exercise across a range of moderators (baseline body mass index (BMI) and exercise duration, intensity, amount, mode, and adherence) to estimate the proportions of participants expected to exceed minimum clinically important differences (MCIDs) for all three outcomes. Bayes factors demonstrated a lack of evidence supporting a high degree of variance attributable to interindividual differences in trainability across all three outcomes. These findings indicate that interindividual variability in observed changes are likely due to measurement error and external behavioural factors, not interindividual differences in trainability. Additionally, we found that a larger proportion of exercise participants were expected to exceed MCIDs compared with controls for all three outcomes. Moderator analyses identified that larger proportions were associated with a range of factors consistent with standard exercise theory and were driven by mean changes. Practitioners should prescribe exercise interventions known to elicit large mean changes to increase the probability that individuals will experience beneficial changes in CRF, waist circumference and body mass.
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Jacques M, Landen S, Romero JA, Yan X, Hiam D, Jones P, Gurd B, Eynon N, Voisin S. Implementation of multiple statistical methods to estimate variability and individual response to training. Eur J Sport Sci 2022; 23:588-598. [PMID: 35234572 DOI: 10.1080/17461391.2022.2048894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
HIGHLIGHTS What are the findings? We implemented five statistical methods in a single study to estimate the magnitude of within-subject variability and quantify responses to exercise training at the individual level.The various proposed methods used to estimate individual responses to training provide different types of information and rely on different assumptions that are difficult to test.Within-subject variability is often large in magnitude, and as such, should be systematically evaluated and carefully considered in future studies to successfully estimate individual responses to training. How might it impact on clinical practice in the future? Within-subject variability in response to exercise training is a key factor that must be considered in order to obtain a reproducible measurement of individual response to exercise training. This is akin to ensuring data is reproducible for each subject.Our findings provide guidelines for future exercise training studies to ensure results are reproducible within participants and to minimize wasting precious research resources.By implementing five suggested methods to estimate individual response to training, we highlight their feasibility, strengths, weaknesses, and costs, for researchers to make the best decision on how to accurately measure individual responses to exercise training.
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Affiliation(s)
- Macsue Jacques
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Shanie Landen
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | | | - Xu Yan
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Danielle Hiam
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia.,Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Patrice Jones
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Brendon Gurd
- School of Kinesiology and health studies, Queen's University, Kingston, ON
| | - Nir Eynon
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - Sarah Voisin
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
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Bonafiglia JT, Preobrazenski N, Gurd BJ. A Systematic Review Examining the Approaches Used to Estimate Interindividual Differences in Trainability and Classify Individual Responses to Exercise Training. Front Physiol 2021; 12:665044. [PMID: 34819869 PMCID: PMC8606564 DOI: 10.3389/fphys.2021.665044] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Many reports describe statistical approaches for estimating interindividual differences in trainability and classifying individuals as "responders" or "non-responders." The extent to which studies in the exercise training literature have adopted these statistical approaches remains unclear. Objectives: This systematic review primarily sought to determine the extent to which studies in the exercise training literature have adopted sound statistical approaches for examining individual responses to exercise training. We also (1) investigated the existence of interindividual differences in trainability, and (2) tested the hypothesis that less conservative thresholds inflate response rates compared with thresholds that consider error and a smallest worthwhile change (SWC)/minimum clinically important difference (MCID). Methods: We searched six databases: AMED, CINAHL, EMBASE, Medline, PubMed, and SportDiscus. Our search spanned the aerobic, resistance, and clinical or rehabilitation training literature. Studies were included if they used human participants, employed standardized and supervised exercise training, and either: (1) stated that their exercise training intervention resulted in heterogenous responses, (2) statistically estimated interindividual differences in trainability, and/or (3) classified individual responses. We calculated effect sizes (ESIR) to examine the presence of interindividual differences in trainability. We also compared response rates (n = 614) across classification approaches that considered neither, one of, or both errors and an SWC or MCID. We then sorted response rates from studies that also reported mean changes and response thresholds (n = 435 response rates) into four quartiles to confirm our ancillary hypothesis that larger mean changes produce larger response rates. Results: Our search revealed 3,404 studies, and 149 were included in our systematic review. Few studies (n = 9) statistically estimated interindividual differences in trainability. The results from these few studies present a mixture of evidence for the presence of interindividual differences in trainability because several ESIR values lay above, below, or crossed zero. Zero-based thresholds and larger mean changes significantly (both p < 0.01) inflated response rates. Conclusion: Our findings provide evidence demonstrating why future studies should statistically estimate interindividual differences in trainability and consider error and an SWC or MCID when classifying individual responses to exercise training. Systematic Review Registration: [website], identifier [registration number].
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | | | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Herold F, Törpel A, Hamacher D, Budde H, Zou L, Strobach T, Müller NG, Gronwald T. Causes and Consequences of Interindividual Response Variability: A Call to Apply a More Rigorous Research Design in Acute Exercise-Cognition Studies. Front Physiol 2021; 12:682891. [PMID: 34366881 PMCID: PMC8339555 DOI: 10.3389/fphys.2021.682891] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
The different responses of humans to an apparently equivalent stimulus are called interindividual response variability. This phenomenon has gained more and more attention in research in recent years. The research field of exercise-cognition has also taken up this topic, as shown by a growing number of studies published in the past decade. In this perspective article, we aim to prompt the progress of this research field by (i) discussing the causes and consequences of interindividual variability, (ii) critically examining published studies that have investigated interindividual variability of neurocognitive outcome parameters in response to acute physical exercises, and (iii) providing recommendations for future studies, based on our critical examination. The provided recommendations, which advocate for a more rigorous study design, are intended to help researchers in the field to design studies allowing them to draw robust conclusions. This, in turn, is very likely to foster the development of this research field and the practical application of the findings.
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Affiliation(s)
- Fabian Herold
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | | | - Dennis Hamacher
- Department of Sport Science, German University for Health and Sports (DHGS), Berlin, Germany
| | - Henning Budde
- Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Liye Zou
- Exercise and Mental Health Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
| | - Tilo Strobach
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Notger G Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, MSH Medical School Hamburg, Hamburg, Germany
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Dong G, Wang Y. EFFECT OF PHYSICAL EXERCISE ON INCREASING THE MAXIMUM OXYGEN UPTAKE OF SKELETAL MUSCLE. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127072021_0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Aerobic exercise can improve the physical function of athletes and increase the oxygen content in skeletal muscles. This has a significant reference value for evaluating training effects and judging sports fatigue. Objective: Maximum oxygen uptake is one of the most critical indicators of aerobic work capacity. The thesis analyzes the medical promotion effect of physical exercise on the oxygen content of skeletal muscle. Methods: The thesis performed aerobic exercises on two groups of young rowers. Athletes in group A performed high-load exercise, and athletes in group B performed low-load exercise. At the same time, we placed a detector on the athletes’ skeletal muscle to test the volunteer's muscle oxygen content and other physiological indicators. Results: Comparing high-load exercise and low-load exercise, the maximum oxygen uptake and the utilization rate of the maximum oxygen uptake when reaching the anaerobic net were 10% and 16% higher, respectively. There was no difference in the activity of muscle enzymes between the two groups. Conclusions: After aerobic training, the muscle's oxygen utilization capacity is strengthened. Physical exercise promotes the maximum oxygen uptake of skeletal muscles. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
| | - Yu Wang
- Nanchang Institute of Technology, China
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8
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Bonafiglia JT, Islam H, Preobrazenski N, Ma A, Deschenes M, Erlich AT, Quadrilatero J, Hood DA, Gurd BJ. Examining interindividual differences in select muscle and whole-body adaptations to continuous endurance training. Exp Physiol 2021; 106:2168-2176. [PMID: 33998072 DOI: 10.1113/ep089421] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/12/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of the study? Do interindividual differences in trainability exist for morphological and molecular skeletal muscle responses to aerobic exercise training? What is the main finding and its importance? Interindividual differences in trainability were present for some, but not all, morphological and molecular outcomes included in our study. Our findings suggest that is inappropriate, and perhaps erroneous, to assume that variability in observed responses reflects interindividual differences in trainability in skeletal muscle responses to aerobic exercise training. ABSTRACT Studies have interpreted a wide range of morphological and molecular changes in human skeletal muscle as evidence of interindividual differences in trainability. However, these interpretations fail to account for the influence of random measurement error and within-subject variability. The purpose of the present study was to use the standard deviation of individual response (SDIR ) statistic to test the hypothesis that interindividual differences in trainability are present for some but not all skeletal muscle outcomes. Twenty-nine recreationally-active males (age: 21±2 years; BMI: 24±3; VO2 peak: 45±7 mL/kg/min) completed four weeks of continuous training (REL; n = 14) or control (CTRL; n = 15). Maximal enzyme activities (citrate synthase and β-HAD), capillary density, fibre type composition, fibre-specific SDH activity and substrate storage (IMTG and glycogen), and markers of mitophagy (BNIP3, NIX, PRKN, and PINK1) were measured in vastus lateralis samples collected before and after the intervention. We also calculated SDIR values for VO2 peak, peak work rate, and the onset of blood lactate accumulation for REL and a separate group that exercised at the negative talk test (TT) stage. Although positive SDIR values - indicating interindividual differences in trainability - were obtained for aerobic capacity outcomes, maximal enzyme activities, capillary density, all fibre-specific outcomes, and BNIP3 protein content, the remaining outcomes produced negative SDIR values indicating a large degree of random measurement error and/or within-subject variability. Our findings question the interpretation of heterogeneity in observed responses as evidence of interindividual differences in trainability and highlight the importance of including control groups when analyzing individual skeletal muscle response to exercise training. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jacob T Bonafiglia
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Hashim Islam
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.,School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - Nicholas Preobrazenski
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Ma
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Madeleine Deschenes
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Avigail T Erlich
- Muscle Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - David A Hood
- Muscle Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Brendon J Gurd
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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