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Woorons X, Billaut F, Lamberto C. Running exercise with end-expiratory breath holding up to the breaking point induces large and early fall in muscle oxygenation. Eur J Appl Physiol 2021; 121:3515-3525. [PMID: 34532775 DOI: 10.1007/s00421-021-04813-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The goal of this study was to assess the effects of repeated running bouts with end-expiratory breath holding (EEBH) up to the breaking point on muscle oxygenation. METHODS Eight male runners participated in three randomised sessions each including two exercises on a motorised treadmill. The first exercise consisted in performing 10-12 running bouts with EEBH of maximum duration either (separate sessions) at 60% (active recovery), 80% (passive recovery) or 100% (passive recovery) of the maximal aerobic velocity (MAV). Each repetition started at the onset of EEBH and ended at its release. In the second exercise of the session, subjects replicated the same procedure but with normal breathing (NB). Arterial oxygen saturation (SpO2), heart rate (HR) and the change in vastus lateralis muscle deoxy-haemoglobin/myoglobin (Δ[HHb/Mb]) and total haemoglobin/myoglobin (Δ[THb/Mb]) were continuously monitored throughout exercises. RESULTS On average, the EEBHs were maintained for 10.1 ± 1.1 s, 13.2 ± 1.8 s and 12.2 ± 1.7 s during exercise at 60%, 80% and 100% of MAV, respectively. In the three exercise intensities, SpO2 (mean nadir values: 76.3 ± 2.5 vs 94.5 ± 2.5%) and HR were lower with EEBH than with NB at the end of the repetitions; whereas, the mean Δ[HHb/Mb] (12.6 ± 5.2 vs 7.7 ± 4.4 µm) and Δ[THb/Mb] (- 0.6 ± 2.3 vs 3.8 ± 2.6 µm) were, respectively, higher and lower with EEBH (p < 0.05). CONCLUSION This study showed that performing repeated bouts of running exercises with EEBH up to the breaking point induced a large and early drop in muscle oxygenation compared with the same exercise with NB. This phenomenon was probably the consequence of the strong arterial oxygen desaturation induced by the maximal EEBHs.
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Affiliation(s)
- Xavier Woorons
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, EA 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 59000, Lille, France. .,ARPEH, Association for Research and Promotion of Hypoventilation Training, 18 rue Saint Gabriel, 59800, Lille, France.
| | - François Billaut
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC, G1V 0S6, Canada
| | - Christine Lamberto
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, Bobigny, France
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2
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Modelling the relationships between arterial oxygen saturation, exercise intensity and the level of aerobic performance in acute hypoxia. Eur J Appl Physiol 2021; 121:1993-2003. [PMID: 33782716 DOI: 10.1007/s00421-021-04667-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to establish a model to estimate the level of arterial oxygen saturation (SpO2) and help determine the appropriate hypoxic dose in humans exercising in acute hypoxia. METHODS SpO2 values were collected in seven untrained (UTS) and seven endurance-trained male subjects (ETS) who performed six cycle incremental and maximal tests at sea level and at simulated altitudes of 1000, 1500, 2500, 3500 and 4500 m. Oxygen uptake was continuously measured and maximal oxygen uptake ([Formula: see text]) was determined in each subject and at each altitude. Intensity was expressed as percentage of [Formula: see text]. RESULTS There were strong non-linear relationships between altitude and SpO2 at low, moderate and high intensity both in ETS and UTS (r = 0.97, p < 0.001). SpO2 was significantly correlated to exercise intensity at sea level and at all simulated altitudes in ETS but only from 2500 m in UTS. There were inverse correlations between SpO2 and sea-level [Formula: see text] at all altitudes, which were stronger from 2500 m and with the increase in exercise intensity. The three-variable model we established predicts (p < 0.001) the SpO2 level of individuals exercising in acute hypoxia based on their sea-level [Formula: see text], the intensity of exercise and the altitude level. CONCLUSION The model demonstrates that the drop of SpO2 during exercise in acute hypoxia is larger with the increase in both sea-level [Formula: see text] and exercise intensity. The model also highlights that the pivotal altitude from which the fall in SpO2 is exacerbated is between 2000 and 2500 m, depending on both sea-level [Formula: see text] and exercise intensity.
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3
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Short C, Saunders C, Davies JC. Horses for courses: Learning from functional tests of pulmonary health? Pediatr Pulmonol 2020; 55:1855-1858. [PMID: 32413194 DOI: 10.1002/ppul.24818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/30/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Christopher Short
- Royal Brompton and Harefield NHS Foundation Trust, Chelsea, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Clare Saunders
- Royal Brompton and Harefield NHS Foundation Trust, Chelsea, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Jane C Davies
- Royal Brompton and Harefield NHS Foundation Trust, Chelsea, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
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4
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A Focused Review on the Maximal Exercise Responses in Hypo- and Normobaric Hypoxia: Divergent Oxygen Uptake and Ventilation Responses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145239. [PMID: 32698542 PMCID: PMC7400084 DOI: 10.3390/ijerph17145239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/26/2022]
Abstract
The literature suggests that acute hypobaric (HH) and normobaric (NH) hypoxia exposure elicits different physiological responses. Only limited information is available on whether maximal cardiorespiratory exercise test outcomes, performed on either the treadmill or the cycle ergometer, are affected differently by NH and HH. A focused literature review was performed to identify relevant studies reporting cardiorespiratory responses in well-trained male athletes (individuals with a maximal oxygen uptake, VO2max > 50 mL/min/kg at sea level) to cycling or treadmill running in simulated acute HH or NH. Twenty-one studies were selected. The exercise tests in these studies were performed in HH (n = 90) or NH (n = 151) conditions, on a bicycle ergometer (n = 178) or on a treadmill (n = 63). Altitudes (simulated and terrestrial) varied between 2182 and 5400 m. Analyses (based on weighted group means) revealed that the decline in VO2max per 1000 m gain in altitude was more pronounced in acute NH vs. HH (-7.0 ± 1.4% vs. -5.6 ± 0.9%). Maximal minute ventilation (VEmax) increased in acute HH but decreased in NH with increasing simulated altitude (+1.9 ± 0.9% vs. -1.4 ± 1.8% per 1000 m gain in altitude). Treadmill running in HH caused larger decreases in arterial oxygen saturation and heart rate than ergometer cycling in acute HH, which was not the case in NH. These results indicate distinct differences between maximal cardiorespiratory responses to cycling and treadmill running in acute NH or HH. Such differences should be considered when interpreting exercise test results and/or monitoring athletic training.
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5
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Dominelli PB, Sheel AW. Exercise-induced arterial hypoxemia; some answers, more questions. Appl Physiol Nutr Metab 2019; 44:571-579. [DOI: 10.1139/apnm-2018-0468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Exercise-induced arterial hypoxemia (EIAH) is characterized by the decrease in arterial oxygen tension and oxyhemoglobin saturation during dynamic aerobic exercise. Since the time of the initial observations, our knowledge and understanding of EIAH has grown, but many unknowns remain. The purpose of this review is to provide an update on recent findings, highlight areas of disagreement, and identify where information is lacking. Specifically, this review will place emphasis on (i) the occurrence of EIAH during submaximal exercise, (ii) whether there are sex differences in the development and severity of EIAH, and (iii) unresolved questions and future directions.
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Affiliation(s)
- Paolo B. Dominelli
- Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - A. William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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6
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Nader E, Guillot N, Lavorel L, Hancco I, Fort R, Stauffer E, Renoux C, Joly P, Germain M, Connes P. Eryptosis and hemorheological responses to maximal exercise in athletes: Comparison between running and cycling. Scand J Med Sci Sports 2018; 28:1532-1540. [PMID: 29356101 DOI: 10.1111/sms.13059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 12/20/2022]
Abstract
We compared the effects of cycling and running exercise on hemorheological and hematological properties, as well as eryptosis markers. Seven endurance-trained subjects randomly performed a progressive and maximal exercise test on a cycle ergometer and a treadmill. Blood was sampled at rest and at the end of the exercise to analyze hematological and blood rheological parameters including hematocrit (Hct), red blood cell (RBC) deformability, aggregation, and blood viscosity. Hemoglobin saturation (SpO2), blood lactate, and glucose levels were also monitored. Red blood cell oxidative stress, calcium content, and phosphatidylserine exposure were determined by flow cytometry to assess eryptosis level. Cycling exercise increased blood viscosity and RBC aggregation whereas it had no significant effect on RBC deformability. In contrast, blood viscosity remained unchanged and RBC deformability increased with running. The increase in Hct, lactate, and glucose concentrations and the loss of weight at the end of exercise were not different between running and cycling. Eryptosis markers were not affected by exercise. A significant drop in SpO2 was noted during running but not during cycling. Our study showed that a progressive and maximal exercise test conducted on a cycle ergometer increased blood viscosity while the same test conducted on a treadmill did not change this parameter because of different RBC rheological behavior between the 2 tests. We also demonstrated that a short maximal exercise does not alter RBC physiology in trained athletes. We suspect that exercise-induced hypoxemia occurring during running could be at the origin of the RBC rheological behavior differences with cycling.
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Affiliation(s)
- E Nader
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
| | - N Guillot
- Univ-Lyon, CarMeN Laboratory, INSERM 1060, INRA 1397, Université Claude Bernard Lyon 1, INSA Lyon, Villeurbanne, France
| | - L Lavorel
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - I Hancco
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - R Fort
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Service de Médecine Interne, Hôpital Edouard Herriot, Lyon, France
| | - E Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Médecine du Sommeil et des Maladies Respiratoires, Hôpital Croix Rousse, Lyon, France
| | - C Renoux
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Biochimie des Pathologies Erythrocytaires, Bron, France
| | - P Joly
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Biochimie des Pathologies Erythrocytaires, Bron, France
| | - M Germain
- Hospices Civils de Lyon, Service d'Exploration Fonctionnelle Respiratoire, Hôpital Croix Rousse, Lyon, France
| | - P Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Équipe "Biologie Vasculaire et du Globule Rouge", Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France.,Institut Universitaire de France (IUF), Paris, France
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7
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Respiratory muscle strength is decreased after maximal incremental exercise in trained runners and cyclists. Respir Physiol Neurobiol 2017; 248:25-30. [PMID: 29155334 DOI: 10.1016/j.resp.2017.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/14/2017] [Accepted: 11/14/2017] [Indexed: 01/11/2023]
Abstract
The respiratory muscle fatigue seems to be able to limit exercise performance and may influence the determination of maximal oxygen uptake (V̇O2max) or maximum aerobic work rate during maximal incremental test. The aim of this study was therefore to investigate whether maximal incremental exercise decreases respiratory muscle strength. We hypothesized that respiratory muscle strength (maximal pressure) will decrease after maximal incremental exercise to exhaustion. 36 runners and 23 cyclists completed a maximal incremental test on a treadmill or a cycle ergometer with continuous monitoring of expired gases. Maximal inspiratory (MIP) and expiratory (MEP) pressure measurements were taken at rest and post- exercise. At rest, the MIP and MEP were 140±25 and 172±27 in runners vs. 115±26 and 146±33 in cyclists (p<0.05 between groups, respectively). The rest values of MIP and MEP were correlated to the V̇O2peak in all athletes, r=0.34, p<0.01 and r=0.36, p<0.01, respectively. At exhaustion, the MIP and MEP decreased significantly post- test by 13±7% and 13±5% in runners vs. 17±11% and 15±10% in cyclists (p>0.05), respectively. Our results suggest that respiratory muscle strength is decreased following maximal incremental exercise in trained runners and cyclists.
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8
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Constantini K, Tanner DA, Gavin TP, Harms CA, Stager JM, Chapman RF. Prevalence of Exercise-Induced Arterial Hypoxemia in Distance Runners at Sea Level. Med Sci Sports Exerc 2017; 49:948-954. [PMID: 28009787 DOI: 10.1249/mss.0000000000001193] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE It has been reported that ~50% of endurance-trained men demonstrate exercise-induced arterial hypoxemia (EIAH) during heavy exercise. However, this often-cited prevalence rate comes from a single study using a cohort of 25 highly trained men who completed maximal cycle ergometry. As arterial oxyhemoglobin saturation (SpO2) during maximal exercise is reported to be significantly lower during treadmill versus cycle ergometry in the same subjects, we hypothesized that the prevalence of EIAH would be greater than previously reported (and commonly referenced) in a larger cohort of highly endurance-trained men during maximal treadmill running. METHODS Data from 124 highly trained male distance runners (V˙O2max range = 60.3-84.7 mL·kg·min) were retrospectively examined from previously published studies completed in the Indiana University Human Performance Laboratory. Subjects completed a constant speed, progressive-grade treadmill exercise test to volitional exhaustion, and arterial oxyhemoglobin saturation (SaO2ear) in all subjects was estimated using the same oximeter (Hewlett Packard 47201A). RESULTS Using similar inclusion criteria as previously published for highly trained (V˙O2max > 68 mL·kg·min) and for EIAH (SaO2ear ≤ 91%), 55 of 79 subjects (70%) exhibited exercise-induced arterial desaturation. Across all 124 subjects, 104 (84%) demonstrated at least moderate EIAH (SaO2ear ≤ 93%) during maximal treadmill exercise. SaO2ear was significantly yet weakly correlated with V˙E/V˙O2 (P < 0.01, r = 0.28) and V˙E/V˙CO2 (P < 0.001, r = 0.33) but not with V˙O2max. CONCLUSION These results indicate that the prevalence of EIAH in highly trained men during maximal treadmill exercise at sea level is greater compared with previously suggested data, with exercise mode perhaps playing a factor in the number of athletes who experience EIAH.
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Affiliation(s)
- Keren Constantini
- 1HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN; 2Department of Health and Kinesiology, Purdue University, West Lafayette, IN; and 3Department of Kinesiology, Kansas State University, Manhattan, KS
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9
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Gonzalez-Millan C, Perez-Brunicardi D, Salinero JJ, Lara B, Abián-Vicen J, Areces F, Ruiz-Vicente D, Soriano L, Del Coso J. Physiological Demands of Elite Cross-Country Skiing During a Real Competition. J Strength Cond Res 2017; 31:1536-1543. [PMID: 28538302 DOI: 10.1519/jsc.0000000000001616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was to assess different physiological variables before and after a 5-km (women) and 10-km (men) cross-country skiing competition to determine potential mechanisms of fatigue. Fourteen elite-level skiers competed in an official cross-country skiing competition using the classical style (9 men and 5 women). Instantaneous skiing velocity was measured during the race by means of 15-Hz global positioning system devices. Before and after the race, a sample of venous blood was obtained to assess changes in blood lactate and serum electrolyte and myoglobin concentrations. Prerace to postrace changes in blood oxygen saturation, forced vital capacity during a spirometry test, jump height during a countermovement jump, and handgrip force were also measured. Mean race speed was 15.8 ± 2.5 and 15.4 ± 1.5 km·h, whereas mean heart rate was 171 ± 6 and 177 ± 3 b·min for men and women, respectively. There were no significant prerace to postrace changes in jump height, handgrip force, and forced vital capacity in men and women. Blood oxygen saturation was reduced from prerace to postrace in men (95.9 ± 2.1% to 93.1 ± 2.3%, p = 0.02) and women (97.8 ± 1.1% to 92.4 ± 2.1%, p < 0.01), whereas blood lactate concentration increased at the end of the race in men (1.4 ± 0.5 to 4.9 ± 2.1 mmol·L, p < 0.01) and women (1.9 ± 0.1 to 6.9 ± 3.2 mmol·L, p < 0.01). After the race, blood markers of muscle damage were at low concentrations, whereas serum electrolytes remained unchanged. Fatigue in 5- and 10-km cross-country skiing competitions was related to a reduced blood oxygen carrying capacity and presumably increased muscle and blood acidosis, whereas the influence of exercise-induced muscle damage on fatigue was minor.
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Affiliation(s)
- Cristina Gonzalez-Millan
- 1Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain; 2Faculty of Education, University of Segovia, Segovia, Spain; and 3Performance and Sport Rehabilitation Laboratory, University of Castilla La Mancha, Toledo, Spain
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10
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Wrobel JP, Ellis MJ, Kee K, Stuart-Andrews CR, Thompson BR. Maximal exercise does not increase ventilation heterogeneity in healthy trained adults. Physiol Rep 2016; 4:4/7/e12747. [PMID: 27044853 PMCID: PMC4831321 DOI: 10.14814/phy2.12747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/02/2016] [Indexed: 11/29/2022] Open
Abstract
The effect of exercise on ventilation heterogeneity has not been investigated. We hypothesized that a maximal exercise bout would increase ventilation heterogeneity. We also hypothesized that increased ventilation heterogeneity would be associated with exercise‐induced arterial hypoxemia (EIAH). Healthy trained adult males were prospectively assessed for ventilation heterogeneity using lung clearance index (LCI), Scond, and Sacin at baseline, postexercise and at recovery, using the multiple breath nitrogen washout technique. The maximal exercise bout consisted of a maximal, incremental cardiopulmonary exercise test at 25 watt increments. Eighteen subjects were recruited with mean ± SD age of 35 ± 9 years. There were no significant changes in LCI, Scond, or Sacin following exercise or at recovery. While there was an overall reduction in SpO2 with exercise (99.3 ± 1 to 93.7 ± 3%, P < 0.0001), the reduction in SpO2 was not associated with changes in LCI, Scond or Sacin. Ventilation heterogeneity is not increased following a maximal exercise bout in healthy trained adults. Furthermore, EIAH is not associated with changes in ventilation heterogeneity in healthy trained adults.
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Affiliation(s)
- Jeremy P Wrobel
- Department of Medicine, Monash University, Melbourne, Australia Allergy, Immunology & Respiratory Medicine, The Alfred, Melbourne, Australia Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, Australia
| | - Matthew J Ellis
- Allergy, Immunology & Respiratory Medicine, The Alfred, Melbourne, Australia
| | - Kirk Kee
- Department of Medicine, Monash University, Melbourne, Australia Allergy, Immunology & Respiratory Medicine, The Alfred, Melbourne, Australia
| | | | - Bruce R Thompson
- Department of Medicine, Monash University, Melbourne, Australia Allergy, Immunology & Respiratory Medicine, The Alfred, Melbourne, Australia
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12
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LeGear T, LeGear M, Preradovic D, Wilson G, Kirkham A, Camp PG. Does a Nintendo Wii exercise program provide similar exercise demands as a traditional pulmonary rehabilitation program in adults with COPD? CLINICAL RESPIRATORY JOURNAL 2014; 10:303-10. [PMID: 25351282 DOI: 10.1111/crj.12216] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/22/2014] [Accepted: 09/29/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS The chronic obstructive pulmonary disease (COPD) population can experience lower activity and fitness levels than the non-COPD population. The Nintendo Wii may be an appropriate at-home training device for the COPD population, which could be used as a supplement for a pulmonary rehabilitation program. This study was a randomized, within-subject, cross-over study involving 10 adults with COPD previously enrolled in St Paul's Hospital's pulmonary rehabilitation program. This study attempted to determine if specific Wii activities resulted in similar energy expenditures to that of a more traditional pulmonary rehabilitation activity. METHODS Participants completed two 15-min exercise interventions in a single session, with a washout period of 30 min in-between. The interventions were an experimental Wii intervention and a traditional treadmill intervention. RESULTS There was no significant difference in total energy expenditure between the two 15-min exercise interventions [mean difference 36.3 joules; 95% confidence interval (CI): 31.4, 104]. There was no significant difference in heart rate (mean difference -0.167 beats per minute; 95% CI: -4.83, 4.50), rating of perceived exertion (mean difference 0.100; 95% CI: -0.416, 0.616) and Borg dyspnea scale (mean difference 0.267; 95% CI: -0.004, 0.537) between the two 15-min exercise interventions. There was a significant difference in SpO2 between the two 15-min exercise interventions (Wii intervention mean difference 2.33% > treadmill intervention; 95% CI: 1.52, 3.15). CONCLUSION Gaming technology can provide an exercise program that has similar cardiovascular demands to traditional pulmonary rehabilitation programs for patients with COPD. Further research is necessary to address feasibility and long-term adherence.
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Affiliation(s)
- Tyler LeGear
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Mark LeGear
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Dejan Preradovic
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Geoffrey Wilson
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Ashley Kirkham
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Pat G Camp
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
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13
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Duke JW, Stickford JL, Weavil JC, Chapman RF, Stager JM, Mickleborough TD. Operating lung volumes are affected by exercise mode but not trunk and hip angle during maximal exercise. Eur J Appl Physiol 2014; 114:2387-97. [DOI: 10.1007/s00421-014-2956-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 07/12/2014] [Indexed: 10/25/2022]
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14
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Tanner DA, Duke JW, Stager JM. Ventilatory patterns differ between maximal running and cycling. Respir Physiol Neurobiol 2013; 191:9-16. [PMID: 24211317 DOI: 10.1016/j.resp.2013.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 10/26/2022]
Abstract
To determine the effect of exercise mode on ventilatory patterns, 22 trained men performed two maximal graded exercise tests; one running on a treadmill and one cycling on an ergometer. Tidal flow-volume (FV) loops were recorded during each minute of exercise with maximal loops measured pre and post exercise. Running resulted in a greater VO2peak than cycling (62.7±7.6 vs. 58.1±7.2mLkg(-1)min(-1)). Although maximal ventilation (VE) did not differ between modes, ventilatory equivalents for O2 and CO2 were significantly larger during maximal cycling. Arterial oxygen saturation (estimated via ear oximeter) was also greater during maximal cycling, as were end-expiratory (EELV; 3.40±0.54 vs. 3.21±0.55L) and end-inspiratory lung volumes, (EILV; 6.24±0.88 vs. 5.90±0.74L). Based on these results we conclude that ventilatory patterns differ as a function of exercise mode and these observed differences are likely due to the differences in posture adopted during exercise in these modes.
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Affiliation(s)
- David A Tanner
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA
| | - Joseph W Duke
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA
| | - Joel M Stager
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA.
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Stickland MK, Lindinger MI, Olfert IM, Heigenhauser GJF, Hopkins SR. Pulmonary gas exchange and acid-base balance during exercise. Compr Physiol 2013; 3:693-739. [PMID: 23720327 PMCID: PMC8315793 DOI: 10.1002/cphy.c110048] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
As the first step in the oxygen-transport chain, the lung has a critical task: optimizing the exchange of respiratory gases to maintain delivery of oxygen and the elimination of carbon dioxide. In healthy subjects, gas exchange, as evaluated by the alveolar-to-arterial PO2 difference (A-aDO2), worsens with incremental exercise, and typically reaches an A-aDO2 of approximately 25 mmHg at peak exercise. While there is great individual variability, A-aDO2 is generally largest at peak exercise in subjects with the highest peak oxygen consumption. Inert gas data has shown that the increase in A-aDO2 is explained by decreased ventilation-perfusion matching, and the development of a diffusion limitation for oxygen. Gas exchange data does not indicate the presence of right-to-left intrapulmonary shunt developing with exercise, despite recent data suggesting that large-diameter arteriovenous shunt vessels may be recruited with exercise. At the same time, multisystem mechanisms regulate systemic acid-base balance in integrative processes that involve gas exchange between tissues and the environment and simultaneous net changes in the concentrations of strong and weak ions within, and transfer between, extracellular and intracellular fluids. The physicochemical approach to acid-base balance is used to understand the contributions from independent acid-base variables to measured acid-base disturbances within contracting skeletal muscle, erythrocytes and noncontracting tissues. In muscle, the magnitude of the disturbance is proportional to the concentrations of dissociated weak acids, the rate at which acid equivalents (strong acid) accumulate and the rate at which strong base cations are added to or removed from muscle.
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Affiliation(s)
- Michael K. Stickland
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michael I. Lindinger
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - I. Mark Olfert
- Robert C. Byrd Health Sciences Center, Center for Cardiovascular and Respiratory Sciences, Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | | | - Susan R. Hopkins
- Departments of Medicine and Radiology, University of California, San Diego, San Diego, California
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Power GA, Handrigan GA, Basset FA. Ventilatory response during an incremental exercise test: A mode of testing effect. Eur J Sport Sci 2012. [DOI: 10.1080/17461391.2011.573580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Puthucheary Z, Skipworth JR, Rawal J, Loosemore M, Van Someren K, Montgomery HE. Genetic Influences in Sport and Physical Performance. Sports Med 2011; 41:845-59. [DOI: 10.2165/11593200-000000000-00000] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Millet GP, Vleck VE, Bentley DJ. Physiological differences between cycling and running: lessons from triathletes. Sports Med 2009; 39:179-206. [PMID: 19290675 DOI: 10.2165/00007256-200939030-00002] [Citation(s) in RCA: 174] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this review was to provide a synopsis of the literature concerning the physiological differences between cycling and running. By comparing physiological variables such as maximal oxygen consumption (V O(2max)), anaerobic threshold (AT), heart rate, economy or delta efficiency measured in cycling and running in triathletes, runners or cyclists, this review aims to identify the effects of exercise modality on the underlying mechanisms (ventilatory responses, blood flow, muscle oxidative capacity, peripheral innervation and neuromuscular fatigue) of adaptation. The majority of studies indicate that runners achieve a higher V O(2max) on treadmill whereas cyclists can achieve a V O(2max) value in cycle ergometry similar to that in treadmill running. Hence, V O(2max) is specific to the exercise modality. In addition, the muscles adapt specifically to a given exercise task over a period of time, resulting in an improvement in submaximal physiological variables such as the ventilatory threshold, in some cases without a change in V O(2max). However, this effect is probably larger in cycling than in running. At the same time, skill influencing motor unit recruitment patterns is an important influence on the anaerobic threshold in cycling. Furthermore, it is likely that there is more physiological training transfer from running to cycling than vice versa. In triathletes, there is generally no difference in V O(2max) measured in cycle ergometry and treadmill running. The data concerning the anaerobic threshold in cycling and running in triathletes are conflicting. This is likely to be due to a combination of actual training load and prior training history in each discipline. The mechanisms surrounding the differences in the AT together with V O(2max) in cycling and running are not largely understood but are probably due to the relative adaptation of cardiac output influencing V O(2max) and also the recruitment of muscle mass in combination with the oxidative capacity of this mass influencing the AT. Several other physiological differences between cycling and running are addressed: heart rate is different between the two activities both for maximal and submaximal intensities. The delta efficiency is higher in running. Ventilation is more impaired in cycling than in running. It has also been shown that pedalling cadence affects the metabolic responses during cycling but also during a subsequent running bout. However, the optimal cadence is still debated. Central fatigue and decrease in maximal strength are more important after prolonged exercise in running than in cycling.
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Influence of performance level on exercise-induced arterial hypoxemia during prolonged and successive exercise in triathletes. Int J Sports Physiol Perform 2009; 3:482-500. [PMID: 19223673 DOI: 10.1123/ijspp.3.4.482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To study the relationship between performance and exercise-induced arterial hypoxemia (EIAH), 5 internationally ranked (INT) and 8 regionally ranked (REG) triathletes performed cycle-run successions (CR) and control runs (R) in competition-like conditions: at approximately 75% VO2max. METHODS Ventilatory parameters and oxyhemoglobin saturation (SpO2) data were collected continuously. Arteriolized partial pressure in O2 (PaO2) and alveolar ventilation (VA) were measured before and after cycling (CRcycle), the successive run (CRrun), and R. Pulmonary diffusing capacity (DLco) was measured at rest and 10 minutes post-CR. Training and short-distance triathlon data were collected. RESULTS INT showed significantly greater experience than REG in competition years (P>.05), training regimen (P>.05), and swimming (P>.05), and cycling (P>.05) volumes; running showed a trend (P<.06). Cycling, running, and total triathlon performances were significantly higher in INT than REG (P>.01). SpO2 during CR dropped significantly more in INT than in REG. Both groups showed significant inverse correlations between the magnitude of the SpO2 change from CRcycle to CRrun and the triathlon running time (r=-0.784; P<.05 and r=-0.699; P<.05; respectively). When compared with CRcycle, PaO2 significantly decreased and VA significantly increased after CRrun and R in both groups (P<.01). DLco significantly dropped between pre- and postexercise in CR and R with no between-group difference (P<.05). CONCLUSIONS EIAH was aggravated in higher performers during simulated cycle-run segments, related to longer experience and heavier training regimens. Possibly, relative hypoventilation caused this aggravated EIAH in INT, although pulmonary diffusion limitation was observed in both groups. Beyond EIAH severity, the magnitude of SpO2 variations during the cycle-run transition may affect triathlon running performance.
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Holmberg HC, Rosdahl H, Svedenhag J. Lung function, arterial saturation and oxygen uptake in elite cross country skiers: influence of exercise mode. Scand J Med Sci Sports 2006; 17:437-44. [PMID: 17040487 DOI: 10.1111/j.1600-0838.2006.00592.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Arterial desaturation during exercise is common in endurance-trained athletes, a phenomenon often more pronounced when the muscle mass engaged in the exercise is large. With this background, the present study monitored seven international-level cross country skiers performing on a treadmill while running (RUN), double poling (DP; upper body exercise) and diagonal skiing (DIA; arm and leg exercise). Static and dynamic lung function tests were performed and oxygen uptake was measured during submaximal and maximal exercise. Lung function variables (including the diffusion capacity) were only 5-20% higher than reported in sedentary men. Vital capacity was considerably lower than expected from the skiers' maximal oxygen uptake (VO(2max)), but the maximal ventilation followed a linear relationship with VO(2max). None or only a mild desaturation was observed in DP, RUN and DIA. Blood lactate concentration was slightly higher in DIA than in DP but not different from RUN. In DIA, VO(2max) was 6.23 +/- 0.47 L/min (mean +/- SD), which was 3.8% and 13.9% higher than in RUN and DP, respectively, with similar peak heart rates for the three exercise modes. No relationships were present either between the degree of desaturation and pulmonary functions tests, or with peak oxygen uptakes. The low blood lactate accumulation during the exhaustive efforts contributed to the arterial oxygen saturation being mild in spite of the very high oxygen uptake observed in these skiers.
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Affiliation(s)
- H-C Holmberg
- Department of Physiology & Pharmacology, Karolinska Institute, Stockholm, Sweden.
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Hopkins SR. Exercise induced arterial hypoxemia: the role of ventilation-perfusion inequality and pulmonary diffusion limitation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2006; 588:17-30. [PMID: 17089876 DOI: 10.1007/978-0-387-34817-9_3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Many apparently healthy individuals experience pulmonary gas exchange limitations during exercise, and the term "exercise induced arterial hypoxemia" (EIAH) has been used to describe the increase in alveolar-arterial difference for oxygen (AaDO2), which combined with a minimal alveolar hyperventilatory response, results in a reduction in arterial PO2. Despite more than two decades of research, the mechanisms of pulmonary gas exchange limitations during exercise are still debated. Using data in 166 healthy normal subjects collated from several previously published studies it can be shown that approximately 20% of the variation in PaO2 between individuals can be explained on the basis of variations in alveolar ventilation, whereas variations in AaDO2 explain approximately 80%. Using multiple inert gas data the relative contributions of ventilation-perfusion ("VA/Q") inequality and diffusion limitation to the AaDO2 can be assessed. During maximal exercise, both in individuals with minimal (AaDO2 < 20 Torr, x = 13 +/- 5, means +/- SD, n = 35) and moderate to severe (AaDO2= 25-40 Torr, x = 33 +/- 6, n = 20) gas exchange limitations, VA/Q inequality is an important contributor to the AaDO2. However, in subjects with minimal gas exchange impairment, VA/Q inequality accounts for virtually all of the AaDO2 (12 +/- 6 Torr), whereas in subjects with moderate to severe gas exchange impairment it accounts for less than 50% of the AaDO2 (15 +/- 6 Torr). Using this framework, the difficulties associated with unraveling the mechanisms of pulmonary gas exchange limitations during exercise are explored, and current data discussed.
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Affiliation(s)
- Susan R Hopkins
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0623, USA.
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Abstract
Horses are bred selectively for aerobic performance and have extraordinarily high maximal oxygen consumption, approximately double the mass-specific value for human athletes. Pulmonary limitations to exercise performance are well described in these animals, including exercise-induced arterial hypoxemia and exercise-induced pulmonary hemorrhage. In human athletes, pulmonary limitations are recognized increasingly as affecting athletic performance. Potential pulmonary limitations during maximal exercise are compared in human and equine athletes.
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Affiliation(s)
- Susan R Hopkins
- Division of Physiology, Department of Medicine, University of California--San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
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Croley AN, Zwetsloot KA, Westerkamp LM, Ryan NA, Pendergast AM, Hickner RC, Pofahl WE, Gavin TP. Lower capillarization, VEGF protein, and VEGF mRNA response to acute exercise in the vastus lateralis muscle of aged vs. young women. J Appl Physiol (1985) 2005; 99:1872-9. [PMID: 16024519 DOI: 10.1152/japplphysiol.00498.2005] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In humans, the majority of studies demonstrate an age-associated reduction in the number of capillaries surrounding skeletal muscle fibers; however, recent reports in rats suggest that muscle capillarization is well maintained with advanced age. In sedentary and trained men, aging lowers the number of capillaries surrounding type II, but not type I, skeletal muscle fibers. The fiber type-specific effect of aging on muscle capillarization is unknown in women. Vascular endothelial growth factor (VEGF) is important in the basal maintenance of skeletal muscle capillarization, and lower VEGF expression is associated with increased age in nonskeletal muscle tissue of women. Compared with young women (YW), we hypothesized that aged women (AW) would demonstrate 1) lower muscle capillarization in a fiber type-specific manner and 2) lower VEGF and VEGF receptor expression at rest and in response to acute exercise. Nine sedentary AW (70 + 8 yr) and 11 YW (22 + 3 yr) had vastus lateralis muscle biopsies obtained before and at 4 h after a submaximal exercise bout for the measurement of morphometry and VEGF and VEGF receptor expression. In AW compared with YW, muscle capillary contacts were lower overall (YW: 2.36 + 0.32 capillaries; AW: 2.08 + 0.17 capillaries), specifically in type II (YW: 2.37 + 0.39 capillaries; AW: 1.91 + 0.36 capillaries) but not type I fibers (YW: 2.36 + 0.34 capillaries; AW: 2.26 + 0.24 capillaries). Muscle VEGF protein was 35% lower at rest, and the exercise-induced increase in VEGF mRNA was 50% lower in AW compared with YW. There was no effect of age on VEGF receptor expression. These results provide evidence that, in the vastus lateralis of women, 1) capillarization surrounding type II muscle fibers is lower in AW compared with YW and 2) resting VEGF protein and the VEGF mRNA response to exercise are lower in AW compared with YW.
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Affiliation(s)
- Andrea N Croley
- Department of Exercise and Sport Science, East Carolina University, Greenville, NC 27858, USA
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Laursen PB, Rhodes EC, Langill RH, Taunton JE, McKenzie DC. Exercise-induced arterial hypoxemia is not different during cycling and running in triathletes. Scand J Med Sci Sports 2005; 15:113-7. [PMID: 15773866 DOI: 10.1111/j.1600-0838.2004.00391.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined the effect of running and cycling on exercise-induced arterial hypoxemia (EIAH) in individuals well trained in each modality. Thirteen male triathletes (X+/-SD: age=36+/-5 years, mass=69+/-8 kg, body fat=12+/-1%) performed progressive exercise to exhaustion during cycle ergometry and treadmill running. Gas exchange was determined, while oxyhemoglobin saturation (SaO(2)) was measured with an ear oximeter. At maximal exercise, the respiratory exchange ratio (1.15+/-0.06 vs. 1.10+/-0.05) and the ventilatory equivalent for oxygen uptake (37.6+/-3.8 vs. 34.2+/-2.7) were greater during cycling vs. running (P<0.05). However, there were no differences at maximal exercise in oxygen uptake (64.4+/-3.2 vs. 67.0+/-4.6 mL kg(-1) min(-1)), SaO(2) (93.4+/-2.8% vs. 92.6+/-2.2%), or the ventilatory equivalent for carbon dioxide (V(E)/VCO(2); 33.1+/-3.1 vs. 31.0+/-3.1), during cycling vs. running, respectively. During submaximal exercise, the V(E)/VCO(2) was less for cycling (26.0+/-1.0) compared with running (29.1+/-0.4; P<0.05), but this had no apparent effect on the SaO(2) response. In conclusion, EIAH was not significantly different during cycling and running in athletes who were well trained in both exercise modalities.
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Affiliation(s)
- Paul B Laursen
- School of Biomedical and Sports Science, Edith Cowen University, Bldg. 19 Rm. 162, 100 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
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Guenette JA, Diep TT, Koehle MS, Foster GE, Richards JC, Sheel AW. Acute hypoxic ventilatory response and exercise-induced arterial hypoxemia in men and women. Respir Physiol Neurobiol 2004; 143:37-48. [PMID: 15477171 DOI: 10.1016/j.resp.2004.07.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2004] [Indexed: 11/28/2022]
Abstract
Recent studies claim a higher prevalence of exercise-induced arterial hypoxemia (EIAH) in women relative to men and that diminished peripheral chemosensitivity is related to the degree of arterial desaturation during exercise in male endurance athletes. The purpose of this study was to determine the relationship between the acute ventilatory response to hypoxia (AHVR) and EIAH and the potential influence of gender in trained endurance cyclists and untrained individuals. Healthy untrained males (n = 9) and females (n = 9) and trained male (n = 11) and female (n = 10) cyclists performed an isocapnic AHVR test followed by an incremental cycle test to exhaustion. Oxyhemoglobin saturation (Sa(O(2)) was lower in trained men (91.4 +/- 0.9%) and women (91.3 +/- 0.9%) compared to their untrained counterparts (94.4 +/- 0.8% versus 94.3 +/- 0.7%) (P < 0.05). AHVR and maximal O(2) consumption were related for all subjects (r = -0.46), men (r = -0.45) and women (r = -0.53) (P < 0.05) but AHVR was unrelated to Sa(O(2)) for any groups (P > 0.05). We conclude that resting AHVR does not have a significant role in maintaining Sa(O(2)) during sea-level maximal cycle exercise in men or women.
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Affiliation(s)
- Jordan A Guenette
- Health and Integrative Physiology Laboratory, School of Human Kinetics, The University of British Columbia, Vancouver, BC, Canada V6T 1Z1
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Nielsen HB. Arterial desaturation during exercise in man: implication for O2 uptake and work capacity. Scand J Med Sci Sports 2003; 13:339-58. [PMID: 14617055 DOI: 10.1046/j.1600-0838.2003.00325.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Exercise-induced arterial hypoxaemia is defined as a reduction in the arterial O2 pressure (PaO2) by more than 1 kPa and/or a haemoglobin O2 saturation (SaO2) below 95%. With blood gas analyses ideally reported at the actual body temperature, desaturation is a consistent finding during maximal ergometer rowing. Arterial desaturation is most pronounced at the end of a maximal exercise bout, whereas the reduction in PaO2 is established from the onset of exercise. Exercise-induced arterial hypoxaemia is multifactorial. The ability to maintain a high alveolar O2 pressure (PAO2) is critical for blood oxygenation and this appears to be difficult in large individuals. A large lung capacity and, in turn, diffusion capacity seem to protect PaO2. A widening of the PAO2-PaO2 difference does indicate that a diffusion limitation, a ventilation-perfusion mismatch and/or a shunt influence the transport of O2 from alveoli to the pulmonary capillaries. An inspired O2 fraction of 0.30 reduces the widened PAO2-PaO2 difference by 75% and prevents a reduction of PaO2 and SaO2. With a marked increase in cardiac output, diffusion limitation combined with a fast transit time dominates the O2 transport problem. Furthermore, a postexercise reduction in pulmonary diffusion capacity suggests that the alveolo-capillary membrane is affected. An antioxidant attenuates oxidative burst by neutrophilic granulocytes, but it does not affect PaO2, SaO2 or O2 uptake (VO2), and the ventilatory response to maximal exercise also remains the same. It is proposed, though, that increased concentration of certain cytokines correlates to exercise-induced hypoxaemia as cytokines stimulate mast cells and basophilic granulocytes to degranulate histamine. The basophil count increases during maximal rowing. Equally, histamine release is associated with hypoxaemia and when the release of histamine is prevented, the reduction in PaO2 is attenuated. During maximal exercise, an extreme lactate spill-over to blood allows pH decrease to below 7.1 and according to the O2 dissociation curve this is critical for SaO2. When infusion of sodium bicarbonate maintains a stable blood buffer capacity, acidosis is attenuated and SaO2 increases from 89% to 95%. This enables exercise capacity to increase, an effect also seen when O2 supplementation to inspired air restores arterial oxygenation. In that case, exercise capacity increases less than can be explained by VO2 and CaO2. Furthermore, the change in muscle oxygenation during maximal exercise is not affected when hyperoxia and sodium bicarbonate attenuate desaturation. It is proposed that other organs benefit from enhanced O2 availability, and especially the brain appears to increase its oxygenation during maximal exercise with hyperoxia.
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Affiliation(s)
- Henning Bay Nielsen
- The Copenhagen Muscle Research Centre Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Laursen PB, Shing CM, Jenkins DG. Reproducibility of the cycling time to exhaustion at .VO2peak in highly trained cyclists. CANADIAN JOURNAL OF APPLIED PHYSIOLOGY = REVUE CANADIENNE DE PHYSIOLOGIE APPLIQUEE 2003; 28:605-15. [PMID: 12904637 DOI: 10.1139/h03-046] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of the present study was to examine, in highly trained cyclists, the reproducibility of cycling time to exhaustion (T(max)) at the power output equal to that attained at peak oxygen uptake (.VO2peak) during a progressive exercise test. Forty-three highly trained male cyclists (M +/- SD; age = 25 +/- 6 yrs; weight = 75 +/- 7 kg; .VO2peak = 64.8 +/- 5.2 ml.kg-1.min-1) performed two T(max) tests one week apart. While the two measures of T(max) were strongly related (r = 0.884; p < 0.001), T(max) from the second test (245 +/- 57 s) was significantly higher than that of the first (237 +/- 57 s; p = 0.047; two-tailed). Within-subject variability in the present study was calculated to be 6 +/- 6%, which was lower than that previously reported for T(max) in sub-elite runners (25%). The mean T(max) was significantly (p < 0.05) related to both the second ventilatory turnpoint (VT(2); r = 0.38) and to .VO2peak (r = 0.34). Despite a relatively low within-subject coefficient of variation, these data demonstrate that the second score in a series of two T(max) tests may be significantly greater than the first. Moreover, the present data show that T(max) in highly trained cyclists is moderately related to VT(2) and .VO2peak.
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Affiliation(s)
- Paul B Laursen
- Human Performance Laboratory, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia 4072
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28
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Pirhonen JP, Lindqvist PG, Marsal K. A longitudinal study of maternal oxygen saturation during short-term submaximal exercise. Clin Physiol Funct Imaging 2003; 23:37-41. [PMID: 12558612 DOI: 10.1046/j.1475-097x.2003.00467.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Longitudinal prospective study before, during and after normal pregnancy of the effect of short-term submaximal exercise on maternal oxygen saturation. METHODS Fourteen healthy women were recruited to the study before a planned pregnancy, and were followed seven times during the pregnancy and for up to 6 month after delivery. A submaximal bicycle exercise test with a target heart rate of 85% of the predicted age-adjusted maximum was performed. Maternal oxygen saturation was continuously recorded using a pulse oximeter. RESULTS Maternal oxygen saturation at maximum work-load had increased significantly already at 8 weeks gestation compared with preconception levels, and remained at a significantly higher level until 29 weeks of gestation. Thereafter, the oxygen saturation continued to be higher even at 6 month postpartum. During the exercise test, the lowest saturation was found during the late recovery period, this remained unchanged before, during and after pregnancy. CONCLUSION A pregnant woman responds to short-term exercise by increasing the oxygen saturation until 29 weeks. After that, the saturation level decreases but remains at a higher level even 6 month after delivery compared with preconception levels.
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Affiliation(s)
- Jouko P Pirhonen
- Department of Obstetrics and Gynecology, University of Lund, Sweden.
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Nielsen HB, Bredmose PP, Strømstad M, Volianitis S, Quistorff B, Secher NH. Bicarbonate attenuates arterial desaturation during maximal exercise in humans. J Appl Physiol (1985) 2002; 93:724-31. [PMID: 12133884 DOI: 10.1152/japplphysiol.00398.2000] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The contribution of pH to exercise-induced arterial O2 desaturation was evaluated by intravenous infusion of sodium bicarbonate (Bic, 1 M; 200-350 ml) or an equal volume of saline (Sal; 1 M) at a constant infusion rate during a "2,000-m" maximal ergometer row in five male oarsmen. Blood-gas variables were corrected to the increase in blood temperature from 36.5 +/- 0.3 to 38.9 +/- 0.1 degrees C (P < 0.05; means +/- SE), which was established in a pilot study. During Sal exercise, pH decreased from 7.42 +/- 0.01 at rest to 7.07 +/- 0.02 but only to 7.34 +/- 0.02 (P < 0.05) during the Bic trial. Arterial PO2 was reduced from 103.1 +/- 0.7 to 88.2 +/- 1.3 Torr during exercise with Sal, and this reduction was not significantly affected by Bic. Arterial O2 saturation was 97.5 +/- 0.2% at rest and decreased to 89.0 +/- 0.7% during Sal exercise but only to 94.1 +/- 1% with Bic (P < 0.05). Arterial PCO2 was not significantly changed from resting values in the last minute of Sal exercise, but in the Bic trial it increased from 40.5 +/- 0.5 to 45.9 +/- 2.0 Torr (P < 0.05). Pulmonary ventilation was lowered during exercise with Bic (155 +/- 14 vs. 142 +/- 13 l/min; P < 0.05), but the exercise-induced increase in the difference between the end-tidal O2 pressure and arterial PO2 was similar in the two trials. Also, pulmonary O2 uptake and changes in muscle oxygenation as determined by near-infrared spectrophotometry during exercise were similar. The enlarged blood-buffering capacity after infusion of Bic attenuated acidosis and in turn arterial desaturation during maximal exercise.
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Affiliation(s)
- Henning B Nielsen
- The Copenhagen Muscle Research Center, Department of Anesthesia, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Rice AJ, Scroop GC, Thornton AT, McNaughton NS, Rogers KJ, Chapman MJ, Greville HW, Scicchitano R, Gore CJ. Arterial hypoxaemia in endurance athletes is greater during running than cycling. RESPIRATION PHYSIOLOGY 2000; 123:235-46. [PMID: 11007990 DOI: 10.1016/s0034-5687(00)00174-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The effect of both training discipline and exercise modality on exercise-induced hypoxaemia (EIH) was examined in seven runners and six cyclists during 5 min high intensity treadmill and cycle exercise. There were no significant interactions between training discipline, exercise modality and arterial P(O(2)) (Pa(O(2))) when subject groups were considered separately but when pooled there were significant differences between exercise modalities. After min 2 of exercise arterial hydrogen ion concentration, minute ventilation, alveolar P(O(2)) (PA(O(2))) and Pa(O(2)) were all lower with treadmill running with the largest differential for the latter occurring at min 5 (treadmill, 80.8+/-1.8; cycle, 90.2+/-2.5, mmHg, N=13, P< or = 0.05). At every min of exercise, the differences in Pa(O(2)) between the ergometers were strongly associated with similar differences in PA(O(2)) and alveolar to arterial P(O(2)) (PA(O(2))-Pa(O(2))). It is concluded that the greater EIH with treadmill running is a consequence of the combined effect of a reduced lactic acidosis-induced hyperventilation and greater ventilation-perfusion inequality with this exercise mode.
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Affiliation(s)
- A J Rice
- Department of Thoracic Medicine, Royal Adelaide Hospital, 275 North Terrace, Adelaide, SA, Australia.
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Hopkins SR, Barker RC, Brutsaert TD, Gavin TP, Entin P, Olfert IM, Veisel S, Wagner PD. Pulmonary gas exchange during exercise in women: effects of exercise type and work increment. J Appl Physiol (1985) 2000; 89:721-30. [PMID: 10926659 DOI: 10.1152/jappl.2000.89.2.721] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Exercise-induced arterial hypoxemia (EIAH) has been reported in male athletes, particularly during fast-increment treadmill exercise protocols. Recent reports suggest a higher incidence in women. We hypothesized that 1-min incremental (fast) running (R) protocols would result in a lower arterial PO(2) (Pa(O(2))) than 5-min increment protocols (slow) or cycling exercise (C) and that women would experience greater EIAH than previously reported for men. Arterial blood gases, cardiac output, and metabolic data were obtained in 17 active women [mean maximal O(2) uptake (VO(2 max)) = 51 ml. kg(-1). min(-1)]. They were studied in random order (C or R), with a fast VO(2 max) protocol. After recovery, the women performed 5 min of exercise at 30, 60, and 90% of VO(2 max) (slow). One week later, the other exercise mode (R or C) was similarly studied. There were no significant differences in VO(2 max) between R and C. Pulmonary gas exchange was similar at rest, 30%, and 60% of VO(2 max). At 90% of VO(2 max), Pa(O(2)) was lower during R (mean +/- SE = 94 +/- 2 Torr) than during C (105 +/- 2 Torr, P < 0.0001), as was ventilation (85.2 +/- 3.8 vs. 98.2 +/- 4.4 l/min BTPS, P < 0.0001) and cardiac output (19.1 +/- 0.6 vs. 21.1 +/- 1.0 l/min, P < 0.001). Arterial PCO(2) (32.0 +/- 0.5 vs. 30.0 +/- 0.6 Torr, P < 0.001) and alveolar-arterial O(2) difference (A-aDO(2); 22 +/- 2 vs. 16 +/- 2 Torr, P < 0.0001) were greater during R. Pa(O(2)) and A-aDO(2) were similar between slow and fast. Nadir Pa(O(2)) was </=80 Torr in four women (24%) but only during fast-R. In all subjects, Pa(O(2)) at VO(2 max) was greater than the lower 95% prediction limit calculated from available data in men (n = 72 C and 38 R) for both R and C. These data suggest intrinsic differences in gas exchange between R and C, due to differences in ventilation and also efficiency of gas exchange. The Pa(O(2)) responses to R and C exercise in our 17 subjects do not differ significantly from those previously observed in men.
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Affiliation(s)
- S R Hopkins
- Division of Physiology, Department of Medicine, University of California, San Diego, La Jolla 92093, USA.
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