Repeatability of measurements of oxygen consumption, heart rate and Borg's scale in men during ergometer cycling

Can the heart rate response at the respiratory compensation point be used to retrieve the maximal metabolic steady state?

The metabolic rate (VO2) at the maximal metabolic steady state (MMSS) is generally not different from the VO2 at the respiratory compensation point (RCP). Based on this, it is often assumed that the heart rate (HR) at RCP would also be similar to that at MMSS. The study aims to compare the HR at RCP with that at MMSS. Seventeen individuals completed a ramp-incremental test, a series of severe-intensity trials to estimate critical power and two-to-three 30-min trials to confirm MMSS. The HR at RCP was retrieved by linear interpolation of the ramp-VO2/HR relationship and compared to the HR at MMSS recorded at 10, 15, 20, 25 and 30 min. The HR at RCP was 166 ± 12 bpm. The HR during MMSS at the timepoints of interest was 168 ± 8, 171 ± 8, 175 ± 9, 177 ± 9 and 178 ± 10 bpm. The HR at RCP was not different from the HR at MMSS at 10 min (P > 0.05) but lower at subsequent timepoints (P < 0.05) with this difference becoming progressively larger. For all timepoints, limits of agreement were large (~30 bpm). Given these differences and the variability at the individual level, the HR at RCP cannot be used to control the metabolic stimulus of endurance exercise.

Muscle fatigue in participants of indoor cycling

BACKGROUND

Indoor Cycling (IC) has been gaining recognition and popularity within recent years and few studies have investigated its benefits for sedentary participants.

OBJECTIVE

The aim of this study was to evaluate differences in the surface electromyography (sEMG) variables, heart rate (HR), and subjective effort in sedentary participants while they performed an IC session and to compare their results with the trained subjects, to answer the question: Are trained cyclists less susceptible to muscle fatigue, since it is expected that they make less effort?

DESIGN

Twenty-six volunteers were split into two groups according to their fitness status and weekly training load. Each participant completed an IC session in a private gym, lasting 45 minutes and were encouraged to follow the pedaling frequency and cycle resistance, within their limitations. Main Outcome Measures: HR, participants' subjective effort on the Borg Scale of Perceived Exertion (Borg Scale) and sEMG data were compared between groups.

RESULTS

28.6% of the sedentary participants withdrew from the study. Exercise intensity, assessed using the HR, was similar in both groups. The subjective perceived effort, assessed using the Borg Scale, was significantly higher in the sedentary group. All muscles considered in the sedentary group had higher variation levels of Root Mean Square (RMS) and Median Frequency (MF) than those in the trained group.

CONCLUSION

Sedentary participants are more likely to present fatigue and IC can be incorporated into protocols for this population, but their fitness levels should be taken into account because each performance depends on the individual's physical fitness.

LEVEL OF EVIDENCE

IIIb.

Curved Walking Rehabilitation with a Rotating Treadmill in Patients with Parkinson's Disease: A Proof of Concept

Training subjects to step-in-place eyes open on a rotating platform while maintaining a fixed body orientation in space [podokinetic stimulation (PKS)] produces a posteffect consisting in inadvertent turning around while stepping-in-place eyes closed [podokinetic after-rotation (PKAR)]. Since the rationale for rehabilitation of curved walking in Parkinson's disease is not fully known, we tested the hypothesis that repeated PKS favors the production of curved walking in these patients, who are uneasy with turning, even when straight walking is little affected. Fifteen patients participated in 10 training sessions distributed in 3 weeks. Both counterclockwise and clockwise PKS were randomly administered in each session. PKS velocity and duration were gradually increased over sessions. The velocity and duration of the following PKAR were assessed. All patients showed PKAR, which increased progressively in peak velocity and duration. In addition, before and at the end of the treatment, all patients walked overground along linear and circular trajectories. Post-training, the velocity of walking bouts increased, more so for the circular than the linear trajectory. Cadence was not affected. This study has shown that parkinsonian patients learn to produce turning while stepping when faced with appropriate training and that this capacity translates into improved overground curved walking.

Effects of walking-induced fatigue on gait function and tripping risks in older adults

BACKGROUND

Fatigue and ageing contribute to impaired control of walking and are linked to falls. In this project, fatigue was induced by maximum speed walking to examine fatigue effects on lower limb trajectory control and associated tripping risk and overall gait functions of older adults.

METHODS

Eleven young (18-35 years) and eleven older adults (>65 years) conducted 5-minute preferred speed treadmill walking prior to and following 6-minute maximum fast walking. Spatio-temporal gait parameters and minimum foot clearance (MFC) were obtained. Maximal muscle strength (hamstrings and quadriceps) was measured on an isokinetic dynamometer. Heart rate (HR) and rating of perceived exertion (RPE) assessed physiological effort and subjective fatigue. Physiological Cost Index computed walking efficiency.

RESULTS

Fatigue due to fast walking increased step length, double support time and variability of step width. Only older adults reduced MFC due to fatigue. A trend of longer double support with greater MFC was found in the non-dominant limb. Lower walking efficiency was characterised as the ageing effect. Older adults did not increase HR during fast walking but higher RPE scores were observed.

CONCLUSIONS

Older adults can increase tripping risk by 6 minutes of fast walking possibly by both impaired walking efficiency based on cardiac capacity and higher perceived fatigue due to elevated caution level. Regardless of age, increased step width variability due to fatigue was observed, a sign of impaired balance. Longer double support and greater MFC observed in the older adults' non-dominant limb could be an asymmetrical gait adaptation for safety.

Exercise training after burn injury: a survey of practice

Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits.

Analysis of weight change and Borg rating of perceived exertion as measurements of runner health and safety during a 6-day, multistage, remote ultramarathon

OBJECTIVE

To determine the feasibility of using weight change and Borg score as tools for monitoring runner health and safety during a multistage, remote ultramarathon.

DESIGN

Observational cohort study of feasibility on nonblinded event participants.

SETTING

Six-day, multistage, remote ultramarathon in Utah.

PARTICIPANTS

Twenty-seven athletes in the 2012 Desert R.A.T.S. (Race Across the Sand) ultramarathon.

ASSESSMENT OF RISK FACTORS

Participant weight, health conditions that limited race participation, such as fatigue or exhaustion, and Borg score were reviewed.

MAIN OUTCOME MEASURES

Inability to complete a stage of the race (Did Not Finish status) or development of a clinically significant health condition during the race. Potential prognostic risk factors, such as a high Borg score and weight loss, were analyzed.

RESULTS

An overall decrease in weight was observed over the course of the event. Median percent weight changes were losses of 2.96% (day 1), 7.42% (day 2), 2.21% (day 4), and 3.35% (day 6). There was no statistically significant difference in percent weight change between the 14 runners who finished the race and the 13 runners who did not finish the race (U = 73; z = 0.189; P = 0.85). Runners' ability to complete the race was related to the development of adverse health conditions (P = 0.004). Median Borg scores reported were 15 (day 1), 17 (day 2), 13 (day 3), 16 (day 4), and 15 (day 6). Only 2 racers who finished the entire event without adverse events ever gave a Borg score of ≥ 18.

CONCLUSIONS

The feasibility of weight change as a tool for monitoring runner health and safety in this setting is limited, but the Borg rating of perceived exertion warrants further study as a potential field expedient tool for monitoring runner health and safety during a multiday, remote ultramarathon.

Effects of propranolol and exercise training in children with severe burns

OBJECTIVES

To investigate whether propranolol administration blocks the benefits induced by exercise training in severely burned children.

STUDY DESIGN

Children aged 7-18 years (n = 58) with burns covering ≥30% of the total body surface area were enrolled in this randomized trial during their acute hospital admission. Twenty-seven patients were randomized to receive propranolol, whereas 31 served as untreated controls. Both groups participated in 12 weeks of in-hospital resistance and aerobic exercise training. Muscle strength, lean body mass, and peak oxygen consumption (VO2 peak) were measured before and after exercise training. Paired and unpaired Student t tests were used for within and between group comparisons, and χ(2) tests for nominal data.

RESULTS

Age, length of hospitalization, and total body surface area burned were similar between groups. In both groups, muscle strength, lean body mass, and VO2 peak were significantly greater after exercise training than at baseline. The percent change in VO2 peak was significantly greater in the propranolol group than in the control group (P < .05).

CONCLUSIONS

Exercise-induced enhancements in muscle mass, strength, and VO2 peak are not impaired by propranolol. Moreover, propranolol improves the aerobic response to exercise in massively burned children.

Validity and reliability of multiparameter physiological measurements recorded by the Equivital LifeMonitor during activities of various intensities

The Equivital LifeMonitor EQ02 is a multiparameter body-worn system capable of logging and transmitting physiological data describing a wearer's cardiorespiratory and thermal status. A number of vital signs can be acquired by the system, including electrocardiography, respiratory inductance plethysmography, posture/activity, multipoint skin temperature, and core temperature. The validity and reliability of the multiparameter physiological data recorded by the EQ02 were assessed. Participants performed resting, low-, and moderate intensity activities and wore the EQ02 and other calibrated laboratory physiological monitoring devices simultaneously. Heart rate, respiratory rate, multipoint skin temperature, and core temperature recorded by the EQ02 were compared with measurements recorded by standard devices. Results show that the validity error scores for HR and RR for all three activities were not significantly different from zero, and the CV, 95% LOA, and r were all clinically accepted. The validity error score for MT(SK) (0.59°C) falls outside the limits of 0.5°C, but the differences were parallel, r remained high (0.96), and 95% LOA remained narrow (±0.88°C). The validity error score for T(C) (-0.1°C) was similar in direction and magnitude to other studies, and r (0.98) and 95% LOA (±0.22°C) showed acceptable agreement between devices. The reliability error scores for HR, RR, MT(SK), and T(C) between trials were significantly different from zero. The 95% LOA, CV, and ICC for the EQ02 were similar to standard devices and were all clinically accepted. These findings demonstrate the validity and reliability of the EQ02 for ambulatory monitoring of multiple physiological parameters and suggest that the system could be used to provide a complete human physiological monitoring platform for the study of occupational health, environmental hygiene, and other application fields requiring ambulatory monitoring of multiparameter physiological status.

Prediction of maximal aerobic capacity in severely burned children

INTRODUCTION

Maximal oxygen uptake (VO₂ peak) is an indicator of cardiorespiratory fitness, but requires expensive equipment and a relatively high technical skill level.

PURPOSE

The aim of this study is to provide a formula for estimating VO₂ peak in burned children, using information obtained without expensive equipment.

METHODS

Children, with ≥ 40% total surface area burned (TBSA), underwent a modified Bruce treadmill test to assess VO(2) peak at 6 months after injury. We recorded gender, age, %TBSA, %3rd degree burn, height, weight, treadmill time, maximal speed, maximal grade, and peak heart rate, and applied McHenry's select algorithm to extract important independent variables and Robust multiple regression to establish prediction equations.

RESULTS

42 children; 7-17 years old were tested. Robust multiple regression model provided the equation: VO₂ =10.33-0.62 × age (years)+1.88 × treadmill time (min)+2.3 (gender; females = 0, males = 1). The correlation between measured and estimated VO₂ peak was R = 0.80. We then validated the equation with a group of 33 burned children, which yielded a correlation between measured and estimated VO₂ peak of R = 0.79.

CONCLUSIONS

Using only a treadmill and easily gathered information, VO₂ peak can be estimated in children with burns.

Repeatability of exercise behaviors in mice

PURPOSE

Measurements of exercise behaviors in rodents such as maximal treadmill endurance and physical activity are often used in the literature; however, minimal data are available regarding the repeatability of measurements used for these exercise behaviors. This study assessed the repeatability of a commonly used maximal exercise endurance treadmill test as well as voluntary physical activity measured by wheel running in mice.

METHODS

Repeatability of treadmill tests were analyzed for both inbred and outbred mice in addition to a 10 week repeatability analysis using Balb/cJ mice (n=20). Voluntary daily physical activity was assessed by distance, duration, and speed of wheel running (WR). Physical activity measurements on days 5 and 6 of WR in a large cohort (n=739) of both inbred and outbred mice were compared.

RESULTS

No significant differences (p>0.05) in exercise endurance were found between different cohorts of Balb/cJ and DBA/2J mice indicating strains overall generally test the same; however, significant differences between tests were seen within BaD2F(2) animals (p<0.001). Bland-Altman analysis revealed a lack of agreement between weekly endurance tests within mouse, and correlation analysis showed lack of consistent correlations between weekly endurance tests within mouse. No significant differences were found for WR measurements within mouse between days (p=0.99). High correlations between days within mouse for WR were found (r=0.74-0.85).

CONCLUSIONS

High intra-mouse variability between repeated endurance tests suggests that treadmill testing in an enclosed chamber with shock grid for motivation to run in mice is not repeatable. Conversely, high correlation and agreement between days of wheel-running measurements suggest that voluntary activity (WR) is repeatable and stable within individual mice.

Factors influencing physiological responses to small-sided soccer games

The aim of this study was to examine the effects of exercise type, field dimensions, and coach encouragement on the intensity and reproducibility of small-sided games. Data were collected on 20 amateur soccer players (body mass 73.1 +/- 8.6 kg, stature 1.79 +/- 0.05 m, age 24.5 +/- 4.1 years, VO(2max) 56.3 +/- 4.8 ml x kg(-1) x min(-1)). Aerobic interval training was performed during three-, four-, five- and six-a-side games on three differently sized pitches, with and without coach encouragement. Heart rate, rating of perceived exertion (RPE) on the CR10-scale, and blood lactate concentration were measured. Main effects were found for exercise type, field dimensions, and coach encouragement (P < 0.05), but there were no interactions between any of the variables (P > 0.15). During a six-a-side game on a small pitch without coach encouragement, exercise intensity was 84 +/- 5% of maximal heart rate, blood lactate concentration was 3.4 +/- 1.0 mmol x l(-1), and the RPE was 4.8. During a three-a-side game on a larger pitch with coach encouragement, exercise intensity was 91 +/- 2% of maximal heart rate, blood lactate concentration was 6.5 +/- 1.5 mmol x l(-1), and the RPE was 7.2. Typical error expressed as a coefficient of variation ranged from 2.0 to 5.4% for percent maximal heart rate, from 10.4 to 43.7% for blood lactate concentration, and from 5.5 to 31.9% for RPE. The results demonstrate that exercise intensity during small-sided soccer games can be manipulated by varying the exercise type, the field dimensions, and whether there is any coach encouragement. By using different combinations of these factors, coaches can modulate exercise intensity within the high-intensity zone and control the aerobic training stimulus.

Aerobic and functional capacity in a group of healthy women: reference values and repeatability

Twenty-five randomly selected, low or moderately fit and healthy women (22-44 years) rated their perceived physical capacity and performed an incremental cycle exercise test with respiratory gas analysis. The aerobic and functional capacity did not decrease with age. However, tauVo(2) increased with age. The mean value of the perceived physical capacity was 10 metabolic equivalents and that of Vo(2max) 2075 ml min(-1). The increasing anaerobic metabolism was determined at three points DX (where the rate of Vco(2) increase just exceeds the rate of Vo(2) increase), PX (where Vco(2)/Vo(2) = 1.0) and PQ (where ventilation increase disproportionately in relation to Vco(2)). The mean Vo(2) (% of Vo(2max)) at DX, PX and PQ were 1263 (63%), 1528 (73%) and 1620 (78%) ml min(-1), respectively. The mean value of deltaVo(2)/deltaW was 10.2 ml min(-1) W(-1) while that of tauVo(2) was 0.578 (age) + 15.6. Ten women performed a test and re-test on two consecutive days, and eight of these performed another re-test 4 weeks later. The repeatability was analysed and the variations were expressed as 2 SD of the differences between the tests. The variation was greater for the 4-week re-test than the day-to-day re-test regarding Vo(2max), o(2) at DX, PX and PQ, deltaVo(2)/deltaW and HR. The variation in Vo(2max), PX and deltaVo(2)/deltaW for the 4-week re-test was more than twice that of the previously reported 4-week variation for men. The considerable variation, especially for 4-week re-testing for women should be considered when evaluating the effects of exercise and rehabilitation.

Determination of both the time constant of vO2 and DeltavO2/DeltaW from a single incremental exercise test: validation and repeatability

A single incremental cycle exercise test including a steady-state load, combined with respiratory gas exchange, was performed with the objective of determining the time constant (tauVO(2)) and the amount of oxygen required at each load (DeltaVO(2)/DeltaW) by using a novel equation. The protocol was validated using four exercise tests at different constant loads and conventionally fitted mono-exponential functions to determine tauVO(2), and interpolation of VO(2) versus load to determine DeltaVO(2)/DeltaW. No significant differences were seen between the means of either tauVO(2) or DeltaVO(2)/DeltaW determined with the two protocols. The correlation coefficient was 0.62 for tauVO(2) and 0.48 for DeltaVO(2)/DeltaW. The absolute differences (2 SD) were 11.6 s for tauVO(2) and 1.1 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. The equations were compared in the same steady-state test and good agreement of tauVO(2) was obtained (R = 0.99). The 5-6-week repeatability (incremental test) was evaluated. No statistical differences were seen between the mean of the repeated tests. The difference between the tests (2 SD) were 20 s for tauVO(2) and 1.2 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. In conclusion, tauVO(2) and DeltaVO(2)/DeltaW can be determined from a single incremental test. The validation showed an acceptable agreement, although the variations in absolute values were not negligible. This could partly be explained by the natural day-to-day variation and fluctuations in incoming raw data. The test-retest variation in absolute values was considerable, which must be taken into account when using tauVO(2) and DeltaVO(2)/DeltaW for evaluation of aerobic function.

A refined technique for determining the respiratory gas exchange responses to anaerobic metabolism during progressive exercise - repeatability in a group of healthy men

The respiratory gas exchange and ventilation during an incremental cycle exercise test were analysed in a group of 19 healthy, moderately fit men. Different computer algorithms were used to estimate the VO2 values where: (i) the rate of VCO(2) increase just exceeds the rate of VO(2) increase (DX, derivative crossing), (ii) VCO(2)/VO(2) = 1.00 (PX, point of crossing) and (iii) ventilation (VE) increases disproportionately in relation to VCO(2) (PQ, point of VCO(2) equivalent rise). The DX and PQ measurements were analysed using a new approach employing polynomial regression and the value of PX was determined following low-pass filtration of raw data. The repeatability of the measurements was evaluated with a 5-6 week interval between the tests. The correlations between tests were 0.75 at DX, 0.85 at PX and 0.62 at PQ. The mean differences between the repeated tests were not statistically significant. The repeatability of VO2, in absolute values expressed as +/-2 SD of the differences between the tests, had values of 5.0, 6.1 and 9.5 ml min(-1) kg(-1) for DX, PX and PQ, respectively. The mean value of VO(2) for each measurement point expressed as a percentage of VO(2 max) was 54% at DX, 68% at PX and 70% at PQ. The most common sequence of the measured values was DX < PX < PQ, but the sequence DX < PQ < PX was also observed. It is concluded that the gas exchange responses to developing anaerobic metabolism during progressive exercise can be characterized by a series of thresholds. However, the considerable variation in absolute values in the two testing occasions requires further attention.