Oxygen Uptake-Work Rate Relationship During Two Consecutive Ramp Exercise Tests

The Oxygen Uptake Plateau-A Critical Review of the Frequently Misunderstood Phenomenon

A flattening of the oxygen uptake–work rate relationship at severe exercise indicates the achievement of maximum oxygen uptake \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left({\text{VO}}_{2\max } \right)$$\end{document}VO2max. Unfortunately, a distinct plateau \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left( {{{\text{VO}}}_{2} {\text{pl}}} \right)$$\end{document}VO2pl at \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2maxis not found in all participants. The aim of this investigation was to critically review the influence of research methods and physiological factors on the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence. It is shown that many studies used inappropriate definitions or methodical approaches to check for the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl. In contrast to the widespread assumptions it is unclear whether there is higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence in (uphill) running compared to cycling exercise or in discontinuous compared to continuous incremental exercise tests. Furthermore, most studies that evaluated the validity of supramaximal verification phases, reported verification bout durations, which are too short to ensure that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max have been achieved by all participants. As a result, there is little evidence for a higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence and a corresponding advantage for the diagnoses of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max when incremental tests are supplemented by supramaximal verification bouts. Preliminary evidence suggests that the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl in continuous incremental tests is determined by physiological factors like anaerobic capacity, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2-kinetics and accumulation of metabolites in the submaximal intensity domain. Subsequent studies should take more attention to the use of valid \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl definitions, which require a cut-off at ~ 50% of the submaximal \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2 increase and rather large sampling intervals. Furthermore, if verification bouts are used to verify the achievement of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{{2{\text{peak}}}}$$\end{document}VO2peak/\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max, it should be ensured that they can be sustained for sufficient durations.

Effect of intensive prior exercise on muscle fiber activation, oxygen uptake kinetics, and oxygen uptake plateau occurrence

Purpose

We tested the hypothesis that the described increase in oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2)-plateau incidence following a heavy-severe prior exercise is caused by a steeper increase in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2 and muscle fiber activation in the submaximal intensity domain.

Methods

Twenty-one male participants performed a standard ramp test, a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2max}}}}$$\end{document}V˙O2max verification bout, an unprimed ramp test with an individualized ramp slope and a primed ramp test with the same ramp slope, which was preceded by an intensive exercise at 50% of the difference between gas exchange threshold and maximum workload. Muscle fiber activation was recorded from vastus lateralis, vastus medialis, and gastrocnemius medialis using a surface electromyography (EMG) device in a subgroup of 11 participants. Linear regression analyses were used to calculate the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-(\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Delta \dot{V}{\text{O}}_{{2}} /\Delta P$$\end{document}ΔV˙O2/ΔP) and EMG-(∆RMS/∆P) ramp test kinetics.

Results

Twenty out of the 21 participants confirmed their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2max}}}}$$\end{document}V˙O2max in the verification bout. The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-plateau incidence in these participants did not differ between the unprimed (n = 8) and primed (n = 7) ramp test (p = 0.500). The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Delta \dot{V}{\text{O}}_{{2}} /\Delta P$$\end{document}ΔV˙O2/ΔP was lower in the primed compared to the unprimed ramp test (9.40 ± 0.66 vs. 10.31 ± 0.67 ml min⁻¹ W⁻¹, p < 0.001), whereas the ∆RMS/∆P did not differ between the ramp tests (0.62 ± 0.15 vs. 0.66 ± 0.14% W⁻¹; p = 0.744).

Conclusion

These findings do not support previous studies, which reported an increase in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-plateau incidence as well as steeper increases in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2 and muscle fiber activation in the submaximal intensity domain following a heavy-severe prior exercise.

Cardiopulmonary exercise test in myocardial ischemia detection

Exercise electrocardiography has low sensitivity for detection of myocardial ischemia. However, when combined with cardiopulmonary exercise testing (CPEX), the sensitivity and specificity of ischemia detection improves significantly. CPEX offers unique advantages over imaging techniques in tricky situations such as balanced ischemia. Early abnormal oxygen uptake would point toward profound coronary stenosis that could be missed in perfusion imaging. CPEX could be an invaluable tool in asymptomatic left bundle branch block pattern, without exposing patients to the risks of computerized tomography or invasive coronary angiography. Normal oxygen uptake curves would rule out significant coronary stenosis as the cause of left bundle branch block pattern. Elseways, abnormal oxygen uptake in patients with normal coronary arteries could indicate microvascular angina. Furthermore, exercise capacity is an excellent predictor of cardiovascular risk in those with and without heart disease. Using two clinical cases we introduce the concept of gas-exchange and hemodynamic changes encountered in ischemic heart disease.

Which Cutoffs for Secondary V˙O2max Criteria Are Robust to Diurnal Variations?

PURPOSE

The aim was to determine the minimum maximum oxygen uptake (V˙O2max) criteria cut-offs in highly trained athletes (i.e., maximum RER [RERmax], maximum HR [HRmax], maximum RPE [RPEmax], and maximum blood lactate concentration [BLmax]) necessary to determine maximum oxygen uptake (V˙O2max) during cardiopulmonary exercise tests (CPET), by balancing type I and type II errors. A further aim was to investigate if the defined cutoffs would be robust to diurnal and to day-to-day variations.

METHODS

Data from two CPET studies involving young athletes were analyzed. In the first study, 70 male participants performed one CPET until exhaustion to define cutoffs. In the second study, eight males and five females performed one CPET on seven consecutive days at six different times of day (i.e., diurnal variation). The time of the CPET was identical on the sixth and seventh days (i.e., day-to-day variation). To ensure comparability both studies were carried out under the same conditions.

RESULTS

Participants' mean V˙O2max was 63.0 ± 5.3 mL·kg·min. RERmax ≥1.10 was reached by 100%, HRmax ≥95% of age-predicted HRmax by 99%, RPEmax ≥19 by 100%, and BLmax ≥8 mmol·L by 100% of participants, respectively. Regarding the intraday variations, latter cutoffs were not reached in two cases for RERmax and in one case for HRmax and BLmax. Intraclass correlations for the day-to-day variability were r = 0.823 for RERmax, r = 0.828 for HRmax, and r = 0.380 for BLmax, respectively.

CONCLUSIONS

The proposed high cut-off values for secondary criteria provide some assurance that V˙O2max may have been achieved in athletes without increasing type II errors. However, type I errors may still occur indicating that further methods such as V˙O2-plateau or V˙O2-validation may be required.

Oxygen uptake plateau occurrence depends on oxygen kinetics and oxygen deficit accumulation

We tested the hypothesis that participants with an oxygen uptake ( V ˙ O 2 ) plateau during incremental exercise exhibit a lower VO₂ -deficit (VO_2DEF )-accumulation in the submaximal intensity domain due to faster ramp and square wave O₂ -kinetics. Twenty-six male participants performed a standard ramp test (increment: 30 W·min^-1 ), a ramp test with an individualized ramp slope and a two-step (moderate and severe) square wave exercise followed by a V ˙ O 2 m a x -verification bout. VO_2DEF was calculated by the difference between individualized ramp test V ˙ O₂ and V ˙ O₂ -demand estimated from steady-state V ˙ O₂ -kinetics. Twenty-four participants verified their V ˙ O_2max in the verification test. Ten of them showed a plateau in the individualized ramp test. VO_2DEF at the end of this ramp test (4.34 ± 0.60 vs 4.54 ± 0.43 L) was not different between the plateau and the non-plateau group (P > 0.05). The plateau group had a significantly (P < 0.05) lower VO_2DEF 2 minutes before termination of the individualized ramp test (2.24 ± 0.40 vs 2.78 ± 0.33 L). This coincided with a shorter mean response time (43 ± 9 vs 53 ± 7 seconds), a higher increase in V ˙ O₂ per W (10.1 ± 0.2 vs 9.2 ± 0.5 mL·min^-1 ·W^-1 ) at the individualized ramp test as well as shorter time constants of moderate (36 ± 6 vs 48 ± 7 seconds) and severe (62 ± 9 vs 86 ± 10 seconds) square wave kinetics (all P < 0.05). We conclude that the V ˙ O₂ -plateau occurrence requires a fast V ˙ O₂ -kinetics and a low VO_2DEF -accumulation at intensities below V ˙ O_2max .

Muscle V˙O2-power output nonlinearity in constant-power, step-incremental, and ramp-incremental exercise: magnitude and underlying mechanisms

A computer model of the skeletal muscle bioenergetic system was used to simulate time courses of muscle oxygen consumption (V˙O2), cytosolic metabolite (ADP, PCr, P_i, and ATP) concentrations, and pH during whole‐body constant‐power exercise (CPE) (6 min), step‐incremental exercise (SIE) (30 W/3 min), and slow (10 W/min), medium (30 W/min), and fast (50 W/min) ramp‐incremental exercise (RIE). Different ESA (each‐step activation) of oxidative phosphorylation (OXPHOS) intensity‐ATP usage activity relationships, representing different muscle fibers recruitment patterns, gave best agreement with experimental data for CPE, and for SIE and RIE. It was assumed that the muscle V˙O2‐power output (PO) nonlinearity is related to a time‐ and PO‐dependent increase in the additional ATP usage underlying the slow component of the V˙O2 on‐kinetics minus the increase in ATP supply by anaerobic glycolysis leading to a decrease in V˙O2. The muscle V˙O2‐PO relationship deviated upward (+) or downward (−) from linearity above critical power (CP), and the nonlinearity equaled +16% (CPE),+12% (SIE), +8% (slow RIE), +1% (moderate RIE), and −2% (fast RIE) at the end of exercise, in agreement with experimental data. During SIE and RIE, changes in PCr and P_i accelerated moderately above CP, while changes in ADP and pH accelerated significantly with time and PO. It is postulated that the intensity of the additional ATP usage minus ATP supply by anaerobic glycolysis determines the size of the muscle V˙O2‐PO nonlinearity. It is proposed that the extent of the additional ATP usage is proportional to the time integral of PO ‐ CP above CP.

Influence of acute passive stretching on the oxygen uptake vs work rate slope during an incremental cycle test

PURPOSE

The aim of the study was to investigate the effects of acute passive stretching on O2 uptake (VO2) vs work rate slope during a continuous incremental ramp exercise.

METHODS

On two different occasions, eight participants (age 23 ± 3 years; stature 1.71 ± 0.10 m; body mass 68 ± 8 kg; mean ± SD) performed two maximum incremental ramp tests on a cycle ergometer (25 W/min), with and without pre-exercise stretching. During tests, we measured VO2 and other metabolic and cardiorespiratory parameters on a breath-by-breath basis. The VO2 vs work rate slopes were calculated below (S 1) and above (S 2) the first ventilatory threshold (VET1).

RESULTS

With stretching: (1) peak VO2 did not change, while peak work rate decreased (P < 0.05, ES = -0.41; CI -1.40/-0.58); (2) in spite of a similar S 1, S 2 was steeper by about 11 % (P < 0.05; ES = 0.62; CI -0.38/-1.62).

CONCLUSIONS

Stretching reduced peak work rate and altered the [Formula: see text] vs work rate relationship above VET1 (S 2), without affecting peak VO2. The present findings have practical implications, questioning the use of stretching manoeuvres especially when peak work rate plays a key role in exercise performance.

Resposta da cinética de consumo de oxigênio e da eficiência mecânica delta de homens e mulheres em diferentes intensidades de esforço

INTRODUÇÃO:A eficiência mecânica delta (EMΔ ) e a cinética do consumo de oxigênio (K<img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2) são influenciadas por parâmetros metabólicos musculares e pelo transporte de <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2. O objetivo do presente estudo foi determinar a diferença na K<img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 e na EMΔ em três intensidades de esforço nos dois gêneros. MÉTODOS: 56 sujeitos (26 mulheres) foram submetidos ao protocolo de esforço escalonado, contínuo e máximo (GxT) no cicloergômetro mecânico para determinação da potência aeróbia máxima (<img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2máx), carga máxima (Wmax), limiar anaeróbio (AT) e ponto de compensação respiratória (PCR). O AT foi determinado através dos métodos V-slope e E <img src="/img/revistas/rbme/v17n4/a13cr02.jpg" align="absmiddle" /><img src="/img/revistas/rbme/v17n4/a13cr02.jpg" align="absmiddle" />E / <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2; o PCR através da relação <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 versus <img src="/img/revistas/rbme/v17n4/a13cr02.jpg" align="absmiddle" />E ; ambos por dois avaliadores. A EMΔ e a K <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 foram consideradas como a inclinação entre <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 versus Watts e <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 versus tempo (s), respectivamente, do começo do teste até o AT (S1), do AT ao PCR (S2) e do PCR ao <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2máx (S3), determinada por análise de regressão linear. RESULTADOS: Para a EMΔ, diferenças significativas foram observadas entre S1 versus S2 (p = 0,001), S1 versus S3 (p = 0,001) e S2 versus S3 (p = 0,006). Não foi observada diferença (p = 0,060) ou interação significativa (p = 0,062) entre homens versus mulheres. Para a K <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 diferenças significativas foram observadas entre S1 versus S3 (p = 0,001) e S2 versus S3 (p = 0,001) em ambos gêneros. Diferenças (p = 0,001) e interação significativa (p = 0,006) foram observadas entre homens versus mulheres, no último parâmetro. CONCLUSÕES: A EMΔ decresce com o incremento da intensidade de trabalho, porém, não há diferenças quando se compara homens e mulheres. Por outro lado, as mulheres apresentam K <img src="/img/revistas/rbme/v17n4/a13cr01.jpg" align="absmiddle" />2 mais rápida do que os homens.

Influence of priming exercise on muscle deoxy[Hb + Mb] during ramp cycle exercise

The aim of the present study was to gain better insight into the mechanisms underpinning the sigmoid pattern of deoxy[Hb + Mb] during incremental exercise by assessing the changes in the profile following prior high-intensity exercise. Ten physically active students performed two incremental ramp (25 W min(-1)) exercises (AL and LL, respectively) preceded on one occasion by incremental arm (10 W min(-1)) and on another occasion by incremental leg exercise (25 W min(-1)), which served as the reference test (RT). Deoxy[Hb + Mb] was measured by means of near-infrared spectroscopy and surface EMG was recorded at the Vastus Lateralis throughout the exercises. Deoxy[Hb + Mb], integrated EMG and Median Power Frequency (MdPF) were expressed as a function of work rate (W) and compared between the exercises. During RT and AL deoxy[Hb + Mb] followed a sigmoid increase as a function of work rate. However, during LL deoxy[Hb + Mb] increased immediately from the onset of the ramp exercise and thus no longer followed a sigmoid pattern. This different pattern in deoxy[Hb + Mb] was accompanied by a steeper slope of the iEMG/W-relationship below the GET (LL: 0.89 ± 0.11% W(-1); RT: 0.74 ± 0.08% W(-1); AL: 0.72 ± 0.10% W(-1)) and a more pronounced decrease in MdPF in LL (17.2 ± 4.5%) compared to RT (5.0 ± 2.1%) and AL (3.9 ± 3.2%). It was observed that the sigmoid pattern of deoxy[Hb + Mb] was disturbed when the ramp exercise was preceded by priming leg exercise. Since the differences in deoxy[Hb + Mb] were accompanied by differences in EMG it can be suggested that muscle fibre recruitment is an important underlying mechanism for the pattern of deoxy[Hb + Mb] during ramp exercise.

Comparisons of local and systemic aerobic fitness parameters between finswimmers with different athlete grade levels

To study the relationship between the local and systemic aerobic fitness parameters, and between the muscle oxygenation and aerobic performance, 16 female finswimmers were recruited and divided into high-level (HL) group and low-level group. Cardiorespiratory function, blood lactate concentration and near infrared spectroscopy muscle oxygenation in the vastus lateralis (VL) were monitored simultaneously during a maximal incremental exercise. We found that the break point (Bp) of the oxygenation index (OI) in the VL (BpVL) had significant correlations with lactate threshold (LT) and gas exchange threshold (GET), and the appearance sequence of the three thresholds was BpVL ≈ LT ≤ GET. When considering different levels, the [Formula: see text] at BpVL, LT and GET were higher in the HL group. During intensive exercise, there were significantly faster [Formula: see text] increase and evidently slower OI decrease in the HL group, suggesting that faster [Formula: see text] increase in the HL group slowed down the muscle deoxygenation and facilitated subjects to cycle to higher workloads. In conclusion, multi-modality approaches combining local and systemic physiological monitoring technologies might provide better explanations of the relationship between local and systemic aerobic fitness parameters, and might be a novel way to analyze the difference between groups of different levels.

Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise

Dietary nitrate (NO3−) supplementation with beetroot juice (BR) over 4–6 days has been shown to reduce the O2cost of submaximal exercise and to improve exercise tolerance. However, it is not known whether shorter (or longer) periods of supplementation have similar (or greater) effects. We therefore investigated the effects of acute and chronic NO3−supplementation on resting blood pressure (BP) and the physiological responses to moderate-intensity exercise and ramp incremental cycle exercise in eight healthy subjects. Following baseline tests, the subjects were assigned in a balanced crossover design to receive BR (0.5 l/day; 5.2 mmol of NO3−/day) and placebo (PL; 0.5 l/day low-calorie juice cordial) treatments. The exercise protocol (two moderate-intensity step tests followed by a ramp test) was repeated 2.5 h following first ingestion (0.5 liter) and after 5 and 15 days of BR and PL. Plasma nitrite concentration (baseline: 454 ± 81 nM) was significantly elevated (+39% at 2.5 h postingestion; +25% at 5 days; +46% at 15 days; P < 0.05) and systolic and diastolic BP (baseline: 127 ± 6 and 72 ± 5 mmHg, respectively) were reduced by ∼4% throughout the BR supplementation period ( P < 0.05). Compared with PL, the steady-state V̇o2during moderate exercise was reduced by ∼4% after 2.5 h and remained similarly reduced after 5 and 15 days of BR ( P < 0.05). The ramp test peak power and the work rate at the gas exchange threshold (baseline: 322 ± 67 W and 89 ± 15 W, respectively) were elevated after 15 days of BR (331 ± 68 W and 105 ± 28 W; P < 0.05) but not PL (323 ± 68 W and 84 ± 18 W). These results indicate that dietary NO3−supplementation acutely reduces BP and the O2cost of submaximal exercise and that these effects are maintained for at least 15 days if supplementation is continued.

Ventilatory inefficiency in major depressive disorder: a potential adjunct for cardiac risk stratification in depressive disorders?

BACKGROUND

Cardiopulmonary exercise testing (CPET) provides insights into ventilatory, cardiac and metabolic dysfunction in heart and lung diseases and might play a role in cardiac risk stratification in major depressive disorder (MDD).

OBJECTIVE

The VE/VCO(2)-slope indicates ventilatory efficiency and has been applied to stratify the cardiac risk in heart failure (HF). Therefore, the current study was conducted to evaluate and classify ventilatory efficiency and its relationship to physical fitness and disease severity in MDD.

METHODS

Exhaustive incremental exercise testing was completed by 15 female MDD patients and pair matched controls. The ventilatory threshold (VT) and the VE/VCO(2)-slope were assessed. Statistical analyses were conducted by means of MANOVAs and follow-up univariate ANOVAs.

RESULTS

In patients with MDD, significant different relative work rates and oxygen uptakes at the VT in comparison to healthy controls were observed. Furthermore, we found an increased VE/VCO(2)-slope in depressed patients. We additionally report an inverse relationship between the VE/VCO(2)-slope and peak power output as well as peak oxygen uptake solely in patients. We did not observe any association of assessed parameters with disease severity.

CONCLUSION

CPET measures indicate ventilatory inefficiency in patients with MDD. The elevated VE/VCO(2)-slope indicates that patients with MDD need to ventilate significantly more to a given amount of developing CO(2). Further investigations are needed to verify the application of the ventilatory classification system to stratify cardiovascular risk in depressive disorder.

Pulmonary O2 uptake on-kinetics in sprint- and endurance-trained athletes

Pulmonary O2 uptake kinetics during "step" exercise have not been characterized in young, sprint-trained (SPT), athletes. Therefore, the objective of this study was to test the hypotheses that SPT athletes would have (i) slower phase II kinetics and (ii) a greater oxygen uptake "slow component" when compared with endurance-trained (ENT) athletes. Eight sub-elite SPT athletes (mean (+/-SD) age=25 (+/-7) y; mass=80.3 (+/-7.3) kg) and 8 sub-elite ENT athletes (age=28 (+/-4) y; mass=73.2 (+/-5.1) kg) completed a ramp incremental cycle ergometer test, a Wingate 30 s anaerobic sprint test, and repeat "step" transitions in work rate from 20 W to moderate- and severe-intensity cycle exercise, during which pulmonary oxygen uptake was measured breath by breath. The phase II oxygen uptake kinetics were significantly slower in the SPT athletes both for moderate (time constant, tau; SPT 32 (+/-4) s vs. ENT 17 (+/-3) s; p<0.01) and severe (SPT 32 (+/-12) s vs. ENT 20 (+/-6) s; p<0.05) exercise. The amplitude of the slow component (derived by exponential modelling) was not significantly different between the groups (SPT 0.55 (+/-0.12) L.min(-1) vs. ENT 0.50 (+/-0.22) L.min(-1)), but the increase in oxygen uptake between 3 and 6 min of severe exercise was greater in the SPT athletes (SPT 0.37 (+/-0.08) L.min(-1) vs. ENT 0.20 (+/-0.09) L.min(-1); p<0.01). The phase II tau was significantly correlated with indices of aerobic exercise performance (e.g., peak oxygen uptake (moderate-intensity r=-0.88, p<0.01; severe intensity r=-0.62; p<0.05), whereas the relative amplitude of the oxygen uptake slow component was significantly correlated with indices of anaerobic exercise performance (e.g., Wingate peak power output; r=0.77; p<0.01). Thus, it could be concluded that sub-elite SPT athletes have slower phase II oxygen uptake kinetics and a larger oxygen uptake slow component compared with sub-elite ENT athletes. It appears that indices of aerobic and anaerobic exercise performance differentially influence the fundamental and slow components of the oxygen uptake kinetics.

Prior exercise delays the onset of acidosis during incremental exercise

The effects of prior moderate- and prior heavy-intensity exercise on the subsequent metabolic response to incremental exercise were examined. Healthy, young adult subjects (n = 8) performed three randomized plantar-flexion exercise tests: 1) an incremental exercise test (approximately 0.6 W/min) to volitional fatigue (Ramp); 2) Ramp preceded by 6 min of moderate-intensity, constant-load exercise below the intracellular pH threshold (pHT; Mod-Ramp); and 3) Ramp preceded by 6 min of heavy-intensity, constant-load exercise above pHT (Hvy-Ramp); the constant-load and incremental exercise periods were separated by 6 min of rest. (31)P-magnetic resonance spectroscopy was used to continuously monitor intracellular pH, phosphocreatine concentration ([PCr]), and inorganic phosphate concentration ([P(i)]). No differences in exercise performance or the metabolic response to exercise were observed between Ramp and Mod-Ramp. However, compared with Ramp, a 14% (SD 10) increase (P < 0.01) in peak power output (PPO) was observed in Hvy-Ramp. The improved exercise performance in Hvy-Ramp was accompanied by a delayed (P = 0.01) onset of intracellular acidosis [Hvy-Ramp 60.4% PPO (SD 11.7) vs. Ramp 45.8% PPO (SD 9.4)] and a delayed (P < 0.01) onset of rapid increases in [P(i)]/[PCr] [Hvy-Ramp 61.5% PPO (SD 12.0) vs. Ramp 45.1% PPO (SD 9.1)]. In conclusion, prior heavy-intensity exercise delayed the onset of intracellular acidosis and enhanced exercise performance during a subsequent incremental exercise test.

The Work Rate Corresponding to Ventilatory Threshold During Steady-State and Ramp Exercise

Purpose:

The work rate (WR) corresponding to ventilatory threshold (VT) is an appropriate intensity for regenerative and low-intensity training sessions. During incremental ramp exercise, VO2 increase lags behind WR increase. Traditionally, a VO2 time delay (td) of 45 seconds is used to calculate the WR at VT from such tests. Considerable inaccuracies were observed when using this constant td. Therefore, this study aimed at reinvestigating the temporal relationship between VO2 and WR at VT.

Methods:

20 subjects (VO2peak 49.9 to 72.6 mL · min–1 · kg–1) performed a ramp test in order to determine VT and a subsequent steady-state test during which WR was adjusted to elicit the VO2 corresponding to VT. The difference in WR and heart rate at VT was calculated between the ramp and the steady-state test (WRdiff, HRdiff) as well as the time delay corresponding to WRdiff during ramp exercise.

Results:

Mean values were td = 85 ± 26 seconds (range 38 to 144), WRdiff = 45 ± 12 W (range 23 to 67), HRdiff = 1 ± 9 beats/min (range –21 to +15). The limits of agreement for the difference between WR at VT during ramp and steady-state exercise were ± 24 W. No signifi cant influence on td, WRdiff, or HRdiff from differences in endurance capacity (VO2peak and VT; P > .10 for all correlations) or ramp increment (P = .26, .49, and .85, respectively) were observed.

Conclusion:

The wide ranges of td, WRdiff, and HRdiff prevent the derivation of exact training guidelines from single-ramp tests. It is advisable to perform a steady-state test to exactly determine the WR corresponding to VT.

A test to establish maximum O2 uptake despite no plateau in the O2 uptake response to ramp incremental exercise

The O2 uptake (Vo2) response to ramp incremental (RI) exercise does not consistently demonstrate plateau-like behavior at the limit of tolerance, and hence the requirements for a maximum Vo2 commonly are not met, despite apparent maximum effort. We sought to determine whether an appended step exercise (SE) test at a work rate greater than that achieved in a preceding ramp test would establish the plateau criterion. Seven healthy male adults performed RI cycle ergometry (20 W/min) to the limit of tolerance, followed by 5-min recovery (20 W) and then an SE test at 105% (RISE-105) of the final work rate (WRpeak) achieved during RI. Five of these subjects also performed an RI test followed by SE at 95% WRpeak (RISE-95). Vo2 was measured breath by breath using a turbine and mass spectrometer. The average of the final 15 s of RI or SE was used to establish respective Vo2 peaks. When Vo2 peak was approached, a constant Vo2 value (e.g., a plateau) was not discernable during any RI or SE component of the tests. Although the WRpeak [mean (SD)] was higher during the SE portion [359 W (SD 31)] than during the RI portion [341 W (SD 29)] of the RISE-105, the peak Vo2 was not different [SE, 4.30 l/min (SD 0.51); RI, 4.33 l/min (SD 0.52); P=0.49; n=7]. Similarly, in the RISE-95 test, WRpeak was 310 W (SD 31) for the SE portion and 326 W (SD 32) for the RI portion, yet the peak Vo2 values were not different [SE, 4.12 l/min (SD 0.53); RI, 4.11 l/min (SD 0.48); P=0.78; n=5]. The lack of notable difference between the Vo2 peaks established at different WRpeak values in our RISE protocols provides the plateau criterion for verification of maximum Vo2 in a single test session, even when the data response profiles do not themselves evidence a plateau.