Heart rate prescriptions from performance and anthropometrical characteristics

Rating of Perceived Exertion: A Large Cross-Sectional Study Defining Intensity Levels for Individual Physical Activity Recommendations

BACKGROUND

Physical inactivity is a growing risk factor worldwide, therefore getting people into sports is necessary. When prescribing physical activity, it is essential to recommend the correct training intensities. Cardiopulmonary exercise testing (CPX) enables precise determination of individuals' training intensities but is unavailable for a broad population. Therefore, the Borg scale allows individuals to assess perceived exertion and set their intensity easily and cost-efficiently. In order to transfer CPX to rating of perceived exertion (RPE), previous studies investigated RPE on specific physiological anchors, e.g. blood lactate (bLa) concentrations, but representativeness for a broad population is questionable. Some contradictory findings regarding individual factors influencing RPE occur, whereas univariable analysis has been performed so far. Moreover, a multivariable understanding of individual factors influencing RPE is missing. This study aims to determine RPE values at the individual anaerobic threshold (LT2) and defined bLa concentrations in a large cohort and to evaluate individual factors influencing RPE with multivariable analysis.

METHODS

CPX with bicycle or treadmill ergometer of 6311 participants were analyzed in this cross-sectional study. RPE values at bLa concentrations 2 mmol/l, 3 mmol/l, 4 mmol/l, and LT2 (first rise in bLa over baseline + 1.5 mmol/l) were estimated by spline interpolation. Multivariable cumulative ordinal regression models were performed to assess the influence of sex, age, type of ergometry, VO2max, and duration of exercise testing on RPE.

RESULTS

Median values [interquartile range (IQR)] of the total population were RPE 13 [11; 14] at 2 mmol/l, RPE 15 [13; 16] at 3 mmol/l, RPE 16 [15; 17] at 4 mmol/l, and RPE 15 [14; 16] at LT2. Main influence of individual factors on RPE were seen especially at 2 mmol/l: male sex (odds ratio (OR) [95%-CI]: 0.65 [0.587; 0.719]), treadmill ergometry (OR 0.754 [0.641; 0.886]), number of stages (OR 1.345 [1.300; 1.394]), age (OR 1.015 [1.012; 1.018]), and VO2max (OR 1.023 [1.015; 1.030]). Number of stages was the only identified influencing factor on RPE at all lactate concentrations/LT2 (3 mmol/l: OR 1.290 [1.244; 1.336]; 4 mmol/l: OR 1.229 [1.187; 1.274]; LT2: OR 1.155 [1.115; 1.197]).

CONCLUSION

Our results suggest RPE ≤ 11 for light intensity, RPE 12-14 for moderate intensity, and RPE 15-17 for vigorous intensity, which slightly differs from the current American College of Sports Medicine (ACSM) recommendations. Additionally, we propose an RPE of 15 delineating heavy and severe intensity domain. Age, sex, type of ergometry, duration of exercise, and cardiopulmonary fitness should be considered when recommending individualized intensities with RPE, primarily at lower intensities. Therefore, this study can be used as a new guideline for prescribing individual RPE values in the clinical practice, predominantly for endurance type exercise.

Cardiorespiratory fitness modulates prestimulus EEG microstates during a sustained attention task

Higher cardiorespiratory fitness is associated with an increased ability to perform sustained attention tasks and detect rare and unpredictable signals over prolonged periods. The electrocortical dynamics underlying this relationship were mainly investigated after visual stimulus onset in sustained attention tasks. Prestimulus electrocortical activity supporting differences in sustained attention performance according to the level of cardiorespiratory fitness have yet to be examined. Consequently, this study aimed to investigate EEG microstates 2 seconds before the stimulus onset in 65 healthy individuals aged 18-37, differing in cardiorespiratory fitness, while performing a psychomotor vigilance task. The analyses showed that a lower duration of the microstate A and a higher occurrence of the microstate D correlated with higher cardiorespiratory fitness in the prestimulus periods. In addition, increased global field power and occurrence of microstate A were associated with slower response times in the psychomotor vigilance task, while greater global explained variance, coverage, and occurrence of microstate D were linked to faster response times. Our collective findings showed that individuals with higher cardiorespiratory fitness exhibit typical electrocortical dynamics that allow them to allocate their attentional resources more efficiently when engaged in sustained attention tasks.

Electrocortical correlates of the association between cardiorespiratory fitness and sustained attention in young adults

Cardiorespiratory fitness is thought to be positively related to sustained attention. However, the underlying mechanisms of this relationship have yet to be fully elucidated. The objective of this study was to i) explore the relationship between cardiorespiratory fitness and sustained attention in 72 young adults (18-37 years old) and ii) provide insight on the electrocortical dynamics supporting sustained attention performance in individuals differing in cardiorespiratory fitness by means of EEG topographic analyses and source localization. Behaviorally, cardiorespiratory fitness was related to faster response times and higher accuracy in the psychomotor vigilance task even when adjusting the model with confounding variables such as age, body mass index and chronic physical activity. However, there was no relationship between cardiorespiratory fitness and the classic vigilance decrement observed in the sustained attention task. At the electrocortical level, higher cardiorespiratory fitness was related to increased global field power (310-333 ms poststimulus) localized in the posterior cingulate cortex (BA 30) followed by changes in scalp topographies around the P3b ERP component (413-501 ms poststimulus), which corresponded to earlier activation of the supplementary motor areas (BA 6). This is the first study using high-density EEG, which harnesses the whole spatiotemporal dynamics of the relationship between cardiorespiratory fitness and sustained attention in young adults.

Constant power threshold—predicting maximal lactate steady state in recreational cyclists

Introduction

Prolonged time trials proved capable of precisely estimating anaerobic threshold. However, time trial studies in recreational cyclists are missing. The aim of the present study was to evaluate accuracy and viability of constant power threshold, which is the highest power output constantly maintainable over time, for estimating maximal lactate steady state in recreational athletes.

Methods

A total of 25 recreational athletes participated in the study of whom 22 (11 female, 11 male) conducted all constant load time trials required for determining constant power threshold 30 min and 45 min, which is the highest power output constantly maintainable over 30 min and 45 min, respectively. Maximal lactate steady state was assessed subsequently from blood samples taken every 5 min during the time trials.

Results

Constant power threshold over 45 min (175.5 ± 49.6 W) almost matched power output at maximal lactate steady state (176.4 ± 50.5 W), whereas constant power threshold over 30 min (181.4 ± 51.4 W) was marginally higher (P = 0.007, d = 0.74). Interrelations between maximal lactate steady state and constant power threshold 30 min and constant power threshold 45 min were very close (R2 = 0.99, SEE = 8.9 W, Percentage SEE (%SEE) = 5.1%, P < 0.001 and R2 = 0.99, SEE = 10.0 W, %SEE = 5.7%, P < 0.001, respectively).

Conclusions

Determination of constant power threshold is a straining but viable and precise alternative for recreational cyclists to estimate power output at maximal lactate steady state and thus maximal sustainable oxidative metabolic rate.

Retrospective Analysis of Training and Its Response in Marathon Finishers Based on Fitness App Data

Objective: Finishing a marathon requires to prepare for a 42.2 km run. Current literature describes which training characteristics are related to marathon performance. However, which training is most effective in terms of a performance improvement remains unclear.

Methods: We conducted a retrospective analysis of training responses during a 16 weeks training period prior to an absolved marathon. The analysis was performed on unsupervised fitness app data (Runtastic) from 6,771 marathon finishers. Differences in training volume and intensity between three response and three marathon performance groups were analyzed. Training response was quantified by the improvement of the velocity of 10 km runs Δv₁₀ between the first and last 4 weeks of the training period. Response and marathon performance groups were classified by the 33.3rd and 66.6th percentile of Δv₁₀ and the marathon performance time, respectively.

Results: Subjects allocated in the faster marathon performance group showed systematically higher training volume and higher shares of training at low intensities. Only subjects in the moderate and high response group increased their training velocity continuously along the 16 weeks of training.

Conclusion: We demonstrate that a combination of maximized training volumes at low intensities, a continuous increase in average running speed up to the aimed marathon velocity and high intensity runs ≤ 5 % of the overall training volume was accompanied by an improved 10 km performance which likely benefited the marathon performance as well. The study at hand proves that unsupervised workouts recorded with fitness apps can be a valuable data source for future studies in sport science.

Accuracy of training recommendations based on a treadmill multistage incremental exercise test

Competitive runners will occasionally undergo exercise in a laboratory setting to obtain predictive and prescriptive information regarding their performance. The present research aimed to assess whether the physiological demands of lab-based treadmill running (TM) can simulate that of over-ground (OG) running using a commonly used protocol. Fifteen healthy volunteers with a weekly mileage of ≥ 20 km over the past 6 months and treadmill experience participated in this cross-sectional study. Two stepwise incremental tests until volitional exhaustion was performed in a fixed order within one week in an Outpatient Clinic research laboratory and outdoor athletic track. Running velocity (IATspeed), heart rate (IATHR) and lactate concentration at the individual anaerobic threshold (IATbLa) were primary endpoints. Additionally, distance covered (DIST), maximal heart rate (HRmax), maximal blood lactate concentration (bLamax) and rate of perceived exertion (RPE) at IATspeed were analyzed. IATspeed, DIST and HRmax were not statistically significantly different between conditions, whereas bLamax and RPE at IATspeed showed statistical significance (p < 0.05). Apart from RPE at IATspeed, IATspeed, DIST, HRmax and bLamax strongly correlate between conditions (r = 0.815-0.988). High reliability between conditions provides strong evidence to suggest that running on a treadmill are physiologically comparable to that of OG and that training recommendations and be made with assurance.

Effects of a Short Physical Exercise Intervention on Patients with Multiple Sclerosis (MS)

BACKGROUND

The aim of this prospective randomized controlled trial was to investigate if a short-term endurance or combined endurance/resistance exercise program was sufficient to improve aerobic capacity and maximum force in adult patients (18-65 years) with multiple sclerosis (MS).

METHODS

All patients performed a three-month exercise program consisting of two training sessions per week, lasting 40 min each, with moderate intensity. All patients had a maximum value of 6 (low to moderate disability) on the Expanded Disability Status Scale (EDSS). One group (combined workout group (CWG); 15 females, 4 males) completed a combined endurance/resistance workout (20 min on a bicycle ergometer, followed by 20 min of resistance training), while the other group (endurance workout group (EWG); 13 females, 5 males) completed a 40 min endurance training program. Aerobic capacity was assessed as peak oxygen uptake, ventilatory anaerobic threshold, and workload expressed as Watts. Maximum force of knee and shoulder extensors and flexors was measured using isokinetic testing. Quality of life was assessed with the SF-36 questionnaire, and fatigue was measured using the Modified Fatigue Impact Scale.

RESULTS

Both training groups increased in aerobic capacity and maximum force. EWG, as well as CWG, showed improvement in several subscales of the SF-36 questionnaire and decrease of their fatigue.

CONCLUSION

A short exercise intervention increased both aerobic capacity and maximum force independent of whether endurance or combined endurance/resistance workouts were performed.

Effects of adjunctive exercise on physiological and psychological parameters in depression: a randomized pilot trial

OBJECTIVE

Major depressive disorder (MDD) is associated with decreased physical activity and increased rates of the metabolic syndrome (MetS), a risk factor for the development of type 2 diabetes and cardiovascular disorders. Exercise training has been shown to improve cardiorespiratory fitness and metabolic syndrome factors. Therefore, our study aimed at examining whether patients receiving an exercise program as an adjunct to inpatient treatment will benefit in terms of physiological and psychological factors.

METHOD

Fourty-two inpatients with moderate to severe depression were included. Twenty-two patients were randomized to additional 3x weekly exercise training (EXERCISE) and compared to treatment as usual (TAU). Exercise capacity was assessed as peak oxygen uptake (VO2peak), ventilatory anaerobic threshold (VAT) and workload expressed as Watts (W). Metabolic syndrome was defined according to NCEP ATPIII panel criteria.

RESULTS

After 6 weeks of treatment, cardiorespiratory fitness (VO2peak, VAT, Watt), waist circumference and HDL cholesterol were significantly improved in EXERCISE participants. Treatment response expressed as ≥50% MADRS reduction was more frequent in the EXERCISE group.

CONCLUSIONS

Adjunctive exercise training in depressed inpatients improves physical fitness, MetS factors, and psychological outcome. Given the association of depression with cardiometablic disorders, exercise training is recommended as an adjunct to standard antidepressant treatment.

Comparison of physiological and perceptual responses between continuous and intermittent cycling

The present study tested the hypothesis that the exercise protocol (continuous vs. intermittent) would affect the physiological response and the perception of effort during aquatic cycling. Each protocol was divided on four stages. Heart rate, arterial blood pressure, blood lactate concentration, central and peripheral rate of perceived exertion were collected in both protocols in aquatic cycling in 10 women (values are mean ± SD): age=32.8 ± 4.8 years; height=1.62 ± 0.05 cm; body mass=61.60 ± 5.19 kg; estimated body fat=27.13 ± 4.92%. Protocols were compared through two way ANOVA with Scheffé’s post-hoc test and the test of Mann- Whitney for rate of perceived exertion with α=0.05. No systematic and consistent differences in heart rate, arterial blood pressure, double product and blood lactate concentration were found between protocols. On the other hand, central rate of perceived exertion was significantly higher at stage four during continuous protocol compared with intermittent protocol (p=0.01), while the peripheral rate of perceived exertion presented higher values at stages three (p=0.02) and four (p=0.00) in the continuous protocol when compared to the results found in intermittent protocol. These findings suggest that although the aquatic cycling induces similar physiologic demands in both protocols, the rate of perceived exertion may vary according to the continuous vs. intermittent nature of the exercise.

Unusual cause of exercise-induced ventricular fibrillation in a well-trained adult endurance athlete: a case report

Introduction

The diseases responsible for sudden deaths in athletes differ considerably with regard to age. In young athletes, congenital malformations of the heart and/or vascular system cause the majority of deaths and can only be detected noninvasively by complex diagnostics. In contrast, in older athletes who die suddenly, atherosclerotic disease of the coronary arteries is mostly found. Reports of congenital coronary anomalies as a cause of sudden death in older athletes are rare.

Case presentation

A 48-year-old man who was a well-trained, long-distance runner collapsed at the finish of a half marathon because of a myocardial infarction with ventricular fibrillation. Coronary angiography showed an anomalous origin of the right coronary artery from the left sinus of Valsalva with minimal wall alterations. Multislice computed tomography of the coronary arteries confirmed these findings. Cardiomagnetic resonance imaging demonstrated a mild hypokinesia of the basal right- and left-ventricular posterior wall. An electrophysiological study showed an inducible temporary polymorphic ventricular tachycardia and an inducible ventricular fibrillation. The athlete was subsequently treated by acetylsalicylic acid 100 mg (0-1-0), bisoprolol 2.5 mg (1-0-0) and atorvastatin 10 mg (0-0-1) and was instructed to keep his training intensity under the 'individual anaerobic threshold'. Intense and long-lasting exercise under extreme environmental conditions, particularly heat, should also be avoided.

Conclusion

This case report presents a coronary anomaly as the most likely reason for an exercise-induced myocardial infarction with ventricular fibrillation in a well-trained 48-year-old endurance athlete. Therefore, coronary anomalies have also to be considered as a possible cause of cardiac problems in older athletes.

Effect of multiple oral doses of androgenic anabolic steroids on endurance performance and serum indices of physical stress in healthy male subjects

Anabolic androgenic steroids (AAS) are doping agents that are mostly used for improvement of strength and muscle hypertrophy. In some sports, athletes reported that the intake of AAS is associated with a better recovery, a higher training load capacity and therefore an increase in physical and mental performances. The purpose of this study was to evaluate, the effect of multiple doses of AAS on different physiological parameters that could indirectly relate the physical state of athletes during a hard endurance training program. In a double blind settings, three groups (n = 9, 8 and 8) were orally administered placebo, testosterone undecanoate or 19-norandrostenedione, 12 times during 1 month. Serum biomarkers (creatine kinase, ASAT and urea), serum hormone profiles (testosterone, cortisol and LH) and urinary catecholamines (noradrenalin, adrenalin and dopamine) were evaluated during the treatment. Running performance was assessed before and after the intervention phase by means of a standardized treadmill test. None of the measured biochemical variables showed significant impact of AAS on physical stress level. Data from exercise testing on submaximal and maximal level did not reveal any performance differences between the three groups or their response to the treatment. In the present study, no effect of multiple oral doses of AAS on endurance performance or bioserum recovery markers was found.