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Simon A, Derella C, Looney J, Norland K, Wang X, Harris R. Daily Physical Activity Does Not Contribute to Differences in Muscle Oxidative Capacity Between Overweight and Obesity. Endocrinol Diabetes Metab 2024; 7:e513. [PMID: 39141578 PMCID: PMC11324093 DOI: 10.1002/edm2.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/09/2024] [Accepted: 07/14/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The interaction between physical activity, skeletal muscle health, and adiposity has been explored in normal weight and overweight/obesity grouped together; however, the overall risks associated with being overweight are less than those observed with obesity and can be confounded by disparities in both sex and race. Thus, the present study sought to investigate the intricate interplay of daily physical activity and skeletal muscle oxidative capacity (SMOC) in overweight and obesity, while exploring how sex and race impact this dynamic relationship. METHODS One hundred and forty participants were grouped by body mass index (BMI) as overweight (n = 73; BMI >25-<30 kg/m2) or obese (n = 67; BMI ≥30 kg/m2). SMOC was assessed using near-infrared spectroscopy and daily physical activity was assessed for 7 days using accelerometry. RESULTS Overweight individuals exhibited a higher (p = 0.004) SMOC and engaged in more (p = 0.007) vigorous physical activity compared to obese individuals. In addition, SMOC was lower (p = 0.005) in obese non-Hispanic Black (NHB) men compared to overweight NHB men. No relationships between physical activity and SMOC were observed. CONCLUSION Physical activity is not associated with differences in SMOC in overweight and obesity. Obese individuals engage in less vigorous physical activity and exhibit lower SMOC compared to overweight individuals and these differences are emphasised in NHB men.
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Affiliation(s)
- Abigayle B. Simon
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Cassandra C. Derella
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Jacob C. Looney
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Kimberly Norland
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Ryan A. Harris
- Georgia Prevention Institute, Medical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
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2
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Pelka EZ, Davis BR, McDaniel J. Sourcebook update: using near-infrared spectroscopy to assess skeletal muscle oxygen uptake. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:566-572. [PMID: 38779745 DOI: 10.1152/advan.00047.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/16/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
Monitoring the metabolic cost or oxygen consumption associated with rest and exercise is crucial to understanding the impact of disease or physical training on the health of individuals. Traditionally, measuring the skeletal muscle oxygen cost associated with exercise/muscle contractions can be rather expensive or invasive (i.e., muscle biopsies). More recently, specific protocols designed around the use of near-infrared spectroscopy (NIRS) have been shown to provide a quick, noninvasive easy-to-use tool to measure skeletal muscle oxygen consumption ([Formula: see text]). However, the data and results from NIRS devices are often misunderstood. Thus the primary purpose of this sourcebook update is to provide several experimental protocols students can utilize to improve their understanding of NIRS technology, learn how to analyze results from NIRS devices, and better understand how muscle contraction intensity and type (isometric, concentric, or eccentric) influence the oxygen cost of muscle contractions.NEW & NOTEWORTHY Compared to traditional methods, near-infrared spectroscopy (NIRS) provides a relatively cheap and easy-to-use noninvasive technique to measure skeletal muscle oxygen uptake following exercise. This laboratory not only enables students to learn about the basics of NIRS and muscle energetics but also addresses more complex questions regarding skeletal muscle physiology.
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Affiliation(s)
- Edward Z Pelka
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, Ohio, United States
| | - B Ryan Davis
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, Ohio, United States
| | - John McDaniel
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, Ohio, United States
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3
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Jeskanen T, Ylinen V, Valtonen RIP, Tulppo MP. Reproducibility and sex differences in muscle oxygenation during brachial artery occlusion in healthy participants. Clin Physiol Funct Imaging 2024; 44:388-395. [PMID: 38666417 DOI: 10.1111/cpf.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/26/2024] [Accepted: 04/15/2024] [Indexed: 08/07/2024]
Abstract
SIGNIFICANCE Near-infrared spectroscopy (NIRS) measurement is a widely used technique to measure muscle oxygenation. A knowledge of the reproducibility of NIRS measurements is essential for the correct interpretation of data. AIM Our aim was to test the reproducibility and sex differences of NIRS measurements during brachial artery occlusion in healthy participants. APPROACH An NIRS device was used to measure muscle oxygenation and microvascular function during a 5 min brachial occlusion. Muscle oxygen consumption (mVO2) and tissue saturation index (TSI%) were used. The occlusion test was performed three times on separate days for males (n = 13, 28 ± 8 years) and females (n = 13, 29 ± 7 years). RESULTS During the occlusion phase, the reproducibility of mVO2 was excellent (intraclass correlation; ICC = 0.90). During the reperfusion phase, the maximal change in TSI% revealed the best reproducibility (ICC = 0.77). There were no sex differences in reproducibility. Male participants had higher muscle oxygenation during occlusion (mVO2, 0.054 ± 0.010 vs. 0.038 ± 0.012 mLO2/min/100 g, p = 0.001, male and female, respectively). There were no sex differences during the reperfusion phase. CONCLUSION The reproducibility of NIRS to measure muscle oxygenation and microvascular function during circulation occlusion and reperfusion is good to excellent. Muscle oxygen capacity measured during occlusion is higher in males compared to females, and there are no sex differences in microvascular function during the reperfusion phase.
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Affiliation(s)
- Tommi Jeskanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Venla Ylinen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Rasmus I P Valtonen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mikko P Tulppo
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
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4
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Rasica L, Inglis EC, Mazzolari R, Iannetta D, Murias JM. Methodological considerations on near-infrared spectroscopy derived muscle oxidative capacity. Eur J Appl Physiol 2024; 124:2069-2079. [PMID: 38400931 PMCID: PMC11199286 DOI: 10.1007/s00421-024-05421-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Different strategies for near-infrared spectroscopy (NIRS)-derived muscle oxidative capacity assessment have been reported. This study compared and evaluated (I) approaches for averaging trials; (II) NIRS signals and blood volume correction equations; (III) the assessment of vastus lateralis (VL) and tibialis anterior (TA) muscles in two fitness levels groups. METHODS Thirty-six participants [18 chronically trained (CT: 14 males, 4 females) and 18 untrained (UT: 10 males, 8 females)] participated in this study. Two trials of twenty transient arterial occlusions were performed for NIRS-derived muscle oxidative capacity assessment. Muscle oxygen consumption ( V ˙ O2m) was estimated from deoxygenated hemoglobin (HHb), corrected for blood volume changes following Ryan (HHbR) and Beever (HHbB) equations, and from oxygen saturation (StO2) in VL and TA. RESULTS Superimposing or averaging V ˙ O2m or averaging the rate constants (k) from the two trials resulted in equivalent k values [two one-sided tests (TOST) procedure with 5% equivalence margin-P < 0.001]. Whereas HHbR (2.35 ± 0.61 min-1) and HHbB (2.34 ± 0.58 min-1) derived k were equivalent (P < 0.001), StO2 derived k (2.81 ± 0.92 min-1) was greater (P < 0.001) than both. k values were greater in CT vs UT in both muscles (VL: + 0.68 min-1, P = 0.002; TA: + 0.43 min-1, P = 0.01). CONCLUSION Different approaches for averaging trials lead to similar k. HHb and StO2 signals provided different k, although different blood volume corrections did not impact k. Group differences in k were detected in both muscles.
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Affiliation(s)
- Letizia Rasica
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | - Raffaele Mazzolari
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Danilo Iannetta
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Juan M Murias
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
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Derella CC, Thomas J, Harris RA. Women Have Greater Endothelin-B Receptor Function and Lower Mitochondrial Capacity Compared to Men With Type 1 Diabetes. J Clin Endocrinol Metab 2023; 108:2561-2568. [PMID: 37009678 PMCID: PMC10686691 DOI: 10.1210/clinem/dgad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/04/2023]
Abstract
CONTEXT Type 1 diabetes (T1D) negatively affects both the endothelin system and muscle oxidative capacity. The endothelin pathway is a critical regulator of microcirculatory function and may exhibit sexual dichotomy by which healthy premenopausal women have greater endothelin-B receptor (ETBR) function compared to men. Moreover, T1D may differentially alter muscle oxidative capacity in men and women; however, whether ETBR function is impaired in women compared to men with T1D and its relationship with muscle oxidative capacity has yet to be explored. OBJECTIVE The purpose of this investigation was to determine if ETBR-mediated dilation is impaired in women compared to men with T1D and if this is related to their skeletal muscle oxidative capacity. METHODS Men (n = 9; glycated hemoglobin A1c [HbA1c] = 7.8 ± 1.0%) and women (N = 10 women; HbA1c = 8.4 ± 1.3%) with uncomplicated T1D were recruited for this investigation. Near-infrared spectroscopy (NIRS) and intradermal microdialysis (750 nM BQ-123 + ET-1 [10-20-10-8 mol/L]) were used to evaluate skeletal muscle oxidative capacity and assess ETBR-mediated vasodilation, respectively. RESULTS Skeletal muscle oxidative capacity was significantly lower (P = .031) in women compared with men with T1D. However, ETBR-mediated dilation induced a significantly greater (P = .012) vasodilatory response in women compared to men with T1D, and the area under the curve was negatively associated with skeletal muscle oxidative capacity (r = -.620; P = .042). CONCLUSION Compared to men with uncomplicated T1D, muscle oxidative capacity was lower and ETBR-mediated vasodilation was higher in women with uncomplicated T1D. ETBR-induced vasodilatory capacity was inversely related to skeletal muscle oxidative capacity, suggesting there may be compensatory mechanisms occurring to preserve microvascular blood flow in women with T1D.
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Affiliation(s)
- Cassandra C Derella
- Department of Physiology, Augusta University, Augusta, GA 30912, USA
- Georgia Prevention Institute, Augusta University, Augusta, GA 30912, USA
| | - Jeffery Thomas
- Georgia Prevention Institute, Augusta University, Augusta, GA 30912, USA
| | - Ryan A Harris
- Department of Physiology, Augusta University, Augusta, GA 30912, USA
- Georgia Prevention Institute, Augusta University, Augusta, GA 30912, USA
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Manferdelli G, Raberin A, Millet GP. Muscle O 2 diffusion capacity by NIRS: A new approach in the air. J Physiol 2022; 600:5163-5164. [PMID: 36205221 DOI: 10.1113/jp283882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 01/05/2023] Open
Affiliation(s)
| | - Antoine Raberin
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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7
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Pilotto AM, Adami A, Mazzolari R, Brocca L, Crea E, Zuccarelli L, Pellegrino MA, Bottinelli R, Grassi B, Rossiter HB, Porcelli S. Near-infrared spectroscopy estimation of combined skeletal muscle oxidative capacity and O 2 diffusion capacity in humans. J Physiol 2022; 600:4153-4168. [PMID: 35930524 PMCID: PMC9481735 DOI: 10.1113/jp283267] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/27/2022] [Indexed: 01/05/2023] Open
Abstract
The final steps of the O2 cascade during exercise depend on the product of the microvascular-to-intramyocyteP O 2 ${P}_{{{\rm{O}}}_{\rm{2}}}$ difference and muscle O2 diffusing capacity (D m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ ). Non-invasive methods to determineD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ in humans are currently unavailable. Muscle oxygen uptake (mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ ) recovery rate constant (k), measured by near-infrared spectroscopy (NIRS) using intermittent arterial occlusions, is associated with muscle oxidative capacity in vivo. We reasoned that k would be limited byD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ when muscle oxygenation is low (kLOW ), and hypothesized that: (i) k in well oxygenated muscle (kHIGH ) is associated with maximal O2 flux in fibre bundles; and (ii) ∆k (kHIGH - kLOW ) is associated with capillary density (CD). Vastus lateralis k was measured in 12 participants using NIRS after moderate exercise. The timing and duration of arterial occlusions were manipulated to maintain tissue saturation index within a 10% range either below (LOW) or above (HIGH) half-maximal desaturation, assessed during sustained arterial occlusion. Maximal O2 flux in phosphorylating state was 37.7 ± 10.6 pmol s-1 mg-1 (∼5.8 ml min-1 100 g-1 ). CD ranged 348 to 586 mm-2 . kHIGH was greater than kLOW (3.15 ± 0.45 vs. 1.56 ± 0.79 min-1 , P < 0.001). Maximal O2 flux was correlated with kHIGH (r = 0.80, P = 0.002) but not kLOW (r = -0.10, P = 0.755). Δk ranged -0.26 to -2.55 min-1 , and correlated with CD (r = -0.68, P = 0.015). mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ k reflects muscle oxidative capacity only in well oxygenated muscle. ∆k, the difference in k between well and poorly oxygenated muscle, was associated with CD, a mediator ofD m O 2 $D{{\rm{m}}}_{{{\rm{O}}}_2}$ . Assessment of muscle k and ∆k using NIRS provides a non-invasive window on muscle oxidative and O2 diffusing capacity. KEY POINTS: We determined post-exercise recovery kinetics of quadriceps muscle oxygen uptake (mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ ) measured by near-infrared spectroscopy (NIRS) in humans under conditions of both non-limiting (HIGH) and limiting (LOW) O2 availability, for comparison with biopsy variables. The mV ̇ O 2 ${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$ recovery rate constant in HIGH O2 availability was hypothesized to reflect muscle oxidative capacity (kHIGH ) and the difference in k between HIGH and LOW O2 availability (∆k) was hypothesized to reflect muscle O2 diffusing capacity. kHIGH was correlated with phosphorylating oxidative capacity of permeabilized muscle fibre bundles (r = 0.80). ∆k was negatively correlated with capillary density (r = -0.68) of biopsy samples. NIRS provides non-invasive means of assessing both muscle oxidative and oxygen diffusing capacity in vivo.
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Affiliation(s)
- Andrea M. Pilotto
- Department of MedicineUniversity of UdineUdineItaly
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
| | - Alessandra Adami
- Department of KinesiologyUniversity of Rhode IslandKingstonRIUSA
| | - Raffaele Mazzolari
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
- Department of Physical Education and SportUniversity of the Basque Country (UPV/EHU)Vitoria‐GasteizSpain
| | - Lorenza Brocca
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
| | - Emanuela Crea
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
| | | | - Maria A. Pellegrino
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
- Interdipartimental Centre for Biology and Sport MedicineUniversity of PaviaPaviaItaly
| | - Roberto Bottinelli
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
- Interdipartimental Centre for Biology and Sport MedicineUniversity of PaviaPaviaItaly
| | - Bruno Grassi
- Department of MedicineUniversity of UdineUdineItaly
| | - Harry B. Rossiter
- Division of Respiratory and Critical Care Physiology and MedicineThe Lundquist Institute for Biomedical Innovation at Harbor–UCLA Medical CenterTorranceCAUSA
| | - Simone Porcelli
- Department of Molecular MedicineInstitute of PhysiologyUniversity of PaviaPaviaItaly
- Institute of Biomedical TechnologiesNational Research CouncilMilanItaly
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Lai RE, Holman ME, Chen Q, Rivers J, Lesnefsky EJ, Gorgey AS. Assessment of mitochondrial respiratory capacity using minimally invasive and noninvasive techniques in persons with spinal cord injury. PLoS One 2022; 17:e0265141. [PMID: 35275956 PMCID: PMC8916668 DOI: 10.1371/journal.pone.0265141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/16/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose Muscle biopsies are the gold standard to assess mitochondrial respiration; however, biopsies are not always a feasible approach in persons with spinal cord injury (SCI). Peripheral blood mononuclear cells (PBMCs) and near-infrared spectroscopy (NIRS) may alternatively be predictive of mitochondrial respiration. The purpose of the study was to evaluate whether mitochondrial respiration of PBMCs and NIRS are predictive of respiration of permeabilized muscle fibers after SCI. Methods Twenty-two individuals with chronic complete and incomplete motor SCI between 18–65 years old were recruited to participate in the current trial. Using high-resolution respirometry, mitochondrial respiratory capacity was measured for PBMCs and muscle fibers of the vastus lateralis oxidizing complex I, II, and IV substrates. NIRS was used to assess mitochondrial capacity of the vastus lateralis with serial cuff occlusions and electrical stimulation. Results Positive relationships were observed between PBMC and permeabilized muscle fibers for mitochondrial complex IV (r = 0.86, P < 0.0001). Bland-Altman displayed agreement for complex IV (MD = 0.18, LOA = -0.86 to 1.21), between PBMCs and permeabilized muscles fibers. No significant relationships were observed between NIRS mitochondrial capacity and respiration in permeabilized muscle fibers. Conclusions This is the first study to explore and support the agreement of less invasive clinical techniques for assessing mitochondrial respiratory capacity in individuals with SCI. The findings will assist in the application of PBMCs as a viable alternative for assessing mitochondrial health in persons with SCI in future clinical studies.
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Affiliation(s)
- Raymond E. Lai
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States of America
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Matthew E. Holman
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States of America
- Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Qun Chen
- Division of Cardiology, Division of Internal Medicine, Pauley Heart Center, Department of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jeannie Rivers
- Surgical Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, United States of America
| | - Edward J. Lesnefsky
- Division of Cardiology, Division of Internal Medicine, Pauley Heart Center, Department of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
- Medical Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, United States of America
| | - Ashraf S. Gorgey
- Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States of America
- Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia, United States of America
- * E-mail:
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Caterini JE, Ratjen F, Barker AR, Williams CA, Rendall K, Schneiderman JE, Wells GD. Exercise intolerance in cystic fibrosis-the role of CFTR modulator therapies. J Cyst Fibros 2021; 21:282-292. [PMID: 34955387 DOI: 10.1016/j.jcf.2021.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/18/2021] [Accepted: 11/20/2021] [Indexed: 12/11/2022]
Abstract
Exercise intolerance is common in people with CF (pwCF), but not universal among all individuals. While associated with disease prognosis, exercise intolerance is not simply a reflection of the degree of lung disease. In people with severe CF, respiratory limitations may contribute more significantly to impaired exercise capacity than in those with mild-moderate CF. At all levels of disease severity, there are peripheral factors e.g., abnormal macro- and micro-vascular function that impair blood flow and reduce oxygen extraction, and mitochondrial defects that diminish metabolic efficiency. We discuss advances in understanding the central and peripheral mechanisms underlying exercise intolerance in pwCF. Exploring both the central and peripheral factors that contribute to exercise intolerance in CF can help inform the development of new therapeutic targets, as well as help define prognostic criteria.
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Affiliation(s)
- Jessica E Caterini
- Translational Medicine Program, SickKids Research Institute, Toronto, ON M5G 0A4, Canada; Queen's Medical School, Kingston, ON K7L 3N6, Canada
| | - Felix Ratjen
- Translational Medicine Program, SickKids Research Institute, Toronto, ON M5G 0A4, Canada; Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada; Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Kate Rendall
- Translational Medicine Program, SickKids Research Institute, Toronto, ON M5G 0A4, Canada
| | - Jane E Schneiderman
- Division of Respiratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada; Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Greg D Wells
- Translational Medicine Program, SickKids Research Institute, Toronto, ON M5G 0A4, Canada.
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10
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Vendrusculo FM, Bueno GS, Gheller MF, Campos NE, Schiwe D, de Almeida IS, Becker NA, Heinzmann-Filho JP, Donadio MVF. Peripheral muscle strength is associated with aerobic fitness and use of antibiotics in patients with cystic fibrosis. Int J Clin Pract 2021; 75:e14050. [PMID: 33497024 DOI: 10.1111/ijcp.14050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/19/2021] [Indexed: 12/13/2022] Open
Abstract
AIMS Individuals with cystic fibrosis (CF) may develop muscle abnormalities, although little is known on its clinical and functional impact. This study aimed to evaluate the association of peripheral muscle strength with aerobic fitness, habitual physical activity, lung function and the use of antibiotics (ATB) in patients with CF. METHODS A cross-sectional study where individuals aged ≥6 years underwent peripheral muscle strength evaluation (biceps, quadriceps and hamstrings) and performed a cardiopulmonary exercise test. Demographic, anthropometric, genetic, lung function and total days of ATB use within 1 year of tests were also collected. RESULTS Correlation was found for biceps (r = .45; P = .002) strength with the peak oxygen consumption (VO2 peak). Muscle strength (biceps and quadriceps) also correlated with the ventilatory equivalent for oxygen consumption (VE /VO2 ) at anaerobic threshold (AT) and with the ventilatory equivalent for carbon dioxide production (VE /VCO2 ) both at AT and peak exercise. Negative correlations were found for quadriceps (r = -.39) and hamstrings (r = -.42) with the total days of ATB use in the following year. Patients needing to use ATB presented lower biceps strength (P = .05) and individuals with VO2 peak lower than 37 mL·kg-1 ·min-1 presented lower muscle strength for both biceps (P = .01) and quadriceps (P = .02). CONCLUSIONS The results have shown that peripheral muscle strength is associated with aerobic fitness and the use of antibiotics in patients with CF.
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Affiliation(s)
- Fernanda Maria Vendrusculo
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Sabino Bueno
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Mailise Fátima Gheller
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Natália Evangelista Campos
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniele Schiwe
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ingrid Silveira de Almeida
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Nicolas Acosta Becker
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - João Paulo Heinzmann-Filho
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
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11
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Rodriguez-Miguelez P, Seigler N, Ishii H, Crandall R, McKie KT, Forseen C, Harris RA. Exercise Intolerance in Cystic Fibrosis: Importance of Skeletal Muscle. Med Sci Sports Exerc 2021; 53:684-693. [PMID: 33105385 PMCID: PMC7969358 DOI: 10.1249/mss.0000000000002521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Exercise intolerance, evaluated by O2 consumption, predicts mortality in cystic fibrosis (CF). People with CF exhibit skeletal muscle dysfunctions that may contribute to an imbalance between O2 delivery and utilization. Sildenafil, a phosphodiesterase type 5 inhibitor, increases blood flow and improves O2 consumption, although the exact mechanisms in CF have yet to be elucidated. Thus, we hypothesized that exercise intolerance in CF is limited primarily by an impaired skeletal muscle O2 utilization, and sildenafil improves exercise tolerance in CF by addressing this mismatch between O2 demand and extraction. METHODS Fifteen individuals with mild to moderate CF and 18 healthy controls completed an incremental exercise test and measurements of gaseous exchange, chronotropic response, hemodynamics, and O2 extraction and utilization. People with CF also completed a 4-wk treatment with sildenafil with a subsequent follow-up evaluation after treatment. RESULTS Skeletal muscle O2 extraction and utilization during exercise were reduced in people with CF when compared with controls. Exercise capacity in our CF population was minimally limited by hemodynamic or chronotopic responses, whereas peripheral O2 extraction was more closely associated with exercise capacity. The study also demonstrated that 4 wk of sildenafil improved skeletal muscle O2 utilization during exercise to similar values observed in healthy individuals. CONCLUSIONS Individuals with mild to moderate CF exhibit exercise intolerance secondary to a reduction in O2 utilization by the exercising skeletal muscle. The present study demonstrated that 4 wk of sildenafil treatment improves the capacity of the skeletal muscle to use O2 more efficiently during exercise. Findings from the present study highlight the importance of targeting skeletal muscle O2 utilization to improve exercise tolerance in CF.
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Affiliation(s)
- Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
- Georgia Prevention Institute, Augusta University, Augusta GA
| | - Nichole Seigler
- Georgia Prevention Institute, Augusta University, Augusta GA
| | - Haruki Ishii
- Georgia Prevention Institute, Augusta University, Augusta GA
| | - Reva Crandall
- Georgia Prevention Institute, Augusta University, Augusta GA
| | | | - Caralee Forseen
- Pulmonary and Critical Care Medicine, Augusta University, Augusta GA
| | - Ryan A. Harris
- Georgia Prevention Institute, Augusta University, Augusta GA
- Sport and Exercise Science Research Institute, University of Ulster, Jordanstown, United Kingdom
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12
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Combret Y, Medrinal C, Prieur G, Robledo Quesada A, Gillot T, Gravier FE, Bonnevie T, Lamia B, Le Roux P, Reychler G. Oxygen uptake kinetics during treadmill walking in adolescents with clinically stable cystic fibrosis. Physiother Theory Pract 2021; 38:1389-1397. [PMID: 33390080 DOI: 10.1080/09593985.2020.1868029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Oxygen uptake (V̇O2) kinetics have been shown to be slowed in adolescents with cystic fibrosis (CF) during heavy-intensity cycling and maximal exercise testing.Objectives: This study investigated V̇O2 kinetics in adolescents with CF compared to control adolescents (CON) during a treadmill-walking exercise.Methods: Eight adolescents with CF and mild-to-moderate pulmonary obstruction (5 girls; 13.1 ± 2.5 years; FEV1 67.8 ± 21.4%) and 18 CON adolescents (10 girls; 13.8 ± 1.8 years) were recruited. Pulmonary gas exchange and ventilation were measured during a single transition of 10 min of treadmill walking and a 5 min seated recovery period. Participant's walking speed was determined during a one-minute self-paced walking task along a 50-m corridor. A six-parameter, non-linear regression model was used to describe the changes in V̇O2 function during the treadmill walking and recovery, with monoexponential curve fitting used to describe the mean response time (MRT1) at the onset of exercise, and the half-life (T1/2V̇O2) at the offset of exercise. V̇O2 baseline and amplitude, minute ventilation and respiratory equivalents were recorded.Results: V̇O2 kinetics were slower in CF group compared to CON group during the treadmill walking with a greater MRT1 (32 ± 14 s vs 21 ± 16 s; p = .04, effect size = 0.75). The T1/2V̇O2 was prolonged during recovery in CF group compared to CON group (86 ± 24 s vs 56 ± 22 s; p = .04, effect size = 1.31). The mean VE/V̇CO2 during exercise was the only parameter significantly greater in CF group compared to CON group (32.9 ± 2.3 vs 29.0 ± 2.4; p < .01, effect size = 1.66). Conclusion: V̇O2 kinetics were found to be slowed in adolescents with CF during treadmill walking.
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Affiliation(s)
- Yann Combret
- Physiotherapy Department, Le Havre Hospital, Montivilliers, France.,Institut De Recherche Et d'Expérimentation Clinique (IREC), Pôle De Pneumologie, ORL and Dermatologie, Université Catholique De Louvain, Brussels, Belgium
| | - Clément Medrinal
- Physiotherapy Department, Le Havre Hospital, Montivilliers, France.,Erphan, Paris-Saclay University, UVSQ, Versailles, France.,Saint Michel School of Physiotherapy, Paris, France
| | - Guillaume Prieur
- Physiotherapy Department, Le Havre Hospital, Montivilliers, France.,Institut De Recherche Et d'Expérimentation Clinique (IREC), Pôle De Pneumologie, ORL and Dermatologie, Université Catholique De Louvain, Brussels, Belgium.,UPRES EA3830 - GRHV, Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | | | - Timothée Gillot
- Cetaps, EA3832, Rouen University, Mont Saint Aignan, France.,School of Physiotherapy, Rouen University Hospital, Rouen, France
| | - Francis-Edouard Gravier
- UPRES EA3830 - GRHV, Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France.,ADIR Association, Rouen University Hospital, Bois-Guillaume, France
| | - Tristan Bonnevie
- UPRES EA3830 - GRHV, Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France.,ADIR Association, Rouen University Hospital, Bois-Guillaume, France
| | - Bouchra Lamia
- UPRES EA3830 - GRHV, Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France.,Pulmonology Department, Le Havre Hospital, Montivilliers, France.,Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France
| | - Pascal Le Roux
- Pediatric Department, Le Havre Hospital, Montivilliers, France
| | - Grégory Reychler
- Institut De Recherche Et d'Expérimentation Clinique (IREC), Pôle De Pneumologie, ORL and Dermatologie, Université Catholique De Louvain, Brussels, Belgium.,Department of Physical Medicine and Rehabilitation, Saint-Luc University Clinics, Brussels, Belgium
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13
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Wilson J, You X, Ellis M, Urquhart DS, Jha L, Duncan M, Tian S, Harris RA, Kotsimbos T, Keating D. VO 2max as an exercise tolerance endpoint in people with cystic fibrosis: Lessons from a lumacaftor/ivacaftor trial. J Cyst Fibros 2020; 20:499-505. [PMID: 33358691 DOI: 10.1016/j.jcf.2020.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND The impact of lumacaftor/ivacaftor on exercise tolerance in people with cystic fibrosis (CF) has not been thoroughly studied. METHODS We conducted a multisite Phase 4 trial comparing the impact of lumacaftor/ivacaftor on exercise tolerance with that of placebo in participants ≥ 12 years of age with CF homozygous for F508del-CFTR. The primary endpoint was relative change from baseline in maximum oxygen consumption (VO2max) during cardiopulmonary exercise testing (CPET) at Week 24. The key secondary endpoint was relative change from baseline in exercise duration during CPET at Week 24. Other secondary endpoints included changes in other indices of exercise tolerance and changes in CF assessments; safety and tolerability were assessed as an endpoint. RESULTS Seventy participants were randomized to receive lumacaftor/ivacaftor (n = 34) or placebo (n = 36). The least-squares mean difference for lumacaftor/ivacaftor versus placebo in relative change in VO2max from baseline at Week 24 was -3.2% (95% CI: -9.2, 2.9; P=0.3021); the least-squares mean difference in relative change from baseline in exercise duration at Week 24 was -3.2% (95% CI: -8.0, 1.6). Safety results were consistent with the known lumacaftor/ivacaftor safety profile. CONCLUSIONS Definitive conclusions regarding the impact of lumacaftor/ivacaftor on exercise tolerance cannot be drawn from these results; however, multicenter studies using CPETs can be reliably performed with multiple time points and conventional methods, provided that calibration can be achieved. Future studies of exercise tolerance may benefit from lessons learned from this study. NCT02875366.
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Affiliation(s)
- John Wilson
- Monash University, Melbourne, VIC, Australia; Alfred Hospital, Melbourne, VIC, Australia.
| | - Xiaojun You
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | - Matt Ellis
- Alfred Hospital, Melbourne, VIC, Australia.
| | - Don S Urquhart
- Royal Hospital for Children and Young People, Edinburgh, Scotland, UK.
| | - Lokesh Jha
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA
| | | | - Simon Tian
- Vertex Pharmaceuticals Incorporated, Boston, MA, USA.
| | - Ryan A Harris
- Georgia Prevention Institute, Augusta University, Augusta, GA, USA.
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14
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Saynor ZL, Gruet M, Rodriguez-Miguelez P, Harris RA. Oxygen transport and utilisation during exercise in cystic fibrosis: contributors to exercise intolerance. Exp Physiol 2020; 105:1979-1983. [PMID: 33119143 DOI: 10.1113/ep088106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/21/2020] [Indexed: 01/04/2023]
Abstract
NEW FINDINGS What is the topic of this review? This review highlights the central and peripheral mechanisms that alter oxygen transport and utilisation and thereby contribute to exercise limitation in people with cystic fibrosis, considering also viable therapeutic targets for intervention. What advances does it highlight? Although traditionally considered a respiratory condition, pathological intramuscular and cardiovascular changes in people with cystic fibrosis appear to be key determinants of exercise intolerance up until the later stages of respiratory disease. Even young, habitually active patients with normal lung function experience multisystemic abnormalities, which play a role in exercise intolerance. ABSTRACT Cystic fibrosis (CF) is a complex condition, commonly associated with exercise limitation. The mechanisms responsible for this in CF are of interest, given that lower aerobic fitness is associated with an increased risk of being hospitalised with pulmonary exacerbation, a poorer quality of life and a poorer prognosis. Pathophysiological changes in lung function are considered central to CF, and may contribute to exercise limitation. However, it is now clear that the pathogenesis of exercise limitation in this population is multifactorial, with alterations in cardiovascular, muscle and pulmonary function contributing. Whilst some of these changes are attributable to respiratory disease per se, the CF transmembrane conductance regulator protein is also found in skeletal muscle and the vascular endothelium and can directly alter central and localised oxygen delivery, as well as the ability to effectively extract and utilise oxygen at the myocyte level. Since intense exercise poses considerable challenges to arterial oxygen content and/or blood flow and its supply to the working skeletal muscle, evaluating the exercise physiology of people with CF has helped us understand the mechanisms underlying exercise intolerance. Through several investigations over recent years, we have collectively demonstrated that people with CF exhibit reduced skeletal muscle oxygen extraction and utilisation during exercise, with a lesser contribution from haemodynamic or chronotropic mechanisms. Taken together, our findings highlight the importance of targeting mechanisms of skeletal muscle oxygen utilisation in CF to improve exercise tolerance and we offer potential therapeutic interventional strategies.
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Affiliation(s)
- Zoe L Saynor
- School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Mathieu Gruet
- Laboratory of the Impact of Physical Activity on Health (IAPS), Toulon University, Toulon, France
| | - Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA, USA
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15
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Coelho CC, Aquino EDS, Diniz ALR, Santos MDS, Oliveira LCD, Poeiras PTC, Pereira DAG. Tissue oxygenation in peripheral muscles and functional capacity in cystic fibrosis: a cross-sectional study. Exp Physiol 2020; 105:1571-1578. [PMID: 32770583 DOI: 10.1113/ep088764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022]
Abstract
NEW FINDINGS What is the central question of this study? How do peripheral muscle tissue oxygenation and physical conditioning levels of children and adolescents with cystic fibrosis compare to demographically matched controls? What is the main finding and its importance? Children and adolescents with cystic fibrosis consumed more oxygen, more quickly and exhibited slower recovery, demonstrating that there may have been deficiencies in oxygen supply related to both oxygen uptake and oxygen transport. ABSTRACT Cystic fibrosis affects skeletal muscle performance and functional capacity. However, it is currently unclear how peripheral muscle behaviour is affected, especially in children and adolescents. To examine this, we compared tissue oxygenation of children and adolescents with cystic fibrosis against healthy volunteers. We also evaluated the functional capacity of participants via the modified shuttle test (MST) and assessed for associations between performance and near-infrared spectroscopy. A total of 124 participants enrolled. Participants were divided into either the cystic fibrosis group (CFG) or the healthy group (HG). Statistical comparisons between groups were evaluated with the Mann-Whitney U test and associations with functional capacity were evaluated using Spearman's correlation coefficient. CFG volunteers scored lower on the MST compared to the HG. They walked shorter distances (P = 0.001) with less efficiency because they performed the tests with a less efficient walking economy (P = 0.001) and a greater deoxyhaemoglobin concentration (P = 0.001). Further, they experienced reduced tissue oxygen saturation (P = 0.037) faster than the HG. As a result, they presented lower respiratory (P = 0.001) and lower heart (P = 0.001) rate values at the end of the MST, with a longer post-test heart rate recovery time (P = 0.005). There was a significant association between deoxygenation time and functional capacity. The CFG consumed more oxygen, more quickly, with a slower recovery, reflecting impairments in the dynamics of muscle oxygen extraction. The results suggest differences in functional capacity and haemodynamic recovery in children and adolescents with cystic fibrosis.
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Affiliation(s)
- Cristiane Cenachi Coelho
- Hospital Infantil João Paulo II - FHEMIG, Brazil.,Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Brazil
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16
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Zhang C, Hodges B, McCully KK. Reliability and reproducibility of a four arterial occlusions protocol for assessing muscle oxidative metabolism at rest and after exercise using near-infrared spectroscopy. Physiol Meas 2020; 41:065002. [PMID: 32392553 DOI: 10.1088/1361-6579/ab921c] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess the reliability and reproducibility of using a four arterial occlusions protocol and near-infrared spectroscopy (NIRS) to measure resting and post-exercise muscle oxidative metabolism (mVO2). APPROACH mVO2 was measured on the forearm muscles on two different days (day1 and day2) within one week in 11 healthy young adults (24.2 ± 2.7 years; 5 males). mVO2 was measured using NIRS during four repeated arterial occlusions at rest, and 5 min after exercise consisting of 90 s of rapid concentric contractions (5 minEPOC). MAIN RESULTS Resting mVO2 with four measurements was 17.88 ± 3.04% min-1 on day 1 and 19.42 ± 3.03% min-1 on day 2 (p = 0.171) with a coefficient of variation (CV) of 10.1%. When using only the first measurement, the CV increased to 18.5% (p = 0.039). 5minEPOC was 212.4 ± 142.5% and 177.1 ± 125.8% higher than resting and was not different between days one and two (53.83 ± 21.17% min-1 and 52.22 ± 22.10% min-1, respectively, p= 0.199). The CV and intraclass correlation (ICC) for 5minEPOC between days one and two were, 6.5% and 0.98, respectively. Using only the first value for 5minEPOC resulted in slightly higher CV but similar ICC (7.6% and 0.98, respectively; both p > 0.05). SIGNIFICANCE Our results suggest that within a single testing session, one arterial occlusion can provide reproducible measurements for both resting and post-exercise mVO2 similar to that of a four arterial occlusions protocol. While a four arterial occlusion protocol provides similar reliability for post-exercise mVO2 with one arterial occlusion, it reduces the day-to-day variance for resting mVO2 and therefore should be employed for longitudinal studies.
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Affiliation(s)
- Chuan Zhang
- Department of Kinesiology, University of Georgia, Athens, GA, United States of America
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17
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McCully KK, Liebowitz Z, Sumner MD, Beard S. Mitochondrial capacity using NIRS and incomplete recovery curves: Proximal and Medial Vastus Lateralis muscle. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2020; 11237. [PMID: 32742056 DOI: 10.1117/12.2546051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Near-Infrared Spectroscopy (NIRS) has been used to measure muscle mitochondrial capacity (mVO2max) as the recovery rate constant of muscle metabolism after exercise. The current method requires as many as 50 short ischemic occlusions to generate 2 recovery rate constants. PURPOSE To determine the effectiveness of using a 6-occlusion protocol (Mito6) versus one with 22 occlusions (Mito22) to measure muscle mitochondrial capacity. METHOD In two independent data sets (bicep n=7, forearm A n=23), recovery curves were analyzed independently using both the Mito6 and Mito22 analyses. A third data set (Forearm B, n=16) was generated on forearm muscles of healthy subjects using four Mito6 tests performed in succession. Recovery rate constants were generated using a MATLAB routine. RESULTS When calculated from the same data set, the recovery rate constants were not significantly different between the Mito22 and Mito6 analyses for the bicep (1.43+0.33min-1, 1.43+0.35min-1, p=0.81) and the forearm A (1.97+0.40min-1, 1.97+0.43min-1, p=0.90). The correlation between Mito22 and Mito6 recovery rate constants was y=1.07x-0.09, R2=0.90 for the bicep data and 1.00x+0.01, R2=0.85 for the forearm A data. When performing the four Mito6 tests in the Forearm B study; recovery rate constants were not different between tests (1.50±0.51 min-1, 1.42±0.54 min-1, 1.26±0.41 min-1, 1.29±0.47 min-1, P>0.05). CONCLUSIONS Muscle mitochondrial capacity was not different between the Mito6 analysis and the longer Mito22 analysis. The Mito6 protocol was considered more practical as it used fewer ischemic occlusion periods, and multiple tests could be performed in succession in less time. There were no order effects for the rate constants of four repeated Mito6 tests of mitochondrial capacity, supporting the use of multiple tests to improve accuracy.
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Affiliation(s)
- Kevin K McCully
- Non-Invasive Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, Georgia, USA 30602
| | - Zachary Liebowitz
- Non-Invasive Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, Georgia, USA 30602
| | - Maxwell D Sumner
- Non-Invasive Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, Georgia, USA 30602
| | - Samuel Beard
- Non-Invasive Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, Georgia, USA 30602
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18
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Sumner MD, Beard S, Pryor EK, Das I, McCully KK. Near Infrared Spectroscopy Measurements of Mitochondrial Capacity Using Partial Recovery Curves. Front Physiol 2020; 11:111. [PMID: 32116804 PMCID: PMC7033681 DOI: 10.3389/fphys.2020.00111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background Near-infrared spectroscopy (NIRS) has been used to measure muscle mitochondrial capacity (mVO2max) as the recovery rate constant of muscle metabolism after exercise. The current method requires as many as 50 short ischemic occlusions to generate two recovery rate constants. Purpose To determine the validity and repeatability of using a 6-occlusion protocol versus one with 22 occlusions to measure muscle mitochondrial capacity. The order effect of performing multiple Mito6 test was also evaluated. Method In two independent data sets (bicep n = 7, forearm A n = 23), recovery curves were analyzed independently using both the 6 and 22 occlusion methods. A third data set (forearm B n = 16) was generated on the forearm muscles of healthy subjects using four 6-occlusion tests performed in succession. Recovery rate constants were generated using a MATLAB routine. Results When calculated from the same data set, the recovery rate constants were not significantly different between the 22 occlusion and 6 occlusion methods for the bicep (1.43 ± 0.33 min–1, 1.43 ± 0.35 min–1, p = 0.81) and the forearm A (1.97 ± 0.40 min–1, 1.97 ± 0.43 min–1, p = 0.90). Equivalence testing showed that the mean difference was not different than zero and the 90% confidence intervals were within 5% of the average rate constant. This was true for the Mito6 and the Mito5∗ approaches. Bland–Altman analysis showed a slope of 0.21 min–1 and an r of 0.045 for the bicep dataset and a slope of −0.01 min–1 and an r of 0.045 for the forearm A dataset. When performing the four 6-occlusion tests; recovery rate constants showed no order effects (1.50 ± 0.51 min–1, 1.42 ± 0.54 min–1, 1.26 ± 0.41 min–1, 1.29 ± 0.47 min–1, P > 0.05). Conclusion The Mito6 analysis is a valid and repeatable approach to measure mitochondrial capacity. The Mito6 protocol used fewer ischemic occlusion periods and multiple tests could be performed in succession in less time, increasing the practicality of the NIRS mitochondrial capacity test. There were no order effects for the rate constants of four repeated 6-occlusion tests of mitochondrial capacity, supporting the use of multiple tests to improve accuracy.
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Affiliation(s)
- Maxwell D Sumner
- Non-Invasive Exercise Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Samuel Beard
- Non-Invasive Exercise Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Elizabeth K Pryor
- Non-Invasive Exercise Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Indrajit Das
- Non-Invasive Exercise Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Kevin K McCully
- Non-Invasive Exercise Muscle Physiology Lab, Department of Kinesiology, University of Georgia, Athens, GA, United States
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Chung S, Nelson MD, Hamaoka T, Jacobs RA, Pearson J, Subudhi AW, Jenkins NT, Bartlett MF, Fitzgerald LF, Miehm JD, Kent JA, Lucero AA, Rowlands DS, Stoner L, McCully KK, Call J, Rodriguez-Miguelez P, Harris RA, Porcelli S, Rasica L, Marzorati M, Quaresima V, Ryan TE, Vernillo G, Millet GP, Malatesta D, Millet GY, Zuo L, Chuang CC. Commentaries on Viewpoint: Principles, insights, and potential pitfalls of the noninvasive determination of muscle oxidative capacity by near-infrared spectroscopy. J Appl Physiol (1985) 2019; 124:249-255. [PMID: 29364790 DOI: 10.1152/japplphysiol.00857.2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lee Stoner
- Massey University,University of North Carolina at Chapel Hill
| | | | | | | | | | | | - Letizia Rasica
- National Research Council, Italy,University of Milan, Italy
| | | | | | | | | | | | | | | | - Li Zuo
- The Ohio State University College of Medicine
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20
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Lai N, Kummitha C, Drumm M, Hoppel C. Alterations of skeletal muscle bioenergetics in a mouse with F508del mutation leading to a cystic fibrosis-like condition. Am J Physiol Endocrinol Metab 2019; 317:E327-E336. [PMID: 31211618 PMCID: PMC6732463 DOI: 10.1152/ajpendo.00064.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High energy expenditure is reported in cystic fibrosis (CF) animal models and patients. Alterations in skeletal muscle oxidative capacity, fuel utilization, and the creatine kinase-phosphocreatine system suggest mitochondrial dysfunction. Studies were performed on congenic C57BL/6J and F508del (Cftrtm1kth) mice. Indirect calorimetry was used to measure gas exchange to evaluate aerobic capacity during treadmill exercise. The bioenergetic function of skeletal muscle subsarcolemmal (SSM) and interfibrillar mitochondria (IFM) was evaluated using an integrated approach combining measurement of the rate of oxidative phosphorylation by polarography and of electron transport chain activities by spectrophotometry. CF mice have reduced maximal aerobic capacity. In SSM of these mice, oxidative phosphorylation was impaired in the presence of complex I, II, III, and IV substrates except when glutamate was used as substrate. This impairment appeared to be caused by a defect in complex V activity, whereas the oxidative system of the electron transport chain was unchanged. In IFM, oxidative phosphorylation and electron transport chain activities were preserved, whereas complex V activity was reduced, in CF. Furthermore, creatine kinase activity was reduced in both SSM and IFM of CF skeletal muscle. The decreased complex V activity in SSM resulted in reduced oxidative phosphorylation, which could explain the reduced skeletal muscle response to exercise in CF mice. The decrease in mitochondrial creatine kinase activity also contributed to this poor exercise response.
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Affiliation(s)
- Nicola Lai
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia
- Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Chinna Kummitha
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia
- Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia
- Department of Biomedical Engineering, School of Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Mitchell Drumm
- Department of Genetics, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Charles Hoppel
- Department of Pharmacology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
- Center for Mitochondrial Disease, School of Medicine, Case Western Reserve University, Cleveland, Ohio
- Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio
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21
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Venturelli M, Villa F, Ruzzante F, Tarperi C, Rudi D, Milanese C, Cavedon V, Fonte C, Picelli A, Smania N, Calabria E, Skafidas S, Layec G, Schena F. Neuromuscular and Muscle Metabolic Functions in MELAS Before and After Resistance Training: A Case Study. Front Physiol 2019; 10:503. [PMID: 31105594 PMCID: PMC6498991 DOI: 10.3389/fphys.2019.00503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
Mitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes syndrome (MELAS) is a rare degenerative disease. Recent studies have shown that resistant training (RT) can ameliorate muscular force in mitochondrial diseases. However, the effects of RT in MELAS are unknown. The aim of this case report was to investigate the effects of RT on skeletal muscle and mitochondrial function in a 21-years old patient with MELAS. RT included 12 weeks of RT at 85% of 1 repetition maximum. Body composition (DXA), in vivo mitochondrial respiration capacity (mVO2) utilizing Near-infrared spectroscopy on the right plantar-flexor muscles, maximal voluntary torque (MVC), electrically evoked resting twitch (EET) and maximal voluntary activation (VMA) of the right leg extensors (LE) muscles were measured with the interpolated twitch technique. The participant with MELAS exhibited a marked increase in body mass (1.4 kg) and thigh muscle mass (0.3 kg). After the training period MVC (+5.5 Nm), EET (+2.1 N⋅m) and VMA (+13.1%) were ameliorated. Data of mVO2 revealed negligible changes in the end-exercise mVO2 (0.02 mM min-1), Δ mVO2 (0.09 mM min-1), while there was a marked amelioration in the kinetics of mVO2 (τ mVO2; Δ70.2 s). This is the first report of RT-induced ameliorations on skeletal muscle and mitochondrial function in MELAS. This case study suggests a preserved plasticity in the skeletal muscle of a patient with MELAS. RT appears to be an effective method to increase skeletal muscle function, and this effect is mediated by both neuromuscular and mitochondrial adaptations.
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Affiliation(s)
- Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Department of Internal Medicine, Division of Geriatrics, The University of Utah, Salt Lake City, UT, United States
| | - Federica Villa
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Ruzzante
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cantor Tarperi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Doriana Rudi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Valentina Cavedon
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cristina Fonte
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Calabria
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Spyros Skafidas
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gwenael Layec
- Department of Kinesiology, University of Massachusetts, Amherst MA, United States
- Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, United States
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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22
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Rovedder PME, Borba GC, Anderle M, Flores J, Ziegler B, Barreto SSM, Roth Dalcin PDT. Peripheral muscle strength is associated with lung function and functional capacity in patients with cystic fibrosis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1771. [PMID: 30776177 DOI: 10.1002/pri.1771] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/19/2018] [Accepted: 12/17/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Paula Maria Eidt Rovedder
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabrielle Costa Borba
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mariluce Anderle
- Serviço de Fisioterapia-Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | - Josani Flores
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bruna Ziegler
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Paulo de Tarso Roth Dalcin
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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23
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Rodriguez-Miguelez P, Erickson ML, McCully KK, Harris RA. CrossTalk proposal: Skeletal muscle oxidative capacity is altered in patients with cystic fibrosis. J Physiol 2018; 595:1423-1425. [PMID: 28247513 DOI: 10.1113/jp272486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | - Kevin K McCully
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA, USA.,Sport and Exercise Science Research Institute, University of Ulster, Jordanstown, Northern Ireland, UK
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24
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Characterising skeletal muscle haemoglobin saturation during exercise using near-infrared spectroscopy in chronic kidney disease. Clin Exp Nephrol 2018; 23:32-42. [PMID: 29961156 PMCID: PMC6344386 DOI: 10.1007/s10157-018-1612-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/20/2018] [Indexed: 12/13/2022]
Abstract
Background Chronic kidney disease (CKD) patients have reduced exercise capacity. Possible contributing factors may include impaired muscle O2 utilisation through reduced mitochondria number and/or function slowing the restoration of muscle ATP concentrations via oxidative phosphorylation. Using near-infrared spectroscopy (NIRS), we explored changes in skeletal muscle haemoglobin/myoglobin O2 saturation (SMO2%) during exercise. Methods 24 CKD patients [58.3 (± 16.5) years, eGFR 56.4 (± 22.3) ml/min/1.73 m2] completed the incremental shuttle walk test (ISWT) as a marker of exercise capacity. Using NIRS, SMO2% was measured continuously before, during, and after (recovery) exercise. Exploratory differences were investigated between exercise capacity tertiles in CKD, and compared with six healthy controls. Results We identified two discrete phases; a decline in SMO2% during incremental exercise, followed by rapid increase upon cessation (recovery). Compared to patients with low exercise capacity [distance walked during ISWT, 269.0 (± 35.9) m], patients with a higher exercise capacity [727.1 (± 38.1) m] took 45% longer to reach their minimum SMO2% (P = .038) and recovered (half-time recovery) 79% faster (P = .046). Compared to controls, CKD patients took significantly 56% longer to recover (i.e., restore SMO2% to baseline, full recovery) (P = .014). Conclusions Using NIRS, we have determined for the first time in CKD, that favourable SMO2% kinetics (slower deoxygenation rate, quicker recovery) are associated with greater exercise capacity. These dysfunctional kinetics may indicate reduced mitochondria capacity to perform oxidative phosphorylation—a process essential for carrying out even simple activities of daily living. Accordingly, NIRS may provide a simple, low cost, and non-invasive means to evaluate muscle O2 kinetics in CKD.
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25
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Kenis-Coskun O, Karadag-Saygi E, Bahar-Ozdemir Y, Gokdemir Y, Karadag B, Kayhan O. The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis. Ital J Pediatr 2017; 43:106. [PMID: 29162121 PMCID: PMC5696729 DOI: 10.1186/s13052-017-0426-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/15/2017] [Indexed: 01/23/2023] Open
Abstract
Background Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF. Methods Patients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability. Results Fifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p = 0.006 and p = 0.01) and spine appearance and movement (p = 0.001 and p = 0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45 ± 7.79 while it was 20.47 ± 6.95 in the CF group (p = 0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters. Conclusion In patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.
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Affiliation(s)
- Ozge Kenis-Coskun
- Semsi Denizer Cad Dr Lutfi Kirdar Kartal Research and Training Hospital, Physical Medicine and Rehabilitation Department Istanbul, 34890, Istanbul, Turkey.
| | - Evrim Karadag-Saygi
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department Istanbul, Istanbul, Turkey
| | - Yeliz Bahar-Ozdemir
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department Istanbul, Istanbul, Turkey
| | - Yasemin Gokdemir
- Marmara University Medical Faculty Pediatric Pulmonology Department Istanbul, Istanbul, Turkey
| | - Bulent Karadag
- Marmara University Medical Faculty Pediatric Pulmonology Department Istanbul, Istanbul, Turkey
| | - Onder Kayhan
- Marmara University Medical Faculty Physical Medicine and Rehabilitation Department Istanbul, Istanbul, Turkey
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26
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Blood flow regulation and oxidative stress during submaximal cycling exercise in patients with cystic fibrosis. J Cyst Fibros 2017; 17:256-263. [PMID: 28923457 DOI: 10.1016/j.jcf.2017.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/28/2017] [Accepted: 08/29/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The impact of blood flow regulation and oxidative stress during exercise in cystic fibrosis (CF) has yet to be investigated. METHODS A maximal graded exercise test was conducted to determine exercise capacity (VO2 peak) and peak workload in 14 pediatric patients with mild CF (age 14±3y, FEV1 93±16 % predicted) and 14 demographically-matched controls. On a separate visit, participants performed submaximal cycling up to 60% of peak workload where brachial artery blood velocity was determined using Doppler ultrasound. Retrograde and antegrade components were further analyzed as indices of blood flow regulation. RESULTS The cumulative AUC for retrograde velocity was lower in patients versus controls (1770±554 vs. 3440±522cm, P=0.038). In addition, an exaggerated oxidative stress response during exercise occurred in patients only (P=0.004). CONCLUSION These data suggest that patients with mild CF exhibit impaired blood flow regulation and an exaggerated oxidative stress response to submaximal exercise.
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27
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Willingham TB, McCully KK. In Vivo Assessment of Mitochondrial Dysfunction in Clinical Populations Using Near-Infrared Spectroscopy. Front Physiol 2017; 8:689. [PMID: 28959210 PMCID: PMC5603672 DOI: 10.3389/fphys.2017.00689] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/28/2017] [Indexed: 12/13/2022] Open
Abstract
The ability to sustain submaximal exercise is largely dependent on the oxidative capacity of mitochondria within skeletal muscle, and impairments in oxidative metabolism have been implicated in many neurologic and cardiovascular pathologies. Here we review studies which have demonstrated the utility of Near-infrared spectroscopy (NIRS) as a method of evaluating of skeletal muscle mitochondrial dysfunction in clinical human populations. NIRS has been previously used to noninvasively measure tissue oxygen saturation, but recent studies have demonstrated the utility of NIRS as a method of evaluating skeletal muscle oxidative capacity using post-exercise recovery kinetics of oxygen metabolism. In comparison to historical methods of measuring muscle metabolic dysfunction in vivo, NIRS provides a more versatile and economical method of evaluating mitochondrial oxidative capacity in humans. These advantages generate great potential for the clinical applicability of NIRS as a means of evaluating muscle dysfunction in clinical populations.
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Affiliation(s)
| | - Kevin K McCully
- Department of Kinesiology, University of GeorgiaAthens, GA, United States
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28
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Peripheral muscle abnormalities in cystic fibrosis: Etiology, clinical implications and response to therapeutic interventions. J Cyst Fibros 2017; 16:538-552. [DOI: 10.1016/j.jcf.2017.02.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 02/10/2017] [Accepted: 02/12/2017] [Indexed: 12/14/2022]
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29
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Adami A, Rossiter HB. Principles, insights, and potential pitfalls of the noninvasive determination of muscle oxidative capacity by near-infrared spectroscopy. J Appl Physiol (1985) 2017; 124:245-248. [PMID: 28684592 DOI: 10.1152/japplphysiol.00445.2017] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alessandra Adami
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center , Torrance, California
| | - Harry B Rossiter
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center , Torrance, California
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30
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Bossie HM, Willingham TB, Schoick RAV, O'Connor PJ, McCully KK. Mitochondrial capacity, muscle endurance, and low energy in friedreich ataxia. Muscle Nerve 2017; 56:773-779. [PMID: 28000230 DOI: 10.1002/mus.25524] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In this study we noninvasively evaluated skeletal muscle mitochondrial capacity, muscle-specific endurance, and energy/fatigue feelings in persons with Friedreich ataxia (FRDA) and able-bodied controls (AB). METHODS Forearm mitochondrial capacity was measured in FRDA (n = 16) and AB (n = 10) study participants using the rate of recovery of oxygen consumption after electrical stimulation with near-infrared spectroscopy. Mechanomyography (MMG) assessed muscle endurance after electrical stimulation for 3 minutes at 2 Hz, 4 Hz, and 6 Hz. Validated scales assessed disease severity and energy/fatigue feelings. RESULTS Groups did not differ in mitochondrial capacity (FRDA and AB: 1.8 ± 0.3 L/min). The difference in muscle endurance at 6 Hz was lower by 19.2% in the FRDA group (group effect: P < 0.001). Feelings of physical energy were 34% lower in FRDA group. In FDRA muscle, endurance was positively related to mitochondrial capacity (r = 0.59, P = 0.03), and disease severity was negatively related to mitochondrial capacity (r = -0.55, P = 0.04) and muscle endurance (r = -0.60, P = 0.01). CONCLUSION Non-invasive measures of skeletal muscle mitochondrial capacity and muscle-specific endurance are useful in monitoring FRDA. Muscle Nerve 56: 773-779, 2017.
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Affiliation(s)
- Hannah M Bossie
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, Georgia, 30605, USA
| | - T Bradley Willingham
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, Georgia, 30605, USA
| | - Robbi A Van Schoick
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, Georgia, 30605, USA
| | - Patrick J O'Connor
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, Georgia, 30605, USA
| | - Kevin K McCully
- Department of Kinesiology, University of Georgia, 330 River Road, Athens, Georgia, 30605, USA
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31
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Hulzebos HJE, Jeneson JAL, van der Ent CK, Werkman MS, Takken T. Rebuttal from Erik H. J. Hulzebos, Jeroen A. L. Jeneson, Cornelis K. van der Ent, Maarten S. Werkman and Tim Takken. J Physiol 2017; 595:1431-1432. [DOI: 10.1113/jp273739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | | | | | - Tim Takken
- University Medical Center Utrecht; Utrecht The Netherlands
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32
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Rodriguez-Miguelez P, Erickson ML, McCully KK, Harris RA. Rebuttal from Paula Rodriguez-Miguelez, Melissa L. Erickson, Kevin K. McCully and Ryan A. Harris. J Physiol 2017; 595:1429. [PMID: 28247515 DOI: 10.1113/jp273738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | - Kevin K McCully
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Ryan A Harris
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA, USA.,Sport and Exercise Science Research Institute, University of Ulster, Jordanstown, Northern Ireland, UK
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33
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Absence of calf muscle metabolism alterations in active cystic fibrosis adults with mild to moderate lung disease. J Cyst Fibros 2017; 16:98-106. [DOI: 10.1016/j.jcf.2016.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 11/19/2022]
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34
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Van Iterson EH, Wheatley CM, Baker SE, Olson TP, Morgan WJ, Snyder EM. The Coupling of Peripheral Blood Pressure and Ventilatory Responses during Exercise in Young Adults with Cystic Fibrosis. PLoS One 2016; 11:e0168490. [PMID: 27997623 PMCID: PMC5172623 DOI: 10.1371/journal.pone.0168490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 11/30/2016] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Cystic fibrosis (CF) is commonly recognized as a pulmonary disease associated with reduced airway function. Another primary symptom of CF is low exercise capacity where ventilation and gas-exchange are exacerbated. However, an independent link between pathophysiology of the pulmonary system and abnormal ventilatory and gas-exchange responses during cardiopulmonary exercise testing (CPET) has not been established in CF. Complicating this understanding, accumulating evidence suggests CF demonstrate abnormal peripheral vascular function; although, the clinical implications are unclear. We hypothesized that compared to controls, relative to total work performed (WorkTOT), CF would demonstrate increased ventilation accompanied by augmented systolic blood pressure (SBP) during CPET. METHODS 16 CF and 23 controls (age: 23±4 vs. 27±4 years, P = 0.11; FEV1%predicted: 73±14 vs. 96±5, P<0.01) participated in CPET. Breath-by-breath oxygen uptake ([Formula: see text]), ventilation ([Formula: see text]), and carbon dioxide output ([Formula: see text]) were measured continuously during incremental 3-min stage step-wise cycle ergometry CPET. SBP was measured via manual sphygmomanometry. Linear regression was used to calculate [Formula: see text] slope from rest to peak-exercise. RESULTS Compared to controls, CF performed less WorkTOT during CPET (90±19 vs. 43±14 kJ, respectively, P<0.01). With WorkTOT as a covariate, peak [Formula: see text] (62±8 vs. 90±4 L/min, P = 0.76), [Formula: see text] (1.8±0.3 vs. 2.7±0.1 L/min, P = 0.40), and SBP (144±13 vs. 152±6 mmHg, P = 0.88) were similar between CF and controls, respectively; whereas CF demonstrated increased [Formula: see text] slope (38±4 vs. 28±2, P = 0.02) but lower peak [Formula: see text] versus controls (22±5 vs. 33±4 mL/kg/min, P<0.01). There were modest-to-moderate correlations between peak SBP with [Formula: see text] (r = 0.30), [Formula: see text] (r = 0.70), and [Formula: see text] (r = 0.62) in CF. CONCLUSIONS These data suggest that relative to WorkTOT, young adults with mild-to-moderate severity CF demonstrate augmented [Formula: see text] slope accompanied by increased SBP during CPET. Although the underlying mechanisms remain unclear, the coupling of ventilatory inefficiency with increased blood pressure suggest important contributions from peripheral pathophysiology to low exercise capacity in CF.
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Affiliation(s)
- Erik H. Van Iterson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
| | - Courtney M. Wheatley
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
| | - Sarah E. Baker
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States of America
| | - Thomas P. Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
| | - Wayne J. Morgan
- Department of Pediatrics, University of Arizona, 1501 N. Campbell Avenue, Room 3301, Tucson, AZ, United States of America
| | - Eric M. Snyder
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
- Department of Kinesiology, University of Minnesota, Cooke Hall, 1900 University Ave SE. Minneapolis, MN, United States of America
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SAYNOR ZOELOUISE, BARKER ALANROBERT, OADES PATRICKJOHN, WILLIAMS CRAIGANTHONY. Impaired Pulmonary V˙O2 Kinetics in Cystic Fibrosis Depend on Exercise Intensity. Med Sci Sports Exerc 2016; 48:2090-2099. [DOI: 10.1249/mss.0000000000001004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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36
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Werkman M, Jeneson J, Helders P, Arets B, van der Ent K, Velthuis B, Nievelstein R, Takken T, Hulzebos E. Exercise oxidative skeletal muscle metabolism in adolescents with cystic fibrosis. Exp Physiol 2016; 101:421-31. [PMID: 26707538 PMCID: PMC4925307 DOI: 10.1113/ep085425] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/23/2015] [Indexed: 12/21/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do intrinsic abnormalities in oxygenation and/or muscle oxidative metabolism contribute to exercise intolerance in adolescents with mild cystic fibrosis? What is the main finding and its importance? This study found no evidence that in adolescents with mild cystic fibrosis in a stable clinical state intrinsic abnormalities in skeletal muscle oxidative metabolism seem to play a clinical significant role. Based on these results, we concluded that there is no metabolic constraint to benefit from exercise training. Patients with cystic fibrosis (CF) are reported to have limited exercise capacity. There is no consensus about a possible abnormality in skeletal muscle oxidative metabolism in CF. Our aim was to test the hypothesis that abnormalities in oxygenation and/or muscle oxidative metabolism contribute to exercise intolerance in adolescents with mild CF. Ten adolescents with CF (12-18 years of age; forced expiratory volume in 1 s >80% of predicted; and resting oxygen saturation >94%) and 10 healthy age-matched control (HC) subjects were tested with supine cycle ergometry using near-infrared spectroscopy and (31)P magnetic resonance spectroscopy to study skeletal muscle oxygenation and oxidative metabolism during rest, exercise and recovery. No statistically significant (P > 0.1) differences in peak workload and peak oxygen uptake per kilogram lean body mass were found between CF and HC subjects. No differences were found between CF and HC subjects in bulk changes of quadriceps phosphocreatine (P = 0.550) and inorganic phosphate (P = 0.896) content and pH (P = 0.512) during symptom-limited exercise. Furthermore, we found statistically identical kinetics for phosphocreatine resynthesis during recovery for CF and HC subjects (P = 0.53). No statistically significant difference in peak exercise arbitrary units for total haemoglobin content was found between CF and HC subjects (P = 0.66). The results of this study provide evidence that in patients with mild CF and a stable clinical status (without signs of systemic inflammation and/or chronic Pseudomonas aeruginosa colonization), no intrinsic metabolic constraints and/or abnormalities in oxygenation and/or muscle oxidative metabolism contribute to exercise intolerance.
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Affiliation(s)
- Maarten Werkman
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Jeneson
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul Helders
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bert Arets
- Cystic Fibrosis Center and Department of Pediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kors van der Ent
- Cystic Fibrosis Center and Department of Pediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Birgitta Velthuis
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Rutger Nievelstein
- Department of Radiology, University Medical Center Utrecht, The Netherlands
| | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Laboratory, Utrecht, The Netherlands
| | - Erik Hulzebos
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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