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Orcioli-Silva D, Beretta VS, Santos PCR, Rasteiro FM, Marostegan AB, Vitório R, Gobatto CA, Manchado-Gobatto FB. Cerebral and muscle tissue oxygenation during exercise in healthy adults: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:459-471. [PMID: 38462172 PMCID: PMC11184313 DOI: 10.1016/j.jshs.2024.03.003] [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: 10/16/2023] [Revised: 12/21/2023] [Accepted: 02/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Near-infrared spectroscopy (NIRS) technology has allowed for the measurement of cerebral and skeletal muscle oxygenation simultaneously during exercise. Since this technology has been growing and is now successfully used in laboratory and sports settings, this systematic review aimed to synthesize the evidence and enhance an integrative understanding of blood flow adjustments and oxygen (O2) changes (i.e., the balance between O2 delivery and O2 consumption) within the cerebral and muscle systems during exercise. METHODS A systematic review was conducted using PubMed, Embase, Scopus, and Web of Science databases to search for relevant studies that simultaneously investigated cerebral and muscle hemodynamic changes using the near-infrared spectroscopy system during exercise. This review considered manuscripts written in English and available before February 9, 2023. Each step of screening involved evaluation by 2 independent authors, with disagreements resolved by a third author. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodological quality of the studies. RESULTS Twenty studies were included, of which 80% had good methodological quality, and involved 290 young or middle-aged adults. Different types of exercises were used to assess cerebral and muscle hemodynamic changes, such as cycling (n = 11), treadmill (n = 1), knee extension (n = 5), isometric contraction of biceps brachii (n = 3), and duet swim routines (n = 1). The cerebral hemodynamics analysis was focused on the frontal cortex (n = 20), while in the muscle, the analysis involved vastus lateralis (n = 18), gastrocnemius (n = 3), biceps brachii (n = 5), deltoid (n = 1), and intercostal muscle (n = 1). Overall, muscle deoxygenation increases during exercise, reaching a plateau in voluntary exhaustion, while in the brain, oxyhemoglobin concentration increases with exercise intensity, reaching a plateau or declining at the exhaustion point. CONCLUSION Muscle and cerebral oxygenation respond differently to exercise, with muscle increasing O2 utilization and cerebral tissue increasing O2 delivery during exercise. However, at the exhaustion point, both muscle and cerebral oxygenation become compromised. This is characterized by a reduction in blood flow and a decrease in O2 extraction in the muscle, while in the brain, oxygenation reaches a plateau or decline, potentially resulting in motor failure during exercise.
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Affiliation(s)
- Diego Orcioli-Silva
- Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences (FCA), University of Campinas (UNICAMP), Limeira 13484-350, Brazil; Posture and Gait Studies Laboratory (LEPLO), Institute of Biosciences, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil.
| | - Victor Spiandor Beretta
- Physical Education Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Paulo Cezar Rocha Santos
- Department of Computer Science & Applied Mathematics, Weizmann Institute of Science, Rehovot 7610001, Israel; Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan 5265601, Israel
| | - Felipe Marroni Rasteiro
- Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences (FCA), University of Campinas (UNICAMP), Limeira 13484-350, Brazil
| | - Anita Brum Marostegan
- Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences (FCA), University of Campinas (UNICAMP), Limeira 13484-350, Brazil
| | - Rodrigo Vitório
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Claudio Alexandre Gobatto
- Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences (FCA), University of Campinas (UNICAMP), Limeira 13484-350, Brazil
| | - Fúlvia Barros Manchado-Gobatto
- Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences (FCA), University of Campinas (UNICAMP), Limeira 13484-350, Brazil
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Mateikaitė-Pipirienė K, Jean D, Paal P, Horakova L, Kriemler S, Rosier AJ, Andjelkovic M, Beidleman BA, Derstine M, Hefti JP, Hillebrandt D, Keyes LE. Menopause and High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2024; 25:1-8. [PMID: 37922458 DOI: 10.1089/ham.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Mateikaitė-Pipirienė, Kastė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J. Rosier, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, and Linda E. Keyes for the UIAA MedCom writing group on Women's Health in the Mountains. Menopause and high altitude: A scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 25:1-8, 2024. Background: Older people are an important fraction of mountain travelers and climbers, many of them postmenopausal women. The aim of this work was to review health issues that older and postmenopausal women may experience at high altitude, including susceptibility to high-altitude illness. Methods: We performed a scoping review for the UIAA Medical Commission series on Women's Health in the mountains. We searched PubMed and Cochrane libraries and performed an additional manual search. The primary search focused on articles assessing lowland women sojourning at high altitude. Results: We screened 7,165 potential articles. The search revealed three relevant articles, and the manual search another seven articles and one abstract. Seven assessed menopausal low-altitude residents during a high-altitude sojourn or performing hypoxic tests. Four assessed high-altitude residents. We summarize the results of these 11 studies. Conclusions: Data are limited on the effects of high altitude on postmenopausal women. The effects of short-term, high-altitude exposure on menopause symptoms are unknown. Menopause has minimal effect on the physiological responses to hypoxia in physically fit women and does not increase the risk of acute mountain sickness. Postmenopausal women have an increased risk of urinary tract infections, which may be exacerbated during mountain travel. More research is needed on the physiology and performance of older women at high altitude.
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Affiliation(s)
- Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Clinics, Elektrėnai Division, Lithuania
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelesus Medical University, Salzburg, Austria
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alison J Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- US Army Research Institute of Environmental Medicine, Military Performance Division, Natick MA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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Raberin A, Burtscher J, Burtscher M, Millet GP. Hypoxia and the Aging Cardiovascular System. Aging Dis 2023; 14:2051-2070. [PMID: 37199587 PMCID: PMC10676797 DOI: 10.14336/ad.2023.0424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023] Open
Abstract
Older individuals represent a growing population, in industrialized countries, particularly those with cardiovascular diseases, which remain the leading cause of death in western societies. Aging constitutes one of the largest risks for cardiovascular diseases. On the other hand, oxygen consumption is the foundation of cardiorespiratory fitness, which in turn is linearly related to mortality, quality of life and numerous morbidities. Therefore, hypoxia is a stressor that induces beneficial or harmful adaptations, depending on the dose. While severe hypoxia can exert detrimental effects, such as high-altitude illnesses, moderate and controlled oxygen exposure can potentially be used therapeutically. It can improve numerous pathological conditions, including vascular abnormalities, and potentially slows down the progression of various age-related disorders. Hypoxia can exert beneficial effects on inflammation, oxidative stress, mitochondrial functions, and cell survival, which are all increased with age and have been discussed as main promotors of aging. This narrative review discusses specificities of the aging cardiovascular system in hypoxia. It draws upon an extensive literature search on the effects of hypoxia/altitude interventions (acute, prolonged, or intermittent exposure) on the cardiovascular system in older individuals (over 50 years old). Special attention is directed toward the use of hypoxia exposure to improve cardiovascular health in older individuals.
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Affiliation(s)
- Antoine Raberin
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | - Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, A-6020, Austria.
| | - Grégoire P. Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
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Albertus-Cámara I, Rochel-Vera C, Lomas-Albaladejo JL, Ferrer-López V, Martínez-González-Moro I. Ventilatory Pattern Influences Tolerance to Normobaric Hypoxia in Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4935. [PMID: 36981844 PMCID: PMC10049086 DOI: 10.3390/ijerph20064935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Tolerance to breathing in conditions with a decreased oxygen ratio is subject-specific. A normobaric hypoxia tolerance test (NHTT) is performed to assess the ability of each individual, as this may be influenced by genetic or personal factors such as age or gender. The aim of this study is to test the influence of deep breathing on hypoxia tolerance time. MATERIAL AND METHODS A total of 45 subjects (21 parachutists and 24 students) performed two NHTTs at 5050 m altitude (iAltitude). Arterial (SatO2) and muscle (SmO2) oxygen saturation were monitored with the Humon Hex® device. The first NHTT was performed with free breathing, without any instructions; and the second NHTT was performed with wide, slow, diaphragmatic breathing. The NHTT was terminated at the end of 10 min or when a value of less than 83% was obtained. RESULTS The first NHTT was completed by 38.1% of parachutist and 33.3% of students while the second NHTT was completed by 85.7% and 75%, respectively. In the second NHTT, both parachutists and students had a significantly (p = 0.001) longer duration compared to the first NHTT. SmO2 and SatO2 values also increased significantly (p < 0.001) in both groups (p < 0.05). CONCLUSION Performing controlled diaphragmatic breathing is successful in increasing hypoxia tolerance time and/or SatO2 values.
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Burtscher J, Mallet RT, Burtscher M, Millet GP. Hypoxia and brain aging: Neurodegeneration or neuroprotection? Ageing Res Rev 2021; 68:101343. [PMID: 33862277 DOI: 10.1016/j.arr.2021.101343] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/12/2022]
Abstract
The absolute reliance of the mammalian brain on oxygen to generate ATP renders it acutely vulnerable to hypoxia, whether at high altitude or in clinical settings of anemia or pulmonary disease. Hypoxia is pivotal to the pathogeneses of myriad neurological disorders, including Alzheimer's, Parkinson's and other age-related neurodegenerative diseases. Conversely, reduced environmental oxygen, e.g. sojourns or residing at high altitudes, may impart favorable effects on aging and mortality. Moreover, controlled hypoxia exposure may represent a treatment strategy for age-related neurological disorders. This review discusses evidence of hypoxia's beneficial vs. detrimental impacts on the aging brain and the molecular mechanisms that mediate these divergent effects. It draws upon an extensive literature search on the effects of hypoxia/altitude on brain aging, and detailed analysis of all identified studies directly comparing brain responses to hypoxia in young vs. aged humans or rodents. Special attention is directed toward the risks vs. benefits of hypoxia exposure to the elderly, and potential therapeutic applications of hypoxia for neurodegenerative diseases. Finally, important questions for future research are discussed.
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Affiliation(s)
- Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland; Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | - Robert T Mallet
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland
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Allsopp GL, Hoffmann SM, Feros SA, Pasco JA, Russell AP, Wright CR. The Effect of Normobaric Hypoxia on Resistance Training Adaptations in Older Adults. J Strength Cond Res 2020; 36:2306-2312. [PMID: 32881839 DOI: 10.1519/jsc.0000000000003780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Allsopp, GL, Hoffmann, SM, Feros, SA, Pasco, JA, Russell, AP, and Wright, CR. The effect of normobaric hypoxia on resistance training adaptations in older adults. J Strength Cond Res XX(X): 000-000, 2020-The effect of normobaric hypoxia on strength, body composition, and cardiovascular fitness was investigated after a resistance training intervention in older adults. A single-blinded, randomized control trial recruited 20 healthy adults aged 60-75 years for an 8-week resistance training intervention in normoxia (n = 10) or normobaric hypoxia (14.4% O2; n = 10). Subjects performed 2 sessions per week of upper-body and lower-body exercises at 70% of 1 repetition maximum (1RM). Pretraining and post-training, maximal oxygen uptake (V[Combining Dot Above]O2max), muscular endurance (30 maximal knee flexions/extensions), and 5RM were assessed, with 5RM used to calculate 1RM. Subjects underwent whole-body dual-energy x-ray absorptiometry (DXA) at pretraining and post-training for fat and lean mass quantification. Significance was set at p < 0.05. Subjects in both groups substantially improved their calculated 1RM strength for leg extension, pectoral fly, row, and squat (normoxia; 30, 38, 27, and 29%, hypoxia; 43, 50, 28, and 64%, respectively); however, hypoxia did not augment this response. Hypoxia did not enhance V[Combining Dot Above]O2max or muscular endurance responses after the training intervention, with no improvements seen in either group. Fat mass and lean mass remained unchanged in both groups after the intervention. In summary, 8 weeks of resistance training in hypoxia was well tolerated in healthy older adults and increased upper-body and lower-body strength. However, the magnitude of strength and lean muscle improvements in hypoxia was no greater than normoxia; therefore, there is currently no evidence to support the use of hypoxic resistance training in older adults.
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Affiliation(s)
- Giselle L Allsopp
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Samantha M Hoffmann
- Center for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, Australia
| | - Simon A Feros
- Center for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, Australia
| | - Julie A Pasco
- Epi-Center for Healthy Ageing, IMPACT SRC, Deakin University, Geelong, Victoria, Australia.,Department of Medicine-Western Health, Melbourne Medical School, the University of Melbourne, St Albans, Victoria, Australia.,Barwon Health, Ryrie Street, Geelong, Victoria, Australia
| | - Aaron P Russell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Craig R Wright
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Richalet JP, Lhuissier F, Jean D. Ventilatory Response to Hypoxia and Tolerance to High Altitude in Women: Influence of Menstrual Cycle, Oral Contraception, and Menopause. High Alt Med Biol 2019; 21:12-19. [PMID: 31855465 DOI: 10.1089/ham.2019.0063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Introduction: Tolerance to high altitude in women might be influenced by hormonal status since female hormones modulate ventilation. Methods: Our objectives were (i) to explore in 1060 women, the influence of the phase of menstrual cycle, oral contraception, and menopause with or without hormonal treatment, on hypoxic ventilatory response at exercise (HVRe) and hypoxic cardiac response at exercise (HCRe) measured during a routine hypoxia exercise test, before an exposure to high altitude; (ii) to determine in 260 women exposed to high altitude, the influence of menopause and oral contraceptive and other drug use, on the prevalence of severe acute mountain sickness (sAMS). Four groups were defined: premenopausal with or without oral contraception and postmenopausal with or without hormonal treatment. Results: In premenopausal women without contraception, HVRe was higher in the early luteal/midluteal phase than in the early follicular phase (0.89 ± 0.37 vs. 0.75 ± 0.27 mL/[min · kg], p = 0.03). HVRe was similar in postmenopausal versus premenopausal women. HCRe was lower in postmenopausal women (p < 0.001), due to aging. HVRe decreased from second to fourth decade of age and increased from fourth to eighth decade, while HCRe consistently decreased with aging. Oral contraception or hormonal treatment had no effect on responses to hypoxia. The prevalence of sAMS was similar in all groups. Severe high-altitude illness score was higher and HVRe lower in women with sAMS. Conclusion: (i) physiological responses to hypoxic exercise depend on the ovarian cycle phase and menopause status, (ii) oral contraception and hormonal treatment have no influence on the tolerance to high altitude, and (iii) independent of hormonal status, aging modulates physiological responses to hypoxia.
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Affiliation(s)
- Jean-Paul Richalet
- INSERM U1272 Hypoxie et Poumon, Université Paris 13, Bobigny, France.,Département Médical, Institut National de l'Expertise et de la Performance, Paris, France
| | - François Lhuissier
- INSERM U1272 Hypoxie et Poumon, Université Paris 13, Bobigny, France.,Assistance Publique Hôpitaux de Paris, Hôpital Jean-Verdier, Bondy, France
| | - Dominique Jean
- CHU Grenoble-Alpes, Centre Pluridisciplinaire de Diagnostic Prénatal, Grenoble, France
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Park HY, Jung WS, Kim J, Lim K. Twelve weeks of exercise modality in hypoxia enhances health-related function in obese older Korean men: A randomized controlled trial. Geriatr Gerontol Int 2019; 19:311-316. [PMID: 30788892 DOI: 10.1111/ggi.13625] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/06/2018] [Accepted: 01/01/2019] [Indexed: 12/19/2022]
Abstract
AIM The aim of the present study was to examine the effect of exercise intervention in hypoxia as a novel treatment method for obesity in older men. METHODS A total of 24 obese 65-70-year-old Korean men (66.5 ± 0.8 years) were randomly assigned to undergo hypoxic training (n = 12) or normoxic training (n = 12), and all participants carried out an exercise intervention composed of aerobic exercise on a treadmill (30 min) and bicycle (30 min), and resistance exercise (30-40 min) in normoxia, and 3000-m normobaric hypoxia separately for a total of 12 weeks, three times a week. Health-related dependent variables (body composition, physical fitness, pulmonary function and heart rate variability) were evaluated at pre- and post-exercise intervention. RESULTS Hypoxic training showed more improved body composition (bodyweight -5.68 vs -3.16 kg, %body fat -5.50 vs -1.97%, fat-free mass 2.09 vs 1.06 kg), physical fitness (chair sit-to-stand 5.67 vs 4.58, pegboard 3.58 vs 2.17, tandem test -1.74 vs -1.31 s, one leg standing 6.27 vs 3.71 s), pulmonary function (forced vital capacity 0.15 vs 0.02 L, forced expiratory volume in 1 s 0.23 vs 0.01 L, percent of forced expiratory volume in 1 s 0.87 vs 0.08, maximal voluntary ventilation 5.26 vs 2.22 L) and heart rate variability (high frequency 0.94 vs 0.19 ms2 , low frequency/high frequency -0.28 vs -0.08, salivary cortisol -0.13 vs -0.04 μg/dL) than normoxic training. CONCLUSIONS Compared with normoxic training, hypoxic training is a novel and successful health promotion method in obese older populations. Geriatr Gerontol Int 2019; 19: 311-316.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Won-Sang Jung
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Jisu Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Korea.,Department of Physical Education, Konkuk University, Seoul, Korea
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Morélot‐Panzini C. Respiratory‐related cortical activity in patients with COPD and aged normal individuals: towards a different vision of dyspnoea? J Physiol 2018; 596:6137-6138. [DOI: 10.1113/jp276761] [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)
- Capucine Morélot‐Panzini
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de PneumologieMédecine Intensive et Réanimation, (Département “R3S”) F‐75013 Paris France
- Sorbonne UniversitéINSERM UMRS1158 Neurophysiologie respiratoire expérimentale et clinique F‐75005 Paris France
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Chacaroun S, Vega-Escamilla Y Gonzalez I, Flore P, Doutreleau S, Verges S. Physiological responses to hypoxic constant-load and high-intensity interval exercise sessions in healthy subjects. Eur J Appl Physiol 2018; 119:123-134. [PMID: 30315366 DOI: 10.1007/s00421-018-4006-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study was to assess the acute cardiorespiratory as well as muscle and cerebral tissue oxygenation responses to submaximal constant-load (CL) and high-intensity interval (HII) cycling exercise performed in normoxia and in hypoxia at similar intensity, reproducing whole-body endurance exercise training sessions as performed in sedentary and clinical populations. METHODS Healthy subjects performed two CL (30 min, 75% of maximal heart rate, n = 12) and two HII (15 times 1-min high-intensity exercise-1-min passive recovery, n = 12) cycling exercise sessions in normoxia and in hypoxia [mean arterial oxygen saturation 76 ± 1% (clamped) during CL and 77 ± 5% (inspiratory oxygen fraction 0.135) during HII]. Cardiorespiratory and near-infrared spectroscopy parameters as well as the rate of perceived exertion were continuously recorded. RESULTS Power output was 21 ± 11% and 15% (according to protocol design) lower in hypoxia compared to normoxia during CL and HII exercise sessions, respectively. Heart rate did not differ between normoxic and hypoxic exercise sessions, while minute ventilation was higher in hypoxia during HII exercise only (+ 13 ± 29%, p < 0.05). Quadriceps tissue saturation index did not differ significantly between normoxia and hypoxia (CL 60 ± 8% versus 59 ± 5%; HII 59 ± 10% versus 56 ± 9%; p > 0.05), while prefrontal cortex deoxygenation was significantly greater in hypoxia during both CL (66 ± 4% versus 56 ± 6%) and HII (58 ± 5% versus 55 ± 5%; p < 0.05) sessions. The rate of perceived exertion did not differ between normoxic and hypoxic CL (2.4 ± 1.7 versus 2.9 ± 1.8) and HII (6.9 ± 1.4 versus 7.5 ± 0.8) sessions (p > 0.05). CONCLUSION This study indicates that at identical heart rate, reducing arterial oxygen saturation near 75% does not accentuate muscle deoxygenation during both CL and HII exercise sessions compared to normoxia. Hence, within these conditions, larger muscle hypoxic stress should not be expected.
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Affiliation(s)
- S Chacaroun
- HP2 Laboratory, INSERM U1042, UM Sports Pathologies, Hôpital Sud, Univ. Grenoble Alpes, Avenue Kimberley, 38 434, Echirolles, France
| | - I Vega-Escamilla Y Gonzalez
- HP2 Laboratory, INSERM U1042, UM Sports Pathologies, Hôpital Sud, Univ. Grenoble Alpes, Avenue Kimberley, 38 434, Echirolles, France
| | - P Flore
- HP2 Laboratory, INSERM U1042, UM Sports Pathologies, Hôpital Sud, Univ. Grenoble Alpes, Avenue Kimberley, 38 434, Echirolles, France
| | - S Doutreleau
- HP2 Laboratory, INSERM U1042, UM Sports Pathologies, Hôpital Sud, Univ. Grenoble Alpes, Avenue Kimberley, 38 434, Echirolles, France.,Grenoble Alpes University Hospital, Grenoble, France
| | - Samuel Verges
- HP2 Laboratory, INSERM U1042, UM Sports Pathologies, Hôpital Sud, Univ. Grenoble Alpes, Avenue Kimberley, 38 434, Echirolles, France. .,Grenoble Alpes University Hospital, Grenoble, France.
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Mourot L. Limitation of Maximal Heart Rate in Hypoxia: Mechanisms and Clinical Importance. Front Physiol 2018; 9:972. [PMID: 30083108 PMCID: PMC6064954 DOI: 10.3389/fphys.2018.00972] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/02/2018] [Indexed: 12/17/2022] Open
Abstract
The use of exercise intervention in hypoxia has grown in popularity amongst patients, with encouraging results compared to similar intervention in normoxia. The prescription of exercise for patients largely rely on heart rate recordings (percentage of maximal heart rate (HRmax) or heart rate reserve). It is known that HRmax decreases with high altitude and the duration of the stay (acclimatization). At an altitude typically chosen for training (2,000-3,500 m) conflicting results have been found. Whether or not this decrease exists or not is of importance since the results of previous studies assessing hypoxic training based on HR may be biased due to improper intensity. By pooling the results of 86 studies, this literature review emphasizes that HRmax decreases progressively with increasing hypoxia. The dose–response is roughly linear and starts at a low altitude, but with large inter-study variabilities. Sex or age does not seem to be a major contributor in the HRmax decline with altitude. Rather, it seems that the greater the reduction in arterial oxygen saturation, the greater the reduction in HRmax, due to an over activity of the parasympathetic nervous system. Only a few studies reported HRmax at sea/low level and altitude with patients. Altogether, due to very different experimental design, it is difficult to draw firm conclusions in these different clinical categories of people. Hence, forthcoming studies in specific groups of patients are required to properly evaluate (1) the HRmax change during acute hypoxia and the contributing factors, and (2) the physiological and clinical effects of exercise training in hypoxia with adequate prescription of exercise training intensity if based on heart rate.
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Affiliation(s)
- Laurent Mourot
- EA 3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation Platform, University of Franche-Comté, Besançon, France.,Tomsk Polytechnic University, Tomsk, Russia
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Andrianopoulos V, Vogiatzis I, Gloeckl R, Bals R, Koczulla RA, Kenn K. Cerebral oxygen availability during exercise in COPD patients with cognitive impairment. Respir Physiol Neurobiol 2018; 254:64-72. [PMID: 29729396 DOI: 10.1016/j.resp.2018.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 02/07/2023]
Abstract
Insufficient cerebral blood flow regulation to meet increasing metabolic demand during physical exertion could be associated with cognitive impairment. We compared cerebral oxygen availability during exercise in cognitively impaired (CI) to cognitively normal (CN) COPD patients. Fifty-two patients (FEV1: 51 ± 16%) were classified as CN or CI according to the Montreal Cognitive Assessment. Patients performed cycle-ergometry at 75% peak capacity with continuous measurement of Near-Infrared Spectroscopy frontal-cortex Tissue oxygen Saturation Index (TSI), cerebral haemoglobin indices (oxy/deoxy/total- Hb), transcutaneous carbon-dioxide partial pressure (TcPCO2), and arterial oxygen saturation (SpO2). Twenty-one patients (40%) presented evidences of CI. During exercise, CN and CI patients exhibited mild to moderate SpO2decline (nadir[Δ]≥ -3 ± 2% and -5 ± 3%, respectively) but preserved baseline frontal-cortex TSI levels, whilst presenting small TcPCO2 perturbations and increased cerebral total-Hb (post [Δ]≥ 2.0 ± 3 μM sec-1). CI patients preserve the capacity to adequately maintain cerebral oxygen availability during submaximal exercise. Therefore, rehabilitative exercise training in CI patients with COPD exhibiting mild to moderate exercise-induced SpO2 decline does not appear to lead to reduced cerebral oxygen availability.
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Affiliation(s)
- Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany.
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University Newcastle, United Kingdom; Faculty of Physical Education and Sports Sciences, National and Kapodistrian University of Athens, Greece.
| | - Rainer Gloeckl
- Department of Respiratory Medicine & Exercise Therapy, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department for Prevention and Sports Medicine, Klinikum Rechts der Isar, Technical University Munich (TUM), Munich, Germany.
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany.
| | - Rembert A Koczulla
- Department of Respiratory Medicine & Exercise Therapy, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany; German Center of Lung Research (DZL), Giessen-Marburg, Germany.
| | - Klaus Kenn
- Department of Respiratory Medicine & Exercise Therapy, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany; Department of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany; German Center of Lung Research (DZL), Giessen-Marburg, Germany.
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