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Kipp S, Arn SR, Leahy MG, Guenette JA, Sheel AW. The metabolic cost of breathing for exercise ventilations: effects of age and sex. J Appl Physiol (1985) 2024; 137:329-342. [PMID: 38841757 DOI: 10.1152/japplphysiol.00282.2023] [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: 05/04/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
Given that there are both sex-based structural differences in the respiratory system and age-associated declines in pulmonary function, the purpose of this study was to assess the effects of age and sex on the metabolic cost of breathing (V̇o2RM) for exercise ventilations in healthy younger and older males and females. Forty healthy participants (10 young males 24 ± 3 yr; 10 young females 24 ± 3 yr; 10 older males 63 ± 3 yr, 10 older females 63 ± 6 yr) mimicked their exercise breathing patterns (voluntary hyperpnea) in the absence of exercise across a range of exercise intensities. At peak exercise, V̇o2RM represented a significantly greater fraction of peak oxygen consumption (V̇o2peak) in young females, 12.7 ± 4.0%, compared with young males, 10.7 ± 3.0% (P = 0.027), whereas V̇o2RM represented 13.5 ± 2.3% of V̇o2peak in older females and 13.2 ± 3.3% in older males. At relative ventilations, there was a main effect of age, with older males consuming a significantly greater fraction of V̇o2RM (6.6 ± 1.9%) than the younger males (4.4 ± 1.3%; P = 0.012), and older females consuming a significantly greater fraction of V̇o2RM (6.9 ± 2.5%) than the younger females (5.1 ± 1.4%; P = 0.004) at 65% V̇emax. Furthermore, both younger and older males had significantly better respiratory muscle efficiency than their female counterparts at peak exercise (P = 0.011; P = 0.015). Similarly, younger participants were significantly more efficient than older participants (6.5 ± 1.5% vs. 5.5 ± 2.0%; P = 0.001). Normal age-related changes in respiratory function, in addition to sex-based differences in airway anatomy, appear to influence the ventilatory responses and the cost incurred to breathe during exercise.NEW & NOTEWORTHY Here we show that at moderate and high-intensity exercise, older individuals incur a higher cost to breathe than their younger counterparts. However, as individuals age, the sex difference in the cost of breathing narrows. Collectively, our findings suggest that the normative age-related changes in respiratory structure and function, and sex differences in airway anatomy, appear to influence the ventilatory responses to exercise and the oxygen cost to breathe.
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Affiliation(s)
- Shalaya Kipp
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sierra R Arn
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
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Koike J, Ogawa T. Effect of Inspiratory Muscle-Loaded Exercise Training on Ventilatory Response and Intercostal Muscle Deoxygenation During Incremental Cycling Exercise. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-13. [PMID: 38986154 DOI: 10.1080/02701367.2024.2365291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/31/2024] [Indexed: 07/12/2024]
Abstract
Purpose: This study evaluated the effects of exercise training (ET) and inspiratory muscle-loaded exercise training (IMLET) on ventilatory response and intercostal muscle deoxygenation levels during incremental cycling exercise. Methods: Twenty-one male participants were randomly divided into IMLET (n = 10) or ET (n = 11) groups. All participants underwent a 4-week cycling exercise training at 60% peak oxygen uptake. IMLET loaded 50% of maximal inspiratory pressure (PImax). Respiratory muscle strength test, respiratory muscle endurance test (RMET), resting hypoxic ventilatory responsiveness (HVR) test, and incremental cycling test were performed pre- and post-training. Results: The extent of improvement in the PImax was significantly greater in the IMLET group (24%) than in the ET group (8%) (p = .018), and an extended RMET time was observed in the IMLET group (p < .001). Minute ventilation (V ˙ E ) during exercise was unchanged in both groups before and after training, but tidal volume during exercise increased in the IMLET group. The increase in the exercise intensity threshold for muscle deoxygenation was similar in both groups (p < .001). HVR remained unchanged in both groups post-training. The exercise duration for the incremental exercise until reaching fatigue increased by 7.9% after ET and 6.9% after IMLET (p < .001). Conclusion: The 4-week IMLET improved respiratory muscle strength and endurance but did not alter HVR. Respiratory muscle deoxygenation was alleviated by exercise training, with a limited impact of inspiratory load training.
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Dominelli PB, Sheel AW. The pulmonary physiology of exercise. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:238-251. [PMID: 38205515 DOI: 10.1152/advan.00067.2023] [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: 04/28/2023] [Revised: 12/14/2023] [Accepted: 01/07/2024] [Indexed: 01/12/2024]
Abstract
The pulmonary system is the first and last "line of defense" in terms of maintaining blood gas homeostasis during exercise. Our review provides the reader with an overview of how the pulmonary system responds to acute exercise. We undertook this endeavor to provide a companion article to "Cardiovascular Response to Exercise," which was published in Advances in Physiological Education. Together, these articles provide the readers with a solid foundation of the cardiopulmonary response to acute exercise in healthy individuals. The intended audience of this review is level undergraduate or graduate students and/or instructors for such classes. By intention, we intend this to be used as an educational resource and seek to provide illustrative examples to reinforce topics as well as highlight uncertainty to encourage the reader to think "beyond the textbook." Our treatment of the topic presents "classic" concepts along with new information on the pulmonary physiology of healthy aging.NEW & NOTEWORTHY Our narrative review is written with the student of the pulmonary physiology of exercise in mind, be it a senior undergraduate or graduate student or those simply refreshing their knowledge. We also aim to provide examples where the reader can incorporate real scenarios.
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Affiliation(s)
- Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - A William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
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Molgat-Seon Y, Sawatzky MAT, Dominelli PB, Kirby M, Guenette JA, Bourbeau J, Tan WC, Sheel AW. Dysanapsis is not associated with exertional dyspnoea in healthy male and female never-smokers aged 40 years and older. Appl Physiol Nutr Metab 2024; 49:223-235. [PMID: 37847929 DOI: 10.1139/apnm-2023-0246] [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: 10/19/2023]
Abstract
In healthy adults, airway-to-lung (i.e., dysanapsis) ratio is lower and dyspnoea during exercise at a given minute ventilation (V̇E) is higher in females than in males. We investigated the relationship between dysanapsis and sex on exertional dyspnoea in healthy adults. We hypothesized that females would have a smaller airway-to-lung ratio than males and that exertional dyspnoea would be associated with airway-to-lung ratio in males and females. We analyzed data from n = 100 healthy never-smokers aged ≥40 years enrolled in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study who underwent pulmonary function testing, a chest computed tomography scan, and cardiopulmonary exercise testing. The luminal area of the trachea, right main bronchus, left main bronchus, right upper lobe, bronchus intermedius, left upper lobe, and left lower lobe were 22%-37% smaller (all p < 0.001) and the airway-to-lung ratio (i.e., average large conducting airway diameter relative to total lung capacity) was lower in females than in males (0.609 ± 0.070 vs. 0.674 ± 0.082; p < 0.001). During exercise, there was a significant effect of V̇E, sex, and their interaction on dyspnoea (all p < 0.05), indicating that dyspnoea increased as a function of V̇E to a greater extent in females than in males. However, after adjusting for age and total lung capacity, there were no significant associations between airway-to-lung ratio and measures of exertional dyspnoea, regardless of sex (all r < 0.34; all p > 0.05). Our findings suggest that sex differences in airway size do not contribute to sex differences in exertional dyspnoea.
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Affiliation(s)
- Yannick Molgat-Seon
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
- Centre for Heart and Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Mathieu A T Sawatzky
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - Paolo B Dominelli
- Department of KinesiologyUniversity of Waterloo, Waterloo, ON N2 L3G1, Canada
| | - Miranda Kirby
- Department of PhysicsToronto Metropolitan University, Toronto, ON M5 B2K3, Canada
| | - Jordan A Guenette
- Centre for Heart and Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
- Department of Physical TherapyThe University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- School of Kinesiology, The University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Jean Bourbeau
- Department of MedicineMcGill University, Montreal, QC H4A 3J1, Canada
| | - Wan C Tan
- Centre for Heart and Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - A William Sheel
- Centre for Heart and Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
- School of Kinesiology, The University of British Columbia, Vancouver, BC V6T 1Z1, Canada
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Yoon S, Cederbaum LA, Côté JN. Females show less decline in contractile function than males after repeated all-out cycling. Appl Physiol Nutr Metab 2024; 49:199-212. [PMID: 37820383 DOI: 10.1139/apnm-2023-0184] [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: 10/13/2023]
Abstract
Females demonstrate greater fatigue resistance during a range of exercise modalities; however, this may be confounded by the lower mechanical work completed. Accordingly, this study examined the sex-specific peripheral and central fatigue mechanisms during repeated all-out cycling and whether they are affected by total mechanical work performed. A total of 26 healthy young adults (12 females) performed 10 × 10 s all-out cycling interspersed by 30 s passive recovery. Metabolic responses, peripheral and central fatigue, were quantified via changes in pre- to post-exercise blood lactate, potentiated quadriceps twitch force (and contractile properties) evoked via supramaximal electrical stimulation of the femoral nerve, and voluntary activation of the knee extensors, respectively. During exercise, mechanical work, vastus lateralis muscle activation (via surface electromyography), and deoxygenation (via near-infrared spectroscopy) were recorded. Sex comparison analyses were performed before and after statistically controlling for total mechanical work (via ANCOVA). Mechanical work and muscle activation plateaued at similar sprint repetition (sprint 5) and voluntary activation change (pre vs. post) was similar between the sexes. Females, however, showed lower %work decrement (i.e., fatigability; P = 0.037) and peripheral responses as evident by lower reductions in quadriceps twitch force (P < 0.001) and muscle deoxygenation (P = 0.001). Adjusting for total mechanical work did not change these sex comparison results. We show that females' greater fatigue resistance during repeated all-out cycling may not be attributed to the greater total mechanical work performed but could be mediated by lower peripheral fatigue in the knee extensor muscles.
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Affiliation(s)
- SangHoon Yoon
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
| | - Lauren A Cederbaum
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, QC H2W 1S4, Canada
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Bernal JB, Downer JDR, Lin VHJ. Under pressure: examining the effect of modulating intrathoracic pressure swings on cardiac output. J Physiol 2024; 602:543-544. [PMID: 38261651 DOI: 10.1113/jp285976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Jona B Bernal
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
| | - Joshua D R Downer
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
| | - Vanessa H J Lin
- Department of Kinesiology, University of Toronto, Toronto, Ontario, Canada
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Sato S, Ishida K, Tanaka NI, Katayama K. Impact of high-intensity interval hyperpnea on aerobic energy release and inspiratory muscle fatigue. Respir Physiol Neurobiol 2024; 319:104170. [PMID: 37838229 DOI: 10.1016/j.resp.2023.104170] [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] [Received: 07/22/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
Respiratory muscle endurance training reportedly has beneficial effects on whole-body endurance performance. We produced a novel high-intensity interval (HII) protocol and characterized the associated physiological responses and respiratory muscle fatigue. Peak oxygen uptake of respiratory muscle (V̇O2peakRM) was estimated during the respiratory incremental test. The HII session consisted of five 3-minute hyperpnea periods at 100%V̇O2peakRM interspersed with 2-minute periods at 40%V̇O2peakRM (25 min total). The high-intensity continuous (HIC) session involved a single time-to-end bout of hyperpnea at 100%V̇O2peakRM. The moderate-intensity continuous (MIC) session involved 25 min of hyperpnea at 60% of maximal voluntary ventilation. V̇O2RM was recorded continuously, and maximal inspiratory pressure (PImax) was assessed before and after the sessions. HII session: V̇O2RM gradually increased as the sets proceeded, whereas PImax decreased significantly. HIC session: V̇O2RM increased progressively, and the time to end was 6.5 ± 0.5 min. PImax decreased significantly. MIC session: V̇O2RM did not change for 25 min, and PImax remained unchanged. The duration of V̇O2RM at near- and supra-maximal levels in the HII session (10 ± 1 min) was longer than that in the HIC session (4 ± 1 min). The decrease in PImax was larger in the HII session (-12 ± 3 %) than MIC session (-4 ± 3 %). The HII protocol is characterized by a longer time to maximally stimulate the aerobic energy system of respiratory muscle than the HIC protocol and greater inspiratory muscle fatigue than the traditional MIC protocol. These results suggest that the HII protocol could enhance the efficacy of respiratory muscle training programs.
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Affiliation(s)
- Suzuna Sato
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Noriko I Tanaka
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan; Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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Peters CM, Dempsey JA, Hopkins SR, Sheel AW. Is the Lung Built for Exercise? Advances and Unresolved Questions. Med Sci Sports Exerc 2023; 55:2143-2159. [PMID: 37443459 PMCID: PMC11186580 DOI: 10.1249/mss.0000000000003255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
ABSTRACT Nearly 40 yr ago, Professor Dempsey delivered the 1985 ACSM Joseph B. Wolffe Memorial Lecture titled: "Is the lung built for exercise?" Since then, much experimental work has been directed at enhancing our understanding of the functional capacity of the respiratory system by applying complex methodologies to the study of exercise. This review summarizes a symposium entitled: "Revisiting 'Is the lung built for exercise?'" presented at the 2022 American College of Sports Medicine annual meeting, highlighting the progress made in the last three-plus decades and acknowledging new research questions that have arisen. We have chosen to subdivide our topic into four areas of active study: (i) the adaptability of lung structure to exercise training, (ii) the utilization of airway imaging to better understand how airway anatomy relates to exercising lung mechanics, (iii) measurement techniques of pulmonary gas exchange and their importance, and (iv) the interactions of the respiratory and cardiovascular system during exercise. Each of the four sections highlights gaps in our knowledge of the exercising lung. Addressing these areas that would benefit from further study will help us comprehend the intricacies of the lung that allow it to meet and adapt to the acute and chronic demands of exercise in health, aging, and disease.
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Affiliation(s)
| | - Jerome A Dempsey
- Population Health Science, John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, WI
| | - Susan R Hopkins
- Department of Radiology, University of California San Diego, La Jolla, CA
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Angus SA, Taylor JL, Mann LM, Williams AM, Stöhr EJ, Au JS, Sheel AW, Dominelli PB. Attenuating intrathoracic pressure swings decreases cardiac output at different intensities of exercise. J Physiol 2023; 601:4807-4821. [PMID: 37772933 DOI: 10.1113/jp285101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023] Open
Abstract
Intrathoracic pressure (ITP) swings that permit spontaneous ventilation have physiological implications for the heart. We sought to determine the effect of respiration on cardiac output (Q ̇ $\dot Q$ ) during semi-supine cycle exercise using a proportional assist ventilator to minimize ITP changes and lower the work of breathing (Wb ). Twenty-four participants (12 females) completed three exercise trials at 30%, 60% and 80% peak power (Wmax ) with unloaded (using a proportional assist ventilator, PAV) and spontaneous breathing. Intrathoracic and intraabdominal pressures were measured with balloon catheters placed in the oesophagus and stomach. Left ventricular (LV) volumes andQ ̇ $\dot Q$ were determined via echocardiography. Heart rate (HR) was measured with electrocardiogram and a customized metabolic cart measured oxygen uptake (V ̇ O 2 ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}}}$ ). Oesophageal pressure swings decreased from spontaneous to PAV breathing by -2.8 ± 3.1, -4.9 ± 5.7 and -8.1 ± 7.7 cmH2 O at 30%, 60% and 80% Wmax , respectively (P = 0.01). However, the decreases in Wb were similar across exercise intensities (27 ± 42 vs. 35 ± 24 vs. 41 ± 22%, respectively, P = 0.156). During PAV breathing compared to spontaneous breathing,Q ̇ $\dot Q$ decreased by -1.0 ± 1.3 vs. -1.4 ± 1.4 vs. -1.5 ± 1.9 l min-1 (all P < 0.05) and stroke volume decreased during PAV breathing by -11 ± 12 vs. -9 ± 10 vs. -7 ± 11 ml from spontaneous breathing at 30%, 60% and 80% Wmax , respectively (all P < 0.05). HR was lower during PAV breathing by -5 ± 4 beats min-1 at 80% Wmax (P < 0.0001). Oxygen uptake decreased by 100 ml min-1 during PAV breathing compared to spontaneous breathing at 80% Wmax (P < 0.0001). Overall, attenuating ITPs mitigated LV preload and ejection, thereby suggesting that the ITPs associated with spontaneous respiration impact cardiac function during exercise. KEY POINTS: Pulmonary ventilation is accomplished by alterations in intrathoracic pressure (ITP), which have physiological implications on the heart and dynamically influence the loading parameters of the heart. Proportional assist ventilation was used to attenuate ITP changes and decrease the work of breathing during exercise to examine its effects on left ventricular (LV) function. Proportional assist ventilation with progressive exercise intensities (30%, 60% and 80% Wmax ) led to reductions in cardiac output at all intensities, primarily through reductions in stroke volume. Decreases in LV end-diastolic volume (30% and 60% Wmax ) and increases in LV end-systolic volume (80% Wmax ) were responsible for the reduction in stroke volume. The relationship between cardiac output and oxygen uptake is disrupted during respiratory muscle unloading.
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Affiliation(s)
- Sarah A Angus
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joshua L Taylor
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leah M Mann
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Alexandra M Williams
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Science, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric J Stöhr
- Institute of Sports Science, COR-HELIX, Leibniz University Hannover, Hannover, Germany
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Jason S Au
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Andrew William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Cross TJ, Isautier JMJ, Kelley EF, Hubbard CD, Morris SJ, Smith JR, Duke JW. A Systematic Review of Methods Used to Determine the Work of Breathing during Exercise. Med Sci Sports Exerc 2023; 55:1672-1682. [PMID: 37126027 DOI: 10.1249/mss.0000000000003187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Measurement of the work of breathing (Wb) during exercise provides useful insights into the energetics and mechanics of the respiratory muscles across a wide range of minute ventilations. The methods and analytical procedures used to calculate the Wb during exercise have yet to be critically appraised in the literature. PURPOSE The aim of this systematic review was to evaluate the quality of methods used to measure the Wb during exercise in the available literature. METHODS We conducted an extensive search of three databases for studies that measured the Wb during exercise in adult humans. Data were extracted on participant characteristics, flow/volume and pressure devices, esophageal pressure (P oes ) catheters, and methods of Wb analysis. RESULTS A total of 120 articles were included. Flow/volume sensors used were primarily pneumotachographs ( n = 85, 70.8%), whereas the most common pressure transducer was of the variable reluctance type ( n = 63, 52.5%). Esophageal pressure was frequently obtained via balloon-tipped catheters ( n = 114, 95.0%). Few studies mentioned calibration, frequency responses, and dynamic compensation of their measurement devices. The most popular method of measuring the Wb was pressure-volume integration ( n = 51, 42.5%), followed by the modified Campbell ( n = 28, 23.3%) and Dean & Visscher diagrams ( n = 26, 21.7%). Over one-third of studies did not report the methods used to process their pressure-volume data, and the majority (60.8%) of studies used the incorrect Wb units and/or failed to discuss the limitations of their Wb measurements. CONCLUSIONS The findings of this systematic review highlight the need for the development of a standardized approach for measuring Wb, which is informative, practical, and accessible for future researchers.
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Affiliation(s)
- Troy J Cross
- Faculty of Medicine and Health, University of Sydney, NSW, AUSTRALIA
| | | | - Eli F Kelley
- Air Force Research Laboratory, 711HPW/RHBFP, Wright-Patterson Air Force Base, OH
| | - Colin D Hubbard
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
| | - Sarah J Morris
- Faculty of Medicine and Health, University of Sydney, NSW, AUSTRALIA
| | - Joshua R Smith
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ
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Ramsook AH, Dominelli PB, Angus SA, Senefeld JW, Wiggins CC, Joyner MJ. The oxygen transport cascade and exercise: Lessons from comparative physiology. Comp Biochem Physiol A Mol Integr Physiol 2023; 282:111442. [PMID: 37182787 PMCID: PMC10330610 DOI: 10.1016/j.cbpa.2023.111442] [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: 02/24/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
Studies of animal physiology not only provide valuable knowledge for the species in question, but also offer insights into human physiology. This thought is best highlighted by the 'Krogh Principle', which states "for many problems there is an animal on which it can be most conveniently studied". This graphical review focuses on three distinct stages of the oxygen transport cascade in which human exercise physiology knowledge has been enhanced by studies carried out in animal models. We begin by exploring ventilation, and the detrimental effects of cold, dry air on the airways in two sets of elite athletes, the cross-country skier and the racing sled dog. We then discuss the transport of oxygen via hemoglobin in humans and deer mice with relatively shifted oxygen dissociation curves. Finally, we consider the technical difficulties of measuring respiratory muscle blood flow in exercising humans and how an equine model can provide an understanding of the distribution of blood flow during exercise. These cases illustrate the complementary nature of physiological studies across species.
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Affiliation(s)
- Andrew H Ramsook
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA. https://twitter.com/ahramsook
| | - Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sarah A Angus
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jonathon W Senefeld
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. https://twitter.com/jwsenefeld
| | - Chad C Wiggins
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA. https://twitter.com/cwiggs5
| | - Michael J Joyner
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, USA; Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
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Burrowes KS, Ruppage M, Lowry A, Zhao D. Sex matters: the frequently overlooked importance of considering sex in computational models. Front Physiol 2023; 14:1186646. [PMID: 37520817 PMCID: PMC10374267 DOI: 10.3389/fphys.2023.1186646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Personalised medicine and the development of a virtual human or a digital twin comprises visions of the future of medicine. To realise these innovations, an understanding of the biology and physiology of all people are required if we wish to apply these technologies at a population level. Sex differences in health and biology is one aspect that has frequently been overlooked, with young white males being seen as the "average" human being. This has not been helped by the lack of inclusion of female cells and animals in biomedical research and preclinical studies or the historic exclusion, and still low in proportion, of women in clinical trials. However, there are many known differences in health between the sexes across all scales of biology which can manifest in differences in susceptibility to diseases, symptoms in a given disease, and outcomes to a given treatment. Neglecting these important differences in the development of any health technologies could lead to adverse outcomes for both males and females. Here we highlight just some of the sex differences in the cardio-respiratory systems with the goal of raising awareness that these differences exist. We discuss modelling studies that have considered sex differences and touch on how and when to create sex-specific models. Scientific studies should ensure sex differences are included right from the study planning phase and results reported using sex as a biological variable. Computational models must have sex-specific versions to ensure a movement towards personalised medicine is realised.
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Affiliation(s)
- K. S. Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - M. Ruppage
- Department of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A. Lowry
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - D. Zhao
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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13
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Shiffman VJ, Rose P, Hughes B, Koehle MS, McKinney J, McKenzie DC, Leahy MG, Kipp S, Peters CM, Sheel AW. EXERCISE-INDUCED ARTERIAL HYPOXEMIA IN FEMALE MASTERS ATHTLETES. Respir Physiol Neurobiol 2023:104099. [PMID: 37385421 DOI: 10.1016/j.resp.2023.104099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/01/2023]
Abstract
The purpose of the study was to characterize exercise induced arterial hypoxemia (EIAH) in female masters athletes (FMA). We hypothesized that FMA would experience EIAH during treadmill running. Eight FMA (48-57 years) completed pulmonary function testing and an incremental exercise test until exhaustion (V̇O2max=45.7±6.5, range:35-54ml/kg/min). On a separate day, the participants were instrumented with a radial arterial catheter and an esophageal temperature probe. Participants performed three to four constant load exercise tests at 60-70, 75, 90, 95, and 100% of maximal oxygen uptake while sampling arterial blood and recording esophageal temperature. We found that FMA decrease their partial pressure of oxygen (86.0±7.6, range:73-108mmHg), arterial saturation (96.2±1.2, range:93-98%), and widen their alveolar to arterial oxygen difference (23.2±8.8, range:5-42mmHg) during all exercise intensities however, with variability in terms of severity and pattern. Our findings suggest that FMA experience EIAH however aerobic fitness appears unrelated to occurrence or severity (r=0.13, p=0.756).
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Affiliation(s)
- Viviana J Shiffman
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
| | - Peter Rose
- Department of Anesthesia, Vancouver Coastal Health, Vancouver BC, Canada.
| | - Bevan Hughes
- Department of Anesthesia, Vancouver Coastal Health, Vancouver BC, Canada.
| | - Michael S Koehle
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada; Division of Sport and Exercise Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - James McKinney
- Division of Cardiology, University of British Columbia, Vancouver, BC, Canada.
| | - Donald C McKenzie
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada; Division of Sport and Exercise Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Michael G Leahy
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
| | - Shalaya Kipp
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
| | - Carli M Peters
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
| | - A William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.
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14
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THE RESPIRATORY PHYSIOLOGY OF EXERCISE: AGE AND SEX CONSIDERATIONS. CURRENT OPINION IN PHYSIOLOGY 2023. [DOI: 10.1016/j.cophys.2023.100652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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15
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Inspiratory Muscle Training Improves Maximal Inspiratory Pressure Without Increasing Performance in Elite Swimmers. Int J Sports Physiol Perform 2023; 18:320-325. [PMID: 36754056 DOI: 10.1123/ijspp.2022-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/04/2022] [Accepted: 11/18/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE To analyze the effect of inspiratory muscle training (IMT) on the maximal inspiratory mouth pressure (MIP) and performance of elite swimmers. METHODS Eight participants performed a 3000-m swimming test (T-3000), followed by blood lactate measurements at 1 and 5 minutes postexercise.. The testing protocol was carried out before and after 6 weeks of IMT, in which a high-volume IMT group (HV-IMT) (n = 4) performed IMT twice a day-in the morning in a seated position and in the afternoon in a concurrent session of IMT and core muscle training. Also, a low-volume IMT group (LV-IMT) (n = 4) performed IMT in the morning session only. RESULTS After the intervention, both groups improved their MIP, HV-IMT (132.75 [27.42] to 156.75 [21.88] cmH2O; P = .010; d = 0.967) and LV-IMT (149.25 [22.82] to 171.50 [23.74] cmH2O; P = .013; d = 0.955), without a significant difference between groups (P = .855). Regarding swimming performance, there were no changes between groups in the T-3000 (P = .472) or lactate removal rate (P = .104). CONCLUSION IMT increased inspiratory muscle strength in elite swimmers, but there was no association or meaningful impact on swimming performance.
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16
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Gerson EAM, Dominelli PB, Leahy MG, Kipp S, Guenette JA, Archiza B, Sheel AW. The effect of proportional assist ventilation on the electrical activity of the human diaphragm during exercise. Exp Physiol 2023; 108:296-306. [PMID: 36420595 PMCID: PMC10103863 DOI: 10.1113/ep090808] [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: 09/01/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the effect of lowering the normally occurring work of breathing on the electrical activity and pressure generated by the diaphragm during submaximal exercise in healthy humans? What is the main finding and its importance? Ventilatory assist during exercise elicits a proportional lowering of both the work performed by the diaphragm and diaphragm electrical activity. These findings have implications for exercise training studies using proportional assist ventilation to reduce diaphragm work in patients with cardiopulmonary disease. ABSTRACT We hypothesized that when a proportional assist ventilator (PAV) is applied in order to reduce the pressure generated by the diaphragm, there would be a corresponding reduction in electrical activity of the diaphragm. Healthy participants (five male and four female) completed an incremental cycle exercise test to exhaustion in order to calculate workloads for subsequent trials. On the experimental day, participants performed submaximal cycling, and three levels of assisted ventilation were applied (low, medium and high). Ventilatory parameters, pulmonary pressures and EMG of the diaphragm (EMGdi ) were obtained. To compare the PAV conditions with spontaneous breathing intervals, ANOVA procedures were used, and significant effects were evaluated with a Tukey-Kramer test. Significance was set at P < 0.05. The work of breathing was not different between the lowest level of unloading and spontaneous breathing (P = 0.151) but was significantly lower during medium (25%, P = 0.02) and high (36%, P < 0.001) levels of PAV. The pressure-time product of the diaphragm (PTPdi ) was lower across PAV unloading conditions (P < 0.05). The EMGdi was significantly lower in medium and high PAV conditions (P = 0.035 and P < 0.001, respectively). The mean reductions of EMGdi with PAV unloading were 14, 22 and 39%, respectively. The change in EMGdi for a given lowering of PTPdi with the PAV was significantly correlated (r = 0.61, P = 0.01). Ventilatory assist during exercise elicits a reduction in the electrical activity of the diaphragm, and there is a proportional lowering of the work of breathing. Our findings have implications for exercise training studies using assisted ventilation to reduce diaphragm work in patients with cardiopulmonary disease.
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Affiliation(s)
- Emily A. M. Gerson
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Michael G. Leahy
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Shalaya Kipp
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Jordan A. Guenette
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Centre for Heart Lung InnovationProvidence ResearchThe University of British Columbia, St. Paul's HospitalVancouverBritish ColumbiaCanada
- Department of Physical TherapyFaculty of MedicineThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Bruno Archiza
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Department of PhysiotherapyCardiopulmonary Physiotherapy LaboratoryNucleus of Research in Physical Exercise, Federal University of Sao CarlosSao CarlosBrazil
| | - Andrew William Sheel
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
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17
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Shiozawa K, Shimizu K, Saito M, Ishida K, Mizuno S, Katayama K. Sex differences in blood pressure and inactive limb blood flow responses during dynamic leg exercise with increased inspiratory muscle work. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:782-798. [PMID: 36544598 PMCID: PMC9748326 DOI: 10.18999/nagjms.84.4.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022]
Abstract
We hypothesized that, compared with young males, young females have a smaller decrease in blood flow to the inactive limb, accompanied by a smaller increase in arterial blood pressure, during dynamic exercise with increased inspiratory muscle work. Young males and females performed dynamic knee-extension and -flexion exercises for 10 min (spontaneous breathing for 5 min and voluntary hyperpnoea with or without inspiratory resistance for 5 min). Mean arterial blood pressure (MAP) and mean blood flow (MBF) in the brachial artery were continuously measured by means of finger photoplethysmography and Doppler ultrasound, respectively. No sex differences were found in the ΔMAP and ΔMBF (Δ: from baseline) during exercise without inspiratory resistance. In contrast, the ΔMAP during exercise with inspiratory resistive breathing was greater (P < 0.05) in males (+31.3 ± 2.1 mmHg, mean ± SE) than females (+18.9 ± 3.2 mmHg). The MBF during exercise with inspiratory resistance did not change in males (-4.4 ± 10.6 mL/min), whereas it significantly increased in females (+25.2 ± 15.4 mL/min). These results suggest that an attenuated inspiratory muscle-induced metaboreflex in young females affects blood flow distribution during submaximal dynamic leg exercise.
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Affiliation(s)
- Kana Shiozawa
- Department of Exercise and Sports Physiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kaori Shimizu
- Faculty of Human Development, Kokugakuin University, Yokohama, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Koji Ishida
- Department of Exercise and Sports Physiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Sahiro Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Department of Exercise and Sports Physiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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18
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Ryan BJ, Seeley AD, Pitsas DM, Mayer TA, Caldwell AR, Ceaser TG, Luippold AJ, Charkoudian N, Salgado RM. Influence of graded hypercapnia on endurance exercise performance in healthy humans. Am J Physiol Regul Integr Comp Physiol 2022; 323:R638-R647. [PMID: 36094451 PMCID: PMC9602925 DOI: 10.1152/ajpregu.00132.2022] [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: 06/20/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022]
Abstract
Military and/or emergency services personnel may be required to perform high-intensity physical activity during exposure to elevated inspired carbon dioxide (CO2). Although many of the physiological consequences of hypercapnia are well characterized, the effects of graded increases in inspired CO2 on self-paced endurance performance have not been determined. The aim of this study was to compare the effects of 0%, 2%, and 4% inspired CO2 on 2-mile run performance, as well as physiological and perceptual responses during time trial exercise. Twelve physically active volunteers (peak oxygen uptake = 49 ± 5 mL·kg-1·min-1; 3 women) performed three experimental trials in a randomized, single-blind, crossover manner, breathing 21% oxygen with either 0%, 2%, or 4% CO2. During each trial, participants completed 10 min of walking at ∼40% peak oxygen uptake followed by a self-paced 2-mile treadmill time trial. One participant was unable to complete the 4% CO2 trial due to lightheadedness during the run. Compared with the 0% CO2 trial, run performance was 5 ± 3% and 7 ± 3% slower in the 2% and 4% CO2 trials, respectively (both P < 0.001). Run performance was significantly slower with 4% versus 2% CO2 (P = 0.046). The dose-dependent performance impairments were accompanied by stepwise increases in mean ventilation, despite significant reductions in running speed. Dyspnea and headache were significantly elevated during the 4% CO2 trial compared with both the 0% and 2% trials. Overall, our findings show that graded increases in inspired CO2 impair endurance performance in a stepwise manner in healthy humans.
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Affiliation(s)
- Benjamin J Ryan
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Afton D Seeley
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Dina M Pitsas
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Thomas A Mayer
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Aaron R Caldwell
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Tyrone G Ceaser
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Adam J Luippold
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Roy M Salgado
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
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19
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Faghy MA, Shei R, Armstrong NCD, White M, Lomax M. Physiological impact of load carriage exercise: Current understanding and future research directions. Physiol Rep 2022; 10:e15502. [PMID: 36324291 PMCID: PMC9630762 DOI: 10.14814/phy2.15502] [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] [Received: 05/21/2022] [Revised: 09/18/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Load carriage (LC) refers to the use of personal protective equipment (PPE) and/or load-bearing apparatus that is mostly worn over the thoracic cavity. A commonplace task across various physically demanding occupational groups, the mass being carried during LC duties can approach the wearer's body mass. When compared to unloaded exercise, LC imposes additional physiological stress that negatively impacts the respiratory system by restricting chest wall movement and altering ventilatory mechanics as well as circulatory responses. Consequently, LC activities accelerate the development of fatigue in the respiratory muscles and reduce exercise performance in occupational tasks. Therefore, understanding the implications of LC and the effects specific factors have on physiological capacities during LC activity are important to the implementation of effective mitigation strategies to ameliorate the detrimental effects of thoracic LC. Accordingly, this review highlights the current physiological understanding of LC activities and outlines the knowledge and efficacy of current interventions and research that have attempted to improve LC performance, whilst also highlighting pertinent knowledge gaps that must be explored via future research activities.
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Affiliation(s)
- Mark A. Faghy
- Biomedical Research Theme, School of Human SciencesUniversity of DerbyDerbyUK
| | - Ren‐Jay Shei
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Nicola C. D. Armstrong
- Defence Science and Technology LaboratorySalisburyUK
- Extreme Environments Laboratory, School of Sport, Health and Exercise ScienceUniversity of PortsmouthPortsmouthUK
| | - Mark White
- Rocky Mountain University of Health ProfessionsProvoUtahUSA
| | - Mitch Lomax
- Extreme Environments Laboratory, School of Sport, Health and Exercise ScienceUniversity of PortsmouthPortsmouthUK
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20
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MOLGAT-SEON YANNICK, DOMINELLI PAOLOB, PETERS CARLIM, KIPP SHALAYA, WELCH JOSEPHF, PARMAR HANNAR, RABBANI TIAN, MANN LEAHM, GRIFT GRACIEO, GUENETTE JORDANA, SHEEL AWILLIAM. Predictors of Expiratory Flow Limitation during Exercise in Healthy Males and Females. Med Sci Sports Exerc 2022; 54:1428-1436. [DOI: 10.1249/mss.0000000000002938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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21
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Ishii N, Tomita K, Kawamura K, Setaka Y, Yoshida R, Takeshima R. Effects of breathing control using visual feedback of thoracoabdominal movement on aerobic exercise. Respir Physiol Neurobiol 2022; 301:103887. [PMID: 35318123 DOI: 10.1016/j.resp.2022.103887] [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] [Received: 11/21/2021] [Revised: 02/19/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To clarify whether voluntary respiratory movement control strategy is sustainable during exercise and to determine its effect on aerobic exercise. MATERIAL AND METHODS Ten healthy men were enrolled in this study. We developed a device that can convert information on thoracoabdominal changes from an inductance plethysmograph and display the Konno-Mead diagram on the monitor in real time for each breath. On the first day, an incremental load test (ILT) was performed under two conditions. On the second day, a constant load test (CLT) was performed under two conditions using the load 1 min before the anaerobic threshold (AT). RESULTS In the ILT, a significant prolongation of AT time was observed with voluntary respiratory movement control. In the CLT, carbon dioxide excretion showed no significant interaction, but the gas exchange ratio did. CONCLUSION Voluntary respiratory movement control using a combination of chest band and visual feedback of thoracoabdominal movements may be a respiratory strategy to enhance aerobic exercise.
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Affiliation(s)
- Nobuhisa Ishii
- Department of Rehabilitation, Ibaraki Prefectural Central Hospital, 6528 koibuchi, Kasama-city, Ibaraki 309-1793, Japan; Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
| | - Kazuhide Tomita
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan; Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
| | - Kenta Kawamura
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
| | - Yukako Setaka
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
| | - Ryo Yoshida
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
| | - Reiko Takeshima
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Inashiki District, Ibaraki 300-0394, Japan.
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22
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Bhammar DM, Balmain BN, Babb TG, Bernhardt V. Sex differences in the ventilatory responses to exercise in mild-moderate obesity. Exp Physiol 2022; 107:965-977. [PMID: 35771362 PMCID: PMC9357174 DOI: 10.1113/ep090309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of the study? What are the sex differences in ventilatory responses during exercise in adults with obesity. What is the main finding and its importance? Tidal volume and expiratory flows are lower in females when compared with males at higher levels of ventilation despite small increases in end-expiratory lung volumes. Since dyspnea on exertion is a frequent complaint, particularly in females with obesity, careful attention should be paid to unpleasant respiratory symptoms and mechanical ventilatory constraints before prescribing exercise. ABSTRACT Obesity is associated with altered ventilatory responses, which may be exacerbated in females due to the functional consequences of sex-related morphological differences in the respiratory system. This study examined sex differences in ventilatory responses during exercise in adults with obesity. Healthy adults with obesity (n = 73; 48 females) underwent pulmonary function testing, underwater weighing, magnetic resonance imaging, a graded exercise test to exhaustion, and two constant work rate exercise tests; one at a fixed work rate (60W for females and 105W for males) and one at a relative intensity (50% of peak oxygen uptake, V̇O2peak ). Metabolic, respiratory, and perceptual responses were assessed during exercise. Compared with males, females used a smaller proportion of their ventilatory capacity at peak exercise (69.13 ± 14.49 vs. 77.41 ± 17.06 % maximum voluntary ventilation, P = 0.0374). Females also utilized a smaller proportion of their forced vital capacity (FVC) at peak exercise (tidal volume: 48.51±9.29 vs. 54.12±10.43 %FVC, P = 0.0218). End-expiratory lung volumes were 2-4% higher in females compared with males during exercise (P<0.05), while end-inspiratory lung volumes were similar. Since the males were initiating inspiration from a lower lung volume, they experienced greater expiratory flow limitation during exercise. Ratings of perceived breathlessness during exercise were similar between females and males at comparable levels of ventilation. In summary, sex differences in the manifestations of obestity-related mechanical ventilatory constraints were observed. Since dyspnea on exertion is a common complaint in patients with obesity, particularly in females, exercise prescriptions should be tailored with the goal of minimizing unpleasant respiratory sensations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dharini M Bhammar
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA.,Center for Tobacco Research, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Bryce N Balmain
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA
| | - Vipa Bernhardt
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA.,Department of Health & Human Performance, Texas A&M University - Commerce, Commerce, TX, USA
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23
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O'Bryan SM, Connor KR, Drummer DJ, Lavin KM, Bamman MM. Considerations for Sex-Cognizant Research in Exercise Biology and Medicine. Front Sports Act Living 2022; 4:903992. [PMID: 35721874 PMCID: PMC9204149 DOI: 10.3389/fspor.2022.903992] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 12/15/2022] Open
Abstract
As the fields of kinesiology, exercise science, and human movement developed, the majority of the research focused on male physiology and extrapolated findings to females. In the medical sphere, basing practice on data developed in only males resulted in the removal of drugs from the market in the late 1990s due to severe side effects (some life-threatening) in females that were not observed in males. In response to substantial evidence demonstrating exercise-induced health benefits, exercise is often promoted as a key modality in disease prevention, management, and rehabilitation. However, much like the early days of drug development, a historical literature knowledge base of predominantly male studies may leave the exercise field vulnerable to overlooking potentially key biological differences in males and females that may be important to consider in prescribing exercise (e.g., how exercise responses may differ between sexes and whether there are optimal approaches to consider for females that differ from conventional approaches that are based on male physiology). Thus, this review will discuss anatomical, physiological, and skeletal muscle molecular differences that may contribute to sex differences in exercise responses, as well as clinical considerations based on this knowledge in athletic and general populations over the continuum of age. Finally, this review summarizes the current gaps in knowledge, highlights the areas ripe for future research, and considerations for sex-cognizant research in exercise fields.
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Affiliation(s)
- Samia M. O'Bryan
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kathleen R. Connor
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Devin J. Drummer
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kaleen M. Lavin
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
| | - Marcas M. Bamman
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
- *Correspondence: Marcas M. Bamman
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24
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Cao Y, Fujii N, Fujimoto T, Lai YF, Ogawa T, Hiroyama T, Enomoto Y, Nishiyasu T. CO 2-Enriched Air Inhalation Modulates the Ventilatory and Metabolic Responses of Endurance Runners During Incremental Running in Hypobaric Hypoxia. High Alt Med Biol 2022; 23:125-134. [PMID: 35613387 DOI: 10.1089/ham.2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cao, Yinhang, Naoto Fujii, Tomomi Fujimoto, Yin-Feng Lai, Takeshi Ogawa, Tsutomu Hiroyama, Yasushi Enomoto, and Takeshi Nishiyasu. CO2-enriched air inhalation modulates the ventilatory and metabolic responses of endurance runners during incremental running in hypobaric hypoxia. High Alt Med Biol. 23:125-134, 2022. Aim: We measured the effects of breathing CO2-enriched air on ventilatory and metabolic responses during incremental running exercise under moderately hypobairc hypoxic (HH) conditions. Materials and Methods: Ten young male endurance runners [61.4 ± 6.0 ml/(min·kg)] performed incremental running tests under three conditions: (1) normobaric normoxia (NN), (2) HH (2,500 m), and (3) HH with 5% CO2 inhalation (HH+CO2). The test under NN was always performed first, and then, the two remaining tests were completed in random and counterbalanced order. Results: End-tidal CO2 partial pressure (55 ± 3 vs. 35 ± 1 mmHg), peak ventilation (163 ± 14 vs. 152 ± 12 l/min), and peak oxygen uptake [52.3 ± 5.5 vs. 50.5 ± 4.9 ml/(min·kg)] were all higher in the HH+CO2 than HH trial (all p < 0.01), respectively. However, the duration of the incremental test did not differ between HH+CO2 and HH trials. Conclusion: These data suggest that chemoreflex activation by breathing CO2-enriched air stimulates breathing and aerobic metabolism during maximal intensity exercise without affecting exercise performance in male endurance runners under a moderately hypobaric hypoxic environment.
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Affiliation(s)
- Yinhang Cao
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China.,Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Tomomi Fujimoto
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan.,Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Yin-Feng Lai
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Takeshi Ogawa
- Division of Art, Music, and Physical Education, Osaka Kyoiku University, Osaka, Japan
| | - Tsutomu Hiroyama
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Yasushi Enomoto
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
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Dominelli PB, Molgat-Seon Y. Sex, gender and the pulmonary physiology of exercise. Eur Respir Rev 2022; 31:31/163/210074. [PMID: 35022254 PMCID: PMC9488949 DOI: 10.1183/16000617.0074-2021] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/09/2021] [Indexed: 01/11/2023] Open
Abstract
In this review, we detail how the pulmonary system's response to exercise is impacted by both sex and gender in healthy humans across the lifespan. First, the rationale for why sex and gender differences should be considered is explored, and then anatomical differences are highlighted, namely that females typically have smaller lungs and airways than males. Thereafter, we describe how these anatomical differences can impact functional aspects such as respiratory muscle energetics and activation, mechanical ventilatory constraints, diaphragm fatigue, and pulmonary gas exchange in healthy adults and children. Finally, we detail how gender can impact the pulmonary response to exercise. Biological sex can influence the pulmonary response to exercise in healthy individuals across the lifespanhttps://bit.ly/3ejMDrv
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Affiliation(s)
| | - Yannick Molgat-Seon
- Dept of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB, Canada.,Centre for Heart and Lung Innovation, Providence Health Care Research Institute, St Paul's Hospital, Vancouver, BC, Canada
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Contreras-Briceño F, Espinosa-Ramirez M, Keim-Bagnara V, Carreño-Román M, Rodríguez-Villagra R, Villegas-Belmar F, Viscor G, Gabrielli L, Andía ME, Araneda OF, Hurtado DE. Determination of the Respiratory Compensation Point by Detecting Changes in Intercostal Muscles Oxygenation by Using Near-Infrared Spectroscopy. Life (Basel) 2022; 12:life12030444. [PMID: 35330195 PMCID: PMC8954259 DOI: 10.3390/life12030444] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to evaluate if the changes in oxygen saturation levels at intercostal muscles (SmO2-m.intercostales) assessed by near-infrared spectroscopy (NIRS) using a wearable device could determine the respiratory compensation point (RCP) during exercise. Fifteen healthy competitive triathletes (eight males; 29 ± 6 years; height 167.6 ± 25.6 cm; weight 69.2 ± 9.4 kg; V˙O2-máx 58.4 ± 8.1 mL·kg−1·min−1) were evaluated in a cycle ergometer during the maximal oxygen-uptake test (V˙O2-máx), while lung ventilation (V˙E), power output (watts, W) and SmO2-m.intercostales were measured. RCP was determined by visual method (RCPvisual: changes at ventilatory equivalents (V˙E·V˙CO2−1, V˙E·V˙O2−1) and end-tidal respiratory pressure (PetO2, PetCO2) and NIRS method (RCPNIRS: breakpoint of fall in SmO2-m.intercostales). During exercise, SmO2-m.intercostales decreased continuously showing a higher decrease when V˙E increased abruptly. A good agreement between methods used to determine RCP was found (visual vs NIRS) at %V˙O2-máx, V˙O2, V˙E, and W (Bland-Altman test). Correlations were found to each parameters analyzed (r = 0.854; r = 0.865; r = 0.981; and r = 0,968; respectively. p < 0.001 in all variables, Pearson test), with no differences (p < 0.001 in all variables, Student’s t-test) between methods used (RCPvisual and RCPNIRS). We concluded that changes at SmO2-m.intercostales measured by NIRS could adequately determine RCP in triathletes.
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Affiliation(s)
- Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Facultad de Medicina, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
- Correspondence: ; Tel.: +56-22-3541512
| | - Maximiliano Espinosa-Ramirez
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Vicente Keim-Bagnara
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Matías Carreño-Román
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Rafael Rodríguez-Villagra
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Fernanda Villegas-Belmar
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
| | - Luigi Gabrielli
- Laboratory of Exercise Physiology, Department of Health Science, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile; (M.E.-R.); (V.K.-B.); (M.C.-R.); (R.R.-V.); (F.V.-B.); (L.G.)
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Facultad de Medicina, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
| | - Marcelo E. Andía
- Biomedical Imaging Center, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Oscar F. Araneda
- Laboratory of Integrative Physiology of Biomechanics and Physiology of Effort (LIBFE), Kinesiology School, Faculty of Medicine, Universidad de los Andes, Santiago 7620001, Chile;
| | - Daniel E. Hurtado
- Department of Structural and Geotechnical Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
- Schools of Engineering, Medicine and Biological Sciences, Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
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Commentaries on Viewpoint: Consider iron status when making sex comparisons in human physiology. J Appl Physiol (1985) 2022; 132:703-709. [PMID: 35274549 DOI: 10.1152/japplphysiol.00016.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shei RJ, Paris HL, Sogard AS, Mickleborough TD. Time to Move Beyond a "One-Size Fits All" Approach to Inspiratory Muscle Training. Front Physiol 2022; 12:766346. [PMID: 35082689 PMCID: PMC8784843 DOI: 10.3389/fphys.2021.766346] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual's training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.
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Affiliation(s)
- Ren-Jay Shei
- Global Medical Department, Mallinckrodt Pharmaceuticals Company, Hampton, NJ, United States
| | - Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, United States
| | - Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
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Travers G, Kippelen P, Trangmar SJ, González-Alonso J. Physiological Function during Exercise and Environmental Stress in Humans-An Integrative View of Body Systems and Homeostasis. Cells 2022; 11:383. [PMID: 35159193 PMCID: PMC8833916 DOI: 10.3390/cells11030383] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/26/2022] Open
Abstract
Claude Bernard's milieu intérieur (internal environment) and the associated concept of homeostasis are fundamental to the understanding of the physiological responses to exercise and environmental stress. Maintenance of cellular homeostasis is thought to happen during exercise through the precise matching of cellular energetic demand and supply, and the production and clearance of metabolic by-products. The mind-boggling number of molecular and cellular pathways and the host of tissues and organ systems involved in the processes sustaining locomotion, however, necessitate an integrative examination of the body's physiological systems. This integrative approach can be used to identify whether function and cellular homeostasis are maintained or compromised during exercise. In this review, we discuss the responses of the human brain, the lungs, the heart, and the skeletal muscles to the varying physiological demands of exercise and environmental stress. Multiple alterations in physiological function and differential homeostatic adjustments occur when people undertake strenuous exercise with and without thermal stress. These adjustments can include: hyperthermia; hyperventilation; cardiovascular strain with restrictions in brain, muscle, skin and visceral organs blood flow; greater reliance on muscle glycogen and cellular metabolism; alterations in neural activity; and, in some conditions, compromised muscle metabolism and aerobic capacity. Oxygen supply to the human brain is also blunted during intense exercise, but global cerebral metabolism and central neural drive are preserved or enhanced. In contrast to the strain seen during severe exercise and environmental stress, a steady state is maintained when humans exercise at intensities and in environmental conditions that require a small fraction of the functional capacity. The impact of exercise and environmental stress upon whole-body functions and homeostasis therefore depends on the functional needs and differs across organ systems.
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Affiliation(s)
- Gavin Travers
- The European Astronaut Centre, The European Space Agency, Linder Höhe, 51147 Cologne, Germany;
| | - Pascale Kippelen
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge UB8 3PH, UK;
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
| | - Steven J. Trangmar
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK;
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge UB8 3PH, UK;
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
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Webb KL, Dominelli PB, Baker SE, Klassen SA, Joyner MJ, Senefeld JW, Wiggins CC. Influence of High Hemoglobin-Oxygen Affinity on Humans During Hypoxia. Front Physiol 2022; 12:763933. [PMID: 35095551 PMCID: PMC8795792 DOI: 10.3389/fphys.2021.763933] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/22/2021] [Indexed: 01/11/2023] Open
Abstract
Humans elicit a robust series of physiological responses to maintain adequate oxygen delivery during hypoxia, including a transient reduction in hemoglobin-oxygen (Hb-O2) affinity. However, high Hb-O2 affinity has been identified as a beneficial adaptation in several species that have been exposed to high altitude for generations. The observed differences in Hb-O2 affinity between humans and species adapted to high altitude pose a central question: is higher or lower Hb-O2 affinity in humans more advantageous when O2 availability is limited? Humans with genetic mutations in hemoglobin structure resulting in high Hb-O2 affinity have shown attenuated cardiorespiratory adjustments during hypoxia both at rest and during exercise, providing unique insight into this central question. Therefore, the purpose of this review is to examine the influence of high Hb-O2 affinity during hypoxia through comparison of cardiovascular and respiratory adjustments elicited by humans with high Hb-O2 affinity compared to those with normal Hb-O2 affinity.
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Affiliation(s)
- Kevin L. Webb
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stephen A. Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Chad C. Wiggins,
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Tantisattamo E, Imhof C, Jager KJ, Hilbrands LB, Guidotti R, Islam M, Katicic D, Konings C, Molenaar FM, Nistor I, Noordzij M, Rodríguez Ferrero ML, Verhoeven MAM, de Vries APJ, Kalantar-Zadeh K, Gansevoort RT, Vart P. OUP accepted manuscript. Clin Kidney J 2022; 15:1348-1360. [PMID: 35747092 PMCID: PMC8992331 DOI: 10.1093/ckj/sfac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background In the general population with coronavirus disease 2019 (COVID-19), obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney transplant with COVID-19. Methods Data from the European Renal Association COVID-19 Database (ERACODA) were used. KFRT patients diagnosed with COVID-19 between 1 February 2020 and 31 January 2021 were included. The association of Quetelet's body mass index (BMI) (kg/m2), divided into: <18.5 (lean), 18.5–24.9 (normal weight), 25–29.9 (overweight), 30–34.9 (obese I) and ≥35 (obese II/III), with 3-month mortality was investigated using Cox proportional-hazards regression analyses. Results In 3160 patients on KFRT (mean age: 65 years, male: 61%), 99 patients were lean, 1151 normal weight (reference), 1160 overweight, 525 obese I and 225 obese II/III. During follow-up of 3 months, 28, 20, 21, 23 and 27% of patients died in these categories, respectively. In the fully adjusted model, the hazard ratios (HRs) for 3-month mortality were 1.65 [95% confidence interval (CI): 1.10, 2.47], 1 (ref.), 1.07 (95% CI: 0.89, 1.28), 1.17 (95% CI: 0.93, 1.46) and 1.71 (95% CI: 1.27, 2.30), respectively. Results were similar among dialysis patients (N = 2343) and among those living with a kidney transplant (N = 817) (Pinteraction = 0.99), but differed by sex (Pinteraction = 0.019). In males, the HRs for the association of aforementioned BMI categories with 3-month mortality were 2.07 (95% CI: 1.22, 3.52), 1 (ref.), 0.97 (95% CI: 0.78. 1.21), 0.99 (95% CI: 0.74, 1.33) and 1.22 (95% CI: 0.78, 1.91), respectively, and in females corresponding HRs were 1.34 (95% CI: 0.70, 2.57), 1 (ref.), 1.31 (95% CI: 0.94, 1.85), 1.54 (95% CI: 1.05, 2.26) and 2.49 (95% CI: 1.62, 3.84), respectively. Conclusion In KFRT patients with COVID-19, on dialysis or a kidney transplant, obesity is associated with an increased risk of mortality at 3 months. This is in contrast to the obesity paradox generally observed in dialysis patients. Additional studies are required to corroborate the sex difference in the association of obesity with mortality.
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Affiliation(s)
| | | | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca Guidotti
- Institute of Nephrology, City Hospital Waid and Triemli, Zurich, Switzerland
| | - Mahmud Islam
- Zonguldak Ataturk state hospital, Zonguldak, Turkey
| | - Dajana Katicic
- Croatian Society of Nephrology, Dialysis and Transplantation, Croatia
| | | | | | - Ionut Nistor
- Faculty of Medicine, University of Medicine and Pharmacy, Grigore T.Popa, Iași, Romania
| | - Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Peters CM, Leahy MG, Hohert G, Lane P, Lam S, Sin DD, McKenzie DC, Sheel AW. Airway luminal area and the resistive work of breathing during exercise in healthy young females and males. J Appl Physiol (1985) 2021; 131:1750-1761. [PMID: 34709072 DOI: 10.1152/japplphysiol.00418.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
We examined the relationship between the work of breathing (Wb) during exercise and in vivo measures of airway size in healthy females and males. We hypothesized that sex differences in airway luminal area would explain the larger resistive Wb during exercise in females. Healthy participants (n = 11 females and n = 11 males; 19-30 yr) completed a cycle exercise test to exhaustion where Wb was assessed using an esophageal balloon catheter. On a separate day, each participant underwent a bronchoscopy procedure for optical coherence tomography measures of seven airways. In vivo measures of luminal area were made for the fourth to eighth airway generations. A composite index of airway size was calculated as the sum of the luminal area for each generation, and the total area was calculated based on Weibel's model. We found that index of airway size (males: 37.4 ± 6.3 mm2 vs. females: 27.5 ± 7.4 mm2) and airway area calculated based on Weibel's model (males: 2,274 ± 557 mm2 vs. females: 1,594 ± 389 mm2) were significantly larger in males (both P = 0.003). When minute ventilation was greater than ∼60 L·min-1, the resistive Wb was higher in females. At the highest equivalent flow achieved by all subjects, resistance to inspired flow was larger in females and significantly associated with two measures of airway size in all subjects: index of airway size (r = 0.524, P = 0.012) and Weibel area (r = 0.525, P = 0.012). Our findings suggest that innate sex differences in luminal area result in a greater resistive Wb during exercise in females compared with males.NEW & NOTEWORTHY We hypothesized that the higher resistive work of breathing in females compared with males during high-intensity exercise is due to smaller airways. In vivo measures of the fourth to eighth airway generations made using optical coherence tomography show that females tend to have smaller airway luminal areas of the fourth to sixth airway generations. Sex differences in airway luminal area result in a greater resistive work of breathing during exercise in females compared with males.
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Affiliation(s)
- Carli M Peters
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Geoffrey Hohert
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Pierre Lane
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Stephen Lam
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada.,Department of Medicine (Respirology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald C McKenzie
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew William Sheel
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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Martinez-Navarro I, Collado E, Hernando B, Hernando C. Pulmonary and Inspiratory Muscle Function Response to a Mountain Ultramarathon. J Sports Sci Med 2021; 20:706-713. [PMID: 35321133 PMCID: PMC8488829 DOI: 10.52082/jssm.2021.706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/18/2021] [Indexed: 06/14/2023]
Abstract
The study aimed to provide within-race data on the time course of pulmonary function during a mountain ultramarathon (MUM). Additionally, we wanted to assess possible sex differences regarding pre- to post-race change in pulmonary and inspiratory muscle function. Lastly, we were interested in evaluating whether changes in respiratory function were associated with relative running speed and due to general or specific fatigue. 47 athletes (29 males and 18 females; 41 ± 5 years) were submitted to a cardiopulmonary exercise test (CPET) before a 107-km MUM. Spirometric variables: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF); maximal inspiratory pressure (MIP); squat jump (SJ) and handgrip strength (HG) were assessed before and after the race. Additionally PEF was measured at three aid stations (33rd, 66th and 84th km) during the race. PEF declined from the 33rd to the 66th km (p = 0.004; d = 0.72) and from the 84th km to the finish line (p = 0.003; d = 0.90), while relative running speed dropped from the first (0-33 km) to the second (33-66 km) race section (p < 0.001; d = 1.81) and from the third (66-84 km) to the last race section (p < 0.001; d = 1.61). Post-race, a moderate reduction was noted in FVC (-13%; p < 0.001; d = 0.52), FEV1 (-19.5%; p < 0.001; d = 0.65), FEV1/FVC (-8.4%; p = 0.030; d = 0.59), PEF (-20.3%; p < 0.001; d = 0.58), MIP (-25.3%; p < 0.001; d = 0.79) and SJ (-31.6%; p < 0.001; d = 1.42). Conversely, HG did not change from pre- to post-race (-1.4%; p = 0.56; d = 0.05). PEF declined during the race in parallel with running speed drop. No sex differences were noted regarding post-race respiratory function, except that FEV1/FVC decay was significantly greater among women. The magnitude of pre- to post-race respiratory function decline was uncorrelated with relative running speed.
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Affiliation(s)
- Ignacio Martinez-Navarro
- Physical Education and Sports Department, University of Valencia, Valencia, Spain
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain
| | - Eladio Collado
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | | | - Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
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Predictors of outcome in patients with myasthenic crisis undergoing non-invasive mechanical ventilation: A retrospective 20 year longitudinal cohort study from a single Italian center. Neuromuscul Disord 2021; 31:1241-1250. [PMID: 34782245 DOI: 10.1016/j.nmd.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/05/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022]
Abstract
About 20% of patients with myasthenia gravis (MG) may develop myasthenic crisis (MC) requiring ventilation, either invasive (MV) or non-invasive (NIV) and intensive unit care (ICU). NIV failure in patients with MC can occur up to 60% of cases admitted to ICU. Moreover it is not known the outcome of MC receiving NIV. Purpose of this study was to identify predictors of outcome in MC who underwent non-invasive ventilator support outside ICU setting. We enrolled 90 patients, 53 females and 37 males admitted to University Hospital of Modena (Italy) between January 2000 and September 2020. Median age at MC was 65 years. Thirty-four patients (37.8%) required MV. Thymectomy was performed in 45 cases, associated with thymoma in 55%, with hyperplastic thymus in 33%. First-line treatment was plasmaexchange (38.8%) or intravenous immunoglobulins (45.6%). Males exhibited higher risk of MV than females .Patients in MV were treated with plasmaexchange as first-line therapy . Our in-hospital mortality rate was low. Nine patients underwent tracheostomy which was significantly related to male gender. Comorbidities had significant effect on length of ICU .Our study confirms as predictors of prognosis in our patients male gender, older age at onset, infections as trigger, pneumonia.
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Ishii N, Tomita K, Takeshima R, Kawamura K, Setaka Y, Yoshida R, Imura S. Effects of visual feedback of thoracoabdominal motion on oxygen consumption during hyperventilation - Pilot study. J Bodyw Mov Ther 2021; 28:317-322. [PMID: 34776158 DOI: 10.1016/j.jbmt.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/26/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Respiratory muscle oxygen consumption increases with the work of breathing. We hypothesized that reducing excessive respiratory muscle activity during exercise may improve exercise tolerance. METHOD We developed a device to provide real-time visual feedback of thoracoabdominal movement and used it to examine the influence of visual feedback of thoracoabdominal movement during diaphragmatic breathing on oxygen consumption in eight healthy men. While sitting on a wheelchair with the backrest reclined at 60°, oxygen consumption per body weight (VO2/BW), minute ventilation (VE), tidal volume (VT), and breathing frequency (fR) were measured, breath-by-breath, using an expired-gas analyzer. The breathing pattern was analyzed by inductance plethysmography, with transducer bands over the chest and abdomen recording thoracoabdominal movements. RESULTS There was no significant difference in RatioTH-ABD and the ventilatory parameters between diaphragmatic breathing and diaphragmatic breathing with visual feedback. The average VO2/BW during diaphragmatic breathing with visual feedback was 0.6 ml/kg lower than that during diaphragmatic breathing without visual feedback (p<0.05). CONCLUSION When visual feedback was used during diaphragmatic breathing, the RatioTH-ABD remained essentially unchanged, but VO2/BW decreased significantly. This suggests that visual feedback of thoracoabdominal movement during diaphragmatic breathing may reduce respiratory muscle oxygen consumption.
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Affiliation(s)
- Nobuhisa Ishii
- Department of Rehabilitation, Ibaraki Prefectural Central Hospital, Kasama-city, Ibaraki, Japan; Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Kazuhide Tomita
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan; Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan.
| | - Reiko Takeshima
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Kenta Kawamura
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Yukako Setaka
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Ryo Yoshida
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Shigeyuki Imura
- Master Course of Science in Physical Therapy, Takasaki University of Health and Welfare Graduate School of Health Care, Takasaki-city, Gunma, Japan
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Espinosa-Ramírez M, Moya-Gallardo E, Araya-Román F, Riquelme-Sánchez S, Rodriguez-García G, Reid WD, Viscor G, Araneda OF, Gabrielli L, Contreras-Briceño F. Sex-Differences in the Oxygenation Levels of Intercostal and Vastus Lateralis Muscles During Incremental Exercise. Front Physiol 2021; 12:738063. [PMID: 34658921 PMCID: PMC8517227 DOI: 10.3389/fphys.2021.738063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023] Open
Abstract
This study aimed to examine sex differences in oxygen saturation in respiratory (SmO2-m.intercostales) and locomotor muscles (SmO2-m.vastus lateralis) while performing physical exercise. Twenty-five (12 women) healthy and physically active participants were evaluated during an incremental test with a cycle ergometer, while ventilatory variables [lung ventilation ( V . E), tidal volume (Vt), and respiratory rate (RR)] were acquired through the breath-by-breath method. SmO2 was acquired using the MOXY® devices on the m.intercostales and m.vastus lateralis. A two-way ANOVA (sex × time) indicated that women showed a greater significant decrease of SmO2-m.intercostales, and men showed a greater significant decrease of SmO2-m.vastus lateralis. Additionally, women reached a higher level of ΔSmO2-m.intercostales normalized to V . E (L⋅min-1) (p < 0.001), whereas men had a higher level of ΔSmO2-m.vastus lateralis normalized to peak workload-to-weight (watts⋅kg-1, PtW) (p = 0.049), as confirmed by Student's t-test. During an incremental physical exercise, women experienced a greater cost of breathing, reflected by greater deoxygenation of the respiratory muscles, whereas men had a higher peripheral load, indicated by greater deoxygenation of the locomotor muscles.
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Affiliation(s)
- Maximiliano Espinosa-Ramírez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Moya-Gallardo
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Araya-Román
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Santiago Riquelme-Sánchez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Guido Rodriguez-García
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - W Darlene Reid
- Physical Therapy, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Oscar F Araneda
- Laboratory of Integrative Physiology of Biomechanics and Physiology of Effort (LIBFE), Faculty of Medicine, Kinesiology School, Universidad de los Andes, Santiago, Chile
| | - Luigi Gabrielli
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Division of Cardiovascular Diseases, Faculty of Medicine, Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.,Division of Cardiovascular Diseases, Faculty of Medicine, Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
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Evaluation of sex-based differences in airway size and the physiological implications. Eur J Appl Physiol 2021; 121:2957-2966. [PMID: 34331574 DOI: 10.1007/s00421-021-04778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Recent evidence suggests healthy females have significantly smaller central conducting airways than males when matched for either height or lung volume during analysis. This anatomical sex-based difference could impact the integrative response to exercise. Our review critically evaluates the literature on direct and indirect techniques to measure central conducting airway size and their limitations. We present multiple sources highlighting the difference between male and female central conducting airway size in both pediatric and adult populations. Following the discussion of measurement techniques and results, we discuss the functional implications of these differences in central conducting airway size, including work of breathing, oxygen cost of breathing, and how these impacts will continue into elderly populations. We then discuss a range of topics for the future direction of airway differences and the benefits they could provide to both healthy and diseased populations. Specially, these sex-differences in central conducting airway size could result in different aerosol deposition or how lung disease manifests. Finally, we detail emerging techniques that uniquely allow for high-resolution imaging to be paired with detailed physiological measures.
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Johnson MA, Sharpe GR, Needham RS, Williams NC. Effects of Prior Voluntary Hyperventilation on the 3-min All-Out Cycling Test in Men. Med Sci Sports Exerc 2021; 53:1482-1494. [PMID: 33481485 DOI: 10.1249/mss.0000000000002608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The ergogenic effects of respiratory alkalosis induced by prior voluntary hyperventilation (VH) are controversial. This study examined the effects of prior VH on derived parameters from the 3-min all-out cycling test (3MT). METHODS Eleven men ( = 46 ± 8 mL·kg-1·min-1) performed a 3MT preceded by 15 min of rest (CONT) or VH ( = 38 ± 5 L·min-1) with PETCO2 reduced to 21 ± 1 mm Hg (HYP). End-test power (EP; synonymous with critical power) was calculated as the mean power output over the last 30 s of the 3MT, and the work done above EP (WEP; synonymous with W') was calculated as the power-time integral above EP. RESULTS At the start of the 3MT, capillary blood PCO2 and [H+] were lower in HYP (25.2 ± 3.0 mm Hg, 27.1 ± 2.6 nmol·L-1) than CONT (43.2 ± 2.0 mm Hg, 40.0 ± 1.5 nmol·L-1) (P < 0.001). At the end of the 3MT, blood PCO2 was still lower in HYP (35.7 ± 5.4 mm Hg) than CONT (40.6 ± 5.0 mm Hg) (P < 0.001). WEP was 10% higher in HYP (19.4 ± 7.0 kJ) than CONT (17.6 ± 6.4 kJ) (P = 0.006), whereas EP was 5% lower in HYP (246 ± 69 W) than CONT (260 ± 74 W) (P = 0.007). The ΔWEP (J·kg-1) between CONT and HYP correlated positively with the PCO2 immediately before the 3MT in HYP (r = 0.77, P = 0.006). CONCLUSION These findings suggest that acid-base changes elicited by prior VH increase WEP but decrease EP during the all-out 3MT.
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Affiliation(s)
- Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UNITED KINGDOM
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Archiza B, Leahy MG, Kipp S, Sheel AW. An integrative approach to the pulmonary physiology of exercise: when does biological sex matter? Eur J Appl Physiol 2021; 121:2377-2391. [PMID: 33903937 DOI: 10.1007/s00421-021-04690-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
Historically, many studies investigating the pulmonary physiology of exercise (and biomedical research in general) were performed exclusively or predominantly with male research participants. This has led to an incomplete understanding of the pulmonary response to exercise. More recently, important sex-based differences with respect to the human respiratory system have been identified. The purpose of this review is to summarize current findings related to sex-based differences in the pulmonary physiology of exercise. To that end, we will discuss how morphological sex-based differences of the respiratory system affect the respiratory response to exercise. Moreover, we will discuss sex-based differences of the physiological integrative responses to exercise, and how all these differences can influence the regulation of breathing. We end with a brief discussion of pregnancy and menopause and the accompanying ventilatory changes observed during exercise.
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Affiliation(s)
- Bruno Archiza
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada.
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - Shalaya Kipp
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
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Umutlu G, Acar NE, Sinar DS, Akarsu G, Güven E, Yildirim İ. COVID-19 and physical activity in sedentary individuals: differences in metabolic, cardiovascular, and respiratory responses during aerobic exercise performed with and without a surgical face masks. J Sports Med Phys Fitness 2021; 62:851-858. [PMID: 33885256 DOI: 10.23736/s0022-4707.21.12313-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Coronavirus-19 (COVID-19) impairs metabolic, cardiovascular, and pulmonary functions in human metabolism, and wearing face masks is recommended for the prevention of contracting or exposing others to cardio-respiratory infections. Since the effect of wearing a surgical face mask (SFM) on cardiopulmonary exercise capacity has not been systematically reported we aimed to determine the effects of wearing SFM during an incremental walking test on metabolic, cardiovascular, and pulmonary gas exchange responses in sedentary individuals. METHODS The evaluations were performed using a repeated measures study design. Seven sedentary males (age:40years, height:178cm, weight:88kg, BMI:28kg/m2, VO2max:32.7±3.9ml/kg/min) and 7 sedentary female participants (age:34years, height:169cm, weight:62kg, BMI:22kg/m2, VO2max:32.1±6.8 ml/kg/min) volunteered to participate in the current study. Anthropometric parameters were measured using a Bioelectrical impedance analysis prior to each testing session. The measures of lung function assessed by spirometry, breathing pattern, maximal exercise capacity with-and-without mask were measured with a breath-by-breath automated exercise metabolic system during incremental Bruce protocol on a treadmill with two consecutive sessions with 48-h intervals. Blood pressure values (systolic and diastolic pressure) of the individuals were taken and recorded within 1 minute at the end of every ten minutes, without speed changes. RESULTS VO2, VCO2, and VE were significantly lower during exercise performed with SFM (p<0.001). Heart rate, systolic and diastolic blood pressure were also found significantly higher during exercise performed with SFM (p<0.01). CONCLUSIONS Wearing a SFM during incremental walking predispose a decrease in oxygen delivery while increasing pulmonary ventilation in sedentary individuals. Thus, it could be speculated that surgical face masks have a negative impact on oxygen delivery during exercise which results in decreased exercise performance due to the restricted ventilatory conditions.
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Affiliation(s)
- Gökhan Umutlu
- Institute of Education Sciences, Mersin University, Mersin, Turkey -
| | - Nasuh E Acar
- Faculty of Sports Sciences, Mersin University, Mersin, Turkey
| | - Derya S Sinar
- Institute of Education Sciences, Mersin University, Mersin, Turkey
| | - Gizem Akarsu
- Faculty of Sports Sciences, Mersin University, Mersin, Turkey
| | - Erkan Güven
- Faculty of Sports Sciences, Mersin University, Mersin, Turkey
| | - İrfan Yildirim
- Faculty of Sports Sciences, Mersin University, Mersin, Turkey
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Dominelli PB, Wiggins CC, Roy TK, Secomb TW, Curry TB, Joyner MJ. The Oxygen Cascade During Exercise in Health and Disease. Mayo Clin Proc 2021; 96:1017-1032. [PMID: 33714599 PMCID: PMC8026750 DOI: 10.1016/j.mayocp.2020.06.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/08/2020] [Accepted: 06/29/2020] [Indexed: 12/28/2022]
Abstract
The oxygen transport cascade describes the physiological steps that bring atmospheric oxygen into the body where it is delivered and consumed by metabolically active tissue. As such, the oxygen cascade is fundamental to our understanding of exercise in health and disease. Our narrative review will highlight each step of the oxygen transport cascade from inspiration of atmospheric oxygen down to mitochondrial consumption in both healthy active males and females along with clinical conditions. We will focus on how different steps interact along with principles of homeostasis, physiological redundancies, and adaptation. In particular, we highlight some of the parallels between elite athletes and clinical conditions in terms of the oxygen cascade.
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Affiliation(s)
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Tuhin K Roy
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Timothy W Secomb
- Departments of Physiology and Mathematics, University of Arizona, Tucson
| | - Timothy B Curry
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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Beltrami FG, Kurz J, Roos E, Spengler CM. Current limits for flowmeter resistance in metabolic carts can negatively affect exercise performance. Physiol Rep 2021; 9:e14814. [PMID: 33904647 PMCID: PMC8077138 DOI: 10.14814/phy2.14814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/30/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate whether a metabolic cart using a flowmeter in the upper range of accepted resistance to airflow (<1.5 cmH2 O∙L-1 ∙s-1 for flows up to 14 L∙s-1 , American Thoracic Society) negatively impacts exercise performance in healthy individuals. METHODS 16 recreationally active males (age 25 ± 1 years, height 180 ± 6 cm, weight 73.5 ± 5.8 kg, all mean ± SD) performed two incremental tests on a bicycle ergometer on each of two visits, using a metabolic cart with a flowmeter of either low (Oxycon Pro) or high (Innocor) airflow resistance. Mouth pressures, gas exchange, blood lactate concentration [La- ], perception of breathlessness, respiratory, and leg exertion were assessed throughout the tests. RESULTS Tests performed with the Innocor were significantly shorter (15.3 ± 3.2 vs. 15.8 ± 3.3 min, p < 0.0001) and showed higher maximal flow resistance (1.3 ± 0.2 vs. 0.3 ± 0.0 cmH2 O∙L-1 ∙s-1 , p < 0.0001). At end-exercise, peak oxygen consumption (-200 ± 220 ml.min-1 , p < 0.0001), minute ventilation (-19.9 ± 10.5 L.min-1 , p < 0.0001), breathing frequency (-5.4 ± 5.2 breaths.min-1 , p < 0.0001), heart rate (-2.1 ± 3.6 bpm, p = 0.002) and [La- ] (-0.7 ± 1.0 mmol.L-1 , p < 0.0001), but not tidal volume (-0.1 ± 0.2 L, p = 0.172) were lower with the Innocor, while the perception of breathlessness was higher (+3.8 ± 5.1 points, p < 0.0001). CONCLUSIONS Airflow resistance in the upper range of current guidelines can significantly affect exercise performance and respiratory pattern in young, healthy males during incremental exercise. The present results indicate the need to revisit guidelines for devices used in ergospirometry.
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Affiliation(s)
- Fernando G. Beltrami
- Exercise Physiology LabInstitute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
| | - Jérôme Kurz
- Exercise Physiology LabInstitute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
| | - Elena Roos
- Exercise Physiology LabInstitute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
| | - Christina M. Spengler
- Exercise Physiology LabInstitute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
- Zurich Center for Integrative Human Physiology (ZIHP)University of ZurichZurichSwitzerland
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43
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Gideon EA, Cross TJ, Coriell CL, Duke JW. The effect of estimating chest wall compliance on the work of breathing during exercise as determined via the modified Campbell diagram. Am J Physiol Regul Integr Comp Physiol 2021; 320:R268-R275. [PMID: 33356877 DOI: 10.1152/ajpregu.00263.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The modified Campbell diagram provides one of the most comprehensive assessments of the work of breathing (Wb) during exercise, wherein the resistive and elastic work of inspiration and expiration are quantified. Importantly, a necessary step in constructing the modified Campbell diagram is to obtain a value for chest wall compliance (CCW). To date, it remains unknown whether estimating or directly measuring CCW impacts the Wb, as determined by the modified Campbell diagram. Therefore, the purpose of this study was to evaluate whether the components of the Wb differ when the modified Campbell diagram is constructed using an estimated versus measured value of CCW. Forty-two participants (n = 26 men, 16 women) performed graded exercise to volitional exhaustion on a cycle ergometer. CCW was measured directly at rest via quasistatic relaxation. Estimated values of CCW were taken from prior literature. The measured value of CCW was greater than that obtained via estimation (214 ± 52 mL/cmH2O vs. 189 ± 18 mL/cmH2O; P < 0.05). At modest-to-high minute ventilations (i.e., 50-200 L/min), the inspiratory elastic Wb was greater and expiratory resistive Wb was lower, when modified Campbell diagrams were constructed using estimated compared with measured values of CCW (P = 0.001). These differences were however small and never exceeded ±5%. Thus, although our findings demonstrate that estimating CCW has a measurable impact on the determination of the Wb, its effect appears relatively small within a cohort of healthy adults during graded exercise.
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Affiliation(s)
- Elizbeth A Gideon
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Troy J Cross
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Catherine L Coriell
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | - Joseph W Duke
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona
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Hopkins SR, Dominelli PB, Davis CK, Guenette JA, Luks AM, Molgat-Seon Y, Sá RC, Sheel AW, Swenson ER, Stickland MK. Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease. Ann Am Thorac Soc 2021; 18:399-407. [PMID: 33196294 PMCID: PMC7919154 DOI: 10.1513/annalsats.202008-990cme] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
To minimize transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus responsible for coronavirus disease (COVID-19), the U.S. Centers for Disease Control and Prevention and the World Health Organization recommend wearing face masks in public. Some have expressed concern that these may affect the cardiopulmonary system by increasing the work of breathing, altering pulmonary gas exchange and increasing dyspnea, especially during physical activity. These concerns have been derived largely from studies evaluating devices intentionally designed to severely affect respiratory mechanics and gas exchange. We review the literature on the effects of various face masks and respirators on the respiratory system during physical activity using data from several models: cloth face coverings and surgical masks, N95 respirators, industrial respirators, and applied highly resistive or high-dead space respiratory loads. Overall, the available data suggest that although dyspnea may be increased and alter perceived effort with activity, the effects on work of breathing, blood gases, and other physiological parameters imposed by face masks during physical activity are small, often too small to be detected, even during very heavy exercise. There is no current evidence to support sex-based or age-based differences in the physiological responses to exercise while wearing a face mask. Although the available data suggest that negative effects of using cloth or surgical face masks during physical activity in healthy individuals are negligible and unlikely to impact exercise tolerance significantly, for some individuals with severe cardiopulmonary disease, any added resistance and/or minor changes in blood gases may evoke considerably more dyspnea and, thus, affect exercise capacity.
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Affiliation(s)
| | - Paolo B. Dominelli
- Department of Pediatrics, University of California, San Diego, California
| | | | - Jordan A. Guenette
- Centre for Heart Lung Innovation
- Department of Physical Therapy, Faculty of Medicine, and
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew M. Luks
- St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Yannick Molgat-Seon
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
| | | | - A. William Sheel
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Erik R. Swenson
- St. Paul’s Hospital, Vancouver, British Columbia, Canada
- Medical Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Michael K. Stickland
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; and
- G. F. MacDonald Centre for Lung Health (Covenant Health) and
- Medicine Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
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Hardy TA, Paula-Ribeiro M, Silva BM, Lyall GK, Birch KM, Ferguson C, Taylor BJ. The cardiovascular consequences of fatiguing expiratory muscle work in otherwise resting healthy humans. J Appl Physiol (1985) 2021; 130:421-434. [PMID: 33356985 DOI: 10.1152/japplphysiol.00116.2020] [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: 11/22/2022] Open
Abstract
In 11 healthy adults (25 ± 4 yr; 2 female, 9 male subjects), we investigated the effect of expiratory resistive loaded breathing [65% maximal expiratory mouth pressure (MEP), 15 breaths·min-1, duty cycle 0.5; ERLPm] on mean arterial pressure (MAP), leg vascular resistance (LVR), and leg blood flow ([Formula: see text]). On a separate day, a subset of five male subjects performed ERL targeting 65% of maximal expiratory gastric pressure (ERLPga). ERL-induced expiratory muscle fatigue was confirmed by a 17 ± 5% reduction in MEP (P < 0.05) and a 16 ± 12% reduction in the gastric twitch pressure response to magnetic nerve stimulation (P = 0.09) from before to after ERLPm and ERLPga, respectively. From rest to task failure in ERLPm and ERLPga, MAP increased (ERLPm = 31 ± 10 mmHg, ERLPga = 18 ± 9 mmHg, both P < 0.05), but group mean LVR and [Formula: see text] were unchanged (ERLPm: LVR = 0.78 ± 0.21 vs. 0.97 ± 0.36 mmHg·mL-1·min, [Formula: see text] = 133 ± 34 vs. 152 ± 74 mL·min-1; ERLPga: LVR = 0.70 ± 0.21 vs. 0.84 ± 0.33 mmHg·mL-1·min, [Formula: see text] = 160 ± 48 vs. 179 ± 110 mL·min-1) (all P ≥ 0.05). Interestingly, [Formula: see text] during ERLPga oscillated within each breath, increasing (∼66%) and decreasing (∼50%) relative to resting values during resisted expirations and unresisted inspirations, respectively. In conclusion, fatiguing expiratory muscle work did not affect group mean LVR or [Formula: see text] in otherwise resting humans. We speculate that any sympathetically mediated peripheral vasoconstriction was counteracted by transient mechanical effects of high intra-abdominal pressures during ERL.NEW & NOTEWORTHY Fatiguing expiratory muscle work in otherwise resting humans elicits an increase in sympathetic motor outflow; whether limb blood flow ([Formula: see text]) and leg vascular resistance (LVR) are affected remains unknown. We found that fatiguing expiratory resistive loaded breathing (ERL) did not affect group mean [Formula: see text] or LVR. However, within-breath oscillations in [Formula: see text] may reflect a sympathetically mediated vasoconstriction that was counteracted by transient increases in [Formula: see text] due to the mechanical effects of high intra-abdominal pressure during ERL.
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Affiliation(s)
- Tim A Hardy
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Marcelle Paula-Ribeiro
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Bruno M Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Gemma K Lyall
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Karen M Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Carrie Ferguson
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Bryan J Taylor
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
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Do Sex Differences in Physiology Confer a Female Advantage in Ultra-Endurance Sport? Sports Med 2021; 51:895-915. [PMID: 33502701 DOI: 10.1007/s40279-020-01417-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 01/09/2023]
Abstract
Ultra-endurance has been defined as any exercise bout that exceeds 6 h. A number of exceptional, record-breaking performances by female athletes in ultra-endurance sport have roused speculation that they might be predisposed to success in such events. Indeed, while the male-to-female performance gap in traditional endurance sport (e.g., marathon) remains at ~ 10%, the disparity in ultra-endurance competition has been reported as low as 4% despite the markedly lower number of female participants. Moreover, females generally outperform males in extreme-distance swimming. The issue is complex, however, with many sports-specific considerations and caveats. This review summarizes the sex-based differences in physiological functions and draws attention to those which likely determine success in extreme exercise endeavors. The aim is to provide a balanced discussion of the female versus male predisposition to ultra-endurance sport. Herein, we discuss sex-based differences in muscle morphology and fatigability, respiratory-neuromechanical function, substrate utilization, oxygen utilization, gastrointestinal structure and function, and hormonal control. The literature indicates that while females exhibit numerous phenotypes that would be expected to confer an advantage in ultra-endurance competition (e.g., greater fatigue resistance, greater substrate efficiency, and lower energetic demands), they also exhibit several characteristics that unequivocally impinge on performance (e.g., lower O2-carrying capacity, increased prevalence of GI distress, and sex-hormone effects on cellular function/injury risk). Crucially, the advantageous traits may only manifest as ergogenic in the extreme endurance events which, paradoxically, are those that females less often contest. The title question should be revisited in the coming years, when/if the number of female participants increases.
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Shimizu K, Shiozawa K, Ishida K, Saito M, Mizuno S, Akima H, Katayama K. Age and sex differences in blood pressure responses during hyperpnoea. Exp Physiol 2021; 106:736-747. [PMID: 33428277 DOI: 10.1113/ep089171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023]
Abstract
NEW FINDINGS What is the central question of this study? Increased respiratory muscle activation is associated with neural and cardiovascular consequences via the respiratory muscle-induced metaboreflex. Does ageing and/or sex influence the arterial blood pressure response during voluntary normocapnic incremental hyperpnoea? What is the main finding and its importance? The increase in blood pressure during hyperpnoea was smaller in younger females than in older females, whereas no difference was found between older males and older females. The blunted respiratory muscle-induced metaboreflex in younger females is normalized with advancing age, whereas ageing has no such effect in males. ABSTRACT We hypothesized that older females (OF) have a greater arterial blood pressure response to increased respiratory muscle work compared with younger females (YF) and that no such difference exists between older males (OM) and younger males (YM). To test these hypotheses, cardiovascular responses during voluntary normocapnic incremental hyperpnoea were evaluated and compared between older and younger subjects. An incremental respiratory endurance test (IRET) was performed as follows: target minute ventilation was initially set at 30% of the maximal voluntary ventilation (MVV12) and was increased by 10% of MVV12 every 3 min. The test was terminated when the subject could not maintain the target percentage of MVV12. Heart rate and mean arterial blood pressure (MAP) were recorded continuously. The increase in MAP from baseline (ΔMAP) during the IRET in OM (+24.0 ± 14.7 mmHg, mean ± SD) did not differ (P = 0.144) from that in YM (+24.3 ± 13.4 mmHg), but it was greater (P = 0.004) in OF (+31.2 ± 11.6 mmHg) than in YF (+10.3 ± 5.5 mmHg). No significant difference in ΔMAP during the IRET was observed between OM and OF (P = 0.975). These results suggest that the respiratory muscle-induced metaboreflex is blunted in YF, but it could be normalized with advancing age. In males, ageing has little effect on the respiratory muscle-induced metaboreflex. These results show no sex difference in the respiratory muscle-induced metaboreflex in older adults.
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Affiliation(s)
- Kaori Shimizu
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Kana Shiozawa
- Department of Sports and Fitness, Faculty of Wellness, Shigakkan University, Obu, Japan.,Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Sahiro Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan.,Research Fellowship for Young Scientists of Japan Society for the Promotion of Science
| | - Hiroshi Akima
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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Ramsook AH, Peters CM, Leahy MG, Archiza B, Mitchell RA, Jasinovic T, Koehle MS, Guenette JA, Sheel AW. Near-infrared spectroscopy measures of sternocleidomastoid blood flow during exercise and hyperpnoea. Exp Physiol 2020; 105:2226-2237. [PMID: 33111424 DOI: 10.1113/ep089045] [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: 08/31/2020] [Accepted: 10/26/2020] [Indexed: 01/20/2023]
Abstract
NEW FINDINGS What is the central question of this study? How does sternocleidomastoid blood flow change in response to increasing ventilation and whole-body exercise intensity? What is the main finding and its importance? Sternocleidomastoid blood flow increased with increasing ventilation. For a given ventilation, sternocleidomastoid blood flow was lower during whole-body exercise compared to resting hyperpnoea. These findings suggest that locomotor muscle work exerts an effect on respiratory muscle blood flow that can be observed in the sternocleidomastoid. ABSTRACT Respiratory muscle work influences the distribution of blood flow during exercise. Most studies have focused on blood flow to the locomotor musculature rather than the respiratory muscles, owing to the complex anatomical arrangement of respiratory muscles. The purpose of this study was to examine how accessory respiratory (i.e. sternocleidomastoid, and muscles in the intercostal space) muscle blood flow changes in response to locomotor muscle work. Seven men performed 5 min bouts of constant load cycling exercise trials at 30%, 60% and 90% of peak work rate in a randomized order, followed by 5 min bouts of voluntary hyperpnoea (VH) matching the ventilation achieved during each exercise (EX) trial. Blood-flow index (BFI) of the vastus lateralis, sternocleidomastoid (SCM) and seventh intercostal space (IC) were estimated using near-infrared spectroscopy and indocyanine green and expressed relative to resting levels. BFISCM was greater during VH compared to EX (P = 0.002) and increased with increasing exercise intensity (P = 0.036). BFISCM reached 493 ± 219% and 301 ± 215% rest during VH and EX at 90% peak work rate, respectively. BFIIC increased to 242 ± 178% and 210 ± 117% rest at 30% peak work rate during VH and EX, respectively. No statistically significant differences in BFIIC were observed with increased work rate during VH or EX (both P > 0.05). Moreover, there was no observed difference in BFIIC between conditions (P > 0.05). BFISCM was lower for a given minute ventilation during EX compared to VH, suggesting that accessory respiratory muscle blood flow is influenced by whole-body exercise.
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Affiliation(s)
- Andrew H Ramsook
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Carli M Peters
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruno Archiza
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Reid A Mitchell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Tin Jasinovic
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Koehle
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - A William Sheel
- Centre for Heart Lung Innovation, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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Ansdell P, Thomas K, Hicks KM, Hunter SK, Howatson G, Goodall S. Physiological sex differences affect the integrative response to exercise: acute and chronic implications. Exp Physiol 2020; 105:2007-2021. [PMID: 33002256 DOI: 10.1113/ep088548] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022]
Abstract
NEW FINDINGS What is the topic of this review? We review sex differences within physiological systems implicated in exercise performance; specifically, how they integrate to determine metabolic thresholds and fatigability. Thereafter, we discuss the implications that these sex differences might have for long-term adaptation to exercise. What advances does it highlight? The review collates evidence from recent physiological studies that have investigated sex as a biological variable, demonstrating that the physiological response to equivalent 'dosages' of exercise is not the same in males and females; thus, highlighting the need to research diversity in physiological responses to interventions. ABSTRACT The anatomical and physiological differences between males and females are thought to determine differences in the limits of human performance. The notion of studying sex as a biological variable has recently been emphasized in the biosciences as a vital step in enhancing human health. In this review, we contend that the effects of biological sex on acute and chronic responses must be studied and accounted for when prescribing aerobic exercise, much like any intervention targeting the optimization of physiological function. Emerging evidence suggests that the response of physiological systems to exercise differs between males and females, potentially mediating the beneficial effects in healthy and clinical populations. We highlight evidence that integrative metabolic thresholds during exercise are influenced by phenotypical sex differences throughout many physiological systems. Furthermore, we discuss evidence that female skeletal muscle is more resistant to fatigue elicited by equivalent dosages of high-intensity exercise. How the different acute responses affect the long-term trainability of males and females is considered, with discussion about tailoring exercise to the characteristics of the individual presented within the context of biological sex. Finally, we highlight the influence of endogenous and exogenous sex hormones on physiological responses to exercise in females. Sex is one of many mediating influences on the outcomes of exercise, and with careful experimental designs, physiologists can advance the collective understanding of diversity in physiology and optimize outcomes for both sexes.
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Affiliation(s)
- Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kevin Thomas
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kirsty M Hicks
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Sandra K Hunter
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.,Water Research Group, School of Environmental Sciences and Development, North-West University, Potchefstroom, South Africa
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Wiggins CC, Baker SE, Shepherd JRA, Uchida K, Joyner MJ, Dominelli PB. Body position does not influence muscle oxygenation during submaximal cycling. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
| | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
| | - John R. A. Shepherd
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
| | - Koji Uchida
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
| | - Paolo B. Dominelli
- Department of Anesthesiology and Perioperative Medicine Mayo Clinic Rochester MN USA
- Department of Kinesiology University of Waterloo Waterloo ON Canada
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