Oxygen Uptake Kinetics in Youth: Characteristics, Interpretation, and Application

The Influence of Acute Hypoxia on Oxygen Uptake and Muscle Oxygenation Kinetics During Cycling Exercise in Prepubertal Boys

PURPOSE

To examine the effect of normobaric hypoxia on pulmonary oxygen uptake (V˙O2) and muscle oxygenation kinetics during incremental and moderate-intensity exercise in children.

METHODS

Eight prepubertal boys (9-11 y) performed incremental cycle tests to exhaustion in both normoxia and hypoxia (fraction of inspired O2 of 15%) followed by repeat 6-minute transitions of moderate-intensity exercise in each condition over subsequent visits.

RESULTS

Maximal oxygen uptake (V˙O2max) was reduced in hypoxia compared with normoxia (1.69 [0.20] vs 1.87 [0.26] L·min-1, P = .028), although the gas exchange threshold was not altered in absolute terms (P = .33) or relative to V˙O2max (P = .78). During moderate-intensity exercise, the phase II V˙O2 time constant (τ) was increased in hypoxia (18 [9] vs 24 [8] s, P = .025), with deoxyhemoglobin τ unchanged (17 [8] vs 16 [6], P ≥ .28).

CONCLUSIONS

In prepubertal boys, hypoxia reduced V˙O2max and slowed V˙O2 phase II kinetics during moderate-intensity exercise, despite unchanged deoxyhemoglobin kinetics. These data suggest an oxygen delivery dependence of V˙O2max and moderate-intensity V˙O2 kinetics under conditions of reduced oxygen availability in prepubertal boys.

Long-Term Alterations in Pulmonary V˙O2 and Muscle Deoxygenation On-Kinetics During Heavy-Intensity Exercise in Competitive Youth Cyclists: A Cohort Study

PURPOSE

The aim of this investigation was to assess alterations of pulmonary oxygen uptake (V˙O2) and muscle deoxygenation on-kinetics during heavy-intensity cycling in youth cyclists over a period of 15 months.

METHODS

Eleven cyclists (initial age, 14.3 [1.6] y; peak V˙O2, 62.2 [4.5] mL·min-1·kg-1) visited the laboratory twice on 3 occasions within 15 months. Participants performed an incremental ramp exercise test and a constant workrate test within the heavy-intensity domain during the first visit and second visit, respectively. Subsequently, parameter estimates of the V˙O2 and muscle deoxygenation on-kinetics were determined with mono-exponential models.

RESULTS

The V˙O2 phase II time constant decreased from occasion 1 (34 [4] s) to occasion 2 (30 [4] s, P = .005) and 3 (28 [4] s, P = .010). However, no significant alteration was observed between occasions 2 and 3 (P = .565). The V˙O2 slow component amplitude either expressed in absolute values (ie, L·min-1) or relative to end exercise V˙O2 (ie, %) showed no significant changes throughout the study (P = .972 and .996). Furthermore, the muscle deoxygenation on-kinetic mean response time showed no significant changes throughout the study (18 [8], 18 [3], and 16 [5] s for occasions 1, 2, and 3, respectively; P = .279).

CONCLUSION

These results indicate proportional enhancements of local muscle oxygen distribution and utilization, which both contributed to the speeding of the V˙O2 on-kinetics herein.

Longitudinal alterations of pulmonary V.O2 on-kinetics during moderate-intensity exercise in competitive youth cyclists are related to alterations in the balance between microvascular O2 distribution and muscular O2 utilization

Purpose

The main purpose of the current study was to investigate the dynamic adjustment of pulmonary oxygen uptake (V.O2) in response to moderate-intensity cycling on three occasions within 15 months in competitive youth cyclists. Furthermore, the muscle Δdeoxy[heme] on-kinetics and the Δdeoxy[heme]-to-V.O2 ratio were modeled to examine possible mechanistic basis regulating pulmonary V.O2 on-kinetics.

Methods

Eleven cyclists (initial age, 14.3 ± 1.6 y; peak V.O2, 62.2 ± 4.5 mL.min−1.kg−1) with a training history of 2–5 years and a training volume of ~10 h per week participated in this investigation. V.O2 and Δdeoxy[heme] responses during workrate-transitions to moderate-intensity cycling were measured with breath-by-breath spirometry and near-infrared spectroscopy, respectively, and subsequently modeled with mono-exponential models to derive parameter estimates. Additionally, a normalized Δdeoxy[heme]-to-V.O2 ratio was calculated for each participant. One-way repeated-measures ANOVA was used to assess effects of time on the dependent variables of the responses.

Results

The V.O2 time constant remained unchanged between the first (~24 s) and second visit (~22 s, P > 0.05), whereas it was significantly improved through the third visit (~13 s, P = 0.006–0.013). No significant effects of time were revealed for the parameter estimates of the Δdeoxy[heme] response (P > 0.05). A significant Δdeoxy[heme]-to-V.O2 ratio “overshoot” was evident on the first (1.09 ± 0.10, P = 0.006) and second (1.05 ± 0.09, P = 0.047), though not the third (0.97 ± 0.10, P > 0.05), occasion. These “overshoots” showed strong positive relationships with the V.O2 time constant during the first (r = 0.66, P = 0.028) and second visit (r = 0.76, P = 0.007). Further, strong positive relationships have been observed between the individual changes of the fundamental phase τp and the Δdeoxy[heme]-to-V.O2 ratio “overshoot” from occasion one to two (r = 0.70, P = 0.017), and two to three (r = 0.74, P = 0.009).

Conclusion

This suggests that improvements in muscle oxygen provision and utilization capacity both occurred, and each may have contributed to enhancing the dynamic adjustment of the oxidative “machinery” in competitive youth cyclists. Furthermore, it indicates a strong link between an oxygen maldistribution within the tissue of interrogation and the V.O2 time constant.

Heart rate and gas exchange dynamic responses to multiple brief exercise bouts (MBEB) in early- and late-pubertal boys and girls

Natural patterns of physical activity in youth are characterized by brief periods of exercise of varying intensity interspersed with rest. To better understand systemic physiologic response mechanisms in children and adolescents, we examined five responses [heart rate (HR), respiratory rate (RR), oxygen uptake (V̇O2 ), carbon dioxide production (V̇CO2 ), and minute ventilation (V̇E), measured breath-by-breath] to multiple brief exercise bouts (MBEB). Two groups of healthy participants (early pubertal: 17 female, 20 male; late-pubertal: 23 female, 21 male) performed five consecutive 2-min bouts of constant work rate cycle-ergometer exercise interspersed with 1-min of rest during separate sessions of low- or high-intensity (~40% or 80% peak work, respectively). For each 2-min on-transient and 1-min off-transient we calculated the average value of each cardiopulmonary exercise testing (CPET) variable (Y̅). There were significant MBEB changes in 67 of 80 on- and off-transients. Y̅ increased bout-to-bout for all CPET variables, and the magnitude of increase was greater in the high-intensity exercise. We measured the metabolic cost of MBEB, scaled to work performed, for the entire 15 min and found significantly higher V̇O2 , V̇CO2 , and V̇E costs in the early-pubertal participants for both low- and high-intensity MBEB. To reduce breath-by-breath variability in estimation of CPET variable kinetics, we time-interpolated (second-by-second), superimposed, and averaged responses. Reasonable estimates of τ (<20% coefficient of variation) were found only for on-transients of HR and V̇O2 . There was a remarkable reduction in τHR following the first exercise bout in all groups. Natural patterns of physical activity shape cardiorespiratory responses in healthy children and adolescents. Protocols that measure the effect of a previous bout on the kinetics of subsequent bouts may aid in the clinical utility of CPET.

Effects of Aging on Hemodynamic Kinetics in Different Intensities of Dynamic Exercise

Healthy aging hemodynamics is known to exhibit a time-dependent loss of function. We aimed at verifying whether older men would have a slowed cardiac output and stroke volume dynamics in response to the onset ("on") and on recovery ("off") of exercise in comparison to young men. Twenty healthy active men (10 young and 10 older) were recruited. Participants performed an incremental cardiopulmonary exercise testing on a cycle ergometer, and on another day, 3 constant workload tests in different intensities. Compared to younger, older men exhibited a slower cardiac output and stroke volume dynamics in both on and off transients for all exercise intensities (all P < 0.05). During higher intensities, both younger and older men had slower hemodynamic kinetics compared to lower intensities (all P < 0.05). There was strong negative relationship between the time constant of cardiac output on-kinetics during high-intensity with maximal exercise performance in both groups (r = -0.88, P < 0.01). We interpret these findings to mean that healthy older men have slowed hemodynamic kinetics compared to younger, but this difference becomes less evident in higher intensities of exercise.

Oxygen Uptake Kinetics in Endurance Trained Youth and Adult Cyclists

Previous studies reported faster pulmonary oxygen uptake kinetics at the onset of exercise in untrained youth compared with adults. Whether or not these differences are identical for trained groups have not been examined. The purpose of this study was to compare ˙VO₂ kinetics of youth and adult cyclists at moderate and heavy-intensity exercise. Thirteen adult (age: 23.2 ± 4.8 years; ˙VO_2peak 68.4 ± 6.8 mL·min^-1.kg^-1) and thirteen youth cyclists (age: 14.3 ± 1.5 years; ˙VO_2peak 61.7 ± 4.3 mL·min^-1.kg^-1) completed a series of 6-min square wave exercises at moderate and heavy-intensity exercise at 90 rev·min^-1. A two-way repeated-measure ANOVA was conducted to identify differences between groups and intensities. The time constant, time delay and the mean response time were not significantly different between youth and adult cyclists (p > 0.05). We found significant differences between intensities, with a faster time constant during moderate than heavy-intensity exercise in youth (24.1 ± 7.0 s vs. 31.8 ± 5.6 s; p = 0.004) and adults (22.7 ± 5.6 s vs. 28.6 ± 5.7 s; p < 0.001). The present data suggest that the effect of training history in adult cyclists compensate for the superior primary response of the oxygen uptake kinetics typically seen in youth compared to adults. Furthermore, the ˙VO₂ response is dependent of work rate intensity in trained youth and adult cyclists.

Oxygen uptake kinetics during treadmill walking in adolescents with clinically stable cystic fibrosis

Background: Oxygen uptake (V̇O₂) kinetics have been shown to be slowed in adolescents with cystic fibrosis (CF) during heavy-intensity cycling and maximal exercise testing.Objectives: This study investigated V̇O₂ kinetics in adolescents with CF compared to control adolescents (CON) during a treadmill-walking exercise.Methods: Eight adolescents with CF and mild-to-moderate pulmonary obstruction (5 girls; 13.1 ± 2.5 years; FEV₁ 67.8 ± 21.4%) and 18 CON adolescents (10 girls; 13.8 ± 1.8 years) were recruited. Pulmonary gas exchange and ventilation were measured during a single transition of 10 min of treadmill walking and a 5 min seated recovery period. Participant's walking speed was determined during a one-minute self-paced walking task along a 50-m corridor. A six-parameter, non-linear regression model was used to describe the changes in V̇O₂ function during the treadmill walking and recovery, with monoexponential curve fitting used to describe the mean response time (MRT₁) at the onset of exercise, and the half-life (T_1/2V̇O₂) at the offset of exercise. V̇O₂ baseline and amplitude, minute ventilation and respiratory equivalents were recorded.Results: V̇O₂ kinetics were slower in CF group compared to CON group during the treadmill walking with a greater MRT₁ (32 ± 14 s vs 21 ± 16 s; p = .04, effect size = 0.75). The T_1/2V̇O2 was prolonged during recovery in CF group compared to CON group (86 ± 24 s vs 56 ± 22 s; p = .04, effect size = 1.31). The mean VE/V̇CO₂ during exercise was the only parameter significantly greater in CF group compared to CON group (32.9 ± 2.3 vs 29.0 ± 2.4; p < .01, effect size = 1.66). Conclusion: V̇O₂ kinetics were found to be slowed in adolescents with CF during treadmill walking.

Effect of High-Intensity Training and Asthma on the V˙O2 Kinetics of Adolescents

PURPOSE

High-intensity interval training (HIIT) represents a potent stimulus to the dynamic oxygen uptake (V˙O2) response in adults, but whether the same is evident in youth is unknown. HIIT has also been suggested to place a lower demand on the respiratory system, decreasing the likelihood of exacerbation in those with respiratory conditions, such as asthma.

METHODS

Sixty-nine adolescents (13.6 ± 0.9 yr; 36 asthma) took part, 35 of which (17 asthma) participated in a 30-min HIIT intervention three times a week for 6 months. Each participant completed an incremental ramp test to volitional exhaustion and three heavy-intensity constant work rate tests to determine the dynamic V˙O2, heart rate, and deoxyhemoglobin response at baseline, midintervention, postintervention and at a 3-month follow-up.

RESULTS

There was no influence of asthma at baseline or in response to the intervention. Participants in the intervention group demonstrated a faster V˙O2 time constant (τp) after intervention (intervention: 29.2 ± 5.7 s vs control: 34.2 ± 6.5 s; P = 0.003), with these differences maintained at follow-up (intervention: 32.5 ± 5.5 s vs control: 37.3 ± 8.7 s; P = 0.008). The intervention was associated with a speeding of the concentration of deoxyhemoglobin τ (pre: 20.1 ± 4.7 s vs post: 18.2 ± 4.1 s; P = 0.05) compared with a slowing over the same time period in the control participants (pre: 17.9 ± 4.9 s vs post: 20.1 ± 4.6 s; P = 0.012). Heart rate kinetics were not altered (pre: 46.5 ± 12.2 s vs post: 47.7 ± 11.1 s; P = 0.98).

CONCLUSION

These findings highlight the potential utility of school-based HIIT as a strategy to enhance the V˙O2 kinetics of youth, regardless of the presence of asthma.

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

OBJECTIVE

To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants.

METHODS

Cross-sectional study including individuals aged 6-18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed.

RESULTS

Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV₁) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake (VO_2peak) was 34.1 ± 7.8 mL kg^-1 min^-1. A significant correlation between ventilatory reserve and FEV₁ (r = 0.57; p = 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV₁ fall in the EIB test for both V_E/VO₂ (r = 0.47; p = 0.02) and V_E/VCO₂ (r = 0.46; p = 0.02). Patients with FEV₁<80% had lower ventilatory reserve (p = 0.009). In addition, resting heart rate correlated with VO_2peak (r=-0.40; p = 0.04), V_E/VO₂ (r = 0.46; p = 0.02) and V_E/VCO₂ (r = 0.48; p = 0.01).

CONCLUSIONS

Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.

Relationship between (non)linear phase II pulmonary oxygen uptake kinetics with skeletal muscle oxygenation and age in 11-15 year olds

NEW FINDINGS

What is the central question of this study? Do the phase II parameters of pulmonary oxygen uptake ( V ̇ O 2 ) kinetics display linear, first-order behaviour in association with alterations in skeletal muscle oxygenation during step cycling of different intensities or when exercise is initiated from an elevated work rate in youths. What is the main finding and its importance? Both linear and non-linear features of phase II V ̇ O 2 kinetics may be determined by alterations in the dynamic balance between microvascular O₂ delivery and utilization in 11-15 year olds. The recruitment of higher-order (i.e. type II) muscle fibres during 'work-to-work' cycling might be responsible for modulating V ̇ O 2 kinetics with chronological age.

ABSTRACT

This study investigated in 19 male youths (mean age: 13.6 ± 1.1 years, range: 11.7-15.7 years) the relationship between pulmonary oxygen uptake ( V ̇ O 2 ) and muscle deoxygenation kinetics during moderate- and very heavy-intensity 'step' cycling initiated from unloaded pedalling (i.e. U → M and U → VH) and moderate to very heavy-intensity step cycling (i.e. M → VH). Pulmonary V ̇ O 2 was measured breath-by-breath along with the tissue oxygenation index (TOI) of the vastus lateralis using near-infrared spectroscopy. There were no significant differences in the phase II time constant ( τ V ̇ O 2 p ) between U → M and U → VH (23 ± 6 vs. 25 ± 7 s; P = 0.36); however, the τ V ̇ O 2 p was slower during M → VH (42 ± 16 s) compared to other conditions (P < 0.001). Quadriceps TOI decreased with a faster (P < 0.01) mean response time (MRT; i.e. time delay + τ) during U → VH (14 ± 2 s) compared to U → M (22 ± 4 s) and M → VH (20 ± 6 s). The difference (Δ) between the τ V ̇ O 2 p and MRT-TOI was greater during U → VH compared to U → M (12 ± 7 vs. 2 ± 7 s, P < 0.001) and during M → VH (23 ± 15 s) compared to other conditions (P < 0.02), suggesting an increased proportional speeding of fractional O₂ extraction. The slowing of the τ V ̇ O 2 p during M → VH relative to U → M and U → VH correlated positively with chronological age (r = 0.68 and 0.57, respectively, P < 0.01). In youths, 'work-to-work' transitions slowed microvascular O₂ delivery-to-O₂ utilization with alterations in phase II V ̇ O 2 dynamics accentuated between the ages of 11 and 15 years.