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Bennett S, Tiollier E, Owens DJ, Brocherie F, Louis JB. Implications of Heat Stress-induced Metabolic Alterations for Endurance Training. Int J Sports Med 2024; 45:422-435. [PMID: 38401534 DOI: 10.1055/a-2251-3170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
Inducing a heat-acclimated phenotype via repeated heat stress improves exercise capacity and reduces athletes̓ risk of hyperthermia and heat illness. Given the increased number of international sporting events hosted in countries with warmer climates, heat acclimation strategies are increasingly popular among endurance athletes to optimize performance in hot environments. At the tissue level, completing endurance exercise under heat stress may augment endurance training adaptation, including mitochondrial and cardiovascular remodeling due to increased perturbations to cellular homeostasis as a consequence of metabolic and cardiovascular load, and this may improve endurance training adaptation and subsequent performance. This review provides an up-to-date overview of the metabolic impact of heat stress during endurance exercise, including proposed underlying mechanisms of altered substrate utilization. Against this metabolic backdrop, the current literature highlighting the role of heat stress in augmenting training adaptation and subsequent endurance performance will be presented with practical implications and opportunities for future research.
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Affiliation(s)
- Samuel Bennett
- Center for Biological Clocks Research, Texas A&M University, College Station, United States
| | - Eve Tiollier
- Laboratory Sport, Expertise and Performance, Research Department, Institut National du Sport de l'Expertise et de la Performance, Paris, France
| | - Daniel J Owens
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance, Research Department, Institut National du Sport de l'Expertise et de la Performance, Paris, France
| | - Julien B Louis
- Laboratory Sport, Expertise and Performance, Research Department, Institut National du Sport de l'Expertise et de la Performance, Paris, France
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
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Watanabe K, Koch Esteves N, Gibson OR, Akiyama K, Watanabe S, González-Alonso J. Heat-related changes in the velocity and kinetic energy of flowing blood influence the human heart's output during hyperthermia. J Physiol 2024; 602:2227-2251. [PMID: 38690610 DOI: 10.1113/jp285760] [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: 10/03/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024] Open
Abstract
Passive whole-body hyperthermia increases limb blood flow and cardiac output (Q ̇ $\dot Q$ ), but the interplay between peripheral and central thermo-haemodynamic mechanisms remains unclear. Here we tested the hypothesis that local hyperthermia-induced alterations in peripheral blood flow and blood kinetic energy modulate flow to the heart andQ ̇ $\dot Q$ . Body temperatures, regional (leg, arm, head) and systemic haemodynamics, and left ventricular (LV) volumes and functions were assessed in eight healthy males during: (1) 3 h control (normothermic condition); (2) 3 h of single-leg heating; (3) 3 h of two-leg heating; and (4) 2.5 h of whole-body heating. Leg, forearm, and extracranial blood flow increased in close association with local rises in temperature while brain perfusion remained unchanged. Increases in blood velocity with small to no changes in the conduit artery diameter underpinned the augmented limb and extracranial perfusion. In all heating conditions,Q ̇ $\dot Q$ increased in association with proportional elevations in systemic vascular conductance, related to enhanced blood flow, blood velocity, vascular conductance and kinetic energy in the limbs and head (all R2 ≥ 0.803; P < 0.001), but not in the brain. LV systolic (end-systolic elastance and twist) and diastolic functional profiles (untwisting rate), pulmonary ventilation and systemic aerobic metabolism were only altered in whole-body heating. These findings substantiate the idea that local hyperthermia-induced selective alterations in peripheral blood flow modulate the magnitude of flow to the heart andQ ̇ $\dot Q$ through changes in blood velocity and kinetic energy. Localised heat-activated events in the peripheral circulation therefore affect the human heart's output. KEY POINTS: Local and whole-body hyperthermia increases limb and systemic perfusion, but the underlying peripheral and central heat-sensitive mechanisms are not fully established. Here we investigated the regional (leg, arm and head) and systemic haemodynamics (cardiac output:Q ̇ $\dot Q$ ) during passive single-leg, two-leg and whole-body hyperthermia to determine the contribution of peripheral and central thermosensitive factors in the control of human circulation. Single-leg, two-leg, and whole-body hyperthermia induced graded increases in leg blood flow andQ ̇ $\dot Q$ . Brain blood flow, however, remained unchanged in all conditions. Ventilation, extracranial blood flow and cardiac systolic and diastolic functions only increased during whole-body hyperthermia. The augmentedQ ̇ $\dot Q$ with hyperthermia was tightly related to increased limb and head blood velocity, flow and kinetic energy. The findings indicate that local thermosensitive mechanisms modulate regional blood velocity, flow and kinetic energy, thereby controlling the magnitude of flow to the heart and thus the coupling of peripheral and central circulation during hyperthermia.
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Affiliation(s)
- Kazuhito Watanabe
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
- Faculty of Education and Human Studies, Akita University, Akita, Japan
| | - Nuno Koch Esteves
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
- Research Centre, University College of Osteopathy, London, UK
| | - Oliver R Gibson
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, UK
| | - Koichi Akiyama
- Department of Anesthesiology, Kindai University Hospital, Osaka, Japan
| | - Sumie Watanabe
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
- Faculty of Education and Human Studies, Akita University, Akita, Japan
| | - José González-Alonso
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
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Koch Esteves N, McDonald J, González‐Alonso J. Thermo-haemodynamic coupling during regional thigh heating: Insight into the importance of local thermosensitive mechanisms in blood circulation. Exp Physiol 2024; 109:600-613. [PMID: 38230961 PMCID: PMC10988708 DOI: 10.1113/ep091556] [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: 09/28/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
A positive relationship between local tissue temperature and perfusion exists, with isolated limb-segment hyperthermia stimulating hyperaemia in the heated region without affecting the adjacent, non-heated limb segment. However, whether partial-limb segment heating evokes a heightened tissue perfusion in the heated region without directly or reflexly affecting the non-heated tissues of the same limb segment remains unknown. This study investigated, in 11 healthy young adults, the lower limb temperature and haemodynamic responses to three levels of 1 h upper-leg heating, none of which alter core temperature: (1) whole-thigh (WTH; water-perfused garment), (2) quadriceps (QH; water-perfused garment) and (3) partial-quadriceps (PQH; pulsed shortwave diathermy) heating. It was hypothesised that perfusion would only increase in the heated regions. WTH, QH and PQH increased local heated tissue temperature by 2.9 ± 0.6, 2.0 ± 0.7 and 2.9 ± 1.3°C (P < 0.0001), respectively, whilst remaining unchanged in the non-heated hamstrings and quadriceps tissues during QH and PQH. WTH induced a two-fold increase in common femoral artery blood flow (P < 0.0001) whereas QH and PQH evoked a similar ∼1.4-fold elevation (P ≤ 0.0018). During QH and PQH, however, tissue oxygen saturation and laser-Doppler skin blood flow in the adjacent non-heated hamstrings or quadriceps tissues remained stable (P > 0.5000). These findings in healthy young humans demonstrate a tight thermo-haemodynamic coupling during regional thigh heating, providing further evidence of the importance of local heat-activated mechanisms on the control of blood circulation.
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Affiliation(s)
- Nuno Koch Esteves
- Division of Sport, Health, and Exercise Sciences, Department of Life Sciences, College of Health, Medicine and Lifes SciencesBrunel University LondonUxbridgeUK
- University College of OsteopathyLondonUK
| | - Jeneil McDonald
- Division of Sport, Health, and Exercise Sciences, Department of Life Sciences, College of Health, Medicine and Lifes SciencesBrunel University LondonUxbridgeUK
| | - José González‐Alonso
- Division of Sport, Health, and Exercise Sciences, Department of Life Sciences, College of Health, Medicine and Lifes SciencesBrunel University LondonUxbridgeUK
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Su Y, Hoekstra SP, Leicht CA. Hot water immersion is associated with higher thermal comfort than dry passive heating for a similar rise in rectal temperature and plasma interleukin-6 concentration. Eur J Appl Physiol 2024; 124:1109-1119. [PMID: 37870668 PMCID: PMC10954860 DOI: 10.1007/s00421-023-05336-8] [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: 05/16/2023] [Accepted: 09/28/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To compare the perceptual responses and interleukin-6 (IL-6) concentration following rectal temperature-matched dry heat exposure (DH) and hot water immersion (HWI). METHODS Twelve healthy young adults (BMI 23.5 ± 3.6 kg/m2; age: 25.8 ± 5.7 years) underwent 3 trials in randomised order: DH (air temperature 68.9 °C), HWI (water temperature 37.5 °C), and thermoneutral dry exposure (CON, air temperature 27.3 °C). Blood samples to determine IL-6 plasma concentration were collected; basic affect and thermal comfort, rectal and skin temperature (Tskin) were assessed throughout the intervention. RESULTS Rectal temperature (Trec) did not differ between DH (end temperature 38.0 ± 0.4 °C) and HWI (37.9 ± 0.2 °C, P = 0.16), but was higher compared with CON (37.0 ± 0.3 °C; P ≤ 0.004). Plasma IL-6 concentration was similar after DH (pre to post: 0.8 ± 0.5 to 1.4 ± 1.5 pg·ml-1) and HWI (0.5 ± 0.2 to 0.9 ± 0.6 pg·ml-1; P = 0.46), but higher compared with CON (0.6 ± 0.5 to 0.6 ± 0.4 pg·ml-1; P = 0.01). At the end of the intervention, basic affect and thermal comfort were most unfavourable during DH (Basic affect; DH: - 0.7 ± 2.9, HWI: 0.8 ± 1.9, CON 1.9 ± 1.9, P ≤ 0.004; Thermal comfort; 2.6 ± 0.8, HWI: 1.4 ± 0.9 and CON: 0.2 ± 0.4; P ≤ 0.004). Mean Tskin was highest for DH, followed by HWI, and lowest for CON (DH: 38.5 ± 1.3 °C, HWI: 36.2 ± 0.5 °C, CON: 31.6 ± 0.7 °C, P < 0.001). CONCLUSION The IL-6 response did not differ between DH and HWI when matched for the elevation in Trec. However, thermal comfort was lower during DH compared to HWI, which may be related to the higher Tskin during DH.
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Affiliation(s)
- Yunuo Su
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Sven P Hoekstra
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Christof A Leicht
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
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Koch Esteves N, Khir AW, González‐Alonso J. Lower limb hyperthermia augments functional hyperaemia during small muscle mass exercise similarly in trained elderly and young humans. Exp Physiol 2023; 108:1154-1171. [PMID: 37409754 PMCID: PMC10988472 DOI: 10.1113/ep091275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
NEW FINDINGS What is the central question of the study? Ageing is postulated to lead to underperfusion of human limb tissues during passive and exertional hyperthermia, but findings to date have been equivocal. Thus, does age have an independent adverse effect on local haemodynamics during passive single-leg hyperthermia, single-leg knee-extensor exercise and their combination? What is the main finding and its importance? Local hyperthermia increased leg blood flow over three-fold and had an additive effect during knee-extensor exercise with no absolute differences in leg perfusion between the healthy, exercise-trained elderly and the young groups. Our findings indicate that age per se does not compromise lower limb hyperaemia during local hyperthermia and/or small muscle mass exercise. ABSTRACT Heat and exercise therapies are recommended to improve vascular health across the lifespan. However, the haemodynamic effects of hyperthermia, exercise and their combination are inconsistent in young and elderly people. Here we investigated the acute effects of local-limb hyperthermia and exercise on limb haemodynamics in nine healthy, trained elderly (69 ± 5 years) and 10 young (26 ± 7 years) adults, hypothesising that the combination of local hyperthermia and exercise interact to increase leg perfusion, albeit to a lesser extent in the elderly. Participants underwent 90 min of single whole-leg heating, with the contralateral leg remaining as control, followed by 10 min of low-intensity incremental single-leg knee-extensor exercise with both the heated and control legs. Temperature profiles and leg haemodynamics at the femoral and popliteal arteries were measured. In both groups, heating increased whole-leg skin temperature and blood flow by 9.5 ± 1.2°C and 0.7 ± 0.2 L min-1 (>3-fold), respectively (P < 0.0001). Blood flow in the heated leg remained 0.7 ± 0.6 and 1.0 ± 0.8 L min-1 higher during exercise at 6 and 12 W, respectively (P < 0.0001). However, there were no differences in limb haemodynamics between cohorts, other than the elderly group exhibiting a 16 ± 6% larger arterial diameter and a 51 ± 6% lower blood velocity following heating (P < 0.0001). In conclusion, local hyperthermia-induced limb hyperperfusion and/or small muscle mass exercise hyperaemia are preserved in trained older people despite evident age-related structural and functional alterations in their leg conduit arteries.
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Affiliation(s)
- Nuno Koch Esteves
- Division of Sport, Health, and Exercise Sciences, Department of Life SciencesBrunel University LondonUxbridgeUK
| | | | - José González‐Alonso
- Division of Sport, Health, and Exercise Sciences, Department of Life SciencesBrunel University LondonUxbridgeUK
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Gibson OR, Astin R, Puthucheary Z, Yadav S, Preston S, Gavins FNE, González-Alonso J. Skeletal muscle angiogenic, regulatory, and heat shock protein responses to prolonged passive hyperthermia of the human lower limb. Am J Physiol Regul Integr Comp Physiol 2023; 324:R1-R14. [PMID: 36409025 DOI: 10.1152/ajpregu.00320.2021] [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: 11/23/2022]
Abstract
Passive hyperthermia induces a range of physiological responses including augmenting skeletal muscle mRNA expression. This experiment aimed to examine gene and protein responses to prolonged passive leg hyperthermia. Seven young participants underwent 3 h of resting unilateral leg heating (HEAT) followed by a further 3 h of rest, with the contralateral leg serving as an unheated control (CONT). Muscle biopsies were taken at baseline (0 h), and at 1.5, 3, 4, and 6 h in HEAT and 0 and 6 h in CONT to assess changes in selected mRNA expression via qRT-PCR, and HSP72 and VEGFα concentration via ELISA. Muscle temperature (Tm) increased in HEAT plateauing from 1.5 to 3 h (+3.5 ± 1.5°C from 34.2 ± 1.2°C baseline value; P < 0.001), returning to baseline at 6 h. No change occurred in CONT. Endothelial nitric oxide synthase (eNOS), Forkhead box O1 (FOXO-1), Hsp72, and VEGFα mRNA increased in HEAT (P < 0.05); however, post hoc analysis identified that only Hsp72 mRNA statistically increased (at 4 h vs. baseline). When peak change during HEAT was calculated angiopoietin 2 (ANGPT-2) decreased (-0.4 ± 0.2-fold), and C-C motif chemokine ligand 2 (CCL2) (+2.9 ± 1.6-fold), FOXO-1 (+6.2 ± 4.4-fold), Hsp27 (+2.9 ± 1.7-fold), Hsp72 (+8.5 ± 3.5-fold), Hsp90α (+4.6 ± 3.7-fold), and VEGFα (+5.9 ± 3.1-fold) increased from baseline (all P < 0.05). At 6 h Tm were not different between limbs (P = 0.582; CONT = 32.5 ± 1.6°C, HEAT = 34.3 ± 1.2°C), and only ANGPT-2 (P = 0.031; -1.3 ± 1.4-fold) and VEGFα (P = 0.030; 1.1 ± 1.2-fold) differed between HEAT and CONT. No change in VEGFα or HSP72 protein concentration were observed over time; however, peak change in VEGFα did increase (P < 0.05) in HEAT (+140 ± 184 pg·mL-1) versus CONT (+7 ± 86 pg·mL-1). Passive hyperthermia transiently augmented ANGPT-2, CCL2, eNOS, FOXO-1, Hsp27, Hsp72, Hsp90α and VEGFα mRNA, and VEGFα protein.
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Affiliation(s)
- Oliver R Gibson
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom.,Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Rónan Astin
- Department of Medicine, Centre for Human Health and Performance, University College London, London, United Kingdom
| | - Zudin Puthucheary
- Adult Critical Care Unit, Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Shreya Yadav
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - Sophie Preston
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - Felicity N E Gavins
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom.,Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, United Kingdom
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Henderson M, Halsey L. The metabolic upper critical temperature of the human thermoneutral zone. J Therm Biol 2022; 110:103380. [DOI: 10.1016/j.jtherbio.2022.103380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/11/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022]
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Chou TH, Coyle EF. Cardiovascular responses to hot skin at rest and during exercise. Temperature (Austin) 2022; 10:326-357. [PMID: 37554384 PMCID: PMC10405766 DOI: 10.1080/23328940.2022.2109931] [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: 06/10/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Integrative cardiovascular responses to heat stress during endurance exercise depend on various variables, such as thermal stress and exercise intensity. This review addresses how increases in skin temperature alter and challenge the integrative cardiovascular system during upright submaximal endurance exercise, especially when skin is hot (i.e. >38°C). Current evidence suggests that exercise intensity plays a significant role in cardiovascular responses to hot skin during exercise. At rest and during mild intensity exercise, hot skin increases skin blood flow and abolishes cutaneous venous tone, which causes blood pooling in the skin while having little impact on stroke volume and thus cardiac output is increased with an increase in heart rate. When the heart rate is at relatively low levels, small increases in heart rate, skin blood flow, and cutaneous venous volume do not compromise stroke volume, so cardiac output can increase to fulfill the demands for maintaining blood pressure, heat dissipation, and the exercising muscle. On the contrary, during more intense exercise, hot skin does not abolish exercise-induced cutaneous venoconstriction possibly due to high sympathetic nerve activities; thus, it does not cause blood pooling in the skin. However, hot skin reduces stroke volume, which is associated with a decrease in ventricular filling time caused by an increase in heart rate. When the heart rate is high during moderate or intense exercise, even a slight reduction in ventricular filling time lowers stroke volume. Cardiac output is therefore not elevated when skin is hot during moderate intensity exercise.
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Affiliation(s)
- Ting-Heng Chou
- Center for Regenerative Medicine, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Edward F. Coyle
- Department of Kinesiology and Health Education, The University of Texas at Austin, Texas, Tx, USA
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Rodrigues P, Trajano GS, Stewart IB, Minett GM. Potential role of passively increased muscle temperature on contractile function. Eur J Appl Physiol 2022; 122:2153-2162. [PMID: 35771296 PMCID: PMC9463203 DOI: 10.1007/s00421-022-04991-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Declines in muscle force, power, and contractile function can be observed in older adults, clinical populations, inactive individuals, and injured athletes. Passive heating exposure (e.g., hot baths, sauna, or heated garments) has been used for health purposes, including skeletal muscle treatment. An acute increase in muscle temperature by passive heating can increase the voluntary rate of force development and electrically evoked contraction properties (i.e., time to peak twitch torque, half-relation time, and electromechanical delay). The improvements in the rate of force development and evoked contraction assessments with increased muscle temperature after passive heating reveal peripheral mechanisms’ potential role in enhancing muscle contraction. This review aimed to summarise, discuss, and highlight the potential role of an acute passive heating stimulus on skeletal muscle cells to improve contractile function. These mechanisms include increased calcium kinetics (release/reuptake), calcium sensitivity, and increased intramuscular fluid.
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Affiliation(s)
- Patrick Rodrigues
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Ian B Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Geoffrey M Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, A Wing O Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
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Dmochowski JP, Khadka N, Cardoso L, Meneses E, Lee K, Kim S, Jin Y, Bikson M. Computational Modeling of Deep Tissue Heating by an Automatic Thermal Massage Bed: Predicting the Effects on Circulation. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 4:925554. [PMID: 35774152 PMCID: PMC9238293 DOI: 10.3389/fmedt.2022.925554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Automatic thermal and mechanical massage beds support self-managed treatment, including reduction of pain and stress, enhanced circulation, and improved mobility. As the devices become more sophisticated (increasing the degrees of freedom), it is essential to identify the settings that best target the desired tissue. To that end, we developed an MRI-derived model of the lower back and simulated the physiological effects of a commercial thermal-mechanical massage bed. Here we specifically estimated the tissue temperature and increased circulation under steady-state conditions for typical thermal actuator settings (i.e., 45–65°C). Energy transfer across nine tissues was simulated with finite element modeling (FEM) and the resulting heating was coupled to blood flow with an empirically-guided model of temperature-dependent circulation. Our findings indicate that thermal massage increases tissue temperature by 3–8°C and 1–3°C at depths of 2 and 3 cm, respectively. Importantly, due to the rapid (non-linear) increase of circulation with local temperature, this is expected to increase blood flow four-fold (4x) at depths occupied by deep tissue and muscle. These predictions are consistent with prior clinical observations of therapeutic benefits derived from spinal thermal massage.
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Affiliation(s)
- Jacek P. Dmochowski
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
- *Correspondence: Jacek P. Dmochowski
| | - Niranjan Khadka
- Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Luis Cardoso
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
| | - Edson Meneses
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
| | - Kiwon Lee
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
| | - Sungjin Kim
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
| | - Youngsoo Jin
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
- Asan Medical Center, Seoul, South Korea
| | - Marom Bikson
- Department of Biomedical Engineering, City College of New York, New York, NY, United States
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Zhang S, Ma P, Muheremu A, Sun R, Chai H, Jiang K. Hemodynamic analysis of intermittent pneumatic compression combined with hyperthermia after total hip arthroplasty: an experiment on male rabbits. Am J Transl Res 2022; 14:3344-3359. [PMID: 35702082 PMCID: PMC9185028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the effect of intermittent pneumatic compression combined with hyperthermia (IPCH) on the hemodynamic changes in lower limbs of male rabbits and to clarify whether its efficacy is superior to that of intermittent pneumatic compression (IPC) or hyperthermia (HT) alone. METHODS Thirty male adult New Zealand white rabbits with a body mass of 2.6±0.3 kg were obtained to establish a model of postoperative hypercoagulable state by simulating left hip surgery. Then they were randomly divided into HT group, IPC group, and IPCH group. Relevant hemodynamic parameters were examined by color Doppler ultrasound before and after treatment. A femoral vein finite element model was established according to fluid mechanics to analyze the blood flow velocity distribution vector, total deformation, equivalent stress of the femoral vein and venous valve. RESULTS The heart rate, blood flow per minute, and mean and peak blood velocity of the femoral vein in IPCH group were significantly higher than those in HT and IPC groups (P<0.05). There was no significant difference in venous diameter (P>0.05). The blood flow velocity distribution vector, the total deformation of femoral vein, and the equivalent stress between femoral vein and venous valve in the IPCH group were higher than those in HT and IPC groups, but the total deformation of venous valve was smaller in IPCH group. CONCLUSIONS IPCH superimposes the effects of IPC and HT, and can more effectively promote changes in local blood circulation to prevent deep vein thrombosis.
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Affiliation(s)
- Siping Zhang
- Department of Orthopedics, Sixth Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830002, Xinjiang, P. R. China
| | - Pengcheng Ma
- Department of Orthopedics, Sixth Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830002, Xinjiang, P. R. China
| | - Aikeremujiang Muheremu
- Department of Spine Surgery, Sixth Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830002, Xinjiang, P. R. China
| | - Rongxin Sun
- Department of Orthopedics, Chengdu Second People’s HospitalChengdu 610000, Sichuan, P. R. China
| | - Hao Chai
- Department of Orthopedics, Sixth Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830002, Xinjiang, P. R. China
| | - Kan Jiang
- Department of Orthopedics, Sixth Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830002, Xinjiang, P. R. China
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Physiological Function during Exercise and Environmental Stress in Humans-An Integrative View of Body Systems and Homeostasis. Cells 2022; 11:cells11030383. [PMID: 35159193 PMCID: PMC8833916 DOI: 10.3390/cells11030383] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [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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13
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Ogawa T, Hoekstra SP, Kamijo YI, Goosey-Tolfrey VL, Walsh JJ, Tajima F. F, Leicht CA. Serum and plasma brain-derived neurotrophic factor concentration are elevated by systemic but not local passive heating. PLoS One 2021; 16:e0260775. [PMID: 34882699 PMCID: PMC8659342 DOI: 10.1371/journal.pone.0260775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) plays a key role in neuronal adaptations. While previous studies suggest that whole-body heating can elevate circulating BDNF concentration, this is not known for local heating protocols. This study investigated the acute effects of whole-body versus local passive heating on serum and plasma BDNF concentration. Using a water-perfused suit, ten recreationally active males underwent three 90 min experimental protocols: heating of the legs with upper-body cooling (LBH), whole-body heating (WBH) and a control condition (CON). Blood samples were collected before, immediately after and 1 h post-heating for the determination of serum and plasma BDNF concentration, platelet count as well as the BDNF release per platelet. Rectal temperature, cardiac output and femoral artery shear rate were assessed at regular intervals. Serum and plasma BDNF concentration were elevated after WBH (serum: 19.1±5.0 to 25.9±11.3 ng/ml, plasma: 2.74±0.9 to 4.58±2.0; p<0.044), but not LBH (serum: 19.1±4.7 to 22.3±4.8 ng/ml, plasma: 3.25±1.13 to 3.39±0.90 ng/ml; p>0.126), when compared with CON (serum: 18.6±6.4 to 16.8±3.4 ng/ml, plasma: 2.49±0.69 to 2.82±0.89 ng/ml); accompanied by an increase in platelet count (p<0.001). However, there was no change in BDNF content per platelet after either condition (p = 0.392). All physiological measures were elevated to a larger extent after WBH compared with LBH (p<0.001), while shear rate and rectal temperature were higher during LBH than CON (p<0.038). In conclusion, WBH but not LBH acutely elevates circulating BDNF concentration. While these findings further support the use of passive heating to elevate BDNF concentration, a larger increase in shear rate, sympathetic activity and/or rectal temperature than found after LBH appears needed to induce an acute BDNF response by passive heating.
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Affiliation(s)
- Takahiro Ogawa
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Sven P. Hoekstra
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
| | - Yoshi-Ichiro Kamijo
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | | | - Jeremy J. Walsh
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Fumihiro Tajima F.
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
| | - Christof A. Leicht
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- * E-mail:
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Kim K, Kargl C, Ro B, Song Q, Stein K, Gavin TP, Roseguini BT. Neither Peristaltic Pulse Dynamic Compressions nor Heat Therapy Accelerate Glycogen Resynthesis after Intermittent Running. Med Sci Sports Exerc 2021; 53:2425-2435. [PMID: 34107509 PMCID: PMC8516698 DOI: 10.1249/mss.0000000000002713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) after prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function, and the expression of factors involved in skeletal muscle remodeling. METHODS Twenty-six trained individuals were randomly allocated to either a PPDC (n = 13) or a HT (n = 13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g·kg-1 protein plus 1.0 g·kg-1 carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained before and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after, and 24 h after the exercise bout. RESULTS The changes in glycogen content were similar (P > 0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9 ± 34.3 vs PPDC: 29.6 ± 34 mmol·kg-1 wet wt) and ~210 min (Control: 45.8 ± 40.7 vs PPDC: 52 ± 25.3 mmol·kg-1 wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9 ± 26.1 vs HT: 38.7 ± 21.3 mmol·kg-1 wet wt) and ~210 min (Control: 61.4 ± 50.6 vs HT: 63.4 ± 17.5 mmol·kg-1 wet wt) after local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness, and the mRNA expression and protein abundance of select factors were also similar (P > 0.05) in both thighs, irrespective of the treatment. CONCLUSIONS A single 1-h session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function after prolonged intermittent shuttle running.
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Affiliation(s)
- Kyoungrae Kim
- Department of Health and Kinesiology, West Lafayette, IN
| | | | - Bohyun Ro
- Department of Health and Kinesiology, West Lafayette, IN
| | - Qifan Song
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Kimberly Stein
- Gatorade Sport Science Institute, PepsiCo R&D Life Sciences, Barrington, IL
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15
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Shields KL, Broxterman RM, Jarrett CL, Bisconti AV, Park SH, Richardson RS. The passive leg movement technique for assessing vascular function: the impact of baseline blood flow. Exp Physiol 2021; 106:2133-2147. [PMID: 34411365 DOI: 10.1113/ep089818] [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: 06/04/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the central question of this study? The passive leg movement (PLM) assessment of vascular function utilizes the blood flow response in the common femoral artery (CFA): what is the impact of baseline CFA blood flow on the PLM response? What is the main finding and its importance? Although an attenuated PLM response is not an obligatory consequence of increased baseline CFA blood flow, increased blood flow through the deep femoral artery will diminish the response. Care should be taken to ensure that a genuine baseline leg blood flow is obtained prior to performing a PLM vascular function assessment. ABSTRACT The passive leg movement (PLM) assessment of vascular function utilizes the blood flow response in the common femoral artery (CFA). This response is primarily driven by vasodilation of the microvasculature downstream from the deep (DFA) and, to a lesser extent, the superficial (SFA) femoral artery, which facilitate blood flow to the upper and lower leg, respectively. However, the impact of baseline CFA blood flow on the PLM response is unknown. Therefore, to manipulate baseline CFA blood flow, PLM was performed with and without upper and lower leg cutaneous heating in 10 healthy subjects, with blood flow (ultrasound Doppler) and blood pressure (finometer) assessed. Baseline blood flow was significantly increased in the CFA (∼97%), DFA (∼109%) and SFA (∼78%) by upper leg heating. This increase in baseline CFA blood flow significantly attenuated the PLM-induced total blood flow in the DFA (∼62%), which was reflected by a significant fall in blood flow in the CFA (∼49%), but not in the SFA. Conversely, lower leg heating increased blood flow in the CFA (∼68%) and SFA (∼160%), but not in the DFA. Interestingly, this increase in baseline CFA blood flow only significantly attenuated the PLM-induced total blood flow in the SFA (∼60%), and not in the CFA or DFA. Thus, although an attenuated PLM response is not an obligatory consequence of an increase in baseline CFA blood flow, an increase in baseline blood flow through the DFA will diminish the PLM response. Therefore, care should be taken to ensure that a genuine baseline leg blood flow is obtained prior to performance of a PLM vascular function assessment.
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Affiliation(s)
- Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Angela V Bisconti
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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16
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Koch Esteves N, Gibson OR, Khir AW, González‐Alonso J. Regional thermal hyperemia in the human leg: Evidence of the importance of thermosensitive mechanisms in the control of the peripheral circulation. Physiol Rep 2021; 9:e14953. [PMID: 34350727 PMCID: PMC8339537 DOI: 10.14814/phy2.14953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 02/04/2023] Open
Abstract
Hyperthermia is thought to increase limb blood flow through the activation of thermosensitive mechanisms within the limb vasculature, but the precise vascular locus in which hyperthermia modulates perfusion remains elusive. We tested the hypothesis that local temperature-sensitive mechanisms alter limb hemodynamics by regulating microvascular blood flow. Temperature and oxygenation profiles and leg hemodynamics of the common (CFA), superficial (SFA) and profunda (PFA) femoral arteries, and popliteal artery (POA) of the experimental and control legs were measured in healthy participants during: (1) 3 h of whole leg heating (WLH) followed by 3 h of recovery (n = 9); (2) 1 h of upper leg heating (ULH) followed by 30 min of cooling and 1 h ULH bout (n = 8); and (3) 1 h of lower leg heating (LLH) (n = 8). WLH increased experimental leg temperature by 4.2 ± 1.2ºC and blood flow in CFA, SFA, PFA, and POA by ≥3-fold, while the core temperature essentially remained stable. Upper and lower leg blood flow increased exponentially in response to leg temperature and then declined during recovery. ULH and LLH similarly increased the corresponding segmental leg temperature, blood flow, and tissue oxygenation without affecting these responses in the non-heated leg segment, or perfusion pressure and conduit artery diameter across all vessels. Findings demonstrate that whole leg hyperthermia induces profound and sustained elevations in upper and lower limb blood flow and that segmental hyperthermia matches the regional thermal hyperemia without causing thermal or hemodynamic alterations in the non-heated limb segment. These observations support the notion that heat-activated thermosensitive mechanisms in microcirculation regulate limb tissue perfusion during hyperthermia.
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Affiliation(s)
- Nuno Koch Esteves
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Ashraf W. Khir
- Department of Mechanical and Aerospace EngineeringCollege of Engineering, Design and Physical SciencesBrunel University LondonUxbridgeUK
| | - José González‐Alonso
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
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17
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Effects of Acute Exposure to Thermal Stress on Cardiorespiratory Function, Skeletal Muscle Oxygenation, and Exercise Performance in Healthy Males. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147404. [PMID: 34299853 PMCID: PMC8307583 DOI: 10.3390/ijerph18147404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022]
Abstract
We investigated the effects of acute thermal stress (30 °C and 40 °C) and ordinary temperature (20 °C) on cardiorespiratory function, skeletal muscle oxygenation, and exercise performance in healthy men. Eleven healthy males (21.5 ± 2.3 years) performed a graded exercise test (GXT) using a cycle ergometer in each environmental condition (20 °C, 30 °C, and 40 °C) in a random order with an interval of 1 week between each test. Before the test, they were allowed to rest for 30 min in a given environmental condition. All dependent variables (body temperature, cardiorespiratory function parameters, skeletal muscle oxygenation profiles, and exercise performance) were measured at rest and during GXT. GXT was started at 50 W and increased by 25 W every 2 min until subjects were exhausted. Body temperature increased proportionally at rest and at the end of exercise as thermal stress increased. There were no differences in the rating of perceived exertion, oxygen uptake, respiratory exchange ratio, and carbon dioxide excretion between environmental conditions. Heart rate (HR), minute ventilation (VE), and blood lactate levels were significantly higher at 30 °C and 40 °C than at 20 °C, and oxygen pulse was significantly lower at 40 °C than at 20 °C at various exercise loads. None of the skeletal muscle oxygenation profiles showed significant changes at rest or during exercise. Maximal oxygen uptake, peak power, and exercise time significantly decreased proportionally as thermal stress increased, and this decrease was most pronounced at 40 °C. Acute thermal stress induces a decrease in exercise performance via increased body temperature, HR, VE, and blood lactate levels and decreased oxygen pulse during load-homogenized exercise. This phenomenon was more prominent at 40 °C than at 30 °C and 20 °C.
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18
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Hoekstra SP, Ogawa T, Dos Santos M, Handsley G, Bailey SJ, Goosey-Tolfrey VL, Tajima F, Cheng JL, Leicht CA. The effects of local versus systemic passive heating on the acute inflammatory, vascular and glycaemic response. Appl Physiol Nutr Metab 2021; 46:808-818. [DOI: 10.1139/apnm-2020-0704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to compare the acute cardiometabolic and perceptual responses between local and whole-body passive heating. Using a water-perfused suit, 10 recreationally active males underwent three 90 min conditions: heating of the legs with upper-body cooling (LBH), whole-body heating (WBH) and exposure to a thermoneutral temperature (CON). Blood samples were collected before and up to 3 h post-session to assess inflammatory markers, while a 2 h oral glucose tolerance test was initiated 1 h post-session. Femoral artery blood flow and perceptual responses were recorded at regular intervals. The interleukin (IL)-6 incremental area under the curve (iAUC) was higher for LBH (1096 ± 851 pg/mL × 270 min) and WBH (833 ± 476 pg/mL × 270 min) compared with CON (565 ± 325 pg/mL × 270 min; p < 0.047). Glucose concentrations were higher after WBH compared with LBH and CON (p < 0.046). Femoral artery blood flow was higher at the end of WBH (1713 ± 409 mL/min) compared with LBH (943 ± 349 mL/min; p < 0.001), and higher in LBH than CON (661 ± 222 mL/min; p = 0.002). Affect and thermal comfort were more negative during WBH compared with LBH and CON (p < 0.010). In conclusion, local passive heating elevated blood flow and the IL-6 iAUC. However, while resulting in more positive perceptual responses, the majority of the included cardiometabolic markers were attenuated compared with WBH. Novelty: The increase in the IL-6 iAUC in response to passive heating is not reduced by upper-body cooling. Upper-body cooling attenuates the plasma nitrite, IL-1ra and femoral artery blood flow response to passive heating. Upper-body cooling leads to more positive perceptual responses to passive heating.
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Affiliation(s)
- Sven P. Hoekstra
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takahiro Ogawa
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Miguel Dos Santos
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Greg Handsley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Stephen J. Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Victoria L. Goosey-Tolfrey
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Fumihiro Tajima
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Jem L. Cheng
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Christof A. Leicht
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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20
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Monroe JC, Song Q, Emery MS, Hirai DM, Motaganahalli RL, Roseguini BT. Acute effects of leg heat therapy on walking performance and cardiovascular and inflammatory responses to exercise in patients with peripheral artery disease. Physiol Rep 2021; 8:e14650. [PMID: 33369253 PMCID: PMC7758979 DOI: 10.14814/phy2.14650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 11/24/2022] Open
Abstract
Lower-extremity peripheral artery disease (PAD) is associated with increased risk of cardiovascular events and impaired exercise tolerance. We have previously reported that leg heat therapy (HT) applied using liquid-circulating trousers perfused with warm water increases leg blood flow and reduces blood pressure (BP) and the circulating levels of endothelin-1 (ET-1) in patients with symptomatic PAD. In this sham-controlled, randomized, crossover study, sixteen patients with symptomatic PAD (age 65 ± 5.7 years and ankle-brachial index: 0.69 ± 0.1) underwent a single 90-min session of HT or a sham treatment prior to a symptom-limited, graded cardiopulmonary exercise test on the treadmill. The primary outcome was the peak walking time (PWT) during the exercise test. Secondary outcomes included the claudication onset time (COT), resting and exercise BP, calf muscle oxygenation, pulmonary oxygen uptake (V̇O2 ), and plasma levels of ET-1, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Systolic, but not diastolic BP, was significantly lower (~7 mmHg, p < .05) during HT when compared to the sham treatment. There was also a trend for lower SBP throughout the exercise and the recovery period following HT (p = .057). While COT did not differ between treatments (p = .77), PWT tended to increase following HT (CON: 911 ± 69 s, HT: 954 ± 77 s, p = .059). Post-exercise plasma levels of ET-1 were also lower in the HT session (CON: 2.0 ± 0.1, HT: 1.7 ± 0.1, p = .02). Calf muscle oxygenation, V̇O2 , COT, IL-6, and TNF-α did not differ between treatments. A single session of leg HT lowers BP and post-exercise circulating levels of ET-1 and may enhance treadmill walking performance in symptomatic PAD patients.
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Affiliation(s)
- Jacob C. Monroe
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
| | - Qifan Song
- Department of StatisticsPurdue UniversityWest LafayetteINUSA
| | - Michael S. Emery
- Department of Cardiovascular MedicineCleveland ClinicClevelandOHUSA
| | - Daniel M. Hirai
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
| | - Raghu L. Motaganahalli
- Division of Vascular SurgeryDepartment of SurgeryIndiana University School of MedicineIndianapolisINUSA
| | - Bruno T. Roseguini
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
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21
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Kim K, Monroe JC, Gavin TP, Roseguini BT. Local Heat Therapy to Accelerate Recovery After Exercise-Induced Muscle Damage. Exerc Sport Sci Rev 2020; 48:163-169. [PMID: 32658042 DOI: 10.1249/jes.0000000000000230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The prolonged impairment in muscle strength, power, and fatigue resistance after eccentric exercise has been ascribed to a plethora of mechanisms, including delayed muscle refueling and microvascular and mitochondrial dysfunction. This review explores the hypothesis that local heat therapy hastens functional recovery after strenuous eccentric exercise by facilitating glycogen resynthesis, reversing vascular derangements, augmenting mitochondrial function, and stimulating muscle protein synthesis.
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Affiliation(s)
- Kyoungrae Kim
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
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22
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Watanabe K, Stöhr EJ, Akiyama K, Watanabe S, González‐Alonso J. Dehydration reduces stroke volume and cardiac output during exercise because of impaired cardiac filling and venous return, not left ventricular function. Physiol Rep 2020; 8:e14433. [PMID: 32538549 PMCID: PMC7294577 DOI: 10.14814/phy2.14433] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/12/2020] [Indexed: 12/17/2022] Open
Abstract
Dehydration accrued during intense prolonged whole-body exercise in the heat compromises peripheral blood flow and cardiac output ( Q ˙ ). A markedly reduced stroke volume (SV) is a key feature of the dehydration-induced cardiovascular strain, but whether the lower output of the heart is mediated by peripheral or cardiac factors remains unknown. Therefore, we repeatedly quantified left ventricular (LV) volumes, LV mechanics (LV twist, a marker of systolic muscle function, and LV untwisting rate, an independent marker of LV muscle relaxation), left intra-ventricular pressure gradients, blood volume and peripheral blood flow during 2 hr of cycling in the heat with and without dehydration (DEH: 4.0 ± 0.2% body mass loss and EUH: euhydration control, respectively) in eight participants (three females and five males). While brachial and carotid blood flow, blood volume, SV, LV end-diastolic volume (LVEDV), cardiac filling time, systemic vascular conductance and Q ˙ were reduced in DEH compared to EUH after 2 hr, LV twist and untwisting rate tended to be higher (p = .09 and .06, respectively) and intra-ventricular pressure gradients were not different between the two conditions (p = .22). Furthermore, LVEDV in DEH correlated strongly with blood volume (r = .995, p < .01), head and forearms beat volume (r = .98, p < .05), and diastolic LV filling time (r = .98, p < .05). These findings suggest that the decline in SV underpinning the blunted Q ˙ with exercise-induced dehydration is caused by compromised LV filling and venous return, but not intrinsic systolic or diastolic LV function.
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Affiliation(s)
- Kazuhito Watanabe
- Centre for Human Performance, Exercise and RehabilitationBrunel University LondonUxbridgeUK
- Faculty of Education and Human StudiesAkita UniversityAkitaJapan
| | - Eric J. Stöhr
- Cardiff School of Sport and Health SciencesCardiff Metropolitan UniversityCardiffUK
- Department of MedicineDivision of CardiologyColumbia University Irving Medical CenterNew York CityNYUSA
| | - Koichi Akiyama
- Department of AnesthesiologyYodogawa Christian HospitalOsakaJapan
| | - Sumie Watanabe
- Centre for Human Performance, Exercise and RehabilitationBrunel University LondonUxbridgeUK
| | - José González‐Alonso
- Centre for Human Performance, Exercise and RehabilitationBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesBrunel University LondonUxbridgeUK
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Abstract
People undertaking prolonged vigorous exercise experience substantial bodily fluid losses due to thermoregulatory sweating. If these fluid losses are not replaced, endurance capacity may be impaired in association with a myriad of alterations in physiological function, including hyperthermia, hyperventilation, cardiovascular strain with reductions in brain, skeletal muscle and skin blood perfusion, greater reliance on muscle glycogen and cellular metabolism, alterations in neural activity and, in some conditions, compromised muscle metabolism and aerobic capacity. The physiological strain accompanying progressive exercise-induced dehydration to a level of ~ 4% of body mass loss can be attenuated or even prevented by: (1) ingesting fluids during exercise, (2) exercising in cold environments, and/or (3) working at intensities that require a small fraction of the overall body functional capacity. The impact of dehydration upon physiological function therefore depends on the functional demand evoked by exercise and environmental stress, as cardiac output, limb blood perfusion and muscle metabolism are stable or increase during small muscle mass exercise or resting conditions, but are impaired during whole-body moderate to intense exercise. Progressive dehydration is also associated with an accelerated drop in perfusion and oxygen supply to the human brain during submaximal and maximal endurance exercise. Yet their consequences on aerobic metabolism are greater in the exercising muscles because of the much smaller functional oxygen extraction reserve. This review describes how dehydration differentially impacts physiological function during exercise requiring low compared to high functional demand, with an emphasis on the responses of the human brain, heart and skeletal muscles.
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Tan JS, Lin CC, Chen GS. Vasomodulation of peripheral blood flow by focused ultrasound potentiates improvement of diabetic neuropathy. BMJ Open Diabetes Res Care 2020; 8:8/1/e001004. [PMID: 32188594 PMCID: PMC7078690 DOI: 10.1136/bmjdrc-2019-001004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/31/2020] [Accepted: 02/22/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Effective treatment methods for diabetic peripheral neuropathy are still lacking. Here, a focused ultrasound (FUS) technique was developed to improve blood flow in diabetic peripheral vessels and potentially treat diabetic peripheral neuropathy. RESEARCH DESIGN AND METHODS Male adult Sprague-Dawley rats at 4 weeks poststreptozotocin injections were adopted as models for diabetic neuropathic rats. For single FUS treatment, blood perfusion in the skin of the pad of the middle toe was measured before, during, and after the medial and lateral plantar arteries were treated by FUS. For multiple FUS treatments, blood perfusion measurements, von Frey and hot plate testing and nerve conduction velocity measurements were performed before ultrasonic treatment on the first day of each week, and the microvascular and neural fiber densities in the pad of the toe were measured on the first day of the last week. RESULTS The blood perfusion rate significantly increased for 7-10 min in the control and neuropathic rats after a single ultrasound exposure. Multiple ultrasound treatments compared with no treatments significantly increased blood perfusion at the second week and further enhanced perfusion at the third week in the neuropathic rats. Additionally, the paw withdrawal force and latency significantly increased from 34.33±4.55 g and 3.96±0.25 s at the first week to 39.10±5.02 g and 4.77±0.71 s at the second week and to 41.13±2.57 g and 5.24±0.86 s at the third week, respectively. The low nerve conduction velocity in the diabetic rats also improved after the ultrasound treatments. Additionally, ultrasound treatments halted the decrease in microvessel and neural fiber densities in the skin of the diabetic toes. Histologic analysis indicated no damage to the treated arteries or neighboring tissue. CONCLUSIONS FUS treatment can increase upstream arterial blood flow in diabetic feet, ameliorate the decrease in downstream microvessel perfusion and halt neuropathic progression.
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Affiliation(s)
- Joo-Shin Tan
- Department of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Taiwan
| | - Chou-Ching Lin
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Gin-Shin Chen
- Department of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Taiwan
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Hohtola E, González‐Alonso J. Motor unit function during cold induced thermogenesis in muscle-New perspectives on old concepts. Acta Physiol (Oxf) 2020; 228:e13408. [PMID: 31637847 DOI: 10.1111/apha.13408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Esa Hohtola
- Department of Ecology and Genetics University of Oulu Oulu Finland
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da Costa Daniele TM, de Bruin PFC, de Matos RS, de Bruin GS, Maia Chaves C, de Bruin VMS. Exercise effects on brain and behavior in healthy mice, Alzheimer's disease and Parkinson's disease model-A systematic review and meta-analysis. Behav Brain Res 2020; 383:112488. [PMID: 31991178 DOI: 10.1016/j.bbr.2020.112488] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/28/2019] [Accepted: 01/16/2020] [Indexed: 12/12/2022]
Abstract
This systematic review and meta-analysis examines how exercise modifies brain and behavior in healthy mice, dementia (D) and Parkinson disease (PD) models. A search was performed on the Medline and Scopus electronic databases (2008-2019). Search terms were "mice", "brain", "treadmill", "exercise", "physical exercise". In the total, 430 were found but only 103 were included. Animals n = 1,172; exercised 4-8 weeks (Range 24 h to 32 weeks), 60 min/day (Range 8-120 min per day), and 10/12 m/min (Range 0.2 m/min to 36 m/min). Hippocampus, cerebral cortex, striatum and whole brain were more frequently investigated. Exercise improved learning and memory. Meta-analysis showed that exercise increased: cerebral BDNF in health (n = 150; z = 5.8, CI 3.43-12.05; p < 0.001 I2 = 94.3 %), D (n = 124; z = 4.18, CI = 2.22-9.12; p < 0.001; I2 = 93.7 %) and PD (n = 16 z = 4.26, CI 5.03-48.73 p < 0.001 I2 = 94.8 %). TrkB improved in health (n = 84 z = 5.49, CI 3.8-17.73 p < 0.001, I2 = 0.000) and PD (n = 22; z = 3.1, CI = 2.58-67.3, p < 0.002 I2 = 93.8 %). Neurogenesis increased in health (n = 68; z = 7.08, CI 5.65-21.25 p < 0.001; I2 17.58) and D model (n = 116; z = 4.18, CI 2.22-9.12 p < 0.001 I2 93.7 %). Exercise augmented amyloid clearance (n = 166; z = 7.51 CI = 4.86-14.85, p < 0.001 I2 = 58.72) and reduced amyloid plaques in D models (n = 49; z = 4.65, CI = 3.94-15.3 p < 0.001 I2 = 0.000). In conclusion, exercise improved brain and behavior, neurogenesis in healthy and dementia models, reduced toxicity and cerebral amyloid. Evidence regarding inflammation, oxidative stress and energy metabolism were scarce. Studies examining acute vs chronic exercise, extreme training and the durability of exercise benefit were rare. Vascular or glucose metabolism changes were seldom reported.
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Affiliation(s)
- Thiago Medeiros da Costa Daniele
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Ceará, Fortaleza, Brazil; Sleep and Biological Rhythms Laboratory, UFC, Brazil; Universidade Federal do Ceará (UFC), Brazil; Universidade de Fortaleza (UNIFOR).
| | - Pedro Felipe Carvalhedo de Bruin
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Ceará, Fortaleza, Brazil; Sleep and Biological Rhythms Laboratory, UFC, Brazil; Universidade Federal do Ceará (UFC), Brazil.
| | - Robson Salviano de Matos
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Ceará, Fortaleza, Brazil; Sleep and Biological Rhythms Laboratory, UFC, Brazil; Universidade Federal do Ceará (UFC), Brazil.
| | - Gabriela Sales de Bruin
- Universidade Federal do Ceará (UFC), Brazil; Department of Neurology, Washington University in St Louis, United States.
| | - Cauby Maia Chaves
- Universidade Federal do Ceará (UFC), Brazil; Departamento de Clínica Odontológica, UFC, Brazil.
| | - Veralice Meireles Sales de Bruin
- Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Ceará, Fortaleza, Brazil; Sleep and Biological Rhythms Laboratory, UFC, Brazil; Universidade Federal do Ceará (UFC), Brazil.
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27
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Low DA, Jones H, Cable NT, Alexander LM, Kenney WL. Historical reviews of the assessment of human cardiovascular function: interrogation and understanding of the control of skin blood flow. Eur J Appl Physiol 2019; 120:1-16. [PMID: 31776694 PMCID: PMC6969866 DOI: 10.1007/s00421-019-04246-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/19/2019] [Indexed: 02/06/2023]
Abstract
Several techniques exist for the determination of skin blood flow that have historically been used in the investigation of thermoregulatory control of skin blood flow, and more recently, in clinical assessments or as an index of global vascular function. Skin blood flow measurement techniques differ in their methodology and their strengths and limitations. To examine the historical development of techniques for assessing skin blood flow by describing the origin, basic principles, and important aspects of each procedure and to provide recommendations for best practise. Venous occlusion plethysmography was one of the earliest techniques to intermittently index a limb’s skin blood flow under conditions in which local muscle blood flow does not change. The introduction of laser Doppler flowmetry provided a method that continuously records an index of skin blood flow (red cell flux) (albeit from a relatively small skin area) that requires normalisation due to high site-to-site variability. The subsequent development of laser Doppler and laser speckle imaging techniques allows the mapping of skin blood flow from larger surface areas and the visualisation of capillary filling from the dermal plexus in two dimensions. The use of iontophoresis or intradermal microdialysis in conjunction with laser Doppler methods allows for the local delivery of pharmacological agents to interrogate the local and neural control of skin blood flow. The recent development of optical coherence tomography promises further advances in assessment of the skin circulation via three-dimensional imaging of the skin microvasculature for quantification of vessel diameter and vessel recruitment.
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Affiliation(s)
- David A Low
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - N Tim Cable
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Liverpool, UK
| | - Lacy M Alexander
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - W Larry Kenney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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28
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Age-related attenuation of conduit artery blood flow response to passive heating differs between the arm and leg. Eur J Appl Physiol 2018; 118:2307-2318. [DOI: 10.1007/s00421-018-3953-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
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Wilhelm EN, González-Alonso J, Chiesa ST, Trangmar SJ, Kalsi KK, Rakobowchuk M. Whole-body heat stress and exercise stimulate the appearance of platelet microvesicles in plasma with limited influence of vascular shear stress. Physiol Rep 2018; 5:5/21/e13496. [PMID: 29122961 PMCID: PMC5688785 DOI: 10.14814/phy2.13496] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/13/2017] [Indexed: 01/02/2023] Open
Abstract
Intense, large muscle mass exercise increases circulating microvesicles, but our understanding of microvesicle dynamics and mechanisms inducing their release remains limited. However, increased vascular shear stress is generally thought to be involved. Here, we manipulated exercise‐independent and exercise‐dependent shear stress using systemic heat stress with localized single‐leg cooling (low shear) followed by single‐leg knee extensor exercise with the cooled or heated leg (Study 1, n = 8) and whole‐body passive heat stress followed by cycling (Study 2, n = 8). We quantified femoral artery shear rates (SRs) and arterial and venous platelet microvesicles (PMV–CD41+) and endothelial microvesicles (EMV–CD62E+). In Study 1, mild passive heat stress while one leg remained cooled did not affect [microvesicle] (P ≥ 0.05). Single‐leg knee extensor exercise increased active leg SRs by ~12‐fold and increased arterial and venous [PMVs] by two‐ to threefold, even in the nonexercising contralateral leg (P < 0.05). In Study 2, moderate whole‐body passive heat stress increased arterial [PMV] compared with baseline (mean±SE, from 19.9 ± 1.5 to 35.5 ± 5.4 PMV.μL−1.103, P < 0.05), and cycling with heat stress increased [PMV] further in the venous circulation (from 27.5 ± 2.2 at baseline to 57.5 ± 7.2 PMV.μL−1.103 during cycling with heat stress, P < 0.05), with a tendency for increased appearance of PMV across exercising limbs. Taken together, these findings demonstrate that whole‐body heat stress may increase arterial [PMV], and intense exercise engaging either large or small muscle mass promote PMV formation locally and systemically, with no influence upon [EMV]. Local shear stress, however, does not appear to be the major stimulus modulating PMV formation in healthy humans.
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Affiliation(s)
- Eurico N Wilhelm
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - José González-Alonso
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Scott T Chiesa
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Steven J Trangmar
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Kameljit K Kalsi
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Mark Rakobowchuk
- Centre for Human Performance, Exercise, and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom .,Faculty of Science, Department of Biological Sciences, Thompson Rivers University, Kamloops, British Columbia, Canada
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Hawley JA, Lundby C, Cotter JD, Burke LM. Maximizing Cellular Adaptation to Endurance Exercise in Skeletal Muscle. Cell Metab 2018; 27:962-976. [PMID: 29719234 DOI: 10.1016/j.cmet.2018.04.014] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The application of molecular techniques to exercise biology has provided novel insight into the complexity and breadth of intracellular signaling networks involved in response to endurance-based exercise. Here we discuss several strategies that have high uptake by athletes and, on mechanistic grounds, have the potential to promote cellular adaptation to endurance training in skeletal muscle. Such approaches are based on the underlying premise that imposing a greater metabolic load and provoking extreme perturbations in cellular homeostasis will augment acute exercise responses that, when repeated over months and years, will amplify training adaptation.
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Affiliation(s)
- John A Hawley
- Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia.
| | - Carsten Lundby
- Centre for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Louise M Burke
- Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; Department of Sport Nutrition, Australian Institute of Sport, Belconnen, ACT, Australia
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Dorey TW, O'Brien MW, Robinson SA, Kimmerly DS. Knee-high compression socks minimize head-up tilt-induced cerebral and cardiovascular responses following dynamic exercise. Scand J Med Sci Sports 2018; 28:1766-1774. [PMID: 29575406 DOI: 10.1111/sms.13084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/30/2022]
Abstract
In healthy individuals during a non-exercised state, knee-high compression socks (CS) may reduce the magnitude of lower limb venous pooling during orthostasis but are not effective at minimizing the incidence of pre-syncopal symptoms. However, exaggerated reductions in cerebral blood flow velocity (CBV) and cardiac stroke volume (SV) occur during passive head-up tilt (HUT) testing following dynamic exercise. It is unknown if CS can minimize post-exercise HUT-induced decrements in CBV and SV in this population. To test the hypothesis that CS will attenuate the reductions in SV and CBV during 60° HUT following 60 minutes of moderate-intensity (60% VO2 peak) cycling exercise. Ten healthy volunteers (22.6 ± 2.1 years, 24.1 ± 2.5 kg/m2 ) completed pre- and post-exercise 15-minute HUT tests during randomized CS and Control (no CS) conditions. Changes in blood pressure (finger plethysmography), SV (Modelflow® method), and CBV (Transcranial Doppler) were measured during HUT and preceding supine rest periods. Pre-exercise HUT-induced similar (all, P > .47) reductions in SV (Control; -23.1 ± 11.5%, CS; -20.5 ± 10.9%) and CBV (Control; -18.1 ± 6.3%, CS; -15.3 ± 9.0%). However, larger post-exercise decreases in SV and CBV during HUT were observed in the Control versus CS condition. Specifically, CS attenuated the drop in SV (Control: -32.9 ± 5.6%, CS: -24.3 ± 11.6%; P = .01) and CBV (Control: -25.1 ± 5.8%, CS: -17.6 ± 7.8%; P = .02) during the post-exercise HUT test. These results indicate that CS attenuated HUT-induced reductions in SV and CBV following moderate-intensity cycling exercise and suggest that CS may be an effective countermeasure to reduce the incidence of post-exercise syncope in vulnerable populations.
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Affiliation(s)
- T W Dorey
- School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax, NS, Canada
| | - M W O'Brien
- School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax, NS, Canada
| | - S A Robinson
- School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax, NS, Canada
| | - D S Kimmerly
- School of Health and Human Performance, Division of Kinesiology, Dalhousie University, Halifax, NS, Canada
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Mantegazza V, Contini M, Botti M, Ferri A, Dotti F, Berardi P, Agostoni P. Improvement in exercise capacity and delayed anaerobic metabolism induced by far-infrared-emitting garments in active healthy subjects: A pilot study. Eur J Prev Cardiol 2018; 25:1744-1751. [PMID: 29621885 DOI: 10.1177/2047487318768598] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Far-infrared-emitting garments have several biological properties including the capability to increase blood perfusion in irradiated tissues. Design The aim of the study was to evaluate whether far-infrared radiation increases exercise capacity and delays anaerobic metabolism in healthy subjects. Methods With a double-blind, crossover protocol, a maximal cardiopulmonary exercise test was performed in 20 volunteers, wearing far-infrared or common sport clothes, identical in texture and colour. Results Comparing far-infrared with placebo garments, higher oxygen uptake at peak of exercise and longer endurance time were observed (peak oxygen uptake 38.0 ± 8.9 vs. 36.2 ± 8.5 ml/kg/min, endurance time 592 ± 85 vs. 570 ± 71 seconds; P < 0.01); the anaerobic threshold was significantly delayed (anaerobic threshold time 461 ± 93 vs. 417 ± 103 seconds) and anaerobic threshold oxygen uptake and anaerobic threshold oxygen pulse were significantly higher (25.3 ± 6.4 vs. 20.9 ± 5.4 ml/kg/min and 13.3 ± 3.8 vs. 12.4 ± 3.3 ml/beat, respectively). In 10 subjects the blood lactate concentration was measured every 2 minutes during exercise and at peak; lower values were observed with far-infrared fabrics compared to placebo from the eighth minute of exercise, reaching a significant difference at 10 minutes (3.6 ± 0.83 vs. 4.4 ± 0.96 mmol/l; P = 0.02). Conclusions In healthy subjects, exercising with a far-infrared outfit is associated with an improvement in exercise performance and a delay in anaerobic metabolism. In consideration of the acknowledged non-thermic properties of functionalised clothes, these effects could be mediated by an increase in oxygen peripheral delivery secondary to muscular vasodilation. These data suggest the need for testing far-infrared-emitting garments in patients with exercise limitation or in chronic cardiovascular and respiratory patients engaged in rehabilitation programmes.
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Affiliation(s)
| | - Mauro Contini
- 1 Heart Failure Unit, Centro Cardiologico Monzino IRCCS, Italy
| | | | - Ada Ferri
- 3 Engineering Department, Politecnico di Torino, Italy
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Kalsi KK, Chiesa ST, Trangmar SJ, Ali L, Lotlikar MD, González-Alonso J. Mechanisms for the control of local tissue blood flow during thermal interventions: influence of temperature-dependent ATP release from human blood and endothelial cells. Exp Physiol 2018; 102:228-244. [PMID: 27859767 PMCID: PMC5363389 DOI: 10.1113/ep085910] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/14/2016] [Indexed: 12/17/2022]
Abstract
New Findings What is the central question of this study? Skin and muscle blood flow increases with heating and decreases with cooling, but the temperature‐sensitive mechanisms underlying these responses are not fully elucidated. What is the main finding and its importance? We found that local tissue hyperaemia was related to elevations in ATP release from erythrocytes. Increasing intravascular ATP augmented skin and tissue perfusion to levels equal or above thermal hyperaemia. ATP release from isolated erythrocytes was altered by heating and cooling. Our findings suggest that erythrocytes are involved in thermal regulation of blood flow via modulation of ATP release.
Local tissue perfusion changes with alterations in temperature during heating and cooling, but the thermosensitivity of the vascular ATP signalling mechanisms for control of blood flow during thermal interventions remains unknown. Here, we tested the hypotheses that the release of the vasodilator mediator ATP from human erythrocytes, but not from endothelial cells or other blood constituents, is sensitive to both increases and reductions in temperature and that increasing intravascular ATP availability with ATP infusion would potentiate thermal hyperaemia in limb tissues. We first measured blood temperature, brachial artery blood flow and plasma [ATP] during passive arm heating and cooling in healthy men and found that they increased by 3.0 ± 1.2°C, 105 ± 25 ml min−1 °C−1 and twofold, respectively, (all P < 0.05) with heating, but decreased or remained unchanged with cooling. In additional men, infusion of ATP into the brachial artery increased skin and deep tissue perfusion to levels equal or above thermal hyperaemia. In isolated erythrocyte samples exposed to different temperatures, ATP release increased 1.9‐fold from 33 to 39°C (P < 0.05) and declined by ∼50% at 20°C (P < 0.05), but no changes were observed in cultured human endothelial cells, plasma or serum samples. In conclusion, increases in plasma [ATP] and skin and deep tissue perfusion with limb heating are associated with elevations in ATP release from erythrocytes, but not from endothelial cells or other blood constituents. Erythrocyte ATP release is also sensitive to temperature reductions, suggesting that erythrocytes may function as thermal sensors and ATP signalling generators for control of tissue perfusion during thermal interventions.
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Affiliation(s)
- Kameljit K Kalsi
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK
| | - Scott T Chiesa
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK
| | - Steven J Trangmar
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK
| | - Leena Ali
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK.,Department of Anaesthetics, Ealing Hospital NHS Trust, Southall, UK
| | - Makrand D Lotlikar
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK.,Department of Anaesthetics, Ealing Hospital NHS Trust, Southall, UK
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, UK
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Trangmar SJ, Chiesa ST, Kalsi KK, Secher NH, González-Alonso J. Whole body hyperthermia, but not skin hyperthermia, accelerates brain and locomotor limb circulatory strain and impairs exercise capacity in humans. Physiol Rep 2017; 5:5/2/e13108. [PMID: 28108645 PMCID: PMC5269410 DOI: 10.14814/phy2.13108] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 12/26/2022] Open
Abstract
Cardiovascular strain and hyperthermia are thought to be important factors limiting exercise capacity in heat‐stressed humans, however, the contribution of elevations in skin (Tsk) versus whole body temperatures on exercise capacity has not been characterized. To ascertain their relationships with exercise capacity, blood temperature (TB), oxygen uptake (V̇O2), brain perfusion (MCA Vmean), locomotor limb hemodynamics, and hematological parameters were assessed during incremental cycling exercise with elevated skin (mild hyperthermia; HYPmild), combined core and skin temperatures (moderate hyperthermia; HYPmod), and under control conditions. Both hyperthermic conditions increased Tsk versus control (6.2 ± 0.2°C; P < 0.001), however, only HYPmod increased resting TB, leg blood flow and cardiac output (Q̇), but not MCA Vmean. Throughout exercise, Tsk remained elevated in both hyperthermic conditions, whereas only TB was greater in HYPmod. At exhaustion, oxygen uptake and exercise capacity were reduced in HYPmod in association with lower leg blood flow, MCA Vmean and mean arterial pressure (MAP), but similar maximal heart rate and TB. The attenuated brain and leg perfusion with hyperthermia was associated with a plateau in MCA and two‐legged vascular conductance (VC). Mechanistically, the falling MCA VC was coupled to reductions in PaCO2, whereas the plateau in leg vascular conductance was related to markedly elevated plasma [NA] and a plateau in plasma ATP. These findings reveal that whole‐body hyperthermia, but not skin hyperthermia, compromises exercise capacity in heat‐stressed humans through the early attenuation of brain and active muscle blood flow.
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Affiliation(s)
- Steven J Trangmar
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Scott T Chiesa
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Kameljit K Kalsi
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Niels H Secher
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom.,The Copenhagen Muscle Research Centre, Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
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Trangmar SJ, González-Alonso J. New Insights Into the Impact of Dehydration on Blood Flow and Metabolism During Exercise. Exerc Sport Sci Rev 2017; 45:146-153. [PMID: 28419001 DOI: 10.1249/jes.0000000000000109] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Exercise-induced dehydration can lead to impaired perfusion to multiple regional tissues and organs. We propose that the impact of dehydration on regional blood flow and metabolism is dependent on the extent of the cardiovascular demand imposed by exercise, with the greatest physiological strain seen when approaching cardiovascular and aerobic capacities.
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Affiliation(s)
- Steven J Trangmar
- 1Department of Life Sciences, University of Roehampton, London; and 2Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
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36
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Racinais S, Cocking S, Périard JD. Sports and environmental temperature: From warming-up to heating-up. Temperature (Austin) 2017; 4:227-257. [PMID: 28944269 DOI: 10.1080/23328940.2017.1356427] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/09/2017] [Accepted: 07/09/2017] [Indexed: 01/22/2023] Open
Abstract
Most professional and recreational athletes perform pre-conditioning exercises, often collectively termed a 'warm-up' to prepare for a competitive task. The main objective of warming-up is to induce both temperature and non-temperature related responses to optimize performance. These responses include increasing muscle temperature, initiating metabolic and circulatory adjustments, and preparing psychologically for the upcoming task. However, warming-up in hot and/or humid ambient conditions increases thermal and circulatory strain. As a result, this may precipitate neuromuscular and cardiovascular impairments limiting endurance capacity. Preparations for competing in the heat should include an acclimatization regimen. Athletes should also consider cooling interventions to curtail heat gain during the warm-up and minimize dehydration. Indeed, although it forms an important part of the pre-competition preparation in all environmental conditions, the rise in whole-body temperature should be limited in hot environments. This review provides recommendations on how to build an effective warm-up following a 3 stage RAMP model (Raise, Activate and Mobilize, Potentiate), including general and context specific exercises, along with dynamic flexibility work. In addition, this review provides suggestion to manipulate the warm-up to suit the demands of competition in hot environments, along with other strategies to avoid heating-up.
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Affiliation(s)
- Sébastien Racinais
- Aspetar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar.,French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
| | - Scott Cocking
- Aspetar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar.,Research Institute for Sport and Exercise Science, Liverpool John Moores University, United Kingdom
| | - Julien D Périard
- Aspetar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar.,University of Canberra, Research Institute for Sport and Exercise, Canberra, Australia
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37
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Kuhlenhoelter AM, Kim K, Neff D, Nie Y, Blaize AN, Wong BJ, Kuang S, Stout J, Song Q, Gavin TP, Roseguini BT. Heat therapy promotes the expression of angiogenic regulators in human skeletal muscle. Am J Physiol Regul Integr Comp Physiol 2016; 311:R377-91. [PMID: 27357800 DOI: 10.1152/ajpregu.00134.2016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/12/2016] [Indexed: 01/08/2023]
Abstract
Heat therapy has been shown to promote capillary growth in skeletal muscle and in the heart in several animal models, but the effects of this therapy on angiogenic signaling in humans are unknown. We evaluated the acute effect of lower body heating (LBH) and unilateral thigh heating (TH) on the expression of angiogenic regulators and heat shock proteins (HSPs) in healthy young individuals. Exposure to LBH (n = 18) increased core temperature (Tc) from 36.9 ± 0.1 to 37.4 ± 0.1°C (P < 0.01) and average leg skin temperature (Tleg) from 33.1 ± 0.1 to 39.6 ± 0.1°C (P < 0.01), but did not alter the levels of circulating angiogenic cytokines and bone marrow-derived proangiogenic cells (CD34(+)CD133(+)). In skeletal muscle, the change in mRNA expression from baseline of vascular endothelial growth factor (VEGF), angiopoietin 2 (ANGPT2), chemokines CCL2 and CX3CL1, platelet factor-4 (PF4), and several members of the HSP family was higher 30 min after the intervention in the individuals exposed to LBH (n = 11) compared with the control group (n = 12). LBH also reduced the expression of transcription factor FOXO1 (P = 0.03). Exposure to TH (n = 14) increased Tleg from 32.8 ± 0.2 to 40.3 ± 0.1°C (P < 0.05) but Tc remained unaltered (36.8 ± 0.1°C at baseline and 36.9 ± 0.1°C at 90 min). This intervention upregulated the expression of VEGF, ANGPT1, ANGPT2, CCL2, and HSPs in skeletal muscle but did not affect the levels of CX3CL1, FOXO-1, and PF4. These findings suggest that both LBH and TH increase the expression of factors associated with capillary growth in human skeletal muscle.
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Affiliation(s)
| | - Kyoungrae Kim
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Dustin Neff
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Yaohui Nie
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana; Department of Animal Sciences, Purdue University, West Lafayette, Indiana
| | - A Nicole Blaize
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Brett J Wong
- Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia
| | - Shihuan Kuang
- Department of Animal Sciences, Purdue University, West Lafayette, Indiana
| | - Julianne Stout
- Indiana University School of Medicine-Lafayette, West Lafayette, Indiana; and
| | - Qifan Song
- Department of Statistics, Purdue University, West Lafayette, Indiana
| | - Timothy P Gavin
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana;
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38
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Neff D, Kuhlenhoelter AM, Lin C, Wong BJ, Motaganahalli RL, Roseguini BT. Thermotherapy reduces blood pressure and circulating endothelin-1 concentration and enhances leg blood flow in patients with symptomatic peripheral artery disease. Am J Physiol Regul Integr Comp Physiol 2016; 311:R392-400. [PMID: 27335279 DOI: 10.1152/ajpregu.00147.2016] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/15/2016] [Indexed: 11/22/2022]
Abstract
Leg thermotherapy (TT) application reduces blood pressure (BP) and increases both limb blood flow and circulating levels of anti-inflammatory mediators in healthy, young humans and animals. The purpose of the present study was to determine the impact of TT application using a water-circulating garment on leg and systemic hemodynamics and on the concentrations of circulating cytokines and vasoactive mediators in patients with symptomatic peripheral artery disease (PAD). Sixteen patients with PAD and intermittent claudication (age: 63 ± 9 yr) completed three experimental sessions in a randomized order: TT, control intervention, and one exercise testing session. The garment was perfused with 48°C water for 90 min in the TT session and with 33°C water in the control intervention. A subset of 10 patients also underwent a protocol for the measurement of blood flow in the popliteal artery during 90 min of TT using phase-contrast MRI. Compared with the control intervention, TT promoted a significant reduction in systolic (∼11 mmHg) and diastolic (∼6 mmHg) BP (P < 0.05) that persisted for nearly 2 h after the end of the treatment. The serum concentration of endothelin-1 (ET-1) was significantly lower 30 min after exposure to TT (Control: 2.3 ± 0.1 vs. TT: 1.9 ± 0.09 pg/ml, P = 0.026). In addition, TT induced a marked increase in peak blood flow velocity (∼68%), average velocity (∼76%), and average blood flow (∼102%) in the popliteal artery (P < 0.01). These findings indicate that TT is a practical and effective strategy to reduce BP and circulating ET-1 concentration and enhance leg blood flow in patients with PAD.
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Affiliation(s)
- Dustin Neff
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | | | - Chen Lin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brett J Wong
- Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia; and
| | | | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana;
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39
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Cardiovascular adaptations supporting human exercise-heat acclimation. Auton Neurosci 2016; 196:52-62. [DOI: 10.1016/j.autneu.2016.02.002] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/29/2016] [Accepted: 02/04/2016] [Indexed: 11/22/2022]
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40
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Chiesa ST, Trangmar SJ, González-Alonso J. Temperature and blood flow distribution in the human leg during passive heat stress. J Appl Physiol (1985) 2016; 120:1047-58. [PMID: 26823344 PMCID: PMC4894946 DOI: 10.1152/japplphysiol.00965.2015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 01/22/2016] [Indexed: 01/19/2023] Open
Abstract
The ability of direct heat stress to increase limb blood flow is well known, but the magnitude and profile of hemodynamic responses within the major vessels of the leg have not been explored. Here, we systematically characterize these responses through a wide range of heat stress levels and show that isolated leg heating confers potentially beneficial hemodynamic changes equivalent to those of moderate whole body hyperthermia, with these hemodynamic adjustments being predominantly driven by local temperature-sensitive mechanisms. The influence of temperature on the hemodynamic adjustments to direct passive heat stress within the leg's major arterial and venous vessels and compartments remains unclear. Fifteen healthy young males were tested during exposure to either passive whole body heat stress to levels approaching thermal tolerance [core temperature (Tc) + 2°C; study 1; n = 8] or single leg heat stress (Tc + 0°C; study 2; n = 7). Whole body heat stress increased perfusion and decreased oscillatory shear index in relation to the rise in leg temperature (Tleg) in all three major arteries supplying the leg, plateauing in the common and superficial femoral arteries before reaching severe heat stress levels. Isolated leg heat stress increased arterial blood flows and shear patterns to a level similar to that obtained during moderate core hyperthermia (Tc + 1°C). Despite modest increases in great saphenous venous (GSV) blood flow (0.2 l/min), the deep venous system accounted for the majority of returning flow (common femoral vein 0.7 l/min) during intense to severe levels of heat stress. Rapid cooling of a single leg during severe whole body heat stress resulted in an equivalent blood flow reduction in the major artery supplying the thigh deep tissues only, suggesting central temperature-sensitive mechanisms contribute to skin blood flow alone. These findings further our knowledge of leg hemodynamic responses during direct heat stress and provide evidence of potentially beneficial vascular alterations during isolated limb heat stress that are equivalent to those experienced during exposure to moderate levels of whole body hyperthermia.
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Affiliation(s)
- Scott T Chiesa
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Steven J Trangmar
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
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41
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Trangmar SJ, Chiesa ST, Llodio I, Garcia B, Kalsi KK, Secher NH, González-Alonso J. Dehydration accelerates reductions in cerebral blood flow during prolonged exercise in the heat without compromising brain metabolism. Am J Physiol Heart Circ Physiol 2015; 309:H1598-607. [PMID: 26371170 PMCID: PMC4670459 DOI: 10.1152/ajpheart.00525.2015] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/03/2015] [Indexed: 11/23/2022]
Abstract
Reductions in cerebral blood flow and extracranial perfusion, induced by dehydration during prolonged exercise in the heat, may be coupled to fatigue. However, cerebral metabolism remains stable through enhanced O2 and glucose extraction. Thus, fatigue developed during prolonged exercise with dehydration is related to reductions in cerebral blood flow rather than to the cerebral metabolic rate for O2. Dehydration hastens the decline in cerebral blood flow (CBF) during incremental exercise, whereas the cerebral metabolic rate for O2 (CMRO2) is preserved. It remains unknown whether CMRO2 is also maintained during prolonged exercise in the heat and whether an eventual decline in CBF is coupled to fatigue. Two studies were undertaken. In study 1, 10 male cyclists cycled in the heat for ∼2 h with (control) and without fluid replacement (dehydration) while internal and external carotid artery blood flow and core and blood temperature were obtained. Arterial and internal jugular venous blood samples were assessed with dehydration to evaluate CMRO2. In study 2, in 8 male subjects, middle cerebral artery blood velocity was measured during prolonged exercise to exhaustion in both dehydrated and euhydrated states. After a rise at the onset of exercise, internal carotid artery flow declined to baseline with progressive dehydration (P < 0.05). However, cerebral metabolism remained stable through enhanced O2 and glucose extraction (P < 0.05). External carotid artery flow increased for 1 h but declined before exhaustion. Fluid ingestion maintained cerebral and extracranial perfusion throughout nonfatiguing exercise. During exhaustive exercise, however, euhydration delayed but did not prevent the decline in cerebral perfusion. In conclusion, during prolonged exercise in the heat, dehydration accelerates the decline in CBF without affecting CMRO2 and also restricts extracranial perfusion. Thus, fatigue is related to a reduction in CBF and extracranial perfusion rather than CMRO2.
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Affiliation(s)
- Steven J Trangmar
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
| | - Scott T Chiesa
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
| | - Iñaki Llodio
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
| | - Benjamin Garcia
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
| | - Kameljit K Kalsi
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
| | - Niels H Secher
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and Department of Anaesthesia, The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Denmark
| | - José González-Alonso
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, United Kingdom; and
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42
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González-Alonso J, Calbet JAL, Boushel R, Helge JW, Søndergaard H, Munch-Andersen T, van Hall G, Mortensen SP, Secher NH. Blood temperature and perfusion to exercising and non-exercising human limbs. Exp Physiol 2015; 100:1118-31. [PMID: 26268717 PMCID: PMC5049637 DOI: 10.1113/ep085383] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/07/2015] [Indexed: 12/11/2022]
Abstract
NEW FINDINGS What is the central question of this study? Temperature-sensitive mechanisms are thought to contribute to blood-flow regulation, but the relationship between exercising and non-exercising limb perfusion and blood temperature is not established. What is the main finding and its importance? The close coupling among perfusion, blood temperature and aerobic metabolism in exercising and non-exercising extremities across different exercise modalities and activity levels and the tight association between limb vasodilatation and increases in plasma ATP suggest that both temperature- and metabolism-sensitive mechanisms are important for the control of human limb perfusion, possibly by activating ATP release from the erythrocytes. Temperature-sensitive mechanisms may contribute to blood-flow regulation, but the influence of temperature on perfusion to exercising and non-exercising human limbs is not established. Blood temperature (TB ), blood flow and oxygen uptake (V̇O2) in the legs and arms were measured in 16 healthy humans during 90 min of leg and arm exercise and during exhaustive incremental leg or arm exercise. During prolonged exercise, leg blood flow (LBF) was fourfold higher than arm blood flow (ABF) in association with higher TB and limb V̇O2. Leg and arm vascular conductance during exercise compared with rest was related closely to TB (r(2) = 0.91; P < 0.05), plasma ATP (r(2) = 0.94; P < 0.05) and limb V̇O2 (r(2) = 0.99; P < 0.05). During incremental leg exercise, LBF increased in association with elevations in TB and limb V̇O2, whereas ABF, arm TB and V̇O2 remained largely unchanged. During incremental arm exercise, both ABF and LBF increased in relationship to similar increases in V̇O2. In 12 trained males, increases in femoral TB and LBF during incremental leg exercise were mirrored by similar pulmonary artery TB and cardiac output dynamics, suggesting that processes in active limbs dominate central temperature and perfusion responses. The present data reveal a close coupling among perfusion, TB and aerobic metabolism in exercising and non-exercising extremities and a tight association between limb vasodilatation and increases in plasma ATP. These findings suggest that temperature and V̇O2 contribute to the regulation of limb perfusion through control of intravascular ATP.
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Affiliation(s)
- José González-Alonso
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK.,The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - José A L Calbet
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Physical Education, and Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Robert Boushel
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Jørn W Helge
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Centre for Healthy Ageing, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hans Søndergaard
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thor Munch-Andersen
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Gerrit van Hall
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stefan P Mortensen
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark
| | - Niels H Secher
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark
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