Duration of “Phase I” V̇o2p: a comparison of methods used in its estimation and the effects of varying moderate-intensity work rate

Confidence intervals estimator of the kinetic parameters: do its reliability depend on the assembling method of the oxygen uptakes?

Gas exchange data acquired repeatedly under the same exercise conditions are assembled together to improve the kinetic parameters of breath-by-breath oxygen uptake. The latter are provided by the non-linear regression procedure, together with the corresponding estimators of the width of the Confidence Intervals (i.e., the Asymptotic Standard Errors; ASEs). We tested, for two different assembling procedures, whether the range of values identified by the ASE actually correspond to the 95% Confidence Interval. Ten O2 uptake responses were acquired on 10 healthy volunteers performing a square-wave moderate-intensity exercise. Kinetic parameters were estimated running the non-linear regression with a mono-exponential model on an increasingly greater number of responses (Nr, from 1 to 10), assembled together using the "stacking" and the "1-s-bins" procedures. Kinetic values obtained assembling together the 10 repetitions were assumed as "true" values. The time constant was not affected by Nr or by the assembling procedure (ANOVA; p>0.54 and p>0.16, respectively). The corresponding ASE decreased according to Nr (ANOVA; p=0.000), being significantly smaller for the "1-s-bins" procedure compared to the "stacking" one (ANOVA; p<0.001). Excluding 20s at the start of the fitting window, the range of values identified with the ASE provided by the "1-s-bins" and the "stacking" procedures included the "true" value in 85% and in 95% of cases, respectively. The "stacking" procedure should be preferred since it yielded ASEs for the time constant that provided a range of values satisfying the statistical meaning of the width of the Confidence Intervals, at the given degree of probability.

Modeling VO2 on-kinetics based on intensity-dependent Delayed Adjustment and Loss of Efficiency (DALE)

This study presents and evaluates a new mathematical model of V̇O₂ on-kinetics, with the following properties: (i) a progressively slower primary phase following the size-principle of motor unit recruitment, explaining the delayed V̇O₂ steady state seen in the heavy exercise intensity domain, and (ii) a severe-domain slow component modelled as a time-dependent decrease in efficiency. Breath-by-breath V̇O₂ measurements from eight subjects performing step cycling transitions, in the moderate, heavy and severe exercise domains, were fitted to the conventional 3-phase model and the new model. Model performance was evaluated with a residual analysis and by comparing Bayesian (BIC) and corrected Akaike (AICc) information criteria. The residual analysis showed no systematic deviations, except perhaps for the initial part of the primary phase. BIC favored the new model, being 9.3 (SD 7.1) lower than the conventional model while AICc was similar between models. Compared to the conventional 3-phase model, the proposed model distinguishes between the kinetic adaptations in the heavy and severe domains by predicting a delayed steady state V̇O₂ in the heavy and no steady state V̇O₂ in the severe domain. This allows to determine when stable oxygen costs of exercise are attainable and it also represents a first step in defining time-dependent oxygen costs when stable energy conversion efficiency is not attainable.

Priming the cardiodynamic phase of pulmonary oxygen uptake through voluntary modulations of the respiratory pump at the onset of exercise

NEW FINDINGS

What is the central question of this study? The initial increase in oxygen uptake ( V ̇ O 2 ) at exercise onset results from pulmonary perfusion changes secondary to an increased venous return. Breathing mechanics contribute to venous return through abdominal and intrathoracic pressures variation. Can voluntary breathing techniques (abdominal or rib cage breathing) increase venous return and improve V ̇ O 2 at exercise onset? What is the main finding and its importance? Abdominal and rib cage breathing increase venous return and V ̇ O 2 at exercise onset. This mechanism could be clinically relevant in patients with impaired cardiac function limiting oxygen transport.

ABSTRACT

We examined how different breathing patterns can modulate venous return and alveolar gas transfer during exercise transients in humans. Ten healthy men transitioned from rest to moderate cycling while breathing spontaneously (SP) or with voluntary increases in abdominal (AB) or intrathoracic (RC) pressure swings. We used double body plethysmography to determine blood displacements between the trunk and the extremities (V_bs ). From continuous signals of airflow and O₂ fraction, we calculated breath-by-breath oxygen uptake at the mouth and used optoelectronic plethysmography to correct for lung O₂ store changes and calculate alveolar O₂ transfer ( V ̇ O 2 A ). Oesophageal (P_oes ) and gastric (P_ga ) pressures were monitored using balloon-tipped catheters. Cardiac stroke volume was measured using impedance cardiography. During the cardiodynamic phase (Φ1) of V ̇ O 2 A -on kinetics (20 s following exercise onset), AB and RC increased total alveolar oxygen transfer compared to SP (227 ± 32, P = 0.019 vs. 235 ± 27, P = 0.001 vs. 206 ± 20 ml, mean ± SD). P_ga and P_oes swings increased with AB (by 24.4 ± 9.6 cmH₂ O, P < 0.001) and RC (by 14.5 ± 5.7 cmH₂ O, P < 0.001), respectively. AB yielded a greater increase in intra-breath V_bs swings compared with RC and SP (+0.30 ± 0.14 vs. +0.16 ± 0.11, P < 0.001 vs. +0.10 ± 0.05 ml, P = 0.006) and increased the sum of stroke volumes compared to SP (4.47 ± 1.28 vs. 3.89 ± 0.96 litres, P = 0.053), while RC produced significant central blood translocation from the extremities compared with SP (by 493 ± 311 ml, P < 0.001). Our findings indicate that combining exercise onset with AB or RC increases venous return, thus increasing mass oxygen transport above metabolic consumption during Φ1 and limiting the oxygen deficit incurred.

Faster oxygen uptake, heart rate, and ventilatory kinetics in stepping compared with cycle ergometry in patients with COPD during moderate-intensity exercise

Step tests are a stressful and feasible cost-effective modality to evaluate aerobic performance. However, the eccentric in addition to concentric muscle contractions of the legs on stepping emerge as a potential speeding factor for cardioventilatory and metabolic adjustments towards a steady-state, since eccentric contractions would prompt an earlier and stronger mechanoreceptor activation, as well as higher heart rate/cardiac output adjustments to the same metabolic demand. Moreover, shorter tests are ideal for exercise-limited subjects. Nine subjects with chronic obstructive pulmonary disease were invited to participate in comprehensive lung function tests and constant work tests performed on different days at a 90% gas exchange threshold for 6 min, in single-step tests or cycle ergometry. After careful monoexponential regression modelling, statistically relevant faster phase II time constants for oxygen uptake (45 ± 18 s vs 53 ± 17 s, p = 0.017) and minute ventilation (61 ± 13 s vs 74 ± 17 s, p = 0.027) were observed in the 6-min step tests compared with cycle ergometry, respectively. Despite an absence of heart rate time constant difference (43 ± 20 s vs 69 ± 46 s, p = 0.167), there was a significantly faster rate constant toward a steady state for heart rate (p = 0.02). In addition, 4-min compared with 6-min analysis presented similar results (p > 0.05), providing an appropriate steady-state. We conclude that step tests might elicit faster time constants compared with cycle ergometry, at the same average metabolic level, and 4-min analysis has similar mean errors compared with 6-min analysis within an acceptable range. New studies, comprising mechanisms and detailed physiological backgrounds, are necessary.

Changes in pulmonary oxygen uptake and muscle deoxygenation kinetics during cycling exercise in older women performing walking training for 12 weeks

PURPOSE

This study examined the hypothesis that walking training (WT) could accelerate the slowed time constant (τ) of phase II in pulmonary oxygen uptake ([Formula: see text]O₂) on-kinetics in older women. Also, we aimed to demonstrate that O₂ delivery and O₂ utilization were better matched at the site of gas exchange in exercising muscles when τ[Formula: see text]O₂ was shortened.

METHODS

20 recreationally active older women underwent WT sessions of approximately 60 min, 3-4 times a week for 12 weeks. We assessed [Formula: see text]O₂, heart rate (HR) and deoxygenated-hemoglobin concentration ([HHb]) kinetics during a constant-load exercise test before training (0 week-Pre), and at 6 and 12 weeks (6 weeks-Mid, 12 weeks-Post) throughout the training period.

RESULTS

Maximal oxygen uptake ([Formula: see text]O_2max) was unchanged throughout the training program. τHR tended to decline at Mid (58.6 ± 22.0 s), and was significantly shorter at Post (51.7 ± 21.7 s, p = 0.01) compared to Pre (67.1 ± 23.8 s). τ[Formula: see text]O₂ significantly decreased from 38.9 ± 8.6 s for Pre, to 31.5 ± 7.9 s for Mid (p = 0.02), and 32.3 ± 10.5 s for Post (p = 0.03). The normalized [HHb] to [Formula: see text]O₂ ratio (Δ[HHb]/Δ[Formula: see text]O₂) at Pre (1.32 ± 0.93) gradually approached the perfectly matched value (= 1.0) at Mid (1.15 ± 0.61) and Post (1.07 ± 0.52).

CONCLUSIONS

The restoration to baseline (≒ 30 s) of the slower τ[Formula: see text]O₂ due to WT, which may reflect better matching of O₂ delivery and O₂ utilization at the site of gas exchange, suggests that a longer period of WT could be a useful tool for improving exercise tolerance in older individuals.

Data collection, handling, and fitting strategies to optimize accuracy and precision of oxygen uptake kinetics estimation from breath-by-breath measurements

Phase 2 pulmonary oxygen uptake kinetics (ϕ2 τV̇o_2P) reflect muscle oxygen consumption dynamics and are sensitive to changes in state of training or health. This study identified an unbiased method for data collection, handling, and fitting to optimize V̇o_2P kinetics estimation. A validated computational model of V̇o_2P kinetics and a Monte Carlo approach simulated 2 × 10⁵ moderate-intensity transitions using a distribution of metabolic and circulatory parameters spanning normal health. Effects of averaging (interpolation, binning, stacking, or separate fitting of up to 10 transitions) and fitting procedures (biexponential fitting, or ϕ2 isolation by time removal, statistical, or derivative methods followed by monoexponential fitting) on accuracy and precision of V̇o_2P kinetics estimation were assessed. The optimal strategy to maximize accuracy and precision of τV̇o_2P estimation was 1-s interpolation of 4 bouts, ensemble averaged, with the first 20 s of exercise data removed. Contradictory to previous advice, we found optimal fitting procedures removed no more than 20 s of ϕ1 data. Averaging method was less critical: interpolation, binning, and stacking gave similar results, each with greater accuracy compared with analyzing repeated bouts separately. The optimal procedure resulted in ϕ2 τV̇o_2P estimates for transitions from an unloaded or loaded baseline that averaged 1.97 ± 2.08 and 1.04 ± 2.30 s from true, but were within 2 s of true in only 47-62% of simulations. Optimized 95% confidence intervals for τV̇o_2P ranged from 4.08 to 4.51 s, suggesting a minimally important difference of ~5 s to determine significant changes in τV̇o_2P during interventional and comparative studies.NEW & NOTEWORTHY We identified an unbiased method to maximize accuracy and precision of oxygen uptake kinetics (τV̇o_2P) estimation. The optimum number of bouts to average was four; interpolation, bin, and stacking averaging methods gave similar results. Contradictory to previous advice, we found that optimal fitting procedures removed no more than 20 s of phase 1 data. Our data suggest a minimally important difference of ~5 s to determine significant changes in τV̇o_2P during interventional and comparative studies.