Blood lactate accumulation and muscle deoxygenation during incremental exercise

A systematic review of the relationship between muscle oxygen dynamics and energy rich phosphates. Can NIRS help?

BACKGROUND

Phosphocreatine dynamics provide the gold standard evaluation of in-vivo mitochondrial function and is tightly coupled with oxygen availability. Low mitochondrial oxidative capacity has been associated with health issues and low exercise performance.

METHODS

To evaluate the relationship between near-infrared spectroscopy-based muscle oxygen dynamics and magnetic resonance spectroscopy-based energy-rich phosphates, a systematic review of the literature related to muscle oxygen dynamics and energy-rich phosphates was conducted. PRISMA guidelines were followed to perform a comprehensive and systematic search of four databases on 02-11-2021 (PubMed, MEDLINE, Scopus and Web of Science). Beforehand pre-registration with the Open Science Framework was performed. Studies had to include healthy humans aged 18-55, measures related to NIRS-based muscle oxygen measures in combination with energy-rich phosphates. Exclusion criteria were clinical populations, laboratory animals, acutely injured subjects, data that only assessed oxygen dynamics or energy-rich phosphates, or grey literature. The Effective Public Health Practice Project Quality Assessment Tool was used to assess methodological quality, and data extraction was presented in a table.

RESULTS

Out of 1483 records, 28 were eligible. All included studies were rated moderate. The studies suggest muscle oxygen dynamics could indicate energy-rich phosphates under appropriate protocol settings.

CONCLUSION

Arterial occlusion and exercise intensity might be important factors to control if NIRS application should be used to examine energetics. However, more research needs to be conducted without arterial occlusion and with high-intensity exercises to support the applicability of NIRS and provide an agreement level in the concurrent course of muscle oxygen kinetics and muscle energetics.

TRIAL REGISTRATION

https://osf.io/py32n/ .

KEY POINTS

1. NIRS derived measures of muscle oxygenation agree with gold-standard measures of high energy phosphates when assessed in an appropriate protocol setting. 2. At rest when applying the AO protocol, in the absence of muscle activity, an initial disjunction between the NIRS signal and high energy phosphates can been seen, suggesting a cascading relationship. 3. During exercise and recovery a disruption of oxygen delivery is required to provide the appropriate setting for evaluation through either an AO protocol or high intensity contractions.

Sex differences in hemodynamic response to high-intensity interval exercise

Sex differences in the cardiorespiratory and hemodynamic response to exercise exist due to differences in heart size, blood volume, and hemoglobin mass, eliciting higher maximal oxygen uptake (VO2max ) in men versus women. Data are equivocal whether sex differences in training responsiveness occur. This study investigated potential sex differences in the hemodynamic response (stroke volume (SV) and cardiac output (CO)) to high-intensity interval exercise (HIIE). Habitually active men (n = 15) and women (n = 13) underwent VO2max testing, followed by three HIIE sessions consisting of the 4 × 4, 10 × 1, and reduced exertion high-intensity training (REHIT), whose order was randomized. During exercise, oxygen uptake (VO2 ) and hemodynamic responses were determined. Results showed no sex difference in peak relative VO2 (p = 0.263), CO (p = 0.277), or SV (p = 0.116), although absolute values were higher in men (p < 0.05). Peak absolute (127.3 ± 20.6 vs. 115.2 ± 16.6 mL/beat, p = 0.004, d = 0.66) and relative SV (111.0 ± 15.5 vs. 100.7 ± 11.1% max, p = 0.005, d = 0.78) were higher with REHIT versus 4 × 4. No sex differences in mean relative VO2 , CO, or SV occurred (p > 0.05). Data showed lower mean VO2 during REHIT versus 4 × 4 (59.3 ± 6.8 vs. 65.8 ± 5.8 %VO2max , p < 0.001, d = 1.05) and 10 × 1 (59.3 ± 6.8 vs. 69.1 ± 7.4 %VO2max , p < 0.001, d = 1.4). Mean CO was lower in REHIT than 10 × 1 (79.8 ± 8.6 vs. 84.0 ± 7.4% max, p = 0.012, d = 0.53). Previously reported differences in VO2max response to HIIE may not be due to unique hemodynamic responses.

Muscle oxygen saturation rates coincide with lactate-based exercise thresholds

INTRODUCTION

Monitoring muscle metabolic activity via blood lactate is a useful tool for understanding the physiological response to a given exercise intensity. Recent indications suggest that skeletal muscle oxygen saturation (SmO2), an index of the balance between local O2 supply and demand, may describe and predict endurance performance outcomes.

PURPOSE

We tested the hypothesis that SmO2 rate is tightly related to blood lactate concentration across exercise intensities, and that deflections in SmO2 rate would coincide with established blood lactate thresholds (i.e., lactate thresholds 1 and 2).

METHODS

Ten elite male soccer players completed an incremental running protocol to exhaustion using 3-min work to 30 s rest intervals. Blood lactate samples were collected during rest and SmO2 was collected continuously via near-infrared spectroscopy from the right and left vastus lateralis, left biceps femoris and the left gastrocnemius.

RESULTS

Muscle O2 saturation rate (%/min) was quantified after the initial 60 s of each 3-min segment. The SmO2 rate was significantly correlated with blood lactate concentrations for all muscle sites; RVL, r = - 0.974; LVL, r = - 0.969; LG, r = - 0.942; LHAM, r = - 0.907. Breakpoints in SmO2 rate were not significantly different from LT1 or LT2 at any muscle sites (P > 0.05). Bland-Altman analysis showed speed threshold estimates via SmO2 rate and lactate are similar at LT2, but slightly greater for SmO2 rate at LT1.

CONCLUSIONS

Muscle O2 saturation rate appears to provide actionable information about maximal metabolic steady state and is consistent with bioenergetic reliance on oxygen and its involvement in the attainment of metabolic steady state.

Operational Modal Analysis of Near-Infrared Spectroscopy Measure of 2-Month Exercise Intervention Effects in Sedentary Older Adults with Diabetes and Cognitive Impairment

The Global Burden of Disease Study (GBD 2019 Diseases and Injuries Collaborators) found that diabetes significantly increases the overall burden of disease, leading to a 24.4% increase in disability-adjusted life years. Persistently high glucose levels in diabetes can cause structural and functional changes in proteins throughout the body, and the accumulation of protein aggregates in the brain that can be associated with the progression of Alzheimer's Disease (AD). To address this burden in type 2 diabetes mellitus (T2DM), a combined aerobic and resistance exercise program was developed based on the recommendations of the American College of Sports Medicine. The prospectively registered clinical trials (NCT04626453, NCT04812288) involved two groups: an Intervention group of older sedentary adults with T2DM and a Control group of healthy older adults who could be either active or sedentary. The completion rate for the 2-month exercise program was high, with participants completing on an average of 89.14% of the exercise sessions. This indicated that the program was practical, feasible, and well tolerated, even during the COVID-19 pandemic. It was also safe, requiring minimal equipment and no supervision. Our paper presents portable near-infrared spectroscopy (NIRS) based measures that showed muscle oxygen saturation (SmO2), i.e., the balance between oxygen delivery and oxygen consumption in muscle, drop during bilateral heel rise task (BHR) and the 6 min walk task (6MWT) significantly (p < 0.05) changed at the post-intervention follow-up from the pre-intervention baseline in the T2DM Intervention group participants. Moreover, post-intervention changes from pre-intervention baseline for the prefrontal activation (both oxyhemoglobin and deoxyhemoglobin) showed statistically significant (p < 0.05, q < 0.05) effect at the right superior frontal gyrus, dorsolateral, during the Mini-Cog task. Here, operational modal analysis provided further insights into the 2-month exercise intervention effects on the very-low-frequency oscillations (<0.05 Hz) during the Mini-Cog task that improved post-intervention in the sedentary T2DM Intervention group from their pre-intervention baseline when compared to active healthy Control group. Then, the 6MWT distance significantly (p < 0.01) improved in the T2DM Intervention group at post-intervention follow-up from pre-intervention baseline that showed improved aerobic capacity and endurance. Our portable NIRS based measures have practical implications at the point of care for the therapists as they can monitor muscle and brain oxygenation changes during physical and cognitive tests to prescribe personalized physical exercise doses without triggering individual stress response, thereby, enhancing vascular health in T2DM.

Cardio-Respiratory and Muscle Oxygenation Responses to Submaximal and Maximal Exercise in Normobaric Hypoxia: Comparison between Children and Adults

As differential physiological responses to hypoxic exercise between adults and children remain poorly understood, we aimed to comprehensively characterise cardiorespiratory and muscle oxygenation responses to submaximal and maximal exercise in normobaric hypoxia between the two groups. Following familiarisation, fifteen children (Age = 9 ± 1 years) and fifteen adults (Age = 22 ± 2 years) completed two graded cycling exercise sessions to exhaustion in a randomized and single-blind manner in normoxia (NOR; FiO2 = 20.9) and normobaric hypoxia (HYP; FiO2 = 13.0) exercises conditions. Age-specific workload increments were 25 W·3 min−1 for children and 40 W·3 min−1 for adults. Gas exchange and vastus lateralis oxygenation parameters were measured continuously via metabolic cart and near-infrared spectroscopy, respectively. Hypoxia provoked significant decreases in maximal power output PMAX (children = 29%; adults 16% (F = 39.3; p < 0.01)) and power output at the gas exchange threshold (children = 10%; adults:18% (F = 8.08; p = 0.01)) in both groups. Comparable changes were noted in most respiratory and gas exchange parameters at similar power outputs between groups. Children, however, demonstrated, lower PETCO2 throughout the test at similar power outputs and during the maintenance of V˙CO2 at the maximal power output. These data indicate that, while most cardiorespiratory responses to acute hypoxic exercise are comparable between children and adults, there exist age-related differential responses in select respiratory and muscle oxygenation parameters.

Diagnosing Sport-Related Flow Limitations in the Iliac Arteries Using Near-Infrared Spectroscopy

Background: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NIRS) is a non-invasive technique that measures skeletal muscle oxygenation as reflected by the balance of O2 delivery from microvascular blood flow and O2 uptake by metabolic activity. Therefore, NIRS potentially serves as a novel technique for diagnosing FLIA. The purpose of this study is to compare the diagnostic accuracy of NIRS-derived absolute, amplitude, and kinetic variables in legs during and after a maximal exercise test with ABIFlexed. Methods: ABIFlexed and NIRS were studied in 33 healthy subjects and 201 patients with FLIA diagnosed with echo-Doppler. Results: After maximal exercise, NIRS kinetic variables, such as the half value time and mean response time, resulted in a range of 0.921 to 0.939 AUC for the diagnosis of FLIA when combined with ABIFlexed. Conversely, ABIFlexed measurements alone conferred significantly worse test characteristics (AUC 0.717, p < 0.001). Conclusions: NIRS may serve as a diagnostic adjunct in patients with possible FLIA.

Muscle Oxygen Saturation Breakpoints Reflect Ventilatory Thresholds in Both Cycling and Running

Pulmonary gas exchange analysis was compared to changes in muscle oxygen saturation as measured by near-infrared spectroscopy. First, ventilatory thresholds determined by common gas exchange analysis and breakpoints in muscle oxygen saturation were assessed for agreement during exercise with increasing intensity. Secondly, the relationship between muscle oxygen saturation as a surrogate for local oxygen extraction and peak oxygen uptake was assessed. In order to lend robustness to future NIRS testing on a broader scale, considering its potential for simple and cost-effective application, the question of a running versus a cycling modality was integrated into the design. Ten participants, of whom five were recreationally trained cyclists and five recreationally trained runners, were tested; each during a cycling test and a running test with increasing intensity to voluntary exhaustion. Muscle oxygen saturation and pulmonary gas exchange measurements were conducted. Bland-Altman analysis showed a moderate degree of agreement between both muscle oxygen saturation breakpoint 1 and muscle oxygen saturation breakpoint 2 and corresponding ventilatory threshold 1 and ventilatory threshold 2, for both cycling and running disciplines; generally speaking, muscle oxygen saturation breakpoints underestimated ventilatory thresholds. Additionally, a strong relationship could be seen between peak oxygen uptake and the minimally attained muscle oxygen saturation during cycling exercise. Muscle oxygen saturation measured using NIRS was determined to be a suitable method to assess ventilatory thresholds by finding breakpoints in muscle oxygen saturation, and muscle oxygen saturation minimum was linked to peak oxygen uptake.

Post-Exercise Hyperbaric Oxygenation Improves Recovery for Subsequent Performance

Background: The improvement of athletes' recovery seems crucial to maintaining a high-performance level. Since hyperbaric oxygenation (HBO) could be a valuable recovery method, this study aimed at determining the effects of post-exercise HBO at modest pressure (97% O₂; 1.3 ATA) on physiological response and subsequent cycling performance compared to passive recovery (PR; 21% O₂; 1 ATA). Methods: Twelve trained cyclists completed two testing sessions in a random crossover design. Both sessions consisted of one fatiguing exercise immediately followed by either HBO or PR recovery intervention (75 minutes), then a 5-minute maximal cycling effort. Cycling power output, heart rate variability (HRV) during recovery, blood lactate, and the rating of perceived exertion (RPE) were analyzed and compared between conditions. Results: Compared with PR, the cycling power output was significantly higher after HBO (307.5 ± 19.0 W vs 314.5 ± 19.3 W; p = .005; ES = 0.11 [-0.70-0.90]). Moreover, several HRV indices revealed an improvement in HRV recovery in HBO condition. Blood lactate was not significantly different between conditions, neither following the fatiguing exercise nor the maximal effort. HBO decreased RPE after maximal cycling effort and improved the perceived recovery the day after testing sessions (p < .001). Conclusion: This study suggests that HBO is an efficient strategy to improve cardiac parasympathetic reactivation and is beneficial for subsequent performance.

Test–retest reliability of skeletal muscle oxygenation measurement using near‐infrared spectroscopy during exercise in patients with sport‐related iliac artery flow limitation

The ankle‐brachial index is an accurate tool for detecting claudication in atherosclerotic patients. However, this technique fails to identify subtle flow limitations of the iliac arteries (FLIA) in endurance athletes. Near‐infrared spectroscopy (NIRS) is a noninvasive technique that measures skeletal muscle tissue oxygenation status. The aim of the present study is to examine the absolute and relative test–retest reliability of NIRS and evaluate its potential as a diagnostic tool in FLIA. NIRS‐derived exercise variables were analyzed during exercise and recovery in FLIA 17 patients and 19 healthy controls. The relative reliability of absolute variables (such as the maximal value) were slight to yet predominantly substantial (intraclass correlation coefficient [ICC], ICC range: 0.06–0.76) with good to excellent absolute reliability (absolute limits of agreement [ALoA], ALoA range: 0.8 ± 10.2 to 0.7 ± 13.1; coefficient of variation [CV], CV range: 5%–11%). Absolute values encompassing signal amplitudes showed moderate to almost perfect relative reliability (ICC range: 0.51–0.89) and poor to good absolute reliability (ALoA range: −1.3 ± 7.0 to −2.5 ± 15.7; CV range: 15%–32%). Kinetic variables showed moderate to almost perfect relative reliability for most recovery kinetics variables (ICC range: 0.54–0.86) with fair to good absolute reliability (ALoA range: 0.4 ± 12.2 to 3.9 ± 37.9; CV range: 18%–27%). Particularly, kinetic variables showed significant differences between patients and healthy subjects. NIRS is found to be a reliable method for examining muscle tissue oxygenation variables. Given the significant differences in especially recovery kinetics between normal subjects and patients, NIRS may contribute to diagnosing FLIA in endurance athletes.

Determination of second lactate threshold using near-infrared spectroscopy in elite cyclists

The use of near-infrared spectroscopy could be an interesting alternative to other invasive or expensive methods to estimate the second lactate threshold. Our objective was to compare the intensities of the muscle oxygen saturation breakpoint obtained with the Humon Hex and the second lactate threshold in elite cyclists. Ninety cyclists performed a maximal graded exercise test. Blood capillary lactate was obtained at the end of steps and muscle oxygenation was continuously monitored. There were no differences (p>0.05) between muscle oxygen oxygenation breakpoint and second lactate threshold neither in power nor in heart rate, nor when these values were relativized as a percentage of maximal aerobic power or maximum heart rate. There were also no differences when men and women were studied separately. Both methods showed a highly correlation in power (r=0.914), percentage of maximal aerobic power (r=0.752), heart rate (r=0.955), and percentage of maximum heart rate (r=0.903). Bland-Altman resulted in a mean difference of 0.05±0.27 W·kg-1, 0.91±4.93%, 0.63±3.25 bpm, and 0.32±1.69% for power, percentage of maximal aerobic power, heart rate and percentage of maximum heart rate respectively. These findings suggest that Humon may be a non-invasive and low-cost alternative to estimate the second lactate threshold intensity in elite cyclists.

Developing a near-infrared spectroscopy and microwave-induced thermoacoustic tomography-based dual-modality imaging system

Near-infrared spectroscopy (NIRS) techniques can provide noninvasive in vivo hemoglobin oxygenation information but suffer from relatively low resolution in biological tissue imaging. Microwave-induced thermoacoustic tomography (TAT) can produce high-resolution images of the biological tissue anatomy but offer limited physiological information of samples because of the single species of the chromophore it maps. To overcome these drawbacks and take advantage of the merits of the two independent techniques, we built a dual-modality system by combining a NIRS system and a TAT system to image biological tissues. A series of phantom trials were carried out to demonstrate the performance of the new system. The spatial resolution is about 1 mm, with a penetration depth of at least 17.5 mm in the human subject. A cohort of five healthy subjects was recruited to conduct real-time forearm venous and arterial cuff occlusion experiments. Numerous results showed that this dual-modality system could measure oxygen metabolism and simultaneously provide anatomical structure changes of biological tissues. We also found that although the hemoglobin concentration varied consistently with many other published papers, the TAT signal intensity of veins showed an opposite variation tendency in the venous occlusion stage compared with other existing work. A detailed explanation is given to account for the discrepancy, thus, providing another possibility for the forearm experiments using TAT. Furthermore, based on the multiple types of information afforded by this dual-modality system, a pilot clinical application for the diagnosis of anemia is discussed.

Monitoring adaptation of skin tissue oxygenation during cycling ergometer exercise by frequency-domain diffuse optical spectroscopy

In addition to supplying oxygen molecule O2 for metabolic functions during the adaptation to exercise, blood also plays a critical role in heat dissipation for core temperature stabilization. This study investigates the status of hemodynamic oxygenation in the forearm's skin tissue of three participants during a complete ergometer exercise from the resting to exercising, and to recovering conditions using a three-wavelength frequency-domain diffuse reflectance spectroscopy (FD DRS) alongside the monitoring of heartbeat rate and skin temperature. The FD DRS system was synchronized with radiofrequency (RF)-modulated input photon sources and the respective output to extract time-course absorption and scattering coefficients of the skin tissue, which, through the fitting of lambert's law of absorbance, can be used to determine the concentration of oxygenated/deoxygenated hemoglobin molecules, and consequentially, the oxygen saturation of skin tissue and total hemoglobin (THb) concentration. Expressly, a sudden jump in heartbeat rate at the beginning of the exercise, a temporal lag of the rising edge of skin temperature behind that of the THb concentration in the procession of step-wise incremental working intensity, and the uprising of THb in the exhaustion zone in responses to the physiological adaptation to exercise were identified. Finally, conclusive remarks were drawn that the FD DRS system is useful in extracting the hemodynamic properties of forearm skin which is often being neglected in previous exercise physiology studies by DRS-related techniques. The detailed variation of hemodynamic and optical scattering parameters of forearm skin elucidated in the studies can be applied for the analysis of athletes' physiological status, and may be a potential reference for the design of future wearable devices.

Near Infrared Spectroscopy for Muscle Specific Analysis of Intensity and Fatigue during Cross-Country Skiing Competition-A Case Report

The aims of the study were to assess the robustness and non-reactiveness of wearable near-infrared spectroscopy (NIRS) technology to monitor exercise intensity during a real race scenario, and to compare oxygenation between muscle groups important for cross-country skiing (XCS). In a single-case study, one former elite XCS (age: 39 years, peak oxygen uptake: 65.6 mL/kg/min) was equipped with four NIRS devices, a high-precision global navigation satellite system (GNSS), and a heart rate (HR) monitor during the Vasaloppet long-distance XCS race. All data were normalized to peak values measured during incremental laboratory roller skiing tests two weeks before the race. HR reflected changes in terrain and intensity, but showed a constant decrease of 0.098 beats per minute from start to finish. Triceps brachii (TRI) muscle oxygen saturation (SmO2) showed an interchangeable pattern with HR and seems to be less affected by drift across the competition (0.027% drop per minute). Additionally, TRI and vastus lateralis (VL) SmO2 revealed specific loading and unloading pattern of XCS in uphill and downhill sections, while rectus abdominus (RA) SmO2 (0.111% drop per minute) reflected fatigue patterns occurring during the race. In conclusion, the present preliminary study shows that NIRS provides a robust and non-reactive method to monitor exercise intensity and fatigue mechanisms when applied in an outdoor real race scenario. As local exercise intensity differed between muscle groups and central exercise intensity (i.e., HR) during whole-body endurance exercise such as XCS, NIRS data measured at various major muscle groups may be used for a more detailed analysis of kinetics of muscle activation and compare involvement of upper body and leg muscles. As TRI SmO2 seemed to be unaffected by central fatigue mechanisms, it may provide an alternative method to HR and GNSS data to monitor exercise intensity.

Contextualizing the biological relevance of standardized high-resolution respirometry to assess mitochondrial function in permeabilized human skeletal muscle

Aim

This study sought to provide a statistically robust reference for measures of mitochondrial function from standardized high‐resolution respirometry with permeabilized human skeletal muscle (ex vivo), compare analogous values obtained via indirect calorimetry, arterial‐venous O₂ differences and ³¹P magnetic resonance spectroscopy (in vivo) and attempt to resolve differences across complementary methodologies as necessary.

Methods

Data derived from 831 study participants across research published throughout March 2009 to November 2019 were amassed to examine the biological relevance of ex vivo assessments under standard conditions, ie physiological temperatures of 37°C and respiratory chamber oxygen concentrations of ~250 to 500 μmol/L.

Results

Standard ex vivo‐derived measures are lower (Z ≥ 3.01, P ≤ .0258) en masse than corresponding in vivo‐derived values. Correcting respiratory values to account for mitochondrial temperatures 10°C higher than skeletal muscle temperatures at maximal exercise (~50°C): (i) transforms data to resemble (Z ≤ 0.8, P > .9999) analogous yet context‐specific in vivo measures, eg data collected during maximal 1‐leg knee extension exercise; and (ii) supports the position that maximal skeletal muscle respiratory rates exceed (Z ≥ 13.2, P < .0001) those achieved during maximal whole‐body exercise, e.g. maximal cycling efforts.

Conclusion

This study outlines and demonstrates necessary considerations when actualizing the biological relevance of human skeletal muscle respiratory control, metabolic flexibility and bioenergetics from standard ex vivo‐derived assessments using permeabilized human muscle. These findings detail how cross‐procedural comparisons of human skeletal muscle mitochondrial function may be collectively scrutinized in their relationship to human health and lifespan.

Maximal Fat Oxidation: Comparison between Treadmill, Elliptical and Rowing Exercises

Fat oxidation during exercise is associated with cardio-metabolic benefits, but the extent of which whole-body exercise modality elicits the greatest fat oxidation remains unclear. We investigated the effects of treadmill, elliptical and rowing exercise on fat oxidation in healthy individuals. Nine healthy males participated in three, peak oxygen consumption tests, on a treadmill, elliptical and rowing ergometer. Indirect calorimetry was used to assess maximal oxygen consumption (V̇O_2peak), maximal fat oxidation (MFO) rates, and the exercise intensity MFO occurred (Fat_max). Mixed venous blood was collected to assess lactate and blood gases concentrations. While V̇O_2peak was similar between exercise modalities, MFO rates were higher on the treadmill (mean ± SD; 0.61 ± 0.06 g·min^-1) compared to both the elliptical (0.41 ± 0.08 g·min^-1, p = 0.022) and the rower (0.40 ± 0.08 g·min^-1, p = 0.017). Fat_max values were also significantly higher on the treadmill (56.0 ± 6.2 %V̇O_2peak) compared to both the elliptical (36.8 ± 5.4 %V̇O_2peak, p = 0.049) and rower (31.6 ± 5.0 %V̇O_2peak, p = 0.021). Post-exercise blood lactate concentrations were also significantly lower following treadmill exercise (p = 0.021). Exercising on a treadmill maximizes fat oxidation to a greater extent than elliptical and rowing exercises, and remains an important exercise modality to improve fat oxidation, and consequently, cardio-metabolic health.

Isolated finger flexor vs. exhaustive whole-body climbing tests? How to assess endurance in sport climbers?

PURPOSE

Sport climbing requires high-intensity finger flexor contractions, along with a substantial whole-body systemic oxygen uptake ([Formula: see text]O₂) contribution. Although fatigue is often localised to the finger flexors, the role of systemic ̇[Formula: see text]O₂ and local aerobic mechanisms in climbing performance remains unclear. As such, the primary purpose of this study was to determine systemic and local muscle oxygen responses during both isolated finger flexion and incremental exhaustive whole-body climbing tests. The secondary aim was to determine the relationship of isolated and whole-body climbing endurance tests to climbing ability.

METHODS

Twenty-two male sport climbers completed a series of isometric sustained and intermittent forearm flexor contractions, and an exhaustive climbing test with progressive steepening of the wall angle on a motorised climbing ergometer. Systemic [Formula: see text]O₂ and flexor digitorum profundus oxygen saturation (StO₂) were recorded using portable metabolic analyser and near-infra red spectroscopy, respectively.

RESULTS

Muscle oxygenation breakpoint (MOB) was identifiable during an incremental exhaustive climbing test with progressive increases in angle (82 ± 8% and 88 ± 8% [Formula: see text]O₂ and heart rate climbing peak). The peak angle from whole-body treadwall test and impulse from isolated hangboard endurance tests were interrelated (R² = 0.58-0.64). Peak climbing angle together with mean [Formula: see text]O₂ and StO₂ from submaximal climbing explained 83% of variance in self-reported climbing ability.

CONCLUSIONS

Both systemic and muscle oxygen kinetics determine climbing-specific endurance. Exhaustive climbing and isolated finger flexion endurance tests are interrelated and suitable to assess climbing-specific endurance. An exhaustive climbing test with progressive wall angle allows determination of the MOB.

New Zealand blackcurrant extract enhances muscle oxygenation during repeated intermittent forearm muscle contractions in advanced and elite rock climbers

Anthocyanin-rich New Zealand blackcurrant (NZBC) may improve forearm muscle oxygenation and enhance performance in high-level rock climbers. As such, using a double-blind, randomised, cross-over design study, twelve participants performed an oxidative capacity assessment, and two successive exhaustive exercise trials (submaximal forearm muscle contractions at 60% of their maximal volitional contraction). Each visit was conducted following 7-days intake of 600 mg·day^-1 NZBC extract or placebo. Oxidative capacity was estimated by calculating the oxygen half time recovery using near infrared spectroscopy. Time to exhaustion (s), impulse (kg·s), and minimum tissue saturation index (min-TSI %) were assessed during both the exercise trials. Muscle oxidative capacity was greater with NZBC (mean difference [MD] = 5.3 s, 95% confidence intervals [95% CI] = 0.4-10.2 s; p = 0.036; Cohen's d = 0.94). During the exercise trials, there was an interaction for min-TSI % (time x condition, p = 0.046; ηp2= 0.372), which indicated a greater level of oxygen extraction during trial two with NZBC extract (MD = 9%, 95% CI = 2-15%) compared to the placebo (MD = 2%, 95% CI = 1-7%). There was a decrease in time to exhaustion (p <0.001, ηp2 = 0.693) and impulse (p = 0.001, ηp2 = 0.672) in exercise trial two, with no effect of NZBC extract. In high-level rock climbers 7-days NZBC extract improves forearm muscle oxygenation with no effect on isolated forearm muscle performance.

Hormetic modulation of angiogenic factors by exercise-induced mechanical and metabolic stress in human skeletal muscle

This study used an integrative experimental model in humans to investigate whether muscle angiogenic factors are differentially modulated by exercise stimuli eliciting different degrees of mechanical and metabolic stress. In a randomized crossover design, 12 men performed two low-volume high-intensity exercise regimens, including short sprint intervals (SSI) or long sprint intervals (LSI) inducing pronounced mechanical/metabolic stress, and a high-volume moderate-intensity continuous exercise protocol (MIC) inducing mild but prolonged mechanical/metabolic stress. Gene and protein expression of angiogenic factors was determined in vastus lateralis muscle samples obtained before and after exercise. Exercise upregulated muscle VEGF mRNA to a greater extent in LSI and MIC compared with SSI. Analysis of angiogenic factors sensitive to shear stress revealed more marked exercise-induced VEGF receptor 2 (VEGF-R2) mRNA responses in MIC than SSI, as well as greater platelet endothelial cell adhesion molecule (PECAM-1) and endothelial nitric oxide synthase (eNOS) mRNA responses in LSI than SSI. No apparent exercise-induced phosphorylation of shear stress-sensory proteins VEGF-R2^Tyr1175, PECAM-1^Tyr713, and eNOS^Ser1177 was observed despite robust elevations in femoral artery shear stress. Exercise evoked greater mRNA responses of the mechanical stretch sensor matrix metalloproteinase-9 (MMP9) in SSI than MIC. Exercise-induced mRNA responses of the metabolic stress sensor hypoxia-inducible factor-1α (HIF-1α) were more profound in LSI than SSI. These results suggest that low-volume high-intensity exercise transcriptionally activates angiogenic factors in a mechanical/metabolic stress-dependent manner. Furthermore, the angiogenic potency of low-volume high-intensity exercise appears similar to that of high-volume moderate-intensity exercise, but only on condition of eliciting severe mechanical/metabolic stress. We conclude that the angiogenic stimulus produced by exercise depends on both magnitude and protraction of myocellular homeostatic perturbations.NEW & NOTEWORTHY Skeletal muscle capillary growth is orchestrated by angiogenic factors sensitive to mechanical and metabolic signals. In this study, we employed an integrative exercise model to synergistically target, yet to different extents and for different durations, the mechanical and metabolic components of muscle activity that promote angiogenesis. Our results suggest that the magnitude of the myocellular perturbations incurred during exercise determines the amplitude of the angiogenic molecular signals, implying hormetic modulation of skeletal muscle angiogenesis by exercise-induced mechanical and metabolic stress.

Endocrine and Metabolic Responses to Endurance Exercise Under Hot and Hypoxic Conditions

Purpose

We explored the effect of heat stress during an acute endurance exercise session in hypoxia on endocrine and metabolic responses.

Methods

A total of 12 healthy males cycled at a constant workload (60% of the power output associated with their maximal oxygen uptake under each respective condition) for 60 min in three different environments: exercise under hot and hypoxia (H+H; fraction of inspiratory oxygen or FiO₂: 14.5%, 32°C), exercise under hypoxia (HYP; FiO₂: 14.5%, 23°C), and exercise under normoxia (NOR; FiO₂: 20.9%, 23°C). After completing the exercise, participants remained in the chamber for 3 h to evaluate metabolic and endocrine responses under each environment. Changes in muscle oxygenation (only during exercise), blood variables, arterial oxygen saturation, and muscle temperature were determined up to 3 h after exercise.

Results

Serum erythropoietin (EPO) level was increased to similar levels in both H+H and HYP at 3 h after exercise compared with before exercise (P < 0.05), whereas no significant increase was found under NOR. No significant difference between H+H and HYP was observed in the serum EPO level, blood lactate level, or muscle oxygenation at any time (P > 0.05). Exercise-induced serum growth hormone (GH) elevation was significantly greater in H+H compared with HYP (P < 0.05) and HYP showed significantly lower value than NOR (P < 0.05). Arterial oxygen saturation during exercise was significantly lower in H+H and HYP compared with NOR (P < 0.05). Furthermore, H+H showed higher value compared with HYP (P < 0.05).

Conclusion

The serum EPO level increased significantly with endurance exercise in hypoxia. However, the addition of heat stress during endurance exercise in hypoxia did not augment the EPO response up to 3 h after completion of exercise. Exercise-induced GH elevation was significantly augmented when the hot exposure was combined during endurance exercise in hypoxia. Muscle oxygenation levels during endurance exercise did not differ significantly among the conditions. These findings suggest that combined hot and hypoxic stresses during endurance exercise caused some modifications of metabolic and endocrine regulations compared with the same exercise in hypoxia.

Detection of ventilatory thresholds using near-infrared spectroscopy with a polynomial regression model

Whether near-infrared spectroscopy (NIRS) is a convenient and accurate method of determining first and second ventilatory thresholds (VT₁ and VT₂) using raw data remains unknown. This study investigated the reliability and validity of VT₁ and VT₂ determined by NIRS skeletal muscle hemodynamic raw data via a polynomial regression model. A total of 100 male students were recruited and performed maximal cycling exercises while their cardiopulmonary and NIRS muscle hemodynamic data were measured. The criterion validity of VT_1VET and VT_2VET were determined using a traditional V-slope and ventilatory efficiency. Statistical significance was set at α = . 05. There was high reproducibility of VT_1NIRS and VT_2NIRS determined by a NIRS polynomial regression model during exercise (VT_1NIRS, r = 0.94; VT_2NIRS, r = 0.93). There were high correlations of VT_1VET vs VT_1NIRS (r = 0.93, p < .05) and VT_2VET vs VT_2NIRS (r = 0.94, p < .05). The oxygen consumption (VO₂) between VT_1VET and VT_1NIRS or VT_2VET and VT_2NIRS was not significantly different. NIRS raw data are reliable and valid for determining VT₁ and VT₂ in healthy males using a polynomial regression model. Skeletal muscle raw oxygenation and deoxygenation status reflects more realistic causes and timing of VT₁ and VT₂.

Near-infrared spectroscopy as a quantitative spasticity assessment tool: A systematic review

The purpose of this paper is to systematically review the literature on the use of near-infrared spectroscopy (NIRS) for assessing spasticity. MEDLINE, CINAHL, and EMBASE were searched for human and/or animal studies written in the English language published until November 2018. that used NIRS to examine the hemodynamics and/or metabolism of spastic musculature were included. Of the 35 articles identified, five met the inclusion criteria. Two reviewers independently extracted spasticity outcomes, NIRS instrumentation specifications, and NIRS hemodynamic and metabolic measures from each article. Risk of bias was assessed using the Downs & Black tool for non-randomized studies. Three different models of NIRS devices were used in the five studies. Four studies examined the effects of passive limb movements and one examined active hand movements on NIRS parameters in spastic and non-spastic muscle. Owing to the small number and diverse nature of the studies, statistical comparison was deemed inappropriate. Rather, descriptive comparisons were drawn and levels of evidence were assigned based on the modified Sackett Scale. There is level 4 evidence that NIRS can non-invasively detect and measure differences between spastic and non-spastic muscles in blood volume and oxidative capacity changes over time or in response to interventions, and may correlate with other, established measures of spasticity, such as the Modified Ashworth Scale (MAS) and electromyography (EMG). Future research studies should use a validated definition of spasticity for inclusion criteria, a control group, and standardized NIRS variables.

The Effect of Carotid Chemoreceptor Inhibition on Exercise Tolerance in Chronic Heart Failure

Purpose

Chronic heart failure (CHF) is characterized by heightened sympathetic nervous activity, carotid chemoreceptor (CC) sensitivity, marked exercise intolerance and an exaggerated ventilatory response to exercise. The purpose of this study was to determine the effect of CC inhibition on exercise cardiovascular and ventilatory function, and exercise tolerance in health and CHF.

Methods

Twelve clinically stable, optimally treated patients with CHF (mean ejection fraction: 43 ± 2.5%) and 12 age- and sex-matched healthy controls were recruited. Participants completed two time-to-symptom-limitation (TLIM) constant load cycling exercise tests at 75% peak power output with either intravenous saline or low-dose dopamine (2 μg⋅kg^–1⋅min^–1; order randomized). Ventilation was measured using expired gas data and operating lung volume data were determined during exercise by inspiratory capacity maneuvers. Cardiac output was estimated using impedance cardiography, and vascular conductance was calculated as cardiac output/mean arterial pressure.

Results

There was no change in TLIM in either group with dopamine (CHF: saline 13.1 ± 2.4 vs. dopamine 13.5 ± 1.6 min, p = 0.78; Control: saline 10.3 ± 1.2 vs. dopamine 11.5 ± 1.3 min, p = 0.16). In CHF patients, dopamine increased cardiac output (p = 0.03), vascular conductance (p = 0.01) and oxygen delivery (p = 0.04) at TLIM, while ventilatory parameters were unaffected (p = 0.76). In controls, dopamine improved vascular conductance at TLIM (p = 0.03), but no other effects were observed.

Conclusion

Our findings suggest that the CC contributes to cardiovascular regulation during full-body exercise in patients with CHF, however, CC inhibition does not improve exercise tolerance.

Muscle oxygen dynamics in elite climbers during finger-hang tests at varying intensities

The aim of this study was to measure muscle oxygen saturation (SmO₂) dynamics during a climbing specific task until failure in varying conditions. Our prediction was that SmO₂ should be a good marker to predict task failure. Eleven elite level climbers performed a finger-hang test on a 23 mm wooden rung under four different weighted conditions, 1. body weight (BW), 2. body weight +20% (BW +20), 3. body weight −20% (BW −20) and 4. body weight −40% (BW −40), maintaining half crimp grip until voluntary exhaustion. During each trial SmO₂ and time to task failure (TTF) were measured. TTF was then compared to the minimally attainable value of SmO₂ (SmO₂min) and time to SmO₂min (TTmin). There is a considerable degree of agreement between attainable SmO₂min at high intensity conditions (M_BW = 21.6% ± 6.4; M_BW+20 = 24.0% ± 7.0; M_BW−20 = 23.0% ± 7.3). Bland-Altman plot with an a priori set equivalency interval of ±5% indicate that these conditions are statistically not different (M_{BW-BW + 20} = −2.4%, 95% CI [1.4, −6.2]; M_BW−Bw−20 = −1.3, 95% CI [2.5, −5.1]). The fourth and lowest intensity condition (M_{BW −40} = 32.4% ± 8.8) was statistically different and not equivalent (M_{BW-BW −40} = −8.8%, 95% CI [−5.0, −12.6]). The same agreement was found between TTF and TTmin for the high intensity conditions plotted via Bland-Altman. While the rate with which oxygen was extracted and utilised changed with the conditions, the attainable SmO₂min remained constant at high intensity conditions and was related to TTF.

Muscle Oxygenation During Hypoxic Exercise in Children and Adults

INTRODUCTION

While hypoxia is known to decrease peak oxygen uptake ( V . ⁢ o _{2 max}) and maximal power output in both adults and children its influence on submaximal exercise cardiorespiratory and, especially, muscle oxygenation responses remains unclear.

METHODS

Eight pre-pubertal boys (age = 8 ± 2 years.; body mass (BM) = 29 ± 7 kg) and seven adult males (age = 39 ± 4 years.; BM = 80 ± 8 kg) underwent graded exercise tests in both normoxic (P_iO₂ = 134 ± 0.4 mmHg) and hypoxic (P_iO₂ = 105 ± 0.6 mmHg) condition. Continuous breath-by-breath gas exchange and near infrared spectroscopy measurements, to assess the vastus lateralis oxygenation, were performed during both tests. The gas exchange threshold (GET) and muscle oxygenation thresholds were subsequently determined for both groups in both conditions.

RESULTS

In both groups, hypoxia did not significantly alter either GET or the corresponding V . ⁢ o ₂ at GET. In adults, higher V . _E levels were observed in hypoxia (45 ± 6 l/min) compared to normoxia (36 ± 6 l/min, p < 0.05) at intensities above GET. In contrast, in children both the hypoxic V . _E and V . ⁢ o ₂ responses were significantly greater than those observed in normoxia only at intensities below GET (p < 0.01 for V . _E and p < 0.05 for V . ⁢ o ₂). Higher exercise-related heart rate (HR) levels in hypoxia, compared to normoxia, were only noted in adults (p < 0.01). Interestingly, hypoxia per se did not influence the muscle oxygenation thresholds during exercise in neither group. However, and in contrast to adults, the children exhibited significantly higher total hemoglobin concentration during hypoxic as compared to normoxic exercise (tHb) at lower exercise intensities (30 and 60 W, p = 0.01).

CONCLUSION

These results suggest that in adults, hypoxia augments exercise ventilation at intensities above GET and might also maintain muscle blood oxygenation via increased HR. On the other hand, children exhibit a greater change of muscle blood perfusion, oxygen uptake as well as ventilation at exercise intensities below GET.

Complex I is bypassed during high intensity exercise

Human muscles are tailored towards ATP synthesis. When exercising at high work rates muscles convert glucose to lactate, which is less nutrient efficient than respiration. There is hence a trade-off between endurance and power. Metabolic models have been developed to study how limited catalytic capacity of enzymes affects ATP synthesis. Here we integrate an enzyme-constrained metabolic model with proteomics data from muscle fibers. We find that ATP synthesis is constrained by several enzymes. A metabolic bypass of mitochondrial complex I is found to increase the ATP synthesis rate per gram of protein compared to full respiration. To test if this metabolic mode occurs in vivo, we conduct a high resolved incremental exercise tests for five subjects. Their gas exchange at different work rates is accurately reproduced by a whole-body metabolic model incorporating complex I bypass. The study therefore shows how proteome allocation influences metabolism during high intensity exercise.

The effect of carotid chemoreceptor inhibition on exercise tolerance in chronic obstructive pulmonary disease: A randomized-controlled crossover trial

BACKGROUND

Patients with chronic obstructive pulmonary disease (COPD) have an exaggerated ventilatory response to exercise, contributing to exertional dyspnea and exercise intolerance. We recently demonstrated enhanced activity and sensitivity of the carotid chemoreceptor (CC) in COPD which may alter ventilatory and cardiovascular regulation and negatively affect exercise tolerance. We sought to determine whether CC inhibition improves ventilatory and cardiovascular regulation, dyspnea and exercise tolerance in COPD.

METHODS

Twelve mild-moderate COPD patients (FEV₁ 83 ± 15 %predicted) and twelve age- and sex-matched healthy controls completed two time-to-symptom limitation (T_LIM) constant load exercise tests at 75% peak power output with either intravenous saline or low-dose dopamine (2 μg·kg^-1·min^-1, order randomized) to inhibit the CC. Ventilatory responses were evaluated using expired gas data and dyspnea was evaluated using a modified Borg scale. Inspiratory capacity maneuvers were performed to determine operating lung volumes. Cardiac output was estimated using impedance cardiography and vascular conductance was calculated as cardiac output/mean arterial pressure (MAP).

RESULTS

At a standardized exercise time of 4-min and at T_LIM; ventilation, operating volumes and dyspnea were unaffected by dopamine in COPD patients and controls. In COPD, dopamine decreased MAP and increased vascular conductance at all time points. In controls, dopamine increased vascular conductance at T_LIM, while MAP was unaffected.

CONCLUSION

There was no change in time to exhaustion in either group with dopamine. These data suggest that the CC plays a role in cardiovascular regulation during exercise in COPD; however, ventilation, dyspnea and exercise tolerance were unaffected by CC inhibition in COPD patients.

Maximal oxygen consumption and oxygen muscle saturation recovery following repeated anaerobic sprint test in youth soccer players

BACKGROUND

The purpose of the study was to examine whether differences in aerobic capacity (VO2max) influence muscle reoxygenation following repeated anaerobic sprint test (RAST) in soccer players. We hypothesized that muscle reoxygenation is faster in players with higher aerobic capacity.

METHODS

Ten male, youth soccer players participated in the study and performed RAST on a synthetic grass field. Oxygen saturation in muscle (StO2) of the right vastus lateralis muscle was measured by near-infrared spectroscopy. Half the time that was required for StO2 recovery (T1/2 StO2) after RAST was used to evaluate the reoxygenation in the recovery period after testing. The T1/2 StO2 was defined as the time from the end of RAST testing to the time of reaching 50% of StO2. Aerobic capacity (VO2max) was estimated by the Yo-Yo Intermittent Recovery Test level 1 (YYIR1).

RESULTS

The T1/2 StO2 had a significant inverse correlation with VO2max (r=-0.71; P=0.021) and with the distance which was covered by players on YYIR1 test (r=-0.71; P=0.021). In contrast, StO2 recovery rate showed no significant correlations with the VO2max in subjects.

CONCLUSIONS

These results indicate that aerobic capacity can influence vastus lateralis reoxygenation following RAST in youth soccer players.

Association Between Deoxygenated Hemoglobin Breaking Point, Anaerobic Threshold, and Rowing Performance

PURPOSE

To compare the intensity and physiological responses of deoxygenated hemoglobin breaking point ([HHb]BP) and anaerobic threshold (AnT) during an incremental test and to verify their association with 2000-m rowing-ergometer performance in well-trained rowers.

METHODS

A total of 13 male rowers (mean [SD] age = 24 [11] y and V˙O2peak = 63.7 [6.1] mL·kg-1·min-1) performed a step incremental test. Gas exchange, vastus lateralis [HHb], and blood lactate concentration were measured. Power output, V˙O2, and heart rate of [HHb]BP and AnT were determined and compared with each other. A 2000-m test was performed in another visit.

RESULTS

No differences were found between [HHb]BP and AnT in the power output (236 [31] vs 234 [31] W; Δ = 0.7%), 95% confidence interval [CI] 6.7%), V˙O2 (4.2 [0.5] vs 4.3 [0.4] L·min-1; Δ = -0.8%, 95% CI 4.0%), or heart rate (180 [16] vs 182 [12] beats·min-1; Δ = -1.6%, 95% CI 2.1%); however, there was high typical error of estimate (TEE) and wide 95% limits of agreement (LoA) for power output (TEE 10.7%, LoA 54.1-50.6 W), V˙O2 (TEE 5.9%, LoA -0.57 to 0.63 L·min-1), and heart rate (TEE 2.4%, LoA -9.6 to 14.7 beats·min-1). Significant correlations were observed between [HHb]BP (r = .70) and AnT (r = .89) with 2000-m mean power.

CONCLUSIONS

These results demonstrate a breaking point in [HHb] of the vastus lateralis muscle during the incremental test that is capable of distinguishing rowers with different performance levels. However, the high random error would compromise the use of [HHb]BP for training and testing in rowing.

Changes in microvascular oxygenation and total hemoglobin concentration of the vastus lateralis during neuromuscular electrical stimulation (NMES)

Background and Introduction: Neuromuscular electrical stimulation (NMES) is predicated on eliciting muscle contractions and increasing muscle demand to promote increase in strength. Previous studies have shown differences in the magnitude of elicited force among various NMES waveforms but less is known about metabolic demand of muscle during NMES.Objective/Purpose: The purpose of this study was to compare elicited force and muscle metabolic demand during electrically elicited contractions using different NMES waveforms.Methods: A single-session repeated measures design was used. Electrically elicited force (EEF), microvascular oxygenation (SmO2), total hemoglobin concentration ([THC]) of the vastus lateralis, and subject tolerance (VAS score) were measured using three NMES waveforms; burst modulated alternating current (Russian), biphasic pulsed current (VMS®), and burst modulated biphasic pulsed current (VMS-burst®).Results: A significant main effect for waveform was noted for EEF (F = 12.693, p < .001), SmO2 (F = 8.340, p = .001), and VAS (F = 4.213, p = .025), but not [THC]. Compared to Russian current, VMS-burst and VMS resulted in significantly greater EEF (p = .001; p = .009) and local metabolic demand (i.e. decreased SmO2) (p = .005; p = .003), but not [THC]. VAS was significantly greater (p = .023) for VMS (4.2) compared to Russian (3.07) but not different between VMS-burst and Russian and VMS-burst and VMS.Conclusion: Greater muscle force and local metabolic demand were observed with VMS-burst and VMS compared to Russian current. These data provide novel evidence to guide clinical decision making when selecting an NMES waveform.

The oral nitrate-reducing capacity correlates with peak power output and peak oxygen uptake in healthy humans

Interest in inorganic nitrate and nitrite has grown substantially over the past decade as research has revealed the role of these anions in enhancing nitric oxide (NO) availability through an oral pathway. Nitrite synthesis in the mouth seems to be an important mechanism to feed the circulatory system with this anion. This is interesting since greater plasma nitrite concentration has been associated with better fitness levels in humans, but this question has not been investigated in relation to salivary nitrite concentration. Additionally, no previous study has investigated the oral nitrate-reducing capacity in regards to peak oxygen uptake (VO_2peak) or peak power output (W_peak) in humans. Thus, the main goal of this study was to investigate whether salivary nitrite and nitrate concentration and the oral nitrate-reducing capacity were associated with VO2_peak and W_peak in healthy humans. Fifty individuals (22 females and 28 males; 38.8 ± 14.3 years/old; BMI = 22.8 ± 3.9) performed a graded exercise test on a cycle ergometer to assess their VO_2peak and W_peak. Unstimulated salivary samples were taken before and 20 min after exercise to measure nitrate/nitrite, pH and lactate. The oral nitrate-reducing capacity was also assessed in 25 subjects before and after exercise. Oral nitrate-reducing capacity was positively associated with W_peak (r_s = 0.64; P = 0.001) and the VO_2peak (r_s = 0.54; P = 0.005). Similar correlations were found when these variables were analysed after exercise. In addition, a significant decrease in salivary pH (pre: 7.28 ± 0.361; post-exercise: 7.16 ± 0.33; P = 0.003) accompanied by an increase of salivary lactate (pre: 0.17 ± 0.14 mmol/L; post-exercise: 0.48 ± 0.38; P < 0.001) was found after exercise. However, these changes did not have any impact on salivary nitrate/nitrite concentration and the oral nitrate-reducing capacity after exercise. In conclusion, this is the first evidence showing a link between the oral nitrate-reducing capacity and markers of aerobic fitness levels in healthy humans.

Single-leg cycling increases limb-specific blood flow without concurrent increases in normalised power output when compared with double-leg cycling in healthy middle-aged adults

This study examined the acute performance, cardiovascular and local muscular responses to perceived exertion-based high-intensity interval exercise using either double- or single-leg cycling. Fifteen healthy middle-aged adults completed, on separate occasions, ten 30-s double-leg intervals interspersed with 60 s passive recovery and twenty (ten with each leg) 30-s single-leg intervals interspersed with 60 s passive recovery. Impedance cardiography, blood pressure, muscle oxygenation and total haemoglobin content (near-infrared spectroscopy), oxygen consumption and power output were measured throughout each session. Normalised to the lean mass used during each trial, single-leg cycling resulted in lower power output (single-leg: 8.92 ± 1.74 W kg^-1 and double-leg: 10.41 ± 3.22 W kg^-1; p < 0.05) but greater oxygen consumption (single-leg: 103 ± 11 mL kg^-1 min^-1 and double-leg: 84 ± 21 mL kg^-1 min^-1; p < 0.01) and cardiac output (single-leg: 1407 ± 334 mL kg^-1 min^-1 and double-leg: 850 ± 222 mL kg^-1 min^-1; p < 0.01), compared with double-leg cycling. Mean arterial pressure (double-leg: 108 ± 11 mmHg and single-leg: 102 ± 10 mmHg), change in total haemoglobin content (double-leg: 8.76 ± 10.65 µM cm s^-1 and single-leg: 13.42 ± 4.10 µM cm s^-1) and change in tissue oxygenation index (double-leg: -4.51 ± 3.56% and single-leg: -3.97 ± 3.91%) were not different between double-leg and single-leg cycling. When compared to double-leg cycling, single-leg cycling elicited a higher cardiac output relative to the lean mass, but this did not result in greater power output. The dissociation between blood availability and power output is consistent with an ageing model characterised by a decrease in local oxygen delivery and distribution capability.

Validation of a novel wearable, wireless technology to estimate oxygen levels and lactate threshold power in the exercising muscle

There is a growing interest in monitoring muscle oxygen saturation (SmO₂), which is a localized measure of muscle oxidative metabolism and can be acquired continuously and noninvasively using near‐infrared spectroscopy (NIRS) methods. Most NIRS systems are cumbersome, expensive, fiber coupled devices, with use limited to lab settings. A novel, low cost, wireless, wearable has been developed for use in athletic training. In this study, we evaluate the advantages and limitations of this new simple continuous‐wave (CW) NIRS device with respect to a benchtop, frequency‐domain near‐infrared spectroscopy (FDNIRS) system. Oxygen saturation and hemoglobin/myoglobin concentration in the exercising muscles of 17 athletic individuals were measured simultaneously with the two systems, while subjects performed an incremental test on a stationary cycle ergometer. In addition, blood lactate concentration was measured at the end of each increment with a lactate analyzer. During exercise, the correlation coefficients of the SmO₂ and hemoglobin/myoglobin concentrations between the two systems were over 0.70. We also found both systems were insensitive to the presence of thin layers of varying absorption, mimicking different skin colors. Neither system was able to predict the athletes’ lactate threshold power accurately by simply using SmO₂ thresholds. Instead, the proprietary software of the wearable device was able to predict the athletes’ lactate threshold power within half of one power increment of the cycling test. These results indicate this novel wearable device may provide a physiological indicator of athlete's exertion.

Tissue Oxygenation in Response to Different Relative Levels of Blood-Flow Restricted Exercise

Blood flow restrictive (BFR) exercise elicits a localized hypoxic environment compatible with greater metabolic stress. We intended to compare the acute changes in muscle microvascular oxygenation following low-intensity knee extension exercise, combined with different levels of BFR. Thirteen active young men (age: 23.8 ± 5.4 years) were tested for unilateral knee extension exercise (30 + 15 + 15 + 15 reps at 20% one repetition maximum) on four different conditions: no-BFR (NOBFR), 40, 60, and 80% of arterial occlusion pressure (AOP). Deoxyhemoglobin+myoglobin concentration Deoxy[Hb+Mb], total hemoglobin [T(H+Mb)] and tissue oxygen saturation [TOI] were measured on the vastus lateralis muscle using near-infrared spectroscopy (NIMO, Nirox srl, Brescia, Italy). The magnitude of change in Deoxy[Hb+Mb]during exercise was similar between 60 and 80% AOP. Overall, compared to that seen during 60 and 80% AOP, NOBFR as well as 40% AOP resulted in a lower magnitude of change in Deoxy[Hb+Mb] (p < 0.05). While the oxygen extraction decreased during each inter-set resting interval in NOBFR and 40% AOP, this was not the case for 60 or 80% AOP. Additionally, TOI values obtained during recovery from each set of exercise were similarly affected by all conditions. Finally, our data also show that, when performed at higher restrictive values (60 and 80%), BFR exercise increases total Deoxy[Hb+Mb] extraction (p < 0.05). Taken together, we provide evidence that BFR is effective for increasing deoxygenation and reducing tissue oxygenation during low-intensity exercise. We also showed that when using low loads, a relative pressure above 40% of the AOP at rest is required to elicit changes in microvascular oxygenation compared with the same exercise with unrestricted conditions.

Understanding near infrared spectroscopy and its application to skeletal muscle research

Near infrared spectroscopy (NIRS) is a powerful noninvasive tool with which to study the matching of oxygen delivery to oxygen utilization and the number of new publications utilizing this technique has increased exponentially in the last 20 yr. By measuring the state of oxygenation of the primary heme compounds in skeletal muscle (hemoglobin and myoglobin), greater understanding of the underlying control mechanisms that couple perfusive and diffusive oxygen delivery to oxidative metabolism can be gained from the laboratory to the athletic field to the intensive care unit or emergency room. However, the field of NIRS has been complicated by the diversity of instrumentation, the inherent limitations of some of these technologies, the associated diversity of terminology, and a general lack of standardization of protocols. This Cores of Reproducibility in Physiology (CORP) will describe in basic but important detail the most common methodologies of NIRS, their strengths and limitations, and discuss some of the potential confounding factors that can affect the quality and reproducibility of NIRS data. Recommendations are provided to reduce the variability and errors in data collection, analysis, and interpretation. The goal of this CORP is to provide readers with a greater understanding of the methodology, limitations, and best practices so as to improve the reproducibility of NIRS research in skeletal muscle.

Onset of Accelerated Muscle Deoxygenation During the 20-m Shuttle Run Test in Boys

PURPOSE

This study aimed to compare the relative exercise intensity at which the onset of accelerated muscle deoxygenation occurs during the 20-m shuttle run test (20mSRT) between boys and men and to examine whether the timing of the onset of acceleration appearance is related to 20mSRT performance in boys.

METHODS

Twenty-four boys performed the 20mSRT, during which concentration changes in oxygenated and deoxygenated hemoglobin and myoglobin (ΔOxy-Hb and ΔDeoxy-Hb, respectively) in the m. vastus lateralis were monitored using a portable near-infrared spectroscopy device. The boys' data were compared with those of 29 men in a previous study.

RESULTS

An onset of accelerated decrease in Δ[Oxy-Hb - Deoxy-Hb] was found in 11 of the 24 boys (45.8%) and 20 of the 29 men (69.0%) and was found at a higher relative exercise intensity in the boys than in the men. The number of laps at which the onset of acceleration occurred correlated with total laps in the boys (r = .87).

CONCLUSIONS

These findings demonstrate that the onset of accelerated muscle deoxygenation during the 20mSRT occurs at a higher relative exercise intensity in boys than in men. Our findings also show that the timing of the onset of acceleration appearance is associated with 20mSRT performance in boys.

Oxygenation time course and neuromuscular fatigue during repeated cycling sprints with bilateral blood flow restriction

The aim was to evaluate changes in peripheral and cerebral oxygenation, cardiorespiratory, and performance differences, as well as neuromuscular fatigue across multiple levels of blood flow restriction (BFR) during a repeated cycling sprint test to exhaustion (RST). Participants performed three RST (10-sec maximal sprints with 20-sec recovery until exhaustion) with measurements of power output and V̇O2peak as well as oxygenation (near-infrared spectroscopy) of the vastus lateralis and prefrontal cortex. Neuromuscular fatigue was assessed by femoral nerve stimulation to evoke the vastus lateralis. Tests were conducted with proximal lower limb bilateral vascular occlusion at 0%, 45%, and 60% of resting pulse elimination pressure. Total work decreased with BFR (52.5 ± 22.9% at 45%, 68.6 ± 32.6% at 60%, P < 0.01 compared with 0%) as V̇O2peak (12.6 ± 9.3% at 45%, 18.2 ± 7.2% at 60%, compared with 0%, P < 0.01). Decreased changes in muscle deoxyhemoglobin (∆[HHb]) during sprints were demonstrated at 60% compared to 0% (P < 0.001). Changes in total hemoglobin concentrations (∆[tHb]) increased at both 45% and 60% compared with 0% (P < 0.001). Cerebral ∆[tHb] increased toward exhaustion (P < 0.05). Maximal voluntary contraction (MVC), voluntary activation level (VAL), and root mean square (RMS)/M-wave ratio decreased at 60% compared with 0% (P < 0.001, all). MVC and VAL decreased between 45% and 60% (P < 0.05, both). The application of BFR during RST induced greater changes in tissue perfusion (via blood volume, ∆[tHb]) suggesting a possible stimulus for vascular blood flow regulation. Additionally, high-intensity sprint exercise with partial ischemia may challenge cerebral blood flow regulation and influence local fatigue development due to protection of cerebral function.

Characterising skeletal muscle haemoglobin saturation during exercise using near-infrared spectroscopy in chronic kidney disease

Background

Chronic kidney disease (CKD) patients have reduced exercise capacity. Possible contributing factors may include impaired muscle O₂ utilisation through reduced mitochondria number and/or function slowing the restoration of muscle ATP concentrations via oxidative phosphorylation. Using near-infrared spectroscopy (NIRS), we explored changes in skeletal muscle haemoglobin/myoglobin O₂ saturation (SMO₂%) during exercise.

Methods

24 CKD patients [58.3 (± 16.5) years, eGFR 56.4 (± 22.3) ml/min/1.73 m²] completed the incremental shuttle walk test (ISWT) as a marker of exercise capacity. Using NIRS, SMO₂% was measured continuously before, during, and after (recovery) exercise. Exploratory differences were investigated between exercise capacity tertiles in CKD, and compared with six healthy controls.

Results

We identified two discrete phases; a decline in SMO₂% during incremental exercise, followed by rapid increase upon cessation (recovery). Compared to patients with low exercise capacity [distance walked during ISWT, 269.0 (± 35.9) m], patients with a higher exercise capacity [727.1 (± 38.1) m] took 45% longer to reach their minimum SMO₂% (P = .038) and recovered (half-time recovery) 79% faster (P = .046). Compared to controls, CKD patients took significantly 56% longer to recover (i.e., restore SMO₂% to baseline, full recovery) (P = .014).

Conclusions

Using NIRS, we have determined for the first time in CKD, that favourable SMO₂% kinetics (slower deoxygenation rate, quicker recovery) are associated with greater exercise capacity. These dysfunctional kinetics may indicate reduced mitochondria capacity to perform oxidative phosphorylation—a process essential for carrying out even simple activities of daily living. Accordingly, NIRS may provide a simple, low cost, and non-invasive means to evaluate muscle O₂ kinetics in CKD.

Muscle oxygenation profiles between active and inactive muscles with nitrate supplementation under hypoxic exercise

Whether dietary nitrate supplementation improves exercise performance or not is still controversial. While redistribution of sufficient oxygen from inactive to active muscles is essential for optimal exercise performance, no study investigated the effects of nitrate supplementation on muscle oxygenation profiles between active and inactive muscles. Nine healthy males performed 25 min of submaximal (heart rate ~140 bpm; EX_sub) and incremental cycling (EX_max) until exhaustion under three conditions: (A) normoxia without drink; (B) hypoxia (FiO₂ = 13.95%) with placebo (PL); and (c) hypoxia with beetroot juice (BR). PL and BR were provided for 4 days. Oxygenated and deoxygenated hemoglobin (HbO₂ and HHb) were measured in vastus lateralis (active) and biceps brachii (inactive) muscles, and the oxygen saturation of skeletal muscle (StO₂; HbO₂/total Hb) were calculated. During EX_sub, BR suppressed the HHb increases in active muscles during the last 5 min of exercise. During EX_max, time to exhaustion with BR (513 ± 24 sec) was significantly longer than with PL (490 ± 39 sec, P < 0.05). In active muscles, BR suppressed the HHb increases at moderate work rates during EX_max compared to PL (P < 0.05). In addition, BR supplementation was associated with greater reductions in HbO₂ and StO₂ at higher work rates in inactive muscles during EX_max. Collectively, these findings indicate that short‐term dietary nitrate supplementation improved hypoxic exercise tolerance, perhaps, due to suppressed increases in HHb in active muscles at moderate work rates. Moreover, nitrate supplementation caused greater reductions in oxygenation in inactive muscle at higher work rates during hypoxic exercise.

Changes in Muscle and Cerebral Deoxygenation and Perfusion during Repeated Sprints in Hypoxia to Exhaustion

During supramaximal exercise, exacerbated at exhaustion and in hypoxia, the circulatory system is challenged to facilitate oxygen delivery to working tissues through cerebral autoregulation which influences fatigue development and muscle performance. The aim of the study was to evaluate the effects of different levels of normobaric hypoxia on the changes in peripheral and cerebral oxygenation and performance during repeated sprints to exhaustion. Eleven recreationally active participants (six men and five women; 26.7 ± 4.2 years, 68.0 ± 14.0 kg, 172 ± 12 cm, 14.1 ± 4.7% body fat) completed three randomized testing visits in conditions of simulated altitude near sea-level (~380 m, F_IO₂ 20.9%), ~2000 m (F_IO₂ 16.5 ± 0.4%), and ~3800 m (F_IO₂ 13.3 ± 0.4%). Each session began with a 12-min warm-up followed by two 10-s sprints and the repeated cycling sprint (10-s sprint: 20-s recovery) test to exhaustion. Measurements included power output, vastus lateralis, and prefrontal deoxygenation [near-infrared spectroscopy, delta (Δ) corresponds to the difference between maximal and minimal values], oxygen uptake, femoral artery blood flow (Doppler ultrasound), hemodynamic variables (transthoracic impedance), blood lactate concentration, and rating of perceived exertion. Performance (total work, kJ; −27.1 ± 25.8% at 2000 m, p < 0.01 and −49.4 ± 19.3% at 3800 m, p < 0.001) and pulse oxygen saturation (−7.5 ± 6.0%, p < 0.05 and −18.4 ± 5.3%, p < 0.001, respectively) decreased with hypoxia, when compared to 400 m. Muscle Δ hemoglobin difference ([Hbdiff]) and Δ tissue saturation index (TSI) were lower (p < 0.01) at 3800 m than at 2000 and 400 m, and lower Δ deoxyhemoglobin resulted at 3800 m compared with 2000 m. There were reduced changes in peripheral [Δ[Hbdiff], ΔTSI, Δ total hemoglobin ([tHb])] and greater changes in cerebral (Δ[Hbdiff], Δ[tHb]) oxygenation throughout the test to exhaustion (p < 0.05). Changes in cerebral deoxygenation were greater at 3800 m than at 2000 and 400 m (p < 0.01). This study confirms that performance in hypoxia is limited by continually decreasing oxygen saturation, even though exercise can be sustained despite maximal peripheral deoxygenation. There may be a cerebral autoregulation of increased perfusion accounting for the decreased arterial oxygen content and allowing for task continuation, as shown by the continued cerebral deoxygenation.

Hypoxia affects tissue oxygenation differently in the thigh and calf muscles during incremental running

PURPOSE

The present study was performed to determine the impact of hypoxia on working muscle oxygenation during incremental running, and to compare tissue oxygenation between the thigh and calf muscles.

METHODS

Nine distance runners and triathletes performed incremental running tests to exhaustion under normoxic and hypoxic conditions (fraction of inspired oxygen = 0.15). Peak pulmonary oxygen uptake ([Formula: see text]) and tissue oxygen saturation (StO₂) were measured simultaneously in both the vastus lateralis and medial gastrocnemius.

RESULTS

Hypoxia significantly decreased peak running speed and [Formula: see text] (p < 0.01). During incremental running, StO₂ in the vastus lateralis decreased almost linearly, and the rate of decrease from warm-up (180 m min^-1) to [Formula: see text] was significantly greater than in the medial gastrocnemius under both normoxic and hypoxic conditions (p < 0.01). StO₂ in both muscles was significantly decreased under hypoxic compared with normoxic conditions at all running speeds (p < 0.01). The rate at which StO₂ was decreased by hypoxia was greater in the vastus lateralis as the running speed increased, whereas it changed little in the medial gastrocnemius.

CONCLUSIONS

These results suggest that the thigh is more deoxygenated than the calf under hypoxic conditions, and that the effects of hypoxia on tissue oxygenation differ between these two muscles during incremental running.

Faster V̇O2 kinetics after priming exercises of different duration but same fatigue

This study compared the responses of two priming exercises of similar fatigue on the adjustment of the oxygen uptake time constant (τV̇O₂) in cycling. Ten healthy young adults (25 ± 3 yr) performed: three step transitions from a 20-W baseline to the power output (PO) below the gas exchange threshold (MOD, MOD_PRE); a 3-min bout (P_3MIN) at 90% of peak PO (PO_peak), followed by MOD (MOD_3MIN); and a 6-min bout (P_6MIN) at 80% of PO_peak, followed by MOD (MOD_6MIN). The O₂ supply-to-O₂ demand ([HHb]/V̇O₂) ratio was calculated for MOD_PRE, MOD_3MIN, and MOD_6MIN. Neuromuscular fatigue was measured isometrically pre- and post-priming exercise. Reductions in maximal voluntary contraction (-29 ± 6 vs -34 ± 7%) and high-frequency doublet amplitude (-48 ± 13 vs -43 ± 11%) were not significantly different between P_3MIN vs P_6MIN, suggesting similar fatigue. τV̇O₂ for MOD_3MIN and MOD_6MIN were similar, being ~25% smaller than MOD_PRE. The [HHb]/V̇O₂ ratio was significantly greater in MOD_PRE (1.13 ± 0.12) compared to MOD_3MIN (1.02 ± 0.04) and MOD_6MIN (1.02 ± 0.04). This study showed that priming exercise of shorter duration and higher intensity, was sufficient to accelerate V̇O₂ kinetics similarly to that observed subsequent to P_6MIN when the muscle fatigue was similar.

Accelerated point of muscle deoxygenation during the 20-m shuttle run test

This study examined whether the point of accelerated deoxygenation of active muscle occurs during the 20-m shuttle run test (20mSRT) and, if so, whether it is associated with exercise performance in the test. Twenty-nine male subjects performed the 20mSRT, and concentration changes in oxyhaemoglobin (ΔOxy-Hb) and deoxyhaemoglobin (ΔDeoxy-Hb) in the m. vastus lateralis were measured using a portable near-infrared spectroscopy device. The difference between the relative concentration changes in ΔOxy-Hb and ΔDeoxy-Hb (Δ[Oxy-Hb - Deoxy-Hb]) was regarded as the muscle oxygenation index. Group-averaged Δ[Oxy-Hb - Deoxy-Hb] showed progressive decrease during the test. However, among the individuals, we found an accelerated point of decrease in Δ[Oxy-Hb - Deoxy-Hb] in 20 subjects, which revealed that the laps at the accelerated point correlated with the total laps (r = 0·78). These results demonstrate that the accelerated deoxygenation of active muscle occurs during the 20mSRT, but not in all cases. Our findings also indicate that if the accelerated point of muscle deoxygenation occurs, the timing of its appearance is related to 20mSRT performance.

Lactate threshold by muscle electrical impedance in professional rowers

Lactate threshold (LT) is one of the physiological parameters usually used in rowing sport training prescription because it indicates the transitions from aerobic to anaerobic metabolism. Assessment of LT is classically based on a series of values of blood lactate concentrations obtained during progressive exercise tests and thus has an invasive aspect. The feasibility of noninvasive LT estimative through bioelectrical impedance spectroscopy (BIS) data collected in thigh muscles during rowing ergometer exercise tests was investigated. Nineteen professional rowers, age 19 (mean) ± 4.8 (standard deviation) yr, height 187.3 ± 6.6 cm, body mass 83 ± 7.7 kg, and training experience of 7 ± 4 yr, were evaluated in a rowing ergometer progressive test with paired measures of blood lactate concentration and BIS in thigh muscles. Bioelectrical impedance data were obtained by using a bipolar method of spectroscopy based on the current response to a voltage step. An electrical model was used to interpret BIS data and to derive parameters that were investigated to estimate LT noninvasively. From the serial blood lactate measurements, LT was also determined through Dmax method (LT_Dmax). The zero crossing of the second derivative of kinetic of the capacitance electrode (Ce), one of the BIS parameters, was used to estimate LT. The agreement between the LT estimates through BIS (LT_BIS) and through Dmax method (LT_Dmax) was evaluated using Bland-Altman plots, leading to a mean difference between the estimates of just 0.07 W and a Pearson correlation coefficient r = 0.85. This result supports the utilization of the proposed method based on BIS parameters for estimating noninvasively the lactate threshold in rowing.

Wearable Lactate Threshold Predicting Device is Valid and Reliable in Runners

Borges, NR and Driller, MW. Wearable lactate threshold predicting device is valid and reliable in runners. J Strength Cond Res 30(8): 2212-2218, 2016-A commercially available device claiming to be the world's first wearable lactate threshold predicting device (WLT), using near-infrared LED technology, has entered the market. The aim of this study was to determine the levels of agreement between the WLT-derived lactate threshold workload and traditional methods of lactate threshold (LT) calculation and the interdevice and intradevice reliability of the WLT. Fourteen (7 male, 7 female; mean ± SD; age: 18-45 years, height: 169 ± 9 cm, mass: 67 ± 13 kg, V[Combining Dot Above]O2max: 53 ± 9 ml·kg·min) subjects ranging from recreationally active to highly trained athletes completed an incremental exercise test to exhaustion on a treadmill. Blood lactate samples were taken at the end of each 3-minute stage during the test to determine lactate threshold using 5 traditional methods from blood lactate analysis which were then compared against the WLT predicted value. In a subset of the population (n = 12), repeat trials were performed to determine both inter-reliability and intrareliability of the WLT device. Intraclass correlation coefficient (ICC) found high to very high agreement between the WLT and traditional methods (ICC > 0.80), with TEMs and mean differences ranging between 3.9-10.2% and 1.3-9.4%. Both interdevice and intradevice reliability resulted in highly reproducible and comparable results (CV < 1.2%, TEM <0.2 km·h, ICC > 0.97). This study suggests that the WLT is a practical, reliable, and noninvasive tool for use in predicting LT in runners.

Oxygenation Threshold Derived from Near-Infrared Spectroscopy: Reliability and Its Relationship with the First Ventilatory Threshold

BACKGROUND

Near-infrared spectroscopy (NIRS) measurements of oxygenation reflect O2 delivery and utilization in exercising muscle and may improve detection of a critical exercise threshold.

PURPOSE

First, to detect an oxygenation breakpoint (Δ[O2HbMb-HHbMb]-BP) and compare this breakpoint to ventilatory thresholds during a maximal incremental test across sexes and training status. Second, to assess reproducibility of NIRS signals and exercise thresholds and investigate confounding effects of adipose tissue thickness on NIRS measurements.

METHODS

Forty subjects (10 trained male cyclists, 10 trained female cyclists, 11 endurance trained males and 9 recreationally trained males) performed maximal incremental cycling exercise to determine Δ[O2HbMb-HHbMb]-BP and ventilatory thresholds (VT1 and VT2). Muscle haemoglobin and myoglobin O2 oxygenation ([HHbMb], [O2HbMb], SmO2) was determined in m. vastus lateralis. Δ[O2HbMb-HHbMb]-BP was determined by double linear regression. Trained cyclists performed the maximal incremental test twice to assess reproducibility. Adipose tissue thickness (ATT) was determined by skinfold measurements.

RESULTS

Δ[O2HbMb-HHbMb]-BP was not different from VT1, but only moderately related (r = 0.58-0.63, p<0.001). VT1 was different across sexes and training status, whereas Δ[O2HbMb-HHbMb]-BP differed only across sexes. Reproducibility was high for SmO2 (ICC = 0.69-0.97), Δ[O2HbMb-HHbMb]-BP (ICC = 0.80-0.88) and ventilatory thresholds (ICC = 0.96-0.99). SmO2 at peak exercise and at occlusion were strongly related to adipose tissue thickness (r2 = 0.81, p<0.001; r2 = 0.79, p<0.001). Moreover, ATT was related to asymmetric changes in Δ[HHbMb] and Δ[O2HbMb] during incremental exercise (r = -0.64, p<0.001) and during occlusion (r = -0.50, p<0.05).

CONCLUSION

Although the oxygenation threshold is reproducible and potentially a suitable exercise threshold, VT1 discriminates better across sexes and training status during maximal stepwise incremental exercise. Continuous-wave NIRS measurements are reproducible, but strongly affected by adipose tissue thickness.

An integrated view on the oxygenation responses to incremental exercise at the brain, the locomotor and respiratory muscles

In the past two decades oxygenation responses to incremental ramp exercise, measured non-invasively by means of near-infrared spectroscopy at different locations in the body, have advanced the insights on the underpinning mechanisms of the whole-body pulmonary oxygen uptake ([Formula: see text]) response. In healthy subjects the complex oxygenation responses at the level of locomotor and respiratory muscles, and brain were simplified and quantified by the detection of breakpoints as a deviation in the ongoing response pattern as work rate increases. These breakpoints were located in a narrow intensity range between 75 and 90 % of the maximal [Formula: see text] and were closely related to traditionally determined thresholds in pulmonary gas exchange (respiratory compensation point), blood lactate measurements (maximal lactate steady state), and critical power. Therefore, it has been assumed that these breakpoints in the oxygenation patterns at different sites in the body might be equivalent and could, therefore, be used interchangeably. In the present review the typical oxygenation responses (at locomotor and respiratory muscle level, and cerebral level) are described and a possible framework is provided showing the physiological events that might link the breakpoints at different body sites with the thresholds determined from pulmonary gas exchange and blood lactate measurements. However, despite a possible physiological association, several arguments prevent the current practical application of these breakpoints measured at a single site as markers of exercise intensity making it highly questionable whether measurements of the oxygenation response at one single site can be used as a reflection of whole-body responses to different exercise intensities.