A test to establish maximum O2 uptake despite no plateau in the O2 uptake response to ramp incremental exercise

Heavy-intensity priming exercise extends the V̇o2max plateau and increases peak-power output during ramp-incremental exercise

This study investigated whether a heavy-intensity priming exercise precisely prescribed within the heavy-intensity domain would lead to a greater peak-power output (POpeak) and a longer maximal oxygen uptake (V̇o2max) plateau. Twelve recreationally active adults participated in this study. Two visits were required: 1) a step-ramp-step test [ramp-incremental (RI) control], and 2) an RI test preceded by a priming exercise within the heavy-intensity domain (RI primed). A piecewise equation was used to quantify the V̇o2 plateau duration (V̇o2plateau-time). The mean response time (MRT) was computed during the RI control condition. The delta (Δ) V̇o2 slope (S; mL·min-1·W-1) and V̇o2-Y intercept (Y; mL·min-1) within the moderate-intensity domain between conditions (RI primed minus RI control) were also assessed using a novel graphical analysis. V̇o2plateau-time (P = 0.001; d = 1.27) and POpeak (P = 0.003; d = 1.08) were all greater in the RI primed. MRT (P < 0.001; d = 2.45) was shorter in the RI primed compared with the RI control. A larger ΔV̇o2plateau-time was correlated with a larger ΔMRT between conditions (r = -0.79; P = 0.002). This study demonstrated that heavy-intensity priming exercise lengthened the V̇o2plateau-time and increased POpeak. The overall faster RI-V̇o2 responses seem to be responsible for the longer V̇o2plateau-time. Specifically, a shorter MRT, but not changes in RI-V̇o2-slopes, was associated with a longer V̇o2plateau-time following priming exercise.NEW & NOTEWORTHY It remains unclear whether priming exercise extends the maximal oxygen uptake (V̇o2max) plateau and increases peak-power output (POpeak) during ramp-incremental (RI) tests. This study demonstrates that a priming exercise, precisely prescribed within the heavy-intensity domain, extends the plateau at V̇o2max and leads to a greater POpeak. Specifically, the extended V̇o2max plateau was associated with accelerated RI-V̇o2 responses.

Effects of acute simulated altitude on the maximal lactate steady state in humans

We sought to determine the effects of acute simulated altitude on the maximal lactate steady state (MLSS) and physiological responses to cycling at and 10 W above the MLSS-associated power output (PO) (MLSSp and MLSSp+10, respectively). Eleven (4 females) participants (means [SD]; 28 [4] yr; V̇o2max: 54.3 [6.9] mL·kg-1·min-1) acclimatized to ∼1,100 m performed 30-min constant PO trials in simulated altitudes of 0 m sea level (SL), 1,111 m mild altitude (MILD), and 2,222 m moderate altitude (MOD). MLSSp, defined as the highest PO with stable (<1 mM change) blood lactate concentration ([BLa]) between 10 and 30 min, was significantly lower in MOD (209 [54] W) compared with SL (230 [56] W; P < 0.001) and MILD (225 [58] W; P = 0.001), but MILD and SL were not different (P = 0.12). V̇o2 and V̇co2 decreased at higher simulated altitudes due to lower POs (P < 0.05), but other end-exercise physiological responses (e.g., [BLa], ventilation [V̇e], heart rate [HR]) were not different between conditions at MLSSp or MLSSp + 10 (P > 0.05). At the same absolute intensity (MLSSp for MILD), [BLa], HR, and V̇E and all perceptual variables were exacerbated in MOD compared with SL and MILD (P < 0.05). Maximum voluntary contraction, voluntary activation, and potentiated twitch forces were exacerbated at MLSSp + 10 relative to MLSSp within conditions (P < 0.05); however, condition did not affect performance fatiguability at the same relative or absolute intensity (P > 0.05). As MLSSp decreased in hypoxia, adjustments in PO are needed to ensure the same relative intensity across altitudes, but common indices of exercise intensity may facilitate exercise prescription and monitoring in hypoxia.NEW & NOTEWORTHY This study demonstrates the power output and metabolic rate associated with the maximal lactate steady-state (MLSS) decline in response to simulated altitude; however, common indices of exercise intensity remained unchanged when cycling was performed at the work rate associated with MLSS at each simulated altitude. These results support previous studies that investigated the effects of hypoxia on alternative measures of the critical intensity of exercise and will inform exercise prescription/monitoring across altitudes.

A friend in need is a friend indeed: Acute tandem rope skipping enhances inter-brain synchrony of socially avoidant individuals

Team-based physical activity (PA) can improve social cognition; however, few studies have investigated the neurobiological mechanism underlying this benefit. Accordingly, a hyper-scanning protocol aimed to determine whether the interbrain synchrony (IBS) is influenced by an acute bout of team-based PA (i.e., tandem rope skipping). Specifically, we had socially avoidant participants (SOA, N=15 dyads) and their age-matched controls (CO, N=16 dyads) performed a computer-based cooperative task while EEG was recorded before and after two different experimental conditions (i.e., 30-min of team-based PA versus sitting). Phase locking value (PLV) was used to measure IBS. Results showed improved frontal gamma band IBS after the team-based PA compared to sitting when participants received successful feedback in the task (Mskipping = 0.016, Msittting = -0.009, p = 0.082, ηp2 = 0.387). The CO group showed a larger change in frontal and central gamma band IBS when provided failure feedback in the task (Mskipping = 0.017, Msittting = -0.009, p = 0.075, ηp2 = 0.313). Thus, results suggest that socially avoidant individuals may benefit from team-based PA via improved interbrain synchrony. Moreover, our findings deepen our understanding of the neurobiological mechanism by which team-based PA may improve social cognition among individuals with or without social avoidance.

A verification phase adds little value to the determination of maximum oxygen uptake in well-trained adults

PURPOSE

The objective was to investigate if performing a sub-peak or supra-peak verification phase following a ramp test provides additional value for determining 'true' maximum oxygen uptake ( V ˙ O2).

METHODS

17 and 14 well-trained males and females, respectively, performed two ramp tests each followed by a verification phase. While the ramp tests were identical, the verification phase differed in power output, wherein the power output was either 95% or 105% of the peak power output from the ramp test. The recovery phase before the verification phase lasted until capillary blood lactate concentration was ≤ 4 mmol·L-1. If a V ˙ O2 plateau occurred during ramp test, the following verification phase was considered to provide no added value. If no V ˙ O2 plateau occurred and the highest V ˙ O2 ( V ˙ O2peak) during verification phase was < 97%, between 97 and 103%, or > 103% of V ˙ O2peak achieved during the ramp test, no value, potential value, and certain value were attributed to the verification phase, respectively.

RESULTS

Mean (standard deviation) V ˙ O2peak during both ramp tests was 64.5 (6.0) mL·kg-1·min-1 for males and 54.8 (6.2) mL·kg-1·min-1 for females. For the 95% verification phase, 20 tests showed either a V ˙ O2 plateau during ramp test or a verification V ˙ O2peak < 97%, indicating no value, 11 showed potential value, and 0 certain value. For the 105% verification phase, the values were 26, 5, and 0 tests, respectively.

CONCLUSION

In well-trained adults, a sub-peak verification phase might add little value in determining 'true' maximum V ˙ O2, while a supra-peak verification phase adds no value.

Supramaximal Testing to Confirm the Achievement of V̇O 2max in Acute Hypoxia

PURPOSE

We sought to determine if supramaximal exercise testing confirms the achievement of V̇O 2max in acute hypoxia. We hypothesized that the incremental and supramaximal V̇O 2 will be sufficiently similar in acute hypoxia.

METHODS

Twenty-one healthy adults (males n = 13, females n = 8) completed incremental and supramaximal exercise tests in normoxia and acute hypoxia (fraction inspired oxygen = 0.14) separated by at least 48 h. Incremental exercise started at 80 and 60 W in normoxia and 40 and 20 W in hypoxia for males and females, respectively, with all increasing by 20 W each minute until volitional exhaustion. After a 20-min postexercise rest period, a supramaximal test at 110% peak power until volitional exhaustion was completed.

RESULTS

Supramaximal exercise testing yielded a lower V̇O 2 than incremental testing in hypoxia (3.11 ± 0.78 vs 3.21 ± 0.83 L·min -1 , P = 0.001) and normoxia (3.71 ± 0.91 vs 3.80 ± 1.02 L·min -1 , P = 0.01). Incremental and supramaximal V̇O 2 were statistically similar, using investigator-determined equivalence bounds ±150 mL·min -1 , in hypoxia ( P = 0.02, 90% confidence interval [CI] = 0.05-0.14) and normoxia ( P = 0.03, 90% CI = 0.01-0.14). Likewise, using ±2.1 mL·kg -1 ·min -1 bounds, incremental and supramaximal V̇O 2 values were statistically similar in hypoxia ( P = 0.04, 90% CI = 0.70-2.0) and normoxia ( P = 0.04, 90% CI = 0.30-2.0).

CONCLUSIONS

Despite differences in the oxygen cascade, incremental and supramaximal V̇O 2 values were statistically similar in both hypoxia and normoxia, demonstrating the utility of supramaximal verification of V̇O 2max in the setting of acute hypoxia.

Confirming the attainment of maximal oxygen uptake within special and clinical groups: A systematic review and meta-analysis of cardiopulmonary exercise test and verification phase protocols

BACKGROUND AND AIM

A plateau in oxygen uptake ([Formula: see text]) during an incremental cardiopulmonary exercise test (CPET) to volitional exhaustion appears less likely to occur in special and clinical populations. Secondary maximal oxygen uptake ([Formula: see text]) criteria have been shown to commonly underestimate the actual [Formula: see text]. The verification phase protocol might determine the occurrence of 'true' [Formula: see text] in these populations. The primary aim of the current study was to systematically review and provide a meta-analysis on the suitability of the verification phase for confirming 'true' [Formula: see text] in special and clinical groups. Secondary aims were to explore the applicability of the verification phase according to specific participant characteristics and investigate which test protocols and procedures minimise the differences between the highest [Formula: see text] values attained in the CPET and verification phase.

METHODS

Electronic databases (PubMed, Web of Science, SPORTDiscus, Scopus, and EMBASE) were searched using specific search strategies and relevant data were extracted from primary studies. Studies meeting inclusion criteria were systematically reviewed. Meta-analysis techniques were applied to quantify weighted mean differences (standard deviations) in peak [Formula: see text] from a CPET and a verification phase within study groups using random-effects models. Subgroup analyses investigated the differences in [Formula: see text] according to individual characteristics and test protocols. The methodological quality of the included primary studies was assessed using a modified Downs and Black checklist to obtain a level of evidence. Participant-level [Formula: see text] data were analysed according to the threshold criteria reported by the studies or the inherent measurement error of the metabolic analysers and displayed as Bland-Altman plots.

RESULTS

Forty-three studies were included in the systematic review, whilst 30 presented quantitative information for meta-analysis. Within the 30 studies, the highest mean [Formula: see text] values attained in the CPET and verification phase protocols were similar (mean difference = -0.00 [95% confidence intervals, CI = -0.03 to 0.03] L·min-1, p = 0.87; level of evidence, LoE: strong). The specific clinical groups with sufficient primary studies to be meta-analysed showed a similar [Formula: see text] between the CPET and verification phase (p > 0.05, LoE: limited to strong). Across all 30 studies, [Formula: see text] was not affected by differences in test protocols (p > 0.05; LoE: moderate to strong). Only 23 (53.5%) of the 43 reviewed studies reported how many participants achieved a lower, equal, or higher [Formula: see text] value in the verification phase versus the CPET or reported or supplied participant-level [Formula: see text] data for this information to be obtained. The percentage of participants that achieved a lower, equal, or higher [Formula: see text] value in the verification phase was highly variable across studies (e.g. the percentage that achieved a higher [Formula: see text] in the verification phase ranged from 0% to 88.9%).

CONCLUSION

Group-level verification phase data appear useful for confirming a specific CPET protocol likely elicited [Formula: see text], or a reproducible [Formula: see text], for a given special or clinical group. Participant-level data might be useful for confirming whether specific participants have likely elicited [Formula: see text], or a reproducible [Formula: see text], however, more research reporting participant-level data is required before evidence-based guidelines can be given.

TRIAL REGISTRATION

PROSPERO (CRD42021247658) https://www.crd.york.ac.uk/prospero.

Including supramaximal verification reduced uncertainty in VO2peak response rate

Many reports describe using a supramaximal verification phase-exercising at a power output higher than the highest power output recorded during an incremental cardiopulmonary test-to validate VO2max. The impact of verification phases on estimating the proportion of individuals who increased VO2peak in response to high-intensity interval training (HIIT) remains an underexplored area in the individual response literature. This analysis investigated the influence of same-day and separate-day verification phases during repeated measurements (incremental tests-INCR1 and INCR2; incremental tests + supramaximal verification phases-INCR1+ and INCR2+) of VO2peak on typical error (TE) and the proportion of individuals classified as responders (i.e., the response rate) following 4 weeks of HIIT (n = 25) or a no-exercise control period (n = 9). Incorporation of supramaximal verification consistently reduced the standard deviation of individual response, TE, and confidence interval (CI) widths. However, variances were statistically similar across all groups (p > 0.05). Response rates increased when incorporating either one (INCR1 to INCR1+; 24%-48%, p = 0.07) or two (INCR2 to INCR2+; 28%-48%, p = 0.063) supramaximal verification phases. However, response rates remained unchanged when either zero-based thresholds or smallest worthwhile difference response thresholds were used (50% and 90% CIs, all p > 0.05). Supramaximal verification phases reduced random variability in VO2peak response to HIIT. Compared with separate-day testing (INCR2 and INCR2+), the incorporation of a same-day verification (INCR1+) reduced CI widths the most. Researchers should consider using a same-day verification phase to reduce uncertainty and better estimate VO2peak response rate to HIIT.

Biological sex does not influence the peak cardiac output response to twelve weeks of sprint interval training

Sprint interval training (SIT) increases peak oxygen uptake (V̇O2peak) but the mechanistic basis is unclear. We have reported that 12 wk of SIT increased V̇O2peak and peak cardiac output (Q̇peak) and the changes in these variables were correlated. An exploratory analysis suggested that Q̇peak increased in males but not females. The present study incorporated best practices to examine the potential influence of biological sex on the Q̇peak response to SIT. Male and female participants (n = 10 each; 21 ± 4 y) performed 33 ± 2 sessions of SIT over 12 wk. Each 10-min session involved 3 × 20-s 'all-out' sprints on an ergometer. V̇O2peak increased after SIT (3.16 ± 1.0 vs. 2.89 ± 1.0 L/min, η2p = 0.53, p < 0.001) with no sex × time interaction (p = 0.61). Q̇peak was unchanged after training (15.2 ± 3.3 vs. 15.1 ± 3.0 L/min, p = 0.85), in contrast to our previous study. The peak estimated arteriovenous oxygen difference increased after training (204 ± 30 vs. 187 ± 36 ml/L, p = 0.006). There was no effect of training or sex on measures of endothelial function. We conclude that 12 wk of SIT increases V̇O2peak but the mechanistic basis remains unclear. The capacity of inert gas rebreathing to assess changes in Q̇peak may be limited and invasive studies that use more direct measures are needed.

Acute Oxygen Consumption Response to Fast Start High-Intensity Intermittent Exercise

The current investigation compared the acute oxygen consumption (VO2) response of two high-intensity interval exercises (HIIE), fast start (FSHIIE), and steady power (SPHIIE), which matched w prime (W') depletion. Eight cyclists completed an incremental max test and a three-minute all-out test (3MT) to determine maximal oxygen consumption (VO2max), critical power (CP), and W'. HIIE sessions consisted of 3 X 4 min intervals interspersed by 3 min of active recovery, with W' depleted by 60% (W'target) within each working interval. SPHIIE depleted the W'target consistently throughout the 3 min intervals, while FSHIIE depleted the W'target by 50% within the first minute, with the remaining 50% depleted evenly across the remainder of the interval. The paired samples t-test revealed no differences in the percentage of training time spent above 90% of VO2max (PT ≥ 90% VO2max) between SPHIIE and FSHIIE with an average of 25.20% and 26.07%, respectively. Pairwise comparisons indicated a difference between minute 1 peak VO2, minute 2, and minute 3, while no differences were present between minutes 2 and 3. The results suggest that when HIIE formats are matched based on W' expenditure, there are no differences in PT ≥ 90% VO2max or peak VO2 during each interval.

Exercise Physiology and Cardiopulmonary Exercise Testing

Aerobic, or endurance, exercise is an energy requiring process supported primarily by energy from oxidative adenosine triphosphate synthesis. The consumption of oxygen and production of carbon dioxide in muscle cells are dynamically linked to oxygen uptake (V̇O2) and carbon dioxide output (V̇CO2) at the lung by integrated functions of cardiovascular, pulmonary, hematologic, and neurohumoral systems. Maximum oxygen uptake (V̇O2max) is the standard expression of aerobic capacity and a predictor of outcomes in diverse populations. While commonly limited in young fit individuals by the capacity to deliver oxygen to exercising muscle, (V̇O2max) may become limited by impairment within any of the multiple systems supporting cellular or atmospheric gas exchange. In the range of available power outputs, endurance exercise can be partitioned into different intensity domains representing distinct metabolic profiles and tolerances for sustained activity. Estimates of both V̇O2max and the lactate threshold, which marks the upper limit of moderate-intensity exercise, can be determined from measures of gas exchange from respired breath during whole-body exercise. Cardiopulmonary exercise testing (CPET) includes measurement of V̇O2 and V̇CO2 along with heart rate and other variables reflecting cardiac and pulmonary responses to exercise. Clinical CPET is conducted for persons with known medical conditions to quantify impairment, contribute to prognostic assessments, and help discriminate among proximal causes of symptoms or limitations for an individual. CPET is also conducted in persons without known disease as part of the diagnostic evaluation of unexplained symptoms. Although CPET quantifies a limited sample of the complex functions and interactions underlying exercise performance, both its specific and global findings are uniquely valuable. Some specific findings can aid in individualized diagnosis and treatment decisions. At the same time, CPET provides a holistic summary of an individual's exercise function, including effects not only of the primary diagnosis, but also of secondary and coexisting conditions.

Analysis of Individual V˙O2max Responses during a Cardiopulmonary Exercise Test and the Verification Phase in Physically Active Women

This study aimed to investigate the test-retest reliability, mean, and individual responses in the measurement of maximal oxygen consumption (V˙O2max) during a cardiopulmonary exercise test (CPET) and the verification phase during cycle ergometry in women. Nine women (22 ± 2 yrs, 166.0 ± 4.5 cm, 58.6 ± 7.7 kg) completed a CPET, passively rested for 5 min, and then completed a verification phase at 90% of peak power output to determine the highest V˙O2 from the CPET (V˙O2CPET) and verification phase (V˙O2verification) on 2 separate days. Analyses included a two-way repeated measures ANOVA, intraclass correlation coefficients (ICC2,1), standard errors of the measurement (SEM), minimal differences (MD), and coefficients of variation (CoV). There was no test (test 1 versus test 2) × method (CPET vs. verification phase) interaction (p = 0.896) and no main effect for method (p = 0.459). However, test 1 (39.2 mL·kg-1·min-1) was significantly higher than test 2 (38.3 mL·kg-1·min-1) (p = 0.043). The V˙O2CPET (ICC = 0.984; CoV = 1.98%; SEM = 0.77 mL·kg-1·min-1; MD = 2.14 mL·kg-1·min-1) and V˙O2verification (ICC = 0.964; CoV = 3.30%; SEM = 1.27 mL·kg-1·min-1; MD = 3.52 mL·kg-1·min-1) demonstrated "excellent" reliability. Two subjects demonstrated a test 1 V˙O2CPET that exceeded the test 2 V˙O2CPET, and one subject demonstrated a test 1 V˙O2verification that exceeded the test 2 V˙O2verification by more than the respective CPET and verification phase MD. One subject demonstrated a V˙O2CPET that exceeded the V˙O2verification, and one subject demonstrated a V˙O2verification that exceeded the V˙O2CPET by more than the MD. These results demonstrate the importance of examining the individual responses in the measurement of the V˙O2max and suggest that the MD may be a useful threshold to quantify real individual changes in V˙O2.

The Minimal Difference as an Individual Threshold to Examine the Utility of a Verification Bout in Determining V̇O 2max

PURPOSE

A square-wave verification bout to confirm maximal oxygen uptake (V̇O 2max ) from a graded exercise test (GXT) has been recommended based on mean responses. This study used the test-retest reliability, mean, and individual differences between the highest V̇O 2 from the GXT (V̇O 2GXT ) and verification bout (V̇O 2verification ) to examine the efficacy of a verification bout in the determination of O 2max in healthy, recreationally trained, well-motivated men.

METHODS

Ten men (24 ± 4 yr) completed a GXT on a cycle ergometer followed by a submaximal verification bout to determine V̇O 2GXT and V̇O 2verification . After completion of the initial GXT, subjects rested for 5 min then performed the verification bout at 90% of the peak power output from the initial GXT. Analyses included a two-way repeated-measures ANOVA, intraclass correlation coefficients (ICC 2,1 ), standard errors of the measurement (SEM), minimal differences (MD), and coefficients of variation (COV).

RESULTS

There was no test (test 1 vs test 2)-method (GXT vs verification) interaction ( P = 0.300) and no main effect for test ( P = 0.690), but there was a main effect for method ( P = 0.003). The V̇O 2GXT (46.0 mL⋅kg -1 ⋅min -1 ) was significantly greater than V̇O 2verification (43.9 mL⋅kg -1 ⋅min -1 ), collapsed across test. The V̇O 2GXT (ICC = 0.970, SEM = 1.63 mL⋅kg -1 ⋅min -1 , MD = 4.51 mL⋅kg -1 ⋅min -1 , COV = 3.54%) and the V̇O 2verification (ICC = 0.953, SEM = 1.87 mL⋅kg -1 ⋅min -1 , MD = 5.17 mL⋅kg -1 ⋅min -1 , COV = 4.25%) demonstrated "excellent" reliability. No subject exceeded the MD test-retest for V̇O 2GXT or V̇O 2verification . No subject had a V̇O 2verification that exceeded V̇O 2GXT by more than the MD, but two subjects had a V̇O 2GXT , which exceeded V̇O 2verification by more than the MD.

CONCLUSIONS

The excellent reliability of V̇O 2GXT in addition to the examination of the individual differences between V̇O 2GXT and V̇O 2verification using the MD indicated that a standalone GXT was sufficient to determine V̇O 2max .

The efficacy of a verification stage for determining V˙O2max and the impact of sampling intervals

It is unknown whether oxygen uptake (V̇O₂) sampling intervals influence the efficacy of a verification stage following a graded exercise test (GXT). Fifteen females and 14 males (18-25 years) completed a maximal treadmill GXT. After a 5 ​min recovery, the verification stage began at the speed and grade corresponding with the penultimate stage from the GXT. Maximal oxygen consumption (V̇O_2max) from the incremental GXT (iV̇O_2max) and V̇O_2max from the verification stage (verV̇O_2max) were determined using 10 seconds (s), 30 ​s, and 60 ​s from breath ​× ​breath averages. There was no main effect for V̇O_2max measure (iV̇O_2maxvs. verV̇O_2max) 10 ​s ([47.9 ​± ​8.31] ml∙kg^-1∙min^-1 vs [48.85 ​± ​7.97] ml∙kg^-1∙min^-1), 30 ​s ([46.94 ​± ​8.62] ml∙kg^-1∙min^-1 vs [47.28 ​± ​7.97] ml∙kg^-1∙min^-1), and 60 ​s ([46.17 ​± ​8.62] ml∙kg^-1∙min^-1 vs [46.00 ​± ​8.00] ml∙kg^-1∙min^-1]. There was a stage ​× ​sampling interval interaction as the difference between (verV̇O_2max-iV̇O_2max) was greater for 10-s than 60-s sampling intervals. The verV̇O_2max was > 4% higher than iV̇O_2maxin 31%, 31%, and 17% of the tests for the 10-s, 30-s, and 60-s sampling intervals respectively. Sensitivity for the plateau was < 30% for 10-s, 30-s, and 60-s sampling intervals. Specificity ranged from 44% to 60% for all sampling intervals. Sensitivity for heart rate ​+ ​respiratory exchange ratio was > 90% for all sampling intervals; while specificity was < 25%. Findings from the present study suggest that the efficacy of verification stages for eliciting a higher V̇O_2max may be influenced by the sampling interval utilized.

Verification Phase Confirms V̇O 2max in a Hot Environment in Sedentary Untrained Males

PURPOSE

This study aimed to assess the V̇O 2 uptake obtained during a GXT and subsequent verification phase in untrained participants in a hot environment.

METHODS

Twelve sedentary males completed a GXT followed by a biphasic supramaximal-load verification phase in a hot environment (39°C, 32% relative humidity). Rest between tests occurred in a temperate chamber and lasted until gastrointestinal temperature returned to baseline.

RESULTS

Mean verification phase V̇O 2max (37.8 ± 4.3 mL·kg -1 ·min -1 ) was lower than GXT (39.8 ± 4.1 mL·kg -1 ·min -1 ; P = 0.03) and not statistically equivalent. Using an individualized analysis approach, only 17% (2/12) of participants achieved a V̇O 2 plateau during the GXT. Verification phase confirmed GXT V̇O 2max in 100% of participants, whereas the traditional and the new age-dependent secondary V̇O 2max criteria indicated GXT V̇O 2max achievement at much lower rates (8/12 [67%] vs 7/12 [58%], respectively). Correlational indices between GXT and verification phase V̇O 2max were strong (intraclass correlation coefficient = 0.95, r = 0.86), and Bland-Altman analysis revealed a low mean bias of -2.1 ± 1.9 mL·kg -1 ·min -1 and 95% limits of agreement (-5.8 to 1.7 mL·kg -1 ·min -1 ).

CONCLUSIONS

Very few untrained males achieved a V̇O 2 plateau during GXT in the heat. When conducting GXT in a hot condition, the verification phase remains a valuable addition to confirm V̇O 2max in untrained males.

Validity and repeatability of cardiopulmonary exercise testing in interstitial lung disease

BACKGROUND

Cardiopulmonary exercise testing (CPET), and its primary outcome of peak oxygen uptake (VO_2peak), are acknowledged as biomarkers in the diagnostic and prognostic management of interstitial lung disease (ILD). However, the validity and repeatability of CPET in those with ILD has yet to be fully characterised, and this study fills this evidence gap.

METHODS

Twenty-six people with ILD were recruited, and 21 successfully completed three CPETs. Of these, 17 completed two valid CPETs within a 3-month window, and 11 completed two valid CPETs within a 6-month window. Technical standards from the European Respiratory Society established validity, and repeatability was determined using mean change, intraclass correlation coefficient and typical error.

RESULTS

Every participant (100%) who successfully exercised to volitional exhaustion produced a maximal, and therefore valid, CPET. Approximately 20% of participants presented with a plateau in VO₂, the primary criteria for establishing a maximal effort. The majority of participants otherwise presented with secondary criteria of respiratory exchange ratios in excess of 1.05, and maximal heart rates in excess of their predicted values. Repeatability analyses identified that the typical error (expressed as percent of coefficient of variation) was 20% over 3-months in those reaching volitional exhaustion.

CONCLUSION

This work has, for the first time, fully characterised how patients with ILD respond to CPET in terms of primary and secondary verification criteria, and generated novel repeatability data that will prove useful in the assessment of disease progression, and future evaluation of therapeutic regimens where VO_2peak is used as an outcome measure.

Adding Vibration During Varied-Intensity Work Intervals Increases Time Spent Near Maximal Oxygen Uptake in Well-Trained Cyclists

PURPOSE

Previous research suggests that the percentage of maximal oxygen uptake attained and the time it is sustained close to maximal oxygen uptake (eg, >90%) can serve as a good criterion to judge the effectiveness of a training stimulus. The aim of this study was to investigate the acute effects of adding vibration during varied high-intensity interval training (HIIT) sessions on physiological and neuromuscular responses.

METHODS

Twelve well-trained cyclists completed a counterbalanced crossover protocol, wherein 2 identical varied HIIT cycling sessions were performed with and without intermittent vibration to the lower-intensity workloads of the work intervals (6 × 5-min work intervals and 2.5-min active recovery). Each 5-minute work interval consisted of 3 blocks of 40 seconds performed at 100% of maximal aerobic power interspersed with 60-second workload performed at a lower power output, equal to the lactate threshold plus 20% of the difference between lactate threshold and maximal aerobic power. Oxygen uptake and electromyographic activity of lower and upper limbs were recorded during all 5-minute work intervals.

RESULTS

Adding vibration induced a longer time ≥90% maximal oxygen uptake (11.14 [7.63] vs 8.82 [6.90] min, d = 0.64, P = .048) and an increase in electromyographic activity of lower and upper limbs during the lower-intensity workloads by 20% (16%) and 34% (43%) (d = 1.09 and 0.83; P = .03 and .015), respectively.

CONCLUSION

Adding vibration during a varied HIIT session increases the physiological demand of the cardiovascular and neuromuscular systems, indicating that this approach can be used to optimize the training stimulus of well-trained cyclists.

The reliability, validity and usefulness of the 30-15 intermittent fitness test for cardiorespiratory fitness assessment in military personnel

The objectives of this study were to investigate the reliability, validity, and usefulness of the 30-15 intermittent fitness test (30-15_IFT) in soldiers. The 34 infantry members of the Slovenian armed forces were recruited as participants. Participants performed the continuous incremental treadmill test (TR), a 2-mile run (2_MR) test, and two 30-15_IFT tests. Additionally, participants were divided into a highest-scoring group (HSG) and a lowest-scoring group (LSG) based on their scores on the Army Physical Fitness Test. A very high reliability ratings were observed for 30-15_IFT measures, as follows: end-running speed (ERS) ERS_IFT (ICC = 0.971)_, maximal heart rate (HR_max) HR_maxIFT (IC = 0.960)_, and maximal relative oxygen consumption (VO_2max) VO_2max-IFT (ICC = 0.975)_. Although 30-15_IFT measures demonstrated high correlations (r = 0.695-0.930) to the same measures of TR test, ERS, HR_max and VO_2max were higher in the 30-15_IFT (p > 0.05)_. Furthermore, ERS_IFT and predicted VO_2maxIFT were higher in HSG compared to LSG, whereas HR_max did not differ. The results of this study show that the 30-15_IFT test is a reliable, valid and useful tool for assessing cardiorespiratory fitness in the armed forces. Moreover, the ERS and predicted VO₂max values derived from the 30-15_IFT could be considered more sensitive markers of combat readiness than the parameters derived from the TR and 2_MR tests.Trial registration number: NCT05218798.

Practical guidance for firefighter applicants preparing for cardiorespiratory fitness testing: a secondary analysis of self-reported physical activity levels

Adequate cardiorespiratory fitness is critical for firefighters since an insufficient level of fitness threatens the integrity of their operations and could be dangerous for their lives. In fact, the leading cause of mortality for on-duty firefighters is not injury but sudden cardiac death. Therefore, to mitigate these risks, potential firefighter recruits are often required to perform a graded exercise test to determine their cardiorespiratory fitness as part of the recruitment process. However, there are currently limited data available to prospective firefighters on the amounts and types of exercises needed to be successful in the graded exercise test, commonly known as a V̇O_2max test. Physiological parameters for the current secondary analysis were collected on firefighter applicants who performed the graded exercise test where 72% were successful and 28% were unsuccessful to meet the minimum standard set at 42.5 ml kg^-1 min^-1. Prior to their test, applicants were asked to describe their exercise training routine by indicating the number of minutes per week spent exercising. Activities were then divided into one of two categories: endurance exercise or strength and power exercise training. The total exercise training describes the sum of all activities performed each week. The sum of endurance exercise activities and the sum of strength and power exercise activities were compared between the successful and the unsuccessful groups and results showed that successful applicants had a higher training volume and performed more endurance exercise training as compared to unsuccessful applicants. Therefore, practical recommendations related to exercise training regime are presented for firefighter applicants to embrace as guidance to prepare for their graded exercise test as part of their recruitment process.

Longitudinal assessment of cardiorespiratory fitness and body mass of young healthy adults during COVID-19 pandemic

Physical activity was reduced during the COVID-19 pandemic, especially when lockdowns were mandated; however, little is known about the impact of these lifestyle changes on objective measures of cardiorespiratory fitness. To address this knowledge gap, we evaluated the cardiorespiratory fitness of 14 young healthy adults (4 women, age: 27±6 yr) just prior to the pandemic and after ~1 year of public health measures being in place. During fitness assessments, participants performed submaximal pseudorandom cycling exercise to assess cardiorespiratory kinetics, and a 25 W·min^-1 ramp-incremental cycling test to determine peak oxygen uptake (V̇O₂). Cluster analysis identified two subgroups of participants: those who had reduced peak V̇O₂ at the 1-year follow-up (-0.50±0.17 L·min^-1) and those whose peak V̇O₂ was maintained (0.00±0.10 L·min^-1). Participants with reduced peak V̇O₂ also exhibited slower heart rate kinetics (interaction: p=0.01), reduced peak O₂ pulse (interaction: p<0.001), and lower peak work rate (interaction: p<0.001) after 1 year of the pandemic, whereas these variables were unchanged in the group of participants who maintained peak V̇O₂. Regardless of changes in peak V̇O₂, both subgroups of participants gained body mass (main effect: p=0.002), which was negatively correlated with participants' level of self-reported physical activity level at the follow-up assessment (mass: ρ=-0.59, p=0.03) These findings suggest that some young healthy individuals lost cardiorespiratory fitness during the pandemic, while others gained weight, but both changes could potentially increase the risk of adverse health outcomes and disease later in life if left unaddressed.

Efficacy of interval exercise training to improve vascular health in sedentary postmenopausal females

BACKGROUND

Menopause represents a turning point where vascular damage begins to outweigh reparative processes, leading to increased cardiovascular disease (CVD) risk. Exercise training reduces CVD risk in postmenopausal females via improvements in traditional risk factors and direct changes to the vasculature. We assessed the effect of moderate (MODERATE-IT) versus heavy (HEAVY-IT) intensity interval exercise training upon markers of cardiovascular health and vascular repair in postmenopausal females.

METHODS

Twenty-seven healthy postmenopausal females (56 ± 4 yr) were assigned to 12 weeks of either MODERATE-IT or HEAVY-IT, twice per week. MODERATE-IT consisted of 10s work, and 10s active recovery repeated for 30 min. HEAVY-IT comprised 30s work, and 30s active recovery repeated for 21 ± 2 min. Endothelial function (flow-mediated dilation), arterial stiffness (pulse wave velocity), and V̇O_2peak were assessed pre-training and post-training. Blood samples were obtained pre-training and post-training for enumeration of circulating angiogenic cells (CACs), culture of CACs, and lipoprotein profile.

RESULTS

V̇O_2peak increased 2.4 ± 2.8 ml/kg/min following HEAVY-IT only (p < 0.05). Brachial blood pressure and endothelial function were unchanged with exercise training (p > 0.05). Peripheral pulse wave velocity reduced 8% with exercise training, irrespective of intensity (p < 0.05). Exercise training had no effect on lipoprotein profile or endothelin-1 (p > 0.05). CAC adhesion to vascular smooth muscle cells (VSMC) increased 30 min post plating following MODERATE-IT only (p < 0.05).

CONCLUSIONS

HEAVY-IT was more effective at increasing V̇O_2peak in postmenopausal females. The ability of CACs to adhere to VSMC improved following MODERATE-IT but not HEAVY-IT. Interval training had the same effect on endothelial function (no change) and arterial stiffness (reduced), regardless of exercise intensity.

Effects of different exercise intensities on prefrontal activity during a dual task

The effects of physical exercise on cognitive tasks have been investigated. However, it is unclear how different exercise intensities affect the neural activity. In this study, we investigated the neural activity in the prefrontal cortex (PFC) by varying the exercise intensity while participants performed a dual task (DT). Twenty healthy young adults performed serial subtraction while driving a cycle ergometer. Exercise intensity was set to one of three levels: low, moderate, or high intensity. We did not find any significant change in PFC activity during DT under either the control (no exercise) or low-intensity conditions. In contrast, we observed a significant increase in PFC activity during DT under moderate- and high-intensity conditions. In addition, we observed complex hemodynamics after DT. PFC activity decreased from baseline after DT under the control condition, while it increased under the low-intensity condition. PFC activity remained higher than the baseline level after DT under the moderate-intensity condition but returned to baseline under the high-intensity condition. The results suggest that moderate-intensity exercise with a cognitive load effectively increases PFC activity, and low-intensity exercise may increase PFC activity when combined with a cognitive load.

Reliability and validity of 30-15 intermittent fitness test for cardiorespiratory fitness assessment among infantry members of Slovenian armed forces: A study protocol

Introduction

Cardiorespiratory fitness (CRF) testing is routinely performed by most armed and tactical forces around the world as part of their recruitment process for new members or simply as an annual examination of their personnel. A 2-mile run (2MR) test is among the most commonly used. However, as it is performed outdoors, weather, climate, and terrain can influence the results and often limit the maximum performance. Also, this test has been shown to be difficult for individuals because the pacing strategy is self-paced. As such, it does not reflect the real situation on the battlefield, where most activities are externally driven by the environment and the enemy. Therefore, we believe that the 30-15 Intermittent Fitness Test (30-15IFT) may be a suitable tool for measuring CRF and battle readiness of military personnel. Moreover, given the importance of visual attention to military personnel we aim to investigate the differences in visual attention between better and less physically prepared infantry members and its corresponding response to maximal endurance running test.

Methods and analysis

This randomized cross-over study using a within-subjects test-retest design will enroll 32 infantry members of the Slovenian Armed Forces. To investigate the reliability and validity of the 30-15IFT test, an incremental treadmill test (TR), a 2MR test, and two identical 30-15IFT will be performed in randomized order. Additionally, participants will be subsequently divided into two groups based on their score on the Army Physical Fitness Test (APFT), whereas differences in visual attention will be assessed by using the d2 test. The primary analysis will assess differences in key physiological outcomes between the different CRF tests (TR vs. 2MR vs. 30-15IFT). In addition, the relative reliability of all dependent variables between two 30-15IFT trials will be estimated by interclass correlation coefficient (ICC), while relationship between maximal oxygen uptake, heart rate and maximal running speed of 30-15IFT, TR and 2MR will be assessed using Pearson's correlation.

Ethics and dissemination

Ethical approval was obtained from the National Medical Ethics Committee (reference number: 0120-495/2021/6). The results of the proposed study will be disseminated through publication in peer-reviewed journals.

Clinical Trial Registration

[www.ClinicalTrials.gov], identifier [NCT05218798].

Cardiovascular magnetic resonance assessment of left atrial size and function in endurance athletes

Background: Left atrial (LA) dilatation is linked to cardiovascular disease and atrial fibrillation but its associations in athletes are unknown. The authors investigated whether aerobic fitness and clinical parameters are associated with LA dilatation and emptying fraction (EF) in endurance athletes. Materials & methods: 65 endurance athletes underwent cardiovascular magnetic resonance to assess LA size and function along with fitness assessment. 25 sedentary controls underwent an identical cardiovascular magnetic resonance protocol. Results: In athletes, LA volume index was elevated, while total and passive LAEFs were decreased versus sedentary controls. Increasing age and maximal oxygen uptake were associated with LA volume index. Only older age was associated with decreased total LAEF. Conclusion: LA dilatation in athletes is associated with increasing age and aerobic fitness rather than conventional cardiovascular risk factors.

Effects of Low-Carbohydrate Diet and Exercise Training on Gut Microbiota

Objective

This study was aimed to evaluate the effects of low-carbohydrate diet (LC) and incorporated high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) on gut microbiota, and the associations between changes in gut microbiota and cardiometabolic health-related profiles.

Methods

Fifty overweight/obese Chinese females (age 22.2 ± 3.3 years, body mass index 25.1 ± 3.1 kg/m–2) were randomized to the groups of LC, LC and HIIT (LC-HIIT, 10 repetitions of 6-s sprints and 9-s rest), and LC and MICT group (LC-MICT, cycling at 50–60% V̇O2peak for 30 min). The LC-HIIT and LC-MICT experienced 20 training sessions over 4 weeks.

Results

The 4-week LC intervention with/without additional training failed to change the Shannon, Chao 1, and Simpson indexes (p &gt; 0.05), LC increased Phascolarctobacterium genus, and LC-HIIT reduced Bifidobacterium genus after intervention (p &lt; 0.05). Groups with extra exercise training increased short-chain fatty acid-producing Blautia genus (p &lt; 0.05) and reduced type 2 diabetes-related genus Alistipes (p &lt; 0.05) compared to LC. Sutterella (r = −0.335) and Enterobacter (r = 0.334) were associated with changes in body composition (p &lt; 0.05). Changes in Ruminococcus, Eubacterium, and Roseburia genera were positively associated with blood pressure (BP) changes (r = 0.392–0.445, p &lt; 0.05), whereas the changes in Bacteroides, Faecalibacterium, and Parabacteroides genera were negatively associated with BP changes (r = −0.567 to −0.362, p &lt; 0.05).

Conclusion

LC intervention did not change the α-diversity and overall structure of gut microbiota. Combining LC with exercise training may have additional benefits on gut physiology. Specific microbial genera were associated with LC- and exercise-induced regulation of cardiometabolic health.

Verification of Maximal Oxygen Uptake in Active Military Personnel During Treadmill Running

ABSTRACT

Figueiredo, PS, Looney, DP, Pryor, JL, Doughty, EM, McClung, HL, Vangala, SV, Santee, WR, Beidleman, BA, and Potter, AW. Verification of maximal oxygen uptake in active military personnel during treadmill running. J Strength Cond Res 36(4): 1053-1058, 2022-It is unclear whether verification tests are required to confirm "true" maximal oxygen uptake (V̇o2max) in modern warfighter populations. Our study investigated the prevalence of V̇o2max attainment in U.S. Army soldiers performing a traditional incremental running test. In addition, we examined the utility of supramaximal verification testing as well as repeated trials for familiarization for accurate V̇o2max assessment. Sixteen U.S. Army soldiers (1 woman, 15 men; age, 21 ± 2 years; height, 1.73 ± 0.06 m; body mass, 71.6 ± 10.1 kg) completed 2 laboratory visits, each with an incremental running test (modified Astrand protocol) and a verification test (110% maximal incremental test speed) on a motorized treadmill. We evaluated V̇o2max attainment during incremental testing by testing for the definitive V̇O2 plateau using a linear least-squares regression approach. Peak oxygen uptake (V̇o2peak) was considered statistically equivalent between tests if the 90% confidence interval around the mean difference was within ±2.1 ml·kg-1·min-1. Oxygen uptake plateaus were identified in 14 of 16 volunteers for visit 1 (87.5%) and all 16 volunteers for visit 2 (100%). Peak oxygen uptake was not statistically equivalent, apparent from the mean difference in V̇o2peak measures between the incremental test and verification test on visit 1 (2.3 ml·kg-1·min-1, [1.3-3.2]) or visit 2 (1.1 ml·kg-1·min-1 [0.2-2.1]). Interestingly, V̇o2peak was equivalent, apparent from the mean difference in V̇o2peak measures between visits for the incremental tests (0.0 ml·kg-1·min-1 [-0.8 to 0.9]) but not the verification tests (-1.2 ml·kg-1·min-1 [-2.2 to -0.2]). Modern U.S. Army soldiers can attain V̇o2max by performing a modified Astrand treadmill running test. Additional familiarization and verification tests for confirming V̇o2max in healthy active military personnel may be unnecessary.

Comparison of the Field-Based Intermittent Running Fitness Test 30-15 and the Treadmill Multistage Incremental Test for the Assessment of Cardiorespiratory Fitness in Elite Handball Players

The aim of the present study was to investigate whether the physiological parameters indicative of cardiorespiratory fitness obtained during the 30-15 intermittent fitness (30-15IFT) test and the multistage laboratory treadmill endurance (TR) test differ. Nineteen elite handball players were recruited for the current study and assigned in a cross-over manner to one of two tests to be performed 48 h apart at each visit to the testing facility. The results showed that VO2max (percentage difference [PC] = 6.1%; p = 0.004) and maximal running velocity (V) (PC = 19.4%; p < 0.001) were significantly higher for the 30-15IFT test than that obtained during the TR test. Furthermore, the onset of blood lactate accumulation was shown to be significantly higher for all measures considered to predict it during 30-15IFT compared to TR as follows: VO2max (PC = 12.6%; p = 0.001), running speed (PC = 33.9%; p < 0.001), and maximal heart rate (PC = 7.5%; p < 0.001). The current study highlights the importance of sport-specific testing, particularly for measuring individual cardiorespiratory fitness in elite handball players, as TR may underestimate crucial variables used for both diagnostics and training prescription.

A Subject-Tailored Variability-Based Platform for Overcoming the Plateau Effect in Sports Training: A Narrative Review

The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms contribute to a lack of continuous improvement with most exercise regimens. Attempts to overcome this plateau in exercise have been only partially successful, and it remains a significant unmet need in both healthy subjects and those suffering from chronic neuromuscular, cardiopulmonary, and metabolic diseases. Variability patterns characterize many biological processes, from cellular to organ levels. The present review discusses the significant obstacles in overcoming the plateau in training and establishes a platform to implement subject-tailored variability patterns to prevent and overcome this plateau in muscle and cardiorespiratory performance.

Type of self-talk matters: Its effects on perceived exertion, cardiorespiratory, and cortisol responses during an iso-metabolic endurance exercise

Self-talk is an effective mental training technique that has been shown to facilitate or debilitate an athlete's performance, depending on its valence. Although the effects of self-talk have been supported by observing change in sport performance, little is known about how self-talk can induce physiological changes. Specifically, it is important to understand if the type of self-talk (positive, neutral, or negative) and can influence stress-related parameters, such as perceived exertion, cardiorespiratory, and cortisol responses. The study's objective was therefore to investigate the top-down effect of positive and negative self-talk compared to a dissociative activity during an iso-metabolic running exercise on autonomic regulation of cardiorespiratory function. Twenty-nine well-trained male runners [38 ± 13 years, 177 ± 7 cm and 73 ± 7 kg] volunteered to participate in a randomized-group design study that included a negative self-talk (NST), a positive self-talk, and a dissociative group (DG). First, participants underwent an incremental running test on a treadmill to determine the maximal oxygen uptake (V̇O_2max ). Next, participants received a mental training session on self-talk and created three positive and three negative self-talk statements. Finally, participants underwent a 60-min steady-state running exercise on a treadmill at 70% of V̇O_2max , during which they were cued at 20-, 35-, and 50-min with their personal self-created positive or negative self-talk statements while the DG listened to a documentary. Cardiorespiratory parameters and rate of perceived exertion (RPE) were recorded throughout the 60-min endurance exercise. In addition, salivary cortisol samples were obtained at waking and after treatment. Although oxygen uptake, carbon dioxide production, RPE, and heart rate significantly changed overtime during the 60-min steady-state running exercise, no significant main treatment effect was found. However, RPE scores, minute ventilation, breathing frequency, and salivary cortisol were significantly higher in the NST group compared to the two other groups. These data suggest that NST [emotion-induced stress, as reflected by elevated cortisol] altered the breathing frequency response. In conclusion, manipulating self-talk alters hormonal response patterns, modulates cardiorespiratory function, and influences perceived exertion.

Baseline Aerobic Fitness in High School and College Football Players: Critical for Prescribing Safe Exercise Regimens

BACKGROUND

Nontraumatic fatalities occur on a regular basis in high school (HS) and college football athletes, primarily in obese linemen performing high-intensity exercise. One contributing factor to these deaths may be a mismatch between baseline aerobic (cardiorespiratory) fitness and exercise regimens.

HYPOTHESIS

There is a wide range of aerobic fitness in HS and college football players. Body mass index (BMI) is a safe and simple method for estimating baseline aerobic fitness.

STUDY DESIGN

Retrospective cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A retrospective review was performed on 79 HS football athletes who had VO_2Peak (mL·kg^-1·min^-1) measured during the offseason. Multivariate regression analysis was used to determine if BMI (obese, overweight, and normal; kg/m²), position played (linemen vs other), year in school (freshmen vs other), and/or race (African American vs White) were risk factors for poor aerobic fitness. A separate cohort of 135 (48 HS; 87 college) football athletes performed a 6-minute run test to determine speed (miles/min), extrapolate VO_2Max, and calculate reference values for suggested upper threshold safe starting speeds (85% of maximum) for aerobic training based on BMI. The relationship between BMI and VO_2Peak was assessed. The exercise regimens (speeds) of 2 collegiate football fatalities from the public domain were used to predict their VO_2Max values.

RESULTS

Mean VO_2Peak (mL·kg^-1·min^-1) was 38.5 ± 8.6 (range 19.1-60.6); when grouped by BMI, low scores (<40) were found in 87.5% of obese (32.4 ± 7.7), 47.8% of overweight (40.8 ± 7.6), and 45.2% of normal (41.4 ± 7.8) athletes. VO_2Peak was significantly lower in linemen (32.8 ± 6.4; P = 0.007) compared with nonlineman (41.8 ± 7.9), and in obese players (by BMI; 32.4; P = 0.019) compared with nonobese players (41.4 ± 7.6), but did not differ by age, year in school, or race. Means for speed (min/mile) and extrapolated VO_2Max (mL·kg^-1·min^-1) for the 6-minute run test by BMI groups were both significantly different (P = 0.001) for normal (7.0 ± 0.6; 51.1 ± 2.6), overweight (7.6 ± 0.8; 46.5 ± 3.2), and obese (8.9 ± 1.5; 36.8 ± 5.9) athletes. There was a significant negative correlation (r = -0.551; P = 0.001; R² = 0.304) between VO_2Peak and BMI. Safe starting speed recommendations for running 1 mile range from 7.3 to 12.1 min/mile for BMIs 20 to 40 kg/m² for HS and college athletes. For the 2 fatalities (mean, BMI of 36.5 kg/m²) repetitive sprint speeds were 49 and 89% higher than our safe starting speeds for their BMI.

CONCLUSION

A large spectrum of baseline aerobic fitness was noted in HS and college football players. Obese players and linemen had statistically lower baseline aerobic fitness, a major risk factor for possible heat illness. BMI is an acceptable surrogate for VO_2Peak and can be employed to develop safe training regimens without the need for a maximum fitness test, which can place the athlete at risk for a medical event.

CLINICAL RELEVANCE

Knowledge of BMI provides an estimate of baseline aerobic fitness and a foundation for prescribing safe, individualized exercise regimens.

Real Assessment of Maximum Oxygen Uptake as a Verification After an Incremental Test Versus Without a Test

The study was conducted to compare peak oxygen uptake (VO_2peak) measured with the incremental graded test (GXT) (VO_2peak) and two tests to verify maximum oxygen uptake, performed 15 min after the incremental test (VO_2peak1) and on a separate day (VO_2peak2). The aim was to determine which of the verification tests is more accurate and, more generally, to validate the VO_2max obtained in the incremental graded test on cycle ergometer. The study involved 23 participants with varying levels of physical activity. Analysis of variance showed no statistically significant differences for repeated measurements (F = 2.28, p = 0.118, η² = 0.12). Bland–Altman analysis revealed a small bias of the VO_2peak1 results compared to the VO_2peak (0.4 ml⋅min^–1⋅kg^–1) and VO_2peak2 results compared to the VO_2peak (−0.76 ml⋅min^–1⋅kg^–1). In isolated cases, it was observed that VO_2peak1 and VO_2peak2 differed by more than 5% from VO_2peak. Considering the above, it can be stated that among young people, there are no statistically significant differences between the values of VO_2peak measured in the following tests. However, in individual cases, the need to verify the maximum oxygen uptake is stated, but performing a second verification test on a separate day has no additional benefit.

Impacts of high-intensity exercise on the metabolomics profile of human skeletal muscle tissue

The study aimed to identify and quantify the metabolites profile and metabolic pathways in human muscle tissue engaged during exhaustive high-intensity cycling exercise. Seven healthy physically active men performed a graded exercise test and an exhaustive supramaximal effort at 115% of maximal aerobic power with muscles biopsies performed in rest and immediately after exhaustion for quantifying of muscle metabolites changes by ¹ H-NMR spectroscopy. The time until exhaustion (tlim) recorded was 224.7 ± 35.5 s whereas the muscle pH at exhaustion was 6.48 ± 0.05. A total of 54 metabolites were identified and quantified. The most enriched and impacted pathways included: beta oxidation of very long chain fatty acids, mitochondrial electron transport chain, alanine aspartate, and glutamate metabolism, citric acid cycle, arginine biosynthesis, propanoate metabolism, threonine and 2-oxobutanoate degradation and pyruvate metabolism. In addition, the muscle concentrations in Post exercise, compared to Pre increased significantly (p < 0.0398) for fumarate (42.0%), succinate (101.2%), glucose (249.7%), lactate (122.8%), O-acetylcarnitine (164.7%), glycerol (79.3%), AMP (288.2%), 2-oxobutyrate (121.0%), and methanol (58.5%), whereas decreased significantly (p < 0.010) for creatine phosphate (-70.2%), ADP (-56.5%), carnitine (-33.5%), and glutamate (-42.3%). Only the succinate was significantly correlated with tlim (r = -0.76; p = 0.0497). Besides the classical expected contribution of glycolytic and phosphagen energetic pathways, it was demonstrated that the high-intensity exercise is also associated with pathways indicatives of amino acid and fatty acid oxidation metabolisms, highlighting the inverse relation between changes in the intramuscular succinate levels and tlim.

Menstrual cycle impacts adipokine and lipoprotein responses to acute high-intensity intermittent exercise bout

Due to hormonal fluctuation, the menstrual cycle impacts inflammatory response and lipid metabolism; moreover, the anti-atherogenic and anti-inflammatory effects of exercise in this cycle, mainly high-intensity intermittent exercise (HIIE), need to be examined. Therefore, the aim of the current study was to investigate the influence of menstrual cycle phases on adipokine and lipoprotein responses after acute HIIE sessions in healthy women. Fourteen women (age: 24 ± 2 years; BMI: 22.79 ± 1.89 kg·m²) were recruited to perform two HIIE sessions (10 × 1 min running at 90% of maximum aerobic velocity, with 1 min recovery); one during the follicular phase (FP) and other during the luteal phase (LP), randomly. Blood samples were collected at rest, immediately, and 60 min after HIIE sessions. Macrophage inflammatory protein-1α (MIP-1α), leptin, adiponectin, total cholesterol, triacylglycerol (TAG), HDL-c, and glucose concentrations were analyzed. At rest, higher MIP-1α concentrations were observed during the LP compared to FP (p = 0.017). Likewise, leptin (p = 0.050), LDL-c (p = 0.015), and non-HDL (p = 0.016) were statistically higher in the LP. In contrast, the adiponectin/leptin ratio was lower in the LP compared to the ratio found in the FP (p = 0.032). Immediately post-HIIE sessions, in both menstrual phases, higher TAG (p = 0.001) and HDL-c (p = 0.001) concentrations were found, which returned to resting levels after 60 min. In conclusion, adipokine and lipoprotein responses after a single HIIE session are regulated by the phase of the menstrual cycle, contributing to inflammatory conditions, and demonstrating the importance of considering the phases of the menstrual cycle for the periodization of physical training.

Comparison of constant load exercise intensity for verification of maximal oxygen uptake following a graded exercise test in older adults

Maximal oxygen uptake (VO2 max) declines with advancing age and is a predictor of morbidity and mortality risk. The purpose here was to assess the utility of constant load tests performed either above or below peak work rate obtained from a graded exercise test for verification of VO2 max in older adults. Twenty-two healthy older adults (9M, 13F, 67 ± 6 years, BMI: 26.3 ± 5.1 kg·m-2 ) participated in the study. Participants were asked to complete two experimental trials in a randomized, counterbalanced cross-over design. Both trials (cycle ergometer) consisted of (1) an identical graded exercise test (ramp) and (2) a constant load test at either 85% (CL85; n = 22) or 110% (CL110; n = 20) of the peak work rate achieved during the associated ramp (performed 10-min post ramp). No significant differences were observed for peak VO2 (L·min-1 ) between CL85 (1.86 ± 0.72; p = 0.679) or CL110 (1.79 ± 0.73; p = 0.200) and the associated ramp (Ramp85, 1.85 ± 0.73; Ramp110, 1.85 ± 0.57). Using the study participant's mean coefficient of variation in peak VO2 between the two identical ramp tests (2.9%) to compare individual differences between constant load tests and the associated ramp revealed 19/22 (86%) of participants achieved a peak VO2 during CL85 that was similar or higher versus the ramp, while only 13/20 (65%) of participants achieved a peak VO2 during CL110 that was similar or higher versus the ramp. These data indicate that if a verification of VO2 max is warranted when testing older adults, a constant load effort at 85% of ramp peak power may be more likely to verify VO2 max as compared to an effort at 110% of ramp peak power.

Responders and non-responders to aerobic exercise training: beyond the evaluation of V˙O2max

The evaluation of the maximal oxygen uptake ( V ˙ O 2 max ) following exercise training is the classical assessment of training effectiveness. Research has lacked in investigating whether individuals that do not respond to the training intervention ( V ˙ O 2 max ), also do not improve in other health-related parameters. We aimed to investigate the cardiovascular and metabolic adaptations (i.e., performance, body composition, blood pressure, vascular function, fasting blood markers, and resting cardiac function and morphology) to exercise training among participants who showed different levels of V ˙ O 2 max responsiveness. Healthy sedentary participants engaged in a 6-week exercise training program, three times a week. Our results showed that responders had a greater increase in peak power output, second lactate threshold, and microvascular responsiveness, whereas non-responders had a greater increase in cycling efficiency. No statistical differences were observed in body composition, blood pressure, fasting blood parameters, and resting cardiac adaptations. In conclusion, our study showed, for the first time, that in addition to the differences in the V ˙ O 2 max , a greater increase in microvascular responsiveness in responders compared to non-responders was observed. Additionally, responders and non-responders did not show differences in the adaptations on metabolic parameters. There is an increasing need for personalized training prescription, depending on the target clinical outcome.

Power Reserve at Intolerance in Ramp-Incremental Exercise Is Dependent on Incrementation Rate

INTRODUCTION

The mechanism(s) of exercise intolerance at V˙O2max remain poorly understood. In health, standard ramp-incremental (RI) exercise is limited by fatigue-induced reductions in maximum voluntary cycling power. Whether neuromuscular fatigue also limits exercise when the RI rate is slow and RI peak power at intolerance is lower than standard RI exercise, is unknown.

METHODS

In twelve healthy participants, maximal voluntary cycling power was measured during a short (~6 s) isokinetic effort at 80 rpm (Piso) at baseline and, using an instantaneous switch from cadence-independent to isokinetic cycling, immediately at the limit of RI exercise with RI rates of 50, 25, and 10 W·min-1 (RI-50, RI-25, and RI-10). Breath-by-breath pulmonary gas exchange was measured throughout.

RESULTS

Baseline Piso was not different among RI rates (analysis of variance; P > 0.05). Tolerable duration increased with decreasing RI rate (RI-50, 411 ± 58 s vs RI-25, 732 ± 93 s vs RI-10, 1531 ± 288 s; P < 0.05). At intolerance, V˙O2peak was not different among RI rates (analysis of variance; P > 0.05), but RI peak power decreased with RI rate (RI-50, 361 ± 48 W vs RI-25, 323 ± 39 W vs RI-10, 275 ± 38 W; P < 0.05). Piso at intolerance was 346 ± 43 W, 353 ± 45 W, and 392 ± 69 W for RI-50, RI-25, and RI-10, respectively (P < 0.05 for RI-10 vs RI-50 and RI-25). At intolerance, in RI-50 and RI-25, Piso was not different from RI peak power (P > 0.05), thus there was no "power reserve." In RI-10, Piso was greater than RI peak power at intolerance (P < 0.001), that is, there was a "power reserve."

CONCLUSIONS

In RI-50 and RI-25, the absence of a power reserve suggests the neuromuscular fatigue-induced reduction in Piso coincided with V˙O2max and limited the exercise. In RI-10, the power reserve suggests neuromuscular fatigue was insufficient to limit the exercise, and additional mechanisms contributed to intolerance at V˙O2max.

Utility of Verification Testing to Confirm Attainment of Maximal Oxygen Uptake in Unhealthy Participants: A Perspective Review

Maximal oxygen uptake (VO₂max) is strongly associated with endurance performance as well as health risk. Despite the fact that VO₂max has been measured in exercise physiology for over a century, robust procedures to ensure that VO₂max is attained at the end of graded exercise testing (GXT) do not exist. This shortcoming led to development of an additional bout referred to as a verification test (VER) completed after incremental exercise or on the following day. Workloads used during VER can be either submaximal or supramaximal depending on the population tested. Identifying a true VO₂max value in unhealthy individuals at risk for or having chronic disease seems to be more paramount than in healthy and active persons, who face much lower risk of premature morbidity and mortality. This review summarized existing findings from 19 studies including 783 individuals regarding efficacy of VER in unhealthy individuals to determine its efficacy and feasibility in eliciting a 'true' VO₂max in this sample. Results demonstrated that VER is a safe and suitable approach to confirm attainment of VO₂max in unhealthy adults and children, as in most studies VER-derived VO₂max is similar of that obtained in GXT. However, many individuals reveal higher VO₂max in response to VER and protocols used across studies vary, which merits additional work identifying if an optimal VER protocol exists to elicit 'true' VO₂max in this particular population.

Training status affects between-protocols differences in the assessment of maximal aerobic velocity

Purpose

Continuous incremental protocols (CP) may misestimate the maximum aerobic velocity (V_max) due to increases in running speed faster than cardiorespiratory/metabolic adjustments. A higher aerobic capacity may mitigate this issue due to faster pulmonary oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂) kinetics. Therefore, this study aimed to compare three different protocols to assess V_max in athletes with higher or lower training status.

Methods

Sixteen well-trained runners were classified according to higher (HI) or lower (LO) \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O_2max\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂-kinetics was calculated across four 5-min running bouts at 10 km·h⁻¹. Two CPs [1 km·h⁻¹ per min (CP1) and 1 km·h⁻¹ every 2-min (CP2)] were performed to determine V_max\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O_2max, lactate-threshold and submaximal \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂/velocity relationship. Results were compared to the discontinuous incremental protocol (DP).

Results

V_max, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O_2max, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙CO₂ and VE were higher [(P < 0.05,(ES:0.22/2.59)] in HI than in LO. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂-kinetics was faster [P < 0.05,(ES:-2.74/ − 1.76)] in HI than in LO. \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂/velocity slope was lower in HI than in LO [(P < 0.05,(ES:-1.63/ − 0.18)]. V_max and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂/velocity slope were CP1 > CP2 = DP for HI and CP1 > CP2 > DP for LO. A lower [P < 0.05,(ES:0.53/0.75)] V_max-difference for both CP1 and CP2 vs DP was found in HI than in LO. V_max-differences in CP1 vs DP showed a large inverse correlation with V_max, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O_2max and lactate-threshold and a very large correlation with \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂-kinetics.

Conclusions

Higher aerobic training status witnessed by faster \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}$$\end{document}V˙O₂ kinetics led to lower between-protocol V_max differences, particularly between CP2 vs DP. Faster kinetics may minimize the mismatch issues between metabolic and mechanical power that may occur in CP. This should be considered for exercise prescription at different percentages of V_max.

Incremental and decremental cardiopulmonary exercise testing protocols produce similar maximum oxygen uptake in athletes

The aim of the study was to evaluate and compare the maximal oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max) achieved during incremental and decremental protocols in highly trained athletes. Nineteen moderate trained runners and rowers completed, on separate days, (i) an initial incremental \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max test (INC) on a treadmill, followed by a verification phase (VER); (ii) a familiarization of a decremental test (DEC); (iii) a tailored DEC; (iv) a test with decremental and incremental phases (DEC-INC); (v) and a repeated incremental test (INC_F). During each test \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O₂, carbon dioxide production, ventilation, heart and breath rates and ratings of perceived exertion were measured. No differences were observed in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max between INC (61.3 ± 5.2 ml kg⁻¹ min⁻¹) and DEC (61.1 ± 5.1 ml kg⁻¹ min⁻¹; average difference of ~ 11.58 ml min⁻¹; p = 0.831), between INC and DEC-INC (60.9 ± 5.3 ml kg⁻¹ min⁻¹; average difference of ~ 4.8 ml min⁻¹; p = 0.942) or between INC and INC_F (60.7 ± 4.4 ml kg⁻¹ min⁻¹; p = 0.394). \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max during VER (59.8 ± 5.1 ml kg⁻¹ min⁻¹) was 1.50 ± 2.20 ml kg⁻¹ min⁻¹ lower (~ 2.45%; p = 0.008) compared with values measured during INC. The typical error in the test-to-test changes for evaluating \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max over the five tests was 2.4 ml kg⁻¹ min⁻¹ (95% CI 1.4–3.4 ml kg⁻¹ min⁻¹). Decremental tests do not elicit higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O_2max than incremental tests in trained runners and rowers, suggesting that a plateau in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{\mathrm{V}}$$\end{document}V˙O₂ during the classic incremental and verification tests represents the maximum ceiling of aerobic power.

Effect of Combined Interval and Continuous Exercise Training on Gastric Emptying, Appetite, and Adaptive Responses in Men With Overweight and Obesity

Background/Objectives: Characterizing compensatory and adaptive responses to exercise assists in understanding changes in energy balance and health outcomes with exercise interventions. This study investigated the effects of a short-term exercise intervention (combining high intensity interval (HII) and continuous exercise) on (1) gastric emptying, appetite and energy intake; and (2) other adaptive responses including cardiorespiratory fitness, in inactive men with overweight/obesity. Methods: Fifteen men (BMI: 29.7 ± 3.3 kg/m-2) completed a 4-wk supervised exercise intervention, consisting of 5 exercise sessions per week alternating between HII (30 s at 100% VO2max followed by 30 s recovery) and continuous (at 50% VO2max) training on a cycle ergometer, progressing from 30 to 45 min session duration. Gastric emptying (13C-octanoic acid breath test), appetite (visual analog scale), energy intake (ad libitum lunch meal), body composition (air displacement plethysmography), non-exercise activity (accelerometery) VO2max, blood pressure, and fasting concentrations of glucose, insulin, and ghrelin were measured before and after (≥48 h) the intervention. Results: Gastric emptying, glucose, insulin and ghrelin were unchanged, but energy intake at the ad libitum lunch test meal significantly increased at post-intervention (+171 ± 116 kcal, p < 0.01). Body weight (-0.9 ± 1.1 kg), waist circumference (-2.3 ± 3.5 cm) and percent body fat (-0.9 ± 1.1%) were modestly reduced (P < 0.05). VO2max increased (+4.4 ± 2.1 ml.kg.min-1) by 13% and systolic (-6.2 ± 8.4 mmHg) and diastolic (-5.8 ± 2.2 mmHg) blood pressure were significantly reduced (P ≤ 0.01 for all). Conclusions: Four weeks of exercise training did not alter gastric emptying, indicating gastric emptying may only adapt to a higher volume/longer duration of exercise or changes in other characteristics associated with regular exercise. The combination of HII and continuous exercise training had beneficial effects on body composition, cardiorespiratory fitness, and blood pressure and warrants further investigation in larger randomized controlled trials.

Twelve weeks of sprint interval training increases peak cardiac output in previously untrained individuals

INTRODUCTION

Sprint interval training (SIT), characterized by brief bouts of 'supramaximal' exercise interspersed with recovery periods, increases peak oxygen uptake ([Formula: see text]) despite a low total exercise volume. Per the Fick principle, increased [Formula: see text] is attributable to increased peak cardiac output ([Formula: see text]) and/or peak arterio-venous oxygen difference (a-vO_2diff). There are limited and equivocal data regarding the physiological basis for SIT-induced increases in [Formula: see text], with most studies lasting ≤ 6 weeks.

PURPOSE

To determine the effect of 12 weeks of SIT on [Formula: see text], measured using inert gas rebreathing, and the relationship between changes in [Formula: see text] and [Formula: see text].

METHODS

15 healthy untrained adults [6 males, 9 females; 21 ± 2 y (mean ± SD)] performed 28 ± 3 training sessions. Each session involved a 2-min warm-up at 50 W, 3 × 20-s 'all-out' cycling bouts (581 ± 221 W) interspersed with 2-min of recovery, and a 3-min cool-down at 50 W.

RESULTS

Measurements performed before and after training showed that 12 weeks of SIT increased [Formula: see text] (17.0 ± 3.7 vs 18.1 ± 4.6 L/min, p = 0.01, partial η² = 0.28) and [Formula: see text] (2.63 ± 0.78 vs 3.18 ± 1.1 L/min, p < 0.01, partial η² = 0.58). The changes in these two variables were correlated (r² = 0.46, p < 0.01). Calculated peak a-vO_2diff also increased after training (154 ± 22 vs 174 ± 23 ml O₂/L; p < 0.01) and was correlated with the change in [Formula: see text] (r² = 0.33, p = 0.03). Exploratory analyses revealed an interaction (p < 0.01) such that [Formula: see text] increased in male (+ 10%, p < 0.01) but not female participants (+ 0.6%, p = 0.96), suggesting potential sex-specific differences.

CONCLUSION

Twelve weeks of SIT increased [Formula: see text] by 6% in previously untrained participants and the change was correlated with the larger 21% increase in [Formula: see text].

Recovery from Fatigue after Cycling Time Trials in Elite Endurance Athletes

INTRODUCTION

We determined the recovery from neuromuscular fatigue in six professional (PRO) and seven moderately trained (MOD) cyclists after repeated cycling time trials of various intensities/durations.

METHOD

Participants performed two 1-min (1minTT) or two 10-min (10minTT) self-paced cycling time trials with 5 min of recovery in between. Central and peripheral fatigue were quantified via preexercise to postexercise (15-s through 15-min recovery) changes in voluntary activation (VA) and potentiated twitch force. VA was measured using the interpolated twitch technique, and potentiated twitch force was evoked by single (QTsingle) and paired (10-Hz (QT10) and 100-Hz (QT100)) electrical stimulations of the femoral nerve.

RESULTS

Mean power output was 32%-72% higher during all the time trials and decreased less (-10% vs -13%) from the first to second time trial in PRO compared with MOD (P < 0.05). Conversely, exercise-induced reduction in QTsingle and QT10/QT100 was significantly lower in PRO after every time trial (P < 0.05). Recovery from fatigue from 15 s to 2 min for QTsingle and QT10/QT100 was slower in PRO after every time trial (P < 0.05). In both groups, the reduction in QTsingle was lower after the 10minTTs compared with 1minTTs (P < 0.05). Conversely, VA decreased more after the 10minTTs compared with 1minTTs (P < 0.05).

CONCLUSION

Our findings showed that excitation-contraction coupling was preserved after exercise in PRO compared with MOD. This likely contributed to the improved performance during repeated cycling time trials of various intensity/duration in PRO, despite a slower rate of recovery in its early phase. Finally, the time course of recovery from neuromuscular fatigue in PRO was dependent on the effects of prolonged low-frequency force depression.

The Oxygen Uptake Plateau-A Critical Review of the Frequently Misunderstood Phenomenon

A flattening of the oxygen uptake–work rate relationship at severe exercise indicates the achievement of maximum oxygen uptake \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left({\text{VO}}_{2\max } \right)$$\end{document}VO2max. Unfortunately, a distinct plateau \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left( {{{\text{VO}}}_{2} {\text{pl}}} \right)$$\end{document}VO2pl at \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2maxis not found in all participants. The aim of this investigation was to critically review the influence of research methods and physiological factors on the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence. It is shown that many studies used inappropriate definitions or methodical approaches to check for the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl. In contrast to the widespread assumptions it is unclear whether there is higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence in (uphill) running compared to cycling exercise or in discontinuous compared to continuous incremental exercise tests. Furthermore, most studies that evaluated the validity of supramaximal verification phases, reported verification bout durations, which are too short to ensure that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max have been achieved by all participants. As a result, there is little evidence for a higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence and a corresponding advantage for the diagnoses of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max when incremental tests are supplemented by supramaximal verification bouts. Preliminary evidence suggests that the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl in continuous incremental tests is determined by physiological factors like anaerobic capacity, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2-kinetics and accumulation of metabolites in the submaximal intensity domain. Subsequent studies should take more attention to the use of valid \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl definitions, which require a cut-off at ~ 50% of the submaximal \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2 increase and rather large sampling intervals. Furthermore, if verification bouts are used to verify the achievement of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{{2{\text{peak}}}}$$\end{document}VO2peak/\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max, it should be ensured that they can be sustained for sufficient durations.

Oxygen Uptake Plateau Diagnosis Using a New Developed Segmented Regression Estimation Method for Autocorrelated Data

OBJECTIVE

Some proposals for oxygen uptake plateau identification are based on linear regression adaptations. However, linear regression does not adequately explain the oxygen uptake nonlinear dynamics. Recently, segmented regression was considered as an alternative to fit this dynamics, by performing an approximation by straight line segments, which provided a satisfactory fit. In this context, the non-plateau and plateau hypotheses were verified by means of a Wald-type test. This work aims to extend these proposals to scenarios with autocorrelated data.

METHODS

We propose an algorithm to estimate the segmented regression model under autocorrelation using generalized least squares and suggest a bootstrap method to resample from the null distribution of Wald's statistic. The performance of the estimate and methods of the plateau diagnosis were evaluated via Monte Carlo experiments.

RESULTS

The empirical results show that, under autocorrelation, the proposed estimator performs better when compared to the classic method, mainly in scenarios with small sample sizes and moderate/strong autocorrelation structure. The simulations also showed that the plateau diagnosis test has a coherent empirical Type 1 Error probability and good power.

CONCLUSION

We proposed an alternative to estimate the parameters of a segmented regression model for autocorrelated data and an oxygen consumption plateau bootstrap test, and concluded the methods present good performance under simulated and applied case studies.

SIGNIFICANCE

The proposed method was used to model real oxygen consumption data. Empirical evidence shows that the methods can be used to objectively identify the plateau in oxygen consumption only by specifying a tolerable significance level.

The effect of posture on maximal oxygen uptake in active healthy individuals

PURPOSE

Semi-supine and supine cardiopulmonary exercise testing (CPET) with concurrent cardiac imaging has emerged as a valuable tool for evaluating patients with cardiovascular disease. Yet, it is unclear how posture effects CPET measures. We aimed to discern the effect of posture on maximal oxygen uptake (VO₂max) and its determinants using three clinically relevant cycle ergometers.

METHODS

In random order, 10 healthy, active males (Age 27 ± 7 years; BMI 23 ± 2 kg m²) underwent a ramp CPET and subsequent constant workload verification test performed at 105% peak ramp power to quantify VO₂max on upright, semi-supine and supine cycle ergometers. Doppler echocardiography was conducted at peak exercise to measure stroke volume (SV) which was multiplied by heart rate (HR) to calculate cardiac output (CO).

RESULTS

Compared to upright (46.8 ± 11.2 ml/kg/min), VO₂max was progressively reduced in semi-supine (43.8 ± 10.6 ml/kg/min) and supine (38.2 ± 9.3 ml/kg/min; upright vs. semi-supine vs. supine; all p ≤ 0.005). Similarly, peak power was highest in upright (325 ± 80 W), followed by semi-supine (298 ± 72 W) and supine (200 ± 51 W; upright vs. semi-supine vs. supine; all p < 0.01). Peak HR decreased progressively from upright to semi-supine to supine (186 ± 11 vs. 176 ± 13 vs. 169 ± 12 bpm; all p < 0.05). Peak SV and CO were lower in supine relative to semi-supine and upright (82 ± 22 vs. 92 ± 26 vs. 91 ± 24 ml and 14 ± 3 vs. 16 ± 4 vs. 17 ± 4 l/min; all p < 0.01), but not different between semi-supine and upright.

CONCLUSION

VO₂max is progressively reduced in reclined postures. Thus, posture should be considered when comparing VO₂max results between different testing modalities.

Interval training causes the same exercise enjoyment as moderate-intensity training to improve cardiorespiratory fitness and body composition in young Chinese women with elevated BMI

This study examined the effects of 12 weeks of sprint interval training (SIT), high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiorespiratory fitness (peak oxygen uptake, VO_2peak), body composition and physical activity enjoyment in overweight young women. Sixty-six participants (age 21.2 ± 1.4 years, body mass index (BMI) 26.0 ± 3.0 kg·m^-2, body fat percentage 39.0 ± 2.8%) were randomly assigned to non-exercise control (CON), thrice-weekly SIT (80 × 6 s "all-out" cycling interspersed with 9 s rest), and HIIT (4 min cycling at 90% VO_2peak followed with 3 min recovery for ~ 60 min) or MICT (~ 65 min continuous cycling at 60% VO_2peak) with equivalent mechanical work (200/300 KJ). Compared to the CON group, all three training groups had significant and similar improvements in VO_2peak (~ +20%, d = 2.5-3.4), fat mass (~ -10%, d = 1.3-2.1) and body fat percentage (~ -5%, d = 1.0-1.1) after a 12-week intervention. Similar high levels of enjoyment were observed among groups for most (~70%) of the training sessions. The findings suggest that the three training regimes are equally enjoyable and could result in similar improvements in cardiorespiratory fitness and body composition in overweight/obese young women, but SIT is a more time-efficient strategy.

Determining the Optimal Workrate for Cycle Ergometer Verification Phase Testing in Males with Obesity

The aim of the present study was to assess the validity of verification phase (VP) testing and a 3 min all-out test to determine critical power (CP) in males with obesity. Nine young adult males with a body mass index (BMI) ≥ 30 kg·m⁻² completed a cycle ergometer ramp-style VO_2max test, four randomized VP tests at 80, 90, 100, and 105% of maximum wattage attained during the ramp test, and a 3 min all-out test. There was a significant main effect for VO_2max across all five tests (p = 0.049). Individually, 8 of 9 participants attained a higher VO_2max (L/min) during a VP test compared to the ramp test. A trend (p = 0.06) was observed for VO_2max during the 90% VP test (3.61 ± 0.54 L/min) when compared to the ramp test (3.37 ± 0.39 L/min). A significantly higher VO_2max (p = 0.016) was found in the VP tests that occurred below 130% of CP wattage (N = 15, VO_2max = 3.76 ± 0.52 L/min) compared to those that were above (N = 21, VO_2max = 3.36 ± 0.41 L/min). Our findings suggest submaximal VP tests at 90% may elicit the highest VO_2max in males with obesity and there may be merit in using % of CP wattage to determine optimal VP intensity.

Peripheral BDNF and psycho-behavioral aspects are positively modulated by high-intensity intermittent exercise and fitness in healthy women

Acute high-intensity intermittent exercise (HIIE) induces the myokine secretion associated with neurogenesis, as well brain-derived neurotrophic factor (BDNF); however, it remains unknown how the menstrual phase influences this secretion after an acute exercise session. The current study aimed to investigate the effects of HIIE performed in luteal and follicular menstrual phases on BDNF, cognitive function, mood, and exercise enjoyment. Fourteen healthy women completed four experimental sessions, randomly. One graded exercise test (GXT) and one HIIE session (10 × 1-min runs 90% peak GXT velocity [1-min recovery]) were performed for each menstrual phase. Blood samples were collected at rest and immediately after efforts, and the profile of mood states questionnaire (POMS) and Stroop-task test were applied. During the HIIE, subjective scales were applied (feeling, felt arousal, rate of perceived exertion, and physical activity enjoyment). The main results showed that the serum BDNF presented no difference between menstrual phases (p = 0.870); however, HIIE increased BDNF concentration in both menstrual phases (p = 0.030). In addition, the magnitude of circulating BDNF variation (Δ%BDNF) and [Formula: see text] demonstrated an inverse relationship in the follicular phase (r =  - 0.539, p = 0.046), whereas in the luteal phase, Δ%BDNF was negatively correlated with time test (r =  - 0.684, p = 0.007) and RPE (r =  - 0.726, p = 0.004) in GXT. No differences between menstrual phases were observed for POMS (p ≥ 0.05); however, HIIE attenuated tension (p < 0.01), depression (p < 0.01), and anger moods (p < 0.01), independently of menstrual phases. The subjective scales and Stroop-task test did not show differences. In conclusion, menstrual cycle phase does not affect serum BDNF levels, cognitive function, mood, and exercise enjoyment. Contrary, HIIE increases peripheral BDNF and attenuates tension, depression, and anger independently of menstrual phase. In addition, Δ%BDNF was correlated with physical fitness in the follicular phase, exhibiting higher changes in women with lower physical fitness status.

Is a verification phase useful for confirming maximal oxygen uptake in apparently healthy adults? A systematic review and meta-analysis

BACKGROUND

The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET).

OBJECTIVE

To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained.

METHODS

MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol.

RESULTS

Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias.

CONCLUSIONS

The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances.

PROSPERO REGISTRATION ID

CRD42019123540.