Effects of hyperoxic training on performance and cardiorespiratory response to exercise

A HIF-1 signature dominates the attenuation in the human skeletal muscle transcriptional response to high-intensity interval training

High-intensity interval training (HIIT) generates profound metabolic adaptations in skeletal muscle. These responses mirror performance improvements but follow a non-linear pattern comprised of an initial fast phase followed by a gradual plateau effect. The complete time-dependent molecular sequelae that regulates this plateau effect remains unknown. We hypothesize that the plateau effect during HIIT is restricted to specific pathways with communal upstream transcriptional regulation. To investigate this, eleven healthy men performed nine sessions of HIIT (10x4 minutes of cycling at 91 % of HR_max) over a 3-week period. Before and 3h after the 1^st and 9^th exercise bout, skeletal muscle biopsies were obtained, and RNA sequencing performed. Almost 2,000 genes across 84 pathways were differentially expressed in response to a single HIIT session. The overall transcriptional response to acute exercise was strikingly similar at 3 weeks, 83 % (n=1650) of the genes regulated after the 1^st bout of exercise were similarly regulated by the 9^th bout, albeit with a smaller effect size, and the response attenuated to on average 70 % of the 1^st bout. The attenuation differed substantially between pathways and was very pronounced for glycolysis and cellular adhesion but more preserved for MAPK and VEGF-A signalling. The attenuation was driven by a combination of changes in steady-state expression and specific transcriptional regulation. Given that the exercise intensity was progressively increased, and that the attenuation was pathway specific, we suggest that moderation of muscular adaptation after a period of training stems from targeted regulation rather than a diminished exercise stimulus.

Oxidative Stress and Inflammation, MicroRNA, and Hemoglobin Variations after Administration of Oxygen at Different Pressures and Concentrations: A Randomized Trial

Exercise generates reactive oxygen species (ROS), creating a redox imbalance towards oxidation when inadequately intense. Normobaric and hyperbaric oxygen (HBO) breathed while not exercising induces antioxidant enzymes expression, but literature is still poor. Twenty-two athletes were assigned to five groups: controls; 30%, or 50% O₂; 100% O₂ (HBO) at 1.5 or 2.5 atmosphere absolute (ATA). Twenty treatments were administered on non-training days. Biological samples were collected at T0 (baseline), T1 (end of treatments), and T2 (1 month after) to assess ROS, antioxidant capacity (TAC), lipid peroxidation, redox (amino-thiols) and inflammatory (IL-6, 10, TNF-α) status, renal function (i.e., neopterin), miRNA, and hemoglobin. At T1, O₂ mixtures and HBO induced an increase of ROS, lipid peroxidation and decreased TAC, counterbalanced at T2. Furthermore, 50% O₂ and HBO treatments determined a reduced state in T2. Neopterin concentration increased at T1 breathing 50% O₂ and HBO at 2.5 ATA. The results suggest that 50% O₂ treatment determined a reduced state in T2; HBO at 1.5 and 2.5 ATA similarly induced protective mechanisms against ROS, despite the latter could expose the body to higher ROS levels and neopterin concentrations. HBO resulted in increased Hb levels and contributed to immunomodulation by regulating interleukin and miRNA expression.

Effect of practical hyperoxic high-intensity interval training on exercise performance

This study investigated the effect of a practical hyperoxic high-intensity interval training (HIIT) on aerobic and anaerobic exercise capacity. Sixteen male athletes were randomized into 2 groups: normoxic HIIT (NHIIT, n = 8) group or hyperoxic HIIT (HHIIT, n = 8) group and trained for 3 weeks (2 days/week) on a cycle ergometer (2-min intervals, with 2-min rest between intervals) at maximal workload, which was obtained during a maximal graded exercise test under normoxia. All training sessions were performed until exhaustion. Participants performed maximal graded exercise, submaximal exercise, and 90-s maximal exercise tests before and after the training period. Maximal oxygen uptake (P < 0.01) increased significantly in both groups. Blood lactate curve during submaximal exercise improved significantly only in the HHIIT group (P < 0.01). Mean power output during maximal exercise increased significantly only in the HHIIT group (P = 0.02). This study demonstrated that a practical hyperoxic HHIIT might be effective for improving aerobic capacity and anaerobic performance.

Effects of all-out sprint interval training under hyperoxia on exercise performance

All-out sprint interval training (SIT) is speculated to be an effective and time-efficient training regimen to improve the performance of aerobic and anaerobic exercises. SIT under hypoxia causes greater improvements in anaerobic exercise performance compared with that under normoxia. The change in oxygen concentration may affect SIT-induced performance adaptations. In this study, we aimed to investigate the effects of all-out SIT under hyperoxia on the performance of aerobic and anaerobic exercises. Eighteen college male athletes were randomly assigned to either the normoxic sprint interval training (NST, n = 9) or hyperoxic (60% oxygen) sprint interval training (HST, n = 9) group and performed 3-week SIT (six sessions) consisting of four to six 30-sec all-out cycling sessions with 4-min passive rest. They performed maximal graded exercise, submaximal exercise, 90-sec maximal exercise, and acute SIT tests on a cycle ergometer before and after the 3-week intervention to evaluate the performance of aerobic and anaerobic exercises. Maximal oxygen uptake significantly improved in both groups. However, blood lactate curve during submaximal exercise test significantly improved only in the HST group. The accumulated oxygen deficit (AOD) during 90-sec maximal exercise test significantly increased only in the NST group. The average values of mean power outputs over four bouts during the acute SIT test significantly improved only in the NST group. These findings suggest that all-out SIT might induce greater improvement in aerobic exercise performance (blood lactate curve) but impair SIT-induced enhancements in anaerobic exercise performance (AOD and mean power output).

Influence of Hyperoxic-Supplemented High-Intensity Interval Training on Hemotological and Muscle Mitochondrial Adaptations in Trained Cyclists

Background: Hyperoxia (HYPER) increases O₂ carrying capacity resulting in a higher O₂ delivery to the working muscles during exercise. Several lines of evidence indicate that lactate metabolism, power output, and endurance are improved by HYPER compared to normoxia (NORM). Since HYPER enables a higher exercise power output compared to NORM and considering the O₂ delivery limitation at exercise intensities near to maximum, we hypothesized that hyperoxic-supplemented high-intensity interval training (HIIT) would upregulate muscle mitochondrial oxidative capacity and enhance endurance cycling performance compared to training in normoxia. Methods: 23 trained cyclists, age 35.3 ± 6.4 years, body mass 75.2 ± 9.6 kg, height 179.8 ± 7.9 m, and VO₂max 4.5 ± 0.7 L min^-1 performed 6 weeks polarized and periodized endurance training on a cycle ergometer consisting of supervised HIIT sessions 3 days/week and additional low-intensity training 2 days/week. Participants were randomly assigned to either HYPER (F_IO₂ 0.30; n = 12) or NORM (F_IO₂ 0.21; n = 11) breathing condition during HIIT. Mitochondrial respiration in permeabilized fibers and isolated mitochondria together with maximal and submaximal VO₂, hematological parameters, and self-paced endurance cycling performance were tested pre- and posttraining intervention. Results: Hyperoxic training led to a small, non-significant change in performance compared to normoxic training (HYPER 6.0 ± 3.7%, NORM 2.4 ± 5.0%; p = 0.073, ES = 0.32). This small, beneficial effect on the self-paced endurance cycling performance was not explained by the change in VO₂max (HYPER 1.1 ± 3.8%, NORM 0.0 ± 3.7%; p = 0.55, ES = 0.08), blood volume and hemoglobin mass, mitochondrial oxidative phosphorylation capacity (permeabilized fibers: HYPER 27.3 ± 46.0%, NORM 16.5 ± 49.1%; p = 0.37, ES = 3.24 and in isolated mitochondria: HYPER 26.1 ± 80.1%, NORM 15.9 ± 73.3%; p = 0.66, ES = 0.51), or markers of mitochondrial content which were similar between groups post intervention. Conclusions: This study showed that 6 weeks hyperoxic-supplemented HIIT led to marginal gain in cycle performance in already trained cyclists without change in VO₂max, blood volume, hemoglobin mass, mitochondrial oxidative phosphorylation capacity, or exercise efficiency. The underlying mechanisms for the potentially meaningful performance effects of hyperoxia training remain unexplained and may raise ethical questions for elite sport.

The Effects of Hyperoxia on Sea-Level Exercise Performance, Training, and Recovery: A Meta-Analysis

BACKGROUND

Acute exercise performance can be limited by arterial hypoxemia, such that hyperoxia may be an ergogenic aid by increasing tissue oxygen availability. Hyperoxia during a single bout of exercise performance has been examined using many test modalities, including time trials (TTs), time to exhaustion (TTE), graded exercise tests (GXTs), and dynamic muscle function tests. Hyperoxia has also been used as a long-term training stimulus or a recovery intervention between bouts of exercise. However, due to the methodological differences in fraction of inspired oxygen (F_iO₂), exercise type, training regime, or recovery protocols, a firm consensus on the effectiveness of hyperoxia as an ergogenic aid for exercise training or recovery remains unclear.

OBJECTIVES

The aims of this study were to (1) determine the efficacy of hyperoxia as an ergogenic aid for exercise performance, training stimulus, and recovery before subsequent exercise; and (2) determine if a dose-response exists between F_iO₂ and exercise performance improvements.

DATA SOURCE

The PubMed, Web of Science, and SPORTDiscus databases were searched for original published articles up to and including 8 September 2017, using appropriate first- and second-order search terms.

STUDY SELECTION

English-language, peer-reviewed, full-text manuscripts using human participants were reviewed using the process identified in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.

DATA EXTRACTION

Data for the following variables were obtained by at least two of the authors: F_iO₂, wash-in time for gas, exercise performance modality, heart rate, cardiac output, stroke volume, oxygen saturation, arterial and/or capillary lactate, hemoglobin concentration, hematocrit, arterial pH, arterial oxygen content, arterial partial pressure of oxygen and carbon dioxide, consumption of oxygen and carbon dioxide, minute ventilation, tidal volume, respiratory frequency, ratings of perceived exertion of breathing and exercise, and end-tidal oxygen and carbon dioxide partial pressures.

DATA GROUPING

Data were grouped into type of intervention (acute exercise, recovery, and training), and performance data were grouped into type of exercise (TTs, TTE, GXTs, dynamic muscle function), recovery, and training in hyperoxia.

DATA ANALYSIS

Hedges' g effect sizes and 95% confidence intervals were calculated. Separate Pearson's correlations were performed comparing the effect size of performance versus F_iO₂, along with the effect size of arterial content of oxygen, arterial partial pressure of oxygen, and oxygen saturation.

RESULTS

Fifty-one manuscripts were reviewed. The most common F_iO₂ for acute exercise was 1.00, with GXTs the most investigated exercise modality. Hyperoxia had a large effect improving TTE (g = 0.89), and small-to-moderate effects increasing TTs (g = 0.56), GXTs (g = 0.40), and dynamic muscle function performance (g = 0.28). An F_iO₂ ≥ 0.30 was sufficient to increase general exercise performance to a small effect or higher; a moderate positive correlation (r = 0.47-0.63) existed between performance improvement of TTs, TTE, and dynamic muscle function tests and F_iO₂, but not GXTs (r = 0.06). Exercise training and recovery supplemented with hyperoxia trended towards a large and small ergogenic effect, respectively, but the large variability and limited amount of research on these topics prevented a definitive conclusion.

CONCLUSION

Acute exercise performance is increased with hyperoxia. An F_iO₂ ≥ 0.30 appears to be beneficial for performance, with a higher F_iO₂ being correlated to greater performance improvement in TTs, TTE, and dynamic muscle function tests. Exercise training and recovery supplemented with hyperoxic gas appears to have a beneficial effect on subsequent exercise performance, but small sample size and wide disparity in experimental protocols preclude definitive conclusions.

The Impact of Hyperoxia on Human Performance and Recovery

Hyperoxia results from the inhalation of mixtures of gas containing higher partial pressures of oxygen (O₂) than normal air at sea level. Exercise in hyperoxia affects the cardiorespiratory, neural and hormonal systems, as well as energy metabolism in humans. In contrast to short-term exposure to hypoxia (i.e. a reduced partial pressure of oxygen), acute hyperoxia may enhance endurance and sprint interval performance by accelerating recovery processes. This narrative literature review, covering 89 studies published between 1975 and 2016, identifies the acute ergogenic effects and health concerns associated with hyperoxia during exercise; however, long-term adaptation to hyperoxia and exercise remain inconclusive. The complexity of the biological responses to hyperoxia, as well as the variations in (1) experimental designs (e.g. exercise intensity and modality, level of oxygen, number of participants), (2) muscles involved (arms and legs) and (3) training status of the participants may account for the discrepancies.

Highs and lows of hyperoxia: physiological, performance, and clinical aspects

Molecular oxygen (O₂) is a vital element in human survival and plays a major role in a diverse range of biological and physiological processes. Although normobaric hyperoxia can increase arterial oxygen content ([Formula: see text]), it also causes vasoconstriction and hence reduces O₂ delivery in various vascular beds, including the heart, skeletal muscle, and brain. Thus, a seemingly paradoxical situation exists in which the administration of oxygen may place tissues at increased risk of hypoxic stress. Nevertheless, with various degrees of effectiveness, and not without consequences, supplemental oxygen is used clinically in an attempt to correct tissue hypoxia (e.g., brain ischemia, traumatic brain injury, carbon monoxide poisoning, etc.) and chronic hypoxemia (e.g., severe COPD, etc.) and to help with wound healing, necrosis, or reperfusion injuries (e.g., compromised grafts). Hyperoxia has also been used liberally by athletes in a belief that it offers performance-enhancing benefits; such benefits also extend to hypoxemic patients both at rest and during rehabilitation. This review aims to provide a comprehensive overview of the effects of hyperoxia in humans from the "bench to bedside." The first section will focus on the basic physiological principles of partial pressure of arterial O₂, [Formula: see text], and barometric pressure and how these changes lead to variation in regional O₂ delivery. This review provides an overview of the evidence for and against the use of hyperoxia as an aid to enhance physical performance. The final section addresses pathophysiological concepts, clinical studies, and implications for therapy. The potential of O₂ toxicity and future research directions are also considered.

Effects of Exercise Training under Hyperbaric Oxygen on Oxidative Stress Markers and Endurance Performance in Young Soccer Players: A Pilot Study

The aim of the present study was to determine the effects of three weeks of hyperbaric oxygen (HBO₂) training on oxidative stress markers and endurance performance in young soccer players. Participants (18.6 ± 1.6 years) were randomized into hyperbaric-hyperoxic (HH) training (n = 6) and normobaric normoxic (NN) training (n = 6) groups. Immediately before and after the 5th, 10th, and 15th training sessions, plasma oxidative stress markers (lipid hydroperoxides and uric acid), plasma antioxidant capacity (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid [TROLOX]), arterial blood gases, acid-base balance, bases excess (BE), and blood lactate analyses were performed. Before and after intervention, maximal oxygen uptake (VO₂max) and peak power output (PPO) were determined. Neither HH nor NN experienced significant changes on oxidative stress markers or antioxidant capacity during intervention. VO₂max and PPO were improved (moderate effect size) after HH training. The results suggest that HBO₂ endurance training does not increase oxidative stress markers and improves endurance performance in young soccer players. Our findings warrant future investigation to corroborate that HBO₂ endurance training could be a potential training approach for highly competitive young soccer players.

Does hyperoxic recovery during cross-country skiing team sprints enhance performance?

PURPOSE

This study aimed to determine the acute responses of breathing oxygen-enriched air during the recovery periods of a simulated 3 × 3-min cross-country skiing team sprint competition at simulated low altitude.

METHODS

Eight well-trained male endurance athletes performed two 3 × 3-min team sprint simulations on a double-poling ergometer at simulated altitude set at ∼ 1800 m. During the recovery periods between the 3 × 3-min sprints, all the athletes inhaled either hyperoxic (FiO2 = 1.00) or hypoxic (FiO2 ∼ 0.165) air in randomized and single-blind order. The mean total power output (P(mean tot)) and the mean power output of each sprint (P(mean) 1,2,3) were determined. Perceived exertion, capillary oxygen saturation of hemoglobin, partial pressure of oxygen, and blood lactate concentration were measured before and after all the sprints.

RESULTS

No differences in P(mean tot) were found between hyperoxic (198.4 ± 27.1 W) and hypoxic (200.2 ± 28.0 W) recovery (P = 0.57, effect size [d] = 0.07). P(mean) 1,2,3 (P > 0.90, d = 0.04-0.09) and RPE (P > 0.13, d = 0.02-0.63) did not differ between hyperoxic and hypoxic recovery. The partial pressure of oxygen (P < 0.01, d = 0.06-5.45) and oxygen saturation (P < 0.01, d = 0.15-5.40) during hyperoxic recovery were higher than those during hypoxic recovery. The blood lactate concentration was also lower directly after the third sprint (P = 0.03, d = 0.54) with hyperoxic recovery.

CONCLUSION

Results indicate that trained endurance athletes who inhale 100% oxygen during recovery periods in a cross-country skiing team sprint at low altitude do not exhibit enhanced performance despite the improvement in the key physiological variables of endurance performance.

Single-leg cycle training is superior to double-leg cycling in improving the oxidative potential and metabolic profile of trained skeletal muscle

Single-leg cycling may enhance the peripheral adaptations of skeletal muscle to a greater extent than double-leg cycling. The purpose of the current study was to determine the influence of 3 wk of high-intensity single- and double-leg cycle training on markers of oxidative potential and muscle metabolism and exercise performance. In a crossover design, nine trained cyclists (78 ± 7 kg body wt, 59 ± 5 ml·kg(-1)·min(-1) maximal O(2) consumption) performed an incremental cycling test and a 16-km cycling time trial before and after 3 wk of double-leg and counterweighted single-leg cycle training (2 training sessions per week). Training involved three (double) or six (single) maximal 4-min intervals with 6 min of recovery. Mean power output during the single-leg intervals was more than half that during the double-leg intervals (198 ± 29 vs. 344 ± 38 W, P < 0.05). Skeletal muscle biopsy samples from the vastus lateralis revealed a training-induced increase in Thr(172)-phosphorylated 5'-AMP-activated protein kinase α-subunit for both groups (P < 0.05). However, the increase in cytochrome c oxidase subunits II and IV and GLUT-4 protein concentration was greater following single- than double-leg cycling (P < 0.05). Training-induced improvements in maximal O(2) consumption (3.9 ± 6.2% vs. 0.6 ± 3.6%) and time-trial performance (1.3 ± 0.5% vs. 2.3 ± 4.2%) were similar following both interventions. We conclude that short-term high-intensity single-leg cycle training can elicit greater enhancement in the metabolic and oxidative potential of skeletal muscle than traditional double-leg cycling. Single-leg cycling may therefore provide a valuable training stimulus for trained and clinical populations.

Aerobic interval training improves VO2 peak in coronary artery disease patients; no additional effect from hyperoxia

OBJECTIVES

To investigate whether hyperoxic aerobic interval training improves training quality in coronary artery disease patients.

DESIGN

Twenty-one stable coronary artery disease patients were recruited to hyperoxic (n=10) and normoxic (n=11) groups (age: 62.4 +/- 6.8 years). Patients underwent 30 supervised 44 minutes interval training sessions using treadmill walking, at 85-95% of peak heart rate.

RESULTS

Arterial saturation was significantly increased by 3% at pretest from normoxic to hyperoxic testing conditions. Peak oxygen uptake and stroke volume increased significantly by 16% and 17% (p<0.05) and by 16% and 18% (p<0.05) in the hyperoxic and normoxic training groups respectively. No difference was revealed between groups for peak oxygen uptake and stroke volume. Blood volumes were unchanged from pre to post training. Peak oxygen uptake measured in normoxia and hyperoxia in the hyperoxia training group revealed no difference.

CONCLUSION

The present study shows that breathing 100% oxygen enriched air during aerobic interval training in stable coronary artery disease patients does not improve peak oxygen uptake above the level attained with normoxic training.

The effects of training in hyperoxia vs. normoxia on skeletal muscle enzyme activities and exercise performance

Inspiring a hyperoxic (H) gas permits subjects to exercise at higher power outputs while training, but there is controversy as to whether this improves skeletal muscle oxidative capacity, maximal O(2) consumption (Vo(2 max)), and endurance performance to a greater extent than training in normoxia (N). To determine whether the higher power output during H training leads to a greater increase in these parameters, nine recreationally active subjects were randomly assigned in a single-blind fashion to train in H (60% O(2)) or N for 6 wk (3 sessions/wk of 10 x 4 min at 90% Vo(2 max)). Training heart rate (HR) was maintained during the study by increasing power output. After at least 6 wk of detraining, a second 6-wk training protocol was completed with the other breathing condition. Vo(2 max) and cycle time to exhaustion at 90% of pretraining Vo(2 max) were tested in room air pre- and posttraining. Muscle biopsies were sampled pre- and posttraining for citrate synthase (CS), beta-hydroxyacyl-coenzyme A dehydrogenase (beta-HAD), and mitochondrial aspartate aminotransferase (m-AsAT) activity measurements. Training power outputs were 8% higher (17 W) in H vs. N. However, both conditions produced similar improvements in Vo(2 max) (11-12%); time to exhaustion (approximately 100%); and CS (H, 30%; N, 32%), beta-HAD (H, 23%; N, 21%), and m-AsAT (H, 21%; N, 26%) activities. We conclude that the additional training stimulus provided by training in H was not sufficient to produce greater increases in the aerobic capacity of skeletal muscle and whole body Vo(2 max) and exercise performance compared with training in N.