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

Muscle Oximetry in Sports Science: An Updated Systematic Review

BACKGROUND

In the last 5 years since our last systematic review, a significant number of articles have been published on the technical aspects of muscle near-infrared spectroscopy (NIRS), the interpretation of the signals and the benefits of using the NIRS technique to measure the physiological status of muscles and to determine the workload of working muscles.

OBJECTIVES

Considering the consistent number of studies on the application of muscle oximetry in sports science published over the last 5 years, the objectives of this updated systematic review were to highlight the applications of muscle oximetry in the assessment of skeletal muscle oxidative performance in sports activities and to emphasize how this technology has been applied to exercise and training over the last 5 years. In addition, some recent instrumental developments will be briefly summarized.

METHODS

Preferred Reporting Items for Systematic Reviews guidelines were followed in a systematic fashion to search, appraise and synthesize existing literature on this topic. Electronic databases such as Scopus, MEDLINE/PubMed and SPORTDiscus were searched from March 2017 up to March 2023. Potential inclusions were screened against eligibility criteria relating to recreationally trained to elite athletes, with or without training programmes, who must have assessed physiological variables monitored by commercial oximeters or NIRS instrumentation.

RESULTS

Of the identified records, 191 studies regrouping 3435 participants, met the eligibility criteria. This systematic review highlighted a number of key findings in 37 domains of sport activities. Overall, NIRS information can be used as a meaningful marker of skeletal muscle oxidative capacity and can become one of the primary monitoring tools in practice in conjunction with, or in comparison with, heart rate or mechanical power indices in diverse exercise contexts and across different types of training and interventions.

CONCLUSIONS

Although the feasibility and success of the use of muscle oximetry in sports science is well documented, there is still a need for further instrumental development to overcome current instrumental limitations. Longitudinal studies are urgently needed to strengthen the benefits of using muscle oximetry in sports science.

Physiological Responses to Supramaximal Running Exercise with End-Expiratory Breath Holding up to the Breaking Point

This study aimed to assess the physiological responses to repeated running exercise performed at supramaximal intensity and with end-expiratory breath holding (EEBH) up to the breaking point. Eight male runners participated in two running testing sessions on a motorized treadmill. In the first session, participants performed two sets of 8 repetitions at 125% of maximal aerobic velocity and with maximum EEBH. Each repetition started at the onset of EEBH and ended at its release. In the second session, participants replicated the same procedure, but with unrestricted breathing (URB). The change in cerebral and muscle oxygenation (Δ[Hbdiff]), total haemoglobin concentration (Δ[THb]) and muscle reoxygenation were continuously assessed. End-tidal oxygen (PETO2) and carbon dioxide pressure (PETCO2), arterial oxygen saturation (SpO2) and heart rate (HR) were also measured throughout exercise.On average, EEBH was maintained for 10.1 ± 1 s. At the breaking point of EEBH, PETO2 decreased to 54.1 ± 8 mmHg, whereas PETCO2 increased to 74.8 ± 3.1 mmHg. At the end of repetitions, SpO2 (nadir values 74.9 ± 5.0 vs. 95.7 ± 0.8%) and HR were lower with EEBH than with URB. Cerebral and muscle Δ[Hbdiff] were also lower with EEBH, whereas this condition induced higher cerebral and muscle Δ[THb] and greater muscle reoxygenation. This study showed that performing repeated bouts of supramaximal running exercises with EEBH up to the breaking point induced a fall in arterial, cerebral and muscle oxygenation compared with the URB condition. These phenomena were accompanied by increases in regional blood volume likely resulting from compensatory vasodilation to preserve oxygen delivery to the brain and muscles.

Hypoxia Does Not Change Performance and Psychophysiological Responses During Repeated Cycling Sprints to Exhaustion With Short Exercise-to-Rest Ratio

PURPOSE

To compare the acute performance and psychophysiological responses of repeated cycling sprints to exhaustion with a short exercise-to-rest ratio (1:6), between different effort durations and inspired oxygen fractions.

METHODS

On separate visits, 10 active participants completed 6 repeated cycling sprint exercises to exhaustion with 3 different effort durations (5, 10, and 20 s) and 2 conditions of inspired oxygen (20.9% and 13.6%). Exercise-to-rest ratio was 1:6 for all trials (ie, 5:30, 10:60, and 20:120). Vastus lateralis muscle oxygenation (near-infrared spectroscopy), blood lactate concentration, and lower-limb and breathing discomfort, using ratings of perceived exertion, were measured.

RESULTS

Number of sprints and peak power output decreased while blood lactate increased (all P < .001) during 5:30 compared with 10:60 or 20:120. No condition or interaction effects were reported for blood lactate and exercise-related sensation. Muscle deoxyhemoglobin increased (P < .001) and total hemoglobin decreased (P = .002) during sprint with increasing sprint duration (no condition or interaction).

CONCLUSION

During repeated-sprint exercise to exhaustion with a short exercise-to-rest ratio, the psychophysiological responses did not differ between normoxia and moderate hypoxia, probably due to an extended recovery period. It means that hypoxia did not modify repeated-sprint exercise performance with a short exercise-to-rest ratio. The sprint duration was the primary underlying factor of the observed differences in performance and muscle oxygenation reported between the repeated-sprint exercise sessions.

The Oxidative-Glycolytic Balance Influenced by Sprint Duration Is Key during Repeated Sprint in Hypoxia

PURPOSE

This study investigates the effects of normobaric hypoxia on repeated sprint exercise (RSE) with different balance between oxidative (phosphocreatine and oxidative pathway) and glycolytic contributions. Therefore, performance and psychophysiological responses were compared during RSE to exhaustion with the same exercise-to-rest ratio (1:2) but different sprint durations (5, 10, or 20 s) either in normoxic (RSN) or hypoxic (RSH; F io2 = 0.13) conditions.

METHODS

On separate visits, 10 active participants completed in random order three cycling RSN (5:10; 10:20 and 20:40) and three similar RSH sessions to exhaustion. Vastus lateralis muscle oxygenation was recorded by near-infrared spectroscopy. Blood lactate concentration, limb and breathing discomfort, and ratings of perceived exertion were measured.

RESULTS

Total sprint number was smaller in hypoxia than in normoxia for 5:10 (20.8 ± 8.6 vs 14.7 ± 3.4; P = 0.014) and 10:20 (13.7 ± 6.3 vs 8.8 ± 2.5; P = 0.018) but not 20:40 (5.6 ± 1.9 vs 5.6 ± 2.5). The fatigue index was larger in hypoxia only for 5:10 (-43.5%, P < 0.001). Irrespective of condition, blood lactate concentration increased with the sprint duration with higher values for 20:40 than 5:10 (13.1 ± 2.7 vs 11.5 ± 2.2 mmoL·L -1 ; P = 0.027). Limb and breathing discomfort and ratings of perceived exertion did not differ in all RSE. Muscle oxygenation was mainly impacted by sprint duration (i.e., main effect of sprint duration on [HHb] min, [tHb] max, Δ[HHb], and Δ[tHb]) but not by hypoxia. The normoxia-to-hypoxia percentage decrease for total sprint number for 5:10 was correlated with the highest power output over 5 s ( R2 = 0.55; P = 0.013) and 10 s ( R2 = 0.53; P = 0.016).

CONCLUSIONS

Hypoxia impairs repeated sprint ability when the oxidative but not the glycolytic contribution is substantial. The oxidative-glycolytic balance, influenced partly by sprint duration, is key during repeated sprint in hypoxia.

High Dose of Acute Normobaric Hypoxia Does Not Adversely Affect Sprint Interval Training, Cognitive Performance and Heart Rate Variability in Males and Females

Although preliminary studies suggested sex-related differences in physiological responses to hypoxia, the effects of sex on sprint interval training (SIT) performance in different degrees of hypoxia are largely lacking. The aim of this study was to examine the acute effect of different doses of normobaric hypoxia on SIT performance as well as heart rate variability (HRV) and cognitive performance (CP) in amateur-trained team sport players by comparing potential sex differences. In a randomized, double-blind, crossover design, 26 (13 females) amateur team-sport (football, basketball, handball, rugby) players completed acute SIT (6 × 15 s all-out sprints, separated with 2 min active recovery, against a load equivalent to 9% of body weight) on a cycle ergometer, in one of four conditions: (I) normoxia without a mask (FiO2: 20.9%) (CON); (II) normoxia with a mask (FiO2: 20.9%) (NOR); (III) moderate hypoxia (FiO2: 15.4%) with mask (MHYP); and (IV) high hypoxia (FiO2: 13.4%) with mask (HHYP). Peak (PPO) and mean power output (MPO), HRV, heart rate (HR), CP, capillary lactate (BLa), and ratings of perceived exertion (RPE) pre- and post-SIT were compared between CON, NOR, MHYP and HHYP. There were no significant differences found between trials for PPO (p = 0.55), MPO (p = 0.44), RPE (p = 0.39), HR (p = 0.49), HRV (p > 0.05) and CP (response accuracy: p = 0.92; reaction time: p = 0.24). The changes in MP, PP, RPE, HR, CP and HRV were similar between men and women (all p > 0.05). While BLa was similar (p = 0.10) between MHYP and HHYP trials, it was greater compared to CON (p = 0.01) and NOR (p = 0.01), without a sex-effect. In conclusion, compared to normoxia, hypoxia, and wearing a mask, have no effect on SIT acute responses (other than lactate), including PP, MP, RPE, CP, HR, and cardiac autonomic modulation either in men or women.

The Methodological Quality of Studies Investigating the Acute Effects of Exercise During Hypoxia Over the Past 40 years: A Systematic Review

Exercise under hypoxia and the physiological impact compared to normoxia or hypoxia has gained attention in the last decades. However, methodological quality assessment of articles in this area is lacking in the literature. Therefore, this article aimed to evaluate the methodologic quality of trials studying exercise under hypoxia. An electronic search was conducted until December 2021. The search was conducted in PubMed, CENTRAL, and PEDro using the PICO model. (P) Participants had to be healthy, (I) exercise under normobaric or hypobaric hypoxia had to be (C) compared to exercise in normoxia or hypoxia on (O) any physiological outcome. The 11-item PEDro scale was used to assess the methodological quality (internal validity) of the studies. A linear regression model was used to evaluate the evolution of trials in this area, using the total PEDro score of the rated trials. A total of n = 81 studies met the inclusion criteria and were processed in this study. With a mean score of 5.1 ± 0.9 between the years 1982 and 2021, the mean methodological quality can be described as “fair.” Only one study reached the highest score of 8/10, and n = 2 studies reached the lowest observed value of 3/10. The linear regression showed an increase of the PEDro score of 0.1 points per decade. A positive and small tendency toward increased methodologic quality was observed. The current results demonstrate that a positive and small tendency can be seen for the increase in the methodological quality in the field of exercise science under hypoxia. A “good” methodological quality, reaching a PEDro score of 6 points can be expected in the year 2063, using a linear regression model analysis. To accelerate this process, future research should ensure that methodological quality criteria are already included during the planning phase of a study.

Augmented muscle deoxygenation during repeated sprint exercise with post-exercise blood flow restriction

Blood flow restriction (BFR) during low-intensity exercise has been known to be a potent procedure to alter metabolic and oxygen environments in working muscles. Moreover, the use of BFR during inter-set rest periods of repeated sprint exercise has been recently suggested to be a potent procedure for improving training adaptations. The present study was designed to determine the effect of repeated sprint exercise with post-exercise BFR (BFR during rest periods between sprints) on muscle oxygenation in working muscles. Eleven healthy males performed two different conditions on different days: either repeated sprint exercise with BFR during rest periods between sets (BFR condition) or without BFR (CON condition). A repeated sprint exercise consisted of three sets of 3 × 6-s maximal sprints (pedaling) with 24s rest periods between sprints and 5 min rest periods between sets. In BFR condition, two min of BFR (100-120 mmHg) for both legs was conducted between sets. During the exercise, power output and arterial oxygen saturation (SpO₂ ) were evaluated. Muscle oxygenation for the vastus lateralis muscle, exercise-induced changes in muscle blood flow, and muscle oxygen consumption were measured. During BFR between sets, BFR condition presented significantly higher deoxygenated hemoglobin + myoglobin (p < 0.01) and lower tissue saturation index (p < 0.01) than those in CON condition. However, exercise-induced blood lactate elevation and reduction of blood pH did not differ significantly between the conditions. Furthermore, power output throughout nine sprints did not differ significantly between the two conditions. In conclusion, repeated sprint exercise with post-exercise BFR augmented muscle deoxygenation and local hypoxia, without interfering power output.

Hyperoxia Improves Repeated-Sprint Ability and the Associated Training Load in Athletes

This study investigated the impact of hyperoxic gas breathing (HYP) on repeated-sprint ability (RSA) and on the associated training load (TL). Thirteen team- and racquet-sport athletes performed 6-s all-out sprints with 24-s recovery until exhaustion (power decrement ≥ 15% for two consecutive sprints) under normoxic (NOR: F_IO₂ 0.21) and hyperoxic (HYP: F_IO₂ 0.40) conditions in a randomized, single-blind and crossover design. The following variables were recorded throughout the tests: mechanical indices, arterial O₂ saturation (S_pO₂), oxygenation of the vastus lateralis muscle with near-infrared spectroscopy, and electromyographic activity of the vastus lateralis, rectus femoris, and gastrocnemius lateralis muscles. Session TL (work × rate of perceived exertion) and neuromuscular efficiency (work/EMG [Electromyography]) were calculated. Compared with NOR, HYP increased S_pO₂ (2.7 ± 0.8%, Cohen's effect size ES 0.55), the number of sprints (14.5 ± 8.6%, ES 0.28), the total mechanical work (13.6 ± 6.8%, ES 0.30), and the session TL (19.4 ± 7.0%, ES 0.33). Concomitantly, HYP increased the amplitude of muscle oxygenation changes during sprints (25.2 ± 11.7%, ES 0.36) and recovery periods (26.1 ± 11.4%, ES 0.37), as well as muscle recruitment (9.9 ± 12.1%, ES 0.74), and neuromuscular efficiency (6.9 ± 9.0%, ES 0.24). It was concluded that breathing a hyperoxic mixture enriched to 40% O₂ improves the total work performed and the associated training load during an open-loop RSA session in trained athletes. This ergogenic impact may be mediated by metabolic and neuromuscular alterations.

A Combined Hot and Hypoxic Environment during Maximal Cycling Sprints Reduced Muscle Oxygen Saturation: A Pilot Study

The present study investigated the effects of a combined hot and hypoxic environment on muscle oxygenation during repeated 15-s maximal cycling sprints. In a single-blind, cross-over study, nine trained sprinters performed three 15-s maximal cycling sprints interspersed with 7-min passive recovery in normoxic (NOR; 23℃, 50%, FiO₂ 20.9%), normobaric hypoxic (HYP; 23℃, FiO₂ 14.5%), and hot normobaric hypoxic (HH; 35℃, FiO₂ 14.5%) environments. Relative humidity was set to 50% in all trials. The vastus lateralis muscle oxygenation was evaluated during exercise using near-infrared spectroscopy. The oxygen uptake (VO₂) and arterial oxygen saturation (SpO₂) were also monitored. There was no significant difference in peak or mean power output among the three conditions. The reduction in tissue saturation index was significantly greater in the HH (-17.0 ± 2.7%) than in the HYP (-10.4 ± 2.8%) condition during the second sprint (p < 0.05). The average VO₂ and SpO₂ were significantly lower in the HYP (VO₂ = 980 ± 52 mL/min, SpO₂ = 82.9 ± 0.8%) and HH (VO₂ = 965 ± 42 mL/min, SpO₂ = 83.2 ± 1.2%) than in the NOR (VO₂ = 1149 ± 40 mL/min, SpO₂ = 90.6 ± 1.4%; p < 0.05) condition. In conclusion, muscle oxygen saturation was reduced to a greater extent in the HH than in the HYP condition during the second bout of three 15-s maximal cycling sprints, despite the equivalent hypoxic stress between HH and HYP.

Muscle Ionic Shifts During Exercise: Implications for Fatigue and Exercise Performance

Exercise causes major shifts in multiple ions (e.g., K⁺ , Na⁺ , H⁺ , lactate^- , Ca²⁺ , and Cl^- ) during muscle activity that contributes to development of muscle fatigue. Sarcolemmal processes can be impaired by the trans-sarcolemmal rundown of ion gradients for K⁺ , Na⁺ , and Ca²⁺ during fatiguing exercise, while changes in gradients for Cl^- and Cl^- conductance may exert either protective or detrimental effects on fatigue. Myocellular H⁺ accumulation may also contribute to fatigue development by lowering glycolytic rate and has been shown to act synergistically with inorganic phosphate (Pi) to compromise cross-bridge function. In addition, sarcoplasmic reticulum Ca²⁺ release function is severely affected by fatiguing exercise. Skeletal muscle has a multitude of ion transport systems that counter exercise-related ionic shifts of which the Na⁺ /K⁺ -ATPase is of major importance. Metabolic perturbations occurring during exercise can exacerbate trans-sarcolemmal ionic shifts, in particular for K⁺ and Cl^- , respectively via metabolic regulation of the ATP-sensitive K⁺ channel (K_ATP ) and the chloride channel isoform 1 (ClC-1). Ion transport systems are highly adaptable to exercise training resulting in an enhanced ability to counter ionic disturbances to delay fatigue and improve exercise performance. In this article, we discuss (i) the ionic shifts occurring during exercise, (ii) the role of ion transport systems in skeletal muscle for ionic regulation, (iii) how ionic disturbances affect sarcolemmal processes and muscle fatigue, (iv) how metabolic perturbations exacerbate ionic shifts during exercise, and (v) how pharmacological manipulation and exercise training regulate ion transport systems to influence exercise performance in humans. © 2021 American Physiological Society. Compr Physiol 11:1895-1959, 2021.

Muscle and cerebral oxygenation during cycling in chronic obstructive pulmonary disease: A scoping review

To synthesize evidence for prefrontal cortex (PFC), quadriceps, and respiratory muscle oxygenation using near-infrared spectroscopy (NIRS) during cycling in individuals with chronic obstructive pulmonary disease (COPD). A scoping review was performed searching databases (inception-August 2020): Ovid MEDLINE, EMBASE, Cochrane Systematic Reviews, Cochrane Central Register of Controlled Clinical Trials, CINAHL, SPORTDiscus and Pedro. The search focused on COPD, cycling, and NIRS outcomes. 29 studies (541 COPD participants) were included. Compared to healthy individuals (8 studies), COPD patients at lower cycling workloads had more rapid increases in vastus lateralis (VL) deoxygenated hemoglobin (HHb); lower increases in VL total hemoglobin (tHb) and blood flow; and lower muscle tissue saturation (StO₂). Heliox and bronchodilators were associated with smaller and slower increases in VL HHb. Heliox increased VL and intercostal blood flow compared to room air and supplemental oxygen in COPD patients (1 study). PFC oxygenated hemoglobin (O₂Hb) increased in COPD individuals during cycling in 5 of 8 studies. Individuals with COPD and heart failure demonstrated worse VL and PFC NIRS outcomes compared to patients with only COPD-higher or more rapid increase in VL HHb and no change or decrease in PFC O₂Hb. Individuals with COPD present with a mismatch between muscle oxygen delivery and utilization, characterized by more rapid increase in VL HHb, lower muscle O₂Hb and lower muscle StO₂. PFC O₂Hb increases or tends to increase in individuals with COPD during exercise, but this relationship warrants further investigation. NIRS can be used to identify key deoxygenation thresholds during exercise to inform PFC and muscle oxygenation.

Repeated Wingate sprints is a feasible high-quality training strategy in moderate hypoxia

Sprint-interval training (SIT) is efficient at improving maximal aerobic capacity and anaerobic fitness at sea-level and may be a feasible training strategy at altitude. Here, it was evaluated if SIT intensity can be maintained in mild to moderate hypoxia. It was hypothesized that 6 x 30 s Wingate sprint performance with 2 min active rest between sprints can be performed in hypoxic conditions corresponding to ~3,000 m of altitude without reducing mean power output (MPO). In a single-blinded, randomized crossover design, ten highly-trained male endurance athletes with a maximal oxygen uptake ([Formula: see text]O2max) of 68 ± 5 mL O2 × min-1 × kg-1 completed 6 x 30 s all-out Wingate cycling sprints separated by two-minute active recovery on four separate days in a hypobaric chamber. The ambient pressure within the chamber on each experimental day was 772 mmHg (~0 m), 679 mmHg (~915 m), 585 mmHg (~ 2,150 m), and 522 mmHg (~3,050 m), respectively. MPO was not different at sea-level and up to ~2,150 m (~1% and ~3% non-significant decrements at ~915 and ~2,150 m, respectively), whereas MPO was ~5% lower (P<0.05) at ~3,050 m. Temporal differences between altitudes was not different for peak power output (PPO), despite a main effect of altitude. In conclusion, repeated Wingate exercise can be completed by highly-trained athletes at altitudes up to ~2,150 m without compromising MPO or PPO. In contrast, MPO was compromised in hypobaric hypoxia corresponding to ~3,050 m. Thus, SIT may be an efficient strategy for athletes sojourning to moderate altitude and aiming to maintain training quality.

Insights for Blood Flow Restriction and Hypoxia in Leg Versus Arm Submaximal Exercise

PURPOSE

To assess tissue oxygenation, along with metabolic and physiological responses during blood flow restriction (BFR, bilateral vascular occlusion) and systemic hypoxia conditions during submaximal leg- versus arm-cycling exercise.

METHODS

In both legs and arms, 4 randomized sessions were performed (normoxia 400 m, fraction of inspired oxygen [FIO2] 20.9% and normobaric hypoxia 3800 m, FIO2 13.1% [0.1%]; combined with BFR at 0% and 45% of resting pulse elimination pressure). During each session, a single 6-minute steady-state submaximal exercise was performed to measure physiological changes and oxygenation (near-infrared spectroscopy) of the muscle tissue in both the vastus lateralis (legs) and biceps brachii (arms).

RESULTS

Total hemoglobin concentration ([tHb]) was 65% higher (P < .001) in arms versus legs, suggesting that arms had a greater blood perfusion capacity than legs. Furthermore, there were greater changes in tissue blood volume [tHb] during BFR compared with control conditions (P = .017, F = 5.45). The arms elicited 7% lower tissue saturation (P < .001) and were thus more sensitive to the hypoxia-induced reduction in oxygen supply than legs, no matter the condition. This indicates that legs and arms may elicit different regulatory hemodynamic mechanisms (ie, greater blood flow in arms) for limiting the decreased oxygen delivery during exercise with altered arterial oxygen content.

CONCLUSIONS

The combination of BFR and/or hypoxia led to increased [tHb] in both limbs likely due to greater vascular resistance; further, arms were more responsive than legs. This possibly influences the maintenance of oxygen delivery and enhances perfusion pressure, suggesting greater vascular reactivity in arms than in legs.

Active Preconditioning With Blood Flow Restriction or/and Systemic Hypoxic Exposure Does Not Improve Repeated Sprint Cycling Performance

Purpose

The aim of this study was to evaluate the effects of active preconditioning techniques using blood flow restriction or/and systemic hypoxic exposure on repeated sprint cycling performance and oxygenation responses.

Methods

Participants were 17 men; 8 were cycle trained (T: 21 ± 6 h/week) and 9 were untrained but physically active (UT). Each participant completed 4 cycles of 5 min stages of cycling at 1.5 W⋅kg^–1 in four conditions [Control; IPC (ischemic preconditioning) with partial blood flow restriction (60% of relative total occlusion pressure); HPC (hypoxic preconditioning) in normobaric systemic hypoxia (F_IO₂ 13.6%); and HIPC (hypoxic and ischemic preconditioning combined)]. Following a 40 min rest period, a repeated sprint exercise (RSE: 8 × 10 s sprints; 20 s of recovery) was performed. Near-infrared spectroscopy parameters [for each sprint, change in deoxyhemoglobin (Δ[HHb]), total hemoglobin (Δ[tHb]), and tissue saturation index (ΔTSI%)] were measured.

Results

Trained participants achieved higher power outputs (+10–16%) than UT in all conditions, yet RSE performance did not differ between active preconditioning techniques in the two groups. All conditions induced similar sprint decrement scores during RSE in both T and UT (16 ± 2 vs. 23 ± 9% in CON; 17 ± 3 vs. 19 ± 6% in IPC; 18 ± 5 vs. 20 ± 10% in HPC; and 17 ± 3 vs. 21 ± 5% in HIPC, for T and UT, respectively). During the sprints, Δ[HHb] was larger after IPC than both HPC and CON in T (p < 0.001). The Δ[tHb] was greater after HPC than all other conditions in T, whereas IPC, HPC, and HIPC induced higher Δ[tHb] than CON in UT.

Conclusion

None of the active preconditioning methods had an ergogenic effect on repeated sprint cycling performance, despite some specific hemodynamic responses (e.g., greater oxygen extraction and changes in blood volume), which were emphasized in the trained cyclists.

Separate and combined effects of local and systemic hypoxia in resistance exercise

PURPOSES

This study quantified performance, physiological, and perceptual responses during resistance exercise to task failure with blood flow restriction (BFR), in systemic hypoxia, and with these stimuli combined.

METHODS

Fourteen young men were tested for 1-repetition maximum (1RM) in the barbell biceps curl and lying triceps extension exercises. On separate visits, subjects performed exercise trials (4 sets to failure at 70% 1RM with 90 s between sets) in six separate randomized conditions, i.e., in normoxia or hypoxia (fraction of inspired oxygen = 20.9% and 12.9%, respectively) combined with three different levels of BFR (0%, 45%, or 60% of resting arterial occlusion pressure). Muscle activation and oxygenation were monitored via surface electromyography and near-infrared spectroscopy, respectively. Arterial oxygen saturation, heart rate, and perceptual responses were assessed following each set.

RESULTS

Compared to set 1, the number of repetitions before failure decreased in sets 2, 3, and 4 for both exercises (all P < 0.001), independently of the condition (P > 0.065). Arterial oxygen saturation was lower with systemic hypoxia (P < 0.001), but not BFR, while heart rate did not differ between conditions (P > 0.341). Muscle oxygenation and activation during exercise trials remained unaffected by the different conditions (all P ≥ 0.206). A significant main effect of time, but not condition, was observed for overall perceived discomfort, difficulty breathing, and limb discomfort (all P < 0.001).

CONCLUSION

Local and systemic hypoxic stimuli, or a combination of both, did not modify the fatigue-induced change in performance, trends of muscle activation or oxygenation, nor exercise-related sensations during a multi-set resistance exercise to task failure.

Muscle Oxygenation During Repeated Double-Poling Sprint Exercise in Normobaric Hypoxia and Normoxia

We compared upper limb muscle oxygenation responses during repeated double-poling sprint exercise in normobaric hypoxia and normoxia. Eight male kayakers completed a repeated double-poling sprint exercise (3 × 3 × 20-s maximal sprints, 40-s passive recovery, 5-min rest) in either hypoxia (HYP, FiO₂ = 14.5%) or normoxia (NOR, FiO₂ = 20.9%). Power output, muscle oxygenation of triceps brachii muscle (using near infrared spectroscopy), arterial oxygen saturation, and cardiorespiratory variables were monitored. Mean power output tended to be lower (-5.2%; P = 0.06) in HYP compared with NOR, while arterial oxygen saturation (82.9 ± 0.9% vs. 90.5 ± 0.8%) and systemic oxygen uptake (1936 ± 140 vs. 2408 ± 83 mL⋅min^-1) values were lower (P < 0.05). Exercise-induced increases in deoxygenated hemoglobin (241.7 ± 46.9% vs. 175.8 ± 27.2%) and total hemoglobin (138.0 ± 18.1% vs. 112.1 ± 6.7%) were greater in HYP in reference to NOR (P < 0.05). Despite moderate hypoxia exacerbating exercise-induced elevation in blood perfusion of active upper limb musculature, power output during repeated double-poling exercise only tended to be lower.

Vascular and oxygenation responses of local ischemia and systemic hypoxia during arm cycling repeated sprints

OBJECTIVES

The purpose of this study was to investigate the acute vascular and oxygenation responses to repeated sprint exercise during arm cycling with either blood flow restriction (BFR) or systemic hypoxia alone or in combination.

DESIGN

The study design was a single-blinded repeated-measures assessment of four conditions with two levels of normobaric hypoxia (400 m and 3800 m) and two levels of BFR (0% and 45% of total occlusion).

METHODS

Sixteen active participants (eleven men and five women; mean ± SD; 26.4 ± 4.0 years old; 73.8 ± 9.8 kg; 1.79 ± 0.07 m) completed 5 sessions (1 familiarization, 4 conditions). During each test visit, participants performed a repeated sprint arm cycling test to exhaustion (10 s maximal sprints with 20 s recovery until exhaustion) to measure power output, metabolic equivalents, blood flow, as well as oxygenation (near-infrared spectroscopy) of the biceps brachii muscle tissue.

RESULTS

Repeated sprint performance was decreased with both BFR and systemic hypoxia conditions. Greater changes between minimum-maximum of sprints in total hemoglobin concentration (Δ[tHb]) were demonstrated with BFR (400 m, 45% and 3800 m, 45%) than without (400 m, 0% and 3800 m, 0%) (p < 0.001 for both). Additionally, delta tissue saturation index (ΔTSI) decreased more with both BFR conditions than without (p < 0.001 for both). The absolute maximum TSI was progressively reduced with both BFR and systemic hypoxia (p < 0.001).

CONCLUSIONS

By combining high-intensity, repeated sprint exercise with BFR and/or systemic hypoxia, there is a robust stimulus detected by increased changes in blood perfusion placed on specific vascular mechanisms, which were more prominent in BFR conditions.

Neuromuscular evaluation of arm-cycling repeated sprints under hypoxia and/or blood flow restriction

PURPOSE

This study aimed to determine the effects of hypoxia and/or blood flow restriction (BFR) on an arm-cycling repeated sprint ability test (aRSA) and its impact on elbow flexor neuromuscular function.

METHODS

Fourteen volunteers performed an aRSA (10 s sprint/20 s recovery) to exhaustion in four randomized conditions: normoxia (NOR), normoxia plus BFR (N_BFR), hypoxia (FiO₂ = 0.13, HYP) and hypoxia plus BFR (H_BFR). Maximal voluntary contraction (MVC), resting twitch force (Db10), and electromyographic responses from the elbow flexors [biceps brachii (BB)] to electrical and transcranial magnetic stimulation were obtained to assess neuromuscular function. Main effects of hypoxia, BFR, and interaction were analyzed on delta values from pre- to post-exercise.

RESULTS

BFR and hypoxia decreased the number of sprints during aRSA with no significant cumulative effect (NOR 16 ± 8; N_BFR 12 ± 4; HYP 10 ± 3 and H_BFR 8 ± 3; P < 0.01). MVC decrease from pre- to post-exercise was comparable whatever the condition. M-wave amplitude (- 9.4 ± 1.9% vs. + 0.8 ± 2.0%, P < 0.01) and Db10 force (- 41.8 ± 4.7% vs. - 27.9 ± 4.5%, P < 0.01) were more altered after aRSA with BFR compared to without BFR. The exercise-induced increase in corticospinal excitability was significantly lower in hypoxic vs. normoxic conditions (e.g., BB motor evoked potential at 75% of MVC: - 2.4 ± 4.2% vs. + 16.0 ± 5.9%, respectively, P = 0.03).

CONCLUSION

BFR and hypoxia led to comparable aRSA performance impairments but with distinct fatigue etiology. BFR impaired the muscle excitation-contraction coupling whereas hypoxia predominantly affected corticospinal excitability indicating incapacity of the corticospinal pathway to adapt to fatigue as in normoxia.

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

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

The Effects of High-Intensity Interval Exercise and Hypoxia on Cognition in Sedentary Young Adults

Background and Objectives: Limited research has evaluated the effects of acute exercise on cognition under different conditions of inspired oxygenation. Thus, the purpose of this study was to examine the effects of high-intensity interval exercise (HIE) under normoxia (inspired fraction of oxygen (FIO₂): 0.209) and moderate hypoxia (FIO₂: 0.154) on cognitive function. Design: A single-blinded cross-over design was used to observe the main effects of exercise and oxygen level, and interaction effects on cognitive task performance. Methods: Twenty inactive adults (10 males and 10 females, 19–27 years old) performed a cognitive task (i.e., the Go/No-Go task) before and immediately after an acute bout of HIE under normoxic and hypoxic conditions. The HIE comprised 10 repetitions of 6 s high-intensity cycling against 7.5% body weight interspersed with 30 s passive recovery. Heart rate, peripheral oxygen saturation (SpO₂) and rating of perceived exertion were monitored. Results: The acute bout of HIE did not affect the reaction time (p = 0.204, η² = 0.083) but the accuracy rate decreased significantly after HIE under both normoxic and hypoxic conditions (p = 0.001, η² = 0.467). Moreover, moderate hypoxia had no influence either on reaction time (p = 0.782, η² = 0.004) or response accuracy (p = 0.972, η² < 0.001). Conclusions: These results indicate that an acute session of HIE may impair response accuracy immediately post-HIE, without sacrificing reaction time. Meanwhile moderate hypoxia was found to have no adverse effect on cognitive function in inactive young adults, at least in the present study.

Physiological responses to hypoxic constant-load and high-intensity interval exercise sessions in healthy subjects

PURPOSE

The aim of this study was to assess the acute cardiorespiratory as well as muscle and cerebral tissue oxygenation responses to submaximal constant-load (CL) and high-intensity interval (HII) cycling exercise performed in normoxia and in hypoxia at similar intensity, reproducing whole-body endurance exercise training sessions as performed in sedentary and clinical populations.

METHODS

Healthy subjects performed two CL (30 min, 75% of maximal heart rate, n = 12) and two HII (15 times 1-min high-intensity exercise-1-min passive recovery, n = 12) cycling exercise sessions in normoxia and in hypoxia [mean arterial oxygen saturation 76 ± 1% (clamped) during CL and 77 ± 5% (inspiratory oxygen fraction 0.135) during HII]. Cardiorespiratory and near-infrared spectroscopy parameters as well as the rate of perceived exertion were continuously recorded.

RESULTS

Power output was 21 ± 11% and 15% (according to protocol design) lower in hypoxia compared to normoxia during CL and HII exercise sessions, respectively. Heart rate did not differ between normoxic and hypoxic exercise sessions, while minute ventilation was higher in hypoxia during HII exercise only (+ 13 ± 29%, p < 0.05). Quadriceps tissue saturation index did not differ significantly between normoxia and hypoxia (CL 60 ± 8% versus 59 ± 5%; HII 59 ± 10% versus 56 ± 9%; p > 0.05), while prefrontal cortex deoxygenation was significantly greater in hypoxia during both CL (66 ± 4% versus 56 ± 6%) and HII (58 ± 5% versus 55 ± 5%; p < 0.05) sessions. The rate of perceived exertion did not differ between normoxic and hypoxic CL (2.4 ± 1.7 versus 2.9 ± 1.8) and HII (6.9 ± 1.4 versus 7.5 ± 0.8) sessions (p > 0.05).

CONCLUSION

This study indicates that at identical heart rate, reducing arterial oxygen saturation near 75% does not accentuate muscle deoxygenation during both CL and HII exercise sessions compared to normoxia. Hence, within these conditions, larger muscle hypoxic stress should not be expected.

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

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

Influence of averaging method on muscle deoxygenation interpretation during repeated-sprint exercise

Near-infrared spectroscopy (NIRS) is a common tool used to study oxygen availability and utilization during repeated-sprint exercise. However, there are inconsistent methods of smoothing and determining peaks and nadirs from the NIRS signal, which make interpretation and comparisons between studies difficult. To examine the effects of averaging method on deoxyhaemoglobin concentration ([HHb]) trends, nine males performed ten 10-s sprints, with 30 seconds of recovery, and six analysis methods were used for determining peaks and nadirs in the [HHb] signal. First, means were calculated over predetermined windows in the last 5 and 2 seconds of each sprint and recovery period. Second, moving 5-seconds and 2-seconds averages were also applied, and peaks/nadirs were determined for each 40-seconds sprint/recovery cycle. Third, a Butterworth filter was used to smooth the signal, and the resulting signal output was used to determine peaks and nadirs from predetermined time points and a rolling approach. Correlation and residual analysis showed that the Butterworth filter attenuated the "noise" in the signal, while maintaining the integrity of the raw data (r = .9892; mean standardized residual -9.71 × 10³  ± 3.80). Means derived from predetermined windows, irrespective of length and data smoothing, underestimated the magnitude of peak and nadir [HHb] compared to a rolling mean approach. Consequently, sprint-induced metabolic changes (inferred from Δ[HHb]) were underestimated. Based on these results, we suggest using a digital filter to smooth NIRS data, rather than an arithmetic mean, and a rolling approach to determine peaks and nadirs for accurate interpretation of muscle oxygenation trends.