Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies: support of pioneer work using invasive or non-continuous measures

Introduction

It is known that maximum oxygen uptake depends on age, sex, endurance capacity, and chronic heart failure. However, due to the required invasive or often applied non-continuous approaches, less is known on underlying central and peripheral factors. Thus, this study aimed to investigate the effects of age, sex, endurance capacity, and chronic heart failure on non-invasively and continuously measured central and peripheral factors of oxygen uptake.

Methods

15 male children (11 ± 1 years), 15 male (24 ± 3 years) and 14 female recreationally active adults (23 ± 2 years), 12 male highly trained endurance athletes (24 ± 3 years), and 10 male elders (59 ± 6 years) and 10 chronic heart failure patients (62 ± 7 years) were tested during a cardiopulmonary exercise test on a cycling ergometer until exhaustion for: blood pressure, heart rate, stroke volume, cardiac output, cardiac power output, vastus lateralis muscle oxygen saturation, and (calculated) arterio-venous oxygen difference. For the non-invasive and continuous measurement of stroke volume and muscle oxygen saturation, bioreactance analysis and near-infrared spectroscopy were used, respectively. A two-factor repeated measure ANOVA and partial eta-squared effect sizes (η p 2 ) were applied for statistical analyses at rest, 80, and 100% of oxygen uptake.

Results

For the age effect, there were statistically significant group differences for all factors (p ≤ .033; η p 2 ≥ .169 ). Concerning sex, there were group differences for all factors (p ≤ .010; η p 2 ≥ .223 ), except diastolic blood pressure and heart rate (p ≥ .698; η p 2 ≤ .006 ). For the effect of endurance capacity, there were no group differences for any of the factors (p ≥ .065; η p 2 ≤ .129 ). Regarding chronic heart failure, there were group differences for the heart rate and arterio-venous oxygen difference (p ≤ .037; η p 2 ≥ .220 ).

Discussion

Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies. Since most of our findings support pioneer work using invasive or non-continuous measures, the validity of our applied technologies is indirectly confirmed. Our outcomes allow direct comparison between different groups serving as reference data and framework for subsequent studies in sport science and medicine aiming to optimise diagnostics and interventions in athletes and patients.

Metabolic Power in Team and Racquet Sports: A Systematic Review with Best-Evidence Synthesis

Background

In intermittent team and racquet sports, metabolic loads are rarely investigated as they are difficult to examine, e.g., by portable metabolic carts and lactate measures. However, determining the instantaneous metabolic power of intermittent running from acceleration and speed data is possible. Recently, this potential has gained more interest in research and practice due to the development of player tracking technologies that allow easy access to the required data. The aim of this review was to systematically investigate the validity and point out the evidence of this new approach for estimating metabolic loads in intermittent sports. To provide an in-depth understanding of this approach and its validity, the fundamental aspects of the underlying concept were also considered.

Methods

PubMed®, Cochrane Library, Web of Science™, and BISp-surf databases were included in the search conducted on March 1, 2021. Studies assessing physiological and methodological validation as well as conceptual studies of the metabolic power approach in intermittent sports players without diseases or injuries were deemed eligible. The quality assessment was implemented using a modified 12-item version of the Downs and Black checklist. Additionally, a best-evidence synthesis of the validation studies was performed to clarify the direction and strength of the evidence.

Results

Of 947 studies that were identified, 31 met the eligibility criteria of which 7 were physiological, 13 methodological validation, and 11 conceptual studies. Gold standards for validating the metabolic power approach were predominantly oxygen uptake with 6 and traditional running speed analysis with 8 studies for physiological and methodological validation, respectively. The best-evidence synthesis showed conflicting to strong and moderate to strong evidence for physiological and methodological validity of the approach, respectively. The conceptual studies revealed several modifications regarding the approach that need to be considered. Otherwise, incorrect implementation can occur.

Conclusions

Evidence of the physiological validity of the metabolic power approach ranged from conflicting to strong. However, this should be treated with caution as the validation studies were often partially implemented incorrectly as shown by the underlying concept studies. Moreover, strong evidence indicated that the approach is valid from a methodological perspective. Future studies must consider what the metabolic power approach can and cannot actually display.

A lack of research exists in studies concerning children, females, and team and racquet sports besides soccer and the application of more profound physiological approaches for the validation and assessment of metabolic power estimated by acceleration and speed data is needed.

Previous physiological validation studies are outdated as there have been adaptations concerning the metabolic power approach for estimating metabolic loads over recent years, and methodological validation studies revealing its superiority over the traditional running speed approach.

Distinction between walking and running, different terrains, as well as aerobic and anaerobic energy supply should be considered when assessing metabolic power in team and racquet sports.

Risk factors and prevention strategies for shoulder injuries in overhead sports: an updated systematic review

PURPOSE

The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality.

METHODS

All methodological procedures were performed in line with a previous systematic review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies.

RESULTS

A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting).

CONCLUSIONS

There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports.

Non-invasively measured central and peripheral factors of oxygen uptake differ between patients with chronic heart failure and healthy controls

Background

Maximum oxygen uptake is an established measurement of diagnosing chronic heart failure and underlies various central and peripheral factors. However, central and peripheral factors are little investigated, because they are usually measured invasively. The aim of this study was to compare non-invasively measured central and peripheral factors of oxygen uptake between patients with chronic heart failure and healthy controls.

Methods

Ten male patients with heart failure with reduced ejection fraction (62 ± 4 years; body mass index: 27.7 ± 1.8 kg/m²; ejection fraction: 30 ± 4%) and ten male healthy controls (59 ± 3 years; body mass index: 27.7 ± 1.3 kg/m²) were tested for blood pressure, heart rate, stroke volume, cardiac output, and cardiac power output (central factors) as well as muscle oxygen saturation of the vastus lateralis and biceps brachii muscle (peripheral factors) during an incremental cycling test. Stroke volume and muscle oxygen saturation were non-invasively measured by a bioreactance analysis and near-infrared spectroscopy, respectively. Additionally, a maximum isometric strength test of the knee extensors was conducted. Magnitude-based inferences were computed for statistical analyses.

Results

Patients had a likely to most likely lower oxygen uptake, mean arterial pressure, and heart rate at maximum load as well as very likely lower isometric peak torque. Contrary, patients had a possibly to likely higher stroke volume and muscle oxygen saturation of the vastus lateralis muscle at maximum load. Differences in cardiac output, cardiac power output, and muscle oxygen saturation of the biceps brachii muscle at maximum load were unclear.

Conclusions

Non-invasively measured central and peripheral factors of oxygen uptake differ between patients with chronic heart failure and healthy controls. Therefore, it is promising to measure both types of factors in patients with chronic heart failure to optimize the diagnosis and therapy.