Asthma and high-intensity interval training have no effect on clustered cardiometabolic risk or arterial stiffness in adolescents

PURPOSE

Cardiometabolic risk, including arterial stiffness, is increasing in youth. Those with asthma are suggested to be particularly at risk of cardiovascular disease. Efficient and effective strategies are required to prevent the atherosclerotic process in youth. The purpose of this study was to investigate the effect of 6 months high-intensity interval training (HIIT) on cardiometabolic risk in youth with and without asthma.

METHODS

65 adolescents (31 mild asthma; 34 non-asthma) were recruited, 32 (16 asthma) of whom were randomly allocated to receive HIIT three times per week for 6 months. At baseline, mid-intervention, post-intervention and at a 3-month follow-up, anthropometric, metabolic and vascular determinants of cardiometabolic risk were assessed. Following principal component analysis (PCA), linear mixed models were used to assess the influence of asthma, HIIT and their interaction.

RESULTS

Seven factors were identified which explained 88% of the common variance shared among the parameters. Those with asthma demonstrated lower arterial stiffness factor scores mid-intervention (P = 0.047) and lower cholesterol factor scores post-intervention (P = 0.022) but there was no effect of the intervention, or interaction effects, on any PCA-identified factor, at any time-point. HIIT was associated with a lower low-density lipoprotein and diastolic blood pressure at mid-intervention.

DISCUSSION

Neither arterial stiffness nor clustered cardiometabolic risk are influenced by HIIT in adolescents with or without asthma, despite important changes in blood lipid and pressure profiles. Blood pressure, augmentation and pulse wave velocity should be considered physiologically distinct constructs and as potential markers of cardiovascular health.

Using photo-elicitation to explore perceptions of physical activity among young people with cystic fibrosis

BACKGROUND

Physical activity is recommended in the management of cystic fibrosis (CF). The aim of this study was to explore motives, barriers and enablers to physical activity among this population.

METHODS

Twelve participants (12-18 years) were recruited via convenience sampling. Photo-elicitation alongside semi-structured interviews were used to explore participants' views and experiences of physical activity.

RESULTS

Our findings revealed motives for physical activity including health, enjoyment and autonomy. Those with families who valued physical activity tended to have positive attitudes towards physical activity, and valued and integrated it into their lives. Moreover, they were likely to be intrinsically motivated to be active. Several factors enable and act as barriers to physical activity. Whilst CF influenced physical activity, the majority of enablers and barriers raised where congruent with the general populations.

CONCLUSION

This study provides support that healthcare providers should encourage both young people with CF and their families to be active, and subsequently informs the development of clinical interventions to support physical activity among young people with CF and their families.

Methodology and reliability of respiratory muscle assessment

The optimal method for respiratory muscle endurance (RME) assessment remains unclear. This study assessed the test-retest reliability of two RME-test methodologies. Fifteen healthy adults attended the laboratory on four occasions, separated by 5 ± 2 days, and completed each test in a random, "one on two" order. They performed spirometry testing, maximal respiratory pressure assessment and two different RME tests: an inspiratory resistive breathing (IRB) and an isocapnic hyperpnea endurance (IHE) test. Typical error, expressed as coefficient of variation, for IRB maximal inspiratory pressure (MIP) and IHE maximal ventilation were 12.21 (8.85-19.67) % and 10.73 (7.78-17.29) %, respectively. Intraclass correlation coefficients for the same parameters were 0.83 (0.46-0.94) and 0.80 (0.41-0.93), respectively. No correlations were found between RME parameters derived from the IHE and IRB tests (all p > 0.05). Significant positive correlations were found between both IRB and IHE outcomes and spirometry parameters, MIP and maximal expiratory pressure (p < 0.05). Given these results, IRB and IHE appear to be suitable for RME testing in healthy people, although they may reflect different physiological mechanisms (respiratory mechanics and respiratory muscle capacity for IHE test vs. inspiratory muscle capacity for IRB test). Future studies are therefore warranted that compare IRB and IHE tests in clinical settings.

The reliability of force-velocity-power profiling during over-ground sprinting in children and adolescents

Anaerobic performance in youth has received little attention partly due to the lack of a "gold-standard" measurement. However, force-velocity-power (F-v-P) profiling recently showed high reliability and validity in trained adults. Therefore, the aim was to determine the reliability of F-v-P profiling in children and adolescents. Seventy-five children (60 boys, 15 girls; age: 14.1 ± 2.6 years) completed three 30 m sprints. Velocity was measured at 46.875 Hz using a radar device. The F-v-P profile was fitted to a velocity-time curve allowing instantaneous power variables to be calculated. Reliability was assessed using the intra-class correlation coefficient (ICC), coefficient of variation (CV), standard error of measurement (SEM) and smallest worthwhile change (SWC). High reliability was evident for absolute peak (P_peak) and mean power (P_mean), P_peak and P_mean expressed relative to body mass, peak and mean velocity, 30 m sprint time, peak horizontal force (F₀), relative F₀, mechanical efficiency index and fatigue rate (ICC: 0.75-0.88; CV: 1.9-9.4%) with time to peak power demonstrating moderate reliability (ICC: 0.50; CV: 9.5%). The F-v-P model demonstrated at least moderate reliability for all variables. This therefore provides a potential alternative for paediatric researchers assessing sprint performance and the underlying kinetics.

The effect of constant-intensity endurance training and high-intensity interval training on aerobic and anaerobic parameters in youth

INTRODUCTION

High-Intensity Interval Training (HIIT) and Constant-Intensity Endurance Training (CIET) improves peak oxygen uptake (V̇O₂) similarly in adults; but in children this remains unclear, as does the influence of maturity.

METHODS

Thirty-seven boys formed three groups: HIIT (football; n = 14; 14.3 ± 3.1 years), CIET (distance runners; n = 12; 13.1 ± 2.5 years) and a control (CON) group (n = 11; 13.7 ± 3.2 years). Peak V̇O₂ and gas exchange threshold (GET) were determined from a ramp test and anaerobic performance using a 30 m sprint pre-and-post a three-month training cycle.

RESULTS

The HIIT groups peak V̇O₂ was significantly higher than the CON group pre (peak V̇O₂: 2.54 ± 0.63 l·min^-1 vs 2.03 ± 0.53 l·min^-1, d = 0.88; GET: 1.41 ± 0.26 l·min^-1 vs 1.13 ± 0.29 l·min^-1, d = 1.02) and post-training (peak V̇O₂: 2.63 ± 0.73 l·min^-1 vs 2.08 ± 0.64 l·min^-1, d = 0.80; GET: 1.32 ± 0.33 l·min^-1 vs 1.15 ± 0.38 l·min^-1, d = 0.48). All groups showed a similar magnitude of change during the training (p > 0.05).

CONCLUSION

HIIT was not superior to CIET for improving aerobic or anaerobic parameters in adolescents. Secondly, pre- and post-pubertal participants demonstrated similar trainability.

Effect of asthma and six-months high-intensity interval training on heart rate variability during exercise in adolescents

Little is known regarding the influence of asthma and exercise, and their interaction, on heart rate variability (HRV) in adolescents. Thirty-one adolescents with asthma (13.7±0.9 years; 21.9±3.9 kg·m^-2; 19 boys, 12 girls) and thirty-three healthy adolescents (13.8±0.9 years; 20.3±3.2 kg·m^-2; 16 boys, 17 girls) completed an incremental ramp test and three heavy-intensity constant-work-rate cycle tests. Thirteen adolescents (7 boys, 6 girls; 6 asthma, 7 control) completed six-months high-intensity interval training (HIIT) and were compared to age- and sex-matched controls. Standard time-domain, frequency-domain and non-linear indices of HRV were derived at baseline, three- and six-months. Asthma did not influence HRV at baseline or following HIIT. Total power, low frequency and normalised low frequency power, and sympathovagal balance increased at three-months in HIIT, subsequently declining towards baseline at six-months. Normalised high frequency power was reduced at three-months in both groups, which was sustained at six-months. No effects of HIIT were observed in the time-domain nor in the non-linear indices. HRV was not influenced by asthma, potentially because such derangements are a function of disease progression, severity or duration. HIIT may be associated with a short-term shift towards greater sympathetic predominance during exercise, perhaps caused by physiological overload and fatigue.

Promotion of physical activity for adolescents with cystic fibrosis: a qualitative study of UK multi disciplinary cystic fibrosis teams

BACKGROUND

The Cystic Fibrosis Trust recently published a standards of care document which stated that patients should be given a physical activity (PA) programme based on their motivations, fitness, and willingness to be active. However, there remains much debate regarding the roles and responsibilities for PA promotion, as well as "optimal" recommendations and advice. This study aimed to qualitatively explore cystic fibrosis (CF) multidisciplinary teams (MDTs) advice, recommendations and practices relating to PA promotion for adolescents with CF.

METHOD

Semi-structured interviews were conducted with fifteen members of CF MDTs (11 physiotherapists, two dieticians and two paediatricians). Thematic analysis was used to analyse the data.

RESULTS

Major themes identified were: (1) structure of MDTs, (2) recommendations relating to intensities, durations and types of PA, and (3) use of exercise testing. Participants reported variation between MDTs in terms of who is responsible for promoting and supporting PA, the nature of advice given to patients, and the use of exercise testing. Participants consistently lacked confidence in their own or others' knowledge to provide standardised recommendations to patients and highlighted that PA promotion and support was often overlooked during busy periods.

CONCLUSIONS

Despite its importance, PA support and promotion is not always prioritised. MDTs lack confidence in their ability to promote PA. Standardised advice and training relating to optimal intensities, durations and types of PA would provide a baseline from which to individualise advice to each patient and could increase confidence in PA promotion among MDTs.

Investigating the relationship between energy expenditure, walking speed and angle of turning in humans

Recent studies have suggested that changing direction is associated with significant additional energy expenditure. A failure to account for this additional energy expenditure of turning has significant implications in the design and interpretation of health interventions. The purpose of this study was therefore to investigate the influence of walking speed and angle, and their interaction, on energy expenditure in 20 healthy adults (7 female; 28±7 yrs). On two separate days, participants completed a turning protocol at one of 16 speed- (2.5, 3.5, 4.5, 5.5 km∙h^-1) and angle (0, 45, 90, 180°) combinations, involving three minute bouts of walking, interspersed by three minutes seated rest. Each condition involved 5 m of straight walking before turning through the pre-determined angle with the speed dictated by a digital, auditory metronome. Tri-axial accelerometry and magnetometry were measured at 60 Hz, in addition to gas exchange on a breath-by-breath basis. Mixed models revealed a significant main effect for speed (F = 121.609, P < 0.001) and angle (F = 19.186, P < 0.001) on oxygen uptake (V˙O2) and a significant interaction between these parameters (F = 4.433, P < 0.001). Specifically, as speed increased, V˙O2 increased but significant increases in V˙O2 relative to straight line walking were only observed for 90° and 180° turns at the two highest speeds (4.5 and 5.5 km∙hr^-1). These findings therefore highlight the importance of accounting for the quantity and magnitude of turns completed when estimating energy expenditure and have significant implications within both sport and health contexts.

Longitudinal investigation of training status and cardiopulmonary responses in pre- and early-pubertal children

PURPOSE

The presence of a maturational threshold that modulates children's physiological responses to exercise training continues to be debated, not least due to a lack of longitudinal evidence to address this question. The purpose of this study was to investigate the interaction between swim-training status and maturity in nineteen trained (T, 10 ± 1 years, -2.4 ± 1.9 years pre-peak height velocity, 8 boys) and fifteen untrained (UT, 10 ± 1 years, -2.3 ± 0.9 years pre-peak height velocity, 5 boys) children, at three annual measurements.

METHODS

In addition to pulmonary gas exchange measurements, stroke volume (SV) and cardiac output ([Formula: see text]) were estimated by thoracic bioelectrical impedance during incremental ramp exercise.

RESULTS

At baseline and both subsequent measurement points, trained children had significantly (P < 0.05) higher peak oxygen uptake (year 1 T 1.75 ± 0.34 vs. UT 1.49 ± 0.22; year 2 T 2.01 ± 0.31 vs. UT 1.65 ± 0.08; year 3 T 2.07 ± 0.30 vs. UT 1.77 ± 0.16 l min(-1)) and [Formula: see text] (year 1 T 15.0 ± 2.9 vs. UT 13.2 ± 2.2; year 2 T 16.1 ± 2.8 vs. UT 13.8 ± 2.9; year 3 T 19.3 ± 4.4 vs. UT 16.0 ± 2.7 l min(-1)). Furthermore, the SV response pattern differed significantly with training status, demonstrating the conventional plateau in UT but a progressive increase in T. Multilevel modelling revealed that none of the measured pulmonary or cardiovascular parameters interacted with maturational status, and the magnitude of the difference between T and UT was similar, irrespective of maturational status.

CONCLUSION

The results of this novel longitudinal study challenge the notion that differences in training status in young people are only evident once a maturational threshold has been exceeded.