Active mobility and mental health: A scoping review towards a healthier world

Research has proven that engaging in active mobility (AM), namely walking and cycling for transportation, significantly enhances physical activity levels, leading to better physical health. It is still unclear whether AM could also offer any mental health benefits. This scoping review aims to provide a comprehensive understanding of the current knowledge on the relationship between AM and mental health, given its crucial role in public health. The authors searched online databases to isolate primary studies written in English involving an adult sample (16 or over). AM was the exposure factor. Many mental health elements were included as outcomes (depression, anxiety, self-esteem, self-efficacy, stress, psychological and subjective well-being, resilience, loneliness and social support, quality of life, mood, life satisfaction and sleep). The results were organised in a narrative summary per each outcome selected, graphical syntheses and an overview of gaps to be further examined. The authors identified a total of 55 papers as relevant. The results show inconsistency in study designs, definition and operationalisation of the variables, approach and methodologies used. A cross-sectional design was the dominant choice, primarily examining data from national public health surveys. Nonetheless, there has been improvement in outcomes of interests, initially mainly the quality of life and affect. Lately, authors have focused on a broader range of mental health-related factors (such as travel satisfaction). The experimental studies showed promising mental health improvements in those who used active modes more than those who used motorised vehicles. It creates a rationale for further research towards implementing a unified theoretical and methodological framework to study the link between AM and mental health. The ultimate goal is to generate solid conclusions that could support building societies and cities through public health promotion and sustainable strategies, like walking and cycling as a means of transport.

Pharmacological Blockade of Muscle Afferents and Perception of Effort: A Systematic Review with Meta-analysis

BACKGROUND

The perception of effort provides information on task difficulty and influences physical exercise regulation and human behavior. This perception differs from other-exercise related perceptions such as pain. There is no consensus on the role of group III/IV muscle afferents as a signal processed by the brain to generate the perception of effort.

OBJECTIVE

The aim of this meta-analysis was to investigate the effect of pharmacologically blocking muscle afferents on the perception of effort.

METHODS

Six databases were searched to identify studies measuring the ratings of perceived effort during physical exercise, with and without pharmacological blockade of muscle afferents. Articles were coded based on the operational measurement used to distinguish studies in which perception of effort was assessed specifically (effort dissociated) or as a composite experience including other exercise-related perceptions (effort not dissociated). Articles that did not provide enough information for coding were assigned to the unclear group.

RESULTS

The effort dissociated group (n = 6) demonstrated a slight increase in ratings of perceived effort with reduced muscle afferent feedback (standard mean change raw, 0.39; 95% confidence interval 0.13-0.64). The group effort not dissociated (n = 2) did not reveal conclusive results (standard mean change raw, - 0.29; 95% confidence interval - 2.39 to 1.8). The group unclear (n = 8) revealed a slight ratings of perceived effort decrease with reduced muscle afferent feedback (standard mean change raw, - 0.27; 95% confidence interval - 0.50 to - 0.04).

CONCLUSIONS

The heterogeneity in results between groups reveals that the inclusion of perceptions other than effort in its rating influences the ratings of perceived effort reported by the participants. The absence of decreased ratings of perceived effort in the effort dissociated group suggests that muscle afferent feedback is not a sensory signal for the perception of effort.

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study

Introduction

The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure.

Methods

International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance.

Results

Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting.

Discussion

Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.

Development of a Revised Conceptual Framework of Physical Training for Use in Research and Practice

A conceptual framework has a central role in the scientific process. Its purpose is to synthesize evidence, assist in understanding phenomena, inform future research and act as a reference operational guide in practical settings. We propose an updated conceptual framework intended to facilitate the validation and interpretation of physical training measures. This revised conceptual framework was constructed through a process of qualitative analysis involving a synthesis of the literature, analysis and integration with existing frameworks (Banister and PerPot models). We identified, expanded, and integrated four constructs that are important in the conceptualization of the process and outcomes of physical training. These are: (1) formal introduction of a new measurable component 'training effects', a higher-order construct resulting from the combined effect of four possible responses (acute and chronic, positive and negative); (2) explanation, clarification and examples of training effect measures such as performance, physiological, subjective and other measures (cognitive, biomechanical, etc.); (3) integration of the sport performance outcome continuum (from performance improvements to overtraining); (4) extension and definition of the network of linkages (uni and bidirectional) between individual and contextual factors and other constructs. Additionally, we provided constitutive and operational definitions, and examples of theoretical and practical applications of the framework. These include validation and conceptualization of constructs (e.g., performance readiness), and understanding of higher-order constructs, such as training tolerance, when monitoring training to adapt it to individual responses and effects. This proposed conceptual framework provides an overarching model that may help understand and guide the development, validation, implementation and interpretation of measures used for athlete monitoring.

The Effect of a Competitive Futsal Match on Psychomotor Vigilance in Referees

CONTEXT

Referees' physical and cognitive performance are important for successful officiating in team sports. There is a lack of research on cognitive performance of referees in general, and none in futsal.

PURPOSE

To assess referees' performance on the psychomotor vigilance task (PVT) before and after competitive futsal matches during the Football Association (FA) National Futsal League 2015/16.

METHODS

Fourteen futsal referees (mean [SD] age 34.3 [10.0] y) from the FA National Futsal group were included. The referees were required to undertake a 10-min PVT 60 min before the match kickoff time (pretest) and immediately after matches (posttest). They also completed the Brunel Mood Scale (BRUMS) questionnaire before the prematch PVT and after the postmatch PVT.

RESULT

Data were analyzed by paired t tests comparing prematch and postmatch results. There was a significant difference in BRUMS parameters vigor (9.5 [2.5] prematch vs 6.3 [2.4] postmatch, P = .001) and fatigue (1.4 [1.3] prematch vs 5.6 [3.1] postmatch, P < .001). However, PVT performance was significantly improved (mean reaction time 248.3 [26.2] ms prematch vs 239.7 [22.4] ms postmatch, P = .023).

CONCLUSIONS

The present results show, contrary to the authors' initial hypothesis, that psychomotor performance is improved as opposed to decreased after a single match. The postmatch improvement suggests that exercise can acutely enhance cognitive performance, which could be used to inform warm-up practices (eg, optimal duration and intensity) geared toward optimizing referees' cognitive performance during matches.

Transcranial Direct Current Stimulation over the Left Dorsolateral Prefrontal Cortex Improves Inhibitory Control and Endurance Performance in Healthy Individuals

The dorsolateral prefrontal cortex (DLPFC) is a crucial brain region for inhibitory control, an executive function essential for behavioral self-regulation. Recently, inhibitory control has been shown to be important for endurance performance. Improvement in inhibitory control was found following transcranial direct current stimulation (tDCS) applied over the left DLPFC (L-DLPFC). This study examined the effect tDCS on both an inhibitory control and endurance performance in a group of healthy individuals. Twelve participants received either real tDCS (Real-tDCS) or placebo tDCS (Sham-tDCS) in randomized order. The anodal electrode was placed over the L-DLPFC while the cathodal electrode was placed above Fp2. Stimulation lasted 30min with current intensity set at 2mA. A Stroop test was administered to assess inhibitory control. Heart rate (HR), ratings of perceived exertion (RPE), and leg muscle pain (PAIN) were monitored during the cycling time to exhaustion (TTE) test, while blood lactate accumulation (∆B[La^-]) was measured at exhaustion. Stroop task performance was improved after Real-tDCS as demonstrated by a lower number of errors for incongruent stimuli (p=0.012). TTE was significantly longer following Real-tDCS compared to Sham-tDCS (p=0.029, 17±8 vs 15±8min), with significantly lower HR (p=0.002) and RPE (p<0.001), while no significant difference was found for PAIN (p>0.224). ∆B[La^-] was significantly higher at exhaustion in Real-tDCS (p=0.040). Our findings provide preliminary evidence that tDCS with the anodal electrode over the L-DLPFC can improve both inhibitory control and endurance cycling performance in healthy individuals.

Comparing the Effects of Three Cognitive Tasks on Indicators of Mental Fatigue

This investigation assessed the impact of three cognitively demanding tasks on cognitive performance, subjective, and physiological indicators of mental fatigue. Following familiarization, participants completed four testing sessions, separated by 48 h. During each session, participants watched a 45-min emotionally neutral documentary (control) or completed one of the following computer tasks: Psychomotor Vigilance Task (PVT); AX-Continuous Performance Test (AX-CPT); or Stroop Task. Mental fatigue was assessed before and at regular periods for 60 min following the 45-min treatments. Cognitive performance was assessed using 3-min PVT, and task performance. Subjective assessments were conducted using the Brunel Mood Scale, and visual analog scales (VAS). Physiological indicators of mental fatigue included electroencephalography (EEG), and heart rate variability (HRV). Subjective ratings of mental fatigue increased from pre to 0-min post in all-treatments, but not the documentary (p < 0.05). Subjective fatigue (VAS) remained higher (p < 0.05) than pretreatment values for 20-, 50-, and 60-min following the PVT, Stroop, and AX-CPT respectively. The cognitively demanding tasks had unclear effects on 3-min PVT, EEG, and HRV assessments. Tasks requiring response inhibition appear to induce fatigue for longer durations than a simple vigilance task. Simple VAS appear to be the most practical method for assessing mental fatigue.

The Effect of Anodal Transcranial Direct Current Stimulation Over Left and Right Temporal Cortex on the Cardiovascular Response: A Comparative Study

Background: Stimulation of the right and left anterior insular cortex, increases and decreases the cardiovascular response respectively, thus indicating the brain’s lateralization of the neural control of circulation. Previous experiments have demonstrated that transcranial direct current stimulation (tDCS) modulates the autonomic cardiovascular control when applied over the temporal cortex. Given the importance of neural control for a normal hemodynamic response, and the potential for the use of tDCS in the treatment of cardiovascular diseases, this study investigated whether tDCS was capable of modulating autonomic regulation.

Methods: Cardiovascular response was monitored during a post-exercise muscle ischemia (PEMI) test, which is well-documented to increase sympathetic drive. A group of 12 healthy participants performed a PEMI test in a control (Control), sham (Sham) and two different experimental sessions where the anodal electrode was applied over the left temporal cortex and right temporal cortex with the cathodal electrode placed over the contralateral supraorbital area. Stimulation lasted 20 min at 2 mA. The hemodynamic profile was measured during a PEMI test. The cardiovascular parameters were continuously measured with a transthoracic bio-impedance device both during the PEMI test and during tDCS.

Results: None of the subjects presented any side effects during or after tDCS stimulation. A consistent cardiovascular response during PEMI test was observed in all conditions. Statistical analysis did not find any significant interaction and any significant main effect of condition on cardiovascular parameters (all ps > 0.316) after tDCS. No statistical differences regarding the hemodynamic responses were found between conditions and time during tDCS stimulation (p > 0.05).

Discussion: This is the first study comparing the cardiovascular response after tDCS stimulation of left and right TC both during exercise and at rest. The results of the current study suggest that anodal tDCS of the left and right TC does not affect functional cardiovascular response during exercise PEMI test and during tDCS. In light of the present and previous findings, the effect of tDCS on the cardiovascular response remains inconclusive.

Effects of caffeine on reaction time are mediated by attentional rather than motor processes

BACKGROUND

Caffeine has a well-established effect on reaction times (RTs) but the neurocognitive mechanisms underlying this are unclear.

METHODS

In the present study, 15 female participants performed an oddball task after ingesting caffeine or a placebo, and electroencephalographic data were obtained. Single-trial P3b latencies locked to the stimulus and to the response were extracted and mediation models were fitted to the data to test whether caffeine's effect on RTs was mediated by its effect on either type of P3b latencies.

RESULTS

Stimulus-locked latencies showed clear evidence of mediation, with approximately a third of the effect of caffeine on RTs running through the processes measured by stimulus-locked latencies. Caffeine did not affect response-locked latencies, so could not mediate the effect.

DISCUSSION

These findings are consistent with caffeine's effect on RTs being a result of its effect on perceptual-attentional processes, rather than motor processes. The study is the first to apply mediation analysis to single-trial P3b data and this technique holds promise for mental chronometric studies into the effects of psychopharmacological agents. The R code for performing the single trial analysis and mediation analysis are included as supplementary materials.

The effect of mental fatigue on critical power during cycling exercise

PURPOSE

Time to exhaustion (TTE) tests used in the determination of critical power (CP) and curvature constant (W') of the power-duration relationship are strongly influenced by the perception of effort (PE). This study aimed to investigate whether manipulation of the PE alters the CP and W'.

METHODS

Eleven trained cyclists completed a series of TTE tests to establish CP and W' under two conditions, following a mentally fatiguing (MF), or a control (CON) task. Both cognitive tasks lasted 30 min followed by a TTE test. Ratings of PE and heart rate (HR) were measured during each TTE. Blood lactate was taken pre and post each TTE test. Ratings of perceived mental and physical fatigue were taken pre- and post-cognitive task, and following each TTE test.

RESULTS

Perceived MF significantly increased as a result of the MF task compared to baseline and the CON task (P < 0.05), without a change in perceived physical fatigue (P > 0.05). PE was significantly higher during TTE in the MF condition (P < 0.05). Pre-post blood lactate accumulation was significantly lower after each TTE in MF condition (P < 0.05). HR was not significant different between conditions (P > 0.05). Neither cognitive task induced any change in CP (MF 253 ± 51 vs. CON 247 ± 58W; P > 0.05), although W' was significantly reduced in the MF condition (MF 22.8 ± 4.5 vs. CON 29.3 ± 6.3 kJ; P < 0.01).

CONCLUSION

MF has no effect of CP, but reduces the W' in trained cyclists. Lower lactate accumulation during TTE tests following MF suggests that cyclists were not able to fully expend W' even though they exercised to volitional exhaustion.

Bilateral extracephalic transcranial direct current stimulation improves endurance performance in healthy individuals

BACKGROUND

Transcranial direct current stimulation (tDCS) has been used to enhance endurance performance but its precise mechanisms and effects remain unknown.

OBJECTIVE

To investigate the effect of bilateral tDCS on neuromuscular function and performance during a cycling time to task failure (TTF) test.

METHODS

Twelve participants in randomized order received a placebo tDCS (SHAM) or real tDCS with two cathodes (CATHODAL) or two anodes (ANODAL) over bilateral motor cortices and the opposite electrode pair over the ipsilateral shoulders. Each session lasted 10 min and current was set at 2 mA. Neuromuscular assessment was performed before and after tDCS and was followed by a cycling time to task failure (TTF) test. Heart rate (HR), ratings of perceived exertion (RPE), leg muscle pain (PAIN) and blood lactate accumulation (ΔB[La^-]) in response to the cycling TTF test were measured.

RESULTS

Corticospinal excitability increased in the ANODAL condition (P < 0.001) while none of the other neuromuscular parameters showed any change. Neuromuscular parameters did not change in the SHAM and CATHODAL conditions. TTF was significantly longer in the ANODAL (P = 0.003) compared to CATHODAL and SHAM conditions (12.61 ± 4.65 min; 10.61 ± 4.34 min; 10.21 ± 3.47 min respectively), with significantly lower RPE and higher ΔB[La^-] (P < 0.001). No differences between conditions were found for HR (P = 0.803) and PAIN during the cycling TTF test (P = 0.305).

CONCLUSION

Our findings demonstrate that tDCS with the anode over both motor cortices using a bilateral extracephalic reference improves endurance performance.

Differential control of respiratory frequency and tidal volume during high-intensity interval training

NEW FINDINGS

What is the central question of this study? By manipulating recovery intensity and exercise duration during high-intensity interval training (HIIT), we tested the hypothesis that fast inputs contribute more than metabolic stimuli to respiratory frequency (f_R ) regulation. What is the main finding and its importance? Respiratory frequency, but not tidal volume, responded rapidly and in proportion to changes in workload during HIIT, and was dissociated from some markers of metabolic stimuli in response to both experimental manipulations, suggesting that fast inputs contribute more than metabolic stimuli to f_R regulation. Differentiating between f_R and tidal volume may help to unravel the mechanisms underlying exercise hyperpnoea. Given that respiratory frequency (f_R ) has been proposed as a good marker of physical effort, furthering the understanding of how f_R is regulated during exercise is of great importance. We manipulated recovery intensity and exercise duration during high-intensity interval training (HIIT) to test the hypothesis that fast inputs (including central command) contribute more than metabolic stimuli to f_R regulation. Seven male cyclists performed an incremental test, a 10 and a 20 min continuous time trial (TT) as preliminary tests. Subsequently, recovery intensity and exercise duration were manipulated during HIIT (30 s work and 30 s active recovery) by performing four 10 min and one 20 min trial (recovery intensities of 85, 70, 55 and 30% of the 10 min TT mean workload; and 85% of the 20 min TT mean workload). The work intensity of the HIIT sessions was self-paced by participants to achieve the best performance possible. When manipulating recovery intensity, f_R , but not tidal volume (V_T ), showed a fast response to the alternation of the work and recovery phases, proportional to the extent of workload variations. No association between f_R and gas exchange responses was observed. When manipulating exercise duration, f_R and rating of perceived exertion were dissociated from V_T , carbon dioxide output and oxygen uptake responses. Overall, the rating of perceived exertion was strongly correlated with f_R (r = 0.87; P < 0.001) but not with V_T . These findings may reveal a differential control of f_R and V_T during HIIT, with fast inputs appearing to contribute more than metabolic stimuli to f_R regulation. Differentiating between f_R and V_T may help to unravel the mechanisms underlying exercise hyperpnoea.

Effect of a Mediterranean Type Diet on Inflammatory and Cartilage Degradation Biomarkers in Patients with Osteoarthritis

OBJECTIVES

To investigate the effects of a Mediterranean type diet on patients with osteoarthritis (OA).

PARTICIPANTS

Ninety-nine volunteers with OA (aged 31 - 90 years) completed the study (83% female).

SETTING

Southeast of England, UK.

DESIGN

Participants were randomly allocated to the dietary intervention (DIET, n = 50) or control (CON, n = 49). The DIET group were asked to follow a Mediterranean type diet for 16 weeks whereas the CON group were asked to follow their normal diet.

MEASUREMENTS

All participants completed an Arthritis Impact Measurement Scale (AIMS2) pre-, mid- and post- study period. A subset of participants attended a clinic at the start and end of the study for assessment of joint range of motion, ROM (DIET = 33, CON = 28), and to provide blood samples (DIET = 29, CON = 25) for biomarker analysis (including serum cartilage oligomeric matrix protein (sCOMP) (a marker of cartilage degradation) and a panel of other relevant biomarkers including pro- and anti-inflammatory cytokines).

RESULTS

There were no differences between groups in the response of any AIMS2 components and most biomarkers (p > 0.05), except the pro-inflammatory cytokine IL-1α, which decreased in the DIET group (~47%, p = 0.010). sCOMP decreased in the DIET group by 1 U/L (~8%, p = 0.014). There was a significant improvement in knee flexion and hip rotation ROM in the DIET group (p < 0.05).

CONCLUSIONS

The average reduction in sCOMP in the DIET group (1 U/L) represents a meaningful change, but the longer term effects require further study.

Effects of caffeine on neuromuscular fatigue and performance during high-intensity cycling exercise in moderate hypoxia

Purpose

To investigate the effects of caffeine on performance, neuromuscular fatigue and perception of effort during high-intensity cycling exercise in moderate hypoxia.

Methods

Seven adult male participants firstly underwent an incremental exercise test on a cycle ergometer in conditions of acute normobaric hypoxia (fraction inspired oxygen = 0.15) to establish peak power output (PPO). In the following two visits, they performed a time to exhaustion test (78 ± 3% PPO) in the same hypoxic conditions after caffeine ingestion (4 mg kg⁻¹) and one after placebo ingestion in a double-blind, randomized, counterbalanced cross-over design.

Results

Caffeine significantly improved time to exhaustion by 12%. A significant decrease in subjective fatigue was found after caffeine consumption. Perception of effort and surface electromyographic signal amplitude of the vastus lateralis were lower and heart rate was higher in the caffeine condition when compared to placebo. However, caffeine did not reduce the peripheral and central fatigue induced by high-intensity cycling exercise in moderate hypoxia.

Conclusion

The caffeine-induced improvement in time to exhaustion during high-intensity cycling exercise in moderate hypoxia seems to be mediated by a reduction in perception of effort, which occurs despite no reduction in neuromuscular fatigue.

Locomotor Muscle Fatigue Does Not Alter Oxygen Uptake Kinetics during High-Intensity Exercise

The V˙O2 slow component (V˙O2sc) that develops during high-intensity aerobic exercise is thought to be strongly associated with locomotor muscle fatigue. We sought to experimentally test this hypothesis by pre-fatiguing the locomotor muscles used during subsequent high-intensity cycling exercise. Over two separate visits, eight healthy male participants were asked to either perform a non-metabolically stressful 100 intermittent drop-jumps protocol (pre-fatigue condition) or rest for 33 min (control condition) according to a random and counterbalanced order. Locomotor muscle fatigue was quantified with 6-s maximal sprints at a fixed pedaling cadence of 90 rev·min⁻¹. Oxygen kinetics and other responses (heart rate, capillary blood lactate concentration and rating of perceived exertion, RPE) were measured during two subsequent bouts of 6 min cycling exercise at 50% of the delta between the lactate threshold and V˙O2max determined during a preliminary incremental exercise test. All tests were performed on the same cycle ergometer. Despite significant locomotor muscle fatigue (P = 0.03), the V˙O2sc was not significantly different between the pre-fatigue (464 ± 301 mL·min⁻¹) and the control (556 ± 223 mL·min⁻¹) condition (P = 0.50). Blood lactate response was not significantly different between conditions (P = 0.48) but RPE was significantly higher following the pre-fatiguing exercise protocol compared with the control condition (P < 0.01) suggesting higher muscle recruitment. These results demonstrate experimentally that locomotor muscle fatigue does not significantly alter the V˙O2 kinetic response to high intensity aerobic exercise, and challenge the hypothesis that the V˙O2sc is strongly associated with locomotor muscle fatigue.

Transcranial direct current stimulation improves isometric time to exhaustion of the knee extensors

Transcranial direct current stimulation (tDCS) can increase cortical excitability of a targeted brain area, which may affect endurance exercise performance. However, optimal electrode placement for tDCS remains unclear. We tested the effect of two different tDCS electrode montages for improving exercise performance. Nine subjects underwent a control (CON), placebo (SHAM) and two different tDCS montage sessions in a randomized design. In one tDCS session, the anodal electrode was placed over the left motor cortex and the cathodal on contralateral forehead (HEAD), while for the other montage the anodal electrode was placed over the left motor cortex and cathodal electrode above the shoulder (SHOULDER). tDCS was delivered for 10min at 2.0mA, after which participants performed an isometric time to exhaustion (TTE) test of the right knee extensors. Peripheral and central neuromuscular parameters were assessed at baseline, after tDCS application and after TTE. Heart rate (HR), ratings of perceived exertion (RPE), and leg muscle exercise-induced muscle pain (PAIN) were monitored during the TTE. TTE was longer and RPE lower in the SHOULDER condition (P<0.05). Central and peripheral parameters, and HR and PAIN did not present any differences between conditions after tDCS stimulation (P>0.05). In all conditions maximal voluntary contraction (MVC) significantly decreased after the TTE (P<0.05) while motor-evoked potential area (MEP) increased after TTE (P<0.05). These findings demonstrate that SHOULDER montage is more effective than HEAD montage to improve endurance performance, likely through avoiding the negative effects of the cathode on excitability.

Mental Fatigue Impairs Soccer-Specific Physical and Technical Performance

PURPOSE

To investigate the effects of mental fatigue on soccer-specific physical and technical performance.

METHODS

This investigation consisted of two separate studies. Study 1 assessed the soccer-specific physical performance of 12 moderately trained soccer players using the Yo-Yo Intermittent Recovery Test, Level 1 (Yo-Yo IR1). Study 2 assessed the soccer-specific technical performance of 14 experienced soccer players using the Loughborough Soccer Passing and Shooting Tests (LSPT, LSST). Each test was performed on two occasions and preceded, in a randomized, counterbalanced order, by 30 min of the Stroop task (mentally fatiguing treatment) or 30 min of reading magazines (control treatment). Subjective ratings of mental fatigue were measured before and after treatment, and mental effort and motivation were measured after treatment. Distance run, heart rate, and ratings of perceived exertion were recorded during the Yo-Yo IR1. LSPT performance time was calculated as original time plus penalty time. LSST performance was assessed using shot speed, shot accuracy, and shot sequence time.

RESULTS

Subjective ratings of mental fatigue and effort were higher after the Stroop task in both studies (P < 0.001), whereas motivation was similar between conditions. This mental fatigue significantly reduced running distance in the Yo-Yo IR1 (P < 0.001). No difference in heart rate existed between conditions, whereas ratings of perceived exertion were significantly higher at iso-time in the mental fatigue condition (P < 0.01). LSPT original time and performance time were not different between conditions; however, penalty time significantly increased in the mental fatigue condition (P = 0.015). Mental fatigue also impaired shot speed (P = 0.024) and accuracy (P < 0.01), whereas shot sequence time was similar between conditions.

CONCLUSIONS

Mental fatigue impairs soccer-specific running, passing, and shooting performance.

Reliability of a Novel High Intensity One Leg Dynamic Exercise Protocol to Measure Muscle Endurance

We recently developed a high intensity one leg dynamic exercise (OLDE) protocol to measure muscle endurance and investigate the central and peripheral mechanisms of muscle fatigue. The aims of the present study were to establish the reliability of this novel protocol and describe the isokinetic muscle fatigue induced by high intensity OLDE and its recovery. Eight subjects performed the OLDE protocol (time to exhaustion test of the right leg at 85% of peak power output) three times over a week period. Isokinetic maximal voluntary contraction torque at 60 (MVC60), 100 (MVC100) and 140 (MVC140) deg/s was measured pre-exercise, shortly after exhaustion (13 ± 4 s), 20 s (P20) and 40 s (P40) post-exercise. Electromyographic (EMG) signal was analyzed via the root mean square (RMS) for all three superficial knee extensors. Mean time to exhaustion was 5.96 ± 1.40 min, coefficient of variation was 8.42 ± 6.24%, typical error of measurement was 0.30 min and intraclass correlation was 0.795. MVC torque decreased shortly after exhaustion for all angular velocities (all P < 0.001). MVC60 and MVC100 recovered between P20 (P < 0.05) and exhaustion and then plateaued. MVC140 recovered only at P40 (P < 0.05). High intensity OLDE did not alter maximal EMG RMS of the three superficial knee extensors during MVC. The results of this study demonstrate that this novel high intensity OLDE protocol could be reliably used to measure muscle endurance, and that muscle fatigue induced by high intensity OLDE should be examined within ~ 30 s following exhaustion.

The Central Governor Model of Exercise Regulation Teaches Us Precious Little about the Nature of Mental Fatigue and Self-Control Failure

Self-control is considered broadly important for many domains of life. One of its unfortunate features, however, is that it tends to wane over time, with little agreement about why this is the case. Recently, there has been a push to address this problem by looking to the literature in exercise physiology, specifically the work on the central governor model of physical fatigue. Trying to explain how and why mental performance wanes over time, the central governor model suggests that exertion is throttled by some central nervous system mechanism that receives information about energetic bodily needs and motivational drives to regulate exertion and, ultimately, to prevent homeostatic breakdown, chiefly energy depletion. While we admire the spirit of integration and the attempt to shed light on an important topic in psychology, our concern is that the central governor model is very controversial in exercise physiology, with increasing calls to abandon it altogether, making it a poor fit for psychology. Our concerns are threefold. First, while we agree that preservation of bodily homeostasis makes for an elegant ultimate account, the fact that such important homeostatic concerns can be regularly overturned with even slight incentives (e.g., a smile) renders the ultimate account impotent and points to other ultimate functions for fatigue. Second, despite the central governor being thought to take as input information about the metabolic needs of the body, there is no credible evidence that mental effort actually consumes inordinate amounts of energy that are not already circulating in the brain. Third, recent modifications of the model make the central governor appear like an all-knowing homunculus and unfalsifiable in principle, thus contributing very little to our understanding of why people tend to disengage from effortful tasks over time. We note that the latest models in exercise physiology have actually borrowed concepts and models from psychology to understand physical performance.

The effect of transcranial direct current stimulation of the motor cortex on exercise-induced pain

PURPOSE

Transcranial direct current stimulation (tDCS) provides a new exciting means to investigate the role of the brain during exercise. However, this technique is not widely used in exercise science, with little known regarding effective electrode montages. This study investigated whether tDCS of the motor cortex (M1) would elicit an analgesic response to exercise-induced pain (EIP).

METHODS

Nine participants completed a VO2max test and three time to exhaustion (TTE) tasks on separate days following either 10 min 2 mA tDCS of the M1, a sham or a control. Additionally, seven participants completed 3 cold pressor tests (CPT) following the same experimental conditions (tDCS, SHAM, CON). Using a well-established tDCS protocol, tDCS was delivered by placing the anodal electrode above the left M1 with the cathodal electrode above dorsolateral right prefrontal cortex. Gas exchange, blood lactate, EIP and ratings of perceived exertion (RPE) were monitored during the TTE test. Perceived pain was recorded during the CPT.

RESULTS

During the TTE, no significant differences in time to exhaustion, RPE or EIP were found between conditions. However, during the CPT, perceived pain was significantly (P < 0.05) reduced in the tDCS condition (7.4 ± 1.2) compared with both the CON (8.6 ± 1.0) and SHAM (8.4 ± 1.3) conditions.

CONCLUSION

These findings demonstrate that stimulation of the M1 using tDCS does not induce analgesia during exercise, suggesting that the processing of pain produced via classic measures of experimental pain (i.e., a CPT) is different to that of EIP. These results provide important methodological advancement in developing the use of tDCS in exercise.

Central alterations of neuromuscular function and feedback from group III-IV muscle afferents following exhaustive high-intensity one-leg dynamic exercise

The aims of this investigation were to describe the central alterations of neuromuscular function induced by exhaustive high-intensity one-leg dynamic exercise (OLDE, study 1) and to indirectly quantify feedback from group III-IV muscle afferents via muscle occlusion (MO, study 2) in healthy adult male humans. We hypothesized that these central alterations and their recovery are associated with changes in afferent feedback. Both studies consisted of two time-to-exhaustion tests at 85% peak power output. In study 1, voluntary activation level (VAL), M-wave, cervicomedullary motor evoked potential (CMEP), motor evoked potential (MEP), and MEP cortical silent period (CSP) of the knee extensor muscles were measured. In study 2, mean arterial pressure (MAP) and leg muscle pain were measured during MO. Measurements were performed preexercise, at exhaustion, and after 3 min recovery. Compared with preexercise values, VAL was lower at exhaustion (-13 ± 13%, P < 0.05) and after 3 min of recovery (-6 ± 6%, P = 0.05). CMEP area/M area was lower at exhaustion (-38 ± 13%, P < 0.01) and recovered after 3 min. MEP area/M area was higher at exhaustion (+25 ± 27%, P < 0.01) and after 3 min of recovery (+17 ± 20%, P < 0.01). CSP was higher (+19 ± 9%, P < 0.01) only at exhaustion and recovered after 3 min. Markers of afferent feedback (MAP and leg muscle pain during MO) were significantly higher only at exhaustion. These findings suggest that the alterations in spinal excitability and CSP induced by high-intensity OLDE are associated with an increase in afferent feedback at exhaustion, whereas central fatigue does not fully recover even when significant afferent feedback is no longer present.

Mental fatigue induced by prolonged self-regulation does not exacerbate central fatigue during subsequent whole-body endurance exercise

It has been shown that the mental fatigue induced by prolonged self-regulation increases perception of effort and reduces performance during subsequent endurance exercise. However, the physiological mechanisms underlying these negative effects of mental fatigue are unclear. The primary aim of this study was to test the hypothesis that mental fatigue exacerbates central fatigue induced by whole-body endurance exercise. Twelve subjects performed 30 min of either an incongruent Stroop task to induce a condition of mental fatigue or a congruent Stroop task (control condition) in a random and counterbalanced order. Both cognitive tasks (CTs) were followed by a whole-body endurance task (ET) consisting of 6 min of cycling exercise at 80% of peak power output measured during a preliminary incremental test. Neuromuscular function of the knee extensors was assessed before and after CT, and after ET. Rating of perceived exertion (RPE) was measured during ET. Both CTs did not induce any decrease in maximal voluntary contraction (MVC) torque (p = 0.194). During ET, mentally fatigued subjects reported higher RPE (mental fatigue 13.9 ± 3.0, control 13.3 ± 3.2, p = 0.044). ET induced a similar decrease in MVC torque (mental fatigue -17 ± 15%, control -15 ± 11%, p = 0.001), maximal voluntary activation level (mental fatigue -6 ± 9%, control -6 ± 7%, p = 0.013) and resting twitch (mental fatigue -30 ± 14%, control -32 ± 10%, p < 0.001) in both conditions. These findings reject our hypothesis and confirm previous findings that mental fatigue does not reduce the capacity of the central nervous system to recruit the working muscles. The negative effect of mental fatigue on perception of effort does not reflect a greater development of either central or peripheral fatigue. Consequently, mentally fatigued subjects are still able to perform maximal exercise, but they are experiencing an altered performance during submaximal exercise due to higher-than-normal perception of effort.

Cortical substrates of the effects of caffeine and time-on-task on perception of effort

Caffeine intake results in a decrease in perception of effort, but the cortical substrates of this perceptual effect of caffeine are unknown. The aim of this randomized counterbalanced double-blind crossover study was to investigate the effect of caffeine on the motor-related cortical potential (MRCP) and its relationship with rating of perceived effort (RPE). We also investigated whether MRCP is associated with the increase in RPE occurring over time during submaximal exercise. Twelve healthy female volunteers performed 100 intermittent isometric knee extensions at 61 ± 5% of their maximal torque 1.5 h after either caffeine (6 mg/kg) or placebo ingestion, while RPE, vastus lateralis electromyogram (EMG), and MRCP were recorded. RPE and MRCP amplitude at the vertex during the first contraction epoch (0–1 s) were significantly lower after caffeine ingestion compared with placebo ( P < 0.05) and were significantly higher during the second half of the submaximal intermittent isometric knee-extension protocol compared with the first half ( P < 0.05). No significant effects of caffeine and time-on-task were found for EMG amplitude and submaximal force output variables. The covariation between MRCP and RPE across both caffeine and time-on-task ( r10 = −0.335, P < 0.05) provides evidence in favor of the theory that perception of effort arises from neurocognitive processing of corollary discharges from premotor and motor areas of the cortex. Caffeine seems to reduce perception of effort through a reduction in the activity of cortical premotor and motor areas necessary to produce a submaximal force, and time-on-task has the opposite effect.

Does mental exertion alter maximal muscle activation?

Mental exertion is known to impair endurance performance, but its effects on neuromuscular function remain unclear. The purpose of this study was to test the hypothesis that mental exertion reduces torque and muscle activation during intermittent maximal voluntary contractions of the knee extensors. Ten subjects performed in a randomized order three separate mental exertion conditions lasting 27 min each: (i) high mental exertion (incongruent Stroop task), (ii) moderate mental exertion (congruent Stroop task), (iii) low mental exertion (watching a movie). In each condition, mental exertion was combined with 10 intermittent maximal voluntary contractions of the knee extensor muscles (one maximal voluntary contraction every 3 min). Neuromuscular function was assessed using electrical nerve stimulation. Maximal voluntary torque, maximal muscle activation and other neuromuscular parameters were similar across mental exertion conditions and did not change over time. These findings suggest that mental exertion does not affect neuromuscular function during intermittent maximal voluntary contractions of the knee extensors.

Prolonged mental exertion does not alter neuromuscular function of the knee extensors

PURPOSE

The aim of this study was to test the hypotheses that prolonged mental exertion (i) reduces maximal muscle activation and (ii) increases the extent of central fatigue induced by subsequent endurance exercise.

METHODS

The neuromuscular function of the knee extensor muscles was assessed in 10 male subjects in two different conditions: (i) before and after prolonged mental exertion leading to mental fatigue and (ii) before and after an easy cognitive task (control). Both cognitive tasks lasted 90 min and were followed by submaximal isometric knee extensor exercise until exhaustion (endurance task), and a third assessment of neuromuscular function.

RESULTS

Time to exhaustion was 13% ± 4% shorter in the mental fatigue condition (230 ± 22 s) compared with the control condition (266 ± 26 s) (P < 0.01). Prolonged mental exertion did not have any significant effect on maximal voluntary contraction torque, voluntary activation level, and peripheral parameters of neuromuscular function. A similar significant decrease in maximal voluntary contraction torque (mental fatigue condition: -26.7% ± 5.7%; control condition: -27.6% ± 3.3%, P < 0.001), voluntary activation level (mental fatigue: -10.6% ± 4.3%; control condition: -11.2% ± 5.2%, P < 0.05), and peripheral parameters of neuromuscular function occurred in both conditions after the endurance task. However, mentally fatigued subjects rated perceived exertion significantly higher during the endurance task compared with the control condition (P < 0.05).

CONCLUSIONS

These findings provide the first experimental evidence that prolonged mental exertion (i) does not reduce maximal muscle activation and (ii) does not increase the extent of central fatigue induced by subsequent endurance exercise. The negative effect of mental fatigue on endurance performance seems to be mediated by the higher perception of effort rather than impaired neuromuscular function.

Exertional fatigue in patients with CKD

BACKGROUND

Fatigue is one of the most prevalent symptoms in chronic kidney disease (CKD). However, fatigue mechanisms are poorly understood due in part to nonspecific definitions. This study investigates exertional fatigue during simulated activities of daily living, focusing on oxygen delivery and utilization.

STUDY DESIGN

"Explanatory" matched-cohort study.

PARTICIPANTS & SETTING

13 patients with CKD (stages 3b-4; mean age, 62 ± 13 [SD] years) and 13 healthy controls, mean matched for age, height, body mass and composition, and physical activity level. Participants completed an incremental cycle ergometer test to simulate energy expenditure of typical activities of daily living.

FACTOR

4 exercise intensities: 1, 1.8, 2.4, and 3.1 metabolic equivalent tasks (METs).

OUTCOMES

The primary outcome was exertional fatigue by rating of perceived exertion (RPE) on a 6-20 scale.

MEASUREMENTS

Other multidimensional measures of fatigue: UK Short Form Health Survey 36 (UK SF-36) Vitality and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) subscales. Physiologic measures of the oxygen transport and utilization chain (expired gas analysis, cardiac output, and arterial oxygen content) and blood lactate.

RESULTS

RPE was increased in patients compared with controls at 2.4 (10.5 [ie, light] ± 2.7 vs 8.7 [very light] ± 1.7 units) and 3.1 (12.5 [somewhat hard] ± 2.6 vs 10.2 [light] ± 1.7 units) METs (interaction P = 0.03), which was consistent with higher chronic fatigue in patients by both the UK SF-36 Vitality (P = 0.01) and FACIT-Fatigue (P = 0.004) subscales. Arterial oxygen content was decreased in patients (P = 0.001), but cardiac output and oxygen extraction ratio were unchanged, decreasing oxygen delivery (P = 0.04). Respiratory exchange ratio (P = 0.004) and blood lactate production (P = 0.002) were increased.

LIMITATIONS

Those inherent to a matched-cohort study.

CONCLUSIONS

Using a novel application of the outcome measure RPE, patients with non-dialysis-dependent CKD reported considerable exertional fatigue during simulated activities of daily living. Poor compensation for mild anemia contributed to this symptom. In addition to anemia, the entire oxygen transport chain needs to be targeted to treat fatigue in patients with CKD.

Are the benefits of a high-intensity progressive resistance training program sustained in rheumatoid arthritis patients? A 3-year followup study

OBJECTIVE

Rheumatoid arthritis (RA) patients were reassessed for body composition and physical function mean ± SD 39 ± 6 months after commencing a randomized controlled trial involving 24 weeks of either high-intensity progressive resistance training (PRT) or low-intensity range of movement exercise (control) to determine whether the benefits of PRT (i.e., reduced fat mass [FM], increased lean mass [LM], and improved function) were retained.

METHODS

Nine PRT and 9 control subjects were reassessed for body composition (dual x-ray absorptiometry) and function (knee extensor strength, chair test, arm curl test, 50-foot walk) approximately 3 years after resuming normal activity following the exercise intervention.

RESULTS

At followup, PRT subjects remained significantly leaner than control subjects (P = 0.03), who conversely had accumulated considerable FM during the study period (approximately -1.0 kg versus +2.4 kg, PRT versus controls). PRT subjects also retained most of the improvement in walking speed gained from training (P = 0.03 versus controls at followup). In contrast, the PRT-induced gains in LM and strength-related function were completely lost. Data from the controls suggest that established and stable RA patients have similar rates of LM loss but elevated rates of FM accretion relative to age-matched sedentary non-RA controls.

CONCLUSION

We found that long-term resumption of normal activity resulted in loss of PRT-induced improvements in LM and strength-related function, but substantial retention of the benefits in FM reduction and walking ability. The relatively long-term benefit of reduced adiposity, in particular, is likely to be clinically significant, as obesity is very prevalent among RA patients and is associated with their disability and exacerbated cardiovascular disease risk.

The face of effort: frowning muscle activity reflects effort during a physical task

It is a common observation that exertion of effort is associated with a specific facial expression. However, this facial expression has never been quantified during physical tasks and its relationship with effort is unknown. The aims of the present study were to measure frowning muscle activity during a physical task with electromyography (EMG) and to investigate the relationship between facial EMG and effort. Effort was experimentally manipulated by increasing task difficulty and inducing muscle weakness. Twenty men performed leg extensions with four relative workloads. The fatigue group (n=10) repeated the leg extensions after fatiguing eccentric exercise, and the control group repeated just the leg extensions. Facial EMG amplitude, ratings of perceived effort (RPE), and leg EMG amplitude increased significantly with increasing task difficulty and with muscle fatigue. Facial EMG, RPE, and leg EMG all correlated significantly. The results suggest that frowning muscle activity reflects effort during physical tasks.

Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial

OBJECTIVE

To confirm, in a randomized controlled trial (RCT), the efficacy of high-intensity progressive resistance training (PRT) in restoring muscle mass and function in patients with rheumatoid arthritis (RA). Additionally, to investigate the role of the insulin-like growth factor (IGF) system in exercise-induced muscle hypertrophy in the context of RA.

METHODS

Twenty-eight patients with established, controlled RA were randomized to either 24 weeks of twice-weekly PRT (n = 13) or a range of movement home exercise control group (n = 15). Dual x-ray absorptiometry-assessed body composition (including lean body mass [LBM], appendicular lean mass [ALM], and fat mass); objective physical function; disease activity; and muscle IGFs were assessed at weeks 0 and 24.

RESULTS

Analyses of variance revealed that PRT increased LBM and ALM (P < 0.01); reduced trunk fat mass by 2.5 kg (not significant); and improved training-specific strength by 119%, chair stands by 30%, knee extensor strength by 25%, arm curls by 23%, and walk time by 17% (for objective function tests, P values ranged from 0.027 to 0.001 versus controls). In contrast, body composition and physical function remained unchanged in control patients. Changes in LBM and regional lean mass were associated with changes in objective function (P values ranged from 0.126 to <0.0001). Coinciding with muscle hypertrophy, previously diminished muscle levels of IGF-1 and IGF binding protein 3 both increased following PRT (P < 0.05).

CONCLUSION

In an RCT, 24 weeks of PRT proved safe and effective in restoring lean mass and function in patients with RA. Muscle hypertrophy coincided with significant elevations of attenuated muscle IGF levels, revealing a possible contributory mechanism for rheumatoid cachexia. PRT should feature in disease management.

Mental fatigue impairs physical performance in humans

Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity. Although the impact of mental fatigue on cognitive and skilled performance is well known, its effect on physical performance has not been thoroughly investigated. In this randomized crossover study, 16 subjects cycled to exhaustion at 80% of their peak power output after 90 min of a demanding cognitive task (mental fatigue) or 90 min of watching emotionally neutral documentaries (control). After experimental treatment, a mood questionnaire revealed a state of mental fatigue (P = 0.005) that significantly reduced time to exhaustion (640 +/- 316 s) compared with the control condition (754 +/- 339 s) (P = 0.003). This negative effect was not mediated by cardiorespiratory and musculoenergetic factors as physiological responses to intense exercise remained largely unaffected. Self-reported success and intrinsic motivation related to the physical task were also unaffected by prior cognitive activity. However, mentally fatigued subjects rated perception of effort during exercise to be significantly higher compared with the control condition (P = 0.007). As ratings of perceived exertion increased similarly over time in both conditions (P < 0.001), mentally fatigued subjects reached their maximal level of perceived exertion and disengaged from the physical task earlier than in the control condition. In conclusion, our study provides experimental evidence that mental fatigue limits exercise tolerance in humans through higher perception of effort rather than cardiorespiratory and musculoenergetic mechanisms. Future research in this area should investigate the common neurocognitive resources shared by physical and mental activity.

Do we really need a central governor to explain brain regulation of exercise performance?

In this paper two different models of brain regulation of exercise performance are critically compared: the central governor model proposed by Noakes and colleagues, and an alternative psycholobiological model based on motivational intensity theory.

Similar sensitivity of time to exhaustion and time-trial time to changes in endurance

PURPOSE

There is widespread misunderstanding about the ability of constant-power tests to quantify changes in endurance performance. We have therefore compared the sensitivity of a constant-power test with that of a time trial for the effects of arterial oxygenation on endurance performance.

METHODS

Eight cyclists performed three constant-power rides to exhaustion and three 5-km time trials on a cycle ergometer in conditions of normoxia, hypoxia, and hyperoxia. After logarithmic transformation of performance times, sensitivity was calculated as the mean change in time divided by the error of measurement derived from the standard deviation of change scores.

RESULTS

In normoxia, performance times were 488 +/- 77 s for the constant-power test and 454 +/- 16 s (mean +/- SD) for the time trial. The mean and standard deviation of the change in performance time from normoxia to hypoxia were much larger in the constant-power test (-45% +/- 13%) than in the time trial (5.7% +/- 1.6%); there was a similar disparity in the change from normoxia to hyperoxia (123% +/- 37% and -4.1% +/- 1.4%, respectively). However, sensitivity for the normoxia-hypoxia change in performance in the constant-power test (6.3, 90% confidence interval 4.3-11.4) was similar to that in the time trial (4.5, 3.0-8.2); sensitivities were also similar for the normoxia-hyperoxia changes (3.2, 2.1-6.0; 3.8, 2.5-6.9, respectively). P values for mean performance changes (range, 0.0002-0.000002) reflected these sensitivities.

CONCLUSIONS

Time to exhaustion has sensitivity similar to that of time-trial time for the effects of arterial oxygenation and presumably other factors affecting endurance performance. Sensitivity need not be a concern when using constant-power tests to quantify changes in endurance performance.

Locomotor muscle fatigue increases cardiorespiratory responses and reduces performance during intense cycling exercise independently from metabolic stress

Locomotor muscle fatigue, defined as an exercise-induced reduction in maximal voluntary force, occurs during prolonged exercise, but its effects on cardiorespiratory responses and exercise performance are unknown. In this investigation, a significant reduction in locomotor muscle force (−18%, P < 0.05) was isolated from the metabolic stress usually associated with fatiguing exercise using a 100-drop-jumps protocol consisting of one jump every 20 s from a 40-cm-high platform. The effect of this treatment on time to exhaustion during high-intensity constant-power cycling was measured in study 1 ( n = 10). In study 2 ( n = 14), test duration (871 ± 280 s) was matched between fatigue and control condition (rest). In study 1, locomotor muscle fatigue caused a significant curtailment in time to exhaustion (636 ± 278 s) compared with control (750 ± 281 s) ( P = 0.003) and increased cardiac output. Breathing frequency was significantly higher in the fatigue condition in both studies despite similar oxygen consumption and blood lactate accumulation. In study 2, high-intensity cycling did not induce further fatigue to eccentrically-fatigued locomotor muscles. In both studies, there was a significant increase in heart rate in the fatigue condition, and perceived exertion was significantly increased in study 2 compared with control. These results suggest that locomotor muscle fatigue has a significant influence on cardiorespiratory responses and exercise performance during high-intensity cycling independently from metabolic stress. These effects seem to be mediated by the increased central motor command and perception of effort required to exercise with weaker locomotor muscles.

Heart rate and blood lactate correlates of perceived exertion during small-sided soccer games

The rating of perceived exertion (RPE) could be a practical measure of global exercise intensity in team sports. The purpose of this study was to examine the relationship between heart rate (%HR(peak)) and blood lactate ([BLa(-)]) measures of exercise intensity with each player's RPE during soccer-specific aerobic exercises. Mean individual %HR(peak), [BLa(-)] and RPE (Borg's CR 10-scale) were recorded from 20 amateur soccer players from 67 soccer-specific small-sided games training sessions over an entire competitive season. The small-sided games were performed in three 4min bouts separated with 3min recovery on various sized pitches and involved 3-, 4-, 5-, or 6-players on each side. A stepwise linear multiple regression was used to determine a predictive equation to estimate global RPE for small-sided games from [BLa(-)] and %HR(peak). Partial correlation coefficients were also calculated to assess the relationship between RPE, [BLa(-)] and %HR(peak). Stepwise multiple regression analysis revealed that 43.1% of the adjusted variance in RPE could be explained by HR alone. The addition of [BLa(-)] data to the prediction equation allowed for 57.8% of the adjusted variance in RPE to be predicted (Y=-9.49-0.152 %HR(peak)+1.82 [BLa(-)], p<0.001). These results show that the combination of [BLa(-)] and %HR(peak) measures during small-sided games is better related to RPE than either %HR(peak) or [BLa(-)] measures alone. These results provide further support the use of RPE as a measure of global exercise intensity in soccer.

A vertical jump force test for assessing bilateral strength asymmetry in athletes

PURPOSE

To establish the validity and reliability of a new vertical jump force test (VJFT) for the assessment of bilateral strength asymmetry in a total of 451 athletes.

METHODS

The VJFT consists of countermovement jumps with both legs simultaneously: one on a single force platform, the other on a leveled wooden platform. Jumps with the right or the left leg on the force platform were alternated. Bilateral strength asymmetry was calculated as [(stronger leg - weaker leg)/stronger leg] x 100. A positive sign indicates a stronger right leg; a negative sign indicates a stronger left leg. Studies 1 (N = 59) and 2 (N = 41) examined the correlation between the VJFT and other tests of lower-limb bilateral strength asymmetry in male athletes. In study 3, VJFT reliability was assessed in 60 male athletes. In study 4, the effect of rehabilitation on bilateral strength asymmetry was examined in seven male and female athletes 8-12 wk after unilateral knee surgery. In study 5, normative data were determined in 313 male soccer players.

RESULTS

Significant correlations were found between VJFT and both the isokinetic leg extension test (r = 0.48; 95% confidence interval, 0.26-0.66) and the isometric leg press test (r = 0.83; 0.70-0.91). VJFT test-retest intraclass correlation coefficient was 0.91 (0.85-0.94), and typical error was 2.4%. The change in mean [-0.40% (-1.25 to 0.46%)] was not substantial. Rehabilitation decreased bilateral strength asymmetry (mean +/- SD) of the athletes recovering from unilateral knee surgery from 23 +/- 3 to 10 +/- 4% (P < 0.01). The range of normal bilateral strength asymmetry (2.5th to 97.5th percentiles) was -15 to 15%.

CONCLUSIONS

The assessment of bilateral strength asymmetry with the VJFT is valid and reliable, and it may be useful in sports medicine.

Validity and reliability of the Siconolfi Step Test for assessment of physical fitness in patients with systemic lupus erythematosus

OBJECTIVE

Patients with systemic lupus erythematosus (SLE) have poor physical fitness as measured by maximal oxygen uptake (VO(2max)), which is associated with disability and fatigue. The purpose of this study was to validate, in this population, the Siconolfi Step Test (SST) developed to predict VO(2max) in healthy individuals.

METHODS

Thirty patients with well-controlled SLE were tested on a cycle ergometer until volitional exhaustion, and 25 women and 4 men (mean +/- SD age 48 +/- 14 years, weight 71.5 +/- 13.7 kg) fulfilled the criteria for maximal effort. VO(2max) measured during this incremental test was compared with VO(2max) predicted by the SST using Bland and Altman 95% limits of agreement (LOA) and intraclass correlation coefficient (ICC). The SST was repeated twice to assess its reliability.

RESULTS

The ICC between predicted and measured VO(2max) (mean +/- SD 1.67 +/- 0.41 liters/minute versus 1.57 +/- 0.39 liters/minute) was moderately high (0.73, P < 0.001). Bland and Altman analysis revealed a trend for a positive bias (P = 0.083) and 95% LOA of +/-0.58 liters/minute. There was a very high ICC (0.97, P < 0.001) between VO(2max) predicted by the first and second SST (mean +/- SD 1.66 +/- 0.40 liters/minute versus 1.67 +/- 0.41 liters/minute), and no significant bias (P = 0.500). The 95% LOA were +/-0.20 liters/minute.

CONCLUSION

The results demonstrate that the SST is well tolerated, reasonably valid, and highly reliable in patients with well-controlled SLE. Therefore, this simple, submaximal exercise test might be useful for assessing physical fitness in clinical practice and epidemiologic studies.

Factors influencing physiological responses to small-sided soccer games

The aim of this study was to examine the effects of exercise type, field dimensions, and coach encouragement on the intensity and reproducibility of small-sided games. Data were collected on 20 amateur soccer players (body mass 73.1 +/- 8.6 kg, stature 1.79 +/- 0.05 m, age 24.5 +/- 4.1 years, VO(2max) 56.3 +/- 4.8 ml x kg(-1) x min(-1)). Aerobic interval training was performed during three-, four-, five- and six-a-side games on three differently sized pitches, with and without coach encouragement. Heart rate, rating of perceived exertion (RPE) on the CR10-scale, and blood lactate concentration were measured. Main effects were found for exercise type, field dimensions, and coach encouragement (P < 0.05), but there were no interactions between any of the variables (P > 0.15). During a six-a-side game on a small pitch without coach encouragement, exercise intensity was 84 +/- 5% of maximal heart rate, blood lactate concentration was 3.4 +/- 1.0 mmol x l(-1), and the RPE was 4.8. During a three-a-side game on a larger pitch with coach encouragement, exercise intensity was 91 +/- 2% of maximal heart rate, blood lactate concentration was 6.5 +/- 1.5 mmol x l(-1), and the RPE was 7.2. Typical error expressed as a coefficient of variation ranged from 2.0 to 5.4% for percent maximal heart rate, from 10.4 to 43.7% for blood lactate concentration, and from 5.5 to 31.9% for RPE. The results demonstrate that exercise intensity during small-sided soccer games can be manipulated by varying the exercise type, the field dimensions, and whether there is any coach encouragement. By using different combinations of these factors, coaches can modulate exercise intensity within the high-intensity zone and control the aerobic training stimulus.

Nandrolone Decanoate as Anabolic Therapy in Chronic Kidney Disease: A Randomized Phase II Dose-Finding Study

BACKGROUND/AIMS

In patients with chronic kidney disease (CKD) receiving adequate erythropoietin therapy, the ideal dose of nandrolone decanoate (ND) to enhance muscle mass is not known.

METHODS

In this phase II dose-finding study, 54 patients with CKD stage 5 were randomized to either low, medium or high doses of ND (50, 100 or 200 mg/week for 24 weeks, respectively, in males; doses halved in females), while 7 patients acted as non-randomized controls. The primary outcome measure was appendicular lean mass (ALM) by dual-energy X-ray absorptiometry. Fluid overload (hydration of the fat-free mass) and indicators of physical functioning were secondary measures. Harms were also recorded. Data were analysed using Quade's (1967) non-parametric analysis of covariance.

RESULTS

ND increased ALM in a dose-responsive manner (change scores = 0.3 +/- 0.3 vs. 0.8 +/- 0.3 vs. 1.5 +/- 0.5 vs. 2.1 +/- 0.4 kg, control vs. low vs. medium vs. high dose groups, respectively, p < 0.001) with no increases in fluid overload but no consistent effect on physical functioning. The highest dose of ND (100 mg/week) was intolerable in females because of virilizing effects.

CONCLUSION

If goals of future studies are to improve body composition, dosing of ND up to 200 mg/week in males and 50 mg/week in females should be investigated. However, to realize improvements in physical functioning, future phase III trials of ND may require additional interventions such as exercise training.

The physiology of mountain biking

Mountain biking is a popular outdoor recreational activity and an Olympic sport. Cross-country circuit races have a winning time of approximately equal 120 minutes and are performed at an average heart rate close to 90% of the maximum, corresponding to 84% of maximum oxygen uptake (VO2max). More than 80% of race time is spent above the lactate threshold. This very high exercise intensity is related to the fast starting phase of the race; the several climbs, forcing off-road cyclists to expend most of their effort going against gravity; greater rolling resistance; and the isometric contractions of arm and leg muscles necessary for bike handling and stabilisation. Because of the high power output (up to 500W) required during steep climbing and at the start of the race, anaerobic energy metabolism is also likely to be a factor of off-road cycling and deserves further investigation. Mountain bikers' physiological characteristics indicate that aerobic power (VO2max >70 mL/kg/min) and the ability to sustain high work rates for prolonged periods of time are prerequisites for competing at a high level in off-road cycling events. The anthropometric characteristics of mountain bikers are similar to climbers and all-terrain road cyclists. Various parameters of aerobic fitness are correlated to cross-country performance, suggesting that these tests are valid for the physiological assessment of competitive mountain bikers, especially when normalised to body mass. Factors other than aerobic power and capacity might influence off-road cycling performance and require further investigation. These include off-road cycling economy, anaerobic power and capacity, technical ability and pre-exercise nutritional strategies.