Effects of Different Durations at Fixed Intensity Exercise on Internal Load and Recovery-A Feasibility Pilot Study on Duration as an Independent Variable for Exercise Prescription

Duration is a rarely investigated marker of exercise prescription. The aim of this study was to test the feasibility of the methodological approach, assessing effects of different duration constant-load exercise (CLE) on physiological responses (internal load) and recovery kinetics. Seven subjects performed an incremental exercise (IE) test, one maximal duration CLE at 77.6 ± 4.8% V˙O2max, and CLE's at 20%, 40%, and 70% of maximum duration. Heart rate (HR), blood lactate (La), and glucose (Glu) concentrations were measured. Before, 4, 24, and 48 h after CLE's, submaximal IE tests were performed. HR variability (HRV) was assessed in orthostatic tests (OT). Rating of perceived exertion (RPE) was obtained during all tests. CLE's were performed at 182 ± 27 W. HR_peak, La_peak, V˙Epeak, and RPE_peak were significantly higher in CLE's with longer duration. No significant differences were found between CLE's for recovery kinetics for HR, La, and Glu in the submaximal IE and for HRV or OT. Despite no significant differences, recovery kinetics were found as expected, indicating the feasibility of the applied methods. Maximum tests and recovery tests closer to CLE's termination are suggested to better display recovery kinetics. These findings are a first step to prescription of exercise by both intensity and duration on an individual basis.

Exercise duration: Independent effects on acute physiologic responses and the need for an individualized prescription

An individualization of exercise prescription is implemented mainly in terms of intensity but not for duration. To survey the need for an individualized exercise duration prescription, we investigated acute physiologic responses during constant‐load exercise of maximal duration (t_max) and determined so‐called duration thresholds. Differences between absolute (min) and relative terms (% t_max) of exercise duration were analyzed. Healthy young and trained male and female participants (n = 11) performed an incremental exercise test and one t_max constant‐load exercise test at a target intensity of 10% of maximal power output below the second lactate turn point (LTP₂). Blood lactate, heart rate, and spirometric data were measured during all tests. t_max was markedly different across subjects (69.6 ± 14.8 min; range: 40–90 min). However, distinct duration phases separated by duration thresholds (DTh) were found in most measured variables. These duration thresholds (except DTh1) were significantly related to t_max (DTh2: r² = 0.90, p < 0.0001; DTh3: r² = 0.98, p < 0.0001) and showed substantial interindividual differences if expressed in absolute terms (DTh2: 24.8 ± 6.0 min; DTh3: 47.4 ± 10.6 min) but not in relative terms (DTh2: 35.4 ± 2.7% t_max; DTh3: 67.9 ± 2.4% t_max). Our data showed that (1) maximal duration was individually different despite the same relative intensity, (2) duration thresholds that were related to t_max could be determined in most measured variables, and (3) duration thresholds were comparable between subjects if expressed in relative terms. We therefore conclude that duration needs to be concerned as an independent variable of exercise prescription.

The Effect of Lower Body Anaerobic Pre-Loading on Upper Body Ergometer Time Trial Performance

Pre-competitive conditioning has become a substantial part of successful performance. In addition to temperature changes, a metabolic conditioning can have a significant effect on the outcome, although the right dosage of such a method remains unclear. The main goal of the investigation was to measure how a lower body high-intensity anaerobic cycling pre-load exercise (HIE) of 25 s affects cardiorespiratory and metabolic responses in subsequent upper body performance. Thirteen well-trained college-level male cross-country skiers (18.1 ± 2.9 years; 70.8 ± 7.6 kg; 180.6 ± 4.7 cm; 15.5 ± 3.5% body fat) participated in the study. The athletes performed a 1000-m maximal double-poling upper body ergometer time trial performance test (TT) twice. One TT was preceded by a conventional low intensity warm-up (TT_low) while additional HIE cycling was performed 9 min before the other TT (TT_high). Maximal double-poling performance after the TT_low (225.1 ± 17.6 s) was similar (p > 0.05) to the TT_high (226.1 ± 15.7 s). Net blood lactate (La) increase (delta from end of TT minus start) from the start to the end of the TT_low was 10.5 ± 2.2 mmol L⁻¹ and 6.5 ± 3.4 mmol L⁻¹ in TT_high (p < 0.05). La net changes during recovery were similar for both protocols, remaining 13.5% higher in TT_high group even 6 min after the maximal test. VCO₂ was lower (p < 0.05) during the last 400-m split in TT_high, however during the other splits no differences were found (p < 0.05). Respiratory exchange ratio (RER) was significantly lower in TT_high in the third, fourth and the fifth 200 m split. Participants individual pacing strategies showed high relation (p < 0.05) between slower start and faster performance. In conclusion, anaerobic metabolic pre-conditioning leg exercise significantly reduced net-La increase, but all-out upper body performance was similar in both conditions. The pre-conditioning method may have some potential but needs to be combined with a pacing strategy different from the usual warm-up procedure.

Effects of 6 Weeks of Different High-Intensity Interval and Moderate Continuous Training on Aerobic and Anaerobic Performance

Cavar, M, Marsic, T, Corluka, M, Culjak, Z, Cerkez Zovko, I, Müller, A, Tschakert, G, and Hofmann, P. Effects of 6 weeks of different high-intensity interval and moderate continuous training on aerobic and anaerobic performance. J Strength Cond Res 33(1): 44-56, 2019-To provide practical data, we compared the training effects of 3 different programs, using a shuttle run stimulus, on aerobic and anaerobic performance, measured using the 20-m maximal shuttle run (Beep) test and 300-yd shuttle run, respectively. Forty-five physically trained men, with a mean age of 21.1 ± 1.8 years, participated. The 6-week, 12-session training programs included 2 high-intensity interval training (HIIT) protocols, with either a short (SH) or long (LH) shuttle run interval, and a continuous shuttle run (CON), which was used as a control. The training intensity was based on the maximal shuttle run speed (MASS), measured on the Beep test, to elicit the relevant values of the time to exhaustion (TTE). Short (SH) training was performed at 115-120%(MASS), with a 10-second work to 10-second rest scheme, and the number of repetitions to be completed set to 70% of each participant's maximum (∼15 repetitions). LH training was performed at an intensity of 90-95%(MASS), with the duration set to 70%(TTE) (∼4 minutes). For both SH and LH, 3 sets were completed at each session, with a 2-3 minutes of rest between sets. CON training consisted of continuous shuttle running for 35 minutes at an intensity of 70%(MASS). Both SH and LH yielded a large training effect (p < 0.01), with SH preferentially improving anaerobic performance and LH preferentially improving aerobic performance. No effect of CON training was identified. Our findings indicate that these different training protocols cannot be used interchangeably and that the Beep test is useful in prescribing the intensity and duration of HIIT.

Performance Enhancing Effect of Metabolic Pre-conditioning on Upper-Body Strength-Endurance Exercise

High systemic blood lactate (La) was shown to inhibit glycolysis and to increase oxidative metabolism in subsequent anaerobic exercise. Aim of this study was to examine the effect of a metabolic pre-conditioning (MPC) on net La increase and performance in subsequent pull-up exercise (PU). Nine trained students (age: 25.1 ± 1.9 years; BMI: 21.7 ± 1.4) performed PU on a horizontal bar with legs placed on a box (angular hanging) either without or with MPC in a randomized order. MPC was a 26.6 ± 2 s all out shuttle run. Each trial started with a 15-min warm-up phase. Time between MPC and PU was 8 min. Heart rate (HR) and gas exchange measures (VO₂, VCO₂, and VE) were monitored, La and glucose were measured at specific time points. Gas exchange measures were compared by area under the curve (AUC). In PU without MPC, La increased from 1.24 ± 0.4 to 6.4 ± 1.4 mmol⋅l^-1, whereas with MPC, PU started at 9.28 ± 1.98 mmol⋅l^-1 La which increased to 10.89 ± 2.13 mmol⋅l^-1. With MPC, net La accumulation was significantly reduced by 75.5% but performance was significantly increased by 1 rep (4%). Likewise, net oxygen uptake VO₂ (50% AUC), pulmonary ventilation (VE) (34% AUC), and carbon dioxide VCO₂ production (26% AUC) were significantly increased during PU but respiratory exchange ratio (RER) was significantly blunted during work and recovery. MPC inhibited glycolysis and increased oxidative metabolism and performance in subsequent anaerobic upper-body strength-endurance exercise.

Acute Exercise-Induced Circulating Haematopoietic Stem and Progenitor Cells in Cardiac Patients - A Case Series

BACKGROUND

Exercise-induced circulating haematopoietic stem and progenitor cell (HPC) number has been discussed in the context of regeneration in heart disease patients.

OBJECTIVE

The aim of this pilot study was to compare the effect of different exercise protocols usually applied in cardiac rehabilitation on the number of acute, exercise-induced HPCs, related to potential mediators, e.g. biomarkers of sympathetic and oxidative stress, and inflammation.

METHODS

This is a case series comprising seven patients suffering from coronary heart disease (CHD) undertaken at the Center for Ambulant Cardiac Rehabilitation. Patients (n=6) performed two exercise modes (constant-load, CLE; high-intensity interval, HIIE) in randomised order. Venous blood was drawn before and immediately after each test to assess CD34+/CD45+ HPC number by flow cytometry and biomarkers in blood plasma. The primary outcome was the change in HPC number, the secondary outcomes were changes in sympathetic/oxidative stress and markers of inflammation.

RESULTS

Both exercise modes resulted in a non-significant increase in HPC number after exercise, even when the results of both tests were combined. Overall, free norepinephrine increased significantly and was positively related to exercise-induced HPC number (r=0.70, p<0.05). Markers of sympathetic activation (fNE), oxidative stress (myeloperoxidase) and inflammation (interleukin-6) significantly increased after CLE and HIIE with no difference between tests.

CONCLUSIONS

Interestingly, acute CLE and HIIE did not stimulate significant HPC mobilisation in CHD, although both exercise modes elevated circulating concentrations of sympathetic activation. Haematopoietic stem and progenitor cell mobilisation could be blunted due to disease-related bone-marrow exhaustion.

Different Heart Rate Patterns During Cardio-Pulmonary Exercise (CPX) Testing in Individuals With Type 1 Diabetes

To investigate the heart rate during cardio-pulmonary exercise (CPX) testing in individuals with type 1 diabetes (T1D) compared to healthy (CON) individuals. Fourteen people (seven individuals with T1D and seven CON individuals) performed a CPX test until volitional exhaustion to determine the first and second lactate turn points (LTP₁ and LTP₂), ventilatory thresholds (VT₁ and VT₂), and the heart rate turn point. For these thresholds cardio-respiratory variables and percentages of maximum heart rate, heart rate reserve, maximum oxygen uptake and oxygen uptake reserve, and maximum power output were compared between groups. Additionally, the degree and direction of the deflection of the heart rate to performance curve (k_HR) were compared between groups. Individuals with T1D had similar heart rate at LTP₁ (mean difference) -11, [(95% confidence interval) -27 to 4 b.min^-1], at VT₁ (-12, -8 to 33 b.min^-1) and at LTP₂ (-7, -13 to 26 b.min^-1), at VT₂ (-7, -13 to 28 b.min^-1), and at the heart rate turn point (-5, -14 to 24 b.min^-1) (p = 0.22). Heart rate expressed as percentage of maximum heart rate at LTP₁, VT₁, LTP₂, VT₂ and the heart rate turn point as well as expressed as percentages of heart rate reserve at LTP₂, VT₂ and the heart rate turn point was lower in individuals with T1D (p < 0.05). k_HR was lower in T1D compared to CON individuals (0.11 ± 0.25 vs. 0.51 ± 0.32, p = 0.02). Our findings demonstrate that there are clear differences in the heart rate response during CPX testing in individuals with T1D compared to CON individuals. We suggest using submaximal markers to prescribe exercise intensity in people with T1D, as the heart rate at thresholds is influenced by k_HR. Clinical Trial Identifier: NCT02075567 (https://clinicaltrials.gov/ct2/show/NCT02075567).

Atypical blood glucose response to continuous and interval exercise in a person with type 1 diabetes: a case report

Background

Therapy must be adapted for people with type 1 diabetes to avoid exercise-induced hypoglycemia caused by increased exercise-related glucose uptake into muscles. Therefore, to avoid hypoglycemia, the preexercise short-acting insulin dose must be reduced for safety reasons. We report a case of a man with long-lasting type 1 diabetes in whom no blood glucose decrease during different types of exercise with varying exercise intensities and modes was found, despite physiological hormone responses.

Case presentation

A Caucasian man diagnosed with type 1 diabetes for 24 years performed three different continuous high-intensity interval cycle ergometer exercises as part of a clinical trial (ClinicalTrials.gov identifier NCT02075567). Intensities for both modes of exercises were set at 5% below and 5% above the first lactate turn point and 5% below the second lactate turn point. Short-acting insulin doses were reduced by 25%, 50%, and 75%, respectively. Measurements taken included blood glucose, blood lactate, gas exchange, heart rate, adrenaline, noradrenaline, cortisol, glucagon, and insulin-like growth factor-1. Unexpectedly, no significant blood glucose decreases were observed during all exercise sessions (start versus end, 12.97 ± 2.12 versus 12.61 ± 2.66 mmol L⁻¹, p = 0.259). All hormones showed the expected response, dependent on the different intensities and modes of exercises.

Conclusions

People with type 1 diabetes typically experience a decrease in blood glucose levels, particularly during low- and moderate-intensity exercises. In our patient, we clearly found no decline in blood glucose, despite a normal hormone response and no history of any insulin insensitivity. This report indicates that there might be patients for whom the recommended preexercise therapy adaptation to avoid exercise-induced hypoglycemia needs to be questioned because this could increase the risk of severe hyperglycemia and ketosis.

Intensity- and Duration-Based Options to Regulate Endurance Training

The regulation of endurance training is usually based on the prescription of exercise intensity. Exercise duration, another important variable of training load, is rarely prescribed by individual measures and mostly set from experience. As the specific exercise duration for any intensity plays a substantial role regarding the different kind of cellular stressors, degree, and kind of fatigue as well as training effects, concepts integrating the prescription of both intensity and duration within one model are needed. An according recent approach was the critical power concept which seems to have a physiological basis; however, the mathematical approach of this concept does not allow applying the three zones/two threshold model of metabolism and its different physiological consequences. Here we show the combination of exercise intensity and duration prescription on an individual basis applying the power/speed to distance/time relationship. The concept is based on both the differentiation of intensities by two lactate or gas exchange variables derived turn points, and on the relationship between power (or velocity) and duration (or distance). The turn points define three zones of intensities with distinct acute metabolic, hormonal, and cardio-respiratory responses for endurance exercise. A maximal duration exists for any single power or velocity such as described in the power-duration relationship. Using percentages of the maximal duration allows regulating fatigue, recovery time, and adaptation for any single endurance training session. Four domains of duration with respect to induced fatigue can be derived from maximal duration obtained by the power-duration curve. For any micro-cycle, target intensities and durations may be chosen on an individual basis. The model described here is the first conceptual framework of integrating physiologically defined intensities and fatigue related durations to optimize high-performance exercise training.

Acute Physiological Responses to Short- and Long-Stage High-Intensity Interval Exercise in Cardiac Rehabilitation: A Pilot Study

Despite described benefits of aerobic high-intensity interval exercise (HIIE), the acute responses during different HIIE modes and associated health risks have only been sparsely discovered in heart disease patients. Therefore, the aim of this study was to investigate the acute responses for physiological parameters, cardiovascular and inflammatory biomarkers, and catecholamines yielded by two different aerobic HIIE protocols compared to continuous exercise (CE) in phase III cardiac rehabilitation. Eight cardiac patients (7 with coronary heart disease, 1 with myocarditis; 7 males, 1 female; age: 63.0 ± 9.4 years; height: 1.74 ± 0.05 m; weight: 83.6 ± 8.7 kg), all but one treated with ß-blocking agents, performed a maximal symptom-limited incremental exercise test (IET) and three different exercise tests matched for mean load (Pmean) and total duration: 1) short HIIE with a peak workload duration (tpeak) of 20 s and a peak workload (Ppeak) equal to the maximum power output (Pmax) from IET; 2) long HIIE with a tpeak of 4 min, Ppeak was corresponding to the power output at 85 % of maximal heart rate (HRmax) from IET; 3) CE with a target workload equal to Pmean of both HIIE modes. Acute metabolic and peak cardiorespiratory responses were significantly higher during long HIIE compared to short HIIE and CE (p < 0.05) except HRpeak which tended to be higher in long HIIE than in short HIIE (p = 0.08). Between short HIIE and CE, no significant difference was found for any parameter. Acute responses of cardiovascular and inflammatory biomarkers and catecholamines didn't show any significant difference between tests (p > 0.05). All health-related variables remained in a normal range in any test except NT-proBNP, which was already elevated at baseline. Despite a high Ppeak particularly in short HIIE, both HIIE modes were as safe and as well tolerated as moderate CE in cardiac patients by using our methodological approach. Key pointsHigh-intensity interval exercise (HIIE) with short peak workload durations (tpeak) induce a lower acute metabolic and peak cardiorespiratory response compared to intervals with long tpeak despite higher peak workload intensities and identical mean load. No significant difference for any physiological parameter was found between short HIIE and CE.Between short HIIE, long HIIE, and CE, no significant difference was found in the increase (or decrease, respectively,) of health related markers such as cardiovascular biomarkers, catecholamines, or inflammatory parameters during exercise.During all exercise modes, all risk markers remained in a normal range except for NT-proBNP which was, however, already elevated at baseline.Short HIIE, long HIIE, and CE were safely performed by patients with CHD or myocarditis in cardiac rehabilitation by using our methodological approach to exercise prescription. This approach included the prescription of exercise intensities with respect to LTP1, LTP2, and Pmax as well as a conscious setting of Pmean at a moderate level (80 % of PLTP2). Importantly, all exercise modes were matched for Pmean and exercise duration in order to enable a comparison of the three protocols.

Effects of High-Intensity Interval Exercise versus Moderate Continuous Exercise on Glucose Homeostasis and Hormone Response in Patients with Type 1 Diabetes Mellitus Using Novel Ultra-Long-Acting Insulin

Introduction

We investigated blood glucose (BG) and hormone response to aerobic high-intensity interval exercise (HIIE) and moderate continuous exercise (CON) matched for mean load and duration in type 1 diabetes mellitus (T1DM).

Material and Methods

Seven trained male subjects with T1DM performed a maximal incremental exercise test and HIIE and CON at 3 different mean intensities below (A) and above (B) the first lactate turn point and below the second lactate turn point (C) on a cycle ergometer. Subjects were adjusted to ultra-long-acting insulin Degludec (Tresiba/ Novo Nordisk, Denmark). Before exercise, standardized meals were administered, and short-acting insulin dose was reduced by 25% (A), 50% (B), and 75% (C) dependent on mean exercise intensity. During exercise, BG, adrenaline, noradrenaline, dopamine, cortisol, glucagon, and insulin-like growth factor-1, blood lactate, heart rate, and gas exchange variables were measured. For 24 h after exercise, interstitial glucose was measured by continuous glucose monitoring system.

Results

BG decrease during HIIE was significantly smaller for B (p = 0.024) and tended to be smaller for A and C compared to CON. No differences were found for post-exercise interstitial glucose, acute hormone response, and carbohydrate utilization between HIIE and CON for A, B, and C. In HIIE, blood lactate for A (p = 0.006) and B (p = 0.004) and respiratory exchange ratio for A (p = 0.003) and B (p = 0.003) were significantly higher compared to CON but not for C.

Conclusion

Hypoglycemia did not occur during or after HIIE and CON when using ultra-long-acting insulin and applying our methodological approach for exercise prescription. HIIE led to a smaller BG decrease compared to CON, although both exercises modes were matched for mean load and duration, even despite markedly higher peak workloads applied in HIIE. Therefore, HIIE and CON could be safely performed in T1DM.

Trial Registration

ClinicalTrials.gov NCT02075567 http://www.clinicaltrials.gov/ct2/show/NCT02075567

How to regulate the acute physiological response to "aerobic" high-intensity interval exercise

The acute physiological processes during "aerobic" high-intensity interval exercise (HIIE) and their regulation are inadequately studied. The main goal of this study was to investigate the acute metabolic and cardiorespiratory response to long and short HIIE compared to continuous exercise (CE) as well as its regulation and predictability. Six healthy well-trained sport students (5 males, 1 female; age: 25.7 ± 3.1 years; height: 1.80 ± 0.04 m; weight: 76.7 ± 6.4 kg; VO2max: 4.33 ± 0.7 l·min(-1)) performed a maximal incremental exercise test (IET) and subsequently three different exercise sessions matched for mean load (Pmean) and exercise duration (28 min): 1) long HIIE with submaximal peak workloads (Ppeak = power output at 95 % of maximum heart rate), peak workload durations (tpeak) of 4 min, and recovery durations (trec) of 3 min, 2) short HIIE with Ppeak according to the maximum power output (Pmax) from IET, tpeak of 20 s, and individually calculated trec (26.7 ± 13.4 s), and 3) CE with a target workload (Ptarget) equating to Pmean of HIIE. In short HIIE, mean lactate (Lamean) (5.22 ± 1.41 mmol·l(-1)), peak La (7.14 ± 2.48 mmol·l(-1)), and peak heart rate (HRpeak) (181.00 ± 6.66 b·min(-1)) were significantly lower compared to long HIIE (Lamean: 9.83 ± 2.78 mmol·l(-1); Lapeak: 12.37 ± 4.17 mmol·l(-1), HRpeak: 187.67 ± 5.72 b·min(-1)). No significant differences in any parameters were found between short HIIE and CE despite considerably higher peak workloads in short HIIE. The acute metabolic and peak cardiorespiratory demand during "aerobic" short HIIE was significantly lower compared to long HIIE and regulable via Pmean. Consequently, short HIIE allows a consciously aimed triggering of specific and desired or required acute physiological responses. Key pointsHigh-intensity interval exercise (HIIE) with short peak workload durations (tpeak) induce a lower acute metabolic and peak cardiorespiratory response compared to intervals with long tpeak despite higher peak workload intensities (Ppeak) and identical mean load (Pmean).Short HIIE response is the same as in continuous exercise (CE) matched for Pmean.It is possible to regulate and predict the acute physiological response by means of Pmean for short HIIE but not for long HIIE.The use of fixed percentages of maximal heart rate (HRmax) for exercise intensity prescription yields heterogeneous exercise stimuli across subjects. Therefore, objective individual markers such as the first and the second lactate turn point are recommend prescribing exercise intensity not only for continuous but also for intermittent exercise.

Influence of acute normobaric hypoxia on physiological variables and lactate turn point determination in trained men

The goal of this study is to evaluate the response of physiological variables to acute normobaric hypoxia compared to normoxia and its influence on the lactate turn point determination according to the three-phase model of energy supply (Phase I: metabolically balanced at muscular level; Phase II: metabolically balanced at systemic level; Phase III: not metabolically balanced) during maximal incremental exercise. Ten physically active (VO2max 3.9 [0.49] l·min(-1)), healthy men (mean age [SD]: 25.3 [4.6] yrs.), participated in the study. All participants performed two maximal cycle ergometric exercise tests under normoxic as well as hypoxic conditions (FiO2 = 14%). Blood lactate concentration, heart rate, gas exchange data, and power output at maximum and the first and the second lactate turn point (LTP1, LTP2), the heart rate turn point (HRTP) and the first and the second ventilatory turn point (VETP1, VETP2) were determined. Since in normobaric hypoxia absolute power output (P) was reduced at all reference points (max: 314 / 274 W; LTP2: 218 / 184 W; LTP1: 110 / 96 W), as well as VO2max (max: 3.90 / 3.23 l·min(-1); LTP2: 2.90 / 2.43 l·min(-1); LTP1: 1.66 / 1.52 l·min(-1)), percentages of Pmax at LTP1, LTP2, HRTP and VETP1, VETP2 were almost identical for hypoxic as well as normoxic conditions. Heart rate was significantly reduced at Pmax in hypoxia (max: 190 / 185 bpm), but no significant differences were found at submaximal control points. Blood lactate concentration was not different at maximum, and all reference points in both conditions. Respiratory exchange ratio (RER) (max: 1.28 / 1.08; LTP2: 1.13 / 0.98) and ventilatory equivalents for O2 (max: 43.4 / 34.0; LTP2: 32.1 / 25.4) and CO2 (max: 34.1 / 31.6; LTP2: 29.1 / 26.1) were significantly higher at some reference points in hypoxia. Significant correlations were found between LTP1 and VETP1 (r = 0.778; p < 0.01), LTP2 and HRTP (r = 0.828; p < 0.01) and VETP2 (r = 0.948; p < 0.01) for power output for both conditions. We conclude that the lactate turn point determination according to the three-phase-model of energy supply is valid in normobaric, normoxic as well as hypoxic conditions. The turn points for La, HR, and VE were reproducible among both conditions, but shifted left to lower workloads. The lactate turn point determination may therefore be used for the prescription of exercise performance in both environments. Key PointsThe lactate turn point concept can be used for performance testing in normoxic and hypoxic conditionsThe better the performance of the athletes the higher is the effect of hypoxiaThe HRTP and LTP2 are strongly correlated that allows a simple performance testing using heart rate measures only.

Low endogenous thrombin potential in trained subjects

INTRODUCTION

A paradox seems to exist: exercising leads to clotting activation in conventional clotting tests, but exercising persons have a low risk of thrombosis. In this study we tried to evaluate the effect of exercise performance status on in vitro plasma thrombin generation, which represents an overall function test of hemostasis.

MATERIALS AND METHODS

We compared 56 trained subjects to 98 healthy age matched sedentary volunteers. Blood samples were analyzed for thrombin generation using calibrated automated thrombography. Microparticles were quantified using ELISA. Additionally prothrombin fragments 1 + 2, thrombin-antithrombin complex, tissue factor pathway inhibitor, antithrombin and prothrombin were measured. The group of the trained subjects performed an incremental cycle-ergometer exercise test after taking the blood sample.

RESULTS

A significantly lower endogenous thrombin potential was observed in the group of the trained subjects compared to the sedentary individuals (p = 0.007). Microparticles (ELISA) were significantly lower in the trained subjects compared to the sedentary subjects (p = 0.001). Prothrombin fragments 1 + 2 (p < 0.001) and thrombin-antithrombin complex (p = 0.01) were significant higher in the trained subjects and antithrombin (p = 0.02) as well as prothrombin (p < 0.0001) were significantly lower in this group, whereas tissue factor pathway inhibitor values did not show significant differences. Both maximal and submaximal power output was significantly negatively related to endogenous thrombin potential (r = -0.43, r = -0.45) and thrombin peak (r = -0.44, r = -0.42).

CONCLUSIONS

Trained subjects have a lower endogenous thrombin potential than sedentary subjects possibly explaining the lower incidence of thrombosis in this group despite a higher acute clotting activation during strenuous exercise.

Energy expenditure and sex differences of golf playing

The purpose of the study was to assess the average physical intensity and energy expenditure during a single round of golf on hilly and flat courses in a heterogeneous group of healthy men and women of varying age and golf handicap. Forty-two males and 24 females completed an incremental cycle-ergometer exercise test to determine exercise performance markers. The heart rate (HR), duration, distance, walking speed, ascent and descent were measured via a global positioning system (GPS)/HR monitor during the game and energy expenditure was calculated. Playing 9 or 18-holes of golf, independent of the golf course design, the average HR was not significantly different between sexes or the subgroups. The intensities were light with respect to the percentage of maximal HR and metabolic equivalents of task (METs). Total energy expenditure of all participants was not significantly different for hilly (834 ± 344 kcal) vs. flat courses (833 ± 295 kcal) whereas male players expended significantly greater energy than female players (926 ± 292 vs. 556 ± 180 kcal), but did not have significantly greater relative energy expenditure (2.8 ± 0.8 vs. 2.2 ± 0.7 METs). As a high volume physical activity, playing golf is suggested to yield health benefits. Since the intensity was well below recommended limits, golf may have health related benefits unrelated to the intensity level of the activity.

Governmental regulations for early retirement by means of energy expenditure cut offs

OBJECTIVES

Long-term heavy work impairs employees, and they may retire prematurely by law. We investigated the value of energy expenditure (EE) during work shifts as a means to define heavy workload.

METHODS

The study comprised 79 male [mean age 32.2 (standard deviation [SD] 7.5) years] and 33 female [33.5 (SD 11.2) years] employees in different occupations classified as "heavy work" (EE of 1400 and 2000 kcal for women and men, respectively). Cycle ergometry determined exercise performance. Gas exchange measures were performed during selected phases of work, and heart rate (HR) recordings were obtained for a complete work shift. EE was calculated from gas exchange measures.

RESULTS

Male and female subjects differed significantly for maximal power output (P(max)) [men=206.3 (SD 47.3) watts; women=149.6 (SD 36.1) watts] and maximal oxygen consumption (VO(2max)) [men=2.965 (SD 0.63) l/min; women= 1.958 (SD 0.50) l/min] in the cycle ergometer test. Shift HR (HR(Sh)) was found between 102 (SD 14) b/min [57.6 (SD 8.5) % HR(max)] and 99 (SD 10) b/min [55.5 (SD 5.9) % HR(max)] dependent on tasks and groups. Working EE was found between 1864 (SD 732) kcal and 1249 (SD 609) kcal for men and women, respectively, but approximately 60% of subjects were well below the legal limits.

CONCLUSIONS

The legal definition of heavy workload by mean working EE per 8-hour work shift applies to all investigated occupations; however, a substantial proportion of workers may not fulfill the criterion if applied individually. Alternative definitions of heavy workload in terms of absolute oxygen consumption or EE relative to cardiorespiratory fitness lead to similar classification results of the investigated occupations.

Special needs to prescribe exercise intensity for scientific studies

There is clear evidence regarding the health benefits of physical activity. These benefits follow a dose-response relationship with a particular respect to exercise intensity. Guidelines for exercise testing and prescription have been established to provide optimal standards for exercise training. A wide range of intensities is used to prescribe exercise, but this approach is limited. Usually percentages of maximal oxygen uptake (VO₂) or heart rate (HR) are applied to set exercise training intensity but this approach yields substantially variable metabolic and cardiocirculatory responses. Heterogeneous acute responses and training effects are explained by the nonuniform heart rate performance curve during incremental exercise which significantly alters the calculations of %HR_max and %HRR target HR data. Similar limitations hold true for using %VO_2max and %VO₂R. The solution of these shortcomings is to strictly apply objective submaximal markers such as thresholds or turn points and to tailor exercise training within defined regions.