High-intensity locomotor training during inpatient rehabilitation improves the discharge ambulation function of patients with stroke. A systematic review with meta-analysis

OBJECTIVE

To evaluate the evidence of high-intensity locomotor training on outcomes related to gait and balance for patients with stroke in inpatient rehabilitation.

METHODS

Four databases were searched (PubMed, CINAHL, Web of Science, and MedLINE) for articles published prior to 13 June 2023. Studies of adults (>18 years old) with a diagnosis of stroke who received a high-intensity locomotor intervention while admitted to an inpatient rehabilitation facility were included. A functional outcome in the domain of gait speed, gait endurance, or balance must have been reported. Following the screening of 1052 studies, 43 were selected for full-text review. Studies were assessed for risk of bias using the tool appropriate to the study type. Gait speed, gait endurance, and balance outcome data were extracted for further analysis.

RESULTS

Eight studies were selected with risk of bias ratings as moderate (4), high (2), and low (2). Six studies were analyzed in the meta-analysis (N = 635). A random-effects model analyzed between-group differences. Standard mean differences demonstrated that high-intensity locomotor training produces a moderate effect on gait endurance (0.50) and gait speed (0.41) and a negligible effect on balance (0.08) compared with usual care.

CONCLUSIONS

The meta-analysis supports the use of high-intensity locomotor training over usual care for improving gait speed and gait endurance during inpatient post-stroke. Future studies should investigate dose-response relationships of high-intensity locomotor training in this setting.

PROSPERO REGISTRATION

#CRD42022341329.

External training load and performance recovery after small-sided games in soccer: Insights for return-to-play management

The return-to-play process' characteristics can vary by injury and sport type but are typically composed of phases of different durations, training targets, and intensities that gradually increase the physiological and mechanical load. In team sports, contact drills are a necessary part of the last phases of this process, and they should be planned using the optimal mechanical load. The present study investigated the external load and kinetic recovery in U19 soccer players performing 6vs6 and 3vs3 small-sided games. A global positioning system (GPS) measured external load metrics. The rate of perceived exertion (RPE) was registered at the end. Total quality of recovery (TQR) was collected at the beginning of the training session and after 24 h. Moreover, before and after the small-sided games (SSGs) and at 24 h, delayed-onset muscle soreness (DOMS) of the legs, sprinting time, and vertical jump height (CMJ) were collected. 6vs6 presented higher values in total distance low-, moderate-, high, and very-high-speed distance, and maximum speed (p < 0.05). However, 3vs3 showed higher number of sprints, acceleration, and deceleration at different intensities. Furthermore, no difference was shown in RPE. The effect of fatigue on sprint seems greater for 6vs6, showing an impairment persistent at 24 h (p < 0.05). Moreover, CMJ height was impaired after 6vs6 and at 24 h (p < 0.05) but did not change after 3vs3 (p > 0.05). DOMS values after SSGs and at 24 h were higher than baseline for both conditions (p < 0.05), while TQR decreased at 24 h in both conditions (p < 0.05). Based on our results, it seems that 6vs6, leading to a greater high-speed running distance, might cause a training load that needs more time to recover. This point may be crucial in a return-to-play process, especially when hamstring muscles are involved.

Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial

BACKGROUND

Children with mobility disabilities, including those with cerebral palsy, have limited options and limited time to exercise to manage their cardiometabolic health and cardiorespiratory fitness. Regular cardiovascular exercise during childhood is a critical health behavior for preventing health decline in adulthood. Thus, there is an urgent need for accessible, age-appropriate, convenient exercise modalities in this group. Sprint-intensity interval training (SIT), combined with telehealth procedures, may be ideal for children with disabilities. SIT includes repetitive bouts of maximal exercise effort combined with rest periods, which can be effective in eliciting comparable results to moderate-exercise training with very short training durations.

OBJECTIVE

This phase 1 pilot feasibility randomized controlled trial aims to investigate the potential effects of a 12-week SIT program on indicators of cardiorespiratory fitness and cardiometabolic health among children with cerebral palsy. An ancillary aim is to evaluate the feasibility of the program through several process feasibility metrics.

METHODS

This study uses a 2-armed parallel group design. A total of 50 physically inactive children with cerebral palsy (aged 6-17 years) will be randomly allocated into 1 of 2 groups: a 12-week SIT or a waitlist control group that continues habitual activity for 12 weeks. The SIT prescription includes 3 tele-supervised sessions per week with 30 repeated sequences of 4 seconds of maximal arm exercise, with active recovery, warm-up, and cooldown periods (for an approximately 20-minute total session). SIT includes guided videos with child-themed arm routines and music. The exercise sessions will be remotely supervised through a web-based videoconference application and include safety monitoring equipment. Outcomes are measured at pre- and postintervention (weeks 0 and 13, respectively). Health outcome measures include peak oxygen consumption (VO2 peak), measured by a graded exercise test; high-sensitivity C-reactive protein and blood insulin, hemoglobin A1c, triglycerides, and cholesterol using a finger stick dried blood spot test; blood pressure, using a sphygmomanometer; and body composition (total mass, total lean mass, tissue % lean, and tissue % fat) using dual x-ray absorptiometry. Feasibility will be evaluated by the following metrics: adverse events or problems experienced throughout the intervention related to participant safety; perceived enjoyment; and recruitment, enrollment, and attrition rates.

RESULTS

Recruitment procedures started in November 2023. All data are anticipated to be collected by February 2025. Full trial results are anticipated to be analyzed and submitted for publication by March 2025. Secondary analyses of data will be subsequently published.

CONCLUSIONS

This trial tests an accessible and low-cost exercise program that leverages principles of high-intensity exercise to provide a convenient program for children with physical disabilities. Knowledge obtained from this study will inform the development of a larger trial for improving the cardiometabolic health, cardiorespiratory fitness, and well-being of children with physical disabilities.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05619211; https://clinicaltrials.gov/study/NCT05619211.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56499.

Feasibility of a new intervention addressing group-based balance and high-intensity training, physical activity, and employment in individuals with multiple sclerosis: a pilot randomized controlled trial

Background and purpose

Impaired sensorimotor function, reduced physical activity and unemployment are common challenges in persons with multiple sclerosis (pwMS), even when disability is low. CoreDISTparticipation is a new, multidisciplinary intervention delivered across healthcare levels systematically addressing these elements. This study primarily aimed to evaluate the feasibility of CoreDISTparticipation in terms of process, resources, management, and scientific outcomes. The secondary aim was to evaluate initial efficacy in terms of possible short-term effects compared with the usual care on barriers to employment, balance, walking, health-related quality of life (HRQoL), and physical activity.

Methods

This assessor-blinded prospective pilot randomized controlled trial included 29 pwMS [Expanded Disability Status Scale (EDSS): 0-3.5] randomly allocated to the intervention group (CoreDISTparticipation) (n = 15) or usual care (n = 14). CoreDISTparticipation consists of three phases: (1) hospital outpatient clinic: MS nurse work-focused session and physiotherapist exploring balance; (2) municipality: a digital meeting with pwMS, employer, MS nurse, and physiotherapist addressing employment and physical activity, 4 weeks indoor CoreDIST balance training (60 min × 2/week); and (3) 4 weeks outdoor CoreDIST balance training and high-intensity running/walking (60 min × 2/week). Assessments were undertaken at baseline and at weeks 6 and 11. Primary feasibility metric outcomes were the reporting of process, resources, management, and scientific outcomes. Efficacy measures included evaluation of the Multiple Sclerosis Work Difficulties Questionnaire-23 Norwegian Version (MSWDQ-23NV) and 6 Minute Walk-test as well as the Trunk Impairment Scale-modified Norwegian Version, Mini-Balance Evaluation Systems Test (Mini-BESTest), Multiple Sclerosis Walking Scale-12, Multiple Sclerosis Impact Scale-29 Norwegian Version (MSIS-29NV), ActiGraph wGT3x-BT monitors, and AccuGait Optimized force platform. The statistical analyses included repeated-measures mixed models performed in IBM SPSS Version 29.

Results

The primary feasibility metric outcomes demonstrated the need for minor adjustments in regard to the content of the intervention and increasing the number of staff. In regard to the efficacy measures, one person attended no postintervention assessments and was excluded, leaving 28 participants (mean EDSS: 1.8, SD: 1). The mean percentage employment was 46.3 (SD: 35.6) and 65.4 (SD: 39.3) in the CoreDISTparticipation and usual care group, respectively. No between-group differences were found. MSWDQ-23NV demonstrated a within-group difference of 5.7 points from baseline to Week 11 (P = 0.004; confidence interval: 2.2-9.3). Mini-BESTest and MSIS-29NV demonstrated within-group differences. The study is registered in ClinicalTrials.gov (Identifier: NCT05057338).

Discussion

The CoreDISTparticipation intervention is feasible to support pwMS when the identified feasibility metric outcomes in regard to process, resource, management, and scientific outcome metrics are adjusted to improve feasibility. Regarding efficacy measures, no between-group differences were detected; however, within-group differences in barriers to employment, balance, and HRQoL were detected for the CoreDISTparticipation group. A larger comparative trial is needed to explore between-group differences and should accurately and precisely define usual care and address the identified limitations of this study.

High-intensity drinking and hours spent drinking

BACKGROUND

High-intensity drinking (HID) is associated with negative consequences, but it remains unclear whether a time qualifier (i.e., time spent drinking) is needed to identify individuals at highest risk. To improve the measurement and conceptualization of HID, we examined the utility of adding a time qualifier to define what constitutes an occasion of HID using repeated daily surveys in a sample of young adults.

METHODS

Participants were selected from a nationally representative sample of 12th-grade students in the United States who participated in the Monitoring the Future (MTF) study in Spring 2018. In 2019 and 2020, young adults (at modal ages 19-20) responded to annual and daily (14 consecutive days per year) online surveys about their alcohol use.

RESULTS

When we compared moderate drinking days (less than 4/5 drinks for women/men), binge drinking days (4-7/5-9 drinks), and HID days (8+/10+ drinks), HID days had the longest duration of drinking (5.2 h), highest peak estimated blood alcohol concentration (eBAC, 0.30%), and greatest drinking pace (2.58 drinks/h). HID was associated with a greater number of negative consequences than either moderate or binge drinking; adjusting for time spent drinking did not impact this interpretation. HID was reported on 10.9% of days; when defined as 8/10+ drinks in 4 h or 2 h, HID was reported on 4.8% and 1.0% of days, respectively. Nearly all differences in eBAC and negative consequences persisted across drinking intensity despite the introduction of time constraints.

CONCLUSIONS

HID days were characterized by both a longer time spent drinking and a more rapid pace of drinking. Adding a time qualifier to the definition of HID would restrict variability by only describing the minority of days and does not improve the distinctions among levels of risk.

High-intensity home health physical therapy among older adult Veterans: A randomized controlled trial

BACKGROUND

Older adult Veterans are at high risk for adverse health outcomes following hospitalization. Since physical function is one of the largest potentially modifiable risk factors for adverse health outcomes, our purpose was to determine if progressive, high-intensity resistance training in home health physical therapy (PT) improves physical function in Veterans more than standardized home health PT and to determine if the high-intensity program was comparably safe, defined as having a similar number of adverse events.

METHODS

We enrolled Veterans and their spouses during an acute hospitalization who were recommended to receive home health care on discharge because of physical deconditioning. We excluded individuals who had contraindications to high-intensity resistance training. A total of 150 participants were randomized 1:1 to either (1) a progressive, high-intensity (PHIT) PT intervention or (2) a standardized PT intervention (comparison group). All participants in both groups were assigned to receive 12 visits (3 visits/week over 30 days) in their home. The primary outcome was gait speed at 60 days. Secondary outcomes included adverse events (rehospitalizations, emergency department visits, falls and deaths after 30 and 60-days), gait speed, Modified Physical Performance Test, Timed Up-and-Go, Short Physical Performance Battery, muscle strength, Life-Space Mobility assessment, Veterans RAND 12-item Health Survey, Saint Louis University Mental Status exam, and step counts at 30, 60, 90, 180 days post-randomization.

RESULTS

There were no differences between groups in gait speed at 60 days, and no significant differences in adverse events between groups at either time point. Similarly, physical performance measures and patient reported outcomes were not different at any time point. Notably, participants in both groups experienced increases in gait speed that met or exceeded established clinically important thresholds.

CONCLUSIONS

Among older adult Veterans with hospital-associated deconditioning and multimorbidity, high-intensity home health PT was safe and effective in improving physical function, but not found to be more effective than a standardized PT program.

Positional Differences in Absolute vs. Relative Training Loads in Elite Academy Soccer Players

Weekly training loads are typically reported using absolute values and are not individualized according to competition positional demands (relative values). The aim of this study was to evaluate absolute and relative training loads and compare across playing positions during a full in-season in an elite soccer academy. 24 elite academy soccer players, categorized into five positions (CD: central defender [n = 4]; FB: full back [n = 5]; CM: central midfielder [n = 6]; WM: wide midfielder [n = 5]; FW: forward [n = 4]), were monitored using a global positioning system. Absolute training load was calculated using the total distance, the distance at moderate-speed ([15-20[ km·h-1), high-speed ([20-25[ km·h-1), sprint (> 25 km·h-1), the total number of accelerations (> 3 m·s-2) and decelerations (< -3 m·s-2). Relative training load was calculated by dividing absolute training loads by mean values from the competitive matches. Training loads were determined daily according to their distance from match day (MD). One-way ANOVAs were performed to evaluate differences between playing positions. Absolute moderate-speed distance was greater for WM compared to CD (p = 0.015, and p = 0.017), while the opposite was shown for relative values (p = 0.014, and p < 0.001) on MD-4 and MD-3, respectively. The absolute moderate-speed distance was not different between CD, FB, CM, and FW, whereas relative values were greater for CD on MD+2 and MD-4 (p < 0.05). FB and WM performed greater absolute high-speed distance than CD on MD-4 and MD-3 (p < 0.05) while no difference was highlighted for relative values.Our results demonstrated that in the present academy players, training load for CD was underestimated using absolute training loads for moderate and high-speed distances. In contrast, relative training loads highlighted WM as an underloaded position. Therefore, relative training loads are recommended as they contextualize training loads according to competitive demands and favor training individualization.

Evidence of High-Intensity Exercise on Lower Limb Functional Outcomes and Safety in Acute and Subacute Stroke Population: A Systematic Review

This systematic review investigated the effects of high-intensity exercise (HIE) on lower limb (LL) function in acute and subacute stroke patients. A systematic electronic search was performed in PubMed, CINAHL and the Web of Science from inception to 30 June 2022. Outcomes examined included LL function and measures of activities of daily living such as the Barthel index, 6 min walk test (6MWT), gait speed and Berg balance scale (BBS), adverse events and safety outcomes. The methodological quality and the quality of evidence for each study was assessed using the PEDro scale and the Risk of Bias 2 tool (RoB 2). HIE was defined as achieving at least 60% of the heart rate reserve (HRR) or VO₂ peak, 70% of maximal heart rate (HR_max), or attaining a score of 14 or more on the rate of perceived exertion Borg scale (6-20 rating scale). This study included randomized controlled trials (RCTs) which compared an intervention group of HIE to a control group of lower intensity exercise, or no intervention. All participants were in the acute (0-3 months) and subacute (3-6 months) stages of stroke recovery. Studies were excluded if they were not RCTs, included participants from a different stage of stroke recovery, or if the intervention did not meet the pre-defined HIE criteria. Overall, seven studies were included that used either high-intensity treadmill walking, stepping, cycling or overground walking exercises compared to either a low-intensity exercise (n = 4) or passive control condition (n = 3). Three studies reported significant improvements in 6MWT and gait speed performance, while only one showed improved BBS scores. No major adverse events were reported, although minor incidents were reported in only one study. This systematic review showed that HIE improved LL functional task performance, namely the 6MWT and gait speed. Previously, there was limited research demonstrating the efficacy of HIE early after stroke. This systematic review provides evidence that HIE may improve LL function with no significant adverse events report for stroke patients in their acute and subacute rehabilitation stages. Hence, HIE should be considered for implementation in this population, taking into account the possible benefits in terms of functional outcomes, as compared to lower intensity interventions.

Acute Effects of High-Intensity Functional Training and Moderate-Intensity Continuous Training on Cognitive Functions in Young Adults

BACKGROUND

The purpose of the present study was to compare the influence of an acute bout of high-intensity functional training (HIFT) with an acute bout of moderate-intensity continuous training (MICT) on measures of cognitive function.

METHODS

Sixty-nine young adults (Mean ± SD: age = 21.01 ± 2.79 yrs; body mass = 69.65 ± 6.62 kg; height = 1.74 ± 0.05 m; Body Mass Index = 22.8 ± 1.41) gave informed consent and were randomly divided into three groups. The HIFT group, with 27 participants, performed a high-intensity (>85% Max. HR) circuit of functional exercises for 30 min. The MICT group, with 28 participants, performed moderate-intensity (70-80% Max. HR) continuous training on a cyclo-ergometer. The control group did not perform any activity. The Stroop Test, Word Recall and N-Back Test were completed to assess during the familiarization period, immediately before and immediately after the training's bouts.

RESULTS

The repeated measures ANOVA did not show significant mean differences for any group. However, the T-Test for the paired samples demonstrated very significant differences in the Stroop Test, in terms of fastest response time (FRT; mean difference (MD) = -1.14, p < 0.01, d = 0.9), mean response time (MRT; MD = -2.16, p < 0.01, d = 0.66) and the number of correct answers (NCA; MD = 1.08, p < 0.05, d = 0.5) in the HIFT group and in the MICT group (FRT; MD = -1.79, p < 0.01, d = 0.9), (MRT; MD = -3.07, p < 0.01, d = 0.9) (NCA; MD = 1.54, p < 0.05, d = 0.5).

CONCLUSIONS

There were no differences in the control group. HIFT and MICT may elicit specific influences on cognitive function, mainly in executive function and selective attention.

Physical Demands during the Game and Compensatory Training Session (MD + 1) in Elite Football Players Using Global Positioning System Device

The aims of this study were to analyze the differences of physical demands of non-starter players regarding the playing time during the competition and to evaluate the physical demands of the compensatory training (MD + 1C) for substitute players in elite football. The match statistics and MD + 1C of substitute players from a professional Spanish LaLiga football club were analyzed using a 10-Hz global positioning system (GPS) Apex GPS system device, which has been validated as a reliable and valid method to analyze performance in team sports, during all games of the 2016/2017, 2017/2018 and 2018/2019 seasons. The starting players showed both lower total distances covered and high-intensity actions compared to the substitutes. Regarding the minutes played by the substitutes, greater physical performance was found for the players with fewer minutes (5−15 min). Furthermore, no differences were found between first and second divisions regarding physical performance of substitutes (p > 0.05). This study highlights the importance of individualizing the workload of training sessions for substitutes and starters. Furthermore, the complementary session should be individualized according to the minutes played by the substitutes. These players are potentially under-loaded compared to starters, especially in terms of high-intensity actions, therefore additional session-specific training for each substitute would be useful to reach the optimal training load according to the minutes played during the game.

Warm-Up Intensity and Time-Course Effects on Jump Height under Cold Conditions

With this study, we aimed to investigate the effects of different warm-up intensities on counter-movement jump (CMJ) performance over time under cold conditions. Eleven male collegiate athletes volunteered. The participants performed high-intensity warm-up (HWU) at 80% VO2max and moderate-intensity warm-up (MWU) at 60% VO2max for 15 min on a bicycle ergometer in a laboratory room at 10 °C. CMJ height, vastus lateralis muscle temperature, heart rate, and perceived fatigue were measured before warm-up (Pre), immediately after (Post 0), 10 min after (Post 10), and 20 min after (Post 20). Significant main effects and interactions were found for CMJ height (time, p < 0.001 and ηp2 = 0.859; interaction, p = 0.007 and ηp2 = 0.327). HWU significantly increased CMJ height at Post 0 to Post 20 compared to that at Pre (p < 0.01), whereas MWU increased CMJ height at Post 0 only compared to that at Pre (p < 0.001). The results indicate that HWU achieved an increase in CMJ height for 20 min. MWU changed CMJ height instantly, but the change did not last compared to HWU in a cold environment.

Quantifying the immediate response of the soil microbial community to different grazing intensities on irrigated pastures

Grazing is known to affect soil microbial communities, nutrient cycling, and forage quantity and quality over time. However, a paucity of information exists for the immediate changes in the soil physicochemical and microbial environment in response to different grazing strategies. Soil microbes drive nutrient cycling and are involved in plant-soil-microbe relationships, making them potentially vulnerable to plant-driven changes in the soil environment caused by grazing. To test the hypothesis that variable grazing intensities modulate immediate effects on the soil microbial community, we conducted a grazing trial of three management approaches; high-intensity, short-duration grazing (HDG), low-intensity, medium-duration grazing (LDG), and no grazing (NG). Soil and vegetation samples were collected before grazing and 24 hours, 1 week, and 4 weeks after HDG grazing ended. Soil labile carbon (C) and nitrogen (N) pools, vegetation biomass, and soil microbial diversity and functional traits were determined, including extracellular enzymatic assays and high-throughput sequencing of the bacterial 16S rRNA and fungal ITS2 regions. We found that labile soil C and inorganic N increased following the LDG grazing while C-cycling extracellular enzymatic activities increased in response to HDG grazing but both total extracellular enzymatic activity profiles and soil abiotic profiles were mostly affected by temporal fluxes. The soil fungal community composition was strongly affected by the interaction of sampling time and grazing treatment, while the soil bacterial community composition was largely affected by sampling time with a lesser impact from grazing treatment. We identified several key fungal taxa that may influence immediate responses to grazing and modulate plant-soil-microbe interactions. There was strong evidence of temporal influences on soil biogeochemical variables and the soil microbiome, even within our narrow sampling scheme. Our results indicate that the soil ecosystem is dynamic and responsive to different grazing strategies within very short time scales, showing the need for further research to understand plant-soil-microbe interactions and how these feedback mechanisms can inform sustainable land management.

Physiological role of anticipatory cardiorespiratory responses to exercise

This study aimed to investigate whether anticipatory cardiorespiratory responses vary depending on the intensity of the subsequent exercise bout, and whether anticipatory cardiorespiratory adjustments contribute importantly to enhancing exercise performance during high-intensity exercise. Eleven healthy men were provided advance notice of the exercise intensity and a countdown to generate anticipation during 10 min prior to exercise at 0, 50, 80 or 95% maximal work-rate (Experiment 1). A different group of subjects (n = 15) performed a time to exhaustion trial with or without anticipatory countdown (Experiment 2). In Experiment 1, heart rate (HR), oxygen uptake (V_O2 ) and minute ventilation (V_E ) during pre-exercise resting period increased over time and depended on the subsequent exercise intensity. Specifically, there was already a 7.4% increase in HR from more than 5 min prior to the start of exercise at 95% maximal work-rate, followed by progressively augmented increases of 12.5% between 2 and 3 min before exercise, 24.4% between 0 and 1 min before exercise. In Experiment 2, the initial HR for the first 10 s of exercise in the task with anticipation was 11.4% larger compared to without anticipation (p < 0.01), and the difference in HR between the two conditions decreased in a time-dependent manner. In contrast, the initial increases in V_O2 and V_E were significantly lower in the task with anticipation than that without anticipation. The time to exhaustion during high-intensity exercise was 14.6% longer under anticipation condition compared to no anticipation (135 ± 26 s vs. 119 ± 26 s, p = 0.003). In addition, the enhanced exercise performance correlated positively with increased HR response just before and immediately after exercise onset (p < 0.01). These results showed that anticipatory cardiorespiratory adjustments (feedforward control) via the higher brain that operate before starting exercise may play an important role in minimizing the time delay of circulatory response and enhancing performance after onset of high-intensity exercise in man.

Changes in Body Composition and Strength after 12 Weeks of High-Intensity Functional Training with Two Different Loads in Physically Active Men and Women: A Randomized Controlled Study

This study examined the effects of two different resistance loads during high-intensity Functional Training (HIFT) on body composition and maximal strength. Thirty-one healthy young individuals were randomly assigned into three groups: moderate load (ML: 70% 1-RM), low load-(LL: 30% 1-RM), and control (CON). Each experimental group performed HIFT three times per week for 12 weeks with a similar total volume load. Body fat decreased equally in both experimental groups after 6 weeks of training (p < 0.001), but at the end of training it further decreased only in LL compared to ML (−3.19 ± 1.59 vs. −1.64 ± 1.44 kg, p < 0.001), with no change in CON (0.29 ± 1.08 kg, p = 0.998). Lean body mass (LBM) increased after 6 weeks of training (p = 0.019) in ML only, while after 12 weeks a similar increase was observed in LL and ML (1.11 ± 0.65 vs. ML: 1.25 ± 1.59 kg, p = 0.034 and 0.013, respectively), with no change in CON (0.34 ± 0.67 kg, p = 0.991). Maximal strength increased similarly in four out of five exercises for both experimental groups by between 9.5% and 16.9% (p < 0.01) at the end of training, with no change in CON (−0.6 to 4.9%, p > 0.465). In conclusion, twelve weeks of HIFT training with either low or moderate resistance and equal volume load resulted in an equal increase in LBM and maximal strength, but different fat loss.

The Effects of Exercise Order on the Psychophysiological Responses, Physical and Technical Performances of Young Soccer Players: Combined Small-Sided Games and High-Intensity Interval Training

This study aimed to compare the order effects of combined small-sided games (SSGs) and high-intensity interval training (HIIT) on the psychophysiological responses and physical and technical performances of young soccer players. Twenty-four soccer players (aged 14.63 ± 0.71 years) were randomly divided into SSGs + HIIT (n = 12) and HIIT + SSGs (n = 12) for 6 weeks. The SSGs consisted of two 4-16 min rounds of 2, 3, and four-a-side games with 2 min of passive resting, whereas the HIIT consisted of 6-10 min of high-intensity runs at varying intensities (from 90 to 100%). Pre-test and post-test elements included a 5-30 m sprint test, countermovement jump test, zigzag agility test with the ball and without the ball, repeated sprint ability test, speed dribbling ability test, three-corner run test, and Yo-Yo Intermittent Recovery Test level 1. Both combined training interventions produced similar improvements in physical performance and technical responses (p ≥ 0.05, d values ranging from 0.40 to 1.10). However, the combined HIIT + SSGs training produced meaningfully lower perceived exertion (p = 0.00, d = 2.98) and greater physical enjoyment (p = 0.00, d = 4.28) compared with the SSGs + HIIT intervention. Furthermore, the SSGs + HIIT group showed a higher training load than those from the HIIT + SSGs group for all weeks (p ≤ 0.05, d values ranging from 1.36 to 2.05). The present study's results might be used by coaches and practitioners to design training programmes for youth soccer players.

Effect of Differing Durations of High-Intensity Intermittent Activity on Cognitive Function in Adolescents

Exercise duration may influence the acute effects on cognition. However, only one study to date has explored the dose-response relationship between exercise duration and cognition in adolescents. Thus, the purpose of this study was to investigate the effect of differing durations of high-intensity intermittent running on cognition in adolescents. Thirty-eight adolescents (23 girls) completed three trials separated by 7 d: 30 min exercise, 60 min exercise, and rest; in a randomised crossover design. The exercise was a modified version of the Loughborough Intermittent Shuttle Test (LIST), which elicited high-intensity intermittent exercise. Cognitive function tests (Stroop test, Sternberg paradigm, Flanker task) were completed 30 min pre, immediately post, and 45 min post exercise. Response times on the incongruent level of the Flanker task improved to a greater extent 45 min following the 30 min LIST, compared to rest (p = 0.009). Moreover, response times improved to a greater extent on the three-item level of Sternberg paradigm 45 min following the 30 min LIST, compared to the 60 min LIST (p = 0.002) and rest (p = 0.013), as well as on the five-item level 45 min following the 30 min LIST, compared to the 60 min LIST (p = 0.002). In conclusion, acute exercise enhanced subsequent cognition in adolescents, but overall, 30 min of high-intensity intermittent running is more favourable to adolescents' cognition, compared to 60 min.

Process Evaluation of Project FFAB (Fun Fast Activity Blasts): A Multi-Activity School-Based High-Intensity Interval Training Intervention

Introduction: Over the last decade, research into the impact of school-based high-intensity interval training (HIIT) on young people's health has markedly increased. Despite this, most authors have focused on the outcomes of their intervention, rather than the process of how the study was conducted. The aim of our study, therefore, was to conduct a mixed methods process evaluation of Project FFAB (Fun Fast Activity Blasts), a school-based HIIT intervention for adolescents. The objectives were to explore study recruitment, reach, intervention dose, fidelity, participants' experiences, context, and future implementation.

Methods: Recruitment was assessed by comparing the number of students who received study information, to those who provided consent. Reach was described as the number of participants who completed the intervention. Dose was reported via the number of HIIT sessions delivered, total exercise time commitment, HIIT exercise time, and session attendance. Post-intervention focus groups were conducted with intervention participants (n = 33; aged 14.1 ± 0.3 years; mean ± standard deviation). These discussions explored aspects of intervention fidelity (extent that the intervention was delivered as intended); participants' experiences of the HIIT sessions; context (exploration of the nuances of school-based HIIT); and ideas for future implementation.

Results: Recruitment, reach, and dose data indicate that Project FFAB was largely delivered as planned. Focus group data identified a mismatch between perceived vs. prescribed work: rest ratio for the multi-activity HIIT drills. Generally, the HIIT drills were well-received; participants often reported they were fun to complete, and the use of heart rate monitors was helpful for interpreting exercise intensity. Some participants stated that greater variety in the HIIT drills would be preferable. The timing and structure of the HIIT sessions that took place outside of physical education lessons received mixed responses.

Conclusion: Collectively, our study supports the use of school-based HIIT and provides valuable insights into how such interventions can be implemented. Project FFAB could be modified to account for individuals' preferences on when the exercise sessions took place. In addition, a wider range of activities could be included, and the prescribed work: rest ratio of the HIIT drills could be better communicated.

High-intensity exercise in hypoxia improves endothelial function via increased nitric oxide bioavailability in C57BL/6 mice

Aim

The optimal exercise intensity to improve endothelial function remains unclear, as well as whether the addition of hypoxia could potentiate this function. Therefore, the aim of this study was to compare the effects of different exercise intensities in normoxia and hypoxia on vascular reactivity and nitric oxide (NO) bioavailability in mice.

Methods

C57BL/6 mice underwent treadmill running three times per week, for 4 weeks at either low, maximal or supramaximal intensity in normoxia or hypoxia (inspire oxygen fraction = 0.13). Vascular reactivity and expression of genes and proteins involved in NO production/bioavailability were assessed in aorta using isolated vessel tension experiments, RT‐qPCR and western blot, respectively. Circulating NO metabolites and pro‐/antioxidant markers were measured.

Results

Hypoxic exercise improved both acetylcholine‐induced vasorelaxation and phenylephrine‐induced vasoconstriction compared to normoxic exercise, independently of intensity. In hypoxia, a higher acetylcholine‐induced vasorelaxation was observed with high intensities (supramaximal and maximal) compared to low intensity. Exercise protocols modulated endothelial nitric oxide synthase (eNOS) and α1‐adrenergic receptor (α₁‐AR) mRNA level, but not superoxide dismutase 3 (SOD3) and p47phox. No significant differences were observed for protein expression of α₁‐AR, total eNOS, phosphorylated eNOS, SOD isoforms and p47phox. However, plasma SOD and catalase activities were significantly increased in hypoxic supramaximal compared to hypoxic low intensity, while concentration of nitrotyrosine significantly decreased. The latter was also observed in hypoxic maximal and supramaximal compared to the same intensities in normoxia.

Conclusion

Hypoxic high‐intensity exercise increases NO bioavailability and improves vascular function, opening promising clinical perspectives for cardiovascular disease prevention.

HIIT'ing or MISS'ing the Optimal Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of High- Versus Moderate-Intensity Exercise Prescription

Introduction: Polycystic Ovary syndrome (PCOS) is a metabolic disorder associated with increased cardiovascular disease risk. Exercise is an effective treatment strategy to manage symptoms and reduce long-term health risk. High-intensity interval training (HIIT) has been suggested as a more efficient exercise mode in PCOS; however, it is not clear whether HIIT is superior to moderate intensity steady state exercise (MISS).

Methods: We synthesized available data through a systematic review and meta-analysis to compare the effectiveness of isolated HIIT and MISS exercise interventions. Our primary outcome measures were cardiorespiratory fitness and insulin resistance, measured using V˙O_2max and HOMA-IR respectively.

Results: A total of 16 studies were included. Moderate-quality evidence from 16 studies identified significant improvements in V˙O_2max following MISS (Δ = 1.081 ml/kg/min, p < 0.001, n = 194), but not HIIT (Δ = 0.641 ml/kg/min, p = 0.128, n = 28). Neither HIIT nor MISS improved HOMA-IR [(Δ = −0.257, p = 0.374, n = 60) and (Δ = −0.341, p = 0.078, n = 159), respectively].

Discussion: A significant improvement in V˙O_2max was evident following MISS, but not HIIT exercise in women with PCOS. This contrasts with previous literature in healthy and clinical cohorts that report superior benefits of HIIT. Therefore, based on available moderate-quality evidence, HIIT exercise does not provide superior outcomes in V˙O_2max compared with MISS, although larger high-quality interventions are needed to fully address this. Additional dietary/pharmacological interventions may be required in conjunction with exercise to improve insulin sensitivity.

Boxing vs Sensory Exercise for Parkinson's Disease: A Double-Blinded Randomized Controlled Trial

Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson's disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson's Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.

Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review

BACKGROUND

Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited.

OBJECTIVE

To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI.

METHODS

The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury.

RESULTS

The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings.

CONCLUSION

The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.

Long-Term Domiciliary Noninvasive Ventilation for COPD

COPD can lead to abnormalities in oxygenation as well as ventilation. Thanks to pioneering work by Dr Thomas Petty, supplemental oxygen therapy has been shown to improve morbidity and mortality for individuals with COPD and severe daytime hypoxemia. However, efforts to augment ventilation have been less uniformly successful. Recent studies employing a so-called high-intensity noninvasive ventilation strategy, which used high inspiratory pressures and backup breathing frequency to reduce arterial carbon dioxide levels, have shown improved quality of life and reduced mortality. Thus, efforts are underway to better identify and treat patients with COPD who might benefit from noninvasive ventilation, though many practical questions remain.

The dose-response relationship between interval-training and VO2max in well-trained endurance runners: A systematic review

Success in endurance running is primarily determined by maximal aerobic power (VO_2max), fractional utilization, and running economy (RE). Within the literature, two training modalities have been identified to improve VO_2max; continuous training (CT) and interval-training (IT). The efficacy of IT to improve VO_2max in well-trained runners remains equivocal, as does whether a dose-response relationship exists between the IT training load performed and changes in VO_2max. A keyword search was performed in five electronic databases. Seven studies met the inclusion criteria for this systematic review. The training impulse (TRIMP) was calculated to analyse relationships between training load and changes in VO_2max, by calculating the time accumulated in certain intensity domains throughout a training intervention. Non-significant (P>0.05) improvements in VO_2max were reported in six studies, with only one study reporting a significant (P<0.05) improvement following the IT interventions. A relationship between the training session impulse of the interval-training performed (IT S_TRIMP) and VO_2max improvements were observed. The efficacy of IT to improve VO_2max in well-trained runners remains equivocal, nevertheless, the novel method of training-load analysis demonstrates a relationship between the IT S_TRIMP and VO_2max improvements. This provides practical application for the periodization of IT within the training regime of well-trained distance runners.

Low and High-Intensity Ultrasound in Dairy Products: Applications and Effects on Physicochemical and Microbiological Quality

Milk and dairy products have a major role in human nutrition, as they contribute essential nutrients for child development. The nutritional properties of dairy products are maintained despite applying traditional processing techniques. Nowadays, so-called emerging technologies have also been implemented for food manufacture and preservation purposes. Low- and high-intensity ultrasounds are among these technologies. Low-intensity ultrasounds have been used to determine, analyze and characterize the physical characteristics of foods, while high-intensity ultrasounds are applied to accelerate particular biological, physical and chemical processes during food product handling and transformation. The objective of this review is to explain the phenomenology of ultrasounds and to detail the differences between low and high-intensity ultrasounds, as well as to present the advantages and disadvantages of each one in terms of the processing, quality and preservation of milk and dairy products. Additionally, it reviews the rheological, physicochemical and microbiological applications in dairy products, such as raw milk, cream, yogurt, butter, ice cream and cheese. Finally, it explains some methodologies for the generation of emulsions, homogenates, crystallization, etc. Currently, low and high-intensity ultrasounds are an active field of study, and they might be promising tools in the dairy industry.

Acute Physiological Responses to Ultra Short Race-Pace Training in Competitive Swimmers

Ultra Short Race Pace training (USRPT) is an emerging training modality devised in 2011 to deviate from high-volume swimming training that is typically prescribed. USRPT aims to replicate the exact demands of racing, through its unique prescription of race-pace velocity sets with short rest intervals. It has been surmised, with little physiological evidence, that USRPT provides swimmers with the best opportunity to optimize the conditioning, technique, and psychology aspects of racing at the most specific velocity of the relevant event, with low blood lactate concentration. The aim of this study was to examine acute physiological responses of USRPT. Fourteen swimmers were recruited to perform a USRPT set: 20 x 25 m freestyle with a 35-s rest interval. Swimmers were required to maintain the velocity of their 100 m personal best time for each sprint. Sprint performance, blood lactate, heart rate and the RPE were measured. Blood lactate was taken before, during (after every 4 sprints) and 3 minutes after the USRPT protocol. Heart rate monitors were used to profile the heart rate. Athletes reported the RPE before- and after completion of the USRPT set. Sprint times increased by 3.3-10.8% when compared to the first sprint (p < 0.01). There was high blood lactate concentration (13.6 ± 3.1mmol/l), a significant change in the RPE from 8 ± 1.6 to 18 ± 1.6 (p < 0.01) and a substantially high heart rate profile with an average HR_max of 188 ± 9 BPM. The results show the maximal intensity nature of USRPT and portray it as an anaerobic style of training.

Integrating high-intensity interval training into the workplace: The Work-HIIT pilot RCT

The purpose of this study was to assess the feasibility and preliminary efficacy of a high-intensity interval training (HIIT) intervention integrated into the workplace on physical and mental health outcomes in a sample of adults. The Work-HIIT intervention was evaluated at the University of Newcastle (March-July 2019). University employees (18+ years) who self-identified as predominantly sedentary at work (n = 47, 43.0 ± 10.7 years; 41 female) were recruited, screened, and randomized after baseline assessments into Work-HIIT (n = 24) or wait-list control (n = 23) conditions. Participants were asked to attend 2-3 researcher-facilitated HIIT sessions/week (weeks 1-8). Sessions included a 2-minute gross-motor warm-up, followed by various combinations of aerobic and muscular fitness exercises lasting 8 minutes (using 30:30 second work: rest intervals). Program feasibility was assessed using measures of satisfaction, compliance, adherence, fidelity, and retention. Physiological and psychological outcomes were measured at baseline and 9 weeks. Feasibility data were investigated using descriptive statistics and efficacy outcomes determined using linear mixed models and Cohen's d effect sizes. Participant ratings showed high levels of satisfaction (4.6/5); 71% of participants attended ≥2 sessions/wk and averaged 85.9% HR_max across all sessions (including rest and work intervals). Small-to-medium positive effects resulted for cardiorespiratory fitness [+2.9 laps, 95% CI (-4.19-10.14); d = 0.34] and work productivity [+0.26, d = 0.47]. Large positive effects resulted for muscular fitness [push-ups +3.5, d = 0.95; standing jump +10.1 cm, d = 1.12]; HIIT self-efficacy [+16.53, d = 1.57]; sleep [weekday +0.76 hours, d = 1.05]; and autonomous motivation [+0.23, d = 0.76]. This study supports the feasibility and preliminary efficacy of facilitator-led Work-HIIT as a time-efficient, enjoyable, and convenient workplace exercise option for adults.

Prevalence of Injuries in Exercise Programs Based on Crossfit®, Cross Training and High-Intensity Functional Training Methodologies: A Systematic Review

Current literature shows studies that question the safety of the practices carried out in high-intensity training modalities such as CrossFit®, Cross Training or High-Intensity Functional Training, which may lead to a greater risk in the prevalence of injuries. The aim of this study was to analyze in detail the prevalence of injuries occurring in training based on the CrossFit®, Cross Training or High-Intensity Functional Training modalities, through a systematic review, as well as evaluating the methodological quality of the included studies. We used the recommendations of the PRISMA protocol. For the quality analysis of the studies, we applied the tool proposed by the National Institute of Health (United States). The areas that mainly present a higher risk of injury during CrossFit, Cross Training or High-Intensity Functional Training practices are shoulders, knees and back. Additionally, 11 of the 12 included studies displayed a poor methodological quality according to the quality tool used.

Heart rate and stroke rate misrepresent supramaximal sprint kayak training as quantified by power

This study examined the utility of novel measures of power output (PO) compared to traditional measures of heart rate (HR) and stroke rate (SR) for quantifying high-intensity sprint kayak training. Twelve well-trained, male and female sprint kayakers (21.3 ± 6.8 y) completed an on-water graded exercise test (GXT) and a 200-, 500- and 1000-m time-trial for the delineation of individualised training zones (T) for HR (5-zone model, T1-T5), SR and PO (8-zone model, T1-T8). Subsequently, athletes completed two repeat trials of a high-intensity interval (HIIT) and a sprint interval (SIT) training session, where intensity was prescribed using individualised PO-zones. Time-in-zone (minutes) using PO, SR and HR was then compared for both HIIT and SIT. Compared to PO, time-in-zone using HR was higher for T1 in HIIT and SIT (P < 0.001, d ≥ 0.90) and lower for T5 in HIIT (P < 0.001, d = 1.76). Average and peak HR were not different between HIIT (160 ± 9 and 173 ± 11 bpm, respectively) and SIT (157 ± 13 and 174 ± 10 bpm, respectively) (P ≥ 0.274). In HIIT, time-in-zone using SR was higher for T4 (P < 0.001, d = 0.85) and was lower for T5 (P = 0.005, d = 0.43) and T6 (P < 0.001, d = 0.94) compared to PO. In SIT, time-in-zone using SR was lower for T7 (P = 0.001, d = 0.66) and was higher for T8 (P = 0.004, d = 0.70), compared to PO. Heart rate measures were unable to differentiate training demands across different high-intensity sessions, and could therefore misrepresent the training load in such instances. Furthermore, SR may not provide a sensitive measure for detecting changes in intensity due to fatigue, whereas PO may be more suitable.

Acute Effects of a Static Vs. a Dynamic Stretching Warm-up on Repeated-Sprint Performance in Female Handball Players

This randomized cross-over study examined the effects of typical static and dynamic stretching warm-up protocols on repeated-sprint performance. Thirteen young female handball players performed a 5 min aerobic warm-up followed by one of three stretching protocols for the lower limbs: (1) static stretching, (2) dynamic-ballistic stretching, and (3) no stretching before performing five all-out sprints on a cycle ergometer. Each protocol was performed on a different occasion, separated by 2-3 days. Range of movement (ROM) was also measured before and after the warm-up protocols with a sit-and-reach test. Fixed and random effects of each stretching protocol on repeated sprint performance were estimated with mixed linear modeling and data were evaluated via standardization and magnitude-based inferences. In comparison to no stretching, there were small increases in ROM after dynamic stretching (12.7%, ±0.7%; mean, ±90% confidence limits) and static stretching (19.2%, ±0.9%). There were small increases in the average power across all sprints with dynamic stretching relative to static stretching (3.3%, ±2.4%) and no stretching (3.0%, ±2.4%) and trivial to small increases in the average power in the 1st and 5th trials with dynamic stretching compared to static stretching (3.9%, ±2.6%; 2.6%, ±2.6%, respectively) and no stretching (2.0%, ±2.7%; 4.1%, ±2.8%, respectively). There were also trivial and small decreases in power across all sprints with static relative to dynamic stretching (-1.3%, ±2.8%) and no stretching (-3.5%, ±2.9%). Dynamic stretching improved repeated-sprint performance to a greater extent than static stretching and no stretching.

Cardioprotective effects of high-intensity interval training are mediated through microRNA regulation of mitochondrial and oxidative stress pathways

Human studies have shown high-intensity interval training (HIIT) has beneficial cardiovascular effects and is typically more time-efficient compared with traditional endurance exercise. The main goal of this study is to show the potential molecular and functional cardiovascular benefits of HIIT compared with endurance training (ET). Three groups of mice were used including sedentary-control, ET mice, and HIIT mice groups. Results indicated ejection fraction was increased in HIIT compared with ET while fractional shortening was increased in the HIIT group compared with both groups. Blood flow of the abdominal aorta was increased in both exercise groups compared with control. Increases in cross-sectional area and mitochondrial and antioxidative markers in HIIT compared with control were observed, along with several microRNAs. These findings indicate HIIT has specific cardiac-protective effects and may be a viable alternative to traditional ET as a cardiovascular preventative medicine intervention.

Heart rate variability mediates motivation and fatigue throughout a high-intensity exercise program

High-intensity exercise interventions are often promoted as a time-efficient public health intervention to combat chronic disease. However, increased physical effort and subsequent fatigue can be barriers to long-term maintenance of high-intensity exercise programs. The purpose of the present study was to determine if heart rate variability (HRV) mediated state traits related to exercise program adherence. Fifty-five healthy men and women (ages 19-35 years) used a commercially available smartphone application to monitor daily HRV status throughout a 6-week high-intensity exercise intervention. Participants reported state motivation to exercise and global physical fatigue immediately prior to each exercise session. Temporary shifts toward increased parasympathetic reactivation (p = 0.030) resulted in significant increases in daily fatigue (p < 0.001) and decreases in motivation to exercise (p = 0.028). Through modulation of exercise volume, in response to these temporary shifts in HRV, these effects were reversed (p < 0.001) via increased parasympathetic withdrawal (p = 0.018). For the first time, these data demonstrate a mediating effect of HRV on adherence-related trait states throughout a high-intensity exercise program. Applied strategies, such as appropriately timed exercise volume moderation, may be able to leverage this effect and help facilitate long-term exercise program maintenance. Novelty These data establish a link between expected shifts in HRV throughout high-intensity exercise programs with motivation to participate and physical fatigue. Modulation of training volume, in response to these shifts, can optimize adherence-related behavioral responses during high-exercise programs.

Montmorency cherry supplement does not affect aerobic exercise performance in healthy men

Aim: To determine the effects of short-term Montmorency cherry (MC) supplementation upon exercise performance, total blood nitrate levels, muscle oxygenation, and slow-component [Formula: see text]O₂ kinetics. Methods: Twelve healthy male participants ingested a MC or placebo (PL) supplement in a randomized cross-over fashion over a six day period then cycled at a power output achieved at 70% of [Formula: see text]O₂ peak for a maximum of 30 minutes or until exhaustion. Near-Infrared Spectroscopy sensors were used to determine muscle oxygenation. Blood was collected one hour post-supplement consumption on day one, day six, and one hour post-exercise. Results: All results are presented as mean ± SEM. Blood nitrate (μM/L) levels were not different one hour post-ingestion (MC = 8.30 ± 2.15, PL = 8.18 ± 1.86), following six days of supplementation (MC = 9.14 ± 1.89, PL = 7.24 ± 1.75) or one hour post-exercise (MC = 9.63 ± 1.61, PL = 7.97 ± 1.92) for treatment F = 0.26, p = 0.62; for time F = 0.45, p = 0.64; or treatment by time interaction F = 2.28, p = 0.13. Muscle oxygenation was not different between treatments for the right or left vastus lateralis, F = 0.68, p = 0.81 nor was time to respiratory compensation point (minutes) (MC = 18.40 ± 1.48, PL = 17.16 ± 1.78) F = 0.52, p = 0.60. MC supplement ingestion does not alter blood nitrate levels. Conclusion: Short-term MC ingestion does not increase muscle oxygenation during cycling exercise nor does it change slow-component [Formula: see text]O₂ kinetics.

High-Intensity Interval Training in Normobaric Hypoxia Leads to Greater Body Fat Loss in Overweight/Obese Women than High-Intensity Interval Training in Normoxia

A moderate hypoxic stimulus is considered a promising therapeutic modality for several pathological states including obesity. There is scientific evidence suggesting that when hypoxia and physical activity are combined, they could provide benefits for the obese population. The aim of the present study was to investigate if exposure to hypoxia combined with two different protocols of high-intensity interval exercise in overweight/obese women was more effective compared with exercise in normoxia. Study participants included 82 overweight/obese women, who started a 12 week program of 36 sessions, and were randomly divided into four groups: (1) aerobic interval training in hypoxia (AitH; FiO₂ = 17.2%; n = 13), (2) aerobic interval training in normoxia (AitN; n = 15), (3) sprint interval training in hypoxia (SitH; n = 15), and (4) sprint interval training in normoxia (SitN; n = 18). Body mass, body mass index, percentage of total fat mass, muscle mass, basal metabolic rate, fat, and carbohydrate oxidation, and fat and carbohydrate energy were assessed. Outcomes were measured at baseline (T1), after 18 training sessions (T2), 7 days after the last session (T3), and 4 weeks after the last session (T4). The fat mass in the SitH group was significantly reduced compared with the SitN group from T1 to T3 (p < 0.05) and from T1 to T4 (p < 0.05) and muscle mass increased significantly from T1 to T4 (p < 0.05). Fat mass in the AitH group decreased significantly (p < 0.01) and muscle mass increased (p = 0.022) compared with the AitN group from T1 to T4. All training groups showed a reduction in the percentage of fat mass, with a statistically significant reduction in the hypoxia groups (p < 0.05). Muscle mass increased significantly in the hypoxia groups (p < 0.05), especially at T4. While fat oxidation tended to increase and oxidation of carbohydrates tended to decrease in both hypoxia groups, the tendency was reversed in the normoxia groups. Thus, high-intensity interval training under normobaric intermittent hypoxia for 12 weeks in overweight/obese women seems to be promising for reducing body fat content with a concomitant increase in muscle mass.

Physical, Physiological and Perceptual Match Demands of Amateur Mixed Gender Touch Players

The purpose of this study was to provide a position specific (middle, link [male], link [female], wing) analysis of mixed gender touch on the physical physiological and perceptual demands of amateur players during match-play across a season. Distance and speed measures were obtained through the use of 10-Hz global positioning system devices, whilst telemetric heart rate devices were used determine a range of physiological measures. Players also provided a rating of perceived exertion following each match. The greatest physical demand was associated with the middle playing position by comparison to all others (Distance travelled ≥5.00 m·s^-1 effect size [ES]: 0.01-0.13; average distance ≥5.00 m·s^-1 ES: 0.11-0.38). Those playing as a middle also displayed a greater physiological (Mean heart rate ES: 0.05-0.13) and perceptual demand (rating of perceived exertion ES: 0.01-0.04). However, most measures reported only a trivial effect between each playing position. The findings provide an insight into the differing demands associated with the different playing positions within mixed gender touch which practitioners can use to provide more position-specific conditioning programs.

Acute cardiorespiratory, perceptual and enjoyment responses to high-intensity interval exercise in adolescents

This study aimed to examine adolescents' acute cardiorespiratory and perceptual responses during high-intensity interval exercise (HIIE) and enjoyment responses following HIIE and work-matched continuous moderate intensity exercise (CMIE). Fifty-four 12- to 15-year olds (27 boys) completed 8 × 1-min cycling at 90% peak power with 75-s recovery (HIIE) and at 90% of the gas exchange threshold (CMIE). Absolute oxygen uptake ([Formula: see text]), percentage of maximal [Formula: see text] (%[Formula: see text]), heart rate (HR), percentage of maximal HR (%HR_max) and ratings of perceived exertion (RPE) were collected during HIIE. Enjoyment was measured using the physical activity enjoyment scale (PACES) following HIIE and CMIE. Boys elicited higher absolute [Formula: see text] during HIIE work (p < .01, effect size (ES) > 1.22) and recovery (p < .02, ES > 0.51) intervals but lower %[Formula: see text] during HIIE recovery intervals compared to girls (p < .01, ES > 0.67). No sex differences in HR and %HR_max were evident during HIIE and 48 participants attained ≥90% HR_max. Boys produced higher RPE at intervals 6 (p = .004, ES = 1.00) and 8 (p = .003, ES = 1.00) during HIIE. PACES was higher after HIIE compared with CMIE (p = .003, ES = 0.58). Items from PACES "I got something out of it", "It's very exciting" and "It gives me a strong feeling of success" were higher after HIIE (all p < .01, ES > 0.32). The items "I feel bored" and "It's not at all interesting" were higher after CMIE (all p < .01, ES > 0.46). HIIE elicits a maximal cardiorespiratory response in most adolescents. Greater enjoyment after HIIE was due to elevated feelings of reward, excitement and success and may serve as a strategy to promote health in youth.

Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial

BACKGROUND

The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional inspiratory muscle training (IMT).

METHODS

A three-armed randomized controlled trial comparing the two training modalities and routine care was conducted in surgical LC patients. Patient groups received one of three treatment regimens: (I) high-intensity pulmonary rehabilitation (PR) that combined IMT with conventional resistance training (CRT) (combined PR group); (II) conventional PR (single IMT group); or (III) routine preoperative preparation (control group). The primary endpoint was a change in the occurrence of post-operative pulmonary complications (PPCs) that occurred within 30 days after surgery, while secondary endpoints included changes in length of hospital stay, quality of life (QoL) scores, 6-min walk distance (6-MWD) and peak expiratory flow (PEF).

RESULTS

A total of 90 enrolled patients were randomized into three groups with a computer-based 1:1:1 ratio. The intention-to-treat analysis of the study revealed that, compared with the Control Group, the Combined PR Group had a significant increase in ^∆6-MWD (by 32.67 m, P=0.002), ^∆PEF (by 14.3 L/min, P=0.001), ^∆global scores (by 3.7, P=0.035); and a reduced ^∆average total hospital stay (by 3.2 d, P=0.001) and ∆postoperative stay (by 3.6 d, P=0.001). With regard to PPC rate, the Combined PR Group had a somewhat lower PPC severity (grade II-V) compared to the Control Group.

CONCLUSIONS

This hospital-based short-term program of PR combining high-intensity IMT with CRT was significantly superior to the conventional IMT program, indicating that this approach would be a feasible strategy for treating LC patients, especially those waiting operations with surgery-related risk factors.

Loads and movement speed affect energy expenditure during circuit resistance exercise

Circuit resistance training (CT) constitutes a high-intensity interval program commonly used to target weight loss; however, the loads and exercise patterns that maximize energy expenditure (EE) remain undetermined. We examined differences in EE among CT protocols using varying loads and contraction speeds in recreationally trained males and females. Seven males (age, 21.1 ± 0.5 years) and 8 females (age, 20.0 ± 0.9 years) performed 3 randomized CT protocols incorporating 3 circuits using heavy-load (80% 1-repetition maximum (1RM)) explosive (HLEC), heavy-load, controlled (2 s) (HLCC), and moderate-load (50% 1RM) explosive contractions (MLEC). Expired air was collected continuously before, during, and after exercise. Blood lactate was collected at rest, immediately postexercise, and 5 min postexercise. No significant differences were detected for resting EE; however, there was a significant difference among conditions during exercise (p = 0.034, η_p² = 0.229). Post hoc analysis revealed that MLEC produced significantly higher EE than HLCC, but not HLEC (p = 0.023). There was a significant difference among conditions for rate of EE during exercise (p = 0.003, η_p² = 0.361). Post hoc analysis revealed that HLEC produced a significantly higher EE rate than HLCC (p = 0.012) or MLEC (p = 0.001). A condition × sex interaction was seen for blood lactate changes (η_p² = 0.249; p = 0.024). Females produced significantly greater change for MLEC than HLEC (p = 0.011), while males showed no significant differences. Our results favor CT using MLEC for a higher EE during a full workout; however, the rate of EE was highest when using HLEC.

In-hospital statin underutilization among high-risk patients: delayed uptake of the 2013 cholesterol guidelines in a U.S. cohort

OBJECTIVES

Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital.

METHODS

We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain. Prescribing patterns were evaluated 6 months and 18 months after the release of the 2013 guidelines. High-intensity statin was defined as atorvastatin 40-80 mg or rosuvastatin 20-40 mg per day.

RESULTS

632 patients were included in our study. The following percentages of patients were discharged on high-intensity statin (6 months; 18 months): (i) Cardiology (80%; 85%), (ii) CV Surgery (52%, 65%), (iii) Neurology (59%; 66%), and (iv) Internal Medicine (45%; 48%). Among the four groups, Cardiology was the most likely to discharge patients on high-intensity statin (p < 0.001) in 2014 and in 2015. Cardiology, CV Surgery, and Neurology significantly increased the percentage of patients on high-intensity statin from pre-admission to time of discharge in both years.

CONCLUSION

High-intensity statin therapy is underutilized among high-risk cardiovascular patients admitted to the hospital. Variations exist in prescribing patterns of different specialties who manage high-risk populations. This data can be used to test quality improvement interventions to improve rates of high-intensity statin utilization among high-risk patients prior to hospital discharge.

A comparison of methods to estimate anaerobic capacity: Accumulated oxygen deficit and W' during constant and all-out work-rate profiles

This study investigated (i) whether the accumulated oxygen deficit (AOD) and curvature constant of the power-duration relationship (W') are different during constant work-rate to exhaustion (CWR) and 3-min all-out (3MT) tests and (ii) the relationship between AOD and W' during CWR and 3MT. Twenty-one male cyclists (age: 40 ± 6 years; maximal oxygen uptake [V̇O_2max]: 58 ± 7 ml · kg^-1 · min^-1) completed preliminary tests to determine the V̇O₂-power output relationship and V̇O_2max. Subsequently, AOD and W' were determined as the difference between oxygen demand and oxygen uptake and work completed above critical power, respectively, in CWR and 3MT. There were no differences between tests for duration, work, or average power output (P ≥ 0.05). AOD was greater in the CWR test (4.18 ± 0.95 vs. 3.68 ± 0.98 L; P = 0.004), whereas W' was greater in 3MT (9.55 ± 4.00 vs. 11.37 ± 3.84 kJ; P = 0.010). AOD and W' were significantly correlated in both CWR (P < 0.001, r = 0.654) and 3MT (P < 0.001, r = 0.654). In conclusion, despite positive correlations between AOD and W' in CWR and 3MT, between-test differences in the magnitude of AOD and W', suggest that both measures have different underpinning mechanisms.

Applying the Critical Speed Concept to Racing Strategy and Interval Training Prescription

The use of personal records (PRs) for running different distances may be used to derive critical speed (CS) and the finite capacity for running speeds exceeding CS (D'). Using CS and D', individualized speed-time and distance-time relationships can be modeled (ie, time limits associated with running at a given speed or a given distance can be derived via linear regression with a high degree of accuracy). The running 3-min all-out exercise test (3 MT) has emerged as a method for estimating CS and D' on a large group of athletes in a single visit. Such a procedure is useful when PRs are not readily available (eg, team-sport athletes). This article reviews how to administer and interpret the running 3 MT, how CS and D' can inform racing strategy, and how CS and D' can be used to prescribe and evaluate high-intensity interval training (HIIT). Directions for deriving HIIT bouts using either fixed distances or fixed speeds are provided along with CS dose-responses to short-term HIIT programs.

Sprint interval and moderate-intensity cycling training differentially affect adiposity and aerobic capacity in overweight young-adult women

The purpose of the study was to examine the effects of sprint interval training (SIT) and moderate-intensity continuous cycle training (MICT), with equal estimated energy expenditure during training on body composition and aerobic capacity. Body composition measured via dual-energy X-ray absorptiometry and aerobic capacity were assessed following 6 weeks of training in previously inactive overweight/obese young women (n = 52; age, 20.4 ± 1.5 years; body mass index, 30.3 ± 4.5 kg·m^-2, 67.3% white). Training was performed in a group-exercise format that mimicked cycling classes offered by commercial fitness facilities, and included 3 weekly sessions of either 30-s "all-out" sprints followed by 4 min of active recovery (SIT), or continuous cycling at 60%-70% heart rate reserve to expend a similar amount of energy. Participants were randomized to SIT or MICT, attended a similar number of sessions (15.0 ± 1.5 sessions vs. 15.8 ± 1.9 sessions, P = 0.097) and expended a similar amount of energy (541.8 ± 104.6 kJ·session^-1 vs. 553.5 ± 138.1 kJ·session^-1, P = 0.250). Without significant changes in body mass (P > 0.05), greater relative reductions occurred in SIT than in MICT in total fat mass (3.6% ± 5.6% vs. 0.6% ± 3.9%, P = 0.007), and android fat mass (6.6% ± 6.9% vs. 0.7% ± 6.5%, P = 0.002). Aerobic capacity (mL·kg^-1·min^-1) increased significantly following both interventions (P < 0.05), but the relative increase was 2-fold greater in SIT than in MICT (14.09% ± 10.31% vs. 7.06% ± 7.81%, P < 0.001). In conclusion, sprint-interval cycling reduces adiposity and increases aerobic capacity more than continuous moderate-intensity cycling of equal estimated energy expenditure in overweight/obese young women.

Is High-Intensity Functional Training (HIFT)/CrossFit Safe for Military Fitness Training?

High-intensity functional training (HIFT) is a promising fitness paradigm that gained popularity among military populations. Rather than biasing workouts toward maximizing fitness domains such as aerobic endurance, HIFT workouts are designed to promote general physical preparedness. HIFT programs have proliferated as a result of concerns about the relevance of traditional physical training (PT), which historically focused on aerobic condition via running. Other concerns about traditional PT include: (1) the relevance of service fitness tests given current combat demands, (2) the perception that military PT is geared toward passing service fitness tests, and (3) that training for combat requires more than just aerobic endurance. Despite its' popularity in the military, concerns have been raised about HIFT's injury potential, leading to some approaches being labeled as "extreme conditioning programs" by several military and civilian experts. Given HIFT programs' popularity in the military and concerns about injury, a review of data on HIFT injury potential is needed to inform military policy. The purpose of this review is to: (1) provide an overview of scientific methods used to appropriately compare injury rates among fitness activities and (2) evaluate scientific data regarding HIFT injury risk compared to traditional military PT and other accepted fitness activities.

Transepithelial High-Intensity Cross-Linking for the Treatment of Progressive Keratoconus: 2-year Outcomes

PURPOSE

To report 2-year outcomes of transepithelial high-intensity cross-linking (CXL) procedure in the treatment of patients with progressive keratoconus.

METHODS

Forty-eight eyes of 48 consecutive progressive keratoconus patients who underwent transepithelial accelerated CXL procedure were enrolled in the study. Each patient underwent pre- and postoperative comprehensive ophthalmologic examinations including determination of refractive error as spherical equivalent (SE) and corrected distant visual acuity (CDVA), slit lamp biomicroscopic examination, fundoscopy, and a detailed analysis on a Scheimplug+Placido device (Sirius, CSO, Florence, Italy). The riboflavin solution, which was composed of riboflavin 0.25% with hydroxypropyl methylcellulose (HPMC) and benzalkonium chloride (BAC) (ParaCel, Avedro), was used in the procedure. The cornea was exposed to ultraviolet A light (KXL System, Avedro Inc., Waltham, MS, USA) for 2 minutes and 40 seconds at an irradiance of 45 mW/cm².

RESULTS

The mean age of the patients was 25.9 ± 4.0 (ranging from 18 to 33) years. No significant changes were observed in the mean CDVA, SE, and topographic indices at year 1 and year 2 visits compared to preoperative examination. The mean corneal thickness at the thinnest point was significantly higher at year 1 and year 2 visits than at preoperative examination (p1 = 0.014 and p2 = 0.017, respectively). No intra- or postoperative complications or adverse reactions were observed.

CONCLUSIONS

Transepithelial high-intensity (irradiance of 45 mW/cm² for 2 minutes and 40 seconds) CXL using 0.25% riboflavin solution was a safe and effective method to halt the progression of keratoconus for a 2-year follow-up period.

Interleukin-6 and associated cytokine responses to an acute bout of high-intensity interval exercise: the effect of exercise intensity and volume

Acute increases in interleukin (IL)-6 following prolonged exercise are associated with the induction of a transient anti-inflammatory state (e.g., increases in IL-10) that is partly responsible for the health benefits of regular exercise. The purposes of this study were to investigate the IL-6-related inflammatory response to high-intensity interval exercise (HIIE) and to determine the impact of exercise intensity and volume on this response. Ten participants (5 males and 5 females) completed 3 exercise bouts of contrasting intensity and volume (LOW, MOD, and HIGH). The HIGH protocol was based upon standard HIIE protocols, while the MOD and LOW protocols were designed to enable a comparison of exercise intensity and volume with a fixed duration. Inflammatory cytokine concentrations were measured in plasma (IL-6, IL-10) and also determined the level of gene expression (IL-6, IL-10, and IL-4R) in peripheral blood. The plasma IL-6 response to exercise (reported as fold changes) was significantly greater in HIGH (2.70 ± 1.51) than LOW (1.40 ± 0.32) (P = 0.04) and was also positively correlated to the mean exercise oxygen uptake (r = 0.54, P < 0.01). However, there was no change in anti-inflammatory IL-10 or IL-4R responses in plasma or at the level of gene expression. HIIE caused a significant increase in IL-6 and was greater than that seen in low-intensity exercise of the same duration. The increases in IL-6 were relatively small in magnitude, and appear to have been insufficient to induce the acute systemic anti-inflammatory effects, which are evident following longer duration exercise.

Task Failure during Exercise to Exhaustion in Normoxia and Hypoxia Is Due to Reduced Muscle Activation Caused by Central Mechanisms While Muscle Metaboreflex Does Not Limit Performance

To determine whether task failure during incremental exercise to exhaustion (IE) is principally due to reduced neural drive and increased metaboreflex activation eleven men (22 ± 2 years) performed a 10 s control isokinetic sprint (IS; 80 rpm) after a short warm-up. This was immediately followed by an IE in normoxia (Nx, P_IO₂:143 mmHg) and hypoxia (Hyp, P_IO₂:73 mmHg) in random order, separated by a 120 min resting period. At exhaustion, the circulation of both legs was occluded instantaneously (300 mmHg) during 10 or 60 s to impede recovery and increase metaboreflex activation. This was immediately followed by an IS with open circulation. Electromyographic recordings were obtained from the vastus medialis and lateralis. Muscle biopsies and blood gases were obtained in separate experiments. During the last 10 s of the IE, pulmonary ventilation, VO₂, power output and muscle activation were lower in hypoxia than in normoxia, while pedaling rate was similar. Compared to the control sprint, performance (IS-Wpeak) was reduced to a greater extent after the IE-Nx (11% lower P < 0.05) than IE-Hyp. The root mean square (EMG_RMS) was reduced by 38 and 27% during IS performed after IE-Nx and IE-Hyp, respectively (Nx vs. Hyp: P < 0.05). Post-ischemia IS-EMG_RMS values were higher than during the last 10 s of IE. Sprint exercise mean (IS-MPF) and median (IS-MdPF) power frequencies, and burst duration, were more reduced after IE-Nx than IE-Hyp (P < 0.05). Despite increased muscle lactate accumulation, acidification, and metaboreflex activation from 10 to 60 s of ischemia, IS-Wmean (+23%) and burst duration (+10%) increased, while IS-EMG_RMS decreased (−24%, P < 0.05), with IS-MPF and IS-MdPF remaining unchanged. In conclusion, close to task failure, muscle activation is lower in hypoxia than in normoxia. Task failure is predominantly caused by central mechanisms, which recover to great extent within 1 min even when the legs remain ischemic. There is dissociation between the recovery of EMG_RMS and performance. The reduction of surface electromyogram MPF, MdPF and burst duration due to fatigue is associated but not caused by muscle acidification and lactate accumulation. Despite metaboreflex stimulation, muscle activation and power output recovers partly in ischemia indicating that metaboreflex activation has a minor impact on sprint performance.

Neck-cooling improves repeated sprint performance in the heat

The present study evaluated the effect of neck-cooling during exercise on repeated sprint ability in a hot environment. Seven team-sport playing males completed two experimental trials involving repeated sprint exercise (5 × 6 s) before and after two 45 min bouts of a football specific intermittent treadmill protocol in the heat (33.0 ± 0.2°C; 53 ± 2% relative humidity). Participants wore a neck-cooling collar in one of the trials (CC). Mean power output and peak power output declined over time in both trials but were higher in CC (540 ± 99 v 507 ± 122 W, d = 0.32; 719 ± 158 v 680 ± 182 W, d = 0.24 respectively). The improved power output was particularly pronounced (d = 0.51-0.88) after the 2nd 45 min bout but the CC had no effect on % fatigue. The collar lowered neck temperature and the thermal sensation of the neck (P < 0.001) but had no effect on heart rate, fluid loss, fluid consumption, lactate, glucose, plasma volume change, cortisol, or thermal sensation (P > 0.05). There were no trial differences but interaction effects were demonstrated for prolactin concentration and rating of perceived exertion (RPE). Prolactin concentration was initially higher in the collar cold trial and then was lower from 45 min onwards (interaction trial × time P = 0.04). RPE was lower during the football intermittent treadmill protocol in the collar cold trial (interaction trial × time P = 0.01). Neck-cooling during exercise improves repeated sprint performance in a hot environment without altering physiological or neuroendocrinological responses. RPE is reduced and may partially explain the performance improvement.

Do physiological measures predict selected CrossFit(®) benchmark performance?

Purpose

CrossFit^® is a new but extremely popular method of exercise training and competition that involves constantly varied functional movements performed at high intensity. Despite the popularity of this training method, the physiological determinants of CrossFit performance have not yet been reported. The purpose of this study was to determine whether physiological and/or muscle strength measures could predict performance on three common CrossFit “Workouts of the Day” (WODs).

Materials and methods

Fourteen CrossFit Open or Regional athletes completed, on separate days, the WODs “Grace” (30 clean and jerks for time), “Fran” (three rounds of thrusters and pull-ups for 21, 15, and nine repetitions), and “Cindy” (20 minutes of rounds of five pull-ups, ten push-ups, and 15 bodyweight squats), as well as the “CrossFit Total” (1 repetition max [1RM] back squat, overhead press, and deadlift), maximal oxygen consumption (VO₂max), and Wingate anaerobic power/capacity testing.

Results

Performance of Grace and Fran was related to whole-body strength (CrossFit Total) (r=−0.88 and −0.65, respectively) and anaerobic threshold (r=−0.61 and −0.53, respectively); however, whole-body strength was the only variable to survive the prediction regression for both of these WODs (R²=0.77 and 0.42, respectively). There were no significant associations or predictors for Cindy.

Conclusion

CrossFit benchmark WOD performance cannot be predicted by VO₂max, Wingate power/capacity, or either respiratory compensation or anaerobic thresholds. Of the data measured, only whole-body strength can partially explain performance on Grace and Fran, although anaerobic threshold also exhibited association with performance. Along with their typical training, CrossFit athletes should likely ensure an adequate level of strength and aerobic endurance to optimize performance on at least some benchmark WODs.

High-intensity functional training improves functional movement and body composition among cancer survivors: a pilot study

This pilot study investigated feasibility and preliminary efficacy of a high-intensity functional training (HIFT) group-exercise programme among adult cancer survivors within 5 years of last cancer treatment. Eight participants were assigned to a 5-week, 3 days/week HIFT intervention with four testing sessions and 12 workouts along with mobility and stretching exercises. Feasibility was assessed by initiation, adherence, and acceptability. Efficacy was determined by changes from baseline to post-test in health-related quality of life, body composition and functional movement. The recruitment rate was 80% and the adherence rate was 75%. Significant improvements were found for emotional functioning (P = 0.042) and body composition (lean mass +3.8 ± 2.1 kg, P = 0.008; fat mass -3.3 ± 1.0 kg, P = 0.001; body fat percentage -4.7 ± 1.2%, P < 0.001). Participants also significantly improved on five of seven functional movements: balance (P = 0.032), carrying a weighted object (P = 0.004), lower body strength and power (P = 0.009), aerobic capacity and endurance (P = 0.039), and perceived difficulty for flexibility (P = 0.012). Five weeks of HIFT training was well-received and feasible for most cancer survivors, and effective for improving emotional functioning, body composition and functional movement.

The Impact of Continuous and Interval Cycle Exercise on Affect and Enjoyment

Rates of physical activity remain low despite public health efforts. One form of physical activity that provides significant physiological benefit but has not been evaluated in terms of affective and enjoyment responses is interval exercise.

PURPOSE

The purpose of this study was to compare affect and enjoyment assessed before, during, and after interval and continuous exercise sessions.

METHOD

Twenty-four participants (12 men, 12 women; body mass index = 24 ± 4, maximal oxygen consumption = 41 ± 5 mL/kg/min) completed a maximal cycle ergometer test used to prescribe experimental trials: (a) moderate continuous, (b) heavy continuous, (c) heavy interval, and (d) severe interval. All trials were 20 min in length, and all intervals utilized 60-s segments and a 1:1 work-to-rest ratio.

RESULTS

Affective and enjoyment responses were significantly less positive for the heavy continuous trials in comparison with all other trials during exercise (p < .05; ES = .2-.8). Additionally, both severe and heavy interval exercise were more enjoyable than heavy continuous exercise (p > .05).

CONCLUSION

Findings suggest that interval protocols produce affective and enjoyment responses that are equal to moderate continuous exercise and more positive than heavy continuous exercise. These results indicate that interval-based exercise may be a viable alternative to continuous exercise in the promotion of health and fitness.