Exercise Performance Research Articles

A Single Night in Hypoxia Either with or without Ketone Ester Ingestion Reduces Sleep Quality Without Impacting Next Day Exercise Performance

ABSTRACT Background Sleeping at altitude is highly common in athletes as an integral part of altitude training camps or sport competitions. However, concerns have been raised due to expected negative effects on sleep quality, thereby potentially hampering exercise recovery and next-day exercise performance. We recently showed that ketone ester (KE) ingestion beneficially impacted sleep following strenuous, late evening exercise in normoxia, and alleviated hypoxemia. Therefore, we hypothesized that KE ingestion may be an effective strategy to attenuate hypox(em)ia-induced sleep dysregulations. Methods Eleven healthy, male participants completed three experimental sessions including normoxic training and subsequent sleep in normoxia or at a simulated altitude of 3,000 m while receiving either KE or placebo post-exercise and pre-sleep. Sleep was evaluated using polysomnography, while next-day exercise performance was assessed through a 30-min all-out time trial (TT30’). Physiological measurements included oxygen status, heart rate variability, ventilatory parameters, blood acid-base balance and capillary blood gases. Results Hypoxia caused a ~3% drop in sleep efficiency, established through a doubled wakefulness after sleep onset and a ~22% reduction in slow wave sleep. KE ingestion alleviated the gradual drop in SpO2 throughout the first part of the night, but did not alter hypoxia-induced sleep dysregulations. Neither KE, nor nocturnal hypoxia affected TT30’ performance, but nocturnal hypoxia hampered heart rate recovery following TT30’. Conclusions We observed that sleeping at 3,000 m altitude impairs sleep efficiency. Although this hypoxia-induced sleep disruption was too subtle to limit exercise performance, we for the first time indicate that sleeping at altitude might impair next-day exercise recovery. KE alleviated nocturnal hypoxemia only when SpO2 values dropped below ~85%, but this did not translate into improved sleep or next-day exercise performance.

Web-based pulmonary telehabilitation: a systematic review.

Web-based pulmonary telerehabilitation (WBPTR) can serve as a valuable tool when access to conventional care is limited. This review assesses a series of studies that explore pulmonary telerehabilitation programmes delivered via web-based platforms. The studies involved participants with moderate to severe chronic obstructive pulmonary disease (COPD). Of the 3190 participants, 1697 engaged in WBPTR platforms, while the remaining 1493 comprised the control groups. Sixteen studies were included in the meta-analysis. Web-based pulmonary telerehabilitation led to an increase in daily step count (MD 446.66, 95% CI 96.47 to 796.86), though this did not meet the minimum clinically important difference. Additionally, WBPTR did not yield significant improvements in the six-minute walking test (MD 5.01, 95% CI - 5.19 to 15.21), health-related quality of life as measured by the St. George's Respiratory Questionnaire (MD - 0.15, 95% CI - 2.24 to 1.95), or the Chronic Respiratory Disease Questionnaire (MD 0.17, 95% CI - 0.13 to 0.46). Moreover, there was no significant improvement in dyspnoea-related health status, as assessed by the Chronic Respiratory Disease Questionnaire (MD - 0.01, 95% CI - 0.29 to 0.27) or the modified Medical Research Council Dyspnoea Scale (MD - 0.14, 95% CI - 0.43 to 0.14). Based on these findings, this review concludes that WBPTR does not offer substantial advantages over traditional care. While slight improvements in exercise performance were observed, no meaningful enhancements were noted in dyspnoea or quality of life metrics. Overall, WBPTR remains a complementary and accessible option for managing and monitoring COPD patients. However, further research and innovation are required to improve its efficacy and adapt it to various clinical environments.

Leveraging Data Analytics to Investigate the Effectiveness of Flipped Classroom Models: A Case Study of Practical Programming Teaching

Educators face multiple challenges when teaching programming, such as the intricate nature of programming knowledge, the choice of effective teaching methods, and the diverse abilities of learners. Traditional teaching methods often fail to address these challenges, leading to higher dropout rates and lower student grades. This paper explores a study on the effectiveness of the flipped classroom model as a strategy to enhance student engagement in a practical programming course. In addition, learning data was analyzed to examine the relationship between pre-class preparation and in-class learning outcomes. The study's results indicate that the flipped classroom model significantly enhances student engagement and performance. Students who diligently completed pre-class assignments and dedicated more time to study demonstrated improved performance in subsequent in-class exercises. The results emphasize the potential of the flipped classroom model as a successful teaching method for increasing student involvement, encouraging self-directed learning, and ultimately improving the overall educational experience in programming courses.

Changes in Exercise Performance in Patients During a 6-Week Inpatient Psychiatric Rehabilitation Program and Associated Effects on Depressive Symptoms

Background/Objectives: The impact of exercise on affective disorders has been demonstrated in various studies. However, almost no data are available on performance effects. Therefore, this study investigated exercise performance related to the severity of depression symptoms in a pre–post within-subjects design in a 6-week standard inpatient psychiatric rehabilitation program. Methods: A total of 53 individuals (20 female; mean age, 40.98 ± 11.33) with a primary diagnosis of depression performed a cardiopulmonary exercise test (CPX) to obtain maximal oxygen uptake (VO2max), maximal power output (Pmax), and the first and second ventilatory threshold (VT1, VT2) at the start and the end of the rehabilitation. Degree of depression was assessed by Becks Depression Inventory (BDI) and the Brief Symptom Inventory test (BSI). Overall activity was measured by accelerometer step-counts. Results: Mean total step-count per day during rehabilitation was high (12,586 ± 2819 steps/day). Patients’ BDI and BSI at entry were 21.6 ± 8.83 and 65.1 ± 6.8, respectively, and decreased significantly (p < 0.001) following rehabilitation, to 10.1 ± 9.5 and 54.5 ± 11.3, respectively. Pmax and VO2max increased significantly (p < 0.001) from entry values (182.6 ± 58.7 W, 29.74 ± 5.92 mL·kg−1·min−1) following rehabilitation: by 11.91 ± 12.09 W and 1.35 ± 2.78 mL·kg−1·min−1, respectively. VT1 and VT2 showed a similar behavior. An increase in physical performance could predict improvement in BDI (R2 = 0.104, F(1,48) = 5.582, p = 0.022) but not in BSI. Conclusions: The program was associated with improved mental health status in all patients and increased performance in the majority of patients, although increases were small. Since improvements in exercise performance may be positively related to depression symptoms and comorbidities, it is recommended to individualize and tailor exercise programs, which could yield larger effects.

Gender differences in the effects of urban environment on nighttime exercise behaviours: a qualitative study

ObjectiveWith the acceleration of urbanization, nighttime exercise behaviours have rapidly emerged. Existing research indicates a correlation between urban environments and physical activity; however, studies focusing specifically on nighttime are still insufficient, particularly regarding gender differences. This study aims to identify the key factors in urban environments that influence residents’ nighttime exercise behaviours and to explore the gender differences within these influences.MethodsPurposeful sampling was employed to conduct semi-structured interviews with 30 residents who regularly engage in nighttime exercise. All transcribed interviews were analyzed using Colaizzi’s phenomenological data analysis method.ResultsThe findings revealed that physical environment and environmental perception are the two primary factors influencing nighttime exercise behaviour. These factors are further divided into 10 specific sub-themes: lighting, green spaces, site facilities and layout, traffic coherence, entertainment facilities, smart sports equipment, sense of safety, convenience, pleasure, and sense of belonging.ConclusionFemales demonstrate a heightened sensitivity to the perception of the physical environment, placing greater emphasis on the feelings and experiences it provides. Males, on the other hand, focus more on the direct impact of the physical environment, such as its specific effects on exercise performance. Future urban planning and public policy should give greater consideration to gender differences in the use of urban exercise facilities, ensuring that nighttime exercise environments meet the needs of residents of different genders. This approach will contribute to enhancing overall community vitality and improving residents’ health.

A INFLUÊNCIA DA MÚSICA NO DESEMPENHO DURANTE ATIVIDADES FÍSICAS

This study aims to describe evidence of how music preference can mediate exercise responses and performance benefits, identifying which factors may be particularly beneficial for optimizing performance. In addition, the practical implications for practitioners will be highlighted with considerations for strategies to elicit maximum performance through musical preference. The research methodology of this study was based on a literature review study, without the participation of the population or samples. Thus, the articles were extracted for the first time by the authors. The full texts of the relevant articles were then independently evaluated by the authors and advisor. The understandings of each study related to the proposed theme were extracted from all the experiments included. When the data on music and its relationship with physical activity were not explicitly provided, the other significant contents were analyzed to verify which data extraction would be feasible from the works to incorporate this review study. Through the current evidence, it is therefore concluded that an important aspect to increase performance with music is personal choice. In many gyms, locker rooms, and competition environments, music is played over a loudspeaker. The current data available therefore suggests that if music played over the speakers is not preferred by the individual who strives, the performance may suffer from depredations. Thus, coaches and athletes must consider individual musical preferences when trying to optimize performance and training.

No effect of grape juice on exercise-induced muscle damage or performance in male runners: a randomized, placebo-controlled, triple-blind clinical trial.

This study aimed to verify the effect of grape juice (Vitis Labrusca) intake on exercise-induced muscle damage (EIMD) and exercise performance parameters (5-km running time-trial [TT], running economy, and countermovement jump [CMJ]). Twenty trained male runners were randomized into two blinded groups and consumed either placebo (n=9) or grape juice (n=11) for six consecutive days (600 mL/day). On the fourth day, the participants performed a downhill running (-15%) at speed that elicited 70% V̇O2max for 20 minutes, to induce muscle damage, followed by assessment of running economy, 5-km TT, and CMJ tests. Blood samples were obtained before and after the exercise tests for quantifying total phenols, creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH). On the sixth day, blood parameters and CMJ were evaluated. A two-way ANCOVA mixed model was employed for data analysis, the effects were the juice groups, measurement and a interaction between the factors. EIMD was confirmed by increased levels of indirect markers (serum AST and LDH activities) and an impairment in TT and CMJ performances after 48 hours. The 5-km TT, economy, and CMJ were compromised after EIMD, to a similar extent in the groups. Blood concentrations of CK, LDH, AST, and total phenolic compounds presented similar time course behavior between the groups, showing no group × time interaction effects. In conclusion, grape juice consumption over six days did not attenuate EIMD markers or the impairment in running performance in trained male runners. (ReBEC number: RBR-9jkkvbb).

The whole-body and skeletal muscle metabolic response to 14 days of highly controlled low energy availability in endurance-trained females.

This study investigated the effects of 14 days low energy availability (LEA) versus optimal energy availability (OEA) in endurance-trained females on substrate utilization, insulin sensitivity, and skeletal muscle mitochondrial oxidative capacity; and the impact of metabolic changes on exercise performance. Twelve endurance-trained females (V̇O2max 55.2 ± 5.1 mL × min-1 × kg-1) completed two 14-day randomized, blinded, cross-over, controlled dietary interventions: (1) OEA (51.9 ± 2.0 kcal × kg fat-free mass (FFM)-1 × day-1) and (2) LEA (22.3 ± 1.5 kcal × kg FFM-1 × day-1), followed by 3 days OEA. Participants maintained their exercise training volume during both interventions (approx. 8 h × week-1 at 79% heart rate max). Skeletal muscle mitochondrial respiratory capacity, glycogen, and maximal activity of CS, HAD, and PFK were unaltered with LEA. 20-min time trial endurance performance was impaired by 7.8% (Δ -16.8 W, 95% CI: -23.3 to -10.4, p < .001) which persisted following 3 days refueling post-LEA (p < .001). Fat utilization was increased post-LEA as evidenced by: (1) 99.4% (p < .001) increase in resting plasma free fatty acids (FFA); (2) 270% (p = .007) larger reduction in FFA in response to acute exercise; and (3) 28.2% (p = .015) increase in resting fat oxidation which persisted during submaximal exercise (p < .001). These responses were reversed with 3 days refueling. Daily glucose control (via CGM), HOMA-IR, HOMA-β, were unaffected by LEA. Skeletal muscle O2 utilization and carbohydrate availability were not limiting factors for aerobic exercise capacity and performance; therefore, whether LEA per se affects aspects of training quality/recovery requires investigation.

Abstract 4145857: The effect of homebase exercise training on single ventricle heart (SVH) function, exercise performance, body composition and quality of Life in children and adolescents living with a Fontan circulation

Objectives: Fontan patients have impaired exercise capacity. Exercise training has been shown to improve exercise performance. We aim to determine the effect of exercise training on SVH function, and its correlation with exercise capacity, body composition and self-reported QOL. Methods: 31 paediatric Fontan patients were prospectively recruited to complete 3x30 minute homebased HIIT sessions per week for 20 weeks. Baseline physical activity levels, including structured sports participation, daily step-counts and active-zone-minutes (AZM) were recorded by accelerometer (Fitbit inspire3). Patients were considered active if they met 2 of the 3 criteria: 1/Structured sports training ≥ 2 per week (moderate-vigorous intensity &gt;30 minutes) 2/Daily steps ≥ 10k 3/AZM ≥60 minutes per day Bio-impedance-analysis, cardiopulmonary exercise tests, echocardiography including deformation imaging and PedQL questionnaires were performed at baseline and upon completion. Results: 28 participants completed the programme. 86% had good compliance (completed &gt;45/60 sessions). 17 male (60.7%), mean age 14.3±2.03 years, 14 LV-dominant, 14 non-LV dominant (9RV, 5BiV). No serious adverse events reported. The exercise duration improved from 7.56±2.6 to 9.16±2.5 minutes, p&lt;0.001 and peak workload from 110±43.6 to 129±45.8 watts, p&lt;0.001. Indexed oxygen consumption (VO 2 /kg peak) improved from 30.9±7.1 to 32.2±7ml/min/kg, p=0.003 and oxygen pulse, O 2 pulse peak from 9.1±2.6 to 9.7±3 mL/beat, p&lt;0.001. Submaximal analysis showed normal %predicted VO2 (&gt;40%) and improvement of O 2 pulse, p=0.024. LV systolic function showed improved MAPSE from 1.65±0.2 to 1.86±0.2, p=0.017, and improved apical rotation from 2.3±3.8 to 5.9±3.1, p=0.043. RV systolic function showed improved TAPSE of 1.4±0.2 to 1.6±0.3, p=0.032 and FAC of 44±5.6% to 49±10.5%, p=0.170. Self-reported QOL scores were higher in Fontan children who were physically active at baseline, with a downward trend noted when poor compliance was evident (Child’s QOL V3.0 91.21±0.7 to 86.1±5.2, p=0.018 (Table 2). Although no significant change in body composition, a higher appendicular skeletal muscle mass, SMMa% and lower body fat% were noted pre and post exercise training in the active Fontan group (Table 3), Conclusions: We observed significant improvements in both the submaximal and peak exercise performance in paediatric Exercise training associated with improvement of single ventricle longitudinal systolic function and ventricular mechanics.

Scientometric analysis of articles of respiratory gas mixtures and their application in emergency medicine

Relevance. In humans, specific respiratory gas mixtures (RGMs) significantly maximize the effect of anesthesia and treatment of certain diseases, as well as enhance body functional reserves and exercise performance. The objective is to identify major research prospects on the RGM capacity to optimize the functional status of humans, as represented in publications by Russian investigators.Methods. In response to the RGMs query, the Scientific Electronic Library search engine generated a dataset of 513 publications by Russian investigators, published from 2006 to 2023. For further analysis of the publications, the VOSviewer 1.6.20 software was implemented for clustering of keywords with a frequency of ≥ 4 presented in ≥ 8 publications either by individual authors or co-authorship networks.Results and discussion. The average annual number of articles was (23 ± 3). The dynamics of increasing publications were revealed. The scientometric analysis of the selected publications revealed that the content was highly demanded among readers. For instance, the average citation number per paper was 3.29, with a substantial self-citation rate of 30.2 %. Journals with the largest number of publications by top scientific networks were identified. The VOSviewer analysis produced 7 keyword clusters: Cluster 1 for xenon anesthesia – 258 papers (35 %) with the total link strength of 29 %; Cluster 2 for hypoxic training – 171 papers (23.2%) with the total link strength of 22.5 %; Cluster 3 for gas composition in confined spaces – 76 papers (10.3 %) and 22 % total link strength; Cluster 4 for oxygen-helium gas mixture – 132 papers (17.9 %) with 16.4 % total link strength; Cluster 5 for the neuroprotective effects of gas mixtures – 32 papers (4.3 %) with 3.6 % total link strength; Cluster 6 for the anti-stress effect of xenon-rich inhalation therapy – 40 papers (5.4 %) with 3.6 % total link strength; Cluster 7 for low-flow anesthesia – 28 papers (3.8 %) with 3.6 % total link strength.Conclusion. Scientometric studies can enhance the data support for scientific research of advanced strategies to optimize human functional status and increasing performance at work for professionals operating in extreme occupational environments.

Abstract 4135534: Total and Regional Lung Volumes And Pulmonary Blood Flow In Repaired Tetralogy Of Fallot - Smaller Lungs And A Maldistribution of Flow

Introduction: Many pts with repaired tetralogy of Fallot (rTOF) are left with residual pulmonary regurgitation (PR) and poor exercise performance. Small studies in young children suggest that the total lung volume of rTOF pts are smaller than normal and may contribute to these sequelae. As exercise and cardiac performance are intimately related to lung function, it’s surprising that few rTOF studies have investigated cardiopulmonary interactions. Aims: To determine if regional and total lung volumes in rTOF pts are the same size as normals and if the larger amount of forward blood flow courses to the bigger lung. We hypothesized that this may not be the case. Methods: rTOF patients undergoing clinically indicated cardiac magnetic resonance (CMR) were evaluated for lung volumes using dark blood imaging (figure) and blood flow to the branch pulmonary arteries (bPA) using velocity mapping. Significance &lt; P=0.05. Results: Eleven rTOF patients and 25 normal controls were studied. Total control lung volume was significantly larger than those of rTOF. Regional rTOF right and left lung volumes were smaller than their respective control lung volumes, barely missed statistical significance (table). In 6 rTOF pts with CMR prior to and after pulmonary valve replacement (PVR), lung volumes did not differ between the 2 timepoints (1034 vs 998 cc/m 2 respectively). Only 3/11 (27%) rTOF pts had the higher bPA flow coursing to the higher regional lung. The ratio of right bPA forward flow/right lung volume to left bPA forward flow/left lung volume ranged from 0.72-1.51 (ideal balanced flow to each lung would be 1), implying a maldistribution of flow. Conclusion: rTOF patients have smaller total lung volumes than controls with no change after PVR in our study. In addition, only a small proportion of rTOF patients have the larger amount of flow coursing to the larger lung. The ratio of individual bPA flow to individual lung volume implies a maldistribution of pulmonary flow relative to the respective lung volume. Our findings may have implications for timing of PVR, partially explaining PR and poor exercise performance. Flow limiters placed by cath or surgery may be able to redistribute the appropriate flow to regional lung fields.

The Electroencephalogram (EEG) Study for Estimating Endurance Sports Performance Base on Eigenvalues Extraction Method

Objectives. Brain–behavior connections are a new means to evaluate sports performance. This electroencephalogram (EEG) study aims to estimate endurance exercise performance by investigating eigenvalue trends and comparing their sensitivity and linearity. Methods. Twenty-three cross-country skiers completed endurance cycling tasks. Twenty-four-channel full-brain EEG signals were recorded in the motor phase and recovery phase continuously. Eighteen EEG eigenvalues calculation methods were collected, commonly used in previous research. Time-frequency, band power, and nonlinear analyses were used to calculate the EEG eigenvalues. Their regression coefficients and correlation coefficients were calculated and compared, with the linear regression method. Results. The time-frequency eigenvalues shift slightly throughout the test. The power eigenvalues changed significantly before and after motor and recovery, but the linearity was not satisfactory. The sensitivity and linearity of the nonlinear eigenvalues were stronger than the other eigenvalues. Of all eigenvalues, Shannon entropy showed completely non-overlapping distribution intervals in the regression coefficients of the two phases, which were −0.1474 ± 0.0806 s−1 in the motor phase and 0.2560 ± 0.1365 s−1 in the recovery phase. Shannon entropy amplitude decreased more in the F region of the brain than in the other regions. Additionally, the higher the level of sport, the slower the decline in Shannon entropy of the athlete. Conclusions. The Shannon entropy method provided more accurate estimations for endurance exercise performance compared to other eigenvalues.

Abstract 4137985: Impaired Skeletal Muscle Condition and Stroke Volume Reserve Characterize Poor Exercise Performance in Childhood Cancer Survivors

Background: Childhood cancer survivors (CCS) frequently show poor exercise performance, but its pathophysiology and clinical significance are poorly understood. Methods: Poor exercise performers, defined as peak oxygen consumption (VO2)/kg &lt; 80% of predicted maximum VO2/kg, were enrolled, including 40 CCS (20 males, 20 females) and 32 controls (15 males, 17 females) from 79 CCS and 147 age-matched controls, respectively. Peak and submaximal CPET parameters were compared between CCS and controls with poor exercise performance. Submaximal slope parameters represent a trend up to anaerobic threshold (AT). Results: Ages and anthropometric measurements (weight, height, and body mass index) were comparable between CCS and controls in both sexes (Table 1). Both resting and peak heart rate (HR) were significantly higher in CCS than in controls in males. There was no significant difference in peak VO2/kg, peak oxygen pulse (OP)/kg, peak respiratory exchange ratio, or VO2/kg at AT (VAT/kg) between CCS and controls in both sexes. Peak work rate (WR/kg) was significantly lower in CCS compared with that in controls in both sexes, suggesting reduced muscle strength in CCS. Figure 1 demonstrates decreased muscle mass/strength in CCS than in controls. In males, Δ[VO2/kg]/ ΔHR was significantly lower in CCS than in controls, indicating limited stroke volume reserve (SVR) in male CCS. In female, although there was no significant difference in Δ[VO2/kg]/ΔHR between CCS and controls, HR-dependency expressed by ΔHR/Δ[WR/kg] was significantly higher in CCS than in controls, suggesting impaired SVR. ΔVO2/ΔWR, a marker for physical conditioning, was comparable between CCS and controls in both sexes. Conclusions: Poor exercise performance in CCS is characterized mainly by decreased muscle mass/strength and impaired SVR for both sexs. Impaired SVR may be an early sign of subclinical cardiotoxicity. Poor exercise performance in CCS should be improved to prevent future cardiovascular complications.

Abstract 4137186: No Room for Chronotropic Incompetence in Living Fontan Patients: Enhanced Heart Rate Increase in Response to Exercise to Compensate Low Stroke Volume Reserve

Background: Fontan patients reveal decreased peak exercise performance in combination with low peak heart rate (HR), which is frequently interpreted as chronological incompetence. This is counterproductive as HR increase has to be enhanced to compensate limited stroke volume increase in Fontan physiology. Methods: Cardiopulmonary exercise testing (CPET) data in asymptomatic Fontan patients and age-matched control subjects were retrospectively studied. Peak and submaximal CPET parameters were obtained by cycle ergometer. Chronotropic capacity was assessed by peak HR/peak [WR/kg] and submaximal slope of HR/[work rate (WR)/kg] (ΔHR/Δ[WR/kg]) for males and females, separately. Results: Table 1 presents CPET data of Fontan patients (51) and controls (65). Fontan patients showed significantly lower peak HR, peak WR, peak oxygen consumption (VO2)/kg, %predicted maximum VO2, and peak oxygen pulse (pOP)/kg than controls in both sexes whereas peak HR/peak [WR/kg] was significantly higher in Fontan patients, indicating higher HR at the maximum effort in Fontan patients than in controls. Fontan patients showed higher ΔHR/Δ[WR/kg], a marker for HR-dependency, and lower Δ[VO2/kg]/ΔHR, a surrogate of stroke volume, suggesting higher HR was compensating lower stroke volume during submaximal phase of exercise in Fontan patients. Figure 1 demonstrates a linear relationship between ΔHR/ΔWR and peak HR/peak WR in both sexes. Male Fontan patients revealed a comparable trend with controls, whereas female Fontan patients showed higher HR increase at the peak exercise effort than controls with the same ΔHR/ΔWR, suggesting more limited stroke volume reserve than male Fontan patients. Conclusions: Fontan patients showed higher HR-response to exercise than controls in both sexes due to limitation in stroke volume increase. Our data indicate that lower peak HR in Fontan patients results from early exhaustion due to limited stroke volume reserve rather than primary chronotropic incompetence.

Abstract 4140111: Impact of Digital Health Tools on Patients Undergoing Cardiac Rehabilitation

Digital health apps are novel tools that have the potential to enhance patient care. However, their benefits in the context of cardiac rehabilitation (CR) are not well studied. This study aims to examine an app’s effectiveness in enhancing exercise performance. The app (KardioPAC) connects to both Bluetooth and cellular-enabled BP devices, which allows providers to monitor and communicate with patients remotely. We aim to assess the app’s impact on functional capacity (metabolic equivalents /METs) compared to standard of care (SOC) CR. This study took place at UC San Diego. Participants were recruited from CR, and randomized in a 1:1 ratio to the two study arms (KardioPAC+CR vs SOC CR). The intervention group was requested to take BP at home and upload via KardioPAC. They additionally received a BP reminder daily and got an intra-app call from the care team at least every 1-2 weeks and when needed. All patients, including SOC arm, were asked to complete a pre- and post-CR visit. In each visit, several measurements (including blood pressure, METs, and quality of life questionnaires) were recorded. The study was approved by the UCSD IRB. All statistical analyses were performed on Python 3.11.8. From Jan 2023 to Mar 2024, 43 patients were enrolled. Table 1 shows their demographics. The mean METs changes are 3.68 vs 2.97 (Intervention vs Control, p=0.052). The mean METs percent changes are 104.39% vs 81.22% (Intervention vs Control, p=0.042), as plotted in Figure 1. Our study found that digital tools significantly enhance CR patients’ performance, even with a small sample size. Furthermore, we found positive signals of digital tools in reducing patients’ blood pressure and improving their quality of life. Patients’ behavior could be changed by incorporating digital tools into daily practice. Our study warrants large-scale studies to investigate the underlying mechanisms and verify the broader benefits of digital tools, including physical, mental, and social improvements.

Ginsenoside-Enriched Extract from Black Ginseng Anti-Fatigue Effects by Improving Antioxidant Capacity and Mitochondrial Function

In this study, we investigated the anti-fatigue effects of black ginseng ginsenosides using exercise performance tests, serum analyses, and gene expression profiling. No significant differences in dietary intake or body weight were observed between groups. The low-dose black ginseng (LBG) group showed no significant improvements in swimming and rotating rod tests. In contrast, the medium (MBG)- and high-dose (HBG) groups showed notable increases in swimming time and significant improvements in the rotating rod test. All treatment groups exhibited longer running times, particularly the HBG group. Serum analysis revealed increased muscle and hepatic glycogen, catalase, and lactate dehydrogenase levels in the MBG and HBG groups, whereas lactate, lipid peroxide, and superoxide dismutase levels were decreased. Additionally, gene expression analysis showed significant upregulation of key antioxidant and mitochondrial function genes, including those encoding cationic amino acid transporter 2, stearoyl-CoA desaturase-2, nuclear respiratory factor 1, nuclear factor erythroid 2-related factor 2, mitochondrial transcription factor A, cytochrome c oxidase II, and NADH–ubiquinone oxidoreductase core subunit 1, particularly in the HBG group, indicating enhanced antioxidant capacity and improved mitochondrial function. These findings suggested that black ginseng ginsenosides effectively mitigated fatigue.

A comparative analysis of physical fitness characteristics and rugby-specific game skills of schoolboy players by playing standards: Implications for talent identification programs in resource-constrained settings

Background: Rugby has not grown extensively in Africa compared to other continents, necessitating talent identification (TID) programs to recruit junior talent. However, it is unclear which physical characteristics and rugby-specific game skills to base the objective recruitment of potentially talented young players. Objectives: This study profiled the physical fitness characteristics and rugby-specific game skills of schoolboy rugby players by playing standards to identify variables differentiating elite from sub-elite players from Under 16 (U16) to U19 age categories. The study further compared Zimbabwean cohort data with similar data from international/regional countries. Methods: A cross-sectional design was utilised with 158 Zimbabwean schoolboy players playing competitive (elite) and non-competitive (sub-elite) rugby. The participants were measured for anthropometrics, speed, agility, upper-and-lower-muscular strength/power, muscle flexibility, prolonged high-intensity intermittent running ability, repeated high-intensity exercise performance ability, tackling, passing, and catching abilities. Results: For U16s, Vertical Jump (VJ), 2kg Medicine Ball Chest Throw (2kg MBCT), Wall-Sit-Leg Strength (WSLS), Yo-Yo Intermittent Recovery Level 1 (Yo-Yo IRL1), Tackling and Catching Ability tests discriminated elite from sub-elite players. Among U19s, the following tests differentiated elite from sub-elite players: VJ, 2kg MBCT, WSLS, 20-m/40-m linear speed, 60-s Push Up, One-Repetition Maximum Back Squat (IRM BS), 1RM Bench Press (BP), Repeated High-Intensity Exercise (RHIE), Tackling and Passing Ability. Elite Zimbabwean schoolboy rugby players were significantly leaner, slower, and “weaker” than their international/regional counterparts. Conclusion: The results suggest important physical fitness characteristics and rugby-specific game skills for future identification of potentially talented players at U16/U19 categories.

Hemodynamic responses at anaerobic threshold during exercise in preload insufficiency.

Preload insufficiency is an underrecognized cause of exercise intolerance identified during invasive cardiopulmonary exercise testing, and defined hemodynamically by decreased biatrial filling pressures, cardiac output, and oxygen consumption (V̇O2) at peak effort. Patients with preload insufficiency, however, typically present with symptoms of dyspnea on exertion, and/or exercise intolerance at submaximal efforts, particularly when performing activities of daily living. The cardiopulmonary hemodynamics and physiology at submaximal work levels of preload insufficiency have not been previously investigated. We hypothesized that preload insufficiency hemodynamics exist along a continuum, with submaximal exercise values reflecting peak exercise cardiopulmonary hemodynamics. We compared submaximal cardiopulmonary hemodynamics, measured at anaerobic threshold, between preload insufficiency patients and age-matched controls referred for dyspnea but with normal exercise responses. Our study included 66 patients: 41 with preload insufficiency and 25 controls. Preload insufficiency patients exhibit significantly reduced V̇O2, watts, and METS at submaximal levels compared to controls, alongside earlier anaerobic threshold achievement and similar heart rates at anaerobic threshold. These findings underscore the profound impact of preload insufficiency on submaximal exercise capacity, emphasizing the importance of its recognition and management. This insight sets the stage for further investigations into interventions targeting preload insufficiency at submaximal exercise levels to enhance both exercise performance and quality of life.

Impact of limb occlusion pressure assessment position on performance, cardiovascular, and perceptual responses in blood flow restricted low-load resistance exercise: A randomized crossover trial

ABSTRACT This study investigated the effect of limb occlusion pressure (LOP) position on exercise performance, cardiovascular responses, and perceptual experiences during seated bilateral leg extensions with and without blood flow restriction (BFR). Thirty resistance-trained males (age: 22 ± 2 years; weight: 74.4 ± 13.6 kg; height: 177.4 ± 6.4 cm; BMI: 23.5 ± 3.3 kg/m2) participated. Each performed exercise to failure (4 sets, 30% 1RM, 1 min rest) in three conditions: Supine LOP-BFR, Seated LOP-BFR, and no-BFR. BFR was applied at 60% LOP. Significant interaction effects were found for RPE (p = 0.021, d = 0.76), RPD (p < 0.01, d = 1.72), and DOMS (p < 0.01, d = 2.28). Statistically significant fewer repetitions were completed in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.5), Seated LOP-BFR vs. no-BFR (p < 0.01, d = 1.0), and Seated LOP-BFR vs. Supine LOP-BFR (p < 0.01, d = 0.6). RPE was higher in Seated LOP-BFR vs. no-BFR (p < 0.01, d = 0.52). RPD was higher in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.62) and Seated LOP-BFR vs. no-BFR (p < 0.01, d = 1.25). DOMS was higher in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.77) and Seated LOP-BFR vs. no-BFR (p < 0.01, d = 3.52). Seated LOP-BFR increased perceptual demands and reduced repetitions compared to Supine LOP-BFR. Both LOP-BFR conditions reduced repetitions compared to no-BFR without affecting cardiovascular measures.

Single and consecutive 10-day remote ischemic preconditioning modify physical performance, post-exercise exerkine levels, and inflammation

PurposeRemote ischemic preconditioning (RIPC) is a method of protection against induced ischemia reperfusion injury, and an increasing number of studies showed some of its inconclusive ergogenic effects in sports. RIPC involves short cycles of cuff inflation followed by its deflation which may affect many body systems. While most of the studies focus on single RIPC effects, there is insufficient data regarding training-like repeated RIPC interventions. Thus, in this study, we analyzed the effect of a single- and consecutive 10-day RIPC procedure on a single leg, focusing on the exerkine levels and changes in inflammation markers following the Wingate Anaerobic Test (WAnT).MethodsTwo single-blinded, sham-controlled protocols were designed to evaluate the 1) single (crossover study) and 2) consecutive 10-day (parallel study) RIPC effects on the WAnT performance and exercise-induced lactate, glucose, exerkine, and inflammation markers (BDNF; IL-6; IL-10; IL-15; LIF; oncostatin M). In each protocol, 37 physically active men (19.98 ± 1.17 years) were randomly assigned into two groups according to a particular study design.ResultsAn increase in participants’ mean (4.81%, p &amp;lt; 0.05) and peak power (6.25%, p &amp;lt; 0.05) during the WAnT was observed only after the consecutive 10-day RIPC. Similarly, a significant 15.5% (p &amp;lt; 0.05) decrease in the IL-6 concentration 120 min after the WAnT was observed only in the consecutive 10-day RIPC protocol, as well as a 12.2% (p &amp;lt; 0.01) increase in oncostatin M 60 min after the WAnT.ConclusionThe results demonstrate the efficacy of the consecutive 10-day RIPC procedure in modulating exercise performance and post-exercise inflammation markers.