Gas Exchange Threshold Research Articles

Effects of 5-Week Oral Acetazolamide on Incremental Cycling Exercise in Pulmonary Arterial and Chronic Thromboembolic Pulmonary Hypertension: A Randomized Placebo-Controlled, Double-Blinded, Crossover Trial

Introduction: Acetazolamide (AZA) improves nocturnal and daytime blood oxygenation in patients with pulmonary vascular disease (PVD), defined as pulmonary arterial and distal chronic thromboembolic pulmonary hypertension (CTEPH), and may improve exercise performance. Methods: We investigated the effect of 5 weeks of AZA (250 mg bid) versus placebo on maximal load during incremental cycling ramp exercise in patients with PVD studied in a randomized controlled, double-blind, crossover design, separated by > 2 weeks of washout. Results: Twenty-five patients (12 pulmonary arterial hypertension, 13 CTEPH, 40% women, age 62 ± 15 years) completed the trial according to the protocol. Maximum load was similar after 5 weeks of AZA versus placebo (113 ± 9 vs. 117 ± 9 watts [W]), mean difference −4 W (95% CI: −9 to 1, p = 0.138). With AZA, maximum (max)-exercise partial pressure of O₂ (PaO₂) was significantly higher by 1.1 kPa (95% CI: 0.5–1.8, p = 0.003), while arterial pH and partial pressure of CO₂ were significantly lower. Gas exchange threshold was reached at a higher load with AZA (108 ± 8 W vs. 97 ± 8 W) and was therefore delayed by 11 W (95% CI: 3–19, p = 0.013), while the ventilatory equivalent for O₂ and CO₂ were significantly higher at both the max-exercise and gas exchange threshold with AZA versus placebo. Conclusion: AZA for 5 weeks did not significantly change maximum exercise capacity in patients with PVD despite a significant increase in PaO₂. The beneficial effects of increased blood oxygenation may have been diminished by increased ventilation due to AZA-induced metabolic acidosis and increased dyspnea.

Heart Rate Variability Thresholds: Agreement with Established Approaches and Reproducibility in Trained Females and Males.

To determine in trained females and males i) the agreement between the gas exchange threshold (GET), lactate threshold 1 (LT1), and heart rate variability threshold 1 (HRVT1), as well as between the respiratory compensation point (RCP), lactate threshold 2 (LT2), and heart rate variability threshold 2 (HRVT2), and ii) the reproducibility of HRVT1 and HRVT2 during 2-min incremental step protocols. Fifty-seven trained participants (24 females) completed a 2-min step incremental test to task failure. Nineteen participants (eight females) completed a second test to evaluate reproducibility. Gas exchange and ventilatory responses, blood lactate concentration, and RR time series were recorded to assess the oxygen consumption (V̇O 2 ) and heart rate (HR) associated with the GET, RCP, LT1, LT2, HRVT1, and HRVT2. V̇O 2 -GET versus V̇O 2 -HRVT1 and HR-GET versus HR-HRVT1 were statistically different for females (29.5 ± 4.0 vs 34.6 ± 6.1 mL·kg -1 ·min -1 ; 154 ± 11 vs 166 ± 12 bpm) and for males (33.9 ± 4.2 vs 42.7 ± 4.6 mL·kg -1 ·min -1 ; 145 ± 11 vs 165 ± 9 bpm; P < 0.001). V̇O 2 and HR at HRVT1 were greater than at LT1 ( P < 0.05). V̇O 2 -RCP versus V̇O 2 -HRVT2 and HR-RCP versus HR-HRVT2 were not statistically different for females (40.1 ± 4.7 vs 39.5 ± 6.7 mL·kg -1 ·min -1 ; 177 ± 9 vs 176 ± 9 bpm) and males (48.4 ± 5.4 vs 47.8 ± 4.8 mL·kg -1 ·min -1 ; 176 ± 8 vs 175 ± 9 bpm; P > 0.05). V̇O 2 and HR responses at LT2 were similar to HRVT2 ( P > 0.05). Intraclass correlation coefficient for V̇O 2 -HRVT1, HR-HRVT1, V̇O 2 -HRVT2, and HR-HRVT2 indicated good reproducibility when comparing the two different time points to standard methods. Whereas HRVT2 is a valid and reproducible estimate of the RCP/LT2, current approaches for HRVT1 estimation did not show good agreement with outcomes at GET and LT1.

Effects of 24-week Polarized Training vs. Threshold Training in Obese Male Adults.

The combination of high volume of moderate-intensity continuous training with a low volume of high-intensity interval training improved body composition and physical capacities in individuals with obesity. However, polarized training (POL) has never been used in adult men with obesity. Thus, the purpose of this study was to investigate changes in body composition and physical capacities induced by a 24-week POL or threshold (THR) program in obese male adults. Twenty male patients (mean age 39.8±6.3 yrs; mean body mass index [BMI] 31.6±2.7 kg∙m-2) participated in this study (n: 10 POL, n: 10 THR). After 24-week, body mass (BM) and fat mass (FM) decreased by -3.20±3.10 kg (P<0.05) and -3.80±2.80 kg (P<0.05), respectively, similarly in both groups. Maximal oxygen uptake ( ̇VO2max) and ̇VO2 at respiratory compensation point (RCP) increased in the POL group (+8.5±12.2 and+9.0±17.0%, P<0.05) and in the THR group (+4.24±8.64 and+4.0±6.70%, P<0.05), as well ̇VO2 at gas exchange threshold (GET) increased similarly in both groups (+12.8±12.0%, P<0.05). POL and THR were equally effective in improving body composition and physical capacities in obese subjects. Future studies are needed to determine whether adherence to the training program can be improved by adding a running competition compared with a group without competition at the end of the training program.

A new protocol for a single-stage combined cardiopulmonary and echocardiography exercise test: a pilot study.

The value of cardiopulmonary exercise testing (CPET) and exercise stress echocardiography (ESE) in managing cardiac disease is well known, but no standard CPET-ESE protocol is currently recommended. This pilot study aims to compare feasibility and cardiac function responses between a new high-intensity single-stage combined test (CPET-hiESE) and a standard maximal ESE (smESE). After screening and maximal CPET, all volunteers (n = 21) underwent three ESE modalities: (i) based on the gas exchange threshold (hiESE-GET, 40% of peak-GET, 6 min), (ii) based on heart rate (HR) (hiESE-HR, 80% of peak HR, 6 min), and (iii) smESE (85% of predicted peak HR for age, 3 min). Speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI) were measured at each step. There was superior image quality and data completeness for the right ventricle strain for both hiESE modalities compared with smESE (71.4 and 76.2 vs. 42.9%, P = 0.07). Left ventricular STE data completeness was similar for all three conditions. Despite systematically higher HR, work rate and levels of exertion in the smESE compared with hiESE, STE and TDI parameters were not systematically different. Concordance correlation coefficients ranged from 0.56 to 0.88, lowest for strain rate parameters and mean difference from -0.34 to 1.53, highest for TDI measurements. The novel CPET-hiESE protocol allowed for better data completeness, at lower levels of exertion compared with smESE, without systematically different cardiac reserve measurements in healthy participants. This single-stage protocol can be individualized to clinical populations, which would provide practical advantages to standard testing.

Differential impact of heat and hypoxia on dynamic oxygen uptake and deoxyhemoglobin parameters during incremental exhaustive exercise.

Purpose: This study aims to explore the relationship between the dynamic changes in oxygen uptake () and deoxyhemoglobin (HHb) and peripheral fatigue in athletes during incremental exhaustive exercise under different environmental conditions, including high temperature and humidity environment, hypoxic environment, and normal conditions. Methods: 12 male modern pentathlon athletes were recruited and performed incremental exhaustive exercise in three different environments: normal condition (23°C, 45%RH, FiO2 = 21.0%, CON), high temperature and humidity environment (35°C, 70%RH, FiO2 = 21.0%, HOT), and hypoxic environment (23°C, 45%RH, FiO2 = 15.6%, HYP). Gas metabolism data of the athletes were collected, and muscle oxygen saturation (SmO2) and total hemoglobin content in the vastus lateralis muscles (VL) were measured to calculate the deoxyhemoglobin content. Linear and nonlinear function models were used to fit the characteristic parameters of and HHb changes. Results: The results showed that compared to the CON, , , and exercise time were decreased in the HOT and HYP (p < 0.05). and OUES were reduced in the HOT and HYP compared to the CON (p < 0.05). The Gas exchange threshold in the CON corresponded to higher than in the HYP and HOT (p < 0.05). was reduced in the HOT compared to the HYP (p < 0.05). ΔEHHb was higher in the HOT compared to the CON (p < 0.05). ΔEHHb-1 was increased in the HYP compared to the CON (p < 0.05). There was a negative correlation between ΔEHHb and corresponding in the HOT (r = -0.655, p < 0.05), and a negative correlation between ΔEHHb-1 and corresponding in the HYP (r = -0.606, p < 0.05). Conclusion: Incremental exhaustive exercise in hypoxic environment and high temperature and humidity environments inhibits gas exchange and oxygen supply to skeletal muscle tissue in athletes. For athletes, the accelerated deoxygenation response of skeletal muscles during incremental exhaustive exercise in high temperature and humidity environments, as well as the excessive deoxygenation response before BP of deoxyhemoglobin in hypoxic environment, may be contributing factors to peripheral fatigue under different environmental conditions.

Intensity Distribution of Collegiate Cross-Country Competitions.

The primary purpose of the current investigation was to perform an intensity distribution analysis of a collegiate cross-country (CC) competition, with a secondary purpose to compare race times (RT) with modeled performance times (MPT). Participants completed an incremental treadmill test to determine gas exchange threshold (GET), while the three-minute all-out test was conducted on a 400 m outdoor track to determine critical velocity (CV) and D prime (D'). GET and CV were used as physiological markers for the intensity zones based on heart rate (HR) and running velocity (RV), while CV and D' were used to determine modeled performance times. Participants wore a Global Positioning System (GPS) watch and heart rate (HR) monitor during competition races. Statistically, less time was spent in HR Zone 1 (12.1% ± 13.7%) compared to Zones 2 (37.6% ± 30.2%) and 3 (50.3% ± 33.7%), while a statically greater amount of time was spent in RV Zone 2 (75.0% ± 20.7%) compared to Zones 1 (8.4% ± 14.0%) and 3 (16.7% ± 19.1%). RTs (1499.5 ± 248.5 seconds (s)) were statistically slower compared to MPTs (1359.6 ± 192.7 s). The observed differences in time spent in each zone are speculated to be related to the influence of environmental conditions on internal metrics and difference in the kinetics of HR and running velocity. Differences in RTs and MPTs are likely due to the MPT equation modeling all-out performance and not considering race strategies.

Improving the Agreement Between the First Heart-Rate-Variability Threshold and the Gas-Exchange Threshold.

The first heart-rate (HR) -variability (HRV) -derived threshold based on detrended fluctuation analysis alpha 1 (DFA a1) has shown inconsistent agreement with the gas-exchange threshold (GET). This study examined whether a custom method of computing thefirst HRV threshold (HRVT1) based on individual HRV characteristics would improve agreement. Fourteen participants underwent ramp incremental testing measuring gas-exchange variables and RR intervals. Comparisons were made between the oxygen consumption (V˙O2)/HR at the GET versus the V˙O2/HR at the standard DFA a1 = 0.75 (HRVT1s) or a custom value (HRVT1c) based on the DFA a1 midway between the maximum seen during the early ramp incremental and 0.5. Mean values for GET V˙O2 versus HRVT1s V˙O2 and GETHR versus HRVT1sHR were statistically different (25.4 [3.3] vs 29.8 [6.8]mL·kg-1·min-1, P = .01, d = 0.80; 131 [11] vs 146 [22]beats·min-1, P = .005, d = 0.91). There were no statistical differences when using the HRVT1c (25.4 [3.3] vs 25.1 [5.7]mL·kg-1·min-1, P = .77, d = 0.08; 131 [11] vs 132 [17]beats·min-1, P = .65, d = 0.12). Equivalence between GET and HRVT1c V˙O2/HR was also verified. Mean maximal DFA a1 during the early ramp incremental was 1.52 (0.22) with mean HRVT1c of 1.01 (0.11). Pearson r correlation coefficients were between .67 and .70 for all GET to HRVT1 comparisons. The second HRV threshold and respiratory compensation point parameters showed agreement and correlations in line with prior studies. The HRVT1c showed stronger agreement to GET parameters than seen using the HRVT1s. It is recommended that evaluations of the HRVT1 consider this approach in determining the HR and V˙O2 at this threshold.

The Influence of Acute Hypoxia on Oxygen Uptake and Muscle Oxygenation Kinetics During Cycling Exercise in Prepubertal Boys.

To examine the effect of normobaric hypoxia on pulmonary oxygen uptake (V˙O2) and muscle oxygenation kinetics during incremental and moderate-intensity exercise in children. Eight prepubertal boys (9-11y)performed incremental cycle tests to exhaustion in both normoxia and hypoxia (fraction of inspired O2 of 15%) followed by repeat 6-minute transitions of moderate-intensity exercise in each condition over subsequent visits. Maximal oxygen uptake (V˙O2max) was reduced in hypoxia compared with normoxia (1.69 [0.20] vs 1.87 [0.26]L·min-1, P = .028), although the gas exchange threshold was not altered in absolute terms (P = .33) or relative to V˙O2max (P = .78). During moderate-intensity exercise, the phase II V˙O2 time constant (τ) was increased in hypoxia (18 [9] vs 24 [8]s, P = .025), with deoxyhemoglobin τ unchanged (17 [8] vs 16 [6], P ≥ .28). In prepubertal boys, hypoxia reduced V˙O2max and slowed V˙O2 phase II kinetics during moderate-intensity exercise, despite unchanged deoxyhemoglobin kinetics. These data suggest an oxygen delivery dependence of V˙O2max and moderate-intensity V˙O2 kinetics under conditions of reduced oxygen availability in prepubertal boys.

Evaluation of the "Step-Ramp-Step" Protocol: Accurate Aerobic Exercise Prescription with Different Steps and Ramp Slopes.

To assess whether: i) a lower amplitude constant-load MOD is appropriate to determine the mean response time (MRT); ii) the method accurately corrects the dissociation in the V̇O 2 -PO relationship during ramp compared with constant-load exercise when using different ramp slopes. Eighteen participants (7 females) performed three SRS tests including: i) step-transitions into MOD from 20 to 50 W (MOD 50 ) and 80 W (MOD 80 ); and ii) slopes of 15, 30, and 45 W·min -1 . The V̇O 2 and PO at the gas exchange threshold (GET) and the corrected respiratory compensation point (RCP CORR ) were determined. Two to three 30-min constant-load trials evaluated the V̇O 2 and PO at the maximal metabolic steady state (MMSS). There were no differences in V̇O 2 at GET (1.97 ± 0.36, 1.99 ± 0.36, 1.95 ± 0.30 L·min -1 ), and RCP (2.81 ± 0.57, 2.86 ± 0.59, 2.84 ± 0.59) between 15, 30, and 45 W·min -1 ramps, respectively ( P > 0.05). The MRT in seconds was not affected by the amplitude of the MOD or the slope of the ramp (range 19 ± 10 s to 23 ± 20 s; P > 0.05). The mean PO at GET was not significantly affected by the amplitude of the MOD or the slope of the ramp (range 130 ± 30 W to 137 ± 30 W; P > 0.05). The PO at RCP CORR was similar for all conditions ((range 186 ± 43 W to 193 ± 47 W; P > 0.05). The SRS protocol accounts for the V̇O 2 MRT when using smaller amplitude steps, and for the V̇O 2 slow component when using different ramp slopes, allowing for accurate partitioning of the exercise intensity domains in a single test.

The Effects of a 90-km Outdoor Cycling Ride on Performance Outcomes Derived From Ramp-Incremental and 3-Minute All-Out Tests.

Bitel, M, Keir, DA, Grossman, K, Barnes, M, Murias, JM, and Belfry, GR. The effects of a 90-km outdoor cycling ride on performance outcomes derived from ramp-incremental and 3-minute all-out tests. J Strength Cond Res 38(3): 540-548, 2024-The purpose of this study was to determine whether laboratory-derived exercise intensity and performance demarcations are altered after prolonged outdoor cycling. Male recreational cyclists ( n = 10; RIDE) performed an exhaustive ramp-incremental test (RAMP) and a 3-minute all-out test (3MT) on a cycle ergometer before and after a 90-km cycling ride. RAMP-derived maximal oxygen uptake (V̇O 2max ), gas exchange threshold (GET), respiratory compensation point (RCP), and associated power output (PO), as well as 3MT-derived critical power (CP) and work performed above CP, were compared before and after ∼3 hours of outdoor cycling. Six active men served as "no-exercise" healthy controls (CON), who, instead, rested for 3 hours between repeated RAMP and 3MT tests. During the 90-km ride, the duration within the moderate-intensity, heavy-intensity, and severe-intensity domains was 59 ± 24%, 40 ± 24%, and 1 ± 1%, respectively. Compared with pre-90 km, post-RAMP exhibited reductions in (a) V̇O 2max (4.04 ± 0.48 vs. 3.80 ± 0.38 L·min -1 ; p = 0.026) and associated PO (392 ± 30 W vs. 357 ± 26 W; p = 0.002); (b) the V̇O 2 and PO at RCP (3.49 ± 0.46 vs. 3.34 ± 0.43 L·min -1 ; p = 0.040 and 312 ± 40 W vs. 292 ± 24 W; p = 0.023); and (c) the PO (214 ± 32 W vs. 198 ± 25 W; p = 0.027), but not the V̇O 2 at GET (2.52 ± 0.44 vs. 2.44 ± 0.38 L·min -1 ; p = 0.388). Pre-90 km vs. post-90 km 3MT variables showed reduced W' (9.8 ± 3.4 vs. 6.8 ± 2.6 kJ; p = 0.002) and unchanged CP (304 ± 26 W and 297 ± 34 W; p = 0.275). In the CON group, there were no differences in V̇O 2max , GET, RCP, W', CP, or associated power outputs ( p > 0.05) pre-to-post 3 hours of rest. The preservation of critical power demonstrates that longer-duration maximal efforts may be sustained after long-duration cycle. However, shorter sprints and higher-intensity efforts eliciting V̇O 2max will exhibit decreased PO after 3 hours of a predominantly moderate-intensity cycle.

Analysing experienced and inexperienced cyclists’ attentional focus and self-regulatory strategies during varying intensities of fixed perceived effort cycling: A mixed method study

Using a think aloud approach during fixed perceived effort exercise is a unique method to explore the decision-making processes that guide the self-regulation of perceived effort during endurance-based activity. In a two-part study, authors investigated the attentional focus and self-regulatory strategies associated with: Part A - perceived effort corresponding to (RPEGET) and above gas exchange threshold (RPE+15%GET); Part B - between experienced and inexperienced cyclists during fixed perceived effort cycling tasks. Eighteen (15 male, 3 female) healthy, active individuals completed three visits (visit 1 – ramped incremental test and familiarisation, visit 2 and 3–30-min fixed perceived effort cycling). During which, power output, heart rate, lactate, think aloud, and perceptual markers were taken. Random-intercepts linear mixed-effects models assessed the condition, time, and condition × time interactions on all dependent variables. Power output, heart rate, lactate and instances of internal sensory monitoring (t195=2.57,p=.011,β=0.95[0.23,1.68]) and self-regulation (t195=4.14,p=.001,β=1.69[0.89,2.49]) were significantly higher in the RPE+15%GET versus RPEGET trial. No significant differences between inexperienced and experienced cyclists for internal sensory monitoring (t196=−1.78,p=.095,β=−1.73[−3.64,0.18]) or self-regulatory thoughts (t196=−0.39,p=.699,β=−1.06[−6.32,4.21]) were noted but there were significant condition × time interactions for internal monitoring (t196=2.02,p=.045,β=0.44[0.01,0.87]) and self-regulation (t196=3.45,p=.001,β=0.85[0.37,1.33]). Seemingly, experienced athletes associatively attended to internal psychophysiological state and subsequently self-regulate their psychophysiological state at earlier stages of exercise than inexperienced athletes. This is the first study to exhibit the differences in attentional focus and self-regulatory strategies that are activated based on perceived effort intensity and experience level in cyclists.

Critical power is a key threshold determining the magnitude of post-exercise hypotension in non-hypertensive young males.

The effect of different exercise intensities on the magnitude of post-exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post-exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non-hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W' (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post-exercise hypotension: 10% above critical power (10%>CP), 10% below critical power (10%<CP), 10% above GET (10%>GET) and 10% below GET (10%<GET). The post-exercise decrease (i.e., the minimum post-exercise values) in mean arterial (10%>CP: -12.7±8.3 vs. 10%<CP: v3.5±2.9mmHg), diastolic (10%>CP: -9.6±9.8 vs. 10%<CP: -1.4±5.0mmHg) and systolic (10%>CP: -23.8±7.0 vs. 10%<CP: -9.9±4.3mmHg) blood pressures were greater following exercise performed 10%>CP compared to all other trials (all P<0.01). No effects of exercise intensity on the magnitude of post-exercise hypotension were observed during exercise performed below critical power (all P>0.05). Critical power represents a threshold above which the magnitude of post-exercise hypotension is greatly augmented. NEW FINDINGS: What is the central questions of this study? What is the influence of exercise intensity on the magnitude of post-exercise hypotension with respect to metabolic thresholds? What is the main finding and its importance? The magnitude of post-exercise hypotension is greatly increased following exercise performed above critical power. However, below critical power, there was no clear effect of exercise intensity on the magnitude of post-exercise hypotension.

Stroke and physiological relationships during the incremental front crawl test: outcomes for planning and pacing aerobic training.

Purpose: This study aimed to evaluate the physiological responses associated with the stroke length (SL) and stroke rate (SR) changes as swimming velocity increases during an incremental step-test. Moreover, this study also aimed to verify if SL and SR relationships toward maximal oxygen uptake (V̇O2max), gas respiratory compensation point (RCP), exchange threshold (GET), and swimming cost can be applied to the management of endurance training and control aerobic pace. Methods: A total of 19 swimmers performed the incremental test until volitional exhaustion, with each stage being designed by percentages of the 400m (%v400) maximal front crawl velocity. V̇O2max, GET, RCP, and the respective swimming velocities (v) were examined. Also, the stroke parameters, SL, SR, the corresponding slopes (SLslope and SRslope), and the crossing point (Cp) between them were determined. Results: GET and RCP corresponded to 70.6% and 82.4% of V̇O2max (4185.3 ± 686.1mLmin-1), and V̇O2 at Cp, SLslope, and SRslope were observed at 129.7%, 75.3%, and 61.7% of V̇O2max, respectively. The swimming cost from the expected V̇O2 at vSLslope (0.85 ± 0.18kJm-1), vSRslope (0.77 ± 0.17kJm-1), and vCp (1.09 ± 0.19kJm-1) showed correlations with GET (r = 0.73, 0.57, and 0.59, respectively), but only the cost at vSLslope and vCp correlated to RCP (0.62 and 0.69) and V̇O2max (0.70 and 0.79). Conclusion: SL and SR exhibited a distinctive pattern for the V̇O2 response as swimming velocity increased. Furthermore, the influence of SL on GET, RCP, and V̇O2max suggests that SLslope serves as the metabolic reference of heavy exercise intensity, beyond which the stroke profile defines an exercise zone with high cost, which is recommended for an anaerobic threshold and aerobic power training. In turn, the observed difference between V̇O2 at SRslope and GET suggests that the range of velocities between SL and SR slopes ensures an economical pace, which might be recommended to develop long-term endurance. The results also highlighted that the swimming intensity paced at Cp would impose a high anaerobic demand, as it is located above the maximal aerobic velocity. Therefore, SLslope and SRslope are suitable indexes of submaximal to maximal aerobic paces, while Cp's meaning still requires further evidence.

Tramadol is a performance-enhancing drug in highly trained cyclists: a randomized controlled trial.

Tramadol is a potent narcotic analgesic reportedly used in multiple sports to reduce exertional pain and confer a performance advantage. This study sought to identify whether tramadol enhances performance in time trial cycling. Twenty-seven highly trained cyclists were screened for tramadol sensitivity and then attended the laboratory across three visits. Visit 1 identified maximal oxygen uptake, peak power output, and gas exchange threshold through a ramp incremental test. Participants returned to the laboratory on two further occasions to undertake cycling performance tests following the ingestion of either 100 mg of soluble tramadol or a taste-matched placebo control in a double-blind, randomized, and crossover design. In the performance tests, participants completed a 30 min non-exhaustive fixed intensity cycling task at a heavy exercise intensity (272 ± 42 W), immediately followed by a competitive self-paced 25-mile time trial (TT). Following removal of two outlier data sets, analysis was completed on n = 25. Participants completed the TT significantly faster (d = 0.54, P = 0.012) in the tramadol condition (3758 s ± 232 s) compared with the placebo condition (3808 s ± 248 s) and maintained a significantly higher mean power output (+9 W) throughout the TT (ηp2 = 0.262, P = 0.009). Tramadol reduced perception of effort during the fixed intensity trial (P = 0.026). The 1.3% faster time in the tramadol condition would be sufficient to change the outcomes of a race and is highly meaningful and pervasive in this cohort of highly trained cyclists. The data from this study suggests that tramadol is a performance-enhancing drug.NEW & NOTEWORTHY In the current study, when cycling with tramadol participants completed a time trial on average 50 s faster and at a 9 W higher power output than the placebo control. The study used both a fixed intensity and self-paced time trial exercise tasks to reflect the demands of a stage race. The outcomes from this study were used by the World Anti-Doping Agency to inform their addition of tramadol to the Prohibited List in 2024.

Physiological Characteristics of Competitive Male Junior Cyclists Transitioning to the Under-23 Level: A Retrospective Comparative Study.

The purpose of the current investigation was to retrospectively assess possible differences in physiological performance characteristics between junior cyclists signing a contract with an under-23 (U23) development team versus those failing to sign such a contract. Twenty-five male junior cyclists (age: 18.1 [0.7]y, stature: 181.9 [6.0]cm, body mass: 69.1 [7.9]kg, peak oxygen uptake: 71.3 [6.2]mL·min-1·kg-1) were assigned to this investigation. Between September and October of the last year in the junior category, each cyclist performed a ramp incremental exercise test to determine certain physiological performance characteristics. Subsequently, participants were divided in 2 groups: (1)those signing a contract with a U23 development team (JUNIORU23) and (2)those failing to sign such a contract (JUNIORNON-U23). Unpaired t tests were used to assess possible between-groups differences in physiological performance characteristics. The level of statistical significance was set at P < .05 two tailed. No significant between-groups differences in submaximal (ie,gas exchange threshold, respiratory compensation point) and maximal physiological performance characteristics (ie,peak work rate, peak oxygen uptake) expressed in absolute values (ie,L·min-1, W) were observed (P > .05). However, significant between-groups differences were observed when physiological performance characteristics were expressed relative to the cyclists' body weights (P < .05). The current investigation showed that junior cyclists stepping up to a U23 development team might be retrospectively differentiated from junior cyclists not stepping up based on certain physiological performance characteristics, which might inform practitioners and/or federations working with young cyclists during the long-term athletic development process.

Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study

PurposeAlthough cardiac troponin I (cTnI) increase following strenuous exercise has been observed, the development of exercise-induced myocardial edema remains unclear. Cardiac magnetic resonance (CMR) native T1/T2 mapping is sensitive to the pathological increase of myocardial water content. Therefore, we evaluated exercise-induced acute myocardial changes in recreational cyclists by incorporating biomarkers, echocardiography and CMR.MethodsNineteen male recreational participants (age: 48 ± 5 years) cycled the ‘L’étape du tour de France” (EDT) 2021’ (175 km, 3600 altimeters). One week before the race, a maximal graded cycling test was conducted to determine individual heart rate (HR) training zones. One day before and 3–6 h post-exercise 3 T CMR and echocardiography were performed to assess myocardial native T1/T2 relaxation times and cardiac function, and blood samples were collected. All participants were asked to cycle 2 h around their anaerobic gas exchange threshold (HR zone 4).ResultsEighteen participants completed the EDT stage in 537 ± 58 min, including 154 ± 61 min of cycling time in HR zone 4. Post-race right ventricular (RV) dysfunction with reduced strain and increased volumes (p < 0.05) and borderline significant left ventricular global longitudinal strain reduction (p = 0.05) were observed. Post-exercise cTnI (0.75 ± 5.1 ng/l to 69.9 ± 41.6 ng/l; p < 0.001) and T1 relaxation times (1133 ± 48 ms to 1182 ± 46 ms, p < 0.001) increased significantly with no significant change in T2 (p = 0.474). cTnI release correlated with increase in T1 relaxation time (p = 0.002; r = 0.703), post-race RV dysfunction (p < 0.05; r = 0.562) and longer cycling in HR zone 4 (p < 0.05; r = 0.607).ConclusionStrenuous exercise causes early post-race cTnI increase, increased T1 relaxation time and RV dysfunction in recreational cyclists, which showed interdependent correlation. The long-term clinical significance of these changes needs further investigation.Trial registration numbers and dateNCT 04940650 06/18/2021. NCT 05138003 06/18/2021.

Agreement between left and right middle cerebral artery blood velocity responses to incremental and constant work-rate exercise in healthy males and females

Objective. To quantify the agreement between left and right middle cerebral artery blood velocity (MCAv) responses to incremental and constant work-rate exercise in adults. Approach Seventeen healthy adults (23.8 ± 2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer, three 6-minute transitions at a moderate-intensity, and three at a heavy-intensity, all on separate days. Bilateral MCAv was measured throughout using transcranial Doppler ultrasonography, with left and right MCAv data analysed separately. Data were analysed at baseline, gas exchange threshold, respiratory compensation point and exhaustion during ramp incremental exercise. MCAv responses to constant work-rate exercise were analysed using a mono-exponential model, to determine time- and amplitude-based kinetic response parameters. Main Results Left and right MCAv responses to incremental and constant work-rate exercise were significantly, strongly and positively correlated (r ≥ 0.61, P < 0.01). Coefficient of variation (left versus right) ranged from 7.3%–20.7%, 6.4%–26.2% and 5.9%–22.5% for ramp, moderate and heavy-intensity exercise, respectively. The relative change in MCAv from baseline was higher in the right compared to left MCAv during ramp, moderate and heavy-intensity exercise (all P < 0.05), but the effect sizes were small (d ≤ 0.4). Small mean left–right differences were present during ramp incremental exercise at all time-points (<6 cm s−1; <4%), and for all kinetic parameters during moderate and heavy-intensity exercise (<3 cm s−1, <3%, <4 s). Significance These findings demonstrate similarities between left and right MCAv responses to incremental and constant-work rate exercise in adults on a group-level, but also highlight individual variation in the agreement between left and right MCAv exercise responses.

Medium chain triglycerides with a C8:C10 ratio of 30:70 enhances cognitive performance and mitigates the cognitive decline associated with prolonged exercise in young and healthy adults

IntroductionProlonged exercise has been linked to a decline in cognitive function due to a variety of factors, such as a drop in oxygen in the prefrontal cortex and an increase in stress hormones and neurotransmitters. Medium chain triglycerides (MCTs) may possibly offset this decline as they provide energy for the brain via both direct and indirect pathways, alongside promoting chronic physiological adaptations within the brain. MethodsParticipants were divided into two groups; MCT (n = 9) and Placebo (n = 10). The MCT gels contained 6 g of MCT with a C8:C10 ratio of 30:70, whereas the placebo gels contained carbohydrates of similar calorific value to the MCT gels. Participants visited the laboratory on three occasions (familiarisation/fitness test, pre-supplementation, post-supplementation), during which they performed a battery of cognitive tasks assessing domains such as processing speed, working memory, selective attention, decision making and coordination, before and after a prolonged bout of exercise (60 mins at 90% gas exchange threshold (GET). A 2-week supplementation period between visits 2 and 3 involved the ingestion of 2 gels per day. ResultsExercise resulted in detriments in most cognitive tasks pre-supplementation for both groups, and post-supplementation for the Placebo group (main effect ps< 0.05). Post-supplementation, the effect of exercise was mediated in the MCT group for all cognitive tasks (main effect ps< 0.05), except for the Digit and Spatial Span Backwards test phases (main effect ps> 0.05). Furthermore, MCT supplementation enhanced before-exercise cognitive performance and in some measures, such as working memory, this was maintained after-exercise (interaction effect ps> 0.05). ConclusionsChronic MCT supplementation enhanced before-exercise cognitive performance and offset the cognitive decline caused by a prolonged bout of exercise. In some cases, improvements in before-exercise cognitive performance were maintained after-exercise.

An undergraduate laboratory to study exercise thresholds.

In exercise physiology, laboratory components help students connect theoretical concepts to their own exercise experiences and introduce them to data collection, analysis, and interpretation using classic techniques. Most courses include a lab protocol that involves exhaustive incremental exercise during which expired gas volumes and concentrations of oxygen and carbon dioxide are measured. During these protocols, there are characteristic alterations in gas-exchange and ventilatory profiles that give rise to two exercise thresholds: the gas exchange threshold (GET) and the respiratory compensation point (RCP). The ability to explain why these thresholds occur and how they are identified are fundamental to learning in exercise physiology and requisite to the understanding of core concepts including exercise intensity, prescription, and performance. Proper identification of GET and RCP requires the assembly of 8 data plots. In the past, the burden of time and expertise required to process and prepare data for interpretation has been a source of frustration. In addition, students often express a desire for more opportunities to practice/refine their skills. The objective of this article is to share a blended laboratory model that features the "Exercise Thresholds App" - a free online resource that eliminates post-processing of data and provides a bank of profiles on which end-users can practice threshold identification skills with immediate feedback. In addition to including pre-laboratory and post-laboratory recommendations, we present student accounts of understanding, engagement, and satisfaction following completion of the laboratory experience and introduce a new quiz feature of the app to assist instructors with evaluating student learning.

Oxygen Uptake Kinetics and Time Limit at Maximal Aerobic Workload in Tethered Swimming.

This study aimed to apply an incremental tethered swimming test (ITT) with workloads (WL) based on individual rates of front crawl mean tethered force (Fmean) for the identification of the upper boundary of heavy exercise (by means of respiratory compensation point, RCP), and therefore to describe oxygen uptake kinetics (VO2k) and time limit (tLim) responses to WL corresponding to peak oxygen uptake (WLVO2peak). Sixteen swimmers of both sexes (17.6 ± 3.8 years old, 175.8 ± 9.2 cm, and 68.5 ± 10.6 kg) performed the ITT until exhaustion, attached to a weight-bearing pulley-rope system for the measurements of gas exchange threshold (GET), RCP, and VO2peak. The WL was increased by 5% from 30 to 70% of Fmean at every minute, with Fmean being measured by a load cell attached to the swimmers during an all-out 30 s front crawl bout. The pulmonary gas exchange was sampled breath by breath, and the mathematical description of VO2k used a first-order exponential with time delay (TD) on the average of two rest-to-work transitions at WLVO2peak. The mean VO2peak approached 50.2 ± 6.2 mL·kg-1·min-1 and GET and RCP attained (respectively) 67.4 ± 7.3% and 87.4 ± 3.4% VO2peak. The average tLim was 329.5 ± 63.6 s for both sexes, and all swimmers attained VO2peak (100.4 ± 3.8%) when considering the primary response of VO2 (A1' = 91.8 ± 6.7%VO2peak) associated with the VO2 slow component (SC) of 10.7 ± 6.7% of end-exercise VO2, with time constants of 24.4 ± 9.8 s for A1' and 149.3 ± 29.1 s for SC. Negative correlations were observed for tLim to VO2peak, WLVO2peak, GET, RCP, and EEVO2 (r = -0.55, -0.59, -0.58, -0.53, and -0.50). Thus, the VO2k during tethered swimming at WLVO2peak reproduced the physiological responses corresponding to a severe domain. The findings also demonstrated that tLim was inversely related to aerobic conditioning indexes and to the ability to adjust oxidative metabolism to match target VO2 demand during exercise.