Maximal Heart Rate Research Articles

Application of immersive virtual reality in the training of wheelchair boxers: evaluation of exercise intensity and users experience additional load– a pilot exploratory study

BackgroundOver the last few years, there has been a growing interest in workout apps and active virtual reality video games (AVRGs), which provide entertainment and enable users to undertake various forms of physical activity (PA) at home. Presumably, these types of exercises can be particularly useful for people with physical disabilities, who experience problems with access to sports and leisure facilities due to architectural and communication barriers. However, it is interesting whether the intensity of PA in VR is high enough to provide users with health benefits, as it is mainly based on arm movements.ObjectiveThe main aim of the study was to evaluate the intensity of physical exercise of wheelchair boxers during a boxing training session using the FitXR app in immersive VR in light of health-related PA recommendations. The effect of Velcro-fastened hand-held weights (HHWs) on the intensity of PA undertaken by people in VR was also examined, and the attractiveness of virtual exercise were assessed in the opinion of users.MethodsPA intensity was evaluated using a heart rate monitor based on the percentage of maximal heart rate (% HRmax) and the Borg’s rating of perceived exertion (RPE 6–20). The attractiveness perceived during exercise by users were evaluated using the Physical Activity Enjoyment Scale (PACES 1–7 scale).ResultsThe study shows that the exercise intensity of the athletes during wheelchair boxing training in VR is at a beneficial moderate level for health (HRave=68.98% HRmax). The use of HHWs (0.5 kg) does not significantly increase the PA intensity of the individuals during virtual exercise. Users with disabilities highly rated the attractiveness (6.32 ± 0.79 points) of PA during virtual boxing training.ConclusionsBoxing exercises in VR can be an attractive and health-related form of PA for wheelchair boxers and a supplement to their conventional training.

Adding LIT to HIIT: Is Low-Intensity Training Vital for Endurance-Trained Athletes during a 7-day HIIT Shock Microcycle?

This study aimed to investigate the effects of a 7-d high-intensity interval training shock microcycle (HIIT-SM) with or without additional low-intensity training (LIT) on aerobic fitness and endurance performance compared with a control group (CG). Thirty-three endurance-trained athletes (7 women, 26 men, mean ± SD: age, 30.2 ± 6.9 yr; maximal oxygen uptake (V̇O 2max ), 59.8 ± 4.9 mL·min -1 ·kg -1 ) performed exercise testing at T1 and were randomly assigned to one of three groups: i) HSM, 10 running-based HIIT sessions (5 × 4 min at 90%-95% maximal heart rate) over 7 d; ii) HSM + LIT, equal to HSM with additional 30 min of LIT after each HIIT; iii) CG, regular training. Exercise testing was repeated 3 d (T2), 7 d (T3), and 14 d (T4) after the intervention. A 5-km time trial (TT 5km ) was performed 3-4 d before T1 and 10-11 d after the intervention. Data were analyzed by two-way repeated-measures ANOVA. No interaction effect was found for V̇O 2max ( P = 0.170, pη2 = 0.09), peak power output ( P = 0.734, pη2 = 0.04), and work economy ( P = 0.804, pη2 = 0.03). There was an interaction for velocity at lactate threshold ( P = 0.006, pη2 = 0.18) with increased velocity in HSM at T2 (3.2%, P = 0.030), T3 (4%, P = 0.006), T4 (4%, P = 0.003), as well as in HSM + LIT for T2 (3.2%, P = 0.011), whereas CG showed no change. There was an interaction for TT 5km ( P = 0.044, pη2 = 0.19), with HSM improving 2.7% ( P = 0.003) and HSM + LIT 2.3% ( P = 0.010), whereas CG was, on average, -0.3% ( P = 0.821) slower. HIIT-SM with or without additional LIT has negligible effects on V̇O 2max but improves other key endurance variables in endurance-trained athletes. No superiority of either intervention group was demonstrated. Therefore, additional LIT during HIIT-SM is not beneficial.

PEMBERDAYAAN LANSIA DALAM UPAYA PENATALAKSANAAN HIPERTENSI DI KELURAHAN TARATARA SATU

Elderly is when a person becomes older and experiences a decline in physical function, which is characterized by a decrease in muscle mass and strength, maximum heart rate, increased body fat, and decreased brain function. The reason for choosing the service topic is because elderly people cannot do activities for long enough and have to do more activities at home, which causes them to feel anxious about their condition and experience stress, which has an impact on their quality of life. The service method used is the lecture and talk show method with elderly people suffering from hypertension. The result of this service activity is that there is an increase in knowledge about the management of hypertension in the elderly. This activity is very important to carry out, especially targeting elderly people with hypertension because the elderly are no longer able to carry out activities and are unable to comply with taking anti-hypertension medication, so they need to be provided with counseling or socialization regarding the management of hypertension.

The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019.

This preliminary study examined the influence of estimated menstrual-cycle (MC)phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). Sessional rating of perceived exertion responses to total distances ≥5km were higher during the luteal phase (+0.6-1.0au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73au, P = .0275). Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.

Maximal cardiopulmonary exercise testing in glioblastoma patients undergoing chemotherapy: assessment of feasibility, safety, and physical fitness status.

Maximal cardiopulmonary exercise testing (max. CPET) provides the most accurate measurement of cardiorespiratory fitness. However, glioblastoma (GBM) patients often undergo less intensive tests, e.g., 6-min walk test or self-rating scales. This study aims to demonstrate feasibility and safety of max. CPET in GBM patients, concurrently evaluating their physical fitness status. Newly diagnosed GBM patients undergoing adjuvant chemotherapy were offered participation in an exercise program. At baseline, max. CPET assessed cardiorespiratory fitness including peak oxygen consumption (VO2peak), peak workload, and physical work capacity (PWC) at 75% of age-adjusted maximal heart rate (HR). Criteria for peak workload were predefined based on threshold values in HR, respiratory quotient, respiratory equivalent, lactate, and rate of perceived effort. Data were compared to normative values. Adverse events were categorized according to standardized international criteria. Further, self-reported exercise data pre- and post-diagnosis were gathered. All 36 patients (median-aged 60; 21 men) met the predefined criteria for peak workload. Mean absolute VO2peak was 1750 ± 529 ml/min, peak workload averaged 130 ± 43 W, and mean PWC was 0.99 ± 0.38 W/kg BW, all clinically meaningful lower than age- and sex-predicted normative values (87%, 79%, 90%, resp.). Only once (3%) a minor, transient side effect occurred (post-test dizziness, no intervention needed). Self-reported exercise decreased from 15.8 MET-h/week pre-diagnosis to 7.2 MET-h/week post-diagnosis. Max. CPET in this well-defined population proved feasible and safe. GBM patients exhibit reduced cardiorespiratory fitness, indicating the need for tailored exercise to enhance health and quality of life. CPET could be essential in establishing precise exercise guidelines.

Different methods to determine maximum heart rate and its influence on internal training load in futsal players

Objetivos: O objetivo deste estudo foi comparar a frequência cardíaca máxima (FCmáx) determinada em partida oficial (OM), teste de recuperação intermitente Yo-Yo nível 1 (YYIR-1) e equações de previsão de idade em jogadores de futsal, avaliando também os efeitos do uso dessas abordagens de FCmáx nos resultados da carga de treinamento interna (TL), uma vez que a FCmáx influencia a TL cálculo interno. Métodos: A FCmax de jogadores profissionais de futsal masculino (n=8) foi determinada em OM, YYIR-1 e por quatro equações preditas por idade: Fox-HRmax; Hossack-FCmáx; Tanaka-FCmáx; Nikolaidis-FCmáx. Além disso, o O TL interno de sete sessões de treinamento foi calculado individualmente a cada dia para cada uma das seis abordagens de FCmáx usando Método de Edwards. A análise estatística compreendeu ANOVA para medidas repetidas (p < 0,05) e tamanho do efeito d de Cohen (ES). Resultados: Fox-FCmáx superestimou todas as outras equações de FCmáx e YYIR-1 FCmáx, e Nikolaidis-FCmáx superestimou Tanaka-FCmáx e Hossack-FCmáx (p = 0,01; ηP 2 = 0,496). Os resultados estatísticos do TRIMP foram estatisticamente semelhantes FCmax mas subestimada (p = 0,008; ηP 2 = 0,513). Inferências pareadas mostraram que a FCmáx da MO apresentou um grande efeito (d: 0,83) em comparação ao YYIR-1 e um efeito moderado (d: -0,35 a 0,35) em comparação ao Fox-HRmax, Tanaka-FCmáx e Hossack-FCmáx. Nikolaidis-FCmáx apresentou menor diferença com OM, FCmáx (d: -0,13, trivial) e TRIMP (d: -0,09, trivial). Conclusão: A FCmáx do OM apresentou efeito maior em comparação ao YYIR-1, enquanto a equação de Nikolaidis-FCmáx foi menor e diferiu da FCmáx da MO. Os treinadores de futsal são incentivados a usar OM para determinar a FCmáx e a equação de Nikolaidis-FCmáx quando os esforços máximos não são possíveis, evitando superestimações TRIMP que pode prejudicar a prescrição da carga de treinamento e os ganhos físicos.

The Effect of HIIT on Increasing VO2 Max in White Water Rafting Athletes

This research was carried out to find out the effect of training using the High Intensity Interval Training (HIIT) model on increasing VO2 Max in white water rafting athletes. This research design is an experimental pre-post design. This research used 28 white water rafting athletes, consisting of 16 male athletes and 12 female athletes. The athlete's age range is 16-22 years. All research subjects were in healthy condition. All subjects were given the same treatment, namely training using the HIIT model. Intervention with HIIT cardio training. The HIIT training model uses an intensity of 90-100% of Maximal Heart Rate (MHR). HIIT is done with a ratio of 30 seconds of exercise then 3 minutes of rest. Exercise uses an intensity of 90% MHR in the first week and will be increased every week until it reaches 100% MHR. Exercises were carried out for 6 weeks with a frequency of 4x per week. VO2 Max measurements are carried out using a multistage test instrument. In this research, it can be seen that HIIT exercise carried out for 6 weeks with a frequency of 4 times per week can increase athletes' VO2 Max. There is a significant difference in VO2 Max between male and female athletes with a difference test result of P < 0.05. Exercise using the HIIT model which is carried out for 6 weeks with a frequency of 4x a week can increase the VO2 Max of white water rafting athletes. HIIT training can be used as a recommendation to increase VO2 Max for white water rafting athletes.

The Effects of L-Carnitine Supplementation During Concurrent Training on the Functional Capacities and Body Composition in Obese Men

Abstract Background Despite extensive research, the effects of L-carnitine supplementation in treating obesity are still unclear and equivocal. L-carnitine transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement. The purpose of the present research is to investigate the efficacy of L-carnitine during concurrent training on the functional capacities and body composition in obese men. Methods Thirty nonactive, obese males (age = 37.2 ± 1.5 years; body mass index = 33.8 ± 2.5 kg/m2) participated in this research. The participants were randomly divided into three groups: experimental group 1 (EXP1)—concurrent training with L-carnitine supplementation; experimental group 2 (EXP2)—L-carnitine supplementation without training; and control group—without training or L-carnitine supplementation. Concurrent training was performed for 8 weeks, three sessions per week, with a training intensity ranging from 60 to 75% of the maximum heart rate reserve and one-repetition maximum. Both experimental groups were supplemented with 35 mg L-carnitine supplement per kilogram body weight. Various functional and body composition variables were collected at three time points (pre-test, mid-test, and post-test). Results A number of variables were significantly improved in EXP1 after 4 and 8 weeks (systolic blood pressure, maximal oxygen consumption, weight, body mass index, and one-repetition maximum) and only after 8-weeks (diastolic blood pressure, resting heart rate, percentage of body fat, and fat-free mass). No significant changes were observed for EXP2 and the control group. Conclusion L-carnitine supplementation, in conjunction with concurrent training, emerges as a highly effective approach for enhancing body composition and boosting functional capacities in obese adult men. Therefore, it is recommended that overweight male individuals integrate concurrent training into their regimen while taking L-carnitine.

The Relationships with Maximal Aerobic Speed, Maximal Oxygen Uptake and Isokinetic Strength in Hearing Impaired Men's Handball Players

Study aim: This study aimed to analyze the relationships between weekly training frequency, changes in training duration, and Maximal Aerobic Speed (MAS), Maximum Oxygen Uptake (VO2max), and Isokinetic Strength over an 8-week period (pre-season 8 weeks). Material and methods: Eighteen hearing-impaired handball players (age: 26.78±2.26 years; height: 177.76±4.40 cm; body weight: 64.94±2.73 kg, training experience 13.1±2.6 years) were positioned in defense and offense based on their playing positions and were monitored for 8 weeks. Repeated Measures ANOVA test was performed for the pre-test and post-test comparisons of defense and offense players, frequency and distribution is observed, average standard deviation, maximum, and minimum values were taken. Results: The analysis results revealed a significant large positive difference in the agonist/antagonist ratio in the right extremity (p < 0.01). Conclusion: Throughout the study, fluctuating changes in the numbers and durations of training sessions were observed to significantly increase and correlate with changes in the players' fitness status. There is a statistically significant difference between pre-test and post- test values for maximal oxygen consumption (VO2max), maximal aerobic speed (MAS), and maximal heart rate (HRmax) (p< 0.01). However, the variability in the large positive difference in the agonist/antagonist ratio in the right extremity suggests that it cannot be solely explained by the number and duration of training sessions in terms of fitness level.

Fitness tests as predictors of physical exertion on graded hiking trails

Lack of information regarding the level of fitness required to complete a hiking trail may create perceived and real health risks for inexperienced hikers. In this study, the link between current fitness levels of potential hikers and actual exertion on hiking trails is investigated. In particular, we investigated whether simple, pre-hike fitness tests (Step-up and Cooper tests) could be used to predict physical exertion on two graded hiking trails (Trail 1: graded easy; Trail 2: graded moderate). Fifty participants completed the pre-hike fitness tests and the two hiking trails. Correlations between relevant sets of variables were calculated, together with the associated p-value. Analysis of covariance (ANCOVA) models followed by model selection were used to investigate if the exertion levels on the two trails, as characterised by the minimum heart rate (HR), mean HR and maximum HR at the end of the trail, could be predicted by the pre-hike fitness tests. A statistical model was created that predicts the mean HR and maximum HR of hikers undertaking an easy and a moderate hike; the Step-up test best predicted mean and maximum HR on Trial 1, and maximum HR on Trail 2, while the combination of Step-up and Cooper tests best predicted mean HR on Trail 2. Management implicationsPark managers are continuously looking to implement new and novel techniques that will increase customer enjoyment, while simultaneously minimise customer risk. By using an accurate predictive model such as the one proposed, managers can improve users' experiences. Satisfied customers are more likely to return to these facilities and positive reviews may increase facility usage.

Physical Demands of Walking Football in Patients With Cardiovascular Risk Factors and Diseases.

To compare the exercise intensity of walking football (WF) with walking (WA) and to describe specific movement characteristics of WF. Cross-sectional study. Sports facilities Saarland University, Germany. Eighteen patients with cardiovascular risk factors CVRFs and diseases (13 men and 5 women, age: 69 ± 10 years). Patients completed a WF match and WA session of 2 x 10 min each. Video analysis was used to characterize movements during WF. Rate of perceived exertion (RPE, Borg Scale 6-20), % maximum heart rate (HR max ), musculoskeletal pain on a visual analog scale (VAS, 1-100 mm) before and up to 72 hours after exercise, and movement patterns during WF. The mean RPE during WF (12.1 ± 2.7) and WA (11.9 ± 3.0) did not differ ( P = 0.63). The mean HR during WF (79 ± 12% of HR max ) was higher than during WA (71% ± 11%; P < 0.01). The HR variability coefficient of variation during WF (10.3% ± 5.8%) and WA (7.1 ± 5.5%) did not differ ( P = 0.13). There was no influence of exercise mode (WF vs WA) on musculoskeletal pain perception ( P = 0.96 for interaction). Injury-inciting activities such as lunges (median: 0.5 [interquartile range (IQR) 0-1.3]) and goal kicks (median: 4 [IQR: 1.8-5.3]) occurred rarely during WF. Walking football might represent an alternative to WA for health prevention programs in patients with CVRF and diseases as it is characterized by a manageable cardiocirculatory strain, moderate RPE, low pain induction, and a low number of injury-inciting activities.

Gender and Body Mass Index Difference in Aerobic Capacity: A Study in Moroccan High School Students.

Different tests are used to evaluate the aerobic capacity of a person. This study aims to investigate the gender and Body Mass Index (BMI) difference in aerobic capacity measured by using shuttle and Spartacus test. The study was conducted on 230 high school students (135 girls and 95 boys) followed their study in public establishment in kenitra city (Morocco). All participants were classified according to their gender (male vs. female) and their BMI (normal weight vs. overweight-obese) and performed the both test of shuttle and Spartacus. Running speed at the last completed stage, run time, maximum heart rate (max HR) max HR and perceived exertion were measured and analyzed. For each test, VO2max was estimated by using the proposed equation. There was significant BMI difference in the measured parameters (p<0.001). Difference in VO2max between male and female remained significant with high-speed level in boys. A significant difference between males and females (p < 0.001) was observed in shuttle test. Participants with normal weight or physical activity had good aerobic capacity. Compared to the Shuttle test, the Spartacus provides a 11.5% higher final speed (11.2 vs. 9.7km/h) and a total test time 2.3 times longer (11.3vs. 4.9 min) (p < 0.001). Our study underlines the interest of the Spartacus test and is preliminary. Indeed, these results must now be replicated in a larger sample of obese adolescents.

Abstract P345: Is a Fixed Value of the Rate of Gas Exchange Appropriate to Indicate the Maximum Effort of Obese and Nonobese Adults Undergoing a Treadmill Cardiopulmonary Exercise Test?

Introduction: Obese individuals present a higher O2 uptake/workload during a treadmill cardiopulmonary exercise test (CPET) in addition to chronotropic and biomechanical impairment, which preclude them, many times, from reaching a maximal rate of gas exchange (Rmax) &gt; 1.0. Therefore, it is necessary to develop reference values for Rmax for a treadmill CPET according to age, sex, and a wide range of body mass index (BMI). Objectives: To establish reference values for Rmax for a treadmill CPET according to age, sex, and BMI. Methods: We re-examined 1,612 treadmill ramp CPETs of adults (893 women), of which 772 were obese (BMI ≥ 30 kg/m 2 ). We excluded tests of nonobese participants with HRmax &lt; 85% of predicted, of any participant with a rate of perceived exertion in the BORG scale &lt; 4 (intense), and of those that we had operational problems during the test. We produced a Rmax percentile table according to sex, age (&lt; 33, 34 to 46, and &gt; 46 years), and BMI (&lt; 30 and ≥ 30 kg/m 2 ). We fit stepwise multiple regressions to investigate the influence of age, sex, BMI, and cardiovascular risk on Rmax. We also presented an obesity-specific equation to estimate maximum heart rate (HRmax). Results: We evaluated 442 eutrophic participants (BMI &lt; 25 kg/m 2 ), 398 were overweighted (BMI = 25 - 29.99 kg/m 2 ), 295 had class 1 obesity (BMI = 30 - 34.99 kg/m 2 ), 247 had class 2 obesity (BMI = 35 - 39.99 kg/m 2 ) and 230 had class 3 obesity (BMI ≥ 40 kg/m 2 ). Age, sex, and BMI were the main determinants of Rmax (R 2 = 0.195). The table with percentiles confirmed that the lower limits of Rmax did not reach 1.0, especially in older, obese, and female participants (Table 1). In the obese participants, we could predict HRmax as 195.2 - (0.796 x age). Conclusions: The Rmax values in a treadmill CPET should be chosen considering attributes such as age, sex, and BMI. Our results suggest that fixed values of Rmax are not appropriate to indicate maximum effort, especially in people with low cardiorespiratory fitness.

Placebo effects on kayak sprint performance in child athletes

AbstractEmpirical research with adults reveals that performance‐enhancing placebo effects emerge in sports and exercise. However, there is no research on children. Coaches' messages to them could have positive, performance‐improving (placebo) or negative, performance‐impairing (nocebo) effects. This experiment examined the former by ascribing fictive performance‐enhancing properties to an ingredient of the Tic Tac mint to 12 children (aged 12.67 ± SD = 1.83 years), all elite kayakers. Another kayaker was an actor who helped enhance the credibility of the information. The children completed 2‐min kayak ergometer sprints in counterbalanced control and placebo conditions. The measures included heart rate (HR), feeling state, perceived arousal, and expected‐ and perceived‐ performances. Pre‐sprint and maximal HR during the sprint and distance completed in 2 minutes were statistically significantly higher (p &lt; 0.005) in the placebo than in the control condition without being affected by order effects. While the expected performance in the placebo session was higher (p = 0.008), perceived performances did not differ statistically between the conditions. This study reveals a sport performance‐related objective, but not subjective, placebo effect in children after a short kayak sprint. The findings have practical implications for performance‐related messages children receive from their coaches and others and show how their altered beliefs can influence their performance.

Plasma metabolomic profile in orthostatic intolerance children with high levels of plasma homocysteine

BackgroundOrthostatic intolerance, which includes vasovagal syncope and postural orthostatic tachycardia syndrome, is common in children and adolescents. Elevated plasma homocysteine levels might participate in the pathogenesis of orthostatic intolerance. This study was designed to analyze the plasma metabolomic profile in orthostatic intolerance children with high levels of plasma homocysteine.MethodsPlasma samples from 34 orthostatic intolerance children with a plasma homocysteine concentration > 9 µmol/L and 10 healthy children were subjected to ultra-high-pressure liquid chromatography and quadrupole-time-of-flight mass spectrometry analysis.ResultsA total of 875 metabolites were identified, 105 of which were significantly differential metabolites. Choline, 1-stearoyl-2-linoleoyl-sn-glycero-3-phosphocholine, 1-(1Z-octadecenyl)-2-(4Z,7Z,10Z,13Z,16Z,19Z-docosahexaenoyl)-sn-glycero-3-phosphocholine, histidine, isocitric acid, and DL-glutamic acid and its downstream metabolites were upregulated, whereas 1-palmitoyl-sn-glycero-3-phosphocholine, 1-stearoyl-sn-glycerol 3-phosphocholine, sphingomyelin (d18:1/18:0), betaine aldehyde, hydroxyproline, and gamma-aminobutyric acid were downregulated in the orthostatic intolerance group compared with the control group. All these metabolites were related to choline and glutamate. Heatmap analysis demonstrated a common metabolic pattern of higher choline, 1-stearoyl-2-linoleoyl-sn-glycero-3-phosphocholine, and DL-glutamic acid, and lower sphingomyelin (d18:1/18:0), 1-stearoyl-sn-glycerol 3-phosphocholine, and 1-palmitoyl-sn-glycero-3-phosphocholine in patients with certain notable metabolic changes (the special group) than in the other patients (the common group). The maximum upright heart rate, the change in heart rate from the supine to the upright position, and the rate of change in heart rate from the supine to the upright position of vasovagal syncope patients were significantly higher in the special group than in the common group (P < 0.05). Choline, 1-stearoyl-2-linoleoyl-sn-glycero-3-phosphocholine, and DL-glutamic acid were positively correlated with the rate of change in heart rate from the supine to the upright position in vasovagal syncope patients (P < 0.05).ConclusionsThe levels of choline-related metabolites and glutamate–related metabolites changed significantly in orthostatic intolerance children with high levels of plasma homocysteine, and these changes were associated with the severity of illness. These results provided new light on the pathogenesis of orthostatic intolerance.

Effects of home-based exergaming on cardio-metabolic and cognitive health in physically inactive individuals.

To examine the effects of a home-based exergame training over 6 weeks on cardio-metabolic and cognitive health, as well as training adherence, in physically inactive individuals. Twenty participants were equipped with an exergame system specifically designed for use at home. Each participant performed at least three weekly exercise sessions at ≥80% of their individual maximum heart rate, over 6 weeks. Exercise duration increased biweekly until 75 min of vigorous exercise were performed in Weeks 5 and 6. Maximum oxygen uptake (VO2max), cardio-metabolic profiling, and neuro-cognitive tests were performed at baseline and study end. Additionally, training adherence was assessed via training diaries. After 6 weeks of home-based exergaming, VO2max increased significantly, while there was a significant decrease in heart rate (resting and maximum), blood pressure (systolic, diastolic and mean), and low-density lipoprotein cholesterol. Dynamic balance and reaction time improved after 6 weeks of exergaming. Training adherence was 88.4%. Home-based exergaming induced a clinically relevant increase in VO2max, a determinant of cardiovascular health, accompanied by further improvements in cardiovascular, metabolic and neuro-cognitive parameters. Exergaming may, therefore, offer an innovative approach to increasing regular physical activity, improving metabolic risk profile, and preventing chronic diseases.

High-intensity interval training improves respiratory and cardiovascular adjustments before and after initiation of exercise.

Purpose: High-intensity interval training (HIIT) may induce training-specific physiological adaptations such as improved respiratory and cardiovascular adjustments before and after the onset of high-intensity exercise, leading to improved exercise performance during high-intensity exercise. The present study investigated the effects of HIIT on time-dependent cardiorespiratory adjustment during maximal exercise and before and after initiation of high-intensity exercise, as well as on maximal exercise performance. Methods: 21 healthy male college students were randomly assigned to HIIT group (n = 11) or control group (n = 10). HIIT group performed training on a cycle ergometer once a week for 8 weeks. The training consisted of three bouts of exercise at 95% maximal work rate (WRmax) until exhaustion. Before and after the HIIT program, dynamic cardiorespiratory function was investigated by ramp and step exercise tests, and HIIT-induced cardiac morphological changes were assessed using echocardiography. Results: HIIT significantly improved not only maximal oxygen uptake and minute ventilation, but also maximal heart rate (HR), systolic blood pressure (SBP), and time to exhaustion in both exercise tests (p < 0.05). Time-dependent increases in minute ventilation (VE) and HR before and at the start of exercise were significantly enhanced after HIIT. During high-intensity exercise, there was a strong correlation between percent change (from before to after HIIT program) in time to exhaustion and percent change in HRmax (r = 0.932, p < 0.001). Furthermore, HIIT-induced cardiac morphological changes such as ventricular wall hypertrophy was observed (p < 0.001). Conclusion: We have demonstrated that HIIT at 95% WRmax induces training-specific adaptations such as improved cardiorespiratory adjustments, not only during maximal exercise but also before and after the onset of high-intensity exercise, improvement of exercise performance mainly associated with circulatory systems.

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study

Cardioneuroablation (CNA) is currently considered as a promising treatment option for patients with symptomatic bradycardia caused by vagotonia. This study aims to further investigate its safety and efficacy in patients suffering from vagal bradycardia. A total of 60 patients with vagal bradycardia who underwent CNA in the First Affiliated Hospital of Xinjiang Medical University from November 2019 to June 2022. Preoperative atropine tests revealed abnormal vagal tone elevation in all patients. First, the electroanatomic structures of the left atrium was mapped out by using the Carto 3 system, according to the protocol of purely anatomy-guided and local fractionated intracardiac electrogram-guided CNA methods. The upper limit of ablation power of superior left ganglion (SLGP) and right anterior ganglion (RAGP) was not more than 45W with an ablation index of 450.Postoperative transesophageal cardiac electrophysiological examination was performed 1 to 3 months after surgery. The atropine test was conducted when appropriate. Twelve-lead electrocardiogram, Holter electrocardiogram, and skin sympathetic nerve activity were reviewed at 1, 3, 6 and 12 months after operation. Adverse events such as pacemaker implantation and other complications were also recorded to analyze the safety and efficacy of CNA in the treatment of vagus bradycardia. Sixty patients were enrolled in the study (38 males, mean age 36.67 ± 9.44, ranging from 18 to 50 years old). None of the patients had a vascular injury, thromboembolism, pericardial effusion, or other surgical complications. The mean heart rate, minimum heart rate, low frequency, low/high frequency, acceleration capacity of rate, and skin sympathetic nerve activity increased significantly after CNA. Conversely, SDNN, PNN50, rMSSD, high frequency, and deceleration capacity of rate values decreased after CNA (all P < 0.05). At 3 months after ablation, the average heart rate, maximum heart rate, and acceleration capacity of heart rate remained higher than those before ablation, and the deceleration capacity of heart rate remained lower than those before ablation and the above results continued to follow up for 12 months after ablation (all P < 0.05). There was no significant difference in other indicators compared with those before ablation (all P > 0.05). The remaining 81.67% (49/60) of the patients had good clinical results, with no episodes of arrhythmia during follow-up. CNA may be a safe and effective treatment for vagal-induced bradycardia, subject to confirmation by larger multicenter trials.

Efficacy and Safety of Prehospital Diltiazem

Objective This study assesses the likelihood of clinical improvement and adverse events from EMS-administered diltiazem. Current prehospital protocols direct paramedics to administer diltiazem, a calcium channel blocker, to decrease the heart rate (HR) of symptomatic, hemodynamically stable patients with rapid atrial fibrillation. However, diltiazem can also cause systemic hypotension and bradycardia, which can precipitate end-organ injury. Methods To assess whether the rate control benefit of prehospital diltiazem outweighs the risk of adverse events, we conducted a retrospective chart review of all adult patients who received diltiazem from Maryland Advanced Life Support EMS clinicians between January 1, 2019, and March 31, 2022. Collected data included patient demographics, vital signs, diltiazem dose, transport times, administered medications, and procedures. The main outcomes were clinical improvement (HR <100 beats per minute or ≥20% decrease from the maximum HR) and adverse events (bradycardia or hypotension). Multivariable logistic regression was used for statistical analysis. Results During the study period, 2396 patients received prehospital diltiazem and 94% of these patients (n = 2254) were included in the study. Overall, 1414 (63.8%) patients improved clinically, 604 (27.3%) patients achieved rate control as defined by a HR of <100 beats per minute, and 78 patients (3.5%) experienced an adverse event. Patients over the age of 50 were less likely to clinically improve with diltiazem administration. Adverse events were more likely in patients with systolic blood pressures (SBP) less than 140 mmHg, patients with maximum HR of less than 120 beats per minute, and patients who received nitroglycerin. Conclusions Prehospital diltiazem is effective and safe for most patients. Adverse events are more likely in patients with baseline SBP less than 140 mmHg, HR less than 120 beats per minute, and concurrent nitroglycerin administration. Future opportunities for research include examining the relationship between adverse events and underlying etiology as well as investigating downstream outcomes.

Development of Field Tests for Cardiovascular Fitness Assessment in Wheelchair.

It is essential to consider both physique and physical fitness factors to minimize the risk of injuries and optimize athletic performance among elite athletes. Athletes with disabilities face limitations in fitness assessments compared to their healthy counterparts. The aim of this study was to revalidate established cardiovascular fitness assessment methods and develop field tests for wheelchair athletes. As representatives registered at the Korea Paralympic Committee's Athletes Training Center in Icheon, athletes with physical disabilities participating in para ice hockey (n = 14), who were capable of wheelchair control, were volunteered. Prior to cardiovascular fitness assessments using an ergometer and a shuttle run, demographic characteristics were surveyed, and physical measurements and muscle strength (grip strength) were recorded. All the participants performed one ergometer test based on cardiovascular fitness criteria, and for shuttle run validation, two trials were conducted using existing audio cues (National Physical Fitness 100, 20 m shuttle run). For the development of the shuttle run, considering wheelchair turning, signal-to-sound intervals were increased by 1 s and 1.5 s, respectively, in two trials. An analysis of the correlation with the maximal oxygen consumption (VO2max) in comparison to the reference criterion, an ergometer, demonstrated high correlations in the first trial (r = 0.738) and the second trial (r = 0.780). Similarly, significant correlations were observed with the maximum heart rate (HRmax) in the first trial (r = 0.689) and the second trial (r = 0.896). Thus, the 15 m shuttle run is validated as a field test for assessing cardiovascular fitness in athletes with disabilities. Correlation analysis with maximal oxygen uptake (VO2max) compared to the reference criterion, an ergometer, revealed a correlation of 0.815 with a 1 s interval audio cue and 0.355 with a 1.5 s interval audio cue. A high correlation was observed with the 1 s interval audio cue. Regarding the maximum heart rate (HRmax), the correlations were 0.665 with a 1 s interval audio cue. Once again, a high correlation was noted with the 1 s interval audio cue. The field test selected for measuring cardiovascular fitness in wheelchair athletes involved performing a 15 m shuttle run while in the wheelchair. The test utilized an audio cue with a 1 s increased interval between the signal sounds.