Incremental Cycle Research Articles

Peak fat oxidation is positively associated with vastus lateralis CD36 content, fed-state exercise fat oxidation, and endurance performance in trained males.

PurposeWhole-body fat oxidation during exercise can be measured non-invasively during athlete profiling. Gaps in understanding exist in the relationships between fat oxidation during incremental fasted exercise and skeletal muscle parameters, endurance performance, and fat oxidation during prolonged fed-state exercise.MethodsSeventeen endurance-trained males underwent a (i) fasted, incremental cycling test to assess peak whole-body fat oxidation (PFO), (ii) resting vastus lateralis microbiopsy, and (iii) 30-min maximal-effort cycling time-trial preceded by 2-h of fed-state moderate-intensity cycling to assess endurance performance and fed-state metabolism on separate occasions within one week.ResultsPFO (0.58 ± 0.28 g.min−1) was associated with vastus lateralis citrate synthase activity (69.2 ± 26.0 μmol.min−1.g−1 muscle protein, r = 0.84, 95% CI 0.58, 0.95, P < 0.001), CD36 abundance (16.8 ± 12.6 μg.g−1 muscle protein, rs = 0.68, 95% CI 0.31, 1.10, P = 0.01), pre-loaded 30-min time-trial performance (251 ± 51 W, r = 0.76, 95% CI 0.40, 0.91, P = 0.001; 3.2 ± 0.6 W.kg−1, r = 0.62, 95% CI 0.16, 0.86, P = 0.01), and fat oxidation during prolonged fed-state cycling (r = 0.83, 95% CI 0.57, 0.94, P < 0.001). Addition of PFO to a traditional model of endurance (peak oxygen uptake, power at 4 mmol.L−1 blood lactate concentration, and gross efficiency) explained an additional ~ 2.6% of variation in 30-min time-trial performance (adjusted R2 = 0.903 vs. 0.877).ConclusionThese associations suggest non-invasive measures of whole-body fat oxidation during exercise may be useful in the physiological profiling of endurance athletes.

Sub-Minute Analysis of Lactate from a Single Blood Drop Using Capillary Electrophoresis with Contactless Conductivity Detection in Monitoring of Athlete Performance.

A simple and fast method for the analysis of lactate from a single drop of blood was developed. The finger-prick whole blood sample (10 µL) was diluted (1:20) with a 7% (w/v) solution of [tris(hydroxymethyl)methylamino] propanesulfonic acid and applied to a blood plasma separation device. The device accommodates a membrane sandwich composed of an asymmetric polysulfone membrane and a supporting textile membrane that allows the collection of blood plasma into a narrow glass capillary in less than 20 s. Separated and simultaneously diluted blood plasma was directly injected into a capillary electrophoresis instrument with a contactless conductivity detector (CE-C4D) and analyzed in less than one minute. A separation electrolyte consisted of 10 mmol/L l-histidine, 15 mmol/L dl-glutamic acid, and 30 µmol/L cetyltrimethylammonium bromide. The whole procedure starting from the finger-prick sampling until the CE-C4D analysis was finished, took less than 5 min and was suitable for monitoring lactate increase in blood plasma during incremental cycling exercise. The observed lactate increase during the experiments measured by the developed CE-C4D method correlated well with the results from a hand-held lactate analyzer (R = 0.9882). The advantage of the developed CE method is the speed, significant savings per analysis, and the possibility to analyze other compounds from blood plasma.

Aerobic Threshold Identification in a Cardiac Disease Population Based on Correlation Properties of Heart Rate Variability.

An index of heart rate (HR) variability correlation properties, the short-term scaling exponent alpha1 of detrended fluctuation analysis (DFA a1) has shown potential to delineate the first ventilatory threshold (VT1). This study aims to extend this concept to a group of participants with cardiac disease. Sixteen volunteers with stable coronary disease or heart failure performed an incremental cycling ramp to exhaustion PRE and POST a 3-week training intervention. Oxygen uptake (VO2) and HR at VT1 were obtained from a metabolic cart. An ECG was processed for DFA a1 and HR. The HR variability threshold (HRVT) was defined as the VO2, HR or power where DFA a1 reached a value of 0.75. Mean VT1 was reached at 16.82 ± 5.72 mL/kg/min, HR of 91.3 ± 11.9 bpm and power of 67.8 ± 17.9 watts compared to HRVT at 18.02 ± 7.74 mL/kg/min, HR of 94.7 ± 14.2 bpm and power of 73.2 ± 25.0 watts. Linear relationships were seen between modalities, with Pearson’s r of 0.95 (VO2), 0.86 (HR) and 0.87 (power). Bland–Altman assessment showed mean differences of 1.20 mL/kg/min, 3.4 bpm and 5.4 watts. Mean peak VO2 and VT1 did not change after training intervention. However, the correlation between PRE to POST change in VO2 at VT1 with the change in VO2 at HRVT was significant (r = 0.84, p < 0.001). Reaching a DFA a1 of 0.75 was associated with the VT1 in a population with cardiac disease. VT1 change after training intervention followed that of the HRVT, confirming the relationship between these parameters.

The Art of Living is Living with the Art; Is it Essential that Bapedi People Are Able to Live with and embrace the past? Yes, Definitely

For many centuries, music has been used in different indigenous African religious rituals as part of communal and personal religious rites. In the Bapedi society, songs accompany every phase of the divination process and, also any other task which they perform communally, for example, ancestor veneration. The purpose of this study was to investigate how Bapedi traditional healers and their trainees create imprecatory songs, as well as their societal value. The main questions the study addressed are: a) how do Bapedi traditional healers create imprecatory songs; and b) what is the societal value of these songs in the Bapedi culture. The study used a naturalistic approach and the methods of data collection were video recordings of cultural and religious rituals, interviews and observations. The study has revealed that in the Bapedi society like in other African societies, narratives in imprecatory songs can be classified broadly into three, namely: segmental narrative; incremental cycle and multiple recycle forms. The results have also shown that Bapedi imprecation songs serve various functions such as education, upholding and promoting morals and customs through advice, insults and mockery. This paper is submitted for consideration for the ICMS XXV, 25th International Conference entitled “Ideas and Research on Recent Issues”; University of Southern California.

Feasibility, Methodology, and Interpretation of Broad-Scale Assessment of Cardiorespiratory Fitness in a Large Community-Based Sample

Cardiorespiratory fitness (CRF) is intricately related to health status. The optimal approach for CRF quantification is through assessment of peak oxygen uptake (VO2), but such measurements have been largely confined to small referral populations. Here we describe protocols and methodological considerations for peak VO2 assessment and determination of volitional effort in a large community-based sample. Maximum incremental ramp cycle ergometry cardiopulmonary exercise testing (CPET) was performed by Framingham Heart Study participants at a routine study visit (2016 to 2019). Of 3,486 individuals presenting for a multicomponent study visit, 3,116 (89%) completed CPET. The sample was middle-aged (54 ± 9 years), with 53% women, body mass index 28.3 ± 5.6 kg/m2, 48% with hypertension, 6% smokers, and 8% with diabetes. Exercise duration was 12.0 ± 2.1 minutes (limits 3.7to20.5). No major cardiovascular events occurred. A total of 98%, 96%, 90%, 76%, and 57% of the sample reached peak respiratory exchange ratio (RER) values of ≥1.0, ≥1.05, ≥1.10, ≥1.15, and ≥1.20, respectively (mean peak RER=1.21 ± 0.10). With rising peak RER values up to ≈1.10, steep changes were observed for percent predicted peak VO2, VO2 at the ventilatory threshold/peak VO2, heart rate response, and Borg (subjective dyspnea) scores. More shallow changes for effort dependent CPET variables were observed with higher achieved RER values. In conclusion, measurement of peak VO2 is feasible and safe in a large sample of middle-aged, community-dwelling individuals with heterogeneous cardiovascular risk profiles. Peak RER ≥1.10 was achievable by the majority of middle-aged adults and RER values beyond this threshold did not necessarily correspond to higher peak VO2 values.

Effects of Exercise Intensity on Pedal Force Asymmetry during Cycling

The purpose of the current investigation was to examine the effects of exercise intensity and a participant’s cycling experience on asymmetry in pedal forces during cycling. Participants were classified as cycling experienced (CE) or non-cycling experienced (NCE) based on self-reported training history. Participants completed an incremental cycling test via a cycle ergometer with inspired and expired gases, capillary blood lactate and pedaling forces collected throughout the test. Group X exercise intensity comparisons were analyzed at workloads corresponding to 2 mmol/L and 4 mmol/L for the blood lactate accumulation and peak power output, respectively. No Group X exercise intensity interactions for any variables (p &gt; 0.05) were observed. The main effect on the exercise intensity was observed for absolute (p = 0.000, η2 = 0.836) and relative (p = 0.000, η2 = 0.752) power outputs and pedal force effectiveness (PFE) (p = 0.000, η2 = 0.728). The main effect for the group was observed for absolute (p = 0.007, η2 = 0.326) and relative (p = 0.001, η2 = 0.433) power outputs, the absolute difference between the lower limbs in power production (p = 0.047, η2 = 0.191), the peak crank torque asymmetry index (p = 0.031, η2 = 0.222) and the PFE (p = 0.014, η2 = 0.280). The exercise intensity was observed to have no impact on asymmetry in pedaling forces during cycling.

Estimation of anaerobic threshold by cardiac repolarization instability: a prospective validation study

BackgroundAssessing lactate (LT) or anaerobic thresholds (AT) in athletes is an important tool to control training intensities and to estimate individual performance levels. Previously we demonstrated that ECG-based assessment of cardiac repolarization instability during exercise testing allows non-invasive estimation of AT in recreational athletes. Here, we validate this method in professional and amateur team sports athletes.MethodsWe included 65 team sports athletes (32 professionals and 33 amateur athletes; 51 men, 14 women, mean age 22.3 ± 5.2 years) undergoing a standardized incremental cycle exercise test. During exercise testing a high-resolution ECG (1000 Hz) was recorded in Frank-leads configuration and beat-to-beat vector changes of cardiac repolarization (dT°) were assessed by previously established technologies. Repolarization-based AT (ATdT°) was estimated by its typical dT°-signal pattern. Additionally, LT was detected in accordance to methods established by Mader (LTMader) and Dickhuth (LTDickhuth).ResultsAll athletes performed exercise testing until exhaustion with a mean maximum workload of 262.3 ± 60.8 W (241.8 ± 64.4 W for amateur athletes and 283.4 ± 49.5 W for professional athletes). Athletes showed ATdT° at 187.6 ± 44.4 W, LTDickhuth at 181.1 ± 45.6 W and LTMader at 184.3 ± 52.4 W. ATdT° correlated highly significantly with LTDickhuth (r = 0.96, p < 0.001) and LTMader (r = 0.98, p < 0.001) in the entire cohort of athletes as well as in the subgroups of professional and amateur athletes (p < 0.001 for all).ConclusionsATdT°, defined by the maximal discordance between dT° and heart rate, can be assessed reliably and non-invasively via the use of a high-resolution ECG in professional and amateur athletes.

Sex-Specific Effects of Respiratory Muscle Endurance Training on Cycling Time Trial Performance in Normoxia and Hypoxia.

Objectives: We tested the hypotheses that respiratory muscle endurance training (RMET) improves endurance cycling performance differently in women and men and more so in hypoxia than in normoxia.Design: A prospective pre–post cross-over study with two testing conditions.Methods: Healthy and active women (seven, 24 ± 4 years, mean ± standard deviation [SD]) and men (seven, 27 ± 5 years) performed incremental cycling to determine maximum oxygen consumption (VO2peak) and power output (Wpeak) and on different days two 10-km cycling time trials (TTs) in normoxia and normobaric hypoxia (FiO2, 0.135, ~3,500 m equivalent), in a balanced randomized order. Next they performed supervised RMET in normoxia (4 weeks, 5 days/week, 30 min/day eucapnic hyperpnea at ~60% predicted maximum voluntary ventilation) followed by identical post-tests. During TTs, heart rate, ear oximetry reading, and Wpeak were recorded.Results: The VO2peak and Wpeak values were unchanged after RMET. The TT was improved by 7 ± 6% (p < 0.001) in normoxia and 16 ± 6% (p < 0.001) in hypoxia. The difference between normoxic and hypoxic TT was smaller after RMET as compared with that before RMET (14% vs. 21%, respectively, p < 0.001). All effects were greater in women (p < 0.001). The RMET did not change the heart rate or ear oximetry reading during TTs.Conclusion: We found a greater effect of RMET on cycling TT performance in women than in men, an effect more pronounced in hypoxia. These findings are congruent with the contention of a more pronounced performance-limiting role of the respiratory system during endurance exercise in hypoxia compared with normoxia and more so in women whose respiratory system is undersized compared with that of men.

Health-Related and Motor Performance-Related Fitness and Physical Activity Among Youth With Cystic Fibrosis.

Little is known about motor competence and the longitudinal development of motor performance among youth with cystic fibrosis (CF). In this study, we assessed aspects of motor performance in different age groups of young patients with CF and compared them with a healthy reference group of same aged children. We also examined the development of motor performance among different age groups of these children with CF, using The Deutscher Motorik Test (DMT) to assess attributes of health-related and motor performance-related fitness. We used an incremental ergometer cycle test to determine maximal exercise capacity (expressed as peak workload). We evaluated and recorded habitual physical activity (PA) as measured by the number of steps per day and the time spent in different PA intensities (expressed in metabolic equivalents). In total, 31 children and adolescents with CF agreed to participate (13 girls,18 boys) aged 6-17 years (M = 11.3, SD =3.3 years); they had a mean one second forced expiratory volume (expressed as a percentage of predicted value [% pred]) of 87.2% (SD = 22.3%). We found their values of health-related and motor performance-related fitness to be significantly lower (p < 0.05) than those of their healthy peer participants. In contrast to the reference group, participants with CF up to 14 years of age showed a linear improvement in these values and in their PA, followed by a plateau or even a nonsignificant decrease after age 14.These findings have important implications for the development and prescription of exercise programs for children with CF. Besides aerobic and strength exercises, we recommend that neuromuscular training be integrated into exercise programs to improve the coordinative abilities of youth with CF. More attention should be paid to vulnerable older adolescents to ensure their long-term motivation to maintain exercise participation.

Impaired Exercise Tolerance in Repaired Tetralogy of Fallot Is Associated With Impaired Biventricular Contractile Reserve: An Exercise-Stress Real-Time Cardiovascular Magnetic Resonance Study.

Correction of tetralogy of Fallot (cTOF) often results in pulmonary valve pathology and right ventricular (RV) dysfunction. Reduced exercise capacity in cTOF patients cannot be explained by these findings alone. We aimed to explore why cTOF patients exhibit impaired exercise capacity with the aid of a comprehensive cardiopulmonary exercise testing (CPET) and real-time cardiovascular magnetic resonance exercise testing (CMR-ET) protocol. Thirty three cTOF patients and 35 matched healthy controls underwent CPET and CMR-ET in a prospective case-control study. Real-time steady-state free precession cine and phase-contrast sequences were obtained during incremental supine in-scanner cycling at 50, 70, and 90 W. RV and left ventricle (LV) volumes and pulmonary blood flow (Qp) were calculated. Differences of CPET and CMR-ET between cTOF versus controls and correlations between CPET and CMR-ET parameters in cTOF were evaluated statistically for all CMR exercise levels using Mann-Whitney U and Spearman rank-order correlation tests. CPET capacity was significantly lower in cTOF than in controls. cTOF patients exhibited not only significantly reduced Qp and RV function but also lower LV function on CMR-ET. Higher CPET values in cTOF correlated with higher Qp (Qp 90 W versus carbon dioxide ventilatory equivalent %: R=-0.519, P<0.05), higher LV-end-diastolic volume indexed to body surface area (LV-end-diastolic volume indexed to body surface area at 50 W versus oxygen uptake in % at maximum exercise on CPET R=0.452, P<0.05), and change in LV ejection fraction (EF; LV-EF at 90 W versus Watt %: r=-0.463, P<0.05). No correlation was found with regard to RV-EF. Significant RV-LV interaction was observed during CMR-ET (RV-EF versus LV-EF at 50 W and 70 W: r=0.66, P<0.02 and r=0.52, P<0.05, respectively). Impaired exercise capacity in cTOF resulted from a reduction in not only RV, but also LV function. cTOF with good exercise capacity on CPET demonstrated higher LV reserve and pulmonary blood flow during incremental CMR-ET. Apart from RV parameters, CMR-ET-derived LV function could be a valuable tool to stratify cTOF patients for pulmonary valve replacement.

Partitioning The Work Of Breathing During Running And Cycling Using Optoelectronic Plethysmography

Work of breathing (B) derived from a single lung volume and pleural pressure is limited and does not fully characterize the mechanical work done by the respiratory musculature. It has long been known abdominal activation increases with increasing exercise intensity, yet the mechanical work done by these muscles is not reflected in B. Optoelectronic plethysmography (OEP) is a 3-dimentional motion analysis tool that measures the positions and displacements of reflective markers on the thorax and abdomen to calculate volume changes. Importantly, OEP permits an assessment of the ribcage and abdominal contribution to volume changes during breathing. PURPOSE: We sought to: (1) show the volumes measured using OEP (VCW) were comparable to volumes from flow integration (Vt) during cycling and running, and (2) to demonstrate that partitioned ribcage and abdominal volume from OEP could be utilized to quantify the mechanical work done by the ribcage (BRC) and abdomen (BAB) during exercise. METHODS: We fit 11 subjects (6 males/5 females; age, 26 ± 3 years; body mass, 73 ± 10 kg; height, 177 ± 6 cm; maximal oxygen uptake, 55.2 ± 9.8 ml/kg/min) with 89 reflective markers, and esophageal and gastric balloon catheters. Subjects completed an incremental cycling test to exhaustion and a series of submaximal treadmill running trials. RESULTS: We found good agreement between VCW vs. Vt during cycling (bias = 0.002) (p > 0.05) and running (bias = 0.016) (p > 0.05). From rest to maximal-exercise, BAB increased by 84% (range: 30-99%; BAB: 1 ± 1 J/min to 61 ± 52 J/min). The relative contribution of the abdomen increased from 17 ± 9% at rest to 26 ± 16% during maximal-exercise. CONCLUSION: Our study highlights and provides a quantitative measure of the role of the abdominal muscles during exercise. Incorporating the work done by the abdomen allows for a greater understanding of the mechanical tasks required by the respiratory muscles under physiologically relevant conditions such as exercise. Moreover, our approach could be used to gain insight into how the respiratory system functions under pathophysiological conditions and injury.

Reduced Endurance Capacity and Suboptimal Energy Availability in Top-Level Female Cyclists

Women's professional cycling has grown in popularity, and this increase is also apparent in Brazil, which has increased its female cycling calendar in recent years. The aim of this observational study was to (1)determine training and competition loads of a top-level Brazilian female cycling team, (2)evaluate nutrition and clinical health, and (3)measure whether exercise capacity changed throughout the season. Training and competition data were collected over the season using global positioning system monitors, while laboratory-based physiological and performance measures (incremental cycling test, 30-s Wingate, 4-km time trial) and clinical and nutritional analyses were performed at time points throughout the season. Total distance covered over the year was 11,124 (2895)km (7382-14,698km). Endurance capacity was reduced over the season (P = .005) but not anaerobic power (all P > .05). Nutrition and stress markers remained largely unchanged throughout the season, although there were some individual fluctuations in some measures, and testosterone concentration was low for some. Median estimated energy availability ranged between 32.3 and 56.8kcal·kgLBM-1·d-1 during training and 26.4 and 53.8kcal·kgLBM-1·d-1 during competition. Percentage of training spent in optimal estimated energy availability was generally low, with 3 athletes spending <35% within the optimal intake. Substantial training and competition loads of the monitored professional Brazilian female cyclists may have reduced exercise capacity toward the end of the season, indicative of a grueling yearlong schedule. Several athletes may have had suboptimal energy availability during the season, potentially affecting testosterone concentration. These data demonstrate the difficulties in maintaining optimal nutrition, health, and performance throughout a season in professional female cycling and highlight the need for quality sport-science support for this type of top-level athlete.

Qualitative Components of Dyspnea during Incremental Exercise across the COPD Continuum.

Evaluation of the intensity and quality of activity-related dyspnea is potentially useful in people with chronic obstructive pulmonary disease (COPD). The present study sought to examine associations between qualitative dyspnea descriptors, dyspnea intensity ratings, dynamic respiratory mechanics, and exercise capacity during cardiopulmonary exercise testing (CPET) in COPD and healthy controls. In this cross-sectional study, 261 patients with mild-to-very severe COPD (forced expiratory volume in 1 s, 62 ± 25%pred) and 94 age-matched controls (forced expiratory volume in 1 s, 114 ± 14%pred) completed an incremental cycle CPET to determine peak oxygen uptake (V˙O2peak). Throughout exercise, expired gases, operating lung volumes, and dyspnea intensity were assessed. At peak exercise, dyspnea quality was assessed using a modified 15-item questionnaire. Logistic regression analysis revealed that among 15 dyspnea descriptors, only those alluding to the cluster "unsatisfied inspiration" were consistently associated with an increased likelihood for both critical inspiratory mechanical constraint (end-inspiratory lung volume/total lung capacity ratio ≥0.9) during exercise and reduced exercise capacity (V˙O2peak < lower limit of normal) in COPD (odds ratio (95% confidence interval), 3.26 (1.40-7.60) and 3.04 (1.24-7.45), respectively; both, P < 0.05). Thus, patients reporting "unsatisfied inspiration" (n = 177 (68%)) had an increased relative frequency of critical inspiratory mechanical constraint and low exercise capacity compared with those who did not select this descriptor, regardless of COPD severity or peak dyspnea intensity scores. In patients with COPD, regardless of disease severity, reporting descriptors in the unsatisfied inspiration cluster complemented traditional assessments of dyspnea during CPET and helped identify patients with critical mechanical abnormalities germane to exercise intolerance.

Pattern of the Heart Rate Performance Curve in Subjects with Beta-Blocker Treatment and Healthy Controls.

(1): Heart rate performance curve (HRPC) in incremental exercise was shown to be not uniform, causing false intensity estimation applying percentages of maximal heart rate (HRmax). HRPC variations are mediated by β-adrenergic receptor sensitivity. The aim was to study age and sex dependent differences in HRPC patterns in adults with β-blocker treatment (BB) and healthy controls (C). (2): A total of 535 (102 female) BB individuals were matched 1:1 for age and sex (male 59 ± 11 yrs, female 61 ± 11 yrs) in C. From the maximum incremental cycle ergometer exercise a first and second heart rate (HR) threshold (Th1 and Th2) was determined. Based on the degree of the deflection (kHR), HRPCs were categorized as regular (downward deflection (kHR > 0.1)) and non-regular (upward deflection (kHR < 0.1), linear time course). (3): Logistic regression analysis revealed a higher odds ratio to present a non-regular curve in BB compared to C (females showed three times higher odds). The odds for non-regular HRPC in BB versus C decreased with older age (OR interaction = 0.97, CI = 0.94–0.99). Maximal and submaximal performance and HR variables were significantly lower in BB (p < 0.05). %HRmax was significantly lower in BB versus C at Th2 (male: 77.2 ± 7.3% vs. 80.8 ± 5.0%; female: 79.2 ± 5.1% vs. 84.0 ± 4.3%). %Pmax at Th2 was similar in BB and C. (4): The HRPC pattern in incremental cycle ergometer exercise is different in individuals receiving β-blocker treatment compared to healthy individuals. The effects were also dependent on age and sex. Relative HR values at Th2 varied substantially depending on treatment. Thus, the percentage of Pmax seems to be a stable and independent indicator for exercise intensity prescription.

Obesity Blunts the Ventilatory Response to Exercise in Men and Women.

Rationale: Obesity presents a mechanical load to the thorax, which could perturb the generation of minute ventilation (V̇e) during exercise. Because the respiratory effects of obesity are not homogenous among all individuals with obesity and obesity-related effects could vary depending on the magnitude of obesity, we hypothesized that the exercise ventilatory response (slope of the V̇e and carbon dioxide elimination [V̇co2] relationship) would manifest itself differently as the magnitude of obesity increases.Objectives: To investigate the V̇e/V̇co2 slope in an obese population that spanned across a wide body mass index (BMI) range.Methods: A total of 533 patients who presented to a surgical weight loss center for pre-bariatric surgery testing performed an incremental maximal cycling test and were studied retrospectively. The V̇e/V̇co2 slope was calculated up to the ventilatory threshold. Patients were examined in groups based on BMI (category 1: 30-39.9 kg/m2, category 2: 40-49.9 kg/m2, and category 3: ≥50 kg/m2). Because the respiratory effects of obesity could be sex and/or age specific, we further examined patients in groups by sex and age (younger: <50 yr and older: ≥50 yr). Differences in the V̇e/V̇co2 slope were then compared between BMI category, age, and sex using a three-way ANOVA.Results: No significant BMI category by sex by age interactions was detected (P = 0.75). The V̇e/V̇co2 slope decreased with increases in BMI (category 1, 29.1 ± 4.0; category 2, 28.4 ± 4.1; and category 3, 27.1 ± 3.3) and was elevated in women (28.9 ± 4.1) compared with men (26.7 ± 3.2) (BMI category by sex interaction, P < 0.05). No age-related differences were observed (BMI category by age interaction, P = 0.55). The partial pressure for end-tidal CO2 was elevated at the ventilatory threshold in BMI category 3 compared with BMI categories 1 and 2 (both P < 0.01).Conclusions: These findings suggest that obesity presents a unique challenge to augmenting ventilatory output relative to CO2 elimination, such that the increase in the exercise ventilatory response becomes blunted as the magnitude of obesity increases. Further studies are required to investigate the clinical consequences and the mechanisms that may explain the attenuation of exercise ventilatory response with increasing BMI in men and women with obesity.

Heart rate variability kinetics during different intensity domains of cycling exercise in healthy subjects

ABSTRACT The purpose of this study was to verify the heart rate variability (HRV) and heart rate (HR) kinetics during the fundamental phase in different intensity domains of cycling exercise. Fourteen males performed five exercise sessions: (1) maximal incremental cycling test; (2) two rest-to-exercise transitions for each intensity domain, that is, heavy (Δ30) and severe (Δ60) domains. HRV markers (SD1 and SD2) and HR kinetics in the fundamental phase were analyzed by first-order exponential fitting. There were no significant differences in amplitude values between SD1Δ30 (8.98 ± 3.52 ms) and SD1Δ60 (9.44 ± 3.24 ms) and SD2Δ30 (24.93 ± 9.16 ms) and SD2Δ60 (25.98 ± 7.29 ms). Significant difference was observed between HRΔ30 (52 ± 7 bpm) and HRΔ60 (63 ± 8 bpm). The time constant (τ) values were significantly different between SD1Δ30 (17.61 ± 6.26 s) and SD1Δ60 (13.86 ± 5.90 s), but not between SD2Δ30 (20.06 ± 3.73 s) and SD2Δ60 (19.47 ± 6.03 s) or HRΔ30 (56.75 ± 18.22 s) and HRΔ60 (58.49 ± 15.61 s). However, the τ values for HRΔ30 were higher and significantly different in relation to SD1Δ30 and SD2Δ30, as well as for HRΔ60 in relation to SD1Δ60 and SD2Δ60. The kinetics of the autonomic variable (SD1 marker) was accelerated by the increased intensity. Moreover, significant differences were found for the τ values, with faster HRV markers than HR, in both intensities of Δ30 and Δ60, which suggests that these variables indicate distinct and specific cardiac autonomic response times during different intensity domains in cycling. HIGHLIGHTS The application of HRV to optimize exercise prescription at different effort intensities is extremely important to obtain assertive and effective results. Analysis of the kinetic responses of HRV is a useful tool for the evaluation of exercise performance and health status. A faster kinetics was found for HRV markers in comparison to HR, for both intensities analysed, which suggests that these variables indicate distinct and specific cardiac autonomic response times during different intensity domains in cycling.

Energy metabolism during exercise in patients with β-enolase deficiency (GSDXIII).

AimTo investigate the in vivo skeletal muscle metabolism in patients with β‐enolase deficiency (GSDXIII) during exercise, and the effect of glucose infusion.MethodsThree patients with GSDXIII and 10 healthy controls performed a nonischemic handgrip test as well as an incremental cycle ergometer test measuring maximal oxidative consumption (VO2max) and a 1‐hour submaximal cycle test at an intensity of 65% to 75% of VO2max. The patients repeated the submaximal exercise after 2 days, where they received a 10% iv‐glucose supplementation.ResultsPatients had lower VO2max than healthy controls, and two of three patients had to stop prematurely during the intended 1‐hour submaximal exercise test. During nonischemic forearm test, all patients were able to produce lactate in normal amounts. Glucose infusion had no effect on patients' exercise capacity.ConclusionsPatients with GSDXIII experience exercise intolerance and episodes of myoglobinuria, even to the point of needing renal dialysis, but still retain an almost normal anaerobic metabolic response to submaximal intensity exercise. In accordance with this, glucose supplementation did not improve exercise capacity. The findings show that GSDXIII, although causing episodic rhabdomyolysis, is one of the mildest metabolic myopathies affecting glycolysis.

Power Output and Efficiency During Supine, Recumbent, and Upright Cycle Ergometry.

Recumbent and supine cycling are common exercise modes in rehabilitation and clinical settings but the influence of postures on work efficiency is unclear. Therefore, the aim of this study was to compare metabolic and ventilatory efficiency during upright, recumbent, and supine postures. Potential differences should be assessed for suitable diagnostics and for prescriptions of training that probably is performed in alternative postures. Eighteen healthy subjects (age: 47.2 ± 18.4 years; 10 female, 8 male) participated in the study and each completed three incremental cycle ergometer tests until exhaustion in upright, recumbent (40°), and supine positions. Gas exchange, heart rate (HR), and lactate concentrations were analyzed and efficiency was calculated subsequently. Testing sessions were performed in random order within a 2-week period. Upright cycling resulted in significantly higher peak values [power output, oxygen uptake (Vo2), HR] as well as performance at lactate and ventilatory thresholds in comparison to recumbent or supine positions. Vco2/Vo2 slope and ventilatory efficiency (VE/Vco2 slope) were not affected by posture. Aerobic work efficiency (Vo2/P slope) and gross efficiency (GE) differed significantly between postures. Hereby, GE was lowest in supine cycling, particularly obvious in a mainly aerobic condition at 70 Watt [Median 11.6 (IQR 10.9–13.3) vs. recumbent: 15.9 (IQR 15.6–18.3) and upright: 17.4 (IQR 15.1–18.3)]. Peak power as well as GE and work efficiency values are influenced by cycling position, reinforcing the importance of adjusting test results for training prescriptions. Surprisingly, ventilatory efficiency was not affected in this study and therefore does not seem to falsify test results for pulmonary diagnostics.

Relationship Between Critical Power and Different Lactate Threshold Markers in Recreational Cyclists.

Purpose: To analyze the relationship between critical power (CP) and different lactate threshold (LT2) markers in cyclists.Methods: Seventeen male recreational cyclists [33 ± 5 years, peak power output (PO) = 4.5 ± 0.7 W/kg] were included in the study. The PO associated with four different fixed (onset of blood lactate accumulation) and individualized (Dmaxexp, Dmaxpol, and LTΔ1) LT2 markers was determined during a maximal incremental cycling test, and CP was calculated from three trials of 1-, 5-, and 20-min duration. The relationship and agreement between each LT2 marker and CP were then analyzed.Results: Strong correlations (r = 0.81–0.98 for all markers) and trivial-to-small non-significant differences (Hedges’ g = 0.01–0.17, bias = 1–9 W, and p > 0.05) were found between all LT2 markers and CP with the exception of Dmaxexp, which showed the strongest correlation but was slightly higher than the CP (Hedges’ g = 0.43, bias = 20 W, and p < 0.001). Wide limits of agreement (LoA) were, however, found for all LT2 markers compared with CP (from ±22 W for Dmaxexp to ±52 W for Dmaxpol), and unclear to most likely practically meaningful differences (PO differences between markers >1%, albeit <5%) were found between markers attending to magnitude-based inferences.Conclusion: LT2 markers show a strong association and overall trivial-to-small differences with CP. Nevertheless, given the wide LoA and the likelihood of potentially meaningful differences between these endurance-related markers, caution should be employed when using them interchangeably.

Effect of Exercise-Induced Reductions in Blood Volume on Cardiac Output and Oxygen Transport Capacity.

We wanted to demonstrate the relationship between blood volume, cardiac size, cardiac output and maximum oxygen uptake (O2max) and to quantify blood volume shifts during exercise and their impact on oxygen transport. Twenty-four healthy, non-smoking, heterogeneously trained male participants (27 ± 4.6 years) performed incremental cycle ergometer tests to determine O2max and changes in blood volume and cardiac output. Cardiac output was determined by an inert gas rebreathing procedure. Heart dimensions were determined by 3D echocardiography. Blood volume and hemoglobin mass were determined by using the optimized CO-rebreathing method. The O2max ranged between 47.5 and 74.1 mL⋅kg–1⋅min–1. Heart volume ranged between 7.7 and 17.9 mL⋅kg–1 and maximum cardiac output ranged between 252 and 434 mL⋅kg–1⋅min–1. The mean blood volume decreased by 8% (567 ± 187 mL, p = 0.001) until maximum exercise, leading to an increase in [Hb] by 1.3 ± 0.4 g⋅dL–1 while peripheral oxygen saturation decreased by 6.1 ± 2.4%. There were close correlations between resting blood volume and heart volume (r = 0.73, p = 0.002), maximum blood volume and maximum cardiac output (r = 0.68, p = 0.001), and maximum cardiac output and O2max (r = 0.76, p < 0.001). An increase in maximum blood volume by 1,000 mL was associated with an increase in maximum stroke volume by 25 mL and in maximum cardiac output by 3.5 L⋅min–1. In conclusion, blood volume markedly decreased until maximal exhaustion, potentially affecting the stroke volume response during exercise. Simultaneously, hemoconcentrations maintained the arterial oxygen content and compensated for the potential loss in maximum cardiac output. Therefore, a large blood volume at rest is an important factor for achieving a high cardiac output during exercise and blood volume shifts compensate for the decrease in peripheral oxygen saturation, thereby maintaining a high arteriovenous oxygen difference.