VO2max Research Articles

The IntegraPark Study: An Opportunity to Facilitate High-Intensity Exercise with Immersive Virtual Reality in Parkinson's Disease Patients.

high-intensity exercise is a feasible and effective modality in the early stages of Parkinson's disease (PD). However, there are only a few studies that have carried out this type of intervention in customizable immersive virtual reality (IVR) environments. We explore the feasibility and effects of IVR-based high-intensity training through rowing and cycling exercises on the functional capacity, quality of life, and progression of PD. a total of 12 participants (61.50 ± 10.49 years old; 41.7% female, 58.3% male; stages I-III) were part of the study, which consisted of interventions of rowing and cycling in an IVR commercial exergame (25 min; twice per week for 14 weeks). The main variables measured were functional capacity, handgrip strength, functional mobility (TUG), functional lower-limb strength (FTSST), aerobic capacity (2-min step test), quality of life (PDQ-39), and Parkinson's disease progression (MDS-UPDRS). the results showed a general improvement in handgrip strength in both hands (p = 0.008; d = 0.28), FTSST (p = 0.029; d = 0.96), and TUG times (p = 0.152; d = 0.22). Aerobic capacity, assessed by a 2-min step test, showed enhanced scores (p = 0.031; d = 0.78). Related to the PDQ-39, all dimensions of the scale were enhanced, highlighting activities of daily living (p = 0.047; d = 0.29) and bodily discomfort (p = 0.041; d = 0.37). Finally, the main symptoms of the disease were reduced, with an improvement in the parameters that show a better incidence of disease progression, such as Part IA and IB (p = 0.013; d = 0.29 and p = 0.021; d = 0.25, respectively), Part II (p = 0.021; d = 0.23), Part III (p = 0.040; d = 0.39), and Part IV (p = 0.013; d = 0.39). the therapeutic exercise (rowing and cycling), when carried out at a high intensity and in a personalized IVR scenario, appear to be a feasible and safe modality for patients with stages I-III of PD, improving their functional capacity, quality of life, and disease progression.

Observational study of the effects of maximal oxygen uptake on cognitive function and performance during prolonged military exercise

IntroductionMilitary operations place high demands on many cognitive functions, and stressful events characterise the military work environment. The study aimed to examine the relationship between cardiorespiratory fitness, stress response, cognitive...

Impact of sprint interval training on post-fatigue mitochondrial rate in professional boxers.

Professional boxing is a sport that requires a high aerobic capacity to prevent fatigue and allow athletes to perform over 4-12 rounds. Typically, athletes will go into a heavy training period in a pre-bout camp lasting 6 to 9weeks. This study investigates the impact of 3weeks of repeated Wingate sprint interval training, performed on standard gym ergometer bikes, on skeletal muscle endurance and mitochondrial function. Ten male professional boxers (age: 26 ± 4years, height: 175 ± 5cm, weight: 70 ± 5kg) participated in the study. Baseline testing involved a NIRS monitor attached to the rectus femoris muscle prior to an incremental time to exhaustion test on a treadmill. After the treadmill test participants underwent a series of arterial occlusions to determine mitochondrial function post-volitional exhaustion. Participants then continued their own training for 3weeks and then repeated baseline testing. After the second testing session, participants undertook three weekly sprint sessions consisting of 3 × 30s maximal sprints with 60s recovery. Testing was repeated 3weeks later. The time to exhaustion increased by > 6% after 3weeks of sprint interval training as compared to baseline and control (p < 0.05). Skeletal muscle oxygen saturation (SmO2) at exhaustion was increased by 5.5% after 3weeks of sprint interval training as compared to baseline and control (p = 0.008). Skeletal muscle mitochondrial rate post exhaustion was increased by 160% after 3weeks of sprint interval training as compared to baseline and control (p < 0.001). The study demonstrated that SIT led to increased incremental time to exhaustion, higher SmO2 levels at volitional exhaustion and increased mitochondrial rates in professional boxers. These findings suggest that SIT should be an integral part of a boxe's conditioning regimen to improve performance and safety within the ring.

Daily physical activity and prognostic implications in patients with heart failure: an accelerometer study.

Physical activity (PA) measured by accelerometry is proposed as a novel trial endpoint for heart failure (HF). However, standardised methods and associations with established markers are lacking. This study aimed to examine PA measurements and accelerometer repeatability in patients with HF and age- and sex-matched controls, and study correlations with established prognostic HF markers, body composition, and quality of life (QoL). Accelerometry was performed in 105 patients with HF with left ventricular ejection fraction (LVEF) ≤ 40% and in 46 controls. Participants also underwent dual X-ray absorptiometry, cardiopulmonary exercise testing, a six-minute walking test (6MWT), echocardiography, and NT-proBNP measurement, and completed a QoL questionnaire. Average acceleration was markedly reduced in patients with HF compared with healthy controls (16.1 ± 4.8mg vs 27.2 ± 8.5mg, p < 0.001). Healthy controls spent a median daily 56min (IQR 41-96min) in moderate-to-vigorous PA (MVPA), whereas HF patients spent only 12min (IQR 6-24) in MVPA. In HF patients, average acceleration correlated moderately with 6MWT (R = 0.41, p < 0.001) and maximal oxygen uptake (peak VO2) (R = 0.36, p < 0.001) but not with NT-proBNP, LVEF, or QoL. Patients in NYHA class II showed a higher average acceleration than patients in NYHA III (16.6 ± 4.9mg vs 14.0 ± 3.6mg, p = 0.01). Daily PA was severely reduced in patients with HF compared with healthy controls. In HF patients, we found moderate correlations of accelerometer measurements with markers of physical capacity but not with LVEF or NT-proBNP. NCT05063955. Registered 01 June 2021-retrospectively registered.

Effect of aerobic exercise program on neuropathic pain and quality of life in person with paraplegia: study protocol for a randomized controlled trial

BackgroundIndividuals with spinal cord injury (SCI) often suffer from neuropathic pain which is often disabling and negatively affects function, participation, and quality of life (QoL). Pharmacological treatments lack efficacy in neuropathic pain reduction hence studying alternatives to drug treatment is necessary. Preclinical evidence of various aerobic exercises has shown positive effects on neuropathic pain but scientific studies investigating its effect in the SCI human population are limited.MethodologyThis study is a double-blind, parallel, two-group, randomized controlled trial with an interventional study design that aims to evaluate the effectiveness of aerobic exercise program on neuropathic pain and quality of life (QoL) in individuals with chronic paraplegia. Thirty individuals with chronic paraplegia with the neurological level of injury from T2 to L2 will be recruited from the rehabilitation department at a super specialty hospital based on the inclusion criteria. Using a 1:1 allocation ratio, the participants will be randomly assigned to one of the two groups. The intervention group will perform high-intensity interval training (HIIT) aerobic exercise using an arm ergometer based on their peak heart rate, and the control group will perform free-hand arm aerobic exercise. In both groups, the intervention will be delivered as 30-min sessions, four times a week for 6 weeks.Outcome measuresInternational Spinal Cord Injury Pain Basic Data Set Version 3.0 will be used for diagnosing and assessing neuropathic pain and its interference with day-to-day activities, mood, and sleep. The International Spinal Cord Society (ISCoS) QoL basic data set will be used to assess QoL, and 6-min push test distance will be used to assess peak heart rate and aerobic capacity.DiscussionThe effectiveness of the aerobic exercise program will be assessed based on the changes in neuropathic pain score and its interference with day-to-day activities, mood, sleep, QoL, and aerobic capacity after 3 weeks mid-intervention and after 6 weeks post-intervention. The trial will provide new knowledge about the effectiveness of the aerobic exercise program in improving neuropathic pain and QoL in individuals with chronic paraplegia.Trial registrationClinical Trials Registry-India CTRI/2023/08/056257. Registered on 8 August 2023.

An intermittent recovery test for soccer players: a validation study.

Soccer is an intermittent team sport that demands high aerobic capacity. On field, soccer players' aerobic capacity, assessed through the maximal oxygen uptake (VO<inf>2</inf>max), is usually determined by an intermittent recovery test. The aim of this study was to obtain a construct validity of a new intermittent recovery test (IRT) with a fixed speed and a progressive decrement of rest period. Twenty-five male soccer players were recruited to perform an incremental continuous test (ICT) and the new IRT, to compare their physiological data. Fifteen male soccer players were involved to perform a test-retest of IRT to assess its reliability. VE<inf>peak</inf>, absolute VO<inf>2</inf>max, relative VO<inf>2</inf>max and VCO<inf>2</inf>peak registered during ICT and IRT correlated strongly (Pearson's correlation coefficient ranges from 0.75 to 0.80, with very large as magnitude of effects and with P<0.001). IRT showed reliability from good to excellent regarding VE<inf>peak</inf>, absolute VO<inf>2</inf>max, relative VO<inf>2</inf>max, VCO<inf>2</inf>peak and covered distance (ICC values ranged from 0.82 to 0.95). These findings and its underlying physiological and muscular demands, suggest that IRT can be considered as a valid and reliable test to assess aerobic capacity in soccer players during the competitive period.

Effects of Altitude Training and Sea-Level Training Programs on the Physiological and Performance of Elite Chinese Male Marathon Runners

Background and Aims: Examining the differences between sea-level training programs and altitude offers important new perspectives on how environmental influences affect physiological adaptations and athletic performance. By being aware of these variations, coaches and athletes can tailor training plans to the unique conditions of altitude, which may improve performance in terms of endurance, oxygen use, and general athletic ability. Thus, this study aimed to investigate the effects of altitude training on physiological adaptation and performance in Chinese elite male marathon runners compared to plains training. By comparing the results of altitude training with those of sea-level training, this study sought to determine whether altitude training has a significant advantage in terms of physiological adaptation and performance enhancement for the Chinese elite male marathoner. In addition, exploring the variability of altitude training responses will help to inform an in-depth understanding of training strategies affecting elite marathoners and help to optimize performance enhancement methods in endurance sports. Methodology: Thirty-two Chinese elite male marathon runners will be recruited and subjected to a randomized controlled trial (RCT) in which they will be assigned to either a high altitude or plains training group. SPSS was used to perform independent samples t-tests and paired samples t-tests on the data of technical indicators. Both groups will receive structured and standardized training for a predetermined period, with the altitude of the high-altitude training set at 2366 m for 8 weeks. Results: (1) In the experimental group, the differences in red blood cells (RBC), maximal heart rate (HRmax), maximal oxygen uptake (VO2max), and full marathon performance before the altitude experiment compared to after the altitude experiment were significant (P=0.001); the differences in maximal anaerobic power and hemoglobin (HB) before the experiment were substantial (P&lt;0.005); and the differences in maximal heart rate (HRmax) between the 28 days of the experiment and the post-experiment were substantial. (HRmax) difference was substantial (P=0.001). (2) The red blood cells (RBC), hemoglobin (HB), and maximal oxygen uptake (VO2max) of the experimental group were significantly higher than those of the control group compared with the control group (P &lt; 0.005) Conclusion: The results of the study showed that eight weeks of altitude training at an altitude of 2,366 meters above sea level could improve the athletes' performance in the marathon and aerobic capacity, and could be used in the training of marathon runners.

Do Different Playing Formats and Aerobic Capacity Influence Variances in Psychophysiological Demands and Technical Performance in Small-Sided Games? A Study among Under-17 Male Soccer Players.

This study aimed to: (i) analyze the variations in psychophysiological demands (mean heart rate, meanHR; rate of perceived exertion, RPE) and technical performance (umber of successful and unsuccessful passes, and occurrences of ball loss) between 2v2 and 4v4 small-sided games (SSGs) formats, and (ii) examine the relationships of aerobic capacity measured in Yo-Yo Intermittent Recovery Test (YYIRT) on psychophysiological and technical performance during SSGs. This study used a cross-sectional design with repeated measures, where the same players participated in both 2v2 and 4v4 formats across two training sessions per format. Twenty-four talent/developmental male youth soccer players, aged 16.6 ± 0.5 years. The meanHR, measured through heart rate sensors, the RPE, assessed using the CR6-20 scale, and the number of successful and unsuccessful passes, along with occurrences of ball loss, recorded using an ad hoc observational tool, were evaluated in each repetition. Players during the 2v2 format had significantly greater mean HR (+4.1%; p < 0.001; d = 2.258), RPE (+12.2%; p < 0.001; d = 2.258), successful passes (+22.2%; p = 0.006; d = 0.884), unsuccessful passes (+62.5%; p < 0.001; d = 1.197) and lost balls (+111.1%; p < 0.001; d = 2.085) than 4v4 format. The YYIRT was significantly and largely correlated with unsuccessful passes (r = 0.502; p = 0.012) and lost balls (r = 0.421; p = 0.041) in 2v2 format. In conclusion, this study suggests that engaging in 2v2 activities constitutes a more intense form of practice, significantly enhancing individual participation in technical aspects. Moreover, aerobic capacity may influence the smaller formats of play and how players perform key technical actions. Therefore, coaches must consider this to ensure the necessary performance in such games.

A Randomized Controlled Trial to Determine the Impact of Resistance Training versus Aerobic Training on the Management of FGF-21 and Related Physiological Variables in Obese Men with Type 2 Diabetes Mellitus.

Fibroblast growth factor 21 (FGF-21) has been suggested as a potential therapeutic target for insulin resistance in health-related metabolic disorders such as type 2 diabetes. Despite the metabolic effects of resistance (RT) and aerobic training (AT) on diabetes symptoms, uncertainty exists regarding the superiority of effects manifested through these training approaches on FGF-21 and biochemical and physiological variables associated with metabolic disorders in men diagnosed with type 2 diabetes. This study aimed to investigate the impact of a 12-week RT and AT on FGF-21 levels and symptoms associated with metabolic disorders in male individuals diagnosed with type 2 diabetes. Thirty-six sedentary obese diabetic men (40 to 45 years old) were matched based on the level of FGF-1. They and were randomly divided into two training groups (RT, n = 12 and AT, n = 12) performing three days per week of moderate-intensity RT or AT for 12 weeks and an inactive control group (n = 12). Both training interventions significantly improved FGF-21, glucose metabolism, lipid profile, hormonal changes, strength, and aerobic capacity. Subgroup analysis revealed that RT had greater adaptive responses (p < 0.01) in fasting blood sugar (ES = -0.52), HOMA-IR (ES = -0.87), testosterone (ES = 0.52), cortisol (ES = -0.82), FGF-21 (ES = 0.61), and maximal strength (ES = 1.19) compared to AT. Conversely, AT showed greater changes (p < 0.01) in cholesterol (ES = -0.28), triglyceride (ES = -0.64), HDL (ES = 0.46), LDL (ES = -0.73), and aerobic capacity (ES = 1.18) compared to RT. Overall, both RT and AT interventions yielded significant moderate to large ES in FGF-21 levels and enhanced the management of biochemical variables. RT is an effective method for controlling FGF-21 levels and glucose balance, as well as for inducing hormonal changes. On the other hand, AT is more suitable for improving lipid profiles in overweight men with type 2 diabetes mellitus.

Long-Term Effects of Three Different Exercise Training Modes on Cardiorespiratory Fitness of Female Flamenco Dancers

BACKGROUND: It is well established that high-intensity interval training (HIIT) is effective in enhancing athletes’ performance and improving the health of recreational exercisers. However, there is a dearth of comprehensive recommendations regarding the integration of HIIT into the exercise routines of flamenco dancers. Therefore, this study aimed to evaluate how three different 10-week training programs—including traditional flamenco training (control group, CG) alone or combined with HIIT or muscular strength and endurance training (MSET)—impact the cardiovascular fitness (maximal oxygen consumption, VO2max) of female flamenco dancers, specifically focusing on the effectiveness of additional training methods. METHODS: A group of 33 trained female flamenco dancers was randomly divided into three groups: HIIT (n=11), MSET (n=11), and a control group (CG, n=11). VO2max was assessed through breath-by-breath gas analysis during an incremental treadmill test. All participants, including the control group, engaged in uniform choreography sessions at moderate intensity (55–60% of reserve heart rate [HRR], 50 min/day, twice a week). In addition, the HIIT and MSET groups underwent supplementary training sessions twice a week (40 min/day) for 10 weeks, utilizing different techniques and intensities (HIIT: 80–90% of HRmax; MSET: 55–75% of HRmax). RESULTS: A statistically significant 19.7% improvement in aerobic capacity (VO2max) was observed in the HIIT group (p ≤ 0.05), with large effect sizes (ES) compared to MSET (p=0.011; ES = 2.423) and CG (p=0.034; ES=1.664). CONCLUSION: These findings indicate that HIIT training, when integrated with dance lessons, enhances aerobic capacity more effectively compared to traditional dance training alone or traditional dance training supplemented with MSET. Therefore, integrating HIIT into dance training programs as supplementary training may be particularly effective in improving aerobic capacity for female flamenco dancers.

Short physical performance battery in aerobic capacity and physical activity evaluation of individuals with peripheral artery disease: An exploratory study

BackgroundPeripheral artery disease (PAD) negatively affects functional ability. Persons with PAD experience gait limitation, and changes in mobility, muscle strength, and balance. Assessing individuals with PAD with tests of lower limb performance during activities other than walking may provide information about aerobic capacity. ObjectiveTo evaluate whether the Short Physical Performance Battery (SPPB) can discriminate aerobic capacity and level of physical activity in individuals with PAD. MethodsThe SPPB, Incremental Shuttle Walking Test (ISWT), and the Human Activity Profile (HAP) were completed by 42 volunteers with PAD. The sample was stratified into tertiles by the distance walked in the ISWT and the Adjusted Activity Score (AAS) of HAP. One-way analysis of variance with a post-hoc least significant difference was used to compare the SPPB values between tertiles of ISWT and AAS of HAP. P-value < 0.05 was considered significant. ResultsThe mean age was 65 ± 7.7 years, the walking distance was 259.29 ± 115.28 m, and AAS of HAP was 68.36 ± 9.04. There was a significant difference in the total SPPB score and scores for gait speed and sit-to-stand for groups stratified by ISWT and AAS of HAP(p = 0.01). The balance domain was different only for groups stratified into tertiles by AAS of HAP(p = 0.04). ConclusionThe results of this study have clinical relevance for the evaluation of individuals with PAD at different aerobic and physical activity levels. The SPPB is a viable alternative in the practice of the specialty of vascular nursing and other areas of health to assess patients whose ability to perform walking tests is often limited.

Development of A Comprehensive Test for Talent Identification in Chinese Youth Racewalking Athletes

Background and Aim: Talent identification forms the foundation of competitive sports. Scientific selection of young people with strong athletic talent and potential to compete in sports training is key to developing high-level athletes and achieving excellent athletic results. Therefore, this study aims to develop a comprehensive test for talent identification in Chinese youth racewalking athletes. Materials and Methods: This is a research and experimental development (R&amp;D) study. There are approximately 300 youth racewalkers in China, and this study is implemented in 115 athletes. The main steps and methods of the study are as follows: (1) Literature review and content analysis, search and sort out the factors related to excellent racewalking performance; (2) Invite 7 experts to fill in the semi-structured questionnaire and form a preliminary draft of the comprehensive test; (3) Invite 21 experts to conduct a Delphi evaluation of the comprehensive test content and revise the comprehensive test; (4) Implement the comprehensive test and analyze the data, select the key test through correlation analysis, and conduct a Test-retest analysis to confirm test reliability; (5) Complete the second round of Delphi evaluation and to construct the final comprehensive test and norms. Results: The final comprehensive test for talent identification in Chinese youth racewalking athletes includes five aspects: anthropometric, physiological, physical fitness, skill, and psychology. The comprehensive test for males included 11 items as follows: (1) Pelvic Width; (2) Thigh Length; (3) Calf Length; (4) VO2 max; (5) 400m Run; (6) 3000m Run; (7) 1000m Racewalking; (8) Sit and Reach; (9) Willpower; (10) Mental Resilience; and (11) Expectation of Winning. The comprehensive test for females included 8 items as follows: (1) Thigh Length; (2) Calf Length; (3) VO2 max; (4) 400m Run; (5) 1000m Racewalking; (6) Standing Long Jump; (7) Willpower; and (8) Motivation to Participate. Conclusion: The holistic evaluation of Chinese youth racewalking athletes encompasses a diverse range of factors, from physical dimensions to psychological attributes, reflecting a nuanced understanding of talent beyond mere physical prowess.

Exceptional exercise capacity in a late bloomer octogenarian triathlete.

Maximal oxygen uptake (V̇O<inf>2max</inf>) gradually declines across the lifespan. However, little is known about the octogenarians. This is a knowledge gap given that individuals living >80 years old is the fastest expanding age-group world-wide. The increase in the elderly population has generated greater awareness in healthy ageing including psychosocial, physical, and cognitive domains, all of which benefit from engagement in physical activity or sport. In the present article are reported characteristics of an octogenarian man (GM), starting training for triathlon when he was 75 years old. GM performed an incremental Cardiopulmonary Treadmill-Running Exercise Test (CPX). A competitive 5-day consecutive triathlon event (sprint distance on days 1, 3, 4, 5 and Olympic distance on day 2) was monitored using an advanced smartwatch. Between 2021 and 2022, he trained for 10-to-12 hours/week, and participated in 59 and 39 competitions, respectively. The CPX showed a V̇O<inf>2max</inf> of 39.8 mL·min-1·kg-1, the 3rd highest value ever described in the literature among octogenarians and corresponding to the ≈60th percentile of 40-to-49-year-old men. During the 5-day triathlon (overall 12:15 h:min), 88% of time was spent at 77-95% of maximum heart rate (i.e., vigorous exercise intensity). In addition, GM was the 2022 Triathlon Olympic distance World Champion. The remarkably high V̇O<inf>2max</inf> and performance described herein were associated with exceptionally high exercise volume and intensity during training and competition, up to more than four times the recommended physical activity by current guidelines. These results further support the benefits of endurance exercise among octogenarians.

Executive functions in male and female older adults with aligned levels of VO2max.

Studies have shown a positive relationship between cardiorespiratory fitness (CRF) and executive functioning in older adults. Although this relationship has been well established, there seems to be a gap in the literature on the role of sex differences concerning CRF and executive functions. The current study aimed to assess the effect of sex in the relationship between CRF and cognition in older adults by stratifying the results to examine effects in males and females. Ninety-six older adults (61 females) gave their written, informed consent to participate in this cross-sectional study. All participants underwent a maximal continuous graded exercise test on a cycle ergometer to assess their maximal oxygen uptake (VO<inf>2max</inf>) and a computerized Stroop task (naming, inhibition, and switching) to assess their executive functions. According to VO<inf>2max</inf> test results and the American College of Sports Medicine's guidelines, females and males were classified into higher-fit and lower-fit groups. A general linear model and estimated marginal means analyses were applied. Results showed no significant differences in the naming, inhibition and switching performance tests between male and female older adults (P>0.05). Based on the observed positive relationship between CRF and executive functioning, the data of the current study supports the idea that aerobic exercise, which typically increases CRF, is well-situated to improve executive functioning in older adults, irrespective of sex.

Lifelong physiology of a former marathon world-record holder: the pros and cons of extreme cardiac remodeling.

In a 77-year-old former world-record-holding male marathoner (2:08:33.6), this study sought to investigate the impact of lifelong intensive endurance exercise on cardiac structure, function, and the trajectory of functional capacity (determined by maximal oxygen consumption, V̇o2max) throughout the adult lifespan. As a competitive runner, our athlete (DC) reported performing up to 150-300 miles/wk of moderate-to-vigorous exercise and sustained 10-15 h/wk of endurance exercise after retirement from competition. DC underwent maximal cardiopulmonary exercise testing in 1970 (aged 27 yr), 1991 (aged 49 yr), and 2020 (aged 77 yr) to determine V̇o2max. At his evaluation in 2020, DC also underwent comprehensive cardiac assessments including resting echocardiography, and resting and exercise cardiac magnetic resonance to quantify cardiac structure and function at rest and during peak supine exercise. DC's V̇o2max showed minimal change from 27 yr (69.7 mL/kg/min) to 49 yr (68.1 mL/kg/min), although it eventually declined by 36% by the age of 77 yr (43.6 mL/kg/min). DC's V̇o2max at 77 yr, was equivalent to the 50th percentile for healthy 20- to 29-yr-old males and 2.4 times the requirement for maintaining functional independence. This was partly due to marked ventricular dilatation (left-ventricular end-diastolic volume: 273 mL), which facilitates a large peak supine exercise stroke volume (200 mL) and cardiac output (22.2 L/min). However, at the age of 78 yr, DC developed palpitations and fatigue and was found to be in atrial fibrillation requiring ablation procedures to revert his heart to sinus rhythm. Overall, this life study of a world champion marathon runner exemplifies the substantial benefits and potential side effects of many decades of intense endurance exercise.NEW & NOTEWORTHY This life study of a 77-yr-old former world champion marathon runner exemplifies the impact of lifelong high-volume endurance exercise on functional capacity (V̇o2max equivalent to a 20- to 29-yr-old), partly due to extreme ventricular remodeling that facilitates a large cardiac output during exercise despite reduced maximal heart rate. Although it is possible that this extreme remodeling may contribute to developing atrial fibrillation, the net benefits of extreme exercise throughout this athlete's lifespan favor increased health span and expected longevity.

67 Does the volume or intensity of steps matter more on maximal oxygen consumption?

67 Does the volume or intensity of steps matter more on maximal oxygen consumption?

A Comparative Analysis of High-Intensity Technique-Specific Intervals and Short Sprint Interval Training in Taekwondo Athletes: Effects on Cardiorespiratory Fitness and Anaerobic Power.

Technique-specific high-intensity interval training (HIITTS) has been proven to be an effective method to enhance the sport-specific bio-motor abilities of taekwondo athletes. However, studies regarding its effects on comprehensive measures of cardiorespiratory fitness are limited. Furthermore, there is a lack of clarity regarding the extent of individual adaptations to this method compared to HIIT in the form of repeated sprints (HIITRS). This study compared the individual adaptations to HIITRS and HIITTS on cardiorespiratory fitness and anaerobic power in trained taekwondo athletes (age = 19.8 ± 1.3 years; body mass = 75.4 ± 9.1 kg; height = 1.73 ± 0.0 .m). All participants completed three sessions per week of a 60-minute regular taekwondo training. Following the 60-minute training, participants completed 3 sets of 10 × 4 s all-out HIITRS or same sets of repeated kicks with both legs (HIITTS) over a 6-week training period. In both groups, rest intervals were set at 15 seconds between efforts and one minute between sets. Before and after the training period, participants underwent a series of lab- and field-based tests to evaluate cardiorespiratory fitness and bio-motor abilities. Both interventions resulted in significant improvements in maximum oxygen uptake (V̇O2max), O2 pulse (V̇O2/HR), first ventilatory threshold (VT1), second ventilatory threshold (VT2), cardiac output (Q̇max), stroke volume (SV), peak power output (PPO), average power output (APO), squat jump (SJ), and countermovement jump (CMJ). However, linear speed (20-m speed time) and taekwondo-specific agility test (TSAT) only responded to HIITRS. HIITRS resulted in greater changes in V̇O2max, V̇O2/HR, VT2, and Q̇max, and higher percentage of responders in measured parameters than HIITTS. In addition, HIITRS elicited lower inter-individual variability (CV) in percent changes from pre- to post-training in all measured variables. These results suggest that incorporating 3 sessions per week of HIITRS into regular taekwondo training results in significantly greater and more homogenized adaptations in cardiorespiratory fitness and bio-motor abilities than HIITTS among trained taekwondo athletes.

Herbal extract (Cervus elaphus Linnaeus, Angelica gigas Nakai, and Astragalus membranaceus Bunge) ameliorates chronic fatigue: A randomized, placebo-controlled, double-blind trial

BackgroundChronic fatigue syndrome (CFS) reduces the health-related quality of life in the working-age population; however, studies have rarely investigated this group. A mixture of Cervus elaphus Linnaeus, Angelica gigas Nakai, and Astragalus membranaceus Bunge (CAA) may be an effective anti-fatigue supplement. However, few clinical trials have explored the anti-fatigue effects of herbal medicines in human participants. Therefore, this study aimed to investigate the effects of the CAA herbal complex on muscle fatigue and endurance capacity in a randomized, placebo-controlled, double-blind trial. MethodsIn an 8-week trial, 80 patients with chronic fatigue symptoms were randomly assigned to the CAA (43.5 ± 1.2 years) or placebo group (41.8 ± 1.3 years). Fatigue and cardiorespiratory endurance were measured at baseline, interim, and post-intervention. Fatigue-related blood biomarkers were assessed before and at the end of the intervention. ResultsA significant improvement in overall fatigue scores was observed on the fatigue severity scale (p = 0.038), multidimensional fatigue inventory (p = 0.037), and 24-hour visual analog scale (p = 0.002) in the CAA group compared to those in the placebo group. Fatigue improvement was observed in the CAA group, as well as physiological variables, such as increased maximal exercise time to exhaustion (p = 0.003), distance until exhaustion (p = 0.003), and maximum oxygen consumption (p = 0.039). ConclusionCAA positively and significantly affected fatigue and cardiorespiratory endurance in patients with chronic fatigue, suggesting the potential use of herbal supplements for treating chronic fatigue. Trial registrationClinical Research Information Service (CRIS, https://cris.nih.go.kr/): KCT0005613.

O95 HYPERTENSIVE RESPONSE TO EXERCISE RELATIVE-TO-FITNESS AND LEFT VENTRICULAR HYPERTROPHY ARE ASSOCIATED WITH INCREASED RISK OF CARDIOVASCULAR EVENTS: EVIDENCE FROM THE EXERCISE STRESS TEST COLLABORATION (EXERTION) STUDY

Background. A hypertensive response to exercise (HRE) is associated with a high prevalence of left ventricular hypertrophy (LVH), both being related to an increased risk of cardiovascular disease (CVD). However, these associations may be influenced by aerobic capacity (fitness). This study aimed to determine if an HRE considered relative-to-fitness and LVH are associated with increased risk for CVD events. Methods. Records for 4,307 individuals (aged 58.6±12.7 years, 52.0% male) who underwent exercise stress echocardiography were linked to administrative health datasets (hospital and emergency admissions) to ascertain CVD events (n=458, mean follow-up, 44.8±25.9 months). LVH presence/absence (LVH+/LVH-) was defined as LV mass index adjusted for body surface area around a cut point of ≥115 g/m2 for men and ≥95 g/m2 for women. HRE presence/absence (HRE+/HRE-) relative-to-fitness was defined as peak systolic blood pressure (SBP) divided by peak metabolic equivalents around a cut point of ≥90th percentile. Survival analysis using Cox-proportional hazard regression was used to compare CVD event rates across the four groups defined by the combinations of HRE+/HRE- with LVH+/LVH-, adjusted for age, sex, pre-exercise SBP, and CVD history. Results. Compared to the reference group (HRE-/LVH-), there was a stepwise increase in CVD event rate (Figure 1) across the following groups: HRE+/LVH- [Adjusted HR(95%CI), 1.34(1.02-1.76)], HRE-/LVH+ [Adjusted HR(95%CI), 2.1(1.6-3.76)], HRE+/LVH+ [Adjusted HR(95%CI), 2.55(1.64-3.97)]. Conclusion. Individuals with both HRE considered relative-to-fitness and LVH are at the highest risk of CVD events, greater than either clinical presentation alone. These results emphasise the need to address an HRE and low fitness in people with LVH to improve CVD risk management.

523. FIVE YEARS OF FLOT THERAPY. RANDOMIZED CONTROLLED TRIAL EVIDENCE IN PRACTICE

Abstract Introduction The combination of 5-flurouracil, oxaliplatin, leucovorin and docetaxel (FLOT) is an effective chemotherapy regime in locally advanced, resectable gastro-oesophageal adenocarcinoma. Since the FLOT4-AIO randomised controlled trial demonstrated superiority over ECF/ECX it has been standard of care at many centres and European Society of Medical Oncology’s recommended perioperative regimen. After over five years of offering this treatment to patients we assessed how this evidence had translated into practice; identifying factors that predict dose reduction or incomplete therapy and overall survival. Method Patients who had the combination of neoadjuvant FLOT chemotherapy and oesophagectomy for adenocarcinoma of the oesophagus or gastro-oesophageal junction between February 2018 and September 2023 were identified from a prospectively collected database. Data on completion of chemotherapy, perioperative outcomes and long-term survival were collected. Pathological regression was assessed using Mandard tumour regression grade (TRG). The peri-operative, pathological, and long-term outcomes of patients who completed four cycles of neoadjuvant FLOT was compared with those who had reduced dose or early cessation. Statistical analysis used IBM SPSS, with Mann-Whitney U and Chi squared for variable analysis and univariate cox regression for survival. Results Eighty patients were included with a median age of 66 (47-79), 84% were male. Full dose completion was achieved by 57 (71%) patients, 20 (25%) had dose reduction and 7(8%) did not complete four cycles. Age, anaerobic threshold and VO2 max were not significantly different between those completing or not completing neoadjuvant chemotherapy (p=0.460, p=0.624, p=0.104 respectively); or requiring dose reductions (p=0.317, p=0.587, p=0.82). Median TRG across all three groups was 3. Median follow up was 55.4 months and mean overall survival was 53.4 months. No difference in survival was observed between those who completed or did not complete neoadjuvant FLOT (p=0.45). Conclusion Completion of neoadjuvant chemotherapy was lower in this cohort of patients than FLOT4-AIO. Rates of pathological complete response were similar. This translated into similar mean overall survival. Median survival was unable to be calculated as survival exceeds 50% at the time of our study. The use of FLOT has translated well into the routine neoadjuvant clinical setting with acceptable short- and long-term outcomes.