Perceived Exertion Research Articles

The role of physical exercise in modifying cardiovascular parameters in hypertensive patients

Hypertension is among the top risk factors for cardiovascular diseases. Diversified rehabilitation programs are needed to limit the progression of the high blood pressure condition. The welfare of aquatic therapy is acknowledged, but hydrotherapeutic procedures are rarely used in cardiovascular diseases. The study aims to assess the impact of an exhaustive hydro-kinetic thermo therapeutic program compared to other methods of treatment, i.e., cardiovascular rehabilitation program, recommendation for a healthy life, and antihypertensive medication. Four groups of patients (46 years ±0,32) diagnosed with hypertension participated in four different rehabilitation programs to analyze the impact on their effort capacity. Their ability to achieve average effort without the appearance of fatigue symptoms was studied for a period of eight weeks by monitoring six parameters: systolic blood pressure (SBP), diastolic blood pressure (DBP), Borg Scale, Medical Research Council Dyspnoea Scale (MRC-DS), pulse (P) and oxygen saturation (O2). Group A, which benefited only of recommendations for a healthy life, didn’t register any significant p values between the initial and final evaluation; group B, which had medications and recommendations for a healthy life, registered significant p values for 2 parameters (SBP and P have p<0.0001); group C, which took part in a cardiovascular rehabilitation program, obtained significant p values for 5 parameters (SBP, DBP, Borg, MRC-DS and O2 have p<0.0001); Group D, the recipient of hydrotherapeutic program, registered significant p values for all statistically 6 monitored parameters (SBP, DBP, Borg, MRC-DS, P and O2 have p<0.0001). Physical activity in water performed regularly within a controlled therapeutic program with the thermal and electrotherapy components, leading to improved capacity for the effort by decreasing blood pressure values and dyspnea parameters.

The use of Loss Velocity and the Rate of Perceived Exertion to Assess Effort Intensity During Sets of Bench Press Exercise Performed until Exhaustion

The objective of the present study was to verify the agreement and correlation between effort intensity determined from the rate of perceived exertion (RPE) and loss velocity in sets performed to exhaustion in the bench press exercise at a self-selected velocity. Thirty-five men and women practitioners of resistance training (33.61±8.16 years; 172.75±11.04 cm of stature; 76.79±15.57 kg of body mass) were evaluated. Participants were familiarized and then performed two sets of bench press performed until exhaustion at a self-selected velocity at 70% and 85% of one-repetition maximum (1RM). Loss velocity was measured by a linear position transducer (Ergonauta® encoder) applied to velocity-based training. A 3-point RPE scale was used to evaluate the perceived exertion of the individuals. The analysis of agreement (Kappa test) and correlation (Spearman test) were applied (p<0.05). The results of the study indicated the existence of a moderate degree of agreement (κ = 0.499; κ = 0.509 for 70% and 85% of 1RM, respectively), but a strong correlation (ρ = 0.720; ρ = 0.753 for 70% and 85% of 1RM, respectively) between the effort intensity determined by the Ergonauta and the RPE, at both intensities analyzed (70% and 85% of 1RM). Despite the lack of perfect agreement between methods, loss velocity and RPE seem to demonstrate strong consistency, allowing both to be used for controlling intensity in resistance training. The results of this study should be interpreted in light of individual characteristics, type of exercise, and training objectives.

Feature importance for estimating rating of perceived exertion from cardiorespiratory signals using machine learning.

The purpose of this study is to investigate the importance of respiratory features, relative to heart rate (HR), when estimating rating of perceived exertion (RPE) using machine learning models. A total of 20 participants aged 18 to 43 were recruited to carry out Yo-Yo level-1 intermittent recovery tests, while wearing a COSMED K5 portable metabolic machine. RPE information was collected throughout the Yo-Yo test for each participant. Three regression models (linear, random forest, and a multi-layer perceptron) were tested with 8 training features (HR, minute ventilation (VE), respiratory frequency (Rf), volume of oxygen consumed (VO2), age, gender, weight, and height). Using a leave-one-subject-out cross validation, the random forest model was found to be the most accurate, with a root mean square error of 1.849, and a mean absolute error of 1.461 ± 1.133. Feature importance was estimated via permutation feature importance, and VE was found to be the most important for all three models followed by HR. Future works that aim to estimate RPE using wearable sensors should therefore consider using a combination of cardiovascular and respiratory data.

The Impact of Pressure Training on the Performance of Semi-Professional Female Rugby League Players.

The aim of this study was to examine the effect of pressure training on the performance of semi-professional female rugby league athletes. Using a within-subjects design, 16 female athletes (19.9 ± 3.4 years) performed a passing accuracy task under three conditions; (1) a control condition; (2) a physiological fatigue condition; and (3) a threat of consequence condition. Passing performance, perceived pressure, rate of perceived exertion (RPE), and self-confidence were assessed. A significant main effect of conditions was found for rate of perceived exertion (p < 0.001), self-confidence (p < 0.028), and perceived pressure (p = 0.011). There was no main effect of condition on passing performance. Post hoc comparisons revealed that RPE was significantly higher in the physiological fatigue condition when compared to the control (p = 0.009) and threat of consequence conditions (p < 0.001). Perceived pressure was significantly higher in the threat of consequence condition compared to the control condition (p = 0.037). The main findings of this study are that (1) passing performance was not impacted by pressure training conditions, and (2) threats of consequences are an effective manipulation to generate pressure in female semi-professional rugby league players. These results offer nuanced insights into the impact of pressure generation in training environments for female semi-professional rugby league athletes.

Telemedicine-assisted exercise program (TAEP) for coronary heart disease

Introduction &amp; Purpose Cardiovascular diseases (CVD) are a common cause of declining physical performance and quality of life. Despite the recommendation of physical activity as class 1A in the American Heart Association’s guidelines for cardiac rehabilitation (Pelliccia et al., 2021) and the clear need for innovative rehabilitation programs, no tele-medical exercise program has been adopted into standard care (Scherrenberg et al., 2021; Snoswell et al., 2020). Classic CVD exercise therapy typically includes group ergometer and strength training. The primary aim of this project was to integrate exercise as a pillar of therapy in the HerzMobil Tirol project, leading to the implementation of a telemedicine-assisted exercise program. Methods Patients enrolled in the CHD project had the opportunity to participate in TAEP. The initial and final therapeutic examinations included a medical history interview, the 1-minute sit-to-stand test (STS; Strassmann et al., 2013) and standardized EQ-5D-5L to assess the quality of life. Based on the guidelines and the classic CVD therapy the TAEP participants completed a twelve-week home-based exercise program. It included endurance training (5 days/week for 30 minutes) and video-guided strength, mobility and coordination training (2-3 times/week), where the focus was on strength training. The program was analysed and adapted individually by an exercise therapist. The intensity was controlled using the Borg scale and the talk test (Bok et al., 2022). Results 22 patients completed the TAEP, 77% (n = 17) were male and 23% (n = 5) were female and the median age was 61 (53-71) years. During the twelve weeks, the patients completed a median of 257 (213-351) minutes per week of endurance-oriented exercise training (e.g. walking or cycling) and performed video-guided home-based strength training with a median of twice (1-2) per week. 95% of patients fulfilled the recommendations for endurance training and 64% for strength training. The TAEP participants showed a significant (p &lt; 0.001) increase in STS with a median of 37% (18-24). There was a significant improvement in quality of life according to the EQ-5D-5L health scale with a median from 70 (60-85) to 83 (79-95; p &lt; 0.001). Discussion The current literature on cardiovascular diseases and exercise as therapy continues to underline the importance of physical activity for the prevention and treatment of these conditions. Studies indicate that regular exercise can reduce the risk of cardiovascular diseases and serves as an effective complement to pharmacological therapy. The results of the present project show that the integration of exercise therapy into a telemedical care program is feasible and effective. However, the lack of a control group and the small sample size made it difficult to compare the results directly and if the observed changes are actually attributable to the TAEP. Conclusion In our programme, we have learned that (1) a doctor’s recommendation for exercise therapy and (2) personal contact between the exercise therapist and the patient are key to patients’ adherence to exercise therapy. The TAEP was well received by the patients and feasible irrespective of the patients’ age. In the age of digitalisation, telemedicine-supported training therapy is an option in cardiac rehabilitation, even for people in remote catchment areas. References Bok, D., Rakovac, M., &amp; Foster, C. (2022). An examination and critique of subjective methods to determine exercise intensity: The talk test, feeling scale, and rating of perceived exertion. Sports Medicine, 52(9), 2085–2109. https://doi.org/10.1007/s40279-022-01690-3 Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., Hansen, D., Heidbuchel, H., Myers, J., Niebauer, J., Papadakis, M., Piepoli, M. F., Prescott, E., Roos-Hesselink, J. W., Graham Stuart, A., … Rakhit, D. (2021). 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. European Heart Journal, 42(1), 17–96. https://doi.org/10.1093/eurheartj/ehaa605 Scherrenberg, M., Wilhelm, M., Hansen, D., Völler, H., Cornelissen, V., Frederix, I., Kemps, H., &amp; Dendale, P. (2021). The future is now: A call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology. European Journal of Preventive Cardiology, 28(5), 524–540. https://doi.org/10.1177/2047487320939671 Strassmann, A., Steurer-Stey, C., Lana, K. D., Zoller, M., Turk, A. J., Suter, P., &amp; Puhan, M. (2013). Population-based reference values for the 1-min sit-to-stand test. International Journal of Public Health, 58(6), 949–953. https://doi.org/10.1007/s00038-013-0504-z Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., &amp; Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), Article e17298. https://doi.org/10.2196/17298

Exploring the potential of cardiopulmonary exercise testing (CPET) for individualised pulmonary rehabilitation in people with interstitial lung disease (ILD): A systematic review protocol

Background This review aims to identify which cardiopulmonary exercise test (CPET) derived variables can be used to personalise pulmonary rehabilitation for people with interstitial lung diseases. A ‘one size fits all’ approach does not benefit every patient due to a multitude of unique characteristics, subsets and phenotypes. No condition specific personalised pulmonary rehabilitation guidelines exist in this area and exercise programme development is lacking. This leads to wide variation in the success within the literature and clinical practice. Methods MEDLINE, Embase, CINAHL, SPORTDiscus and the Cochrane Database of Systematic Reviews will be searched to identify studies that utilise CPET variables for PR development. Quality assessment is to be performed using the Critical Appraisal Skills Program (CASP) checklists for single cohort studies and randomised controlled studies. Discussion The primary outcomes found within the included studies for peak volume of oxygen consumption (VO2peak), work rate (WRpeak), oxygen consumption at anaerobic threshold (VO2-AT), heart rate and rate of perceived exertion (RPE) would help determine which variables are optimal for prescription success. Identification of reliable methods to personalise pulmonary rehabilitation for people with interstitial lung disease would enhance what is already known and potentially lead to best practice guideline development. Registration In accordance with the guidelines, this systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 07 May 2024 (registration number CRD42024543174).

Effects of Sports Bras and Breast Volume on Pulmonary System and Respiratory Symptom Responses to Exercise in Healthy Females.

This study assessed the individual and combined effects of sports bras and breast volume on pulmonary system and respiratory symptom responses to exercise in recreationally-active females. Twenty-three healthy females (18-27 y; bra sizes 32B-36DDD) were divided into small and large breast volume groups (SBV and LBV, respectively) around median volume (324 ml; mean ± SD SBV: 284 ± 38 ml vs. LBV: 560 ± 97 ml; p < 0.001, g = 3.84). Participants completed three 5-minute bouts of constant-load cycle exercise at 30, 60, and 90% of their peak power output while wearing a high-support sports bra, low-support sports bralette, or their own (self-selected) sports bra in randomized order. Measurements included ventilation, breathing pattern, respiratory pressures, diaphragm electromyogram (EMGdi), and ratings of perceived exertion (RPE), breathlessness (intensity and unpleasantness) and chest tightness due to bra. Compared to low-support and personal sports bras, the high-support sports bra evoked stronger sensations of restricted breathing and chest tightness ('slight' to 'moderate' restriction in n = 7 [30%] vs. n = 1 [4%] in low-support and personal bras; p = 0.014). There was, however, no evidence of greater concomitant inspiratory constraints, EMGdi, or inspiratory muscle pressure generation in either bra (all p > 0.05). Notably, LBV compared to SBV participants reported greater RPE (p = 0.037, ηp2 = 0.20), breathlessness intensity (p = 0.039, ηp2 = 0.20) and unpleasantness (p = 0.041; ηp2 = 0.19), which, in the setting of comparable pulmonary system responses to exercise, was likely driven by stronger perceived chest tightness and/or bra awareness in LBV participants. Despite evoking mild-to-moderately severe chest tightness due to bra during exercise - correctly fitted sports bras, whether low- or high-support, do not impose a physiological burden to the respiratory system and its response to mild-to-heavy intensity exercise in otherwise healthy females.

Implementing a Pulmonary Telerehabilitation Program for Young Adults with Post-COVID-19 Conditions: A Pilot Study.

Several studies have shown that pulmonary telerehabilitation (PTR) improves respiratory capacity. However, there is little evidence of its effectiveness in youth with post-COVID-19 conditions (PCC). This study analyzed the effects of a PTR program on young adults with PCC. Sixteen youths were randomly assigned to a control group (CG) or an experimental group (EG), with eight participants each. The EG participated in a PTR program that included twelve remote, asynchronous four-week sessions with diaphragmatic breathing and aerobic exercises. Vital signs (SpO2, HR, RR, BP), physical capacity (sit-to-stand test), cardiorespiratory capacity (6-Minute Walk Test), and perceived exertion (Borg scale) were assessed in both groups. Statistical analyses showed a significant decrease in RR and HR (p < 0.012) and an increase in SpO2 (p < 0.042), physical (p < 0.012), and respiratory (p < 0.028) capacity. Perceived effort decreased significantly in both groups (CG: p < 0.006; EG: p < 0.001) only for physical but not for cardiorespiratory capacity (p < 0.106). There were no statistical changes registered in BP (p > 0.05). The PTR program, which includes respiratory and aerobic exercises, is feasible and effective in improving physical and cardiorespiratory capacity in young people with PCC, as well as reducing HR, RR, and dyspnea.

Cortisol and insulin behaviors during an ultramarathon event: are they real markers of extreme exertion?

The current work aimed to describe and compare the cortisol and insulin concentrations behavior and rate of perceived exertion (RPE) during a 115 km ultramarathon race. Nine ultrarunners (eight males) were evaluated six times (0, 37, 60, 76, 89 and 115 km). At each moment, saliva samples (for cortisol and insulin assessment) and RPE (CR10 scale) were collected. Statistical analysis included correlation, one-way repeated measure ANOVA, and Statistical Parametric Mapping to define discrete and continues changes and compare cortisol, insulin and RPE profiles. Our main findings revealed an early peak in cortisol and RPE, accompanied by a decline in insulin responses (402±49 min of the race, P<0.05). Cortisol and insulin only showed magnitude differences with inverse behaviors until ~6% (7 km) of the ultramarathon duration. Cortisol and RPE presented similar behaviors, rising from the beginning of the race and remaining elevated throughout the race (η2=0.91 and η2=1.0, P<0.001). Insulin levels decreased when the race started, remaining below 60% of baseline values from the midpoint to the end of the race (P=0.04). The study showed an imbalance in the catabolic/anabolic hormone profile during an ultramarathon race, with a prominence in catabolic state. It should be considered in the ultramarathon races preparation and participation due to its possible detrimental effect on the athlete's health.

Influence of Surgical Mask on Exertion Perception and Select Physiological Parameters During an Incremental Test in Healthy Subjects

Background: During cardiac or pulmonary rehabilitation exercises, the use of a surgical mask may not be well tolerated by patients, especially those experiencing dyspnea during certain activities due to their underlying health conditions. The purpose of this study was to describe the influence of a surgical mask on exertion perception and some physiological parameters during an incremental test in healthy subjects. Methods: A descriptive study involving 16 healthy adult individuals was conducted. The BRUCE incremental protocol was performed twice, with and without the use of a surgical mask. Results: No significant changes were found in vital signs, such as heart rate (p: 0.8684), mean arterial pressure (p: 0.2781), and peripheral oxygen saturation (p: 0.5314). However, the respiratory rate showed a significant difference (p: 0.023). Furthermore, significant differences were observed in the distance covered (p: 0.0005), duration (p: 0.0003), and measured intensity (METs) (p: 0.0117). Metabolic acidosis (p: 0.032), hypocapnia (p: 0.238), and hyperlactatemia (p: 0.024) were detected in the analysis of arterial gases. Oxygenation parameters, such as PaO2 (p: 0.038) and PaO2/FiO2 ratio (p: 0.038), were higher in the mask-off trial. Conclusion: Surgical masks induce negative changes in METs, distance covered, and duration during an incremental treadmill test. Although no significant impact on vital signs was observed, the use of a surgical mask resulted in statistically significant but not clinically relevant decreases in oxygenation parameters. The stages of the Bruce protocol were achieved differently when participants wore a surgical mask. conclusion: During a treadmill incremental test, surgical masks induce negative changes in MET, distance covered, and duration. Although no significant impact was observed on vital signs, wearing a surgical mask resulted in statistically significant but not clinically relevant decreases in oxygenation parameters. The stages of the Bruce protocol were achieved differently when participants wore a surgical mask.

Effects of Music on Repeated-Sprint Performance of Elite Tunisian Soccer Players: Comparing Morning to Afternoon Practice Sessions.

Our aim in the present study was to examine the effect of listening to self-selected music during soccer warm-ups in morning and afternoon sessions on repeated-sprint performances of elite soccer players. Twenty elite academy male soccer players performed a repeated-sprint ability (RSA) test in the morning (i.e., 07:00hours) and in the afternoon (i.e., 17:00hours), with or without listening to music during the warm-up period. The RSA test consisted of six 40-meter sprints with 180° direction changes interspersed with a 20-second passive recovery period. Ratings of perceived exertion (RPE) were obtained at the end of the warm-up period and immediately after the RSA test. Results showed that listening to music during warming-up had no significant effect on these selected performance measures (i.e., mean sprint time, best sprint time, RSA decrement), regardless of whether performances were in the morning or the afternoon. Moreover, players reported higher post-warm-up RPE scores in the music listening condition than in the no-music listening condition, only in the afternoon session. Furthermore, RPE scores measured after the RSA test were higher in the no-music listening condition compared to the music listening condition, only in the morning session. Thus, the use of music during warming-up in elite soccer players appears to be an individual athlete's choice but not a reliable means of enhancing performance.

The effects of low vs. high rating of perceived exertion clamp exercise on performance, neuromuscular, and muscle oxygen saturation responses in females.

This study examined the time course of changes in force, relative to critical force (CF), electromyographic amplitude (EMG AMP), neuromuscular efficiency (NE), and muscle oxygen saturation (SmO2), as well as time to task failure (TTF) and performance fatigability (PF) during isometric handgrip holds to failure (HTF) anchored to the rating of perceived exertion (RPE) at 3 and 7. Ten females completed pre-test maximal voluntary isometric contractions (MVICs), submaximal HTF at four percentages of MVIC, an HTF at RPE = 3 and 7, and post-test MVICs. Analyses included paired samples t-tests, repeated measures ANOVAs and planned comparisons. TTF was not different between RPE 3 (540.4 ± 262.1s) and 7 (592.2 ± 299.6s), but PF for RPE 7 (42.1 ± 19.1%) was greater than RPE 3 (33.5 ± 15.4%) (p < 0.05). There were RPE-dependent decreases in force, EMG AMP, and NE across three discernable phases during the HTF (p < 0.01), but there were no significant changes in SmO2 across time. Although there were overall similar patterns across time for force, neuromuscular, and muscle metabolic responses between the RPE holds, the greater PF at RPE 7 than RPE 3 may be explained by the longer sustained time above CF at RPE 7, resulting in greater accumulation of intramuscular metabolites and afferent feedback. Throughout each trial, it is possible that force was adjusted to avoid the sensory tolerance limit, and the task was ended when force could no longer be reduced to maintain the assigned RPE, resulting in a similar TTF for RPE 7 and RPE 3.

Inhalation of Hydrogen-rich Gas before Acute Exercise Alleviates Exercise Fatigue: A Randomized Crossover Study.

Hydrogen, as an antioxidant, may have the potential to mitigate fatigue and improve selected oxidative stress markers induced by strenuous exercise. This study focused on a previously unexplored approach involving pre-exercise inhalation of hydrogen-rich gas (HRG). Twenty-four healthy adult men first completed pre-laboratories to determine maximum cycling power (Wmax) and maximum cycling time (Tmax). Then they were subjected to ride Tmax at 80% Wmax and 60-70 rpm on cycle ergometers after inhaled HRG or placebo gas (air) for 60-minute in a double-blind, counterbalanced, randomized, and crossover design. The cycling frequency in the fatigue modeling process and the rating of perceived exertion (RPE) at the beginning and end of the ride were recorded. Before gas inhalation and after fatigue modeling, visual analog scale (VAS) for fatigue and counter-movement jump (CMJ) were tested, and blood samples were obtained. The results showed that compared to a placebo, HRG inhalation induced significant improvement in VAS, RPE, the cycling frequency during the last 30 seconds in the fatigue modeling process, the ability to inhibit hydroxyl radicals, and serum lactate after exercise (p<0.028), but not in CMJ height and glutathione peroxidase activity. The cycling frequency during the last 30 seconds of all other segments in the fatigue modeling process was within the range of 60-70 rpm. In conclusion, HRG inhalation prior to acute exercise can alleviate exercise-induced fatigue, maintain functional performance, and improve hydroxyl radical and lactate levels.

The Effectiveness and Validity of Inspiratory Muscle Training in the Training Process of Disabled Swimmers.

Objectives: The aim of this study was to evaluate the effect of medium-intensity inspiratory muscle training added to standard swimming training on inspiratory muscle strength and aerobic endurance levels and training status in disabled swimming athletes. Methods: This study involved 16 disabled athletes: group I-athletes performing swimming training with 8 weeks inspiratory muscle training-IMT (50% of the maximum inspiratory pressure); group II-athletes performing standard swimming training with 8 weeks inspiratory muscle training (15% MIP). The following tests were performed three times: MIP, MEP, Borg RPE scale and swimming test: T-30 test; 8 × 100 progressive test. Results: There was a significant increase in the MIP and MEP in group I after IMT. There was a significant increase in the distance swam during the T-30 only in group I after IMT. Significant differences were found between the first and third measurements in group I, and the effect was maintained at follow-up. There was also a significant reduction in La concentration in group I after IMT. There was a significant reduction in heart rate at 88% and 93% of the maximum speed in group I after the applied training. Conclusion: Inspiratory muscle training with 50% of the maximum inspiratory pressure load significantly increased the respiratory muscle strength of disabled swimmers. The application of higher-intensity IMT effectively improved the training level and physiological parameters of the swimmers' effort, indicating the need to include this type of training in the standard preparation of disabled swimmers.

Classification of Patients Based on Dyspnea and Desaturation During Exercise in Interstitial Lung Disease.

Dyspnea and desaturation during exercise are essential assessment items for pulmonary rehabilitation. Characterizing patients using these 2 factors may be important for providing more effective pulmonary rehabilitation. This study aimed to categorize subjects with interstitial lung disease (ILD) using dyspnea and desaturation at the end of the 6-min walk test (6MWT). This was a retrospective study including 230 stable subjects with ILD who underwent 6MWT in our out-patient department at a general hospital in Japan. The modified Borg scale and oxygen saturation determined by SpO2 at the end of the 6MWT were used for cluster analysis using the k-means method with k = 4. Subjects were classified into 4 characteristic clusters. SpO2 at the end of the 6MWT was lower in cluster 4 (80.5 ± 3.0%) than in clusters 1 (94.3 ± 2.0%), 2 (94.3 ± 1.9%), and 3 (87.9 ± 1.8%) and was lower in cluster 3 than in clusters 1 and 2. The modified Borg scale score at the end of the 6MWT was higher in clusters 2 (4 [3-8]), 3 (3 [0-9]), and 4 (4 [0-7]) than in cluster 1 (0.5 [0-2.0]) and was higher in cluster 2 than in cluster 3. Subjects with ILD were classified into 4 characteristic clusters using dyspnea and SpO2 at the end of the 6MWT. The 4 clusters are characterized as follows: Cluster 1 had mild desaturation and mild dyspnea; cluster 2 had mild desaturation and severe dyspnea; cluster 3 had both moderate desaturation and dyspnea, and cluster 4 had both severe desaturation and dyspnea. These classification data offer insight for individualized pulmonary rehabilitation for patients with ILD.

The Effects of L-Citrulline and Malic Acid on Substrate Utilisation and Lactate Elimination

Endurance athletes often aim to improve their aerobic metabolism. The aim of this pilot study was to examine if malic acid and L-citrulline supplementation can improve aerobic metabolism and lactate elimination. Nine young (23.9 ± 1.9 years) recreational male athletes participated in this study. Following a standardised breakfast and a body composition analysis (InBody720), 6000 mg of citrulline and 3000 mg of malic acid or a placebo of 300 mL of water were consumed on three separate days in a cross-over design using a double-blind method. Sixty minutes after the supplementation, participants completed a ramp bicycle spiroergometer protocol (35 W/3 min) until reaching a respiratory exchange ratio (RER) of 1.1, followed by a 9 min active recovery. Cadence, heart rate (HR), rate of perceived exertion (RPE), respiratory parameters and lactate levels were registered. The RPExHR value was calculated to accurately characterise exhaustion. During the exercise protocol, citrulline supplementation induced significantly lower RER values at 70-105-140 W compared to malic acid and the placebo, respectively. There was no difference in lactate levels neither during rest nor at RER 1.1. RPExHR rate values were significantly lower after malic acid supplementation compared to placebo at 175 and 210 W. Power at RER 1.1 was higher after malic acid (+4 W) and citrulline (+5 W) supplementation. Although the supplementation failed to decrease lactate levels, lower RER and RPE values may indicate a performance-enhancing benefit.

Evaluation of fatigue and fatigability in people with Duchenne muscular dystrophy using a dynamic arm support – a pilot study

Background Due to progressive muscle wasting and weakness in patients with Duchenne Muscular Dystrophy (DMD), physical fatigability increases, upper extremity function reduces, which negatively impacts quality of life. Assistive technology such as dynamic arm supports (DAS) may help reduce this fatigability. This study aims to assess whether the novel Yumen ‘EXone’ DAS can reduce upper extremity fatigue and fatigability in DMD patients and healthy controls (HC), both with and without the DAS. Additionally, longitudinal changes in DMD patients were evaluated. Methods Five DMD patients from the Yumen Bionics pioneer program and five HCs participated. Two submaximal tests simulating drinking and reaching were performed for two minutes, each with and without DAS. DMD participants completed these tests twice, at baseline (T0) and after 6-9 months (T1), while HCs completed them once. Physical fatigability was measured by the number of repetitions and changes in surface electromyography (sEMG) amplitude. Subjective fatigue was assessed using the Borg Scale (6-20) Rate of Perceived Exertion (RPE). Results DMD participants generally performed more repetitions with the DAS than without. HCs showed similar or increased repetitions with the DAS. Assessing fatigability with sEMG was difficult due to the compensatory mechanisms used for the tests. Subjective fatigue scores on the Borg Scale were lower with the DAS for both DMD patients and HCs. Conclusion The Yumen ‘EXone’ DAS effectively reduces both fatigue and fatigability in DMD patients and healthy controls. Despite the methodological shortcomings, this research is one of the first studies investigating the impact of DAS on fatigue and fatigability.

Effect of repeated sessions of transcranial direct current stimulation on subjective and objective measures of recovery and performance in soccer players following a soccer match simulation

We investigated the effect of repeated sessions of anodal transcranial direct current stimulation (a-tDCS) on subjective and objective measures of recovery, cognitive and sport-specific performance in professional soccer players following a soccer match simulation (SMS). Sixteen soccer players participated in this randomized, crossover, and sham-controlled study. They completed baseline assessments of well-being, total quality recovery (TQR), electromyographic activity (EMG) of the thigh muscles, countermovement jump (CMJ), and cognitive and Loughborough soccer passing test (LSPT) skills. Then, the participants engaged in an SMS routine (2 × 45 min, 15-min intervals). There was no significant difference in rating of perceived exertion (RPE) during the SMS in the anodal (17.25 ± 0.85) and sham (16.93 ± 0.92) conditions (p = 0.19). Following the SMS, the participants were randomized to receive three sessions of a-tDCS (2 mA, 20 min, +F3/−F4) targeting the left dorsolateral prefrontal cortex (DLPFC) or sham immediately after, 24 h, and 48 h after the SMS. Finally, the same outcome measures were evaluated 24 and 48 h following the SMS. A two-way repeated-measures ANOVA showed that a-tDCS stimulation improved passing skills (decreased time to perform the LSPT and number of errors; all ps < 0.01; d = 0.56–2.9) and increased the feeling of well-being (p = 0.02; d = 2.8), with no effect on TQR, cognitive performance, CMJ performance, and EMG. Therefore, the results of the present study indicate, for the first time, that repeated a-tDCS could be used as an adjunct method to accelerate soccer players' well-being and technical performance recovery, particularly after congested matches and/or training sessions. These findings may also be applicable to other team sports with characteristics similar to soccer (e.g., futsal, handball, basketball, etc.).

Diaphragm Muscle Atrophy Contributes to Low Physical Capacity in COVID-19 Survivors.

Fatigue and dyspnea are the most commonly reported long-term complaints in individuals previously infected with SARS-CoV-2. This study aimed to comprehensively evaluate diaphragm muscle function in post-COVID-19 patients and investigate whether potential diaphragm dysfunction contributes to physical functioning impairment. A total of 46 patients who qualified for pulmonary rehabilitation were examined. Diaphragm muscle function parameters were evaluated using ultrasonography, while the severity of dyspnea, aerobic capacity, and the amount of energy used by the body during physical activity were assessed using the six-minute walk test, mMRC scale, and Metabolic Equivalent Task (MET), respectively. We identified that 69.5% of patients had diaphragm atrophy and 6.5% had diaphragm paralysis. The percentage of atrophy was not related to age, gender, BMI, oxygen therapy usage during the COVID-19 infection course, and disease severity. Patients who experienced cough, fever, and no loss of smell during the COVID-19 course had significantly greater diaphragm inspiratory thickness values, while patients with cough and no smell disorders had a significantly lower percentage of diaphragm atrophy. Diaphragm functional parameters were strongly associated with selected variables of exercise tolerance, such as distance in the six-minute walk test, oxygen saturation levels, fatigue, and exertion on the Borg scale. In conclusion, diaphragm muscle dysfunction is a serious long-term post-COVID-19 consequence and can be viewed as a major contributing factor to prolonged functional impairments.

P212 COMPARISON OF COLLEGE STUDENTS’ HEALTH METRICS DURING TRADITIONAL AND VIRTUAL REALITY BASED CYCLING

Background: Most college students do not meet the recommended physical activity guidelines. Novel technology such as virtual reality (VR) may be used to promote physical activity among sedentary students. Purpose: To investigate physiological changes in heart rate (HR), blood-pressure (BP) and rating of perceived exertion (RPE) among college students during stationary cycling with and without VR. Methods: Twenty-two college-students (7 M/15F; 18-30years) were recruited on campus. Students separately &amp; randomly completed 2 separate cycling-sessions (with and without VR). The VZFit Ring Racer application with Meta Quest 2 VR Headset synced to a RENPHO smart AI bike was used for the VR session. HR, BP and RPE were assessed at 5-min intervals. Results: Only, RPE at 5-min interval was significant (p=0.032) between the non-VR and VR groups, which may be attributed to the fact that participants were focused more on the VR environment rather than the exercise session, potentially lowering their RPE. Conclusions: In this preliminary data, college students HR, BP &amp; RPE were influenced during the VR session with RPE being lower. This suggests that VR may reduce the perception of effort for a given exercise intensity, and it could be used as a tool to engage students and promote physical activity, in an otherwise sedentary student population.