Perceptual Responses Research Articles

Acute effects of static balance exercise combined with different levels of blood flow restriction on motor performance fatigue as well as physiological and perceptual responses in young healthy males and females

PurposeThis study investigated the acute effects of a static balance exercise combined with different blood flow restriction (BFR) pressures on motor performance fatigue development and recovery as well as physiological and perceptual responses during exercise in males and females.MethodsTwenty-four recreational active males (n = 13) and females (n = 11) performed static balance exercise on a BOSU ball (3 sets of 60 s with 30 s rest in-between) on three separate (> 3 days) laboratory visits with three different BFR pressures (80% arterial occlusion pressure [AOP], 40%AOP, 30 mmHg [SHAM]) in random order. During exercise, activity of various leg muscles, vastus lateralis muscle oxygenation, and ratings of effort and pain perception were recorded. Maximal squat jump height was measured before, immediately after, 1, 2, 4, and 8 min after exercise to quantify motor performance fatigue development and recovery.ResultsQuadriceps muscle activity as well as ratings of effort and pain were highest, while muscle oxygenation was lowest in the 80%AOP compared to the 40%AOP and SHAM condition, with no differences in postural sway between conditions. Squat jump height declined after exercise with the highest reduction in the 80%AOP (− 16.4 ± 5.2%) followed by the 40%AOP (− 9.1 ± 3.2%), and SHAM condition (− 5.4 ± 3.3%). Motor performance fatigue was not different after 1 min and 2 min of recovery in 40% AOP and 80% AOP compared to SHAM, respectively.ConclusionStatic balance exercise combined with a high BFR pressure induced the largest changes in physiological and perceptual responses, without affecting balance performance. Although motor performance fatigue was increased by BFR, it may not lead to long-term impairments in maximal performance.

Persistent Contralateral Pain Compromises Exercise Tolerance but Does not Alter Corticomotor Responses During Repeated, Submaximal Isometric Knee Extensions to Task Failure

Muscle pain is an important determinant of exercise tolerance, but its relationship with neurophysiological responses during a submaximal exercise trial is unclear. The purpose of this study was to determine the effect of persistent contralateral pain on neurophysiological function and perceptual responses during ipsilateral isometric knee extensions to task failure. Ten participants performed a single-leg repeated submaximal isometric knee extensions with (PAIN) or without (CTRL) constant pain induced by intermittent blood flow occlusion combined with evoked muscle contraction applied to the contralateral, resting leg. Transcranial magnetic stimulation (TMS) applied over the motor cortex was used to assess corticospinal excitability (quantified as motor evoked potentials), corticospinal inhibition (quantified as silent period duration), and short interval intracortical inhibition. Maximal voluntary contractions (MVCs), coupled with femoral nerve stimulation to the exercising leg, were performed every 12 submaximal contractions to assess neuromuscular function. Perceived leg pain and effort were also assessed throughout the exercise. The experimental pain shortened the time to task failure compared to CTRL (P = 0.019). Although time effects were present, no differences appeared between conditions for MVC force, voluntary activation, or potentiated twitch force across both tasks (all P > 0.05). Additionally, no differences between CTRL and PAIN were demonstrated for any TMS-derived measures assessing corticospinal responses. Exercising leg pain was higher in CTRL (P = 0.018), as was perceived exertion (P = 0.030). Overall, when using a persistent, submaximal experimental pain intervention, it appears that although muscle pain compromises exercise tolerance, this phenomenon occurs independently of potential alterations in corticomotor mechanisms.

Perceived timing of postural instability onset

BackgroundThis study investigates the perceived onset of postural instability, a critical aspect of balance. Prior research using Temporal Order Judgment (TOJ) tasks revealed that postural perturbations must occur significantly earlier than an auditory reference stimulus for individuals to perceive them as simultaneous. However, there are methodological concerns with this previous work, particularly an unbalanced stimulus onset asynchrony (SOA) distribution. Research questionDoes the point of subjective simultaneity (PSS) between postural perturbation onset and an auditory reference stimulus differ between SOA distributions unequally (distribution 1) and equally (distribution 2) distributed around true simultaneity (0 ms)? MethodsA repeated measures design was employed, presenting two different SOA distributions to 10 participants using a TOJ task during both distribution 1 (88 trials) and distribution 2 (72 trials) SOA distributions. Paired t-tests were used to determine if there was a significant difference between the PSS of distribution 1 and 2. One-sample t-tests were also performed on the PSS values of both conditions in comparison to 0 ms (defined as true simultaneity) to determine if perceptual responses were delayed. ResultsDistribution 1 led to a perceived delay of postural instability onset by 20.34 ms, while distribution 2 resulted in a perceived delay of the auditory stimulus of 3.52 ms. However, neither condition was significantly different from each other nor from true simultaneity. SignificanceThese findings suggest that the perception of postural instability onset is not slow, contrary to previous beliefs, and emphasize the importance of controlling methodological parameters when examining sensory cues. This understanding will help inform falls prevention strategies.

Priming of the autonomic nervous system after an experimental human pain model.

Modulated autonomic responses to noxious stimulation have been reported in experimental and clinical pain. These effects are likely mediated by nociceptive sensitization, but may also, more simply reflect increased stimulus-associated arousal. To disentangle between sensitization- and arousal-mediated effects on autonomic responses to noxious input, we recorded sympathetic skin responses (SSRs) in response to 10 pinprick and heat stimuli before (PRE) and after (POST) an experimental heat pain model to induce secondary hyperalgesia (EXP) and a control model (CTRL) in 20 healthy females. Pinprick and heat stimuli were individually adapted for pain perception (4/10) across all assessments. Heart rate (HR), heart rate variability (HRV) and skin conductance (SCL) were assessed before, during, and after the experimental pain model. Both pinprick- and heat-induced SSRs habituated from PRE to POST in CTRL, but not EXP (p=0.033). Background SCL (during stimuli application) was heightened in EXP compared to CTRL condition during pinprick and heat stimuli (p=0.009). Our findings indicate that enhanced SSRs after an experimental pain model are neither fully related to subjective pain, as SSRs dissociated from perceptual responses, nor to nociceptive sensitization, as SSRs were enhanced after both modalities. Our findings can, however, be explained by priming of the autonomic nervous system during the experimental pain model, which makes the autonomic nervous system more susceptible to noxious input. Taken together, autonomic readouts have the potential to objectively assess not only nociceptive sensitization, but also priming of the autonomic nervous system, which may be involved in the generation of distinct clinical pain phenotypes.

How visible street greenery moderates traffic noise to improve acoustic comfort in pedestrian environments

The effects of street greenery on the perceptual response to the acoustic comfort of pedestrian streets in traffic noise environments were examined through an experimental study that considered an audio-visual environment with no/low, medium, and high street greenery, dominated by road traffic, anthropogenic, and natural sounds. The results showed that the differences in the acoustic comfort evaluations without and with medium or high greenery were statistically significant. Under the effects of greenery, the acoustic comfort evaluation of each sound type dominating the environments without greenery increased by as much as one level, based on a five-point ordinal category scale. Considering various greenery conditions, dominant sound sources, and environmental functions, greenery was the most significant factor affecting acoustic comfort, and evaluations of pedestrian environments without greenery increased more in leisure environments (0.65–1.42) than in transportation environments (0.45–1.29) when road traffic sounds were at lower levels (50, 55, and 60 dBA) and anthropogenic and natural sounds were predominantly heard and influenced by street greenery. However, sound levels were the most significant factor affecting acoustic comfort when road traffic at 50–70 dBA was predominantly heard. Based on the negative linear relationships between sound levels and acoustic comfort evaluations for no/low, medium, and high greenery conditions, the evaluations affected by greenery increased with the increase in road traffic sound levels in transportation environments, whereas those influenced by either high or medium greenery in leisure environments tended to decrease gradually. These audio-visual perception-based findings provide reference guidance for PE quality optimization and related urban design considering comfortable sound environments.

An embodiment of the cinematographer: emotional and perceptual responses to different camera movement techniques.

We investigate the relationship between camera movement techniques and cognitive responses in audiences, reporting on an experiment exploring the effects of different camera movement methods on viewers' degree of immersion and emotional response. This follows directly from preceding experimental literature and is further motivated by accounts and experiences of practicing cinematographers (authors included), which indicates a correspondence between the two. We designed three different cinematic scenes with indifferent moods, and shot each one time with Steadicam, dolly, handheld, and static camera, resulting in 12 different clips. A total of 44 non-professional participants watched the clips and rated their reactions in terms of arousal and degree of involvement. Experimental results are mixed: movement affects the sense of involvement but not necessarily emotional response. We present and discuss some further explorative results and possible future directions to improve the design. We argue in this contribution that there is value in experimental approaches to cinematography, enabling the systematic study of creative intuitions and audience responses in controlled settings.

Dynamic State-Space Modeling With Factorial Memories in Temporal Dominance of Sensations, Emotions and Temporal Liking

There are few mathematical models that describe how human perceptual and affective responses evolve with time. We developed a state-space model of the interrelationships based on time-evolving perceptual and affective responses acquired by the temporal dominance (TD) method. We defined and computed the state variables that endow the system with memory using canonical variate analysis. Furthermore, we determined the model parameters on the basis of a cross-validation approach such that the observed and estimated changes in the affective responses are highly correlated. We applied this method to the TD curves of responses to eating strawberries and plum pickles, reported in our previous work. The model describes what happens during food intake in terms of a few state variables that summarize a large number of observable responses reductively, thus helping to make the perceptual and affective dynamics understandable.

An embodiment of the Cinematographer: emotional and perceptual responses to different camera movement techniques

An embodiment of the Cinematographer: emotional and perceptual responses to different camera movement techniques

Defocus flicker of chromatic stimuli deactivates accommodation.

Tunable lenses, optical elements able to change their optical power within milliseconds, constitute an emerging technology increasingly used in ophthalmic applications. In this study, 25 subjects looked through tunable lenses at a chromatic stimulus to evaluate the perceptual response of the human visual system to periodic changes in defocus of 0.25D of amplitude and 15 Hz of temporal frequency. These defocus changes produce flicker and chromatic distortions that change with the overall level of defocus. The task in this study was to minimize the flicker by varying the average optical power, and it was performed for different myopic and hyperopic starting points. Subjects also performed a blur-minimization task in a black-and-white stimulus of the same geometry. The flicker-minimization task is more repeatable than the blur-minimization task (standard deviations ±0.17D and ±0.49D). The time per repetition of the flicker-minimization task is only 38s. Cycloplegia severely affects the blur-minimization, but not the flicker-minimization task, confirming that defocus flicker deactivates the accommodative system. This discovery can be used to develop new methods for measuring the refractive error of the eye that does not require supervision and can potentially improve existing subjective methods in terms of accuracy, precision, and measurement time.

Responses to Exercise at the Critical Heart Rate vs. the Power Output Associated With the Critical Heart Rate.

Succi, PJ, Dinyer-McNeely, TK, Voskuil, CC, Abel, MG, Clasey, JL, and Bergstrom, HC. Responses to exercise at the critical heart rate vs. the power output associated with the critical heart rate. J Strength Cond Res XX(X): 000-000, 2023-This study examined the physiological (volume of oxygen consumption [V̇o2], heart rate [HR], power output [PO], respiration rate [RR], muscle oxygen saturation [%SmO2]), neuromuscular (electromyographic and mechanomyographic amplitude [EMG AMP and MMG AMP] and mean power frequency [EMG MPF and MMG MPF]), and perceptual (rating of perceived exertion [RPE]) responses during exercise anchored at the critical heart rate (CHR) vs. the PO associated with CHR (PCHR). Nine subjects (mean ± SD; age = 26 ± 3 years) performed a graded exercise test and 4 constant PO trials to exhaustion at 85-100% of peak PO (PP) to derive CHR and PCHR on a cycle ergometer. Responses were recorded during trials at CHR (173 ± 9 b·min-1, time to exhaustion [TLim] = 45.5 ± 20.2 minutes) and PCHR (198 ± 58 W, TLim = 21.0 ± 17.8 minutes) and normalized to their respective values at PP in 10% intervals. There were significant (p ≤ 0.05) mode (CHR vs. PCHR) × time (10%-100% TLim) interactions for all variables (p < 0.001-0.036) except MMG AMP (p > 0.05). Post hoc analyses indicated differences across time for CHR V̇o2 (%change = -22 ± 16%), PCHR V̇o2 (19 ± 5%), CHR RR (24 ± 23%), PCHR RR (45 ± 14%), CHR PO (-33 ± 11%), PCHR HR (22 ± 5%), CHR RPE (22 ± 14%), PCHR RPE (39 ± 6%), CHR %SmO2 (41 ± 33%), PCHR %SmO2 (-18 ± 40%), CHR EMG AMP (-13 ± 15%), PCHR EMG AMP (13 ± 13%), CHR EMG MPF (9 ± 8%), CHR MMG MPF (7 ± 11%), and PCHR MMG MPF (-3 ± 14%). The critical heart rate was more sustainable than PCHR but required adjustments in PO which traversed intensity domains and caused dissociations of the responses previously observed in exercise anchored to PO. These dissociations indicated the demands to exercise varied with anchoring scheme and provides an important consideration for practitioners prescribing endurance exercise.

How interior design responds to neurodiversity: implementing wearable technologies in neurodesign processes

This perspective article, looking through the lens of neurodiversity, discusses the benefits and challenges of implementing virtual environments and wearable technologies in interior design and related fields. While the relationship between human perception and built environments has long been studied in the environmental design disciplines, the direct impact on occupant performance related to neurodiversity has been underexplored in research, with a shortage of knowledge supporting how it can be applied in design practice concerning the end users. Individuals’ perceptual, cognitive, and affective responses to their surroundings vary, as neurodiversity plays a key role in the invisible, human-environment interaction. Thus, measuring, analyzing, and understanding affective, perceptual, and cognitive experiences is a challenging process in which various factors come into play, and no single method or measurement can adequately work for all. Due to such challenges, research has also utilized various biometric measurements and tools for immersive experiments in physical and virtual environments, e.g., eye tracking used in studies on gaze behaviors and immersive virtual reality (IVR) used in studies on the spatial perception of dementia patients. Along with empirical methods, studies have stressed the contribution of phenomenology to looking into the hidden dimension, the ‘why factors’ of perception, cognition, and affectivity. Concerning the methodological approach, this perspective article shares insights into a novel process model, Participatory Neurodesign (PND) framework, used in wayfinding research and design processes utilizing eye tracking and IVR. Opportunities for neurodesign research and design practice are also discussed, focusing on the health, safety, and wellbeing of end-users.

Sustainability and perceptual responses during handgrip holds to failure at two fatigue thresholds.

Critical force (CF) provides an estimate of the asymptote of the force-duration curve and the physical working capacity at the rating of perceived exertion (PWCRPE) estimates the highest force that can be sustained without an increase in perceived exertion. Handgrip-related musculoskeletal disorders and injuries derived from sustained or repetitive motion-induced muscle fatigue are prevalent in the industrial workforce. Thus, it is important to understand the physiological mechanisms underlying performance during handgrip specific tasks to describe individual work capacities. This study examined prolonged, isometric, handgrip exercises by comparing the relative force levels, sustainability, and perceptual responses at two fatigue thresholds, CF and PWCRPE. Ten women (26.5 ± 3.5years) performed submaximal, isometric handgrip holds to failure (HTF) with the dominant hand at four, randomly ordered percentages (30, 40, 50, and 60%) of maximal voluntary isometric contraction (MVIC) force to determine CF and PWCRPE. Isometric handgrip HTF were performed at CF and PWCRPE. Time to task failure and RPE responses were recorded. There were no differences in the relative forces (p = 0.381) or sustainability (p = 0.390) between CF (18.9 ± 2.5% MVIC; 10.1 ± 2.7min) and PWCRPE (19.5 ± 7.9% MVIC; 11.6 ± 8.4min), and the RPE increased throughout both holds at CF and PWCRPE. It is possible that complex physio-psychological factors may have contributed to the fatigue-induced task failure. CF and PWCRPE may overestimate the highest force output that can be maintained for an extended period of time without fatigue or perceptions of fatigue for isometric handgrip holds.

Linking paranormal and conspiracy beliefs to illusory pattern perception through signal detection theory

Previous research indicates that irrational beliefs (Paranormal beliefs & conspiracy theory endorsement) are associated with the perception of patterns in noise, but the previous findings do not conclusively describe this relationship. This study aims to disentangle the underlying parameters of this association by applying a signal detection theory approach, thus allowing to distinguish illusory pattern perception (false alarms) from perceptual sensitivity and response tendencies—while also taking base rate information into account. Results from a large sample (N = 723) indicate that paranormal beliefs relate to a more liberal response bias and a lower perceptual sensitivity, and that this relationship is driven by illusory pattern perception. Such a clear pattern could not be observed for conspiracy beliefs, for which the increase in false alarm rates was moderated by the base rate. The associations between irrational beliefs and illusory pattern perception were however less substantial compared to other sources of variance. Implications are discussed.

Short vs. Long Bouts of All-Out Rope Skipping: Effects on Metabolic and Perceptual Responses

Rope skipping has been well documented for eliciting positive effects on various health outcomes and contributing to overall physical activity levels. However, the specific health benefits may depend on the duration and intensity of the exercise bouts. This study aimed to compare the (1) metabolic and (2) perceptual responses between short (30 s) and long (3 min) bouts of all-out rope skipping, and to (3) evaluate the reliability and validity of a newly invented electronic rope (E-rope). A total of 23 young adults (13 males and 10 females; aged 23.23 ± 2.62 y) repeated short and long skipping bouts on two testing days. The oxygen consumption (V·O2), peak respiratory exchange ratio (RER), heart rate (HR), rate of perceived exertion (RPE), and post-exercise muscle soreness were assessed during each trial. Longer skipping bouts (148.33 skips·min−1) resulted in significantly greater metabolic responses (p &lt; 0.01, d = 1.00–3.27), higher rates of perceived exertion (p &lt; 0.01, d = 2.28), and more post-exercise muscle soreness (p &lt; 0.01, d = 0.66–1.49) compared to shorter bouts (165.83 skips·min−1). The E-rope demonstrated sufficient concurrent validity (r &gt; 0.9) and between-day reliability (ICC3,1 = 0.89–0.95) but slightly overestimated the number of skips. Both long and short all-out skipping bouts were considered moderate-to-vigorous exercise, but longer bouts resulted in higher metabolic and perceptual demands. These findings may be useful for practitioners to strategically apply different skipping bouts to improve physical activity levels and facilitate training adaptation. The E-rope could serve as a self-monitoring and self-evaluating tool.

Parieto-occipital ERP indicators of gut mechanosensation in humans

Understanding the neural processes governing the human gut-brain connection has been challenging due to the inaccessibility of the body’s interior. Here, we investigated neural responses to gastrointestinal sensation using a minimally invasive mechanosensory probe by quantifying brain, stomach, and perceptual responses following the ingestion of a vibrating capsule. Participants successfully perceived capsule stimulation under two vibration conditions (normal and enhanced), as evidenced by above chance accuracy scores. Perceptual accuracy improved significantly during the enhanced relative to normal stimulation, which was associated with faster stimulation detection and reduced reaction time variability. Capsule stimulation induced late neural responses in parieto-occipital electrodes near the midline. Moreover, these ‘gastric evoked potentials’ showed intensity-dependent increases in amplitude and were significantly correlated with perceptual accuracy. Our results replicated in a separate experiment, and abdominal X-ray imaging localized most capsule stimulations to the gastroduodenal segments. Combined with our prior observation that a Bayesian model is capable of estimating computational parameters of gut-brain mechanosensation, these findings highlight a unique form of enterically-focused sensory monitoring within the human brain, with implications for understanding gut feelings and gut-brain interactions in healthy and clinical populations.

Self-selected or fixed: is there an optimal rest interval for controlling intensity in high-intensity interval resistance training?

This study investigated the effects of different rest interval strategies during high-intensity interval resistance training (HIRT) on cardiorespiratory, perceptual, and enjoyment responses among trained young men. Sixteen men experienced with HIRT underwent cardiopulmonary exercise testing and were familiarized with the exercises and HIRT protocol. On the subsequent three visits, interspaced 48-72h, participants performed HIRT sessions with different rest intervals in a randomized order: 10s and 30s fixed rest intervals (FRI-10 and FRI-30), and self-selected rest interval (SSRI). Oxygen uptake (VO2), heart rate (HR), and recovery perception (Total Quality Recovery Scale) were measured during HIRT, while enjoyment responses (Physical Activity Enjoyment Scale) were assessed immediately after the sessions. The VO2 during exercise was greater in FRI-10 than FRI-30 (55% VO2max and 47% VO2max, respectively, p = 0.01), while no difference occurred between SSRI and bouts performed with fixed intervals (52% VO2max vs. FRI, p > 0.05). HR, excess post-exercise oxygen consumption (EPOC), recovery perception, and enjoyment responses were similar across conditions (p > 0.05). Exercise intensity was not affected by the rest interval strategy. High exercise intensity was maintained in sessions performed with FRI or SSRI, without negative repercussions on the duration of training sessions and enjoyment responses after exercise sessions.

Intermittent blood flow occlusion modulates neuromuscular, perceptual, and cardiorespiratory determinants of exercise tolerance during cycling.

Constant blood flow occlusion (BFO) superimposed on aerobic exercise can impair muscle function and exercise tolerance; however, no study has investigated the effect of intermittent BFO on the associated responses. Fourteen participants (n = 7 females) were recruited to compare neuromuscular, perceptual, and cardiorespiratory responses to shorter (5:15s, occlusion-to-release) and longer (10:30s) BFO applied during cycling to task failure. In randomized order, participants cycled to task failure (task failure 1) at 70% of peak power output with (i) shorter BFO, (ii) longer BFO, and (iii) no BFO (Control). Upon task failure in the BFO conditions, BFO was removed, and participants continued cycling until a second task failure (task failure 2). Maximum voluntary isometric knee contractions (MVC) and femoral nerve stimuli were performed along with perceptual measures at baseline, task failure 1, and task failure 2. Cardiorespiratory measures were recorded continuously across the exercises. Task failure 1 was longer in Control than 5:15s and 10:30s (P < 0.001), with no differences between the BFO conditions. At task failure 1, 10:30s elicited a greater decline in twitch force compared to 5:15s and Control (P < 0.001). At task failure 2, twitch force remained lower in 10:30s than Control (P = 0.002). Low-frequency fatigue developed to a greater extent in 10:30s compared to Control and 5:15s (P < 0.047). Dyspnea and Fatigue were greater for Control than 5:15s and 10:30s at the end of task failure 1 (P < 0.002). Exercise tolerance during BFO is primarily dictated by the decline in muscle contractility and accelerated development of effort and pain.

Comparison of anaerobic speed reserve and maximal aerobic speed methods to prescribe short format high-intensity interval training.

The purpose of the study was to compare the degree of intersubject variability in the cardiorespiratory, metabolic, and perceptual responses to high-intensity interval training (HIIT) prescribed based on the relative anaerobic speed reserve (ASR) or maximal aerobic speed (MAS) and to identify the optimal % ASR for execution of such HIIT. Seventeen male physical education students (age: 23.6 ± 1.1 years, height: 180.2 ± 5.9, body mass: 78.3 ± 8.1 kg; % body fat: 14.3 ± 2.7%) volunteered to execute three randomly scheduled 10-min HIIT exercises at 110% vVO2max , Δ15% ASR, or Δ25% ASR. Analysis of variance for repeated measures and the least significant difference post-hoc test were used to compare the physiological responses and the mean of individual residuals between the training sessions. The coefficients of variation (CV) of time spent ≥90% of maximal oxygen uptake (VO2max ) and maximal heart rate (HRmax ), peak VO2 , mean VO2 , peak HR, mean HR, blood lactate [La], and rating of perceived exertion (RPE) were 48.7%, 35.9%, 9.3%, 7%, 3.5%, 4.8%, 32%, and 16.9% during 110% vVO2max , 47.2%, 31%, 7.5%, 6.7%, 3.9%, 4.6%, 24.2%, and 14.6% during Δ15% ASR, and 48.1%, 31.5%, 7.6%, 8.4%, 3.6%, 4.1%, 20.2%, and 3.4% during Δ25% ASR session, respectively. Only the residuals in RPE were significantly (p < 0.001) higher in 110% vVO2max and Δ15% ASR in comparison to Δ25% ASR. Time spent ≥90% HRmax /VO2max was maximized during Δ15% ASR session, albeit this was not significantly different from other sessions. The ASR-based method leads to reduced CVs of physiological and perceptual responses during 10-min HIIT; however, only reductions in [La] and RPE may be considered practically meaningful. Practitioners can use vVO2max for prescription of 10-min HIIT session comprised of 15-s work and passive recovery intervals.

Modeling enablers of agility of healthcare organizations

PurposeThis purpose of the study is to investigate enablers of building agility capabilities in healthcare organisations in developing countries. The key research questions are: (1) What are the key enablers for building healthcare agility? (2) Is there an interdependence among the enablers of healthcare agility? (3) What is the driving and dependence power of the enabling factors of healthcare agility?Design/methodology/approachThe enablers for building capabilities of organisational agility were identified from the extant literature. Perceptual responses for pair-wise comparison of identified enablers were collected from 17 clinical and non-clinical professionals working in Indian hospitals through online interviews. Participants were selected from India which supposedly represents the socioeconomic contexts and healthcare systems in developing economies. Next, the data was analysed using multicriteria decision-making (MCDM) techniques to develop a structural framework depicting the enablers and their interdependence.FindingsThe TISM framework showed that the two most influential enablers of healthcare agility in developing countries are policy and regulatory support and strategic commitment and resource availability. The results were based on the analysis of four enablers identified from the literature. The results of MICMAC analysis revealed the driving and dependence power of each enabler and classified the enablers into driving, autonomous, dependence and linkage groups.Practical implicationsThe study will help stakeholders and academics in the healthcare domain in devising effective strategies for building agility within healthcare systems and processes.Originality/valueThe study contributes to the service operations literature on building agile systems for dynamic and complex service environments.

Hypoxia Does Not Impair Resistance Exercise Performance or Amplify Post-Exercise Fatigue

ABSTRACT Purpose: To determine whether performing resistance exercise in hypoxia acutely reduces performance and increases markers of fatigue, and whether these responses are exaggerated if exercising at high versus low work rates (i.e., exercising to failure or volume matched non-failure). Methods: Following a within-subject design, 20 men completed two trials in hypoxia (13% oxygen) and two in normoxia (21% oxygen). The first session for hypoxic and normoxic conditions comprised six sets of bench press and shoulder press to failure (high work rate), while subsequent sessions involved the same volume distributed over 12 sets (low work rate). Physical performance (concentric velocity) and perceptual responses were measured during exercise and for 72 hr post-exercise. Neuromuscular performance (bench throw velocity) was assessed pre- and post-session. Results: Hypoxia did not affect physical performance, neuromuscular performance, and perceptual recovery when exercising at high or low work rates. Higher work rate exercise caused greater acute decrements in physical performance and post-exercise neuromuscular performance and increased perceived exertion and muscle soreness (p ≤ 0.006), irrespective of hypoxia. Conclusions: Hypoxia does not impact on resistance exercise performance or increase markers of physical and perceptual fatigue. Higher exercise work rates may impair physical performance, and exaggerate fatigue compared to low work rate exercise, irrespective of environmental condition. Practitioners can prescribe hypoxic resistance exercise without compromising physical performance or inducing greater levels of fatigue. For athletes who are required to train with high frequency, decreasing exercise work rate may reduce post-exercise markers of fatigue for the same training volume.