Ramp-incremental Exercise Test Research Articles

Characterizing the Exponential Profile of W' Recovery Following Partial Depletion.

The aim of this study was to characterize W' recovery kinetics in response to a partial W' depletion. We hypothesized that W' recovery following partial depletion would be better described by a biexponential than by a monoexponential model. Nine healthy men performed a ramp incremental exercise test, three to five constant load trials to determine critical power and W', and ten experimental trials to quantify W' depletion. Each experimental trial consisted of two constant load work bouts (WB1 + WB2) interspersed by a recovery interval. WB1 was designed to evoke a 25% or 75% W' depletion (DEP25% + DEP75%). Subsequently, participants recovered for 30, 60, 120, 300 or 600 s, and then performed WB2 to exhaustion in order to calculate the observed W' recovery (W'OBS). W'OBS data were fitted using monoexponential and biexponential models, both with a variable and a fixed model amplitude. Root mean square error (RMSE) and Akaike information criterion (AICc) were calculated to evaluate the models' goodness-of-fit. The biexponential model fits were associated with overall lower RMSE values (0.4-5.0%) compared to the monoexponential models (2.9-8.0%). However, ΔAICc resulted in negative values (-15.5 and -23.3) for the model fits where the amplitude was free, thereby favoring the use of a monoexponential model for both depletion conditions. For the model fits where the amplitude was fixed at 100%, ΔAICc was negative for DEP25% (-15.0), but positive for DEP75% (11.2). W'OBS values were strongly correlated between both depletion conditions (r = 0.92), and positively associated with V̇O2peak, CP and GET (r = 0.67-0.77). The present study results did not provide evidence in favor of a biexponential modeling technique to characterize W' recovery following partial depletion. Moreover, we demonstrated that fixed t values were insufficient to model W' recovery across different depletion levels, and that W' recovery was positively associated with aerobic fitness. These findings underline the importance of employing variable and individualized t values in future predictive W' models.

Better Cardiorespiratory Fitness Defined as VO2max Increases the Chance of Partial Clinical Remission and Prolongs Remission Duration in People with Newly Diagnosed Type 1 Diabetes.

An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VO2max) is an objective measure of the body's aerobic capacity. To assess VO2max, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up. The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VO2max was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test). The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VO2max level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, P = .009. Univariate and multivariate regression confirmed a significant association between VO2max and presence of pCR [AOR 1.26 (1.05-1.52), P = .015]. Duration of remission was longer among group with higher VO2max results [15 (9-24) vs 9 (0-12) months, P = .043]. The positive relationship was observed between diabetes duration and VO2max (rs = 0.484, P = .005). Multivariate linear regression confirms a significant association between remission duration and VO2max (ml/min/kg) (β = 0.595, P = .002). The higher VO2max, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission.

Critical power is a key threshold determining the magnitude of post-exercise hypotension in non-hypertensive young males.

The effect of different exercise intensities on the magnitude of post-exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post-exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non-hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W' (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post-exercise hypotension: 10% above critical power (10%>CP), 10% below critical power (10%<CP), 10% above GET (10%>GET) and 10% below GET (10%<GET). The post-exercise decrease (i.e., the minimum post-exercise values) in mean arterial (10%>CP: -12.7±8.3 vs. 10%<CP: v3.5±2.9mmHg), diastolic (10%>CP: -9.6±9.8 vs. 10%<CP: -1.4±5.0mmHg) and systolic (10%>CP: -23.8±7.0 vs. 10%<CP: -9.9±4.3mmHg) blood pressures were greater following exercise performed 10%>CP compared to all other trials (all P<0.01). No effects of exercise intensity on the magnitude of post-exercise hypotension were observed during exercise performed below critical power (all P>0.05). Critical power represents a threshold above which the magnitude of post-exercise hypotension is greatly augmented. NEW FINDINGS: What is the central questions of this study? What is the influence of exercise intensity on the magnitude of post-exercise hypotension with respect to metabolic thresholds? What is the main finding and its importance? The magnitude of post-exercise hypotension is greatly increased following exercise performed above critical power. However, below critical power, there was no clear effect of exercise intensity on the magnitude of post-exercise hypotension.

Physiological Characteristics of Competitive Male Junior Cyclists Transitioning to the Under-23 Level: A Retrospective Comparative Study.

The purpose of the current investigation was to retrospectively assess possible differences in physiological performance characteristics between junior cyclists signing a contract with an under-23 (U23) development team versus those failing to sign such a contract. Twenty-five male junior cyclists (age: 18.1 [0.7]y, stature: 181.9 [6.0]cm, body mass: 69.1 [7.9]kg, peak oxygen uptake: 71.3 [6.2]mL·min-1·kg-1) were assigned to this investigation. Between September and October of the last year in the junior category, each cyclist performed a ramp incremental exercise test to determine certain physiological performance characteristics. Subsequently, participants were divided in 2 groups: (1)those signing a contract with a U23 development team (JUNIORU23) and (2)those failing to sign such a contract (JUNIORNON-U23). Unpaired t tests were used to assess possible between-groups differences in physiological performance characteristics. The level of statistical significance was set at P < .05 two tailed. No significant between-groups differences in submaximal (ie,gas exchange threshold, respiratory compensation point) and maximal physiological performance characteristics (ie,peak work rate, peak oxygen uptake) expressed in absolute values (ie,L·min-1, W) were observed (P > .05). However, significant between-groups differences were observed when physiological performance characteristics were expressed relative to the cyclists' body weights (P < .05). The current investigation showed that junior cyclists stepping up to a U23 development team might be retrospectively differentiated from junior cyclists not stepping up based on certain physiological performance characteristics, which might inform practitioners and/or federations working with young cyclists during the long-term athletic development process.

Can We Accurately Predict Critical Power and W' from a Single Ramp Incremental Exercise Test?

The purpose of this study was to examine the suitability of a single ramp incremental test to predict critical power (CP) and W' . We hypothesized that CP would correspond to the corrected power output (PO) at the respiratory compensation point (RCP) and W' would be calculable from the work done above RCP. One hundred fifty-three healthy young people (26 ± 4 yr, 51.4 ± 7.6 mL·min -1 ·kg -1 ) performed a maximal ramp test (20, 25, or 30 W·min -1 ), followed by three to five constant load trials to determine CP and W' . CP and W' were estimated using a "best individual fit" approach, selecting the mathematical model with the smallest total error. The RCP was identified by means of gas exchange analysis and then translated into its appropriate PO by applying a correction strategy in order to account for the gap in the V̇O 2 /PO relationship between ramp and constant load exercise. We evaluated the agreement between CP and the PO at RCP, and between W' and the total work done above CP ( W'RAMP > CP ) and above RCP ( W'RAMP > RCP ) during the ramp test. The CP was significantly higher than the PO at RCP (Δ = 8 ± 16 W, P < 0.001). W'RAMP > CP was significantly lower than W' (Δ = 1.9 ± 3.3 kJ, P < 0.001), whereas W'RAMP > RCP and W' did not differ from each other (Δ = -0.6 ± 5.8 kJ, P = 0.21). Despite the fact that CP and RCP occurred in close proximity, the estimation of W' from ramp exercise may be problematic given the likelihood of underestimation and considering the large variability. Therefore, we do not recommend the interchangeable use of CP and W' values derived from constant load versus ramp exercise, in particular, when the goal is to obtain accurate estimates or to predict performance capacity.

Alterations in aerobic fitness and muscle deoxygenation during ramp incremental exercise in trained youth cyclists: a ~3-year longitudinal study

ABSTRACT Alterations of aerobic fitness and muscle deoxygenation during a ramp incremental exercise test (GXT) were assessed on two occasions within a time-frame of 2.9 ± 0.1y in competitive youth cyclists. Nine cyclists (age, 14.5 ± 1.1y; peak oxygen uptake (O2peak), 62.6 ± 4.2 mL.min−1.kg−1) participated in this investigation. O2peak, the gas exchange threshold (GET) and the respiratory compensation point (RCP), as well as the muscle deoxygenation response pattern were determined during a GXT using open circuit spirometry and near-infrared spectroscopy, respectively. T-tests and Pearson’s correlations were used to assess effects of time on the dependent variables and relationships between changes of parameter estimates of aerobic fitness and the muscle deoxygenation response, respectively. Workrate and metabolic rate at GET (33 ± 20 and 42 ± 23%) and RCP (36 ± 20 and 40 ± 22%), and O2peak (30 ± 18%) significantly increased throughout the study (P < 0.05). The muscle deoxygenation response showed a significant rightward shift from occasion one to two (P < 0.05). Alterations in the workrate/metabolic rate at RCP, and O2peak, were correlated with alterations of the muscle deoxygenation response (R = 0.71–0.89, P < 0.05). Together, this is thought to indicate a superior muscle perfusion within the tissue of interrogation at the same metabolic rate on occasion two vs. one, which partially contributed to the improved aerobic fitness in the cyclists herein.

Evaluating the Accuracy of Using Fixed Ranges of METs to Categorize Exertional Intensity in a Heterogeneous Group of Healthy Individuals: Implications for Cardiorespiratory Fitness and Health Outcomes.

Appropriate quantification of exertional intensity remains elusive. To compare, in a large and heterogeneous cohort of healthy females and males, the commonly used intensity classification system (i.e., light, moderate, vigorous, near-maximal) based on fixed ranges of metabolic equivalents (METs) to an individualized schema based on the exercise intensity domains (i.e., moderate, heavy, severe). A heterogenous sample of 565 individuals (females 165; males 400; age range 18-83years old) were included in the study. Individuals performed a ramp-incremental exercise test from which gas exchange threshold (GET), respiratory compensation point (RCP) and maximum oxygen uptake (VO2max) were determined to build the exercise intensity domain schema (moderate = METs ≤ GET; heavy = METs > GET but ≤ RCP; severe = METs > RCP) for each individual. Pearson's chi-square tests over contingency tables were used to evaluate frequency distribution within intensity domains at each MET value. A multi-level regression model was performed to identify predictors of the amplitude of the exercise intensity domains. A critical discrepancy existed between the confines of the exercise intensity domains and the commonly used fixed MET classification system. Overall, the upper limit of the moderate-intensity domain ranged between 2 and 13 METs and of the heavy-intensity domain between 3 and 18 METs, whereas the severe-intensity domain included METs from 4 onward. Findings show that the common practice of assigning fixed values of METs to relative categories of intensity risks misclassifications of the physiological stress imposed by exercise and physical activity. These misclassifications can lead to erroneous interpretations of the dose-response relationship of exercise and physical activity.

Influence of Warm-Up Prior to Incremental Exercise Test on Aerobic Performance in Physically Active Men

Abstract Introduction. The aim of the study was to verify the influence of warm-up before a ramp incremental exercise test with linearly increasing loads on the maximal values of physiological variables which determine performance. Material and methods. Thirteen healthy and physically active male students (age = 23.3 ± 1.5 years, body height = 179.1 ± 8.6 cm and body mass = 79.5 ± 9.1 kg) completed a cross-over comparison of two incremental exercise test interventions – an incremental exercise test with a 15-minute warm-up at an intensity of 60% of the maximal oxygen uptake obtained in the first incremental exercise test and the same test without warm-up. Results. The peak values of physiological variables were statistically significantly higher for the incremental exercise test with warm-up, the differences between tests being 2.66% for peak power output (p = 0.039, t = 2.312, ES = 0.24), 7.75% for peak oxygen uptake (p = 0.000, t = 5.225, ES = 0.56), 7.72% for peak minute ventilation (p = 0.005, t = 3.346, ES = 0.53) and 1.62% for peak heart rate (p = 0.019, t = 2.690, ES = 0.60). Conclusions. Warm-up before a ramp incremental exercise test resulted in higher values of maximal oxygen uptake, maximal minute ventilation, maximal heart rate and peak power output.

Sprint interval exercise versus continuous moderate intensity exercise: acute effects on tissue oxygenation, blood pressure and enjoyment in 18-30 year old inactive men.

BackgroundSprint interval training (SIT) can be as effective, or more effective, than continuous moderate intensity exercise (CMIE) for improving a primary risk factor for cardiometabolic disease, low cardiorespiratory fitness (CRF). However, there has been no direct comparison in inactive individuals, of the acute effects of a session of SIT with a work-matched session of CMIE on local oxygen utilisation, which is a primary stimulus for increasing CRF. Furthermore, post-exercise blood pressure (BP) and enjoyment, if symptomatic and low, respectively, have implications for safety and adherence to exercise and have not been compared between these specific conditions. It was hypothesised that in young inactive men, local oxygen utilisation would be higher, while post-exercise BP and enjoyment would be lower for SIT, when compared to CMIE.MethodsA total of 11 inactive men (mean ± SD; age 23 ± 4 years) completed a maximal ramp-incremental exercise test followed by two experiment conditions: (1) SIT and (2) work-matched CMIE on a cycle ergometer on separate days. Deoxygenated haemoglobin (∆HHb) in the pre-frontal cortex (FH), gastrocnemius (GN), left vastus lateralis (LVL) and the right vastus lateralis (RVL) muscles, systemic oxygen utilisation (VO2), systolic (SBP) and diastolic (DBP) blood pressure and physical activity enjoyment scale (PACES) were measured during the experiment conditions.ResultsDuring SIT, compared to CMIE, ∆HHb in FH (p = 0.016) and GN (p = 0.001) was higher, while PACES (p = 0.032) and DBP (p = 0.043) were lower. No differences in SBP and ∆HHb in LVL and RVL were found between conditions.ConclusionsIn young inactive men, higher levels of physiological stress occurred during SIT, which potentially contributed to lower levels of post-exercise DBP and enjoyment, when compared to CMIE.

Carotid chemoreflex activity restrains post-exercise cardiac autonomic control in healthy humans and in patients with pulmonary arterial hypertension.

Dysfunction of post-exercise cardiac autonomic control is associated with increased mortality risk in healthy adults and in patients with cardiorespiratory diseases. The afferent mechanisms that regulate the post-exercise cardiac autonomic control remain unclear. We found that afferent signals from carotid chemoreceptors restrain the post-exercise cardiac autonomic control in healthy adults and patients with pulmonary arterial hypertension (PAH). Patients with PAH had higher carotid chemoreflex sensitivity, and the magnitude of carotid chemoreceptor restraint of autonomic control was greater in patients with PAH as compared to healthy adults. The results demonstrate that the carotid chemoreceptors contribute to the regulation of post-exercise cardiac autonomic control, and suggest that the carotid chemoreceptors may be a potential target to treat post-exercise cardiac autonomic dysfunction in patients with PAH. Dysfunction of post-exercise cardiac autonomic control predicts mortality, but its underlying mechanisms remain unclear. We tested whether carotid chemoreflex activity restrains post-exercise cardiac autonomic control in healthy adults (HA), and whether such restraint is greater in patients with pulmonary arterial hypertension (PAH) who may have both altered carotid chemoreflex and altered post-exercise cardiac autonomic control. Twenty non-hypoxaemic patients with PAH and 13 age- and sex-matched HA pedalled until 90% of peak work rate observed in a symptom-limited ramp-incremental exercise test. Recovery consisted of unloaded pedalling for 5min followed by seated rest for 6min. During recovery, subjects randomly inhaled either 100% O2 (hyperoxia) to inhibit the carotid chemoreceptor activity, or 21% O2 (normoxia) as control. Post-exercise cardiac autonomic control was examined via heart rate (HR) recovery (HRR; HR change after 30, 60, 120 and 300s of recovery, using linear and non-linear regressions of HR decay) and HR variability (HRV; time and spectral domain analyses). As expected, the PAH group had higher carotid chemosensitivity and worse post-exercise HRR and HRV than HA. Hyperoxia increased HRR at 30, 60 and 120s and absolute spectral power HRV in both groups. Additionally, hyperoxia resulted in an accelerated linear HR decay and increased time domain HRV during active recovery only in the PAH group. In conclusion, the carotid chemoreceptors restrained recovery of cardiac autonomic control from exercise in HA and in patients with PAH, with the restraint greater for some autonomic indexes in patients with PAH.

An equation to predict the maximal lactate steady state from ramp-incremental exercise test data in cycling

ObjectivesThe maximal lactate steady state (MLSS) represents the highest exercise intensity at which an elevated blood lactate concentration ([Lac]b) is stabilized above resting values. MLSS quantifies the boundary between the heavy-to-very-heavy intensity domains but its determination is not widely performed due to the number of trials required. DesignThis study aimed to: (i) develop a mathematical equation capable of predicting MLSS using variables measured during a single ramp-incremental cycling test and (ii) test the accuracy of the optimized mathematical equation. MethodsThe predictive MLSS equation was determined by stepwise backward regression analysis of twelve independent variables measured in sixty individuals who had previously performed ramp-incremental exercise and in whom MLSS was known (MLSSobs). Next, twenty-nine different individuals were prospectively recruited to test the accuracy of the equation. These participants performed ramp-incremental exercise to exhaustion and two-to-three 30-min constant-power output cycling bouts with [Lac]b sampled at regular intervals for determination of MLSSobs. Predicted MLSS (MLSSpred) and MLSSobs in both phases of the study were compared by paired t-test, major-axis regression and Bland–Altman analysis. ResultsThe predictor variables of MLSS were: respiratory compensation point (Wkg−1), peak oxygen uptake (V˙O2peak) (mlkg−1min−1) and body mass (kg). MLSSpred was highly correlated with MLSSobs (r=0.93; p<0.01). When this equation was tested on the independent group, MLSSpred was not different from MLSSobs (234±43 vs. 234±44W; SEE 4.8W; r=0.99; p<0.01). ConclusionsThese data support the validity of the predictive MLSS equation. We advocate its use as a time-efficient alternative to traditional MLSS testing in cycling.

Using ramp-incremental V̇O2 responses for constant-intensity exercise selection.

Despite compelling evidence to the contrary, the view that oxygen uptake (V̇O2) increases linearly with exercise intensity (e.g., power output, speed) until reaching its maximum persists within the exercise physiology literature. This viewpoint implies that the V̇O2 response at any constant intensity is predictable from a ramp-incremental exercise test. However, the V̇O2 versus task-specific exercise intensity relationship constructed from ramp-incremental versus constant-intensity exercise are not equivalent preventing the use of V̇O2 responses from 1 domain to predict those of the other. Still, this "linear" translational framework continues to be adopted as the guiding principle for aerobic exercise prescription and there remains in the sport science literature a lack of understanding of how to interpret V̇O2 responses to ramp-incremental exercise and how to use those data to assign task-specific constant-intensity exercise. The objectives of this paper are to (i) review the factors that disassociate the V̇O2 versus exercise intensity relationship between ramp-incremental and constant-intensity exercise paradigms; (ii) identify when it is appropriate (or not) to use ramp V̇O2 responses to accurately assign constant-intensity exercise; and (iii) illustrate the technical and theoretical challenges with prescribing constant-intensity exercise solely on information acquired from ramp-incremental tests. Actual V̇O2 data collected during cycling exercise and V̇O2 kinetics modelling are presented to exemplify these concepts. Possible solutions to overcome these challenges are also presented to inform on appropriate intensity selection for individual-specific aerobic exercise prescription in both research and practical settings.

Muscle metabolic and neuromuscular determinants of fatigue during cycling in different exercise intensity domains.

Lactate or gas exchange threshold (GET) and critical power (CP) are closely associated with human exercise performance. We tested the hypothesis that the limit of tolerance (Tlim) during cycle exercise performed within the exercise intensity domains demarcated by GET and CP is linked to discrete muscle metabolic and neuromuscular responses. Eleven men performed a ramp incremental exercise test, 4-5 severe-intensity (SEV; >CP) constant-work-rate (CWR) tests until Tlim, a heavy-intensity (HVY; <CP but >GET) CWR test until Tlim, and a moderate-intensity (MOD; <GET) CWR test until Tlim Muscle biopsies revealed that a similar (P > 0.05) muscle metabolic milieu (i.e., low pH and [PCr] and high [lactate]) was attained at Tlim (approximately 2-14 min) for all SEV exercise bouts. The muscle metabolic perturbation was greater at Tlim following SEV compared with HVY, and also following SEV and HVY compared with MOD (all P < 0.05). The normalized M-wave amplitude for the vastus lateralis (VL) muscle decreased to a similar extent following SEV (-38 ± 15%), HVY (-68 ± 24%), and MOD (-53 ± 29%), (P > 0.05). Neural drive to the VL increased during SEV (4 ± 4%; P < 0.05) but did not change during HVY or MOD (P > 0.05). During SEV and HVY, but not MOD, the rates of change in M-wave amplitude and neural drive were correlated with changes in muscle metabolic ([PCr], [lactate]) and blood ionic/acid-base status ([lactate], [K+]) (P < 0.05). The results of this study indicate that the metabolic and neuromuscular determinants of fatigue development differ according to the intensity domain in which the exercise is performed.NEW & NOTEWORTHY The gas exchange threshold and the critical power demarcate discrete exercise intensity domains. For the first time, we show that the limit of tolerance during whole-body exercise within these domains is characterized by distinct metabolic and neuromuscular responses. Fatigue development during exercise greater than critical power is associated with the attainment of consistent "limiting" values of muscle metabolites, whereas substrate availability and limitations to muscle activation may constrain performance at lower intensities.

Relationship between cardiac deformation parameters measured by cardiovascular magnetic resonance and aerobic fitness in endurance athletes.

BackgroundAthletic training leads to remodelling of both left and right ventricles with increased myocardial mass and cavity dilatation. Whether changes in cardiac strain parameters occur in response to training is less well established. In this study we investigated the relationship in trained athletes between cardiovascular magnetic resonance (CMR) derived strain parameters of cardiac function and fitness.MethodsThirty five endurance athletes and 35 age and sex matched controls underwent CMR at 3.0 T including cine imaging in multiple planes and tissue tagging by spatial modulation of magnetization (SPAMM). CMR data were analysed quantitatively reporting circumferential strain and torsion from tagged images and left and right ventricular longitudinal strain from feature tracking of cine images. Athletes performed a maximal ramp-incremental exercise test to determine the lactate threshold (LT) and maximal oxygen uptake (V̇O2max).ResultsLV circumferential strain at all levels, LV twist and torsion, LV late diastolic longitudinal strain rate, RV peak longitudinal strain and RV early and late diastolic longitudinal strain rate were all lower in athletes than controls. On multivariable linear regression only LV torsion (beta = −0.37, P = 0.03) had a significant association with LT. Only RV longitudinal late diastolic strain rate (beta = −0.35, P = 0.03) had a significant association with V̇O2max.ConclusionsThis cohort of endurance athletes had lower LV circumferential strain, LV torsion and biventricular diastolic strain rates than controls. Increased LT, which is a major determinant of performance in endurance athletes, was associated with decreased LV torsion. Further work is needed to understand the mechanisms by which this occurs.

No reserve in isokinetic cycling power at intolerance during ramp incremental exercise in endurance-trained men.

During whole body exercise in health, maximal oxygen uptake (V̇o2max) is typically attained at or immediately before the limit of tolerance (LoT). At the V̇o2max and LoT of incremental exercise, a fundamental, but unresolved, question is whether maximal evocable power can be increased above the task requirement, i.e., whether there is a "power reserve" at the LoT. Using an instantaneous switch from cadence-independent (hyperbolic) to isokinetic cycle ergometry, we determined maximal evocable power at the limit of ramp-incremental exercise. We hypothesized that in endurance-trained men at LoT, maximal (4 s) isokinetic power would not differ from the power required by the task. Baseline isokinetic power at 80 rpm (Piso; measured at the pedals) and summed integrated EMG from five leg muscles (ΣiEMG) were measured in 12 endurance-trained men (V̇o2max = 4.2 ± 1.0 l/min). Participants then completed a ramp incremental exercise test (20-25 W/min), with instantaneous measurement of Piso and ΣiEMG at the LoT. Piso decreased from 788 ± 103 W at baseline to 391 ± 72 W at LoT, which was not different from the required ramp-incremental flywheel power (352 ± 58 W; P > 0.05). At LoT, the relative reduction in Piso was greater than the relative reduction in the isokinetic ΣiEMG (50 ± 9 vs. 63 ± 10% of baseline; P < 0.05). During maximal ramp incremental exercise in endurance-trained men, maximum voluntary power is not different from the power required by the task and is consequent to both central and peripheral limitations in evocable power. The absence of a power reserve suggests both the perceptual and physiological limits of maximum voluntary power production are not widely dissociated at LoT in this population.

Exercise Intensity Thresholds: Identifying the Boundaries of Sustainable Performance.

Critical power (CP), respiratory compensation point (RCP), maximal lactate steady state (MLSS), and deoxyhemoglobin breakpoint ([HHb]BP) are alternative functional indices that are thought to demarcate the highest exercise intensity that can be tolerated for long durations. We tested the hypothesis that CP, RCP, MLSS, and [HHb]BP occur at the same metabolic intensity by examining the pulmonary oxygen uptake (V˙)O2p and power output (PO) associated with each "threshold." Twelve healthy men (mean ± SD age, 27 ± 3 yr) performed the following tests on a cycle ergometer: i) four to five exhaustive tests for determination of CP, ii) two to three 30-min constant-power trials for MLSS determination, and iii) a ramp incremental exercise test from which the V˙O2p and PO at RCP and [HHb]BP were determined. During each trial, breath-by-breath V˙O2p and ventilatory variables were measured with a metabolic cart and flowmeter turbine; near-infrared spectroscopy-derived [HHb] was monitored using a frequency domain multidistance system, and arterialized capillary blood lactate was sampled at regular intervals. There were no differences (P > 0.05) among the V˙O2p values associated with CP, RCP, MLSS, and [HHb]BP (CP, 3.29 ± 0.48; RCP, 3.34 ± 0.45; MLSS, 3.27 ± 0.44; [HHb]BP, 3.41 ± 0.46 L·min(-1)); however, the PO associated with RCP (262 ± 48 W) and [HHb]BP (273 ± 41 W) were greater (P < 0.05) than both CP (226 ± 45 W) and MLSS (223 ± 39 W), which, themselves, were not different (P > 0.05). Although the standard methods for determination of CP, RCP, MLSS, and [HHb]BP are different, these indices occur at the same V˙O2p, suggesting that i) they may manifest as a result of similar physiological phenomenon and ii) each provides a valid delineation between tolerable and intolerable constant-power exercise.

Inspiratory resistance decreases limb blood flow in COPD patients with heart failure

To the Editor: Chronic heart failure (CHF) with reduced left ventricular ejection fraction is a common and disabling comorbidity of chronic obstructive pulmonary disease (COPD) [1]. Understanding the mechanisms underlying exercise intolerance is paramount to providing a rationale to effectively rehabilitate the fast-growing population of patients with COPD plus CHF. The inspiratory muscles, in particular, are characteristically overloaded in COPD plus CHF, with greater elastic and resistive work of breathing. Moreover, these muscles might be functionally weakened as ventilation increases during exercise in patients with COPD [2]. It has been postulated that fatiguing contractions would stimulate diaphragmatic thinly myelinated group III and unmyelinated group IV fibres, thereby increasing limb sympathetic outflow and vascular resistance. The so-called respiratory muscle metaboreflex would then redirect blood flow from locomotor to respiratory muscles to avoid, or at least postpone, the impending failure of the “vital pump” [3, 4]. In this context, we previously found marked blood flow reduction to nonactive and active limbs during inspiratory resistive loading in CHF [5]. Work from our laboratory also showed improved peripheral muscle oxygen delivery after respiratory muscle unloading (under stable cardiac output and arterial oxygen content) in CHF-free COPD [6] and COPD-free CHF [7]. It is therefore conceivable that the coexistence of CHF would potentiate the respiratory muscle metaboreflex in patients with a primary diagnosis of COPD. After giving informed consent, 22 optimally treated patients with moderate-to-severe (Global Initiative for Chronic Obstructive Lung Disease stage II–III) COPD (10 with coexistent CHF, i.e. left ventricular ejection fraction <45% by echocardiography) and 10 age- and sex-matched controls underwent a ramp-incremental exercise test for …

Effect of prior metabolic rate on the kinetics of oxygen uptake during moderate-intensity exercise.

Pulmonary oxygen uptake (VO2) dynamics during moderate-intensity exercise are often assumed to be dynamically linear (i.e. neither the gain nor the time constant (tau) of the response varies as a function of work rate). However, faster, slower and unchanged VO2 kinetics have been reported during work-to-work transitions compared to rest-to-work transitions, all within the moderate-intensity domain. In an attempt to resolve these discrepancies and to improve the confidence of the parameter estimation, we determined the VO2 response dynamics using the averaged response to repeated exercise bouts in seven healthy male volunteers. Each subject initially performed a ramp-incremental exercise test for the estimation of the lactate threshold (thetaL). They then performed an average of four repetitions of each of three constant-work-rate (WR) tests: (1) between 20 W and a work rate of 50% (WR50) between 20 W and 90% thetaL (step 1-->2), (2) between WR50 and 90% thetaL (step 2-->3), and (3) between 20 W and 90% thetaL (step 1-->3); 6 min was spent at each work rate increment and decrement. Parameters of the kinetic response of phase II VO2 were established by non-linear least-squares fitting techniques. The kinetics of VO2 were significantly slower at the upper reaches of the moderate-intensity domain (step 2-->3) compared to steps 1-->2 and 1-->3 [group mean (SD) phase II tau: step 1-->2 25.3 (4.9) s, step 2-->3 40.0 (7.4) s and step 1-->3 32.2 (6.9) s]. The off-transient values of tau were not significantly different from each other: 36.8 (16.3) s, 38.9 (11.6) s and 30.8 (5.7) s for steps 1-->2, 2-->3 and 1-->3, respectively. Surprisingly, the on-transient gain (G, deltaVO2/deltaWR) was also found to vary among the three steps [G = 10.56 (0.42) ml x min(-1) W(-1) 11.85 (0.64) ml x min(-1) W(-1) and 11.23 (0.52) ml x min(-1) W(-1) for steps 1-->2, 2-->3 and 1-->3, respectively]; the off-transient G did not vary significantly and was close to that for the on-transient step 1-->3 in all cases. Our results do not support a dynamically linear system model of VO2 during cycle ergometer exercise even in the moderate-intensity domain. The greater oxygen deficit per unit power increment in the higher reaches of the moderate-intensity domain necessitates a greater transient lactate contribution to the energy transfer, or a greater phosphocreatine breakdown, or possibly both.