Effects of regular physical activity on skeletal muscle structural, energetic, and microvascular properties in carriers of sickle cell trait.

To assess the effects of regular physical activity on muscle functional characteristics of carriers of sickle cell trait (SCT), 39 untrained (U) and trained (T) hemoglobin (Hb)AA (CON) and SCT subjects (U-CON, n = 12; U-SCT, n = 8; T-CON, n = 10; and T-SCT, n = 9) performed a graded exercise and a time to exhaustion (T(ex)) test, and were subjected to a muscle biopsy. Maximal power, total work performed during T(ex), citrate synthase and cytochrome c oxidase (COX) activities, respiratory chain complexes I and IV content, and capillary density (CD), diameter (COD), and surface area (CSA) were upregulated by the same proportion in T-CON and T-SCT compared with their untrained counterparts. These proportionally similar differences imply that the observed discrepancies between U-SCT and U-CON remained in the trained subjects. Specifically, both CD and COX remained and tended to remain lower, and both COD and CSA remained and tended to remain higher in T-SCT than in T-CON. Besides, carriers of SCT displayed specific adaptations with regular physical activity: creatine kinase activity; complexes II, III, and V content; and type I fiber surface area and capillary tortuosity were lower or unchanged in T-SCT than in U-SCT. In summary, our results show that 1) carriers of SCT adapted almost similarly to CON to regular physical activity for most of the studied muscle characteristics, 2) oxidative potential remains altered in physically active carriers of SCT compared with HbAA counterparts, and 3) the specific remodeling of muscle microvascular network persists in the trained state.

Effects of carbohydrates-BCAAs-caffeine ingestion on performance and neuromuscular function during a 2-h treadmill run: a randomized, double-blind, cross-over placebo-controlled study.

BACKGROUND: Carbohydrates (CHOs), branched-chain amino acids (BCAAs) and caffeine are known to improve running performance. However, no information is available on the effects of a combination of these ingredients on performance and neuromuscular function during running. METHODS: The present study was designed as a randomized double-blind cross-over placebo-controlled trial. Thirteen trained adult males completed two protocols, each including two conditions: placebo (PLA) and Sports Drink (SPD: CHOs 68.6 g.L-1, BCAAs 4 g.L-1, caffeine 75 mg.L-1). Protocol 1 consisted of an all-out 2 h treadmill run. Total distance run and glycemia were measured. In protocol 2, subjects exercised for 2 h at 95% of their lowest average speeds recorded during protocol 1 (whatever the condition). Glycemia, blood lactate concentration and neuromuscular function were determined immediately before and after exercise. Oxygen consumption (V˙O2), heart rate (HR) and rate of perceived exertion (RPE) were recorded during the exercise. Total fluids ingested were 2 L whatever the protocols and conditions. RESULTS: Compared to PLA, ingestion of SPD increased running performance (p = 0.01), maintained glycemia and attenuated central fatigue (p = 0.04), an index of peripheral fatigue (p = 0.04) and RPE (p = 0.006). Maximal voluntary contraction, V˙O2, and HR did not differ between the two conditions. CONCLUSIONS: This study showed that ingestion of a combination of CHOs, BCAAs and caffeine increased performance by about 2% during a 2-h treadmill run. The results of neuromuscular function were contrasted: no clear cut effects of SPD were observed. TRIAL REGISTRATION: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT00799630.

Skeletal muscle structural and energetic characteristics in subjects with sickle cell trait, alpha-thalassemia, or dual hemoglobinopathy.

Previous studies have shown that subjects with sickle cell trait (SCT), alpha-thalassemia (alpha-t), and the dual hemoglobinopathy (SCT/alpha-t) manifest subtle, albeit significant, differences during exercise. To better understand such differences, we assessed skeletal muscle histomorphological and energetic characteristics in 10 control HbAA subjects (C), 5 subjects with alpha-t (alpha-t), 6 SCT carriers (SCT) and 9 SCT carriers with alpha-t (SCT/alpha-t). Subjects underwent a muscle biopsy and also performed an incremental maximal exercise and a time to exhaustion test. There were no observable differences in daily energy expenditure, maximal power output (Pmax), or time to exhaustion at 110% Pmax (Tex) among the groups. Blood lactate concentrations measured at the end of the Tex, muscle fiber type distribution, and mean phosphofructokinase (PFK), lactate dehydrogenase (LDH), beta-hydroxyacyl-CoA-dehydrogenase (HAD), and citrate synthase (CS) activities were all similar among the four groups. However, SCT was associated with a lower cytochrome-c oxidase (COx) activity in type IIa fibers (P<0.05), and similar trends were observed in fiber types I and IIx. Trends toward lower creatine kinase (CK) activity (P=0.0702) and higher surface area of type IIx fibers were observed in SCT (P=0.0925). In summary, these findings support most of the previous observations in SCT, such as 1) similar maximal power output and associated maximal oxygen consumption (VO2max) values and 2) lower exercise performances during prolonged submaximal exercise. Furthermore, performances during short supramaximal exercise were not different in SCT. Finally, the dual hemoglobinopathy condition does not seem to affect muscle characteristics.

Central and peripheral contributions to neuromuscular fatigue induced by a 24-h treadmill run.

This experiment investigated the fatigue induced by a 24-h running exercise (24TR) and particularly aimed at testing the hypothesis that the central component would be the main mechanism responsible for neuromuscular fatigue. Neuromuscular function evaluation was performed before, every 4 h during, and at the end of the 24TR on 12 experienced ultramarathon runners. It consisted of a determination of the maximal voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), the maximal voluntary activation (%VA) of the KE and PF, and the maximal compound muscle action potential amplitude (Mmax) on the soleus and vastus lateralis. Tetanic stimulations also were delivered to evaluate the presence of low-frequency fatigue and the KE maximal muscle force production ability. Strength loss occurred throughout the exercise, with large changes observed after 24TR in MVC for both the KE and PF muscles (-40.9+/-17.0 and -30.3+/-12.5%, respectively; P<0.001) together with marked reductions of %VA (-33.0+/-21.8 and -14.8+/-18.9%, respectively; P<0.001). A reduction of Mmax amplitude was observed only on soleus, and no low-frequency fatigue was observed for any muscle group. Finally, KE maximal force production ability was reduced to a moderate extent at the end of the 24TR (-10.2%; P<0.001), but these alterations were highly variable (+/-15.7%). These results suggest that central factors are mainly responsible for the large maximal muscle torque reduction after ultraendurance running, especially on the KE muscles. Neural drive reduction may have contributed to the relative preservation of peripheral function and also affected the evolution of the running speed during the 24TR.

Effects of muscular biopsy on the mechanics of running.

Muscle biopsy is a widely used technique in protocols aiming at studying physical capacities and fiber profiles of athletes, and muscular adaptations to exercise. Side effects of biopsy alone on physiological parameters have recently been pointed out, and we sought to determine whether a single biopsy had effects on the main stride mechanical parameters. Ten male runners performed 4-min runs before and after undergoing a biopsy of their left vastus lateralis muscle. Step frequency and duty factor were significantly higher after biopsy (2.86 +/- 0.14 vs. 2.82 +/- 0.15 Hz, and 0.77 +/- 0.04 vs. 0.75 +/- 0.05, respectively), whereas other factors were significantly lower: maximal vertical ground reaction force (1,601 +/- 240 vs. 1,643 +/- 230 N), loading rate (53.9 +/- 12.8 vs. 58.4 +/- 13.5 bw s(-1)), center of mass vertical displacement (0.056 +/- 0.008 vs. 0.058 +/- 0.008 m) and external mechanical work at each step (1.14 +/- 0.10 vs. 1.24 +/- 0.10 J kg(-1) step(-1)). These effects were observed on the left (biopsed) leg, but also on the right one for the external mechanical work, the duty factor and the maximal vertical ground reaction force, showing that a single biopsy had both ipsi- and contralateral effects on running mechanics.

Characterization of the mechanical properties of backpacks and their influence on the energetics of walking.

The objectives of the experiment were (i) to characterize the mechanical properties of backpacks and (ii) to study the influence of a flexible backpack on the energetics and kinematics of walking. Twelve subjects walked at different speeds on a treadmill with each of two backpacks loaded with 25% bodyweight, with either a rigid or a flexible link between the body attachment and the suspended loads. A single degree of freedom linear model of the link between the pack and the trunk was used to calculate the stiffness and damping coefficient of the two backpacks. The oxygen consumption (VO2) and the vertical acceleration of both the backpack and trunk were measured. The vertical excursion of the pack given by the model was significantly correlated with that actually measured (R=0.87, p<0.001). At 3.7 and 4.5 km h(-1) the flexible pack induced lower acceleration peaks (respectively -22% and -8%; p<0.05) and tended to reduce VO2 (p=0.055 at 4.5 km h(-1)) compared with the rigid one. At 5.2 and 6 km h(-1) both the accelerative forces and VO2 increased with the flexible pack (p<0.05) mainly because of the high vertical movement of the pack. It was concluded that a simple model can be used to predict the vertical excursion of the pack and that a flexible backpack can provide energetic benefits when its oscillations are nearly in phase with those of the trunk. However, any resonance effect can lead to a modified walking pattern and an increased metabolic cost.

Influence of speed variation and age on the asymmetry of ground reaction forces and stride parameters of normal gait in children.

The purpose of this study was to assess the influence of age and speed on the asymmetry of ground reaction forces (GRFs) and spatiotemporal parameters (STPs) during normal gait in 4- to 10-year-old children. Forty-seven children walked at three speeds on a treadmill dynamometer (ADAL; Tecmachine, Andrézieux Bouthéon, France). Thirty steps were recorded at each speed for each foot for each child. The GRF and stride parameters were normalized to body weight and to body height, respectively. A left-right symmetry index (SI) was calculated for each parameter. The influence of both age and speed on the different SI was examined with a two-way analysis of variance. GRF and STP were asymmetric (SI ranged from +/- 1.92% to +/- 45.05%). The SI of forces Fz1 and Fy1 are negative in children aged 4-6 years, indicating that left Fz1 and Fy1 are higher than right Fz1 and Fy1. The cross effect of age and speed on the asymmetries of gait parameters was not significant There was no significant effect of age on the asymmetries of vertical GRF and STP. The asymmetry of vertical propulsive force (Fz3) alone increased with the speed (P < 0.05). This study showed that the different tasks performed by the lower limbs could be responsible for the asymmetry of GRF and STP in children aged 4-6 years. It also shows that upper and lower limits of normal asymmetry of gait parameters are different. Therefore no single criterion value can be used to assess the symmetry of several gait parameters. The small values of upper and lower limits of symmetry indices of vertical forces and stride duration show that the symmetry indices of these variables are reliable measurements and should thus be used in symmetry analysis of gait in normal and disabled children.

Effects of training in normoxia and normobaric hypoxia on time to exhaustion at the maximum rate of oxygen uptake.

The effects of endurance training in normoxia or in hypoxia on time to exhaustion ( T(lim)) at the work rate corresponding to peak oxygen uptake (VO(2peak)) were examined at sea level in 13 healthy subjects. Before and after training the subjects performed the following: (1) incremental exercises up to exhaustion to determine peak oxygen uptake in normoxia (VO(2peak)N), the percentage of this value at the 4 mmol l(-1) blood lactate concentration (VO(2)4%N) and the work rate corresponding to VO(2peak)N (Pa(peak)N), (2) a 5-min 90% Pa(peak)N exercise followed by a 10-min passive recovery to determine the maximal blood lactate concentration (La(max)) measured during the recovery, and (3) a T(lim) at Pa(peak)N. Training consisted of pedalling 2 h a day, 6 days a week, for 4 weeks. Five subjects trained in normobaric hypoxia [HT; partial pressure of inhaled oxygen ( P(I)O(2)) 89 mmHg] and eight subjects trained at the same relative work rates in normoxia (NT; P(I)O(2) 141 mmHg). The training-induced improvement of all the measured parameters were closely matched between the HT and the NT ( P>0.05). Training increased T(lim) by 59.7% [164(40) s]. The value of T(lim) was related to VO(2)4%N and to La(max) before and after training. Also, the training-induced improvement of T(lim) was related to the concomitant decrease in La(max). It is concluded that: (1) endurance training including continuous high-intensity exercises improves T(lim) for exercises performed at the same relative (higher absolute) work rate after training, (2) intermittent hypoxic training has no potentiating effect on T(lim) as compared with training in normoxia, and (3) the intra-individual training-induced improvement of T(lim) was associated with metabolic alteration in relation to lactate accumulation.

Alteration of QT rate dependence reflects cardiac autonomic imbalance in patients with obstructive sleep apnea syndrome.

QT rate dependence is one of the major properties of ventricular repolarization with its circadian and autonomic modulations. The authors postulated that dynamic alterations in QT interval adaptation could help characterize patients with cardiac autonomic alterations, like those with obstructive sleep apnea syndrome (OSAS). To assess ventricular repolarization features in patients with OSAS, QT parameters and their dynamicity along RR intervals were compared from 24-hour ECG data of patients with and without this syndrome, assessing cardiac autonomic nervous system equilibrium by means of time-domain and frequency-domain analyses of heart rate variability (HRV). The study group consisted of 74 consecutive patients referred to the Sleep Laboratory for clinically suspected OSAS. The syndrome was confirmed in 30 (40.5%) patients according to standard polysomnographic criteria. QT length related to heart rate (HR) was found significantly shorter for HR < 70 beats/min in patients with OSAS(-1.32 +/- 0.35)compared with patients without OSAS(-1.99 +/- 0.40; P < 0.01). This flattened relationship was correlated with the severity of the sleep related disorder. Using multiple linear regression analysis, the apnea/hypopnea index and nocturnal normalized high frequencies (HFnu) were the most significant predictors of the QT/RR slope(R = 0.61; P < 0.0001). OSAS is significantly associated with a flattened relationship between QT duration and RR interval at low HRs. The alteration of cardiac parasympathetic tone occurring in severe OSAS patients may explain this altered rate dependent adaptation of myocardial repolarization.

Decrease in peak heart rate with acute hypoxia in relation to sea level VO(2max).

The aim of this study was to evaluate the influence of arterial oxygen saturation ( SaO(2)) on maximal heart rate during maximal exercise under conditions of acute hypoxia compared with normoxia. Forty-six males were divided into three groups depending on their sea level maximal oxygen consumption ( VO(2max)): high [GH, VO(2max)=64.2 (3.3) ml x min(-1) x kg(-1)], medium [GM, 50.8 (3.9) ml x min(-1) x kg(-1)] and low [GL, 41.0 (1.9) ml x min(-1) x kg(-1)]. All subjects performed a maximal exercise test in two conditions of inspired oxygen tension ( PIO(2), (149 mmHg and 70 mmHg). Among the GM group, seven subjects performed five supplementary incremental exercise tests at PIO(2) 136, 118, 104, 92, and 80 mmHg. Measurements of VO(2max) and SaO(2) using an ear-oxymeter were carried out at all levels of PIO(2). The decrease in SaO(2 )and peak heart rate (HR(peak)) with PIO(2) became significant from 104 and 92 mmHg. SaO(2) correlated with the decrease in HR(peak). For PIO(2)=70 mmHg, the decrease in VO(2max), SaO(2) and HR(peak) was, respectively, 44%, 62%, and 17.0 bpm for GH, 38%, 68%, and 14.7 bpm for GM, and 34%, 68%, and 11.8 bpm for GL. During maximal exercise in hypoxia, SaO(2) was lower for GH than GM and GL ( p<0.01). Among subjects in GH, five presented exercise-induced hypoxemia (EIH) when exercising in normoxia. The EIH group exhibited a greater decrement in HR(peak) than the non-EIH group at maximal hypoxic exercise (21.2 bpm vs. 15.0 bpm; p<0.05). When subjects are exposed to acute hypoxia, the lower SaO(2), due either to lower PIO(2) or to training status, is associated with lower HR(peak).

Arrhythmic risk stratification after myocardial infarction using ambulatory electrocardiography signal averaging.

Ambulatory ECG had been proposed to examine the amplified high resolution signal-averaged electrocardiogram (SAECG). Clinical investigations are required to confirm the predictive value of such a high resolution technique in arrhythmic risk stratification. The prognostic value of ambulatory Holter SAECG was evaluated in 108 postinfarction patients for the purpose of predicting the occurrence of serious arrhythmic (SARR) events (sudden cardiac death [SCD], VT, or VF) in comparison with classical real-time SAECG. During the 42+/-8 months of follow-up, the sudden cardiac death mortality was 4.6% (five deaths), six (5.6%) patients had VT, and one (0.9%) VF. QRSd was found to be the most predictive parameter using ROC curves analysis for SAAR + outcome (W = 0.833 and W = 0.803 for 25-250 Hz and 40-250 Hz filters, respectively) followed by RMS (W = 0.766 and W = 0.721) and LAS (W = 0.759, W = 0.709) (all P < 0.01). Abnormal Holter SAECG for 25 and 40-Hz LP filter were significant predictors of SARR+ by log-rank test (P < 0.01, P < 0.05, respectively). This study confirms that valuable prognostic information can be obtained from the ambulatory high resolution ECG technique and that Holter SAECG may predict arrhythmic risk in a postinfarction population.