Second Ventilatory Threshold Assessed by Heart Rate Variability in a Multiple Shuttle Run Test.

Many studies have focused on heart rate variability in association with ventilatory thresholds. The purpose of the current study was to consider the ECG-derived respiration and the high frequency product of heart rate variability as applicable methods to assess the second ventilatory threshold (VT2). Fifteen healthy young soccer players participated in the study. Respiratory gases and ECGs were collected during an incremental laboratory test and in a multistage shuttle run test until exhaustion. VΤ2 was individually calculated using the deflection point of ventilatory equivalents. In addition, VT2 was assessed both by the deflection point of ECG-derived respiration and high frequency product. Results showed no statistically significant differences between VT2, and the threshold as determined with high frequency product and ECG-derived respiration (F(2,28)=0.83, p=0.45, η2=0.05). A significant intraclass correlation was observed for ECG-derived respiration (r=0.94) and high frequency product (r=0.95) with VT2. Similarly, Bland Altman analysis showed a considerable agreement between VT2 vs. ECG-derived respiration (mean difference of -0.06 km·h-1, 95% CL: ±0.40) and VT2 vs. high frequency product (mean difference of 0.02 km·h-1, 95% CL: ±0.38). This study suggests that, high frequency product and ECG-derived respiration are indeed reliable heart rate variability indices determining VT2 in a field shuttle run test.

The effect of prolonged intense physical exercise of special forces volunteers on their plasma protein denaturation profile examined by differential scanning calorimetry.

The human blood plasma proteome profile has been an area of intensive investigation and differential scanning calorimetry (DSC) has come forward as a novel tool in analyzing plasma heat capacity changes to monitor various physiological responses in health and disease. This study used DSC to assess potential alterations in the plasma heat capacity profile of albumin and globulins during extremely demanding physical exercise. We monitored the changes in denaturation profiles of those plasma proteins for five consecutive days of an extraordinary exercise training schedule in 14 young male Special Forces volunteers, as well as after a 30-day recovery period. The major effect of the prolonged intense exercise was the continuous upward shift of the albumin peak by 2°-3 °C on the initial days of exercise, with a tendency to plateau circa the 5th day of exercise. In addition, some redistribution of the denaturational enthalpy was observed upon exercise, where the globulins peak increased relative to the albumin peak. Noteworthy, the alterations in the plasma proteome denaturational profiles were not persistent, as virtually full recovery of the initial status was observed after 30 days of recovery. Our findings indicate that 5 days of exhaustive physical exercise of highly trained individuals enhanced the thermal stability of plasma albumin shifting its denaturational transition to higher temperatures. We surmise that these effects may be a result of increased blood oxygenation during the prolonged intense exercise and, consequently, of albumin oxidation as part of the overall adaptation mechanisms of the body to extreme physical and/or oxidative stress.

Interval exercise induces milder respiratory responses compared to continuous exercise.

The purpose of this study was to explore the respiratory response of acute interval and continuous exercise (CE) of low and high intensity. Fourteen recreational athletes (7 men and 7 women; VO2max = 35.7 ± 6.1 mlkg-1min-1) performed a bout of continuous and a bout of interval exercise (IE) both consisted of 5-min cycling at low intensity [80% of the power output (W) of the predetermined gas exchange threshold (GET) (80%WGET)] and 5-min cycling at high intensity {WGET plus the work rate corresponding to 50% of the difference between peak power output (PPO) at oxygen uptake (VO2max) test and the WGET [WGET + 0.50 Δ(PPO - WGET)]}. CE compared to IE induced significant higher heart rate and ventilation as well as significant higher levels of mouth occlusion pressure for 0.1 s (P0.1) (P < 0.05) during low and high intensities. Our results indicate that CE stimulates respiration more than IE when the exercise is performed at the same relative intensity.

Anterior cruciate ligament deficiency reduces walking economy in "copers" and "non-copers".

PURPOSE: Patients with ACL injury requiring surgical treatment (non-copers) demonstrate altered neuromuscular control and gait pattern compared with those returning to their pre-injury activities without surgery (copers). Pathological gait pattern may increase the energy cost of walking. We compared the energy cost of flat, uphill, and downhill walking between ACL-deficient and healthy individuals and between "copers" and "non-copers". METHODS: Nineteen young males with unilateral ACL injury were allocated into "copers" and "non-copers" according to their ability to return to pre-injury activity without ACL reconstruction. Lysholm and IKDC scales were recorded, and a control group (n = 10) matched for physical characteristics and activity levels was included. All participants performed 8-min walking tasks at 0, +10, and -10 % gradients. Energy cost was assessed by measurement of oxygen consumption (VO2). HR and ventilation (VE), respiratory exchange ratio (RER), and VE/VO2 were also measured. RESULTS: VO2 and HR were higher in ACL-deficient patients than in controls during walking at 0, +10, and -10 % gradients (p < 0.01-0.05). There were no differences between "copers" and "non-copers" in VO2 and HR for any gradient. No differences were observed in VE, RER, and VE/VO2 among the three groups. CONCLUSIONS: The walking economy of level, uphill, and downhill walking is reduced in ACL-deficient patients. Despite the improved functional and clinical outcome of "copers", their walking economy appears similar to that of "non-copers" but impaired compared with healthy individuals. The higher energy demand and effort during locomotion in "copers" and "non-copers" has clinical implications for designing safer rehabilitation programmes. The increased energy cost in "copers" may be another parameter to consider when deciding on the most appropriate therapeutic intervention (operative and non-operative), particularly for athletes. LEVEL OF EVIDENCE: II.

Anatomic single-bundle anterior cruciate ligament reconstruction improves walking economy: hamstrings tendon versus patellar tendon grafts.

PURPOSE: Anterior cruciate ligament (ACL) injury is associated with a pathologic gait pattern and increased energy cost during locomotion. ACL reconstruction could improve the gait pattern. Hamstrings tendon (HAM) and bone-patellar tendon-bone (BPTB) grafts are usually used for reconstruction. The aim of this study was to compare the efficacy of anatomic ACL reconstruction with HAM and BPTB grafts on improving and normalizing the energy cost and physiologic reserves during flat, uphill, and downhill walking. METHODS: Twenty male subjects with unilateral ACL injuries were randomly assigned to ACL reconstruction with a HAM (n = 10) or BPTB (n = 10) graft. Ten matched controls were also enrolled. All participants performed three 8-min walking tasks at 0, +10, and -10 % gradients before and 9 months after surgery. Energy cost (oxygen consumption, VO2), heart rate (HR), and ventilation (VE) were measured. Lysholm/IKDC scores were recorded. RESULTS: Pre-operatively, VO2, HR, and VE were higher in the HAM and BPTB groups than in controls during walking at 0, +10, and -10 % gradients (p < 0.001-0.01). Post-operatively, both HAM and BPTB groups showed reduced VO2, HR, and VE during the three walking tasks (p < 0.001-0.01). Although the post-operative VO2 in both surgical groups reached 90-95 % of the normative (control) value during walking, it remained elevated against the value observed in controls (p < 0.001-0.01). The HAM and BPTB groups showed no differences in post-surgical VO2 or HR during walking at all three gradients. CONCLUSION: Anatomic ACL reconstruction with either HAM or BPTB graft resulted in similar short-term improvements in energy cost and nearly normalized locomotion economy and cardiorespiratory reserves during flat, uphill, and downhill walking. The improved locomotion economy is an additional benefit of anatomic ACL reconstruction, irrespective of the type of graft used, that the orthopaedic surgeons should consider. LEVEL OF EVIDENCE: II.

Comparison of inflammatory responses to a soccer match between elite male and female players.

The aim of this study was to compare the inflammatory responses between male and female soccer players for a period of 48 hours after an official match. Blood samples were taken from 83 subjects (22 elite male and 21 elite female soccer players and 20 male and 20 female inactive individuals) in the morning of the game day, immediately after the soccer game and 24 and 48 hours after the match. Average relative exercise intensity during the match was similar in male and female players, as indicated by mean heart rate that was 86.9 ± 4.3 and 85.6 ± 2.3% of maximal heart rate (p = 0.23), respectively. Interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) increased 2- to 4-fold above resting values, peaking immediately after the match. C-reactive protein (CRP) and creatine kinase peaked 24 hours after the match. Interleukin 6, CRP, and creatine kinase responses were similar in male and female players, but the peak in TNF-α was 18% higher in male players. Interleukin 6, TNF-α, and CRP at rest were lower in male and female players compared with the control subjects, suggesting a protective effect of regular exercise training regarding the inflammatory profile. The results of this study show that a soccer match induces significant inflammatory responses in both male and female players, with only TNF-α peak values being lower in females. Because of the effects of inflammatory responses on performance and health of the players, it is suggested that coaches and trainers should adjust exercise training programs after a match to promote recovery and protect the athletes' health.

Effects of Concurrent High-Intensity and Strength Training on Muscle Power and Aerobic Performance in Young Soccer Players during the Pre-Season.

The aim of the present study was to evaluate two different intervention programs applied during a 4-week pre-season period. Twenty-nine players participated in this study and were divided into two groups. One group (BallTrain, n = 12, age: 17.8 ± 0.4 years, body mass: 73.9 ± 7.6 kg, height: 178 ± 0.1 cm, body fat: 9.6 ± 5.3%) performed a higher percentage of aerobic training with ball and strength training using plyometrics and exercises with body weight. The other group (HIITTrain, n = 17, age: 17.8 ± 0.7 years, body mass: 73.3 ± 5.0 kg, height: 179 ± 0.1 cm, body fat: 8.0 ± 2.3%) trained with high-intensity interval training (HIIT) without the ball and performed resistance training with weights in the same session. Both groups trained for strength (two times/week) and performed aerobic-anaerobic fitness without the ball, passing games, and tactical and small-sided games. Lower limb power (CMJ) and aerobic fitness (Yo-Yo intermittent recovery test level 1-IR1) were evaluated before and after the four-week training program. Yo-Yo IR1 performance was improved in both groups, but the improvement was greater for the HIITTrain than BallTrain group (468 ± 180 vs. 183 ± 177 m, p = 0.07). CMJ showed a non-significant improvement in the BallTrain group (5.8 ± 8.8%, p = 0.16), but it decreased by 8.1 ± 9% (p = 0.001), in the HIITTrain group. In conclusion, we have shown that a short pre-season period of training results in improvements in aerobic fitness in both groups, with high-intensity interval training showing superior adaptations than training with the ball. However, CMJ performance was reduced in this group, possibly suggesting higher fatigue levels and overload, and/or showing the effects of concurrent HIITTrain and strength training in soccer.

Exercise and Nutrition Strategies for Combating Sarcopenia and Type 2 Diabetes Mellitus in Older Adults.

Medical and technology development have drastically the improved quality of life and, consequently, life expectancy. Nevertheless, the more people who enter the third-age, the more geriatric syndromes expand in the elderly. Sarcopenia and Type 2 diabetes mellitus (T2DM) are common diseases among the elderly and the literature has extensively studied these two diseases separately. Recent evidence, however, revealed that there is a bidirectional relationship between sarcopenia and T2DM. The aims of the present review were: (1) to present diet and exercise interventions for the management of sarcopenia and T2DM and (2) identify which diet and exercise interventions can be used simultaneously in order to effectively deal with these two disorders. Exercise and a balanced diet are used as effective countermeasures for combating sarcopenia and T2DM in older adults based on their bidirectional relationship. Lifestyle changes such as exercise and a balanced diet seem to play an important role in the remission of the diseases. Results showed that chronic exercise can help towards glycemic regulation as well as decrease the incidence rate of muscle degradation, while diet interventions which focus on protein or amino acids seem to successfully treat both disorders. Despite the fact that there are limited studies that deal with both disorders, it seems that a combined exercise regime (aerobic and resistance) along with protein intake > 1gr/kg/d is the safest strategy to follow in order to manage sarcopenia and T2DM concurrently.

The effect of muscle blood flow restriction on hemodynamics, cerebral oxygenation and activation at rest.

This study tested the hypothesis that muscle blood flow restriction reduces muscle and cerebral oxygenation at rest. In 26 healthy males, aged 33 ± 2 yrs, physiological variables were continuously recorded during a 10-min period in 2 experimental conditions: a) with muscle blood flow restriction through thigh cuffs application inflated at 120 mm Hg (With Cuffs, WC) and b) without restriction (No Cuffs, NC). Muscle and cerebral oxygenation were reduced by muscle blood flow restriction as suggested by the increase in both muscle and cerebral deoxygenated hemoglobin (Δ[HHb]; p < 0.01) and the decrease of muscle and cerebral oxygenation index (Δ[HbDiff]; p < 0.01). Hemodynamic responses were not affected by such muscle blood flow restriction, whereas baroreflex sensitivity was reduced (p = 0.009). The perception of leg discomfort was higher (p < 0.001) in the WC than in the NC condition. This study suggests that thigh cuffs application inflated at 120 mm Hg is an effective method to reduce muscle oxygenation at rest. These changes at the muscular level seem to be sensed by the central nervous system, evoking alterations in cerebral oxygenation and baroreflex sensitivity. Novelty: Thigh cuffs application inflated at 120 mm Hg effectively reduces muscle oxygenation at rest. Limiting muscle oxygenation appears to reduce cerebral oxygenation, and baroreflex sensitivity, at rest. Even in healthy subjects, limiting muscle oxygenation, at rest, affects neural integration.

Assessment of Resilience of the Hellenic Navy Seals by Electrodermal Activity during Cognitive Tasks.

Stress resilience plays a key role in task performance during emergencies, especially in occupations like military special forces, with a routine consisting of unexpected events. Nevertheless, reliable and applicable measurements of resilience in predicting task performance in stressful conditions are still researched. This study aimed to explore the stress response in the Hellenic Navy SEALs (HN-SEALs), using a cognitive-physiological approach. Eighteen candidates under intense preparation for their enlistment in the HN-SEALs and 16 healthy controls (HCs) underwent Stroop tests, along with mental-state and personality examination. Simultaneously, electrodermal activity (EDA) was assessed during each one of cognitive testing procedures. Compared to healthy control values, multiple components of EDA values were found decreased (p < 0.05) in the HN-SEALs group. These results were associated with an increase in resilience level in the HN-SEALs group, since a restricted sympathetic reactivity according to the reduced EDA values was observed during the stressful cognitive testing. This is the first report providing physiological measurements of the sympathetic response of HN-SEALs to a stressful situation and suggests that EDA turns out to be a simple and objective tool of sympathetic activation and it may be used as a complementary index of resilience in HN-SEALs candidates.

Resilience of the Hellenic navy seals assessed by heart rate variability during cognitive tasks.

OBJECTIVES: The interaction between high physical performance under extreme conditions in military and the simultaneous control of the cognitive executive functioning has been a subject of research in literature for the past few decades. Stroop test and Heart-rate variability (HRV), have been verified valuable clinical tools for the assessment of cerebral and autonomic/ cardiovascular stress responses respectively. METHODS: Thirty-four subjects were enrolled in this study. Of them, 18 were candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (HN-SEALs) and 16 were healthy controls (HC). All subjects underwent stroop tasks, along with mental state and personality examination. HRV variables in time and frequency domains recordings were acquired, during each aforementioned cognitive testing procedure. RESULTS: Our results showed that HNS's performance on both cognitive and emotion stroop tasks were equivalent to controls (p≥.054); however, HNS exhibited statistically significant lower levels of HRV in different time and frequency domain variables, compared to HC (ranged from p<.01 to p<.05). Finally, in a between group comparison of the psychometric tools, HNS had significantly higher somatization, anxiety and neuroticism than HC. CONCLUSION: In conclusion, these findings indicate that HNS display flexibility in their autonomic regulation during cognitive and emotional tasks. This characteristic is closely related to problem solving or adaptability skills. Therefore, we support that HRV measurement turns out to be an invaluable tool for both scientific and clinical insights, promising to be an index regarding the psychophysiological resilience especially in the neurovisceral integration (NVI) model.