Independent, additive and interactive effects of acute normobaric hypoxia and cold on submaximal and maximal endurance exercise.

PURPOSE: To evaluate the independent and combined effects of hypoxia (FiO2 = 13.5%) and cold (- 20 °C) on physiological and perceptual responses to endurance exercise. METHODS: 14 trained male subjects ( V . O2max: 64 ± 5 mL/kg/min) randomly performed a discontinuous maximal incremental test to exhaustion on a motorized treadmill under four environmental conditions: Normothermic-Normoxia (N), Normothermic-Hypoxia (H), Cold-Normoxia (C) and Cold-Hypoxia (CH). Performance and physiological and perceptual responses throughout exercise were evaluated. RESULTS: Maximal WorkLoad (WL) and WL at lactate threshold (LT) were reduced in C (- 2.3% and - 3.5%) and H (- 18.0% and - 21.7%) compared to N, with no interactive (p = 0.25 and 0.81) but additive effect in CH (- 21.5% and - 24.6%). Similarly, HRmax and Vemax were reduced in C (- 3.2% and - 14.6%) and H (- 5.0% and - 7%), showing additive effects in CH (- 7.7% and - 16.6%). At LT, additive effect of C (- 2.8%) and H (- 3.8%) on HR reduction in CH (- 5.7%) was maintained, whereas an interactive effect (p = 0.007) of the two stressors combined was noted on Ve (C: - 3.1%, H: + 5.5%, CH: - 10.9%). [La] curve shifted on the left in CH, displaying an interaction effect between the 2 stressors on this parameter. Finally, RPE at LT was exclusively reduced by hypoxia (p < 0.001), whereas TSmax is synergistically reduced by cold and hypoxia (interaction p = 0.047). CONCLUSION: If compared to single stress exposure, exercise performance and physiological and perceptual variables undergo additive or synergistic effects when cold and hypoxia are combined. These results provide new insight into human physiological responses to extreme environments.

Whole-genome and transcriptome analysis enhances precision cancer treatment options.

BACKGROUND: Recent advances are enabling delivery of precision genomic medicine to cancer clinics. While the majority of approaches profile panels of selected genes or hotspot regions, comprehensive data provided by whole-genome and transcriptome sequencing and analysis (WGTA) present an opportunity to align a much larger proportion of patients to therapies. PATIENTS AND METHODS: Samples from 570 patients with advanced or metastatic cancer of diverse types enrolled in the Personalized OncoGenomics (POG) program underwent WGTA. DNA-based data, including mutations, copy number and mutation signatures, were combined with RNA-based data, including gene expression and fusions, to generate comprehensive WGTA profiles. A multidisciplinary molecular tumour board used WGTA profiles to identify and prioritize clinically actionable alterations and inform therapy. Patient responses to WGTA-informed therapies were collected. RESULTS: Clinically actionable targets were identified for 83% of patients, of which 37% of patients received WGTA-informed treatments. RNA expression data were particularly informative, contributing to 67% of WGTA-informed treatments; 25% of treatments were informed by RNA expression alone. Of a total 248 WGTA-informed treatments, 46% resulted in clinical benefit. RNA expression data were comparable to DNA-based mutation and copy number data in aligning to clinically beneficial treatments. Genome signatures also guided therapeutics including platinum, poly-ADP ribose polymerase inhibitors and immunotherapies. Patients accessed WGTA-informed treatments through clinical trials (19%), off-label use (35%) and as standard therapies (46%) including those which would not otherwise have been the next choice of therapy, demonstrating the utility of genomic information to direct use of chemotherapies as well as targeted therapies. CONCLUSIONS: Integrating RNA expression and genome data illuminated treatment options that resulted in 46% of treated patients experiencing positive clinical benefit, supporting the use of comprehensive WGTA profiling in clinical cancer care.

Shared and task-specific muscle synergies of Nordic walking and conventional walking.

Nordic walking is a form of walking that includes a poling action, and therefore an additional subtask, with respect to conventional walking. The aim of this study was to assess whether Nordic walking required a task-specific muscle coordination with respect to conventional walking. We compared the electromyographic (EMG) activity of 15 upper- and lower-limb muscles of 9 Nordic walking instructors, while executing Nordic walking and conventional walking at 1.3 ms-1 on a treadmill. Non-negative matrix factorization method was applied to identify muscle synergies, representing the spatial and temporal organization of muscle coordination. The number of muscle synergies was not different between Nordic walking (5.2 ± 0.4) and conventional walking (5.0 ± 0.7, P = .423). Five muscle synergies accounted for 91.2 ± 1.1% and 92.9 ± 1.2% of total EMG variance in Nordic walking and conventional walking, respectively. Similarity and cross-reconstruction analyses showed that 4 muscle synergies, mainly involving lower-limb and trunk muscles, are shared between Nordic walking and conventional walking. One synergy acting during upper limb propulsion is specific to Nordic walking, modifying the spatial organization and the magnitude of activation of upper limb muscles compared to conventional walking. The inclusion of the poling action in Nordic walking does not increase the complexity of movement control and does not change the coordination of lower limb muscles. This makes Nordic walking a physical activity suitable also for people with low motor skill.

Cross-country skiing movement factorization to explore relationships between skiing economy and athletes' skills.

We investigated the relationships between the biomechanics of the double poling (DP) technique in cross-country skiing, its economy, and athletes' skill. To this aim, skiers' motion has been factorized into components through principal component analysis (PCA). Eight high-level (HL) and eight regional level (RL) male cross-country skiers performed a 5-minute submaximal DP trial while roller skiing on a treadmill at 14 km h-1 and 2° incline. Whole-body kinematics was recorded with a motion capture system. PCA was applied to markers coordinates to extract principal movements (PMk ), which were ranked by their variance. Energy cost (EC) of locomotion was calculated from ergospirometric measurements. Results showed that 96.7%±0.6% of total skiing pattern variance can be described with the first three PMk. (Shoulder and trunk flexion-extension are described PM1 and PM2 and elbow flexion-extension are mainly represented in PM2 and PM3. The variance of further components, consisting of residual movements (eg, slow postural changes or high-frequency vibrations), was greater for the RL than the HL skiers (4.0%±0.5% vs 2.6%±0.3%; P<.001) and was positively correlated with EC (R2 =.646; P<.001). PCA permitted to describe the biomechanics of the DP technique through a limited set of principal movements. Skiing skills and economy appeared to be related to a skier's ability to simplify movement complexity, suggesting that an efficient skier is better able to reduce superfluous movement components during DP.

Changes in upper and lower body muscle involvement at increasing double poling velocities: an ecological study.

This study evaluated muscle activity changes in different body compartments during on-snow double poling at increasing velocities. 21 well-trained, male cross-country skiers performed five 3-min double poling trials on a snowy track at 15, 16.5, 18, 19.5, and 21 km/h (set by an audio-pace system). A sixth trial was performed by maintaining a constant maximal speed. Actual skiing velocities were verified using a photocell system. Only 11 subjects met the pre-defined inclusion criteria during the trials and were included in the data analysis. Electromyographical signals from seven muscles, wrist acceleration and heart rate during the last minute of each trial were recorded. Cycle and poling times were measured from acceleration signals; mean muscular activation over a cycle was calculated for each muscle. With increasing double poling velocities from aerobic to maximal intensity (from 65% to 100% of maximal heart rate), upper limb muscles activation was maintained constant (P > 0.05), while trunk and lower limb involvement increased significantly (P < 0.01) with a linear trend. Rectus abdominis and rectus femoris muscles showed the higher rate of change. Trunk and lower limbs provide a progressively greater contribution to the propulsion when increasing double poling velocities are performed, to support the limited capacity of exercise response of upper body muscles. The remarkable rate of involvement of the muscles near the core region of the body becomes strategic to cope with the increased demands of propulsive power.

Central and peripheral fatigue in knee and elbow extensor muscles after a long-distance cross-country ski race.

Although elbow extensors (EE) have a great role in cross-country skiing (XC) propulsion, previous studies on neuromuscular fatigue in long-distance XC have investigated only knee extensor (KE) muscles. In order to investigate the origin and effects of fatigue induced by long-distance XC race, 16 well-trained XC skiers were tested before and after a 56-km classical technique race. Maximal voluntary isometric contraction (MVC) and rate of force development (RFD) were measured for both KE and EE. Furthermore, electrically evoked double twitch during MVC and at rest were measured. MVC decreased more in KE (-13%) than in EE (-6%, P = 0.016), whereas the peak RFD decreased only in EE (-26%, P = 0.02) but not in KE. The two muscles showed similar decrease in voluntary activation (KE -5.0%, EE -4.8%, P = 0.61) and of double twitch amplitude (KE -5%, EE -6%, P = 0.44). A long-distance XC race differently affected the neuromuscular function of lower and upper limbs muscles. Specifically, although the strength loss was greater for lower limbs, the capacity to produce force in short time was more affected in the upper limbs. Nevertheless, both KE and EE showed central and peripheral fatigue, suggesting that the origins of the strength impairments were multifactorial for the two muscles.

Biomechanical analysis of the herringbone technique as employed by elite cross-country skiers.

This investigation was designed to analyse the kinematics and kinetics of cross-country skiing at different velocities with the herringbone technique on a steep incline. Eleven elite male cross-country skiers performed this technique at maximal, high, and moderate velocities on a snow-covered 15° incline. They positioned their skis laterally (25 to 30°) with a slight inside tilt and planted their poles laterally (8 to 12°) with most leg thrust force exerted on the inside forefoot. Although 77% of the total propulsive force was generated by the legs, the ratio between propulsive and total force was approximately fourfold higher for the poles. The cycle rate increased with velocity (1.20 to 1.60 Hz), whereas the cycle length increased from moderate up to high velocity, but then remained the same at maximal velocity (2.0 to 2.3 m). In conclusion, with the herringbone technique, the skis were angled laterally without gliding, with the forces distributed mainly on the inside forefoot to enable grip for propulsion. The skiers utilized high cycle rates with major propulsion by the legs, highlighting the importance of high peak and rapid generation of leg forces.

Effects of a similar amount of regular non-structured or competitive physical activity across late adulthood: a cross-sectional study.

Introduction: Master athletes are examples of successful aging. It is not clear whether it is the competitive-oriented training or just the amount of total regular exercise that reduces the age-related decline in physiological functions. We aimed to compare health-related parameters in competitive (C) and physically active older adults (A) that performed the same weekly physical activity (PA) amount. Methods: Seventeen C and 17 A were matched for age (8 and 9 male participants under and over 70 years old respectively, for both groups) and weekly PA amount (GPAQ). Body composition, leg and arm maximal strength, balance and reaction time were measured; moreover, leg and arm exercise efficiency, estimated VO2max, and VO2/HR relationships were evaluated. Perception of life and sleep quality was also assessed through specific questionnaires (SF-36 and PSQI). The effect of group (C vs. A), age (U70 vs. O70) and their interaction was examined through a Two-Way ANOVA test. Results: C dedicated more time to vigorous PA compared to A (p = 0.03), while less to moderate daily work (p < 0.01) and active commuting (p = 0.06). C exhibited better body composition (all p < 0.05), higher leg maximal strength (p < 0.05) and a trend for elevated arm strength (p = 0.06). Reaction time, leg and arm cycling efficiency were similar in the two groups (all p > 0.05), while balance reduced in A O70. Estimated VO2max was higher for C in leg cycling (p = 0.05) and remained constant across ages (all p > 0.05). VO2/HR relationship, life and sleep quality did not differ for groups and ages. Conclusions: Regular physical exercise of about 6,000 METs/week seems to have a beneficial effect on health-related parameters, both in non-structured and competitive PA, when compared to sedentary behaviour. However, the older adults engaged in competitive training exhibit further advantages: better body composition, higher arm and leg muscle strength, and higher leg VO2max. This study highlights the importance of encouraging active lifestyles for maintaining long-term health, high levels of life quality perception and reducing age-related decline. However, vigorous training suitability needs to be verified by a team of PA specialists.

Poling force analysis in diagonal stride at different grades in cross country skiers.

The aim of this study was to characterize the dynamic parameters of poling action during low to moderate uphill skiing in the diagonal stride technique. Twelve elite cross country skiers performed an incremental test using roller skis on a treadmill at 9 km/h at seven different grades, from 2° to 8°. The pole ground reaction force and the pole inclination were measured, and the propulsive force component and poling power were then calculated. The duration of the active poling phase remained unchanged, while the recovery time decreased with the increase in the slope. The ratio between propulsive and total poling forces (effectiveness) was approximately 60% and increased with the slope. Multiple regression estimated that approximately 80% of the variation of the poling power across slopes was explained by the increase of the poling force, the residual variation was explained by the decrease of the pole inclination, while a small contribution was provided by the increase of the poling relative to the cycle time. The higher power output required to ski at a steeper slope was partially supplied by a greater contribution of the power generated through the pole that arises not only by an increase of the force exerted but also by an increase of its effectiveness.

Assessment of the reliability of a custom built Nordic Ski Ergometer for cross-country skiing power test.

AIM: Despite the recent development of cross-country ski technique having led to an increase in the importance of upper body power, there is a substantial lack of specific equipment for upper body force and power evaluation. In order to achieve good reproducibility of the skiing motion, a new upper body ergometer has been developed in our lab and tested by elite cross-country skiers. In this study, the reliability of this device was assessed comparing upper body power measurements with double poling ski performance in the field. METHODS: The new apparatus consists of an electric motor acting as load and actively controlled by a personal computer on the basis of force and velocity data. Nine cross-country skiers (age: 21.7+/-3.12 years; body weight: 72.2+/-3.8 kg), competing at international level, performed a ski test on a 1.2 km long sprint track and a 50 s exercise on the Nordic Ski Ergometer. The velocity of the last section (180 m, slope 1.37%) of the track, performed using the double poling technique at maximal voluntary intensity, was related to the upper body power measured at the ergometer. RESULTS: Mean upper body power was 9.22+/-2.29 W kg(-1), while average velocity on the section considered was 6.66+/-0.67 m s(-1). A high correlation (R(2)=0.871) was found between upper body power and ski velocity. CONCLUSION: In addition to overcoming the main limitations that affect traditionally used equipment, the strong relationship between the parameters obtained with the new ergometer and ski velocity indicates their ability to assess athletes performance. The new apparatus could therefore be considered a ski specific testing equipment for cross-country skiers which is useful for reproducing upper body involvement in cross-country ski-ing in a laboratory setting.

Metabolic and kinematic parameters during walking with poles in Parkinson's disease.

In healthy people, energy expenditure is generally higher during walking with poles (WP) than during conventional walking (W). In persons with Parkinson's disease (PD), walking is slower and may be associated with greater energy consumption, stride-to-stride variability, and difficulty in regulating stride length. The aim of this study was to determine whether treadmill WP at three different speeds could induce changes in gait kinematics and oxygen consumption in PD patients. The study sample was 20 patients with mild-to-moderate PD and 20 age-matched healthy controls. Subjects underwent 5-min W and WP treadmill tests at three different speeds (2.5, 3.5, and 4.5 km/h). Metabolic and gait parameters (ventilation, gas exchange, stride count and length) were recorded. As compared with the healthy controls, higher energy consumption (P < 0.05) (and other metabolic parameters), shorter stride, and reduced cadence (P < 0.05) were observed for the PD patients, independent of the walking technique. All subjects were noted to take longer strides during WP (P < 0.001), especially at the lowest treadmill speed. However, significantly higher energy consumption was observed only for the healthy controls (P < 0.05). No changes in metabolic parameters during WP were recorded; however, a substantial improvement in gait cycle length was noted for the PD patients.

Characterization of arm-gun movement during air pistol aiming phase.

AIM: Air pistol shooting is a sport requiring extreme movement precision. The purpose of our study is to collect and analyze kinematic data of arm/gun complex during the pointing phase in order to characterize movement and between segment coordination by means of time and frequency domain analysis techniques. METHODS: Thirteen air pistol athletes participated to the recording sessions held at the 10 m shooting range. Kinematic data of neck, shoulder, elbow, wrist and gun were collected during the aiming phase using an optoelectronic motion capture system. Displacement series were split up in slow drift and tremor components. Amplitude of the movement of each segment and strength of the relationship between adjacent segments were estimated in time domain respectively by means of standard deviation and coefficient of regression. Moreover, coherence and phase spectral functions were calculated to assess between-segment coupling at different frequencies. RESULTS: Significantly larger movements were seen for slow drift component with respect to tremor one for all segments especially for lateral movements. Higher between segment correlation were found for lateral direction and for slow drift component. The coherence calculated on vertical series of tremor component showed significant coupling at 1.5 Hz and 5-7 Hz with phase opposition between wrist and gun motion at 5-7 Hz. CONCLUSIONS: Slow drift motion appears to affect mainly lateral movements and all the segments were equally involved indicating a probable origin in postural body sway. Vertical displacements could be referred to shoulder and wrist motion with features typical of physiological tremor. Quantitative characterization of segments displacements during aiming phase may serve as a basis for scientific evaluation and training in competitive precision shooting.

Improvement of the accuracy of noise measurements by the two-amplifier correlation method.

We present a novel method for device noise measurement, based on a two-channel cross-correlation technique and a direct "in situ" measurement of the transimpedance of the device under test (DUT), which allows improved accuracy with respect to what is available in the literature, in particular when the DUT is a nonlinear device. Detailed analytical expressions for the total residual noise are derived, and an experimental investigation of the increased accuracy provided by the method is performed.