Respiratory function in uncomplicated type 1 diabetes: Blunted during exercise even though normal at rest!

AIMS: Type 1 diabetes is associated with a substantially increased risk of impaired lung function, which may impair aerobic fitness. We therefore aimed to examine the ventilatory response during maximal exercise and the pulmonary diffusion capacity function at rest in individuals with uncomplicated type 1 diabetes. METHODS: In all, 17 adults with type 1 diabetes free from micro-macrovascular complications (glycated haemoglobin: 8.0 ± 1.3%), and 17 non-diabetic adults, carefully matched to the type 1 diabetes group according to gender, age, level of physical activity and body composition, participated in our study. Lung function was assessed by spirometry and measurements of the combined diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) at rest. Subjects performed a maximal exercise test during which the respiratory parameters were measured. RESULTS: At rest, DLCO (30.4 ± 6.1 ml min-1  mmHg-1 vs. 31.4 ± 5.7 ml min-1 mmHg-1 , respectively, p = 0.2), its determinants Dm (membrane diffusion capacity) and Vc (pulmonary capillary volume) were comparable among type 1 diabetes and control groups, respectively. Nevertheless, spirometry parameters (forced vital capacity = 4.9 ± 1.0 L vs. 5.5 ± 1.0 L, p < 0.05; forced expiratory volume 1 = 4.0 ± 0.7 L vs. 4.3 ± 0.7 L, p < 0.05) were lower in individuals with type 1 diabetes, although in the predicted normal range. During exercise, ventilatory response to exercise was different between the two groups: tidal volume was lower in type 1 diabetes vs. individuals without diabetes (p < 0.05). Type 1 diabetes showed a reduced VO2max (34.7 ± 6.8 vs. 37.9 ± 6.3, respectively, p = 0.04) in comparison to healthy subjects. CONCLUSIONS: Individuals with uncomplicated type 1 diabetes display normal alveolar-capillary diffusion capacity and at rest, while their forced vital capacity, tidal volumes and VO2 are reduced during maximal exercise.

Multiple Sustainable Benefits of a Rehabilitation Program in Therapeutic Management of Hypermobile Ehlers-Danlos Syndrome: A Prospective and Controlled Study at Short- and Medium-Term.

OBJECTIVE: To evaluate the effects of a 9-week rehabilitation program (RP) for patients with hypermobile Ehlers-Danlos syndrome (hEDS) in the short- and medium-term. DESIGN: Nonrandomized controlled trial with 6 months follow-up. SETTING: Outpatient rehabilitation program. PARTICIPANTS: A referred sample of 36 hEDS patients were assessed for eligibility (N=36), 25 were included, 22 completed the RP and 19 completed the follow-up. INTERVENTIONS: A 9 -week control period without intervention followed by a 9-week RP. MAIN OUTCOME MEASURE: Functional exercise capacity was used as a primary outcome measure. Balance, kinesiophobia, fatigue, pain, quality of life, anxiety, depression, and hyperventilation were measured as secondary outcomes. RESULTS: No significant change was observed during the 9-week control period before the RP. There was a significant improvement immediately after the RP for the functional exercise capacity, balance with eyes closed, fatigue, and quality of life (P<.05). Even more improvements were found 6 weeks after the end of the RP, and there was still an improvement after 6 months in functional exercise capacity, kinesiophobia, depression, hyperventilation, and some components of the quality of life. CONCLUSION: This study supports the effectiveness of an RP as a useful management tool for hEDS patients.

The effect of acute heat exposure on the determination of exercise thresholds from ramp and step incremental exercise.

PURPOSE: The aim of this study was to examine how respiratory (RT) and lactate thresholds (LT) are affected by acute heat exposure in the two most commonly used incremental exercise test protocols (RAMP and STEP) for functional evaluation of aerobic fitness, exercise prescription and monitoring training intensities. METHODS: Eleven physically active male participants performed four incremental exercise tests, two RAMP (30 W·min-1) and two STEP (40 W·3 min-1), both in 18 °C (TEMP) and 36 °C (HOT) with 40% relative humidity to determine 2 RT and 16 LT, respectively. Distinction was made within LT, taking into account the individual lactate kinetics (LTIND) and fixed value lactate concentrations (LTFIX). RESULTS: A decrease in mean power output (PO) was observed in HOT at LT (-6.2 ± 1.9%), more specific LTIND (-5.4 ± 1.4%) and LTFIX (-7.5 ± 2.4%), compared to TEMP, however not at RT (-1.0 ± 2.7%). The individual PO difference in HOT compared to TEMP over all threshold methods ranged from -53 W to +26 W. Mean heart rate (HR) did not differ in LT, while it was increased at RT in HOT (+10 ± 8 bpm). CONCLUSION: This study showed that exercise thresholds were affected when ambient air temperature was increased. However, a considerable degree of variability in the sensitivity of the different threshold concepts to acute heat exposure was found and a large individual variation was noticed. Test design and procedures should be taken into account when interpreting exercise test outcomes.

Critical power, W' and W' reconstitution in women and men.

PURPOSE: The aim of this study was to compare critical power (CP) and work capacity W', and W' reconstitution (W'REC) following repeated maximal exercise between women and men. METHODS: Twelve women ([Formula: see text]O2PEAK: 2.53 ± 0.37 L·min-1) and 12 men ([Formula: see text]O2PEAK: 4.26 ± 0.30 L·min-1) performed a minimum of 3 constant workload tests, to determine CP and W', and 1 maximal exercise repetition test with three work bouts (WB) to failure, to quantify W'REC during 2 recovery periods, i.e., W'REC1 and W'REC2. An independent samples t test was used to compare CP and W' values between women and men, and a repeated-measures ANOVA was used to compare W'REC as fraction of W' expended during the first WB, absolute W'REC, and normalized to lean body mass (LBM). RESULTS: CP normalized to LBM was not different between women and men, respectively, 3.7 ± 0.5 vs. 4.1 ± 0.4 W·kgLBM-1, while W' normalized to LBM was lower in women 256 ± 29 vs. 305 ± 45 J·kgLBM-1. Fractional W'REC1 was higher in women than in men, respectively, 74.0 ± 12.0% vs. 56.8 ± 9.5%. Women reconstituted less W' than men in absolute terms (8.7 ± 1.2 vs. 10.9 ± 2.0 kJ) during W'REC1, while normalized to LBM no difference was observed between women and men (174 ± 23 vs. 167 ± 31 J·kgLBM-1). W'REC2 was lower than W'REC1 both in women and men. CONCLUSION: Sex differences in W'REC (absolute women < men; fractional women > men) are eliminated when LBM is accounted for. Prediction models of W'REC might benefit from including LBM as a biological variable in the equation. This study confirms the occurrence of a slowing of W'REC during repeated maximal exercise.

Evidence of ventilatory constraints during exercise in hypermobile Ehlers-Danlos syndrome.

PURPOSE: Hypermobile Ehlers-Danlos syndrome (hEDS) is a connective tissue disorder with many different symptoms such as pain, fatigue, dysautonomia, or respiratory symptoms. Among the respiratory manifestations described, the most frequent are exertional dyspnea and breathing difficulties. Mechanical ventilatory constraints during exercise could participate in these respiratory manifestations. The objective of this study was to explore the response of pulmonary flow-volume loops to exercise in patients with hEDS and to look for dynamic hyperinflation and expiratory flow limitation during exercise. METHODS: For this purpose, breathing pattern and tidal exercise flow-volume loops were recorded at two workloads (30% and 80% of the peak power output) of a constant load exercise test. RESULTS: Twelve patients were included (11 women, mean age 41 ± 14 years). The results showed a decrease (p = 0.028) in the inspiratory capacity (from 3.12 ± 0.49 L to 2.97 ± 0.52 L), an increase (p = 0.025) in the end-expiratory lung volume (from 0.73 ± 0.68 L to 0.88 ± 0.66 L, i.e., from EELV comprising 17 ± 12% to 21 ± 12% of forced vital capacity) between the two workloads in favor of dynamic hyperinflation, and half of the patients had expiratory flow limitations. CONCLUSION: This exploratory study provides evidence for mechanical ventilatory constraints during exercise in patients with hEDS, which may induce discomfort during exercise and could contribute to the respiratory symptomatology. TRIAL REGISTRATION NUMBER: This study is part of a larger clinical trial (ID: NCT04680793, December 2020).

Changes in Pulmonary Function After Long-duration Adventure Racing in Adolescent Athletes.

The present study investigated the acute effects of a mixed-modality, long-duration adventure race on pulmonary function in adolescent athletes. Twenty male adolescents aged 14 to 17 years volunteered to participate in a wilderness adventure race of 68.5-km. Expiratory function was evaluated before, immediately after, and 24 h after race completion. Measurements included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF). Maximal inspiratory and expiratory mouth static pressures (MIP and MEP, respectively) were also measured using a portable hand-held mouth pressure meter across the same time points. The mean completion time of the race was 05:38±00:20 hours. A significant post-race decrease in FVC was observed immediately after the race (-5.2%, p=0.01). However, no significant changes were observed for FEV1, PEF and the FEV1/FVC and FEV1/PEF ratios. In addition, estimates of respiratory muscle strength (MIP and MEP) were unaffected by the race. The long-duration adventure race induced no marked reduction in expiratory pulmonary function and this response was associated with no apparent respiratory muscle fatigue. Therefore, the pulmonary system of trained adolescent athletes was sufficiently robust to sustain the mixed-modality, long-duration adventure race of ~ 5-6 h.

Influence of grade of obesity on the achievement of VO2max using an incremental treadmill test in youths.

The purpose of this study was to analyze the influence of grade of obesity on the probability of achieving a VO2 plateau and threshold secondary criteria for verifying VO2max during a treadmill walk test in youths with obesity. Therefore, 72 youths with obesity (aged 8-16) performed an incremental treadmill walk test to exhaustion during which oxygen uptake (VO2), minute ventilation (VE), heart rate (HR) and rating of perceived exertion were continuously measured. HR corresponding to a "hard" level of perceived exertion was reported and expressed as a percentage of the predicted HRmax. The rate of achievement of criteria for validation VO2max (VO2 plateau; HR>95% theoretical HRmax; RER>1.0; rating of perceived exertion ≥ "hard") was compared between participants with grade I and grade II obesity. 37% of the participants achieved a VO2 plateau and 23% achieved both an HR>95% and RER >1.0. Youths with grade II obesity had lower minute ventilation (p<0.01) tended to be more likely to reach an HR>95% (OR = 0.33; P=0.06) and a "hard" rating of perceived exertion than grade I (OR = 4.5; P=0.07). However, there was no influence of grade of obesity on the achievement of VO2 plateau, and RER>1.0.

Implication of Blood Rheology and Pulmonary Hemodynamics on Exercise-Induced Hypoxemia at Sea Level and Altitude in Athletes.

This study aimed to investigate the changes in blood viscosity, pulmonary hemodynamics, nitric oxide (NO) production, and maximal oxygen uptake (V˙O2max) during a maximal incremental test conducted in normoxia and during exposure to moderate altitude (2,400 m) in athletes exhibiting exercise-induced hypoxemia at sea level (EIH). Nine endurance athletes with EIH and eight without EIH (NEIH) performed a maximal incremental test under three conditions: sea level, 1 day after arrival in hypoxia, and 5 days after arrival in hypoxia (H5) at 2,400 m. Gas exchange and oxygen peripheral saturation (SpO2) were continuously monitored. Cardiac output, pulmonary arterial pressure, and total pulmonary vascular resistance were assessed by echocardiography. Venous blood was sampled before and 3 min after exercise cessation to analyze blood viscosity and NO end-products. At sea level, athletes with EIH exhibited an increase in blood viscosity and NO levels during exercise while NEIH athletes showed no change. Pulmonary hemodynamics and aerobic performance were not different between the two groups. No between-group differences in blood viscosity, pulmonary hemodynamics, and V˙O2max were found at 1 day after arrival in hypoxia. At H5, lower total pulmonary vascular resistance and greater NO concentration were reported in response to exercise in EIH compared with NEIH athletes. EIH athletes had greater cardiac output and lower SpO2 at maximal exercise in H5, but no between-group differences occurred regarding blood viscosity and V˙O2max. The pulmonary vascular response observed at H5 in EIH athletes may be involved in the greater cardiac output of EIH group and counterbalanced the drop in SpO2 in order to achieve similar V˙O2max than NEIH athletes.

Immediate and 6-week after effects of a rehabilitation program for Ehlers-Danlos syndrome hypermobile type patients: A retrospective study.

Ehlers-Danlos syndromes (EDS) are a group of inherited connective tissue disorders with an impaired quality of life in association with fatigue, pain, and kinesiophobia. A retrospective evaluation of the effects of an outpatient rehabilitation program (RP) was performed in Ehlers-Danlos syndrome hypermobile type (hEDS) patients. The 6-minute walk test (6MWT) was used to evaluate functional capacity. Kinesiophobia, fatigue, pain, and quality of life were self-evaluated at the start, at the end, and 6 weeks after the end of the RP. The retrospective analysis of patients' records showed significant improvement for the walked distance during the 6MWT (491.8 ± 72.5 vs. 439.4 ± 100.9 m) maintained at 6-week follow-up (p = .001), significant improvement for kinesiophobia (p = .033) and the impact of fatigue on activity (p = .01), and significant increase for quality of life with in particular improvements of vitality (p = .001). This retrospective study showed encouraging results of a RP for hEDS patients on functional capacity and quality of life, and prospective studies with long-term follow-up are needed to confirm them.

Physiological adaptations to repeated sprint training in hypoxia induced by voluntary hypoventilation at low lung volume.

PURPOSE: This study investigated the effects of repeated-sprint (RS) training in hypoxia induced by voluntary hypoventilation at low lung volume (RSH-VHL) on physiological adaptations, RS ability (RSA) and anaerobic performance. METHODS: Over a 3-week period, eighteen well-trained cyclists completed six RS sessions in cycling either with RSH-VHL or with normal conditions (RSN). Before (Pre) and after (Post) the training period, the subjects performed an RSA test (10 × 6-s all-out cycling sprints) during which oxygen uptake [Formula: see text] and the change in both muscle deoxyhaemoglobin (Δ[HHb]) and total haemoglobin (Δ[THb]) were measured. A 30-s Wingate test was also performed and maximal blood lactate concentration ([La]max) was assessed. RESULTS: At Post compared to Pre, the mean power output during both the RSA and the Wingate tests was improved in RSH-VHL (846 ± 98 vs 911 ± 117 W and 723 ± 112 vs 768 ± 123 W, p < 0.05) but not in RSN (834 ± 52 vs 852 ± 69 W, p = 0.2; 710 ± 63 vs 713 ± 72 W, p = 0.68). The average [Formula: see text] recorded during the RSA test was significantly higher in RSH-VHL at Post but did not change in RSN. No change occurred for Δ[THb] whereas Δ[HHb] increased to the same extent in both groups. [Lamax] after the Wingate test was higher in RSH-VHL at Post (13.9 ± 2.8 vs 16.1 ± 3.2 mmol L-1, p < 0.01) and tended to decrease in RSN (p = 0.1). CONCLUSIONS: This study showed that RSH-VHL could bring benefits to both RSA and anaerobic performance through increases in oxygen delivery and glycolytic contribution. On the other hand, no additional effect was observed for the indices of muscle blood volume and O2 extraction.

Cerebral and Muscle Oxygenation during Repeated Shuttle Run Sprints with Hypoventilation.

Ten highly-trained Jiu-Jitsu fighters performed 2 repeated-sprint sessions, each including 2 sets of 8 x ~6 s back-and-forth running sprints on a tatami. One session was carried out with normal breathing (RSN) and the other with voluntary hypoventilation at low lung volume (RSH-VHL). Prefrontal and vastus lateralis muscle oxyhemoglobin ([O2Hb]) and deoxyhemoglobin ([HHb]) were monitored by near-infrared spectroscopy. Arterial oxygen saturation (SpO2), heart rate (HR), gas exchange and maximal blood lactate concentration ([La]max) were also assessed. SpO2 was significantly lower in RSH-VHL than in RSN whereas there was no difference in HR. Muscle oxygenation was not different between conditions during the entire exercise. On the other hand, in RSH-VHL, cerebral oxygenation was significantly lower than in RSN (-6.1±5.4 vs-1.5±6.6 µm). Oxygen uptake was also higher during the recovery periods whereas [La]max tended to be lower in RSH-VHL. The time of the sprints was not different between conditions. This study shows that repeated shuttle-run sprints with VHL has a limited impact on muscle deoxygenation but induces a greater fall in cerebral oxygenation compared with normal breathing conditions. Despite this phenomenon, performance is not impaired, probably because of a higher oxygen uptake during the recovery periods following sprints.

Trunk Muscle Aerobic Metabolism Responses in Endurance Athletes, Combat Athletes and Untrained Men.

This study investigated aerobic metabolism responses in trunk muscles during a prolonged trunk extension exercise in athletes and untrained young men. The aim was to analyze the adaptations induced by 2 types of sports: one involving intensive use of trunk muscles (i. e., judo), and one known to induce high aerobic capacity in the whole body (i. e., cycling). Eleven judokas, 10 cyclists and 9 healthy untrained young men performed trunk extension exercises on an isokinetic dynamometer. During the first session, muscle strength was assessed during maximal trunk extension. During a second session, a 5-min exercise was performed to investigate aerobic responses with regard to trunk muscles. The near infrared spectroscopy technique and a gas exchange analyzer were used continuously to evaluate mechanical efficiency, V̇O2 on-set kinetics, trunk muscle deoxygenation and blood volume. Judokas showed greater trunk strength and mechanical efficiency (p<0.05). Cyclists presented faster V̇O2 on-set kinetics (p<0.05) and greater muscle deoxygenation and blood volume compared to untrained men (p<0.001). These results suggest that practicing judo improves trunk extension efficiency whereas cycling accelerates aerobic pathways and enhances microvascular responses to trunk extension exercise. Sport practice improves aerobic metabolism responses in trunk extensor muscles differently, according to the training specificities.

Acute effects of repeated cycling sprints in hypoxia induced by voluntary hypoventilation.

PURPOSE: This study aimed to investigate the acute responses to repeated-sprint exercise (RSE) in hypoxia induced by voluntary hypoventilation at low lung volume (VHL). METHODS: Nine well-trained subjects performed two sets of eight 6-s sprints on a cycle ergometer followed by 24 s of inactive recovery. RSE was randomly carried out either with normal breathing (RSN) or with VHL (RSH-VHL). Peak (PPO) and mean power output (MPO) of each sprint were measured. Arterial oxygen saturation, heart rate (HR), gas exchange and muscle concentrations of oxy-([O2Hb]) and deoxyhaemoglobin/myoglobin ([HHb]) were continuously recorded throughout exercise. Blood lactate concentration ([La]) was measured at the end of the first (S1) and second set (S2). RESULTS: There was no difference in PPO and MPO between conditions in all sprints. Arterial oxygen saturation (87.7 ± 3.6 vs 96.9 ± 1.8% at the last sprint) and HR were lower in RSH-VHL than in RSN during most part of exercise. The changes in [O2Hb] and [HHb] were greater in RSH-VHL at S2. Oxygen uptake was significantly higher in RSH-VHL than in RSN during the recovery periods following sprints at S2 (3.02 ± 0.4 vs 2.67 ± 0.5 L min-1 on average) whereas [La] was lower in RSH-VHL at the end of exercise (10.3 ± 2.9 vs 13.8 ± 3.5 mmol.L-1; p < 0.01). CONCLUSIONS: This study shows that performing RSE with VHL led to larger arterial and muscle deoxygenation than with normal breathing while maintaining similar power output. This kind of exercise may be worth using for performing repeated sprint training in hypoxia.

Effect of pedaling cadence on muscle oxygenation during high-intensity cycling until exhaustion: a comparison between untrained subjects and triathletes.

PURPOSE: The aim of this study was to compare the muscle oxygenation between trained and untrained subjects during heavy exercise until exhaustion at two extreme pedaling cadences using a NIRS system. METHODS: Nine untrained male subjects and nine male competitive triathletes cycled until exhaustion at an intensity corresponding to 90 % of the power output achieved at peak oxygen uptake at 40 and 100 rpm. Gas exchanges were measured breath-by-breath during each exercise. Muscle (de)oxygenation was monitored continuously by near-infrared spectroscopy on the Vastus Lateralis. RESULTS: Muscle deoxygenation (∆deoxy[Hb + Mb], i.e., O2 extraction) and ∆total[Hb + Mb] were significantly higher at 40 rpm compared to 100 rpm during the exercise in untrained subjects but not in triathletes (p < 0.05). The time performed until exhaustion was significantly higher at 40 than at 100 rpm in untrained subjects (373 ± 55 vs. 234 ± 37 s, respectively) but not in triathletes (339 ± 69 vs. 325 ± 66 s). CONCLUSIONS: These results indicate that high aerobic fitness (1) allows for better regulation between [Formula: see text]O2M and VO2M following the change in pedaling cadence, and (2) is the most important factor in the relationship between pedaling cadence and performance.

Paraspinal muscle oxygenation and mechanical efficiency are reduced in individuals with chronic low back pain.

This study aimed to compare the systemic and local metabolic responses during a 5-min trunk extension exercise in individuals with chronic low back pain (CLBP) and in healthy individuals. Thirteen active participants with CLBP paired with 13 healthy participants performed a standardised 5-min trunk extension exercise on an isokinetic dynamometer set in continuous passive motion mode. During exercise, we used near-infrared spectroscopy to measure tissue oxygenation (TOI) and total haemoglobin-myoglobin (THb). We used a gas exchange analyser to measure breath-by-breath oxygen consumption (V̇O2) and carbon dioxide produced (V̇CO2). We also calculated mechanical efficiency. We assessed the intensity of low back pain sensation before and after exercise by using a visual analogue scale. In participants with CLBP, low back pain increased following exercise (+ 1.5 units; p < 0.001) and THb decreased during exercise (- 4.0 units; p = 0.043). Paraspinal muscle oxygenation (65.0 and 71.0%, respectively; p = 0.009) and mechanical efficiency (4.7 and 5.3%, respectively; p = 0.034) were both lower in participants with CLBP compared with healthy participants. The increase in pain sensation was related to the decrease in tissue oxygenation (R2 = - 0.420; p = 0.036). Decreases in total haemoglobin-myoglobin and mechanical efficiency could involve fatigability in exercise-soliciting paraspinal muscles and, therefore, exacerbate inabilities in daily life. Given the positive correlation between tissue oxygenation and exercise-induced pain exacerbation, muscle oxygenation may be related to persisting and crippling low back pain.

Physiological Responses to Supramaximal Running Exercise with End-Expiratory Breath Holding up to the Breaking Point.

This study aimed to assess the physiological responses to repeated running exercise performed at supramaximal intensity and with end-expiratory breath holding (EEBH) up to the breaking point. Eight male runners participated in two running testing sessions on a motorized treadmill. In the first session, participants performed two sets of 8 repetitions at 125% of maximal aerobic velocity and with maximum EEBH. Each repetition started at the onset of EEBH and ended at its release. In the second session, participants replicated the same procedure, but with unrestricted breathing (URB). The change in cerebral and muscle oxygenation (Δ[Hbdiff]), total haemoglobin concentration (Δ[THb]) and muscle reoxygenation were continuously assessed. End-tidal oxygen (PETO2) and carbon dioxide pressure (PETCO2), arterial oxygen saturation (SpO2) and heart rate (HR) were also measured throughout exercise.On average, EEBH was maintained for 10.1 ± 1 s. At the breaking point of EEBH, PETO2 decreased to 54.1 ± 8 mmHg, whereas PETCO2 increased to 74.8 ± 3.1 mmHg. At the end of repetitions, SpO2 (nadir values 74.9 ± 5.0 vs. 95.7 ± 0.8%) and HR were lower with EEBH than with URB. Cerebral and muscle Δ[Hbdiff] were also lower with EEBH, whereas this condition induced higher cerebral and muscle Δ[THb] and greater muscle reoxygenation. This study showed that performing repeated bouts of supramaximal running exercises with EEBH up to the breaking point induced a fall in arterial, cerebral and muscle oxygenation compared with the URB condition. These phenomena were accompanied by increases in regional blood volume likely resulting from compensatory vasodilation to preserve oxygen delivery to the brain and muscles.

Impairment of lung volume perception and breathing control in hypermobile Ehlers-Danlos syndrome.

Breathing difficulties and exertional dyspnea are frequently reported in hypermobile Ehlers-Danlos syndrome (hEDS); however, they are not clearly explained. An impaired proprioception or the addition of a cognitive task could influence ventilatory control. How can the perception of lung volume be measured? Is lung volume perception impaired in hEDS patients? Is the breathing control impaired during a cognitive task in hEDS patients? A device was developed to assess the accuracy of lung volume perception in patients with hEDS and matched control subjects. In the second step, ventilation was recorded in both groups with and without a cognitive task. Two groups of 19 subjects were included. The accuracy of lung volume perception was significantly (P < 0.01) lower at 30% of inspired vital capacity in patients with hEDS in comparison to the control group, and they showed erratic ventilation (based on spatial and temporal criteria) when performing a cognitive task. These data support the influence of the proprioceptive deficit on ventilatory control in hEDS patients. These elements may help to understand the respiratory manifestations found in hEDS. Future research should focus on this relationship between lung volume perception and ventilation, and could contribute to our understanding of other pathologies or exercise physiology.Trial registration number: ClinicalTrials.gov, NCT05000151.

Effect of high-intensity interval training on the profile of muscle deoxygenation heterogeneity during incremental exercise.

This study examines the effect of high-intensity interval training (HIT) on the spatial distribution of muscle deoxygenation during incremental exercise. Young untrained male adults (n = 11) performed an incremental bicycle exercise before and after a running HIT of 6 weeks. Muscle deoxygenation (HHb) and blood volume (Hb(tot)) were monitored continuously by near-infrared spectroscopy at eight sites in the vastus lateralis. The rise in HHb during incremental exercise was significantly higher after training, in comparison with before training (P = 0.020), whereas the rise in Hb(tot) was not affected by training. The standard deviation of HHb and the relative dispersion of HHb at the eight sites were not significantly different irrespective of the intensity of exercise between pre- and post-training. After training, the standard deviation of HHb was greater at 60, 70, and 80 % of VO2(max) than at rest. Finally, training significantly increased the standard deviation of Hb(tot) (P = 0.036). These results indicate that HIT changes the muscle deoxygenation profile during incremental exercise, suggesting an improvement in the O(2) extraction with training. HIT did not reduce the spatial heterogeneity of muscle deoxygenation and blood volume during incremental exercise. This indicates that the intra-muscular distribution of the VO(2)/O(2) delivery ratio was not improved by 6 weeks HIT.

Cerebral oxygenation during hyperoxia-induced increase in exercise tolerance for untrained men.

This study aimed to investigate the involvement of cerebral oxygenation in limitation of maximal exercise. We hypothesized that O2 supplementation improves physical performance in relation to its effect on cerebral oxygenation during exercise. Eight untrained men (age 27 ± 6 years; VO2 max 45 ± 8 ml min(-1) kg(-1)) performed two randomized exhaustive ramp exercises on a cycle ergometer (1 W/3 s) under normoxia and hyperoxia (FIO2 = 0.3). Cerebral (ΔCOx) and muscular (ΔMOx) oxygenation responses to exercise were monitored using near-infrared spectroscopy. Power outputs corresponding to maximal exercise intensity, to threshold of ΔCOx decline (ThCOx) and to the respiratory compensation point (RCP) were determined. Power output (W max = 302 ± 20 vs. 319 ± 28 W) and arterial O2 saturation estimated by pulse oximetry (SpO2 = 95.7 ± 0.9 vs. 97.0 ± 0.5 %) at maximal exercise were increased by hyperoxia (P < 0.05). However, the ΔMOx response during exercise was not significantly modified with hyperoxia. RCP (259 ± 17 vs. 281 ± 25 W) and ThCOx (259 ± 23 vs. 288 ± 30 W) were, however, improved (P < 0.05) with hyperoxia and the ThCOx shift was related to the W max improvement with hyperoxia (r = 0.71, P < 0.05). The relationship between the change in cerebral oxygenation response to exercise and the performance improvement with hyperoxia supports that cerebral oxygenation is limiting the exercise performance in healthy young subjects.