Aerobic high-intensity interval training and maximal strength training in patients with unspecific musculoskeletal disorders improve V̇O2peak and maximal strength more than moderate training.

Improving peak oxygen uptake (V̇O2peak) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although high-intensity training yield superior outcomes for these factors, patients with MSDs may not tolerate high-intensity due to pain and fear. Therefore, we examined the effect and feasibility of incorporating aerobic high-intensity intervals (HIITs) and maximal strength training (MST) in a standard clinical rehabilitation program for patients with unspecific MSDs. 73 patients (45 ± 10 years) with MSDs partaking in a standard, public, and 4-week rehabilitation program were randomized to high-intensity training (HG: 4 × 4 minutes intervals at ∼90% of maximal heart rate; HRmax, and 4 × 4 repetitions leg press at ∼90% of 1 repetition maximum; 1RM, with maximal intended velocity) or keep todays treatment of low-to moderate-intensity training (MG: various cycling, walking, and/or running activities at ∼70%-80% of HRmax and 3 × 8 - 10 repetitions leg press at ∼75% of 1RM without maximal intended velocity). HG improved V̇O2peak (12 ± 7%) and leg press 1RM (43 ± 34%) more than moderate-intensity group (V̇O2peak; 5 ± 6%, 1RM; 19 ± 18%, both p < 0.001). We observed that no adverse events and no between-group differences in dropout rate or self-reported quality of life (both p > 0.05). There were positive correlations between improved V̇O2peak and improved physical (p = 0.024) and emotional (0.016) role functioning. We conclude that both high-intensity interval training and MST are feasible and improve V̇O2peak and maximal strength more than standard low-to moderate-intensity treatment of patients with unspecific MSDs. Our findings suggest that high-intensity training should be implemented as a part of standard clinical care of this patient population.

Abdominal aerobic endurance exercise reveals spot reduction exists: A randomized controlled trial.

The existence of spot reduction, exercise-induced local body fat reduction, has been debated for half a century. Although the evidence is equivocal, no study has applied aerobic endurance training closely matching interventions for energy expenditure. Sixteen overweight (BMI: 29.8 ± 3.3(SD) kg m-2 ) males (43 ± 9 years) were randomized to: (1) abdominal endurance exercise (AG), combining treadmill running at 70% HRmax (27 min) with 4 × 4 min (30%-40% maximal strength, 1RM) of torso rotation and abdominal crunches (57 min), 4 days⋅week-1 for 10 weeks; or (2) control group (CG) performing only treadmill running (45 min) at 70% HRmax . Local fat mass was measured by dual-energy x-ray absorptiometry (DEXA), along with 1RM, and pulmonary oxygen uptake (to control energy expenditure during training). Trunk fat mass decreased more (697 g, 3%, p < 0.05) in AG (1170 ± 1093 g, 7%; p < 0.05) than in CG (no change). Total fat mass (AG: 1705 ± 1179 g, 6%; CG: 1134 ± 731 g, 5%; both p < 0.01) and body weight (AG: 1.2 ± 1.2 kg, 1%, p < 0.05; CG: 2.3 ± 0.9 kg, 3%, p < 0.01) decreased similarly in AG/CG. Torso rotation (AG: 32 ± 16 kg, 39%, p < 0.01; CG: no change) and abdominal crunch 1RM (AG: 35 ± 16 kg, 36%, p < 0.01; CG: 13 ± 12 kg, 17%, p < 0.05) increased more (p < 0.05/0.01) in AG than CG. Abdominal endurance exercise utilized more local fat than treadmill running, indicating that spot reduction exists in adult males.

Aerobic high-intensity intervals improve V̇O2max more than supramaximal sprint intervals in females, similar to males.

INTRODUCTION: Maximal oxygen uptake (V̇O2max ) is a pivotal factor for aerobic endurance performance. Recently, aerobic high-intensity interval training (HIIT) was documented to be superior to sprint interval training (SIT) in improving V̇O2max in well-trained males. However, as mounting evidence suggests that physiological responses to training are sex-dependent, examining the effects of HIIT versus SIT on V̇O2max , anaerobic capacity, and endurance performance in females is warranted. METHODS: We randomized 81 aerobically well-trained females (22 ± 2 years, 51.8 ± 3.6 mL∙kg-1 ∙min-1 V̇O2max ), training three times weekly for 8 weeks, to well-established protocols: (1) HIIT 4 × 4 min at ~95% of maximal aerobic speed (MAS), with 3 min active recovery (2) SIT 8 × 20 s at ~150% of MAS, with 10 s passive recovery (3) SIT 10 × 30 s at ~175% of MAS, with 3.5 min active recovery. RESULTS: Only HIIT 4 × 4 min increased V̇O2max (7.3 ± 3.1%), different from both SIT groups (all p < 0.001). Anaerobic capacity (maximal accumulated oxygen deficit) increased following SIT 8 × 20 s (6.5 ± 10.5%, p < 0.05), SIT 10 × 30 s (14.4 ± 13.7%, p < 0.05; different from HIIT 4 × 4 min, p < 0.05). SIT 10 × 30 s resulted in eight training-induced injuries, different from no injuries following HIIT 4 × 4 min and SIT 8 × 20 s (p < 0.001). All groups improved long-distance (3000-meter) and sprint (300-meter) running performance (all p < 0.001). SIT protocols improved sprint performance more than HIIT 4 × 4 min (p < 0.05). Compared to previous male results, no increase in V̇O2max following SIT 8 × 20 s (p < 0.01), and a higher injury rate for SIT 10 × 30 s (p < 0.001), were evident. CONCLUSIONS: In aerobically well-trained women, HIIT is superior to SIT in increasing V̇O2max while all-out treadmill running SIT is potentially more harmful.

Stroke volume response during prolonged exercise depends on left ventricular filling: evidence from a ß-blockade study.

Prolonged moderate-intensity exercise leads to a progressive upward drift in heart rate (HR) that may compromise stroke volume (SV). Alternatively, the HR drift may be related to abated SV due to impaired ventricular function. The aim of this study was to examine the effects of cardiovascular drift on left ventricular volumes and in turn SV. Thirteen healthy young males completed two 60-min cycling bouts on a semirecumbent cycle ergometer at 57% maximal oxygen consumption (V̇o2max) either under placebo condition (CON) or after ingesting a small dose of ß1-blockers (BB). Measurements of HR, end-diastolic volume (EDV), and end-systolic volume were obtained by echocardiography and used to calculate SV. Other variables such as ear temperature, skin temperature, blood pressure, and blood volume were measured to assess potential changes in thermoregulatory needs and loading conditions. HR drift was successfully prevented when using BB from min 10 to min 60 (128 ± 9 to 126 ± 8 beats/min, P = 0.29) but not in CON (134 ± 10 to 148 ± 10 beats/min, P < 0.01). Conversely, during the same time, SV increased by 13% when using BB (103 ± 9 to 116 ± 7 mL, P < 0.01), whereas it was unchanged in CON (99 ± 7 to 101 ± 9 mL, P = 0.37). The SV behavior was mediated by a 4% increase in EDV in the BB condition (164 ± 18 to 170 ± 18 mL, P < 0.01), whereas no change was observed in the CON condition (162 ± 18 to 160 ± 18 mL, P = 0.23). In conclusion, blocking HR drift enhances EDV and SV during prolonged exercise. These findings suggest that SV behavior is tightly related to filling time and loading conditions of the left ventricle.

Maximal aerobic and anaerobic power and time performance in 800 m double poling ergometer.

The purpose of this study was to investigate to what extent aerobic power (MAP), maximal anaerobic power (MANP), anaerobic capacity measured as time to exhaustion at 130% MAP (TTE), and maximal accumulated oxygen deficit (MAOD) correlated with 800 m double poling time trial performance (800TT) in a ski ergometer. A second aim was to investigate the relationship between TTE and MAOD, and to what extent TTE and MAOD would relate to anaerobic power reserve (APR). Eighteen cross-country skiers were tested for peak oxygen uptake (VO2peak) and oxygen cost of double poling to assess MAP. Peak power measurements during a 100 m TT were performed to assess MANP. TTE and an 800TT with continuous VO2 measurements were performed to assess time performance and MAOD. All tests were performed on a ski ergometer. Both MAP and MANP correlated strongly (r = - 0.936 and - 0.922, respectively, p < 0.01) with 800TT. Neither TTE nor MAOD correlated with 800TT. TTE correlated moderately with MAOD, both in mL kg-1 and in %VO2peak (r = 0.559, p < 0.05 and 0.621, p < 0.01, respectively). Both TTE and MAOD seemed to be a product of APR. These results suggest focusing on MAP and MANP, but not anaerobic capacity to explain time performance in an event with approximately 3 min duration.

Aerobic high-intensity intervals are superior to improve V̇O2max compared with sprint intervals in well-trained men.

Maximal oxygen uptake (V̇O2max ) may be the single most important factor for long-distance running performance. Interval training, enabling high intensity, is forwarded as the format that yields the largest increase in V̇O2max . However, it is uncertain if an optimal outcome on V̇O2max , anaerobic capacity, and running performance is provided by training with a high aerobic intensity or high overall intensity. Thus, we randomized 48 aerobically well-trained men (23 ± 3 years) to three commonly applied interval protocols, one with high aerobic intensity (HIIT) and two with high absolute intensity (sprint interval training; SIT), 3× week for 8 weeks: (1) HIIT: 4 × 4 min at ~95% maximal aerobic speed (MAS) with 3 min active breaks. (2) SIT: 8 × 20 s at ~150% MAS with 10 s passive breaks. (3) SIT: 10 × 30 s at ~175% MAS with 3.5 min active breaks. V̇O2max increased more (p < 0.001) following HIIT, 4 × 4 min (6.5 ± 2.4%, p < 0.001) than SIT, 8 × 20 s (3.3 ± 2.4%, p < 0.001) and SIT, 10 × 30 s (n.s.). This was accompanied by a larger (p < 0.05) increase in stroke volume (O2 -pulse) following HIIT, 4 × 4 min (8.1 ± 4.1%, p < 0.001) compared with SIT, 8 × 20 s (3.8 ± 4.2%, p < 0.01) and SIT, 10 × 30 (n.s.). Anaerobic capacity (maximal accumulated oxygen deficit) increased following SIT, 8 × 20 s (p < 0.05), but not after HIIT, 4 × 4 min, nor SIT, 10 × 30 s. Long-distance (3000-m) endurance performance increased (p < 0.05-p < 0.001) in all groups (HIIT, 4 × 4 min: 5.9 ± 3.2%; SIT, 8 × 20 s: 4.1 ± 3.7%; SIT, 10 × 30 s: 2.2 ± 2.2%), with HIIT increasing more than SIT, 10 × 30 s (p < 0.05). Sprint (300-m) performance exhibited within-group increases in SIT, 8 × 20 s (4.4 ± 2.0%) and SIT, 10 × 30 s (3.3 ± 2.8%). In conclusion, HIIT improves V̇O2max more than SIT. Given the importance of V̇O2max for most endurance performance scenarios, HIIT should typically be the chosen interval format.

Prediction of VO2max From Submaximal Exercise Using the Smartphone Application Myworkout GO: Validation Study of a Digital Health Method.

BACKGROUND: Physical inactivity remains the largest risk factor for the development of cardiovascular disease worldwide. Wearable devices have become a popular method of measuring activity-based outcomes and facilitating behavior change to increase cardiorespiratory fitness (CRF) or maximal oxygen consumption (VO2max) and reduce weight. However, it is critical to determine their accuracy in measuring these variables. OBJECTIVE: This study aimed to determine the accuracy of using a smartphone and the application Myworkout GO for submaximal prediction of VO2max. METHODS: Participants included 162 healthy volunteers: 58 women and 104 men (17-73 years old). The study consisted of 3 experimental tests randomized to 3 separate days. One-day VO2max was assessed with Metamax II, with the participant walking or running on the treadmill. On the 2 other days, the application Myworkout GO used standardized high aerobic intensity interval training (HIIT) on the treadmill to predict VO2max. RESULTS: There were no significant differences between directly measured VO2max (mean 49, SD 14 mL/kg/min) compared with the VO2max predicted by Myworkout GO (mean 50, SD 14 mL/kg/min). The direct and predicted VO2max values were highly correlated, with an R2 of 0.97 (P<.001) and standard error of the estimate (SEE) of 2.2 mL/kg/min, with no sex differences. CONCLUSIONS: Myworkout GO accurately calculated VO2max, with an SEE of 4.5% in the total group. The submaximal HIIT session (4 x 4 minutes) incorporated in the application was tolerated well by the participants. We present health care providers and their patients with a more accurate and practical version of health risk estimation. This might increase physical activity and improve exercise habits in the general population.

Maximal strength training in patients with inflammatory rheumatic disease: implications for physical function and quality of life.

PURPOSE: Patients with inflammatory rheumatic disease (IRD) have attenuated muscle strength in the lower extremities, resulting in impaired physical function and quality of life. Although maximal strength training (MST), applying heavy resistance, is documented to be a potent countermeasure for such attenuation, it is uncertain if it is feasible in IRD given the pain, stiffness, and joint swelling that characterize the population. METHODS: 23 patients with IRD (49 ± 13 years; 20 females/3 males), diagnosed with spondyloarthritis, rheumatoid arthritis, or systemic lupus erythematosus, were randomized to MST or a control group (CG). The MST group performed four × four repetitions dynamic leg press two times per week for 10 weeks at ~ 90% of one repetition maximum (1RM). Before and after training 1RM, rate of force development (RFD), and health-related quality of life (HRQoL) were measured. RESULTS: Session attendance in the MST group was 95%, of which 95% conducted according to MST protocol. Furthermore, MST increased 1RM (29 ± 12%, p = 0.001) and early and late phase RFD (33-76%, p < 0.05). All improvements were different from the CG (p < 0.05). MST also resulted in HRQoL improvements in the dimensions; physical functioning, general health, and vitality (p < 0.05). Physical functioning was associated with 1RM (rho = 0.55, p < 0.01) and early phase RFD (rho = 0.53-0.71, p < 0.01; different from CG p < 0.05). CONCLUSIONS: Despite being characterized by pain, stiffness, and joint swelling, patients with IRD appear to tolerate MST well. Given the improvements in 1RM, RFD, and HRQoL MST should be considered as a treatment strategy to counteract attenuated muscle strength, physical function, and HRQoL. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04998955, retrospectively registered.

Relationships Between Maximal Aerobic Speed, Lactate Threshold, and Double Poling Velocity at Lactate Threshold in Cross-Country Skiers.

Purpose: To investigate the relationships between maximal aerobic speed (MAS), lactate threshold in per cent of peak oxygen uptake (LT) and velocity at LT (LTv) in cross-country skiers. Secondly, we aimed to explore the fit of an equation previously used in cyclists and runners in a cohort of well-trained, competitive cross-country skiers for calculation of LTv. Thirdly, we aimed to investigate if a new LTv could still be calculated after a period of regular training only by providing a new MAS. Methods: Ninety-five competitive cross-country skiers (65 males and 30 females) were tested for maximal oxygen uptake (VO2max), peak oxygen uptake in double poling (DP-VO2peak), oxygen cost of double poling (CDP), LT, and LTv. Thirty-five skiers volunteered to be tested 3 months later to evaluate potential changes in LT and LTv. Results: Velocity at LT was mainly determined by MAS (r = 0.88, p < 0.01). LT did not show a significant impact on LTv. The product of MAS·LT precisely predicted LTv at baseline (r = 0.99, SEE = 2.4%), and by only measuring MAS, a new LTv could be accurately calculated (r = 0.92, SEE = 6.8%) 3 months later in a sub-set of the initial 95 skiers (n = 35). Conclusion: The results suggest that LT has minor impact on LTv in DP tested in a laboratory. LTv seemed to be predominantly determined by MAS, and we suggest to put more focus on MAS and less on LT and LTv in regular testing to evaluate aerobic performance capacity in DP.

Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial.

BACKGROUND: Aerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity. METHODS: This was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM). RESULTS: 73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6-21) points and 11 (95% CI 5-17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups. CONCLUSIONS: Patients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity. TRIALS REGISTRATION: Regional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738).

Heat tolerance during uncompensable heat stress in men and women wearing firefighter personal protective equipment.

Firefighters run a risk of heat strain during occupational tasks. The number of female firefighters has been increasing, but research relevant to this group is still scarce. We aimed to investigate whether there are any sex differences in heat tolerance or physiological responses during uncompensable heat stress while wearing firefighter personal protective equipment. Twelve female (28 ± 7 years, 66 ± 5 kg, 51.7 ± 4.7 mL kg-1 min-1) and 12 male (27 ± 7 years, 83 ± 8 kg, 58.8 ± 7.5 mL kg-1 min-1) participants performed walking (maximum of 60 min) at 6W·kg-1, 40 °C, and 14% relative humidity. No differences were observed between groups in heat tolerance, rectal temperature, heart rate, percent body mass loss, thermal sensation, and rate of perceived exertion. Thus, when personnel are selected using gender-neutral physical employment standards, sex is not an independent factor influencing heat tolerance when wearing firefighter personal protective equipment during uncompensable heat stress.

Smartphone-Assisted High-Intensity Interval Training in Inflammatory Rheumatic Disease Patients: Randomized Controlled Trial.

BACKGROUND: Patients with inflammatory rheumatic diseases (IRDs) experience disease-related barriers to physical training. Compared with the general population, IRD patients are reported to have reduced maximal oxygen uptake (VO2max) and physical activity levels. Supervised high-intensity interval training (HIIT) is documented to counteract the reduced VO2max and poor cardiovascular health associated with IRDs. However, supervised HIIT is resource demanding. OBJECTIVE: This study sought to investigate if self-administered 4×4-min HIIT guided by a smartphone app (Myworkout GO) could yield similar HIIT-induced effects as standard 4×4-min HIIT performed under the guidance and supervision of health care professionals. The effects studied were on VO2max and health-related quality of life (HRQoL). METHODS: Forty patients (33 female patients, mean age 48 years, SD 12 years; 7 male patients, mean age 52 years, SD 11 years) diagnosed with rheumatoid arthritis, spondyloarthritis, or systemic lupus erythematosus were randomized to a supervised group (SG) or an app group (AG). Both groups were instructed to perform 4×4-min intervals with a rate of perceived exertion of 16 to 17, corresponding to 85% to 95% of the maximal heart rate, twice a week for 10 weeks. Treadmill VO2max and HRQoL measured using RAND-36 were assessed before and after the exercise period. RESULTS: VO2max increased (P<.001) in both groups after 10 weeks of HIIT, with improvements of 3.6 (SD 1.3) mL/kg/min in the SG and 3.7 (SD 1.5) mL/kg/min in the AG. This was accompanied by increases in oxygen pulse in both groups (P<.001), with no between-group differences apparent for either measure. Improvements in the HRQoL dimensions of bodily pain, vitality, and social functioning were observed for both groups (P<.001 to P=.04). Again, no between-group differences were detected. CONCLUSIONS: High-intensity 4×4-min interval training increased VO2max and HRQoL, contributing to patients' reduced cardiovascular disease risk, improved health and performance, and enhanced quality of life. Similar improvements were observed following HIIT when IRD patients were guided using perceived exertion by health care professionals or the training was self-administered and guided by the app Myworkout GO. Utilization of the app may help reduce the cost of HIIT as a treatment strategy in this patient population. TRIAL REGISTRATION: ClinicalTrials.gov NCT04649528; https://clinicaltrials.gov/ct2/show/NCT04649528.

Effects of Individual Changes in Training Distribution on Maximal Aerobic Capacity in Well-Trained Cross-Country Skiers: A Follow-Up Study.

The purpose of this study was to evaluate individual changes in training distribution and the subsequent effects on maximal oxygen uptake (VO2max). The participants were well-trained cross-country skiers who had performed a year with no substantial changes in training prior to this study. Six cross-country skiers, who were participants in a larger previous study, volunteered for a follow-up study. All skiers performed self-motivated changes in training distribution for a new preparation period in this follow-up, generally by more high-intensity training (HIT). All training characteristics were registered from training diaries. During the follow-up period, all skiers performed an incremental VO2max test in February 2020 and August 2020. Training were categorized into three different training periods; (1) February 2019 to February 2020 (P 1) representing the training performed prior to the follow-up, (2) February 2020 to July 2020 (P 2), and (3) July 2020 to August 2020 (P 3). On average, the skiers increased their VO2max by 5.8 ± 5.0% (range: -1.8 to + 10.2%) during the follow-up study compared with the average VO2max during the preceding year. Total training volume increased on average by 10.0 and 25.7% in P 2 and P 3, respectively, compared with P 1. The average volume of HIT was similar between P 1 and P 2 but increased 62.8% in P 3. However, large individual differences in training changes were observed. In conclusion, the present study revealed that individual changes in training distribution generated an increased VO2max in four out of six already well-trained cross-country skiers. Reduced total training volume (three out of six) and increased (four out of six) HIT volume were the most marked changes.

Aerobic and Anaerobic Speed Predicts 800-m Running Performance in Young Recreational Runners.

The main aim was to investigate the impact of maximal aerobic speed (MAS), maximal anaerobic speed (MANS), and time to exhaustion (TTE) at 130% MAS, on 800-m running time performance (800TT). A second aim was to investigate the impact of anaerobic speed reserve (ASR), i.e., the relative difference between MAS and MANS, on TTE. A total of 22 healthy students classified as recreational runners participated in a cross-sectional study. They were tested for maximal oxygen consumption (VO2max), oxygen cost of running (CR), time performance at 100 m (100TT), time performance at 800 m (800TT), and TTE. MAS was calculated as VO2max × CR -1, and MANS was calculated as 100TT velocity. Both MAS and MANS correlated individually with 800TT (r = -0.74 and -0.67, respectively, p < 0.01), and the product of MAS and MANS correlated strongly (r = -0.82, p < 0.01) with 800TT. TTE did not correlate with 800TT. Both ASR and % MANS correlated strongly with TTE (r = 0.90 and -0.90, respectively, p < 0.01). These results showed that 800TT was first and foremost dependent on MAS and MANS, and with no impact from TTE. It seemed that TTE was merely a product of each runner's individual ASR. We suggest a simplified model of testing and training for 800TT, namely, by focusing on VO2max, CR, and short sprint velocity, i.e., MAS and MANS.

Responses to Maximal Strength Training in Different Age and Gender Groups.

PURPOSE: The present study aimed to investigate the potential impact of age, gender, baseline strength, and selected candidate polymorphisms on maximal strength training (MST) adaptations. METHODS: A total of 49 subjects (22 men and 27 women) aged 20-76 years, divided into five age groups, completed an 8 weeks MST intervention. Each MST session consisted of 4 sets with 4 repetitions at ∼85-90% of one-repetition maximum (1RM) intensity in leg-press, three times per week. 1RM was tested pre and post the intervention and blood samples were drawn to genotype candidate polymorphisms ACE I/D (rs1799752), ACTN3 R577X (rs1815739), and PPARGC1A Gly482Ser (rs8192678). RESULTS: All age groups increased leg-press 1RM (p < 0.01), with a mean improvement of 24.2 ± 14.0%. There were no differences in improvements between the five age groups or between male and female participants, and there were no non-responders. Baseline strength status did not correlate with 1RM improvements. PPARGC1A rs8192678 T allele carriers had a 15% higher age- and gender corrected baseline 1RM than the CC genotype (p < 0.05). C allele carriers improved 1RM (%) by 34.2% more than homozygotes for the T allele (p < 0.05). CONCLUSION: To the best of our knowledge, this is the first study to report improvement in leg-press maximal strength regardless of gender, baseline strength status in all age groups. The present study is also first to demonstrate an association between the PPARGC1A rs8192678 and maximal strength and its trainability in a moderately trained cohort. MST may be beneficial for good health and performance of all healthy individuals.

Effect of Aerobic Exercise Intensity on Energy Expenditure and Weight Loss in Severe Obesity-A Randomized Controlled Trial.

OBJECTIVE: This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure. METHODS: This was a single-center randomized controlled trial of patients with severe obesity allocated to a 24-week moderate-intensity continuous training (MICT) program or a combined MICT with high-intensity interval training (HIIT/MICT) program. The primary outcome was energy expenditure during exercise (EEDE). Secondary outcomes included resting metabolic rate, cardiorespiratory fitness, and body composition. RESULTS: A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per-protocol analysis showed that EEDE increased by 10% (95% CI: 3%-17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%-10%) in the MICT group (n = 24), with no differences between groups. In the 8- to 16- week per-protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively. CONCLUSIONS: Patients completing a 24-week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24-week MICT program. The HIIT/MICT group experienced, on average, a 3-kg-larger weight loss than the MICT group.

Improving Utilization of Maximal Oxygen Uptake and Work Economy in Recreational Cross-Country Skiers With High-Intensity Double-Poling Intervals.

PURPOSE: To investigate the effect of a double-poling (DP) high-intensity aerobic interval-training (HIT) intervention performed without increasing total HIT volume. This means that regular HIT training (eg, running) was replaced by HIT DP. The aim was to explore whether this intervention could improve peak oxygen uptake in DP, the fractional utilization of maximal oxygen uptake (VO2max) in DP, oxygen cost of DP, maximal aerobic speed, and a 3-km DP time trial. METHODS: Nine non-specially-DP-trained cross-country skiers (intervention group) and 9 national-level cross-country skiers (control group) were recruited. All participants were tested for VO2max in running, peak oxygen uptake in DP, oxygen cost of DP, and time-trial performance before and after a 6-wk, 3-times-per-week HIT DP intervention. The intervention group omitted all regular HIT with HIT in DP, leaving the total weekly amount of HIT unchanged. RESULTS: Seven participants in each group completed the study. VO2max in running remained unchanged in both groups, whereas peak oxygen uptake in DP improved by 7.1% (P = .005) in the intervention group. The fractional utilization of VO2max in DP thus increased by 7.3% (P = .019), oxygen cost of DP by 9.2% (P = .047), maximal aerobic speed by 16.5% (P = .009), and time trial by 19.5% (P = .004) in the intervention group but remained unchanged in the control group. CONCLUSIONS: The results indicate that a 6-wk HIT DP intervention could be an effective model to improve DP-specific capacities, with maintenance of VO2max in running.

No Change - No Gain; The Effect of Age, Sex, Selected Genes and Training on Physiological and Performance Adaptations in Cross-Country Skiing.

The aim was to investigate the effect of training, sex, age and selected genes on physiological and performance variables and adaptations before, and during 6 months of training in well-trained cross-country skiers. National-level cross-country skiers were recruited for a 6 months observational study (pre - post 1 - post 2 test). All participants were tested in an outside double poling time trial (TTDP), maximal oxygen uptake in running (RUN-VO2max), peak oxygen uptake in double poling (DP-VO2peak), lactate threshold (LT) and oxygen cost of double poling (CDP), jump height and maximal strength (1RM) in half squat and pull-down. Blood samples were drawn to genetically screen the participants for the ACTN3 R577X, ACE I/D, PPARGC1A rs8192678, PPARG rs1801282, PPARA rs4253778, ACSL1 rs6552828, and IL6 rs1474347 polymorphisms. The skiers were instructed to train according to their own training programs and report all training in training diaries based on heart rate measures from May to October. 29 skiers completed all testing and registered their training sufficiently throughout the study period. At pre-test, significant sex and age differences were observed in TTDP (p < 0.01), DP-VO2peak (p < 0.01), CDP (p < 0.05), MAS (p < 0.01), LTv (p < 0.01), 1RM half squat (p < 0.01), and 1RM pull-down (p < 0.01). For sex, there was also a significant difference in RUN-VO2max (p < 0.01). No major differences were detected in physiological or performance variables based on genotypes. Total training volume ranged from 357.5 to 1056.8 min per week between participants, with a training intensity distribution of 90-5-5% in low-, moderate- and high-intensity training, respectively. Total training volume and ski-specific training increased significantly (p < 0.05) throughout the study period for the whole group, while the training intensity distribution was maintained. No physiological or performance variables improved during the 6 months of training for the whole group. No differences were observed in training progression or training adaptation between sexes or age-groups. In conclusion, sex and age affected physiological and performance variables, with only a minor impact from selected genes, at baseline. However, minor to no effect of sex, age, selected genes or the participants training were shown on training adaptations. Increased total training volume did not affect physiological and performance variables.

Factors Influencing Running Velocity at Lactate Threshold in Male and Female Runners at Different Levels of Performance.

BACKGROUND: The primary aim was to examine the relationship between lactate threshold (LT) expressed as percentage of maximal oxygen uptake (VO2max) and running velocity at LT (LTV). A secondary aim was to investigate to what extent VO2max, oxygen cost of running (CR), and maximal aerobic speed (MAS) determined LTV. A third aim was to investigate potential differences in LT and LTV between elite, national and recreational runners, as well as possible gender differences regarding VO2max, CR, LT, and LTV. METHODS: Seventy-five competitive runners (37 males and 38 females) with an average VO2max of 63.0 ± 9.3 mL⋅kg-1⋅min-1, and an average LTV of 13.6 ± 2.3 km⋅h-1 were tested for VO2max, LT, LTV, MAS, and CR. RESULTS: Lactate threshold did not correlate with LTV. With an r - value of 0.95 (p < 0.001) and a standard error of estimate of 4.0%, the product of MAS and individual LT determined 90% of LTV, outside a range of ±0.27 km⋅h-1. LTV increased with higher performance level. However, LT did not differ between elite, national and recreational runners. Female runners had 2.5% higher LT, 8% lower LTV, and 21% lower VO2max, but 9% better CR than male runners. CONCLUSION: Lactate threshold did not correlate with LTV. The product of MAS and LT correlated strongly with LTV. There were no differences between elite, national and recreational runners regarding LT, but female runners had higher LT than the male runners. Female runners at the same relative performance level had lower LTV and VO2max, but better CR than male runners.

Large Inter-Individual Differences in Responses to a Block of High Intensity Aerobic Interval Training: A Case Series in National-level Cyclists and Triathletes.

The aim was to investigate individual responses on VO2max and performance to a block of high intensity aerobic interval training (HIIT) in national-level endurance athletes. METHODS: National-level cyclists and triathletes (five men and two women, 31 ± 3.3 years, VO2max 65.1 ± 3.3 ml·kg-1·min-1) conducted 14 HIIT sessions (4×4 min uphill running at 90-95% maximal heart rate) in nine days during preseason. VO2max in running and cycling, lactate threshold (LT) in cycling, oxygen cost of cycling (CC), and a cycling time-trial (TT) were tested two days pre and seven days post intervention. Feasibility was determined using attendance rates, adherence (defined as completing all sessions), and reported adverse events. RESULTS: The results showed that adherence was 100% with 100% attendance rate. No adverse events were reported. TT (-75.6 ± 50.8 seconds, p < 0.0001) but not VO2max cycling (-0.2 ± 4.6 ml×kg-1×min-1, p = 0.53) or running (0.2 ± 1.2 ml×kg-1×min-1, p = 0.85) was improved on group level. The individual responses varied from -8.2% to +14.5% change in VO2max, and -7.5% to +0.8% in TT. CONCLUSIONS: The large inter-individual differences in responses call for tailor-making HIIT blocks, mapping of biomarkers to avoid overtraining, and studying the effects of such blocks with longer follow-up than seven days.