Individual Changes in Respiratory Compliance Upon Immersion May Predict Susceptibility to Immersion Pulmonary Edema.

BACKGROUND: Immersion pulmonary edema (IPE) is a frequent diving accident, and it is the primary cause of hospitalization for young military divers during training. The objective of this study was to identify immersion-induced parameters predicting individual susceptibility to IPE. METHODS: Eighteen experienced male divers having completed at least 100 dives were recruited. Eight divers had previously been hospitalized for IPE (IPE), and the other ten had never developed IPE (non-IPE). The two groups were matched for age, BMI, and number of dives performed. Ventilatory function and overall compliance of the respiratory system (Crs) were measured on land and during head-out-of-water immersion. Subjects also performed 30 min of fin swimming in a channel at 33 m min-1. Following this exercise, the presence of extravascular lung water, revealed by ultrasound lung comets (ULC), was assessed. RESULTS: In the whole group, the decrease in Crs upon immersion correlated with the immersion-induced alterations to expiratory reserve volume, ERV (r2 = 0.91; p < 0.001), inspiratory reserve volume, IRV (r2 = 0.94; p < 0.001), and tidal volume, Vt, changes (r2 = 0.43; p < 0.003). The number of ULC correlated strongly with immersion-induced changes in ventilatory function (r2 = 0.818; p < 0.001 for ERV, r2 = 0.849; p < 0.001 for IRV, r2 = 0.304; p = 0.0164 for Vt) and reduced Crs (r2 = 0.19; p < 0.001). The variations of ERV, IRV, and Crs at rest induced by head-out-of-water immersion and the number of ULC measured after swimming for 30 min were significantly greater in IPE subjects. CONCLUSION: In the face of similar immersion stresses, the extent of alterations to ventilatory function and the number of ULCs were very different between individuals but remained statistically correlated. These parameters were significantly greater in divers with a history of IPE. Alterations to pulmonary function and, in particular, to pulmonary compliance induced by head-out-of-water immersion, through their effects on work of breathing appear to allow the identification of divers with a greater susceptibility to developing IPE. Measurement of these parameters could therefore be proposed as a predictive test for the risk of developing IPE.

Oxygen uptake ( V ˙ O2) and pulmonary ventilation ( V ˙ E) during military surface fin swimming in a swimming flume: Effects of surface immersion.

Introduction: During military fin swimming, we suspected that oxygen uptake ( V ˙ O2) and pulmonary ventilation ( V ˙ E) might be much higher than expected. In this framework, we compared these variables in the responses of trained military divers during land cycling and snorkeling exercises. Methods: Eighteen male military divers (32.3 ± 4.2 years; 178.0 ± 5.0 cm; 76.4 ± 3.4 kg; 24.1 ± 2.1 kg m-2) participated in this study. They performed two test exercises on two separate days: a maximal incremental cycle test (land condition), and an incremental fin swimming (fin condition) in a motorized swimming flume. Results: The respective fin and land V ˙ O2max were 3,701 ± 39 mL min-1 and 4,029 ± 63 mL min-1 (p = 0.07), these values were strongly correlated (r 2 = 0.78 p < 0.01). Differences in V ˙ O2max between conditions increased relative to l; V ˙ O2max (r 2 = 0.4 p = 0.01). Fin V ˙ E max values were significantly lower than land V ˙ E max values (p = 0.01). This result was related to both the significantly lower fin Vt and f (p < 0.01 and <0.04, respectively). Consequently, the fin V ˙ E max / V ˙ O2max ratios were significantly lower than the corresponding ratios for land values (p < 0.01), and the fin and land V ˙ E max were not correlated. Other parameters measured at exhaustion-PaO2, PaCO2, and SO2 - were similar in fin and land conditions. Furthermore, no significant differences between land and fin conditions were observed for peak values for heart rate, blood lactate concentration, and respiratory exchange ratio R. Conclusion: Surface immersion did not significantly reduce the V ˙ O2max in trained divers relative to land conditions. As long as V ˙ O2 remained below V ˙ O2max , the V ˙ E values were identical in the two conditions. Only at V ˙ O2max was V ˙ E higher on land. Although reduced by immersion, V ˙ E max provided adequate pulmonary gas exchange during maximal fin swimming.

Targeting autonomic nervous system as a biomarker of well-ageing in the prevention of stroke.

Stroke prediction is a key health issue for preventive medicine. Atrial fibrillation (AF) detection is well established and the importance of obstructive sleep apneas (OSA) has emerged in recent years. Although autonomic nervous system (ANS) appears strongly implicated in stroke occurrence, this factor is more rarely considered. However, the consequences of decreased parasympathetic activity explored in large cohort studies through measurement of ANS activity indicate that an ability to improve its activity level and equilibrium may prevent stroke. In support of these observations, a compensatory neurostimulation has already proved beneficial on endothelium function. The available data on stroke predictions from ANS is based on many long-term stroke cohorts. These data underline the need of repeated ANS evaluation for the general population, in a medical environment, and remotely by emerging telemedicine digital tools. This would help uncovering the reasons behind the ANS imbalance that would need to be medically adjusted to decrease the risk of stroke. This ANS unbalance help to draw attention on clinical or non-clinical evidence, disclosing the vascular risk, as ANS activity integrates the cumulated risk from many factors of which most are modifiable, such as metabolic inadaptation in diabetes and obesity, sleep ventilatory disorders, hypertension, inflammation, and lack of physical activity. Treating these factors may determine ANS recovery through the appropriate management of these conditions. Natural aging also decreases ANS activity. ANS recovery will decrease global circulating inflammation, which will reinforce endothelial function and thus protect the vessels and the associated organs. ANS is the whistle-blower of vascular risk and the actor of vascular health. Such as, ANS should be regularly checked to help draw attention on vascular risk and help follow the improvements in response to our interventions. While today prediction of stroke relies on classical cardiovascular risk factors, adding autonomic biomarkers as HRV parameters may significantly increase the prediction of stroke.

Preventive measures for the critical postexercise period in sickle cell trait and disease.

The immediate postexercise/physical activity period is critical for sickle cell trait (SCT) carriers and disease (SCD) patients. Exercise-related blood acidosis is known to trigger the cascade of HbS deoxygenation and polymerization, leading to red blood cell sickling and subsequent complications. Unfortunately, two facts worsen exercise-related blood acidosis during the initial postexercise period: First, blood lactate and H+ concentrations continue to increase for several minutes after exercise completion, exacerbating blood acidosis. Second, blood lactate concentration remains elevated and pH altered for 20-45 min during inactivity after intense exercise, keeping acid/base balance disturbed for a long period after exercise. Therefore, the risk of complications (including vasoocclusive crises and even sudden death) persists and even worsens several minutes after intense exercise completion in SCT carriers or SCD patients. Light physical activity following intense exercise (namely, active recovery) may, by accelerating lactate removal and acid/base balance restoration, reduce the risk of complications. Scientific evidence suggests that light exercise at or below the first lactate threshold is an appropriate strategy.

Factors of Rowing Ergometer Performance in High-Level Female Rowers.

The present study investigated morphological and physiological factors of rowing ergometer performance over 2000 m (P2000, W) in 70 national and international level [27 lightweight (LW) and 43 heavyweight (HW)] female rowers. Maximal oxygen uptake (V̇O2max, L.min-1), maximal aerobic power (Pamax, W), power output corresponding to 4 mmol.L-1 blood lactate concentration expressed in absolute (PLa4, W) and relative to Pamax (PLa4%, %) values, peak power output (Ppeak, W), and rowing gross efficiency (RGE, %) were determined during an incremental rowing test. In the whole group, Ppeak was the best predictor of P2000 (r=0.89, p<0.001), as it was shown in men. PLa4 (r=0.87), V̇O2max (r=0.83), body mass (r=0.65), and height (r=0.64) were also significantly correlated with P2000 (p<0.001 for all). Ppeak was also the best predictor of P2000 when the two sub-groups LW and HW were considered separately. It was concluded that Ppeak is an overall index of physiological rowing capacity in groups of high-level LW and HW female rowers. The predictive value of Ppeak is similar to that of PLa4, but Ppeak presents the advantage of being obtained with a simple ergometer test without biological measurements.

Factors affecting the energy cost of level running at submaximal speed.

Metabolic measurement is still the criterion for investigation of the efficiency of mechanical work and for analysis of endurance performance in running. Metabolic demand may be expressed either as the energy spent per unit distance (energy cost of running, C r) or as energy demand at a given running speed (running economy). Systematic studies showed a range of costs of about 20 % between runners. Factors affecting C r include body dimensions: body mass and leg architecture, mostly calcaneal tuberosity length, responsible for 60-80 % of the variability. Children show a higher C r than adults. Higher resting metabolism and lower leg length/stature ratio are the main putative factors responsible for the difference. Elastic energy storage and reuse also contribute to the variability of C r. The increase in C r with increasing running speed due to increase in mechanical work is blunted till 6-7 m s(-1) by the increase in vertical stiffness and the decrease in ground contact time. Fatigue induced by prolonged or intense running is associated with up to 10 % increased C r; the contribution of metabolic and biomechanical factors remains unclear. Women show a C r similar to men of similar body mass, despite differences in gait pattern. The superiority of black African runners is presumably related to their leg architecture and better elastic energy storage and reuse.

Modeling of performance and ANS activity for predicting future responses to training.

PURPOSE: Our aim was to assess whether we can predict satisfactorily performance in swimming and high frequency power (HF power) of heart rate variability from the responses to previous training. We have tested predictions using the model of Banister and the variable dose-response model. METHODS: Data came from ten swimmers followed during 30 weeks of training with performance and HF power measured each week. The first 15-week training period was used to estimate the parameters of each model for both performance and HF power. Both were then predicted in response to the training done during the second 15-week training period. The bias and precision were estimated from the mean and SD of the difference between prediction and actual value expressed as a percentage of performance or HF power at the first week. RESULTS: With the variable-dose response model, the bias for performance prediction was -0.24 ± 0.06 and the precision 0.69 ± 0.24% (mean ± between-subject SD). For HF power, the bias was 0 ± 21 and the precision 22 ± 8%. When HF power was transformed into performance using a quadratic relation in each swimmer established from the first 15-week period, the bias was 0.18 ± 0.74 and the precision 0.80 ± 0.30%. No clear trend in the error was observed during the second period. CONCLUSIONS: This study showed that the modeling of training effects on performance allowed accurate performance prediction supporting its relevance to control and predict week after week the responses to future training.

Influence of individual energy cost on running capacity in warm, humid environments.

PURPOSE: Challenging environmental conditions including heat and humidity are associated with particular risks to the health of runners and triathletes during prolonged events. The heat production of a runner is the product of its energy cost of running (C r) by its velocity. Since C r varies greatly among humans, those individuals with high C r are more exposed to heat stress in warm and humid conditions. Although risk factor awareness is crucial to the prevention of heat stroke and potential fatalities associated therewith, how C r affects the highest sustainable velocity (V) at which maximal heat loss matches heat production has not been quantified to date. METHODS: Here, we computed in virtual runners weighting 45-75 kg, the influence of C r variability from 3.8 to 4.4 J·m(-1)·kg(-1) on V. Heat loss by radiation, convection, and conduction was assessed from known equations including body dimensions, running velocity (3.4-6.2 m·s(-1)), air temperature (T a, 10-35 °C) and relative humidity (r h, 50, 70 and 90 %). RESULTS: We demonstrated a marked and almost linear influence of C r on V in hot and humid conditions: +0.1 J·kg(-1)·m(-1) in C r corresponded to -4 % in V. For instance, in conditions 25 °C r h 70 %, 65-kg runners with low C r could sustain a running speed of 5.7 m·s(-1) as compared to only 4.3 m·s(-1) in runners with high C r, which is huge. CONCLUSION: We conclude that prior knowledge of individual C r in athletes exposed to somewhat warm and humid environments during prolonged running is one obvious recommendation for minimizing heat illness risk.

Differences in lactate exchange and removal abilities between high-level African and Caucasian 400-m track runners.

The present study aimed to investigate (1) whether high-level 400-m track runners of different ethnic origin displayed divergent post-run blood lactate concentrations (p400m[La]) and (2) if this discrepancy was based on differences in lactate exchange and removal abilities. Twenty male African (n = 12) and Caucasian (n = 8) runners, paired in terms of personal record, performed (1) an all-out 400-m run to measure p400m[La] at 3, 5 and 7 min into recovery and (2) a 1-min 25.2 km h(-1) running (not maximal but standardized) exercise followed by 90-min passive recovery to determine individual blood lactate recovery curves (IBLRC). IBLRCs were fitted to a bi-exponential time function: [Formula: see text] where γ 1 and γ 2 denote lactate exchange ability between the previously worked muscles and blood, and overall ability for lactate removal, respectively. The quantity of lactate accumulated at the end of the 1-min exercise (Q LaA) was also estimated. Our study showed that after the all-out 400-m run, p400m[La] was lower in African than in Caucasian runners at 3 and 5 min but not at 7 min into recovery. After the standardized exercise, γ 1 and γ 2 were lower (p < 0.01) and Q LaA was higher (p < 0.05) in African than in Caucasian runners. These data suggest that for similar performance levels, ethnicity involves differences in lactate accumulation, exchange and removal.

Mechanical determinants of 100-m sprint running performance.

Sprint mechanics and field 100-m performances were tested in 13 subjects including 9 non-specialists, 3 French national-level sprinters and a world-class sprinter, to further study the mechanical factors associated with sprint performance. 6-s sprints performed on an instrumented treadmill allowed continuous recording of step kinematics, ground reaction forces (GRF), and belt velocity and computation of mechanical power output and linear force-velocity relationships. An index of the force application technique was computed as the slope of the linear relationship between the decrease in the ratio of horizontal-to-resultant GRF and the increase in velocity. Mechanical power output was positively correlated to mean 100-m speed (P < 0.01), as was the theoretical maximal velocity production capability (P < 0.011), whereas the theoretical maximal force production capability was not. The ability to apply the resultant force backward during acceleration was positively correlated to 100-m performance (r (s) > 0.683; P < 0.018), but the magnitude of resultant force was not (P = 0.16). Step frequency, contact and swing time were significantly correlated to acceleration and 100-m performance (positively for the former, negatively for the two latter, all P < 0.05), whereas aerial time and step length were not (all P > 0.21). Last, anthropometric data of body mass index and lower-limb-to-height ratio showed no significant correlation with 100-m performance. We concluded that the main mechanical determinants of 100-m performance were (1) a "velocity-oriented" force-velocity profile, likely explained by (2) a higher ability to apply the resultant GRF vector with a forward orientation over the acceleration, and (3) a higher step frequency resulting from a shorter contact time.

A model for the training effects in swimming demonstrates a strong relationship between parasympathetic activity, performance and index of fatigue.

Competitive swimming as a physical activity results in changes to the activity level of the autonomic nervous system (ANS). However, the precise relationship between ANS activity, fatigue and sports performance remains contentious. To address this problem and build a model to support a consistent relationship, data were gathered from national and regional swimmers during two 30 consecutive-week training periods. Nocturnal ANS activity was measured weekly and quantified through wavelet transform analysis of the recorded heart rate variability. Performance was then measured through a subsequent morning 400 meters freestyle time-trial. A model was proposed where indices of fatigue were computed using Banister's two antagonistic component model of fatigue and adaptation applied to both the ANS activity and the performance. This demonstrated that a logarithmic relationship existed between performance and ANS activity for each subject. There was a high degree of model fit between the measured and calculated performance (R(2)=0.84±0.14,p<0.01) and the measured and calculated High Frequency (HF) power of the ANS activity (R(2)=0.79±0.07, p<0.01). During the taper periods, improvements in measured performance and measured HF were strongly related. In the model, variations in performance were related to significant reductions in the level of 'Negative Influences' rather than increases in 'Positive Influences'. Furthermore, the delay needed to return to the initial performance level was highly correlated to the delay required to return to the initial HF power level (p<0.01). The delay required to reach peak performance was highly correlated to the delay required to reach the maximal level of HF power (p=0.02). Building the ANS/performance identity of a subject, including the time to peak HF, may help predict the maximal performance that could be obtained at a given time.

Level of physical activity at the age of 65 predicts successful aging seven years later: the PROOF study.

BACKGROUND: Physical activity has a pleiotropic effect and is a significant factor in successful aging. This study aims to quantify the relationship between the physical activity of a 65-year-old cohort and the level of life satisfaction and self-rated health 7 years later. METHODS: A total of 988 questionnaires were sent by mail to a representative sample of healthy pensioners. Life satisfaction and health status were estimated on two visual analogical scales in answer to the following questions: (1) How would you estimate your state of health? and (2) Are you generally satisfied with your life? The level of physical activity was estimated using a questionnaire which enabled us to calculate: (1) Daily energy expenditure (DEE), (2) physical activity energy expenditure (PAEE), (3) daily energy expenditure higher than 5 metabolic equivalents (METs) (DEQisa), (4) Activity index (PAEE/DEE), (5) VO(2) peak. RESULTS: In all, 686 responses were validated. The average age was 72.9 ± 1.2 years old with 59.5% of women (n = 408). Amongst the sample, 98.8% (n = 676) lived in their own homes and 25.2% (n = 172) lived alone. Mean DEE was 10.365 ± 1.964 kJ/24 h, mean PAEE was 4.479 ± 1.170 kJ/24 h, mean activity index was 0.42 ± 0.05, and mean estimated oxygen uptake (VO(2)) peak was 22.5 ± 1.6 mL/min per kg. Activity index and VO(2) peak were the variables most significantly correlated with self-rated health (p = 0.0032 and p = 0.0011, respectively) and life satisfaction (p = 0.0117 and p = 0.0053). CONCLUSIONS: Energy spent in activity and VO(2) peak estimated from DEE, measured at the age of 65, appear to be strong predictors of well-being 7 years later.

Force-velocity relationship in cycling revisited: benefit of two-dimensional pedal forces analysis.

PURPOSE: Maximal cycling exercise has been widely used to describe the power-velocity characteristics of lower-limb extensor muscles. This study investigated the contribution of each functional sector (i.e., extension, flexion, and transitions sectors) on the total force produced over a complete pedaling cycle. We also examined the ratio of effective force to the total pedal force, termed index of mechanical effectiveness (IE), in explaining differences in power between subjects. METHODS: Two-dimensional pedal forces and crank angles were measured during a cycling force-velocity test performed by 14 active men. Mean values of forces, power output, and IE over four functional angular sectors were assessed: top = 330 degrees -30 degrees , downstroke = 30 degrees -150 degrees , bottom = 150 degrees -210 degrees , and upstroke = 210 degrees -330 degrees . RESULTS: Linear and quadratic force-velocity and power-velocity relationships were obtained for downstroke and upstroke. Maximal power output (Pmax) generated over these two sectors represented, respectively, 73.6% +/- 2.6% and 10.3% +/- 1.8% of Pmax assessed over the entire cycle. In the whole group, Pmax over the complete cycle was significantly related to Pmax during the downstroke and upstroke. IE significantly decreased with pedaling rate, especially in bottom and upstroke. There were significant relationships between power output and IE for top and upstroke when the pedaling rate was below or around the optimal value and in all the sectors at very high cadences. CONCLUSIONS: Although data from force-velocity test primarily characterize the muscular function involved in the downstroke phase, they also reflect the flexor muscles' ability to actively pull on the pedal during the upstroke. IE influences the power output in the upstroke phase and near the top dead center, and IE accounts for differences in power between subjects at high pedaling rates.

Physiological correlates of performance. Case study of a world-class rower.

This report describes the changes in physiological capacity of a heavy-weight rower who obtained seven medals in World Championships and Olympic Games. The investigation was carried out over the last 6 years of the rower's international competition career in comparison with peer champions, and the following 4 years. Over the first period, maximal oxygen uptake (VO(2max)) remained above 6 l min(-1) which is an outstanding value. The training load measured over the last 18 months of the period increased from 119 to 142 km wk(-1) of rowing. Four years after the international competition period, VO(2max) had only declined by 3.6% although the training load had declined by 35%. These data suggest that the ability of this rower to compete at top level for years was related to ability to maintain an outstanding VO(2max). Gross efficiency and ability to rely on anaerobic glycolysis did not emerge as relevant factors.

Physiological demands of different sailing techniques of the new Olympic windsurfing class.

The introduction of the new Olympic class windsurf-board has prompted sailors to develop a new technique of sail "pumping" (rhythmically pulling the sail so that it acts as a wing). Contrary to the old technique that mainly involved upper body activity, the new one requires both upper and lower body muscle activity. Accordingly, the aim of the present study was to compare the performance characteristics of the board (speed and pointing angle ability relative to the direction of the wind) as well as the sailors' physiological demands during sail pumping with the old and new pumping techniques. Nineteen male, highly-trained (V(O)(2max)): 65.1 +/- 5.9 ml min(-1) kg(-1)), international level windsurfers from six different countries underwent two testing sessions on-water in a balanced order. Compared to the old pumping technique the mean distance sailed with the new technique (1,872 +/- 15 and 1,764 +/- 13 m, respectively) and the board speed (3.42 +/- 0.49 and 3.81 +/- 0.28 m s(-1), respectively) were significantly (P < 0.05) shorter and greater, respectively. Consequently, the time taken to sail the testing course was significantly shorter with the new compared to the old technique (390 +/- 8 vs. 420 +/- 16 s). Despite the finding that the new technique was sustained at a significantly higher fraction of V(O)(2max) (80.5 +/- 5.2 and 72.7 +/- 4.5%, respectively) compared to the old technique, total energy expenditure (130.7 +/- 11.3 and 128.1 +/- 9.2 Kcal, respectively) and blood lactate concentration 3 min into recovery (9.4 +/- 2.2 and 8.5 +/- 1.7 mmol l(-1), respectively) were not different. It is concluded that application of the new sail pumping technique improves the performance characteristics of the board without increasing the sailors' total metabolic requirement.

Autonomic nervous system activity and decline as prognostic indicators of cardiovascular and cerebrovascular events: the 'PROOF' Study. Study design and population sample. Associations with sleep-related breathing disorders: the 'SYNAPSE' Study.

BACKGROUND: Transversal studies have underlined the association between the decline in autonomic nervous system (ANS) activity and all-cause mortality. However, the predictive value of ANS has never been prospectively assessed in a general population-based cohort. METHOD: The PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) cohort study was designed to prospectively assess the predictive value of ANS activity level in the general population, with regard to cardiovascular and cerebrovascular events, and death. This predictive power will be compared with the usual and newly discovered risk factors for the purposes of developing a risk model. RESULTS: A prospective cohort of elderly subjects aged 65 years upon study entry were recruited from the electoral list of the city of Saint-Etienne, France. Three initial 2-year examination programs were scheduled for 7 years (2001-2007), followed by late events monitoring. At each examination, ANS activity was assessed along with clinical and biological cardiovascular risk factors, brain MRI, neuropsychological evaluation, physical activity profile, and sleep-related breathing disorders. The main study outcomes are stroke, myocardial infarction and death from any cause. A cohort consisting of 1,011 subjects aged 65.6 (0.8) years was constituted. CONCLUSION: Despite other selective characteristics, the associations between ANS activity and events will be applicable to other populations.

The leveling-off of oxygen uptake is related to blood lactate accumulation. Retrospective study of 94 elite rowers.

To assess whether the ability to demonstrate a plateau in oxygen consumption VO2 could be related to adaptation to exercise, the data obtained over a period of 10 years on 94 elite oarsmen who had participated in annual testing were re-evaluated. The test consisted in an incremental step protocol until volitional exhaustion. VO2, heart rate (HR), blood lactate ([La]b) and respiratory exchange ratio (RER) were measured at each step. The maximal oxygen consumption (VO2max), the power corresponding to VO2maxPamax and the maximal power achieved (Ppeak) were recorded. Thirty-eight oarsmen achieved a VO2 plateau and were designated as Pla; 56 did not and were designed as N-Pla. The Pla and N-Pla VO2max, Pamax and maximal HR values were similar. In comparison with N-Pla, the Pla group displayed a rightward shift of the [La]b versus power curve, accounted for by both the increased percentage of VO2max corresponding to 4 mmol l(-1) and the decreased value of [La]b corresponding to Pamax (P<0.05). Pla oarsmen attained a higher Ppeak expressed as % of Pamax (P<0.05) and also showed better ergometer performance (P<0.05). In a sub-group of 53 oarsmen constituted on the basis of Pamax values close to 400 W, for a given power output, the Pla subjects had significantly lower HR, RER, and [La]b values at each sub-maximal stage of the test. These results suggest that achieving a [Formula: see text] plateau during completion of an incremental step protocol accounts for greater muscle ability to maintain homeostasis during exercise. These differences give the oarsmen an advantage in rowing competitions.

Influence of maxillary mouthguards on physiological parameters.

INTRODUCTION: The purpose of this study was to test the influence of two types of maxillary mouthguards (a self-adapted and a custom-made model: SA and CM, respectively) on various physiological parameters generally associated with performance in team sports. METHODS: Nineteen trained male subjects participating in team sports were tested. Visual reaction time, explosive power, ventilation at rest, and ventilation and oxygen consumption during submaximal and maximal exercise were measured in three randomized conditions: normal, with SA mouthguards, or with CM mouthguards. RESULTS: Wearing SA or CM mouthguards did not significantly alter any of the measured parameters compared with the normal condition. CONCLUSIONS: Wearing a maxillary mouthguard does not affect the main physiological parameters generally associated with team sport performance. These results provide additional support to the policy of encouraging athletes to wear individually fitted maxillary mouthguards.

An elevated sarcolemmal lactate (and proton) transport capacity is an advantage during muscle activity in healthy humans.

The etiology of muscle fatigue remains incompletely solved especially in vivo (3). The causes of muscle fatigue vary according to the type, duration and intensity of exercise, and to the physical fitness and health status of the subjects. Nevertheless, an elevated sarcolemmal lactate (and proton) transport capacity constitutes an advantage during muscle activity. During moderate-intensity exercise, efficient lactate exchanges contribute to the cell-cell lactate shuttle i.e., the delivery of lactate for its utilization as fuel by neighboring or distant active and oxidative muscles fibers or as substrate by other tissues (e.g. for neoglucogenesis by the liver) (1). During high-intensity exercise, the lactate exchange ability was positively correlated with the capacity to prolong exercise (4). Whether this correlation between the lactate exchange ability and performance was (directly or indirectly) causal or coincidental, the question is still under debate. Nevertheless, it remains that an elevated lactate exchange ability seems to constitute a protective mechanism against muscle fatigue. Since the transport of lactate across the sarcolemma is mediated mainly by the lactate-H+ cotransport via the monocarboxylate transporters MCT1 and MCT4, an elevated lactate transport capacity delays both muscle lactate accumulation and intracellular pH decrease and seems to favor muscle activity. In accordance, previous experiments have shown that metabolic alkalosis enhances the net lactate release rate from the active muscles and work capacity (2, 5) contrary to acidosis that reduces lactate efflux from muscle and exercise tolerance (5). All this makes an elevated sarcolemmal lactate (and proton) transport capacity an advantage during muscle activity.