Inter-day reliability of heart rate complexity and variability metrics in healthy highly active younger and older adults.

PURPOSE: To investigate the inter-day reliability of time-domain, frequency-domain, and nonlinear HRV metrics in healthy highly active younger and older adults. The study also assessed the effect of age on the HRV metrics. METHODS: Forty-four older adults (34 M, 10F; 59 ± 5 years; [Formula: see text] = 40.9 ± 7.6 ml kg-1 min-1) and twenty-two younger adults (16 M, 6F; 22 ± 4 years; [Formula: see text] = 47.2 ± 12.8 ml kg-1 min-1) attended the laboratory. Visit one assessed aerobic fitness through an exercise test. In visits two and three, participants completed a 30-min supine RR interval measurement to derive the HRV metrics. RESULTS: The younger group (YG) and older group (OG) demonstrated poor to good day-to-day relative and absolute reliability for all HRV metrics (OG, ICCs = 0.33 to 0.69 and between day CVs = 3.8 to 29.2%; YG, ICCs = 0.37 to 0.93 and between day CVs = 3.5 to 36.5%). There was a significant reduction in ApEn (P < 0.001), SampEn (P = 0.031), RMSSD (P < 0.001), SDNN (P < 0.001), LF power (P < 0.001) and HF power (P < 0.001), HRV metrics with ageing. There was no significant effect of age the complexity metrics DFA α1 (P = 0.107), α2 (P = 0.147) and CI-8 (P = 0.493). CONCLUSION: HRV metrics are reproducible between days in both healthy highly active younger and older adults. There is a decline in linear and nonlinear HRV metrics with age, albeit there being no age-related change in the nonlinear metrics, DFA α1, α2 and CI-8.

Functional threshold power and the (manufactured) critical power controversy.

We read with concern yet another communication from Dotan regarding the critical power (CP) concept which contains a litany of factual errors, false statements, and dated physiological interpretations. Space does not permit us to rebut every incorrect point made about our work (Wong et al., 2022) and the wider field in which it sits, but we will address what we consider to be some of the more egregious errors in his letter. We would first note, however, that our paper was not actually focused on the critical power concept.

Tramadol is a performance-enhancing drug in highly trained cyclists: a randomized controlled trial.

Tramadol is a potent narcotic analgesic reportedly used in multiple sports to reduce exertional pain and confer a performance advantage. This study sought to identify whether tramadol enhances performance in time trial cycling. Twenty-seven highly trained cyclists were screened for tramadol sensitivity and then attended the laboratory across three visits. Visit 1 identified maximal oxygen uptake, peak power output, and gas exchange threshold through a ramp incremental test. Participants returned to the laboratory on two further occasions to undertake cycling performance tests following the ingestion of either 100 mg of soluble tramadol or a taste-matched placebo control in a double-blind, randomized, and crossover design. In the performance tests, participants completed a 30 min non-exhaustive fixed intensity cycling task at a heavy exercise intensity (272 ± 42 W), immediately followed by a competitive self-paced 25-mile time trial (TT). Following removal of two outlier data sets, analysis was completed on n = 25. Participants completed the TT significantly faster (d = 0.54, P = 0.012) in the tramadol condition (3758 s ± 232 s) compared with the placebo condition (3808 s ± 248 s) and maintained a significantly higher mean power output (+9 W) throughout the TT (ηp2 = 0.262, P = 0.009). Tramadol reduced perception of effort during the fixed intensity trial (P = 0.026). The 1.3% faster time in the tramadol condition would be sufficient to change the outcomes of a race and is highly meaningful and pervasive in this cohort of highly trained cyclists. The data from this study suggests that tramadol is a performance-enhancing drug.NEW & NOTEWORTHY In the current study, when cycling with tramadol participants completed a time trial on average 50 s faster and at a 9 W higher power output than the placebo control. The study used both a fixed intensity and self-paced time trial exercise tasks to reflect the demands of a stage race. The outcomes from this study were used by the World Anti-Doping Agency to inform their addition of tramadol to the Prohibited List in 2024.

Intra- and interindividual reliability of muscle pain induced by an intramuscular injection of hypertonic saline injection into the quadriceps.

BACKGROUND: Intramuscular injections of hypertonic saline are commonly used to induce experimental muscle pain, but reliability data on this technique are lacking. This study investigated the intra- and interindividual reliability of pain measures from a hypertonic saline injection into the vastus lateralis. METHODS: Fourteen healthy participants (6 female) attended three laboratory visits where they received an intramuscular injection of 1 mL hypertonic saline into the vastus lateralis. Changes in pain intensity were recorded on an electronic visual analogue scale, and pain quality was assessed after pain had resolved. Reliability was assessed with the coefficient of variation (CV), minimum detectable change (MDC) and intraclass correlation coefficient (ICC) with 95% CIs. RESULTS: Mean pain intensity displayed high levels of intraindividual variability (CV = 16.3 [10.5-22.0]%) and 'poor' to 'very good' relative reliability (ICC = 0.71 [0.45-0.88]) but had a MDC of 11 [8-16] au (out of 100). Peak pain intensity exhibited high levels of intraindividual variability (CV = 14.8 [8.8-20.8]%) with 'moderate' to 'excellent' levels of relative reliability (ICC = 0.81 [0.62-0.92]), whereas the MDC was 18 [14-26] au. Measures of pain quality exhibited good reliability. Interindividual variability in pain measures was high (CV > 37%). CONCLUSIONS: Intramuscular injections of 1 mL of hypertonic saline into the vastus lateralis display substantial levels of interindividual variability, but MDC is below the clinically important changes in pain. This model of experimental pain is suitable for studies involving repeated exposures. SIGNIFICANCE: Many pain research studies have performed intramuscular injections of hypertonic saline to investigate responses to muscle pain. However, the reliability of this technique is not well established. We examined the pain response over three repeated sessions of a hypertonic saline injection. The pain induced by hypertonic saline has considerable interindividual variability but has largely acceptable intraindividual reliability. Therefore, the injections of hypertonic saline to induce muscle pain are a reliable model of experimental muscle pain.

Reproducibility of NIRS-derived mitochondrial oxidative capacity in highly active older adults.

INTRODUCTION: In-vivo techniques using near-infrared spectroscopy (NIRS) have been developed to assess skeletal muscle mitochondrial oxidative capacity. However, the test-retest and day-to-day reliability of NIRS-derived mitochondrial oxidative capacity has yet to be established in older individuals. Therefore, the primary aim of this study was to determine the day-to-day and test-retest reliability of NIRS-derived mitochondrial oxidative capacity in older adults. The secondary aim was to examine the relationship between NIRS-derived mitochondrial capacity and whole-body aerobic fitness. MATERIAL AND METHODS: Twenty-four healthy individuals (19 M, 5F; aged 60 ± 4 years; maximal oxygen uptake (V̇O2peak) = 41.2 ± 6.8 ml.kg-1.min-1) completed three visits to the laboratory. Visit one assessed isometric maximal voluntary contractions of the knee extensors and aerobic capacity through an incremental exercise test. In visits two and three participants completed two measurements of NIRS-derived mitochondrial oxidative capacity in the vastus lateralis (VL). RESULTS: NIRS-derived mitochondrial oxidative capacity was found to have good to excellent day-to-day reliability (Day 1 vs Day 2; coefficient of variation (CV) = 7.0 %; standard error of measurement (SEM) = 5.2; intra-class correlation coefficient (ICC) = 0.94) and test re-test reliability (Day 1 [Test 1 vs Test 2]; CV = 5.0 %; SEM = 3.7; ICC 0.97 and Day 2 [Test 1 vs Test 2]; CV = 6.3 %; SEM = 4.9; ICC = 0.93). NIRS-derived mitochondrial oxidative capacity was found to be significantly correlated with V̇O2peak (r = -0.61; R2 = 0.37; P = 0.002), oxygen uptake at the gas exchange threshold (r = -0.49; R2 = 0.24; P = 0.02), and oxygen uptake at the respiratory compensation point (r = -0.57; R2 = 0.32; P = 0.004). CONCLUSION: NIRS provides a reliable method for deriving a measure of VL mitochondrial oxidative capacity in highly active older adults and demonstrates a significant relationship with measures of whole-body aerobic fitness.

The association of end-spurt behaviour with seasonal best time in long-distance freestyle pool swimming.

To analyse the association of seasonal best time, distance and different performance levels with end-spurt behaviour in one swimming season. Race results in 800 and 1500 m pool freestyle swimming in the season 2018/2019 including 14,930 races and 2650 swimmers were obtained. The end-spurt for each race was determined by means of an End-Spurt Indicator (ESI). Subsequently, ESI was used as a dependent variable and influences were analysed using a linear mixed model with fixed effects for seasonal best time, distance, and performance level amongst others. In the 800 and 1500 m races swimmers showed a mean ESI of 2.08 (95% CI: 2.02-2.13) and 3.68 (95% CI: 3.59-3.76), respectively. There was a significant association between seasonal best time and ESI, with a better seasonal best time showing a greater ESI (F = 70.5, P < .001, f2 = 0.04). A significant effect on greater ESI was also observed for longer distance (F = 1067.5, P < .001, f2 = 0.06) and higher performance level (F = 91.1, P < .001, f2 = 0.02). Elite swimmers had a mean ESI of 5.47 (95% CI: 4.91-6.03), sub-elite swimmers of 3.74 (95% CI: 3.53-3.95) and competitive swimmers of 2.41 (95% CI: 2.37-2.46). A more pronounced end-spurt is associated with seasonal best time in long-distance pool swimming, higher performance level of the swimmer and longer race distance.

Test-retest reliability of a 30-min fixed perceived effort cycling exercise.

PURPOSE: Using exercise protocols at a fixed rating of perceived effort (RPE) is a useful method for exploring the psychophysical influences on exercise performance. However, studies that have employed this protocol have arbitrarily selected RPE values without considering how these values correspond to exercise intensity thresholds and domains. Therefore, aligning RPE intensities with established physiological thresholds seems more appropriate, although the reliability of this method has not been assessed. METHODS: Eight recreationally active cyclists completed two identical ramped incremental trials on a cycle ergometer to identify gas exchange threshold (GET). A linear regression model plotted RPE responses during this test alongside gas parameters to establish an RPE corresponding to GET (RPEGET) and 15% above GET (RPE+15%GET). Participants then completed three trials at each intensity, in which performance, physiological, and psychological measures were averaged into 5-min time zone (TZ) intervals and 30-min 'overall' averages. Data were assessed for reliability using intraclass correlation coefficients (ICC) and accompanying standard error measurements (SEM), 95% confidence intervals, and coefficient of variations (CoV). RESULTS: All performance and gas parameters showed excellent levels of test-retest reliability (ICCs = > .900) across both intensities. Performance, gas-related measures, and heart rate averaged over the entire 30-min exercise demonstrated good intra-individual reliability (CoV = < 5%). CONCLUSION: Recreationally active cyclists can reliably replicate fixed perceived effort exercise across multiple visits when RPE is aligned to physiological thresholds. Some evidence suggests that exercise at RPE+15%GET is more reliable than RPEGET.

The effect of hypertonic saline evoked muscle pain on neurophysiological changes and exercise performance in the contralateral limb.

Non-local muscle pain may impair endurance performance through neurophysiological mechanisms, but these are relatively unknown. This study examined the effects of muscle pain on neuromuscular and neurophysiological responses in the contralateral limb. On separate visits, nine participants completed an isometric time to task failure (TTF) using the right knee extensors after intramuscular injection of isotonic saline (CTRL) or hypertonic saline (HYP) into the left vastus lateralis. Measures of neuromuscular fatigue were taken before, during and after the TTF using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation. Mean pain intensity was greater in the left leg in HYP (3.3 ± 1.9) compared to CTRL (0.4 ± 0.7; P < 0.001) which was combined with a reduced TTF by 9.8% in HYP (4.54 ± 0.56 min) compared to CTRL (5.07 ± 0.77 min; P = 0.005). Maximum voluntary force was not different between conditions (all P > 0.05). Voluntary activation was lower in HYP compared to CTRL (P = 0.022). No difference was identified between conditions for doublet amplitude (P > 0.05). Furthermore, no difference in MEP·Mmax-1 or the TMS silent period between conditions was observed (all P > 0.05). Non-local pain impairs endurance performance of the contralateral limb. This impairment in performance is likely due to the faster attainment of the sensory tolerance limit from a greater amount of sensory feedback originating from the non-exercising, but painful, left leg.

Comparison of Physiological Responses and Muscle Activity During Incremental and Decremental Cycling Exercise.

OBJECTIVE: To investigate whether a cycling test based on decremental loads (DEC) could elicit higher maximal oxygen uptake (V˙O2max) values compared with an incremental test (INC). DESIGN: Nineteen well-trained individuals performed an INC and a DEC test on a single day, in randomized order. METHODS: During INC, the load was increased by 20 W·min-1 until task failure. During DEC, the load started at 20 W higher than the peak load achieved during INC (familiarization trial) and was progressively decreased. Gas exchange and electromyography (EMG) activity (n = 11) from 4 lower-limb muscles were monitored throughout the tests. Physiological and EMG data measured at V˙O2max were compared between the 2 protocols using paired t tests. RESULTS: V˙O2max during the DEC was 3.0% (5.9%) higher than during INC (range 94%-116%; P = .01), in spite of a lower power output (-21 [20] W, P < .001) at V˙O2max. Pulmonary ventilation (P = .036) and breathing rate (P = .023) were also higher during DEC. EMG activity measured at V˙O2max was not different between tests, despite the lower output during DEC. CONCLUSIONS: A DEC exercise test produces higher V˙O2max in cycling compared with an INC test, which was accompanied by higher pulmonary ventilation and similar EMG activity. The additional O2 uptake during DEC might be related to extra work performed either by the respiratory muscles and/or the less oxidatively efficient leg muscles.

The effect of elevated muscle pain on neuromuscular fatigue during exercise.

PURPOSE: Muscle pain can impair exercise performance but the mechanisms for this are unknown. This study examined the effects of muscle pain on neuromuscular fatigue during an endurance task. METHODS: On separate visits, twelve participants completed an isometric time-to-task failure (TTF) exercise of the right knee extensors at ~ 20% of maximum force following an intramuscular injection of isotonic saline (CTRL) or hypertonic saline (HYP) into the vastus lateralis. Measures of neuromuscular fatigue were taken before, during and after the TTF using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation. RESULTS: The mean pain intensity was 57 ± 10 in HYP compared to 38 ± 18 in CTRL (P < 0.001). TTF was reduced in HYP (4.36 ± 0.88 min) compared to CTRL (5.20 ± 0.39 min) (P = 0.003). Maximum voluntary force was 12% lower at minute 1 (P = 0.003) and 11% lower at minute 2 in HYP (P = 0.013) compared to CTRL. Voluntary activation was 4% lower at minute 1 in HYP compared to CTRL (P = 0.006) but not at any other time point (all P > 0.05). The TMS silent period was 9% longer at 100 s during the TTF in HYP compared to CTRL (P = 0.026). CONCLUSION: Muscle pain reduces exercise performance through the excacerbation of neuromuscular fatigue that is central in origin. This appears to be from inhibitory feedback from group III/IV nociceptors which acts to reduce central motor output.

Pharmacological hypotheses: Is acetaminophen selective in its cyclooxygenase inhibition?

The precise mechanistic action of acetaminophen (ACT; paracetamol) remains debated. ACT's analgesic and antipyretic actions are attributed to cyclooxygenase (COX) inhibition preventing prostaglandin (PG) synthesis. Two COX isoforms (COX1/2) share 60% sequence structure, yet their functions vary. COX variants have been sequenced among various mammalian species including humans. A COX1 splice variant (often termed COX3) is purported by some as the elusive target of ACT's mechanism of action. Yet a physiologically functional COX3 isoform has not been sequenced in humans, refuting these claims. ACT may selectively inhibit COX2, with evidence of a 4.4-fold greater COX2 inhibition than COX1. However, this is markedly lower than other available selective COX2 inhibitors (up to 433-fold) and tempered by proof of potent COX1 inhibition within intact cells when peroxide tone is low. COX isoform inhibition by ACT may depend on subtle in vivo physiological variations specific to ACT. In vivo ACT efficacy is reliant on intact cells and low peroxide tone while the arachidonic acid concentration state can dictate the COX isoform preferred for PG synthesis. ACT is an effective antipyretic (COX2 preference for PG synthesis) and can reduce afebrile core temperature (likely COX1 preference for PG synthesis). Thus, we suggest with specificity to human in vivo physiology that ACT: (i) does not act on a third COX isoform; (ii) is not selective in its COX inhibition; and (iii) inhibition of COX isoforms are determined by subtle and nuanced physiological variations. Robust research designs are required in humans to objectively confirm these hypotheses.

The influence of environmental and core temperature on cyclooxygenase and PGE2 in healthy humans.

Whether cyclooxygenase (COX)/prostaglandin E2 (PGE2) thermoregulatory pathways, observed in rodents, present in humans? Participants (n = 9) were exposed to three environments; cold (20 °C), thermoneutral (30 °C) and hot (40 °C) for 120 min. Core (Tc)/skin temperature and thermal perception were recorded every 15 min, with COX/PGE2 concentrations determined at baseline, 60 and 120 min. Linear mixed models identified differences between and within subjects/conditions. Random coefficient models determined relationships between Tc and COX/PGE2. Tc [mean (range)] increased in hot [+ 0.8 (0.4-1.2) °C; p < 0.0001; effect size (ES): 2.9], decreased in cold [- 0.5 (- 0.8 to - 0.2) °C; p < 0.0001; ES 2.6] and was unchanged in thermoneutral [+ 0.1 (- 0.2 to 0.4) °C; p = 0.3502]. A relationship between COX2/PGE2 in cold (p = 0.0012) and cold/thermoneutral [collapsed, condition and time (p = 0.0243)] was seen, with higher PGE2 associated with higher Tc. A within condition relationship between Tc/PGE2 was observed in thermoneutral (p = 0.0202) and cold/thermoneutral [collapsed, condition and time (p = 0.0079)] but not cold (p = 0.0631). The data suggests a thermogenic response of the COX/PGE2 pathway insufficient to defend Tc in cold. Further human in vivo research which manipulates COX/PGE2 bioavailability and participant acclimation/acclimatization are warranted to elucidate the influence of COX/PGE2 on Tc.

Effects of experimentally induced muscle pain on endurance performance: A proof-of-concept study assessing neurophysiological and perceptual responses.

Pain arising from exercise potentiates fatigue and impairs the performance of endurance exercise. We assessed neurophysiological and perceptual responses to endurance exercise performed under experimentally induced muscle pain by a model that separates muscle pain from muscle fatigue. After a series of pilot studies investigating different hypertonic saline volumes, 17 healthy males performed a preliminary VO2PEAK test before performing a familiarization of the cycling time-to-exhaustion exercise (80% of the peak power output in the VO2PEAK test). Participants, performed a baseline exercise session before the sessions with hypertonic and isotonic saline injections in the vastus lateralis of both legs, in a crossover and counterbalanced design. Neurophysiological and perceptual responses such as electroencephalography (EEG) in frontal, prefrontal, parietal, and motor cortex, electromyography (EMG) of the vastus lateralis and biceps femoris muscles, ratings of perceived exertion (RPE), pain sensation, and affective valence were measured at rest and during exercise. The hypertonic injection reduced the resting EEG alpha-beta ratio in the frontal and prefrontal cortex. When compared to exercise performed after the isotonic injection (430.5 ± 152.6 s), hypertonic injection shortened the time-to-exhaustion (357.5 ± 173.0 s), reduced the EMG of the assessed muscles, and increased the muscle co-contraction during exercise. The hypertonic injection also reduced the EEG alpha-beta ratio in the prefrontal and parietal cortex, increased RPE and pain sensation, and reduced affective valence during exercise. This proof-of-concept study showed that hypertonic injection-induced muscle pain reduced endurance performance, promoting centrally mediated alterations in motor command and cortical activation, as well as an interplay of perceptual responses.

Muscle pain from an intramuscular injection of hypertonic saline increases variability in knee extensor torque reproduction.

The intensity of exercise-induced pain (EIP) reflects the metabolic environment in the exercising muscle, so during endurance exercise, this may inform the intelligent regulation of work rate. Conversely, the acute debilitating effects of EIP on motor unit recruitment could impair the estimation of force produced by the muscle and impair judgement of current exercise intensity. This study investigated whether muscle pain that feels like EIP, administered via intramuscular injection of hypertonic saline, interferes with the ability to accurately reproduce torque in a muscle group relevant to locomotive exercise. On separate days, 14 participants completed an isometric torque reproduction task of the knee extensors. Participants were required to produce torque at 15% and 20% maximal voluntary isometric torque (MVIT), without visual feedback before (baseline), during (pain/no pain), and after (recovery) an injection of 0.9% isotonic saline (Control) or 5.8% hypertonic saline (Experimental) into the vastus lateralis of the right leg. An elevated reported intensity of pain, and a significantly increased variance in mean contraction torque at both 15% (P = 0.049) and 20% (P = 0.002) MVIT was observed in the Experimental compared to the Control condition. Both 15 and 20% target torques were performed at a similar pain intensity in the Experimental condition (15% MVIT: 4.2 ± 1.9; 20% MVIT: 4.5 ± 2.2; P > 0.05). These findings demonstrate that the increased muscle pain from the injection of hypertonic saline impeded accurate reproduction of knee extensor torque. These findings have implications for the detrimental impact of EIP on exercise regulation and endurance performance.NEW & NOTEWORTHY We provide novel data demonstrating that the presence of muscle pain interferes with estimations of torque produced by the knee extensors, which could impair judgment of work rate during endurance exercise. The novelty of our study is in the application of the hypertonic saline experimental model into a quadriceps muscle during short, submaximal isometric contractions at an intensity that provides a more translatable assessment of the impact of exercise-induced pain on work-rate regulation during whole body exercise.

The effect of tDCS applied to the dorsolateral prefrontal cortex on cycling performance and the modulation of exercise induced pain.

Transcranial direct current stimulation (tDCS) is a neuromodulatory tool purported to enhance endurance performance through reducing fatigue related perceptions, including exercise-induced pain (EIP). We examined whether tDCS of the left DLPFC (1) can reduce EIP during a fixed intensity cycling trial (FI), (2) can improve cycling time trial (TT) performance, and (3) whether this was affected by a bilateral or an extracephalic montage. This investigation was comprised of two parts (study one and two). In both studies, participants completed a 10-minute FI trial and a 15-minute TT after 10 min of 2 mA anodal left DLPFC tDCS, SHAM or no stimulation. In study one, 11 participants received tDCS via a bilateral montage. In study two, 20 participants received tDCS using an extracephalic montage. Pain was recorded throughout the FI and TT trials, with power output (PO) monitored during the TT. Study one saw no significant changes in pain (tDCS 4.3 ± 2.0; SHAM 4.0 ± 1.8; control 3.8 ± 1.4) during the FI trial and no significant differences in distance covered, pain or PO in the TT. In study two there were no differences in pain reported in the FI trial, or distance covered (P = 0.239), pain or PO in the TT. In summary, tDCS of the DLPFC did not induce analgesia and provided no ergogenic effect for TT performance, moreover these observations were consistent across both the extracephalic and bilateral montage. These findings are in line with an increasing number of studies demonstrating the inconsistent effects of tDCS.

Muscle pain induced by hypertonic saline in the knee extensors decreases single-limb isometric time to task failure.

PURPOSE: Increased nociceptive activity and the experience of exercise-induced pain (EIP) may contribute to fatigue during endurance exercise. To investigate this, a pain model that produces pain similar to EIP and decouples its relationship to exercise intensity is required. This study (1) compared the quality of pain caused by a hypertonic saline injection into the vastus lateralis in resting and exercise conditions, and (2) investigated whether this pain contributes to changes in time to task failure. METHODS: On separate days, 18 participants completed a time to task failure at 20% maximal voluntary torque (MVT), a resting hypertonic saline intramuscular injection, and in a further three visits a time to task failure at 10% MVT following injection of isotonic saline, hypertonic saline or a control (no injection). RESULTS: In a subset of eligible participants (n = 12), the hypertonic saline combined with 10% MVT produced a qualitative experience of pain (assessed by the McGill Pain Questionnaire) that felt similar to EIP. 10% MVT with hypertonic saline significantly elevated pain intensity in the first 20% of the time to task failure and caused a significantly (P < 0.05) shorter time to task failure (448 ± 240 s) compared with the isotonic saline (605 ± 285 s) and control (514 ± 197 s) conditions. CONCLUSION: These findings demonstrate that hypertonic saline increases the intensity of pain during exercise, which results in a faster occurrence of exercise-induced fatigue. These results provide important evidence supporting pain as a limiting factor in endurance performance.

Effect of transcranial direct current stimulation on exercise performance: A systematic review and meta-analysis.

BACKGROUND: Transcranial direct current stimulation (tDCS) has been used to improve exercise performance, though the protocols used, and results found are mixed. OBJECTIVE: We aimed to analyze the effect of tDCS on improving exercise performance. METHODS: A systematic search was performed on the following databases, until December 2017: PubMed/MEDLINE, Embase, Web of Science, SCOPUS, and SportDiscus. Full-text articles that used tDCS for exercise performance improvement in adults were included. We compared the effect of anodal (anode near nominal target) and cathodal (cathode near nominal target) tDCS to a sham/control condition on the outcome measure (performance in isometric, isokinetic or dynamic strength exercise and whole-body exercise). RESULTS: 22 studies (393 participants) were included in the qualitative synthesis and 11 studies (236 participants) in the meta-analysis. The primary motor cortex (M1) was the main nominal tDCS target (n = 16; 72.5%). A significant effect favoring anodal tDCS (a-tDCS) applied before exercise over M1 was found on cycling time to exhaustion (mean difference = 93.41 s; 95%CI = 27.39 s-159.43 s) but this result was strongly influenced by one study (weight = 84%), no effect was found for cathodal tDCS (c-tDCS). No significant effect was found for a-tDCS applied on M1 before or during exercise on isometric muscle strength of the upper or lower limbs. Studies regarding a-tDCS over M1 on isokinetic muscle strength presented mixed results. Individual results of studies using a-tDCS applied over the prefrontal and motor cortices either before or during dynamic muscle strength testing showed positive results, but performing meta-analysis was not possible. CONCLUSION: For the protocols tested, a-tDCS but not c-tDCS vs. sham over M1 improved exercise performance in cycling only. However, this result was driven by a single study, which when removed was no longer significant. Further well-controlled studies with larger sample sizes and broader exploration of the tDCS montages and doses are warranted.

Prescribing 6-weeks of running training using parameters from a self-paced maximal oxygen uptake protocol.

PURPOSE: The self-paced maximal oxygen uptake test (SPV) may offer effective training prescription metrics for athletes. This study aimed to examine whether SPV-derived data could be used for training prescription. METHODS: Twenty-four recreationally active male and female runners were randomly assigned between two training groups: (1) Standardised (STND) and (2) Self-Paced (S-P). Participants completed 4 running sessions a week using a global positioning system-enabled (GPS) watch: 2 × interval sessions; 1 × recovery run; and 1 × tempo run. STND had training prescribed via graded exercise test (GXT) data, whereas S-P had training prescribed via SPV data. In STND, intervals were prescribed as 6 × 60% of the time that velocity at [Formula: see text] ([Formula: see text]) could be maintained (Tmax). In S-P, intervals were prescribed as 7 × 120 s at the mean velocity of rating of perceived exertion 20 (vRPE20). Both groups used 1:2 work:recovery ratio. Maximal oxygen uptake ([Formula: see text]), [Formula: see text], Tmax, vRPE20, critical speed (CS), and lactate threshold (LT) were determined before and after the 6-week training. RESULTS: STND and S-P training significantly improved [Formula: see text] by 4 ± 8 and 6 ± 6%, CS by 7 ± 7 and 3 ± 3%; LT by 5 ± 4% and 7 ± 8%, respectively (all P < .05), with no differences observed between groups. CONCLUSIONS: Novel metrics obtained from the SPV can offer similar training prescription and improvement in [Formula: see text], CS and LT compared to training derived from a traditional GXT.

Endurance Performance is Influenced by Perceptions of Pain and Temperature: Theory, Applications and Safety Considerations.

Models of endurance performance now recognise input from the brain, including an athlete's ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use.