The Effects of High Intensity Interval Training vs Steady State Training on Aerobic and Anaerobic Capacity.

UNLABELLED: High intensity interval training (HIIT) has become an increasingly popular form of exercise due to its potentially large effects on exercise capacity and small time requirement. This study compared the effects of two HIIT protocols vs steady-state training on aerobic and anaerobic capacity following 8-weeks of training. Fifty-five untrained college-aged subjects were randomly assigned to three training groups (3x weekly). Steady-state (n = 19) exercised (cycle ergometer) 20 minutes at 90% of ventilatory threshold (VT). Tabata (n = 21) completed eight intervals of 20s at 170% VO2max/10s rest. Meyer (n = 15) completed 13 sets of 30s (20 min) @ 100% PVO2 max/ 60s recovery, average PO = 90% VT. Each subject did 24 training sessions during 8 weeks. RESULTS: There were significant (p < 0.05) increases in VO2max (+19, +18 and +18%) and PPO (+17, +24 and +14%) for each training group, as well as significant increases in peak (+8, + 9 and +5%) & mean (+4, +7 and +6%) power during Wingate testing, but no significant differences between groups. Measures of the enjoyment of the training program indicated that the Tabata protocol was significantly less enjoyable (p < 0.05) than the steady state and Meyer protocols, and that the enjoyment of all protocols declined (p < 0.05) across the duration of the study. The results suggest that although HIIT protocols are time efficient, they are not superior to conventional exercise training in sedentary young adults. Key pointsSteady state training equivalent to HIIT in untrained studentsMild interval training presents very similar physiologic challenge compared to steady state trainingHIIT (particularly very high intensity variants were less enjoyable than steady state or mild interval trainingEnjoyment of training decreases across the course of an 8 week experimental training program.

Effects of beta-alanine supplementation on sprint endurance.

Recent research has shown that beta-alanine (BA) supplementation can increase intramuscular carnosine levels. Carnosine is an intramuscular buffer, and it has been linked to improvements in performance, specifically during bouts of high-intensity exercise that are likely limited by muscle acidosis. Therefore, the purpose of this study was to examine the effect of BA supplementation on sprint endurance at 2 different supramaximal intensities. Twenty-one anaerobically trained (rugby players [n = 4], wrestlers [n = 11], and recreationally strength trained athletes [n = 6]) college-aged men participated in a double-blind, placebo controlled study. The subjects performed an incremental VO2max test and 2 sprint to exhaustion tests set at 115 and 140% of their VO2max on a motorized treadmill before (PRE) and after (POST) a 5-week supplementation period. During this time, the subjects ingested either a BA supplement or placebo (PLA) with meals. The subjects ingested 4 g·d(-1) of BA or PLA during the first week and 6 g·d(-1) the following 4 weeks. Capillary blood samples were taken before and after each sprint to determine blood lactate response to the sprint exercise. No significant group (BA, PLA) × intensity (115%, 140%; p = 0.60), group by time (PRE, POST; p = 0.72), or group × intensity × time (p = 0.74) interactions were observed for time to exhaustion. In addition, similar nonsignificant observations were made for lactate response to the sprints (group × intensity, p = 0.43; group × time, p = 0.33, group × intensity × time, p = 0.56). From the results of this study, it was concluded that beta-alanine supplementation did not have a significant effect on sprint endurance at supramaximal intensities.

Evidence That Rating of Perceived Exertion Growth During Fatiguing Tasks is Scalar and Independent of Exercise Mode.

INTRODUCTION: The relationship between the percentage of a fatiguing ambulatory task completed and rating of perceived exertion (RPE) appears to be linear and scalar, with a relatively narrow "window." Recent evidence has suggested that a similar relationship may exist for muscularly demanding tasks. METHODS: To determine whether muscularly demanding tasks fit within this "ambulatory window," we tested resistance-trained athletes performing bench press and leg press with different loadings predicted to allow 5, 10, 20, and 30 repetitions and measured RPE (category ratio scale) at the end of the concentric action for each repetition. RESULTS: There was a regular, and strongly linear, pattern of growth of RPE for both bench press (r = .89) and leg press (r = .90) during the tasks that allowed 5.2 (1.2), 11.6 (1.9), 22.7 (2.0), and 30.8 (3.2) repetitions for bench press and 5.5 (1.5), 11.4 (1.6), 20.2 (3.0), and 32.4 (4.2) repetitions for leg press, respectively. CONCLUSIONS: The path of the RPE growth versus percentage task fit within the window evident for ambulatory tasks. The results suggest that the RPE versus percentage task completed relationship is scalar, relatively linear, and apparently independent of exercise mode.

Indoor Cycling Energy Expenditure: Does Sequence Matter?

Although cycling class intensity can be modified by changing interval intensity sequencing, it has not been established whether the intensity order can alter physiological and perceptual responses. Therefore, this study aimed to determine the effects of interval intensity sequencing on energy expenditure (EE), physiological markers, and perceptual responses during indoor cycling. Healthy volunteers (10 males = 20.0 ± 0.8years; 8 females = 21.3 ± 2.7years) completed three randomly ordered interval bouts (mixed pyramid-MP, ascending intervals-AI, descending intervals-DI) including three 3-min work bouts at 50%, 75%, and 100% of peak power output (PPO) and three 3-min recovery periods at 25% PPO. Heart rate (HR) and oxygen consumption (VO2) were expressed as percentages of maximal HR (%HRmax) and VO2 (%VO2max). EE was computed for both the work bout and for the 5-min recovery period. Session Rating of Perceived Exertion (sRPE) and Exercise Enjoyment Scale (EES) were recorded. No differences emerged for % HRmax (MP = 73.3 ± 6.1%; AI = 72.1 ± 4.9%; DI = 71.8 ± 4.5%), % VO2max (MP = 51.8 ± 4.6%; AI = 51.4 ± 3.9%; DI = 51.3 ± 4.5%), EE (MP = 277.5 ± 39.9 kcal; AI = 275.8 ± 39.4 kcal; DI = 274.9 ± 42.1 kcal), EES (MP = 4.9 ± 1.0; AI = 5.3 ± 1.1; DI = 4.9 ± 0.9), and sRPE (MP = 4.9 ± 1.0; AI = 5.3 ± 1.1; DI = 4.9 ± 0.9). EE during recovery was significantly (p < 0.005) lower after DI (11.9 ± 3.2 kcal) with respect to MP (13.2 ± 2.5 kcal) and AI (13.3 ± 2.5 kcal). Although lower EE was observed during recovery in DI, interval intensity sequencing does not affect overall EE, physiological markers, and perceptual responses.

Functional Translation of Exercise Responses from Exercise Testing to Exercise Training: The Test of a Model.

Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.

Summated Hazard Score as a Powerful Predictor of Fatigue in Relation to Pacing Strategy.

During competitive events, the pacing strategy depends upon how an athlete feels at a specific moment and the distance remaining. It may be expressed as the Hazard Score (HS) with momentary HS being shown to provide a measure of the likelihood of changing power output (PO) within an event and summated HS as a marker of how difficult an event is likely to be perceived to be. This study aimed to manipulate time trial (TT) starting strategies to establish whether the summated HS, as opposed to momentary HS, will improve understanding of performance during a simulated cycling competition. Seven subjects (peak PO: 286 ± 49.7 W) performed two practice 10-km cycling TTs followed by three 10-km TTs with imposed PO (±5% of mean PO achieved during second practice TT and a self-paced TT). PO, rating of perceived exertion (RPE), lactate, heart rate (HR), HS, summated HS, session RPE (sRPE) were collected. Finishing time and mean PO for self-paced (time: 17.51 ± 1.41 min; PO: 234 ± 62.6 W), fast-start (time: 17.72 ± 1.87 min; PO: 230 ± 62.0 W), and slow-start (time: 17.77 ± 1.74 min; PO: 230 ± 62.7) TT were not different. There was a significant interaction between each secondary outcome variable (PO, RPE, lactate, HR, HS, and summated HS) for starting strategy and distance. The evolution of HS reflected the imposed starting strategy, with a reduction in PO following a fast-start, an increased PO following a slow-start with similar HS during the last part of all TTs. The summated HS was strongly correlated with the sRPE of the TTs (r = 0.88). The summated HS was higher with a fast start, indicating greater effort, with limited time advantage. Thus, the HS appears to regulate both PO within a TT, but also the overall impression of the difficulty of a TT.

The effect of beta-alanine supplementation on power performance during repeated sprint activity.

The dipeptide carnosine has been shown to contribute to the buffer capacity of hydrogen ions (H) during intense exercise. Increasing skeletal muscle carnosine levels through beta-alanine (BA) supplementation has been shown to maintain acid-base balance, delay fatigue, and improve exercise performance. We designed this study to examine the effect of 5 weeks of BA supplementation on repeat high-intensity sprint performance. Nineteen, physically active, college men were divided into 2 groups (control [C], n = 10 or BA, n = 9). We performed double-blind placebo-controlled study where subjects ingested 4 g per day during the first week and 6 g per day over the next 4 weeks of a placebo (rice flour) or a BA supplement. Subjects completed 2 sets of 5 5-second sprints with 45-second recovery separated by 2 minutes of active recovery. All tests were conducted on a non-motorized treadmill against a resistance of 15% of the participant's body weight. We recorded horizontal power (HP) of the running sprint. Post-exercise capillary blood samples were analyzed for lactate to determine the metabolic demands. There were no significant between-group differences (p > 0.05) in HPpeak or HPmean for the repeat sprint protocol. No significant between-group differences were found for performance decrement (% fatigue) for HPpeak or HPmean. In addition, no significant interactions were observed. Post-exercise blood lactate values were similar pre and post supplementation in both groups. The results of this study clearly indicate that 5 weeks of BA supplementation provides no benefit for repeat sprint performance.

The effects of cold whirlpool on power, speed, agility, and range of motion.

The purpose was to determine if cold whirlpool treatment decreases functional performance equally regardless of gender. A secondary aim was to determine if there is a gradual increase in functional performance across time. Twenty-one college-aged subjects volunteered to participate in this study and were required to perform four measures of functional performance including: counter movement vertical jump, T-test, 36.58-meter dash (40-yard), and active range of motion of the ankle. Participants were treated with a 20 minute, 10 degree Celsius cold whirlpool following the pre-test of a given functional performance measure. Participants demonstrated significant decreases in counter movement vertical jump, T-test, and 40-yard dash performance immediately following treatment. Vertical jump performance remained impaired for at least 32 minutes. While both the T-test and 40-yard dash were affected for 7 and 22 minutes post- treatment, respectively. Participants also demonstrated significant decreases in peak power and average power immediately after and for 32 minutes post-treatment. Dorsiflexion was significantly decreased 7 and 12 minutes following treatment. There were no differences for plantar flexion, inversion, or eversion. These data suggest functional performance was affected immediately following and for up to 32 minutes after cold whirlpool treatment. It was also evident that there is a gradual performance increase for each measure of functional performance across time. Therefore, the consequences should be carefully considered before returning athletes to activity following cold whirlpool treatment. Key pointsCryotherapy is a common and highly effective modality in treating acute and chronic athletic injuries.The results indicated that cold whirlpool does have an immediate and subsequent effect on functional performance.Understanding how cold whirlpool adversely affects functional performance allows clinicians to continue using this modality before vigorous athletic activity.

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations.

OBJECTIVE: To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations. BACKGROUND: One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment. The critical concern in managing a dislocation is deciding when a joint can be reduced onsite and when the patient should be splinted and transported for reduction to be performed in the hospital or medical setting. Factors that influence the decision-making process include the following: whether the AT possesses a documented protocol that is supported by his or her supervising physician(s), employer documents, and respective state regulations; the AT's qualifications and experience; the dislocated joint; whether the dislocation is first time or recurrent; the patient's age and general health; and whether associated injuries are present. RECOMMENDATIONS: These guidelines are intended to provide considerations for the initial care of specific joint dislocations. They are not intended to represent the standard of care and should not be interpreted as a standard of care for therapeutic or legal discussion.

Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.

OBJECTIVE: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. BACKGROUND: A 23-year-old male collegiate wrestler injured his neck in a wrestling tournament match and experienced pain, weakness, and numbness in his left upper extremity. He completed that match and 1 additional match that day with mild symptoms. Evaluation by a certified athletic trainer 6 days postinjury showed radiculopathy in the C7 distribution of his left upper extremity. He was evaluated further by the team physician, a primary care physician, and a neurosurgeon. DIFFERENTIAL DIAGNOSIS: Cervical spine injury, stinger/burner, peripheral nerve injury, spinal cord injury, thoracic outlet syndrome, brachial plexus radiculopathy. TREATMENT: The patient initially underwent nonoperative management with ice, heat, massage, electrical stimulation, shortwave diathermy, and nonsteroidal anti-inflammatory drugs without symptom resolution. Cervical spine radiographs were negative for bony pathologic conditions. Magnetic resonance imaging showed evidence of T1-T2 disc herniation. The patient underwent surgery to resolve the symptoms and enable him to participate for the remainder of the wrestling season. UNIQUENESS: Whereas brachial plexus radiculopathy commonly is seen in collision sports, a postfixed brachial plexus in which the T2 nerve root has substantial contribution to the innervation of the upper extremity is a rare anatomic variation with which many health care providers are unfamiliar. CONCLUSIONS: The injury sustained by the wrestler appeared to be C7 radiculopathy due to a brachial plexus traction injury. However, it ultimately was diagnosed as radiculopathy due to a T1-T2 thoracic intervertebral disc herniation causing impingement of a postfixed brachial plexus and required surgical intervention. Athletic trainers and physicians need to be aware of the anatomic variations of the brachial plexus when evaluating and caring for patients with suspected brachial plexus radiculopathies.

Breaking away: effects of nonuniform pacing on power output and growth of rating of perceived exertion.

UNLABELLED: The rating of perceived exertion (RPE) normally grows as a scalar function of relative competitive distance, suggesting that it may translate between the brain and body relative to managing fatigue during time-trial exercise. In nonstandard pacing situations, a reciprocal relationship between RPE and power output (PO) would be predicted. PURPOSE: To determine whether PO would decrease when RPE was forced above the normal growth curve during a cycle time trial. METHODS: Well-trained cyclists performed randomly ordered 10-km cycle time trials. In CONTROL they rode at their own best pace throughout. In BURST, they made a 1-km "burst" at the 4-km mark and then finished as rapidly as possible. RESULTS: CONTROL was significantly (P < .05) faster than BURST (16:36 vs 17:00 min). During CONTROL, responses between 4 and 5 km were PO, 240 W; RPE, 5-6; and blood lactate [HLa], 8-9 mmol/L. During BURST PO increased to 282 W, then fell to 220 W after the burst and remained below CONTROL until the end spurt (9 km). RPE increased to 9 during the burst but returned to the normal RPE growth pattern by 6 km; [HLa] increased to ~13 mmol/L after the burst and remained elevated throughout the remainder of the trial. CONCLUSIONS: The reciprocal behavior of RPE and PO after BURST supports the hypothesis that RPE translates between the brain and the body during heavy exercise. However, the continuing reduction of PO after the burst, even after RPE returned to its normal growth pattern, suggests that PO is regulated in a more complex manner than reflected solely by RPE.

Hip-abductor fatigue and single-leg landing mechanics in women athletes.

CONTEXT: Reduced hip-abductor strength and muscle activation may be associated with altered lower extremity mechanics, which are thought to increase the risk for anterior cruciate ligament injury. However, experimental evidence supporting this relationship is limited. OBJECTIVE: To examine the changes in single-leg landing mechanics and gluteus medius recruitment that occur after a hip-abductor fatigue protocol. DESIGN: Descriptive laboratory study. PATIENTS OR OTHER PARTICIPANTS: Twenty physically active women (age  =  21.0 ± 1.3 years). INTERVENTION(S): Participants were tested before (prefatigue) and after (postfatigue) a hip-abductor fatigue protocol consisting of repetitive side-lying hip abduction. MAIN OUTCOME MEASURE(S): Outcome measures included sagittal-plane and frontal-plane hip and knee kinematics at initial contact and at 60 milliseconds after initial contact during 5 single-leg landings from a height of 40 cm. Peak hip and knee sagittal-plane and frontal-plane joint moments during this time interval were also analyzed. Measures of gluteus medius activation, including latency, peak amplitude, and integrated signal, were recorded. RESULTS: A small (<1°) increase in hip-abduction angle at initial contact and a small (<1°) decrease in knee-abduction (valgus) angle at 60 milliseconds after contact were observed in the postfatigue landing condition. No other kinematic changes were noted for the knee or hip at initial contact or at 60 milliseconds after initial contact. Peak external knee-adduction moment decreased 27% and peak hip adduction moment decreased 24% during the postfatigue landing condition. Gluteus medius activation was delayed after the protocol, but no difference in peak or integrated signal was seen during the landing trials. CONCLUSIONS: Changes observed during single-leg landings after hip-abductor fatigue were not generally considered unfavorable to the integrity of the anterior cruciate ligament. Further work may be justified to study the role of hip-abductor activation in protecting the knee during landing.

The diagnostic value of the Clarke sign in assessing chondromalacia patella.

CONTEXT: Various techniques have been described for assessing conditions that cause pain at the patellofemoral (PF) joint. The Clarke sign is one such test, but the diagnostic value of this test in assessing chondromalacia patella is unknown. OBJECTIVE: To (1) investigate the diagnostic value of the Clarke sign in assessing the presence of chondromalacia patella using arthroscopic examination of the PF joint as the "gold standard," and (2) provide a historical perspective of the Clarke sign as a clinical diagnostic test. DESIGN: Validation study. SETTING: All patients of one of the investigators who had knee pain or injuries unrelated to the patellofemoral joint and were scheduled for arthroscopic surgery were recruited for this study. PATIENTS OR OTHER PARTICIPANTS: A total of 106 otherwise healthy individuals with no history of patellofemoral pain or dysfunction volunteered. MAIN OUTCOME MEASURE(S): The Clarke sign was performed on the surgical knee by a single investigator in the clinic before surgery. A positive test was indicated by the presence of pain sufficient to prevent the patient from maintaining a quadriceps muscle contraction against manual resistance for longer than 2 seconds. The preoperative result was compared with visual evidence of chondromalacia patella during arthroscopy. RESULTS: Sensitivity was 0.39, specificity was 0.67, likelihood ratio for a positive test was 1.18, likelihood ratio for a negative test was 0.91, positive predictive value was 0.25, and negative predictive value was 0.80. CONCLUSIONS: Diagnostic validity values for the use of the Clarke sign in assessing chondromalacia patella were unsatisfactory, supporting suggestions that it has poor diagnostic value as a clinical examination technique. Additionally, an extensive search of the available literature for the Clarke sign reveals multiple problems with the test, causing significant confusion for clinicians. Therefore, the use of the Clarke sign as a routine part of a knee examination is not beneficial, and its use should be discontinued.

The talk test as a marker of exercise training intensity.

PURPOSE: Correlative data have suggested that the Talk Test (TT) may be a surrogate of the ventilatory threshold (VT). This study examined manipulations of either the VT or exercise protocol to test the hypothesis that the TT and VT are related in a robust way, adequate for exercise prescription. METHODS: Healthy young adults participated in 4 independent series of experiments designed to decrease (blood donation) or increase (training) VT, or to systematically vary the exercise intensity above and below VT. These interventions were matched to responses of the TT. RESULTS: The changes in the exercise intensity at VT and at the last positive stage of the TT matched each other following both blood donation and training. When exercise intensity was varied above and below VT, the predicted ability to speak was well matched to observations of the TT. Predictive errors biased toward passing the TT when exercise intensity was greater than VT. The time required for the result of TT to become negative when exercise intensity was more than VT, decreased with increasing intensity but averaged more than the 2 minutes that has been used in previous studies. CONCLUSIONS: This study confirms the robust relationship between VT and the TT during various interventions and suggests that the TT is suitable for exercise prescription.

Slipping Rib Syndrome in a Collegiate Swimmer: A Case Report.

Objective: To present the unique case of a collegiate swimmer who experienced nearly 9 months of unresolved rib pain.Background: A 20-year-old collegiate swimmer was jumping up and down, warming up before a race, when she experienced pain in the area of her left lower rib cage. She completed the event and 2 additional events that day with moderate discomfort. The athlete was evaluated by a certified athletic trainer 3 days postinjury and followed up over the next 9 months with the team physician, a chiropractor, a nonsurgical sports medicine physician, and a thoracic surgeon.Differential Diagnosis: Intercostal strain, oblique strain, fractured rib, somatic dysfunction, hepatosplenic conditions, pleuritic chest pain, slipping rib syndrome.Treatment: The athlete underwent 4 months of conservative treatment (eg, activity modification, ice, ultrasound, hot packs, nonsteroidal anti-inflammatory drugs) after the injury, independently sought chiropractic intervention (12 treatments) 4 to 6 months postinjury, was referred to physical therapy (10 visits) by a nonsurgical sports medicine physician 6 to 8 months postinjury, and finally underwent surgical intervention 9 months after the onset of the initial symptoms.Uniqueness: Slipping rib syndrome was first described in 1919. However, many health care professionals who are involved with diagnosing and treating athletes and active individuals (eg, athletic trainers, physicians) are relatively unfamiliar with this musculoskeletal condition.Conclusions: It is important for clinicians and team physicians to familiarize themselves with and consider the diagnosis of slipping rib syndrome when assessing and managing individuals with persistent abdominal and/or thoracic pain.