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

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

Effect of protocol on peak power output in continuous incremental cycle exercise tests.

PURPOSE: Peak power output ([Formula: see text]peak) in an incremental exercise test (EXT) is considered an important predictor of performance for cyclists. However, [Formula: see text]peak is protocol dependent. The purpose of this study was to model the effect of EXT design on [Formula: see text]peak. METHODS: An adapted version of a previously developed mathematical model was used. For the purpose of validity testing, we compared predicted [Formula: see text]peak differences (predicted Δ[Formula: see text]peak) with actual Δ[Formula: see text]peak found in sports science literature. RESULTS: The model quantified Δ[Formula: see text]peak between 36 EXT designs with stage durations in the range 1-5 min and increments in the range 10-50 W. Predicted Δ[Formula: see text]peak and actual Δ[Formula: see text]peak across a wide range of performance levels of cyclists were in good agreement. Depending on the specific combination of increment and stage duration, [Formula: see text]peak may be widely different or equivalent. A minimum difference in increment (5 W) or in stage duration (1 min) already results in significantly different [Formula: see text]peak. In EXTs having the same ratio between increment and stage duration, [Formula: see text]peak in the EXT with the shortest stage duration or the greatest increment is significantly higher. Tests combining 15 W, 25 W or 40 W increments with 2, 3 and 4 min stage durations, respectively, are 'special' in that their [Formula: see text]peak approximates the power output associated with maximal oxygen uptake ([Formula: see text]). CONCLUSIONS: The modeling results allow comparison of [Formula: see text]peak between widely different EXT designs. Absolute performance level does not affect Δ[Formula: see text]peak. [Formula: see text]peak15/2, [Formula: see text]peak25/3 and [Formula: see text]peak40/4 constitute a practical physiologic reference for performance diagnostics and exercise intensity prescription.

Mechanisms affecting exercise ventilatory inefficiency-airflow obstruction relationship in male patients with chronic obstructive pulmonary disease.

BACKGROUND: Exercise ventilatory inefficiency is usually defined as high ventilation ([Formula: see text]) versus low CO2 output ([Formula: see text]). The inefficiency may be lowered when airflow obstruction is severe because [Formula: see text] cannot be adequately increased in response to exercise. However, the ventilatory inefficiency-airflow obstruction relationship differs to a varying degree. This has been hypothesized to be affected by increased dead space fraction of tidal volume (VD/VT), acidity, hypoxemia, and hypercapnia. METHODS: A total of 120 male patients with chronic obstructive pulmonary disease were enrolled. Lung function and incremental exercise tests were conducted, and [Formula: see text] versus [Formula: see text] slope ([Formula: see text]) and intercept ([Formula: see text]) were obtained by linear regression. Arterial blood gas analysis was also performed in 47 of the participants during exercise tests. VD/VT and lactate level were measured. RESULTS: VD/VTpeak was moderately positively related to [Formula: see text] (r = 0.41) and negatively related to forced expired volume in 1 sec % predicted (FEV1%) (r = - 0.27), and hence the FEV1%- [Formula: see text] relationship was paradoxical. The higher the [Formula: see text], the higher the pH and PaO2, and the lower the PaCO2 and exercise capacity. [Formula: see text] was marginally related to VD/VTrest. The higher the [Formula: see text], the higher the inspiratory airflow, work rate, and end-tidal PCO2peak. CONCLUSION: 1) Dead space ventilation perturbs the airflow- [Formula: see text] relationship, 2) increasing ventilation thereby increases [Formula: see text] to maintain biological homeostasis, and 3) the physiology- [Formula: see text]- [Formula: see text] relationships are inconsistent in the current and previous studies. TRIAL REGISTRATION: MOST 106-2314-B-040-025 .

Effect of ramp slope on different methods to determine lactate threshold in semi-professional soccer players.

The present study aimed to investigate the effect of stage duration in incremental protocols on lactate threshold (LT), determined by different methods. Sixteen semi-professional soccer-players performed a 4-min stage incremental discontinuous (DP) and two maximal incremental running continuous (1 km h-1· min-1, CP1; and 1 km h-1·2 min-1 CP2) protocols. Blood-lactate concentration [La-] was measured at baseline and during the protocols. LT was determined using DMAX, DMAX-MOD, 4-mM⋅L-1, Δ1-mM⋅L-1 and Log-Log methods. Log-Log showed no difference in LT between CP1, CP2 and DP. Conversely, LT was determined at higher velocity in CP1 than CP2 for DMAX (15.2 ± 0.5 vs 14.4 ± 1.2 km⋅h-1, P = 0.002), DMAX-MOD (16.0 ± 0.5 vs 14.7 ± 1.3 km⋅h-1, P < 0.001), 4-mM⋅L-1 (15.5 ± 1.4 vs 14.4 ± 1.2 km⋅h-1, P < 0.001), Δ1-mM⋅L-1 (15.5 ± 1.3 vs 14.4 ± 1.2 km⋅h-1, P < 0.001). Higher LT in CP1 than DP for DMAX (15.2 ± 0.5 vs 13.0 ± 1.0 km⋅h-1, P < 0.001) and DMAX-MOD (16.0 ± 0.5 vs 13.6 ± 1.6 km⋅h-1, P < 0.001) was found (P < 0.001). Log-Log resulted in shorter but accurate protocols to determine LT.

Increased consumption and vasodilatory effect of nitrite during exercise.

This study investigated the effects of aerobic-to-anaerobic exercise on nitrite stores in the human circulation and evaluated the effects of systemic nitrite infusion on aerobic and anaerobic exercise capacity and hemodynamics. Six healthy volunteers were randomized to receive sodium nitrite or saline for 70 min in two separate occasions in an exercise study. Subjects cycled on an upright electronically braked cycle ergometer 30 min into the infusion according to a ramp protocol designed to attain exhaustion in 10 min. They were allowed to recover for 30 min thereafter. The changes of whole blood nitrite concentrations over the 70-min study period were analyzed by pharmacokinetic modeling. Longitudinal measurements of hemodynamic and clinical variables were analyzed by fitting nonparametric regression spline models. During exercise, nitrite consumption/elimination rate was increased by ∼137%. Cardiac output (CO), mean arterial pressure (MAP), and pulmonary artery pressure (PAP) were increased, but smaller elevation of MAP and larger increases of CO and PAP were found during nitrite infusion compared with placebo control. The higher CO and lower MAP during nitrite infusion were likely attributed to vasodilation and a trend toward decrease in systemic vascular resistance. In contrast, there were no significant changes in mean pulmonary artery pressures and pulmonary vascular resistance. These findings, together with the increased consumption of nitrite and production of iron-nitrosyl-hemoglobin during exercise, support the notion of nitrite conversion to release NO resulting in systemic vasodilatation. However, at the dosing used in this protocol achieving micromolar plasma concentrations of nitrite, exercise capacity was not enhanced, as opposed to other reports using lower dosing.

The Effect of Skeletal Muscle Oxygenation on Hemodynamics, Cerebral Oxygenation and Activation, and Exercise Performance during Incremental Exercise to Exhaustion in Male Cyclists.

This study aimed to elucidate whether muscle blood flow restriction during maximal exercise is associated with alterations in hemodynamics, cerebral oxygenation, cerebral activation, and deterioration of exercise performance in male participants. Thirteen healthy males, cyclists (age 33 ± 2 yrs., body mass: 78.6 ± 2.5 kg, and body mass index: 25.57 ± 0.91 kg·m-1), performed a maximal incremental exercise test on a bicycle ergometer in two experimental conditions: (a) with muscle blood flow restriction through the application of thigh cuffs inflated at 120 mmHg (with cuffs, WC) and (b) without restriction (no cuffs, NC). Exercise performance significantly deteriorated with muscle blood flow restriction, as evidenced by the reductions in V˙O2max (-17 ± 2%, p < 0.001), peak power output (-28 ± 2%, p < 0.001), and time to exhaustion (-28 ± 2%, p < 0.001). Muscle oxygenated hemoglobin (Δ[O2Hb]) during exercise declined more in the NC condition (p < 0.01); however, at exhaustion, the magnitude of muscle oxygenation and muscle deoxygenation were similar between conditions (p > 0.05). At maximal effort, lower cerebral deoxygenated hemoglobin (Δ[HHb]) and cerebral total hemoglobin (Δ[THb]) were observed in WC (p < 0.001), accompanied by a lower cardiac output, heart rate, and stroke volume vs. the NC condition (p < 0.01), whereas systolic blood pressure, rating of perceived exertion, and cerebral activation (as assessed by electroencephalography (EEG) activity) were similar (p > 0.05) between conditions at task failure, despite marked differences in exercise duration, maximal aerobic power output, and V˙O2max. In conclusion, in trained cyclists, muscle blood flow restriction during an incremental cycling exercise test significantly limited exercise performance. Exercise intolerance with muscle blood flow restriction was mainly associated with attenuated cardiac responses, despite cerebral activation reaching similar maximal levels as without muscle blood flow restriction.

Comparing the reliability of muscle oxygen saturation with common performance and physiological markers across cycling exercise intensity.

Introduction: Wearable near-infrared spectroscopy (NIRS) measurements of muscle oxygen saturation (SmO2) demonstrated good test-retest reliability at rest. We hypothesized SmO2 measured with the Moxy monitor at the vastus lateralis (VL) would demonstrate good reliability across intensities. For relative reliability, SmO2 will be lower than volume of oxygen consumption (V̇O2) and heart rate (HR), higher than concentration of blood lactate accumulation ([BLa]) and rating of perceived exertion (RPE). We aimed to estimate the reliability of SmO2 and common physiological measures across exercise intensities, as well as to quantify within-participant agreement between sessions. Methods: Twenty-one trained cyclists completed two trials of an incremental multi-stage cycling test with 5 min constant workload steps starting at 1.0 watt per kg bodyweight (W·kg-1) and increasing by 0.5 W kg-1 per step, separated by 1 min passive recovery intervals until maximal task tolerance. SmO2, HR, V̇O2, [BLa], and RPE were recorded for each stage. Continuous measures were averaged over the final 60 s of each stage. Relative reliability at the lowest, median, and highest work stages was quantified as intraclass correlation coefficient (ICC). Absolute reliability and within-subject agreement were quantified as standard error of the measurement (SEM) and minimum detectable change (MDC). Results: Comparisons between trials showed no significant differences within each exercise intensity for all outcome variables. ICC for SmO2 was 0.81-0.90 across exercise intensity. ICC for HR, V̇O2, [BLa], and RPE were 0.87-0.92, 0.73-0.97, 0.44-0.74, 0.29-0.70, respectively. SEM (95% CI) for SmO2 was 5 (3-7), 6 (4-9), and 7 (5-10)%, and MDC was 12%, 16%, and 18%. Discussion: Our results demonstrate good-to-excellent test-retest reliability for SmO2 across intensity during an incremental multi-stage cycling test. V̇O2 and HR had excellent reliability, higher than SmO2. [BLa] and RPE had lower reliability than SmO2. Muscle oxygen saturation measured by wearable NIRS was found to have similar reliability to V̇O2 and HR, and higher than [BLa] and RPE across exercise intensity, suggesting that it is appropriate for everyday use as a non-invasive method of monitoring internal load alongside other metrics.

Differences between the Vastus Lateralis and Gastrocnemius Lateralis in the Assessment Ability of Breakpoints of Muscle Oxygenation for Aerobic Capacity Indices During an Incremental Cycling Exercise.

In recent years, breakpoints (Bp) of muscle oxygenation have been measured in local muscles using near infrared spectroscopy (NIRS) to assess (predict) systemic aerobic capacity indices [lactate threshold (LT), gas exchange threshold (GET) and maximal oxygen uptake (VO2peak)]. We investigated muscular differences in the assessment (predictive) ability of the Bp of muscle oxygenation for aerobic capacity indices during incremental cycling exercise on the aerobic capacity indices. Thirty-one active college students were recruited for an incremental cycling exercise test, during which NIRS muscle oxygenation in the vastus lateralis (VL) and gastrocnemius lateralis (GL), blood lactate concentration and cardiopulmonary variables were measured simultaneously in a multi-modality approach. A linear regression model was used to analyse the relationship between the Bp of the muscle oxygenation index (OI) and the systemic aerobic capacity indices. The Bp of the muscle OI in both the VL (BpVL) and GL (BpGL) were significantly correlated with the aerobic capacity indices. Additionally, the BpVL had a better goodness-of-fit [higher coefficient of determination (R(2), p < 0.001) and lower root mean squared error (RMSE, p < 0.03)] in the linear regressions and occurred earlier than the BpGL. In conclusion, both the BpVL and the BpGL could be measured by NIRS to assess the systemic aerobic capacity indices; however, there were muscular differences in the assessment ability of the Bp of muscle oxygenation.

Surya Namaskar: As an Alternative for Aerobic Fitness.

Context: "Surya Namaskar" (SN) may be used as a need-based short-duration aerobic activity in a confined space to establish as a substitute of an equivalent routine physical training in challenging stressful conditions. Materials and Methods: Noninvasive oxygen-kinetics metabolic responses between SN and endurance work on bicycle ergometry (BE) were compared across different phases of maximal oxygen uptake percentage (%VO2 max). SN, comprising three complete rounds per min (36 beats/min of a metronome; SN consists of 12 poses per round), was performed rhythmically and continuously for 5 min to simulate an incremental BE test (25 watts/2 min at 60 rpm). Results: SN results in a significant (P < 0.05) greater increase of arteriovenous oxygen difference at 71%-80% VO2 max while keeping a low respiratory exchange ratio (P < 0.01 and 0.001) at 41%-80% VO2 max exercising state. Conclusions: SN could be an ideal form of aerobic exercise instead of BE.

Features of electromyography threshold of the respiratory muscles during incremental exercise test.

In this study, we aimed to examine the electromyography threshold (EMGT) of the respiratory muscle and accessory respiratory muscles. Sixteen healthy men underwent an incremental exercise test at 15 W/minute to the end point. Expired gases and electromyograms of the respiratory and lower limb muscles were measured. The breakpoints for the EMG and expired gas data were analyzed using a segmented regression model. EMGT of the sternocleidomastoid and diaphragm was significantly more delayed than the ventilation threshold (VT) (287.94 s, 288.15 s vs. 185.5 s, p = 0.028 and 0.044, respectively). The EMGT of respiratory muscles and VT were not related, though EMGT of rectus femoris and vastus lateralis correlated with VT (r = 0.854, p < 0.001; r = 0.657, p = 0.011, respectively). EMGT of respiratory muscles may be influenced by multiple factors, such as central command and afferent input of mechanical stimulation from muscles, in addition to VT-induced changes in metabolic dynamics.

Validation of a smart shirt for heart rate variability measurements at rest and during exercise.

Heart rate variability (HRV) monitoring is a promising option to estimate the autonomic nervous system regulation responding to exercise. Textiles with embedded sensors recording heartbeat intervals are a simple tool for data collection. The so-called smart shirts offer comfort for daily use and are managed easily. Their measurement accuracy for HRV calculation at rest is promising, but remains questionable during exercise. Therefore, the present study validated the Ambiotex smart shirt using HRV indices (root mean square of successive differences, rel. HF power [high-frequency power percentage of total power] and rel. LF [low-frequency power percentage of total power] power) during exercise. Eighty-three healthy participants (31 ± 6 years; 39 females, 44 males) completed an incremental exercise test on a bicycle ergometer wearing the smart shirt and an electrocardiogram simultaneously. We compared HRV indices of segments at rest (5 min), at warm-up (3 min) and twice at the exercise test (each 5 min). At rest and at warm-up, we observed excellent linear relationship (r > 0.96; R2 ​​​​​ > 0.94), excellent relative reliability (intraclass correlation coefficient ≥ 0.98; α ≥ 0.98) and acceptable agreement (bias < 10%). During the exercise test, measurement accuracy declined with increasing intensity but remained high (>0.8), although results for partial HRV indices were insufficient. In addition, percentage bias was unacceptable during an exercise test. However, the findings support the validity of the smart shirt for measuring HRV, especially at rest and at warm-up. We suggest using the smart shirt for monitoring HRV indices on a daily basis, but caution should be taken in the interpretation of HRV indices obtained during moderate to vigorous exercise intensities.

Hierarchical stratification of the factors related to exertional dyspnoea and exercise intolerance in male COPD patients.

BACKGROUND: The order and extent of interactions across the factors affecting exertional dyspnoea (ED) and exercise intolerance (EI) in patients with chronic obstructive pulmonary disease (COPD) are not clear. We hypothesized that lung and non-lung variables were the primary variables, ED was the secondary variable and EI was the tertiary variable. METHODS: Data on demographics, blood tests, cardiac imaging, lung function tests and invasive dead space fractions (VD/VT) during incremental exercise test of 46 male COPD subjects were obtained. These variables were categorized by factor analysis and pair-wise correlation analysis was conducted. The best factor of each category was selected and then multivariate regression was conducted. RESULTS: Peak tidal inspiratory flow (VT/TIpeak), VD/VTpeak and tidal lung expansion capability, and resting diffusing capacity of the lungs (DLCO)% predicted were the primary pulmonary factors most related to ED, whereas body mass index (BMI), haemoglobin and cholesterol levels were the primary non-pulmonary factors. In multivariate regression analysis, VT/TIpeak, VD/VTpeak and DLCO% were the primary factors most related to ED (r2 = 0.69); ED was most related to EI (r = -0.74 to -0.83). CONCLUSION: Using hierarchical stratification and statistical methods may improve understanding of the pathophysiology of ED and EI in patients with COPD. KEY MESSAGESThe pathophysiology of exertional dyspnoea (ED) and exercise intolerance (EI) in chronic obstructive pulmonary disease (COPD) is complex. The order and extent of interactions across factors are not clear. In multivariate regression analysis, we found that tidal inspiratory flow, dead space fraction and resting diffusing capacity of the lungs % but not the non-pulmonary factors affected ED.Using correlation coefficients, we further found that ED was the secondary variable and EI was the tertiary variable.Hierarchical stratification of the important factors associated with ED and EI in patients with COPD clarifies their relationships and could be incorporated into management programmes and outcome studies for these patients.

Comparison of the Ramp and Step Incremental Exercise Test Protocols in Assessing the Maximal Fat Oxidation Rate in Youth Cyclists.

The incremental exercise test is the most common method in assessing the maximal fat oxidation (MFO) rate. The main aim of the study was to determine whether the progressive linear RAMP test can be used to assess the maximal fat oxidation rate along with the intensities that trigger its maximal (FATmax) and its minimal (FATmin) values. Our study comprised 57 young road cyclists who were tested in random order. Each of them was submitted to two incremental exercise tests on an electro-magnetically braked cycle-ergometer - STEP (50 W·3 min-1) and RAMP (~0.278 W·s-1) at a 7-day interval. A stoichiometric equation was used to calculate the fat oxidation rate, while the metabolic thresholds were defined by analyzing ventilation gases. The Student's T-test, Bland-Altman plots and Pearson's linear correlations were resorted to in the process of statistical analysis. No statistically significant MFO variances occurred between the tests (p = 0.12) and its rate amounted to 0.57 ± 0.15 g·min-1 and 0.53 ± 0.17 g·min-1 in the STEP and RAMP, respectively. No statistically significant variances in the absolute and relative (to maximal) values of oxygen uptake and heart rate were discerned at the FATmax and FATmin intensities. The RAMP test displayed very strong oxygen uptake correlations between the aerobic threshold and FATmax (r = 0.93, R2 = 0.87, p < 0.001) as well as the anaerobic threshold and FATmin (r = 0.88, R2 = 0.78, p < 0.001). Our results corroborate our hypothesis that the incremental RAMP test as well as the STEP test are reliable tools in assessing MFO, FATmax and FATmin intensities.

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease.

Physiological dead space volume (VD) and dynamic hyperinflation (DH) are two different types of abnormal pulmonary physiology. Although they both involve lung volume, their combination has never been advocated, and thus their effect and implication are unclear. This study aimed (1) to combine VD and DH, and (2) investigate their relationship and clinical significance during exercise, as well as (3) identify a noninvasive variable to represent the VD fraction of tidal volume (VD/VT). Forty-six male subjects with chronic obstructive pulmonary disease (COPD) and 34 healthy male subjects matched for age and height were enrolled. Demographic data, lung function, and maximal exercise were investigated. End-expiratory lung volume (EELV) was measured for the control group and estimated for the study group using the formulae reported in our previous study. The VD/VT ratio was measured for the study group, and reference values of VD/VT were used for the control group. In the COPD group, the DHpeak/total lung capacity (TLC, DHpeak%) was 7% and the EELVpeak% was 70%. After adding the VDpeak% (8%), the VDDHpeak% was 15% and the VDEELVpeak% was 78%. Both were higher than those of the healthy controls. In the COPD group, the VDDHpeak% and VDEELVpeak% were more correlated with dyspnea score and exercise capacity than that of the DHpeak% and EELV%, and had a similar strength of correlation with minute ventilation. The VTpeak/TLC (VTpeak%), an inverse marker of DH, was inversely correlated with VD/VT (R2 ≈ 0.50). Therefore, we recommend that VD should be added to DH and EELV, as they are physiologically meaningful and VTpeak% represents not only DH but also dead space ventilation. To obtain VD, the VD/VT must be measured. Because obtaining VD/VT requires invasive arterial blood gases, further studies on noninvasive predicting VD/VT is warranted.

The Effect of Exercise on the Skin Content of the Reduced Form of NAD and Its Response to Transient Ischemia and Reperfusion in Highly Trained Athletes.

Reduced nicotinamide adenine dinucleotide (NADH) is synthesized in the cellular nucleus, cytoplasm and mitochondria but oxidized into NAD+ almost exclusively in mitochondria. Activation of human skin by the 340 nm ultraviolet light triggers natural fluorescence at the light length of 460 nm, which intensity is proportional to the skin NADH content. This phenomenon is used by the Flow Mediated Skin Fluorescence (FMSF) which measures changes in the skin NADH content during transient ischemia and reperfusion. We examined the effects of exercise to exhaustion on the skin changes of NADH in response to 200 s forearm ischemia and reperfusion in 121 highly trained athletes (94 men and 27 women, long-distance running, triathlon, taekwondo, rowing, futsal, sprint running, fencing, and tennis). We found that exercise until exhaustion changes the skin content of NADH, modifies NADH turnover at rest, during ischemia and reperfusion in the most superficial living skin cells. Compared to the pre-exercise, there were significant increases in: mean fluorescence recorded during rest as the baseline value (B mean) (p < 0.001), the maximal fluorescence that increased above the baseline during controlled forearm ischemia (FImax) (p < 0.001, only in men), the minimal fluorescence after decreasing below the baseline during reperfusion (FRmin) (p < 0.001 men; p < 0.01 women) and the difference between B mean and FRmin (R min) (p < 0.01), and reductions in the difference between FImax and B mean (I max) (p < 0.001) and I max/IRampl ratio (CImax) (p < 0.001) after the incremental exercise test. There was no statistical difference between pre- and post-exercise the maximal range of the fluorescence change during ischemia and reperfusion (IRampl). In conclusion, exercise to exhaustion modifies the skin NADH content at rest, during ischemia and reperfusion as well as the magnitude of changes in the NADH caused by ischemia and reperfusion. Our findings suggest that metabolic changes in the skin NADH accompanying exercise extend beyond muscles and affect other cells and organs.

Alterations in Exercise-Induced Plasma Adenosine Triphosphate Concentration in Highly Trained Athletes in a One-Year Training Cycle.

This study aimed to assess the effect of training loads on plasma adenosine triphosphate responsiveness in highly trained athletes in a 1 y cycle. Highly trained futsal players (11 men, age range 20-31 y), endurance athletes (11 men, age range 18-31 y), sprinters (11 men, age range 21-30 y), and control group (11 men, age range 22-34 y) were examined across four characteristic training phases in response to an incremental treadmill test until exhaustion. A considerably higher exercise and post-exercise plasma adenosine triphosphate concentrations were observed in consecutive training phases in highly trained athletes, with the highest values reached after the competitive period. No differences in plasma adenosine triphosphate concentrations were found in the control group during the 1 y cycle. Sprinters showed a higher absolute and net increase in plasma adenosine triphosphate concentration by 60-114% during exercise in consecutive training phases than futsal players (63-101%) and endurance athletes (64-95%). In this study, we demonstrated that exercise-induced adenosine triphosphate concentration significantly changes in highly trained athletes over an annual training cycle. The obtained results showed that high-intensity but not low- to moderate-intensity training leads to an increased adenosine triphosphate response to exercise, suggesting an important role of ATP for vascular plasticity.

Is the FTP Test a Reliable, Reproducible and Functional Assessment Tool in Highly-Trained Athletes?

The aim of the current study was to assess reliability of the Functional Threshold Power test (FTP) and the corresponding intensity sustainable for 1-hour in a "quasi-steady state". Highly-trained athletes (n = 19) completed four non-randomized tests over successive weeks on a Wattbike; a 3-min incremental test (GxT) to exhaustion, two 20-min FTP tests and a 60-min test at computed FTP (cFTP). Power at cFTP was calculated by reducing 20-min FTP data by 5% and was compared with power at Dmax and lactate threshold (TLac). Ventilatory and blood lactate (BLa) responses to cFTP were measured to determine whether cFTP was quasi-steady state. Agreement between consecutive FTP tests was quantified using a Bland-Altman plot with 95% limits of agreement (95% LoA) set at ± 20 W. Satisfactory agreement between FTP tests was detected (95% LoA = +13 and -17 W, bias +2 W). The 60-min effort at cFTP was successfully completed by 17 participants, and BLa and ventilatory data at cFTP were classified as quasi-steady state. A 5% increase in power above cFTP destabilized BLa data (p < 0.05) and prompted VO2 to increase to peak GxT rates. The FTP test is therefore deemed representative of the uppermost power a highly-trained athlete can maintain in a quasi-steady state for 60-min. Agreement between repeated 20-min FTP tests was judged acceptable.

Amyotrophic Lateral Sclerosis and Oxidative Stress: A Double-Blind Therapeutic Trial After Curcumin Supplementation.

OBJECTIVE: To investigate the efficacy of curcumin oral supplementation (600 mg/day, Brainoil), a natural antioxidant compound, in Amyotrophic Lateral Sclerosis (ALS). METHODS: Patients were randomized into two groups: Group A received placebo for 3 months, then Brainoil for the following 3 months, Group B took Brainoil for 6 months. The evaluations were conducted at basal (T0), after 3 months of double blinded Brainoil or placebo treatment (T1), and after the 3 month open-label phase (T2). Clinical evaluations and oxidative stress biomarkers, including oxidative protein products (AOPPs), ferric reducing ability (FRAP), total thiols (T-SH) and lactate, were evaluated, compared to a control group, during an incremental forearm exercise test. RESULTS: Over the entire study Group B showed a stable score of the ALS-FRS-r which decreased in Group A (p<0.01), in parallel with a reduction of AOPPs (p<0.01) which was not detected into Group A. Also FRAP exercise values remained stable in Group B, while in Group A they were reduced without treatment at T1 (0.05T0 exercise lactate was lower compared to Group A (p<0.01). Compared to controls, the whole ALS population showed a greater oxidative stress (p<0.001), those treated with curcumin (Group B) exhibiting decreased exercise AOPPs at T2 with values approaching those of controls. CONCLUSION: Although further studies are needed to confirm these data, treatment with curcumin shows encouraging results indicating a slight slowdown in disease progression, improving aerobic metabolism and oxidative damage, this also contributing to deepen knowledge into the pathogenic mechanisms of ALS.

Cardiopulmonary exercise testing for risk prediction in major abdominal surgery.

Reduced exercise capacity is associated with increased postoperative morbidity. Cardiopulmonary exercise testing variables can be used to risk stratify patients. This information can be used to help guide the choice of surgical procedure and to decide on the most appropriate postoperative care environment. Thus CPET can aid collaborative decision making and improve the process of informed consent. In the future, CPET may be combined with other risk predictors to improve outcome prediction. Furthermore early evidence suggests that CPET can be used to guide prehabilitation training programs, improving fitness and thereby reducing perioperative risk.

Abnormal Lactate Levels Affect Motor Performance in Myotonic Dystrophy Type 1.

Myotonic Dystrophy type 1 (DM1) is a dominantly inherited disease comprehending multiple features. Fatigue and exhaustion during exercise often represent significant factors able to negatively influence their compliance to rehabilitation programs. Mitochondrial abnormalities and a significant increase in oxidative markers, previously reported, suggest the hypothesis of a mitochondrial functional impairment. The study aims at evaluating oxidative metabolism efficiency in 18 DM1 patients and in 15 healthy subjects, through analysis of lactate levels at rest and after an incremental exercise test. The exercise protocol consisted of a submaximal incremental exercise performed on an electronically calibrated treadmill, maintained in predominantly aerobic condition. Lactate levels were assessed at rest and at 5, 10 and 30 minutes after the end of the exercise. The results showed early exercise-related fatigue in DM1 patients, as they performed a mean number of 9 steps, while controls completed the whole exercise. Moreover, while resting values of lactate were comparable between the patients and the control group (p=0.69), after the exercise protocol, dystrophic subjects reached higher values of lactate, at any recovery time (p<0,05). These observations suggest an early activation of anaerobic metabolism, thus evidencing an alteration in oxidative metabolism of such dystrophic patients. As far as intense aerobic training could be performed in DM1 patients, in order to improve maximal muscle oxidative capacity and blood lactate removal ability, then, this safe and validate method could be used to evaluate muscle oxidative metabolism and provide an efficient help on rehabilitation programs to be prescribed in such patients.