Impaired muscle oxygenation despite normal pulmonary function in type 2 diabetes without complications.

Long-term hyperglycemia in individuals with type 2 diabetes (T2D) can detrimentally impact pulmonary function and muscle oxygenation. As a result, these factors can impede the body's adaptation to physical exertion. We aimed to evaluate the oxygen pathway during maximal exercise among overweight/obese individuals with type 2 diabetes free from complications, in comparison with a group of matched overweight/obese individuals without diabetes, specifically concentrating on the effects on pulmonary function and muscle oxygenation. Fifteen overweight/obese adults with type 2 diabetes [glycated hemoglobin (HbA1c) = 8.3 ± 1.2%] and 15 matched overweight/obese adults without diabetes underwent pre- and post exercise lung function assessment. A maximal incremental exercise test was conducted, monitoring muscle oxygenation using near-infrared spectroscopy and collecting arterial blood gas samples. Both groups exhibited normal lung volumes at rest and after exercise. Spirometric lung function did not significantly differ pre- and post exercise in either group. During maximal exercise, the type 2 diabetes group showed significantly lower augmentation in total hemoglobin and deoxygenated hemoglobin compared with the control group. Despite comparable usual physical activity levels and comparable heart rates at exhaustion, the type 2 diabetes group had a lower peak oxygen consumption than controls. No significant differences were found in arterial blood gas analyses ([Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text]) between the groups. Individuals with type 2 diabetes free from complications displayed normal pulmonary function at rest and post exercise. However, impaired skeletal muscle oxygenation during exercise, resulting from reduced limb blood volume and altered muscle deoxygenation, may contribute to the lower V̇o2peak observed in this population.NEW & NOTEWORTHY Individuals with type 2 diabetes free from micro- and macrovascular complications have normal resting pulmonary function, but their V̇o2peak is impaired due to poor skeletal muscle oxygenation during exercise. Tailoring exercise regimes for this population should prioritize interventions aimed at enhancing muscle oxygenation and blood flow improvement.

Effects of acute phosphodiesterase type 5 inhibition on skeletal muscle interstitial PO2 during contractions and recovery.

The oxygen partial pressure within the interstitial space (PO2is; mmHg) provides the driving force for oxygen diffusion into the myocyte thereby supporting oxidative phosphorylation. We tested the hypothesis that potentiation of the nitric oxide pathway with sildenafil (phosphodiesterase type 5 inhibitor) would enhance PO2is during muscle metabolic transitions, thereby slowing PO2is on- and accelerating PO2is off-kinetics. The rat spinotrapezius muscle (n = 17) was exposed for PO2is measurements via phosphorescence quenching under control (CON), low-dose sildenafil (1 mg/kg i.a., SIL1) and high-dose sildenafil (7 mg/kg i.a., SIL7). Data were collected at rest and during submaximal twitch contractions (1 Hz, 4-6 V, 3 min) and recovery (3 min). Mean arterial blood pressure (MAP; mmHg) was reduced with both SIL1 (pre:132 ± 5; post:99 ± 5) and SIL7 (pre:111 ± 6; post:99 ± 4) (p < 0.05). SIL7 elevated resting PO2is (18.4 ± 1.1) relative to both CON (15.7 ± 0.7) and SIL1 (15.2 ± 0.7) (p < 0.05). In addition, SIL7 increased end-recovery PO2is (17.7 ± 1.6) compared to CON (12.8 ± 0.9) and SIL1 (13.4 ± 0.8) (p < 0.05). The overall PO2is response during recovery (i.e., area under the PO2is curve) was greater in SIL7 (4107 ± 444) compared to CON (3493 ± 222) and SIL1 (3114 ± 205 mmHg s) (p < 0.05). Contrary to our hypothesis, there was no impact of acute SIL (1 or 7 mg/kg) on the speed of the PO2is response during contractions or recovery (p > 0.05). However, sildenafil lowered MAP and improved skeletal muscle interstitial oxygenation in healthy rats. Specifically, SIL7 enhanced PO2is at rest and during recovery from submaximal muscle contractions. Potentiation of the nitric oxide pathway with sildenafil enhances microvascular blood-myocyte O2 transport and is expected to improve repeated bouts of contractile activity.

Side differences and reproducibility of the Moxy muscle oximeter during cycling in trained men.

PURPOSE: Portable near-infrared spectroscopy devices allow measurements of muscle oxygen saturation (SmO2) in real time and non-invasively. To use NIRS for typical applications including intensity control and load monitoring, the day-to-day variability needs to be known to interpret changes confidently. This study investigates the absolute and relative test-retest reliability of the Moxy Monitor and investigates side differences of SmO2 at the vastus lateralis muscle of both legs in cyclists. METHODS: Twelve trained cyclists and triathletes completed 3 incremental step tests with 5 min step duration starting at 1.0 W/kg with an increase of 0.5 W/kg separated by 2-7 days. SmO2 was averaged over the last minute of each stage. For all power outputs, the intra-class coefficient (ICC), the standard error of measurement (SEM) and the minimal detectable change (MDC) were calculated. Dominant and non-dominant leg SmO2 were compared using a three-factor ANOVA and limits of agreement (LoA). RESULTS: ANOVA showed no significant systematic differences between trials and side. For both legs and all intensities, the ICC ranged from 0.79 to 0.92, the SEM from 5 to 9% SmO2 and the MDC from 14 to 18% SmO2. The bias and LoA between both legs were -2.0% ± 19.9% SmO2. CONCLUSION: Relative reliability of SmO2 was numerically good to excellent according to current standards. However, it depends on the specific analytical goal whether the test-retest reliability is deemed sufficient. Wide LoA indicate side differences in muscle oxygenation during exercise unexplained by leg dominance.

Characterization of muscle oxygenation response in well-trained handcyclists.

PURPOSE:  Peripheral responses might be important in handcycling, given the involvement of small muscles compared to other exercise modalities. Therefore, the goal of this study was to compare changes in muscle oxygen saturation (∆SmO2) and deoxyhemoglobin level (∆[HHb]) between different efforts and muscles. METHODS:  Handcyclists participated in a Wingate, a maximal incremental test and a 20-min time-trial (TT). Oxygen uptake (VO2) as well as ∆SmO2, ∆[HHb], deoxygenation and reoxygenation rates in the triceps brachii (TB), biceps brachii (BB), anterior deltoid (AD) and extensor carpi radialis brevis (ER) were measured. RESULTS:  ER ∆[HHb]max was 37% greater in the incremental test than in the Wingate (ES = 0.392, P = 0.031). TT mean power (W/kg) was associated with BB ∆SmO2min measured in the incremental test (r = -0.998 [-1.190, -0.806], P = 0.002) and in the Wingate (r = -0.994 [-1.327, -0.661], P = 0.006). MAP (W/kg) was associated with Wingate BB ∆SmO2min (r = -0.983 [-0.999, -0.839], P = 0.003), and Wingate peak (r = 0.649 [0.379, 0.895], P = 0.008) and mean power (W/kg) (r = 0.925 [0.752, 0.972], P = 0.003) was associated with right handgrip force. The strongest physiological predictor for TT performance was BB ∆SmO2min in the incremental test (P = 0.002, r2 = 0.993, SEE 0.016 W/kg), Wingate BB ∆SmO2min for MAP (P = 0.003, r2 = 0.956, SEE 0.058 W/kg) and right handgrip force for Wingate peak power (P = 0.005, r2 = 0.856, SEE 0.551 W/kg). CONCLUSION:  Peripheral aerobic responses (muscle oxygenation) were predictive of handcycling performance.

Reference ranges of peripheral-muscle oxygenation in term neonates delivered by Caesarean section during immediate transition after birth.

AIM: To establish reference ranges of peripheral-muscle regional oxygen saturation (prSO2) and peripheral fractional tissue oxygen extraction (pFTOE) during the first 15 min after birth in stable term neonates. METHODS: Secondary outcome parameters of prospective observational studies in healthy term neonates delivered by Caesarean section were analysed. prSO2 was measured on the right forearm using the INVOS 5100C monitor. pFTOE was calculated out of prSO2 and arterial oxygen saturation (SpO2). Centile charts (10th-90th) of prSO2 and pFTOE were defined during the first 15 min after birth. RESULTS: Three-hundred-five term neonates with a mean gestational age and birth weight of 39.0 ± 0.9 weeks and 3321 ± 454 g, respectively, were included. The 50th centiles of prSO2 were 39% (minute two), 52% (minute five), 71% (minute 10), and 73% (minute 15). The 50th centiles of pFTOE were 0.529 (minute two), 0.378 (minute five), 0.237 (minute 10), and 0.231 (minute 15). CONCLUSION: Reference ranges of prSO2 and pFTOE were established for term neonates delivered by Caesarean section during the immediate transition after birth. These reference ranges increase knowledge of physiological processes taking place immediately after birth and are necessary for possible future clinical applications.

Comparison of NIRS exercise intensity thresholds with maximal lactate steady state, critical power and rowing performance.

This study aimed to compare the intensity of deoxygenated haemoglobin concentration ([HHb]) and tissue saturation index (TSI) breakpoints ([HHb]-BP and TSI-BP) with maximal lactate steady state (MLSS) and critical power (CP), and to describe their association with 2000-m rowing ergometer performance. Fourteen male rowers performed on a rowing ergometer: I) a discontinuous incremental test with 3-min stages (INC3); II) a continuous incremental test with 1-min stages (INC1); III) constant workload tests to determine MLSS; and IV) performance tests of 500 m, 1000 m, 2000 m and 6000 m to determine CP.CP (257 ± 39 W; 3.79 ± 4.1 L · min-1) was higher than [HHb]-BP3 (205 ± 26 W; 3.48 ± 2.9 L · min-1), [HHb]-BP1 (207 ± 27 W; 3.27 ± 3.2 L · min-1), and TSI-BP3 (218 ± 31 W; 3.51 ± 3.0 L · min-1), but not higher than TSI-BP1 (222 ± 34 W; 3.43 ± 3.2 L · min-1). MLSS (187 ± 26 W; 3.33 ± 3.2 L · min-1) was lower than TSI-BP3 and TSI-BP1 for power output, but not different in any comparison for ⩒O2. The limits of agreement for power output and ⩒O2 suggest poor agreement among these thresholds. The low level of agreement compromises the use of [HHb]-BP and TSI-BP for estimating MLSS and CP; therefore, these thresholds should not be considered interchangeable.

The Improvement in Exercise Performance during Reduced Muscle Mass Exercise is Associated with an Increase in Femoral Blood Flow in Older and Younger Endurance-Trained Athletes.

This study investigated whether the improved performance observed with maximal self-paced single-leg (SL), compared with double-leg (DL) cycling, is associated with enhanced femoral blood flow and/or altered tissue oxygenation. The hyperaemic response to exercise was assessed in younger and older athletes. Power output was measured in 12 older (65 ± 4 y) and 12 younger (35 ± 5 y) endurance-trained individuals performing 2 x 3 min maximal self-paced exercise using SL and DL cycling. Blood flow (BF) in the femoral artery was assessed using Doppler ultrasound and muscle oxygenation was measured using near-infrared spectroscopy on the vastus lateralis. SL cycling elicited a greater power output (295 ± 83 vs 265 ± 70 W, P < 0.001) and peak femoral BF (1749.1 ± 533.3 vs 1329.7 ± 391.7 ml/min, P < 0.001) compared with DL cycling. Older individuals had a lower peak BF in response to exercise (1355.4 ± 385.8 vs 1765.2 ± 559.6 ml/min, P = 0.019) compared with younger individuals. Peak BF in response to exercise was correlated with power output during SL (r = 0.655, P = 0.002) and DL (r = 0.666, P = 0.001) cycling. The greater exercise performance during SL compared with DL cycling may be partly explained by a greater hyperaemic response when reducing active muscle mass. Despite regular endurance training, older athletes had a lower femoral BF in response to maximal self-paced exercise compared with younger athletes.

Low-load Resistance Exercise with Perceptually Primed Practical Blood Flow Restriction Induces Similar Motor Performance Fatigue, Physiological Changes, and Perceptual Responses Compared to Traditional Blood Flow Restriction in Males and Females.

In the recent past, practical blood flow restriction (pBFR) using non-pneumatic, usually elastic cuffs has been established as a cost-effective alternative to traditional blood flow restriction (BFR) using pneumatic cuffs, especially for training in large groups. This study investigated whether low-load resistance exercise with perceptually primed pBFR using an elastic knee wrap is suitable to induce similar motor performance fatigue as well as physiological and perceptual responses compared to traditional BFR using a pneumatic nylon cuff in males and females. In a randomized, counterbalanced cross-over study, 30 healthy subjects performed 4 sets (30-15-15-15 repetitions) of unilateral knee extensions at 20% of their one-repetition-maximum. In the pBFR condition, each individual was perceptually primed to a BFR pressure corresponding to 60% of their arterial occlusion pressure. Before and after exercise, maximal voluntary torque, maximal muscle activity, and cuff pressure-induced discomfort were assessed. Moreover, physiological (i.e., muscle activity, muscle oxygenation) and perceptual responses (i.e., effort and exercise-induced leg muscle pain) were recorded during exercise. Moderate correlations with no differences between pBFR and BFR were found regarding the decline in maximal voluntary torque and maximal muscle activity. Furthermore, no to very strong correlations between conditions, with no differences, were observed for muscle activity, muscle oxygenation, and perceptual responses during exercise sets. However, cuff pressure-induced discomfort was lower in the pBFR compared to the BFR condition. These results indicate that low-load resistance exercise combined with perceptually primed pBFR is a convenient and less discomfort inducing alternative to traditional BFR. This is especially relevant for BFR training with people who have a low cuff-induced discomfort tolerance.

Muscle Oxygenation and Microvascular Reactivity Across Different Stages of CKD: A Near-Infrared Spectroscopy Study.

RATIONALE & OBJECTIVE: Previous studies in chronic kidney disease (CKD) showed that vascular dysfunction in different circulatory beds progressively deteriorates with worsening CKD severity. This study evaluated muscle oxygenation and microvascular reactivity at rest, during an occlusion-reperfusion maneuver, and during exercise in patients with different stages of CKD versus controls. STUDY DESIGN: Observational controlled study. SETTING & PARTICIPANTS: 90 participants (18 per CKD stage 2, 3a, 3b, and 4, as well as 18 controls). PREDICTOR: CKD stage. OUTCOME: The primary outcome was muscle oxygenation at rest. Secondary outcomes were muscle oxygenation during occlusion-reperfusion and exercise, and muscle microvascular reactivity (hyperemic response). ANALYTICAL APPROACH: Continuous measurement of muscle oxygenation [tissue saturation index (TSI)] using near-infrared spectroscopy at rest, during occlusion-reperfusion, and during a 3-minute handgrip exercise (at 35% of maximal voluntary contraction). Aortic pulse wave velocity and carotid intima-media thickness were also recorded. RESULTS: Resting muscle oxygenation did not differ across the study groups (controls: 64.3% ± 2.9%; CKD stage 2: 63.8% ± 4.2%; CKD stage 3a: 64.1% ± 4.1%; CKD stage 3b: 62.3% ± 3.3%; CKD stage 4: 62.7% ± 4.3%; P=0.6). During occlusion, no significant differences among groups were detected in the TSI occlusion magnitude and TSI occlusion slope. However, during reperfusion the maximum TSI value was significantly lower in groups of patients with more advanced CKD stages compared with controls, as was the hyperemic response (controls: 11.2%±3.7%; CKD stage 2: 8.3%±4.6%; CKD stage 3: 7.8%±5.5%; CKD stage 3b: 7.3%±4.4%; CKD stage 4: 7.2%±3.3%; P=0.04). During the handgrip exercise, the average decline in TSI was marginally lower in patients with CKD than controls, but no significant differences were detected across CKD stages. LIMITATIONS: Moderate sample size, cross-sectional evaluation. CONCLUSIONS: Although no differences were observed in muscle oxygenation at rest or during occlusion, the microvascular hyperemic response during reperfusion was significantly impaired in CKD and was most prominent in more advanced CKD stages. This impaired ability of microvasculature to respond to stimuli may be a crucial component of the adverse vascular profile of patients with CKD and may contribute to exercise intolerance. PLAIN-LANGUAGE SUMMARY: Previous studies in chronic kidney disease (CKD) have shown that vascular dysfunction in different circulatory beds progressively deteriorates with CKD severity. This study evaluated muscle oxygenation and microvascular reactivity at rest, during an occlusion-reperfusion maneuver, and during exercise in patients with nondialysis CKD versus controls, as well as across different CKD stages. It showed that the microvascular hyperemic response after an arterial occlusion was significantly impaired in CKD and was worst in patients with more advanced CKD. No significant differences were detected in skeletal muscle oxygenation or muscle oxidative capacity at rest or during the handgrip exercise when comparing patients with CKD with controls or comparing across CKD stages. The impaired ability of microvasculature to respond to stimuli may be a component of the adverse vascular profile of patients with CKD and may contribute to exercise intolerance.

Reactive hyperemia half-time response is associated with skeletal muscle oxygen saturation changes during cycling exercise.

We investigated the relationship between muscle microvascular responses during reactive hyperemia as assessed using near-infrared spectroscopy (NIRS) with changes in skeletal muscle oxygen saturation during exercise. Thirty young untrained adults (M/W: 20/10; 23 ± 5 years) completed a maximal cycling exercise test to determine exercise intensities performed on a subsequent visit separated by seven days. At the second visit, post-occlusive reactive hyperemia was measured as changes in NIRS-derived tissue saturation index (TSI) at the left vastus lateralis muscle. Variables of interest included desaturation magnitude, resaturation rate, resaturation half-time, and hyperemic area under the curve. Afterwards, two 4-minute bouts of moderate intensity cycling followed by one bout of severe intensity cycling to fatigue took place while TSI was measured at the vastus lateralis muscle. TSI was averaged across the last 60-s of each moderate intensity bout then averaged together for analysis, and at 60-s into severe exercise. The change in TSI (∆TSI) during exercise is expressed relative to a 20 W cycling baseline. On average, the ΔTSI was -3.4 ± 2.4 % and -7.2 ± 2.8 % during moderate and severe intensity cycling, respectively. Resaturation half-time was correlated with the ΔTSI during moderate (r = -0.42, P = 0.01) and severe (r = -0.53, P = 0.002) intensity exercise. No other reactive hyperemia variable was found to correlate with ΔTSI. These results indicate that resaturation half-time during reactive hyperemia represents a resting muscle microvascular measure that associates with the degree of skeletal muscle desaturation during exercise in young adults.

Application of blood flow restriction in hypoxic environment augments muscle deoxygenation without compromising repeated sprint exercise performance.

NEW FINDINGS: What is the central question of this study? Does applying blood flow restriction during the rest periods of repeated sprint exercise in a hypoxic environment lead to greater local hypoxia within exercising muscles without compromising training workload? What is the main finding and its importance? Repeated sprint exercise with blood flow restriction administered during rest periods under systemic hypoxia led to severe local hypoxia within the exercised muscles without a reduction in power output. The maintained power output might be due to elevated neuromuscular activation. Accordingly, the proposed repeated sprint exercise in the current study may be an effective training modality. ABSTRACT: Repeated sprint exercise (RSE) is a popular training modality for a wide variety of athletic activities. The purpose of this study was to assess the combined effects of systemic hypoxia and blood flow restriction (BFR) on muscle deoxygenation and RSE performance. Twelve healthy young men performed a standard RSE training modality (five sets of 10 s maximal sprint with a 60 s rest) under four different conditions: (1) normoxic control (NC), normoxia (N, 20.9%) + control BFR (C, 0 mmHg); (2) normoxic BFR (NB), normoxia (N, 20.9%) + BFR (B, 140 mmHg); (3) hypoxic control (HC), hypoxia (H, 13.7%) + control BFR (C, 0 mmHg); and (4) hypoxic BFR (HB): hypoxia (H, 13.7%) + BFR (B, 140 mmHg). BFR was only administered during the rest period of the respective RSE trials. In the local exercising muscles, muscle oxygen saturation ( Sm O 2 $\textit{Sm}{O}_{2}$ ) and neuromuscular activity were measured using near-infrared spectroscopy and surface electromyography, respectively. SmO2 was lower in systemic hypoxia conditions relative to normoxia conditions (P < 0.05). A rther decrease in SmO2 was observed in HB relative to HC (Set 1: HC 70.0 ± 17.5 vs. HB 57.4 ± 11.3%, P = 0.001; Set 4: HC 67.5 ± 14.6 vs. HB 57.0 ± 12.0%, P = 0.013; Set 5: HC 61.0 ± 15.3 vs. HB 47.7 ± 11.9%, P < 0.001). No differences in RSE performance were observed between any of the conditions (P > 0.05). Interestingly, an elevated neuromuscular activity was seen in response to the BFR, particularly during conditions of systemic hypoxia (P < 0.05). Thus, RSE with BFR administered during rest periods under systemic hypoxia led to severe local hypoxia without compromising training workload.

Carbohydrate intake before and during high intensity exercise with reduced muscle glycogen availability affects the speed of muscle reoxygenation and performance.

Muscle glycogen state and carbohydrate (CHO) supplementation before and during exercise may impact responses to high-intensity interval training (HIIT). This study determined cardiorespiratory, substrate metabolism, muscle oxygenation, and performance when completing HIIT with or without CHO supplementation in a muscle glycogen depleted state. On two occasions, in a cross-over design, eight male cyclists performed a glycogen depletion protocol prior to HIIT during which either a 6% CHO drink (60 g.hr-1) or placebo (%CHO, PLA) was consumed. HIIT consisted of 5 × 2 min at 80% peak power output (PPO), 3 × 10-min bouts of steady-state (SS) cycling (50, 55, 60% PPO), and a time-to-exhaustion (TTE) test. There was no difference in SS [Formula: see text], HR, substrate oxidation and gross efficiency (GE %) between CHO and PLA conditions. A faster rate of muscle reoxygenation (%. s-1) existed in PLA after the 1st (Δ - 0.23 ± 0.22, d = 0.58, P < 0.05) and 3rd HIIT intervals (Δ - 0.34 ± 0.25, d = 1.02, P < 0.05). TTE was greater in CHO (7.1 ± 5.4 min) than PLA (2.5 ± 2.3 min, d = 0.98, P < 0.05). CHO consumption before and during exercise under reduced muscle glycogen conditions did not suppress fat oxidation, suggesting a strong regulatory role of muscle glycogen on substrate metabolism. However, CHO ingestion provided a performance benefit under intense exercise conditions commenced with reduced muscle glycogen. More research is needed to understand the significance of altered muscle oxygenation patterns during exercise.

Adaptations to 4 weeks of high-intensity interval training in healthy adults with different training backgrounds.

PURPOSE: This study investigated the physical fitness and oxygen uptake kinetics ([Formula: see text]) along with the exercise-onset O2 delivery (heart rate kinetics, τHR; changes in normalized deoxyhemoglobin/[Formula: see text] ratio, Δ[HHb]/[Formula: see text]) adaptations of individuals with different physical activity (PA) backgrounds responding to 4 weeks of high-intensity interval training (HIIT), and the possible effects of skeletal muscle mass (SMM) on training-induced adaptations. METHODS: Twenty subjects (10 high-PA level, HIIT-H; 10 moderate-PA level, HIIT-M) engaged in 4 weeks of treadmill HIIT. Ramp-incremental (RI) test and step-transitions to moderate-intensity exercise were performed. Cardiorespiratory fitness, body composition, muscle oxygenation status, VO2 and HR kinetics were assessed at baseline and post-training. RESULTS: HIIT improved fitness status for HIIT-H ([Formula: see text], + 0.26 ± 0.07 L/min; SMM, + 0.66 ± 0.70 kg; body fat, - 1.52 ± 1.93 kg; [Formula: see text], - 7.11 ± 1.05 s, p < 0.05) and HIIT-M ([Formula: see text], 0.24 ± 0.07 L/min, SMM, + 0.58 ± 0.61 kg; body fat, - 1.64 ± 1.37 kg; [Formula: see text], - 5.48 ± 1.05 s, p < 0.05) except for visceral fat area (p = 0.293) without between-group differences (p > 0.05). Oxygenated and deoxygenated hemoglobin amplitude during the RI test increased for both groups (p < 0.05) except for total hemoglobin (p = 0.179). The Δ[HHb]/[Formula: see text] overshoot was attenuated for both groups (p < 0.05) but only eliminated in HIIT-H (1.05 ± 0.14 to 0.92 ± 0.11), and no change was observed in τHR (p = 0.144). Linear mixed-effect models presented positive effects of SMM on absolute [Formula: see text] (p < 0.001) and ΔHHb (p = 0.034). CONCLUSION: Four weeks of HIIT promoted positive adaptations in physical fitness and [Formula: see text] kinetics, with the peripheral adaptations attributing to the observed improvements. The training effects are similar between groups suggesting that HIIT is effective for reaching higher physical fitness levels.

Adding heat stress to repeated-sprint training in hypoxia does not enhance performance improvements in canoe/kayak athletes.

PURPOSE: The present study investigated the effects of adding heat stress to repeated-sprint training in hypoxia on performance and physiological adaptations in well-trained athletes. METHODS: Sixteen canoe/kayak sprinters conducted 2 weeks of repeated-sprint training consisting of three sets of 5 × 10 s sprints with 20 s active recovery periods under conditions of either normobaric hypoxia (RSH, FiO2: 14.5%, ambient temperature: 18 ℃, n = 8) or combined heat and normobaric hypoxia (RSHH, FiO2: 14.5%, ambient temperature: 38 ℃, n = 8). Before and after training, the 10 × 10 s repeated-sprint ability (RSA) test and 500 m time trial were performed on a canoe/kayak ergometer. RESULTS: Peak and average power outputs during the RSA test were significantly improved after training in both RSH (peak power: + 21.5 ± 4.6%, P < 0.001; average power: + 12.5 ± 1.9%, P < 0.001) and RSHH groups (peak power: + 18.8 ± 6.6%, P = 0.005; average power: + 10.9 ± 6.8%, P = 0.030). Indirect variables of skeletal muscle oxygen extraction (deoxygenated hemoglobin) and blood perfusion (total hemoglobin) during the RSA test were significantly increased after training in the RSH group (P = 0.041 and P = 0.034, respectively) but not in the RSHH group. In addition, finish time during the 500 m time trial was significantly shortened after the training only in the RSH group (RSH: - 3.9 ± 0.8%, P = 0.005; RSHH: - 3.1 ± 1.4%, P = 0.078). CONCLUSION: Adding heat stress to RSH does not enhance performance improvement and may partially mask muscle tissue adaptation.

The impact of leg position on muscle blood flow and oxygenation during low-intensity rhythmic plantarflexion exercise.

PURPOSE: Resistance training (RT) is an effective countermeasure to combat physical deconditioning whereby localized hypoxia within the limb increases metabolic stress eliciting muscle adaptation. The current study sought to examine the influence of gravity on muscle oxygenation (SmO2) alongside vascular hemodynamic responses. METHODS: In twelve young healthy adults, an ischemic occlusion test and seven minutes of low-intensity rhythmic plantarflexion exercise were used alongside superficial femoral blood flow and calf near-infrared spectroscopy to assess the microvascular vasodilator response, conduit artery flow-mediated dilation, exercise-induced hyperemia, and SmO2 with the leg positioned above or below the heart in a randomized order. RESULTS: The microvascular vasodilator response, assessed by peak blood flow (798 ± 231 mL/min vs. 1348 ± 290 mL/min; p < 0.001) and reperfusion slope 10 s of SmO2 after cuff deflation (0.75 ± 0.45%.s-1 vs.2.40 ± 0.94%.s-1; p < 0.001), was attenuated with the leg above the heart. This caused a blunted dilatation of the superficial femoral artery (3.0 ± 2.4% vs. 5.2 ± 2.1%; p = 0.008). Meanwhile, blood flow area under the curve was comparable (above the heart: 445 ± 147 mL vs. below the heart: 474 ± 118 mL; p = 0.55) in both leg positions. During rhythmic exercise, the increase in femoral blood flow was lower in the leg up position (above the heart: 201 ± 94% vs. below the heart: 292 ± 114%; p = 0.001) and contributed to a lower SmO2 (above the heart: 41 ± 18% vs. below the heart 67 ± 5%; p < 0.001). CONCLUSION: Positioning the leg above the heart results in attenuated peak vascular dilator response and exercise-induced hyperemia that coincided with a lower SmO2 during low-intensity plantarflexion exercise.

No Difference in Muscle Basal Oxygenation in a Bedridden Population Pre and Post Rehabilitation.

Long periods of bed rest for elderly population, due to a femur fracture event, can cause a deterioration in the muscular capacity. Therefore, monitoring of the muscle oxidative capacity in this fragile population is necessary to define the muscular oxidative metabolism state before and after a rehabilitation period. The time-domain near-infrared spectroscopy (TD-NIRS) technique enables the absolute values to be calculated for hemodynamic parameters such as oxy- (O2Hb), deoxy- (HHb), total- (tHb) haemoglobin, and tissue oxygen saturation (SO2) of the muscular tissue. In this work, we have characterized vastus lateralis muscle hemodynamics during a baseline period at two different time points: after the surgery (PRE) and after 15 days of rehabilitation (POST). The mean values for the absolute values of the hemodynamic parameters were: O2Hb_PRE = 49.1 ± 14.1 µM; O2Hb_POST = 47.1 ± 13.4 µM; HHb_PRE = 28.3 ± 10.3 µM; HHb_POST = 26.7 ± 9.9 µM; tHb_PRE = 77.3 ± 23.6 µM; tHb_POST = 73.8 ± 21.4 µM; SO2_PRE = 63.9 ± 4.0% and SO2_POST = 64.9 ± 5.6%. The hemodynamic parameters did not show significant differences at both group and single subject level. These results suggest that for this kind of population, the baseline of the hemodynamic parameters is not the best one to consider to assess the rehabilitation progresses in terms of muscular oxidative metabolism.

Relationship Between Muscle Deoxygenation and Cardiac Output in Subjects Without Attenuation of Deoxygenation Hemoglobin Concentration Near the End of Ramp Cycling Exercise: A Longitudinal Study.

The aim of this study was to investigate the longitudinal relationship between the slopes of systemic and quadriceps muscle O2 dynamics in subjects without attenuation point in deoxygenated hemoglobin concentration at vastus lateralis (APdeoxy-Hb@VL) during high-intensity cycling. Seven young men without APdeoxy-Hb@VL performed ramp cycling exercise until exhaustion before and after 8 weeks, while continuing recreational physical activities throughout that period. Muscle O2 saturation (SmO2) and deoxy-Hb were monitored at the vastus lateralis (VL) and rectus femoris (RF) by near infrared spectroscopy oximetry during exercise. Cardiac output (CO) was also continuously assessed. During high-intensity exercise, at VL, a significantly steeper slope of deoxy-Hb was found after 8 weeks compared with before, while the slopes of deoxy-Hb at RF were not significantly changed. Though a decrease in the slope of CO after 8 weeks did not reach significance (p = 0.12), the change in the slope of CO was significantly related to the change in the slopes of deoxy-Hb at VL (rs = -0.89, p < 0.01) and RF (rs = -0.86, p < 0.05). Our data reinforces the idea that, in subjects without APdeoxy-Hb@VL, the slope of muscle deoxygenation at VL during high-intensity cycling exercise may partly be explained by systemic O2 supply, rather than O2 balance in other thigh muscles.

Peripheral muscle oxygenation and symptoms of stress in adolescents with and without temporomandibular disorder.

OBJECTIVE: To compare peripheral muscle oxygenation levels and the prevalence of psychological stress in adolescents with and without temporomandibular disorder (TMD). METHODS: A cross-sectional study was performed with adolescents submitted into two groups: those diagnosed with TMD (DG) and control (CG). Muscle oxygenation was measured by near-infrared spectroscopy in the masseter and upper trapezius muscles. Symptoms of stress were assessed by Lipp's Stress Symptom Inventory for Adults or Child Stress Scale. A Student t-test was used for intergroup comparisons and association between categorical variables by chi-square test, phi coefficient of correlation, odds ratio, and two-way ANOVA. RESULTS: Fifty-three adolescents were evaluated and a significant reduction was observed in the oxyhemoglobin level in the masseter muscle at rest (p = 0.04) and contraction (p = 0.02). A greater total hemoglobin level was found in the upper trapezius muscle at rest in DG (p = 0.03), with a significant difference in the tissue saturation index during contraction (p = 0.05) intergroup. Individuals in the DG were 4.523 times more likely to exhibit signs and symptoms of stress than in CG. CONCLUSION: Adolescents from DG showed reduced masseter oxyhemoglobin values at rest and during contraction and showed more signs and symptoms of stress than healthy controls. In the upper trapezius, DG showed higher values of total circulating hemoglobin, essential for greater blood flow and efficient maximum voluntary contraction. CLINICAL RELEVANCE: Changes in tissue oxygenation and stress in adolescents with TMD prompted the earlier treatment of this population to prevent disease progression into adulthood.

A single dose of microencapsulated cocoa supplementation attenuated eccentric exercise-induced endothelial dysfunction.

In the present study, it was evaluated whether microencapsulated cocoa supplementation could attenuate endothelial dysfunction caused by eccentric exercise in healthy subjects. Thirteen volunteers were enrolled in this double-blind, placebo-controlled, crossover study. Flow-mediated dilatation (FMD), blood flow and muscle O2 saturation (StO2) were evaluated by ultrasound and near-infrared spectroscopy (NIRS), respectively, before and after microencapsulated cocoa supplementation. The eccentric exercise was performed after microencapsulated cocoa supplementation to generate vascular dysfunction. Eccentric exercise significantly reduced FMD in the PLA condition, but cocoa attenuated this exercise effect. No significant effect was observed on muscle StO2 and blood flow after eccentric exercise and nutritional supplementation. In conclusion, the present study showed that a single dose of microencapsulated cocoa ingestion attenuated FMD-induced eccentric exercise. These findings suggest that a single dose of microencapsulated cocoa may be an alternative nutritional strategy to attenuate vascular dysfunction induced by eccentric exercise in healthy individuals.

Training zones through muscle oxygen saturation during a graded exercise test in cyclists and triathletes.

Use of muscle oxygen saturation (SmO2) has been validated as a performance factor during incremental exercise with portable near-infrared stereoscopy (NIRS) technology. However, there is little knowledge about the use of SmO2 to identify training zones. The objective of this study was to evaluate the metabolic zones by SmO2: maximum lipid oxidation zone (Fatmax), ventilatory thresholds (VT1 and VT2) and maximum aerobic power (MAP) during a graded exercise test (GXT). Forty trained cyclists and triathletes performed a GXT. Output power (W), heart rate (HR), oxygen consumption (VO2), energy expenditure (kcal/min) and SmO2 were measured. Data were analysed using the ANOVA test, ROC curves and multiple linear regressions. Significance was established at p ≤ 0.05. SmO2 decreases were observed from baseline (LB) to Fatmax (Δ = -16% p < 0.05), Fatmax to VT1 (Δ = -16% p < 0.05) and VT1 to VT2 (Δ = -45% p < 0.01). Furthermore, SmO2 together with weight, HR and output power have the ability to predict VO2 and energy expenditure by 89% and 90%, respectively. We conclude that VO2 and energy expenditure values can be approximated using SmO2 together with other physiological parameters and SmO2 measurements can be a complementary parameter to discriminate aerobic workload and anaerobic workload in athletes.