Training for intense exercise performance: high-intensity or high-volume training?

Differences in training characteristics between junior, under 23 and professional cyclists

The aim was to compare the training characteristics of junior, under 23 and professional road cyclists. Training data collected during the 2019 competitive season of thirty male cyclists, divided into three age-related categories (JUN; U23; PRO), were retrospectively analyzed for training characteristics, external and internal training load. Higher duration per training session were observed in PRO (2.6 ± 0.3 h) compared to both U23 (2.2 ± 0.3 h; P < 0.001) and JUN (2.0 ± 0.2 h; P < 0.001). Elevation gain per distance was higher in PRO (13.8 ± 1.9 m⋅km-1) compared to U23 (10.6 ± 0.9 m⋅km-1; P = 0.001) and JUN (6.7 ± 0.3 m⋅km-1; P < 0.001), and in U23 compared to JUN (P < 0.001). Annual total work was lower in JUN (3694 ± 467 kJ⋅kg-1) compared to U23 (5268 ± 746 kJ⋅kg-1; P = 0.001) and PRO (5759 ± 1103 kJ⋅kg-1; P < 0.001). eTRIMP per hour was higher in JUN (151 ± 40) compared to both U23 (115 ± 23; P = 0.003) and PRO (112 ± 22; P = 0.013). JUN spent more training time at medium and high heart rate intensity zones compared to U23 and PRO (P < 0.05).

The Salzburg 10/7 HIIT shock cycle study: the effects of a 7-day high-intensity interval training shock microcycle with or without additional low-intensity training on endurance performance, well-being, stress and recovery in endurance trained athletes-study protocol of a randomized controlled trial

BACKGROUND

Performing multiple high-intensity interval training (HIIT) sessions in a compressed period of time (approximately 7-14 days) is called a HIIT shock microcycle (SM) and promises a rapid increase in endurance performance. However, the efficacy of HIIT-SM, as well as knowledge about optimal training volumes during a SM in the endurance-trained population have not been adequately investigated. This study aims to examine the effects of two different types of HIIT-SM (with or without additional low-intensity training (LIT)) compared to a control group (CG) on key endurance performance variables. Moreover, participants are closely monitored for stress, fatigue, recovery, and sleep before, during and after the intervention using innovative biomarkers, questionnaires, and wearable devices.

METHODS

This is a study protocol of a randomized controlled trial that includes the results of a pilot participant. Thirty-six endurance trained athletes will be recruited and randomly assigned to either a HIIT-SM (HSM) group, HIIT-SM with additional LIT (HSM + LIT) group or a CG. All participants will be monitored before (9 days), during (7 days), and after (14 days) a 7-day intervention, for a total of 30 days. Participants in both intervention groups will complete 10 HIIT sessions over 7 consecutive days, with an additional 30 min of LIT in the HSM + LIT group. HIIT sessions consist of aerobic HIIT, i.e., 5 × 4 min at 90-95% of maximal heart rate interspersed by recovery periods of 2.5 min. To determine the effects of the intervention, physiological exercise testing, and a 5 km time trial will be conducted before and after the intervention.

RESULTS

The feasibility study indicates good adherence and performance improvement of the pilot participant. Load monitoring tools, i.e., biomarkers and questionnaires showed increased values during the intervention period, indicating sensitive variables.

CONCLUSION

This study will be the first to examine the effects of different total training volumes of HIIT-SM, especially the combination of LIT and HIIT in the HSM + LIT group. In addition, different assessments to monitor the athletes' load during such an exhaustive training period will allow the identification of load monitoring tools such as innovative biomarkers, questionnaires, and wearable technology.

TRIAL REGISTRATION

clinicaltrials.gov, NCT05067426. Registered 05 October 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05067426 . Protocol Version Issue date: 1 Dec 2021. Original protocol. Authors: TLS, NH.

Effect of Two Different Training Interventions on Cycling Performance in Mountain Bike Cross-Country Olympic Athletes

To improve performance in endurance sports, it is important to include both high-intensity and low-intensity training, but there is neither a universally accepted practice nor clear scientific evidence that allows reliable statements about the predominance of a specific training method. This randomized controlled trial compared the effects of a polarized training model (POL) to a low-intensity training model (LIT) on physiological parameters and mountain bike cross-country Olympic (XCO) race performance in eighteen competitive XCO athletes (17.9 ± 3.6 years). The superiority of one of the two methods could not be shown in this study. The results did not show statistically significant differences between POL and LIT, as both interventions led to slight improvements. However, a small tendency toward better effects for POL was seen for cycling power output during the race (4.4% vs. –2.2%), at the 4 mmol/L (6.1% vs. 2.8%) and individual anaerobic lactate threshold (5.1% vs. 2.3%), and for maximal aerobic performance (4.4% vs. 2.6%), but not for maximal efforts lasting 10 to 300 s. Despite the lack of significant superiority in this and some other studies, many athletes and coaches prefer POL because it produces at least equivalent effects and requires less training time.

Test-Retest Reliability of Ultrasonographic Measurements from the Rectus Femoris Muscle 1-5 Years after Anterior Cruciate Ligament Reconstruction in the Ipsilateral and Contralateral Legs: An Observational, Case-Control Study

About 40% of traumatic injuries in sports are related to the knee. Of these, 33% require arthroscopic surgery. The rehabilitative ultrasound imaging technique is a simple method to obtain objective real-time results on the state and measurement of the musculoskeletal tissue and its use can represent an important change in the process of functional diagnosis and recovery of these injuries. The aim was to quantify the differences in the thickness, muscle contraction time, and muscle relaxation time of the rectus femoris muscle between individuals with knee arthroscopy and healthy individuals and to verify the reliability of the inter-examiner measurements in these ultrasound variables. An observational case-control study with individuals (18−60 years aged) who underwent surgery for anterior cruciate ligament through knee arthroscopy a year or more before. A total of 38 subjects were divided into 2 groups, case and control. Ultrasound measurements were taken of the following outcomes: thickness at rest and contraction, muscle contraction time, and muscle relaxation time of the rectus femoris muscle. Excellent inter-examiner reliability was obtained for all ultrasound measurements (ICC3.3 > 0.90). No significant changes were found in the rate of contraction or rest of the rectus femoris muscle. On the other hand, if significant changes in the thickness of the rectus femoris muscle were found between control and case group. Arthroscopic surgery for anterior cruciate ligament reconstruction does not appear to modify function but does modify the thickness of the rectus femoris muscle on ultrasound examination. Ultrasound appears to be a reliable tool for the study of these measurements in the rectus femoris muscle.

The Fitness-Fatigue Model: What's in the Numbers?

PURPOSE

The purpose of this commentary is to outline some of the pitfalls when using the fitness-fatigue model to unravel the interaction between training load and performance. By doing so, we encourage sport scientists and coaches to interpret the parameters from the model with some extra caution.

CONCLUSIONS

Caution is needed when interpreting the fitness-fatigue model since the parameter values are influenced by the starting parameter values, the modeling technique, and the input of the model. Also, the use of general constants should be avoided since they do not account for interindividual differences and differences between training-load methods. Therefore, we advise sport scientists and coaches to use the model as a way to work more data-informed rather than working data-driven.

The Molecular Signature of High-intensity Training in the Human Body

High-intensity training is becoming increasingly popular outside of elite sport for health prevention and rehabilitation. This expanded application of high-intensity training in different populations requires a deeper understanding of its molecular signature in the human body. Therefore, in this integrative review, cellular and systemic molecular responses to high-intensity training are described for skeletal muscle, cardiovascular system, and the immune system as major effectors and targets of health and performance. Different kinds of stimuli and resulting homeostatic perturbations (i. e., metabolic, mechanical, neuronal, and hormonal) are reflected, taking into account their role in the local and systemic deflection of molecular sensors and mediators, and their role in tissue and organ adaptations. In skeletal muscle, a high metabolic perturbation induced by high-intensity training is the major stimulus for skeletal muscle adaptation. In the cardio-vascular system, high-intensity training induces haemodynamic stress and deflection of the Ca 2+ handling as major stimuli for functional and structural adaptation of the heart and vessels. For the immune system haemodynamic stress, hormones, exosomes, and O2 availability are proposed stimuli that mediate their effects by alteration of different signalling processes leading to local and systemic (anti)inflammatory responses. Overall, high-intensity training shows specific molecular signatures that demonstrate its high potential to improve health and physical performance.

Acute and Long-Term Effects of Concurrent Resistance and Swimming Training on Swimming Performance

Dry-land resistance exercise (RT) is routinely applied concurrent to swimming (SWIM) training sessions in a year-round training plan. To date, the impact of the acute effect of RT on SWIM or SWIM on RT performance and the long-term RT-SWIM or SWIM-RT training outcome has received limited attention. The existing studies indicate that acute RT or SWIM training may temporarily decrease subsequent muscle function. Concurrent application of RT-SWIM or SWIM-RT may induce similar physiological alterations. Such alterations are dependent on the recovery duration between sessions. Considering the long-term effects of RT-SWIM, the limited existing data present improvements in front crawl swimming performance, dry-land upper and lower body maximum strength, and peak power in swim turn. Accordingly, SWIM-RT training order induces swimming performance improvements in front crawl and increments in maximum dry-land upper and lower body strength. Concurrent application of RT-SWIM or SWIM-RT training applied within a training day leads in similar performance gains after six to twelve weeks of training. The current review suggests that recovery duration between RT and SWIM is a predisposing factor that may determine the training outcome. Competitive swimmers may benefit after concurrent application with both training order scenarios during a training cycle.

How Do the Effects of an 8-Week Intervention Influence Subsequent Performance Development in Cross-Country Skiers?

PURPOSE

To investigate how the effects of increased low- versus high-intensity endurance training in an 8-week intervention influenced the subsequent development of performance and physiological indices in cross-country skiers.

METHODS

Forty-four (32 men and 12 women) junior cross-country skiers were randomly assigned into a low-intensity training group (LITG, n = 20) or high-intensity training group (HITG, n = 24) for an 8-week intervention followed by 5 weeks of standardized training with similar intensity distribution, and thereafter 14 weeks of self-chosen training. Performance and physiological indices in running and in roller-ski skating were determined preintervention, after the intervention, and after the standardized training period. Roller-ski skating was also tested after the period of self-chosen training.

RESULTS

No between-groups changes from preintervention to after the standardized training period were found in peak speed when incremental running and roller-ski skating (P = .83 and .51), although performance in both modes was improved in the LITG (2.4% [4.6%] and 3.3% [3.3%], P < .05) and in roller-ski skating for HITG (2.6% [3.1%], P < .01). While improvements in maximal oxygen consumption running and peak oxygen uptake roller-ski skating were greater in HITG than in LITG from preintervention to after the intervention, no between-groups differences were found from preintervention to after the standardized training period (P = .50 and .46), although peak oxygen uptake in roller-ski skating significantly improved in HITG (5.7% [7.0%], P < .01). No changes either within or between groups were found after the period of self-chosen training.

CONCLUSIONS

Differences in adaptations elicited by a short-term intervention focusing on low- versus high-intensity endurance training had little or no effect on the subsequent development of performance or physiological indices following a period of standardized training in cross-country skiers.

Theacrine does not enhance physical performance or training status over 8 weeks

Fatigue is a condition that may affect physical performance during training sessions. Consequently, this will impact training performance and will also affect the performance of the individual in the long term. Caffeine is extensively used to counteract fatigue; however, it contains several side effects. Theacrine might be used as an alternative to caffeine, providing the same benefits without the side effects. The current study aimed to investigate the effects of 8 weeks of supplementation with theacrine on physical performance and training status of young amateur athletes. Twenty-two subjects were divided into two groups – Theacrine Group (T) and Placebo Group (P) – and evaluated before and after the intervention period. Evaluations included physical tests and hormonal values of insulin like growth factor (IGF)-I and IGF binding protein (IGFBP)-3, used as markers of training status. Results demonstrated that theacrine was not capable of promoting benefits regarding the physical performance of the subjects. It also had no effects on serum secretion of IGF-I and its binding protein, IGFBP-3. Therefore, the findings of this study do not support the use of theacrine to increase physical performance.

Cross-Sectional Differences in Race Demands Between Junior, Under 23, and Professional Road Cyclists

PURPOSE

To compare the race demands of junior (JUN), under 23 (U23), and professional (PRO) road cyclists.

METHODS

Thirty male cyclists, divided into 3 age-related categories (JUN, n = 10; U23, n = 10; and PRO, n = 10), participated in this study. Race data collected during the 2019 competitive season were retrospectively analyzed for race characteristics, external, and internal competition load.

RESULTS

Higher annual and per race duration, distance, elevation gain, Edward's training impulse, total work, and work per hour were observed in PRO versus U23 and JUN, and U23 versus JUN (P < .01). PRO and U23 recorded higher mean maximal power (RPOs) between 5 and 180 minutes compared with JUN (P < .01). Edward's training impulse per hour was higher in JUN than PRO and U23 (P < .01). Accordingly, JUN spent a higher percentage of racing time in high internal intensity zones compared with U23 and PRO, while these 2 categories spent more time at low internal intensity zones (P < .01).

CONCLUSIONS

JUN races were shorter and included less elevation gain per distance unit compared to U23 and PRO races, but more internally demanding. JUN produced less power output in the moderate-, heavy-, and severe-intensity exercise domains compared with U23 and PRO (RPOs: 5-180 min). U23 and PRO races presented similar work demands per hour and RPOs, but PRO races were longer than U23.

Multiple Applications of Different Exercise Modalities with Rodents

A large proportion of chronic diseases can be derived from a sedentary lifestyle. Raising physical activity awareness is indispensable, as lack of exercise is the fourth most common cause of death worldwide. Animal models in different research fields serve as important tools in the study of acute or chronic noncommunicable disorders. With the help of animal-based exercise research, exercise-mediated complex antioxidant and inflammatory pathways can be explored, which knowledge can be transferred to human studies. Whereas sustained physical activity has an enormous number of beneficial effects on many organ systems, these animal models are easily applicable in several research areas. This review is aimed at providing an overall picture of scientific research studies using animal models with a focus on different training modalities. Without wishing to be exhaustive, the most commonly used forms of exercise are presented.

Different endurance exercises modulate NK cell cytotoxic and inhibiting receptors

PURPOSE

Induction of IDO depends on the activation of AhR forming the AhR/IDO axis. Activated AhR can transcribe various target genes including cytotoxic and inhibiting receptors of NK cells. We investigated whether AhR and IDO levels as well as activating (NKG2D) and inhibiting (KIR2DL1) NK cell receptors are influenced by acute exercise and different chronic endurance exercise programs.

METHODS

21 adult breast and prostate cancer patients of the TOP study (NCT02883699) were randomized to intervention programs of 12 weeks of (1) endurance standard training or (2) endurance polarized training after a cardiopulmonary exercise test (CPET). Serum was collected pre-CPET, immediately post-CPET, 1 h post-CPET and after 12 weeks post-intervention. Flow cytometry analysis was performed on autologous serum incubated NK-92 cells for: AhR, IDO, KIR2DL1 and NKG2D. Differences were investigated using analysis-of-variance for acute and analysis-of-covariance for chronic effects.

RESULTS

Acute exercise: IDO levels changed over time with a significant increase from post-CPET to 1 h post-CPET (p = 0.03). KIR2DL1 levels significantly decreased over time (p < 0.01). NKG2D levels remained constant (p = 0.31). Chronic exercise: for both IDO and NKG2D a significant group × time interaction, a significant time effect and a significant difference after 12 weeks of intervention were observed (IDO: all p < 0.01, NKG2D: all p > 0.05).

CONCLUSION

Both acute and chronic endurance training may regulate NK cell function via the AhR/IDO axis. This is clinically relevant, as exercise emerges to be a key player in immune regulation.

Effects of Increased Load of Low- Versus High-Intensity Endurance Training on Performance and Physiological Adaptations in Endurance Athletes

PURPOSE

To compare the effects of increased load of low- versus high-intensity endurance training on performance and physiological adaptations in well-trained endurance athletes.

METHODS

Following an 8-week preintervention period, 51 (36 men and 15 women) junior cross-country skiers and biathletes were randomly allocated into a low-intensity (LIG, n = 26) or high-intensity training group (HIG, n = 25) for an 8-week intervention period, load balanced using the overall training impulse score. Both groups performed an uphill running time trial and were assessed for laboratory performance and physiological profiling in treadmill running and roller-ski skating preintervention and postintervention.

RESULTS

Preintervention to postintervention changes in running time trial did not differ between groups (P = .44), with significant improvements in HIG (-2.3% [3.2%], P = .01) but not in LIG (-1.5% [2.9%], P = .20). There were no differences between groups in peak speed changes when incremental running and roller-ski skating to exhaustion (P = .30 and P = .20, respectively), with both modes being significantly improved in HIG (2.2% [3.1%] and 2.5% [3.4%], both P < .01) and in roller-ski skating for LIG (1.5% [2.4%], P < .01). There was a between-group difference in running maximal oxygen uptake changes (P = .04), tending to improve in HIG (3.0% [6.4%], P = .09) but not in LIG (-0.7% [4.6%], P = .25). Changes in roller-ski skating peak oxygen uptake differed between groups (P = .02), with significant improvements in HIG (3.6% [5.4%], P = .01) but not in LIG (-0.1% [0.17%], P = .62).

CONCLUSION

There was no significant difference in performance adaptations between increased load of low- versus high-intensity training in well-trained endurance athletes, although both methods improved performance. However, increased load of high-intensity training elicited better maximal oxygen uptake adaptations compared to increased load of low-intensity training.

What Is Intensity and How Can It Benefit Exercise Intervention in People With Stroke? A Rapid Review

Background: Stroke is one of the major causes of chronic physical disability in the United Kingdom, typically characterized by unilateral weakness and a loss of muscle power and movement coordination. When combined with pre-existing comorbidities such as cardiac disease and diabetes, it results in reductions in cardiovascular (CV) fitness, physical activity levels, functional capacity, and levels of independent living. High-intensity training protocols have shown promising improvements in fitness and function for people with stroke (PwS). However, it remains unclear how intensity is defined, measured, and prescribed in this population. Further, we do not know what the optimal outcome measures are to capture the benefits of intensive exercise. Aim: To understand how intensity is defined and calibrated in the stroke exercise literature to date and how the benefits of high-intensity training in PwS are measured. Methods: A rapid review of the literature was undertaken to provide an evidence synthesis that would provide more timely information for decision-making (compared with a standard systematic review). Electronic databases were searched (including Medline, PubMed, CINAHL, and Embase for studies from 2015 to 2020). These were screened by title and abstract for inclusion if they: (a) were specific to adult PwS; and (b) were high-intensity exercise interventions. Eligible studies were critically appraised using the Mixed Method Appraisal Tool (MMAT). The data extraction tool recorded the definition of intensity, methods used to measure and progress intensity within sessions, and the outcomes measure used to capture the effects of the exercise intervention. Results: Seventeen studies were selected for review, 15 primary research studies and two literature reviews. Sixteen of the 17 studies were of high quality. Nine of the primary research studies used bodyweight-supported treadmills to achieve the high-intensity training threshold, four used static exercise bikes, and two used isometric arm strengthening. Five of the primary research studies had the aim of increasing walking speed, five aimed to increase CV fitness, three aimed to improve electroencephalogram (EEG) measured cortical evoked potentials and corticospinal excitability, and two investigated any changes in muscle strength. Although only one study gave a clear definition of intensity, all studies clearly defined the high-intensity protocol used, with most (15 out of 17 studies) clearly describing threshold periods of high-intensity activity, followed by rest or active recovery periods (of varying times). All of the studies reviewed used outcomes specific to body structure and function (International Classification of Functioning, Disability, and Health (ICF) constructs), with fewer including outcomes relating to activity and only three outcomes relating to participation. The reported effect of high-intensity training on PwS was promising, however, the underlying impact on neurological, musculoskeletal, and CV systems was not clearly specified. Conclusions: There is a clear lack of definition and understanding about intensity and how thresholds of intensity in this population are used as an intervention. There is also an inconsistency about the most appropriate methods to assess and provide a training protocol based on that assessment. It remains unclear if high-intensity training impacts the desired body system, given the diverse presentation of PwS, from a neuromuscular, CV, functional, and psychosocial perspective. Future work needs to establish a clearer understanding of intensity and the impact of exercise training on multiple body systems in PwS. Further understanding into the appropriate assessment tools to enable appropriate prescription of intensity in exercise intervention is required. Outcomes need to capture measures specific not only to the body system, but also level of function and desired goals of individuals.

Biomechanical Response of the Lower Extremity to Running-Induced Acute Fatigue: A Systematic Review

Objective: To investigate (i) typical protocols used in research on biomechanical response to running-induced fatigue, (ii) the effect of sport-induced acute fatigue on the biomechanics of running and functional tests, and (iii) the consistency of analyzed parameter trends across different protocols.

Methods: Scopus, Web of Science, Pubmed, and IEEE databases were searched using terms identified with the Population, Interest and Context (PiCo) framework. Studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and appraised using the methodological index for non-randomized studies MINORS scale. Only experimental studies with at least 10 participants, which evaluated fatigue during and immediately after the fatiguing run were included. Each study was summarized to record information about the protocol and parameter trends. Summary trends were computed for each parameter based on the results found in individual studies.

Results: Of the 68 included studies, most were based on in-lab (77.9%) protocols, endpoint measurements (75%), stationary measurement systems (76.5%), and treadmill environment (54.4%) for running. From the 42 parameters identified in response to acute fatigue, flight time, contact time, knee flexion angle at initial contact, trunk flexion angle, peak tibial acceleration, CoP velocity during balance test showed an increasing behavior and cadence, vertical stiffness, knee extension force during MVC, maximum vertical ground reaction forces, and CMJ height showed a decreasing trend across different fatigue protocols.

Conclusion: This review presents evidence that running-induced acute fatigue influences almost all the included biomechanical parameters, with crucial influence from the exercise intensity and the testing environment. Results indicate an important gap in literature caused by the lack of field studies with continuous measurement during outdoor running activities. To address this gap, we propose recommendations for the use of wearable inertial sensors.

Different endurance exercises modulate NK cell cytotoxic and inhibiting receptors

Purpose

Induction of IDO depends on the activation of AhR forming the AhR/IDO axis. Activated AhR can transcribe various target genes including cytotoxic and inhibiting receptors of NK cells. We investigated whether AhR and IDO levels as well as activating (NKG2D) and inhibiting (KIR2DL1) NK cell receptors are influenced by acute exercise and different chronic endurance exercise programs.

Methods

21 adult breast and prostate cancer patients of the TOP study (NCT02883699) were randomized to intervention programs of 12 weeks of (1) endurance standard training or (2) endurance polarized training after a cardiopulmonary exercise test (CPET). Serum was collected pre-CPET, immediately post-CPET, 1 h post-CPET and after 12 weeks post-intervention. Flow cytometry analysis was performed on autologous serum incubated NK-92 cells for: AhR, IDO, KIR2DL1 and NKG2D. Differences were investigated using analysis-of-variance for acute and analysis-of-covariance for chronic effects.

Results

Acute exercise: IDO levels changed over time with a significant increase from post-CPET to 1 h post-CPET (p = 0.03). KIR2DL1 levels significantly decreased over time (p < 0.01). NKG2D levels remained constant (p = 0.31). Chronic exercise: for both IDO and NKG2D a significant group × time interaction, a significant time effect and a significant difference after 12 weeks of intervention were observed (IDO: all p < 0.01, NKG2D: all p > 0.05).

Conclusion

Both acute and chronic endurance training may regulate NK cell function via the AhR/IDO axis. This is clinically relevant, as exercise emerges to be a key player in immune regulation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04735-z.

Maximal muscular power: lessons from sprint cycling

Maximal muscular power production is of fundamental importance to human functional capacity and feats of performance. Here, we present a synthesis of literature pertaining to physiological systems that limit maximal muscular power during cyclic actions characteristic of locomotor behaviours, and how they adapt to training. Maximal, cyclic muscular power is known to be the main determinant of sprint cycling performance, and therefore we present this synthesis in the context of sprint cycling. Cyclical power is interactively constrained by force-velocity properties (i.e. maximum force and maximum shortening velocity), activation-relaxation kinetics and muscle coordination across the continuum of cycle frequencies, with the relative influence of each factor being frequency dependent. Muscle cross-sectional area and fibre composition appear to be the most prominent properties influencing maximal muscular power and the power-frequency relationship. Due to the role of muscle fibre composition in determining maximum shortening velocity and activation-relaxation kinetics, it remains unclear how improvable these properties are with training. Increases in maximal muscular power may therefore arise primarily from improvements in maximum force production and neuromuscular coordination via appropriate training. Because maximal efforts may need to be sustained for ~15-60 s within sprint cycling competition, the ability to attenuate fatigue-related power loss is also critical to performance. Within this context, the fatigued state is characterised by impairments in force-velocity properties and activation-relaxation kinetics. A suppression and leftward shift of the power-frequency relationship is subsequently observed. It is not clear if rates of power loss can be improved with training, even in the presence adaptations associated with fatigue-resistance. Increasing maximum power may be most efficacious for improving sustained power during brief maximal efforts, although the inclusion of sprint interval training likely remains beneficial. Therefore, evidence from sprint cycling indicates that brief maximal muscular power production under cyclical conditions can be readily improved via appropriate training, with direct implications for sprint cycling as well as other athletic and health-related pursuits.

Heart rate dynamics and lactate following high-intensity race-pace continuous vs interval workouts in highly trained athletes

PURPOSE

The present study aimed to compare the physiological responses of high-intensity race-pace continuous vs. interval workouts commonly used in middle-distance athletics, by means of analyzing post-exercise cardiac autonomic regulation and lactate.

METHODS

Nineteen highly-trained 800-m male runners were asked to run a 600-m race-pace continuous workout and a 2 × 4 × 200-m interval training, counterbalanced and randomized within one week of difference. Blood lactate jointly with linear and nonlinear heart rate dynamics were assessed during the immediate 15-min recovery. Age-category (Under23-Senior vs. Juvenile-Junior) was considered as an inter-subject factor.

RESULTS

Peak lactate was higher following the interval training (15.51 ± 0.99 vs 13.83 ± 1.77 mmol L-1; P < 0.05) whereas lactate removal was almost nonexistent 15 min after both workouts (between 0 and 16%). Vagal modulation (ln RMSSD and lnRMSSD to RR ratio) remained significantly depressed at the end of recovery following both workouts, although the alteration was larger following the interval training. Detrended Fluctuation Analysis evidenced a more random HR behavior (DFA1 closer to 0.5) during the first 9 min of recovery after the interval training, whereas no significant change was observed in heart rate complexity (SampEn). Neither were differences found in post-exercise lactate and HR dynamics as a function of age-category.

CONCLUSIONS

High-intensity workouts commonly used in middle-distance athletics, both race-pace continuous and intervallic approaches, induce a large depression of vagal modulation in highly trained runners, although interval trainings appear to induce even a greater alteration of both linear and nonlinear HR dynamics and a higher post-exercise peak lactate.

Monitoring and Behavior of Biomotor Skills in Futsal Athletes During a Season

Futsal is a sport that presents alternation of high and low intensity moments, which lacks investigations regarding the effects of the organization of the training load on biomotor skills. In this sense, this study aims to verify the monitoring of the training load throughout the season and the behavior of biomotor skills in futsal athletes. Twelve futsal athletes (24.5 ± 4.9 years, 1.79 ± 0.6 m, 72.4 ± 9.4 kg, and 9.4 ± 4.3% fat) from the adult category who competed in the first division of the Paulista championship participated in the study. Throughout the season the internal training load (ITL) was calculated, through the relationship between volume (minutes) and the rate of perceived exertion (RPE), monotony, and training strain. The training periods were divided into: preparatory, competitive and competitive II, for a total of four moments of evaluation: M1: at the beginning of the preparatory period; M2: 5th week, at the end of the preparatory period; M3: 13th week, in the middle of the competitive period; and M4: at the start of the competitive period II. The tests used were: (i) Power of lower limbs: counter movement jump (CMJ); (ii) Displacement speed, over the 10-meter distance (V10m); and (iii) Aerobic power, by the Carminatti test (T-CAR). The variables analyzed were compared at the different moments of evaluation, normally distributed variables (Volume, S-RPE, strain, and monotony) were analyzed using the ANOVA ONE-WAY variance test followed by the Tukey. Variables that did not show normality (lower limb power, speed, and aerobic power) were compared using the Friedman test followed by Dunn's multiple comparisons test and was presented by median and interquartile interval. The significance value adopted was p < 0.05. A significant improvement (p < 0.05) was observed in the power of lower limbs from M1 (37.5 ± 5.5 cm) to M3 (40.8 ± 5.7 cm), from M2 (38.9 ± 5.5 cm) to M3 (40.8 ± 5.7 cm), and from M1 (37.5 ± 5.5 cm) to M4 (40.2 ± 5.4 cm). Aerobic power showed a significant increase (p < 0.05) from M1 (12.1 ± 0.7 km/h) to M3 (12.7 ± 7 km/h) and from M1 (12.1 ± 0.7 km/h) to M4 (12.73 ± 1.04 km/h). The internal training load showed a difference between competitive I and II in relation to the preparatory period (p < 0.05). In conclusion, the proposed training organization was sufficient to improve the power of the lower limbs and the aerobic power.

Training Distribution During a Paralympic Cycle for a Multiple Swimming Champion With Paraplegia: A Case Report

PURPOSE

To describe the training volume, intensity distribution, and use of swimming styles during a Paralympic cycle in a multiple swimming champion with paraplegia.

METHODS

The female Paralympic swimmer was 23-26 years of age and had a body mass of 60 to 62 kg and a body height of 174 cm. She has a spinal cord injury at the Th6 level, competed in the S5/SB4 Para swimming classes, and uses a wheelchair for mobility. Training time, as well as distance in the different intensity zones and swimming styles, was registered with the "workouts for swim coaches" software throughout a full Paralympic cycle.

RESULTS

The Para swimmer performed a total of 388, 524, 471, and 656 annual hours of swimming, corresponding to 1126, 1504, 1463, and 1993 km, in the 2012-13, 2013-14, 2014-15, and 2015-16 seasons, respectively. In addition, she performed 1 to 3 weekly dry-land strength sessions and 4 to 6 weekly dry-land basic skill sessions. She conducted 91% to 94% of the swimming distance in each macrocycle at low intensity, 2% to 4% at moderate intensity, and 3% to 6% at high intensity. She performed 78% to 84% of the swimming distance in each macrocycle in the freestyle swimming technique and the remaining 16% to 22% in the backstroke, breaststroke, and butterfly techniques.

CONCLUSION

This case study exemplifies how a female Paralympic swimmer with paraplegia progressed her training in the seasons leading up to the Paralympic Games, reaching an annual training distance of 2000 km, which is similar to that of able-bodied swimmers.

Effects of Heat Acclimation and Acclimatisation on Maximal Aerobic Capacity Compared to Exercise Alone in Both Thermoneutral and Hot Environments: A Meta-Analysis and Meta-Regression

Background

Heat acclimation and acclimatisation (HA) is typically used to enhance tolerance to the heat, thereby improving performance. HA might also confer a positive adaptation to maximal oxygen consumption (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max), although this has been historically debated and requires clarification via meta-analysis.

Objectives

(1) To meta-analyse all studies (with and without control groups) that have investigated the effect of HA on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation in thermoneutral or hot environments; (2) Conduct meta-regressions to establish the moderating effect of selected variables on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation following HA.

Methods

A search was performed using various databases in May 2020. The studies were screened using search criteria for eligibility. Twenty-eight peer-reviewed articles were identified for inclusion across four separate meta-analyses: (1) Thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max within-participants (pre-to-post HA); (2) Hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max within-participants (pre-to-post HA); (3) Thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max measurement; HA vs. control groups; (4) Hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max measurement, HA vs. control groups. Meta-regressions were performed for each meta-analysis based on: isothermal vs. iso-intensity programmes, days of heat exposure, HA ambient temperature (°C), heat index, HA session duration (min), ambient thermal load (HA session x ambient temperature), mean mechanical intensity (W) and the post-HA testing period (days).

Results

The meta-analysis of pre–post differences in thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max demonstrated small-to-moderate improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max (Hedges’ g = 0.42, 95% CI 0.24–0.59, P < 0.001), whereas moderate improvements were found for the equivalent analysis of hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max changes (Hedges’ g = 0.63, 95% CI 0.26–1.00, P < 0.001), which were positively moderated by the number of days post-testing (P = 0.033, β = 0.172). Meta-analysis of control vs. HA thermoneutral \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max demonstrated a small improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max in HA compared to control (Hedges’ g = 0.30, 95% CI 0.06–0.54, P = 0.014) and this effect was larger for the equivalent hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max analysis where a higher (moderate-to-large) improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max was found (Hedges’ g = 0.75, 95% CI 0.22–1.27, P = 0.005), with the number of HA days (P = 0.018; β = 0.291) and the ambient temperature during HA (P = 0.003; β = 0.650) positively moderating this effect.

Conclusion

HA can enhance \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation in thermoneutral or hot environments, with or without control group consideration, by at least a small and up to a moderate–large amount, with the larger improvements occurring in the heat. Ambient heat, number of induction days and post-testing days can explain some of the changes in hot \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$V{\text{O}}_{2\max }$$\end{document}VO2max adaptation.

Blood flow restriction training and the high-performance athlete: science to application

The manipulation of blood flow in conjunction with skeletal muscle contraction has greatly informed the physiological understanding of muscle fatigue, blood pressure reflexes, and metabolism in humans. Recent interest in using intentional blood flow restriction (BFR) has focused on elucidating how exercise during periods of reduced blood flow affects typical training adaptations. A large initial appeal for BFR training was driven by studies demonstrating rapid increases in muscle size, strength, and endurance capacity, even when notably low intensities and resistances, which would typically be incapable of stimulating change in healthy populations, were used. The incorporation of BFR exercise into the training of strength- and endurance-trained athletes has recently been shown to provide additive training effects that augment skeletal muscle and cardiovascular adaptations. Recent observations suggest BFR exercise alters acute physiological stressors such as local muscle oxygen availability and vascular shear stress, which may lead to adaptations that are not easily attained with conventional training. This review explores these concepts and summarizes both the evidence base and knowledge gaps regarding the application of BFR training for athletes.

Intensity Paradox-Low-Fit People Are Physically Most Active in Terms of Their Fitness

Depending on their cardiorespiratory fitness (CRF), people may perceive the exertion of incident physical activity (PA) differently. Therefore, the use of relative intensity thresholds based on individual fitness have been proposed to evaluate the accumulation of PA at different intensity levels. A subsample of the FinFit2017-study, 1952 adults (803 men and 1149 women) aged 20–69 years, participated in this study. Their maximal oxygen uptake (VO₂max) was predicted with a 6 min walk test, and they were instructed to wear a triaxial hip-worn accelerometer for one week. The participants were divided into CRF tertiles by five age groups and sex. Raw acceleration data were analyzed with the mean amplitude deviation method in 6 s epochs. Additionally, the data were smoothed with 1 min and 6 min exponential moving averages. The absolute intensity threshold for moderate activity was 3.0 metabolic equivalent (MET) and for vigorous 6.0 MET. Correspondingly, the relative thresholds were 40% and 60% of the oxygen uptake reserve. Participants in the lowest CRF tertile were the most active with relative thresholds, and participants in the highest CRF tertile were the most active with absolute thresholds. High-fit people easily reached the absolute thresholds, while people in the lowest CRF tertile had to utilize most of their aerobic capacity on a daily basis simply to keep up with their daily chores or peers.

The Training Characteristics of World-Class Male Long-Distance Cross-Country Skiers

Purpose: To investigate the training characteristics of world-class long-distance cross-country skiers.

Methods: Twelve world-class male long-distance cross-country skiing specialists reported training from their best season, through a questionnaire and follow-up interviews. Training data were systemized by training form (endurance, strength, and speed), intensity [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and exercise mode, followed by a division into different periodization phases. Specific sessions utilized in the various periodization phases were also analyzed.

Results: The annual training volume was 861 ± 90 h, consisting of 795 ± 88 h (92%) of endurance training, 53 ± 17 h (6%) of strength training, and 13 ± 14 h (2%) of speed training. A pyramidal (asymptotic) endurance training distribution was employed (i.e., 88.7% LIT, 6.4% MIT, and 4.8% HIT). Out of this, 50–60% of the endurance training was performed with double poling (DP), typically in the form of a daily 3- to 5-h session. A relatively evenly distributed week-to-week periodization of training load was commonly used in the general preparation period, whereas skiers varied between high-load training weeks and competition weeks, with half the training volume and a reduced amount of DP during the competition period.

Conclusions: To match the specific demands of long-distance cross-country skiing, specialized long-distance skiers perform relatively long but few training sessions and use a pyramidal intensity distribution pattern and a large amount of training spent using the DP technique.

Effects of an experimental taper period on male and female swimmers

BACKGROUND

This study investigated the possible influence of the gender on the responses of swimmers during a taper period (TP).

METHODS

Ten males (19 ± 3 years and 73.5 ± 7.8 kg) and ten females (17 ± 2 years and 54.7 ± 7.2 kg) swimmers were submitted to a 12-week training, followed by three weeks of the TP. Before and after the TP we evaluated the performance at 100 m freestyle, stroke parameters and lactacidemic responses; lactate minimum intensity (LMI) and stroke parameters associated with LMI and the propulsive force in tethered swimming. TP consisted of 14 sessions with mean volume 2,253 ± 1,213 m•session-1 at an intensity below than the LMI, 1,730 ± 327 m•session-1 at an intensity near the LMI and 1,530 ± 1,019 m•session-1 at an intensity above the LMI.

RESULTS

Significant effects of the genders were observed for LMI and stroke parameters (p-value < 0.001 and η2 > 0.52 [large]) and propulsive force (p-value = 0.001; η2 = 0.59 [large]). However, no significant effects of the TP were identified in the performance of the 100 m freestyle (p-value = 0.66; η2 = 0.006 [small]), propulsive force (p-value > 0.63; η2 < 0.006 [small]), aerobic parameters (LMI: p-value = 0.32 and η2 = 0.03 [small]) and mechanical parameters (p-value > 0.23; η2 = 0.01 [small]). Nonetheless, the peak blood lactate concentrations were improved after TP (p-value = 0.014; η2 = 0.16 [large]), without significant interactions (p-value = 0.38; η2 = 0.02 [small]), as well as the mechanical parameters during maximum 100 m freestyle (p-value < 0.04 and η2 > 0.10 [medium]).

CONCLUSIONS

Hence, men and women presenting significantly different values in the age group studied, the responses observed after the TP investigated were the same independent of gender.

Low-Dose Ammonium Preconditioning Enhances Endurance in Submaximal Physical Exercises

Preconditioning is often used in medicine to protect organs from ischemic damage and in athletes to enhance the performances. We tested whether low-dose ammonium preconditioning (AMP) could have a beneficial effect on physical exercises (PE). We used Cardiopulmonary Exercise Testing (CPET) on a treadmill to investigate the effects of low-dose AMP on the physical exercise capacity of professional track and field athletes and tested twenty-five athletes. Because of the individual differences between athletes, we performed a preliminary treadmill test (Pre-test) and, according to the results, the athletes were randomly allocated into the AMP and control (placebo, PL) group based on the similarity of the total distance covered on a treadmill. In the AMP group, the covered distance increased (11.3 ± 3.6%, p < 0.02) compared to Pre-test. Similarly, AMP significantly increased O₂ uptake volume—VO₂ (4.6 ± 2.3%, p < 0.03) and pulmonary CO₂ output—VCO₂ (8.7 ± 2.8%, p < 0.01). Further, the basic blood parameters (pH, pO₂, and lactate) shift was lower despite the greater physical exercise progress in the AMP group compared to Pre-test, whereas in the placebo group there were no differences between Pre-test and Load-test. Importantly, the AMP significantly increased red blood cell count (6.8 ± 2.0%, p < 0.01) and hemoglobin concentration (5.3 ± 1.9%, p < 0.01), which might explain the beneficial effects in physical exercise progress. For the first time, we showed that low-dose AMP had clear beneficial effects on submaximal PE.

The Effect of High-Intensity Intermittent Training on the Acute Gait Plantar Pressure in Healthy Young Adults

High-intensity intermittent training (HIIT) has been successfully applied in various sports activities, as HIIT was considered as one of the most efficient training methods of exercise for improving physical performance and reducing the weight of overweight individuals. However, its acute effects of HIIT on gait and balance performance were not addressed. Thus, in this study we examined the acute effects of HIIT on dynamic postural control compared with steady-state training (SST) by analyzing plantar pressure parameters. In this study, sixteen healthy male adults were examined in 3 days. After exhaustive ramp-like cycle ergometer testing, the maximal heart rate (HRmax) of each participant was determined on the first day, then either a 20 minutes HIIT at 80–90% of HRmax or a 20 minutes SST at 60% of HRmax was randomly performed on the second and third day, respectively. Plantar pressure parameters were collected at comfortable walking velocity immediately after HIIT and SST respectively, and compared with the baseline data of plantar pressure gathered before maximal ramp test on the first day. The results showed significant differences in the plantar pressure in these three conditions of gait. Compared to pre-intervention and pre-SST, peak pressure and maximum force in the middle and lateral metatarsal increased significantly in post-HIIT. Meanwhile, the foot balance data indicate that post-HIIT exhibits more foot pronation than baseline. The center of pressure (COP) trajectory was medially shifted during the stance phase in post-SST, and noticeably in post-HIIT. The displacement and velocity of medial-lateral COP in the initial contact phase were greater in post-HIIT; while during the forefoot contact phase, post-HIIT showed fewer time percentages and greater velocity of medial-lateral COP. In conclusion, a single high-intensity intermittent training session adversely affected the acute dynamic postural control than steady-state training in healthy male adults.

Intensity Control During Block-Periodized High-Intensity Training: Heart Rate and Lactate Concentration During Three Annual Seasons in World-Class Cross-Country Skiers

Purpose: To describe heart rate (HR) and blood lactate (Bla⁻) responses during high-intensity interval training (HIT) in a long-term block-periodized HIT regimen in world-class cross-country (XC) skiers.

Methods: Data were collected in 14 world-class female XC skiers (aged 25 ± 5 years; body mass, 60.4 ± 6.5 kg; and maximal HR, 194 ± 8 beats · min⁻¹) throughout three entire seasons. The HR and Bla⁻ values were determined at the end of 572 intervals performed during 63 sessions and 17 HIT blocks utilizing different exercise modes: running, running with poles, and skiing (on-snow and roller ski) with classic and skating techniques.

Results: The mean HR was 91 ± 3% of HR_max with a corresponding Bla⁻ of 7.3 ± 2.1 mmol · L⁻¹. The average HR and Bla⁻ values were relatively similar across the different exercise modes, except for a lower HR (~90 vs. 92% of HR_max) for on-snow and roller ski classical skiing and lower Bla⁻ values (5.9 vs. 7.0–7.8 mmol · L⁻¹) for on-snow classical skiing compared to the other modes, both P < 0.05. An increase in HR and Bla⁻ was observed from interval working periods 1 to 3 (90–92% of HR_max and 6.5–7.7 mmol · L⁻¹) and further from 3 to 5 (92–93% of HR_max and 7.7–9.0 mmol · L⁻¹), all P < 0.05.

Conclusions: We describe long-term use of HIT-block periodization among world-class XC skiers who achieved target HR and Bla⁻ levels in all six exercise modes employed. According to athletes and coaches, the key to successful blocks was intensity control to allow for high-quality HIT sessions throughout the entire HIT block.

Individualized Aerobic Exercise in Neuromuscular Diseases: A Pilot Study on the Feasibility and Preliminary Effectiveness to Improve Physical Fitness

OBJECTIVE

Clear guidelines to prescribe aerobic exercise in neuromuscular diseases (NMD) are lacking, which hampers effective application in neuromuscular rehabilitation. This pilot study evaluated the feasibility and preliminary effectiveness of an individualized aerobic exercise program according to a recently developed training guide (B-FIT) to improve physical fitness in individuals with NMD.

METHODS

Thirty-one individuals who were ambulatory and had 15 different slowly progressive NMD participated in a 4-month, polarized, home-based, aerobic exercise program. The program included 2 low-intensity sessions and 1 high-intensity session per week. Feasibility outcomes were the following: completion rate, proportion of followed sessions, adverse events, and participant and therapist satisfaction based on a self-designed questionnaire. Submaximal incremental exercise tests were used to assess the effects on physical fitness.

RESULTS

Twenty-six participants (84%) completed the B-FIT program, and the proportion of followed sessions was >75%. Three adverse events were reported and resolved. Regarding satisfaction, participants (based on n = 9) reported feeling fitter, but training was considered insufficiently challenging. Physical therapists (n = 5) reported that B-FIT provides a clear, well-grounded guidance. They perceived the time investment for initiating the program and the carry-over to primary care as the main barriers. The mean (SD) submaximal heart rate (based on n = 20) reduced significantly by -6.5 beats per minute (95% CI = -11.8 to -1.2), from 121.7 (16.5) at baseline to 115.2 (14.3) after intervention. Submaximal ratings of perceived exertion, anaerobic threshold, and peak workload also improved significantly (P < .05).

CONCLUSION

The outcomes of this pilot study suggest that individualized aerobic exercise according to B-FIT is feasible and has potential to improve physical fitness in a wide variety of slowly progressive NMD. However, some barriers must be addressed before investigating the efficacy in a randomized controlled trial.

IMPACT

The outcomes of this study demonstrate the feasibility of individualized aerobic exercise according to the B-FIT training guide and the potential to improve physical fitness in NMD. Physical therapists indicated that the use of B-FIT provides a clear, well-grounded guidance. The training guide can support health care professionals in the application of aerobic exercise in adult neuromuscular rehabilitation.

LAY SUMMARY

Individualized exercise according to the B-FIT training guide is feasible in a wide variety of slowly progressive NMD and might help improve physical fitness.

Effect of High-Intensity Interval Training Versus Moderate-Intensity Aerobic Continuous Training on Galectin-3 Gene Expression in Postmenopausal Women: A Randomized Controlled Trial

Galectin-3 is a pro-inflammatory biomarker associated with the pathogenesis of heart failure (HF). Physical-activity reduces the risk of heart-failure by modification of inflammation and fibrosis. The purpose of this study was to compare the effects of 8 weeks of high-intensity interval training (HIIT) versus moderate-intensity aerobic continuous training on a predictive factor of HF in postmenopausal women. Thirty sedentary postmenopausal women were randomly assigned to three groups. The first group performed the HIIT program at 60%-90%, and the second group performed an exercise program at 50%-65% of HR reserve. The control group maintained their normal daily regular physical activity level. The gene expressions of galectin-3 and lipid profiles were measured at the baseline and the end of Week 8. The HIIT and moderate-intensity aerobic continuous training attenuated the gene expression of galectin-3, serum low-density lipoprotein, cholesterol, and triglyceride concentrations and enhanced high-density lipoprotein concentrations. These changes were considerably higher in the HIIT group. Our results show that HIIT is superior to moderate-intensity aerobic continuous training in improving the decrease in HF risk in postmenopausal women.

A comparison of CrossFit and concurrent training on myonectin, insulin resistance and physical performance in healthy young women

OBJECTIVE

To compare the effect of CrossFit and concurrent aerobic + resistance training (CT) on circulating myonectin levels, insulin resistance index, and physical performance in young women.

MATERIALS AND METHODS

Thirty healthy women were randomly assigned to CrossFit (n = 16) and CT (n = 14) groups, exercising three sessions per week for eight weeks. Serum myonectin levels, insulin resistance index, body composition, and performance variables were evaluated before and after the intervention period.

RESULTS

Neither the CrossFit nor the CT group improved in myonectin levels and insulin resistance index. While, fat percentage, muscle mass, upper-limb strength, VO_2max, HR at rest, lower body mean power output, and upper body peak power output improved more after CrossFit than the CT.

CONCLUSION

It seems that CrossFit exercises by targeting multiple fitness components in one exercise session may allow participants to perform more activity in less time.

Six Weeks of Polarized Versus Moderate Intensity Distribution: A Pilot Intervention Study

BACKGROUND

Previous research indicates that polarized training-intensity-distribution (TID) programs could enhance endurance performance. Short-distance triathletes, however, perform most of their competition-specific training around moderate-intensity intervals. There is still a lack of evidence as to which program is more beneficial during triathlete training. This pilot study examined 6 weeks of training-macrocycle using polarized intensity distribution compared to moderate TID and it's effects on sub-maximal and maximal performance indices during running and cycling.

METHODS

Fifteen moderately trained triathletes were either assigned to an intervention group (INT, n = 7, 2 females/5 males, Age: 29.1 ± 7.6) or a control group (CON, n = 8, 2 females/6 males, Age: 30.3 ± 6.1). We used the minimization method (Strata: gender, age competition times, training volumes) to allocate the groups. The participants underwent incremental cycling and running testings before and after the intervention period to assess performance indices until objective exhaustion. CON employed a moderate TID with either medium-intensity (MIT) or low-intensity training (LIT). INT used polarized training intensity distribution (TID), with either LIT or high-intensity training (HIT). Average training hours and anthropometric data did not indicate any differences between CON and INT during the study period. We applied the polarization index of >2 in INT (2.1 ± 0.4) and <1 in CON (0.9 ± 0.3).

RESULTS

Both groups notably improved their lactate threshold 2 (+2.8 ± 5.1 %, p = 0.026) and peak (+5.4 ± 6.2 %, p = 0.002) running performance. We did not observe statistically significant time × group interaction effects in any of the performance outcomes between both groups.

CONCLUSION

Polarized TID in moderately trained triathletes did not prove to be superior compared to a more moderate TID. However, more studies in larger and more highly trained subjects are needed.

What Should I Eat before Exercise? Pre-Exercise Nutrition and the Response to Endurance Exercise: Current Prospective and Future Directions

The primary variables influencing the adaptive response to a bout of endurance training are exercise duration and exercise intensity. However, altering the availability of nutrients before and during exercise can also impact the training response by modulating the exercise stimulus and/or the physiological and molecular responses to the exercise-induced perturbations. The purpose of this review is to highlight the current knowledge of the influence of pre-exercise nutrition ingestion on the metabolic, physiological, and performance responses to endurance training and suggest directions for future research. Acutely, carbohydrate ingestion reduces fat oxidation, but there is little evidence showing enhanced fat burning capacity following long-term fasted-state training. Performance is improved following pre-exercise carbohydrate ingestion for longer but not shorter duration exercise, while training-induced performance improvements following nutrition strategies that modulate carbohydrate availability vary based on the type of nutrition protocol used. Contrasting findings related to the influence of acute carbohydrate ingestion on mitochondrial signaling may be related to the amount of carbohydrate consumed and the intensity of exercise. This review can help to guide athletes, coaches, and nutritionists in personalizing pre-exercise nutrition strategies, and for designing research studies to further elucidate the role of nutrition in endurance training adaptations.

Acute Physiological Responses to Ultra Short Race-Pace Training in Competitive Swimmers

Ultra Short Race Pace training (USRPT) is an emerging training modality devised in 2011 to deviate from high-volume swimming training that is typically prescribed. USRPT aims to replicate the exact demands of racing, through its unique prescription of race-pace velocity sets with short rest intervals. It has been surmised, with little physiological evidence, that USRPT provides swimmers with the best opportunity to optimize the conditioning, technique, and psychology aspects of racing at the most specific velocity of the relevant event, with low blood lactate concentration. The aim of this study was to examine acute physiological responses of USRPT. Fourteen swimmers were recruited to perform a USRPT set: 20 x 25 m freestyle with a 35-s rest interval. Swimmers were required to maintain the velocity of their 100 m personal best time for each sprint. Sprint performance, blood lactate, heart rate and the RPE were measured. Blood lactate was taken before, during (after every 4 sprints) and 3 minutes after the USRPT protocol. Heart rate monitors were used to profile the heart rate. Athletes reported the RPE before- and after completion of the USRPT set. Sprint times increased by 3.3-10.8% when compared to the first sprint (p < 0.01). There was high blood lactate concentration (13.6 ± 3.1mmol/l), a significant change in the RPE from 8 ± 1.6 to 18 ± 1.6 (p < 0.01) and a substantially high heart rate profile with an average HR_max of 188 ± 9 BPM. The results show the maximal intensity nature of USRPT and portray it as an anaerobic style of training.

The acute physiological and perceptual effects of recovery interval intensity during cycling-based high-intensity interval training

Purpose

The current study sought to investigate the role of recovery intensity on the physiological and perceptual responses during cycling-based aerobic high-intensity interval training.

Methods

Fourteen well-trained cyclists (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak: 62 ± 9 mL kg⁻¹ min⁻¹) completed seven laboratory visits. At visit 1, the participants’ peak oxygen consumption (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak) and lactate thresholds were determined. At visits 2–7, participants completed either a 6 × 4 min or 3 × 8 min high-intensity interval training (HIIT) protocol with one of three recovery intensity prescriptions: passive (PA) recovery, active recovery at 80% of lactate threshold (80A) or active recovery at 110% of lactate threshold (110A).

Results

The time spent at > 80%, > 90% and > 95% of maximal minute power during the work intervals was significantly increased with PA recovery, when compared to both 80A and 110A, during both HIIT protocols (all P ≤ 0.001). However, recovery intensity had no effect on the time spent at > 90% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak (P = 0.11) or > 95% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2peak}}}}$$\end{document}V˙O2peak (P = 0.50) during the work intervals of both HIIT protocols. Session RPE was significantly higher following the 110A recovery, when compared to the PA and 80A recovery during both HIIT protocols (P < 0.001).

Conclusion

Passive recovery facilitates a higher work interval PO and similar internal stress for a lower sRPE when compared to active recovery and therefore may be the efficacious recovery intensity prescription.

Photobiomodulation Therapy Modulates Muscle Gene Expression and Improves Performance of Rats Subjected to a Chronic Resistance Exercise Protocol

Objective: In professional sports activities, the search for increased performance is constant. Electrophysical agents, including photobiomodulation (PBM), have been used in the sports context to accelerate postworkout recovery, prevent injuries, and even to improve performance. This study aims to investigate the effects of infrared laser (904 nm) on skeletal muscle gene expression of performance-related proteins of rats submitted to a chronic resistance training protocol. Materials and methods: Male Wistar rats (n = 40), weighing ±300 g were divided into four groups: sedentary control (CT, n = 10); irradiated control (CTL, n = 10); exercised not irradiated (EX, n = 10); exercised irradiated (EXL, n = 10). To assess the performance, the maximum carrying test was adapted and applied 72 h prior the training and 72 h after the last exercise session. The vertical weight climbing protocol was adapted for resistance training 3 × per week with 48 h interval between each session: first week adaptation, second week 25% of body weight (BW), third week 50% BW, fourth week 75% BW, and fifth week 100% BW. Animals were irradiated before exercise on hind paws 50 sec each, with infrared laser 904 nm 5 days per week, during 4 weeks, 9 J per leg in a total of 18 J energy per day. Results: The EXL performed more climbing (7.1 ± 0.91) compared to EX (4.4 ± 0.63). PBM promoted increased expression of lactate dehydrogenase enzyme, mammalian target of rapamycin protein, and androgen receptor (p < 0.05) but not the myosin heavy chain (p = 0.43). Conclusions: PBM therapy increases the expression of performance-related muscle mass gain genes besides improving the resistance training performance.

Fractal Correlation Properties of Heart Rate Variability: A New Biomarker for Intensity Distribution in Endurance Exercise and Training Prescription?

Exercise and training prescription in endurance-type sports has a strong theoretical background with various practical applications based on threshold concepts. Given the challenges and pitfalls of determining individual training zones on the basis of subsystem indicators (e.g., blood lactate concentration, respiratory parameters), the question arises whether there are alternatives for intensity distribution demarcation. Considering that training in a low intensity zone substantially contributes to the performance outcome of endurance athletes and exceeding intensity targets based on a misleading aerobic threshold can lead to negative performance and recovery effects, it would be desirable to find a parameter that could be derived via non-invasive, low cost and commonly available wearable devices. In this regard, analytics conducted from non-linear dynamics of heart rate variability (HRV) have been adapted to gain further insights into the complex cardiovascular regulation during endurance-type exercise. Considering the reciprocal antagonistic behavior and the interaction of the sympathetic and parasympathetic branch of the autonomic nervous system from low to high exercise intensities, it may be promising to use an approach that utilizes information about the regulation quality of the organismic system to determine training-intensity distribution. Detrended fluctuation analysis of HRV and its short-term scaling exponent alpha1 (DFA-alpha1) seems suitable for applied sport-specific settings including exercise from low to high intensities. DFA-alpha1 may be taken as an indicator for exercise prescription and intensity distribution monitoring in endurance-type sports. The present perspective illustrates the potential of DFA-alpha1 for diagnostic and monitoring purposes as a “global” system parameter and proxy for organismic demands.

The Effect of Sports Rules Amendments on Exercise Intensity during Taekwondo-Specific Workouts

We aimed to compare the change in exercise response to taekwondo-specific circuit workouts before and after competition rule amendments. A total of 240 workouts in 15 elite athletes were analyzed over two years. Physiological and kinematic data were gathered with the wireless Bioharness system along with capillary blood samples for lactate concentration. Progressive exercise tests until exhaustion were periodically performed to obtain reference data. The rule changes resulted in significant increases (mainly medium or large effects) in the physiological (2.9-14.4%) and kinematic (4.8-10.1%) response to taekwondo-specific workouts. The largest increases were for peak breathing rate (12.0%), energy expenditure (6.6%), blood lactate immediately after exercise (10.2%) and at the 30th min of recovery (14.4%), and peak kinematic activity (10.1%). Significant differences between taekwondo-specific workouts and tournament combats persisted after the shift from old to new rules, ranging from 2.4 to 38.5% for physiological and from 2.9 to 15.5% for kinematic variables. The largest workout-combat differences were revealed for post-exercise (15.9%) and recovery (38.5%) blood lactate, peak (-15.8%) and relative (-15.0%) breathing rate, and mechanical (13.5%) and physiological (14.2%) intensity. Our study suggests that the rule amendments significantly modify the exercise response to discipline-specific workouts and that taekwondo-specific training sessions do not fully recreate the tournament demands in terms of physiological and kinematic load.

HRV-Guided Training for Professional Endurance Athletes: A Protocol for a Cluster-Randomized Controlled Trial

Physiological training responses depend on sympathetic (SNS) and parasympathetic nervous system (PNS) balance. This activity can be measured using heart rate variability (HRV). Such a measurement method can favor individualized training planning to improve athletes’ performance. Recently, HRV-guided training has been implemented both on professional and amateur sportsmen and sportswomen with varied results. There is a dearth of studies involving professional endurance athletes following a defined HRV-guided training protocol. The objectives of the proposed protocol are: (i) to determine changes in the performance of high-level athletes after following an HRV-guided or a traditional training period and (ii) to determine differences in the athletes’ performance after following both training protocols. This will be a 12-week cluster-randomized controlled protocol in which professional athletes will be assigned to an HRV-based training group (HRV-G) or a traditional-based training group (TRAD-G). TRAD-G will train according to a predefined training program. HRV-G training will depend on the athletes’ daily HRV. The maximal oxygen uptake (VO_2max) attained in an incremental treadmill test will be considered as the primary outcome. It is expected that this HRV-guided training protocol will improve functional performance in the high-level athletes, achieving better results than a traditional training method, and thus providing a good strategy for coaches of high-level athletes.

The importance of the verification phase following an incremental exercise to ensure maximum oxygen consumption

BACKGROUND

The purpose of this study was to analyze cardiac output (Qc), stroke volume (SV), heart rate (HR), and arterio-venous O<inf>2</inf> difference (a-vO<inf>2diff</inf>) responses throughout a graded exercise test (GXT) and verification phase (VP) to examine whether SV decrement during the GXT is a main factor for underestimation of the maximal O<inf>2</inf> uptake (V̇O<inf>2max</inf>), or not.

METHODS

Seven well-trained male cyclists volunteered for this study (V̇O<inf>2max</inf>: 61.7±6.13 mL∙min^-1∙kg^-1). Following submaximal tests, participants were asked to perform GXT until exhaustion. Then, multisession verifications were performed on different days using ±3% constant work rates. The highest 30-second mean of V̇O<inf>2</inf> was considered as the V̇O<inf>2max</inf> and corresponding external power as peak power output (PPO). The Qc, SV, HR, and a-vO<inf>2diff</inf> responses were evaluated at both GXT and VP by nitrous-oxide rebreathing method. After repeated-measures analyses, possible significant differences were investigated by LSD/Wilcoxon.

RESULTS

It was shown that the HR and a-vO<inf>2diff</inf> reached their potentially highest values at the end of the both GXT and VP (192.9±8.8 vs. 190.7±7.9 bpm; 17.1±1.6 vs. 16.9±1.1%, respectively; P>0.05); however, SV (128.8±11.2 vs. 137.3±11.2 mL; P=0.029) and Qc (24.8±2.02 vs. 26.2±2.71 L·min^-1; P=0.046) were lower at GXT when compared to the VP. V̇O<inf>2</inf> means were, therefore, higher in VP when compared to the GXT (61.7±6.13 vs. 59.1±6.2 mL∙min^-1∙kg^-1; P=0.041).

CONCLUSIONS

The GXT provided only a peak V̇O<inf>2</inf> but not the V̇O<inf>2max</inf>. Consequently, the real V̇O<inf>2max</inf> and PPO could be provided by only VP administrations. This is likely to result from the lower Qc and SV responses observed from a prolonged incremental test protocol when compared to short bouts of constant work rate trials.

The physiology of rowing with perspective on training and health

PURPOSE

This review presents a perspective on the expansive literature on rowing.

METHODS

The PubMed database was searched for the most relevant literature, while some information was obtained from books.

RESULTS

Following the life span of former rowers paved the way to advocate exercise for health promotion. Rowing involves almost all muscles during the stroke and competition requires a large oxygen uptake, which is challenged by the pulmonary diffusion capacity and restriction in blood flow to the muscles. Unique training adaptations allow for simultaneous engagement of the legs in the relatively slow movement of the rowing stroke that, therefore, involves primarily slow-twitch muscle fibres. Like other sport activities, rowing is associated with adaptation not only of the heart, including both increased internal diameters and myocardial size, but also skeletal muscles with hypertrophy of especially slow-twitch muscle fibres. The high metabolic requirement of intense rowing reduces blood pH and, thereby, arterial oxygen saturation decreases as arterial oxygen tension becomes affected.

CONCLUSION

Competitive rowing challenges most systems in the body including pulmonary function and circulatory control with implication for cerebral blood flow and neuromuscular activation. Thus, the physiology of rowing is complex, but it obviously favours large individuals with arms and legs that allow the development of a long stroke. Present inquiries include the development of an appropriately large cardiac output despite the Valsalva-like manoeuvre associated with the stroke, and the remarkable ability of the brain to maintain motor control and metabolism despite marked reductions in cerebral blood flow and oxygenation.

Hematological and Running Performance Modification of Trained Athletes after Reverse vs. Block Training Periodization

The aim of the present study was to analyze the effect of block (BP) and a reverse training periodization (RP) in the hematological and running performance of amateur trained athletes. Modifications in hematological, aerobic, and anaerobic running performance and countermovement jump before and after twelve weeks of BP vs. RP training programs were analyzed in 16 trained athletes (eight males: 40.0 ± 6.2 years; 179.2 ± 12.8 cm; 73.8 ± 12.2 kg; and eight females: 34.2 ± 4.1 years; 163.4 ± 9.6 cm; 57.0 ± 11.0 kg). A significant decrease in heart rate (HR) at ventilatory threshold (VT1) (p = 0.031; ES = 1.40) was observed in RP without changes in BP. In addition, RP increased significantly VO₂max (p = 0.004; ES = 0.47), speed at VO₂max (p = 0.001; ES = 1.07), HR at VT2 (p < 0.001; ES = 1.32) and VT1 (p = 0.046; ES = 0.57), while BP improved VO₂max (p = 0.004; ES = 0.51), speed at VO₂max (p = 0.016; ES = 0.92), and HR at VT2 (p = 0.023; ES = 0.78). In addition, only RP increased anaerobic performance in a running-based anaerobic sprint test (RAST) (mean sprint: p = 0.009; ES = 0.40, best sprint: p = 0.019; ES = 0.30 and total time: p = 0.009; ES = 0.40). Moreover, both types of training periodization proposed in this study maintained hematological values and efficiently improved jump performance (p = 0.044; ES = 0.6) in RP and p = 0.001; ES = 0.75 in BP). Therefore, twelve weeks of either RP or BP is an effective strategy to increase jump and aerobic running performance maintaining hematological values, but only RP increases anaerobic running performance.

Efficacy of a physical activity programme combining individualized aerobic exercise and coaching to improve physical fitness in neuromuscular diseases (I'M FINE): study protocol of a randomized controlled trial

Background

In individuals with neuromuscular diseases (NMD), symptoms of muscle weakness, fatigue and pain may limit physical activity. Inactivity leads to reduced physical fitness, which further complicates daily life functioning. Due to inconclusive evidence regarding exercise in NMD, the optimal training approach and strategies to preserve an active lifestyle remain to be determined. The physical activity programme I’M FINE, consisting of individualized aerobic exercise to improve physical fitness and coaching to preserve an active lifestyle, was therefore developed. The primary objective of this study will be to evaluate the efficacy of the I’M FINE programme in terms of improved physical fitness in individuals with slowly progressive NMD, compared to usual care.

Methods

A multicentre, assessor-blinded, two armed, randomized controlled trial will be conducted in a sample of 90 individuals with slowly progressive NMD. Participants motivated to improve their reduced physical fitness will be randomized (ratio 1:1) to the I’M FINE intervention or usual care. The I’M FINE intervention consists of a six-month physical activity programme, including individualized home-based aerobic exercise to improve physical fitness (i.e. peak oxygen uptake), and motivational interviewing coaching (e.g. goal setting, self-management) to adopt and preserve an active lifestyle. Measurements will be performed at baseline, post-intervention, and at 12- and 18-months follow-up. The primary outcome is peak oxygen uptake (VO₂ peak) directly post intervention. Main secondary outcomes are physical capacity, muscle strength, self-efficacy, daily activity, quality of life and markers of metabolic syndrome. The primary analysis compares change in VO₂ peak post-intervention between the intervention and usual care group, with analysis of covariance.

Discussion

The I’M FINE study will provide evidence regarding the efficacy of a physical activity intervention on the physical fitness and active lifestyle over the short- and long-term in individuals with slowly progressive NMD. These outcomes could potentially improve the (inter)national guidelines for efficacy of aerobic exercise programmes and provide insight in achieving a more active lifestyle in NMD.

Trial registration

(5/11/2018): Netherlands Trial Register NTR7609 (retrospectively registered), https://www.trialregister.nl/trial/7344. However, the Ethics Review Committee of the Amsterdam Medical Center (AMC) approved the study protocol on 7/11/2017. No adjustments were made to the approved study protocol before the first participant enrolment and registration. Registration was done after the second participant enrolment and the information in the register corresponds one on one with the approved study protocol.

Fatigue Induced Changes in Muscle Strength and Gait Following Two Different Intensity, Energy Expenditure Matched Runs

Purpose

To investigate changes in hip and knee strength, kinematics, and running variability following two energy expenditure matched training runs; a medium intensity continuous run (MICR) and a high intensity interval training session (HIIT).

Methods

Twenty (10 Females, 10 Males) healthy master class runners were recruited. Each participant completed the HIIT consisting of six repetitions of 800 m with a 1:1 work: rest ratio. The MICR duration was set to match energy expenditure of the HIIT session. Hip and knee muscular strength were examined pre and post both HIIT and MICR. Kinematics and running variability for hip and knee, along with spatiotemporal parameters were assessed at start and end of each run-type. Changes in variables were examined using both 2 × 2 ANOVAs with repeated measures and on an individual level when the change in a variable exceeded the minimum detectable change (MDC).

Results

All strength measures exhibited significant reductions at the hip and knee (P < 0.05) with time for both run-types; 12% following HIIT, 10.6% post MICR. Hip frontal plane kinematics increased post run for both maximum angle (P < 0.001) and range of motion (P = 0.003). Runners exhibited increased running variability for nearly all variables, with the HIIT having a greater effect. Individual assessment revealed that not all runners were effected post run and that following HIIT more runners had reduced muscular strength, altered kinematics and increased running variability.

Conclusion

Runners exhibited fatigue induced changes following typical training runs, which could potentially present risk of injury development. Group and individual assessment revealed different findings where the use of MDC is recommended over that of P-values.

Effects of high intensity interval training on exercise capacity in people with chronic pulmonary conditions: a narrative review

BACKGROUND

Exercise training is important in the management of adults with chronic pulmonary conditions. However, achieving high intensity exercise may be challenging for this clinical population. There has been clinical interest in applying interval-based training as a strategy to optimise the load that can be tolerated during exercise training. Evidence for such an approach is limited in most chronic pulmonary populations.

MAIN BODY

In this narrative review, we provide an appraisal of studies investigating whole-body high intensity interval training (HIIT) in adults with chronic obstructive pulmonary disease (COPD). This is the first review to also include studies investigating HIIT in people with conditions other than COPD. Studies undertaken in adults with a chronic pulmonary condition were reviewed when participants were randomised to receive; (i) HIIT or no exercise or, (ii) HIIT or moderate intensity continuous exercise. Data were extracted on peak rate of oxygen uptake (VO2peak; 'cardiorespiratory fitness') and maximal work rate (Wmax; 'exercise capacity').In people with COPD, two studies demonstrated between-group differences favouring HIIT compared with no exercise. There appears to be no advantage for HIIT compared to continuous exercise on these outcomes. In people with cystic fibrosis (CF), no studies have compared HIIT to no exercise and the two studies that compared HIIT to continuous exercise reported similar benefits. In people prior to resection for non-small cell lung cancer, one study demonstrated a between-group difference in favour of HIIT compared with no exercise on VO2peak. In people with asthma, one study demonstrated a between-group difference in favour of HIIT compared with no exercise on VO2peak and one that compared HIIT to continuous exercise reported similar benefits. No studies were identified non-CF bronchiectasis or interstitial lung diseases.

CONCLUSIONS

High intensity interval training increases cardiorespiratory fitness and exercise capacity when compared with no exercise and produces a similar magnitude of change as continuous exercise in people with COPD. There is a paucity of studies exploring the effects of HIIT in other chronic pulmonary conditions.

Changes in Renal Parameters during a Training Camp among Handball Players in the Sub-Saharan Environment

The aim of the study was to describe the changes in kidney parameters induced by 10 days of tapering (TP) during a training camp (TC), where the players were preparing for a group competition, in 15 female handball team members of a Division 1 Amateur of Benin, in the sub-Saharan environment. Measures were taken in all the players before and after the intensive training (IT) and tapering (TP) phases in an intervention study. The estimated glomerular filtration rate (eGFR) with the CKD-EPI 4-level race formula, the fractional excretions of sodium (FeNa) and potassium (FeK), the urine potassium-to-sodium ratio (Na/K urine), and the hemoglobin rate [Hb] were determined for all participants. At the end of IT, eGFR and FeNa increased, respectively, by 22.39% (P < 0.01) and 143.85% (P < 0.01), but the variation of FeK is not significant (P > 0.05). The number of abnormally low eGFR values (<90 mL/min/1.73 m²) was reduced from 11 to 5 (P < 0.05). At the end of TP, the eGFR and urine Na-to-K ratio remained on average constant (P > 0.05) but FeNa decreased by 96.32% (P < 0.001) and FeK increased by 144.41% (P < 0.001). The [Hb] rate increased by 9.80% (P < 0.001), and players had inadequate hydration practice. The results suggested that in addition to its already known effects, TP preserves the positive effects of IT on glomerular function in athletes preparing for a competition that presents a major challenge.

The therapeutic potential of exercise for neuropsychiatric diseases: A review

Exercise is known to have a myriad of health benefits. There is much to be learned from the effects of exercise and its potential for prevention, attenuation and treatment of multiple neuropsychiatric diseases and behavioral disorders. Furthermore, recent data and research on exercise benefits with respect to major health crises, such as, that of opioid and general substance use disorders, make it very important to better understand and review the mechanisms of exercise and how it could be utilized for effective treatments or adjunct treatments for these diseases. In addition, mechanisms, epigenetics and sex differences are examined and discussed in terms of future research implications.

Understanding placebo and nocebo effects in the context of sport: A psychological perspective

Research over the past 15 years on the placebo effect has substantiated its contribution to the efficacy of established treatments for a range of clinical conditions and identified its underlying mechanisms. There is also evidence that placebo effects contribute to the performance benefits of many ergogenic aids, and that performance can worsen when dummy treatments are associated with expectations of a harmful outcome (i.e. nocebo effect). Unfortunately, the bulk of sport research involving placebos and nocebos continues to be hampered by outdated definitions and conceptualizations of placebo effects and their mechanisms. This has implications not only for research but also application, as nearly 50% of athletes report experiencing a beneficial placebo effect, and a similar proportion of coaches report providing placebos to their athletes. The objective of this paper is to attempt to stimulate research by presenting updated definitions of placebo and nocebo effects in the context of sport, describing their major mechanisms and, highlighting the importance of the psychosocial context on placebo effects in the sport setting.