Longitudinal investigation of training status and cardiopulmonary responses in pre- and early-pubertal children

A Prospective Study on Maximal Oxygen Uptake and Cardiovascular Functions in 12-Year-Old Endurance Athletes and Their Non-Endurance-Trained Peers

The maximal oxygen uptake (V̇O2max) is typically higher in endurance-trained adolescents than in non-endurance-trained peers. However, the specific mechanisms contributing to this remain unclear, as well as the impact of training during this developmental stage. This study aims to compare V̇O2max and cardiovascular functions between 12-year-old endurance athletes and non-endurance-trained over a 14-month period. Anthropometrics, V̇O2max, hemoglobin mass (Hbmass), blood volume (BV), and left-ventricular morphology were assessed four times over the 14 months in a group of young cross-country skiers (END, n = 42, age: 12.4 ± 0.5, girls: n = 27) and a group of controls (CON, n = 26, age: 12.3 ± 0.3, girls: n = 15). Throughout the 14-month follow-up, END did more weekly training than CON (7.0 ± 2.3 vs. 2.5 ± 2.4 h, p < 0.001), with only END conducting endurance training. END had ~18% higher V̇O2max relative to fat-free mass (FFM) than CON (p < 0.001). Stroke volume (SV) and left ventricular end-diastolic volume (LV EDV) relative to FFM were also higher for END than CON (p < 0.001 and 0.004), while no significant differences were found for Hbmass and BV. No significant interaction was seen for group and time for V̇O2max (p = 0.352-0.767) or any cardiovascular parameters (p = 0.131-0.956) in absolute measures or relative to FFM. In conclusion, the END group exhibited higher V̇O2max, LV EDV, and SV compared to the CON group, with no significant difference in BV and Hbmass. Despite substantial differences in training volume, the progression of these variables over the 14-month period was similar in both groups.

Effects of Swimming Exercise on Early Adolescents' Physical Conditioning and Physical Health: A Systematic Review

BACKGROUND/OBJECTIVES

Swimming is a popular and cost-effective way to prevent sedentary behavior and improve physical conditioning and health during early adolescence. However, information on its impact and benefits on daily life activities is lacking. This systematic review aims to summarize the chronic effects of swimming on physical conditioning and physical health outcomes in early adolescents.

METHODS

The PRISMA 2020 guidelines were followed and PubMed, Scopus, Web of Science, and International Symposium of Biomechanics and Medicine in Swimming proceedings databases were searched. Eligibility criteria were defined on the PICOS framework (healthy adolescents in early puberty, swimming programmes or training, passive or active control groups, general effects on physical conditioning or health, longitudinal) and risk of bias was assessed using RoBANS 2.

RESULTS

From 2365 records, 20 non-randomized studies met the defined criteria. High heterogeneity in sample size and intervention was observed. While studies related to physical conditioning (n = 5) focused on physiological variables and muscular function, the evidence regarding physical health outcomes (n = 15) explored bone accrual, haemodynamics, body composition, musculoskeletal system, and lung growth. High overall risk of bias (70%) was observed due to strict criteria.

CONCLUSIONS

Swimming exercise seems to improve cardiorespiratory fitness, cardiac output, haemodynamics, heart growth, motor performance, and body composition of early adolescents. Despite clear evidence that exists on these chronic effects, research on bone health, postural deficit, motor skills, and sleep quality is still missing.

Effects of Sex, Training, and Maturity Status on the Cardiopulmonary and Muscle Deoxygenation Responses during Incremental Ramp Exercise

Whilst participation in regular exercise and sport has generally increased over recent decades globally, fundamental questions remain regarding the influence of growth, maturation, and sex on the magnitude of training response throughout adolescence. Trained (108 participants, 43 girls; age: 14.3 ± 1.8 years) and untrained (108 participants, 43 girls; age: 14.7 ± 1.7 years) adolescents completed an incremental ramp test to exhaustion during which breath by gas exchange, beat-by-beat heart rate (HR), stroke volume (SV) and cardiac output (Q·) and muscle deoxygenation were assessed. Device-based physical activity was also assessed over seven consecutive days. Boys, irrespective of training status, had a significantly higher absolute (2.65 ± 0.70 L min−1 vs. 2.01 ± 0.45 L min−1, p < 0.01) and allometrically scaled (183.8 ± 31.4 mL·kg−b min−1 vs. 146.5 ± 28.5 mL·kg−b min−1, p < 0.01) peak oxygen uptake (V·O2) than girls. There were no sex differences in peak HR, SV or Q· but boys had a higher muscle deoxygenation plateau when expressed against absolute work rate and V·O2 (p < 0.05). Muscle deoxygenation appears to be more important in determining the sex differences in peak V·O2 in youth. Future research should examine the effects of sex on the response to different training methodologies in youth.

High-Intensity Interval Training and Cardiometabolic Risk Factors in Children: A Meta-analysis

CONTEXT

High-intensity interval training (HIIT) has been widely used to prevent and treat cardiovascular risk factors in adolescents and adults; nevertheless, the available evidence in children is scarce.

OBJECTIVE

To synthesize evidence regarding the effectiveness of HIIT interventions on improving cardiovascular risk factors and cardiorespiratory fitness (CRF) in children from 5 to 12 years old.

DATA SOURCES

We searched 5 databases, Medline, Embase, SPORTDiscus, the Cochrane Library, and Web of Science.

STUDY SELECTION

Randomized controlled trials (RCTs) evaluating the effectiveness of HIIT interventions on cardiometabolic risk factors and CRF in children were included.

DATA EXTRACTION

Meta-analyses were conducted to determine the effect of HIIT on body composition, cardiometabolic and CRF variables in comparison with nontraining control groups.

RESULTS

A total of 11 RCTs and 512 participants were included. The results of the meta-analysis revealed a significant improvement in peak oxygen uptake (standardized mean difference [SMD] = 0.70, 95% confidence interval [CI] = 0.28 to 1.12; P = 0.001], in total cholesterol [SMD = -1.09, 95% CI = -1.88 to -0.30; P = 0.007], in low-density lipoprotein cholesterol [SMD = -1.28, 95% CI = -2.34 to -0.23; P = 0.017] and triglycerides [SMD = -0.71, 95% CI = -1.15 to -0.28; P = 0.001) levels.

LIMITATIONS

Because of the small number of available RCTs, it was not possible to conduct a subgroup analysis or a linear meta-regression analysis.

CONCLUSIONS

HIIT is a feasible and time-efficient approach for improving CRF, total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels in children.

Multilevel allometric modelling of maximum cardiac output, maximum arteriovenous oxygen difference, and peak oxygen uptake in 11-13-year-olds

PURPOSES

To investigate longitudinally (1) the contribution of morphological covariates to explaining the development of maximum cardiac output ([Formula: see text] max) and maximum arteriovenous oxygen difference (a-vO2 diff max), (2) sex differences in [Formula: see text] max and a-vO2 diff max once age, maturity status, and morphological covariates have been controlled for, and, (3) the contribution of concurrent changes in morphological and cardiovascular covariates to explaining the sex-specific development of peak oxygen uptake ([Formula: see text]).

METHODS

Fifty-one (32 boys) 11-13-year-olds had their peak [Formula: see text], maximum heart rate (HR max), [Formula: see text] max, and a-vO2 diff max determined during treadmill running on three annual occasions. The data were analysed using multilevel allometric modelling.

RESULTS

There were no sex differences in HR max which was not significantly (p > 0.05) correlated with age, morphological variables, or peak [Formula: see text]. The best-fit models for [Formula: see text] max and a-vO2 diff max were with fat-free mass (FFM) as covariate with age, maturity status, and haemoglobin concentration not significant (p > 0.05). FFM was the dominant influence on the development of peak [Formula: see text]. With FFM controlled for, the introduction of either [Formula: see text] max or a-vO2 diff max to multilevel models of peak [Formula: see text] resulted in significant (p < 0.05) additional contributions to explaining the sex difference.

CONCLUSIONS

(1) With FFM controlled for, there were no sex differences in [Formula: see text] max or a-vO2 diff max, (2) FFM was the dominant influence on the development of peak [Formula: see text], and (3) with FFM and either [Formula: see text] max or a-vO2 diff max controlled for, there remained an unresolved sex difference of ~ 4% in peak [Formula: see text].

Multilevel allometric modelling of maximal stroke volume and peak oxygen uptake in 11-13-year-olds

PURPOSE

To investigate (1) whether maximal stroke volume (SVmax) occurs at submaximal exercise intensities, (2) sex differences in SVmax once fat-free mass (FFM) has been controlled for, and, (3) the contribution of concurrent changes in FFM and SVmax to the sex-specific development of peak oxygen uptake [Formula: see text].

METHODS

The peak [Formula: see text] s of 61 (34 boys) 11-12-year-olds were determined and their SV determined during treadmill running at 2.28 and 2.50 m s-1 using carbon dioxide rebreathing. The SVmax and peak [Formula: see text] of 51 (32 boys) students who volunteered to be tested treadmill running at 2.50 m s-1 on three annual occasions were investigated using multilevel allometric modelling. The models were founded on 111 (71 from boys) determinations of SVmax, FFM, and peak [Formula: see text].

RESULTS

Progressive increases in treadmill running speed resulted in significant (p < 0.01) increases in [Formula: see text], but SV levelled-off with nonsignificant (p > 0.05) changes within ~ 2-3%. In the multilevel models, SVmax increased proportionally to FFM0.72 and with FFM controlled for, there were no significant (p > 0.05) sex differences. Peak [Formula: see text] increased with FFM but after adjusting for FFM0.98, a significant (p < 0.05) sex difference in peak [Formula: see text] remained. Introducing SVmax to the multilevel model revealed a significant (p < 0.05), but small additional effect of SVmax on peak [Formula: see text].

CONCLUSIONS

Fat-free mass explained sex differences in SVmax, but with FFM controlled for, there was still a ~ 5% sex difference in peak [Formula: see text]. SVmax made a modest additional contribution to explain the development of peak [Formula: see text] but there remained an unresolved sex difference of ~ 4%.

The effect of constant-intensity endurance training and high-intensity interval training on aerobic and anaerobic parameters in youth

INTRODUCTION

High-Intensity Interval Training (HIIT) and Constant-Intensity Endurance Training (CIET) improves peak oxygen uptake (V̇O₂) similarly in adults; but in children this remains unclear, as does the influence of maturity.

METHODS

Thirty-seven boys formed three groups: HIIT (football; n = 14; 14.3 ± 3.1 years), CIET (distance runners; n = 12; 13.1 ± 2.5 years) and a control (CON) group (n = 11; 13.7 ± 3.2 years). Peak V̇O₂ and gas exchange threshold (GET) were determined from a ramp test and anaerobic performance using a 30 m sprint pre-and-post a three-month training cycle.

RESULTS

The HIIT groups peak V̇O₂ was significantly higher than the CON group pre (peak V̇O₂: 2.54 ± 0.63 l·min^-1 vs 2.03 ± 0.53 l·min^-1, d = 0.88; GET: 1.41 ± 0.26 l·min^-1 vs 1.13 ± 0.29 l·min^-1, d = 1.02) and post-training (peak V̇O₂: 2.63 ± 0.73 l·min^-1 vs 2.08 ± 0.64 l·min^-1, d = 0.80; GET: 1.32 ± 0.33 l·min^-1 vs 1.15 ± 0.38 l·min^-1, d = 0.48). All groups showed a similar magnitude of change during the training (p > 0.05).

CONCLUSION

HIIT was not superior to CIET for improving aerobic or anaerobic parameters in adolescents. Secondly, pre- and post-pubertal participants demonstrated similar trainability.

Children's Aerobic Trainability and Related Questions

In response to Armstrong's recent Special Topics review of "Top 10 Research Questions Related to Youth Aerobic Fitness," this commentary revisits some of the points raised, particularly in relation to the question of whether a child‒adult trainability difference does indeed exist. Discussed are the validity of much of the existing pediatric maximal oxygen consumption data upon which trainability conclusions are drawn, why differential trainability is likely a fact rather than a doubt, a reasoned novel approach to explaining the phenomenon, and how that explanation can bear upon and answer several of the other raised questions. The commentary is intended to inspire and encourage fresh thinking not only in relation to pediatric aerobic trainability, but more generally, regarding pediatric exercise physiology and performance and how they differ from those of adults.

High-Intensity Interval Training Interventions in Children and Adolescents: A Systematic Review

BACKGROUND

Whilst there is increasing interest in the efficacy of high-intensity interval training in children and adolescents as a time-effective method of eliciting health benefits, there remains little consensus within the literature regarding the most effective means for delivering a high-intensity interval training intervention. Given the global health issues surrounding childhood obesity and associated health implications, the identification of effective intervention strategies is imperative.

OBJECTIVES

The aim of this review was to examine high-intensity interval training as a means of influencing key health parameters and to elucidate the most effective high-intensity interval training protocol.

METHODS

Studies were included if they: (1) studied healthy children and/or adolescents (aged 5-18 years); (2) prescribed an intervention that was deemed high intensity; and (3) reported health-related outcome measures.

RESULTS

A total of 2092 studies were initially retrieved from four databases. Studies that were deemed to meet the criteria were downloaded in their entirety and independently assessed for relevance by two authors using the pre-determined criteria. From this, 13 studies were deemed suitable. This review found that high-intensity interval training in children and adolescents is a time-effective method of improving cardiovascular disease biomarkers, but evidence regarding other health-related measures is more equivocal. Running-based sessions, at an intensity of >90% heart rate maximum/100-130% maximal aerobic velocity, two to three times a week and with a minimum intervention duration of 7 weeks, elicit the greatest improvements in participant health.

CONCLUSION

While high-intensity interval training improves cardiovascular disease biomarkers, and the evidence supports the effectiveness of running-based sessions, as outlined above, further recommendations as to optimal exercise duration and rest intervals remain ambiguous owing to the paucity of literature and the methodological limitations of studies presently available.

Top 10 Research Questions Related to Youth Aerobic Fitness

Peak oxygen uptake ([Formula: see text]₂) is internationally recognized as the criterion measure of youth aerobic fitness, but despite pediatric data being available for almost 80 years, its measurement and interpretation in relation to growth, maturation, and health remain controversial. The trainability of youth aerobic fitness continues to be hotly debated, and causal mechanisms of training-induced changes and their modulation by chronological age, biological maturation, and sex are still to be resolved. The daily physical activity of youth is characterized by intermittent bouts and rapid changes in intensity, but physical activity of the intensity and duration required to determine peak [Formula: see text]₂ is rarely (if ever) experienced by most youth. In this context, it may therefore be the transient kinetics of pulmonary [Formula: see text]₂ that best reflect youth aerobic fitness. There are remarkably few rigorous studies of youth pulmonary [Formula: see text]₂ kinetics at the onset of exercise in different intensity domains, and the influence of chronological age, biological maturation, and sex during step changes in exercise intensity are not confidently documented. Understanding the trainability of the parameters of youth pulmonary [Formula: see text]₂ kinetics is primarily based on a few comparative studies of athletes and nonathletes. The underlying mechanisms of changes due to training require further exploration. The aims of the present article are therefore to provide a brief overview of aerobic fitness during growth and maturation, increase awareness of current controversies in its assessment and interpretation, identify gaps in knowledge, raise 10 relevant research questions, and indicate potential areas for future research.

A meta-analysis of maturation-related variation in adolescent boy athletes' adaptations to short-term resistance training

This meta-analysis investigated the maturation-related pattern of adaptations to resistance training in boy athletes. We included studies examining the effects of 4-16-week resistance training programmes in healthy boy athletes aged 10-18 years. Pooled estimates of effect size for change in strength across all studies (n = 19) were calculated using the inverse-variance random effects model for meta-analyses. Estimates were also calculated for groups based on likely biological maturity status ("before", "during" and "after" peak height velocity). Using the standardised mean difference, resistance training increased strength across all groups (effect size = 0.98, [CI: 0.70-1.27]). Strength gains were larger during (1.11 [0.67-1.54]) and after (1.01 [0.56-1.46]) peak height velocity than before (0.5 [-0.06-1.07]). Adaptations to resistance training are greater in adolescent boys during or after peak height velocity. These findings should help coaches to optimise the timing of training programmes that are designed to improve strength in boy athletes.