The effect of functional overreaching on parameters of autonomic heart rate regulation

Insult of Ultraendurance Events on Blood Pressure: A Systematic Review and Meta-Analysis

The rise of ultraendurance sports in the past two decades warrants evaluation of the impact on the heart and vessels of a growing number of athletes participating. Blood pressure is a simple, inexpensive method to evaluate one dimension of an athlete's cardiovascular health. No systematic review or meta-analysis to date has chronicled and delineated the effects of ultraendurance races, such as ultramarathons, marathons, half-marathons, and Ironman triathlon events, specifically on heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) measurements in supine and standing positions before and after the event. This meta-analysis reviews the effects of ultraendurance events on positional and calculated hemodynamic values. Data were extracted from 38 studies and analyzed using a random effects model with a total of 1,645 total blood pressure measurements. Of these, 326 values were obtained from a standing position, and 1,319 blood pressures were taken supine. Pre-race and post-race measurements were evaluated for clinical significance using established standards of hypotension and orthostasis. HR and calculated BP features, such as PP and MAP, were evaluated. Across all included studies, the mean supine post-race HR increased by 21±8 beats per minute (bpm) compared to pre-race values. The mean standing post-race HR increased by 23±14 bpm when compared with pre-race HR. Overall, there was a mean SBP decrease of 19±9 mmHg and a DBP decrease of 9±5 mmHg post-race versus pre-race values. MAP variations reflected SBP and DBP changes. The mean supine and standing pre-race blood pressures across studies were systolic (126±7; 124±14) and diastolic (76±6; 75±12), suggesting that some athletes may enter races with existing hypertension. The post-race increase in the mean HR and decline in mean blood pressure across examined studies suggest that during long-term events, ultramarathon athletes perform with relatively asymptomatic hypotension.

Individually guided training prescription by heart rate variability and self-reported measure of stress tolerance in recreational runners: Effects on endurance performance

The aim of this study was to determine the effect of endurance training individually guided by objective (Heart Rate Variability-HRV) or self-report measure of stress (DALDA-questionnaire) in comparison to predefined endurance training prescription for improving endurance performance in recreational runners. After a 2-week preliminary baseline period to establish resting HRV and self-reported measure of stress, thirty-six male recreational runners were randomly assigned to HRV-guided (G_HRV; n = 12), DALDA-guided (G_D; n = 12) or predefined training (G_T; n = 12) prescription groups. Before and after 5-weeks of endurance training, participants performed a track field peak velocity (V_{peak_TF}), time limit (T_lim) at 100% of V_{peak_TF} and 5 km time-trial (5 km TT) tests. G_D lead to higher improvements in V_{peak_TF} (8.4 ± 1.8%; ES = 1.41) and 5 km TT (-12.8 ± 4.2%; ES = -1.97), than G_HRV (6.6 ± 1.5% and -8.3 ± 2.8%; ES = -1.20; 1.24) and G_T (4.9 ± 1.5% and -6.0 ± 3.3%; ES = -0.82; 0.68), respectively, with no differences for T_lim. Self-report measures of stress may be used to individualize endurance training prescription on a daily basis leading to better performance enhancement, which may be used with HRV for a holistic understanding of daily training-induce adaptations.

Evaluating the Typical Day-to-Day Variability of WHOOP-Derived Heart Rate Variability in Olympic Water Polo Athletes

Heart rate (HR) and HR variability (HRV) can be used to infer readiness to perform exercise in athletic populations. Advancements in the photoplethysmography technology of wearable devices such as WHOOP allow for the frequent and convenient measurement of HR and HRV, and therefore enhanced application in athletes. However, it is important that the reliability of such technology is acceptable prior to its application in practical settings. Eleven elite male water polo players (age 28.8 ± 5.3 years [mean ± standard deviation]; height 190.3 ± 3.8 cm; body mass 95.0 ± 6.9 kg; international matches 117.9 ± 92.1) collected their HR and HRV daily via a WHOOP strap (WHOOP 3.0, CB Rank, Boston, MA, USA) over 16 weeks ahead of the 2021 Tokyo Olympic Games. The WHOOP strap quantified HR and HRV via wrist-based photoplethysmography during overnight sleep periods. The weekly (i.e., 7-day) coefficient of variation in lnRMSSD (lnRMSSD_CV) and HR (HR_CV) was calculated as a measure of day-to-day variability in lnRMSSD and HR, and presented as a mean of the entire recording period. The mean weekly lnRMSSD_CV and HR_CV over the 16-week period was 5.4 ± 0.7% (mean ± 95% confidence intervals) and 7.6 ± 1.3%, respectively. The day-to-day variability in WHOOP-derived lnRMSSD and HR is within or below the range of day-to-day variability in alternative lnRMSSD (~3-13%) and HR (~10-11%) assessment protocols, indicating that the assessment of HR and HRV by WHOOP does not introduce any more variability than that which is naturally present in these variables.

Markers of Cardiac Autonomic Function During Consecutive Day Peak Exercise Tests in People With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) have been shown to exhibit altered ventilatory characteristics on the second of two progressive maximal cardiopulmonary exercise tests (CPET) performed on consecutive days. However, maximal exercise can exacerbate symptoms for ME/CFS patients and cause significant post-exertional malaise. Assessment of heart rate (HR) parameters known to track post-exertional fatigue may represent more effective physiological markers of the condition and could potentially negate the need for maximal exercise testing. Sixteen ME/CFS patients and 10 healthy controls underwent a sub-maximal warm-up followed by CPET on two consecutive days. Ventilation, ratings of perceived exertion, work rate (WR) and HR parameters were assessed throughout on both days. During sub-maximal warm-up, a time effect was identified for the ratio of low frequency to high frequency power of HR variability (p=0.02) during sub-maximal warm-up, and for HR at ventilatory threshold (p=0.03), with both being higher on Day Two of testing. A significant group (p<0.01) effect was identified for a lower post-exercise HR recovery (HRR) in ME/CFS patients. Receiver operator characteristic curve analysis of HRR revealed an area under the curve of 74.8% (p=0.02) on Day One of testing, with a HRR of 34.5bpm maximising sensitivity (63%) and specificity (40%) suggesting while HRR values are altered in ME/CFS patients, low sensitivity and specificity limit its potential usefulness as a biomarker of the condition.

Generalized tonic-clonic seizures are accompanied by changes of interrelations within the autonomic nervous system

PURPOSE

A seizure is a strong central stimulus that affects multiple subsystems of the autonomic nervous system (ANS), and results in different interactions across ANS modalities. Here, we aimed to evaluate whether multimodal peripheral ANS measures demonstrate interactions before and after seizures as compared to controls to provide the basis for seizure detection and forecasting based on peripheral ANS signals.

METHODS

Continuous electrodermal activity (EDA), heart rate (HR), peripheral body temperature (TEMP), and respiratory rate (RR) calculated based on blood volume pulse were acquired by a wireless multi-sensor device. We selected 45 min of preictal and 60 min of postictal data and time-matched segments for controls. Data were analyzed over 15-min windows. For unimodal analysis, mean values over each time window were calculated for all modalities and analyzed by Friedman's two-way analysis of variance.

RESULTS

Twenty-one children with recorded generalized tonic-clonic seizures (GTCS), and 21 age- and gender-matched controls were included. Unimodal results revealed no significant effect for RR and TEMP, but EDA (p = 0.002) and HR (p < 0.001) were elevated 0-15 min after seizures. The averaged bimodal correlation across all pairs of modalities changed for 15-min windows in patients with seizures. The highest correlations were observed immediately before (0.85) and the lowest correlation immediately after seizures. Overall, average correlations for controls were higher.

SIGNIFICANCE

Multimodal ANS changes related to GTCS occur within and across autonomic nervous system modalities. While unimodal changes were most prominent during postictal segments, bimodal correlations increased before seizures and decreased postictally. This offers a promising avenue for further research on seizure detection, and potentially risk assessment for seizure recurrence and sudden unexplained death in epilepsy.

Heart-Rate Acceleration Is Linearly Related to Anaerobic Exercise Performance

PURPOSE

To prescribe training loads to improve performance, one must know how an athlete is responding to loading. The maximal rate of heart-rate increase (rHRI) during the transition from rest to exercise is linearly related to changes in endurance exercise performance and can be used to infer how athletes are responding to changes in training load. Relationships between rHRI and anaerobic exercise performance have not been evaluated. The objective of this study was to evaluate relationships between rHRI and anaerobic exercise performance.

METHODS

Eighteen recreational strength and power athletes (13 male and 5 female) were tested on a cycle ergometer for rHRI, 6-second peak power output, anaerobic capacity (30-s average power), and blood lactate concentration prior to (PRE), and 1 (POST1) and 3 (POST3) hours after fatiguing high-intensity interval cycling.

RESULTS

Compared with PRE, rHRI was slower at POST1 (effect size [ES] = -0.38, P = .045) but not POST3 (ES = -0.36, P = .11). PPO was not changed at POST1 (ES = -0.12, P = .19) but reduced at POST3 (ES = -0.52, P = .01). Anaerobic capacity was reduced at POST1 (ES = -1.24, P < .001) and POST3 (ES = -0.83, P < .001), and blood lactate concentration was increased at POST1 (ES = 1.73, P < .001) but not at POST3 (ES = 0.75, P = .11). rHRI was positively related to PPO (B = 0.19, P = .03) and anaerobic capacity (B = 0.14, P = .005) and inversely related to blood lactate concentration (B = -0.22, P = .04).

CONCLUSIONS

rHRI is linearly related to acute changes in anaerobic exercise performance and may indicate how athletes are responding to training to guide the application of training loads.

Functional Overreaching in Endurance Athletes: A Necessity or Cause for Concern?

There are variable responses to short-term periods of increased training load in endurance athletes, whereby some athletes improve without deleterious effects on performance, while others show diminished exercise performance for a period of days to months. The time course of the decrement in performance and subsequent restoration, or super compensation, has been used to distinguish between the different stages of the fitness-fatigue adaptive continuum termed functional overreaching (FOR), non-functional overreaching (NFOR) or overtraining syndrome. The short-term transient training-induced decrements in performance elicited by increases in training load (i.e. FOR) are thought be a sufficient and necessary component of a training program and are often deliberately induced in training to promote meaningful physiological adaptations and performance super-compensation. Despite the supposition that deliberately inducing FOR in athletes may be necessary to achieve performance super-compensation, FOR has been associated with various negative cardiovascular, hormonal and metabolic consequences. Furthermore, recent studies have demonstrated dampened training and performance adaptations in FOR athletes compared to non-overreached athletes who completed the same training program or the same relative increase in training load. However, this is not always the case and a number of studies have also demonstrated substantial performance super-compensation in athletes who were classified as being FOR. It is possible that there are a number of contextual factors that may influence the metabolic consequences associated with FOR and classifying this training-induced state of fatigue based purely on a decrement in performance may be an oversimplification. Here, the most recent research on FOR in endurance athletes will be critically evaluated to determine (1) if there is sufficient evidence to indicate that inducing a state of FOR is necessary and required to induce a performance super-compensation; (2) the metabolic consequences that are associated with FOR; (3) strategies that may prevent the negative consequences of overreaching.

Heart rate-based indices to detect parasympathetic hyperactivity in functionally overreached athletes. A meta-analysis

Investigations into the sensitivity of heart rate-(HR) derived indices for tracking parasympathetic nervous system (PNS) changes in functionally overreached (F-OR) endurance-trained athletes have produced equivocal findings. Lack of clarity may be a result of methodological inconsistencies. Therefore, the aims of this systematic review and meta-analysis were (a) to determine the sensitivity of resting and post-exercise vagal-related HR variability (HRV) and HR recovery (HRR) indices to detect PNS modulation in F-OR and non-overreached (non-OR) athletes, and (b) to investigate the influence of methodological factors on the sensitivity of HR-based indices to detect PNS hyperactivity in F-OR athletes. We searched CENTRAL, Scopus, PubMed, Embase, and Web of Science up to May 2020 for the following terms: male and female endurance-trained athletes, controlled and uncontrolled studies that carried out an overload training period, and PNS modulation measured in resting and post-exercise, pre- and post-overload training period. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure based on the training-induced fatigue status (F-OR vs non-OR athletes), and the influence of methodological issues to detect PNS hyperactivity in F-OR was assessed by subgroup analyses. Pooled analysis showed that resting vagal-related HRV indices did not detect PNS hyperactivity in F-OR athletes (SMD₊ = -0.01; 95% confidence interval [CI] = -0.51, 0.50), and no statistical difference (P = .600) was found with non-OR athletes (SMD₊ = 0.15; 95% CI = -0.14, 0.45). However, subgroup analysis based on HRV parameter showed a moderate statistical increase in weekly averaged HRV in F-OR athletes (SMD₊ = 0.81; 95% CI = 0.35, 1.26), while isolated HRV values did not reach statistical significance (SMD₊ = -0.45; 95% CI = -0.96, 0.06). We observed a moderate and statistically significant increase in HRR indices among F-OR athletes (SMD₊ = 0.65; 95% CI = 0.44, 0.87), no changes for non-OR athletes (SMD₊ = 0.10; 95% CI = -0.15, 0.34), and statistically significant differences between F-OR and non-OR athletes (P < .001). Insufficient data prevented meta-analysis for post-exercise vagal-related HRV indices. Our findings show that when methodological factors are considered, HR-based indices are sensitive to increased PNS modulation in F-OR.

The Impact of Functional Overreaching on Post-exercise Parasympathetic Reactivation in Runners

While post-exercise heart rate (HR) variability (HRV) has been shown to increase in response to training leading to improvements in performance, the effect of training leading to decrements in performance (i.e., overreaching) on this parameter has been largely ignored. This study evaluated the effect of heavy training leading to performance decrements on sub-maximal post-exercise HRV. Running performance [5 km treadmill time-trial (5TTT)], post-exercise HRV [root-mean-square difference of successive normal R-R intervals (RMSSD)] and measures of subjective training tolerance (Daily Analysis of Life Demands for Athletes "worse than normal" scores) were assessed in 11 male runners following 1 week of light training (LT), 2 weeks of heavy training (HT) and a 10 day taper (T). Post-exercise RMSSD was assessed following 5 min of running exercise at an individualised speed eliciting 85% of peak HR. Time to complete 5TTT likely increased following HT (ES = 0.14 ± 0.03; p < 0.001), and then almost certainly decreased following T (ES = -0.30 ± 0.07; p < 0.001). Subjective training tolerance worsened after HT (ES = -2.54 ± 0.62; p = 0.001) and improved after T (ES = 2.16 ± 0.64; p = 0.004). In comparison to LT, post-exercise RMSSD likely increased at HT (ES = 0.65 ± 0.55; p = 0.06), and likely decreased at T (ES = -0.69 ± 0.45; p = 0.02). A moderate within-subject correlation was found between 5TTT and post-exercise RMSSD (r = 0.47 ± 0.36; p = 0.03). Increased post-exercise RMSSD following HT demonstrated heightened post-exercise parasympathetic modulation in functionally overreached athletes. Heightened post-exercise RMSSD in this context appears paradoxical given this parameter also increases in response to improvements in performance. Thus, additional measures such as subjective training tolerance are required to interpret changes in post-exercise RMSSD.

Muscle fiber typology is associated with the incidence of overreaching in response to overload training

Variability in the performance responses following an overload training period and subsequent taper was associated with the variation in the muscle fiber typology of the gastrocnemius. Runners with an estimated higher proportion of type I fibers (i.e., lower carnosine z-score) were able to maintain performance in response to an overload training period and subsequently achieve a superior performance supercompensation. These findings show that muscle fiber typology contributes to the variability in performance responses following training.

Heart rate acceleration at relative workloads during treadmill and overground running for tracking exercise performance during functional overreaching

Maximal rate of heart rate (HR) increase (rHRI) as a measure of HR acceleration during the transition from rest to exercise, or during an increase in workload, tracks exercise performance. rHRI assessed at relative rather than absolute workloads may track performance better, and a field test would increase applicability. This study therefore aimed to evaluate the sensitivity of rHRI assessed at individualised relative workloads during treadmill and overground running for tracking exercise performance. Treadmill running performance (5 km time trial; 5TTT) and rHRI were assessed in 11 male runners following 1 week of light training (LT), 2 weeks of heavy training (HT) and a 10-day taper (T). rHRI was the first derivative maximum of a sigmoidal curve fit to HR data collected during 5 min of treadmill running at 65% peak HR (rHRI65%), and subsequent transition to 85% peak HR (rHRI85%). Participants ran at the same speeds overground, paced by a foot-mounted accelerometer. Time to complete 5TTT likely increased following HT (ES = 0.14 ± 0.03), and almost certainly decreased following T (ES = - 0.30 ± 0.07). Treadmill and field rHRI65% likely increased after HT in comparison to LT (ES ≤ 0.48 ± 0.32), and was unchanged at T. Treadmill and field rHRI85% was unchanged at HT in comparison to LT, and likely decreased at T in comparison to LT (ES ≤ - 0.55 ± 0.50). 5TTT was not correlated with treadmill or field rHRI65% or rHRI85%. rHRI65% was highly correlated between treadmill and field tests across LT, HT and T (r ≥ 0.63), but correlations for rHRI85% were trivial to moderate (r ≤ 0.42). rHRI assessed at relative exercise intensities does not track performance. rHRI assessed during the transition from rest to running overground and on a treadmill at the same running speed were highly correlated, suggesting that rHRI can be validly assessed under field conditions at 65% of peak HR.

Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals

Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m2) were collected. Results. 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.

Optimisation of assessment of maximal rate of heart rate increase for tracking training-induced changes in endurance exercise performance

The maximal rate of heart rate (HR) increase (rHRI), a marker of HR acceleration during transition from rest to submaximal exercise, correlates with exercise performance. In this cohort study, whether rHRI tracked performance better when evaluated over shorter time-periods which include a greater proportion of HR acceleration and less steady-state HR was evaluated. rHRI and five-km treadmill running time-trial performance (5TTT) were assessed in 15 runners following one week of light training (LT), two weeks of heavy training (HT) and 10-day taper (T). rHRI was the first derivative maximum of a sigmoidal curve fit to one, two, three and four minutes of R-R data during transition from rest to running at 8 km/h (rHRI_8 km/h), 10.5 km/h_, 13 km/h and transition from 8 to 13 km/h (rHRI_8–13km/h). 5TTT time increased from LT to HT (effect size [ES] 1.0, p < 0.001) then decreased from HT to T (ES −1.7, p < 0.001). 5TTT time was inversely related to rHRI_8 km/h assessed over two (B = −5.54, p = 0.04) three (B = −5.34, p = 0.04) and four (B = −5.37, p = 0.04) minutes, and rHRI_8–13km/h over one (B = −11.62, p = 0.006) and three (B = −11.44, p = 0.03) minutes. 5TTT correlated most consistently with rHRI_8 km/h. rHRI_8 km/h assessed over two to four minutes may be suitable for evaluating athlete responses to training.

Multimodal approach towards understanding the changes in the autonomic nervous system induced by an ultramarathon

Purpose: Running an ultramarathon can be considered as a multifaceted, intense stressor inducing changes within the autonomic nervous system (ANS). The aim of this study was to examine changes within and across ANS modalities in response to an ultramarathon.Methods: Thirteen runners (44.3 ± 5.9 years) completed a 65 km run. Electrodermal activity (EDA), heart rate (HR), and skin temperature measured at wrist (Temp), were recorded before and after running. Three-minute intervals were analysed. Mean values were compared by t-tests for dependent samples. Joint principal component analysis-canonical correlation analysis (PCA-CCA) and multiset CCA techniques were employed to measure the interactions between either any two or among all modalities.Results: HR (p < 0.01) and EDA (p < 0.01) increased, while Temp decreased (p < 0.01). PCA-CCA revealed one significant component (p < 0.05) for each modality pair in pre and post measures. Component strength increased from pre (mean = 0.73) to post (mean = 0.92) test. Multiset CCA supported the assumption of increasing strength of correlations across modalities.Conclusion: Ultramarathon, an intense physical stressor, increases correlations across modalities pointing towards a reorganization of central ANS control to restore dynamic balance after physical load. This characterization of ANS-states might offer new avenues for training control.

Effects of almond, dried grape and dried cranberry consumption on endurance exercise performance, recovery and psychomotor speed: protocol of a randomised controlled trial

Background

Foods rich in nutrients, such as nitrate, nitrite, L-arginine and polyphenols, can promote the synthesis of nitric oxide (NO), which may induce ergogenic effects on endurance exercise performance. Thus, consuming foods rich in these components, such as almonds, dried grapes and dried cranberries (AGC), may improve athletic performance. Additionally, the antioxidant properties of these foods may reduce oxidative damage induced by intense exercise, thus improving recovery and reducing fatigue from strenuous physical training. Improvements in NO synthesis may also promote cerebral blood flow, which may improve cognitive function.

Methods and analysis

Ninety-six trained male cyclists or triathletes will be randomised to consume ~2550 kJ of either a mixture of AGC or a comparator snack food (oat bar) for 4 weeks during an overreaching endurance training protocol comprised of a 2-week heavy training phase, followed by a 2-week taper. The primary outcome is endurance exercise performance (5 min time-trial performance) and secondary outcomes include markers of NO synthesis (plasma and urinary nitrites and nitrates), muscle damage (serum creatine kinase and lactate dehydrogenase), oxidative stress (F2-isoprostanes), endurance exercise function (exercise efficiency, submaximal oxygen consumption and substrate utilisation), markers of internal training load (subjective well-being, rating of perceived exertion, maximal rate of heart rate increase and peak heart rate) and psychomotor speed (choice reaction time).

Conclusion

This study will evaluate whether consuming AGC improves endurance exercise performance, recovery and psychomotor speed across an endurance training programme, and evaluate the mechanisms responsible for any improvement.

Trial registration number

ACTRN12618000360213.

Exercise-Induced Changes of Multimodal Interactions Within the Autonomic Nervous Network

Physical exercise has been shown to modulate activity within the autonomic nervous system (ANS). Considering physical exercise as a holistic stimulus on the nervous system and specifically the ANS, uni- and multimodal analysis tools were applied to characterize centrally driven interactions and control of ANS functions. Nineteen young and physically active participants performed treadmill tests at individually determined moderate and high intensities. Continuous electrodermal activity (EDA), heart rate (HR), and skin temperature at wrist (Temp) were recorded by wireless multisensor devices (Empatica^® E4, Milan, Italy) before and 30 min after exercise. Artifact-free continuous 3 min intervals were analyzed. For unimodal analysis, mean values were calculated, for bimodal and multimodal analysis canonical correlation analysis (CCA) was performed. Unimodal results indicate that physical exercise affects ANS activity. More specifically, Temp increased due to physical activity (moderate intensity: from 34.15°C to 35.34°C and high intensity: from 34.11°C to 35.09°C). HR increased more for the high (from 60.76 bpm to 79.89 bpm) than for the moderate (from 64.81 bpm to 70.83 bpm) intensity. EDA was higher for the high (pre: 8.06 μS and post: 9.37 μS) than for the moderate (pre: 4.31 μS and post: 3.91 μS) intensity. Bimodal analyses revealed high variations in correlations before exercise. The overall correlation coefficient showed varying correlations in pretest measures for all modality pairs (EDA-HR, HR-Temp, Temp-EDA at moderate: 0.831, 0.998, 0.921 and high: 0.706, 0, 0.578). After exercising at moderate intensity coefficients changed little (0.828, 0.744, 0.994), but increased substantially for all modality pairs after exercising at high intensity (0.976, 0.898, 0.926). Multimodal analysis confirmed bimodal results. Exercise-induced changes in ANS activity can be found in multiple ANS modalities as well as in their interactions. Those changes are intensity-specific: with higher intensity the interactions increase. Canonical correlations between different ANS modalities may therefore offer a feasible approach to determine exercise induced modulations of ANS activity.

Heart-Rate Variability in Elite Synchronized Swimmers

PURPOSE

To determine whether heart-rate variability (HRV) was correlated with other training-load and training-tolerance markers for monitoring the effect of a training session on elite synchronized swimmers.

METHODS

The authors recorded the resting HRV of 12 elite swimmers (mean age = 21.5 [3.5] y) 3 times over 1 wk with a cadence of 48 h prior to the 2015 World Swimming Championships. They continuously monitored heart rate and obtained salivary cortisol (SC) samples before and after the last training session of the week. The authors measured capillary blood lactate (La) 2, 4, and 8 min after the last training session and monitored recovery HRV. They assessed rating of perceived exertion (RPE) over the entire session and tested the association between the highest La concentration (La_peak), SC, and RPE and relative changes (Δ%) in the natural logarithm of the root-mean-square successive difference of intervals (LnRMSSD). The authors also calculated the smallest worthwhile change of the averaged pre and post LnRMSSD measurements.

RESULTS

There were periods of pronounced bradycardia (60.5 [16.7] beats/min) during training exercises corresponding to apneic exercise. The magnitude-based inferences showed nonclinically meaningful changes of LnRMSSD. La_peak (6.8 [2.7] mmol/L) correlated positively with Δ%LnRMSSD and Δ%SC (r = .89, P = .001 and r = .61, P = .04, respectively).

CONCLUSIONS

There was no change in LnRMSSD and La_peak, Δ%SC, and RPE indicated reduced sympathetic activation and positive adaptation to the stress imposed by the session. Isolated HRV assessment may reveal a controversial interpretation of autonomic nervous system status or the training tolerance in elite synchronized swimming athletes due to the influence of the diving response.

Submaximal heart rate seems inadequate to prescribe and monitor intensified training

The aim of this study is to investigate whether the change in (sub)maximal heart rate after intensified training is associated with the change in performance. Thirty subjects were recruited who performed cardiopulmonary exercise tests to exhaustion 2 weeks before (pre), 1 week after (post) and 5 weeks after (follow-up) an 8-day non-competitive amateur cycling event (TFL). The exercise volume during the TFL was 7.7 fold the volume during the preparation period. Heart rate and cardiopulmonary parameters were obtained at standardised absolute submaximal workloads (low, medium and high intensity) and at peak level each test. Subjects were classified as functionally overreached (FOR) or acute fatigued (AF) based on the change in performance. No differences between FOR and AF were observed for heart rate (P = .51). On total group level (AF + FOR), post-TFL heart rate decreased significantly at low (-4.4 beats·min^-1, 95% CI [-8.7, -0.1]) and medium (-5.5 beats·min^-1 [-8.5, -2.4]), but not at high intensity. Peak heart rate decreased -3.4 beats·min^-1 [-6.1, -0.7]. O₂pulse was on average 0.49 ml O₂·beat^-1 [0.09, 0.89] higher at all intensities after intensified training. No changes in ⩒O₂ (P = .44) or the ventilatory threshold (P = .21) were observed. Pearson's correlation coefficients revealed negative associations between heart rate and O₂pulse at low (r = -.56, P < .01) and medium intensity (r = -.54, P < .01), but not with ⩒O₂ or any other submaximal parameter. (Sub)maximal heart rate decreased after the TFL. However, this decrease is unrelated to the change in performance. Therefore, heart rate seems inadequate to prescribe and monitor intensified training.

Cardiac Autonomic Modulations and Psychological Correlates in the Yukon Arctic Ultra: The Longest and the Coldest Ultramarathon

Studies on human physical performance in extreme environments have effectively approached the investigation of adaptation mechanisms and their physiological limits. As scientific interest in the interplay between physiological and psychological aspects of performance is growing, we aimed to investigate cardiac autonomic control, by means of heart rate variability, and psychological correlates, in competitors of a subarctic ultramarathon, taking place over a 690 km course (temperatures between +5 and -47°C). At baseline (PRE), after 277 km (D1), 383 km (D2), and post-race (POST, 690 km), heart rate (HR) recordings (supine, 15 min), psychometric measurements (Profile of Mood States/POMS, Borg fatigue, and Karolinska Sleepiness Scale scores both upon arrival and departure) were obtained in 16 competitors (12 men, 4 women, 38.6 ± 9.5 years). As not all participants reached the finish line, comparison of finishers (FIN, n = 10) and non-finishers (NON, n = 6), allowed differential assessment of performance. Resting HR increased overall significantly at D1 (FIN +15.9; NON +14.0 bpm), due to a significant decrease in parasympathetic drive. This decrease was in FIN only partially recovered toward POST. In FIN only, baseline HR was negatively correlated with mean velocity [r -0.63 (P.04)] and parasympathetic drive [pNN50+: r -0.67 (P.03)], a lower HR and a higher vagal tone predicting a better performance. Moreover, in FIN, a persistent increase of the long-term self-similarity coefficient, assessed by detrended fluctuation analysis (DFAα2), was retrieved, possibly due to higher alertness. As for psychometrics, at D1, POMS Vigor decreased (FIN: -7.0; NON: -3.8), while Fatigue augmented (FIN: +6.9; NON: +5.0). Sleepiness increased only in NON, while Borg scales did not exhibit changes. Baseline comparison of mood states with normative data for athletes displayed significantly higher positive mood in our athletes. Results show that: the race conditions induced early decreases in parasympathetic drive; the extent of vagal withdrawal, associated to the timing of its recovery, is crucial for success; pre-competition lower resting HR predicts a better performance; psychological profile is reliably depicted by POMS, but not by Borg fatigue scales. Therefore, assessment of heart rate variability and psychological profile may monitor and partly predict performance in long-duration ultramarathon in extreme cold environment.

Overload blunts baroreflex only in overreached athletes

OBJECTIVES

Heart rate variability (HRV) is commonly used to diagnose overreaching and monitor athletes' responses to training. Baroreflex sensitivity (BRS) is modified by changes in training load and might be another means to detect overreaching. The goal of this study was to assess BRS and HRV changes in two groups of athletes responding either negatively (FOR) or positively (AF) to similar training overload.

DESIGN

Fifteen athletes performed 2-week baseline (BSL) training followed by 3-week overload (+45%; OVL) and 2-week recovery (-20%; RCV).

METHODS

HRV, training load and subjective fatigue were measured daily via questionnaires. BRS, salivary cortisol and testosterone, and submaximal exercise and maximal 3-km run performances were measured at the end of each period.

RESULTS

Based on their performance change during OVL, 8 athletes were diagnosed as FOR and 7 as AF. Subjective fatigue was increased in FOR athletes during OVL. BRS increased in AF but not in FOR athletes during RCV. At the end of RCV, cortisol and testosterone were higher than BSL in both groups.

CONCLUSIONS

Three weeks of similar training overload can induce either performance enhancement or overreaching. The changes in submaximal exercise and maximal performances and in subjective fatigue were the fastest-responding parameters that distinguished the two groups of athletes during OVL. Training overload blunted the increase in BRS in FOR only. Most of the differences in BRS were observed during the recovery period. BRS appears to be a more sensitive parameter than HRV for early monitoring of responses to training.

Heart Rate Variability: An Old Metric with New Meaning in the Era of Using mHealth technologies for Health and Exercise Training Guidance. Part Two: Prognosis and Training

It has been demonstrated that heart rate variability (HRV) is predictive of all-cause and cardiovascular mortality using clinical ECG recordings. This is true for rest, exercise and ambulatory HRV clinical ECG device recordings in prospective cohorts. Recently, there has been a rapid increase in the use of mobile health technologies (mHealth) and commercial wearable fitness devices. Most of these devices use ECG or photo-based plethysmography and both are validated for providing accurate heart rate measurements. This offers the opportunity to make risk information from HRV more widely available. The physiology of HRV and the available technology by which it can be assessed has been summarised in Part 1 of this review. In Part 2 the association between HRV and risk stratification is addressed by reviewing the current evidence from data acquired by resting ECG, exercise ECG and medical ambulatory devices. This is followed by a discussion of the use of HRV to guide the training of athletes and as a part of fitness programmes.

Exercise and the Cortisol Awakening Response: A Systematic Review

Background

The cortisol awakening response (CAR) has been used as a biomarker of stress response in a multitude of psychological investigations. While a myriad of biochemical responses have been proposed to monitor responses to exercise training, the use of CAR within the exercise and sports sciences is currently limited and is a potentially underutilized variable. Therefore, the purpose of this review was to collate studies that incorporate both exercise and CAR, in an effort to better understand (a) whether CAR is a useful marker for monitoring exercise stress and (b) how CAR may be most appropriately used in future research.

Methods

A systematic review of the literature was conducted, following PRISMA guidelines. Searches were conducted using PubMed, SportDISCUS, Scopus, and PsychInfo databases, using search terms related toCAR and exercise and physical activity.

Results

10,292 articles were identified in the initial search, with 32 studies included in the final analysis. No studies investigated the effects of laboratory-controlled exercise on CAR. Variable effects were observed, possibly due to inconsistencies in study design, methodology, population, and CAR analysis. The available literature suggests a threshold of exercise may be required to alter the HPA axis and affect CAR. Moreover, CAR may represent a combination of previous exercise load and upcoming stress, making current interpretation of field-based observational research challenging.

Conclusions

More research is needed to fully elucidate the influence of exercise on CAR and address a number of gaps in the literature, including controlling exercise load, consistent sample collection, and CAR calculation and analysis.

Maximal rate of heart rate increase correlates with fatigue/recovery status in female cyclists

PURPOSE

Being able to identify how an athlete is responding to training would be useful to optimise adaptation and performance. The maximal rate of heart rate increase (rHRI), a marker of heart rate acceleration has been shown to correlate with performance changes in response to changes in training load in male athletes; however, it has not been established if it also correlates with performance changes in female athletes.

METHODS

rHRI and cycling performance were assessed in six female cyclists following 7 days of light training (LT), 14 days of heavy training (HT) and a 10 day taper period. rHRI was the first derivative maximum of a sigmoidal curve fit to R-R data recorded during 5 min of cycling at 100 W. Cycling performance was assessed as work done (kJ) during time-trials of 5 (5TT) and 60 (60TT) min duration.

RESULTS

5TT was possibly decreased at HT (ES ± 90% confidence interval = - 0.16 ± 0.25; p = 0.60), while, 5TT and 60TT very likely to almost certainly increased from HT to taper (ES = 0.71 ± 0.24; p = 0.007 and ES = 0.42 ± 0.19; p = 0.02, respectively). Large within-subject correlations were found between rHRI, and 5TT (r = 0.65 ± 0.37; p = 0.02) and 60TT (r = 0.70 ± 0.31; p = 0.008).

CONCLUSIONS

rHRI during the transition from rest to light exercise correlates with training induced-changes in exercise performance in females, suggesting that rHRI may be a useful monitoring tool for female athletes.