Study of blood flow parameters measured in femoral artery after exercise: correlation with maximum oxygen uptake

Physical fitness in adolescent patients with familial Mediterranean fever

INTRODUCTION

Familial Mediterranean fever (FMF) is the most frequent monogenic auto-inflammatory disease worldwide responsible for episodes of fever, serositis and musculoskeletal symptoms. Inflammatory attacks are responsible for sedentary behavior and FMF patients may be at increased cardiovascular risk. Cardiorespiratory Fitness (CRF) and physical capacities during adolescence are associated with cardiovascular mortality in adulthood. In this study, we aimed to describe the physical fitness of FMF adolescents.

METHODS

A monocentric retrospective study at the Versailles Hospital between January 2020 and June 2023. All FMF patients over 14-year-old who had completed a routine physical test were included. Clinical and physical data including results of the 6-minute walking test, timed unipedal stance test, Ruffier-Dickson index, 30-seconds chair-stand test and sit-and-reach test were extracted from medical records. Results were compared with previously published normative reference values and criterion-referenced standards for healthy subjects.

RESULTS

Eighteen FMF patients (12 girls, 6 boys) were included. The median age was 16 years old [14-18]. Clinical history included joint symptoms (n = 11), chest pleuritis (n = 8), and leg pain (n = 11). Estimated VO2max was below the recommended thresholds in 13 patients, which predicts cardiovascular risk. Cardiovascular adaptation was poor in 11 patients. Low VO2max was associated with CRP > 5 mg/l on test day and history of joint symptoms.

CONCLUSION

FMF patients displayed altered physical capacities compared to normative values of healthy subjects. History of musculoskeletal pain, systemic inflammation and sedentary behavior may participate in impaired physical abilities and promote cardiovascular diseases in adulthood. Specific exercise programs could benefit patients for disease control and cardiovascular risk reduction.

Modified Isoinertial-Based Ruffier Test in Healthy Individuals: A Feasibility Study

Cardiorespiratory fitness is an essential indicator in sports science and sports medicine that can be assessed with several tests. The Ruffier test is a submaximal test valid to estimate maximum oxygen uptake; it consists of 30 squats in 45 s, which may be challenging for inexperienced individuals. This study aims to verify the feasibility of a modified inertial-based version of the Ruffier test to assess cardiorespiratory fitness with 10 squats in 15 s. Both classic and isoinertial Ruffier tests were administered to thirty-five healthy young adults (20 men and 15 women), age 22.06 ± 2.13 years, BMI 23.87 ± 2.74. The two one-sided test confirmed the comparability of the isoinertial Ruffier test with its classic version within equivalence bounds of ±3.726. Furthermore, gender, age, body weight, the difference between peak heart rate after isoinertial squatting and resting heart rate, and the isoinertial Ruffier index are the coefficients of our best VO₂max prediction model with an adjusted R² of 0.937, sensitivity of 0.89, and specificity of 0.81. The study evidenced the feasibility of the isoinertial Ruffier test to measure cardiorespiratory fitness through a quick, safe, and short squat test easy to perform in fitness centers and primary care clinics.

Effectiveness of Different Modalities of Remote Online Training in Young Healthy Males

Since 2020 there has been an increase in demand for home workouts. Therefore, different ways of delivering distance training have been proposed to promote “stay active at home.” This study aimed to compare the effectiveness of three different training programs consisting of a total of 15 workouts (three sessions per week): supervised livestreaming (LS), unsupervised following a video recording (VR), and unsupervised following a written program (WP). Changes in anthropometric and cardiovascular variables, muscle fitness, and physical activity levels were evaluated. To provide a meaningful analysis for significant comparisons between small groups, mean differences (∆), 95% confidence interval (95% C.I.), and Cohen’s effect sizes (E.S.) were also calculated. The three training modalities increased physical activity levels, with an adherence rate of LS = 93.3%, VR = 86%, and WP = 74%. Although there was no reduction in body weight, waist circumference decreased by 1.3 cm (95% C.I. = −2.1, −0.5; E.S. = 0.170; p < 0.004). Furthermore, where LS, VR, and WP resulted in improvements in muscle fitness, only LS showed changes in cardiovascular variables, such as resting heart rate (∆ = −7.3 bpm; 95% C.I. = −11.9, −2.7; E.S. = 1.296; p < 0.001) and Ruffier’s index (∆ = −2.1bpm; 95% C.I. = −3.5, −0.8; E.S. 1.099; p < 0.001). Remote online training proved its effectiveness over a short period of time. However, supervised training proved to be the most effective, highlighting the importance of an experienced trainer.

Anthropometric Measures as Predictive Indicators of Metabolic Risk in a Population of "Holy Week Costaleros"

Preventive measures are a priority in those groups that perform intense physical efforts without physical preparation and that can also be overweight or obese. One of the groups that reflect these characteristics is the costaleros of the Holy Week of Andalusia, Spain. This paper aims to describe the effect of obesity on blood pressure. A descriptive cross-sectional study was conducted on 101 costaleros. The anthropometric measures were determined through segmental impedance. Cardiac recovery and anaerobic power were measured through the Ruffier⁻Dickson test and the Abalakov test, respectively. Blood pressure was measured when the individuals were at rest. The Kruskal⁻Wallis test was applied for of continuous parameters and the X² test for dichotomous measures. Binary logistic regression models were used for the subsequent analysis with R-square and Receiver Operating Characteristic (ROC) curves. The average population was 28 years of age, 173.7 cm tall, and 82.59 Kg weigh. The excess of body fat was 11.27 Kg and Body Mass Index was 27.33 Kg/m². 72.3% showed abnormal blood pressure and 68.2% were overweight. 32.7% had a waist-hip ratio higher than 0.94. The probability of presenting abnormal blood pressure was higher among the subjects whose fat content was higher and muscle content was lower.

Comparison of Maximum Oxygen Uptake and Rating Perceived Exertion in Woman's Kabaddi Athletes (Without Breathy Voice to Severe Breathy Voice)

OBJECTIVE

There is limited research on voice problems of athletes, especially Kabaddi athletes who use their voice during Kabaddi exercises and may damage their vocal folds and impair their voice quality. The present study aimed to compare maximum oxygen uptake (VO₂max) and rating perceived exertion (RPE) in Woman's Kabaddi athletes without breathy voice (BV) to severe BV.

MATERIALS AND METHODS

Seventy woman's Kabaddi athletes (mean age of 20.5 ± 2.7 years, height of 163 ± 3.6 cm, weight of 61.4 ± 5.4 kg) at the club and national team level (without BV to severe BV) were compared in this study. Data were collected by imaging the larynx by a stroboscopic device (there is gap and asymmetry between vocal folds, presence of mass on vocal folds, muscle tension dysphonia, hoarseness, and harshness), evaluating the voice parameters by Vocal Assessment software (mean F₀ (Hz), F₀SD (Hz), jitter (%), shimmer (%), Normal Noise Energy (NNE) (dB)), and calculating VO₂max by Bruce treadmill test. RPE was calculated by a 15-point (6-20) Borg test.

RESULTS

The results showed that 39 (55.17%) subjects had moderate and high BV symptoms and 31 (44.28%) had no symptoms of BV and low BV. The mean fundamental frequency in the group with moderate and severe BV was equal to 2.59 Hz opposite the mean fundamental frequency in the group without BV and low BV was equal to 0.65 Hz, and in contrast, the jitter (0.47%) opposite (0.19%) and the shimmer was equal to (6.64%) opposite (0.67%) and the NNE was equal to (-3.08 dB) In front of (-11.95 dB). There was no significant difference between VO2max in two groups of Woman's Kabaddi athletes as well as RPE in two groups of Woman's Kabaddi athletes at significant level of P ≤ 0.05.

CONCLUSIONS

Severe BV is affected by voice abuse. Voice abuse during Kabaddi is negatively affecting the quality of voice. After Kabaddi sport, athletes are complained from obstruction, hoarseness, and harshness due to disturbances in vocal folds and throat dryness. According to the data obtained from this study, abuse has a negative effect on vocal folds, which is followed by BV in various degrees in Kabaddi athletes.

A 45-Second Self-Test for Cardiorespiratory Fitness: Heart Rate-Based Estimation in Healthy Individuals

Cardio-respiratory fitness (CRF) is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up to accomplish our objectives. Data from 81 healthy volunteers (age: 29 ± 8 years, BMI: 24.0 ± 2.9), 18 of whom females, were used to validate this test against gold standard. Nineteen volunteers repeated this test twice in order to evaluate its repeatability. CRF estimation models were developed using heart rate (HR) features extracted from the resting, exercise, and the recovery phase. The most predictive HR feature was the intercept of the linear equation fitting the HR values during the recovery phase normalized for the height2 (r2 = 0.30). The Ruffier-Dickson Index (RDI), which was originally developed for this squat test, showed a negative significant correlation with CRF (r = -0.40), but explained only 15% of the variability in CRF. A multivariate model based on RDI and sex, age and height increased the explained variability up to 53% with a cross validation (CV) error of 0.532 L ∙ min-1 and substantial repeatability (ICC = 0.91). The best predictive multivariate model made use of the linear intercept of HR at the beginning of the recovery normalized for height2 and age2; this had an adjusted r2 = 0. 59, a CV error of 0.495 L·min-1 and substantial repeatability (ICC = 0.93). It also had a higher agreement in classifying CRF levels (κ = 0.42) than RDI-based model (κ = 0.29). In conclusion, this simple 45 s self-test can be used to estimate and classify CRF in healthy individuals with moderate accuracy and large repeatability when HR recovery features are included.

Cardiorespiratory Improvements Achieved by American College of Sports Medicine's Exercise Prescription Implemented on a Mobile App

Background

Strong evidence shows that an increase in cardiorespiratory fitness (CRF) and physical activity (PA) reduces cardiovascular disease risk.

Objective

To test whether a scientifically endorsed program to increase CRF and PA, implemented on an easy-to-use, always-accessible mobile app would be effective in improving CRF.

Methods

Of 63 healthy volunteers participating, 18 tested the user interface of the Cardio-Fitness App (CF-App); and 45 underwent a 2-week intervention period, of whom 33 eventually concluded it. These were assigned into three groups. The Step-based App (Step-App) group (n=8), followed 10,000 steps/day prescription, the CF-App group (n=13), and the Supervised Cardio-Fitness (Super-CF) group (n=12), both followed a heart rate (HR)-based program according to American College of Sports Medicine (ACSM) guidelines, but either implemented on the app, or at the gym, respectively. Participants were tested for CRF, PA, resting systolic and diastolic blood pressures (SBP, DBP), resting, exercise, and recovery HR.

Results

CRF increased in all groups (+4.9%; P<.001). SBP decreased in all groups (-2.6 mm Hg; P=.03). DBP decrease was higher in the Super-CF group (-3.5 mm Hg) than in the Step-App group (-2.1 mm Hg; P<.001). Posttest exercise HR decreased in all groups (-3.4 bpm; P=.02). Posttest recovery HR was lower in the Super-CF group (-10.1 bpm) than in the other two groups (CF-App: -4.9 bpm, Step-App: -3.3 bpm; P<.001). The CF-App group, however, achieved these improvements with more training heart beats (P<.01).

Conclusions

A 10,000 steps/day target-based app improved CRF similar to an ACSM guideline-based program whether it was implemented on a mobile app or in supervised gym sessions.

Active commuting to school, weight status, and cardiometabolic risk in children from rural areas: the Cuenca study

PURPOSE

The aim of this study was to examine (a) whether distance from home to school is a determinant of active commuting to school (ACS), (b) the relationship between distance from home to heavily used facilities (school, green spaces, and sports facilities) and the weight status and cardiometabolic risk categories, and (c) whether ACS has a positive impact on schoolchildren's health.

METHOD

A cross-sectional study was conducted with 956 schoolchildren aged 10 to 12 years from the province of Cuenca, Spain. Height, weight, fat mass, waist circumference, blood pressure, fasting plasma lipid profile, insulin, fitness, physical activity, and ACS were measured. Distances from home to facilities were measured by a geographic information system, and a validated metabolic syndrome index was used.

FINDINGS

Children living closer to school (less than 600 m) commuted actively to school more frequently than children living further away (more than 800 m). Normoweight boys lived further away from sports facilities than overweight/obese peers, and children presenting higher cardiometabolic risk levels lived closer to school than those who did not. No differences were found between children who daily walked/cycled to school and those commuting actively to school less frequently in body mass index, metabolic syndrome index, fitness, and physical activity.

CONCLUSIONS

ACS had no positive impact on schoolchildren's health. Distance to school is an indicator of active commuting. However, it seems that not enough physical activity is done to prevent obesity and cardiometabolic risk factors in rural areas.

Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings

Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of VO(2max) during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the VO(2max) estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating VO(2max), one has to be aware of the effects of medication on heart rate-based submaximal protocols. In the home setting, the submaximal protocols need to be accessible to users with a broad range of characteristics in terms of age, equipment, time available, and an absence of supervision. In this setting, the smart use of sensors such as accelerometers and heart rate monitors will result in protocol-free VO(2max) assessments. In conclusion, the need for a low-risk, low-cost, low-supervision, and objective evaluation of VO(2max) has brought about the development and the validation of a large number of submaximal exercise tests. It is of paramount importance to use these tests in the right context (sports, clinical, home), to consider the population in which they were developed, and to be aware of their limitations.

Metabolic and vascular support for the role of myoglobin in humans: a multiparametric NMR study

In human muscle the role of myoglobin (Mb) and its relationship to factors such as muscle perfusion and metabolic capacity are not well understood. We utilized nuclear magnetic resonance (NMR) to simultaneously study the Mb concentration ([Mb]), perfusion, and metabolic characteristics in calf muscles of athletes trained long term for either sprint or endurance running after plantar flexion exercise and cuff ischemia. The acquisitions for 1H assessment of Mb desaturation and concentration, arterial spin labeling measurement of muscle perfusion, and 31P spectroscopy to monitor high-energy phosphate metabolites were interleaved in a 4-T magnet. The endurance-trained runners had a significantly elevated [Mb] (0.28 ± 0.06 vs. 0.20 ± 0.03 mmol/kg). The time constant of creatine rephosphorylation (τPCr), an indicator of oxidative capacity, was both shorter in the endurance-trained group (34 ± 6 vs. 64 ± 20 s) and negatively correlated with [Mb] across all subjects ( r = 0.58). The time to reach maximal perfusion after cuff release was also both shorter in the endurance-trained group (306 ± 74 vs. 560 ± 240 s) and negatively correlated with [Mb] ( r = 0.56). Finally, Mb reoxygenation rate tended to be higher in the endurance-trained group and was positively correlated with τPCr ( r = 0.75). In summary, these NMR data reveal that [Mb] is increased in human muscle with a high oxidative capacity and a highly responsive vasculature, and the rate at which Mb resaturates is well correlated with the rephosphorylation rate of Cr, each of which support a teleological role for Mb in O2 transport within highly oxidative human skeletal muscle.