Respiratory frequency and tidal volume during exercise: differential control and unbalanced interdependence

Energetics of sinusoidal exercise below and across critical power and the effects of fatigue

PURPOSE

Previous studies investigating sinusoidal exercise were not devoted to an analysis of its energetics and of the effects of fatigue. We aimed to determine the contribution of aerobic and anaerobic lactic metabolism to the energy balance and investigate the fatigue effects on the cardiorespiratory and metabolic responses to sinusoidal protocols, across and below critical power (CP).

METHODS

Eight males (26.6 ± 6.2 years; 75.6 ± 8.7 kg; maximum oxygen uptake 52.8 ± 7.9 ml·min-1·kg-1; CP 218 ± 13 W) underwent exhausting sinusoidal cycloergometric exercises, with sinusoid midpoint (MP) at CP (CPex) and 50 W below CP (CP-50ex). Sinusoid amplitude (AMP) and period were 50 W and 4 min, respectively. MP, AMP, and time-delay (tD) between mechanical and metabolic signals of expiratory ventilation (V ˙ E ), oxygen uptake (V ˙ O 2 ), and heart rate ( f H ) were assessed sinusoid-by-sinusoid. Blood lactate ([La-]) and rate of perceived exertion (RPE) were determined at each sinusoid.

RESULTS

V ˙ O 2 AMP was 304 ± 11 and 488 ± 36 ml·min-1 in CPex and CP-50ex, respectively. Asymmetries between rising and declining sinusoid phases occurred in CPex (36.1 ± 7.7 vs. 41.4 ± 9.7 s forV ˙ O 2 tD up and tD down, respectively; P < 0.01), with unchanged tDs.V ˙ O 2 MP and RPE increased progressively during CPex. [La-] increased by 2.1 mM in CPex but remained stable during CP-50ex. Anaerobic contribution was larger in CPex than CP-50ex.

CONCLUSION

The lower aerobic component during CPex than CP-50ex associated with lactate accumulation explained lowerV ˙ O 2 AMP in CPex. The asymmetries in CPex suggest progressive decline of muscle phosphocreatine concentration, leading to fatigue, as witnessed by RPE.

Prolonged exercise shifts ventilatory parameters at the moderate-to-heavy intensity transition

PURPOSE

To quantify the effects of prolonged cycling on the rate of ventilation ([Formula: see text]), frequency of respiration (FR), and tidal volume (VT) associated with the moderate-to-heavy intensity transition.

METHODS

Fourteen endurance-trained cyclists and triathletes (one female) completed an assessment of the moderate-to-heavy intensity transition, determined as the first ventilatory threshold (VT1), before (PRE) and after (POST) two hours of moderate-intensity cycling. The power output, [Formula: see text], FR, and VT associated with VT1 were determined PRE and POST.

RESULTS

As previously reported, power output at VT1 significantly decreased by ~ 10% from PRE to POST. The [Formula: see text] associated with VT1 was unchanged from PRE to POST (72 ± 12 vs. 69 ± 13 L.min-1, ∆ - 3 ± 5 L.min-1, ∆ - 4 ± 8%, P = 0.075), and relatively consistent (within-subject coefficient of variation, 5.4% [3.7, 8.0%]). The [Formula: see text] associated with VT1 was produced with increased FR (27.6 ± 5.8 vs. 31.9 ± 6.5 breaths.min-1, ∆ 4.3 ± 3.1 breaths.min-1, ∆ 16 ± 11%, P = 0.0002) and decreased VT (2.62 ± 0.43 vs. 2.19 ± 0.36 L.breath-1, ∆ - 0.44 ± 0.22 L.breath-1, ∆ - 16 ± 7%, P = 0.0002) in POST.

CONCLUSION

These data suggest prolonged exercise shifts ventilatory parameters at the moderate-to-heavy intensity transition, but [Formula: see text] remains stable. Real-time monitoring of [Formula: see text] may be a useful means of assessing proximity to the moderate-to-heavy intensity transition during prolonged exercise and is worthy of further research.

Identification of Respiration Types Through Respiratory Signal Derived From Clinical and Wearable Electrocardiograms

GOAL

To evaluate suitability of respiratory signals derived from clinical 12-lead electrocardiograms (ECGs) and wearable 1-lead ECG to identify different respiration types.

METHODS

ECGs were simultaneously acquired through the M12R ECG Holter by Global Instrumentation and the chest strap BioHarness 3.0 by Zephyr from 42 healthy subjects alternating normal breathing, breath holding, and deep breathing. Respiration signals were derived from the ECGs through the Segmented-Beat Modulation Method (SBMM)-based algorithm and the algorithms by Van Gent, Charlton, Soni and Sarkar, and characterized in terms of breathing rate and amplitude. Respiration classification was performed through a linear support vector machine and evaluated by F1 score.

RESULTS

Best F1 scores were 86.59%(lead V2) and 80.57%, when considering 12-lead and 1-lead ECGs, respectively, and using SBMM-based algorithm.

CONCLUSION

ECG-derived respiratory signals allow reliable identification of different respiration types even when acquired through wearable sensors, if associated to appropriate processing algorithms, such as the SBMM-based algorithm.

Effects of Pre-Exercise Voluntary Hyperventilation on Metabolic and Cardiovascular Responses During and After Intense Exercise

Purpose: We investigated the effects of pre-exercise voluntary hyperventilation and the resultant hypocapnia on metabolic and cardiovascular responses during and after high-intensity exercise. Methods: Ten healthy participants performed a 60-s cycling exercise at a workload of 120% peak oxygen uptake in control (spontaneous breathing), hypocapnia and normocapnia trials. Hypocapnia was induced through 20-min pre-exercise voluntary hyperventilation. In the normocapnia trial, voluntary hyperpnea was performed with CO2 inhalation to prevent hypocapnia. Results: Pre-exercise end-tidal CO2 partial pressure was lower in the hypocapnia trial than the control or normocapnia trial, with similar levels in the control and normocapnia trials. Average V ˙ O 2 during the entire exercise was lower in both the hypocapnia and normocapnia trials than in the control trial (1491 ± 252vs.1662 ± 169vs.1806 ± 149 mL min-1), with the hypocapnia trial exhibiting a greater reduction than the normocapnia trial. Minute ventilation during exercise was lower in the hypocapnia trial than the normocapnia trial. In addition, minute ventilation during the first 10s of the exercise was lower in the normocapnia than the control trial. Pre-exercise hypocapnia also reduced heart rates and arterial blood pressures during the exercise relative to the normocapnia trial, a response that lasted through the subsequent early recovery periods, though end-tidal CO2 partial pressure was similar in the two trials. Conclusions: Our results suggest that pre-exercise hyperpnea and the resultant hypocapnia reduce V ˙ O 2 during high-intensity exercise. Moreover, hypocapnia may contribute to voluntary hyperventilation-mediated cardiovascular responses during the exercise, and this response can persist into the subsequent recovery period, despite the return of arterial CO2 pressure to the normocapnic level.

Mitochondrial-targeted antioxidant ingestion acutely blunts VO2max in physically inactive females

PURPOSE

To determine the acute effects of a mitochondrial targeting antioxidant (MitoQ) on the metabolic response during exercise.

METHODS

Nine (n = 9) physically inactive females (age 47 ± 22 years) performed two trials (Placebo and MitoQ) in a double-blind randomized cross-over design. In both trials, participants performed an exercise protocol consisting of 3-min stages at submaximal workloads followed by a ramp protocol to volitional exhaustion. Participants received either Placebo or MitoQ (80 mg) 1 h prior to exercise. Indirect calorimetry and cardiovascular measurements were collected throughout the duration of the exercise bout.

RESULTS

Submaximal metabolic and cardiovascular variables were not different between trials (p > 0.05). VO2max was higher (p = 0.03) during Placebo (23.5 ± 5.7 mL kg min-1 ) compared to MitoQ (21.0 ± 6.6 mL kg min-1 ). Maximal ventilation was also higher (p = 0.02) in Placebo (82.4 ± 17.7 L/min) compared to MitoQ (75.0 ± 16.8 L/min). Maximal cardiovascular variables and blood lactate were not different between trials (p > 0.05).

CONCLUSION

An acute dose of MitoQ blunted VO2max , which was primarily mediated by impairment of ventilatory function. These data suggest that the acute accumulation of exercise-induced mitochondrial reactive oxygen species (mtROS) are necessary for maximal aerobic capacity. Further research is warranted on mtROS-antioxidant cell signaling cascades, and how they relate to mitochondrial function during exercise.

Alterations in step frequency and muscle activities using body weight support influence the ventilatory response to sinusoidal walking in humans

The use of body weight support (BWS) can reveal important insights into the relationship between lower-limb muscle activities and the ventilatory response during sinusoidal walking. Here, healthy participants (n = 15) walked on a treadmill while 0%, 30%, and 50% of their body weight was supported with BWS. The walking speed was varied sinusoidally between 3 and 6 km h-1, and three different frequencies, and periods ranging from 2 to 10 min were used. Breath-by-breath ventilation ([Formula: see text]) and CO2 output ([Formula: see text]) were measured. The tibialis anterior (TA) muscle activity was measured by electromyography throughout the walking. The amplitude (Amp), normalized Amp [Amp ratio (%)], and phase shift (PS) of the sinusoidal variations in measurement variables were calculated using a Fourier analysis. The results revealed that the Amp ratio in [Formula: see text] increased with the increase in BWS. A steeper slope of the [Formula: see text]-[Formula: see text] relationship and greater [Formula: see text]/[Formula: see text] values were observed under reduced body weight conditions. The Amp ratio in TA muscle was significantly positively associated with the Amp ratio in the [Formula: see text] (p < 0.001). These findings indicate that the greater amplitude in the TA muscle under BWS may have been a potent stimulus for the greater response of ventilation during sinusoidal walking.

Ventilation and perceived exertion are sensitive to changes in exercise tolerance: arm+leg cycling vs. leg cycling

Purpose: Growing evidence suggests that respiratory frequency (f R) is a marker of physical effort and a variable sensitive to changes in exercise tolerance. The comparison between arm+leg cycling (Arm+leg) and leg cycling (Leg) has the potential to further test this notion because a greater exercise tolerance is expected in the Arm+leg modality. We systematically compared Arm+leg vs. Leg using different performance tests. Methods: Twelve males underwent six performance tests in separate, randomized visits. Three tests were performed in each of the two exercise modalities, i.e. an incremental test and two time-to-exhaustion (TTE) tests performed at 90% or 75% of the peak power output reached in the Leg incremental test (PPOLeg). Exercise tolerance, perceived exertion, and cardiorespiratory variables were recorded during all the tests. Results: A greater exercise tolerance (p < 0.001) was found for Arm+leg in the incremental test (337 ± 32 W vs. 292 ± 28 W), in the TTE test at 90% of PPOLeg (638 ± 154 s vs. 307 ± 67 s), and in the TTE test at 75% of PPOLeg (1,675 ± 525 s vs. 880 ± 363 s). Unlike V ˙ O2 and heart rate, both f R and minute ventilation were lower (p < 0.003) at isotime in all the Arm+leg tests vs. Leg tests. Furthermore, a lower perceived exertion was observed in the Arm+leg tests, especially during the TTE tests (p < 0.001). Conclusion: Minute ventilation, f R and perceived exertion are sensitive to the improvements in exercise tolerance observed when comparing Arm+leg vs. Leg, unlike V ˙ O2 and heart rate.

Respiratory Pattern Analysis for Different Breathing Types and Recording Sensors in Healthy Subjects

Accurate monitoring of respiratory activity can lead to early identification and treatment of possible respiratory failure. However, spontaneous breathing can vary considerably. To quantify this variability, this study aimed at comparing the breathing pattern characteristics obtained from several recording sensors during different breathing types. Respiratory activity was recorded with a pneumotachograph and two inductive plethysmographic bands, thoracic and abdominal, in 23 healthy volunteers (age 21.5±1.2 years, 13 females). The subjects were asked to breathe at their natural rate, in successive stages: first freely, then through their nose, nose and mouth, mouth alone, and finally deep and shallow. Both band signals were compared to the pneumotach-derived (gold standard) volume signal. The time series of inspiratory and expiratory duration, total cycle duration and tidal volume were estimated from each of these signals, and also from the sum of the thoracic and abdominal bands. This composite signal showed the highest correlation with the volume signal for almost all subjects, and also had a significantly higher correlation with those obtained from the gold standard volume, compared to either band. In general, breathing parameters increased from basal to nose-mouth breathing, had a minimum in shallow breathing and a maximum in deep breathing. Women exhibited a significantly longer exhalation phase than men during deep breathing, in the combined bands and the gold standard volume. In conclusion, variations in respiratory cycle morphology in different breathing types can be well captured by the simple addition of abdominal and thoracic band signals.Clinical Relevance- Breathing pattern variability can be identified by the combination of abdominal and thoracic bands.

Multivariable Regression Model to Estimate Tidal Volume for Different Respiratory Patterns

Respiratory patterns present great variability, both in healthy subjects and in patients with different diseases and forms of nasal, oral, superficial or deep breathing. The analysis of this variability depends, among others, on the device used to record the signals that describe these patterns. In this study, we propose multivariable regression models to estimate tidal volume (VT) considering different breathing patterns. Twenty-three healthy volunteers underwent continuous multisensor recordings considering different modes of breathing. Respiratory flow and volume signals were recorded with a pneumotachograph and thoracic and abdominal respiratory inductive plethysmographic bands. Several respiratory parameters were extracted from the volume signals, such as inspiratory and expiratory areas (Areains, Areaexp), maximum volume relative to the cycle start and end (VTins, VTexp), inspiratory and expiratory time (Tins, Texp), cycle duration (Ttot), and normalized parameters of clinical interest. The parameters with the greatest individual predictive power were combined using multivariable models to estimate VT. Their performance were quantified in terms of determination coefficient (R2), relative error (ER) and interquartile range (IQR). Using only three parameters, the results obtained for the thoracic band (VTexp, Ttot, Areaexp) were better than those obtained from the abdominal band (VTexp, Tins, Areains) with R2 = 0.94 (IQR: 0.07); ER = 6.99 (IQR: 6.12) vs R2 = 0.91 (IQR: 0.09), ER = 8.70 (IQR: 4.62). Overall performance increased to R2 = 0.97 (IQR: 0.02) and ER = 4.60 (IQR: 3.68) when parameters from the different bands were combined, further improving when was applied to segments with different inspiration-expiration patterns. In particular, the nose-nose ER = 1.39 (IQR: 0.73), nose-mouth ER = 2.11 (IQR: 1.23) and mouth-mouth ER = 2.29 (IQR: 1.44) patterns showed the best results compared to those obtained for basal, shallow and deep breathing.Clinical relevance- Respiratory pattern variability can be described using multivariable regression model for tidal volume.

NBCe1-B/C-knockout mice exhibit an impaired respiratory response and an enhanced renal response to metabolic acidosis

The sodium-bicarbonate cotransporter (NBCe1) has three primary variants: NBCe1-A, -B and -C. NBCe1-A is expressed in renal proximal tubules in the cortical labyrinth, where it is essential for reclaiming filtered bicarbonate, such that NBCe1-A knockout mice are congenitally acidemic. NBCe1-B and -C variants are expressed in chemosensitive regions of the brainstem, while NBCe1-B is also expressed in renal proximal tubules located in the outer medulla. Although mice lacking NBCe1-B/C (KOb/c) exhibit a normal plasma pH at baseline, the distribution of NBCe1-B/C indicates that these variants could play a role in both the rapid respiratory and slower renal responses to metabolic acidosis (MAc). Therefore, in this study we used an integrative physiologic approach to investigate the response of KOb/c mice to MAc. By means of unanesthetized whole-body plethysmography and blood-gas analysis, we demonstrate that the respiratory response to MAc (increase in minute volume, decrease in pCO2) is impaired in KOb/c mice leading to a greater severity of acidemia after 1 day of MAc. Despite this respiratory impairment, the recovery of plasma pH after 3-days of MAc remained intact in KOb/c mice. Using data gathered from mice housed in metabolic cages we demonstrate a greater elevation of renal ammonium excretion and greater downregulation of the ammonia recycling enzyme glutamine synthetase in KOb/c mice on day 2 of MAc, consistent with greater renal acid-excretion. We conclude that KOb/c mice are ultimately able to defend plasma pH during MAc, but that the integrated response is disturbed such that the burden of work shifts from the respiratory system to the kidneys, delaying the recovery of pH.

Design and Testing of a Smart Facemask for Respiratory Monitoring during Cycling Exercise

Given the importance of respiratory frequency (f_R) as a valid marker of physical effort, there is a growing interest in developing wearable devices measuring f_R in applied exercise settings. Biosensors measuring chest wall movements are attracting attention as they can be integrated into textiles, but their susceptibility to motion artefacts may limit their use in some sporting activities. Hence, there is a need to exploit sensors with signals minimally affected by motion artefacts. We present the design and testing of a smart facemask embedding a temperature biosensor for f_R monitoring during cycling exercise. After laboratory bench tests, the proposed solution was tested on cyclists during a ramp incremental frequency test (RIFT) and high-intensity interval training (HIIT), both indoors and outdoors. A reference flowmeter was used to validate the f_R extracted from the temperature respiratory signal. The smart facemask showed good performance, both at a breath-by-breath level (MAPE = 2.56% and 1.64% during RIFT and HIIT, respectively) and on 30 s average f_R values (MAPE = 0.37% and 0.23% during RIFT and HIIT, respectively). Both accuracy and precision (MOD ± LOAs) were generally superior to those of other devices validated during exercise. These findings have important implications for exercise testing and management in different populations.

Cardiorespiratory optimal point as a submaximal evaluation tool in endurance athletes: An exploratory study

Introduction: The cardiorespiratory optimal point (COP) represents the lowest minute ventilation to oxygen consumption ratio (VE/VO2) and can be estimated during a CPET at submaximal intensity when an exercise test until volitional fatigue is not always advisable (i.e., a conflict zone where you cannot be confident of the security because near-competition, off-season, among other). COP's physiological components have not been wholly described yet. Therefore, this study seeks to identify the determinants of COP in highly trained athletes and its influence on maximum and sub-maximum variables during CPET through principal c omponent analysis (PCA) (explains the dataset's variance). Methods: Female (n = 9; age, 17.4 ± 3.1 y; maximal VO2 [VO2max]), 46.2 ± 5.9 mL/kg/min) and male (n = 24; age, 19.7 ± 4.0 y; VO2max, 56.1 ± 7.6 mL/kg/min) athletes performed a CPET to determine the COP, ventilatory threshold 1 (VT1) and 2 (VT2), and VO2max. The PCA was used to determine the relationship between variables and COP, explaining their variance. Results: Our data revealed that females and males displayed different COP values. Indeed, males showed a significant diminished COP compared to the female group (22.6 ± 2.9 vs. 27.2 ±3.4 VE/VO2, respectively); nevertheless, COP was allocated before VT1 in both groups. Discussion: PC analysis revealed that the COP variance was mainly explained (75.6%) by PC1 (expired CO₂ at VO2max) and PC2 (VE at VT2), possibly influencing cardiorespiratory efficiency at VO2max and VT2. Our data suggest that COP could be used as a submaximal index to monitor and assess cardiorespiratory system efficiency in endurance athletes. The COP could be particularly useful during the offseason and competitive periods and the return to the sports continuum.

Differential control of respiratory frequency and tidal volume during exercise

The lack of a testable model explaining how ventilation is regulated in different exercise conditions has been repeatedly acknowledged in the field of exercise physiology. Yet, this issue contrasts with the abundance of insightful findings produced over the last century and calls for the adoption of new integrative perspectives. In this review, we provide a methodological approach supporting the importance of producing a set of evidence by evaluating different studies together-especially those conducted in 'real' exercise conditions-instead of single studies separately. We show how the collective assessment of findings from three domains and three levels of observation support the development of a simple model of ventilatory control which proves to be effective in different exercise protocols, populations and experimental interventions. The main feature of the model is the differential control of respiratory frequency (f_R) and tidal volume (V_T); f_R is primarily modulated by central command (especially during high-intensity exercise) and muscle afferent feedback (especially during moderate exercise) whereas V_T by metabolic inputs. Furthermore, V_T appears to be fine-tuned based on f_R levels to match alveolar ventilation with metabolic requirements in different intensity domains, and even at a breath-by-breath level. This model reconciles the classical neuro-humoral theory with apparently contrasting findings by leveraging on the emerging control properties of the behavioural (i.e. f_R) and metabolic (i.e. V_T) components of minute ventilation. The integrative approach presented is expected to help in the design and interpretation of future studies on the control of f_R and V_T during exercise.

Restricted nasal-only breathing during self-selected low intensity training does not affect training intensity distribution

Introduction: Low-intensity endurance training is frequently performed at gradually higher training intensities than intended, resulting in a shift towards threshold training. By restricting oral breathing and only allowing for nasal breathing this shift might be reduced. Methods: Nineteen physically healthy adults (3 females, age: 26.5 ± 5.1 years; height: 1.77 ± 0.08 m; body mass: 77.3 ± 11.4 kg; VO₂peak: 53.4 ± 6.6 mL·kg^-1 min^-1) performed 60 min of self-selected, similar (144.7 ± 56.3 vs. 147.0 ± 54.2 W, p = 0.60) low-intensity cycling with breathing restriction (nasal-only breathing) and without restrictions (oro-nasal breathing). During these sessions heart rate, respiratory gas exchange data and power output data were recorded continuously. Results: Total ventilation (p < 0.001, η_p ² = 0.45), carbon dioxide release (p = 0.02, η_p ² = 0.28), oxygen uptake (p = 0.03, η_p ² = 0.23), and breathing frequency (p = 0.01, η_p ² = 0.35) were lower during nasal-only breathing. Furthermore, lower capillary blood lactate concentrations were found towards the end of the training session during nasal-only breathing (time x condition-interaction effect: p = 0.02, η_p ² = 0.17). Even though discomfort was rated marginally higher during nasal-only breathing (p = 0.03, η_p ² = 0.24), ratings of perceived effort did not differ between the two conditions (p ≥ 0.06, η_p ² = 0.01). No significant "condition" differences were found for intensity distribution (time spent in training zone quantified by power output and heart rate) (p ≥ 0.24, η_p ² ≤ 0.07). Conclusion: Nasal-only breathing seems to be associated with possible physiological changes that may help to maintain physical health in endurance athletes during low intensity endurance training. However, it did not prevent participants from performing low-intensity training at higher intensities than intended. Longitudinal studies are warranted to evaluate longitudinal responses of changes in breathing patterns.

Acute ventilatory responses to swimming at increasing intensities

Background

Physical exercise is a source of stress to the human body, triggering different ventilatory responses through different regulatory mechanisms and the aquatic environment imposes several restrictions to the swimmer, particularly regarding the restricted ventilation. Thus, we aimed to assess the acute ventilatory responses and to characterize the adopted breathing patterns when swimming front crawl at increasing intensity domains.

Methods

Eighteen well-trained swimmers performed 7 × 200 m front crawl (0.05 m∙s^-1 velocity increments) and a maximal 100 m (30 s rest intervals). Pulmonary gas exchange and ventilation were continuously measured (breath-by-breath) and capillary blood samples for lactate concentration ([La^-]) analysis were collected at rest, during intervals and at the end of the protocol, allowing the identification of the low, moderate, heavy, severe and extreme intensity domains.

Results

With the swimming velocity rise, respiratory frequency (f _R), [La^-] and stroke rate (SR) increased ([29.1-49.7] breaths∙min^-1, [2.7-11.4] mmol∙L^-1, [26.23-40.85] cycles; respectively) and stroke length (SL) decreased ([2.43-2.04] m∙min^-1; respectively). Oxygen uptake (VO₂), minute ventilation (VE), carbon dioxide production (VCO₂) and heart rate (HR) increased until severe ([37.5-53.5] mL∙kg^-1∙min^-1, [55.8-96.3] L∙min^-1, [32.2-51.5] mL∙kg^-1∙min^-1 and [152-182] bpm; respectively) and stabilized from severe to extreme (53.1 ± 8.4, mL∙kg^-1∙min^-1, 99.5 ± 19.1 L∙min^-1, 49.7 ± 8.3 mL∙kg^-1∙min^-1 and 186 ± 11 bpm; respectively) while tidal volume (V_T) was similar from low to severe ([2.02-2.18] L) and decreased at extreme intensities (2.08 ± 0.56 L). Lastly, the f _R/SR ratio increased from low to heavy and decreased from severe to the extreme intensity domains (1.12 ± 0.24, 1.19 ± 0.25, 1.26 ± 0.26, 1.32 ± 0.26 and 1.23 ± 0.26).

Conclusions

Our findings confirm a different ventilatory response pattern at extreme intensities when compared to the usually evaluated exertions. This novel insight helps to understand and characterize the maximal efforts in swimming and reinforces the importance to include extreme efforts in future swimming evaluations.

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

BACKGROUND

Wearing face masks in public is an effective strategy for preventing the spread of viruses; however, it may negatively affect exercise responses. Therefore, this review aimed to explore the effects of wearing different types of face masks during exercise on various physiological and psychological outcomes in healthy individuals.

METHODS

A literature search was conducted using relevant electronic databases, including Medline, PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials on April 05, 2022. Studies examining the effect of mask wearing (surgical mask, cloth mask, and FFP2/N95 respirator) during exercise on various physiological and psychological parameters in apparently healthy individuals were included. For meta-analysis, a random effects model was used. Mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI) were calculated to analyze the total effect and the effect in subgroups classified based on face mask and exercise types. The quality of included studies was examined using the revised Cochrane risk-of-bias tool.

RESULTS

Forty-five studies with 1264 participants (708 men) were included in the systematic review. Face masks had significant effects on gas exchange when worn during exercise; this included differences in oxygen uptake (SMD - 0.66, 95% CI - 0.87 to - 0.45), end-tidal partial pressure of oxygen (MD - 3.79 mmHg, 95% CI - 5.46 to - 2.12), carbon dioxide production (SMD - 0.77, 95% CI - 1.15 to - 0.39), and end-tidal partial pressure of carbon dioxide (MD 2.93 mmHg, 95% CI 2.01-3.86). While oxygen saturation (MD - 0.48%, 95% CI - 0.71 to - 0.26) decreased slightly, heart rate was not affected. Mask wearing led to higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation. Moreover, a small effect on exercise performance was observed in individuals wearing FFP2/N95 respirators (SMD - 0.42, 95% CI - 0.76 to - 0.08) and total effect (SMD - 0.23, 95% CI - 0.41 to - 0.04).

CONCLUSION

Wearing face masks during exercise modestly affected both physiological and psychological parameters, including gas exchange, pulmonary function, and subjective discomfort in healthy individuals, although the overall effect on exercise performance appeared to be small. This review provides updated information on optimizing exercise recommendations for the public during the COVID-19 pandemic.

SYSTEMATIC REVIEW REGISTRATION NUMBER

This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42021287278).

Rope Jumping Strength Monitoring on Smart Devices via Passive Acoustic Sensing

Rope jumping, as a fitness exercise recommended by many sports medicine practitioners, can improve cardiorespiratory capacity and physical coordination. Existing rope jump monitoring systems have limitations in terms of convenience, comfort, and exercise intensity evaluation. This paper presents a rope jump monitoring system using passive acoustic sensing. Our system exploits the off-the-shelf smartphone and headphones to capture the user's rope-jumping sound and breathing sound after exercise. Given the captured acoustic data, the system uses a short-time energy-based approach and the high correlation between rope jumping cycles to detect the rope-jumping sound frames, then applies a dual-threshold endpoint detection algorithm to calculate the number of rope jumps. Finally, our system performs regression predictions of exercise intensity based on features extracted from the jumping speed and the mel spectrograms of the user's breathing sound. The significant advantage of the system lies in the solution of the problem of poorly characterized mel spectrograms. We employ an attentive mechanism-based GAN to generate optimized breathing sound mel spectrograms and apply domain adversarial adaptive in the network to improve the migration capability of the system. Through extensive experiments, our system achieves (on average) 0.32 and 2.3% error rates for the rope jumping count and exercise intensity evaluation, respectively.

Repeatability of ventilatory, metabolic and biomechanical responses to an intermittent incremental swimming protocol

OBJECTIVE

This study aimed to determine the repeatability of ventilatory, metabolic and biomechanical variables assessed at a large spectrum of front crawl swimming intensities. We hypothesized a strong agreement (combined with a small range of variation) between a typical step protocol performed in two experimental moments.

APPROACH

Forty competitive swimmers performed a 7 x 200 m front crawl intermittent incremental protocol (0.05 m∙s-1 velocity rises and 30 s intervals) on two different occasions (48-72 h apart). Pulmonary gas exchange and ventilation were continuously measured breath-by-breath, metabolic variables were assessed during the intervals and biomechanical analysis was done at every protocol step.

MAIN RESULTS

Concomitantly with the velocity increment, oxygen uptake, carbon dioxide production, ventilation, respiratory frequency, respiratory exchange ratio, averaged expiratory concentrations, end tidal oxygen and ventilatory equivalents for oxygen and carbon dioxide and blood lactate concentrations rose (p < 0.001), averaged expiratory concentrations and end tidal carbon dioxide and duration of inspiration, expiration and total breathing cycle decreased (p < 0.001), while tidal volume and volumes of oxygen and carbon dioxide expired maintained constant. Stroke frequency and stroke length increased and decreased (respectively) with the swimming velocity raise. No differences between experimental moments were observed in most of the assessed variables (p > 0.05), with a low dispersion (0.49-9.94%) except for lactate concentrations and inspiration and expiration durations (11.00-17.16%). Moderate-nearly perfect direct relationships and a good-excellent degree of reliability between moments were verified for all the assessed variables (r = 0.50-1.00, ICC = 0.76-1.00, p < 0.001), except for respiratory exchange ratio.

SIGNIFICANCE

The reliability analysis confirmed the repeatability of the assessed ventilatory, metabolic and biomechanical variables, with the obtained data well representing swimmers physiological condition when monitoring performance through a commonly used step protocol.

Estimation of Tidal Volume during Exercise Stress Test from Wearable-Device Measures of Heart Rate and Breathing Rate

Tidal volume (TV), defined as the amount of air that moves in or out of the lungs with each respiratory cycle, is important in evaluating the respiratory function. Although TV can be reliably measured in laboratory settings, this information is hardly obtainable under everyday living conditions. Under such conditions, wearable devices could provide valuable support to monitor vital signs, such as heart rate (HR) and breathing rate (BR). The aim of this study was to develop a model to estimate TV from wearable-device measures of HR and BR during exercise. HR and BR were acquired through the Zephyr Bioharness 3.0 wearable device in nine subjects performing incremental cycling tests. For each subject, TV during exercise was obtained with a metabolic cart (Cosmed). A stepwise regression algorithm was used to create the model using as possible predictors HR, BR, age, and body mass index; the model was then validated using a leave-one-subject-out cross-validation procedure. The performance of the model was evaluated using the explained variance (R2), obtaining values ranging from 0.65 to 0.72. The proposed model is a valid method for TV estimation with wearable devices and can be considered not subject-specific and not instrumentation-specific.

Potential impacts of Washington State's wildfire worker protection rule on construction workers

Driven by climate change, wildfires are increasing in frequency, duration, and intensity across the Western United States. Outdoor workers are being exposed to increasing wildfire-related particulate matter and smoke. Recognizing this emerging risk, Washington adopted an emergency rule and is presently engaged in creating a permanent rule to protect outdoor workers from wildfire smoke exposure. While there are growing bodies of literature on the exposure to and health effects of wildfire smoke in the general public and wildland firefighters, there is a gap in knowledge about wildfire smoke exposure among outdoor workers generally and construction workers specifically-a large category of outdoor workers in Washington totaling 200,000 people. Several data sources were linked in this study-including state-collected employment data and national ambient air quality data-to gain insight into the risk of PM2.5 exposure among construction workers and evaluate the impacts of different air quality thresholds that would have triggered a new Washington emergency wildfire smoke rule aimed at protecting workers from high PM2.5 exposure. Results indicate the number of poor air quality days has increased in August and September in recent years. Over the last decade, these months with the greatest potential for particulate matter exposure coincided with an annual peak in construction employment that was typically 9.4-42.7% larger across Washington counties (one county was 75.8%). Lastly, the 'encouraged' threshold of the Washington emergency rule (20.5 μg m-3) would have resulted in 5.5 times more days subject to the wildfire rule on average across all Washington counties compared to its 'required' threshold (55.5 μg m-3), and in 2020, the rule could have created demand for 1.35 million N-95 filtering facepiece respirators among construction workers. These results have important implications for both employers and policy makers as rules are developed. The potential policy implications of wildfire smoke exposure, exposure control strategies, and data gaps that would improve understanding of construction worker exposure to wildfire smoke are also discussed.

How to Investigate the Effect of Music on Breathing during Exercise: Methodology and Tools

Music is an invaluable tool to improve affective valence during exercise, with the potential contribution of a mechanism called rhythmic entrainment. However, several methodological limitations impair our current understanding of the effect of music on relevant psychophysiological responses to exercise, including breathing variables. This study presents conceptual, methodological, and operational insight favoring the investigation of the effect of music on breathing during exercise. Three tools were developed for the quantification of the presence, degree, and magnitude of music-locomotor, locomotor-breathing, and music-breathing entrainment. The occurrence of entrainment was assessed during 30 min of moderate cycling exercise performed either when listening to music or not, and was complemented by the recording of relevant psychophysiological and mechanical variables. Respiratory frequency and expiratory time were among the physiological variables that were affected to a greater extent by music during exercise, and a significant (p < 0.05) music-breathing entrainment was found in all 12 participants. These findings suggest the importance of evaluating the effect of music on breathing responses to exercise, with potential implications for exercise prescription and adherence, and for the development of wearable devices simultaneously measuring music, locomotor, and breathing signals.

Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running

Running is among the most popular sporting hobbies and often chosen specifically for intrinsic psychological benefits. However, up to 40% of runners may experience exercise-induced dyspnoea as a result of cascading physiological phenomena, possibly causing negative psychological states or barriers to participation. Breathing techniques such as slow, deep breathing have proven benefits at rest, but it is unclear if they can be used during exercise to address respiratory limitations or improve performance. While direct experimental evidence is limited, diverse findings from exercise physiology and sports science combined with anecdotal knowledge from Yoga, meditation, and breathwork suggest that many aspects of breathing could be improved via purposeful strategies. Hence, we sought to synthesize these disparate sources to create a new theoretical framework called “Breath Tools” proposing breathing strategies for use during running to improve tolerance, performance, and lower barriers to long-term enjoyment.

Cardiorespiratory responses to muscle metaboreflex activation in fibrosing interstitial lung disease

New Findings

What is the central question of this study?

We determined whether sensory feedback from metabolically sensitive skeletal muscle afferents (metaboreflex) causes a greater ventilatory response and higher dyspnoea ratings in fibrosing interstitial lung disease (FILD).

What is the main finding and its importance?

Ventilatory responses and dyspnoea ratings during handgrip exercise and metaboreflex isolation were not different in FILD and control groups. Blood pressure and heart rate responses to handgrip were attenuated in FILD but not different to controls during metaboreflex isolation. These findings suggest that the muscle metaboreflex contribution to the respiratory response to exercise is not altered in FILD.

Abstract

Exercise limitation and dyspnoea are hallmarks of fibrosing interstitial lung disease (FILD); however, the physiological mechanisms are poorly understood. In other respiratory diseases, there is evidence that an augmented muscle metaboreflex may be implicated. We hypothesized that metaboreflex activation in FILD would result in elevated ventilation and dyspnoea ratings compared to healthy controls, due to augmented muscle metaboreflex. Sixteen FILD patients (three women, 69±14 years; mean±SD) and 16 age‐matched controls (four women, 67±7 years) were recruited. In a randomized cross‐over design, participants completed two min of rhythmic handgrip followed by either (i) two min of post‐exercise circulatory occlusion (PECO trial) to isolate muscle metaboreflex activation, or (ii) rested for four min (Control trial). Minute ventilation (V˙E; pneumotachometer), dyspnoea ratings (0–10 Borg scale), mean arterial pressure (MAP; finger photoplethysmography) and heart rate (HR; electrocardiogram) were measured. V˙E was higher in the FILD group at baseline and exercise increased V˙E similarly in both groups. V˙E remained elevated during PECO, but there was no between‐group difference in the magnitude of this response (ΔV˙E FILD 4.2 ± 2.5 L·min^–1 vs. controls 3.6 ± 2.4 L·min^–1, P = 0.596). At the end of PECO, dyspnoea ratings in FILD were similar to controls (1.0 ± 1.3 units vs. 0.5 ± 1.1 units). Exercise increased MAP and HR (P < 0.05) in both groups; however, responses were lower in FILD. Collectively, these findings suggest that there is not an augmented effect of the muscle metaboreflex on breathing and dyspnoea in FILD, but haemodynamic responses to handgrip are reduced relative to controls.

The Impact of Ubiquitous Face Masks and Filtering Face Piece Application During Rest, Work and Exercise on Gas Exchange, Pulmonary Function and Physical Performance: A Systematic Review with Meta-analysis

BACKGROUND

Protection against airborne infection is currently, due to the COVID-19-associated restrictions, ubiquitously applied during public transport use, work and leisure time. Increased carbon dioxide re-inhalation and breathing resistance may result thereof and, in turn, may negatively impact metabolism and performance.

OBJECTIVES

To deduce the impact of the surgical mask and filtering face piece type 2 (FFP2) or N95 respirator application on gas exchange (pulse-derived oxygen saturation (SpO₂), carbon dioxide partial pressure (PCO₂), carbon dioxide exhalation (VCO₂) and oxygen uptake (VO₂)), pulmonary function (respiratory rate and ventilation) and physical performance (heart rate HR, peak power output W_peak).

METHODS

Systematic review with meta-analysis. Literature available in Medline/Pubmed, the Cochrane Library and the Web of Knowledge with the last search on the 6^th of May 2021. Eligibility criteria: Randomised controlled parallel group or crossover trials (RCT), full-text availability, comparison of the acute effects of ≥ 1 intervention (surgical mask or FFP2/N95 application) to a control/comparator condition (i.e. no mask wearing). Participants were required to be healthy humans and > 16 years of age without conditions or illnesses influencing pulmonary function or metabolism. Risk of bias was rated using the crossover extension of the Cochrane risk of bias assessment tool II. Standardised mean differences (SMD, Hedges' g) with 95% confidence intervals (CI) were calculated, overall and for subgroups based on mask and exercise type, as pooled effect size estimators in our random-effects meta-analysis.

RESULTS

Of the 1499 records retrieved, 14 RCTs (all crossover trials, high risk of bias) with 25 independent intervention arms (effect sizes per outcome) on 246 participants were included. Masks led to a decrease in SpO₂ during vigorous intensity exercise (6 effect sizes; SMD = - 0.40 [95% CI: - 0.70, - 0.09], mostly attributed to FFP2/N95) and to a SpO₂-increase during rest (5 effect sizes; SMD = 0.34 [95% CI: 0.04, 0.64]); no general effect of mask wearing on SpO₂ occurred (21 effect sizes, SMD = 0.34 [95% CI: 0.04, 0.64]). Wearing a mask led to a general oxygen uptake decrease (5 effect sizes, SMD = - 0.44 [95% CI: - 0.75, - 0.14]), to slower respiratory rates (15 effect sizes, SMD = - 0.25 [95% CI: - 0.44, - 0.06]) and to a decreased ventilation (11 effect sizes, SMD = - 0.43 [95% CI: - 0.74, - 0.12]). Heart rate (25 effect sizes; SMD = 0.05 [95% CI: - 0.09, 0.19]), W_peak (9 effect sizes; SMD = - 0.12 [95% CI: - 0.39, 0.15]), PCO₂ (11 effect sizes; SMD = 0.07 [95% CI: - 0.14, 0.29]) and VCO₂ (4 effect sizes, SMD = - 0.30 [95% CI: - 0.71, 0.10]) were not different to the control, either in total or dependent on mask type or physical activity status.

CONCLUSION

The number of crossover-RCT studies was low and the designs displayed a high risk of bias. The within-mask- and -intensity-homogeneous effects on gas exchange kinetics indicated larger detrimental effects during exhausting physical activities. Pulse-derived oxygen saturation was increased during rest when a mask was applied, whereas wearing a mask during exhausting exercise led to decreased oxygen saturation. Breathing frequency and ventilation adaptations were not related to exercise intensity. FFP2/N95 and, to a lesser extent, surgical mask application negatively impacted the capacity for gas exchange and pulmonary function but not the peak physical performance. Registration: Prospero registration number: CRD42021244634.

What We Are Learning from COVID-19 for Respiratory Protection: Contemporary and Emerging Issues

Infectious respiratory diseases such as the current COVID-19 have caused public health crises and interfered with social activity. Given the complexity of these novel infectious diseases, their dynamic nature, along with rapid changes in social and occupational environments, technology, and means of interpersonal interaction, respiratory protective devices (RPDs) play a crucial role in controlling infection, particularly for viruses like SARS-CoV-2 that have a high transmission rate, strong viability, multiple infection routes and mechanisms, and emerging new variants that could reduce the efficacy of existing vaccines. Evidence of asymptomatic and pre-symptomatic transmissions further highlights the importance of a universal adoption of RPDs. RPDs have substantially improved over the past 100 years due to advances in technology, materials, and medical knowledge. However, several issues still need to be addressed such as engineering performance, comfort, testing standards, compliance monitoring, and regulations, especially considering the recent emergence of pathogens with novel transmission characteristics. In this review, we summarize existing knowledge and understanding on respiratory infectious diseases and their protection, discuss the emerging issues that influence the resulting protective and comfort performance of the RPDs, and provide insights in the identified knowledge gaps and future directions with diverse perspectives.

Ozone Exposure, Outdoor Physical Activity, and Incident Type 2 Diabetes in the SALSA Cohort of Older Mexican Americans

BACKGROUND

Type 2 diabetes is a leading contributor to the global burden of morbidity and mortality. Ozone (O3) exposure has previously been linked to diabetes.

OBJECTIVE

We studied the impact of O3 exposure on incident diabetes risk in elderly Mexican Americans and investigated whether outdoor physical activity modifies the association.

METHODS

We selected 1,090 Mexican American participants from the Sacramento Area Latino Study on Aging conducted from 1998 to 2007. Ambient O3 exposure levels were modeled with a land-use regression built with saturation monitoring data collected at 49 sites across the Sacramento metropolitan area. Using Cox proportional hazard models, we estimated the risk of developing incident diabetes based on average O3 exposure modeled for 5-y prior to incident diabetes diagnosis or last follow-up. Further, we estimated outdoor leisure-time physical activity at baseline and investigated whether higher vs. lower levels modified the association between O3 exposure and diabetes.

RESULTS

In total, 186 incident diabetes cases were identified during 10-y follow-up. Higher levels of physical activity were negatively associated with incident diabetes [hazard ratio (HR)=0.64 (95% CI: 0.43, 0.95)]. The estimated HRs for incident diabetes was 1.13 (95% CI: 1.00, 1.28) per 10-ppb increment of 5-y average O3 exposure; also, this association was stronger among those physically active outdoors [HR=1.52 (95% CI: 1.21, 1.90)], and close to null for those reporting lower levels of outdoor activity [HR=1.04 (95% CI: 0.90, 1.20), pinteraction=0.01].

CONCLUSIONS

Our findings suggest that ambient O3 exposure contributes to the development of type 2 diabetes, particularly among those with higher levels of leisure-time outdoor physical activity. Policies and strategies are needed to reduce O3 exposure to guarantee that the health benefits of physical activity are not diminished by higher levels of O3 pollution in susceptible populations such as older Hispanics. https://doi.org/10.1289/EHP8620.

Intercostal Muscles Oxygenation and Breathing Pattern during Exercise in Competitive Marathon Runners

The study aimed to evaluate the association between the changes in ventilatory variables (tidal volume (Vt), respiratory rate (RR) and lung ventilation (V.E)) and deoxygenation of m.intescostales (∆SmO₂-m.intercostales) during a maximal incremental exercise in 19 male high-level competitive marathon runners. The ventilatory variables and oxygen consumption (V.O₂) were recorded breath-by-breath by exhaled gas analysis. A near-infrared spectroscopy device (MOXY^®) located in the right-hemithorax allowed the recording of SmO₂-m.intercostales. To explore changes in oxygen levels in muscles with high demand during exercise, a second MOXY^® records SmO₂-m.vastus laterallis. The triphasic model of exercise intensity was used for evaluating changes in SmO₂ in both muscle groups. We found that ∆SmO₂-m.intercostales correlated with V.O_2-peak (r = 0.65; p = 0.002) and the increase of V.E (r = 0.78; p = 0.001), RR (r = 0.54; p = 0.001), but not Vt (p = 0.210). The interaction of factors (muscles × exercise-phases) in SmO₂ expressed as an arbitrary unit (a.u) was significant (p = 0.005). At VT1 there was no difference (p = 0.177), but SmO₂-m.intercostales was higher at VT2 (p < 0.001) and V.O_2-peak (p < 0.001). In high-level competitive marathon runners, the m.intercostales deoxygenation during incremental exercise is directly associated with the aerobic capacity and increased lung ventilation and respiratory rate, but not tidal volume. Moreover, it shows less deoxygenation than m.vastus laterallis at intensities above the aerobic ventilatory threshold.

Effects of Prior Voluntary Hyperventilation on the 3-min All-Out Cycling Test in Men

INTRODUCTION

The ergogenic effects of respiratory alkalosis induced by prior voluntary hyperventilation (VH) are controversial. This study examined the effects of prior VH on derived parameters from the 3-min all-out cycling test (3MT).

METHODS

Eleven men ( = 46 ± 8 mL·kg-1·min-1) performed a 3MT preceded by 15 min of rest (CONT) or VH ( = 38 ± 5 L·min-1) with PETCO2 reduced to 21 ± 1 mm Hg (HYP). End-test power (EP; synonymous with critical power) was calculated as the mean power output over the last 30 s of the 3MT, and the work done above EP (WEP; synonymous with W') was calculated as the power-time integral above EP.

RESULTS

At the start of the 3MT, capillary blood PCO2 and [H+] were lower in HYP (25.2 ± 3.0 mm Hg, 27.1 ± 2.6 nmol·L-1) than CONT (43.2 ± 2.0 mm Hg, 40.0 ± 1.5 nmol·L-1) (P < 0.001). At the end of the 3MT, blood PCO2 was still lower in HYP (35.7 ± 5.4 mm Hg) than CONT (40.6 ± 5.0 mm Hg) (P < 0.001). WEP was 10% higher in HYP (19.4 ± 7.0 kJ) than CONT (17.6 ± 6.4 kJ) (P = 0.006), whereas EP was 5% lower in HYP (246 ± 69 W) than CONT (260 ± 74 W) (P = 0.007). The ΔWEP (J·kg-1) between CONT and HYP correlated positively with the PCO2 immediately before the 3MT in HYP (r = 0.77, P = 0.006).

CONCLUSION

These findings suggest that acid-base changes elicited by prior VH increase WEP but decrease EP during the all-out 3MT.

Assessing the Tidal Volume through Wearables: A Scoping Review

The assessment of respiratory activity based on wearable devices is becoming an area of growing interest due to the wide range of available sensors. Accordingly, this scoping review aims to identify research evidence supporting the use of wearable devices to monitor the tidal volume during both daily activities and clinical settings. A screening of the literature (Pubmed, Scopus, and Web of Science) was carried out in December 2020 to collect studies: i. comparing one or more methodological approaches for the assessment of tidal volume with the outcome of a state-of-the-art measurement device (i.e., spirometry or optoelectronic plethysmography); ii. dealing with technological solutions designed to be exploited in wearable devices. From the initial 1031 documents, only 36 citations met the eligibility criteria. These studies highlighted that the tidal volume can be estimated by using different technologies ranging from IMUs to strain sensors (e.g., resistive, capacitive, inductive, electromagnetic, and optical) or acoustic sensors. Noticeably, the relative volumetric error of these solutions during quasi-static tasks (e.g., resting and sitting) is typically ≥10% but it deteriorates during dynamic motor tasks (e.g., walking). As such, additional efforts are required to improve the performance of these devices and to identify possible applications based on their accuracy and reliability.

Applying ubiquitous sensing to estimate perceived exertion based on cardiorespiratory features

Reliable monitoring of one’s response to exercise intensity is imperative to effectively plan and manage training, but not always practical in impact sports settings. This study aimed to evaluate if an inexpensive mobile cardio-respiratory monitoring system can achieve similar performance to a metabolic cart in estimating rated perceived exertion. Eight adult men volunteered to perform treadmill tests under different conditions. Cardiorespiratory data were collected using a metabolic cart and an instrumented oral-cavity device, as well as their ratings of perceived exertion. Pearson correlation corrected for repeated measurements and stepwise regression analysis were used to observe the relationship between the cardiorespiratory features and the ratings of perceived exertion and determine the proportion of the variance of exertion that could be explained by the measurements. Minute ventilation was found to be the most associated variable to perceived exertion, closely followed by a novel metric called the audio minute volume, which can be collected by the oral-cavity device. A generalised linear model combining minute ventilation, audio minute volume, heart rate and respiration rate accounted for 64% of the variance in perceived exertion, whilst a model with only audio minute volume accounted for 56%. Our study indicates that minute ventilation is key to estimating perceived exertion during indoor running exercises. Audio minute volume was also observed to perform comparably to a lab-based metabolic cart in estimating perceived exertion. This research indicates that mobile techniques offer the potential for real-world data collection of an athlete’s physiological load and estimation of perceived exertion.

Effects of induced local ischemia during a 4-km cycling time trial on neuromuscular fatigue development

The present study analyzed the effects of local ischemia during endurance exercise on neuromuscular fatigue (NMF). Nine cyclists performed, in a counterbalanced order, two separate 4-km cycling time trials (TT) with (ISCH) or without (CONTR) induced local ischemia. NMF was characterized by using isometric maximal voluntary contractions (IMVC), whereas central [voluntary activation (VA)] and peripheral fatigue [peak torque of potentiated twitch (TwPt)] of knee extensors were evaluated using electrically evoked contractions performed before (PRE) and 1 min after (POST) the TT. Electromyographic activity (EMG), power output (PO), oxygen uptake (V̇o₂), and rating of perceived exertion (RPE) were also recorded. The decrease in IMVC (-15 ± 9% vs. -10 ± 8%, P = 0.66), VA (-4 ± 3% vs. -3 ± 3%, P = 0.46), and TwPt (-16 ± 7% vs. -19 ± 14%, P = 0.67) was similar in ISCH and CONTR. Endurance performance was drastically reduced in ISCH condition (512 ± 29 s) compared with CONTR (386 ± 17 s) (P < 0.001), which was accompanied by lower EMG, PO, and V̇o₂ responses (all P < 0.05). RPE was greater in ISCH compared with CONTR (P < 0.05), but the rate of change was similar throughout the TT (8.19 ± 2.59 vs. 7.81 ± 2.01 RPE.% of total time^-1, P > 0.05). These results indicate that similar end-exercise NMF levels were accompanied by impaired endurance performance in ISCH compared with CONTR. These novel findings suggest that the local reduced oxygen availability affected the afferent feedback signals to the central nervous system, ultimately increasing perceived effort and reducing muscle activity and exercise intensity to avoid surpassing a sensory tolerance limit before the finish line.

The effects of sinusoidal linear drifts on the estimation of cardiorespiratory dynamic parameters during sinusoidal workload forcing: a simulation study

This study aimed at investigating whether: 1) different sinusoidal linear drifts would affect the estimation of the dynamic parameters amplitude (A) and phase lag (φ) of minute ventilation (V˙_E), oxygen uptake, carbon dioxide production and heart rate (HR) sinusoidal responses when the frequency analysis technique (F) is performed; 2) the Marquardt-Levenberg non-linear fitting technique (ML) would provide more precise estimations of A and φ of drifted sinusoidal responses compared to F. For each cardiorespiratory variable, fifteen responses to sinusoidal forcing of different sinusoidal periods were simulated by using a first-order dynamic linear model. A wide range of linear drifts were subsequently applied. A and φ were computed for all drifted and non-drifted responses by using both F (A_F and φ_F) and ML (A_ML and φ_ML). For non-drifted responses, no differences between A_F vs A_ML and φ_F vs φ_ML were found. Whereas A_F and φ_F were affected by the sinusoidal linear drifts, A_ML and φ_ML were not. Significant interaction effects (technique x drift) were found for A (P <  0.001; ƞ_P² > 0.247) and φ (P <  0.001; ƞ_P² > 0.851). Higher goodness of fit values were observed when using ML for drifted V˙_E and HR responses only. The present findings suggest ML as a recommended technique to use when sinusoidal linear drifts occur during sinusoidal exercise, and provide new insights on how to analyse drifted cardiorespiratory sinusoidal responses.

Breath-Jockey: Development and Feasibility Assessment of a Wearable System for Respiratory Rate and Kinematic Parameter Estimation for Gallop Athletes

In recent years, wearable devices for physiological parameter monitoring in sports and physical activities have been gaining momentum. In particular, some studies have focused their attention on using available commercial monitoring systems mainly on horses during training sessions or competitions. Only a few studies have focused on the jockey's physiological and kinematic parameters. Although at a glance, it seems jockeys do not make a lot of effort during riding, it is quite the opposite. Indeed, especially during competitions, they profuse a short but high intensity effort. To this extend, we propose a wearable system integrating conductive textiles and an M-IMU to simultaneously monitor the respiratory rate (RR) and kinematic parameters of the riding activity. Firstly, we tested the developed wearable system on a healthy volunteer mimicking the typical riding movements of jockeys and compared the performances with a reference instrument. Lastly, we tested the system on two gallop jockeys during the "137∘ Derby Italiano di Galoppo". The proposed system is able to track both the RR and the kinematic parameters during the various phases of the competition both at rest and during the race.

The effect of pedalling cadence on respiratory frequency: passive vs. active exercise of different intensities

PURPOSE

Pedalling cadence influences respiratory frequency (f_R) during exercise, with group III/IV muscle afferents possibly mediating its effect. However, it is unclear how exercise intensity affects the link between cadence and f_R. We aimed to test the hypothesis that the effect of cadence on f_R is moderated by exercise intensity, with interest in the underlying mechanisms.

METHODS

Ten male cyclists performed a preliminary ramp incremental test and three sinusoidal experimental tests on separate visits. The experimental tests consisted of 16 min of sinusoidal variations in cadence between 115 and 55 rpm (sinusoidal period of 4 min) performed during passive exercise (PE), moderate exercise (ME) and heavy exercise (HE). The amplitude (A) and phase lag (φ) of the dependent variables were calculated.

RESULTS

During PE, f_R changed in proportion to variations in cadence (r = 0.85, P < 0.001; A = 3.9 ± 1.4 breaths·min^-1; φ = - 5.3 ± 13.9 degrees). Conversely, the effect of cadence on f_R was reduced during ME (r = 0.73, P < 0.001; A = 2.6 ± 1.3 breaths·min^-1; φ = - 25.4 ± 26.3 degrees) and even more reduced during HE (r = 0.26, P < 0.001; A = 1.8 ± 1.0 breaths·min^-1; φ = - 70.1 ± 44.5 degrees). No entrainment was found in any of the sinusoidal tests.

CONCLUSION

The effect of pedalling cadence on f_R is moderated by exercise intensity-it decreases with the increase in work rate-and seems to be mediated primarily by group III/IV muscle afferents, at least during passive exercise.

The Importance of Respiratory Rate Monitoring: From Healthcare to Sport and Exercise

Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.

Low Frequency Severe-Intensity Interval Training Markedly Alters Respiratory Compensation Point During Incremental Exercise in Untrained Male

This study investigated the effect of low-frequency severe-intensity interval training on the respiratory compensation point (RCP) during incremental exercise test. Eighteen healthy males (age; 20.7 ± 2.2 years, range 18 to 29 years, height; 174.0 ± 5.6 cm, weight; 68.8 ± 13.5 kg) were randomly assigned to an interval training group or a control group. Interval training was conducted once weekly for 3 months. Each session consisted of three bouts of bicycle ergometer exercise at 80% maximum work rate until volitional fatigue. Before (baseline) and after the 3-month intervention, incremental exercise test was performed on a bicycle ergometer for determination of ventilatory threshold (VT), RCP, and peak oxygen consumption (V̇_{O 2} peak). The training program resulted in significant increases of V̇_{O 2} peak (+ 14%, p < 0.001, η p 2 = 0.437), oxygen consumption (V̇_{O 2}) at VT (+ 18%, p < 0.001, η p 2 = 0.749) and RCP (+ 15%, p = 0.03, η p 2 = 0.239) during incremental exercise test in the training group. Furthermore, a significant positive correlation was observed between the increase in V̇_{O 2} peak and increase in V̇_{O 2} at RCP after intervention (r = 0.87, p = 0.002) in the training group. Tidal volumes at VT (p = 0.04, η p 2 = 0.270) and RCP (p = 0.01, η p 2 = 0.370) also increased significantly after intervention compared to baseline. Low-frequency severe-intensity interval training induced a shift in RCP toward higher work rate accompanied by higher tidal volume during incremental exercise test.

A mathematical framework for estimating risk of airborne transmission of COVID-19 with application to face mask use and social distancing

A mathematical model for estimating the risk of airborne transmission of a respiratory infection such as COVID-19 is presented. The model employs basic concepts from fluid dynamics and incorporates the known scope of factors involved in the airborne transmission of such diseases. Simplicity in the mathematical form of the model is by design so that it can serve not only as a common basis for scientific inquiry across disciplinary boundaries but it can also be understandable by a broad audience outside science and academia. The caveats and limitations of the model are discussed in detail. The model is used to assess the protection from transmission afforded by face coverings made from a variety of fabrics. The reduction in the transmission risk associated with increased physical distance between the host and susceptible is also quantified by coupling the model with available and new large eddy simulation data on scalar dispersion in canonical flows. Finally, the effect of the level of physical activity (or exercise intensity) of the host and the susceptible in enhancing the transmission risk is also assessed.

Respiratory Frequency as a Marker of Physical Effort During High-Intensity Interval Training in Soccer Players

PURPOSE

Variables currently used in soccer training monitoring fail to represent the physiological demand of the player during movements like accelerations, decelerations, and directional changes performed at high intensity. We tested the hypothesis that respiratory frequency (fR) is a marker of physical effort during soccer-related high-intensity exercise.

METHODS

A total of 12 male soccer players performed a preliminary intermittent incremental test and 2 shuttle-run high-intensity interval training (HIIT) protocols, in separate visits. The 2 HIIT protocols consisted of 12 repetitions over 9 minutes and differed in the work-to-recovery ratio (15:30 vs 30:15 s). Work rate was self-paced by participants to achieve the longest possible total distance in each HIIT protocol.

RESULTS

Work-phase average metabolic power was higher (P < .001) in the 15:30-second protocol (31.7 [3.0] W·kg-1) compared with the 30:15-second protocol (22.8 [2.0] W·kg-1). Unlike heart rate and oxygen uptake, fR showed a fast response to the work-recovery alternation during both HIIT protocols, resembling changes in metabolic power even at supramaximal intensities. Large correlations (P < .001) were observed between fR and rating of perceived exertion during both 15:30-second (r = .87) and 30:15-second protocols (r = .85).

CONCLUSIONS

Our findings suggest that fR is a good marker of physical effort during shuttle-run HIIT in soccer players. These findings have implications for monitoring training in soccer and other team sports.

Reliability of NIRS portable device for measuring intercostal muscles oxygenation during exercise

This study assessed the intra-individual reliability of oxygen saturation in intercostal muscles (SmO₂-m.intercostales) during an incremental maximal treadmill exercise by using portable NIRS devices in a test-retest study. Fifteen marathon runners (age, 24.9 ± 2.0 years; body mass index, 21.6 ± 2.3 kg·m^-2; V̇O₂-peak, 63.7 ± 5.9 mL·kg^-1·min^-1) were tested on two separate days, with a 7-day interval between the two measurements. Oxygen consumption (V̇O₂) was assessed using the breath-by-breath method during the V̇O₂-test, while SmO₂ was determined using a portable commercial device, based in the near-infrared spectroscopy (NIRS) principle. The minute ventilation (VE), respiratory rate (RR), and tidal volume (Vt) were also monitored during the cardiopulmonary exercise test. For the SmO₂-m.intercostales, the intraclass correlation coefficient (ICC) at rest, first (VT1) and second ventilatory (VT2) thresholds, and maximal stages were 0.90, 0.84, 0.92, and 0.93, respectively; the confidence intervals ranged from -10.8% - +9.5% to -15.3% - +12.5%. The reliability was good at low intensity (rest and VT1) and excellent at high intensity (VT2 and max). The Spearman correlation test revealed (p ≤ 0.001) an inverse association of SmO₂-m.intercostales with V̇O₂ (ρ = -0.64), VE (ρ = -0.73), RR (ρ = -0.70), and Vt (ρ = -0.63). The relationship with the ventilatory variables showed that increased breathing effort during exercise could be registered adequately using a NIRS portable device.

Contact-Based Methods for Measuring Respiratory Rate

There is an ever-growing demand for measuring respiratory variables during a variety of applications, including monitoring in clinical and occupational settings, and during sporting activities and exercise. Special attention is devoted to the monitoring of respiratory rate because it is a vital sign, which responds to a variety of stressors. There are different methods for measuring respiratory rate, which can be classed as contact-based or contactless. The present paper provides an overview of the currently available contact-based methods for measuring respiratory rate. For these methods, the sensing element (or part of the instrument containing it) is attached to the subject's body. Methods based upon the recording of respiratory airflow, sounds, air temperature, air humidity, air components, chest wall movements, and modulation of the cardiac activity are presented. Working principles, metrological characteristics, and applications in the respiratory monitoring field are presented to explore potential development and applicability for each method.