Autonomic control of heart rate during and after exercise : measurements and implications for monitoring training status

Dose-response relationship between evening exercise and sleep

Public health guidelines recommend exercise as a key lifestyle intervention for promoting and maintaining healthy sleep function and reducing disease risk. However, strenuous evening exercise may disrupt sleep due to heightened sympathetic arousal. This study examines the association between strenuous evening exercise and objective sleep, using data from 14,689 physically active individuals who wore a biometric device during a one-year study interval (4,084,354 person-nights). Here we show later exercise timing and higher exercise strain are associated with delayed sleep onset, shorter sleep duration, lower sleep quality, higher nocturnal resting heart rate, and lower nocturnal heart rate variability. Regardless of strain, exercise bouts ending ≥4 hours before sleep onset are not associated with changes in sleep. Our results suggest evening exercise-particularly involving high exercise strain-may disrupt subsequent sleep and nocturnal autonomic function. Individuals aiming to improve sleep health may benefit from concluding exercise at least 4 hours before sleep onset or electing lighter strain exercises within this window.

Novel possibilities of acceleration time series for performance and acute fatigue assessment in uphill trail running

The potential for assessing performance and acute fatigue in uphill trail running (UTR) through acceleration time series remains underexplored. For this purpose, time-variability of body acceleration and covariation among limb acceleration were studied in UTR. Twenty competitive and young trail runners participated in a simulation UTR test covering a distance of 4758 meters, with a total elevation gain of 575 meters and an average slope of 13.6%. Four sections with clear slope differences were identified. Detrended Fluctuation Analysis of upper back acceleration and Principal Component Analysis among wrists and ankle acceleration were performed for the whole test and for each section.The outcomes were correlated with performance and standardized effect size was used to compare sections. The main findings suggest that (a) runners with higher performance showed less persistence in body acceleration fluctuations and greater interlimb diversity, and (b) the steepest parts, particularly the final and effortful section, showed increased persistence in body acceleration and some runners lost interlimb covariation.In conclusion, time-variability and coordination analyses of acceleration time series seem to be sensitive to performance and acute fatigue in UTR, which opens further possibilities for providing more integrative, dynamic, and practical assessment tools.

A seated virtual exercise program to improve cardiovascular function in adults with chronic neurological impairments: a randomized controlled trial

Background

Individuals with chronic neurological impairments often face significant barriers to regular exercise such as limited access to facilities, transportation challenges, and safety concerns. Tele-exercise has emerged as a potential solution to these challenges, particularly in the context of the COVID-19 pandemic. This study aimed to investigate the effects of a seated home-based tele-exercise regimen on cardiovascular function in adults with chronic neurological impairments.

Methods

In this virtual randomized controlled trial, 63 participants with Chronic Neurological Impairments were randomized into either a synchronous group that attended live online exercise sessions via Zoom, or an asynchronous group that accessed pre-recorded exercise sessions. Both groups completed three 45 min sessions per week focused on moderate to high-intensity seated exercises over 12 weeks. Primary outcomes including Heart Rate (HR) Recovery (HRR), HR at Rest (HR Rest) and HR at peak exercise (HR Max) were averaged across three sessions at baseline, mid-study, and end of study. Secondary outcomes, including satisfaction with the equipment and virtual format were assessed using custom-designed surveys, while exercise motivation, enjoyment, and quality of life were measured using standardized instruments.

Results

The analysis of HRR across the pre (p = 0.57), mid (p = 0.7), and post time points (p = 0.61) revealed no statistically significant differences between the synchronous and asynchronous groups. HR Rest and HR Max did not change over time. The synchronous group showed higher exercise motivation compared to the asynchronous group (p = 0.0001). Satisfaction with the virtual format was high, with 90% of participants reporting satisfaction with the use of the Polar heart rate monitor and 84% with Zoom.

Conclusion

While no significant cardiovascular improvements were observed, the study highlights the feasibility of a virtual, seated exercise program for individuals with chronic neurological impairments. The higher reported exercise motivation in the synchronous group suggests that live, interactive sessions may be more engaging for participants. These findings underscore the potential of tele-exercise programs to provide accessible, home-based interventions, though further research is necessary to assess their long-term impact on cardiovascular health and overall well-being.

Clinical Trial Registration

identifier (NCT04564495).

Enhancing cardiovascular monitoring: a non-linear model for characterizing RR interval fluctuations in exercise and recovery

This work aimed to develop and validate a novel non-linear model to characterize RR interval (RRi) time-dependent fluctuations throughout a rest-exercise-recovery protocol, offering a more precise and physiologically relevant representation of cardiac autonomic responses than traditional HRV metrics or linear approaches. Using data from a cohort of 272 elderly participants, the model employs logistic functions to capture the non-stationary and transient nature of RRi time-dependent fluctuations, with parameter estimation achieved via Hamiltonian Monte Carlo. Sobol sensitivity analysis identified baseline RRi (α) and recovery proportion (c) as the primary drivers of variability, underscoring their critical roles in autonomic regulation and resilience. Validation against real-world RRi data demonstrated robust model performance (R2 = 0.868, CI95%[0.834, 0.895] and Root Mean Square Error [RMSE] = 32.6 ms, CI95%[30.01, 35.77]), accurately reflecting autonomic recovery and exercise-induced fluctuations. By advancing real-time cardiovascular assessments, this framework holds significant potential for clinical applications in rehabilitation and cardiovascular monitoring in athletic contexts to optimize performance and recovery. These findings highlight the model's ability to provide precise, physiologically relevant assessments of autonomic function, paving the way for its use in personalized health monitoring and performance optimization across diverse populations.

The Effect of Heart Rate Variability Biofeedback on Recovery After Aerobic Exercise

Recovery is a critical factor in athletic performance, and accelerating this process is essential to enable athletes to perform more effectively in both training load and competitive performance. After exercise, immediate recovery is potentially helpful for investigating autonomic activity levels, as they are definable with heart rate variability (HRV). The purpose of this study was to examine the effect of ten sessions of HRV-Biofeedback (HRV-BF) training on recovery process parameters after the aerobic performance. In this study, twenty-four soccer players aged 18-24 volunteered to participate. The athletes who met the research criteria were divided into an experimental group (n = 12) and a control group (n = 12). Each participant's height, weight, BMI, body fat percentage, and aerobic capacity were measured before and after the 10-session intervention. The experimental group participated in a 10-session HRV-BF training and soccer training program, while the control group only participated in a 10-session soccer training program. Aerobic capacity tests were then applied again to experimental and control group participants. The effect of biofeedback on the three HRV parameters during the 5-minute acute recovery period after the test was investigated. The results showed that regularly applied HRV-BF training can significantly shorten the HRV recovery parameter after exercise. Specifically, the athletes who performed HRV-BF training demonstrated faster cardiovascular recovery after aerobic exercise. This suggests that implementing HRV-BF training for athletes can significantly accelerate their recovery processes during and after competitions. Given recent technological advancements, it is promising to consider adding HRV-BF training to stress management interventions, particularly in relation to physiological stress indicators.

Impact of exhaustive exercise on autonomic nervous system activity: insights from HRV analysis

Introduction

Exhaustive exercise is a common training method in sports, but its impact on the autonomic nervous system of the human body remains unclear. Understanding the effects of exhaustive exercise on the body and its connection with the autonomic nervous system and central nervous system is crucial for guiding healthy training methods.

Methods

Twenty-three participants were selected, and exhaustive exercise intervention was performed using the Bruce Protocol. By measuring heart rate variability (HRV), the effects of exhaustive exercise on the autonomic nervous system function were analyzed.

Results

After exhaustive exercise, time-domain indices SDNN, RMSSD, and PNN50 all significantly decreased, with changes reaching significant levels (p < 0.01). Among them, the decrease in pNN50 was particularly pronounced, with a change rate of -94.55%. Frequency-domain indices VLF, LF, and HF also showed significant decreases (p < 0.01), but the ratio of LF to HF showed an upward trend (p < 0.01), with LF showing a greater decrease. Nonlinear indices SD1 and SD2 showed extremely significant decreases (p < 0.01), and the SD2/SD1 ratio showed a significant increase (p < 0.01), indicating significant changes in HRV nonlinear characteristics after exercise.

Discussion

Exhaustive exercise leads to a decrease in autonomic nervous system activity and an increase in sympathetic nervous system activity. These findings underscore the profound impact of exhaustive exercise on the autonomic nervous system, with implications for understanding the physiological responses to intense physical exertion. Further research is warranted to explore the long-term effects of exhaustive exercise on autonomic regulation and its potential implications for training methodologies and athlete health.

Sensitivity of Minimally Invasive Protocols to Monitor Changes in Endurance Performance in Elite Junior Football (Soccer) Players

PURPOSE

Adequate physical fitness is a key requirement for elite footballers. Maximal fitness tests are the standard for evaluating fitness but are often fatiguing and time consuming. This study investigated the ability of various minimally invasive protocols to reflect changes in standard parameters of football players' physical fitness.

METHODS

Twenty-one elite junior footballers performed 2 standard fitness tests (stepwise incremental treadmill test with blood-lactate and heart-rate [HR] measurements and Yo-Yo Intermittent Recovery 1 test) and various proxy fitness evaluations (submaximal runs with measurement of exercise HR and HR recovery and external-to-internal load ratios with data collected during match play) 3 times over the course of 19 weeks. Changes in the standard parameters were compared with changes in proxy parameters.

RESULTS

Changes in maximal endurance performance showed small to moderate associations with HR-based proxy parameters (r = -.1 to -.46; P = .004-.56), whereas changes in the running velocity at anaerobic threshold had trivial to moderate associations (r = -.07 to -.39; P = .01-.67). Alterations in HR recovery following 2 short, submaximal runs were very largely correlated with changes in the running velocity corresponding to an HR of 170 beats·min-1 (r = -.74 and r = -.75; P < .001). Changes in external-to-internal load ratios derived from match play were not significantly correlated with changes in any of the standard parameters (r = -.03 to .31; P > .05).

CONCLUSIONS

Parameters of maximal running performance and parameters describing physiological thresholds do not seem to be adequately captured by different minimally invasive protocols. In contrast, HR recovery following short, submaximal runs may be a valid tool to monitor changes in aerobic endurance adaptations.

Dynamics of cardio-muscular networks in exercise and fatigue

A fundamental question in cardiovascular and muscle physiology is how the heart operates in synchrony with distinct muscles to regulate homeostasis, enable movement and adapt to exercise demands and fatigue. Here we investigate how autonomic regulation of cardiac function synchronizes and integrates as a network with the activity of distinct muscles during exercise. Further, we establish how the network of cardio-muscular interactions reorganizes with fatigue. Thirty healthy young adults performed two body weight squat tests until exhaustion. Simultaneous recordings were taken of a 3-lead electrocardiogram (EKG) along with electromyography (EMG) signals from the left and right vastus lateralis, and left and right erector spinae. We first obtained instantaneous heart rate (HR) derived from the EKG signal and decomposed the EMG recordings in 10 frequency bands (F1-F10). We next quantified pair-wise coupling (cross-correlation) between the time series for HR and all EMG spectral power frequency bands in each leg and back muscle. We uncovered the first profiles of cardio-muscular network interactions, which depend on the role muscles play during exercise and muscle fibre histochemical characteristics. Additionally, we observed a significant decline in the degree of cardio-muscular coupling with fatigue, characterized by complex transitions from synchronous to asynchronous behaviour across a range of timescales. The network approach we utilized introduces new avenues for the development of novel network-based markers, with the potential to characterize multilevel cardio-muscular interactions to assess global health, levels of fatigue, fitness status or the effectiveness of cardiovascular and muscle injury rehabilitation programmes. KEY POINTS: The heart operates in synchrony with muscles to regulate homeostasis, enable movement, and adapt to exercise demands and fatigue. However, the precise mechanisms regulating cardio-muscular coupling remain unknown. This study introduces a pioneering approach to assess cardio-muscular network interactions by examining the synchronization of cardiac function with muscle activity during exercise and fatigue. We uncover the first profiles of cardio-muscular interactions characterized by specific hierarchical organization of link strength. We observe a significant decline in the degree of cardio-muscular coupling with fatigue, marked by complex transitions from synchronous to asynchronous behaviour. This network approach offers new network-based markers to characterize multilevel cardio-muscular interactions to assess global health, levels of fatigue, fitness status or the effectiveness of cardiovascular and muscle injury rehabilitation programmes.

Effects of aerobic training on cardiopulmonary fitness in patients with long COVID-19: a randomized controlled trial

BACKGROUND

Long COVID-19 is characterized by systemic deterioration of the entire body, leading to significant physical and mental disorders. Exercise training has the potential to improve persistent symptoms and cardiopulmonary functions.

METHOD

This was a single-center, randomized, controlled trial. Twenty-four patients aged 18 to 75 years who had a history of SARS-CoV-2 infection and long COVID symptoms. Patients were randomly allocated in a 1:1 ratio to receive either a 4-week exercise training program or an attention control group. The training group participated in 12 supervised aerobic sessions on a cycling ergometer over 4 weeks. The outcomes were to assess the impact of a 4-week aerobic exercise on the persistent symptoms and cardiopulmonary fitness, the surrogate endpoints of COVID-19 recovery and cardiopulmonary health.

RESULTS

After the 4-week intervention, significant reductions were observed in the total number of symptoms in the training group. Specifically, 67.8% of patients in the training group exhibited reduced or completely resolved symptoms, in comparison to 16.7% in the control group (P = 0.013). After adjusting for gender, significant improvements in the training group were observed for exercise time (Pgroup*time = 0.028), maximum load (Pgroup*time = 0.01), and peak VO2 (Pgroup*time = 0.001), as well as O2 pulse (Pgroup*time = 0.042) and maximum heart rate (Pgroup*time = 0.007). The score of Short Form-12, depression, anxiety, perceived stress, and insomnia did not show significant changes between groups (Pgroup*time > 0.05).

CONCLUSION

A supervised aerobic training program has the potential to alleviate persistent symptoms and improve exercise tolerance in patients with long COVID-19. Further research is necessary to confirm these effects in a large population. This intervention could be easily implemented in non-hospital settings, potentially benefiting a broader range of individuals.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov NCT05961462. Registered on July 25, 2023.

Cardiac autonomic responses to high-intensity kettlebell training in untrained young women: A pilot study

BACKGROUND

and purpose: The autonomic recovery after exercise provides information about the cardiovascular overload employed during the training session. The autonomic response over a training course is unclear in exercises performed at high intensities, such as kettlebell training. The study aimed to characterize the cardiac autonomic modulation after exercise in three distinct phases of a high-intensity kettlebell training program in young women.

METHODS

Ten women (25.0 ± 2.9 years; 23.4 ± 3.0 kg/m2) were submitted to 10 weeks of training divided into three phases (three times a week). The autonomic response was measured in the pre-exercise and at 10, 20, and 30 min of recovery and evaluated temporal and linear analysis of heart rate variability (HRV) indices.

RESULTS

vigorous intensity was performed in the sessions (75-86% HRmax). There was a significant reduction of HRV measured during post-exercise recovery (p < 0.05). In the initial two phases, the parasympathetic activity did not rebound to pre-exercise values (p < 0.05), and sympathetic was increased significantly until the end of the recovery period (p < 0.05). The third phase demonstrated the resumption of almost all the HRV indices at pre-exercise values at 20 min of recovery (p > 0.05).

CONCLUSION

The high-intensity kettlebell training program reduces HRV to 30 min of recovery (phases I and II). In the last phase (III), HRV components returned in 20 min. In addition, the program promoted improvement in aerobic fitness.

Case Report: Differences in self-selected pacing in 20, 40, and 60 ironman-distance triathlons: a case study

Background

Triathletes are pushing their limits in multi-stage Ironman-distance triathlons. In the present case study, we investigated the pacing during 20, 40, and 60 Ironman-distance triathlons in 20, 40, and 60 days, respectively, of one professional IRONMAN® triathlete.

Case study

Event 1 (20 Ironman-distance triathlons in 20 days), Event 2 (40 Ironman-distance triathlons in 40 days), and Event 3 (60 Ironman-distance triathlons in 60 days) were analyzed by discipline (swimming, cycling, running, and overall event time), by Deca intervals (10 days of consecutive Ironman-distance triathlons) and additional data (sleep duration, body mass, heart rate in cycling and running). To test differences between Events and Deca intervals within the same discipline, T-tests (2 groups) or one-way ANOVAs (3 or more groups) were used.

Results

Swimming splits were fastest in Event 1, (ii) cycling and running splits were fastest in both Event 2 and 3, (iii) overall speed was fastest in Event 3, (iv) sleep duration increased during Event 2 but decreased in Event 3, (v) body mass decreased in Event 2, but increased in Event 3 and (vi) heart rate during cycling was similar in both Event 2 and 3. In contrast, heart rate during running was greater in Event 3.

Conclusion

In a professional IRONMAN® triathlete finishing 20, 40, and 60 Ironman-distance triathlons in 20, 40, and 60 days, respectively, split performances and both anthropometrical and physiological changes such as body mass and heart rate differed depending upon the duration of the events.

Different humidity environments do not affect the subsequent exercise ability of college football players after aerobic high-intensity interval training

Previous studies have explored the effect of differing heat and relative humidity (RH) environments on the performance of multiple anaerobic high-intensity interval training (HIIT). Still, its impact on physiological responses and performance following aerobic HIIT has not been well studied. This study examined the effects of differing RH environments on physiological responses and performance in college football players following HIIT. Twelve college football completed HIIT under four different environmental conditions: (1) 25 °C/20% RH (Control group); (2) 35 °C/20% RH (H20 group); (3) 35 °C/40% RH (H40 group); (4) 35 °C/80% RH (H80 group). The heart rate (HR), mean arterial pressure (MAP), lactate, tympanic temperature (TT), skin temperature (TS), thermal sensation (TS), and rating of perceived exertion (RPE) were recorded continuously throughout the exercise. The heart rate variability (HRV): including root mean squared differences of the standard deviation (RMSSD)、standard deviation differences of the standard deviation (SDNN)、high frequency (HF), low frequency (LF), squat jump height (SJH), cycling time to exhaustion (TTE), and sweat rate (SR) were monitored pre-exercise and post-exercise. The HR, MAP, lactate, TT, Ts, TS, and RPE in the 4 groups showed a trend of rapid increase, then decreased gradually. There was no significant difference in HR, MAP, TT, or RPE between the 4 groups at the same time point (p > 0.05), in addition to this, when compared to the C group, the lactate, Ts, TS in the other 3 groups significant differences were observed at the corresponding time points (p < 0.05). The RMSSD, SDNN, HF, and LF levels in the 4 groups before exercise were not significantly different. The RMSSD and HF in the H40 and H80 groups were significantly decreased and other HRV indicators showed no significant difference after exercise. In sports performance measurement, the SJH and TTE were significantly decreased, but there was no significant difference in the 4 groups. The SR was no significant difference in the 4 groups after exercise. In conclusion, heat and humidity environments elicited generally greater physiological effects compared with the normal environment but did not affect sports performance in college football players.

Association between arterial stiffness and autonomic dysfunction in participants underwent treadmill exercise testing: a cross-sectional analysis

Data on the impact of arterial stiffness on autonomic function are limited. We sought to investigate whether heart rate recovery (HRR), a predictor of autonomic function, is impaired in patients with increased arterial stiffness. A total of 475 participants (mean age 55.8 ± 11.1 years, 34.3% women) who underwent a treadmill exercise test (TET) for the evaluation of chest pain were retrospectively analyzed. All patients underwent brachial-ankle pulse wave velocity (baPWV) measurement on the same day. HRR was defined as the difference in heart rate from maximal exercise to 1 min of recovery. Participants with the lowest HRR tertile were older and had more cardiovascular risk factors than those with the highest HRR tertile. Simple correlation analysis showed that baPWV was negatively correlated with HRR (r =  - 0.327, P < 0.001). In multiple linear regression analysis, there was a significant association between baPWV and HRR, even after adjusting for potential confounders (β =  - 0.181, P < 0.001). In participants who underwent TET, baPWV was negatively correlated with HRR. The results of our study indicate a potential relationship between arterial stiffness and the autonomic nervous system.

Cardiorespiratory coupling is associated with exercise capacity in athletes: A cross-sectional study

PURPOSE

To determine the association between exercise capacity based on peak oxygen uptake (VO2peak) and resting cardiorespiratory coupling (CRC) levels in athletes and non-athletes' subjects.

METHODS

A cross-sectional study was carried out in 42 apparently healthy male subjects, aged between 20 and 40 years old. The participants were allocated into athletes (n = 21) and non-athletes (n = 21) groups. Resting electrocardiogram and respiratory movement (RESP) were simultaneously acquired during 15 min in supine position and quiet breathing. The beat-to-beat heart period (HP) and RESP series were determined from the recorded signals. Traditional analysis of HP based on frequency domain indexes was performed considering the high-frequency (0.15 - 0.45 Hz) components. To compute the CRC, the linear association between HP and RESP series was determined via squared coherence function and directionality of interaction was investigated through the causal extension of this approach. The exercise capacity was assessed through incremental cardiopulmonary exercise testing in order to determine the VO2peak.

RESULTS

Traditional analysis of HP based on high-frequency index was not correlated with exercise capacity in the athletes (r = -0.1, p = 0.5) and non-athletes (r = -0.1, p = 0.3) cohorts. However, resting CRC values was associated with exercise capacity in athletes (r = 0.4, p = 0.03), but not in the non-athletes group (r = -0.2, p = 0.3).

CONCLUSION

These results suggest that improved resting values of CRC is associated with higher exercise capacity (VO2peak) in endurance athletes. Moreover, frequency domain of HP was not sensitive to identifying this relationship, probably because effects of training on parasympathetic modulation might be affected by respiratory dynamics, and this influence has a directionality (i.e., from RESP to HP).

The effects of daily dose of intense exercise on cardiac responses and atrial fibrillation

Atrial fibrillation (AF) is a supraventricular tachyarrhythmia that is strongly associated with cardiovascular (CV) disease and sedentary lifestyles. Despite the benefits of exercise on overall health, AF incidence in high-level endurance athletes rivals that of CV disease patients, suggesting a J-shaped relationship with AF. To investigate the dependence of AF vulnerability on exercise, we varied daily swim durations (120, 180 or 240 min day-1 ) in 7-week-old male CD1 mice. We assessed mice after performing equivalent amounts of cumulative work during swimming (i.e. ∼700 L O2  kg-1 ), as determined from O2 consumption rates (V ̇ O 2 ${\dot V_{{{\mathrm{O}}_2}}}$ ). The meanV ̇ O 2 ${\dot V_{{{\mathrm{O}}_2}}}$ during exercise increased progressively throughout the training period and was indistinguishable between the swim groups. Consistent with similar improvements in aerobic conditioning induced by swimming, skeletal muscle mitochondria content increased (P = 0.027) indistinguishably between exercise groups. Physiological ventricular remodelling, characterized by mild hypertrophy and left ventricular dilatation, was also similar between exercised mice without evidence of ventricular arrhythmia inducibility. By contrast, prolongation of daily swim durations caused progressive and vagal-dependent heart rate reductions (P = 0.008), as well as increased (P = 0.005) AF vulnerability. As expected, vagal inhibition prolonged (P = 0.013) atrial refractoriness, leading to reduced AF vulnerability, although still inducible in the 180 and 240 min swim groups. Accordingly, daily swim dose progressively increased atrial hypertrophy (P = 0.003), fibrosis (P < 0.001) and macrophage accumulation (P = 0.006) without differentially affecting the ventricular tissue properties. Thus, increasing daily exercise duration drives progressively adverse atrial-specific remodelling and vagal-dependent AF vulnerability despite robust and beneficial aerobic conditioning and physiological remodelling of ventricles and skeletal muscle. KEY POINTS: Previous studies have suggested that a J-shaped dose-response relationship exists between physical activity and cardiovascular health outcomes, with moderate exercise providing protection against many cardiovascular disease conditions, whereas chronic endurance exercise can promote atrial fibrillation (AF). We found that AF vulnerability increased alongside elevated atrial hypertrophy, fibrosis and inflammation as daily swim exercise durations in mice were prolonged (i.e. ≥180 min day-1 for 6 weeks). The MET-h week-1 (based on O2  measurements during swimming) needed to induce increased AF vulnerability mirrored the levels linked to AF in athletes. These adverse atria effects associated with excessive daily exercise occurred despite improved aerobic conditioning, skeletal muscle adaptation and physiological ventricular remodelling. We suggest that atrial-specific changes observed with exercise arise from excessive elevations in venous filling pressures during prolonged exercise bouts, which we argue has implications for all AF patients because elevated atrial pressures occur in most cardiovascular disease conditions as well as ageing which are linked to AF.

Psychophysiological Effects of Slow-Paced Breathing on Adolescent Swimmers' Subjective Performance, Recovery States, and Control Perception

This study examined the effect of a Slow-Paced Breath (i.e., 6 breaths per minute) without Biofeedback (SPB-NoHRVB) protocol on semi-elite adolescent swimmers' psychological and physiological states during a seven-week ecological training period. A linear mixed-effects multilevel regression analysis approach was used with 13 adolescent national-level swimmers. Athletes were randomly assigned to an intervention group (n = 7) and a control group (n = 6). Seven waves of assessments were completed weekly during a seven-week training preparation in ecological conditions. During the protocol, swimmers completed subjective quantitative measures (RESTQ-36-R-Sport; cognitive perceived stress and control states about the training process, training subjective performance, and subjective internal training load) and physiological heart rate (HR) (HR of exercise, absolute and normalized HR recovery during the first 60 s of recovery; HRR60 and nHRR60) and heart rate variability (HRV) (MeanRR, RMSSD, LFnu and HFnu, LF/HF ration) tests (through a submaximal heart rate (5'-5' test) once a week. Results revealed that the SPB-NoHRVB protocol significantly predicts biopsychosocial recovery states, cognitive perception of control, and training subjective performance (i.e., a significant effect of the SPB-NoHRVB protocol with the dependent variables simple time trajectories). However, no significant effects were found for biopsychosocial stress scales, cognitively perceived stress, HR, or HRV markers. Our results suggest that SPB-NoHRVB induces simple evolutions over time for crucial variables in athletes' adaptation to the training process (i.e., cognitive appraisals and biopsychosocial states). In contrast, it highlights that SPB-NoHRVB does not induce better stress states. This specific effect on the resource component is an exciting result that will be discussed in the manuscript.

Sex Differences in Heart Rate Variability and Vascular Function Following High-Intensity Interval Training in Young Adults

High-intensityintervaltraining (HIIT) issuperiortoothertrainingstrategies in both male andfemalehealthyindividuals. Understanding sex-specificdifferences in cardiac auto-regulation maycontributetothe optimal trainingstrategiesfor HIIT. The presentstudyaimedtoidentifysexdifferences in heart rate variability (HRV) andvascularfunctionfollowing HIIT in youngadults. Twenty-fourphysicallyactiveyoung male andfemaleadults (M: 12, F: 12, age: 19.5 yr, BMI: 22.1 kg·m-2) volunteeredtoparticipate in thestudy. Participantsperformed 10 boutsof HIIT including 20 s of high-intensitycycling at 115-130% Wmaxfollowedby 100 s ofrecovery. The cardiac auto-regulationsincluding HRV andvascularfunctionweremeasured at five different time points. The R-R interval, rMSSD, and SDNN wererecoveredfaster in malesthan in females after 15 min of HIIT. Thereweresexdifferences in theautonomicnervoussystemwhereln LF andln HF activitiesalongwithsympathovagalbalance (ln LF/HF) weregreater in femalescomparedwithmalesimmediatelyand 15 min after HIIT. However, nosignificantdifferences in bloodpressureand brachial-ankle pulse wavevelocitywereobservedbetween male andfemaleparticipants. Overall, HRV was moreactivated in femalesthan in malesfollowing HIIT, but theacuteresponse in vascularfunction was not different betweensexes. In futurestudies, sex-specificadaptationsofcardiacautoregulationfollowingrepeated HIIT mayneedtobeperformed.

Acute Effects of Fatigue on Cardiac Autonomic Nervous Activity

The onset of fatigue disrupts the functioning of the autonomic nervous system (ANS), potentially elevating the risk of life-threatening incidents and impairing daily performance. Previous studies mainly focused on physical fatigue (PF) and mental fatigue (MF) effects on the ANS, with limited knowledge concerning the influence of physical-mental fatigue (PMF) on ANS functionality. This study aimed to assess the immediate impact of PMF on ANS function and to compare its effects with those of PF and MF on ANS function. Thirty-six physically active college students (17 females) without burnout performed 60-min cycling exercises, AX-Continuous Performance Task (AX-CPT), and cycling combined with AX-CPT to induce PF, MF, and PMF respectively. Subjective fatigue levels were measured using the Rating of Perceived Exertion scale and the Visual Analog Scale-Fatigue. Heart rate variability was measured before and after each protocol to assess cardiac autonomic function. The proposed tasks successfully induced PF, MF, and PMF, demonstrated by significant changes in subjective fatigue levels. Compared with baseline, PMF decreased the root mean square of successive differences (RMSSD) between normal heartbeats (P < 0.001, d = 0.50), the standard deviation of normal-to-normal RR intervals (SDNN) (P < 0.01, d = 0.33), and the normalized high-frequency (nHF) power (P < 0.001, d = 0.32) while increased the normalized low-frequency (nLF) power (P < 0.001, d = 0.35) and the nLF/nHF ratio (P < 0.001, d = 0.40). Compared with MF, PMF significantly decreased RMSSD (P < 0.001, η2 = 0.431), SDNN (P < 0.001, η2 = 0.327), nLF (P < 0.01, η2 = 0.201), and nHF (P < 0.001, η2 = 0.377) but not the nLF/nHF ratio. There were no significant differences in ΔHRV (i.e., ΔRMSSD, ΔSDNN, ΔnLF/nHF, ΔnLF, and ΔnHF), heart rate, and training impulse between PF- and PMF-inducing protocols. Cognitive performance (i.e., accuracy) in AX-CPT during the PMF-inducing protocol was significantly lower than that during the MF-inducing protocol (P < 0.001, η2 = 0.101). PF and PMF increased sympathetic activity and decreased parasympathetic activity, while MF enhanced parasympathetic activity.

Clinical studies on the electric automatic massage therapy for recovery of acute sports fatigue

BACKGROUND

Acute sports fatigue impairs athletes' performance and causes other health issues; therefore, an effective method of relieving acute sports fatigue is being researched.

OBJECTIVE

The present study was envisaged to evaluate the effect of electric auto-massage therapy and proprioceptive neuromuscular facilitated (PNF) stretching method on the recovery of acute exercise fatigue using the heart rate variability-based multi-physiological index and RPE scale, and to explore the underlying principle and mechanism.

METHOD

Sixty volunteers were divided into the stretching group, massage group and control group (20 subjects each) using the complete randomization method. The massage group chose the kneading, pressing, tapping and patting techniques using the intelligent massage chair to intervene on the volunteers, the stretching group chose the PNF stretching method to intervene on the volunteers, while the control group did not adopt any of these techniques. The Rating Of Perceived Exertion (RPE) score, heart rate (HR), grip strength, skin electrical activity, heart rate variability (HRV) and blood oxygen saturation (SpO2) of the three groups were recorded before and after the intervention.

RESULTS

Before the intervention, there was no statistically significant difference between the values of heart rate variability (HRV) in the three groups (P> 0.05), while after the intervention, there was a statistically significant difference between the values of heart rate variability - low frequency/high frequency (HRV (LF/HF)) and HRV (HF) in the three groups as: HRV (HF): ηH2= 0.10; P= 0.022; HRV (LF/HF): ηH2= 0.44; P= 0.001. The results indicated that the different intervention methods presented substantial effects on the values of HRV (HF) and HRV (LF/HF) in the volunteers. The HRV (HF) values of massage group, stretching group and control group were compared, and the difference between the massage group and control group was statistically significant (P= 0.019). Further, the HRV (HF) values of massage group rose more significantly than control group after the intervention, and the difference between HRV (HF) values of massage group and stretching group was not statistically significant. When comparing the HRV (LF/HF) values of massage group, stretching group and control group, the differences between the massage group and stretching group and control group were statistically significant (P= 0.001, P< 0.05), and it was observed that the HRV (LF/HF) values of massage group decreased more significantly than those of stretching group and control group after the intervention. The difference in HRV (LF) values between the three groups after the intervention was not statistically significant (P> 0.05).

CONCLUSION

1. It was observed that the electric automatic massage therapy played a vital role in the rapid relief of exercise fatigue by soothing and regulating the human phototropic system, reducing vagal tone, and accelerating the excretion of metabolites; while PNF stretching relieved the exercise fatigue by providing physical and verbal communication to transfer the perception of fatigue, and by promoting the excretion of metabolites through muscle isometric contraction. 2. The effect of electric auto-massage therapy was marginally stronger than the commonly used PNF stretching exercise method.

Validity and sensitivity of field tests' heart-rate recovery assessment in recreational football players

We aimed at examining the criterion validity and sensitivity of heart-rate recovery (HRRec) in profiling cardiorespiratory fitness in male recreational football players in the untrained and trained status, using endurance field-tests. Thirty-two male untrained subjects (age 40 ± 6 years, VO2max 41.7 ± 5.7 ml·kg-1·min-1, body mass 82.7 ± 9.8 kg, stature 173.3 ± 7.4 cm) participated in a 12-week (2‒3 sessions per week) recreational football intervention and were tested pre- and post-intervention (i.e. untrained and trained status). The participants performed three intermittent field tests for aerobic performance assessment, namely Yo-Yo intermittent endurance level 1 (YYIE1) and level 2 (YYIE2) tests, and Yo-Yo intermittent recovery level 1 (YYIR1) test. VO2max was assessed by performing a progressive maximal treadmill test (TT) and maximal HR (HRmax) determined as the maximal value across the testing conditions (i.e., Yo-Yo intermittent tests or TT). HRRec was calculated as the difference between Yo-Yo tests' HRpeak or HRmax and HR at 30 s (HR30), 60 s (HR60) and 120 s (HR120) and considered as beats·min-1 (absolute) and as % of tests' HRpeak or HRmax values. Significant post-intervention improvements (p<0.0001) were shown in VO2max (8.6%) and Yo-Yo tests performance (23-35%). Trivial to small (p>0.05) associations were found between VO2max and HRRec (r = -0.05-0.27, p>0.05) across the Yo-Yo tests, and training status either expressed as percentage of HRpeak or HRmax. The results of this study do not support the use of field-test derived HRRec to track cardiorespiratory fitness and training status in adult male recreational football players.

Heart rate recovery to assess fitness: comparison of different calculation methods in a large cross-sectional study

We propose a cross-sectional study based on 980 maximal effort tests to quantify the effect of the calculation method of heart rate recovery (HRR) on its association with cardiorespiratory fitness (CRF). For five different time t₀ after exercise cessation, HRR has been calculated as: the difference and the ratio between maximal measured heart rate and heart rate (HR) at t₀HR at t₀the decay time of an exponential decay encompassing the first t₀ minutes of the HR recovery.The associations between HRR indices and CRF were estimated from generalized estimating equations stratified by gender and adjusted for age and body mass index. For HRR indices based on exponential regression, no significant association with CRF was found, whereas the other HRR indices are associated with CRF when t₀ is at least 1 minute and is maximum for t₀ = 2 minutes for females and t₀ = 3 minutes for males.

A single session of whole-body cryotherapy boosts maximal cycling performance and enhances vagal drive at rest

Whole-body cryotherapy (WBC) has been reported to maximize physical recovery after exercise and reduce the ensuing muscle damage. In addition, WBC triggers cardiovascular responses leading to an increased vagal drive. Here we tested whether WBC may boost exercise performance as well as post-exercise recovery. Moreover, we compared the effects of WBC and exercise on sympathovagal balance and tested whether these two factors may interact. ECG was recorded in 28 healthy adults who underwent rest, all-out effort on a cycloergometer, 5 min recovery and again rest. After 3-5 days, WBC (3 min exposure to - 150 °C air) was applied and the whole procedure repeated. Total exercise duration was split into the time needed to reach peak power output (t_PEAK) and the time to exhaustion (t_EXH). The post-exercise exponential decay of HR was characterized by its delay from exercise cessation (t_DELAY) and by its time constant (τ_OFF). Sympathovagal balance was evaluated by measuring HR variability power in the low (LF) and high (HF) frequency bands, both before exercise and after recovery from it. Sympathetic vs. vagal predominance was assessed by the sympathovagal index LFnu. Paired t-tests indicated that WBC increased t_EXH and reduced t_DELAY, speeding up the HR recovery. These results suggest that WBC may be exploited to boost exercise performance by about 12-14%. ANOVA on HR variability confirmed that exercise shifted the sympathovagal balance towards sympathetic predominance, but it also highlighted that WBC enhanced vagal drive at rest, both before exercise and after full recovery, covering ~ 70% of the exercise effect.

Assessment of Fatigue and Recovery in Sport: Narrative Review

Fatigue is a phenomenon associated with decreases in both physical and cognitive performances and increases in injury occurrence. Competitive athletes are required to complete demanding training programs with high workloads to elicit the physiological and musculoskeletal adaptations plus skill acquisition necessary for performance. High workloads, especially sudden rapid increases in training loads, are associated with the occurrence of fatigue. At present, there is limited evidence elucidating the underlying mechanisms associating the fatigue generated by higher workloads and with an increase in injury risk. The multidimensional nature and manifestation of fatigue have led to differing definitions and dichotomies of the term. Consequently, a plethora of physiological, biochemical, psychological and performance markers have been proposed to measure fatigue and recovery. Those include self-reported scales, countermovement jump performance, heart rate variability, and saliva and serum biomarker analyses. The purpose of this review is to provide an overview of fatigue and recovery plus methods of assessments.

Minimally Invasive Ways to Monitor Changes in Cardiocirculatory Fitness in Running-based Sports: A Systematic Review

This systematic review provides a synthesis of research investigating submaximal protocols to monitor changes in cardiocirculatory fitness in running-based sports. Following PRISMA guidelines, 2,452 records were identified and 14 studies, representing 515 athletes, satisfied the eligibility criteria. While most studies found large associations between changes in heart rate at standardized, submaximal running speeds and changes in aerobic fitness (r=0.51-0.88), three studies failed to establish a relationship (r=0.19-0.35). The intensity of the submaximal protocols seems to be relevant, with changes in running speeds at 90% of maximal heart rate showing larger relationships with changes in aerobic fitness (r=0.52-0.79) compared to 70% of maximal heart rate (r=0.24-0.52). Conversely, changes in post-exercise heart rate variability were very largely associated with changes in aerobic fitness when the testing protocols were less intense (70% of maximal heart rate) (r=0.76-0.88), but not when the test required participants to achieve 90% of their maximal heart rate (r=-0.02-0.06). Studies on post-exercise heart rate recovery revealed inconclusive results (r=-0.01- -0.55), while rate of heart rate increase may be a promising athlete monitoring metric (r=0.08- -0.84) but requires further research. In summary, when executed, analyzed, and interpreted appropriately, submaximal protocols can provide valuable information regarding changes in athlete cardiocirculatory fitness.

Innate immunity changes in soccer players after whole-body cryotherapy

Whole-body cryotherapy (WBC) consists of short exposure (up to 2–3 min) to dry air at cryogenic temperatures (up to -190 °C) and has recently been applied for muscle recovery after injury to reduce the inflammation process. We aimed to determine the impact of cryotherapy on immunological, hormonal, and metabolic responses in non-professional soccer players (NPSPs). Nine male NPSPs (age: 20 ± 2 years) who trained regularly over 5 consecutive days, immediately before and after each training session, were subjected to WBC treatment (WBC-t). Blood samples were collected for the evaluation of fifty analytes including hematologic parameters, serum chemistry, and hormone profiles. Monocytes phenotyping (Mo) was performed and plasmatic markers, usually increased during inflammation [CCL2, IL-18, free mitochondrial (mt)DNA] or with anti-inflammatory effects (IL2RA, IL1RN), were quantified. After WBC-t, we observed reduced levels of ferritin, mean corpuscular hemoglobin, mean platelet volume, testosterone, and estradiol, which however remain within the normal ranges. The percentage of the total, intermediates and non-classical Mo increased, while classical Mo decreased. CXCR4 expression decreased in each Mo subset. Plasma IL18 and IL2RA levels decreased, while IL1RN only exhibited a tendency to decrease and CCL2 showed a tendency to increase. Circulating mtDNA levels were not altered following WBC-t. The differences observed in monocyte subsets after WBC-t may be attributable to their redistribution into the surrounding tissue. Moreover, the decrease of CXCR4 in Mo subpopulations could be coherent with their differentiation process. Thus, WBC through yet unknown mechanisms could promote their differentiation having a role in tissue repair.

Blood pressure response to exercise in children and adolescents

Blood pressure changes during exercise are part of the physiological response to physical activity. Exercise stress testing can detect an exaggerated blood pressure response in children and adolescent. It is applied for certain clinical conditions, but is also commonly used as part of the assessment of athletes. The interpretation of blood pressure values in response to exercise during childhood and adolescence requires appropriate reference data. We discuss the available reference values and their limitations with regard to device, exercise protocol and normalization. While the link between an exaggerated blood pressure response and cardiovascular events and mortality has been demonstrated for adults, the situation is less clear for children and adolescents. We discuss the existing evidence and propose that under certain circumstances it might be reasonable to have children and adolescents undergo exercise stress testing as a rather non-invasive procedure to add additional information with regard to their cardiovascular risk profile. Based on the existing data future studies are needed to extend our current knowledge on possible links between the presence of certain clinical conditions, the detectability of an exaggerated blood pressure response during childhood and adolescence and the risk of developing cardiovascular morbidity and mortality in later life.

Comparison of the acute physiological and perceptual responses between resistance-type and cycling high-intensity interval training

Purpose: The purpose of the present study was to compare the acute physiological and perceptual responses between resistance-type high-intensity interval training (R-HIIT)and cycling high-intensity interval training (C-HIIT).

Methods: Twelve healthy and active men randomly performed C-HIIT and R-HIIT. The C-HIIT protocol was performed on a cycle ergometer and consisted of ten 60 s working intervals at 90% PPO separated by a 60 s active recovery at 25% PPO. The R-HIIT protocol consisted of ten 60 s working intervals (barbell back squat with a load of 20% bodyweight, maximum 30 reps) separated by 60 s passive recovery period in an unloaded standing position. Oxygen consumption (V˙O₂), heart rate (HR), energy expenditure (EE) and rating of perceived exertion (RPE) were measured during exercise. Blood lactate concentration (Blac), serum testosterone and cortisol, and heart rate variability (HRV) were measured before and after exercise.

Results: Peak (p < 0.05) and average V˙O₂ (p < 0.001), aerobic (p < 0.001) and total EE (p < 0.05) were higher during C-HIIT compared to R-HIIT. Blac after exercise (p < 0.05) and anaerobic glycolytic EE (p < 0.05) during exercise were higher in R-HIIT compared to C-HIIT. No differences (p > 0.05) in peak and average HR, serum testosterone and cortisol, HRV, and RPE responses were observed between C-HIIT and R-HIIT.

Conclusion: The R-HIIT protocol can elicit similar cardiovascular, hormones, and perceptual responses as C-HIIT but with a higher contribution to the anaerobic glycolysis energy system. In contrast, C-HIIT is superior to R-HIIT for increasing oxygen consumption during exercise. Therefore, the two types of HIIT may lead to different metabolic and neuromuscular adaptations.

Application of a Reactive Agility Training Program Using Light-Based Stimuli to Enhance the Physical and Cognitive Performance of Car Racing Drivers: A Randomized Controlled Trial

BACKGROUND

There is a need to develop strategies that could contribute to the physical and mental preparation of motorsport athletes. A common method used by experienced motorsport athlete physical trainers is flashing light devices to train or assess reactive agility, despite limited evidence. Therefore, in the present study, we determined the effects of a 6-week reactive agility training program using light-based stimuli on the physiological and cognitive abilities of car racing drivers.

MATERIALS AND METHODS

The CONSORT guidelines for randomized controlled trial were used. In a single-blinded randomized controlled trial, 24 car racing drivers (EXP, n = 12; CON, n = 12) performed a comprehensive battery of cognitive tests marketed specifically at motorsport athletes from Vienna test system (VTS) at rest or during moderate intensity exercise on a bicycle. Physiological abilities were determined via a maximal incremental cardio-respiratory treadmill test. Baseline and post-intervention tests were performed on three consecutive days. Participants in EXP underwent a 6-week intervention consisting of 60-min training sessions twice a week using the Witty SEM light stimulus.

RESULTS

Participants in EXP but not in CON performed some of the VTS cognitive tasks with higher accuracy and/or shorter reaction time after the intervention at rest and during exercise. Car racing drivers performed the STROOP word-reading condition more accurately when the task was performed during the exercise vs. rest, regardless of group. In addition, the intervention induced beneficial changes in peak heart rate (HR), HR at gas exchange threshold, ventilation, and relative maximal oxygen consumption (rVO₂ max). In contrast, body mass and fat mass increased, while peak HR and rVO₂ max decreased in CON. Finally, participants in EXP improved their reactive agility performance and reaction time throughout the training program.

CONCLUSION

Overall, the reactive agility training program using light-based stimuli appeared to be efficient to induce beneficial effects on some physiological and cognitive performance measures; therefore, it may have the potential to contribute to car racing drivers' physical and mental performance.

Decrease of heart rate variability during exercise: An index of cardiorespiratory fitness

The present study proposes to measure and quantify the heart rate variability (HRV) changes during effort as a function of the heart rate and to test the capacity of the produced indices to predict cardiorespiratory fitness measures. Therefore, the beat-to-beat cardiac time interval series of 18 adolescent athletes (15.2 ± 2.0 years) measured during maximal graded effort test were detrended using a dynamical first-order differential equation model. HRV was then calculated as the standard deviation of the detrended RR intervals (SDRR) within successive windows of one minute. The variation of this measure of HRV during exercise is properly fitted by an exponential decrease of the heart rate: the SDRR is divided by 2 every increase of heart rate of 20 beats/min. The HR increase necessary to divide by 2 the HRV is linearly inversely correlated with the maximum oxygen consumption (r = -0.60, p = 0.006), the maximal aerobic power (r = -0.62, p = 0.006), and, to a lesser extent, to the power at the ventilatory thresholds (r = -0.53, p = 0.02 and r = -0.47, p = 0.05 for the first and second threshold). It indicates that the decrease of the HRV when the heart rate increases is faster among athletes with better fitness. This analysis, based only on cardiac measurements, provides a promising tool for the study of cardiac measurements generated by portable devices.

Neurophysiological Markers for Monitoring Exercise and Recovery Cycles in Endurance Sports

The current study analyzes the suitability and reliability of selected neurophysiological and vegetative nervous system markers as biomarkers for exercise and recovery in endurance sport. Sixty-two healthy men and women, endurance trained and moderately trained, performed two identical acute endurance tests (running trial 1 and running trial 2) followed by a washout period of four weeks. Exercise protocol consisted of an acute running trial lasting 60 minutes. An intensity corresponding to 95% of the heart rate at individual anaerobic threshold for 40 minutes was followed by 20 minutes at 110%. At pre-exercise, post-exercise, three hours post-exercise and 24 hours post-exercise, experimental diagnostics on Brain-derived neurotrophic factor (BDNF), heart rate variability (HRV), Stroop Color and Word Test (SCWT), and Short-Form McGill Pain Questionnaire (SF-MPQ) were performed. Significant changes over time were found for all parameters (p < .05). Furthermore, there was an approached statistical significance in the interaction between gender and training status in BDNF regulation (F₍₃₎ = 2.43; p = 0.06), while gender differences were found only for LF/HF-ratio (3hPoEx, F₍₃₎ = 3.40; p = 0.002). Regarding the reliability, poor ICC-values (< 0.5) were found for BDNF, Stroop sensitivity and pNN50, while all other parameters showed moderate ICC-values (0.5-0.75). Plasma-BDNF, SCWT performance, pain perception and all HRV parameters are suitable exercise-sensitive markers after an acute endurance exercise. Moreover, pain perception, SCWT reaction time and all HRV parameters show a moderate reliability, others rather poor. In summary, a selected neurophysiological and vegetative marker panel can be used to determine exercise load and recovery in endurance sports, but its repeatability is limited due to its vaguely reliability.

Pilot Feasibility Assessment of a Tailored Physical Activity Prescription in Overweight and Obese People in a Public Hospital

We aimed to evaluate the feasibility of a tailored physical activity (PA) prescription in overweight and obese people in a tertiary hospital in Lima, Peru. A feasibility pre-post-pilot study was conducted using mixed methods. Participants received a tailored prescription scheme for PA that lasted twelve weeks. It included two prescription sessions, three follow-up phone calls, and three evaluations. Primary feasibility outcomes were recruitment, visits, and phone call adherence. Primary intervention outcomes were self-reported PA levels and the 6 min walk test. Out of 228 people invited to participate, 30 were enrolled and received the first session of prescription, 11 went to the second session, and 21 went to the final evaluation; phone call participation decreased progressively during follow-up. There were no differences in the 6th week and the 12th week compared to the baseline for all the measures, except in the 6 min walk test. The participants considered the intervention was well designed, but they suggested complementing it with dietary instructions. The prescription of PA in overweight and obese people is feasible for promoting PA, but its implementation requires refinements to anticipate possible barriers to changing behavior.

Stress Levels in Handball Coaching-Case Study: Preliminary Analysis of the Differences between Training and Match

Stress plays a significant role in competitions and in the training of sports participants, and coaches are no exception. To better cope with stressful situations, close monitoring of coaches' stress levels before, during, and after training and competitions is recommended. According to studies, the use of cortisol (C) and alpha-amylase (AA) as biomarkers for monitoring acute stress is recommended. Therefore, the aim of our study was to compare HR, salivary C and AA, and STAI scores before, during, and after handball matches and training sessions. The study examined one professional handball coach, aged 37, in stress markers (salivary cortisol (C) and alpha-amylase (AA) concentrations), heart rate (HR), and the State-Trait Anxiety Inventory (STAI) scores in five matches/training sessions in the First Qatar Handball League. Statistical analysis included the calculation of descriptive statistic parameters, Mann-Whitney U test for differences between match-training time points, and the effect size analysis (Cohen's d) to calculate the magnitude of differences between match-training time points. Presented markers (C and AA) had statistically stronger reactions before, during, and after the matches than the corresponding time points of the training sessions, similar to HR data and STAI scores. Results indicate that, before and during the matches, the analyzed markers of stress increased, which might lead to the conclusion that coaches are more anxious than frightened before and during matches. Thus, stress-coping strategies for handball coaches should be more focused on stress anticipation and anxiety control.

Are Measurement Instruments Responsive to Assess Acute Responses to Load in High-Level Youth Soccer Players?

Purpose

The aim of this study was to assess the short-term responsiveness of measurement instruments aiming at quantifying the acute psycho-physiological response to load in high-level adolescent soccer players.

Methods

Data were collected from 16 high-level male youth soccer players from the Under 15 age group. Players were assessed on two occasions during the week: after 2 days of load accumulation (“high load”) and after at least 48 h of rest. Measurements consisted of the Short Recovery and Stress Scale (SRSS), a countermovement jump (CMJ) and a sub-maximal run to assess exercise heart-rate (HRex) and heart-rate recovery (HRR60s). Training load was quantified using total distance and high-speed running distance to express external and sRPE training load to express internal load. It was expected that good instruments can distinguish reliably between high load and rest.

Results

Odd ratios (0.74–1.73) of rating one unit higher or lower were very low for athlete-reported ratings of stress and recovery of the SRSS. Standardized mean high load vs. rest differences for CMJ parameters were trivial to small (−0.31 to 0.34). The degree of evidence against the null hypothesis that changes are interchangeable ranged from p = 0.04 to p = 0.83. Moderate changes were observed for HRex (−0.62; 90% Cl −0.78 to −0.47; p = 3.24 × 10−9), while small changes were evident for HRR60s (0.45; 90% Cl 0.08–0.80; p = 0.04). Only small to moderate repeated-measures correlations were found between the accumulation of load and acute responses across all measurement instruments. The strongest relationships were observed between HRex and total distance (rm-r = −0.48; 90% Cl −0.76 to −0.25).

Conclusion

Results suggest that most of the investigated measurement instruments to assess acute psycho-physiological responses in adolescent soccer players have limited short-term responsiveness. This questions their potential usefulness to detect meaningful changes and manage subsequent training load and program adequate recovery.

Rapid Weight Loss Coupled with Sport-Specific Training Impairs Heart Rate Recovery in Greco-Roman Wrestlers

Wrestling is a sport that can be classified with the use of alternating aerobic–anaerobic metabolism with moderate but high-impact energy expenditure. Heart rate recovery (HRR) is the difference between heart rate during exercise and a certain amount of time after the start of recovery. The goal of this study was to determine the difference in HRR between two phases: high-intensity sport-specific training (HISST) combined with rapid weight loss (RWL)—phase 1 (P1) and HISST only—phase 2 (P2). Ten national-level wrestlers were included in this study. All participants underwent HISST along with RWL procedures for P1. Seven days later, during P2, an identical training session was performed with no RWL included. We found a statistically significant difference in the values obtained after the first and second minutes of recovery in the second set for both cases (p = 0.034 and p = 0.037, respectively), with higher HR values recorded in P1. It can be concluded that there is undoubtedly a difference in HRR during training and RWL compared to HISST alone. Additionally, HISST along with RWL could compromise the aerobic component of recovery.

The ability of a submaximal cycle ergometer test to detect longitudinal changes in VO2max

Background

The purpose of the present study was to examine the ability of a submaximal cycling test to detect longitudinal changes in maximal oxygen uptake (VO₂max) and examine the conformity between changes in measured and estimated VO₂max over a time span of 5–8 years.

Methods

A total of 35 participants (21 men and 14 women), aged 29 to 63 years, performed the Ekblom-Bak (EB) submaximal cycle test for estimation of VO₂max and a maximal treadmill running test for direct measurement of VO₂max. The baseline tests were conducted between 2009 and 2012, and the follow-up tests were completed 5 to 8 years later. Pearson’s coefficient of correlation (r) and paired sample t-test were used to analyse the association between change in measured and estimated VO₂max. Random and systematic errors between the measured and estimated VO₂max were evaluated using Bland-Altman plots. Repeated measures ANOVA were used to test differences between changes over time.

Results

There was no significant change in mean measured VO₂max between baseline and follow-up (p = 0.91), however large individual variations were noted (− 0.78 to 0.61 L/min). The correlation between individual change in measured and estimated VO₂max was r = 0.75 (p < 0.05), and the unstandardised B-coefficient from linear regression modelling was 0.88 (95% CI 0.61 to 1.15), i.e., for each litre of change in estimated VO₂max, the measured value had changed 0.88 L. The correlation between baseline and follow-up errors (the difference between estimated-measured VO₂max at each occasion) was r = 0.84 (p < 0.05). With regard to the testing procedure, repeated measures ANOVA revealed that there was no significant difference between the group who exercised at the same work rates at baseline and follow-up (n = 25), and those who required a change in work rate (n = 10).

Conclusions

The EB test detected a change in VO₂max with reasonably good precision over a time span of 5–8 years. Further studies are needed to evaluate if the test can be used in clinical populations and in subjects with different medications.

High-Intensity Functional Training Guided by Individualized Heart Rate Variability Results in Similar Health and Fitness Improvements as Predetermined Training with Less Effort

Heart rate variability (HRV) may be useful for prescribing high-intensity functional training (HIFT) exercise programs. This study aimed to compare effects of HRV-guided and predetermined HIFT on cardiovascular function, body composition, and performance.

METHODS

Recreationally-active adults (n = 55) were randomly assigned to predetermined HIFT (n = 29, age = 24.1 ± 4.1 years) or HRV-guided HIFT (n = 26, age = 23.7 ± 4.5) groups. Both groups completed 11 weeks of daily HRV recordings, 6 weeks of HIFT (5 d·week-1), and pre- and post-test body composition and fitness assessments. Meaningful changes in resting HRV were used to modulate (i.e., reduce) HRV-guided participants' exercise intensity. Linear mixed models were used with Bonferroni post hoc adjustment for analysis.

RESULTS

All participants significantly improved resting heart rate, lean mass, fat mass, strength, and work capacity. However, no significant between-groups differences were observed for cardiovascular function, body composition, or fitness changes. The HRV-guided group spent significantly fewer training days at high intensity (mean difference = -13.56 ± 0.83 days; p < 0.001).

CONCLUSION

HRV-guided HIFT produced similar improvements in cardiovascular function, body composition, and fitness as predetermined HIFT, despite fewer days at high intensity. HRV shows promise for prescribing individualized exercise intensity during HIFT.

Heart rate variability before and after 14 weeks of training in Thoroughbred horses and Standardbred trotters with different training experience

Changes in heart rate and heart rate variabilty (HRV) were investigated in untrained (UT; starting their first racing season) and detrained (DT; with 1–3 years of race experience) racehorses before and after 14-week conventional training. HRV was measured at rest over 1 h between 9:00 and 10:00 AM on the usual rest day of the horses. The smallest worthwhile change (SWC) rate was calculated for all HRV parameters. UT horses had significantly higher heart rate compared to DT (P<0.001). There were no gender- or training-related differences in heart rate. The root-mean-square of successive differences (rMSSD) in the consecutive inter-beat-intervals obtained after the 14-week training period was lower compared to pre-training rMSSD (P<0.001). The rMSSD was not influenced by breed, age or gender. In DT horses, there was a significant decrease in the high frequency (HF) component of HRV (P≤0.05) as the result of the 14-week training. These results may reflect saturation of high-frequency oscillations of inter-beat intervals rather than the reduction in parasympathetic influence on the heart. The HF did not differ significantly between the two measurements in UT horses; however, 16.6% of the animals showed a decrease in HF below SWC (P≤0.05). This supports the likelihood of parasympathetic saturation. Although no significant decrease in heart rate was found for the post-training, 30.0% of DT and 58.3% of UT horses still showed a decrease in heart rate below the SWC. Also by individual examination, it was also visible that despite significant post-training decrease in rMSSD, 1 (4.6%) DT and 2 (6.7%) UT horses reached SWC increase in rMMSD. In the case of these horses, the possibility of maladaptation should be considered. The present results indicate that similar to as found in human athletes, cardiac ANS status of racehorses also changes during the physiological adaptation to training. To explore more precise links between HRV and training effectiveness in horses, a more frequent recording would be necessary. Detailed analysis of HRV parameters based on SWC will be able to highlight the importance of fitness evaluation at individual level.

Effects of High-Intensity Interval Exercise and Acute Partial Sleep Deprivation on Cardiac Autonomic Modulation

Sleep deprivation in healthy adults has been associated with disrupted autonomic nervous system function, which in turn has been linked to cardiovascular health. High-intensity interval exercise (HIIE) may affect both sleep and cardiac autonomic modulation. Purpose: To investigate the impact of acute partial sleep deprivation on autonomic cardiac regulation before and after an acute bout of HIIE and the length of time for the autonomic system to return to resting levels. Methods: Fifteen healthy males with body mass index (BMI) of 25.8 ± 2.7 kg·m^-2 and age 31 ± 5 y participated in a reference sleep (~9.5 hr) with no HIIE (RS), a reference sleep with HIIE (RSX), and an acute partial sleep deprivation (~3.5 hr) with HIIE (SDX). HIIE was performed in 3:2 intervals at 90% and 40% of VO₂ reserve. Autonomic regulation through HRV selected time and frequency domain indices were recorded the night before, the morning of the next day, 1 hr-, 2 hr-, 4hr-, and 6-hr post-exercise. Results: HIIE performed in a 3:2 W:R ratio decreased the HRV (p < .05) at 1-hr post exercise and it took up to 4 hr to return to baseline levels. Parasympathetic related HRV indices increased the morning of the next day for SDX (p < .05). Acute partial sleep deprivation and HIIE did not modify the HRV responses compared to reference sleep and HIIE. Conclusion: HRV disturbance typically seen in responses to an acute episode of HIIE is not influenced by acute partial sleep deprivation.

Investigating the Immediate Influence of Moderate Pedal Exercises during an Assembly Work on Performance and Workload in Healthy Men

Physical inactivity has increased in prevalence among adults in industrialized and developing countries owing to the fact that the majority of job situations require individuals to remain seated for extended periods of time. This research aims to evaluate the influence of cycling on a stationary bike while executing a keyboard assembly task on the task completion time, error percentage, and physiological and subjective measurements. The physiological measures were electroencephalography (EEG) and electrocardiographic (ECG) signal responses, whereas the subjective measures were subjective workload ratings and subjective body discomforts. Two variables were evaluated, namely assembly methods (with versus without pedal exercises at a moderate intensity) and session testing (pre- versus post-test). Thus, the repeated measures design (i.e., assembly method by session testing of participants) was used. According to the completion time, error %, participant self-reports, and ECG and EEG statistical analysis data, the participants' performances in the keyboard assembly task did not decrease while they performed pedaling exercises (p > 0.05). Additionally, when participants completed the assembly task while executing the pedaling exercises, the mean inter-beat (RR) intervals significantly reduced (p < 0.05) while the mean heart rate increased (p < 0.05), which mean that pedaling exercises caused physical workloads on the participants. Participant performance was unaffected by performing a workout while performing the assembly activity. Thus, administrations should encourage their employees to engage in short sessions of moderate-intensity exercise similar to the suggested exercise in the study to improve a person's physical health during work without interfering with the effectiveness of work.

Acute effects of long-distance races on heart rate variability and arterial stiffness: A systematic review and meta-analysis

This study systematically reviewed and quantified the effects of running a long-distance race (LDR) on heart rate variability (HRV) and arterial stiffness (AS). All types of races of a distance equal to or greater than a marathon (≥42.2 km) were included. A total of 2,220 articles were identified, 52 were included in the qualitative analysis, and 48 were meta-analysed. The standardised mean difference pre- and post-race of various time-domain and frequency-domain indices of HRV, mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP) and carotid-femoral pulse wave velocity (cfPWV) was calculated. Regarding HRV, there was a significant decrease in most of the variables considered as markers of parasympathetic activity, indicating a shift of autonomic balance towards a reduced vagal tone. Regarding vascular variables, there was a significant drop in blood pressure and reduced AS. In conclusion, running an LDR seems to have a considerable acute effect on the autonomic nervous system, haemodynamics, and vascular properties. The observed effects could be categorised within the expected acute responses to long-lasting, strenuous exercise.

Feasibility of a wearable biosensor device to characterize exercise and sleep in neurology residents

BACKGROUND

Research suggests optimizing sleep, exercise and work-life balance may improve resident physician burnout. Wearable biosensors may allow residents to detect and correct poor sleep and exercise habits before burnout develops. Our objectives were to evaluate the feasibility of a wearable biosensor to characterize exercise/sleep in neurology residents and examine its relationship to self-reported, validated survey measures. We also assessed the device's impact on well-being and barriers to use.

METHODS

This prospective cohort study evaluated the WHOOP Strap 2.0 in neurology residents. Participants completed regular online surveys, including self-reported hours of sleep/exercise, and validated sleep/exercise scales at 3-month intervals. Autonomic, exercise, and sleep measures were obtained from WHOOP. Changes were evaluated over time via linear regression. Survey and WHOOP metrics were compared using Pearson correlations.

RESULTS

Sixteen (72.7%) of 22 eligible participants enrolled. Eleven (68.8%) met the minimum usage requirement (6+ months) and were classified as 'consecutive wearers.' Significant increases were found in sleep duration and exercise intensity. Moderate-to-low correlations were found between survey responses and WHOOP measures. Most (73%) participants reported a positive impact on well-being. Barriers to use included 'Forgetting to wear' (20%) and 'not motivational' (23.3%).

CONCLUSION

Wearable biosensors may be a feasible tool to evaluate sleep/exercise in residents.

Rehabilitation program combining physical exercise and heart rate variability biofeedback in hematologic patients: a feasibility study

Purpose

Hematologic patients have a poorer health-related quality of life due to the disease and its treatments. Non-pharmacological interventions represent an opportunity in tertiary cancer prevention to manage persistent symptoms and support patients in their return to active daily living. This interventional study aimed to evaluate the feasibility of a program combining physical exercise (PE) and heart rate variability biofeedback (HRVB) in hematologic patients.

Method

Hematologic patients in remission within 6 months participated in a 12-week rehabilitation program including 24 supervised sessions of PE associated with 10 supervised sessions of HRVB and daily home-based practice of paced breathing. We assessed patient adherence, fatigue, physical function, and heart rate variability.

Results

Twenty patients were included, 17 completed the protocol and 3 dropped out due to disease progression or time constraints; no adverse events or incidents were reported. Participation rates were 85% for PE and 98% for HRVB-supervised sessions. Significant improvements of physical capacity (6-min walk test, p < 0.001; 50-foot walk test, p < 0.001), muscle strength (grip force test, p < 0.01), and flexibility (toe-touch test, p < 0.001; back scratch test, p < 0.05) were measured. Coherence ratio (p < 0.001) and low-frequency spectral density of HRV signal (p < 0.003) increased significantly, suggesting improved autonomic function. Fatigue, static balance, and other time and frequency indicators of HRV were not improved (all p > 0.05).

Conclusion

A rehabilitation program combining PE and HRVB is feasible in hematologic patients and effective on physical function. Further research with a larger sample size is needed to investigate effectiveness on patients’ autonomic functions and their impacts on symptomatology.

A method to quantify autonomic nervous system function in healthy, able-bodied individuals

BACKGROUND

The autonomic nervous system (ANS) maintains physiological homeostasis in various organ systems via parasympathetic and sympathetic branches. ANS function is altered in common diffuse and focal conditions and heralds the beginning of environmental and disease stresses. Reliable, sensitive, and quantitative biomarkers, first defined in healthy participants, could discriminate among clinically useful changes in ANS function. This framework combines controlled autonomic testing with feature extraction during physiological responses.

METHODS

Twenty-one individuals were assessed in two morning and two afternoon sessions over two weeks. Each session included five standard clinical tests probing autonomic function: squat test, cold pressor test, diving reflex test, deep breathing, and Valsalva maneuver. Noninvasive sensors captured continuous electrocardiography, blood pressure, breathing, electrodermal activity, and pupil diameter. Heart rate, heart rate variability, mean arterial pressure, electrodermal activity, and pupil diameter responses to the perturbations were extracted, and averages across participants were computed. A template matching algorithm calculated scaling and stretching features that optimally fit the average to an individual response. These features were grouped based on test and modality to derive sympathetic and parasympathetic indices for this healthy population.

RESULTS

A significant positive correlation (p = 0.000377) was found between sympathetic amplitude response and body mass index. Additionally, longer duration and larger amplitude sympathetic and longer duration parasympathetic responses occurred in afternoon testing sessions; larger amplitude parasympathetic responses occurred in morning sessions.

CONCLUSIONS

These results demonstrate the robustness and sensitivity of an algorithmic approach to extract multimodal responses from standard tests. This novel method of quantifying ANS function can be used for early diagnosis, measurement of disease progression, or treatment evaluation.

TRIAL REGISTRATION

This study registered with Clinicaltrials.gov , identifier NCT04100486 . Registered September 24, 2019, https://www.clinicaltrials.gov/ct2/show/NCT04100486 .

Hematology, Hormones, Inflammation, and Muscle Damage in Elite and Professional Soccer Players: A Systematic Review with Implications for Exercise

BACKGROUND

Knowledge of the long-term effects of soccer training on hematological, hormonal, inflammatory, and muscle damage markers and physical performance may help to better design strength and conditioning programs for performance development and injury prevention for the individual player and the team.

OBJECTIVES

The aim of this systematic review was to summarize and discuss evidence on the long-term effects of soccer training on selected hematological, hormonal, inflammatory, and muscle damage markers and physical performance in elite and professional soccer players. A second goal was to investigate associations between selected physiological markers and measures of performance.

METHODS

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature search was conducted in four electronic databases (PubMed, ISI Web of Knowledge, Web of Science, and SPORTDiscus) from inception until August 2020 to identify articles related to soccer training effects. To be included in this systematic review, studies had to examine male elite (national level) and/or professional (international level) soccer players aged > 17 years and a soccer training period > 4 weeks, and report outcomes related to hematological, hormonal, inflammatory, muscle damage, and performance markers.

RESULTS

The search syntax initially identified 2420 records. After screening titles, abstracts, and full texts, 20 eligible studies were included in this systematic review, with training durations lasting between 4 and 18 weeks in 15 studies, around 6 months in four studies, and around 1 year in one study. Effects of long-term soccer training revealed parameter-specific increases or decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance. Two studies showed a moderate increase in hematological markers such as hemoglobin (effect size [ES] = 0.67-0.93). Parameter-specific changes were noted for hormonal markers in the form of increases for total testosterone (ES = 0.20-0.67) and free testosterone (FT) (ES = 0.20-0.65) and decreases for cortisol (ES =  - 0.28 to - 1.31). Finally, moderate to very large increases were found for muscle damage markers such as creatine kinase (ES = 0.94-6.80) and physical performance such as countermovement jump (CMJ) height (ES = 0.50-1.11) and squat jump (SJ) height (ES = 0.65-1.28). After long-term periods of soccer training, significant positive correlations were found between percentage change (Δ%) in FT and Δ% in CMJ height (r = 0.94; p = 0.04) and between Δ% in total testosterone/cortisol (TT/C) ratio and Δ% in SJ (r = 0.89; p = 0.03).

CONCLUSIONS

Findings suggest that long-term soccer training induces increases/decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance in male elite and professional soccer players. These fluctuations can be explained by different contextual factors (e.g., training load, duration of training, psychological factors, mood state). Interestingly, the observed changes in hormonal parameters (FT and TT/C) were related to vertical jump performance changes (e.g., CMJ and SJ). Anabolic hormones and TT/C can possibly be used as a tool to identify physical performance alteration after long-term soccer training.