Acute Exercise with Moderate Hypoxia Reduces Arterial Oxygen Saturation and Cerebral Oxygenation without Affecting Hemodynamics in Physically Active Males

Hemodynamics and cerebral oxygenation during acute exercise in moderate normobaric hypoxia and with concurrent cognitive task in young healthy males

The present investigation aimed to study the cardiovascular responses and the cerebral oxygenation (Cox) during exercise in acute hypoxia and with contemporary mental stress. Fifteen physically active, healthy males (age 29.0 ± 5.9 years) completed a cardiopulmonary test on a cycle ergometer to determine the workload at their gas exchange threshold (GET). On a separate day, participants performed two randomly assigned exercise tests pedaling for 6 min at a workload corresponding to 80% of the GET: (1) during normoxia (NORMO), and (2) during acute, normobaric hypoxia at 13.5% inspired oxygen (HYPO). During the last 3 min of the exercise, they also performed a mental task (MT). Hemodynamics were assessed with impedance cardiography, and peripheral arterial oxygen saturation and Cox were continuously measured by near-infrared spectroscopy. The main results were that both in NORMO and HYPO conditions, the MT caused a significant increase in the heart rate and ventricular filling rate. Moreover, MT significantly reduced (74.8 ± 5.5 vs. 62.0 ± 5.2 A.U.) Cox, while the reaction time (RT) increased (813.3 ± 110.2 vs. 868.2 ± 118.1 ms) during the HYPO test without affecting the correctness of the answers. We conclude that in young, healthy males, adding an MT during mild intensity exercise in both normoxia and acute moderate (normobaric) hypoxia induces a similar hemodynamic response. However, MT and exercise in HYPO cause a decrease in Cox and an impairment in RT.

Male and Female Mitochondria Respond Differently after Exercising in Acute Hypoxia

The use of hypoxic devices among athletes who train in normobaric hypoxia has become increasingly popular; however, the acute effects on heart and brain metabolism are not yet fully understood. This study aimed to investigate the mitochondrial bioenergetics in trained male and female Wistar rats after acute hypoxia training. The experimental plan included exercising for 30 min on a treadmill in a Plexiglas cage connected to a hypoxic generator set at 12.5% O2 or in normoxia. After the exercise, the rats were sacrificed, and their mitochondria were isolated from their brains and hearts. The bioenergetics for each complex of the electron transport chain was tested using a Clark-type electrode. The results showed that following hypoxia training, females experienced impaired oxidative phosphorylation through complex II in heart subsarcolemmal mitochondria, while males had an altered ADP/O in heart interfibrillar mitochondria, without any change in oxidative capacity. No differences from controls were evident in the brain, but an increased electron transport system efficiency was observed with complex I and IV substrates in males. Therefore, the study's findings suggest that hypoxia training affects the heart mitochondria of females more than males. This raises a cautionary flag for female athletes who use hypoxic devices.

Concomitant dual-site tDCS and dark chocolate improve cognitive and endurance performance following cognitive effort under hypoxia: a randomized controlled trial

Ten male cyclists were randomized into four experimental conditions in this randomized, cross-over, double-blind, and sham-controlled study to test the combined effect of acute dark chocolate (DC) ingestion and anodal concurrent dual-site transcranial direct current stimulation (a-tDCS) targeting M1 and left DLPFC on cognitive and whole-body endurance performance in hypoxia after performing a cognitive task. Two hours before the sessions, chocolate was consumed. After arriving at the lab, participants completed an incongruent Stroop task for 30 min in hypoxia (O2 = 13%) to induce mental fatigue, followed by 20 min of tDCS (2 mA) in hypoxia. Then, in hypoxia, they performed a time-to-exhaustion task (TTE) while measuring physiological and psychophysiological responses. Cognitive performance was measured at baseline, after the Stroop task, and during and after TTE. TTE in 'DC + a-tDCS' was significantly longer than in 'white chocolate (WC) + a-tDCS' and WC + sham-tDCS'. The vastus medialis muscle electromyography amplitude was significantly higher in 'DC + a-tDCS' and 'DC + sham-tDCS' than in 'WC + sh-tDCS'. During and after the TTE, choice reaction time was significantly lower in 'DC + a-tDCS' compared to 'WC + sh-tDCS'. Other physiological or psychophysiological variables showed no significant differences. The concurrent use of acute DC consumption and dual-site a-tDCS might improve cognitive and endurance performance in hypoxia.

Post-Exertion Rate of Reperfusion vs Point-by-Point analysis of skeletal tissue near-infrared spectroscopy during repeated fatigue recovery under normoxia and hypoxemia

OBJECTIVE

Near-Infrared Spectroscopy (NIRS) analysis techniques can often be complex to perform and interpret resulting in a barrier for wide-spread clinical use. The traditional Point-by-Point analysis methodology and our Post-Exertion Rate of Reperfusion method were examined during the recovery phases following repeated bouts of physical exertion to determine the physiological processes and information captured by each methodology under normal exertion conditions (FiO₂: 0.210) and when in hypoxic conditions (FiO₂: 0.129).

METHODS

To achieve this, a total of n = 15 participants performed 3 sets of leg extensions to failure at 70 % their maximal effort. A 1-min rest was performed following each set where the Point-by-Point analysis means were calculated at every 6-s time to recovery for a total of 10 mean values. The Post-Exertion Rate of Reperfusion examined the linear slopes for the entire 60-s. The near-infrared spectroscopy device was placed over the vastus lateralis and measure for muscle tissue oxygen saturation, oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin were obtained for both the Point-by-Point and Post-Exertion Rate of Reperfusion analysis.

RESULTS

Post-Exertion Rate of Reperfusion slopes were significantly different between normoxia and hypoxia for muscle tissue oxygen saturation (Normoxia: 0.151-0.171; Hypoxia: 0.068-0.116), oxygenated hemoglobin (Normoxia: 0.127 - 0.134; Hypoxia: 0.045 - 0.076), deoxygenated hemoglobin (Normoxia: -0.142 to -0.152; Hypoxia: -0.054 to -0.100), and total hemoglobin (Normoxia: -0.011 to 0.0250; Hypoxia: -0.009 to 0.024). Point-by-Point analysis identified significant differences between muscle tissue oxygen saturation and oxygenated hemoglobin, but not deoxygenated hemoglobin and total hemoglobin.

CONCLUSION

Point-by-Point analysis and Post-Exertion Rate of Reperfusion can each provide distinctly unique information during exertional recovery. Point-by-Point analysis was ideal for detecting the onset of change in muscle oxygen status. Post-Exertion Rate of Reperfusion identified overall rates of change and was shown to be more sensitive at identifying changes in overall recovery of skeletal tissue reperfusion rates. Point-by-Point analysis and Post-Exertion Rate of Reperfusions may be utilized individually or separately to improve the interpretability of skeletal NIRS metrics within research or clinical settings.

Effects of Acute Moderate Hypoxia versus Normoxia on Metabolic and Cardiac Function and Skeletal Muscle Oxygenation during Endurance Exercise at the Same Heart Rate Level

This study aimed to investigate the effects of acute moderate hypoxia (HYP), compared with those of normoxia (NORM), during endurance exercise with the same HR level on metabolic function, skeletal muscle oxygenation, and cardiac function. Twelve healthy men (aged 25.1 ± 2.3 years) completed 30 min of endurance exercise using a cycle ergometer with the same HR level (136.5 ± 1.5 bpm) corresponding to 70% maximal heart rate (HRmax) under NORM (760 mmHg) and HYP (526 mmHg, simulated 3000 m altitude) after a 30 min exposure in the respective environments on different days, in random order. Exercise load, rating of perceived exertion (RPE), metabolic function (saturation of percutaneous oxygen; SpO₂, minute ventilation; oxygen uptake; VO₂, carbon dioxide excretion; respiratory exchange ratio; RER, and oxygen pulse), skeletal muscle oxygen profiles (oxyhemoglobin, oxhb, deoxyhemoglobin, dxhb, total hemoglobin, and tissue oxygenation index; StO₂), and cardiac function (heart rate, stroke volume, cardiac output, end-diastolic volume, end-systolic volume, and ejection fraction) were measured during endurance exercise. HYP showed a lower exercise load with the same RPE during exercise than did NORM. In addition, HYP showed a lower SpO₂, VO₂, oxygen pulse, oxhb, and StO₂, and a higher RER and dxhb during exercise than NORM. We found that HYP showed lower exercise load and VO₂ at the same RPE than NORM and also confirmed a higher anaerobic metabolism and oxygen inflow into skeletal muscle tissue due to the limitation of oxygen delivery capacity.

Efficacy of comprehensive nursing in patients with pneumoconiosis and its influence on quality of life

OBJECTIVE

To investigate the efficacy of comprehensive nursing for patients with pneumoconiosis and its influence on patients' quality of life (QoL).

METHODS

Sixty-two patients with pneumoconiosis diagnosed and treated in the Henan Provincial Institute for Occupational Health (Henan No. 3 Provicial People's Hospital) from October 2018 to October 2019 were included in this retrospective study. According to the nursing model, patients receiving comprehensive nursing were included in the experimental group (n=31) and those receiving general care were included in the reference group (n=31). The pulmonary function (PF) indices, QoL score, emotional score and health behavior compliance were compared between the two groups before and after nursing.

RESULTS

(1) A significantly higher overall response rate was determined in the experimental group compared with the reference group (P<0.05). (2) There were no significant differences in heart rate (HR) and oxygen saturation between the two groups before nursing intervention (P>0.05). After nursing, significantly lower HR and higher oxygen saturation were observed in the experimental group compared with the reference group (all P<0.05). (3) The PF indexes also showed no significant differences between the two groups before nursing (P>0.05). After nursing, the experimental group exhibited higher forced expiratory volume in 1 second percent predicted (FEV1%_pred), forced vital capacity percent predicted (FVC%_pred), and blood oxygen partial pressure than the reference group, with statistical significance (all P<0.05). (4) The two groups showed similar QoL before nursing (P>0.05). After nursing, the experimental group scored significantly higher in physiological function, mental health, social function and vitality than the reference group (P<0.05). (5) The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores, which were not statistically different between groups before nursing (P>0.05), were significantly lower in the experimental group after nursing compared with reference group (P<0.05). (6) The compliance of medication, diet, respiratory training and home oxygen therapy was higher in the experimental group compared with the reference group, showing statistical significance (P<0.05).

CONCLUSIONS

Comprehensive nursing care for patients with pneumoconiosis can effectively enhance the curative effect, PF and QoL of patients, improve their HR, oxygen saturation and mood, and enhance their compliance with health behaviors.