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1.
J Frailty Aging ; 13(1): 31-34, 2024.
Article in English | MEDLINE | ID: mdl-38305440

ABSTRACT

The aim of the present study was to investigate the association between handgrip strength and mortality in Brazilian frail nonagenarians and centenarians. Eighty-one oldest old were included (mean age [SD]: 94.2 [3.8] years). Data on strength was assessed by handgrip strength. Mortality rate of the participants was evaluated at 1-year follow-up after the functional assessment. A logistic regression analysis was used to assess differences in categories of handgrip strength between groups regarding the mortality rate. Forty-six participants (56.8%) had reduced handgrip strength. After 1 year, there were 16 deaths. Those older adults with a low handgrip strength had higher prevalence (28.3% vs. 8.6%) and increased risk of mortality than those with preserved handgrip strength (Odds ratio=4.4, confidence interval 95% 1.1, 18.4) (p=0.042). Reduced handgrip strength is associated with higher mortality rate at 1-year follow-up in Brazilian frail nonagenarians and centenarians.


Subject(s)
Frail Elderly , Frailty , Aged, 80 and over , Aged , Humans , Centenarians , Nonagenarians , Hand Strength , Brazil/epidemiology , Frailty/epidemiology
2.
Scand J Med Sci Sports ; 28(6): 1671-1680, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29396987

ABSTRACT

Adaptations to 6 weeks of supervised hamstring stretching training and its potential impact on symptoms of eccentric exercise-induced muscle damage (EIMD) were studied in 10 young, untrained men with limited hamstrings flexibility. Participants performed unilateral flexibility training (experimental leg; EL) on an isokinetic dynamometer, while the contralateral limb acted as control (CL). Hip range of motion (ROM), passive, isometric, and concentric torques, active optimum angle, and biceps femoris and semitendinosus muscle thickness and ultrasound echo intensity were assessed both before and after the training. Additionally, muscle soreness was assessed before and after an acute eccentric exercise bout in both legs (EL and CL) at post-training only. Hip ROM increased (P < .001) only in EL after the training (EL = 10.6° vs CL = 1.6°), but no changes (P > .05) in other criterion measurements were observed. After a bout of eccentric exercise at the end of the program, isometric and dynamic peak torques and muscle soreness ratings were significantly altered at all time points equally in EL and CL. Also, active optimum angle was reduced immediately, 48 and 72 hours post-exercise, and hip ROM was reduced at 48 and 72 hours equally in EL and CL. Finally, biceps femoris muscle thickness was significantly increased at all time points, and semitendinosus thickness and echo intensity significantly increased at 72 hours, with no significant differences between legs. The stretching training protocol significantly increased hip ROM; however, it did not induce a protective effect on EIMD in men with tight hamstrings.


Subject(s)
Hamstring Muscles/physiology , Muscle Stretching Exercises , Myalgia/prevention & control , Range of Motion, Articular , Adaptation, Physiological , Adult , Hip/physiology , Humans , Male , Resistance Training , Torque , Young Adult
3.
Scand J Med Sci Sports ; 25(5): e524-30, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25556301

ABSTRACT

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at -110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage.


Subject(s)
Cryotherapy/methods , Quadriceps Muscle/physiopathology , Recovery of Function , Adolescent , Exercise/physiology , Humans , Isometric Contraction , Male , Myalgia/therapy , Quadriceps Muscle/diagnostic imaging , Quadriceps Muscle/pathology , Time Factors , Torque , Ultrasonography , Young Adult
4.
Int J Sports Med ; 35(14): 1161-9, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25144436

ABSTRACT

This study aimed to compare the oxygen uptake (VO2), the muscle activity of lower limbs, and the vertical ground reaction force (V-GRF) of women performing water aerobic exercises at different intensities. 12 young women performed the experimental protocol, which consisted of 3 water exercises (stationary running [SR], frontal kick [FK] and cross country skiing [CCS]) at 3 intensities (first and second ventilatory thresholds and maximum effort). A two-way repeated measures ANOVA was used. Regarding VO2, different responses between intensities (p<0.001) were found, and values between exercises were similar. For electromyographic activity (EMG), differences between intensities for all muscles (p<0.001) were found. Greater EMG signals were observed in the FK compared to SR for rectus femoris, semitendinosus, vastus lateralis and biceps femoris muscles (p<0.05). Regarding V-GRF, there was an increase in the V-GRF at greater intensities compared to the first ventilatory threshold (p=0.001). In addition, lower values were found during CCS compared to the SR and FK exercises (p<0.001). Thus, greater cardiorespiratory and neuromuscular responses were observed with increasing intensity. Exercises such as CCS could be used to attenuate the V-GRF; if the purpose is to reduce the muscular activity of lower limbs at a specific intensity, SR could be recommended.


Subject(s)
Exercise/physiology , Lower Extremity/physiology , Muscle, Skeletal/physiology , Oxygen Consumption/physiology , Water , Adult , Anaerobic Threshold , Biomechanical Phenomena , Electromyography , Female , Humans , Young Adult
5.
Int J Sports Med ; 35(14): 1155-60, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25144438

ABSTRACT

The aim of this study was to evaluate the effects of a single partial-body cryotherapy bout between training sessions on strength recovery. 12 young men (23.9±5.9 years) were randomly exposed to 2 different conditions separated by 7 days: 1) Partial-body cryotherapy (subjects were exposed to 3 min of partial-body cryotherapy at - 110 °C between 2 high-intensity training sessions); 2) Control (subjects were not exposed to partial-body cryotherapy between 2 high-intensity training sessions). Subjects were exposed to partial-body cryotherapy after the first training session. The 2 knee extension high-intensity training sessions were separated by a 40-min rest interval. Knee extension training consisted of 6 sets of 10 repetitions at 60°.s(-1) for concentric actions and 6 sets of 10 at 180.s(-1) for eccentric actions. The decrease in eccentric peak torque and total work was significantly (p<0.05) less after partial-body cryotherapy (5.6 and 2%, respectively) when compared to control (16 and 11.6%, respectively). However, the decrease in concentric peak torque and total work was not different (p>0.05) between partial-body cryotherapy (9.4 and 6.5%, respectively) and control (7.5 and 5.2%, respectively). These results indicate that the use of partial-body cryotherapy between-training sessions can enhance eccentric muscle performance recovery.


Subject(s)
Cryotherapy , Muscle Strength/physiology , Muscle, Skeletal/physiology , Resistance Training , Adult , Humans , Knee/physiology , Male , Torque , Young Adult
6.
Int J Sports Med ; 35(1): 41-8, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23771835

ABSTRACT

The aim was to investigate the effects of the intra-session exercise order during water-based concurrent training on the neuromuscular adaptations in young women. 26 women (25.1±2.9 years) were placed into 2 groups: resistance prior to (RA) or after (AR) aerobic training. Subjects performed resistance (sets at maximal effort) and aerobic training (exercises at heart rate corresponding to the second ventilatory threshold) twice a week over 12 weeks, performing both exercise types in the same training session. Upper (elbow flexion) and lower-body (knee extension) one-repetition maximum test (1RM) and peak torque (PT) were evaluated. The muscle thickness (MT) of upper (sum of MT of biceps brachii and brachialis) and lower-body (sum of MT of vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris) was determined by ultrasonography. Moreover, the maximal electromyographic activity (EMG) of upper (biceps brachii) and lower-body (sum of EMG of vastus lateralis and rectus femoris) was measured. Both RA and AR groups increased the upper and lower-body 1RM and PT, while the lower-body 1RM increases observed in the RA was greater than AR (43.58±14.00 vs. 27.01±18.05%). RA and AR showed MT increases in all muscles evaluated, while the lower-body MT increases observed in the RA were also greater than AR (10.24±3.11 vs. 5.76±1.88%). There were increases in the maximal EMG of upper and lower-body in both RA and AR, with no differences between groups. Performing resistance prior to aerobic exercise during water-based concurrent training seems to optimize the lower-body strength and hypertrophy.


Subject(s)
Adaptation, Physiological/physiology , Exercise/physiology , Muscle, Skeletal/physiology , Water , Adult , Electromyography , Female , Healthy Volunteers , Humans , Isometric Contraction/physiology , Leg/physiology , Muscle Strength/physiology , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/growth & development , Oxygen Consumption , Resistance Training/methods , Torque , Ultrasonography
7.
J Sports Med Phys Fitness ; 53(3): 255-60, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23715249

ABSTRACT

AIM: Declines in muscular strength resulting from reduced serum anabolic hormones and neural activity may influence the reduction in aerobic capacity in older men. However, there has been little investigation into the relationship between steroid hormones and muscular strength, as well as endurance capacity in elderly subjects. The purpose of this study was to investigate the possible relationship between serum steroid hormones, strength and aerobic performance in older men. METHODS: Twenty-eight aged men (65±4 years) were evaluated in dynamic strength (one repetition maximum test), isometric strength (maximal voluntary contraction) and rate of force development. Peak oxygen uptake and maximal workload were determined during a ramp protocol on a cycle ergometer. In addition, blood samples were taken to determine basal cortisol, total and free testosterone. RESULTS: No correlations were found between steroid hormonal concentrations and the performance parameters investigated. CONCLUSION: Our results suggest that single measurements of steroids hormones concentrations are not related to the strength and endurance capacity of healthy South-American elderly men.


Subject(s)
Hydrocortisone/blood , Muscle Strength/physiology , Physical Endurance/physiology , Testosterone/blood , Aged , Brazil , Ergometry , Humans , Male , Oxygen Consumption/physiology
8.
Int J Sports Med ; 34(10): 881-7, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23549690

ABSTRACT

The aim of the present study was to compare the peak vertical ground reaction force (V-GRF(peak)) and impulse of women performing water aerobic exercises at different intensities in aquatic and dry land environments. 15 young women performed 1 session in each environment consisting of 3 water aerobic exercises (stationary running, frontal kick and cross country skiing) performed at 3 cadences (first ventilatory threshold, second ventilatory threshold and maximum effort, as determined during exercise in water) in a randomized order. 2-way and 3-way repeated measures ANOVA were used to analyze the impulse and V-GRF(peak), respectively. Significantly lower values of V-GRF(peak) and impulse (p<0.001) were observed for the aquatic environment. Significant differences were observed among all cadences for V-GRF(peak) and impulse (p<0.001) in both environments except for the V-GRF(peak) between the cadences corresponding to the second ventilatory threshold and maximum effort in the aquatic environment. In addition, significantly lower V-GRF(peak) values in the aquatic environment were found for cross country skiing compared to the other exercises (p<0.001). Thus, water exercises are safe for people that need to minimize vertical ground reaction force; however, an important issue to be considered during water aerobics training is the exercise and intensity to be prescribed.


Subject(s)
Exercise/physiology , Water , Adult , Biomechanical Phenomena , Exercise Test , Female , Healthy Volunteers , Humans , Oxygen Consumption
9.
Age (Dordr) ; 35(6): 2329-44, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23288690

ABSTRACT

The purpose of the present study was to review the scientific literature that investigated concurrent training adaptations in elderly populations, with the aim of identifying the optimal combination of both training program variables (i.e., strength and endurance) to avoid or minimize the interference effect in the elderly. Scielo, Science Citation Index, MEDLINE, Scopus, SPORTDiscus, and ScienceDirect databases were searched. Concurrent training is the most effective strategy by which to improve neuromuscular and cardiorespiratory functions as well as functional capacity in the elderly. The volume and frequency of training appears to play a critical role in concurrent training-induced adaptations in elderly subjects. Furthermore, new evidence indicates that the intra-session exercise order may influence the magnitude of physiological adaptations. Despite the interference effect on strength gains that is caused by concurrent training, this type of training is advantageous in that the combination of strength and endurance training produces both neuromuscular and cardiovascular adaptations in the elderly. The interference phenomenon may be observed in elderly subjects when a moderate weekly volume of concurrent training (i.e., three times per week) is performed. However, even with the occurrence of this phenomenon, the performance of three concurrent training sessions per week appears to optimize the strength gains in relative brief periods of training (12 weeks). Moreover, performing strength prior to endurance exercise may optimize both neuromuscular and cardiovascular gains.


Subject(s)
Adaptation, Physiological/physiology , Aging/physiology , Muscle Strength/physiology , Muscle, Skeletal/physiology , Physical Endurance/physiology , Resistance Training/methods , Aged , Humans
10.
Int J Sports Med ; 33(12): 962-9, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22782384

ABSTRACT

The objective of the present study was to evaluate and compare the neuromuscular, morphological and functional adaptations of older women subjected to 3 different types of strength training. 58, healthy women (67 ± 5 year) were randomized to experimental (EG, n=41) and control groups (CG, n=17) during the first 6 weeks when the EG group performed traditional resistance exercise for the lower extremity. Afterwards, EG was divided into three specific strength training groups; a traditional group (TG, n=14), a power group (PG, n=13) that performed the concentric phase of contraction at high speed and a rapid strength group (RG, n=14) that performed a lateral box jump exercise emphasizing the stretch-shortening-cycle (SSC). Subjects trained 2 days per week through the entire 12 weeks. Following 6 weeks of generalized strength training, significant improvements occurred in EG for knee extension one-repetition (1RM) maximum strength (+19%), knee extensor muscle thickness (MT, +15%), maximal muscle activation (+44% average) and onset latency ( -31% average) for vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) compared to CG (p<0.05). Following 6 more weeks of specific strength training, the 1RM increased significantly and similarly between groups (average of +21%), as did muscle thickness of the VL (+25%), and activation of VL (+44%) and VM (+26%). The onset latency of RF (TG=285 ± 109 ms, PG=252 ± 76 ms, RG=203 ± 43 ms), reaction time (TG=366 ± 99 ms, PG=274 ± 76 ms, RG=201 ± 41 ms), 30-s chair stand (TG=18 ± 3, PG=18 ± 1, RG=21 ± 2) and counter movement jump (TG=8 ± 2 cm, PG=10 ± 3 cm, RG=13 ± 2 cm) was significantly improved only in RG (p<0.05). At the end of training, the rate of force development (RFD) over 150 ms (TG=2.3 ± 9.8 N·s(-1), PG=3.3 ± 3.2 N·s(-1), RG=3.8 ± 6.8 N·s(-1), CG=2.3 ± 7.0 N·s(-1)) was significantly greater in RG and PG than in TG and CG (p<0.05). In conclusion, rapid strength training is more effective for the development of rapid force production of muscle than other specific types of strength training and by consequence, better develops the functional capabilities of older women.


Subject(s)
Muscle, Skeletal/physiology , Resistance Training/methods , Aged , Female , Humans , Middle Aged , Muscle Strength/physiology
11.
Int J Sports Med ; 33(8): 627-34, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22562730

ABSTRACT

The aim of the present study was to compare the effects of using different intensities and types of aerobic exercise (i. e., cycle ergometer or running) during concurrent training on neuromuscular adaptations. A total of 44 young women were randomly assigned to 1 of 4 groups: concurrent strength and continuous running training (SCR, n=10), concurrent strength and interval running training (SIR, n=11), concurrent strength and continuous cycle ergometer training (SCE, n=11), or strength training only (STO, n=12). Each group trained twice a week during 11 weeks. The following strength measurements were made on all subjects before and after training period: maximal strength (1RM) in knee extension, bench press and leg press exercises; local muscular endurance (number of repetitions at 70% of 1 RM) in knee extension and bench press exercises; and isometric and isokinetic peak torque of knee extension. There were significant increases in the upper and lower-body 1 RM, isometric and isokinetic peak torque in all training groups (p<0.001), with no differences between groups. The present results suggest that in young women, concurrent training performed twice a week promotes similar neuromuscular adaptations to strength training alone, regardless of the type and the intensity in which the aerobic training is performed.


Subject(s)
Adaptation, Physiological , Bicycling/physiology , Exercise/physiology , Physical Endurance/physiology , Resistance Training/methods , Running/physiology , Adult , Ergometry , Female , Humans , Muscle Strength/physiology , Young Adult
12.
Int J Sports Med ; 32(12): 916-23, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22052026

ABSTRACT

The aim of the study was to compare the cardiorespiratory and neuromuscular responses to water aerobics exercise performed with and without equipment. 15 women performed stationary jogging combined with elbow flexion/extension without equipment, with water-drag forces equipment and with water-floating equipment, at 2 submaximal cadences and at maximal cadence. Heart rate, oxygen uptake and electromyographic signal from biceps brachii, triceps brachii, biceps femoris and rectus femoris were collected during the exercise. The heart rate and oxygen uptake showed significantly higher values during the execution of the water aerobics exercise with either equipment compared to the execution without equipment. In addition, significant difference was found between submaximal cadences. For neuromuscular responses, no significant differences were found between the submaximal cadences for all muscles analyzed; however, significant differences were found between these submaximal cadences and the maximal cadence. Similarly, the results showed no significant differences between the execution of the exercise with or without equipment, except in the muscle activation of triceps brachii and biceps femoris, which was higher when using water-floating and water-drag forces equipment, respectively. In conclusion, the water aerobics exercise presented higher cardiorespiratory responses with equipment and also increased the cadence of execution. Nevertheless, neuromuscular responses were higher only at maximal cadence.


Subject(s)
Cardiovascular Physiological Phenomena , Exercise/physiology , Muscle, Skeletal/metabolism , Musculoskeletal Physiological Phenomena , Water , Adaptation, Physiological , Analysis of Variance , Body Composition , Elbow/physiology , Electromyography , Female , Heart Rate/physiology , Humans , Oxygen Consumption , Respiratory Physiological Phenomena , Young Adult
13.
Neuroscience ; 192: 661-74, 2011 Sep 29.
Article in English | MEDLINE | ID: mdl-21712072

ABSTRACT

Patients suffering from depression frequently display hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) resulting in elevated cortisol levels. One main symptom of this condition is anhedonia. There is evidence that exercise training can be used as a rehabilitative intervention in the treatment of depressive disorders. In this scenario, the aim of the present study was to assess the effect of an aerobic exercise training protocol on the depressive-like behavior, anhedonia, induced by repeated dexamethasone administration. The study was carried out on adult male Wistar rats randomly divided into four groups: the "control group" (C), "exercise group" (E), "dexamethasone group" (D) and the "dexamethasone plus exercise group" (DE). The exercise training consisted of swimming (1 h/d, 5 d/wk) for 3 weeks, with an overload of 5% of the rat body weight. Every day rats were injected with either dexamethasone (D/DE) or saline solution (C/E). Proper positive controls, using fluoxetine, were run in parallel. Decreased blood corticosterone levels, reduced adrenal cholesterol synthesis and adrenal weight (HPA disruption), reduced preference for sucrose consumption and increased immobility time (depressive-like behavior), marked hippocampal DNA oxidation, increased IL-10 and total brain-derived neurotrophic factor (BDNF; pro-plus mature-forms) and a severe loss of body mass characterized the dexamethasone-treated animals. Besides increasing testosterone blood concentrations, the swim training protected depressive rats from the anhedonic state, following the same profile as fluoxetine, and also from the dexamethasone-induced impaired neurochemistry. The data indicate that physical exercise could be a useful tool in preventing and treating depressive disorders.


Subject(s)
Anhedonia/physiology , Depression/rehabilitation , Physical Conditioning, Animal/methods , Animals , Brain-Derived Neurotrophic Factor/biosynthesis , Depression/complications , Dexamethasone/toxicity , Disease Models, Animal , Gene Expression/physiology , Glucocorticoids/toxicity , Hippocampus/metabolism , Hypothalamo-Hypophyseal System/metabolism , Interleukin-10/biosynthesis , Male , Pituitary-Adrenal System/metabolism , Rats , Rats, Wistar , Real-Time Polymerase Chain Reaction , Swimming
14.
Int J Sports Med ; 31(10): 689-97, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20617484

ABSTRACT

The aim of the present study was to investigate the effects of concurrent strength and endurance training on neuromuscular and hormonal parameters in elderly men. 23 healthy men (65±4 years) were randomly assigned to 1 of 3 groups: concurrent (CG, n=8), strength (SG, n=8) or endurance group (EG, n=7). The programs consisted, of strength training, endurance training on a cycle ergometer or a combination of both in the same session 3 times per week over a duration of 12 weeks. Subjects were evaluated on parameters related to muscle strength, muscle activation and serum hormones. There were significant increases in lower-body strength in all groups (P<0.05), with higher increases in SG (67%) than CG (41%) and both were higher than EG (25%) (p<0.01). Only SG and CG increased upper-body strength (p<0.01), with no significant difference between the 2 groups. Furthermore, there were significant decreases in free testosterone in EG after training. Significant increases in isometric strength and maximal muscle activation (p<0.05) as well as decreases in the submaximal muscle activation to the same load, were only seen in SG (p<0.05). The present results suggest that the interference effect observed due to concurrent strength and endurance training could be related to impairment of neural adaptations.


Subject(s)
Bicycling/physiology , Muscle Strength/physiology , Physical Endurance/physiology , Resistance Training/methods , Aged , Ergometry , Humans , Male , Middle Aged , Testosterone/blood
15.
J Sports Med Phys Fitness ; 49(2): 142-51, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19528891

ABSTRACT

AIM: The aim of the current study was to analyze the heart rate (HR), oxygen uptake (V.O(2)), and percentage of maximal HR (%HR(max)) and V.O(2) (%V.O(2max)) responses to stationary running exercise performed at different cadences on land (LA) and in water (WA). METHODS: The sample comprised 12 apparently healthy women (mean age 22.33+/-0.57 years). The exercise was performed in WA and LA environments (interval of 2 hours) at submaximal cadences of 60, 80 and 100 bpm for a period of 4 min at each cadence (interval of 5 min). HR and V.O(2) data were collected using a Polar S610TM and Aerosport KB1-C gas analyzer, respectively. The data were analyzed using factorial ANOVA for mixed models, Tukey's post hoc and Pearson's correlation test, with P<0.05 (SPSS version 13.0). RESULTS: Significant differences were found between the environments for all variables (HR, V.O(2), %HR(max) and %V.O(2max): P<0.001), with higher values for LA. Significant differences were found between the cadences for all variables (HR, V.O(2), %HR(max) and %V.O(2max): P<0.001). The effect of the interaction environment cadence was only significant for %HR(max) (P=0.041). The correlations between HR and V.O(2) (WA: r=0.857; P<0.001 and LA: r=0.556; P<0.001) and %HR(max) and %V.O(2) (WA: r=0.860; P<0.001 and LA: r=0.798; P<0.001) exhibited high and significant correlation coefficient values, especially for WA, suggesting that variable increased linearly with increases in cadence. CONCLUSIONS: The results suggest that cardiorespiratory responses to stationary running exercise are lower in WA, though they can be maximized by increasing the execution cadence.


Subject(s)
Exercise/physiology , Heart Rate , Oxygen Consumption , Running/physiology , Adaptation, Physiological , Exercise Test/methods , Exercise Tolerance/physiology , Female , Humans , Young Adult
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