High-intensity interval training improves respiratory and cardiovascular adjustments before and after initiation of exercise.

Purpose: High-intensity interval training (HIIT) may induce training-specific physiological adaptations such as improved respiratory and cardiovascular adjustments before and after the onset of high-intensity exercise, leading to improved exercise performance during high-intensity exercise. The present study investigated the effects of HIIT on time-dependent cardiorespiratory adjustment during maximal exercise and before and after initiation of high-intensity exercise, as well as on maximal exercise performance. Methods: 21 healthy male college students were randomly assigned to HIIT group (n = 11) or control group (n = 10). HIIT group performed training on a cycle ergometer once a week for 8 weeks. The training consisted of three bouts of exercise at 95% maximal work rate (WRmax) until exhaustion. Before and after the HIIT program, dynamic cardiorespiratory function was investigated by ramp and step exercise tests, and HIIT-induced cardiac morphological changes were assessed using echocardiography. Results: HIIT significantly improved not only maximal oxygen uptake and minute ventilation, but also maximal heart rate (HR), systolic blood pressure (SBP), and time to exhaustion in both exercise tests (p < 0.05). Time-dependent increases in minute ventilation (VE) and HR before and at the start of exercise were significantly enhanced after HIIT. During high-intensity exercise, there was a strong correlation between percent change (from before to after HIIT program) in time to exhaustion and percent change in HRmax (r = 0.932, p < 0.001). Furthermore, HIIT-induced cardiac morphological changes such as ventricular wall hypertrophy was observed (p < 0.001). Conclusion: We have demonstrated that HIIT at 95% WRmax induces training-specific adaptations such as improved cardiorespiratory adjustments, not only during maximal exercise but also before and after the onset of high-intensity exercise, improvement of exercise performance mainly associated with circulatory systems.

Determination of exercise intensity domains during upright versus supine cycling: a methodological study.

Background: There is a growing interest among the research community and clinical practitioners to investigate cardiopulmonary exercise test (CPET) procedures and protocols utilized in supine cycling. Materials and Methods: The current study investigated the effects of posture on indicators of exercise intensity including gas exchange threshold (GET), respiratory compensation point (RCP), and the rate of peak oxygen uptake (V̇O2 peak), as well as the role of V̇O2 mean response time (MRT) in determining exercise intensity domains in nineteen healthy men (age: 22 ± 3 years). Two moderate-intensity step-transitions from 20 to 100 Watt (W) were completed, followed by a maximal CPET. After completing the ramp test, participants performed a constant-load at 90% of their attained peak power output (PPO). Results: No differences were observed in the V̇O2 MRT between the two positions, although the phase II-time constant (τV̇O2p) was 7 s slower in supine position compared to upright (p = 0.001). The rate of O2 uptake in the supine position at GET and RCP were lower compared to the upright position (208 ± 200 mL·min-1 (p = 0.007) and 265 ± 235 mL·min-1 (p = 0.012) respectively). Besides, V̇O2 peak was significantly decreased (by 6%, p = 0.002) during supine position. These findings were confirmed by the wide limits of agreement between the measures of V̇O2 in different postures (V̇O2 peak: -341 to 859; constant-load test: -528 to 783; GET: -375 to 789; RCP: -520 to 1021 all in mL·min-1). Conclusion: Since an accurate identification of an appropriate power output (PO) from a single-visit CPET remains a matter of debate, especially for supine cycling, we propose that moderate-intensity step-transitions preceding a ramp CPET could be a viable addition to ensure appropriate exercise-intensity domain determination, in particular upon GET-based prescription.

Rib cage distortion and dynamic hyperinflation during two exercise intensities in people with COPD.

BACKGROUND: The relationship between rib cage (RC) motion abnormalities, dynamic hyperinflation (DH), and exercise capacity in people with COPD is controversial. AIM: To investigate RC distortion and operational chest wall volumes during moderate and high constant-rate exercises in people with COPD. METHODS: Seven male participants [median(Q1-Q3) age: 63(60.0-66.0) years; FEV1: 39.0(38.0-63.0)% of predicted] performed a symptom-limited incremental exercise testing on cycle ergometer, followed by constant-rate tests (60 % and 80 % of peak work rate). Optoelectronic plethysmography was used to evaluate RC distortion: phase angle-PhAng, inspiratory phase ratio-PhRIB, expiratory phase ratio-PhREB; and chest wall volumes: end-inspiratory volume-Vei and end-expiratory volume-Vee. RESULTS: PhRIB and PhREB significantly increased during both constant-rate exercise tests, without difference between them. In general, Vei of the chest wall significantly increased in both exercise intensities while Vee did not change. CONCLUSIONS: The occurrence of RC distortion seemed not to limit the exercise capacity in people with COPD evaluated, and it was present even in the absence of DH.

Cardiopulmonary and metabolic physiology during hemodialysis and inter/intradialytic exercise.

Hemodialysis is associated with numerous symptoms and side effects that, in part, may be due to subclinical hypoxia. However, acute cardiopulmonary and metabolic physiology during hemodialysis is not well defined. Intradialytic and interdialytic exercise appear to be beneficial and may alleviate these side effects. To better understand these potential benefits, the acute physiological response to exercise should be evaluated. The aim of this study was to compare and characterize the acute physiological response during hemodialysis, intradialytic exercise, and interdialytic exercise. Cardiopulmonary physiology was evaluated during three conditions: 1) hemodialysis without exercise (HD), 2) intradialytic exercise (IDEx), and 3) interdialytic exercise (Ex). Exercise consisted of 30-min constant load cycle ergometry at 90% V̇O2AT (anaerobic threshold). Central hemodynamics (via noninvasive bioreactance) and ventilatory gas exchange were recorded during each experimental condition. Twenty participants (59 ± 12 yr, 16/20 male) completed the protocol. Cardiac output (Δ = -0.7 L/min), O2 uptake (Δ = -1.4 mL/kg/min), and arterial-venous O2 difference (Δ = -2.0 mL/O2/100 mL) decreased significantly during HD. Respiratory exchange ratio exceeded 1.0 throughout HD and IDEx. Minute ventilation was lower (P = 0.001) during IDEx (16.5 ± 1.1 L/min) compared with Ex (19.8 ± 1.0 L/min). Arterial-venous O2 difference was partially restored further to IDEx (4.6 ± 1.9 mL/O2/100 mL) compared with HD (3.5 ± 1.2 mL/O2/100 mL). Hemodialysis altered cardiopulmonary and metabolic physiology, suggestive of hypoxia. This dysregulated physiology contributed to a greater physiological demand during intradialytic exercise compared with interdialytic exercise. Despite this, intradialytic exercise partly normalized cardiopulmonary physiology during treatment, which may translate to a reduction in the symptoms and side effects of hemodialysis.NEW & NOTEWORTHY This study is the first, to our knowledge, to directly compare cardiopulmonary and metabolic physiology during hemodialysis, intradialytic exercise, and interdialytic exercise. Hemodialysis was associated with increased respiratory exchange ratio, blunted minute ventilation, and impaired O2 uptake and extraction. We also identified a reduced ventilatory response during intradialytic exercise compared with interdialytic exercise. Impaired arterial-venous O2 difference during hemodialysis was partly restored by intradialytic exercise. Despite dysregulated cardiopulmonary and metabolic physiology during hemodialysis, intradialytic exercise was well tolerated.

Ventilatory and chronotropic incompetence during incremental and constant load exercise in end-stage renal disease: a comparative physiology study.

Maximal O2 uptake is impaired in end-stage renal disease (ESRD), reducing quality of life and longevity. While determinants of maximal exercise intolerance are well defined, little is known of limitation during submaximal constant load exercise. By comparing individuals with ESRD and healthy controls, the aim of this exploratory study was to characterize mechanisms of exercise intolerance in participants with ESRD by assessing cardiopulmonary physiology at rest and during exercise. Resting spirometry and echocardiography were performed in 20 dialysis-dependent participants with ESRD (age: 59 ± 12 yr, 14 men and 6 women) and 20 healthy age- and sex-matched controls. Exercise tolerance was assessed with ventilatory gas exchange and central hemodynamics during a maximal cardiopulmonary exercise test and 30 min of submaximal constant load exercise. Left ventricular mass (292 ± 102 vs. 185 ± 83 g, P = 0.01) and filling pressure (E/e': 6.48 ± 3.57 vs. 12.09 ± 6.50 m/s, P = 0.02) were higher in participants with ESRD; forced vital capacity (3.44 ± 1 vs. 4.29 ± 0.95 L/min, P = 0.03) and peak O2 uptake (13.3 ± 2.7 vs. 24.6 ± 7.3 mL·kg-1·min-1, P < 0.001) were lower. During constant load exercise, the relative increase in the arterial-venous O2 difference (13 ± 18% vs. 74 ± 18%) and heart rate (32 ± 18 vs. 75 ± 29%) were less in participants with ESRD despite exercise being performed at a higher percentage of maximum minute ventilation (48 ± 3% vs. 39 ± 3%) and heart rate (82 ± 2 vs. 64 ± 2%). Ventilatory and chronotropic incompetence contribute to exercise intolerance in individuals with ESRD. Both are potential targets for medical and lifestyle interventions.

Intensity Thresholds and Maximal Lactate Steady State in Small Muscle Group Exercise.

The aim of our study is to determine the first (LTP1) and the second (LTP2) lactate turn points during an incremental bicep curl test and to verify these turn points by ventilatory turn points (VT1 and VT2) and constant-load exercise tests. Twelve subjects performed a one-arm incremental bicep curl exercise (IET) after a one repetition maximum (1RM) test to calculate the step rate for the incremental exercise (1RM/45). Workload was increased every min at a rate of 30 reps/min until maximum. To verify LTPs, VT1 and VT2 were determined from spirometric data, and 30 min constant-load tests (CL) were performed at 5% Pmax below and above turn points. Peak load in IET was 5.3 ± 0.9 kg (Lamax: 2.20 ± 0.40 mmol·L-1; HRmax: 135 ± 15 b·min-1; VO2max: 1.15 ± 0.30 L·min-1). LTP1 was detected at 1.9 ± 0.6 kg (La: 0.86 ± 0.36 mmol·L-1; HR 90 ± 13 b·min-1; VO2: 0.50 ± 0.05 L·min-1) and LTP2 at 3.8 ± 0.7 kg (La: 1.38 ± 0.37 mmol·L-1; 106 ± 10 b·min-1; VO2: 0.62 ± 0.11 L·min-1). Constant-load tests showed a lactate steady-state in all tests except above LTP2, with early termination after 16.5 ± 9.1 min. LTP1 and LTP2 could be determined in IET, which were not significantly different from VT1/VT2. Constant-load exercise validated the three-phase concept, and a steady-state was found at resting values below VT1 and in all other tests except above LTP2. It is suggested that the three-phase model is also applicable to small muscle group exercise.

Metronome-Paced Incremental Hyperventilation May Predict Exercise Tolerance and Dyspnea as a Surrogate for Dynamic Lung Hyperinflation During Exercise.

Background: Dynamic lung hyperinflation (DLH) has been evaluated based on decreased inspiratory capacity (IC) during exercise load. However, this is not routinely done in clinical practice. We have developed a convenient method of metronome-paced incremental hyperventilation (MPIH) and reported its usefulness. In the present study, we compared these two methods for evaluating DLH and examined whether our MPIH method can be used to predict DLH during exercise. Methods: DLH was measured by MPIH and constant load exercise (CLE) in 35 patients with stable COPD. DLH was defined as the most decreased IC (IClowest) and the most decreases in IC from IC at rest (-IClowest), and we compared between these two methods. Results: The IClowest in CLE and the -IClowest in MPIH were significantly lower in emphysema-dominant COPD than in emphysema-nondominant COPD. Both IClowest and -IClowest showed significant correlations between the two methods (r = 0.67, p < 0.01 and r = 0.44, p < 0.01, respectively). The endurance time of CLE was significantly correlated with IClowest following MPIH (r = 0.62, p < 0.01) but not with that obtained by the CLE method. Furthermore, the IClowest of MPIH was more significantly correlated with endurance time in emphysema-dominant COPD. Weak but significant correlations between the -IClowest obtained by each method and maximum modified Borg scale were observed (MPIH: r = 0.38, p = 0.02; CLE: r = 0.37, p = 0.03). Conclusion: The MPIH method may be a convenient method to predict exercise tolerance and dyspnea as a clinically useful synergic screening surrogate for DLH during exercise.

Physiological responses to hypoxic constant-load and high-intensity interval exercise sessions in healthy subjects.

PURPOSE: The aim of this study was to assess the acute cardiorespiratory as well as muscle and cerebral tissue oxygenation responses to submaximal constant-load (CL) and high-intensity interval (HII) cycling exercise performed in normoxia and in hypoxia at similar intensity, reproducing whole-body endurance exercise training sessions as performed in sedentary and clinical populations. METHODS: Healthy subjects performed two CL (30 min, 75% of maximal heart rate, n = 12) and two HII (15 times 1-min high-intensity exercise-1-min passive recovery, n = 12) cycling exercise sessions in normoxia and in hypoxia [mean arterial oxygen saturation 76 ± 1% (clamped) during CL and 77 ± 5% (inspiratory oxygen fraction 0.135) during HII]. Cardiorespiratory and near-infrared spectroscopy parameters as well as the rate of perceived exertion were continuously recorded. RESULTS: Power output was 21 ± 11% and 15% (according to protocol design) lower in hypoxia compared to normoxia during CL and HII exercise sessions, respectively. Heart rate did not differ between normoxic and hypoxic exercise sessions, while minute ventilation was higher in hypoxia during HII exercise only (+ 13 ± 29%, p < 0.05). Quadriceps tissue saturation index did not differ significantly between normoxia and hypoxia (CL 60 ± 8% versus 59 ± 5%; HII 59 ± 10% versus 56 ± 9%; p > 0.05), while prefrontal cortex deoxygenation was significantly greater in hypoxia during both CL (66 ± 4% versus 56 ± 6%) and HII (58 ± 5% versus 55 ± 5%; p < 0.05) sessions. The rate of perceived exertion did not differ between normoxic and hypoxic CL (2.4 ± 1.7 versus 2.9 ± 1.8) and HII (6.9 ± 1.4 versus 7.5 ± 0.8) sessions (p > 0.05). CONCLUSION: This study indicates that at identical heart rate, reducing arterial oxygen saturation near 75% does not accentuate muscle deoxygenation during both CL and HII exercise sessions compared to normoxia. Hence, within these conditions, larger muscle hypoxic stress should not be expected.

Efficacy of constant load verification testing to confirm VO2 max attainment.

Although maximal oxygen uptake (VO2 max) has been measured for almost 100 years, it is unknown when 'true' VO2 max is attained. Primary (the VO2 plateau) and secondary criteria are used to confirm VO2 max incidence, but frequency of the VO2 plateau varies, and secondary criteria are relatively invalid. The verification test (VER) seems to elicit similar estimates of VO2 max versus the incremental value (INC), yet existing data are limited by small populations and use of inadequate criteria to confirm 'true' VO2 max. We investigated the efficacy of VER by analysing data from 109 participants who underwent INC followed by VER at 105% or 110% of peak power output (PPO). Differences in VO2 max between VER and INC were analysed, and intraclass correlation coefficient (ICC), standard error of the mean (SEM) and minimum difference (MD) were computed. Results showed that VO2 max was significantly higher (2%, P<0·05) in INC versus VER, VO2 max was highly related between protocols (ICC = 0·99) and SEM and MD were low. However, 11% of participants did not reveal 'true' VO2 max as the verification value was higher than INC by 3·0% - 3·3%. Fitness level altered the difference in VO2 max between INC and VER in study one, as lower fitness individuals showed a larger difference in VO2 max between protocols, although gender did not affect the difference in VO2 max between protocols. Our data show that VER does not verify 'true' VO2 max in all individuals, which may be related to their fitness level.

Measurement of the maximum oxygen uptake V̇o2max: V̇o2peak is no longer acceptable.

The maximum rate of O2 uptake (i.e., V̇o2max), as measured during large muscle mass exercise such as cycling or running, is widely considered to be the gold standard measurement of integrated cardiopulmonary-muscle oxidative function. The development of rapid-response gas analyzers, enabling measurement of breath-by-breath pulmonary gas exchange, has facilitated replacement of the discontinuous progressive maximal exercise test (that produced an unambiguous V̇o2-work rate plateau definitive for V̇o2max) with the rapidly incremented or ramp testing protocol. Although this is more suitable for clinical and experimental investigations and enables measurement of the gas exchange threshold, exercise efficiency, and V̇o2 kinetics, a V̇o2-work rate plateau is not an obligatory outcome. This shortcoming has led to investigators resorting to so-called secondary criteria such as respiratory exchange ratio, maximal heart rate, and/or maximal blood lactate concentration, the acceptable values of which may be selected arbitrarily and result in grossly inaccurate V̇o2max estimation. Whereas this may not be an overriding concern in young, healthy subjects with experience of performing exercise to volitional exhaustion, exercise test naïve subjects, patient populations, and less motivated subjects may stop exercising before their V̇o2max is reached. When V̇o2max is a or the criterion outcome of the investigation, this represents a major experimental design issue. This CORP presents the rationale for incorporation of a second, constant work rate test performed at ~110% of the work rate achieved on the initial ramp test to resolve the classic V̇o2-work rate plateau that is the unambiguous validation of V̇o2max The broad utility of this procedure has been established for children, adults of varying fitness, obese individuals, and patient populations.

The effects of warming-up on the blood lactate kinetics during exercise / 体力科学

The present investigation was designed to examine the effects of warming-up (W-up) on the blood lactate kinetics during 5 minutes of pedaling exercise. Five healthy male adults were the subjects. The intencity of the criterion task (CT) was about 80% VO<SUB>2</SUB>max, and that of the W-up was a work load corresponding to the anaerobic threshold. Between W-up and CT there were five-minute rest periods on the bicycle ergometer. In order to determine the blood lactate values, blood samples were taken from the antecubital vein at the following times: rest, pre-CT, and 3, 5, 7, and 30-minutes after CT. Expired gas was analysed continuously for the calculation of VO<SUB>2</SUB>, VCO<SUB>2</SUB>, R, VE. The heart rate was recorded every min-ute from ECG.<BR>Blood lactate values increased 3.23±0.91 mmol/<I>l</I> after W-up, a significant increase over the resting values. The peak blood lactate during the W-up experiment (4.62±0.84 mmol/<I>l</I>) was significantly lower than that of the control experiment (6.48±1.69 mmol/<I>l</I>) . Differences in lactate before and after CT (ΔLa) was found to be significantly lower in experiments with W-up (1.39±0.99 mmol/<I>l</I>) as compared with control experiments (5.37±1.62 mmol/<I>l</I>) . In one subject, the blood lactate levels decreased during CT after W-up, while lactate levels increased during CT without W-up. VO<SUB>2</SUB> during CT were very similar in both experiments. These results indicate that this kind of W-up delays the rate of blood lactate accumulation during CT.