The effects of high-intensity functional training on cardiometabolic risk factors and exercise enjoyment in men and women with metabolic syndrome: study protocol for a randomized, 12-week, dose-response trial.

BACKGROUND: Individuals with metabolic syndrome (MetS) are at a greater risk for developing atherosclerotic cardiovascular disease (ASCVD) than those without MetS, due to underlying endothelial dysfunction, dyslipidemia, and insulin resistance. Exercise is an effective primary and secondary prevention strategy for MetS; however, less than 25% of adults meet the minimum stated public recommendations. Barriers often identified are lack of enjoyment and lack of time. High-intensity functional training (HIFT), a time-efficient modality of exercise, has shown some potential to elicit positive affectivity and elicit increased fitness and improved glucose metabolism. However, the effects of HIFT on dyslipidemia and endothelial dysfunction have not been explored nor have the effects been explored in a population with MetS. Additionally, no studies have investigated the minimal dose of HIFT per week to see clinically meaningful changes in cardiometabolic health. The purpose of this study is to (1) determine the dose-response effect of HIFT on blood lipids, insulin resistance, and endothelial function and (2) determine the dose-response effect of HIFT on body composition, fitness, and perceived enjoyment and intention to continue the exercise. METHODS/DESIGN: In this randomized, dose-response trial, participants will undergo a 12-week HIFT intervention of either 1 day/week, 2 days/week, or 3 days/week of supervised, progressive exercise. Outcomes assessed at baseline and post-intervention will be multiple cardiometabolic markers, and fitness. Additionally, the participant's affective response will be measured after the intervention. DISCUSSION: The findings of this research will provide evidence on the minimal dose of HIFT per week to see clinically meaningful improvements in the risk factors of MetS, as well as whether this modality is likely to mitigate the barriers to exercise. If an effective dose of HIFT per week is determined and if this modality is perceived positively, it may provide exercise specialists and health care providers a tool to prevent and treat MetS. TRIAL REGISTRATION: ClinicalTrials.gov NCT05001126 . August 11, 2021.

Validity of 3 protocols for verifying VO2 max.

The verification bout has emerged as a technique for confirming 'true' VO2 max; however, validity during a single visit is unknown. We evaluated 3 different GXT durations with severe intensity verification bouts. On 3 separate days, in counterbalanced order, 12 recreational-trained men completed short (9±1 min), middle (11±1 min), and long (13±2 min) duration GXTs followed by exhaustive, sine wave verification bouts during the same visit. Intensities for verification were set at speeds equivalent to 2-stages minus end-GXT speed. No differences (p<0.05) in VO2 max (mL/kg/min) were observed between short (49.1), middle (48.2), and long (48.8) protocols. In addition, no differences in verification bout duration occurred between protocols (3±1 min). Validity of VO2 max was strongest for the middle duration protocol (ICC α=0.97; typical error=1 mL/kg/min; CV=2%). A small, but significantly higher HR (max) (∼1-2 bpm) was observed for the long protocol. Maximum respiratory exchange ratios were inconsistent (ICC α ranged 0.58-0.68). Our findings indicate GXT-verification bout testing during a single visit is a valid means of measuring 'true' VO2 max. The 10 min target for GXT duration was the optimum.

The cardiovascular and metabolic responses to Wii Fit video game playing in middle-aged and older adults.

AIM: The purpose of this study was (a) to assess the cardiovascular and metabolic responses to Wii Fit video games and (b) to determine if Wii Fit video games meet the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness. METHODS: Twenty men and women (mean±SD age, height, and weight: = 58.1±8.8 years, 172.1±10.5 cm, 87.1±22.8 kg, respectively) completed a 20-min Wii Fit testing session consisting of six separate aerobic and balance games. Cardiovascular and metabolic data were collected via a portable calorimetric measurement system. RESULTS: Mean relative exercise intensity was 43.4±16.7% of heart rate reserve. Absolute exercise intensity in metabolic equivalents (METS) was 3.5±0.96. Total net energy expenditure for the Wii Fit video game playing session was 116.2±40.9 kcal/session. CONCLUSION: Results indicate that playing Wii Fit video games is a feasible alternative to more traditional aerobic exercise modalities for middle-aged and older adults that fulfills the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness.

Supramaximal testing to confirm attainment of VO2max in sedentary men and women.

Supramaximal testing is widely used to verify VO2max attainment, yet its efficacy in sedentary subjects is unknown. The aim of the study was to test this hypothesis in men and women completing maximal cycle ergometry. Fifteen sedentary subjects (age=22.4+/-3.9 year) completed incremental exercise, and returned at least 24 h later to complete constant load exercise at 105% peak work rate (Wmax). Another group of nine sedentary men and women (age=21.8+/-5 year) completed supramaximal exercise at 115% Wmax 1-1.5 h after incremental exercise. During exercise, gas exchange data and heart rate (HR) were continuously obtained. VO2max was similar (p>0.05) between incremental and supramaximal exercise in subjects in the first (32.32+/-4.81 mL/kg/min vs. 31.80+/-5.35 mL/kg/min) and second subset (40.63+/-3.61 mL/kg/min vs. 41.66+/-5.55 mL/kg/min). Maximal HR was lower (p<0.05) with supramaximal exercise, yet respiratory exchange ratio was higher (p<0.05). Test-retest reliability (r=0.81-0.89, p<0.05) for VO2max was high during repeated bouts of supramaximal testing. Findings support use of this protocol to confirm VO2max attainment in healthy, sedentary men and women completing incremental cycle ergometry.

Elucidating determinants of the plateau in oxygen consumption at VO2max.

BACKGROUND: A plateau in oxygen consumption (VO2) is the primary means of confirming that maximal oxygen uptake (VO2max) is attained during incremental exercise to fatigue. However, it is still unresolved what causes expression of a plateau in VO2 at the end of incremental exercise. OBJECTIVES: To elucidate incidence and identify determinants of the VO2 plateau in subjects of varying fitness. METHODS: Thirty subjects (mean (SD) age and VO2max 26.9 (9.8) years and 3.4 (0.8) litre/min respectively) were separated into three groups: endurance trained (ET; n = 9), recreationally active (Rec; n = 11), and strength/sprint trained (STR; n = 10). During three separate visits, subjects completed incremental treadmill exercise during which breath by breath gas exchange data were obtained. Body composition was measured using a three site skinfolds model. Force production of the knee extensors and flexors was assessed using isokinetic dynamometry. RESULTS: VO2max was significantly higher (p < 0.05) in the ET group vs STR and Rec. The change in VO2 (DeltaVO2) at VO2max was not different (p > 0.05) in the ET group (33.0 (27.3) ml/min) compared with the Rec group (30.3 (24.1) ml/min) and the STR group (44.4 (23.8) ml/min). No correlations (p > 0.05) were evident between DeltaVO2 at VO2max and VO2max (r = 0.05), fat-free mass (r = 0.12), and muscular strength (r = -0.12). CONCLUSIONS: The incidence of a plateau in VO2 at VO2max (from correlation data) is not due to factors related to training status or physical fitness of subjects, but is altered by analysis and interpretation of gas exchange data.