Cardiopulmonary and metabolic responses during a 2-day CPET in myalgic encephalomyelitis/chronic fatigue syndrome: translating reduced oxygen consumption to impairment status to treatment considerations.

BACKGROUND: Post-exertional malaise (PEM), the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), represents a constellation of abnormal responses to physical, cognitive, and/or emotional exertion including profound fatigue, cognitive dysfunction, and exertion intolerance, among numerous other maladies. Two sequential cardiopulmonary exercise tests (2-d CPET) provide objective evidence of abnormal responses to exertion in ME/CFS but validated only in studies with small sample sizes. Further, translation of results to impairment status and approaches to symptom reduction are lacking. METHODS: Participants with ME/CFS (Canadian Criteria; n = 84) and sedentary controls (CTL; n = 71) completed two CPETs on a cycle ergometer separated by 24 h. Two-way repeated measures ANOVA compared CPET measures at rest, ventilatory/anaerobic threshold (VAT), and peak effort between phenotypes and CPETs. Intraclass correlations described stability of CPET measures across tests, and relevant objective CPET data indicated impairment status. A subset of case-control pairs (n = 55) matched for aerobic capacity, age, and sex, were also analyzed. RESULTS: Unlike CTL, ME/CFS failed to reproduce CPET-1 measures during CPET-2 with significant declines at peak exertion in work, exercise time, V ˙ e, V ˙ O2, V ˙ CO2, V ˙ T, HR, O2pulse, DBP, and RPP. Likewise, CPET-2 declines were observed at VAT for V ˙ e/ V ˙ CO2, PetCO2, O2pulse, work, V ˙ O2 and SBP. Perception of effort (RPE) exceeded maximum effort criteria for ME/CFS and CTL on both CPETs. Results were similar in matched pairs. Intraclass correlations revealed greater stability in CPET variables across test days in CTL compared to ME/CFS owing to CPET-2 declines in ME/CFS. Lastly, CPET-2 data signaled more severe impairment status for ME/CFS compared to CPET-1. CONCLUSIONS: Presently, this is the largest 2-d CPET study of ME/CFS to substantiate impaired recovery in ME/CFS following an exertional stressor. Abnormal post-exertional CPET responses persisted compared to CTL matched for aerobic capacity, indicating that fitness level does not predispose to exertion intolerance in ME/CFS. Moreover, contributions to exertion intolerance in ME/CFS by disrupted cardiac, pulmonary, and metabolic factors implicates autonomic nervous system dysregulation of blood flow and oxygen delivery for energy metabolism. The observable declines in post-exertional energy metabolism translate notably to a worsening of impairment status. Treatment considerations to address tangible reductions in physiological function are proffered. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, retrospectively registered, ID# NCT04026425, date of registration: 2019-07-17.

Usefulness of the cardiopulmonary exercise test up to the anaerobic threshold for pati-ents aged ≥ 80 years with cardiovascular disease on cardiac rehabilitation.

OBJECTIVE: A cardiopulmonary exercise test provides information regarding appropriate exercise intensity, but there have been few reports on its use in patients over 80 years of age. DESIGN: Retrospective observational study. PATIENTS: A total of 511 cardiovascular disease patients who performed a cardiopulmonary exercise test from February 2011 to January 2020 were investigated. METHODS: Patients were stratified according to age: < 70 years, 70-79 years, and ≥ 80 years, and the results of the cardiopulmonary exercise test up to anaerobic threshold were compared. RESULTS: Patients in the < 70 age bracket showed higher oxygen consumption, carbon dioxide output, and ventilatory volume and lower ventilation equivalents per oxygen consumption and carbon dioxide output in all time periods. However, there were no significant differences in these parameters or the work rate (70-79 years of age: 41.4 ± 11.7 watts, vs ≥ 80 years: 42.2 ± 10.9 watts, p = 0.95) or oxygen consumption per body weight at anaerobic threshold (12.2 ± 0.2 ml/min/kg, vs 12.1 ± 0.4 ml/min/kg, p = 0.97) between the 70-79 year age bracket and the ≥ 80 year age bracket. CONCLUSION: Even for cardiovascular disease patients age ≥ 80 years, a cardiopulmonary exercise test up to anaerobic threshold can supply useful information for guiding cardiac rehabilitation.

Effects of high-intensity interval training and resistance training on physiological parameters and performance of well-trained runners: A randomized controlled trial.

This study aimed to verify the effects of 4 weeks of high-intensity interval training (HIIT), heavy (HRT) and explosive (ERT) resistance training on aerobic, anaerobic and neuromuscular parameters and performance of well-trained runners. Twenty-six male athletes were divided into HIIT (n = 10), HRT (n = 7) and ERT (n = 9) groups. Maximal oxygen uptake (VO2max) and the corresponding velocity (vVO2max), anaerobic threshold (AT), running economy (RE), oxygen uptake kinetics, lower-body strength (1RM) and power (CMJ), and the 1500m and 5000m time-trial (TT) were determined. Improvements were observed in vVO2max (mean difference (Δ): 2.6%; effect size (ES): 0.63) with HIIT, while AT was incresead in ERT (Δ: 4.3%; ES: 0.73) and HRT (Δ: 6.9%; ES: 0.72) groups. The CMJ performance was increased in ERT (Δ: 13.8%; ES: 1.03), HRT (Δ: 6.9%; ES: 0.55) and HIIT (Δ: 5.4%; ES: 0.34), whereas 1RM increase in HRT (Δ: 38.1%; ES: 1.21) and ERT (Δ: 49.2%; ES: 0.96) groups. HIIT improved the 1500m (Δ: -2.3%; ES: -0.62) and both HRT (Δ: -1.6%; ES: -0.32) and ERT (Δ: -1.7%; ES: -0.31) the 5000m TT. Despite performance adaptations were dependent on the training characteristics, both RT and HIIT model constitute an alternative for training periodization.

The Influence of Pedaling Frequency on Blood Lactate Accumulation in Cycling Sprints.

Anaerobic performance diagnostics in athletes relies on accurate measurements of blood lactate concentration and the calculation of blood lactate accumulation resulting from glycolytic processes. In this study, we investigated the impact of pedaling frequency on blood lactate accumulation during 10-second maximal isokinetic cycling sprints. Thirteen trained males completed five 10-second maximal isokinetic cycling sprints on a bicycle ergometer at different pedaling frequencies (90 rpm, 110 rpm, 130 rpm, 150 rpm, 170 rpm) with continuous power and frequency measurement. Capillary blood samples were taken pre-exercise and up to 30 minutes post-exercise to determine the maximum blood lactate concentration.Blood lactate accumulation was calculated as the difference between maximal post-exercise and pre-start blood lactate concentration. Repeated measurement ANOVA with Bonferroni-adjusted post hoc t-tests revealed significant progressive increases in maximal blood lactate concentration and accumulation with higher pedaling frequencies (p<0.001; η2+>+0.782).The findings demonstrate a significant influence of pedaling frequency on lactate accumulation, emphasizing its relevance in anaerobic diagnostics. Optimal assessment of maximal lactate formation rate is suggested to require a pedaling frequency of at least 130 rpm or higher, while determining metabolic thresholds using the maximal lactate formation rate may benefit from a slightly lower pedaling frequency.

Hemodynamic, ventilatory and gas exchange responses to exercise using a cycle ergometer and the incremental shuttle walk test in pregnant women.

BACKGROUND: Cardiovascular disease, including hypertension, in pregnant women is a leading cause of morbidity and mortality globally. The development of reference intervals for cardiovascular responses using exercising testing to measure oxygen utilisation (V̇O2) with cardiopulmonary exercise testing (CPET), and distances walked using the incremental shuttle walk test (ISWT), may be promising methods to assess and stratify pregnant women regarding their risk of adverse pregnancy outcomes, to encourage exercise during pregnancy, and to improve exercise prescriptions during pregnancy. We aimed to determine the reference intervals for V̇O2 at rest, anaerobic threshold (AT), and submaximal exercise using CPET, and the reference interval for the ISWT, to develop a correlation equitation that predicts submaximal V̇O2 from the distance walked in the ISWT, and to explore the relationship between hemoglobin (Hb) and ferritin concentration and V̇O2 at AT in women in second trimester. METHODS: After prospective IRB approval (HREC 15/23) and clinical trials registration (ANZCTR ACTRN12615000964516), and informed written consent, we conducted CPET and the ISWT according to international guidelines in a university associated tertiary referral obstetric and adult medicine hospital, in healthy pregnant women in second trimester (14 to 27 gestational weeks). Hemoglobin and ferritin concentrations were recorded from pathology results in the participants' medical records at the time of exercise testing. Adverse events were recorded. RESULTS: About 90 participants undertook CPET, 28 of which also completed the ISWT. The mean ± SD age and body mass index (BMI) were 32 ± 3.2 years, and 25 ± 2.7 kg/m2. Median (IQR) gestation was 23 (22-24) weeks. One in 4 women were 24 weeks or greater gestation. The reference intervals for V̇O2 at rest, AT, and submaximal exercise were 2.9 to 5.3, 8.1 to 20.7, and 14.1 to 30.5 mL/kg/min respectively. The reference interval for the ISWT was 218 to 1058 meters. The correlation equation to predict submaximal V̇O2 from the distance walked in the ISWT was submaximal V̇O2 (mL/kg/min) = 0.012*distance walked in ISWT (m) + 14.7 (95%CI slope 0.005-0.070, Pearson r = 0.5426 95%CI 0.2126-0.7615, P = .0029). Hemoglobin concentration was positively correlated with V̇O2 at AT (AT V̇O2 (mL/kg/min) = 0.08*Hb (g/L) + 4.9 (95%CI slope 0.0791-0.143, Pearson r = 0.2538 95%CI 0.049-0.438, P = .016). There was no linear association between ferritin and submaximal V̇O2 (Pearson r = 0.431 P = .697). There were no maternal or fetal complications. CONCLUSIONS: CPET and ISWT are safe and feasible in women in second trimester including those at or beyond 24 weeks gestation. We have established the reference interval for V̇O2 at rest, AT, and submaximal exercise by CPET, the reference interval for the distance walked for the ISWT, and a correlation equation to predict submaximal V̇O2 for use in clinical practice and research. Hemoglobin rather than ferritin is likely correlated with exercise capacity in pregnancy suggesting vigilance to correct lower hemoglobin levels may positively impact maternal health. CLINICAL TRIALS REGISTRY: The study was prospectively registered with the Australian and New Zealand Clinical Date of registration - 15/9/2015; Date of initial participant enrolment - 4/11/2015; Clinical trial identification number; ACTRN12615000964516; URL of the registration site - https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369216.

The Effects of Load, Crank Position, and Sex on the Biomechanics and Performance during an Upper Body Wingate Anaerobic Test.

INTRODUCTION: The upper body Wingate Anaerobic Test (WAnT) is a 30-s maximal effort sprint against a set load (percentage of body mass). However, there is no consensus on the optimal load and no differential values for males and females, even when there are well-studied anatomical and physiological differences in muscle mass for the upper body. Our goal was to describe the effects of load, sex, and crank position on the kinetics, kinematics, and performance of the upper body WAnT. METHODS: Eighteen participants (9 females) performed three WAnTs at 3%, 4%, and 5% of body mass. Arm crank forces, 2D kinematics, and performance variables were recorded during each WAnT. RESULTS: Our results showed an increase of ~49% effective force, ~36% peak power, ~5° neck flexion, and ~30° shoulder flexion from 3% to 5% load ( P < 0.05). Mean power and anaerobic capacity decreased by 15%, with no changes in fatigue index ( P < 0.05). The positions of higher force efficiency were at 12 and 6 o'clock. The least force efficiency occurred at 3 o'clock ( P < 0.05). Sex differences showed that males produced 97% more effective force and 109% greater mean power than females, with 11.7% more force efficiency ( P < 0.001). Males had 16° more head/neck flexion than females, and females had greater elbow joint variability with 17° more wrist extension at higher loads. Males cycled ~32% faster at 3% versus 5% WAnT load with a 65% higher angular velocity than females. Grip strength, maximal voluntary isometric contraction, mass, and height positively correlated with peak and mean power ( P < 0.001). CONCLUSIONS: In conclusion, load, sex, and crank position have a significant impact on performance of the WAnT. These factors should be considered when developing and implementing an upper body WAnT.

Heavy-, Severe-, and Extreme-, but Not Moderate-Intensity Exercise Increase V̇o 2max and Thresholds after 6 wk of Training.

INTRODUCTION: This study assessed the effect of individualized, domain-based exercise intensity prescription on changes in maximal oxygen uptake (V̇O 2max ) and submaximal thresholds. METHODS: Eighty-four young healthy participants (42 females, 42 males) were randomly assigned to six age, sex, and V̇O 2max -matched groups (14 participants each). Groups performed continuous cycling in the 1) moderate (MOD), 2) lower heavy (HVY1), and 3) upper heavy-intensity (HVY2) domain; interval cycling in the form of 4) high-intensity interval training (HIIT) in the severe-intensity domain, or 5) sprint-interval training (SIT) in the extreme-intensity domain; or no exercise for 6) control (CON). All training groups, except SIT, were work-matched. Training participants completed three sessions per week for 6 wk with physiological evaluations performed at PRE, MID, and POST intervention. RESULTS: Compared with the change in V̇O 2max (∆V̇O 2max ) in CON (0.1 ± 1.2 mL·kg -1 ·min -1 ), all training groups, except MOD (1.8 ± 2.7 mL·kg -1 ·min -1 ), demonstrated a significant increase ( P < 0.05). HIIT produced the highest increase (6.2 ± 2.8 mL·kg -1 ·min -1 ) followed by HVY2 (5.4 ± 2.3 mL·kg -1 ·min -1 ), SIT (4.7 ± 2.3 mL·kg -1 ·min -1 ), and HVY1 (3.3 ± 2.4 mL·kg -1 ·min -1 ), respectively. The ΔPO at the estimated lactate threshold ( θLT ) was similar across HVY1, HVY2, HIIT, and SIT, which were all greater than CON ( P < 0.05). The ΔV̇O 2 and ΔPO at θLT for MOD was not different from CON ( P > 0.05). HIIT produced the highest ΔPO at maximal metabolic steady state, which was greater than CON, MOD, and SIT ( P < 0.05). CONCLUSIONS: This study demonstrated that i) exercise intensity is a key component determining changes in V̇O 2max and submaximal thresholds and ii) exercise intensity domain-based prescription allows for a homogenous metabolic stimulus across individuals.

Heart Rate Variability Thresholds: Agreement with Established Approaches and Reproducibility in Trained Females and Males.

PURPOSE: To determine in trained females and males i) the agreement between the gas exchange threshold (GET), lactate threshold 1 (LT1), and heart rate variability threshold 1 (HRVT1), as well as between the respiratory compensation point (RCP), lactate threshold 2 (LT2), and heart rate variability threshold 2 (HRVT2), and ii) the reproducibility of HRVT1 and HRVT2 during 2-min incremental step protocols. METHODS: Fifty-seven trained participants (24 females) completed a 2-min step incremental test to task failure. Nineteen participants (eight females) completed a second test to evaluate reproducibility. Gas exchange and ventilatory responses, blood lactate concentration, and RR time series were recorded to assess the oxygen consumption (V̇O 2 ) and heart rate (HR) associated with the GET, RCP, LT1, LT2, HRVT1, and HRVT2. RESULTS: V̇O 2 -GET versus V̇O 2 -HRVT1 and HR-GET versus HR-HRVT1 were statistically different for females (29.5 ± 4.0 vs 34.6 ± 6.1 mL·kg -1 ·min -1 ; 154 ± 11 vs 166 ± 12 bpm) and for males (33.9 ± 4.2 vs 42.7 ± 4.6 mL·kg -1 ·min -1 ; 145 ± 11 vs 165 ± 9 bpm; P < 0.001). V̇O 2 and HR at HRVT1 were greater than at LT1 ( P < 0.05). V̇O 2 -RCP versus V̇O 2 -HRVT2 and HR-RCP versus HR-HRVT2 were not statistically different for females (40.1 ± 4.7 vs 39.5 ± 6.7 mL·kg -1 ·min -1 ; 177 ± 9 vs 176 ± 9 bpm) and males (48.4 ± 5.4 vs 47.8 ± 4.8 mL·kg -1 ·min -1 ; 176 ± 8 vs 175 ± 9 bpm; P > 0.05). V̇O 2 and HR responses at LT2 were similar to HRVT2 ( P > 0.05). Intraclass correlation coefficient for V̇O 2 -HRVT1, HR-HRVT1, V̇O 2 -HRVT2, and HR-HRVT2 indicated good reproducibility when comparing the two different time points to standard methods. CONCLUSIONS: Whereas HRVT2 is a valid and reproducible estimate of the RCP/LT2, current approaches for HRVT1 estimation did not show good agreement with outcomes at GET and LT1.

Effects of acute and multi-day low-dose sodium bicarbonate intake on high-intensity endurance exercise performance in male recreational cyclists.

PURPOSE: This study aimed to compare the effects of acute and multi-day low-dose sodium bicarbonate (SB) intake on high-intensity endurance exercise performance. METHODS: In a randomized, double-blind, cross-over design, twelve recreational male cyclists (age: 31.17 ± 4.91 years; V ˙ O2peak: 47.98 ± 7.68 ml·kg-1·min-1) completed three endurance performance tests following acute SB (ASB, 0.2 g·kg-1 SB), multi-day SB (MSB, 0.2 g·kg-1·day-1 SB for four days), and placebo (PLA) intake. The high-intensity endurance performance was assessed with a cycling exercise test, wherein participants cycled on a bicycle ergometer at 95% of the predetermined anaerobic threshold for 30 min, followed by a time-to-exhaustion test at 110% of the anaerobic threshold. Data were analyzed using one-way and two-way repeated-measures ANOVA. RESULTS: Significant main effects of supplementation protocol were evident in pre-exercise bicarbonate concentrations (F = 27.93; p < 0.01; partial eta squared (η2) = 0.72; false discovery rate (FDR)-adjusted p value = 0.001). Prior to performance test, blood bicarbonate concentrations were significantly higher in MSB (25.78 ± 1.63 mmol·L-1 [95% CI 26.55-28.44] (p < 0.001; FDR-adjusted p value = 0.001)) and ASB (27.49 ± 1.49 mmol·L-1 [95% CI 24.75-26.81] (p < 0.001; FDR-adjusted p value = 0.007)) compared to PLA (23.75 ± 1.40 mmol·L-1 [95% CI 22.86 to 24.64]). Time-to-exhaustion increased in MSB (54.27 ± 9.20 min [95% CI 48.43-60.12]) compared to PLA (49.75 ± 10.80 min [95% CI 42.89-56.62]) (p = 0.048); however, this increase in MSB did not reach the significance threshold of 1% FDR (FDR-adjusted p value = 0.040). No significant difference was noted in exhaustion times between ASB (51.15 ± 8.39 min [95% CI 45.82-56.48]) and PLA (p > 0.05). CONCLUSION: Both acute and multi-day administration of low-dose SB improves buffering system in cyclists; nevertheless, neither intervention demonstrates sufficient efficacy in enhancing high-intensity endurance performance.

An 8-week Forced-rate Aerobic Cycling Program Improves Cardiorespiratory Fitness in Persons With Chronic Stroke: A Randomized Controlled Trial.

OBJECTIVE: To examine the cardiorespiratory effects of a forced-rate aerobic exercise (FE) intervention among individuals with chronic stroke compared with an upper extremity repetitive task practice (UE RTP) control group. DESIGN: Secondary analysis of data from a randomized controlled trial. SETTING: Research laboratory. PARTICIPANTS: Individuals with chronic stroke (N=60). INTERVENTIONS: Participants completed 24 sessions of FE followed by RTP (FE+RTP, N=30) or time matched RTP alone (N=30). The FE+RTP group was prescribed exercise at 60%-80% of heart rate reserve on a motorized stationary cycle ergometer for 45 minutes followed by 45 minutes of RTP. The control group completed 90 minutes of RTP. MAIN OUTCOME MEASURES: Metabolic exercise stress tests on a cycle ergometer were conducted at baseline and post-intervention. Outcomes included peak oxygen consumption (peak V̇o2) and anaerobic threshold (AT). RESULTS: Fifty participants completed the study intervention and pre/post stress tests. The FE+RTP group demonstrated significantly greater improvements in peak V̇o2 from 16.4±5.7 to 18.3±6.4 mL/min/kg compared with the RTP group (17.0±5.6 to 17.2±5.6 mL/min/kg, P=.020) and significantly greater improvements in AT from 10.3±2.8 to 11.5±3.6 mL/min/kg compared with the RTP group (10.8±3.9 to 10.4±3.2 mL/min/kg, P=.020). In analyzing predictors of post-intervention peak V̇o2, the multivariable linear regression model did not reveal a significant effect of age, sex, body mass index, or beta blocker usage. Similarly, bivariate linear regression models for the FE group only did not find any exercise variables (aerobic intensity, power, or cycling cadence) to be significant predictors of peak V̇o2. CONCLUSIONS: While the aerobic exercise intervention was integrated into rehabilitation to improve UE motor recovery, it was also effective in eliciting significant and meaningful improvements in cardiorespiratory fitness. This novel rehabilitation model may be an effective approach to improve motor and cardiorespiratory function in persons recovering from stroke.

The polymorphism T1470A of the SLC16A1 gene is associated with the lactate and ventilatory thresholds but not with fat oxidation capacity in young men.

PURPOSE: To examine the association of the single nucleotide polymorphism A1470T in the SLC16A1 gene with blood lactate accumulation during a graded exercise test and its associated metaboreflex. METHODS: Forty-six Latin-American men (Age: 27 ± 6 years; Body fat: 17.5 ± 4.7%) performed a graded exercise test on a treadmill for the assessment of maximal oxygen uptake (VO2max), lactate threshold (LT), ventilatory threshold (VT) and the exercise intensity corresponding to maximal fat oxidation rate (FATmax), via capillary blood samples and indirect calorimetry. Genomic DNA was extracted from a peripheral blood sample. Genotyping assay was carried out by real-time polymerase chain reaction to identify the A1470T polymorphism (rs1049434). RESULTS: Genotypes distribution were in Hardy-Weinberg equilibrium (X2 = 5.6, p > 0.05), observing allele frequencies of 0.47 and 0.53 for the A and T alleles, respectively. No difference in VO2max, body composition nor FATmax were observed across genotypes, whereas carriers of the TT genotype showed a higher LT (24.5 ± 2.2 vs. 15.6 ± 1.7 mL kg-1 min-1, p < 0.01) and VT in comparison to carriers of the AA + AT genotypes (32.5 ± 3.3 vs. 21.7 ± 1.5 mL kg-1 min-1, p < 0.01). Both, VO2max and the A1470T polymorphism were positively associated to the LT (R2 = 0.50, p < 0.01) and VT (R2 = 0.55, p < 0.01). Only VO2max was associated to FATmax (R2 = 0.39, p < 0.01). CONCLUSION: Independently of cardiorespiratory fitness, the A1470T polymorphism is associated to blood lactate accumulation and its associated ventilatory response during submaximal intensity exercise. However, the A1470 polymorphism does not influence fat oxidation capacity during exercise in young men.

Effect of Acute Altitude Exposure on Anaerobic Threshold Assessed by a Novel Electrocardiogram-Based Method.

Background: Acute altitude has a relevant impact on exercise physiology and performance. Therefore, the positive impact on the performance level is utilized as a training strategy in professional as well as recreational athletes. However, ventilatory thresholds (VTs) and lactate thresholds (LTs), as established performance measures, cannot be easily assessed at high altitudes. Therefore, a noninvasive, reliable, and cost-effective method is needed to facilitate and monitor training management at high altitudes. High Alt Med Biol. 25:94-99, 2024. Methods: In a cross-sectional setting, a total of 14 healthy recreational athletes performed a graded cycling exercise test at sea level (Munich, Germany: 512 m/949 mbar) and high altitude (Zugspitze: 2,650 m/715 mbar). Anaerobic thresholds (ATs) were assessed using a novel method based on beat-to-beat repolarization instability (dT) detected by Frank-lead electrocardiogram (ECG) monitoring. The ECG-based ATs (ATdT°) were compared to routine LTs assessed according to Dickhuth and Mader. Results: After acute altitude exposure, a decrease in AT was detected using a novel ECG-based method (ATdT°: 159.80 ± 52.21 W vs. 134.66 ± 34.91 W). AtdT° levels correlated significantly with LTDickhuth and LTMader, at baseline (rDickhuth/AtdT° = 0.979; p < 0.001) (rMader/AtdT° = 0.943; p < 0.001), and at high altitude (rDickhuth/AtdT° = 0.969; p < 0.001) (rMader/AtdT° = 0.942; p < 0.001). Conclusion: Assessment of ATdT is a reliable method to detect performance alterations at altitude. This novel method may facilitate the training management of athletes at high altitudes.

Development of deep-learning models for real-time anaerobic threshold and peak VO2 prediction during cardiopulmonary exercise testing.

AIMS: Exercise intolerance is a clinical feature of patients with heart failure (HF). Cardiopulmonary exercise testing (CPET) is the first-line examination for assessing exercise capacity in patients with HF. However, the need for extensive experience in assessing anaerobic threshold (AT) and the potential risk associated with the excessive exercise load when measuring peak oxygen uptake (peak VO2) limit the utility of CPET. This study aimed to use deep-learning approaches to identify AT in real time during testing (defined as real-time AT) and to predict peak VO2 at real-time AT. METHODS AND RESULTS: This study included the time-series data of CPET recorded at the Department of Cardiovascular Medicine, Kyushu University Hospital. Two deep neural network models were developed to: (i) estimate the AT probability using breath-by-breath data and (ii) predict peak VO2 using the data at the real-time AT. The eligible CPET contained 1472 records of 1053 participants aged 18-90 years and 20% were used for model evaluation. The developed model identified real-time AT with 0.82 for correlation coefficient (Corr) and 1.20 mL/kg/min for mean absolute error (MAE), and the corresponding AT time with 0.86 for Corr and 0.66 min for MAE. The peak VO2 prediction model achieved 0.87 for Corr and 2.25 mL/kg/min for MAE. CONCLUSION: Deep-learning models for real-time CPET analysis can accurately identify AT and predict peak VO2. The developed models can be a competent assistant system to assess a patient's condition in real time, expanding CPET utility.

Cardiopulmonary exercise testing can be used to evaluate the condition of patients with heart failure during exercise. Developed deep-learning models can accurately predict a patient's anaerobic threshold in real time and peak oxygen uptake. The models can be used by clinicians for more objective and accurate assessments in real time, expanding the utility of cardiopulmonary exercise testing.

3-min All-out Test to Evaluate Aerobic and Anaerobic Indexes in Court Team Sports.

This study aimed to test the reproducibility of the 3-min all-out effort applied using shuttle running and compare its values to aerobic parameters. On the first day, 14 futsal players underwent an exhaustive test to determine the maximal incremental speed (MIS) and anaerobic threshold (AnT). On the second day, the participants performed the 3-min all-out effort (n=14), which was repeated after 48 h (third day) to test its reproducibility (n=11). Peak oxygen consumption (V̇ O2PEAK) and peak blood lactate concentrations ([La-]) were determined from 3-min all-out efforts performed through a 20-m shuttle run on the official court. The distance covered, mean speed, and critical speed (CS) during the 3-min all-out presented direct relationships with aerobic parameters determined through the incremental test (r>0.62). The distance covered above CS (D') presented a direct relationship with peak lactate concentrations induced by a 3-min all-out effort (r=0.81). Despite the acceptable levels of reproducibility observed for most of the 3-min all-out variables, the minimal detectable change for D' was high (72%). Our results demonstrated the potential use of mean speed to evaluate aerobic fitness. However, the applicability of the 3-min all-out shuttle run test to monitor training adaptations should be avoided, at least in nonexperienced athletes.

Do freedivers and spearfishermen differ in local muscle oxygen saturation and anaerobic power?

BACKGROUND: Freediving is defined as an activity where athletes repetitively dive and are exposed to long efforts with limited oxygen consumption. Therefore, anaerobic features are expected to be an important facet of diving performance. This study aimed to investigate differences in anaerobic capacity and local muscle oxygenation in spearfisherman and freedivers. METHODS: The sample of participants included 17 male athletes (nine freedivers, and eight spearfishermen), with an average age of 37.0±8.8 years, training experience of 10.6±9.5 years, body mass of 82.5±9.5 kg and height of 184.2±5.7 cm. Anthropometric characteristics included: body mass, body height, seated height, and body fat percentage. Wingate anaerobic test was conducted, during which local muscle oxygenation was measured with a NIRS device (Moxy monitor). Wingate power outputs were measured (peak power [W/kg] and average power [W/kg]), together with muscle oxygenation variables (baseline oxygen saturation [%], desaturation slope [%/s], minimum oxygen saturation [%], half time recovery [s], and maximum oxygen saturation [%]). RESULTS: The differences were not obtained between freedivers and spearfisherman in power outputs (peak power (9.24±2.08 spearfisherman; 10.68±1.04 freedivers; P=0.14); average power (6.85±0.95 spearfisherman; 7.44±0.60 freedivers; P=0.15) and muscle oxygenation parameters. However, analysis of effect size showed a moderate effect in training experience (0.71), PP (0.89), AP (0.75), Desat slope mVLR (0.66), half time recovery mVLR (0.90). CONCLUSIONS: The non-existence of differences between freedivers and spearfishermen indicates similar training adaptations to the anaerobic demands. However, the results show relatively low anaerobic capacities of our divers that could serve as an incentive for the further development of these mechanisms.

Anaerobic threshold using sweat lactate sensor under hypoxia.

We aimed to investigate the reliability and validity of sweat lactate threshold (sLT) measurement based on the real-time monitoring of the transition in sweat lactate levels (sLA) under hypoxic exercise. In this cross-sectional study, 20 healthy participants who underwent exercise tests using respiratory gas analysis under hypoxia (fraction of inspired oxygen [FiO2], 15.4 ± 0.8%) in addition to normoxia (FiO2, 20.9%) were included; we simultaneously monitored sLA transition using a wearable lactate sensor. The initial significant elevation in sLA over the baseline was defined as sLT. Under hypoxia, real-time dynamic changes in sLA were successfully visualized, including a rapid, continual rise until volitionary exhaustion and a progressive reduction in the recovery phase. High intra- and inter-evaluator reliability was demonstrated for sLT's repeat determinations (0.782 [0.607-0.898] and 0.933 [0.841-0.973]) as intraclass correlation coefficients [95% confidence interval]. sLT correlated with ventilatory threshold (VT) (r = 0.70, p < 0.01). A strong agreement was found in the Bland-Altman plot (mean difference/mean average time: - 15.5/550.8 s) under hypoxia. Our wearable device enabled continuous and real-time lactate assessment in sweat under hypoxic conditions in healthy participants with high reliability and validity, providing additional information to detect anaerobic thresholds in hypoxic conditions.

Comparison of usefulness of two tests measuring anaerobic performance of untrained and soccer-training girls U12.

The study aimed to investigate the usefulness of the Running-based Anaerobic Sprint Test (RAST) in anaerobic performance estimation in trained and untrained girls U12, and the effect of an 8-week training period in female U12 soccer players on anaerobic performance. A comparative study of two structurally different anaerobic tests was performed to reach the goal. The study was designed as a non-randomized, controlled before-and-after trial. Fourteen female soccer players (FSP) and twelve untrained girls (UNT) participated in the study. During that time, all participants were subjected to school's physical education classes and the FSP additionally participated in regular soccer training. The anaerobic performance was evaluated twice, within 8-weeks period, using the traditional Wingate test (WAnT) and the RAST. A significant increase in the anaerobic performance of the FSP was noted (p < 0.05). In both tests peak, average, and relative power were significantly improved (p < 0.005). Nevertheless, strong, statistically significant (p < 0.05) correlation coefficients (0.50 < r < 0.70) were found for pre-training measurements between the WAnT and the RAST power parameters in absolute values. In UNT group significant improvement was found in peak, average and min power (p < 0.05) in the RAST. The improvement in anaerobic performance after training along with the strong correlation noted between the WAnT and the RAST power parameters prove the usefulness of the RAST in assessing anaerobic capacity in female youth athletes. Its simplicity encourages its use in monitoring anaerobic capacity in both trained and untrained girls.