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Purpose: Individuals with constitutional thinness have been presented with a lower muscular energy metabolism at the cellular level but their effective aerobic capacities and exercise-related energy efficiency remains unexplored. The present study compares maximal and sub-maximal aerobic capacities between subjects with constitutional thinness and age-matched normal-weight ones., Methods: Anthropometric measures, body composition (Dual-X-ray absorptiometry), physical activity and sedentary time (GT3x actigraphs), and maximal aerobic capacities (cycling V ˙ O 2peak test) were assessed in 18 constitutionally thin (CT-body mass index < 17.5 kg m -2 ) and 17 normal-weight (NW-body mass index between 20 and 25 kg m -2 ) women. Energy efficiency was assessed during a submaximal cycling test and a walking exercise., Results: CT had a lower body mass and body mass index compared to NW. Absolute peak oxygen uptake and maximal aerobic power were lower in CT subjects compared to NW (ES: - 1.63 [- 2.40; - 0.86] and - 1.32 [- 2.05; - 0.58], p < 0.001). V ˙ O 2peak related to body mass was not different between groups. Gross and net efficiency (ES: - 0.78 [- 1.48; - 0.06], p = 0.03 and ES: - 0.73 [- 1.43; - 0.01], p = 0.05) were lower in CT compared to NW during the submaximal cycling exercise. The gross energy cost of walking related to body mass was lower in subjects with CT (ES: - 1.80 [- 2.60; - 0.97, p = 0.05), with no difference for the net one. Perceived exertion was similar between groups in responses to both submaximal exercises., Conclusion: Constitutionally thin women do not show impaired aerobic capacities at moderate to maximal intensities despite lower energy efficiency while cycling and walking at low-to-moderate intensities., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The present study aimed to characterize the exercise-induced neuromuscular fatigue and its possible links with cerebral and muscular oxygen supply and utilization to provide mechanistic insights into the reduced exercise capacity characterizing patients with end-stage renal disease (ESRD)., Methods: Thirteen patients with ESRD and thirteen healthy males (CTR group) performed a constant-force sustained isometric contraction at 50% of their maximal voluntary isometric contraction (MVC) until exhaustion. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis, and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQ tw,pot ) evoked by supramaximal electrical stimulation, respectively. To assess cerebral and muscular oxygenation, throughout exercise, near-infrared spectroscopy allowed investigation of changes in oxyhemoglobin (∆O 2 Hb), deoxyhemoglobin (∆HHb), and total hemoglobin (∆THb) in the prefrontal cortex and in the vastus lateralis muscle., Results: ESRD patients demonstrated lower exercise time to exhaustion than that of CTR (88.8 ± 15.3 s and 119.9 ± 14.6 s, respectively, P < 0.01). Following the exercise, MVC, Q tw,pot , and VA reduction were similar between the groups (P > 0.05). There was no significant difference in muscle oxygenation (∆O 2 Hb) between the two groups (P > 0.05). Cerebral and muscular blood volume (∆THb) and oxygen extraction (∆HHb) were significantly blunted in the ESRD group (P < 0.05). A significant positive correlation was observed between time to exhaustion and cerebral blood volume (∆THb) in both groups (r 2  = 0.64, P < 0.01)., Conclusions: These findings support cerebral hypoperfusion as a factor contributing to the reduction in exercise capacity characterizing ESRD patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Fatigue is frequent in people with multiple sclerosis (pwMS) impacting physical and cognitive functions. Lower aerobic capacity and regional thalamic volume may be involved in the pathophysiology of fatigue in pwMS., Objectives: To identify associations between thalamic nuclei volumes, aerobic capacity and fatigue and to investigate whether the influence of aerobic capacity on fatigue in pwMS is mediated by thalamic integrity., Methods: Eighty-three pwMS underwent a clinical evaluation with assessment of fatigue (Modified Fatigue Impact Scale [MFIS]), including physical (pMFIS) and cognitive (cMFIS) components, and peak of oxygen uptake (VO2peak). PwMS and 63 sex- and age-matched healthy controls (HC) underwent a 3 T brain MRI to quantify volume of the whole thalamus and its nuclei., Results: Compared to HC, pwMS showed higher global MFIS, pMFIS and cMFIS scores, and lower VO2peak and thalamic volumes (p < 0.001). In pwMS, higher VO2peak was significantly associated with lower MFIS and pMFIS scores (r value = - 0.326 and - 0.356; pFDR ≤ 0.046) and higher laterodorsal thalamic nucleus (Dor) cluster volume (r value = 0.300; pFDR = 0.047). Moreover, lower Dor thalamic cluster volume was significantly associated with higher MFIS, pMFIS and cMFIS scores (r value range = - 0.305; - 0.293; pFDR ≤ 0.049). The volume of Dor thalamic cluster partially mediated the positive effects of VO2peak on both MFIS and cMFIS, with relative indirect effects of 21% and 32% respectively. No mediation was found for pMFIS., Conclusions: Higher VO2peak is associated with lower fatigue in pwMS, likely acting on Dor thalamic cluster volume integrity. Such an effect might be different according to the type of fatigue (cognitive or physical)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Purpose: Dietary nitrate (NO 3 - ) supplementation can lower systolic blood pressure (SBP) and improve exercise performance. Salivary flow rate (SFR) and pH are key determinants of oral NO 3 - reduction and purported to peak in the afternoon. We tested the hypotheses that NO 3 - -rich beetroot juice (BR) would increase plasma [nitrite] ([NO 2 - ]), lower SBP and improve exercise performance to a greater extent in the afternoon (AFT) compared to the morning (MORN) and evening (EVE)., Method: Twelve males completed six experimental visits in a repeated-measures, crossover design. NO 3 - -depleted beetroot juice (PL) or BR (~ 13 mmol NO 3 - ) were ingested in the MORN, AFT and EVE. SFR and pH, salivary and plasma [NO 3 - ] and [NO 2 - ], brachial SBP and central SBP were measured pre and post supplementation. A severe-intensity exercise tolerance test was completed to determine cycling time to exhaustion (TTE)., Results: There were no between-condition differences in mean SFR or salivary pH. The elevation in plasma [NO 2 - ] after BR ingestion was not different between BR-MORN, BR-AFT and BR-EVE. Brachial SBP was unchanged following BR supplementation in all conditions. Central SBP was reduced in BR-MORN (- 3 ± 4 mmHg), BR-AFT (- 4 ± 3 mmHg), and BR-EVE (- 2 ± 3 mmHg), with no differences between timepoints. TTE was not different between BR and PL at any timepoint., Conclusion: Acute BR supplementation was ineffective at improving TTE and brachial SBP and similarly effective at increasing plasma [NO 2 - ] and lowering central SBP across the day, which may have implications for informing NO 3 - supplementation strategies., (© 2023. The Author(s).)

Purpose: Constant blood flow occlusion (BFO) superimposed on aerobic exercise can impair muscle function and exercise tolerance; however, no study has investigated the effect of intermittent BFO on the associated responses. Fourteen participants (n = 7 females) were recruited to compare neuromuscular, perceptual, and cardiorespiratory responses to shorter (5:15s, occlusion-to-release) and longer (10:30s) BFO applied during cycling to task failure., Methods: In randomized order, participants cycled to task failure (task failure 1) at 70% of peak power output with (i) shorter BFO, (ii) longer BFO, and (iii) no BFO (Control). Upon task failure in the BFO conditions, BFO was removed, and participants continued cycling until a second task failure (task failure 2). Maximum voluntary isometric knee contractions (MVC) and femoral nerve stimuli were performed along with perceptual measures at baseline, task failure 1, and task failure 2. Cardiorespiratory measures were recorded continuously across the exercises., Results: Task failure 1 was longer in Control than 5:15s and 10:30s (P < 0.001), with no differences between the BFO conditions. At task failure 1, 10:30s elicited a greater decline in twitch force compared to 5:15s and Control (P < 0.001). At task failure 2, twitch force remained lower in 10:30s than Control (P = 0.002). Low-frequency fatigue developed to a greater extent in 10:30s compared to Control and 5:15s (P < 0.047). Dyspnea and Fatigue were greater for Control than 5:15s and 10:30s at the end of task failure 1 (P < 0.002)., Conclusion: Exercise tolerance during BFO is primarily dictated by the decline in muscle contractility and accelerated development of effort and pain., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The present study aimed to characterize the etiology of exercise-induced neuromuscular fatigue and its consequences on the force-duration relationship to provide mechanistic insights into the reduced exercise capacity characterizing early-stage breast cancer patients., Methods: Fifteen early-stage breast cancer patients and fifteen healthy women performed 60 maximal voluntary isometric quadriceps contractions (MVCs, 3 s of contraction, 2 s of relaxation). The critical force was determined as the mean force of the last six contractions, while W' was calculated as the force impulse generated above the critical force. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQTw) evoked by supramaximal electrical stimulation, respectively., Results: Early-stage breast cancer patients demonstrated lower MVC than controls preexercise (- 15%, P = 0.022), and this reduction persisted throughout the 60-MVC exercise (- 21%, P = 0.002). The absolute critical force was lower in patients than in controls (144 ± 29N vs. 201 ± 47N, respectively, P < 0.001), while W' was similar (P = 0.546), resulting in lower total work done (- 23%, P = 0.001). This was associated with lower muscle activation in the vastus lateralis (P < 0.001), vastus medialis (P = 0.003) and rectus femoris (P = 0.003) in patients. Immediately following exercise, ΔVA showed a greater reduction in patients compared to controls (- 21.6 ± 13.3% vs. - 12.6 ± 7.7%, P = 0.040), while ΔQTw was similar (- 60.2 ± 13.2% vs. - 52.8 ± 19.4%, P = 0.196)., Conclusion: These findings support central fatigue as a primary cause of the reduction in exercise capacity characterizing early-stage breast cancer patients treated with chemotherapy., Clinical Trials Registration: No. NCT04639609-November 20, 2020., (© 2023. The Author(s).)

Purpose: The aim of this study was to investigate the individual [Formula: see text] reconstitution kinetics of trained cyclists following repeated bouts of incremental ramp exercise, and to determine an optimal mathematical model to describe [Formula: see text] reconstitution., Methods: Ten trained cyclists (age 41 ± 10 years; mass 73.4 ± 9.9 kg; [Formula: see text] 58.6 ± 7.1 mL kg min -1 ) completed three incremental ramps (20 W min -1 ) to the limit of tolerance with varying recovery durations (15-360 s) on 5-9 occasions. [Formula: see text] reconstitution was measured following the first and second recovery periods against which mono-exponential and bi-exponential models were compared with adjusted R 2 and bias-corrected Akaike information criterion (AICc)., Results: A bi-exponential model outperformed the mono-exponential model of [Formula: see text] reconstitution (AICc 30.2 versus 72.2), fitting group mean data well (adjR 2  = 0.999) for the first recovery when optimised with parameters of fast component (FC) amplitude = 50.67%; slow component (SC) amplitude = 49.33%; time constant (τ) FC  = 21.5 s; τ SC  = 388 s. Following the second recovery, W' reconstitution reduced by 9.1 ± 7.3%, at 180 s and 8.2 ± 9.8% at 240 s resulting in an increase in the modelled τ SC to 716 s with τ FC unchanged. Individual bi-exponential models also fit well (adjR 2  = 0.978 ± 0.017) with large individual parameter variations (FC amplitude 47.7 ± 17.8%; first recovery: (τ) FC  = 22.0 ± 11.8 s; (τ) SC  = 377 ± 100 s; second recovery: (τ) FC  = 16.3.0 ± 6.6 s; (τ) SC  = 549 ± 226 s)., Conclusions: W' reconstitution kinetics were best described by a bi-exponential model consisting of distinct fast and slow phases. The amplitudes of the FC and SC remained unchanged with repeated bouts, with a slowing of W' reconstitution confined to an increase in the time constant of the slow component., (© 2021. The Author(s).)

Purpose: Continuous incremental protocols (CP) may misestimate the maximum aerobic velocity (V max ) due to increases in running speed faster than cardiorespiratory/metabolic adjustments. A higher aerobic capacity may mitigate this issue due to faster pulmonary oxygen uptake ([Formula: see text]O 2 ) kinetics. Therefore, this study aimed to compare three different protocols to assess V max in athletes with higher or lower training status., Methods: Sixteen well-trained runners were classified according to higher (HI) or lower (LO) [Formula: see text]O 2max [Formula: see text]O 2 -kinetics was calculated across four 5-min running bouts at 10 km·h -1 . Two CPs [1 km·h -1 per min (CP1) and 1 km·h -1 every 2-min (CP2)] were performed to determine V max [Formula: see text]O 2max , lactate-threshold and submaximal [Formula: see text]O 2 /velocity relationship. Results were compared to the discontinuous incremental protocol (DP)., Results: V max , [Formula: see text]O 2max , [Formula: see text]CO 2 and VE were higher [(P < 0.05,(ES:0.22/2.59)] in HI than in LO. [Formula: see text]O 2 -kinetics was faster [P < 0.05,(ES:-2.74/ - 1.76)] in HI than in LO. [Formula: see text]O 2 /velocity slope was lower in HI than in LO [(P < 0.05,(ES:-1.63/ - 0.18)]. V max and [Formula: see text]O 2 /velocity slope were CP1 > CP2 = DP for HI and CP1 > CP2 > DP for LO. A lower [P < 0.05,(ES:0.53/0.75)] V max -difference for both CP1 and CP2 vs DP was found in HI than in LO. V max -differences in CP1 vs DP showed a large inverse correlation with V max , [Formula: see text]O 2max and lactate-threshold and a very large correlation with [Formula: see text]O 2 -kinetics., Conclusions: Higher aerobic training status witnessed by faster [Formula: see text]O 2 kinetics led to lower between-protocol V max differences, particularly between CP2 vs DP. Faster kinetics may minimize the mismatch issues between metabolic and mechanical power that may occur in CP. This should be considered for exercise prescription at different percentages of V max ., (© 2021. The Author(s).)

Purpose: The purpose of the present study was to determine whether a contiguous ramp and all-out exercise test could accurately determine critical power (CP) in a single laboratory visit during both upright and supine cycle exercise., Methods: Healthy males completed maximal ramp-incremental exercise on a cycle ergometer in the upright (n = 15) and supine positions (n = 8), with task failure immediately followed by a 3-min all-out phase for determination of end-test power (EP). On separate days, participants undertook four constant-power tests in either the upright or supine positions with the limit of tolerance ranging from ~ 2 to 15 min for determination of CP., Results: During upright exercise, EP was highly correlated with (R 2  = 0.93, P < 0.001) and not different from CP (CP = 221 ± 40 W vs. EP = 226 ± 46 W, P = 0.085, 95% limits of agreement - 30, 19 W). During supine exercise, EP was also highly correlated with (R 2  = 0.94, P < 0.001) and not different from CP (CP = 140 ± 42 W vs. EP = 136 ± 40 W, P = 0.293, 95% limits of agreement - 16, 24 W)., Conclusion: The present data suggest that EP derived from a contiguous ramp all-out exercise test is not different from the gold-standard method of CP determination during both upright and supine cycle exercise when assessed at the group level. However, the wide limits of agreement observed within the present study suggest that EP and CP should not be used interchangeably., (© 2021. The Author(s).)

Purpose: While ideal for developing aerobic capacity, traditional endurance training (ET) is extremely time-consuming and may lack the specificity to maintain indices of speed and power in team sport athletes. In contrast, low-volume short-duration sprint interval training (SIT) has been shown to improve [Formula: see text]O 2 max to a similar extent as ET. However, to date, few studies have compared the effects of running-based SIT and ET, on aerobic capacity and indices of speed and power of trained team sport athletes., Methods: Club level male Gaelic football players were randomly assigned to SIT (n = 13; 26.5 ± 4.87 years) or ET (n = 12; 25.4 ± 2.58 years) groups. Participants trained 3 days week -1 for 6 weeks. [Formula: see text]O 2 max, RE, v[Formula: see text]O 2 max, blood lactate concentrations, Wingate test performance, running speed, jump performance and intermittent endurance performance (IEP) were measured at baseline and after 6 weeks., Results: An increase in [Formula: see text]O 2 max (p < 0.05), v[Formula: see text]O 2 max (p < 0.001) and IEP (p < 0.001) following 6 weeks of both SIT and ET was observed. Wingate mean power (p < 0.001), peak power (p < 0.001) and fatigue index (p < 0.005) were all significantly improved following training in both groups. Velocity at LT was significantly higher and performance in the 20-m running speed and VJ tests were significantly reduced post training in the ET group (all p < 0.005)., Conclusion: Despite the large difference in total training time, a running-based protocol of SIT is a time efficient training method for improving aerobic capacity and IEP while maintaining indices of lower body power and running speed in team-sport players.

Purpose: High doses of glucocorticoids induce skeletal muscle weakness. The aim of this study was to evaluate the effects of exercise therapy on skeletal muscle strength, mass, and exercise capacity in patients with connective tissue disease treated with high doses of glucocorticoids., Methods: This prospective, observational, single-center, cohort study included 35 patients aged ≥ 15 years diagnosed with connective tissue disease who received high-dose glucocorticoids and physical training. Exercise therapy, including moderate aerobic and strength training, was performed five times a week. Knee extension strength, skeletal muscle mass, anaerobic threshold, and peak oxygen consumption were measured at the beginning of exercise therapy and at discharge., Results: After 6 weeks of aerobic and strength exercises, skeletal muscle mass significantly decreased by 5.5%, right knee extension decreased by 11.6%, and left knee extension decreased by 9.7%. The anaerobic threshold and peak oxygen consumption significantly increased by 13.0% and 9.0%, respectively. The increase in glucocorticoid dose was inversely correlated with changes in knee extension strength., Conclusion: In patients with connective tissue disease being treated with high-dose glucocorticoids, exercise therapy might attenuate the decrease in skeletal muscle mass and strength and increase the anaerobic threshold and peak oxygen consumption, thus moderating the side effects of high-dose glucocorticoid treatment. Trial registration The trial is registered with UMIN (University Hospital Medical Information Network), ID number UMIN000038836.

Introduction: Cocoa flavanols (CF) may exert health benefits through their potent vasodilatory effects, which are perpetuated by elevations in nitric oxide (NO) bioavailability. These vasodilatory effects may contribute to improved delivery of blood and oxygen (O 2 ) to exercising muscle., Purpose: Therefore, the objective of this study was to examine how CF supplementation impacts pulmonary O 2 uptake ([Formula: see text]) kinetics and exercise tolerance in sedentary middle-aged adults., Methods: We employed a double-blind cross-over, placebo-controlled design whereby 17 participants (11 male, 6 female; mean ± SD, 45 ± 6 years) randomly received either 7 days of daily CF (400 mg) or placebo (PL) supplementation. On day 7, participants completed a series of 'step' moderate- and severe-intensity exercise tests for the determination of [Formula: see text] kinetics., Results: During moderate-intensity exercise, the time constant of the phase II [Formula: see text] kinetics ([Formula: see text]) was decreased by 15% in CF as compared to PL (mean ± SD; PL 40 ± 12 s vs. CF 34 ± 9 s, P = 0.019), with no differences in the amplitude of [Formula: see text] (A[Formula: see text]; PL 0.77 ± 0.32 l min -1 vs. CF 0.79 ± 0.34 l min -1 , P = 0.263). However, during severe-intensity exercise, [Formula: see text], the amplitude of the slow component ([Formula: see text]) and exercise tolerance (PL 435 ± 58 s vs. CF 424 ± 47 s, P = 0.480) were unchanged between conditions., Conclusion: Our data show that acute CF supplementation enhanced [Formula: see text] kinetics during moderate-, but not severe-intensity exercise in middle-aged participants. These novel effects of CFs, in this demographic, may contribute to improved tolerance of moderate-activity physical activities, which appear commonly present in daily life., Trial Registration: Registered under ClinicalTrials.gov Identifier no. NCT04370353, 30/04/20 retrospectively registered.

Purpose: Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue., Methods: 24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1g at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps., Results: AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA p < 0.001; iAG - 25%, cAG - 26%, CTRL - 33%), plantar flexion strength (group * time p = 0.003; iAG - 35%, cAG - 31%, CTRL - 48%) and plantar flexion RFD (group * time p = 0.020; iAG - 28%, cAG - 12%, CTRL - 40%). Women showed more pronounced losses than men in jumping power (p < 0.001) and knee extension strength (p = 0.010)., Conclusion: The AG protocols were not suitable to maintain aerobic exercise capacity, probably due to the very low cardiorespiratory demand of this intervention. However, they mitigated some losses in muscle function, potentially due to the low-intensity muscle contractions during centrifugation used to avoid presyncope.

Purpose: Aerobic exercise capacity is reduced in patients with chronic kidney disease, partly due to alterations at the muscular and microvascular level. This study evaluated oxygen uptake (VO 2 ) kinetics as indicator of muscular oxidative metabolism in a population of Kidney Transplant Recipients (KTRs)., Methods: Two groups of KTRs enrolled 3 (n = 21) and 12 months (n = 14) after transplantation and a control group of healthy young adults (n = 16) underwent cardiopulmonary exercise testing on cycle-ergometer. The protocol consisted in two subsequent constant, moderate-load exercise phases with a final incremental test until exhaustion., Results: The time constant of VO 2 kinetics was slower in KTRs at 3 and 12 months after transplantation compared to controls (50.4 ± 13.1 s and 43.8 ± 11.6 s vs 28.9 ± 8.4 s, respectively; P < 0.01). Peak VO 2 was lower in KTRs evaluated 3 months after transplantation compared to patients evaluated after 1 year (21.3 ± 4.3 and 26.4 ± 8.0 mL/kg/min; P = 0.04). Blood haemoglobin (Hb) concentration was higher in KTRs evaluated at 12 months (12.8 ± 1.7 vs 14.6 ± 1.7 g/dL; P < 0.01). Among KTRs, τ showed a moderate negative correlation with Peak VO 2 (ρ = - 0.52) and Oxygen uptake efficiency slope (OUES) (r = - 0.57) while no significant correlation with Hb and peak heart rate., Conclusions: KTRs show slower VO 2 kinetics compared to healthy controls. Hb and peak VO 2 seem to improve during the first year after transplantation. VO 2 kinetics were significantly associated with indices of cardiorespiratory fitness, but less with central determinants of aerobic capacity, thus suggesting a potential usefulness of adding this index of muscular oxidative metabolism to functional evaluation in KTRs.

Purpose: There is evidence of both the preventive effects and poor acceptance of mouthguards. There are various effects on performance depending on the type of mouthguard model. Hemodynamic responses to wearing a mouthguard have not been described. The aim of this study was to investigate the effects of self-adapted mouthguards with breathing channels (SAMG vent )., Methods: In this randomized crossover study, 17 healthy, active subjects (age 25.12 ± 2.19 years) underwent body plethysmography and performed two incremental exertion tests wearing a (SAMG vent ) and not wearing (CON) a mouthguard. Blood lactate, spirometrics, and thoracic impedance were measured during these maximum exercise tests., Results: The mean values using a SAMG vent revealed significantly greater airway resistance compared to CON (0.53 ± 0.16 kPa·L -1 vs. 0.35 ± 0.10 kPa·L -1 , respectively; p = < 0.01). At maximum load, ventilation with SAMGv ent was less than CON (118.4 ± 28.17 L min -1 vs. 128.2 ± 32.16 L min -1 , respectively; p = < 0.01). At submaximal loads, blood lactate responses with SAMG vent were higher than CON (8.68 ± 2.20 mmol·L -1 vs. 7.89 ± 1.65 mmol·L -1 , respectively; p < 0.01). Maximum performance with a SAMG vent was 265.9 ± 59.9 W, and without a mouthguard was 272.9 ± 60.8 W (p < 0.01). Maximum stroke volume was higher using a SAMG vent than without using a mouthguard (138.4 ± 29.9 mL vs. 130.2 ± 21.2 mL, respectively; p < 0.01)., Conclusion: Use of a self-adapted mouthguard led to increased metabolic effort and a significant reduction in ventilation parameters. Unchanged oxygen uptake may be the result of cardiopulmonary compensation and increased breathing efforts, which slightly affects performance. These results and the obvious preventive effects of mouthguards support their use in sports.

Purpose: To compare performance data of adolescents collected with five different bicycle spiroergometry protocols and to assess the necessity for establishing standard values for each protocol., Methods: One-hundred-twenty adolescents completed two bicycle spiroergometries within 14 days. One of the two tests was performed based on our institutional weight-adapted protocol (P0). The other test was performed based on one out of four exercise protocols widely used for children and adolescents (P1, 2, 3 or 4) with 30 persons each. The two tests were performed in a random order. Routine parameters of cardiopulmonary exercise tests (CPET) such as VO 2 peak, maximum power, O 2 pulse, OUES, VE/VCO 2 slope as well as ventilatory and lactate thresholds were investigated. Agreement between protocols was evaluated by Bland-Altman analysis, coefficients of variation (CV) and intra-class correlation coefficients (ICC)., Results: None of the CPET parameters were significantly different between P0 and P1, 2, 3 or 4. For most of the parameters, low biases between P0 and P1-P4 were found and 95% confidence intervalls were narrow. CV and ICC values largely corresponded to well-defined analytical goals (CV < 10% and ICC > 0.9). Only maximal power (Pmax) showed differences in size and drift of the bias depending on the length of the step duration of the protocols., Conclusion: Comparability between examination protocols has been shown for CPET parameters independent on step duration. Protocol-dependent standard values do not appear to be necessary. Only Pmax is dependent on the step duration, but in most cases, this has no significant influence on the fitness assessment.

Background and Purpose: The development of myocardial fibrosis is a major complication of Type 2 diabetes mellitus (T2DM), impairing myocardial deformation and, therefore, cardiac performance. It remains to be established whether abnormalities in longitudinal strain (LS) exaggerate or only occur in well-controlled T2DM, when exposed to exercise and, therefore, cardiac stress. We therefore studied left ventricular LS at rest and during exercise in T2DM patients vs. healthy controls., Methods and Results: Exercise echocardiography was applied with combined breath-by-breath gas exchange analyses in asymptomatic, well-controlled (HbA1c: 6.9 ± 0.7%) T2DM patients (n = 36) and healthy controls (HC, n = 23). Left ventricular LS was assessed at rest and at peak exercise. Peak oxygen uptake (V̇O 2peak ) and workload (W peak ) were similar between groups (p > 0.05). Diastolic (E, e' s , E/e') and systolic function (left ventricular ejection fraction) were similar at rest and during exercise between groups (p > 0.05). LS (absolute values) was significantly lower at rest and during exercise in T2DM vs. HC (17.0 ± 2.9% vs. 19.8 ± 2% and 20.8 ± 4.0% vs. 23.3 ± 3.3%, respectively, p < 0.05). The response in myocardial deformation (the change in LS from rest up to peak exercise) was similar between groups (+ 3.8 ± 0.6% vs. + 3.6 ± 0.6%, in T2DM vs. HC, respectively, p > 0.05). Multiple regression revealed that HDL-cholesterol, fasted insulin levels and exercise tolerance accounted for 30.5% of the variance in response of myocardial deformation in the T2DM group (p = 0.002)., Conclusion: Myocardial deformation is reduced in well-controlled T2DM and despite adequate responses, such differences persist during exercise., Trial Registration: NCT03299790, initially released 09/12/2017.

Purpose: High-level spinal cord injury (SCI) can result in spinal and supraspinal respiratory control deficits leading to insufficient ventilatory responses to exercise and training-related adaptations. We hypothesized a serotonin agonist, known to improve respiratory function in animal models, would improve adaptations to whole-body functional electrical stimulation (FES) exercise training in patients with acute high-level SCI., Methods: We identified 10 patients (< 2 years of injury with SCI from C4 to T3) in our program who had performed 6 months of FES-row training while on Buspirone (29 ± 17 mg/day) between 2012 and 2018. We also identified well-matched individuals who trained for six months but not on Buspirone (n = 11). A peak incremental FES-rowing exercise test and resting pulmonary function test had been performed before and after training., Results: Those on Buspirone demonstrated greater increases in peak oxygen consumption (VO 2 peak: + 0.24 ± 0.23 vs. + 0.10 ± 0.13 L/min, p = 0.08) and peak ventilation (VEpeak: + 6.5 ± 8.1 vs. - 0.7 ± 6.9 L/min, p < 0.05) compared to control. In addition, changes in VO 2 peak and VEpeak were correlated across all patients (r = 0.63, p < 0.01), but most strongly in those on Buspirone (r = 0.85, p < 0.01). Furthermore, changes in respiratory function correlated with increased peak tidal volume in the Buspirone group (r > 0.66, p < 0.05)., Conclusion: These results suggest Buspirone improves cardiorespiratory adaptations to FES-exercise training in individuals with acute, high-level SCI. The strong association between increases in ventilatory and aerobic capacities suggests improved respiratory function is a mechanism; however, controlled studies are needed to determine if this preliminary finding is reproducible.

Purpose: There is a profound gap in the understanding of the eccentric cycling intensity continuum, which prevents accurate exercise prescription based on desired physiological responses. This may underestimate the applicability of eccentric cycling for different training purposes. Thus, we aimed to summarize recent research findings and screen for possible new approaches in the prescription and investigation of eccentric cycling., Method: A search for the most relevant and state-of-the-art literature on eccentric cycling was conducted on the PubMed database. Literature from reference lists was also included when relevant., Results: Transversal studies present comparisons between physiological responses to eccentric and concentric cycling, performed at the same absolute power output or metabolic load. Longitudinal studies evaluate responses to eccentric cycling training by comparing them with concentric cycling and resistance training outcomes. Only one study investigated maximal eccentric cycling capacity and there are no investigations on physiological thresholds and/or exercise intensity domains during eccentric cycling. No study investigated different protocols of eccentric cycling training and the chronic effects of different load configurations., Conclusion: Describing physiological responses to eccentric cycling based on its maximal exercise capacity may be a better way to understand it. The available evidence indicates that clinical populations may benefit from improvements in aerobic power/capacity, exercise tolerance, strength and muscle mass, while healthy and trained individuals may require different eccentric cycling training approaches to benefit from similar improvements. There is limited evidence regarding the mechanisms of acute physiological and chronic adaptive responses to eccentric cycling.

Purpose: Children born preterm have impaired lung function and altered lung structure. However, there are conflicting reports on how preterm birth impacts aerobic exercise capacity in childhood. We aimed to investigate how neonatal history and a diagnosis of bronchopulmonary dysplasia (BPD) impact the relationship between function and structure of the lung, and aerobic capacity in school-aged children born very preterm., Methods: Preterm children (≤ 32 w completed gestation) aged 9-12 years with (n = 38) and without (n = 35) BPD, and term-born controls (n = 31), underwent spirometry, lung volume measurements, gas transfer capacity, a high-resolution computer tomography (CT) scan of the chest, and an incremental treadmill exercise test., Results: Children born preterm with BPD had an elevated breathing frequency to tidal volume ratio compared to term controls (76% vs 63%, p = 0.002). The majority (88%) of preterm children had structural changes on CT scan. There were no differences in peak V̇O 2 (47.1 vs 47.7 mL/kg/min, p = 0.407) or oxygen uptake efficiency slope when corrected for body weight (67.6 vs 67.3, p = 0.5) between preterm children with BPD and term controls. There were no differences in any other exercise outcomes. The severity of structural lung disease was not associated with exercise outcomes in this preterm population., Conclusion: Children born preterm have impaired lung function, and a high prevalence of structural lung abnormalities. However, abnormal lung function and structure do not appear to impact on the aerobic exercise capacity of preterm children at school age.

Purpose: This study investigated whether intermittent post-exercise sauna bathing across three-weeks endurance training improves exercise heat tolerance and exercise performance markers in temperate conditions, compared to endurance training alone. The subsidiary aim was to determine whether exercise-heat tolerance would further improve following 7-Weeks post-exercise sauna bathing., Methods: Twenty middle-distance runners (13 female; mean ± SD, age 20 ± 2 years, [Formula: see text]O 2max 56.1 ± 8.7 ml kg -1  min -1 ) performed a running heat tolerance test (30-min, 9 km h -1 /2% gradient, 40 °C/40%RH; HTT) and temperate (18 °C) exercise tests (maximal aerobic capacity [[Formula: see text]O 2max ], speed at 4 mmol L -1 blood lactate concentration ([La - ]) before (Pre) and following three-weeks (3-Weeks) normal training (CON; n = 8) or normal training with 28 ± 2 min post-exercise sauna bathing (101-108 °C, 5-10%RH) 3 ± 1 times per week (SAUNA; n = 12). Changes from Pre to 3-Weeks were compared between-groups using an analysis of co-variance. Six SAUNA participants continued the intervention for 7 weeks, completing an additional HTT (7-Weeks; data compared using a one-way repeated-measures analysis of variance)., Results: During the HTT, SAUNA reduced peak rectal temperature (T rec ; - 0.2 °C), skin temperature (- 0.8 °C), and heart rate (- 11 beats min -1 ) more than CON at 3-Weeks compared to Pre (all p < 0.05). SAUNA also improved [Formula: see text]O 2max (+ 0.27 L -1  min -1 ; p = 0.02) and speed at 4 mmol L -1 [La - ] (+ 0.6 km h -1 ; p = 0.01) more than CON at 3-Weeks compared to Pre. Only peak T rec (- 0.1 °C; p = 0.03 decreased further from 3-Weeks to 7-Weeks in SAUNA (other physiological variables p > 0.05)., Conclusions: Three-weeks post-exercise sauna bathing is an effective and pragmatic method of heat acclimation, and an effective ergogenic aid. Extending the intervention to seven weeks only marginally improved T rec .

Purpose: Decline in skeletal muscle mitochondrial oxidative capacity (MOC) is associated with reduced aerobic capacity and increased risk of cardiovascular and metabolic disease. Measuring skeletal muscle MOC may be an alternative method to assess aerobic capacity, especially for individuals unable to perform a whole-body maximum oxygen uptake protocol. In this study, linear regression analysis in two leg muscles was performed to determine whether MOC values could be used to predict whole-body peak oxygen uptake., Methods: MOC was measured with near infrared spectroscopy (NIRS) in the medial gastrocnemius (MG) and vastus lateralis (VL) muscles of 26 participants (age, 27.1 ± 5.8 years old). Whole-body peak oxygen uptake (VO 2 peak) was determined by indirect calorimetry during a continuous ramp protocol on a cycle ergometer., Results: VO 2 peak values were significantly correlated with the muscle recovery rate constant (k) of the MG (kMG, r = 0.59; p < 0.01) and VL (kVL, r = 0.63; p < 0.01) muscles. Summing recovery rate constants of both muscles together (kMG + kVL) improved the strength of the correlation with VO 2 peak (r = 0.78; p < 0.0001) and could explain a majority of the variance (R 2  = 0.61) between the two measurements., Conclusion: Data suggest that NIRS can provide reliable MOC measurements on two leg muscles that correlate well with whole-body peak oxygen uptake.

Purpose: Treatment for head and neck cancer is associated with multiple side effects, including loss of body mass, impaired physical function and reduced health-related quality of life. This study aimed to investigate the impact of treatment (radiation therapy ± concurrent chemotherapy) on (i) muscle strength, muscle cross-sectional area and patient-reported outcomes, and (ii) central and peripheral alterations during a whole-body exercise task., Methods: Ten people with head and neck cancer (4 female; 50 ± 9 years) completed a lab visit before and after (56 ± 30 days) completion of treatment. Participants performed a neuromuscular assessment (involving maximal isometric voluntary contractions in the knee extensors and electrical stimulation of the femoral nerve) before and during intermittent cycling to volitional exhaustion. Anthropometrics and patient-reported outcomes were also assessed., Results: From before to after treatment, maximal isometric muscle strength was reduced (P = 0.002, d = 0.73), as was potentiated twitch force (P < 0.001, d = 0.62), and muscle cross-sectional area (e.g., vastus lateralis: P = 0.010, d = 0.64). Exercise time was reduced (P = 0.008, d = 0.62) and peripheral processes contributed to a reduction in maximal force due to cycling. After treatment, the severity of self-reported fatigue increased (P = 0.041, r = - 0.65) and health-related quality of life decreased (P = 0.012, r = - 0.79)., Conclusion: Neuromuscular function was impaired in patients with head and neck cancer after treatment. Whole-body exercise tolerance was reduced and resulted in predominantly peripheral, rather than central, disturbances to the neuromuscular system. Future research should evaluate strength training after treatment for head and neck cancer, with the overall aim of reducing fatigue and improving health-related quality of life.

Purpose: To investigate the relationship between the recovery of neuromuscular fatigue and the recovery of amount of work done above critical power (W´)., Methods: Ten healthy men performed, on different days, constant work rate exercises until task failure to determine critical power (CP) and W´. In the three following visits, participants performed two exhausting constant work rate exercises estimated to induce task failure within 6 min (P6 1 and P6 2 ), interspaced by 3, 6 or 15 min of recovery. Neuromuscular function was assessed before and periodically after the P6 1 using percutaneous electrical femoral nerve stimulation. The W´ recovery was measured from the total work performed above CP during the P6 2 ., Results: The P6 1 induced a full use of W´ and a reduction in maximal voluntary contraction (MVC, - 19 ± 4%), voluntary activation (VA, - 6 ± 2%) and twitch force stimulated at 1 Hz (- 37 ± 11%), 10 Hz (- 50 ± 16%) and 100 Hz (- 32 ± 11%), when compared to baseline (P < 0.05). The time constant of VA recovery was significantly faster than the time constant of W´ recovery (P < 0.05), but there was no significant difference between the time constant of W´ recovery and the time constant of recovery of MVC or twitch force stimulated at 1, 10 and 100 Hz (P > 0.05). However, the time constant of W´ recovery was only associated to the time constant of MVC recovery (r = 0.73, P < 0.05)., Conclusion: The W´ recovery is not associated to the recovery of peripheral or central fatigue alone. Rather, W´ seems to be associated to the recovery of the overall capacity to generate force.

Aims: Endurance athletes develop cardiac remodeling to cope with increased cardiac output during exercise. This remodeling is both anatomical and functional and shows large interindividual variability. In this study, we quantify local geometric ventricular remodeling related to long-standing endurance training and assess its relationship with cardiovascular performance during exercise., Methods: We extracted 3D models of the biventricular shape from end-diastolic cine magnetic resonance images acquired from a cohort of 89 triathlon athletes and 77 healthy sedentary subjects. Additionally, the athletes underwent cardio-pulmonary exercise testing, together with an echocardiographic study at baseline and few minutes after maximal exercise. We used statistical shape analysis to identify regional bi-ventricular shape differences between athletes and non-athletes., Results: The ventricular shape was significantly different between athletes and controls (p < 1e-6). The observed regional remodeling in the right heart was mainly a shift of the right ventricle (RV) volume distribution towards the right ventricular infundibulum, increasing the overall right ventricular volume. In the left heart, there was an increment of left ventricular mass and a dilation of the left ventricle. Within athletes, the amount of such remodeling was independently associated to higher peak oxygen pulse (p < 0.001) and weakly with greater post-exercise RV free wall longitudinal strain (p = 0.03)., Conclusions: We were able to identify specific bi-ventricular regional remodeling induced by long-lasting endurance training. The amount of remodeling was associated with better cardiopulmonary performance during an exercise test.

Based on the strong linear relationship between heart rate (HR) and oxygen consumption, the Åstrand-Ryhming cycle ergometer test (Astrand and Ryhming in J Appl Physiol 7:218-221, 1954) is a widely used submaximal test to predict whole body maximal oxygen consumption ([Formula: see text]). However, a similar test predicting peak oxygen consumption ([Formula: see text]) in the upper extremities is not established, and may be very useful for individuals unable to use their lower extremities or/and if separation of upper extremity aerobic capacity is sought after. Thus, the aim of the current study was to develop a submaximal test predicting [Formula: see text] in arm-cycling. Forty-nine healthy volunteers (25 women: 38 ± 13 years; 24 men: 39 ± 12 years) tested arm-cycle [Formula: see text] on a protocol with 4-min, 21-W increments to exhaustion. The data were contrasted to treadmill [Formula: see text] values. Arm-cycle [Formula: see text] was 66 ± 8% of [Formula: see text] (r = 0.92, p < 0.001; women: 1.9 ± 0.4 L min -1 ; men: 3.0 ± 0.7 L min -1 ). Arm-cycle HR and [Formula: see text] exhibited correlations of r = 0.79 and r = 0.78 for women and men, respectively, while corresponding correlations between work rate and [Formula: see text] were r = 0.95 (women) and r = 0.89 (men) (all p < 0.001). Arm-cycle [Formula: see text] prediction revealed a standard error of estimate (SEE) of 11.2% (women) and 10.2% (men), and was primarily due to individual arm-cycle maximal HR (women: 173 ± 13 beats min -1 ; men: 174 ± 10 beats min -1 ; correction factor: 5-7%). In conclusion, from a single 4-min stage of submaximal arm cycling, [Formula: see text] can be predicted with a SEE of 10-11%. The arm-cycle test may have important value for individuals who rely on arms in sports and occupations, and for patients with lower extremity disabilities.

Purpose: To characterize left ventricular diastolic function during an exertional challenge in adults with incomplete cervical spinal cord Injury (icSCI)., Methods: In this cross-sectional study, a two-group convenience sample was used to compare left ventricular LV diastolic performance during a 5-10 W·min -1 incremental arm ergometer exercise protocol, using bioimpedance cardiography. Subjects were eight males with cervical incomplete spinal cord injury (icSCI; C5-C7: age 39 ± 14 years) versus eight able-bodied males (CON: age 38 ± 13 years). Left ventricular (LV) diastolic indices included end-diastolic volume (EDV) and early diastolic filling ratio (EDFR). LV ejection time (LVET), inotropic index (dZ/dT 2 ) and stroke volume (SV) were compared between the groups at peak exercise, and maximum workload for the icSCI group (isomax)., Results: EDV (at peak exercise:131.4 ± 7.3 vs 188.78 ± 9.4, p < 0.001; at isomax: 131.4 ± 7.3 vs 169 ± 23, p = 0.0009) and EDFR (at peak exercise 73 ± 14% vs 119 ± 11%, p = 0.006; at isomax 94 ± 10; p = 0.009) were significantly reduced in icSCI compared to CON, respectively. Significant differences in LVET (icSCI: 273 ± 48 vs CON: 305 ± 68; p = 0.1) and dZ/dT 2 (icSCI: 0.64 ± 0.11 vs CON: 0.85 ± 0.31; p = 0.1) were not observed at isomax, despite a significant decrease in SV in the subjects with icSCI (77.1 ± 6.05 mL vs 105.8 ± 9.2 mL, p < 0.00) CONCLUSION: Left ventricular filling was impaired in the subjects with icSCI as evidenced at both peak exercise and isomax. It is likely that restrictions on the skeletal muscle pump mechanized the impairment but increased left ventricular wall stiffness could not be excluded as a mediator.

Purpose: The long-term implications of premature birth on autonomic nervous system (ANS) function are unclear. Heart rate recovery (HRR) following maximal exercise is a simple tool to evaluate ANS function and is a strong predictor of cardiovascular disease. Our objective was to determine whether HRR is impaired in young adults born preterm (PYA)., Methods: Individuals born between 1989 and 1991 were recruited from the Newborn Lung Project, a prospectively followed cohort of subjects born preterm weighing < 1500 g with an average gestational age of 28 weeks. Age-matched term-born controls were recruited from the local population. HRR was measured for 2 min following maximal exercise testing on an upright cycle ergometer in normoxia and hypoxia, and maximal aerobic capacity (VO 2max ) was measured., Results: Preterms had lower VO 2max than controls (34.88 ± 5.24 v 46.15 ± 10.21 ml/kg/min, respectively, p < 0.05), and exhibited slower HRR compared to controls after 1 and 2 min of recovery in normoxia (absolute drop of 20 ± 4 v 31 ± 10 and 41 ± 7 v 54 ± 11 beats per minute (bpm), respectively, p < 0.01) and hypoxia (19 ± 5 v 26 ± 8 and 39 ± 7 v 49 ± 13 bpm, respectively, p < 0.05). After adjusting for VO 2max , HRR remained slower in preterms at 1 and 2 min of recovery in normoxia (21 ± 2 v 30 ± 2 and 42 ± 3 v 52 ± 3 bpm, respectively, p < 0.05), but not hypoxia (19 ± 3 v 25 ± 2 and 40 ± 4 v 47 ± 3 bpm, respectively, p > 0.05)., Conclusions: Autonomic dysfunction as seen in this study has been associated with increased rates of cardiovascular disease in non-preterm populations, suggesting further study of the mechanisms of autonomic dysfunction after preterm birth.

Purpose and Methods: To compare the effects of thoracic load carriage on the ventilatory and perceptual responses to graded exercise, 14 pairs of height-matched, physically active males and females completed randomly ordered modified Balke treadmill exercise tests with and without a correctly sized and fitted 20.4 kg backpack and work clothing. Subjects walked at 1.56 m.s - 1 while grade was increased by 2% every 2 min until exhaustion. Ventilatory responses were measured with open circuit spirometry and perceptual responses were evaluated using the modified Borg scale. Inspiratory capacity maneuvers were performed to calculate operating lung volumes., Results: Despite height matching, males had significantly greater lung volumes and peak oxygen uptake ([Formula: see text]O 2peak ). Peak [Formula: see text]O 2 and ventilation ([Formula: see text] E ) were lower (p < 0.05) for all subjects under load. Throughout exercise, the ventilatory equivalents for [Formula: see text]O 2 and carbon dioxide production were significantly higher in females, independent of condition. At similar relative submaximal intensities (%[Formula: see text]O 2peak ), there was no difference in [Formula: see text] E between conditions in either group, however, all subjects adopted a rapid and shallow breathing pattern under load with decreased tidal volume secondary to lower end-inspiratory lung volume. The relative changes in breathing pattern and operating lung volume between unloaded and loaded conditions were similar between males and females. Females reported significantly higher dyspnea ratings for a given [Formula: see text] E compared to males; however, the relationship between dyspnea and [Formula: see text] E was unaffected by load carriage., Conclusion: The relative response patterns for ventilatory and perceptual responses to graded exercise with thoracic loading were similar in males and females.

Background: The hybrid assistive limb (HAL) is the world's first cyborg-type robot suit that provides motion assistance to physically challenged patients. HAL is expected to expand the possibilities of exercise therapy for severe cardiac patients who have difficulty in moving on their own legs. As a first step, we examined whether or not the motion assistance provided by HAL during exercise could effectively reduce the cardiopulmonary burden in healthy subjects., Methods: A total of ten healthy male adults (35 ± 12 years) underwent cardiopulmonary exercise testing (CPX) on a cycle ergometer with or without assistance from HAL. The CPX protocol consisted of four 3-min stages performed in a continuous sequence: rest, 0 W, 40 W, and 80 W. The heart rate (HR), blood pressure, oxygen uptake (VO 2 ), minute ventilation (VE), and gas exchange ratio (R) were monitored during the CPX., Results: At 0 W, the HR, VO 2 , and VE were significantly higher when HAL was used. At 80 W, however, the HR (107 ± 14 vs 114 ± 14 beats/min, p < 0.01), systolic blood pressure (141 ± 15 vs 155 ± 20 mmHg, p < 0.01), VO 2 (17.6 ± 2.4 vs 19.0 ± 2.5 mL/min/kg, p < 0.05), and R (0.88 ± 0.04 vs 0.95 ± 0.09, p < 0.05) were significantly lower when HAL was used., Conclusions: HAL has the potential to reduce cardiopulmonary burden during moderate-intensity exercise and can, therefore, be used as a support for exercise therapy. Further studies on cardiac patients are expected to contribute to the establishment of a new exercise therapy program using HAL.

Purpose: This study characterised oxygen uptake efficiency (OUE) in children with mild-to-moderate cystic fibrosis (CF). Specifically, it investigated (1) the utility of OUE parameters as potential submaximal surrogates of peak oxygen uptake ([Formula: see text]), and (2) the relationship between OUE and disease severity., Methods: Cardiopulmonary exercise test (CPET) data were collated from 72 children [36 CF, 36 age- and sex-matched controls (CON)], with OUE assessed as its highest 90-s average (plateau; OUEP), the gas exchange threshold (OUE GET ) and respiratory compensation point (OUE RCP ). Pearson's correlation coefficients, independent t tests and factorial ANOVAs assessed differences between groups and the use of OUE measures as surrogates for [Formula: see text]., Results: A significant (p < 0.05) reduction in allometrically scaled [Formula: see text] and all OUE parameters was found in CF. Significant (p < 0.05) correlations between measurements of OUE and allometrically scaled [Formula: see text], were observed in CF (r = 0.49-0.52) and CON (r = 0.46-0.52). Furthermore, measures of OUE were significantly (p < 0.05) correlated with pulmonary function (FEV 1%predicted ) in CF (r = 0.38-0.46), but not CON (r = -0.20-0.14). OUEP was able to differentiate between different aerobic fitness tertiles in CON but not CF., Conclusions: OUE parameters were reduced in CF, but were not a suitable surrogate for [Formula: see text]. Clinical teams should, where possible, continue to utilise maximal CPET parameters to measure aerobic fitness in children and adolescents with CF. Future research should assess the prognostic utility of OUEP as it does appear sensitive to disease status and severity.

Purpose: To determine the impact of breathing valve resistance on peak aerobic capacity ([Formula: see text]) and running economy (RE) in endurance-trained and recreationally active individuals., Methods: Ten endurance-trained males (ETM), 10 endurance-trained females (ETF), 10 recreationally active males (RAM), and 10 recreationally active females (RAF) participated in this study. On two separate occasions, subjects performed identical graded exercise treadmill protocols using either a Hans Rudolph 2700 (high resistance) or a Daniels' (low resistance) two-way non-rebreathing valve. Parameters obtained from these protocols included energy expenditure (EE), ventilation ([Formula: see text]), heart rate, respiratory exchange ratio, RE, [Formula: see text], and time to exhaustion (TTE)., Results: When using the Daniels' valve, all groups had lower submaximal EE (- 2.4, - 3.4, - 2.7, and - 2.0% for ETM, ETF, RAM, and RAF) and better RE (- 2.7, - 3.5, - 1.9, and - 1.8% for ETM, ETF, RAM and RAF) across all submaximal speeds. Only the ET groups had lower submaximal [Formula: see text] (4.6 and 3.8% for ETM and ETF) when using the Daniels' valve. TTE increased when using the Daniels' valve for all groups (6.0, 10.9, 6.2 and 9.8% for ETM, ETF, RAM and RAF), but [Formula: see text] was unaltered., Conclusion: Compared to the Daniels' valve, the Hans Rudolph 2700 valve altered the assessment of RE, submaximal EE, and TTE regardless of fitness level or sex, but did not change [Formula: see text]. Therefore, airflow resistance of a breathing valve must be considered when assessing and comparing EE, RE and TTE in the applied and research settings.

Purpose: Although high-intensity interval training (HIT) seems to promote greater improvements in aerobic parameters than continuous training, the influence of exercise intensity on [Formula: see text] on-kinetics remains under investigation., Methods: After an incremental test, twenty-one recreationally trained cyclists performed several time-to-exhaustion tests to determine critical power (CP), and the highest intensity (I HIGH), and the lowest exercise duration (T LOW) at which [Formula: see text] is attained during constant exercise. Subjects also completed a series of step transitions to moderate- and heavy-intensity work rates to determine pulmonary [Formula: see text] on-kinetics. Surface electromyography (EMG) of vastus lateralis muscle and blood lactate accumulation (∆BLC) was measured during heavy exercise. Subjects were assigned to one of two 4-week work-matched training groups: the lower [105 % CP: n = 11; 4 × 5 min at 105 % CP (218 ± 39 W), 1 min recovery] or the upper [I HIGH: n = 10; 8 × 100 % I HIGH (355 ± 60 W), 1:2 work:recovery ratio] intensity of the severe exercise domain., Results: The two interventions were similarly effective in reducing the phase II [Formula: see text] time constant during moderate (105 % CP: 34 ± 13 to 25 ± 8 s; I HIGH: 31 ± 9 to 23 ± 6 s) and heavy exercise (105 % CP: 25 ± 7 to 18 ± 5 s; I HIGH: 27 ± 7 to 16 ± 5 s) and in reducing the amplitude of [Formula: see text] slow component, EMG amplitude, and ∆BLC during heavy exercise., Conclusion: In conclusion, the short-term adjustments in response to step transitions to moderate and heavy exercise were independent of training intensity within the severe exercise domain.

Purpose: This study aimed to evaluate the accuracy of a novel approach for predicting the one-repetition maximum (1RM). The prediction is based on the force-velocity and load-velocity relationships determined from measured force and velocity data collected during resistance-training exercises with incremental submaximal loads. 1RM was determined as the load corresponding to the intersection of these two curves, where the gravitational force exceeds the force that the subject can exert., Methods: The proposed force-velocity-based method (FVM) was tested on 37 participants (23.9 ± 3.1 year; BMI 23.44 ± 2.45) with no specific resistance-training experience, and the predicted 1RM was compared to that achieved using a direct method (DM) in chest-press (CP) and leg-press (LP) exercises., Results: The mean 1RM in CP was 99.5 kg (±27.0) for DM and 100.8 kg (±27.2) for FVM (SEE = 1.2 kg), whereas the mean 1RM in LP was 249.3 kg (±60.2) for DM and 251.1 kg (±60.3) for FVM (SEE = 2.1 kg). A high correlation was found between the two methods for both CP and LP exercises (0.999, p < 0.001). Good agreement between the two methods emerged from the Bland and Altman plot analysis., Conclusion: These findings suggest the use of the proposed methodology as a valid alternative to other indirect approaches for 1RM prediction. The mathematical construct is simply based on the definition of the 1RM, and it is fed with subject's muscle strength capacities measured during a specific exercise. Its reliability is, thus, expected to be not affected by those factors that typically jeopardize regression-based approaches.

Purpose: Sprint interval training (SIT) provides a potent stimulus for improving maximal aerobic capacity ([Formula: see text]), which is among the strongest markers for future cardiovascular health and premature mortality. Cycling-based SIT protocols involving six or more 'all-out' 30-s Wingate sprints per training session improve [Formula: see text], but we have recently demonstrated that similar improvements in [Formula: see text] can be achieved with as few as two 20-s sprints. This suggests that the volume of sprint exercise has limited influence on subsequent training adaptations. Therefore, the aim of the present study was to examine whether a single 20-s cycle sprint per training session can provide a sufficient stimulus for improving [Formula: see text]., Methods: Thirty sedentary or recreationally active participants (10 men/20 women; mean ± SD age: 24 ± 6 years, BMI: 22.6 ± 4.0 kg m(-2), [Formula: see text]: 33 ± 7 mL kg(-1) min(-1)) were randomised to a training group or a no-intervention control group. Training involved three exercise sessions per week for 4 weeks, consisting of a single 20-s Wingate sprint (no warm-up or cool-down). [Formula: see text] was determined prior to training and 3 days following the final training session., Results: Mean [Formula: see text] did not significantly change in the training group (2.15 ± 0.62 vs. 2.22 ± 0.64 L min(-1)) or the control group (2.07 ± 0.69 vs. 2.08 ± 0.68 L min(-1); effect of time: P = 0.17; group × time interaction effect: P = 0.26)., Conclusion: Although we have previously demonstrated that regularly performing two repeated 20-s 'all-out' cycle sprints provides a sufficient training stimulus for a robust increase in [Formula: see text], our present study suggests that this is not the case when training sessions are limited to a single sprint.

Unlabelled: Rock-climbing performance is largely dependent on the endurance of the forearm flexors. Recently, it was reported that forearm flexor endurance in elite climbers is independent of the ability to regulate conduit artery (brachial) blood flow, suggesting that endurance is not primarily dependent on the ability of the brachial artery to deliver oxygen, but rather the ability of the muscle to perfuse and use oxygen, i.e., skeletal muscle oxidative capacity., Purpose: The aim of the study was to determine whether an index of oxidative capacity in the flexor digitorum profundus (FDP) predicts the best sport climbing red-point grade within the last 6 months. Participants consisted of 46 sport climbers with a range of abilities., Methods: Using near-infrared spectroscopy, the oxidative capacity index of the FDP was assessed by calculating the half-time for tissue oxygen resaturation (O2HTR) following 3-5 min of ischemia., Results: Linear regression, adjusted for age, sex, BMI, and training experience, revealed a 1-s decrease in O2HTR was associated with an increase in red-point grade by 0.65 (95 % CI 0.35-0.94, Adj R (2)  = 0.53)., Conclusions: Considering a grade of 0.4 separated the top four competitors in the 2015 International Federation Sport Climbing World Cup, this finding suggests that forearm flexor oxidative capacity index is an important determinant of rock-climbing performance.

Purpose: We analyzed the best performance times of master cycling athletes in the 200-3000 m track competitions to estimate the decay of maximal aerobic power (MAP) and anaerobic capacity (AnS) with aging., Methods: In various decades of age (30-80 years), MAP and AnS were estimated using an iterative procedure as the values that minimize the difference between: (1) the metabolic power ([Formula: see text]) necessary to cover a given distance (d) in the time t and; (2) the maximal metabolic power ([Formula: see text]) maintained at a constant level throughout the competition., Results: MAP started decreasing at 45 years of age. Thereafter, it showed an average percent rate of decrease of about 16 % for decade, as previously shown in other classes of master athletes. In addition, AnS seemed to decay by about 11 % every 10 years from the second part of the fifth decade., Conclusions: The decay of MAP occurred in spite of the active lifestyle of the subjects and it may be attributed to the progressive impairment of maximal O2 delivery and/or of peripheral O2 utilization. The loss of AnS might derive from the progressive loss of muscle mass occurring after the fifth decade of life, to the progressive qualitative deterioration of the anaerobic energy yielding pathways or to the lower capacity of MN recruitment during maximal efforts. The proposed approach may be applied to other types of human locomotion of whom the relationship between performance t and [Formula: see text] is known.

Purpose: To investigate the effects of combined strength and speed endurance (SE) training along with a reduced training volume on performance, running economy and muscular adaptations in endurance-trained runners., Methods: Sixteen male endurance runners (VO2-max: ~60 ml kg(-1) min(-1)) were randomly assigned to either a combined strength and SE training (CSS; n = 9) or a control (CON; n = 7) group. For 8 weeks, CSS replaced their normal moderate-intensity training (~63 km week(-1)) with SE (2 × week(-1)) and strength training (2 × week(-1)) as well as aerobic high (1 × week(-1)) and moderate (1 × week(-1)) intensity training with a reduction in total volume of ~58 %, whereas CON continued their training (~45 km week(-1))., Results: In CSS, 400-m and Yo-Yo intermittent recovery test performance was improved by 5 % (P < 0.01) and 19 % (P < 0.001), respectively, during the intervention period. Maximal aerobic speed was 0.6 km h(-1) higher (P < 0.05), and maximal activity of lactate dehydrogenase subunits 1 and 2 was 17 % (P < 0.05) higher after compared to before the intervention period. Time to exhaustion and peak blood lactate during an incremental treadmill test was 9 % (P < 0.05) and 32 % (P < 0.01), respectively, higher and expression of Na(+)-K(+) pump β1 subunit was 15 % higher (P < 0.05) after compared to before the intervention period. 10-K performance, maximum oxygen uptake and running economy were unchanged. In CON, no changes were observed., Conclusions: Adding strength and speed endurance training, along with a reduced training volume, can improve short-term exercise capacity and induce muscular adaptations related to anaerobic capacity in endurance-trained runners.

Purpose: A decline in physical capacity takes place with increasing age that negatively affects overall physical function including work ability and the ability to perform typical activities of daily living (ADL). The overall aim of the present study was to determine the neuromuscular adaptations to long-term (1 year) football and strength training in older untrained adults, and to assess the concurrent effect on functional ADL capacity., Methods: Twenty-seven healthy elderly males (68.2 ± 3.2 years) were randomly assigned to 12 months of either recreational football training (FT: n = 10), strength training (ST: n = 9) or served as inactive controls (CON: n = 8). Recreational football training consisted of small-sided training sessions whereas strength training consisted of high intensity exercises targeting the lower extremity and upper body. Maximal thigh muscle strength and rate of force development (RFD) were assessed with isokinetic dynamometry, while postural balance and vertical jumping performance were evaluated using force plate analysis. Furthermore, functional ability was evaluated by stair-ascent and chair-rising testing., Results: A total of nine, nine and seven participants from FT, ST and CON, respectively, were included in the analysis. Both exercise regimens led to substantial gains in functional ability, evidenced by 24 and 18 % reduced stair-ascent time, and 32 and 21 % increased chair-rising performance in FT and ST, respectively (all P < 0.05). Long-term strength training led to increased concentric (14 %; P < 0.01) and isometric (23 %; P < 0.001) quadriceps and isometric hamstring strength (44 %; P < 0.0001), whereas football training mainly resulted in enhanced hamstring strength (18 %, P < 0.05) and RFD (89 %, P < 0.0001)., Conclusions: Long-term (1 year) strength training led to increased quadriceps and hamstring strength, whereas the adaptations to football training mainly included enhanced strength and rapid force capacity of the hamstring muscles. Gains in functional ability were observed in response to both training regimens, evidenced by reduced stair-ascent time and increased chair-rising performance. Long-term football exercise and strength training both appear to be effective interventional strategies to improve factors of importance for ADL by counteracting the age-related decline in lower limb strength and functional capacity among old male adults. This could potentially be a way to improve work ability of senior workers.

Purpose: To determine the target intensity for fast walking during interval walking training (IWT) in water for middle-aged and older people to enhance physical fitness., Methods: Thirty-one women [59 ± 5 (SD) years old] were randomly divided into two groups: IWT on land (LG, N = 15) and in water (WG, N = 16). All subjects were instructed to perform ≥ 6 sets of fast and slow walking for 3 min each in a day, ≥ 4 days week(-1), for 8 weeks, at an intensity 35% higher than the oxygen consumption rate at the gas exchange threshold (VO2GET), with a subjective feeling of 16-18 points of the Borg scale during fast walking in each condition. Before and after IWT, we measured VO2GET, peak aerobic capacity (VO2peak) by graded walking and cycling tests on land and isometric knee extension (F EXT) and flexion (F FLX) forces., Results: Before IWT, the VO2GET for walking in water was 14% higher and the heart rate (HR) at a given VO2 was ~10 beats min(-1) lower (P=0.001) than on land. During IWT, subjects in both groups performed IWT for ~4 days week(-1)(P > 0.9) with a 14% higher fast walking intensity in WG than in LG (P < 0.05). After IWT, the VO2peak and VO2GET for cycling, F EXT and F FLX increased more in WG than in LG (all, P < 0.05)., Conclusion: Walking in water elevated VO2GET and decreased HR at a given exercise intensity in middle-aged and older women, which enabled them to perform exercise at a higher metabolic rate than on land due to improved subjective feelings, which, for these subjects, resulted in greater gains in physical fitness.

The authors of this study examined the effects of muscle fatigue on balance indices and recovery time in recreationally trained individuals after incremental tests on a treadmill and a cycle ergometer. Sixteen participants (male N = 11, female N = 5) (mean age = 21.2 ± 2 years) completed this study. Balance measures were performed on a Biodex Balance System via the Dynamic Balance Test. Balance was measured pre-exercise, immediately post-exercise, and at 3-, 6-, 9-, 12-, 15-, 18-, and 21-min post-exercise. Immediately following the fatiguing treadmill test, balance increased significantly in the overall stability index (SI) (from 4.38 ± 2.48 to 6.09 ± 1.80) and the anterior/posterior index (API) (from 3.49 ± 2.18 to 5.28 ± 1.81) (p < 0.01). Immediately following the fatiguing cycle test, balance was not altered significantly in SI or API. Balance was not altered significantly for the medial/lateral index for either exercise test at any time point. Additionally, there were no significant differences in time to recovery. At 12-min post-exercise, all indices were below pre-exercise values, indicating that fatiguing exercise has a positive effect on balance over time. These results are consistent with previous research, suggesting that any effects of fatigue on balance are seen immediately and are diminished as time after exercise increases.

The effects of exercise-induced muscle damage (EIMD) on the physiological, metabolic and perceptual responses during upper body arm cranking exercise are unknown. Nine physically active male participants performed 6 min of arm cranking exercise at ventilatory threshold (VT), followed by a time to exhaustion (TTE) trial at a workload corresponding to 80 % of the difference between VT and [Formula: see text] 48 h after bench pressing exercise (10 × 6 repetitions at 70 % one repetition maximum) or 20 min sitting (control). Reductions in isokinetic strength and increased muscle soreness of the elbow flexors and extensors were evident at 24 and 48 h after bench pressing exercise (P < 0.05). Despite no change in [Formula: see text], [Formula: see text], HR and blood lactate concentration ([Bla]) between conditions (P > 0.05), rating of perceived exertion (RPE) was higher during the 6 min arm cranking after bench pressing exercise compared to the control condition (P < 0.05). TTE was reduced in the treatment condition (207.2 ± 91.9 cf. 293.4 ± 75.6 s; P < 0.05), as were end [Formula: see text] (P < 0.05) and [Bla] at 0, 5 and 10 min after exercise (P < 0.05). RPE during the TTE trial was higher after bench pressing (P < 0.05), although end RPE was not different between conditions (P > 0.05). This study provides evidence that EIMD caused by bench pressing exercise increases the sense of effort during arm cranking exercise that leads to a reduced exercise tolerance. The findings have implications for individuals participating in concurrent endurance and resistance training of the upper body.

The purpose of this investigation was to determine the influence of heat stress on the dynamics of muscle metabolic perturbation during high-intensity exercise. Seven healthy males completed single-legged knee-extensor exercise until the limit of tolerance on two separate occasions. In a randomized order the subjects underwent 40 min of lower-body immersion in warm water at 42°C prior to exercise (HOT) or received no prior thermal manipulation (CON). Following the intervention, muscle metabolism was measured at rest and throughout exercise using (31)P-MRS. The tolerable duration of high-intensity exercise was reduced by 36% after passive heating (CON: 474 ± 146 vs. HOT: 303 ± 76 s; P = 0.005). Intramuscular pH was lower over the first 60 s of exercise (CON: 7.05 ± 0.02 vs. HOT: 7.00 ± 0.03; P = 0.019) in HOT compared to CON. The rate of muscle [PCr] degradation during exercise was greater in the HOT condition (CON: -0.17 ± 0.08 vs. HOT: -0.25 ± 0.10% s(-1); P = 0.006) and pH also tended to change more rapidly in HOT (P = 0.09). Muscle [PCr] (CON: 26 ± 14 vs. HOT: 29 ± 10%), [Pi] (CON: 504 ± 236 vs. HOT: 486 ± 186%) and pH (CON: 6.84 ± 0.13 vs. HOT: 6.80 ± 0.14; P > 0.05) were not statistically different at the limit of tolerance (P > 0.05 for all comparisons). These results suggest that the reduced time-to-exhaustion during high-intensity knee-extensor exercise following lower-body heating might be related, in part, to accelerated rates of change of intramuscular [PCr] and pH towards 'critical' values that limit muscle function.

High-intensity interval training (HIT) has been proposed as a time-efficient alternative to traditional cardiorespiratory exercise training, but is very fatiguing. In this study, we investigated the effects of a reduced-exertion HIT (REHIT) exercise intervention on insulin sensitivity and aerobic capacity. Twenty-nine healthy but sedentary young men and women were randomly assigned to the REHIT intervention (men, n = 7; women, n = 8) or a control group (men, n = 6; women, n = 8). Subjects assigned to the control groups maintained their normal sedentary lifestyle, whilst subjects in the training groups completed three exercise sessions per week for 6 weeks. The 10-min exercise sessions consisted of low-intensity cycling (60 W) and one (first session) or two (all other sessions) brief 'all-out' sprints (10 s in week 1, 15 s in weeks 2-3 and 20 s in the final 3 weeks). Aerobic capacity ([Formula: see text]) and the glucose and insulin response to a 75-g glucose load (OGTT) were determined before and 3 days after the exercise program. Despite relatively low ratings of perceived exertion (RPE 13 ± 1), insulin sensitivity significantly increased by 28% in the male training group following the REHIT intervention (P < 0.05). [Formula: see text] increased in the male training (+15%) and female training (+12%) groups (P < 0.01). In conclusion we show that a novel, feasible exercise intervention can improve metabolic health and aerobic capacity. REHIT may offer a genuinely time-efficient alternative to HIT and conventional cardiorespiratory exercise training for improving risk factors of T2D.

Body mass (BM) is a confounding variable in human performance. We hypothesized that adjusting 6-min walk distance (6MWD) for BM differences using allometric scaling would allow meaningful individual and group comparisons. We aimed to use allometric scaling of 6MWD to BM to provide an index for comparing walking performance in middle-aged and older adults. One hundred and twenty subjects (40-87 years) participated. Anthropometry, spirometry, and two walk tests were evaluated. We adjusted 6MWD to BM, gender, and age using an allometric procedure. The allometric exponents were prospectively applied in a validation sample of 44 healthy subjects. Body mass presented significant negative correlation (p < 0.01) with 6MWD · BM(-1) in middle-aged and older adults (r = -0.70 and -0.46, respectively). The allometric exponent (b) for 6MWD was significantly higher for older than middle-aged adults (0.35 ± 0.20 vs. 0.11 ± 0.08, respectively). The resulting BM exponents were similar in male and female subjects (0.22 ± 0.13 and 0.17 ± 0.09, respectively). The correlation between 6MWD · BM(-b ) and BM using the exponents (0.11 or 0.35) was not statistically different from zero (r = 0.00) in the validation sample, suggesting that allometric analysis did not penalize the subjects based on BM. Allometric scaling of 6MWD in middle-aged and older adults may be useful for evaluating walking performance free of the confounding effect of BM, even in the absence of a table of norms.

The purpose of this study was to assess the physiological adaptations in physically fit individuals to a period of intensified training. Ten trained males cycled outdoors ~170 km day(-1) on 19 out of 21 days. Expired gas was collected on days 1 and 21 during maximal graded exercise and used for the determination of gross efficiency and whole body substrate use. Muscle biopsies were obtained before and after exercise on days 2 and 22 for the determination of mtDNA/gDNA ratio, gene expression, metabolic enzyme activity and glycogen use. Muscle glycogen before and after exercise, fat oxidation, and gross efficiency increased, carbohydrate oxidation decreased (p < 0.05), and VO(2max) did not change over the 21 days of training. Citrate synthase (CS), β-hydroxyacyl CoA dehydrogenase (β-HAD) and cytochrome c oxidase (COX) enzyme activity did not change with training. CS and β-HAD mRNA did not change with acute exercise or training. COX (subunit IV) mRNA increased with acute exercise (p < 0.05) but did not change over the 21 days. PGC-1α mRNA increased with acute exercise, but did not increase to the same degree on day 22 as it did on day 2 (p < 0.05). UCP3 mRNA decreased with training (p < 0.05). Acute exercise caused an increase in mitofusin2 (MFN2) mRNA (p < 0.05) and a trend for an increase in mtDNA/gDNA ratio (p = 0.057). However, training did not affect MFN2 mRNA or mtDNA/gDNA ratio. In response to 3,211 km of cycling, changes in substrate use and gross efficiency appear to be more profound than mitochondrial adaptations in trained individuals.

The aim of this study is to test our hypothesis that normal exercise tolerance differs according to gender and to identify potential functional cardiac relationships, which could explain those differences. A total of 44 healthy individuals with mean age of 49 ± 12 years (28-74 years, 22 males) constituted the study cohort. All individuals underwent resting and exercise Doppler echocardiogram simultaneously with peak oxygen uptake analysis (pVO(2)). At equal pVO(2), males achieved higher peak exercise workload (p < 0.001) and females higher heart rate (p < 0.001) but the two groups maintained similar indexed left ventricular (LV) stroke volume (SV) and cardiac output. Indexed LV end-diastolic (LVDVI) and end-systolic volumes (LVSVI) were smaller in females (p < 0.001 and p < 0.01, respectively), but filling time (FT) was shorter (p < 0.001) and they had higher early diastolic (E) velocity (p = 0.004), E/E (m) (myocardial E velocity) (p < 0.001) and global longitudinal strain rate atrial velocity (GLSRa') (p = 0.02), compared to males. In males, workload (p < 0.01), LVDVI (p < 0.01), LVSVI (p < 0.05), SVI (p < 0.001) directly but LV myocardial isovolumic relaxation time (IVRTm) (p < 0.01) inversely correlated with pVO(2). In females, mitral E velocity (p < 0.01), GLSRs' (p < 0.05) positively and LVFT negatively (p < 0.05) correlated with pVO(2). In a multivariable analysis SVI in males (p < 0.01) and GLSRs' in females (p < 0.01) were the strongest predictors for pVO(2). Thus, normal exercise capacity as determined by pVO(2) is related to the indexed stroke volume in males and left atrial pressure in females. These native normal differences between genders may explain the known vulnerability of women to endurance exercise compared to men.

Increased brain dopamine availability improves prolonged exercise tolerance in the heat. It is unclear whether supplementing the amino-acid precursor of dopamine increases exercise capacity in the heat. Eight healthy male volunteers [mean age 32 ± 11 (SD) years; body mass 75.3 ± 8.1 kg; peak oxygen uptake ([Formula: see text]) 3.5 ± 0.3 L min(-1)] performed two exercise trials separated by at least 7 days in a randomised, crossover design. Subjects consumed 500 mL of a flavoured sugar-free drink (PLA), or the same drink with 150 mg kg body mass(-1) tyrosine (TYR) in a double-blind manner 1 h before cycling to exhaustion at a constant exercise intensity equivalent to 68 ± 5% [Formula: see text] in 30°C and 60% relative humidity. Pre-exercise plasma tyrosine:large neutral amino acids increased 2.9-fold in TYR (P < 0.01), while there was no change in PLA (P > 0.05). Subjects cycled longer in TYR compared to PLA (80.3 ± 19.7 min vs. 69.2 ± 14.0 min; P < 0.01). Core temperature, mean weighted skin temperature, heart rate, ratings of perceived exertion and thermal sensation were similar in TYR and PLA during exercise and at exhaustion (P > 0.05) despite longer exercise time in TYR. The results show that acute tyrosine supplementation is associated with increased endurance capacity in the heat in moderately trained subjects. The results also suggest for the first time that the availability of tyrosine, a nutritional dopamine precursor, can influence the ability to subjectively tolerate prolonged submaximal constant-load exercise in the heat.