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Long-term analysis of prospective randomized clinical trial data.Lumbar total disk replacement (TDR) has been found to have equivalent or superior clinical outcomes compared with fusion and decreased radiographic incidence of adjacent level degeneration in single-level cases.The purpose of this particular analysis was to determine the incidence and risk factors for secondary surgery in patients treated with TDR or circumferential fusion at 2 contiguous levels of the lumbar spine.A total of 229 patients were treated and randomized to receive either TDR or circumferential fusion to treat degenerative disk disease at 2 contiguous levels between L3 and S1 (TDR, n=161; fusion, n=68).Overall, at final 5-year follow-up, 9.6% of subjects underwent a secondary surgery in this study. The overall rate of adjacent segment disease was 3.5% (8/229). At 5 years, the percentage of subjects undergoing secondary surgeries was significantly lower in the TDR group versus fusion (5.6% vs. 19.1%, P=0.0027).Most secondary surgeries (65%, 17/26) occurred at the index levels. Index level secondary surgeries were most common in the fusion cohort (16.2%, 11/68 subjects) versus TDR (3.1%, 5/161 subjects, P=0.0009). There no statistically significant difference in the adjacent level reoperation rate between TDR (2.5%, 4/161) and fusion (5.9%, 4/68). The most common reason for index levels reoperation was instrumentation removal (n=9). Excluding the instrumentation removals, there was not a significant difference between the treatments in index level reoperations or in reoperations overall.There were significantly fewer reoperations in TDR patients compared with fusion patients. However, most of the secondary surgeries were instrumentation removal in the fusion cohort. Discounting the instrumentation removals, there was no significant difference in reoperations between TDR and fusion. These results are indicative that lumbar TDR is noninferior to fusion.

We aimed to determine the neurophysiological mechanisms associated with reduced endurance performance during cognitive-motor dual task at different levels of cognitive load, compared to a motor task alone. Eighteen healthy men performed isometric quadriceps contractions at 15% of maximal voluntary contraction (blocks of 170 s interspaced by neuromuscular evaluations) until exhaustion. This task was performed on three separate days: (a) in the absence of concomitant cognitive task, (b) with concomitant 1-back task, and (c) with concomitant 2-back task. Autonomic nervous system activity, perceived exertion, and cognitive performance were continuously monitored. Peripheral and central determinants of neuromuscular function were assessed at rest, between each block, and at task failure using femoral nerve stimulation. Endurance time was shorter during 2-back (982 ± 545 s) and 1-back (1,128 ± 592 s) conditions, compared with control (1,306 ± 836 s). Voluntary activation level was lower in 2-back (87.1%; p < 0.001) and 1-back (88.6%; p = 0.04) conditions compared to control (91.2%) at isotime (100% of the shortest test duration). Sympathetic activity showed a greater increase in 2-back condition compared to control. Perceived muscular exertion was higher during 2-back than during control. Cognitive performance decreased similarly with time during both cognitive-motor dual task but was always lower during 2-back condition. Motor performance is reduced when adding a concomitant demanding memory task to a prolonged isometric exercise. This can be explained by the interaction of various psychological and neurophysiological factors including higher perceived exertion, greater perturbations of autonomic nervous system activity, and cerebral impairments leading to earlier onset of central fatigue.

OBJECTIVE The purpose of this study was to evaluate the 7-year cost-effectiveness of cervical total disc replacement (CTDR) versus anterior cervical discectomy and fusion (ACDF) for the treatment of patients with single-level symptomatic degenerative disc disease. A change in the spending trajectory for spine care is to be achieved, in part, through the selection of interventions that have been proven effective yet cost less than other options. This analysis complements and builds upon findings from other cost-effectiveness evaluations of CTDR through the use of long-term, patient-level data from a randomized study. METHODS This was a 7-year health economic evaluation comparing CTDR versus ACDF from the US commercial payer perspective. Prospectively collected health care resource utilization and treatment effects (quality-adjusted life years [QALYs]) were obtained from individual patient-level adverse event reports and SF-36 data, respectively, from the randomized, multicenter ProDisc-C total disc replacement investigational device exemption (IDE) study and post-approval study. Statistical distributions for unit costs were derived from a commercial claims database and applied using Monte Carlo simulation. Patient-level costs and effects were modeled via multivariate probabilistic analysis. Confidence intervals for 7-year costs, effects, and net monetary benefit (NMB) were obtained using the nonparametric percentile method from results of 10,000 bootstrap simulations. The robustness of results was assessed through scenario analysis and within a parametric regression model controlling for baseline variables. RESULTS Seven-year follow-up data were available for more than 70% of the 209 randomized patients. In the base-case analysis, CTDR resulted in mean per-patient cost savings of $12,789 (95% CI $5362–$20,856) and per-patient QALY gains of 0.16 (95% CI −0.073 to 0.39) compared with ACDF over 7 years. CTDR was more effective and less costly in 90.8% of probabilistic simulations. CTDR was cost-effective in 99.8% of sensitivity analysis simulations and generated a mean incremental NMB of $20,679 (95% CI $6053–$35,377) per patient at a willingness-to-pay threshold of $50,000/QALY. CONCLUSIONS Based on this modeling evaluation, CTDR was found to be more effective and less costly over a 7-year time horizon for patients with single-level symptomatic degenerative disc disease. These results are robust across a range of scenarios and perspectives and are intended to support value-based decision making.

International audience; Introduction : The study aimed to investigate how a distortion of perceived exertion in the heat may affect, during a self-paced cycling exercise preceded by prior cognitive task, the thermal perception and the subsequent regulation of power output in high level athletes.Methods : Eleven endurance trained male athletes completed four experimental sessions including a 30-min fixed-RPE (15-Hard) cycling exercise in neutral (TMP-22 °C) and hot (HOT-37 °C) conditions, following a 60-min incongruent Stroop task (EXP) or passively watching documentary films (CON). Central and peripheral performances of the knee extensors were assessed before the cognitive task and after the exercise.Results : Although mental demand and effort were higher in EXP (P

Background and Purpose— EmboTrap is a novel stent retriever designed to achieve rapid and substantial flow restoration in acute ischemic stroke secondary to large-vessel occlusions. Here, we evaluated EmboTrap’s safety and efficacy compared with established stent retrievers. Methods— ARISE II (Analysis of Revascularization in Ischemic Stroke With EmboTrap) was a single-arm, prospective, multicenter study, comparing the EmboTrap device to a composite performance goal criterion derived using a Bayesian meta-analysis from the pivotal SWIFT (Solitaire device) and TREVO 2 (Trevo device) trials. Patients at 11 US and 8 European sites were eligible for inclusion if they had large-vessel occlusions and moderate-to-severe neurological deficits within 8 hours of symptom onset. The primary efficacy end point was achievement of modified Thrombolysis in Cerebral Ischemia (mTICI) reperfusion scores of ≥2b within 3 EmboTrap passes as adjudicated by the core laboratory. The primary safety end point was a composite of symptomatic intracerebral hemorrhage and serious adverse device effects. Secondary end points included functional independence (modified Rankin Scale, 0–2) and all-cause mortality at 90 days. Results— Between October 2015 and February 2017, 227 patients were enrolled and treated with the EmboTrap device. The primary efficacy end point (mTICI ≥2b within 3 passes) was achieved in 80.2% (95% confidence interval, 74%–85% versus 56% performance goal criterion; P value, Conclusions— The EmboTrap stent-retriever mechanical thrombectomy device demonstrated high rates of substantial reperfusion and functional independence in patients with acute ischemic stroke secondary to large-vessel occlusions. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT02488915.

The aim of the present study was to compare the maximal isometric torque and cardio-respiratory parameters in well-trained young and master triathletes prior to and following an Olympic distance triathlon. One day before and 24 h following the event, participants performed three maximum voluntary isometric knee extensions and flexions and an incremental running test on a treadmill to determine the maximal isometric torque, maximal oxygen uptake VO(2max), speed at VO(2max) (vVO(2)max), speed at ventilatory thresholds (VT1 and VT2) and submaximal running economy. Prior to the event VO(2max), vVO(2)max, speed at ventilatory thresholds and running economy were significantly lower in master athletes, but maximal voluntary torque was similar between the groups. 24 h following the race, a similar significant decrease in VO(2max) (-3.1% in masters, and -6.2% in young, p < 0.05), and vVO(2)max (-9.5% in masters, and -5.6% in young, p < 0.05) was observed in both the groups. The speed at VT2 significantly decreased only in master athletes (-8.3%, p < 0.05), while no change was recorded in maximal voluntary torque or submaximal running economy following the event. The results indicate that for well-trained subjects, the overall relative exercise intensity during an Olympic distance triathlon and the fatigue 24 h following the event seem to be independent of age.

This study describes the decline in performance with age during Olympic triathlon Age Groups World Championships among the different locomotion modes. Mean performance of top 10 performers were analyzed for each group of age using the exponential model proposed by Baker, Tang, and Turner (2003, Experimental Aging Research, 29, 47-65). Comparison in performance decline was done between locomotion modes. Decline in performance in triathlon as a function of age follows an exponential model. A significant interaction effect between age and locomotion mode was observed on performance values. In swimming, a significant decrease was observed close to 5% per year after 45 years. Decline in performance was less pronounced in cycling until 60 years. Analysis of the effect of age in the different locomotion modes of a triathlon could provide information for maintaining quality of life with aging.

BERNARD, T., C. HAUSSWIRTH, Y. LE MEUR, F. BIGNET. S. DOREL and J. BRISSWALTER. Distribution of Power Output during the Cycling Stage of a Triathlon World Cup. Med. Sci. Sports Exerc., Vol. 41, No. 6, pp. 1296‐1302, 2009. Purpose: The aim of this study was to evaluate the power output (PO) during the cycle phase of the Beijing World Cup test event of the Olympic triathlon in China 2008. Methods: Ten elite triathletes (5 females, 5 males) performed two laboratory tests: an incremental cycling test during which PO, HR at ventilatory thresholds (VT1 and VT2), and maximal aerobic power (MAP) were assessed, and a brief all-out test to determine maximal anaerobic power output (MAnP). During the cycle part of competition, PO and HR were measured directly with portable device. The amount of time spent below PO at VT1 (zone 1), between PO at VT1 and VT2 (zone 2), between PO at VT2 and MAP (zone 3) and above MAP (zone 4) was analyzed. Results: A significant decrease in PO, speed, and HR values was observed during the race. The distribution of time was 51 T 9% for zone 1, 17 T 6% for zone 2, 15 T 3% for zone 3, and 17 T 6% was performed at workloads higher than MAP (zone 4). From HR values, the triathletes spent 27 T 12% in zone 1, 26 T 8% in zone 2, and 48 T 14% above VT2. Conclusions: This study indicates a progressive reduction in speed, PO, and HR, coupled with an increase in variability during the event. The Olympic distance triathlon requires a higher aerobic and anaerobic involvement than constant-workload cycling exercises classically analyzed in laboratory settings (i.e., time trial) or Ironman triathlons. Furthermore, monitoring direct PO could be

International audience; The purpose of this study was to evaluate the accuracy and the reliability a new running computer system (RS800sd, Polar®, Kempele, Finland) which includes the measurement of running speed (RS) and stride rate (SR). Eight well-trained triathletes participated in this study. First, they completed an incremental continuous maximum test on a treadmill (from 12 km.h-1 9 to 18 km.h-1) at 0% grade. Secondly, the subjects took part in a second test to determine RS800sd intra-reproductibility to evaluate running speed. They ran twice during 5 minutes at a pace corresponding to their maximal lactate steady-state. During these two tests, RS and SR were recorded by the RS800sd system, by an optical sensor system (for RS) and a force-sensitive device (for SR). No difference was found between the RS800sd system and the reference systems both for RS (ICC=0.95) and SR (ICC=0.69). Moreover RS measures were statistically repeatable (r2=0.97, P

Locomotive efficiency is cited as an important component to endurance performance; however, inconsistent observations of age-related changes in efficiency question its influence in the performance of masters athletes.This study examined locomotive efficiency in young and masters triathletes during both a run and cycle test.Twenty young (28.5 ± 2.6 years) and 20 masters (59.8 ± 1.3 years) triathletes completed an incremental cycling and running test to determine maximal aerobic consumption (VO2max) and the first ventilatory threshold (VT1). Participants then completed 10-min submaximal running and cycling tests at VT1 during which locomotive efficiency was calculated from expired ventilation. Additionally, body fat percentage was determined using skin-fold assessment.During the cycle and run, VO2max was lower in the masters (48.3 ± 5.4 and 49.6 ± 4.8 ml kg(-1) min(-1), respectively) compared with young (61.6 ± 5.7 and 62.4 ± 5.2 ml kg(-1) min(-1), respectively) cohort. Maximal running speed and the cycling power output corresponding to VO2max were also lower in the masters (15.1 ± 0.8 km h(-1) and 318.6 ± 26.0 W) compared with the young (19.5 ± 1.3 km h(-1) and 383.6 ± 35.0 W) cohort. Cycling efficiency was lower (-11.2%) in the masters compared with young cohort. Similar results were observed for the energy cost of running (+10.8%); however, when scaled to lean body mass, changes were more pronounced during the run (+22.1%).Within trained triathletes, ageing can influence efficiency in both the run and cycle discipline. While disregarded in the past, efficiency should be considered in research examining performance in ageing athletes.

International audience; The aim of this study was to investigate the metabolic responses to variable versus constant-intensity (CI) during 20-km cycling on subsequent 5-km running performance. Ten triathletes, not only completed one incremental cycling test to determine maximal oxygen uptake and maximal aerobic power (MAP), but also three various cycle-run (C–R) combinations conducted in outdoor conditions. During the C–R sessions, subjects performed first a 20-km cycletime trial with a freely chosen intensity (FCI, ~80% MAP) followed by a 5-km run performance. Subsequently, triathletes were required to perform in a random order, two C–R sessions including either a CI, corresponding to the mean power of FCI ride, or a variable-intensity (VI) during cycling with power changes ranging from 68 to 92% MAP, followed immediately by a 5-km run. Metabolic responses and performances were measured during the C–R sessions. Running performance was significantly improved after CI ride (1118 ± 72 s) compared to those after FCI ride (1134 ± 64 s) or VI ride (1168 ± 73 s) despite similar metabolic responses and performances reported during the three cycling bouts. Moreover, metabolic variables were not significantly different between the run sessions in our triathletes. Given the lack of significant differences in metabolic responses between the C–R sessions, the improvement in running time after FCI and CI rides compared to VI ride suggests that other mechanisms, such as changes in neuromuscular activity of peripheral skeletal muscle or muscle fatigue, probably contribute to the influence of power output variation on subsequent running performance.

The aim of this study was to investigate the effects of drafting, i.e., swimming directly behind a competitor, on biomechanical adaptation during subsequent cycling. Eight well-trained male triathletes underwent three submaximal sessions in a counterbalanced order. These sessions comprised a 10-min ride on a bicycle ergometer at 75% of maximal aerobic power (MAP) at a freely chosen cadence. This exercise was preceded either by a 750-m swim performed alone at competition pace (SCA trial: swimming-cycling alone), a 750-m swim in a drafting position at the same pace as during SCA (SCD trial: swimming-cycling with drafting), or a cycling warm-up at 30% of MAP for the same duration as the SCA trial (CTRL trial). The results indicated that the decrease in metabolic load when swimming in a drafting position (SCD trial) was associated with a significantly lower pedal rate and significantly higher mean and peak resultant torques when compared to the SCA trial, p < 0.05. These results could be partly explained by the lower relative intensity during swimming in the SCD trial when compared with the SCA trial, involving a delayed manifestation of fatigue in the muscles of the lower limbs at the onset of cycling.

Heart rate (HR) was monitored in 66 French pubertal boys (B, na 28) and girls (G, na 38) aged 11- 16 years to evaluate habitual physical activity (HPA) over a 1-week period in the winter. The HR and the percentage of heart rate reserve (%HRR) were taken to be indexes of the metabolic activity for the whole day and for the diAerent parts of the day. The HPA was evaluated from the time spent each day below 50%HRR, between 50%-70%HRR and above 70%HRR, which related to the time spent in no or low physical activity (NLPA), moderate physical activity (MPA) and vigor- ous physical activity (VPA), respectively. No sex diAer- ences were observed in the average %HRR each day {%HRRmean, (B 30 (SD 4)%; G 32 (SD 4)%)} or in NLPA (B 715 (SD 61) min, G 711 (SD 81) min) and VPA (B 19 (SD 16) min, G 21 (SD 21) min) throughout the week. During school days, daily %HRRmean was 7% smaller in 14-16 year olds compared to 11-13 year olds. This was linked to a decrease in MPA and a concomitant increase in NLPA (P < 0:05). Daily %HRRmean varied significantly during the week (range: 28-34% HRR). There were significant diAerences among the periods of the day (P < 0:05). The HR was the greatest during physical education lessons (128 (SD 11) beats AE min )1 ), recreation (113 (SD 15) beats AE min )1 ) and lunch break (108 (SD 12) beats AE min )1 ) and the lowest during the evening (94 (SD 10) beats AE min )1 ). It was only during the lunch breaks that %HRRmean was greater (P < 0:05) on school days than on free days. Of all the teenagers studied 32% were considered active during the week.

Background:Compression garments are increasingly popular in long-distance running events where they are used to limit cumulative fatigue and symptoms associated with mild exercise-induced muscle damage (EIMD). However, the effective benefits remain unclear.Objective:This study examined the effect of wearing compression stockings (CS) on EIMD indicators. Compression was applied during or after simulated trail races performed at competition pace in experienced off-road runners.Methods:Eleven highly trained male runners participated in 3 simulated trail races (15.6 km: uphill section 6.6 km, average gradient 13%, and downhill section 9.0 km, average gradient –9%) in a randomized crossover trial. The effect of wearing CS while running or during recovery was tested and compared with a control condition (ie, run and recovery without CS; non- CS). Indicators of muscle function, muscle damage (creatine kinase; CK), inflammation (interleukin-6; IL-6), and perceived muscle soreness were recorded at baseline (1 h before warm-up) and 1, 24, and 48 h after the run.Results:Perceived muscle soreness was likely to be lower when participants wore CS during trail running compared with the control condition (1 h postrun, 82% chance; 24 h postrun, 80% chance). A likely or possibly beneficial effect of wearing CS during running was also found for isometric peak torque at 1 h postrun (70% chance) and 24 h postrun (60% chance) and throughout the recovery period on countermovement jump, compared with non-CS. Possible, trivial, or unclear differences were observed for CK and IL-6 between all conditions.Conclusion:Wearing CS during simulated trail races mainly affects perceived leg soreness and muscle function. These benefits are visible very shortly after the start of the recovery period.

International audience; PURPOSE: To evaluate spring-mass (SM) behavior and associated electromyographic (EMG) activity during a run to exhaustion following a cycle exercise in trained triathletes. METHODS: Ten triathletes completed four tests: a cycling test to determine V˙O(2max); a running test to determine the lactate threshold (LT); a 5 min control run at LT (C-Run) followed after a total recovery period by a cycle-to-run session to exhaustion [30 min of cycling at ∼80% V˙O(2max) followed by a run until exhaustion at LT (T-Run)]. SM behavior and EMG signals in nine lower limb muscles were recorded throughout the running sessions. RESULTS: Immediately after cycling, leg stiffness was 12.1% higher than its C-Run value and a concomitant increase of EMG activity of knee extensors was observed during pre-contact. Throughout T-Run, leg stiffness decreased by 7.3%, while knee extensors and ankle flexors activities decreased during pre-contact and braking phases. No significant variations in SM parameters and no significant increase of muscle activity were reported between C-Run and the end of T-Run. CONCLUSION: SM behavior during the cycle-run test was consistent with EMG activity changes. Cessation of exercise was not associated with significant alterations of stiffness values and EMG activity.

International audience; The objective of this study was to investigate the effects of wearing compression socks (CS) on performance indicators and physiological responses during prolonged trail running. Eleven trained runners completed a 15.6 km trail run at a competition intensity whilst wearing or not wearing CS. Counter movement jump, maximal voluntary contraction and the oxygenation profile of vastus lateralis muscle using near-infrared spectroscopy (NIRS) method were measured before and following exercise. Run time, heart rate (HR), blood lactate concentration and ratings of perceived exertion were evaluated during the CS and non-CS sessions. No significant difference in any dependent variables was observed during the run sessions. Run times were 5681.1±503.5 and 5696.7±530.7 s for the non-CS and CS conditions, respectively. The relative intensity during CS and non-CS runs corresponded to a range of 90.5–91.5% HRmax. Although NIRS measurements such as muscle oxygen uptake and muscle blood flow significantly increased following exercise (+57.7% and + 42.6%,+59.2% and + 32.4%, respectively for the CS and non-CS sessions, P

Purpose:The purpose of the present study was to examine relationships between athlete’s pacing strategies and running performance during an international triathlon competition.Methods:Running split times for each of the 107 finishers of the 2009 European Triathlon Championships (42 females and 65 males) were determined with the use of a digital synchronized video analysis system. Five cameras were placed at various positions of the running circuit (4 laps of 2.42 km). Running speed and an index of running speed variability (IRSVrace) were subsequently calculated over each section or running split.Results:Mean running speed over the frst 1272 m of lap 1 was 0.76 km-h–1 (+4.4%) and 1.00 km-h–1 (+5.6%) faster than the mean running speed over the same section during the three last laps, for females and males, respectively (P < .001). A significant inverse correlation was observed between RSrace and IRSVrace for all triathletes (females r = -0.41, P = .009; males r = -0.65, P = .002; and whole population -0.76, P = .001). Females demonstrated higher IRSVrace compared with men (6.1 ± 0.5 km-h–1 and 4.0 ± 1.4 km-h–1, for females and males, respectively, P = .001) due to greater decrease in running speed over uphill sections.Conclusions:Pacing during the run appears to play a key role in high-level triathlon performance. Elite triathletes should reduce their initial running speed during international competitions, even if high levels of motivation and direct opponents lead them to adopt an aggressive strategy.

International audience; The aim of the present study was to determine the best pacing strategy to adopt during the initial phase of a short distance triathlon run for highly trained triathletes. Ten highly trained male triathletes completed an incremental running test to determine maximal oxygen uptake, a 10-km control run at free pace and three individual time-trial triathlons (1.5-km swimming, 40-km cycling, 10-km running) in a randomised order. Swimming and cycling speeds were imposed as identical to the first triathlon performed and the first run kilometre was done alternatively 5% faster (Tri-Run+5%), 5% slower (Tri-Run−5%) and 10% slower (Tri-Run−10%) than the control run (C-Run). The subjects were instructed to finish the 9 remaining kilometres as quickly as possible at a free self-pace. Tri-Run−5% resulted in a significantly faster overall 10-km performance than Tri-Run+5% and Tri-Run−10% (p < 0.05) but no significant difference was observed with C-Run (p > 0.05) (2,028 ± 78 s vs. 2,000 ± 72 s, 2,178 ± 121 s and 2,087 ± 88 s, for Tri-Run−5%, C-Run, Tri-Run+5% and Tri-Run−10%, respectively). Tri-Run+5% strategy elicited higher values for oxygen uptake, ventilation, heart rate and blood lactate at the end of the first kilometre than the three other conditions. After 5 and 9.5 km, these values were higher for Tri-Run−5% (p < 0.05). The present results showed that the running speed achieved during the cycle-to-run transition is crucial for the improvement of the running phase as a whole. Triathletes would benefit to automate a pace 5% slower than their 10-km control running speed as both 5% faster and 10% slower running speeds over the first kilometre involved weaker overall performances.

International audience; The aim of this study was twofold: i) to analyze age-related declines in swimming, cycling, and running performances for Olympic and Ironman triathlons, and ii) to compare age-related changes in these three disciplines between the Olympic and Ironman triathlons. Swimming, cycling, running and total time performances of the top 10 males between 20 and 70 years of age (in 5 years intervals) were analyzed for two consecutive world championships (2006 and 2007) for Olympic and Ironman distances. There was a lesser age-related decline in cycling performance (P55 years) and running (>50 years), respectively. In contrast, an age-related decline in swimming performance seemed independent of triathlon distance. The age-related decline in triathlon performance is specific to the discipline, with cycling showing less declines in performance with age than swimming and running. The magnitude of the declines in cycling and running performance at Ironman distance is greater than at Olympic distance, suggesting that task duration exerts an important influence on the magnitude of the age-associated changes in triathlon performance.

International audience; Purpose: The aim of this study was to compare the pacing strategies adopted by women and men during a World Cup ITU triathlon.Methods: Twelve elite triathletes (6 females, 6 males) competed in a World Cup Olympic distance competition where speed and heart rate (HR) were measured in the three events. The power output (PO) was recorded in cycling to determine the time spent in 5 intensity zones ([0-10% VT1[ ; [10% VT1-VT1[ ; [VT1-VT2[ ; [VT2-MAP[ and ≥ MAP) (VT : ventilatory threshold; MAP : maximal aerobic power).Results: Swimming and running speeds decreased similarly for both genders (p < 0.05) and HR values were similar through the whole race (92±2% and 92±3% of maximal HR for women and men, respectively). The distribution of time spent in the 5 zones during the cycling leg was the same for both genders. The men's speed and PO decreased after the first bike lap (p < 0.05) and the women spent relatively more time above MAP in the hilly sections (45±4% vs. 32±4%). The men's running speed decreased significantly over the whole circuit, whereas the women slowed only over the uphill and downhill sections (p < 0.05).Conclusion: This study indicates that both female and male elite triathletes adopted similar positive pacing strategies during swimming and running legs. Men pushed the pace harder during the swim-to-cycle transition contrary to the women and female triathletes were more affected by changes in slope during the cycling and running phases.

International audience; The aim of this study was to determine whether variable power cycling produced greater neuromuscular fatigue of knee extensor muscles than constant power cycling at the same mean power output. Eight male triathletes (age : 33 ± 5 yr, mass : 74 ± 4 kg, OV&2max : 62 ± 5 ml.kg-1.min-1, maximal aerobic power : 392 ± 17 W) performed two 30 min trials on a cycle ergometer in a random order. Cycling exercise was performed either at a constant power output (CP) corresponding to 75% of the maximal aerobic power (MAP) or a variable power output (VP) with alternating ± 15%, ± 5%, and ± 10% of 75% MAP approximately every 5 min. Maximal voluntary contraction (MVC) torque, maximal voluntary activation level, and excitation-contraction coupling process of knee extensor muscles were evaluated before and immediately after the exercise using the technique of electrically evoked contractions (single and paired stimulations). Oxygen uptake, ventilation, and heart rate were also measured at regular intervals during the exercise. Averaged metabolic variables were not significantly different between the two conditions. Similarly, reductions in MVC torque (≈ -11%, P < 0.05) after cycling were not different (P > 0.05) between CP and VP trials. The magnitude of central and peripheral fatigue was also similar at the end of the two cycling exercises. It is concluded that following 30 min of endurance cycling, semi-elite triathletes experienced no additional neuromuscular fatigue by varying power (from ± 5 to 15%) compared with a protocol that involved a constant power.

The purpose of this study was to determine the effects of a 1,500-m swim on energy expenditure during a subsequent cycle task. Eight well-trained male triathletes (age 26.0 ± 5.0 yrs; height 179.6 ± 4.5 cm; mass 71.3 ± 5.8 kg; [Formula: see text] 71.9 ± 7.8 ml kg−1•min−1) underwent two testing sessions in counterbalanced order. The sessions consisted of a 30-min ride on the cycle ergometer at 75% of maximal aerobic power (MAP), and at a pedaling frequency of 95 rev•min−1, preceded either by a 1,500-m swim at 1.20 m•s−1 (SC trial) or by a cycling warm-up at 30% of MAP (C trial). Respiratory and metabolic data were collected between the 3rd and the 5th min, and between the 28th and 30th min of cycling. The main results indicated a significantly lower gross efficiency (13.0%) and significantly higher blood lactate concentration (56.4%), [Formula: see text] (5.0%), HR (9.3%), [Formula: see text] (15.7%), and RF (19.9%) in the SC compared to the C trial after 5 min, p

To investigate the effects of fluid ingestion on neuromuscular function during prolonged cycling exercise.Eight well trained subjects exercised for 180 minutes in a moderate environment at a workload requiring approximately 60% maximal oxygen uptake. Two conditions, fluid (F) and no fluid (NF) ingestion, were investigated.During maximal voluntary isometric contraction (MVC), prolonged cycling exercise reduced (p0.05) the maximal force generating capacity of quadriceps muscles (after three hours of cycling) and root mean square (RMS) values (after two hours of cycling) with no difference between the two conditions despite greater body weight loss (p0.05) in NF. The mean power frequency (MPF) for vastus lateralis muscle was reduced (p0.05) and the rate of force development (RFD) was increased (p0.05) only during NF. During cycling exercise, integrated electromyographic activity and perceived exertion were increased in both conditions (p0.05) with no significant effect of fluid ingestion.The results suggest that fluid ingestion did not prevent the previously reported decrease in maximal force with exercise duration, but seems to have a positive effect on some indicators of neuromuscular fatigue such as mean power frequency and rate of force development during maximal voluntary contraction. Further investigations are needed to assess the effect of change in hydration on neural mechanisms linked to the development of muscular fatigue during prolonged exercise.

The aim of the present study was to investigate the variability of the energy cost of running (Cr) during a simulated duathlon performed in outdoor conditions by elite duathletes. This duathlon consisted of 5 km of running, 30 km of cycling, and 5 km of running. The main result was the lack of significant difference in Cr between the two running bouts (210 +/- 10 mL d'O2.km-1.kg-1 vs. 217 +/- 10 mL d'O2.km-1.kg-1). This result is different from those observed during a triathlon, where an increase of energy cost of running bout has been reported. Furthermore, during a short-distance duathlon performed by well-trained subjects, none of the physiological (ventilation alteration, metabolic changes, or dehydration) or biomechanical factors that are classically evoked in triathlon research to explain Cr variability seem to be affected by the run-cycle-run transition. These results seem to minimize the negative effect of the cycle-to-run transition during a short-duration event in well-trained subjects.

International audience; Purpose: The aim of the present study was to investigate the effects of drafting (i.e., swimming directly behind a competitor) while swimming with a wet suit on physiological parameters and cadence during subsequent cycling.Methods: Eight well-trained male triathletes underwent two submaximal sessions conducted in a counterbalanced order. One of these sessions (SAC) consisted of a 750-m swim, performed at competition pace, followed by a 15-min ride on a bicycle ergometer at 75% of maximal aerobic power and at a freely chosen cadence. During the other session (SDC) the subjects swam 750 m in a drafting position at the same pace as during SAC and then performed the 15-min cycling test at the same intensity as during SAC.Results: The main result indicated that cycling efficiency was significantly improved when the cycling session was preceded by a swimming bout performed in drafting position compared with an isolated swimming bout (+4.8%, P < 0.05). Conclusion: These results could be partly explained by the lower relative intensity observed during swimming in the SDC trial when compared with the SAC trial. This study suggests the relative importance of swimming condition and highlights the advantage of drafting during the swimming portion of a sprint triathlon.

The aim of this study was to investigate the effects of swimming with a wetsuit on energy expenditure during subsequent cycling. Nine well-trained triathletes underwent three submaximal trials. The first trial (SC) consisted of a 750-m swim realised at a competition pace, followed by a 10-min cycling exercise at a power output corresponding to the ventilatory threshold . The two other trials were composed of the same cycling exercise, preceded either by a 750-m swim with a wetsuit (WSC) or by a cycling warm-up (Ctrl). The main results are that the WSC trial was characterised by significantly lower swimming cadence (-14%), heart rate (-11%), and lactate values (-47%) compared to the SC trial, p0.05. Moreover, cycling efficiency was significantly higher in the WSC trial compared to the SC trial (12.1% difference, p0.05). The lower relative intensity observed during swimming with a wetsuit suggest the relative importance of swimming condition on the total performance in a sprint triathlon.

International audience; After the swim to cycle transition of a triathlon, perceived exertion (RPE) during cycling was higher than during a single cycling bout for 8 well-trained triathletes, but swimming in a drafting position led to lower RPE responses and energy cost of cycling than swimming alone.

International audience; Purpose: The purpose of this study was to investigate the influence of different cycling cadences on metabolic and kinematic parameters during subsequent running.Methods: Eight triathletes performed two incremental tests (running and cycling) to determine maximal oxygen uptake (V̇O2max) and ventilatory threshold (VT) values, a cycling test to assess the energetically optimal cadence (EOC), three cycle-run succession sessions (C-R, 30-min cycle + 15-min run), and one 45-min isolated run (IR). EOC, C-R, and IR sessions were realized at an intensity corresponding to VT + 5%. During the cycling bouts of C-R sessions, subjects had to maintain one of the three pedaling cadences corresponding to the EOC (72.5 ± 4.6 rpm), the freely chosen cadence (FCC; 81.2 ± 7.2 rpm), and the theoretical mechanical optimal cadence (MOC, 90 rpm; Neptune and Hull, 1999).Results: Oxygen uptake (V̇O2) increased during the 30-min cycling only at MOC (+12.0%) and FCC (+10.4%). During the running periods of C-R sessions, V̇O2, minute ventilation, and stride-rate values were significantly higher than during the IR session (respectively, +11.7%, +15.7%, and +7.2%). Furthermore, a significant effect of cycling cadence was found on V̇O2 variability during the 15-min subsequent run only for MOC (+4.1%) and FCC (+3.6%).Conclusion; The highest cycling cadences (MOC, FCC) contribute to an increase in energy cost during cycling and the appearance of a V̇O2 slow component during subsequent running, whereas cycling at EOC leads to a stability in energy cost of locomotion with exercise duration. Several hypotheses are proposed to explain these results such as changes in fiber recruitment or hemodynamic modifications during prolonged exercise.

This study was designed to analyze the effect of the menstrual cycle phase on maximal anaerobic performance during short-term anaerobic tests.Seven eumenorrheic women (NOC) and 10 women using monophasic oral contraceptives (OC) performed three anaerobic tests (force-velocity, multi-jump, and squatting jump tests) during menstruation (M: between days 1 and 4), the midfollicular phase (F: between days 7 and 9), and the midluteal phase (L: between days 19 and 21) of the ovarian cycle. Follicular and luteal phases were confirmed by serum progesterone levels. The order of testing sessions was randomly assigned and a 15-min standardized warm-up preceded each testing session. Rectal temperatures were taken before (Trec(b)) and after (Trec(a)) warm-up.No significant differences were observed among M, F, and L in Trec(b), Trec(a) maximal cycling power (Pmax(c)), maximal jumping power (Pmax(j)), or maximal height of jump (h(j)) in either NOC or OC. Ten of the women suffered premenstrual or menstrual symptoms (MS); the other seven did not report any premenstrual or menstrual discomfort (NMS). Presence or absence of symptoms was not correlated with oral contraceptive use. No significant differences were observed among the three stages of the menstrual cycle in Pmax(c), Pmax(j), or h(j) in NMS. In MS, only Pmax(j) decreased by 8% in M compared with that in F (P0.05).Although there were no significant differences in maximal anaerobic performance during different menstrual cycle phases, results of this study suggest that the presence or absence of premenstrual or menstrual syndrome symptoms may have an effect, possibly through an action on the stretch-shortening cycle of tendons and ligaments.

Diurnal variations in ventilatory and cardiorespiratory responses to submaximal treadmill exercise were analysed in 11 eumenorrhoeic women and in 10 women using monophasic oral contraceptives. Subjects performed submaximal treadmill exercise at three intensities averaging 7, 8, and 9 km x h(-1), each for 4 min at 0800, 1300 and 1700 hours, assigned randomly on 3 separate days. Rectal temperature was measured before (T(rec(b))) and after (T(rec(a))) exercise. Cardiac frequency (f(c)), ventilation (V(E)), oxygen uptake (VO(2)), carbon dioxide output (VCO(2)), and respiratory exchange ratio (R) were assessed in the last minute of each stage of the exercise. Both T(rec(b)) and T(rec(a)) increased from 0800 to 1700 hours (P0.001). For a given submaximal work rate, VO(2) and VCO(2) were higher in the afternoon compared to the morning. Similarly, R was increased at 1700 hours compared to 0800 hours during the recovery period following exercise (P0.05). However, V(E) did not vary significantly during the day at any of the running intensities. No significant interactions (group x time of day) were observed in any of the studied parameters. In contrast to ventilation, the VO(2) and VCO(2) of the females during submaximal exercise were both affected by the time of day, without any differences between eumenorrhoeic women and users of oral contraceptives.

Time of day variations in maximal anaerobic leg exercise were studied in 23 men mean age 23 (SD 3) years. All the subjects performed two anaerobic tests (force-velocity and multi-jump tests) and those familiar with sprinting ran an additional 50-m dash (n = 16). The maximal anaerobic powers for cycling and jumping (Pcycling and Pjump) and maximal anaerobic velocity (vpeak) were performed consecutively in the same order for all tests. The force-velocity and force-power relationships were established to determine Pcycling. The flight time (tf) and the ground contact time (tc) were recorded from five consecutive jumps on a jump-ergometer to calculate Pjump. The vpeak was measured between the 35th and the 45th m during the dash-run. The test schedules were at 0900, 1400 and 1800 hours on separate days in random order. Rectal temperatures (Tre) and body mass (mb) were measured before each test. The Tre increased significantly from 0900 to 1800 hours (P0.001) but mb did not vary during the day (P0.05). The Pcycling and Pjump were higher at 1400 and 1800 hours than at 0900 hours. The differences between the morning and the afternoon reached 3% (P0.05) for Pcycling and 5%-7% for Pjump (P0.01). The time-of-day effect was significant for tf (P0.05) but not for tc. During the dash-run tests, the differences almost reached significance for vpeak between 0900 and 1800 hours (P = 0.0544). No significant variations were observed between 1400 and 1800 hours for cycling, jumping and running tests. A time-of-day effect in the maximal anaerobic power of cycle and multi-jump tests existed. Such variations would have pronounced effects when expressed in competitions.

Relationships between percentage of maximal oxygen consumption (%VO2max) and percentage of maximal heart rate reserve (%f(cr)) were compared during steady states of exercise (S), transitory states of exercise (T) and a 5-min recovery period (R). Male adults [mean age 27 (SD 10) years] were studied exercising on a treadmill (TR, n = 26), cycle ergometer (CE, n = 14) and arm traction bench (ATB, n = 14). The exercise intensity was adjusted according to the subjects in order to reach exhaustion in 4-5 steps of 2 min (ATB) or 3 min (TR, CE). The 1st min of each stage was considered as T and the last minute of each stage as S. The oxygen consumption (VO2) and heart rate (f(c)) were recorded simultaneously. Significant correlations were observed for each type of exercise and for each state between %f(cr) and %VO2max (r range 0.87-1.00). During T and R, the %VO2max versus %f(cr) relationships were laterally shifted, suggesting a resetting of f(c) control mechanisms. In S, the intercept was greater than in T and R; in T, the slope was greater than in S and R. The VO2 could be predicted from individual %VO2max versus %f(cr) relationships during T and R as is usually done in S using specific equations. Taking into consideration the average relationships established on the three ergometers, the standard error of the predicted VO2 during S and T reached 10%-20% and 22%-38% in R. During exercise, the higher the intensity the better was the prediction of VO2 from f(c) (r range 0.46-0.60, P0.001). Therefore except at high exercise intensities, it was found that individual relationships had to be used to obtain an accurate estimation of VO2.

Habitual physical activity (HPA) was studied in 30 boys and 34 girls aged 6-11 years. All the children performed a shuttle run test (SRT) to assess maximal heart frequency (fcmaxSRT) and to evaluate maximal oxygen uptake (VO2maxSRT). Heart rate (fc) was measured continuously from Monday to Sunday, using a heart rate counter. The time spent at fc greater than 140 beats. min-1 (tfc140) and at fc greater than 160 beats. min-1 (tfc160) permitted HPA to be evaluated. The daily heart rate (fcd) and the percentage of heart rate reserve (%fcrd) were calculated to evaluate the metabolic activity. In the boys and girls, fcd and % fcrd varied little with age. The metabolic activity varied in a rhythmical way during the week and was higher during school days than during free days (P0.001). The children were more active during school days (ds) than during the free days (df). This observation was particularly marked in the boys having tfc140 being twice as high during ds compared to df [tfc140, ds 85 (SD 25), df 40 (SD 26) min; tfc160, ds 36 (SD 19), df 16 (SD 13) min]. During ds tfc160 was greater in the boys than in the girls (P0.01). The same held for tfc140 and % fcrd from the age of 9 years (P0.001). It was during the recreation periods that the differences between the boys and the girls were observed (P0.01). There was no significant difference between the boys and the girls during lessons, in the evening and during df (% fcrd 26-28%, tfc140 35-45 min, tfc160 10-18 min). In contrast, the children who were physically active in a sports club, had less spontaneous physical activity and % fcrd, tfc140, tfc160 and VO2maxSRT were identical to those of the other children.

The study aimed to determine the effects of self-regulated and variable intensities sustained during short-term heat acclimation training on cycling performance. Seventeen competitive-level male athletes performed a twenty-kilometre cycling time trial before (TT-PRE), immediately after (TT-POST1) and one week after (TT-POST2) a 5-day acclimation training program, including either RPE-regulated intermittent (HA-HIT, N=9) or fixed and low-intensity (HA-LOW, N=8) training sessions in the heat (39 °C; 40 % relative humidity). Total training volume was 23 % lower in HA-HIT compared to HA-LOW. Physiological responses were evaluated during a forty-minute fixed-RPE cycling exercise performed before (HST-PRE) and immediately after (HST-POST) heat acclimation. All participants in HA-LOW group tended to improve mean power output from TT-PRE to TT-POST1 (+8.1 ± 5.2 %; ES = 0.55 ± 0.23), as well as eight of the nine athletes in HA-HIT group (+4.3 ± 2.0 %; ES = 0.29 ± 0.31) without difference between groups, but TT-POST2 results showed that improvements were dissipated one week after. Similar improvements in thermal sensation and lower elevations of core temperature in HST-POST following HA-LOW and HA-HIT training protocols suggest that high intensity and RPE regulated bouts could be an efficient strategy for short term heat acclimation protocols, for example prior to the competition. Furthermore, the modest impact of lowered thermal sensation on cycling performance confirms that perceptual responses of acclimated athletes are dissociated from physiological stress when exercising in the heat.