Determination of second lactate threshold using near-infrared spectroscopy in elite cyclists

The use of near-infrared spectroscopy could be an interesting alternative to other invasive or expensive methods to estimate the second lactate threshold. Our objective was to compare the intensities of the muscle oxygen saturation breakpoint obtained with the Humon Hex and the second lactate threshold in elite cyclists. Ninety cyclists performed a maximal graded exercise test. Blood capillary lactate was obtained at the end of steps and muscle oxygenation was continuously monitored. There were no differences (p>0.05) between muscle oxygen oxygenation breakpoint and second lactate threshold neither in power nor in heart rate, nor when these values were relativized as a percentage of maximal aerobic power or maximum heart rate. There were also no differences when men and women were studied separately. Both methods showed a highly correlation in power (r=0.914), percentage of maximal aerobic power (r=0.752), heart rate (r=0.955), and percentage of maximum heart rate (r=0.903). Bland-Altman resulted in a mean difference of 0.05±0.27 W·kg–1, 0.91±4.93%, 0.63±3.25 bpm, and 0.32±1.69% for power, percentage of maximal aerobic power, heart rate and percentage of maximum heart rate respectively. These findings suggest that Humon may be a non-invasive and low-cost alternative to estimate the second lactate threshold intensity in elite cyclists.

Therapeutic Benefits of Short-Arm Human Centrifugation in Multiple Sclerosis–A New Approach

Short-arm human centrifugation (SAHC) is proposed as a robust countermeasure to treat deconditioning and prevent progressive disability in a case of secondary progressive multiple sclerosis. Based on long-term physiological knowledge derived from space medicine and missions, artificial gravity training seems to be a promising physical rehabilitation approach toward the prevention of musculoskeletal decrement due to confinement and inactivity. So, the present study proposes a novel infrastructure based on SAHC to investigate the hypothesis that artificial gravity ameliorates the degree of disability. The patient was submitted to a 4-week training programme including three weekly sessions of 30 min of intermittent centrifugation at 1.5–2 g. During sessions, cardiovascular, muscle oxygen saturation (SmO2) and electroencephalographic (EEG) responses were monitored, whereas neurological and physical performance tests were carried out before and after the intervention. Cardiovascular parameters improved in a way reminiscent of adaptations to aerobic exercise. SmO2 decreased during sessions concomitant with increased g load, and, as training progressed, SmO2 of the suffering limb dropped, both effects suggesting increased oxygen use, similar to that seen during hard exercise. EEG showed increased slow and decreased fast brain waves, with brain reorganization/plasticity evidenced through functional connectivity alterations. Multiple-sclerosis-related disability and balance capacity also improved. Overall, this study provides novel evidence supporting SAHC as a promising therapeutic strategy in multiple sclerosis, based on mechanical loading, thereby setting the basis for future randomized controlled trials.

Muscle Oxygenation, Heart Rate, and Blood Lactate Concentration During Submaximal and Maximal Interval Swimming

This study aimed to determine the relationship between three testing procedures during different intensity interval efforts in swimming. Twelve national-level swimmers of both genders executed, on different occasions and after a standardized warm-up, a swimming protocol consisting of either a submaximal (Submax: 8 efforts of 50 m) or a maximal interval (Max: 4 efforts of 15 m), followed by two series of four maximal 25 m efforts. Near-infrared spectroscopy in terms of muscle oxygen saturation (SmO2), heart rate (HR), and blood lactate concentration (BLa) were analyzed at three testing points: after the Submax or the Max protocol (TP1), after the 1st 4 × 25-m (TP2), and after the 2nd maximal 4 × 25-m set (TP3). BLa and HR showed significant changes during all testing points in both protocols (P ≤ 0.01; ES range: 0.45–1.40). SmO2 was different only between TP1 and TP3 in both protocols (P ≤ 0.05–0.01; ES range: 0.36–1.20). A large correlation during the Max protocol between SmO2 and HR (r: 0.931; P ≤ 0.01), and also between SmO2 and BLa was obtained at TP1 (r: 0.722; P ≤ 0.05). A range of moderate-to-large correlations was revealed for SmO2/HR, and BLa/HR for TP2 and TP3 after both protocols (r range: 0.595–0.728; P ≤ 0.05) were executed. SmO2 is a novel parameter that can be used when aiming for a comprehensive evaluation of competitive swimmers' acute responses to sprint interval swimming, in conjunction with HR and BLa.

Exercise Training Increases Resting Calf Muscle Oxygen Metabolism in Patients with Peripheral Artery Disease

Exercise training can mitigate symptoms of claudication (walking-induced muscle pain) in patients with peripheral artery disease (PAD). One adaptive response enabling this improvement is enhanced muscle oxygen metabolism. To explore this issue, we used arterial-occlusion diffuse optical spectroscopy (AO-DOS) to measure the effects of exercise training on the metabolic rate of oxygen (MRO2) in resting calf muscle. Additionally, venous-occlusion DOS (VO-DOS) and frequency-domain DOS (FD-DOS) were used to measure muscle blood flow (F) and tissue oxygen saturation (StO2), and resting calf muscle oxygen extraction fraction (OEF) was calculated from MRO2, F, and blood hemoglobin. Lastly, the venous/arterial ratio (γ) of blood monitored by FD-DOS was calculated from OEF and StO2. PAD patients who experience claudication (n = 28) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 months of supervised exercise training. Optical measurements were obtained at baseline and at 3 months in both groups. Resting MRO2, OEF, and F, respectively, increased by 30% (12%, 44%) (p < 0.001), 17% (6%, 45%) (p = 0.003), and 7% (0%, 16%) (p = 0.11), after exercise training (median (interquartile range)). The pre-exercise γ was 0.76 (0.61, 0.89); it decreased by 12% (35%, 6%) after exercise training (p = 0.011). Improvement in exercise performance was associated with a correlative increase in resting OEF (R = 0.45, p = 0.02).

The use of near-infrared spectroscopy for the evaluation of a 4-week rehabilitation program in patients with COPD

Background Near-infrared spectroscopy (NIRS) technology can evaluate muscle metabolism and oxygenation. NIRS-based oximeters can measure skeletal muscle oxygen delivery and utilization during static and dynamic work non-invasively. Our goal was to assess the value and usability of NIRS technology in chronic obstructive pulmonary disease (COPD) rehabilitation program. Methods Forty patients with COPD participated in a 4-week inpatient rehabilitation program that included breathing exercises and personalized cycle/treadmill training adjusted to the functional capacity, physical activity and comorbidities of the patients. A NIRS muscle oxygen monitor was used to measure tissue oxygenation and hemoglobin levels. Total hemoglobin index, average muscle oxygenation, minimal and maximal muscle oxygenation were recorded before and after the rehabilitation program. Results Rehabilitation resulted improvement in 6 min walking distance (6MWD:335.3 ± 110. vs. 398.3 ± 126.2 m; P < 0.01), maximal inspiratory pressure (MIP: 57.7 ± 22.7 vs. 63.6 ± 18.0 cmH2O; P < 0.01), chest wall expansion (CWE: 2.84 ± 1.26 vs, 4.00 ± 1.76 cm; P < 0.01), breath hold time (BHT: 25.8 ± 10.6 vs. 29.2 ± 11.6 s; P < 0.01) and grip strength (GS: 24.9 ± 11.9 vs. 27.0 ± 11.4 kg; P < 0.01). Quality of life improvement was monitored by COPD Assessment Test (CAT: 17.00 ± 8.49 vs. 11.89 ± 7.3, P < 0.05). Total hemoglobin index (tHb: 12.8 ± 1.3% vs. 12.8 ± 1.4), average muscle oxygenation (SmO2: 67.5 ± 14.4% vs. 65.2 ± 20.4%) showed a tendency for improvement. Maximal muscle oxygenation decreased (SmO2 max: 98.0 ± 20.5% vs. 90.1 ± 14.3%; P < 0.01). Minimal muscle oxygenation increased (SmO2 min: 42.6 ± 12.6% vs. 54.8 ± 14.3%; P < 0.01). Conclusions NIRS results showed that muscle oxygenation and microcirculation can be described as a high-risk factor in COPD patients. The 4-week rehabilitation improves functional parameters, quality of life and tissue oxygenation levels in COPD patients.

Physiological and Biomechanical Responses to Cross-Country Skiing in Varying Terrain: Low- vs. High-Intensity

The purposes of our study were to investigate the physiological and biomechanical responses to low-intensity (LI) and high-intensity (HI) roller ski skating on varying terrain and compare these responses between training intensities. Nine elite male skiers performed treadmill roller skiing consisting of two 21 min sessions (7 × 3 min laps) at LI and HI with the same set inclines and intensity-dependent speeds (LI/HI: distance: 5.8/7.5 km, average speed: 16.7/21.3 km/h). Physiological and biomechanical variables were measured continuously, and each movement cycle and sub-technique employed were detected and classified with a machine learning model. Both the LI and HI sessions induced large terrain-dependent fluctuations (relative to the maximal levels) in heart rate (HR, 17.7 vs. 12.2%-points), oxygen uptake (V.O2, 33.0 vs. 31.7%-points), and muscle oxygen saturation in the triceps brachii (23.9 vs. 33.4%-points) and vastus lateralis (12.6 vs. 24.3%-points). A sub-technique dependency in relative power contribution from poles and skis exhibited a time-dependent shift from Lap 1 to Lap 7 toward gradually more ski power (6.6 vs. 7.8%-points, both p &lt; 0.01). The terrain-dependent fluctuations did not differ between LI and HI for V.O2 (p = 0.50), whereas HR fluctuated less (p &lt; 0.01) and displayed a time-dependent increase from Lap 2 to Lap 7 (7.8%-points, p &gt; 0.01) during HI. Oxygen saturation shifted 2.4% points more for legs than arms from LI to HI (p &gt; 0.05) and regarding sub-technique, 14.7% points more G3 on behalf of G2 was employed on the steepest uphill during HI (p &lt; 0.05). Within all sub-techniques, cycle length increased two to three times more than cycle rate from LI to HI in the same terrains, while the corresponding poling time decreased more than ski contact time (all p &gt; 0.05). In sum, both LI and HI cross-country (XC) skiing on varying terrain induce large terrain-dependent physiological and biomechanical fluctuations, similar to the patterns found during XC skiing competitions. The primary differences between training intensities were the time-dependent increase in HR, reduced relative oxygen saturation in the legs compared to the arms, and greater use of G3 on steep uphill terrain during HI training, whereas sub-technique selection, cycle rate, and pole vs. ski power distribution were similar across intensities on flat and moderately uphill terrain.

Blood volume vs. deoxygenated NIRS signal: computational analysis of the effects muscle O2 delivery and blood volume on the NIRS signals

Near-infrared spectroscopy (NIRS) signals quantify the oxygenated (ΔHbMbO2) and deoxygenated (ΔHHbMb) heme group concentrations. ΔHHbMb has been preferred to ΔHbMbO2 in evaluating skeletal muscle oxygen extraction because it is assumed to be insensitive to blood volume (BV) changes, but uncertainties exist on this assumption. To analyze this assumption a computational model of oxygen transport and metabolism is used to quantify the effect of O2 delivery and BV changes on the NIRS signals from a canine model of muscle oxidative metabolism (Med.Sci.SportsExerc.,48(10)2013-2020,2016). The computational analysis accounts for microvascular (ΔHbO2, ΔHHb) and extravascular (ΔHMb, ΔHMb) oxygenated and deoxygenated forms. Simulations predicted muscle oxygen uptake and NIRS signal changes well for blood flows ranging from resting to contracting muscle. Additional NIRS signal simulations were obtained in the absence or presence of BV changes corresponding to a heme groups concentration changes (ΔHbMb=0-48μM). Under normal delivery (Q=1.0L kg-1min-1) of contracting muscle, capillary oxygen saturation (SO2) was 62% with capillary ΔHbO2 and ΔHHb of ±41μM for ΔHbMb=0. An increase of BV (ΔHbMb =24mM) caused a ΔHbO2 decrease (16mM) almost twice as much as the increase observed for ΔHHb (9μM). When SO2 increased to more than 80%, only ΔHbO2 was significantly affected by BV changes. The analysis indicates that microvascular SO2 is a key factor in determining the sensitivity of ΔHbMbO2 and ΔHHbMb to BV changes. Contrary to a common assumption, the ΔHHbMb is affected by BV changes in normal contracting muscle and even more in the presence of impaired O2 delivery.