Search Results (146)

Military schools primarily aim to prepare young people for the admission procedures of military academies. In this specific environment, the high overall load can generate burnout in cadets and the consequent failure to achieve scholastic and military objectives. The present study investigated how a training protocol based entirely on internal load and a reflective approach in a military-type school context affects participants’ physical efficacy, efficiency, and psychological outcomes. For this study, 63 cadets who were 17 years old from an Italian military school were recruited. Twenty-two of them were allocated into a control group (CG), twenty-one were allocated into a group exercising based on external load (EG), and twenty we allocated into a group exercising based on internal load (IG). All groups performed tests of physical efficacy (maximal tests) and physical efficiency (self-perception-based submaximal test) and answered psychological questionnaires to assess motivation, self-efficacy, and enjoyment. Group participants attended eight weeks of interventions in which physical education lessons were led as follows: the EG performed a circuit training at 50% of maximal repetitions, the IG performed a circuit training at value six on Borg’s scale, and the CG attended curricular physical education lessons. Tests were then repeated. The IG increased physical efficacy more than the EG and CG, while only the IG increased physical efficiency. The IG and EG improved in psychological variables more than the CG. Education in self-perception and self-regulation could help cadets better manage their psychophysical status, allowing them to reach the physical demands for academic admission. Full article

Background/Objectives: The coronavirus disease (COVID-19) pandemic was associated with an intense impact on health worldwide. Among the sequelae, it became necessary to clarify respiratory impairment related to lung function and aerobic capacity, as well as the treatment of curative and preventive measures of pulmonary involvement. In this context, this study aimed to compare vital signs, the sensation of dyspnea (Borg scale), lung function, and exercise tolerance before and after the use of non-invasive mechanical ventilation (NIV) in adults of both sexes after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: A cross-sectional analytical clinical study was performed with the inclusion of individuals who had been diagnosed with COVID-19 at least three months before data collection. Individuals were evaluated for vital signs (heart rate and peripheral oxygen saturation), Borg scale, spirometry, and submaximal exercise protocol of two minutes of the step test before and after receiving NIV in ventilation mode by continuous positive airway pressure of 6 cm H₂O for 30 min. Results: A total of 50 participants were enrolled and grouped as a mild (N = 25) or severe (N = 25) clinical phenotype during SARS-CoV-2 infection according to the criteria of the World Health Organization. In our data, the forced vital capacity (p < 0.001), the ratio between the forced expiratory volume in the first one second to the forced vital capacity and the forced vital capacity (p = 0.020), and the two-minute submaximal step exercise protocol (number of steps—p = 0.001) showed a statistical improvement in the severe clinical phenotype group after NIV. In addition, forced expiratory volume in the first one second to the forced vital capacity (p = 0.032) and the two-minute submaximal step exercise protocol (number of steps—p < 0.001) showed a statistical improvement in the mild clinical phenotype group after NIV. No changes were described for vital signs and the Borg scale. Conclusions: This study allowed us to identify that NIV is a tool that promotes better exercise capacity by increasing the number of steps achieved in both clinical phenotype groups and improving lung function observed in the spirometry markers. Full article

Background/Objectives: In cardiac rehabilitation, the 6-minute walk test (6-MWT) is a standard assessment of initial evaluation. It measures walking distance as a surrogate of submaximal physical performance. Thereby, a subjective rating of perceived exertion, assessed by the Borg Scale, plays an important role. It has been observed that patients with coronary heart disease often rate themselves lower than the person supervising the test. Since this discrepancy might lead to inadequate exercise prescription, this study aims to explore reasons for low self-rating. Methods: In a qualitative study, influencing factors for low self-rating were collected from patients using interviews and questionnaires and from a focus group of physiotherapists. The evaluation was based on the grounded theory. Results: Self-image after retirement emerged as the central factor, as it shaped patients’ behavior during the 6-MWT and their subsequent self-assessment. Additionally, five different categories of causal conditions were detected from ten patients and five therapists: fears, physical limitations, test instruction, testing conditions, and therapists’ expectations. Conclusions: Patients with coronary heart disease had poor self-perception of exercise intensity and limited understanding of the meaning of the Borg Scale and the 6-MWT. Physiotherapists should place greater emphasis on patients’ perceived exertion to be able to effectively tailor exercise prescription and, therefore, improve attainment of cardiac rehabilitation goals and long-term adherence. Full article

The cardiorespiratory optimal point (COP) is an emerging submaximal parameter from cardiopulmonary exercise testing (CPET) that reflects the optimal balance between cardiac workload and pulmonary ventilation. Recent studies have explored the clinical utility and prognostic value of the COP in various populations, particularly in patients with heart failure (HF). This comprehensive literature review evaluated the current evidence on the COP and its potential as an independent risk factor for cardiovascular disease and mortality. The COP has been identified as a predictor of all-cause and cardiovascular mortality, with elevated values being significantly associated with an increased risk. Studies have demonstrated that higher COP values correlate with greater mortality risk independent of traditional risk factors, with significant sex-based differences. Evidence suggests that COP values greater than 26 significantly influence mortality rates and lead to a worse prognosis in patients with HF. For example, individuals with a COP > 30 had an approximately six-fold higher mortality risk (17.1%) than those with a COP < 22, and the combination of a high COP (>30) + low VO₂max leads to a significant increase in the risks of adverse effects (30.9%). This underscores the importance of the COP in the clinical management and risk stratification of HF patients. While the COP shows promise as a valuable submaximal marker with significant prognostic implications, further research is needed to establish its superiority over other established prognostic markers and elucidate the underlying mechanisms linking the COP to health outcomes. Nonetheless, the ability of the COP to predict mortality and enhance risk stratification in diverse populations makes it a promising tool in clinical practice. Full article

Equine asthma is a common cause of poor performance, but little is known about its impact on submaximal exercise. The aim of the present study was to evaluate the effects of equine asthma and potential confounding factors on recovery of respiratory rate (RR) and heart rate (HR) after a lunging exercise test. Thirty-seven horses completed a standardized 15 min lunging exercise including HR and RR recording pre- and up to 30 min post-exercise and venous blood lactate measurement. Endoscopy was performed and bronchoalveolar lavage fluid cytology was used to categorize horses as controls or asthmatics. In the univariate analyses, asthmatic horses (n = 21) showed prolonged RR recovery (OR 52.25, 95% CI 5.17–528.28, p = 0.001) and took more than 15 min to return to pre-exercise levels. Prolonged recovery was associated with bronchoalveolar lavage fluid neutrophilia (OR 1.14, 95% CI 1.01–1.29, p = 0.04) and also with trot velocity (OR 17.32, 95% CI 1.23–244.15, p = 0.03). HR recovery increased with higher training level (OR 0.14, 95% CI 0.02–0.83, p = 0.03) and decreased with age (OR 1.20, 95% CI 1.03–1.40, p = 0.02). RR recovery after the submaximal lunging exercise could offer a practical test for functional deficits associated with equine asthma. Full article

This study aimed to investigate the effects of 6-week inspiratory muscle training (IMT) on pain, pulmonary functions, respiratory muscle strength, lower extremity functionality, exercise capacity and quality of life (QoL) in individuals with chronic venous disease (CVD). Individuals were randomly assigned to training (TG) (n = 15, 45.53 ± 8.64 years) and control (CG) (n = 15, 47 ± 9.30 years) groups. While individuals in the TG performed IMT (30 min/everyday), individuals in the CG performed thoracic expansion exercises (TEEs) (10 respiratory cycles/set, four sets/day). Pain, pulmonary function and respiratory muscle strength tests, lower body strength and functional mobility, submaximal exercise capacity and QoL were assessed in all individuals. After 6 weeks, FEV₁/FVC, PEF, FEF_25–75% and MIP significantly increased in the TG compared to the CG (p < 0.05). Within the TG, FEV₁, PEF, FEF_25–75%, MIP, sit-to-stand number and 6-MWT distance significantly increased while resting pain, activity pain and QoL scores significantly decreased after 6 weeks (p < 0.05). Within the CG, FVC and sit-to-stand number significantly increased while activity pain and QoL scores decreased after 6 weeks (p < 0.05). Inspiratory muscle strength and pulmonary functions improved following IMT compared to TEE in individuals with CVD. As pulmonary functions, pain, lower extremity functionality and QoL may improve via IMT or TEE in individuals with CVD, submaximal capacity may improve following IMT. Full article

Whether impairments in submaximal and maximal effort capacities in individuals following acute COVID-19 infection resemble those found in patients with chronic pulmonary disease remains unclear. We aimed to analyze the submaximal and maximal effort capacities of patients after COVID-19 infection and those with alterations in lung mechanics similar to those observed in patients with chronic respiratory diseases. This retrospective cross-sectional observational study paired a group of post-COVID-19 individuals with another group of patients with chronic respiratory disease, using spirometric patterns similar to those observed post-COVID-19. Data from Spirometry, 6 min walk test (6-MWT), and cardiopulmonary exercise test (CPET) variables were compared, and correlations between spirometric variables and 6-WT/CPET were examined. The final sample comprised 20 patients, including 10 post-COVID-19 patients with a restrictive lung disease (RLD) pattern identified using spirometry and 10 patients with RLD. Both groups presented similar patterns of the analyzed variables, with significant correlations observed between forced vital capacity (FVC) the distance and speed achieved during the 6-MWT, and a negative correlation between FVC and V’ E max. The degree of restriction in the overall sample influenced the covered distance and speed during the 6-MWT as well as the maximum minute ventilation during maximal effort. Full article

Background/Objectives: Pulmonary rehabilitation clinics are traditionally located at higher altitudes (HAs), where lower PO₂ reduces exercise capacity and blood oxygenation. Eccentric cycling exercise (ECC), with its lower cardiorespiratory demand compared to concentric cycling (CON), might therefore be a potential advantageous training modality at HAs, particularly for individuals with reduced exercise capacity. This study aimed to compare the cardiorespiratory responses of ECC while breathing normoxic versus hypoxic gas in healthy participants. Methods: This randomized, controlled crossover trial involved healthy participants performing CON in normoxia (FiO₂ = 0.21), followed by two incremental ECC tests until 70–100% of peak exercise, one with normoxia and one with normobaric hypoxia (FiO₂ = 0.15), in a randomized order. Oxygen uptake (V’O2) and additional outcomes were measured breath-by-breath. Endpoints were defined at rest, 50%, 70%, peak exercise, and isotime. The trial is registered on clinicaltrails.gov (NCT05185895). Results: Twelve healthy participants (age: 30 ± 11 years, six females) completed the study. During both interventions, V’O₂ increased linearly with exercise intensity, with no significant differences between normoxic and hypoxic conditions. At peak exercise, SpO₂ and peak work rate were significantly lowered by 5% (95%CI: 3 to 8%, p < 0.001) and by 22 W (95%CI: 8 to 36 W, p = 0.009) in hypoxia compared to normoxia. Other outcomes were unchanged. When comparing CON to ECC in normoxia, the mean differences in V’O2 increased with higher loads. Conclusions: This study demonstrated that V’O₂ and other cardiopulmonary parameters remain unchanged when performing ECC in hypoxia compared to normoxia. Comparing CON to ECC in normoxia, participants achieved higher workloads and greater V’O₂ consumption during CON compared to ECC at comparable watts, confirming the higher metabolic cost associated with CON. We identified that the optimal submaximal ECC intensities, with the highest difference in V’O₂ between CON versus ECC, are around 40% of peak V’O₂. Full article

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21–37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9–12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults. Full article

In an era where childhood health is increasingly at risk, understanding the role of physical activity in promoting well-being is critical. The COR-School project investigates the impact of physical activity on cardiometabolic health in over 700 Spanish children and adolescents aged 8 to 16 years. Over three years, the study will conduct three assessments (baseline and two follow-ups) to evaluate peak post-exercise levels of high-sensitivity cardiac troponin T (hs-cTnT), a biomarker for cardiac stress, following a submaximal 20 m shuttle run test. Secondary objectives include examining the influence of maturational status, physical activity, and cardiorespiratory fitness on hs-cTnT. Participants will complete fitness tests, questionnaires on health habits, sleep, and diet, as well as anthropometric and body composition measurements. Blood samples collected at baseline and three hours post-exercise will measure cardiac biomarkers and lipid profiles. Cardiovascular responses will be tracked using heart rate monitors. Normal ranges of hs-cTnT will be determined using data distribution (percentiles or mean ± SD), stratified by age, sex, and maturational stage. Statistical analyses, including repeated measures ANOVA and Pearson correlation, will explore trends across time, sex, developmental stages, and other health-related outcomes. Beyond providing clinical insights by establishing reference values for hs-cTnT in healthy youth after exercise, findings will inform educational policies to promote physical activity in schools, emphasizing its role in improving fitness, health behaviors, and overall development. Full article

Frequent changes in altitude and oxygen levels limit the practical application of traditionally derived exercise thresholds or training zones based on heart rate (HR) or blood lactate concentration (bLa). We investigated the transferability of a muscle oxygenation (SmO₂)-based intensity prescription between different hypoxic conditions to assess the suitability of real-time SmO₂ measurements for ski-mountaineering (SKIMO) athletes during submaximal endurance exercise. A group of 15 well-trained male SKIMO athletes performed a graded-intensity run test in normoxia (87 m ASL, FiO₂ = 20.8%) to determine the anaerobic threshold (AnT) with the mod-Dmax method, and maximal lactate steady state (MLSS) assessments in acute normobaric hypoxia (3000 m ASL, FiO₂ = 14.4%) with the intensity aligned to 90–105% of SmO₂ at the normoxia-determined AnT. SmO₂, HR, and bLa were monitored during both tests. The number of MLSS assessments without a bLa increase over 1 mmol·L⁻¹ was reported. Paired t-tests with Cohen’s d effect sizes and intraclass correlation coefficient (ICC) were computed to compare the bLa and HR at the AnT in normoxia and MLSS averages in hypoxia, as both corresponded to equivalent SmO₂. Out of the 15 MLSS assessments, 11 (73.3%) were performed without a bLa increase over 1 mmol·L⁻¹. Significant differences at equivalent SmO₂ in normoxia and hypoxia were found for HR (175 ± 11.7 vs. 160 ± 14.2 bpm, p = 0.005, d = 1.02), but not for bLa (4.9 ± 1.2 vs. 5.1 ± 2.4 mmol·L⁻¹, p = 0.845, d = −0.05). ICC(2,k) for HR and bLa were 0.56 (95% CI: −0.24, 0.85) and 0.40 (95% CI: −0.75, 0.80), respectively. The results indicate a fair transferability of a SmO₂-based intensity prescription between different hypoxic conditions in well-trained SKIMO athletes during submaximal endurance exercise. The practical significance of the observations depends on the required accuracy of the exercise intensity determination. Full article

Background: Oestradiol has been implicated as a factor in substrate utilisation in male and mouse studies but the effect of acute changes during the menstrual cycle is yet to be fully understood. Objective: To determine the role of oestradiol in respiratory exchange ratio (RER) during exercise at various intensities. Methods: This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. From inception to November 2023, four online databases (Cochrane, SPORTDiscus, MEDline and Web of Science) were searched for relevant articles. Studies that reported a resting oestradiol measurement in naturally menstruating women with exercise at a percentage of maximal aerobic capacity (%V˙O_2max) were included. Mean and standard deviation for oestradiol, RER and exercise intensity were extracted and study quality assessed using a modified Downs and Black checklist. Risk of bias was assessed using I₂ measure of heterogeneity and Egger’s regression test, assessment of bias from methodological quality was identified by sensitivity analysis. Eligible datasets were extracted for pairwise comparisons within a meta-analysis and correlation between change in oestradiol and change in RER. Data were also pooled to produce a mean and standard deviation for RER for menstrual stage and for low and high oestradiol groups. Results: Twenty-four articles were identified, over 50% were identified as high quality. Sixteen articles included datasets eligible for meta-analysis. Eleven articles utilised a submaximal constant-load exercise intensity, finding a standardised mean difference of − 0.09 ([CI: −0.35–0.17], p = 0.5) suggesting no effect of menstrual phase on constant-load exercise RER. In six articles using incremental exercise tests to exhaustion, a standardised mean difference of 0.60 ([CI 0.00–1.19], p = 0.05) was identified towards a higher maximal RER attained in follicular compared to luteal phase. There was no correlation (R = −0.26, p = 0.2) between change in oestradiol and change in RER between phases. All 24 articles, totalling 650 participants, were included in pooled analysis. When grouped by menstrual cycle phase or when grouped by oestradiol levels, RER was higher in the follicular phase than the luteal phase at low and high constant load exercise intensities. Discussion: Findings from the pooled-analysis and meta-analysis suggest that there may be menstrual cycle phase differences in RER that are intensity dependent. These differences may be related to sex hormone levels, but this was not supported by evidence of correlation between differences in RER and differences in oestradiol. At present, it remains best practice to assess performance in the same menstrual cycle phase if seeking to assess change from baseline. Full article

(1) Background: Heart failure (HF) leads to functional disability and major cardiovascular events (MACEs). Cardiopulmonary exercise testing (CPET) is the gold standard for assessing aerobic capacity and prognostic stratification. This study aimed to evaluate the predischarge CPET variables in patients with acute decompensated HF and identify the submaximal CPET variables with prognostic value. (2) Methods: A retrospective cohort study was conducted at a tertiary center in Taiwan. Patients surviving their first episode of decompensated HF and undergoing predischarge CPET (February 2017 to January 2023) were analyzed. Follow-up was conducted until a MACE or administrative censoring (up to 5 years). Cox regression identified the significant predictors of MACE. (3) Results: The study included 553, 485, and 267 patients at the 3-month, 1-year, and 5-year follow-ups, respectively. MACE rates were 15.0%, 34.2%, and 50.9%. The VE/VCO2 slope was a significant predictor of MACE at all intervals. A VE/VCO2 slope >38.95 increased the risk of MACE by 2.49-fold at 3 months and 1.81-fold at 1 year (both p < 0.001). A slope > 37.35 increased the 5-year MACE risk by 1.75-fold (p = 0.002). (4) Conclusions: The VE/VCO2 slope is a significant submaximal CPET predictor of MACE in patients post-acute decompensated HF for both short- and long-term outcomes. Full article

Background/Objectives: The purpose of this study was to investigate the effect of a short-term passive post-exercise heat acclimation (HA) protocol on anaerobic performance in college students. Methods: In total, 28 participants (age 22.3 ± 2.1 years, height 168 ± 9.1 cm, mass 71.5 ± 16.6 kg) volunteered and were randomly divided into either an intervention (INT) or control (CON) group. Both groups followed a consecutive two-day protocol, consisting of a 25 min submaximal cycle @ 50–60% heart rate reserve (HRR), followed by a 25 min hot water immersion (INT) or nothing (CON). All participants performed a 30 s Wingate Anaerobic Test (WAnT) on four separate occasions—familiarization, pre-intervention, acutely post-intervention, and 24 h post intervention. The WAnT measured their peak power (W), relative peak power (W/kg), mean power (W), fatigue index (%), and total work (kJ). Results: From the results of the Factorial ANOVA, it was found that there were no significant differences, with no main effect for group (INT vs. CON) or time (Trials 1–4) and no significant interaction across all measured variables (p > 0.05). Conclusions: A two-day post-exercise passive HA protocol utilizing hot water immersion had no significant effect on the measurement of anaerobic performance in college students. Full article

Background: Preliminary research suggests that acupuncture can improve cardiovascular function. The purpose of our study was to determine if electroacupuncture can improve performance and post-exercise recovery. Methods: Thirty-two healthy people participated in this study (14 men and 18 women, aged 23.6 ± 3.5 years). The first visit included baseline measurements. Then, the participants received daily electroacupuncture at acupuncture point PC6 for a week, followed by a second visit. Heart rate, perceived exertion, and systolic and diastolic blood pressure were measured before, during, and after a YMCA submaximal bike test. Results: The heart rate was significantly reduced during the final stage of the YMCA test (151.3 ± 7.0 to 146.7 ± 11.8; p = 0.013) on the second visit. The rate of perceived exertion was significantly lower during all stages in Visit 2 (average RPE Visit 2 = 10.71 ± 2.02; average RPE Visit 1 = 11.45 ± 1.98; p = 0.004). Systolic blood pressure significantly decreased during the 5 min post-test recovery (SBP Visit 2 = 116.9 ± 12.0; SBP Visit 1 = 145.7 ± 14.6, p < 0.05). Conclusions: A week of electroacupuncture at PC6 led to reduced heart rate and perceived exertion during exercise, making the workload feel less strenuous. Electroacupuncture at PC6 shows potential for increasing participation in physical activities by making them feel easier to accomplish. Full article