Influence of intervals of radiant heat on performance and pacing dynamics during rowing exercise

Abstract: The purpose of this study was to investigate whether intervals of radiant heat during thermoneutral exercise altered either the performance outcome or the dynamics of pacing within the exercise bout. Eleven male participants ( ; 56 ± 12 ml∙kg-1∙min-1) performed three 5000m exercise trials on a rowing ergometer in three different conditions, in a random order. The participants were either: non-warmed (NW), warmed (W), or periodically warmed in intervals throughout each trial (IW). Warming was achieved using radiant heat lamps to raise the localised environmental temperature from 18 ˚C to 35 ˚C. Intervals of warming were applied over fixed periods of the 5000m bouts between 1000-2000m (W1) and 3000-4000m (W2). The results of the experiment demonstrated that performance time and average power output of the 5000m matched intensity trials were not significantly different between conditions (p=0.10 ; p=0.189). However, the application of warming significantly reduced intra-trial power output during the first (W1) interval in the IW condition (p=0.03) but not during the second (W2) warming interval (p=0.10). Tsk increased by 0.51˚C (p=0.05) in response to the application of warming during W1 in the IW condition and by 0.15 ˚C in W2 (p=0.28). No significant between-condition differences were observed in Tc throughout the trials. These findings suggest that an abrupt change to environmental conditions brought about through intervals of radiant warming can affect the transient pacing dynamics of an exercise bout, but not necessarily impact overall performance time. Performance time appears unaffected by intervals of radiant heat during an exercise bout, although further work is required in more challenging dynamic environmental conditions

Validity of telemetric-derived measures of heart rate variability: a systematic review

Heart rate variability (HRV) is a widely accepted indirect measure of autonomic function with widespread application across many settings. Although traditionally measured from the 'gold standard' criterion electrocardiography (ECG), the development of wireless telemetric heart rate monitors (HRMs) extends the scope of the HRV measurement. However, the validity of telemetric-derived data against the criterion ECG data is unclear. Thus, the purpose of this study was twofold: (a) to systematically review the validity of telemetric HRM devices to detect inter-beat intervals and aberrant beats; and (b) to determine the accuracy of HRV parameters computed from HRM-derived inter-beat interval time series data against criterion ECG-derived data in healthy adults aged 19 to 62 yrs. A systematic review of research evidence was conducted. Four electronic databases were accessed to obtain relevant articles (PubMed, EMBASE, MEDLINE and SPORTDiscus. Articles published in English between 1996 and 2016 were eligible for inclusion. Outcome measures included temporal and power spectral indices (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). The review confirmed that modern HRMs (Polar® V800™ and Polar® RS800CX™) accurately detected inter-beat interval time-series data. The HRV parameters computed from the HRM-derived time series data were interchangeable with the ECG-derived data. The accuracy of the automatic in-built manufacturer error detection and the HRV algorithms were not established. Notwithstanding acknowledged limitations (a single reviewer, language bias, and the restricted selection of HRV parameters), we conclude that the modern Polar® HRMs offer a valid useful alternative to the ECG for the acquisition of inter-beat interval time series data, and the HRV parameters computed from Polar® HRM-derived inter-beat interval time series data accurately reflect ECG-derived HRV metrics, when inter-beat interval data are processed and analyzed using identical protocols, validated algorithms and software, particularly under controlled and stable conditions

The long-term prognostic significance of 6-minute walk test distance in patients with chronic heart failure

Background. The 6-minute walk test (6-MWT) is used to assess patients with chronic heart failure (CHF). The prognostic significance of the 6-MWT distance during long-term followup ( > 5 years) is unclear. Methods. 1,667 patients (median [inter-quartile range, IQR]) (age 72 [65-77] ; 75% males) with heart failure due to left ventricular systolic impairment undertook a 6-MWT as part of their baseline assessment and were followed up for 5 years. Results. At 5 years' followup, those patients who died (n = 959) were older at baseline and had a higher log NT pro-BNP than those who survived to 5 years (n = 708). 6-MWT distance was lower in those who died [163 (153) m versus 269 (160) m; P 360 m. 6-MWT distance was a predictor of all-cause mortality (HR 0.97; 95% CI 0.96-0.97; Chi-square = 184.1; P < 0.0001). Independent predictors of all-cause mortality were decreasing 6-MWT distance, increasing age, increasing NYHA classification, increasing log NT pro-BNP, decreasing diastolic blood pressure, decreasing sodium, and increasing urea. Conclusion. The 6-MWT is an important independent predictor of all-cause mortality following long-term followup in patients with CHF. © 2014 Lee Ingle et al

Effectiveness of a six-week high-intensity interval training programme on cardiometabolic markers in sedentary males

High-intensity interval training (HIT) has been proposed as an effective, time efficient strategy to elicit similar cardiometabolic health benefits as traditional moderate-intensity endurance training. This is an important consideration as "lack of time" is a common cited barrier to regular physical activity

Pre-participation Cardiac Screening in Young Athletes: Models and Criteria

This is the second of two review articles focusing on the value of preparticipation cardiac screening in young athletes. The article focuses on the efficacy of the resting 12-lead electrocardiogram (ECG), physical examination, and medical history questionnaire, which commonly make up the first stage of a cardiac screening protocol. The review then focuses on specific structural and electrical abnormalities which are responsible for sudden cardiac death (SCD) in young athletes – the most common of which is hypertrophic cardiomyopathy. The identification of appropriate ‘red flag’ signs and symptoms is essential for teasing out potential pathological conditions and allowing differentiation from often benign physiological adaptations. The final section provides guidance on how the resting 12-lead ECG can be used to separate pathological from physiological adaptations in young athletes

Impact of exercise-induced bronchoconstriction on athletic performance and airway health in rugby union players

Background: There is emerging evidence that the prevalence of exercise-induced bronchospasm (EIB) is significantly under-reported in many sports. There is little known about the potential performance improvement that may exist when sports players are detected and treated for EIB. Methods: Professional rugby union players with no previous history of asthma volunteered to participate in the study. Each player performed the rugby football union (RFU) fitness test and completed a eucapnic voluntary hyperpnoea (EVH) challenge at baseline and 12 weeks later. A player with a positive EVH result was prescribed beclomethasone inhaler (200 µg; two puffs per day) for 12 weeks. Players with a negative EVH test were randomly allocated to either a placebo inhaler group or acted as controls. Results: Twenty-nine rugby union players (mean ± SD; age 22.1 ± 4.2 years; body mass 100.1 ± 6.9 kg; height 1.84 ± 0.07 m) were recruited. Seven players (24% of total) had a positive EVH challenge with a mean decrease in FEV1 of -13.6 ±3.5 % from baseline. There was no significant group difference (P=0.359)in performance improvement of the RFU fitness test between the EVH positive group (mean ?: -22.3 seconds; 8.0 ± 2.8% improvement), placebo group (mean ?: -16.5 seconds; 6.7 ± 1.6% improvement), and controls (mean ?: -12.2 seconds; 5.7 ± 3.5% improvement). Conclusion: Prevalence of EIB in professional rugby union players was 24%. A 12-week prescription of beclomethasone (200 µg) showed similar improvements in RFU fitness test performance in players diagnosed with EIB compared to players with healthy airway responsiveness

Associations between cardiorespiratory fitness and the metabolic syndrome in British men

Background Age and body mass index (BMI) are positively associated with the development of the metabolic syndrome (MetS). Cardiorespiratory fitness (CRF) can attenuate BMI-related increases in prevalence of MetS, but the nature of this association across different age strata has not been fully investigated. Aim To identify the association between CRF and MetS prevalence across age strata (20–69 years) and determine whether associations are independent of BMI. Methods CRF was estimated from incremental treadmill exercise in British men attending preventative health screening. Participants were placed in four age strata (20–39, 40–49, 50–59 and 60–69 years) and classified as fit or unfit using age-related cut-offs. The presence of MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Results 9666 asymptomatic men (48.7±8.4 years) were enrolled. The prevalence of MetS was 25.5% in all men and ranged from 17.1% in those aged 20–39 years to 30.6% in those aged 60–69 years. Fit men's likelihood of meeting the criteria for MetS was half (OR=0.51, 95% CI 0.46 to 0.57) that of unfit men. The likelihood of MetS was 32–53% lower across age strata in fit, compared with unfit men. Adjustment for BMI attenuated the association, though it remained significant in men aged 20–49 years. Conclusions The cardiometabolic benefits of CRF are independent of BMI particularly in men <50 years. Public health messages should emphasise the important role of CRF alongside weight management for enhancing cardiometabolic health

Insufficient exercise intensity for clinical benefit? Monitoring and quantification of a community-based Phase III cardiac rehabilitation programme: A United Kingdom perspective.

Background: In recent years, criticism of the percentage range approach for individualised exercise prescription has intensified and we were concerned that sub-optimal exercise dose (especially intensity) may be in part responsible for the variability in the effectiveness of cardiac rehabilitation (CR) programmes in the United Kingdom (UK). The aim was to investigate the fidelity of a structured Phase III CR programme, by monitoring and quantifying exercise training intensity. Design: Observational study. Methods: The programme comprised 16 sessions over 8 weeks, where patients undertook an interval, circuit training approach within national guidelines for exercise prescription (40-70% heart rate reserve [HRR]). All patients wore an Apple Watch (Series 0 or 2, Watch OS2.0.1, Apple Inc., California, USA). We compared the mean % heart rate reserve (%HRR) achieved during the cardiovascular training component (%HRR-CV) of a circuit-based programme, with the %HRR during the active recovery phases (%HRR-AR) in a randomly selected cohort of patients attending standard CR. We then compared the mean %HRR-CV achieved with the minimal exercise intensity threshold during supervised exercise (40% HRR) recommended by national governing bodies. Results: Thirty cardiac patients (83% male; mean age [SD] 67 [10] years; BMI 28.3 [4.6] kg∙m-2 ) were recruited. We captured 332 individual training sessions. The mean %HRR-CV and %HRR-AR were 37 (10) %, and 31 (13) %, respectively. There was weak evidence to support the alternative hypothesis of a difference between the %HRR-CV and 40% HRR. There was very strong evidence to accept the alternative hypothesis that the mean %HRR-AR was lower than the mean %HRR-CV (median standardised effect size 1.1 (95%CI: 0.563 to 1.669) with a moderate to large effect. Conclusion: Mean exercise training intensity was below the lower limit of the minimal training intensity guidelines for a Phase III CR programme. These findings may be in part responsible for previous reports highlighting the significant variability in effectiveness of UK CR services and poor CRF improvements observed from several prior investigations

Influence of appendicular skeletal muscle mass on resting metabolic equivalents in patients with cardiovascular disease: Implications for exercise training and prescription

The metabolic equivalent (MET) is a widely used physiological concept for quantifying levels of habitual physical activity and cardiorespiratory fitness (CRF). The MET conveys the oxygen consumption requirements of physical activities as multiples of the resting or basal metabolic rate (RMR). It may also be used to prescribe workloads for exercise training in patient groups, including those attending cardiac rehabilitation. One MET is considered to be equivalent to the oxygen consumed per kilogram of body mass at rest (while sitting) and, due to practical issues with direct metabolic cart measurements, it is conventionally approximated as 3.5 ml/kg–1/min–1. This expression of resting energy expenditure has been incorporated within physical activity position statements and guidelines. However, a number of factors – including age, sex, body mass (fat-free mass), cardiometabolic health and CRF – influence the RMR, which might limit the broad applicability of the conventional 1 MET at a population level. Widely prescribed cardiac drugs (i.e. beta blockers) have also been cited to influence the RMR, with some inconsistent findings in men. We aimed to evaluate the potential limitations of using the estimated MET in a cohort of patients with coronary heart disease (CHD), in whom we recently reported a positive association between skeletal muscle mass and peak oxygen uptake (O2peak). We hypothesized that patients with a lower skeletal muscle mass would also have a lower RMR, determined by resting respiratory gas analysis, and this would affect the accuracy of the aerobic exercise prescription based on METs

Development of a composite model derived from cardiopulmonary exercise tests to predict mortality risk in patients with mild-to-moderate heart failure

Objective: Cardiopulmonary exercise testing (CPET) is used to predict outcome in patients with mild-to-moderate heart failure (HF). Single CPET-derived variables are often used, but we wanted to see if a composite score achieved better predictive power. Methods: Retrospective analysis of patient records at the Department of Cardiology, Castle Hill Hospital, Kingston-upon-Hull. 387 patients [median (25th-75th percentile)] [age 65 (56-72) years; 79% males; LVEF 34 (31-37) %] were included. Patients underwent a symptomlimited, maximal CPET on a treadmill. During a median follow up of 8.6 ± 2.1 years in survivors, 107 patients died. Survival models were built and validated using a hybrid approach between the bootstrap and Cox regression. Nine CPET-derived variables were included. Z-score defined each variable's predictive strength. Model coefficients were converted to a risk score. Results: Four CPET-related variables were independent predictors of all-cause mortality in the survival model: the presence of exertional oscillatory ventilation (EOV), increasing slope of the relation between ventilation and carbon dioxide production (VE/VCO2 slope), decreasing oxygen uptake efficiency slope (OUES), and an increase in the lowest ventilatory equivalent for carbon dioxide (VEqCO2 nadir). Individual predictors of mortality ranged from 0.60 to 0.71 using Harrell’s C-statistic, but the optimal combination of EOV + VE/VCO2 slope + OUES + VEqCO2 nadir reached 0.75. The Hull CPET risk score had a significantly higher area under the curve (0.78) when compared to the Heart Failure Survival Score (AUC=0.70;