The association of elevated blood pressure during ischaemic exercise with sport performance in Master athletes with and without morbidity

Background An exaggerated exercise blood pressure (BP) is associated with a reduced exercise capacity. However, its connection to physical performance during competition is unknown. Aim To examine BP responses to ischaemic handgrip exercise in Master athletes (MA) with and without underlying morbidities and to assess their association with athletic performance during the World Master Track Cycling Championships 2019. Methods Forty-eight Master cyclists [age 59±13yrs; weekly training volume 10.4±4.1 h/week; handgrip maximum voluntary contraction (MVC) 46.3±11.5 kg] divided into 2 matched groups (24 healthy MA and 24 MA with morbidity) and 10 healthy middle-aged non-athlete controls (age 48.3±8.3 years; MVC 40.4±14.8 kg) performed 5 min of forearm occlusion including 1 min handgrip isometric contraction (40%MVC) followed by 5 min recovery. Continuous beat-by-beat BP was recorded using fnger plethysmography. Age-graded performance (AGP) was calculated to compare race performances among MA. Healthy Master cyclists were further grouped into middle-age (age 46.2±6.4 years; N:12) and old-age (age 65.0±7.7 years; N:12) for comparison with middle-aged non-athlete controls. Results Healthy and morbidity MA groups showed similar BP responses during forearm occlusion and AGP (90.1±4.3% and 91.0±5.3%, p>0.05, respectively). Healthy and morbidity MA showed modest correlation between the BP rising slope for 40%MVC ischaemic exercise and AGP (r=0.5, p<0.05). MA showed accelerated SBP recovery after cessation of ischaemic handgrip exercise compared to healthy non-athlete controls. Conclusion Our fndings associate long-term athletic training with improved BP recovery following ischaemic exercise regardless of age or reported morbidity. Exaggerated BP in Master cyclists during ischaemic exercise was associated with lower AGP during the World Master Cycling Championships

Age-related declines in muscle and respiratory function are proportionate to declines in performance in Master Track Cyclists

Purpose Respiratory and musculoskeletal function decline with age, irrespective of physical activity levels. Previous work has suggested that the age-related rate of decline in function of these two systems might be similar, but it is not known to what extent each system contributes to decreasing performance in ageing master cyclists. Therefore, the purposes of this study are (1) whether the age-related rate of decline in respiratory function, respiratory muscle strength, muscle architecture, muscle function, haemoglobin concentration, haematocrit and performance in master cyclists is uniform and (2) which parameters contribute most to the reduction in performance with age. Methods Master cyclists were recruited during the Track Cycling Masters World Championship 2019 in Manchester. Respiratory function and respiratory muscle strength were determined using spirometry and a mouth pressure device, respectively. Muscle architecture was determined using ultrasonography, and muscle function by countermovement jump. Results Forced expiratory volume in the frst second, forced vital capacity, fascicle length, muscle thickness, take-of velocity, jump power, jump power per body mass, handgrip strength, haemoglobin concentration and performance correlated negatively with age (p≤0.043). The age-related rate of decline did not difer signifcantly between parameters (p=0.124), but it was slower for haemoglobin concentration (p=0.041). Take-of velocity was the major determinant of performance in 200, 500 and 2000 m track cycling disciplines (R2 adj=0.675, 0.786 and 0.769, respectively; p<0.001). Conclusion Age-related decline in respiratory and muscle system is accompanied by a similar rate of decline in performance. The major contribution to the age-related decline of performance is reduced muscle function, specifcally take-of velocity

High ventilatory inefficiency with low psoas muscle index is associated with an increase in the risk of 3-year mortality after liver resection and pancreaticoduodenectomy

Body composition assessed with computed tomography (CT)1 images and cardiopulmonary exercise fitness (CPET)2 of liver resection or pancreaticoduodenectomy patients show promising value to prognose surgical outcomes. The combination of CT and CPET may better predict patients’ survival rate after surgery than these techniques independently. This is a retrospective study that collected abdominal CT images and CPET measures of liver resection or pancreaticoduodenectomy patients from the CPET NHS Manchester Foundation Trust research databases. Abdominal CT images were segmented based on Hounsfield Units and CPET was performed until volitional exhaustion. Parameters derived from abdominal CT image analysis at L3 L4 were psoas muscle index (P index), calculated as psoas muscle cross-sectional area (tissue at 29 to 150 Hounsfield units [HU])/height2, and psoas intramuscular adipose tissue (tissue at 190 to -30 HU). CPET parameters were maximum volume of oxygen consumption, anaerobic threshold and ventilatory equivalents of CO2 (VE/VCO2 slope). Cox regression identified CT- and CPET derived parameters with a significant relationship with 1- and 3-year survival rate. After, Patients were classified into two groups based on the median value of the CT or CPET parameters related with 1- or 3-year survival rate. The 1- and 3-year mortality Hazard Ratios (HRs) of the two groups were calculated using Cox regression. Overall, 89 patients (57 men and 32 women, 70 [64-74] years old) were included. P index (HR [95%CI]: 0.830 [0.699-0.984], p=0.032) and VE/VCO2 slope (HR [95%CI]: 1.041 [1.012-1.070], p32.1) showed a higher risk of 3-year mortality (HR [95%CI]: 2.471 [1.292-4.723], p<0.01). The combined used of CT images and CPET analysis better prognosed the risk of 3 year mortality after pancreaticoduodenectomy and liver resection than the use of CT and CPET independently

The combined effects of age and athletic status on muscle function and structure in master track cyclists

Ageing is associated with a decline in physical capacity. The effects of an increasingly sedentary lifestyle on physical performance in later life are often overlooked. Masters athletes maintain high levels of physical activity into old age, mitigating the effects of sedentary lifestyles. The aim of this study was to determine the age-related changes in muscle structure and function in elite Master Cyclists and age-matched non-athletes. Male Masters Cycling athletes were tested at the 2019 UCI Track Cycling World Masters Championships and recreationally active controls were recruited from the general population. Groups were stratified by age and athlete status: 26 middle-age athletes (mean age:50.2±6.7years, body mass:85.5±11.7kg), 33 older athletes (mean age:69.8±5.7years, body mass:77.2±10.6kg), 11 middle-age controls (mean age:46.8±7.6years, body mass:83.1±17.9kg) and 23 older controls (mean age:69.7±6.8years, body mass:72.4± 12.6kg), (mean±s). Receiving ethical approved from the Institutional Ethics Committee at Manchester Metropolitan University vastus lateralis (VL) muscle thickness, pennation angle, and fascicle length were measured using real-time Bmode Ultrasonography. Maximum relative power (W·kg-1), maximum relative force (N·kg-1), take-off velocity (m·s-1), maximum velocity (m·s-1), force efficiency and maximum counter movement jump height (m), were measured using jump mechanography. The data from the ‘older’ groups (athletes and controls) were expressed as a percentage of their respective mean ‘middle-age’ group values. Comparisons using t-tests and Mann-Whitney U tests were made between the percentage difference between middle-age and older athletes, and the percentage difference between middle-age and older controls. Regression models assessed relationships between force and muscle measurements across age, and athletic status. Controls showed a greater percentage decline with age in maximum relative power (P < 0.001), maximum velocity (P < 0.001), force efficiency (P < 0.001) and jump height (P < 0.001) compared to athletes. However, athletes showed a significantly greater percentage decline with age in maximum relative force (P < 0.001) in comparison to controls. Maximum relative power and maximum take-off velocity correlated with VL muscle thickness in older athletes (R2 adj=0.13-0.33, P=0.001 - 0.031). Master cyclists maintained a greater percentage of power, velocity, force efficiency and jump height capabilities when compared to controls. As maximum relative force values showed a greater decline in athletes, the maintenance relative power was likely due to maintenance of muscle shortening velocity. This suggests chronic exercise training can prevent or attenuate the agerelated slowing of skeletal muscle and attenuate loss of power in old age. Muscle thickness was a key determinant of muscle function for older athletes

Differences in Vastus Lateralis muscle thickness and maximum knee extension force between Master athletes, non-athletes and patients undergoing major abdominal surgery

INTRODUCTION: An important cause of frailty in old age is sarcopenia, which is associated with poor prognosis in major abdominal surgery1. While muscle mass is important, there is increasing evidence that the force generating capacity is proportionally more reduced during ageing than muscle mass2. The aim of this study is to obtain a measure of muscle size (Vastus Lateralis (VL) thickness), muscle function (maximal voluntary force generating capacity (MVC)) and the ratio between MVC and VL thickness, providing a measure of ‘muscle quality’. As a substantial component of the development of frailty is likely to be attributable to low levels of physical activity, we hypothesise that 1) muscle mass and function are lower in patients undergoing a major abdominal surgery compared to age-matched Master athletes (MAs) and non-MAs and 2) poor muscle function is predictive of poor surgical outcomes in patients undergoing major abdominal surgery. METHODS: Major abdominal surgery patients (hepatobiliary, MASP) were recruited during a preoperative clinic at MFT (UK). Non-MAs were recruited from the general population of Manchester, presented without any co-morbidities, whilst sprint-trained MAs were recruited from members of Finnish Track and Field Organizations. Ultrasound images of the VL were processed (ImageJ v.1.80) to obtain VL thickness (in mm). A strap placed above the tibial malleolus and attached to a custom dynamometer recorded MVC (in N) during a maximal isometric knee extension while participants were sitting down on a chair with knee and hip at 90°. Surgical outcomes were length of stay in hospital (LOS) (in days) and readmission after surgery. Differences in VL thickness and MVC/VL thickness between groups was assessed with an ANCOVA with age as covariate to assess differences in the age-related decline. Bonferroni post-hoc test assessed differences between groups. RESULTS: A total of 98 male participants were included (MASP: N=31, 73±6 yrs, non-MAs: N=20, 73±5 yrs and MAs: N=47, 71±6 yrs). The mean LOS was 6 days (range: 2-12 days) No significant differences were found in VL thickness between groups (p=0.099), however MVC/VL thickness was lower in MASP compared with MAs and non-MAs (p0.05). In the patient group, no significant relationship was found between VL thickness or MVC/VL thickness with LOS, and no difference was found in VL thickness and MVC/VL thickness between readmitted and non-readmitted patients (p>0.05). CONCLUSION: Muscle quality, but not muscle thickness, appears to be negatively affected in MASP when compared to age matched controls. Future work should explore the impact of muscle quality on long-term surgical outcomes (1-year and 3-year survival rate) as similarly to our previous work, we found no relationship between any muscle parameter and short-term surgical outcomes3. A limitation of this study is that only male was included

Age-related declines in muscle and respiratory function are proportionate to declines in performance in Master Track Cyclists

Abstract Purpose Respiratory and musculoskeletal function decline with age, irrespective of physical activity levels. Previous work has suggested that the age-related rate of decline in function of these two systems might be similar, but it is not known to what extent each system contributes to decreasing performance in ageing master cyclists. Therefore, the purposes of this study are (1) whether the age-related rate of decline in respiratory function, respiratory muscle strength, muscle architecture, muscle function, haemoglobin concentration, haematocrit and performance in master cyclists is uniform and (2) which parameters Methods Master cyclists were recruited during the TrackCycling Masters World Championship 2019 in Manchester. Respg spirometry and a mouth pressure device, respectively. Muscle architecture was determined using ultrasonography, and muscle function by countermovement jump. Results Forced expiratory volume in the frst second, forced vital capacity, fascicle length, muscle thickness, take-of velocity, jump power, jump power per body mass, handgrip strength, haemoglobin concentration and performance correlated negatively with age (p≤0.043). The age-related rate of decline did not difer signifcantly between parameters (p=0.124), but it was slower for haemoglobin concentration (p=0.041). Take-of velocity was the major determinant of performance in 200, 500 and 2000 m track cycling disciplines (R2 adj=0.675, 0.786 and 0.769, respectively; p<0.001). Conclusion Age-related decline in respiratory and muscle system is accompanied by a similar rate of decline in performance. The major contribution to the age-related decline of performance is reduced muscle function, specifcally take-off velocity

Effects of nociceptive and mechanosensitive afferents sensitization on central and peripheral hemodynamics following exercise-induced muscle damage

This study aims to test the separated and combined effects of mechanoreflex activation and nociception through exercise-induced muscle damage (EIMD) on central and peripheral haemodynamics before and during single passive leg movement (sPLM). Eight healthy young males undertook four experimental sessions, in which a sPLM was performed on the dominant limb while in each specific session the contralateral was: a) in a resting condition (CTRL), b) stretched (ST), c) resting after EIMD called delayed-onset-muscle-soreness (DOMS) condition, or d) stretched after EIMD (DOMS+ST). EIMD was used to induce DOMS in the following 24-48h. Femoral blood flow (FBF) was assessed using doppler ultrasound while central haemodynamics were assessed via finger photoplethysmography. Leg vascular conductance (LVC) was calculated as FBF/MAP. RR-interval were analyzed in the time (RMSSD) and frequency domain (LF/HF). Blood samples were collected before each condition and gene expression analysis showed increased fold changes for P2X4 and IL1β in DOMS and DOMS+ST compared with baseline. Resting FBF and LVC were decreased only in the DOMS+ST condition (-26ml/min and -50ml/mmHg/min respectively) with decreased RMSSD and increased LF/HF ratio. MAP, HR, CO, and SV were increased in ST and DOMS+ST compared with CTRL. Marked decreases of delta peaks and AUC for FBF (∆: -146ml/min and -265ml respectively) and LVC (∆: -8.66ml/mmHg/min and ±1.7ml/mmHg/min respectively) all p<.05. These results suggest that combination of mechanoreflex and nociception resulted in decreased vagal tone and concomitant rise in sympathetic drive that led to increases in resting central hemodynamic with reduce limb blood flow before and during sPLM