Applied Physiology

Regional differences in facial skin blood flow responses to thermal stimulation Abstract Purpose The facial skin blood flow (SkBF) shows regional differences in the responses to a given stimulation. The facial SkBFs, especially in the eyelid and nose exhibit unique response to physiological and psychological stimuli, but the mechanisms inducing those regional differences remain unclear. To investigate whether the regional differences in the local control of vasomotion in facial vessels correspond to the regional differences in facial SkBF response, we monitored the relative change of facial SkBF to regional thermal stimulation. We hypothesized that heat stimulation dilates the cutaneous vessels in the eyelid, while cold stimulation constricts those in the nose, which was based on previous findings Methods: A thermal stimulator was used to apply temperature increase (from 20 to 40 °C at 2 °C/min) and decrease (from 40 to 20 °C at 2°C/min) in a randomized order to the right eyelid, nose, right cheek, and forehead of 14 healthy young males. The facial SkBF was measured for 10 s using laser-speckle flowgraphy when temperatures of 20 °C, 30 °C, and 40 °C had been applied for 30 s in both trials. Results The SkBF in the eyelid did not change significantly during any thermal stimulation, and the nasal SkBF did not decrease significantly during cold stimulation. The SkBFs in the cheek and forehead increased significantly with the applied temperature. Conclusions These findings indicate that a large regional variation exists in facial skin blood flow response to local heating or cooling and that the regional variation did not correspond to the unique SkBF responses in the previous studies.

The effect of severe and moderate hypoxia on exercise at a fixed level of perceived exertion Abstract Purpose The purpose of this study was to determine the primary cues regulating perceived effort and exercise performance using a fixed-RPE protocol in severe and moderate hypoxia. Methods Eight male participants (26 ± 6 years, 76.3 ± 8.6 kg, 178.5 ± 3.6 cm, 51.4 ± 8.0 mL kg− 1 min− 1 \(\dot {V}\) O2max) completed three exercise trials in environmental conditions of severe hypoxia (FIO2 0.114), moderate hypoxia (FIO2 0.152), and normoxia (FIO2 0.202). They were instructed to continually adjust their power output to maintain a perceived effort (RPE) of 16, exercising until power output declined to 80% of the peak 30-s power output achieved. Results Exercise time was reduced (severe hypoxia 428 ± 210 s; moderate hypoxia 1044 ± 384 s; normoxia 1550 ± 590 s) according to a reduction in FIO2 (P < 0.05). The rate of oxygen desaturation during the first 3 min of exercise was accelerated in severe hypoxia (− 5.3 ± 2.8% min− 1) relative to moderate hypoxia (− 2.5 ± 1.0% min− 1) and normoxia (− 0.7 ± 0.3% min− 1). Muscle tissue oxygenation did not differ between conditions (P > 0.05). Minute ventilation increased at a faster rate according to a decrease in FIO2 (severe hypoxia 27.6 ± 6.6; moderate hypoxia 21.8 ± 3.9; normoxia 17.3 ± 3.9 L min− 1). Moderate-to-strong correlations were identified between breathing frequency (r = − 0.718, P < 0.001), blood oxygen saturation (r = 0.611, P = 0.002), and exercise performance. Conclusions The primary cues for determining perceived effort relate to progressive arterial hypoxemia and increases in ventilation.

A proof-of-concept trial of HELIOX with different fractions of helium in a human study modeling upper airway obstruction Abstract Background Helium in oxygen (HELIOX) can relieve airway obstruction and lower the work of breathing because it increases the threshold at which turbulent gas flow is induced. Less turbulent and more laminar flow lowers the work of breathing. According to guidelines, the fraction of Helium in HELIOX should be maximized (e.g. to 79%). Here, we investigate whether HELIOX with less than 60% of Helium is able to relieve the sensation of dyspnea in healthy volunteers. Methods 44 volunteers underwent resistive loading breathing different gases (medical air and HELIOX with a fraction of 25%, 50% or 75% helium in oxygen) in a double-blinded crossover design. Subjects rated their degree of dyspnea (primary outcome parameter) and the variability of noninvasively measured systolic blood pressure was assessed. Results Dyspnea was significantly reduced by HELIOX-containing mixtures with a fraction of helium of 25% or more. Similarly, blood pressure variability was reduced significantly even with helium 25% during respiratory loading with the higher load, whereas with the smaller load an effect could only be obtained with the highest helium fraction of 75%. Conclusion In this clinical trial, HELIOX with less than 60% of helium in oxygen decreased the sensation of dyspnea and blood pressure variability, a surrogate parameter for airway obstruction. Therefore, higher oxygen fractions might be applied without losing the helium-related benefits for the treatment of upper airway obstruction. Trial registration Registration with clinical trials (NCT00788788) and EMA (EudraCT number: 2006-005289-37).

Damage protective effects conferred by low-intensity eccentric contractions on arm, leg and trunk muscles Abstract Purpose Low-intensity eccentric contractions with a load corresponding to 10% of maximal voluntary isometric contraction strength (10% EC) attenuate muscle damage in a subsequent bout of higher-intensity eccentric contractions performed within 2 weeks for the elbow flexors, knee flexors and knee extensors. However, it is not known whether this strategy could be applied to other muscles. This study investigated whether 10% EC would confer damage protective effect on high-intensity eccentric contractions (80% EC) for nine different muscle groups. Methods Untrained young men were placed to an experimental or a control group (n = 12/group). Experimental group performed 50 eccentric contractions with a load corresponding to 10% EC at 2 days prior to 50 eccentric contractions with 80% EC for the elbow flexors and extensors, pectoralis, knee flexors and extensors, plantar flexors, latissimus, abdominis and erector spinae. Control group performed 80% EC without 10% EC. Changes in maximal voluntary isometric contraction strength (MVC) and muscle soreness, plasma creatine kinase (CK) activity and myoglobin concentration after 80% EC were compared between groups by a mixed-factor ANOVA. Results MVC recovered faster (e.g., 6–31% greater MVC at 5 days post-exercise), and peak muscle soreness was 36–54% lower for Experimental than Control group for the nine muscles (P < 0.05). Increases in plasma CK activity and myoglobin concentration were smaller for Experimental (e.g., peak CK: 2763 ± 3459 IU/L) than Control group (120,360 ± 50,158 IU/L). Conclusions These results showed that 10% EC was effective for attenuating the magnitude of muscle damage after 80% EC for all muscles, although the magnitude of the protective effect differed among the muscles.

Characterization of torque generating properties of ankle plantar flexor muscles in ambulant adults with cerebral palsy Abstract Purpose Weakness of plantar flexor muscles is related to reduced push-off and forward propulsion during gait in persons with cerebral palsy (CP). It has not been clarified to what an extent altered muscle contractile properties contribute to this muscle weakness. Here, we investigated the torque generating capacity and muscle fascicle length in the triceps surae muscle throughout ankle range of motion (ROM) in adults with CP using maximal single muscle twitches elicited by electrical nerve stimulation and ultrasonography. Methods Fourteen adults with CP (age 36, SD 10.6, GMFCS I–III) and 17 neurological intact (NI) adults (age 36, SD 4.5) participated. Plantar flexor torque during supramaximal stimulation of the tibial nerve was recorded in a dynamometer at 8 ankle angles throughout ROM. Medial gastrocnemius (MG) fascicle length was tracked using ultrasonography. Results Adults with CP showed reduced plantar flexor torque and fascicle shortening during supramaximal stimulation throughout ROM. The largest torque generation was observed at the ankle joint position where the largest shortening of MG fascicles was observed in both groups. This was at a more plantarflexed position in the CP group. Conclusion Reduced torque and fascicle shortening during supramaximal stimulation of the tibial nerve indicate impaired contractile properties of plantar flexor muscles in adults with CP. Maximal torque was observed at a more plantarflexed position in adults with CP indicating an altered torque-fascicle length/ankle angle relation. The findings suggest that gait rehabilitation in adults with CP may require special focus on improvement of muscle contractility.

Muscle quality as a complementary prognostic tool in conjunction with sarcopenia assessment in younger and older individuals Abstract Purpose This pilot study investigated differences in lean tissue mass, muscle strength, muscle quality (strength per unit of muscle mass; MQ), and functional performance in healthy younger and older individuals. The most robust predictors of appendicular lean mass (ALM) were then determined in each group. Methods Fifty younger (18–45 years) and 50 older (60–80 years) participants completed tests of upper and lower body strength alongside body composition by dual-energy X-ray absorptiometry from which upper- and lower-body MQ were estimated. Available cut-points for older people were used to determine low upper-body MQ in both groups. Low lower-body MQ was determined as at least two standard deviations below the mean of the younger group. Functional performance was assessed by gait speed. Sarcopenia was identified using two established definitions. Results Upper and lower body strength, ALM, lower-body MQ and gait speed were significantly higher in the younger group (all p < 0.002). Sarcopenia was identified in 2–4% of the older group. Low upper-body MQ was evident in 32% and 42% of the younger and older group, respectively. Low lower-body MQ was observed in 4% of younger participants, and 50% of older participants. In both groups, the most robust predictors of ALM were upper and lower body strength (young R2 = 0.74, 0.82; older R2 = 0.68, 0.72). Conclusions Low MQ despite low prevalence rates of sarcopenia in both groups suggests a need for age-specific MQ cut-points. Muscle quality assessments might be useful complementary prognostic tools alongside existing sarcopenia definitions.

Neuromuscular adaptations to wide-pulse high-frequency neuromuscular electrical stimulation training Abstract Purpose No studies have evaluated the potential benefits of wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) despite it being an interesting alternative to conventional NMES. Hence, this study evaluated neuromuscular adaptations induced by 3 weeks of WPHF NMES. Methods Ten young healthy individuals (training group) completed nine sessions of WPHF NMES training spread over 3 weeks, whereas seven individuals (control group) only performed the first and last sessions. Plantar flexor neuromuscular function (maximal voluntary contraction (MVC) force, voluntary activation level, H reflex, V wave, contractile properties) was evaluated before the first and last training sessions. Each training session consisted of ten 20-s WPHF NMES contractions (pulse duration: 1 ms, stimulation frequency: 100 Hz) interspaced by 40 s of recovery and delivered at an intensity set to initially evoke ~ 5% of MVC force. The averaged mean evoked forces produced during the ten WPHF NMES-evoked contractions of a given session as well as the sum of the ten contractions force time integral (total FTI) were computed. Results Total FTI (+ 118 ± 98%) and averaged mean evoked forces (+ 96 ± 91%) increased following the 3-week intervention (p < 0.05); no changes were observed in the control group. The intervention did not induce any change (p > 0.05) in parameters used to characterize plantar flexor neuromuscular function. Conclusion Three weeks of WPHF NMES increased electrically evoked forces but induced no other changes in plantar flexor neuromuscular properties. Before introducing WPHF NMES clinically, optimal training program characteristics (such as frequency, duration and intensity) remain to be identified.

High-intensity interval exercise promotes post-exercise hypotension of greater magnitude compared to moderate-intensity continuous exercise Abstract Purpose Physical exercise is associated with reduced blood pressure (BP). Moderate-intensity continuous exercise (MCE) promotes post-exercise hypotension (PEH), which is highly recommended to hypertensive patients. However, recent studies with high-intensity interval exercise (HIIE) have shown significant results in cardiovascular disease. Thus, this study aimed to analyze PEH in hypertensive subjects submitted to HIIE and compare it to post MCE hypotension. Methods 20 hypertensive adults (51 ± 8 years), treated with antihypertensive medications, were submitted to two different exercise protocols and a control session. The MCE was performed at 60–70% of VO2 reserve, while HIIE was composed of five bouts of 3 min at 85–95% VO2 reserve with 2 min at 50% of VO2 reserve. The following variables were evaluated during exercise, pre- and post-session: clinical BP, heart rate (HR), double product, perception of effort, body mass, height and body mass index. Results Systolic BP decreased after exercise in both sessions, showing greater decrease after HIIE (− 7 ± 10 and − 11 ± 12 mmHg, after MCE and HIIE, respectively, p ≤ 0.01). Diastolic BP also decreased after both sessions, but there were no significant differences between the two sessions (− 4 ± 8 and − 7 ± 8 mmHg, after MCE and HIIE, respectively). Conclusion Both exercise sessions produced PEH, but HIIE generated a greater magnitude of hypotension. The HIIE protocol performed in this study caused a greater cardiovascular stress during exercise; however, it was safe for the studied population and efficient for reducing BP after exercise.

Effects of the trunk position on muscle stiffness that reflects elongation of the lumbar erector spinae and multifidus muscles: an ultrasonic shear wave elastography study Abstract Purpose The present study aimed to clarify the effects of the trunk position on muscle stiffness that reflects elongation of the lumbar erector spinae and lumbar multifidus muscles using ultrasonic shear wave elastography (SWE). Methods The study included ten healthy men. The shear elastic modulus of the left lumbar erector spinae and lumbar multifidus muscles were evaluated using ultrasonic SWE. Measurement postures for the left lumbar erector spinae muscle were (1) prone position (Rest), (2) sitting position with the trunk flexed (Flexion), (3) the Flexion position adding right trunk lateral flexion (Flexion-Lateral Flexion), and (4) the Flexion position adding right trunk rotation (Flexion-Rotation 1). The left lumbar multifidus muscle were measured in positions (1)–(3), and (5) the Flexion position adding left trunk rotation (Flexion-Rotation 2). Results The shear elastic modulus of the lumbar erector spinae muscle in the Flexion-Lateral Flexion position was significantly higher than that in the Rest, Flexion, or Flexion-Rotation 1 positions. Shear elastic modulus of the lumbar multifidus muscle was similar in the Flexion, Flexion-Lateral Flexion, and Flexion-Rotation 2 positions, but significantly lower in the Rest position. Conclusions The results of the present study suggest that the lumbar erector spinae muscle is stretched effectively in the position adding trunk contralateral lateral flexion to flexion. The results also indicate that the lumbar multifidus muscle, which does not appear to be affected by adding trunk contralateral lateral flexion or ipsilateral rotation to flexion, is stretched effectively in the trunk flexion position.

Suitability of jumps as a form of high-intensity interval training: effect of rest duration on oxygen uptake, heart rate and blood lactate Abstract Purpose High-intensity interval training (HIT) has been shown to be an effective endurance training method. However, most HIT research has been conducted on running and cycling. The aim of this study was to assess the suitability of intermittent exercises such as jumps as a type of HIT. Methods Respiratory gases, heart rate and ground reaction forces were recorded for 21 participants (age 25 ± 4 years, mass 73 ± 12 kg, 13 male) during 5 distinct jump sessions on different days that varied with respect to the rest durations in between series (0, 15 or 30 s) and in between jumps (0, 1 or 2 s). Blood lactate was determined 3 min after the last series. Prior to the first session, maximal jump height as well as V′O2max during cycling was recorded. Results Peak oxygen uptake and heart rate were nearly maximal during all five jump sessions (87–99% of V′O2max, 96–98% of maximal heart rate). The time spent at more than 90% of V′O2max (1–43% of the total session duration), average jump height (34–82% of maximal jump height) and lactate accumulation (4–9 mmol/l) differed between jump sessions, mainly depending on the rest interval between jumps (p < 0.001, rmANOVA between sessions with different rest intervals between jumps). Conclusion With short rest intervals, jumping elicited comparable acute responses as reported for running or cycling HIT. Thus, training programs using intermittent exercises should elicit similar adaptations as other forms of HIT, provided the rest intervals are sufficiently short. Heart rate might be of limited value when comparing different types of HIT.