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Journal: Clinical physiology and functional imaging


Reference values for working capacity, blood pressure, heart rate, perceived exertion, etc. during bicycle exercise tests have been sought after for many years. This is because earlier commonly used reference values for physical work capacity have been either too low or too high when compared to the clinical experience of several Swedish departments of clinical physiology. The aim of the study was to compare two commonly used reference materials with normal outcomes from a clinical database.

Concepts: Comparison, Blood, Heart, Avicenna, Artery, Pulse, Vein, Outcome


Mouth rinsing with a CHO solution has been suggested to improve short (<1 h) endurance performance through central effect. We examined the effects of mouth rinsing with a CHO solution on running time to exhaustion on a treadmill. Six well-trained subjects ran to exhaustion at 85% VO2max , on three separate occasions. Subjects received either an 8% CHO solution or a placebo (PLA) every 15 min to mouth rinse (MR) or a 6% CHO solution to ingest (ING). Treatments were assigned in a randomized, counterbalanced fashion, with the mouth-rinsing treatments double-blinded. Blood samples were taken to assess glucose (Glu) and lactate (Lac), as well as the perceived exertion (RPE). Gas exchange and heart rate (HR) were collected during all trials. Subjects ran longer (P = 0·038) in both the MR (2583 ± 686 s) and ING (2625 ± 804 s) trials, compared to PLA (1935 ± 809 s), covering a greater distance (MR 9685 ± 3511·62 m; ING 9855 ± 4118·62; PLA 7295 ± 3727 m). RER was significantly higher in both ING and MR versus PLA. No difference among trials was observed for other metabolic or cardiovascular variables (VO2 , Lac, Glu, HR), nor for RPE. Endurance capacity, based on time to exhaustion on a treadmill, was improved when either mouth rinsing or ingesting a CHO solution, compared to PLA.

Concepts: Ingestion, Mouth, Exercise physiology, VO2 max, Physical fitness


This study is aimed at analysing the scientific literature related to physiological responses in synchronized swimmers, produced from 2006 to 2016. A systematic review was conducted using electronic databases (Google Scholar, PubMed, SportDiscus, Web Science, Scielo and Scopus) in national and international journals. The articles were selected using the following inclusion criteria: composed samples of synchronized swimmers of both sexes, articles in English, Spanish and Portuguese, published from 2006 to 2016. Ten studies were included. The concentration of the articles and their publication was as follows: Europe (77%) and North America (23%). The protocols used analyse physiological responses in synchronized swimmers athletes during competitions or laboratory tests, lactate measurements, heart rate, rates of perceived exertion, VO2 and lung volume. The subjects of 100% of the studies included in this review were athletes of junior and senior categories who volunteered. Only 03 of the 10 studies have compared the physiological responses in volunteers who were not synchronized swimmers to synchronized swimmer athletes. The studies were conducted using different methodologies, which makes it difficult to compare them, so the standardization of instruments and definitions is essential for the scientific advancement in this field. In addition, it would be interesting to expand the research of these physiological responses in synchronized swimmers using base level or beginners as sample.

Concepts: Lung, Science, Swimming, Open access, Citation index, Olympic sports, Synchronized swimming


Rate of force development (RFD) refers to the ability of the neuromuscular system to increase contractile force from a low or resting level when muscle activation is performed as quickly as possible, and it is considered an important muscle strength parameter, especially for athletes in sports requiring high-speed actions. The assessment of RFD has been used for strength diagnosis, to monitor the effects of training interventions in both healthy populations and patients, discriminate high-level athletes from those of lower levels, evaluate the impairment in mechanical muscle function after acute bouts of eccentric muscle actions and estimate the degree of fatigue and recovery after acute exhausting exercise. Notably, the evaluation of RFD in human skeletal muscle is a complex task as influenced by numerous distinct methodological factors including mode of contraction, type of instruction, method used to quantify RFD, devices used for force/torque recording and ambient temperature. Another important aspect is our limited understanding of the mechanisms underpinning rapid muscle force production. Therefore, this review is primarily focused on (i) describing the main mechanical characteristics of RFD; (ii) analysing various physiological factors that influence RFD; and (iii) presenting and discussing central biomechanical and methodological factors affecting the measurement of RFD. The intention of this review is to provide more methodological and analytical coherency on the RFD concept, which may aid to clarify the thinking of coaches and sports scientists in this area.

Concepts: Energy, Muscle, Skeletal muscle, Acetylcholine, Neuromuscular disease


To compare physiological responses of chronic fatigue syndrome (CFS/ME), multiple sclerosis (MS) and healthy controls (HC) following a 24-h repeated exercise test.

Concepts: Physiology, Avicenna, Multiple sclerosis, Fatigue, Chronic fatigue syndrome


Exercise enjoyment has been shown to be important for adherence. Minimal data exist on enjoyment of intense exercise, especially in clinical populations. The purpose of this study was to evaluate enjoyment levels of overweight and obese subjects undergoing 3 weeks of high-intensity interval training. Forty-two generally healthy overweight and obese men and women (body mass index = 30·8 ± 4·8 kg × m(-2) ) volunteered for this study. Exercise enjoyment was quantified using the Exercise Enjoyment Scale before and after each of nine total interval training sessions, over a three-week period. Heart rate and ratings of perceived exertion (RPE) were measured at the end of each interval and training session. There were no significant differences in enjoyment between training groups (P > 0·05). Exercise enjoyment improved significantly over the three-week training phase (P < 0·05). Enjoyment levels were relatively high to begin training: mean ± SD: 4·2 ± 1·0 out of a 7 point scale. Heart rate and RPE were significantly reduced (P < 0·05) from pre- (day 1) to post-training (day 9). High-intensity interval training may be an enjoyable form of exercise for overweight and obese men and women. Enjoyment levels may continue to increase following initial introduction to this type of training. Due to the small time demand and high enjoyment, interval training may be an effective exercise approach in a sedentary population.

Concepts: Obesity, Physical exercise, Exercise, Overweight, High-intensity interval training, Interval training, Sedentary lifestyle, Long slow distance


Biofeedback of heart rate variability (HRV) was applied to patients with diabetic polyneuropathy using a new mobile device allowing regularly scheduled self-measurements without the need of visits to a special autonomic laboratory. Prolonged generation of data over an eight-week period facilitated more precise investigation of cardiac autonomic function and assessment of positive and negative trends of HRV parameters over time. Statistical regression analyses revealed significant trends in 11 of 17 patients, while no significant differences were observed when comparing autonomic screening by short-term HRV and respiratory sinus arrhythmia at baseline and after the 8 weeks training period. Four patients showed positive trends of HRV parameters despite the expected progression of cardiac autonomic dysfunction over time. Patient compliance was above 50% in all but two patients. The results of this preliminary study indicate a good practicality of the handheld device and suggest a potential positive effect on cardiac autonomic neuropathy in patients with type 2 diabetes.

Concepts: Time, Regression analysis, Hypertension, Diabetes mellitus type 2, Diabetes mellitus, Cardiology, Mobile device, Electrical conduction system of the heart


Stretch training is widely used in a variety of fitness-related capacities such as increasing joint range of motion, preventing contractures, and alleviating injuries. Moreover, some researches indicate that stretch training may induce muscle hypertrophy; however, studies on the topic have been primarily relegated to animal and in vitro models. The purpose of this brief review was to evaluate whether stretch training is a viable strategy to induce muscle hypertrophy in humans. An extensive literature search was performed using PubMed/MEDLINE, SciELO, and Scopus databases, using terms related to stretching and muscle hypertrophy. Only human trials that evaluated changes in measures of muscle size or architecture following training protocols that it was performed stretching exercises were selected for inclusion. Of the 10 studies identified, 3 observed some significantly positive effects of stretch training on muscle structure. Intriguingly, in these studies, the stretching was carried out with an apparatus that aided in its performance, or with an external overload. In all studies the subjects performed stretching at their own self-determined range-of-motion, no effect was observed. Of the 5 available studies that integrated stretching into a resistance-training program, 2 applied the stretching in the interset-rest period and were the ones that showed enhanced muscle growth. In conclusion, passive, low-intensity stretch does not appear to confer beneficial changes in muscle size and architecture; alternatively, albeit limited evidence suggests that when stretching is done with a certain degree of tensile strain (particularly when loaded, or added between active muscle contractions) may elicit muscle hypertrophy.


We investigated the effects of volume-matched resistance training (RT) with different training loads and rest intervals on acute responses and long-term muscle and strength gains. Ten subjects trained with short rest (30 s) combined with low load (20 RM) (SL) and ten subjects performed the same protocol with long rest (3 min) and high load (8 RM) (LH). Cross-sectional area (CSA) of the upper arm was measured by magnetic resonance imaging before and after 8 weeks of training. Acute stress markers such as growth hormone (GH) and muscle thickness (MT) changes have been assessed pre and post a single RT session. Only the SL group demonstrated significant increases in GH (7704·20 ± 11833·49%, P<0·05) and MT (35·2 ± 16·9%, P<0·05) immediately after training. After 8 weeks, the arm CSA s in both groups significantly increased [SL: 9·93 ± 4·86% (P<0·001), LH: 4·73 ± 3·01% (P<0·05)]. No significant correlation between acute GH elevations and CSA increases could be observed. We conclude that short rest combined with low-load training might induce a high amount of metabolic stress ultimately leading to improved muscle hypertrophy while long rest with high-load training might lead to superior strength increases. Acute GH increases seem not to be directly correlated with muscle hypertrophy.

Concepts: Metabolism, Growth hormone, Magnetic resonance imaging, Strength training, Italian language, Trigraph, Anabolism, Russian language


In the exercise testing measures of cardiorespiratory fitness need to be scaled by body size or composition to enable comparison between individuals. Traditionally used weight-proportional measures are potentially confounded by body adiposity that hampers their interpretation and applicability in the clinical assessment of cardiorespiratory fitness.