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BACKGROUND AND AIM: A plateau in oxygen uptake ([Formula: see text]) during an incremental cardiopulmonary exercise test (CPET) to volitional exhaustion appears less likely to occur in special and clinical populations. Secondary maximal oxygen uptake ([Formula: see text]) criteria have been shown to commonly underestimate the actual [Formula: see text]. The verification phase protocol might determine the occurrence of 'true' [Formula: see text] in these populations. The primary aim of the current study was to systematically review and provide a meta-analysis on the suitability of the verification phase for confirming 'true' [Formula: see text] in special and clinical groups. Secondary aims were to explore the applicability of the verification phase according to specific participant characteristics and investigate which test protocols and procedures minimise the differences between the highest [Formula: see text] values attained in the CPET and verification phase. METHODS: Electronic databases (PubMed, Web of Science, SPORTDiscus, Scopus, and EMBASE) were searched using specific search strategies and relevant data were extracted from primary studies. Studies meeting inclusion criteria were systematically reviewed. Meta-analysis techniques were applied to quantify weighted mean differences (standard deviations) in peak [Formula: see text] from a CPET and a verification phase within study groups using random-effects models. Subgroup analyses investigated the differences in [Formula: see text] according to individual characteristics and test protocols. The methodological quality of the included primary studies was assessed using a modified Downs and Black checklist to obtain a level of evidence. Participant-level [Formula: see text] data were analysed according to the threshold criteria reported by the studies or the inherent measurement error of the metabolic analysers and displayed as Bland-Altman plots. RESULTS: Forty-three studies were included in the systematic review, whilst 30 presented quantitative information for meta-analysis. Within the 30 studies, the highest mean [Formula: see text] values attained in the CPET and verification phase protocols were similar (mean difference = -0.00 [95% confidence intervals, CI = -0.03 to 0.03] L·min-1, p = 0.87; level of evidence, LoE: strong). The specific clinical groups with sufficient primary studies to be meta-analysed showed a similar [Formula: see text] between the CPET and verification phase (p > 0.05, LoE: limited to strong). Across all 30 studies, [Formula: see text] was not affected by differences in test protocols (p > 0.05; LoE: moderate to strong). Only 23 (53.5%) of the 43 reviewed studies reported how many participants achieved a lower, equal, or higher [Formula: see text] value in the verification phase versus the CPET or reported or supplied participant-level [Formula: see text] data for this information to be obtained. The percentage of participants that achieved a lower, equal, or higher [Formula: see text] value in the verification phase was highly variable across studies (e.g. the percentage that achieved a higher [Formula: see text] in the verification phase ranged from 0% to 88.9%). CONCLUSION: Group-level verification phase data appear useful for confirming a specific CPET protocol likely elicited [Formula: see text], or a reproducible [Formula: see text], for a given special or clinical group. Participant-level data might be useful for confirming whether specific participants have likely elicited [Formula: see text], or a reproducible [Formula: see text], however, more research reporting participant-level data is required before evidence-based guidelines can be given. TRIAL REGISTRATION: PROSPERO (CRD42021247658) https://www.crd.york.ac.uk/prospero.

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ABSTRACT: Pérez-Ifrán, P, Magallanes, CA, de S. Castro, FA, Astorino, TA, and Benítez-Flores, S. Extremely low-volume burpee interval training equivalent to 8 minutes per session improves vertical jump compared with sprint interval training in real-world circumstances. J Strength Cond Res 38(1): 10-20, 2024-The aim of this study was to compare the cardiometabolic and physical effects of 2 time-matched high-intensity programs in a real-world environment. Forty-three active and healthy adults (sex = 31 men and 12 women; age = 27 ± 5 years; peak heart rate [HR peak ] = 190.7 ± 10.6 beat·min -1 ) were randomized to 2 very low-volume protocols (∼8 minutes): sprint interval training (SIT) ( n = 15), burpee interval training (BIT) ( n = 15), and control (CON) ( n = 13). Subjects in SIT and BIT performed 5 days of 10 × 4 second "all-out" efforts with 30 seconds of recovery. Body composition, blood pressure, countermovement jump (CMJ), 10-m sprint, shuttle run test (SRT), autonomic modulation , self-efficacy, and intention were evaluated before and after training. Sprint interval training elicited a higher %HR peak , energy expenditure, rating of perceived exertion category ratio 10 scale, and feeling scale than BIT ( p < 0.05). SRT distance was significantly improved in SIT ( p = 0.03, d = 0.62), whereas CMJ height was significantly enhanced in BIT ( p = 0.0014, d = 0.72). Self-efficacy progressively worsened for SIT than for BIT as sessions increased, and significant differences were found in 5× a week frequency between protocols ( p = 0.040, d = 0.79). No differences in intention to engage were detected between the regimens ( p > 0.05). No changes were observed in body composition, blood pressure, 10-m sprint, SRTV̇O 2max , or autonomic variables with training ( p > 0.05). Results exhibit that extremely low-volume SIT improved running performance, whereas BIT increased the vertical jump.

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PURPOSE: The postural transition from sitting to standing is a moment of dysautonomic occurrence in individuals with Spinal Cord Injury (SCI). Different tools can be used to minimize this event, such as virtual reality. Thus, we aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition from the sitting to orthostatism position using a cognitive virtual reality (VR) task. METHODS: Individuals with and without SCI were positioned on the Easy Stand® device, sitting at rest, at 0° considering the angle between the seat and the floor, elevation at 45°, and orthostatism at 90°, for 5 minutes in each position. Heart rate variability (HRV) measures of sympathovagal balance were collected (heart rate receiver: Polar V800). The groups were subdivided into two groups, one that performed VR as an intervention during the postural angle changes and another group that did not perform VR. RESULTS: We evaluated 76 individuals, 40 with a medical diagnosis of SCI and 36 who composed the able-bodied control group without SCI, matched by age and sex. The HRV results showed that the SCI group who performed the task in VR demonstrated no significant difference in parasympathetic activation and global variability between the sitting versus 90° positions. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90° positions. CONCLUSION: The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.

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ABSTRACT: Benítez-Flores, S, de S. Castro, FA, Lusa Cadore, E, and Astorino, TA. Sprint interval training attenuates neuromuscular function and vagal reactivity compared with high-intensity functional training in real-world circumstances. J Strength Cond Res 37(5): 1070-1078, 2023-The aim of this study was to compare the acute cardiovascular and neuromuscular effects of 3 time-matched sessions of high-intensity training. Eighteen moderately active adults (9 women and 9 men [age: 23 ± 2.9 years; maximum oxygen consumption (V̇ o2 max): 47.6 ± 4.1 ml·kg -1 ·min -1 ]) performed three low-volume (∼9 minutes) sessions in a randomized order: sprint interval training (SIT), burpee interval training (BIT) (10 × 5 seconds efforts × 35 seconds recovery), and vigorous intensity continuous training (VICT) (6 minutes 5 seconds of running at ∼85% of peak heart rate [HR peak ]). Indices related to heart rate (HR), neuromuscular performance (counter movement jump height [CMJ height ] and squat and bench press power), and autonomic balance (heart rate recovery and heart rate variability [HRR and HRV] )were monitored during exercise. Sprint interval training and VICT elicited a higher HR mean (171.3 ± 8.4 and 166.5 ± 7.5 vs. 150.5 ± 13.6 b·min -1 , p < 0.001) and time of ≥90%HR peak (133.3 ± 117.4 and 110 ± 128.9 vs. 10 ± 42.4 seconds, p < 0.01) than BIT. Sprint interval training exhibited a slower HRR and lower HRV than BIT and VICT ( p < 0.05) postsession. Moreover, only SIT resulted in a significant decline ( p < 0.01) in CMJ height (34.7 ± 7.2 to 33.5 ± 7.2 cm), relative squat mean power (25.5 ± 4.5 to 23.8 ± 4.9 W·kg -1 ), and relative bench press peak power (6.9 ± 2.4 to 6.2 ± 2.5 W·kg -1 ). Results revealed that SIT diminishes the sympathovagal reactivation and neuromuscular performance compared with work-matched BIT and VICT.

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Acute psychological responses to physical activity may help explain long-term adherence to it. Thus, we compared acute psychological responses to different exercise protocols with identical durations. Eighteen moderately active young adults [Mage = 23, SD = 3 years; MVO2max (maximum oxygen consumption) = 42.8, SD = 4.3 mL·kg-1·min-1; MBMI (body mass index) = 24, SD = 2 kg·m-2] completed three low-volume exercise sessions in a crossover research design: (a) sprint interval training (SIT), (b) burpee interval training (BIT) requiring 10 × 5 second efforts with 35 seconds of passive recovery, and (c) a single bout of vigorous intensity continuous training (VICT) requiring 6 minutes and 5 seconds of running at ∼85% of peak heart rate (HRpeak). We assessed participants' ratings of perceived exertion (RPE), affective valence, enjoyment, intention, preference, and self-reported recovery and wellness before, during, and after each session. BIT was associated with significantly greater enjoyment, preference, and exercise intention (at 5 × week) than VICT (p ≤ .05). SIT elicited greater RPE (M = 5.38, SD = 2.00) than both BIT (M = 2.88, SD = 1.23) and VICT (M = 3.55, SD = 1.38) (p ≤ .05), and we observed a higher increase in RPE over time with SIT versus BIT (p = .019). For affective valence, SIT (M = 0.55, SD = 2.12) elicited a more aversive response than both BIT (M = 2.55, SD = 1.09) and VICT (M = 1.94, SD = 1.51) (p ≤ .05), and there was a higher increase in this aversive response to SIT over time (p < .05). Forty-eight-hour postexercise session muscle soreness was significantly lower with VICT than with BIT (p = .03). Overall, BIT was associated with more positive psychological responses than SIT and VICT.

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The aim of this study was to compare the acute responses to three time-matched exercise regimens. Ten trained adults (age, maximum oxygen consumption (VO2max), and body mass index (BMI) = 25.9 ± 5.6 yr, 50.9 ± 5.4 mL·kg-1·min-1, and 22.1 ± 1.8 kg·m-2) completed sprint interval training (SIT) requiring 14 × 5 s efforts with 35 s of recovery, high-intensity interval training (HIIT) consisting of 18 × 15 s efforts at ~90% of peak heart rate (HRpeak) with 15 s of recovery, and vigorous continuous training (CT) consisting of 8.75 min at ~85 %HRpeak, in randomized order. Heart rate, blood lactate concentration, rating of perceived exertion, affective valence, and enjoyment were monitored. Moreover, indices of neuromuscular function, autonomic balance, diet, mental stress, incidental physical activity (PA), and sleep were measured 24 h after each session to analyze the magnitude of recovery. Both HIIT and CT exhibited a greater %HRpeak and time ≥ 90 %HRpeak than SIT (p < 0.05). Blood lactate and rating of perceived exertion were higher in response to SIT and HIIT vs. CT (p < 0.05); however, there were no differences in enjoyment (p > 0.05). No differences were exhibited in any variable assessed along 24 h post-exercise between conditions (p > 0.05). These data suggest that HIIT and CT accumulate the longest duration at near maximal intensities, which is considered a key factor to enhance VO2max.

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BACKGROUND: The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET). OBJECTIVE: To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained. METHODS: MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol. RESULTS: Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias. CONCLUSIONS: The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances. PROSPERO REGISTRATION ID: CRD42019123540.

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Previous results reveal a decline in affective valence in response to progressive exercise in adults. However, this similar decline is not universally observed in response to high intensity interval exercise (HIIE), which may be due to its intermittent nature. The aim of the current study was to examine potential predictors of the in-task affective valence to low-volume HIIE (LV-HIIE; 10 × 60 s high-intensity intervals at 90% of maximal treadmill velocity interspersed by 60 s at 30% of maximal treadmill velocity). We analyzed data from 76 males (age and body mass index = 26.5 ±â€¯4.4 yr and 27.3 ±â€¯5.4 kg/m2) who had participated in previous investigations in our lab. Throughout each session, affective valence (Feeling Scale; + 5 to -5), rating of perceived exertion (RPE; Borg scale 6 to 20), and heart rate (HR) were measured. The predictors of in-task affective valence were analyzed during different phases of the LV-HIIE session (i.e. beginning, average of high-intensity intervals 1-3; middle, average of high-intensity intervals 4-7; and end, average of high-intensity intervals 8-10). Results showed a significant decline in affective valence (p < 0.001), increase in RPE (p < 0.001) and HR (p < 0.001) in response to LV-HIIE. Primary predictors of in-task affective valence to LV-HIIE were physical activity level and RPE (beginning, R2 = 0.511, p < 0.001; middle, R2 = 0.681, p < 0.001; end, R2 = 0.742, p = 0.008). In conclusion, physical activity level and perceived exertion significantly predict the in-task affective valence to LV-HIIE in adult males.

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