BackgroundIn research clinic settings, overweight adults undertaking HIIT (high intensity interval training) improve their fitness as effectively as those undertaking conventional walking programs but can do so within a shorter time spent exercising. We undertook a randomized controlled feasibility (pilot) study aimed at extending HIIT into a real world setting by recruiting overweight/obese, inactive adults into a group based activity program, held in a community park.MethodsParticipants were allocated into one of three groups. The two interventions, aerobic interval training and maximal volitional interval training, were compared with an active control group undertaking walking based exercise. Supervised group sessions (36 per intervention) were held outdoors. Cardiorespiratory fitness was measured using VO2max (maximal oxygen uptake, results expressed in ml/min/kg), before and after the 12 week interventions.ResultsOn ITT (intention to treat) analyses, baseline (N = 49) and exit (N = 39) O2 was 25.3±4.5 and 25.3±3.9, respectively. Participant allocation and baseline/exit VO2max by group was as follows: Aerobic interval training N =  16, 24.2±4.8/25.6±4.8; maximal volitional interval training N = 16, 25.0±2.8/25.2±3.4; walking N = 17, 26.5±5.3/25.2±3.6. The post intervention change in VO2max was +1.01 in the aerobic interval training, −0.06 in the maximal volitional interval training and −1.03 in the walking subgroups. The aerobic interval training subgroup increased VO2max compared to walking (p = 0.03). The actual (observed, rather than prescribed) time spent exercising (minutes per week, ITT analysis) was 74 for aerobic interval training, 45 for maximal volitional interval training and 116 for walking (p =  0.001). On descriptive analysis, the walking subgroup had the fewest adverse events.ConclusionsIn contrast to earlier studies, the improvement in cardiorespiratory fitness in a cohort of overweight/obese participants undertaking aerobic interval training in a real world setting was modest. The most likely reason for this finding relates to reduced adherence to the exercise program, when moving beyond the research clinic setting.Trial RegistrationACTR.org.au ACTRN12610000295044

Bicarbonate is possibly more beneficial to sprint performance than lactate and probably more beneficial than citrate or chloride. We recommend ingestion of sodium bicarbonate to enhance sprint performance.

Although assays for the most popular markers of exercise-induced oxidative stress may experience methodological flaws, there is sufficient credible evidence to suggest that exercise is accompanied by an increased generation of free radicals, resulting in a measurable degree of oxidative modifications to various molecules. However, the mechanisms responsible are unclear. A common assumption that increased mitochondrial oxygen consumption leads per se to increased reactive oxygen species (ROS) production is not supported by in vitro and in vivo data. The specific contributions of other systems (xanthine oxidase, inflammation, haem protein auto-oxidation) are poorly characterised. It has been demonstrated that ROS have the capacity to contribute to the development of muscle fatigue in situ, but there is still a lack of convincing direct evidence that ROS impair exercise performance in vivo in humans. It remains unclear whether exercise-induced oxidative modifications have little significance, induce harmful oxidative damage, or are an integral part of redox regulation. It is clear that ROS play important roles in numerous physiological processes at rest; however, the detailed physiological functions of ROS in exercise remain to be elucidated.

The aim was to investigate the effects of low-load resistant training combined with vascular occlusion or normobaric hypoxic exposure, on neuromuscular function. In a randomised controlled trial, well-trained athletes took part in a 5-week training of knee flexor/extensor muscles in which low-load resistant exercise (20% of one repetition maximum, 1-RM) was combined with either (1) an occlusion pressure of approximately 230 mmHg (KT, n = 10), (2) hypoxic air to generate an arterial blood oxygen saturation of ~80% (HT, n = 10), or (3) with no additional stimulus (CT, n = 10). Before and after training, participants completed the following tests: 3-s maximal voluntary contraction (MVC₃), 30-s MVC, and an endurance test (maximal number of repetitions at 20% 1-RM, Reps₂₀). Electromyographic activity (root mean square, RMS) was measured during tests and the cross-sectional area (CSA) of the quadriceps and hamstrings was measured pre- and post-training. Relative to CT, KT, and HT showed likely increases in MVC₃ (11.0 ± 11.9 and 15.0 ± 13.1%, mean ± 90% confidence interval), MVC₃₀ (10.2 ± 9.0 and 18.3 ± 17.4%), and Reps₂₀ (28.9 ± 23.7 and 23.3 ± 24.0%). Compared to the CT group, CSA increased in the KT (7.6 ± 5.8) and HT groups (5.3 ± 3.0). KT had a large effect on RMS during MVC₃, compared to CT (effect size 0.8) and HT (effect size 0.8). We suspect hypoxic conditions created within the muscles during vascular occlusion and hypoxic training may play a key role in these performance enhancements.

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Summary Various changes in physiological parameters are associated with overtraining, which can be a serious problem for human and equine athletes. A 34 week longitudinal study was conducted to investigate the effects of an acute training overload on physiological parameters in 10 Standardbred racehorses. After 24 weeks of training, horses received 8 weeks of increased workload, followed by 2 weeks recovery. Horses performed a 2400 m time trial and a progressive submaximal exercise test on alternate weeks. By the end of the heavy training period, the average time for the final 1200 m of the time trial increased by 4.0% (95% probable range of true value 1.7–5.8) and peak velocity decreased by 6.9% (4.7–8.9), indicating that overtraining had occurred. Acute overtraining coincided with an increase in blood lactate concentration after the time trial and submaximal test. There were also substantial decreases in bodyweight, plasma cortisol concentration and packed cell volume after the time trial, and in the velocity at a heart rate of 200/min (V200). Parameters that showed no clear‐cut change with overtraining included maximal and recovery heart rate, basal plasma cortisol, plasma and red cell volume, and markers of skeletal damage (plasma concentrations of creatine kinase and aspartate aminotransferase). Bodyweight, V200, postexercise blood lactate and plasma cortisol concentrations may all be useful for detecting acute overtraining in equine athletes.

Background: Endoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission). Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups. Results: Across 348 patients from 20 centres, the median time to endoscopy was 21.2 h (IQR 12.0-35.7), comprising median admission to referral and referral to endoscopy times of 8.1 h (IQR 3.7-18.1) and 6.7 h (IQR 3.0-23.1), respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0-87.5%, p ¼ 0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7:00 and 19:00 hours or via the emergency department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1 d; p ¼ 0.004), but not 30-d mortality (p ¼ 0.344). Conclusions: The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.

Treadmill tests for maximal oxygen uptake (V̇O2max) have traditionally used set speed and incline increments regardless of participants training or exercise background. The aim of this study was to determine the validity of a novel athlete-led protocol for determining maximal aerobic fitness in adults. Twenty-nine participants (21 male, 8 female, age 29.8 ± 9.5 y, BMI 24.4 ± 3.1, mean ± SD) from a variety of exercise backgrounds were asked to complete two maximal treadmill running tests (using the standard Bruce or a novel athlete-led protocol [ALP]) to volitional failure in a counter-balanced randomised cross-over trial one week apart. We found no substantial difference in maximal oxygen uptake (47.0 ± 9.1 and 46.8 ± 10.7 ml·kg−1·min−1, mean ± SD for the ALP and Bruce protocols respectively), evidenced by the Spearman correlation coefficient of 0.93 (90% confidence limits, 0.88-0.96). However, compared to the Bruce protocol, participants completing the ALP protocol attained a substantially higher maximal heart rate (ALP = 182.8 ± 10.5, Bruce = 179.7 ± 8.7 beats·min−1). Additionally, using the Bruce protocol took a longer period of time (23.2 ± 17.0 s) compared to the ALP protocol. It seems that using either treadmill protocol will give you similar maximal oxygen uptake results. We suggest the ALP protocol which is simpler, quicker and probably better at achieving maximal heart rates is a useful alternative to the traditional Bruce protocol.