Muscle deoxygenation and oxygen uptake plateau occurrence in children with obesity

doi:10.21203/rs.3.rs-1757244/v1

Download PDF

Original Research Article

Muscle deoxygenation and oxygen uptake plateau occurrence in children with obesity

https://doi.org/10.21203/rs.3.rs-1757244/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background: In children with obesity, the imbalance between O₂ delivery and extraction might be related to the inability to achieve VO_2max during treadmill tests. The aim of the study is to characterize the changes in muscle deoxyhemoglobin (BPdeoxy[heme]) in the gastrocnemius medialis of children with obesity. 26 children with obesity (11.6±1.7 y) performed a treadmill walking test to exhaustion during which pulmonary gas exchanges and gastrocnemius medialis deoxy[heme] responses were measured continuously. BP_deoxy[heme] was determined for each participant using piecewise double-linear regressions. VO_2peak and deoxy[heme] responses were compared between participants who achieved the criteria for verifying VO_2max (VO₂ plateau or both heart rate >95% and respiratory exchange ratio >1.0) and those not.

Results: BP_deoxy[heme] was detected in 25 out of 26 participants at 77±9% VO_2peak and occurred at a similar relative intensity both subgroups. There was no relationship between BP_deoxy[heme] and VO_2peak.

Conclusion: The imbalance between O₂ delivery and extraction occur at high intensites during a treadmill walking test in youth with obesity, that may partly explain their difficulty to further continue the test regardless of the achievement of the criteria for verifying VO_2max.

obesity

children

VO2max

muscle deoxygenation

treadmill

near infrared spectroscopy (NIRS)

Cardiorespiratory fitness and fatness explain different components of cardiometabolic risks in preadolescent children (1). The gold standard for measuring cardiorespiratory fitness is the maximum oxygen uptake (VO_2max), which theoretically reflects the highest value of VO₂ attainable by an individual. VO_2max is typically assessed using incremental cycling or running exercises until exhaustion (2). Since walking is the most representative physical activity in free-living conditions, treadmill walking tests have been used by several authors to measure aerobic fitness in youth with obesity (3–5). However, during treadmill tests, most youth with obesity are not achieving VO_2max according to both the primary VO_2max verification criteria which the occurence of a VO₂ plateau) (5) and the secondary threshold criteria, that are typically a heart rate (HR) > 95% of their maximal theoretical value and a respiratory exchange ratio > 1 (3–5). Although it could be suggested that these results do not apply since these criteria are not appropriate for verifying VO_2max (6–9), a recent study using supramaximal test showed that VO_2max was not achieved during an incremental cycling test in youth with and without obesity (9). Despite that no similar study was performed using treadmill walking tests, current pediatric litterature suggests that youth with obesity are unable to reach their VO_2max during an incremental exercise. Although motivational and exertional factors play a decisive role in a progressive test conducted until exhaustion (10), it can hypothesize that peripheral limitations occur during a treadmill walking test in youth with obesity. Peripheral limitations have been proposed to explain that a high part of these children (which remains difficult to estimate) are limited during high-intensity weight-bearing exercises (11). Since calf (rather than thigh) muscles appear to be mainly involved during a treadmill walking exercise (12), it is relevant to study whether calf muscles deoxygenation could be related to the aerobic performance during a progressive walking test in youth with obesity.

Near-infrared spectroscopy (abbreviated "NIRS") permits to measure the tissue quantities of oxy [hemoglobin + myoglobin] (oxy[heme]) and deoxy [hemoglobin + myoglobin] (deoxy[heme]) in a non-invasive way, based on the different absorptive properties of these forms of hemoglobin (13, 14). Deoxy[heme] would reflect the balance between O₂ delivery and O₂ utilization at the level of the explored tissue (15). By adding the amounts of deoxy[heme] and oxy[heme], it is possible to determine the total amount of heme molecules (hemoglobin + myoglobin) present in the tissue, denoted total[heme], which would reflect variations in tissular blood volume (16). NIRS can be easily combined with mouth gas analysis to study the relationships between whole body gas pulmonary gas exchanges (oxygen uptake = VO₂, carbon dioxide output = VCO₂, minute ventilation = VE) and hemodynamic muscle responses (deoxy[heme], oxy[heme], total[heme], tissular saturation in oxygen - STO₂(%)) during exercise. During a ramp or incremental test, deoxy[heme] measured at the level of the vastus lateralis would increase in a sigmoid (17) or a double-linear (18–20) pattern. The relative intensity from which the increase in deoxy[heme] slows down in response to increased muscle work, called the "breakpoint" (BPdeoxy[heme]). BP_deoxy[heme] would characterize the balance between O₂ delivery and utilization within the explored tissues (19). At the level of the vastus lateralis, BP_deoxy[heme] appeared positively correlated with VO_2max (21) and the lactic threshold (22) in adults, but this was not observed in children (23). In boys, the timing of BP_deoxy[heme] correlated with the number of stops completed during the 20m shuttle run test (24) suggesting that running aerobic performance is partly determined by the balance between O₂ delivery and utilization at the thigh muscles level. Likewise, it could be hypothesized that the balance between O₂ delivery and utilization at the calf muscles’ level is a major determinant of aerobic performance during a walking test. However, no study had yet measured the deoxy[heme] responses to an incremental treadmill walking test in this muscle group, which is particularly involved during a walking exercise (12).

Thus, the main purpose of this study was to characterize the calf muscles deoxy[heme] profile of youth with obesity during an incremental treadmill walking test. Our secondary purpose was to compare the deoxy[heme] profile between those who achieve the usual criteria for verifying VO_2max and those not. Our main hypothesis was that a breakpoint in calf muscles deoxy[heme] would occur during the test regardless of the achievement of usual criteria for verifying VO_2max, suggesting that changes in deoxy[heme] are independant of the attainment of a VO₂ plateau or secondary threshold criteria for veryfing VO_2max in youth with obesity.

Participants

Children with obesity participating in a multidisciplinary program to manage pediatric obesity were included in this study. The inclusion criteria were an age between 9 and 15 years old and a BMI superior to the 85th percentile of the IOTF standards for BMI, defining grade I obesity in children (25). These children are referred to this multidisciplinary program by their practitioner and the hospital center of the area before the excess weight reaches a level requiring hospital care. Prior their inclusion appointment to the protocol, the children and their parents were provided with an oral and written explanation of the experimental procedure and the purposes of the study, in a language adapted to their level of understanding. Then, the voluntary children and at least one of their parents signed a written consent summarizing the information relating to the study. The study was conducted according to the Declaration of Helsinki (2013) and approved by the French National Ethics Committee in Sports Science (CER STAPS n° 2020-11-02-44).

General procedure

The experiments took place in the department of pulmonary medicine at the local hospital center. Participants were called in the morning between 10 a.m. and 12 p.m. or in the afternoon between 3 p.m. and 7 p.m and were asked to have a light meal to avoid digestive discomfort during the test. Parents were asked to make sure that their children did not exercise intensively during the 48 hours preceding the appointment. Before the experiments, the participants’ heights were measured in standing and seated position using a stadiometer, and the participants were weighted using a bioimpedance analysis scale (Tanita DC-360, Japan) which allowed us to obtain an estimate of their body composition in two compartments (fat-free mass and fat mass), to calculate their BMI z-score based on the IOTF (25) and WHO (26) standards, and their peak height velocity (27).

Incremental exercise

As part of their monitoring, the participants performed a treadmill walk test to exhaustion. The warm-up consisted of level walking at a pace between 3.0 to 4.5 km.h^− 1 so that the heart-rate (HR) reached a steady-state at 60 ± 5% of the theoretical maximum HR estimated with the Tanaka formula (28) [HR_peaktheo = 208 − 0.7 * age] to guarantee a similar starting intensity for all participants. Then, the slope increased by 2% per minute and the speed was kept constant until the slope had reached 10%. From the sixth minute, the slope was maintained at 10% and the speed increased by 0.3 km.h^− 1 for a starting speed between 3.0 km.h^− 1 and 3.7 km.h^− 1 or by 0.4 km.h^− 1 for a starting speed between 3.7 and 4.5 km.h-1. The test ended when the participant was no longer able to continue the test despite the encouragement of the experimenter. We chose this protocol because it was demonstrated that treadmill tests with both speed and slope-based increments are associated with the achievement of a higher VO₂ that tests with only slope-based increments (29). The relative timing at which the protocol changed to increase in speed only (i.e., when the slope reached 10%) was calculated [relative timing (%) = 300 * 100 / total exercise duration (seconds)]. To provide data about the rate of achievement of usual primary and secondary VO_2max verification criteria using a treadmill walking test in youth with obesity, the achievement of a pulmonary VO₂ plateau (primary criteria) HR and RER-based secondary VO_2max verification criteria (HR > 95% theoretical maximal HR; RER > 1.0) was reported (see « processing of exercise data »). Despite their lack of sensitivity (6–7, 30–31), these criteria were used to help explore the physiological mechanisms related to the inability of our participants to continue an incremental walking test. As part of the inclusion criteria for this study, only the participants who manifested a state of volitional exhaustion were included in the analysis, so as not to include those who terminated for motivational reasons.

Heart rate and pulmonary gas exchanges

Pulmonary gas exchange responses (VO₂, VCO₂, VE) were collected breath-by-breath using a portable pulmonary gas analyzer (Cosmed K4b², Italy) calibrated before the exercises following the manufacturer's recommendations. HR was measured continuously using a validated optical heart rate monitor (Polar OH1, Polar, Finland) (32) positioned at the left wrist.

Near-Infrared Spectroscopy

Muscle hemodynamic responses (deoxy[heme], total[heme]) were collected using a portable NIRS device (Portamon, USA), which has been previously described and validated during exercise (33). The differential path factor was set at 5.5. The raw measurements (10 Hz) are converted into a digital signal from which it is possible to study the kinetics of oxy[heme] and deoxy[heme] in the tissue measured. The baseline of the signal was sent from a 30s moving average of the data measured after 3 minutes of warm-up. The device was positioned on the belly of the medial head of the gastrocnemius (5–8 cm below the popliteal fossa). In accordance with the manufacturer’s recommendations, the NIRS probe was wrapped to the leg to maintain position and to ensure external light did not affect the measurement. The skinfold was measured at the probe site using a caliper (Harpenden, USA) to ensure that it was lower than the 20mm estimated depth penetration of the light. A mark made with an erasable felt was made to check if the device moved during the exercise (this did not happen).

Processing of exercise data

Data processing was carried out using R software (version 3.6.2). Participants were considered to have reached a VO₂ plateau when the increase in VO₂ during the completed last minute of effort was < 50% of the increase observable during the penultimate minute of effort (34). The peak in VO₂ response (VO_2peak) was the highest values observables on a moving-averaged interval of 30 seconds (from the raw data) as recently recommended in children (35). They were called “peak” values instead of “maximum” values because not every participant achieved a true VO_2max. The VO_2peak was reported in absolute terms (VO_2peak/ABS) and in relation to body mass (VO_2peak/BM in ml.kg^− 1.min^− 1) and fat-free mass (VO_2peak/FFM in ml.kgFFM-1.min^− 1). The highest HR (HR_peak) was the highest value recorded on a 3-points (HR) moving average overall the test. The muscle hemodynamics data were moving-averaged over an interval of 1 second. The relative intensity at which BP_deoxy[heme] occurred was determined from the raw data using “piece-wise” double-linear regression on constant signal portions obtained during exercise and evaluating which combination of models produced the smallest sum of squared residuals (18–20).

Statistical analyzes

Statistical analyzes were carried out using R software (version 3.6.2). The normality and homogeneity of the distributions were checked respectively with the Shapiro-Wilk test and the F test of Snedecor. Clinical characteristics and exercise data (including BP_deoxy[heme]) were compared using Student t-tests between girls and boys. Pearson correlation tests were used to study the relationship between 1) the timing at BP_deoxy[heme] and the exercise duration and 2) the BP_deoxy[heme] (%VO_2peak) and the VO_2peak. The significance threshold was set at p < 0.05.

Participants characteristics and exercise data by subgroups (VO_2max criteria achievers vs. non-achievers) are presented in Table 1.

Table 1

Participants’ clinical characteristics and peak exercise data by VO_2max achievement subgroups (VO_2max criteria non-achievers vs VO_2max criteria achievers).
	VO_2max criteria achievers 7 girls ; 5 boys	VO_2max criteria non-achievers 6 girls ; 8 boys
Age (years)	11.2 ± 1.8	12.0 ± 1.6
Growth status (years from PHV)	-0.8 ± 1.9	-0.5 ± 1.6
Height (cm)	151 ± 13	154 ± 10
BM (kg)	65.8 ± 22	64.2 ± 17
%FM	36.1 ± 8	34.2 ± 8
IOTF BMI z-score (SD)	2.6 ± 0.6	2.2 ± 0.7*
Skinfold (mm)	15 + 3	13 + 3
Exercise duration (seconds)	623 ± 171	635 ± 155
VO_2peak/BM (mL.kgBM^− 1.min^− 1)	29.5 ± 7.3	29.7 ± 5.6
VO_2peak/FFM (mL.kgFFM^− 1.min^− 1)	45.9 ± 6.9	45.3 ± 7.4
RER_peak	1.07 ± 0.2	1.09 ± 0.1
HR_peak (bpm)	186 ± 12	182 ± 16
HR_peak(% HR_peaktheo)	93 ± 6	91 ± 8
BP_deoxy[heme] (%VO_2peak)	76 ± 9 (n = 11)	77 ± 10 (n = 14)
BP_deoxy[heme] (% exercise duration)	53 ± 13 (n = 11)	49 ± 19 (n = 14)
Δ Deoxy[heme] (% baseline)	30 ± 18	35 ± 12
1. Data are presented as mean ± standard deviation (SD) values. Between-plateau group differences : * (p < 0.05); (p < 0.01); * (p < 0.001).

*** Table 1 here ***

The achievement of both primary and secondary VO_2max verification criteria is represented in Table 2. A VO₂ plateau has been achieved by 11 participants and 2 participants achieved the secondary VO_2max verification criteria used in this study, one of which achieved a VO₂ plateau. Thus, 12 participants (46%) would be considered as VO_2max achievers according to these criteria. The treadmill test lasted 630 ± 160 seconds (~ 10 min), between 321 and 951 seconds (~ 5 and 16 minutes).

Table 2

Number and rate of achievement of the primary (VO₂ plateau) and the secondary threshold criteria (HR > 95% HR_maxtheo ; QR > 1.0) for verifying VO_2max. Volitional exhaustion was achieved by every participant as part of the inclusion criteria. Bold lines refers to the achievement of VO_2max.
VO_2max criteria	Number of participants	Proportion of participants
VO₂ plateau	11/26	42%
HR > 95% HR_maxtheo	3/26	12%
QR > 1.0	15/26	58%
HR + RER criteria	2/26	8%
VO_2max achievement	12/26	46%

*** Table 2 here ***

Time course haemodynamic (deoxy[heme], STO₂(%), total[heme] and oxy[heme]) are plotted for each group in the Fig. 1. BP_deoxy[heme] was detectable in 25 out of 26 participants. It occured at 77 ± 9%VO_2peak and 50 ± 16% of exercise time. The mean amplitude of the deoxy[heme] response was 32 ± 15%. There were no significant differences in any of these parameters (p > 0.46 overall) between those who achieve the criteria for verifying VO_2max and those not.

*** Fig. 1 here ***

The timing of BP_deoxy[heme], expressed in seconds, was correlated with the total duration of the exercise (r = 0.64, p < 0.001). However, no relationship between BP_deoxy[heme] and VO_2peak was found. Furthermore, there was no time relationship between BP_deoxy[heme] and the relative timing at which the change in protocol incrementation occured (p > 0.60).

To our knowledge, this study is the first to examine changes in muscle deoxy[heme] during an incremental test in youth with obesity using near-infrared spectroscopy. Current pediatric litterature suggest that a minority of children with obesity can achieve VO_2max during an incremental test, whether using a cycling (9) or a treadmill walking (3–5) protocol. While limitations of peripheral origin seem to be involved during high-intensity aerobic effort in youth with obesity (11), no study has yet measured the changes in muscle deoxy[heme] during to this type of protocol. Thus, the main of this study was to characterize the breakpoints in calves’ muscles deoxy[heme] to investigate if the breakpoints could be related to the inability to continue an incremental treadmill walking test in youth with obesity.

To assess the balance between O₂ delivery and utilization capacity, the breakpoint deoxyhemoglobin (BP_deoxy[heme]) is a valid and reproducible method (36–38). The breakpoint in deoxy[heme] would represent a transition from which there is a mismatch between O₂ delivery and O₂ utilization in the explored tissue. During an incremental cycling test, it was hypothesized that the breakpoint in deoxy[heme] was due to the ceiling of muscular O₂ extraction capacity (20). However, another study showed the existence of an O₂ extraction « reserve » (40), suggesting that O₂ delivery rather than O₂ extraction caused the deoxy[heme] to reach a plateau. According to the latter hypothesis, this phenomenon could result from an attenuated need to increase fractional O₂ extraction until the end of the test due to a local surplus of blood flow, supporting previous hypothesis that blood flow redistribution to the active tissues causes O₂ extraction to plateau rather than the ceiling of muscle O₂ extraction capacities (40). In the vastus lateralis during a cycling exercise, this event would occur at intensities close to the maximal lactate steady state (MLSS) and the respiratory compensation point (RCP) (20, 23, 41) from which the accumulation of metabolites triggers the release of vasodilatator compounds such as ATP, [La] and nitric oxide (40). However, since our protocol was not appropriate to detect RCPs (change in incrementation during the test and starting at an intensity ~ 60%HR_peak), we failed to detect RCPs in the present study.

The novel finding of this study is that in youth with obesity performing an incremental treadmill test, a breakpoint in calf muscles deoxy[heme] occured at ~ 75–80% VO_2peak, as previously found is the vastus lateralis (36–38) and other muscle of the quadriceps (39). Interestingly, the breakpoint occured at lower intensities (~ 75–80%VO_2peak) than those found in the vastus lateralis during a cycling exercise in children without obesity (~ 90%VO_2peak) (23), suggesting a better matching between O₂ delivery and utilization in the gastrocnemius during walking than in the vastus lateralis during cycling. Since the pattern of deoxy[heme] is closely proportional to the level of muscle activation (39), it is possible that the gastrocnemius medialis was activated to a lower extent in our treadmill protocol than the vastus lateralis in the cycling protocol of Vandekerchkove et al. As previously suggested, this might be due to the fact that the gastrocnemius medialis contains more slow-twitch type fibers than the vastus lateralis (39). Unfortunately, our interpretation remains limited by the absence of concomitant NIRS measurements at the level of the vastus lateralis during our protocol, as well as a lack of EMG data during the test. Furthermore, since no blood flow occlusion was performed, it is not possible from the present results to check whether or not the maximal O₂ extraction capacity was reached during the test.

The secondary purpose of this study was to compare the deoxy[heme] profile between those who achieve a VO₂ plateau or the secondary threshold criteria for verifying VO_2max (i.e., a HR > 95% theoretical HR_max and a RER > 1.0). Current pediatric litterature suggests that children with obesity are not achieving VO_2max during an incremental test (3–5, 9), thus is it relevant to suspect that peripheral rather than central limitations occur during these tests in this population. Our results found no differences regarding the BP_deoxy[heme] between VO_2max criteria achievers vs. nonachievers, suggesting that BP_deoxy[heme] was more related to the performance in our treadmill test than the attainment of a VO₂ plateau or the threshold criteria for verifying VO_2max. However, we are not able to ascertain whether BP_deoxy[heme] was related to the fact that some participants do not achieve VO_2max during the test because the criteria used in this study are not appropriate to verify VO_2max (6, 9, 30–31). In this context, further studies should compare BP_deoxy[heme] between participants who achieve VO_2max and those not by verifying the VO_2max using a supramaximal test as recently recommended in young people.

There are two mains’ reasons why we have decided to use calf muscles as a measurement site. The first reason come from the scientific rational according to which calf muscles are more involved than thigh muscles during walking exercises (12). The second and more obvious reason is that the skinfold is ~ 25% lower in the calf than the thigh in children (42), allowing the signal to get more easily into the muscle tissue. In our study, the skinfold was ~ 14 mm, which is under the 20mm estimated depth penetration of the light (half the distance between the light source and the detector (43), which is 40mm in the Portamon NIRS device). Furthermore, NIRS has already been used to measure leg muscles hemodynamic adaptations to a prolonged moderate-intensity cycling exercise in adolescents with obesity whose skinfold averaged ~ 13mm (44). This study showed that a 3-months exercise training programs was associated with an improvement in microvascular hemodynamics responses during a prolonged submaximal exercise. Thus, we estimate that the light effectively penetrates the muscle tissue during the experiments and that the presented NIRS data mostly reflected the variation in muscle deoxygenation responses.

Our study has limitations. Firstly, the present results only apply to treadmill walk tests, during which both the speed and the slope increase. The breakpoint in calf muscles deoxy[heme] might occur at different intensities during other types of walking or running protocols used in children with obesity, such as the 20m shuttle-run test or the recently validated Spartacus test. Secondly, the plateau in muscle deoxy[heme] makes it possible to characterize the achievement of a critical intensity from which the aerobic metabolism is no longer able to meet the energy demand within the muscle tissue. Indeed, to determine whether maximal O₂ extraction capacity was reached during the test, we could have performed a blood flow occlusion just after the end of the test. The main strength of this study is the use of NIRS in youth with obesity which is under-evaluated and the combination of a local (NIRS) and global (indirect calorimetry) measure of metabolism. The present data shed new light on the musculoskeletal responses to an incremental treadmill test in youth with obesity and offers new insights into the factors determining aerobic performance in this population.

During an incremental treadmill walk test, a plateau in deoxyhemoglobin occurred in 25 out of 26 children with obesity at ~ 75–80%VO_2peak and at a comparable intensity between those who achieved a VO₂ plateau and those who did not. Thus, an imbalance between O₂ delivery and extraction occur at high intensites during a treadmill walking test in youth with obesity, that may partly explain their difficulty to further continue the test regardless of the achievement of a VO₂ plateau or the secondary threshold criteria for veryfing VO_2max.

PHV

peak height velocity

standard deviations

VO2peak

maximum oxygen uptake

body mass

FFM

fat-free mass

RER

respiratory exchange ratio

heart rate

breakpoint

deoxy[heme]

deoxyhemoglobin

Ethics approval and consent to participate

Prior their inclusion appointment to the protocol, the children and their parents were provided with an oral and written explanation of the experimental procedure and the purposes of the study, in a language adapted to their level of understanding. Then, the voluntary children and at least one of their parents signed a written consent summarizing the information relating to the study. The study was conducted according to the Declaration of Helsinki (2013) and approved by the French National Ethics Committee in Sports Science (CER STAPS n° 2020-11-02-44).

Consent for publication

Not applicable

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request

Competing interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

LT received a scholarship by the Pôle Metropolitain Côte d’Opale (PMCO) and the University of Littoral Côte d’Opale (ULCO).

Author Contributions

LT wrote the main part of the manuscript. The protocol was designed by LT, PMu, CN and GZ. Data analysis was performed by LT, PMo and TP. All authors have contributed to the improvement of the scientific content and the form of the article.

Acknowledgements

The authors are grateful to the participants, their family, and the pediatric and pulmonology services of the Zuydcoote Hospital Center for participating in the study and to PMCO and ULCO for their financial support.

Authors information

Unité de Recherche Pluridisciplinaire Sport Santé Société, ULR 7369 - URePSSS - Univ. Littoral Côte d’Opale, Univ. Lille, Univ. Artois, F-59000 Lille, France. Louis Toulouse, Pierre Morel & Thierry Peze

Laboratoire Mouvement, Equilibre, Performance, Santé. Campus Montaury, EA 4445 - Université Pau Pays de l'Adour, F-64600 Anglet, France. Charlie Nezondet, Gautier Zunquin

Unité de Recherche Pluridisciplinaire Sport Santé Société,Univ. Lille, ULR 7369 - URePSSS - Univ. Littoral Côte d’Opale, Univ. Artois, F-59000 Lille, France. Patrick Mucci

Stoner L, Pontzer H, Barone Gibbs B, Moore JB, Castro N, Skidmore P, Lark S, Williams MA, Hamlin MJ, Faulkner J. Fitness and Fatness Are Both Associated with Cardiometabolic Risk in Preadolescents. J Pediatr. 2020 Feb;217:39–45.e1.. ;. doi: 10.1016/j.jpeds.2019.09.076. Epub 2019 Nov 20. PMID: 31759583.
Poole DC, Richardson RS. Determinants of oxygen uptake. Implications for exercise testing. Sports Med. 1997 Nov;24(5):308 – 20. doi: 10.2165/00007256-199724050-00003. PMID: 9368277.
Gutin B, Barbeau P, Owens S, Lemmon CR, Bauman M, Allison J, Kang HS, Litaker MS. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr. 2002 May;75(5):818 – 26. doi: 10.1093/ajcn/75.5.818. PMID: 11976154.
Marinov B, Kostianev S, Turnovska T. Ventilatory efficiency and rate of perceived exertion in obese and non-obese children performing standardized exercise. Clin Physiol Funct Imaging. 2002 Jul;22(4):254 – 60. doi: 10.1046/j.1475-097x.2002.00427.x. PMID: 12402447.
Breithaupt P, Adamo KB, Colley RC. The HALO submaximal treadmill protocol to measure cardiorespiratory fitness in obese children and youth: a proof of principle study. Appl Physiol Nutr Metab. 2012 Apr;37(2):308 – 14. doi: 10.1139/h2012-003. Epub 2012 Mar 27. Erratum in: Appl Physiol Nutr Metab. 2017 Nov;42(11):1236. PMID: 22452609.
Midgley AW, Carroll S. Emergence of the verification phase procedure for confirming 'true' VO2max. Scand J Med Sci Sports. 2009 Jun;19(3):313–22. 10.1111/j.1600-0838.2009.00898.x. Epub 2009 Apr 22. PMID: 19422662.. ( :. doi.
Barker AR, Williams CA, Jones AM, Armstrong N. Establishing maximal oxygen uptake in young people during a ramp cycle test to exhaustion. Br J Sports Med. 2011 May;45(6):498–503. 10.1136/bjsm.2009.063180. Epub 2009 Aug 12. PMID: 19679577.. ( :. doi.
Poole DC, Jones AM. Measurement of the maximum oxygen uptake V̇o2max: V̇o2peak is no longer acceptable. J Appl Physiol (1985). 2017 Apr 1;122(4):997–1002. doi: 10.1152/japplphysiol.01063.2016. Epub 2017 Feb 2. PMID: 28153947.
Bhammar DM, Stickford JL, Bernhardt V, Babb TG. Verification of Maximal Oxygen Uptake in Obese and Nonobese Children. Med Sci Sports Exerc. 2017 Apr;49(4):702–10. 10.1249/MSS.0000000000001170. PMID: 27875494; PMCID: PMC5357186.. ( :. doi.
Midgley AW, McNaughton LR, Polman R, Marchant D. Criteria for determination of maximal oxygen uptake: a brief critique and recommendations for future research. Sports Med. 2007;37(12):1019-28. doi: 10.2165/00007256-200737120-00002. PMID: 18027991.
Ratel S, Duché P, Williams CA. Muscle fatigue during high-intensity exercise in children. Sports Med. 2006;36(12):1031-65. doi: 10.2165/00007256-200636120-00004. PMID: 17123327.
Hiroyuki H, Hamaoka T, Sako T, Nishio S, Kime R, Murakami M, Katsumura T. Oxygenation in vastus lateralis and lateral head of gastrocnemius during treadmill walking and running in humans. Eur J Appl Physiol. 2002 Aug;87(4–5):343–9. 10.1007/s00421-002-0644-y. Epub 2002 Jun 15. PMID: 12172872.. ( :. doi.
Ferrari M, Binzoni T, Quaresima V. Oxidative metabolism in muscle. Philos Trans R Soc Lond B Biol Sci. 1997 Jun 29;352(1354):677 – 83. doi: 10.1098/rstb.1997.0049. PMID: 9232855; PMCID: PMC1691965.
Barstow TJ. Understanding near infrared spectroscopy and its application to skeletal muscle research. J Appl Physiol (1985). 2019 May 1;126(5):1360–1376. doi: 10.1152/japplphysiol.00166.2018. Epub 2019 Mar 7. PMID: 30844336.
Hampson NB, Piantadosi CA. Near infrared monitoring of human skeletal muscle oxygenation during forearm ischemia. J Appl Physiol (1985). 1988 Jun;64(6):2449-57. doi: 10.1152/jappl.1988.64.6.2449. PMID: 3403428.
Davis ML, Barstow TJ. Estimated contribution of hemoglobin and myoglobin to near infrared spectroscopy. Respir Physiol Neurobiol. 2013 Apr 1;186(2):180-7. doi: 10.1016/j.resp.2013.01.012. Epub 2013 Jan 26. PMID: 23357615.
Ferri A, Adamo S, Longaretti M, Marzorati M, Lanfranconi F, Marchi A, Grassi B. Insights into central and peripheral factors affecting the "oxidative performance" of skeletal muscle in aging. Eur J Appl Physiol. 2007 Jul;100(5):571–9. 10.1007/s00421-006-0371-x. Epub 2006 Dec 22. PMID: 17186297.. ( :. doi.
Spencer MD, Murias JM, Paterson DH. Characterizing the profile of muscle deoxygenation during ramp incremental exercise in young men. Eur J Appl Physiol. 2012 Sep;112(9):3349–60. 10.1007/s00421-012-2323-y. Epub 2012 Jan 22. PMID: 22270488.. ( :. doi.
Grassi B, Quaresima V, Marconi C, Ferrari M, Cerretelli P. Blood lactate accumulation and muscle deoxygenation during incremental exercise. J Appl Physiol (1985). 1999 Jul;87(1):348 – 55. doi: 10.1152/jappl.1999.87.1.348. PMID: 10409594.
Boone J, Barstow TJ, Celie B, Prieur F, Bourgois J. The interrelationship between muscle oxygenation, muscle activation, and pulmonary oxygen uptake to incremental ramp exercise: influence of aerobic fitness. Appl Physiol Nutr Metab. 2016 Jan;41(1):55–62. 10.1139/apnm-2015-0261. Epub 2015 Oct 6. PMID: 26701120.. ( :. doi.
Iannetta D, Passfield L, Qahtani A, MacInnis MJ, Murias JM. Interlimb differences in parameters of aerobic function and local profiles of deoxygenation during double-leg and counterweighted single-leg cycling. Am J Physiol Regul Integr Comp Physiol. 2019 Dec 1;317(6):R840-R851. doi: 10.1152/ajpregu.00164.2019. Epub 2019 Oct 16. PMID: 31617749; PMCID: PMC6962629.
Wang L, Yoshikawa T, Hara T, Nakao H, Suzuki T, Fujimoto S. Which common NIRS variable reflects muscle estimated lactate threshold most closely? Appl Physiol Nutr Metab. 2006 Oct;31(5):612 – 20. doi: 10.1139/h06-069. PMID: 17111016.
Vandekerckhove K, Coomans I, Moerman A. De Wolf D, Boone J. Characterizing cerebral and locomotor muscle oxygenation to incremental ramp exercise in healthy children: relationship with pulmonary gas exchange. Eur J Appl Physiol 2016 Dec;116(11–12):2345–55. doi: 10.1007/s00421-016-3486-8. Epub 2016 Oct 6. PMID: 27714456.
Kume D, Iguchi A, Endoh H. Accelerated point of muscle deoxygenation during the 20-m shuttle run test. Clin Physiol Funct Imaging. 2018 May;38(3):390–395. doi: 10.1111/cpf.12426. Epub 2017 Apr 16. PMID: 28414877.
Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012 Aug;7(4):284–94. 10.1111/j.2047-6310.2012.00064.x. Epub 2012 Jun 19. PMID: 22715120.. ; ). doi.
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007 Sep;85(9):660–7. doi: 10.2471/blt.07.043497. PMID: 18026621; PMCID: PMC2636412.
Mirwald RL, Baxter-Jones AD, Bailey DA, Beunen GP. An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc. 2002 Apr;34(4):689 – 94. doi: 10.1097/00005768-200204000-00020. PMID: 11932580.
Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001 Jan;37(1):153-6. doi: 10.1016/s0735-1097(00)01054-8. PMID: 11153730.
Lukaski HC, Bolonchuk WW, Klevay LM. Comparison of metabolic responses and oxygen cost during maximal exercise using three treadmill protocols. J Sports Med Phys Fitness. 1989 Sep;29(3):223–9. PMID: 2635252.
Poole DC, Wilkerson DP, Jones AM. Validity of criteria for establishing maximal O2 uptake during ramp exercise tests. Eur J Appl Physiol. 2008 Mar;102(4):403–10. doi: 10.1007/s00421-007-0596-3. Epub 2007 Oct 30. PMID: 17968581.
Sansum KM, Weston ME, Bond B, Cockcroft EJ, O'Connor A, Tomlinson OW, Williams CA, Barker AR. Validity of the Supramaximal Test to Verify Maximal Oxygen Uptake in Children and Adolescents. Pediatr Exerc Sci. 2019 May 1;31(2):213–222. doi: 10.1123/pes.2018-0129. Epub 2019 Mar 18. PMID: 30885084.
Hermand E, Cassirame J, Ennequin G, Hue O. Validation of a Photoplethysmographic Heart Rate Monitor: Polar OH1. Int J Sports Med. 2019 Jul;40(7):462–7. 10.1055/a-0875-4033. Epub 2019 Jun 12. PMID: 31189190.. ( :. doi.
Jones B, Hesford CM, Cooper CE. The use of portable NIRS to measure muscle oxygenation and haemodynamics during a repeated sprint running test. Adv Exp Med Biol. 2013;789:185–191. doi: 10.1007/978-1-4614-7411-1_26. PMID: 23852494.
Wood RE, Hills AP, Hunter GR, King NA, Byrne NM. Vo2max in overweight and obese adults: do they meet the threshold criteria? Med Sci Sports Exerc. 2010 Mar;42(3):470-7. doi: 10.1249/MSS.0b013e3181b666ad. PMID: 19952821.
Blanchard J, Blais S, Chetaille P, Bisson M, Counil FP, Girard TH, Lafrenaye S, Dallaire F. Determination of peak cardiorespiratory fitness parameters in children: which averaging method should we use? J Sports Sci. 2019 Jun;37(11):1265–9. ; ). doi: 10.1080/02640414.2018.1554976. Epub 2018 Dec 13. PMID: 30543316.
Boone J, Koppo K, Barstow TJ, Bouckaert J. Pattern of deoxy[Hb + Mb] during ramp cycle exercise: influence of aerobic fitness status. Eur J Appl Physiol. 2009 Apr;105(6):851–9. 10.1007/s00421-008-0969-2. Epub 2009 Jan 8. PMID: 19130074.. ( :. doi.
Grassi B, Quaresima V. Near-infrared spectroscopy and skeletal muscle oxidative function in vivo in health and disease: a review from an exercise physiology perspective. J Biomed Opt. 2016 Sep;21(9):091313. doi: 10.1117/1.JBO.21.9.091313. PMID: 27443955.
Iannetta D, Qahtani A, Millet GY, Murias JM. Quadriceps Muscles O2 Extraction and EMG Breakpoints during a Ramp Incremental Test. Front Physiol. 2017 Sep;19:8:686. 10.3389/fphys.2017.00686. PMID: 28970805; PMCID: PMC5609583.. ;. doi.
Chin LM, Kowalchuk JM, Barstow TJ, Kondo N, Amano T, Shiojiri T, Koga S. The relationship between muscle deoxygenation and activation in different muscles of the quadriceps during cycle ramp exercise. J Appl Physiol (1985). 2011 Nov;111(5):1259-65. doi: 10.1152/japplphysiol.01216.2010. Epub 2011 Jul 28. PMID: 21799133; PMCID: PMC3220310.
Inglis EC, Iannetta D, Murias JM. The plateau in the NIRS-derived [HHb] signal near the end of a ramp incremental test does not indicate the upper limit of O2 extraction in the vastus lateralis. Am J Physiol Regul Integr Comp Physiol. 2017 Dec 1;313(6):R723-R729. doi: 10.1152/ajpregu.00261.2017. Epub 2017 Sep 20. PMID: 28931547; PMCID: PMC5814694.
Keir DA, Fontana FY, Robertson TC, Murias JM, Paterson DH, Kowalchuk JM, Pogliaghi S. Exercise Intensity Thresholds: Identifying the Boundaries of Sustainable Performance. Med Sci Sports Exerc. 2015 Sep;47(9):1932-40. doi: 10.1249/MSS.0000000000000613. PMID: 25606817.
Jürimäe T, Sudi K, Payerl D, Leppik A, Jürimäe J, Müller R, Tafeit E. Relationships between bioelectric impedance and subcutaneous adipose tissue thickness measured by LIPOMETER and skinfold calipers in children. Eur J Appl Physiol. 2003 Sep;90(1–2):178–84. 10.1007/s00421-003-0878-3. Epub 2003 Jul 9. PMID: 14504951.. ( :. doi.
Chance B, Dait MT, Zhang C, Hamaoka T, Hagerman F. Recovery from exercise-induced desaturation in the quadriceps muscles of elite competitive rowers. Am J Physiol. 1992 Mar;262(3 Pt 1):C766-75. doi: 10.1152/ajpcell.1992.262.3.C766. PMID: 1312785.
Julian V, Thivel D, Pereira B, Costes F, Richard R, Duclos M. Improving Peripheral and Central Vascular Adjustments during Exercise through a Training Program in Adolescents with Obesity. Obes Facts. 2016;9(5):321–31. 10.1159/000447456. Epub 2016 Oct 4. PMID: 27701156; PMCID: PMC5644802.. ; ). doi.

Download PDF

Version 1

posted

You are reading this latest preprint version

Muscle deoxygenation and oxygen uptake plateau occurrence in children with obesity

Status:

Version 1

Abstract

Figures

Background

Methods

Results

Discussion

Conclusion

Abbreviations

Declarations

Funding

Author Contributions

References

Status:

Version 1