ArticlePDF Available

Effects of Two Different Recovery Postures during High-Intensity Interval Training


Abstract and Figures

The purpose of this study was to examine the effects of two different recovery postures, hands on head (HH) and hands on knees (HK), as a form of immediate recovery from high-intensity interval training (HIIT). Twenty female Division II varsity soccer players (age = 20.3 ± 1.1 yr, body mass index = 22.4 ± 1.80 kg·m−2) completed two experimental trials in a randomized, counterbalanced order. Each trial consisted of four intervals on a motorized treadmill consisting of 4 min of running (4 × 4) at 90%–95% HRmax with 3 min of passive recovery between each interval. HR recovery was collected during the first 60 s of each recovery, where volume of carbon dioxide (V[Combining Dot Above]CO2) and tidal volume (VT) were recorded each minute during the 3-min recovery period. Results showed an improved HR recovery (P < 0.001), greater VT (P = 0.008), and increased V[Combining Dot Above]CO2 (P = 0.049), with HK (53 ± 10.9 bpm; 1.44 ± 0.2 L·min−1, 1.13 ± 0.2 L·min−1) compared with HH (31 ± 11.3 bpm; 1.34 ± 0.2 L·min−1, 1.03 ± 0.2 L·min−1). These data indicate that HK posture may be more beneficial than the advocated HH posture as a form of immediate recovery from high-intensity interval training.
Content may be subject to copyright.
Downloaded from by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3oaxD/vH2r77jpRIOFoKoF4KSFGEPQIkEaNvXdaL22Dw= on 02/15/2019
Downloadedfrom by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3oaxD/vH2r77jpRIOFoKoF4KSFGEPQIkEaNvXdaL22Dw= on 02/15/2019
Effects of Two Different Recovery Postures
during High-Intensity Interval Training
Joana V. Michaelson, Lorrie R. Brilla, David N. Suprak, Wren L. McLaughlin, and Dylan T. Dahlquist
Athletes of all levels, from novice to elite, are constantly
looking for strategies to decrease time to recover and boost
athletic performance. It is well known that the respiratory
system plays a crucial role during rest and exercise via buffer-
ing metabolic by-products, such as hydrogen ions (H
carbon dioxide (CO
), to maintain the acidbase homeostasis
and minimizing dysregulation of the excitationcontraction
coupling process in localized muscle tissue (1). Failure to main-
tain this acidbase homeostasis during exercise can have detri-
mental effects on performance (2) and often arises when the
respiratory system lacks the ability to increase alveolar
ventilation, or exercise-induced diaphrag-
matic fatigue sets (3). Thus, increasing
ventilation could subsequently lead to an
increase in tidal volume (V
), a conserva-
tion of respiratory rate, and a more effi-
Consequently, researchers have investi-
gated the effects of different postures during
recovery from exercise and the physiologi-
cal responses to these varying recovery
postures (4,5,6). Most of the research has
focused on evaluating three different posi-
tions: supine, seated, and upright, with
upright standing posture being the most
widely used recovery posture in a sport
(field) setting (7). However, new literature
has begun to indicate that one can acceler-
ate intermediate recovery between exercise
bouts by maximizing the surface area of the diaphragmatic
zone of apposition (ZOA) (8); it has been shown that the
ZOA is maximized during spinal flexion rather than exten-
sion. Because of this, a standing posture with hands on head
(HH) may be less advantageous to postures that increase the
ZOA (e.g., flexed spine and hands on knees [HK]) (7). The
effects of HH versus HK on intermediate recovery and the ZOA
have yet to be investigated.
Furthermore, the position of recovery may also influence
autonomic function, which could lead to a quicker recovery
during performance (9). HR recovery (HRR) has been sug-
gested as a valuable tool in monitoring an athletes training sta-
tus and their response to certain training stimuli (10,11,12).
A faster HRR has been observed as a result of improvements
of aerobic capacity (13). Contrary to this, a delayed HRR re-
sults in impaired performance and a greater chance of fatigue
(12). Improved HRR in the supine position has been demon-
strated following repeated sprint exercise in youth soccer players
(14). HR is mediated by parasympathetic reactivation during
recovery from exercise. Baroreflex mediation and a prolonged
R-R interval in HR that occurs during exhalation is hypothe-
sized to improve the efficiency of gas exchange (15). However,
it is unknown if improved HRR during repeated work to rest
transitions in exercise influences subsequent performance in
trained subjects, especially in female athletes.
Because of the limited information on different standing
postures that could directly affect the ZOA and recovery in a
Exercise Physiology Laboratory, Health and Human Development Department,
Western, Washington University, Bellingham, WA
Address forcorrespondence:Lorrie R. Brilla, Ph.D., Health and Human Develop-
ment Department, Western Washington University, Carver 201L, 516 High
Street, Bellingham, WA 98225-9067 (E-mail:
2379-286 8/0404/00230027
Translational Journal of the ACSM
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on
behalf of the American College of Sports Medicine. This is an open-access arti-
cle distributed under the terms of the Creative Commons Attribution-Non Com-
mercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to
download and share the work provided it is properly cited. The work cannot be
changed in any way or used commercially without permission from the journal.
The purpose of this study was to examine the effects of two different recovery
postures, hands on head (HH) and hands on knees (HK), as a form of immediate
recovery from high-intensity interval training (HIIT). Twenty female Division II varsity
soccer players (age = 20.3 ± 1.1 yr, body mass index = 22.4 ± 1.80 kg·m
pleted two experimental trials in a randomized, counterbalanced order. Each trial
consisted of four intervals on a motorized treadmill consisting of 4 min of running
(4 4) at 90%95% HR
with 3 min of passive recovery between each interval.
HR recovery was collected during the first 60 s of each recovery, where volume of
carbon dioxide (V̇CO
) and tidal volume (V
) were recorded each minute during the
3-min recovery period. Results showed an improved HR recovery (P<0.001),
greater V
(P= 0.008), and increased V̇CO
(P= 0.049), with HK (53 ± 10.9 bpm;
1.44 ± 0.2 L·min
, 1.13 ± 0.2 L·min
) compared with HH (31 ± 11.3 bpm;
1.34 ± 0.2 L·min
, 1.03 ± 0.2 L·min
). These data indicate that HK posture
may be more beneficial than the advocated HH posture as a form of immediate
recovery from high-intensity interval training. Translational Journal of the ACSM 23
Original Investigation
controlled setting, this study was conducted to determine the
effect of using two different recovery postures during standing,
HH and HK on various cardiorespiratory functional mea-
sures. The study focused on observing minute ventilation
), carbon dioxide elimination (V
), and HRR during
the recovery intervals of high-intensity interval training (HIIT).
and frequency of breathing (f
) were used to calculate V
We hypothesized that there would be an effect of the recovery
postures, HH and HK, during the recovery period of HIIT on
Experimental Approach to the Problem
In this study, we aimed to determine whether HH and HK re-
covery postures have a differing influence on recovery of repeated
bouts of high-intensity exercise (full description insubsequent sec-
tions). The researchers examined how the two different postures
could influence cardiorespiratory function during HIIT. The
high-intensity interval exercises were performed on a treadmill
over an orientation session and two testing sessions where HRR,
carbon dioxide elimination (V
,), and tidal volume (V
determined during the recovery phase of the testing.
The study sample consisted of 24 female Division II soccer
players between the ages of 1822 yr old (20.3 ± 1.1 yr). All sub-
jects were in their winter training season when they began partic-
ipation in the study, had familiarization with HIIT protocol
training, and were instructed to not modify their current training
routine. Subjects did not partake in any high-intensity activity the
day before testing, so that fatigue from previous activity would
not affect testing sessions. Subjects refrained from consuming
any caffeine the day of testing and obtained a minimal of 7 h of
sleep the night before. Uniform verbal encouragement was given
to all subjects during all treadmill running sessions. Over the dura-
tion of the study, four subjects dropped out. Three subjects
dropped out due to time conflicts with their scheduled testing
times, and one subjects information was dropped due to incom-
plete data collection, which resulted in a final subject pool of
20 participants. Table 1 presents subject characteristics and spi-
rometer measures in all 20 subjects. All subjects were informed
of protocol, experimental risks, and time involved to complete
the study, and they completed an informed consent document
before partaking in the investigation. The research project was
reviewed and approved by Western Washington UniversitysHu-
man Subjects Committee.
Each subject completed 1 d of baseline measurements, which
included anthropometric measures and pulmonary function tests
before testing. The measures were body mass index, vital capacity,
forced expired volume in 1 s, forced expired volume in 1 s/vital
capacity ratio, and maximum voluntary ventilation. Pulmonary
measures were collected using a Parvomedics spirometer. The
recovery postures were taught and practiced during the baseline
measurement session. HH required them to stand erect with their
hands clasped on top of their head (see Fig. 1). HK required them
to place their hands on their knees, elbows locked, and flexing
through the thoracic region of the spine (see Fig. 2). HK required
additional measurement of thoracic flexion with inclinometers
(Universal Inclinometers; Lindstrom, Chisago County, MN) to
ensure at least 10° of flexion and assure consistency of posture
during recovery intervals (6). Two inclinometers were used to
measure thoracic flexion at T1 and T12.
A multiple participant, within-subject design was conducted.
Subjects were randomly designated a recovery posture to perform,
with the alternate posture for the subsequent testing day. Subjects
performed a total of two treadmill sessions of HIIT separated by
1 wk, which consisted of 4 min of running and 3 min of recovery
Subject Characteristics and Resting Pulmonary Measures.
Subjects 20
Age (yr) 20.3 ± 1.1
Height (m) 1.71 ± 0.10
Body Weight (kg) 65 ± 6.7
BMI (kg·m
VC (L) 4.0 ± 0.6
(L) 3.1 ± 0.4
/VC (%) 80.0 ± 0.1
MVV (L·min
Data are presented as mean ± SD. BMI, body mass index; FEV, forced expired
volume; VC, vital capacity; MVV, maximum voluntary ventilation.
Figure 1: HH recovery posture.
24 Volume 4 Number 4 February 15 2019 Recovery Postures in High-Intensity Training
performed four times (4 4 min), assuming one of the two recov-
ery postures during the recovery period. The submaximal runs
were performed in the same laboratory on the same motorized
treadmill (Precor Treadmill, Woodinville, WA) for each visit. In-
tensities were set to mimic typical training intensities one experi-
ences in the field, set at 90%95% of predicted HR
from the 220 minus age equation (16). Upon arrival, subjects were
fitted with an HR monitor (Polar T31 Transmitter; Polar,
Kempele, Finland) and commenced a familiarization session to
the subsequent exercise challenges. Subjects returned for a total
of two testing sessions, separated by 1 wk. Each session consisted
of a 5-min warm-up at a running speed that elicited 70% of their
at 0% grade on a treadmill followed by four running inter-
vals at an intensity of 9095% of HR
for 4 min, with a 3-min
passive recovery between runs, assuming either HH or HK
postures during recovery. Throughout the 3-min recovery, each
subject was fixed with nose clip and a two-way breathing mouth-
piece valve interfaced with the metabolic cart (Parvomedics
TrueOne Metabolic Cart and Spirometer, Sandy, UT). V
were measured every minute over the recovery period.
was calculated by dividing V˙
by f
. The averages of the respi-
ratory variables during the 3-min recovery were determined and
averaged over the four intervals. HRR is commonly defined as
the difference in HR at the end of exercise and then 60 s later
(17). Similarly, in this study, HRR was measured immediately at
the end of the exercise for 1 min.
Statistical Analysis
Descriptive statistics were determined for each variable. De-
pendent t-tests were used to detect significant differences due to
the two treatments using the Statistical Package for the Social Sci-
ences for Windows (version 25; SPSS Inc., Chicago, IL). The
dependent variables analyzed included HRR, V
ing each recovery posture. Significance was defined as a P0.05.
Cohensdwas calculated for effect size.
Subject characteristics and resting pulmonary measures
are presented in Table 1. Comparison of HRR data revealed
a significant difference between HH and HK postures. HK
posture resulted in significantly faster decrease in HR between
intervals than that of the HH posture, 53 ± 10.9 versus
31 ± 11.3 bpm (P< 0.001). The effect size was very large,
d= 1.98. Figure 1 shows the mean and standard deviation of
HRR in both postures. A difference of 22 bpm between HK
and HH was noted.
was averaged over the four recovery intervals to get a
mean recovery V˙CO
for each posture. The statistically signif-
icant (P< 0.05) effect of the postures was evident between con-
ditions, HK 1.1 ± 0.2 and HH 1.0 ± 0.2 L·min
, respectively
(Fig. 2). The effect size was medium, d=0.5.Therewasasig-
nificant difference (P< 0.05) between HH and HK postures for
. There was a medium effect size, d= 0.5. The HK posture sig-
nificantly increased V
compared with the HH posture V
(1.4 ± 0.2 vs 1.3 ± 0.2 L·min
reveals the difference in V
values between the two postures.
HK posture required additional measurement of thoracic
flexion with inclinometers (Universal Inclinometers, Lindstrom)
during the rest interval to assure consistency of flexion between
each rest interval. Averages of thoracic flexion were recorded at
each rest interval and were 14.6 ± 4.4°, 15.5 ± 7.0°, 17.6 ± 7.6°,
and 19.5 ± 8.2° for rest intervals 1 through 4, respectively.
The present study investigated the effects of two different
intermediate recovery postures (HH vs HK) on repeated sprint
ability in trained female soccer athletes. The results from the
investigation show an improved HRR and greater V
with HK posture when compared with HH posture
after fatiguing high-intensity intervals. There was substantial
improvement in HRR when athletes performed HK (22 bpm
improvement) vs HH.
HK posture causes thoracic flexion and internal rotation
of the rib cage, which has been reported to optimize the ZOA
(18,19). Optimizing the ZOA allows the diaphragm to operate
with maximal efficiency (8). This could explain the greater
cardiorespiratory response seen in the HK condition, which
has been reported in individuals experiencing chronic ob-
structive pulmonary disease and their reduced feelings of dys-
pnea (20,21,22). On average, subjects exhibited an increase in
first rest to 19.5 ± 8.2° in the fourth rest interval during HK pos-
ture. The increase in thoracic flexion with each rest interval may
infer a natural increase in thoracic flexion with fatigue and exer-
cise, further enhancing the ZOA. By contrast, HH posture pro-
motes thoracic extension, which is associated with external
rotation of the rib cage and reduced ZOA (8). This mechanical
linkage between the diaphragm and ribcage (23) could explain
why individuals had a higher HRR after the recovery periods
in the HK versus HH postures.
Figure 2: HK recovery posture. Translational Journal of the ACSM 25
Furthermore, HH posture places the diaphragm in a subop-
timal position, decreasing its mechanical efficiency. A decrease
in the ZOA reduces the ability of the diaphragm to contract
effectively because of its poor position along its lengthtension
curve (10,12). Elevating the arms to 90° or more of shoulder
flexion, as observed with HH posture, changes the impedance
of the torso, rib cage, and abdominal wall (24,25,26). Raising
the arms causes a passive stretch of the thoracic wall and ab-
dominal muscles (overlengthened position), which may place
them in a less effective position for assisting in respiration.
An overlengthened abdominal region may reduce its ability
to effectively oppose the diaphragm, leading to less effective
respiratory mechanics (11,18). These muscle length differences
could explain the discrepancies observed between HH and HK
postures in the current study.
The present study showed increased V
values with
HK when compared with HH. It is suggested that the
HK posture improved exhalation ability of the abdominal
muscles, leading to a slight increase in V
exhibiting an
improved ventilatory profile response. Cavalheri et al. (27)
investigated the effects of arm bracing on respiratory muscle
strength and pulmonary function in patients with chronic ob-
structive pulmonary disease. The results showed greater
maximal inspiratory and expiratory pressures with arms
braced when compared with unbraced arms. The results of
the previous study along with the findings of the present
study suggest that bracing the arms improves respiratory
function by decreasing the postural demands of these mus-
cles, diaphragm, intercostal, abdominals, and accessory
muscles during HK.
Kera and Maruyama (21) further supported this idea of im-
proved force generating capabilities with a braced posture.
They examined the effects of posture on respiratory activity
of the abdominal muscles. The results showed an increased
abdominal activity with the braced position (seated, elbows
on knees) and was attributed to the enhanced position of the
abdominals during trunk flexion. The authors suggested that
the abdominals in this position elicited a greater stretch reflex
during expiration, thereby increasing inspiration and a reduced
feeling of dyspnea in the subjects. Furthermore, diseased popu-
lations in previous studies are known to have a low tolerance
to arm activities that is not only determined by strength or en-
durance but by position of the arm itself (28). Arm elevation at
90° shoulder flexion greatly exacerbates respiratory function,
altering static ventilatory responses when compared with arms
down and below 90° shoulder flexion (28). A study by Couser
et al. (24) examined respiratory and ventilatory muscle recruit-
ment with arms elevated and arms down in healthy subjects.
They reported an increase in metabolic demand (V
, and HR) with arms elevated when compared with
arms down. These findings were associated with additional
increases in V
. In contrast to the present study, those subjects
were seated and did not perform high-intensity bouts of exer-
cise before measurement of cardiorespiratory variables. The
arm positions also differed in both studies and did not follow
similar protocols. Our results showed that V
was similar in
HH and HK (40.4 and 39.4 L·min
was significantly greater with HK (1.4 L·min
) compared
with HH (1.3 L·min
). Couser et al. (24) attributed the in-
crease in V
with arms elevated to increased V
and accessory
muscle activity, which could explain the discrepancies seen be-
tween the studies. Similarly, in the present study, there was a
significant increase in V
with HK in comparison with HH,
suggesting an improved work of breathing when adopting
HK posture. Subjects also subjectively reported more ease in
breathing in the HK posture versus the HH posture. The im-
provement in HRR with HK posture may be attributed to
the improved respiratory mechanics with HK posture, thereby
influencing participantsHR.
In addition, posture may have also influenced the interac-
tions between respiration and neurocardiovascular control of
recovery from exercise. An autonomic effect may also be
influencing the observed accelerated rate of HRR due to the al-
terations on the parasympathetic reactivation (29). The effect
of posture on HRR and parasympathetic reactivation after
exercise has been described for supine, sitting, and standing
(5,7,9,30). Specific to the present study, improved HRR was
demonstrated after repeated sprint exercise after the HK pos-
ture. Consistently, supine posture results in accelerated HRR
and has been documented in soccer players (14). However,
the supine position is not a practical alternative for athletes
recovering from repeated sprints in game competition. Thus,
Figure 3: Mean ± SD of HRR, volume of carbon dioxide (V̇CO
), and tidal volume (V
) over the four rest intervals in HH and HK postures. Error bars are
set at mean ± SD. * Results are significantly different between groups (P<0.05).
26 Volume 4 Number 4 February 15 2019 Recovery Postures in High-Intensity Training
the results from this study indicate HK as a viable option when
supine positions are not feasible.
The ability to recover faster from multiple bouts of exer-
cise is a crucial part of optimizing performance for athletes in
a variety of sports, such as soccer, rugby, basketball, and
American football. Thus, using the best recovery modality, in
this case posture during HIIT, is crucial to minimize fatigue
and potential injuries due to altered biomechanics from the
taxing exercise. On the basis of the findings in this study, HK
posture significantly improved HRR, V
in compari-
son with HH posture. The positive effects of HK posture on
may suggest improved parasympathetic in-
fluences and cardiorespiratory mechanics when adopting this
posture during a recovery period from a fatiguing exercise.
The authors acknowledge the players of Western Washington
University womens soccer team for their participation in the study.
The results of the present study do not constitute endorsement by
the American College of Sports Medicine. The results of the study
are presented clearly, honestly, and without fabrication, falsification,
or inappropriate data manipulation.
All authors declare no conflict of interest. The authors received
no specific funding for this work.
1. Stringer W, Casaburi R, Wasserman K. Acidbase regulation during exercise
and recovery in humans. JApplPhysiol. 1992;72(3):95461.
2. Costill DL, Verstappen F, Kuipers H, Janssen E, Fink W. Acidbase balance
during repeated bouts of exercise: influence of HCO
.Int J Sports Med.
3. Guenette JA, Sheel AW.Physiologicalconsequences of a highwork of breath-
ing during heavy exercise in humans. J Sci Med Sport. 2007;10(6): 34150.
4. Takahashi T, Hayano J, Okada A, Saitoh T, Kamiya A. Effects of the muscle
pump and body posture on cardiovascular responses during recovery from
cycle exercise. Eur J Appl Physiol.2005;94(56):57683.
5. Takahashi T, Okada A, Saitoh T, Hayano J, Miyamoto Y. Difference in human
cardiovascular response between upright and supine recovery from upright
cycle exercise. Eur J Appl Physiol. 2000;81(3):2339.
6. Taoutaou Z, Granier P, Mercier B, Mercier J, Ahmaidi S, Prefaut C. Lactate ki-
netics duringpassive and partially active recovery in endurance and sprint ath-
letes. Eur J Appl Physiol Occup Physiol.1996;73(5):46570.
7. Buchheit M, Al Haddad H, Laursen PB, Ahmaidi S. Effect of body posture on
postexercise parasympathetic reactivation in men. Exp Physiol.2009;94:
8. Boyle KL,Olinick J, Lewis C. Thevalue of blowing up a balloon. NAmJSports
Phys Ther. 2010;5(3):1 7988.
9. Javorka M, Zila I, Balhárek T, Javorka K. Heart rate recovery after exercise: re-
lationsto heart rate variability and complexity.Br az J Med Biol Res.2002;35(8):
10. Borresen J, Lambert MI. Changes in heart rate recovery in response to acute
changes in training load. Eur J Appl Physiol. 2007;101:50311.
11. Boutellier U, Büchel R, Kundert A, Spengler C. The respiratory system as an
exercise limiting factor in normal trained subjects. Eur J Appl Physiol Occup
12. Lamberts RP, Swart J, Capostagno B, Noakes TD, Lambert MI. Heart rate re-
covery as a guide to monitor fatigue and predict changes in performance pa-
rameters. Scand J Med Sci Sports.2010;20(3):44957.
13. Yamamoto K, Miyachi M, Saitoh T, Yoshioka A, Onodera S. Effects of endur-
ance training on resting and post-exercisecardiac autonomiccontrol. Med Sci
Sports Exerc. 2001;33(9):1496502.
14. Buchheit M, Simpson MB, Al Haddad H, Bourdon PC, Mendez-Villanueva A.
Monitoring changes in physical performance with heart rate measures in
young soccer players. Eur J Appl Physiol. 2012;112:71123.
15. HayanoJ, Yasuma F, Okada A, Mukai S, Fujinami T. Respiratory sinusarrhyth-
mia: a phenomenon improving pulmonary gas exchange and circulatory effi-
ciency. Circulation. 1996;94(4):8427.
16. Fox SM, Haskell WL. The exercise stress test: needs for standardization. In:
Eliakim M, Neufeld HN, editors. Cardiology: Current Topics and Progress.
New York: Academic Press; 1970, pp. 14954.
17. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate re-
covery immediately after exercise as a predictor of mortality. N Engl J Med.
18. Hruska RJ Jr. Influences of dysfunctional respiratory mechanics on orofacial
pain. Dent Clin North Am. 1997;41(2):21127.
19. Lando Y, Boiselle PM, Shade D, et al. Effect of lung volume reduction surgery
on diaphragm length in severe chronic obstructive pulmonary disease. Am J
Respir Crit Care Med. 1999;159( 3):796805.
20. Ba A, Delliaux S, Bregeon F, Levy S, Jammes Y. Post-exercise heart rate re-
covery in healthy, obeses, and COPD subjects: relationships with blood lactic
acid and PaO
levels. Clin Res Cardiol.2009;98(1):528.
21. Kera T, Maruyama H. The effect of posture on respiratory activity of the ab-
dominal muscles. J Physiol Anthropol Appl Human Sci. 2005;24(4 ):25965.
22. Perini R, Veicsteinas A. Heart rate variability and autonomic activity at rest and
during exercise in various physiological conditions. Eur J Appl Physiol.2003;
23. Mead J. Functional significance of the area of apposition of diaphragm to rib
cage. Am Rev Respir Dis. 1979;119(2 Pt 2):312.
24. Couser JI Jr, Martinez FJ,Celli BR. Respiratory response and ventilatory mus-
cle recruitment during arm elevation in normal subjects. Chest. 1992;101(2):
25. Dick TE, Hsieh YH, Dhingra RR, et al. Cardiorespiratory coupling: common
rhythms in cardiac, sympathetic, and respiratory activities. Prog Brain Res.
26. McKeough ZJ, Alison JA, Bye PT. Arm positioning alters lungvolumes in sub-
jects with COPD and healthy subjects. Aust J Physiother. 2003;49(2):1337.
27. Cavalheri V, Camillo CA, Brunetto AF, Probst VS, Ramos EM, Pitta F. Effects
of arm bracing posture on respiratory musclestrength and pulmonary function
in patients with chronic obstructive pulmonary disease. Rev Port Pneumol.
28. Dolmage TE, Maestro L, Avendano MA, Goldstein RS. The ventilatory re-
sponse to arm elevation of patients with chronic obstructive pulmonary dis-
ease. Chest J. 1993;104(4):1 097100.
29. BarakOF, Ovcin ZB, Jakovljevic DG, Lozanov-Crvenkovic Z, BrodieDA, Grujic
NG. Heart rate recovery after submaximal exercise in four different recovery
protocols in male athletes and non-athletes. JSportsSciMed.2011;10:
30. ONeill S, McCarthy DS. Postural relief of dyspnoea in severe chronic airflow
limitation: relationship to respiratory muscle strength. Thorax. 1983;38(8):
595600. Translational Journal of the ACSM 27
... Although the 30-s "tired runner's pose" had the lowest average AUROC (0.77, IQR: 0.67-1.00), the performance would still be considered fair [40]. The model's performance on the shorter postural movements (i.e., toe-touches and "tired runner" pose) indicated that postural changes with movements commonly performed in athletic settings have the potential to be used for hydration assessments; these postural changes are likely to be seen when individuals are maximizing their recovery between repeated bouts of activity (e.g., during games/practices) [42]. The high average performance and tight inter-quartile ranges across participants also demonstrated the robustness of our model. ...
Full-text available
Dehydration beyond 2% bodyweight loss should be monitored to reduce the risk of heat-related injuries during exercise. However, assessments of hydration in athletic settings can be limited in their accuracy and accessibility. In this study, we sought to develop a data-driven noninvasive approach to measure hydration status, leveraging wearable sensors and normal orthostatic movements. Twenty participants (10 males, 25.0 ± 6.6 years; 10 females, 27.8 ± 4.3 years) completed two exercise sessions in a heated environment: one session was completed without fluid replacement. Before and after exercise, participants performed 12 postural movements that varied in length (up to 2 min). Logistic regression models were trained to estimate dehydration status given their heart rate responses to these postural movements. The area under the receiver operating characteristic curve (AUROC) was used to parameterize the model’s discriminative ability. Models achieved an AUROC of 0.79 (IQR: 0.75, 0.91) when discriminating 2% bodyweight loss. The AUROC for the longer supine-to-stand postural movements and shorter toe-touches were similar (0.89, IQR: 0.89, 1.00). Shorter orthostatic tests achieved similar accuracy to clinical tests. The findings suggest that data from wearable sensors can be used to accurately estimate mild dehydration in athletes. In practice, this method may provide an additional measurement for early intervention of severe dehydration.
Full-text available
The effects of different recovery protocols on heart rate recovery (HRR) trend through fitted heart rate (HR) decay curves were assessed. Twenty one trained male athletes and 19 sedentary male students performed a submaximal cycle exercise test on four occasions followed by 5 min: 1) inactive recovery in the upright seated position, 2) active (cycling) recovery in the upright seated position, 3) supine position, and 4) supine position with elevated legs. The HRR was assessed as the difference between the peak exercise HR and the HR recorded following 60 seconds of recovery (HRR 60). Additionally the time constant decay was obtained by fitting the 5 minute post-exercise HRR into a first-order exponential curve. Within-subject differences of HRR 60 for all recovery protocols in both groups were significant (p < 0.001) except for the two supine positions (p > 0.05). Values of HRR60 were larger in the group of athletes for all conditions (p < 0.001). The time constant of HR decay showed within-subject differences for all recovery conditions in both groups (p < 0.01) except for the two supine positions (p > 0.05). Between group difference was found for active recovery in the seated position and the supine position with elevated legs (p < 0.05). We conclude that the supine position with or without elevated legs accelerated HRR compared with the two seated positions. Active recovery in the seated upright position was associated with slower HRR compared with inactive recovery in the same position. The HRR in athletes was accelerated in the supine position with elevated legs and with active recovery in the seated position compared with non-athletes.
Full-text available
Recently, we have shown that an untrained respiratory system does limit the endurance of submaximal exercise (64% peak oxygen consumption) in normal sedentary subjects. These subjects were able to increase breathing endurance by almost 300% and cycle endurance by 50% after isolated respiratory training. The aim of the present study was to find out if normal, endurance trained subjects would also benefit from respiratory training. Breathing and cycle endurance as well as maximal oxygen consumption ( [(V)\dot]O2 max\dot VO_{2 max} ) and anaerobic threshold were measured in eight subjects. Subsequently, the subjects trained their respiratory muscles for 4 weeks by breathing 85-1601 min–1 for 30 min daily. Otherwise they continued their habitual endurance training. After respiratory training, the performance tests made at the beginning of the study were repeated. Respiratory training increased breathing endurance from 6.1 (SD 1.8) min to about 40 min. Cycle endurance at the anaerobic threshold [77 (SD 6) % [(V)\dot]O2 max\dot VO_{2 max} ] was improved from 22.8 (SD 8.3) min to 31.5 (SD 12.6) min while [(V)\dot]O2 max\dot VO_{2 max} and the anaerobic threshold remained essentially the same. Therefore, the endurance of respiratory muscles can be improved remarkably even in trained subjects. Respiratory muscle fatigue induced hyperventilation which limited cycle performance at the anaerobic threshold. After respiratory training, minute ventilation for a given exercise intensity was reduced and cycle performance at the anaerobic threshold was prolonged. These results would indicate the respiratory system to be an exercise limiting factor in normal, endurance trained subjects.
Full-text available
The aim of the present study was to verify the validity of using exercise heart rate (HRex), HR recovery (HRR) and post-exercise HR variability (HRV) during and after a submaximal running test to predict changes in physical performance over an entire competitive season in highly trained young soccer players. Sixty-five complete data sets were analyzed comparing two consecutive testing sessions (3–4 months apart) collected on 46 players (age 15.1 ± 1.5 years). Physical performance tests included a 5-min run at 9 km h−1 followed by a seated 5-min recovery period to measure HRex, HRR and HRV, a counter movement jump, acceleration and maximal sprinting speed obtained during a 40-m sprint with 10-m splits, repeated-sprint performance and an incremental running test to estimate maximal cardiorespiratory function (end test velocity V Vam-Eval). Possible changes in physical performance were examined for the players presenting a substantial change in HR measures over two consecutive testing sessions (greater than 3, 13 and 10% for HRex, HRR and HRV, respectively). A decrease in HRex or increase in HRV was associated with likely improvements in V Vam-Eval; opposite changes led to unclear changes in V Vam-Eval. Moderate relationships were also found between individual changes in HRR and sprint [r = 0.39, 90% CL (0.07;0.64)] and repeated-sprint performance [r = −0.38 (−0.05;−0.64)]. To conclude, while monitoring HRex and HRV was effective in tracking improvements in V Vam-Eval, changes in HRR were moderately associated with changes in (repeated-)sprint performance. The present data also question the use of HRex and HRV as systematic markers of physical performance decrements in youth soccer players.
Cardiorespiratory coupling is an encompassing term describing more than the well-recognized influences of respiration on heart rate and blood pressure. Our data indicate that cardiorespiratory coupling reflects a reciprocal interaction between autonomic and respiratory control systems, and the cardiovascular system modulates the ventilatory pattern as well. For example, cardioventilatory coupling refers to the influence of heart beats and arterial pulse pressure on respiration and is the tendency for the next inspiration to start at a preferred latency after the last heart beat in expiration. Multiple complementary, well-described mechanisms mediate respiration's influence on cardiovascular function, whereas mechanisms mediating the cardiovascular system's influence on respiration may only be through the baroreceptors but are just being identified. Our review will describe a differential effect of conditioning rats with either chronic intermittent or sustained hypoxia on sympathetic nerve activity but also on ventilatory pattern variability. Both intermittent and sustained hypoxia increase sympathetic nerve activity after 2 weeks but affect sympatho-respiratory coupling differentially. Intermittent hypoxia enhances sympatho-respiratory coupling, which is associated with low variability in the ventilatory pattern. In contrast, after constant hypobaric hypoxia, 1-to-1 coupling between bursts of sympathetic and phrenic nerve activity is replaced by 2-to-3 coupling. This change in coupling pattern is associated with increased variability of the ventilatory pattern. After baro-denervating hypobaric hypoxic-conditioned rats, splanchnic sympathetic nerve activity becomes tonic (distinct bursts are absent) with decreases during phrenic nerve bursts and ventilatory pattern becomes regular. Thus, conditioning rats to either intermittent or sustained hypoxia accentuates the reciprocal nature of cardiorespiratory coupling. Finally, identifying a compelling physiologic purpose for cardiorespiratory coupling is the biggest barrier for recognizing its significance. Cardiorespiratory coupling has only a small effect on the efficiency of gas exchange; rather, we propose that cardiorespiratory control system may act as weakly coupled oscillator to maintain rhythms within a bounded variability.
Cardiovascular responses were examined in seven healthy male subjects during 10 min of recovery in the upright or supine position following 5 min of upright cycle exercise at 80% peak oxygen uptake. An initial rapid decrease in heart rate (f c) during the early phase of recovery followed by much slower decrease was observed for both the upright and supine positions. The average f c at the 10th min of recovery was significantly lower (P < 0.05) in the supine position than in the upright position, while they were both significantly greater than the corresponding pre-exercise levels (each P < 0.05). Accordingly, the amplitude of the high frequency (HF) component of R-R interval variability (by spectrum analysis) in both positions was reduced with a decrease in mean R-R interval, the relationship being expressed by a regression line – mean R-R interval = 0.006 × HF amplitude + 0.570 (r = 0.905, n = 28, P < 0.001). These results would suggest that the slower reduction in f c following the initial rapid reduction in both positions is partly attributable to a retardation in the restoration of the activity of the cardiac parasympathetic nervous system. Post-exercise upright stroke volume (SV, by impedance cardiography) decreased gradually to just below the pre-exercise level, whereas post-exercise supine SV increased markedly to a level similar to that at rest before exercise. The resultant cardiac output (Q˙ c) and the total peripheral vascular resistance (TPR) in the upright and supine positions returned gradually to their respective pre-exercise levels in the corresponding positions. At the 10th min of recovery, both average SV and Q˙ c were significantly greater (each P < 0.005) in the supine than in the upright position, while average TPR was significantly lower (P < 0.05) in the supine than in the upright position. In contrast, immediately after exercise, mean blood pressure dropped markedly in both the supine and upright positions, and their levels at the 10th min of recovery were similar. Therefore we concluded that arterial blood pressure is maintained relatively constant through various compensatory mechanisms associated with f c, SV, Q˙ c, and TPR during rest and recovery in different body positions.
Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. A therapeutic exercise that promotes optimal posture (diaphragm and lumbar spine position), and neuromuscular control of the deep abdominals, diaphragm, and pelvic floor (lumbar-pelvic stabilization) is desirable for utilization with patients who demonstrate suboptimal respiration and posture. This clinical suggestion presents a therapeutic exercise called the 90/90 bridge with ball and balloon. This exercise was designed to optimize breathing and enhance both posture and stability in order to improve function and/or decrease pain. Research and theory related to the technique are also discussed.
To analyze the effect of arm bracing posture on respiratory muscle strength and pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD). 20 patients with COPD (11 male; 67 ± 8 years; BMI 24 ± 3 Kg · m⁻²) were submitted to assessments of Maximal Inspiratory and Expiratory Pressures (MIP and MEP, respectively) and spirometry with and without arm bracing in a random order. The assessment with arm bracing was done on standing position and the height of the support was adjusted at the level of the ulnar styloid process with elbow flexion and trunk anterior inclination of 30 degrees promoting weight discharge in the upper limbs. Assessment without arm bracing was also performed on standing position, however with the arms relaxed alongside the body. The time interval between assessments was one week. MIP, MEP and maximal voluntary ventilation (MVV) were higher with arm bracing than without arm bracing (MIP 64 ± 22 cmH₂O versus 54 ± 24 cmH₂O, p = 0,00001; MEP 104 ± 37 cmH₂O versus 92 ± 37 cmH₂O, p = 0,00001 and MVV 42 ± 20 L/min versus 38 ± 20 L/min, p = 0,003). Other variables did not show statistical significant difference. The arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD.
Determining the optimal balance between training load and recovery contributes to peak performance in well-trained athletes. The measurement of heart rate recovery (HRR) to monitor this balance has become popular. However, it is not known whether the impairment in performance, which is associated with training-induced fatigue, is accompanied by a change in HRR. Therefore, the aim of this study was to retrospectively analyze the relationship between changes in HRR and cycling performance in a group of well-trained cyclists (n=14) who participated in a 4-week high-intensity training (HIT) program. Subjects were assigned to either a group that continuous had a increase in HRR (G(Incr)) or a group that showed a decrease in HRR (G(Decr)) during the HIT period. Both groups, G(Incr) and G(Decr), showed improvements in the relative peak power output (P=0.001 and 0.016, respectively) and endurance performance parameters (P=0.001 and <0.048, respectively). The average power during the 40-km time trial (40-km TT), however, improved more in G(Incr) (P=0.010), resulting in a tendency for a faster 40-km TT time (P=0.059). These findings suggest that HRR has the potential to monitor changes in endurance performance and contribute to a more accurate prescription of training load in well-trained and elite cyclists.