A brief review of the use of near infrared spectroscopy with particular interest in resistance exercise

There is growing interest in resistance training, but many aspects related to this type of exercise are still not fully understood. Performance varies substantially depending on how resistance training variables are manipulated. Fatigue is a complex phenomenon usually attributed to central (neuronal) and/or peripheral (muscular) origin. Cerebral oxygenation may be associated with the decision to stop exercise, and muscle oxygenation may be related to resistance training responses. Near infrared spectroscopy (NIRS) is a non-invasive optical technique used to monitor cerebral and muscle oxygenation levels. The purpose of this review is to briefly describe the NIRS technique, validation and reliability, and its application in resistance exercise. NIRS-measured oxygenation in cerebral tissue has been validated against magnetic resonance imaging during motor tasks. In muscle tissue, NIRS-measured oxygenation was shown to be highly related to venous oxygen saturation and muscle oxidative rate was closely related to phosphocreatine resynthesis, measured by (31)P-magnetic resonance spectroscopy after exercise. The test-retest reliability of cerebral and muscle NIRS measurements have been established under a variety of experimental conditions, including static and dynamic exercise. Although NIRS has been used extensively to evaluate muscle oxygenation levels during aerobic exercise, only four studies have used this technique to examine these changes during typical resistance training exercises. Muscle oxygenation was influenced by different resistance exercise protocols depending on the load or duration of exercise, the number of sets and the muscle being monitored. NIRS is a promising, non-invasive technique that can be used to evaluate cerebral and muscle oxygenation levels simultaneously during exercise, thereby improving our understanding of the mechanisms influencing performance and fatigue.     

Monitoring tissue oxygen availability with near infrared spectroscopy (NIRS) in health and disease

Near infrared spectroscopy (NIRS) is becoming a widely used research instrument to measure tissue oxygen (O2) status non-invasively. Continuous-wave spectrometers are the most commonly used devices, which provide semi-quantitative changes in oxygenated and deoxygenated hemoglobin in small blood vessels (arterioles, capillaries and venules). Refinement of NIRS hardware and the algorithms used to deconvolute the light absorption signal have improved the resolution and validity of cytochrome oxidase measurements. NIRS has been applied to measure oxygenation in a variety of tissues including muscle, brain and connective tissue, and more recently it has been used in the clinical setting to assess circulatory and metabolic abnormalities. Quantitative measures of blood flow are also possible using NIRS and a light-absorbing tracer, which can be applied to evaluate circulatory responses to exercise along with the assessment of tissue O2 saturation. The venular O2 saturation can be estimated with NIRS by applying venous occlusion and measuring changes in oxygenated vs. total hemoglobin. These various measurements provide the opportunity to evaluate several important metabolic and circulatory patterns in very localized regions of tissue and may be fruitful in the study of occupational syndromes and a variety of diseases.     

Near-infrared spectroscopy: what can it tell us about oxygen saturation in skeletal muscle?

Near-infrared spectroscopy (NIRS) measures hemoglobin saturation in small vessels. A number of interesting studies have used this method. However, difficulties with signal quantification and studies in which NIRS oxygen saturation did not behave as expected raise concerns. NIRS remains promising for studies of skeletal muscle, but a better understanding of the method is needed.     

Effect of muscle tensing on cerebral oxygen status during sustained high +Gz

BACKGROUND: Successful monitoring of oxyhemoglobin during +Gz exposure was recently achieved using near-infrared spectroscopy (NIRS). To assess the effects of muscle tensing on sustained +Gz tolerance, we measured muscle activity and cerebral oxygen status (COS) during anti-G straining maneuvers at sustained high +Gz. METHOD: We exposed 21 male pilots wearing CSU-13/P anti-G suit to two different centrifuge profiles: 1) short-term repeated exposure (5 to 20 s) at 4, 5, 6, 5.5, or 7 Gz; 2) sustained exposure to a + 7Gz plateau for 30 s. During the Gz exposures, surface electromyographic (EMG) measurements were taken from the vastus medialis (VM) and rectus abdominis (RA) muscles. At the same time, the COS was recorded from the left forehead area using a commercial NIRS system. Mean muscular tensing for each muscle was calculated as a percentage of maximal voluntary contraction (% MVC). RESULTS: Oxyhemoglobin (O2Hb) and total hemoglobin (sum of O2Hb and deoxyhemoglobin) were decreased during both short-term and sustained +Gz exposure. RA muscle tensing was positively correlated with changes in the concentration of O2Hb during sustained + 7Gz exposure (r = 0.540, p < 0.05). RA tensing ranged from 6.2 to 36.8%MVC, and O2Hb ranged from -41.3 to -7.28 micromol x L(-1) during the exposures. No significant correlation was observed between VM tensing and O2Hb. CONCLUSION: NIRS measurements confirmed that a muscle straining maneuver increases G tolerance. Higher RA muscle tensing helps preserve brain blood volume during sustained high +Gz.     

Comparison of oxygenation kinetics measured by different placements of the NIRS probe during sustained isometric gripping

The purpose of this study was to compare oxygenation kinetics measured by slightly different placements of a near-infrared spectroscopy (NIRS) probe during sustained isometric gripping. Oxygenation kinetics of sixteen young adult males was measured with two NIRS probes attached to the flexor carpiradialis muscle during gripping for 3 min. One probe (channel 1) was attached at one-third the length of a line from the medial epicondyle of the humerus to the styloid process of radius. Another probe (channel 2) was attached at the palmaris longus. Although the cross-correlation coefficients for the two probe placements regarding oxygenated hemoglobin (oxy-Hb/Mb), deoxygenated hemoglobin (deoxy-Hb/Mb) and tissue oxygenation saturation (StO₂) were low (r_xy, 0.119–0.405), Pearson’s correlation coefficients for the times to reach almost steady state for these parameters were very high (oxy-Hb/Mb, r=0.878; deoxy-Hb/Mb, r=0.769; StO₂, r=0.843; p<0.05). The difference of oxygenation kinetics between the probe placements may reflect the difference of fiber recruitment characteristics in the flexion muscle group. In conclusion, to obtain a stable measurement, it is important that the NIRS probe is placed at the same anatomical point.     

Hemoglobin near-infrared spectroscopy and surface EMG study in muscle ischaemia and fatiguing isometric contraction.

BACKGROUND: To assess how muscle ischaemia and isometric fatiguing contraction influence oxygen content in striated muscle. METHODS: We simultaneously measured changes in hemoglobin near-infrared (NIR) spectroscopy and in surface EMG before, during, and after muscle ischaemia and ischaemia plus muscle isometric fatiguing contraction. Seventeen healthy male subjects (age range: 19-40 yrs) were examined in our Clinical Neurophysiology Unit. Test I (9 subjects): hemoglobin NIR spectroscopy and stimulated surface EMG were measured for 2 minutes at rest, for 4 minutes during complete ischaemia of tibialis anterior muscle, and for twelve minutes during recovery. Test II (all subjects): hemoglobin NIR spectroscopy and surface EMG were measured for 2 minutes with the subjects performing brief non-fatiguing contractions, for 4 minutes with the subject performing maximal isometric contraction in complete ischaemia, and for twelve minutes during recovery. EMG parameters measured: median density frequency (MDF); muscle fiber conduction velocity (MFCV). NIR spectroscopy parameters measured: percentage of amplitude decrement (% AD) and nadir time (NT) during ischaemia and ischaemic effort; half-recovery time (1/2 RT) from ischaemia effort. RESULTS: At EMG, we observed a significant shift towards lower values of both MFCV and MDF during fatiguing isometric contraction. MDF recovery was faster then MFCV recovery. At NIR spectroscopy, the 1/2 RT slowed a fast pattern in twelve subjects and a slow pattern in five. A significant relationship was found between AD% and 1/2 RT values of test I and AD% and 1/2 values of test II. We found a positive relationship between NT and 1/2 RT in test II. CONCLUSIONS: Surface EMG and hemoglobin NIR spectroscopy can be applied simultaneously to evaluate both fatigue intensity and blood flow changes in striated muscle.     

Effect of cycling experience and pedal cadence on the near-infrared spectroscopy parameters

PURPOSE: Previously we demonstrated that the method to reorder near-infrared spectroscopy (NIRS) parameters against crank angle could serve as a useful measure in providing circulatory dynamics and metabolic changes in a working muscle during pedaling exercise. To examine further applicability of this method, we investigated the effects of cycling experience and pedal cadence on the NIRS parameters. METHODS: Noncyclists (NON), triathletes (TRI), and cyclists (CYC) performed pedaling exercises at a work intensity of 75% VO2max while changing pedal cadence (50, 75, 85, and 95 rpm). Physiological and biomechanical responses and NIRS parameters were measured. RESULTS: NIRS measurements determined with the reordered NIRS change demonstrated significant differences depending on the factors. The bottom peak of reordered NIRS changes in muscle blood volume and oxygenation level shifted upward with an increase in pedal cadence in NON but remained unchanged in CYC. The reordered NIRS change demonstrated a temporary increase at the crank angle corresponding to the relaxation phase of the working muscle. This temporary increase was observed even in the highest pedal cadence in CYC. The difference in levels between the peak of the temporary increase and the bottom peak of reordered NIRS change (LPB-diff) for CYC at 85 rpm was significantly larger than that for NON. The results with NIRS parameters corresponded to changes in pedal force and myoelectric activity during pedal thrust. CONCLUSIONS: The bottom peak level of the reordered NIRS changes and LPB-diff determined for blood volume are available to detect noninvasively the differences in circulatory dynamics and metabolic change during pedaling exercises performed at different pedal cadences and also to estimate the difference of physiological and technical developments for endurance cycling in athletes.     

Effect of eccentric exercise on muscle oxidative metabolism in humans

PURPOSE: The purpose of this study was to evaluate the effects of eccentric exercise on muscle oxidative function. METHODS: Thirteen subjects performed high-intensity eccentric cycling for 30 min. Muscle oxidative function in vastus lateralis was evaluated by measurements of respiration in permeabilized muscle fibers (skinned fibers) and from the kinetics of oxyhemoglobin (oxyHb) saturation measured with near infrared spectroscopy (NIRS). RESULTS: After eccentric cycling, all subjects reported extensive delayed onset muscle soreness (DOMS), but plasma markers of muscle damage (creatine kinase and beta-glucuronidase activity) were not significantly altered. The half time of oxyHb desaturation after circulatory occlusion (128 +/- 11 s, mean +/- SE) and oxyHb resaturation after restoration of blood flow (13.8 +/- 0.7 s) were not significantly changed after eccentric cycling (N = 7). Respiration in skinned muscle fibers measured in the absence of ADP and in the presence of a submaximal (0.1 mM) or maximal ADP concentration (1 mM) was not significantly changed after eccentric cycling (N = 6). The sensitivity of respiration to ADP was not significantly changed after eccentric cycling. CONCLUSIONS: Muscle oxidative function (maximal respiration and respiratory control by ADP) was not compromised after high-intensity eccentric cycle exercise. Furthermore, NIRS indicates that after eccentric cycling muscle oxygen utilization and local oxygen transport at rest are unchanged. It is concluded that eccentric cycling, although causing DOMS, does not negatively affect skeletal muscle oxidative function.     

Effects of age on muscle energy metabolism and oxygenation in the forearm muscles

PURPOSE: The effects of aging on muscle metabolism and oxygenation have not yet been elucidated. We evaluated the effects of aging on energy metabolism and oxygenation in sedentary healthy subjects by simultaneously measuring 31P-magnetic resonance spectroscopy (MRS) and near-infrared spectroscopy (NIRS). METHODS: Nine young (28.1 +/- 5.0 yr) and nine older (61.4 +/- 4.6 yr) healthy subjects were studied. The 31P-MR spectrum was obtained every 15 s during and after hand gripping exercise. Intracellular pH (pHi) and PCr/(PCr+Pi) [PCr: phosphocreatine, Pi: inorganic phosphate] were calculated as an index of energy metabolism. The time constant of the PCr/(PCr+Pi) recovery (tau PCr) was calculated. With NIRS, we evaluated the recovery rates of oxygenated (RHbO2) and deoxygenated hemoglobin (RHb) during the initial 10 s of recovery. RESULTS: The PCr/(PCr+Pi) and pHi at rest and at completion of the exercise and tau PCr did not differ between young and older subjects. However, RHbO2 and RHb were significantly slower in older subjects than in young subjects. CONCLUSIONS: The results suggest that muscle energy metabolism in the forearm muscle was not affected by aging. The slower RHbO2 and RHb in older subjects suggested impaired O2 supply, which was probably due to impaired peripheral circulation caused by the process of aging.     

肌氧含量的近红外无损监测及其与气体交换率的对比研究

目的研究运动过程中人体骨骼肌组织肌氧含量的相对变化与心率、摄氧量和气体交换率间的关系。方法利用近红外肌氧监测系统,在体、实时监测中长跑运动员在跑台上运动时肌氧含量的相对变化,并同步测定和记录被试者的心率(HR)、摄氧量(VO2)、二氧化碳呼出量(VCO2)和气体交换率(RER)等参数。结果随着运动强度的改变,上述所测参数均呈现规律性的变化。在0．01水平上,氧合血红蛋白(HbO2)含量的相对变化与HR、VO2,和RER间均具有高度的相关性。结论本研究为无损监测和评定运动员的生理机能状况、掌握训练强度和评价训练效果引入新的测试技术和生物学监测指标。     

Diagnostic and monitoring applications using near infrared (NIR) spectroscopy in cancer and other diseases

Early cancer diagnosis plays a critical role in improving treatment outcomes and increasing survival rates for certain cancers. NIR spectroscopy offers a rapid and cost-effective approach to evaluate the optical properties of tissues at the microvessel level and provides valuable molecular insights. The integration of NIR spectroscopy with advanced data-driven algorithms in portable instruments has made it a cutting-edge technology for medical applications. NIR spectroscopy is a simple, non-invasive and affordable analytical tool that complements expensive imaging modalities such as functional magnetic resonance imaging, positron emission tomography and computed tomography. By examining tissue absorption, scattering, and concentrations of oxygen, water, and lipids, NIR spectroscopy can reveal inherent differences between tumor and normal tissue, often revealing specific patterns that help stratify disease. In addition, the ability of NIR spectroscopy to assess tumor blood flow, oxygenation, and oxygen metabolism provides a key paradigm for its application in cancer diagnosis. This review evaluates the effectiveness of NIR spectroscopy in the detection and characterization of disease, particularly in cancer, with or without the incorporation of chemometrics and machine learning algorithms. The report highlights the potential of NIR spectroscopy technology to significantly improve discrimination between benign and malignant tumors and accurately predict treatment outcomes. In addition, as more medical applications are studied in large patient cohorts, consistent advances in clinical implementation can be expected, making NIR spectroscopy a valuable adjunct technology for cancer therapy management. Ultimately, the integration of NIR spectroscopy into cancer diagnostics promises to improve prognosis by providing critical new insights into cancer patterns and physiology.     

Changes in blood volume and oxygenation level in a working muscle during a crank cycle

PURPOSE: This study examined circulatory and metabolic changes in a working muscle during a crank cycle in a pedaling exercise with near-infrared spectroscopy (NIRS). METHODS: NIRS measurements sampled under stable metabolic and cadence conditions during incremental pedaling exercise were reordered according to the crank angles whose signals were obtained in eight male subjects. RESULTS: The reordered changes in muscle blood volume during a crank cycle demonstrated a pattern change that corresponded to changes in pedal force and electrical muscle activity for pedal thrust. The top and bottom peaks for muscle blood volume change at work intensities of 180 W and 220 W always preceded (88 +/- 32 and 92 +/- 23 ms, respectively) those for muscle oxygenation changes. Significant differences in the level of NIRS parameters (muscle blood volume and oxygenation level) among work intensities were noted with a common shape in curve changes related to pedal force. In addition, a temporary increase in muscle blood volume following a pedal thrust was detected at work intensities higher than moderate. This temporary increase in muscle blood volume might reflect muscle blood flow restriction caused by pedal thrusts. CONCLUSION: The results suggest that circulatory and metabolic conditions of a working muscle can be easily affected during pedaling exercise by work intensity. The present method, reordering of NIRS parameters against crank angle, serves as a useful measure in providing additional findings of circulatory dynamics and metabolic changes in a working muscle during pedaling exercise.     

Muscle deoxygenation as related to work rate

PURPOSE: The kinetics of the decrease in venous O(2) content in response to constant work rate exercise below the lactic acidosis threshold (LAT) is very rapid, reaching a constant value by approximately 1 min. However, for work rates above the LAT, a slow further decrease in venous O(2) content takes place that is attributable to the Bohr effect rather than further decrease in end capillary PO. We hypothesized that similar differences, with respect to the LAT, will be observed in muscle deoxygenation kinetics when studied with near-infrared spectroscopy (NIRS). METHODS: Twelve normal subjects performed three constant work rate tests from unloaded cycling at 60% of LAT, 80% LAT, each with four repetitions, and above LAT (LAT + 35% between LAT and VO(2max) three times, on a cycle ergometer for 6 min. We measured tissue deoxygenation with NIRS, with the probe over the vastus lateralis muscle, time-averaging the repetitions. Gas exchange and heart rate (HR) were measured breath-by-breath and beat-by-beat. RESULTS: Tissue deoxygenation kinetics were significantly faster than VO(2) and HR at 60%- and 80%-LAT work rates. By 1 min of exercise, deoxygenation was constant for the work rate below the LAT. At 30 s, tissue deoxygenation was 70-95% complete, whereas VO(2) and HR were only 30-60% complete. For the work rate above the LAT, a steady state for muscle deoxygenation was not reached during the 6 min of exercise. After 1 min of above-LAT exercise, either one of two patterns of slow change in tissue oxygenation developed, deoxygenation or reoxygenation. It is postulated that these different responses might be due to effects of the exercise lactic acidosis. H accompanying lactate increase might cause further deoxygenation due to the Bohr effect, and acidosis-induced vasodilatation might cause reoxygenation after the initial deoxygenation. CONCLUSION: 1) The kinetics of tissue deoxygenation are significantly more rapid than VO(2) and HR kinetics at all work rates studied, and 2) steady-state in tissue deoxygenation is seen by 1 min of constant work rate exercise below the LAT, but this is much delayed for work rates above the LAT.     

Related trends in locomotor and respiratory muscle oxygenation during exercise

PURPOSE: We investigated the potential effect of respiratory muscle work on leg muscle oxygenation without artificial intervention in non-endurance-trained young subjects and searched for the range of intensity when this effect could occur. METHODS: We simultaneously monitored accessory respiratory and leg muscle oxygenation patterns with near-infrared spectroscopy (NIRS) in 15 healthy young men performing maximal incremental exercise on a cycle ergometer. Pulmonary gas exchange was measured. The respiratory compensation point (RCP) was determined. Oxygenation (RMO2) and blood volume (RMBV) of the serratus anterior (accessory respiratory muscle) and of the vastus lateralis (LegO2 and LegBV) were monitored with NIRS. The breakdown point of accessory respiratory muscle oxygenation (BPRMO2) and the accelerated (BP1LegO2) and attenuated fall (BP2LegO2) in leg muscle oxygenation were detected. RESULTS: BPRMO2 occurred at approximately 85% .VO2max and was related to RCP (r = 0.88, P < 0.001). BP2LegO2 appeared at approximately 83% .VO2max and was related to RCP (r = 0.57, P < 0.05) and with BPRMO2 (r = 0.64, P = 0.01). From BP2LegO2 to maximal exercise, LegBV was significantly reduced (P < 0.05). CONCLUSION: In active subjects exercising at heavy exercise intensities, we observed that the appearance of the accelerated drop in accessory respiratory muscle oxygenation-associated with high ventilatory level-was related with the attenuated fall in leg muscle oxygenation detected with near-infrared spectroscopy. This suggests that the high oxygen requirement of respiratory muscle leads to limited oxygen use by locomotor muscles as demonstrated in endurance-trained subjects. The phenomenon observed was associated with reduced leg blood volume, supporting the occurrence of leg vasoconstriction. These events appeared not only at maximal exercise but onward above the respiratory compensation point.     

Respiratory muscle deoxygenation and ventilatory threshold assessments using near infrared spectroscopy in children

The aim of this study was to assess respiratory muscles deoxygenation and to determine ventilatory threshold using near infrared spectroscopy (NIRS) in children during incremental cardiopulmonary exercise. Fourteen healthy children with a mean +/- SD age of 12.8 +/- 1.4 yrs performed an incremental exercise test on a cycle ergometer. NIRS was used to assess deoxygenation of the respiratory muscles. Ventilatory parameters (oxygen uptake, carbon dioxide production, and ventilation minute), power output, and tissue saturation (StO2) were measured. Ventilatory threshold was determined by the two following methods: the V-slope method which corresponds to the breakpoint in VCO2 as a function VO2 relationship (VT(V-slope)) and the NIRS method which corresponds to the point of rapid fall in StO2 (VT(nirs)). During exercise, the respiratory muscles deoxygenated as the exercise intensity increased. StO2 decrease progressively until an abrupt decrease was observed. No significant differences were observed between cardiorespiratory variables corresponding either to VT(V-slope) or to VT(nirs). The two methods showed a good agreement (data were inside the 95 % confidence interval). Likewise, a significant relationship was found between VT(V-slope) and VT(nirs) for each parameter measured (r = 0.87 to 0.94, p < 0.001). We concluded that respiratory muscles deoxygenate during incremental exercise in children and that ventilatory threshold could be determined by NIRS.     

Helicopter cockpit seat side and trapezius muscle metabolism with night vision goggles

INTRODUCTION: Documented neck strain among military helicopter aircrew is becoming more frequent and many militaries use helicopters that provide pilots with the option of sitting in the left or right cockpit seat during missions. PURPOSE: The purpose of this study was to use near infrared spectroscopy (NIRS) to investigate the physiological changes in trapezius muscle oxygenation and blood volume during night vision goggle (NVG) flights as a function of left and right cockpit seating. METHODS: There were 25 pilots who were monitored during NVG flight simulator missions (97.7 +/- 16.1 min). Bilateral NIRS probes attached to the trapezius muscles at C7 level recorded total oxygenation index (TOI, %), total hemoglobin (tHb), oxyhemoglobin (Hbo2), and deoxyhemo-globin (HHb). RESULTS: No significant differences existed between variables for pilots seated in the right cockpit seat as compared with the pilots seated in the left cockpit seat in either trapezius muscle (pTOI = 0.72; ptHb = 0.72; pHbo2 = 0.57; pHHb = 0.21). CONCLUSION: Alternating cockpit seats on successive missions is not a means to decrease metabolic stress for helicopter pilots using NVG. This suggests that cockpit layout and location of essential instruments with respect to the horizontal and the increased head supported mass of the NVG may be important factors influencing metabolic stress of the trapezius muscle.     

A new direction for ultrasound therapy in sports medicine

Ultrasound therapy is a widely available and frequently used electrophysical agent in sports medicine. However, systematic reviews and meta-analyses have repeatedly concluded that there is insufficient evidence to support a beneficial effect of ultrasound at dosages currently being introduced clinically. Consequently, the role of ultrasound in sports medicine is in question. This does not mean that ultrasound should be discarded as a therapeutic modality. However, it does mean that we may need to look in a new direction to explore potential benefits. A new direction for ultrasound therapy has been revealed by recent research demonstrating a beneficial effect of ultrasound on injured bone. During fresh fracture repair, ultrasound reduced healing times by between 30 and 38%. When applied to non-united fractures, it stimulated union in 86% of cases. These benefits were generated using low-intensity (<0.1 W/cm(2)) pulsed ultrasound (LIPUS), a dose alternative to that traditionally used in sports medicine. Although currently developed for the intervention of bone injuries, LIPUS has the potential to be used on tissues and conditions more commonly encountered in sports medicine. These include injuries to ligament, tendon, muscle and cartilage. This review discusses the effect of LIPUS on bone fractures, the dosages introduced and the postulated mechanisms of action. It concludes by discussing the relevance of these latest findings to sports medicine and how this evidence of a beneficial clinical effect may be implemented to intervene in sporting injuries to bone and other tissues. The aim of the paper is to highlight this latest direction in ultrasound therapy and stimulate new lines of research into the efficacy of ultrasound in sports medicine. In time this may lead to accelerated recovery from injury and subsequent earlier return to activity.     

人体运动氧代谢的实时无创测定

为探讨运动过程中肌肉组织氧含量的变化规律，用无损近红外光谱学技术（ＮＩＲＳ）对１０名运动员１２ｍｉｎ递增有氧负荷运动的肌氧含量做了实时连续监测，同时测定了血乳酸和心率，相关分析表明，有氧代谢运动肌氧含量下降与血乳酸上升的测定值呈线性相关（ｒ＝－０．９６２）在相同负荷下对运动员和普通受试者的肌氧和血乳酸等参数的实时变化情况做了比较，此外，还检测和探讨了以无氧运动为主的短跑过程中肌氧含量的下降和恢复规     

O2 arterial desaturation in endurance athletes increases muscle deoxygenation

PURPOSE: The aim of this study was to compare the muscle deoxygenation measured by near infrared spectroscopy in endurance athletes who presented or not with exercise-induced hypoxemia (EIH) during a maximal incremental test in normoxic conditions. METHODS: Nineteen male endurance sportsmen performed an incremental test on a cycle ergometer to determine maximal oxygen consumption (VO2max) and the corresponding power output (P(max)). Arterial O2 saturation (SaO2) was measured noninvasively with a pulse oxymeter at the earlobe to detect EIH, which was defined as a drop in SaO2 > 4% between rest and the end of the exercise. Muscle deoxygenation of the right vastus lateralis was monitored by near infrared spectroscopy and was expressed in percentage according to the ischemia-hyperemia scale. RESULTS: Ten athletes exhibited arterial hypoxemia (EIH group) and the nine others were nonhypoxemic (NEIH group). Training volume, competition level, VO2max, Pmax, and lactate concentration were similar in the two groups. Nevertheless, muscle deoxygenation at the end of the exercise was significantly greater in the EIH group (P < 0.05). CONCLUSION: Greater muscle deoxygenation at maximal exercise in hypoxemic athletes seems to be due, at least in part, to reduced oxygen delivery--that is, exercise-induced hypoxemia--to working muscle added to the metabolic demand. In addition, our finding is also consistent with the hypothesis of greater muscle oxygen extraction in order to counteract reduced O2 availability.     

Near infrared spectroscopy in the diagnosis of chronic exertional compartment syndrome

BACKGROUND: Patients with chronic exertional compartment syndrome (CECS) experience pain during exercise. An abnormal increase in intracompartmental pressure (ICP) leads to impaired local tissue perfusion resulting in ischemia and pain. At cessation of exercise, pain subsides. Diagnosis is confirmed through postexercise ICP. Near infrared spectroscopy (NIRS) can measure tissue oxygen saturation (StO(2)) noninvasively. HYPOTHESIS: NIRS can diagnose CECS by showing tissue deoxygenation. STUDY DESIGN: Prospective, nonrandomized clinical trial. METHOD: Volunteers completed a standardized exercise protocol. Those suspected of CECS did so preoperatively and postoperatively. StO(2) and ICP were monitored. Data were compared between volunteers and patients and prefasciotomy and postfasciotomy. RESULTS: Significant differences between the StO(2) values of volunteers and patients with CECS were found. Average peak exercise StO(2) value for those with CECS was lower than for the healthy (27 versus 56, P <.05). Patients showed more absolute and percentage change between baseline and peak exercise StO(2) (absolute: 60 versus 35, P <.05; percentage: 67 versus 38, P <.05). StO(2) values in legs with confirmed CECS returned to normal range postfasciotomy. All changes differed significantly with preoperative values. CONCLUSION: StO(2) can distinguish healthy from diseased legs. This study provides evidence supporting NIRS as a noninvasive, painless alternative to ICP in the diagnosis of CECS.