The use of near infrared spectroscopy in sports medicine

In the last 15 years the study of the human muscle energetics in sports medicine underwent a radical change thanks to the progressive introduction of non-invasive techniques, including near infrared (NIR) spectroscopy (NIRS). NIR light (700-1000 nm) penetrates skin, subcutaneous fat and underlying muscle, and is either absorbed (by oxy- and deoxy-haemoglobin) or scattered within the tissue. NIRS is a non-invasive and relatively low cost optical technique that is becoming a widely used instrument for measuring muscle O(2) saturation and changes in haemoglobin volume. Muscle O(2) saturation represents a dynamic balance between O(2) supply and O(2) consumption in the small vessels such as the capillary, arteriolar and venular bed. NIRS offers the advantage of being less restrictive than (31)P-magnetic resonance spectroscopy with regard to muscle performance and more comfortable and suitable for the monitoring, with high temporal resolution (up to 10 Hz), of multiple muscle groups. The aim of this review is to summarise the NIRS instrumentation and the measurable parameters, the role of NIRS in muscle exercise physiology, and the applications in sports medicine. The advantages and the problems of NIRS measurements, in resting and exercising skeletal muscles, are reported. The results of several studies suggest that NIRS is a powerful tool for being applied successfully in sports medicine. NIRS can objectively evaluate muscle oxidative metabolism in athletes and its modifications following potential therapeutic strategies and specific training programs.     

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.     

Application of 31P magnetic resonance spectroscopy to the study of athletic performance

Magnetic resonance spectroscopy is a non-invasive and repeatable method of studying muscle metabolism. Magnetic resonance spectroscopy uses specific radiofrequency pulses in a strong magnetic field to determine the relative concentrations of chemical compounds in the sample. 31P Magnetic resonance spectroscopy provides indirect measures of phosphate compounds such as adenosine triphosphate (ATP), phosphocreatine and inorganic phosphate. Muscle intracellular pH can also be determined. Exercise tests can be performed in the magnet such that the metabolic response to steady-state exercise can be measured. The ratio of inorganic phosphate to phosphocreatine reflects the relative metabolic rate of mitochondrial respiration (V) and the extrapolated maximum capacity of oxidative metabolism (Vm). Normal humans vary considerably in their metabolic response to exercise. These differences are reflected in their Vms and the degree of acidosis during exercise. Active muscles in endurance trained athletes have higher Vms and faster recovery rates than normal controls. Preliminary studies have been done to assess muscle glycolytic capacity by measuring the degree of acidosis during ischaemic exercise. Exercise-induced muscle injury can be detected as an increased inorganic phosphate to phosphocreatine ratio in resting muscle. The increase in the inorganic phosphate to phosphocreatine ratio with injury reaches a peak 1 to 2 days after the injury and lasts for up to a week. Similar increases in the inorganic phosphate to phosphocreatine ratio occur in patients with destructive neuromuscular diseases. Thus changes in the resting inorganic phosphate to phosphocreatine ratio may be used to detect the degree of muscle injury following exercise. Levels of H2PO4- in muscle are thought to be important in causing muscle fatigue during exercise. As 31P magnetic resonance spectroscopy can measure H2PO4-, magnetic resonance spectroscopy has become a useful technique in the study of the metabolic causes of muscle fatigue. It may also be possible to identify the relative populations of fast twitch and slow twitch fibres in a skeletal muscle using pH changes measured with 31P magnetic resonance spectroscopy. Magnetic resonance spectroscopy using other nuclei, such as 1H, 13C and 23Na, have the potential to provide information on other metabolic changes which occur with exercise. Magnetic resonance spectroscopy has shown promise as a technique to monitor the effects of training, including overtraining, in specific muscle groups in athletes.     

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.     

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     

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.     

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.     

Cerebral cortex activity during supramaximal exhaustive exercise

AIM: The purpose of this study was to examine the effect of fatigue resulting from supramaximal dynamic exercise on cerebral cortex activity. METHODS: Five healthy male subjects (age 24.6+/-0.4 years, body weight 62.9+/-1.1 kg, height 175.3+/-1.2 cm, and maximal O2 uptake per body mass 48.4+/-1.3 ml/kg/min) participated in this study. All subjects performed at 120% of maximal oxygen uptake (VO2peak) on a cycle ergometer until reaching a state of volitional fatigue. Cerebral oxygenation was measured by near-infrared spectroscopy (NIRS) throughout the supramaximal constant exhaustive exercise. RESULTS: The mean exercise duration of the subjects was 147.2+/-3.4 s. The peak value of blood lactate concentration within 3-10 min after the exercise test was 14.4+/-0.1 mmol/l. Cerebral oxygenation (8.8+/-1.8 micromol/l) was increased significantly during the first minutes of exercise compared with the pre-exercise value (p<0.05) and cerebral oxygenation decreased with the passage of time during exercise. Cerebral oxygenation at the end of exercise decreased significantly compared with the resting value (-29.9+/-3.4 micromol/l, p<0.05). CONCLUSION: These findings suggest that the exhaustive exercise induces the decrease of cerebral function and that the fatigue resulting from dynamic exercise decreases the cerebral cortex activity.     

Non-invasive quantitative assessment of oxidative metabolism in quadriceps muscles by near infrared spectroscopy

BACKGROUND: Near infrared spectroscopy can be used in non-invasive monitoring of changes in skeletal muscle oxygenation in exercising subjects. OBJECTIVE: To evaluate whether this method can be used to assess metabolic capacity of muscles. Two distinctive variables abstracted from a curve of changes in muscle oxygenation were assessed. METHODS: Exercise on a cycle ergometer was performed by 18 elite male athletes and eight healthy young men. A measuring probe was placed on the skin of the quadriceps muscle to measure reflected light at two wavelengths (760 and 850 nm), so that the relative index of muscle oxygenation could be calculated. Exercise intensity was increased from 50 W in 50 W increments until the subject was exhausted. During exercise, changes in muscle oxygenation and blood lactate concentration were recorded. The following two variables for assessment of muscle oxygenation were then abstracted and analysed by plotting curves of changes in muscle oxygenation: the rate of recovery of muscle oxygen saturation (R(R)) and the relative value of the effective decrease in muscle oxygenation (D(eff)). RESULTS: Data analysis showed a correlation between muscle oxygenation and blood lactate concentration at the various exercise intensities and verified the feasibility of the experiment. Data for the athletes were compared with those for the controls using the Aspin-Welch test of significance; t = 2.3 and 2.86 for R(R) and D(eff) respectively. There were significant differences (p = 0.05) between the athletes and the control group with respect to these two variables. CONCLUSION: R(R) and D(eff) may be distinctive variables that can be used to characterise muscle oxidative metabolism during human body movement.     

Muscle oxygenation and fascicle length during passive muscle stretching in ballet-trained subjects

Muscle stretching transiently decreases muscle-blood flow corresponding to a muscle extension. It may disturb a balance between muscular oxygen demand and oxygen supply to muscles and reduce muscle oxygenation. However, muscle-stretching training may improve blood circulatory condition, resulting in the maintained muscle oxygenation during muscle stretching. The aim of this study was to investigate changes in muscle-blood volume (tHb) and tissue oxygenation index (TOI) during muscle stretching determined by using near-infrared spectroscopy (NIRS) in ballet-trained (BT) and untrained (C) subjects. 11 BT women who regularly perform muscle stretching and 11 C women participated in this study. Fascicle lengths, tHb and TOI in the tibialis anterior muscle were measured during passive plantar flexion from ankle joint angles of 120° (baseline) to 140°, 160°, the maximal comfortable position without pain (CP), and the maximal position (MP). At 160°, the % fascicle-length change from baseline was significantly lower in the BT than the C group, however, for the changes in tHb and TOI the significant interaction effect between the 2 groups was not detected. On the other hand, although the increases in the fascicle length from baseline to CP and MP were greater in BT than C, the tHb and TOI reductions were comparable between groups. We concluded that it appears that BT can extend their muscles without excessive reduction in muscle-blood volume and muscle oxygenation at relatively same but absolutely greater muscle-stretching levels than C. The attenuation in these indices during high-level muscle stretching may be associated with the repetitive muscle stretching of long-term ballet training.     

Muscle fatigue during high-intensity exercise in children

Children are able to resist fatigue better than adults during one or several repeated high-intensity exercise bouts. This finding has been reported by measuring mechanical force or power output profiles during sustained isometric maximal contractions or repeated bouts of high-intensity dynamic exercises. The ability of children to better maintain performance during repeated high-intensity exercise bouts could be related to their lower level of fatigue during exercise and/or faster recovery following exercise. This may be explained by muscle characteristics of children, which are quantitatively and qualitatively different to those of adults.Children have less muscle mass than adults and hence, generate lower absolute power during high-intensity exercise. Some researchers also showed that children were equipped better for oxidative than glycolytic pathways during exercise, which would lead to a lower accumulation of muscle by-products. Furthermore, some reports indicated that the lower ability of children to activate their type II muscle fibres would also explain their greater resistance to fatigue during sustained maximal contractions.The lower accumulation of muscle by-products observed in children may be suggestive of a reduced metabolic signal, which induces lower ratings of perceived exertion. Factors such as faster phosphocreatine resynthesis, greater oxidative capacity, better acid-base regulation, faster readjustment of initial cardiorespiratory parameters and higher removal of metabolic by-products in children could also explain their faster recovery following high-intensity exercise.From a clinical point of view, muscle fatigue profiles are different between healthy children and children with muscle and metabolic diseases. Studies of dystrophic muscles in children indicated contradictory findings of changes in contractile properties and the muscle fatigability. Some have found that the muscle of boys with Duchenne muscular dystrophy (DMD) fatigued less than that of healthy boys, but others have reported that the fatigue in DMD and in normal muscle was the same. Children with glycogenosis type V and VII and dermatomyositis, and obese children tolerate exercise weakly and show an early fatigue. Studies that have investigated the fatigability in children with cerebral palsy have indicated that the femoris quadriceps was less fatigable than that of a control group but the fatigability of the triceps surae was the same between the two groups.Further studies are required to elucidate the mechanisms explaining the origins of muscle fatigue in healthy and diseased children. The use of non-invasive measurement tools such as magnetic resonance imaging and magnetic resonance spectroscopy in paediatric exercise science will give researchers more insight in the future.     

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.     

Effect of creatine on aerobic and anaerobic metabolism in skeletal muscle in swimmers.

OBJECTIVE: To examine the effect of a relatively low dose of creatine on skeletal muscle metabolism and oxygen supply in a group of training athletes. METHODS: 31P magnetic resonance and near-infrared spectroscopy were used to study calf muscle metabolism in a group of 10 female members of a university swimming team. Studies were performed before and after a six week period of training during which they took either 2 g creatine daily or placebo. Calf muscle metabolism and creatine/choline ratios were studied in resting muscle, during plantar flexion exercise (10-15 min), and during recovery from exercise. RESULTS: There was no effect of creatine on metabolite ratios at rest or on metabolism during exercise and recovery from exercise. Muscle oxygen supply and exercise performance were not improved by creatine if compared to placebo treated subjects. CONCLUSIONS: Oral creatine supplementation at 2 g daily has no effect on muscle creatine concentration, muscle oxygen supply or muscle aerobic or anaerobic metabolism during endurance exercise.     

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。     

Regulation of cerebral blood flow during exercise

Constant cerebral blood flow (CBF) is vital to human survival. Originally thought to receive steady blood flow, the brain has shown to experience increases in blood flow during exercise. Although increases have not consistently been documented, the overwhelming evidence supporting an increase may be a result of an increase in brain metabolism. While an increase in metabolism may be the underlying causative factor for the increase in CBF during exercise, there are many modulating variables. Arterial blood gas tensions, most specifically the partial pressure of carbon dioxide, strongly regulate CBF by affecting cerebral vessel diameter through changes in pH, while carbon dioxide reactivity increases from rest to exercise. Muscle mechanoreceptors may contribute to the initial increase in CBF at the onset of exercise, after which exercise-induced hyperventilation tends to decrease flow by pial vessel vasoconstriction. Although elite athletes may benefit from hyperoxia during intense exercise, cerebral tissue is well protected during exercise, and cerebral oxygenation does not appear to pose a limiting factor to exercise performance. The role of arterial blood pressure is important to the increase in CBF during exercise; however, during times of acute hypotension such as during diastole at high-intensity exercise or post-exercise hypotension, cerebral autoregulation may be impaired. The impairment of an increase in cardiac output during exercise with a large muscle mass similarly impairs the increase in CBF velocity, suggesting that cardiac output may play a key role in the CBF response to exercise. Glucose uptake and CBF do not appear to be related; however, there is growing evidence to suggest that lactate is used as a substrate when glucose levels are low. Traditionally thought to have no influence, neural innervation appears to be a protective mechanism to large increases in cardiac output. Changes in middle cerebral arterial velocity are independent of changes in muscle sympathetic nerve activity, suggesting that sympathetic activity does not alter medium-sized arteries (middle cerebral artery).CBF does not remain steady, as seen by apparent increases during exercise, which is accomplished by a multi-factorial system, operating in a way that does not pose any clear danger to cerebral tissue during exercise under normal circumstances.     

Influence of training on NIRS muscle oxygen saturation during submaximal exercise

PURPOSE: Endurance training improves the oxygen delivery and muscle metabolism. Muscle oxygen saturation measured by near infrared spectroscopy (IR-SO(2)), which is primarily influenced by the local delivery/demand balance, should thus be modified by training. We examined this effect by determining the influence of change in blood lactate and muscle capillary density with training on IR-SO(2) in seven healthy young subjects. METHODS: Two submaximal exercise tests at 50% (Ex1) and 80% pretraining VO(2max) (Ex2) were performed before and after a 4-wk endurance-training program. RESULTS: VO(2max) increased only slightly (+8%, NS) with training but the training effect was confirmed by the increased capillary density (+31%, P < 0.01) and citrate synthase activity (50%, P < 0.01), determined from muscle biopsy samples. Before training, blood lactate increased during the first 5 min of Ex1 and then remained constant (3.8 +/- 0.5 mmol x L(-1), P < 0.01), whereas it increased continuously during Ex2 (8.9 +/- 1.8 mmol x L(-1), P < 0.001). After training, lactate decreased significantly and remained constant during the two bouts of exercise (2.0 +/- 0.4 and 3.7 +/- 1.2 at the end of Ex1 and Ex2, respectively, both P < 0.001). During Ex1, IR-SO(2) dropped initially at the onset of exercise and recovered progressively without reaching the resting level. Training did not change this pattern of IR-SO(2). During Ex2, IR-SO(2) decreased progressively during the 15 min of exercise (P < 0.05); IR-SO2 kept constant after the initial drop after training. We found a significant relationship (r = 0.42, P = 0.03) between blood lactate and IR-SO(2) at the end of both bouts of exercise; this relationship was closer before training. By contrast, IR-SO(2) or IR-BV was not related to the capillary density. CONCLUSION: The training-induced adaptation in blood lactate influences IR-SO(2) during mild- to hard-intensity exercise. Thus, NIRS could be used as a noninvasive monitoring of training-induced adaptations.     

Muscular exercise and fatigue

The development of muscular fatigue during exercise is a common phenomenon, and several forms depend on the precise type of exercise performed. The causes are still not clearly established, although the involvement of electrical and metabolic factors have been demonstrated. Several techniques which allow for the analysis of muscle function in terms of electrical activation and energy metabolism are (a) a needle biopsy of muscle for histochemical and metabolic studies, (b) magnetic resonance spectroscopy for the non-invasive study of muscle energy metabolism and pH, (c) electromyographic analysis of the electrical characteristics of muscle, and (d) percutaneous electrical stimulation of muscle for the force-frequency and relaxation characteristics of muscle. Endurance training increases the capacity to sustain exercise possibly by altering muscle energy metabolism and contractile properties. Fatigue is a self-protective mechanism against the damage of contractile machinery of muscle as, for example, with the development of rigor, which occurs if the energy stores are depleted. To illustrate the roles of energy supply and electrical properties in muscle in fatigue, the 'catastrophe theory' used in engineering has been applied. This may explain abrupt changes of function of individual muscle cells, while for the muscle as a whole, fatigue may be manifested as a more gradual loss of force.     

Pilot cerebral oxygen status during air-to-air combat maneuvering

BACKGROUND: Successful monitoring of in-flight cerebral oxygen status (COS; cerebral hemoglobin concentration changes and oxygenation changes under dynamic flight conditions) was recently achieved using near-infrared spectroscopy (NIRS). In this study, we examined the effects of air-to-air combat maneuvering on COS. METHOD: Six F-15 fighter pilots performed 2-vs.-1 air-to-air combat one to three times in each of eight sorties. We took continuous measurements of the pilots' in-flight COS using a commercial NIRS system. We measured the direct effects of G-forces on COS as evidenced by relative concentrations of oxy- and deoxy-hemoglobin. RESULTS: With respect to the G-levels reached during air combat maneuvering (Gz range of -0.4 to + 9.5), oxyhemoglobin concentration (O2Hb) and tissue oxygenation index (TOI, the ratio of oxygenated to total tissue hemoglobin) decreased with increasing G-forces during aerial combat maneuver (ACM). Maximum changes in relative O2Hb ranged from -4.2 to -26 micromol x L(-1). Subjects' experience as measured by total fighter time was an independent determinant of the magnitude of decrease in relative oxygenation. CONCLUSIONS: 1. Pilots' COS declined with dynamic G-forces experienced under aerial combat conditions. 2. Fighter pilots with more flying hours maintained a higher cerebral oxygen level at the same level of G-forces than pilots with less flying time. 3. NIRS technology in the form of the NIRO-300G has matured for continuous monitoring of in-flight cerebral oxygen status under vigorous field conditions.     

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.     

Effects of compression tights on calf muscle oxygenation and venous pooling during quiet resting in supine and standing positions

AIM: We applied near-infrared spectroscopy (NIRS) to evaluate in resting conditions the effects of compression tights (CT) on calf muscle oxygenation and venous pooling compared with Lycra(R) elastic tights (ET) and shorts (no compression) according to the body posture (supine vs standing). METHODS: Twelve sportsmen regularly involved in endurance training volunteered to this study. Their average age, height and weight (+/-SD) were 26.5+/-2.6 years, 177+/-6 cm and 70.1+/-4 kg, respectively. Tissue oxygenation index (TOI), deoxyhemoglobin (HHb), and blood pooling (Hbtot) of the right gastrocnemius medialis were continuously monitored at 2 Hz using a NIRS device (NIRO-300, Hamamatsu Photonics, Japan). A home made transducer was used to measure applied pressure at the interface between skin and clothing over the calf area. Subjects were asked to realize a supine-standing protocol (5 min for each position) by wearing CT, ET or shorts in a counterbalanced order on the same day. RESULTS: HHb and Hbtot concentration changes were significantly lower whereas TOI was significantly higher by wearing CT compared with shorts and ET (P<0.001) as did supine compared to upright postures. The mean pressures applied over the calf were 5.6 and 23.2 mmHg during supine and 5 and 24.1 mmHg during standing for ET and CT, respectively. Pressures were significantly different among clothing according to the following rank order: CT>ET>shorts (P<0.001). CONCLUSIONS: CT compared to ET have positive effects on calf muscle oxygenation and venous pooling in quiet resting positions.