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PURPOSE: This study examined the effect of graded hypoxia during exhaustive intermittent cycling on subsequent exercise performance and neuromuscular fatigue characteristics in normoxia. METHODS: Fifteen well-trained cyclists performed an exhaustive intermittent cycling exercise (EICE 1; 15 s at 30% of anaerobic power reserve interspersed with 45 s of passive recovery) at sea level (SL; FiO2 ~ 0.21), moderate (MH; FiO2 ~ 0.16) and severe hypoxia (SH; FiO2 ~ 0.12). This was followed, after 30 min of passive recovery in normoxia, by an identical exercise bout in normoxia (EICE 2). Neuromuscular function of the knee extensors was assessed at baseline, after EICE 1 (post-EICE 1), and EICE 2 (post-EICE 2). RESULTS: The number of efforts completed decreased with increasing hypoxic severity during EICE 1 (SL: 39 ± 30, MH: 22 ± 13, SH: 13 ± 6; p ≤ 0.02), whereas there was no difference between conditions during EICE 2 (SL: 16 ± 9, MH: 20 ± 14, SH: 24 ± 17; p ≥ 0.09). Maximal torque (p = 0.007), peripheral (p = 0.02) and cortical voluntary activation (p < 0.001), and twitch torque (p < 0.001) decreased from baseline to post-EICE 1. Overall, there were no significant difference in any neuromuscular parameters from post-EICE 1 to post-EICE 2 (p ≥ 0.08). CONCLUSION: Increasing hypoxia severity during exhaustive intermittent cycling hampered exercise capacity, but did not influence performance and associated neuromuscular responses during a subsequent bout of exercise in normoxia performed after 30 min of rest.

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AIM: Heat stress and hypoxia independently influence cerebrocortical activity and impair prolonged exercise performance. This study examined the relationship between electroencephalography (EEG) activity and self-paced exercise performance in control (CON, 18 °C, 40% RH), hot (HOT, 35 °C, 60% RH) and hypoxic (HYP, 18 °C, 40% RH FiO2 : 0.145) conditions. METHODS: Eleven well-trained cyclists completed a 750 kJ cycling time trial in each condition on separate days in a counterbalanced order. EEG activity was recorded with α- and ß-activity evaluated in the frontal (F3 and F4) and central (C3 and C4) areas. Standardized low-resolution brain electromagnetic tomography (sLORETA) was also utilized to localize changes in cerebrocortical activity. RESULTS: Both α- and ß-activity decreased in the frontal and central areas during exercise in HOT relative to CON (P < 0.05). α-activity was also lower in HYP compared with CON (P < 0.05), whereas ß-activity remained similar. ß-activity was higher in HYP than in HOT (P < 0.05). sLORETA revealed that α- and ß-activity increased at the onset of exercise in the primary somatosensory and motor cortices in CON and HYP, while only ß-activity increased in HOT. A decrease in α- and ß-activity occurred thereafter in all conditions, with α-activity being lower in the somatosensory and somatosensory association cortices in HOT relative to CON. CONCLUSION: High-intensity prolonged self-paced exercise induces cerebrocortical activity alterations in areas of the brain associated with the ability to inhibit conflicting attentional processing under hot and hypoxic conditions, along with the capacity to sustain mental readiness and arousal under heat stress.

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The aim of this study was to investigate the effect of repeated passive heat exposure (i.e., acclimation) on muscle contractility in humans. Fourteen nonheat-acclimated males completed two trials including electrically evoked twitches and voluntary contractions in thermoneutral conditions [Cool: 24°C, 40% relative humidity (RH)] and hot ambient conditions in the hyperthermic state (Hot: 44-50°C, 50% RH) on consecutive days in a counterbalanced order. Rectal temperature was ~36.5°C in Cool and was maintained at ~39°C throughout Hot. Both trials were repeated after 11 days of passive heat acclimation (1 h per day, 48-50°C, 50% RH). Heat acclimation decreased core temperature in Cool (-0.2°C, P < 0.05), increased the time required to reach 39°C in Hot (+9 min, P < 0.05) and increased sweat rate in Hot (+0.7 liter/h, P < 0.05). Moreover, passive heat acclimation improved skeletal muscle contractility as evidenced by an increase in evoked peak twitch amplitude both in Cool (20.5 ± 3.6 vs. 22.0 ± 4.0 N·m) and Hot (20.5 ± 4.7 vs. 22.0 ± 4.0 N·m) (+9%, P < 0.05). Maximal voluntary torque production was also increased both in Cool (145 ± 42 vs. 161 ± 36 N·m) and Hot (125 ± 36 vs. 145 ± 30 N·m) (+17%, P < 0.05), despite voluntary activation remaining unchanged. Furthermore, the slope of the relative torque/electromyographic linear relationship was improved postacclimation (P < 0.05). These adjustments demonstrate that passive heat acclimation improves skeletal muscle contractile function during electrically evoked and voluntary muscle contractions of different intensities both in Cool and Hot. These results suggest that repeated heat exposure may have important implications to passively maintain or even improve muscle function in a variety of performance and clinical settings.

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Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.

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Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat.

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Exercise heat acclimation induces physiological adaptations that improve thermoregulation, attenuate physiological strain, reduce the risk of serious heat illness, and improve aerobic performance in warm-hot environments and potentially in temperate environments. The adaptations include improved sweating, improved skin blood flow, lowered body temperatures, reduced cardiovascular strain, improved fluid balance, altered metabolism, and enhanced cellular protection. The magnitudes of adaptations are determined by the intensity, duration, frequency, and number of heat exposures, as well as the environmental conditions (i.e., dry or humid heat). Evidence is emerging that controlled hyperthermia regimens where a target core temperature is maintained, enable more rapid and complete adaptations relative to the traditional constant work rate exercise heat acclimation regimens. Furthermore, inducing heat acclimation outdoors in a natural field setting may provide more specific adaptations based on direct exposure to the exact environmental and exercise conditions to be encountered during competition. This review initially examines the physiological adaptations associated with heat acclimation induction regimens, and subsequently emphasizes their application to competitive athletes and sports.

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This study examined the influence of hyperthermia on middle cerebral artery mean blood velocity (MCA Vmean). Eleven cyclists undertook a 750 kJ self-paced time trial in HOT (35 °C) and COOL (20 °C) conditions. Exercise time was longer in HOT (56 min) compared with COOL (49 min; P < 0.001). Power output in HOT was significantly lower from 40% of work completed onward (P < 0.01). Rectal temperature increased to 39.6 ± 0.6 °C (HOT) and 38.8 ± 0.5 °C (COOL; P < 0.01). Skin temperature, skin blood flow, and heart rate were higher throughout HOT compared with COOL (P < 0.05). A similar increase in ventilation (P < 0.05) and decrease in end-tidal partial pressure of CO2 (PETCO2 ; P < 0.05) occurred in both conditions. Arterial blood pressure and oxygen uptake were lower from 50% of work completed onward in HOT compared with COOL (P < 0.01). MCA Vmean increased at 10% in both conditions (P < 0.01), decreasing thereafter (P < 0.01) and to a greater extent in HOT from 40% of work completed onward (P < 0.05). Therefore, despite a comparable ventilatory response and PETCO2 in the HOT and COOL conditions, the greater level of thermal strain developing in the heat appears to have exacerbated the reduction in MCA Vmean, in part via increases in peripheral blood flow and a decrease in arterial blood pressure.

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We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in temperate (∼20 °C and 55% rH) and hot (∼43 °C and 20% rH) environments. Measurements included maximal voluntary strength, muscle activation, twitch contractile properties, and rate of torque development and soleus EMG (i.e., root mean square activity) rise from 0 to 30, -50, -100, and -200 ms during maximal isometric contractions for plantar flexors. Voluntary activation and peak twitch torque were equally reduced (-1.5% and -16.5%, respectively; P < 0.05) post-matches relative to baseline in both conditions, the latter persisting for at least 48 h, whereas strength losses (∼5%) were not significant. Absolute explosive force production declined (P < 0.05) 30 ms after contraction onset independently of condition, with no change at any other epochs. Globally, normalized rate of force development and soleus EMG activity rise values remained unchanged. In football, match-induced alterations in maximal and rapid torque production capacities of the plantar flexors are moderate and do not differ after competing in temperate and hot environments.

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The aim of this study was to determine the time course of physiological adaptations and their relationship with performance improvements during 2 weeks of heat acclimatization. Nine trained cyclists completed 2 weeks of training in naturally hot environment (34 ± 3 °C; 18 ± 5% relative humidity). On days 1, 6, and 13, they performed standardized heat response tests (HRT-1, 2, 3), and 43.4-km time trials in the heat (TTH-1, 2, 3) were completed on days 2, 7, and 14. Within the first 5-6 days, sweat sodium concentration decreased from 75 ± 22 mmol/L to 52 ± 24 mmol/L, sweat rate increased (+20 ± 15%), and resting hematocrit decreased (-5.6 ± 5.4%), with no further changes during the remaining period. In contrast, power output during TTHs gradually improved from TTH-1 to TTH-2 (+11 ± 8%), and from TTH-2 to TTH-3 (+5 ± 4%). Individual improvements in performance from TTH-1 to TTH-2 correlated with individual changes in hematocrit (assessed after the corresponding HRT; r = -0.79, P < 0.05), however, were not related to changes in performance from TTH-2 to TTH-3. In trained athletes, sudomotor and hematological adaptations occurred within 5-6 days of training, whereas the additional improvement in performance after the entire acclimatization period did not relate to changes in these parameters.

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This study investigated if well-trained cyclists improve V ˙ O 2 m a x and performance in cool conditions following heat acclimatization through natural outdoor training in hot conditions. Eighteen trained male cyclists were tested for physiological adaptations, V ˙ O 2 m a x , peak aerobic power output, exercise efficiency, and outdoor time trial (TT) performance (43.4 km in cool environment, ∼5-13 °C) before and after 2 weeks of training in a cool (CON, n = 9) or hot (∼35 °C, HA, n = 9) environment. After heat acclimatization, TT performance in the heat was improved by 16%; however, there was no change in the HA group in V ˙ O 2 m a x (4.79 ± 0.21 L/min vs 4.82 ± 0.35 L/min), peak aerobic power output (417 ± 16 W vs 422 ± 17 W), and outdoor TT performance in cool conditions (300 ± 14 W/69 ± 3 min vs 302 ± 9 W/69 ± 4 min). The present study shows that 2 weeks of heat acclimatization was associated with marked improvements in TT performance in the heat. However, for the well-trained endurance athletes, this did not transfer to an improved aerobic exercise capacity or outdoor TT performance in cool conditions.

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OBJECTIVES: To examine with a parallel group study design the performance and physiological responses to a 14-day off-season 'live high-train low in the heat' training camp in elite football players. METHODS: Seventeen professional Australian Rules Football players participated in outdoor football-specific skills (32 ± 1°C, 11.5 h) and indoor strength (23 ± 1°C, 9.3 h) sessions and slept (12 nights) and cycled indoors (4.3 h) in either normal air (NORM, n=8) or normobaric hypoxia (14 ± 1 h/day, FiO2 15.2-14.3%, corresponding to a simulated altitude of 2500-3000 m, hypoxic (HYP), n=9). They completed the Yo-Yo Intermittent Recovery level 2 (Yo-YoIR2) in temperate conditions (23 ± 1°C, normal air) precamp (Pre) and postcamp (Post). Plasma volume (PV) and haemoglobin mass (Hb(mass)) were measured at similar times and 4 weeks postcamp (4WPost). Sweat sodium concentration ((Na(+))(sweat)) was measured Pre and Post during a heat-response test (44°C). RESULTS: Both groups showed very large improvements in Yo-YoIR2 at Post (+44%; 90% CL 38, 50), with no between-group differences in the changes (-1%; -9, 9). Postcamp, large changes in PV (+5.6%; -1.8, 5.6) and (Na(+))sweat (-29%; -37, -19) were observed in both groups, while Hb(mass) only moderately increased in HYP (+2.6%; 0.5, 4.5). At 4WPost, there was a likely slightly greater increase in Hb(mass) (+4.6%; 0.0, 9.3) and PV (+6%; -5, 18, unclear) in HYP than in NORM. CONCLUSIONS: The combination of heat and hypoxic exposure during sleep/training might offer a promising 'conditioning cocktail' in team sports.

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Research into the biomechanical manifestation of fatigue during exhaustive runs is increasingly popular but additional understanding of the adaptation of the spring-mass behaviour during the course of strenuous, self-paced exercises continues to be a challenge in order to develop optimized training and injury prevention programs. This study investigated continuous changes in running mechanics and spring-mass behaviour during a 5-km run. 12 competitive triathletes performed a 5-km running time trial (mean performance: Ì´17 min 30 s) on a 200 m indoor track. Vertical and anterior-posterior ground reaction forces were measured every 200 m by a 5-m long force platform system, and used to determine spring-mass model characteristics. After a fast start, running velocity progressively decreased (- 11.6%; P<0.001) in the middle part of the race before an end spurt in the final 400-600 m. Stride length (- 7.4%; P<0.001) and frequency (- 4.1%; P=0.001) decreased over the 25 laps, while contact time (+ 8.9%; P<0.001) and total stride duration (+ 4.1%; P<0.001) progressively lengthened. Peak vertical forces (- 2.0%; P<0.01) and leg compression (- 4.3%; P<0.05), but not centre of mass vertical displacement (+ 3.2%; P>0.05), decreased with time. As a result, vertical stiffness decreased (- 6.0%; P<0.001) during the run, whereas leg stiffness changes were not significant (+ 1.3%; P>0.05). Spring-mass behaviour progressively changes during a 5-km time trial towards deteriorated vertical stiffness, which alters impact and force production characteristics.

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OBJECTIVES: To examine the usefulness of selected physiological and perceptual measures to monitor fitness, fatigue and running performance during a pre-season, 2-week training camp in eighteen professional Australian Rules Football players (21.9±2.0 years). DESIGN: Observational. METHODS: Training load, perceived ratings of wellness (e.g., fatigue, sleep quality) and salivary cortisol were collected daily. Submaximal exercise heart rate (HRex) and a vagal-related heart rate variability index (LnSD1) were also collected at the start of each training session. Yo-Yo Intermittent Recovery level 2 test (Yo-YoIR2, assessed pre-, mid- and post-camp, temperate conditions) and high-speed running distance during standardized drills (HSR, >14.4 km h(-1), 4 times throughout, outdoor) were used as performance measures. RESULTS: There were significant (P<0.001 for all) day-to-day variations in training load (coefficient of variation, CV: 66%), wellness measures (6-18%), HRex (3.3%), LnSD1 (19.0%), but not cortisol (20.0%, P=0.60). While the overall wellness (+0.06, 90% CL (-0.14; 0.02) AU day(-1)) did not change substantially throughout the camp, HRex decreased (-0.51 (-0.58; -0.45)% day(-1)), and cortisol (+0.31 (0.06; 0.57) nmol L(-1)day(-1)), LnSD1 (+0.1 (0.04; 0.06) ms day(-1)), Yo-YoIR2 performance (+23.7 (20.8; 26.6) m day(-1), P<0.001), and HSR (+4.1 (1.5; 6.6) m day(-1), P<0.001) increased. Day-to-day ΔHRex (r=0.80, 90% CL (0.75; 0.85)), ΔLnSD1 (0.51 (r=0.40; 0.62)) and all wellness measures (0.28 (-0.39; -0.17)

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This study investigated the effect of hot conditions on repeated sprint cycling performance and post-exercise alterations in isometric knee extension function. Twelve physically active participants performed 10 × 6-s "all-out" sprints on a cycle ergometer (recovery = 30 s), followed 6 min later by 5 × 6-s sprints (recovery = 30 s) in either a neutral (24 °C/30 %rH) or a hot (35 °C/40 %rH) environment. Neuromuscular tests including voluntary and electrically evoked isometric contractions of the knee extensors were performed before and after exercise. Average core temperature during exercise was higher (38.0 ± 0.1 vs. 37.7 ± 0.1 °C, respectively; P < 0.05) in hot versus neutral environments. Peak power output decreased (-17.9 % from sprint 1 to sprint 10 and -17.0 % from sprint 11 to sprint 15; P < 0.001) across repetitions. Average peak power output during the first ten sprints was higher (+3.1 %; P < 0.01) in the hot ambient temperature condition. Maximal strength (-12 %) and rate of force development (-15 to -26 %, 30-200 ms from the onset of contraction) decreased (P < 0.001) during brief contractions after exercise, irrespectively of the ambient temperature. During brief maximal contractions, changes in voluntary activation (~80 %) were not affected by exercise or temperature. Voluntary activation declined (P < 0.01) during the sustained contraction, with these reductions being more pronounced (P < 0.05) after exercise but not affected by the ambient temperature. Resting twitch amplitude declined (P < 0.001) by ~42 %, independently of the ambient temperature. In conclusion, heat exposure has no effect on the pattern and the extent of isometric knee extensor fatigue following repeated cycling sprints in the absence of hyperthermia.

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Challenging environmental conditions, including heat and humidity, cold, and altitude, pose particular risks to the health of Olympic and other high-level athletes. As a further commitment to athlete safety, the International Olympic Committee (IOC) Medical Commission convened a panel of experts to review the scientific evidence base, reach consensus, and underscore practical safety guidelines and new research priorities regarding the unique environmental challenges Olympic and other international-level athletes face. For non-aquatic events, external thermal load is dependent on ambient temperature, humidity, wind speed and solar radiation, while clothing and protective gear can measurably increase thermal strain and prompt premature fatigue. In swimmers, body heat loss is the direct result of convection at a rate that is proportional to the effective water velocity around the swimmer and the temperature difference between the skin and the water. Other cold exposure and conditions, such as during Alpine skiing, biathlon and other sliding sports, facilitate body heat transfer to the environment, potentially leading to hypothermia and/or frostbite; although metabolic heat production during these activities usually increases well above the rate of body heat loss, and protective clothing and limited exposure time in certain events reduces these clinical risks as well. Most athletic events are held at altitudes that pose little to no health risks; and training exposures are typically brief and well-tolerated. While these and other environment-related threats to performance and safety can be lessened or averted by implementing a variety of individual and event preventative measures, more research and evidence-based guidelines and recommendations are needed. In the mean time, the IOC Medical Commission and International Sport Federations have implemented new guidelines and taken additional steps to mitigate risk even further.

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This study investigated the effects of Ramadan on activity patterns, body composition and muscle function. 11 moderately active Muslim males were screened 1 month and 1 week before, in the last week of, and 1 month after Ramadan. Activity patterns were assessed during 72 h using a tri-axial accelerometer, body composition was evaluated via bio-electrical impedance and muscle function during maximal isometric contractions with EMG recordings. Data showed a modification of the activity pattern during Ramadan with a higher level of activity from 02:00 to 05:00 h (29±26, 364±323 and 27±22 steps.h - 1 before, during and after Ramadan, respectively, P<0.05). However, total daily energy expenditure was similar during all testing periods (506±156, 542±219 and 545±207 Kcal.day - 1, respectively), partly explaining the lack of influence of Ramadan on body mass (70.9±11, 70.0±9 and 70.8±9 Kg, respectively) and composition (all P>0.05). Maximal force, associated electrical activity and neuromuscular efficiency (torque/EMG ratio) were maintained during Ramadan (torque: 254.6±30 N.m - 1, Neuromuscular efficiency: 1.0±0.4 a.u.) to levels observed before (244.3±26 N.m, 1.1±0.5 a.u.) and after the holy month (252.5±31 N.m, 1.1±0.5 a.u.). In summary, our data suggest that the influence of Ramadan should be considered as a modification in the distribution of activity times during the day.

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The aim of this study was to characterize the effect of a 5 km running time trial on the neuromuscular properties of the plantar flexors. Eleven well-trained triathletes performed a series of neuromuscular tests before and immediately after the run on a 200 m indoor track. Muscle activation (twitch interpolation) and normalized EMG activity were assessed during maximal voluntary contraction (MVC) of plantar flexors. Maximal soleus H-reflexes and M-waves were evoked at rest (i.e. H (MAX) and M (MAX), respectively) and during MVC (i.e. H (SUP) and M (SUP), respectively). MVC significantly declined (-27%; P < 0.001) after the run, due to decrease in muscle activation (-8%; P < 0.05) and M (MAX)-normalized EMG activity (-13%; P < 0.05). Significant reductions in M-wave amplitudes (M (MAX): -13% and M (SUP): -16%; P < 0.05) as well as H (MAX)/M (MAX) (-37%; P < 0.01) and H (SUP)/M (SUP) (-25%; P < 0.05) ratios occurred with fatigue. Following exercise, the single twitch was characterized by lower peak torque (-16%; P < 0.001) as well as shorter contraction (-19%; P < 0.001) and half-relaxation (-24%; P < 0.001) times. In conclusion, the reduction in plantar flexors strength induced by a 5 km running time trial is caused by peripheral adjustments, which are attributable to a failure of the neuromuscular transmission and excitation-contraction coupling. Fatigue also decreased the magnitude of efferent motor outflow from spinal motor neurons to the plantar flexors and part of this suboptimal neural drive is the result of an inhibition of soleus motoneuron pool reflex excitability.

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The aim of the present study was to examine the associations between adaptive responses to an in-season soccer training camp in the heat and changes in submaximal exercising heart rate (HRex, 5-min run at 9 km/h), postexercise HR recovery (HRR) and HR variability (HRV). Fifteen well-trained but non-heat-acclimatized male adult players performed a training week in Qatar (34.6 ± 1.9°C wet bulb globe temperature). HRex, HRR, HRV (i.e. the standard deviation of instantaneous beat-to-beat R-R interval variability measured from Poincaré plots SD1, a vagal-related index), creatine kinase (CK) activity, plasma volume (PV) changes, and post-5-min run rate of perceived exertion (RPE) were collected at six occasions in temperate environmental conditions (22°C). Players also performed the yo-yo intermittent recovery test level 1 (Yo-Yo IR1) in the same environmental conditions (22°C), both at the beginning and at the end of the training week. Throughout the intervention, HRex and HRV showed decreasing (P < 0.001) and increasing (P < 0.001) trends, respectively, while HRR remained unaffected (P = 0.84). Changes in HRex [-0.52, 90% confidence limits (-0.64; -0.38), P < 0.001] and SD1 [0.35 (0.19; 0.49), P < 0.001] were correlated with those in PV. There was no change in RPE (P = 0.92), while CK varied according to training contents (P < 0.001), without association with HR-derived measures. Yo-Yo IR1 performance increased by 7 ± 9% (P = 0.009), which was correlated with changes in HRex [-0.64 (-0.84; -0.28), P = 0.01]. In conclusion, we found that an in-season soccer training camp in the heat can significantly improve PV and soccer-specific physical performance; both of which are associated with changes in HRex during a 5-min submaximal run.

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