A thesis submitted to the School of Graduate Studies in partial fulfillment of the requirements for the degree Master of Science. / Sprint interval training (SIT) is a time-efficient strategy to improve cardiorespiratory fitness; however, most protocols have been studied in a laboratory setting and require specialized equipment. We investigated the efficacy of brief intense stair climbing as a practical model of SIT to improve cardiometabolic health, with a key measure being cardiorespiratory fitness as indicated by peak oxygen uptake (VO2peak). Two separate studies, each consisting of an acute and chronic phase, were conducted in a total of 31 sedentary women (age=24±10 y; BMI=23±4 kg•m-2). The acute phase of Study 1 established that the heart rate (HR), blood lactate concentration (BLa), and rating of perceived exertion (RPE) responses were similar when participants (n=8) performed a SIT protocol that involved 3x20-s “all-out” efforts of either continuous stair climbing or cycling, interspersed with 2 min of recovery. The chronic phase demonstrated that when participants (n=12) performed the 3x20-s stair climbing protocol 3 d•wk-1 for 6 wk, absolute and relative VO2peak increased by 12%, or ~1 metabolic equivalent (1.80±0.25 to 2.02±0.27 L•min-1, p<0.001), as there were no changes in body mass (p=0.35), fat free mass (FFM; p=0.09) or % body fat (p=0.42). There were also no changes in resting systolic and diastolic blood pressure (BP; p=0.82 and p=0.97, respectively), resting HR (p=0.62), and fasting insulin sensitivity (p=0.52). The acute phase of Study 2 established that the HR and RPE responses were similar when participants (n=11) performed three different stair climbing protocols. The protocols investigated include the 3x20-s continuous ascent model used in Study 1 (protocol 1), as well as 3x60-s bouts of ascending and descending either one or two flights of stairs, with 60-s of recovery (protocol 2 and 3, respectively). The chronic phase demonstrated that when the same group of subjects performed the 3x60-s 1-flight protocol 3 d•wk-1 for 6 wk, absolute and relative VO2peak increased by 8 and 7%, respectively (1.79±0.36 to 1.93±0.39 L•min-1, p=0.001; 31.2±4.6 to 33.3±5.3 mL•kg-1•min-1; p=0.01). Despite no changes in % body fat (p=0.10), there was an increase 3% increase in FFM (p<0.001). There was no change in systolic (p=0.50) and diastolic BP (p=1.00), but resting HR improved by 8% after training (p=0.03). The change in insulin sensitivity derived from an OGTT was 7.1±11 mg I2•mmol-1•mIU-1•min-1 (p=0.056). These findings demonstrate that brief intense stair climbing is a practical, time-efficient strategy to improve cardiorespiratory fitness in previously untrained women. / Thesis / Master of Science (MSc) / Sprint interval training (SIT), involving brief bouts of very intense exercise separated by short periods of recovery, is a time-efficient alternative to traditional endurance training for improving fitness. This has largely been established in laboratory settings using specialized equipment, which is impractical for many individuals. This project examined whether brief intense stair climbing was a practical model of SIT to elicit adaptations previously shown with cycling protocols. Subjects performed either three 20-s ascents interspersed with 2 min recovery periods, or three 60-s bouts of ascending and descending one or two flights of stairs, with 60-s recovery periods. Both protocols were 10 min in duration including warm-up and cool-down, and subjects trained three days per week for six weeks. The main finding was that stair climbing is a practical, time-efficient model to improve fitness in previously sedentary individuals.

Sprint interval training (SIT) increases peak oxygen uptake (VO2peak) but the mechanistic basis is unclear. The Fick principle broadly attributes increases in VO2peak to changes in peak cardiac output (Qpeak) and/or peak arteriovenous oxygen difference (peak a-vO2diff). The main purpose of this thesis was to investigate the role of Qpeak, measured non-invasively using inert gas rebreathing (IGR), on SIT-induced changes in VO2peak. It also considered the time course of these responses and the influence of biological sex. The SIT protocol involved 3 x 20-s “all out” sprints performed within a 10-min session of low-intensity cycling. Study 1 measured Qpeak after 2, 6, and 12 weeks of SIT and found it was increased after 12 weeks and associated with the change in VO2peak. Peak a-vO2diff, estimated based on the Fick equation (peak a-vO2diff = VO2peak/Qpeak), was also increased after SIT and associated with the change in VO2peak. Study 2 found that a novel constant-load protocol elicited Qpeak values that were non-inferior to an established step protocol, within a margin of 0.5 L/min. Both protocols elicited VO2 values at Qpeak that were similar to VO2peak. The constant load protocol had similar day-to-day repeatability as the VO2peak test (typical error = 6.6 and 6.4%, respectively). Study 3 investigated an exploratory finding from Study 1 that suggested Qpeak was increased in male but not female participants. The design was similar, but Study 3 employed suggested best practices for making sex-based comparisons. Contrary to our hypothesis, Qpeak was unchanged after 12 weeks of SIT and there was no sex-based difference. Like Study 1, peak a-vO2diff was increased and correlated with VO2peak. This thesis advances knowledge regarding the influence of SIT on Qpeak determined non-invasively and highlights the need for more mechanistic work to comprehensively assess the basis for the increase in VO2peak. / Thesis / Candidate in Philosophy / Sprint interval training (SIT) is a form of exercise that involves brief bursts of near-maximal to “all out” efforts separated by short recovery periods. The method improves cardiorespiratory fitness — an important health marker that is quantified as the highest amount of oxygen used by the body during strenuous exercise (VO2peak) — but the mechanisms are not well understood. This thesis examined the effect of SIT on peak cardiac output (Qpeak), which is the highest rate of blood pumped by the heart each minute, and the relationship to changes in VO2peak. Qpeak was measured non-invasively by having participants breathe an inert gas mixture. Two separate 12-week training studies confirmed that SIT increased VO2peak but yielded conflicting results regarding the role of Qpeak. The findings also suggest that the capacity of skeletal muscles to extract oxygen is increased after SIT. Biological sex does not appear to influence SIT-induced changes in Qpeak or VO2peak.

Despite clear recommendations on the minimal amount of physical activity for achieving health benefits and reducing risk of chronic disease, the majority of people in the Western world remain sedentary. As a 'lack of time' has been identified as one of the main barriers to becoming and remaining physically active, in the past decade research has focused on high-intensity interval training (HIT) as a time-efficient alternative to aerobic exercise. Although initial studies convincingly demonstrated equal or better health benefits with various HIT protocols compared to much larger volumes of aerobic exercise, these HIT protocols tend to be very strenuous and as such are unlikely to be adhered to by sedentary populations. Furthermore, most HIT protocols are not as time-efficient as sometimes claimed, with the total time per exercise session generally exceeding 20-30 minutes. This thesis aimed to characterise the effects of a novel reduced-exertion HIT (ReHIT) protocol, requiring a maximum of 2 x 20 s all-out sprint efforts in a 10 min training session, upon insulin sensitivity, aerobic capacity, glycogen utilisation and associated acute metabolic responses. The ReHIT exercise bouts were well tolerated by participants, but were associated with a substantial disturbance of physiological homeostasis including muscle glycogen degradation, lactate accumulation, excursions in plasma volume, post-exercise oxygen consumption, respiratory exchange ratio and heart rate, as well as a skeletal muscle signalling response through AMPK, and increases in skeletal muscle GLUT4 and PGC1α mRNA expression (Chapter 4 and 5). The combined training studies (n=49) provide some support for improvements in key disease biomarkers following ReHIT, with improvements in insulin sensitivity observed in men, and increased aerobic capacity observed in men and women (Chapter 7). These observations highlight a potential regulatory role for glycogen in exercise-induced adaptation. However, the mean improvements in insulin sensitivity in men were not consistent between the two training studies (Chapter 2 and 6), and there was a high level of variability observed between individuals (Chapter 6 and 7). Therefore, the impact of ReHIT on insulin sensitivity needs to be further explored in the context of a randomised controlled trial, and the mechanisms underpinning the large variability in adaptive response need to be characterised.

<p> Increased arterial stiffness and vascular endothelial dysfunction have been identified as independent risk factors for the development and progression of cardiovascular disease. Traditional endurance training has been associated with elevated levels of central arterial compliance and an attenuation of cardiovascular events. As well, the positive benefits of aerobic-based training have been acknowledged as effective modulators of vascular endothelial function. To date, the impact of sprint interval training on cardiovascular health has not been evaluated. Furthermore, the mechanisms responsible for previously observed enhancements in endurance (750 kJ) performance following two weeks of sprint interval training remain unclear, but may be related to changes in vascular structure and function.</p> <p> Nine young healthy males [age: 22 ± 0.5 (mean± SEM)] participated in a two week sprint interval training program consisting of 4-6 30 second maximum effort exercise bouts performed every other day on a cycle ergometer. In addition, each participant was required to complete a 750 kJ time trial on a cycle ergometer as a measure of aerobic exercise performance before (PRE) and after (POST) training. Measurements of supine, resting carotid pulse pressure, carotid cross-sectional compliance, and brachial vascular endothelial function (using flow mediated dilation) were also acquired PRE and POST training.</p> <p> Resting pulse pressure did not show any significant changes with exercise training (PRE= 48.6±1.6, POST= 52.4±2.5 mmHg, p>0.05). Mean brachial artery diameter was not changed with sprint interval training (PRE= 4.29±0.17, POST= 4.38±0.18 mm, p>0.05); however, mean carotid artery diameter increased significantly PRE to POST (PRE= 6.40±0.15, POST= 6.49±0.14 mm, p=0.008). Carotid cross-sectional compliance did not change PRE to POST training (PRE= 0.164±0.010, POST= 0.162±0.007 mm^2/mmHg, p>0.05). Brachial vascular endothelial function measured using flow-mediated dilation did not show a significant change with sprint interval training, however a trend towards improvement was noted (PRE= 4.6±1.8, POST= 6.4±1.0 %, p=0.296). When normalized for shear rate (which was also unaltered with sprint interval training) there were no changes in endothelial function (PRE = 0.158±0.068, POST= 0.198 ± 0.034 %/S^-1, p>0.05). Average brachial post-occlusion blood flow was significantly enhanced following training possibly revealing enhanced resistance vessel function (PRE= 296.0±37.4, POST= 324.8±38.8 ml/min, p=0.04), despite no change in peak brachial blood flow (PRE= 332.0±42.3, POST= 362.6±45.7 ml/min, p>0.05). 750 kJ time trial performance was significantly enhanced with training (PRE = 62.8±4.9; POST= 55.84±3.55 min; p=0.006).</p> <p> In conclusion, sprint interval training did not change resting carotid compliance or brachial endothelial function, despite significant improvements in aerobic performance (750 kJ). However, carotid resting diameters and brachial post occlusion blood flow were significantly increased PRE to POST and a trend towards improvement was seen for brachial flow mediated dilation. The exact mechanisms responsible for such changes remain unknown and require further investigation.</p> / Thesis / Master of Science (MSc)

During inpatient rehabilitation, arm-ergometry training is utilized to improve the physical capacity of patients with a sub-acute spinal cord injury (SCI) to a level that is desirable for performing activities of daily living (ADLs). Previous work has demonstrated that ≥ 20 minutes of moderate-intensity continuous training (MICT) during inpatient rehabilitation, at a frequency of ≥ 3 times per week, is useful for increasing the physical capacity of these patients. However, considering that inpatient rehabilitation is an intensive program, and given the trend towards a shortened length of stay during inpatient rehabilitation, performing MICT on the arm-ergometer can consume a valuable amount of therapy time. Low-volume sprint interval training (SIT) is a time-efficient alternative to MICT for improving indices of physical fitness in healthy and diseased populations. To date, however, there are no published studies comparing SIT to MICT in persons with sub-acute SCI undergoing inpatient rehabilitation.The purpose of this thesis was to evaluate the efficacy of a five-week, thrice weekly low-volume SIT protocol on the arm-ergometer and compare fitness outcomes to traditional MICT in patients with sub-acute SCI undergoing inpatient rehabilitation. Participants with sub-acute SCI undergoing inpatient rehabilitation were recruited and randomly allocated to the SIT or MICT training group. Both types of training utilized the same 2 min. warm-up and 3 min. cool-down. SIT consisted of 3 x 20 sec. “all-out” cycle sprints (≥ 100% of peak power output [POpeak]), interspersed with 2 min. of low activerecovery (≈ 10% of POpeak; total time commitment, 10 mins). MICT involved 20 min. of arm cycling (45 – 60% of POpeak; total time commitment, 25 mins). SIT elicited a higher relativheart rate response, and ratings of perceived exertion than MICT. Following training, we found similar improvements in maximal and sub-maximal physical capacity across groups. Both exercise modes were equally well tolerated, and enjoyable, and there were no differences in self-efficacy across groups. The significance of this work is that it is the first randomized-controlled trial comparing SIT to MICT on the arm-ergometer in individuals with sub-acute SCI undergoing inpatient rehabilitation. The fact that SIT is palatable and can promote similar increases in physical capacity as MICT, despite less than half the time commitment and training volume, means that clinical rehabilitation specialists can now offer a new, more time-efficient, exercise training strategy to elicit improvements in their patients. / Thesis / Master of Science (MSc)

Highly-trained athletes are accustomed to varied and high-volume based exercise stimuli and eliciting adaptation in individuals already possessing the necessary physiology to compete at the highest level is difficult. Therefore, identifying novel, potent and time efficient methods of achieving cumulative training stress is a continual quest for coaches and exercise scientists. This thesis examined the acute and chronic effects of manipulating exercise and recovery during brief all-out sprint cycling on adaptive responses favouring enhanced endurance capacity. Chapter 3 highlighted that low-volume non-work matched all-out sprint cycling, whether it be interval- (4 x 30 s bouts) or continuous based (1 x 2 min bout) provides a similarly potent stimulus for the acute induction of cell signalling pathways and key growth factors associated with mitochondrial biogenesis and angiogenesis in trained individuals. In line with manipulating recovery and in attempting to identify a novel and potent exercise intervention capable of giving athletes more return on their training investment, Chapters 4-6 investigated the efficacy of combining sprint interval training with post-exercise blood flow restriction (BFR). Firstly, it was demonstrated that BFR potentiates HIF-1α mRNA expression in response to SIT, tentatively suggesting an enhanced stimulus for hypoxia- and/or metabolic-mediated cell signalling associated with mitochondrial biogenesis and angiogenesis over SIT alone. Secondly, four weeks of SIT combined with post-exercise BFR provides a greater training stimulus over SIT alone in trained individuals to enhance VO2max (4.7 v 1.1 % change) and MAP (3.8 v 0.2 % change), but not 15-km TT performance. Finally, in response to four weeks of SIT combined with post-exercise BFR, an international female track sprint cyclist increased her CP and W by 7 and 2 % and VO2max and absolute MAP by 3 and 4 %, respectively. Through a combination of an acute in vivo molecular experiment, a training study and an athlete case study, this thesis has introduced a potentially potent and novel training concept that appears capable of augmenting aerobic capacity.

Introduktion: Fysisk aktivitet har stor betydelse för en god hälsa när vi åldras. Trots det är en stor andel av äldre personer stillasittande. Brist på tid och obehagliga upplevelser ses som hinder till träning. Högintensiv träning kan utföras på kort tid och kan ge större hälsofördelar än medelintensiv träning. Däremot har högintensiv träning upplevts för ansträngande och olämpligt för en stillasittande population. En negativ affektiv respons kan minska följsamheten i träningen vilket belyser vikten av att anpassa högintensiv träning för äldre. Forskning om upplevelser av en anpassad högintensiv träningsregim saknas i dagsläget. Syfte: Att beskriva upplevelser av supramaximala cykelintervaller, träningsmotivation och fortsatta träningsvanor hos informanterna, sex månader efter genomförd intervention.  Metod: I studien användes en kvalitativ induktiv ansats. Sex månader efter en träningsintervention genomfördes semi-strukturerade intervjuer. Tio av de intervjuerna har analyserats i denna studie, med deltagare som hade genomfört anpassade supramaximala intervaller på cykel två gånger per vecka under tolv veckor. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Analysen av intervjuerna resulterade i fem kategorier: Träningen fyllde en viktig plats i livet, Att uppleva kroppen genom träning, Gemenskap som ger drivkraft, Träningen som stärkande upplevelse, och Att förändra eller falla in i gamla vanor. Konklusion: Supramaximala anpassade intervaller i grupp är en träningsform som verkar passa äldre personer. Träningen har upplevts lättsam och tidseffektiv. Gruppen har varit viktig och bidragit med glädje och motivation i träningen. Trots ökad motivation till träning har många fallit tillbaka i gamla vanor efter träningsperioden. Individuellt motstånd möjliggör träning på rätt intensitet i en grupp med blandad träningsvana. Dessa insikter kan komma att bli viktiga för att implementera träningsformen.