At any given running speed, weight support with a lower body positive pressure (LBPP) device (i.e. Alter-G treadmill) reduces V̇O2. However, it is unknown how application of LBPP during running impacts lactate metabolism, specifically lactate threshold. Purpose: To determine if body weight unloading with the Alter-G treadmill alters lactate threshold. Methods. Maximal aerobic capacity (V̇O2max) and lactate threshold (LT) was determined in 8 male subjects on an Alter-G treadmill at 100% and 80% body weight loading at 0% grade in a randomized crossover design. V̇O2max tests started at 7 mile h-1 and increase speed by 1 mile h-1 every 2 min till voluntary exhaustion and were separated by a minimum of 7 days. LT tests started at 5 mile h-1 and increased speed to 6, 7, 7.5, 8.0, 8.5, 9.0 (additional stages increase speed by 0.5 mile h-1) every 3 min until the subject reached ¡Ö85% of V̇O2max. LT tests were separated by a minimum 3 days. V̇O2, heart rate (HR), mean arterial blood pressure (MAP) and changes in Hct, [Hb], and total protein ([TP]) were determined on separate days in a randomized crossover design. Plasma lactate concentrations were determined from venous blood samples (4 ml) obtained at rest and during the last minute of each exercise stage. Lactate threshold was determined from a log-log plot of lactate concentration (mM) and relative V̇O2 (ml O2 min-1 kg-1 BM). Results. V̇O2max determined during running at 100% and 80% loading were similar (52.3 ± 0.9 and 52.7 ± 0.7 ml O2 min-1 kg-1 BM, respectively). The energy cost of running at 9 mile h-1 (all subjects completed stages between 5 and 9 mile h-1) was reduced by 12% at 80% body weight (37.2 ± 2.9 ml O2 min-1 kg-1 BM) compared to running at 100% body weight (42.3 ± 1.7 ml O2 min-1 kg-1 BM, <0.05). However, plasma lactate at 9 mile h-1 was similar during 80% and 100% body weight running (3.4 ± 0.4 and 3.1 ± 0.7 mM, respectively). Plasma lactate at a given V̇O2 was higher (p < 0.05) while running at 80% body weight compared to 100% body weight running. Calculated LT at 100% BW loading (36.3 ± 1.3 ml O2 min-1 kg-1 BM) was higher than 80% BW loading (32.2 ± 1.8 ml O2 min-1 kg-1 BM, p<0.05). During running at 80% BW HR was reduced compared to 100% BW running (p<0.05) however the MAP response was similar. During exercise the reduction in PV, at any given V̇O2 was larger at 80% BW compared to 100% BW running (p<0.001). Conclusion. During running, BW unloading with LBPP decreased the energy cost of exercise but not lactate levels. Body weight unloading caused a lowering of the LT. The reduction in whole body energy cost was not associated with a reduction in the lactate production since plasma lactate accumulation at a given speed was similar with and without LBPP.

The primary aim of this thesis was to develop a better understanding of the physiology and perceptual responses associated with the performance of continuous (CE) and intermittent exercise (IE) in patients with moderate chronic obstructive pulmonary disease (COPD). A secondary aim was to examine factors that could potentially limit exercise tolerance in COPD patients, particularly in relation to the dynamics of the cardiovascular system and muscle metabolism. The results of the four studies conducted to achieve these aims are presented in this thesis. In Study 1, the physiological, metabolic and perceptual responses to an acute bout of IE and CE were examined in 10 individuals with moderate COPD. Each subject completed an incremental exercise test to exhaustion on a cycle ergometer. Subjects then performed IE (1 min exercise: 1 min rest ratio) and CE tests at 70% of peak power in random order on separate days. Gas exchange, heart rate, plasma lactate concentration, ratings of breathlessness, inspiratory capacity and the total amount of work completed were measured during each exercise test. Subjects were able to complete a significantly greater amount of work during IE (71 ± 32 kJ) compared with CE (31 ± 24 kJ). Intermittent exercise was associated with significantly lower values for oxygen uptake, expired ventilation and plasma lactate concentration when compared with CE. Subjects also reported a significantly lower rating of breathlessness during IE compared to CE. The degree of dynamic lung hyperinflation (change in end-expiratory lung volume) was lower during IE (0.23 ± 0.07 L) than during CE (0.52 ± 0.13 L). The results suggest that IE may be superior to CE as a mode of training for patients with COPD. The greater amount of total work performed and the lower measured physiological responses attained with intermittent exercise could potentially allow greater training adaptations to be achieved in individuals with more limited lung function. The purpose of Study 2 was to compare the adaptations to 8 wk of supervised intermittent and continuous cycle ergometry training, performed at the same relative intensity and matched for total work completed, in patients with COPD. Nineteen subjects with moderate COPD were stratified according to age, gender, and pulmonary function, and then randomly assigned to either an IE (1 min exercise: 1 min rest ratio) or CE training group. Subjects trained 3 d per week for 8 wk and completed 30 min of exercise. Initial training intensity, i.e., the power output applied during the CE bouts and during the exercise interval of the IE bouts, was determined as 50% of the peak power output achieved during incremental exercise and was increased by 5% each week after 2 wk of training. The total amount of work performed was not significantly different (P=0.74) between the CE (750 ± 90 kJ) and IE (707 ± 92 kJ) groups. The subjects who performed IE (N=9) experienced significantly lower levels of perceived breathlessness and lower limb fatigue during the exercise-training bouts than the group who performed CE (N=10). However, exercise capacity (peak oxygen uptake) and exercise tolerance (peak power output and 6-min walk distance) improved to a similar extent in both training groups. During submaximal constant-load exercise, the improved (faster) phase II oxygen uptake kinetic response with training was independent of exercise mode. Furthermore, training-induced reductions in submaximal exercise heart rate, carbon dioxide output, expired ventilation and blood lactate concentrations were not different between the two training modes. Exercise training also resulted in an equivalent reduction for both training modes in the degree of dynamic hyperinflation observed during incremental exercise. Thus, when total work performed and relative intensity were the same for both training modes, 8 wk of CE or IE training resulted in similar functional improvements and physiological adaptations in patients with moderate COPD. Study 3 examined the relationship between exercise capacity (peak oxygen uptake) and lower limb vasodilatory capacity in 9 patients with moderate COPD and 9 healthy age-matched control subjects. While peak oxygen uptake was significantly lower in the COPD patients (15.8 ± 3.5 mL·min-1·kg-1) compared to the control subjects (25.2 ± 3.5 mL·kg-1·min-1), there were no significant differences between groups in peak calf blood flow or peak calf conductance measured 7 s post-ischemia. Peak oxygen uptake was significantly correlated with peak calf blood flow and peak conductance in the control group, whereas there was no significant relationship found between these variables in the COPD group. However, the rate of decay in blood flow following ischemia was significantly slower (p less than 0.05) for the COPD group (-0.036 ± 0.005 mL·100 mL-1·min-1·s-1) when compared to the control group (-0.048 ± 0.015 mL·100 mL-1·min-1·s-1). The results of this study suggest that the lower peak exercise capacity in patients with moderate COPD is not related to a loss in leg vasodilatory capacity. Study 4 examined the dynamics of oxygen uptake kinetics during high-intensity constant-load cycling performed at 70% of the peak power attained during an incremental exercise test in 7 patients with moderate COPD and 7 healthy age-matched controls. The time constant of the primary component (phase II) of oxygen uptake was significantly slower in the COPD patients (82 ± 8 s) when compared to healthy control subjects (44 ± 4 s). Moreover, the oxygen cost per unit increment in power output for the primary component and the overall response were significantly higher in patients with COPD than in healthy control subjects. A slow component was observed in 5 of the 7 patients with COPD (49 ± 11 mL·min-1), whereas all of the control subjects demonstrated a slow component of oxygen uptake (213 ± 35 mL·min-1). The slow component comprised a significantly greater proportion of the total oxygen uptake response in the healthy control group (18 ± 2%) than in the COPD group (10 ± 2%). In the COPD patients, the slow component amplitude was significantly correlated with the decrease in inspiratory capacity (r = -0.88, P less than 0.05; N=5), indicating that the magnitude of the slow component was larger in individuals who experienced a greater degree of dynamic hyperinflation. This study demonstrated that most patients with moderate COPD are able to exercise at intensities high enough to elicit a slow component of oxygen uptake during constant-load exercise. The significant correlation observed between the slow component amplitude and the degree of dynamic hyperinflation suggests that the work of breathing may contribute to the slow component in patients with COPD.

Previous studies that utilized sodium lactate infusion did not use resistance exercise protocol or analyzed muscle biopsies, or performed sex specific analysis. Aim: We initiated a project where resistance exercise was performed with low and high levels of lactate, acquired by venous lactate infusion where the specific aim of this study was to investigate and chart the physiological characteristics of sodium lactate infusion during a bout of resistance exercise on whole group level and sexes separated Method: A randomized, placebo controlled, cross-over design was implemented where male (n = 8) and female (n = 8) subjects accustomed to resistance exercise visited the laboratory three times for preliminary testing and training familiarization. In the following two experimental trials subjects arrived in an overnight fasted state. A resting state muscle biopsy was extracted from m. vastus lateralis and repeated blood samples were initiated which followed by 20 minute of baseline infusion of either infusate in resting state at 0.05 mmol/kg/min infusion rate with additional bolus doses during subsequent exercise. Following a brief warm up, unilateral knee-extensions (6 x 8-10 reps at 75% of 1-RM) were performered with or without venous infusion of sodium lactate, with volume matched saline as control. Exercise load and volume were matched between trials. Four additional biopsies were extracted at post-exercise, recovery period, and 24-hour post-exercise. Results: Sodium lactate infusion vs saline infusion respectively during resistance exercise yielded significantly higher blood lactate with sodium lactate (6.78 ± 0.33 mmol/l vs 2.99 ± 0.17 mmol/l), plasma lactate (8.86 ± 0.39 mmol/l vs 4.39 ± 0.22 mmol/l), blood sodium (143 ± 0.4 mmol/l vs 142 ± 0.3 mmol/l), blood pH (7.42 ± 0.01 vs 7.34 ± 0.01), but lower blood potassium (3.9 ± 0.1 mmol/l vs 4.2 ±  0.1 mmol/l), all  immediately following exercise. Sodium lactate infusion elicited main effect of trials and muscle lactate increased from baseline (8.5 ± 0.9 mmol·kg-1 dw vs 7.0 ± 0.6 mmol·kg-1 dw) to post-exercise (31.5 ± 2.8 mmol·kg-1 dw vs 26.9 ± 3.2 mmol·kg-1 dw) with sodium lactate and saline infusion respectively. Blood glucose, hemoglobin and muscle pH was not affected by sodium lactate infusion. Conclusions: Utilization of the sodium lactate infusion method during a bout of resistance exercise may be used as tool to effectively increase blood/plasma lactate and, to lesser extent, muscle content of lactate. However, a concomitant slightly alkalizing effect of blood likely will occur. / Tidigare studier som använt natriumlaktat infusion använde inte styrketräningsprotokoll, eller analyserade muskelbiopsier eller utförde könsspecifika analyser. Syfte och frågeställningar: Vi initierade ett projekt där styrketräning utfördes med låga eller höga nivåer av laktat som erhölls genom venös natriumlaktat infusion med det specifika syftet att undersöka och kartlägga fysiologisk karakteristiska av naturiumlaktat infusion under styrketräningsövning på helgrupps- och könsseparerad nivå. Följande frågeställningar inrättades; hur påverkar natriumlaktat infusion under styrketräning helblod- och plasma laktat, glukos, natrium, kalium, plasma volym genom hemoglobin och hematokrit, blod pH, muskellaktat- och muskel pH samt om skillnader i respons finns efter att könsspecifika analyser utförts på dessa variabler. Metod: En randomiserad, placebokontrollerad cross-over design implementerades där styrketräningsvana män (n = 8) och kvinnor (n = 8) besökte laboratoriet tre gånger för preliminäraför tester och träningsfamiliarisering. I efterföljande två experimentella försök anlände försökspersonerna i ett över nattligt fastande tillstånd. En baslinje biopsi extraherades från m. vastus lateralis och repeterade blodprover initierades med efterföljande 20 minuter av baslinje infusion av endera infusat i vilotillstånd med 0.05 mmol/kg/min infusionshastighet med ytterligare bolusdoser under efterföljande träning. Efter en kort uppvärmning utfördes unilaterala knäextensioner (6 x 8-10 reps vid 75% av 1-RM) med eller utan venös infusion av natrium laktat, med volymmatchande saltlösning som kontroll. Träningsbelastning och volym matchades mellan försök. Ytterligare fyra biopsier extraherades vid efter-träning, återhämtningsperiod, och efter 24 timmar. Resultat: Natriumlaktat respektive saltlösnings infusion under styrketräning gav signifikant högre blodlaktat med natriumlaktat infusion (6.78 ± 0.33 mmol/l mot 2.99 ± 0.17 mmol/l), plasmalaktat (8.86 ± 0.39 mmol/l mot 4.39 ± 0.22 mmol/l), blodnatrium (143 ± 0.4 mmol/l mot 142 ± 0.3 mmol/l), blod pH (7.42 ± 0.01 mot 7.34 ± 0.01), men lägre blod kalium (3.9 ± 0.1 mmol/l mot 4.2 ± 0.1 mmol/l), alla direkt efter träning. Natriumlaktat infusion framkallade huvudeffekt av försök och muskellaktat ökade från baslinje (8.5 ± 0.9 mmol·kg-1 dw mot 7.0 ± 0.6 mmol·kg-1 dw) till efter-träning (31.5 ± 2.8 mmol·kg-1 dw mot 26.9 ± 3.2 mmol·kg-1 dw) med natriumlaktat respektive saltlösnings infusion. Blodglukos, hemoglobin och muskel pH påverkades inte av natriumlaktat infusion. Slutsats: Användande av natriumlaktat infusion som metod under styrketräning kan effektivt användas som verktyg för att höja blod/plasma laktat, och i mindre utsträckning, muskellaktat. Emellertid är samtidig alkalisering av blod en sannolik följd. / Potential sex differences in the molecular response to resistance exercise with lactate infusion