Technologies of Effective Training Control in Amateur Triathlon

Non-Invasive Hemodynamic Measurements and Exercise Testing for Accurate

Training Prescription

Anna Zakharova and Kamiliia Mekhdieva

Institute of Physical Education, Sport and Youth Policy, Ural Federal University

named after the first President of Russia B.N. Yeltsin, Mira Street, Yekaterinburg, Russia

Keywords: Triathlon, Amateur Athletes, Training and Testing, Gas-exchange Measurement, Hemodynamic Indicators.

Abstract: Although issues of training in professional triathlon are well highlighted and studied, the approach to

supply, including medical-pedagogical aspects, still remains under debates in amateur triathlon. The

intensity and volume of exercise loads in amateur triathlon tend to those in professional sports, whereas

there is no consensus on efficient training strategy for active individuals engaged in amateur endurance

sports. The objective of the study was to define the role of cardiovascular testing in training program design

in amateur triathlon. Twenty-four healthy active male amateur triathletes aged 26-43 years participated in

the study. Four trials of testing (hemodynamics and gas-exchange monitoring) were conducted to justify the

amendments to training schedule. Based on significant differences of initial hemodynamic parameters (SV,

SI, EDV, EDI) subjects were divided into 2 groups. Determining of the weak aspects of their functional

state enabled to develop an efficient training schedule at the ongoing experiment stages. The obtained

results of the final testing showed significant increase in VO

2max

, maximal power (P

max

) in cycling stress-test

and LV volume characteristics in amateur triathletes.

1 INTRODUCTION

Triathlon is known as a multiple-stage competition.

It involves three endurance disciplines: swimming,

cycling, and running (O’Tool, 1995). Originated in

the beginning of the 20th century, it started the

Olympic history in 2002. In our days the

International Triathlon Union (ITU) consolidates

119 national federations with more than 100

thousand of triathletes. But what is more interesting,

social phenomena of triathlon popularity has non-

sportive background: triathlon is a new form of reply

to mid-life crisis. The explanation is quite easy:

participating in triathlon is a great opportunity to

change oneself and to become a legend. Nowadays

middle-aged people come in amateur triathlon to

find something challenging but available.

Although population of healthy individuals

engaged in amateur sports gradually increases, there

is quite a broad range of possible health issues that

need to be considered. Considering that professional

athletes are provided by high-quality assistance and

medical-biological supply, aimed to minimize the

possible medical risks (Corrado, 2005), amateurs’

health and well-being are on their own responsibi-

lity. As their training intensity and volume almost

come up to professional sport, hence it is critically

important to prescribe trainings with reasonable

accuracy.

Stated above enabled us to formulate the aim of

the study – to estimate the efficiency of stage fun-

ctional testing based on non-invasive hemodynamics

measurements and exercise testing for accurate and

correct training prescription.

2 ORGANIZATION AND

METHODS

Subjects. Twenty-four healthy male amateur

triathletes aged 26-43 (mean age 33.8±4.74 years,

height – 181±5.66 cm, body mass – 80.8±8.86 kg)

were recruited for the study. The participants of the

study had no professional sports background. All

subjects were free of cardiovascular or any other

chronic disease. The investigation conforms to the

principles of the Declaration of Helsinki of the

World Medical Association. Athletes had been infor-

med of the procedures, methods, benefits and possi-

Zakharova, A. and Mekhdieva, K.

Technologies of Effective Training Control in Amateur Tr iathlon - Non-Invasive Hemodynamic Measurements and Exercise Testing for Accurate Training Prescription.

DOI: 10.5220/0006082000830088

In Proceedings of the 4th International Congress on Sport Sciences Research and Technology Support (icSPORTS 2016), pages 83-88

ISBN: 978-989-758-205-9

ble risks involved in the study before their written

consent was obtained. The study was approved by

the Ural Federal University Ethics Committee.

Research Design. Participants were divided into 2

groups according to initial functional state, evaluated

by means of hemodynamic measurements. The

experiment was carried out from December 2015 to

August 2016 and included four consecutive trials of

hemodynamics and gas-exchange measurements

(Table 1). Testing schedule was based on training

periods. All tests were conducted in the laboratory

“Sports and health technologies” of the Institute of

Physical education, sports and youth policy, UrFU.

Exercise Testing. All athletes underwent 12-lead

ECG before exercise testing (ET). To evaluate

aerobic capacity of athletes, the stress-system

Schiller AG Cardiovit AT-104 (Schiller AG,

Switzerland) was used. The maximal ramp cycling

test protocol was applied in accordance with

ACC/AHA 2002 guideline update for exercise

testing (2006). VO

2max

was determined by indirect

calorimetry with the use of portable desktop

metabolic system FitmatePro (COSMED, Italy).

After a 1 min warm-up, subjects started at zero load,

continuously increasing by 40 W per minute until

exhaustion in order to determine HR

max

, VO

2max

maximum attained load (P

max

), VE

max

, anaerobic

threshold (AT). Heart rate monitoring was carried

out with Garmin Forerunner 305 (Garmin, USA)

during the test and immediate post-exercise period

(5 minutes).

2.1 Hemodynamic Measurements

The hemodynamic monitor MARG 10-01

"MicroLux" (Chelyabinsk, Russia) is usually used in

emergency and operation rooms. The device

functioning is based on such noninvasive methods of

hemodynamic monitoring as impedance cardiogra-

phy and spectrophotometry, electrocardiogram

monitoring (ECG), pulse oximetry monitoring,

reography and central hemodynamics monitoring,

blood pressure and temperature.

Measuring Methods. For the experiment a patient

(athlete) was in supine position. Before recording all

subjects were at rest in supine position during 10

minutes. All measured indicators of the central

hemodynamics were automatically registered with 8

ECG electrodes by MicroLux software with beat-to-

beat record.

Central hemodynamic indicators are presented in

four groups: perfusion (stroke volume, cardiac

output, stroke index, cardiac index), preload (end-

diastolic volume, end-diastolic index), afterload (the

index of total peripheral resistance, stroke index of

total peripheral resistance), contractility and left

ventricular activity (contractility index, ejection

fraction; index of left ventricle activity, stroke index

of left ventricle (LV) activity). To investigate the

functional state of young athletes we chose the most

informative for endurance athletes’ hemodynamic

indicators and indices (Shishkina, 2013):

Heart rate (HR, bpm) is the most accessible and

informative indicator of the development of athletes’

cardiovascular system; stroke volume (SV, ml)

values should be a reference point in examining

athletes in endurance sport; stroke index (SI, ml/m

)

is the ratio of stroke volume to body surface area;

end-diastolic volume (EDV, ml) is the maximum

amount of blood received in left ventricle at the end

of diastole; end-diastolic index (EDI, ml/m

) is the

ratio of end-diastolic volume to the body surface

area in square meters; end diastolic volume provides

sufficient stroke volume and cardiac output and is

the guarantor of good tolerance to high intensity

load in training and competitive activities; ejection

fraction (EF, %) changes from 57 to 65 and serves

as an indicator of fitness level as well as the

intensity of previous training process.

Hemodynamics is described by three general

indicators: volemia, inotropy, vascular tone. The

above-mentioned indicators are shown at the

monitor as a percentage of normal values. The

deviations of more than 25% are considered too

high/low in healthy people.

2.2 Cardiovascular Monitoring during

Exercise Test

Maximal cycling test is commonly used in

assessment of physical fitness and aerobic capacity.

It is quite informative, relatively safe and easy

reproducible. Gas-exchange measurements during

stress-test enabled to obtain important information

on athletes’ aerobic capacity (Vilikus, 2012) and

accurate values of metabolic changes under stress

conditions.

The following parameters were simultaneously and

continuously recorded during exercise testing:

oxygen consumption (VO

, ml/kg/min), heart rate

(HR, bpm), systolic blood pressure (SBP, mm Hg),

diastolic blood pressure (DBP, mmHg), cycling

load(P, W), respiratory ventilation (VE, l/min).

icSPORTS 2016 - 4th International Congress on Sport Sciences Research and Technology Support

Table 1: Experiment schedule design.

December 2015 March 2016 June2016 August 2016

Hemodynamic monitoring * * * *

The training focus selection * * *

Exercise testing * * *

Immediate post-exercise measurements of HR,

SBP and DBP during 5 minutes of recovery period

were recorded. The current values of all measured

parameters were demonstrated on the metabolic

analyzer screen and saved in the device memory for

ongoing analysis.

2max

and P

max

are the values of maximal

oxygen uptake and attained load the athlete could

reach. It characterizes an athlete’s integral readiness.

In stress-test HR

max

is an indicator of the priority in

the cardiovascular or muscle fitness: if HR

max

lower than 180 bpm, then there is cardiovascular

priority. And there is a priority of the muscular

system in “heart-muscle balance” if HR

max

is higher

than 200 bpm. VO

2max

, P

max

and HR

max

allow us to

determine the limiting factors of athlete’s

performance (Seluyanov, 2002). According to

modern concepts in cyclical sports physical

workability can be largely limited by either

cardiorespiratory system or muscular system.

2.3 Statistical Analysis

The statistic software package “SPSS Statistics

17.0” (IBM) was used for statistical analysis. Mean

value (M) and standard deviation (SD) for the used

parameters were calculated, t-test was applied for

comparative analysis. The level of significance was

set at P < 0.05. Pearson and Spearmen correlations

between measured parameters were calculated. Two-

way ANOVA was applied to estimate the impact of

particular hemodynamic indices on aerobic capacity

and athletes’ exercise performance.

3 RESULTS AND DISCUSSIONS

The descriptive analysis of hemodynamic data was

performed to define the weak aspects of athletes’

functional state (Table 2). Thus it was found, that:

i) values of measured parameters varied within a

certain range; ii) mean values of volume parameters

and cardiac indices were lower in reference to

athletic norm.

Based on stated above data from the 1

stage of

the proposed study, a group of triathletes was

divided into two groups by the criteria of LV volume

characteristics. It was supposed that the leading

parameter in endurance sport was SV (Zakharova,

2015), as a volumetric indicator, also characterising

LV contractility and heart functional reserve.

Table 2: Hemodynamic parameters at the first stage.

Hemodynamic

indices

Athletic

norm

M±SD

(min-max)

HR at rest, bpm 50-55 62.0±5.95 (51-71)

SV, ml 120-150 113.0±15 (90-131)

SI, ml/m

>70 58.8 ±7.96 (50-73)

EDV, ml >190 177±25.1 (144-210)

EDI, ml/m

>100 90.67±14.9 (65-115)

EF, % ≥60 63.0±2.04 (60-66)

Volemia, % +21 -20-+21

Inotropy, % > +35 16.36±13.1 (0-+50)

Vascular tone, % < – 30 -15.41±12.6 (0- -43)

The 1

group (n=16) was distributed by athletes

with SV < 115 ml, and the 2

group (n=8) – with

SV ≥ 115 ml, respectively. Table 3 demonstrates the

results of comparative analysis of initial

hemodynamic parameters in both groups and

significant differences in selected parameters.

Table 3: Comparative analysis (t-test) of hemodynamic

parameters in groups at the first stage.

Hemodynamic

indices

M±SD

group 2

group

HR at rest, bpm 62.33±4.76 61.67±7.4

SV, ml 100.33±9.3 125.5±5.5**

SI, ml/m

54.4±4.34 65.67 ±6.3**

EDV, ml 157.3±15.7 197.2±13.7**

EDI, ml/m

85.67±7.53 95.67±19.28

EF, % 62.83±1.9 63.17±2.32

Volemia, % 5+16.7 6+10.95

Inotropy, % 6.67±15.01 20±15.81

Vascular tone, % -8.3±8.16 -22±12.77*

*- statistical significance at P < 0.05, ** - P < 0.01.

Before the 1

stage testing trainer’s concept of

week training was designed around 2 intensive

workouts per week of 5 or 6 training days. On

Wednesday triathletes usually had repeated short

sprints on track training accompanied with building

whole body and core stability by holistic explosive

Technologies of Effective Training Control in Amateur Triathlon - Non-Invasive Hemodynamic Measurements and Exercise Testing for

Accurate Training Prescription

power training. Sunday training was long and took

place principally on highly broken country.

After the primary testing and measurement

analysis several corrections were offered for the first

group training program design. The training process

of the athletes with low heart volume indicators was

supposed to be low intensive (HR=120±10). Sport

walking, cycling, skiing on flat terrain, stationary

bicycle training were recommended for low

intensive endurance training in order to increase

heart volumetric parameters. The objective of the

trainings was to improve dimensional characteristics

of the heart and cardiovascular adaptation to

physical loads. The idea is that while HR is

120±10 bpm the stroke volume tends to its

maximum and provides LV with better diastolic

filling.

Based on the obtained data and defined

weaknesses of participants the training focus

selection was made: the 1

group was prescribed

low intensity training. The training strategy of the

group was a combination of short intervals at

high-intensity trainings and statodynamic low

intensive strength workouts (Seluyanov, 2002), high

volume trainings were excluded.

The second stage of the study included

hemodynamic measurements, exercise performance

evaluation and amendments to the training strategy

as the results of functional state evaluation

demonstrated no significant changes in major

parameters in both groups. 2.5 months of amateur

athletes efforts were without results.

The conducted further correlative analysis

enabled us to estimate the relations between

hemodynamic parameters and exercise performance.

It was found that VO

2max

correlated with HR

at rest

(r=-

0,48; P < 0.01), SV (r=0.578; P < 0.01), SI (r=0.56;

P < 0.01), EDV (r=0.56; P < 0.01), as well as with

max

(r=0.676; p<0.01). Positive correlations

between volume indices and aerobic capacity may

serve as a proof of better cardiovascular adaptation

to exercise loads and effectiveness of heart function

in athletes with the increased LV volume and

contractility.

Impact of P

max

on both the exercise performance

and cardiac functional state indices was estimated by

factor analysis results. It was found that factor P

max

had significant impact on variables VO

2max

(P <

0.001) and EDV (P < 0.001).

Thus, it was found out that specific strength

development and, hereafter muscular endurance

improvement may significantly influence on VO

2max

i.e. on performance endurance in amateur triathletes

(Cormie, 2011; Caleb, 2015).

The training guidelines for the next training

period of triathletes (March-May) was rather

different. The second group for maximal power

production enhancement were subjected strength

training for hypertrophy (7-12 reps at 60-80 percent

of 1 RM, three sets per exercise, 2 session per week,

3 weeks). Aerobic middle- and low-volume trainings

with triathlon – specific activities were used to

maintain the technique, improve movement pattern

and keep the aerobic capacity.

In April and May there was high-volume training

for metabolic adaptations, movement efficiency and

nerve system tolerance to enduring work. The power

training component was presented by HIIT overall

strength exercises, mainly with plyometric nature.

Ballistic and TRX training were included for core

stability and psychomotor training as a great

stimulus for improving maximal power in complex

triathlon movements.

For the 1st group athletes low intensive strength

training (Seluyanov, 2002; Shishkina, 2013) aimed

on hypertrophy of slow-twitch muscles was used

instead of intensive strength one. The main idea of

exercises performance is doing them slowly without

leg (arm, back) extension feeling “fire” in muscles

thus organizing specific state for hypertrophy in

slow-twitch motor units.

The aerobic and strength components in April

and May were the same as in the 2nd group but there

was the task to limit HR, not exceeding 180 bmp

during workouts.

In June-August there were more high-intensity

training in both groups. A short-term period of high-

intensity interval training (2 per week) consisting of

repeated exercise bouts performed close to or well

above the maximal oxygen uptake intensity,

interspersed with low-intensity triathlon activities.

Also thanks to participation in triathlon and other

competitions amount of prolonged submaximal

exercise and moderate and long periods of training

“threshold” formed 10-15% of total training volume.

After 3 months of training the final testing

including hemodynamic research and exercise

testing was carried out. Fig.1 and 2 demonstrate the

results of analysis of initial and reached values (4

stage – August 2016) of exercise performance. One

can see that athletes from both groups had positive

changes in VO

2max

and power production. Moreover,

participants from the 1

group also attained the

values of aerobic capacity with no significant

difference in comparison to the 2

group.

One can see that athletes from both groups had

positive changes in VO

2max

and maximum power.

Moreover, participants from the 1

group also

icSPORTS 2016 - 4th International Congress on Sport Sciences Research and Technology Support

Table 4: Hemodynamic parameters at the first and final

stage.

Parameter M±SD

group 2

group

Initial Final Initial Final

HR at rest,

bpm

62.33±

4.76

62.62±

9.74

61.67±

7.4

57.67±

11.55

SV, ml

100.33±9

112.5±

15.61*

125.5±

5.5

121.5±

7.78

SI, ml/m

54.4±

4.34

55.88±

7.36

65.67

±6.3

59.67±

6.11

EDV, ml

157.3±

15.7

176.13±

26.97*

197.2±

13.7

187±

25.46

EDI, ml/m

85.67±

7.53

88.38±

12.1

95.67±

19.28

92.33±

11.15

EF, %

62.83±

1.9

63.5±

1.41

63.17±

2.32

63.3±

1.5

Volemia,

5+16.7 -1.5±

23.5*

6+10.95 3.3±

21.5

Inotropy,

6.67±

15.01

3±14.47 20±5.81 21.67±

2.89

Vascular

tone, %

-8.3±

8.16

3±14.47 -22±

12.77

-19±

11.53

* - Significant differences between hemodynamics

parameters at the 1

and 4

stage P < 0.05.

Figure 1: Maximal attained load (P

max

) during exercise

testing at 3 consecutive stages.

Figure 2: VO

2max

(ml/kg/min) value obtained during

exercise testing at 3 consecutive stages.

attained the values of aerobic capacity with no

significant difference in comparison to the 2

group

(Table 4).

4 CONCLUSIONS

Cardiovascular functional state monitoring enables

to define the main strategy for training prescription.

Combination of hemodynamic and gas-exchange

measurements with simultaneous HR registration

during exercise testing provides with valuable

information for developing a training concept. It is

useful for both correct physical loads dozing and

sufficient cardiac adaptation to increasing exercise

loads, thus it aids amateur athletes to benefit from

sports activity and minimize possible medical risks.

ACKNOWLEDGEMENTS

The work was supported by Act 211 Government of

the Russian Federation, contract № 02.A03.21.0006.

REFERENCES

ACC / AHA 2002 guideline update for exercise testing:

summary article: a report of the American College of

Cardiology / American Heart Association Task Force

on Practice Gudelines. J Am Coll Cardiol; 2006:

48: 1731 pp.

Caleb, D. B., et al., 2015. Strength training for endurance

athletes: theory and practice in Strength and

Conditioning J: 37(2): www.nsca-scj.com.

Cormie, P., McGuigan, M. R. and Newton, R. U., 2011.

Developing neuromuscular power: Part 1 – Biological

basis of maximal power production (review), In J

Sport Med: 41(1): 17-38.

Cormie, P., McGuigan, M. R. and Newton, R. U., 2011.

Developing neuromuscular power: Part 2 – Training

considerations for improving maximal power

production In J Sport Med: 41(2): 125-146.

Corrado, D., 2005. Cardiovascular preparticipation

screening of young competitive athletes for prevention

of sudden cardiac death: proposal for a common

European protocol. Consensus Statement of the Study

Group of Sport Cardiology of the Working group of

Myocardial and Pericardial Diseases of the European

Society of Cardiology. In Eur. Heart J; 26: 516–524.

O’Tool, ML, 1995. Applied physiology of triathlon. In

Sports Med: 19(4): 251-67.

Seluyanov, V., 2002. Intuition is blind without knowledge,

In Skiing Sport: 23: 62-67.

Shishkina, A., Tarbeeva, N., Alimpieva, O., Berdnikova,

A., Tarbeeva, A., Miasnikova, T., 2014. Hemodyna-

Technologies of Effective Training Control in Amateur Triathlon - Non-Invasive Hemodynamic Measurements and Exercise Testing for

Accurate Training Prescription

mics Monitoring in Sport- Using Hemodinamics

Monitor for Sport Training Planing. icSPORTS 2014:

In Proceedings of the 2nd International Congress on

Sports Sciences Research and Technology Support,

Rome, Italy: 103-110.

Shishkina, A., Tarbeeva, N., 2013. Cross-country skiing:

specific strength training for endurance success. In

18th Annual Congress of the European College of

Sport Science Book of Abstracts; Barcelona, Spain.

610.

Vilikus, Z., 2012. Functional Diagnostics. Col Phy Edu

and Sport Palestra.

Zakharova, A., Tarbeeva, N., Tarbeeva, A., Miasnikova,

T., 2015. Healthsaving technologies for young cross

country skiers. Cardiovascular system testing for sport

training program design. In icSPORTS 2015:

Proceedings of the 3rd International Congress on

Sports Sciences Research and Technology Support;

2015: 139-144.

icSPORTS 2016 - 4th International Congress on Sport Sciences Research and Technology Support