Journal of Exercise Physiologyonline

February 2016Volume 19 Number 1

Editor-in-ChiefTommy Boone, PhD, MBAReview BoardTodd Astorino, PhDJulien Baker, PhDSteve Brock, PhDLance Dalleck, PhDEric Goulet, PhDRobert Gotshall, PhDAlexander Hutchison, PhDM. Knight-Maloney, PhDLen Kravitz, PhDJames Laskin, PhDYit Aun Lim, PhDLonnie Lowery, PhDDerek Marks, PhDCristine Mermier, PhDRobert Robergs, PhDChantal Vella, PhDDale Wagner, PhDFrank Wyatt, PhDBen Zhou, PhD

Official Research Journal of the American Society of

Exercise Physiologists

ISSN 1097-9751

Official Research Journal of the American Society of Exercise Physiologists

ISSN 1097-9751

JEPonline

Effects of Lower-Body Compression Garment in Cycle-Ergometer Maximal Exercise Test: Preliminary Data

Jacqueline Souza dos Santos1, Caio Victor de Sousa1, Rafael dos Reis Vieira Olher1, José Morais Souto Filho1, Márcio Rabelo Mota2

1Graduate Program in Physical Education, Universidade Católica de Brasília, Distrito Federal, Brazil; 2Faculty of Health and Education Sciences, Centro Universitário de Brasília, Distrito Federal, Brazil

ABSTRACT

Santos JS, Sousa CV, Olher RRV, Filho JMS, Mota MR. Effects of Lower-Body Compression Garment in Cycle-Ergometer Maximal Exercise Test: Preliminary Data. JEPonline 2016;19(1):88-95. The purpose of this study was to determine the effects of wearing compression stockings during a maximal cycle ergometer exercise test (CT) on metabolic and perceptual variables in recreational cyclists. Five subjects underwent three days of testing in random order: (a) placebo (PL, lower-body garment without compression); and (b) compression (CP, lower-body (knee to ankle) compression garment). The tests were performed on a mechanical cycle ergometer, starting at a 90-watt (W) workload with 30 W increments every 3-min while maintaining 60 rev·min-1 until volitional exhaustion. Lactate concentration ([LAC]), heart rate (HR), oxygen uptake (VO2), and rate of perceived exertion (RPE) were registered at rest and in the final 30-sec of each stage. There were no significant differences across the three exercise sessions (CT, PL, and CP). Moreover, the power output at lactate threshold was not statistically different between the sessions, as well as the duration of each test. We conclude that lower-body compression garment (knee-to-ankle) does not improve physiological performance in trained subjects during an incremental exercise test.

Key Words: Exercise testing, Compression stockings, Ergogenic

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INTRODUCTION

Several studies have focused on investigating the effects of different ergogenic aids on athletic performance (1,7,23,29). The ingestion of dietary supplements (26,28) as well as stimulants and anabolic steroids (17,28) have been the most common ergogenic strategies to increase exercise performance. However, aside from being expensive, the efficacy of some ergogenic aids has been questioned (9,10,21,29,31,32). Moreover, adverse effects of some ergogenic substances have also been reported (13). Given these outcomes, it is reasonable to expect more research on new ergogenic aids in order to safely improve exercise performance.

Compression garments, among these, compression stockings are increasingly popular among professional and recreational athletes (3). The possible beneficial effects seems to be contested in scientific community due to a great heterogeneity of protocols and divergent results (16). The physiological mechanisms involved in a possible performance improvement seems to be a reduction in micro-trauma and muscle damage (30), less muscle vibration and, consequently, less energy expenditure that results in a greater economy of movement (6) and greater comfort. (2). In addition, Bringard (5) reports that lower-body compression can also improve venous return, which may increase the oxygen delivery to the tissue and generate a greater power output.

In that regard, Kemmler and colleagues (12) submitted 21 trained men to a stepwise treadmill test up to a voluntary maximum with and without below-knee compressive stocking. Time under load and total work were significantly higher with compression stockings compared with running socks. Running performance at the anaerobic threshold and aerobic thresholds was significantly higher using compression stockings. Thus, they concluded that stockings with constant compression in the area of the calf muscles significantly improved running performance at different metabolic thresholds. Similarly, Scanlan et al. (24), submitted 12 cyclists to two randomly ordered stepwise incremental tests and two randomly ordered 1-hr time trials on the cycle ergometer. They reported no improvement of performance by wearing a waist-to-ankle compression garment. It is reasonable to infer that the possible physiological benefits may only be realized at submaximal stages, which elevates the chronotropic reserve and reduces the perceived exertion.

Additionally, incremental tests using cycle ergometers seem to elicit a higher metabolic stress in submaximal stages in comparison to treadmill tests (19,20). This consideration suggests that exercise performed using the cycle ergometer can be more sensitive to physiological changes caused by the use of compressive garments when compared to treadmill protocols. To the best of our knowledge, there is only one study (24) that investigated the effects of lower-body compression during incremental cycle ergometer test using a waist-to-ankle garment in professional cyclists, which may be less sensitive to ergogenic aids due their high fitness level.

The purpose of this study was to verify the effects of wearing compression stockings during a maximal exercise test on a cycle ergometer on metabolic [lactate concentrations ([LAC]), hemodynamic (HR and VO2) and perceptual variables [rate perceived of exertion (RPE)] in recreational cyclists. To the best of our knowledge, this has not yet been investigated. We

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hypothesize that a lower-body compression garment may improve muscle comfort, leading to lower production of blood lactate ([LAC]), and lowering the RPE in submaximal stages, which could lead to a higher power output.

METHODS

SubjectsAfter approval by local ethics committee (protocol: 16253413.9.0000.0023), five trained men (mean ± SD age, 2.4 ± 5 yrs; mass, 80.8 ± 11 kg; height, 179 ± 6 cm; VO2 peak, 44 ± 4.9 mL.kg-1.min-1) volunteered to participate. The subjects were not under use of pharmacological treatment, and they did not have a history of cardiovascular diseases. All subjects were informed about the risks and benefits of the study and signed an informed consent form prior to the study getting underway. All procedures were carried out in accordance with the resolution 466/2012 of the Brazilian National Health Council and to the Declaration of Helsinki for experiments to be conducted on humans.

General ProceduresThe subjects were given instructions to maintain their normal training regimen with the exception of not performing high-intensity exercise for 24 hrs before the test. Additionally, the subjects were instructed to avoid alcohol and caffeine on the test day and to avoid food at least 2 hrs before testing. Each subject underwent 3 test sessions that were separated by at least 48 hrs; all sessions were completed within a 2-wk period.

The subjects’ first testing day consisted of: (a) taking anthropometric measures; and (b) the performance of the first cycle ergometer exercise test (CT) to exhaustion (IT). The additional two visits were: (a) the placebo (PL, lower-body garment without compression); and (b) the compression (CP, lower-body compression garment (knee to ankle), with adequate sizes and compression (approximately 20 mmHg) according to the manufacturer instructions (FLETS®X3X Ultra, Brazil). Both the PL and the CP sessions were carried out in random order.

Incremental TestAll tests were conducted in a controlled environment (temperature, 20-22 ºC; humidity, 40 to 50%) accompanied by a cardiologist in order to identify any abnormality during the maximal exercise tests. The tests were performed on a mechanical cycle ergometer (Monark® 828E; Valburg, Sweden). The test was started at a 90 Watts (W) workload with increments of 30 W every 3 min while maintaining 60 rev·min-1 until volitional exhaustion.

During the pre-exercise resting period and the last 20 sec of each incremental stage, a 25 μL sample of capillarized blood was collected from the ear lobe trough heparinized and calibrated glass capillaries, being deposited in microtubes (Eppendorf) containing 50 μL of sodium fluoride (NaF) 1% for latter analyses of the [lac] through an electro-enzymatic method (Yellow Springs 2.700 STAT, OH, USA). The blood lactate kinetics during the IT stages identified the lactate threshold (LT), which was considered an exercise intensity above which an over proportional increase in blood lactate was observed in relation to the increasing workload (27).

Expired gases were also measured during the IT using a gas analyzer (Metalyzer 3B, Cortex

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Biophysik, Germany) that was previously calibrated with a 3-L syringe (flow calibration) and a standard mixed gas containing 4.9% CO2 and 17% O2 (gas calibration). The oxygen uptake (VO2), heart rate (HR), and rate of perceived exertion (RPE) (4) were continuously monitored and recorded during the last 20 sec of each 3-min stage.

Statistical AnalysesA Shapiro–Wilk and Levene’s test verified normality and homogeneity of data, respectively. The data are presented as means ± SD. A multivariate ANOVA was applied in order to compare the three exercise sessions in more than three moments. A repeated measures ANOVA were used to assess differences in workload at lactate threshold (LT), peak power output (PPO), and duration of test among the sessions. The Greenhouse–Geisser correction was used when sphericity was violated (Mauchly’s test, P<0.05). The Bonferroni post hoc was used in both variance analyses. The alpha level was set at 5% (P<0.05). All statistical procedures were performed using the Statistical Software for the Social Sciences (SPSS 21).

RESULTS

Comparison between the groups indicated no significant difference among the CT, PL, or CP sessions for any of the moments (Figure 1). Moreover, the power output at LT, PPO showed no statistical difference between the tests, as well as the duration of each TI (Table 1).

Figure 1. Heart Rate (HR), Rate Perceived of Exertion (RPE), Blood Lactate [LAC], and VO2

during the CT, PL, and CP Sessions. Data expressed as mean ± standard deviation.

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Table 1. Workload Values at LT, PPO, and Duration of the Tests. Cycle Test

CT

Placebo

PL

Compression

CP

LT (W) 138 ± 26.8 150 ± 30 138 ± 34.2

PPO (W) 264 ± 25.1 264 ± 39.1 252 ± 40.2

Duration (sec) 1141 ± 164 1119 ± 198 1119 ± 211

Data expressed as mean ± SD; LT: lactate threshold; PPO: peak power output.

DISCUSSION

The major finding in this study is that the lower body compression garment (knee-to-ankle) did not improve exercise performance. Also, it is interesting that the compression garment did not decrease the subject’s physiological stress during the submaximal workloads of the incremental cycle ergometer test. These findings are in agreement with the work of Scanlan et al. (24). They reported no improvement in performance when wearing a waist-to-ankle compression garment. Conversely, the findings in the present study disagree with Driller and Halson (8) who submitted their subjects to wearing a waist-to-ankle compression and found that mean exercise HR was reduced with a higher mean power output.

As an ergogenic aid, it is believed that the benefit of wearing a lower-body compression garment is related to the improved venous hemodynamics (11,22) that increases end-diastolic volume and cardiac output (14,25), although such changes are not always observed when the subject is not lying down (15,18). There is also the anticipated improvement in O2

delivery to the tissues that appears not to have happened and may be the explanation for the results of the present study (5).

While the use of compressive garments by athletes is increasing, it is likely that the idea of improving performance is more psychological than physiological with obvious difficulties in analyzing the effects if any (16). The present results indicated a visually lower perceived exertion in submaximal workloads, but there were no statistical differences. This finding may be partially explained for the decreased vibration on the target muscle that could make the exercise movements more comfortable, but not necessarily sufficient to translate into an increased economy of energy expenditure.

Limitation of the StudyA possible limitation of the present study was that the applied pressure of the lower-body compression garment was not measured, and only reported the approximated value indicated by the manufacturer. Nonetheless, regarding the potential benefits as an ergogenic aid, Beliard (3) states that the results do not seem to be related to the pressure applied (low or high pressure). This suggests that the reason for this performance improvement in some athletes and absolutely no effects in other athletes remains unknown. We conclude that lower-body compression garment (knee-to-ankle) does not appear to improve performance in

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trained men during incremental exercise test. Future studies should test the use of this aid in submaximal intensities with fixed velocity protocols.

CONCLUSIONS

There were no significant differences across the three exercise sessions (CT, PL, and CP). Moreover, the power output at lactate threshold was not statistically different between the sessions, as well as the duration of each test. We conclude that lower-body compression garment (knee-to-ankle) does not improve physiological performance in trained subjects during an incremental cycle ergometer exercise test.

ACKNOWLEDGMENTSThe authors are thankful to Mr. Renan Renato Cruz dos Santos for their technical assistance, and to Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for granting the scholarships in undergraduate research level (CNPq), MSc (CAPES), and PhD (CAPES). The authors have no conflicts of interest.

Address for correspondence: Caio Victor de Sousa. EPTC, QS07, LT1 s/n Building G, Room 15. Graduate Program in Physical Education, Universidade Católica de Brasília, Distrito Federal, Brazil. Zip Code: 72030-170. E-mail: cvsousa89@gmail.com

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DisclaimerThe opinions expressed in JEPonline are those of the authors and are not attributable to JEPonline, the editorial staff or the ASEP organization.

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