The purpose of this study was to evaluate the reliability of a thoracic electrical bioimpedance based device (PhysioFlow) for the determination of cardiac output and stroke volume during exercise at peak oxygen uptake (peak VO(2) in children. The reliability of peak VO(2) is also reported. Eleven boys and nine girls aged 10-11 years completed a cycle ergometer test to voluntary exhaustion on three occasions each 1 week apart. Peak VO(2) was determined and cardiac output and stroke volume at peak VO(2) were measured using a thoracic bioelectrical impedance device (PhysioFlow). The reliability of peak VO(2) cardiac output and stroke volume were determined initially from pairwise comparisons and subsequently across all three trials analysed together through calculation of typical error and intraclass correlation. The pairwise comparisons revealed no consistent bias across tests for all three measures and there was no evidence of non-uniform errors (heteroscedasticity). When three trials were analysed together typical error expressed as a coefficient of variation was 4.1% for peak VO(2) 9.3% for cardiac output and 9.3% for stroke volume. Results analysed by sex revealed no consistent differences. The PhysioFlow method allows non-invasive, beat-to-beat determination of cardiac output and stroke volume which is feasible for measurements during maximal exercise in children. The reliability of the PhysioFlow falls between that demonstrated for Doppler echocardiography (5%) and CO(2) rebreathing (12%) at maximal exercise but combines the significant advantages of portability, lower expense and requires less technical expertise to obtain reliable results.

The sex difference in peak V˙O2 in 9- to 10-yr-old children is, in part, related to sex-specific changes in muscle O2 extraction dynamics during incremental exercise.

The splitting of muscle phosphocreatine (PCr) plays an integral role in the regulation of muscle O2 utilization during a "step" change in metabolic rate. This study tested the hypothesis that the kinetics of muscle PCr would be faster in children compared with adults both at the onset and offset of moderate-intensity exercise, in concert with the previous demonstration of faster phase II pulmonary O2 uptake kinetics in children. Eighteen peri-pubertal children (8 boys, 10 girls) and 16 adults (8 men, 8 women) completed repeated constant work-rate exercise transitions corresponding to 80% of the Pi/PCr intracellular threshold. The changes in quadriceps [PCr], [Pi], [ADP], and pH were determined every 6 s using 31P-magnetic resonance spectroscopy. No significant (P>0.05) age- or sex-related differences were found in the PCr kinetic time constant at the onset (boys, 21+/-4 s; girls, 24+/-5 s; men, 26+/-9 s; women, 24+/-7 s) or offset (boys, 26+/-5 s; girls, 29+/-7 s; men, 23+/-9 s; women 29+/-7 s) of exercise. Likewise, the estimated theoretical maximal rate of oxidative phosphorylation (Qmax) was independent of age and sex (boys, 1.39+/-0.20 mM/s; girls, 1.32+/-0.32 mM/s; men, 2.36+/-1.18 mM/s; women, 1.51+/-0.53 mM/s). These results are consistent with the notion that the putative phosphate-linked regulation of muscle O2 utilization is fully mature in peri-pubertal children, which may be attributable to a comparable capacity for mitochondrial oxidative phosphorylation in child and adult muscle.

To further understand the mechanism(s) explaining the faster pulmonary oxygen uptake (p(VO)(2)) kinetics found in children compared to adults, this study examined whether the phase II p(VO)(2) kinetics in children are mechanistically linked to the dynamics of intramuscular PCr, which is known to play a principal role in controlling mitochondrial oxidative phosphorylation during metabolic transitions. On separate days, 18 children completed repeated bouts of moderate intensity constant work-rate exercise for determination of (1) PCr changes every 6 s during prone quadriceps exercise using (31)P-magnetic resonance spectroscopy, and (2) breath by breath changes in p(VO)(2) during upright cycle ergometry. Only subjects (n = 12) with 95% confidence intervals

This study examined the reliability of (31)P-magnetic resonance spectroscopy (MRS) to measure parameters of muscle metabolic function in children. On separate days, 14 children (7 boys and 7 girls) completed three knee-extensor incremental tests to exhaustion inside a whole-body scanner (1.5 T, Phillips). The dynamic changes in the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) and intracellular muscle pH were resolved every 30 s. Using plots of Pi/PCr and pH against power output (W), intracellular thresholds (ITs) for each variable were determined using both subjective and objective procedures. The IT(Pi/PCr) and IT(pH) were observed subjectively in 93 and 81% of their respective plots, whereas the objective method identified the IT(Pi/PCr) in 88% of the plots. The IT(pH) was undetectable using the objective method. End exercise (END) END(Pi/PCr), END(pH), IT(Pi/PCr) and IT(pH) were examined using typical error statistics expressed as a % coefficient of variation (CV) across all three exercise tests. The CVs for the power output at the subjectively determined IT(Pi/PCr) and IT(pH) were 10.6 and 10.3%, respectively. Objective identification of the IT(Pi/PCr) had a CV of 16.3%. CVs for END(pH) and END(Pi/PCr) were 0.9 and 50.0%, respectively. MRS provides a valuable window into metabolic changes during exercise in children. During knee-extensor exercise to exhaustion, END(pH) and the subjectively determined IT(Pi/PCr) and IT(pH) demonstrate good reliability and thus stable measures for the future study of developmental metabolism. However, the objectively determined IT(Pi/PCr) and END(Pi/PCr) displayed poor reliability.