The use of microvasculatory indicators in routine and on-line monitoring of exercise tolerance of female gymnasts

Introduction. The functional status of the cardiovascular system is one of the factors limiting the body's physical working capacity. Therefore, the morphological study of the cardiovascular system is of great practical value for sports physiology, specifically in settling the issues of qualification and orientation of athletes and designing the methods for enhancing sports skills [5, 8].

Changes in the microcirculation system are closely correlated with central hemodynamic shifts, providing for the use of the microcirculation parameters as prognostic and diagnostic criteria in assessment of the total body conditioning, since the microcirculatory level defines the adequate trophic support of the cutaneous microregion and reserves of the human body balance control [1,6]. The microcirculature first responses to the environmental factors, which contributes to local hemodynamic adaptations to the needs of the body [2].

The studies related to the state of microcirculatory pathways at muscle work and targeted physical loadings reveal the basic mechanisms of the body’s adaptive responses to exercises [3]. However, the findings of the studies of the exercise-related microcirculatory changes are contradictory, due to morphofunctional parameters of microcirculation being related not only to the amount of loading and fitness level, but the aim of the training process. Thus, the evaluation criteria of the microcirculation level are to be developed to individualize training process in every particular sport.

Rhythmic gymnastics is one of comprehensive coordination sports. The neuromuscular apparatus is the key functional system in this sport, while the cardiorespiratory and nervous systems are the support ones. The adaptation disturbance of the autonomic nervous system can provoke neurocirculatory dystonia (NCD), which is generally common for hypotonic girls. Vegetative regulation control is especially important for female rhythmic gymnastics athletes. Accordingly, the microcirculation studies acquire special value among the female rhythmic gymnastics athletes due to its diagnostic value under NCD [4, 7].

Owing to the rising demands to technical, physical and moral-volitional training of athletes, who specialize in artistic sports, a week micro cycle is an independent unit in planning a training process at all phases of the year training cycle. There exist loading and unloading training phases. The introduction of the unloading phase to bring up to the biggest competitions is associated with the need to prevent the negative phenomena stipulated by the excessive cumulation of training effects. Its timely introducing is related to the development of the methods for routine and on-line monitoring.

The near-patient testing of the athletes’ functional status enables timely changing of the training structure both within a single training session and during a training cycle.

Nowadays various instrumental technologies are widely used for the near-patient testing. The purpose of our study was to design the technique of routine and on-line monitoring in view of the dynamics of cutaneous microcirculation and transcutaneous partial pressure of oxygen in female group rhythmic gymnasts.

Materials and methods. The research methods we applied in our studies were as follows: transcutaneous polarography (TCM 400 monitor, Radiometer Copenhagen) and laser Doppler sonography (BLF21-series laser Doppler flowmeter, Perimed). The values of the microcirculatory indices and the transcutaneous partial pressure of oxygen were tested diring the year training cycle: at the technology development phase in 12 female gymnasts, students OfLesgaft National state university of physical education, sports and health (candidates for master of sports, masters of sports in rhythmic gymnastics, aesthetic group gymnastics specialization, aged 16-19) and at the phase of the “forming” experiment in 7 female gymnasts of the Krasnodar specialized children’s sport school of Olympic reserve (candidates for master of sports, masters of sports in rhythmic gymnastics, group rhythmic gymnastics specialization, aged 14-18).

Practical recommendations. We recommend carrying out the compulsory routine and on-line monitoring of female gymnasts during all loading microcycles, which is followed by correction of the individual work-out plan. Female gymnasts can measure their transcutaneous partial pressure of oxygen (TcPO₂) and skin microcirculation (SM) themselves before training using the TCM 400 monitor and the BLF21-series laser Doppler flowmeter. It does not take the time from the training process, but the coach gets results for further differentiated planning of training loadings with a specific mission.

The test conditions are as follows:

• the subjects are to spend at least 10 min in a constant-temperature room before testing (especially during the cold season);
• cutaneous temperature is to be controlled in the zone of tested indices (contactless digital thermometer is perfect for this purpose).

When planning a research one is to allow for the fact that the tested indices have the information value only in case of interactive studies. So the first test is to be made within the phased integrated monitoring at the conditioning phase of the year training cycle.

When reviewing the TcPO₂ tests one should consider that hypoxia is a significant pathogenetic unit of the energy imbalance in the muscular tissue under strenuous muscle work. The moderate drop of PO₂ in mixed venous blood is tolerable but further decrease implies tissue hypoxia, which brings to both decrease of the physical working capacity and traumas. The essential oxygen supply to the body tissues is related to completeness of ventilation. The ventilation level is defined by its partial pressure. This index shows efficiency of external respiration and can be an indicator of the adequacy of external respiration to potential and urgent needs of the body.

The phase 1 (at the end of the first special conditioning period) is intended to detect the individual oscillatory standards of the tested characteristics (SM and TcPO₂) and teach female gymnasts unsupervised work with the equipment. The tests should be made during 10 work-outs in two week micro cycles. The sequence of tests aimed at unification of results is always the same and should take same time.

The algorithm of estimation of the individual gap between the SM and TcPO₂ standards for routine monitoring

1. Kiselev’s thermometer scale is filled by female athletes in a changing room before training.
2. Romberg’s test is performed by all female gymnasts simultaneously when coming to the gym.
3. 3 min after all female gymnasts were subject to the instrumental near-patient testing of TcPO₂ using two TCM 400 monitors and 4 pairs of electrodes (test time - 2 min).
4. SM is measured along with TcPO₂ using two laser Doppler flowmeters BLF-21 (A) and two R-type indicators (1 min for all female gymnasts).
5. After the TcPO₂ tests within the routine ring monitoring, the electrodes stay fixed on the forearm of female gymnasts for the further post-exercise on-line monitoring and determining the response to performance of the competitive composition - after finishing it, if necessary.
6. Gencha test was made at the same time with all female gymnasts 2 min after the instrumental near-patient testing (8 min in total).
7. When processing the findings of the routine monitoring aimed at detecting the average standard and acceptable fluctuations range of the microcirculatory indices and the transcutaneous partial pressure of oxygen 7 out of 10 characteristics (for 10 days of tests) were taken for every female avoiding the three with the lowest values in Romberg’s test, Gencha’s timed expiratory capacity and Kiselev’s thermometer scale. The rest of the 7 values of the microcirculation and the transcutaneous partial pressure of oxygen represented the individual gap of the allowable data spread - as an example.

The findings on the standard range for 7 female group rhythmic gymnasts (Krasnodar) are adduced in Tab. 1.

Table 1. The indicators of the individual standard of SMand TcPO₂ in 7 gymnasts.

Hereafter, the cases ot decrease of the functional status of female gymnasts can be detected by the decreased TcPO₂ or overrun range of the personal standard of the SM level during the routine monitoring and comparing the obtained indices with the individual gap. The negative on-line correction of training loading is advised in such cases.

Recommendations by the results of the routine automatic check (SM and TcPO₂). The issues allowing female athletes to exercise and of the acceptable amount of physical loadings for each training were settled based on the findings of the routine monitoring (Tab. 2).

Table 2. Negative correction of exercises subject to findings of the routine monitoring.

Note. * - significant decrease of one index; min - personal minimum.

Knowing the gap between the TcPO₂ and SM personal standard and having their test results the coach can adjust exercise himself or use the suggested formula, the result of our observations, using his experience and knowledge of the functional peculiarities of female athletes:

%N = % SM + % TcPO₂,

where %N - decline in TBC and SPF (in %); % SM - decrease of the microcirculation relative to the individual min (in %); % TcPO₂ - decrease of the transcutaneous partial pressure of oxygen relative to the individual min (in %).

Corrections mainly consisted in the TBC and SPF decline during runs-through in full measure, since, in our opinion, if a female gymnast is allowed to a run-through she is to have similar exercises, otherwise it ruins the performance of the composition by the whole team.

Loading is to be adjusted mainly by reducing the number of jumps. Extra dexterity elements (work with objects) and stretching are introduced depending on the level of physical qualities of every single female gymnast at the beginning of the year.

On-line monitoring. The response of the female gymnasts’ cardiovascular system to specific physical loading is controlled immediately after training and after performing a competitive composition. The response to the performed competitive composition is to be tested right after finishing it, for the tested characteristics change immediately (thereby the female gymnasts should be tested in turns - one gymnast after every performance or one is to work with a few electrodes).

The routine monitoring pre-exercise data are used as initial indices. The percent rise (recorded by the mark “+”) or the % decrease (recorded by the mark “-“) of the TcPO₂ and SM levels relative to the pre-exercise values were calculated by the findings.

It is described in the Tables 3 and 4 containing the results of the on-line monitoring of 7 female gymnasts (group exercises of rhythmic gymnastics, Krasnodar).

Table 3. Individual changes of post-exercise TcPO₂,

According to the data of the on-line monitoring, trainer is to draw his attention to the gymnast 3, who has a fall-off of the post-exercise TcPO₂. The gymnast 3 needs an individual approach to organization of her training process during the whole year training cycle and compulsory cardiologist’s supervision, she should be suspended from trainings till final diagnosing. According to the findings of the TcPO₂ measurements the female gymnasts 6 and 7 need their training loading to be corrected. The post-exercise decrease of SM was also marked in the gymnast 7.

The findings of the on-line monitoring can be used for urgent correction of the training process.

Table 4. Individual changes of the post-exercise SM, %.

The TcPO₂ on-line monitoring based recommendations.

1. When controlling the special exercise tolerance (measurement of resting and post-exercise TcPO₂ before and immediately after performing a competitive composition) in the case of decreased TcPO₂, the female gymnast was suspended from further runs-through of the competitive composition and the issue of loading in the next work-out was determined by the results of the routine monitoring.
2. When controlling the training exercise tolerance, if a female gymnast had the decreased TcPO₂ relative to its pre-exercise values the negative correction of loading in the next training (20% decrease of TBC relative to previous training) and additional estimation OfTcPO₂Within the on-line monitoring were carried out. The repeated (in a row) allocation of the TcPCh decrease is accompanied by the decrease of TBC by 50% next day. Its changes more than twice in a row contribute to both decreased TBC and the female gymnast is changed to substitutes.
3. More than a half of female gymnasts had their training loadings decreased for the whole team and recovery methods scheduled in case of allocated deadaptation of different intensity in response to specific loading.

Theoretical and experimental justification. The method of laser Doppler sonography provides for objective assessment of the state of the superficial tissue microhemodynamics, что в совокупности позволяет выявить reserves of the capillary perfusion капиллярной перфузии, the degree of the microcirculatory disturbance, a также возможное участие the Sysmpathetic (spastic) component in the microcirculatory disturbances. The transcutaneous partial pressure of oxygen (TcPO₂) correlates with arterial PO₂ and give the quantitative characteristic of the cutaneous bloodflow.

Microvasculature is one of the first ones to respond to the impact of environmental factors, which contributes to the use of microcirculatory parameters as prognostic and diagnostic criteria when estimating the total body conditioning.

The suggested instrumental technologies of routine and on-line monitoring for the differentiated method of planning a training process were proved efficient in the “forming” educational experiment. 68 adjustments of training loadings (15,8 % of cases) were made within 10 months of the routine and on-line monitoring (the total of 89 tests for each of 5 female first-string gymnasts). Female gymnasts of the experimental group had their special physical fitness indices increased. So, the HR recovery rate was 50,9 ± 1,32 versus 39,04 ± 5,0 % for 5 min in the control group in the final test (at the end of the year learning-training cycle) after two test performances of the competitive composition of female gymnasts from the experimental group (p < 0,01, t = 2,99). The findings for the female athletes from the experimental group revealed the better functional status of their cardiovascular (circulatory efficiency coefficient - 3145,1 ± 192,8 versus 3712,3 ± 187,7 c.u.; Rufie index - 6,9 ± 0,34 versus 10,53 ± 1,6), respiratory systems (Gencha’s timed expiratory capacity - 28,1 ± 1,28 versus 23,86 ± 1,0 s) and vestibular apparatus (Romberg’s test - 29,9 ± 3,14 relative to 21,6 ± 1,85 s). The disease incidence of female athletes from the experimental group dropped (the prior-exercise mean value of absence from trainings due to illness was 17,1 ± 2,4 versus 22,7 ± 3,1 days a year per one female gymnast) along with less notable metabolic changes in the final test (Creatine phosphokinase-МВ (CPK-MB) - 15,1 ± 1,57 versus 19,8 ± 1,57 u/1; total albumin concentration (AC) - 47,5 ± 1,14 versus 43,7 ± 1,28 g/1; effective albumin concentration (EAC) - 41,0 ± 1,0 versus 36,4 ± 1,14 g/1 in the control group).

The advantages of the methods for the transcutaneous monitoring and laser Doppler sonography, such as noninvasiveness, technical simplicity, combined with high information value, are supposed to facilitate its wide introduction into the practice for studies of the regional circulation. Further studies of the microcirculation system will provide for settling the issues of monitoring and control of adaptive responses of the athlete's body at the new methodological level.

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