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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
EDIZIONI MINERVA MEDICA
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Aerobic training program for the enhancements of HR and
VO2 off-kinetics in elite judo athletes
Matteo BONATO, Susanna RAMPICHINI, Marco FERRARA, Stefano BENEDINI,
Paola SBRICCOLI, Giampiero MERATI, Emerson FRANCHINI, Antonio LA TORRE
J Sports Med Phys Fitness 2014 Oct 30 [Epub ahead of print]
THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
Rivista di Medicina, Traumatologia e Psicologia dello Sport
pISSN 0022-4707 - eISSN 1827-1928
Article type: Original Article
The online version of this article is located at http://www.minervamedica.it
1  
  
Title:  Aerobic  training  program  for  the  enhancements  of  HR  and     off-­kinetics  in  elite  judo  athletes  
  
Running  Head:  
  
Authors:  
Matteo Bonato1
, Susanna Rampichini1
, Ferrara Marco1
, Benedini Stefano1
, Sbriccoli Paola2
, Merati                                
Giampiero1
,  Emerson  Franchini3
,  Antonio  La  Torre1
  
  
Institutional  Affiliations:  
1. Department  of  Biomedical  Sciences  for  Health,  Università  degli  Studi  di  Milano,  Milan  Italy.  
2. Department  of  Human  Sciences  and  Health,  University  of  Rome,  Roma,  Italy.  
3. Martial Arts and Combat Sports Research Group, School of Physical Education and Sport,                                      
University  of  São  Paulo  (São  Paulo,  Brazil)  
  
Dates  of  congress  where  the  paper  has  already  been  presented  
V  National  Congress  SISMeS,  Pavia  from  27  to  29  September  2013  
  
Acknowledgements  
The authors would like to thank all the athletes for their voluntary participation in the study and their                                                     
availability  for  the  completion  of  all  experimental  procedures.  
  
Corresponding  Author:  
MSc  Matteo  Bonato  
Department  of  Biomedical  Sciences  for  Health,  Università  degli  Studi  di  Milano,  Milan,  Italy  
Via  Giuseppe  Colombo  71,  20133  Milano,  Italy  
Phone:  +39-­02-­5031  4658  
Fax:  +39-­02-­5031  4630  
E-­Mail:  matteo.bonato@unimi.it    
  
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2  
  
Aerobic  training  program  for  the  enhancements  of  HR  and     off-­kinetics  in  elite  judo  
athletes  
  
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permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to
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3  
  
Abstract  
  
Aim.  The purpose of this study was to investigate the physiologic and performance changes with the                                            
addition  of  high-­intensity  interval  training  (HIIT)  to  a  traditional  judo  programme.    
Methods.  Nine elite judokas (6 males and 3 females;; age: 20±4 yrs;; body mass: 69±2 kg;; height: 172±7                                                  
cm;; judo practice time: 13±6 yrs;; weekly training volume: 13±5 hours, mean±SD) were recruited to                                            
perform a 12-­week specific aerobic training program, which consisted of 2 session/week of 30-­min                                         
continuous run at 60% at Vmax and one session/week of high-­intensity interval training 15x1-­min at 90%                                               
of Vmax with1 min of active recovery at 60% of Vmax. Before and after the intervention all athletes                                                     
performed a graded maximal exercise test to measure maximal oxygen consumption ( max), ventilatory                                      
threshold (VT), maximal velocity  (Vmax), heart rate (HR) and     off kinetics.     and HR recovery                                
kinetics were evaluated on a breath-­by-­breath basis using a single component exponential                                   
function.  Anaerobic  capacity during specific movements was assessed with the Special Judo Fitness Test                                   
(SJFT).    
Results.  The maximal speed reached during the maximal aerobic power test significantly increaseed                                   
(p=0.04), but max did not change. τ  of HR and of     recovery significantly decreased by 17.3%                                         
(p=0.04) and 22.0% (p<0.01), respectively. VT increased (6.6%;; p=0.03) and the SJFT Index improved                                         
(12%;;  p<0.001)  12%  after  training.  
Conclusions. The aerobic fitness of elite judokas may be improved by adding aerobic routines to the                                               
normal  training  enhancing  the  recovery  capacity.    
Key  Words.  Ventilatory  threshold  ⋅  maximal  oxygen  consumption  ⋅  recovery  kinetics  ⋅  Special  Judo  
Fitness  Test.  
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4  
  
  
Introduction  
Judo is a dynamic, high-­intensity intermittent Olympic sport that requires complex skills and tactical                                         
excellence for success.1
The main judo competitions are the Olympic Games and World Championship,                                         
with athletes being divided into weight categories: <60 kg, 66 kg, 73 kg, 81 kg, 90 kg, 100 kg and >100                                                              
kg  for  males  and  <48  kg,  52  kg,  57  kg,  63  kg,  70  kg,  78  kg  and  >78  kg  for  females.    
To classify among the best competitors, judokas have to perform several matches in the same day                                               
(up to 7). The interval between two consecutive matches lasts at least 10 minutes although the mean time                                                     
interval is 15 min.2
A judo match lasts 5 minutes, with 20-­30 s of activity, during which the athletes spend                                                           
most of the time (51±11%) trying to perform a grip3, 4
, interspersed by 10 s intervals.5
If an athlete obtains                             
                             
an ippon (full point), the match ends immediately. Moreover, since 2003, when the time allotted for the                                                  
contest finished and the scores/penalties are the same for athletes (i.e. the match is tied), a “Golden Score”                                                     
decided the result of the contest. Until the end of 2012, if neither athlete obtained any point in the Golden                                                           
Score period the match continued for another 3 minutes and eventually the referees decided the result of                                                  
the match (Hantei decision). However, in 2013 the hantei was removed and the extra-­time just finished                                               
when  one  of  the  athletes  scored.6
    
Even if a judo match may last from few seconds to 8 minutes, the mean duration is 3-­4 minutes.4
                                                        
For these reasons, to be effective judo techniques should be applied with high levels of accuracy, strength,                                                  
velocity  and  power  during  the  entire  match.7
    
Thus, judo match taxes both of the aerobic and the anaerobic systems. The anaerobic systems                                            
provides the short, quick, all-­out bursts of maximal power during the match, while the aerobic systems                                               
contributes to sustain effort for the entire combat duration and to rapidly recover during the brief period of                                                     
rest or reduced effort.1,6
Degoutte et al.1
indicated the peak values of oxygen consumption ( )                                            
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4
5  
  
reached during a match are about 55 ± 5 ml kg-­1
min-­1
, while the heart rate is about of 182 ± 0.4                                                                 
beats·∙min-­1
with a plasma concentration of lactate of 12.3 ± 0.8 mmol·∙l. For these reasons judokas are                                                  
largely classified as athletes who possess a combination of increased aerobic and anaerobic fitness.2
                                         
According to the study of Degoutte et al1
the intensity of a judo match is more than 60-­75% of O2max,                                                           
with a great increase of lactate values, suggesting that a superior aerobic fitness could reasonably provide a                                                  
faster recovery between matches.1, 6
Therefore, the level of anaerobic and aerobic fitness in judokas are           
                                   
regarded  as  important  factors  to  determine  the  victory  or  the  defeat  in  competition.  
Taking in account also that judo is mainly characterized by brief actions performed at high intensity,                                               
a good training program should include exercises capable of enhancing also these characteristics. To this                                            
respect, high intensity interval training (HIIT) protocols could be successfully applied in this discipline.                                         
Indeed HIIT can be broadly defined as repeated bouts of short to moderate duration exercise (i.e. from 10                                                     
seconds to 5 minutes) completed at an intensity that is greater than the ventilatory threshold (VT).8, 9
                                               
  
Exercise bouts are separated by brief periods of low-­intensity work or inactivity that allow a partial but                                                  
often  not  a  full  recovery10
,  a  condition  that  is  similar  to  judo  competition.    
In scientific literature, it has been demonstrated that HIIT can produce faster metabolic and                                         
cardiorespiratory adaptation than continuous endurance training for increasing aerobic power. 10, 11
                                
  
However, only three studies investigated the effects of high-­intensity training on selected aerobic and                                         
anaerobic performances indices in combat sports: Ravier et al.12
for karate, Kim et al.13
for judo and                                                  
Farzad et al.14
for wrestling. In their training protocols they used sprint interval training consisting of short                                                  
bursts of activity lasting 20 s12
, 30 s13
and 35 m sprints14
. For all protocols the recovery period was                                                        
passive: 15 s12
, 4 min13
and 10 s14
. At the end of the training program these authors12,13,14
reported                                                     
improvements of both aerobic and anaerobic performances. These adaptations can be a consequence of                                         
the large requirements from the O2 transports and utilisation, neuromuscular strain and a large anaerobic                                            
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6  
  
glycolytic energy contribution involved in these protocols, according to the classification recently proposed                                      
by  Buchheit  &  Laursen11
.    
However, none of these studies has investigated the effects of HIIT on the recovery parameters.                                            
During recovery does not return immediately to rest values but decrease exponentially in order to                                               
restore metabolic process to pre-­exercise condition. In exercise science the recovery is considered                                      
complete when HR and reach the resting values. The oxygen kinetics during recovery has been                                               
shown to consist of two components, a fast, and a slow phase15, 16
. The former, also known as alactic                                   
                    
phase, covers about 30 sec for t1/2 and is not associated with a decrease of blood lactate concentration,                                                     
but seems to accounts for phosphocreatine (PCr) resynthesis. The latter, called “excess post-­exercise                                      
oxygen consumption” (EPOC) has a t1/2 of about 15-­18 min17
. During this time the lactate rapidly enters                                                  
and leaves the blood and the oxidation is the main fate of lactate18
. Thus, considering that a well-­developed                                                     
aerobic fitness allows the athletes to better recover between the matches, the first aim of this study was to                                                        
examine the off transient phase of and HR in response to an additional high-­intensity interval training                                                  
to typical judo training programme in a group of elite judo athletes. The results obtained could provide                                                  
practical indications to coach and trainers on the opportunity of using more specific training programs                                            
capable of enhancing general and specific characteristics in these athletes. The hypothesis of the present                                            
study was that this training program would result in faster off and HR kinetics and better                                                  
performance  in  a  judo-­specific  test.  
  
Material  and  methods  
Experimental  Design  
This was a 12-­week pre-­post single group study conducted on elite judo athletes. The study was                                               
carried out during the standard off-­season training program in which the strength and conditioning                                         
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7  
  
preparation is favoured. All measurements were performed in baseline (T0) condition and after 12 weeks                                            
of standardized training (T12), divided in 6 week of Standard Judo Training (SJT) and 6 weeks of SJT                                                     
plus  Aerobic  Training  (AT).    
In each testing session data on anthropometry and body composition were collected. Moreover, all                                         
subjects underwent a graded maximal aerobic power test ( max) on a treadmill to assess the max,                                               
the peak of speed and the VT. Maximal post-­exercise [La] and the kinetic characteristics (τ) of both heart                                                     
rate and O2 during recovery were evaluated. The Special Judo Fitness Test (SJFT) was used (see                                               
below)  to  assess  the  anaerobic  capacity.    
Subjects were instructed to attend the laboratory in a rested and fully hydrated state, at least 3h                                                  
after the last meal, and to avoid strenuous exercise in the 24 h preceding each testing session. In addition,                                                        
they  were  asked  to  refrain  from  caffeine  and  alcohol  24  h  before  each  test.    
All tests were performed at the same time of day (±1h) to avoid influence of circadian rhythms.                                                  
Prior  to  data  collection,  subjects  were  fully  familiarised  with  all  exercise  testing  procedures.    
Università degli Studi di Milano, and the Department of Biomedical Sciences for Health approved                                         
the study and a written informed consent was obtained from each participant. All procedures followed                                            
were  in  accordance  with  the  Helsinki  Declaration  of  1975,  as  revised  in  2000.  
  
Participants  
Nine elite judo athletes (6 males and 3 females;; age: 20 ± 4 yrs;; body mass: 69 ± 2 kg;; stature:                                                              
1.72 ± 0.07 m;; time of judo practice: 13 ± 6 yrs;; weekly training volume: 13 ± 5 hours, mean ± SD)                                                                 
volunteered  to  participate  in  this  study.    
Concerning their competitive level, 7 were international and 4 were national level competitors: one                                         
subject was blue belt, 2 subjects brown belt, two subjects black belt 1st
Dan, two subjects black belt 2nd
                                                        
Dan,  and  four  subjects  black  belt  3rd
  Dan.    
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8  
  
  
Anthropometric  assessment  
The anthropometric assessment was performed before each experimental session by the same                                   
operator following the standardized techniques described by Lohman.19
Anthropometric variables included                                
body  mass,  stature,  and  skinfold  thickness  on  the  dominant  side.    
Stature and body mass were measured on field with a portable stadiometer and scale to the nearest                                                  
0.5  cm  and  0.1  kg,  respectively.    
Skinfolds were taken three times in each anatomic site using a calliper (Holtain Ltd, Crymych Uk)                                               
to the nearest 0.2 mm. The average value obtained among the three measures was computed. Body                                               
density (d) was calculated using the Jackson & Pollock equation20
from three skinfolds (Female: triceps,                                            
suprailiac  and  thigh;;  Male:  pectoral,  abdominal  and  thigh).     
The  percentage  of  fat  mass  was  finally  derived  as:  
  
fat  mass  (%)  =  495/  d  –  450.21
  
  
Maximal  aerobic  power  assessment  
Oxygen consumption ( ), carbon dioxide production ( ), respiratory exchange ratio                             
(RER) and pulmonary ventilation ( ) were measured on a breath-­by-­breath basis by a portable                                         
telemetric metabolimeter (k4b2
Cosmed, Rome, Italy) during a graded maximal aerobic power test                                      
performed on a motorized treadmill (Run Now 700, Tecnogym Spa, Italy), set at 1% gradient (Jones et                                                  
al.,  1996).22
    
All tests were carried out in a well-­ventilated laboratory at a temperature of 20-­22°C. The                                            
protocol consisted of 3 minutes of rest, 4 minutes at 8 km⋅h-­1
, after which velocity increased by 0.5 km⋅h-­1
                                                        
every minute until volitional exhaustion. O2max was assessed according to the criterion described by                                         
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4
9  
  
Taylor et al.23
The load at which the test ended, was considered as the maximal aerobic speed (Vmax).                                                     
Heart rate (HR) was recorded during the whole test by a HR monitor (Polar S810, © Polar Electro 2011,                                                        
Kempele,  Finland).    
The VT was assessed according to the gas exchange method (V-­Slope).24
Briefly, the break point                                            
in the vs relationship was detected and considered as the VT. Then the VT was expressed                                                     
in  percentage  of  the   max.    
Recovery kinetics of and HR were evaluated breath-­by-­breath from the end of the                                         
O2max test up to the recovery of the steady state condition. Data were fitted using an exponential function                                                     
with a single component (equation 1) with the non-­linear least-­squares regression technique and the best fit                                               
defined  by  the  minimisation  of  the  residual  sum  of  squares.  
  
Eq  1:     
  
Where  f  refers  to     or  HR,  t  is  the  time,  a0  is  the  plateau  phase  of     or  HR  measured  at  
the  end  of  the  incremental  test,  a1  is  the  decrease  in  the  amplitude,  τ  is  the  time  constant  of  the  exponential  
function  and  TD  is  the  time  delay,  i.e  the  time  the  decay  needs  to  begin.    
  
Special  Judo  Fitness  Test  (SJFT)  
The SJFT was developed by Sterkowicz in 199525
, and then described by Franchini et al., in                                               
1998.26
  This  test  aims  to  evaluate  the  fitness  level  of  judo  athletes  during  specific  movements.    
To perform these test three athletes of similar body mass are needed: 1 participant to be evaluated                                                  
(tori), and 2 other individuals as passive opponents (ukes). The tori begin the test between the 2 ukes that                                                        
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4
10  
  
are 6 metres apart. On an acoustic signal, the tori has to run quickly to one of the ukes and apply a                                                                 
throwing technique called ippon-­seoi-­nage. The tori then immediately has to run to the other uke and                                               
complete another throw. The athlete must complete as many throws as possible within the test time, which                                                  
is composed of three periods (15, 30, and 30 s) separated by 10-­s of recovery. At the end and 1 minute                                                              
thereafter the test, the athlete’s HR was measured (Polar S810, © Polar Electro 2011, Kempele, Finland).                                               
As regards the SJFT, the total number of throws accomplished in the three periods has been computed,                                                  
and the SJFT Index is therefore calculated according to the formula (equation 2) proposed by                                            
Sterkowicz27
:  
  
Eq  2:     
  
Where Final HR (bpm) is the HR measured at the end of SJFT, HR1 (bpm) is the HR measured                                                        
after the end of the test and Total Throws are the total number of throws performed by the tori during                                                           
SJFT. A decrease of the SJFT Index, due to a decrease of HR or an increase in the throws number,                                                           
indicates  an  improvement  of  performance.  
  
Standard  Judo  Training  Program  
During the six weeks of standard judo training all subjects performed nine training sessions a week                                               
(18 h/wk). The program consisted of 4 hours per week of resistance training conducted on Tuesday and                                                  
Thursday at 10:00-­12:00 am. Judo training was performed at 6:00-­8:00 pm from Monday to Friday, and                                               
Saturday from 10:00-­12:00, totalling 12 hours per week and including specific judo exercises (e.g.,                                         
uchi-­komi – technique entrance, nage-­komi – throwing technique practice) and match simulations                                   
(randori).  Moreover,  Saturday  at  3:00-­5:00  pm  a  fighting  session  was  completed.  
  
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4
11  
  
Aerobic  Training  Program  
To maintain the same training volume of the standard judo training during the six weeks of the                                                  
aerobic training protocol subjects performed nine training sessions a week (18 h/wk) as described above.                                            
Additionally, on Monday, Wednesday and Friday the AT was done on the last 30 min of the judo training.                                                        
Among the three AT sessions, the sessions conducted on Mondays and Wednesdays consisted of 30                                            
minutes of continuous run on a treadmill at 60% of Vmax assessed during O2max test. In the third AT                                                        
session subjects performed fifteen 1-­min high-­intensity repetitions at 90% of Vmax with 1 minute of active                                               
recovery at 60% of Vmax between each interval. The high-­intensity 1x1-­min interval training started with                                            
10-­min  warm-­up  and  ended  with  a  3  min  cool-­down  period  with  a  self-­selected  intensity.    
All subjects completed all training sessions without complications. The high-­intensity 1x1-­min                                
interval training protocol was generally well tolerated and subjects did not report dizziness,                                      
light-­headedness  or  nausea,  symptoms  that  occasionally  occur  during  this  type  of  training.  
  
Statistical  analysis  
All parameters measured during the maximal aerobic power test ( max;; Vmax;; VT;; τ ( ) off                                            
kinetics;; τ (HR) off kinetics), and during the SJFT (HR, throws number, and SJFT index) were expressed                                                  
as  mean  values  ±  standard  deviation  (mean  ±  SD)  and  divided  for  gender.    
Statistical analysis was performed using Graph Pad Prism Software, version 5.00 for Windows                                      
(Graph Pad Software, San Diego California USA). Differences between males and females were assessed                                         
by the unpaired Student’s t-­test. Since no significant differences have been detected for the selected                                            
parameters between males and females athletes, data were pooled. The Shapiro-­Wilk normality test was                                         
used to verify the normality condition. Paired T-­test was used to assess the average changes in                                               
performance of the investigated variables. The level of statistical significance was set at p<0.05.                                         
Standardized changes in the mean values were used to assess magnitude of effects (Effect Size, ES).                                               
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12  
  
Values <0.2, <0.6, <1.2 and >2.0 were interpreted as trivial, small, moderate, large and very large,                                               
respectively.27
  
  
Results  
Anthropometric  assessment  
No  significant  changes  were  found  in  the  participant’s  physical  characteristics  at  T12  compared  to  T0.  In  
particular,  mean  ±  SD  for  T0  and  T12  were:  body  mass,  69.4  ±  7.7  and  71.5  ±  8.2  kg;;  BMI,  22.4  ±  1.4  
and  23.3  ±  1.2  kg·∙m-­2
;;  fat  mass,  11.7  ±  7.4  and  12.6  ±  8.9%.  
  
Maximal  aerobic  power  assessment  
Results of max, Vmax and VT are shown in figure 1. No significant changes were detected for                                                  
both relative and absolute max values. However, Vmax at T12 was significantly higher (4.6%;; p<0.05;;                                            
ES=0.4)  than  before  the  training  program.  Finally,  VT  significantly  increased  by  6.6%  (p<0.05;;  ES=0.9).    
The lactate peak at the end of max at T0 was 7.5 ± 2.0 mmol ·∙ l-­1
. No significant changes                                                           
were  detected  at  T12  (7.1  ±  0.9  mmol  ·∙  l-­1
).    
  
***  Figure  1  here  ***  
Off  kinetics    
After  the  12  weeks  training  protocol  the  τ  of     and  HR  significantly  decreased  by  22.0  %  
(p<0.001  ES:  1.2),  and  17.3%  (p<0.05;;  ES:  1.0),  respectively  (Figure  2).    
  
***  Figure  2  here  ***  
Special  Judo  Fitness  Test    
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13  
  
All the results of SJFT at T12 compared to T0 are shown in table 1. After the 12 weeks training                                                           
protocol the SJFT Index improved significantly by 12% (p<0.01, ES: 1.2). After training the HR peak                                               
measured at the end of the SJFT was reduced by a 7% with respect to the pre-­training value (p=0.004,                                                        
ES: 0.7), whereas HR post 1 min was decreased by 8% after the 12 weeks of training (p=0.004, ES: 0.9).                                                           
No significant changes were found as regards the total number of throws in the post training assessment                                                  
(T12).    
  
***  Table  1  here  ***  
  
Discussion  
The purpose of this study was to test the effects of 12 weeks of training on both the aerobic and                                                           
anaerobic profiles in a group of elite judo athletes. Namely, this period of training was divided in 6 weeks                                                        
of standard judo training and 6 weeks of standard judo training plus aerobic training protocol. The main                                                  
results obtained in this study can be summarized as follows: 1) the Vmax and the VT measured during                                                     
O2max test increased significantly;; 2) the recovery time of both O2 and HR decreased;; 3) an                                               
improvement of HR at the end of SJFT and a reduction of the HR one minute after the end of the SJFT                                                                 
was  found.    
The main novelty of the present work consisted of the insertion of an AT protocol alternating two                                                  
sessions of 30 minutes of continuous run on a treadmill at 60% of Vmax and one session of fifteen 1-­min                                                           
high-­intensity  repetitions  at  90%  Vmax  with  1  minute  of  active  recovery  at  60%  Vmax  between  each  interval.  
In particular our aim was not only to insert a traditional AT that is known to effectively improve                                                     
cardiac and skeletal muscle function26
, but a more specific training session capable of enhancing general                                            
and  specific  characteristics  in  judo  athletes  in  accordance  with  their  typical  metabolic  profile.  
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14  
  
For this reason we chose to put in the weekly training which is currently acknowledged as one of                                                     
the most effective forms of exercise to improving physical performance in athletes.8-­11
High-­intensity training                                         
can be broadly defined as repeated bouts of short to moderate duration exercise (i.e. from 10 seconds to 5                                                        
minutes) completed at an intensity that is greater than VT.8, 9
Exercise bouts are separated by brief periods                             
                       
of low-­intensity work or inactivity that allow a partial but often not a full recovery. In particular there are                                                        
different types of high-­intensity training format based on the expected acute physiological response/strain.11
                                      
Our interval training session consisted of 1 minute of effort and one minute of active rest. This was done to                                                           
obtain a direct impact on the physiological response essentially eliciting large requirements from the O2                                            
transport and utilisation systems (i.e. cardiopulmonary system and oxidative muscle fibres), a certain degree                                         
of  neuromuscular  strain  and  an  anaerobic  glycolytic  energy  contribution.10
  
The max values observed in our group were similar to those reported in previous studies30-­37
in                                               
which max ranged from 50 to 60 ml⋅kg-­1
⋅min-­1
and from 40 to 50 ml·∙kg-­1
·∙min-­1
for male and female                                                     
judo athletes, respectively. As expected, at T12 no differences were found in max, as a more frequent                                                  
stimulus seems to be needed to result in an increase in the O2max (i.e., three to five times of specific                                                           
training per week).10
Despite this, a significant increase in Vmax was found. Frequently, highly trained                                            
athletes improve their maximum aerobic speed without concomitant changes in max, normally due to                                         
an improvement in running economy after high-­intensity training protocols.38
The VT values are similar to                                            
those found by Degoutte33
, Little34
, and Sbriccoli et al.37
(i.e., above 80% of O2max). In particular, our                                                  
results indicate that our training led the athletes to VT values close to those of the Italian Olympic Team of                                                           
2004.37
This provide more evidence that aerobic metabolism is not highly developed in high-­level judo                                            
athletes. The 12 weeks of training improved the aerobic fitness of the judo athletes and, as it has been                                                        
hypothesized that a higher values of these variables allow the maintenance of a higher intensity during the                                                  
match39,  40
,  and  an  increase  in  the  intensity  that  can  be  sustained  during  a  judo  competition.    
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At the end of the 12 weeks of training the kinetics of the HR and of the during recovery                                                           
significantly accelerated compared to T0. Looking at the Olympic and World Championship competition                                      
model a high capacity of recovery between two consecutive matches (about 15 min) is fundamental to                                               
delay the accumulation of metabolites (e.g. H+
, Pi and lactate) that are associated with fatigue process40, 41
.                                               
  
Our results demonstrates that the beneficial effects of an AT protocol leads to a shortening of the recovery                                                     
period  after  a  high-­intensity  effort,  and  this  seems  to  be  a  new  finding  when  compared  to  other  studies.  
In our study, the SJFT was utilised to evaluate the specific fitness of the judo athletes. At the end of                                                           
the 12 weeks of training a significant reduction of the SJFT index was found. This result was given via a                                                           
significant reduction of the HR peak at the end of the test and 1-­minute after the conclusion of SJFT. No                                                           
changes were detected on the number of throws. Looking at the classificatory table of SJFT proposed by                                                  
Franchini et al.41
, this whole group passed from a regular to a good classification, suggesting that the                                                  
aerobic  training  proposed  improved  judo  athletes’  specific  performance.    
A possible limitation of this study is the lack of a control group, but according to Atkinson &                                                     
Nevill42
the use of control group in periodization studies is difficult, because athletes are normally submitted                                               
to some type of periodization process. Additionally, there would be ethical problems with restricting a                                            
particular  treatment  to  elite  athletes.    
Although judo is a discipline that requires complex skills and tactical excellence, the conditional                                         
capacities as maximal isometric and dynamic strength to excel in high-­level competitions are also                                         
fundamental. Moreover, the contribution of the aerobic metabolism may be of importance in these athletes                                            
as well. The results of this study consisting of a significant reduction of the recovery kinetics of HR and                                                        
, an increase of the VT, and a reduction of the HR immediately at the end, and 1 minute after the                                                              
SJFT, coaches should consider inserting specific training sessions especially focused on aerobic fitness                                      
improvement. This may speed up metabolic and cardiovascular recovery, enhancing the athletes’                                   
performances. Finally, a good aerobic conditioning could enhance the ability to better recover after a judo                                               
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combat, which may play a significant role in managing a different number of combats within the same                                                  
competition,  thereby  improving  the  performance  ability  in  these  athletes.  
  
     
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21  
  
TABLE  
  
Table  1.  Number  of  throws,  heart  rate  response  and  index  in  the  Special  Judo  Fitness  Test  before  and  
after  12  weeks  of  judo  and  aerobic  training  (n  =  9).  Results  are  expressed  as  mean±SD.  
  
  
     
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FIGURES  
Figure  1.  Differences  at  T12  compared  to  T0  for   O2max  (A,  p>0.05;;  ES:  0.1),  Vmax  (B,  *p<0.05;;  ES:  
0.4)  and  VT  (C,  *p<0.05;;  ES:  0.7).  The  results  in  the  graph  are  shown  as  mean  ±  SD.     
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23  
  
  
Figure  2.  Differences  at  T12  compared  to  T0  for  off     (A,  *p<0.05;;  ES:  1.0)  and  off  HR  (B,  
***p<0.001;;  ES:  1.2).  The  results  in  the  graph  in  the  left  column  are  shown  as  mean  and  the  error  bars  are  
SD.  Furthermore,  the  right  column  shows  the  trends  of  the  recovery  phase  of     and  HR  of  a  subject  
taken  as  an  example.  
  
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Parameter   T0   T12   p  
Throws  A   6  ±  1     6  ±  0   n.s  
Throws  B   11  ±  1   10  ±  0   n.s  
Throws  C   10  ±  1   10  ±  1     n.s  
Total  throws   26  ±  1   26  ±  2   n.s  
HR  after  (bpm)   184  ±  7   177  ±  15   <0.05  
HR  1  min  after  (bpm)   155  ±  15   145  ±  15   <0.01  
Index  SJFT   13.75  ±  0.77   12.24  ±  1.18   <0.001  
  
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Bonato et al., 2014

  • 1. THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS EDIZIONI MINERVA MEDICA This provisional PDF corresponds to the article as it appeared upon acceptance. A copyedited and fully formatted version will be made available soon. The final version may contain major or minor changes. Subscription: Information about subscribing to Minerva Medica journals is online at: http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissions send an email to: journals.dept@minervamedica.it - journals2.dept@minervamedica.it - journals6.dept@minervamedica.it COPYRIGHT© 2014 EDIZIONI MINERVA MEDICA Aerobic training program for the enhancements of HR and VO2 off-kinetics in elite judo athletes Matteo BONATO, Susanna RAMPICHINI, Marco FERRARA, Stefano BENEDINI, Paola SBRICCOLI, Giampiero MERATI, Emerson FRANCHINI, Antonio LA TORRE J Sports Med Phys Fitness 2014 Oct 30 [Epub ahead of print] THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS Rivista di Medicina, Traumatologia e Psicologia dello Sport pISSN 0022-4707 - eISSN 1827-1928 Article type: Original Article The online version of this article is located at http://www.minervamedica.it
  • 2. 1     Title:  Aerobic  training  program  for  the  enhancements  of  HR  and    off-­kinetics  in  elite  judo  athletes     Running  Head:     Authors:   Matteo Bonato1 , Susanna Rampichini1 , Ferrara Marco1 , Benedini Stefano1 , Sbriccoli Paola2 , Merati                       Giampiero1 ,  Emerson  Franchini3 ,  Antonio  La  Torre1     Institutional  Affiliations:   1. Department  of  Biomedical  Sciences  for  Health,  Università  degli  Studi  di  Milano,  Milan  Italy.   2. Department  of  Human  Sciences  and  Health,  University  of  Rome,  Roma,  Italy.   3. Martial Arts and Combat Sports Research Group, School of Physical Education and Sport,                           University  of  São  Paulo  (São  Paulo,  Brazil)     Dates  of  congress  where  the  paper  has  already  been  presented   V  National  Congress  SISMeS,  Pavia  from  27  to  29  September  2013     Acknowledgements   The authors would like to thank all the athletes for their voluntary participation in the study and their                                     availability  for  the  completion  of  all  experimental  procedures.     Corresponding  Author:   MSc  Matteo  Bonato   Department  of  Biomedical  Sciences  for  Health,  Università  degli  Studi  di  Milano,  Milan,  Italy   Via  Giuseppe  Colombo  71,  20133  Milano,  Italy   Phone:  +39-­02-­5031  4658   Fax:  +39-­02-­5031  4630   E-­Mail:  matteo.bonato@unimi.it       This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 3. 2     Aerobic  training  program  for  the  enhancements  of  HR  and    off-­kinetics  in  elite  judo   athletes     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 4. 3     Abstract     Aim.  The purpose of this study was to investigate the physiologic and performance changes with the                               addition  of  high-­intensity  interval  training  (HIIT)  to  a  traditional  judo  programme.     Methods.  Nine elite judokas (6 males and 3 females;; age: 20±4 yrs;; body mass: 69±2 kg;; height: 172±7                                   cm;; judo practice time: 13±6 yrs;; weekly training volume: 13±5 hours, mean±SD) were recruited to                               perform a 12-­week specific aerobic training program, which consisted of 2 session/week of 30-­min                             continuous run at 60% at Vmax and one session/week of high-­intensity interval training 15x1-­min at 90%                                 of Vmax with1 min of active recovery at 60% of Vmax. Before and after the intervention all athletes                                     performed a graded maximal exercise test to measure maximal oxygen consumption ( max), ventilatory                           threshold (VT), maximal velocity  (Vmax), heart rate (HR) and    off kinetics.    and HR recovery                       kinetics were evaluated on a breath-­by-­breath basis using a single component exponential                         function.  Anaerobic  capacity during specific movements was assessed with the Special Judo Fitness Test                         (SJFT).     Results.  The maximal speed reached during the maximal aerobic power test significantly increaseed                         (p=0.04), but max did not change. τ  of HR and of    recovery significantly decreased by 17.3%                             (p=0.04) and 22.0% (p<0.01), respectively. VT increased (6.6%;; p=0.03) and the SJFT Index improved                             (12%;;  p<0.001)  12%  after  training.   Conclusions. The aerobic fitness of elite judokas may be improved by adding aerobic routines to the                                 normal  training  enhancing  the  recovery  capacity.     Key  Words.  Ventilatory  threshold  ⋅  maximal  oxygen  consumption  ⋅  recovery  kinetics  ⋅  Special  Judo   Fitness  Test.   This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 5. 4       Introduction   Judo is a dynamic, high-­intensity intermittent Olympic sport that requires complex skills and tactical                             excellence for success.1 The main judo competitions are the Olympic Games and World Championship,                             with athletes being divided into weight categories: <60 kg, 66 kg, 73 kg, 81 kg, 90 kg, 100 kg and >100                                           kg  for  males  and  <48  kg,  52  kg,  57  kg,  63  kg,  70  kg,  78  kg  and  >78  kg  for  females.     To classify among the best competitors, judokas have to perform several matches in the same day                                 (up to 7). The interval between two consecutive matches lasts at least 10 minutes although the mean time                                     interval is 15 min.2 A judo match lasts 5 minutes, with 20-­30 s of activity, during which the athletes spend                                         most of the time (51±11%) trying to perform a grip3, 4 , interspersed by 10 s intervals.5 If an athlete obtains                                         an ippon (full point), the match ends immediately. Moreover, since 2003, when the time allotted for the                                   contest finished and the scores/penalties are the same for athletes (i.e. the match is tied), a “Golden Score”                                     decided the result of the contest. Until the end of 2012, if neither athlete obtained any point in the Golden                                         Score period the match continued for another 3 minutes and eventually the referees decided the result of                                   the match (Hantei decision). However, in 2013 the hantei was removed and the extra-­time just finished                                 when  one  of  the  athletes  scored.6     Even if a judo match may last from few seconds to 8 minutes, the mean duration is 3-­4 minutes.4                                       For these reasons, to be effective judo techniques should be applied with high levels of accuracy, strength,                                   velocity  and  power  during  the  entire  match.7     Thus, judo match taxes both of the aerobic and the anaerobic systems. The anaerobic systems                               provides the short, quick, all-­out bursts of maximal power during the match, while the aerobic systems                                 contributes to sustain effort for the entire combat duration and to rapidly recover during the brief period of                                     rest or reduced effort.1,6 Degoutte et al.1 indicated the peak values of oxygen consumption ( )                               This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 6. 5     reached during a match are about 55 ± 5 ml kg-­1 min-­1 , while the heart rate is about of 182 ± 0.4                                             beats·∙min-­1 with a plasma concentration of lactate of 12.3 ± 0.8 mmol·∙l. For these reasons judokas are                                   largely classified as athletes who possess a combination of increased aerobic and anaerobic fitness.2                             According to the study of Degoutte et al1 the intensity of a judo match is more than 60-­75% of O2max,                                         with a great increase of lactate values, suggesting that a superior aerobic fitness could reasonably provide a                                   faster recovery between matches.1, 6 Therefore, the level of anaerobic and aerobic fitness in judokas are                                 regarded  as  important  factors  to  determine  the  victory  or  the  defeat  in  competition.   Taking in account also that judo is mainly characterized by brief actions performed at high intensity,                                 a good training program should include exercises capable of enhancing also these characteristics. To this                               respect, high intensity interval training (HIIT) protocols could be successfully applied in this discipline.                             Indeed HIIT can be broadly defined as repeated bouts of short to moderate duration exercise (i.e. from 10                                     seconds to 5 minutes) completed at an intensity that is greater than the ventilatory threshold (VT).8, 9                                   Exercise bouts are separated by brief periods of low-­intensity work or inactivity that allow a partial but                                   often  not  a  full  recovery10 ,  a  condition  that  is  similar  to  judo  competition.     In scientific literature, it has been demonstrated that HIIT can produce faster metabolic and                             cardiorespiratory adaptation than continuous endurance training for increasing aerobic power. 10, 11                         However, only three studies investigated the effects of high-­intensity training on selected aerobic and                             anaerobic performances indices in combat sports: Ravier et al.12 for karate, Kim et al.13 for judo and                                   Farzad et al.14 for wrestling. In their training protocols they used sprint interval training consisting of short                                   bursts of activity lasting 20 s12 , 30 s13 and 35 m sprints14 . For all protocols the recovery period was                                       passive: 15 s12 , 4 min13 and 10 s14 . At the end of the training program these authors12,13,14 reported                                     improvements of both aerobic and anaerobic performances. These adaptations can be a consequence of                             the large requirements from the O2 transports and utilisation, neuromuscular strain and a large anaerobic                               This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 7. 6     glycolytic energy contribution involved in these protocols, according to the classification recently proposed                           by  Buchheit  &  Laursen11 .     However, none of these studies has investigated the effects of HIIT on the recovery parameters.                               During recovery does not return immediately to rest values but decrease exponentially in order to                                 restore metabolic process to pre-­exercise condition. In exercise science the recovery is considered                           complete when HR and reach the resting values. The oxygen kinetics during recovery has been                                 shown to consist of two components, a fast, and a slow phase15, 16 . The former, also known as alactic                                       phase, covers about 30 sec for t1/2 and is not associated with a decrease of blood lactate concentration,                                     but seems to accounts for phosphocreatine (PCr) resynthesis. The latter, called “excess post-­exercise                           oxygen consumption” (EPOC) has a t1/2 of about 15-­18 min17 . During this time the lactate rapidly enters                                   and leaves the blood and the oxidation is the main fate of lactate18 . Thus, considering that a well-­developed                                     aerobic fitness allows the athletes to better recover between the matches, the first aim of this study was to                                       examine the off transient phase of and HR in response to an additional high-­intensity interval training                                   to typical judo training programme in a group of elite judo athletes. The results obtained could provide                                   practical indications to coach and trainers on the opportunity of using more specific training programs                               capable of enhancing general and specific characteristics in these athletes. The hypothesis of the present                               study was that this training program would result in faster off and HR kinetics and better                                   performance  in  a  judo-­specific  test.     Material  and  methods   Experimental  Design   This was a 12-­week pre-­post single group study conducted on elite judo athletes. The study was                                 carried out during the standard off-­season training program in which the strength and conditioning                             This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 8. 7     preparation is favoured. All measurements were performed in baseline (T0) condition and after 12 weeks                               of standardized training (T12), divided in 6 week of Standard Judo Training (SJT) and 6 weeks of SJT                                     plus  Aerobic  Training  (AT).     In each testing session data on anthropometry and body composition were collected. Moreover, all                             subjects underwent a graded maximal aerobic power test ( max) on a treadmill to assess the max,                                 the peak of speed and the VT. Maximal post-­exercise [La] and the kinetic characteristics (τ) of both heart                                     rate and O2 during recovery were evaluated. The Special Judo Fitness Test (SJFT) was used (see                                 below)  to  assess  the  anaerobic  capacity.     Subjects were instructed to attend the laboratory in a rested and fully hydrated state, at least 3h                                   after the last meal, and to avoid strenuous exercise in the 24 h preceding each testing session. In addition,                                       they  were  asked  to  refrain  from  caffeine  and  alcohol  24  h  before  each  test.     All tests were performed at the same time of day (±1h) to avoid influence of circadian rhythms.                                   Prior  to  data  collection,  subjects  were  fully  familiarised  with  all  exercise  testing  procedures.     Università degli Studi di Milano, and the Department of Biomedical Sciences for Health approved                             the study and a written informed consent was obtained from each participant. All procedures followed                               were  in  accordance  with  the  Helsinki  Declaration  of  1975,  as  revised  in  2000.     Participants   Nine elite judo athletes (6 males and 3 females;; age: 20 ± 4 yrs;; body mass: 69 ± 2 kg;; stature:                                           1.72 ± 0.07 m;; time of judo practice: 13 ± 6 yrs;; weekly training volume: 13 ± 5 hours, mean ± SD)                                             volunteered  to  participate  in  this  study.     Concerning their competitive level, 7 were international and 4 were national level competitors: one                             subject was blue belt, 2 subjects brown belt, two subjects black belt 1st Dan, two subjects black belt 2nd                                       Dan,  and  four  subjects  black  belt  3rd  Dan.     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 9. 8       Anthropometric  assessment   The anthropometric assessment was performed before each experimental session by the same                         operator following the standardized techniques described by Lohman.19 Anthropometric variables included                       body  mass,  stature,  and  skinfold  thickness  on  the  dominant  side.     Stature and body mass were measured on field with a portable stadiometer and scale to the nearest                                   0.5  cm  and  0.1  kg,  respectively.     Skinfolds were taken three times in each anatomic site using a calliper (Holtain Ltd, Crymych Uk)                                 to the nearest 0.2 mm. The average value obtained among the three measures was computed. Body                                 density (d) was calculated using the Jackson & Pollock equation20 from three skinfolds (Female: triceps,                               suprailiac  and  thigh;;  Male:  pectoral,  abdominal  and  thigh).     The  percentage  of  fat  mass  was  finally  derived  as:     fat  mass  (%)  =  495/  d  –  450.21     Maximal  aerobic  power  assessment   Oxygen consumption ( ), carbon dioxide production ( ), respiratory exchange ratio                     (RER) and pulmonary ventilation ( ) were measured on a breath-­by-­breath basis by a portable                             telemetric metabolimeter (k4b2 Cosmed, Rome, Italy) during a graded maximal aerobic power test                           performed on a motorized treadmill (Run Now 700, Tecnogym Spa, Italy), set at 1% gradient (Jones et                                   al.,  1996).22     All tests were carried out in a well-­ventilated laboratory at a temperature of 20-­22°C. The                               protocol consisted of 3 minutes of rest, 4 minutes at 8 km⋅h-­1 , after which velocity increased by 0.5 km⋅h-­1                                       every minute until volitional exhaustion. O2max was assessed according to the criterion described by                             This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 10. 9     Taylor et al.23 The load at which the test ended, was considered as the maximal aerobic speed (Vmax).                                     Heart rate (HR) was recorded during the whole test by a HR monitor (Polar S810, © Polar Electro 2011,                                       Kempele,  Finland).     The VT was assessed according to the gas exchange method (V-­Slope).24 Briefly, the break point                               in the vs relationship was detected and considered as the VT. Then the VT was expressed                                     in  percentage  of  the   max.     Recovery kinetics of and HR were evaluated breath-­by-­breath from the end of the                             O2max test up to the recovery of the steady state condition. Data were fitted using an exponential function                                     with a single component (equation 1) with the non-­linear least-­squares regression technique and the best fit                                 defined  by  the  minimisation  of  the  residual  sum  of  squares.     Eq  1:       Where  f  refers  to    or  HR,  t  is  the  time,  a0  is  the  plateau  phase  of    or  HR  measured  at   the  end  of  the  incremental  test,  a1  is  the  decrease  in  the  amplitude,  τ  is  the  time  constant  of  the  exponential   function  and  TD  is  the  time  delay,  i.e  the  time  the  decay  needs  to  begin.       Special  Judo  Fitness  Test  (SJFT)   The SJFT was developed by Sterkowicz in 199525 , and then described by Franchini et al., in                                 1998.26  This  test  aims  to  evaluate  the  fitness  level  of  judo  athletes  during  specific  movements.     To perform these test three athletes of similar body mass are needed: 1 participant to be evaluated                                   (tori), and 2 other individuals as passive opponents (ukes). The tori begin the test between the 2 ukes that                                       This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 11. 10     are 6 metres apart. On an acoustic signal, the tori has to run quickly to one of the ukes and apply a                                             throwing technique called ippon-­seoi-­nage. The tori then immediately has to run to the other uke and                                 complete another throw. The athlete must complete as many throws as possible within the test time, which                                   is composed of three periods (15, 30, and 30 s) separated by 10-­s of recovery. At the end and 1 minute                                           thereafter the test, the athlete’s HR was measured (Polar S810, © Polar Electro 2011, Kempele, Finland).                                 As regards the SJFT, the total number of throws accomplished in the three periods has been computed,                                   and the SJFT Index is therefore calculated according to the formula (equation 2) proposed by                               Sterkowicz27 :     Eq  2:       Where Final HR (bpm) is the HR measured at the end of SJFT, HR1 (bpm) is the HR measured                                       after the end of the test and Total Throws are the total number of throws performed by the tori during                                         SJFT. A decrease of the SJFT Index, due to a decrease of HR or an increase in the throws number,                                         indicates  an  improvement  of  performance.     Standard  Judo  Training  Program   During the six weeks of standard judo training all subjects performed nine training sessions a week                                 (18 h/wk). The program consisted of 4 hours per week of resistance training conducted on Tuesday and                                   Thursday at 10:00-­12:00 am. Judo training was performed at 6:00-­8:00 pm from Monday to Friday, and                                 Saturday from 10:00-­12:00, totalling 12 hours per week and including specific judo exercises (e.g.,                             uchi-­komi – technique entrance, nage-­komi – throwing technique practice) and match simulations                         (randori).  Moreover,  Saturday  at  3:00-­5:00  pm  a  fighting  session  was  completed.     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 12. 11     Aerobic  Training  Program   To maintain the same training volume of the standard judo training during the six weeks of the                                   aerobic training protocol subjects performed nine training sessions a week (18 h/wk) as described above.                               Additionally, on Monday, Wednesday and Friday the AT was done on the last 30 min of the judo training.                                       Among the three AT sessions, the sessions conducted on Mondays and Wednesdays consisted of 30                               minutes of continuous run on a treadmill at 60% of Vmax assessed during O2max test. In the third AT                                       session subjects performed fifteen 1-­min high-­intensity repetitions at 90% of Vmax with 1 minute of active                                 recovery at 60% of Vmax between each interval. The high-­intensity 1x1-­min interval training started with                               10-­min  warm-­up  and  ended  with  a  3  min  cool-­down  period  with  a  self-­selected  intensity.     All subjects completed all training sessions without complications. The high-­intensity 1x1-­min                       interval training protocol was generally well tolerated and subjects did not report dizziness,                           light-­headedness  or  nausea,  symptoms  that  occasionally  occur  during  this  type  of  training.     Statistical  analysis   All parameters measured during the maximal aerobic power test ( max;; Vmax;; VT;; τ ( ) off                               kinetics;; τ (HR) off kinetics), and during the SJFT (HR, throws number, and SJFT index) were expressed                                   as  mean  values  ±  standard  deviation  (mean  ±  SD)  and  divided  for  gender.     Statistical analysis was performed using Graph Pad Prism Software, version 5.00 for Windows                           (Graph Pad Software, San Diego California USA). Differences between males and females were assessed                             by the unpaired Student’s t-­test. Since no significant differences have been detected for the selected                               parameters between males and females athletes, data were pooled. The Shapiro-­Wilk normality test was                             used to verify the normality condition. Paired T-­test was used to assess the average changes in                                 performance of the investigated variables. The level of statistical significance was set at p<0.05.                             Standardized changes in the mean values were used to assess magnitude of effects (Effect Size, ES).                                 This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 13. 12     Values <0.2, <0.6, <1.2 and >2.0 were interpreted as trivial, small, moderate, large and very large,                                 respectively.27     Results   Anthropometric  assessment   No  significant  changes  were  found  in  the  participant’s  physical  characteristics  at  T12  compared  to  T0.  In   particular,  mean  ±  SD  for  T0  and  T12  were:  body  mass,  69.4  ±  7.7  and  71.5  ±  8.2  kg;;  BMI,  22.4  ±  1.4   and  23.3  ±  1.2  kg·∙m-­2 ;;  fat  mass,  11.7  ±  7.4  and  12.6  ±  8.9%.     Maximal  aerobic  power  assessment   Results of max, Vmax and VT are shown in figure 1. No significant changes were detected for                                   both relative and absolute max values. However, Vmax at T12 was significantly higher (4.6%;; p<0.05;;                               ES=0.4)  than  before  the  training  program.  Finally,  VT  significantly  increased  by  6.6%  (p<0.05;;  ES=0.9).     The lactate peak at the end of max at T0 was 7.5 ± 2.0 mmol ·∙ l-­1 . No significant changes                                         were  detected  at  T12  (7.1  ±  0.9  mmol  ·∙  l-­1 ).       ***  Figure  1  here  ***   Off  kinetics     After  the  12  weeks  training  protocol  the  τ  of    and  HR  significantly  decreased  by  22.0  %   (p<0.001  ES:  1.2),  and  17.3%  (p<0.05;;  ES:  1.0),  respectively  (Figure  2).       ***  Figure  2  here  ***   Special  Judo  Fitness  Test     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 14. 13     All the results of SJFT at T12 compared to T0 are shown in table 1. After the 12 weeks training                                         protocol the SJFT Index improved significantly by 12% (p<0.01, ES: 1.2). After training the HR peak                                 measured at the end of the SJFT was reduced by a 7% with respect to the pre-­training value (p=0.004,                                       ES: 0.7), whereas HR post 1 min was decreased by 8% after the 12 weeks of training (p=0.004, ES: 0.9).                                         No significant changes were found as regards the total number of throws in the post training assessment                                   (T12).       ***  Table  1  here  ***     Discussion   The purpose of this study was to test the effects of 12 weeks of training on both the aerobic and                                         anaerobic profiles in a group of elite judo athletes. Namely, this period of training was divided in 6 weeks                                       of standard judo training and 6 weeks of standard judo training plus aerobic training protocol. The main                                   results obtained in this study can be summarized as follows: 1) the Vmax and the VT measured during                                     O2max test increased significantly;; 2) the recovery time of both O2 and HR decreased;; 3) an                                 improvement of HR at the end of SJFT and a reduction of the HR one minute after the end of the SJFT                                             was  found.     The main novelty of the present work consisted of the insertion of an AT protocol alternating two                                   sessions of 30 minutes of continuous run on a treadmill at 60% of Vmax and one session of fifteen 1-­min                                         high-­intensity  repetitions  at  90%  Vmax  with  1  minute  of  active  recovery  at  60%  Vmax  between  each  interval.   In particular our aim was not only to insert a traditional AT that is known to effectively improve                                     cardiac and skeletal muscle function26 , but a more specific training session capable of enhancing general                               and  specific  characteristics  in  judo  athletes  in  accordance  with  their  typical  metabolic  profile.   This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 15. 14     For this reason we chose to put in the weekly training which is currently acknowledged as one of                                     the most effective forms of exercise to improving physical performance in athletes.8-­11 High-­intensity training                             can be broadly defined as repeated bouts of short to moderate duration exercise (i.e. from 10 seconds to 5                                       minutes) completed at an intensity that is greater than VT.8, 9 Exercise bouts are separated by brief periods                                     of low-­intensity work or inactivity that allow a partial but often not a full recovery. In particular there are                                       different types of high-­intensity training format based on the expected acute physiological response/strain.11                           Our interval training session consisted of 1 minute of effort and one minute of active rest. This was done to                                         obtain a direct impact on the physiological response essentially eliciting large requirements from the O2                               transport and utilisation systems (i.e. cardiopulmonary system and oxidative muscle fibres), a certain degree                             of  neuromuscular  strain  and  an  anaerobic  glycolytic  energy  contribution.10   The max values observed in our group were similar to those reported in previous studies30-­37 in                                 which max ranged from 50 to 60 ml⋅kg-­1 ⋅min-­1 and from 40 to 50 ml·∙kg-­1 ·∙min-­1 for male and female                                     judo athletes, respectively. As expected, at T12 no differences were found in max, as a more frequent                                   stimulus seems to be needed to result in an increase in the O2max (i.e., three to five times of specific                                         training per week).10 Despite this, a significant increase in Vmax was found. Frequently, highly trained                               athletes improve their maximum aerobic speed without concomitant changes in max, normally due to                             an improvement in running economy after high-­intensity training protocols.38 The VT values are similar to                               those found by Degoutte33 , Little34 , and Sbriccoli et al.37 (i.e., above 80% of O2max). In particular, our                                   results indicate that our training led the athletes to VT values close to those of the Italian Olympic Team of                                         2004.37 This provide more evidence that aerobic metabolism is not highly developed in high-­level judo                               athletes. The 12 weeks of training improved the aerobic fitness of the judo athletes and, as it has been                                       hypothesized that a higher values of these variables allow the maintenance of a higher intensity during the                                   match39,  40 ,  and  an  increase  in  the  intensity  that  can  be  sustained  during  a  judo  competition.     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 16. 15     At the end of the 12 weeks of training the kinetics of the HR and of the during recovery                                         significantly accelerated compared to T0. Looking at the Olympic and World Championship competition                           model a high capacity of recovery between two consecutive matches (about 15 min) is fundamental to                                 delay the accumulation of metabolites (e.g. H+ , Pi and lactate) that are associated with fatigue process40, 41 .                                   Our results demonstrates that the beneficial effects of an AT protocol leads to a shortening of the recovery                                     period  after  a  high-­intensity  effort,  and  this  seems  to  be  a  new  finding  when  compared  to  other  studies.   In our study, the SJFT was utilised to evaluate the specific fitness of the judo athletes. At the end of                                         the 12 weeks of training a significant reduction of the SJFT index was found. This result was given via a                                         significant reduction of the HR peak at the end of the test and 1-­minute after the conclusion of SJFT. No                                         changes were detected on the number of throws. Looking at the classificatory table of SJFT proposed by                                   Franchini et al.41 , this whole group passed from a regular to a good classification, suggesting that the                                   aerobic  training  proposed  improved  judo  athletes’  specific  performance.     A possible limitation of this study is the lack of a control group, but according to Atkinson &                                     Nevill42 the use of control group in periodization studies is difficult, because athletes are normally submitted                                 to some type of periodization process. Additionally, there would be ethical problems with restricting a                               particular  treatment  to  elite  athletes.     Although judo is a discipline that requires complex skills and tactical excellence, the conditional                             capacities as maximal isometric and dynamic strength to excel in high-­level competitions are also                             fundamental. Moreover, the contribution of the aerobic metabolism may be of importance in these athletes                               as well. The results of this study consisting of a significant reduction of the recovery kinetics of HR and                                       , an increase of the VT, and a reduction of the HR immediately at the end, and 1 minute after the                                           SJFT, coaches should consider inserting specific training sessions especially focused on aerobic fitness                           improvement. This may speed up metabolic and cardiovascular recovery, enhancing the athletes’                         performances. Finally, a good aerobic conditioning could enhance the ability to better recover after a judo                                 This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 17. 16     combat, which may play a significant role in managing a different number of combats within the same                                   competition,  thereby  improving  the  performance  ability  in  these  athletes.         This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
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  • 21. 20     33. Degoutte F, Jouanel P, Filaire E. Energy demands during a judo match and recovery. Br J Sports                                   Med  2003;;37(3):245-­9.   34. Little NG. Physical performance attributes of junior and senior women, juvenile, junior and senior                             men  judokas.  J  Sport  Med  Phys  Fitness  1991;;31:510-­20.   35. Sugiyama M. Energy expenditure of throwing techniques in judo. Proceedings of International Judo                           Federation  Conference;;  1999;;  Birmingham,  United  Kingdom.   36. Franchini E, Takito MY, Kiss MAPDM, Sterkowicz. Physical fitness and anthropometrical                       differences  between  elite  and  non-­elite  judo  players.  Biol  Sport  2005;;22:315-­28.   37. Sbriccoli P, Bazzucchi I, Di Mario A, Marzattinocci G, Felici F. Assessment of maximal                             cardiorespiratory performance and muscle power in the Italian Olympic judoka. J Strength Cond                           Res  (2007);;21(3):738-­44.   38. Foster C, Lucia A. Running Economy. The Forgotten Factor in Elite Performance. Sports Med                             2007;;  37  (4-­5):  316-­9.   39. Gariod L, Favre-­Juvin A, Novel V, Reutenauer H, Majean H, Rossi A. Evaluation du profit                               energetique  des  judokas  par  spectroscopie  RMN  duP31.  Sci  Sports  1995;;10:201–7.   40. Castarlenas JL, Solé J. El etrenamiento de la resistencia en los deportes de lucha com agarre: una                                   propuesta  integradora.  Apunts:  Educ  Fìs  Deportes  1997;;1(47):81-­6.   41. Franchini E, Vecchio FB, Sterkowicz S. A special judo fitness test classificatory table. Arch Budo                               2009;;5:127–9.   42. Atkinson G, Nevill A. Selected issues in the design and analysis of sport performance research. J                                 Sports  Sci  2001;;19:811-­27.       This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 22. 21     TABLE     Table  1.  Number  of  throws,  heart  rate  response  and  index  in  the  Special  Judo  Fitness  Test  before  and   after  12  weeks  of  judo  and  aerobic  training  (n  =  9).  Results  are  expressed  as  mean±SD.           This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 23. 22     FIGURES   Figure  1.  Differences  at  T12  compared  to  T0  for   O2max  (A,  p>0.05;;  ES:  0.1),  Vmax  (B,  *p<0.05;;  ES:   0.4)  and  VT  (C,  *p<0.05;;  ES:  0.7).  The  results  in  the  graph  are  shown  as  mean  ±  SD.     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 24. 23       Figure  2.  Differences  at  T12  compared  to  T0  for  off    (A,  *p<0.05;;  ES:  1.0)  and  off  HR  (B,   ***p<0.001;;  ES:  1.2).  The  results  in  the  graph  in  the  left  column  are  shown  as  mean  and  the  error  bars  are   SD.  Furthermore,  the  right  column  shows  the  trends  of  the  recovery  phase  of    and  HR  of  a  subject   taken  as  an  example.     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 25.   Parameter   T0   T12   p   Throws  A   6  ±  1     6  ±  0   n.s   Throws  B   11  ±  1   10  ±  0   n.s   Throws  C   10  ±  1   10  ±  1     n.s   Total  throws   26  ±  1   26  ±  2   n.s   HR  after  (bpm)   184  ±  7   177  ±  15   <0.05   HR  1  min  after  (bpm)   155  ±  15   145  ±  15   <0.01   Index  SJFT   13.75  ±  0.77   12.24  ±  1.18   <0.001     This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 26. This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4
  • 27. This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. ! COPYRIGHT© 2013 EDIZIONI MINERVA MEDICA ! 4