Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Internal Medicine Neurology Oncology Pediatrics Respiratory Medicine Surgery
Congress Coverage
2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting

Keynote Webinar | Spotlight on Diet and Diabetes

Watch on-demand

An expert-led symposium exploring the prevention and management of type 2 diabetes through dietary interventions. 
ADVANCED SEARCH
Log in
Top
Sports Medicine

22-09-2023 | Systematic Review

The Additional Effect of Training Above the Maximal Metabolic Steady State on VO2peak, Wpeak and Time-Trial Performance in Endurance-Trained Athletes: A Systematic Review, Meta-analysis, and Reality Check

Authors: Michael A. Rosenblat, Jem Arnold, Hannah Nelson, Jennifer Watt, Stephen Seiler

Published in: Sports Medicine

Login to get access

Abstract

Background

To improve sport performance, athletes use training regimens that include exercise below and above the maximal metabolic steady state (MMSS).

Objective

The objective of this review was to determine the additional effect of training above MMSS on VO2peak, Wpeak and time-trial (TT) performance in endurance-trained athletes.

Methods

Studies were included in the review if they (i) were published in academic journals, (ii) were in English, (iii) were prospective, (iv) included trained participants, (v) had an intervention group that contained training above and below MMSS, (vi) had a comparator group that only performed training below MMSS, and (vii) reported results for VO2peak, Wpeak, or TT performance. Medline and SPORTDiscus were searched from inception until February 23, 2023.

Results

Fourteen studies that ranged from 2 to 12 weeks were included in the review. There were 171 recreational and 128 competitive endurance athletes. The mean age and VO2peak of participants ranged from 15 to 43 years and 38 to 68 mL·kg−1·min−1, respectively. The inclusion of training above MMSS led to a 2.5 mL·kg−1·min−1 (95% CI 1.4–3.6; p < 0.01; I2 = 0%) greater improvement in VO2peak. A minimum of 81 participants per group would be required to obtain sufficient power to determine a significant effect (SMD 0.44) for VO2peak. No intensity-specific effect was observed for Wpeak or TT performance, in part due to a smaller sample size.

Conclusion

A single training meso-cycle that includes training above MMSS can improve VO2peak in endurance-trained athletes more than training only below MMSS. However, we do not have sufficient evidence to conclude that concurrent adaptation occurs for Wpeak or TT performance.
Appendix
Available only for authorised users
Literature
1.
Esteve-Lanao J, Juan AF, Earnest CP, Foster C, Lucía A. How do endurance runners actually train? Relationship with competition performance. Med Sci Sports Exerc. 2005;37(3):496–504. PubMedCrossRef
2.
Neal CM, Hunter AM, Galloway SD. A 6-month analysis of training-intensity distribution and physiological adaptation in Ironman triathletes. J Sports Sci. 2011;29(14):1515–23. PubMedCrossRef
3.
Tjelta LI, Enoksen E. Training characteristics of male junior cross country and track runners on European top level. Int J Sports Sci Coach. 2010;5(2):193–203. CrossRef
4.
Jones AM, Burnley M, Black MI, Poole DC, Vanhatalo A. The maximal metabolic steady state: redefining the “gold standard.” Physiol Rep. 2019;7(10): e14098. PubMedPubMedCentralCrossRef
5.
6.
Rosenblat MA, Lin E, da Costa BR, Thomas SG. Programming interval training to optimize time-trial performance: a systematic review and meta-analysis. Sports Med. 2021;51(8):1687–714. PubMedCrossRef
7.
Hausswirth C, Louis J, Aubry A, Bonnet G, Duffield RO, Le Meur Y. Evidence of disturbed sleep and increased Illness in overreached endurance athletes. Med Sci Sports Exerc. 2014;46(5):1036–45. PubMedCrossRef
8.
Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186–205. PubMedCrossRef
9.
Roete AJ, Elferink-Gemser MT, Otter RTA, Stoter IK, Lamberts RP. A systematic review on markers of functional overreaching in endurance athletes. Int J Sports Physiol Perform. 2021;16(8):1065–73. PubMedCrossRef
10.
Rosenblat MA, Perrotta AS, Vicenzino B. Polarized vs. threshold training intensity distribution on endurance sport performance: a systematic review and meta-analysis of randomized controlled trials. J Strength Cond Res. 2019;33(12):3491–500. PubMedCrossRef
11.
Joyner MJ, Coyle EF. Endurance exercise performance: the physiology of champions. J Physiol. 2008;586(1):35–44. PubMedCrossRef
12.
Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000;32(1):70–84. PubMedCrossRef
13.
Taylor HL, Buskirk E, Henschel A. Maximal oxygen intake as an objective measure of cardio-respiratory performance. J Appl Physiol. 1955;8(1):73–80. PubMedCrossRef
14.
Howley ET, Bassett DR, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc. 1995;27(9):1292–301. PubMedCrossRef
15.
Billat LV, Koralsztein JP. Significance of the velocity at VO2max and time to exhaustion at this velocity. Sports Med. 1996;22(2):90–108. PubMedCrossRef
16.
Rosenblat MA, Granata C, Thomas SG. Effect of interval training on the factors influencing maximal oxygen consumption: a systematic review and meta-analysis. Sports Med. 2022;52(6):1329–52. PubMedCrossRef
17.
Rosenblat MA, Perrotta AS, Thomas SG. Effect of high-intensity interval training versus sprint interval training on time-trial performance: a systematic review and meta-analysis. Sports Med. 2020;50(6):1145–61. PubMedCrossRef
18.
Granata C, Oliveira RS, Little JP, Renner K, Bishop DJ. Training intensity modulates changes in PGC-1alpha and p53 protein content and mitochondrial respiration, but not markers of mitochondrial content in human skeletal muscle. FASEB J. 2016;30(2):959–70. PubMedCrossRef
19.
MacInnis MJ, Zacharewicz E, Martin BJ, Haikalis ME, Skelly LE, Tarnopolsky MA, et al. Superior mitochondrial adaptations in human skeletal muscle after interval compared to continuous single-leg cycling matched for total work. J Physiol. 2017;595(9):2955–68. PubMedCrossRef
20.
Laursen PB, Shing CM, Peake JM, Coombes JS, Jenkins DG. Influence of high-intensity interval training on adaptations in well-trained cyclists. J Strength Cond Res. 2005;19(3):527–33. PubMed
21.
Matsuo T, Saotome K, Seino S, Shimojo N, Matsushita A, Iemitsu M, et al. Effects of a low-volume aerobic-type interval exercise on VO2max and cardiac mass. Med Sci Sports Exerc. 2014;46(1):42–50. PubMedCrossRef
22.
Warburton DE, Haykowsky MJ, Quinney HA, Blackmore D, Teo KK, Taylor DA, et al. Blood volume expansion and cardiorespiratory function: effects of training modality. Med Sci Sports Exerc. 2004;36(6):991–1000. PubMedCrossRef
23.
Wright S, Esfandiari S, Elmayergi N, Sasson Z, Goodman JM. Left atrial functional changes following short-term exercise training. Eur J Appl Physiol. 2014;114(12):2667–75. PubMedCrossRef
24.
Esfandiari S, Sasson Z, Goodman JM. Short-term high-intensity interval and continuous moderate-intensity training improve maximal aerobic power and diastolic filling during exercise. Eur J Appl Physiol. 2014;114(2):331–43. PubMedCrossRef
25.
Huang YC, Tsai HH, Fu TC, Hsu CC, Wang JS. High-intensity interval training improves left ventricular contractile function. Med Sci Sports Exerc. 2019;51(7):1420–8. PubMedCrossRef
26.
Scribbans TD, Edgett BA, Vorobej K, Mitchell AS, Joanisse SD, Matusiak JB, et al. Fibre-specific responses to endurance and low volume high intensity interval training: striking similarities in acute and chronic adaptation. PLoS One. 2014;9(6): e98119. PubMedPubMedCentralCrossRef
27.
Gist NH, Fedewa MV, Dishman RK, Cureton KJ. Sprint interval training effects on aerobic capacity: a systematic review and meta-analysis. Sports Med. 2014;44(2):269–79. PubMedCrossRef
28.
Milanović Z, Sporis G, Weston M. Effectiveness of high-intensity interval training (HIT) and continuous endurance training for VO2max improvements: a systematic review and meta-analysis of controlled trials. Sports Med. 2015;45(10):1469–81. PubMedCrossRef
29.
Wen D, Utesch T, Wu J, Robertson S, Liu J, Hu G, et al. Effects of different protocols of high intensity interval training for VO2max improvements in adults: a meta-analysis of randomised controlled trials. J Sci Med Sport. 2019;22(8):941–7. PubMedCrossRef
30.
Mattioni Maturana F, Martus P, Zipfel S, Nieß AM. Effectiveness of HIIE versus MICT in improving cardiometabolic risk factors in health and disease: a meta-analysis. Med Sci Sports Exerc. 2021;53(3):559–73. PubMedCrossRef
31.
32.
Morton RH. Why peak power is higher at the end of steeper ramps: an explanation based on the “critical power” concept. J Sports Sci. 2011;29(3):307–9. PubMedCrossRef
33.
Adami A, Sivieri A, Moia C, Perini R, Ferretti G. Effects of step duration in incremental ramp protocols on peak power and maximal oxygen consumption. Eur J Appl Physiol. 2013;113(10):2647–53. PubMedCrossRef
34.
Bergstrom HC, Housh TJ, Zuniga JM, Traylor DA, Camic CL, Lewis RW Jr, et al. The relationships among critical power determined from a 3-min all-out test, respiratory compensation point, gas exchange threshold, and ventilatory threshold. Res Q Exerc Sport. 2013;84(2):232–8. PubMedCrossRef
35.
Lucía A, Sánchez O, Carvajal A, Chicharro JL. Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography. Br J Sports Med. 1999;33(3):178–85. PubMedPubMedCentralCrossRef
36.
Greco CC, Carita RA, Dekerle J, Denadai BS. Effect of aerobic training status on both maximal lactate steady state and critical power. Appl Physiol Nutr Metab. 2012;37(4):736–43. PubMedCrossRef
37.
Galan-Rioja MA, Gonzalez-Mohino F, Poole DC, Gonzalez-Rave JM. Relative proximity of critical power and metabolic/ventilatory thresholds: systematic review and meta-analysis. Sports Med. 2020;50(10):1771–83. PubMedCrossRef
38.
Bergstrom HC, Housh TJ, Zuniga JM, Traylor DA, Lewis RW, Camic CL, et al. Responses during exhaustive exercise at critical power determined from the 3-min all-out test. J Sports Sci. 2013;31(5):537–45. PubMedCrossRef
39.
Brickley G, Doust J, Williams CA. Physiological responses during exercise to exhaustion at critical power. Eur J Appl Physiol. 2002;88(1–2):146–51. PubMed
40.
McClave SA, LeBlanc M, Hawkins SA. Sustainability of critical power determined by a 3-minute all-out test in elite cyclists. J Strength Cond Res. 2011;25(11):3093–8. PubMedCrossRef
41.
Baron B, Noakes TD, Dekerle J, Moullan F, Robin S, Matran R, et al. Why does exercise terminate at the maximal lactate steady state intensity? Br J Sports Med. 2008;42(10):828–33. PubMedCrossRef
42.
Dittrich N, de Lucas RD, Beneke R, Guglielmo LG. Time to exhaustion at continuous and intermittent maximal lactate steady state during running exercise. Int J Sports Physiol Perform. 2014;9(5):772–6. PubMedCrossRef
43.
Fontana P, Boutellier U, Knöpfli-Lenzin C. Time to exhaustion at maximal lactate steady state is similar for cycling and running in moderately trained subjects. Eur J Appl Physiol. 2009;107(2):187–92. PubMedCrossRef
44.
Mendes TT, Fonseca TR, Ramos GP, Wilke CF, Cabido CE, De Barros CL, et al. Six weeks of aerobic training improves VO2max and MLSS but does not improve the time to fatigue at the MLSS. Eur J Appl Physiol. 2013;113(4):965–73. PubMedCrossRef
45.
Pethick J, Winter SL, Burnley M. Physiological evidence that the critical torque is a phase transition, not a threshold. Med Sci Sports Exerc. 2020;52(11):2390–401. PubMedPubMedCentralCrossRef
46.
Iannetta D, Inglis EC, Mattu AT, Fontana FY, Pogliaghi S, Keir DA, et al. A critical evaluation of current methods for exercise prescription in women and men. Med Sci Sports Exerc. 2020;52(2):466–73. PubMedCrossRef
47.
Sterne JA, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366: l4898. PubMedCrossRef
48.
49.
Hedges L, Olkin I. Statistical methods for meta-analysis. New York: Academic Press; 1981.
50.
Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36(3):1–48. CrossRef
51.
Gaddis GM, Gaddis ML. Introduction to biostatistics: Part 2, Descriptive statistics. Ann Emerg Med. 1990;19(3):309–15. PubMedCrossRef
52.
R Core Team. R: a language and environment for statistical computing. 4.2.2 ed. Vienna: R Foundation for Statistical Computing; 2022.
53.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88. PubMedCrossRef
54.
Quintana DS. A guide for calculating study-level statistical power for meta-analyses. OSF Preprints. osf.io/js79t; 2022.
55.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum; 1988.
56.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58. PubMedCrossRef
57.
Viechtbauer W, Cheung MW. Outlier and influence diagnostics for meta-analysis. Res Synth Methods. 2010;1(2):112–25. PubMedCrossRef
58.
59.
Vevea JL, Hedges LV. A general linear model for estimating effect size in the presence of publication bias. Psychometrika. 1995;60(3):419–35. CrossRef
60.
Driller MW, Fell JW, Gregory JR, Shing CM, Williams AD. The effects of high-intensity interval training in well-trained rowers. Int J Sports Physiol Perform. 2009;4(1):110–21. PubMedCrossRef
61.
Hebisz P, Hebisz R, Zaton M, Ochmann B, Mielnik N. Concomitant application of sprint and high-intensity interval training on maximal oxygen uptake and work output in well-trained cyclists. Eur J Appl Physiol. 2016;116(8):1495–502. PubMedCrossRef
62.
Hottenrott K, Ludyga S, Schulze S. Effects of high intensity training and continuous endurance training on aerobic capacity and body composition in recreationally active runners. J Sports Sci Med. 2012;11(3):483–8. PubMedPubMedCentral
63.
Ingham SA, Carter H, Whyte GP, Doust JH. Physiological and performance effects of low- versus mixed-intensity rowing training. Med Sci Sports Exerc. 2008;40(3):579–84. PubMedCrossRef
64.
Kirchenberger T, Ketelhut S, Ketelhut RG. Effects of moderate- versus mixed-intensity training on VO2peak in young well-trained rowers. Sports. 2021;9(7):92. PubMedPubMedCentralCrossRef
65.
Michalik K, Glinka S, Danek N, Zatoń M. Interval training with active recovery and the physical capacity of recreational male runners. Pol J Sport Tour. 2018;25(4):15–20. CrossRef
66.
Stepto NK, Hawley JA, Dennis SC, Hopkins WG. Effects of different interval-training programs on cycling time-trial performance. Med Sci Sports Exerc. 1999;31(5):736–41. PubMedCrossRef
67.
Esfarjani F, Laursen PB. Manipulating high-intensity interval training: effects on VO2max, the lactate threshold and 3000 m running performance in moderately trained males. J Sci Med Sport. 2007;10(1):27–35. PubMedCrossRef
68.
Silva R, Damasceno M, Cruz R, Silva-Cavalcante MD, Lima-Silva AE, Bishop DJ, et al. Effects of a 4-week high-intensity interval training on pacing during 5-km running trial. Braz J Med Biol Res. 2017;50(12): e6335. PubMedPubMedCentralCrossRef
69.
Ferley DD, Osborn RW, Vukovich MD. The effects of uphill vs. level-grade high-intensity interval training on VO2max, Vmax, V(LT), and Tmax in well-trained distance runners. J Strength Cond Res. 2013;27(6):1549–59. PubMedCrossRef
70.
Hebisz R, Hebisz P, Borkowski J, Zatoń M. Effects of concomitant high-intensity interval training and sprint interval training on exercise capacity and response to exercise- induced muscle damage in mountain bike cyclists with different training backgrounds. Isokinet Exerc Sci. 2019;27(1):21–9. CrossRef
71.
Seiler S, Jøranson K, Olesen BV, Hetlelid KJ. Adaptations to aerobic interval training: interactive effects of exercise intensity and total work duration. Scand J Med Sci Sports. 2013;23(1):74–83. PubMedCrossRef
72.
Born D-P, Zinner C, Sperlich B. The mucosal immune function is not compromised during a period of high-intensity interval training. Is it time to reconsider an old assumption? Front Physiol. 2017;8:485. PubMedPubMedCentralCrossRef
73.
Laursen PB, Blanchard MA, Jenkins DG. Acute high-intensity interval training improves Tvent and peak power output in highly trained males. Can J Appl Physiol. 2002;27(4):336–48. PubMedCrossRef
74.
Laursen PB, Shing CM, Jenkins DG. Reproducibility of a laboratory-based 40-km cycle time-trial on a stationary wind-trainer in highly trained cyclists. Int J Sports Med. 2003;24(7):481–5. PubMedCrossRef
75.
Bradbury DG, Landers GJ, Benjanuvatra N, Goods PS. Comparison of linear and reverse linear periodized programs with equated volume and intensity for endurance running performance. J Strength Cond Res. 2020;34(5):1345–53. PubMedCrossRef
76.
77.
Jones AM. The physiology of the world record holder for the women’s marathon. Int J Sports Sci Coach. 2006;1(2):101–16. CrossRef
78.
79.
Laursen PB, Shing CM, Peake JM, Coombes JS, Jenkins DG. Interval training program optimization in highly trained endurance cyclists. Med Sci Sports Exerc. 2002;34(11):1801–7. PubMedCrossRef
80.
Heneghan C, Perera R, Nunan D, Mahtani K, Gill P. Forty years of sports performance research and little insight gained. BMJ. 2012;345: e4797. PubMedCrossRef
81.
Millet GP, Bentley DJ. Physiological differences between cycling and running: lessons from triathletes. Sports Med. 2009;39(3):179–206. PubMedCrossRef
82.
McIlroy B, Passfield L, Holmberg HC, Sperlich B. Virtual training of endurance cycling—a summary of strengths, weaknesses, opportunities and threats. Front Sports Act Living. 2021;3: 631101. PubMedPubMedCentralCrossRef
83.
Guellich A, Seiler S, Emrich E. Training methods and intensity distribution of young world-class rowers. Int J Sports Physiol Perform. 2009;4(4):448–60. PubMedCrossRef
84.
Solli GS, Tonnessen E, Sandbakk Ø. The training characteristics of the world’s most successful female cross-country skier. Front Physiol. 2017;8:1069. PubMedPubMedCentralCrossRef
85.
Tønnessen E, Sylta Ø, Haugen TA, Hem E, Svendsen IS, Seiler S. The road to gold: training and peaking characteristics in the year prior to a gold medal endurance performance. PLoS One. 2014;9(7): e101796. PubMedPubMedCentralCrossRef
86.
Zapico AG, Calderón FJ, Benito PJ, González CB, Parisi A, Pigozzi F, et al. Evolution of physiological and haematological parameters with training load in elite male road cyclists: a longitudinal study. J Sports Med Phys Fit. 2007;47(2):191–6.
87.
Billat VL, Demarle A, Slawinski J, Paiva M, Koralsztein JP. Physical and training characteristics of top-class marathon runners. Med Sci Sports Exerc. 2001;33(12):2089–97. PubMedCrossRef
88.
Del Giudice M, Bonafiglia JT, Islam H, Preobrazenski N, Amato A, Gurd BJ. Investigating the reproducibility of maximal oxygen uptake responses to high-intensity interval training. J Sci Med Sport. 2020;23(1):94–9. PubMedCrossRef
Metadata
Title
The Additional Effect of Training Above the Maximal Metabolic Steady State on VO2peak, Wpeak and Time-Trial Performance in Endurance-Trained Athletes: A Systematic Review, Meta-analysis, and Reality Check
Authors
Michael A. Rosenblat
Jem Arnold
Hannah Nelson
Jennifer Watt
Stephen Seiler
Publication date
22-09-2023
Publisher
Springer International Publishing
Published in
Sports Medicine
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-023-01924-y