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THE EFFECT OF HIGH-INTENSITY INTERVAL TRAINING ON POST-EXERCISE OXYGEN CONSUMPTION: A META-ANALYSIS

EFECTO DEL ENTRENAMIENTO DE INTERVALOS DE ALTA INTENSIDAD SOBRE EL CONSUMO DE OXÍGENO DESPUÉS DELEJERCICIO: METAANÁLISIS

ABSTRACT

Introduction:

The objective of this study was to present a systematic review and meta-analysis to compare total excess post-exercise oxygen consumption (EPOC) for two training intervention models in healthy individuals, and the secondary objective was to understand whether oxygen consumption after exercise could really promote a meaningful help.

Design:

To design a meta-analysis review to compare two training intervention models (experimental: high-intensity interval training; and control: continuous moderate-intensity) and their effects on total EPOC in healthy individuals.

Participants:

Seventeen studies were considered to be of good methodological quality and with a low risk of bias.

Methods:

Literature searches were performed using the electronic databases with no restriction on year of publication. The keywords used were obtained by consulting Mesh Terms (PubMed) and DeCS (BIREME Health Science Descriptors).

Results:

The present study findings showed a tendency (random-effects model: 0.87, 95%-CI [0.35,1.38], I2=73%, p<0.01) to increase EPOC when measured following high-intensity interval training.

Conclusions:

Our study focused on the analysis of high- and moderate-intensity oxygen uptake results following exercise. Despite the growing popularity of high-intensity interval training, we found that the acute and chronic benefits remain limited. We understand that the lack of a standard protocol and standard training variables provides limited consensus to determine the magnitude of the EPOC. We suggest that longitudinal experimental studies may provide more robust conclusions. Another confounding factor in the studies investigated was the magnitude (time in minutes) of VO2 measurements when assessing EPOC. Measurement times ranged from 60 min to 720 min. Longitudinal studies and controlled experimental designs would facilitate more precise measurements and correct subject numbers would provide accurate effect sizes. Systematic reviewb of Level II studies.

Keywords:
Oxygen consumption; Exercise; HYPERLINK "about:blank" Physical conditioning, human; High-intensity interval training

RESUMEN

Introducción:

El objetivo de este estudio fue presentar una revisión sistemática y un metaanálisis para comparar los efectos de dos modelos de intervención de entrenamiento sobre el exceso de consumo de oxígeno post-ejercicio (EPOC) en individuos sanos en entrenamiento, y el objetivo secundario fue comprender si el consumo de oxígeno después del ejercicio realmente puede proporcionar una ayuda sustancial.

Objetivo:

Preparar una revisión de metaanálisis para comparar un modelo de entrenamiento de dos intervenciones (experimental: entrenamiento en intervalos de alta intensidad; y control: continuo de intensidad moderada) y los efectos sobre el EPOC total en individuos sanos.

Participantes:

Los 17 estudios se consideraron de buena calidad metodológica y de bajo riesgo de sesgo.

Métodos:

Se realizaron búsquedas bibliográficas en bases de datos electrónicas sin restricción de año de publicación. Los descriptores utilizados se obtuvieron de la consulta a Mesh (PubMed) y DeCS (Descriptores en Ciencias de la Salud de BIREME).

Resultados:

Los hallazgos del presente estudio mostraron una tendencia (modelo de efectos aleatorios: 0,87, IC 95% [0,35; 1,38], I2 = 73%, p < 0,01) de aumento del EPOC cuando las medidas se realizaron después de un entrenamiento en intervalos de alta intensidad.

Conclusiones:

Nuestro estudio se centró en el análisis de resultados del consumo de oxígeno post-ejercicio de alta y moderada intensidad.. A pesar de la creciente popularidad del entrenamiento en intervalos de alta intensidad, hemos comprobado que los beneficios agudos y crónicos siguen siendo limitados. Entendemos que la falta de un protocolo y variables de entrenamiento estandarizadas proporcionan un consenso limitado para determinar la magnitud del EPOC. Sugerimos que los estudios experimentales longitudinales pueden proporcionar conclusiones más sólidas. Otro factor de confusión en los estudios investigados fue la magnitud (tiempo en minutos) de las mediciones del VO2 al evaluar el EPOC. Los tiempos de medición oscilaron entre 60 y 720 minutos. Los estudios longitudinales y los diseños experimentales controlados facilitarían mediciones más precisas y el número correcto de sujetos proporcionaría tamaños de efecto precisos. Nivel de evidencia II; Revisión sistemáticab de Estudios.

Descriptores:
Consumo de oxigeno; Ejercicio; Acondicionamiento físico humano; Entrenamiento de intervalos de alta intensidad

RESUMO

Introdução:

O objetivo deste estudo foi apresentar uma revisão sistemática e metanálise para comparar os efeitos de dois modelos de intervenção de treinamento sobre o consumo excessivo de oxigênio pós-exercício (EPOC) em indivíduos saudáveis em treinamento, e o objetivo secundário foi entender se o consumo de oxigênio depois de exercício realmente pode proporcionar ajuda substancial.

Objetivo:

Elaborar uma revisão de metanálise para comparar um modelo de treinamento de duas intervenções (experimental: treinamento intervalado de alta intensidade, e controle: contínuo de intensidade moderada) e o efeito sobre o EPOC total em indivíduos saudáveis.

Participantes:

Os 17 estudos foram considerados de boa qualidade metodológica e baixo risco de viés.

Métodos:

As buscas bibliográficas foram realizadas nos bancos de dados eletrônicos sem restrição de ano de publicação. Os descritores usados foram obtidos em MeSH (PubMed) e DeCS (Descritores em Ciências da Saúde da BIREME).

Resultados:

Os achados do presente estudo mostraram uma tendência (modelo de efeitos aleatórios: 0,87, IC 95% [0,35;1,38], I ² = 73%, p < 0,01) de aumento do EPOC quando as medidas foram realizadas depois de treinamento intervalado de alta intensidade.

Conclusões:

Nosso estudo concentrou-se na análise dos resultados de alta e moderada intensidade no consumo de oxigênio depois do exercício. Apesar da crescente popularidade do treinamento intervalado de alta intensidade, descobrimos que os benefícios agudos e crônicos permanecem limitados. Entendemos que a falta de um protocolo e variáveis padronizadas de treinamento fornecem consenso limitado para determinar a magnitude do EPOC. Sugerimos que estudos experimentais longitudinais podem fornecer conclusões mais robustas. Outro fator de confusão nos estudos investigados foi a magnitude (tempo em minutos) das medidas do VO2na avaliação do EPOC. Os tempos de medição variaram de 60 a 720 min. Estudos longitudinais e projetos experimentais controlados facilitariam medições mais precisas e números corretos de indivíduos forneceriam tamanhos de efeito precisos. Nível de evidência II; Revisão sistemáticabde Estudos.

Descritores:
Consumo de oxigênio; Exercício; Condicionamento físico humano; Treinamento intervalado de alta intensidade

INTRODUCTION

Due to the increase of obesity in recent years, there has been an increase in the search for strategies to help reduce fat mass. One non-pharmacological strategy is exercise. Several training designs, models of exercise, and different intensities and durations have been used to increase energy expenditure during and after exercise. Energy expenditure post exercise is normally quantified by measuring excess post exercise oxygen consumption (EPOC).11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41.

2 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8.

3 Borsheim E, Bahr R. Effect of exercise intensity, duration and mode on post-exercise oxygen consumption. Sports Med. 2003;33(14):1037-60.

4 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92.
- 55 Matsuo T, Ohkawara K, Seino S, Shimojo N, Yamada S, Ohshima H, et al. Cardiorespiratory fitness level correlates inversely with excess post-exercise oxygen consumption after aerobic-type interval training. BMC Res Notes. 2012;5:646. However, finding the exercise mode that increases energy expenditure after exercise is difficult. In addition, an intensity that can be used to control, maintain and decrease body weight and control diseases associated with obesity is also desirable. Energy expenditure during and post-exercise is measured by oxygen uptake (VO2) using a gas analyzer.66 Scott CB. Quantifying the immediate recovery energy expenditure of resistance training. J Strength Cond Res. 2011;25(4):1159-63. , 77 Reis VM, Garrido ND, Vianna J, Sousa AC, Alves JV, Marques MC. Energy cost of isolated resistance exercises across low- to high-intensities. PLoS One. 2017;12(7):e0181311. During exercise, there is an increase in VO2 to support increased energy needs. Post exercise, VO2 does not return to resting levels immediately and may remain elevated for some time. Exercise intensity is an important factor in the determination of excess post-exercise oxygen consumption (EPOC).33 Borsheim E, Bahr R. Effect of exercise intensity, duration and mode on post-exercise oxygen consumption. Sports Med. 2003;33(14):1037-60.

There are several models of training (resistance training, high-intensity training, and continuous training) that can increase EPOC between 1 to 48 hours above resting levels.11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41. , 33 Borsheim E, Bahr R. Effect of exercise intensity, duration and mode on post-exercise oxygen consumption. Sports Med. 2003;33(14):1037-60. , 88 Burke CM, Bullough RC, Melby CL. Resting metabolic rate and postprandial thermogenesis by level of aerobic fitness in young women. Eur J Clin Nutr. 1993;47(8):575-85.

9 Dolezal BA, Potteiger JA, Jacobsen DJ, Benedict SH. Muscle damage and resting metabolic rate after acute resistance exercise with an eccentric overload. Med Sci Sports Exerc. 2000;32(7):1202-7.

10 Melby C, Scholl C, Edwards G, Bullough R. Effect of acute resistance exercise on postexercise energy expenditure and resting metabolic rate. J Appl Physiol (1985). 1993;75(4):1847-53.

11 Melby C, Tincknell T, Schmidt WD. Energy expenditure following a bout of non-steady state resistance exercise. J Sports Med Phys Fitness. 1992;32(2):128-35.

12 Schuenke MD, Mikat RP, McBride JM. Effect of an acute period of resistance exercise on excess post-exercise oxygen consumption: implications for body mass management. Eur J Appl Physiol. 2002;86(5):411-7.
- 1313 Williamson DL, Kirwan JP. A single bout of concentric resistance exercise increases basal metabolic rate 48 hours after exercise in healthy 59-77-year-old men. J Gerontol A Biol Sci Med Sci. 1997;52(6):M352-5. . In this context, it has been suggested that there is a curvilinear relationship between EPOC magnitude (total O2 consumed during recovery) and exercise intensity.

High-intensity interval training (HIIT) has been recommended because of the relatively rapid, increased amount of energy expenditure during and after exercise when compared to continuous aerobic training. However, aerobic training has been reported as an effective method to control or lose weight.1414 Whyte LJ, Ferguson C, Wilson J, Scott RA, Gill JM. Effects of single bout of very high-intensity exercise on metabolic health biomarkers in overweight/obese sedentary men. Metabolism. 2013;62(2):212-9. On the other hand, resistance training (RT) has been described as intermittent in nature and might induce a prolonged EPOC during recovery.22 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8. Tucker et al.1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. have suggested that it is unlikely that the greater fat loss observed after interval exercise training reported in some studies is due to greater EPOC after interval exercise. In this context, Binzen et al.22 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8. investigated the acute effects of 45 min of RT on EPOC and substrate oxidation 120 min following exercise in moderately trained women. The overall 2h EPOC was 6.2 L (RT: 33.4 ± 5.1 L vs . control: 27.2 ± 0.3 L), corresponding to an 18.6% elevation over the measurement period.

The literature seems inconclusive about the magnitude effect of EPOC and the relationship with the intensity of exercise during training. Nowadays, professionals have been recommending high-intensity interval training models related to the relative and absolute increases in energy expenditure following exercise. However, high-intensity interval training models may not be effective for all individuals, especially sedentary, elderly and overweight/obese individuals.1616 Carroll JF, Pollock ML, Graves JE, Leggett SH, Spitler DL, Lowenthal DT. Incidence of injury during moderate- and high-intensity walking training in the elderly. J Gerontol. 1992;47(3):M61-6.

17 Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. 2013.
- 1818 Roos L, Taube W, Zuest P, Clenin G, Wyss T. Musculoskeletal Injuries and Training Patterns in Junior Elite Orienteering Athletes. Biomed Res Int. 2015;15:259531.

Objectives

Therefore, the aim of this study was to present a systematic review and meta-analysis to compare two training intervention models (experimental: high-intensity interval training; and control: continuous moderate-intensity) in total oxygen consumption during recovery (EPOC) in healthy individuals in training, and the secondary objective was to understand whether oxygen consumption after exercise really could promoter meaningfully help.

METHODS

The meta-analysis review was carried out in accordance with the recommendations of Khan et al.1919 Khan KS, Kunz R, Kleijnen J, Antes G. Five steps to conducting a systematic review. J R Soc Med. 2003;96(3):118-21. considering: 1) framing of the questions for a literature review; 2) identification of the relevant research; 3) evaluation of the quality of the studies; 4) summary of the evidence; 5) and interpretation of the results. In addition, we adhered to the 27 items by checklists of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). To ensure transparency and complete communication this systematic review and meta-analysis complied with suggestions outlined previously.2020 Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. The research questions were defined by the PICOS model in accordance with PRISMA guidelines, as follows:

  1. Population: males and females with experience in training.

  2. Intervention: an acute session which incorporated a high-intensity training design.

  3. Comparator: oxygen uptake compared to other interventions (moderate-intensity training).

  4. Outcomes: amount of oxygen uptake after exercise.

  5. Study design: randomized controlled designs, counterbalanced crossover or repeated measure designs that investigated the acute oxygen uptake responses from high-intensity training.

The review was approved and registered at National Institute for Health Research - International prospective register of systematic reviews (PROSPERO) CRD42020170195 last 04/28/2020.

Criteria for considering studies for this review

Type of Studies

We included randomized clinical trials (with parallel-group design, within-person design, cluster design, or the first phase of cross-over trials) evaluating the mindfulness strategies and programs on the resistance training systems, compared to each resistance training system. We excluded non-randomized clinical trials, such as cohorts, case-control, and case reports studies. We did not impose language, publication date, or status restrictions for potentially retrieved records.

Types of participants

We included studies of adult both genre (aged 18 years or over) adults with or without experience in resistance training, without diagnostic diseases.

Type of interventions

We included studies that assessed the effects of training using high-intensity compared to low- or moderate-intensity exercise.

Type of outcome measures

Primary outcomes

  1. Oxygen consumption (liter) and calorie (kcal)

  2. Adverse effects (e. g., worsening of the parameters mentioned above after treatment)

Secondary outcomes

  1. Metabolic changes

  2. Change in level of cardiorespiratory fitness

  3. Effect of exercise on heart rate

Search methods for identification of studies

Literature search

For this review, literature searches were performed using the (Virtual Library for Health - BVS, PubMed, Embase, Ebsco SPORTDiscus and Science Direct) electronic databases without any year restriction. Manual reference searching was performed to identify other relevant studies. The keywords used were obtained through consultation of Mesh Terms (PubMed) and DeCS (keywords of subjects in BIREME health science). The combination of excess post-exercise oxygen consumption (epoc; oxygen consumption; oxygen; metabolic equivalent) and high intensity interval training (High-Intensity; Sprint Interval Training; High-Intensity Intermittent; exercise) with “AND” and “OR” combination: epoc and exercise (pubmed) ((epoc[All Fields] AND (“exercise”[MeSH Terms] OR “exercise”[All Fields])) AND Search((epoc[Title/Abstract]) AND ((“Oxygen Consumption”[Mesh] OR “Consumption, Oxygen” OR “Consumptions, Oxygen” OR “Oxygen Consumption” OR “Metabolic Equivalent”))) AND ((“High-Intensity Interval Training”[Mesh]High Intensity Interval Training OR “High-Intensity Interval Trainings” OR “ Interval Training, High-Intensity” OR “Interval Trainings, High-Intensity” OR “Training, High-Intensity Interval” OR “Trainings, High-Intensity Interval” OR “High-Intensity Intermittent Exercise” OR “Exercise, High-Intensity Intermittent” OR “Exercises, High-Intensity Intermittent” OR “High-Intensity Intermittent Exercises” OR “Sprint Interval Training” OR “Sprint Interval Trainings”)). After the removal of duplicates, the title and abstract of each article were initially screened for suitability. Full-text articles were retrieved in order to determine inclusion or exclusion. Two authors (BCL and EFR) performed the search independently. In the case of any selection bias, a third assessor (GAJ) was included. The search was conducted throughout January 2018 and updated in December of 2019.

Searching other resources

Additionally, we checked the reference list and citations of eligible studies, grey literature (Open Grey, www.opengrey.eu), and related systematic reviews. Where required, we attempted to contact the authors of the original reports for clarification or to request missing data.

Inclusion and exclusion criteria

Studies were included in this review if they met the following criteria: (a) implemented high-intensity in comparison to moderate-intensity; (b) results reported in oxygen consumption (liter) and calorie (kcal); (c) the study had an acute design or part thereof; and (d) was published in an English-language peer-reviewed journal.

Selection of studies and reviewing process

To increase reliability, two researchers ( GAJ and DR ) performed the analyses independently during all stages of the study, and in the case of a discrepancy, a third assessor (GAJ) was used as a moderator. For all included articles, the following data were extracted: (1) study characteristics (author, year, sample size and study design); (2) participant demographics (age, sex and training experience); (3) protocols of the training (high-intensity, and moderate-intensity structure [i.e. rest period, number of sets and repetitions, duration the session, exercise selection and intensity according to the previous studies]);2121 Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-59. , 2222 MacInnis MJ, Gibala MJ. Physiological adaptations to interval training and the role of exercise intensity. J Physiol. 2016;595:2915-30. and (4) outcome measures (VO2 [L], and showed calorie value [kcal]) post-intervention and reported an average change and standard deviation using a validated measure. The reference lists of articles retrieved were then screened for any additional articles that had relevance to the topic, according to previous publications2323 Schoenfeld BJ, Ogborn D, Krieger JW. Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis. J Sports Sci. 2017;35(11):1073-82. ( Figure 1 ).

Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart of the literature search strategy.2020 Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097.

Data extraction and management

Data extraction forms were used to extract data from each study. Data extracted included the size and characteristics of the sample (i.e., age, gender, body weight, height, mass fat, free-fat mass, experience of resistance training), characteristics of the interventions (study design, number of sessions, duration of each session of treatment, intensity of training, a model of training), instruments used to evaluate the outcomes (oxygen consumption), and results of the included studies. Two independent reviewers performed the data extraction. Any disagreements were resolved by a third reviewer. When data were not available in the manuscripts or in the case of uncertainty, the authors were contacted where possible for clarification.

Risk of bias and quality assessment

The risk of bias in the studies was assessed by three authors (GAJ, DR and AF) the according to The Joanna Briggs Institute (JBI) Critical Appraisal tools for use in JBI Systematic Reviews.2424 Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual. Adelaide: The Joanna Briggs Institute; 2017. The JBI critical appraisal checklist for analytical cross-sectional studies for analyzing by the risk of bias was assessed by considering the following questions: were the criteria for inclusion in the sample clearly defined? were the study subjects and the setting described in detail? was the exposure measured in a valid and reliable way? were objective, standard criteria used for the measurement of the conditions? were confounding factors identified? were strategies to deal with confounding factors stated? were the outcomes measured in a valid and reliable way? was appropriate statistical analysis used?

These systematic reviews incorporated a process of critique and appraisal of the research evidence. Therefore, the purpose of this appraisal was to assess the methodological quality of a study and to determine the extent to which a study has addressed the possibility of bias in its design. Conduct, and analysis according to previous models were employed in this meta-analysis2525 Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;(9):CD004366. , 2626 Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Veronese N, et al. Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias. Braz J Psychiatry. 2016;38(3):247-54. ( Figures 2 and 3 ).

Figure 2
Risk of bias of selected studies.
Figure 3
Summary of risk of bias of selected studies by Joanna Briggs Institute (JBI) Critical Appraisal tools for use in JBI Systematic Reviews for risk bias analysis.

Statistical Meta-analysis

Measure of treatment effect

The random-effects meta-analysis was conducted for the performance variable oxygen consumption. The performance variable outcome was presented as standardized mean differences SMD ± standard deviation (SD), and 95% confidence interval (CI) values. For each study, SMD was computed such that positive values indicate that the intervention group (i.e. high-intensity training) was superior to the control group (i.e. moderate-intensity training).2727 Schmid JE, Koch GG, LaVange LM. An overview of statistical issues and methods of meta-analysis. J Biopharm Stat. 1991;1(1):103-20.

Dealing with missing data

Missing data was dealt with as outlined in Chapter 10 of the Cochrane Handbook of Systematic Reviews; hence, where possible, we performed intention-to-treat analysis for primary and secondary outcomes (randomized studies). Irrespective of the study design, we tried to contact the trial investigators or sponsors to obtain missing outcome data. Where these data remain unavailable, we rated the relevant domains of the Cochrane tool for assessing the risk of bias accordingly.

Assessment of heterogeneity

We assessed statistical heterogeneity employing the Cochran Q test to determine the strength of evidence that any heterogeneity was genuine. We considered a threshold of P-value < 0.1 as an indicator of whether heterogeneity (genuine variation in effect sizes) is present. In addition, we examined and interpreted the I2 statistic as follows: < 25% (no heterogeneity); 25% to 49% (low heterogeneity); 50% to 74% (moderate heterogeneity); ≥ 75% (high heterogeneity).2828 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539-58.

Therefore, the effect of training type was determined by standardized SMD values post-intervention after calculating the inverse of the variance.2929 DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials. 2007;28(2):105-14. , 3030 DerSimonian R, Laird N. Meta-Analysis in Clinical Trials. Stat Med. 1986;7(3):177-88. The amount of heterogeneity was estimated (with the DerSimonian-Laird estimator) and incorporated into the standard error of the estimated average effect and the corresponding confidence interval.

Assessment of reporting biases

Funnel plots and Trim and fill were used to assess publication bias using Egger's regression tests where non-significant asymmetry indicated no bias.3131 Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-34.

Data synthesis

The meta-analyses

We used the metafor package version 1.2-1 and rmeta version 3.0 implemented in R-3.6.2 software for Mac to perform and synthesize the direct and indirect evidence of the oxygen consumption post exercise effect. Therefore, all analyses were performed using package meta in R version 1.0.4.4 – © 2009-2016 RStudio, Inc (The R Foundation for Statistical Computing, Vienna, Austria). An α level of p < 0.05 was used to determine statistical significance.

Subgroup analysis and investigation of heterogeneity

We performed subgroup analysis in case of heterogeneity considering the following variables: VO2 or kcal post-exercise: RT = studies that included only resistance exercise, and used instrument equipment, free-weights; RU = studies that included only running training and used a treadmill; and CY = studies that included only cycling training, and used a cycle-ergometer).

Sensitivity analysis

We performed a sensitivity analysis that included: Effects of risk of bias by excluding trials with high or unclear risk of bias; Influence of unpublished studies excluding trials with abstracts only; and Influence of sponsorship by excluding industry-funded studies.

RESULTS

Characteristics of included trials and participants

The 17 studies were judged to be of good methodological quality and at low risk of bias. Full details of the risk of bias are presented in (supplementary material). The presented high-intensity interval training n = 152 experimental group and moderate-intensity training n = 150 control groups (total of 302 adults from both genders were included and randomized respectively). The mean age ranged from 26.17 ± 6.55 years (body mass: 77.26 ± 11.82 kg, stature: 175.17 ± 4.18 cm, body mass index: 25.31 ± 4.48 kg.m2). ( Table 1 (part I and part II ))

Table 1
Outlines Characteristics of Included Trials and Participants and Program of Characteristics Interventions (part I).
Table 1
Outlines Characteristics of Included Trials and Participants and Program of Characteristics Interventions (part II).

Main analysis

Data pooled from 17 studies showed a large effect significant in favor of the experimental group (high-intensity interval training) (SMD: 1.24; 95%-CI [0.78; 1.71]; z: 5.25, Q: 1.08; p < 0.01 ). However, there was large heterogeneity tau22 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8.: 0.6150; H: 1.74 [1.35; 2.24]; I 2= 67% [44.9%; 80.1%].

The intervention characteristics are outlined in Table 2 . Interventions were conducted to compare high-intensity interval training and continuous moderate-intensity in all studies. Ten studies11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41. , 44 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92. , 55 Matsuo T, Ohkawara K, Seino S, Shimojo N, Yamada S, Ohshima H, et al. Cardiorespiratory fitness level correlates inversely with excess post-exercise oxygen consumption after aerobic-type interval training. BMC Res Notes. 2012;5:646. , 3232 de Aguiar RA, Cruz RS, Turnes T, Pereira KL, Caputo F. Relationships between VO2 and blood lactate responses after all-out running exercise. Appl Physiol Nutr Metab. 2015;40(3):263-8.

33 do Nascimento Salvador PC, de Aguiar RA, Teixeira AS, Souza KM, de Lucas RD, Denadai BS, et al. Are the oxygen uptake and heart rate off-kinetics influenced by the intensity of prior exercise? Respir Physiol Neurobiol. 2016;230:60-7.

34 Ferreira GA, Bertuzzi R, De-Oliveira FR, Pires FO, Lima-Silva AE. High-CHO diet increases post-exercise oxygen consumption after a supramaximal exercise bout. Braz J Med Biol Res. 2016;49(11):e5656.

35 Islam H, Townsend LK, Hazell TJ. Excess Postexercise Oxygen Consumption and Fat Utilization Following Submaximal Continuous and Supramaximal Interval Running. Res Q Exerc Sport. 2018;89(4):450-56.

36 Luszczyk M, Flis DJ, Szadejko I, Laskowski R, Ziolkowski W. Excess postexercise oxygen consumption and fat oxidation in recreationally trained men following exercise of equal energy expenditure: comparisons of spinning and constant endurance exercise. J Sports Med Phys Fitness. 2018;58(12):1781-89.

37 Townsend LK, Couture KM, Hazell TJ. Mode of exercise and sex are not important for oxygen consumption during and in recovery from sprint interval training. Appl Physiol Nutr Metab. 2014;39(12):1388-94.
- 3838 Valstad SA, von Heimburg E, Welde B, van den Tillaar R. Comparison of Long and Short High-Intensity Interval Exercise Bouts on Running Performance, Physiological and Perceptual Responses. Sports Med Int Open. 2018;2(1):E20-E27. reported by VO2 in liters; three studies22 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8. , 3939 Haddock BL, Wilkin LD. Resistance training volume and post exercise energy expenditure. Int J Sports Med. 2006;27(2):143-8. , 4040 Thornton MK, Potteiger JA. Effects of resistance exercise bouts of different intensities but equal work on EPOC. Med Sci Sports Exerc. 2002;34(4):715-22. reported outcomes only in energy expenditure in calories (kcal); and five studies1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. , 4141 Greer BK, Sirithienthad P, Moffatt RJ, Marcello RT, Panton LB. EPOC Comparison Between Isocaloric Bouts of Steady-State Aerobic, Intermittent Aerobic, and Resistance Training. Res Q Exerc Sport. 2015;86(2):190-5.

42 Haltom RW, Kraemer RR, Sloan RA, Hebert EP, Frank K, Tryniecki JL. Circuit weight training and its effects on excess postexercise oxygen consumption. Med Sci Sports Exerc. 1999;31(11):1613-8.

43 Littlefield LA, Papadakis Z, Rogers KM, Moncada-Jiménez J, Taylor K, Grandjeana PW. The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men. Appl Physiol Nutr Metab. 2017;42(9):986-93.
- 4444 Schaun GZ, Alberton CL, Ribeiro DO, Pinto SS. Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men. Eur J Appl Physiol. 2017;117(7):1437-44. reported outcomes in both (VO2 and kcal) respectively.

Table 2
Subgroup meta-analysis in all studies.

The cycle ergometer was the most common modality of exercise (eight studies),44 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92. , 55 Matsuo T, Ohkawara K, Seino S, Shimojo N, Yamada S, Ohshima H, et al. Cardiorespiratory fitness level correlates inversely with excess post-exercise oxygen consumption after aerobic-type interval training. BMC Res Notes. 2012;5:646. , 1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. , 3434 Ferreira GA, Bertuzzi R, De-Oliveira FR, Pires FO, Lima-Silva AE. High-CHO diet increases post-exercise oxygen consumption after a supramaximal exercise bout. Braz J Med Biol Res. 2016;49(11):e5656. , 3636 Luszczyk M, Flis DJ, Szadejko I, Laskowski R, Ziolkowski W. Excess postexercise oxygen consumption and fat oxidation in recreationally trained men following exercise of equal energy expenditure: comparisons of spinning and constant endurance exercise. J Sports Med Phys Fitness. 2018;58(12):1781-89. , 3737 Townsend LK, Couture KM, Hazell TJ. Mode of exercise and sex are not important for oxygen consumption during and in recovery from sprint interval training. Appl Physiol Nutr Metab. 2014;39(12):1388-94. , 4141 Greer BK, Sirithienthad P, Moffatt RJ, Marcello RT, Panton LB. EPOC Comparison Between Isocaloric Bouts of Steady-State Aerobic, Intermittent Aerobic, and Resistance Training. Res Q Exerc Sport. 2015;86(2):190-5. , 4343 Littlefield LA, Papadakis Z, Rogers KM, Moncada-Jiménez J, Taylor K, Grandjeana PW. The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men. Appl Physiol Nutr Metab. 2017;42(9):986-93. followed by the Treadmill (seven studies),44 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92. , 3232 de Aguiar RA, Cruz RS, Turnes T, Pereira KL, Caputo F. Relationships between VO2 and blood lactate responses after all-out running exercise. Appl Physiol Nutr Metab. 2015;40(3):263-8. , 3333 do Nascimento Salvador PC, de Aguiar RA, Teixeira AS, Souza KM, de Lucas RD, Denadai BS, et al. Are the oxygen uptake and heart rate off-kinetics influenced by the intensity of prior exercise? Respir Physiol Neurobiol. 2016;230:60-7. , 3535 Islam H, Townsend LK, Hazell TJ. Excess Postexercise Oxygen Consumption and Fat Utilization Following Submaximal Continuous and Supramaximal Interval Running. Res Q Exerc Sport. 2018;89(4):450-56. , 3737 Townsend LK, Couture KM, Hazell TJ. Mode of exercise and sex are not important for oxygen consumption during and in recovery from sprint interval training. Appl Physiol Nutr Metab. 2014;39(12):1388-94. , 3838 Valstad SA, von Heimburg E, Welde B, van den Tillaar R. Comparison of Long and Short High-Intensity Interval Exercise Bouts on Running Performance, Physiological and Perceptual Responses. Sports Med Int Open. 2018;2(1):E20-E27. , 4444 Schaun GZ, Alberton CL, Ribeiro DO, Pinto SS. Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men. Eur J Appl Physiol. 2017;117(7):1437-44. and resistance exercise was the least common modality of exercise (two studies).11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41. , 4242 Haltom RW, Kraemer RR, Sloan RA, Hebert EP, Frank K, Tryniecki JL. Circuit weight training and its effects on excess postexercise oxygen consumption. Med Sci Sports Exerc. 1999;31(11):1613-8.

Table 2 shows a large effect in favor of high-intensity training for VO2 post-exercise using a cycle ergometer or treadmill. There were different significances in favor of high-intensity exercise for energy expenditure (calorie) when the intervention was resistance exercise.

Thus, there is evidence that the results of the meta-analysis were influenced by a publication bias. After analysis the asymmetry in funnel ( t = 1.09; = −0.61 (13), p-value = 0.30), we used the Trim and Fill method for the adjusted effect size.

The adjusting for publication bias showed studies used of high-intensity training seems a positive influence in increasing energy expenditure and/or uptake oxygen post-exercise. The full details are summarized in Figure 4 .

Figure 4
Adjusting bias risk by Trim and Fill method. There were observed between outcomes Experimental group (high-intensity training) and Control group (continuous moderate-intensity training)

DISCUSSION

Our study focused specifically on evaluating high-intensity interval training and moderate-intensity results for oxygen uptake following exercise. We observed that the studies are not conclusive in relation to EPOC. Our study demonstrated a tendency (random-effects model: 0.87, 95%-IC [0.35; 1.38], I 2 = 73%, p < 0.01 ) to increase EPOC when the exercise performed was high-intensity interval training ( Figure 4 ).

Several studies11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41. , 55 Matsuo T, Ohkawara K, Seino S, Shimojo N, Yamada S, Ohshima H, et al. Cardiorespiratory fitness level correlates inversely with excess post-exercise oxygen consumption after aerobic-type interval training. BMC Res Notes. 2012;5:646. , 1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. , 3737 Townsend LK, Couture KM, Hazell TJ. Mode of exercise and sex are not important for oxygen consumption during and in recovery from sprint interval training. Appl Physiol Nutr Metab. 2014;39(12):1388-94. , 4040 Thornton MK, Potteiger JA. Effects of resistance exercise bouts of different intensities but equal work on EPOC. Med Sci Sports Exerc. 2002;34(4):715-22. , 4141 Greer BK, Sirithienthad P, Moffatt RJ, Marcello RT, Panton LB. EPOC Comparison Between Isocaloric Bouts of Steady-State Aerobic, Intermittent Aerobic, and Resistance Training. Res Q Exerc Sport. 2015;86(2):190-5. , 4343 Littlefield LA, Papadakis Z, Rogers KM, Moncada-Jiménez J, Taylor K, Grandjeana PW. The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men. Appl Physiol Nutr Metab. 2017;42(9):986-93. , 4545 Schleppenbach LN, Ezer AB, Gronemus SA, Widenski KR, Braun SI, Janot JM. Speed- and Circuit-Based High-Intensity Interval Training on Recovery Oxygen Consumption. Int J Exerc Sci. 2017;10:942-53. have shown that high-intensity interval training does not elevate oxygen consumption. However, other studies44 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92. , 3232 de Aguiar RA, Cruz RS, Turnes T, Pereira KL, Caputo F. Relationships between VO2 and blood lactate responses after all-out running exercise. Appl Physiol Nutr Metab. 2015;40(3):263-8. , 3434 Ferreira GA, Bertuzzi R, De-Oliveira FR, Pires FO, Lima-Silva AE. High-CHO diet increases post-exercise oxygen consumption after a supramaximal exercise bout. Braz J Med Biol Res. 2016;49(11):e5656. , 3535 Islam H, Townsend LK, Hazell TJ. Excess Postexercise Oxygen Consumption and Fat Utilization Following Submaximal Continuous and Supramaximal Interval Running. Res Q Exerc Sport. 2018;89(4):450-56. , 3838 Valstad SA, von Heimburg E, Welde B, van den Tillaar R. Comparison of Long and Short High-Intensity Interval Exercise Bouts on Running Performance, Physiological and Perceptual Responses. Sports Med Int Open. 2018;2(1):E20-E27. , 3939 Haddock BL, Wilkin LD. Resistance training volume and post exercise energy expenditure. Int J Sports Med. 2006;27(2):143-8. , 4242 Haltom RW, Kraemer RR, Sloan RA, Hebert EP, Frank K, Tryniecki JL. Circuit weight training and its effects on excess postexercise oxygen consumption. Med Sci Sports Exerc. 1999;31(11):1613-8. , 4444 Schaun GZ, Alberton CL, Ribeiro DO, Pinto SS. Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men. Eur J Appl Physiol. 2017;117(7):1437-44. have shown positive results when the intervention used comprises of high-intensity interval training. Therefore, EPOC results are conflicting when we consider previous studies.

After adjusting for publication bias, studies that used high-intensity interval training seemed to positively influence the increase in energy expenditure and/or oxygen uptake after exercise. However, there was a large heterogeneity observed ( I 2 = 73%) between the studies ( Figure 4 ).

The heterogeneity among the studies can be explained by examination of different variables including, age, sex, physical condition, oxygen collection instrument, type of protocol, VO2 intensity, effort strength time, modality mode, weekly frequency, and the magnitude (time-min) of the analysis of oxygen consumption after exercise. In particular, the EPOC magnitude effect presented ranges from 10 to 90 minutes. 44 Cunha FA, Midgley AW, McNaughton LR, Farinatti PT. Effect of continuous and intermittent bouts of isocaloric cycling and running exercise on excess postexercise oxygen consumption. J Sci Med Sport. 2016;19(2):187-92. , 55 Matsuo T, Ohkawara K, Seino S, Shimojo N, Yamada S, Ohshima H, et al. Cardiorespiratory fitness level correlates inversely with excess post-exercise oxygen consumption after aerobic-type interval training. BMC Res Notes. 2012;5:646. , 1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. , 3232 de Aguiar RA, Cruz RS, Turnes T, Pereira KL, Caputo F. Relationships between VO2 and blood lactate responses after all-out running exercise. Appl Physiol Nutr Metab. 2015;40(3):263-8. , 3434 Ferreira GA, Bertuzzi R, De-Oliveira FR, Pires FO, Lima-Silva AE. High-CHO diet increases post-exercise oxygen consumption after a supramaximal exercise bout. Braz J Med Biol Res. 2016;49(11):e5656. , 3838 Valstad SA, von Heimburg E, Welde B, van den Tillaar R. Comparison of Long and Short High-Intensity Interval Exercise Bouts on Running Performance, Physiological and Perceptual Responses. Sports Med Int Open. 2018;2(1):E20-E27. , 3939 Haddock BL, Wilkin LD. Resistance training volume and post exercise energy expenditure. Int J Sports Med. 2006;27(2):143-8. , 4343 Littlefield LA, Papadakis Z, Rogers KM, Moncada-Jiménez J, Taylor K, Grandjeana PW. The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men. Appl Physiol Nutr Metab. 2017;42(9):986-93. , 4444 Schaun GZ, Alberton CL, Ribeiro DO, Pinto SS. Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men. Eur J Appl Physiol. 2017;117(7):1437-44. Other studies were analyzed for over 90 min.11 Abboud GJ, Greer BK, Campbell SC, Panton LB. Effects of load-volume on EPOC after acute bouts of resistance training in resistance-trained men. J Strength Cond Res. 2013;27(7):1936-41. , 22 Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc. 2001;33(6):932-8. , 3535 Islam H, Townsend LK, Hazell TJ. Excess Postexercise Oxygen Consumption and Fat Utilization Following Submaximal Continuous and Supramaximal Interval Running. Res Q Exerc Sport. 2018;89(4):450-56.

36 Luszczyk M, Flis DJ, Szadejko I, Laskowski R, Ziolkowski W. Excess postexercise oxygen consumption and fat oxidation in recreationally trained men following exercise of equal energy expenditure: comparisons of spinning and constant endurance exercise. J Sports Med Phys Fitness. 2018;58(12):1781-89.
- 3737 Townsend LK, Couture KM, Hazell TJ. Mode of exercise and sex are not important for oxygen consumption during and in recovery from sprint interval training. Appl Physiol Nutr Metab. 2014;39(12):1388-94. , 4141 Greer BK, Sirithienthad P, Moffatt RJ, Marcello RT, Panton LB. EPOC Comparison Between Isocaloric Bouts of Steady-State Aerobic, Intermittent Aerobic, and Resistance Training. Res Q Exerc Sport. 2015;86(2):190-5.

Despite the limitations by heterogeneity, our data demonstrate that the intensity of effort can be considered as a determining factor for increasing EPOC during exercises using both treadmills and bicycles. As for caloric parameters, we observed significant changes only in RT ( Table 2 ).

Although our results point to a significant trend towards high intensity exercise, studies are inconclusive when analyzed individually.

For example, studies by Turker et al.1515 Tucker WJ, Angadi SS, Gaesser GA. Excess Postexercise Oxygen Consumption After High-Intensity and Sprint Interval Exercise, and Continuous Steady-State Exercise. J Strength Cond Res. 2016;30(11):3090-97. compared EPOC after high-intensity interval exercise (HIE), and sprint interval exercise (SIE), and steady-state exercise (SSE). Ten recreationally active males participated in a randomized crossover trial. Although 3h EPOC and total net EE after exercise were higher (p=0.01) for SIE (22.0 ± 9.3 L; 110 ± 47 kcal) compared to SSE (12.8 ± 8.5 L; 64 ± 43 kcal), total (exercise + post exercise) net O2 consumed and net EE were greater (p=0.03) for SSE (69.5 ± 18.4 L; 348 ± 92 kcal) than for SIE (54.2 ± 12.0 L; 271 ± 60 kcal). On the other hand, Schaun et al.4444 Schaun GZ, Alberton CL, Ribeiro DO, Pinto SS. Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men. Eur J Appl Physiol. 2017;117(7):1437-44. compared the energy expenditure during and after two treadmill protocols, high-intensity interval training (HIIT) and moderate continuous training (CONT), in young adult men. The protocols HIIT (8 bouts, 20s at 130% of the velocity associated with the VO2 max. on a treadmill with 10s of RI) versus CONT (30min on a treadmill at a submaximal velocity equivalent to 90–95% of HR associated with the anaerobic threshold). No difference was found between the groups for VO2, EE and EPOC post-exercise and were higher than HIIT (69.31 ± 10.88; 26.27 ± 2.28 kcal, respectively).

CONCLUSIONS

Our study focused on the analysis of high and moderate-intensity exercise results and effects on oxygen uptake following exercise. Despite the growing popularity of high-intensity interval training, we found that acute and chronic benefits remain limited. We understand that lack a of similar protocols and the control of the variables that influence training outcomes, will affect the measures that are used to determine EPOC magnitude. We also suggest that controlled longitudinal studies would reveal additional perspectives in relation to the measurement of EPOC. A further confounding factor is the magnitude (time in minutes) of VO2 measurement during EPOC assessment as it ranged from 60 min to 720 min. Longitudinal studies and controlled experimental design would permit a higher combination of effect size which would be a desirable outcome. The findings of the present study showed a tendency (random-effects model: 0.87, 95%-IC [0.35; 1.38], I 2 = 73%, p < 0.01 ) for increases in EPOC post exercise when the exercise performed prior to EPOC measurement was high-intensity interval training.

ACKNOWLEDGEMENTS

The authors, Gustavo Allegretti João, Daniel Rodriguez, Lucas D. Tavares, Nelson Carvas Júnior, Francisco Luciano Pontes Júnior, Roberta Luksevicius Rica, Danilo Sales Bocalini, Julien S. and Aylton Figueira Júnior thank CAPES and FAPES (590/19 – no.84417625/2018) fellowships granted for study development. The fund providers had no role in the decision to publish nor in the preparation of the paper.

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    Haltom RW, Kraemer RR, Sloan RA, Hebert EP, Frank K, Tryniecki JL. Circuit weight training and its effects on excess postexercise oxygen consumption. Med Sci Sports Exerc. 1999;31(11):1613-8.
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    Littlefield LA, Papadakis Z, Rogers KM, Moncada-Jiménez J, Taylor K, Grandjeana PW. The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men. Appl Physiol Nutr Metab. 2017;42(9):986-93.
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    Schleppenbach LN, Ezer AB, Gronemus SA, Widenski KR, Braun SI, Janot JM. Speed- and Circuit-Based High-Intensity Interval Training on Recovery Oxygen Consumption. Int J Exerc Sci. 2017;10:942-53.

Publication Dates

  • Publication in this collection
    17 June 2022
  • Date of issue
    2023

History

  • Received
    11 Jan 2021
  • Accepted
    10 May 2021
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