Body Oxygen Level Test (BOLT) is Not Associated with Exercise Performance in Highly-trained Individuals

Overview

Journal Front Physiol

Date 2024 Sep 18

PMID 39290618

Authors

Tomasz Kowalski

Kinga Rebis

Adrian Wilk

Andrzej Klusiewicz

Szczepan Wiecha

Bartlomiej Paleczny

Affiliations

Soon will be listed here.

Abstract

Introduction: The analysis of chemoreflex and baroreflex sensitivity may contribute to optimizing patient care and athletic performance. Breath-holding tests, such as the Body Oxygen Level Test (BOLT), have gained popularity as a feasible way to evaluate the reflex control over the cardiorespiratory system. According to its proponents, the BOLT score reflects the body's sensitivity to carbon dioxide and homeostasis disturbances, providing feedback on exercise tolerance. However, it has not yet been scientifically validated or linked with exercise performance in highly-trained individuals. Therefore, we investigated the association of BOLT scores with the results of standard performance tests in elite athletes.

Methods: A group of 49 speedskaters performed BOLT, Wingate Anaerobic Test (WAnT), and cardiopulmonary exercise test (CPET) on a cycle ergometer. Peak power, total work, and power drop were measured during WAnT. Time to exhaustion and maximum oxygen uptake were measured during CPET. Spearman's rank correlation and multiple linear regression were performed to analyze the association of BOLT scores with parameters obtained during the tests, age, somatic indices, and training experience.

Results: No significant correlations between BOLT scores and parameters obtained during WAnT and CPET were found, r(47) = -0.172-0.013, = 0.248-0.984. The parameters obtained during the tests, age, somatic indices, and training experience were not significant in multiple linear regression ( = 0.38-0.85). The preliminary regression model showed an of 0.08 and RMSE of 9.78 sec.

Conclusions: Our findings did not demonstrate a significant relationship between BOLT scores and exercise performance. Age, somatic indices, and training experience were not significant in our analysis. It is recommended to interpret BOLT concerning exercise performance in highly-trained populations with a great degree of caution.

References

Barnai M, Laki I, Gyurkovits K, Angyan L, Horvath G . Relationship between breath-hold time and physical performance in patients with cystic fibrosis. Eur J Appl Physiol. 2005; 95(2-3):172-8. DOI: 10.1007/s00421-005-1350-3. View

Cherouveim E, Botonis P, Tsakiris T, Koskolou M, Geladas N . The effect of menstrual cycle on maximal breath-hold time. Respir Physiol Neurobiol. 2020; 274:103381. DOI: 10.1016/j.resp.2020.103381. View

Boulet L, OByrne P . Asthma and exercise-induced bronchoconstriction in athletes. N Engl J Med. 2015; 372(7):641-8. DOI: 10.1056/NEJMra1407552. View

Ponikowski P, Chua T, Anker S, Francis D, Doehner W, Banasiak W . Peripheral chemoreceptor hypersensitivity: an ominous sign in patients with chronic heart failure. Circulation. 2001; 104(5):544-9. DOI: 10.1161/hc3101.093699. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147(8):573-7. DOI: 10.7326/0003-4819-147-8-200710160-00010. View

Gratze G, Mayer H, Luft F, Skrabal F . Determinants of fast marathon performance: low basal sympathetic drive, enhanced postcompetition vasodilatation and preserved cardiac performance after competition. Br J Sports Med. 2008; 42(11):882-8. DOI: 10.1136/bjsm.2007.044271. View

Ohyabu Y, Usami A, Ohyabu I, Ishida Y, Miyagawa C, Arai T . Ventilatory and heart rate chemosensitivity in track-and-field athletes. Eur J Appl Physiol Occup Physiol. 1990; 59(6):460-4. DOI: 10.1007/BF02388629. View

Kara T, Narkiewicz K, Somers V . Chemoreflexes--physiology and clinical implications. Acta Physiol Scand. 2003; 177(3):377-84. DOI: 10.1046/j.1365-201X.2003.01083.x. View

Petek B, Tso J, Churchill T, Guseh J, Loomer G, DiCarli M . Normative cardiopulmonary exercise data for endurance athletes: the Cardiopulmonary Health and Endurance Exercise Registry (CHEER). Eur J Prev Cardiol. 2021; 29(3):536-544. DOI: 10.1093/eurjpc/zwab150. View

10.

Illidi C, Romer L, Johnson M, Williams N, Rossiter H, Casaburi R . Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol. 2023; 123(8):1599-1625. PMC: 10013266. DOI: 10.1007/s00421-023-05166-8. View

11.

Nannini L, Zaietta G, Guerrera A, Varela J, Fernandez O, Flores D . Breath-holding test in subjects with near-fatal asthma. A new index for dyspnea perception. Respir Med. 2006; 101(2):246-53. DOI: 10.1016/j.rmed.2006.05.013. View

12.

Baumert M, Brechtel L, Lock J, Hermsdorf M, Wolff R, Baier V . Heart rate variability, blood pressure variability, and baroreflex sensitivity in overtrained athletes. Clin J Sport Med. 2006; 16(5):412-7. DOI: 10.1097/01.jsm.0000244610.34594.07. View

13.

Bouten J, Debusschere J, Lootens L, Declercq L, Van Eenoo P, Boone J . Six weeks of static apnea training does not affect Hbmass and exercise performance. J Appl Physiol (1985). 2022; 132(3):673-681. DOI: 10.1152/japplphysiol.00770.2021. View

14.

Sutterlin S, Schroijen M, Constantinou E, Smets E, Van den Bergh O, Van Diest I . Breath holding duration as a measure of distress tolerance: examining its relation to measures of executive control. Front Psychol. 2013; 4:483. PMC: 3725515. DOI: 10.3389/fpsyg.2013.00483. View

15.

Dutton K, Blanksby B, Morton A . CO2 sensitivity changes during the menstrual cycle. J Appl Physiol (1985). 1989; 67(2):517-22. DOI: 10.1152/jappl.1989.67.2.517. View

16.

La Rovere M, Pinna G, Raczak G . Baroreflex sensitivity: measurement and clinical implications. Ann Noninvasive Electrocardiol. 2008; 13(2):191-207. PMC: 6931942. DOI: 10.1111/j.1542-474X.2008.00219.x. View

17.

Korzeniewski B, Rossiter H . Skeletal muscle biochemical origin of exercise intensity domains and their relation to whole-body V̇O2 kinetics. Biosci Rep. 2022; 42(8). PMC: 9366749. DOI: 10.1042/BSR20220798. View

18.

Parati G, Ochoa J . Prognostic value of baroreflex sensitivity in heart failure. A 2018 reappraisal. Eur J Heart Fail. 2018; 21(1):59-62. DOI: 10.1002/ejhf.1334. View

19.

Zavoreo I, Basic Kes V, Morovic S, Seric V, Demarin V . Breath holding index in detection of early cognitive decline. J Neurol Sci. 2010; 299(1-2):116-9. DOI: 10.1016/j.jns.2010.08.062. View

20.

Trembach N, Zabolotskikh I . Breath-holding test in evaluation of peripheral chemoreflex sensitivity in healthy subjects. Respir Physiol Neurobiol. 2016; 235:79-82. DOI: 10.1016/j.resp.2016.10.005. View