Journals / Uluslararası Spor Egzersiz ve Antrenman Bilimi Dergisi / 2026 / Cilt: 11 Sayı: 3

Acute and Chronic Lower Limb Ischaemic Preconditioning Increase the Sprint Triathlon Performance in Athletes

Atletlerde Akut ve Kronik Alt Ekstremite İskemik Ön Koşullama Sprint Triatlon Performansını Artırır

Mehmet Zeki Sari(AKDENİZ ÜNİVERSİTESİ)0000-0003-0606-4307
Buğra Gençtürk(Akdeniz Üniversitesi Hareket ve Antrenman ABD.)0000-0002-1006-8450
Aliye Gündoğdu(Akdeniz Üniversitesi Hareket ve Antrenman ABD.)0000-0003-3799-4056
Yaşar Gül Özkaya(AKDENİZ ÜNİVERSİTESİ)0000-0002-4887-8379
Pages
246–255
Publication Date
2025-09-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, its effects on other HRV components were limited.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: This study aimed to investigate the effects of ischemic preconditioning (IPC) on triathlon performance in athletes.
📊
Key Findings & Data:Method: Twenty-four triathletes (8 female, 16 males; mean age: 35.43±1.84 years), with at least 3 years of training and competition experience, participated.
💡
Conclusion & Impact:However, its effects on other HRV components were limited.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Kalp Atım Hızı Değişkenliği · İskemik Ön Koşullama · Triatlon

Abstract

Aim: This study aimed to investigate the effects of ischemic preconditioning (IPC) on triathlon performance in athletes. Method: Twenty-four triathletes (8 female, 16 males; mean age: 35.43±1.84 years), with at least 3 years of training and competition experience, participated. Heart rate (HR), blood pressure, rate of perceived exertion (RPE), respiratory frequency, and heart rate variability (HRV) parameters (SDNN, NN50, PNN50, RMSSD, VLF, LF, HF, LF/HF) were measured following rest, sham, and IPC conditions. IPC was applied both acutely (single session) and chronically (7 consecutive days) using a sphygmomanometer cuff inflated to 220 mmHg for 5 minutes, followed by 5 minutes of reperfusion, repeated four times. Sham involved the same protocol with 20 mmHg pressure. Data was analyzed using t-tests. Results: Triathlon completion time significantly improved after both sham and IPC, but the improvement was greater after IPC (p<0.05). Performance enhancement was more pronounced with chronic IPC. Increased cycling performance largely contributed to the improvement in total triathlon time. Post-exercise heart rate was significantly lower following IPC compared to other conditions (p<0.05), while no other HRV parameters showed significant differences. Conclusion: IPC significantly enhanced triathlon performance, especially when applied chronically, likely due to reduced heart rate after exercise. However, its effects on other HRV components were limited.

Özet

Amaç: Bu çalışmanın amacı, iskemik ön koşullamanın (IPC) triatlon performansı üzerindeki etkilerini araştırmaktır. Yöntem: En az 3 yıllık antrenman ve yarışma deneyimine sahip 24 triatlet (8 kadın, 16 erkek; ort. yaş: 35,43±1,84 yıl) çalışmaya katıldı. Kalp atım hızı (KA), kan basıncı, algılanan efor derecesi (RPE), solunum frekansı ve kalp atım hızı değişkenliği (HRV) parametreleri (SDNN, NN50, PNN50, RMSSD, VLF, LF, HF, LF/HF) istirahat, sham ve IPC koşullarında ölçüldü. IPC, manşet ile 220 mmHg’ye şişirilip 5 dakika basınç uygulanması, ardından 5 dakika reperfüzyon şeklinde, 4 kez tekrar edilerek akut (tek seans) ve kronik (7 gün ardışık) olarak uygulandı. Sham koşulunda ise aynı protokol 20 mmHg basınç ile gerçekleştirildi. Veriler t-testi ile analiz edildi. Bulgular: Triatlon tamamlama süresi hem sham hem de IPC sonrasında anlamlı şekilde iyileşti, ancak IPC sonrasında bu iyileşme daha fazlaydı (p<0,05). Performans artışı özellikle kronik IPC ile daha belirgindi. Toplam triatlon süresindeki iyileşmeye en çok bisiklet performansındaki artış katkıda bulundu. Egzersiz sonrası kalp atım hızı, IPC sonrasında diğer koşullara kıyasla anlamlı derecede daha düşüktü (p<0,05), ancak diğer HRV parametrelerinde anlamlı bir farklılık gözlenmedi. Sonuç: IPC, özellikle kronik uygulandığında, triatlon performansını anlamlı şekilde artırmıştır. Bu etkinin büyük ölçüde egzersiz sonrası kalp atım hızındaki düşüşten kaynaklandığı düşünülmektedir. Ancak IPC’nin diğer HRV bileşenleri üzerindeki etkisi sınırlı kalmıştır.

🔖

Cite This Article

Sari, M. Z., Gençtürk, B., Gündoğdu, A., Özkaya, Y. G. (2025). Acute and Chronic Lower Limb Ischaemic Preconditioning Increase the Sprint Triathlon Performance in Athletes. Uluslararası Spor Egzersiz ve Antrenman Bilimi Dergisi, Cilt: 11 Sayı: 3, 246–255. https://doi.org/10.18826/useeabd.1718989

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (47)

  1. Bailey, T.G., Jones, H., Gregson, W., Atkinson, G., Cable, N.T., & Thijssen, D.H (2012). Effect of ischemic preconditioning on lactate accumulation and running performance. Medicine & Science in Sports & Exercise, 44(11), 2084-2089. https://doi.org/10.1249/mss.0b013e318262cb17
  2. Barbosa TC, Machado AC, Braz ID, Fernandes IA, Vianna LC, Nobrega AC, Silva BM (2015). Remote ischemic preconditioning delays fatigue development during handgrip exercise. Scandinavian Journal of Medicine & Science in Sports, 25, 356–364. https://doi.org/10.1111/sms.12229
  3. Brooks, G.A (2000). Intra-and extra-cellular lactate shuttles. Medicine and science in sports and exercise, 32(4), 790-799. https://doi.org/10.1097/00005768-200004000-00011
  4. Carroll, R., & Yellon, D.M (1999). Myocardial adaptation to ischaemia–the preconditioning phenomenon. International Journal Of Cardiology, 68, S93-S101. https://doi.org/10.1016/S0167-5273(98)00297-6
  5. Caru, M., Levesque, A., Lalonde, F., & Curnier, D. (2019). An overview of ischemic preconditioning in exercise performance: A systematic review. Journal of sport and health science, 8(4), 355-369. https://doi.org/10.1016/j.jshs.2019.01.008
  6. Chaturvedi, R. R., Lincoln, C., Gothard, J. W., Scallan, M. H., White, P. A., Redington, A. N., & Shore, D. F. (1998). Left ventricular dysfunction after open repair of simple congenital heart defects in infants and children: quantitation with the use of a conductance catheter immediately after bypass. The Journal of Thoracic and Cardiovascular Surgery, 115(1), 77-83. https://doi.org/10.1016/S0022-5223(98)70446-5
  7. Clevidence, M. W., Mowery, R. E., & Kushnick, M. R. (2012). The effects of ischemic preconditioning on aerobic and anaerobic variables associated with submaximal cycling performance. European Journal of Applied Physiology, 112, 3649-3654. https://doi.org/10.1007/s00421-012-2345-5
  8. Cooper, C.E., & Brown, G.C (2008). The inhibition of mitochondrial cytochrome oxidase by the gases carbon monoxide, nitric oxide, hydrogen cyanide and hydrogen sulfide: chemical mechanism and physiological significance. Journal of Bioenergetics and Biomembranes, 40(5), 533. https://doi.org/10.1007/s10863-008-9166-6
  9. Cruz, R. S. D. O., De Aguiar, R. A., Turnes, T., Pereira, K. L., & Caputo, F. (2015). Effects of ischemic preconditioning on maximal constant-load cycling performance. Journal of Applied Physiology, 119(9), 961-967. https://doi.org/10.1152/japplphysiol.00498.2015
  10. De Groot, P. C., Thijssen, D. H., Sanchez, M., Ellenkamp, R., & Hopman, M. T. (2010). Ischemic preconditioning improves maximal performance in humans. European journal of applied physiology, 108, 141-146. https://doi.org/10.1007/s00421-009-1195-2
  11. Donato, M., Buchholz, B., Rodríguez, M., Pérez, V., Inserte, J., García‐Dorado, D., & Gelpi, R. J. (2013). Role of the parasympathetic nervous system in cardioprotection by remote hindlimb ischaemic preconditioning. Experimental Physiology, 98(2), 425-434. https://doi.org/10.1113/expphysiol.2012.066217
  12. Gibson, N., White, J., Neish, M., & Murray, A. (2013). Effect of ischemic preconditioning on land-based sprinting in team-sport athletes. International Journal of Sports Physiology and Performance, 8(6), 671-676.
  13. Giricz, Z., Varga, Z. V., Baranyai, T., Sipos, P., Pálóczi, K., Kittel, Á.,. & Ferdinandy, P. (2014). Cardioprotection by remote ischemic preconditioning of the rat heart is mediated by extracellular vesicles. Journal of Molecular and Cellular Cardiology, 68, 75-78. https://doi.org/10.1016/j.yjmcc.2014.01.004
  14. Hashimoto, T., & Brooks, G. A. (2008). Mitochondrial lactate oxidation complex and an adaptive role for lactate production. Medicine & Science in Sports & Exercise, 40(3), 486-494. https://doi.org/10.1249/mss.0b013e31815fcb04
  15. Hausenloy, D.J., Yellon, D.M (2008). Remote ischaemic preconditioning: underlying mechanisms and clinical application. Cardiovascular Research, 79, 377–86. https://doi.org/10.1093/cvr/cvn114
  16. Incognito, A. V., Burr, J. F., & Millar, P. J. (2016). The effects of ischemic preconditioning on human exercise performance. Sports Medicine, 46, 531-544. https://doi.org/10.1007/s40279-015-0433-5
  17. Jean-St-Michel, E., Manlhiot, C., Li, J., Tropak, M., Michelsen, M. M., Schmidt, M. R.,. & Redington, A. N. (2011). Remote preconditioning improves maximal performance in highly trained athletes. Medicine and Science in Sports and Exercise, 43(7), 1280-1286.https://doi.org/10.1249/mss.0b013e318206845d
  18. Kido, K., Suga, T., Tanaka, D., Honjo, T., Homma, T., Fujita, S.,. & Isaka, T. (2015). Ischemic preconditioning accelerates muscle deoxygenation dynamics and enhances exercise endurance during the work‐to‐work test. Physiological Reports, 3(5), e12395. https://doi.org/10.14814/phy2.12395
  19. Kilduff, L. P., Finn, C. V., Baker, J. S., Cook, C. J., & West, D. J. (2013). Preconditioning strategies to enhance physical performance on the day of competition. International Journal of Sports Physiology and Performance, 8(6), 677-681.https://doi.org/10.1123/ijspp.8.6.677
  20. Kimura, M., Ueda, K., Goto, C., Jitsuiki, D., Nishioka, K., Umemura, T.,. & Higashi, Y. (2007). Repetition of ischemic preconditioning augments endothelium-dependent vasodilation in humans: role of endothelium-derived nitric oxide and endothelial progenitor cells. Arteriosclerosis, Thrombosis, and Vascular Biology, 27(6), 1403-1410. https://doi.org/10.1161/ATVBAHA.107.143578
  21. Lalonde, F., & Curnier, D.Y (2015). Can anaerobic performance be improved by remote ischemic preconditioning. The Journal of Strength & Conditioning Research, 29(1), 80-85. https://doi.org/10.1519/JSC.0000000000000609
  22. Lawson, C. S., & Downey, J. M. (1993). Preconditioning: state of the art myocardial protection. Cardiovascular Research, 27(4), 542-550. https://doi.org/10.1093/cvr/27.4.542
  23. Loukogeorgakis, S. P., Panagiotidou, A. T., Broadhead, M. W., Donald, A., Deanfield, J. E., & MacAllister, R. J. (2005). Remote ischemic preconditioning provides early and late protection against endothelial ischemia-reperfusion injury in humans: Role of the autonomic nervous system. Journal of the American College of Cardiology, 46(3), 450-456. https://www.jacc.org/doi/abs/10.1016/j.jacc.2005.04.044
  24. Marocolo, M., da Mota, G. R., Simim, M. A. M., & Coriolano, H. J. A. (2016). Myths and facts about the effects of ischemic preconditioning on performance. International Journal of Sports Medicine, 37(02), 87-96. https://doi.org/10.1055/s-0035-1564253
  25. Murry, C. E., Jennings, R. B., & Reimer, K. A. (1986). Preconditioning with ischemia: A delay of lethal cell injury in ischemic myocardium. Circulation, 74(5), 1124-1136. https://doi.org/10.1161/01.CIR.74.5.1124
  26. Ozkaya, Y. G., Agar, A., Hacioglu, G. Ö. K. Ç. E., Yargicoglu, P., Abidin, I., & Senturk, U. K. (2003). Training induced alterations of visual evoked potentials are not related to body temperature. International Journal of Sports Medicine, 24(05), 359-362. https://doi.org/10.1055/s-2003-40699
  27. Pang, C. Y., Neligan, P., Xu, H., He, W., Zhong, A., Hopper, R., & Forrest, C. R. (1997). Role of ATP-sensitive K+ channels in ischemic preconditioning of skeletal muscle against infarction. American Journal of Physiology-Heart and Circulatory Physiology, 273(1), H44-H51.https://doi.org/10.1152/ajpheart.1997.273.1.H44
  28. Pang, C. Y., Yang, R. Z., Zhong, A., Xu, N., Boyd, B., & Forrest, C. R. (1995). Acute ischaemic preconditioning protects against skeletal muscle infarction in the pig. Cardiovascular Research, 29(6), 782-788. https://doi.org/10.1016/S0008-6363(96)88613-5
  29. Paradis-Deschênes, P., Joanisse, D. R., & Billaut, F. (2016). Ischemic preconditioning increases muscle perfusion, oxygen uptake, and force in strength-trained athletes. Applied Physiology, Nutrition, And Metabolism, 41(9), 938-944. https://doi.org/10.1139/apnm-2015-0561
  30. Patel, H. H., Moore, J., Hsu, A. K., & Gross, G. J. (2002). Cardioprotection at a distance: mesenteric artery occlusion protects the myocardium via an opioid sensitive mechanism. Journal of Molecular and Cellular Cardiology, 34(10), 1317-1323. https://doi.org/10.1006/jmcc.2002.2072
  31. Pell, T. J., Baxter, G. F., Yellon, D. M., & Drew, G. M. (1998). Renal ischemia preconditions myocardium: role of adenosine receptors and ATP-sensitive potassium channels. American Journal of Physiology-Heart and Circulatory Physiology, 275(5), H1542-H1547. https://doi.org/10.1152/ajpheart.1998.275.5.H1542
  32. Peralta, C., Fernández, L., Panés, J., Prats, N., Sans, M., Piqué, J. M.,. & Roselló-Catafau, J. (2001). Preconditioning protects against systemic disorders associated with hepatic ischemia-reperfusion through blockade of tumor necrosis factor–induced P-selectin up-regulation in the rat. Hepatology, 33(1), 100-113. https://doi.org/10.1053/jhep.2001.20529
  33. Przyklenk, K., & Whittaker, P. (2011). Remote ischemic preconditioning: current knowledge, unresolved questions, and future priorities. Journal of Cardiovascular Pharmacology and Therapeutics, 16, 255–9. https://doi.org/10.1177/1074248411409040
  34. Riksen, N.P., Smits, P., & Rongen, G.A. (2006). Ischaemic preconditioning: From molecular characterisation to clinical application-part I. The Netherlands Journal of Medicine, 62(10), 353-63.
  35. Schoemaker, R.G., & Van Heijningen, C.L. (2000). Bradykinin mediates cardiac preconditioning at a distance. Am American Journal of Physiology, 278, H1571–6. https://doi.org/10.1152/ajpheart.2000.278.5.H1571
  36. Schulz, R., Cohen, M.V., Behrends, M., Downey, J.M., & Heusch, G. (2001). Signal transduction of ischemic preconditioning. Cardiovascular Research, 52(2), 181-198. https://doi.org/10.1016/S0008-6363(01)00384-4
  37. Tocco, F., Marongiu, E., Ghiani, G., Sanna, I., Palazzolo, G., Olla, S.,. & Crisafulli, A. (2015). Muscle ischemic preconditioning does not improve performance during self-paced exercise. International Journal of Sports Medicine, 36(01), 9-15. https://doi.org/10.1055/s-0034-1384546
  38. Veighey, K., & MacAllister, R. J. (2012). Clinical applications of remote ischemic preconditioning. Cardiology Research and Practice, 2012(1), 620681. https://doi.org/10.1155/2012/620681
  39. Weinbrenner, C., Schulze, F., Sárváry, L., & Strasser, R. H. (2004). Remote preconditioning by infrarenal aortic occlusion is operative via δ1-opioid receptors and free radicals in vivo in the rat heart. Cardiovascular Research, 61(3), 591-599. https://doi.org/10.1016/j.cardiores.2003.10.008
  40. Yellon, D. M., & Hausenloy, D. J. (2007). Myocardial reperfusion injury. New England Journal of Medicine, 357(11), 1121-1135. https://doi.org/10.1056/NEJMra071667
  41. Ylitalo, K., & Peuhkurinen, K. (2001). Clinical relevance of ischemic preconditioning. Scandinavian Cardiovascular Journal, 35(6), 359-365. https://doi.org/10.1080/14017430152754835
  42. Giricz, Z., Varga, Z. V., Baranyai, T., Sipos, P., Pálóczi, K., Kittel, Á.,. & Ferdinandy, P. (2014). Cardioprotection by remote ischemic preconditioning of the rat heart is mediated by extracellular vesicles. Journal of Molecular and Cellular Cardiology, 68, 75-78. https://doi.org/10.1016/j.yjmcc.2014.01.004
  43. Jean-St-Michel, E., Manlhiot, C., Li, J., Tropak, M., Michelsen, M. M., Schmidt, M. R.,. & Redington, A. N. (2011). Remote preconditioning improves maximal performance in highly trained athletes. Medicine and Science in Sports and Exercise, 43(7), 1280-1286.https://doi.org/10.1249/mss.0b013e318206845d
  44. Kido, K., Suga, T., Tanaka, D., Honjo, T., Homma, T., Fujita, S.,. & Isaka, T. (2015). Ischemic preconditioning accelerates muscle deoxygenation dynamics and enhances exercise endurance during the work‐to‐work test. Physiological Reports, 3(5), e12395. https://doi.org/10.14814/phy2.12395
  45. Kimura, M., Ueda, K., Goto, C., Jitsuiki, D., Nishioka, K., Umemura, T.,. & Higashi, Y. (2007). Repetition of ischemic preconditioning augments endothelium-dependent vasodilation in humans: role of endothelium-derived nitric oxide and endothelial progenitor cells. Arteriosclerosis, Thrombosis, and Vascular Biology, 27(6), 1403-1410. https://doi.org/10.1161/ATVBAHA.107.143578
  46. Peralta, C., Fernández, L., Panés, J., Prats, N., Sans, M., Piqué, J. M.,. & Roselló-Catafau, J. (2001). Preconditioning protects against systemic disorders associated with hepatic ischemia-reperfusion through blockade of tumor necrosis factor–induced P-selectin up-regulation in the rat. Hepatology, 33(1), 100-113. https://doi.org/10.1053/jhep.2001.20529
  47. Tocco, F., Marongiu, E., Ghiani, G., Sanna, I., Palazzolo, G., Olla, S.,. & Crisafulli, A. (2015). Muscle ischemic preconditioning does not improve performance during self-paced exercise. International Journal of Sports Medicine, 36(01), 9-15. https://doi.org/10.1055/s-0034-1384546