Key result
Intrathecal fentanyl accelerates the rate of exercise-induced heart rate increase vs control.
Why the study?
This study evaluated the effect of feedback from group III/IV afferents on the maximal rate of heart rate increase during the rest-to-exercise transition in non-fatigued muscle.
Does lumbar intrathecal fentanyl infusion alter the maximal rate of heart rate increase (rHRI) during the transition from rest to low-intensity exercise in healthy males?
RCT (n=8)
Randomised, counter-balanced, cross-over
No
Does lumbar intrathecal fentanyl infusion alter the maximal rate of heart rate increase (rHRI) during the transition from rest to low-intensity exercise in healthy males?
Feedback from group III/IV skeletal muscle afferents slows the acceleration of heart rate during the transition from rest to light-intensity exercise in males.
Answers are grounded in this paper and cite their sources.
Does not support clinical changes in exercise testing; extends mechanistic evidence that group III/IV afferents slow initial heart rate rise.
Group III/IV skeletal muscle afferents respond to intramuscular mechanical and metabolic stimuli and are more active in fatigued muscle. These afferents project onto the brainstem and motor cortex and modulate cardiovascular and motor responses during exercise. The maximal rate of heart rate (HR) increase (rHRI), a marker of HR acceleration during the rest‐to‐exercise transition, is linearly related to exercise performance across various training and fatigue states, being faster with better exercise performance and vice versa. This study evaluated the effect of feedback from group III/IV afferents on rHRI in non‐fatigued muscle. HR data were collected in eight recreationally active male participants (24 ± 1 years) during the transition from rest to 3 min of cycling at 100 W under control (CON) conditions and following lumbar intrathecal fentanyl (FENT) infusion to impair feedback from group III/IV afferents of the leg. rHRI was defined as the maximal first‐derivative value of a logistic curve fitted to the HR data. Pre‐exercise HR was similar in CON and FENT (CON 91.7 ± 16.7 bpm, FENT 99.8 ± 15.5 bpm, P = 0.250). HR increased more with exercise during CON than FENT (B = 10.01, 95% CI 5.33 to 14.70, P < 0.001) but rHRI was faster during FENT (B = 1.52, 95% CI 0.24 to 2.80, P = 0.020). In non‐fatigued muscle, feedback from group III/IV afferents slowed rHRI. Increased feedback when muscle is fatigued may slow rHRI further which may explain the relationship between rHRI and exercise performance seen in previous studies, but further studies on fatigued muscle are required to confirm this.
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Burgess et al. (2026) conducted an RCT in Healthy recreationally active males (n=8). Lumbar intrathecal fentanyl infusion vs. Control conditions was evaluated on Maximal rate of heart rate increase (rHRI) (B = 1.52, 95% CI 0.24 to 2.80, p=0.020). Lumbar intrathecal fentanyl infusion, which impairs feedback from group III/IV afferents, resulted in a faster maximal rate of heart rate increase (rHRI) compared to control (B = 1.52, P = 0.020).
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