Left atrial mechanics and aortic stiffness following high intensity interval training: a randomised controlled study [Abstract]

Journal article


Jalaludeen, N., Bull, S., Taylor, K. A., Wiles, J., Coleman, D., Mukhtar, O., Cheriyan, J., Wilkinson, I.B., Sharma, R. and O'Driscoll, J. 2020. Left atrial mechanics and aortic stiffness following high intensity interval training: a randomised controlled study [Abstract]. European Heart Journal - Cardiovascular Imaging. 21 (1).
AuthorsJalaludeen, N., Bull, S., Taylor, K. A., Wiles, J., Coleman, D., Mukhtar, O., Cheriyan, J., Wilkinson, I.B., Sharma, R. and O'Driscoll, J.
Abstract

Purpose: High intensity interval training (HIIT) has been shown to improve important health parameters, including aerobic capacity, blood pressure, cardiac autonomic modulation and left ventricular (LV) mechanics. However, adaptations in left atrial (LA) mechanics and aortic stiffness remain unclear.

Methods: Forty-one physically inactive males and females were recruited. Participants were randomised to either a 4-week HIIT intervention (n=21) or 4-week control period (n=20). The HIIT protocol consisted of 3x30-second maximal cycle ergometer sprints with a resistance of 7.5% body weight, interspersed with 2-minutes of active unloaded recovery, 3 times per week. Speckle tracking imaging of the LA and M-Mode tracing of the aorta was performed pre and post HIIT and control period.

Results: Following HIIT, there was significant improvement in LA mechanics, including LA reservoir (13.9±13.4%, p=0.033), LA conduit (8.9±11.2%, p=0.023) and LA contractile (5±4.5%, p=0.044) mechanics compared to the control condition. In addition, aortic distensibility (2.1±2.7cm2dyn-1103, p=0.031) and aortic stiffness index (-2.6±4.6, p=0.041) were improved compared to the control condition. In stepwise linear regression analysis, aortic distensibility change was significantly associated with LA stiffness change R2 of 0.613 (p=0.002).

Conclusion: A short-term programme of HIIT was associated with a significant improvement in LA mechanics and aortic stiffness. These adaptations may have important health implications and contribute to the improved LV diastolic and systolic mechanics, aerobic capacity and blood pressure previously documented following HIIT.

KeywordsAorta; Aortic stiffness; Left atrium; Autonomic nervous system; Cardiovascular disease risk factors; Left ventricle; High intensity interval training; Randomised controlled study; Diastole; Systole; Arterial pressure; Diagnostic imaging; Heart; Linear regression; Aerobic capacity; Ergometers; Two-dimensional speckle tracking
Year2020
JournalEuropean Heart Journal - Cardiovascular Imaging
Journal citation21 (1)
PublisherOxford University Press
ISSN2047-2412
2047-2404
Digital Object Identifier (DOI)doi:10.1093/ehjci/jez319.221
Official URLhttps://doi.org/10.1093/ehjci/jez319.221
Publication dates
Online17 Jan 2020
Publication process dates
Deposited15 Jun 2020
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Reliability of cycling gross efficiency using the Douglas bag method
Hopker, J., Jobson, S., Gregson, H. and Coleman, D. 2012. Reliability of cycling gross efficiency using the Douglas bag method. Medicine and Science in Sports and Exercise. 44 (2), pp. 290-296.
The effect of the rotor crank system on time-trial cycling performance
Coleman, D., Hopker, J., Jobson, S., Galbraith, A. and Nevill, A. 2008. The effect of the rotor crank system on time-trial cycling performance.
A comparison of performance related responses during a 16km time trial between senior and veteran cyclists
Balmer, J., Coleman, D., Davison, R., Smith, M. and Bird, S. 1998. A comparison of performance related responses during a 16km time trial between senior and veteran cyclists.
The relationship between EMG and either heart rate or blood pressure during a single-leg incremental isometric exercise test
Swaine, I., Baross, T., Kay, T. and Wiles, J. 2009. The relationship between EMG and either heart rate or blood pressure during a single-leg incremental isometric exercise test.
Can 4 weeks of isometric exercise lower resting blood pressure in young, healthy, active men?
Swaine, I., Devereux, G. and Wiles, J. 2009. Can 4 weeks of isometric exercise lower resting blood pressure in young, healthy, active men?
Effect of isometric exercise training on resting blood pressure: A meta-analysis of controlled trials
Swaine, I., Owen, A. and Wiles, J. 2009. Effect of isometric exercise training on resting blood pressure: A meta-analysis of controlled trials.
Pedal forces and gross efficiency in cyclists
Coleman, D. 2009. Pedal forces and gross efficiency in cyclists.
Effects of physical activity, performed in accordance with the current recommendations, on CVD risk factors in 40-65 year old men
Perkins, G., Owen, A., Kearney, E., Wiles, J. and Swaine, I. 2007. Effects of physical activity, performed in accordance with the current recommendations, on CVD risk factors in 40-65 year old men.
Effects of walking to and from school on primary school children
Woolf-May, K., Ford, P., Swaine, I., Coleman, D. and Bailey, R. 2007. Effects of walking to and from school on primary school children. Pediatric Exercise Science. 19 (4).
The effect of two different 18-week walking programmes on aerobic fitness, selected blood lipids and factor XIIa
Woolf-May, K., Kearney, E., Jones, D., Davison, C., Coleman, D. and Bird, S. 1998. The effect of two different 18-week walking programmes on aerobic fitness, selected blood lipids and factor XIIa. Journal of Sports Sciences. 16 (8), pp. 701-710.
Placebo effect of an inert gel on experimentally induced leg muscle pain
Hopker, J., Foad, A., Beedie, C., Coleman, D. and Leach, G. 2010. Placebo effect of an inert gel on experimentally induced leg muscle pain. Open Access Journal of Sports Medicine. 1, pp. 215-221.
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Bromley, P., Sritharan, M. and Rosen, S. 2008. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia.
Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom
Itam, S., O'Driscoll, J., Milad, E. and Sharma, R. 2008. Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom.
The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists
Slee, A., O'Driscoll, J., Burnet, S., Hughes, G. and Chen, M. 2009. The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists.
Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease
Aldous, G., Sharma, R., O'Driscoll, J., Ashby, D., Tarn, F. and Choi, P. 2010. Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease.
A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision
O'Driscoll, J., Shave, R. and Cushion, C. 2007. A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision. Journal of Clinical Nursing. 16 (10), pp. 1908-1918.
Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom
O'Driscoll, J. and Sharma, R. 2009. Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom. in: Bennington, E. (ed.) Horizons in World Cardiovascular Research Hauppauge, New York Nova Science Publishers.
Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running
Wiles, J., Bird, S., Hopkins, J. and Riley, M. 1992. Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running. British Journal of Sports Medicine. 26 (2), pp. 116-120.
Effect of pre-exercise protein ingestion upon VO2, R and perceived exertion during treadmill running
Wiles, J., Woodward, R. and Bird, S. 1991. Effect of pre-exercise protein ingestion upon VO2, R and perceived exertion during treadmill running. British Journal of Sports Medicine. 25 (1), pp. 26-30.
Effectiveness of two glycerol ingestion strategies on 40-km cycling time trial performance
Brickell, L., Balmer, J., Theakston, S., Wiles, J. and Bird, S. 2001. Effectiveness of two glycerol ingestion strategies on 40-km cycling time trial performance. Journal of Sports Sciences. 20 (1), pp. 46-47.
We can work it out
Morrissey, M. and Wiles, J. 2001. We can work it out. Nursing Times. 97 (47), pp. 34-36.
Effects of isometric exercise training intensity upon reductions in resting systolic blood pressure
Wiles, J., Coleman, D. and Swaine, I. 2008. Effects of isometric exercise training intensity upon reductions in resting systolic blood pressure.
A novel method for the performance of isometric exercise in the home
Wiles, J., Coleman, D., Dunford, M. and Swaine, I. 2004. A novel method for the performance of isometric exercise in the home.
The precision with which isometric exercise training can be performed according to a given heart rate
Swaine, I., Wiles, J. and Coleman, D. 2008. The precision with which isometric exercise training can be performed according to a given heart rate.
Effects of three types of isometric leg exercise at the same relative exercise intensities on blood pressure
Swaine, I., Wiles, J., Dunford, M. and Coleman, D. 2004. Effects of three types of isometric leg exercise at the same relative exercise intensities on blood pressure.
The freely chosen contribution of the leg kick to the total power during simulated front crawl swimming on a onland ergometer
Swaine, I., Dunford, M., Wiles, J., Coleman, D., Hunter, A. and Carlton, K. 2006. The freely chosen contribution of the leg kick to the total power during simulated front crawl swimming on a onland ergometer.
The reliability of maximal power and 40km outdoor time trial cycling performance
Smith, M., Davison, R., Coleman, D., Balmer, J. and Bird, S. 2000. The reliability of maximal power and 40km outdoor time trial cycling performance. Medicine & Science in Sports & Exercise. 32 (S291).
The effect of different lactate elevation protocols on the lactate minimum
Smith, M., Davison, R., Balmer, J., Coleman, D. and Bird, S. 1999. The effect of different lactate elevation protocols on the lactate minimum. Journal of Sports Sciences. 17, pp. 44-45.
Physiological responses during cycle time trials: variable versus constant power output
Kirkland, A. and Coleman, D. 2009. Physiological responses during cycle time trials: variable versus constant power output. Journal of Sports Sciences. 26 (S130).
Reliability of time to exhaustion at critical power
Kirkland, A. and Coleman, D. 2006. Reliability of time to exhaustion at critical power.
Reliability of time to exhaustion at critical power
Kirkland, A. and Coleman, D. 2006. Reliability of time to exhaustion at critical power.
The effect of the Rotor crank system on time-trial cycling performance
Hopker, J., Jobson, S., Galbraith, A., Coleman, D. and Nevill, A. 2009. The effect of the Rotor crank system on time-trial cycling performance. Journal of Sports Sciences. 26 (S112).
Relationships between gross, delta and pedalling efficiency
Hopker, J. and Coleman, D. 2006. Relationships between gross, delta and pedalling efficiency.
Differences in daily activity levels, dietary energy intake and body composition in primary school children who walk to and from school compared to those who travel by car
Ford, P., Bailey, R., Coleman, D., Woolf-May, K. and Swaine, I. 2006. Differences in daily activity levels, dietary energy intake and body composition in primary school children who walk to and from school compared to those who travel by car.
Caffeine works: whether you believe it or not: evidence for pharmacological effects of caffeine ingestion on 40km cycling performance
Foad, A., Beedie, C. and Coleman, D. 2006. Caffeine works: whether you believe it or not: evidence for pharmacological effects of caffeine ingestion on 40km cycling performance.
The effect of altering ramp rate on the determination of lactate minimum in cyclists
Davison, R., Coleman, D., Balmer, J. and Bird, S. 1998. The effect of altering ramp rate on the determination of lactate minimum in cyclists. Medicine & Science in Sports & Exercise. 30 (S306).
Variability of power output during 40km outdoor time-trial cycling performance
Davison, R., Smith, M., Coleman, D., Balmer, J. and Bird, S. 2000. Variability of power output during 40km outdoor time-trial cycling performance. Medicine & Science in Sports & Exercise. 32 (S291).
The reliability of power output recorded during a maximal aerobic power test using an SRM powercrank and Kingcycle test rig
Davison, R., Balmer, J., Morgan, G., Coleman, D. and Bird, S. 2000. The reliability of power output recorded during a maximal aerobic power test using an SRM powercrank and Kingcycle test rig. Journal of Sports Sciences. 18, pp. 29-30.
Correlates of cycling hill climb ability
Coleman, D., Davison, R., Swan, D. and Bird, S. 1997. Correlates of cycling hill climb ability. Journal of Sports Sciences. 15 (1), pp. 42-43.
The effect of gradient upon cardio respiratory responses and gross mechanical efficiency at the same power output during cycling
Coleman, D., Davison, R., Balmer, J., Proffitt, A., Theakston, S. and Bird, S. 1998. The effect of gradient upon cardio respiratory responses and gross mechanical efficiency at the same power output during cycling. Journal of Sports Sciences. 16 (26).
The energy demands of competitive road race cycling
Coleman, D., Davison, R., Balmer, J., Nunn, M. and Bird, S. 1998. The energy demands of competitive road race cycling. Medicine & Science in Sports & Exercise. 30 (S305).
The effect of prior cycling on the relationship between maximal test parameters and simulated hill climb performance
Coleman, D., Bird, S. and Davison, R. 2002. The effect of prior cycling on the relationship between maximal test parameters and simulated hill climb performance. Journal of Sports Sciences. 20, pp. 18-19.
The effect of creatine supplementation on endurance performance
Coleman, D., Passfield, L., Hales, T. and Wright, M. 1995. The effect of creatine supplementation on endurance performance. Journal of Sports Sciences. 13, pp. 23-24.
Placebo effects of ergogenic aids in sports performance: experimental, psychometric and interview data
Beedie, C., Foad, A., Coleman, D. and Uphill, M. 2006. Placebo effects of ergogenic aids in sports performance: experimental, psychometric and interview data.
Is caffeine all in the head? Evidence for the placebo effects attributable to caffeine in cycling performance
Beedie, C., Stuart, E., Coleman, D. and Foad, A. 2006. Is caffeine all in the head? Evidence for the placebo effects attributable to caffeine in cycling performance.
Maximal power predicts outdoor 16 and 40km cycling time trial power but not performance time
Balmer, J., Smith, M., Davison, R., Coleman, D. and Bird, S. 2000. Maximal power predicts outdoor 16 and 40km cycling time trial power but not performance time. Medicine & Science in Sports & Exercise. 32 (S292).
A comparison of power output recorded by an SRM powercrank and Kingcycle test rig
Balmer, J., Davison, R., Coleman, D. and Bird, S. 2000. A comparison of power output recorded by an SRM powercrank and Kingcycle test rig. Journal of Sports Sciences. 18, pp. 27-28.
Blood lactate and cardio-respiratory responses when cycling for 70min at lactate minimum power output
Balmer, J., Coleman, D., Davison, R., Theakston, S. and Bird, S. 1998. Blood lactate and cardio-respiratory responses when cycling for 70min at lactate minimum power output. Medicine & Science in Sports & Exercise. 30, pp. 306-306.
A comparison of ventilatory responses during a ramp test between senior and veteran cyclists
Balmer, J., Coleman, D., Davison, R., Theakston, S. and Bird, S. 1998. A comparison of ventilatory responses during a ramp test between senior and veteran cyclists. Journal of Sports Sciences. 16, pp. 35-36.
A comparison of performance related responses during a 16-km time trial
Balmer, J., Coleman, D., Davison, R., Smith, M. and Bird, S. 1998. A comparison of performance related responses during a 16-km time trial.
A comparison of the blood lactate responses in senior and veteran cyclists during a 16-km time trial
Balmer, J., Coleman, D., Davison, R. and Bird, S. 1999. A comparison of the blood lactate responses in senior and veteran cyclists during a 16-km time trial. Journal of Sports Sciences. 17, pp. 25-25.
The correlation of blood lactate assessments with 16km cycling time-trial performance: the effect of age
Balmer, J., Coleman, D., Davison, R. and Bird, S. 1997. The correlation of blood lactate assessments with 16km cycling time-trial performance: the effect of age. Journal of Sports Sciences. 15, pp. 37-37.
The relationship between selected cardiovascular variables and exercise intensity during continuous and discontinuous incremental exercise tests
Allum, S., Wiles, J., Coleman, D. and Swaine, I. 2006. The relationship between selected cardiovascular variables and exercise intensity during continuous and discontinuous incremental exercise tests.
Assessment of blood lactate: practical evaluation of the Biosen 5030 lactate analyzer
Davison, R., Coleman, D., Balmer, J., Nunn, M., Theakston, S., Burrows, M. and Bird, S. 2000. Assessment of blood lactate: practical evaluation of the Biosen 5030 lactate analyzer. Medicine & Science in Sports & Exercise. 32 (1), pp. 243-247.
The validity of power output recorded during exercise performance tests using a Kingcycle air-braked cycle ergometer when compared with an SRM powermeter
Balmer, J., Davison, R., Coleman, D. and Bird, S. 2000. The validity of power output recorded during exercise performance tests using a Kingcycle air-braked cycle ergometer when compared with an SRM powermeter. International Journal of Sports Medicine. 21 (3), pp. 195-199.
Familiarisation and reliability of sprint test indices during laboratory and field assessment
Hopker, J., Coleman, D., Wiles, J. and Galbraith, A. 2009. Familiarisation and reliability of sprint test indices during laboratory and field assessment. Journal of Sports Science and Medicine. 8 (4), pp. 528-532.
Changes in cycling efficiency during a competitive season
Hopker, J., Coleman, D. and Passfield, L. 2009. Changes in cycling efficiency during a competitive season. Medicine & Science in Sports & Exercise. 41 (4), pp. 912-919.
Occurrence of injury during officer safety training at Kent Police
Andrew, J., Henry, T., Coleman, D. and Wiles, J. 2009. Occurrence of injury during officer safety training at Kent Police. The Police Journal. 82 (3), pp. 265-274.
Effect of the Rotor crank system on cycling performance
Jobson, S., Hopker, J., Galbraith, A., Coleman, D. and Nevill, A. 2009. Effect of the Rotor crank system on cycling performance. Journal of Sports Science and Medicine. 8 (3), pp. 463-467.
The effects of training on gross efficiency in cycling: a review
Hopker, J., Passfield, L., Coleman, D., Jobson, S., Edwards, L. and Carter, H. 2009. The effects of training on gross efficiency in cycling: a review. International Journal of Sports Medicine. 30 (12), pp. 845-850.
The effects of performing isometric training at two exercise intensities in healthy young males
Wiles, J., Coleman, D. and Swaine, I. 2010. The effects of performing isometric training at two exercise intensities in healthy young males. European Journal of Applied Physiology. 108 (3), pp. 419-428.
The effect of training volume and intensity on competitive cyclists’ efficiency
Hopker, J., Coleman, D., Passfield, L. and Wiles, J. 2010. The effect of training volume and intensity on competitive cyclists’ efficiency. Applied Physiology, Nutrition and Metabolism. 35 (1), pp. 17-22.
Reductions in resting blood pressure after 4 weeks of isometric exercise training
Devereux, G., Wiles, J. and Swaine, I. 2010. Reductions in resting blood pressure after 4 weeks of isometric exercise training. European Journal of Applied Physiology. 109 (4), pp. 601-606.
Effect of isometric exercise on resting blood pressure: a meta analysis
Owen, A., Wiles, J. and Swaine, I. 2010. Effect of isometric exercise on resting blood pressure: a meta analysis. Journal of Human Hypertension. 24 (12), pp. 796-800.
Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine
Swaine, I., Hunter, A., Carlton, K., Wiles, J. and Coleman, D. 2010. Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine. International Journal of Sports Medicine. 31 (12), pp. 854-859.
Identification of placebo responsive participants in 40km laboratory cycling performance
Beedie, C., Foad, A. and Coleman, D. 2008. Identification of placebo responsive participants in 40km laboratory cycling performance. Journal of Sports Science and Medicine. 7 (1), pp. 166-175.
Determination of the lactate minimum points in cyclists
Davison, R., Coleman, D. and Bird, S. 1997. Determination of the lactate minimum points in cyclists. Journal of Sports Sciences. 15, pp. 45-46.
Correlates of simulated hill climb cycling performance
Davison, R., Swan, D., Coleman, D. and Bird, S. 2000. Correlates of simulated hill climb cycling performance. Journal of Sports Sciences. 18 (2), pp. 105-110.
The effect of sodium bicarbonate ingestion on 1500-m racing time
Bird, S., Wiles, J. and Robbins, J. 1995. The effect of sodium bicarbonate ingestion on 1500-m racing time. Journal of Sports Sciences. 13 (5), pp. 399-403.
Activity levels, dietary energy intake, and body composition in children who walk to school
Ford, P., Bailey, R., Coleman, D., Woolf-May, K. and Swaine, I. 2007. Activity levels, dietary energy intake, and body composition in children who walk to school. Pediatric Exercise Science. 19 (4), pp. 393-407.
Pharmacological and psychological effects of caffeine ingestion in 40-km cycling performance
Foad, A., Beedie, C. and Coleman, D. 2008. Pharmacological and psychological effects of caffeine ingestion in 40-km cycling performance. Medicine and Science in Sports and Exercise. 40 (1), pp. 158-165.
Validity and reliability of the Ergomopro Powermeter
Kirkland, A., Coleman, D., Wiles, J. and Hopker, J. 2008. Validity and reliability of the Ergomopro Powermeter. International Journal of Sports Medicine. 29 (11), pp. 913-916.
The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test
Wiles, J., Allum, S., Coleman, D. and Swaine, I. 2007. The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test. Journal of Sports Sciences. 26 (2), pp. 155-162.
A novel method for the performance of isometric exercise in the home
Wiles, J., Coleman, D., Dunford, M. and Swaine, I. 2005. A novel method for the performance of isometric exercise in the home. Journal of Sports Sciences. 23 (8), pp. 795-803.
The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial
Wiles, J., Coleman, D., Tegerdine, M. and Swaine, I. 2006. The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial. Journal of Sports Sciences. 24 (11), pp. 1165-1171.
Validity and reliability of a new isometric hand dynamometer
Wiles, J., Boyson, H., Balmer, J. and Bird, S. 2001. Validity and reliability of a new isometric hand dynamometer. Sports Engineering. 4 (3), pp. 147-152.
Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels
Perkins, G., Owen, A., Swaine, I. and Wiles, J. 2006. Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels. European Journal of Applied Physiology. 98 (5), pp. 516-523.
Differences in efficiency between trained and recreational cyclists
Hopker, J., Coleman, D. and Wiles, J. 2007. Differences in efficiency between trained and recreational cyclists. Applied Physiology, Nutrition and Metabolism. 32 (6), pp. 1036-1042.
Method of lactate elevation does not affect the determination of the lactate minimum
Smith, M., Balmer, J., Coleman, D. and Bird, S. 2002. Method of lactate elevation does not affect the determination of the lactate minimum. Medicine & Science in Sports & Exercise. 34 (11), pp. 1744-1749.
Reliability of sprint test indices in well-trained cyclists
Coleman, D., Wiles, J., Nunn, M. and Smith, M. 2005. Reliability of sprint test indices in well-trained cyclists. International Journal of Sports Medicine. 26 (5), pp. 383-387.
Power output measurement during treadmill cycling
Coleman, D., Wiles, J., Davison, R., Smith, M. and Swaine, I. 2007. Power output measurement during treadmill cycling. International Journal of Sports Medicine. 28 (6), pp. 525-530.
Positive and negative placebo effects resulting from the deceptive administration of an ergogenic aid
Beedie, C., Coleman, D. and Foad, A. 2007. Positive and negative placebo effects resulting from the deceptive administration of an ergogenic aid. International Journal of Sports Nutrition and Exercise Metabolism. 17 (3), pp. 259-269.
Placebo effects of caffeine on cycling performance
Beedie, C., Stuart, E., Coleman, D. and Foad, A. 2006. Placebo effects of caffeine on cycling performance. Medicine & Science in Sports & Exercise. 38 (12), pp. 2159-2164.