Evidence map›Paper›PMID 42709152›Full record

ArticleEuropean journal of applied physiology2026

Network integration and evolution of organ systems interactions during incremental exercise.

Sergi Garcia-Retortillo, Óscar Abenza, Yaopeng J X Ma, Ladda Thiamwong, Hugo Posada-Quintero, Javier Pinzon-Arenas, Carla Leinbach, David H Fukuda, Plamen Ch Ivanov

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Article in European journal of applied physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sergi Garcia-RetortilloCollege of Nursing, University of Central Florida, Orlando, FL, USA.ORCID http://orcid.org/0000-0002-4867-1589
Óscar AbenzaFaculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.ORCID http://orcid.org/0000-0003-4735-1855
Yaopeng J X MaKeck Laboratory for Network Physiology, Department of Physics, Boston University, Boston, MA, USA.ORCID http://orcid.org/0009-0004-6484-0129
Ladda ThiamwongCollege of Nursing, University of Central Florida, Orlando, FL, USA.ORCID http://orcid.org/0000-0001-8506-5812
Hugo Posada-QuinteroBiomedical Engineering, University of Connecticut, Storrs, CT, USA.ORCID http://orcid.org/0000-0003-4514-4772
Javier Pinzon-ArenasBiomedical Engineering, University of Connecticut, Storrs, CT, USA.ORCID http://orcid.org/0000-0001-8521-2077
Carla LeinbachCollege of Nursing, University of Central Florida, Orlando, FL, USA.ORCID http://orcid.org/0009-0003-5829-7855
David H FukudaInstitute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA.ORCID http://orcid.org/0000-0002-4299-7764
Plamen Ch IvanovKeck Laboratory for Network Physiology, Department of Physics, Boston University, Boston, MA, USA. plamen@buphy.bu.edu.ORCID http://orcid.org/0000-0001-7629-762X

Funding

Translational Research Center, Wake Forest University (US) ID0576- -590006-U05244
6 · The paper itself

Abstract

purposeHuman function emerges from dynamic interactions among physiological systems. While decades of research have provided understanding of individual systems, how musculoskeletal, cardiovascular, and respiratory systems coordinate as an integrated network during exercise remains unclear. We characterized multisystem coordination during cardiopulmonary exercise test (CPET) of incremental cycling.

methodsTwenty-six young adults performed a graded cycling test until exhaustion (25 W/min). Continuous synchronized recordings included electromyography from bilateral vastus lateralis (Leg) and erector spinae (Back), three-lead electrocardiography, and respiratory waveform via chest belt. Multisystem coordination was assessed using Amplitude-Amplitude Cross-frequency Coupling (ACFC), which quantifies the dynamic co-modulation of signal amplitudes. ACFC yielded three network-based markers: inter-muscular, cardio-muscular, and respiratory-muscular coupling. Analyses compared the Beginning (first third) and End (last third) of the test.

resultsAt the Beginning, inter-muscular coupling was strongest within the Leg-Leg sub-network. At the End, Leg-Leg coupling decreased by ~30% (p < 0.05), whereas Leg-Back and Back-Back coupling increased by ~100-300% (p < 0.05). Cardio- and respiratory-muscular coupling also increased, by ~30% in Heart-Leg and ~50-75% in Respiration-Leg, with larger and significant increments in the Heart-Back and Respiration-Back sub-networks (p < 0.05).

conclusionIncremental cycling reorganizes multisystem coordination, shifting from leg-dominant toward a distributed muscle-heart-lung network with fatigue. Exercise responses thus arise not only from individual systems, but also from their dynamic coupling as an integrated network. These network markers provide a novel, complementary dimension for assessing integrative physiological function during exercise.

Indexed as

Cardio-muscular interactionsCardiopulmonary exercise testDynamic networksFatigueInter-muscular interactionsNetwork physiologyRespiratory-muscular interactions

Identifiers

PMID42709152

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.