Journal of Science and Medicine in Sport (2007) 10, 8995

ORIGINAL PAPER

Cardiovascular responses during recreational 5-a-side indoor-soccer

Carlo Castagna a,, Romualdo Belardinelli b, Franco M. Impellizzeri c, Grant A. Abt d, Aaron J. Coutts e, Stefano DOttavio a
a

School of Sport and Exercise Sciences, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy b Department of Cardiovascular Rehabilitation and Prevention, G.M. Lancisi Hospital, Ancona, Italy c Human Performance Laboratory, S.S. MAPEI srl, Via Don Minzoni 34, Castellanza, Varese, Italy d St. Martins College, Lancaster, United Kingdom e School of Leisure, Sport and Tourism, University of Technology, Sydney, Australia
Received 25 October 2005 ; received in revised form 9 May 2006; accepted 10 May 2006 KEYWORDS
Soccer; Physical tness; Heart rate; Intermittent exercise; Perceived exertion

Summary The aims of this study were to examine the cardiovascular response to recreational 5-a-side indoor-soccer (5v5) matches (5v5 study, 5v5S, n = 15) and to assess the validity of using heart rate (HR) to estimate oxygen uptake (VO2 ) demands during actual game-play (validity study, VS, n = 16) in young subjects (age 16.8 1.5 years). Game responses during 5v5S were assessed during 30 min matches using short-range telemetry heart-rate monitors. In VS games (12 min), VO2 and HR were monitored with a portable gas analyser (K4b2 , COSMED, Rome, Italy). Individual HRVO2 relationships were determined from a laboratory treadmill run to exhaustion (VS) and a multistage shuttle running tness test (5v5S) using K4b2 . Results showed that 5v5 elicits 83.5 5.4 and 75.3 11.2% of HRpeak and VO2peak , respectively. Ninety-one percent of the playing time (30 min) was spent at HR higher than 70% of HRpeak . In VS match, gas analyses revealed that only 71% of HR variance was explained by VO2 variations. However, playing at approximately 70% of HRpeak elicited 51.6 11.2% of VO2peak . Group actual versus predicted VO2 values demonstrated no signicant differences (p > 0.05), however, large condence limits were observed (+6.20 and 10.53 ml kg1 min1 ). These results show that HR and VO2 responses to recreational 5v5 soccer in young athletes are similar to the exercise intensities recommended by ACSM for promoting cardiovascular health and suggest that HR is valid to prescribe and monitor aerobic intermittent exercise. These results also show that HR measures are acceptable for estimating VO2 during intermittent exercise when assessing large groups, but show that large estimation errors can occur at the individual level. 2006 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Corresponding author at: Via Sparapani 30, 60131 Ancona, Italy. Tel.: +39 071 2866532; fax: +39 071 2866478. E-mail address: castagnac@libero.it (C. Castagna).

1440-2440/$ see front matter 2006 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jsams.2006.05.010

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C. Castagna et al. Since small-sided soccer training may be a viable choice for cardiovascular conditioning in the wider population, more research is required to determine if the training prescription criteria suggested by the ACSM can be applied to these gamebased activities. The guidelines for monitoring and prescribing the cardiovascular stress have been based on the heart rateoxygen uptake (HRVO2 ) relationship.1,9 In continuous, steady-state exercise the HRVO2 relationship has been found to be linear over a wide range of submaximal intensities.9 However, the validity of prescribing exercise intensities during intermittent exercise such as soccer on that basis of the HRVO2 relationship is not clearly understood. For example, some previous studies have reported that the estimate of oxygen uptake (VO2 ) from heart rate (HR) is likely to overstate the actual O2 consumption due to factors that cause HR to rise independently of VO2 (e.g. heat, emotional stress and static exercises).10 Moreover, in sports such as recreational soccer, HR have been observed to be elevated despite the apparent low work-rate during certain periods of a match.11 These discrepancies have been reported to be due to the non-orthodox activities involved in soccer match play such as changing direction, getting-up from the ground, backward/sideward-running or isometric muscular actions taking place occasionally during the game.12 Due to these concerns, it remains unclear whether intermittent exercise can be prescribed using the same recommendations that have been derived for continuous activities. Therefore, the aim of the present study was to examine the cardiovascular response during a recreational 5v5 match. Specically, we wanted to determine if playing 5v5 allowed players to reach and maintain an exercise intensity similar to the ACSM recommendations for the development of aerobic tness. In addition, we were also interested in examining the VO2 response in relation to the HR response in order to validate the use of HR as a reection of the oxygen uptake during intermittent exercise. We proposed that if the HRVO2 relationship during intermittent exercise was similar to that during continuous exercise, then the intensity of 5v5 could be condently prescribed using HR according to the ACSM recommendations for aerobic training.2

Introduction
The health and physical performance benets of increased aerobic tness have been widely reported.1 The American College of Sports Medicine (ACSM) reports aerobic tness is related to the incidence of cardiovascular disease in the general population, such that those with a higher aerobic tness may have reduced the risk for certain chronic degenerative diseases such as coronary heart disease, hypertension and obesity.1 Due to the nature of the oxygen uptake response during endurance exercise and the factors that govern the extent to which aerobic tness is optimally improved (e.g. intensity, duration and frequency), it is generally recommended that exercises of a continuous nature, such as jogging, running, cycling and swimming, are best suited for increasing aerobic tness.1,2 The ACSM recommend that exercise completed at an intensity of 5565% of an individuals maximal heart rate (HRmax ) or 4050% of heart rate reserve (HRR ) as being a minimal threshold for the development of aerobic tness in untrained individuals.1,2 A popular alternative to the continuous exercise modes suggested to be appropriate for the improvement of cardiovascular tness are recreational small-sided soccer games. The global popularity of recreational soccer offers signicant potential as a training mode that can be used to improve cardiovascular tness amongst the people who might not otherwise choose to participate in exercise.3 During the last decade, there have been several studies that have shown that intermittent exercise like small-sided soccer games may be useful for increasing cardiovascular tness.38 For example, Kohno et al.3 reported that lifelong (40 years) participation in 11-a-side soccer promoted aerobic tness in older individuals (age 60 years) with VO2max , values being significantly higher than age-matched untrained individuals. There are several advantages of using intermittent sports such as 5-a-side soccer (5v5) for cardiovascular training. In particular, participation is not inuenced by weather conditions (it is played indoors); games do not require a large playing area and more than 10 players can participate at once. To date, only a few studies have examined the physiological responses to small-sided soccer games with most of these investigating the physiological responses in experienced, well-trained and highly-motivated players.6 To our knowledge, there have been no published studies that have investigated the cardiovascular responses to small-sided soccer training in young recreational players.

Methods
Subjects
This study was conducted with high school students and was divided into two sections: (1) a descrip-

Cardiovascular responses during recreational 5-a-side indoor-soccer

Table 1 Characteristics of the subjects involved in this study (mean S.D.) 5v5S (n = 15) Age (years) Height (cm) Body mass (kg) 16.7 1.2 176 1.0 67.1 8.9 VS (n = 16) 16.9 1.8 177 7 68.8 6.3

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to meet at least two of the following criteria at exhaustion: HR 10 beats min1 of age-predicted maximal HR (220-age); respiratory exchange ratio higher than 1.1, levelling off of VO2 despite treadmill speed increase or MFT speed maintenance.21

5v5 matches
All 5v5 games included a goalkeeper and were completed on the same indoor-soccer court (dimensions: 30 m 15 m). The matches were 30 and 12 min for the 5v5S and VS, respectively. In order to keep game intensity as close as possible to normal recreational 5v5, players were not verbally encouraged or motivated either before or during games. However, the chief investigator was always available to immediately replace the ball when it was kicked out from the playing area. All matches were completed as part of each subjects high school physical education class and only one player was assessed during each match. These study 5v5 matches were played in similar environmental condition 20 1 C and 55 3% air humidity. Heart rate was recorded at every 5 s during the match play using short-range telemetry HR monitors (Polar 610i, Polar Electro Oy, Kempele, Finland) in both the 5v5S and VS studies. The HR recorded during the 30 min 5v5S matches were analysed using three heart-rate zones22 : (1) low-intensity zone (HR < 70% of individual HRpeak ), (2) moderateintensity zone (from 70 to 85% of HRpeak ) and (3) high-intensity zone (>85% HRpeak ). Time spent in the respective HR-zones was reported as a percentage of the total match duration. Oxygen uptake was measured throughout the 12 min 5v5 games in the VS study with K4b2 gas analyser. Twenty minutes after the end of each of the 5v5S matches,23,24 participants were asked to rate game perceived effort (RPE), according to the Borg category ratio (CR-10) scale.25

tion of the cardiovascular responses to 5v5 (5v5 study, 5v5S) and (2) the assessment of the validity of the HRVO2 relationship between intermittent and continuous exercise (validity study, VS). The subjects for the 5v5S (n = 15) and the VS (n = 16) were randomly chosen age matched high-school students. Characteristics of the subjects are shown in Table 1. 5v5S and VS subjects played recreational 5v5 (13 times/week) and 11-a-side competitive soccer (23 times/week), respectively. Ethical clearance was granted from the Ethical Committee of the Istituto Tecnico Industriale Vito Volterra and the Institutional Review Board of MAPEI Sport Service (Castellanza di Varese, Varese, Italy). Prior to the study, all subjects were informed both verbally and in writing of the purpose, about the potential risks and benets of the study. All subjects and their parents gave written informed consent prior to the commencement of the research. Prior to data collection all subjects were familiarised with the methods and procedures used.

Maximal aerobic power

Maximal cardiovascular values (i.e. VO2 and HR) of 5v5S subjects were determined using an exercise specic progressive maximal multistage eld test (Multistage Fitness Test, MFT).5,13,14 Many previous studies have shown the MFT to elicit peak physiological responses similar to values achieved in lab conditions.1317 The MFT was performed over the same playing surface area used for the 5v5 match assessments. VS peak physiological values (i.e. VO2 and HR) were assessed under laboratory conditions using a progressive multistage maximal running test (Bruce protocol18 ) on a motor-driven treadmill (T170, COSMED, Rome, Italy). All laboratory and eld gas analyses were performed using a COSMED portable gas analyser (K4b2 , COSMED) in order to improve data reliability. This analyser has previously been reported to be valid and reliable.19,20 The highest HR achieved at exhaustion for each test was considered the individual peak HR (HRpeak ). Peak oxygen uptake (VO2peak ) was considered as the mean of VO2 values detected during the last 15 s of exercise. All participants were able

Common testing procedures

Before each test subjects were instructed to perform a self-paced and self-administrated warm-up consisting of 510 min jogging followed by 5 min of gentle stretching. In both the 5v5S and VS, the participants were tted with HR monitors and the K4b2 gas analyser before warm-up. Participants were also allowed 23 min ball practice before the commencement of each of the 5v5 match. All testing sessions were administered in random order with at least 3 days apart. Assessments took place at the time corresponding to the usual training session (25 per month). Before each testing session, the K4b2 gas analyser was

92 calibrated according to the manufacturer guidance (COSMED K4b2 user manual, Rome). VO2peak reserve (VO2peakR ) was determined subtracting 3.5 ml kg1 min1 (1MET, resting metabolic rate2 ) from the individual level of maximal aerobic power. HRpeak reserve (HRpeakR ) was determined subtracting resting HR from the individual level of HRpeak . Morning resting HRs were self-determined by students with participants lying in bed (supine position, carotid pulse) just after awakening. Reliability of this procedure was assessed before the commencement of this study using the Bland and Altman procedures.26 No signicant bias was observed between measurements.

C. Castagna et al.

Statistics
Means and standard deviations (S.D.) were calculated for each variable. Before using parametric tests, the assumption of normality was veried using the ShapiroWilk W-test. Time spent in low-, moderate- and high-intensity HR zones during 5v5S matches were analysed using one-way ANOVA. Post hoc analysis was performed using Tukeys HSD test. HR validity in predicting VO2 responses was assessed using Pearsons productmoment correlation coefcients according to the methods described by Bot and Hollander27 Fishers rz transformations were considered when necessary. HRVO2 relationships were determined using linear regression analysis. The degree of association of RPE with VO2peak and mean match HR was assessed using Spearmans rho correlation coefcient. Within and between groups comparisons were performed using paired and unpaired t-tests, respectively. BlandAltman limits of agreement method26 was used to test the difference between cardiovascular responses during 5v5 and treadmill testing in order to test measurement bias. Heteroschedasticity was addressed for each BlandAltman calculation and log transformation of variables was considered if necessary. Signicance was set at p 0.05 a priori.
Figure 1 BlandAltman plot of difference between actual (Actual VO2 ) and estimated VO2 (Est VO2 ) vs. average of actual and estimated VO2 values collected during the 12 min of 5-a-side indoor-soccer. Bias, 2.17; limits of agreement, +6.20 and 10.53.

HRVO2 relationship
The mean correlation coefcient for match HRVO2 relationship in VS was r = 0.83 0.11. This value was signicantly different from the treadmill condition (r = 0.96 0.01, p < 0.001). Mean r values for the MFT HRVO2 relationships corresponded to 0.93 0.12 (p < 0.01). Estimated 5v5 VO2 and HRs from the treadmill HRVO2 relationships were similar to actual values (28.0 4.7 ml kg1 min1 versus 25.8 4.1 ml kg1 min1 and 135 20 beats min1 versus 139 18 beats min1 , respectively, p > 0.05). Fig. 1 shows the BlandAltman plot of treadmill versus actual-play VO2 .

5v5 matches
Mean match HR during the 5v5S was 166 13 beats min1 corresponding to 83.5 5.4% of the individual HRpeak . Using the HRVO2 relationship 5v5S participants were estimated to play at 75.3 11.2% (40.8 6.5 ml kg1 min1 ) of their VO2peak which corresponded to 76.6 6.7 and 74.2 10.8% of their HRpeakR and VO2peakR , respectively. Time spent in the three heart-rate zones during the 5v5S matches are presented in Table 2. No signicant differences were observed between times spent at moderate- and high-intensity during the matches (p > 0.05). During VS match play, the subjects attained 72.4 9.2 and 51.6 11.2% of HRpeak and VO2peak , respectively. This corresponded to 61.3 9.8 and

Results
VS and 5v5S subjects VO2peak were 50.8 6.4 and 53.8 7.8 ml kg1 min1 , respectively (p > 0.05). HRpeak for VS and 5v5S participants were 192 9 and 199 9 beats min1 , respectively. Resting HR were 58 3 and 55 2 beat min1 for 5v5S and VS subjects, respectively. During the MFT, the 5v5S group covered 1789 223 m. The estimated VO2max from the MFT13 resulted in signicantly lower than actual VO2peak (47.1 4.1 ml kg1 min1 , p < 0.001).

Cardiovascular responses during recreational 5-a-side indoor-soccer

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Table 2 Percentage of total playing time spent in low-intensity (<70% HRpeak ), moderate-intensity (7085% HRpeak ) and high-intensity (>85% HRpeak ) activities during a recreational 5-a-side indoor-soccer match (mean S.D.) Low-intensity Percentage of total time
*

Moderate-intensity 39.71 19.98*

High-intensity 50.90 26.07*

9.39 7.49

Signicantly different from low-intensity (p < 0.05).

47.2 11.1% of HRpeakR and VO2peakR , respectively. This result was signicantly different (p < 0.05) from that observed for the 5v5S. Mean post-match RPE in 5v5S was 4.1 0.8. RPE correlated signicantly with VO2peak (rho = 0.61, p < 0.05).

Discussion
The results of the present study show that recreational 5v5 may be an appropriate method for enhancing cardiovascular tness in high school students. In this study, the 5v5 players exercised at approximately 84% of their individual HRpeak . This HR intensity is higher than the minimum suggested for cardiovascular tness by the ACSM (5565% of HRmax ).1 Additionally, the recreational-match 5v5 players only spent 9% of the total playing time at intensities lower than 70% of HRpeak . The present results are similar to those reported by Miles et al.7 for female 4-a-side soccer who found average exercise intensities of approximately 85% of HRmax . In addition, Van Gool et al.28 reported match HRs ranging from 84.4 to 86.7% of HRmax for university team players during an 11-a-side ofcial match. However, both these 4- and 11-a-side studies were conducted during ofcial competition and thus HR responses may have been elevated by competitive stress.7 The oxygen cost (%VO2peak Est) estimated from the HRVO2 relationship during the 5v5 game in this study (75.3 11.2%) was similar to those reported for male and female 4-a-side soccer (80 and 74%, respectively).4,7 An interesting observation in this study was that despite the high mean HRs, global match RPEs were relatively low (between moderate and strong categories of 110 Borgs scale).25 This nding suggests that involvement in soccer match play may reduce a players perception of effort during exercise. Furthermore, the inverse relationship measured between VO2peak and RPE in this study also suggests that the individual level of aerobic tness can inuence a players perception of effort during match play. Nevertheless, since there was no signicant correlation between VO2peak and mean match HRs, it appears that subjects of high or low aerobic tness can equally benet from 5v5 recre-

ational indoor-soccer. However, it should be noted that these inferences are based on the assumption that HR may be regarded as a direct reection of aerobic involvement during actual match play. The HRVO2 regression determined in this study demonstrated that approximately 71% of HR variance might explain variation in VO2 while playing 5v5 indoor-soccer. This is a value that is signicantly different from that found for the same players while running on the treadmill at progressive speeds (r2 = 0.92, p < 0.001). These results agree with previous research27 and conrm that HR during intermittent eld physical activities may have a lower predictive ability of the actual aerobic involvement when compared to continuous exercise. Corroboration of that comes also from the analysis of the expected versus actual-play VO2 using the Bland and Altman plot that revealed individual differences as large as 8 ml kg1 min1 . This is line with Achten and Jeukendrup29 that reported that the estimation of VO2 from the treadmill HRVO2 relationships could be considered valid at group level, but could lead to large error when referred to the individual. Nevertheless, since we found that HR explained about 7174% of VO2 variance, it appears that HR monitoring may still be considered as a valid tool to monitor exercise intensity and aerobic involvement during small-sided soccer games. In this regard, the present results show that estimation of HR and VO2 , using treadmill HRVO2 relationships, were not signicantly different from actual 5v5 values support this inference. It is possible that emotional stress or other occasional, non-orthodox match activities such as backwardsideward-running, sprinting or isometric muscular actions10,11,30 may explain some of the differences in HR response in the 5v5 compared to continuous exercise. However, since we did not quantify this involvement, accurate comment is difcult. Further studies should be performed in order to spread a denitive light as to the reasons that alter HR responses during ball-games, namely activities characterized by bouts of exercise casually developing in terms of intensity and work-rest ratio over the duration of the game. In this study, VS players exercised at 72% of the individual HRpeak which corresponded to about 47% of their VO2peakR . This exercise intensity is within

94 the range (HRs and VO2 not lower than 55%/65% of HRmax or 4049% of VO2maxR , respectively) of the minimum exercise-intensity recommended by the ACSM1 for cardiovascular development in relatively t individuals. Resulting this, recreational 5v5 might be considered as an alternative exercise activity to promote cardiovascular tness in healthy individuals. The present results show that when monitoring HR in casually intermittent activities like 5v5, HRs may not estimate the true individual aerobic involvement. The ACSM1 have reported that exercising at 62, 70, 85 and 90% of HRmax corresponds to 50, 60, 80 and 85% of VO2max , respectively. The direct evaluation of 5v5 VO2 shows that when exercising at 72% of HRpeak players attained 51% of VO2peak . This gure differs remarkably from the %HRmax %VO2max relationship reported by ACSM that estimates the attainment of 60% VO2max when exercising at 70% of HRmax .1 The reason for such a difference may be attributable to the nature of the game that involves exercise bouts performed at various intensities interspersed with period of active or passive recovery.31 In this regard, Balsom et al.32 reported that recovery heart rate did not correspond to oxygen uptake during a repeated sprint protocol. To improve cardiovascular tness, subjects should play at intensities equal or higher than 70% of the individual HRpeak when playing recreational 5v5. However, since HR monitors may not be easily available for recreational soccer players, the Borg CR-10 scale may be used to monitor exercise intensity. In this study, we found that a Borg CR-10 scale rating of 4.0 corresponded to a work intensity of approximately 83% of HRpeak . Although further studies should be carried out in order to investigate the validity of external verbal cues for manipulating game intensities, we suggest that a rating of 4.0 on the Borg scale (moderatestrong) may be considered as a reference point for aerobic tness development in the general population when implementing recreational 5v5 indoor-soccer. In summary, the present results show that recreational 5v5 indoor games in high school students are typically played at an appropriate intensity for enhancing cardiovascular tness according to the previously suggested criteria.1,33 The present results also demonstrated that HR is an appropriate measure for prescribing and monitoring aerobic training during intermittent work such as soccer. This study also demonstrated that HR measures are acceptable for estimating VO2 during intermittent exercise when assessing large groups; however, there were large estimation errors in some players at the individual level. To examine whether and to

C. Castagna et al. what extent 5v5 playing may result in cardiovascular improvements in recreational healthy players, training studies should be implemented. In this regard, the dose-responses criteria should be accurately evaluated before prescribing 5v5 as health enhancing activity for the general population. Training studies that compare 5v5 with continuous exercise activities,34 such as cycling and running-jogging, would be of great interest in order to monitor the magnitude of aerobic-tness improvements and exercise related injury-rates.

Practical implications
Recreational 5-a-side soccer elicits cardiovascular responses useful for aerobic tness development in healthy young individuals. During game activities heart rate has a lower predictive ability of the actual aerobic involvement when compared to continuous exercise. Individual levels of aerobic tness are unrelated to 5-a-side cardiovascular responses.

Acknowledgement
There was no nancial assistance for this project.

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