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Abstract Skeletal muscle undergoes rapid and dynamic changes in energy demand during exercise, limiting the physiological relevance of resting-state measurements. Here, we demonstrate the feasibility of combining hyperpolarised ¹³C magnetic resonance spectroscopy (¹³C-MRS) with ³¹P-MRS to non-invasively measure real-time metabolic responses in exercising human skeletal muscle. Sedentary and endurance-trained men perform plantar-flexion exercise inside a magnetic resonance scanner.
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