Guided imagery, anxiety, heart rate, and heart rate variability during centrifuge training.

PubMed

Jing, Xiaolu; Wu, Ping; Liu, Fang; Wu, Bin; Miao, Danmin

2011-02-01

Centrifuge training is an important method of improving the hypergravity tolerance of pilots, cosmonauts, and Chinese astronauts. However, the concomitants of tension or anxiety often impede training. Guided imagery (GI), a mind-body relaxation technique, provides a behavioral and cognitive means whereby individuals are able to exert control over the focus of attention. This study aims to investigate the immediate effects of GI for reducing stress in centrifuge training. There were 12 healthy young men who were randomly assigned to a GI group or music group. We measured changes in heart rate during centrifuge training, in heart rate variability before and after centrifuge training, and also evaluated relaxation and anxiety in three phases: before intervention, after intervention, and following centrifuge training. The change in the pattern of anxiety was different in the two groups over the three phases. Anxiety (measured by State Anxiety Inventory) in the GI group changed from 31.7 +/- 5.9 to 26.8 +/- 2.6 and 27.8 +/- 4.1, whereas for the music group this changed from 32.2 +/- 7.6 to 31.2 +/- 8.3 and 26.8 +/- 6.8. During centrifuge training, the maximal HR for the GI group (101.2 +/- 8.8) was lower than that of the music group (123.0 +/- 19.1). In addition GI showed a decrease in low frequency (LF, 0.04-0.15 Hz) components and an increase in high frequency (HF, 0.15-0.4 Hz) components before and after centrifuge training. GI was capable of decreasing tension, anxiety, and sympathetic nervous system activity pre- or post-centrifugation.

A new beating-heart off-pump coronary artery bypass grafting training model.

PubMed

Bouma, Wobbe; Kuijpers, Michiel; Bijleveld, Aanke; De Maat, Gijs E; Koene, Bart M; Erasmus, Michiel E; Natour, Ehsan; Mariani, Massimo A

2015-01-01

Training models are essential in mastering the skills required for off-pump coronary artery bypass grafting (OPCAB). We describe a new, high-fidelity, effective and reproducible beating-heart OPCAB training model in human cadavers. Human cadavers were embalmed according to the 'Thiel method' which allows their long-term and repeated use. The training model was constructed by bilateral ligation of the pulmonary veins, cross-clamping of the aorta, positioning of an intra-aortic balloon pump (IABP) in the left ventricle (LV) through the apex (tightened with pledget-reinforced purse strings) and finally placing of a fluid line in the LV through the left atrial appendage (tightened with a pledget-reinforced purse string). The LV was filled with saline to the desired pressure through the fluid line and the IABP was switched on and set to a desired frequency [usually 60-80 beats per minute (bpm)]. A high-fidelity simulation has known limitations, but a more complex, realistic training environment with an actual beating (human) heart strengthens the entire training exercise and is of incremental value. All types of coronary artery anastomosis can be trained with this model. Training should be performed under the supervision of an experienced OPCAB surgeon and training progress is best evaluated with serial Objective Structured Assessment of Technical Skills (OSATS). A score of at least 48 points on the final OSATS ('good' on all components) is recommended before trainees can start their training on patients. The entire set-up provides a versatile training model to help develop and improve the skills required to safely perform beating heart OPCAB anastomoses. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Exercise Training for Heart Failure Patients with and without Systolic Dysfunction: An Evidence-Based Analysis of How Patients Benefit

PubMed Central

Smart, Neil

2011-01-01

Significant benefits can be derived by heart failure patients from exercise training. This paper provides an evidence-based assessment of expected clinical benefits of exercise training for heart failure patients. Meta-analyses and randomized, controlled trials of exercise training in heart failure patients were reviewed from a search of PubMed, Cochrane Controlled Trial Registry (CCTR), CINAHL, and EMBASE. Exercise training improves functional capacity, quality of life, hospitalization, and systolic and diastolic function in heart failure patients. Heart failure patients with preserved systolic function (HFnEF) participating in exercise training studies are more likely to be women and are 5–7 years older than their systolic heart failure (CHF) counterparts. All patients exhibit low functional capacities, although in HFnEF patients this may be age related, therefore subtle differences in exercise prescriptions are required. Published works report that exercise training is beneficial for heart failure patients with and without systolic dysfunction. PMID:20953365

A practical guide to exercise training for heart failure patients.

PubMed

Smart, Neil; Fang, Zhi You; Marwick, Thomas H

2003-02-01

Exercise training has been shown to improve exercise capacity in patients with heart failure. We sought to examine the optimal strategy of exercise training for patients with heart failure. Review of the published data on the characteristics of the training program, with comparison of physiologic markers of exercise capacity in heart failure patients and healthy individuals and comparison of the change in these characteristics after an exercise training program. Many factors, including the duration, supervision, and venue of exercise training; the volume of working muscle; the delivery mode (eg, continuous vs. intermittent exercise), training intensity; and the concurrent effects of medical treatments may influence the results of exercise training in heart failure. Starting in an individually prescribed and safely monitored hospital-based program, followed by progression to an ongoing and progressive home program of exercise appears to be the best solution to the barriers of anxiety, adherence, and "ease of access" encountered by the heart failure patient. Various exercise training programs have been shown to improve exercise capacity and symptom status in heart failure, but these improvements may only be preserved with an ongoing maintenance program.

The 'aerobic/resistance/inspiratory muscle training hypothesis in heart failure'.

PubMed

Laoutaris, Ioannis D

2018-01-01

Evidence from large multicentre exercise intervention trials in heart failure patients, investigating both moderate continuous aerobic training and high intensity interval training, indicates that the 'crème de la crème' exercise programme for this population remains to be found. The 'aerobic/resistance/inspiratory (ARIS) muscle training hypothesis in heart failure' is introduced, suggesting that combined ARIS muscle training may result in maximal exercise pathophysiological and functional benefits in heart failure patients. The hypothesis is based on the decoding of the 'skeletal muscle hypothesis in heart failure' and on revision of experimental evidence to date showing that exercise and functional intolerance in heart failure patients are associated not only with reduced muscle endurance, indication for aerobic training (AT), but also with reduced muscle strength and decreased inspiratory muscle function contributing to weakness, dyspnoea, fatigue and low aerobic capacity, forming the grounds for the addition of both resistance training (RT) and inspiratory muscle training (IMT) to AT. The hypothesis will be tested by comparing all potential exercise combinations, ARIS, AT/RT, AT/IMT, AT, evaluating both functional and cardiac indices in a large sample of heart failure patients of New York Heart Association class II-III and left ventricular ejection fraction ≤35% ad hoc by the multicentre randomized clinical trial, Aerobic Resistance, InSpiratory Training OutcomeS in Heart Failure (ARISTOS-HF trial).

Training-Load Distribution in Endurance Runners: Objective Versus Subjective Assessment.

PubMed

Manzi, Vincenzo; Bovenzi, Antonio; Castagna, Carlo; Sinibaldi Salimei, Paola; Volterrani, Maurizio; Iellamo, Ferdinando

2015-11-01

To assess the distribution of exercise intensity in long-distance recreational athletes (LDRs) preparing for a marathon and to test the hypothesis that individual perception of effort could provide training responses similar to those provided by standardized training methodologies. Seven LDRs (age 36.5 ± 3.8 y) were followed during a 5-mo training period culminating with a city marathon. Heart rate at 2.0 and 4.0 mmol/L and maximal heart rate were used to establish 3 intensity training zones. Internal training load (TL) was assessed by training zones and TRIMPi methods. These were compared with the session-rating-of-perceived-exertion (RPE) method. Total time spent in zone 1 was higher than in zones 2 and 3 (76.3% ± 6.4%, 17.3% ± 5.8%, and 6.3% ± 0.9%, respectively; P = .000 for both, ES = 0.98, ES = 0.99). TL quantified by session-RPE provided the same result. The comparison between session-RPE and training-zones-based methods showed no significant difference at the lowest intensity (P = .07, ES = 0.25). A significant correlation was observed between TL RPE and TL TRIMPi at both individual and group levels (r = .79, P < .001). There was a significant correlation between total time spent in zone 1 and the improvement at the running speed of 2 mmol/L (r = .88, P < .001). A negative correlation was found between running speed at 2 mmol/L and the time needed to complete the marathon (r = -.83, P < .001). These findings suggest that in recreational LDRs most of the training time is spent at low intensity and that this is associated with improved performances. Session-RPE is an easy-to-use training method that provides responses similar to those obtained with standardized training methodologies.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

PubMed Central

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; de Araújo, Thiago Cavalcante Vila Nova; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S.

2015-01-01

OBJECTIVE Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art. PMID:26735604

Peripheral muscle training with resistance exercise bands in patients with chronic heart failure. Long-term effects on walking distance and quality of life; a pilot study.

PubMed

Lans, Charlotta; Cider, Åsa; Nylander, Eva; Brudin, Lars

2018-04-01

This study aimed to describe a method of peripheral muscle training with resistance bands in patients with chronic heart failure (CHF) and to evaluate its effects on the 6 min walk test and quality of life up to 12 months using a home-based programme. Twenty-two patients with stable CHF (19 men and 3 women), mean age 63.2 years (SD 8.1), New York Heart Association class II-III were randomized to individual home-based training (HT group), or home-based training with a group-based start-up in a hospital setting (GT group). A 6 min walk test, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and Short Form with 36 items (SF-36) were administered at baseline and after 3, 6, 9, and 12 months. Exercise training resulted in statistically significant increased walking distance in both groups. The HT group increased on average 107 (80) m from baseline to 12 months, and the GT group by 100 (96) m. Health-related quality of life, measured with MLHFQ and SF-36, reached statistically significant improvements in both groups but at different time points. There were no statistically significant differences between groups on any parameters or follow-ups. Long-term home-based peripheral muscle training in patients with CHF, with or without an introductory period in a hospital setting, can be used for initial improvement and retention of walking distance and health-related quality of life. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Patient-specific pediatric silicone heart valve models based on 3D ultrasound

NASA Astrophysics Data System (ADS)

Ilina, Anna; Lasso, Andras; Jolley, Matthew A.; Wohler, Brittany; Nguyen, Alex; Scanlan, Adam; Baum, Zachary; McGowan, Frank; Fichtinger, Gabor

2017-03-01

PURPOSE: Patient-specific heart and valve models have shown promise as training and planning tools for heart surgery, but physically realistic valve models remain elusive. Available proprietary, simulation-focused heart valve models are generic adult mitral valves and do not allow for patient-specific modeling as may be needed for rare diseases such as congenitally abnormal valves. We propose creating silicone valve models from a 3D-printed plastic mold as a solution that can be adapted to any individual patient and heart valve at a fraction of the cost of direct 3D-printing using soft materials. METHODS: Leaflets of a pediatric mitral valve, a tricuspid valve in a patient with hypoplastic left heart syndrome, and a complete atrioventricular canal valve were segmented from ultrasound images. A custom software was developed to automatically generate molds for each valve based on the segmentation. These molds were 3D-printed and used to make silicone valve models. The models were designed with cylindrical rims of different sizes surrounding the leaflets, to show the outline of the valve and add rigidity. Pediatric cardiac surgeons practiced suturing on the models and evaluated them for use as surgical planning and training tools. RESULTS: Five out of six surgeons reported that the valve models would be very useful as training tools for cardiac surgery. In this first iteration of valve models, leaflets were felt to be unrealistically thick or stiff compared to real pediatric leaflets. A thin tube rim was preferred for valve flexibility. CONCLUSION: The valve models were well received and considered to be valuable and accessible tools for heart valve surgery training. Further improvements will be made based on surgeons' feedback.

Intensity level for exercise training in fibromyalgia by using mathematical models

PubMed Central

2010-01-01

Background It has not been assessed before whether mathematical models described in the literature for prescriptions of exercise can be used for fibromyalgia syndrome patients. The objective of this paper was to determine how age-predicted heart rate formulas can be used with fibromyalgia syndrome populations as well as to find out which mathematical models are more accurate to control exercise intensity. Methods A total of 60 women aged 18-65 years with fibromyalgia syndrome were included; 32 were randomized to walking training at anaerobic threshold. Age-predicted formulas to maximum heart rate ("220 minus age" and "208 minus 0.7 × age") were correlated with achieved maximum heart rate (HRMax) obtained by spiroergometry. Subsequently, six mathematical models using heart rate reserve (HRR) and age-predicted HRMax formulas were studied to estimate the intensity level of exercise training corresponding to heart rate at anaerobic threshold (HRAT) obtained by spiroergometry. Linear and nonlinear regression models were used for correlations and residues analysis for the adequacy of the models. Results Age-predicted HRMax and HRAT formulas had a good correlation with achieved heart rate obtained in spiroergometry (r = 0.642; p < 0.05). For exercise prescription in the anaerobic threshold intensity, the percentages were 52.2-60.6% HRR and 75.5-80.9% HRMax. Formulas using HRR and the achieved HRMax showed better correlation. Furthermore, the percentages of HRMax and HRR were significantly higher for the trained individuals (p < 0.05). Conclusion Age-predicted formulas can be used for estimating HRMax and for exercise prescriptions in women with fibromyalgia syndrome. Karnoven's formula using heart rate achieved in ergometric test showed a better correlation. For the prescription of exercises in the threshold intensity, 52% to 60% HRR or 75% to 80% HRMax must be used in sedentary women with fibromyalgia syndrome and these values are higher and must be corrected for trained patients. PMID:20307323

Training methods for horses: habituation to a frightening stimulus.

PubMed

Christensen, J W; Rundgren, M; Olsson, K

2006-09-01

Responses of horses in frightening situations are important for both equine and human safety. Considerable scientific interest has been shown in development of reactivity tests, but little effort has been dedicated to the development of appropriate training methods for reducing fearfulness. To investigate which of 3 different training methods (habituation, desensitisation and counter-conditioning) was most effective in teaching horses to react calmly in a potentially frightening situation. 1) Horses are able to generalise about the test stimulus such that, once familiar with the test stimulus in one situation, it appears less frightening and elicits a reduced response even when the stimulus intensity is increased or the stimulus is presented differently; and 2) alternative methods such as desensitisation and counter-conditioning would be more efficient than a classic habituation approach. Twenty-seven naive 2-year-old Danish Warmblood stallions were trained according to 3 different methods, based on classical learning theory: 1) horses (n = 9) were exposed to the full stimulus (a moving, white nylon bag, 1.2 x 0.75 m) in 5 daily training sessions until they met a predefined habituation criterion (habituation); 2) horses (n = 9) were introduced gradually to the stimulus and habituated to each step before the full stimulus was applied (desensitisation); 3) horses (n = 9) were trained to associate the stimulus with a positive reward before being exposed to the full stimulus (counter-conditioning). Each horse received 5 training sessions of 3 min per day. Heart rate and behavioural responses were recorded. Horses trained with the desensitisation method showed fewer flight responses in total and needed fewer training sessions to learn to react calmly to test stimuli. Variations in heart rate persisted even when behavioural responses had ceased. In addition, all horses on the desensitisation method eventually habituated to the test stimulus whereas some horses on the other methods did not. Desensitisation appeared to be the most effective training method for horses in frightening situations. Further research is needed in order to investigate the role of positive reinforcement, such as offering food, in the training of horses.

Heart Rate During Sleep: Implications for Monitoring Training Status

PubMed Central

Waldeck, Miriam R.; Lambert, Michael I.

2003-01-01

Resting heart rate has sometimes been used as a marker of training status. It is reasonable to assume that the relationship between heart rate and training status should be more evident during sleep when extraneous factors that may influence heart rate are reduced. Therefore the aim of the study was to assess the repeatability of monitoring heart rate during sleep when training status remained unchanged, to determine if this measurement had sufficient precision to be used as a marker of training status. The heart rate of ten female subjects was monitored for 24 hours on three occasions over three weeks whilst training status remained unchanged. Average, minimum and maximum heart rate during sleep was calculated. The average heart rate of the group during sleep was similar on each of the three tests (65 ± 9, 63 ± 6 and 67 ± 7 beats·min-1 respectively). The range in minimum heart rate variation during sleep for all subjects over the three testing sessions was from 0 to 10 beats·min-1 (mean = 5 ± 3 beats·min-1) and for maximum heart rate variation was 2 to 31 beats·min-1 (mean = 13 ± 9 beats·min-1). In summary it was found that on an individual basis the minimum heart rate during sleep varied by about 8 beats·min-1. This amount of intrinsic day-to-day variation needs to be considered when changes in heart rate that may occur with changes in training status are interpreted. PMID:24688273

Predominance of Intrinsic Mechanism of Resting Heart Rate Control and Preserved Baroreflex Sensitivity in Professional Cyclists after Competitive Training.

PubMed

Azevedo, Luciene Ferreira; Perlingeiro, Patricia; Hachul, Denise Tessariol; Gomes-Santos, Igor Lucas; Tsutsui, Jeane Mike; Negrao, Carlos Eduardo; De Matos, Luciana D N J

2016-01-01

Different season trainings may influence autonomic and non-autonomic cardiac control of heart rate and provokes specific adaptations on heart's structure in athletes. We investigated the influence of transition training (TT) and competitive training (CT) on resting heart rate, its mechanisms of control, spontaneous baroreflex sensitivity (BRS) and relationships between heart rate mechanisms and cardiac structure in professional cyclists (N = 10). Heart rate (ECG) and arterial blood pressure (Pulse Tonometry) were recorded continuously. Autonomic blockade was performed (atropine-0.04 mg.kg-1; esmolol-500 μg.kg-1 = 0.5 mg). Vagal effect, intrinsic heart rate, parasympathetic (n) and sympathetic (m) modulations, autonomic influence, autonomic balance and BRS were calculated. Plasma norepinephrine (high-pressure liquid chromatography) and cardiac structure (echocardiography) were evaluated. Resting heart rate was similar in TT and CT. However, vagal effect, intrinsic heart rate, autonomic influence and parasympathetic modulation (higher n value) decreased in CT (P≤0.05). Sympathetic modulation was similar in both trainings. The autonomic balance increased in CT but still showed parasympathetic predominance. Cardiac diameter, septum and posterior wall thickness and left ventricular mass also increased in CT (P<0.05) as well as diastolic function. We observed an inverse correlation between left ventricular diastolic diameter, septum and posterior wall thickness and left ventricular mass with intrinsic heart rate. Blood pressure and BRS were similar in both trainings. Intrinsic heart rate mechanism is predominant over vagal effect during CT, despite similar resting heart rate. Preserved blood pressure levels and BRS during CT are probably due to similar sympathetic modulation in both trainings.

Evaluation of Computer-Based Training for Health Workers in Echocardiography for RHD.

PubMed

Engelman, Daniel; Okello, Emmy; Beaton, Andrea; Selnow, Gary; Remenyi, Bo; Watson, Caroline; Longenecker, Chris T; Sable, Craig; Steer, Andrew C

2017-03-01

The implementation of screening for rheumatic heart disease at a population-scale would require a considerable increase in human resources. Training nonexpert staff in echocardiography requires appropriate methods and materials. This pre/post study aims to measure the change in the knowledge and confidence of a group of health workers after a computer-assisted training intervention in basic echocardiography for rheumatic heart disease. A syllabus of self-guided, computer-based modules to train nonexpert health workers in basic echocardiography for rheumatic heart disease was developed. Thirty-eight health workers from Uganda participated in the training. Using a pre/post design, identical test instruments were administered before and after the training intervention, assessing the knowledge (using multiple-choice questions) and confidence (using Likert scale questions) in clinical science and echocardiography. The mean total score on knowledge tests rose from 44.8% to 85.4% (mean difference: 40.6%, 95% confidence interval [CI]: 35.4% to 45.8%), with strong evidence for an increase in scores across all knowledge theme areas (p < 0.001). Increased confidence with each key aspect was reported, and there was strong evidence for an increase in the mean score for confidence scales in clinical science (difference: 7.1, 95% CI: 6.2 to 8.0; p < 0.001) and echocardiography (difference: 18.3, 95% CI: 16.6 to 20.0; p < 0.001). The training program was effective at increasing knowledge and confidence for basic echocardiography in nonexpert health workers. Use of computer-assisted learning may reduce the human resource requirements for training staff in echocardiography. Copyright © 2016 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

Quantifying Training Loads in Contemporary Dance.

PubMed

Jeffries, Annie C; Wallace, Lee; Coutts, Aaron J

2017-07-01

To describe the training demands of contemporary dance and determine the validity of using the session rating of perceived exertion (sRPE) to monitor exercise intensity and training load in this activity. In addition, the authors examined the contribution of training (ie, accelerometry and heart rate) and non-training-related factors (ie, sleep and wellness) to perceived exertion during dance training. Training load and ActiGraphy for 16 elite amateur contemporary dancers were collected during a 49-d period, using heart-rate monitors, accelerometry, and sRPE. Within-individual correlation analysis was used to determine relationships between sRPE and several other measures of training intensity and load. Stepwise multiple regressions were used to determine a predictive equation to estimate sRPE during dance training. Average weekly training load was 4283 ± 2442 arbitrary units (AU), monotony 2.13 ± 0.92 AU, strain 10677 ± 9438 AU, and average weekly vector magnitude load 1809,707 ± 1015,402 AU. There were large to very large within-individual correlations between training-load sRPE and various other internal and external measures of intensity and load. The stepwise multiple-regression analysis also revealed that 49.7% of the adjusted variance in training-load sRPE was explained by peak heart rate, metabolic equivalents, soreness, motivation, and sleep quality (y = -4.637 + 13.817%HR peak + 0.316 METS + 0.100 soreness + 0.116 motivation - 0.204 sleep quality). The current findings demonstrate the validity of the sRPE method for quantifying training load in dance, that dancers undertake very high training loads, and a combination of training and nontraining factors contribute to perceived exertion in dance training.

[Heart rate variability and physical exercise. Current status].

PubMed

Hottenrott, Kuno; Hoos, Olaf; Esperer, Hans Dieter

2006-09-01

Heart rate variability (HRV) has long been used in risk stratification for sudden cardiac death and diabetic autonomic neuropathy. In recent years, both time and frequency domain indices of HRV also gained increasing interest in sports and training sciences. In these fields, HRV is currently used for the noninvasive assessment of autonomic changes associated with short-term and long-term endurance exercise training in both leisure sports activity and high-performance training. Furthermore, HRV is being investigated as a diagnostic marker of overreaching and overtraining.A large body of evidence shows that, in healthy subjects and cardiovascular patients of all ages (up to an age of 70 years), regular aerobic training usually results in a significant improvement of overall as well as instantaneous HRV. These changes, which are accompanied by significant reductions in heart rates both at rest and during submaximal exercise, reflect an increase in autonomic efferent activity and a shift in favor of enhanced vagal modulation of the cardiac rhythm. Regular aerobic training of moderate volume and intensity over a minimum period of 3 months seems to be necessary to ensure these effects, which might be associated with a prognostic benefit regarding overall mortality.At present, available data does not allow for final conclusions with respect to the usefulness of traditional HRV indices in assessing an individual's exercise performance and monitoring training load. The discrepant results published so far are due to several factors including insufficient study size and design, and different HRV methods. Large-sized and prospectively designed studies are necessary for clarification. It also remains to be seen, whether the traditional HRV indices prove useful in the diagnosis of overreaching and overtraining. Preliminary results, though promising, need to be confirmed in larger cohorts.A basic problem in HRV analysis is nonstationarity of the heart rate signal, which holds particularly true for exercise conditions. Whether, in these conditions, more robust nonlinear HRV methods offer a benefit has to be established in further work.

Effect of educational program on quality of life of patients with heart failure: a randomized clinical trial.

PubMed

Lakdizaji, Sima; Hassankhni, Hadi; Mohajjel Agdam, Alireza; Khajegodary, Mohammad; Salehi, Rezvanieh

2013-03-01

Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22) received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22) received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

[Study on anti +Gx respiratory maneuver and its training method].

PubMed

Xue, Yue-ying; You, Guang-xing; Wu, Bin; Liu, Xing-hua; Lu, Sheng-qiang; Xie, Bao-sheng

2002-12-01

Objective. To study the anti +Gx respiratory maneuver and its training method. Method. Seven young male subjects undertook the anti +Gx respiratory maneuver training. Their +Gx tolerances were examined on human centrifuge before and after training. The change of respiratory type, breath rate, electrocardiogram, heart rate, arterial oxygen saturation (SaO2), subjective symptom and vision were real-time monitored during the +Gx tolerance examination. Result. Compared with pre-training, the +Gx tolerance increased after training (P<0.05). Dyspnea and chest pain disappeared or obviously lightened and the magnitude of decrease of SaO2 decreased significantly (P<0.05). Conclusion. The above results suggested that the anti +Gx respiratory maneuver can effectively eliminate or alleviate dyspnea and chest pain induced by +Gx stress and increase human +Gx tolerance.

[Hypertension and exercise. Sports methods for the hypertensive patient].

PubMed

Thiele, Holger; Pohlink, Carla; Schuler, Gerhard

2004-06-01

Physical exercise is of paramount therapeutic importance in nonpharmacological interventions of arterial hypertension. The extent and the effects of exercise on blood pressure lowering are analyzed according to the actual literature. Suitable and nonsuitable activities are considered. Dynamic isotonic endurance training is more effective than static isometric exercise. A rather low or moderate extent of endurance training lowers the systolic and diastolic blood pressure by approximately 5-11 mmHg and 3-8 mmHg, respectively. This effect of exercise can be achieved besides the favorable effects on other cardiovascular risk factors. Intensity of exercise should be monitored by the heart rate. The mean intensity should not exceed 70% of the maximal heart rate. An initial ergometry might be suitable for the planning of training recommendations.

Heart-Rate Recovery After Warm-up in Swimming: A Useful Predictor of Training Heart-Rate Response?

PubMed

Ganzevles, Sander P M; de Haan, Arnold; Beek, Peter J; Daanen, Hein A M; Truijens, Martin J

2017-07-01

For training to be optimal, daily training load has to be adapted to the momentary status of the individual athlete, which is often difficult to establish. Therefore, the current study investigated the predictive value of heart-rate recovery (HRR) during a standardized warm-up for training load. Training load was quantified by the variation in heart rate during standardized training in competitive swimmers. Eight female and 5 male Dutch national-level swimmers participated in the study. They all performed 3 sessions consisting of a 300-m warm-up test and a 10 × 100-m training protocol. Both protocols were swum in front crawl at individually standardized velocities derived from an incremental step test. Velocity was related to 75% and 85% heart-rate reserve (% HR res ) for the warm-up and training, respectively. Relative HRR during the first 60 s after the warm-up (HR Rw-up ) and differences between the actual and intended heart rate for the warm-up and the training (ΔHR w-up and ΔHR tr ) were determined. No significant relationship between HRR w-up and ΔHR tr was found (F 1,37 = 2.96, P = .09, R 2 = .07, SEE = 4.65). There was considerable daily variation in ΔHR tr at a given swimming velocity (73-93% HR res ). ΔHR w-up and ΔHR tr were clearly related (F 1,37 = 74.31, P < .001, R 2 = .67, SEE = 2.78). HRR after a standardized warm-up does not predict heart rate during a directly subsequent and standardized training session. Instead, heart rate during the warm-up protocol seems a promising alternative for coaches to make daily individual-specific adjustments to training programs.

Effects of medical training scenarios on heart rate variability and motivation in students and simulated patients.

PubMed

Rieber, Nicole; Betz, Lisa; Enck, Paul; Muth, Eric; Nikendei, Christoph; Schrauth, Markus; Werner, Anne; Kowalski, Axel; Zipfel, Stephan

2009-06-01

Research regarding the experience of stress during medical training scenarios using standardised patients (SPs) has been primarily qualitative and has focused on the SPs. The purpose of this study was to quantitatively evaluate stress and motivation in both students and SPs during these scenarios by measuring heart rate variability (HRV) and administering the German version of the Questionnaire on Current Motivation (QCM). A total of 44 medical students (23 women, 21 men) participated in two medical history-taking training scenarios. In one scenario the SP role-played a patient with a somatic disease; in the other the SP played a patient with a psychosomatic disease, creating easy and difficult scenarios, respectively, for the student. Each student interviewed one of 11 SPs (five women, six men), using the same SP in both scenarios. Heart rate variability was measured during baseline periods and during the training scenarios in both students and SPs. Motivation was assessed before each training scenario. Heart rate variability was lower in both students and SPs during the scenarios compared with baseline values, but did not differ by scenario type. For students, motivation increased when the first scenario involved psychosomatic illness, but decreased when the first condition was somatic. For SPs motivation was consistent over time for scenarios involving psychosomatic disease, but decreased for somatic disease-related scenarios. The training scenarios induced stress in both students and SPs, as indicated by decreased HRV. Student motivation was high, indicating that SP scenarios represent a valid teaching method. Further studies in the natural setting of SP examinations are needed.

Application of Artificial Neural Networks in the Heart Electrical Axis Position Conclusion Modeling

NASA Astrophysics Data System (ADS)

Bakanovskaya, L. N.

2016-08-01

The article touches upon building of a heart electrical axis position conclusion model using an artificial neural network. The input signals of the neural network are the values of deflections Q, R and S; and the output signal is the value of the heart electrical axis position. Training of the network is carried out by the error propagation method. The test results allow concluding that the created neural network makes a conclusion with a high degree of accuracy.

The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials.

PubMed

Hollings, Matthew; Mavros, Yorgi; Freeston, Jonathan; Fiatarone Singh, Maria

2017-08-01

Design We aimed to evaluate the effect of progressive resistance training on cardiorespiratory fitness and muscular strength in coronary heart disease, when compared to control or aerobic training, and when combined with aerobic training. Secondary aims were to evaluate the safety and efficacy of progressive resistance training on other physiological and clinical outcomes. Methods and results Electronic databases were searched from inception until July 2016. Designs included progressive resistance training vs control, progressive resistance training vs aerobic training, and combined training vs aerobic training. From 268,778 titles, 34 studies were included (1940 participants; 71.9% male; age 60 ± 7 years). Progressive resistance training was more effective than control for lower (standardized mean difference 0.57, 95% confidence interval (0.17-0.96)) and upper (1.43 (0.73-2.13)) body strength. Aerobic fitness improved similarly after progressive resistance training (16.9%) or aerobic training (21.0%); (standardized mean difference -0.13, 95% confidence interval (-0.35-0.08)). Combined training was more effective than aerobic training for aerobic fitness (0.21 (0.09-0.34), lower (0.62 (0.32-0.92)) and upper (0.51 (0.27-0.74)) body strength. Twenty studies reported adverse event information, with five reporting 64 cardiovascular complications, 63 during aerobic training. Conclusion Isolated progressive resistance training resulted in an increase in lower and upper body strength, and improved aerobic fitness to a similar degree as aerobic training in coronary heart disease cohorts. Importantly, when progressive resistance training was added to aerobic training, effects on both fitness and strength were enhanced compared to aerobic training alone. Reporting of adverse events was poor, and clinical gaps were identified for women, older adults, high intensity progressive resistance training and long-term outcomes, warranting future trials to confirm safety and effectiveness.

Effect of Heart Rate Variability Biofeedback on Sport Performance, a Systematic Review.

PubMed

Jiménez Morgan, Sergio; Molina Mora, José Arturo

2017-09-01

Aim is to determine if the training with heart rate variability biofeedback allows to improve performance in athletes of different disciplines. Methods such as database search on Web of Science, SpringerLink, EBSCO Academic Search Complete, SPORTDiscus, Pubmed/Medline, and PROQUEST Academic Research Library, as well as manual reference registration. The eligibility criteria were: (a) published scientific articles; (b) experimental studies, quasi-experimental, or case reports; (c) use of HRV BFB as main treatment; (d) sport performance as dependent variable; (e) studies published until October 2016; (f) studies published in English, Spanish, French or Portuguese. The guidelines of the PRISMA statement were followed. Out of the 451 records found, seven items were included. All studies had a small sample size (range from 1 to 30 participants). In 85.71% of the studies (n = 6) the athletes enhanced psychophysiological variables that allowed them to improve their sport performance thanks to training with heart rate variability biofeedback. Despite the limited amount of experimental studies in the field to date, the findings suggest that heart rate variability biofeedback is an effective, safe, and easy-to-learn and apply method for both athletes and coaches in order to improve sport performance.

What Is a Day's Work? A Personnel Practices Guide for Household Employees and Employers.

ERIC Educational Resources Information Center

Bowen, Uvelia S. A.

The guide presents the policies of the Household Employment Association for Reevaluation and Training (HEART) for upgrading the status of household employment. An overview is given of the association's methods of recruitment, training (in its licensed, private trade school), community education, job development, and post-placement counseling. The…

The "Athlete's Heart": relation to gender and race.

PubMed

Di Paolo, F M; Pelliccia, Antonio

2007-08-01

Long-term athletic training is associated with changes in cardiac morphology, commonly described as "athlete's heart." Although numerous studies have investigated the effects of training on cardiac dimensions, most are limited to male Caucasian athletes, and few data are available regarding the effect of long-term exercise training on the woman's heart. This article reviews the athlete's heart in relation to gender and race.

How do cardiorespiratory fitness improvements vary with physical training modality in heart failure patients? A quantitative guide

PubMed Central

Smart, Neil A

2013-01-01

BACKGROUND: Peak oxygen consumption (VO2) is the gold standard measure of cardiorespiratory fitness and a reliable predictor of survival in chronic heart failure patients. Furthermore, any form of physical training usually improves cardiorespiratory fitness, although the magnitude of improvement in peak VO2 may vary across different training prescriptions. OBJECTIVE: To quantify, and subsequently rank, the magnitude of improvement in peak VO2 for different physical training prescriptions using data from published meta-analyses and randomized controlled trials. METHODS: Prospective randomized controlled parallel trials and meta-analyses of exercise training in chronic heart failure patients that provided data on change in peak VO2 for nine a priori comparative analyses were examined. RESULTS: All forms of physical training were beneficial, although the improvement in peak VO2 varied with modality. High-intensity interval exercise yielded the largest increase in peak VO2, followed in descending order by moderate-intensity aerobic exercise, functional electrical stimulation, inspiratory muscle training, combined aerobic and resistance training, and isolated resistance training. With regard to setting, the present study was unable to determine whether outpatient or unsupervised home exercise provided greater benefits in terms of peak VO2 improvment. CONCLUSIONS: Interval exercise is not suitable for all patients, especially the high-intensity variety; however, when indicated, this form of exercise should be adopted to optimize peak VO2 adaptations. Other forms of activity, such as functional electrical stimulation, may be more appropriate for patients who are not capable of high-intensity interval training, especially for severely deconditioned patients who are initially unable to exercise. PMID:24294043

Heart rate recovery and heart rate variability are unchanged in patients with coronary artery disease following 12 weeks of high-intensity interval and moderate-intensity endurance exercise training.

PubMed

Currie, Katharine D; Rosen, Lee M; Millar, Philip J; McKelvie, Robert S; MacDonald, Maureen J

2013-06-01

Decreased heart rate variability and attenuated heart rate recovery following exercise are associated with an increased risk of mortality in cardiac patients. This study investigated the effects of 12 weeks of moderate-intensity endurance exercise (END) and a novel low-volume high-intensity interval exercise protocol (HIT) on measures of heart rate recovery and heart rate variability in patients with coronary artery disease (CAD). Fourteen males with CAD participated in 12 weeks of END or HIT training, each consisting of 2 supervised exercise sessions per week. END consisted of 30-50 min of continuous cycling at 60% peak power output (PPO). HIT involved ten 1-min intervals at 88% PPO separated by 1-min intervals at 10% PPO. Heart rate recovery at 1 min and 2 min was measured before and after training (pre- and post-training, respectively) using a submaximal exercise bout. Resting time and spectral and nonlinear domain measures of heart rate variability were calculated. Following 12 weeks of END and HIT, there was no change in heart rate recovery at 1 min (END, 40 ± 12 beats·min(-1) vs. 37 ± 19 beats·min(-1); HIT, 31 ± 8 beats·min(-1) vs. 35 ± 8 beats·min(-1); p ≥ 0.05 for pre- vs. post-training) or 2 min (END, 44 ± 18 beats·min(-1) vs. 43 ± 19 beats·min(-1); HIT, 42 ± 10 beats·min(-1) vs. 50 ± 6 beats·min(-1); p ≥ 0.05 for pre- vs. post-training). All heart rate variability indices were unchanged following END and HIT training. In conclusion, neither END nor HIT exercise programs elicited training-induced improvements in cardiac autonomic function in patients with CAD. The absence of improvements with training may be attributed to the optimal medical management and normative pretraining state of our sample.

Utility of the Conconi's heart rate deflection to monitor the intensity of aerobic training.

PubMed

Passelergue, Philippe A; Cormery, Bruno; Lac, Gérard; Léger, Luc A

2006-02-01

The Conconi's heart-rate deflection point (HRd) in the heart rate (HR)/speed curve is often used to set aerobic training loads. Training could either be set in percentage running speed or HR at HRd. In order to establish the limits and usefulness of various aerobic-training modalities for intermediate athletic level (physical-education students), acute responses were analyzed while running for a typical 40-minute training session. Speed, HR, lactate, and cortisol were thus recorded during training at 90 and 100% of running speed (RS: n = 14) and HR (HR: n = 16) at HRd (90% running speed [RS90], 100% running speed [RS100], 90% HR [HR90], and 100% HR [HR100]). During constant HR training, RS decreases while HR drifts upward during constant RS training. Half of the subjects can not finish the 40-minute RS100 session. For HR90, RS90, HR100, and RS100, average intensities are 67, 69, 74.9, and 77% maximal aerobic speed (multistage test), respectively. This study indicates that (1) training at HR100 and RS100 is more appropriate to improve high-intensity metabolic capacities (increased cortisol and lactate) while RS100 is too difficult to be maintained for 40 minutes for subjects at that level at least, (2) training at HR90, however, is better to improve endurance and capacity to do a large amount of work considering cortisol and lactate homeostasis, and (3) training at a constant HR using a HR monitor is a good method to control the intensity of the training with subjects not used to pacing themselves with the split-time approach.

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

PubMed Central

2010-01-01

Background Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incomplete spinal cord injury (iSCI). Methods Eleven patients with iSCI participated in a single training session with the gait rehabilitation robot Lokomat. The patients were exposed to four different training modes in random order: During both non-cooperative position control and compliant impedance control, fixed timing of movements was provided. During two variants of the patient-cooperative path control approach, free timing of movements was enabled and the robot provided only spatial guidance. The two variants of the path control approach differed in the amount of additional support, which was either individually adjusted or exaggerated. Joint angles and torques of the robot as well as muscle activity and heart rate of the patients were recorded. Kinematic variability, interaction torques, heart rate and muscle activity were compared between the different conditions. Results Patients showed more spatial and temporal kinematic variability, reduced interaction torques, a higher increase of heart rate and more muscle activity in the patient-cooperative path control mode with individually adjusted support than in the non-cooperative position control mode. In the compliant impedance control mode, spatial kinematic variability was increased and interaction torques were reduced, but temporal kinematic variability, heart rate and muscle activity were not significantly higher than in the position control mode. Conclusions Patient-cooperative robot-aided gait training with free timing of movements made individuals with iSCI participate more actively and with larger kinematic variability than non-cooperative, position-controlled robot-aided gait training. PMID:20828422

Training auscultatory skills: computer simulated heart sounds or additional bedside training? A randomized trial on third-year medical students

PubMed Central

2010-01-01

Background The present study compares the value of additional use of computer simulated heart sounds, to conventional bedside auscultation training, on the cardiac auscultation skills of 3rd year medical students at Oslo University Medical School. Methods In addition to their usual curriculum courses, groups of seven students each were randomized to receive four hours of additional auscultation training either employing a computer simulator system or adding on more conventional bedside training. Cardiac auscultation skills were afterwards tested using live patients. Each student gave a written description of the auscultation findings in four selected patients, and was rewarded from 0-10 points for each patient. Differences between the two study groups were evaluated using student's t-test. Results At the auscultation test no significant difference in mean score was found between the students who had used additional computer based sound simulation compared to additional bedside training. Conclusions Students at an early stage of their cardiology training demonstrated equal performance of cardiac auscultation whether they had received an additional short auscultation course based on computer simulated training, or had had additional bedside training. PMID:20082701

The dynamic cardiac biosimulator: A method for training physicians in beating-heart mitral valve repair procedures.

PubMed

Leopaldi, Alberto M; Wrobel, Krzysztof; Speziali, Giovanni; van Tuijl, Sjoerd; Drasutiene, Agne; Chitwood, W Randolph

2018-01-01

Previously, cardiac surgeons and cardiologists learned to operate new clinical devices for the first time in the operating room or catheterization laboratory. We describe a biosimulator that recapitulates normal heart valve physiology with associated real-time hemodynamic performance. To highlight the advantages of this simulation platform, transventricular extruded polytetrafluoroethylene artificial chordae were attached to repair flail or prolapsing mitral valve leaflets. Guidance for key repair steps was by 2-dimensional/3-dimensional echocardiography and simultaneous intracardiac videoscopy. Multiple surgeons have assessed the use of this biosimulator during artificial chordae implantations. This simulation platform recapitulates normal and pathologic mitral valve function with associated hemodynamic changes. Clinical situations were replicated in the simulator and echocardiography was used for navigation, followed by videoscopic confirmation. This beating heart biosimulator reproduces prolapsing mitral leaflet pathology. It may be the ideal platform for surgeon and cardiologist training on many transcatheter and beating heart procedures. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

The Impact of Learning Style on Healthcare Providers' Preference for Voice Advisory Manikins versus Live Instructors in Basic Life Support Training

ERIC Educational Resources Information Center

DiGiovanni, Lisa Marie

2013-01-01

The American Heart Association's HeartCode[TM] Healthcare Provider (HCP) Basic Life Support (BLS) e-learning program with voice-advisory manikins was implemented in an acute care hospital as the only teaching method offered for BLS certification. On course evaluations, healthcare provider staff commented that the VAM technology for skills practice…

The effects of baseline heart rate recovery normality and exercise training protocol on heart rate recovery in patients with heart failure.

PubMed

Yaylalı, Yalın Tolga; Fındıkoğlu, Gülin; Yurtdaş, Mustafa; Konukçu, Sibel; Şenol, Hande

2015-09-01

It is unclear which exercise training protocol yields superior heart rate recovery (HRR) improvement in heart failure (HF) patients. Whether baseline HRR normality plays a role in the improvement is unknown. We hypothesized that an exercise training protocol and baseline HRR normality would be factors in altering HRR in HF patients. In this prospective, randomized, controlled and 3 group parallel study, 41 stable HF patients were randomly assigned to 3-times-weekly training sessions for 12 weeks, consisting of i) 30 minutes of interval training (IT) (n=17, 63.7±8.8 years old) versus ii) 30 minutes of continuous training (CT) (n=13, 59.6±6.8 years old) versus iii) no training (CON) (n=11, 60.6±9.9 years old). Each patient had cardiopulmonary exercise testing before and after the training program. Maximum heart rates attained during the test and heart rates at 1 and 2 min (HRR1 and HRR2) during the recovery phase were recorded. Paired samples t-test or Wilcoxon signed-rank test was used for comparisons before and after training. One-way ANOVA or Kruskal-Wallis variance analysis was used for comparisons among groups. HRR1 was unchanged after training. HRR2 improved in the IT group after training, and post-training HRR2 values were significantly faster in the IT group than in controls. Both HRR1 and HRR2 was significantly faster, irrespective of exercise protocol in patients with abnormal baseline values after training. HRR1 did not improve after training. HRR2 improved only in the IT group. Both HRRs in patients with abnormal baseline values improved after both exercise protocols. IT might be superior to CT in improving HRR2. Baseline HRR might play a role in its response to exercise.

Combining deep learning and level set for the automated segmentation of the left ventricle of the heart from cardiac cine magnetic resonance.

PubMed

Ngo, Tuan Anh; Lu, Zhi; Carneiro, Gustavo

2017-01-01

We introduce a new methodology that combines deep learning and level set for the automated segmentation of the left ventricle of the heart from cardiac cine magnetic resonance (MR) data. This combination is relevant for segmentation problems, where the visual object of interest presents large shape and appearance variations, but the annotated training set is small, which is the case for various medical image analysis applications, including the one considered in this paper. In particular, level set methods are based on shape and appearance terms that use small training sets, but present limitations for modelling the visual object variations. Deep learning methods can model such variations using relatively small amounts of annotated training, but they often need to be regularised to produce good generalisation. Therefore, the combination of these methods brings together the advantages of both approaches, producing a methodology that needs small training sets and produces accurate segmentation results. We test our methodology on the MICCAI 2009 left ventricle segmentation challenge database (containing 15 sequences for training, 15 for validation and 15 for testing), where our approach achieves the most accurate results in the semi-automated problem and state-of-the-art results for the fully automated challenge. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Heart sounds analysis using probability assessment.

PubMed

Plesinger, F; Viscor, I; Halamek, J; Jurco, J; Jurak, P

2017-07-31

This paper describes a method for automated discrimination of heart sounds recordings according to the Physionet Challenge 2016. The goal was to decide if the recording refers to normal or abnormal heart sounds or if it is not possible to decide (i.e. 'unsure' recordings). Heart sounds S1 and S2 are detected using amplitude envelopes in the band 15-90 Hz. The averaged shape of the S1/S2 pair is computed from amplitude envelopes in five different bands (15-90 Hz; 55-150 Hz; 100-250 Hz; 200-450 Hz; 400-800 Hz). A total of 53 features are extracted from the data. The largest group of features is extracted from the statistical properties of the averaged shapes; other features are extracted from the symmetry of averaged shapes, and the last group of features is independent of S1 and S2 detection. Generated features are processed using logical rules and probability assessment, a prototype of a new machine-learning method. The method was trained using 3155 records and tested on 1277 hidden records. It resulted in a training score of 0.903 (sensitivity 0.869, specificity 0.937) and a testing score of 0.841 (sensitivity 0.770, specificity 0.913). The revised method led to a test score of 0.853 in the follow-up phase of the challenge. The presented solution achieved 7th place out of 48 competing entries in the Physionet Challenge 2016 (official phase). In addition, the PROBAfind software for probability assessment was introduced.

Comparison of the Physical and Technical Demands of Cricket Players During Training and Match-Play.

PubMed

Vickery, Will; Duffield, Rob; Crowther, Rian; Beakley, David; Blanch, Peter; Dascombe, Ben J

2018-03-01

Vickery, W, Duffield, R, Crowther, R, Beakley, D, Blanch, P, and Dascombe, BJ. Comparison of the physical and technical demands of cricket players during training and match-play. J Strength Cond Res 32(3): 821-829, 2018-This study aimed to determine which training method (net-based sessions or center-wicket simulations) currently used in national level and U19 male players cricket provided a more physical and technical match-specific training response. The heart rate, rating of perceived exertion, and movement patterns of 42 male cricket players were measured across the various training and match formats. Video analysis was coded retrospectively to quantify technical loads based on the cricket skills performed. Magnitude-based inferences were based on the standardization of effect and presented with ±90% confidence intervals. Regardless of playing position, differences in physiological demands between training modes and match-play were unclear, with the exception of higher heart rates in fielders during traditional net sessions (mean heart rate: d = -2.7 [-4.7 to -0.7]; 75% of maximum heart rate: d = -1.7 [-3.2 to -0.2]). Typically, the movement demands of center-wicket simulations were similar or greater than match-play, which was most evident in the distance traveled at a high intensity within each playing position (batsmen: d = 6.4 [3.7-9.2]; medium-fast bowlers: d = 1.71 [0.1-3.3]; spin bowlers: d = 6.5 [0.01-13.0]; fielders: d = 0.8 [-0.2 to 1.7]). The technical demands of traditional net cricket training exceeded that of a typical match for each playing position. Specifically, fast bowlers delivered a greater number of balls during net-bowling compared with a match (d = -2.2 [-3.6 to 0.9]). In conclusion, center-wicket simulations more closely matched the physical demands of a One-Day match within batsmen and spin bowlers, whereas traditional cricket training often exceeded match-specific demands.

Evaluating a robust contour tracker on echocardiographic sequences.

PubMed

Jacob, G; Noble, J A; Mulet-Parada, M; Blake, A

1999-03-01

In this paper we present an evaluation of a robust visual image tracker on echocardiographic image sequences. We show how the tracking framework can be customized to define an appropriate shape space that describes heart shape deformations that can be learnt from a training data set. We also investigate energy-based temporal boundary enhancement methods to improve image feature measurement. Results are presented demonstrating real-time tracking on real normal heart motion data sequences and abnormal synthesized and real heart motion data sequences. We conclude by discussing some of our current research efforts.

3D Heart: a new visual training method for electrocardiographic analysis.

PubMed

Olson, Charles W; Lange, David; Chan, Jack-Kang; Olson, Kim E; Albano, Alfred; Wagner, Galen S; Selvester, Ronald H S

2007-01-01

This new training method is based on developing a sound understanding of the sequence in which electrical excitation spreads through both the normal and the infarcted myocardium. The student is made aware of the cardiac electrical performance through a series of 3-dimensional pictures during the excitation process. The electrocardiogram 3D Heart 3-dimensional program contains a variety of different activation simulations. Currently, this program enables the user to view the activation simulation for all of the following pathology examples: normal activation; large, medium, and small anterior myocardial infarction (MI); large, medium, and small posterolateral MI; large, medium, and small inferior MI. Simulations relating to other cardiac abnormalities, such as bundle branch block and left ventricular hypertrophy fasicular block, are being developed as part of a National Institute of Health (NIH) Phase 1 Small Business Innovation Research (SBIR) program.

The algorithm study for using the back propagation neural network in CT image segmentation

NASA Astrophysics Data System (ADS)

Zhang, Peng; Liu, Jie; Chen, Chen; Li, Ying Qi

2017-01-01

Back propagation neural network(BP neural network) is a type of multi-layer feed forward network which spread positively, while the error spread backwardly. Since BP network has advantages in learning and storing the mapping between a large number of input and output layers without complex mathematical equations to describe the mapping relationship, it is most widely used. BP can iteratively compute the weight coefficients and thresholds of the network based on the training and back propagation of samples, which can minimize the error sum of squares of the network. Since the boundary of the computed tomography (CT) heart images is usually discontinuous, and it exist large changes in the volume and boundary of heart images, The conventional segmentation such as region growing and watershed algorithm can't achieve satisfactory results. Meanwhile, there are large differences between the diastolic and systolic images. The conventional methods can't accurately classify the two cases. In this paper, we introduced BP to handle the segmentation of heart images. We segmented a large amount of CT images artificially to obtain the samples, and the BP network was trained based on these samples. To acquire the appropriate BP network for the segmentation of heart images, we normalized the heart images, and extract the gray-level information of the heart. Then the boundary of the images was input into the network to compare the differences between the theoretical output and the actual output, and we reinput the errors into the BP network to modify the weight coefficients of layers. Through a large amount of training, the BP network tend to be stable, and the weight coefficients of layers can be determined, which means the relationship between the CT images and the boundary of heart.

Endurance Training in Normobaric Hypoxia Imposes Less Physical Stress for Geriatric Rehabilitation

PubMed Central

Pramsohler, Stephan; Burtscher, Martin; Faulhaber, Martin; Gatterer, Hannes; Rausch, Linda; Eliasson, Arn; Netzer, Nikolaus C.

2017-01-01

Rationale: Evidence suggests that training in hypoxia can be very effective even while requiring less physical effort. We therefore aimed to measure the effect of endurance training under hypoxic conditions on pulmonary and cardiovascular parameters in an elderly population undergoing inpatient rehabilitation. Methods: Forty patients over age 65 years with multiple co-morbid conditions were recruited during a 3-week stay in a geriatric rehabilitation center. Using a randomized, single-blinded, placebo-controlled design, patients were assigned to a hypoxic (HG) or normoxic (NG) group. HG patients completed seven training sessions of 30 min duration on a treadmill in a normobaric chamber with inspired oxygen fraction (FiO2) of 15.27%, with 10–30 min active training. Training was conducted with target heart rate at 80% of peak oxygen consumption (VO2-peak). NG group performed similar training in sham hypoxia (room air or FiO2 = 20.94%). At pre- and post-test completion, measures included: (1) cycle ergometry with ECG monitoring and measurement of VO2-peak, and (2) echocardiography for ejection fraction. Results: The physical effort required of patients to reach target heart rate was reduced significantly (−28%, p = 0.043) in the HG compared to NG. Cardiopulmonary parameters showed no differences between groups. Conclusion: Endurance training at 3,000 meters elevation imposes less stress on the locomotor systems while resulting in a similar physiological strain (i.e., heart rate). Hypoxic training holds promise for successful geriatric rehabilitation by being more accommodating to physical limitations in geriatric patients. Trial registration: Registration at DRKS. (Approval No. 359/12, Trial No. DRKS00005241). PMID:28785224

Modifying Resilience Mechanisms in At-Risk Individuals: A Controlled Study of Mindfulness Training in Marines Preparing for Deployment

PubMed Central

Johnson, Douglas C.; Thom, Nathaniel J.; Stanley, Elizabeth A.; Haase, Lori; Simmons, Alan N.; Shih, Pei-an B.; Thompson, Wesley K.; Potterat, Eric G.; Minor, Thomas R.; Paulus, Martin P.

2015-01-01

Objective Military deployment can have profound effects on physical and mental health. Few studies have examined whether interventions prior to deployment can improve mechanisms underlying resilience. Mindfulness-based techniques have been shown to aid recovery from stress and may affect brain-behavior relationships prior to deployment. The authors examined the effect of mindfulness training on resilience mechanisms in active-duty Marines preparing for deployment. Method Eight Marine infantry platoons (N=281) were randomly selected. Four platoons were assigned to receive mindfulness training (N=147) and four were assigned to a training-as-usual control condition (N=134). Platoons were assessed at baseline, 8 weeks after baseline, and during and after a stressful combat training session approximately 9 weeks after baseline. The mindfulness training condition was delivered in the form of 8 weeks of Mindfulness-Based Mind Fitness Training (MMFT), a program comprising 20 hours of classroom instruction plus daily homework exercises. MMFT emphasizes interoceptive awareness, attentional control, and tolerance of present-moment experiences. The main outcome measures were heart rate, breathing rate, plasma neuropeptide Y concentration, score on the Response to Stressful Experiences Scale, and brain activation as measured by functional MRI. Results Marines who received MMFT showed greater reactivity (heart rate [d=0.43]) and enhanced recovery (heart rate [d=0.67], breathing rate [d=0.93]) after stressful training; lower plasma neuropeptide Y concentration after stressful training (d=0.38); and attenuated blood-oxygen-level-dependent signal in the right insula and anterior cingulate. Conclusions The results show that mechanisms related to stress recovery can be modified in healthy individuals prior to stress exposure, with important implications for evidence-based mental health research and treatment. PMID:24832476

Heart Rate Monitoring in Team Sports-A Conceptual Framework for Contextualizing Heart Rate Measures for Training and Recovery Prescription.

PubMed

Schneider, Christoph; Hanakam, Florian; Wiewelhove, Thimo; Döweling, Alexander; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2018-01-01

A comprehensive monitoring of fitness, fatigue, and performance is crucial for understanding an athlete's individual responses to training to optimize the scheduling of training and recovery strategies. Resting and exercise-related heart rate measures have received growing interest in recent decades and are considered potentially useful within multivariate response monitoring, as they provide non-invasive and time-efficient insights into the status of the autonomic nervous system (ANS) and aerobic fitness. In team sports, the practical implementation of athlete monitoring systems poses a particular challenge due to the complex and multidimensional structure of game demands and player and team performance, as well as logistic reasons, such as the typically large number of players and busy training and competition schedules. In this regard, exercise-related heart rate measures are likely the most applicable markers, as they can be routinely assessed during warm-ups using short (3-5 min) submaximal exercise protocols for an entire squad with common chest strap-based team monitoring devices. However, a comprehensive and meaningful monitoring of the training process requires the accurate separation of various types of responses, such as strain, recovery, and adaptation, which may all affect heart rate measures. Therefore, additional information on the training context (such as the training phase, training load, and intensity distribution) combined with multivariate analysis, which includes markers of (perceived) wellness and fatigue, should be considered when interpreting changes in heart rate indices. The aim of this article is to outline current limitations of heart rate monitoring, discuss methodological considerations of univariate and multivariate approaches, illustrate the influence of different analytical concepts on assessing meaningful changes in heart rate responses, and provide case examples for contextualizing heart rate measures using simple heuristics. To overcome current knowledge deficits and methodological inconsistencies, future investigations should systematically evaluate the validity and usefulness of the various approaches available to guide and improve the implementation of decision-support systems in (team) sports practice.

Heart Rate Monitoring in Team Sports—A Conceptual Framework for Contextualizing Heart Rate Measures for Training and Recovery Prescription

PubMed Central

Schneider, Christoph; Hanakam, Florian; Wiewelhove, Thimo; Döweling, Alexander; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2018-01-01

A comprehensive monitoring of fitness, fatigue, and performance is crucial for understanding an athlete's individual responses to training to optimize the scheduling of training and recovery strategies. Resting and exercise-related heart rate measures have received growing interest in recent decades and are considered potentially useful within multivariate response monitoring, as they provide non-invasive and time-efficient insights into the status of the autonomic nervous system (ANS) and aerobic fitness. In team sports, the practical implementation of athlete monitoring systems poses a particular challenge due to the complex and multidimensional structure of game demands and player and team performance, as well as logistic reasons, such as the typically large number of players and busy training and competition schedules. In this regard, exercise-related heart rate measures are likely the most applicable markers, as they can be routinely assessed during warm-ups using short (3–5 min) submaximal exercise protocols for an entire squad with common chest strap-based team monitoring devices. However, a comprehensive and meaningful monitoring of the training process requires the accurate separation of various types of responses, such as strain, recovery, and adaptation, which may all affect heart rate measures. Therefore, additional information on the training context (such as the training phase, training load, and intensity distribution) combined with multivariate analysis, which includes markers of (perceived) wellness and fatigue, should be considered when interpreting changes in heart rate indices. The aim of this article is to outline current limitations of heart rate monitoring, discuss methodological considerations of univariate and multivariate approaches, illustrate the influence of different analytical concepts on assessing meaningful changes in heart rate responses, and provide case examples for contextualizing heart rate measures using simple heuristics. To overcome current knowledge deficits and methodological inconsistencies, future investigations should systematically evaluate the validity and usefulness of the various approaches available to guide and improve the implementation of decision-support systems in (team) sports practice. PMID:29904351

Risks and Benefits of Exercise Training in Adults With Congenital Heart Disease.

PubMed

Chaix, Marie-A; Marcotte, François; Dore, Annie; Mongeon, François-Pierre; Mondésert, Blandine; Mercier, Lise-Andrée; Khairy, Paul

2016-04-01

Exercise capacity in adults with various forms of congenital heart disease is substantially lower than that of the general population. Although the underlying congenital heart defect, and its sequelae, certainly contribute to observed exercise limitations, there is evidence suggesting that deconditioning and a sedentary lifestyle are important implicated factors. The prevalence of acquired cardiovascular comorbidities is on the increase in the aging population with congenital heart disease, such that obesity and a sedentary lifestyle confer increased risk. Health fears and misconceptions are common barriers to regular physical activity in adults with congenital heart disease, despite evidence linking lower functional capacity to poor outcomes, and data supporting the safety and efficacy of exercise in bestowing numerous physical and psychosocial rewards. With few exceptions, adults with congenital heart disease should be counselled to exercise regularly. In this contemporary review, we provide a practical approach to assessing adults with congenital heart disease before exercise training. We examine available evidence supporting the safety and benefits of exercise training. Risks associated with exercise training in adults with congenital heart disease are discussed, particularly with regard to sudden cardiac death. Finally, recommendations for exercise training are provided, with consideration for the type of congenital heart disease, the nature (ie, static vs dynamic) and intensity (ie, low, medium, high) of the physical activity, and associated factors such as systemic ventricular dysfunction and residual defects. Further research is required to determine optimal exercise regimens and to identify effective strategies to implement exercise training as a key determinant of healthy living. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

The analysis and utilization of cycling training data.

PubMed

Jobson, Simon A; Passfield, Louis; Atkinson, Greg; Barton, Gabor; Scarf, Philip

2009-01-01

Most mathematical models of athletic training require the quantification of training intensity and quantity or 'dose'. We aim to summarize both the methods available for such quantification, particularly in relation to cycle sport, and the mathematical techniques that may be used to model the relationship between training and performance. Endurance athletes have used training volume (kilometres per week and/or hours per week) as an index of training dose with some success. However, such methods usually fail to accommodate the potentially important influence of training intensity. The scientific literature has provided some support for alternative methods such as the session rating of perceived exertion, which provides a subjective quantification of the intensity of exercise; and the heart rate-derived training impulse (TRIMP) method, which quantifies the training stimulus as a composite of external loading and physiological response, multiplying the training load (stress) by the training intensity (strain). Other methods described in the scientific literature include 'ordinal categorization' and a heart rate-based excess post-exercise oxygen consumption method. In cycle sport, mobile cycle ergometers (e.g. SRM and PowerTap) are now widely available. These devices allow the continuous measurement of the cyclists' work rate (power output) when riding their own bicycles during training and competition. However, the inherent variability in power output when cycling poses several challenges in attempting to evaluate the exact nature of a session. Such variability means that average power output is incommensurate with the cyclist's physiological strain. A useful alternative may be the use of an exponentially weighted averaging process to represent the data as a 'normalized power'. Several research groups have applied systems theory to analyse the responses to physical training. Impulse-response models aim to relate training loads to performance, taking into account the dynamic and temporal characteristics of training and, therefore, the effects of load sequences over time. Despite the successes of this approach it has some significant limitations, e.g. an excessive number of performance tests to determine model parameters. Non-linear artificial neural networks may provide a more accurate description of the complex non-linear biological adaptation process. However, such models may also be constrained by the large number of datasets required to 'train' the model. A number of alternative mathematical approaches such as the Performance-Potential-Metamodel (PerPot), mixed linear modelling, cluster analysis and chaos theory display conceptual richness. However, much further research is required before such approaches can be considered as viable alternatives to traditional impulse-response models. Some of these methods may not provide useful information about the relationship between training and performance. However, they may help describe the complex physiological training response phenomenon.

Application of convolutional artificial neural networks to echocardiograms for differentiating congenital heart diseases in a pediatric population

NASA Astrophysics Data System (ADS)

Perrin, Douglas P.; Bueno, Alejandra; Rodriguez, Andrea; Marx, Gerald R.; del Nido, Pedro J.

2017-03-01

In this paper we describe a pilot study, where machine learning methods are used to differentiate between congenital heart diseases. Our approach was to apply convolutional neural networks (CNNs) to echocardiographic images from five different pediatric populations: normal, coarctation of the aorta (CoA), hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and single ventricle (SV). We used a single network topology that was trained in a pairwise fashion in order to evaluate the potential to differentiate between patient populations. In total we used 59,151 echo frames drawn from 1,666 clinical sequences. Approximately 80% of the data was used for training, and the remainder for validation. Data was split at sequence boundaries to avoid having related images in the training and validation sets. While training was done with echo images/frames, evaluation was performed for both single frame discrimination as well as sequence discrimination (by majority voting). In total 10 networks were generated and evaluated. Unlike other domains where this network topology has been used, in ultrasound there is low visual variation between classes. This work shows the potential for CNNs to be applied to this low-variation domain of medical imaging for disease discrimination.

Ventilatory thresholds determined from HRV: comparison of 2 methods in obese adolescents.

PubMed

Quinart, S; Mourot, L; Nègre, V; Simon-Rigaud, M-L; Nicolet-Guénat, M; Bertrand, A-M; Meneveau, N; Mougin, F

2014-03-01

The development of personalised training programmes is crucial in the management of obesity. We evaluated the ability of 2 heart rate variability analyses to determine ventilatory thresholds (VT) in obese adolescents. 20 adolescents (mean age 14.3±1.6 years and body mass index z-score 4.2±0.1) performed an incremental test to exhaustion before and after a 9-month multidisciplinary management programme. The first (VT1) and second (VT2) ventilatory thresholds were identified by the reference method (gas exchanges). We recorded RR intervals to estimate VT1 and VT2 from heart rate variability using time-domain analysis and time-varying spectral-domain analysis. The coefficient correlations between thresholds were higher with spectral-domain analysis compared to time-domain analysis: Heart rate at VT1: r=0.91 vs. =0.66 and VT2: r=0.91 vs. =0.66; power at VT1: r=0.91 vs. =0.74 and VT2: r=0.93 vs. =0.78; spectral-domain vs. time-domain analysis respectively). No systematic bias in heart rate at VT1 and VT2 with standard deviations <6 bpm were found, confirming that spectral-domain analysis could replace the reference method for the detection of ventilatory thresholds. Furthermore, this technique is sensitive to rehabilitation and re-training, which underlines its utility in clinical practice. This inexpensive and non-invasive tool is promising for prescribing physical activity programs in obese adolescents. © Georg Thieme Verlag KG Stuttgart · New York.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Latty, Drew, E-mail: drew.latty@health.nsw.gov.au; Stuart, Kirsty E; Westmead Breast Cancer Institute, Sydney, New South Wales

Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Furthermore » research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.« less

Clinical Utility of Exercise Training in Heart Failure with Reduced and Preserved Ejection Fraction

PubMed Central

Asrar Ul Haq, Muhammad; Goh, Cheng Yee; Levinger, Itamar; Wong, Chiew; Hare, David L

2015-01-01

Reduced exercise tolerance is an independent predictor of hospital readmission and mortality in patients with heart failure (HF). Exercise training for HF patients is well established as an adjunct therapy, and there is sufficient evidence to support the favorable role of exercise training programs for HF patients over and above the optimal medical therapy. Some of the documented benefits include improved functional capacity, quality of life (QoL), fatigue, and dyspnea. Major trials to assess exercise training in HF have, however, focused on heart failure with reduced ejection fraction (HFREF). At least half of the patients presenting with HF have heart failure with preserved ejection fraction (HFPEF) and experience similar symptoms of exercise intolerance, dyspnea, and early fatigue, and similar mortality risk and rehospitalization rates. The role of exercise training in the management of HFPEF remains less clear. This article provides a brief overview of pathophysiology of reduced exercise tolerance in HFREF and heart failure with preserved ejection fraction (HFPEF), and summarizes the evidence and mechanisms by which exercise training can improve symptoms and HF. Clinical and practical aspects of exercise training prescription are also discussed. PMID:25698883

Race, exercise training, and outcomes in chronic heart failure: Findings from Heart Failure - A Controlled Trial Investigating Outcomes in Exercise TraiNing (HF-ACTION)

PubMed Central

Mentz, Robert J.; Bittner, Vera; Schulte, Phillip J.; Fleg, Jerome L.; Piña, Ileana L.; Keteyian, Steven J.; Moe, Gordon; Nigam, Anil; Swank, Ann M.; Onwuanyi, Anekwe E.; Fitz-Gerald, Meredith; Kao, Andrew; Ellis, Stephen J.; Kraus, William E.; Whellan, David J.; O'Connor, Christopher M.

2014-01-01

Background The strength of race as an independent predictor of long-term outcomes in a contemporary chronic heart failure (HF) population and its association with exercise training response have not been well established. We aimed to investigate the association between race and outcomes and to explore interactions with exercise training in patients with ambulatory HF. Methods We performed an analysis of HF-ACTION, which randomized 2331 patients with HF having an ejection fraction ≤35% to usual care with or without exercise training. We examined characteristics and outcomes (mortality/hospitalization, mortality, and cardiovascular mortality/HF hospitalization) by race using adjusted Cox models and explored an interaction with exercise training. Results There were 749 self-identified black patients (33%). Blacks were younger with significantly more hypertension and diabetes, less ischemic etiology, and lower socioeconomic status versus whites. Blacks had shorter 6-minute walk distance and lower peak VO2 at baseline. Over a median follow-up of 2.5 years, black race was associated with increased risk for all outcomes except mortality. After multivariable adjustment, black race was associated with increased mortality/hospitalization (hazard ratio [HR] 1.16, 95% CI 1.01–1.33) and cardiovascular mortality/HF hospitalization (HR 1.46, 95% CI 1.20–1.77). The hazard associated with black race was largely caused by increased HF hospitalization (HR 1.58, 95% CI 1.27–1.96), given similar cardiovascular mortality. There was no interaction between race and exercise training on outcomes (P >.5). Conclusions Black race in patients with chronic HF was associated with increased prevalence of modifiable risk factors, lower exercise performance, and increased HF hospitalization, but not increased mortality or a differential response to exercise training. PMID:24016498

Measurement of functional capacity requirements to aid in development of an occupation-specific rehabilitation training program to help firefighters with cardiac disease safely return to work.

PubMed

Adams, Jenny; Roberts, Joanne; Simms, Kay; Cheng, Dunlei; Hartman, Julie; Bartlett, Charles

2009-03-15

We designed a study to measure the functional capacity requirements of firefighters to aid in the development of an occupation-specific training program in cardiac rehabilitation; 23 healthy male firefighters with no history of heart disease completed a fire and rescue obstacle course that simulated 7 common firefighting tasks. They wore complete personal protective equipment and portable metabolic instruments that included a data collection mask. We monitored each subject's oxygen consumption (VO(2)) and working heart rate, then calculated age-predicted maximum heart rates (220 - age) and training target heart rates (85% of age-predicted maximum heart rate). During performance of the obstacle course, the subjects' mean working heart rates and peak heart rates were higher than the calculated training target heart rates (t(22) = 5.69 [working vs target, p <0.001] and t(22) = 15.14 [peak vs target, p <0.001]). These findings, with mean results for peak VO(2) (3,447 ml/min) and metabolic equivalents (11.9 METs), show that our subjects' functional capacity greatly exceeded that typically attained by patients in traditional cardiac rehabilitation programs (5 to 8 METs). In conclusion, our results indicate the need for intense, occupation-specific cardiac rehabilitation training that will help firefighters safely return to work after a cardiac event.

Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review

PubMed Central

Saw, Anna E; Main, Luana C; Gastin, Paul B

2016-01-01

Background Monitoring athlete well-being is essential to guide training and to detect any progression towards negative health outcomes and associated poor performance. Objective (performance, physiological, biochemical) and subjective measures are all options for athlete monitoring. Objective We systematically reviewed objective and subjective measures of athlete well-being. Objective measures, including those taken at rest (eg, blood markers, heart rate) and during exercise (eg, oxygen consumption, heart rate response), were compared against subjective measures (eg, mood, perceived stress). All measures were also evaluated for their response to acute and chronic training load. Methods The databases Academic search complete, MEDLINE, PsycINFO, SPORTDiscus and PubMed were searched in May 2014. Fifty-six original studies reported concurrent subjective and objective measures of athlete well-being. The quality and strength of findings of each study were evaluated to determine overall levels of evidence. Results Subjective and objective measures of athlete well-being generally did not correlate. Subjective measures reflected acute and chronic training loads with superior sensitivity and consistency than objective measures. Subjective well-being was typically impaired with an acute increase in training load, and also with chronic training, while an acute decrease in training load improved subjective well-being. Summary This review provides further support for practitioners to use subjective measures to monitor changes in athlete well-being in response to training. Subjective measures may stand alone, or be incorporated into a mixed methods approach to athlete monitoring, as is current practice in many sport settings. PMID:26423706

Effect of training mode on post-exercise heart rate recovery of trained cyclists.

PubMed

McDonald, Kelia G; Grote, Silvie; Shoepe, Todd C

2014-06-28

The sympathetic nervous system dominates the regulation of body functions during exercise. Therefore after exercise, the sympathetic nervous system withdraws and the parasympathetic nervous system helps the body return to a resting state. In the examination of this relationship, the purpose of this study was to compare recovery heart rates (HR) of anaerobically versus aerobically trained cyclists. With all values given as means ± SD, anaerobically trained track cyclists (n=10, age=25.9 ± 6.0 yrs, body mass=82.7 ± 7.1 kg, body fat=10.0 ± 6.3%) and aerobically trained road cyclists (n=15, age=39.9 ± 8.5 yrs, body mass=75.3 ± 9.9 kg, body fat=13.1 ± 4.5%) underwent a maximal oxygen uptake test. Heart rate recovery was examined on a relative basis using heart rate reserve as well as the absolute difference between maximum HR and each of two recovery HRs. The post-exercise change in HR at minute one for the track cyclists and road cyclists respectively were 22 ± 8 bpm and 25 ± 12 bpm. At minute two, the mean drop for track cyclists was significantly (p<0.05) greater than the road cyclists (52 ± 15 bpm and 64 ± 11 bpm). Training mode showed statistically significant effects on the speed of heart rate recovery in trained cyclists. Greater variability in recovery heart rate at minute two versus minute one suggests that the heart rate should be monitored longer than one minute of recovery for a better analysis of post-exercise autonomic shift.

The within-participant correlation between perception of effort and heart rate-based estimations of training load in elite soccer players.

PubMed

Kelly, David M; Strudwick, Anthony J; Atkinson, Greg; Drust, Barry; Gregson, Warren

2016-07-01

The measurement of relative physiological stress during training is important because this is the stimulus for the long-term adaptive response. Measurements of perceived exertion (RPE) have been reported to correlate with the heart rate during field-based training sessions. Nevertheless, there are few studies on how well RPE tracks with the heart rate over repeated training sessions in elite soccer players. Therefore, we aimed to quantify the within-participant correlations between variability in session-RPE (sRPE) and the heart rate in elite male soccer players, and to determine whether the playing position moderated these correlations. The field-based training of four central defenders, four wide defenders, six central midfielders, two wide midfielders and three attackers from an elite English Premier League squad were monitored over an entire in-season competitive period, giving a total of 1010 individual training sessions for study. Correlations between session-RPE and heart rates were quantified using a within-participant model. The correlation between changes in sRPE and heart rates was r = 0.75 (95% CI: 0.71-0.78). This correlation remained high across the various player positions (wide-defender, r = 0.81; central-defender, r = 0.74; wide midfielder, r = 0.70; central midfielder, r = 0.70; attacker, r = 0.84; P < 0.001). The correlation between changes in RPE and heart rates, measured during a season-long period of field-based training, is high in a sample of elite soccer players.

Exercise training preserves vagal preganglionic neurones and restores parasympathetic tonus in heart failure.

PubMed

Ichige, Marcelo H A; Santos, Carla R; Jordão, Camila P; Ceroni, Alexandre; Negrão, Carlos E; Michelini, Lisete C

2016-11-01

Heart Failure (HF) is accompanied by reduced ventricular function, activation of compensatory neurohormonal mechanisms and marked autonomic dysfunction characterized by exaggerated sympathoexcitation and reduced parasympathetic activity. With 6 weeks of exercise training, HF-related loss of choline acetyltransferase (ChAT)-positive vagal preganglionic neurones is avoided, restoring the parasympathetic tonus to the heart, and the immunoreactivity of dopamine β-hydroxylase-positive premotor neurones that drive sympathetic outflow to the heart is reduced. Training-induced correction of autonomic dysfunction occurs even with the persistence of abnormal ventricular function. Strong positive correlation between improved parasympathetic tonus to the heart and increased ChAT immunoreactivity in vagal preganglionic neurones after training indicates this is a crucial mechanism to restore autonomic function in heart failure. Exercise training is an efficient tool to attenuate sympathoexcitation, a hallmark of heart failure (HF). Although sympathetic modulation in HF is widely studied, information regarding parasympathetic control is lacking. We examined the combined effects of sympathetic and vagal tonus to the heart in sedentary (Sed) and exercise trained (ET) HF rats and the contribution of respective premotor and preganglionic neurones. Wistar rats submitted to coronary artery ligation or sham surgery were assigned to training or sedentary protocols for 6 weeks. After haemodynamic, autonomic tonus (atropine and atenolol i.v.) and ventricular function determinations, brains were collected for immunoreactivity assays (choline acetyltransferase, ChATir; dopamine β-hydroxylase, DBHir) and neuronal counting in the dorsal motor nucleus of vagus (DMV), nucleus ambiguus (NA) and rostroventrolateral medulla (RVLM). HF-Sed vs. SHAM-Sed exhibited decreased exercise capacity, reduced ejection fraction, increased left ventricle end diastolic pressure, smaller positive and negative dP/dt, decreased intrinsic heart rate (IHR), lower parasympathetic and higher sympathetic tonus, reduced preganglionic vagal neurones and ChATir in the DMV/NA, and increased RVLM DBHir. Training increased treadmill performance, normalized autonomic tonus and IHR, restored the number of DMV and NA neurones and corrected ChATir without affecting ventricular function. There were strong positive correlations between parasympathetic tonus and ChATir in NA and DMV. RVLM DBHir was also normalized by training, but there was no change in neurone number and no correlation with sympathetic tonus. Training-induced preservation of preganglionic vagal neurones is crucial to normalize parasympathetic activity and restore autonomic balance to the heart even in the persistence of cardiac dysfunction. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

The efficiency coefficient of the rat heart and muscular system after physical training and hypokinesia

NASA Technical Reports Server (NTRS)

Alyukhin, Y. S.; Davydov, A. F.

1982-01-01

The efficiency of an isolated heart did not change after prolonged physical training of rats for an extreme load. The increase in oxygen consumption by the entire organism in 'uphill' running as compared to the resting level in the trained rats was 14% lower than in the control animals. Prolonged hypokinesia of the rats did not elicit a change in the efficiency of the isolated heart.

Integrated genetic and epigenetic prediction of coronary heart disease in the Framingham Heart Study.

PubMed

Dogan, Meeshanthini V; Grumbach, Isabella M; Michaelson, Jacob J; Philibert, Robert A

2018-01-01

An improved method for detecting coronary heart disease (CHD) could have substantial clinical impact. Building on the idea that systemic effects of CHD risk factors are a conglomeration of genetic and environmental factors, we use machine learning techniques and integrate genetic, epigenetic and phenotype data from the Framingham Heart Study to build and test a Random Forest classification model for symptomatic CHD. Our classifier was trained on n = 1,545 individuals and consisted of four DNA methylation sites, two SNPs, age and gender. The methylation sites and SNPs were selected during the training phase. The final trained model was then tested on n = 142 individuals. The test data comprised of individuals removed based on relatedness to those in the training dataset. This integrated classifier was capable of classifying symptomatic CHD status of those in the test set with an accuracy, sensitivity and specificity of 78%, 0.75 and 0.80, respectively. In contrast, a model using only conventional CHD risk factors as predictors had an accuracy and sensitivity of only 65% and 0.42, respectively, but with a specificity of 0.89 in the test set. Regression analyses of the methylation signatures illustrate our ability to map these signatures to known risk factors in CHD pathogenesis. These results demonstrate the capability of an integrated approach to effectively model symptomatic CHD status. These results also suggest that future studies of biomaterial collected from longitudinally informative cohorts that are specifically characterized for cardiac disease at follow-up could lead to the introduction of sensitive, readily employable integrated genetic-epigenetic algorithms for predicting onset of future symptomatic CHD.

Training Enhances Both Locomotor and Cognitive Adaptability to a Novel Sensory Environment

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Ploutz-Snyder, R. J.; Cohen, H. S.

2010-01-01

During adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform required mission tasks. The goal of this project is to develop a sensorimotor adaptability (SA) training program to facilitate rapid adaptation. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. The goal of our present study was to determine if SA training improved both the locomotor and cognitive responses to a novel sensory environment and to quantify the extent to which training would be retained. Methods: Twenty subjects (10 training, 10 control) completed three, 30-minute training sessions during which they walked on the treadmill while receiving discordant support surface and visual input. Control subjects walked on the treadmill but did not receive any support surface or visual alterations. To determine the efficacy of training all subjects performed the Transfer Test upon completion of training. For this test, subjects were exposed to novel visual flow and support surface movement, not previously experienced during training. The Transfer Test was performed 20 minutes, 1 week, 1, 3 and 6 months after the final training session. Stride frequency, auditory reaction time, and heart rate data were collected as measures of postural stability, cognitive effort and anxiety, respectively. Results: Using mixed effects regression methods we determined that subjects who received SA training showed less alterations in stride frequency, auditory reaction time and heart rate compared to controls. Conclusion: Subjects who received SA training improved performance across a number of modalities including enhanced locomotor function, increased multi-tasking capability and reduced anxiety during adaptation to novel discordant sensory information. Trained subjects maintained their level of performance over six months.

Team training for safer birth.

PubMed

Cornthwaite, Katie; Alvarez, Mary; Siassakos, Dimitrios

2015-11-01

Effective and coordinated teamworking is key to achieving safe birth for mothers and babies. Confidential enquiries have repeatedly identified deficiencies in teamwork as factors contributing to poor maternal and neonatal outcomes. The ingredients of a successful multi-professional team are varied, but research has identified some fundamental teamwork behaviours, with good communication, proficient leadership and situational awareness at the heart. Simple, evidence-based methods in teamwork training can be seamlessly integrated into a core, mandatory obstetric emergency training. Training should be an enjoyable, inclusive and beneficial experience for members of staff. Training in teamwork can lead to improved clinical outcomes and better birth experience for women. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Nonrandomized Evaluation of a Brief Nurtured Heart Approach Parent Training Program

ERIC Educational Resources Information Center

Brennan, Alison L.; Hektner, Joel M.; Brotherson, Sean E.; Hansen, Tracy M.

2016-01-01

Background: Parent training programs are increasingly being offered to the general public with little formal evaluation of their effects. One such program, the Nurtured Heart Approach to parenting (NHA; Glasser and Easley in "Transforming the difficult child: The Nurtured Heart Approach," Vaughan Printing, Nashville, 2008), contains…

Report of the 2005 STS Congenital Heart Surgery Practice and Manpower Survey.

PubMed

Jacobs, Marshall L; Mavroudis, Constantine; Jacobs, Jeffrey P; Tchervenkov, Christo I; Pelletier, Glenn J

2006-09-01

Limited information is available concerning the congenital heart surgery workforce in North America. To obtain reliable data, The Society of Thoracic Surgeons (STS) Workforce on Congenital Heart Surgery undertook a subspecialty focused survey. Preliminary research of websites and databases revealed a potential target group of 263 congenital heart surgeons, including 248 surgeons at 121 US centers and 15 at eight Canadian sites. Surveys were sent to these, plus any additional individuals who listed an interest in congenital or pediatric heart surgery on CTSNet or STS websites. Responders include active congenital heart surgeons, inactive, or retired surgeons, adult cardiac surgeons, and surgeons in training. Analysis is based exclusively on the responses of 217 active congenital heart surgeons (>80% of target). Average age was 48.3 +/- 8.3 years (range, 33 to 78). Ten were female (5%), 207 male (95%). American Medical School graduates were 170 (79%), with 9.2 +/- 1.6 years of postgraduate training. Eighty-five percent are Thoracic Board certified. Congenital heart surgery training outside the United States or Canada was obtained by 29 (14%). One hundred twenty-eight (59%) do exclusively congenital heart surgery. One third perform fewer than 100 congenital cases per year, one third perform 100 to 199, and one third perform 200 or more. Congenital heart surgeons have been in their current positions for 9.5 +/- 8.2 years. Eleven are in their first year of practice. Mean anticipated years to retirement is 15.7 +/- 7.5 (range, 1 to 34). Three anticipate retirement within 1 year. At the same time, 39 fellows will complete postgraduate training at 28 centers this year, and 19 will seek positions in North America. These data should help to facilitate rational plans to meet manpower needs, including evolving policies concerning training and certification.

Three Weeks of Overload Training Increases Resting Muscle Sympathetic Activity.

PubMed

Coates, Alexandra M; Incognito, Anthony V; Seed, Jeremy D; Doherty, Connor J; Millar, Philip J; Burr, Jamie F

2018-05-01

Overload training is hypothesized to alter autonomic regulation, although interpretations using indirect measures of heart rate variability are conflicting. The aim of the present study was to examine the effects of overload training on muscle sympathetic nerve activity (MSNA), a direct measure of central sympathetic outflow, in recreational endurance athletes. Measurements of heart rate variability, cardiac baroreflex sensitivity (BRS), MSNA (microneurography), and sympathetic BRS were obtained in 17 healthy triathletes and cyclists after 1 wk of reduced training (baseline) and again after 3 wk of either regular (n = 7) or overload (n = 10) training. After training, the changes (Δ) in peak power output (10 ± 10 vs -12 ± 9 W, P < 0.001), maximal heart rate (-2 ± 4 vs -8 ± 3 bpm, P = 0.006), heart rate variability (SD of normal-to-normal intervals, 27 ± 31 vs -3 ± 25 ms; P = 0.04), and cardiac BRS (7 ± 6 vs -2 ± 8 ms·mm Hg, P = 0.02) differed between the control and overload groups. The change in MSNA burst frequency (-2 ± 2 vs 4 ± 5 bursts per minute, P = 0.02) differed between groups. Across all participants, the changes in resting MSNA and peak power output were correlated negatively (r = -0.51, P = 0.04). No between-group differences in resting heart rate or blood pressure were observed (all P > 0.05). Overload training increased MSNA and attenuated increases in cardiac BRS and heart rate variability observed with regular training. These results support neural adaptations after overload training and suggest that increased central sympathetic outflow may be linked with decreased exercise performance.

Quantification of Training and Competition Loads in Endurance Sports: Methods and Applications.

PubMed

Mujika, Iñigo

2017-04-01

Training quantification is basic to evaluate an endurance athlete's responses to training loads, ensure adequate stress/recovery balance, and determine the relationship between training and performance. Quantifying both external and internal workload is important, because external workload does not measure the biological stress imposed by the exercise sessions. Generally used quantification methods include retrospective questionnaires, diaries, direct observation, and physiological monitoring, often based on the measurement of oxygen uptake, heart rate, and blood lactate concentration. Other methods in use in endurance sports include speed measurement and the measurement of power output, made possible by recent technological advances such as power meters in cycling and triathlon. Among subjective methods of quantification, rating of perceived exertion stands out because of its wide use. Concurrent assessments of the various quantification methods allow researchers and practitioners to evaluate stress/recovery balance, adjust individual training programs, and determine the relationships between external load, internal load, and athletes' performance. This brief review summarizes the most relevant external- and internal-workload-quantification methods in endurance sports and provides practical examples of their implementation to adjust the training programs of elite athletes in accordance with their individualized stress/recovery balance.

Effects of high-intensity interval versus continuous exercise training on post-exercise heart rate recovery in coronary heart-disease patients.

PubMed

Villelabeitia-Jaureguizar, Koldobika; Vicente-Campos, Davinia; Senen, Alejandro Berenguel; Jiménez, Verónica Hernández; Garrido-Lestache, María Elvira Barrios; Chicharro, Jose López

2017-10-01

Heart rate recovery (HRR) has been considered a prognostic and mortality indicator in both healthy and coronary patients. Physical exercise prescription has shown improvements in VO 2 peak and HRR, but most of the studies have been carried out applying continuous training at a moderate intensity, being very limited the use of protocols of high intensity interval training in coronary patients. We aimed to compare the effects of a moderate continuous training (MCT) versus a high intensity interval training (HIIT) programme on VO 2 peak and HRR. Seventy three coronary patients were assigned to either HIIT or MCT groups for 8weeks. Incremental exercise tests in a cycloergometer were performed to obtain VO 2 peak data and heart rate was monitored during and after the exercise test to obtain heart rate recovery data. Both exercise programmes significantly increase VO 2 peak with a higher increase in the HIIT group (HIIT: 4.5±4.46ml/kg/min vs MCT: 2.46±3.57ml/kg/min; p=0.039). High intensity interval training resulted in a significantly increase in HRR at the first and second minute of the recovery phase (15,44±7,04 vs 21,22±6,62, p<0,0001 and 23,73±9,64 vs 31,52±8,02, p<0,0001, respectively). The results of our research show that the application of HIIT to patients with chronic ischemic heart disease of low risk resulted in an improvement in VO 2 peak, and also improvements in post-exercise heart-rate recovery, compared with continuous training. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of exercise on diastolic function in heart failure patients: a systematic review and meta-analysis.

PubMed

Pearson, M J; Mungovan, S F; Smart, N A

2017-03-01

Diastolic dysfunction contributes to the development and progression of heart failure. Conventional echocardiography and tissue Doppler imaging are widely utilised in clinical research providing a number of indices of diastolic function valuable in the diagnosis and prognosis of heart failure patients. The aim of this meta-analysis was to quantify the effect of exercise training on diastolic function in patients with heart failure. Exercise training studies that investigate different indices of diastolic function in patients with heart failure have reported that exercise training improves diastolic function in these patients. We sought to add to the current literature by quantifying, where possible, the effect of exercise training on diastolic function. We conducted database searches (PubMed, EBSCO, EMBASE, and Cochrane Trials Register to 31 July 2016) for exercise based rehabilitation trials in heart failure, using the search terms 'exercise training, diastolic function and diastolic dysfunction'. Data from six studies, with a total of 266 heart failure with reduced ejection fraction (HFrEF) participants, 144 in intervention groups and 122 in control groups, indicated a significant reduction in the ratio of early diastolic transmitral velocity (E) to early diastolic tissue velocity (E') (E/E' ratio) with exercise training, exercise vs. control mean difference (MD) of -2.85 (95% CI -3.66 to -2.04, p < 0.00001). Data from five studies in heart failure with preserved ejection fraction (HFpEF) patients, with a total of 204 participants, 115 in intervention groups and 89 in control groups, also demonstrated a significant improvement in E/E' in exercise vs. control MD of -2.38 (95% CI -3.47 to -1.28, p < 0.0001).

A Medical Student Elective Promoting Humanism, Communication Skills, Complementary and Alternative Medicine and Physician Self-Care: An Evaluation of the HEART Program

PubMed Central

Dossett, Michelle L.; Kohatsu, Wendy; Nunley, William; Mehta, Darshan; Davis, Roger B.; Phillips, Russell S.; Yeh, Gloria

2013-01-01

Objective In 2002 AMSA created a fourth year medical student elective known as HEART that provided the opportunity for students to explore humanism in medicine, self-care, complementary and alternative medicine modalities, communication, activism, and community building in a four week immersion experience. The educational effects of this elective, and whether it has met its stated goals, are unknown. Method The authors conducted a web-based, cross-sectional survey of the first eight cohorts of HEART graduates in 2010. Survey questions assessed respondents’ demographics and perspectives on the educational impact of the elective. Descriptive statistics were used to characterize the sample and qualitative analyses were guided by grounded theory. Results Of 168 eligible alumni, 122 (73%), completed the survey. The majority were female (70%), age ≤35 (77%), and trained in primary care specialties (66%). Half were attendings in practice. The majority of respondents felt the elective taught professionalism (89%) and communication skills (92%) well or very well. The majority highly agreed that the elective helped them better cope with stress during residency training (80%), taught them self-care skills (75%), and improved their ability to empathize and connect with patients (71%). Qualitative analysis of the personal and professional impact of the elective identified twelve common themes with self-discovery, self-care, and collegial development/community most frequently cited. Conclusions The majority of HEART graduates endorse learning important skills and benefiting from the experience both personally and professionally. Aspects of the HEART curriculum may help training programs teach professionalism and improve trainee well-being. PMID:24021470

Modeling and Representation of Human Hearts for Volumetric Measurement

PubMed Central

Guan, Qiu; Wang, Wanliang; Wu, Guang

2012-01-01

This paper investigates automatic construction of a three-dimensional heart model from a set of medical images, represents it in a deformable shape, and uses it to perform volumetric measurements. This not only significantly improves its reliability and accuracy but also makes it possible to derive valuable novel information, like various assessment and dynamic volumetric measurements. The method is based on a flexible model trained from hundreds of patient image sets by a genetic algorithm, which takes advantage of complete segmentation of the heart shape to form a geometrical heart model. For an image set of a new patient, an interpretation scheme is used to obtain its shape and evaluate some important parameters. Apart from automatic evaluation of traditional heart functions, some new information of cardiovascular diseases may be recognized from the volumetric analysis. PMID:22162723

Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses

PubMed Central

Hafstad, Anne Dragøy; Basnet, Purusotam; Ytrehus, Kirsti; Acharya, Ganesh

2015-01-01

Objective To investigate the effects of high intensity interval training (HIIT) on the maternal heart, fetuses and placentas of pregnant rats. Methods Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85–90% of maximal oxygen consumption) for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats), echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples. Results Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03), hypoxia-inducible factor 1α (p = 0.04) and glutathione peroxidase 4.2 (p = 0.02) in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014), superoxide dismutase 1 (p = 0.001) and tissue inhibitor of metallopeptidase 3 (p = 0.049) in the fetal heart. Conclusions Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated. PMID:26566220

Analyzing Exercise Training Effect and Its Impact on Cardiorespiratory and Cardiovascular Fitness

ERIC Educational Resources Information Center

Laumakis, Paul J.; McCormack, Kevin

2014-01-01

This paper provides a statistical investigation of the impact of heart rate levels on training effect for a specific exercise regimen, including an analysis of post-exercise heart rate recovery. Results indicate optimum target values for both average and maximum heart rate during exercise in order to improve both cardiorespiratory and…

FCMPSO: An Imputation for Missing Data Features in Heart Disease Classification

NASA Astrophysics Data System (ADS)

Salleh, Mohd Najib Mohd; Ashikin Samat, Nurul

2017-08-01

The application of data mining and machine learning in directing clinical research into possible hidden knowledge is becoming greatly influential in medical areas. Heart Disease is a killer disease around the world, and early prevention through efficient methods can help to reduce the mortality number. Medical data may contain many uncertainties, as they are fuzzy and vague in nature. Nonetheless, imprecise features data such as no values and missing values can affect quality of classification results. Nevertheless, the other complete features are still capable to give information in certain features. Therefore, an imputation approach based on Fuzzy C-Means and Particle Swarm Optimization (FCMPSO) is developed in preprocessing stage to help fill in the missing values. Then, the complete dataset is trained in classification algorithm, Decision Tree. The experiment is trained with Heart Disease dataset and the performance is analysed using accuracy, precision, and ROC values. Results show that the performance of Decision Tree is increased after the application of FCMSPO for imputation.

Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

PubMed

McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

2007-01-01

To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

[Free from stress by autogenic therapy. Relaxation technique yielding peace of mind and self-insight].

PubMed

Broms, C

1999-02-10

The utilisation of self-regulatory capacity is one of the purposes of autogenic therapy, a method consisting of exercises focused on the limbs, lungs, heart, diaphragm and head. The physiological response is muscle relaxation, increased peripheral blood flow, lower heart rate and blood pressure, slower and deeper breathing, and reduced oxygen consumption. Autogenic training is applicable in most pathological conditions associated with stress, and can be used preventively or as a complement to conventional treatment.

Exercise for Those with Chronic Heart Failure: Matching Programs to Patients.

ERIC Educational Resources Information Center

Braith, Randy W.

2002-01-01

Exercise training increases functional capacity and improves symptoms in selected patients with chronic heart failure and moderate-to-severe left ventricular systolic dysfunction. Aerobic training forms the basis of such a program. This paper describes contributors to exercise intolerance, responses to exercise training, favorable outcomes with…

Exercise training improves peak oxygen consumption and haemodynamics in patients with severe pulmonary arterial hypertension and inoperable chronic thrombo-embolic pulmonary hypertension: a prospective, randomized, controlled trial

PubMed Central

Ehlken, Nicola; Lichtblau, Mona; Klose, Hans; Weidenhammer, Johannes; Fischer, Christine; Nechwatal, Robert; Uiker, Sören; Halank, Michael; Olsson, Karen; Seeger, Werner; Gall, Henning; Rosenkranz, Stephan; Wilkens, Heinrike; Mertens, Dirk; Seyfarth, Hans-Jürgen; Opitz, Christian; Ulrich, Silvia; Egenlauf, Benjamin; Grünig, Ekkehard

2016-01-01

Abstract Aims The impact of exercise training on the right heart and pulmonary circulation has not yet been invasively assessed in patients with pulmonary hypertension (PH) and right heart failure. This prospective randomized controlled study investigates the effects of exercise training on peak VO2/kg, haemodynamics, and further clinically relevant parameters in PH patients. Methods and results Eighty-seven patients with pulmonary arterial hypertension and inoperable chronic thrombo-embolic PH (54% female, 56 ± 15 years, 84% World Health Organization functional class III/IV, 53% combination therapy) on stable disease-targeted medication were randomly assigned to a control and training group. Medication remained unchanged during the study period. Non-invasive assessments and right heart catheterization at rest and during exercise were performed at baseline and after 15 weeks. Primary endpoint was the change in peak VO2/kg. Secondary endpoints included changes in haemodynamics. For missing data, multiple imputation and responder analyses were performed. The study results showed a significant improvement of peak VO2/kg in the training group (difference from baseline to 15 weeks: training +3.1 ± 2.7 mL/min/kg equals +24.3% vs. control −0.2 ± 2.3 mL/min/kg equals +0.9%, P < 0.001). Cardiac index (CI) at rest and during exercise, mean pulmonary arterial pressure, pulmonary vascular resistance, 6 min walking distance, quality of life, and exercise capacity significantly improved by exercise training. Conclusion Low-dose exercise training at 4–7 days/week significantly improved peak VO2/kg, haemodynamics, and further clinically relevant parameters. The improvements of CI at rest and during exercise indicate that exercise training may improve the right ventricular function. Further, large multicentre trials are necessary to confirm these results. PMID:26231884

Discrimination of the "Athlete's Heart" from real disease by electrocardiogram and echocardiogram.

PubMed

Erickson, Christopher C

2017-01-01

Chronic physical training has been shown to produce multiple changes in the heart, resulting in the athlete's heart phenotype. Some of the changes can make it difficult to discern athlete's heart from true cardiac disease, most notably hypertrophic cardiomyopathy. Other diseases such as dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy may be difficult to rule in or out. In this article, the physiological cardiac changes of chronic athletic training are reviewed. A methodological approach using electrocardiography and echocardiography to differentiate between athlete's heart and cardiac disease is proposed.

Heart ABCA1 and PPAR- α Genes Expression Responses in Male rats: Effects of High Intensity Treadmill Running Training and Aqueous Extraction of Black Crataegus-Pentaegyna

PubMed Central

Ghanbari-Niaki, Abbass; Ghanbari-Abarghooi, Safieyh; Rahbarizadeh, Fatemeh; Zare-Kookandeh, Navabeh; Gholizadeh, Monireh; Roudbari, Fatemeh; Zare-Kookandeh, Asghar

2013-01-01

Introduction: Heart as a high metabolic and aerobic tissue is consuming lipid as a fuel for its energy provision at rest during light and moderate exercise, except when lactate level is higher in blood circulation. It has been shown that any type of regular exercise and crataegus species would improve cardiovascular function and minimizes several risk factors via stimulating lipid metabolism by acting on enzymes and genes expression such as ABCA1 and PPAR α which are involving in this process. Materials and Methods: Twenty Wistar male rats (4-6 weeks old, 140-173 g weight) were used. Animals were randomly classified into training (n = 10) and control (n = 10) groups and then divided into saline-control (SC), saline-training (ST), Crataegus-Pentaegyna -control (CPC), and Crataegus-Pentaegyna -training (CPT) groups. Training groups have performed a high-intensity running program (at 34 m/min (0% grade), 60 min/day, 5 days/week) on a motor-driven treadmill for eight weeks. Animals were orally fed with Crataegus-Pentaegyna extraction (500mg/kg) and saline solution for six weeks. Seventy- two hours after the last training session, rats were sacrificed, hearts were excised, cleaned and immediately frozen in liquid nitrogen and stored at -80 °C until RNA extraction. Plasma also was collected for plasma variable measurements. Statistical analysis was performed using a two way analysis of variance, and significance was accepted at P < 0.05. Results: A non-significant (P < 0.4, P < 0.79, respectively) increase in ABCA1 and PPAR α genes expression was accompanied by a significant (P < 0.01, P < 0.04, P < 0.04, respectively) reduction in TC, TG, and VLDL-C levels in Crataegus-Pentaegyna groups. Conclusions: Our findings show that a high intensity treadmill running was able to express ABCA1 and PPAR α in rat heart. Data also possibly indicate that the Crataeguse-Pentaegyna supplementation solely could mimic training effect on the mentioned genes and lipid profiles via different mechanism(s). PMID:25478513

Endurance- and Resistance-Trained Men Exhibit Lower Cardiovascular Responses to Psychosocial Stress Than Untrained Men.

PubMed

Gröpel, Peter; Urner, Maren; Pruessner, Jens C; Quirin, Markus

2018-01-01

Evidence shows that regular physical exercise reduces physiological reactivity to psychosocial stress. However, previous research mainly focused on the effect of endurance exercise, with only a few studies looking at the effect of resistance exercise. The current study tested whether individuals who regularly participate in either endurance or resistance training differ from untrained individuals in adrenal and cardiovascular reactivity to psychosocial stress. Twelve endurance-trained men, 10 resistance-trained men, and 12 healthy but untrained men were exposed to a standardized psychosocial stressor, the Trier Social Stress Test. Measurements of heart rate, free salivary cortisol levels, and mood were obtained throughout the test and compared among the three groups. Overall, both endurance- and resistance-trained men had lower heart rate levels than untrained men, indicating higher cardiac performance of the trained groups. Trained men also exhibited lower heart rate responses to psychosocial stress compared with untrained men. There were no significant group differences in either cortisol responses or mood responses to the stressor. The heart rate results are consistent with previous studies indicating reduced cardiovascular reactivity to psychosocial stress in trained individuals. These findings suggest that long-term endurance and resistance trainings may be related to the same cardiovascular benefits, without exhibiting strong effects on the cortisol reactivity to stress.

Functional Anatomy of the Cardiovascular System: Professional Development for PreK-3 Teachers Using a "Train and Equip" Method Results in Learning Opportunities for Students

ERIC Educational Resources Information Center

Burns, E. Robert

2008-01-01

Preadolescent students are interested in learning the structure and function of the human body. However, their teachers are not trained in this content. The purpose of this project was to expand a successful outreach effort in the health sciences for grade 7-12 teachers to include PreK-3 teachers. A "Healthy Hearts" workshop was offered to train…

Modelling and regulating of cardio-respiratory response for the enhancement of interval training

PubMed Central

2014-01-01

Background The interval training method has been a well known exercise protocol which helps strengthen and improve one’s cardiovascular fitness. Purpose To develop an effective training protocol to improve cardiovascular fitness based on modelling and analysis of Heart Rate (HR) and Oxygen Uptake (VO2) dynamics. Methods In order to model the cardiorespiratory response to the onset and offset exercises, the (K4b2, Cosmed) gas analyzer was used to monitor and record the heart rate and oxygen uptake for ten healthy male subjects. An interval training protocol was developed for young health users and was simulated using a proposed RC switching model which was presented to accommodate the variations of the cardiorespiratory dynamics to running exercises. A hybrid system model was presented to describe the adaptation process and a multi-loop PI control scheme was designed for the tuning of interval training regime. Results By observing the original data for each subject, we can clearly identify that all subjects have similar HR and VO2 profiles. The proposed model is capable to simulate the exercise responses during onset and offset exercises; it ensures the continuity of the outputs within the interval training protocol. Under some mild assumptions, a hybrid system model can describe the adaption process and accordingly a multi-loop PI controller can be designed for the tuning of interval training protocol. The self-adaption feature of the proposed controller gives the exerciser the opportunity to reach his desired setpoints after a certain number of training sessions. Conclusions The established interval training protocol targets a range of 70-80% of HRmax which is mainly a training zone for the purpose of cardiovascular system development and improvement. Furthermore, the proposed multi-loop feedback controller has the potential to tune the interval training protocol according to the feedback from an individual exerciser. PMID:24499131

High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction

PubMed Central

Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M.; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W.; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

2017-01-01

Background: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Methods: Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Results: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left ventricular end-diastolic diameter changes compared with RRE were −2.8 mm (−5.2 to −0.4 mm; P=0.02) in HIIT and −1.2 mm (−3.6 to 1.2 mm; P=0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake (P=0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P=0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. Conclusions: HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046. PMID:28082387

Cardiac cycle-synchronized electrical muscle stimulator for lower limb training with the potential to reduce the heart's pumping workload

PubMed Central

Matsuse, Hiroo; Akimoto, Ryuji; Kamiya, Shiro; Moritani, Toshio; Sasaki, Motoki; Ishizaki, Yuta; Ohtsuka, Masanori; Nakayoshi, Takaharu; Ueno, Takafumi; Shiba, Naoto; Fukumoto, Yoshihiro

2017-01-01

Background The lower limb muscle may play an important role in decreasing the heart’s pumping workload. Aging and inactivity cause atrophy and weakness of the muscle, leading to a loss of the heart-assisting role. An electrical lower limb muscle stimulator can prevent atrophy and weakness more effectively than conventional resistance training; however, it has been reported to increase the heart’s pumping workload in some situations. Therefore, more effective tools should be developed. Methods We newly developed a cardiac cycle-synchronized electrical lower limb muscle stimulator by combining a commercially available electrocardiogram monitor and belt electrode skeletal muscle electrical stimulator, making it possible to achieve strong and wide but not painful muscle contractions. Then, we tested the stimulator in 11 healthy volunteers to determine whether the special equipment enabled lower limb muscle training without harming the hemodynamics using plethysmography and a percutaneous cardiac output analyzer. Results In 9 of 11 subjects, the stimulator generated diastolic augmentation waves on the dicrotic notches and end-diastolic pressure reduction waves on the plethysmogram waveforms of the brachial artery, showing analogous waveforms in the intra-aortic balloon pumping heart-assisting therapy. The heart rate, stroke volume, and cardiac output significantly increased during the stimulation. There was no change in the systolic or diastolic blood pressure during the stimulation. Conclusion Cardiac cycle-synchronized electrical muscle stimulation for the lower limbs may enable muscle training without harmfully influencing the hemodynamics and with a potential to reduce the heart’s pumping workload, suggesting a promising tool for effectively treating both locomotor and cardiovascular disorders. PMID:29117189

Validity and reliability of the session-RPE method for quantifying training load in karate athletes.

PubMed

Tabben, M; Tourny, C; Haddad, M; Chaabane, H; Chamari, K; Coquart, J B

2015-04-24

To test the construct validity and reliability of the session rating of perceived exertion (sRPE) method by examining the relationship between RPE and physiological parameters (heart rate: HR and blood lactate concentration: [La --] ) and the correlations between sRPE and two HR--based methods for quantifying internal training load (Banister's method and Edwards's method) during karate training camp. Eighteen elite karate athletes: ten men (age: 24.2 ± 2.3 y, body mass: 71.2 ± 9.0 kg, body fat: 8.2 ± 1.3% and height: 178 ± 7 cm) and eight women (age: 22.6 ± 1.2 y, body mass: 59.8 ± 8.4 kg, body fat: 20.2 ± 4.4%, height: 169 ± 4 cm) were included in the study. During training camp, subjects participated in eight karate--training sessions including three training modes (4 tactical--technical, 2 technical--development, and 2 randori training), during which RPE, HR, and [La -- ] were recorded. Significant correlations were found between RPE and physiological parameters (percentage of maximal HR: r = 0.75, 95% CI = 0.64--0.86; [La --] : r = 0.62, 95% CI = 0.49--0.75; P < 0.001). Moreover, individual sRPE was significantly correlated with two HR--based methods for quantifying internal training load ( r = 0.65--0.95; P < 0.001). The sRPE method showed the high reliability of the same intensity across training sessions (Cronbach's α = 0.81, 95% CI = 0.61--0.92). This study demonstrates that the sRPE method is valid for quantifying internal training load and intensity in karate.

Monitoring training status with HR measures: do all roads lead to Rome?

PubMed Central

Buchheit, Martin

2014-01-01

Measures of resting, exercise, and recovery heart rate are receiving increasing interest for monitoring fatigue, fitness and endurance performance responses, which has direct implications for adjusting training load (1) daily during specific training blocks and (2) throughout the competitive season. However, these measures are still not widely implemented to monitor athletes' responses to training load, probably because of apparent contradictory findings in the literature. In this review I contend that most of the contradictory findings are related to methodological inconsistencies and/or misinterpretation of the data rather than to limitations of heart rate measures to accurately inform on training status. I also provide evidence that measures derived from 5-min (almost daily) recordings of resting (indices capturing beat-to-beat changes in heart rate, reflecting cardiac parasympathetic activity) and submaximal exercise (30- to 60-s average) heart rate are likely the most useful monitoring tools. For appropriate interpretation at the individual level, changes in a given measure should be interpreted by taking into account the error of measurement and the smallest important change of the measure, as well as the training context (training phase, load, and intensity distribution). The decision to use a given measure should be based upon the level of information that is required by the athlete, the marker's sensitivity to changes in training status and the practical constrains required for the measurements. However, measures of heart rate cannot inform on all aspects of wellness, fatigue, and performance, so their use in combination with daily training logs, psychometric questionnaires and non-invasive, cost-effective performance tests such as a countermovement jump may offer a complete solution to monitor training status in athletes participating in aerobic-oriented sports. PMID:24578692

The Effects of Guided Imagery on Heart Rate Variability in Simulated Spaceflight Emergency Tasks Performers

PubMed Central

Yijing, Zhang; Xiaoping, Du; Fang, Liu; Xiaolu, Jing; Bin, Wu

2015-01-01

Objectives. The present study aimed to investigate the effects of guided imagery training on heart rate variability in individuals while performing spaceflight emergency tasks. Materials and Methods. Twenty-one student subjects were recruited for the experiment and randomly divided into two groups: imagery group (n = 11) and control group (n = 10). The imagery group received instructor-guided imagery (session 1) and self-guided imagery training (session 2) consecutively, while the control group only received conventional training. Electrocardiograms of the subjects were recorded during their performance of nine spaceflight emergency tasks after imagery training. Results. In both of the sessions, the root mean square of successive differences (RMSSD), the standard deviation of all normal NN (SDNN), the proportion of NN50 divided by the total number of NNs (PNN50), the very low frequency (VLF), the low frequency (LF), the high frequency (HF), and the total power (TP) in the imagery group were significantly higher than those in the control group. Moreover, LF/HF of the subjects after instructor-guided imagery training was lower than that after self-guided imagery training. Conclusions. Guided imagery was an effective regulator for HRV indices and could be a potential stress countermeasure in performing spaceflight tasks. PMID:26137491

The Pilates method and cardiorespiratory adaptation to training.

PubMed

Tinoco-Fernández, Maria; Jiménez-Martín, Miguel; Sánchez-Caravaca, M Angeles; Fernández-Pérez, Antonio M; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen

2016-01-01

Although all authors report beneficial health changes following training based on the Pilates method, no explicit analysis has been performed of its cardiorespiratory effects. The objective of this study was to evaluate possible changes in cardiorespiratory parameters with the Pilates method. A total of 45 university students aged 18-35 years (77.8% female and 22.2% male), who did not routinely practice physical exercise or sports, volunteered for the study and signed informed consent. The Pilates training was conducted over 10 weeks, with three 1-hour sessions per week. Physiological cardiorespiratory responses were assessed using a MasterScreen CPX apparatus. After the 10-week training, statistically significant improvements were observed in mean heart rate (135.4-124.2 beats/min), respiratory exchange ratio (1.1-0.9) and oxygen equivalent (30.7-27.6) values, among other spirometric parameters, in submaximal aerobic testing. These findings indicate that practice of the Pilates method has a positive influence on cardiorespiratory parameters in healthy adults who do not routinely practice physical exercise activities.

Aerobic Interval vs. Continuous Training in Patients with Coronary Artery Disease or Heart Failure: An Updated Systematic Review and Meta-Analysis with a Focus on Secondary Outcomes.

PubMed

Pattyn, Nele; Beulque, Randy; Cornelissen, Véronique

2018-05-01

In a previous meta-analysis including nine trials comparing aerobic interval training with aerobic continuous training in patients with coronary artery disease, we found a significant difference in peak oxygen uptake favoring aerobic interval training. The objective of this study was to (1) update the original meta-analysis focussing on peak oxygen uptake and (2) evaluate the effect on secondary outcomes. We conducted a systematic review with a meta-analysis by searching PubMed and SPORTDiscus databases up to March 2017. We included randomized trials comparing aerobic interval training and aerobic continuous training in patients with coronary artery disease or chronic heart failure. The primary outcome was change in peak oxygen uptake. Secondary outcomes included cardiorespiratory parameters, cardiovascular risk factors, cardiac and vascular function, and quality of life. Twenty-four papers were identified (n = 1080; mean age 60.7 ± 10.7 years). Aerobic interval training resulted in a higher increase in peak oxygen uptake compared with aerobic continuous training in all patients (1.40 mL/kg/min; p < 0.001), and in the subgroups of patients with coronary artery disease (1.25 mL/kg/min; p = 0.001) and patients with chronic heart failure with reduced ejection fraction (1.46 mL/kg/min; p = 0.03). Moreover, a larger increase of the first ventilatory threshold and peak heart rate was observed after aerobic interval training in all patients. Other cardiorespiratory parameters, cardiovascular risk factors, and quality of life were equally affected. This meta-analysis adds further evidence to the clinically significant larger increase in peak oxygen uptake following aerobic interval training vs. aerobic continuous training in patients with coronary artery disease and chronic heart failure. More well-designed randomized controlled trials are needed to establish the safety of aerobic interval training and the sustainability of the training response over longer periods.

Heart rate monitoring in soccer: interest and limits during competitive match play and training, practical application.

PubMed

Alexandre, Dellal; da Silva, Cristiano Diniz; Hill-Haas, Stephen; Wong, Del P; Natali, Antonio J; De Lima, Jorge R P; Bara Filho, Mauricio G B; Marins, Joao J C B; Garcia, Emerson Silami; Karim, Chamari

2012-10-01

The identification of physiological loads imposed by soccer training or match play reveals essential information, which may help improve training and recovery strategies. Until today, the use of heart rate (HR) monitoring is not standardized in soccer. Thus, the aim of this review was to analyze, determine and compare the exercise intensity (EI) monitored by HR in professional, youth, and recreational soccer players during matches and training sessions using a meta-analysis. Heart rate is one of the most common physiological variables used to determine exercise internal training load. The mean EI recorded during competitive matches was described as 70-80% of VO2max or 80-90% of maximal heart rate (HRmax), independent of the playing level. With respect to HR training zones, approximately 65% of the total match duration is spent at intensity of 70-90% HRmax and rarely below 65% HRmax. However, although HRmax is mostly employed in the literature, monitoring EI should be expressed in relation to reserve heart rate, as it was described as a more reliable indicator of HR, allowing interindividual comparisons. The HR response according to the playing position indicates that midfielders are characterized by the highest EI, followed by forwards and fullbacks. Moreover, in the second half of the match, the EI is lower than that observed during the first half; this reduction could be correlated with the level of the player's physical conditioning. Consequently, coaches may favor the use of interval training or small-sided training games because these are shown to improve both aerobic capacity and the ability to repeat high-intensity actions. Small-sided games allow reaching similar HR responses to those found during interval training and match play but with greater heterogeneity values. Future investigations should include a larger sample of players with special reference to playing position and the expression of EI in percentage of the reserve heart rate, analyzing the possible intergender differences in HR response.

The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis.

PubMed

Jewiss, D; Ostman, C; Smart, N A

2016-10-15

To quantify the change in effect sizes, for selected clinical outcome measures, in people with heart failure, from resistance exercise, either in isolation, or in combination with aerobic training. Most exercise training data in heart failure, relates to aerobic exercise, we sought to provide current evidence for the benefits of resistance training in this population. We conducted a MEDLINE search (1985 to May 1, 2016), for exercise based rehabilitation trials in heart failure, using search terms 'resistance training, combined training, left ventricular dysfunction, peak VO2, cardio-myopathy and systolic heart dysfunction'. The 27 included studies provided a total of 2321 participants, 1172 in an intervention and 1149 in either sedentary controls or aerobic exercise only groups, producing over 31,263 patient-hours of training. Mortality, hospitalization, resting blood pressure and Left ventricular fraction were all unchanged with resistance or combined aerobic and resistance training. Peak VO2 was improved in combined exercise vs. control MD of 1.43ml·kg(-1)·min(-1) (95% CI 0.63, 2.23, p=0.0004; and in resistance vs. control MD 3.99ml·kg(-1)·min(-1) (95% CI 1.47, 6.51, p=0.002). Quality of Life (MLwHFQ) was improved in combined vs. control MD -8.31 (95% CI -14.3, -2.33, p=0.006). Six-minute walk distance was improved combined exercise vs. control, MD 13.49m (95% CI 1.13, 25.84, p=0.03); and resistance vs. control MD 41.77m (95% CI 21.90, 61.64, p<0.0001): SMD 1.25 (95%CI 0.53, 1.98, p=0.0007). Resistance only or combined training improves peak VO2, quality of life and walking performance in heart failure patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Frequency and duration of interval training programs and changes in aerobic power

NASA Technical Reports Server (NTRS)

Fox, E. L.; Bartels, R. L.; Obrien, R.; Bason, R.; Mathews, D. K.; Billings, C. E.

1975-01-01

The present study was designed to ascertain whether a training frequency of 2 days/wk for a 7- and 13-wk interval training program would produce improvement in maximal aerobic power comparable to that obtained from 7- and 13-wk programs of the same intensity consisting of 4 training days/wk. After training, there was a significant increase in maximal aerobic power that was independent of both training frequency and duration. Maximal heart rate was significantly decreased following training. Submaximal aerobic power did not change with training, but submaximal heart rate decreased significantly with greater decreases the more frequent and the longer the training.

Objective and subjective methods for quantifying training load in wheelchair basketball small-sided games.

PubMed

Iturricastillo, Aitor; Granados, Cristina; Los Arcos, Asier; Yanci, Javier

2017-04-01

The aim of the present study was to analyse the training load in wheelchair basketball small-sided games and determine the relationship between heart rate (HR)-based training load and perceived exertion (RPE)-based training load methods among small-sided games bouts. HR-based measurements of training load included Edwards' training load and Stagno's training impulses (TRIMP MOD ) while RPE-based training load measurements included cardiopulmonary (session RPEres) and muscular (session RPEmus) values. Data were collected from 12 wheelchair basketball players during five consecutive weeks. The total load for the small-sided games sessions was 67.5 ± 6.7 and 55.3 ± 12.5 AU in HR-based training load (Edwards' training load and TRIMP MOD ), while the RPE-based training loads were 99.3 ± 26.9 (session RPEres) and 100.8 ± 31.2 AU (session RPEmus). Bout-to-bout analysis identified greater session RPEmus in the third [P < 0.05; effect size (ES) = 0.66, moderate] and fourth bouts (P < 0.05; ES = 0.64, moderate) than in the first bout, but other measures did not differ. Mean correlations indicated a trivial and small relationship among HR-based and RPE-based training loads. It is suggested that HR-based and RPE-based training loads provide different information, but these two methods could be complementary because one method could help us to understand the limitations of the other.

Serious Game and Virtual World Training: Instrumentation and Assessment

DTIC Science & Technology

2012-12-10

Effectiveness of EEG Neurofeedback Training for ADHD in a Clinical Setting as Measured by Changes in T.O.V.A. Scores, Behavioral Ratings, and WISC-R...Human Physiological Data Collection Methods 24 4.3.1 Electroencephalography ( EEG ) 24 4.3.2 Galvanic Skin Response (GSR) and Heart Rate Variability...Collecting Human Data 24 8 Participant Wearing a 32-Channel EEG Cap 25 9 Future Force Warrior Example Combat Armor 27 10 Screenshot of the Organic

Interactive multimedia for prenatal ultrasound training.

PubMed

Lee, W; Ault, H; Kirk, J S; Comstock, C H

1995-01-01

This demonstration project examines the utility of interactive multimedia for prenatal ultrasound training. A laser-disc library was linked to a three-dimensional (3-D) heart model and other computer-based training materials through interactive multimedia. A testing module presented ultrasound anomalies and related questions to house-staff physicians through the image library. Users were asked to evaluate these training materials on the basis of perceived instructional value, question content, subjects covered, graphics interface, and ease of use; users were also asked for their comments. House-staff physicians indicated that they consider interactive multimedia to be a helpful adjunct to their core fetal imaging rotation. During a 9-month period, 16 house-staff physicians correctly diagnosed 78 +/- 4% of unknown cases presented through the testing module. The 3-D heart model was also perceived to be a useful teaching aid for spatial orientation skills. Our findings suggest that interactive multimedia and volume visualization models can be used to supplement traditional prenatal ultrasound training. The system provides a broad exposure to ultrasound anomalies, increases opportunities for postnatal correlation, emphasizes motion video for ultrasound training, encourages development of independent diagnostic ability, and helps physicians understand anatomic orientation. We hypothesize that interactive multimedia-based tutorials provide a better overall training experience for house-staff physicians. However, these supplementary methods will require formal evaluation of effectiveness to better understand their potential educational impact.

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training.

PubMed

Stöggl, Thomas L; Björklund, Glenn

2017-01-01

The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male ( n = 33) and female ( n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO 2peak ): 61.9 ± 8.0 mL·kg -1 ·min -1 ] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001) and peak lactate ( P = 0.001) during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L -1 ) was changed ( P > 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes.

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

PubMed Central

Stöggl, Thomas L.; Björklund, Glenn

2017-01-01

The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001) and peak lactate (P = 0.001) during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1) was changed (P > 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes. PMID:28824457

Therapeutic Effects of Exercise Training On Selected Cardio-Pulmonary Parameters and Body Composition of Nigerians with Chronic Heart Failure (A Preliminary Study).

PubMed

Ajiboye, O A; Anigbogu, C N; Ajuluchukwu, J N; Jaja, S I

2013-01-01

The use of exercise training in the management of individuals with chronic heart failure has not been widely accepted by health care providers especially in Sub-Saharan Africa because of the possibility that the failing hearts may have a negative response to the increased workload and stress of exercise. The study aimed to evaluate the effects of exercise training (ET) on selected cardio-respiratory and body composition variables of Nigerians with chronic heart failure (CHF). Thirty two Nigerians with CHF (male - 17), aged 30 to 71 years, mean age 54.2 ± 1.9 years and New York Heart Association Functional Class (NYHA) II-III recruited from Cardiology Clinic of Lagos University Teaching Hospital Nigeria participated in the study. They were randomized into exercise (EG) and control groups (CG). Exercise group performed 12-weeks of aerobic and resistance training for 60 minutes, three sessions per week. Selected cardio-respiratory and body composition variables were measured pre and post intervention in both groups. Data was analyzed using SPSS-17 package. Level of significance was set at 0.05. There was no significant difference in the measured variables between the groups at baseline (p > 0.05). Significant improvement was seen in EG in all the measured variables except the systolic (p = 0.29) and diastolic blood pressure (p = 0.45). No adverse effect was observed during the exercise training. No significant improvement was observed in the control group (p > 0.05). Exercise training may improve cardiorespiratory and body composition variables in patients with chronic heart failure.

Evaluating intervention fidelity: an example from a high-intensity interval training study.

PubMed

Taylor, Kathryn L; Weston, Matthew; Batterham, Alan M

2015-01-01

Intervention fidelity refers to the degree to which an experimental manipulation has been implemented as intended, but simple, robust methods for quantifying fidelity have not been well documented. Therefore, we aim to illustrate a rigorous quantitative evaluation of intervention fidelity, using data collected during a high-intensity interval training intervention. Single-group measurement study. Seventeen adolescents (mean age ± standard deviation [SD] 14.0 ± 0.3 years) attended a 10-week high-intensity interval training intervention, comprising two exercise sessions per week. Sessions consisted of 4-7 45-s maximal effort repetitions, interspersed with 90-s rest. We collected heart rate data at 5-s intervals and recorded the peak heart rate for each repetition. The high-intensity exercise criterion was ≥ 90% of individual maximal heart rate. For each participant, we calculated the proportion of total exercise repetitions exceeding this threshold. A linear mixed model was applied to properly separate the variability in peak heart rate between- and within-subjects. Results are presented both as intention to treat (including missed sessions) and per protocol (only participants with 100% attendance; n=8). For intention to treat, the median (interquartile range) proportion of repetitions meeting the high-intensity criterion was 58% (42% to 68%). The mean peak heart rate was 85% of maximal, with a between-subject SD of 7.8 (95% confidence interval 5.4 to 11.3) percentage points and a within-subject SD of 15.1 (14.6 to 15.6) percentage points. For the per protocol analysis, the median proportion of high-intensity repetitions was 68% (47% to 86%). The mean peak heart rate was 91% of maximal, with between- and within-subject SDs of 3.1 (-1.3 to 4.6) and 3.4 (3.2 to 3.6) percentage points, respectively. Synthesising information on exercise session attendance and compliance (exercise intensity) quantifies the intervention dose and informs evaluations of treatment fidelity.

Role of Biofeedback in Optimizing Psychomotor Performance in Sports

PubMed Central

Paul, Maman; Garg, Kanupriya; Singh Sandhu, Jaspal

2012-01-01

Purpose Biofeedback is an emerging tool to acquire and facilitate physiological and psychological domains of the human body like response time and concentration. Thus, the present study aims at determining the reconstitution of psychomotor and performance skills in basketball players through biofeedback training. Methods Basketball players (N=30) with different levels of expertise (university, state and national) aged 18-28 years (both male and female) were randomly divided into 3 equal groups - Experimental group, Placebo group and Control group. The experimental group received Heart Rate Variability Biofeedback training for 10 consecutive days for 20 minutes that included breathing at individual's resonant frequency through a pacing stimulus; Placebo group was shown motivational video clips for 10 consecutive days for 10 minutes, whereas Control group was not given any intervention. At session 1, 10 and 1month follow up, heart rate variability, respiration rate, response time (reaction and movement time), concentration and shooting performance were assessed. Results Two way repeated measure ANOVA was used to simultaneously compare within and between group differences. Response time, concentration, heart rate variability, respiration rate and shooting differences were statistically significant in each group along with interaction of group and time (P<0.001). Also, all the measures showed statistically significant inter group difference (P<0.05). Conclusion The results of the study suggest that biofeedback training may help to train stressed athletes to acquire a control over their psychophysiological processes, thus helping an athlete to perform maximally. PMID:22461963

Enhanced Skeletal Muscle Expression of EcSOD Mitigates Streptozotocin-Induced Diabetic Cardiomyopathy by Reducing Oxidative Stress and Aberrant Cell Signaling

PubMed Central

Call, Jarrod A.; Chain, Kristopher H.; Martin, Kyle S.; Lira, Vitor A.; Okutsu, Mitsuharu; Zhang, Mei; Yan, Zhen

2015-01-01

Background Exercise training enhances extracellular superoxide dismutase (EcSOD) expression in skeletal muscle and elicits positive health outcomes in individuals with diabetes. The goal of this study was to determine if enhanced skeletal muscle expression of EcSOD is sufficient to mitigate streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM). Methods and Results Exercise training promotes EcSOD expression in skeletal muscle and provides protection against DCM; however, it is not known if enhanced EcSOD expression in skeletal muscle plays a functional role in this protection. Here, we show that skeletal muscle-specific EcSOD transgenic mice (TG) are protected from cardiac hypertrophy, fibrosis and dysfunction under the condition of type-1 diabetes induced by STZ injection. We also show that both exercise training and muscle-specific transgenic expression of EcSOD result in elevated EcSOD protein in the blood and heart without increased transcription in the heart, suggesting enhanced expression of EcSOD from skeletal muscle redistributes to the heart. Importantly, cardiac tissue in TG mice displayed significantly reduced oxidative stress, aberrant cell signaling and inflammatory cytokine expression compared with wild type mice under the same diabetic condition. Conclusions Enhanced expression of EcSOD in skeletal muscle is sufficient to mitigate STZ-induced DCM through attenuation of oxidative stress, aberrant cell signaling and inflammation, suggesting a cross-organ mechanism by which exercise training improves cardiac function in diabetes. PMID:25504759

Effect of Exercise Training and +Gz Acceleration Training on Men

NASA Technical Reports Server (NTRS)

Greenleaf, John E.; Simonson, Shawn R.; Stocks, Jodie M.; Evans, Joyce; Knapp, Charles F.; Cowell, Stephenie A.; Pemberton, Kendra N.; Wilson, Heather W.; Vener, Jamie M.; Evetts, Simon N.

2001-01-01

Countermeasures for reduction in work capacity (maximal oxygen uptake and strength) during spaceflight and enhanced orthostatic intolerance during re-entry, landing and egress from the return vehicle are continuing problems. The purpose for this study was to test the hypothesis that passive-acceleration training; supine, interval, exercise plus acceleration training and exercise combined with acceleration training would improve orthostatic tolerance in ambulatory men; and that addition of the aerobic exercise conditioning would not alter this improved tolerance from that of passive-acceleration training. Seven men (24-38 yr) underwent "Passive" training on the Ames human-powered centrifuge (HPC) for 30 min, "Exercise" training on the cycle ergometer with constant +Gz acceleration; and "Combined" exercise training at 40% to 90% of the HPC +Gz(max) exercise level. Maximal supine exercise loads increased significant (P<0.05) by 8.3% (Passive), 12.6% (Exercise), and by 15.4% (Combined) after training, but their post-training maximal oxygen uptakes and maximal heart rates were unchanged. Maximal time to fatigue (endurance) was unchanged with Passive was increased (P<0.05) with Exercise and Combined training. Thus, the exercise in the Exercise and Combined training Phases resulted in greater maximal loads and endurance without effect on maximal oxygen uptake or heart rate. There was a 4% to 6% increase (P<0.05) in all four quadriceps muscle volumes (right and left) after post-Combined training. Resting pre-tilt heart rate was elevated by 12.9% (P<0.05) only after Passive training suggesting that the exercise training attenuated the HR response. Plasma volume (% Delta) was uniformly decreased by 8% to 14% (P<0.05) at tilt-tolerance pre- vs. post-training indicating essentially no effect of training on the level of hypovolemia. Post-training tilt-tolerance time and heart rate were increased (P<0.05) only with Passive training by 37.8% and by 29.1%, respectively. Thus, addition of exercise training appeared to attenuate the increased Passive tilt-tolerance.

Variation in effectiveness of a cardiac auscultation training class with a cardiology patient simulator among heart sounds and murmurs.

PubMed

Kagaya, Yutaka; Tabata, Masao; Arata, Yutaro; Kameoka, Junichi; Ishii, Seiichi

2017-08-01

Effectiveness of simulation-based education in cardiac auscultation training is controversial, and may vary among a variety of heart sounds and murmurs. We investigated whether a single auscultation training class using a cardiology patient simulator for medical students provides competence required for clinical clerkship, and whether students' proficiency after the training differs among heart sounds and murmurs. A total of 324 fourth-year medical students (93-117/year for 3 years) were divided into groups of 6-8 students; each group participated in a three-hour training session using a cardiology patient simulator. After a mini-lecture and facilitated training, each student took two different tests. In the first test, they tried to identify three sounds of Category A (non-split, respiratory split, and abnormally wide split S2s) in random order, after being informed that they were from Category A. They then did the same with sounds of Category B (S3, S4, and S3+S4) and Category C (four heart murmurs). In the second test, they tried to identify only one from each of the three categories in random order without any category information. The overall accuracy rate declined from 80.4% in the first test to 62.0% in the second test (p<0.0001). The accuracy rate of all the heart murmurs was similar in the first (81.3%) and second tests (77.5%). That of all the heart sounds (S2/S3/S4) decreased from 79.9% to 54.3% in the second test (p<0.0001). The individual accuracy rate decreased in the second test as compared with the first test in all three S2s, S3, and S3+S4 (p<0.0001). Medical students may be less likely to correctly identify S2/S3/S4 as compared with heart murmurs in a situation close to clinical setting even immediately after training. We may have to consider such a characteristic of students when we provide them with cardiac auscultation training. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Regular physical exercise improves endothelial function in heart transplant recipients.

PubMed

Schmidt, Alice; Pleiner, Johannes; Bayerle-Eder, Michaela; Wiesinger, Günther F; Rödler, Suzanne; Quittan, Michael; Mayer, Gert; Wolzt, Michael

2002-04-01

Impaired endothelial function is detectable in heart transplant (HTX) recipients and regarded as risk factor for coronary artery disease. We have studied whether endothelial function can be improved in HTX patients participating in a regular physical training program as demonstrated in patients with chronic heart failure, hypertension and coronary artery disease. Male HTX patients and healthy, age-matched controls were studied. Seven HTX patients (age: 60 +/- 6 yr; 6 +/- 2 yr of HTX) participated in an outpatient training program, six HTX patients (age: 63 +/- 8 yr; 7 +/- 1 yr of HTX) maintained a sedentary lifestyle without regular physical exercise since transplantation. A healthy control group comprised six subjects (age: 62 +/- 6 yr). Vascular function was assessed by flow-mediated dilation of the brachial artery (FMD). Systemic haemodynamic responses to intravenous infusion of the endothelium independent vasodilator sodium nitroprusside (SNP) and to NG-monomethyl-L-arginine (L-NMMA), an inhibitor of constitutive nitric oxide synthase, were also measured. Resting heart rate was significantly lower (p < 0.05) in healthy controls (66 +/- 13) than in the HTX training group (83 +/- 11) and in non-training HTX patients (91 +/- 9), baseline blood pressure also tended to be lower in healthy subjects and in the training HTX patients. FMD was significantly higher (p < 0.05) in the control group (8.4 +/- 2.2%) and in the training group (7.1 +/- 2.4%), compared with non-training HTX patients (1.4 +/- 0.8%). The response of systolic blood pressure (p = 0.08) and heart rate (p < 0.05) to L-NMMA was reduced in sedentary HTX patients compared with healthy controls and heart rate response to SNP was also impaired in sedentary HTX patients. Regular aerobic physical training restores vascular function in HTX patients, who are at considerable risk for developing vascular complications. This effect is demonstrable in conduit and systemic resistance arteries.

Exercise prescription for hospitalized people with chronic obstructive pulmonary disease and comorbidities: a synthesis of systematic reviews

PubMed Central

Reid, W Darlene; Yamabayashi, Cristiane; Goodridge, Donna; Chung, Frank; Hunt, Michael A; Marciniuk, Darcy D; Brooks, Dina; Chen, Yi-Wen; Hoens, Alison M; Camp, Pat G

2012-01-01

Introduction The prescription of physical activity for hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can be complicated by the presence of comorbidities. The current research aimed to synthesize the relevant literature on the benefits of exercise for people with multimorbidities who experience an AECOPD, and ask: What are the parameters and outcomes of exercise in AECOPD and in conditions that are common comorbidities as reported by systematic reviews (SRs)? Methods An SR was performed using the Cochrane Collaboration protocol. Nine electronic databases were searched up to July 2011. Articles were included if they (1) described participants with AECOPD, chronic obstructive pulmonary disease (COPD), or one of eleven common comorbidities, (2) were an SR, (3) examined aerobic training (AT), resistance training (RT), balance training (BT), or a combination thereof, (4) included at least one outcome of fitness, and (5) compared exercise training versus control/sham. Results This synthesis examined 58 SRs of exercise training in people with AECOPD, COPD, or eleven chronic conditions commonly associated with COPD. Meta-analyses of endurance (aerobic or exercise capacity, 6-minute walk distance – 6MWD) were shown to significantly improve in most conditions (except osteoarthritis, osteoporosis, and depression), whereas strength was shown to improve in five of the 13 conditions searched: COPD, older adults, heart failure, ischemic heart disease, and diabetes. Several studies of different conditions also reported improvements in quality of life, function, and control or prevention outcomes. Meta-analyses also demonstrate that exercise training decreases the risk of mortality in older adults, and those with COPD or ischemic heart disease. The most common types of training were AT and RT. BT and functional training were commonly applied in older adults. The quality of the SRs for most conditions was moderate to excellent (>65%) as evaluated by AMSTAR scores. Conclusion In summary, this synthesis showed evidence of significant benefits from exercise training in AECOPD, COPD, and conditions that are common comorbidities. A broader approach to exercise and activity prescription in pulmonary rehabilitation may induce therapeutic benefits to ameliorate clinical sequelae associated with AECOPD and comorbidities such as the inclusion of BT and functional training. PMID:22665994

Biofeedback in the treatment of heart failure.

PubMed

McKee, Michael G; Moravec, Christine S

2010-07-01

Biofeedback training can be used to reduce activation of the sympathetic nervous system (SNS) and increase activation of the parasympathetic nervous system (PNS). It is well established that hyperactivation of the SNS contributes to disease progression in chronic heart failure. It has been postulated that underactivation of the PNS may also play a role in heart failure pathophysiology. In addition to autonomic imbalance, a chronic inflammatory process is now recognized as being involved in heart failure progression, and recent work has established that activation of the inflammatory process may be attenuated by vagal nerve stimulation. By interfering with both autonomic imbalance and the inflammatory process, biofeedback-assisted stress management may be an effective treatment for patients with heart failure by improving clinical status and quality of life. Recent studies have suggested that biofeedback and stress management have a positive impact in patients with chronic heart failure, and patients with higher perceived control over their disease have been shown to have better quality of life. Our ongoing study of biofeedback-assisted stress management in the treatment of end-stage heart failure will also examine biologic end points in treated patients at the time of heart transplant, in order to assess the effects of biofeedback training on the cellular and molecular components of the failing heart. We hypothesize that the effects of biofeedback training will extend to remodeling the failing human heart, in addition to improving quality of life.

Heart rate variability (HRV) during virtual reality immersion

PubMed Central

Malińska, Marzena; Zużewicz, Krystyna; Bugajska, Joanna; Grabowski, Andrzej

2015-01-01

The goal of the study was assessment of the hour-long training involving handling virtual environment (sVR) and watching a stereoscopic 3D movie on the mechanisms of autonomic heart rate (HR) regulation among the subjects who were not predisposed to motion sickness. In order to exclude predispositions to motion sickness, all the participants (n=19) underwent a Coriolis test. During an exposure to 3D and sVR the ECG signal was continuously recorded using the Holter method. For the twelve consecutive 5-min epochs of ECG signal, the analysis of heart rate variability (HRV) in time and frequency domains was conducted. After 30 min from the beginning of the training in handling the virtual workstation a significant increase in LF spectral power was noted. The values of the sympathovagal LF/HF index while sVR indicated a significant increase in sympathetic predominance in four time intervals, namely between the 5th and the 10th minute, between the 15th and the 20th minute, between the 35th and 40th minute and between the 55th and the 60th minute of exposure. PMID:26327262

Tansig activation function (of MLP network) for cardiac abnormality detection

NASA Astrophysics Data System (ADS)

Adnan, Ja'afar; Daud, Nik Ghazali Nik; Ishak, Mohd Taufiq; Rizman, Zairi Ismael; Rahman, Muhammad Izzuddin Abd

2018-02-01

Heart abnormality often occurs regardless of gender, age and races. This problem sometimes does not show any symptoms and it can cause a sudden death to the patient. In general, heart abnormality is the irregular electrical activity of the heart. This paper attempts to develop a program that can detect heart abnormality activity through implementation of Multilayer Perceptron (MLP) network. A certain amount of data of the heartbeat signals from the electrocardiogram (ECG) will be used in this project to train the MLP network by using several training algorithms with Tansig activation function.

AED training and its impact on skill acquisition, retention and performance--a systematic review of alternative training methods.

PubMed

Yeung, Joyce; Okamoto, Deems; Soar, Jasmeet; Perkins, Gavin D

2011-06-01

The most popular method of training in basic life support and AED use remains instructor-led training courses. This systematic review examines the evidence for different training methods of basic life support providers (laypersons and healthcare providers) using standard instructor-led courses as comparators, to assess whether alternative method of training can lead to effective skill acquisition, skill retention and actual performance whilst using the AED. OVID Medline (including Medline 1950-November 2010; EMBASE 1988-November 2010) was searched using "training" OR "teaching" OR "education" as text words. Search was then combined by using AND "AED" OR "automatic external defibrillator" as MESH words. Additionally, the American Heart Association Endnote library was searched with the terms "AED" and "automatic external defibrillator". Resuscitation journal was hand searched for relevant articles. 285 articles were identified. After duplicates were removed, 172 references were reviewed for relevance. From this 22 papers were scrutinized and 18 were included. All were manikin studies. Four LOE 1 studies, seven LOE 2 studies and three LOE 4 studies were supportive of alternative AED training methods. One LOE 2 study was neutral. Three LOE 1 studies provided opposing evidence. There is good evidence to support alternative methods of AED training including lay instructors, self directed learning and brief training. There is also evidence to support that no training is needed but even brief training can improve speed of shock delivery and electrode pad placement. Features of AED can have an impact on its use and further research should be directed to making devices user-friendly and robust to untrained layperson. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Physiological Effects of Training.

DTIC Science & Technology

1985-06-25

applies only to short-term programs, the resting heart rate is norrally reduced as a result of aerobic training in all age groups. I0 Studies with ...in order to maintain cardiao output in conjunction with a decreased heart rate, stroke volume has to Increase. Stroke volume increases in the...volume is partially due too increased end diastolic volume. Thus, the pumping ability of the heart , I.e. increased stroke volume, is improved with

AUTONOMIC CONTROL OF HEART RATE AFTER EXERCISE IN TRAINED WRESTLERS

PubMed Central

Báez, San Martín E.; Von Oetinger, A.; Cañas, Jamett R.; Ramírez, Campillo R.

2013-01-01

The objective of this study was to establish differences in vagal reactivation, through heart rate recovery and heart rate variability post exercise, in Brazilian jiu-jitsu wrestlers (BJJW). A total of 18 male athletes were evaluated, ten highly trained (HT) and eight moderately trained (MT), who performed a maximum incremental test. At the end of the exercise, the R-R intervals were recorded during the first minute of recovery. We calculated heart rate recovery (HRR60s), and performed linear and non-linear (standard deviation of instantaneous beat-to-beat R-R interval variability – SD1) analysis of heart rate variability (HRV), using the tachogram of the first minute of recovery divided into four segments of 15 s each (0-15 s, 15-30 s, 30-45 s, 45-60 s). Between HT and MT individuals, there were statistically significant differences in HRR60s (p <0.05) and in the non linear analysis of HRV from SD130-45s (p <0.05) and SD145-60s (p <0.05). The results of this research suggest that heart rate kinetics during the first minute after exercise are related to training level and can be used as an index for autonomic cardiovascular control in BJJW. PMID:24744476

Autonomic control of heart rate after exercise in trained wrestlers.

PubMed

Henríquez, Olguín C; Báez, San Martín E; Von Oetinger, A; Cañas, Jamett R; Ramírez, Campillo R

2013-06-01

The objective of this study was to establish differences in vagal reactivation, through heart rate recovery and heart rate variability post exercise, in Brazilian jiu-jitsu wrestlers (BJJW). A total of 18 male athletes were evaluated, ten highly trained (HT) and eight moderately trained (MT), who performed a maximum incremental test. At the end of the exercise, the R-R intervals were recorded during the first minute of recovery. We calculated heart rate recovery (HRR60s), and performed linear and non-linear (standard deviation of instantaneous beat-to-beat R-R interval variability - SD1) analysis of heart rate variability (HRV), using the tachogram of the first minute of recovery divided into four segments of 15 s each (0-15 s, 15-30 s, 30-45 s, 45-60 s). Between HT and MT individuals, there were statistically significant differences in HRR60s (p <0.05) and in the non linear analysis of HRV from SD130-45s (p <0.05) and SD145-60s (p <0.05). The results of this research suggest that heart rate kinetics during the first minute after exercise are related to training level and can be used as an index for autonomic cardiovascular control in BJJW.

Acute Responses of a Physical Training Session with a Nintendo Wii on Hemodynamic Variables of an Individual with Multiple Sclerosis.

PubMed

Monteiro Junior, Renato Sobral; Dantas, Aretha; de Souza, Cíntia Pereira; da Silva, Elirez Bezerra

2012-12-01

Multiple sclerosis is a neurological illness that decreases motor functions. This disease can cause weakness of cardiorespiratory muscles and impaired functional capacity and quality of life. Therefore it requires preventive treatments. This study investigated the acute responses of a virtual physical training session with the Nintendo(®) (Kyoto, Japan) Wii™ on hemodynamic variables of an individual with multiple sclerosis (relapsing-remitting). A 34-year-old man with multiple sclerosis with previous experience in aerobic, strength, and functional training (2 years) was tested. His Expanded Disability Status Scale was 2.5. We compared the heart rate, blood pressure, and double product obtained at rest and during (heart rate) and after the Nintendo Wii games "Boxing" and "Sword Play." In rest, the variables were measured in the supine position. Our results showed positive hemodynamic alterations after execution of both games. The peak of heart rate was 121 beats per minute (65% of maximal heart rate) and 104 beats per minute (56% of maximal heart rate) for "Boxing" and "Sword Play," respectively. The training session with "Boxing" was able to stimulate the heart rate to achieve the recommended values for the maintenance of physical fitness in accordance with the American College of Sports Medicine guidelines. We conclude that an exercise training program with the Nintendo Wii may improve physical fitness in people with multiple sclerosis. Moreover, these activities could improve affective status and perhaps maintain the individual engaged at treatment program.

Functional and psychosocial effects of either a traditional dancing or a formal exercising training program in patients with chronic heart failure: a comparative randomized controlled study.

PubMed

Kaltsatou, Antonia C H; Kouidi, Evangelia I; Anifanti, Maria A; Douka, Stella I; Deligiannis, Asterios P

2014-02-01

To compare the effects of traditional dancing with formal exercise training in terms of functional and cardiovascular benefits and motivation in patients with chronic heart failure. Randomized controlled trial. Sports Medicine Laboratory. Fifty-one Greek male patients aged 67.1±5.5 years with chronic heart failure of New York Heart Association (NYHA) class II-III, participated in an eight-month study. They were randomly assigned to either training with Greek traditional dances (group A, n=18), formal exercise training (group B, n=16) or a sedentary control group (group C, n=17). At entry and the end of the study all patients underwent cardiopulmonary exercise testing, functional ability assessment and quality of life evaluations. The Intrinsic Motivation Inventory was also used to assess participants' subjective experience. After training group A showed increased peak oxygen consumption by 33.8% (19.5 vs. 26.1 ml/kg/min, p<0.05) and B by 32.3% (19.5 vs. 25.8 ml/kg/min, p<0.05), maximal treadmill tolerance by 48.5% (p<0.05) and by 46.4% (p<0.05), and a decreased Slope of expired minute ventilation for carbon dioxide output (VE/VCO2) slope by 18% (p<0.05) and 19.5% (p<0.05), respectively. Trained patients revealed significant improvement in the quality of life indices. Intrinsic Motivation Inventory was increased only in group A by 26.2% (3.08 vs. 3.87, p<0.05). Exercise training in chronic heart failure patients with Greek traditional dances led to functional and cardiovascular benefits similar to formal exercise training and to a higher level of motivation.

Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial

PubMed Central

O’Connor, Christopher M.; Whellan, David J.; Lee, Kerry L.; Keteyian, Steven J.; Cooper, Lawton S.; Ellis, Stephen J.; Leifer, Eric S.; Kraus, William E.; Kitzman, Dalane W.; Blumenthal, James A.; Rendall, David S.; Miller, Nancy Houston; Fleg, Jerome L.; Schulman, Kevin A.; McKelvie, Robert S.; Zannad, Faiez; Piña, Ileana L.

2010-01-01

Context Guidelines recommend that exercise training be considered for medically stable outpatients with heart failure. Previous studies have not had adequate statistical power to measure the effects of exercise training on clinical outcomes. Objective To test the efficacy and safety of exercise training among patients with heart failure. Design, Setting, and Patients Multicenter, randomized controlled trial among 2331 medically stable outpatients with heart failure and reduced ejection fraction. Participants in Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) were randomized from April 2003 through February 2007 at 82 centers within the United States, Canada, and France; median follow-up was 30 months. Interventions Usual care plus aerobic exercise training, consisting of 36 supervised sessions followed by home-based training, or usual care alone. Main Outcome Measures Composite primary end point of all-cause mortality or hospitalization and prespecified secondary end points of all-cause mortality, cardiovascular mortality or cardiovascular hospitalization, and cardiovascular mortality or heart failure hospitalization. Results The median age was 59 years, 28% were women, and 37% had New York Heart Association class III or IV symptoms. Etiology was ischemic in 51%. Median left ventricular ejection fraction was 25%. Exercise adherence decreased from a median of 95 minutes per week during months 4 through 6 of follow-up to 74 minutes per week during months 10 through 12. A total of 759 (65%) patients in the exercise group died or were hospitalized, compared with 796 (68%) in the usual care group (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.84–1.02; P = .13). There were nonsignificant reductions in the exercise training group for mortality (189 [16%] in the exercise group vs 198 [17%] in the usual care group; HR, 0.96; 95% CI, 0.79–1.17; P = .70), cardiovascular mortality or cardiovascular hospitalization (632 [55%] in the exercise group vs 677 [58%] in the usual care group; HR, 0.92; 95% CI, 0.83–1.03; P = .14), and cardiovascular mortality or heart failure hospitalization (344 [30%] in the exercise group vs 393 [34%] in the usual care group; HR, 0.87; 95% CI, 0.75–1.00; P = .06). In prespecified supplementary analyses adjusting for highly prognostic baseline characteristics, the HRs were 0.89 (95% CI, 0.81–0.99; P = .03) for all-cause mortality or hospitalization, 0.91 (95% CI, 0.82–1.01; P = .09) for cardiovascular mortality or cardiovascular hospitalization, and 0.85 (95% CI, 0.74–0.99; P = .03) for cardiovascular mortality or heart failure hospitalization. Other adverse events were similar between the groups. Conclusions In the protocol-specified primary analysis, exercise training resulted in nonsignificant reductions in the primary end point of all-cause mortality or hospitalization and in key secondary clinical end points. After adjustment for highly prognostic predictors of the primary end point, exercise training was associated with modest significant reductions for both all-cause mortality or hospitalization and cardiovascular mortality or heart failure hospitalization. Trial Registration clinicaltrials.gov Identifier: NCT00047437 PMID:19351941

Impact of a standardized training program on midwives’ ability to assess fetal heart anatomy by ultrasound

PubMed Central

2014-01-01

Background Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. Methods A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later. Results At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later. Conclusions Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important. PMID:24889837

Chronic heat improves mechanical and metabolic response of trained rat heart on ischemia and reperfusion.

PubMed

Levy, E; Hasin, Y; Navon, G; Horowitz, M

1997-05-01

Cardiac mechanics and metabolic performance were studied in isolated perfused hearts of rats subjected to a combined chronic stress of heat acclimation and swimming training (EXAC) or swimming training alone (EX). Diastolic (DP) and systolic pressures (SP), coronary flow (CF), and oxygen consumption were measured during normoperfusion (80 mmHg), and the appearance of ischemic contracture (IC), DP, and SP were measured during progressive graded ischemia, total ischemia (TI), and reperfusion insults. ATP, phosphocreatine, and intracellular pH were measured during TI and reperfusion with 31P nuclear magnetic resonance spectroscopy. During normoperfusion, SP and cardiac efficiency (derived from rate-pressure product-oxygen consumption relationships) were the highest in the 2-mo EXAC hearts (P < 0.0001). During progressive graded ischemia, the development of IC (percentage of total hearts) was similar in both EXAC and EX hearts; the only significant difference was confined to the 1- vs. 2-mo groups. The onset of IC was delayed in the EXAC hearts and, on reperfusion, recovery, particularly of DP, was significantly improved in the latter. After TI, EXAC hearts retained 30% of the ATP pool and there was a delayed decline in intracellular pH. On reperfusion, these hearts also displayed improved ATP and phosphocreatine recovery, the 2-mo EXAC heart demonstrating significantly faster high-energy phosphate salvage, improved diastolic function, and pulse pressure recovery. The data attest to the beneficial effects of heat acclimation on cardiac mechanics of trained rats during normoperfusion and cardiac protection on ischemia and reperfusion. Possibly, energy sparing, lesser acidosis, and shorter duration of IC on ischemia and improved energy salvage on reperfusion contribute synergistically to this potent beneficial effect.

Psychosocial Factors, Exercise Adherence, and Outcomes in Heart Failure Patients: Insights from HF-ACTION

PubMed Central

Cooper, Lauren B.; Mentz, Robert J.; Sun, Jie-Lena; Schulte, Phillip J; Fleg, Jerome L.; Cooper, Lawton S.; Piña, Ileana L.; Leifer, Eric S.; Kraus, William E.; Whellan, David J.; Keteyian, Steven J.; O’Connor, Christopher M.

2016-01-01

Background Psychosocial factors may influence adherence with exercise training for heart failure patients. We aimed to describe the association between social support and barriers to participation with exercise adherence and clinical outcomes. Methods and Results Of patients enrolled in HF-ACTION, 2279 (97.8%) completed surveys to assess social support and barriers to exercise, resulting in the perceived social support score (PSSS) and barriers to exercise score (BTES). Higher PSSS indicated higher levels of social support, while higher BTES indicated more barriers to exercise. Exercise time at 3 and 12 months correlated with PSSS (r= 0.09 and r= 0.13, respectively) and BTES (r= − 0.11 and r= − 0.12, respectively), with higher exercise time associated with higher PSSS and lower BTES (All p <0.005). For CV death or HF hospitalization, there was a significant interaction between randomization group and BTES (p=0.035), which corresponded to a borderline association between increasing BTES and CV death or HF hospitalization in the exercise group (HR 1.25, 95% CI: 0.99, 1.59) but no association in the usual care group (HR 0.83, 95% CI: 0.66, 1.06). Conclusions Poor social support and high barriers to exercise were associated with lower exercise time. PSSS did not impact the effect of exercise training on outcomes. However, for CV death or HF hospitalization, exercise training had a greater impact on patients with lower BTES. Given that exercise training improves outcomes in heart failure patients, assessment of perceived barriers may facilitate individualized approaches to implement exercise training therapy in clinical practice. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437. PMID:26578668

Within-session responses to high-intensity interval training in spinal cord injury.

PubMed

Astorino, Todd Anthony; Thum, Jacob S

2018-02-01

Completion of high-intensity interval training (HIIT) increases maximal oxygen uptake and health status, yet its feasibility in persons with spinal cord injury is unknown. To compare changes in cardiorespiratory and metabolic variables between two interval training regimes and moderate intensity exercise. Nine adults with spinal cord injury (duration = 6.8 ± 6.2 year) initially underwent determination of peak oxygen uptake. During subsequent sessions, they completed moderate intensity exercise, HIIT, or sprint interval training. Oxygen uptake, heart rate, and blood lactate concentration were measured. Oxygen uptake and heart rate increased (p < 0.05) during both interval training sessions and were similar (p > 0.05) to moderate intensity exercise. Peak oxygen uptake and heart rate were higher (p < 0.05) with HIIT (90% peak oxygen uptake and 99% peak heart rate) and sprint interval training (80% peak oxygen uptake and 96% peak heart rate) versus moderate intensity exercise. Despite a higher intensity and peak cardiorespiratory strain, all participants preferred interval training versus moderate exercise. Examining long-term efficacy and feasibility of interval training in this population is merited, considering that exercise intensity is recognized as the most important variable factor of exercise programming to optimize maximal oxygen uptake. Implications for Rehabilitation Spinal cord injury (SCI) reduces locomotion which impairs voluntary physical activity, typically resulting in a reduction in peak oxygen uptake and enhanced chronic disease risk. In various able-bodied populations, completion of high-intensity interval training (HIIT) has been consistently reported to improve cardiorespiratory fitness and other health-related outcomes, although its efficacy in persons with SCI is poorly understood. Data from this study in 9 men and women with SCI show similar changes in oxygen uptake and heart in response to HIIT compared to a prolonged bout of aerobic exercise, although peak values were higher in response to HIIT. Due to the higher peak metabolic strain induced by HIIT as well as universal preference for this modality versus aerobic exercise as reported in this study, further work testing utility of HIIT in this population is merited.

Higher Precision of Heart Rate Compared with VO2 to Predict Exercise Intensity in Endurance-Trained Runners.

PubMed

Reis, Victor M; den Tillaar, Roland Van; Marques, Mario C

2011-01-01

The aim of the present study was to assess the precision of oxygen uptake with heart rate regression during track running in highly-trained runners. Twelve national and international level male long-distance road runners (age 30.7 ± 5.5 yrs, height 1.71 ± 0.04 m and mass 61.2 ± 5.8 kg) with a personal best on the half marathon of 62 min 37 s ± 1 min 22 s participated in the study. Each participant performed, in an all-weather synthetic track five, six min bouts at constant velocity with each bout at an increased running velocity. The starting velocity was 3.33 m·s(-1) with a 0.56 m·s(-1) increase on each subsequent bout. VO2 and heart rate were measured during the runs and blood lactate was assessed immediately after each run. Mean peak VO2 and mean peak heart rate were, respectively, 76.2 ± 9.7 mL·kg(-1)·min(-1) and 181 ± 13 beats·min(-1). The linearity of the regressions between heart rate, running velocity and VO2 were all very high (r > 0.99) with small standard errors of regression (i.e. Sy.x < 5% at the velocity associated with the 2 and 4 mmol·L(-1) lactate thresholds). The strong relationships between heart rate, running velocity and VO2 found in this study show that, in highly trained runners, it is possible to have heart rate as an accurate indicator of energy demand and of the running speed. Therefore, in this subject cohort it may be unnecessary to use VO2 to track changes in the subjects' running economy during training periods. Key pointsHeart rate is used in the control of exercise intensity in endurance sports.However, few studies have quantified the precision of its relationship with oxygen uptake in highly trained runners.We evaluated twelve elite half-marathon runners during track running at various intensities and established three regressions: oxygen uptake / heart rate; heart rate / running velocity and oxygen uptake / running velocity.The three regressions presented, respectively, imprecision of 4,2%, 2,75% and 4,5% at the velocity associated with the 4 mmol·L(-1) threshold.The results of the present study show that, in highly trained runners, it is possible to use heart rate as an accurate index of the external work rate during sub maximal running speeds.

Effect of the low- versus high-intensity exercise training on endoplasmic reticulum stress and GLP-1 in adolescents with type 2 diabetes mellitus.

PubMed

Lee, Sung Soo; Yoo, Jae Ho; So, Yong Seok

2015-10-01

[Purpose] The primary objective of this study was to investigate the effect of low-intensity exercise training compare with high-intensity exercise training on endoplasmic reticulum stress and glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus. [Subjects and Methods] The low-intensity exercise training group performed aerobic exercise training at an intensity of ≤ 45% of the heart rate reserve. The high-intensity interval exercise training group performed interval exercise training at an intensity of ≥ 80% of the heart rate reserve. The exercise-related energy consumption was determined for both groups on a per-week basis (1,200 kcal/week). [Results] Both groups showed improvement in the glucose-regulated protein 78 and dipeptidyl peptidase-4, but the size of the between-group effect was not statistically significant. The high-intensity interval exercise training group showed a significant reduction in percentage body fat. The C-peptide level increased after the 12-weeks programs and was significantly different, between the groups. Fasting glucose, insulin resistance in the fasting state according to homeostasis model assessment, and leptin decreased after the 12-weeks exercise program and were significantly different between the groups, and glucagon-like peptide-1 increased after the 12-week exercise programs and was significantly different between the groups. [Conclusion] In conclusion high-intensity interval exercise training, as defined in this study, may lead to improvements in body composition, glycemic control, endoplasmic reticulum stress, and the glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus.

Effect of the low- versus high-intensity exercise training on endoplasmic reticulum stress and GLP-1 in adolescents with type 2 diabetes mellitus

PubMed Central

Lee, Sung Soo; Yoo, Jae Ho; So, Yong Seok

2015-01-01

[Purpose] The primary objective of this study was to investigate the effect of low-intensity exercise training compare with high-intensity exercise training on endoplasmic reticulum stress and glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus. [Subjects and Methods] The low-intensity exercise training group performed aerobic exercise training at an intensity of ≤ 45% of the heart rate reserve. The high-intensity interval exercise training group performed interval exercise training at an intensity of ≥ 80% of the heart rate reserve. The exercise-related energy consumption was determined for both groups on a per-week basis (1,200 kcal/week). [Results] Both groups showed improvement in the glucose-regulated protein 78 and dipeptidyl peptidase-4, but the size of the between-group effect was not statistically significant. The high-intensity interval exercise training group showed a significant reduction in percentage body fat. The C-peptide level increased after the 12-weeks programs and was significantly different, between the groups. Fasting glucose, insulin resistance in the fasting state according to homeostasis model assessment, and leptin decreased after the 12-weeks exercise program and were significantly different between the groups, and glucagon-like peptide-1 increased after the 12-week exercise programs and was significantly different between the groups. [Conclusion] In conclusion high-intensity interval exercise training, as defined in this study, may lead to improvements in body composition, glycemic control, endoplasmic reticulum stress, and the glucagon-like peptide-1 in adolescents with type 2 diabetes mellitus. PMID:26644644

Endurance training attenuates the increase in peripheral chemoreflex sensitivity with intermittent hypoxia

PubMed Central

Miller, Amanda J.; Sauder, Charity L.; Cauffman, Aimee E.; Blaha, Cheryl A.

2017-01-01

Patients with heart failure and sleep apnea have greater chemoreflex sensitivity, presumably due to intermittent hypoxia (IH), and this is predictive of mortality. We hypothesized that endurance training would attenuate the effect of IH on peripheral chemoreflex sensitivity in healthy humans. Fifteen young healthy subjects (9 female, 26 ± 1 yr) participated. Between visits, 11 subjects underwent 8 wk of endurance training that included running four times/wk at 80% predicted maximum heart rate and interval training, and four control subjects did not change activity. Chemoreflex sensitivity (the slope of ventilation responses to serial oxygen desaturations), blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) were assessed before and after 30 min of IH. Endurance training decreased resting systolic blood pressure (119 ± 3 to 113 ± 3 mmHg; P = 0.027) and heart rate (67 ± 3 to 61 ± 2 beats/min; P = 0.004) but did not alter respiratory parameters at rest (P > 0.2). Endurance training attenuated the IH-induced increase in chemoreflex sensitivity (pretraining: Δ 0.045 ± 0.026 vs. posttraining: Δ −0.028 ± 0.040 l·min−1·% O2 desaturation−1; P = 0.045). Furthermore, IH increased mean blood pressure and MSNA burst rate before training (P < 0.05), but IH did not alter these measures after training (P > 0.2). All measurements were similar in the control subjects at both visits (P > 0.05). Endurance training attenuates chemoreflex sensitization to IH, which may partially explain the beneficial effects of exercise training in patients with cardiovascular disease. PMID:28039190

Faster heart rate and muscular oxygen uptake kinetics in type 2 diabetes patients following endurance training.

PubMed

Koschate, Jessica; Drescher, Uwe; Brinkmann, Christian; Baum, Klaus; Schiffer, Thorsten; Latsch, Joachim; Brixius, Klara; Hoffmann, Uwe

2016-11-01

Cardiorespiratory kinetics were analyzed in type 2 diabetes patients before and after a 12-week endurance exercise-training intervention. It was hypothesized that muscular oxygen uptake and heart rate (HR) kinetics would be faster after the training intervention and that this would be detectable using a standardized work rate protocol with pseudo-random binary sequences. The cardiorespiratory kinetics of 13 male sedentary, middle-aged, overweight type 2 diabetes patients (age, 60 ± 8 years; body mass index, 33 ± 4 kg·m -2 ) were tested before and after the 12-week exercise intervention. Subjects performed endurance training 3 times a week on nonconsecutive days. Pseudo-random binary sequences exercise protocols in combination with time series analysis were used to estimate kinetics. Greater maxima in cross-correlation functions (CCF max ) represent faster kinetics of the respective parameter. CCF max of muscular oxygen uptake (pre-training: 0.31 ± 0.03; post-training: 0.37 ± 0.1, P = 0.024) and CCF max of HR (pre-training: 0.25 ± 0.04; post-training: 0.29 ± 0.06, P = 0.007) as well as peak oxygen uptake (pre-training: 24.4 ± 4.7 mL·kg -1 ·min -1 ; post-training: 29.3 ± 6.5 mL·kg -1 ·min -1 , P = 0.004) increased significantly over the course of the exercise intervention. In conclusion, kinetic responses to changing work rates in the moderate-intensity range are similar to metabolic demands occurring in everyday habitual activities. Moderate endurance training accelerated the kinetic responses of HR and muscular oxygen uptake. Furthermore, the applicability of the used method to detect these accelerations was demonstrated.

Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

PubMed Central

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

2015-01-01

Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality. PMID:25590598

Heart Health: A Resource for Senior High School Physical Education

ERIC Educational Resources Information Center

Online Submission, 2006

2006-01-01

Heart Health is grounded in the skill of learning to listen to the language of the heart. It connects students to their heart-rate data, and offers insights into what these numbers mean using the framework of Heart Zones Training. There are eight learning opportunities that originate from the following questions: How does heart health information…

A Cycle Ergometer Exercise Program Improves Exercise Capacity and Inspiratory Muscle Function in Hospitalized Patients Awaiting Heart Transplantation: a Pilot Study

PubMed Central

Forestieri, Patrícia; Guizilini, Solange; Peres, Monique; Bublitz, Caroline; Bolzan, Douglas W.; Rocco, Isadora S.; Santos, Vinícius B.; Moreira, Rita Simone L.; Breda, João R.; de Almeida, Dirceu R.; Carvalho, Antonio Carlos de C.; Arena, Ross; Gomes, Walter J.

2016-01-01

Objective The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. Methods Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: 1) Control Group (n=11) - conventional protocol; and 2) Intervention Group (n=7) - stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. Results Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (P=0.08 and P=0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (P<0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (P=0.22 and P<0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (P<0.01). Conclusion Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support. PMID:27982348

CPR in the Schools: Training Students to Save Heart Attack Victims.

ERIC Educational Resources Information Center

Britton, Royce J.

1978-01-01

A community cardiac emergency medical plan should include training of family and co-workers of high risk patients, including teenage students. The American Heart Association lists ways to introduce cardiopulmonary resuscitation (CPR) into school curricula and describes the plan implemented in Pennsylvania. (MF)

EMG and Heart Rate Responses Decline within 5 Days of Daily Whole-Body Vibration Training with Squatting

PubMed Central

Rosenberger, André; Liphardt, Anna-Maria; Bargmann, Arne; Müller, Klaus; Beck, Luis; Mester, Joachim; Zange, Jochen

2014-01-01

In this study, we examined the acute effects of a 5-day daily whole-body vibration (WBV) training on electromyography (EMG) responses of the m. rectus femoris and m. gastrocnemius lateralis, heart rate (HR, continuously recorded), and blood lactate levels. The purpose of the study was to investigate the adaptation of muscle activity, heart rate and blood lactate levels during 5 days of daily training. Two groups of healthy male subjects performed either squat exercises with vibration at 20 Hz on a side alternating platform (SE+V, n = 20, age  = 31.9±7.5 yrs., height  = 178.8±6.2 cm, body mass  = 79.2±11.4 kg) or squat exercises alone (SE, n = 21, age  = 28.4±7.3 years, height  = 178.9±7.4 cm, body mass  = 77.2±9.7 kg). On training day 1, EMG amplitudes of the m. rectus femoris were significantly higher (P<0.05) during SE+V than during SE. However, this difference was no longer statistically significant on training days 3 and 5. The heart rate (HR) response was significantly higher (P<0.05) during SE+V than during SE on all training days, but showed a constant decline throughout the training days. On training day 1, blood lactate increased significantly more after SE+V than after SE (P<0.05). On the following training days, this difference became much smaller but remained significantly different. The specific physiological responses to WBV were largest on the initial training day and most of them declined during subsequent training days, showing a rapid neuromuscular and cardiovascular adaptation to the vibration stimulus. PMID:24905721

Changing hearts and minds: Results from a multi-country gender and sexual diversity training.

PubMed

Poteat, Tonia; Park, Chulwoo; Solares, Diego; Williams, John K; Wolf, R Cameron; Metheny, Noah; Vazzano, Andrea; Dent, Juan; Gibbs, Ashley; Nonyane, Bareng Aletta Sanny; Toiv, Nora

2017-01-01

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- and post-training study design. Findings suggest that sustainable decreases in negative attitudes toward gender and sexual minorities are achievable with a one-day training.

The Dalcroze Approach to Music Education: Theory and Applications

ERIC Educational Resources Information Center

Anderson, William Todd

2012-01-01

The methods of the Dalcroze approach to music education--eurhythmics, solfege, and improvisation--have had a profound influence on modern music education. In particular, the overt training in kinesthetic abilities, and the assertion that the relationship between music and movement is an intimate one, is at the heart of Dalcroze's approach to…

Cardiovascular responses to static exercise in distance runners and weight lifters

NASA Technical Reports Server (NTRS)

Longhurst, J. C.; Kelly, A. R.; Gonyea, W. J.; Mitchell, J. H.

1980-01-01

Three groups of athletes including long-distance runners, competitive and amateur weight lifters, and age- and sex-matched control subjects have been studied by hemodynamic and echocardiographic methods in order to determine the effect of the training programs on the cardiovascular response to static exercise. Blood pressure, heart rate, and double product data at rest and at fatigue suggest that competitive endurance (dynamic exercise) training alters the cardiovascular response to static exercise. In contrast to endurance exercise, weight lifting (static exercise) training does not alter the cardiovascular response to static exercise: weight lifters responded to static exercise in a manner very similar to that of the control subjects.

[Educational status and occupational training, occupational status and ischemic heart diseases: a prospective study with data from statutory health insurance in Germany].

PubMed

Peter, Richard; Yong, Mai; Geyer, Siegfried

2003-01-01

To study associations between education, occupational position, and incidence of ischemic heart disease (ICD-9 410-414). A cohort of 151,471 male and female members of a German statutory health insurance company aged between 25 and 65 years was investigated. The cohort comprised all members between 1987 and 1996. Information on ischemic heart disease was derived from clinical diagnosis. Education, training, and occupational position according to the British Registrar General defined the indicators of social status. After adjustment for age and length of observation period, education and training as well as occupational position were associated with the incidence of ischemic heart disease in both men and women. Whereas a gradient was observed in men regarding education and training (odds ratios (OR): 3.41-6.02) men with lower occupational position had higher risk estimates as compared to the highest occupational status group (OR: 1.73-3.05). Among women a gradient was observed concerning education and training (OR: 1.75-3.78). With regard to occupational status position female members of the highest group showed the lowest risk as compared to the lower status groups (OR: 1.58-2.19). Social inequality in ischemic heart disease morbidity was observed among male and female members of a German statutory health insurance. Findings are of importance for health policy and call for preventive action.

Changes in the heart rate recovery to endurance effort after high intensity interval, strength, and concurrent exercise training in patients with insulin resistance.

PubMed

Álvarez, Cristian; Ramírez-Campillo, Rodrigo; Martínez, Cristian; Castro-Sepúlveda, Mauricio; Cano-Montoya, Johnathan; Mancilla, Rodrigo; Flores-Opazo, Marcelo

2017-11-01

The aim of this study was to assess the effects of three exercise training programs in the adaptation of the heart rate recovery of patients with insulin resistance. We studied 43 women with insulin resistance, which were assigned to three training groups: 1) high intensity interval training (HIT, age 39.0±10 years); 2) strength training (ST, age 33.9±9.4 years); 3) HIT+ST (MIXT, age 43.3±8.1 years); and 4) control group (CG, age 40.1±11 years). Heart rate was measured at rest (HRrest), during the 2-km-walking-test (UKKT) for mean (HRDE), and maximum (HRMDE) values, and during the recovery at one, two, and three minutes after the UKKT. Additionally, anthropometric measurements (body mass and body mass index) were assessed. HIT significantly decreased HRrest and HRDE (-4.5% and -2% respectively, P<0.05). MIXT training also decreased HRDE in -3% whilst both average and maximal HR during UKK were significantly increased in the control group HRDE (+2% and +3% respectively). Moreover, there were significant reductions in HR recovery at 1, 2 and 3 minutes after both HIT and MIXT training, whereas these values were increased in control group. Our findings suggest that HIT induces meaningful cardiovascular adaptations in patient with insulin resistance, reducing heart rate at rest, as well as during and after exercise, and that complementary strength training increases these adaptations.

Beta-blockers do not impair the cardiovascular benefits of endurance training in hypertensives.

PubMed

Westhoff, T H; Franke, N; Schmidt, S; Vallbracht-Israng, K; Zidek, W; Dimeo, F; van der Giet, M

2007-06-01

Aerobic physical exercise is broadly recommended as a helpful adjunct to obtain blood pressure control in hypertension. Beta-blockade interacts with heart rate, sympathetic tone, maximal workload and local lactate production. In the present randomized-controlled study, we compared the cardiovascular effects of an endurance training programme in elderly hypertensives with or without beta-blockers and developed a first approach to determine a lactate-based training heart rate in presence of beta-blockade. Fifty-two patients (23 with beta-blocker, 29 without beta-blocker) > or =60 years with systolic 24-h ambulatory blood pressure (ABP) > or =140 mm Hg and/or antihypertensive treatment were randomly assigned to sedentary activity or a heart-rate controlled 12-week treadmill exercise programme (lactate 2.0 mmol/l). In the exercise group, the training significantly decreased systolic and diastolic 24-h ABP, blood pressure on exertion (100 W) and increased endothelium-dependent vasodilation (flow-mediated vasodilation, FMD) and physical performance both in the presence and absence of beta-blockade (P<0.05 each). The extent of ABP reduction did not significantly differ in the presence or absence of beta-blockade (Delta systolic ABP 10.6+/-10.5 vs 10.6+/-8.8 mm Hg, Delta diastolic ABP 5.7+/-8.6 vs 5.8+/-4.0 mm Hg). Mean training heart rate was significantly lower in the patients on beta-blockers (97.2+/-7.7 vs 118.3+/-7.5/min, P<0.001). Lactate-based aerobic endurance training evokes comparable cardiovascular benefits in the presence and absence of beta-blockade including a marked improvement of endothelial function. In the present study, target training heart rate with beta-blockers is about 18% lower than without.

[Voluntary alpha-power increasing training impact on the heart rate variability].

PubMed

Bazanova, O M; Balioz, N V; Muravleva, K B; Skoraia, M V

2013-01-01

In order to study the effect of the alpha EEG power increasing training at heart rate variability (HRV) as the index of the autonomic regulation of cognitive functions there were follow tasks: (1) to figure out the impact of biofeedback in the voluntary increasing the power in the individual high-frequency alpha-band effect on heart rate variability and related characteristics of cognitive and emotional spheres, (2) to determine the nature of the relationship between alpha activity indices and heart rate variability, depending on the alpha-frequency EEG pattern at rest (3) to examine how the individual alpha frequency EEG pattern is reflected in changes HRV as a result of biofeedback training. Psychometric indicators of cognitive performance, the characteristics of the alpha-EEG activity and heart rate variability (HRV) as LF/HF and pNN50 were recorded in 27 healthy men aged 18-34 years, before, during, and after 10 sessions of training of voluntary increase in alpha power in the individual high-frequency alpha band with eyes closed. To determine the biofeedback effect on the alpha power increasing training, data subjects are compared in 2 groups: experimental (14) with the real and the control group (13 people)--with mock biofeedback. The follow up effect of trainings was studied through month over the 10 training sessions. Results showed that alpha biofeedback training enhanced the fluency and accuracy in cognitive performance, decreased anxiety and frontal EMG, increased resting frequency, width and power in individual upper alpha range only in participants with low baseline alpha frequency. While mock biofeedback increased resting alpha power only in participants with high baseline resting alpha frequency and did change neither cognitive performance, nor HRV indices. Biofeedback training eliminated the alpha power decrease in response to arithmetic task in both with high and low alpha frequency participants and this effect was followed up over the month. Mock biofeedback training has no such effect. The positive correlation between the alpha-peak frequency and pNN50 in patients with initially low, but negative--those with high baseline alpha frequency explains the multidirectional biofeedback effects on HRV in low and high alpha frequency subjects. The individual alpha-frequency EEG pattern determines the effectiveness of the alpha EEG biofeedback training in changing heart rate variability, which provides a basis for predicting the results and develop individual approaches to the biofeedback technology implementation that can be used in clinical practice for treatment and rehabilitation of psychosomatic syndromes and in educational training.

Aquatic exercise training and stable heart failure: A systematic review and meta-analysis.

PubMed

Adsett, Julie A; Mudge, Alison M; Morris, Norman; Kuys, Suzanne; Paratz, Jennifer D

2015-01-01

A meta-analysis and review of the evidence was conducted to determine the efficacy of aquatic exercise training for individuals with heart failure compared to traditional land-based programmes. A systematic search was conducted for studies published prior to March 2014, using MEDLINE, PUBMED, Cochrane Library, CINAHL and PEDro databases. Key words and synonyms relating to aquatic exercise and heart failure comprised the search strategy. Interventions included aquatic exercise or a combination of aquatic plus land-based training, whilst comparator protocols included usual care, no exercise or land-based training alone. The primary outcome of interest was exercise performance. Studies reporting on muscle strength, quality of life and a range of haemodynamic and physiological parameters were also reviewed. Eight studies met criteria, accounting for 156 participants. Meta-analysis identified studies including aquatic exercise to be superior to comparator protocols for 6 minute walk test (p < 0.004) and peak power (p < 0.044). Compared to land-based training programmes, aquatic exercise training provided similar benefits for VO(2peak), muscle strength and quality of life, though was not superior. Cardiac dimensions, left ventricular ejection fraction, cardiac output and BNP were not influenced by aquatic exercise training. For those with stable heart failure, aquatic exercise training can improve exercise capacity, muscle strength and quality of life similar to land-based training programmes. This form of exercise may provide a safe and effective alternative for those unable to participate in traditional exercise programmes. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Chronobiometric assessment of autogenic training effects upon blood pressure and heart rate.

PubMed

Watanabe, Y; Halberg, F; Cornélissen, G; Saito, Y; Fukuda, K; Otsuka, K; Kikuchi, T

1996-12-01

Autogenic training, a method of self-hypnosis, lowers the extent of within-day variation of systolic blood pressure assessed by the circadian double amplitude. The blood pressure and heart rate of ten patients, conventionally diagnosed as having hypertension or white-coat hypertension, were automatically monitored at 30-min intervals for 7 days before autogenic training and again for 7 days, at 1 or 2 months after the start of autogenic training (practiced three times daily). The circadian double amplitude of systolic blood pressure of the patients investigated was 3 to 17 mm Hg lower on autogenic training. In 5 patients, reductions by 7 to 17 mm Hg were statistically significant. These results are regarded as provisional statistics, the utility of which depends on replication. By contrast, the over-all group reduction of the circadian double amplitude of systolic blood pressure by 8 mm Hg on the average can be taken at face value. Autogenic training also lowered the circadian double amplitude of diastolic blood pressure, but the effect was small as was the effect of autogenic training upon the MESOR (a rhythm adjusted mean) and acrophase (a measure of the timing of over-all high values recurring each day). The effect of autogenic training upon the circadian double amplitude of systolic blood pressure suggests its trial as first-line treatment of patients with an excessive circadian blood pressure amplitude, a condition which, even in the absence of an elevated 24-hr, average of blood pressure, is associated with a large increase in the risk of developing ischemic stroke or nephropathy.

Carnitine supplementation and depletion: tissue carnitines and enzymes in fatty acid oxidation.

PubMed

Negrao, C E; Ji, L L; Schauer, J E; Nagle, F J; Lardy, H A

1987-07-01

Sixty-two male rats were randomly assigned into a 3 X 2 X 2 factorial design containing 12 groups according to carnitine treatment, exercise training (treadmill, 1 h, 5 times/wk, 8 wk, 26.8 m/min, 15% grade), and physical activity [rested for 60 h before they were killed or with an acute bout of exercise (1 h, 26.8 m/min, 15% grade) immediately before they were killed]. Isotonic saline was injected intraperitoneally 5 times/wk in the controls, whereas 750 mg/kg of L- or D-carnitine, respectively, were injected in the supplemented and depleted treatment groups. A significant increase in free and short-chain acyl carnitine concentration in skeletal muscle and heart was observed in L-carnitine supplemented rats, whereas a significant reduction in skeletal muscle, heart, and liver occurred in rats depleted of L-carnitine. Long-chain acyl carnitine in all tissues was not altered by carnitine treatment; training increased plasma and liver concentrations, whereas acute exercise decreased skeletal muscle and increased liver concentrations. An acute bout of exercise significantly increased short-chain acylcarnitine in liver, regardless of carnitine and/or training effects. beta-Hydroxyacyl-CoA dehydrogenase activity in skeletal muscle was induced by training but reduced by depletion. Carnitine acetyltransferase (CAT) was significantly increased in heart by L-carnitine supplementation, whereas it was reduced by depletion in skeletal muscle. Exercise training significantly increased CAT activity in skeletal muscle but not in heart, whereas acute exercise significantly increased activity in both tissues. Carnitine palmitoyltransferase activity was increased by acute exercise in the heart in only the supplemented and exercise-trained rats.

Negative transfer of heart rate control following biofeedback training: a partial replication.

PubMed

Steptoe, A; Macready, D

1985-09-01

Ability to raise and lower heart rate (HR) on instruction was tested before and after unidirectional biofeedback training in two groups of 10 male volunteers. Instructional control was assessed in 2-min trials before training, and after 5 and 10 biofeedback trials of increasing (Group I) and decreasing (Group D) HR. The magnitude of HR elevations produced by Group D diminished following training, while modifications in Group I were unchanged. This negative transfer effect is discussed in relation to whether voluntary speeding and slowing HR reflect distinct capacities.

A study of the 200-metre fast walk test as a possible new assessment tool to predict maximal heart rate and define target heart rate for exercise training of coronary heart disease patients.

PubMed

Casillas, Jean-Marie; Joussain, Charles; Gremeaux, Vincent; Hannequin, Armelle; Rapin, Amandine; Laurent, Yves; Benaïm, Charles

2015-02-01

To develop a new predictive model of maximal heart rate based on two walking tests at different speeds (comfortable and brisk walking) as an alternative to a cardiopulmonary exercise test during cardiac rehabilitation. Evaluation of a clinical assessment tool. A Cardiac Rehabilitation Department in France. A total of 148 patients (133 men), mean age of 59 ±9 years, at the end of an outpatient cardiac rehabilitation programme. Patients successively performed a 6-minute walk test, a 200 m fast-walk test (200mFWT), and a cardiopulmonary exercise test, with measure of heart rate at the end of each test. An all-possible regression procedure was used to determine the best predictive regression models of maximal heart rate. The best model was compared with the Fox equation in term of predictive error of maximal heart rate using the paired t-test. Results of the two walking tests correlated significantly with maximal heart rate determined during the cardiopulmonary exercise test, whereas anthropometric parameters and resting heart rate did not. The simplified predictive model with the most acceptable mean error was: maximal heart rate = 130 - 0.6 × age + 0.3 × HR200mFWT (R(2) = 0.24). This model was superior to the Fox formula (R(2) = 0.138). The relationship between training target heart rate calculated from measured reserve heart rate and that established using this predictive model was statistically significant (r = 0.528, p < 10(-6)). A formula combining heart rate measured during a safe simple fast walk test and age is more efficient than an equation only including age to predict maximal heart rate and training target heart rate. © The Author(s) 2014.

Hemodynamic Consequences for Circuit Weight Training

ERIC Educational Resources Information Center

Allen, T. Earl; And Others

1976-01-01

This study of high sustained heart rates observed during circuit weight training involving high resistance and low repetitions indicates that such training has no concurrent cardiovascular training effect. (MB)

Influence of taekwondo as security martial arts training on anaerobic threshold, cardiorespiratory fitness, and blood lactate recovery.

PubMed

Kim, Dae-Young; Seo, Byoung-Do; Choi, Pan-Am

2014-04-01

[Purpose] This study was conducted to determine the influence of Taekwondo as security martial arts training on anaerobic threshold, cardiorespiratory fitness, and blood lactate recovery. [Subjects and Methods] Fourteen healthy university students were recruited and divided into an exercise group and a control group (n = 7 in each group). The subjects who participated in the experiment were subjected to an exercise loading test in which anaerobic threshold, value of ventilation, oxygen uptake, maximal oxygen uptake, heart rate, and maximal values of ventilation / heart rate were measured during the exercise, immediately after maximum exercise loading, and at 1, 3, 5, 10, and 15 min of recovery. [Results] At the anaerobic threshold time point, the exercise group showed a significantly longer time to reach anaerobic threshold. The exercise group showed significantly higher values for the time to reach VO2max, maximal values of ventilation, maximal oxygen uptake and maximal values of ventilation / heart rate. Significant changes were observed in the value of ventilation volumes at the 1- and 5-min recovery time points within the exercise group; oxygen uptake and maximal oxygen uptake were significantly different at the 5- and 10-min time points; heart rate was significantly different at the 1- and 3-min time points; and maximal values of ventilation / heart rate was significantly different at the 5-min time point. The exercise group showed significant decreases in blood lactate levels at the 15- and 30-min recovery time points. [Conclusion] The study results revealed that Taekwondo as a security martial arts training increases the maximal oxygen uptake and anaerobic threshold and accelerates an individual's recovery to the normal state of cardiorespiratory fitness and blood lactate level. These results are expected to contribute to the execution of more effective security services in emergencies in which violence can occur.

Design of a Wireless Sensor System with the Algorithms of Heart Rate and Agility Index for Athlete Evaluation

PubMed Central

Li, Meina; Kim, Youn Tae

2017-01-01

Athlete evaluation systems can effectively monitor daily training and boost performance to reduce injuries. Conventional heart-rate measurement systems can be easily affected by artifact movement, especially in the case of athletes. Significant noise can be generated owing to high-intensity activities. To improve the comfort for athletes and the accuracy of monitoring, we have proposed to combine robust heart rate and agility index monitoring algorithms into a small, light, and single node. A band-pass-filter-based R-wave detection algorithm was developed. The agility index was calculated by preprocessing with band-pass filtering and employing the zero-crossing detection method. The evaluation was conducted under both laboratory and field environments to verify the accuracy and reliability of the algorithm. The heart rate and agility index measurements can be wirelessly transmitted to a personal computer in real time by the ZigBee telecommunication system. The results show that the error rate of measurement of the heart rate is within 2%, which is comparable with that of the traditional wired measurement method. The sensitivity of the agility index, which could be distinguished as the activity speed, changed slightly. Thus, we confirmed that the developed algorithm could be used in an effective and safe exercise-evaluation system for athletes. PMID:29039763

Automated Agatston score computation in non-ECG gated CT scans using deep learning

NASA Astrophysics Data System (ADS)

Cano-Espinosa, Carlos; González, Germán.; Washko, George R.; Cazorla, Miguel; San José Estépar, Raúl

2018-03-01

Introduction: The Agatston score is a well-established metric of cardiovascular disease related to clinical outcomes. It is computed from CT scans by a) measuring the volume and intensity of the atherosclerotic plaques and b) aggregating such information in an index. Objective: To generate a convolutional neural network that inputs a non-contrast chest CT scan and outputs the Agatston score associated with it directly, without a prior segmentation of Coronary Artery Calcifications (CAC). Materials and methods: We use a database of 5973 non-contrast non-ECG gated chest CT scans where the Agatston score has been manually computed. The heart of each scan is cropped automatically using an object detector. The database is split in 4973 cases for training and 1000 for testing. We train a 3D deep convolutional neural network to regress the Agatston score directly from the extracted hearts. Results: The proposed method yields a Pearson correlation coefficient of r = 0.93; p <= 0.0001 against manual reference standard in the 1000 test cases. It further stratifies correctly 72.6% of the cases with respect to standard risk groups. This compares to more complex state-of-the-art methods based on prior segmentations of the CACs, which achieve r = 0.94 in ECG-gated pulmonary CT. Conclusions: A convolutional neural network can regress the Agatston score from the image of the heart directly, without a prior segmentation of the CACs. This is a new and simpler paradigm in the Agatston score computation that yields similar results to the state-of-the-art literature.

Empowering: the experiences of exercise among heart transplantation patients in Taiwan.

PubMed

Jeng, Chii; Chu, Fu-Ling; Tsao, Lee-Ing

2002-12-01

To explore the experiences of exercise among Taiwanese heart transplant patients on the basis of a grounded theory. Although studies conducted around the world have proven how important exercise is to heart transplant patients, little information was found about heart transplant patients' exercise experience. In addition, because of different cultural backgrounds, people in Taiwan do not care about 'regular exercise' as much as Americans and Europeans do. Therefore, it is very important to find ways so that they can value 'regular exercise.' In-depth interviews were undertaken with a purposive sample of eight heart transplant patients. Data was analysed by repeated verification. Eight valid cases were separately and thoroughly interviewed while they were exercising at a sports medical centre. The results revealed that 'empowering the new heart' is the core reason for their exercise. During the exercise training process, every participant felt that his or her new heart was filled with power or energy. The 'hardness and endurance' in terms of feeling discomfort in the body was identified at the beginning of post-surgical exercise training. Throughout the process of empowerment, patients experienced the following five interactive behaviour categories: 'self-protection', 'sharing', 'being watched and cared for', 'being aware of the benefits', and 'strengthening the new heart'. Exercise can empower the new heart. After the exercise training, all patients felt that their new hearts were empowered with energy and vigour, and thus were willing to continue exercising. They even expanded their regimen to include folk therapies such as Tai Chi and breathing exercises.

Effects of an individualized home-based unsupervised aerobic training on body composition and physiological parameters in obese adults are independent of gender.

PubMed

Emerenziani, G P; Gallotta, M C; Migliaccio, S; Ferrari, D; Greco, E A; Saavedra, F J; Iazzoni, S; Aversa, A; Donini, L M; Lenzi, A; Baldari, C; Guidetti, L

2018-04-01

Evaluation of the effects of an individualized home-based unsupervised aerobic training on body composition, physical and physiological parameters in female and male obese adults. Two hundred and twenty obese adults (age 47.9 ± 12.4 years; BMI 38.0 ± 7.2 kg/m 2 ) entered the 4-month training program. Body composition, physiological and functional capacities were assessed pre- and post-intervention. All subjects were requested to perform unsupervised aerobic training with the intensity based on heart rate, walking speed and OMNI-RPE score corresponding to the individual ventilatory threshold for at least 5 days/week. After 4-month study period, 40% of patients completed the protocol, 24% had high compliance (HC) (exercise ≥ 3 days/week), while 16% had low compliance (LC) to exercise prescription (exercise < than 3 days/week). In HC group, a significant improvement of body composition variables after training was performed. Moreover, oxygen uptake and metabolic equivalent at peak significantly increased after training. Six-minute walking test (6MWT) distance significantly increased while heart rate during 6MWT was significantly lower after training. No significant differences were found in LC group between pre- and post-intervention in all variables. Interestingly, gender does not influence the effects of training. Our results indicate that subjects, independent of gender, with high compliance to the aerobic training based on a new individualized method can achieve a significant reduction in weight loss and also an improvement in physical and physiological parameters. This innovative personalized prescription could be a valuable tool for exercise physiologist, endocrinologists, and nutritionists to approach and correct life style of obese subjects.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors

PubMed Central

Pumpa, Kate L.; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S.; Semple, Stuart

2016-01-01

Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings. PMID:27781180

Heart Truth for Women: If You Have Heart Disease

MedlinePlus

... failure and a damaged heart muscle. My experience with heart disease started with typical symptoms. It took me some time to get my strength back, but now I exercise regularly and eat healthy foods. To ... counseling, and training. This part of rehab helps you understand your ...

Effect of exercise training on ventilatory efficiency in patients with heart disease: a review.

PubMed

Prado, D M L; Rocco, E A; Silva, A G; Rocco, D F; Pacheco, M T; Furlan, V

2016-06-20

The analysis of ventilatory efficiency in cardiopulmonary exercise testing has proven useful for assessing the presence and severity of cardiorespiratory diseases. During exercise, efficient pulmonary gas exchange is characterized by uniform matching of lung ventilation with perfusion. By contrast, mismatching is marked by inefficient pulmonary gas exchange, requiring increased ventilation for a given CO2 production. The etiology of increased and inefficient ventilatory response to exercise in heart disease is multifactorial, involving both peripheral and central mechanisms. Exercise training has been recommended as non-pharmacological treatment for patients with different chronic cardiopulmonary diseases. In this respect, previous studies have reported improvements in ventilatory efficiency after aerobic exercise training in patients with heart disease. Against this background, the primary objective of the present review was to discuss the pathophysiological mechanisms involved in abnormal ventilatory response to exercise, with an emphasis on both patients with heart failure syndrome and coronary artery disease. Secondly, special focus was dedicated to the role of aerobic exercise training in improving indices of ventilatory efficiency among these patients, as well as to the underlying mechanisms involved.

Neuromuscular electrical stimulation and inspiratory muscle training as potential adjunctive rehabilitation options for patients with heart failure.

PubMed

Arena, Ross; Pinkstaff, Sherry; Wheeler, Emma; Peberdy, Mary Ann; Guazzi, Marco; Myers, Jonathan

2010-01-01

Aerobic and resistance exercise training programs produce an abundance of physiologic and clinical benefits in patients with heart failure (HF). Improved maximal aerobic capacity, submaximal aerobic endurance, muscle force production, perceived quality of life, and skeletal muscle characteristics are among the more established outcomes resulting from these rehabilitation techniques. Moreover, both aerobic and resistance exercise training appear to portend a low risk to patients with HF when appropriate exercise prescription methods are followed. While the aforementioned training techniques will undoubtedly continue to be at the center of a well-formulated rehabilitation program, other adjunctive interventions, which are presently underutilized in clinical practice, may prove beneficial in patients with HF. Specifically, both neuromuscular electrical stimulation (NMES) and inspiratory muscle training (IMT) appear to significantly improve several physiologic, exercise, symptomatologic, and quality-of-life parameters. NMES targets skeletal muscle abnormalities, whereas IMT primarily targets the weakened respiratory musculature, both often encountered in patients with HF. A PubMed search using relevant key words identified 19 original investigations examining the impact of NMES (13 studies) and IMT (6 studies) training programs in patients with HF. The resultant review (1) provides a summary of the original research outcomes of both NMES and IMT in patients with HF; (2) addresses current research gaps, providing a direction for future investigations; and (3) provides clinical scenarios where NMES and IMT may prove to be beneficial during the rehabilitation of patients with HF.

Measurement of Functional Capacity Requirements of Farmers: IMPLICATIONS FOR A CARDIAC REHABILITATION TRAINING PROGRAM.

PubMed

Jordan, Shannon; Karcher, Justin; Rogers, Rebecca; Kennedy, Kathleen; Lawrence, Anne; Adams, Jenny

2017-03-01

Updated cardiac rehabilitation (CR) and return-to-work guidelines from the American College of Sports Medicine (ACSM) now include specificity of training for industrial athletes (exercise training that involves the muscle groups, movements, and energy systems that these patients use during occupational tasks). However, many CR facilities do not apply this principle, relying instead on the traditional protocol that consists primarily of aerobic exercise. This study was conducted to measure the metabolic cost of typical farming tasks and to compare 2 methods of calculating training intensities. Metabolic data were collected from 28 participants (23 men and 5 women, aged 18 to 57 years) while they loaded 10 hay bales, dug a fence posthole, filled 8 seed hoppers, and shoveled grain. Mean metabolic equivalent levels during these activities were 5.9 to 7.6 and participants reached 60% to 70% of heart rate reserve (HRR). By comparison, their mean resting heart rate + 30 beats per minute (RHR+30, a traditional CR intensity level) represented only 28% of HRR. Participants in the current study performed farming tasks within the ACSM's recommended range of 40% to 80% of HRR, and the results suggest that training at RHR+30 would have been inadequate for helping a farmer return to work after a cardiac event. Using the study tasks as a basis, we described exercises that would be appropriate for the supervised resistance training of farmers in a CR setting.

Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

PubMed

Wang, Li-Wei; Ou, Shu-Hua; Tsai, Chien-Sung; Chang, Yue-Cune; Kao, Chi-Wen

2016-01-01

Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P < .001), heart rate recovery (P = .04), and self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P < .001) and self-efficacy (P < .001) were sustained at 1 month after hospital discharge. Our inpatient multimedia exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

Relationships between body dimensions, body weight, age, gender, breed and echocardiographic dimensions in young endurance horses.

PubMed

Trachsel, D S; Giraudet, A; Maso, D; Hervé, G; Hauri, D D; Barrey, E; Robert, C

2016-10-10

The heart's physiological adaptation to aerobic training leads to an increase in heart chamber size, and is referred to as the Athlete's heart. However, heart dimensions are also related to body weight (BWT), body size, growth and (in some species) breed. There are few published data on the relationships between heart dimensions and growth or aerobic training in Arabian and Arabian-related endurance horses. Therefore the objective of the present study was to describe the influence of body dimensions (body length (BL), thoracic circumference (TC), withers height (WH)), BWT, age, gender, breed (purebred Arabians, part-bred Arabians, Anglo-Arabians, and Others) and the initiation of endurance training on echocardiographic measurements in competition-fit endurance horses aged 4 to 6 years. Most left atrial (LA) and left ventricular (LV) dimensions increased with age, whereas LA and LV functional indices did not. Although there was no gender difference for LV dimensions, females had larger LA dimensions. In terms of breed, Anglo-Arabians had the largest LV dimensions. Regression models indicated that the included explanatory factors had a weak influence on heart dimensions. Age, body dimensions, breed and gender showed the most consistent influence on LA dimensions, whereas BWT, breed and kilometres covered in competition showed the most consistent influence on LV dimensions. The increase in echocardiographic dimensions with age indicates on-going growth in our population of 4 to 6 year-old horses. We also observed small changes associated with the initiation of endurance training. Morphometric dimensions had a greater influence on LA dimensions, whereas LV dimensions were also influenced (albeit weakly) by parameters associated with exercise intensity. These results may therefore reflect early adaptations linked to the initiation of endurance training.

Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription.

PubMed

Voorn, Eric L; Gerrits, Karin H; Koopman, Fieke S; Nollet, Frans; Beelen, Anita

2014-05-01

To determine whether the anaerobic threshold (AT) can be identified in individuals with postpolio syndrome (PPS) using submaximal incremental exercise testing, and to compare current guidelines for intensity prescription in PPS with the AT. Cohort study. Research laboratory. Individuals with PPS (N=82). Not applicable. Power output, gas exchange variables, heart rate, and rating of perceived exertion (RPE) were measured in an incremental submaximal cycle ergometry test. Two independent observers identified the AT. Comparison of current guidelines for training intensity prescription in PPS (40%-60% heart rate reserve [HRR] or RPE of 12) with the AT was based on correlations between recommended heart rate and the heart rate at the AT. In addition, we determined the proportion of individuals that would have been recommended to train at an intensity corresponding to their AT. The AT was identified in 63 (77%) of the participants. Pearson correlation coefficients between the recommended heart rate and the heart rate at the AT were lower in cases of 40% HRR (r=.56) and 60% HRR (r=.50) than in cases of prescription based on the RPE (r=.86). Based on the RPE, 55% of the individuals would have been recommended to train at an intensity corresponding to their AT. This proportion was higher compared with 40% HRR (41%) or 60% HRR (18%) as criterion. The AT can be identified in most individuals with PPS offering an individualized target for aerobic training. If the AT cannot be identified (eg, because gas analysis equipment is not available), intensity prescription can best be based on the RPE. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Force properties of skinned cardiac muscle following increasing volumes of aerobic exercise in rats.

PubMed

Boldt, Kevin Rudi; Rios, Jaqueline Lourdes; Joumaa, Venus; Herzog, Walter

2018-05-03

The positive effects of chronic endurance exercise training on health and performance have been well documented. These positive effects have been evaluated primarily at the structural level, and work has begun to evaluate mechanical adaptations of the myocardium. However, it remains poorly understood how the volume of exercise training affects cardiac adaptation. In order to gain some understanding, we subjected three-month-old Sprague-Dawley rats (N=23) to treadmill running for eleven weeks at one of three exercise volumes (moderate, high, and extra high). Following training, hearts were excised and mechanical testing was completed on skinned trabecular fiber bundles. Performance on a maximal fitness test was dose-dependent upon training volume, where greater levels of training led to greater performance. No differences were observed between animals from any group for active stress production. Heart mass and passive stress increases in a dose-dependent manner for animals in the control, moderate, and high duration groups. However, hearts from animals in the extra high duration group presented with inhibited responses for heart mass and passive stress, despite performing greatest on a graded treadmill fitness test. These results suggest that heart mass and passive stress adapt in a dose-dependent manner, until exercise becomes excessive and adaptation is inhibited. Our findings are in agreement with the beneficial role exercise has in cardiac adaptation. However, excessive exercise comes with risks of maladaptation which must be weighed against the desire to increase performance.

Changing hearts and minds: Results from a multi-country gender and sexual diversity training

PubMed Central

Park, Chulwoo; Solares, Diego; Williams, John K.; Wolf, R. Cameron; Metheny, Noah; Vazzano, Andrea; Dent, Juan; Gibbs, Ashley; Nonyane, Bareng Aletta Sanny; Toiv, Nora

2017-01-01

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- and post-training study design. Findings suggest that sustainable decreases in negative attitudes toward gender and sexual minorities are achievable with a one-day training. PMID:28926568

Effects of inspiratory muscle training on autonomic activity, endothelial vasodilator function, and N-terminal pro-brain natriuretic peptide levels in chronic heart failure.

PubMed

Laoutaris, Ioannis D; Dritsas, Athanasios; Brown, Margaret D; Manginas, Athanassios; Kallistratos, Manolis S; Chaidaroglou, Antigoni; Degiannis, Dimitrios; Alivizatos, Peter A; Cokkinos, Dennis V

2008-01-01

To assess the effects of inspiratory muscle training (IMT) on autonomic activity, endothelial function, and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with chronic heart failure. Using age- and sex-matched controlled study, 23 patients (mean left ventricular ejection fraction 29 +/- 2%) were assigned to either a high-intensity training group (n = 14), New York Heart Association (NYHA) class II (n = 9)/III (n = 5), or a low-intensity training group (n = 9), NYHA class II (n = 6)/III (n = 3), exercising at 60% and 15% of sustained maximum inspiratory pressure (SPImax), respectively, 3 times per week for 10 weeks. Before and following IMT, patients underwent cardiopulmonary exercise testing and dyspnea evaluation on exertion. Sympathovagal balance was assessed by heart rate variability (HRV) from 24-hour electrocardiogram and endothelial function, using venous occlusion plethysmography. Serum levels of NT-proBNP were determined. High-intensity training group improved maximum inspiratory pressure (PImax, 105.4 +/- 5.3 vs 79.1 +/- 5 cm H2O, P = .001), SPImax (511 +/- 42 vs 308 +/- 28 cm H2O/sec/10, P = .001), peak oxygen consumption (19 +/- 1.2 vs 17.1 +/- 0.7 mL.kgmin, P = .01) and dyspnea (17.6 +/- 0.2 vs 18.1 +/- 0.1, P = .02). Endothelium-dependent vasodilation, HRV, and NT-proBNP levels were not altered. Low-intensity training group increased only the PImax (97.6 +/- 11.3 vs 84.2 +/- 8.7 cm H2O, P = .03). Improvement in dyspnea and exercise tolerance after IMT were not associated with changes in markers of HRV, endothelial function, and NT-proBNP in patients with mild to moderate chronic heart failure. Further studies on the effects of IMT in advanced heart failure would be worthwhile.

Endurance training in mild hypertension - effects on ambulatory blood pressure and neural circulatory control.

PubMed

Narkiewicz; Somers

1997-10-01

This review examines the effects of a single bout of exercise and of endurance training on blood pressure in patients with hypertension. Possible autonomic mechanisms that mediate these changes in blood pressure are reviewed briefly. Blood pressure rises during exercise. During the second half hour after exercise blood pressure is lower. This p;ost-exercise reduction in blood pressure is associated with a decrease in muscle sympathetic nerve activity, an increase in baroreflex gain and a reduction in the level of blood pressure (set point) at which baroreflex activation occurs. The post-exercise fall in blood pressure appears to be limited to several hours and is not likely to explain any chronic reduction in blood pressure from endurance training. Endurance training elicits modest (approximately 4-5 mmHg) reductions in blood pressure. Because of the intrinsic variability of blood pressure, the decreases in blood pressure after endurance training is evident, especially when multiple measurements of blood pressure are obtained. Studies using 24 h blood pressure measurements suggest that, although endurance training lowers daytime blood pressure, blood pressure during sleep remains unchanged. The mechanism underlying the reduction in blood pressure in endurance training is not known. Although physical fitness is known to attenuate the sympathetic response to acute exercise, whether resting sympathetic drive is decreased with endurance training remains controversial. The slowing of heart rate that accompanies endurance training is also associated with an increase in variability of heart rate. The slower heart rate, increased variability of heart rate and lower blood pressure after endurance training are accompanied by an increase in baroreflex sensitivity. Even though the antihypertensive effect of endurance training is modest, the favourable effects of physical fitness on other risk factors for cardiovascular disease make exercise training an important approach in the management of hypertensive patients, particularly for sedentary patients with borderline and mild hypertension.

Effects of whole-body vibration on heart rate variability: acute responses and training adaptations.

PubMed

Wong, Alexei; Figueroa, Arturo

2018-05-18

Heart rate variability (HRV) is a noninvasive and practical measure of cardiac autonomic nervous system function, mainly the sympathetic and parasympathetic modulations of heart rate. A low HRV has been shown to be indicative of compromised cardiovascular health. Interventions that enhance HRV are therefore beneficial to cardiovascular health. Whole-body vibration (WBV) training has been proposed as an alternative time-efficient exercise intervention for the improvement of cardiovascular health. In this review, we discuss the effect of WBV both acute and after training on HRV. WBV training appears to be a useful therapeutic intervention to improve cardiac autonomic function in different populations, mainly through decreases in sympathovagal balance. Although the mechanisms by which WBV training improves symphathovagal balance are not yet well understood; enhancement of baroreflex sensitivity, nitric oxide bioavailability and angiotensin II levels seem to play an important role. © 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Aerobic training in adults after atrial switch procedure for transposition of the great arteries improves exercise capacity without impairing systemic right ventricular function.

PubMed

Westhoff-Bleck, Mechthild; Schieffer, Bernhard; Tegtbur, Uwe; Meyer, Gerd Peter; Hoy, Ludwig; Schaefer, Arnd; Tallone, Ezequiel Marcello; Tutarel, Oktay; Mertins, Ramona; Wilmink, Lena Mara; Anker, Stefan D; Bauersachs, Johann; Roentgen, Philipp

2013-12-05

Exercise training safely and efficiently improves symptoms in patients with heart failure due to left ventricular dysfunction. However, studies in congenital heart disease with systemic right ventricle are scarce and results are controversial. In a randomised controlled study we investigated the effect of aerobic exercise training on exercise capacity and systemic right ventricular function in adults with d-transposition of the great arteries after atrial redirection surgery (28.2 ± 3.0 years after Mustard procedure). 48 patients (31 male, age 29.3 ± 3.4 years) were randomly allocated to 24 weeks of structured exercise training or usual care. Primary endpoint was the change in maximum oxygen uptake (peak VO2). Secondary endpoints were systemic right ventricular diameters determined by cardiac magnetic resonance imaging (CMR). Data were analysed per intention to treat analysis. At baseline peak VO2 was 25.5 ± 4.7 ml/kg/min in control and 24.0 ± 5 ml/kg/min in the training group (p=0.3). Training significantly improved exercise capacity (treatment effect for peak VO2 3.8 ml/kg/min, 95% CI: 1.8 to 5.7; p=0.001), work load (p=0.002), maximum exercise time (p=0.002), and NYHA class (p=0.046). Systemic ventricular function and volumes determined by CMR remained unchanged. None of the patients developed signs of cardiac decompensation or arrhythmias while on exercise training. Aerobic exercise training did not detrimentally affect systemic right ventricular function, but significantly improved exercise capacity and heart failure symptoms. Aerobic exercise training can be recommended for patients following atrial redirection surgery to improve exercise capacity and to lessen or prevent heart failure symptoms. ( ClinicalTrials.gov #NCT00837603). © 2013.

Intensity level for exercise training in fibromyalgia by using mathematical models.

PubMed

Lemos, Maria Carolina D; Valim, Valéria; Zandonade, Eliana; Natour, Jamil

2010-03-22

It has not been assessed before whether mathematical models described in the literature for prescriptions of exercise can be used for fibromyalgia syndrome patients. The objective of this paper was to determine how age-predicted heart rate formulas can be used with fibromyalgia syndrome populations as well as to find out which mathematical models are more accurate to control exercise intensity. A total of 60 women aged 18-65 years with fibromyalgia syndrome were included; 32 were randomized to walking training at anaerobic threshold. Age-predicted formulas to maximum heart rate ("220 minus age" and "208 minus 0.7 x age") were correlated with achieved maximum heart rate (HRMax) obtained by spiroergometry. Subsequently, six mathematical models using heart rate reserve (HRR) and age-predicted HRMax formulas were studied to estimate the intensity level of exercise training corresponding to heart rate at anaerobic threshold (HRAT) obtained by spiroergometry. Linear and nonlinear regression models were used for correlations and residues analysis for the adequacy of the models. Age-predicted HRMax and HRAT formulas had a good correlation with achieved heart rate obtained in spiroergometry (r = 0.642; p < 0.05). For exercise prescription in the anaerobic threshold intensity, the percentages were 52.2-60.6% HRR and 75.5-80.9% HRMax. Formulas using HRR and the achieved HRMax showed better correlation. Furthermore, the percentages of HRMax and HRR were significantly higher for the trained individuals (p < 0.05). Age-predicted formulas can be used for estimating HRMax and for exercise prescriptions in women with fibromyalgia syndrome. Karnoven's formula using heart rate achieved in ergometric test showed a better correlation. For the prescription of exercises in the threshold intensity, 52% to 60% HRR or 75% to 80% HRMax must be used in sedentary women with fibromyalgia syndrome and these values are higher and must be corrected for trained patients.

Short-term water-based aerobic training promotes improvements in aerobic conditioning parameters of mature women.

PubMed

Costa, Rochelle Rocha; Reichert, Thais; Coconcelli, Leandro; Simmer, Nicole Monticelli; Bagatini, Natália Carvalho; Buttelli, Adriana Cristine Koch; Bracht, Cláudia Gomes; Stein, Ricardo; Kruel, Luiz Fernando Martins

2017-08-01

Aging is accompanied by a decrease in aerobic capacity. Therefore, physical training has been recommended to soften the effects of advancement age. The aim of this study was to assess the effects of a short-term water-based aerobic training on resting heart rate (HR rest ), heart rate corresponding to anaerobic threshold (HR AT ), peak heart rate (HR peak ), percentage value of HR AT in relation to HR peak and test duration (TD) of mature women. Twenty-two women (65.91 ± 4.83 years) were submitted to a five-week water-based interval aerobic training. Aerobic capacity parameters were evaluated through an aquatic incremental test. After training, there was an increase in TD (16%) and HR AT percentage in relation to HR peak (4.68%), and a reduction of HR rest (9%). It is concluded that a water-based aerobic interval training prescribed through HR AT of only five weeks is able to promote improvements in aerobic capacity of mature women. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial.

PubMed

Dor-Haim, Horesh; Barak, Sharon; Horowitz, Michal; Yaakobi, Eldad; Katzburg, Sara; Swissa, Moshe; Lotan, Chaim

2018-01-01

Exercise is considered a valuable nonpharmacological intervention modality in cardiac rehabilitation (CR) programs in patients with ischemic heart disease. The effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac patients' with reduced left ventricular function, post-myocardial infarction (MI) has not been thoroughly investigated. to improve cardiac function with a novel method of combined aerobic-resistance circuit training in a randomized control trial by way of comparing the effectiveness of continuous aerobic training (CAT) to SCT on mechanical cardiac function. Secondary to compare their effect on aerobic fitness, manual strength, and quality of life in men post MI. Finally, to evaluate the safety and feasibility of SCT. 29 men post-MI participants were randomly assigned to either 12-weeks of CAT (n = 15) or SCT (n = 14). Both groups, CAT and SCT exercised at 60%-70% and 75-85% of their heart rate reserve, respectively. The SCT group also engaged in intermittently combined resistance training. Primary outcome measure was echocardiography. Secondary outcome measures were aerobic fitness, strength, and quality of life (QoL). The effectiveness of the two training programs was examined via paired t-tests and Cohen's d effect size (ES). Post-training, only the SCT group presented significant changes in echocardiography (a reduction in E/e' and an increase in ejection fraction, P<0.05). Similarly, only the SCT group presented significant changes in aerobic fitness (an increase in maximal metabolic equivalent, P<0.05). In addition, SCT improvement in the physical component of QoL was greater than this observed in the CAT group. In both training programs, no adverse events were observed. Men post-MI stand to benefit from both CAT and SCT. However, in comparison to CAT, as assessed by echocardiography, SCT may yield greater benefits to the left ventricle mechanical function as well as to the patient's aerobic fitness and physical QoL. Moreover, the SCT program was found to be feasible as well as safe.

'Athlete's heart' in prepubertal children.

PubMed

Rowland, T W; Delaney, B C; Siconolfi, S F

1987-05-01

Bradycardia, cardiomegaly, heart murmurs, and ECG changes are typically observed in adult endurance athletes, but frequency of such changes among children involved in sports training is unclear. Pediatricians need to be aware of whether these features of the "athlete's heart" occur in their patients, because such features may mimic those of cardiac disease. Fourteen prepubertal competitive male swimmers were evaluated by physical examination, ECG and echocardiogram, and findings were compared to those of a group of active but nontrained control boys. Lower resting heart rates and echocardiographic manifestations of chronic left ventricular volume overload were observed among the swimmers. These changes were not manifest on physical examination, however, and no significant ECG alterations were identified among the athletes. These findings indicate that, although features of the athlete's heart are present in children involved in endurance training, seldom will these findings simulate heart disease or be apparent on routine clinical examination.

[Cardiovascular recovery during intermittent exercise in highly-adherent partic pants with hypertension and type 2 diabetes mellitus].

PubMed

Cano-Montoya, Johnattan; Álvarez, Cristian; Martínez, Cristian; Salas, Andrés; Sade, Farid; Ramírez-Campillo, Rodrigo

2016-09-01

Despite the evidence supporting metabolic benefits of high intensity interval exercise (HIIT), there is little information about the cardiovascular response to this type of exercise in patients with type 2 diabetes (T2D) and hypertension (HTA). To analyze the changes in heart rate at rest, at the onset and at the end of each interval of training, after twelve weeks of a HIIT program in T2D and HTA patients. Twenty-three participants with T2D and HTA (20 women) participated in a controlled HIIT program. Fourteen participants attended 90% of more session of exercise and were considered as adherent. Adherent and non-adherent participants had similar body mass index (BMI), and blood pressure. A “1x2x10” (work: rest-time: intervals) HIIT exercise protocol was used both as a test and as training method during twelve weeks. The initial and finishing heart rate (HR) of each of the ten intervals before and after the intervention were measured. After twelve weeks of HIIT intervention, adherent participants had a significant reduction in the heart rate at the onset of exercise, and during intervals 4, 5, 8 and 10. A reduction in the final heart rate was observed during intervals 8 and 10. In the same participants the greatest magnitude of reduction, at the onset or end of exercise was approximately 10 beats/min. No significant changes in BMI, resting heart rate and blood pressure were observed. A HIIT program reduces the cardiovascular effort to a given work-load and improves cardiovascular recovery after exercise.

High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure.

PubMed

Taya, Masanobu; Amiya, Eisuke; Hatano, Masaru; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Tsuji, Masaki; Hosoya, Yumiko; Minatsuki, Shun; Nakayama, Atsuko; Fujiwara, Takayuki; Konishi, Yuto; Yokota, Kazuhiko; Watanabe, Masafumi; Morita, Hiroyuki; Haga, Nobuhiko; Komuro, Issei

2018-01-15

This study investigated the effectiveness and safety of interval training during in-hospital treatment of patients with advanced heart failure. Twenty-four consecutive patients with advanced symptomatic heart failure who were referred for cardiac transplant evaluation were recruited. After performing aerobic exercise for approximate intensity, high-intensity interval training (HIIT) was performed. The protocol consisted of 3 or 4 sessions of 1-min high-intensity exercise aimed at 80% of peak VO 2 or 80% heart rate reserve, followed by 4-min recovery periods of low intensity. In addition to the necessary laboratory data, hand grip strength and knee extensor strength were evaluated at the start of exercise training and both at the start and the end of HIIT. Knee extensor strength was standardized by body weight. The BNP level at the start of exercise training was 432 (812) pg/mL and it significantly decreased to 254 (400) pg/mL (p < 0.001) at the end of HIIT. Hand grip strength did not change during course. By contrast, knee extensor strength significantly increased during HIIT [4.42 ± 1.43 → 5.28 ± 1.45 N/kg, p < 0.001], whereas the improvement of knee extensor strength was not significant from the start of exercise training to the start of HIIT. In addition, the change in knee extensor strength during HIIT was significantly associated with the hemoglobin A1c level at the start of exercise (R = - 0.55; p = 0.015). HIIT has a positive impact on skeletal muscle strength among in-hospital patients with advanced heart failure.

[The exercise training restores the heart rate variability in heart failure patients. A systematic review].

PubMed

Segovia, Victoria; Manterola, Carlos; González, Marcelo; Rodríguez-Núñez, Iván

Cardiovascular diseases are a significant cause of morbidity and mortality in the general population. In this sense, the autonomic imbalance is the cornerstone of the pathophysiology underlying the development of these diseases. The aim of this study was to determine the efficacy of exercise training on heart rate variability (HRV) in adult patients with chronic heart failure. A systematic literature review was conducted in electronic databases. The considered studies were randomised clinical trials, quasi-experimental studies with non-randomised control group, quasi-experimental studies with analysis of pre- and post- intervention, and crossover studies with randomly assigned training and non-training periods. The standardised mean differences were calculated between pre- and post-intervention in both the control and experimental group. Within-subject analysis of the control group showed no statistical significance in the standardised mean differences of HRV. In the experimental group, the standardised mean differences were positive for the root mean square of successive difference (+0.468±0.215; P=.032), high frequency band (HF) (0.934±0.256; P < .001) and low frequency band (LF) (< 0.415±0.096; P=.001). Moreover, the standardised mean difference was negative for LF/HF (-0.747±0.369, P=<.044). On the other hand, only 3 studies entered the comparative meta-analysis. The effect of exercise training was favourable for the experimental group in LF/HF (-2.21±95% CI: -3.83 to -0.60), HF, and LF. The exercise training was effective in increasing HRV and restoring the autonomic balance in patients with heart failure. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

[The basic life support guidance of American Heart Association (AHA)].

PubMed

Higashioka, Hiroaki; Yonemori, Terutake; Maeda, Daigen

2011-04-01

The American Heart Association (AHA) and other member councils of International Liaison Committee on Resuscitation (ILCOR) complete review of resuscitation science every 5 years. And ILCOR publishes Consensus on Science with Treatment Recommendations(CoSTR). The AHA published "American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation(CPR) and Emergency Cardiovascular Care (ECC)" (G2010), that basis on CoSTR 2010 on Oct. 18th, 2010. The switchover to new curriculum based on G2010 on and after Mar. 1st, 2011 is the policy of AHA in their all training courses. The AHA maintains the quality of their training courses by some systems. AHA instructors are trained by some steps of instructor courses and monitoring systems and update their scientific knowledge on resuscitation by e-learning. The authors introduce an outline of basic life support for healthcare providers, the instructor training systems of AHA and summary of basic life support basis on G2010.

A Comparison of Two Instructional Formats on Heart Rate Intensity and Skill Development.

ERIC Educational Resources Information Center

Quinn, Patrick B.; Strand, Brad

1995-01-01

This study examined the effect of adding aerobic training to football skills development activities for male seventh graders. Two groups completed one or the other type of training. Heart rate monitor and skill assessment data indicated that the addition of the planned fitness component did not detract from skill development. (SM)

Cardiopulmonary Rehabilitation, Exercise Training, and Preventive Cardiology: An Overview of a Decade of Research at the Ochsner Heart and Vascular Institute: Presented in part at Grand Rounds, Research Series, Ochsner Medical Institutions, May 17, 1999

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Cassidy, Mark M.; Gilliland, Yvonne E.; Bernal, J. Alberto

1999-01-01

A decade of research from the Ochsner Heart and Vascular Institute's cardiopulmonary rehabilitation and exercise training programs demonstrates the benefits of this therapy on coronary risk factors, exercise capacity, cardiopulmonary parameters, behavioral characteristics, and quality of life in various subgroups of patients, including the elderly, women, obese patients, and groups with dyslipidemia and psychological distress, as well as in patients with congestive heart failure or severe lung disease. Substantial data from our program support the idea that cardiopulmonary rehabilitation and exercise training programs are underemphasized and underutilized for the secondary prevention of coronary artery disease. PMID:21845136

High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study.

PubMed

Angadi, Siddhartha S; Mookadam, Farouk; Lee, Chong D; Tucker, Wesley J; Haykowsky, Mark J; Gaesser, Glenn A

2015-09-15

Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality. Exercise training is an established adjuvant therapy in heart failure; however, the effects of high-intensity interval training (HIIT) in HFpEF are unknown. We compared the effects of HIIT vs. moderate-intensity aerobic continuous training (MI-ACT) on peak oxygen uptake (V̇o₂peak), left ventricular diastolic dysfunction, and endothelial function in patients with HFpEF. Nineteen patients with HFpEF (age 70 ± 8.3 yr) were randomized to either HIIT (4 × 4 min at 85-90% peak heart rate, with 3 min active recovery) or MI-ACT (30 min at 70% peak heart rate). Fifteen patients completed exercise training (HIIT: n = 9; MI-ACT: n = 6). Patients trained 3 days/wk for 4 wk. Before and after training patients underwent a treadmill test for V̇o₂peak determination, 2D-echocardiography for assessment of left ventricular diastolic dysfunction, and brachial artery flow-mediated dilation (FMD) for assessment of endothelial function. HIIT improved V̇o₂peak (pre = 19.2 ± 5.2 ml·kg(-1)·min(-1); post = 21.0 ± 5.2 ml·kg(-1)·min(-1); P = 0.04) and left ventricular diastolic dysfunction grade (pre = 2.1 ± 0.3; post = 1.3 ± 0.7; P = 0.02), but FMD was unchanged (pre = 6.9 ± 3.7%; post = 7.0 ± 4.2%). No changes were observed following MI-ACT. A trend for reduced left atrial volume index was observed following HIIT compared with MI-ACT (-3.3 ± 6.6 vs. +5.8 ± 10.7 ml/m(2); P = 0.06). In HFpEF patients 4 wk of HIIT significantly improved V̇o₂peak and left ventricular diastolic dysfunction. HIIT may provide a more robust stimulus than MI-ACT for early exercise training adaptations in HFpEF. Copyright © 2015 the American Physiological Society.

Comparing maximum rate and sustainability of pacing by mechanical vs. electrical stimulation in the Langendorff-perfused rabbit heart

PubMed Central

Quinn, T. Alexander; Kohl, Peter

2016-01-01

Aims Mechanical stimulation (MS) represents a readily available, non-invasive means of pacing the asystolic or bradycardic heart in patients, but benefits of MS at higher heart rates are unclear. Our aim was to assess the maximum rate and sustainability of excitation by MS vs. electrical stimulation (ES) in the isolated heart under normal physiological conditions. Methods and results Trains of local MS or ES at rates exceeding intrinsic sinus rhythm (overdrive pacing; lowest pacing rates 2.5±0.5 Hz) were applied to the same mid-left ventricular free-wall site on the epicardium of Langendorff-perfused rabbit hearts. Stimulation rates were progressively increased, with a recovery period of normal sinus rhythm between each stimulation period. Trains of MS caused repeated focal ventricular excitation from the site of stimulation. The maximum rate at which MS achieved 1:1 capture was lower than during ES (4.2±0.2 vs. 5.9±0.2 Hz, respectively). At all overdrive pacing rates for which repetitive MS was possible, 1:1 capture was reversibly lost after a finite number of cycles, even though same-site capture by ES remained possible. The number of MS cycles until loss of capture decreased with rising stimulation rate. If interspersed with ES, the number of MS to failure of capture was lower than for MS only. Conclusion In this study, we demonstrate that the maximum pacing rate at which MS can be sustained is lower than that for same-site ES in isolated heart, and that, in contrast to ES, the sustainability of successful 1:1 capture by MS is limited. The mechanism(s) of differences in MS vs. ES pacing ability, potentially important for emergency heart rhythm management, are currently unknown, thus warranting further investigation. PMID:28011835

Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study.

PubMed

Boudet, Gil; Walther, Guillaume; Courteix, Daniel; Obert, Philippe; Lesourd, Bruno; Pereira, Bruno; Chapier, Robert; Vinet, Agnès; Chamoux, Alain; Naughton, Geraldine; Poirier, Paul; Dutheil, Frédéric

2017-02-01

Aims To analyse the effects of different modalities of exercise training on heart rate variability (HRV) in individuals with metabolic syndrome (MetS). Methods and results Eighty MetS participants (aged 50-70 years) were housed and managed in an inpatient medical centre for 21 days, including weekends. Physical activity and food intake/diet were intensively monitored. Participants were randomly assigned into three training groups, differing only by intensity of exercise: moderate-endurance-moderate-resistance ( re), high-resistance-moderate-endurance ( Re), and moderate-resistance-high-endurance ( rE). HRV was recorded before and after the intervention by 24-hour Holter electrocardiogram. Although mean 24-hour heart rate decreased more in Re than re (-11.6 ± 1.6 vs. -4.8 ± 2.1%; P = 0.010), low frequency/high frequency decreased more in re than Re (-20.4 ± 5.5% vs. + 20.4 ± 9.1%; P = 0.002) and rE (-20.4 ± 5.5% vs. -0.3 ± 11.1%; P = 0.003). Very low frequency increased more in Re than re (+121.2 ± 35.7 vs. 42.9 ± 11.3%; P = 0.004). For all HRV parameters, rE ranged between re and Re values. Low frequency/high frequency changes were linked with visceral fat loss only in re (coefficient 5.9, 95% CI 1.9-10.0; P = 0.004). By day 21, HRV parameters of MetS groups (heart rate -8.6 ± 1.0%, standard deviation of R-R intervals + 34.0 ± 6.6%, total power + 63.3 ± 11.1%; P < 0.001) became closer to values of 50 aged-matched healthy controls. Conclusions A 3-week residential programme with intensive volumes of physical activity (15-20 hours per week) enhanced HRV in individuals with MetS. Participants with moderate intensity of training had greater improvements in sympathovagal balance, whereas those with high intensity in resistance training had greater decreases in heart rate and greater increases in very low frequency. Modality-specific relationships were observed between enhanced HRV and visceral fat loss. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT00917917.

Heritability of submaximal exercise heart rate response to exercise training is accounted for by nine SNPs.

PubMed

Rankinen, Tuomo; Sung, Yun Ju; Sarzynski, Mark A; Rice, Treva K; Rao, D C; Bouchard, Claude

2012-03-01

Endurance training-induced changes in hemodynamic traits are heritable. However, few genes associated with heart rate training responses have been identified. The purpose of our study was to perform a genome-wide association study to uncover DNA sequence variants associated with submaximal exercise heart rate training responses in the HERITAGE Family Study. Heart rate was measured during steady-state exercise at 50 W (HR50) on 2 separate days before and after a 20-wk endurance training program in 483 white subjects from 99 families. Illumina HumanCNV370-Quad v3.0 BeadChips were genotyped using the Illumina BeadStation 500GX platform. After quality control procedures, 320,000 single-nucleotide polymorphisms (SNPs) were available for the genome-wide association study analyses, which were performed using the MERLIN software package (single-SNP analyses and conditional heritability tests) and standard regression models (multivariate analyses). The strongest associations for HR50 training response adjusted for age, sex, body mass index, and baseline HR50 were detected with SNPs at the YWHAQ locus on chromosome 2p25 (P = 8.1 × 10(-7)), the RBPMS locus on chromosome 8p12 (P = 3.8 × 10(-6)), and the CREB1 locus on chromosome 2q34 (P = 1.6 × 10(-5)). In addition, 37 other SNPs showed P values <9.9 × 10(-5). After removal of redundant SNPs, the 10 most significant SNPs explained 35.9% of the ΔHR50 variance in a multivariate regression model. Conditional heritability tests showed that nine of these SNPs (all intragenic) accounted for 100% of the ΔHR50 heritability. Our results indicate that SNPs in nine genes related to cardiomyocyte and neuronal functions, as well as cardiac memory formation, fully account for the heritability of the submaximal heart rate training response.

Heritability of submaximal exercise heart rate response to exercise training is accounted for by nine SNPs

PubMed Central

Sung, Yun Ju; Sarzynski, Mark A.; Rice, Treva K.; Rao, D. C.; Bouchard, Claude

2012-01-01

Endurance training-induced changes in hemodynamic traits are heritable. However, few genes associated with heart rate training responses have been identified. The purpose of our study was to perform a genome-wide association study to uncover DNA sequence variants associated with submaximal exercise heart rate training responses in the HERITAGE Family Study. Heart rate was measured during steady-state exercise at 50 W (HR50) on 2 separate days before and after a 20-wk endurance training program in 483 white subjects from 99 families. Illumina HumanCNV370-Quad v3.0 BeadChips were genotyped using the Illumina BeadStation 500GX platform. After quality control procedures, 320,000 single-nucleotide polymorphisms (SNPs) were available for the genome-wide association study analyses, which were performed using the MERLIN software package (single-SNP analyses and conditional heritability tests) and standard regression models (multivariate analyses). The strongest associations for HR50 training response adjusted for age, sex, body mass index, and baseline HR50 were detected with SNPs at the YWHAQ locus on chromosome 2p25 (P = 8.1 × 10−7), the RBPMS locus on chromosome 8p12 (P = 3.8 × 10−6), and the CREB1 locus on chromosome 2q34 (P = 1.6 × 10−5). In addition, 37 other SNPs showed P values <9.9 × 10−5. After removal of redundant SNPs, the 10 most significant SNPs explained 35.9% of the ΔHR50 variance in a multivariate regression model. Conditional heritability tests showed that nine of these SNPs (all intragenic) accounted for 100% of the ΔHR50 heritability. Our results indicate that SNPs in nine genes related to cardiomyocyte and neuronal functions, as well as cardiac memory formation, fully account for the heritability of the submaximal heart rate training response. PMID:22174390

Heart rate variability in the standing position reflects training adaptation in professional soccer players.

PubMed

Ravé, Guillaume; Fortrat, Jacques-Olivier

2016-08-01

To show that heart rate variability (HRV) in the standing position better reflects the way in which athletes adapt to training in so-called intermittent sports than the indicator of resting parasympathetic tone usually employed in endurance sports. Twenty professional soccer players (intermittent sport) took part in a 5-week training session divided into three successive periods: "Warm-up", "Intensive training" and "Tapering". At the beginning and end of each of the three periods, a stand test was carried out and the heart rate was recorded, beat by beat (Polar Team 2). We analysed HRV to determine the indicator mostly used to demonstrate training adaptation in endurance sports (lnRMSSD supine, natural logarithm of root mean square of the successive differences) as well as indicators obtained by means of spectral analysis in both supine and standing position. A decrease in heart rate was observed in the supine position at rest during training (-5.2 ± 1.3 bpm) while lnRMSSD and spectral analysis indicators remained unchanged. The "Warm-up" caused an increase in spectral analysis total power in standing position which was further highlighted by "Tapering" (3.39 ± 0.09, 3.61 ± 0.08 and 3.65 ± 0.09 log ms(2), respectively). However, the autonomic changes are probably more complex than a change in autonomic activity or balance since spectral analysis autonomic indicators remained unchanged. HRV in the standing position could monitor training adaptation in intermittent sports contrary to the indicator usually employed in endurance sports. However, the significance of the HRV change in the standing position during training remains unclear.

Technical Skills Training for Veterinary Students: A Comparison of Simulators and Video for Teaching Standardized Cardiac Dissection.

PubMed

Allavena, Rachel E; Schaffer-White, Andrea B; Long, Hanna; Alawneh, John I

The goal of the study was to evaluate alternative student-centered approaches that could replace autopsy sessions and live demonstration and to explore refinements in assessment procedures for standardized cardiac dissection. Simulators and videos were identified as feasible, economical, student-centered teaching methods for technical skills training in medical contexts, and a direct comparison was undertaken. A low-fidelity anatomically correct simulator approximately the size of a horse's heart with embedded dissection pathways was constructed and used with a series of laminated photographs of standardized cardiac dissection. A video of a standardized cardiac dissection of a normal horse's heart was recorded and presented with audio commentary. Students were allowed to nominate a preference for learning method, and students who indicated no preference were randomly allocated to keep group numbers even. Objective performance data from an objective structure assessment criterion and student perception data on confidence and competency from surveys showed both innovations were similarly effective. Evaluator reflections as well as usage logs to track patterns of student use were both recorded. A strong selection preference was identified for kinesthetic learners choosing the simulator and visual learners choosing the video. Students in the video cohort were better at articulating the reasons for dissection procedures and sequence due to the audio commentary, and student satisfaction was higher with the video. The major conclusion of this study was that both methods are effective tools for technical skills training, but consideration should be given to the preferred learning style of adult learners to maximize educational outcomes.

The convergent validity between two objective methods for quantifying training load in young taekwondo athletes.

PubMed

Haddad, Monoem; Chaouachi, Anis; Castagna, Carlo; Wong, Del P; Chamari, Karim

2012-01-01

Various studies used objective heart rate (HR)-based methods to assess training load (TL). The common methods were Banister's Training Impulse (TRIMP; weights the duration using a weighting factor) and Edwards' TL (a summated HR zone score). Both the methods use the direct physiological measure of HR as a fundamental part of the calculation. To eliminate the redundancy of using various methods to quantify the same construct (i.e., TL), we have to verify if these methods are strongly convergent and are interchangeable. Therefore, the aim of this study was to investigate the convergent validity between Banister's TRIMP and Edwards' TL used for the assessment of internal TL. The HRs were recorded and analyzed during 10 training weeks of the preseason period in 10 male Taekwondo (TKD) athletes. The TL was calculated using Banister's TRIMP and Edwards' TL. Pearson product moment correlation coefficient was used to evaluate the convergent validity between the 2 methods for assessing TL. Very large to nearly perfect relationships were found between individual Banister's TRIMP and Edwards' TL (r values from 0.80 to 0.99; p < 0.001). Pooled Banister's TRIMP and pooled Edwards' TL (pooled data n = 284) were nearly largely correlated (r = 0.89; p < 0.05; 95% confidence interval: 0.86-0.91). In conclusion, these findings suggest that these 2 objective methods, measuring a similar construct, are interchangeable.

The influence of training characteristics on the effect of aerobic exercise training in patients with chronic heart failure: A meta-regression analysis.

PubMed

Vromen, T; Kraal, J J; Kuiper, J; Spee, R F; Peek, N; Kemps, H M

2016-04-01

Although aerobic exercise training has shown to be an effective treatment for chronic heart failure patients, there has been a debate about the design of training programs and which training characteristics are the strongest determinants of improvement in exercise capacity. Therefore, we performed a meta-regression analysis to determine a ranking of the individual effect of the training characteristics on the improvement in exercise capacity of an aerobic exercise training program in chronic heart failure patients. We focused on four training characteristics; session frequency, session duration, training intensity and program length, and their product; total energy expenditure. A systematic literature search was performed for randomized controlled trials comparing continuous aerobic exercise training with usual care. Seventeen unique articles were included in our analysis. Total energy expenditure appeared the only training characteristic with a significant effect on improvement in exercise capacity. However, the results were strongly dominated by one trial (HF-action trial), accounting for 90% of the total patient population and showing controversial results compared to other studies. A repeated analysis excluding the HF-action trial confirmed that the increase in exercise capacity is primarily determined by total energy expenditure, followed by session frequency, session duration and session intensity. These results suggest that the design of a training program requires high total energy expenditure as a main goal. Increases in training frequency and session duration appear to yield the largest improvement in exercise capacity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Legal aspects of the application of the lay rescuer automatic external defibrillator (AED) program in South Korea.

PubMed

Bae, Hyuna

2008-04-01

The American Heart Association has stated that the automatic external defibrillator (AED) is a promising method for achieving rapid defibrillation, and emphasized that AED training and use should be available in every community. The demonstrated safety and effectiveness of the AED make it ideally suited for the delivery of early defibrillation by trained laypersons, and the placement of AEDs in selected locations for immediate use by trained laypersons may enable critical intervention that can significantly increase survival from out-of-hospital cardiac arrest. The American Heart Association recommends the installation of AEDs in public locations such as airports, thus allowing laypersons to conduct defibrillation and cardiopulmonary resuscitation on the occasion of adverse cardiopulmonary events. In Korea, the Ministry of Health and Welfare officially prohibits the installation of AEDs in public locations on the grounds that cardiopulmonary resuscitation and defibrillation are understood as medical practices that can be conducted only by licensed medical practitioners. The purpose of this article is to discuss the necessity for AEDs and the appropriate process for their implementation in Korea, by examining the current pre-AED status of Korea and the relevant legal aspects.

Relationships between rating-of-perceived-exertion- and heart-rate-derived internal training load in professional soccer players: a comparison of on-field integrated training sessions.

PubMed

Campos-Vazquez, Miguel Angel; Mendez-Villanueva, Alberto; Gonzalez-Jurado, Jose Antonio; León-Prados, Juan Antonio; Santalla, Alfredo; Suarez-Arrones, Luis

2015-07-01

To describe the internal training load (ITL) of common training sessions performed during a typical week and to determine the relationships between different indicators of ITL commonly employed in professional football (soccer). Session-rating-of-perceived-exertion TL (sRPE-TL) and heart-rate- (HR) derived measurements of ITL as Edwards TL and Stagno training impulses (TRIMPMOD) were used in 9 players during 3 periods of the season. The relationships between them were analyzed in different training sessions during a typical week: skill drills/circuit training + small-sided games (SCT+SSGs), ball-possession games+technical-tactical exercises (BPG+TTE), tactical training (TT), and prematch activation (PMa). HR values obtained during SCT+SSGs and BPG+TTE were substantially greater than those in the other 2 sessions, all the ITL markers and session duration were substantially greater in SCT+SSGs than in any other session, and all ITL measures in BPG+TTE were substantially greater than in TT and PMa sessions. Large relationships were found between HR>80% HRmax and HR>90% HRmax vs sRPE-TL during BPG+TTE and TT sessions (r=.61-.68). Very large relationships were found between Edwards TL and sRPE-TL and between TRIMPMOD and sRPE-TL in sessions with BPG+TTE and TT (r=.73-.87). Correlations between the different HR-based methods were always extremely large (r=.92-.98), and unclear correlations were observed for other relationships between variables. sRPE-TL provided variable-magnitude within-individual correlations with HR-derived measures of training intensity and load during different types of training sessions typically performed during a week in professional soccer. Caution should be applied when using RPE- or HR-derived measures of exercise intensity/load in soccer training interchangeably.

Purification of cardiac myocytes from human heart biopsies for gene expression analysis.

PubMed

Kosloski, L M; Bales, I K; Allen, K B; Walker, B L; Borkon, A M; Stuart, R S; Pak, A F; Wacker, M J

2009-09-01

The collection of gene expression data from human heart biopsies is important for understanding the cellular mechanisms of arrhythmias and diseases such as cardiac hypertrophy and heart failure. Many clinical and basic research laboratories conduct gene expression analysis using RNA from whole cardiac biopsies. This allows for the analysis of global changes in gene expression in areas of the heart, while eliminating the need for more complex and technically difficult single-cell isolation procedures (such as flow cytometry, laser capture microdissection, etc.) that require expensive equipment and specialized training. The abundance of fibroblasts and other cell types in whole biopsies, however, can complicate gene expression analysis and the interpretation of results. Therefore, we have designed a technique to quickly and easily purify cardiac myocytes from whole cardiac biopsies for RNA extraction. Human heart tissue samples were collected, and our purification method was compared with the standard nonpurification method. Cell imaging using acridine orange staining of the purified sample demonstrated that >98% of total RNA was contained within identifiable cardiac myocytes. Real-time RT-PCR was performed comparing nonpurified and purified samples for the expression of troponin T (myocyte marker), vimentin (fibroblast marker), and alpha-smooth muscle actin (smooth muscle marker). Troponin T expression was significantly increased, and vimentin and alpha-smooth muscle actin were significantly decreased in the purified sample (n = 8; P < 0.05). Extracted RNA was analyzed during each step of the purification, and no significant degradation occurred. These results demonstrate that this isolation method yields a more purified cardiac myocyte RNA sample suitable for downstream applications, such as real-time RT-PCR, and allows for more accurate gene expression changes in cardiac myocytes from heart biopsies.

Measurement of functional capacity requirements of police officers to aid in development of an occupation-specific cardiac rehabilitation training program.

PubMed

Adams, Jenny; Schneider, Jonna; Hubbard, Matthew; McCullough-Shock, Tiffany; Cheng, Dunlei; Simms, Kay; Hartman, Julie; Hinton, Paul; Strauss, Danielle

2010-01-01

This study was designed to measure the functional capacity of healthy subjects during strenuous simulated police tasks, with the goal of developing occupation-specific training for cardiac rehabilitation of police officers. A calibrated metabolic instrument and an oxygen consumption data collection mask were used to measure the oxygen consumption and heart rates of 30 Dallas Police Academy officers and cadets as they completed an 8-event obstacle course that simulated chasing, subduing, and handcuffing a suspect. Standard target heart rates (85% of age-predicted maximum heart rate, or 0.85 x [220 - age]) and metabolic equivalents (METs) were calculated; a matched-sample t test based on differences between target and achieved heart rate and MET level was used for statistical analysis. Peak heart rates during the obstacle course simulation were significantly higher than the standard target heart rates (those at which treadmill stress tests in physicians' offices are typically stopped) (t(29) = 12.81, P < 0.001) and significantly higher than the suggested maximum of 150 beats/min during cardiac rehabilitation training (t(29) = 17.84, P < 0.001). Peak MET levels during the obstacle course simulation were also significantly higher than the goal level (8 METs) that patients typically achieve in a cardiac rehabilitation program (t(29) = 14.73, P < 0.001). We conclude that police work requires a functional capacity greater than that typically attained in traditional cardiac rehabilitation programs. Rehabilitation professionals should consider performing maximal stress tests and increasing the intensity of cardiac rehabilitation workouts to effectively train police officers who have had a cardiac event.

Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review.

PubMed

Burton, Elissa; Farrier, Kaela; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Airey, Phil; Bainbridge, Liz; Hill, Keith D

2017-04-01

Regular participation in resistance training is important for older people to maintain their health and independence, yet participation rates are low. The study aimed to identify motivators and barriers to older people participating in resistance training. A systematic review was conducted including quantitative, qualitative, and mixed-method studies. Searches generated 15,920 citations from six databases, with 14 studies (n = 1,937 participants) included. In total, 92 motivators and 24 barriers were identified. Motivators specific to participating in resistance training included preventing deterioration (disability), reducing risk of falls, building (toning) muscles, feeling more alert, and better concentration. Looking too muscular and thinking participation increased the risk of having a heart attack, stroke, or death, despite the minimal likelihood of these occurring, were barriers. The analysis indicates that increasing participation in resistance training among older people should focus on the specific benefits valued by older people and the dissemination of accurate information to counter misperceptions.

Beneficial effects of exercise training in heart failure are lost in male diabetic rats.

PubMed

Boudia, Dalila; Domergue, Valérie; Mateo, Philippe; Fazal, Loubina; Prud'homme, Mathilde; Prigent, Héloïse; Delcayre, Claude; Cohen-Solal, Alain; Garnier, Anne; Ventura-Clapier, Renée; Samuel, Jane-Lise

2017-12-01

Exercise training has been demonstrated to have beneficial effects in patients with heart failure (HF) or diabetes. However, it is unknown whether diabetic patients with HF will benefit from exercise training. Male Wistar rats were fed either a standard (Sham, n = 53) or high-fat, high-sucrose diet ( n = 66) for 6 mo. After 2 mo of diet, the rats were already diabetic. Rats were then randomly subjected to either myocardial infarction by coronary artery ligation (MI) or sham operation. Two months later, heart failure was documented by echocardiography and animals were randomly subjected to exercise training with treadmill for an additional 8 wk or remained sedentary. At the end, rats were euthanized and tissues were assayed by RT-PCR, immunoblotting, spectrophotometry, and immunohistology. MI induced a similar decrease in ejection fraction in diabetic and lean animals but a higher premature mortality in the diabetic group. Exercise for 8 wk resulted in a higher working power developed by MI animals with diabetes and improved glycaemia but not ejection fraction or pathological phenotype. In contrast, exercise improved the ejection fraction and increased adaptive hypertrophy after MI in the lean group. Trained diabetic rats with MI were nevertheless able to develop cardiomyocyte hypertrophy but without angiogenic responses. Exercise improved stress markers and cardiac energy metabolism in lean but not diabetic-MI rats. Hence, following HF, the benefits of exercise training on cardiac function are blunted in diabetic animals. In conclusion, exercise training only improved the myocardial profile of infarcted lean rats fed the standard diet. NEW & NOTEWORTHY Exercise training is beneficial in patients with heart failure (HF) or diabetes. However, less is known of the possible benefit of exercise training for HF patients with diabetes. Using a rat model where both diabetes and MI had been induced, we showed that 2 mo after MI, 8 wk of exercise training failed to improve cardiac function and metabolism in diabetic animals in contrast to lean animals.

Training residents to be factually accurate and articulate: A case study using foetal heart rate monitoring nomenclature.

PubMed

Stohl, Hindi E; Miller, David A

2016-10-01

Careful communication between members of the obstetric team about intrapartum foetal heart rate is critical for clinical management and patient safety. This study evaluated the benefits of two testing modalities in assessing resident physician knowledge of the 2008 NICHD nomenclature. Multiple-choice (MC) and short-answer (SA) examinations were administered to Obstetrics and Gynecology resident physicians before an educational intervention and then immediately after the training, at 6 months and at 12 months. Test scores on both the MC and the SA examinations improved after the training session. The improvement was sustained over the course of the study. Residents performed higher on the MC examination than on the SA test. This study suggests that formalised teaching in foetal heart rate monitoring improves resident physician knowledge of the NICHD nomenclature and that SA examinations may better discriminate between residents who are and are not able to accurately articulate foetal heart rate monitoring terminology.

Convolutional neural networks for the detection of diseased hearts using CT images and left atrium patches

NASA Astrophysics Data System (ADS)

Dormer, James D.; Halicek, Martin; Ma, Ling; Reilly, Carolyn M.; Schreibmann, Eduard; Fei, Baowei

2018-02-01

Cardiovascular disease is a leading cause of death in the United States. The identification of cardiac diseases on conventional three-dimensional (3D) CT can have many clinical applications. An automated method that can distinguish between healthy and diseased hearts could improve diagnostic speed and accuracy when the only modality available is conventional 3D CT. In this work, we proposed and implemented convolutional neural networks (CNNs) to identify diseased hears on CT images. Six patients with healthy hearts and six with previous cardiovascular disease events received chest CT. After the left atrium for each heart was segmented, 2D and 3D patches were created. A subset of the patches were then used to train separate convolutional neural networks using leave-one-out cross-validation of patient pairs. The results of the two neural networks were compared, with 3D patches producing the higher testing accuracy. The full list of 3D patches from the left atrium was then classified using the optimal 3D CNN model, and the receiver operating curves (ROCs) were produced. The final average area under the curve (AUC) from the ROC curves was 0.840 +/- 0.065 and the average accuracy was 78.9% +/- 5.9%. This demonstrates that the CNN-based method is capable of distinguishing healthy hearts from those with previous cardiovascular disease.

Robust QRS peak detection by multimodal information fusion of ECG and blood pressure signals.

PubMed

Ding, Quan; Bai, Yong; Erol, Yusuf Bugra; Salas-Boni, Rebeca; Zhang, Xiaorong; Hu, Xiao

2016-11-01

QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only. An information fusion framework for robust QRS detection is proposed by leveraging existing ECG and ABP analysis tools and combining heart beats derived from different sources. Results show that our approach achieves an overall accuracy of 90.94% and 88.66% on the training and testing datasets, respectively. Furthermore, we observe expected performance at each step of the proposed approach, as an evidence of the effectiveness of our approach. Discussion on the limitations of our approach is also provided.

Long-term physical exercise and atrial natriuretic peptide in obese Zucker rats.

PubMed

Pörsti, Ilkka; Kähönen, Mika; Wu, Xiumin; Arvola, Pertti; Ruskoaho, Heikki

2002-07-01

Endurance training increases natriuretic peptide synthesis in the hypertrophied myocardium of spontaneously hypertensive rats. We examined the effects of 22-week-long treadmill exercise on plasma and tissue atrial natriuretic peptide in Zucker rats, a model of genetic obesity and moderate hypertension without clear cardiac hypertrophy. The blood pressures of the animals were measured by the tail-cuff method, and plasma and tissue samples for the peptide determinations were taken at the end of the study. The training increased heart weight to body weight ratio, while atrial natriuretic peptide contents in the right and left atrium, ventricular tissue, and plasma did not change. The exercise prevented the elevation of blood pressure, which was observed in non-exercised obese Zucker rats, and also reduced blood pressure in the lean rats. In conclusion, these results suggest that in the absence of preceding myocardial hypertrophy, the long-term exercise-induced workload is not deleterious to the heart in experimental obesity, since no changes in plasma and tissue atrial natriuretic peptide were detected.

Exercise training modalities in chronic heart failure: does high intensity aerobic interval training make the difference?

PubMed

Giallauria, Francesco; Smart, Neil Andrew; Cittadini, Antonio; Vigorito, Carlo

2016-10-14

Exercise training (ET) is strongly recommended in patients with chronic heart failure (CHF). Moderate-intensity aerobic continuous ET is the best established training modality in CHF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Basically, HIIT consists of repeated bouts of high-intensity exercise alternated with recovery periods. In CHF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. These results are intriguing, mostly considering that better functional capacity translates into an improvement of symptoms and quality of life. Notably, HIIT did not reveal major safety issues; although CHF patients should be clinically stable, have had recent exposure to at least regular moderate-intensity exercise, and appropriate supervision and monitoring during and after the exercise session are mandatory. The impact of HIIT on cardiac dimensions and function and on endothelial function remains uncertain. HIIT should not replace other training modalities in heart failure but should rather complement them. Combining and tailoring different ET modalities according to each patient's baseline clinical characteristics (i.e. exercise capacity, personal needs, preferences and goals) seem the most astute approach to exercise prescription.

Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

PubMed Central

Campbell Jenkins, Brenda W.; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

2015-01-01

The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs. PMID:26703701

Opposite effects of training in rats with stable and progressive pulmonary hypertension.

PubMed

Handoko, M L; de Man, F S; Happé, C M; Schalij, I; Musters, R J P; Westerhof, N; Postmus, P E; Paulus, W J; van der Laarse, W J; Vonk-Noordegraaf, A

2009-07-07

Exercise training in pulmonary arterial hypertension (PH) is a promising adjunct to medical treatment. However, it is still unclear whether training is beneficial for all PH patients. We hypothesized that right ventricular adaptation plays a pivotal role in the response to training. Two different dosages of monocrotaline were used in rats to model stable PH with preserved cardiac output and progressive PH developing right heart failure. Two weeks after injection, PH was confirmed by echocardiography, and treadmill training was initiated. Rats were trained for 4 weeks unless manifest right heart failure developed earlier. At the end of the study protocol, all rats were functionally assessed by endurance testing, echocardiography, and invasive pressure measurements. Lungs and hearts were further analyzed in quantitative histomorphologic analyses. In stable PH, exercise training was well tolerated and markedly increased exercise endurance (from 25+/-3.9 to 62+/-3.9 minutes; P<0.001). Moreover, capillary density increased significantly (from 1.21+/-0.12 to 1.51+/-0.07 capillaries per cardiomyocyte; P<0.05). However, in progressive PH, exercise training worsened survival (hazard ratio, 2.7; 95% confidence interval, 1.1 to 14.2) and increased pulmonary vascular remodeling. In addition, training induced widespread leukocyte infiltration into the right ventricle (from 135+/-14 to 276+/-18 leukocytes per 1 mm(2); P<0.001). In our rat model, exercise training was found to be beneficial in stable PH but detrimental in progressive PH. Future studies are necessary to address the clinical implications of our findings.

Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models.

PubMed

Maluf, Miguel Angel; Gomes, Walter José; Bras, Ademir Massarico; Araújo, Thiago Cavalcante Vila Nova de; Mota, André Lupp; Cardoso, Caio Cesar; Coutinho, Rafael Viana dos S

2015-01-01

Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

Using heart rate to predict energy expenditure in large domestic dogs.

PubMed

Gerth, N; Ruoß, C; Dobenecker, B; Reese, S; Starck, J M

2016-06-01

The aim of this study was to establish heart rate as a measure of energy expenditure in large active kennel dogs (28 ± 3 kg bw). Therefore, the heart rate (HR)-oxygen consumption (V˙O2) relationship was analysed in Foxhound-Boxer-Ingelheim-Labrador cross-breds (FBI dogs) at rest and graded levels of exercise on a treadmill up to 60-65% of maximal aerobic capacity. To test for effects of training, HR and V˙O2 were measured in female dogs, before and after a training period, and after an adjacent training pause to test for reversibility of potential effects. Least squares regression was applied to describe the relationship between HR and V˙O2. The applied training had no statistically significant effect on the HR-V˙O2 regression. A general regression line from all data collected was prepared to establish a general predictive equation for energy expenditure from HR in FBI dogs. The regression equation established in this study enables fast estimation of energy requirement for running activity. The equation is valid for large dogs weighing around 30 kg that run at ground level up to 15 km/h with a heart rate maximum of 190 bpm irrespective of the training level. Journal of Animal Physiology and Animal Nutrition © 2015 Blackwell Verlag GmbH.

Psychological Effects of Automated External Defibrillator Training A randomized trial

PubMed Central

Meischke, Hendrika; Diehr, Paula; Phelps, Randi; Damon, Susan; Rea, Tom

2011-01-01

Objectives The objective of this study was to test if an Automated External Defibrillator (AED) training program would positively affect the mental health of family members of high risk patients. Methods 305 ischemic heart disease patients and their family members were randomized to one of four AED training programs: two video-based training programs and two face-to-face training programs that emphasized self-efficacy and perceived control. Patients and family members were surveyed at baseline, 3 and 9 months post ischemic event on demographic characteristics, measures of quality of life (SF=36) , self-efficacy and perceived control. For this study, family members were the focus rather than the patients. Results Regression analyses showed that family members in the face-to-face training programs did not score better on any of the mental health status variables than family members who participated in the other training programs but for an increase in self-efficacy beliefs at 3 months post training. Conclusion The findings suggest that a specifically designed AED training program emphasizing self-efficacy and perceived control beliefs is not likely to enhance family member mental health. PMID:21411144

Report of the 2010 society of thoracic surgeons congenital heart surgery practice and manpower survey.

PubMed

Jacobs, Marshall L; Daniel, Megan; Mavroudis, Constantine; Morales, David L S; Jacobs, Jeffrey P; Fraser, Charles D; Turek, Joseph W; Mayer, John E; Tchervenkov, Christo; Conte, John

2011-08-01

The Society of Thoracic Surgeons (STS) Workforce on Congenital Heart Surgery undertook a second subspecialty Practice and Manpower Survey (2005, 2010) to obtain contemporary data. Preliminary research suggested a potential target group of 273 congenital heart surgeons, including 258 at 125 US centers and 15 at 8 Canadian centers. The web-based survey was sent to these surgeons, plus all individuals listing pediatric cardiac surgery on CTSNet. Two hundred forty-six responders included 213 active congenital heart surgeons, 16 retired congenital heart surgeons, and 17 surgeons in training. Retirement age was 63.5±7.5 years. Two hundred thirteen active congenital heart surgeon responders represent 78% of the original estimate. Their responses generated the following data: The mean age was 49.2±8.5 (range, 35 to 75 years). American medical school graduates included 159 of 201 respondents (79%). Years of postgraduate training was 9.7±1.7. One hundred ninety-seven (92%) respondents were certified in thoracic surgery by the American Board of Thoracic Surgery (ABTS). Twenty-eight of 200 (14%) received their congenital heart surgery training outside the United States or Canada. One hundred forty-three of 190 respondents (75%) perform exclusively congenital heart operations; 31 (16%) perform exclusively pediatric heart operations. Of 186 respondents, 54 (29%) perform fewer than 100 major congenital heart operations per year, 78 (42%) perform 100 to 199 procedures, and 54 (29%) perform 200 procedures or more. Active congenital heart surgeons have been in their current positions for 9.3±8.6 years. Eight respondents are in their first year of practice. For 203 respondents, mean anticipated years to retirement is 16.1±7.6. Twenty-eight anticipate retirement within 5 years; 31 in 6 to 10 years. These data should help facilitate rational plans to meet workforce needs for an expanding patient population. Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Heart Rate Variability Dynamics for the Prognosis of Cardiovascular Risk

PubMed Central

Ramirez-Villegas, Juan F.; Lam-Espinosa, Eric; Ramirez-Moreno, David F.; Calvo-Echeverry, Paulo C.; Agredo-Rodriguez, Wilfredo

2011-01-01

Statistical, spectral, multi-resolution and non-linear methods were applied to heart rate variability (HRV) series linked with classification schemes for the prognosis of cardiovascular risk. A total of 90 HRV records were analyzed: 45 from healthy subjects and 45 from cardiovascular risk patients. A total of 52 features from all the analysis methods were evaluated using standard two-sample Kolmogorov-Smirnov test (KS-test). The results of the statistical procedure provided input to multi-layer perceptron (MLP) neural networks, radial basis function (RBF) neural networks and support vector machines (SVM) for data classification. These schemes showed high performances with both training and test sets and many combinations of features (with a maximum accuracy of 96.67%). Additionally, there was a strong consideration for breathing frequency as a relevant feature in the HRV analysis. PMID:21386966

Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program.

PubMed

Burton, Nicola W; Pakenham, Kenneth I; Brown, Wendy J

2009-11-23

Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 x 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol.L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects. If successful, this program will provide an innovative means by which to promote psychosocial well-being for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups. ACTRN12608000017325.

Specific Circuit Training in Young Judokas: Effects of Rest Duration

ERIC Educational Resources Information Center

Baudry, Stephane; Roux, Patrick

2009-01-01

Ten adolescent judokas performed circuit training consisting of six 40-s periods of judo exercises separated by 40 s (CT1:1), 120 s (CT1:3), or 200 s (CT1:5) of rest. Heart rate, blood lactate concentration, and the number of repetitions were recorded. Heart rate reached [approximately]180 beats[middle dot]min-1 at the end of work periods, with…

Effects of HRV-Guided vs. Predetermined Block Training on Performance, HRV and Serum Hormones.

PubMed

Nuuttila, Olli-Pekka; Nikander, Aku; Polomoshnov, Dmitry; Laukkanen, Jari Antero; Häkkinen, Keijo

2017-11-01

The aim of this study was to compare heart rate variability -guided (HRVG) and predetermined (PD) block periodization of high intensity aerobic training (HIT). Endurance performance, neuromuscular performance, heart rate variability (HRV) and serum hormone concentrations were measured before, in the middle and after the 8-week training period in 24 endurance trained males. Both groups improved significantly maximal treadmill velocity (V max ) (p<0.001) and 3000 m running performance (HRVG; p<0.001 and PD; p=0.001). The relative changes in V max and countermovement jump were significantly greater in HRVG (p<0.05). Nocturnal heart rate decreased in both groups (p<0.01), but HRV (RMSSD, LF and TP) increased significantly only in HRVG (p<0.05). The significant increase in serum testosterone concentration was observed from mid to post in HRVG (p<0.05). Significant correlations were found between individual V max changes and absolute serum testosterone levels. Individual baseline level of HF correlated significantly with V max changes in PD. Block periodization of HIT seems to be an effective way to improve endurance and running performance in already endurance trained males. Based on training induced increases in endurance and neuromuscular performance combined with significant changes in HRV and serum testosterone levels observed in HRVG, individually HRV -guided block training may be more optimal compared to predetermined training. © Georg Thieme Verlag KG Stuttgart · New York.

Aquatic Exercise Training is Effective in Maintaining Exercise Performance in Trained Heart Failure Patients: A Randomised Crossover Pilot Trial.

PubMed

Adsett, Julie; Morris, Norman; Kuys, Suzanne; Hwang, Rita; Mullins, Robert; Khatun, Mohsina; Paratz, Jennifer; Mudge, Alison

2017-06-01

Providing flexible models and a variety of exercise options are fundamental to supporting long-term exercise participation for patients with heart failure (HF). The aim of this pilot study was to determine the feasibility and efficacy of aquatic exercise training during a maintenance phase for a clinical heart failure population. In this 2 x 2 crossover design trial, individuals who had previously completed HF rehabilitation were randomised into either a land-based or aquatic training program once per week for six weeks, after which time they changed to the alternate exercise training protocol for an additional six weeks. Six-minute walk test (6MWT), grip strength, walk speed, and measures of balance were compared for the two training protocols. Fifty-one participants (43 males, mean age 69.2 yrs) contributed data for the analysis. Both groups maintained function during the follow-up period, however improvements in 6MWT were greater in the land-based training group (95% CI: 0.7, 22.5; p=0.038), by a mean difference of 10.8 metres. No significant difference was observed for other parameters when the two training protocols were compared. Attending an aquatic exercise program once per week is feasible for patients with stable HF and may provide a suitable option to maintain functional performance in select patients. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Heart rate changes during electroconvulsive therapy

PubMed Central

2013-01-01

Background This observational study documented heart rate over the entire course of electrically induced seizures and aimed to evaluate the effects of stimulus electrode placement, patients' age, stimulus dose, and additional predictors. Method In 119 consecutive patients with 64 right unilateral (RUL) and 55 bifrontal (BF) electroconvulsive treatments, heart rate graphs based on beat-to-beat measurements were plotted up to durations of 130 s. Results In RUL stimulation, the initial drop in heart rate lasted for 12.5 ± 2.6 s (mean ± standard deviation). This depended on stimulus train duration, age, and baseline heart rate. In seizures induced with BF electrode placement, a sympathetic response was observed within the first few seconds of the stimulation phase (median 3.5 s). This was also the case with subconvulsive stimulations. The mean peak heart rate in all 119 treatments amounted to 135 ± 20 bpm and depended on baseline heart rate and seizure duration; electrode placement, charge dose, and age were insignificant in regression analysis. A marked decline in heart rate in connection with seizure cessation occurred in 71% of treatments. Conclusions A significant independent effect of stimulus electrode positioning on cardiac action was evident only in the initial phase of the seizures. Electrical stimulation rather than the seizure causes the initial heart rate increase in BF treatments. The data reveal no rationale for setting the stimulus doses as a function of intraictal peak heart rates (‘benchmark method’). The marked decline in heart rate at the end of most seizures is probably mediated by a baroreceptor reflex. PMID:23764036

Reference values of left heart echocardiographic dimensions and mass in male peri-pubertal athletes.

PubMed

Cavarretta, Elena; Maffessanti, Francesco; Sperandii, Fabio; Guerra, Emanuele; Quaranta, Federico; Nigro, Antonia; Minati, Monia; Rebecchi, Marco; Fossati, Chiara; Calò, Leonardo; Pigozzi, Fabio

2018-01-01

Background Several articles have proposed reference values in healthy paediatric subjects, but none of them has evaluated a large population of healthy trained adolescents. Design The study purpose was to establish normal echocardiographic measurements of left heart (aortic root, left atrium and left ventricular dimensions and mass) in relation to age, weight, height, body mass index, body surface area and training hours in this specific population. Methods We retrospectively evaluated 2151 consecutive, healthy, peri-pubertal athletes (100% male, mean age 12.4 ± 1.4 years, range 8-18) referred to a single centre for pre-participation screening. All participants were young soccer athletes who trained for a mean of 7.2 ± 1.1 h per week. Results Left ventricular internal diameters, wall thickness, left ventricular mass, aortic root and left atrium diameters were significantly correlated to age, body surface area, height and weight ( p < 0.01). Age, height, weight and body surface area were found associated with chamber size, while body mass index and training hours were not. Inclusion of both age and body size parameters in the statistical models resulted in improved overall explained variance for diameters and left ventricular mass. Conclusion Equations, mean values and percentile charts for the different age groups may be useful as reference data in efficiently assessing left ventricular parameters in young athletes.

Effect of repeated exercise and recovery on heart rate variability in elite trotting horses during high intensity interval training.

PubMed

Cottin, F; Barrey, E; Lopes, P; Billat, V

2006-08-01

Interval training is a commonly used training method for trotting horses. In addition, trainers are provided with efficient and inexpensive heart rate monitor devices for the management of training. Since the high frequency (HF) frequency peak (fHF) of heart rate variability (HRV) corresponds to the breathing frequency in combination with stride frequency during trotting, it is hypothesised that modifications of breathing and stride frequencies induced by repeated exercise could be detected from fHF. RR interval time series of 7 trotting horses were recorded during an interval training session. Interval training was made up of 5 successive 800 m high-velocity trotting runs (H1, H2...H5) separated by 1 min recovery bouts at low speed (R1, R2...R5). Fast Fourier transform (FFT) and Poincaré plot analysis techniques were applied to RR series. Repeated exercise had significant effects on HRV components during interval training. Despite constant trotting velocities during high-speed and recovery, repetition induced a decrease in mean RR interval (H1: 295 +/- 19 vs. H5: 283 +/- 15 msec, P<0.05) and in the root mean square of successive differences in RR series (RMSSD; H1: 6.31 +/- 1.28 vs. H5: 5.31 +/- 1.31 msec, P<0.05). Furthermore, high-speed and recovery repetitions induced an increase in fHF (H1: 1.37 +/- 0.35 vs. H5: 1.62 +/- 0.40 Hz and R1: 0.22 +/- 0.02 vs. R4: 0.64 +/- 0.38 Hz, P<0.05). Hence, recovery induced a decrease in the s.d. of the successive RR series (SDRR; R3: 10.5 +/- 3.96 vs. R5: 6.17 +/- 2.65 msecs, P>0.05) and in the long term index of Poincaré plot (SD2; R1: 43.29 +/- 28.90 vs. R5: 18.19 +/- 9.35 msecs, P<0.05). The observed increase in fHF during the interval training could be induced by alterations of the coupling between breathing and stride frequency linked to the emergence of fatigue. The decrease in SD2 and SDRR during successive recovery bouts could be linked with a deterioration of the recovery pattern. HRV can provide breathing frequency data of Standardbreds during training without any respiratory device. Furthermore, HRV could provide useful makers of the emergence of fatigue states during training.

Mindfulness meditation in aphasia: A case report.

PubMed

Laures-Gore, Jacqueline; Marshall, Rebecca Shisler

2016-04-06

Despite the potential behavioral and neurological benefits of Mindfulness Meditation (MM), its use in treating stroke related communication disabilities appears to be underexplored. Specifically, aphasia, a language disorder resulting from stroke, may be amenable to the benefits of MM because of the observed attention problems often underlying the language symptoms. The current paper presents a case report of an adult with aphasia who was trained in MM. An adult with aphasia completed a five-day mindfulness training, and was assessed on measures of language, attention, and physiological measures of cortisol and heart rate variability. She completed four assessments: two baseline measures, immediately post training, and one week post training (maintenance). Overall, changes were observed in both psychophysiological measures (heart rate and heart rate variability) and behavioral measures (word productivity, phrase length, word generation, decreased impulsivity, and increased attention). Given the psychophysiological and behavioral changes observed in this individual, further exploration of the influence of MM in the treatment of post-stroke aphasia is warranted.

A pilot study on quantification of training load: The use of HRV in training practice.

PubMed

Saboul, Damien; Balducci, Pascal; Millet, Grégoire; Pialoux, Vincent; Hautier, Christophe

2016-01-01

Recent laboratory studies have suggested that heart rate variability (HRV) may be an appropriate criterion for training load (TL) quantification. The aim of this study was to validate a novel HRV index that may be used to assess TL in field conditions. Eleven well-trained long-distance male runners performed four exercises of different duration and intensity. TL was evaluated using Foster and Banister methods. In addition, HRV measurements were performed 5 minutes before exercise and 5 and 30 minutes after exercise. We calculated HRV index (TLHRV) based on the ratio between HRV decrease during exercise and HRV increase during recovery. HRV decrease during exercise was strongly correlated with exercise intensity (R = -0.70; p < 0.01) but not with exercise duration or training volume. TLHRV index was correlated with Foster (R = 0.61; p = 0.01) and Banister (R = 0.57; p = 0.01) methods. This study confirms that HRV changes during exercise and recovery phase are affected by both intensity and physiological impact of the exercise. Since the TLHRV formula takes into account the disturbance and the return to homeostatic balance induced by exercise, this new method provides an objective and rational TL index. However, some simplification of the protocol measurement could be envisaged for field use.

Comparative Effectiveness of Low-Volume Time-Efficient Resistance Training Versus Endurance Training in Patients With Heart Failure.

PubMed

Munch, Gregers Winding; Rosenmeier, Jaya Birgitte; Petersen, Morten; Rinnov, Anders Rasmussen; Iepsen, Ulrik Winning; Pedersen, Bente Klarlund; Mortensen, Stefan Peter

2018-05-01

Cardiorespiratory fitness is positively related to heart failure (HF) prognosis, but lack of time and low energy are barriers for adherence to exercise. We, therefore, compared the effect of low-volume time-based resistance exercise training (TRE) with aerobic moderate-intensity cycling (AMC) on maximal and submaximal exercise capacity, health-related quality of life, and vascular function. Twenty-eight HF patients (New York Heart Association class I-II) performed AMC (n = 14) or TRE (n = 14). Maximal and submaximal exercise capacity, health-related quality of life, and vascular function were evaluated before and after a 6-wk training intervention with 3 training sessions per week. The AMC group and the TRE group trained for 45 and 25 min per training session, respectively. During the training sessions, the TRE and AMC groups trained at 60 ± 4% and 59 ± 2% (mean ± standard deviation) of (Equation is included in full-text article.)O2peak, respectively. The energy expenditure was significantly greater in AMC than in TRE (P < .05). The (Equation is included in full-text article.)O2peak and Wattpeak increased in AMC group (P < .001) and TRE group (P = .001), with no differences between groups. Six-minute walk distance also increased in both groups (AMC, P = .006 and TRE, P = .036), with no difference between groups. Health-related quality of life improved equally in the 2 groups, whereas vascular function did not change in either group. These results demonstrate that AMC and TRE equally improved exercise capacity and health-related quality of life in lower New York Heart Association-stage HF patients, despite less time required as well as lower energy expenditure during TRE than during AMC. Therefore, TRE might represent a time-efficient exercise modality for improving adherence to exercise in patients with class I-II HF.

Reduction of lymphocyte G protein-coupled receptor kinase-2 (GRK2) after exercise training predicts survival in patients with heart failure.

PubMed

Rengo, Giuseppe; Galasso, Gennaro; Femminella, Grazia D; Parisi, Valentina; Zincarelli, Carmela; Pagano, Gennaro; De Lucia, Claudio; Cannavo, Alessandro; Liccardo, Daniela; Marciano, Caterina; Vigorito, Carlo; Giallauria, Francesco; Ferrara, Nicola; Furgi, Giuseppe; Filardi, Pasquale Perrone; Koch, Walter J; Leosco, Dario

2014-01-01

Increased cardiac G protein-coupled receptor kinase-2 (GRK2) expression has a pivotal role at inducing heart failure (HF)-related β-adrenergic receptor (βAR) dysfunction. Importantly, abnormalities of βAR signalling in the failing heart, including GRK2 overexpression, are mirrored in circulating lymphocytes and correlate with HF severity. Exercise training has been shown to exert several beneficial effects on the failing heart, including normalization of cardiac βAR function and GRK2 protein levels. In the present study, we evaluated whether lymphocyte GRK2 levels and short-term changes of this kinase after an exercise training programme can predict long-term survival in HF patients. For this purpose, we prospectively studied 193 HF patients who underwent a 3-month exercise training programme. Lymphocyte GRK2 protein levels, plasma N-terminal pro-brain natriuretic peptide, and norepinephrine were measured at baseline and after training along with clinical and functional parameters (left ventricular ejection fraction, NYHA class, and peak-VO2). Cardiac-related mortality was evaluated during a mean follow-up period of 37 ± 20 months. Exercise was associated with a significant reduction of lymphocyte GRK2 protein levels (from 1.29 ± 0.52 to 1.16 ± 0.65 densitometric units, p < 0.0001). Importantly, exercise related changes of GRK2 (delta values) robustly predicted survival in our study population. Interestingly, HF patients who did not show reduced lymphocyte GRK2 protein levels after training presented the poorest outcome. Our data offer the first demonstration that changes of lymphocyte GRK2 after exercise training can strongly predict outcome in advanced HF.

Heart rate variability and swimming.

PubMed

Koenig, Julian; Jarczok, Marc N; Wasner, Mieke; Hillecke, Thomas K; Thayer, Julian F

2014-10-01

Professionals in the domain of swimming have a strong interest in implementing research methods in evaluating and improving training methods to maximize athletic performance and competitive outcome. Heart rate variability (HRV) has gained attention in research on sport and exercise to assess autonomic nervous system activity underlying physical activity and sports performance. Studies on swimming and HRV are rare. This review aims to summarize the current evidence on the application of HRV in swimming research and draws implications for future research. A systematic search of databases (PubMed via MEDLINE, PSYNDEX and Embase) according to the PRISMA statement was employed. Studies were screened for eligibility on inclusion criteria: (a) empirical investigation (HRV) in humans (non-clinical); (b) related to swimming; (c) peer-reviewed journal; and (d) English language. The search revealed 194 studies (duplicates removed), of which the abstract was screened for eligibility. Fourteen studies meeting the inclusion criteria were included in the review. Included studies broadly fell into three classes: (1) control group designs to investigate between-subject differences (i.e. swimmers vs. non-swimmers, swimmers vs. other athletes); (2) repeated measures designs on within-subject differences of interventional studies measuring HRV to address different modalities of training or recovery; and (3) other studies, on the agreement of HRV with other measures. The feasibility and possibilities of HRV within this particular field of application are well documented within the existing literature. Future studies, focusing on translational approaches that transfer current evidence in general practice (i.e. training of athletes) are needed.

Impact of high-intensity concurrent training on cardiovascular risk factors in persons with multiple sclerosis - pilot study.

PubMed

Keytsman, Charly; Hansen, Dominique; Wens, Inez; O Eijnde, Bert

2017-10-27

High-intensity concurrent training positively affects cardiovascular risk factors. Because this was never investigated in multiple sclerosis, the present pilot study explored the impact of this training on cardiovascular risk factors in this population. Before and after 12 weeks of high-intense concurrent training (interval and strength training, 5 sessions per 2 weeks, n = 16) body composition, resting blood pressure and heart rate, 2-h oral glucose tolerance (insulin sensitivity, glycosylated hemoglobin, blood glucose and insulin concentrations), blood lipids (high- and low-density lipoprotein, total cholesterol, triglyceride levels) and C-reactive protein were analyzed. Twelve weeks of high-intense concurrent training significantly improved resting heart rate (-6%), 2-h blood glucose concentrations (-13%) and insulin sensitivity (-24%). Blood pressure, body composition, blood lipids and C-reactive protein did not seem to be affected. Under the conditions of this pilot study, 12 weeks of concurrent high-intense interval and strength training improved resting heart rate, 2-h glucose and insulin sensitivity in multiple sclerosis but did not affect blood C-reactive protein levels, blood pressure, body composition and blood lipid profiles. Further, larger and controlled research investigating the effects of high-intense concurrent training on cardiovascular risk factors in multiple sclerosis is warranted. Implications for rehabilitation High-intensity concurrent training improves cardiovascular fitness. This pilot study explores the impact of this training on cardiovascular risk factors in multiple sclerosis. Despite the lack of a control group, high-intense concurrent training does not seem to improve cardiovascular risk factors in multiple sclerosis.

Sympathetic adaptations to one-legged training

NASA Technical Reports Server (NTRS)

Ray, C. A.

1999-01-01

The purpose of the present study was to determine the effect of leg exercise training on sympathetic nerve responses at rest and during dynamic exercise. Six men were trained by using high-intensity interval and prolonged continuous one-legged cycling 4 day/wk, 40 min/day, for 6 wk. Heart rate, mean arterial pressure (MAP), and muscle sympathetic nerve activity (MSNA; peroneal nerve) were measured during 3 min of upright dynamic one-legged knee extensions at 40 W before and after training. After training, peak oxygen uptake in the trained leg increased 19 +/- 2% (P < 0.01). At rest, heart rate decreased from 77 +/- 3 to 71 +/- 6 beats/min (P < 0.01) with no significant changes in MAP (91 +/- 7 to 91 +/- 11 mmHg) and MSNA (29 +/- 3 to 28 +/- 1 bursts/min). During exercise, both heart rate and MAP were lower after training (108 +/- 5 to 96 +/- 5 beats/min and 132 +/- 8 to 119 +/- 4 mmHg, respectively, during the third minute of exercise; P < 0.01). MSNA decreased similarly from rest during the first 2 min of exercise both before and after training. However, MSNA was significantly less during the third minute of exercise after training (32 +/- 2 to 22 +/- 3 bursts/min; P < 0.01). This training effect on MSNA remained when MSNA was expressed as bursts per 100 heartbeats. Responses to exercise in five untrained control subjects were not different at 0 and 6 wk. These results demonstrate that exercise training prolongs the decrease in MSNA during upright leg exercise and indicates that attenuation of MSNA to exercise reported with forearm training also occurs with leg training.

Intermittent versus continuous exercise training in chronic heart failure: a meta-analysis.

PubMed

Smart, Neil A; Dieberg, Gudrun; Giallauria, Francesco

2013-06-20

We conducted a meta-analysis of randomized, controlled trials of combined strength and intermittent aerobic training, intermittent aerobic training only and continuous exercise training in heart failure patients. A systematic search was conducted of Medline (Ovid) (1950-September 2011), Embase.com (1974-September 2011), Cochrane Central Register of Controlled Trials and CINAHL (1981-September 19 2011). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, exercise training, interval training and intermittent exercise training. The included studies contained an aggregate of 446 patients, 212 completed intermittent exercise training, 66 only continuous exercise training, 59 completed combined intermittent and strength training and 109 sedentary controls. Weighted mean difference (MD) in Peak VO2 was 1.04mlkg(-1)min(-1) and (95% C.I.) was 0.42-1.66 (p=0.0009) in intermittent versus continuous exercise training respectively. Weighted mean difference in Peak VO2 was -1.10mlkg(-1)min(-1) (95% C.I.) was -1.83-0.37 p=0.003 for intermittent only versus intermittent and strength (combined) training respectively. In studies reporting VE/VCO2 for intermittent versus control groups, MD was -1.50 [(95% C.I. -2.64, -0.37), p=0.01] and for intermittent versus continuous exercise training MD was -1.35 [(95% C.I. -2.15, -0.55), p=0.001]. Change in peak VO2 was positively correlated with weekly exercise energy expenditure for intermittent exercise groups (r=0.48, p=0.05). Combined strength and intermittent exercise appears superior for peak VO2 changes when compared to intermittent exercise of similar exercise energy expenditure. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Stress response and communication in surgeons undergoing training in endoscopic management of major vessel hemorrhage: a mixed methods study.

PubMed

Jukes, Alistair K; Mascarenhas, Annika; Murphy, Jae; Stepan, Lia; Muñoz, Tamara N; Callejas, Claudio A; Valentine, Rowan; Wormald, P J; Psaltis, Alkis J

2017-06-01

Major vessel hemorrhage in endoscopic, endonasal skull-base surgery is a rare but potentially fatal event. Surgical simulation models have been developed to train surgeons in the techniques required to manage this complication. This mixed-methods study aims to quantify the stress responses the model induces, determine how realistic the experience is, and how it changes the confidence levels of surgeons in their ability to deal with major vascular injury in an endoscopic setting. Forty consultant surgeons and surgeons in training underwent training on an endoscopic sheep model of jugular vein and carotid artery injury. Pre-course and post-course questionnaires providing demographics, experience level, confidence, and realism scores were taken, based on a 5-point Likert scale. Objective markers of stress response including blood pressure, heart rate, and salivary alpha-amylase levels were measured. Mean "realism" score assessed posttraining showed the model to be perceived as highly realistic by the participants (score 4.02). Difference in participant self-rated pre-course and post-course confidence levels was significant (p < 0.0001): mean pre-course confidence level 1.66 (95% confidence interval [CI], 1.43 to 1.90); mean post-course confidence level 3.42 (95% CI, 3.19 to 3.65). Differences in subjects' heart rates (HRs) and mean arterial blood pressures (MAPs) were significant between injury models (p = 0.0008, p = 0.0387, respectively). No statistically significant difference in salivary alpha-amylase levels pretraining and posttraining was observed. Results from this study indicate that this highly realistic simulation model provides surgeons with an increased level of confidence in their ability to deal with the rare but potentially catastrophic event of major vessel injury in endoscopic skull-base surgery. © 2017 ARS-AAOA, LLC.

Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation.

PubMed

McNamara, Renae J; McKeough, Zoe J; Mo, Laura R; Dallimore, Jamie T; Dennis, Sarah M

2016-01-01

Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers. The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists.

Effects of cognitive training on change in accuracy in inductive reasoning ability.

PubMed

Boron, Julie Blaskewicz; Turiano, Nicholas A; Willis, Sherry L; Schaie, K Warner

2007-05-01

We investigated cognitive training effects on accuracy and number of items attempted in inductive reasoning performance in a sample of 335 older participants (M = 72.78 years) from the Seattle Longitudinal Study. We assessed the impact of individual characteristics, including chronic disease. The reasoning training group showed significantly greater gain in accuracy and number of attempted items than did the comparison group; gain was primarily due to enhanced accuracy. Reasoning training effects involved a complex interaction of gender, prior cognitive status, and chronic disease. Women with prior decline on reasoning but no heart disease showed the greatest accuracy increase. In addition, stable reasoning-trained women with heart disease demonstrated significant accuracy gain. Comorbidity was associated with less change in accuracy. The results support the effectiveness of cognitive training on improving the accuracy of reasoning performance.

Paediatric cardiology programs in countries with limited resources: how to bridge the gap.

PubMed

Sulafa, K M Ali

2010-07-01

Establishing paediatric cardiology service in a country with limited resources like Sudan is a challenging task. A paediatric cardiac team was formed then the services in different disciplines were gradually established. Echocardiography (echo) clinics were founded in tertiary and peripheral hospitals. Cardiac catheterization (cath) was established at the Sudan Heart Centre (SHC) in 2004 and over 400 procedures had been performed including interventional catheterization like pulmonary valve dilatation, patent ductus arteriosus and atrial septal defect device closure. Congenital heart surgery started in 2001, currently 200 cases are done each year including closed procedures as well as open heart procedures for patients weighing more than 8 kg. Cardiology-cardiac surgery as well as adult congenital heart disease meetings were held and contributed positively to the services. The cardiology-cardiac surgery scientific club meeting was founded as a forum for academic discussions. A fellowship program was established in 2004 and included seven candidates trained in paediatric cardiology and intensive care. Two training courses had been established: congenital heart disease echo and paediatric electrocardiogram interpretation. Links with regional and international cardiac centres had important roles in consolidating our program. Significant obstacles face our service due to the small number of trained personnel, high cost of procedures, the lack of regular supplies and lack of cardiac intensive care facilities for young infants. Bridging the huge gap needs extensive official as well as non-governmental efforts, training more staff, supporting families and collaboration with regional and international centres.

A feasiblity study of an ultrasonic test phantom arm

NASA Astrophysics Data System (ADS)

Schneider, Philip

This thesis is a feasibility study for the creation of a test phantom that replicates the physiological features, from an acoustic and mechanical standpoint, of that of a human arm. Physiological feature set includes; Heart, Arteries, Veins, Bone, Muscle, Fat, Skin, and Dermotographic Features (finger prints). Mechanical Aspects include, vascular compression and distention, elasticity of tissue layers, mechanics of human heart. The end goal of which to have a working understanding of each component in order to create a controllable, real time, physiologically accurate, test phantom for a wide range of ultrasonic based applications. These applications can range from devices like wearable technologies to medical training, to biometric "Liveness" detection methods. The proposed phantom would allow for a number of natural bodily functions to be measured including but not limited to vascular mapping, blood pressure, heart rate, subdermal imaging, and general ultrasonic imaging.

[Role of controlled physical activity as a method of therapy in patients with heart failure after invasive treatment of angina pectoris].

PubMed

Irzmański, Robert; Kapusta, Joanna; Kowalski, Jan

2014-08-01

Due to the aging of the population is an increase in the incidence of heart failure. According to the current guidelines for conduct in the treatment of cardiovascular diseases, rehabilitation is introduced in the first treatment period. Individually matched to the severity of illness of each patient, increases the quality of life of patients and reduces mortality in this group of patients. The aim of the study was to evaluate the effect of controlled exercise on left ventricular systolic function of heart and change the level of concentration of natriuretic peptide NT-pro-BNP in patients with heart failure after invasive treatment of angina pectoris. The study group consisted of 87 patients, men and women aged 35 to 85 years (mean age 65.6 +/- 10.4) with a diagnosis of heart failure. Patients were divided into 3 groups. I group numbering 19 patients (67.3 +/- 7.8) were subjected to two-week cardiac rehabilitation program, representing 46. Group II patients (59.4 +/- 10.9) was qualified for the 4-week program. The basis for rehabilitation of patients accounted for interval training was performed using a bicycle ergometer. Group III--control, representing 22 patients (68.1 +/- 9.2) were excluded from the training groups because of the high risk. Used with them individually tailored program of cardiac rehabilitation. All patients were performed: submaximal exercise test, echocardiography and examined the concentration of NT-pro-BNP (N-terminal pro-B-type natriuretic peptide). After a period of 6 months from the end of the second phase of cardiac rehabilitation in 32 patients who agreed repeated the scope of clinical trials. In groups where physical training was conducted controlled noticed an improvement in EF and reduction of NT pro-BNP. It was also a significant, negative correlation between the degree of damage to the left ventricle (EF), and the level of NT pro-BNP. After a period of 6 months from the end of the second stage of rehabilitation, the analysis showed a statistically significant further and improve. It was observed that the best results were obtained in the group with the longest period of rehabilitation. Rehabilitation, part of cardiac rehabilitation is an important component of therapy in patients with heart failure. By influencing the improvement actions cardiovascular favorable effect on the clinical course of the disease.

Combined use of autogenic therapy and biofeedback in training effective control of heart rate by humans

NASA Technical Reports Server (NTRS)

Cowings, P. S.

1977-01-01

Experiments were performed on 24 men and women (aged 20-27 yr) in three equal groups who were taught to control their own heart rates by autogenic training and biofeedback under dark and sound-isolated conditions. Group I was parasympathetic dominant, group II was sympathetic dominant, and group III consisted of parasympathetic-dominant subjects and controls who received only biofeedback of their own heart rates. The results corroborate three hypotheses: (1) subjects with para-sympathetic-dominant autonomic profiles perform in a way that is both qualitatively and quantitatively different from subjects with sympathetic-dominant autonomic profiles; (2) tests of interindividual variability yield data relevant to individual performance in visceral learning tasks; and (3) the combined use of autogenic training, biofeedback, and verbal feedback is suitable for conditioning large stable autonomic responses in humans.

Exercise physiology, testing, and training in patients supported by a left ventricular assist device.

PubMed

Loyaga-Rendon, Renzo Y; Plaisance, Eric P; Arena, Ross; Shah, Keyur

2015-08-01

The left ventricular assist device (LVAD) is an accepted treatment alternative for the management of end-stage heart failure. As we move toward implantation of LVADs in less severe cases of HF, scrutiny of functional capacity and quality of life becomes more important. Patients demonstrate improvements in exercise capacity after LVAD implantation, but the effect is less than predicted. Exercise training produces multiple beneficial effects in heart failure patients, which would be expected to improve quality of life. In this review, we describe factors that are thought to participate in the persistent exercise impairment in LVAD-supported patients, summarize current knowledge about the effect of exercise training in LVAD-supported patients, and suggest areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Myocardial blood flow and its transit time, oxygen utilization, and efficiency of highly endurance-trained human heart.

PubMed

Heinonen, Ilkka; Kudomi, Nobuyuki; Kemppainen, Jukka; Kiviniemi, Antti; Noponen, Tommi; Luotolahti, Matti; Luoto, Pauliina; Oikonen, Vesa; Sipilä, Hannu T; Kopra, Jaakko; Mononen, Ilkka; Duncker, Dirk J; Knuuti, Juhani; Kalliokoski, Kari K

2014-07-01

Highly endurance-trained athlete's heart represents the most extreme form of cardiac adaptation to physical stress, but its circulatory alterations remain obscure. In the present study, myocardial blood flow (MBF), blood mean transit time (MTT), oxygen extraction fraction (OEF) and consumption (MVO2), and efficiency of cardiac work were quantified in highly trained male endurance athletes and control subjects at rest and during supine cycling exercise using [(15)O]-labeled radiotracers and positron emission tomography. Heart rate and MBF were lower in athletes both at rest and during exercise. OEF increased in response to exercise in both groups, but was higher in athletes (70 ± 21 vs. 63 ± 11 % at rest and 86 ± 13 vs. 73 ± 10 % during exercise). MTT was longer and vascular resistance higher in athletes both at rest and during exercise, but arterial content of 2,3-diphosphoglycerate (oxygen affinity) was unchanged. MVO2 per gram of myocardium trended (p = 0.08) lower in athletes both at rest and during exercise, while myocardial efficiency of work and MVO2 per beat were not different between groups. Arterial levels of free fatty acids were ~twofold higher in athletes likely leading to higher myocardial fatty acid oxidation and hence oxygen cost, which may have blunted the bradycardia-induced decrease in MVO2. Finally, the observed group differences in MBF, OEF, MTT and vascular resistance remained significant also after they were controlled for differences in MVO2. In conclusion, in highly endurance-trained human heart, increased myocardial blood transition time enables higher oxygen extraction levels with a lower myocardial blood flow and higher vascular resistance. These physiological adaptations to exercise training occur independently of the level of oxygen consumption and together with training-induced bradycardia may serve as mechanisms to increase functional reserve of the human heart.

Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk.

PubMed

Fleg, Jerome L

2016-01-01

Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation.

Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk

PubMed Central

Fleg, Jerome L.

2016-01-01

Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation. PMID:27635241

Comparison of Heart Rate Response to Tennis Activity between Persons with and without Spinal Cord Injuries: Implications for a Training Threshold

ERIC Educational Resources Information Center

Barfield, J. P.; Malone, Laurie A.; Coleman, Tristica A.

2009-01-01

The purpose of this study was to evaluate the ability of individuals with spinal cord injury (SCI) to reach a training threshold during on-court sport activity. Monitors collected heart rate (HR) data every 5 s for 11 wheelchair tennis players (WCT) with low paraplegia and 11 able-bodied controls matched on experience and skill level (ABT).…

Selection, Training and Simulation

DTIC Science & Technology

2000-03-01

most Neck training, Altitudetehamber, PBG, Gas nixtures, Trampoline , important in flying. In years to come we will have a Statoergometer, Raling...superagile world, are mentioned neck, more if X-tra head worn equipment is used put below. a lot of stress to this system. In addition stress will 6-6 be...acceleration Pilot selection criteria like body-type, heart-cerebral forces, mainly head to foot (Gz). The heart itself is distance, vagal and sympathetic nerve

Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study).

PubMed

Mendes, Fernanda de Souza Nogueira Sardinha; Sousa, Andréa Silvestre; Souza, Fernando Cesar de Castro Cesar; Pinto, Vivian Liane Mattos; Silva, Paula Simplicio; Saraiva, Roberto Magalhães; Xavier, Sergio Salles; Veloso, Henrique Horta; Holanda, Marcelo Teixeira; Costa, Andréa Rodrigues; Carneiro, Fernanda Martins; Silva, Gilberto Marcelo Sperandio; Borges, Juliana Pereira; Tibirica, Eduardo; Pinheiro, Roberta Olmo; Lara, Flávio Alves; Hasslocher-Moreno, Alejandro Marcel; Brasil, Pedro Emmanuel Alvarenga Americano; Mediano, Mauro Felippe Felix

2016-09-02

The effects of exercise training on Chagas heart disease are still unclear. This study aimed to evaluate the effect of exercise training over functional capacity, cardiac function, quality of life, and biomarkers in Chagas heart disease. The PEACH study is a superiority randomized clinical trial which will include subjects who meet the following criteria: Chagas heart disease with a left ventricular ejection fraction below 45 % with or without heart failure symptoms; clinical stability in the last 3 months; adherence to clinical treatment; and age above 18 years. The exclusion criteria are: pregnancy; neuromuscular limitations; smoking; evidence of non-chagasic heart disease; systemic conditions that limit exercise practice or cardiopulmonary exercise test; unavailability to attend the center three times a week during the intervention period; and practitioners of regular exercise. The intervention group will perform an exercise training intervention three times per week during 6 months and will be compared to the control group without exercise. Both groups will undergo the same monthly pharmaceutical and nutritional counseling as well as standard medical treatment according to the Brazilian consensus on Chagas disease. The primary outcome is functional capacity based on peak exercise oxygen consumption during cardiopulmonary exercise testing. Secondary outcomes are: cardiac function; body composition; muscle respiratory strength; microvascular reactivity; cardiac rhythm abnormalities; autonomic function; biochemical; oxidative stress and inflammatory biomarkers; and quality of life. Subjects will be evaluated at baseline, and at 3 and 6 months after randomization. Thirty patients will be randomly assigned into exercise or control groups at a ratio of 1:1. Findings of the present study will be useful to determine if physical exercise programs should be included as an important additional therapy in the treatment of patients with Chagas heart disease. ClinicalTrials.gov ID: NCT02517632 (registered on 6 August 2015).

Robot-Assisted Training Early After Cardiac Surgery.

PubMed

Schoenrath, Felix; Markendorf, Susanne; Brauchlin, Andreas E; Seifert, Burkhardt; Wilhelm, Markus J; Czerny, Martin; Riener, Robert; Falk, Volkmar; Schmied, Christian M

2015-07-01

To assess feasibility and safety of a robot-assisted gait therapy with the Lokomat® system in patients early after open heart surgery. Within days after open heart surgery 10 patients were subjected to postoperative Lokomat® training (Intervention group, IG) whereas 20 patients served as controls undergoing standard postoperative physiotherapy (Control group, CG). All patients underwent six-minute walk test and evaluation of the muscular strength of the lower limbs by measuring quadriceps peak force. The primary safety end-point was freedom from any device-related wound healing disturbance. Patients underwent clinical follow-up after one month. Both training methods resulted in an improvement of walking distance (IG [median, interquartile range, p-value]: +119 m, 70-201 m, p = 0.005; CG: 105 m, 57-152.5m, p < 0.001) and quadriceps peak force (IG left: +5 N, 3.8 7 N, p = 0.005; IG right: +3.5 N, 1.5-8.8 N, p = 0.011; CG left: +5.5 N, 4-9 N, p < 0.001; CG right: +6 N, 4.3-9.8 N, p < 0.001) in all participants. Results with robot-assisted training were comparable to early postoperative standard in hospital training (median changes in walking distance in percent, p = 0.81; median changes in quadriceps peak force in percent, left: p = 0.97, right p = 0.61). No deep sternal wound infection or any adverse event occurred in the robot-assisted training group. Robot-assisted gait therapy with the Lokomat® system is feasible and safe in patients early after median sternotomy. Results with robot-assisted training were comparable to standard in hospital training. An adapted and combined aerobic and resistance training intervention with augmented feedback may result in benefits in walking distance and lower limb muscle strength (ClinicalTrials.gov number, NCT 02146196). © 2015 Wiley Periodicals, Inc.

Task shifting to clinical officer-led echocardiography screening for detecting rheumatic heart disease in Malawi, Africa.

PubMed

Sims Sanyahumbi, Amy; Sable, Craig A; Karlsten, Melissa; Hosseinipour, Mina C; Kazembe, Peter N; Minard, Charles G; Penny, Daniel J

2017-08-01

Echocardiographic screening for rheumatic heart disease in asymptomatic children may result in early diagnosis and prevent progression. Physician-led screening is not feasible in Malawi. Task shifting to mid-level providers such as clinical officers may enable more widespread screening. Hypothesis With short-course training, clinical officers can accurately screen for rheumatic heart disease using focussed echocardiography. A total of eight clinical officers completed three half-days of didactics and 2 days of hands-on echocardiography training. Clinical officers were evaluated by performing screening echocardiograms on 20 children with known rheumatic heart disease status. They indicated whether children should be referred for follow-up. Referral was indicated if mitral regurgitation measured more than 1.5 cm or there was any measurable aortic regurgitation. The κ statistic was calculated to measure referral agreement with a paediatric cardiologist. Sensitivity and specificity were estimated using a generalised linear mixed model, and were calculated on the basis of World Heart Federation diagnostic criteria. The mean κ statistic comparing clinical officer referrals with the paediatric cardiologist was 0.72 (95% confidence interval: 0.62, 0.82). The κ value ranged from a minimum of 0.57 to a maximum of 0.90. For rheumatic heart disease diagnosis, sensitivity was 0.91 (95% confidence interval: 0.86, 0.95) and specificity was 0.65 (95% confidence interval: 0.57, 0.72). There was substantial agreement between clinical officers and paediatric cardiologists on whether to refer. Clinical officers had a high sensitivity in detecting rheumatic heart disease. With short-course training, clinical officer-led echo screening for rheumatic heart disease is a viable alternative to physician-led screening in resource-limited settings.

Aerobic exercise training improves oxidative stress and ubiquitin proteasome system activity in heart of spontaneously hypertensive rats.

PubMed

de Andrade, Luiz Henrique Soares; de Moraes, Wilson Max Almeida Monteiro; Matsuo Junior, Eduardo Hiroshi; de Orleans Carvalho de Moura, Elizabeth; Antunes, Hanna Karen Moreira; Montemor, Jairo; Antonio, Ednei Luiz; Bocalini, Danilo Sales; Serra, Andrey Jorge; Tucci, Paulo José Ferreira; Brum, Patricia Chakur; Medeiros, Alessandra

2015-04-01

The activity of the ubiquitin proteasome system (UPS) and the level of oxidative stress contribute to the transition from compensated cardiac hypertrophy to heart failure in hypertension. Moreover, aerobic exercise training (AET) is an important therapy for the treatment of hypertension, but its effects on the UPS are not completely known. The aim of this study was to evaluate the effect of AET on UPS's activity and oxidative stress level in heart of spontaneously hypertensive rats (SHR). A total of 53 Wistar and SHR rats were randomly divided into sedentary and trained groups. The AET protocol was 5×/week in treadmill for 13 weeks. Exercise tolerance test, non-invasive blood pressure measurement, echocardiographic analyses, and left ventricle hemodynamics were performed during experimental period. The expression of ubiquitinated proteins, 4-hydroxynonenal (4-HNE), Akt, phospho-Akt(ser473), GSK3β, and phospho-GSK3β(ser9) were analyzed by western blotting. The evaluation of lipid hydroperoxide concentration was performed using the xylenol orange method, and the proteasomal chymotrypsin-like activity was measured by fluorimetric assay. Sedentary hypertensive group presented cardiac hypertrophy, unaltered expression of total Akt, phospho-Akt, total GSK3β and phospho-GSK3β, UPS hyperactivity, increased lipid hydroperoxidation as well as elevated expression of 4-HNE but normal cardiac function. In contrast, AET significantly increased exercise tolerance, decreased resting systolic blood pressure and heart rate in hypertensive animals. In addition, the AET increased phospho-Akt expression, decreased phospho-GSK3β, and did not alter the expression of total Akt, total GSK3β, and ubiquitinated proteins, however, significantly attenuated 4-HNE levels, lipid hydroperoxidation, and UPS's activity toward normotensive group levels. Our results provide evidence for the main effect of AET on attenuating cardiac ubiquitin proteasome hyperactivity and oxidative stress in SHR rats.

Comparison of structured and unstructured physical activity training on predicted VO2max and heart rate variability in adolescents - a randomized control trial.

PubMed

Sharma, Vivek Kumar; Subramanian, Senthil Kumar; Radhakrishnan, Krishnakumar; Rajendran, Rajathi; Ravindran, Balasubramanian Sulur; Arunachalam, Vinayathan

2017-05-01

Physical inactivity contributes to many health issues. The WHO-recommended physical activity for adolescents encompasses aerobic, resistance, and bone strengthening exercises aimed at achieving health-related physical fitness. Heart rate variability (HRV) and maximal aerobic capacity (VO2max) are considered as noninvasive measures of cardiovascular health. The objective of this study is to compare the effect of structured and unstructured physical training on maximal aerobic capacity and HRV among adolescents. We designed a single blinded, parallel, randomized active-controlled trial (Registration No. CTRI/2013/08/003897) to compare the physiological effects of 6 months of globally recommended structured physical activity (SPA), with that of unstructured physical activity (USPA) in healthy school-going adolescents. We recruited 439 healthy student volunteers (boys: 250, girls: 189) in the age group of 12-17 years. Randomization across the groups was done using age and gender stratified randomization method, and the participants were divided into two groups: SPA (n=219, boys: 117, girls: 102) and USPA (n=220, boys: 119, girls: 101). Depending on their training status and gender the participants in both SPA and USPA groups were further subdivided into the following four sub-groups: SPA athlete boys (n=22) and girls (n=17), SPA nonathlete boys (n=95) and girls (n=85), USPA athlete boys (n=23) and girls (n=17), and USPA nonathlete boys (n=96) and girls (n=84). We recorded HRV, body fat%, and VO2 max using Rockport Walk Fitness test before and after the intervention. Maximum aerobic capacity and heart rate variability increased significantly while heart rate, systolic blood pressure, diastolic blood pressure, and body fat percentage decreased significantly after both SPA and USPA intervention. However, the improvement was more in SPA as compared to USPA. SPA is more beneficial for improving cardiorespiratory fitness, HRV, and reducing body fat percentage in terms of magnitude than USPA in adolescent individuals irrespective of their gender and sports activities.

Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial

PubMed Central

Younge, John O.; Wery, Machteld F.; Utens, Elisabeth M. W. J.; Michels, Michelle; Rizopoulos, Dimitris; van Rossum, Liesbeth F. C.; Roos-Hesselink, Jolien W.; Hunink, Myriam M. G.

2017-01-01

There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. Trial registration: www.trialregister.nl NTR3453 PMID:28486559

Needs of caregivers in heart failure management: A qualitative study

PubMed Central

Frost, Julia; Britten, Nicky; Jolly, Kate; Greaves, Colin; Abraham, Charles; Dalal, Hayes

2015-01-01

Objectives To identify the needs of caregivers supporting a person with heart failure and to inform the development of a caregiver resource to be used as part of a home-based self-management programme. Methods A qualitative study informed by thematic analysis involving 26 caregivers in individual interviews or a focus group. Results Three distinct aspects of caregiver support in heart failure management were identified. Firstly, caregivers identified needs about supporting management of heart failure including: coping with the variability of heart failure symptoms, what to do in an emergency, understanding and managing medicines, providing emotional support, promoting exercise and physical activity, providing personal care, living with a cardiac device and supporting depression management. Secondly, as they make the transition to becoming a caregiver, they need to develop skills to undertake difficult discussions about the role; communicate with health professionals; manage their own mental health, well-being and sleep; and manage home and work. Thirdly, caregivers require skills to engage social support, and voluntary and formal services while recognising that the long-term future is uncertain. Discussion The identification of the needs of caregiver has been used to inform the development of a home-based heart failure intervention facilitated by a trained health care practitioner. PMID:25795144

Heart rate recovery and variability following combined aerobic and resistance exercise training in adults with and without Down syndrome.

PubMed

Mendonca, Goncalo V; Pereira, Fernando D; Fernhall, Bo

2013-01-01

Persons with Down syndrome (DS) are at high risk for cardiovascular morbidity and mortality, and there is compelling evidence of autonomic dysfunction in these individuals. The main purpose of this study was to determine whether a combined aerobic and resistance exercise intervention produces similar results in cardiac autonomic function between adults with and without DS. Twenty-five participants (13 DS; 12 non-DS), aged 27-50 years, were included. Aerobic training was performed 3 days/week for 30 min at 65-85% of peak oxygen uptake (VO(2peak)). Resistance training was prescribed for 2 days/week and consisted of two rotations in a circuit of 9 exercises at 12-repetition-maximum. There was a significant improvement in the VO(2peak) and muscle strength of participants with and without DS after training. Heart rate recovery improved at 1 min post-exercise, but only in participants with DS. Both groups of participants exhibited a similar increase in normalized high frequency power and of decrease in normalized low frequency power after training. Therefore, 12 weeks of exercise training enhanced the heart rate recovery in adults with DS, but not in those without DS. Contrasting, the intervention elicited similar gains between groups for cardiovagal modulation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Profile of weekly training load in elite male professional basketball players.

PubMed

Manzi, Vincenzo; D'Ottavio, Stefano; Impellizzeri, Franco M; Chaouachi, Anis; Chamari, Karim; Castagna, Carlo

2010-05-01

The aim of this study was to examine the training load (TL) profile of professional elite level basketball players during the crucial parts of the competitive season (pre-play-off finals). Subjects were 8 full-time professional basketball players (age 28 +/- 3.6 years, height 199 +/-7.2 cm, body mass 102 +/- 11.5 kg, and body fat 10.4 +/- 1.5%) whose heart rate (HR) was recorded during each training session and their individual response to TL monitored using the session-rate of perceived exertion (RPE) method (200 training sessions). The association between the session-RPE method and training HR was used to assess the population validity of the session-RPE method. Significant relationships were observed between individual session-RPE and all individual HR-based TL (r values from 0.69 to 0.85; p < 0.001). Coaches spontaneously provided a tapering phase during the competitive weeks irrespective of the number of games played during it (i.e., 1 or 2 games). The individual weekly players' TL resulted in being not significantly different from each other (p > 0.05). Elite male professional basketball imposes great physiological and psychological stress on players through training sessions and official competitions (1-2 per week). Consequently, the importance of a practical and valid method to assess individual TL is warranted. In this research, we demonstrated that session-RPE may be considered as a viable method to asses TL without the use of more sophisticated tools (i.e., HR monitors). The session-RPE method enabled the detection of periodization patterns in weekly planning in elite professional basketball during the crucial part of the competitive season (1 vs. 2 weekly fixtures model).

High-intensity, occupation-specific training in a series of firefighters during phase II cardiac rehabilitation.

PubMed

Adams, Jenny; Cheng, Dunlei; Berbarie, Rafic F

2013-04-01

Six male firefighters who were referred to phase II cardiac rehabilitation after coronary revascularization participated in a specialized regimen of high-intensity, occupation-specific training (HIOST) that simulated firefighting tasks. During each session, the electrocardiogram, heart rate, and blood pressure were monitored, and the patients were observed for adverse symptoms. No patient had to discontinue HIOST because of adverse arrhythmias or symptoms. For physicians who must make decisions about return to work, the information collected over multiple HIOST sessions might be more thorough and conclusive than the information gained during a single treadmill exercise stress test (the recommended evaluation method).

Interactive Video: Why Trainers Are Tuning In.

ERIC Educational Resources Information Center

Broderick, Richard

1982-01-01

The uses of interactive video are explored through various case studies. They include cardiopulmonary resuscitation training for the Dallas American Heart Association, Ford Motor Company dealership training, employee training at the Los Angeles Plutonium Facility, and others. (CT)

Novel insights into cardiac remodelling revealed by proteomic analysis of the trout heart during exercise training.

PubMed

Dindia, Laura A; Alderman, Sarah L; Gillis, Todd E

2017-05-24

The changes in the cardiac proteome of rainbow trout (Oncorhynchus mykiss) were quantified during the early phases (4, 7, and 14d) of a typical exercise-training regime to provide a comprehensive overview of the cellular changes responsible for developing a trained heart phenotype. Enhanced somatic growth during the 14d experiment was paralleled by cardiac growth to maintain relative ventricular mass. This was reflected in the cardiac proteome by the increased abundance of contractile proteins and cellular integrity proteins as early as Day 4, including a pronounced and sustained increase in blood vessel epicardial substance - an intercellular adhesion protein expressed in the vertebrate heart. An unexpected finding was that proteins involved in energy pathways, including glycolysis, β-oxidation, the TCA cycle, and the electron transport chain, were generally present at lower levels relative to Day 0 levels, suggesting a reduced investment in the maintenance of energy production pathways. However, as the fish demonstrated somatic and cardiac growth during the exercise-training program, this change did not appear to influence cardiac function. The in-depth analysis of temporal changes in the cardiac proteome of trout during the early stages of exercise training reveals novel insights into cardiac remodelling in an important model species. Rainbow trout hearts have a remarkable ability for molecular, structural, and functional plasticity, and the inherent athleticism of these fish makes them ideal models for studies in comparative exercise physiology. Indeed, several decades of research using exercise-trained trout has shown both conserved and unique aspects of cardiac plasticity induced by a sustained increase in the workload of the heart. Despite a strong appreciation for the outcome of exercise training, however, the temporal events that generate this phenotype are not known. This study interrogates the early stages of exercise training using in-depth proteomic analysis to understand the molecular pathways of cardiac remodelling. Two major and novel findings emerge: (1) structural remodelling is initiated very early in training, as evidenced by a general increase in proteins associated with muscle contraction and integrity at Day 4, and (2) the abundance of proteins directly involved in energy production are decreased during 14d of exercise training, which contrasts the general acceptance of an exercise-induced increase in aerobic capacity of muscle, and suggests that regulation of energy pathways occurs at a different biological level than protein abundance. Copyright © 2017 Elsevier B.V. All rights reserved.

A Review of Player Monitoring Approaches in Basketball: Current Trends and Future Directions.

PubMed

Fox, Jordan L; Scanlan, Aaron T; Stanton, Robert

2017-07-01

Fox, JL, Scanlan, AT, and Stanton, R. A review of player monitoring approaches in basketball: current trends and future directions. J Strength Cond Res 31(7): 2021-2029, 2017-Effective monitoring of players in team sports such as basketball requires an understanding of the external demands and internal responses, as they relate to training phases and competition. Monitoring of external demands and internal responses allows coaching staff to determine the dose-response associated with the imposed training load (TL), and subsequently, if players are adequately prepared for competition. This review discusses measures reported in the literature for monitoring the external demands and internal responses of basketball players during training and competition. The external demands of training and competition were primarily monitored using time-motion analysis, with limited use of microtechnology being reported. Internal responses during training were typically measured using hematological markers, heart rate, various TL models, and perceptual responses such as rating of perceived exertion (RPE). Heart rate was the most commonly reported indicator of internal responses during competition with limited reporting of hematological markers or RPE. These findings show a large discrepancy between the reporting of external and internal measures and training and competition demands. Microsensors, however, may be a practical and convenient method of player monitoring in basketball to overcome the limitations associated with current approaches while allowing for external demands and internal responses to be recorded simultaneously. The triaxial accelerometers of microsensors seem well suited for basketball and warrant validation to definitively determine their place in the monitoring of basketball players. Coaching staff should make use of this technology by tracking individual player responses across the annual plan and using real-time monitoring to minimize factors such as fatigue and injury risk.

A system for the model based emergency detection and communication for the telerehabilitation training of cardiopulmonary patients.

PubMed

Helmer, Axel; Kretschmer, Friedrich; Deparade, Riana; Song, Bianying; Meis, Markus; Hein, Andreas; Marschollek, Michael; Tegtbur, Uwe

2012-01-01

Cardiopulmonary diseases affect millions of people and cause high costs in health care systems worldwide. Patients should perform regular endurance exercises to stabilize their health state and prevent further impairment. However, patients are often uncertain about the level of intensity they should exercise in their current condition. The cost of continuous monitoring for these training sessions in clinics is high and additionally requires the patient to travel to a clinic for each single session. Performing the rehabilitation training at home can raise compliance and reduce costs. To ensure safe telerehabilitation training and to enable patients to control their performance and health state, detection of abnormal events during training is a critical prerequisite. Therefore, we created a model that predicts the heart rate of cardiopulmonary patients and that can be used to detect and avoid abnormal health states. To enable external feedback and an immediate reaction in case of a critical situation, the patient should have the possibility to configure the system to communicate warnings and emergency events to clinical and non-clinical actors. To fulfill this task, we coupled a personal health record (PHR) with a new component that extends the classic home emergency systems. The PHR is also used for a training schedule definition that makes use of the predictive HR model. We used statistical methods to evaluate the prediction model and found that our prediction error of 3.2 heart beats per minute is precise enough to enable a detection of critical states. The concept for the communication of alerts was evaluated through focus group interviews with domain experts who judged that it fulfills the needs of potential users.

Computerised electronic foetal heart rate monitoring in labour: automated contraction identification.

PubMed

Georgieva, A; Payne, S J; Redman, C W G

2009-12-01

The foetal heart rate (FHR) response to uterine contractions is crucial to detect foetal distress by electronic FHR monitoring during labour. We are developing a new automated system (OxSys) for decision support in labour, using the Oxford database of intrapartum FHR records. We describe here a novel technique for automated detection of uterus contractions. In addition, we present a comparison of the new method with four other computerised approaches. During training, OxSys achieved sensitivity above 95% and positive predictive value (PPV) of up to 90% for traces of good quality. During testing, OxSys achieved sensitivity = 87% and PPV = 75%. For comparison, a second clinical expert obtained sensitivity = 93% and PPV = 80%, and all other computerised approaches achieved lower values. It was concluded that the proposed method can be employed with confidence in our study on foetal health assessment in labour and future OxSys development.

[Physiological characteristics and the level of risk factors for ischemic heart disease in marathon runners between 30 and 59 years of age].

PubMed

Kostka, T; Drygas, W; Mrozek, P

1989-02-06

The results of anthropometric, biochemical, cardiological and performance capacity studies in the 37 marathon runners, 113 men systematically practising recreational training programme with a domination of endurance exercises and 44 healthy men with little leisure time physical activity have been compared. In comparison with a group of physically non-active persons, the marathon runners are characterized by considerably higher physical working capacity, slimmer figure, lower resting heart rate, lower diastolic blood pressure, high concentration of HDL cholesterol and lower cholesterol: HDL cholesterol index. However, these differences are minimal in comparison with other systematically training persons, and with regard to the majority of factors statistically insignificant. It seems that for reaching the physiological effects desired from the point of view of ischemic heart disease prevention the endurance training of lower capacity and intensity would be sufficient.

Cardiovascular responses during orthostasis - Effect of an increase in maximal O2 uptake

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Montgomery, L. D.; Greenleaf, J. E.

1984-01-01

A study is described which tests the hypothesis that changes in aerobic activity (increases in maximum oxygen uptake) will reduce the effectiveness of cardiovascular reflexes to regulate blood pressure during orthostasis. The hypothesis was tested by measuring heart rate, blood pressure and blood volume responses in eight healthy male subjects before and after an eight-day endurance regimen. The results of the study suggest that the physiologic responses to orthostasis are dependent upon the rate of plasma volume loss and pooling, and are associated with training-induced hypervolemia. It is indicated that endurance type exercise training enhances cardiovascular adjustments during tilt. The implications of these results for the use of exercise training as a countermeasure and/or therapeutic method for the prevention of cardiovascular instability during orthostatic stress are discussed.

Exercise Following a Heart Attack: Some Special Considerations.

ERIC Educational Resources Information Center

Fardy, Paul S.

This paper presents information on the effectiveness of exercise programs for heart attack victims. Some of the observations come from unpublished results of a two year experiment of the National Exercise and Heart Disease Project. The paper first establishes that a group exercise program with trained supervision is advantageous for people with…

An open access database for the evaluation of heart sound algorithms.

PubMed

Liu, Chengyu; Springer, David; Li, Qiao; Moody, Benjamin; Juan, Ricardo Abad; Chorro, Francisco J; Castells, Francisco; Roig, José Millet; Silva, Ikaro; Johnson, Alistair E W; Syed, Zeeshan; Schmidt, Samuel E; Papadaniil, Chrysa D; Hadjileontiadis, Leontios; Naseri, Hosein; Moukadem, Ali; Dieterlen, Alain; Brandt, Christian; Tang, Hong; Samieinasab, Maryam; Samieinasab, Mohammad Reza; Sameni, Reza; Mark, Roger G; Clifford, Gari D

2016-12-01

In the past few decades, analysis of heart sound signals (i.e. the phonocardiogram or PCG), especially for automated heart sound segmentation and classification, has been widely studied and has been reported to have the potential value to detect pathology accurately in clinical applications. However, comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings. This paper describes a public heart sound database, assembled for an international competition, the PhysioNet/Computing in Cardiology (CinC) Challenge 2016. The archive comprises nine different heart sound databases sourced from multiple research groups around the world. It includes 2435 heart sound recordings in total collected from 1297 healthy subjects and patients with a variety of conditions, including heart valve disease and coronary artery disease. The recordings were collected from a variety of clinical or nonclinical (such as in-home visits) environments and equipment. The length of recording varied from several seconds to several minutes. This article reports detailed information about the subjects/patients including demographics (number, age, gender), recordings (number, location, state and time length), associated synchronously recorded signals, sampling frequency and sensor type used. We also provide a brief summary of the commonly used heart sound segmentation and classification methods, including open source code provided concurrently for the Challenge. A description of the PhysioNet/CinC Challenge 2016, including the main aims, the training and test sets, the hand corrected annotations for different heart sound states, the scoring mechanism, and associated open source code are provided. In addition, several potential benefits from the public heart sound database are discussed.

Physical capacity of rescue personnel in the mining industry

PubMed Central

Stewart, Ian B; McDonald, Michael D; Hunt, Andrew P; Parker, Tony W

2008-01-01

Background The mining industry has one of the highest occupational rates of serious injury and fatality. Mine staff involved with rescue operations are often required to respond to physically challenging situations. This paper describes the physical attributes of mining rescue personnel. Methods 91 rescue personnel (34 ± 8.6 yrs, 1.79 ± 0.07 m, 90 ± 15.0 kg) participating in the Queensland Mines Rescue Challenge completed a series of health-related and rescue-related fitness tasks. Health-related tasks comprised measurements of aerobic capacity (VO2max), abdominal endurance, abdominal strength, flexibility, lower back strength, leg strength, elbow flexion strength, shoulder strength, lower back endurance, and leg endurance. Rescue-related tasks comprised an incremental carry (IC), coal shovel (CS), and a hose drag (HD), completed in this order. Results Cardiovascular (VO2max) and muscular endurance was average or below average compared with the general population. Isometric strength did not decline with age. The rescue-related tasks were all extremely demanding with heart rate responses averaging greater than 88% of age predicted maximal heart rates. Heart rate recovery responses were more discriminating than heart rates recorded during the tasks, indicating the hose drag as the most physically demanding of the tasks. Conclusion Relying on actual rescues or mining related work to provide adequate training is generally insufficient to maintain, let alone increase, physical fitness. It is therefore recommended that standards of required physical fitness be developed and mines rescue personnel undergo regularly training (and assessment) in order to maintain these standards. PMID:18847510

Prediction of heart abnormality using MLP network

NASA Astrophysics Data System (ADS)

Hashim, Fakroul Ridzuan; Januar, Yulni; Mat, Muhammad Hadzren; Rizman, Zairi Ismael; Awang, Mat Kamil

2018-02-01

Heart abnormality does not choose gender, age and races when it strikes. With no warning signs or symptoms, it can result to a sudden death of the patient. Generally, heart's irregular electrical activity is defined as heart abnormality. Via implementation of Multilayer Perceptron (MLP) network, this paper tries to develop a program that allows the detection of heart abnormality activity. Utilizing several training algorithms with Purelin activation function, an amount of heartbeat signals received through the electrocardiogram (ECG) will be employed to condition the MLP network.

Effects of aerobic training intensity on resting, exercise and post-exercise blood pressure, heart rate and heart-rate variability.

PubMed

Cornelissen, V A; Verheyden, B; Aubert, A E; Fagard, R H

2010-03-01

We aimed to investigate the effects of endurance training intensity (1) on systolic blood pressure (SBP) and heart rate (HR) at rest before exercise, and during and after a maximal exercise test; and (2) on measures of HR variability at rest before exercise and during recovery from the exercise test, in at least 55-year-old healthy sedentary men and women. A randomized crossover study comprising three 10-week periods was performed. In the first and third period, participants exercised at lower or higher intensity (33% or 66% of HR reserve) in random order, with a sedentary period in between. Training programmes were identical except for intensity, and were performed under supervision thrice for 1 h per week. The results show that in the three conditions, that is, at rest before exercise, during exercise and during recovery, we found endurance training at lower and higher intensity to reduce SBP significantly (P<0.05) and to a similar extent. Further, SBP during recovery was, on average, not lower than at rest before exercise, and chronic endurance training did not affect the response of SBP after an acute bout of exercise. The effect of training on HR at rest, during exercise and recovery was more pronounced (P<0.05) with higher intensity. Finally, endurance training had no significant effect on sympathovagal balance. In conclusion, in participants at higher age, both training programmes exert similar effects on SBP at rest, during exercise and during post-exercise recovery, whereas the effects on HR are more pronounced after higher intensity training.

Is meditation always relaxing? Investigating heart rate, heart rate variability, experienced effort and likeability during training of three types of meditation.

PubMed

Lumma, Anna-Lena; Kok, Bethany E; Singer, Tania

2015-07-01

Meditation is often associated with a relaxed state of the body. However, meditation can also be regarded as a type of mental task and training, associated with mental effort and physiological arousal. The cardiovascular effects of meditation may vary depending on the type of meditation, degree of mental effort, and amount of training. In the current study we assessed heart rate (HR), high-frequency heart rate variability (HF-HRV) and subjective ratings of effort and likeability during three types of meditation varying in their cognitive and attentional requirements, namely breathing meditation, loving-kindness meditation and observing-thoughts meditation. In the context of the ReSource project, a one-year longitudinal mental training study, participants practiced each meditation exercise on a daily basis for 3 months. As expected HR and effort were higher during loving-kindness meditation and observing-thoughts meditation compared to breathing meditation. With training over time HR and likeability increased, while HF-HRV and the subjective experience of effort decreased. The increase in HR and decrease in HF-HRV over training was higher for loving-kindness meditation and observing-thoughts meditation compared to breathing meditation. In contrast to implicit beliefs that meditation is always relaxing and associated with low arousal, the current results show that core meditations aiming at improving compassion and meta-cognitive skills require effort and are associated with physiological arousal compared to breathing meditation. Overall these findings can be useful in making more specific suggestions about which type of meditation is most adaptive for a given context and population. Copyright © 2015 Elsevier B.V. All rights reserved.

Benefits of combined aerobic/resistance/inspiratory training in patients with chronic heart failure. A complete exercise model? A prospective randomised study.

PubMed

Laoutaris, Ioannis D; Adamopoulos, Stamatis; Manginas, Athanassios; Panagiotakos, Demosthenes B; Kallistratos, Manolis S; Doulaptsis, Costas; Kouloubinis, Alexandros; Voudris, Vasilis; Pavlides, Gregory; Cokkinos, Dennis V; Dritsas, Athanasios

2013-09-01

We hypothesised that combined aerobic training (AT) with resistance training (RT) and inspiratory muscle training (IMT) could result in additional benefits over AT alone in patients with chronic heart failure (CHF). Twenty-seven patients, age 58 ± 9 years, NYHA II/III and LVEF 29 ± 7% were randomly assigned to a 12-week AT (n=14) or a combined AT/RT/IMT (ARIS) (n=13) exercise program. AT consisted of bike exercise at 70-80% of max heart rate. ARIS training consisted of AT with RT of the quadriceps at 50% of 1 repetition maximum (1RM) and upper limb exercises using dumbbells of 1-2 kg as well as IMT at 60% of sustained maximal inspiratory pressure (SPI(max)). At baseline and after intervention patients underwent cardiopulmonary exercise testing, echocardiography, evaluation of dyspnea, muscle function and quality of life (QoL) scores. The ARIS program as compared to AT alone, resulted in additional improvement in quadriceps muscle strength (1RM, p=0.005) and endurance (50%1 RM × number of max repetitions, p=0.01), SPI(max) (p<0.001), exercise time (p=0.01), circulatory power (peak oxygen consumption × peak systolic blood pressure, p=0.05), dyspnea (p=0.03) and QoL (p=0.03). ARIS training was safe and resulted in incremental benefits in both peripheral and respiratory muscle weakness, cardiopulmonary function and QoL compared to that of AT. The present findings may add a new prospective to cardiac rehabilitation programs of heart failure patients whilst the clinical significance of these outcomes need to be addressed in larger randomised studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Robot-assisted training for heart failure patients - a small pilot study.

PubMed

Schoenrath, Felix; Markendorf, Susanne; Brauchlin, Andreas Emil; Frank, Michelle; Wilhelm, Markus Johannes; Saleh, Lanja; Riener, Robert; Schmied, Christian Marc; Falk, Volkmar

2015-12-01

The objective of this study was assess robot-assisted gait therapy with the Lokomat® system in heart failure patients. Patients (n = 5) with stable heart failure and a left ventricular ejection fraction of less than 45% completed a four-week aerobic training period with three trainings per week and an integrated dynamic resistance training of the lower limbs. Patients underwent testing of cardiac and inflammatory biomarkers. A cardiopulmonary exercise test, a quality of life score and an evaluation of the muscular strength by measuring the peak quadriceps force was performed. No adverse events occurred. The combined training resulted in an improvement in peak work rate (range: 6% to 36%) and peak quadriceps force (range: 3% to 80%) in all participants. Peak oxygen consumption (range: –3% to + 61%) increased in three, and oxygen pulse (range: –7% to + 44%) in four of five patients. The quality of life assessment indicated better well-being in all participants. NT-ProBNP (+233 to –733 ng/ml) and the inflammatory biomarkers (hsCRP and IL6) decreased in four of five patients (IL 6: +0.5 to –2 mg/l, hsCRP: +0.2 to –6.5 mg/l). Robot-assisted gait therapy with the Lokomat® System is feasible in heart failure patients and was safe in this trial. The combined aerobic and resistance training intervention with augmented feedback resulted in benefits in exercise capacity, muscle strength and quality of life, as well as an improvement of cardiac (NT-ProBNP) and inflammatory (IL6, hsCRP) biomarkers. Results can only be considered as preliminary and need further validation in larger studies. (ClinicalTrials.gov number, NCT 02146196)

Stress Inoculation through Cognitive and Biofeedback Training

DTIC Science & Technology

2010-12-01

based on Heart Rate Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a...Variability ( HRV ) with innovative simulation game-based training tools. The training system described here will be implemented on a mobile device...and studies (e.g. Fletcher & Tobias, 2006; Thayer, 2009). HRV Coherence Training for Stress Resilience Satisfactory performance in stressful

The incidence of training responsiveness to cardiorespiratory fitness and cardiometabolic measurements following individualized and standardized exercise prescription: study protocol for a randomized controlled trial.

PubMed

Weatherwax, Ryan M; Harris, Nigel K; Kilding, Andrew E; Dalleck, Lance C

2016-12-19

There is individual variability to cardiorespiratory fitness (CRF) training, but the underlying cause is not well understood. Traditionally, a standardized approach to exercise prescription has utilized relative percentages of maximal heart rate, heart rate reserve (HRR), maximal oxygen uptake (VO 2 max), or VO 2 reserve to establish exercise intensity. However, this model fails to take into consideration individual metabolic responses to exercise and may attribute to the variability in training responses. It has been proposed that an individualized approach would take into consideration metabolic responses to exercises to increase responsiveness to training. In this randomized control trial, participants will undergo a 12-week exercise intervention using individualized (ventilatory thresholds) and standardized (HRR) methods to prescribe CRF training intensity. Following the intervention, participants will be categorized as responders or non-responders based on changes in maximal aerobic abilities. Participants who are non-responders will complete a second 12-week intervention in a crossover design to determine whether they can become responders with a differing exercise prescription. There are four main research outcomes: (1) determine the cohort-specific technical error to use in the categorization of response rate; (2) determine if an individualized intensity prescription is superior to a standard approach in regards to VO 2 max and cardiometabolic risk factors; (3) investigate the time course changes throughout 12 weeks of CRF training between the two intervention groups; and (4) determine if non-responders can become responders if the exercise prescription is modified. The findings from this research will provide evidence on the effectiveness of individualized exercise prescription related to training responsiveness of VO 2 max and cardiometabolic risk factors compared to a standardized approach and further our understanding of individual exercise responses. If the individualized approach proposed is deemed effective, it may change the way exercise specialists prescribe exercise intensity to enhance training responsiveness. ClinicalTrials.gov, NCT02868710 . Registered on 15 August 2016.

Reduced heart rate variability and vagal tone in anxiety: trait versus state, and the effects of autogenic training.

PubMed

Miu, Andrei C; Heilman, Renata M; Miclea, Mircea

2009-01-28

This study investigated heart rate variability (HRV) in healthy volunteers that were selected for extreme scores of trait anxiety (TA), during two opposite psychophysiological conditions of mental stress, and relaxation induced by autogenic training. R-R intervals, HF and LF powers, and LF/HF ratios were derived from short-term electrocardiographic recordings made during mental stress and relaxation by autogenic training, with respiratory rate and skin conductance being controlled for in all the analyses. The main finding was that high TA was associated with reduced R-R intervals and HF power across conditions. In comparison to mental stress, autogenic training increased HRV and facilitated the vagal control of the heart. There were no significant effects of TA or the psychophysiological conditions on LF power, or LF/HF ratio. These results support the view that TA, which is an important risk factor for anxiety disorders and predictor of cardiovascular morbidity and mortality, is associated with autonomic dysfunction that seems likely to play a pathogenetic role in the long term.

A Human-Centered Approach to CV Care: Infrastructure Development in Uganda.

PubMed

Longenecker, Christopher T; Kalra, Ankur; Okello, Emmy; Lwabi, Peter; Omagino, John O; Kityo, Cissy; Kamya, Moses R; Webel, Allison R; Simon, Daniel I; Salata, Robert A; Costa, Marco A

2018-04-20

In this case study, we describe an ongoing approach to develop sustainable acute and chronic cardiovascular care infrastructure in Uganda that involves patient and provider participation. Leveraging strong infrastructure for HIV/AIDS care delivery, University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University have partnered with U.S. and Ugandan collaborators to improve cardiovascular capabilities. The collaboration has solicited innovative solutions from patients and providers focusing on education and advanced training, penicillin supply, diagnostic strategy (e.g., hand-held ultrasound), maternal health, and community awareness. Key outcomes of this approach have been the completion of formal training of the first interventional cardiologists and heart failure specialists in the country, establishment of 4 integrated regional centers of excellence in rheumatic heart disease care with a national rheumatic heart disease registry, a penicillin distribution and adherence support program focused on retention in care, access to imaging technology, and in-country capabilities to treat advanced rheumatic heart valve disease. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?

PubMed Central

Favrat, B; Pécoud, A; Jaussi, A

2004-01-01

Background The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. Methods 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible. 2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). Results 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. Conclusions The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching. PMID:15056393

CPR Instruction in U.S. High Schools: What Is the State in the Nation?

PubMed

Brown, Lorrel E; Lynes, Carlos; Carroll, Travis; Halperin, Henry

2017-11-28

Cardiopulmonary resuscitation (CPR) training in high schools is required by law in the majority of U.S. states. However, laws differ from state to state, and it is unknown how this legislation is being enacted. The authors sent a cross-sectional, closed survey to educational superintendents in 32 states with CPR laws in June 2016. The authors subsequently performed direct examination and categorization of CPR legislation in 39 states (several states passed legislation as of September 2017). Survey results indicated differing practices with regard to CPR instruction in areas such as course content (63% perform automated external defibrillator training), instructor (47% used CPR-certified teachers/coaches, 30% used other CPR-certified instructors, 11% used noncertified teachers/coaches), and method (7% followed American Red Cross methods, 55% followed American Heart Association methods). CPR laws differ, although almost all (97%) require hands-on training. Although hands-on practice during CPR instruction in high school is required by law in the majority of U.S. states, there is currently no standardized method of implementation. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping.

PubMed

Greaves, Colin J; Wingham, Jennifer; Deighan, Carolyn; Doherty, Patrick; Elliott, Jennifer; Armitage, Wendy; Clark, Michelle; Austin, Jackie; Abraham, Charles; Frost, Julia; Singh, Sally; Jolly, Kate; Paul, Kevin; Taylor, Louise; Buckingham, Sarah; Davis, Russell; Dalal, Hasnain; Taylor, Rod S

2016-01-01

We aimed to establish the support needs of people with heart failure and their caregivers and develop an intervention to improve their health-related quality of life. We used intervention mapping to guide the development of our intervention. We identified "targets for change" by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We then used behaviour change theory, expert opinion and a taxonomy of behaviour change techniques, to identify barriers to and facilitators of change and to match intervention strategies to each target. A patient and public involvement group helped to identify patient and caregiver needs, refine the intervention objectives and strategies and deliver training to the intervention facilitators. A feasibility study (ISRCTN25032672) involving 23 patients, 12 caregivers and seven trained facilitators at four sites assessed the feasibility and acceptability of the intervention and quality of delivery and generated ideas to help refine the intervention. The Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention is a comprehensive self-care support programme comprising the "Heart Failure Manual", a choice of two exercise programmes for patients, a "Family and Friends Resource" for caregivers, a "Progress Tracker" tool and a facilitator training course. The main targets for change are engaging in exercise training, monitoring for symptom deterioration, managing stress and anxiety, managing medications and understanding heart failure. Secondary targets include managing low mood and smoking cessation. The intervention is facilitated by trained healthcare professionals with specialist cardiac experience over 12 weeks, via home and telephone contacts. The feasibility study found high levels of satisfaction and engagement with the intervention from facilitators, patients and caregivers. Intervention fidelity analysis and stakeholder feedback suggested that there was room for improvement in several areas, especially in terms of addressing caregivers' needs. The REACH-HF materials were revised accordingly. We have developed a comprehensive, evidence-informed, theoretically driven self-care and rehabilitation intervention that is grounded in the needs of patients and caregivers. A randomised controlled trial is underway to assess the effectiveness and cost-effectiveness of the REACH-HF intervention in people with heart failure and their caregivers.

Code Team Training: Demonstrating Adherence to AHA Guidelines During Pediatric Code Blue Activations.

PubMed

Stewart, Claire; Shoemaker, Jamie; Keller-Smith, Rachel; Edmunds, Katherine; Davis, Andrew; Tegtmeyer, Ken

2017-10-16

Pediatric code blue activations are infrequent events with a high mortality rate despite the best effort of code teams. The best method for training these code teams is debatable; however, it is clear that training is needed to assure adherence to American Heart Association (AHA) Resuscitation Guidelines and to prevent the decay that invariably occurs after Pediatric Advanced Life Support training. The objectives of this project were to train a multidisciplinary, multidepartmental code team and to measure this team's adherence to AHA guidelines during code simulation. Multidisciplinary code team training sessions were held using high-fidelity, in situ simulation. Sessions were held several times per month. Each session was filmed and reviewed for adherence to 5 AHA guidelines: chest compression rate, ventilation rate, chest compression fraction, use of a backboard, and use of a team leader. After the first study period, modifications were made to the code team including implementation of just-in-time training and alteration of the compression team. Thirty-eight sessions were completed, with 31 eligible for video analysis. During the first study period, 1 session adhered to all AHA guidelines. During the second study period, after alteration of the code team and implementation of just-in-time training, no sessions adhered to all AHA guidelines; however, there was an improvement in percentage of sessions adhering to ventilation rate and chest compression rate and an improvement in median ventilation rate. We present a method for training a large code team drawn from multiple hospital departments and a method of assessing code team performance. Despite subjective improvement in code team positioning, communication, and role completion and some improvement in ventilation rate and chest compression rate, we failed to consistently demonstrate improvement in adherence to all guidelines.

A Simplified, Langendorff-Free Method for Concomitant Isolation of Viable Cardiac Myocytes and Nonmyocytes From the Adult Mouse Heart

PubMed Central

Ackers-Johnson, Matthew; Li, Peter Yiqing; Holmes, Andrew P.; O’Brien, Sian-Marie; Pavlovic, Davor; Foo, Roger S.

2018-01-01

Rationale Cardiovascular disease represents a global pandemic. The advent of and recent advances in mouse genomics, epigenomics, and transgenics offer ever-greater potential for powerful avenues of research. However, progress is often constrained by unique complexities associated with the isolation of viable myocytes from the adult mouse heart. Current protocols rely on retrograde aortic perfusion using specialized Langendorff apparatus, which poses considerable logistical and technical barriers to researchers and demands extensive training investment. Objective To identify and optimize a convenient, alternative approach, allowing the robust isolation and culture of adult mouse cardiac myocytes using only common surgical and laboratory equipment. Methods and Results Cardiac myocytes were isolated with yields comparable to those in published Langendorff-based methods, using direct needle perfusion of the LV ex vivo and without requirement for heparin injection. Isolated myocytes can be cultured antibiotic free, with retained organized contractile and mitochondrial morphology, transcriptional signatures, calcium handling, responses to hypoxia, neurohormonal stimulation, and electric pacing, and are amenable to patch clamp and adenoviral gene transfer techniques. Furthermore, the methodology permits concurrent isolation, separation, and coculture of myocyte and nonmyocyte cardiac populations. Conclusions We present a novel, simplified method, demonstrating concomitant isolation of viable cardiac myocytes and nonmyocytes from the same adult mouse heart. We anticipate that this new approach will expand and accelerate innovative research in the field of cardiac biology. PMID:27502479

Preparing African Americans for careers in health care: the Jackson Heart Study.

PubMed

Srinivasan, Asoka; Brown, James; Fahmy, Nimr; Heitman, Elizabeth; Singh, Madhu; Szklo, Moyses; Taylor, Herman; White, Wendy

2005-01-01

The Jackson Heart Study Undergraduate Training Center (UTC) at Tougaloo College was developed to increase the numbers of African-American students entering public health and health related fields. The UTC includes a scholars program for undergraduate students at Tougaloo College, three four-week programs for high school students called the SLAM (science, language arts, and mathematics) workshops, and an introductory epidemiology course for healthcare professionals and graduate students. The scholars program recruits 12 Tougaloo College freshmen annually for the duration of their undergraduate education. As of the 2005 summer, 512 students have enrolled in the SLAM workshops. The introduction to epidemiology course has provided training for 155 individuals from 1999 to 2004. This paper documents the need for this program based on the conspicuously small proportion of African Americans who are health practitioners in Mississippi. The content and selection process for each program is described, and a summary of the enrollment history, characteristics of the program participants, and their accomplishments is presented. Finally, the methods of program assessment and tracking are discussed.

Heart Rate Response and Lactic Acid Concentration in Squash Players.

ERIC Educational Resources Information Center

Beaudin, Paula; And Others

1978-01-01

It was concluded that playing squash is an activity that results in heart rate responses of sufficient intensity to elicit aerobic training effects without producing high lactic acid concentration in the blood. (MM)

Antepartum fetal heart rate feature extraction and classification using empirical mode decomposition and support vector machine

PubMed Central

2011-01-01

Background Cardiotocography (CTG) is the most widely used tool for fetal surveillance. The visual analysis of fetal heart rate (FHR) traces largely depends on the expertise and experience of the clinician involved. Several approaches have been proposed for the effective interpretation of FHR. In this paper, a new approach for FHR feature extraction based on empirical mode decomposition (EMD) is proposed, which was used along with support vector machine (SVM) for the classification of FHR recordings as 'normal' or 'at risk'. Methods The FHR were recorded from 15 subjects at a sampling rate of 4 Hz and a dataset consisting of 90 randomly selected records of 20 minutes duration was formed from these. All records were labelled as 'normal' or 'at risk' by two experienced obstetricians. A training set was formed by 60 records, the remaining 30 left as the testing set. The standard deviations of the EMD components are input as features to a support vector machine (SVM) to classify FHR samples. Results For the training set, a five-fold cross validation test resulted in an accuracy of 86% whereas the overall geometric mean of sensitivity and specificity was 94.8%. The Kappa value for the training set was .923. Application of the proposed method to the testing set (30 records) resulted in a geometric mean of 81.5%. The Kappa value for the testing set was .684. Conclusions Based on the overall performance of the system it can be stated that the proposed methodology is a promising new approach for the feature extraction and classification of FHR signals. PMID:21244712

Targeting miR-423-5p Reverses Exercise Training–Induced HCN4 Channel Remodeling and Sinus Bradycardia

PubMed Central

D’Souza, Alicia; Pearman, Charles M.; Wang, Yanwen; Nakao, Shu; Logantha, Sunil Jit R.J.; Cox, Charlotte; Bennett, Hayley; Zhang, Yu; Johnsen, Anne Berit; Linscheid, Nora; Poulsen, Pi Camilla; Elliott, Jonathan; Coulson, Jessica; McPhee, Jamie; Robertson, Abigail; da Costa Martins, Paula A.; Kitmitto, Ashraf; Wisløff, Ulrik; Cartwright, Elizabeth J.; Monfredi, Oliver; Lundby, Alicia; Dobrzynski, Halina; Oceandy, Delvac; Morris, Gwilym M.

2017-01-01

Rationale: Downregulation of the pacemaking ion channel, HCN4 (hyperpolarization-activated cyclic nucleotide gated channel 4), and the corresponding ionic current, If, underlies exercise training–induced sinus bradycardia in rodents. If this occurs in humans, it could explain the increased incidence of bradyarrhythmias in veteran athletes, and it will be important to understand the underlying processes. Objective: To test the role of HCN4 in the training-induced bradycardia in human athletes and investigate the role of microRNAs (miRs) in the repression of HCN4. Methods and Results: As in rodents, the intrinsic heart rate was significantly lower in human athletes than in nonathletes, and in all subjects, the rate-lowering effect of the HCN selective blocker, ivabradine, was significantly correlated with the intrinsic heart rate, consistent with HCN repression in athletes. Next-generation sequencing and quantitative real-time reverse transcription polymerase chain reaction showed remodeling of miRs in the sinus node of swim-trained mice. Computational predictions highlighted a prominent role for miR-423-5p. Interaction between miR-423-5p and HCN4 was confirmed by a dose-dependent reduction in HCN4 3′-untranslated region luciferase reporter activity on cotransfection with precursor miR-423-5p (abolished by mutation of predicted recognition elements). Knockdown of miR-423-5p with anti-miR-423-5p reversed training-induced bradycardia via rescue of HCN4 and If. Further experiments showed that in the sinus node of swim-trained mice, upregulation of miR-423-5p (intronic miR) and its host gene, NSRP1, is driven by an upregulation of the transcription factor Nkx2.5. Conclusions: HCN remodeling likely occurs in human athletes, as well as in rodent models. miR-423-5p contributes to training-induced bradycardia by targeting HCN4. This work presents the first evidence of miR control of HCN4 and heart rate. miR-423-5p could be a therapeutic target for pathological sinus node dysfunction in veteran athletes. PMID:28821541

Cardiac arrhythmias during aerobatic flight and its simulation on a centrifuge.

PubMed

Zawadzka-Bartczak, Ewelina K; Kopka, Lech H

2011-06-01

It is well known that accelerations during centrifuge training and during flight can provoke cardiac arrhythmias. Our study was designed to investigate both the similarities and differences between heart rhythm disturbances during flights and centrifuge tests. There were 40 asymptomatic, healthy pilots who performed two training flights and were also tested in a human centrifuge according to a program of rapid onset rate acceleration (ROR) and of centrifuge simulation of the actual acceleration experienced in flight (Simulation). During the flight and centrifuge tests ECG was monitored with the Holter method. ECG was examined for heart rhythm changes and disturbances. During flights, premature ventricular contractions (PVCs) were found in 25% of the subjects, premature supraventricular contractions (PSVCs) and PVCs with bigeminy in 5%, and pairs of PVCs in 2.5% of subjects. During the centrifuge tests, PVCs were experienced by 45% of the subjects, PSVCs and pairs of PVCs by 7.5%, and PVCs with bigeminy by 2.5%. Sinus bradycardia was observed during flights and centrifuge tests in 7.5% of subjects. Comparative evaluation of electrocardiographic records in military pilots during flights and centrifuge tests demonstrated that: 1) there were no clinically significant arrhythmias recorded; and 2) the frequency and kind of heart rhythm disturbances during aerobatic flight and its simulation on a centrifuge were not identical and did not occur repetitively in the same persons during equal phases of the tests.

[Endurance training in hypertension is effective. Which form of sports, frequency and intensity of training? When should adjuvant chemotherapy be considered?].

PubMed

Ketelhut, R G

1998-12-10

Physical activity in the form of endurance training is highly recommendable for hypertensives. Both suitable and unsuitable forms of sports are identified. From various points of view, two one-hour sessions per week would appear to be optimal. The intensity of the activity should be oriented to the heart rate, and, for safety's sake, prior ergometric evaluation should be carried out. As a rule of thumb, the heart rate should not exceed 70% of the maximum rate during exercise. If the blood pressure should nevertheless increase too much, appropriate pharmacological treatment is indicated.

The clinical profile and pathophysiology of atrial fibrillation: relationships among clinical features, epidemiology, and mechanisms.

PubMed

Andrade, Jason; Khairy, Paul; Dobrev, Dobromir; Nattel, Stanley

2014-04-25

Atrial fibrillation (AF) is the most common arrhythmia (estimated lifetime risk, 22%-26%). The aim of this article is to review the clinical epidemiological features of AF and to relate them to underlying mechanisms. Long-established risk factors for AF include aging, male sex, hypertension, valve disease, left ventricular dysfunction, obesity, and alcohol consumption. Emerging risk factors include prehypertension, increased pulse pressure, obstructive sleep apnea, high-level physical training, diastolic dysfunction, predisposing gene variants, hypertrophic cardiomyopathy, and congenital heart disease. Potential risk factors are coronary artery disease, kidney disease, systemic inflammation, pericardial fat, and tobacco use. AF has substantial population health consequences, including impaired quality of life, increased hospitalization rates, stroke occurrence, and increased medical costs. The pathophysiology of AF centers around 4 general types of disturbances that promote ectopic firing and reentrant mechanisms, and include the following: (1) ion channel dysfunction, (2) Ca(2+)-handling abnormalities, (3) structural remodeling, and (4) autonomic neural dysregulation. Aging, hypertension, valve disease, heart failure, myocardial infarction, obesity, smoking, diabetes mellitus, thyroid dysfunction, and endurance exercise training all cause structural remodeling. Heart failure and prior atrial infarction also cause Ca(2+)-handling abnormalities that lead to focal ectopic firing via delayed afterdepolarizations/triggered activity. Neural dysregulation is central to atrial arrhythmogenesis associated with endurance exercise training and occlusive coronary artery disease. Monogenic causes of AF typically promote the arrhythmia via ion channel dysfunction, but the mechanisms of the more common polygenic risk factors are still poorly understood and under intense investigation. Better recognition of the clinical epidemiology of AF, as well as an improved appreciation of the underlying mechanisms, is needed to develop improved methods for AF prevention and management.

Comparison of training methods to improve walking in persons with chronic spinal cord injury: a randomized clinical trial

PubMed Central

Alexeeva, Natalia; Sames, Carol; Jacobs, Patrick L.; Hobday, Lori; DiStasio, Marcello M.; Mitchell, Sarah A.; Calancie, Blair

2011-01-01

Objective To compare two forms of device-specific training – body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) – to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI). Methods Thirty-five adult subjects with a history of chronic SCI (>1 year; AIS ‘C’ or ‘D’) participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre- and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject. Results All three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged. Conclusions Our results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to guide that training. PMID:21903010

Systematic review of the effect of aerobic and resistance exercise training on systemic brain natriuretic peptide (BNP) and N-terminal BNP expression in heart failure patients.

PubMed

Smart, N A; Steele, M

2010-04-30

BNP and the N-terminal portion (NT-pro-BNP) have emerged as powerful tools in the diagnosis and prognosis of heart failure on acute presentation. The aim of this work was to systematically review the effect of exercise training on BNP and NT-pro-BNP levels in patients with left ventricular dysfunction. A systematic search was conducted of Medline (Ovid) (1950-July 2008), Embase.com (1974-current), Cochrane Central Register of Controlled Trials, CINAHL (1981-current) and Web of Science (2000-current) to identify randomized controlled trials of aerobic and/or resistance exercise training in heart failure patients that measured BNP and/or pro-BNP. Primary outcome measures were changes in BNP and NT-pro-BNP. Secondary outcomes were changes in functional capacity and energy expenditure, measures of study quality were also recorded. Nine randomized controlled studies measuring BNP or NT-pro-BNP met our eligibility criteria. Exercise training had a favourable effect on BNP (mean difference -79 pg/ml 95% C.I. -141 to - 17 pg/ml, P=0.01) and NT-pro-BNP (mean difference -621 pg/ml, 95% C.I. -844 to -398 pg/ml, P=<0.00001). Moreover the trials that showed a significant change in NT-pro-BNP all had a weekly exercise energy expenditure of more than 400 Kcal. Data from nine published studies, suggest exercise training has a favorable effect on BNP and NT-pro-BNP in heart failure patients. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Ride comfort analysis with physiological parameters for an e-health train.

PubMed

Lee, Youngbum; Shin, Kwangsoo; Lee, Sangjoon; Song, Yongsoo; Han, Sungho; Lee, Myoungho

2009-12-01

Transportation by train has numerous advantages over road transportation, especially with regard to energy efficiency, ecological features, safety, and punctuality. However, the contrast in ride comfort between standard road transportation and train travel has become a competitive issue. The ride comfort enhancement technology of tilting trains (TTX) is a particularly important issue in the development of the Korean high-speed railroad business. Ride comfort is now defined in international standards such as UIC13 and ISO2631. The Korean standards such as KSR9216 mainly address physical parameters such as vibration and noise. In the area of ride comfort, living quality parameter techniques have recently been considered in Korea, Japan, and Europe. This study introduces biological parameters, particularly variations in heart rate, as a more direct measure of comfort. Biological parameters are based on physiological responses rather than on purely external mechanical parameters. Variability of heart rate and other physiological parameters of passengers are measured in a simulation involving changes in the tilting angle of the TTX. This research is a preliminary study for the implementation of an e-health train, which would provide passengers with optimized ride comfort. The e-health train would also provide feedback on altered ride comfort situations that can improve a passenger's experience and provide a healthcare service on the train. The aim of this research was to develop a ride comfort evaluation system for the railway industry, the automobile industry, and the air industry. The degree of tilt correlated with heart rate, fatigue, and unrelieved alertness.

Baroreflex buffering in sedentary and endurance exercise-trained healthy men.

PubMed

Christou, Demetra D; Jones, Pamela Parker; Seals, Douglas R

2003-06-01

Baroreflex buffering plays an important role in arterial blood pressure control. Previous reports suggest that baroreflex sensitivity may be altered in endurance exercise-trained compared with untrained subjects. It is unknown, however, if in vivo baroreflex buffering is altered in the endurance exercise-trained state in humans. Baroreflex buffering was determined in 36 healthy normotensive men (18 endurance exercise-trained, 41+/-5 [SEM] years; 18 untrained, 41+/-4 years) by measuring the potentiation of the systolic blood pressure responses to a phenylephrine bolus and to incremental phenylephrine infusion during compared with before ganglionic blockade with trimethaphan. The exercise-trained men had a lower resting heart rate and higher maximal oxygen consumption and heart rate variability than the sedentary control subjects (all P=0.01). Mean levels and variability of blood pressure, cardiovagal baroreflex sensitivity (change in heart rate/change in systolic blood pressure), and basal muscle sympathetic nerve activity were not different in the two groups. The systolic blood pressure responses to phenylephrine were not different in the endurance-trained and untrained men before or during ganglionic blockade (P>0.6). Measures of baroreflex buffering with the use of a phenylephrine bolus (3.9+/-0.8 versus 4.0+/-0.7, trained versus untrained, P=0.85) and incremental infusion (2.8+/-0.4 versus 2.5+/-0.6, P=0.67) were similar in the two groups. Baroreflex buffering does not differ in endurance exercise-trained compared with untrained healthy men. These results support the concept that habitual vigorous endurance exercise does not modulate in vivo baroreflex buffering in healthy humans.

Acute Physiological Responses to Strongman Training Compared to Traditional Strength Training.

PubMed

Harris, Nigel K; Woulfe, Colm J; Wood, Matthew R; Dulson, Deborah K; Gluchowski, Ashley K; Keogh, Justin B

2016-05-01

Strongman training (ST) has become an increasingly popular modality, but data on physiological responses are limited. This study sought to determine physiological responses to an ST session compared to a traditional strength exercise training (RST) session. Ten healthy men (23.6 ± 27.5 years, 85.8 ± 10.3 kg) volunteered in a crossover design, where all participants performed an ST session, an RST session, and a resting session within 7 days apart. The ST consisted of sled drag, farmer's walk, 1 arm dumbbell clean and press, and tire flip at loads eliciting approximately 30 seconds of near maximal effort per set. The RST consisted of squat, deadlift, bench press, and power clean, progressing to 75% of 1 repetition maximum. Sessions were equated for approximate total set duration. Blood lactate and salivary testosterone were recorded immediately before and after training sessions. Heart rate, caloric expenditure, and substrate utilization were measured throughout the resting session, both training protocols and for 80 minutes after training sessions. Analyses were conducted to determine differences in physiological responses within and between protocols. No significant changes in testosterone occurred at any time point for either session. Lactate increased significantly immediately after both sessions. Heart rate, caloric expenditure, and substrate utilization were all elevated significantly during ST and RST. Heart rate and fat expenditure were significantly elevated compared to resting in both sessions' recovery periods; calorie and carbohydrate expenditures were not. Compared to RST, ST represents an equivalent physiological stimulus on key parameters indicative of potential training-induced adaptive responses. Such adaptations could conceivably include cardiovascular conditioning.

Modularisation of Vocational Training in Germany, Austria and Switzerland: Parallels and Disparities in a Modernisation Process

ERIC Educational Resources Information Center

Pilz, Matthias

2012-01-01

This article considers the modularisation of initial vocational training (including apprenticeships) as a modernisation strategy in Germany, Austria and Switzerland. Training systems are similarly structured in these three countries with the apprenticeship system at their heart, and the three national philosophies of education and training are…

76 FR 72209 - National Heart, Lung, and Blood Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... Emphasis Panel, Predoctoral Training in Cardiovascular Research. Date: December 15, 2011. Time: 1 p.m. to 2..., Heart and Vascular Diseases Research; 93.838, Lung Diseases Research; 93.839, Blood Diseases and...

The effect of exercise training on biventricular myocardial strain in heart failure with preserved ejection fraction.

PubMed

Angadi, Siddhartha S; Jarrett, Catherine L; Sherif, Moustafa; Gaesser, Glenn A; Mookadam, Farouk

2017-08-01

High-intensity interval training (HIIT) improves peak oxygen uptake and left ventricular diastology in patients with heart failure with preserved ejection fraction (HFpEF). However, its effects on myocardial strain in HFpEF remain unknown. We explored the effects of HIIT and moderate-intensity aerobic continuous training (MI-ACT) on left and right ventricular strain parameters in patients with HFpEF. Furthermore, we explored their relationship with peak oxygen uptake (VO 2peak ). Fifteen patients with HFpEF (age = 70 ± 8.3 years) were randomized to either: (i) HIIT (4 × 4 min, 85-90% peak heart rate, interspersed with 3 min of active recovery; n = 9) or (ii) MI-ACT (30 min at 70% peak heart rate; n = 6). Patients were trained 3 days/week for 4 weeks and underwent VO 2peak testing and 2D echocardiography at baseline and after completion of the 12 sessions of supervised exercise training. Left ventricular (LV) and right ventricular (RV) average global peak systolic longitudinal strain (GLS) and peak systolic longitudinal strain rate (GSR) were quantified. Paired t-tests were used to examine within-group differences and unpaired t-tests used for between-group differences (α = 0.05). Right ventricular average global peak systolic longitudinal strain improved significantly in the HIIT group after training (pre = -18.4 ± 3.2%, post = -21.4 ± 1.7%; P = 0.02) while RV-GSR, LV-GLS, and LV-GSR did not (P > 0.2). No significant improvements were observed following MI-ACT. No significant between-group differences were observed for any strain measure. ΔLV-GLS and ΔRV-GLS were modestly correlated with ΔVO 2peak (r = -0.48 and r = -0.45; P = 0.1, respectively). In patients with HFpEF, 4 weeks of HIIT significantly improved RV-GLS. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Does Mindfulness Improve After Heart Coherence Training in Patients With Chronic Musculoskeletal Pain and Healthy Subjects? A Pilot Study.

PubMed

Soer, Remko; de Jong, Annemieke B; Hofstra, Bert L; Preuper, Henrica R Schiphorst; Reneman, Michiel F

2015-07-01

Mindfulness and heart coherence training (HCT) training are applied increasingly in the treatment of patients with chronic musculoskeletal pain (CMP). Questionnaires have been developed to assess changes in mindfulness but no gold standard is available. Explore the relationship between changes in mindfulness scores and changes in heart coherence after 3 sessions of HCT in patients with CMP and in healthy subjects. Ten patients with CMP and 15 healthy subjects were trained in self-regulation with the use of HCT following a standardized stress relief program developed by the HeartMath Institute. A heart coherence-score (HC-score) was constructed with scores ranging from 0-100 with higher scores reflecting more heart rate variability (HRV) coherency. Change scores, Spearman correlation coefficients, and Wilcoxon Signed Rank test were calculated to test relationships and differences between HC-score, the Mindfulness Attention and Awareness Scale (MAAS) and Five Facet Mindfulness Questionnaire (FFMQ). A new questionnaire was constructed to explore on which mindfulness-related domains patients with CMP report changes after HCT. Increases were present on HC-score in healthy subjects (P<.01) and in patients (P<.01) between baseline and follow-up. Effect sizes on change on the MAAS and FFMQ were low. Weak (r<0.25) and non-significant correlations were observed in change scores between HC-score and MAAS or FFMQ. Patients reported significant favorable differences on 6 mindfulness related domains in the new questionnaire: breathing rhythm, physical awareness, positive or negative emotions, recognition of stressful situations, thoughts, and tendency to actively self-regulate. In this pilot study, mindfulness as assessed by the MAAS and FFMQ does not appear to improve after HCT. HRV coherency, MAAS, and FFMQ measure different constructs and are weakly related. It is of great importance to choose and develop valid measures that reflect patients' states of mindfulness. Content and face validity of measures of mindfulness may be considered in the light of performance-based measures.

Functional electrical stimulation for chronic heart failure: a meta-analysis.

PubMed

Smart, Neil A; Dieberg, Gudrun; Giallauria, Francesco

2013-07-15

We conducted a meta-analysis of randomized, controlled trials of combined electrical stimulation versus conventional exercise training or placebo control in heart failure patients. A systematic search was conducted of Medline (Ovid) (1950-September 2011), Embase.com (1974-September 2011), Cochrane Central Register of Controlled Trials and CINAHL (1981-September 2011). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, exercise training and functional electrical stimulation (FES). FES produced inferior improvements in peak VO2 when compared to cycle training: mean difference (MD) -0.32 ml.kg(-1).min(-1) (95% C.I. -0.63 to -0.02 ml.kg(-1).min(-1), p=0.04), however FES elicited superior improvements in peak VO2: MD 2.30 ml.kg(-1).min(-1) (95% C.I. 1.98 to 2.62 ml.kg(-1).min(-1), p<0.00001); and six minute walk distance to sedentary care or sham FES; MD 46.9 m (95% C.I. 22.5 to 71.3m, p=0.0002). There was no difference in change in quality of life between cycling and FES, but FES elicited significantly larger improvements in Minnesota Living with Heart Failure score than placebo or sham treatment; MD 1.15 (95% C.I. 0.69 to 1.61, p<0.00001). Moreover, the total FES intervention hours were strongly correlated with change in peak VO2, (r=0.80, p=0.02). Passive or active exercise is beneficial for patients with moderate to severe heart failure, but active cycling, or other aerobic/resistance activity is preferred in patients with heart failure who are able to exercise, and FES is the preferred modality in those unable to actively exercise. The benefits of FES may however, be smaller than those observed in conventional exercise training. Aggregate hours of electrical stimulation therapy were associated with larger improvements in cardio-respiratory fitness. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A comparison of methods for analyzing glucose and insulin areas under the curve following nine months of exercise in overweight adults.

PubMed

Potteiger, J A; Jacobsen, D J; Donnelly, J E

2002-01-01

We examined three methods for calculating the area under the curve (AUC) following an oral glucose tolerance test (OGTT) in overweight adults prior to and after 9 months of exercise. Subjects (n=27) were randomly assigned to a control (CON, n=9) or intervention (INT, n=18) group. INT performed supervised exercise 5 days per week, 45 min per session, at 65% of heart rate reserve. OGTTs were administered pre- and post-training. Blood was collected during a 75 g OGTT and analyzed for glucose (GLU) and insulin (INS) concentrations. AUCs were calculated using the incremental, positive incremental, and total AUC methods and the difference scores for pre- and post-training were determined. No differences were observed among the methods for glucose AUC for either group. Significant differences were observed for INT insulin AUC with total AUC (1525+/-3291 microU/1/180 min) significantly greater than incremental AUC (1112+/-3229 microU/1/180 min) or positive incremental AUC (1085+/-3195 microU/I/180 min). Total insulin AUC was significantly reduced following training for INT, while incremental and positive incremental insulin AUCs showed no change. These data suggest that the method of used to calculate AUC may affect the interpretation of whether or not an intervention was effective.

Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial.

PubMed

Cheng, Adam; Brown, Linda L; Duff, Jonathan P; Davidson, Jennifer; Overly, Frank; Tofil, Nancy M; Peterson, Dawn T; White, Marjorie L; Bhanji, Farhan; Bank, Ilana; Gottesman, Ronald; Adler, Mark; Zhong, John; Grant, Vincent; Grant, David J; Sudikoff, Stephanie N; Marohn, Kimberly; Charnovich, Alex; Hunt, Elizabeth A; Kessler, David O; Wong, Hubert; Robertson, Nicola; Lin, Yiqun; Doan, Quynh; Duval-Arnould, Jordan M; Nadkarni, Vinay M

2015-02-01

The quality of cardiopulmonary resuscitation (CPR) affects hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonary arrest (CPA). Most health care professionals fail to perform CPR within established American Heart Association guidelines. To determine whether "just-in-time" (JIT) CPR training with visual feedback (VisF) before CPA or real-time VisF during CPA improves the quality of chest compressions (CCs) during simulated CPA. Prospective, randomized, 2 × 2 factorial-design trial with explicit methods (July 1, 2012, to April 15, 2014) at 10 International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) institutions running a standardized simulated CPA scenario, including 324 CPR-certified health care professionals assigned to 3-person resuscitation teams (108 teams). Each team was randomized to 1 of 4 permutations, including JIT training vs no JIT training before CPA and real-time VisF vs no real-time VisF during simulated CPA. The proportion of CCs with depth exceeding 50 mm, the proportion of CPR time with a CC rate of 100 to 120 per minute, and CC fraction (percentage CPR time) during simulated CPA. The quality of CPR was poor in the control group, with 12.7% (95% CI, 5.2%-20.1%) mean depth compliance and 27.1% (95% CI, 14.2%-40.1%) mean rate compliance. JIT training compared with no JIT training improved depth compliance by 19.9% (95% CI, 11.1%-28.7%; P < .001) and rate compliance by 12.0% (95% CI, 0.8%-23.2%; P = .037). Visual feedback compared with no VisF improved depth compliance by 15.4% (95% CI, 6.6%-24.2%; P = .001) and rate compliance by 40.1% (95% CI, 28.8%-51.3%; P < .001). Neither intervention had a statistically significant effect on CC fraction, which was excellent (>89.0%) in all groups. Combining both interventions showed the highest compliance with American Heart Association guidelines but was not significantly better than either intervention in isolation. The quality of CPR provided by health care professionals is poor. Using novel and practical technology, JIT training before CPA or real-time VisF during CPA, alone or in combination, improves compliance with American Heart Association guidelines for CPR that are associated with better outcomes. clinicaltrials.gov Identifier: NCT02075450.

Improved heart rate recovery despite reduced exercise performance following heavy training: A within-subject analysis.

PubMed

Thomson, Rebecca L; Bellenger, Clint R; Howe, Peter R C; Karavirta, Laura; Buckley, Jonathan D

2016-03-01

The recovery of heart rate (HRR) after exercise is a potential indicator of fitness which has been shown to respond to changes in training. This study investigated the within-individual association between HRR and exercise performance following three different training loads. 11 male cyclists/triathletes were tested after two weeks of light training, two weeks of heavy training and two days of rest. Exercise performance was measured using a 5-min maximal cycling time-trial. HRR was measured over 60s during supine recovery. Exercise performance decreased 2.2±2.5% following heavy training compared with post-light training (p=0.01), and then increased 4.0±4.2% following rest (p=0.004). Most HRR indices indicated a more rapid recovery of heart rate (HR) following heavy training, and reverted to post light training levels following two days of rest. HRR indices did not differ between post-light training and after the rest period (p>0.6). There were inverse within-subject relationships between indices of HRR and performance (r=-0.6, p≤0.004). Peak HR decreased 3.2±5.1bpm following heavy training (p=0.06) and significantly increased 4.9±4.3bpm following recovery (p=0.004). There was a moderate within-subject relationship between peak HR and exercise performance (r=0.7, p≤0.001). Controlling for peak HR reduced the relationships between HRR and performance (r=-0.4-0.5, p<0.05). This study demonstrated that HRR tracks short-term changes in exercise performance within-individuals, such that increases in HRR are associated with poorer exercise performance following heavy training. Peak HR can be compromised under conditions of fatigue, and needs to be taken into account in HRR analyses. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A new beating-heart mitral and aortic valve assessment model with implications for valve intervention training.

PubMed

Bouma, Wobbe; Jainandunsing, Jayant S; Khamooshian, Arash; van der Harst, Pim; Mariani, Massimo A; Natour, Ehsan

2017-02-01

A thorough understanding of mitral and aortic valve motion dynamics is essential in mastering the skills necessary for performing successful valve intervention (open or transcatheter repair or replacement). We describe a reproducible and versatile beating-heart mitral and aortic valve assessment and valve intervention training model in human cadavers. The model is constructed by bilateral ligation of the pulmonary veins, ligation of the supra-aortic arteries, creating a shunt between the descending thoracic aorta and the left atrial appendage with a vascular prosthesis, anastomizing a vascular prosthesis to the apex and positioning an intra-aortic balloon pump (IABP) in the vascular prosthesis, cross-clamping the descending thoracic aorta, and finally placing a fluid line in the shunt prosthesis. The left ventricle is filled with saline to the desired pressure through the fluid line, and the IABP is switched on and set to a desired frequency (usually 60-80 bpm). Prerepair valve dynamic motion can be studied under direct endoscopic visualization. After assessment, the IABP is switched off, and valve intervention training can be performed using standard techniques. This high-fidelity simulation model has known limitations, but provides a realistic environment with an actual beating (human) heart, which is of incremental value. The model provides a unique opportunity to fill a beating heart with saline and to study prerepair mitral and aortic valve dynamic motion under direct endoscopic visualization. The entire set-up provides a versatile beating-heart mitral and aortic valve assessment model, which may have important implications for future valve intervention training. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Improved auscultation skills in paramedic students using a modified stethoscope.

PubMed

Simon, Erin L; Lecat, Paul J; Haller, Nairmeen A; Williams, Carolyn J; Martin, Scott W; Carney, John A; Pakiela, John A

2012-12-01

The Ventriloscope® (Lecat's SimplySim, Tallmadge, OH) is a modified stethoscope used as a simulation training device for auscultation. To test the effectiveness of the Ventriloscope as a training device in teaching heart and lung auscultatory findings to paramedic students. A prospective, single-hospital study conducted in a paramedic-teaching program. The standard teaching group learned heart and lung sounds via audiocassette recordings and lecture, whereas the intervention group utilized the modified stethoscope in conjunction with patient volunteers. Study subjects took a pre-test, post-test, and a follow-up test to measure recognition of heart and lung sounds. The intervention group included 22 paramedic students and the standard group included 18 paramedic students. Pre-test scores did not differ using two-sample t-tests (standard group: t [16]=-1.63, p=0.12) and (intervention group: t [20]=-1.17, p=0.26). Improvement in pre-test to post-test scores was noted within each group (standard: t [17]=2.43, p=0.03; intervention: t [21]=4.81, p<0.0001). Follow-up scores for the standard group were not different from pre-test scores of 16.06 (t [17]=0.94, p=0.36). However, follow-up scores for the intervention group significantly improved from their respective pre-test score of 16.05 (t [21]=2.63, p=0.02). Simulation training using a modified stethoscope in conjunction with standardized patients allows for realistic learning of heart and lung sounds. This technique of simulation training achieved proficiency and better retention of heart and lung sounds in a safe teaching environment. Copyright © 2012 Elsevier Inc. All rights reserved.

Artificial Respiration and Artificial Circulation

PubMed Central

Brook, Joseph; Brook, Morris H.; Lopez, Jose F.

1965-01-01

A training program in the newer methods of treatment of acute cardiopulmonary emergencies which was developed at the University Hospital, University of Saskatchewan, is reported. Artificial respiration by the chance rescuer, primary and secondary resuscitation, and post-resuscitation measures involving the use of special drugs and equipment by trained personnel are described. Figures and tables designed for wall-mounting and ready reference in an emergency situation are presented. Firstaid ventilatory adjuncts for use by trained personnel are classified and critically appraised, and the propriety of their use is emphasized. A plea is made to the medical profession and allied agencies to assume the responsibility of spreading knowledge of the new techniques more widely. Unless effective treatment is instituted early enough to prevent death or permanent anoxic damage to heart and brain, follow-through therapy will often be fruitless. PMID:14339303

Deconditioning-induced exercise responses as influenced by heat acclimation

NASA Technical Reports Server (NTRS)

Shvartz, E.; Bhattacharya, A.; Sperinde, S. J.; Brock, P. J.; Sciaraffa, D.; Haines, R. F.; Greenleaf, J. E.

1979-01-01

A study to determine the effect of heat acclimation and physical training in temperate conditions on changes in exercise tolerance following water-immersion deconditioning is presented. Five young men were tested on a bicycle ergometer before and after heat acclimation and after water immersion. The subjects and the experimental procedure, heat acclimation and exercise training, water immersion, and exercise tolerance are discussed. Heat acclimation resulted in the usual decreases in exercise heart rate and rectal temperature and an increase in sweat rate. Water immersion resulted in substantial diuresis despite water consumed. The results show that heat acclimation provides an effective method of preventing the adverse effects of water-immersion deconditioning on exercise tolerance.

Great Institutions in Cardiothoracic Surgery: The University of Minnesota.

PubMed

Huddleston, Stephen J; Shumway, Sara

2016-01-01

With the loyal support of the chair of Surgery, Dr. Owen H. Wangensteen, the University of Minnesota cardiac surgery program led the way at the dawn of cardiac surgery when Dr F. John Lewis performed the first open heart surgery in the world using hypothermia while repairing an atrial septal defect on September 2, 1952. Soon after, Dr C. Walt Lillehei performed the first repair of a ventriculoseptal defect in the world using cross-circulation on March 26, 1954. Collaborating with Dr Richard DeWall in 1955, they developed the DeWall-Lillehei bubble oxygentor which was used at the University of Minnesota and many other centers worldwide for years to come, making open heart surgery safe and tractable. Dr Vincent Gott, a resident working in the laboratory of Lillehei, developed a method to treat complete heart block using ventricular pacing with a Grass physiological stimulator, and this led to a collaboration with Earl Bakken, founder of the Medtronic Corporation, to develop a temporary pacemaker. The program was fertile ground for many notable trainees, including Dr Norman Shumway, the "Father of Heart Transplant", and Dr Christiaan Barnard who performed the first heart transplant in the world. The collegial and forward thinking nature of the cardiac surgery program continues in the current training program today. Copyright © 2016 Elsevier Inc. All rights reserved.

A study of intensity, fatigue and precision in two specific interval trainings in young tennis players: high-intensity interval training versus intermittent interval training

PubMed Central

Suárez Rodríguez, David; del Valle Soto, Miguel

2017-01-01

Background The aim of this study is to find the differences between two specific interval exercises. We begin with the hypothesis that the use of microintervals of work and rest allow for greater intensity of play and a reduction in fatigue. Methods Thirteen competition-level male tennis players took part in two interval training exercises comprising nine 2 min series, which consisted of hitting the ball with cross-court forehand and backhand shots, behind the service box. One was a high-intensity interval training (HIIT), made up of periods of continuous work lasting 2 min, and the other was intermittent interval training (IIT), this time with intermittent 2 min intervals, alternating periods of work with rest periods. Average heart rate (HR) and lactate levels were registered in order to observe the physiological intensity of the two exercises, along with the Borg Scale results for perceived exertion and the number of shots and errors in order to determine the intensity achieved and the degree of fatigue throughout the exercise. Results There were no significant differences in the average heart rate, lactate or the Borg Scale. Significant differences were registered, on the other hand, with a greater number of shots in the first two HIIT series (series 1 p>0.009; series 2 p>0.056), but not in the third. The number of errors was significantly lower in all the IIT series (series 1 p<0.035; series 2 p<0.010; series 3 p<0.001). Conclusion Our study suggests that high-intensity intermittent training allows for greater intensity of play in relation to the real time spent on the exercise, reduced fatigue levels and the maintaining of greater precision in specific tennis-related exercises. PMID:29021912

Physical fitness interventions for nonambulatory stroke survivors: A mixed-methods systematic review and meta-analysis.

PubMed

Lloyd, Megan; Skelton, Dawn A; Mead, Gillian E; Williams, Brian; van Wijck, Frederike

2018-06-19

Physical fitness training after stroke is recommended in guidelines across the world, but evidence pertains mainly to ambulatory stroke survivors. Nonambulatory stroke survivors (FAC score ≤2) are at increased risk of recurrent stroke due to limited physical activity. This systematic review aimed to synthesize evidence regarding case fatality, effects, experiences, and feasibility of fitness training for nonambulatory stroke survivors. Eight major databases were searched for any type of study design. Two independent reviewers selected studies, extracted data, and assessed study quality, using published tools. Random-effects meta-analysis was used. Following their separate analysis, qualitative and quantitative data were synthesized using a published framework. Of 13,614 records, 33 studies involving 910 nonambulatory participants met inclusion criteria. Most studies were of moderate quality. Interventions comprised assisted walking (25 studies), cycle ergometer training (5 studies), and other training (3 studies), mainly in acute settings. Case fatality did not differ between intervention (1.75%) and control (0.88%) groups (95% CI 0.13-3.78, p = 0.67). Compared with control interventions, assisted walking significantly improved: fat mass, peak heart rate, peak oxygen uptake and walking endurance, maximum walking speed, and mobility at intervention end, and walking endurance, balance, mobility, and independent walking at follow-up. Cycle ergometry significantly improved peak heart rate, work load, peak ventilation, peak carbon dioxide production, HDL cholesterol, fasting insulin and fasting glucose, and independence at intervention end. Effectiveness of other training could not be established. There were insufficient qualitative data to draw conclusions about participants' experiences, but those reported were positive. There were few intervention-related adverse events, and dropout rate ranged from 12 to 20%. Findings suggest safety, effectiveness, and feasibility of adapted fitness training for screened nonambulatory stroke survivors. Further research needs to investigate the clinical and cost-effectiveness as well as experiences of fitness training-especially for chronic stroke survivors in community settings. © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

Myocardial Infarction Injury in Patients with Chronic Lung Disease Entering Pulmonary Rehabilitation: Frequency and Association with Heart Rate Parameters.

PubMed

Sima, Carmen A; Lau, Benny C; Taylor, Carolyn M; van Eeden, Stephan F; Reid, W Darlene; Sheel, Andrew W; Kirkham, Ashley R; Camp, Pat G

2018-03-14

Myocardial infarction (MI) remains under-recognized in chronic lung disease (CLD) patients. Rehabilitation health professionals need accessible clinical measurements to identify the presence of prior MI in order to determine appropriate training prescription. To estimate prior MI in CLD patients entering a pulmonary rehabilitation program, as well as its association with heart rate parameters such as resting heart rate and chronotropic response index. Retrospective cohort design. Pulmonary rehabilitation outpatient clinic in a tertiary care university-affiliated hospital. Eighty-five CLD patients were studied. Electrocardiograms at rest and peak cardiopulmonary exercise testing, performed before pulmonary rehabilitation, were analyzed. Electrocardiographic evidence of prior MI, quantified by the Cardiac Infarction Injury Score (CIIS), was contrasted with reported myocardial events and then correlated with resting heart rate and chronotropic response index parameters. CIIS, resting heart rate, and chronotropic response index. Sixteen CLD patients (19%) demonstrated electrocardiographic evidence of prior MI, but less than half (8%) had a reported MI history (P < .05). The Cohen's kappa test revealed poor level of agreement between CIIS and medical records (kappa = 0.165), indicating that prior MI diagnosis was under-reported in the medical records. Simple and multiple regression analyses showed that resting heart rate but not chronotropic response index was positively associated with CIIS in our population (R 2 = 0.29, P < .001). CLD patients with a resting heart rate higher than 80 beats/min had approximately 5 times higher odds of having prior MI, as evidenced by a CIIS ≥20. CLD patients entering pulmonary rehabilitation are at risk of unreported prior MI. Elevated resting heart rate seems to be an indicator of prior MI in CLD patients; therefore, careful adjustment of training intensity such as intermittent training is recommended under these circumstances. III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Down syndrome

MedlinePlus

... prescribed to prevent a heart infection called endocarditis . Special education and training is offered in most communities for ... be consulted to determine if the child needs special education and training. It is important for the child ...

Lactate threshold responses to a season of professional British youth soccer

PubMed Central

McMillan, K; Helgerud, J; Grant, S; Newell, J; Wilson, J; Macdonald, R; Hoff, J

2005-01-01

Objective: To examine the changes in aerobic endurance performance of professional youth soccer players throughout the soccer season. Methods: Nine youth soccer players were tested at six different time points throughout the soccer season by sub-maximal blood lactate assessment, using an incremental treadmill protocol. Whole blood lactate concentration and heart frequency (Hf) were determined at each exercise stage. Running velocities at the first lactate inflection point (v-Tlac) and at a blood lactate concentration of 4 mmol l–1 (v-4mM) were determined. Results: Running velocity at the two lactate thresholds increased from the start of pre-season training to the early weeks of the competitive season, from 11.67 (0.29) to 12.96 (0.28) km h–1 for v-Tlac, and from 13.62 (0.25) to 14.67 (0.24) km h–1 for v-4mM (p<0.001). However, v-Tlac and v-4mM when expressed relative to maximum heart frequency (Hfmax) remained unchanged. The Hf to blood lactate concentration relationship was unchanged after the pre-season training period. The two expressions of lactate threshold did not reveal differences between each other. Conclusion: Running velocity at v-Tlac and v-4mM increased significantly over the pre-season period, but v-Tlac and v-4mM were unchanged when expressed relative to Hfmax. This finding may indicate that increased endurance performance may be mainly attributable to alterations in Vo2max. Although lactate assessment of soccer players is useful for determining endurance training adaptations in soccer players, additional assessment of the other two determinants of endurance performance (Vo2max and running economy) may provide more useful information for determining physiological adaptations resulting from soccer training and training interventions. PMID:15976165

A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: The two-person CPR study.

PubMed

Roppolo, Lynn P; Heymann, Rahm; Pepe, Paul; Wagner, James; Commons, Bradford; Miller, Ronna; Allen, Emilie; Horne, Leyla; Wainscott, Michael P; Idris, Ahamed H

2011-03-01

The primary purpose of this study was to compare two, shorter, self-directed methods of cardiopulmonary resuscitation (CPR) education for healthcare professionals (HCP) to traditional training with a focus on the trainee's ability to perform two-person CPR. First-year medical students with either no prior CPR for HCP experience or prior training greater than 5 years were randomized to complete one of three courses: 1) HeartCode BLS System, 2) BLS Anytime, or 3) Traditional training. Only data from the adult CPR skills testing station was reviewed via video recording by certified CPR instructors and the Laerdal PC Skill Reporter software program (Laerdal Medical, Stavanger, Norway). There were 180 first-year medical students who met inclusion criteria: 68 were HeartCode BLS System, 53 BLS Anytime group, and 59 traditional group Regarding two-person CPR, 57 (84%) of Heartcode BLS students and 43 (81%) of BLS Anytime students were able to initiate the switch compared to 39 (66%) of traditional course students (p = 0.04). There were no significant differences in the quality of chest compressions or ventilations between the three groups. There was a trend for a much higher CPR skills testing pass rate for the traditional course students. However, failure to "clear to analyze or shock" while using the AED was the most common reason for failure in all groups. The self-directed learning groups not only had a high level of success in initiating the "switch" to two-person CPR, but were not significantly different from students who completed traditional training. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Multiphoton microscopy of ECM proteins in baboon aortic leaflet

NASA Astrophysics Data System (ADS)

Gonzalez, Mariacarla; Saytashev, Ilyas; Luna, Camila; Gonzalez, Brittany; Pinero, Alejandro; Perez, Manuel; Ramaswamy, Sharan; Ramella-Roman, Jessica

2018-02-01

The extracellular matrix (ECM) plays crucial role in defining mechanical properties of a heart valve yet the mechanobiological role of the ECM proteins - collagen and elastin - in living heart valve leaflets is still poorly understood. In this study, non-linear microscopy was used to obtain three dimensional images of collagen and elastin arrangement in aortic leaflets under combined steady flow (850 ml/min) and cyclic flexure (1 Hz) mechanical (dynamic) training. A novel bioreactor capable of mimicking the flow conditions in a living heart was used in this study and was optimized for microscopic imagery. A custom made non-linear microscope was used in this study to provide Second Harmonic Generation (SHG) imaging of collagen arrangement and two-photon imaging of elastin. Two control and three trained leaflet samples from static and dynamic tissue culture were imaged to observe protein changes in the tissue for a period of seven days. Dynamic training led to a decrease in alignment index of the protein fibers compared to the static treatment.

Psychological Factors and Cardiac Risk And Impact of Exercise Training Programs—A Review of Ochsner Studies

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Artham, Surya M.; Gilliland, Yvonne

2007-01-01

Although under-emphasized, substantial evidence indicates that psychological distress, especially depression, hostility, and anxiety, are risk factors for coronary heart disease (CHD) and affect recovery following major coronary heart disease events. We review several major studies from Ochsner Medical Center demonstrating the high prevalence of psychological distress in CHD patients and the marked benefits that occur following formal cardiac rehabilitation and exercise training programs. These benefits include reductions in psychological stress, improvements in CHD risk factors that accompany high stress, and reduced all-cause mortality. These data support the benefits of exercise training and increased levels of fitness to improve psychological stress and subsequent prognosis. PMID:21603539

Cardiac rehabilitation and exercise training in secondary coronary heart disease prevention.

PubMed

Lavie, Carl J; Milani, Richard V

2011-01-01

Substantial evidence indicates that increased levels of physical activity, exercise training, and overall cardiorespiratory fitness provide protection in primary and secondary coronary heart disease (CHD) prevention. Clearly, cardiac rehabilitation and exercise training (CRET) programs have been greatly underused in patients with CHD. We review the benefits of formal CRET programs on CHD risk factors including exercise capacity, obesity indices, plasma lipids, inflammation, and psychosocial stress as well as overall morbidity and mortality. These data support the fact that patients with CHD, especially after major CHD events, need routine referral to CRET programs; and patients should be vigorously encouraged to attend these valuable programs. Copyright © 2011. Published by Elsevier Inc.

Effect of a virtual reality-enhanced exercise protocol after coronary artery bypass grafting.

PubMed

Chuang, Tien-Yow; Sung, Wen-Hsu; Chang, Hwa-Ann; Wang, Ray-Yau

2006-10-01

Virtual reality (VR) technology has gained importance in many areas of medicine. Knowledge concerning the application and the influence of VR-enhanced exercise programs is limited for patients receiving coronary artery bypass grafting. The purpose of this study was to evaluate the effect of a virtual "country walk" on the number of sessions necessary to reach cardiac rehabilitation goals in patients undergoing coronary artery bypass grafting. Twenty subjects who were seen for cardiac rehabilitation between January and June 2004 comprised the study sample. The protocol for this study included an initial maximum graded exercise tolerance test, given to determine the subsequent training goals for the subject, followed by biweekly submaximal endurance training sessions. All subjects were assigned by lot to 1 of 2 submaximal endurance training programs, one (group 2) with and the other (group 1) without the added VR environment. In all other respects, the 2 programs were identical. Each training session lasted for 30 minutes and was carried out twice per week for about 3 months. The primary outcome measures were maximum load during the work sessions, target oxygen consumption, target heart rate (beats per minute), and number of training sessions required to reach rehabilitation goals. By the end of 20 training sessions, only 4 of the 10 control subjects had reached the heart rate target goal of 85% their maximum heart rate. In contrast, 9 of the 10 subjects in the VR program had attained this goal by 9 or fewer training sessions. When target metabolic cost (75% peak oxygen consumption) was used as the training goal, all 10 subjects in the VR program had reached this target after 2 training sessions (or, in some cases, 1 training session), but not until training session 15 did a cumulative number of 9 control subjects reach this goal. These study outcomes clearly support the notion that incorporating a VR environment into cardiac rehabilitation programs will accelerate maximum recovery of patients' cardiovascular function.

77 FR 12856 - National Heart, Lung, and Blood Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... Emphasis Panel, NHLBI Cardiovascular T32 Training Application. Date: March 23, 2012. Time: 1 p.m. to 3 p.m..., Heart and Vascular Diseases Research; 93.838, Lung Diseases Research; 93.839, Blood Diseases and...

Respiratory muscle training improves hemodynamics, autonomic function, baroreceptor sensitivity, and respiratory mechanics in rats with heart failure

PubMed Central

Jaenisch, Rodrigo B.; Hentschke, Vítor S.; Quagliotto, Edson; Cavinato, Paulo R.; Schmeing, Letiane A.; Xavier, Léder L.

2011-01-01

Respiratory muscle training (RMT) improves functional capacity in chronic heart-failure (HF) patients, but the basis for this improvement remains unclear. We evaluate the effects of RMT on the hemodynamic and autonomic function, arterial baroreflex sensitivity (BRS), and respiratory mechanics in rats with HF. Rats were assigned to one of four groups: sedentary sham (n = 8), trained sham (n = 8), sedentary HF (n = 8), or trained HF (n = 8). Trained animals underwent a RMT protocol (30 min/day, 5 day/wk, 6 wk of breathing through a resistor), whereas sedentary animals did not. In HF rats, RMT had significant effects on several parameters. It reduced left ventricular (LV) end-diastolic pressure (P < 0.01), increased LV systolic pressure (P < 0.01), and reduced right ventricular hypertrophy (P < 0.01) and pulmonary (P < 0.001) and hepatic (P < 0.001) congestion. It also decreased resting heart rate (HR; P < 0.05), indicating a decrease in the sympathetic and an increase in the vagal modulation of HR. There was also an increase in baroreflex gain (P < 0.05). The respiratory system resistance was reduced (P < 0.001), which was associated with the reduction in tissue resistance after RMT (P < 0.01). The respiratory system and tissue elastance (Est) were also reduced by RMT (P < 0.01 and P < 0.05, respectively). Additionally, the quasistatic Est was reduced after RMT (P < 0.01). These findings show that a 6-wk RMT protocol in HF rats promotes an improvement in hemodynamic function, sympathetic and vagal heart modulation, arterial BRS, and respiratory mechanics, all of which are benefits associated with improvements in cardiopulmonary interaction. PMID:21903877

Effectiveness of simulator-based echocardiography training of noncardiologists in congenital heart diseases.

PubMed

Wagner, Robert; Razek, Vit; Gräfe, Florentine; Berlage, Thomas; Janoušek, Jan; Daehnert, Ingo; Weidenbach, Michael

2013-07-01

Congenital heart diseases (CHD) are responsible for substantial morbidity and mortality in neonates. The preliminary diagnosis often is made by noncardiologists. For this reason, there is a huge demand of training in echocardiography of CHD. This is difficult to achieve due to limited resources of specialized centers. The goal of this study was to investigate the training effect of the echocardiography simulator EchoCom on trainee's ability to diagnose CHD. We enrolled 10 residents for simulator-based training in echocardiography of CHD. All participants were instructed on the simulator's basic handling and had one hour to scan the first 9 datasets information (ventricular septal defect, atrial septal defect, atrioventricular septal defect, Tetralogy of Fallot, transposition of great arteries, congenital corrected transposition of great arteries, common arterial trunk, hypoplastic left heart syndrome, normal anatomy) and establish a diagnosis. No help was given except for support regarding simulator related issues. Afterward, 2 rounds of structured simulator based echocardiography training focused on echocardiographic anatomy, spatial orientation, standard views, and echocardiographic anatomy of different CHD followed. All participants completed a standardized questionnaire containing 10 multiple-choice (MC) questions focusing on basic theoretical knowledge in echocardiographic anatomy and common CHD. Almost all of the residents invited from the affiliated children's hospital had little (20%) or no experience (80%) in echocardiography of CHD. Their Pretest and Posttest scores showed significant improvement for both, MC test and performance test, respectively. Our study showed that simulator-based training in echocardiography in CHD could be very effective and may assist with training outside the scope of CHD. © 2013, Wiley Periodicals, Inc.

Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial

PubMed Central

Voorn, Eric L.; Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H. L.; Nollet, Frans

2016-01-01

Objective To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. Design A process evaluation using data from an RCT. Patients Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22). Methods Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60–70% heart rate reserve). Results The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group. Conclusion Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. Trial Registration Netherlands National Trial Register NTR1371 PMID:27419388

Xinyinqin: a computer-based heart sound simulator.

PubMed

Zhan, X X; Pei, J H; Xiao, Y H

1995-01-01

"Xinyinqin" is the Chinese phoneticized name of the Heart Sound Simulator (HSS). The "qin" in "Xinyinqin" is the Chinese name of a category of musical instruments, which means that the operation of HSS is very convenient--like playing an electric piano with the keys. HSS is connected to the GAME I/O of an Apple microcomputer. The generation of sound is controlled by a program. Xinyinqin is used as a teaching aid of Diagnostics. It has been applied in teaching for three years. In this demonstration we will introduce the following functions of HSS: 1) The main program has two modules. The first one is the heart auscultation training module. HSS can output a heart sound selected by the student. Another program module is used to test the student's learning condition. The computer can randomly simulate a certain heart sound and ask the student to name it. The computer gives the student's answer an assessment: "correct" or "incorrect." When the answer is incorrect, the computer will output that heart sound again for the student to listen to; this process is repeated until she correctly identifies it. 2) The program is convenient to use and easy to control. By pressing the S key, it is able to output a slow heart rate until the student can clearly identify the rhythm. The heart rate, like the actual rate of a patient, can then be restored by hitting any key. By pressing the SPACE BAR, the heart sound output can be stopped to allow the teacher to explain something to the student. The teacher can resume playing the heart sound again by hitting any key; she can also change the content of the training by hitting RETURN key. In the future, we plan to simulate more heart sounds and incorporate relevant graphs.

Changes in cortisol release and heart rate and heart rate variability during the initial training of 3-year-old sport horses.

PubMed

Schmidt, Alice; Aurich, Jörg; Möstl, Erich; Müller, Jürgen; Aurich, Christine

2010-09-01

Based on cortisol release, a variety of situations to which domestic horses are exposed have been classified as stressors but studies on the stress during equestrian training are limited. In the present study, Warmblood stallions (n=9) and mares (n=7) were followed through a 9 respective 12-week initial training program in order to determine potentially stressful training steps. Salivary cortisol concentrations, beat-to-beat (RR) interval and heart rate variability (HRV) were determined. The HRV variables standard deviation of the RR interval (SDRR), RMSSD (root mean square of successive RR differences) and the geometric means standard deviation 1 (SD1) and 2 (SD2) were calculated. Nearly each training unit was associated with an increase in salivary cortisol concentrations (p<0.01). Cortisol release varied between training units and occasionally was more pronounced in mares than in stallions (p<0.05). The RR interval decreased slightly in response to lunging before mounting of the rider. A pronounced decrease occurred when the rider was mounting, but before the horse showed physical activity (p<0.001). The HRV variables SDRR, RMSSD and SD1 decreased in response to training and lowest values were reached during mounting of a rider (p<0.001). Thereafter RR interval and HRV variables increased again. In contrast, SD2 increased with the beginning of lunging (p<0.05) and no changes in response to mounting were detectable. In conclusion, initial training is a stressor for horses. The most pronounced reaction occurred in response to mounting by a rider, a situation resembling a potentially lethal threat under natural conditions. Copyright (c) 2010 Elsevier Inc. All rights reserved.

An exploration of exercise training effects in coronary heart disease.

PubMed

Piperidou, Eleana; Bliss, Julie

2008-06-01

Coronary Heart Disease (CHD) remains the most common cause of death and disability in many developed and developing countries. The evidence presented so far, clearly shows that exercise training leads to favourable improvements in exercise capacity, lipid levels, weight and psychosocial variables for CHD patients. Nevertheless, despite recommendations and government support, the lack of physical activity remains a major health problem, particularly for people with established CHD. The aim of this review was to explore the effects of exercise training on physical and psychosocial function among CHD patients, by analysing the content of relevant research reports. The findings showed that although there is sufficient evidence that exercise training has a number of effects that are beneficial in treatment and secondary prevention of CHD, different aspects of exercise characteristics (mode, frequency, intensity and duration) for different cardiac patient groups, warrant additional investigation.

The use of mixed-method, part-body pre-cooling procedures for team-sport athletes training in the heat.

PubMed

Duffield, Rob; Steinbacher, Geoff; Fairchild, Timothy J

2009-12-01

The current study investigated the effects of a pre-cooling intervention on physiological and performance responses to team-sport training in the heat. Seven male lacrosse players performed a familiarization session and 2 randomized, counterbalanced sessions consisting of a 30-minute intermittent-sprint conditioning session. Prior to the sessions, players performed a 20-minute mixed-method, part-body cooling intervention (consisting of cooling vests, cold towels to the neck, and ice packs to the quadriceps) or no cooling intervention. Performance was determined from collection of 1 Hz global positioning system (GPS) data and analyzed for distance and speed. Prior to, during, and following the sessions, core temperature, heart rate, rating of perceived exertion (RPE), and thermal sensation scale (TSS) were measured; additionally, a venous blood sample was collected before and after each session for measurement of interleukin-6 (IL-6), insulin-like growth factor (IGF-1) and insulin-like growth factor-binding protein3 (IGF-BP3). Results indicated that a greater distance was covered during the pre-cooling condition (3.35 +/- 0.20 vs. 3.11 +/- 0.13 km; p = 0.05). Further, most of this improvement was evident from a greater distance covered during moderate intensities of 7 to 14 km/h (2.28 +/- 0.18 vs. 2.00 +/- 0.24 km; p = 0.05). Peak speeds and very-high-intensity efforts (20 km/h +/-) were not different between conditions (p > 0.05). The increase in core temperature was blunted following cooling, with a lower core temperature throughout the cooling session (38.8 +/- 0.3 vs. 39.3 +/- 0.4 degrees C; p < 0.05). However, there were no differences in heart rate, RPE, TSS, IL-6, IGF-1, or IGF-BP3 between conditions (p > 0.05). Accordingly, the use of a mixed-method, part-body cooling intervention prior to an intermittent-sprint training session in the heat can assist in reducing thermoregulatory load and improve aspects of training performance for team sports.

A National Survey of Cardiopulmonary Resuscitation Training for the Deaf.

ERIC Educational Resources Information Center

Beck, Kenneth H.; Tomasetti, James A.

1983-01-01

Responses to a national survey by regional directors of the American Heart Association, American National Red Cross, and continuing education programs for the deaf indicated that little is done to train the deaf in cardiopulmonary resuscitation and that communication barriers and inadequate training resources are major reasons. (Author)

High intensity interval training versus moderate intensity continuous training on exercise capacity and quality of life in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis.

PubMed

Gomes Neto, Mansueto; Durães, André Rodrigues; Conceição, Lino Sergio Rocha; Saquetto, Micheli Bernardone; Ellingsen, Øyvind; Carvalho, Vitor Oliveira

2018-06-15

The aim of this study was to investigate the effects of high intensity interval training (HIIT) versus moderate intensity continuous training (MICT) in heart failure patients with reduced ejection fraction (HFrEF). Despite the well-known positive effects of exercise in heart failure patients, the best mode of exercise is still under discussion. We searched Pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (from the earliest date available to October 2017) for randomized controlled trials that evaluated the effects of HIIT versus MICT in HFrEF patients. Weighted mean differences (WMD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I 2 test. 13 studies met the study criteria, including 411 patients. Compared to MICT, HIIT resulted in improvement in Peak VO 2 WMD (1.35 mL·kg -1 ·min -1 95% CI: 0.03 to 2.64 N = 411). HIIT resulted in no difference in VE/VCO 2 slope WMD (-1.21 95% CI: -3.0 to 0.58 N = 135), and quality of life measured by Minnesota Living with Heart Failure questionnaire WMD (1.19 95% CI: -5.81 to 8.19 N = 79). Sub-group analyses comparing studies with and without isocaloric exercise training protocol also showed a nonsignificant difference in peak VO 2 for participants in the HIIT group compared with MICT group. HIIT improves peak VO 2 and should be considered as a component of care of HFrEF patients. However, its superiority versus MICT disappears when isocaloric protocols are compared. An important caveat is uncertainty and variation of actual training intensities compared to program targets. Copyright © 2018 Elsevier B.V. All rights reserved.

Swim-exercised mice show a decreased level of protein O-GlcNAcylation and expression of O-GlcNAc transferase in heart.

PubMed

Belke, Darrell D

2011-07-01

Swim-training exercise in mice leads to cardiac remodeling associated with an improvement in contractile function. Protein O-linked N-acetylglucosamine (O-GlcNAcylation) is a posttranslational modification of serine and threonine residues capable of altering protein-protein interactions affecting gene transcription, cell signaling pathways, and general cell physiology. Increased levels of protein O-GlcNAcylation in the heart have been associated with pathological conditions such as diabetes, ischemia, and hypertrophic heart failure. In contrast, the impact of physiological exercise on protein O-GlcNAcylation in the heart is currently unknown. Swim-training exercise in mice was associated with the development of a physiological hypertrophy characterized by an improvement in contractile function relative to sedentary mice. General protein O-GlcNAcylation was significantly decreased in swim-exercised mice. This effect was mirrored in the level of O-GlcNAcylation of individual proteins such as SP1. The decrease in protein O-GlcNAcylation was associated with a decrease in the expression of O-GlcNAc transferase (OGT) and glutamine-fructose amidotransferase (GFAT) 2 mRNA. O-GlcNAcase (OGA) activity was actually lower in swim-trained than sedentary hearts, suggesting that it did not contribute to the decreased protein O-GlcNAcylation. Thus it appears that exercise-induced physiological hypertrophy is associated with a decrease in protein O-GlcNAcylation, which could potentially contribute to changes in gene expression and other physiological changes associated with exercise.

Cardiovascular responses to a high-volume continuous circuit resistance training protocol.

PubMed

Gotshalk, Lincoln A; Berger, Richard A; Kraemer, William J

2004-11-01

The purpose of this investigation was to determine the level of cardiovascular stress elicited by continuous and prolonged circuit resistance training (CRT). Each of the 11 men who volunteered as a subject were tested to determine oxygen consumption and heart rate responses to a submaximal and maximal treadmill protocol and a CRT session consisting of 10 exercises and 10 repetitions at 40% of 1 repetition maximum (1RM) for each station with 4.6 circuits performed. The physiological stress of the CRT in this study was evident by the sustained heart rate of more than 70% of maximum for 16.6 minutes, with the last 12 minutes at more than 80%. Despite the large anaerobic component in CRT, Vo(2) was sustained at 50% or more of maximum for the final 12 minutes. Treadmill running, involving large muscle groups, increased Vo(2) more rapidly than CRT, where alternating larger and smaller muscle groups were used. In addition, at the same Vo(2) heart rate differed significantly between the 2 modes of activity. Heart rate in CRT was higher (at 165) than the heart rate of 150 found during treadmill running at the same 50% Vo(2). Such workouts may be used in a training cycle in classical linear periodization or in a nonlinear program day targeting local muscular endurance under intense cardiorespiratory conditions, which may help individuals develop enhanced toleration of physiological environments where high cardiovascular demands and higher lactate concentrations are present.

Economic Evaluation of the HF-ACTION Randomized Controlled Trial: An Exercise Training Study of Patients With Chronic Heart Failure

PubMed Central

Reed, Shelby D.; Whellan, David J.; Li, Yanhong; Friedman, Joëlle Y.; Ellis, Stephen J.; Piña, Ileana L.; Settles, Sharon J.; Davidson-Ray, Linda; Johnson, Johanna L.; Cooper, Lawton S.; O’Connor, Christopher M.; Schulman, Kevin A.

2011-01-01

Background HF-ACTION assigned 2331 outpatients with medically stable heart failure to exercise training or usual care. We compared medical resource use and costs incurred by these patients during follow-up. Methods and Results Extensive data on medical resource use and hospital bills were collected throughout the trial for estimates of direct medical costs. Intervention costs were estimated using patient-level trial data, administrative records, and published unit costs. Mean follow-up was 2.5 years. There were 2297 hospitalizations in the exercise group and 2332 in the usual care group (P = .92). The mean number of inpatient days was 13.6 (SD, 27.0) in the exercise group and 15.0 (SD, 31.4) in the usual care group (P = .23). Other measures of resource use were similar between groups, except for trends indicating that fewer patients in the exercise group underwent high-cost inpatient procedures. Total direct medical costs per participant were an estimated $50,857 (SD, $81,488) in the exercise group and $56,177 (SD, $92,749) in the usual care group (95% confidence interval for the difference, $–12,755 to $1547; P = .10). The direct cost of exercise training was an estimated $1006 (SD, $337). Patient time costs were an estimated $5018 (SD, $4600). Conclusions The cost of exercise training was relatively low for the health care system, but patients incurred significant time costs. In this economic evaluation, there was little systematic benefit in terms of overall medical resource use with this intervention. Trial Registration clinicaltrials.gov Identifier: NCT00047437 PMID:20551371

Tai Chi training for patients with coronary heart disease.

PubMed

Lan, Ching; Chen, Ssu-Yuan; Wong, May-Kuen; Lai, Jin-Shin

2008-01-01

Coronary heart disease (CHD) is the leading cause of death in the developed countries and many developing countries. Exercise training is the cornerstone of cardiac rehabilitation program for patients with CHD, and exercise intensities in the 50-70% heart rate reserve have been shown to improve functional capacity. However, recent studies found exercise with lower intensity also displayed benefits to CHD patients, and increased the acceptance of exercise program, particularly unfit and elderly patients. Tai Chi Chuan (TC) is a traditional conditioning exercise in the Chinese community, and recently it has become more popular in the Western societies. The exercise intensity of TC is low to moderate, depending on the training style, posture and duration. Participants can choose to perform a complete set of TC or selected movements according to their needs. Previous research substantiates that TC enhances aerobic capacity, muscular strength, endothelial function and psychological wellbeing. In addition, TC reduces some cardiovascular risk factors, such as hypertension and dyslipidemia. Recent studies have also proved that TC is safe and effective for patients with myocardial infarction, coronary bypass surgery and heart failure. Therefore, TC may be prescribed as an alternative exercise program for selected patients with cardiovascular diseases. In conclusion, TC has potential benefits for patients with CHD, and is appropriate for implementation in the community.

Experimental Evidences Supporting the Benefits of Exercise Training in Heart Failure.

PubMed

Ichige, Marcelo H A; Pereira, Marcelo G; Brum, Patrícia C; Michelini, Lisete C

2017-01-01

Heart Failure (HF), a common end point for many cardiovascular diseases, is a syndrome with a very poor prognosis. Although clinical trials in HF have achieved important outcomes in reducing mortality, little is known about functional mechanisms conditioning health improvement in HF patients. In parallel with clinical studies, basic science has been providing important discoveries to understand the mechanisms underlying the pathophysiology of HF, as well as to identify potential targets for the treatment of this syndrome. In spite of being the end-point of cardiovascular derangements caused by different etiologies, autonomic dysfunction, sympathetic hyperactivity, oxidative stress, inflammation and hormonal activation are common factors involved in the progression of this syndrome. Together these causal factors create a closed link between three important organs: brain, heart and the skeletal muscle. In the past few years, we and other groups have studied the beneficial effects of aerobic exercise training as a safe therapy to avoid the progression of HF. As summarized in this chapter, exercise training, a non-pharmacological tool without side effects, corrects most of the HF-induced neurohormonal and local dysfunctions within the brain, heart and skeletal muscles. These adaptive responses reverse oxidative stress, reduce inflammation, ameliorate neurohormonal control and improve both cardiovascular and skeletal muscle function, thus increasing the quality of life and reducing patients' morbimortality.

Effects of high intensity interval versus moderate continuous training on markers of ventilatory and cardiac efficiency in coronary heart disease patients.

PubMed

Cardozo, Gustavo G; Oliveira, Ricardo B; Farinatti, Paulo T V

2015-01-01

We tested the hypothesis that high intensity interval training (HIIT) would be more effective than moderate intensity continuous training (MIT) to improve newly emerged markers of cardiorespiratory fitness in coronary heart disease (CHD) patients, as the relationship between ventilation and carbon dioxide production (VE/VCO2 slope), oxygen uptake efficiency slope (OUES), and oxygen pulse (O2P). Seventy-one patients with optimized treatment were randomly assigned into HIIT (n = 23, age = 56 ± 12 years), MIT (n = 24, age = 62 ± 12 years), or nonexercise control group (CG) (n = 24, age = 64 ± 12 years). MIT performed 30 min of continuous aerobic exercise at 70-75% of maximal heart rate (HRmax), and HIIT performed 30 min sessions split in 2 min alternate bouts at 60%/90% HRmax (3 times/week for 16 weeks). No differences among groups (before versus after) were found for VE/VCO2 slope or OUES (P > 0.05). After training the O2P slope increased in HIIT (22%, P < 0.05) but not in MIT (2%, P > 0.05), while decreased in CG (-20%, P < 0.05) becoming lower versus HIIT (P = 0.03). HIIT was more effective than MIT for improving O2P slope in CHD patients, while VE/VCO2 slope and OUES were similarly improved by aerobic training regimens versus controls.

Exercise training in adults with repaired tetralogy of Fallot: A randomized controlled pilot study of continuous versus interval training.

PubMed

Novaković, Marko; Prokšelj, Katja; Rajkovič, Uroš; Vižintin Cuderman, Tjaša; Janša Trontelj, Katja; Fras, Zlatko; Jug, Borut

2018-03-15

Adults with repaired tetralogy of Fallot (ToF) have impaired exercise capacity, vascular and cardiac autonomic function, and quality of life (QoL). Specific effects of high-intensity interval or moderate continuous exercise training on these parameters in adults with repaired ToF remain unknown. Thirty adults with repaired ToF were randomized to either high-intensity interval, moderate intensity continuous training (36 sessions, 2-3 times a week) or usual care (no supervised exercise). Exercise capacity, flow-mediated vasodilation, pulse wave velocity, NT-proBNP and fibrinogen levels, heart rate variability and recovery, and QoL (SF-36 questionnaire) were determined at baseline and after the intervention period. Twenty-seven patients (mean age 39±9years, 63% females, 9 from each group) completed this pilot study. Both training groups improved in at least some parameters of cardiovascular health compared to no exercise. Interval-but not continuous-training improved VO2peak (21.2 to 22.9ml/kg/min, p=0.004), flow-mediated vasodilation (8.4 to 12.9%, p=0.019), pulse wave velocity (5.4 to 4.8m/s, p=0.028), NT-proBNP (202 to 190ng/L, p=0.032) and fibrinogen levels (2.67 to 2.46g/L, p=0.018). Conversely, continuous-but not interval-training improved heart rate variability (low-frequency domain, 0.32 to 0.22, p=0.039), heart rate recovery after 2min post-exercise (40 to 47 beats, p=0.023) and mental domain of SF-36 (87 to 95, p=0.028). Both interval and continuous exercise training modalities were safe. Interval training seems more efficacious in improving exercise capacity, vascular function, NT-proBNP and fibrinogen levels, while continuous training seems more efficacious in improving cardiac autonomic function and QoL. (Clinicaltrials.gov, NCT02643810). Copyright © 2018 Elsevier Ireland Ltd. All rights reserved.

Dissociation of heart rate variability and heart rate recovery in well-trained athletes.

PubMed

Lee, C Matthew; Mendoza, Albert

2012-07-01

The purpose of this investigation was to examine the relationships between aerobic fitness, volume of physical activity (PA), heart rate variability (HRV), and heart rate recovery (HRR) in a group of well-trained endurance athletes. Nineteen endurance athletes participated in this study and had aerobic capacities that placed them above the 99th percentile based on normative values (VO(2max): 67.1 ± 2 ml kg(-1) min(-1)). HRV was obtained via an EKG collected during supine rest and reported as high-frequency (HF), low-frequency (LF), and total power (TP). Natural log (ln) transformation was applied when variables violated assumptions of normality. HRR recovery was reported as the reduction in heart rate from peak exercise to the heart rate 1 min after cessation of exercise and PA was estimated from a questionnaire. HRR was significantly correlated with PA and VO(2max) (r = 0.67, P = 0.003 and 0.51, P = 0.039, respectively), but not with any index of HRV. Age was significantly correlated with lnHF (r = -0.49, P = 0.033), lnLF/lnHF (r = 0.48, P = 0.037), and normalized units (NU) of LF (r = 0.47, P = 0.042) and HF (r = -0.47, P = 0.042). Stepwise regression revealed that the strongest predictor of HRR was PA (R (2) = 0.45) and that VO(2max) did not add significant predictive value to the model. The relationship between HRV and age is evident in well-trained endurance athletes, whereas the relationship between HRV and PA/aerobic fitness is not. The maintained relationship between HRR and PA/aerobic fitness suggests that HRR may be a better marker of fitness-related differences in autonomic control in this population.

Analysis of the characteristics of competitive badminton

PubMed Central

Cabello, M; Gonzalez-Badillo, J

2003-01-01

Objective: To describe the characteristics of badminton in order to determine the energy requirements, temporal structure, and movements in the game that indicate performance level. To use the findings to plan training with greater precision. Methods: Eleven badminton players (mean (SD) age 21.8 (3.26) years) with international experience from four different countries (France, Italy, Spain, and Portugal) were studied. Two of the Spanish players were monitored in several matches, giving a total of 14 samples, all during the 1999 Spanish International Tournament. Blood lactate concentration was measured with a reflective photometer. Maximum and average heart rates were recorded with a heart rate monitor. Temporal structure and actions during the matches were determined from video recordings. All variables were measured during and after the game and later analysed using a descriptive study. Results: The results confirmed the high demands of the sport, with a maximum heart rate of 190.5 beats/min and an average of 173.5 beats/min during matches over 28 minutes long and performance intervals of 6.4 seconds and rest time of 12.9 seconds between exchanges. Conclusions: The results suggest that badminton is characterised by repetitive efforts of alactic nature and great intensity which are continuously performed throughout the match. An awareness of these characteristics, together with data on the correlations between certain actions such as unforced errors and winning shots and the final result of the match, will aid in more appropriate planning and monitoring of specific training. PMID:12547746

Nandrolone Plus Moderate Exercise Increases the Susceptibility to Lethal Arrhythmias

PubMed Central

Ghorbani Baravati, Hamideh; Joukar, Siyavash; Fathpour, Hossein; Kordestani, Zeinab

2015-01-01

Background: Until now, no experimental study has directly assessed the arrhythmogenesis of chronic consumption of anabolic androgenic steroids along with moderate-intensity endurance exercise. Objectives: We evaluated the influence of integration of anabolic androgenic steroids along with moderate-intensity endurance exercise on susceptibility to lethal ventricular arrhythmias in rat. Materials and Methods: The animal groups were as follows: control group (CTL); exercise group (EX) which were under 6 weeks of treadmill exercise; nandrolone group (Nan) which received 5 mg/kg of nandrolone decanoate twice a week; vehicle group (Arach) which received Arachis oil (solvent of nandrolone); trained vehicle group (Arach + Ex); and trained nandrolone group (Nan + Ex). One day after ending of the intervention period, arrhythmia was inducted by intravenous infusion of aconitine and ventricular arrhythmias were recorded. Then malondialdehyde (MDA) and glutathione peroxidase (GPX) of heart tissue were measured. Results: Nandrolone, exercise, and their combination were associated with heart hypertrophy. Exercise could prevent the incremental effect of nandrolone on MDA/GPX ratio. Chronic administration of nandrolone with moderate-intensity endurance exercise had no significant effect on blood pressure, heart rate, and basal electrocardiographic parameters. Combination of nandrolone and exercise significantly increased the incidence of ventricular fibrillation (VF) and reduced the VF latency (P < 0.05). Conclusions: The findings suggest that chronic coadministration of nandrolone with moderate-intensity endurance exercise facilitates the VF occurrence in rat. Complementary studies are needed to elucidate the involved mechanisms of this abnormality. PMID:26396972

The effect of heart failure nurse consultations on heart failure patients' illness beliefs, mood and quality of life over a six-month period.

PubMed

Lucas, Rebecca; Riley, Jillian P; Mehta, Paresh A; Goodman, Helen; Banya, Winston; Mulligan, Kathleen; Newman, Stanton; Cowie, Martin R

2015-01-01

To explore the effect contact with a heart failure nurse can have on patients' illness beliefs, mood and quality of life. There is growing interest in patients' illness beliefs and the part they play in a patients understanding of chronic disease. Secondary analysis on two independent datasets. Patients were recruited from five UK hospitals, four in London and one in Sussex. Patients were recruited from an inpatient and outpatient setting. The first dataset recruited 174 patients with newly diagnosed heart failure, whilst the second dataset recruited 88 patients with an existing diagnosis of heart failure. Patients completed the Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale, Illness Perception Questionnaire and the Treatment Representations Inventory at baseline and six months. We used a linear regression model to assess the association that contact with a heart failure nurse had on mood, illness beliefs and quality of life over a six-month period. Patients who had contact with a heart failure nurse were more satisfied with their treatment and more likely to believe that their heart failure was treatable. Contact with a heart failure nurse did not make a statistically significant difference to mood or quality of life. This study has shown that contact with a heart failure nurse can improve patient satisfaction with treatment decisions but has less influence on a patient's beliefs about their personal control, treatment control and treatment concerns. With appropriate support, skills and training, heart failure nurses could play an important role in addressing individual patient's beliefs. There is a need to further investigate this. Exploring patients' illness beliefs and mood could help to enhance person-centred care. Heart failure nurses would need additional training in the techniques used. © 2014 John Wiley & Sons Ltd.

Isometric handgrip training reduces arterial pressure at rest without changes in sympathetic nerve activity

NASA Technical Reports Server (NTRS)

Ray, C. A.; Carrasco, D. I.

2000-01-01

The purpose of this study was to determine whether isometric handgrip (IHG) training reduces arterial pressure and whether reductions in muscle sympathetic nerve activity (MSNA) mediate this drop in arterial pressure. Normotensive subjects were assigned to training (n = 9), sham training (n = 7), or control (n = 8) groups. The training protocol consisted of four 3-min bouts of IHG exercise at 30% of maximal voluntary contraction (MVC) separated by 5-min rest periods. Training was performed four times per week for 5 wk. Subjects' resting arterial pressure and heart rate were measured three times on 3 consecutive days before and after training, with resting MSNA (peroneal nerve) recorded on the third day. Additionally, subjects performed IHG exercise at 30% of MVC to fatigue followed by muscle ischemia. In the trained group, resting diastolic (67 +/- 1 to 62 +/- 1 mmHg) and mean arterial pressure (86 +/- 1 to 82 +/- 1 mmHg) significantly decreased, whereas systolic arterial pressure (116 +/- 3 to 113 +/- 2 mmHg), heart rate (67 +/- 4 to 66 +/- 4 beats/min), and MSNA (14 +/- 2 to 15 +/- 2 bursts/min) did not significantly change following training. MSNA and cardiovascular responses to exercise and postexercise muscle ischemia were unchanged by training. There were no significant changes in any variables for the sham training and control groups. The results indicate that IHG training is an effective nonpharmacological intervention in lowering arterial pressure.

Comparison of Methods for Determining Aerobic Exercise Intensity Using Heart Rate in Acute Leukemia Patients Prior to Induction Chemotherapy

PubMed Central

Story, Christina; Bryant, Ashley Leak; Phillips, Brett; Bailey, Charlotte; Shields, Edgar W.; Battaglini, Claudio

2018-01-01

Introduction Cardiopulmonary exercise testing (CPET), the gold standard of cardiopulmonary evaluation, is used to determine VO2 levels at different aerobic exercise training intensities; however, it may not be feasible to conduct CPET in all clinical settings. Aims To compare the heart rate reserve (HRR) and percent of 220-age methods for prescribing cycle ergometry exercise intensity using heart rate (HR) against the HRs obtained during a CPET in adults undergoing treatment for acute leukemia (AL). Methods In this exploratory study, part of a larger randomized controlled trial, 14 adults with AL completed CPET on a cycle ergometer with indirect calorimetry within 96 hr of admission to a cancer hospital to determine VO2peak and HR corresponding to low (40% VO2peak), moderate (60% VO2peak), and high (75% VO2peak) exercise intensities. Analyses of variance were used to compare estimated HR for each intensity level using the HRR and percent of 220-age methods with HR determined via VO2peak. Results HR corresponding to low-intensity exercise differed significantly across all three methods (p ≤ .05). No significant differences were observed between HR estimated via the percent of 220-age method and determined via VO2peak at moderate (100 ± 8 and 113 ± 24 bpm, p = .122) or high intensities (125 ± 10 and 123 ± 25 bpm, p = .994). Conclusion In adults with AL, HR-based methods for defining aerobic exercise intensities should be used with caution. At low intensity, neither should be used, while at moderate and high intensities, the percent of 220-age equation might serve as an adequate substitute for CPET. PMID:26933148

Noninvasive Determination of Anaerobic Threshold Based on the Heart Rate Deflection Point in Water Cycling.

PubMed

Pinto, Stephanie S; Brasil, Roxana M; Alberton, Cristine L; Ferreira, Hector K; Bagatini, Natália C; Calatayud, Joaquin; Colado, Juan C

2016-02-01

This study compared heart rate (HR), oxygen uptake (VO2), percentage of maximal HR (%HRmax), percentage of maximal VO2, and cadence (Cad) related to the anaerobic threshold (AT) during a water cycling maximal test between heart rate deflection point (HRDP) and ventilatory (VT) methods. In addition, the correlations between both methods were assessed for all variables. The test was performed by 27 men in a cycle ergometer in an aquatic environment. The protocol started at a Cad of 100 b · min(-1) for 3 minutes with subsequent increments of 15 b · min(-1) every 2 minutes until exhaustion. A paired two-tailed Student's t-test was used to compare the variables between the HRDP and VT methods. The Pearson product-moment correlation test was used to correlate the same variables determined by the 2 methods. There was no difference in HR (166 ± 13 vs. 166 ± 13 b · min(-1)), VO2 (38.56 ± 6.26 vs. 39.18 ± 6.13 ml · kg(-1) · min(-1)), %HRmax (89.24 ± 3.84 vs. 89.52 ± 4.29%), VO2max (70.44 ± 7.99 vs. 71.64 ± 8.32%), and Cad (174 ± 14 b · min(-1) vs. 171 ± 8 b · min(-1)) related to AT between the HRDP and VT methods. Moreover, significant relationships were found between the methods to determine the AT for all variables analyzed (r = 0.57-0.97). The estimation of the HRDP may be a noninvasive and easy method to determine the AT, which could be used to adapt individualized training intensities to practitioners during water cycling classes.

Salud Para Su Corazon-NCLR: a comprehensive Promotora outreach program to promote heart-healthy behaviors among hispanics.

PubMed

Balcazar, Hector; Alvarado, Matilde; Hollen, Mary Luna; Gonzalez-Cruz, Yanira; Hughes, Odelinda; Vazquez, Esperanza; Lykens, Kristine

2006-01-01

This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed.

Much potential but many unanswered questions for high-intensity intermittent exercise training for patients with heart failure.

PubMed

Pinkstaff, Sherry O

2015-01-01

There is a robust trove of scientific studies that support the positive physical and mental health benefits associated with aerobic exercise for healthy individuals. These recommendations suggest that more vigorous exercise can be performed on fewer days for the same benefit. High-intensity intermittent exercise (HIIE) training has begun to show promise. HIIE seems safe and improves physiology, quality of life, and functional capacity. This review defines HIIE, discusses its physiologic benefit for patients with heart failure, outlines the studies that have been conducted to date, and places it in the context of the current clinical environment of exercise training for these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III).

PubMed

Vanhees, L; Rauch, B; Piepoli, M; van Buuren, F; Takken, T; Börjesson, M; Bjarnason-Wehrens, B; Doherty, P; Dugmore, D; Halle, M

2012-12-01

The beneficial effect of exercise training and exercise-based cardiac rehabilitation on symptom-free exercise capacity,cardiovascular and skeletal muscle function, quality of life, general healthy lifestyle, and reduction of depressive symptoms and psychosocial stress is nowadays well recognized. However, it remains largely obscure, which characteristics of physical activity (PA) and exercise training--frequency, intensity, time (duration), type (mode), and volume (dose: intensity x duration) of exercise--are the most effective. The present paper, therefore, will deal with these exercise characteristics in the management of individuals with cardiovascular disease, i.e. coronary artery disease and chronic heart failure patients, but also in patients with congenital or valvular heart disease. Based on the current literature, and if sufficient evidence is available, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding frequency, intensity, time and type of PA, and safety aspects during exercise inpatients with cardiovascular disease. This paper is the third in a series of three papers, all devoted to the same theme: the importance of the exercise characteristics in the management of cardiovascular health. Part I is directed to the general population and Part II to individuals with cardiovascular risk factors. In general, PA recommendations and exercise training programmes for patients with coronary artery disease or chronic heart failure need to be tailored to the individual's exercise capacity and risk profile, with the aim to reach and maintain the individually highest fitness level possible and to perform endurance exercise training 30–60 min daily (3–5 days per week) in combination with resistance training 2–3 times a week. Because of the frequently reported dose–response relationship between training effect and exercise intensity, one should seek sufficiently high training intensities, although more scientific evidence on effect sizes and safety is warranted. At present, there is insufficient data to give more specific recommendations on type, dosage, and intensity of exercise in some other cardiovascular diseases, such as congenital heart disease, valve disease, cardiomyopathies, channelopathies, and patients with implanted devices.

Heart ABCA1 and PPAR- α Genes Expression Responses in Male rats: Effects of High Intensity Treadmill Running Training and Aqueous Extraction of Black Crataegus-Pentaegyna.

PubMed

Ghanbari-Niaki, Abbass; Ghanbari-Abarghooi, Safieyh; Rahbarizadeh, Fatemeh; Zare-Kookandeh, Navabeh; Gholizadeh, Monireh; Roudbari, Fatemeh; Zare-Kookandeh, Asghar

2013-11-01

Heart as a high metabolic and aerobic tissue is consuming lipid as a fuel for its energy provision at rest during light and moderate exercise, except when lactate level is higher in blood circulation. It has been shown that any type of regular exercise and crataegus species would improve cardiovascular function and minimizes several risk factors via stimulating lipid metabolism by acting on enzymes and genes expression such as ABCA1 and PPAR α which are involving in this process. Twenty Wistar male rats (4-6 weeks old, 140-173 g weight) were used. Animals were randomly classified into training (n = 10) and control (n = 10) groups and then divided into saline-control (SC), saline-training (ST), Crataegus-Pentaegyna -control (CPC), and Crataegus-Pentaegyna -training (CPT) groups. Training groups have performed a high-intensity running program (at 34 m/min (0% grade), 60 min/day, 5 days/week) on a motor-driven treadmill for eight weeks. Animals were orally fed with Crataegus-Pentaegyna extraction (500mg/kg) and saline solution for six weeks. Seventy- two hours after the last training session, rats were sacrificed, hearts were excised, cleaned and immediately frozen in liquid nitrogen and stored at -80 °C until RNA extraction. Plasma also was collected for plasma variable measurements. Statistical analysis was performed using a two way analysis of variance, and significance was accepted at P < 0.05. A non-significant (P < 0.4, P < 0.79, respectively) increase in ABCA1 and PPAR α genes expression was accompanied by a significant (P < 0.01, P < 0.04, P < 0.04, respectively) reduction in TC, TG, and VLDL-C levels in Crataegus-Pentaegyna groups. Our findings show that a high intensity treadmill running was able to express ABCA1 and PPAR α in rat heart. Data also possibly indicate that the Crataeguse-Pentaegyna supplementation solely could mimic training effect on the mentioned genes and lipid profiles via different mechanism(s).

A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation.

PubMed

Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Betterton, Edward; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

2017-07-01

With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Application of alpha/theta neurofeedback and heart rate variability training to young contemporary dancers: state anxiety and creativity.

PubMed

Gruzelier, J H; Thompson, T; Redding, E; Brandt, R; Steffert, T

2014-07-01

As one in a series on the impact of EEG-neurofeedback in the performing arts, we set out to replicate a previous dance study in which alpha/theta (A/T) neurofeedback and heart rate variability (HRV) biofeedback enhanced performance in competitive ballroom dancers compared with controls. First year contemporary dance conservatoire students were randomised to the same two psychophysiological interventions or a choreology instruction comparison group or a no-training control group. While there was demonstrable neurofeedback learning, there was no impact of the three interventions on dance performance as assessed by four experts. However, HRV training reduced anxiety and the reduction correlated with improved technique and artistry in performance; the anxiety scale items focussed on autonomic functions, especially cardiovascular activity. In line with the putative impact of hypnogogic training on creativity A/T training increased cognitive creativity with the test of unusual uses, but not insight problems. Methodological and theoretical implications are considered. Copyright © 2013 Elsevier B.V. All rights reserved.

Expression of the Mir-133 and Bcl-2 could be affected by swimming training in the heart of ovariectomized rats.

PubMed

Habibi, Parisa; Alihemmati, Alireza; NourAzar, Alireza; Yousefi, Hadi; Mortazavi, Safieh; Ahmadiasl, Nasser

2016-04-01

The beneficial and more potent role of exercise to prevent heart apoptosis in ovariectomized rats has been known. The aim of this study was to examine the effects of swimming training on cardiac expression of Bcl-2, and Mir-133 levels and glycogen changes in the myocyte. Forty animals were separated into four groups as control, sham, ovariectomy (OVX) and ovariectomized group with 8 weeks swimming training (OVX.E). Training effects were evaluated by measuring lipid profiles, Bcl-2 and Mir-133 expression levels in the cardiac tissue. Grafts were analyzed by reverse transcription-polymerase chain reaction for Bcl-2 mRNA and Mir-133 and by Western blot for Bcl-2 protein. Ovariectomy down-regulated Bcl-2 and Mir-133 expression levels in the cardiac tissue, and swimming training up-regulated their expression significantly (P<0.05). Our results showed that regular exercise as a physical replacement therapy could prevent and improve the effects of estrogen deficiency in the cardia.

Is exercise training safe and beneficial in patients receiving left ventricular assist device therapy?

PubMed

Alsara, Osama; Perez-Terzic, Carmen; Squires, Ray W; Dandamudi, Sanjay; Miranda, William R; Park, Soon J; Thomas, Randal J

2014-01-01

Because a limited number of patients receive heart transplantation, alternative therapies, such as left ventricular assist device (LVAD) therapy, have emerged. Published studies have shown that LVAD implantation, by itself, improves exercise tolerance to the point where it is comparable to those with mild heart failure. The improvement in exercise capacity is maximally achieved 12 weeks after LVAD therapy and can continue even after explantation of the device. This effect varies, depending on the type of LVAD and exercise training. The available data in the literature on safety and benefits of exercise training in patients after LVAD implantation are limited, but the data that are available suggest that training trends to be safe and have an impact on exercise capacity in LVAD patients. Although no studies were identified on the role of cardiac rehabilitation programs in the management of LVAD patients, it appears that cardiac rehabilitation programs offer an ideal setting for the provision of supervised exercise training in this patient group.

Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses.

PubMed

Songstad, Nils Thomas; Kaspersen, Knut-Helge Frostmo; Hafstad, Anne Dragøy; Basnet, Purusotam; Ytrehus, Kirsti; Acharya, Ganesh

2015-01-01

To investigate the effects of high intensity interval training (HIIT) on the maternal heart, fetuses and placentas of pregnant rats. Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85-90% of maximal oxygen consumption) for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats), echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples. Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03), hypoxia-inducible factor 1α (p = 0.04) and glutathione peroxidase 4.2 (p = 0.02) in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014), superoxide dismutase 1 (p = 0.001) and tissue inhibitor of metallopeptidase 3 (p = 0.049) in the fetal heart. Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated.

Effects of creatine supplementation associated with resistance training on oxidative stress in different tissues of rats

PubMed Central

2014-01-01

Background Creatine supplementation is known to exert an effect by increasing strength in high intensity and short duration exercises. There is a hypothesis which suggests that creatine supplementation may provide antioxidant activity by scavenging Reactive Oxygen Species. However, the antioxidant effect of creatine supplementation associated with resistance training has not yet been described in the literature. Therefore, we investigated the effect of creatine monohydrate supplementation associated with resistance training over maximum strength gain and oxidative stress in rats. Methods Forty male Wistar rats (250-300 g, 90 days old) were randomly allocated into 4 groups: Sedentary (SED, n = 10), Sedentary + Creatine (SED-Cr, n = 10), Resistance Training (RT, n = 10) and Resistance Training + Creatine (RT-Cr, n = 10). Trained animals were submitted to the RT protocol (4 series of 10–12 repetitions, 90 second interval, 4 times per week, 65% to 75% of 1MR, for 8 weeks). Results In this study, greater strength gain was observed in the SED-Cr, RT and RT-Cr groups compared to the SED group (P < 0.001). The RT-Cr group showed a higher maximum strength gain when compared to other groups (P < 0.001). Creatine supplementation associated with resistance training was able to reduce lipoperoxidation in the plasma (P < 0.05), the heart (P < 0.05), the liver (P < 0.05) and the gastrocnemius (P < 0.05) when compared to control groups. However, the supplementation had no influence on catalase activity (CAT) in the analyzed organs. Only in the heart was the CAT activity higher in the RT-Cr group (P < 0.05). The activity of superoxide dismutase (SOD) was lower in all of the analyzed organs in the SED-Cr group (P < 0.05), while SOD activity was lower in the trained group and sedentary supplemented group (P < 0.05). Conclusions Creatine was shown to be an effective non-enzymatic antioxidant with supplementation alone and also when it was associated with resistance training in rats. PMID:24655435

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation

PubMed Central

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-01-01

Introduction Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. Methods and analysis This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. Ethics and dissemination The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands—Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. Trial registration number NCT02784873; pre-results. PMID:27852718

An Update: The Cardiac Wellness Training Project.

ERIC Educational Resources Information Center

Zinn, Lorraine; Long, Patrick

1983-01-01

This article reports on the scope of activities and the effectiveness of a Colorado program that trained community park and recreation personnel to carry out local cardiac wellness services. Participants were trained to provide rehabilitation and fitness activities for those recovering from heart attacks or surgery and for other high-risk persons.…

"Speak from Your Heart": Students Grow at AIHEC Leadership Training

ERIC Educational Resources Information Center

Snowball, LaVinia Pauline

2009-01-01

This article describes the activities during the annual Summer Student Leadership Training held July 8-10, 2009, in Santa Fe, New Mexico. The leadership training was attended by thirty-five students from 12 tribal colleges and universities. It was presented by the American Indian Higher Education Consortium (AIHEC) Student Congress at the…

Exercise training dose differentially alters muscle and heart capillary density and metabolic functions in an obese rat with metabolic syndrome.

PubMed

Machado, Marcus Vinicius; Vieira, Aline Bomfim; da Conceição, Fabiana Gomes; Nascimento, Alessandro Rodrigues; da Nóbrega, Antonio Claudio Lucas; Tibirica, Eduardo

2017-12-01

What is the central question of this study? Regular exercise is recommended as a non-pharmacological approach for the prevention and treatment of metabolic syndrome. However, the impact of different combinations of intensity, duration and frequency of exercise on metabolic syndrome and microvascular density has not been reported. What is the main finding and its importance? We provide evidence on the impact of aerobic exercise dose on metabolic and microvascular alterations in an experimental model of metabolic syndrome induced by high-fat diet. We found that the exercise frequency and duration were the main factors affecting anthropometric and metabolic parameters and microvascular density in the skeletal muscle. Exercise intensity was related only to microvascular density in the heart. We evaluated the effect of the frequency, duration and intensity of exercise training on metabolic parameters and structural capillary density in obese rats with metabolic syndrome. Wistar-Kyoto rats were fed either a standard commercial diet (CON) or a high-fat diet (HFD). Animals that received the HFD were randomly separated into either a sedentary (SED) group or eight different exercise groups that varied according to the frequency, duration and intensity of training. After 12 weeks of aerobic exercise training, the body composition, aerobic capacity, haemodynamic variables, metabolic parameters and capillary density in the heart and skeletal muscle were evaluated. All the exercise training groups showed reduced resting systolic blood pressure and heart rate and normalized fasting glucose. The minimal amount of exercise (90 min per week) produced little effect on metabolic syndrome parameters. A moderate amount of exercise (150 min per week) was required to reduce body weight and improve capillary density. However, only the high amount of exercise (300 min per week) significantly reduced the amount of body fat depots. The three-way ANOVA showed a main effect of exercise frequency and duration for the improvement of metabolic syndrome and capillary density in skeletal muscle. Exercise intensity was a main factor in reversing microvascular rarefaction in the heart. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

Improving the well-being of nursing leaders through healing touch training.

PubMed

Tang, Rong; Tegeler, Charles; Larrimore, Deborah; Cowgill, Sally; Kemper, Kathi J

2010-08-01

Chronic stress adversely affects performance. We evaluated the effect of Healing Touch training on subjective and objective measures of stress in nursing leaders in an academic health center. In this quasi-experimental single group pretest-post-test study, we recruited nursing leaders at an academic health center and provided 17.5 hours of Healing Touch training over 2 days. We measured subjective measures of stress using visual analog scales as well as heart rate variability 1-2 weeks before and 4 weeks after the training. Target enrollment was exceeded within 2 weeks; all participants were women and the mean age was 47 years. Of the 26 enrollees, 24 completed training, and 20 (77%) completed all pre- and post-training measures. There was significant improvement in self-reported stress, depression, anxiety, relaxation, well-being, and sleep. Heart rate variability changes were also significant for total power, high- and low-frequency power, and coherence, suggesting improved autonomic function consistent with greater well-being. Training nurse leaders in an academic health center in Healing Touch is associated with significant improvements in subjective and objective measures of stress. Additional studies are needed to compare the impact of this training versus stress management training on the nurses themselves and on the quality of care.

2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

PubMed

Kleinman, Monica E; Goldberger, Zachary D; Rea, Thomas; Swor, Robert A; Bobrow, Bentley J; Brennan, Erin E; Terry, Mark; Hemphill, Robin; Gazmuri, Raúl J; Hazinski, Mary Fran; Travers, Andrew H

2018-01-02

Cardiopulmonary resuscitation is a lifesaving technique for victims of sudden cardiac arrest. Despite advances in resuscitation science, basic life support remains a critical factor in determining outcomes. The American Heart Association recommendations for adult basic life support incorporate the most recently published evidence and serve as the basis for education and training for laypeople and healthcare providers who perform cardiopulmonary resuscitation. © 2017 American Heart Association, Inc.

Early Detection of Heart Failure Using Electronic Health Records: Practical Implications for Time Before Diagnosis, Data Diversity, Data Quantity, and Data Density.

PubMed

Ng, Kenney; Steinhubl, Steven R; deFilippi, Christopher; Dey, Sanjoy; Stewart, Walter F

2016-11-01

Using electronic health records data to predict events and onset of diseases is increasingly common. Relatively little is known, although, about the tradeoffs between data requirements and model utility. We examined the performance of machine learning models trained to detect prediagnostic heart failure in primary care patients using longitudinal electronic health records data. Model performance was assessed in relation to data requirements defined by the prediction window length (time before clinical diagnosis), the observation window length (duration of observation before prediction window), the number of different data domains (data diversity), the number of patient records in the training data set (data quantity), and the density of patient encounters (data density). A total of 1684 incident heart failure cases and 13 525 sex, age-category, and clinic matched controls were used for modeling. Model performance improved as (1) the prediction window length decreases, especially when <2 years; (2) the observation window length increases but then levels off after 2 years; (3) the training data set size increases but then levels off after 4000 patients; (4) more diverse data types are used, but, in order, the combination of diagnosis, medication order, and hospitalization data was most important; and (5) data were confined to patients who had ≥10 phone or face-to-face encounters in 2 years. These empirical findings suggest possible guidelines for the minimum amount and type of data needed to train effective disease onset predictive models using longitudinal electronic health records data. © 2016 American Heart Association, Inc.

Analyses of heart rate variability in young soccer players: the effects of sport activity.

PubMed

Bricout, Véronique-Aurélie; Dechenaud, Simon; Favre-Juvin, Anne

2010-04-19

The use of heart rate variability (HRV) in the management of sport training is a practice which tends to spread, especially in order to prevent the occurrence of states of fatigue. To estimate the HRV parameters obtained using a heart rate recording, according to different loads of sporting activities, and to make the possible link with the appearance of fatigue. Eight young football players, aged 14.6 years+/-2 months, playing at league level in Rhône-Alpes, training for 10 to 20 h per week, were followed over a period of 5 months, allowing to obtain 54 recordings of HRV in three different conditions: (i) after rest (ii) after a day with training and (iii) after a day with a competitive match. Under the effect of a competitive match, the HRV temporal indicators (heart rate, RR interval, and pNN50) were significantly altered compared to the rest day. The analysis of the sympathovagal balance rose significantly as a result of the competitive constraint (0.72+/-0.17 vs. 0.90+/-0.20; p<0.05). The main results obtained show that the HRV is an objective and non-invasive monitoring of management of the training of young sportsmen. HRV analysis allowed to highlight any neurovegetative adjustments according to the physical loads. Thus, under the effect of an increase of physical and psychological constraints that a football match represents, the LF/HF ratio rises significantly; reflecting increased sympathetic stimulation, which beyond certain limits could be relevant to prevent the emergence of a state of fatigue. 2009 Elsevier B.V. All rights reserved.

Acute Effects of Different Types of Resistance Training on Cardiac Autonomic Modulation in COPD.

PubMed

Vanderlei, Franciele M; Zandonadi, Fernando; de Lima, Fabiano Franciso; Silva, Bruna S A; Freire, Ana Paula C F; Ramos, Dionei; Ramos, Ercy Mara C

2018-05-22

An exercise modality that has been gaining significant importance in the rehabilitation of subjects with COPD is resistance training. When considering that patients with COPD present alterations in autonomic cardiac modulation caused by the disease itself, it is necessary to investigate the behavior of the autonomic nervous system in relation to this type of exercise. Thus, the objective of this study was to compare the acute effects of resistance training with elastic tubes, elastic bands, and conventional weightlifitng on the behavior of cardiac autonomic modulation in post-exercise recovery in subjects with COPD. Thirty-four subjects with COPD performed an single session of resistance training divided according to the therapeutic resource used: elastic tubes ( n = 10), elastic bands ( n = 11), and conventional bodybuilding ( n = 13). For analysis of cardiac autonomic modulation, the heart rate was obtained beat to beat at rest and immediately after the end of the session for 60 min in a seated position. Heart rate variability indices were obtained in the time and frequency domains. The 3 therapeutic resource types used in the single session of resistance training promoted changes in heart rate variability linear indices in the time and frequency domains; however, post-exercise recovery time was similar for all protocols performed. After single resistance training the elastic tubes group presented a minimum alteration in the post-exercise recovery of cardiac autonomic modulation in the subjects with COPD; however, at 5 min after exercising, the subjects with COPD had already recovered. Therefore, if the purpose of the training is to restore autonomic cardiac modulation, the use of elastic tubes is suggested, when considering their low cost and versatility. Copyright © 2018 by Daedalus Enterprises.

Modeling temporal sequences of cognitive state changes based on a combination of EEG-engagement, EEG-workload, and heart rate metrics

PubMed Central

Stikic, Maja; Berka, Chris; Levendowski, Daniel J.; Rubio, Roberto F.; Tan, Veasna; Korszen, Stephanie; Barba, Douglas; Wurzer, David

2014-01-01

The objective of this study was to investigate the feasibility of physiological metrics such as ECG-derived heart rate and EEG-derived cognitive workload and engagement as potential predictors of performance on different training tasks. An unsupervised approach based on self-organizing neural network (NN) was utilized to model cognitive state changes over time. The feature vector comprised EEG-engagement, EEG-workload, and heart rate metrics, all self-normalized to account for individual differences. During the competitive training process, a linear topology was developed where the feature vectors similar to each other activated the same NN nodes. The NN model was trained and auto-validated on combat marksmanship training data from 51 participants that were required to make “deadly force decisions” in challenging combat scenarios. The trained NN model was cross validated using 10-fold cross-validation. It was also validated on a golf study in which additional 22 participants were asked to complete 10 sessions of 10 putts each. Temporal sequences of the activated nodes for both studies followed the same pattern of changes, demonstrating the generalization capabilities of the approach. Most node transition changes were local, but important events typically caused significant changes in the physiological metrics, as evidenced by larger state changes. This was investigated by calculating a transition score as the sum of subsequent state transitions between the activated NN nodes. Correlation analysis demonstrated statistically significant correlations between the transition scores and subjects' performances in both studies. This paper explored the hypothesis that temporal sequences of physiological changes comprise the discriminative patterns for performance prediction. These physiological markers could be utilized in future training improvement systems (e.g., through neurofeedback), and applied across a variety of training environments. PMID:25414629

Deep convolutional networks for pancreas segmentation in CT imaging

NASA Astrophysics Data System (ADS)

Roth, Holger R.; Farag, Amal; Lu, Le; Turkbey, Evrim B.; Summers, Ronald M.

2015-03-01

Automatic organ segmentation is an important prerequisite for many computer-aided diagnosis systems. The high anatomical variability of organs in the abdomen, such as the pancreas, prevents many segmentation methods from achieving high accuracies when compared to state-of-the-art segmentation of organs like the liver, heart or kidneys. Recently, the availability of large annotated training sets and the accessibility of affordable parallel computing resources via GPUs have made it feasible for "deep learning" methods such as convolutional networks (ConvNets) to succeed in image classification tasks. These methods have the advantage that used classification features are trained directly from the imaging data. We present a fully-automated bottom-up method for pancreas segmentation in computed tomography (CT) images of the abdomen. The method is based on hierarchical coarse-to-fine classification of local image regions (superpixels). Superpixels are extracted from the abdominal region using Simple Linear Iterative Clustering (SLIC). An initial probability response map is generated, using patch-level confidences and a two-level cascade of random forest classifiers, from which superpixel regions with probabilities larger 0.5 are retained. These retained superpixels serve as a highly sensitive initial input of the pancreas and its surroundings to a ConvNet that samples a bounding box around each superpixel at different scales (and random non-rigid deformations at training time) in order to assign a more distinct probability of each superpixel region being pancreas or not. We evaluate our method on CT images of 82 patients (60 for training, 2 for validation, and 20 for testing). Using ConvNets we achieve maximum Dice scores of an average 68% +/- 10% (range, 43-80%) in testing. This shows promise for accurate pancreas segmentation, using a deep learning approach and compares favorably to state-of-the-art methods.

High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction.

PubMed

Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

2017-02-28

Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT ( P =0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P =0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P =0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake ( P =0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P =0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00917046. © 2017 The Authors.

[Endurance training and cardial adaptation (athlete's heart)].

PubMed

Dickhuth, Hans-Hermann; Röcker, Kai; Mayer, Frank; König, Daniel; Korsten-Reck, Ulrike

2004-06-01

One essential function of the cardiovascular system is to provide an adequate blood supply to all organs, including the skeletal muscles at rest and during exercise. Adaptation to chronic exercise proceeds mainly via the autonomic nervous system. On the one hand, peripheral muscles influence the autonomic reactions through "feedback" control via ergoreceptors, in particular, mechano- and chemoreceptors. On the other hand, there is central control in the sense of a "feed forward" regulation, e. g., the reaction of an athlete before competition. Along with other influential factors, such as circulatory presso-, chemo-, and volume receptors, the incoming impulses are processed in vegetative centers.A cardiovascular reaction, then, is the result of nerval and humoral sympathetic and parasympathetic activity. At rest, the parasympathetic tone dominates. It reduces heart frequency and conduction velocity. The high vagal tone is initially reduced with increasing physical exertion and switches at higher intensity to increasingly sympathetic activation. This mechanism of reaction to exercise is supported by inverse central and peripheral transmissions.Chronic endurance training leads to an improved local aerobic capacity of the exercised musculature. At rest, it augments parasympathetic activity when the muscle mass is sufficiently large, i. e., 20-30% of the skeletal musculature. The extent of the adaptation depends on individual factors, such as scope, intensity of training, and type of muscle fiber. A higher vagal tone delays the increase in the sympathetic tone during physical exertion. The regulatory range of heart rate, contractility, diastolic function, and blood pressure is increased. In addition, adaptation results in functional and structural changes in the vascular system. Cardiocirculatory work is economized, and maximum performance and oxygen uptake are improved. Endurance training exceeding an individual limit causes harmonic enlargement and hypertrophy of the heart. The thickness of both, the septum and posterior wall increases to the same extent as the interior volume. The mass/volume ratio, and therefore the maximum systolic wall stress, remains constant in contrast to pathologic forms of hypertrophy. Adaptations, including function and size of the heart, show a regression in healthy inactive persons without any structural heart disease.

Effects of Low Impact Aerobic Dance and Fitball Training on Bone Resorption and Health-Related Physical Fitness in Thai Working Women.

PubMed

Na Ayudthaya, Wanitcha Chatkun; Kritpet, Thanomwong

2015-09-01

To investigate the effects of low impact aerobic dance and fitball training on bone resorption in Thai working women. The samples of this study consisted of 47 females at the age from 35-45. The subjects were divided into two groups: A) 23 females in a low impact aerobic dance (20 min) and fitball (15 min) training group, and B) 24 females in a low impact aerobic dance training group (35 min). Both groups wore a heart rate monitor during the exercise training. The sessions in the training program over 12 weeks were performed a 3-day a week, 35-minute for work out per session at an intensity of 60-80% of maximum heart rate. Before and after the 12-week training program, bone resorption (Telopeptidecrosslinked: β-CrossLaps) and bone formation (N-terminal propeptine of procollagen type 1: P1NP) including physiological and fitness data were assessed. The data of pre and post trainings within and between the groups as well as the data of changes in dependent variables were compared and analyzed by using paired t-test and independent-test. The statistically significant difference was set at the 0.05 level. Both the low impact aerobic dance and fitball training group and the low impact aerobic dance training group revealed their lower level of bone resorption (β-CrossLaps) while the first group showed statistically significant change (p < 0.05). In addition, there were no significant changes of bone resorption (β-CrossLaps) and bone formation (P1NP) between these two groups. However; both groups had not only a significant decrease in resting heart rate, systolic and diastolic pressure, but also an increase in muscular strength and endurance and maximum oxygen uptake when the training was completed. Flexibility ofthe group withfitball was increased significantly (p < 0.05). Low impact aerobic dance and fitball training has the positive effect of slowing down bone resorption and is beneficial to healthy bones. They concurrently increase lower back flexibility.

Group aquatic training improves gait efficiency in adolescents with cerebral palsy.

PubMed

Ballaz, Laurent; Plamondon, Suzanne; Lemay, Martin

2011-01-01

To evaluate the effect and feasibility of a 10-week group aquatic training programme on gait efficiency in adolescents with cerebral palsy (CP). The secondary purpose was to determine the exercise intensity during aquatic training in a heterogeneous group of adolescents with CP and to investigate the impact of the training programme on the musculoskeletal system. Twelve ambulatory adolescents with spastic CP were recruited. They participated in 20 aquatic training sessions (45 min twice a week). Three physical therapists and a sports teacher supervised the training sessions. Participants wore a heart rate monitor to assess sessions' intensity and a floatation device as appropriate. The primary outcome measure was gait efficiency as measured by the gait energy expenditure index (EEI). The secondary measures were (1) gait spatiotemporal parameters, (2) maximal isometric knee strength and (3) gross motor function. Ten adolescents completed the training programme. No adverse effect was reported. Average exercise intensity was mild to moderate for more than half of the training session. A significant reduction of the EEI and the heart rate during walking was observed following the training programme. No significant change was observed on secondary outcome measures. Group aquatic training increases gait efficiency in adolescents with CP. This improvement is related to systemic cardiorespiratory adaptations. Group aquatic training programme is feasible in adolescents presenting CP at different levels of severity.

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jiazhou; Zhao, Kuaike; Peng, Jiayuan

2015-02-15

Purpose: To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient’s anatomic and dosimetric parameters for esophageal cancer patients. Methods: Eighty esophagus patients in the authors’ institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlapmore » volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman’s rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. Results: With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. Conclusions: It is feasible to use patients’ anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.« less

Mobile Phonocardiogram Diagnosis in Newborns Using Support Vector Machine

PubMed Central

Amiri, Amir Mohammad; Abtahi, Mohammadreza; Constant, Nick; Mankodiya, Kunal

2017-01-01

Phonocardiogram (PCG) monitoring on newborns is one of the most important and challenging tasks in the heart assessment in the early ages of life. In this paper, we present a novel approach for cardiac monitoring applied in PCG data. This basic system coupled with denoising, segmentation, cardiac cycle selection and classification of heart sound can be used widely for a large number of the data. This paper describes the problems and additional advantages of the PCG method including the possibility of recording heart sound at home, removing unwanted noises and data reduction on a mobile device, and an intelligent system to diagnose heart diseases on the cloud server. A wide range of physiological features from various analysis domains, including modeling, time/frequency domain analysis, an algorithm, etc., is proposed in order to extract features which will be considered as inputs for the classifier. In order to record the PCG data set from multiple subjects over one year, an electronic stethoscope was used for collecting data that was connected to a mobile device. In this study, we used different types of classifiers in order to distinguish between healthy and pathological heart sounds, and a comparison on the performances revealed that support vector machine (SVM) provides 92.2% accuracy and AUC = 0.98 in a time of 1.14 seconds for training, on a dataset of 116 samples. PMID:28335471

Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study

PubMed Central

Morita, Plinio P; Tallevi, Kevin; Armour, Kevin; Li, John; Nolan, Robert P; Cafazzo, Joseph A

2016-01-01

Background Elevated blood pressure is one of the main risk factors for death globally. Behavioral neurocardiac training (BNT) is a complementary approach to blood pressure and stress management that is intended to exercise the autonomic reflexes, improve stress recovery, and lower blood pressure. BNT involves cognitive-behavioral therapy with a paced breathing technique and heart rate variability biofeedback. BNT is limited to in-clinic delivery and faces an accessibility barrier because of the need for clinical oversight and the use of complex monitoring tools. Objective The objective of this project was to design, develop, and evaluate a wearable electrocardiographic (ECG) sensor system for the delivery of BNT in a home setting. Methods The wearable sensor system, Beat, consists of an ECG sensor and a mobile app. It was developed iteratively using the principles of test-driven Agile development and user-centered design. A usability study was conducted at Toronto General Hospital to evaluate feasibility and user experience and identify areas of improvement. Results The Beatsensor was designed as a modular patch to be worn on the user’s chest and uses standard ECG electrodes. It streams a single-lead ECG wirelessly to a mobile phone using Bluetooth Low Energy. The use of small, low-power electronics, a low device profile, and a tapered enclosure allowed for a device that can be unobtrusively worn under clothing. The sensor was designed to operate with a mobile app that guides users through the BNT exercises to train them to a slow-paced breathing technique for stress recovery. The BNT app uses the ECG captured by the sensor to provide heart rate variability biofeedback in the form of a real-time heart rate waveform to complement and reinforce the impact of the training. Usability testing (n=6) indicated that the overall response to the design and user experience of the system was perceived positively. All participants indicated that the system had a positive effect on stress management and that they would use it at home. Areas of improvement were identified, which focused primarily on the delivery of training and education on BNT through the app. Conclusions The outcome of this project was a wearable sensor system to deliver BNT at home. The system has the potential to offer a complementary approach to blood pressure and stress management at home and reduce current accessibility barriers. PMID:27106171

Comparison of a one-time educational intervention to a teach-to-goal educational intervention for self-management of heart failure: design of a randomized controlled trial

PubMed Central

DeWalt, Darren A; Broucksou, Kimberly A; Hawk, Victoria; Baker, David W; Schillinger, Dean; Ruo, Bernice; Bibbins-Domingo, Kirsten; Holmes, Mark; Weinberger, Morris; Macabasco-O'Connell, Aurelia; Pignone, Michael

2009-01-01

Background Heart failure (HF) is common, costly and associated with significant morbidity and poor quality of life, particularly for patients with low socioeconomic status. Self-management training has been shown to reduce HF related morbidity and hospitalization rates, but there is uncertainty about how best to deliver such training and what patients benefit. This study compares a single session self-management HF training program against a multiple session training intervention and examines whether their effects differ by literacy level. Methods/Design In this randomized controlled multi-site trial, English and Spanish-speaking patients are recruited from university-affiliated General Internal Medicine and Cardiology clinics at 4 sites across the United States. Eligible patients have HF with New York Heart Association class II-IV symptoms and are prescribed a loop diuretic. Baseline data, including literacy level, are collected at enrollment and follow-up surveys are conducted at 1, 6 and 12 months Upon enrollment, both the control and intervention groups receive the same 40 minute, literacy-sensitive, in-person, HF education session covering the 4 key self-management components of daily self assessment and having a plan, salt avoidance, exercise, and medication adherence. All participants also receive a literacy-sensitive workbook and a digital bathroom scale. After the baseline education was completed, patients are randomly allocated to return to usual care or to receive ongoing education and training. The intervention group receives an additional 20 minutes of education on weight and symptom-based diuretic self-adjustment, as well as periodic follow-up phone calls from the educator over the course of 1 year. These phone calls are designed to reinforce the education, assess participant knowledge of the education and address barriers to success. The primary outcome is the combined incidence of all cause hospitalization and death. Secondary outcomes include HF-related quality of life, HF-related hospitalizations, knowledge regarding HF, self-care behavior, and self-efficacy. The effects of each intervention will be stratified by patient literacy, in order to identify any differential effects. Discussion Enrollment of the proposed 660 subjects will continue through the end of 2009. Outcome assessments are projected to be completed by early 2011. Trial Registration ClinicalTrials.gov NCT00378950 PMID:19519904

Effects of exercise training on brain-derived neurotrophic factor in skeletal muscle and heart of rats post myocardial infarction.

PubMed

Lee, Heow Won; Ahmad, Monir; Wang, Hong-Wei; Leenen, Frans H H

2017-03-01

What is the central question of this study? Exercise training increases brain-derived neurotrophic factor (BDNF) in the hippocampus, which depends on a myokine, fibronectin type III domain-containing protein 5 (FNDC5). Whether exercise training after myocardial infarction induces parallel increases in FNDC5 and BDNF expression in skeletal muscle and the heart has not yet been studied. What is the main finding and its importance? Exercise training after myocardial infarction increases BDNF protein in skeletal muscle and the non-infarct area of the LV without changes in FNDC5 protein, suggesting that BDNF is not regulated by FNDC5 in skeletal muscle and heart. An increase in cardiac BDNF may contribute to the improvement of cardiac function by exercise training. Exercise training after myocardial infarction (MI) attenuates progressive left ventricular (LV) remodelling and dysfunction, but the peripheral stimuli induced by exercise that trigger these beneficial effects are still unclear. We investigated as possible mediators fibronectin type III domain-containing protein 5 (FNDC5) and brain-derived neurotrophic factor (BDNF) in the skeletal muscle and heart. Male Wistar rats underwent either sham surgery or ligation of the left descending coronary artery, and surviving MI rats were allocated to either a sedentary (Sed-MI) or an exercise group (ExT-MI). Exercise training was done for 4 weeks on a motor-driven treadmill. At the end, LV function was evaluated, and FNDC5 and BDNF mRNA and protein were assessed in soleus muscle, quadriceps and non-, peri- and infarct areas of the LV. At 5 weeks post MI, FNDC5 mRNA was decreased in soleus muscle and all areas of the LV, but FNDC5 protein was increased in the soleus muscle and the infarct area. Mature BDNF (mBDNF) protein was decreased in the infarct area without a change in mRNA. Exercise training attenuated the decrease in ejection fraction and the increase in LV end-diastolic pressure post MI. Exercise training had no effect on FNDC5 mRNA and protein, but increased mBDNF protein in soleus muscle, quadriceps and the non-infarct area of the LV. The mBDNF protein in the non-infarct area correlated positively with ejection fraction and inversely with LV end-diastolic pressure. In conclusion, mBDNF is induced by exercise training in skeletal muscle and the non-infarct area of the LV, which may contribute to improvement of muscle dysfunction and cardiac function post MI. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

A multidisciplinary approach to overreaching detection in endurance trained athletes.

PubMed

Le Meur, Yann; Hausswirth, Christophe; Natta, Françoise; Couturier, Antoine; Bignet, Frank; Vidal, Pierre Paul

2013-02-01

In sport, high training load required to reach peak performance pushes human adaptation to their limits. In that process, athletes may experience general fatigue, impaired performance, and may be identified as overreached (OR). When this state lasts for several months, an overtraining syndrome is diagnosed (OT). Until now, no variable per se can detect OR, a requirement to prevent the transition from OR to OT. It encouraged us to further investigate OR using a multivariate approach, including physiological, biomechanical, cognitive, and perceptive monitoring. Twenty-four highly trained triathletes were separated into an overload group and a normo-trained group (NT) during 3 wk of training. Given the decrement of their running performance, 11 triathletes were diagnosed as OR after this period. A discriminant analysis showed that the changes of eight parameters measured during a maximal incremental test could explain 98.2% of the OR state (lactatemia, heart rate, biomechanical parameters and effort perception). Variations in heart rate and lactatemia were the two most discriminating factors. When the multifactorial analysis was restricted to these variables, the classification score reached 89.5%. Catecholamines and creatine kinase concentrations at rest did not change significantly in both groups. Running pattern was preserved and cognitive performance decrement was observed only at exhaustion in OR subjects. This study showed that monitoring various variables is required to prevent the transition between NT and OR. It emphasized that an OR index, which combines heart rate and blood lactate concentration changes after a strenuous training period, could be helpful to routinely detect OR.

Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury.

PubMed

Devine, Jennifer M; Wong, Bonnie; Gervino, Ernest; Pascual-Leone, Alvaro; Alexander, Michael P

2016-08-01

To determine whether people with moderate-to-severe traumatic brain injury (TBI) can adhere to a minimally supervised, community-based, vigorous aerobic exercise program. Prospective trial. Young Men's Christian Association (YMCA) facilities. Community-dwelling volunteers (N=10; 8 men, 2 women; age range, 22-49y) 6 to 15 months after moderate-to-severe TBI. Participants received memberships to local YMCAs and brief orientations to exercise. They were then asked to independently complete ≥12 weeks of ≥3 training sessions per week, performed at 65% to 85% of maximum heart rate for ≥30 minutes per session. Participants could self-select exercise modality, provided they met intensity and duration targets. Programmable heart rate monitors captured session intensity and duration. Independence with equipment and facility use and compliance with training goals (session frequency, duration, intensity, total weeks of training). All participants achieved independence with equipment and facility use. All met at least 2 of 4 training goals; half met all 4 goals. Participants averaged (±SD) 3.3±0.7 sessions per week for 13 weeks (range, 6-24). Average ± SD session duration was 62±23 minutes, of which 51±22 minutes occurred at or above individuals' heart rate training targets. People in recovery from moderate-to-severe TBI can, with minimal guidance, perform vigorous, community-based exercise. This suggests that decentralized exercise may be logistically and economically sustainable after TBI, expanding its potential therapeutic utility and rendering longer-duration exercise studies more feasible. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Reflections on a Heart Surgery Career with Insights for Western-Trained Medical Specialists in Developing Countries

PubMed Central

Kabbani, Sami S.

2011-01-01

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 cardiac surgeons, 10 surgical residents, a formal 6-year surgical residency program, a pediatric cardiac unit, an annual caseload of 1,600, and plans to double our productivity in 2 years. The tribulations of establishing sophisticated surgical programs in a developing country are offset by the variety of clinicopathologic conditions that are encountered, and even more so by the psychological rewards of overcoming adversity and serving a population in need. This account may prove to be insightful for Western-trained physicians who seek to develop specialized medical care in emerging societies. PMID:21841854

Reflections on a heart surgery career with insights for Western-trained medical specialists in developing countries.

PubMed

Kabbani, Sami S

2011-01-01

Herein, I describe my experience (spanning 40 years) in helping to develop the specialty of cardiovascular surgery in Syria. Especially in the early years, the challenges were daunting. We initially performed thoracic, vascular, and closed-heart operations while dealing with inadequate facilities, bureaucratic delays, and poorly qualified personnel. After our independent surgical center was established in early 1976, we performed 1 open-heart and 1 closed-heart procedure per day. Open-heart procedures evolved from the few and simple to the multiple and complex, and we solved difficulties as they arose. Today, our cardiac surgical center occupies an entire 6-floor building. We have 12 cardiac surgeons, 10 surgical residents, a formal 6-year surgical residency program, a pediatric cardiac unit, an annual caseload of 1,600, and plans to double our productivity in 2 years. The tribulations of establishing sophisticated surgical programs in a developing country are offset by the variety of clinicopathologic conditions that are encountered, and even more so by the psychological rewards of overcoming adversity and serving a population in need. This account may prove to be insightful for Western-trained physicians who seek to develop specialized medical care in emerging societies.

Development and validation of a risk score for hospitalization for heart failure in patients with Type 2 diabetes mellitus.

PubMed

Yang, Xilin; Ma, Ronald C; So, Wing-Yee; Kong, Alice P; Ko, Gary T; Ho, Chun-Shun; Lam, Christopher W; Cockram, Clive S; Tong, Peter C; Chan, Juliana C

2008-04-22

There are no risk scores available for predicting heart failure in Type 2 diabetes mellitus (T2DM). Based on the Hong Kong Diabetes Registry, this study aimed to develop and validate a risk score for predicting heart failure that needs hospitalisation in T2DM. 7067 Hong Kong Chinese diabetes patients without history of heart failure, and without history and clinical evidence of coronary heart disease at baseline were analyzed. The subjects have been followed up for a median period of 5.5 years. Data were randomly and evenly assigned to a training dataset and a test dataset. Sex-stratified Cox proportional hazard regression was used to obtain predictors of HF-related hospitalization in the training dataset. Calibration was assessed using Hosmer-Lemeshow test and discrimination was examined using the area under receiver's operating characteristic curve (aROC) in the test dataset. During the follow-up, 274 patients developed heart failure event/s that needed hospitalisation. Age, body mass index (BMI), spot urinary albumin to creatinine ratio (ACR), HbA1c, blood haemoglobin (Hb) at baseline and coronary heart disease during follow-up were predictors of HF-related hospitalization in the training dataset. HF-related hospitalization risk score = 0.0709 x age (year) + 0.0627 x BMI (kg/m2) + 0.1363 x HbA1c(%) + 0.9915 x Log10(1+ACR) (mg/mmol) - 0.3606 x Blood Hb(g/dL) + 0.8161 x CHD during follow-up (1 if yes). The 5-year probability of heart failure = 1-S0(5)EXP{0.9744 x (Risk Score - 2.3961)}. Where S0(5) = 0.9888 if male and 0.9809 if female. The predicted and observed 5-year probabilities of HF-related hospitalization were similar (p > 0.20) and the adjusted aROC was 0.920 for 5 years of follow-up. The risk score had adequate performance. Further validations in other cohorts of patients with T2DM are needed before clinical use.

Nandrolone and resistance training induce heart remodeling: role of fetal genes and implications for cardiac pathophysiology.

PubMed

Tanno, Ana Paula; das Neves, Vander José; Rosa, Kaleizu Teodoro; Cunha, Tatiana Sousa; Giordano, Fernanda Cristina Linarello; Calil, Caroline Morini; Guzzoni, Vinicius; Fernandes, Tiago; de Oliveira, Edilamar Menezes; Novaes, Pedro Duarte; Irigoyen, Maria Cláudia; Moura, Maria José Costa Sampaio; Marcondes, Fernanda Klein

2011-10-24

This study was conducted to assess the isolated and combined effects of nandrolone and resistance training on cardiac morphology, function, and mRNA expression of pathological cardiac hypertrophy markers. Wistar rats were randomly divided into four groups and submitted to 6 weeks of treatment with nandrolone and/or resistance training. Cardiac parameters were determined by echocardiography. Heart was analyzed for collagen infiltration. Real-time RT-PCR was used to assess the pathological cardiac hypertrophy markers. Both resistance training and nandrolone induced cardiac hypertrophy. Nandrolone increased the cardiac collagen content, and reduced the cardiac index in non-trained and trained groups, when compared with the respective vehicle-treated groups. Nandrolone reduced the ratio of maximum early to late transmitral flow velocity in non-trained and trained groups, when compared with the respective vehicle-treated groups. Nandrolone reduced the alpha-myosin heavy chain gene expression in both non-trained and trained groups, when compared with the respective vehicle-treated groups. Training reduced the beta-myosin heavy chain gene expression in the groups treated with vehicle and nandrolone. Only the association between training and nandrolone increased the expression of the skeletal alpha-actin gene and atrial natriuretic peptide in the left ventricle. This study indicated that nandrolone, whether associated with resistance training or not, induces cardiac hypertrophy, which is associated with enhanced collagen content, re-expression of fetal genes the in left ventricle, and impaired diastolic and systolic function. Copyright © 2011 Elsevier Inc. All rights reserved.

Possible Mechanism for Modulating Cardiovascular System During Running in Humans

DTIC Science & Technology

2001-10-25

odulated by rhythmic muscle contractions during running. It cillates when step rate and heart rate are not synchronised but abilises when they are... synchronised . A maximum cardiac output n be achieved by synchronising step rate with heart rate at an timal phase delay. eywords – Cardiovascular model...trained athletes. Researches from [3][4][5] suggest at synchronization between the heart rate and the step rate uring running may favor an athlete with

Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

PubMed

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

2015-01-15

Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality.

Murine Model of Repeated Exposures to Conspecific Trained Aggressors Simulates Features of Post-Traumatic Stress Disorder

DTIC Science & Technology

2012-07-20

associated with cardiovascular disease, including increased heart rate, elevated blood pressure, decreased heart rate variability, dyslipidemia , and...Kraemer B, Saner H, Schmid JP, Abbas CC, Begre S. Posttraumatic stress disorder and dyslipidemia : previous research and novel findings from patients with

75 FR 33626 - National Heart, Lung, and Blood Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... Comparative Effectiveness Research in Clinical Hypertension Management. Date: June 24, 2010. Time: 12 p.m. to... Institute Special Emphasis Panel. Ruth L. Kirschstein NRSA Institutional Research Training Grants. Date... Domestic Assistance Program Nos. 93.233, National Center for Sleep Disorders Research; 93.837, Heart and...

The relationships between internal and external training load models during basketball training.

PubMed

Scanlan, Aaron T; Wen, Neal; Tucker, Patrick S; Dalbo, Vincent J

2014-09-01

The present investigation described and compared the internal and external training loads during basketball training. Eight semiprofessional male basketball players (mean ± SD, age: 26.3 ± 6.7 years; stature: 188.1 ± 6.2 cm; body mass: 92.0 ± 13.8 kg) were monitored across a 7-week period during the preparatory phase of the annual training plan. A total of 44 total sessions were monitored. Player session ratings of perceived exertion (sRPE), heart rate, and accelerometer data were collected across each training session. Internal training load was determined using the sRPE, training impulse (TRIMP), and summated-heart-rate-zones (SHRZ) training load models. External training load was calculated using an established accelerometer algorithm. Pearson product-moment correlations with 95% confidence intervals (CIs) were used to determine the relationships between internal and external training load models. Significant moderate relationships were observed between external training load and the sRPE (r42 = 0.49, 95% CI = 0.23-0.69, p < 0.001) and TRIMP models (r42 = 0.38, 95% CI = 0.09-0.61, p = 0.011). A significant large correlation was evident between external training load and the SHRZ model (r42 = 0.61, 95% CI = 0.38-0.77, p < 0.001). Although significant relationships were found between internal and external training load models, the magnitude of the correlations and low commonality suggest that internal training load models measure different constructs of the training process than the accelerometer training load model in basketball settings. Basketball coaching and conditioning professionals should not assume a linear dose-response between accelerometer and internal training load models during training and are recommended to combine internal and external approaches when monitoring training load in players.

Post-exercise heart rate variability recovery: a time-frequency analysis.

PubMed

Peçanha, Tiago; de Paula-Ribeiro, Marcelle; Nasario-Junior, Olivassé; de Lima, Jorge Roberto Perrout

2013-12-01

Most studies investigating the effects of non-pharmacological interventions, such as physical training (PT), on cardiac autonomic control, assessed the HRV only in resting conditions. Recently, a new time-frequency mathematical approach based on the short-time Fourier transform (STFT) method has been validated for the assessment of HRV in non-stationary conditions such as the immediate post-exercise period. The aim of this study was to evaluate the effects of the PT on post-exercise cardiac autonomic control using the time-frequency STFT analysis of the HRV. Twenty-one healthy male volunteers participated in this study. The subjects were initially evaluated for their physical exercise/sport practice and allocated to groups of low physical training ((Low)PT, n = 13) or high physical training (H(igh)PT, n = 8). The post-exercise HRV was assessed by the STFT method, which provides the analysis of dynamic changes in the power of the low- and high-frequency spectral components (LF and HF, respectively) of the HRV during the whole recovery period. Greater LF (from the min 5 to 10) and HF (from the min 6 to 10) in the post-exercise period in the H(igh)PT compared to the (Low)PT group (P < 0.05) was observed. These results indicate that exercise training exerts beneficial effects on post-exercise cardiac autonomic control.

Exercise Effects on Fitness and Bone Mineral Density in Early Postmenopausal Women: 1-Year EFOPS Results.

ERIC Educational Resources Information Center

Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.

2002-01-01

Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…

Heritability of HR and BP Response To Exercise Training in the HERITAGE Family Study.

ERIC Educational Resources Information Center

Rice, Treva; Gagnon, Jacques; Leon, Arthur S.; Skinner, James S.; Wilmore, Jack H.; Bouchard, Claude; Rao, D. C.

2002-01-01

Assessed the heritability of response to exercise training in resting blood pressure (BP) and heart rate (HR) among sedentary Caucasians comprising 98 families who completed an exercise training program. Results indicated that the trainability of systolic BP and HR in families with elevated BP was partially determined by genetic factors. Diastolic…

Routine physiotherapy does not induce a cardiorespiratory training effect post-stroke, regardless of walking ability.

PubMed

Kuys, Suzanne; Brauer, Sandra; Ada, Louise

2006-12-01

Cardiorespiratory fitness is increasingly being recognized as an impairment requiring physiotherapy intervention after stroke. The present study seeks to investigate if routine physiotherapy treatment is capable of inducing a cardiorespiratory training effect and if stroke patients attending physiotherapy who are unable to walk experience less cardiorespiratory stress during physiotherapy when compared to those who are able to walk. A descriptive, observational study, with heart rate monitoring and video-recording of physiotherapy rehabilitation, was conducted. Thirty consecutive stroke patients from a geriatric and rehabilitation unit of a tertiary metropolitan hospital, admitted for rehabilitation, and requiring physiotherapy were included in the study. The main measures of the study were duration (time) and intensity (percentage of heart rate reserve) of standing and walking activities during physiotherapy rehabilitation for non-walking and walking stroke patients. Stroke patients spent an average of 21 minutes participating in standing and walking activities that were capable of inducing a cardiorespiratory training effect. Stroke patients who were able to walk spent longer in these activities during physiotherapy rehabilitation than non-walking stroke patients (p < 0.05). An average intensity of 24% heart rate reserve (HRR) during standing and walking activities was insufficient to result in a cardiorespiratory training effect, with a maximum of 35% achieved for the stroke patients able to walk and 30% for those unable to walk. Routine physiotherapy rehabilitation had insufficient duration and intensity to result in a cardiorespiratory training effect in our group of stroke patients.

The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

PubMed

MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

2009-01-01

Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

Examining the Relationship Between Mental, Physical, and Organizational Factors Associated With Attrition During Maritime Forces Training.

PubMed

Binsch, Olaf; Banko, Katherine M; Veenstra, Bertil J; Valk, Pierre J L

2015-11-01

For infantry units of the Dutch Ministry of Defence, high attrition rates (varying from 42 to 68%) during initial training are a persisting problem. The reasons for this attrition are diverse. Having better insight into the causes of attrition is a prerequisite for implementing preventive measures. To achieve this, a monitoring assessment system was developed that integrated the effects of physical, mental, and organizational determinants on operational readiness. The aim of this study was to implement the monitoring tools and to establish the set of determinants that best predicted attrition during infantry training of new recruits. Eighty-five recruits were monitored over a 24-week infantry training course. Before the training, recruits were screened for medical, psychological, and physical wellness. During the monitoring phase, mental, physiological, and organizational indicants were obtained using an array of tools such as questionnaires, chest belt monitors (for heart rate, acceleration, and skin temperature measurements), and computerized tests (e.g., vigilance, long-term memory). Survival analyses were used to tease out the determinants of individual and grouped predictors of attrition. Nearly half the recruits (47%) failed the training. Attrition was predicted by both physiological and mental determinants. However, the organizational determinant "trainers' judgment" on the "recruits' military quality" dominated the physiological and mental determinants. It was concluded that the monitoring system was successfully implemented during infantry training, and that the survival analysis method emphasized on single effects and interactions between the different determinants. Based on the current findings, we recommend several steps to successfully implement a monitoring method in settings with high demands.

Heart Rate Dynamics after Combined Strength and Endurance Training in Middle-Aged Women: Heterogeneity of Responses

PubMed Central

Goldberger, Ary L.; Tulppo, Mikko P.; Laaksonen, David E.; Nyman, Kai; Keskitalo, Marko; Häkkinen, Arja; Häkkinen, Keijo

2013-01-01

The loss of complexity in physiological systems may be a dynamical biomarker of aging and disease. In this study the effects of combined strength and endurance training compared with those of endurance training or strength training alone on heart rate (HR) complexity and traditional HR variability indices were examined in middle-aged women. 90 previously untrained female volunteers between the age of 40 and 65 years completed a 21 week progressive training period of either strength training, endurance training or their combination, or served as controls. Continuous HR time series were obtained during supine rest and submaximal steady state exercise. The complexity of HR dynamics was assessed using multiscale entropy analysis. In addition, standard time and frequency domain measures were also computed. Endurance training led to increases in HR complexity and selected time and frequency domain measures of HR variability (P<0.01) when measured during exercise. Combined strength and endurance training or strength training alone did not produce significant changes in HR dynamics. Inter-subject heterogeneity of responses was particularly noticeable in the combined training group. At supine rest, no training-induced changes in HR parameters were observed in any of the groups. The present findings emphasize the potential utility of endurance training in increasing the complex variability of HR in middle-aged women. Further studies are needed to explore the combined endurance and strength training adaptations and possible gender and age related factors, as well as other mechanisms, that may mediate the effects of different training regimens on HR dynamics. PMID:24013586

Effect of endurance training on blood pressure regulation, biomarkers and the heart in subjects at a higher age.

PubMed

Cornelissen, V A; Goetschalckx, K; Verheyden, B; Aubert, A E; Arnout, J; Persu, A; Rademakers, F; Fagard, R H

2011-08-01

We reported previously that two otherwise identical training programs at lower (LI) and higher intensity (HI) similarly reduced resting systolic blood pressure (BP) by approximately 4-6 mmHg. Here, we determined the effects of both programs on BP-regulating mechanisms, on biomarkers of systemic inflammation and prothrombotic state and on the heart. In this cross-over study (3 × 10 weeks), healthy participants exercised three times 1 h/week at, respectively, 33% and 66% of the heart rate (HR) reserve, in a random order, with a sedentary period in between. Measurements, performed at baseline and at the end of each period, involved blood sampling, HR variability, systolic BP variability (SBPV) and cardiac magnetic resonance imaging. Thirty-nine participants (18 men; mean age 59 years) completed the study. Responses were not different between both programs (P>0.05). Pooled data from LI and HI showed a reduction in HR (-4.3 ± 8.1%) and an increase in stroke volume (+11 ± 23.1%). No significant effect was seen on SBPV, plasma renin activity, basal nitric oxide and left ventricular mass. Our results suggest that the BP reduction observed appears to be due to a decrease in systemic vascular resistance; training intensity does not significantly affect the results on mechanisms, biomarkers and the heart. © 2010 John Wiley & Sons A/S.

Arterial Stiffness and Autonomic Modulation After Free-Weight Resistance Exercises in Resistance Trained Individuals.

PubMed

Kingsley, J Derek; Mayo, Xián; Tai, Yu Lun; Fennell, Curtis

2016-12-01

Kingsley, JD, Mayo, X, Tai, YL, and Fennell, C. Arterial stiffness and autonomic modulation after free-weight resistance exercises in resistance trained individuals. J Strength Cond Res 30(12): 3373-3380, 2016-We investigated the effects of an acute bout of free-weight, whole-body resistance exercise consisting of the squat, bench press, and deadlift on arterial stiffness and cardiac autonomic modulation in 16 (aged 23 ± 3 years; mean ± SD) resistance-trained individuals. Arterial stiffness, autonomic modulation, and baroreflex sensitivity (BRS) were assessed at rest and after 3 sets of 10 repetitions at 75% 1-repetition maximum on each exercise with 2 minutes of rest between sets and exercises. Arterial stiffness was analyzed using carotid-femoral pulse wave velocity (cf-PWV). Linear heart rate variability (log transformed [ln] absolute and normalized units [nu] of low-frequency [LF] and high-frequency [HF] power) and nonlinear heart rate complexity (Sample Entropy [SampEn], Lempel-Ziv Entropy [LZEn]) were measured to determine autonomic modulation. BRS was measured by the sequence method. A 2 × 2 repeated measures analysis of variance (ANOVA) was used to analyze time (rest, recovery) across condition (acute resistance exercise, control). There were significant increases in cf-PWV (p = 0.05), heart rate (p = 0.0001), normalized LF (LFnu; p = 0.001), and the LF/HF ratio (p = 0.0001). Interactions were also noted for ln HF (p = 0.006), HFnu (p = 0.0001), SampEn (p = 0.001), LZEn (p = 0.005), and BRS (p = 0.0001) such that they significantly decreased during recovery from the resistance exercise compared with rest and the control. There was no effect on ln total power, or ln LF. These data suggest that a bout of resistance exercise using free-weights increases arterial stiffness and reduces vagal activity and BRS in comparison with a control session. Vagal tone may not be fully recovered up to 30 minutes after a resistance exercise bout.

Changes induced by diet and nutritional intake in the lipid profile of female professional volleyball players after 11 weeks of training

PubMed Central

2013-01-01

Background The relationship between cardiovascular disease and lipid profile is well known. Apart from a heart-healthy diet, exercise is the primary factor that can modify this lipid-associated cardiovascular risk. The aim of the study was to evaluate potential changes in the levels of triglycerides, total cholesterol (TC), low-density lipoprotein-cholesterol (LDLc), and high-density lipoprotein-cholesterol (HDLc), as well as atherogenic indices (TC/HDLc and LDLc/HDLc), and also to analyse the diet over 11 weeks of training in female professional volleyball players. Methods The lipid profile of 22 female professional volleyball players was analysed on Day T0 (pre-preseason) and Day T11 (after 11 weeks of training). The consumption of fats by the players was estimated using a food frequency questionnaire, confirmed by seven days of full dietary records. Results By the end of the study, the LDLc levels and both atherogenic indices of the players had decreased (p < 0.05) compared to the values obtained at baseline. In addition, the diet of the players contained 35.5 ± 3.2% of fats (saturated fatty acid: 11.1 ± 1.2%, monounsaturated fatty acid: 14.3 ± 1.9%, and polyunsaturated fatty acid: 7.0 ± 1.1%) and 465 ± 57 mg of dietary cholesterol. Their score for the (monounsaturated + polyunsaturated fatty acid)/saturated fatty acid ratio was 1.9 ± 0.4, less than the recommended ≥ 2. Conclusion These data indicate that the activity of the female professional volleyball players during the first 11 weeks of training in the season was heart healthy, because their lipid profile improved, despite an inadequate intake of fats. PMID:24330488

Comparison of different volumes of high intensity interval training on cardiac autonomic function in sedentary young women.

PubMed

Bhati, Pooja; Bansal, Vishal; Moiz, Jamal Ali

2017-08-24

Purpose The present study was conducted to compare the effects of low volume of high intensity interval training (LVHIIT) and high volume of high intensity interval training (HVHIIT) on heart rate variability (HRV) as a primary outcome measure, and on maximum oxygen consumption (VO2max), body composition, and lower limb muscle strength as secondary outcome measures, in sedentary young women. Methods Thirty-six participants were recruited in this study. The LVHIIT group (n = 17) performed one 4-min bout of treadmill running at 85%-95% maximum heart rate (HRmax), followed by 3 min of recovery by running at 70% HRmax, three times per week for 6 weeks. The HVHIIT group (n = 15) performed four times 4-min bouts of treadmill running at 85%-95% HRmax, interspersed with 3-min of recovery by running at 70% HRmax, 3 times per week for 6 weeks. All criterion measures were measured before and after training in both the groups. Results Due to attrition of four cases, data of 32 participants was used for analysis. A significant increase in high frequency (HF) power (p < 0.001) and decrease in the ratio of low frequency to high frequency power (LF/HF) ratio (p < 0.001) in HRV parameters, was observed post-HVHIIT, whereas, these variables did not change significantly (HF: p = 0.92, LF/HF ratio: p = 0.52) in LVHIIT group. Nevertheless, both the interventions proved equally effective in improving aerobic capacity (VO2max), body composition, and muscle strength. Conclusion The study results suggest that both LVHIIT and HVHIIT are equally effective in improving VO2max, body composition, and muscle strength, in sedentary young women. However, HVHIIT induces parasympathetic dominance as well, as measured by HRV.

Blunted Heart Rate Recovery Is Improved Following Exercise Training in Overweight Adults with Obstructive Sleep Apnea

PubMed Central

Kline, Christopher E.; Crowley, E. Patrick; Ewing, Gary B.; Burch, James B.; Blair, Steven N.; Durstine, J. Larry; Davis, J. Mark; Youngstedt, Shawn D.

2012-01-01

Background Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods The CPET responses of 43 sedentary, overweight adults (body mass index [BMI]>25) with untreated OSA (apnea-hypopnea index [AHI]≥15) were compared against matched non-OSA controls (n=9). OSA participants were then randomized to a 12-week exercise training (n=27) or stretching control treatment (n=16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO2peak), were obtained. Results OSA participants had blunted HRR compared to non-OSA controls at 1 (P=.03), 3 (P=.02), and 5 min post-exercise (P=.03). For OSA participants, exercise training improved VO2peak (P=.04) and HRR at 1 (P=.03), 3 (P<.01), and 5 min post-exercise (P<.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r=−.30, P<.05), but no other CPET markers. Conclusions These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction. PMID:22572632

High-intensity Interval Training Dosage for Heart Failure and Coronary Artery Disease Cardiac Rehabilitation. A Systematic Review and Meta-analysis.

PubMed

Ballesta García, Ismael; Rubio Arias, Jacobo Ángel; Ramos Campo, Domingo Jesús; Martínez González-Moro, Ignacio; Carrasco Poyatos, María

2018-04-09

High-interval intensity training (HIT) has been suggested to improve peak VO 2 in cardiac rehabilitation programs. However, the optimal HIT protocol is unknown. The objective of this study was to identify the most effective doses of HIT to optimize peak VO 2 in coronary artery disease (CAD) and heart failure (HF) patients. A search was conducted in 6 databases (MEDLINE, Web of Science, LILACS, CINAHL, Academic Search Complete, and SportDiscus). Studies using a HIT protocol in CAD or HF patients and measuring peak VO 2 were included. The PEDro Scale and Cochrane Collaboration tools were used. Analyses reported significant improvements in peak VO 2 after HIT in both diseases (P = .000001), with a higher increase in HF patients (P = .03). Nevertheless, in HF patients, there were no improvements when the intensity recovery was ≤ 40% of peak VO 2 (P = .19) and the frequency of training was ≤ 2 d/wk (P = .07). There were significant differences regarding duration in CAD patients, with greater improvements in peak VO 2 when the duration was < 12 weeks (P = .05). In HF, programs lasting < 12 weeks did not significantly improve peak VO 2 (P = .1). The HIT is an effective method for improving peak VO 2 in HF and CAD, with a significantly greater increase in HF patients. The recovery intervals should be active and be between 40% and 60% of peak VO 2 in HF patients. Training frequency should be ≥ 2 d/wk for CAD patients and ≥ 3 d/wk for HF patients. Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Pain threshold is achieved at intensity above anaerobic threshold in patients with intermittent claudication.

PubMed

Ritti-Dias, Raphael Mendes; de Moraes Forjaz, Cláudia Lúcia; Cucato, Gabriel Grizzo; Costa, Luis Augusto Riani; Wolosker, Nelson; de Fátima Nunes Marucci, Maria

2009-01-01

Walking training is considered as the first treatment option for patients with peripheral arterial disease and intermittent claudication (IC). Walking exercise has been prescribed for these patients by relative intensity of peak oxygen uptake (VO2peak), ranging from 40% to 70% VO2peak, or pain threshold (PT). However, the relationship between these methods and anaerobic threshold (AT), which is considered one of the best metabolic markers for establishing training intensity, has not been analyzed. Thus, the aim of this study was to compare, in IC patients, the physiological responses at exercise intensities usually prescribed for training (% VO2peak or % PT) with the ones observed at AT. Thirty-three IC patients performed maximal graded cardiopulmonary treadmill test to assess exercise tolerance. During the test, heart rate (HR), VO2, and systolic blood pressure were measured and responses were analyzed at the following: 40% of VO2peak; 70% of VO2peak; AT; and PT. Heart rate and VO2 at 40% and 70% of VO2peak were lower than those at AT (HR: -13 +/- 9% and -3 +/- 8%, P < .01, respectively; VO2: -52 +/- 12% and -13 +/- 15%, P < .01, respectively). Conversely, HR and VO2 at PT were slightly higher than those at AT (HR: +3 +/- 8%, P < .01; VO2: +6 +/- 15%, P = .04). None of the patients achieved the respiratory compensation point. Prescribing exercise for IC patients between 40% and 70% of VO2peak will induce a lower stimulus than that at AT, whereas prescribing exercise at PT will result in a stimulus above AT. Thus, prescribing exercise training for IC patients on the basis of PT will probably produce a greater metabolic stimulus, promoting better cardiovascular benefits.

The Health Benefits and Challenges of Exercise Training in Persons Living with Schizophrenia: A Pilot Study

PubMed Central

Bredin, Shannon S. D.; Warburton, Darren E. R.; Lang, Donna J.

2013-01-01

Background: In addition to the hallmark cognitive and functional impairments mounting evidence indicates that schizophrenia is also associated with an increased risk for the development of secondary complications, in particular cardio-metabolic disease. This is thought to be the result of various factors including physical inactivity and the metabolic side effects of psychotropic medications. Therefore, non-pharmacological approaches to improving brain health, physical health, and overall well-being have been promoted increasingly. Methods: We report on the health-related physical fitness (body composition, blood pressure, heart rate, and aerobic fitness) and lipid profile of persons living with schizophrenia and effective means to address the challenges of exercise training in this population. Results: There was a markedly increased risk for cardio-metabolic disease in 13 persons living with schizophrenia (Age = 31 ± 7 years) including low aerobic fitness (76% ± 34% of predicted), reduced HDL (60% of cohort), elevated resting heart rate (80% of cohort), hypertension (40% of cohort), overweight and obesity (69% of cohort), and abdominal obesity (54% of cohort). Individualized exercise prescription (3 times/week) was well tolerated, with no incidence of adverse exercise-related events. The exercise adherence rate was 81% ± 21% (Range 48%–100%), and 69% of the participants were able to complete the entire exercise training program. Exercise training resulted in clinically important changes in physical activity, aerobic fitness, exercise tolerance, blood pressure, and body composition. Conclusion: Persons living with schizophrenia appear to be at an increased risk for cardio-metabolic disease. An individualized exercise program has shown early promise for the treatment of schizophrenia and the various cognitive, functional, and physiological impairments that ultimately affect health and well-being. PMID:24961427

[Chronic heart failure].

PubMed

Gosch, Markus

2008-08-01

As a consequence of the increasing life expectancy the number of patients suffering from chronic heart failure has been growing continuously in the past few decades, especially in the group of the old and oldest. Frailty is a clinical syndrome that geriatricians attach great importance to. Like many other diseases chronic heart failure can cause frailty. Based on the experience that we see only a small correlation between the functional capacity of patients with heart failure and the results of cardiological findings, the model of peripheral myopathy in chronic heart failure was developed. Different pathophysiological changes may cause the increasing exercise intolerance in patients with chronic heart failure. We can already consider different experimental approaches to the therapy of frailty caused by chronic heart failure. At the moment we have to focus our efforts on an optimal therapy of heart failure, especially with angiotensin-converting-enzyme inhibitors and beta-blockers, and on individual endurance and strength training.

Yoga respiratory training improves respiratory function and cardiac sympathovagal balance in elderly subjects: a randomised controlled trial

PubMed Central

Santaella, Danilo F; Devesa, Cesar R S; Rojo, Marcos R; Amato, Marcelo B P; Drager, Luciano F; Casali, Karina R; Montano, Nicola

2011-01-01

Objectives Since ageing is associated with a decline in pulmonary function, heart rate variability and spontaneous baroreflex, and recent studies suggest that yoga respiratory exercises may improve respiratory and cardiovascular function, we hypothesised that yoga respiratory training may improve respiratory function and cardiac autonomic modulation in healthy elderly subjects. Design 76 healthy elderly subjects were enrolled in a randomised control trial in Brazil and 29 completed the study (age 68±6 years, 34% males, body mass index 25±3 kg/m2). Subjects were randomised into a 4-month training program (2 classes/week plus home exercises) of either stretching (control, n=14) or respiratory exercises (yoga, n=15). Yoga respiratory exercises (Bhastrika) consisted of rapid forced expirations followed by inspiration through the right nostril, inspiratory apnoea with generation of intrathoracic negative pressure, and expiration through the left nostril. Pulmonary function, maximum expiratory and inspiratory pressures (PEmax and PImax, respectively), heart rate variability and blood pressure variability for spontaneous baroreflex determination were determined at baseline and after 4 months. Results Subjects in both groups had similar demographic parameters. Physiological variables did not change after 4 months in the control group. However, in the yoga group, there were significant increases in PEmax (34%, p<0.0001) and PImax (26%, p<0.0001) and a significant decrease in the low frequency component (a marker of cardiac sympathetic modulation) and low frequency/high frequency ratio (marker of sympathovagal balance) of heart rate variability (40%, p<0.001). Spontaneous baroreflex did not change, and quality of life only marginally increased in the yoga group. Conclusion Respiratory yoga training may be beneficial for the elderly healthy population by improving respiratory function and sympathovagal balance. Trial Registration CinicalTrials.gov identifier: NCT00969345; trial registry name: Effects of respiratory yoga training (Bhastrika) on heart rate variability and baroreflex, and quality of life of healthy elderly subjects. PMID:22021757

d-Cycloserine combined with cue exposure therapy fails to attenuate subjective and physiological craving in cocaine dependence

PubMed Central

Santa Ana, Elizabeth J.; Prisciandaro, James J.; Saladin, Michael E.; McRae-Clark, Aimee L.; Shaftman, Stephanie R.; Nietert, Paul J.; Brady, Kathleen T.

2014-01-01

Background Based on preclinical studies showing that the partial N-methyl-d-aspartate (NMDA) agonist d-cycloserine (DCS) facilitates extinction of cocaine self-administration and cocaine-induced conditioned place preference, we evaluated whether 50 mg of DCS would reduce craving to cocaine cues when combined with cue exposure (CE) in cocaine dependent humans. Methods In this double-blind placebo-controlled pilot study, 47 cocaine dependent participants were randomized to DCS or placebo (PBO), plus CE. Participants received DCS or PBO 30 minutes prior to two CE sessions, conducted one day apart. Craving and heart rate was assessed prior to CE sessions, during CE trials, and after CE trials. These measures were assessed again at a 1-week follow-up (session 3) after the second CE session. Results DCS failed to significantly attenuate cocaine cue reactivity based on subjective craving and physiological reactivity (heart rate) compared to PBO. The CE protocol, consisting of repeated exposure to drug cues combined with skills training, resulted in extinction to cocaine cues as suggested by decreased craving within and between sessions in both treatment conditions. All participants exhibited elevated heart rate with repeated exposures, demonstrating a potentiation in heart rate between sessions. PMID:25808169

Training NOAA Staff on Effective Communication Methods with Local Climate Users

NASA Astrophysics Data System (ADS)

Timofeyeva, M. M.; Mayes, B.

2011-12-01

Since 2002 NOAA National Weather Service (NWS) Climate Services Division (CSD) offered training opportunities to NWS staff. As a result of eight-year-long development of the training program, NWS offers three training courses and about 25 online distance learning modules covering various climate topics: climate data and observations, climate variability and change, NWS national and local climate products, their tools, skill, and interpretation. Leveraging climate information and expertise available at all NOAA line offices and partners allows delivery of the most advanced knowledge and is a very critical aspect of the training program. NWS challenges in providing local climate services includes effective communication techniques on provide highly technical scientific information to local users. Addressing this challenge requires well trained, climate-literate workforce at local level capable of communicating the NOAA climate products and services as well as provide climate-sensitive decision support. Trained NWS climate service personnel use proactive and reactive approaches and professional education methods in communicating climate variability and change information to local users. Both scientifically-unimpaired messages and amiable communication techniques such as story telling approach are important in developing an engaged dialog between the climate service providers and users. Several pilot projects NWS CSD conducted in the past year applied the NWS climate services training program to training events for NOAA technical user groups. The technical user groups included natural resources managers, engineers, hydrologists, and planners for transportation infrastructure. Training of professional user groups required tailoring the instructions to the potential applications of each group of users. Training technical user identified the following critical issues: (1) Knowledge of target audience expectations, initial knowledge status, and potential use of climate information; (2) Leveraging partnership with climate services providers; and, (3) Applying 3H training approach, where the first H stands for Head (trusted science), the second H stands for Heart (make it easy), and the third H for Hand (support with applications).

Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring.

PubMed

Plews, Daniel J; Laursen, Paul B; Stanley, Jamie; Kilding, Andrew E; Buchheit, Martin

2013-09-01

The measurement of heart rate variability (HRV) is often considered a convenient non-invasive assessment tool for monitoring individual adaptation to training. Decreases and increases in vagal-derived indices of HRV have been suggested to indicate negative and positive adaptations, respectively, to endurance training regimens. However, much of the research in this area has involved recreational and well-trained athletes, with the small number of studies conducted in elite athletes revealing equivocal outcomes. For example, in elite athletes, studies have revealed both increases and decreases in HRV to be associated with negative adaptation. Additionally, signs of positive adaptation, such as increases in cardiorespiratory fitness, have been observed with atypical concomitant decreases in HRV. As such, practical ways by which HRV can be used to monitor training status in elites are yet to be established. This article addresses the current literature that has assessed changes in HRV in response to training loads and the likely positive and negative adaptations shown. We reveal limitations with respect to how the measurement of HRV has been interpreted to assess positive and negative adaptation to endurance training regimens and subsequent physical performance. We offer solutions to some of the methodological issues associated with using HRV as a day-to-day monitoring tool. These include the use of appropriate averaging techniques, and the use of specific HRV indices to overcome the issue of HRV saturation in elite athletes (i.e., reductions in HRV despite decreases in resting heart rate). Finally, we provide examples in Olympic and World Champion athletes showing how these indices can be practically applied to assess training status and readiness to perform in the period leading up to a pinnacle event. The paper reveals how longitudinal HRV monitoring in elites is required to understand their unique individual HRV fingerprint. For the first time, we demonstrate how increases and decreases in HRV relate to changes in fitness and freshness, respectively, in elite athletes.

Investigating the use of pre-training measures of autonomic regulation for assessing functional overreaching in endurance athletes.

PubMed

Coates, Alexandra M; Hammond, Sarah; Burr, Jamie F

2018-04-10

The use of heart rate variability (HRV) to inform daily training prescription is becoming common in endurance sport. Few studies, however, have investigated the use of pre-training HRV to predict decreased performance or altered exercising autonomic response, typical of functional overreaching (FOR). Further, a new cardiac vagal tone (ProCVT) technology purports to eliminate some of the noise associated with daily HRV, and therefore may be better at predicting same-day performance. The purpose of this investigation was to examine if changes to resting HRV and ProCVT were associated with alterations in performance, maximal heart rate (HRmax), or heart rate recovery (HRrec) in FOR athletes. Twenty-eight recreational cyclists and triathletes were assigned to experimental/control conditions and underwent: 1 week of reduced training, 3 weeks of overload (OL) or regular training (CON), and 1 week of recovery. Testing occurred following the reduced training week (T1), post-3 weeks of training (T2), and following the recovery week (T3). Measures of resting HRV/ProCVT were collected each testing session, followed by maximal incremental exercise tests with HRrec taken 60 s post-exercise. Performance decreased from T1 to T2 in the OL group vs. CON (Δ-9 ± 12 vs. Δ9 ± 11 W, P < .001), as did HRmax (Δ-8 ± 4 vs. Δ-2 ± 4 bpm, P < .001). HRrec increased from T1 to T2 in the OL group vs. CON (Δ10 ± 9 vs. Δ2 ± 5 beats/min, P < .01). HRV and ProCVT did not change in either group. Same-day resting autonomic measures are insufficient in predicting alterations to performance or exercising HR measures following overload training.

Galectin-3 in Ambulatory Patients with Heart Failure: Results from the HF-ACTION Study

PubMed Central

Felker, G. Michael; Fiuzat, Mona; Shaw, Linda K.; Clare, Robert; Whellan, David J.; Bettari, Luca; Shirolkar, Shailesh C.; Donahue, Mark; Kitzman, Dalane W.; Zannad, Faiez; Piña, Ileana L.; O’Connor, Christopher M.

2011-01-01

Background Galectin-3 is a soluble ß-galactoside-binding lectin released by activated cardiac macrophages. Elevated levels of galectin-3 have been found to be associated with adverse outcomes in patients with heart failure. We evaluated the association between galectin-3 and long-term clinical outcomes in ambulatory heart failure patients enrolled in the HF-ACTION study. Methods and Results HF-ACTION was a randomized controlled trial of exercise training in patients with chronic heart failure due to left ventricular (LV) systolic dysfunction. Galectin-3 was assessed at baseline in a cohort of 895 HF-ACTION subjects with stored plasma samples available. The association between galectin-3 and clinical outcomes was assessed using a series of Cox proportional hazards models. Higher galectin-3 levels were associated with other measures of heart failure severity, including higher NYHA class, lower systolic blood pressure, higher creatinine, higher NTproBNP, and lower maximal oxygen consumption. In unadjusted analysis, there was a significant association between elevated galectin-3 levels and hospitalization-free survival (unadjusted hazard ratio = 1.14 per 3 ng/mL increase in galectin-3, P<0.0001). In multivariable modeling, the prognostic impact of galectin-3 was significantly attenuated by the inclusion of other known predictors and galectin-3 was no longer a significant predictor after the inclusion of NTproBNP. Conclusions Galectin-3 is elevated in ambulatory heart failure patients and is associated with poor functional capacity and other known measures of heart failure severity. In univariate analysis, galectin-3 was significantly predictive of long-term outcomes, but this association did not persist after adjustment for other predictors, especially NTproBNP. PMID:22016505

Heart Sound Biometric System Based on Marginal Spectrum Analysis

PubMed Central

Zhao, Zhidong; Shen, Qinqin; Ren, Fangqin

2013-01-01

This work presents a heart sound biometric system based on marginal spectrum analysis, which is a new feature extraction technique for identification purposes. This heart sound identification system is comprised of signal acquisition, pre-processing, feature extraction, training, and identification. Experiments on the selection of the optimal values for the system parameters are conducted. The results indicate that the new spectrum coefficients result in a significant increase in the recognition rate of 94.40% compared with that of the traditional Fourier spectrum (84.32%) based on a database of 280 heart sounds from 40 participants. PMID:23429515

Interest of analyses of heart rate variability in the prevention of fatigue states in senior runners.

PubMed

Leti, Thomas; Bricout, Véronique A

2013-01-01

The use of heart rate variability (HRV) in the management of sport training is a practice which tends to spread, especially in order to prevent the occurrence of fatigue states. To estimate the HRV parameters obtained using a heart rate recording, according to different exercise impacts, and to make the link with the appearance of subjective fatigue. Ten senior runners, aged 51±5 years, were each monitored over a period of 12 weeks in different conditions: (i) after a resting period, (ii) after a day with training, (iii) after a day of competition and (iv) after a rest day. They also completed three questionnaires, to assess fatigue (SFMS), profile of mood states (POMS) and quality of sleep. The HRV indices (heart rate, LF (n.u.), HF (n.u.) and LF/HF) were significantly altered with the competitive impact, shifting toward a sympathetic predominance. After rest and recovery nights, the LF (n.u.) increased significantly with the competitive impact (62.1±15.2 and 66.9±11.6 vs. 76.0±10.7; p<0.05 respectively) whereas the HF (n.u.) decreased significantly (37.9±15.2 and 33.1±11.6 vs. 24.0±10.7; p<0.05 respectively). Positive correlations were found between fatigue and frequency domain indices and between fatigue and training impact. Autonomic nervous system modulation-fatigue relationships were significant, suggesting the potential use of HRV in follow-up and control of training. Furthermore, the addition of questionnaires constitutes complementary tools that allow to achieve a greater relevance and accuracy of the athletes' fitness and results. Copyright © 2012 Elsevier B.V. All rights reserved.

The patient education - Learning and Coping Strategies - improves adherence in cardiac rehabilitation (LC-REHAB): A randomised controlled trial.

PubMed

Lynggaard, Vibeke; Nielsen, Claus Vinther; Zwisler, Ann-Dorthe; Taylor, Rod S; May, Ole

2017-06-01

Despite proven benefits of cardiac rehabilitation (CR), adherence to CR remains suboptimal. This trial aimed to assess the impact of the patient education 'Learning and Coping Strategies' (LC) on patient adherence to an eight-week CR program. 825 patients with ischaemic heart disease or heart failure were open label randomised to either the LC arm (LC plus CR) or the control arm (CR alone) across three hospital units in Denmark. Both arms received same amount of training and education hours. LC consisted of individual clarifying interviews, participation of experienced patients as co-educators, situational, reflective and inductive teaching. The control arm received structured deductive teaching. The primary outcomes were patient adherence to at least 75% of the exercise training or education sessions. We tested for subgroup effects on the primary outcomes using interaction terms. The primary outcomes were compared across arms using logistic regression. More patients in the LC arm adhered to at least 75% of the exercise training sessions than control (80% versus 73%, adjusted odds ratio (OR):1.48; 95% CI:1.07 to 2.05, P=0.018) and 75% of education sessions (79% versus 70%, adjusted OR:1.61, 1.17 to 2.22, P=0.003). Some evidence of larger effects of LC on adherence was seen for patients with heart failure, low education and household income. Addition of LC strategies improved adherence in rehabilitation both in terms of exercise training and education. Patients with heart failure, low levels of education and household income appear to benefit most from this adherence promoting intervention. www.clinicaltrials.gov identifier NCT01668394. Copyright © 2017 Elsevier B.V. All rights reserved.

Attenuation of Ca2+ homeostasis, oxidative stress, and mitochondrial dysfunctions in diabetic rat heart: insulin therapy or aerobic exercise?

PubMed

da Silva, Márcia F; Natali, Antônio J; da Silva, Edson; Gomes, Gilton J; Teodoro, Bruno G; Cunha, Daise N Q; Drummond, Lucas R; Drummond, Filipe R; Moura, Anselmo G; Belfort, Felipe G; de Oliveira, Alessandro; Maldonado, Izabel R S C; Alberici, Luciane C

2015-07-15

We tested the effects of swimming training and insulin therapy, either alone or in combination, on the intracellular calcium ([Ca(2+)]i) homeostasis, oxidative stress, and mitochondrial functions in diabetic rat hearts. Male Wistar rats were separated into control, diabetic, or diabetic plus insulin groups. Type 1 diabetes mellitus was induced by streptozotocin (STZ). Insulin-treated groups received 1 to 4 UI of insulin daily for 8 wk. Each group was divided into sedentary or exercised rats. Trained groups were submitted to swimming (90 min/day, 5 days/wk, 8 wk). [Ca(2+)]i transient in left ventricular myocytes (LVM), oxidative stress in LV tissue, and mitochondrial functions in the heart were assessed. Diabetes reduced the amplitude and prolonged the times to peak and to half decay of the [Ca(2+)]i transient in LVM, increased NADPH oxidase-4 (Nox-4) expression, decreased superoxide dismutase (SOD), and increased carbonyl protein contents in LV tissue. In isolated mitochondria, diabetes increased Ca(2+) uptake, susceptibility to permeability transition pore (MPTP) opening, uncoupling protein-2 (UCP-2) expression, and oxygen consumption but reduced H2O2 release. Swimming training corrected the time course of the [Ca(2+)]i transient, UCP-2 expression, and mitochondrial Ca(2+) uptake. Insulin replacement further normalized [Ca(2+)]i transient amplitude, Nox-4 expression, and carbonyl content. Alongside these benefits, the combination of both therapies restored the LV tissue SOD and mitochondrial O2 consumption, H2O2 release, and MPTP opening. In conclusion, the combination of swimming training with insulin replacement was more effective in attenuating intracellular Ca(2+) disruptions, oxidative stress, and mitochondrial dysfunctions in STZ-induced diabetic rat hearts. Copyright © 2015 the American Physiological Society.

[Improving physiological and psychological status in a hemodialysis patient: a nursing experience using an exercise training program].

PubMed

Liu, Yueh-Min; Yeh, Mei-Ling; Chung, Yu-Chu

2013-10-01

Exercise training during hemodialysis has been found to improve functional capacity, nutritional status, cardiovascular risk factors, depression, and well being in hemodialysis patients. This report describes a nursing experience that applied exercise training to improve activity intolerance, powerlessness, and ineffective health maintenance in a hemodialysis patient. The care period was from May 11 to July 27, 2012. The author collected information using observation, interview, physical examination, and medical record review and identified patient care problems including activity intolerance, powerlessness, and ineffective health maintenance. In addition to providing individual nursing interventions, the author designed a stationary bicycle installed at the end of the bed. The patient was asked use the bicycle to exercise 30 mins per time, three times per week for a period of 12 weeks during the patient's hemodialysis period. Before and after a 12-week of exercise training, collected the 6-minute walk test (6MWT), self-perceived improvement, and self-reported depression scales were performed prior to and after completion of the intervention. Hematological triglyceride, albumin, and hemoglobin data were collected each week. Heart rate, blood pressure, and oxygen saturation were examined prior to and after the intervention to ensure patient safety. After the 12-week intervention, the average heart rate achieved 40-60% of the maximum heart rate and the heart rate peaked between 85 and 121 bpm. Moreover, the 6MWT distance increased from 210 m to 255 m, triglyceride decreased from 622 mg/dL to 173 mg/dL, and self-perceived fatigue and depression markedly improved. This nursing experience is shared with nurses caring for patients with similar conditions.

Exercise training to reduce sympathetic nerve activity in heart failure patients. A systematic review and meta-analysis.

PubMed

Saavedra, María Javiera; Romero, Fernando; Roa, Jorge; Rodríguez-Núñez, Iván

To determine the effects of exercise training on sympathetic nerve activity in heart failure patients. A systematic review was performed. An electronic search of MEDLINE, ProQuest, SciELO, SPORTDiscus, Rehabilitation and Sport Medicine Source, Cumulative Index to Nursing and Allied Health Literature, Tripdatabase, Science Direct and PEDrO was performed from their inception to February 2017. Clinical trials and quasi-experimental studies were considered for primary article selection. The studies should include patients diagnosed with chronic heart failure that performed exercise training for at least 4 weeks. Sympathetic nerve activity should be measured by microneurography before and after the intervention. The Cochrane Collaboration's Risk of Bias Tool was used to evaluate risk of bias, and the quality of evidence was rated following the GRADE approach. Standardized mean differences (SMD) were calculated for control and experimental groups. Meta-analysis was performed using the random effects model. Five trials were included. Overall, the trials had moderate risk of bias. The experimental group indicated a significant decrease in the number of bursts per minute (SMD -2.48; 95% CI -3.55 to -1.41) when compared to the control group. Meanwhile, a significant decrease was also observed in the prevalence of bursts per 100 beats in the experimental group when compared to the control group (SMD -2.66; 95% CI -3.64 to -1.69). Exercise training could be effective in reducing sympathetic nerve activity in patients with heart failure. The quality of evidence across the studies was moderate. Future studies are necessary to confirm these results. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Telehealth solutions to enable global collaboration in rheumatic heart disease screening.

PubMed

Lopes, Eduardo Lv; Beaton, Andrea Z; Nascimento, Bruno R; Tompsett, Alison; Dos Santos, Julia Pa; Perlman, Lindsay; Diamantino, Adriana C; Oliveira, Kaciane Kb; Oliveira, Cassio M; Nunes, Maria do Carmo P; Bonisson, Leonardo; Ribeiro, Antônio Lp; Sable, Craig

2018-02-01

Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.

Enhancing the Benefits of Written Emotional Disclosure through Response Training

PubMed Central

Konig, Andrea; Eonta, Alison; Dyal, Stephanie R.; Vrana, Scott R.

2014-01-01

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n = 113) or a neutral writing condition (n = 133). Participants in each condition wrote for 20 minutes on three occasions and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure. PMID:24680230

Enhancing the benefits of written emotional disclosure through response training.

PubMed

Konig, Andrea; Eonta, Alison; Dyal, Stephanie R; Vrana, Scott R

2014-05-01

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n=113) or a neutral writing condition (n=133). Participants in each condition wrote for 20 minutes on 3 occasions and received response training (n=79), stimulus training (n=84) or no training (n=83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure. Copyright © 2014. Published by Elsevier Ltd.

Hemodynamic Responses of Unfit Healthy Women at a Training Session with Nintendo Wii: A Possible Impact on the General Well-Being

PubMed Central

Monteiro-Junior, Renato S; Figueiredo, Luiz F; Conceição, Isabel; Carvalho, Carolina; Lattari, Eduardo; Mura, Gioia; Machado, Sérgio; da Silva, Elirez B

2014-01-01

Aims: The purpose of this study was assess the effect of a training session with Nintendo Wii® on the hemodynamic responses of healthy women not involved in regular physical exercise. Method: Twenty-five healthy unfit women aged 28 ± 6 years played for 10 minutes the game Free Run (Wii Fit Plus). The resting heart rate (RHR), systolic and diastolic blood pressures (SBP and DBP), and double (rate-pressure) product (DP) were measured before and after activity. The HR during the activity (exercise heart rate, EHR) was measured every minute. Results: A statistically significant difference was observed between the RHR (75 ± 9 bpm) and the mean EHR (176 ± 15 bpm) (P < 0.001). The EHR remained in the target zone for aerobic exercise until the fifth minute of activity, which coincided with the upper limit of the aerobic zone (80% heart rate reserve (HRR) + RHR) from the sixth to tenth minute. The initial (110 ± 8 mmHg) and final (145 ± 17 mmHg) SBP (P < 0.01) were significantly different, as were the initial (71 ± 8 mmHg) and final (79 ± 9 mmHg) DBP (P < 0.01). A statistically significant difference was observed between the pre- (8.233 ± 1.141 bpm-mmHg) and post-activity (25.590 ± 4.117 bpm-mmHg) DP (P < 0.01). Conclusion: Physical exercise while playing Free Run sufficed to trigger acute hemodynamic changes in healthy women who were not engaged in regular physical exercise. PMID:25614754

Influence of Prolonged Spaceflight on Heart Rate and Oxygen Uptake Kinetics

NASA Astrophysics Data System (ADS)

Hoffmann, U.; Moore, A.; Drescher, U.

2013-02-01

During prolonged spaceflight, physical training is used to minimize cardiovascular deconditioning. Measurement of the kinetics of cardiorespiratory parameters, in particular the kinetic analysis of heart rate, respiratory and muscular oxygen uptake, provides useful information with regard to the efficiency and regulation of the cardiorespiratory system. Practically, oxygen uptake kinetics can only be measured at the lung site (V’O2 resp). The dynamics of V’O2 resp, however, is not identical with the dynamics at the site of interest: skeletal muscle. Eight Astronauts were tested pre- and post-flight using pseudo random binary workload changes between 30 and 80 W. Their kinetic responses of heart rate, respiratory as well as muscular V’O2 kinetics were estimated by using time-series analysis. Statistical analysis revealed that the kinetic responses of respiratory as well as muscular V’O2 kinetics are slowed post-flight than pre-flight. Heart rate seems not to be influenced following flight. The influence of other factors (e. g. astronauts’ exercise training) may impact these parameters and is an area for future studies.

Use of Biotechnology Devices to Analyse Fatigue Process in Swimming Training.

PubMed

Clemente-Suárez, V J; Arroyo-Toledo, J J

2017-06-01

The aim of the present research was to analyze the acute psycho-physiological response during a high intensity interval training (HIIT) session of trained swimmers. We analyzed blood lactate concentration, heart rate, heart rate variability (HRV), arms isometric strength, rating of perceived exertion (RPE) and cortical arousal before and after a HIIT session in 14 trained swimmers (16.2 ± 2.6 years 169.1 ± 10.2 cm 61.3 ± 9.9 kg). HIIT session consisted in: 4 × 10 m tethered swimming resting 90 s between sets, 3 min rest, 16 × 25 m maximum speed swimming resting 30 s between sets. Blood lactate concentration, cortical arousal, and rating of perceived exertion significantly increased (p < 0.05) after HIIT. HRV parameters significantly decreased after HIIT, showing an increase in sympathetic nervous system modulation. Results obtained showed the high impact of HIIT sessions on the swimmer's organism, which may be the cause of adaptation in this low volume training sessions.

Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory From the American Heart Association.

PubMed

Aspry, Karen E; Van Horn, Linda; Carson, Jo Ann S; Wylie-Rosett, Judith; Kushner, Robert F; Lichtenstein, Alice H; Devries, Stephen; Freeman, Andrew M; Crawford, Allison; Kris-Etherton, Penny

2018-06-05

Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized. © 2018 American Heart Association, Inc.

Equalizing Military and Civilian Law Enforcement Certification

DTIC Science & Technology

2012-03-20

9/113 After reviewing the minor amount of pure law enforcement training provided to MPs, it is clear that the program’s elementary design is under...Mentorship. Phase I – LETS encompassed approximately 101 hours of police training designed to provide doctrinal and contemporary police training in...Baton and Heart Saver (Automated External Defibrillator & Cardiopulmonary Resuscitation). Finally, Peacekeeper Academy qualified instructors conducted

Heart-rate variability and training-intensity distribution in elite rowers.

PubMed

Plews, Daniel J; Laursen, Paul B; Kilding, Andrew E; Buchheit, Martin

2014-11-01

Elite endurance athletes may train in a polarized fashion, such that their training-intensity distribution preserves autonomic balance. However, field data supporting this are limited. The authors examined the relationship between heart-rate variability and training-intensity distribution in 9 elite rowers during the 26-wk build-up to the 2012 Olympic Games (2 won gold and 2 won bronze medals). Weekly averaged log-transformed square root of the mean sum of the squared differences between R-R intervals (Ln rMSSD) was examined, with respect to changes in total training time (TTT) and training time below the first lactate threshold (LT(2). Correlations (± 90% confidence limits) for Ln rMSSD were small vs TTT (r = .37 ± .80), moderate vs time LT2 (r = -.22 ± .50). These data provide supportive rationale for the polarized model of training, showing that training phases with increased time spent at high intensity suppress parasympathetic activity, while low-intensity training preserves and increases it. As such, periodized low-intensity training may be beneficial for optimal training programming.

Signal processing methodologies for an acoustic fetal heart rate monitor

NASA Technical Reports Server (NTRS)

Pretlow, Robert A., III; Stoughton, John W.

1992-01-01

Research and development is presented of real time signal processing methodologies for the detection of fetal heart tones within a noise-contaminated signal from a passive acoustic sensor. A linear predictor algorithm is utilized for detection of the heart tone event and additional processing derives heart rate. The linear predictor is adaptively 'trained' in a least mean square error sense on generic fetal heart tones recorded from patients. A real time monitor system is described which outputs to a strip chart recorder for plotting the time history of the fetal heart rate. The system is validated in the context of the fetal nonstress test. Comparisons are made with ultrasonic nonstress tests on a series of patients. Comparative data provides favorable indications of the feasibility of the acoustic monitor for clinical use.

Smart Annotation of Cyclic Data Using Hierarchical Hidden Markov Models.

PubMed

Martindale, Christine F; Hoenig, Florian; Strohrmann, Christina; Eskofier, Bjoern M

2017-10-13

Cyclic signals are an intrinsic part of daily life, such as human motion and heart activity. The detailed analysis of them is important for clinical applications such as pathological gait analysis and for sports applications such as performance analysis. Labeled training data for algorithms that analyze these cyclic data come at a high annotation cost due to only limited annotations available under laboratory conditions or requiring manual segmentation of the data under less restricted conditions. This paper presents a smart annotation method that reduces this cost of labeling for sensor-based data, which is applicable to data collected outside of strict laboratory conditions. The method uses semi-supervised learning of sections of cyclic data with a known cycle number. A hierarchical hidden Markov model (hHMM) is used, achieving a mean absolute error of 0.041 ± 0.020 s relative to a manually-annotated reference. The resulting model was also used to simultaneously segment and classify continuous, 'in the wild' data, demonstrating the applicability of using hHMM, trained on limited data sections, to label a complete dataset. This technique achieved comparable results to its fully-supervised equivalent. Our semi-supervised method has the significant advantage of reduced annotation cost. Furthermore, it reduces the opportunity for human error in the labeling process normally required for training of segmentation algorithms. It also lowers the annotation cost of training a model capable of continuous monitoring of cycle characteristics such as those employed to analyze the progress of movement disorders or analysis of running technique.

Effects of autogenic training on stress response and heart rate variability in nursing students.

PubMed

Lim, Seung-Joo; Kim, Chunmi

2014-12-01

This study was undertaken to confirm the effects of autogenic training (AT) on stress response and heart rate variability in nursing school students experiencing stress related to clinical training. The study was carried out from September 2012 to April 2013 in a quasi-experimental nonequivalent control group using a pretest-posttest design. The participants were 40 nursing students in their third year at either of two nursing colleges. All consented to participate. Nineteen nursing students at one college were assigned to the experimental group and underwent the 8-week AT program, and the other 21 were assigned to the control group and did not undergo any training. Stress response was assessed by questionnaire and HRV was measured three times, that is, before the program, at the end of the program, and 6 months after the end of the AT program. A significant time/group interaction was found for stress response (F = 4.68, p = .012), a subjective indicator. However, no significant interaction was found for the objective indicators of heart rate variability, normalized low frequency (F = 2.59, p = .090), normalized high frequency (F = 2.59, p = .090), or low frequency to high frequency ratio (F = 1.38, p = .257). The results suggest that AT provides an acceptable approach to stress reduction in nursing students. Copyright © 2014. Published by Elsevier B.V.

Athlete's Heart: Is the Morganroth Hypothesis Obsolete?

PubMed

Haykowsky, Mark J; Samuel, T Jake; Nelson, Michael D; La Gerche, Andre

2018-05-01

In 1975, Morganroth and colleagues reported that the increased left ventricular (LV) mass in highly trained endurance athletes versus nonathletes was primarily due to increased end-diastolic volume while the increased LV mass in resistance trained athletes was solely due to an increased LV wall thickness. Based on the divergent remodelling patterns observed, Morganroth and colleagues hypothesised that the increased "volume" load during endurance exercise may be similar to that which occurs in patients with mitral or aortic regurgitation while the "pressure" load associated with performing a Valsalva manoeuvre (VM) during resistance exercise may mimic the stress imposed on the heart by systemic hypertension or aortic stenosis. Despite widespread acceptance of the four-decade old Morganroth hypothesis in sports cardiology, some investigators have questioned whether such a divergent "athlete's heart" phenotype exists. Given this uncertainty, the purpose of this brief review is to re-evaluate the Morganroth hypothesis regarding: i) the acute effects of resistance exercise performed with a brief VM on LV wall stress, and the patterns of LV remodelling in resistance-trained athletes; ii) the acute effects of endurance exercise on biventricular wall stress, and the time course and pattern of LV and right ventricular (RV) remodelling with endurance training; and iii) the value of comparing "loading" conditions between athletes and patients with cardiac pathology. Copyright © 2018. Published by Elsevier B.V.

Cardiac tissue Doppler imaging in sports medicine.

PubMed

Krieg, Anne; Scharhag, Jürgen; Kindermann, Wilfried; Urhausen, Axel

2007-01-01

The differentiation of training-induced cardiac adaptations from pathological conditions is a key issue in sports cardiology. As morphological features do not allow for a clear delineation of early stages of relevant pathologies, the echocardiographic evaluation of left ventricular function is the technique of first choice in this regard. Tissue Doppler imaging (TDI) is a relatively recent method for the assessment of cardiac function that provides direct, local measurements of myocardial velocities throughout the cardiac cycle. Although it has shown a superior sensitivity in the detection of ventricular dysfunction in clinical and experimental studies, its application in sports medicine is still rare. Besides technical factors, this may be due to a lack in consensus on the characteristics of ventricular function in relevant conditions. For more than two decades there has been an ongoing debate on the existence of a supernormal left ventricular function in athlete's heart. While results from traditional echocardiography are conflicting, TDI studies established an improved diastolic function in endurance-trained athletes with athlete's heart compared with controls.The influence of anabolic steroids on cardiac function also has been investigated by standard echocardiographic techniques with inconsistent results. The only TDI study dealing with this topic demonstrated a significantly impaired diastolic function in bodybuilders with long-term abuse of anabolic steroids compared with strength-trained athletes without abuse of anabolic steroids and controls, respectively.Hypertrophic cardiomyopathy is the most frequent cause of sudden death in young athletes. However, in its early stages, it is difficult to distinguish from athlete's heart. By means of TDI, ventricular dysfunction in hypertrophic cardiomyopathy can be disclosed even before the development of left ventricular hypertrophy. Also, a differentiation of left ventricular hypertrophy due to hypertrophic cardiomyopathy or systemic hypertension is possible by TDI. Besides the evaluation of different forms of left ventricular hypertrophy, the diagnosis of myocarditis is also of particular importance in athletes. Today, it still requires myocardial biopsy. The analysis of focal disturbances in myocardial velocities might be a promising non-invasive method; however, systematic validation studies are lacking. An important future issue for the implementation of TDI into routine examination will be the standardisation of procedures and the establishment of significant reference values for the above-mentioned conditions. Innovative TDI parameters also merit further investigation.

Role of physical countermaneuvers in the management of orthostatic hypotension: efficacy and biofeedback augmentation

NASA Technical Reports Server (NTRS)

Bouvette, C. M.; McPhee, B. R.; Opfer-Gehrking, T. L.; Low, P. A.

1996-01-01

OBJECTIVE: To evaluate the efficacy of various physical countermaneuvers in reducing orthostatic hypotension and its associated symptoms and to assess the efficacy of biofeedback training in enhancing the effectiveness of physical countermaneuvers. MATERIAL AND METHODS: In nine study subjects with neurogenic orthostatic hypotension, four training sessions on physical countermaneuvers were performed after tilt-up, three with visual feedback on the effect of physical countermaneuvers on blood pressure and other cardiovascular variables. Blood pressure change and orthostatic symptoms during tilt-up were determined, as were the changes in total peripheral resistance, stroke index, and heart rate. RESULTS: The five female and four male patients had a mean age of 53 years and a mean duration of symptoms of 4.2 years. On an orthostatic symptom scale of 0 to 10, these patients had a mean symptom score of 7.3. The increment in systolic blood pressure was better for some maneuvers (such as leg crossing and a combination) than others (such as neck flexion and abdominal contraction). Three patterns of responses to biofeedback were found. Simple maneuvers such as squatting did not improve with training; visual feedback was needed for maneuvers such as thigh contraction, and performance declined without biofeedback; the third pattern, seen in maneuvers such as leg crossing, showed continued improvement with training, even without biofeedback. A survey at 3 to 4 months after training revealed continued use of physical maneuvers (3.8 +/- 3.1 per day), increased standing time with each episode of presyncopal symptoms (8.3 +/- 5.8 minutes), and continued global symptomatic improvement. Total peripheral resistance, but not heart rate or stroke index, showed significant regression with blood pressure improvement. CONCLUSION: Physical countermaneuvers are efficacious in reducing orthostatic hypotension, can be augmented by use of biofeedback, and may significantly improve the functional outcome. The major mechanism of improvement is an increase in total peripheral resistance, presumably by reducing the vascular capacitance.

A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery.

PubMed

Wnuk, Bartosz R; Durmała, Jacek; Ziaja, Krzysztof; Kotyla, Przemysław; Woźniewski, Marek; Błaszczak, Edward

2016-01-01

Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied. The participants were males, aged 65-75 years, with stable cardiologic status, absence of neurological disorders, and non-symptomatic aneurysm - non-ruptured, no pain complaints and no motor system impairments. The control group had only routine physiotherapy, since therapeutic groups I and II also had walking exercises, forward in group II and backward in group I. Both experimental groups were applied interval training. The patient data analyzed was as follows: hospitalization period-days; 6-min walking test-distance (m), training heart rate (1/min), mean speed (km/h), MET; spirometry test-FVC(L), FEV1(L), FEV1/FVC and PEF(L/s). The hospital stay period in all groups did not vary significantly. Statistical analysis showed that patients with backward walking had a statistically significantly lower reduction of walking distance in the corridor test when compared to the control group (p < 0.05). After the operation, a significant reduction of mean speed in the control group was noted in comparison with both the forward and backward walking groups (p < 0.05). No significant differences were noted between the experimental groups in average walking speed as well as in heart rate in all observed groups. Physical training applied to patients after major abdominal aortic aneurysm surgery influences sustaining the level of exercise tolerance to a small extent. Both backward and forward walking seem to be alternative methods when compared to classic post-surgery physiotherapy.

Cognitive function, stress hormones, heart rate and nutritional status during simulated captivity in military survival training.

PubMed

Lieberman, Harris R; Farina, Emily K; Caldwell, John; Williams, Kelly W; Thompson, Lauren A; Niro, Philip J; Grohmann, Kyle A; McClung, James P

2016-10-15

Stress influences numerous psychological and physiological processes, and its effects have practical implications in a variety of professions and real-world activities. However, few studies have concurrently assessed multiple behavioral, hormonal, nutritional and heart-rate responses of humans to acute, severe stress. This investigation simultaneously assessed cognitive, affective, hormonal, and heart-rate responses induced by an intensely stressful real-world environment designed to simulate wartime captivity. Sixty males were evaluated during and immediately following participation in U.S. Army Survival, Evasion, Resistance, and Escape (SERE) school, three weeks of intense but standardized training for Soldiers at risk of capture. Simulated captivity and intense mock interrogations degraded grammatical reasoning (p<0.005), sustained-attention (p<0.001), working memory (p<0.05) and all aspects of mood assessed by the Profile of Mood States (POMS) questionnaire: Tension/Anxiety, Depression/Dejection, Anger/Hostility, Vigor/Activity, Fatigue/Inertia; Confusion/Bewilderment, and Total Mood Disturbance (p<0.001) It also elevated heart rate (p<0.001); increased serum and salivary cortisol and dehydroepiandrosterone-sulfate (DHEA-s) (p<0.01); elevated serum epinephrine, norepinephrine, and soluble transferrin receptors (sTfR) (p<0.01); increased salivary neuropeptide-Y (NPY) (p<0.001); and decreased serum prolactin and serum and salivary testosterone (p<0.001). Partial recovery was observed immediately after training, but stress-induced changes, particularly in body weight and several of the biomarkers, persisted. This study demonstrates that when individuals were exposed to realistic and controlled simulated captivity, cognition, mood, stress hormones, nutritional status and heart rate are simultaneously altered, and each of these subsequently recovers at different rates. Published by Elsevier Inc.

Multidisciplinary rehabilitation program in recently hospitalized patients with heart failure and preserved ejection fraction: rationale and design of a randomized controlled trial.

PubMed

Koifman, Edward; Grossman, Ehud; Elis, Avishay; Dicker, Dror; Koifman, Bella; Mosseri, Morris; Kuperstein, Rafael; Goldenberg, Ilan; Kamerman, Tamir; Levine-Tiefenbrun, Nava; Klempfner, Robert

2014-12-01

Heart failure with preserved ejection fraction (HFpEF) comprises a large portion of heart failure patients and portends poor prognosis with similar outcome to heart failure with reduced ejection fraction (HFrEF). Thus far, no medical therapy has been shown to improve clinical outcome in this common condition. The study is a randomized-controlled, multicenter clinical trial aimed to determine whether early posthospitalization comprehensive cardiac rehabilitation (CR) including exercise training (ET) in recently hospitalized HFpEF patients reduces the composite end point of all-cause mortality and hospitalizations in comparison with usual care (UC). After undergoing baseline evaluation, patients are randomized to either UC or to ambulatory comprehensive CR program. Patients in the CR arm will participate in a 6-month biweekly ET program according to a predefined protocol, in addition to a complementary home exercise prescribed by a specialist in CR. Exercise training will include endurance and low-intensity resistance training. Patients in the UC arm will be followed up at the outpatient clinic, with management according to current heart failure guidelines. Physician follow-up visits will be conducted at 3, 6, and 12 months for assessment of adherence to therapy and ET, functional status, quality of life, and clinical events. Secondary end points will include quality-of-life questionnaire, economic end points, blood pressure, and hemoglobin A1C levels. Cardiac rehabilitation and ET are relatively inexpensive and accessible and can be beneficial in HFpEF patients. Our trial is designed to evaluate the impact of early posthospitalization comprehensive rehabilitation program on clinical end points of mortality, hospitalization, and quality of life in HFpEF patients. Copyright © 2014 Elsevier Inc. All rights reserved.

A medical student elective promoting humanism, communication skills, complementary and alternative medicine and physician self-care: an evaluation of the HEART program.

PubMed

Dossett, Michelle L; Kohatsu, Wendy; Nunley, William; Mehta, Darshan; Davis, Roger B; Phillips, Russell S; Yeh, Gloria

2013-01-01

In 2002 the American Medical Student Association (AMSA) created a fourth-year medical student elective known as the Humanistic Elective in alternative medicine, Activism, and Reflective Transformation (HEART) that provided the opportunity for students to explore humanism in medicine, self-care, complementary and alternative medicine modalities, communication, activism, and community building in a four-week immersion experience. The educational effects of this elective, and whether it has met its stated goals, are unknown. The authors conducted a web-based, cross-sectional survey of the first eight cohorts of HEART graduates in 2010. Survey questions assessed respondents' demographics and perspectives on the educational impact of the elective. Descriptive statistics were used to characterize the sample and qualitative analyses were guided by grounded theory. Of 168 eligible alumni, 122 (73%) completed the survey. The majority were female (70%), age ≤35 (77%) years, and trained in primary care specialties (66%). Half were attendings in practice. The majority of respondents felt the elective taught professionalism (89%) and communication skills (92%) well or very well. The majority highly agreed that the elective helped them better cope with stress during residency training (80%), taught them self-care skills (75%), and improved their ability to empathize and connect with patients (71%). Qualitative analysis of the personal and professional impact of the elective identified twelve common themes with self-discovery, self-care, and collegial development/community most frequently cited. The majority of HEART graduates endorse learning important skills and benefiting from the experience both personally and professionally. Aspects of the HEART curriculum may help training programs teach professionalism and improve trainee well-being. © 2013 Elsevier Inc. All rights reserved.

Effect of high-intensity training versus moderate training on peak oxygen uptake and chronotropic response in heart transplant recipients: a randomized crossover trial.

PubMed

Dall, C H; Snoer, M; Christensen, S; Monk-Hansen, T; Frederiksen, M; Gustafsson, F; Langberg, H; Prescott, E

2014-10-01

In heart transplant (HTx) recipients, there has been reluctance to recommend high-intensity interval training (HIIT) due to denervation and chronotropic impairment of the heart. We compared the effects of 12 weeks' HIIT versus continued moderate exercise (CON) on exercise capacity and chronotropic response in stable HTx recipients >12 months after transplantation in a randomized crossover trial. The study was completed by 16 HTx recipients (mean age 52 years, 75% males). Baseline peak oxygen uptake (VO2peak ) was 22.9 mL/kg/min. HIIT increased VO2peak by 4.9 ± 2.7 mL/min/kg (17%) and CON by 2.6 ± 2.2 mL/kg/min (10%) (significantly higher in HIIT; p < 0.001). During HIIT, systolic blood pressure decreased significantly (p = 0.037) with no significant change in CON (p = 0.241; between group difference p = 0.027). Peak heart rate (HRpeak ) increased significantly by 4.3 beats per minute (p = 0.014) after HIIT with no significant change in CON (p = 0.34; between group difference p = 0.027). Heart rate recovery (HRrecovery ) improved in both groups with a trend toward greater improvement after HIIT. The 5-month washout showed a significant loss of improvement. HIIT was well tolerated, had a superior effect on oxygen uptake, and led to an unexpected increase in HRpeak accompanied by a faster HRrecovery . This indicates that the benefits of HIIT are partly a result of improved chronotropic response. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Whole-body strength training with Huber Motion Lab and traditional strength training in cardiac rehabilitation: A randomized controlled study.

PubMed

Guiraud, Thibaut; Labrunée, Marc; Besnier, Florent; Sénard, Jean-Michel; Pillard, Fabien; Rivière, Daniel; Richard, Lisa; Laroche, Davy; Sanguignol, Frédéric; Pathak, Atul; Gayda, Mathieu; Gremeaux, Vincent

2017-01-01

Isometric strengthening has been rarely studied in patients with coronary heart disease (CHD), mainly because of possible potential side effects and lack of appropriate and reliable devices. We aimed to compare 2 different modes of resistance training, an isometric mode with the Huber Motion Lab (HML) and traditional strength training (TST), in CHD patients undergoing a cardiac rehabilitation program. We randomly assigned 50 patients to HML or TST. Patients underwent complete blinded evaluation before and after the rehabilitation program, including testing for cardiopulmonary exercise, maximal isometric voluntary contraction, endothelial function and body composition. After 4 weeks of training (16 sessions), the groups did not differ in body composition, anthropometric characteristics, or endothelial function. With HML, peak power output (P=0.035), maximal heart rate (P<0.01) and gain of force measured in the chest press position (P<0.02) were greater after versus before training. Both protocols appeared to be well tolerated, safe and feasible for these CHD patients. A training protocol involving 6s phases of isometric contractions with 10s of passive recovery on an HML device could be safely implemented in rehabilitation programs for patients with CHD and improve functional outcomes. Copyright © 2016. Published by Elsevier Masson SAS.

Endurance performance and nocturnal HRV indices.

PubMed

Nummela, A; Hynynen, E; Kaikkonen, P; Rusko, H

2010-03-01

The effects of endurance training on endurance performance characteristics and cardiac autonomic modulation during night sleep were investigated. Twenty-four sedentary subjects trained over four weeks two hours per week at an average running intensity of 76+/-4% of their heart rate reserve. The R to R ECG-intervals were recorded and heart rate variability indices including high frequency power (HFP) were calculated for the nights following the training days every week. The subjects were divided into responders and non-responders according to the improvements in the maximal velocity of the incremental treadmill test (v(max)). The responders improved their v(max) by 10.9+/-46 % (p < 0.001) while no changes were observed in the non-responders (1.6+/-3.0%), although there were no differences in any training load variables between the groups. In the responders nocturnal HFP was significantly higher during the fourth training week compared to the first training week (p=0.036). Furthermore, a significant correlation was observed between the change in v(max) and the change in nocturnal HFP (r=0.482, p=0.042). It was concluded that after similar training, an increase in cardiac vagal modulation was related to improved v(max) in the sedentary subjects. Georg Thieme Verlag KG Stuttgart.New York.

Heart rate variability in prediction of individual adaptation to endurance training in recreational endurance runners.

PubMed

Vesterinen, V; Häkkinen, K; Hynynen, E; Mikkola, J; Hokka, L; Nummela, A

2013-03-01

The aim of this study was to investigate whether nocturnal heart rate variability (HRV) can be used to predict changes in endurance performance during 28 weeks of endurance training. The training was divided into 14 weeks of basic training (BTP) and 14 weeks of intensive training periods (ITP). Endurance performance characteristics, nocturnal HRV, and serum hormone concentrations were measured before and after both training periods in 28 recreational endurance runners. During the study peak treadmill running speed (Vpeak ) improved by 7.5 ± 4.5%. No changes were observed in HRV indices after BTP, but after ITP, these indices increased significantly (HFP: 1.9%, P=0.026; TP: 1.7%, P=0.007). Significant correlations were observed between the change of Vpeak and HRV indices (TP: r=0.75, P<0.001; HFP: r=0.71, P<0.001; LFP: r=0.69, P=0.01) at baseline during ITP. In order to lead to significant changes in HRV among recreational endurance runners, it seems that moderate- and high-intensity training are needed. This study showed that recreational endurance runners with a high HRV at baseline improved their endurance running performance after ITP more than runners with low baseline HRV. © 2011 John Wiley & Sons A/S.

The role of heart rate variability in sports physiology

PubMed Central

DONG, JIN-GUO

2016-01-01

Heart rate variability (HRV) is a relevant marker reflecting cardiac modulation by sympathetic and vagal components of the autonomic nervous system (ANS). Although the clinical application of HRV is mainly associated with the prediction of sudden cardiac death and assessing cardiovascular and metabolic illness progression, recent observations have suggested its applicability to physical exercise training. HRV is becoming one of the most useful tools for tracking the time course of training adaptation/maladaptation of athletes and in setting the optimal training loads leading to improved performances. However, little is known regarding the role of HRV and the internal effects of physical exercise on an athlete, which may be useful in designing fitness programs ensuring sufficient training load that may correspond with the specific ability of the athlete. In this review, we offer a comprehensive assessment of investigations concerning the interrelation between HRV and ANS, and examine how the application of HRV to physical exercise may play a role in sports physiology. PMID:27168768

The role of heart rate variability in sports physiology.

PubMed

Dong, Jin-Guo

2016-05-01

Heart rate variability (HRV) is a relevant marker reflecting cardiac modulation by sympathetic and vagal components of the autonomic nervous system (ANS). Although the clinical application of HRV is mainly associated with the prediction of sudden cardiac death and assessing cardiovascular and metabolic illness progression, recent observations have suggested its applicability to physical exercise training. HRV is becoming one of the most useful tools for tracking the time course of training adaptation/maladaptation of athletes and in setting the optimal training loads leading to improved performances. However, little is known regarding the role of HRV and the internal effects of physical exercise on an athlete, which may be useful in designing fitness programs ensuring sufficient training load that may correspond with the specific ability of the athlete. In this review, we offer a comprehensive assessment of investigations concerning the interrelation between HRV and ANS, and examine how the application of HRV to physical exercise may play a role in sports physiology.

Effects of exercise training on the cardiovascular system: pharmacological approaches.

PubMed

Zanesco, Angelina; Antunes, Edson

2007-06-01

Physical exercise promotes beneficial health effects by preventing or reducing the deleterious effects of pathological conditions, such as arterial hypertension, coronary artery disease, atherosclerosis, diabetes mellitus, osteoporosis, Parkinson's disease, and Alzheimer disease. Human movement studies are becoming an emerging science in the epidemiological area and public health. A great number of studies have shown that exercise training, in general, reduces sympathetic activity and/or increases parasympathetic tonus either in human or laboratory animals. Alterations in autonomic nervous system have been correlated with reduction in heart rate (resting bradycardia) and blood pressure, either in normotensive or hypertensive subjects. However, the underlying mechanisms by which physical exercise produce bradycardia and reduces blood pressure has not been fully understood. Pharmacological studies have particularly contributed to the comprehension of the role of receptor and transduction signaling pathways on the heart and blood vessels in response to exercise training. This review summarizes and examines the data from studies using animal models and human to determine the effect of exercise training on the cardiovascular system.

A single session of meditation reduces of physiological indices of anger in both experienced and novice meditators.

PubMed

Fennell, Alexander B; Benau, Erik M; Atchley, Ruth Ann

2016-02-01

The goal of the present study was to explore how anger reduction via a single session of meditation might be measured using psychophysiological methodologies. To achieve this, 15 novice meditators (Experiment 1) and 12 practiced meditators (Experiment 2) completed autobiographical anger inductions prior to, and following, meditation training while respiration rate, heart rate, and blood pressure were measured. Participants also reported subjective anger via a visual analog scale. At both stages, the experienced meditators' physiological reaction to the anger induction reflected that of relaxation: slowed breathing and heart rate and decreased blood pressure. Naïve meditators exhibited physiological reactions that were consistent with anger during the pre-meditation stage, while after meditation training and a second anger induction they elicited physiological evidence of relaxation. The current results examining meditation training show that the naïve group's physiological measures mimicked those of the experienced group following a single session of meditation training. Copyright © 2016. Published by Elsevier Inc.

One year of high-intensity interval training improves exercise capacity, but not left ventricular function in stable heart transplant recipients: a randomised controlled trial.

PubMed

Rustad, Lene A; Nytrøen, Kari; Amundsen, Brage H; Gullestad, Lars; Aakhus, Svend

2014-02-01

Heart transplant recipients have lower exercise capacity and impaired cardiac function compared with the normal population. High-intensity interval training (HIIT) improves exercise capacity and cardiac function in patients with heart failure and hypertension, but the effect on cardiac function in stable heart transplant recipients is not known. Thus, we investigated whether HIIT improved cardiac function and exercise capacity in stable heart transplant recipients by use of comprehensive rest- and exercise-echocardiography and cardiopulmonary exercise testing. Fifty-two clinically stable heart transplant recipients were randomised either to HIIT (4 × 4 minutes at 85-95% of peak heart rate three times per week for eight weeks) or to control. Three such eight-week periods were distributed throughout one year. Echocardiography (rest and submaximal exercise) and cardiopulmonary exercise testing were performed at baseline and follow-up. One year of HIIT increased VO 2peak from 27.7 ± 5.5 at baseline to 30.9 ± 5.0 ml/kg/min at follow-up, while the control group remained unchanged (28.5 ± 7.0 vs. 28.0 ± 6.7 ml/kg per min, p < 0.001 for difference between the groups). Systolic and diastolic left ventricular functions at rest and during exercise were generally unchanged by HIIT. Whereas HIIT is feasible in heart transplant recipients and effectively improves exercise capacity, it does not alter cardiac systolic and diastolic function significantly. Thus, the observed augmentation in exercise capacity is best explained by extra-cardiac adaptive mechanisms.

Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial

PubMed Central

2013-01-01

Background To evaluate the effectiveness of a new multifactorial intervention to improve health care for chronic ischemic heart disease patients in primary care. The strategy has two components: a) organizational for the patient/professional relationship and b) training for professionals. Methods/design Experimental study. Randomized clinical trial. Follow-up period: one year. Study setting: primary care, multicenter (15 health centers). For the intervention group 15 health centers are selected from those participating in ESCARVAL study. Once the center agreed to participate patients are randomly selected from the total amount of patients with ischemic heart disease registered in the electronic health records. For the control group a random sample of patients with ischemic heart disease is selected from all 72 health centers electronic records. Intervention components: a) Organizational intervention on the patient/professional relationship. Centered on the Chronic Care Model, the Stanford Expert Patient Program and the Kaiser Permanente model: Teamwork, informed and active patient, decision making shared with the patient, recommendations based on clinical guidelines, single electronic medical history per patient that allows the use of indicators for risk monitoring and stratification. b) Formative strategy for professionals: 4 face-to-face training workshops (one every 3 months), monthly update clinical sessions, online tutorial by a cardiologist, availability through the intranet of the action protocol and related documents. Measurements: Blood pressure, blood glucose, HbA1c, lipid profile and smoking. Frequent health care visits. Number of hospitalizations related to vascular disease. Therapeutic compliance. Drug use. Discussion This study aims to evaluate the efficacy of a multifactorial intervention strategy involving patients with ischemic heart disease for the improvement of the degree of control of the cardiovascular risk factors and of the quality of life, number of visits, and number of hospitalizations. Trial registration NCT01826929 PMID:23915267

Impact of Exercise Training on Peak Oxygen Uptake and its Determinants in Heart Failure with Preserved Ejection Fraction

PubMed Central

Tucker, Wesley J; Nelson, Michael D; Beaudry, Rhys I; Halle, Martin; Sarma, Satyam; Kitzman, Dalane W; Gerche, Andre La

2016-01-01

Heart failure with preserved ejection (HFpEF) accounts for over 50 % of all HF cases, and the proportion is higher among women and older individuals. A hallmark feature of HFpEF is dyspnoea on exertion and reduced peak aerobic power (VO2peak) secondary to central and peripheral abnormalities that result in reduced oxygen delivery to and/or utilisation by exercising skeletal muscle. The purpose of this brief review is to discuss the role of exercise training to improve VO2peak and the central and peripheral adaptations that reduce symptoms following physical conditioning in patients with HFpEF. PMID:28785460

Vision and creation of the American Heart Association pharmaceutical roundtable outcomes research centers.

PubMed

Peterson, Eric D; Spertus, John A; Cohen, David J; Hlatky, Mark A; Go, Alan S; Vickrey, Barbara G; Saver, Jeffrey L; Hinton, Patricia C

2009-11-01

The field of outcomes research seeks to define optimal treatment in practice and to promote the rapid full adoption of efficacious therapies into routine clinical care. The American Heart Association (AHA) formed the AHA Pharmaceutical Roundtable (PRT) Outcomes Research Centers Network to accelerate attainment of these goals. Participating centers were intended to carry out state-of-the-art outcomes research in cardiovascular disease and stroke, to train the next generation of investigators, and to support the formation of a collaborative research network. After a competitive application process, 4 AHA PRT Outcomes Research Centers were selected: Duke Clinical Research Institute; Saint Luke's Mid America Heart Institute; Stanford University-Kaiser Permanente of Northern California; and University of California, Los Angeles. Each center proposed between 1 and 3 projects organized around a single theme in cardiovascular disease or stroke. Additionally, each center will select and train up to 6 postdoctoral fellows over the next 4 years, and will participate in cross-collaborative activities among the centers. The AHA PRT Outcomes Research Centers Network is designed to further strengthen the field of cardiovascular disease and stroke outcomes research by fostering innovative research, supporting high quality training, and encouraging center-to-center collaborations.

[A virtual patient to improve doctor-patient communication : reality or fiction ?

PubMed

Bragard, I; Guillaume, M; Ghuysen, A; Servotte, J C; Ortiz, I; Pétré, B

2018-02-01

The transformations of the health system and the preferences of the patients themselves have led healthcare professionals to rethink the place and role of the patient in the healthcare system, putting the caregivercare relationship and communication at the heart of public health issues. The literature shows that empathic communication is associated with better adherence to treatment, better patient satisfaction and less litigation. However, the initial training programs of health professionals are little oriented towards this field. Moreover, they are mainly based on a direct transition from theory to clinical practice with all the risks that this entails for patients. Some recent studies suggest an interest in virtual reality simulation for the development of these communication skills. This article offers an overview of the potential of virtual clinical simulation as a complementary or even alternative method to traditional teaching methods. Different studies will illustrate these innovations in the training of physicians in clinical reasoning, empathic communication, and in a highly emotional situation such as breaking bad news.

Thermal-work strain in law enforcement personnel during chemical, biological, radiological, and nuclear (CBRN) training

PubMed Central

Yokota, M; Karis, A J; Tharion, W J

2014-01-01

Background: Thermal safety standards for the use of chemical, biological, radiological, and nuclear (CBRN) ensembles have been established for various US occupations, but not for law enforcement personnel. Objectives: We examined thermal strain levels of 30 male US law enforcement personnel who participated in CBRN field training in Arizona, Florida, and Massachusetts. Methods: Physiological responses were examined using unobtrusive heart rate (HR) monitors and a simple thermoregulatory model to predict core temperature (Tc) using HR and environment. Results: Thermal strain levels varied by environments, activity levels, and type of CBRN ensemble. Arizona and Florida volunteers working in hot-dry and hot-humid environment indicated high heat strain (predicted max Tc>38.5°C). The cool environment of Massachusetts reduced thermal strain although thermal strains were occasionally moderate. Conclusions: The non-invasive method of using physiological monitoring and thermoregulatory modeling could improve law enforcement mission to reduce the risk of heat illness or injury. PMID:24999847

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dasari, Paul K. R.; Shazeeb, Mohammed Salman; Könik, Arda

Purpose: Binning list-mode acquisitions as a function of a surrogate signal related to respiration has been employed to reduce the impact of respiratory motion on image quality in cardiac emission tomography (SPECT and PET). Inherent in amplitude binning is the assumption that there is a monotonic relationship between the amplitude of the surrogate signal and respiratory motion of the heart. This assumption is not valid in the presence of hysteresis when heart motion exhibits a different relationship with the surrogate during inspiration and expiration. The purpose of this study was to investigate the novel approach of using the Bouc–Wen (BW)more » model to provide a signal accounting for hysteresis when binning list-mode data with the goal of thereby improving motion correction. The study is based on the authors’ previous observations that hysteresis between chest and abdomen markers was indicative of hysteresis between abdomen markers and the internal motion of the heart. Methods: In 19 healthy volunteers, they determined the internal motion of the heart and diaphragm in the superior–inferior direction during free breathing using MRI navigators. A visual tracking system (VTS) synchronized with MRI acquisition tracked the anterior–posterior motions of external markers placed on the chest and abdomen. These data were employed to develop and test the Bouc–Wen model by inputting the VTS derived chest and abdomen motions into it and using the resulting output signals as surrogates for cardiac motion. The data of the volunteers were divided into training and testing sets. The training set was used to obtain initial values for the model parameters for all of the volunteers in the set, and for set members based on whether they were or were not classified as exhibiting hysteresis using a metric derived from the markers. These initial parameters were then employed with the testing set to estimate output signals. Pearson’s linear correlation coefficient between the abdomen, chest, average of chest and abdomen markers, and Bouc–Wen derived signals versus the true internal motion of the heart from MRI was used to judge the signals match to the heart motion. Results: The results show that the Bouc–Wen model generated signals demonstrated strong correlation with the heart motion. This correlation was slightly larger on average than that of the external surrogate signals derived from the abdomen marker, and average of the abdomen and chest markers, but was not statistically significantly different from them. Conclusions: The results suggest that the proposed model has the potential to be a unified framework for modeling hysteresis in respiratory motion in cardiac perfusion studies and beyond.« less

Adult Congenital Heart Disease: Scope of the Problem.

PubMed

Mazor Dray, Efrat; Marelli, Ariane J

2015-11-01

This article reviews the changing epidemiology of congenital heart disease summarizing its impact on the demographics of the congenital heart disease population and the progress made in order to improve outcomes in this patient population. Birth prevalence of congenital heart disease can be modified by many factors. As a result of decreasing mortality and increasing survival in all forms of congenital heart disease, the median age of patients has increased and adults now compose two-thirds of patients with congenital heart disease. Disease burden and resulting health services utilization increase significantly across the lifespan. Bridging the gap between policy and quality of care can be improved by referral to specialized adult congenital heart disease centers and planning delivery of specialized services that are commensurate with population needs, program accreditation criteria and certified training of designated workforce. Copyright © 2015 Elsevier Inc. All rights reserved.

Autonomic cardiovascular modulation in masters and young cyclists following high-intensity interval training.

PubMed

Borges, Nattai R; Reaburn, Peter R; Doering, Thomas M; Argus, Christos K; Driller, Matthew W

2017-04-01

This study aimed at examining the autonomic cardiovascular modulation in well-trained masters and young cyclists following high-intensity interval training (HIT). Nine masters (age 55.6 ± 5.0 years) and eight young cyclists (age 25.9 ± 3.0 years) completed a HIT protocol of 6 x 30 sec at 175% of peak power output, with 4.5-min' rest between efforts. Immediately following HIT, heart rate and R-R intervals were monitored for 30-min during passive supine recovery. Autonomic modulation was examined by i) heart rate recovery in the first 60-sec of recovery (HRR 60 ); ii) the time constant of the 30-min heart rate recovery curve (HRRτ); iii) the time course of the root mean square for successive 30-sec R-R interval (RMSSD 30 ); and iv) time and frequency domain analyses of subsequent 5-min R-R interval segments. No significant between-group differences were observed for HRR 60 (P = 0.096) or HRR τ (P = 0.617). However, a significant interaction effect was found for RMSSD 30 (P = 0.021), with the master cyclists showing higher RMSSD 30 values following HIT. Similar results were observed in the time and frequency domain analyses with significant interaction effects found for the natural logarithm of the RMSSD (P = 0.008), normalised low-frequency power (P = 0.016) and natural logarithm of high-frequency power (P = 0.012). Following high-intensity interval training, master cyclists demonstrated greater post-exercise parasympathetic reactivation compared to young cyclists, indicating that physical training at older ages has significant effects on autonomic function.

A comparison of 16 weeks of continuous vs intermittent exercise training in chronic heart failure patients.

PubMed

Smart, Neil A; Steele, Michael

2012-01-01

The authors compared the effects of continuous (CON) and intermittent (INT) exercise training programs on functional capacity, quality of life (QOL), and cardiac function in 23 congestive heart failure patients. Patients were randomized to CON exercise training (n=13; aged 66±7 years; peak oxygen consumption [VO(2)], 12.4±2.5 mL/kg/min; weight, 83±12 kg; left ventricular ejection fraction [LVEF], 29.5%±7.2%) or INT exercise training (n=10; aged 59±11 years; VO(2), 12.2±6.5 mL/kg/min; weight, 87±24 kg; LVEF 27%±7.9%). These groups completed 16 weeks of stationary cycling at 70% VO(2) thrice weekly for 30 minutes continuously or 60 minutes (60 seconds work:60 seconds rest) intermittently; both groups completed the same absolute volume of work. Three QOL questionnaire responses, VO(2), LVEF, and regional tissue Doppler were quantified. After exercise training, VO(2) increased by 13% in the CON group (P=.12) and significantly by 21% in the INT group (P=.03), although not significantly between the groups (P=.72). In the CON group, Minnesota Living With Heart Failure score improved at 16 weeks (P=.02), while in the INT group, Hare-Davis scores improved (P=.02). Cardiac volumes, resting and peak LVEF, contractile reserve, and tissue velocities were all unchanged from baseline. Intermittent exercise may improve functional capacity to a greater extent than continuous exercise. QOL changes were variable between groups. © 2011 Wiley Periodicals, Inc.

Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity

PubMed Central

Skrypnik, Damian; Bogdański, Paweł; Mądry, Edyta; Karolkiewicz, Joanna; Ratajczak, Marzena; Kryściak, Jakub; Pupek-Musialik, Danuta; Walkowiak, Jarosław

2015-01-01

Aims To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. Methods 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. Results Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. Conclusion Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity. PMID:25968470

An automatic and accurate method of full heart segmentation from CT image based on linear gradient model

NASA Astrophysics Data System (ADS)

Yang, Zili

2017-07-01

Heart segmentation is an important auxiliary method in the diagnosis of many heart diseases, such as coronary heart disease and atrial fibrillation, and in the planning of tumor radiotherapy. Most of the existing methods for full heart segmentation treat the heart as a whole part and cannot accurately extract the bottom of the heart. In this paper, we propose a new method based on linear gradient model to segment the whole heart from the CT images automatically and accurately. Twelve cases were tested in order to test this method and accurate segmentation results were achieved and identified by clinical experts. The results can provide reliable clinical support.

National Intrepid Center of Excellence: Cutting Edge Interdisciplinary Care for TBI & PH

DTIC Science & Technology

2011-01-26

training • Autogenic Training : Heart Math • Pain Control: Acupuncture, Relaxation • Family Therapy: FOCUS • Wellness: Yoga, Nutrition, Rec, Art... training venue for the dissemination of next generation standards of care and resilience to providers as well as Service Members and families  An...on the NICoE Website (Currently under development) 8 • NICoE’s Training and Education (T&E) mission is to serve as: – An education catalyst for

Neutrophil and Monocyte Bactericidal Responses to 10 Weeks of Low-Volume High-Intensity Interval or Moderate-Intensity Continuous Training in Sedentary Adults

PubMed Central

Shepherd, Sam O.; Wilson, Oliver J.; Adlan, Ahmed M.; Wagenmakers, Anton J. M.; Shaw, Christopher S.; Lord, Janet M.

2017-01-01

Neutrophils and monocytes are key components of the innate immune system that undergo age-associated declines in function. This study compared the impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on immune function in sedentary adults. Twenty-seven (43 ± 11 years) healthy sedentary adults were randomized into ten weeks of either a HIIT (>90% maximum heart rate) or MICT (70% maximum heart rate) group training program. Aerobic capacity (VO2peak), neutrophil and monocyte bacterial phagocytosis and oxidative burst, cell surface receptor expression, and systemic inflammation were measured before and after the training. Total exercise time commitment was 57% less for HIIT compared to that for MICT while both significantly improved VO2peak similarly. Neutrophil phagocytosis and oxidative burst and monocyte phagocytosis and percentage of monocytes producing an oxidative burst were improved by training similarly in both groups. Expression of monocyte but not neutrophil CD16, TLR2, and TLR4 was reduced by training similarly in both groups. No differences in systemic inflammation were observed for training; however, leptin was reduced in the MICT group only. With similar immune-enhancing effects for HIIT compared to those for MICT at 50% of the time commitment, our results support HIIT as a time efficient exercise option to improve neutrophil and monocyte function. PMID:28656073

Rating of Perceived Exertion for Quantification of Training and Combat Loads During Combat Sport-Specific Activities: A Short Review.

PubMed

Slimani, Maamer; Davis, Philip; Franchini, Emerson; Moalla, Wassim

2017-10-01

The aim of this short review was to summarize data pertaining to the rating of perceived exertion (RPE) methods (RPE value and session-RPE) during combat sport-specific activities (i.e., competition and training) based on many factors, including contest type (i.e., official vs. simulated vs. training), combat rounds, age of participants and muscle groups, and their correlation with physiological variables (i.e., blood lactate concentration [La] and heart rate [HR]). The current review shows higher RPE in a match of mixed martial arts (MMAs) than Brazilian jiu-jitsu and kickboxing matches and during the competitive period compared with the precompetitive period. This could be explained by the longer duration of bouts, the higher percentage contribution of aerobic metabolism in MMA than other combat sports and contest type differences (simulated vs. official matches). Thus, this review found significant correlations between RPE or session-RPE, [La] and HR. Particularly, there was a stronger correlation between RPE and [La] during official striking (r = 0.81) than grappling combat sports matches (r = 0.53). In addition, a variation of correlation (moderate to large) between session-RPE and HR-based methods has been reported (i.e., Edwards' training load [r ranged between 0.58 and 0.95] and Banister training impulse [r ranged between 0.52 and 0.86]). Specifically, stronger correlation was apparent in combat sport competition that required a much higher percentage contribution of aerobic metabolism (e.g., karate) and in adult athletes than anaerobic-based combat sports (e.g., taekwondo) and young athletes, respectively. Indeed, the current review highlights that the correlations between session-RPE and HR-based methods were higher during official competition than training sessions. Session-RPE was affected by participants' competitive level, the intensity of session (high vs. low), the training modalities (tactical-technical vs. technical-development vs. simulated competition), and the training volume in combat sports athletes. Rating of perceived exertion is a valid tool for quantifying internal training and combat loads during short- and long-term training and simulated and official competitions in novice and elite combat sport athletes. Furthermore, both RPE methods may be a more reliable measure of intensity or effort when both anaerobic and aerobic systems are appreciably activated. Coaches, sports scientists, and athletes can use session-RPE method to quantify short-term training and combat loads in adult athletes during precompetitive period much more than long-term training and in young athletes during the competitive period. They can also use RPE to monitor combat and short- and long-term training loads to better plan and assist training programs and competitions.

The effect of autogenic training on salivary immunoglobulin A in surgical patients with breast cancer: a randomized pilot trial.

PubMed

Minowa, Chika; Koitabashi, Kikuyo

2014-11-01

Psychological stress among breast cancer patients can inhibit immune function and contribute to disease progression. We investigated the effects of autogenic training (AT), a relaxation method for reducing stress, on salivary immunoglobulin A (sIgA) in breast cancer surgery patients. Thirty patients scheduled to undergo breast cancer surgery were randomly assigned to an AT or control group (usual care). Patients in the AT group underwent training for 7 days after surgery. Salivary IgA and heart rate variability were assessed on the day before surgery, and on the third and seventh postoperative days. Levels of sIgA were significantly higher on the seventh postoperative day in the AT group (n = 7) compared to the control group (n = 7) (p = 0.049). These findings suggest that AT may improve immune function in breast surgery patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Who is Responsible for Training the Civilian Members of the Provincial Reconstruction Teams (PRTs)

DTIC Science & Technology

2010-05-01

Quoted from an interview conducted by AI. Hemingway , "CORDS: Winning Hearts and Minds in Vietnam," Vietnam Magazine, (February 1994). 82 Brig. Gen Dinh...Team-a model for coordination." Air University Review, July-August 1967. Hemingway , AI. "CORDS: Winning Hearts and Minds in Vietnam." Vietnam Magazine

Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

ERIC Educational Resources Information Center

Holly, Deirdre; Sharp, John

2014-01-01

People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

Exercise and the cardiovascular system: clinical science and cardiovascular outcomes.

PubMed

Lavie, Carl J; Arena, Ross; Swift, Damon L; Johannsen, Neil M; Sui, Xuemei; Lee, Duck-Chul; Earnest, Conrad P; Church, Timothy S; O'Keefe, James H; Milani, Richard V; Blair, Steven N

2015-07-03

Substantial evidence has established the value of high levels of physical activity, exercise training (ET), and overall cardiorespiratory fitness in the prevention and treatment of cardiovascular diseases. This article reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the effect of physical activity and cardiorespiratory fitness on cardiovascular diseases. This review also surveys data from epidemiological and ET studies in the primary and secondary prevention of cardiovascular diseases, particularly coronary heart disease and heart failure. These data strongly support the routine prescription of ET to all patients and referrals for patients with cardiovascular diseases, especially coronary heart disease and heart failure, to specific cardiac rehabilitation and ET programs. © 2015 American Heart Association, Inc.

An Experimental Evaluation of Stress-Management Training for the Airborne Soldier

DTIC Science & Technology

1980-06-01

skill takes considerable time and involves the learning of respiration control techniques and exercises to relax both the skeletal and smooth muscle...NUMBER 7. AUTHORia) 8. CONTRACT OR GRANT NUMBER(.) William P. Burke 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT, PROJECT, TASK US Army...block number) Jumpmaster training Performance under stress Stress-management training Stress reaction Respiration -control Heart rate response Deep

Comparison of the effects on dynamic balance and aerobic capacity between objective and subjective methods of high-intensity robot-assisted gait training in chronic stroke patients: a randomized controlled trial.

PubMed

Bae, Young-Hyeon; Lee, Suk Min; Ko, Mansoo

2017-05-01

Robot-assisted gait training (RAGT) is effective for improving dynamic balance and aerobic capacity, but previous RAGT method does not set suitable training intensity. Recently, high-intensity treadmill gait training at 70% of heart rate reserve (HRR) was used for improving aerobic capacity and dynamic balance. This study was designed to compare the effectiveness between objective and subjective methods of high-intensity RAGT for improving dynamic balance and aerobic capacity in chronic stroke. Subjects were randomly allocated into experimental (n = 17) and control (n = 17) groups. The experimental group underwent high-intensity RAGT at 70% of HRR, whereas the control group underwent high-intensity RAGT at an RPE of 15. Both groups received their assigned training for 30 min per session, 3 days per week for 6 weeks. All subjects also received an additional 30 min of conventional physical therapy. Before and after each of the 18 sessions, the dynamic balance and aerobic capacity of all subjects were evaluated by a blinded examiner. After training, Berg Balance Scale (BBS) and Timed Up and Go Test scores, VO 2 max, and VO 2 max/kg were significantly increased in both groups (p < 0.05). These variables in experimental group were significantly greater than control group. However, the BBS score was not significantly different between both groups. All subjects completed high-intensity RAGT. No adverse effect of training was observed in both groups. High-intensity RAGT at 70% of HRR significantly improved dynamic balance and aerobic capacity more than RAGT at RPE of 15. These results suggest that high-intensity RAGT at 70% of HRR is safe and effective for improving dynamic balance and aerobic capacity in chronic stroke.

Automated Management of Exercise Intervention at the Point of Care: Application of a Web-Based Leg Training System

PubMed Central

2015-01-01

Background Recent advances in information and communication technology have prompted development of Web-based health tools to promote physical activity, the key component of cardiac rehabilitation and chronic disease management. Mobile apps can facilitate behavioral changes and help in exercise monitoring, although actual training usually takes place away from the point of care in specialized gyms or outdoors. Daily participation in conventional physical activities is expensive, time consuming, and mostly relies on self-management abilities of patients who are typically aged, overweight, and unfit. Facilitation of sustained exercise training at the point of care might improve patient engagement in cardiac rehabilitation. Objective In this study we aimed to test the feasibility of execution and automatic monitoring of several exercise regimens on-site using a Web-enabled leg training system. Methods The MedExercise leg rehabilitation machine was equipped with wireless temperature sensors in order to monitor its usage by the rise of temperature in the resistance unit (Δt°). Personal electronic devices such as laptop computers were fitted with wireless gateways and relevant software was installed to monitor the usage of training machines. Cloud-based software allowed monitoring of participant training over the Internet. Seven healthy participants applied the system at various locations with training protocols typically used in cardiac rehabilitation. The heart rates were measured by fingertip pulse oximeters. Results Exercising in home chairs, in bed, and under an office desk was made feasible and resulted in an intensity-dependent increase of participants’ heart rates and Δt° in training machine temperatures. Participants self-controlled their activities on smart devices, while a supervisor monitored them over the Internet. Individual Δt° reached during 30 minutes of moderate-intensity continuous training averaged 7.8°C (SD 1.6). These Δt° were used as personalized daily doses of exercise with automatic email alerts sent upon achieving them. During 1-week training at home, automatic notifications were received on 4.4 days (SD 1.8). Although the high intensity interval training regimen was feasible on-site, it was difficult for self- and remote management. Opportunistic leg exercise under the desk, while working with a computer, and training in bed while viewing television were less intensive than dosed exercise bouts, but allowed prolonged leg mobilization of 73.7 minutes/day (SD 29.7). Conclusions This study demonstrated the feasibility of self-control exercise training on-site, which was accompanied by online monitoring, electronic recording, personalization of exercise doses, and automatic reporting of adherence. The results suggest that this technology and its applications are useful for the delivery of Web-based exercise rehabilitation and cardiac training programs at the point of care. PMID:28582243

The Evolution of the Use of β-Blockers to Treat Heart Failure: A Conversation With Finn Waagstein, MD.

PubMed

Waagstein, Finn; Rutherford, John D

2017-09-05

Finn Waagstein was born in Copenhagen in 1938. He graduated from Aarhus University Medical School in 1964. He received his cardiology training in the Sahlgrenska University Hospital at the University of Gothenburg, Sweden. He was appointed Associate Professor in 1980, and he assisted in establishing and directing the first Swedish heart transplant program. From 1990 he directed the heart failure and cardiomyopathy research programs. He is currently Professor of Cardiology and senior physician at Wallenberg Laboratory. In 2002, he was awarded the King Faisal International Prize for Medicine. © 2017 American Heart Association, Inc.

Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial.

PubMed

Brouwers, Rutger W M; Kraal, Jos J; Traa, Simone C J; Spee, Ruud F; Oostveen, Laurence M L C; Kemps, Hareld M C

2017-01-31

Cardiac rehabilitation has beneficial effects on morbidity and mortality in patients with coronary artery disease, but is vastly underutilised and short-term improvements are often not sustained. Telerehabilitation has the potential to overcome these barriers, but its superiority has not been convincingly demonstrated yet. This may be due to insufficient focus on behavioural change and development of patients' self-management skills. Moreover, potentially beneficial communication methods, such as internet and video consultation, are rarely used. We hypothesise that, when compared to centre-based cardiac rehabilitation, cardiac telerehabilitation using evidence-based behavioural change strategies, modern communication methods and on-demand coaching will result in improved self-management skills and sustainable behavioural change, which translates to higher physical activity levels in a cost-effective way. This randomised controlled trial compares cardiac telerehabilitation with centre-based cardiac rehabilitation in patients with coronary artery disease. We randomise 300 patients entering cardiac rehabilitation to centre-based cardiac rehabilitation (control group) or cardiac telerehabilitation (intervention group). The core component of the intervention is a patient-centred web application, which enables patients to adjust rehabilitation goals, inspect training and physical activity data, share data with other caregivers and to use video consultation. After six supervised training sessions, the intervention group continues exercise training at home, wearing an accelerometer and heart rate monitor. In addition, physical activity levels are assessed by the accelerometer for four days per week. Patients upload training and physical activity data weekly and receive feedback through video consultation once a week. After completion of the rehabilitation programme, on-demand coaching is performed when training adherence or physical activity levels decline with 50% or more. The primary outcome measure is physical activity level, assessed at baseline, three months and twelve months, and is calculated from accelerometer and heart rate data. Secondary outcome measures include physical fitness, quality of life, anxiety and depression, patient empowerment, patient satisfaction and cost-effectiveness. This study is one of the first studies evaluating effects and costs of a cardiac telerehabilitation intervention comprising a combination of modern technology and evidence-based behavioural change strategies including relapse prevention. We hypothesise that this intervention has superior effects on exercise behaviour without exceeding the costs of a traditional centre-based intervention. Netherlands Trial Register NTR5156 . Registered 22 April 2015.

A tutorial platform suitable for surgical simulator training (SimMentor).

PubMed

Røtnes, Jan Sigurd; Kaasa, Johannes; Westgaard, Geir; Eriksen, Eivind Myrold; Hvidsten, Per Oyvind; Strøm, Kyrre; Sørhus, Vidar; Halbwachs, Yvon; Haug, Einar; Grimnes, Morten; Fontenelle, Hugues; Ekeberg, Tom; Thomassen, Jan B; Elle, Ole Jakob; Fosse, Erik

2002-01-01

The introduction of simulators in surgical training entails the need to develop pedagogic platforms adapted to the potentials and limitations provided by the information technology. As a solution to the technical challenges in treating all possible interaction events and to obtain a suitable pedagogic approach, we have developed a pedagogic platform for surgical training, SimMentor. In SimMentor the procedure to be practiced is divided into a number of natural phases. The trainee will practice on one phase at a time, however he can select the sequence of phases arbitrarily. A phase is taught by letting the trainee alternate freely between 2 modes: 1: A 3-dimensional animated guidance designed for learning the objectives and challenges in a procedure. 2: An interactive training session through the instrument manipulator device designed for training motoric responses based on visual and tactile responses produced by the simulator. The two modes are interfaced with the same virtual reality platform, thus SimMentor allows a seamless transition between the modes. We have developed a prototype simulator for robotic assisted endoscopic CABG (Coronary Artery Bypass Grafting) procedure by first focusing on the anastomosis part of the operation. Tissue, suture and instrument models have been developed and integrated with a simulated model of a beating heart comprises the elements in the simulator engine that is used in construction a training platform for learning different methods for performing a coronary anastomosis procedure. The platform is designed for integrating the following features: 1) practical approach to handle interactivity events with flexible-objects 3D simulators, 2) methods for quantitative evaluations of performance, 3) didactic presentations, 4) effective ways of producing diversity of clinical and pathological training scenarios.

Individual patient meta-analysis of exercise training effects on systemic brain natriuretic peptide expression in heart failure.

PubMed

Smart, N A; Meyer, T; Butterfield, J A; Faddy, S C; Passino, C; Malfatto, G; Jonsdottir, S; Sarullo, F; Wisloff, U; Vigorito, C; Giallauria, F

2012-06-01

Brain natriuretic peptide (BNP) predicts exercise performance and exercise training may modulate BNP and its N-terminal portion (NT-pro-BNP), we therefore conducted an individual patient analysis of exercise training effects on BNP and NT-pro-BNP. To use an individual patient meta-analysis to relate changes in BNP, NT-pro-BNP, and peak VO(2); to link these changes to volume parameters of exercise training programmes (intensity etc.); and to identify patient characteristics likely to lead to greater improvements in BNP, NT-pro-BNP, and peak VO(2). Individual patient meta-analysis. A systematic search was conducted of Medline (Ovid), Embase.com, Cochrane Central Register of Controlled Trials, and CINAHL (until July 2008) to identify randomized controlled trials of aerobic and/or resistance exercise training in systolic heart failure patients measuring BNP and/or NT-pro-BNP. Primary outcome measures were change in BNP, NT-pro-BNP, and peak VO2. Subanalyses were conducted to identify (1) patient groups that benefit most and (2) exercise programme parameters enhancing favourable changes in primary outcome measures. Ten randomized controlled studies measuring BNP or NT-pro-BNP met eligibility criteria, authors provided individual patient data for 565 patients (313 exercise and 252 controls). Exercise training had favourable effects on BNP (-28.3%, p < 0.0001), NT-pro-BNP (-37.4%, p = < 0.0001), and peak VO(2) (17.8%, p < 0.0001). The analysis showed a significant change in primary outcome measures; moreover, change in BNP (r = -0.31, p < 0.0001) and NT-pro-BNP (r = -0.22, p < 0.0001) were correlated with peak VO(2) change. Exercise training has favourable effects on BNP, NT-pro-BNP, and peak VO(2) in heart failure patients and BNP/NT-pro-BNP changes were correlated with peak VO(2) changes.

Aerobic training and l-arginine supplementation promotes rat heart and hindleg muscles arteriogenesis after myocardial infarction.

PubMed

Ranjbar, Kamal; Rahmani-Nia, Farhad; Shahabpour, Elham

2016-09-01

Arteriogenesis is a main defense mechanism to prevent heart and local tissues dysfunction in occlusive artery disease. TGF-β and angiostatin have a pivotal role in arteriogenesis. We tested the hypothesis that aerobic training and l-arginine supplementation promotes cardiac and skeletal muscles arteriogenesis after myocardial infarction (MI) parallel to upregulation of TGF-β and downregulation of angiostatin. For this purpose, 4 weeks after LAD occlusion, 50 male Wistar rats were randomly distributed into five groups: (1) sham surgery without MI (sham, n = 10), (2) control-MI (Con-MI, n = 10), (3) l-arginine-MI (La-MI, n = 10), (4) exercise training-MI (Ex-MI, n = 10), and (5) exercise and l-arginine-MI (Ex + La-MI). Exercise training groups running on a treadmill for 10 weeks with moderate intensity. Rats in the l-arginine-treated groups drank water containing 4 % l-arginine. Arteriolar density with different diameters (11-25, 26-50, 51-75, and 76-150 μm), TGF-β, and angiostatin gene expression were measured in cardiac (area at risk) and skeletal (soleus and gastrocnemius) muscles. Smaller arterioles decreased in cardiac after MI. Aerobic training and l-arginine increased the number of cardiac arterioles with 11-25 and 26-50 μm diameters parallel to TGF-β overexpression. In gastrocnemius muscle, the number of arterioles/mm(2) was only increased in the 11 to 25 μm in response to training with and without l-arginine parallel to angiostatin downregulation. Soleus arteriolar density with different size was not different between experimental groups. Results showed that 10 weeks aerobic exercise training and l-arginine supplementation promotes arteriogenesis of heart and gastrocnemius muscles parallel to overexpression of TGF-β and downregulation of angiostatin in MI rats.

Effects of exercise training on cellular mechanisms of endothelial nitric oxide synthase regulation in coronary arteries after chronic occlusion

PubMed Central

Zhou, Minglong; Widmer, R. Jay; Xie, Wei; Jimmy Widmer, A.; Miller, Matthew W.; Schroeder, Friedhelm; Parker, Janet L.

2010-01-01

Exercise training enhances agonist-mediated relaxation in both control and collateral-dependent coronary arteries of hearts subjected to chronic occlusion, an enhancement that is mediated in part by nitric oxide. The purpose of the present study was to elucidate exercise training-induced adaptations in specific cellular mechanisms involved in the regulation of endothelial nitric oxide synthase (eNOS) in coronary arteries of ischemic hearts. Ameroid constrictors were surgically placed around the proximal left circumflex coronary artery (LCX) of adult female Yucatan miniature swine. Eight weeks postoperatively, animals were randomized into sedentary (pen-confined) or exercise training (treadmill run; 5 days/wk; 14 wk) protocols. Coronary artery segments (∼1.0 mm luminal diameter) were isolated from collateral-dependent (LCX) and control (nonoccluded left anterior descending) arteries 22 wk after ameroid placement. Endothelial cells were enzymatically dissociated, and intracellular Ca2+ responses (fura 2) to bradykinin stimulation were studied. Immunofluorescence and laser scanning confocal microscopy were used to quantify endothelial cell eNOS and caveolin-1 cellular distribution under basal and bradykinin-stimulated conditions. Immunoblot analysis was used to determine eNOS, phosphorylated (p)-eNOS, protein kinase B (Akt), pAkt, and caveolin-1 protein levels. Bradykinin-stimulated nitrite plus nitrate (NOx; nitric oxide metabolites) levels were assessed via HPLC. Exercise training resulted in significantly enhanced bradykinin-mediated increases in endothelial Ca2+ levels, NOx levels, and the distribution of eNOS-to-caveolin-1 ratio at the plasma membrane in endothelial cells of control and collateral-dependent arteries. Exercise training also significantly increased total eNOS and phosphorylated levels of eNOS (pSer1179) in collateral-dependent arteries. Total eNOS protein levels were also significantly increased in collateral-dependent arteries of sedentary animals. These data provide new insights into exercise training-induced adaptations in cellular mechanisms of nitric oxide regulation in collateral-dependent coronary arteries of chronically occluded hearts that contribute to enhanced nitric oxide production. PMID:20363881

Exercise-based cardiac rehabilitation in heart transplant recipients.

PubMed

Anderson, Lindsey; Nguyen, Tricia T; Dall, Christian H; Burgess, Laura; Bridges, Charlene; Taylor, Rod S

2017-04-04

Heart transplantation is considered to be the gold standard treatment for selected patients with end-stage heart disease when medical therapy has been unable to halt progression of the underlying pathology. Evidence suggests that aerobic exercise training may be effective in reversing the pathophysiological consequences associated with cardiac denervation and prevent immunosuppression-induced adverse effects in heart transplant recipients. To determine the effectiveness and safety of exercise-based rehabilitation on the mortality, hospital admissions, adverse events, exercise capacity, health-related quality of life, return to work and costs for people after heart transplantation. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO) and Web of Science Core Collection (Thomson Reuters) to June 2016. We also searched two clinical trials registers and handsearched the reference lists of included studies. We included randomised controlled trials (RCTs) of parallel group, cross-over or cluster design, which compared exercise-based interventions with (i) no exercise control (ii) a different dose of exercise training (e.g. low- versus high-intensity exercise training); or (iii) an active intervention (i.e. education, psychological intervention). The study population comprised adults aged 18 years or over who had received a heart transplant. Two review authors independently screened all identified references for inclusion based on pre-specified inclusion criteria. Disagreements were resolved by consensus or by involving a third person. Two review authors extracted outcome data from the included trials and assessed their risk of bias. One review author extracted study characteristics from included studies and a second author checked them against the trial report for accuracy. We included 10 RCTs that involved a total of 300 participants whose mean age was 54.4 years. Women accounted for fewer than 25% of all study participants. Nine trials which randomised 284 participants to receive exercise-based rehabilitation (151 participants) or no exercise (133 participants) were included in the main analysis. One cross-over RCT compared high-intensity interval training with continued moderate-intensity training in 16 participants. We reported findings for all trials at their longest follow-up (median 12 weeks).Exercise-based cardiac rehabilitation increased exercise capacity (VO 2peak ) compared with no exercise control (MD 2.49 mL/kg/min, 95% CI 1.63 to 3.36; N = 284; studies = 9; moderate quality evidence). There was evidence from one trial that high-intensity interval exercise training was more effective in improving exercise capacity than continuous moderate-intensity exercise (MD 2.30 mL/kg/min, 95% CI 0.59 to 4.01; N = 16; 1 study). Four studies reported health-related quality of life (HRQoL) measured using SF-36, Profile of Quality of Life in the Chronically Ill (PLC) and the World Health Organization Quality Of Life (WHOQoL) - BREF. Due to the variation in HRQoL outcomes and methods of reporting we were unable to meta-analyse results across studies, but there was no evidence of a difference between exercise-based cardiac rehabilitation and control in 18 of 21 HRQoL domains reported, or between high and moderate intensity exercise in any of the 10 HRQoL domains reported. One adverse event was reported by one study.Exercise-based cardiac rehabilitation improves exercise capacity, but exercise was found to have no impact on health-related quality of life in the short-term (median 12 weeks follow-up), in heart transplant recipients whose health is stable.There was no evidence of statistical heterogeneity across trials for exercise capacity and no evidence of small study bias. The overall risk of bias in included studies was judged as low or unclear; more than 50% of included studies were assessed at unclear risk of bias with respect to allocation concealment, blinding of outcome assessors and declaration of conflicts of interest. Evidence quality was assessed as moderate according to GRADE criteria. We found moderate quality evidence suggesting that exercise-based cardiac rehabilitation improves exercise capacity, and that exercise has no impact on health-related quality of life in the short-term (median 12 weeks follow-up), in heart transplant recipients. Cardiac rehabilitation appears to be safe in this population, but long-term follow-up data are incomplete and further good quality and adequately-powered trials are needed to demonstrate the longer-term benefits of exercise on safety and impact on both clinical and patient-related outcomes, such as health-related quality of life, and healthcare costs.

Effective heart disease prediction system using data mining techniques.

PubMed

Singh, Poornima; Singh, Sanjay; Pandi-Jain, Gayatri S

2018-01-01

The health care industries collect huge amounts of data that contain some hidden information, which is useful for making effective decisions. For providing appropriate results and making effective decisions on data, some advanced data mining techniques are used. In this study, an effective heart disease prediction system (EHDPS) is developed using neural network for predicting the risk level of heart disease. The system uses 15 medical parameters such as age, sex, blood pressure, cholesterol, and obesity for prediction. The EHDPS predicts the likelihood of patients getting heart disease. It enables significant knowledge, eg, relationships between medical factors related to heart disease and patterns, to be established. We have employed the multilayer perceptron neural network with backpropagation as the training algorithm. The obtained results have illustrated that the designed diagnostic system can effectively predict the risk level of heart diseases.

The Specificity of Rugby Union Training Sessions in Preparation for Match Demands.

PubMed

Campbell, Patrick G; Peake, Jonathan M; Minett, Geoffrey M

2018-04-01

Investigations into the specificity of rugby union training practices in preparation for competitive demands have predominantly focused on physical and physiological demands. The evaluation of the contextual variance in perceptual strain or skill requirements between training and matches in rugby union is unclear, yet holistic understanding may assist to optimize training design. This study evaluated the specificity of physical, physiological, perceptual, and skill demands of training sessions compared with competitive match play in preprofessional, elite club rugby union. Global positioning system devices, video capture, heart rate, and session ratings of perceived exertion were used to assess movement patterns, skill completions, physiologic, and perceptual responses, respectively. Data were collected across a season (training sessions n = 29; matches n = 14). Participants (n = 32) were grouped in playing positions as: outside backs, centers, halves, loose forwards, lock forwards, and front row forwards. Greater total distance, low-intensity activity, maximal speed, and meters per minute were apparent in matches compared with training in all positions (P < .02; d > 0.90). Similarly, match heart rate and session ratings of perceived exertion responses were higher than those recorded in training (P < .05; d > 0.8). Key skill completions for forwards (ie, scrums, rucks, and lineouts) and backs (ie, kicks) were greater under match conditions than in training (P < .001; d > 1.50). Considerable disparities exist between the perceptual, physiological, and key skill demands of competitive matches versus training sessions in preprofessional rugby union players. Practitioners should consider the specificity of training tasks for preprofessional rugby players to ensure the best preparation for match demands.

Knockout of p21-activated kinase-1 attenuates exercise-induced cardiac remodelling through altered calcineurin signalling

PubMed Central

Davis, Robert T.; Simon, Jillian N.; Utter, Megan; Mungai, Paul; Alvarez, Manuel G.; Chowdhury, Shamim A.K.; Heydemann, Ahlke; Ke, Yunbo; Wolska, Beata M.; Solaro, R. John

2015-01-01

Aims Despite its known cardiovascular benefits, the intracellular signalling mechanisms underlying physiological cardiac growth remain poorly understood. Therefore, the purpose of this study was to investigate a novel role of p21-activated kinase-1 (Pak1) in the regulation of exercise-induced cardiac hypertrophy. Methods and results Wild-type (WT) and Pak1 KO mice were subjected to 6 weeks of treadmill endurance exercise training (ex-training). Cardiac function was assessed via echocardiography, in situ haemodynamics, and the pCa–force relations in skinned fibre preparations at baseline and at the end of the training regimen. Post-translational modifications to the sarcomeric proteins and expression levels of calcium-regulating proteins were also assessed following ex-training. Heart weight/tibia length and echocardiography data revealed that there was marked hypertrophy following ex-training in the WT mice, which was not evident in the KO mice. Additionally, following ex-training, WT mice demonstrated an increase in cardiac contractility, myofilament calcium sensitivity, and phosphorylation of cardiac myosin-binding protein C, cardiac TnT, and tropomyosin compared with KO mice. With ex-training in WT mice, there were also increased protein levels of calcineurin and increased phosphorylation of phospholamban. Conclusions Our data suggest that Pak1 is essential for adaptive physiological cardiac remodelling and support previous evidence that demonstrates Pak1 signalling is important for cardiac growth and survival. PMID:26464331

Exercise training improves function of circulating angiogenic cells in patients with chronic heart failure.

PubMed

Van Craenenbroeck, Emeline M; Hoymans, Vicky Y; Beckers, Paul J; Possemiers, Nadine M; Wuyts, Kurt; Paelinck, Bernard P; Vrints, Christiaan J; Conraads, Viviane M

2010-09-01

Alterations in circulating angiogenic cells (CAC) and endothelial progenitor cells (EPC), known to contribute to endothelial repair, could explain the reversal of endothelial function in response to exercise training. Moreover, training-induced vascular remodeling might affect the acute response of EPC and CAC following a single exercise bout. We studied the impact of exercise training on CAC function and numbers of CD34(+)/KDR(+) EPC in patients with chronic heart failure (CHF) and we assessed the effect of acute exercise on CAC and EPC in sedentary and trained patients. Twenty-one sedentary CHF patients underwent 6-month exercise training and were compared to a non-trained control group (n = 17) and 10 healthy age-matched subjects. At baseline and follow-up, flow-mediated dilation was assessed and graded exercise testing (GXT) was performed. Before and immediately after GXT, CAC migratory capacity was assessed in vitro and circulating CD34(+)/KDR(+) EPC were quantified using flow cytometry. At baseline, CAC migration was significantly impaired in sedentary CHF patients but normalized acutely after GXT. Training corrected endothelial dysfunction, which coincided with a 77% increase in CAC migration (P = 0.0001). Moreover, the GXT-induced improvement detected at baseline was no longer observed after training. Numbers of CD34(+)/KDR(+) EPC increased following 6-month exercise training (P = 0.021), but were not affected by GXT, either prior or post-training. In conclusion, the present findings demonstrate for the first time that exercise training in CHF reverses CAC dysfunction and increases numbers of CD34(+)/KDR(+) EPC, which is accompanied by improvement of peripheral endothelial function. The acute exercise-induced changes in CAC function wane with exercise training, suggesting that repetitive exercise bouts progressively lead to functional endothelial repair.

Training Intensity Distribution Over a Four-Year Cycle in Olympic Champion Rowers: Different Roads Lead to Rio.

PubMed

Plews, Daniel J; Laursen, Paul B

2017-09-27

The purpose of this study was to compare the training intensity distribution (TID) of the undefeated world champion male rowing New Zealand (kiwi) pair over a four-year Olympic cycle, across training phases, training years, and between individuals. Training data, including heart rate and boat speed, were recorded in the athletes rowing in the same boat between March 2013 and August 2016, ending with the Rio Olympics final. Progressive exercise tests assessed first (LT 1 ) and second (LT 2 ) lactate thresholds and associated heart rates, to determine the percentage of training performed below, between and above these demarcation points. Training an average of only 12-15 h/wk throughout the Olympic cycle, the mean percent distribution of time (±SD) at each training intensity was 80.4 ± 5.5% LT 2 for Rower A and 67.3 ± 9.0% LT 2 for Rower B. Across the years 2014-2016, Rower A performed most likely more training

College Should Be an Intellectual Workout

ERIC Educational Resources Information Center

Malesic, Jonathan

2013-01-01

The physical fitness required to perform complex athletic feats has a parallel in the intellectual fitness it takes to perform complex mental tasks. At the heart of liberal education sits the idea that moderate training in several disciplines is better than intensive training in just one. Through exercising students' abilities in interpreting…

Professional Environment for Teacher Professional Development

ERIC Educational Resources Information Center

Zascerinska, Jelena

2010-01-01

Introduction. Teaching and training are at the heart of the knowledge society where the continuing professional development of teachers and trainers provides the cornerstone for the development of a high quality education and training systems. The Aim of the Study. To identify a design of professional environment for teacher professional…

Understanding the Impact of Cardiopulmonary Resuscitation Training on Participants' Perceived Confidence Levels

ERIC Educational Resources Information Center

Nordheim, Shawn M.

2013-01-01

This pre-experimental, participatory action research study investigated the impact of Cardiopulmonary Resuscitation (CPR) training on participants' perceived confidence and willingness to initiate CPR. Parents of seventh and eighth grade students were surveyed. Parent participants were asked to watch the American Heart Association's Family and…

Exercise Training and Energy Expenditure following Weight Loss

PubMed Central

Hunter, Gary R.; Fisher, Gordon; Neumeier, William H.; Carter, Stephen J.; Plaisance, Eric P.

2015-01-01

Purpose Determine the effects of aerobic or resistance training on activity related energy expenditure (AEE, kcal/d) and physical activity index (ARTE) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by a decrease in AEE, ARTE, and non-training physical activity energy expenditure (NEAT) and that exercise training would prevent decreases in free living energy expenditure. Methods 140 pre-menopausal women underwent an average of 25 pound weight loss during an 800 kcal/day diet of furnished food. One group aerobically trained 3 times/wk (40 min/d), another resistance trained 3 times/wk (10 exercises/2 sets x10 repetitions) and the third group did not exercise. DXA was used to measure body composition, indirect calorimetry to measure resting (REE) and walking energy expenditure, and doubly labeled water to measure total energy expenditure (TEE). AEE, ARTE, and non-training physical activity energy expenditure (NEAT) were calculated. Results TEE, REE, and NEAT all decreased following weight loss for the no exercise group, but not for the aerobic and resistance trainers. Only REE decreased in the two exercise groups. The resistance trainers increased ARTE. Heart rate and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Conclusion Exercise training prevents a decrease in energy expenditure, including free living energy expenditure separate from the exercise training, following weight loss. Resistance training increased physical activity, while ease and economy in walking associates with increased TEE, AEE, NEAT, and ARTE. PMID:25606816

Cardiovascular correlates of emotional state, cognitive workload and time-on-task effect during a realistic flight simulation.

PubMed

Hidalgo-Muñoz, Antonio R; Mouratille, Damien; Matton, Nadine; Causse, Mickaël; Rouillard, Yves; El-Yagoubi, Radouane

2018-04-05

In aviation, emotion and cognitive workload can considerably increase the probability of human error. An accurate online physiological monitoring of pilot's mental state could prevent accidents. The heart rate (HR) and heart rate variability (HRV) of 21 private pilots were analysed during two realistic flight simulator scenarios. Emotion was manipulated by a social stressor and cognitive workload with the difficulty of a secondary task. Our results confirmed the sensitivity of the HR to cognitive demand and training effects, with increased HR when the task was more difficult and decreased HR with training (time-on-task). Training was also associated with an increased HRV, with increased values along the flight scenario time course. Finally, the social stressor seemed to provoke an emotional reaction that enhanced motivation and performance on the secondary task. However, this was not reflected by the cardiovascular activity. Copyright © 2018 Elsevier B.V. All rights reserved.

The Mucosal Immune Function Is Not Compromised during a Period of High-Intensity Interval Training. Is It Time to Reconsider an Old Assumption?

PubMed

Born, Dennis-Peter; Zinner, Christoph; Sperlich, Billy

2017-01-01

Purpose: The aim of the study was to evaluate the mucosal immune function and circadian variation of salivary cortisol, Immunoglobin-A (sIgA) secretion rate and mood during a period of high-intensity interval training (HIIT) compared to long-slow distance training (LSD). Methods: Recreational male runners ( n = 28) completed nine sessions of either HIIT or LSD within 3 weeks. The HIIT involved 4 × 4 min of running at 90-95% of maximum heart rate interspersed with 3 min of active recovery while the LSD comprised of continuous running at 70-75% of maximum heart rate for 60-80 min. The psycho-immunological stress-response was investigated with a full daily profile of salivary cortisol and immunoglobin-A (sIgA) secretion rate along with the mood state on a baseline day, the first and last day of training and at follow-up 4 days after the last day of training. Before and after the training period, each athlete's running performance and peak oxygen uptake (V · O 2peak ) was determined with an incremental exercise test. Results: The HIIT resulted in a longer time-to-exhaustion ( P = 0.02) and increased V · O 2peak compared to LSD ( P = 0.01). The circadian variation of sIgA secretion rate showed highest values in the morning immediately after waking up followed by a decrease throughout the day in both groups ( P < 0.05). With HIIT, the wake-up response of sIgA secretion rate was higher on the last day of training ( P < 0.01) as well as the area under the curve (AUC G ) higher on the first and last day of training and follow-up compared to the LSD ( P = 0.01). Also the AUC G for the sIgA secretion rate correlated with the increase in V · O 2peak and running performance. The AUC G for cortisol remained unaffected on the first and last day of training but increased on the follow-up day with both, HIIT and LSD ( P < 0.01). Conclusion: The increased sIgA secretion rate with the HIIT indicates no compromised mucosal immune function compared to LSD and shows the functional adaptation of the mucosal immune system in response to the increased stress and training load of nine sessions of HIIT.

The Mucosal Immune Function Is Not Compromised during a Period of High-Intensity Interval Training. Is It Time to Reconsider an Old Assumption?

PubMed Central

Born, Dennis-Peter; Zinner, Christoph; Sperlich, Billy

2017-01-01

Purpose: The aim of the study was to evaluate the mucosal immune function and circadian variation of salivary cortisol, Immunoglobin-A (sIgA) secretion rate and mood during a period of high-intensity interval training (HIIT) compared to long-slow distance training (LSD). Methods: Recreational male runners (n = 28) completed nine sessions of either HIIT or LSD within 3 weeks. The HIIT involved 4 × 4 min of running at 90–95% of maximum heart rate interspersed with 3 min of active recovery while the LSD comprised of continuous running at 70–75% of maximum heart rate for 60–80 min. The psycho-immunological stress-response was investigated with a full daily profile of salivary cortisol and immunoglobin-A (sIgA) secretion rate along with the mood state on a baseline day, the first and last day of training and at follow-up 4 days after the last day of training. Before and after the training period, each athlete's running performance and peak oxygen uptake (V·O2peak) was determined with an incremental exercise test. Results: The HIIT resulted in a longer time-to-exhaustion (P = 0.02) and increased V·O2peak compared to LSD (P = 0.01). The circadian variation of sIgA secretion rate showed highest values in the morning immediately after waking up followed by a decrease throughout the day in both groups (P < 0.05). With HIIT, the wake-up response of sIgA secretion rate was higher on the last day of training (P < 0.01) as well as the area under the curve (AUCG) higher on the first and last day of training and follow-up compared to the LSD (P = 0.01). Also the AUCG for the sIgA secretion rate correlated with the increase in V·O2peak and running performance. The AUCG for cortisol remained unaffected on the first and last day of training but increased on the follow-up day with both, HIIT and LSD (P < 0.01). Conclusion: The increased sIgA secretion rate with the HIIT indicates no compromised mucosal immune function compared to LSD and shows the functional adaptation of the mucosal immune system in response to the increased stress and training load of nine sessions of HIIT. PMID:28744226

Biometric and Emotion Identification: An ECG Compression Based Method.

PubMed

Brás, Susana; Ferreira, Jacqueline H T; Soares, Sandra C; Pinho, Armando J

2018-01-01

We present an innovative and robust solution to both biometric and emotion identification using the electrocardiogram (ECG). The ECG represents the electrical signal that comes from the contraction of the heart muscles, indirectly representing the flow of blood inside the heart, it is known to convey a key that allows biometric identification. Moreover, due to its relationship with the nervous system, it also varies as a function of the emotional state. The use of information-theoretic data models, associated with data compression algorithms, allowed to effectively compare ECG records and infer the person identity, as well as emotional state at the time of data collection. The proposed method does not require ECG wave delineation or alignment, which reduces preprocessing error. The method is divided into three steps: (1) conversion of the real-valued ECG record into a symbolic time-series, using a quantization process; (2) conditional compression of the symbolic representation of the ECG, using the symbolic ECG records stored in the database as reference; (3) identification of the ECG record class, using a 1-NN (nearest neighbor) classifier. We obtained over 98% of accuracy in biometric identification, whereas in emotion recognition we attained over 90%. Therefore, the method adequately identify the person, and his/her emotion. Also, the proposed method is flexible and may be adapted to different problems, by the alteration of the templates for training the model.

Biometric and Emotion Identification: An ECG Compression Based Method

PubMed Central

Brás, Susana; Ferreira, Jacqueline H. T.; Soares, Sandra C.; Pinho, Armando J.

2018-01-01

We present an innovative and robust solution to both biometric and emotion identification using the electrocardiogram (ECG). The ECG represents the electrical signal that comes from the contraction of the heart muscles, indirectly representing the flow of blood inside the heart, it is known to convey a key that allows biometric identification. Moreover, due to its relationship with the nervous system, it also varies as a function of the emotional state. The use of information-theoretic data models, associated with data compression algorithms, allowed to effectively compare ECG records and infer the person identity, as well as emotional state at the time of data collection. The proposed method does not require ECG wave delineation or alignment, which reduces preprocessing error. The method is divided into three steps: (1) conversion of the real-valued ECG record into a symbolic time-series, using a quantization process; (2) conditional compression of the symbolic representation of the ECG, using the symbolic ECG records stored in the database as reference; (3) identification of the ECG record class, using a 1-NN (nearest neighbor) classifier. We obtained over 98% of accuracy in biometric identification, whereas in emotion recognition we attained over 90%. Therefore, the method adequately identify the person, and his/her emotion. Also, the proposed method is flexible and may be adapted to different problems, by the alteration of the templates for training the model. PMID:29670564

Does the Timing of Measurement Alter Session-RPE in Boxers?

PubMed

Uchida, Marco C; Teixeira, Luis F M; Godoi, Vladmir J; Marchetti, Paulo H; Conte, Marcelo; Coutts, Aaron J; Bacurau, Reury F P

2014-01-01

The purpose of this study was to compare the influence of measuring the overall session rating of perceived exertion (session-RPE) at 10 vs. 30 minutes following exercise. Eight boxers completed three different standardized training sessions of different intensities (easy, moderate and hard) in a matchedpairs, randomized research design. Exercise intensity was assessed during each bout by measuring heart rate, blood lactate concentration and session-RPE. To assess the effect of measurement timing on session-RPE, RPE data were collected either 10 or 30 minutes post-exercise. There was no significant effect of measurement time on session-RPE values following easy (10 minutes: session-RPE = 1.3 ± 1.0 Arbitrary Unit (AU), %Heart Rate Reserve (HRR) = 49.5 ± 11.1, and ∆Blood lactate = -2.3 ± 16.3%; 30 minutes: session-RPE = 1.7 ± 1.0 AU, %HRR = 51.3 ± 10.8, and ∆Blood lactate = 0.7 ± 25.2%), moderate (10 minutes: session-RPE = 2.7 ± 1.6 AU, %HRR = 67.2 ± 10.8, and ∆Blood lactate = 2.2 ± 19%; 30 minutes: session-RPE = 2.5 ± 0.9 AU, %HRR = 67.2 ± 5.9, and ∆Blood lactate = 24.5 ± 17.1%) and hard (10 minutes: session-RPE = 5.7 ± 1.0 AU, %HRR = 88.1 ± 6.3, and ∆Blood lactate = 146.3 ± 87.9%; 30 minutes: session-RPE = 5.8 ± 1.9 AU, %HRR> = 83.3 ± 8.0, and ∆Blood lactate = 91.6 ± 39%) sessions. In conclusion, our findings suggest that session-RPE can be used in boxing training routines across a range of intensities and accurate measurements can be determined as early as 10 minutes after exercise. Key PointsIt is difficult to quantify and monitoring the external training load in martial arts (e.g. Aikido, Kung Fu, Judo) and physical combat sports (e.g. Boxing, Muay Thai), session RPE method appears to be a reliable method to quantifying training load in those sports.For many athletes it is impractical to wait 30 minutes after training session to provide a session-RPE. The present findings show that collecting ses-sion-RPE measures at 10 min following exercise ses-sions of various intensities (i.e. easy, moderate, and hard) provide similar values as if taken 30 min fol-lowing the session.Our data have significant practical benefit and fur-ther support the practical usefulness of session-RPE for measuring internal training load in sport.

The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety.

PubMed

Lee, Jieun; Kim, Jung K; Wachholtz, Amy

Previous research studies have indicated that biofeedback treatment and relaxation techniques are effective in reducing psychological and physical symptoms (Hammond, 2005; Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E., 2008). However, dearth of studies has compared heart rate variability (HRV) biofeedback treatment and relaxation training to reduce trait anxiety. The objective of this study was to determine the effect of HRV biofeedback treatment and relaxation training in reducing trait anxiety compared to control group without any treatment using students in a science and engineering university of South Korea. For the present study, a total of 15 graduate students with moderate level of trait anxiety were recruited for 4 individual sessions every two weeks. They were randomly assigned into three groups: biofeedback treatment (n = 5), relaxation training (n = 5), and no treatment control group (n = 5). Our results revealed significant difference in change score of trait anxiety between the HRV biofeedback treatment and the no treatment control group. However, no significant difference was found between the relaxation training group and the no treatment control group. In addition, there was no significant difference between the HRV biofeedback treatment and the relaxation training. Results of the present study indicate that there is potential benefit in utilizing HRV biofeedback treatment for stress management programs and/or anxiety reduction treatment.

Effects of a Whatsapp-delivered physical activity intervention to enhance health-related physical fitness components and cardiovascular disease risk factors in older adults.

PubMed

Muntaner-Mas, Adrià; Vidal-Conti, Josep; Borràs, Pere A; Ortega, Francisco B; Palou, Pere

2017-01-01

This pilot study evaluated the feasibility and preliminary effectiveness of a 10-week WhatsApp-based intervention aimed at enhancing health-related physical fitness components and cardiovascular disease (CVD) risk factors compared with a face-to-face condition. Participants (N.=32) were assigned to one of three groups: training group (N.=16), mobile group (N.=7) and control group (N.=9). Training group and mobile group performed the same training program, based on strength training with elastics bands and aerobic exercise, during 10 weeks; only the delivery mode differed. The mobile group increased handgrip strength, aerobic capacity and decreased systolic blood pressure and heart rate after exercise though there were no significant differences respect to control group. The training group decreased significantly systolic blood pressure (P=0.038), diastolic blood pressure (P=0.005), mean arterial pressure (P=0.006) and heart rate after exercise (P=0.002), respect to control group. Comparison between training and mobile group showed that WhatsApp-based physical activity intervention was less effective than face-to-face condition. The results indicate that the use of an online social network produced slight changes in some health-related physical fitness components and CVD risk factors.

Maternal blood pressure and heart rate response to pelvic floor muscle training during pregnancy.

PubMed

Ferreira, Cristine H; Naldoni, Luciane M V; Ribeiro, Juliana Dos Santos; Meirelles, Maria Cristina C C; Cavalli, Ricardo de Carvalho; Bø, Kari

2014-07-01

To assess whether maternal blood pressure (BP) and heart rate (HR) change significantly in response to pelvic floor muscle training during pregnancy. Longitudinal exploratory study with repeated measurements. Twenty-seven nulliparous healthy women of mean age 23.3 years (range 18-36) and mean body mass index 23.4 (range 23.1-29.5). Individual supervised pelvic floor muscle training from gestational week 20 till 36 with assessment of BP and HR at gestational weeks 20, 24, 28, 32 and 36. Systolic and diastolic BP was measured before and after each training session and HR was monitored during each session. Pelvic floor muscle training did not change BP. 77% (n = 21) of participants exceeded 70% of estimated maximum HR during at least one session. The time for exceeding 70% of estimated maximum HR was between 2.2 and 3.2 % of the total exercise session. Increases in BP and HR from gestational weeks 20 till 36 were within normal limits for pregnant women. Pelvic floor muscle training in nulliparous sedentary pregnant women does not increase BP. It significantly increases HR during the exercise sessions, but only for a limited period of time and with no negative long-term effect on BP or HR. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Influence of ECG sampling rate in fetal heart rate variability analysis.

PubMed

De Jonckheere, J; Garabedian, C; Charlier, P; Champion, C; Servan-Schreiber, E; Storme, L; Debarge, V; Jeanne, M; Logier, R

2017-07-01

Fetal hypoxia results in a fetal blood acidosis (pH<;7.10). In such a situation, the fetus develops several adaptation mechanisms regulated by the autonomic nervous system. Many studies demonstrated significant changes in heart rate variability in hypoxic fetuses. So, fetal heart rate variability analysis could be of precious help for fetal hypoxia prediction. Commonly used fetal heart rate variability analysis methods have been shown to be sensitive to the ECG signal sampling rate. Indeed, a low sampling rate could induce variability in the heart beat detection which will alter the heart rate variability estimation. In this paper, we introduce an original fetal heart rate variability analysis method. We hypothesize that this method will be less sensitive to ECG sampling frequency changes than common heart rate variability analysis methods. We then compared the results of this new heart rate variability analysis method with two different sampling frequencies (250-1000 Hz).

The effects of aerobic exercise training on psychosocial aspects of men with type 2 diabetes mellitus.

PubMed

Sardar, Mohammad Ali; Boghrabadi, Vahdat; Sohrabi, Mehdi; Aminzadeh, Reza; Jalalian, Mehrdad

2014-01-20

This study was conducted to examine the effects of aerobic exercise training on psychosocial aspects (mental health, the aspects of physical symptoms, anxiety and insomnia, social functioning, and depression) in patients with type 2 diabetes mellitus. 53 men who had type 2 diabetes mellitus for a mean duration of the disease for 3±5 years were selected purposely and classified randomly into experimental (27 patients) and a control group (26 patients). Patients in the experimental group did aerobic exercise training three times a week for eight weeks. The exercise included an aerobic activity for 45 to 60 minutes during which the patients' heart rates were maintained at 60-70 percent of heart rate reserve on ergo meter bikes. The eight-week aerobic exercise training had significant effects on mental health (p = 0.002), subscales of physical symptoms (p = 0.006), and anxiety and insomnia (p = 0.001). It had no significant effects on subscales related to disorder of social functioning (p = 0.117) and depression (p = 0.657). Aerobic exercise training can be considered as an appropriate program for improving the health of the patients with type 2 diabetes mellitus, and it also can improve their mental health.

[Exercise therapy as a therapeutic concept].

PubMed

Reer, R; Ziegler, M; Braumann, K-M

2005-08-01

Lack of exercise is a primary cause for today's level of morbidity and mortality in the Western world. Thus, exercise as a therapeutic modality has an important role. Beneficial effects of exercise have been extensively documented, specifically in primary and secondary prevention of coronary heart disease (CHD), diabetes mellitus, hypertension, disorders of fat metabolism, heart insufficiency, cancer, etc. A regular (at least 3 x per week) endurance training program of 30-40 min duration at an intensity of 65-70% of VO(2)max involving large muscle groups is recommended. The specific exercise activity can also positively affect individuals with orthopedic disease patterns, i.e., osteoporosis, back pain, postoperative rehabilitation, etc. Endurance strength training in the form of sequential training involving approx. 8-10 different exercises for the most important muscle groups 2 x per week is a suitable exercise therapy. One to three sets with 8-12 repetitions per exercise should be performed until volitional exhaustion of the trained muscle groups among healthy adults and 15-20 repetitions among older and cardiac patients. Apart from a positive effect on the locomotor system, this type of strength training has positive effects on CHD, diabetes mellitus, and cancer.

Dynamic correlations between heart and brain rhythm during Autogenic meditation

PubMed Central

Kim, Dae-Keun; Lee, Kyung-Mi; Kim, Jongwha; Whang, Min-Cheol; Kang, Seung Wan

2013-01-01

This study is aimed to determine significant physiological parameters of brain and heart under meditative state, both in each activities and their dynamic correlations. Electrophysiological changes in response to meditation were explored in 12 healthy volunteers who completed 8 weeks of a basic training course in autogenic meditation. Heart coherence, representing the degree of ordering in oscillation of heart rhythm intervals, increased significantly during meditation. Relative EEG alpha power and alpha lagged coherence also increased. A significant slowing of parietal peak alpha frequency was observed. Parietal peak alpha power increased with increasing heart coherence during meditation, but no such relationship was observed during baseline. Average alpha lagged coherence also increased with increasing heart coherence during meditation, but weak opposite relationship was observed at baseline. Relative alpha power increased with increasing heart coherence during both meditation and baseline periods. Heart coherence can be a cardiac marker for the meditative state and also may be a general marker for the meditative state since heart coherence is strongly correlated with EEG alpha activities. It is expected that increasing heart coherence and the accompanying EEG alpha activations, heart brain synchronicity, would help recover physiological synchrony following a period of homeostatic depletion. PMID:23914165

Dynamic correlations between heart and brain rhythm during Autogenic meditation.

PubMed

Kim, Dae-Keun; Lee, Kyung-Mi; Kim, Jongwha; Whang, Min-Cheol; Kang, Seung Wan

2013-01-01

This study is aimed to determine significant physiological parameters of brain and heart under meditative state, both in each activities and their dynamic correlations. Electrophysiological changes in response to meditation were explored in 12 healthy volunteers who completed 8 weeks of a basic training course in autogenic meditation. Heart coherence, representing the degree of ordering in oscillation of heart rhythm intervals, increased significantly during meditation. Relative EEG alpha power and alpha lagged coherence also increased. A significant slowing of parietal peak alpha frequency was observed. Parietal peak alpha power increased with increasing heart coherence during meditation, but no such relationship was observed during baseline. Average alpha lagged coherence also increased with increasing heart coherence during meditation, but weak opposite relationship was observed at baseline. Relative alpha power increased with increasing heart coherence during both meditation and baseline periods. Heart coherence can be a cardiac marker for the meditative state and also may be a general marker for the meditative state since heart coherence is strongly correlated with EEG alpha activities. It is expected that increasing heart coherence and the accompanying EEG alpha activations, heart brain synchronicity, would help recover physiological synchrony following a period of homeostatic depletion.

[The effect of sodium chloride baths on the physical work capacity and extrasystole of patients with ischemic heart disease and stable stenocardia].

PubMed

Klemenkov, S V; Davydova, O B; Levitskiĭ, E F; Chashchin, N F; Sharova, O Ia; Kubushko, I V

1999-01-01

73 patients with ischemic heart disease (IHD) and stable angina pectoris of NYHA class I and II underwent balneotherapy. 43 of them took a course of sodium chloride baths, 30 control patients took common water baths. As shown by spiroveloergometry and Holter monitoring, sodium chloride baths are a good training modality in IHD patients. They enhance muscular performance and coronary heart reserve, reduce the mean 24-h number of ventricular extrasystoles by 49.9%, supraventricular extrasystoles by 57.5%.

Implantable Heart Aid

NASA Technical Reports Server (NTRS)

1980-01-01

Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

SU-G-BRC-13: Model Based Classification for Optimal Position Selection for Left-Sided Breast Radiotherapy: Free Breathing, DIBH, Or Prone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, H; Liu, T; Xu, X

Purpose: There are clinical decision challenges to select optimal treatment positions for left-sided breast cancer patients—supine free breathing (FB), supine Deep Inspiration Breath Hold (DIBH) and prone free breathing (prone). Physicians often make the decision based on experiences and trials, which might not always result optimal OAR doses. We herein propose a mathematical model to predict the lowest OAR doses among these three positions, providing a quantitative tool for corresponding clinical decision. Methods: Patients were scanned in FB, DIBH, and prone positions under an IRB approved protocol. Tangential beam plans were generated for each position, and OAR doses were calculated.more » The position with least OAR doses is defined as the optimal position. The following features were extracted from each scan to build the model: heart, ipsilateral lung, breast volume, in-field heart, ipsilateral lung volume, distance between heart and target, laterality of heart, and dose to heart and ipsilateral lung. Principal Components Analysis (PCA) was applied to remove the co-linearity of the input data and also to lower the data dimensionality. Feature selection, another method to reduce dimensionality, was applied as a comparison. Support Vector Machine (SVM) was then used for classification. Thirtyseven patient data were acquired; up to now, five patient plans were available. K-fold cross validation was used to validate the accuracy of the classifier model with small training size. Results: The classification results and K-fold cross validation demonstrated the model is capable of predicting the optimal position for patients. The accuracy of K-fold cross validations has reached 80%. Compared to PCA, feature selection allows causal features of dose to be determined. This provides more clinical insights. Conclusion: The proposed classification system appeared to be feasible. We are generating plans for the rest of the 37 patient images, and more statistically significant results are to be presented.« less

Heart smart: a multifaceted cardiovascular risk reduction program for grade school students.

PubMed

Hunter, S M; Johnson, C C; Little-Christian, S; Nicklas, T A; Harsha, D; Arbeit, M L; Webber, L S; Berenson, G S

1990-05-01

Abstract Heart Smart Program is a health education intervention for grades kindergarten through six which encourages the acquisition and maintenance of health-enhancing behaviors. These include nutritious eating habits; physical fitness and exercise; saying "no" to cigarette smoking, alcohol, and drugs; and control of stress. Social Cognitive Theory is used to derive the necessary training concepts for children with reinforcement of these concepts occurring in six areas: the curriculum, school lunch, staff development, physical activity, environment, and parental support. The necessary training mechanisms provide mastery experiences, knowledge transfer, role modeling, and emotional and physiological feedback. The program incorporates the influence of the social environment on learning and builds support from parents, teachers and school staff.

Potential contributions of training intensity on locomotor performance in individuals with chronic stroke.

PubMed

Holleran, Carey L; Rodriguez, Kelly S; Echauz, Anthony; Leech, Kristan A; Hornby, T George

2015-04-01

Many interventions can improve walking ability of individuals with stroke, although the training parameters that maximize recovery are not clear. For example, the contribution of training intensity has not been well established and may contribute to the efficacy of many locomotor interventions. The purpose of this preliminary study was to evaluate the effects of locomotor training intensity on walking outcomes in individuals with gait deficits poststroke. Using a randomized cross-over design, 12 participants with chronic stroke (>6-month duration) performed either high-intensity (70%-80% of heart rate reserve; n = 6) or low-intensity (30%-40% heart rate reserve; n = 6) locomotor training for 12 or fewer sessions over 4 to 5 weeks. Four weeks following completion, the alternate training intervention was performed. Training intensity was manipulated by adding loads or applying resistance during walking, with similar speeds, durations, and amount of stepping practice between conditions. Greater increases in 6-Minute Walk Test performance were observed following high-intensity training compared with low-intensity training. A significant interaction of intensity and order was also observed for 6-Minute Walk Test and peak treadmill speed, with the largest changes in those who performed high-intensity training first. Moderate correlations were observed between locomotor outcomes and measures of training intensity. This study provides the first evidence that the intensity of locomotor practice may be an important independent determinant of walking outcomes poststroke. In the clinical setting, the intensity of locomotor training can be manipulated in many ways, although this represents only 1 parameter to consider.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A90).

The effect of physical contact on changes in fatigue markers following rugby union field-based training.

PubMed

Roe, Gregory; Darrall-Jones, Joshua; Till, Kevin; Phibbs, Padraic; Read, Dale; Weakley, Jonathon; Rock, Andrew; Jones, Ben

2017-07-01

Repeated physical contact in rugby union is thought to contribute to post-match fatigue; however, no evidence exists on the effect of contact activity during field-based training on fatigue responses. Therefore, the purpose of this study was to examine the effect of contact during training on fatigue markers in rugby union players. Twenty academy rugby union players participated in the cross-over study. The magnitude of change in upper- and lower-body neuromuscular function (NMF), whole blood creatine kinase concentration [CK] and perception of well-being was assessed pre-training (baseline), immediately and 24 h post-training following contact and non-contact, field-based training. Training load was measured using mean heart rate, session rating of perceived exertion (sRPE) and microtechnology (Catapult Optimeye S5). The inclusion of contact during field-based training almost certainly increased mean heart rate (9.7; ±3.9%) and sRPE (42; ±29.2%) and resulted in likely and very likely greater decreases in upper-body NMF (-7.3; ±4.7% versus 2.7; ±5.9%) and perception of well-being (-8.0; ±4.8% versus  -3.4; ±2.2%) 24 h post-training, respectively, and almost certainly greater elevations in [CK] (88.2; ±40.7% versus 3.7; ±8%). The exclusion of contact from field-based training almost certainly increased running intensity (19.8; ±5%) and distance (27.5; ±5.3%), resulting in possibly greater decreases in lower-body NMF (-5.6; ±5.2% versus 2.3; ±2.4%). Practitioners should be aware of the different demands and fatigue responses of contact and non-contact, field-based training and can use this information to appropriately schedule such training in the weekly microcycle.

Response of the arterial blood pressure of quadriplegic patients to treadmill gait training.

PubMed

Carvalho, D C L; Cliquet, A

2005-09-01

Blood pressure pattern was analyzed in 12 complete quadriplegics with chronic lesions after three months of treadmill gait training. Before training, blood pressure values were obtained at rest, during treadmill walking and during the recovery phase. Gait training was performed for 20 min twice a week for three months. Treadmill gait was achieved using neuromuscular electrical stimulation, assisted by partial body weight relief (30-50%). After training, blood pressure was evaluated at rest, during gait and during recovery phase. Before and after training, mean systolic blood pressures and heart rates increased significantly during gait compared to rest (94.16 +/- 5.15 to 105 +/- 5.22 mmHg and 74.27 +/- 10.09 to 106.23 +/- 17.31 bpm, respectively), and blood pressure decreased significantly in the recovery phase (86.66 +/- 9.84 and 57.5 +/- 8.66 mmHg, respectively). After three months of training, systolic blood pressure became higher at rest (94.16 +/- 5.15 mmHg before training and 100 +/- 8.52 mmHg after training; P < 0.05) and during gait exercise (105 +/- 5.22 mmHg before and 110 +/- 7.38 mmHg after training; P < 0.05) when compared to the initial values, with no changes in heart rate. No changes occurred in blood pressure during the recovery phase, with the lower values being maintained. A drop in systolic pressure from 105 +/- 5.22 to 86.66 +/- 9.84 mmHg before training and from 110 +/- 7.38 to 90 +/- 7.38 mmHg after training was noticed immediately after exercise, thus resulting in hypotensive symptoms when chronic quadriplegics reach the sitting position from the upright position.

Resistance training alters skeletal muscle structure and function in human heart failure: effects at the tissue, cellular and molecular levels

PubMed Central

Toth, Michael J; Miller, Mark S; VanBuren, Peter; Bedrin, Nicholas G; LeWinter, Martin M; Ades, Philip A; Palmer, Bradley M

2012-01-01

Reduced skeletal muscle function in heart failure (HF) patients may be partially explained by altered myofilament protein content and function. Resistance training increases muscle function, although whether these improvements are achieved by correction of myofilament deficits is not known. To address this question, we examined 10 HF patients and 14 controls prior to and following an 18 week high-intensity resistance training programme. Evaluations of whole muscle size and strength, single muscle fibre size, ultrastructure and tension and myosin–actin cross-bridge mechanics and kinetics were performed. Training improved whole muscle isometric torque in both groups, although there were no alterations in whole muscle size or single fibre cross-sectional area or isometric tension. Unexpectedly, training reduced the myofibril fractional area of muscle fibres in both groups. This structural change manifested functionally as a reduction in the number of strongly bound myosin–actin cross-bridges during Ca2+ activation. When post-training single fibre tension data were corrected for the loss of myofibril fractional area, we observed an increase in tension with resistance training. Additionally, training corrected alterations in cross-bridge kinetics (e.g. myosin attachment time) in HF patients back to levels observed in untrained controls. Collectively, our results indicate that improvements in myofilament function in sedentary elderly with and without HF may contribute to increased whole muscle function with resistance training. More broadly, these data highlight novel cellular and molecular adaptations in muscle structure and function that contribute to the resistance-trained phenotype. PMID:22199163

Effects of nandrolone and resistance training on the blood pressure, cardiac electrophysiology, and expression of atrial β-adrenergic receptors.

PubMed

das Neves, Vander José; Tanno, Ana Paula; Cunha, Tatiana Sousa; Fernandes, Tiago; Guzzoni, Vinicius; da Silva, Carlos Alberto; de Oliveira, Edilamar Menezes; Moura, Maria José Costa Sampaio; Marcondes, Fernanda Klein

2013-05-30

This study was performed to assess isolated and combined effects of nandrolone and resistance training on the blood pressure, cardiac electrophysiology, and expression of the β1- and β2-adrenergic receptors in the heart of rats. Wistar rats were randomly divided into four groups and submitted to a 6-week treatment with nandrolone and/or resistance training. Cardiac hypertrophy was accessed by the ratio of heart weight to the final body weight. Blood pressure was determined by a computerized tail-cuff system. Electrocardiography analyses were performed. Western blotting was used to access the protein levels of the β1- and β2-adrenergic receptors in the right atrium and left ventricle. Both resistance training and nandrolone induced cardiac hypertrophy. Nandrolone increased systolic blood pressure depending on the treatment time. Resistance training decreased systolic, diastolic and mean arterial blood pressure, as well as induced resting bradycardia. Nandrolone prolonged the QTc interval for both trained and non-trained groups when they were compared to their respective vehicle-treated one. Nandrolone increased the expression of β1- and β2-adrenergic receptors in the right atrium for both trained and non-trained groups when they were compared to their respective vehicle-treated one. This study indicated that nandrolone, associated or not with resistance training increases blood pressure depending on the treatment time, induces prolongation of the QTc interval, and increases the expression of β1- and β2-adrenergic receptors in the cardiac right atrium, but not in the left ventricle. Copyright © 2013. Published by Elsevier Inc.

Influence of Football on Physiological Cardiac Indexes in Professional and Young Athletes

PubMed Central

Francavilla, Cristian V.; Sessa, Francesco; Salerno, Monica; Albano, Giuseppe D.; Villano, Ines; Messina, Giovanni; Triolo, Fabio; Todaro, Lorenzo; Ruberto, Maria; Marsala, Gabriella; Cascio, Orazio; Mollica, Maria P.; Monda, Vincenzo; Cibelli, Giuseppe; Valenzano, Anna; Zammit, Christian; Monda, Marcellino; Messina, Antonietta

2018-01-01

Background: After long-term intensive training, considerable morphological and functional heart changes occur in professional athletes. Such changes arise progressively and regress upon interruption of the physical activity. Morphological and functional alterations on heart are known as “Athlete's heart” condition. Objective: This study aims to compare echocardiographic parameters in two different groups of professional athletes. Furthermore, a prospective study is performed analyzing the echocardiographic changes occurring in 12 professional players in 3 years of follow-up. Materials and Methods: 78 football players were examined from July 2011 to May 2016 (40 enrolled in Group A and 38 in Group B). Twelve players of GROUP A were followed for 3 consecutive seasons. The general clinical examination, the cardiopulmonary evaluation, the ECG, the ergometer stress test, the spirometric examination and the standard cardiac eco color doppler test were recorded. Results: Left ventricle dimensions, left atrium dimensions, and interventricular septum dimensions were higher in A players than in B players. Moreover, following up 12 players for 3 years, a statistically significant increase of such values was observed. Discussion: In A players, higher dimensions of the left chambers and the interventricular septum were observed, compared to B players. No statistically significant difference was found regarding the ejection fraction. The 3 years follow-up showed a statistically significant increase of both left chambers and interventricular septum dimensions, particularly in the second and third year. Conclusions: These findings demonstrated that A players have higher echocardiographic parameters respect to B players. The results of this study support the scientific theory that long-term intensive training influences heart function, inducing “athlete's heart” with morphological adaptations. No significant echocardiographic variation within the examined sample was observed for different roles (goalkeeper, defender, midfielder, or attacker) or skills of individual players. PMID:29541036

Evaluation of HeartSmarts, a Faith-Based Cardiovascular Health Education Program.

PubMed

Tettey, Naa-Solo; Duran, Pedro A; Andersen, Holly S; Boutin-Foster, Carla

2017-02-01

In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p < 0.001), diastolic BP (3.38 mmHg, p < 0.001), weight (3lbs., p = 0.001), and BMI (0.46, p = 0.001). Cardiovascular disease health assessment scores had an average increase of 12.74 correct responses (p < 0.001). The HeartSmarts program may be an effective ecumenical and cultural model for disseminating health messages and reducing cardiovascular risk among African Americans.

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy.

PubMed

Wang, Jiazhou; Jin, Xiance; Zhao, Kuaike; Peng, Jiayuan; Xie, Jiang; Chen, Junchao; Zhang, Zhen; Studenski, Matthew; Hu, Weigang

2015-02-01

To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient's anatomic and dosimetric parameters for esophageal cancer patients. Eighty esophagus patients in the authors' institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlap volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman's rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. It is feasible to use patients' anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.

Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

PubMed Central

Reed, Shelby D.; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L.; Bowers, Margaret T.; Samsa, Gregory P.; Paul, Sara; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara J.

2011-01-01

Background Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Methods and Results Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers or health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. Conclusions The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions. PMID:22147884

Applying Resilience Promotion Training Among Special Forces Police Officers

PubMed Central

Andersen, Judith P.; Papazoglou, Konstantinos; Koskelainen, Mari; Nyman, Markku; Gustafsberg, Harri; Arnetz, Bengt B.

2015-01-01

Police Special Forces (a.k.a. special weapons and tactics [SWAT]) officers are tasked with responding to the most critical situations, including incidents that require specialized skills and equipment beyond typical policing activities. In this study, we tested the feasibility of applying Arnetz and colleagues’ resilience promotion training that was developed for patrol officers to SWAT team officers (n = 18). The resilience promotion training program included psychoeducation focused on police stress and resilience, and the practice of resilience promotion techniques (controlled breathing and imagery) while listening to audio-recorded critical incident scenarios. The aims of this study were to (a) examine if a resilience training program was relevant and accepted by SWAT team officers and (b) assess participants’ physiological stress responses (heart rate, respiration) during the resilience training sessions to note if there were improvements in stress responding over time. Our findings revealed that participants were able to significantly reduce their average heart rate and improve their ability to engage in controlled respiration (i.e., breathing) during simulated critical incidents over the course of the 5-day training. Improvements in stress responding were observed even when the critical incident scenarios became more graphic. Results suggest that an intervention to reduce stress responses of SWAT officers to critical incident scenarios works in a simulated training setting. Translation of these findings to real-world occupational hazards is a recommended next step. PMID:26137394

Sensitivity of monthly heart rate and psychometric measures for monitoring physical performance in highly trained young handball players.

PubMed

Buchheit, M

2015-05-01

The aim of the present study was to examine whether monthly resting heart rate (HR), HR variability (HRV) and psychometric measures can be used to monitor changes in physical performance in highly-trained adolescent handball players. Data were collected in 37 adolescent players (training 10±2.1 h.wk(-1)) on 11 occasions from September to May during the in-season period, and included an estimation of training status (resting HR and HRV, the profile of mood state (POMS) questionnaire), and 3 physical performance tests (a 10-m sprint, a counter movement jump and a graded aerobic intermittent test, 30-15 Intermittent Fitness Test). The sensitivity of HR and psychometric measures to changes in physical performance was poor (< 20%), irrespective of the training status markers and the performance measures. The specificity was however strong (> 75%), irrespective of the markers and the performance measures. Finally, the difference in physical performance between players with better vs. worse estimated training status were all almost certainly trivial. The present results highlight the limitation of monthly measures of resting HR, HRV and perceived mood and fatigue for predicting in-season changes in physical performance in highly-trained adolescent handball players. This suggests that more frequent monitoring might be required, and/or that other markers might need to be considered. © Georg Thieme Verlag KG Stuttgart · New York.