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Sample records for incremental exercise test

  1. Physiological and perceptual responses to incremental exercise testing in healthy men: effect of exercise test modality.

    PubMed

    Muscat, Kristina M; Kotrach, Houssam G; Wilkinson-Maitland, Courtney A; Schaeffer, Michele R; Mendonca, Cassandra T; Jensen, Dennis

    2015-11-01

    In a randomized cross-over study of 15 healthy men aged 20-30 years, we compared physiological and perceptual responses during treadmill and cycle exercise test protocols matched for increments in work rate - the source of increased locomotor muscle metabolic and contractile demands. The rates of O2 consumption and CO2 production were higher at the peak of treadmill versus cycle testing (p ≤ 0.05). Nevertheless, work rate, minute ventilation, tidal volume (VT), breathing frequency (fR), inspiratory capacity (IC), inspiratory reserve volume (IRV), tidal esophageal (Pes,tidal) and transdiaphragmatic pressure swings (Pdi,tidal), peak expiratory gastric pressures (Pga,peak), the root mean square of the diaphragm electromyogram (EMGdi,rms) expressed as a percentage of maximum EMGdi,rms (EMGdi,rms%max), and dyspnea ratings were similar at the peak of treadmill versus cycle testing (p > 0.05). Ratings of leg discomfort were higher at the peak of cycle versus treadmill exercise (p ≤ 0.05), even though peak O2 consumption was lower during cycling. Oxygen consumption, CO2 production, minute ventilation, fR, Pes,tidal, Pdi,tidal and Pga,peak were higher (p ≤ 0.05), while VT, IC, IRV, EMGdi,rms%max, and ratings of dyspnea and leg discomfort were similar (p > 0.05) at all or most submaximal work rates during treadmill versus cycle exercise. Our findings highlight important differences (and similarities) in physiological and perceptual responses at maximal and submaximal work rates during incremental treadmill and cycle exercise testing protocols. The lack of effect of exercise test modality on peak work rate advocates for the use of this readily available parameter to optimize training intensity determination, regardless of exercise training mode.

  2. Difference in Physiological Components of VO2 Max During Incremental and Constant Exercise Protocols for the Cardiopulmonary Exercise Test.

    PubMed

    Yamamoto, Junshiro; Harada, Tetsuya; Okada, Akinori; Maemura, Yuko; Yamamoto, Misaki; Tabira, Kazuyuki

    2014-08-01

    [Purpose] VO2 is expressed as the product of cardiac output and O2 extraction by the Fick equation. During the incremental exercise test and constant high-intensity exercise test, VO2 results in the attainment of maximal O2 uptake at exhaustion. However, the differences in the physiological components, cardiac output and muscle O2 extraction, have not been fully elucidated. We tested the hypothesis that constant exercise would result in higher O2 extraction than incremental exercise at exhaustion. [Subjects] Twenty-five subjects performed incremental exercise and constant exercise at 80% of their peak work rate. [Methods] Ventilatory, cardiovascular, and muscle oxygenation responses were measured using a gas analyzer, Finapres, and near-infrared spectroscopy, respectively. [Results] VO2 was not significantly different between the incremental exercise and constant exercise. However, cardiac output and muscle O2 saturation were significantly lower for the constant exercise than the incremental exercise at the end of exercise. [Conclusion] These findings indicate that if both tests produce a similar VO2 value, the VO2 in incremental exercise would have a higher ratio of cardiac output than constant exercise, and VO2 in constant exercise would have a higher ratio of O2 extraction than incremental exercise at the end of exercise.

  3. The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test.

    PubMed

    Wiles, Jonathan D; Allum, Simon R; Coleman, Damian A; Swaine, Ian L

    2008-01-15

    Currently, it is not possible to prescribe isometric exercise at an intensity that corresponds to given heart rates or systolic blood pressures. This might be useful in optimizing the effects of isometric exercise training. Therefore, the aim of this study was to explore the relationships between isometric exercise intensity and both heart rate and systolic blood pressure during repeated incremental isometric exercise tests. Fifteen participants performed seated isometric double-leg knee extension, during which maximum voluntary contraction (MVC) was assessed, using an isokinetic dynamometer. From this, a corresponding peak electromyographic activity (EMG(peak)) was determined. Subsequently, participants performed two incremental isometric exercise tests (at least 48 h apart) at 10, 15, 20, 25, and 30% EMG(peak), during which steady-state heart rate and systolic blood pressure were recorded. In all participants, there were linear relationships between %EMG(peak) and heart rate (r at least 0.91; P < 0.05) and between %EMG(peak) and systolic blood pressure (r at least 0.92; P < 0.05). Also, when repeated tests were compared, there were no differences in the slopes (P > 0.50) or elevations (P > 0.10) for either of the relationships. Therefore, these linear relationships could be used to identify isometric exercise training intensities that correspond to precise heart rates or systolic blood pressures. Training performed in this way might provide greater insight into the underlying mechanisms for the cardiovascular adaptations that are known to occur as a result.

  4. Comparative determination of ventilatory efficiency from constant load and incremental exercise testing.

    PubMed

    Algul, S; Ugur, F A; Ayar, A; Ozcelik, O

    2017-08-15

    The analysis of the relationships between minute ventilation (VE) to CO2 output (VCO2), referred to as ventilatory efficiency, in response to incremental exercise testing, is considered a useful index for assessing the presence and severity of cardiopulmonary and metabolic diseases. The effects of constant load exercise testing performed at work intensity associated with anaerobic threshold (AT) and respiratory compensation points (RCP), on the accurate measurements of ventilatory efficiency are not well known. The aim of this present study was to investigate the reliability of the VE/VCO2 ratio obtained from constant load exercise tests performed with two important metabolic rates (at the AT and RCP) and compare it to that of those of incremental exercise tests. A total of 20 young male (20.8±0.4 yr) subjects initially performed an incremental exercise test and then two constant load exercise tests, on different days. Respiratory and pulmonary gas exchange variables were used to estimate AT and RCP. A paired t-test was used to analyse data. AT and RCP (average) occurred the at 60% and at 71% of peak O2 uptake, respectively. The lowest VE/VCO2 ratio recorded within the first 2 minutes of constant load exercise tests with a work load of AT (26.4±0.3) and RCP (26.7±0.5) was not statistically different from the lowest ratio obtained from the incremental exercise tests (26.0±0.7). In the constant load exercise test, despite the different metabolic rates, the increase in ventilation corresponded closely with the increase in CO2 production, reflecting an optimal ventilation and perfusion ratio. Clinicians should consider the constant load exercise test work load associated with AT and RCP as it provides a meaningful lowest value for ventilatory efficiency.

  5. The validity of incremental exercise testing in discriminating of physiological profiles in elite runners.

    PubMed

    Legaz-Arrese, Alejandro; Munguía-Izquierdo, D; Carranza-García, L E; Reverter-Masía, J; Torres-Dávila, C G; Medina-Rodríguez, R E

    2011-06-01

    The goal of this study was to determine whether traditional ergoespirometric incremental exercise testing carried out to the point of exhaustion could be useful in distinguishing the physiological profiles of elite runners that compete in races that lasted about 8 minutes versus those that lasted about 2 hours. Ten male marathon runners (performance time: 2:12:04, coefficient of variation (CV) = 2.33%) and 8 male 3000 m steeplechase runners (performance time: 8:37.83, CV = 2.12%) performed an incremental test on the treadmill (starting speed 10 km·h-1; increments, 2 km·h-1; increment duration, 3 min to exhaustion). Heart rate (HR), VO2, and lactate concentrations were measured at the end of each exercise level. At maximal effort, there were no differences between the groups regarding VO2max and maximal HR; however, the workload time, vVO2max and peak treadmill velocity were significantly higher in the 3000 m steeplechase group (p<0.05). At submaximal effort, there were no significant differences between groups for VO2 (ml·kg-1·min-1), HR, or lactate. Our results show that this type of testing was not sufficient for discriminating the physiological profiles of elite runners who competed in middle-distance versus long-distance events (e.g. in the marathon and the 3000 m steeplechase).

  6. Lactate minimum test during incremental running after a submaximal cycling exercise: a novel test with training applications for triathletes.

    PubMed

    Vicente-Campous, D; Barbado, C; Nuñez, M J; Chicharro, J L

    2014-12-01

    The purpose of the present study was to determine whether running speed determined in a lactate minimum test (lactate minimum intensity, LMI) during a treadmill incremental exercise performed just after submaximal cycling corresponds to the speed of a respiratory exchange ratio of 1.00 (RER-1) and, by extension, to the maximal lactate steady state (MLSS) previously obtained in a standard incremental exercise test. Eighteen moderately trained triathletes (15 men, 3 women) underwent two exercise sessions 72 h apart in random order: 1) a standard incremental treadmill test to identify the speed corresponding to RER-1, and 2) a submaximal exercise test on a bicycle-ergometer to obtain the LT (lactate threshold) followed by the incremental portion of the lactate minimum test on the treadmill. No significant differences were detected between running speed and heart rate at RER-1 and LMI (14.44±1.24 vs. 14.11±1.36 km·h-1 and 166.38±9.30 vs. 169.55±8.97 beats·min-1, respectively). Moreover, 95% of the differences between the results of the two incremental tests for running speed and heart rate were within the limits of agreement. These findings suggest the possibility of obtaining a valid physiological profile of a triathlete using a single test to assess the level of training in both cycling and running.

  7. The mathematical analysis of the heart rate and blood lactate curves during incremental exercise testing.

    PubMed

    Rosic, Mirko; Ilic, V; Obradovic, Z; Pantovic, S; Rosic, G

    2011-12-01

    This paper describes a new mathematical approach for the analysis of HR (heart rate) and BL (blood lactate) curves during incremental exercise testing using a HR/BL curve and its derivatives, taking into account the native shape of all curves, without any linear approximation. Using this approach the results indicate the appearance of three characteristic points (A, B and C) on the HR/BL curve. The point A on the HR/BL curve which is the value that corresponds to the load (12.73 ± 0.46 km h-1) at which BL starts to increase above the resting levels (0.9 ± 0.06 mM), and is analogous to Lactate Turn Point 1 (LTP1). The point C on the HR/BL curve which corresponds to a BL of approximately 4mM, and is analogous to LTP2. The point B on the HR/BL curve, which corresponds to the load (16.32 ± 0.49 km h-1) at which the moderate increase turns into a more pronounced increase in BL. This point has not been previously recognized in literature. We speculate this point represents attenuation of left ventricular ejection fraction (LVEF) increase, accompanied by the decrease in diastolic time duration during incremental exercise testing. Proposed mathematical approach allows precise determination of lactate turnpoints during incremental exercise testing.

  8. Non-invasive prediction of blood lactate response to constant power outputs from incremental exercise tests.

    PubMed

    Sullivan, C S; Casaburi, R; Storer, T W; Wasserman, K

    1995-01-01

    We determined the ability of gas exchange analyses during incremental exercise tests (IXT) to predict blood lactate levels associated with a range of constant power output cycle ergometer tests. Twenty-seven healthy young men performed duplicate IXT and four 15-min constant power output tests at intensities ranging from moderate to very severe, before and after a training program. End-exercise blood lactate levels were approximated from superficial venous samples obtained 60 s after each constant power output test. From IXT, the power outputs corresponding to peak oxygen uptake (Wmax) and lactic acidosis threshold (WLAT), were determined. We examined the ability of four measures of exercise intensity to predict blood lactate levels for power outputs above the LAT: (1) power output (W), (2) power difference (W-WLAT), (3) power fraction (W/Wmax) and (4) power difference to delta ratio [(W-WLAT)/(Wmax-WLAT)]. Correlation coefficients were r = 0.38, 0.69, 0.75, and 0.81, respectively. The best linear regression prediction equation was: lactate (mmol.l-1) = 12.2[(W-WLAT)/(Wmax-WLAT)] + 0.7 mmol.l-1. This relationship was not significantly affected by training, despite increased values of LAT and peak oxygen uptake. Normalizing exercise intensity to the range of power outputs between WLAT and Wmax provided an estimate of blood lactate response to constant power outputs with a standard error of the estimate of 1.66 mmol.l-1.

  9. Signal-morphology impedance cardiography during incremental cardiopulmonary exercise testing in pulmonary arterial hypertension.

    PubMed

    Ferreira, Eloara M; Ota-Arakaki, Jaquelina S; Barbosa, Priscila B; Siqueira, Ana Cristina B; Bravo, Daniela M; Kapins, Carlos Eduardo B; Silva, Célia Maria C; Nery, Luiz Eduardo; Neder, J Alberto

    2012-09-01

    Haemodynamic responses to exercise are related to physical impairment and worse prognosis in patients with pulmonary arterial hypertension (PAH). It is clinically relevant, therefore, to investigate the practical usefulness of non-invasive methods of monitoring exercise haemodynamics in this patient population. Using a novel impedance cardiography (ICG) approach that does not require basal impedance estimations and relies on a morphological analysis of the impedance signal (Signal-Morphology-ICG(™)), stroke volume (SV) and cardiac index (CI) were evaluated in 50 patients and 21 age-matched controls during a ramp-incremental cardiopulmonary exercise testing. Technically unacceptable readings were found in 12 of 50 (24%) patients. In the remaining subjects, early decrease (N = 9) or a 'plateau' in SV (N = 8) and Δ (peak-unloaded exercise) SV <10 ml were markers of more advanced PAH (P<0.05). ΔCI ≤ 1.5-fold and early estimated lactate threshold were the only independent predictors of a severely reduced peak oxygen uptake (VO(2)) in patients (R(2) = 0.71, P<0.001). The finding of ΔCI ≤ 1.5-fold plus peak VO(2) < 50% predicted was associated with a number of clinical and functional markers of disease severity (P<0.001). In addition, abnormal SV responses and ΔCI ≤ 1.5-fold were significantly related to 1-year frequency of PAH-related adverse events (death and balloon atrial septostomy, N = 8; P<0.05). 'Qualitative' and 'semi-quantitative' signal-morphology impedance cardiography(™) (PhysioFlow(™)) during incremental exercise provided clinically useful information to estimate disease severity and short-term prognosis in patients with PAH in whom acceptable impedance signals could be obtained. © 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

  10. Clinical Usefulness of Response Profiles to Rapidly Incremental Cardiopulmonary Exercise Testing

    PubMed Central

    Ramos, Roberta P.; Alencar, Maria Clara N.; Treptow, Erika; Arbex, Flávio; Ferreira, Eloara M. V.; Neder, J. Alberto

    2013-01-01

    The advent of microprocessed “metabolic carts” and rapidly incremental protocols greatly expanded the clinical applications of cardiopulmonary exercise testing (CPET). The response normalcy to CPET is more commonly appreciated at discrete time points, for example, at the estimated lactate threshold and at peak exercise. Analysis of the response profiles of cardiopulmonary responses at submaximal exercise and recovery, however, might show abnormal physiologic functioning which would not be otherwise unraveled. Although this approach has long been advocated as a key element of the investigational strategy, it remains largely neglected in practice. The purpose of this paper, therefore, is to highlight the usefulness of selected submaximal metabolic, ventilatory, and cardiovascular variables in different clinical scenarios and patient populations. Special care is taken to physiologically justify their use to answer pertinent clinical questions and to the technical aspects that should be observed to improve responses' reproducibility and reliability. The most recent evidence in favor of (and against) these variables for diagnosis, impairment evaluation, and prognosis in systemic diseases is also critically discussed. PMID:23766901

  11. Incremental exercise test for the evaluation of peak oxygen consumption in paralympic swimmers.

    PubMed

    de Souza, Helton; DA Silva Alves, Eduardo; Ortega, Luciana; Silva, Andressa; Esteves, Andrea M; Schwingel, Paulo A; Vital, Roberto; DA Rocha, Edilson A; Rodrigues, Bruno; Lira, Fabio S; Tufik, Sergio; DE Mello, Marco T

    2016-04-01

    Peak oxygen consumption (VO2peak) is a fundamental parameter used to evaluate physical capacity. The objective of this study was to explore two types of incremental exercise tests used to determine VO2peak in four Paralympic swimmers: arm ergometer testing in the laboratory and testing in the swimming pool. On two different days, the VO2peak values of the four athletes were measured in a swimming pool and by a cycle ergometer. The protocols identified the VO2peak by progressive loading until the volitional exhaustion maximum was reached. The results were analyzed using the paired Student's t-test, Cohen's d effect sizes and a linear regression. The results showed that the VO2peak values obtained using the swimming pool protocol were higher (P=0.02) than those obtained by the arm ergometer (45.8±19.2 vs. 30.4±15.5; P=0.02), with a large effect size (d=3.20). When analyzing swimmers 1, 2, 3 and 4 individually, differences of 22.4%, 33.8%, 60.1% and 27.1% were observed, respectively. Field tests similar to the competitive setting are a more accurate way to determine the aerobic capacity of Paralympic swimmers. This approach provides more sensitive data that enable better direction of training, consequently facilitating improved performance.

  12. Mathematical analysis of the heart rate performance curve during incremental exercise testing.

    PubMed

    Rosic, G; Pantovic, S; Niciforovic, J; Colovic, V; Rankovic, V; Obradovic, Z; Rosic, Mirko

    2011-03-01

    In this study we performed laboratory treadmill protocols of increasing load. Heart rate was continuously recorded and blood lactate concentration was measured for determination of lactate threshold by means of LTD-max and LT4.0 methods.Our results indicate that the shape of heart rate performance curve (HRPC) during incremental testing depends on the applied exercise protocol (change of initial speed and the step of running speed increase, with the constant stage duration). Depending on the applied protocol, the HRPC can be described by linear, polynomial (S-shaped), and exponential mathematical expression.We presented mathematical procedure for estimation of heart rate threshold points at the level of LTD-max and LT4.0, by means of exponential curve and its relative deflection from the initial trend line (tangent line to exponential curve at the point of starting heart rate). The relative deflection of exponential curve from the initial trend line at the level of LTD-max and/or LT4.0 can be defined, based on the slope of the initial trend line. Using originally developed software that allows mathematical analysis of heart rate-load relation, LTD-max and/or LT4.0 can be estimated without direct measurement of blood lactate concentration.

  13. Thermography for skin temperature evaluation during dynamic exercise: a case study on an incremental maximal test in elite male cyclists.

    PubMed

    Ludwig, Nicola; Trecroci, Athos; Gargano, Marco; Formenti, Damiano; Bosio, Andrea; Rampinini, Ermanno; Alberti, Giampietro

    2016-12-01

    The use of thermal imaging in monitoring the dynamic of skin temperature during prolonged physical exercise is central to assess athletes' ability to dissipate heat from the skin surface to the environment. In this study, seven elite cyclists completed an incremental maximal cycling test to evaluate their skin temperature response under controlled-environment conditions. Thermal images have been analyzed using a method based on maxima detection (Tmax). Data confirmed a reduction in skin temperature due to vasoconstriction during the exercise, followed by a temperature increment after exhaustion. A characteristic hot-spotted thermal pattern was found over the skin surface in all subjects. This research confirmed also the notable ability by highly trained cyclists to modify skin temperature during an incremental muscular effort. This study gives additional contributions for understanding the capability of the Tmax method applied to the thermoregulatory physiological processes.

  14. Sex-Based Effects on Immune Changes Induced by a Maximal Incremental Exercise Test in Well-Trained Swimmers

    PubMed Central

    Morgado, José P.; Monteiro, Cristina P.; Matias, Catarina N.; Alves, Francisco; Pessoa, Pedro; Reis, Joana; Martins, Fátima; Seixas, Teresa; Laires, Maria J.

    2014-01-01

    Studies examining the immune response to acute intensive swimming have shown increased leukocytosis and lymphocyte populations. However, studies concerning mucosal immunity and sex differences remain controversial. The objective of the study was to examine sex differences on the immune response to maximal incremental swimming exercise in well trained swimmers. Participants (11 females, controlled for menstrual cycle phase effects; 10 males) performed a maximal incremental 7x200 m front crawl set. Fingertip capillary blood samples were obtained after each 200 m swim for lactate assessment. Venous blood and saliva samples were collected before and 5 minutes after the swimming test to determine total numbers of leukocytes, lymphocytes and subpopulations, and serum and salivary immunoglobulin A (IgA) levels. IgA secretion rate was calculated. Menstrual cycle phase did not influence the immune response to exercise. As for sex differences, exercise induced an increase in leukocytes, total lymphocytes, CD3+, CD4+, CD8+, and CD16+/56+ in males. In females, only leukocytosis, of a lower magnitude than was observed in males, occurred. CD19+ increased and CD4+/CD8+ ratio decreased in both groups following exercise whilst IgA, SIgA concentrations, and srIgA did not change. Both males and females finished the incremental exercise very close to the targeted race velocity, attaining peak blood lactate concentrations of 14.6±2.25 and 10.4±1.99 mmol.L-1, respectively. The effect of a maximal incremental swimming task on immunity is sex dependent and more noticeable in men. Males, as a consequence of higher levels of immunosurveillance may therefore be at a lower risk of infection than females. Key Points Maximal exercise induces an immune response. This study investigated the influence of sex over the leukocytes subpopulations and mucosal immune responses to maximal swimming. Male swimmers showed a stronger increase of T helper, T cytotoxic and NK lymphocytes than females

  15. Sex-based effects on immune changes induced by a maximal incremental exercise test in well-trained swimmers.

    PubMed

    Morgado, José P; Monteiro, Cristina P; Matias, Catarina N; Alves, Francisco; Pessoa, Pedro; Reis, Joana; Martins, Fátima; Seixas, Teresa; Laires, Maria J

    2014-09-01

    Studies examining the immune response to acute intensive swimming have shown increased leukocytosis and lymphocyte populations. However, studies concerning mucosal immunity and sex differences remain controversial. The objective of the study was to examine sex differences on the immune response to maximal incremental swimming exercise in well trained swimmers. Participants (11 females, controlled for menstrual cycle phase effects; 10 males) performed a maximal incremental 7x200 m front crawl set. Fingertip capillary blood samples were obtained after each 200 m swim for lactate assessment. Venous blood and saliva samples were collected before and 5 minutes after the swimming test to determine total numbers of leukocytes, lymphocytes and subpopulations, and serum and salivary immunoglobulin A (IgA) levels. IgA secretion rate was calculated. Menstrual cycle phase did not influence the immune response to exercise. As for sex differences, exercise induced an increase in leukocytes, total lymphocytes, CD3(+), CD4(+), CD8(+), and CD16(+)/56(+) in males. In females, only leukocytosis, of a lower magnitude than was observed in males, occurred. CD19(+) increased and CD4(+)/CD8(+) ratio decreased in both groups following exercise whilst IgA, SIgA concentrations, and srIgA did not change. Both males and females finished the incremental exercise very close to the targeted race velocity, attaining peak blood lactate concentrations of 14.6±2.25 and 10.4±1.99 mmol.L(-1), respectively. The effect of a maximal incremental swimming task on immunity is sex dependent and more noticeable in men. Males, as a consequence of higher levels of immunosurveillance may therefore be at a lower risk of infection than females. Key PointsMaximal exercise induces an immune response.This study investigated the influence of sex over the leukocytes subpopulations and mucosal immune responses to maximal swimming.Male swimmers showed a stronger increase of T helper, T cytotoxic and NK lymphocytes than

  16. Perspective: Does Laboratory-Based Maximal Incremental Exercise Testing Elicit Maximum Physiological Responses in Highly-Trained Athletes with Cervical Spinal Cord Injury?

    PubMed

    West, Christopher R; Leicht, Christof A; Goosey-Tolfrey, Victoria L; Romer, Lee M

    2015-01-01

    The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate) responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push). In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardized exercise intensities.

  17. Perspective: Does Laboratory-Based Maximal Incremental Exercise Testing Elicit Maximum Physiological Responses in Highly-Trained Athletes with Cervical Spinal Cord Injury?

    PubMed Central

    West, Christopher R.; Leicht, Christof A.; Goosey-Tolfrey, Victoria L.; Romer, Lee M.

    2016-01-01

    The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate) responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push). In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardized exercise intensities. PMID:26834642

  18. Challenging a dogma of exercise physiology: does an incremental exercise test for valid VO 2 max determination really need to last between 8 and 12 minutes?

    PubMed

    Midgley, Adrian W; Bentley, David J; Luttikholt, Hans; McNaughton, Lars R; Millet, Gregoire P

    2008-01-01

    A widely cited recommendation is that to elicit valid maximal oxygen uptake (VO(2 max)) values, incremental exercise tests should last between 8 and 12 minutes. However, this recommendation originated from the findings of a single experimental study conducted by Buchfuhrer et al. in 1983. Although this study is an important contribution to scientific knowledge, it should not be viewed as sufficient evidence to support the recommendation for eliciting valid VO(2 max) values. At least eight studies have reported that durations as short as 5 minutes and as long as 26 minutes elicit VO(2 max) values similar to those derived from tests of 8-12 minutes' duration. Two studies reported that the shorter test protocols elicited significantly higher VO(2 max) values in untrained men and women. In three studies that reported significantly higher VO(2 max) values determined during tests of 8-12 minutes than during more prolonged tests, the prolonged tests were associated with maximal treadmill grades of 20-25%, compared with 6-10% in the shorter tests. Therefore, intolerable treadmill grades, rather than the prolonged test duration, may have limited the ability to elicit VO(2 max). In view of the available evidence, test administrators, reviewers and journal editors should not view 8-12 minutes' duration for incremental exercise tests as obligatory for valid VO(2 max) determination. Current evidence suggests that to elicit valid VO(2 max) values, cycle ergometer tests should last between 7 and 26 minutes and treadmill tests between 5 and 26 minutes. This is dependent on the qualification that short tests are preceded by an adequate warm-up and that treadmill grades do not exceed 15%. Current research is too limited to indicate appropriate test duration ranges for discontinuous test protocols, or protocols incorporating high treadmill grades.

  19. Quantification and physiological significance of the rightward shift of the V-slope during incremental cardiopulmonary exercise testing.

    PubMed

    Nishijima, Hirotaka; Kondo, Kazuo; Yonezawa, Kazuya; Hashimoto, Hiroki; Sakurai, Masayuki

    2017-01-01

    Ventilatory anaerobic threshold (VAT) is frequently used as a measure of exercise tolerance, with the V-slope method being the standard; however, this needs to be visually determined. Over the years, we have observed that the V-slope itself often appears to shift rightward before the appearance of the VAT (RtShift: rightward shift of V-slope). This phenomenon has long been known to occur during the first 1-2 min of steady-state exercise and disappears thereafter; it is attributed to CO2 storage, presumably in active muscle. However, during incremental exercise, we have observed that the RtShift persists; furthermore, it seems to be related to the level of VAT. Therefore, we attempted to objectively quantify the RtShift, and to confirm its relationship to an index of exercise tolerance (VAT). This study was based on a retrospective analysis of data from 100 cardiopulmonary ramp exercise tests (submaximal) performed by patients with cardiac disease. VAT was determined with the visual V-slope method. The horizontal distances between the diagonal R = 1 line and each data point on the V-slope plot to the right of R = 1 were measured; the average of these measurements was used as an objectively determined estimate of RtShift. The predominant portion of RtShift occurred earlier than VAT. The mean RtShift was 33.9 ± 25.0 mL⋅min(-1) VO2, whereas the mean VAT was 635 ± 220 mL⋅min(-1). RtShift positively correlated with VAT (r = 718, p < 0.001), confirming previous visual observations. It also significantly correlated with ΔVO2/Δwork rate, a marker of oxygen uptake efficiency (r = 0.531, p < 0.001). We identified that among patients with cardiac disease, V-slope is shifted rightward to varying degrees. The objectively quantified rightward shift of V-slope is significantly correlated with an index of exercise tolerance (VAT). Furthermore, it appears to occur at even lower work rates. This may offer a new objective means of estimating

  20. Effects of general fatigue induced by incremental maximal exercise test on gait stability and variability of healthy young subjects.

    PubMed

    Vieira, Marcus Fraga; de Sá E Souza, Gustavo Souto; Lehnen, Georgia Cristina; Rodrigues, Fábio Barbosa; Andrade, Adriano O

    2016-10-01

    The purpose of this study was to determine whether general fatigue induced by incremental maximal exercise test (IMET) affects gait stability and variability in healthy subjects. Twenty-two young healthy male subjects walked in a treadmill at preferred walking speed for 4min prior (PreT) the test, which was followed by three series of 4min of walking with 4min of rest among them. Gait variability was assessed using walk ratio (WR), calculated as step length normalized by step frequency, root mean square (RMSratio) of trunk acceleration, standard deviation of medial-lateral trunk acceleration between strides (VARML), coefficient of variation of step frequency (SFCV), length (SLCV) and width (SWCV). Gait stability was assessed using margin of stability (MoS) and local dynamic stability (λs). VARML, SFCV, SLCV and SWCV increased after the test indicating an increase in gait variability. MoS decreased and λs increased after the test, indicating a decrease in gait stability. All variables showed a trend to return to PreT values, but the 20-min post-test interval appears not to be enough for a complete recovery. The results showed that general fatigue induced by IMET alters negatively the gait, and an interval of at least 20min should be considered for injury prevention in tasks with similar demands.

  1. Effect of Different Seat Heights during an Incremental Sit-To-Stand Exercise Test on Peak Oxygen Uptake in Young, Healthy Women.

    PubMed

    Nakamura, Keisuke; Nagasawa, Yuya; Sawaki, Shoji; Yokokawa, Yoshiharu; Ohira, Masayoshi

    2016-09-01

    'Sit-to-stand' exercise uses the repetitive motion of standing up and sitting down in a chair, a common activity of daily living. A new assessment using an incremental sit-to-stand exercise test employs an external sound to control the speed of standing-up and allows increases in work rate. The aims of the study were to examine the effect of different seat heights on peak oxygen uptake (peak VO2) during an incremental sit-to-stand exercise and to assess any difference between peak VO2 values during incremental sit-to-stand exercise compared with a cycle ergometer test. Thirteen healthy young women (age: 23.1 ± 2.6 years, height: 1.61 ± 0.06 m, body mass: 51.9 ± 7.4 kg·m(-2)) participated in four incremental sit-to-stand tests with different seat heights and cycle tests in random order. The seat heights were adjusted to 100%, 80%, 120%, and 140% of knee height distance (100%, 80%, 120%, and 140% incremental sit-to-stand exercise, respectively). The peak VO2 and completion time were measured during incremental sit-to-stand and cycle ergometer tests, and repeated-measures analysis of variance and Student's paired t-test with Holm's method were used to evaluate differences between these variables. The peak VO2 values increased by about 10-12 mL·min(-1)·kg(-1) as the seat height on the ISTS decreased over a 60% range of lower leg lengths. The peak VO2 values on the 80%, 100%, 120%, and 140% incremental sit-to-stand tests were about 11%, 25%, 40%, and 50% lower than that on the cycle ergometer test, respectively. The peak VO2 on the incremental sit-to-stand test increased as seat height decreased. These findings are useful to determine which seat height on the incremental sit-to-stand tests test is suitable for different populations.

  2. Validity and Reproducibility of an Incremental Sit-To-Stand Exercise Test for Evaluating Anaerobic Threshold in Young, Healthy Individuals

    PubMed Central

    Nakamura, Keisuke; Ohira, Masayoshi; Yokokawa, Yoshiharu; Nagasawa, Yuya

    2015-01-01

    Sit-to-stand exercise (STS) is a common activity of daily living. The objectives of the present study were: 1) to assess the validity of aerobic fitness measurements based on anaerobic thresholds (ATs), during incremental sit-to-stand exercise (ISTS) with and without arm support compared with an incremental cycle-ergometer (CE) test; and 2) to examine the reproducibility of the AT measured during the ISTSs. Twenty-six healthy individuals randomly performed the ISTS and CE test. Oxygen uptakes at the AT (AT-VO2) and heart rate at the AT (AT-HR) were determined during the ISTSs and CE test, and repeated-measures analyses of variance and Tukey’s post-hoc test were used to evaluate the differences between these variables. Pearson correlation coefficients were used to assess the strength of the relationship between AT-VO2 and AT-HR during the ISTSs and CE test. Data analysis yielded the following correlations: AT-VO2 during the ISTS with arm support and the CE test, r = 0.77 (p < 0.05); AT-VO2 during the ISTS without arm support and the CE test, r = 0.70 (p < 0.05); AT-HR during the ISTS with arm support and the CE test, r = 0.80 (p < 0.05); and AT-HR during the ISTS without arm support and the CE test, r = 0.66 (p < 0.05). The AT-VO2 values during the ISTS with arm support (18.5 ± 1.9 mL·min-1·kg-1) and the CE test (18.4 ± 1.8 mL·min-1·kg-1) were significantly higher than those during the ISTS without arm support (16.6 ± 1.8 mL·min-1·kg-1; p < 0.05). The AT-HR values during the ISTS with arm support (126 ± 10 bpm) and the CE test (126 ± 13 bpm) were significantly higher than those during the ISTS without arm support (119 ± 9 bpm; p < 0.05). The ISTS with arm support may provide a cardiopulmonary function load equivalent to the CE test; therefore, it is a potentially valid test for evaluating AT-VO2 and AT-HR in healthy, young adults. Key points The ISTS is a simple test that varies only according to the frequency of standing up, and requires only a small

  3. A Reduction in Maximal Incremental Exercise Test Duration 48 h Post Downhill Run Is Associated with Muscle Damage Derived Exercise Induced Pain

    PubMed Central

    Chrismas, Bryna C. R.; Taylor, Lee; Siegler, Jason C.; Midgley, Adrian W.

    2017-01-01

    Purpose: To examine whether exercise induced muscle damage (EIMD) and muscle soreness reduce treadmill maximal incremental exercise (MIE) test duration, and true maximal physiological performance as a consequence of exercise induced pain (EIP) and perceived effort. Methods: Fifty (14 female), apparently healthy participants randomly allocated into a control group (CON, n = 10), or experimental group (EXP, n = 40) visited the laboratory a total of six times: visit 1 (familiarization), visit 2 (pre 1), visit 3 (pre 2), visit 4 (intervention), visit 5 (24 h post) and visit 6 (48 h post). Both groups performed identical testing during all visits, except during visit 4, where only EXP performed a 30 min downhill run and CON performed no exercise. During visits 2, 3, and 6 all participants performed MIE, and the following measurements were obtained: time to exhaustion (TTE), EIP, maximal oxygen consumption (V·O2max), rate of perceived exertion (RPE), maximum heart rate (HRmax), maximum blood lactate (BLamax), and the contribution of pain to terminating the MIE (assessed using a questionnaire). Additionally during visits 1, 2, 3, 5, and 6 the following markers of EIMD were obtained: muscle soreness, maximum voluntary contraction (MVC), voluntary activation (VA), creatine kinase (CK). Results: There were no significant differences (p ≥ 0.32) between any trials for any of the measures obtained during MIE for CON. In EXP, TTE decreased by 34 s (3%), from pre 2 to 48 h post (p < 0.001). There was a significant association between group (EXP, CON) and termination of the MIE due to “pain” during 48 h post (χ2 = 14.7, p = 0.002). Conclusion: EIMD resulted in premature termination of a MIE test (decreased TTE), which was associated with EIP, MVC, and VA. The exact mechanisms responsible for this require further investigation. PMID:28337151

  4. Effect of Different Seat Heights during an Incremental Sit-To-Stand Exercise Test on Peak Oxygen Uptake in Young, Healthy Women

    PubMed Central

    Nakamura, Keisuke; Nagasawa, Yuya; Sawaki, Shoji; Yokokawa, Yoshiharu; Ohira, Masayoshi

    2016-01-01

    ‘Sit-to-stand’ exercise uses the repetitive motion of standing up and sitting down in a chair, a common activity of daily living. A new assessment using an incremental sit-to-stand exercise test employs an external sound to control the speed of standing-up and allows increases in work rate. The aims of the study were to examine the effect of different seat heights on peak oxygen uptake (peak VO2) during an incremental sit-to-stand exercise and to assess any difference between peak VO2 values during incremental sit-to-stand exercise compared with a cycle ergometer test. Thirteen healthy young women (age: 23.1 ± 2.6 years, height: 1.61 ± 0.06 m, body mass: 51.9 ± 7.4 kg·m-2) participated in four incremental sit-to-stand tests with different seat heights and cycle tests in random order. The seat heights were adjusted to 100%, 80%, 120%, and 140% of knee height distance (100%, 80%, 120%, and 140% incremental sit-to-stand exercise, respectively). The peak VO2 and completion time were measured during incremental sit-to-stand and cycle ergometer tests, and repeated-measures analysis of variance and Student’s paired t-test with Holm’s method were used to evaluate differences between these variables. The peak VO2 values increased by about 10-12 mL·min-1·kg-1 as the seat height on the ISTS decreased over a 60% range of lower leg lengths. The peak VO2 values on the 80%, 100%, 120%, and 140% incremental sit-to-stand tests were about 11%, 25%, 40%, and 50% lower than that on the cycle ergometer test, respectively. The peak VO2 on the incremental sit-to-stand test increased as seat height decreased. These findings are useful to determine which seat height on the incremental sit-to-stand tests test is suitable for different populations. Key points Researchers involved in collecting data in this study have no financial or personal interest in the outcome of results or the sponsor. The ISTS is a simple test that requires only a small space and a chair, and the

  5. Primary motor cortex activity is elevated with incremental exercise intensity.

    PubMed

    Brümmer, V; Schneider, S; Strüder, H K; Askew, C D

    2011-05-05

    While the effects of exercise on brain cortical activity from pre-to post-exercise have been thoroughly evaluated, few studies have investigated the change in activity during exercise. As such, it is not clear to what extent changes in exercise intensity influence brain cortical activity. Furthermore, due to the difficulty in using brain-imaging methods during complex whole-body movements like cycling, it is unclear to what extent the activity in specific brain areas is altered with incremental exercise intensity over time. Latterly, active electroencephalography (EEG) electrodes combined with source localization methods allow for the assessment of brain activity, measured as EEG current density, within specific cortical regions. The present study aimed to investigate the application of this method during exercise on a cycle ergometer, and to investigate the effect of increasing exercise intensity on the magnitude and location of any changes in electrocortical current density. Subjects performed an incremental cycle ergometer test until subjective exhaustion. Current density of the EEG recordings during each test stage, as well as before and after exercise, was determined. Spatial changes in current density were localized using low-resolution brain electromagnetic tomography (LORETA) to three regions of interest; the primary motor cortex, primary sensory cortex and prefrontal cortex, and were expressed relative to current density within the local lobe. It was demonstrated that the relative current density of the primary motor cortex was intensified with increasing exercise intensity, whereas activity of the primary sensory cortex and that of the prefrontal cortex were not altered with exercise. The results indicate that the combined active EEG/LORETA method allows for the recording of brain cortical activity during complex movements and incremental exercise. These findings indicate that primary motor cortex activity is elevated with incremental exercise intensity

  6. Effect of flunixin meglumine on selected physiologic and performance parameters of athletically conditioned thoroughbred horses subjected to an incremental exercise stress test.

    PubMed

    Colahan, Patrick T; Bailey, James E; Chou, Chi-Chung; Johnson, Martha; Rice, Brett L; Jones, Galin L; Cheeks, Joseph P

    2002-01-01

    Twelve clinically sound, healthy, athletically conditioned Thoroughbred horses were subjected to an incremental exercise stress test to determine the effects and period of detection of a single dose of flunixin meglumine (1.1 mg/kg by intravenous injection) in serum and urine by ELISA. Flunixin concentrations, performance, and hematologic and clinical chemical parameters were measured. All horses were rotated through four treatment groups of a Latin-square design providing for each horse to serve as its own control. Flunixin meglumine reduced prostaglandin F(1alpha) and thromboxane concentrations that had been increased by intense exercise. Performance parameters did not improve and prostaglandin concentrations did not significantly correlate with total run time. Exercise did not change the flunixin elimination profile in either serum or urine, and concentrations were found to be below the detection limit of the ELISA test within 36 hours in serum and 120 hours in urine.

  7. Reliability and validity of an agility-like incremental exercise test with multidirectional change-of-direction movements in response to a visual stimulus.

    PubMed

    Born, Dennis-Peter; Kunz, Philipp; Sperlich, Billy

    2017-05-01

    The aim of the study was to evaluate the reliability and validity of cardiorespiratory and metabolic variables, that is, peak oxygen uptake (V'O2peak) and heart rate (HRpeak), obtained from an agility-like incremental exercise test for team sport athletes. To investigate the test-retest reliability, 25 team sport athletes (age: 22 ± 3 years, body mass: 75 ± 7 kg, height: 182 ± 6 cm) performed an agility-like incremental exercise test on the SpeedCourt (SC) system incorporating multidirectional change-of-direction (COD) movements twice. For each step of the incremental SC test, the athletes covered a 40-m distance interspersed with a 10-sec rest period. Each 40 m distance was split into short sprints (2.25-6.36 m) separated by multidirectional COD movements (0°-180°), which were performed in response to an external visual stimulus. All performance and physiological data were validated with variables obtained from a ramp-like treadmill and Yo-Yo intermittent recovery level 2 test (Yo-Yo IR2). The incremental SC test revealed high test-retest reliability for the time to exhaustion (ICC = 0.85, typical error [TE] = 0.44, and CV% = 3.88), V'O2peak, HRpeak, ventilation, and breathing frequency (ICC = 0.84, 0.72, 0.89, 0.77, respectively). The time to exhaustion (r = 0.50, 0.74) of the incremental SC test as well as the peak values for V'O2 (r = 0.59, 0.52), HR (r = 0.75, 0.78), ventilation (r = 0.57, 0.57), and breathing frequency (r = 0.68, 0.68) were significantly correlated (P ≤ 0.01) with the ramp-like treadmill test and the Yo-Yo IR2, respectively. The incremental SC test represents a reliable and valid method to assess peak values for V'O2 and HR with respect to the specific demand of team sport match play by incorporating multidirectional COD movements, decision making, and cognitive components. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the

  8. Variations in serum magnesium and hormonal levels during incremental exercise.

    PubMed

    Soria, Marisol; González-Haro, Carlos; Ansón, Miguel Angel; Iñigo, Carmen; Calvo, Maria Luisa; Escanero, Jesús Fernando

    2014-01-01

    In this study, we examined the relationship between plasma magnesium levels and hormonal variations during an incremental exercise test until exhaustion in 27, well-trained, male endurance athletes. After a warm-up of 10 min at 2 W/kg, the test began at an initial workload of 2.5 W/kg and continued with increments of 0.5 W/kg every 10 min until exhaustion. Plasma magnesium, catecholamine, insulin, glucagon, parathyroid hormone (PTH), calcitonin, aldosterone and cortisol levels were determined at rest, at the end of each stage and three, five and seven minutes post-exercise. With the incremental exercise test, no variations in plasma magnesium levels were found, while plasma adrenaline, noradrenaline, PTH, glucagon and cortisol levels increased significantly. Over the course of the exercise, plasma levels of insulin decreased significantly, but those of calcitonin remained steady. During the recovery period, catecholamines and insulin returned to basal levels. These findings indicate that the magnesium status of euhydrated endurance athletes during incremental exercise testing may be the result of the interrelation between several hormonal variations.

  9. Effect of stage duration on maximal heart rate and post-exercise blood lactate concentration during incremental treadmill tests.

    PubMed

    Machado, Fabiana A; Kravchychyn, Ana Claudia P; Peserico, Cecilia S; da Silva, Danilo F; Mezzaroba, Paulo V

    2013-05-01

    This study compared the responses during maximal incremental treadmill tests of 1-min, 2-min, and 3-min stage durations mainly in terms of maximal heart rate (HRmax) and peak blood lactate concentration (LApeak). Repeated-measures. Thirty-four male, recreational, endurance-trained runners (40±13 years) performed three tests on a motorized treadmill. The tests started at 8kmh(-1) with increments of 1kmh(-1) every 1min for the short-stage protocol, every 2min for the intermediate-stage protocol, and every 3min for the long-stage protocol. LApeak was defined for each subject as the highest value among the lactate concentrations determined at the end of each test and at the third, fifth and seventh minutes after test, during passive recovery. Analysis of variance revealed a significant effect of the stage duration on the HRmax (p=0.003) and LApeak (p=0.001). The HRmax was higher in the intermediate-stage compared to the short-stage protocol (184.8±12.7 vs. 181.8±12.1beatsmin(-1), p<0.001), but no significant differences were found between the long-stage (183.1±12.1beatsmin(-1)) and the intermediate-stage or short-stage protocols (p>0.05). The LApeak was lower in the long-stage compared to the short-stage and intermediate-stage protocols (7.9±2.2 vs. 9.4±2.2 and 9.2±1.9mmolL(-1), respectively, p<0.05). Further, blood lactate reached peak concentration at the fifth minute after test for all the protocols. Thus, HRmax and LApeak depend on the stage duration of the incremental test, but the moment at which blood lactate reaches peak concentration is independent of the duration. Further, we suggest 2-min stage duration protocols to determine HRmax. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. Rating of perceived exertion in maximal incremental tests during head-out water-based aerobic exercises.

    PubMed

    Alberton, Cristine Lima; Pinto, Stephanie Santana; Gorski, Tatiane; Antunes, Amanda Haberland; Finatto, Paula; Cadore, Eduardo Lusa; Bergamin, Marco; Kruel, Luiz Fernando Martins

    2016-09-01

    The present study aimed to assess the relationship between rating of perceived exertion (RPE) and percentage of peak oxygen uptake ([Formula: see text]) during three head-out water-based aerobic exercises. In addition, the RPE at the second ventilatory threshold (VT2) was also compared among them. Twenty young women performed head-out water-based maximal tests for the exercises stationary running (SR), frontal kick (FK) and cross-country skiing (CCS). RPE was monitored during the tests and the values corresponding to VT2 and training zones corresponding to 50-59%, 60-69%, 70-79%, 80-89% and [Formula: see text] were determined. Regression analysis, descriptive statistics and ANOVA with repeated measures were used. Significant relationships were observed between the RPE and [Formula: see text] (r = 0.858-0.893; P < 0.001) for all head-out water-based aerobic exercises. Average RPE ranged from 12.1-12.7 in the training zone corresponding to 50-59%, from 13.7-14.8 to 60-69%, from 15.8-16.4 to 70-79%, from 17.3-18.1 to 80-89% and from 18.5-18.9 to [Formula: see text]. No significant differences were found among the three head-out water-based aerobic exercises at VT2 (P > 0.05; SR: 16.1 ± 0.9, FK: 16.7 ± 1.5, CCS: 15.9 ± 1.3). The results support the use of RPE to control the relative intensity of training during head-out water-based aerobic exercises and indicate values near to 16-17 when targeting VT2 intensity for young women.

  11. Blood glucose threshold and the metabolic responses to incremental exercise tests with and without prior lactic acidosis induction.

    PubMed

    Simões, Herbert Gustavo; Campbell, Carmen S G; Kushnick, Michael R; Nakamura, Akiko; Katsanos, Christos S; Baldissera, Vilmar; Moffatt, Robert J

    2003-08-01

    This study compared the metabolic-ventilatory responses and the glycemic threshold identified during lactate minimum (LM) and individual anaerobic threshold (IAT) tests. In addition, the ability to determine the anaerobic power, aerobic-anaerobic transition (Trans) (e.g. ventilatory threshold; VT) and the maximal oxygen consumption (VO(2max)) all within a single incremental treadmill test (IT) was investigated. Fifteen physically fit men [25.9 (5.5) years; 77.4 (6.5) kg] performed the following: test 1, IT for IAT; and test 2, LM: 30-s Wingate test followed by 8 min rest and then an IT that was the same as test 1. Blood lactate concentration [lac], glucose concentration [gluc], pH, PO(2), PCO(2), base excess (BE) and ventilatory variables were measured. At the beginning of the IT for LM, the ventilation, PO(2) and VO(2) were higher and the pH, BE and PCO(2) were lower in relation to IAT ( P<0.05), while no differences were observed after reaching LM intensity during IT. Moreover, the Trans could be identified by [lac] (IAT, LM), minute ventilation [V(E;) VT identified during IAT protocol (VT-IAT) and VT identified during LM protocol (VT-LM)], and [gluc] (IGT, GM) during the IT for IAT and LM. The velocities (kilometers per hour) corresponding to IAT (12.6+/-1.6), VT-IAT (12.5+/-1.7), IGT (12.6+/-1.6), LM (12.5+/-1.5), VT-LM (12.3+/-1.5), and GM (12.6+/-1.9) were not different from each other and the LM and IAT protocols resulted in the similar VO(2max). We concluded that: (1) after reaching the LM the metabolic responses during IT are similar to IAT; (2) performing a Wingate test prior to an IT does not interfere with the Trans and VO(2max) attainment; (3) and the IGT and GM can predict the Trans.

  12. Reference values for the incremental shuttle walk test in patients with cardiovascular disease entering exercise-based cardiac rehabilitation.

    PubMed

    Cardoso, Fernando M F; Almodhy, Meshal; Pepera, Garyfalia; Stasinopoulos, Dimitrios M; Sandercock, Gavin R H

    2017-01-01

    The incremental shuttle walk test (ISWT) is used to assess functional capacity of patients entering cardiac rehabilitation. Factors such as age and sex account for a proportion of the variance in test performance in healthy individuals but there are no reference values for patients with cardiovascular disease. The aim of this study was to produce reference values for the ISWT. Participants were n = 548 patients referred to outpatient cardiac rehabilitation who underwent a clinical examination and performed the ISWT. We used regression to identify predictors of performance and produced centile values using the generalised additive model for location, scale and shape model. Men walked significantly further than women (395 ± 165 vs. 269 ± 118 m; t = 9.5, P < 0.001) so data were analysed separately by sex. Age (years) was the strongest predictor of performance in men (β = -5.9; 95% CI: -7.1 to -4.6 m) and women (β = -4.8; 95% CI: -6.3 to 3.3). Centile curves demonstrated a broadly linear decrease in expected ISWT values in males (25-85 years) and a more curvilinear trend in females. Patients entering cardiac rehabilitation present with highly heterogeneous ISWT values. Much of the variance in performance can be explained by patients' age and sex. Comparing absolute values with age-and sex-specific reference values may aid interpretation of ISWT performance during initial patient assessment at entry to cardiac rehabilitation.

  13. Ambient temperature and relative humidity influenced packed cell volume, total plasma protein and other variables in horses during an incremental submaximal field exercise test.

    PubMed

    Hargreaves, B J; Kronfeld, D S; Naylor, J R

    1999-07-01

    Thermoregulation may limit exercise performance under hot and humid conditions. This study compared heart rate (HR), respiratory rate (RR), rectal temperature (Tr), packed cell volume (PCV) and total plasma protein concentration (TPP) during a submaximal incremental field exercise test under high vs. low ambient temperature and relative humidity. Ten horses were tested 3 times in summer (July) and 3 times in autumn (September). Heart rate was measured continuously, the other variables at rest and immediately after 4 min at 3.5, 4.5 and 7.0 m/s, separated by 3 min rest intervals, and after 5 and 10 min recovery. Data for all variables were significantly greater during exercise and recovery in the hot vs. cool conditions, respectively: after 4 min at 7.0 m/s, HR was 135+/-1 and 123+/-1/min (P<0.0001), Tr was 39.0+/-0.06 and 38.0+/-0.05 degrees C (P<0.0001), RR was 99+/-3 and 50+/-3/min (P<0.0001), PCV was 48.8+/-0.06 and 42.1+/-0.3% (P<0.0001) and TPP was 7.7+/-0.14 and 7.6+/-0.12 g/l (P = 0.026). These data reflect the thermal burden during submaximal exercise under hot conditions in the field. The greater relative PCV increase in the heat probably conferred a thermoregulatory advantage and reflected a greater circulating red cell volume increase rather than a decrease of plasma volume. This study illustrates how differences in environmental conditions can affect assessment of exercise responses and how these factors must be considered in monitoring progress during fitness and acclimatisation regimes in the field.

  14. Determination of both the time constant of vO2 and DeltavO2/DeltaW from a single incremental exercise test: validation and repeatability.

    PubMed

    Wisén, Anita G M; Wohlfart, Björn

    2004-09-01

    A single incremental cycle exercise test including a steady-state load, combined with respiratory gas exchange, was performed with the objective of determining the time constant (tauVO(2)) and the amount of oxygen required at each load (DeltaVO(2)/DeltaW) by using a novel equation. The protocol was validated using four exercise tests at different constant loads and conventionally fitted mono-exponential functions to determine tauVO(2), and interpolation of VO(2) versus load to determine DeltaVO(2)/DeltaW. No significant differences were seen between the means of either tauVO(2) or DeltaVO(2)/DeltaW determined with the two protocols. The correlation coefficient was 0.62 for tauVO(2) and 0.48 for DeltaVO(2)/DeltaW. The absolute differences (2 SD) were 11.6 s for tauVO(2) and 1.1 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. The equations were compared in the same steady-state test and good agreement of tauVO(2) was obtained (R = 0.99). The 5-6-week repeatability (incremental test) was evaluated. No statistical differences were seen between the mean of the repeated tests. The difference between the tests (2 SD) were 20 s for tauVO(2) and 1.2 ml min(-1) W(-1) for DeltaVO(2)/DeltaW. In conclusion, tauVO(2) and DeltaVO(2)/DeltaW can be determined from a single incremental test. The validation showed an acceptable agreement, although the variations in absolute values were not negligible. This could partly be explained by the natural day-to-day variation and fluctuations in incoming raw data. The test-retest variation in absolute values was considerable, which must be taken into account when using tauVO(2) and DeltaVO(2)/DeltaW for evaluation of aerobic function.

  15. [Exercise tests in spirometry].

    PubMed

    Löllgen, H; Dirschedl, P; Fahrenkrog, U

    1994-01-01

    Actual situation: There is a great variety of exercise programs (formerly called protocols) used in daily routine and general practice. Exercise programs vary with increments, step-duration, speed and grade, although standard recommendations have been published recently. In the USA, the Bruce program is widely accepted, although some criticism has been published. Comparing different exercise programs it is obvious, that maximal values (VO2, heart rate etc.) are only moderately affected by the program, but submaximal values are strongly influenced by the methodological procedure. Advantages and disadvantages of the different exercise testing procedures will be presented. As we need some standardized exercise programs to avoid "free-style ergometry", recommendations may be based on the following assumptions: Exercise testing should not be too short nor too long (10-12 min total test time), work rate increments should be intermediate (adapted to physical fitness), work rate steps should be about 2 min or an individualized ramp test should be used. Exercise test programs have to be selected according to the patient's fitness, to the disease or function to be studied, and to the laboratory setting. Standardization is strongly recommended.

  16. Does Stroke Volume Increase During an Incremental Exercise? A Systematic Review

    PubMed Central

    Vieira, Stella S.; Lemes, Brunno; de T. C. de Carvalho, Paulo; N. de Lima, Rafael; S. Bocalini, Danilo; A. S. Junior, José; Arsa, Gisela; A. Casarin, Cezar; L. Andrade, Erinaldo; J. Serra, Andrey

    2016-01-01

    Introduction: Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. Methods: A comprehensive review of the Cochrane Library’s, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. Results: The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. Conclusion: The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load. PMID:27347221

  17. Does Stroke Volume Increase During an Incremental Exercise? A Systematic Review.

    PubMed

    Vieira, Stella S; Lemes, Brunno; de T C de Carvalho, Paulo; N de Lima, Rafael; S Bocalini, Danilo; A S Junior, José; Arsa, Gisela; A Casarin, Cezar; L Andrade, Erinaldo; J Serra, Andrey

    2016-01-01

    Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. A comprehensive review of the Cochrane Library's, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load.

  18. Early ventilation-heart rate breakpoint during incremental cycling exercise.

    PubMed

    Gravier, G; Delliaux, S; Ba, A; Delpierre, S; Guieu, R; Jammes, Y

    2014-03-01

    Previous observations having reported a transient hypoxia at the onset of incremental exercise, we investigated the existence of concomitant ventilatory and heart rate (HR) breakpoints.33 subjects executed a maximal cycling exercise with averaging for successive 5-s periods of HR, ventilation, tidal volume (VT), mean inspiratory flow rate (VT/Ti), and end-tidal partial pressures of O2 (PETO2) and CO2. In 10 subjects, the transcutaneous partial pressure of O2 (PtcO2) was recorded and the venous blood lactic acid (LA) concentration measured.At the beginning of exercise, PETO2 decreased, reaching a nadir, then progressively increased until the exercise ended. PtcO2 varied in parallel. Whether or not a 0-W cycling period preceded the incremental exercise, the rate of changes in VE, VT, VT/Ti and HR significantly increased when the nadir PO2 was reached. The ventilatory/ HR breakpoint was measured at 33±4% of VO2max, whereas the ventilatory threshold (VTh) was detected at 67±4% of VO2max and LA began to increase at 45 to 50% of VO2max.During incremental cycling exercise, we identified the existence of HR and ventilatory breakpoints in advance of both lactate and ventilatory thresholds which coincided with modest hypoxia and hypercapnia. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Blood flow patterns during incremental and steady-state aerobic exercise.

    PubMed

    Coovert, Daniel; Evans, LeVisa D; Jarrett, Steven; Lima, Carla; Lima, Natalia; Gurovich, Alvaro N

    2017-05-30

    Endothelial shear stress (ESS) is a physiological stimulus for vascular homeostasis, highly dependent on blood flow patterns. Exercise-induced ESS might be beneficial on vascular health. However, it is unclear what type of ESS aerobic exercise (AX) produces. The aims of this study are to characterize exercise-induced blood flow patterns during incremental and steady-state AX. We expect blood flow pattern during exercise will be intensity-dependent and bidirectional. Six college-aged students (2 males and 4 females) were recruited to perform 2 exercise tests on cycleergometer. First, an 8-12-min incremental test (Test 1) where oxygen uptake (VO2), heart rate (HR), blood pressure (BP), and blood lactate (La) were measured at rest and after each 2-min step. Then, at least 48-hr. after the first test, a 3-step steady state exercise test (Test 2) was performed measuring VO2, HR, BP, and La. The three steps were performed at the following exercise intensities according to La: 0-2 mmol/L, 2-4 mmol/L, and 4-6 mmol/L. During both tests, blood flow patterns were determined by high-definition ultrasound and Doppler on the brachial artery. These measurements allowed to determine blood flow velocities and directions during exercise. On Test 1 VO2, HR, BP, La, and antegrade blood flow velocity significantly increased in an intensity-dependent manner (repeated measures ANOVA, p<0.05). Retrograde blood flow velocity did not significantly change during Test 1. On Test 2 all the previous variables significantly increased in an intensity-dependent manner (repeated measures ANOVA, p<0.05). These results support the hypothesis that exercise induced ESS might be increased in an intensity-dependent way and blood flow patterns during incremental and steady-state exercises include both antegrade and retrograde blood flows.

  20. .VO2max is not altered by self-pacing during incremental exercise.

    PubMed

    Chidnok, Weerapong; Dimenna, Fred J; Bailey, Stephen J; Burnley, Mark; Wilkerson, Daryl P; Vanhatalo, Anni; Jones, Andrew M

    2013-02-01

    We tested the hypothesis that incremental cycling to exhaustion that is paced using clamps of the rating of perceived exertion (RPE) elicits higher .VO2max values compared to a conventional ramp incremental protocol when test duration is matched. Seven males completed three incremental tests to exhaustion to measure .VO2max. The incremental protocols were of similar duration and included: a ramp test at 30 W min(-1) with constant cadence (RAMP1); a ramp test at 30 W min(-1) with cadence free to fluctuate according to subject preference (RAMP2); and a self-paced incremental test in which the power output was selected by the subject according to prescribed increments in RPE (SPT). The subjects also completed a .VO2max 'verification' test at a fixed high-intensity power output and a 3-min all-out test. No difference was found for .VO2max between the incremental protocols (RAMP1 = 4.33 ± 0.60 L min(-1); RAMP2 = 4.31 ± 0.62 L min(-1); SPT = 4.36 ± 0.59 L min(-1); P > 0.05) nor between the incremental protocols and the peak.VO2max measured during the 3-min all-out test (4.33 ± 0.68 L min(-1)) or the .VO2max measured in the verification test (4.32 ± 0.69 L min(-1)). The integrated electromyogram, blood lactate concentration, heart rate and minute ventilation at exhaustion were not different (P > 0.05) between the incremental protocols. In conclusion, when test duration is matched, SPT does not elicit a higher .VO2max compared to conventional incremental protocols. The striking similarity of .VO2max measured across an array of exercise protocols indicates that there are physiological limits to the attainment of .VO2max that cannot be exceeded by self-pacing.

  1. [Effect of menstrual cycle on cardiorespiratory system during incremental exercise].

    PubMed

    Mesaki, N; Sasaki, J; Shoji, M; Iwasaki, H; Asano, K; Eda, M

    1986-01-01

    According to the results of questionnaires to college athletes, they believe the follicular phase is better than luteal phase for competitive sports. However, it is not clear whether there is significant difference in athletic performance between the two phases of the menstrual cycle. The effects of the menstrual cycle on the cardiorespiratory system were investigated in exercising women who are top players of basketball in Japan. They performed incremental exercise on a cycle ergometer. During the exercise, the ECG and heart rate (HR) were monitored. The expired air was sampled continuously and expiratory gas volume/minute (VE), oxygen uptake (VO2), carbon dioxide output (VCO2), gas exchange ratio(R) and respiratory rate (Resp. E.) were measured. Blood samples were collected to measure the blood lactic acid concentration during the exercise. HR in the luteal phase is higher than in the follicular phase at rest and throughout the exercise. VE, R and Resp. R. at rest and during exercise indicated a tendency to a higher level in the follicular phase. The blood lactic acid concentration during exercise in the follicular phase indicated a tendency to increase more rapidly than in luteal phase. However, no statistical differences in the cardiorespiratory system were detected when the follicular and luteal phase were compared. These results did not indicate conclusively in which phase it is better for athletic women to take part in competitive sports.

  2. The effect of glycemic index on plasma glucose and lactate levels during incremental exercise.

    PubMed

    Stannard, S R; Constantini, N W; Miller, J C

    2000-03-01

    Consumption of low glycemic index (GI) foods before submaximal endurance exercise may be beneficial to performance. To test whether this may also be true for high intensity exercise, 10 trained cyclists began an incremental exercise test to exhaustion 65 min after consuming equal carbohydrate portions of glucose (HGI), pasta (LGI), and a noncarbohydrate control (PL). Time to fatigue did not differ significantly (p = 0.05) between treatments. Plasma glucose concentration was significantly lower after LGI vs. HGI from 15 to 45 min of rest postprandial. During exercise, plasma glucose concentration was significantly lower after HGI vs. LGI from 200 W until exhaustion. Plasma lactate concentration following HGI was significantly higher than PL from 30 min of rest postprandial through to the end of the 200-W workload. Plasma lactate concentration following LGI was significantly lower than after HGI from 45 min of rest postprandial through to the end of the 100-W workload. At higher exercise intensities, there was no significant difference in plasma lactate levels between treatments. These findings suggest that a high GI carbohydrate meal (1 g/kg body wt) 65 min prior to exercise decreases plasma glucose and increases plasma lactate levels compared to a low GI meal, but not enough to be detrimental to incremental exercise performance.

  3. Mechanical ventilatory constraints during incremental exercise in healthy and cystic fibrosis children.

    PubMed

    Borel, Benoit; Leclair, Erwan; Thevenet, Delphine; Beghin, Laurent; Gottrand, Frédéric; Fabre, Claudine

    2014-03-01

    To analyze breathing pattern and mechanical ventilatory constraints during incremental exercise in healthy and cystic fibrosis (CF) children. Thirteen healthy children and 6 children with cystic fibrosis volunteered to perform an incremental test on a treadmill. Exercise tidal flow/volume loops were plotted every minute within a maximal flow/volume loop (MFVL). Expiratory flow limitation (expFL expressed in %Vt) was evaluated and end-expiratory and end-inspiratory lung volumes (EELV and EILV) were estimated from expiratory reserve volume relative to vital capacity (ERV/FVC) and from inspiratory reserve volume relative to vital capacity (IRV/FVC). During the incremental exercise, expFL was first observed at 40% of maximal aerobic speed in both groups. At maximal exercise, 46% of healthy children and 83% of CF children presented expFL, without significant effect of cystic fibrosis on the severity of expFL. According to the two-way ANOVA results, both groups adopted similar breathing pattern and breathing strategies as no significant effect of CF has been revealed. But, according to one-way ANOVA results, a significant increase of ERV/FVC associated with a significant decrease of IRV/FVC from resting value shave been observed in healthy children at maximal exercise, but not in CF children. The hypothesis of this study was based on the assumption that mild cystic fibrosis could induce more frequent and more severe mechanical ventilatory constraints due to pulmonary impairment and breathing pattern disturbances. But, this study did not succeed to highlight an effect of mild cystic fibrosis on the mechanical ventilatory constraints (expFL and dynamic hyperinflation) that occur during an incremental exercise. This absence of effect could be due to the absence of an impact of the disease on spirometric data, breathing pattern regulation during exercise and breathing strategy. © 2013 Wiley Periodicals, Inc.

  4. Diet-induced obesity accelerates blood lactate accumulation of rats in response to incremental exercise to maximum.

    PubMed

    Chen, Chiao-Nan Joyce; Liao, Yi-Hung; Lin, Shang-Ying; Yu, Jun-Xian; Li, Zhen-Jie; Lin, Yu-Chieh; Chang, Gwo-Jyh; Lin, Chung-Hao; Wong, Alice May-Kuen

    2017-08-30

    Blood lactate increases during incremental exercise at high-intensity workloads and limited exercise capacity is a characteristic of obese animals. This study examined whether blood lactate changes in response to incremental exercise is disrupted in obese animals. Muscular and hepatic proteins that are critical in lactate metabolism were also investigated. Rats were randomized to either standard chow (control) or high fat diet (HFD) groups. All animals underwent an incremental treadmill test after 14 weeks of diet intervention. Blood lactate levels were measured before and after the treadmill test. Activities of mitochondrial oxidative phosphorylation and glycolysis were examined in muscle tissues. Proteins in the liver and skeletal muscles that participate in the turnover of blood lactate were determined by Western blot. Running time in the incremental treadmill test decreased in the HFD group, and blood lactate accumulated faster in these animals than in the control group. Animals with HFD had a decreased level of hepatic monocarboxylate transporter 2, the protein responsible for blood lactate uptake in the liver. Skeletal muscles of animals with HFD showed greater glycolytic activity and decreased content of lactate dehydrogenase B, which converts lactate to pyruvate. Blood lactate accumulated faster during incremental exercise in obese animals and associated with their decreased exercise performance. Changes in the metabolic pattern of muscles and changes of liver and muscle proteins associated with lactate utilization likely contribute to the abnormal response of blood lactate to incremental exercise in obese animals. Copyright © 2017, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.

  5. Adults with initial metabolic syndrome have altered muscle deoxygenation during incremental exercise.

    PubMed

    Machado, Alessandro da Costa; Barbosa, Thales Coelho; Kluser Sales, Allan Robson; de Souza, Marcio Nogueira; da Nóbrega, Antonio Claudio Lucas; Silva, Bruno Moreira

    2017-02-01

    Reduced aerobic power is independently associated with metabolic syndrome (MetS) incidence and prevalence in adults. This study investigated whether muscle deoxygenation (proxy of microvascular O2 extraction) during incremental exercise is altered in MetS and associated with reduced oxygen consumption ( V˙O2peak ). Twelve men with initial MetS (no overt diseases and medication-naive; mean ± SD, age 38 ± 7 years) and 12 healthy controls (HCs) (34 ± 7 years) completed an incremental cycling test to exhaustion, in which pulmonary ventilation and gas exchange (metabolic analyzer), as well as vastus lateralis deoxygenation (near infrared spectroscopy), were measured. Subjects with MetS, in contrast to HCs, showed lower V˙O2peak normalized to total lean mass, similar V˙O2 response to exercise, and earlier break point (BP) in muscle deoxygenation. Consequently, deoxygenation slope from BP to peak exercise was greater. Furthermore, absolute V˙O2peak was positively associated with BP in correlations adjusted for total lean mass. MetS, without overt diseases, altered kinetics of muscle deoxygenation during incremental exercise, particularly at high-intensity exercise. Therefore, the balance between utilization and delivery of O2 within skeletal muscle is impaired early in MetS natural history, which may contribute to the reduction in aerobic power. © 2017 The Obesity Society.

  6. The effect of precooling on cardiovascular and metabolic strain during incremental exercise.

    PubMed

    Smith, Denise L; Fehling, Patricia C; Hultquist, Eric M; Arena, Logan; Lefferts, Wesley K; Haller, Jeannie M; Storer, Thomas W; Cooper, Christopher B

    2013-09-01

    The purpose of this study was to investigate the effect of precooling on the chronotropic index defined as the slope of the heart rate (HR) and oxygen uptake during incremental exercise. Ten men performed incremental exercise following 2 conditions: control (rest in a thermoneutral laboratory, 21.5 ± 0.7 °C; performed first) and precooling (cold-water immersion, 23.1 ± 0.2 °C). Prior to exercise, core temperature was significantly lower for precooling (36.6 ± 0.3 °C) compared with control (37.1 ± 0.4 °C; p < 0.001) and remained lower throughout exercise (p < 0.05). Time to volitional fatigue during the incremental exercise test was significantly longer in the control (914 ± 97 s) compared with precooling (889 ± 97 s; p = 0.015). Precooling reduced HR by 8-10 beats·min(-1) compared with control throughout exercise (peak HR: precooling, 178 ± 9 beats·min(-1); control, 188 ± 6 beats·min(-1); p = 0.001). Oxygen uptake did not differ between conditions (p > 0.05). The chronotropic index did not differ between conditions (p = 0.301); however, the y intercept was significantly lower (p = 0.009) for precooling (53.6 ± 11.0) compared with control (67.3 ± 11.0). Thus, the benefit of precooling was a lower HR that was maintained throughout exercise rather than a reduced rate of rise in HR. These results suggest the potential use of precooling to mitigate cardiovascular strain in individuals working at elevated metabolic rates. However, the reduced exercise time warrants consideration.

  7. Oxygenation of the calf muscle during an incremental, intermittent walking exercise assessed by NIRS

    NASA Astrophysics Data System (ADS)

    Härtel, S.; Kutzner, C.; Schneider, D.; Grieger, S.; Neumaier, M.; Kohl-Bareis, M.

    2011-07-01

    We use near infrared spectroscopy (NIRS) for the non-invasive assessment of calf oxygenation during a new walking protocol in healthy subjects of different fitness levels. The protocol increases the exercise power by an increase of the skew rather than speed, and the incremental power steps are intermitted by a 30 s rest which serves for blood sampling. The NIRS measurement parameter of tissue oxygenation are discussed, and a high correlation of the oxygen saturation (tissue oxygenation index) difference between exercise and rest period with exercise power is observed. This difference parameter can be interpreted as strongly linked to blood flow rather than oxygenation. This finding is supported by comparison with spirometry data. The effect of training is discussed. The exercise protocol is suited for testing unfit, or older subjects and the data discussed here servers as a test for a larger trial with heart clinic patients.

  8. The constant work rate critical power protocol overestimates ramp incremental exercise performance.

    PubMed

    Black, Matthew I; Jones, Andrew M; Kelly, James A; Bailey, Stephen J; Vanhatalo, Anni

    2016-12-01

    The parameters of the power-duration relationship (i.e., the critical power, CP, and the curvature constant, W') may theoretically predict maximal performance capability for exercise above the CP. The CP and W' are associated with the parameters of oxygen uptake ([Formula: see text]O2) kinetics, which can be altered by manipulation of the work-rate forcing function. We tested the hypothesis that the CP and W' derived from constant work-rate (CWR) prediction trials would overestimate ramp incremental exercise performance. Thirty subjects (males, n = 28; females, n = 2) performed a ramp incremental test, and 3-5 CWR prediction trials for the determination of the CP and W'. Multiple ramp incremental tests and corresponding CP and W' estimates were available for some subjects such that in total 51 ramp test performances were predicted. The ramp incremental test performance (729 ± 113 s) was overestimated by the CP and W' estimates derived from the best (751 ± 114 s, P < 0.05) and worst (749 ± 111 s, P < 0.05) individual fits of CWR prediction trial data. The error in the prediction was inversely correlated with the magnitude of the W' for the best (r = -0.56, P < 0.05) and worst individual fits (r = -0.36, P < 0.05). The overestimation of ramp incremental performance suggests that the CP and W' derived from different work-rate forcing functions, thus resulting in different [Formula: see text]O2 kinetics, cannot be used interchangeably. The present findings highlight a potential source of error in performance prediction that is of importance to both researchers and applied practitioners.

  9. Breakpoints in ventilation, cerebral and muscle oxygenation, and muscle activity during an incremental cycling exercise

    PubMed Central

    Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

    2014-01-01

    The aim of this study was to locate the breakpoints of cerebral and muscle oxygenation and muscle electrical activity during a ramp exercise in reference to the first and second ventilatory thresholds. Twenty-five cyclists completed a maximal ramp test on an electromagnetically braked cycle-ergometer with a rate of increment of 25 W/min. Expired gazes (breath-by-breath), prefrontal cortex and vastus lateralis (VL) oxygenation [Near-infrared spectroscopy (NIRS)] together with electromyographic (EMG) Root Mean Square (RMS) activity for the VL, rectus femoris (RF), and biceps femoris (BF) muscles were continuously assessed. There was a non-linear increase in both cerebral deoxyhemoglobin (at 56 ± 13% of the exercise) and oxyhemoglobin (56 ± 8% of exercise) concomitantly to the first ventilatory threshold (57 ± 6% of exercise, p > 0.86, Cohen's d < 0.1). Cerebral deoxyhemoglobin further increased (87 ± 10% of exercise) while oxyhemoglobin reached a plateau/decreased (86 ± 8% of exercise) after the second ventilatory threshold (81 ± 6% of exercise, p < 0.05, d > 0.8). We identified one threshold only for muscle parameters with a non-linear decrease in muscle oxyhemoglobin (78 ± 9% of exercise), attenuation in muscle deoxyhemoglobin (80 ± 8% of exercise), and increase in EMG activity of VL (89 ± 5% of exercise), RF (82 ± 14% of exercise), and BF (85 ± 9% of exercise). The thresholds in BF and VL EMG activity occurred after the second ventilatory threshold (p < 0.05, d > 0.6). Our results suggest that the metabolic and ventilatory events characterizing this latter cardiopulmonary threshold may affect both cerebral and muscle oxygenation levels, and in turn, muscle recruitment responses. PMID:24782786

  10. Exercise-induced increments in plasma levels of propranolol and noradrenaline.

    PubMed Central

    Hurwitz, G A; Webb, J G; Walle, T; Bai, S A; Daniell, H B; Gourley, L; Boyd Loadholt, C; Gaffney, T E

    1983-01-01

    Exercise-induced changes in the plasma levels of propranolol and noradrenaline were determined in nine volunteers. Total plasma propranolol levels were increased during submaximal treadmill exercise, with exercise-induced increments of 13 +/- 4% at 4 h after the last dose, 18 +/- 7% at 9 h and 41 +/- 5% at 16 h. Exercise-induced increments in plasma propranolol were observed after single as well as repeated doses. During exercise, increments in plasma propranolol were correlated temporally with changes in plasma noradrenaline. Exercise-induced increments in plasma noradrenaline were greater during propranolol administration than during placebo periods. The changes in plasma propranolol concentration during exercise may reflect a redistribution of propranolol at its site(s) of action. PMID:6661342

  11. Metastable Pain-Attention Dynamics during Incremental Exhaustive Exercise.

    PubMed

    Slapšinskaitė, Agnė; Hristovski, Robert; Razon, Selen; Balagué, Natàlia; Tenenbaum, Gershon

    2016-01-01

    Background: Pain attracts attention on the bodily regions. Attentional allocation toward pain results from the neural communication across the brain-wide network "connectome" which consists of pain-attention related circuits. Connectome is intrinsically dynamic and spontaneously fluctuating on multiple time-scales. The present study delineates the pain-attention dynamics during incremental cycling performed until volitional exhaustion and investigates the potential presence of nested metastable dynamics. Method: Fifteen young and physically active adults completed a progressive incremental cycling test and reported their discomfort and pain on a body map every 15 s. Results: The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout five temporal windows reaching an average of 4.26 ± 0.59 locations per participant. A total of 37 different locations were reported and marked as painful for all participants throughout the cycling task. Significant differences in entropy were observed between all temporal windows except the fourth and fifth windows. Transient dynamics of bodily locations with perceived discomfort and pain were spanned by three principal components. The metastable dynamics of the body pain locations groupings over time were discerned by three time scales: (1) the time scale of shifts (15 s); (2) the time scale of metastable configurations (100 s), and (3) the observational time scale (1000 s). Conclusion: The results of this study indicate that body locations perceived as painful increase throughout the incremental cycling task following a switching metastable and nested dynamics. These findings support the view that human brain is intrinsically organized into active, mutually interacting complex and nested functional networks, and that subjective experiences inherent in pain perception depict identical dynamical principles to the neural tissue in the brain.

  12. Metastable Pain-Attention Dynamics during Incremental Exhaustive Exercise

    PubMed Central

    Slapšinskaitė, Agnė; Hristovski, Robert; Razon, Selen; Balagué, Natàlia; Tenenbaum, Gershon

    2017-01-01

    Background: Pain attracts attention on the bodily regions. Attentional allocation toward pain results from the neural communication across the brain-wide network “connectome” which consists of pain-attention related circuits. Connectome is intrinsically dynamic and spontaneously fluctuating on multiple time-scales. The present study delineates the pain-attention dynamics during incremental cycling performed until volitional exhaustion and investigates the potential presence of nested metastable dynamics. Method: Fifteen young and physically active adults completed a progressive incremental cycling test and reported their discomfort and pain on a body map every 15 s. Results: The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout five temporal windows reaching an average of 4.26 ± 0.59 locations per participant. A total of 37 different locations were reported and marked as painful for all participants throughout the cycling task. Significant differences in entropy were observed between all temporal windows except the fourth and fifth windows. Transient dynamics of bodily locations with perceived discomfort and pain were spanned by three principal components. The metastable dynamics of the body pain locations groupings over time were discerned by three time scales: (1) the time scale of shifts (15 s); (2) the time scale of metastable configurations (100 s), and (3) the observational time scale (1000 s). Conclusion: The results of this study indicate that body locations perceived as painful increase throughout the incremental cycling task following a switching metastable and nested dynamics. These findings support the view that human brain is intrinsically organized into active, mutually interacting complex and nested functional networks, and that subjective experiences inherent in pain perception depict identical dynamical principles to the neural tissue in the brain. PMID:28111563

  13. Noninvasive detection of change in skeletal muscle oxygenation during incremental exercise with near-infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Liu, Fang; Luo, Qingming; Xu, Guodong; Li, Pengcheng

    2003-12-01

    Near infrared spectroscopy (NIRS) has been developed as a non-invasive method to assess O2 delivery, O2 consumption and blood flow, in diverse local muscle groups at rest and during exercise. The aim of this study was to investigate local O2 consumption in exercising muscle by use of near-infrared spectroscopy (NIRS). Ten elite athletes of different sport items were tested in rest and during step incremental load exercise. Local variations of quadriceps muscles were investigated with our wireless NIRS blood oxygen monitor system. The results show that the changes of blood oxygen relate on the sport items, type of muscle, kinetic capacity et al. These results indicate that NIRS is a potential useful tool to detect local muscle oxygenation and blood flow profiles; therefore it might be easily applied for evaluating the effect of athletes training.

  14. Advanced Mechanical Ventilatory Constraints During Incremental Exercise in Class III Obese Male Subjects.

    PubMed

    Chlif, Mehdi; Temfemo, Abdou; Keochkerian, David; Choquet, Dominique; Chaouachi, Anis; Ahmaidi, Said

    2015-04-01

    We investigated the role of mechanical ventilatory constraints in obese class III subjects during incremental exercise. We examined 14 control subjects (body mass index [BMI], 23.6 ± 3.2 kg/m(2)), 15 obese class II subjects (BMI, 37.2 ± 4.5 kg/m(2)), and 17 obese class III subjects (BMI, 53.4 ± 6.8 kg/m(2)). All subjects performed pulmonary function tests and maximal inspiratory pressure at rest, ventilatory parameters, flow-volume loops, and rated perceived exertion and breathlessness during exercise. All subjects had normal pulmonary function. Obesity resulted in increased minute ventilation for a given submaximal work rate, although minute ventilation during peak exercise was lowest in the obese class III subjects. End-expiratory lung volume was significantly lower in the obese subjects at rest and during exercise at the ventilatory threshold but not during peak exercise. During heavy-to-peak exercise, the obese subjects increased their end-expiratory lung volume, whereas the control group continued to decrease this parameter. Compared with controls, end-inspiratory lung volume was significantly lower in obese class II subjects and obese class III subjects at rest and at the ventilatory threshold but not during peak exercise. At maximal exercise, obese class III subjects had a greater end-inspiratory lung volume than obese class II subjects and controls. Obese class III subjects displayed a greater expiratory air flow limitation at rest, at the ventilatory threshold, and during peak exercise than both controls and obese class II subjects. Mechanical ventilatory constraints increase progressively with degrees of obesity, contributing to exercise limitation in obese subjects. Copyright © 2015 by Daedalus Enterprises.

  15. Taurine supplementation has anti-atherogenic and anti-inflammatory effects before and after incremental exercise in heart failure.

    PubMed

    Ahmadian, Mehdi; Roshan, Valiollah Dabidi; Aslani, Elaheh; Stannard, Stephen R

    2017-07-01

    The purpose of this study was to examine the anti-atherogenic and anti-inflammatory effect of supplemental taurine prior to and following incremental exercise in patients with heart failure (HF). Patients with HF and left ventricle ejection fraction less than 50%, and placed in functional class II or III according to the New York Heart Association classification, were randomly assigned to two groups: (1) taurine supplementation; or (2) placebo. The taurine group received oral taurine (500 mg) 3 times a day for 2 weeks, and performed exercise before and after the supplementation period. The placebo group followed the same protocol, but with a starch supplement (500 mg) rather than taurine. The incremental multilevel treadmill test was done using a modified Bruce protocol. Our results indicate that inflammatory indices [C-reactive protein (CRP), platelets] decreased in the taurine group in pre-exercise, post-supplementation and post-exercise, post-supplementation as compared with pre-exercise, pre-supplementation ( p < 0.05) whereas these indices increased in pre-exercise, post-supplementation and post-exercise, post-supplementation as compared with pre-exercise, pre-supplementation in the placebo group ( p < 0.05). Our results also show that atherogenic indices [Castelli's Risk Index-I (CRI-I), Castelli's Risk Index-II (CRI-II) and Atherogenic Coefficient (AC)] decreased in the taurine group in pre-exercise, post-supplementation and post-exercise, post-supplementation as compared with pre-exercise, pre-supplementation ( p < 0.05). No such changes were noted in the placebo group ( p > 0.05). our results suggest that 2 weeks of oral taurine supplementation increases the taurine levels and has anti-atherogenic and anti-inflammatory effects prior to and following incremental exercise in HF patients.

  16. Stage duration and increase of work load in incremental testing on a cycle ergometer.

    PubMed

    Stockhausen, W; Grathwohl, D; Bürklin, C; Spranz, P; Keul, J

    1997-01-01

    Any variation of the test protocol for incremental testing (IT) in cycle ergometry may affect the accuracy of the determination of anaerobic threshold (AnT). For lactate threshold concepts, indicating the maximum lactate steady-state (max Lass), the formation of the quasi-steady-state (QSS=95% of steady-state level) is evident. Previous studies have not specified the time that it takes for blood lactate to stabilize following incremental changes in WL. The purpose of this study was to identify the minimum duration of exercise necessary to establish QSS following various increments in WL (10, 20, 30, 40 and 50 W). Eight male endurance-trained cyclists [relative maximal oxygen consumption = 64.8 (4.2) ml x kg(-1) x min(-1)] performed three different exercise tests on a cycle ergometer: (1) an exhaustive IT with a starting WL of 100 W, followed by 20-W increments every 3 min; (2) a threshold test with 20-W increments every 9 min to determine the MaxLaSS; and (3) five incremental exercise tests (from 100/110 W, with 20-W increments every 3 min) with a final 10-, 20-, 30-, 40- or 50- W increment lasting 10 min, at 10 W below MaxLaSS (T10-T50 experiments). The time constant of lactate kinetics (tau), the time constant of lactate elimination, and the time taken to elicite QSS, defined as 95% of the time taken to reach steady-state level (t95%), were calculated in the T10-T50 experiments. The tau and t95% increased significantly with WL increment size: the correlation was not linear. Smaller WL increments required proportionally longer durations. Mean (SD) t95% values (min:s) were 1:57 (0:27) (T10), 2:58 (0.16) (T20), 4:08 (0:23) (T30), 4:45 (0:45) (T40) and 5:06 (0:43) (T50). The application of these references in IT protocols may lead to an extension of total test duration, particularly with smaller increments. Therefore, lactate threshold modelling, the training status of the athletes and comparability with lactate measurements obtained during training events should be

  17. Translation of exercise testing to exercise prescription using the talk test.

    PubMed

    Jeanes, Elizabeth M; Jeans, Elizabeth A; Foster, Carl; Porcari, John P; Gibson, Mark; Doberstein, Scott

    2011-03-01

    Traditionally defined in terms of %maximal heart rate (%HRmax) or %maximal metabolic equivalents, the process of exercise prescription is still difficult and individually imprecise. An alternative, and simpler, method is to define exercise intensity in terms of the Talk Test, which may be a surrogate for ventilatory threshold and more consistent with contemporary recommendations for index training intensity in well-trained and athletic individuals. This study was designed to determine how much of a reduction in the absolute exercise intensity from those observed during incremental exercise testing was necessary to allow for comfortable speech during exercise training. Fourteen well-trained (5-7 h·wk(-1)) individuals performed 2 incremental exercise tests (to evaluate reproducibility) and 3 steady-state training bouts (40 minutes), based on the stage before the last positive (LP) stage of the Talk Test (LP-1), the LP stage, and the equivocal (EQ) stage. The LP-1 and LP runs resulted in %HRmax and rating of perceived exertion (RPE) values within the recommended range for exercise training, the EQ run in an unacceptably high %HRmax and RPE. Most subjects could still speak comfortably during the LP-1 and LP stages, and no subject could speak comfortably during the EQ stage. The HR (r = 0.84), RPE (r = 0.81), and Talk Test (r = 0.71) responses during paired incremental tests were well correlated. The results of this test suggest that the absolute exercise intensity during the LP-1 and LP stages of incremental exercise tests with the Talk Test may produce steady-state exercise responses appropriate for training in well-trained and athletic individuals and that the reproducibility of the Talk Test is satisfactory.

  18. Reliability of near infrared spectroscopy (NIRS) for measuring forearm oxygenation during incremental handgrip exercise.

    PubMed

    Celie, Bert; Boone, Jan; Van Coster, Rudy; Bourgois, Jan

    2012-06-01

    The purpose of this study was to test the reliability of a new handgrip exercise protocol measuring forearm oxygenation in 20 healthy subjects on two occasions. The retest took place 48 h later and at the same time of the day. The incremental exercise consisted of 2 min steps of cyclic handgrip contraction (1/2 Hz) separated by 1 min of recovery. The exercise started at 20% MVC, was increased with 10% MVC each step and was performed until exhaustion (69.5 and 73% MVC). Near infrared spectroscopy (NIRS) was used to measure deoxygenation (deoxy[Hb + Mb]) and oxygen saturation (SmO(2)) in the forearm muscles. Prior to the exercise protocol an arterial occlusion of the forearm was performed until deoxy(Hb + Mb) did no longer increase. Maximal increase in deoxy[Hb + Mb] during 10 s of each exercise bout was expressed relative to the occlusion amplitude. ICC was used to examine the test-retest reliability. Significant ICC's were reported at 50% (r = 0.466, p = 0.017) and 60% MVC (r = 0.553, p = 0.005). The group mean of the maximum increase in oxygen extraction was 45.6 ± 16.7% and at the retest 44.9 ± 17.0% with an ICC of r = 0.867 (p < 0.001) which could be classified (Landis and Koch 1979) as almost perfect. The absolute SmO(2) values showed reliable ICC's for every submaximal intensity except at 60% MVC. An ICC of r = 0.774 (p < 0.001) was found at maximal intensity. The results of the present study show that deoxy[Hb + Mb] and SmO(2) responses during this protocol are highly reliable and indicate that this protocol could be used to get insight into deoxygenation and oxygen saturation in a population with low exercise tolerance.

  19. Reproducibility of incremental maximal cycle ergometer testing in patients with restrictive lung disease.

    PubMed Central

    Marciniuk, D. D.; Watts, R. E.; Gallagher, C. G.

    1993-01-01

    BACKGROUND--Exercise testing has become an important tool in the diagnosis and treatment of restrictive lung disease. The reproducibility of variables measured during exercise testing was examined in subjects with stable restrictive lung disease. METHODS--Six subjects, who had never previously undergone exercise testing, each underwent three maximal incremental exercise studies on a bicycle ergometer conducted during a 28 day period. RESULTS--Data collected at rest, before exercise, were not significantly different during the three study days. Comparison of results at the end of the exercise tests from the three studies also revealed no evidence of a significant learning effect. Reproducibility of exercise performance by subjects was assessed by the coefficient of variation. The mean within subject coefficient of variation at the end of the exercise tests was 5.6% for work rate, 7.9% for exercise duration, and 9.5% for dyspnoea. The mean within subject coefficient of variation obtained at the end of the exercise tests was 5.3% for oxygen uptake (VO2), 2.5% for oxygen saturation (SaO2), 4.0% for heart rate (HR), 5.5% for minute ventilation (VE), 5.8% for respiratory frequency (f), and 4.6% for tidal volume (VT). The mean within subject coefficient of variation at 40% and 70% of maximal work rates for VO2 was 5.7% and 5.6% respectively, for SaO2 1.3% and 1.5%, for HR 4.8% and 4.0%, for VE 6.3% and 6.6%, for f 10.1% and 7.8%, and for VT 6.0% and 4.5%. CONCLUSIONS--Variables measured during clinical exercise testing in subjects with restrictive lung disease are highly reproducible. No significant learning effect was found on repeated testing in subjects who had never previously undergone exercise testing. PMID:8236071

  20. Relationship between skin temperature and muscle activation during incremental cycle exercise.

    PubMed

    Priego Quesada, Jose I; Carpes, Felipe P; Bini, Rodrigo R; Salvador Palmer, Rosario; Pérez-Soriano, Pedro; Cibrián Ortiz de Anda, Rosa M

    2015-02-01

    While different studies showed that better fitness level adds to the efficiency of the thermoregulatory system, the relationship between muscular effort and skin temperature is still unknown. Therefore, the present study assessed the relationship between neuromuscular activation and skin temperature during cycle exercise. Ten physically active participants performed an incremental workload cycling test to exhaustion while neuromuscular activations were recorded (via surface electromyography - EMG) from rectus femoris, vastus lateralis, biceps femoris and gastrocnemius medialis. Thermographic images were recorded before, immediately after and 10 min after finishing the cycling test, at four body regions of interest corresponding to the muscles where neuromuscular activations were monitored. Frequency band analysis was conducted to assess spectral properties of EMG signals in order to infer on priority in recruitment of motor units. Significant inverse relationship between changes in skin temperature and changes in overall neuromuscular activation for vastus lateralis was observed (r<-0.5 and p<0.04). Significant positive relationship was observed between skin temperature and low frequency components of neuromuscular activation from vastus lateralis (r>0.7 and p<0.01). Participants with larger overall activation and reduced low frequency component for vastus lateralis activation presented a better adaptive response of their thermoregulatory system by showing fewer changes in skin temperature after incremental cycling test.

  1. Effects of coca chewing on metabolic and hormonal changes during graded incremental exercise to maximum.

    PubMed

    Spielvogel, H; Caceres, E; Koubi, H; Sempore, B; Sauvain, M; Favier, R

    1996-02-01

    We examined the effects of 1 h of coca chewing on metabolic and hormonal responses during incremental exercise to exhaustion in traditional coca chewers (C; n = 8), and the results were compared with a group of nonchewers (n = 13). For 1 h, C chewed approximately 12 g of coca leaves that resulted in the apparition of cocaine in blood that reached 72 +/- 9 ng/ml. In resting conditions, even though sympathoadrenergic activity (as assessed by norepinephrine and epinephrine plasma levels) was similar in both groups, C displayed a higher level of plasma free fatty acids. Oxygen uptake measured at exhaustion and delta work efficiency during exercise were similar in both groups. During the incremental exercise, C displayed a significantly lower arterial oxygen saturation that cannot be explained by a reduced ventilatory response after coca chewing. In fact, even at maximal exercise, both ventilatory output and ventilatory equivalent were higher in C compared with nonchewers. It is concluded that the beneficial effects of coca chewing on exercise tolerance reported frequently by traditional coca users is not related to either an improved maximal exercise capacity or an increased work efficiency. However, during incremental exercise, coca chewing appeared to result in an increased free fatty acid availability that could be beneficial for prolonged submaximal exercise.

  2. Incremental shuttle walk test in the assessment of patients with obstructive sleep apnea-hypopnea syndrome.

    PubMed

    Billings, Catherine G; Aung, Thida; Renshaw, Stephen A; Bianchi, Stephen M

    2013-08-01

    Obstructive sleep apnea-hypopnea syndrome is associated independently with an increase in cardiovascular risk factors and is associated with self-reported lack of exercise. We aimed to investigate the utility of the incremental shuttle walk test in routine clinical practice to monitor physical capacity of patients with obstructive sleep apnea-hypopnea syndrome and explore whether continuous positive airway pressure therapy alters exercise capacity. Participants with symptomatic moderate/severe obstructive sleep apnea-hypopnea syndrome attending for a trial of continuous positive airway pressure therapy completed questionnaires assessing sleepiness and physical activity and underwent an incremental shuttle walk test. Subjects compliant or partially compliant with continuous positive airway pressure therapy underwent reassessment at 2 weeks, 3 months and 6 months post-initiation of therapy. Participants unable to tolerate continuous positive airway pressure therapy completed a single reassessment 6 months after their initial visit. Continuous positive airway pressure therapy resulted in an increased distance walked during the incremental shuttle walk test. Improvements in cardiovascular responses to exercise were identified. Compliant patients reported increased daily activity. The incremental shuttle walk test is a simple, reproducible and safe test that is responsive to continuous positive airway pressure treatment. Our findings support the use of the incremental shuttle walk test for monitoring the effects of continuous positive airway pressure treatment and may suggest its use in rehabilitation programmes designed to reduce obesity and cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome. © 2013 European Sleep Research Society.

  3. Prefrontal and motor cortex EEG responses and their relationship to ventilatory thresholds during exhaustive incremental exercise.

    PubMed

    Robertson, C V; Marino, F E

    2015-09-01

    The purpose of this study was to measure the EEG response in the prefrontal cortex (PFC) and motor cortex (MC) during incremental exercise and align these responses with ventilatory parameters. The EEG activity at the motor (MC) and frontal cortices was measured during an incremental exercise test (IET) in 11 cyclists (peak oxygen uptake VO2peak 4.1 ± 0.74 (SD) L min(-1)). EEG power spectral densities were calculated for alpha slow (αS) (8-10 Hz), alpha fast, (αF) (10-13 Hz), Beta (β) (13-30 Hz), and Gamma (γ) (30-40 Hz). EEG data were calculated as % change from eyes open (EO) baseline and a repeated measures analysis of variance (ANOVA) was performed on regions of interest (ROI), time and bandwidth. All EEG activity increased from 50 % Vo2peak to ventilatory threshold (VT) (P = 0.045) and respiratory compensation point (RCP) (P = 0.019) and decreased from RCP to end of exercise (END) (P = 0.04). Significant differences between regions were found at the VLPFC and MC for both αS and αF. αS and αF increased from 50 % VO2peak to RCP (14.9 ± 10.2 to 23.8 ± 15.5 and 18.9 ± 10.6 to 26.12 ± 12.7, respectively) and then decreased to END (23.8 ± 15.5 to 14.4 ± 10.3 and 26.1 ± 12.7, to 17.7 ± 8.8, respectively) (P < 0.01) and concomitantly only decreased significantly in MC in αF from VT to END (P < 0.05). There is a decline in the EEG response to exercise in the PFC following the RCP, whilst alpha activity in the MC is preferentially maintained; therefore, changes within the PFC appear to play a role in exercise termination.

  4. Effect of incremental exercise on initiation and movement times in a choice response, whole body psychomotor task

    PubMed Central

    McMorris, T; Delves, S; Sproule, J; Lauder, M; Hale, B

    2005-01-01

    Objectives: To examine how exercise at moderate and maximal intensities affects performance on a choice response time, whole body psychomotor task. Methods: Subjects (n = 12) were tested on a three-choice response time task, after rest and after exercise at 70% and 100% maximum power output (W·max). The dependent variables were time to begin forward momentum (initiation time) and time to complete the movement (movement time). Stride time for the first and second strides and number of strides to cover first 1.1 m were also measured. Blood lactate concentrations and heart rate were recorded before and after completion of each psychomotor test. The subjects subjectively assessed the amount of effort that they used to complete the task. Results: Repeated measures analysis of variance showed a significant effect for initiation (F2,22 = 11.47, p<0.001) and movement times (F2,22 = 14.61, p<0.001). Post hoc least significant difference (LSD) tests showed that initiation time after exercise at 70% W·max was significantly faster than that in the other two conditions. Speed of initiation after rest was significantly quicker than that after exercise at W·max. For movement time, LSD tests showed that time after maximal exercise was significantly slower than that in the other two conditions. Stride time for the second stride showed a significant effect (F2,22 = 6.20, p<0.01). LSD tests found that time after exercise at W·max was significantly slower in the other two conditions. Stepwise multiple regression analyses found that the increment of change, from rest, of lactate concentrations could significantly predict the increment of change in initiation (R2 = 0.40) and movement (R2 = 0.50) times. Conclusions: Exercise affects a whole body task differently from purely cognitive tasks. Central factors are probably more important than peripheral factors. PMID:16046339

  5. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents

    PubMed Central

    Gowing, Lucy; Forsey, Jonathan; Ramanujam, Paramanantham; Miller, Felicity; Stuart, A Graham; Williams, Craig A.

    2015-01-01

    Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m2) completed an incremental cardiopulmonary exercise test (25 W·3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V̇o2peak) of 40.6 ± 8.9 ml·kg−1·min−1 and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V̇o2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology. PMID:26475589

  6. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.

    PubMed

    Pieles, Guido E; Gowing, Lucy; Forsey, Jonathan; Ramanujam, Paramanantham; Miller, Felicity; Stuart, A Graham; Williams, Craig A

    2015-12-15

    Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m(2)) completed an incremental cardiopulmonary exercise test (25 W · 3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V̇o 2peak) of 40.6 ± 8.9 ml · kg(-1) · min(-1) and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V̇o 2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology.

  7. Understanding the incremental value of novel diagnostic tests for tuberculosis.

    PubMed

    Arinaminpathy, Nimalan; Dowdy, David

    2015-12-03

    Tuberculosis is a major source of global mortality caused by infection, partly because of a tremendous ongoing burden of undiagnosed disease. Improved diagnostic technology may play an increasingly crucial part in global efforts to end tuberculosis, but the ability of diagnostic tests to curb tuberculosis transmission is dependent on multiple factors, including the time taken by a patient to seek health care, the patient's symptoms, and the patterns of transmission before diagnosis. Novel diagnostic assays for tuberculosis have conventionally been evaluated on the basis of characteristics such as sensitivity and specificity, using assumptions that probably overestimate the impact of diagnostic tests on transmission. We argue for a shift in focus to the evaluation of such tests' incremental value, defining outcomes that reflect each test's purpose (for example, transmissions averted) and comparing systems with the test against those without, in terms of those outcomes. Incremental value can also be measured in units of outcome per incremental unit of resource (for example, money or human capacity). Using a novel, simplified model of tuberculosis transmission that addresses some of the limitations of earlier tuberculosis diagnostic models, we demonstrate that the incremental value of any novel test depends not just on its accuracy, but also on elements such as patient behaviour, tuberculosis natural history and health systems. By integrating these factors into a single unified framework, we advance an approach to the evaluation of new diagnostic tests for tuberculosis that considers the incremental value at the population level and demonstrates how additional data could inform more-effective implementation of tuberculosis diagnostic tests under various conditions.

  8. Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain

    SciTech Connect

    Currie, P.J.; Kelly, M.J.; Harper, R.W.; Federman, J.; Kalff, V.; Anderson, S.T.; Pitt, A.

    1983-11-01

    The incremental value of clinical assessment, exercise electrocardiography (ECG) and biplane radionuclide ventriculography (RVG) in the prediction of coronary artery disease (CAD) was assessed in 105 men without myocardial infarction who were undergoing coronary angiography for investigation of chest pain. Independent clinical assessment of chest pain was made prospectively by 2 physicians. Graded supine bicycle exercise testing was symptom-limited. Right anterior oblique ECG-gated first-pass RVG and left anterior oblique ECG-gated equilibrium RVG were performed at rest and exercise. Regional wall motion abnormalities were defined by agreement of 2 of 3 blinded observers. A combined strongly positive exercise ECG response was defined as greater than or equal to 2 mm ST depression or 1.0 to 1.9 mm ST depression with exercise-induced chest pain. A multivariate logistic regression model for the preexercise prediction of CAD was derived from the clinical data and selected 2 variables: chest pain class and cholesterol level. A second model assessed the incremental value of the exercise test in prediction of CAD and found 2 exercise variables that improved prediction: RVG wall motion abnormalities, and a combined strongly positive ECG response. Applying the derived predictive models, 37 of the 58 patients (64%) with preexercise probabilities of 10 to 90% crossed either below the 10% probability threshold or above the 90% threshold and 28 (48%) also moved across the 5 and 95% thresholds. Supine exercise testing with ECG and biplane RVG together, but neither test alone, effectively adds to clinical prediction of CAD. It is most useful in men with atypical chest pain and when the ECG and RVG results are concordant.

  9. Oxygenation trends in vastus lateralis muscle during incremental and intense anaerobic cycle exercise in young men and women.

    PubMed

    Bhambhani, Y; Maikala, R; Esmail, S

    2001-06-01

    The purposes of this study were to compare the acute cardiorespiratory responses and muscle oxygenation trends during incremental cycle exercise to exhaustion with those observed during 30 s and 45 s Wingate tests in healthy men and women, and to examine the relationships between selected variables among these tests. Seventeen healthy junior badminton players, nine men [mean age, height, body mass and maximal oxygen uptake (VO2max) were 15.8 (SD 0.8) years, 1.73 (SD 0.08) m, 65.6 (SD 6.3) kg and 50.6 (SD 6.9) ml x kg(-1) x min(-1) respectively] and eight women [mean age, height, body mass and VO2max were 16.6 (SD 1.0) years, 1.65 (SD 0.03) m, 62.7 (SD 4.5) kg and 42.0 (SD 5.0) ml x kg(-1) x min(-1) respectively] completed a stepwise incremental exercise test to voluntary exhaustion and two Wingate tests lasting 30 s and 45 s in three separate sessions in random order. Cardiorespiratory responses were monitored breath-by-breath using a metabolic cart interfaced with an electrocardiogram. Tissue absorbancy trends were continuously recorded from the right vastus lateralis muscle using dual wavelength near infrared spectroscopy. Oxygen uptake and heart rate were significantly higher during the incremental test when compared to the two Wingate tests in the men and women. However, the oxygen pulse (oxygen utilization per heart beat, i.e., the product of stroke volume and arterio-venous oxygen difference) was not significantly different among the three tests in both sexes. The minimal tissue absorbancy, an index of muscle deoxygenation, was also not significantly different among the three tests in both sexes. Significant relationships were observed for the oxygen uptake (r2=0.72) and oxygen pulse (r2=0.60) between the incremental and 45 s Wingate tests in the sample for both sexes combined. The minimal tissue absorbancy, however, was not significantly related between the two tests. It was concluded that the significantly higher oxygen uptake during the incremental test

  10. [Cardiopulmonary exercise testing].

    PubMed

    Ilarraza-Lomelí, Hermes

    2012-01-01

    Cardiopulmonary exercise test is a useful tool in the diagnosis and prognosis of patients with cardiovascular, pulmonary, neuromuscular and even metabolic disorders. The composition and the analysis of expired gas, and the characteristics of ventilatory dynamics, let us see how energy is transformed, within the cells (mitochondrial cristae), through several metabolic processes. Using the cardiopulmonary exercise testing, physicians can distinguish among several causes of dyspnea with undetermined origin. On the other hand, this test represents an important support to indicate the indication of a graft-transplant (heart, lung or both) in patients with severe heart disease, lung disease or both. Cardiopulmonary test has also been used to evaluate high performance athletes and patients with congenital heart disease. In the past, physicians and patients had a restricted access to the performance of a cardiopulmonary exercise testing, mainly due to the complexity and high costs of this technology. Nowadays, this kind of equipment has been simplified and the costs lowered, in consequence this test became a real alternative in daily work.

  11. Comparing dynamic hyperinflation and associated dyspnea induced by metronome-paced tachypnea versus incremental exercise.

    PubMed

    Calligaro, Gregory L; Raine, Richard I; Bateman, Mary E; Bateman, Eric D; Cooper, Christopher B

    2014-02-01

    Dynamic hyperinflation (DH) during exercise is associated with both dyspnea and exercise limitation in COPD. Metronome-paced tachypnoea (MPT) is a simple alternative for studying DH. We compared MPT with exercise testing (XT) as methods of provoking DH, and assessed their relationship with dyspnea. We studied 24 patients with moderate COPD (FEV1 59 ± 9% predicted) after inhalation of ipratropium/salbutamol combination or placebo in a double-blind, crossover design. Inspiratory capacity (IC) was measured at baseline and after 30 seconds of MPT with breathing frequencies (fR) of 20, 30 and 40 breaths/min and metronome-defined I:E ratios of 1:1 and 1:2, in random sequence, followed by incremental cycle ergometry with interval determinations of IC. DH was defined as a decline in IC from baseline (∆IC) for both methods. Dyspnea was assessed using a Borg CR-10 scale. ∆IC during MPT was greater with higher fR and I:E ratio of 1:1 versus 1:2, and less when patients were treated with bronchodilator rather than placebo (P = 0.032). DH occurred during 19 (40%) XTs, and during 35 (73%) tests using MPT. Eleven of 18 (61%) non-congruent XTs (where DH occurred on MPT but not XT) terminated before fR of 40 breaths/min was reached. Although greater during XT, the intensity of dyspnea bore no relationship to DH during either MPT and XT. MPT at 40 breaths/min and I:E of 1:1 elicits the greatest ∆IC, and is a more sensitive method for demonstrating DH. The relationship between DH and dyspnea is complex and not determined by DH alone.

  12. Ramp exercise protocols for clinical and cardiopulmonary exercise testing.

    PubMed

    Myers, J; Bellin, D

    2000-07-01

    Historically, the protocol used for exercise testing has been based on tradition, convenience or both. In the 1990s, a considerable amount of research has focused on the effect of the exercise protocol on test performance, including exercise tolerance, diagnostic accuracy, gas exchange patterns and the accuracy with which oxygen uptake (VO2) is predicted from the work rate. Studies have suggested that protocols which contain large and/or unequal increments in work cause a disruption in the normal linear relation between VO2 and work rate, leading to an overprediction of metabolic equivalents. Other studies have demonstrated that such protocols can mask the salutary effects of an intervention, and some have suggested that the protocol design can influence the diagnostic performance of the test. Guidelines published by major organisations have therefore suggested that the protocol be individualised based on the patient being tested and the purpose of the test. The ramp approach to exercise testing has recently been advocated because it facilitates recommendations made in these guidelines. This article reviews these issues and discusses the evolution of ramp testing which has occurred in the 1990s.

  13. Sample Proficiency Test exercise

    SciTech Connect

    Alcaraz, A; Gregg, H; Koester, C

    2006-02-05

    The current format of the OPCW proficiency tests has multiple sets of 2 samples sent to an analysis laboratory. In each sample set, one is identified as a sample, the other as a blank. This method of conducting proficiency tests differs from how an OPCW designated laboratory would receive authentic samples (a set of three containers, each not identified, consisting of the authentic sample, a control sample, and a blank sample). This exercise was designed to test the reporting if the proficiency tests were to be conducted. As such, this is not an official OPCW proficiency test, and the attached report is one method by which LLNL might report their analyses under a more realistic testing scheme. Therefore, the title on the report ''Report of the Umpteenth Official OPCW Proficiency Test'' is meaningless, and provides a bit of whimsy for the analyses and readers of the report.

  14. Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing

    PubMed Central

    Stickland, Michael K.; Butcher, Scott J.; Marciniuk, Darcy D.; Bhutani, Mohit

    2012-01-01

    The cardiopulmonary exercise test (CPET) is an important physiological investigation that can aid clinicians in their evaluation of exercise intolerance and dyspnea. Maximal oxygen consumption (V˙O2max) is the gold-standard measure of aerobic fitness and is determined by the variables that define oxygen delivery in the Fick equation (V˙O2 = cardiac output × arterial-venous O2 content difference). In healthy subjects, of the variables involved in oxygen delivery, it is the limitations of the cardiovascular system that are most responsible for limiting exercise, as ventilation and gas exchange are sufficient to maintain arterial O2 content up to peak exercise. Patients with lung disease can develop a pulmonary limitation to exercise which can contribute to exercise intolerance and dyspnea. In these patients, ventilation may be insufficient for metabolic demand, as demonstrated by an inadequate breathing reserve, expiratory flow limitation, dynamic hyperinflation, and/or retention of arterial CO2. Lung disease patients can also develop gas exchange impairments with exercise as demonstrated by an increased alveolar-to-arterial O2 pressure difference. CPET testing data, when combined with other clinical/investigation studies, can provide the clinician with an objective method to evaluate cardiopulmonary physiology and determination of exercise intolerance. PMID:23213518

  15. Evaluation of the Incremental Prognostic Utility of Increasingly Complex Testing in Chronic Heart Failure.

    PubMed

    Ahmad, Tariq; O'Brien, Emily C; Schulte, Phillip J; Stevens, Susanna R; Fiuzat, Mona; Kitzman, Dalane W; Adams, Kirkwood F; Kraus, William E; Piña, Ileana L; Donahue, Mark P; Zannad, Faiez; Whellan, David J; O'Connor, Christopher M; Felker, G Michael

    2015-07-01

    Current heart failure (HF) risk prediction models do not consider how individual patient assessments occur in incremental steps; furthermore, each additional diagnostic evaluation may add cost, complexity, and potential morbidity. Using a cohort of well-treated ambulatory HF patients with reduced ejection fraction who had complete clinical, laboratory, health-related quality of life, imaging, and exercise testing data, we estimated incremental prognostic information provided by 5 assessment categories, performing an additional analysis on those with available N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. We compared the incremental value of each additional assessment (quality of life screen, laboratory testing, echocardiography, and exercise testing) to baseline clinical assessment for predicting clinical outcomes (all-cause mortality, all-cause mortality/hospitalization, and cardiovascular death/HF hospitalizations), gauging incremental improvements in prognostic ability with more information using area under the curve and reclassification improvement (net reclassification index), with and without NT-proBNP availability. Of 2331 participants, 1631 patients had complete clinical data; of these, 1023 had baseline NT-proBNP. For prediction of all-cause mortality, models with incremental assessments sans NT-proBNP showed improvements in C-indices (0.72 [clinical model alone]-0.77 [complete model]). Compared with baseline clinical assessment alone, net reclassification index improved from 0.035 (w/laboratory data) to 0.085 (complete model). These improvements were significantly attenuated for models in the subset with measured NT-proBNP data (c-indices: 0.80 [w/laboratory data]-0.81 [full model]); net reclassification index improvements were similarly marginal (0.091→0.096); prediction of other clinical outcomes had similar findings. In chronic HF patients with reduced ejection fraction, the marginal benefit of complex prognostic evaluations should be

  16. Comparison of forearm blood flow responses to incremental handgrip and cycle ergometer exercise: relative contribution of nitric oxide

    PubMed Central

    Green, Daniel J; Bilsborough, William; Naylor, Louise H; Reed, Chris; Wright, Jeremy; O'Driscoll, Gerry; Walsh, Jennifer H

    2005-01-01

    The contribution of endothelium-derived nitric oxide (NO) to exercise hyperaemia remains controversial. Disparate findings may, in part, be explained by different shear stress stimuli as a result of different types of exercise. We have directly compared forearm blood flow (FBF) responses to incremental handgrip and cycle ergometer exercise in 14 subjects (age ± s.e.m.) using a novel software system which calculates conduit artery blood flow continuously across the cardiac cycle by synchronising automated edge-detection and wall tracking of high resolution B-mode arterial ultrasound images and Doppler waveform envelope analysis. Monomethyl arginine (l-NMMA) was infused during repeat bouts of each incremental exercise test to assess the contribution of NO to hyperaemic responses. During handgrip, mean FBF increased with workload (P < 0.01) whereas FBF decreased at lower cycle workloads (P < 0.05), before increasing at 120 W (P < 0.001). Differences in these patterns of mean FBF response to different exercise modalities were due to the influence of retrograde diastolic flow during cycling, which had a relatively larger impact on mean flows at lower workloads. Retrograde diastolic flow was negligible during handgrip. Although mean FBF was lower in response to cycling than handgrip exercise, the impact of l–NMMA was significant during the cycle modality only (P < 0.05), possibly reflecting the importance of an oscillatory antegrade/retrograde flow pattern on shear stress-mediated release of NO from the endothelium. In conclusion, different types of exercise present different haemodynamic stimuli to the endothelium, which may result in differential effects of shear stress on the vasculature. PMID:15513940

  17. Correlation Analysis of Exercise-Induced Changes in Plasma Trace Element and Hormone Levels During Incremental Exercise in Well-Trained Athletes.

    PubMed

    Soria, Marisol; Anson, Miguel; Escanero, Jesús F

    2016-03-01

    This study analyzes the relationship between hormonal changes induced by exercise and variations in trace elements associated with oxidative stress during incremental exercise. Nineteen well-trained endurance athletes performed a cycle ergometer test: after a warm-up of 10 min at 2.0 W kg(-1), workload increased by 0.5 W kg(-1) every 10 min until exhaustion. The analysis was controlled for prior diet and activity patterns, levels of exercise training, and time of day (circadian rhythms). Whole blood lactate concentration and plasma concentrations of ions (Zn, Se, Mn, and Co), insulin, glucagon, aldosterone, thyroid stimulating hormone (TSH), calcitonin, and parathyroid hormone (PTH) were measured at rest; at the end of each stage; and 3, 5, and 7 min post-exercise. The statistical analysis involved paired non-parametric tests and correlation coefficients. No significant differences were found in Mn or Co levels as a function of exercise intensity. Zn and Se levels at the end of the exercise protocol and over the recovery time were significantly different to baseline. Further, Zn levels were significantly correlated with aldosterone, calcitonin, and PTH levels, while Se levels were associated with aldosterone, calcitonin, and TSH levels. Our results indicate several different patterns of association between acute changes in hormone concentrations and variations in trace element concentrations related to oxidative stress during submaximal exercise.

  18. Intermittent versus Continuous Incremental Field Tests: Are Maximal Variables Interchangeable?

    PubMed Central

    Carminatti, Lorival J.; Possamai, Carlos A. P.; de Moraes, Marcelo; da Silva, Juliano F.; de Lucas, Ricardo D.; Dittrich, Naiandra; Guglielmo, Luiz G. A.

    2013-01-01

    The aim of the present study was to compare physiological responses derived from an incremental progressive field test with a constant speed test i.e. intermittent versus continuous protocol. Two progressive maximum tests (Carminatti`s test (T-CAR) and the Vameval test (T-VAM)), characterized by increasing speed were used. T-CAR is an intermittent incremental test, performed as shuttle runs; while T-VAM is a continuous incremental test performed on an athletic track. Eighteen physically active, healthy young subjects (21.9 ± 2.0 years; 76.5 ± 8.6 kg, 1.78 ± 0.08 m, 11.2 ± 5.4% body fat), volunteered for this study. Subjects performed four different maximum test sessions conducted in the field: two incremental tests and two time to exhaustion tests (TTE) at peak test velocities (PV). No significant differences were found for PV (T-CAR = 15.6 ± 1.2; T-VAM = 15.5 ± 1.3 km·h-1) and maximal HR (T-CAR = 195 ± 11; T- VAM = 194 ± 14 bpm). During TTE, there were no significant differences for HR (TTET-CAR and TTET-VAM = 192 ± 12 bpm). However, there was a significant difference in TTE (p = 0.04) (TTET-CAR = 379 ± 84, TTET-VAM = 338 ± 58 s) with a low correlation (r = 0.41). The blood lactate concentration measured at the end of the TTE tests, showed no significant difference (TTET-CAR = 13.2 ± 2.4 vs. TTET-VAM = 12.9 ± 2.4 mmol·l-1). Based on the present findings, it is suggested that the maximal variables derived from T-CAR and T-VAM can be interchangeable in the design of training programs. Key points T-CAR is an intermittent shuttle run test that predicts the maximal aerobic speed with accuracy, hence, test results could be interchangeable with continuous straight-line tests. T-CAR provides valid field data for evaluating aerobic fitness. In comparison with T-VAM, T-CAR may be a more favourable way to prescribe intermittent training using a shuttle-running protocol. PMID:24149741

  19. Influence of muscle metabolic heterogeneity in determining the V̇o2p kinetic response to ramp-incremental exercise.

    PubMed

    Keir, Daniel A; Benson, Alan P; Love, Lorenzo K; Robertson, Taylor C; Rossiter, Harry B; Kowalchuk, John M

    2016-03-01

    The pulmonary O2 uptake (V̇o2p) response to ramp-incremental (RI) exercise increases linearly with work rate (WR) after an early exponential phase, implying that a single time constant (τ) and gain (G) describe the response. However, variability in τ and G of V̇o2p kinetics to different step increments in WR is documented. We hypothesized that the "linear" V̇o2p-WR relationship during RI exercise results from the conflation between WR-dependent changes in τ and G. Nine men performed three or four repeats of RI exercise (30 W/min) and two step-incremental protocols consisting of four 60-W increments beginning from 20 W or 50 W. During testing, breath-by-breath V̇o2p was measured by mass spectrometry and volume turbine. For each individual, the V̇o2p RI response was characterized with exponential functions containing either constant or variable τ and G values. A relationship between τ and G vs. WR was determined from the step-incremental protocols to derive the variable model parameters. τ and G increased from 21 ± 5 to 98 ± 20 s and from 8.7 ± 0.6 to 12.0 ± 1.9 ml·min(-1)·W(-1) for WRs of 20-230 W, respectively, and were best described by a second-order (τ) and a first-order (G) polynomial function of WR (lowest Akaike information criterion score). The sum of squared residuals was not different (P > 0.05) when the V̇o2p RI response was characterized with either the constant or variable models, indicating that they described the response equally well. Results suggest that τ and G increase progressively with WR during RI exercise. Importantly, these relationships may conflate to produce a linear V̇o2p-WR response, emphasizing the influence of metabolic heterogeneity in determining the apparent V̇o2p-WR relationship during RI exercise.

  20. No reserve in isokinetic cycling power at intolerance during ramp incremental exercise in endurance-trained men.

    PubMed

    Ferguson, Carrie; Wylde, Lindsey A; Benson, Alan P; Cannon, Daniel T; Rossiter, Harry B

    2016-01-01

    During whole body exercise in health, maximal oxygen uptake (V̇o2max) is typically attained at or immediately before the limit of tolerance (LoT). At the V̇o2max and LoT of incremental exercise, a fundamental, but unresolved, question is whether maximal evocable power can be increased above the task requirement, i.e., whether there is a "power reserve" at the LoT. Using an instantaneous switch from cadence-independent (hyperbolic) to isokinetic cycle ergometry, we determined maximal evocable power at the limit of ramp-incremental exercise. We hypothesized that in endurance-trained men at LoT, maximal (4 s) isokinetic power would not differ from the power required by the task. Baseline isokinetic power at 80 rpm (Piso; measured at the pedals) and summed integrated EMG from five leg muscles (ΣiEMG) were measured in 12 endurance-trained men (V̇o2max = 4.2 ± 1.0 l/min). Participants then completed a ramp incremental exercise test (20-25 W/min), with instantaneous measurement of Piso and ΣiEMG at the LoT. Piso decreased from 788 ± 103 W at baseline to 391 ± 72 W at LoT, which was not different from the required ramp-incremental flywheel power (352 ± 58 W; P > 0.05). At LoT, the relative reduction in Piso was greater than the relative reduction in the isokinetic ΣiEMG (50 ± 9 vs. 63 ± 10% of baseline; P < 0.05). During maximal ramp incremental exercise in endurance-trained men, maximum voluntary power is not different from the power required by the task and is consequent to both central and peripheral limitations in evocable power. The absence of a power reserve suggests both the perceptual and physiological limits of maximum voluntary power production are not widely dissociated at LoT in this population.

  1. Influence of muscle metabolic heterogeneity in determining the V̇o2p kinetic response to ramp-incremental exercise

    PubMed Central

    Keir, Daniel A.; Benson, Alan P.; Love, Lorenzo K.; Robertson, Taylor C.

    2015-01-01

    The pulmonary O2 uptake (V̇o2p) response to ramp-incremental (RI) exercise increases linearly with work rate (WR) after an early exponential phase, implying that a single time constant (τ) and gain (G) describe the response. However, variability in τ and G of V̇o2p kinetics to different step increments in WR is documented. We hypothesized that the “linear” V̇o2p-WR relationship during RI exercise results from the conflation between WR-dependent changes in τ and G. Nine men performed three or four repeats of RI exercise (30 W/min) and two step-incremental protocols consisting of four 60-W increments beginning from 20 W or 50 W. During testing, breath-by-breath V̇o2p was measured by mass spectrometry and volume turbine. For each individual, the V̇o2p RI response was characterized with exponential functions containing either constant or variable τ and G values. A relationship between τ and G vs. WR was determined from the step-incremental protocols to derive the variable model parameters. τ and G increased from 21 ± 5 to 98 ± 20 s and from 8.7 ± 0.6 to 12.0 ± 1.9 ml·min−1·W−1 for WRs of 20-230 W, respectively, and were best described by a second-order (τ) and a first-order (G) polynomial function of WR (lowest Akaike information criterion score). The sum of squared residuals was not different (P > 0.05) when the V̇o2p RI response was characterized with either the constant or variable models, indicating that they described the response equally well. Results suggest that τ and G increase progressively with WR during RI exercise. Importantly, these relationships may conflate to produce a linear V̇o2p-WR response, emphasizing the influence of metabolic heterogeneity in determining the apparent V̇o2p-WR relationship during RI exercise. PMID:26679614

  2. Effects of endurance training on reduction of plasma glucose during high intensity constant and incremental speed tests in Wistar rats

    PubMed Central

    Abreu, P.; Vitzel, K.F.; Monteiro, I.C.C.R.; Lima, T.I.; Queiroz, A.N.; Leal-Cardoso, J.H.; Hirabara, S.M.; Ceccatto, V.M.

    2016-01-01

    The aim of this research was to investigate the effects of endurance training on reduction of plasma glucose during high intensity constant and incremental speed tests in Wistar rats. We hypothesized that plasma glucose might be decreased in the exercised group during heavy (more intense) exercise. Twenty-four 10-week-old male Wistar rats were randomly assigned to sedentary and exercised groups. The prescription of endurance exercise training intensity was determined as 60% of the maximum intensity reached at the incremental speed test. The animals were trained by running on a motorized treadmill, five days/week for a total period of 67 weeks. Plasma glucose during the constant speed test in the exercised group at 20 m/min was reduced at the 14th, 21st and 28th min compared to the sedentary group, as well at 25 m/min at the 21st and 28th min. Plasma glucose during the incremental speed test was decreased in the exercised group at the moment of exhaustion (48th min) compared to the sedentary group (27th min). Endurance training positively modulates the mitochondrial activity and capacity of substrate oxidation in muscle and liver. Thus, in contrast to other studies on high load of exercise, the effects of endurance training on the decrease of plasma glucose during constant and incremental speed tests was significantly higher in exercised than in sedentary rats and associated with improved muscle and hepatic oxidative capacity, constituting an important non-pharmacological intervention tool for the prevention of insulin resistance, including type 2 diabetes mellitus. PMID:27783805

  3. Effects of endurance training on reduction of plasma glucose during high intensity constant and incremental speed tests in Wistar rats.

    PubMed

    Abreu, P; Vitzel, K F; Monteiro, I C C R; Lima, T I; Queiroz, A N; Leal-Cardoso, J H; Hirabara, S M; Ceccatto, V M

    2016-10-24

    The aim of this research was to investigate the effects of endurance training on reduction of plasma glucose during high intensity constant and incremental speed tests in Wistar rats. We hypothesized that plasma glucose might be decreased in the exercised group during heavy (more intense) exercise. Twenty-four 10-week-old male Wistar rats were randomly assigned to sedentary and exercised groups. The prescription of endurance exercise training intensity was determined as 60% of the maximum intensity reached at the incremental speed test. The animals were trained by running on a motorized treadmill, five days/week for a total period of 67 weeks. Plasma glucose during the constant speed test in the exercised group at 20 m/min was reduced at the 14th, 21st and 28th min compared to the sedentary group, as well at 25 m/min at the 21st and 28th min. Plasma glucose during the incremental speed test was decreased in the exercised group at the moment of exhaustion (48th min) compared to the sedentary group (27th min). Endurance training positively modulates the mitochondrial activity and capacity of substrate oxidation in muscle and liver. Thus, in contrast to other studies on high load of exercise, the effects of endurance training on the decrease of plasma glucose during constant and incremental speed tests was significantly higher in exercised than in sedentary rats and associated with improved muscle and hepatic oxidative capacity, constituting an important non-pharmacological intervention tool for the prevention of insulin resistance, including type 2 diabetes mellitus.

  4. Skeletal muscle power and fatigue at the tolerable limit of ramp-incremental exercise in COPD.

    PubMed

    Cannon, Daniel T; Coelho, Ana Claudia; Cao, Robert; Cheng, Andrew; Porszasz, Janos; Casaburi, Richard; Rossiter, Harry B

    2016-12-01

    Muscle fatigue (a reduced power for a given activation) is common following exercise in chronic obstructive pulmonary disease (COPD). Whether muscle fatigue, and reduced maximal voluntary locomotor power, are sufficient to limit whole body exercise in COPD is unknown. We hypothesized in COPD: 1) exercise is terminated with a locomotor muscle power reserve; 2) reduction in maximal locomotor power is related to ventilatory limitation; and 3) muscle fatigue at intolerance is less than age-matched controls. We used a rapid switch from hyperbolic to isokinetic cycling to measure the decline in peak isokinetic power at the limit of incremental exercise ("performance fatigue") in 13 COPD patients (FEV1 49 ± 17%pred) and 12 controls. By establishing the baseline relationship between muscle activity and isokinetic power, we apportioned performance fatigue into the reduction in muscle activation and muscle fatigue. Peak isokinetic power at intolerance was ~130% of peak incremental power in controls (274 ± 73 vs. 212 ± 84 W, P < 0.05), but ~260% in COPD patients (187 ± 141 vs. 72 ± 34 W, P < 0.05), greater than controls (P < 0.05). Muscle fatigue as a fraction of baseline peak isokinetic power was not different in COPD patients vs. controls (0.11 ± 0.20 vs. 0.19 ± 0.11). Baseline to intolerance, the median frequency of maximal isokinetic muscle activity, was unchanged in COPD patients but reduced in controls (+4.3 ± 11.6 vs. -5.5 ± 7.6%, P < 0.05). Performance fatigue as a fraction of peak incremental power was greater in COPD vs. controls and related to resting (FEV1/FVC) and peak exercise (V̇E/maximal voluntary ventilation) pulmonary function (r(2) = 0.47 and 0.55, P < 0.05). COPD patients are more fatigable than controls, but this fatigue is insufficient to constrain locomotor power and define exercise intolerance. Copyright © 2016 the American Physiological Society.

  5. Comparison of heart and respiratory rate variability measures using an intermittent incremental submaximal exercise model.

    PubMed

    Barrera-Ramirez, Juliana; Bravi, Andrea; Green, Geoffrey; Seely, Andrew J; Kenny, Glen P

    2013-11-01

    To better understand the alterations in cardiorespiratory variability during exercise, the present study characterized the patterns of change in heart rate variability (HRV), respiratory rate variability (RRV), and combined cardiorespiratory variability (HRV-RRV) during an intermittent incremental submaximal exercise model. Six males and six females completed a submaximal exercise protocol consisting of an initial baseline resting period followed by three 10-min bouts of exercise at 20%, 40%, and 60% of maximal aerobic capacity (V̇O2max). The R-R interval and interbreath interval variability were measured at baseline rest and throughout the submaximal exercise. A group of 93 HRV, 83 RRV, and 28 HRV-RRV measures of variability were tracked over time through a windowed analysis using a 5-min window size and 30-s window step. A total of 91 HRV measures were able to detect the presence of exercise, whereas only 46 RRV and 3 HRV-RRV measures were able to detect the same stimulus. Moreover, there was a loss of overall HRV and RRV, loss of complexity of HRV and RRV, and loss of parasympathetic modulation of HRV (up to 40% V̇O2max) with exercise. Conflicting changes in scale-invariant structure of HRV and RRV with increases in exercise intensity were also observed. In summary, in this simultaneous evaluation of HRV and RRV, we found more consistent changes across HRV metrics compared with RRV and HRV-RRV.

  6. A New Method for Incremental Testing of Finite State Machines

    NASA Technical Reports Server (NTRS)

    Pedrosa, Lehilton Lelis Chaves; Moura, Arnaldo Vieira

    2010-01-01

    The automatic generation of test cases is an important issue for conformance testing of several critical systems. We present a new method for the derivation of test suites when the specification is modeled as a combined Finite State Machine (FSM). A combined FSM is obtained conjoining previously tested submachines with newly added states. This new concept is used to describe a fault model suitable for incremental testing of new systems, or for retesting modified implementations. For this fault model, only the newly added or modified states need to be tested, thereby considerably reducing the size of the test suites. The new method is a generalization of the well-known W-method and the G-method, but is scalable, and so it can be used to test FSMs with an arbitrarily large number of states.

  7. Comparison between the changes in muscle oxygenation and blood lactate concentration in finswimmers during incremental exercise

    NASA Astrophysics Data System (ADS)

    Wang, Bangde; Tian, Qingping; Zhang, Zhongxing; Gong, Hui

    2009-08-01

    For the purpose of comparing the response in local skeletal muscle oxygenation and blood lactate concentration during incremental exercise, 8 female finswimmers were recruited to take an incremental exercise on a cycle ergometer. Muscle oxygenation in right vastus lateralis (VL) were monitored by continuous wave near infrared spectroscopy (CW NIRS), respiratory gas exchange and blood lactate concentration ([La]b) were simultaneously measured by a metabolic system and a portable blood lactate analyzer respectively. NIRS measurements showed a muscle oxygenation index inflection point (OIip), from which the muscle oxygenation started to decrease dramatically. Significant correlations have been found between OIip and blood lactate threshold identified at the lowest [La]b value which was >0.5 mmol/L lower than that obtained at the following workload. These results might suggest that the CW NIRS measurement could be applied to monitor lactate threshold noninvasively.

  8. Physiological responses to incremental exercise in the heat following internal and external precooling.

    PubMed

    James, C A; Richardson, A J; Watt, P W; Gibson, O R; Maxwell, N S

    2015-06-01

    Twelve males completed three incremental, discontinuous treadmill tests in the heat [31.9(1.0) °C, 61.9(8.9)%] to determine speed at two fixed blood lactate concentrations (2 and 3.5 mmol/L), running economy (RE), and maximum oxygen uptake ( V ˙ O 2 m a x ). Trials involved 20 min of either internal cooling (ICE, 7.5 g/kg ice slurry ingestion) or mixed-methods external cooling (EXT, cold towels, forearm immersion, ice vest, and cooling shorts), alongside no intervention (CON). Following precooling, participants ran 0.3 km/h faster at 2 mmol/L and 0.2 km/h faster at 3.5 mmol/L (P = 0.04, partial η(2)  = 0.27). Statistical differences were observed vs CON for ICE (P = 0.03, d = 0.15), but not EXT (P = 0.12, d = 0.15). There was no effect of cooling on RE (P = 0.81, partial η(2)  = 0.02), nor on V ˙ O 2 m a x (P = 0.69, partial η(2)  = 0.04). An effect for cooling on physiological strain index was observed (P < 0.01, partial η(2)  = 0.41), with differences vs CON for EXT (P = 0.02, d = 0.36), but not ICE (P = 0.06, d = 0.36). Precooling reduced thermal sensation (P < 0.01, partial η(2)  = 0.66) in both cooling groups (P < 0.01). Results indicate ICE and EXT provide similar physiological responses for exercise up to 30 min duration in the heat. Differing thermoregulatory responses are suggestive of specific event characteristics determining the choice of cooling. Precooling appears to reduce blood lactate accumulation and reduce thermoregulatory and perceptual strain during incremental exercise. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Sleep quality and duration are associated with performance in maximal incremental test.

    PubMed

    Antunes, B M; Campos, E Z; Parmezzani, S S; Santos, R V; Franchini, E; Lira, F S

    2017-08-01

    Inadequate sleep patterns may be considered a trigger to development of several metabolic diseases. Additionally, sleep deprivation and poor sleep quality can negatively impact performance in exercise training. However, the impact of sleep duration and sleep quality on performance during incremental maximal test performed by healthy men is unclear. Therefore, the purpose of the study was to analyze the association between sleep pattern (duration and quality) and performance during maximal incremental test in healthy male individuals. A total of 28 healthy males volunteered to take part in the study. Sleep quality, sleep duration and physical activity were subjectively assessed by questionnaires. Sleep pattern was classified by sleep duration (>7h or <7h of sleep per night) and sleep quality according to the sum of measured points and/or scores by the Pittsburgh Sleep Quality Index (PSQI). Incremental exercise test was performed at 35 watts for untrained subjects, 70 watts for physically active subjects and 105 watts for well-trained subjects. HRmax was correlated with sleep quality (r=0.411, p=0.030) and sleep duration (r=-0.430, p=0.022). Participants reporting good sleep quality presented higher values of Wmax, VO2max and lower values of HRmax when compared to participants with altered sleep. Regarding sleep duration, only Wmax was influenced by the amount of sleeping hours per night and this association remained significant even after adjustment by VO2max. Sleep duration and quality are associated, at least in part, with performance during maximal incremental test among healthy men, with losses in Wmax and HRmax. In addition, our results suggest that the relationship between sleep patterns and performance, mainly in Wmax, is independent of fitness condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Does the incremental shuttle walk test require maximal effort in young obese women?

    PubMed

    Jürgensen, S P; Trimer, R; Di Thommazo-Luporini, L; Dourado, V Z; Bonjorno-Junior, J C; Oliveira, C R; Arena, R; Borghi-Silva, A

    2016-07-11

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 - age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option.

  11. Prediction of heart rate and oxygen uptake during incremental and maximal exercise in healthy adults.

    PubMed

    Fairbarn, M S; Blackie, S P; McElvaney, N G; Wiggs, B R; Paré, P D; Pardy, R L

    1994-05-01

    Measurement of heart rate and oxygen uptake during incremental exercise and at maximal exercise is useful in evaluating mechanisms responsible for exercise limitation in patients with cardiopulmonary disease. Presently used prediction equations are based on relatively small groups of subjects in whom there was an uneven distribution of subjects with regard to age and sex or based on equations that were from extrapolated data. Our prediction equations are based on data from 231 men and women equally divided within decades between 20 and 80 years. Patients exercised to a symptom-limited maximum on a cycle ergometer while measurements of heart rate and oxygen uptake were recorded. The relationship between heart rate and oxygen uptake throughout exercise (HR:VO2) was determined using a statistical technique that included each data point from each subject. The HR:VO2 throughout incremental exercise was best described by separate equations for women younger than 50 years and older than 50 years and for men younger than 70 years and older than 70 years. Prediction equations for maximal heart rate (HRmax) and maximal oxygen uptake (VO2max) were developed by linear regression and were selected from all possible combinations of parameters. The HRmax was most accurately predicted by age alone for both sexes. Unlike the HR:VO2 relationship, the slope of the line relating heart rate to age was not different for the older women compared with the younger women so that a single equation was derived to predict HRmax. A single equation for the men was also sufficient since the slope of heart rate to age was the same for all ages. To most accurately predict VO2max, a separate equation was required for both the women and men that included age, height, and weight.

  12. Cardiopulmonary Exercise Testing in Pediatrics.

    PubMed

    Takken, Tim; Bongers, Bart C; van Brussel, Marco; Haapala, Eero A; Hulzebos, Erik H J

    2017-07-01

    Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared with adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine. As the physiological responses to exercise change during growth and development, appropriate pediatric reference values are essential for an adequate interpretation of the cardiopulmonary exercise test.

  13. Effects of incremental exercise on cerebral oxygenation measured by near-infrared spectroscopy: a systematic review.

    PubMed

    Rooks, Cherie R; Thom, Nathaniel J; McCully, Kevin K; Dishman, Rod K

    2010-10-01

    We conducted a systematic review and meta-regression analysis to quantify effects of exercise on brain hemodynamics measured by near-infrared spectroscopy (NIRS). The results indicate that acute incremental exercise (categorized relative to aerobic capacity (VO(2)peak) as low - <30% VO(2)peak; moderate - ≥30% VO(2)peak to <60% VO(2)peak; hard - ≥60% VO(2)peak to exercise compared to baseline. In conclusion, prefrontal oxygenation measured with NIRS in healthy people showed a quadratic response to incremental exercise, rising between moderate and hard intensities, then falling at very hard intensities. Training status influenced the responses. While methodological improvements in measures of brain oxygen are forthcoming, these results extend the evidence relevant to existing models of central limitations to maximal exercise.

  14. Pacing accuracy during an incremental step test in adolescent swimmers.

    PubMed

    Scruton, Adrian; Baker, James; Roberts, Justin; Basevitch, Itay; Merzbach, Viviane; Gordon, Dan

    2015-01-01

    To assess pacing accuracy in a group of adolescent swimmers during an incremental step test. Fifteen well-trained swimmers (age 15±1.5 years; height 170.2±8.8 cm; mass 60.2±6.6 kg), completed two 7×200 m tests, separated by ~72 hours. They swam to a predetermined incrementally increasing pace per step and were instructed to swim at even pace. Upon completion of each step, rating of perceived exertion, heart rate and blood lactate were recorded. Significant differences observed for both trials between actual and predicted swim time (P<0.05). Significant differences also observed between the first and second 100 m of each step in trial 1 for step 1 (P=0.001, effect size [ES] =0.54), step 2 (P=0.0001, ES =0.57), step 4 (P=0.0001, ES =0.53), step 5 (P=0.005, ES =0.65), step 6 (P=0.0001, ES =0.50), and step 7 (P=0.0001, ES =0.70). Similar responses witnessed for trial 2 (P<0.05). Findings suggest that the finite anaerobic capacity was engaged sooner than would normally be anticipated, as a function of an inability to regulate pace. This is proposed to be a consequence of the volume of exposure to the biological and psychological sensations and cognitive developmental status. Given the apparent error in pacing judgment exhibited in this population group, caution should be applied when adopting such tests to monitor training responses with adolescent athletes, and alternate means of modulating pace be investigated.

  15. An electromyographic-based test for estimating neuromuscular fatigue during incremental treadmill running.

    PubMed

    Camic, Clayton L; Kovacs, Attila J; Enquist, Evan A; VanDusseldorp, Trisha A; Hill, Ethan C; Calantoni, Austin M; Yemm, Allison J

    2014-12-01

    The purposes of the present study were two fold: (1) to determine if the model used for estimating the physical working capacity at the fatigue threshold (PWCFT) from electromyographic (EMG) amplitude data during incremental cycle ergometry could be applied to treadmill running to derive a new neuromuscular fatigue threshold for running, and (2) to compare the running velocities associated with the PWCFT, ventilatory threshold (VT), and respiratory compensation point (RCP). Fifteen college-aged subjects (21.5 ± 1.3 y, 68.7 ± 10.5 kg, 175.9 ± 6.7 cm) performed an incremental treadmill test to exhaustion with bipolar surface EMG signals recorded from the vastus lateralis. There were significant (p < 0.05) mean differences in running velocities between the VT (11.3 ± 1.3 km h(-1)) and PWCFT (14.0 ± 2.3 km h(-1)), VT and RCP (14.0 ± 1.8 km h(-1)), but not the PWCFT and RCP. The findings of the present study indicated that the PWCFT model could be applied to a single continuous, incremental treadmill test to estimate the maximal running velocity that can be maintained prior to the onset of neuromuscular fatigue. In addition, these findings suggested that the PWCFT, like the RCP, may be used to differentiate the heavy from severe domains of exercise intensity.

  16. Plasma ammonia response to incremental cycling and walking tests in COPD.

    PubMed

    Calvert, L D; Steiner, M C; Morgan, M D; Singh, S J

    2010-05-01

    It is well documented that plasma ammonia accumulates during exercise under conditions of metabolic stress. Metabolic stress (when skeletal muscle ATP supply fails to meet demand) occurs at low work rates during cycling in patients with COPD, but not been described during walking. Walking is an important activity for many patients with COPD and is commonly prescribed in pragmatic outpatient pulmonary rehabilitation programmes. In this study we explored whether metabolic stress occurs during incremental walking at the low work rates these patients achieve. Twenty-nine subjects with stable COPD [mean(SD) age 68(7)years, FEV(1) 50(19)% predicted] performed maximal cardiopulmonary exercise tests on a cycle ergometer and treadmill. Plasma ammonia concentration was measured at rest, 1 and 2min of exercise, peak exercise and 2min recovery. Subjects achieved mean(SD) cycle work rate of 57(20)W with VO(2max) 15.5(4.6)ml/min per kg, and treadmill distance 284(175)m with VO(2peak) 16.8(4.2)ml/min per kg. Plasma ammonia concentration rose significantly (p<0.001) with walking [mean(SEM) change 24.7(3.8)micromol/l] and cycling [mean(SEM) change 35.2(4.3)micromol/l], but peak exercise ammonia was lower in walking (p<0.01). In a subgroup of subjects (n=7) plasma ammonia did not rise during either cycling or walking despite similar lactate rise and peak exercise indices. Our data indicate that failure of muscle ATP re-synthesis to meet demand and development of metabolic stress can occur during walking in COPD patients at the low work rates these patients achieve. This may therefore be a factor contributing to exercise limitation independent of ventilatory limitation.

  17. Long Maximal Incremental Tests Accurately Assess Aerobic Fitness in Class II and III Obese Men

    PubMed Central

    Lanzi, Stefano; Codecasa, Franco; Cornacchia, Mauro; Maestrini, Sabrina; Capodaglio, Paolo; Brunani, Amelia; Fanari, Paolo; Salvadori, Alberto; Malatesta, Davide

    2015-01-01

    This study aimed to compare two different maximal incremental tests with different time durations [a maximal incremental ramp test with a short time duration (8-12 min) (STest) and a maximal incremental test with a longer time duration (20-25 min) (LTest)] to investigate whether an LTest accurately assesses aerobic fitness in class II and III obese men. Twenty obese men (BMI≥35 kg.m-2) without secondary pathologies (mean±SE; 36.7±1.9 yr; 41.8±0.7 kg*m-2) completed an STest (warm-up: 40 W; increment: 20 W*min-1) and an LTest [warm-up: 20% of the peak power output (PPO) reached during the STest; increment: 10% PPO every 5 min until 70% PPO was reached or until the respiratory exchange ratio reached 1.0, followed by 15 W.min-1 until exhaustion] on a cycle-ergometer to assess the peak oxygen uptake V˙O2peak and peak heart rate (HRpeak) of each test. There were no significant differences in V˙O2peak (STest: 3.1±0.1 L*min-1; LTest: 3.0±0.1 L*min-1) and HRpeak (STest: 174±4 bpm; LTest: 173±4 bpm) between the two tests. Bland-Altman plot analyses showed good agreement and Pearson product-moment and intra-class correlation coefficients showed a strong correlation between V˙O2peak (r=0.81 for both; p≤0.001) and HRpeak (r=0.95 for both; p≤0.001) during both tests. V˙O2peak and HRpeak assessments were not compromised by test duration in class II and III obese men. Therefore, we suggest that the LTest is a feasible test that accurately assesses aerobic fitness and may allow for the exercise intensity prescription and individualization that will lead to improved therapeutic approaches in treating obesity and severe obesity. PMID:25875746

  18. Long maximal incremental tests accurately assess aerobic fitness in class II and III obese men.

    PubMed

    Lanzi, Stefano; Codecasa, Franco; Cornacchia, Mauro; Maestrini, Sabrina; Capodaglio, Paolo; Brunani, Amelia; Fanari, Paolo; Salvadori, Alberto; Malatesta, Davide

    2015-01-01

    This study aimed to compare two different maximal incremental tests with different time durations [a maximal incremental ramp test with a short time duration (8-12 min) (STest) and a maximal incremental test with a longer time duration (20-25 min) (LTest)] to investigate whether an LTest accurately assesses aerobic fitness in class II and III obese men. Twenty obese men (BMI≥35 kg.m-2) without secondary pathologies (mean±SE; 36.7±1.9 yr; 41.8±0.7 kg*m-2) completed an STest (warm-up: 40 W; increment: 20 W*min-1) and an LTest [warm-up: 20% of the peak power output (PPO) reached during the STest; increment: 10% PPO every 5 min until 70% PPO was reached or until the respiratory exchange ratio reached 1.0, followed by 15 W.min-1 until exhaustion] on a cycle-ergometer to assess the peak oxygen uptake [Formula: see text] and peak heart rate (HRpeak) of each test. There were no significant differences in [Formula: see text] (STest: 3.1±0.1 L*min-1; LTest: 3.0±0.1 L*min-1) and HRpeak (STest: 174±4 bpm; LTest: 173±4 bpm) between the two tests. Bland-Altman plot analyses showed good agreement and Pearson product-moment and intra-class correlation coefficients showed a strong correlation between [Formula: see text] (r=0.81 for both; p≤0.001) and HRpeak (r=0.95 for both; p≤0.001) during both tests. [Formula: see text] and HRpeak assessments were not compromised by test duration in class II and III obese men. Therefore, we suggest that the LTest is a feasible test that accurately assesses aerobic fitness and may allow for the exercise intensity prescription and individualization that will lead to improved therapeutic approaches in treating obesity and severe obesity.

  19. [Effect of incremental cycling exercise performed before and 24 hours after blood withdrawal on the concentration of morphologic elements of blood in young health men].

    PubMed

    Duda, Krzysztof; Majerczak, Joanna; Zoładz, Jerzy A; Duda, Janina P; Kołodziejski, Leszek; Rychlik, Urszula; Kulpa, Jan

    2005-01-01

    The aim of this study was to evaluate the effect of incremental cycling exercise test performed before and 24 hours after blood donation (withdrawal of 450 ml of blood) on the plasma volume and concentration of morphologic elements of blood. Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg x m(-2); VO2max 2903 +/- 334 ml x min(-1), volunteered for this study. The exercise test started at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed once in the control study (7-12 days before blood donation) and repeated 24 hrs after blood donation. The blood samples were taken from the antecubital vein, in a sitting position (1) at rest, (2) at the stage of 100 W power output, (3) at the end of the test (the stage of exhaustion) and (4) at 2 hours after the end of the test. The changes in plasma volume were evaluated according to changes in hemoglobin and hematocrit concentrations. The significance of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p<0.05) decrease in plasma volume was found in both study. It amounted to--11.1 +/- 2.9% in the control study, and to--13.0 +/- 3.9% after blood donation. Within 2 hours after the end of the exercise test plasma volume returned to the pre-exercise value in the control study and exceeded the pre-exercise value by 3.9 +/- 6.7% (p<0.05) in the study performed after blood donation. The MCV, MCH, and MCHC values were not affected by the exercise performed before and after blood donation. In the control study, at the end of the incremental exercise test a significant increase in the leukocyte, lymphocyte and thrombocyte count was found. At 2 hours after exercise thrombocytes count returned to the pre-exercise level, whereas the exercise-induced leucocytosis remained at the end-exercise level. The lymphocyte count decreased to lymphopenic level. During the incremental

  20. Chronotropic and pressor effects of water ingestion at rest and in response to incremental dynamic exercise.

    PubMed

    Mendonca, Goncalo V; Teixeira, Micael S; Heffernan, Kevin S; Fernhall, Bo

    2013-06-01

    Ingestion of water attenuates the chronotropic response to submaximal exercise. However, it is not known whether this effect is equally manifested during dynamic exercise below and above the ventilatory threshold (VT). We explored the effects of water ingestion on the heart rate response to an incremental cycle-ergometer protocol. In a randomized fashion, 19 healthy adults (10 men and nine women, age 20.9 ± 1.8 years) ingested 50 and 500 ml of water before completing a cycle-ergometer protocol on two separate days. The heart rate and oxygen uptake ( ) responses to water ingestion were analysed both at rest and during exercise performed below and above the VT. The effects of water intake on brachial blood pressure were measured only at rest. Resting mean arterial pressure increased and resting heart rate decreased, but only after 500 ml of water (P < 0.05). Compared with that seen after 50 ml of water, the 500 ml volume elicited an overall decrease in submaximal heart rate (P < 0.05). In contrast, drinking 500 ml of water did not affect submaximal . The participants' maximal heart rate, maximal and VT were similar between conditions. Our results therefore indicate that, owing to its effects on submaximal heart rate over a broad spectrum of intensities, the drinking of water should be recognized as a potential confounder in cardiovascular exercise studies. However, by showing no differences between conditions for submaximal , they also suggest that the magnitude of heart rate reduction after drinking 500 ml of water may be of minimal physiological significance for exercise cardiorespiratory capacity.

  1. Exercise Testing in Hypertension Patients

    DTIC Science & Technology

    2001-10-25

    Chinese Version) before the exercise testing. According to the daily mobility, existing symptoms and physiological adaptability, physical function of the...completed the WHOQOL-BREF and the physical function questionnaire, and the form of general information, includ- ing age, sex and etc. All...sys- tem. During the exercising testing the function of symp a- thetic nerve and parasympathetic nerve will be more active than that in the resting

  2. Does the incremental shuttle walk test require maximal effort in young obese women?

    PubMed Central

    Jürgensen, S.P.; Trimer, R.; Di Thommazo-Luporini, L.; Dourado, V.Z.; Bonjorno-Junior, J.C.; Oliveira, C.R.; Arena, R.; Borghi-Silva, A.

    2016-01-01

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX) on a treadmill to responses obtained by the incremental shuttle walk test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 – age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option. PMID:27409333

  3. Inspiratory muscle performance in endurance-trained elderly males during incremental exercise.

    PubMed

    Chlif, Mehdi; Keochkerian, David; Temfemo, Abdou; Choquet, Dominique; Ahmaidi, Said

    2016-07-01

    The aim of this study was to compare the inspiratory muscle performance during an incremental exercise of twelve fit old endurance-trained athletes (OT) with that of fit young athletes (YT) and healthy age-matched controls (OC). The tension-time index (TT0.1) was determined according to the equation TT0.1=P0.1/PImax×ti/ttot, where P0.1 is the mouth occlusion pressure, PImax the maximal inspiratory pressure and ti/ttot the duty cycle. For a given VCO2, OT group displayed P0.1, P0.1/PImax ratio, TT0.1 and effective impedance of the respiratory muscle values which were lower than OC group and higher than YT group. At maximal exercise, P0.1/PImax ratio and TT0.1 was still lower in the OT group than OC group and higher than YT group. This study showed lower inspiratory muscle performance attested by a higher (TT0.1) during exercise in the OT group than YT group, but appeared to be less marked in elderly men having performed lifelong endurance training compared with sedentary elderly subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Changes in Pain Perception in Women During and Following an Exhaustive Incremental Cycling Exercise

    PubMed Central

    Drury, Daniel G.; Greenwood, Katelyn; Stuempfle, Kristin J.; Koltyn, Kelli F.

    2005-01-01

    Exercise has been found to alter pain sensitivity with a hypoalgesic response (i.e., diminished sensitivity to pain) typically reported during and/or following high intensity exercise. Most of this research, however, has involved the testing of men. Thus, the purpose of the following investigation was to examine changes in pain perception in women during and following exercise. Seventeen healthy female subjects (age 20.47±.87; VO2 peak 36.77± 4.95) volunteered to undergo pain assessment prior to, during, and after a graded exhaustive VO2 peak cycling challenge. Heart Rate (HR) and Oxygen Uptake (VO2) were monitored along with electro-diagnostic assessments of Pain Threshold (PT) and Pain Tolerance (PTOL) at: 1) baseline (B), 2) during exercise (i.e., 120 Watts), 3) at exhaustive intensity (VO2 peak), and 4) 10 minutes into recovery (R). Data were analyzed using repeated measures ANOVA to determine differences across trials. Significant differences in PT and PTOL were found across trials (PT, p = 0.0043; PTOL p = 0.0001). Post hoc analyses revealed that PT were significantly elevated at VO2 peak in comparison to B (p = 0.007), 120 Watts (p = 0.0178) and R (p = 0.0072). PTOL were found to be significantly elevated at 120 Watts (p = 0.0247), VO2 peak (p < 0.001), and R (p = 0.0001) in comparison to B. In addition, PTOL were found to be significantly elevated at VO2 peak in comparison to 120 Watts (p = 0.0045). It is concluded that exercise-induced hypoalgesia occurs in women during and following exercise, with the hypoalgesic response being most pronounced following exhaustive exercise. Key Points Exercise-induced hypoalgesia (i.e., elevated PT and PTOL) was found to occur in women during and following exercise, with the hypoalgesic response being most pronounced during exhaustive exercise. PMID:24453524

  5. Translation of submaximal exercise test responses to exercise prescription using the Talk Test.

    PubMed

    Foster, Carl; Porcari, John P; Gibson, Mark; Wright, Glenn; Greany, John; Talati, Neepa; Recalde, Pedro

    2009-12-01

    The exercise intensity at the Talk Test (TT) has been shown to be highly correlated with objective physiological markers, a useful outcome marker in patients with heart disease, a useful tool for avoiding exertional ischemia, and responsive to both positive and negative changes in exercise capacity. This randomized observational study evaluated the ability of the intensity at the TT during exercise testing to define absolute training workloads. Sedentary adults (n = 14) performed an incremental Balke type exercise test (3.0-3.5 mph at 0% grade, +2% grade every 2 minutes). Heart rate (HR), rating of perceived exertion (RPE), and TT were evaluated at each stage. Subsequently, the subjects performed 3 x 20-minute exercise bouts with the workload over the last 10 minutes of each bout equal to the absolute intensity at the stage preceding the LP (LP-1), at the last positive stage of the TT (LP), and at the first equivocal stage of the TT (EQ). During LP-1, LP, and EQ, HR was 140 +/- 23, 151 +/- 20, and 160 +/- 21 bpm, or 73 +/- 11, 79 +/- 9, and 82 +/- 9 % HRmax; RPE (CR scale) was 3.6 +/- 1.5, 4.4 +/- 1.8, and 6.3 +/- 2.2. The TT Score-ranked as 1 = comfortable speech, 2 = slightly uncomfortable speech, and 3 = speech not comfortable-was 1.4 +/- 0.5, 1.8 +/- 0.4, and 2.6 +/- 0.5 LP-1, LP, and at EQ, LP, respectively. The results suggest that to prescribe absolute training intensity from the TT and to get appropriate HR, RPE, and TT responses in sedentary individuals during training, the workload needs to be based on the intensity approximately 1 stage (approximately 1.0-1.2 metabolic equivalents) below the LP stage observed during an incremental test.

  6. Incremental shuttle walk test: Reference values and predictive equation for healthy Indian adults

    PubMed Central

    Agarwal, Bela; Shah, Monal; Andhare, Nilesh; Mullerpatan, Rajani

    2016-01-01

    Purpose: Physical inactivity in Indians is leading to an increase in noncommunicable disorders at an early age in life. Early identification and quantification of the lack of physical activity using simple and reliable exercise testing is the need of the hour. The incremental shuttle walk test (ISWT) is an externally paced walk test widely used for the evaluation of exercise capacity. Currently the normative values available for clinical reference are generated from Western populations. Hence, the study was conducted to find normative values for the ISWT in healthy Indian adults (17-75 years). Materials and Methods: A convenience sample of 862 subjects was recruited after ethical approval was obtained. All subjects were divided into groups as per age and gender. For age, the grouping was as follows: Group 1: Young adulthood (17-40 years), group 2: Middle adulthood (40-65 years), and group 3: Old adulthood (>65 years). The ISWT was performed as per standard protocol by Sally Singh. Results: The average distance walked were 709.2m,556.4m and 441.3m in females and 807.9 m, 639.6 m and 478.2 m in males in the three respective age groups. Stepwise regression analysis revealed age and gender as key variables correlating with incremental shuttle walk distance (ISWD). The derived predictive equations for males and females may be given as follows: 740.351 - (5.676 × age) + (99.007 × gender). Conclusion: Reference values were generated for healthy Indian adults. Physiological response to the ISWT was shown to be affected by gender and increasing age. Easily measurable variables explained 68% of the variance seen in the test, making the reference equation a relevant part of the evaluation of the ISWT. PMID:26933305

  7. Prolonged incremental tests do not necessarily compromise VO2max in well-trained athletes.

    PubMed

    Pierce, S J; Hahn, A G; Davie, A; Lawton, E W

    1999-12-01

    Existing literature suggests that tests for maximal oxygen uptake (VO2max) should last 8-12 minutes and that prolonged tests do not produce valid measurements. The research underlying this suggestion has been performed with non-athletic populations and trained athletes may be more tolerant of longer protocols. Eleven rowers (8 males, 3 females) each underwent four different incremental tests on a standard rowing ergometer in randomised counterbalanced order. One of the tests was continuous with workload increments each minute (IT1MIN). This test lasted an average of 12 min+/-4 s (SEM). The other three tests were discontinuous and consisted of 7 stages separated by 1-minute recovery intervals. Stage durations of 3, 4 and 5 min were used in the different tests (IT3MIN, IT4MIN and IT5MIN). Mean values for VO2max were almost identical for IT1MIN (4.56+/-0.22 L x min(-1)), IT3MIN (4.60+/-0.23 L x min(-1)) and IT4MIN (4.60+/-0.21 L x min(-1)), while IT5MIN produced a significantly lower value (4.47+/-0.21 L x min(-1), p<0.05). There was no significant difference between protocols in peak post-exercise blood lactate concentration (approx 13 mmol x L(-1) in each case), but IT1MIN produced lower peak heart rates and higher respiratory exchange ratios. We conclude that with well trained rowing athletes discontinuous test protocols involving 7 stages of 3-4 minutes duration can provide valid measurements of VO2max.

  8. Decreased foot inversion force and increased plantar surface after maximal incremental running exercise.

    PubMed

    Vie, Bruno; Brerro-Saby, Christelle; Weber, Jean Paul; Jammes, Yves

    2013-06-01

    Formulating the hypothesis that a maximal running exercise could induce fatigue of some foot muscles, we searched for electromyographic (EMG) signs of fatigue in the tibialis anterior (TA), peroneus longus (PL), and gastrocnemius medialis (GM) muscles. We also searched for post-exercise alterations of the stationary upright standing in normal-arched feet subjects. Healthy subjects performed a maximal running exercise. Surface EMGs of the TA, PL, and GM muscles were analysed during maximal dynamic efforts. Before and after the running bout, we measured the evoked compound muscle potential (M-wave) in TA, the maximal force into inversion (MIF), and the repartition of the plantar and barycentre surfaces with a computerised stationary platform. During maximal running exercise, the median frequency of the EMG spectra declined in TA while it remained stable in the PL and GM muscles. After the exercise, MIF decreased, and both the rearfoot plantar surface and the barycentre surface increased. We concluded that a maximal running bout elicits EMG signs of fatigue, though only in the TA muscle. It also elicits post-exercise changes in the foot position during stationary upright standing which indicates a foot eversion. These data solely concern a maximal running test and they can not be extrapolated to walking or running at a low speed. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Left ventricular twist mechanics during incremental cycling and knee extension exercise in healthy men.

    PubMed

    Beaumont, Alexander; Hough, John; Sculthorpe, Nicholas; Richards, Joanna

    2017-01-01

    The objective of the present study was to investigate left ventricular (LV) twist mechanics in response to incremental cycling and isometric knee extension exercises. Twenty-six healthy male participants (age = 30.42 ± 6.17 years) were used to study peak twist mechanics at rest and during incremental semi-supine cycling at 30 and 60% work rate maximum (W max) and during short duration (15 s contractions) isometric knee extension at 40 and 75% maximum voluntary contraction (MVC), using two-dimensional speckle tracking echocardiography. Data presented as mean ± standard deviation or median (interquartile range). LV twist increased from rest to 30% W max (13.21° ± 4.63° to 20.04° ± 4.76°, p < 0.001) then remained unchanged. LV systolic and diastolic twisting velocities progressively increased with exercise intensity during cycling from rest to 60% W max (twisting, 88.21° ± 20.51° to 209.05° ± 34.56° s(-1), p < 0.0001; untwisting, -93.90 (29.62)° to -267.31 (104.30)° s(-1), p < 0.0001). During the knee extension exercise, LV twist remained unchanged with progressive intensity (rest 13.40° ± 4.80° to 75% MVC 16.77° ± 5.54°, p > 0.05), whilst twisting velocity increased (rest 89.15° ± 21.77° s(-1) to 75% MVC 124.32° ± 34.89° s(-1), p < 0.01). Untwisting velocity remained unchanged from rest [-90.60 (27.19)° s(-1)] to 40% MVC (p > 0.05) then increased from 40 to 75% MVC [-98.44 (43.54)° s(-1) to -138.42 (73.29)° s(-1), p < 0.01]. Apical rotations and rotational velocities were greater than basal during all conditions and intensities (all p < 0.01). Cycling increased LV twist to 30% W max which then remained unchanged thereafter, whereas twisting velocities showed further increases to greater intensities. A novel finding is that LV twist was unaffected by incremental knee extension, yet systolic and diastolic twisting velocities augmented with isometric exercise.

  10. Exercise stress testing

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1975-01-01

    Positive maximum stress tests in the management of coronary patients are discussed. It is believed that coronary angiography would be the ultimate test to predict the future of patients with coronary heart disease. Progression of angina, myocardial infarction, and death due to heart disease were analyzed.

  11. Exercise stress testing

    NASA Technical Reports Server (NTRS)

    Schuster, B.

    1975-01-01

    Positive maximum stress tests in the management of coronary patients are discussed. It is believed that coronary angiography would be the ultimate test to predict the future of patients with coronary heart disease. Progression of angina, myocardial infarction, and death due to heart disease were analyzed.

  12. Incremental shuttle walk test distance and autonomic dysfunction predict survival in pulmonary arterial hypertension.

    PubMed

    Billings, Catherine G; Hurdman, Judith A; Condliffe, Robin; Elliot, Charlie A; Smith, Ian A; Austin, Matthew; Armstrong, Iain J; Hamilton, Neil; Charalampopoulos, Athanasios; Sabroe, Ian; Swift, Andrew J; Rothman, Alexander M; Wild, Jim M; Lawrie, Allan; Waterhouse, Judith C; Kiely, David G

    2017-08-01

    To ensure effective monitoring of pulmonary arterial hypertension (PAH), a simple, reliable assessment of exercise capacity applicable over a range of disease severity is needed. The aim of this study was to assess the ability of the incremental shuttle walk test (ISWT) to correlate with disease severity, measure sensitivity to change, and predict survival in PAH. We enrolled 418 treatment-naïve patients with PAH with baseline ISWT within 3 months of cardiac catheterization. Clinical validity and prognostic value of ISWT distance were assessed at baseline and 1 year. ISWT distance was found to correlate at baseline with World Health Organization functional class, Borg score, and hemodynamics without a ceiling effect (all p < 0.001). Walking distance at baseline and after treatment predicted survival; the area under the receiver operating characteristic curve for ability of ISWT distance to predict mortality was 0.655 (95% confidence interval 0.553-0.757; p = 0.004) at baseline and 0.737 (95% confidence interval 0.643-0.827; p < 0.001) at 1 year after initiation of treatment. Change in ISWT distance also predicted survival (p = 0.04). Heart rate (HR) and systolic blood pressure (SBP) parameters reflecting autonomic response to exercise (highest HR, change in HR, HR recovery at 1 minute >18 beats/min, highest SBP, change in SBP, and 3-minute SBP ratio) were significant predictors of survival (all p < 0.05). In patients with PAH, the ISWT is simple to perform, allows assessment of maximal exercise capacity, is sensitive to treatment effect, predicts outcome, and has no ceiling effect. Also, measures of autonomic function made post-exercise predict survival in PAH. Copyright © 2017. Published by Elsevier Inc.

  13. Proprioceptive isokinetic exercise test

    NASA Technical Reports Server (NTRS)

    Dempster, P. T.; Bernauer, E. M.; Bond, M.; Greenleaf, J. E.

    1993-01-01

    Proprioception, the reception of stimuli within the body that indicates position, is an important mechanism for optimal human performance. People exposed to prolonged bed rest, microgravity, or other deconditioning situations usually experience reduced proprioceptor and kinesthetic stimuli that compromise body balance, posture, and equilibrium. A new proprioceptive test is described that utilizes the computer-driven LIDO isokinetic ergometer. An overview of the computer logic, software, and testing procedure for this proprioceptive test, which can be performed with the arms or legs, is described.

  14. Exercise stress test

    MedlinePlus

    ... must not eat, smoke, or drink beverages containing caffeine or alcohol for 3 hours (or more) before ... most cases, you will be asked to avoid caffeine for 24 hours before the test. This includes: ...

  15. Mechanical ventilatory constraints during incremental cycle exercise in human pregnancy: implications for respiratory sensation

    PubMed Central

    Jensen, Dennis; Webb, Katherine A; Davies, Gregory A L; O'Donnell, Denis E

    2008-01-01

    The aim of this study was to identify the physiological mechanisms of exertional respiratory discomfort (breathlessness) in pregnancy by comparing ventilatory (breathing pattern, airway function, operating lung volumes, oesophageal pressure (Poes)-derived indices of respiratory mechanics) and perceptual (breathlessness intensity) responses to incremental cycle exercise in 15 young, healthy women in the third trimester (TM3; between 34 and 38 weeks gestation) and again 4–5 months postpartum (PP). During pregnancy, resting inspiratory capacity (IC) increased (P < 0.01) and end-expiratory lung volume decreased (P < 0.001), with no associated change in total lung capacity (TLC) or static respiratory muscle strength. This permitted greater tidal volume (VT) expansion throughout exercise in TM3, while preserving the relationship between contractile respiratory muscle effort (tidal Poes swing expressed as a percentage of maximum inspiratory pressure (PImax)) and thoracic volume displacement (VT expressed as a percentage of vital capacity) and between breathlessness and ventilation (V̇E). At the highest equivalent work rate (HEWR = 128 ± 5 W) in TM3 compared with PP: V̇E, tidal Poes/PImax and breathlessness intensity ratings increased by 10.2 l min−1 (P < 0.001), 8.8%PImax (P < 0.05) and 0.9 Borg units (P < 0.05), respectively. Pulmonary resistance was not increased at rest or during exercise at the HEWR in TM3, despite marked increases in mean tidal inspiratory and expiratory flow rates, suggesting increased bronchodilatation. Dynamic mechanical constraints on VT expansion (P < 0.05) with associated increased breathlessness intensity ratings (P < 0.05) were observed near peak exercise in TM3 compared with PP. In conclusion: (1) pregnancy-induced increases in exertional breathlessness reflected the normal awareness of increased V̇E and contractile respiratory muscle effort; (2) mechanical adaptations of the respiratory system, including recruitment of resting IC

  16. Alveolar gas exchange and tissue oxygenation during incremental treadmill exercise, and their associations with blood O2 carrying capacity

    PubMed Central

    Rissanen, Antti-Pekka E.; Tikkanen, Heikki O.; Koponen, Anne S.; Aho, Jyrki M.; Hägglund, Harriet; Lindholm, Harri; Peltonen, Juha E.

    2012-01-01

    The magnitude and timing of oxygenation responses in highly active leg muscle, less active arm muscle, and cerebral tissue, have not been studied with simultaneous alveolar gas exchange measurement during incremental treadmill exercise. Nor is it known, if blood O2 carrying capacity affects the tissue-specific oxygenation responses. Thus, we investigated alveolar gas exchange and tissue (m. vastus lateralis, m. biceps brachii, cerebral cortex) oxygenation during incremental treadmill exercise until volitional fatigue, and their associations with blood O2 carrying capacity in 22 healthy men. Alveolar gas exchange was measured, and near-infrared spectroscopy (NIRS) was used to monitor relative concentration changes in oxy- (Δ[O2Hb]), deoxy- (Δ[HHb]) and total hemoglobin (Δ[tHb]), and tissue saturation index (TSI). NIRS inflection points (NIP), reflecting changes in tissue-specific oxygenation, were determined and their coincidence with ventilatory thresholds [anaerobic threshold (AT), respiratory compensation point (RC); V-slope method] was examined. Blood O2 carrying capacity [total hemoglobin mass (tHb-mass)] was determined with the CO-rebreathing method. In all tissues, NIPs coincided with AT, whereas RC was followed by NIPs. High tHb-mass associated with leg muscle deoxygenation at peak exercise (e.g., Δ[HHb] from baseline walking to peak exercise vs. tHb-mass: r = 0.64, p < 0.01), but not with arm muscle- or cerebral deoxygenation. In conclusion, regional tissue oxygenation was characterized by inflection points, and tissue oxygenation in relation to alveolar gas exchange during incremental treadmill exercise resembled previous findings made during incremental cycling. It was also found out, that O2 delivery to less active m. biceps brachii may be limited by an accelerated increase in ventilation at high running intensities. In addition, high capacity for blood O2 carrying was associated with a high level of m. vastus lateralis deoxygenation at peak exercise

  17. Alveolar gas exchange and tissue oxygenation during incremental treadmill exercise, and their associations with blood O(2) carrying capacity.

    PubMed

    Rissanen, Antti-Pekka E; Tikkanen, Heikki O; Koponen, Anne S; Aho, Jyrki M; Hägglund, Harriet; Lindholm, Harri; Peltonen, Juha E

    2012-01-01

    The magnitude and timing of oxygenation responses in highly active leg muscle, less active arm muscle, and cerebral tissue, have not been studied with simultaneous alveolar gas exchange measurement during incremental treadmill exercise. Nor is it known, if blood O(2) carrying capacity affects the tissue-specific oxygenation responses. Thus, we investigated alveolar gas exchange and tissue (m. vastus lateralis, m. biceps brachii, cerebral cortex) oxygenation during incremental treadmill exercise until volitional fatigue, and their associations with blood O(2) carrying capacity in 22 healthy men. Alveolar gas exchange was measured, and near-infrared spectroscopy (NIRS) was used to monitor relative concentration changes in oxy- (Δ[O(2)Hb]), deoxy- (Δ[HHb]) and total hemoglobin (Δ[tHb]), and tissue saturation index (TSI). NIRS inflection points (NIP), reflecting changes in tissue-specific oxygenation, were determined and their coincidence with ventilatory thresholds [anaerobic threshold (AT), respiratory compensation point (RC); V-slope method] was examined. Blood O(2) carrying capacity [total hemoglobin mass (tHb-mass)] was determined with the CO-rebreathing method. In all tissues, NIPs coincided with AT, whereas RC was followed by NIPs. High tHb-mass associated with leg muscle deoxygenation at peak exercise (e.g., Δ[HHb] from baseline walking to peak exercise vs. tHb-mass: r = 0.64, p < 0.01), but not with arm muscle- or cerebral deoxygenation. In conclusion, regional tissue oxygenation was characterized by inflection points, and tissue oxygenation in relation to alveolar gas exchange during incremental treadmill exercise resembled previous findings made during incremental cycling. It was also found out, that O(2) delivery to less active m. biceps brachii may be limited by an accelerated increase in ventilation at high running intensities. In addition, high capacity for blood O(2) carrying was associated with a high level of m. vastus lateralis deoxygenation at

  18. Specificity of a Maximal Step Exercise Test

    ERIC Educational Resources Information Center

    Darby, Lynn A.; Marsh, Jennifer L.; Shewokis, Patricia A.; Pohlman, Roberta L.

    2007-01-01

    To adhere to the principle of "exercise specificity" exercise testing should be completed using the same physical activity that is performed during exercise training. The present study was designed to assess whether aerobic step exercisers have a greater maximal oxygen consumption (max VO sub 2) when tested using an activity specific, maximal step…

  19. Specificity of a Maximal Step Exercise Test

    ERIC Educational Resources Information Center

    Darby, Lynn A.; Marsh, Jennifer L.; Shewokis, Patricia A.; Pohlman, Roberta L.

    2007-01-01

    To adhere to the principle of "exercise specificity" exercise testing should be completed using the same physical activity that is performed during exercise training. The present study was designed to assess whether aerobic step exercisers have a greater maximal oxygen consumption (max VO sub 2) when tested using an activity specific, maximal step…

  20. Predicted maximal heart rate for upper body exercise testing.

    PubMed

    Hill, M; Talbot, C; Price, M

    2016-03-01

    Age-predicted maximal heart rate (HRMAX ) equations are commonly used for the purpose of prescribing exercise regimens, as criteria for achieving maximal exertion and for diagnostic exercise testing. Despite the growing popularity of upper body exercise in both healthy and clinical settings, no recommendations are available for exercise modes using the smaller upper body muscle mass. The purpose of this study was to determine how well commonly used age-adjusted prediction equations for HRMAX estimate actual HRMAX for upper body exercise in healthy young and older adults. A total of 30 young (age: 20 ± 2 years, height: 171·9 ± 32·8 cm, mass: 77·7 ± 12·6 kg) and 20 elderly adults (age: 66 ± 6 years, height: 162 ± 8·1 cm, mass: 65·3 ± 12·3 kg) undertook maximal incremental exercise tests on a conventional arm crank ergometer. Age-adjusted maximal heart rate was calculated using prediction equations based on leg exercise and compared with measured HRMAX data for the arms. Maximal HR for arm exercise was significantly overpredicted compared with age-adjusted prediction equations in both young and older adults. Subtracting 10-20 beats min(-1) from conventional prediction equations provides a reasonable estimate of HRMAX for upper body exercise in healthy older and younger adults. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  1. Testing single point incremental forming molds for thermoforming operations

    NASA Astrophysics Data System (ADS)

    Afonso, Daniel; de Sousa, Ricardo Alves; Torcato, Ricardo

    2016-10-01

    Low pressure polymer processing processes as thermoforming or rotational molding use much simpler molds then high pressure processes like injection. However, despite the low forces involved with the process, molds manufacturing for this operations is still a very material, energy and time consuming operation. The goal of the research is to develop and validate a method for manufacturing plastically formed sheets metal molds by single point incremental forming (SPIF) operation for thermoforming operation. Stewart platform based SPIF machines allow the forming of thick metal sheets, granting the required structural stiffness for the mold surface, and keeping the short lead time manufacture and low thermal inertia.

  2. The incremental value of stress testing in patients with acute chest pain beyond serial cardiac troponin testing.

    PubMed

    Aldous, Sally; Richards, A Mark; Cullen, Louise; Pickering, John W; Than, Martin

    2016-05-01

    In patients with acute chest pain and normal range cardiac troponin (cTn), accurate risk stratification for acute coronary syndrome is challenging. This study assesses the incremental value of stress testing to identify patients for angiography with a view to revascularisation. A single-centre observational study recruited patients with acute chest pain in whom serial cTn tests were negative and stress testing (exercise tolerance testing/dobutamine stress echocardiography) was performed. Stress tests were reported as negative, non-diagnostic or positive. The primary outcomes were revascularisation on index admission, or cardiac death and myocardial infarction over 1 year follow-up. Of 749 patients recruited, 709 underwent exercise tolerance testing and 40 dobutamine stress echo of which 548 (73.2%) were negative, 169 (22.6%) were non-diagnostic and 32 (4.3%) were positive. Patients with positive tests (n=19 (59.4%)) were more likely to undergo index admission revascularisation than patients with non-diagnostic (n=15 (8.9%)) (p<0.001) tests who in turn were more likely undergo index admission revascularisation than those with negative tests (n=2 (0.4%)) (p<0.001). The risks of adverse events including cardiovascular death/acute myocardial infarction were low and were similar across stress test outcomes. The incremental value of stress testing was the identification of an additional 34 (4.5% (95% CI 3.0% to 6.0%)) patients who underwent index admission revascularisation with a view to preventing future adverse events. Uncertainty in whether revascularisation prevents adverse events in patients with negative cTn means the choice to undertake stress testing depends on whether clinicians perceive value in identifying 4.5% of these patients for revascularisation. ACTRN1260900028327, ACTRN12611001069943. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Quadriceps Muscles O2 Extraction and EMG Breakpoints during a Ramp Incremental Test.

    PubMed

    Iannetta, Danilo; Qahtani, Ahmad; Millet, Guillaume Y; Murias, Juan M

    2017-01-01

    Muscle deoxygenated breakpoint ([HHb]BP) has been found to be associated with other indices of exercise tolerance in the vastus lateralis (VL) muscle but not in the vastus medialis (VM) and rectus femoris (RF). Purpose: To investigate whether the [HHb]BP occurs also in the VM and RF muscles and whether or not it is associated with other physiological indices of exercise tolerance, such as the EMG threshold (EMGt) and the respiratory compensation point (RCP). Methods: Twelve young endurance trained participants performed maximal ramp incremental (RI) cycling tests (25-30 W·min(-1) increments). Muscle oxygen extraction and activity as well as ventilatory and gas exchange parameters were measured. After accounting for the mean response time, the oxygen uptake ([Formula: see text]O2) corresponding to the RCP, [HHb]BP, and the EMGt was determined. Results: Peak power output (POpeak) was 359 ± 48 W. Maximal oxygen consumption ([Formula: see text]O2max) was 3.87 ± 0.46 L·min(-1). The [Formula: see text]O2 at the RCP was 3.39 ± 0.41 L·min(-1). The [Formula: see text]O2 (L·min(-1)) corresponding to the [HHb]BP and EMGt were: 3.49 ± 0.46 and 3.40 ± 0.44; 3.44 ± 0.61 and 3.43 ± 0.49; 3.59 ± 0.52, and 3.48 ± 0.46 for VL, VM, and RF, respectively. Pearson's correlation between these thresholds ranged from 0.90 to 0.97 (P < 0.05). No difference was found for the absolute [Formula: see text]O2 and the normalized PO (%) at which the thresholds occurred in all three muscles investigated (P > 0.05). Although in eight out of 12 participants, the [HHb]BP in the RF led to a steeper increase instead of leading to a plateau-like response as observed in the VL and VM, the [Formula: see text]O2 at the breakpoints still coincided with that at the RCP. Conclusions: This study demonstrated that local indices of exercise tolerance derived from different portions of the quadriceps are not different to the systemic index of the RCP.

  4. Slower heart rate and oxygen consumption kinetic responses in the on- and off-transient during a discontinuous incremental exercise: effects of aging.

    PubMed

    Simões, Rodrigo P; Bonjorno, José C; Beltrame, Thomas; Catai, Aparecida M; Arena, Ross; Borghi-Silva, Audrey

    2013-01-01

    The analysis of the kinetic responses of heart rate (HR) and oxygen consumption (VO(2)) are an important tool for the evaluation of exercise performance and health status. The purpose of this study was to investigate the effects of aging on the HR and VO(2) kinetics during the rest-exercise transition (on-transient) and the exercise-recovery transition (off-transient), in addition to investigating the influence of exercise intensity (mild and moderate) on these variables. A total of 14 young (23±3 years) and 14 elderly (70±4 years) healthy men performed an incremental exercise testing (ramp protocol) on a cycle-ergometer to determine the maximal power (MP). Discontinuous exercise testing was initiated at 10% of the MP with subsequent increases of 10% until exhaustion. The measurement of HR, ventilatory and metabolic variables and blood lactate were obtained at rest and during the discontinuous exercise. The lactate threshold was determined in each subject and was similar between the groups (30±7% of MP in the young group and 29±5% of MP in the elderly group, p>0.05). The HR and VO(2) kinetics (on- and off-transient) were slower in the elderly group compared to the young group (p<0.05). Additionally, in the young group, the values of HR and VO(2) kinetics were higher in the moderate compared to the mild exercise intensity. We concluded that the elderly group presented with slower HR and VO(2) kinetics in relation to the young group for both on- and off-transients of the dynamic exercise. Moreover, in the young group, the kinetic responses were slower in the moderate intensity in relation to the mild intensity.

  5. Do field walking tests produce similar cardiopulmonary demands to an incremental treadmill test in obese individuals with treated OSA?

    PubMed

    Evans, Rachael A; Dolmage, Thomas E; Robles, Priscila G; Goldstein, Roger S; Brooks, Dina

    2014-07-01

    Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (Vo2pk), is an independent predictor of mortality in obesity. We investigated whether Vo2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA. Individuals with treated OSA and a BMI > 30 kg/m2 were recruited. Participants completed an ITMT, two 6-min walk tests (6MWTs), and two incremental shuttle walk tests (ISWTs) on three separate days in a randomized order. Expired gas analysis was performed during all tests. The study was completed by 16 patients (nine men) (mean [SD] age, 58 [12] y; BMI, 36.1 [7.6] kg/m2). There was no difference (P = .27) in Vo2pk assessed by the ITMT and the ISWT (2,266 [478] and 2,017 [561] mL/min, respectively). The Vo2pk measured by the 6MWT (1,778 [360] mL/min) was lower than that measured by the ITMT (P < .01). The limits of agreement for Vo2pk between the ISWT and the ITM were ± 730 mL/min. Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak, whereas the 6MWT demonstrated a rapid rise to a plateau. The ISWT can be used instead of an ITMT and in preference to the 6MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA. However, the imprecision of the agreement in Vo2pk between the ITMT and ISWT means they cannot be used interchangeably in an individual. ClinicalTrials.gov; No.: NCT01930513; www.clinicaltrials.gov.

  6. Incremental large and small muscle mass exercise in patients with heart failure: evidence of preserved peripheral haemodynamics and metabolism

    PubMed Central

    Esposito, F.; Wagner, P. D.; Richardson, R. S.

    2015-01-01

    Aim Doubt still remains as to whether peripheral vascular and skeletal muscle dysfunction accompanies the compromised cardiac function associated with heart failure with reduced ejection fraction (HFrEF). The aim of this study was to examine the effect of HFrEF on the haemodynamic and metabolic responses to exercise with both a large (cycle) and a small [knee extensor (KE)] muscle mass in comparison with well-matched healthy controls (Ctrls). Methods Utilizing blood sampling and thermodilution blood flow measurements, we studied incremental cycle and KE exercise in 12 patients with HFrEF (ejection fraction: 25 ± 3%) and eight Ctrls. Results Incremental cycle exercise in both groups [heart failure with reduced ejection fraction (HFrEF): 23 ± 1 to 116 ± 10; Ctrls: 22 ± 1 to 137 ± 5 W] resulted in a similar rise in blood flow (HFrEF: 1525 ± 132 to 4216 ± 408; Ctrls: 1774 ± 161 to 4713 ± 448 mL min−1), oxygen uptake (HFrEF: 206 ± 24 to 586 ± 34; Ctrls: 252 ± 21 to 747 ± 89 mL min−1) and lactate efflux across the leg (HFrEF: 479 ± 122 to 4929 ± 1255; Ctrls: 537 ± 155 to 5776 ± 1010 mM min−1). Vascular resistance fell similarly in both groups with increasing exercise intensity (HFrEF: 66 ± 10 to 24 ± 3; Ctrls: 69 ± 12 to 24 ± 4 mmHg L−1 min−1). Incremental KE exercise also revealed similar haemodynamic and metabolic responses in both Ctrls and patients. Conclusion Although assessed in a relatively small cohort, these data reveal that, when compared with well-matched healthy Ctrls, alterations in peripheral haemodynamics and skeletal muscle metabolism during exercise may not be an obligatory accompaniment to HFrEF. PMID:25393513

  7. Incremental large and small muscle mass exercise in patients with heart failure: evidence of preserved peripheral haemodynamics and metabolism.

    PubMed

    Esposito, F; Wagner, P D; Richardson, R S

    2015-03-01

    Doubt still remains as to whether peripheral vascular and skeletal muscle dysfunction accompanies the compromised cardiac function associated with heart failure with reduced ejection fraction (HFrEF). The aim of this study was to examine the effect of HFrEF on the haemodynamic and metabolic responses to exercise with both a large (cycle) and a small [knee extensor (KE)] muscle mass in comparison with well-matched healthy controls (Ctrls). Utilizing blood sampling and thermodilution blood flow measurements, we studied incremental cycle and KE exercise in 12 patients with HFrEF (ejection fraction: 25 ± 3%) and eight Ctrls. Incremental cycle exercise in both groups [heart failure with reduced ejection fraction (HFrEF): 23 ± 1 to 116 ± 10; Ctrls: 22 ± 1 to 137 ± 5 W] resulted in a similar rise in blood flow (HFrEF: 1525 ± 132 to 4216 ± 408; Ctrls: 1774 ± 161 to 4713 ± 448 mL min(-1)), oxygen uptake (HFrEF: 206 ± 24 to 586 ± 34; Ctrls: 252 ± 21 to 747 ± 89 mL min(-1)) and lactate efflux across the leg (HFrEF: 479 ± 122 to 4929 ± 1255; Ctrls: 537 ± 155 to 5776 ± 1010 mm min(-1)). Vascular resistance fell similarly in both groups with increasing exercise intensity (HFrEF: 66 ± 10 to 24 ± 3; Ctrls: 69 ± 12 to 24 ± 4 mmHg L(-1) min(-1) ). Incremental KE exercise also revealed similar haemodynamic and metabolic responses in both Ctrls and patients. Although assessed in a relatively small cohort, these data reveal that, when compared with well-matched healthy Ctrls, alterations in peripheral haemodynamics and skeletal muscle metabolism during exercise may not be an obligatory accompaniment to HFrEF. © 2014 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  8. Predictive values for cardiopulmonary exercise testing in sedentary Chinese adults.

    PubMed

    Ong, Kian Chung; Loo, Chian Min; Ong, Yong Yau; Chan, Siew Pang; Earnest, Arul; Saw, Seang Mei

    2002-09-01

    Normative data for cardiopulmonary exercise testing (CPET) may vary among subjects of different races. The objectives of the present study were to: (i) establish normal standards for cardiopulmonary responses during incremental cycle ergometer testing in order to derive predictive equations for clinically useful variables during CPET of Chinese subjects; and (ii) determine the validity of existing prediction equations of maximal exercise performance for use in our local Chinese population. The maximal and submaximal cardiopulmonary responses were analysed for 95 healthy sedentary adult Chinese subjects (48 men and 47 women; aged 20-70 years) who underwent CPET using a cycle ergometer and an incremental work-rate protocol until symptom limitation. Measurements, at maximal exercise, of oxygen uptake (VO2(max)), power output and heart rate were regressed on age, height, weight and gender. The predictive equations for these exercise parameters performed better than those published previously in out-sample predictive accuracy. Comparison with previous studies also showed that prediction equations of VO2(max) derived from studies based predominantly or exclusively on Caucasian populations overestimated the actual values for our subjects. Previously established prediction equations for maximal exercise performance during CPET based on non-Chinese populations may not be applicable to Chinese subjects in our population.

  9. Treadmill exercise testing with increasing inclination as exercise protocol for wheelchair athletes.

    PubMed

    Knechtle, B; Köpfli, W

    2001-12-01

    Treadmill testing on a progressive incline of 11 wheelchair athletes. To determine if a novel treadmill exercise protocol which uses increments in inclination, rather than the standard increments in velocity, can be used to effectively determine maximum oxygen uptake VO2max for elite wheelchair athletes. Nottwil, Switzerland. Eleven elite wheelchair basketball players (29.3+/-6.3 years, 72.7+/-16.9 kg and 177+/-9.6 cm) performed an exercise protocol with increasing inclination on the treadmill. Eight players had a spinal cord injury (SCI), two had no lesion of the central nervous system and one had poliomyelitis. VO2max and heart rate were measured continuously, while serum lactate was determined immediately after the exercise protocol. Athletes reached a maximal heart rate of 185+/-11.4 bpm and maximal lactate of 10.2+/-2.1 mmol/l. VO2max was 35.1+/-4.9 ml/min/kg. The correlation between heart rate and VO(2) at different inclinations was statistically significant and comparable to able-bodied subjects. An exercise protocol with increasing inclination is a valid alternative to an exercise protocol with increasing velocity.

  10. Peak oxygen uptake in a sprint interval testing protocol vs. maximal oxygen uptake in an incremental testing protocol and their relationship with cross-country mountain biking performance.

    PubMed

    Hebisz, Rafał; Hebisz, Paulina; Zatoń, Marek; Michalik, Kamil

    2017-04-01

    In the literature, the exercise capacity of cyclists is typically assessed using incremental and endurance exercise tests. The aim of the present study was to confirm whether peak oxygen uptake (V̇O2peak) attained in a sprint interval testing protocol correlates with cycling performance, and whether it corresponds to maximal oxygen uptake (V̇O2max) determined by an incremental testing protocol. A sample of 28 trained mountain bike cyclists executed 3 performance tests: (i) incremental testing protocol (ITP) in which the participant cycled to volitional exhaustion, (ii) sprint interval testing protocol (SITP) composed of four 30 s maximal intensity cycling bouts interspersed with 90 s recovery periods, (iii) competition in a simulated mountain biking race. Oxygen uptake, pulmonary ventilation, work, and power output were measured during the ITP and SITP with postexercise blood lactate and hydrogen ion concentrations collected. Race times were recorded. No significant inter-individual differences were observed in regards to any of the ITP-associated variables. However, 9 individuals presented significantly increased oxygen uptake, pulmonary ventilation, and work output in the SITP compared with the remaining cyclists. In addition, in this group of 9 cyclists, oxygen uptake in SITP was significantly higher than in ITP. After the simulated race, this group of 9 cyclists achieved significantly better competition times (99.5 ± 5.2 min) than the other cyclists (110.5 ± 6.7 min). We conclude that mountain bike cyclists who demonstrate higher peak oxygen uptake in a sprint interval testing protocol than maximal oxygen uptake attained in an incremental testing protocol demonstrate superior competitive performance.

  11. Influence of a custom-made maxillary mouthguard on gas exchange parameters during incremental exercise in amateur road cyclists.

    PubMed

    Piero, Malpezzi; Simone, Uliari; Jonathan, Myers; Maria, Spiridonova; Giulio, Grossi; Francesco, Terranova; Gabriella, Collini; Laura, Amabile; Eva, Bernardi; Gianni, Mazzoni; Francesco, Conconi; Giovanni, Grazzi

    2015-03-01

    Mouthguards are frequently used for protection purposes, particularly by athletes competing in contact sports. However, there is increasing evidence supporting their use for improving performance. Studies have focused their use in athletes who do not traditionally use mouthguards and who may be looking for a performance edge. The aim of the current study was to evaluate the influence of a custom-made mouthguard (Parabite Malpezzi, PM) on maximal and submaximal physiological parameters related to performance in road cycling. Ten well-trained amateur road cyclists (34 ± 6 years) performed an incremental cardiopulmonary exercise test to exhaustion on a frictional braked cycle ergometer. Work rate (WR), heart rate, oxygen consumption ((Equation is included in full-text article.)), carbon dioxide production, and ventilation at the lactate threshold, at the respiratory compensation point (RCP), and at maximal exercise (MAX) were determined in normal conditions (C) and wearing PM. Cycling economy was also evaluated by analyzing the slope of the (Equation is included in full-text article.)/WR (Δ(Equation is included in full-text article.)/ΔWR, in milliliters per watt per minute) relationship during the test. Wearing the PM compared with C resulted in significant increases in WR at RCP (281 ± 32 vs. 266 ± 19 W, p = 0.04) and at MAX (353 ± 44 vs. 339 ± 38 W, p = 0.004). The PM also resulted in an average 8% lower Δ(Equation is included in full-text article.)/ΔWR (9.5 ± 1.1 vs. 10.3 ± 1.1 ml·W·min, p = 0.06) but did not significantly modify any of the other measured parameters at LT, RCP and MAX. To the best of our knowledge, this study is the first to evaluate the effects of a dentistry-designed mouthguard on physical performance of road cyclists. These results provide support for cyclists to correct jaw posture that may improve their exercise performance.

  12. Incremental Validity of Enhanced Computer Administered Testing (ECAT)

    DTIC Science & Technology

    1995-12-01

    Over 10,000 recruits were tested with nine experimental computerized tests of working memory, spatial ability, and psychomotor ability. Data on the...exceeding .10) for prediction of Air Force and Navy Air Traffic Control performance using Working Memory and Spatial tests, and even larger increases for...the Army’s 11H Heavy Antiarmor Weapons Crewman time-on-target averages, using psychomotor and spatial tests. Other schools, where ASVAB’s validity

  13. A preliminary study of a running speed based heart rate prediction during an incremental treadmill exercise.

    PubMed

    Dae-Geun Jang; Byung-Hoon Ko; Sub Sunoo; Sang-Seok Nam; Hun-Young Park; Sang-Kon Bae

    2016-08-01

    This preliminary study investigates feasibility of a running speed based heart rate (HR) prediction. It is basically motivated from the assumption that there is a significant relationship between HR and the running speed. In order to verify the assumption, HR and running speed data from 217 subjects of varying aerobic capabilities were simultaneously collected during an incremental treadmill exercise. A running speed was defined as a treadmill speed and its corresponding heart rate was calculated by averaging the last one minute HR values of each session. The feasibility was investigated by assessing a correlation between the heart rate and the running speed using inter-subject (between-subject) and intra-subject (within-subject) datasets with regression orders of 1, 2, 3, and 4, respectively. Furthermore, HR differences between actual and predicted HRs were also employed to investigate the feasibility of the running speed in predicting heart rate. In the inter-subject analysis, a strong positive correlation and a reasonable HR difference (r = 0.866, 16.55±11.24 bpm @ 1st order; r = 0.871, 15.93±11.49 bpm @ 2nd order; r = 0.897, 13.98±10.80 bpm @ 3rd order; and r = 0.899, 13.93±10.64 bpm @ 4th order) were obtained, and a very high positive correlation and a very low HR difference (r = 0.978, 6.46±3.89 bpm @ 1st order; r = 0.987, 5.14±2.87 bpm @ 2nd order; r = 0.996, 2.61±2.03 bpm @ 3rd order; and r = 0.997, 2.04±1.73 bpm @ 4th order) were obtained in the intra-subject analysis. It can therefore be concluded that 1) heart rate is highly correlated with a running speed; 2) heart rate can be approximately estimated by a running speed with a proper statistical model (e.g., 3rd-order regression); and 3) an individual HR-speed calibration process may improve the prediction accuracy.

  14. Acute incremental exercise, performance of a central executive task, and sympathoadrenal system and hypothalamic-pituitary-adrenal axis activity.

    PubMed

    McMorris, Terry; Davranche, Karen; Jones, Glenys; Hall, Ben; Corbett, Jo; Minter, Charles

    2009-09-01

    The purposes of this study were to examine the effect of acute incremental exercise on the performance of a central executive task; the responses of the sympathoadrenal system (SAS) and hypothalamic-pituitary-adrenal axis (HPAA) during exercise, while simultaneously carrying out the central executive task; and the ability of Delta plasma concentrations of epinephrine, norepinephrine, adrenocorticotropin hormone (ACTH) and cortisol to predict Delta performance on the central executive task. Subjects undertook a flanker task at rest and during exercise at 50% and 80% maximum aerobic power (MAP). SAS and HPAA activity were measured pre- and post-treatment by plasma concentrations of catecholamines, and cortisol and ACTH, respectively. Reaction time (RT) and number of errors for congruent and incongruent trials on the flanker task showed significant main effects with performance at 80% MAP higher than in the other conditions. RT post-correct responses were significantly faster than RT post-error at rest and 50% MAP but not at 80%. Pre- and post-treatment catecholamines showed a main effect of exercise with a linear increase. Post-treatment ACTH concentrations at 80% MAP were significantly greater than in the other conditions. Delta epinephrine and ACTH combined were significant predictors of Delta RT and Delta norepinephrine was a significant predictor of Delta number of errors. It was concluded that exercise must be at a high intensity to affect performance on the flanker task. Both the SAS and HPAA appear to play a role in the exercise-cognition interaction.

  15. Adjustments of pulmonary O2 uptake and muscle deoxygenation during ramp incremental exercise and constant-load moderate-intensity exercise in young and older adults

    PubMed Central

    Gravelle, Braden M. R.; Murias, Juan M.; Spencer, Matthew D.; Paterson, Donald H.

    2012-01-01

    The matching of muscle O2 delivery to O2 utilization can be inferred from the adjustments in muscle deoxygenation (Δ[HHb]) and pulmonary O2 uptake (V̇o2p). This study examined the adjustments of V̇o2p and Δ[HHb] during ramp incremental (RI) and constant-load (CL) exercise in adult males. Ten young adults (YA; age: 25 ± 5 yr) and nine older adults (OA; age: 70 ± 3 yr) completed two RI tests and six CL step transitions to a work rate (WR) corresponding to 1) 80% of the estimated lactate threshold (same relative WR) and 2) 50 W (same absolute WR). V̇o2p was measured breath by breath, and Δ[HHb] of the vastus lateralis was measured using near-infrared spectroscopy. Δ[HHb]-WR profiles were normalized from baseline (0%) to peak Δ[HHb] (100%) and fit using a sigmoid function. The sigmoid slope (d) was greater (P < 0.05) in OA (0.027 ± 0.01%/W) compared with YA (0.017 ± 0.01%/W), and the c/d value (a value corresponding to 50% of the amplitude) was smaller (P < 0.05) for OA (133 ± 40 W) than for YA (195 ± 51 W). No age-related differences in the sigmoid parameters were reported when WR was expressed as a percentage of peak WR. V̇o2p kinetics compared with Δ[HHb] kinetics for the 50-W transition were similar between YA and OA; however, Δ[HHb] kinetics during the transition to 80% of the lactate threshold were faster than V̇o2p kinetics in both groups. The greater reliance on O2 extraction displayed in OA during RI exercise suggests a lower O2 delivery-to-O2 utilization relationship at a given absolute WR compared with YA. PMID:22961268

  16. An Incremental Shuttle Wheel Test for Wheelchair Tennis Players.

    PubMed

    Groot, Sonja de; Valent, Linda J; Fickert, Richard; Pluim, Babette M; Houdijk, Han

    2016-11-01

    To determine the relationship between outcomes of the shuttle wheel test (SWT) and peak oxygen uptake (VO2peak) during that test and whether SWT and VO2peak can discriminate between different skill levels of wheelchair tennis players. Fifteen wheelchair tennis players performed an SWT on a tennis court while VO2 was measured continuously. Outcome measures were VO2peak and achieved stage. Relations between outcomes and Dutch wheelchair tennis ranking were calculated with Spearman correlation. Independent t tests were used to test for differences between national and international players. Moderate correlations were found between VO2peak and SWT outcome (r = .40-.47). The tennis ranking correlated weakly with VO2peak (r = -.35) and strongly with SWT outcome (r = -.80). A significant difference was found between national and international players for achieved stage (P = .027) and VO2peak (P = .027). The SWT outcome only explained a small part of the variance in VO2peak among players, so it cannot be considered a valid test for aerobic capacity. However, SWT outcomes are related to the skill level of the player and give a good indication of the overall peak wheelchair performance.

  17. Energy system contribution in a maximal incremental test: correlations with pacing and overall performance in a 10-km running trial

    PubMed Central

    Damasceno, M.V.; Pasqua, L.A.; Lima-Silva, A.E.; Bertuzzi, R.

    2015-01-01

    This study aimed to verify the association between the contribution of energy systems during an incremental exercise test (IET), pacing, and performance during a 10-km running time trial. Thirteen male recreational runners completed an incremental exercise test on a treadmill to determine the respiratory compensation point (RCP), maximal oxygen uptake (V˙O2max), peak treadmill speed (PTS), and energy systems contribution; and a 10-km running time trial (T10-km) to determine endurance performance. The fractions of the aerobic (WAER) and glycolytic (WGLYCOL) contributions were calculated for each stage based on the oxygen uptake and the oxygen energy equivalents derived by blood lactate accumulation, respectively. Total metabolic demand (WTOTAL) was the sum of these two energy systems. Endurance performance during the T10-km was moderately correlated with RCP, V˙O2maxand PTS (P<@0.05), and moderate-to-highly correlated with WAER, WGLYCOL, and WTOTAL (P<0.05). In addition, WAER, WGLYCOL, and WTOTAL were also significantly correlated with running speed in the middle (P<0.01) and final (P<0.01) sections of the T10-km. These findings suggest that the assessment of energy contribution during IET is potentially useful as an alternative variable in the evaluation of endurance runners, especially because of its relationship with specific parts of a long-distance race. PMID:26397970

  18. The interrelationship between muscle oxygenation, muscle activation, and pulmonary oxygen uptake to incremental ramp exercise: influence of aerobic fitness.

    PubMed

    Boone, Jan; Barstow, Thomas J; Celie, Bert; Prieur, Fabrice; Bourgois, Jan

    2016-01-01

    We investigated whether muscle and ventilatory responses to incremental ramp exercise would be influenced by aerobic fitness status by means of a cross-sectional study with a large subject population. Sixty-four male students (age: 21.2 ± 3.2 years) with a heterogeneous peak oxygen uptake (51.9 ± 6.3 mL·min(-1)·kg(-1), range 39.7-66.2 mL·min(-1)·kg(-1)) performed an incremental ramp cycle test (20-35 W·min(-1)) to exhaustion. Breath-by-breath gas exchange was recorded, and muscle activation and oxygenation were measured with surface electromyography and near-infrared spectroscopy, respectively. The integrated electromyography (iEMG), mean power frequency (MPF), deoxygenated [hemoglobin and myoglobin] (deoxy[Hb+Mb]), and total[Hb+Mb] responses were set out as functions of work rate and fitted with a double linear function. The respiratory compensation point (RCP) was compared and correlated with the breakpoints (BPs) (as percentage of peak oxygen uptake) in muscle activation and oxygenation. The BP in total[Hb+Mb] (83.2% ± 3.0% peak oxygen uptake) preceded (P < 0.001) the BP in iEMG (86.7% ± 4.0% peak oxygen uptake) and MPF (86.3% ± 4.1% peak oxygen uptake), which in turn preceded (P < 0.01) the BP in deoxy[Hb+Mb] (88.2% ± 4.5% peak oxygen uptake) and RCP (87.4% ± 4.5% peak oxygen uptake). Furthermore, the peak oxygen uptake was significantly (P < 0.001) positively correlated to the BPs and RCP, indicating that the BPs in total[Hb+Mb] (r = 0.66; P < 0.001), deoxy[Hb+Mb] (r = 0.76; P < 0.001), iEMG (r = 0.61; P < 0.001), MPF (r = 0.63; P < 0.001), and RCP (r = 0.75; P < 0.001) occurred at a higher percentage of peak oxygen uptake in subjects with a higher peak oxygen uptake. In this study a close relationship between muscle oxygenation, activation, and pulmonary oxygen uptake was found, occurring in a cascade of events. In subjects with a higher aerobic fitness level this cascade occurred at a higher relative intensity.

  19. Changes in intraocular pressure after exercise test

    PubMed Central

    Esfahani, Morteza Abdar; Gharipour, Mojgan; Fesharakinia, Hamid

    2017-01-01

    Background: The decrease in intraocular pressure (IOP) within exercise has been recently suggested; however, this change remained ambiguous following exercise test. The present study aimed to assess changes in IOP induced by exercise test in patients who suspected to coronary artery disease (CAD) and indicated for exercise test evaluation. Methods: In a cross-sectional study at the cardiovascular research center of Amin Heart Hospital in Isfahan, 101 eyes from 51 consecutive patients suspected to CAD aged 30–70 years referred for exercise testing were evaluated. IOP was measured at the three time points of before exercise test as well as 5 and 20 min after completing exercise test using Schiotz tonometer. All exercise tests were programmed by the treadmill. Results: The mean IOP in all assessed eyes was 16.12 ± 2.61 mmHg initially that was gradually decreased to 13.79 ± 2.40 mmHg 5 min after the exercise test, but elevated to 15.67 ± 2.26 mmHg 20 min after the test. Assessing IOP following exercise testing showed a significant decrease in IOP in 75 eyes (74.3%), remained unchanged in 19.8% of eyes, and even elevated in 5.9% of eyes. There was a significant direct association between patients' age and IOP changes assessed by the Pearson's correlation test (r = 0.350,P = 0.009). No significant difference was revealed in the trend of the changes in IOP after exercise test between men and women, between left-sided and right-sided eyes as well as between different body mass index subgroups. Conclusion: IOP temporarily reduced after exercise test, but return to baseline value shortly after test. This lowering is more evident in advanced aging. PMID:28298859

  20. Exercise Stress Testing: Indications and Common Questions.

    PubMed

    Garner, Kathryn K; Pomeroy, William; Arnold, James J

    2017-09-01

    Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery. Exercise stress testing without imaging is the preferred initial choice for risk stratification in most women. Sensitivity and specificity increase with the use of adjunctive imaging such as echocardiography or myocardial perfusion imaging with single-photon emission computed tomography. Exercise stress testing is rarely an appropriate option to evaluate persons with known coronary artery disease who have no new symptoms less than two years after percutaneous intervention or less than five years after coronary artery bypass grafting. The Duke treadmill score has excellent prognostic value for exercise stress testing. Imaging is not necessary if patients are able to achieve more than 10 metabolic equivalents on exercise stress testing. Exercise stress testing is not indicated before noncardiac surgeries in patients who can achieve 4 metabolic equivalents without symptoms.

  1. Myocardial response to incremental exercise in endurance-trained athletes: influence of heart rate, contractility and the Frank-Starling effect.

    PubMed

    Warburton, Darren E R; Haykowsky, Mark J; Quinney, H Arthur; Blackmore, Derrick; Teo, Koon K; Humen, Dennis P

    2002-09-01

    Recent evidence indicates that endurance-trained athletes are able to increase their stroke volume (SV) throughout incremental upright exercise, probably due to a progressively greater effect of the Frank-Starling mechanism. This is contrary to the widely held belief that SV reaches a plateau at a submaximal heart rate (irrespective of fitness level), owing to a limitation in the time for diastolic filling. The purpose of this investigation was to evaluate whether endurance-trained athletes rely on a progressively greater effect of the Frank-Starling mechanism throughout incremental exercise. A secondary purpose was to evaluate the effects of postural position on the cardiovascular responses to incremental exercise. Ten male cyclists participated in this investigation. Left ventricular function was assessed throughout incremental exercise in the supine and upright positions (counterbalanced) using radionuclide ventriculography. Stroke volume increased in a linear fashion during incremental exercise in both the upright and supine positions. The increases in cardiac output (Q) throughout incremental to maximal exercise (in both the supine and upright positions) were significantly related to changes in heart rate, myocardial contractility and the Frank-Starling mechanism. Percentage changes in end-diastolic volume and SV were significantly greater in the upright position versus the supine position, reflecting an increased reliance on the Frank-Starling effect to increase Q. We conclude from this investigation that highly trained endurance athletes are able to make progressively increasing usage of the Frank-Starling effect throughout incremental exercise. Postural position has a significant effect on the relative contribution of heart rate, myocardial contractility and the Frank-Starling mechanism to the increase in Q during exercise conditions.

  2. Antioxidant Expression Response to Free Radicals in Active Men and Women Fallowing to a Session Incremental Exercise; Numerical Relationship Between Antioxidants and Free Radicals

    PubMed Central

    Baghaiee, Behrouz; Aliparasti, Mohammad Reza; Almasi, Shohreh; Siahkuhian, Marefat; Baradaran, Behzad

    2016-01-01

    Background Energy production is a necessary process to continue physical activities, and exercise is associated with more oxygen consumption and increase of oxidative stress. what seems important is the numerical relationship between antioxidant and free radicals. Although the activity of some enzymes increases with physical activities, but it is possible that gene expression of this enzyme is not changed during exercise. Objectives The aim of the present study is to investigate the antioxidant enzymes gene expression and changes in malondialdehyde (MDA) and total antioxidant capacity (TAC) levels in men and women affected by a session of incremental exercise and to carefully and numerically assess the relationship between MDA changes and gene expression and activity of antioxidant enzymes. Materials and Methods 12 active men and 12 active women (21 - 24 years old) participated voluntarily in this study. Peripheral blood samples were taken from the subjects in three phases, before and after graduated exercise test (GXT) and 3 hours later (recovery). Results The gene expression of manganese superoxide dismutase (MnSOD) enzyme increased significantly in women in the recovery phase (P < 0.05). Catalase gene expression significantly increased in men in both phases (immediately & recovery) (P < 0.05). But the changes in active women were only significant immediately after the exercise. TAC levels increased significantly in men in the recovery phase and in active women immediately after the exercise (P < 0.05). MDA activity also increased significantly in men in both phases (P < 0.05). However, in women the increase was significant only in the recovery phase (P < 0.05). There was a reverse relationship between changes in MnSOD and copper- and zinc-containing superoxide dismutase (Cu/ZnSOD) levels and MDA in men (P < 0.05). In active women there was also a significant relationship between changes in MDA and gene expression of Cu/ZnSOD and TAC (P < 0.05). Conclusions The

  3. Two Levels of Caffeine Ingestion on Blood Lactate and Free Fatty Acid Responses during Incremental Exercise.

    ERIC Educational Resources Information Center

    McNaughton, Lars

    1987-01-01

    Research was conducted to determine the effects of two doses of caffeine on the lactate threshold and also to examine the effects on substrate utilization during incremental cycle ergometry. Results found that caffeine increased heart rates and free fatty acid levels for all workloads and decreased blood lactate levels at some of the workloads.…

  4. Two Levels of Caffeine Ingestion on Blood Lactate and Free Fatty Acid Responses during Incremental Exercise.

    ERIC Educational Resources Information Center

    McNaughton, Lars

    1987-01-01

    Research was conducted to determine the effects of two doses of caffeine on the lactate threshold and also to examine the effects on substrate utilization during incremental cycle ergometry. Results found that caffeine increased heart rates and free fatty acid levels for all workloads and decreased blood lactate levels at some of the workloads.…

  5. Submaximal Exercise Testing Treadmill and Floor Walking.

    DTIC Science & Technology

    1978-05-01

    G., Greyson, J. S., and van der Walt, V. H., "Walk or Jog for Health: II, Iatimating the Maximi Aerobic Capacity for Exercise ,* South &frIca Kedical...Regression Equations versus Determined from Maximal Exercise Test ............ 76 12 Group Means, Percent Errors, and Standard Errors for Maximal Aerobic ...work capacity, expressed as aerobic power, and the associated heart rate with known work i loads have been accomplished through graded exercise tests

  6. Exercise testing in cardiac rehabilitation. Exercise prescription and beyond.

    PubMed

    Williams, M A

    2001-08-01

    The prescription of exercise, either as a part of a formal exercise training program or as a means to increase physical activity in general, has been and will remain a primary component of cardiac rehabilitation and secondary prevention programming. Wherever possible, this prescription should be based on a recent exercise test that documents the cardiac patient's functional capacity, cardiac and hemodynamic responses to exercise, and signs and symptoms associated with exertion. Clearly the prescription of exercise and suggestions for increasing levels of physical activity must be based on accepted principles of exercise physiology and expected training responses. Nonetheless, the art of exercise prescription should guarantee flexible methodologies to meet the specific needs of each individual patient. Although the patient must accept ultimate responsibility for participation, the clinician bears the burden of continually attempting to reinforce the importance of increasing caloric expenditure and motivating patients to initiate and commit to long-term participation in a safe and appropriately designed program of exercise and increasing physical activity.

  7. Role of CO2 in the cerebral hyperemic response to incremental normoxic and hyperoxic exercise.

    PubMed

    Smith, K J; Wildfong, K W; Hoiland, R L; Harper, M; Lewis, N C; Pool, A; Smith, S L; Kuca, T; Foster, G E; Ainslie, P N

    2016-04-15

    Cerebral blood flow (CBF) is temporally related to exercise-induced changes in partial pressure of end-tidal carbon dioxide (PetCO2 ); hyperoxia is known to enhance this relationship. We examined the hypothesis that preventing PetCO2 from rising (isocapnia) during submaximal exercise with and without hyperoxia [end-tidal Po2(PetO2 ) = 300 mmHg] would attenuate the increases in CBF. Additionally, we aimed to identify the magnitude that breathing, per se, influences the CBF response to normoxic and hyperoxic exercise. In 14 participants, CBF (intra- and extracranial) measurements were measured during exercise [20, 40, 60, and 80% of maximum workload (Wmax)] and during rest while ventilation (V̇e) was volitionally increased to mimic volumes achieved during exercise (isocapnic hyperpnea). While V̇ewas uncontrolled during poikilocapnic exercise, during isocapnic exercise and isocapnic hyperpnea, V̇ewas increased to prevent PetCO2 from rising above resting values (∼40 mmHg). Although PetCO2 differed by 2 ± 3 mmHg during normoxic poikilocapnic and isocapnic exercise, except for a greater poikilocapnic compared with isocapnic increase in blood velocity in the posterior cerebral artery at 60% Wmax, the between condition increases in intracranial (∼12-15%) and extracranial (15-20%) blood flow were similar at each workload. The poikilocapnic hyperoxic increases in both intra- and extracranial blood-flow (∼17-29%) were greater compared with poikilocapnic normoxia (∼8-20%) at intensities >40% Wmax(P< 0.01). During both normoxic and hyperoxic conditions, isocapnia normalized both the intracranial and extracranial blood-flow differences. Isocapnic hyperpnea did not alter CBF. Our findings demonstrate a differential effect of PetCO2 on CBF during exercise influenced by the prevailing PetO2.

  8. Role of CO2 in the cerebral hyperemic response to incremental normoxic and hyperoxic exercise

    PubMed Central

    Wildfong, K. W.; Hoiland, R. L.; Harper, M.; Lewis, N. C.; Pool, A.; Smith, S. L.; Kuca, T.; Ainslie, P. N.

    2016-01-01

    Cerebral blood flow (CBF) is temporally related to exercise-induced changes in partial pressure of end-tidal carbon dioxide (PetCO2); hyperoxia is known to enhance this relationship. We examined the hypothesis that preventing PetCO2 from rising (isocapnia) during submaximal exercise with and without hyperoxia [end-tidal Po2 (PetO2) = 300 mmHg] would attenuate the increases in CBF. Additionally, we aimed to identify the magnitude that breathing, per se, influences the CBF response to normoxic and hyperoxic exercise. In 14 participants, CBF (intra- and extracranial) measurements were measured during exercise [20, 40, 60, and 80% of maximum workload (Wmax)] and during rest while ventilation (V̇e) was volitionally increased to mimic volumes achieved during exercise (isocapnic hyperpnea). While V̇e was uncontrolled during poikilocapnic exercise, during isocapnic exercise and isocapnic hyperpnea, V̇e was increased to prevent PetCO2 from rising above resting values (∼40 mmHg). Although PetCO2 differed by 2 ± 3 mmHg during normoxic poikilocapnic and isocapnic exercise, except for a greater poikilocapnic compared with isocapnic increase in blood velocity in the posterior cerebral artery at 60% Wmax, the between condition increases in intracranial (∼12-15%) and extracranial (15–20%) blood flow were similar at each workload. The poikilocapnic hyperoxic increases in both intra- and extracranial blood-flow (∼17–29%) were greater compared with poikilocapnic normoxia (∼8–20%) at intensities >40% Wmax (P < 0.01). During both normoxic and hyperoxic conditions, isocapnia normalized both the intracranial and extracranial blood-flow differences. Isocapnic hyperpnea did not alter CBF. Our findings demonstrate a differential effect of PetCO2 on CBF during exercise influenced by the prevailing PetO2. PMID:26769951

  9. Heart rate recovery after the 10-m incremental shuttle walking test in older adults with intellectual disabilities.

    PubMed

    Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

    2014-03-01

    Heart rate recovery (HRR) after exercise is an independent predictor for cardiovascular and all-cause mortality. To investigate the usefulness of HRR in cardiorespiratory exercise testing in older adults with intellectual disabilities (ID), the aims of this study were (a) to assess HRR in older adults with ID after the 10-m incremental shuttle walking test (ISWT) and (b) its association with personal characteristics (gender, age, distance walked on the ISWT, level of ID, genetic syndrome causing ID, autism, behavioral problems, and peak heart rate (HRpeak)). HRR was assessed after the 10-m incremental shuttle walking test in 300 older adults (>50 years) with borderline to profound ID. HRR was defined as the change from HRpeak during the ISWT to heart rate measured after 1, 2, 3, 4, and 5 min of passive recovery. The largest decrease in heart rate was in the first minute of recovery leveling off toward the fifth minute of recovery. An abnormal HHR (≤12 bpm) was seen in 36.1% of the participants with Down syndrome (DS) and in 30.7% of the participants with ID by other causes. After the fifth minute the heart rates of 69.4% of the participants with DS and of 61.4% of the participants with ID by other causes returned to resting levels. HRpeak and distance walked on the ISWT were positively related to all HRR measures. More severe ID was negatively related and having DS positively related to HRR after 3-5 min of recovery. The other characteristics were not significantly associated to HRR. HRR is a potentially useful outcome measure in cardiorespiratory fitness testing of older adults with ID with a direct, objective, and non-invasive measurement. Further research is needed to identify the relation between HRR and adverse health outcomes in this population.

  10. Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography

    PubMed Central

    Lucia, A.; Sanchez, O.; Carvajal, A.; Chicharro, J. L.

    1999-01-01

    OBJECTIVES: To investigate the validity and reliability of surface electromyography (EMG) as a new non-invasive determinant of the metabolic response to incremental exercise in elite cyclists. The relation between EMG activity and other more conventional methods for analysing the aerobic-anaerobic transition such as blood lactate measurements (lactate threshold (LT) and onset of blood lactate accumulation (OBLA)) and ventilatory parameters (ventilatory thresholds 1 and 2 (VT1 and VT2)) was studied. METHODS: Twenty eight elite road cyclists (age 24 (4) years; VO2MAX 69.9 (6.4) ml/kg/min; values mean (SD)) were selected as subjects. Each of them performed a ramp protocol (starting at 0 W, with increases of 5 W every 12 seconds) on a cycle ergometer (validity study). In addition, 15 of them performed the same test twice (reliability study). During the tests, data on gas exchange and blood lactate levels were collected to determine VT1, VT2, LT, and OBLA. The root mean squares of EMG signals (rms-EMG) were recorded from both the vastus lateralis and the rectus femoris at each intensity using surface electrodes. RESULTS: A two threshold response was detected in the rms-EMG recordings from both muscles in 90% of subjects, with two breakpoints, EMGT1 and EMGT2, at around 60-70% and 80-90% of VO2MAX respectively. The results of the reliability study showed no significant differences (p > 0.05) between mean values of EMGT1 and EMGT2 obtained in both tests. Furthermore, no significant differences (p > 0.05) existed between mean values of EMGT1, in the vastus lateralis and rectus femoris, and VT1 and LT (62.8 (14.5) and 69.0 (6.2) and 64.6 (6.4) and 68.7 (8.2)% of VO2MAX respectively), or between mean values of EMGT2, in the vastus lateralis and rectus femoris, and VT2 and OBLA (86.9 (9.0) and 88.0 (6.2) and 84.6 (6.5) and 87.7 (6.4)% of VO2MAX respectively). CONCLUSION: rms-EMG may be a useful complementary non-invasive method for analysing the aerobic- anaerobic transition

  11. Similar results for face mask versus mouthpiece during incremental exercise to exhaustion.

    PubMed

    Wagner, Dale R; Clark, Nicolas W

    2016-01-01

    Investigations in the 1990s evaluated the influence of breathing assemblies on respiratory variables at rest and during exercise; however, research on new models of breathing assemblies is lacking. This study compared metabolic gas analysis data from a mouthpiece with a noseclip (MOUTH) and a face mask (MASK). Volunteers (7 males, 7 females; 25.1 ± 2.7 years) completed two maximal treadmill tests within 1 week, one MOUTH and one MASK, in random order. The difference in maximal oxygen consumption (VO2max) between MOUTH (52.7 ± 11.3 ml · kg(-1) · min(-1)) and MASK (52.2 ± 11.7 ml · kg(-1) · min(-1)) was not significant (P = 0.53). Likewise, the mean MOUTH-MASK differences in minute ventilation (VE), fraction of expired oxygen (FEO2) and carbon dioxide (FECO2), respiration rate (RR), tidal volume (Vt), heart rate (HR), and rating of perceived exertion (RPE) at maximal and submaximal intensities were not significant (P > 0.05). Furthermore, there was no systematic bias in the error scores (r = -0.13, P = 0.66), and 12 of the 14 participants had a VO2max difference of ≤3 ml · kg(-1) · min(-1) between conditions. Finally, there was no clear participant preference for using the MOUTH or MASK. Selection of MOUTH or MASK will not affect the participant's gas exchange or breathing patterns.

  12. Conducting distributed exercises: coordinated design and testing

    NASA Astrophysics Data System (ADS)

    Sottilare, Robert A.

    1995-06-01

    This paper provides a basis for planning, designing, and testing distributed exercises and experiments. Lessons learned from the Synthetic Theater of War--Europe (STOW-E) exercise conducted in November 1994 are incorporated to provide system engineers/integrators areas of consideration in the design and testing of distributed interactive simulation (DIS) exercises and experiments. Issues involving DIS compliance in accordance with IEEE 1278.1, and interoperability and compatibility testing measures are also discussed. Design and test issues for live, virtual, and constructive simulations are considered. This paper assumes basic knowledge of DIS principles.

  13. Cerebrovascular Responses to Incremental Exercise During Hypobaric Hypoxia: Effect of Oxygenation on Maximal Performance

    DTIC Science & Technology

    2008-01-01

    cerebral (frontal lobe) (COX) and muscle (vastus lateralis) oxygenation ( MOX ) (near infrared spectros- copy), middle cerebral artery blood flow...PETCO2 and COX dropped throughout exercise, while MCA Vmean fell only from 75 to 100% Ẇmax. MOX fell from rest to 75% Ẇmax at SL and AH and...throughout exercise in CH. The magnitude of fall in COX, but not MOX , was different between conditions (CH AH SL). FIO2 0.60 at Ẇmax did not prolong

  14. Muscle metabolism and activation heterogeneity by combined 31P chemical shift and T2 imaging, and pulmonary O2 uptake during incremental knee-extensor exercise.

    PubMed

    Cannon, Daniel T; Howe, Franklyn A; Whipp, Brian J; Ward, Susan A; McIntyre, Dominick J; Ladroue, Christophe; Griffiths, John R; Kemp, Graham J; Rossiter, Harry B

    2013-09-01

    The integration of skeletal muscle substrate depletion, metabolite accumulation, and fatigue during large muscle-mass exercise is not well understood. Measurement of intramuscular energy store degradation and metabolite accumulation is confounded by muscle heterogeneity. Therefore, to characterize regional metabolic distribution in the locomotor muscles, we combined 31P magnetic resonance spectroscopy, chemical shift imaging, and T2-weighted imaging with pulmonary oxygen uptake during bilateral knee-extension exercise to intolerance. Six men completed incremental tests for the following: (1) unlocalized 31P magnetic resonance spectroscopy; and (2) spatial determination of 31P metabolism and activation. The relationship of pulmonary oxygen uptake to whole quadriceps phosphocreatine concentration ([PCr]) was inversely linear, and three of four knee-extensor muscles showed activation as assessed by change in T2. The largest changes in [PCr], [inorganic phosphate] ([Pi]) and pH occurred in rectus femoris, but no voxel (72 cm3) showed complete PCr depletion at exercise cessation. The most metabolically active voxel reached 11 ± 9 mM [PCr] (resting, 29 ± 1 mM), 23 ± 11 mM [Pi] (resting, 7 ± 1 mM), and a pH of 6.64 ± 0.29 (resting, 7.08 ± 0.03). However, the distribution of 31P metabolites and pH varied widely between voxels, and the intervoxel coefficient of variation increased between rest (∼10%) and exercise intolerance (∼30-60%). Therefore, the limit of tolerance was attained with wide heterogeneity in substrate depletion and fatigue-related metabolite accumulation, with extreme metabolic perturbation isolated to only a small volume of active muscle (<5%). Regional intramuscular disturbances are thus likely an important requisite for exercise intolerance. How these signals integrate to limit muscle power production, while regional "recruitable muscle" energy stores are presumably still available, remains uncertain.

  15. Muscle metabolism and activation heterogeneity by combined 31P chemical shift and T2 imaging, and pulmonary O2 uptake during incremental knee-extensor exercise

    PubMed Central

    Cannon, Daniel T.; Howe, Franklyn A.; Whipp, Brian J.; Ward, Susan A.; McIntyre, Dominick J.; Ladroue, Christophe; Griffiths, John R.; Kemp, Graham J.

    2013-01-01

    The integration of skeletal muscle substrate depletion, metabolite accumulation, and fatigue during large muscle-mass exercise is not well understood. Measurement of intramuscular energy store degradation and metabolite accumulation is confounded by muscle heterogeneity. Therefore, to characterize regional metabolic distribution in the locomotor muscles, we combined 31P magnetic resonance spectroscopy, chemical shift imaging, and T2-weighted imaging with pulmonary oxygen uptake during bilateral knee-extension exercise to intolerance. Six men completed incremental tests for the following: 1) unlocalized 31P magnetic resonance spectroscopy; and 2) spatial determination of 31P metabolism and activation. The relationship of pulmonary oxygen uptake to whole quadriceps phosphocreatine concentration ([PCr]) was inversely linear, and three of four knee-extensor muscles showed activation as assessed by change in T2. The largest changes in [PCr], [inorganic phosphate] ([Pi]) and pH occurred in rectus femoris, but no voxel (72 cm3) showed complete PCr depletion at exercise cessation. The most metabolically active voxel reached 11 ± 9 mM [PCr] (resting, 29 ± 1 mM), 23 ± 11 mM [Pi] (resting, 7 ± 1 mM), and a pH of 6.64 ± 0.29 (resting, 7.08 ± 0.03). However, the distribution of 31P metabolites and pH varied widely between voxels, and the intervoxel coefficient of variation increased between rest (∼10%) and exercise intolerance (∼30–60%). Therefore, the limit of tolerance was attained with wide heterogeneity in substrate depletion and fatigue-related metabolite accumulation, with extreme metabolic perturbation isolated to only a small volume of active muscle (<5%). Regional intramuscular disturbances are thus likely an important requisite for exercise intolerance. How these signals integrate to limit muscle power production, while regional “recruitable muscle” energy stores are presumably still available, remains uncertain. PMID:23813534

  16. Assessing cardiac pumping capability by exercise testing and inotropic stimulation.

    PubMed Central

    Tan, L B; Bain, R J; Littler, W A

    1989-01-01

    In heart failure both functional capacity and prognosis are primarily determined by the degree of pump dysfunction. Although data on haemodynamic function at rest may indicate impaired cardiac function, they do not assess the capacity of the heart to respond to stress. Maximal bicycle ergometry and incremental intravenous inotropic stimulation in 31 patients with moderately severe heart failure were evaluated as methods of stressing the heart to determine cardiac pumping capability, which is defined as the cardiac power obtained during maximal stimulation. There was good agreement between the cardiac pumping capabilities assessed by these two methods. Maximal cardiac power output was better than maximal cardiac output and left ventricular stroke work index in representing cardiac pumping capability, because it was less dependent on the type of stimulation used during evaluation. Inotropic challenge is at least as effective as exercise testing in assessing cardiac pumping capability in heart failure, and may be a better method in patients who find physical exercise difficult. PMID:2757870

  17. Assessing cardiac pumping capability by exercise testing and inotropic stimulation.

    PubMed

    Tan, L B; Bain, R J; Littler, W A

    1989-07-01

    In heart failure both functional capacity and prognosis are primarily determined by the degree of pump dysfunction. Although data on haemodynamic function at rest may indicate impaired cardiac function, they do not assess the capacity of the heart to respond to stress. Maximal bicycle ergometry and incremental intravenous inotropic stimulation in 31 patients with moderately severe heart failure were evaluated as methods of stressing the heart to determine cardiac pumping capability, which is defined as the cardiac power obtained during maximal stimulation. There was good agreement between the cardiac pumping capabilities assessed by these two methods. Maximal cardiac power output was better than maximal cardiac output and left ventricular stroke work index in representing cardiac pumping capability, because it was less dependent on the type of stimulation used during evaluation. Inotropic challenge is at least as effective as exercise testing in assessing cardiac pumping capability in heart failure, and may be a better method in patients who find physical exercise difficult.

  18. Eccentric exercise testing and training

    NASA Technical Reports Server (NTRS)

    Clarkson, Priscilla M.

    1994-01-01

    Some researchers and practitioners have touted the benefits of including eccentric exercise in strength training programs. However, others have challenged its use because they believe that eccentric actions are dangerous and lead to injuries. Much of the controversy may be based on a lack of understanding of the physiology of eccentric actions. This review will present data concerning eccentric exercise in strength training, the physiological characteristics of eccentric exercise, and the possible stimulus for strength development. Also a discussion of strength needs for extended exposure to microgravity will be presented. Not only is the use of eccentric exercise controversial, but the name itself is fraught with problems. The correct pronunciation is with a hard 'c' so that the word sounds like ekscentric. The confusion in pronunciation may have been prevented if the spelling that Asmussen used in 1953, excentric, had been adopted. Another problem concerns the expressions used to describe eccentric exercise. Commonly used expressions are negatives, eccentric contractions, lengthening contractions, resisted muscle lengthenings, muscle lengthening actions, and eccentric actions. Some of these terms are cumbersome (i.e., resisted muscle lengthenings), one is slang (negatives), and another is an oxymoron (lengthening contractions). Only eccentric action is appropriate and adoption of this term has been recommended by Cavanagh. Despite the controversy that surrounds eccentric exercise, it is important to note that these types of actions play an integral role in normal daily activities. Eccentric actions are used during most forms of movement, for example, in walking when the foot touches the ground and the center of mass is decelerated and in lowering objects, such as placing a bag of groceries in the car.

  19. Exercise Testing: Who, When, and Why?

    PubMed

    Nelson, Nicole; Asplund, Chad A

    2016-03-01

    There are different modalities of exercise testing that can provide valuable information to physicians about patient and athlete fitness and cardiopulmonary status. Cardiopulmonary exercise testing (CPX) is a form of exercise testing that measures ventilatory and gas exchange, heart rate, electrocardiogram, and blood pressures to provide detailed information on the cardiovascular, pulmonary, and muscular systems. This testing allows an accurate quantification of functional capacity/measure of exercise tolerance, diagnosis of cardiopulmonary disease, disease-progression monitoring or response to intervention, and the prescription of exercise and training. CPX directly measures inhaled and exhaled ventilator gases to determine the maximal oxygen uptake, which reflects the body's maximal use of oxygen and defines the limits of the cardiopulmonary system. CPX is the ideal modality to evaluate causes of exertional fatigue and dyspnea, especially in complex cases in which the etiology could be cardiac, pulmonary, or deconditioning. Exercise tolerance has become an important outcome measure in patients with chronic obstructive pulmonary disease and congestive heart failure, as well as other chronic diseases, and is a well-recognized predictor of mortality. Older athletes or those with underlying medical conditions could benefit from exercise testing for risk stratification and clearance to participate, as well as to help set their training zones and determine their functional limitations.

  20. Comparison of laboratory- and field-based exercise tests for COPD: a systematic review

    PubMed Central

    Fotheringham, Iain; Meakin, Georgina; Punekar, Yogesh Suresh; Riley, John H; Cockle, Sarah M; Singh, Sally J

    2015-01-01

    Exercise tests are often used to evaluate the functional status of patients with COPD. However, to the best of our knowledge, a comprehensive systematic comparison of these tests has not been performed. We systematically reviewed studies reporting the repeatability and/or reproducibility of these tests, and studies comparing their sensitivity to therapeutic intervention. A systematic review identified primary manuscripts in English reporting relevant data on the following exercise tests: 6-minute walk test (6MWT) and 12-minute walk test, incremental and endurance shuttle walk tests (ISWT and ESWT, respectively), incremental and endurance cycle ergometer tests, and incremental and endurance treadmill tests. We identified 71 relevant studies. Good repeatability (for the 6MWT and ESWT) and reproducibility (for the 6MWT, 12-minute walk test, ISWT, ESWT, and incremental cycle ergometer test) were reported by most studies assessing these tests, providing patients were familiarized with them beforehand. The 6MWT, ISWT, and particularly the ESWT were reported to be sensitive to therapeutic intervention. Protocol variations (eg, track layout or supplemental oxygen use) affected performance significantly in several studies. This review shows that while the validity of several tests has been established, for others further study is required. Future work will assess the link between these tests, physiological mechanisms, and patient-reported measures. PMID:25834421

  1. Evaluation of sprint exercise testing protocols in wheelchair athletes.

    PubMed

    Knechtle, B; Hardegger, K; Müller, G; Odermatt, P; Eser, P; Knecht, H

    2003-03-01

    Comparison of five different exercise testing protocols with different speeds on a treadmill with seven wheelchair athletes. To determine which speed and duration in an exercise protocol is best to test wheelchair athletes performing sprint races on a track. Swiss Paraplegic Centre, Nottwil, Switzerland. Three elite and four junior wheelchair athletes (18.7+/-6.8 years, 52.1+/-9.7 kg and 165.3+/-19.3 cm) performed five different exercise testing protocols at different speeds on a treadmill until exhaustion. Maximal effort treadmill (0.7% incline) testing protocols were performed using three timeframes. The first was focussing on short duration tests (S1 and S2) where incremental increases in velocity (0.42 and 0.1 m.s(-1)) were required from a stationary start. The second were medium duration tests (M1 and M2) where the athlete started at their 200 m and 800 m personal best time (mean velocities) and then had the velocity increased 1 km.h(-1) by every 10 and 60 s respectively. The long duration test (L) started at 14 km.h(-1) and velocity was increased by 2 km.h(-1) every 120 s. Maximal heart rate, maximal concentration of lactate, maximal speed, and maximal duration of the test were measured. The highest concentration of lactate and the highest heart rates were measured in the longest tests. During maximal effort testing wheelchair athletes are able to produce higher lactate concentrations when tested for longer duration. Post test lactate assessments provide little information in short duration testing protocols. Sequential lactate assessments post-test may provide additional information on the rate of recovery for middle distance wheelchair athletes and warrants further investigation.

  2. Inspiratory Muscle Performance of Former Smokers and Nonsmokers Using the Test of Incremental Respiratory Endurance.

    PubMed

    Formiga, Magno F; Campos, Michael A; Cahalin, Lawrence P

    2017-09-26

    Smoking has potential deleterious effects on respiratory muscle function. Smokers may present with reduced inspiratory muscle strength and endurance. We compared inspiratory muscle performance of nonsmokers with that of former smokers without overt respiratory problems via the Test of Incremental Respiratory Endurance. This study was performed on 42 healthy subjects between the ages of 30 and 79 y (mean ± SD of 56.5 ± 14.4 y). Fourteen male and 7 female former smokers were matched to nonsmokers based on sex, age, height, and weight. Subjects completed a questionnaire about their health and current smoking status. Testing included the best of 3 or more consistent trials. The Test of Incremental Respiratory Endurance measurements included maximal inspiratory pressure measured from residual volume as well as sustained maximal inspiratory pressure and inspiratory duration measured from residual volume to total lung capacity during a maximal sustained inhalation. No significant difference in inspiratory performance of the entire group of former smokers compared with nonsmokers was found. However, separate sex analyses found a significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers (518.7 ± 205.0 pressure time units vs 676.5 ± 255.2 pressure time units, P = .041). We found similar maximal inspiratory pressure between former smokers and nonsmokers via the Test of Incremental Respiratory Endurance, but the significant difference in sustained maximal inspiratory pressure between male former smokers and nonsmokers suggests that the sustained maximal inspiratory pressure may have greater discriminatory ability in assessing the effects of smoking on inspiratory muscle performance. Further investigation of the effects of smoking on inspiratory performance via the Test of Incremental Respiratory Endurance is warranted. Copyright © 2017 by Daedalus Enterprises.

  3. Incremental Testing Design on Slide Board for Speed Skaters: Comparison Between Two Different Protocols.

    PubMed

    Piucco, Tatiane; OʼConnell, Jessica; Stefanyshyn, Darren; de Lucas, Ricardo Dantas

    2016-11-01

    Piucco, T, O'Connell, J, Stefanyshyn, D, and de Lucas, RD. Incremental testing design on slide board for speed skaters: comparison between two different protocols. J Strength Cond Res 30(11): 3116-3121, 2016-The aim of this study was to investigate the effect of stage duration (Long-stage-LS: 3-minute, Short-stage-SS: 1-minute) on maximal and submaximal aerobic physiological variables during a simulated skating test performed on a slide board. Ten well-trained male speed skaters performed 2 maximal incremental tests on slide board until voluntary exhaustion. The second ventilatory threshold (VT2) was determined by the ventilatory equivalent method. All participants reached the criteria for maximal oxygen uptake (V[Combining Dot Above]O2max) attainment in both protocols. Maximal cadence (CADmax), V[Combining Dot Above]O2 at VT2 and cadence at VT2 (CADVT2) were significantly higher during SS protocol, but maximal heart rate was significantly lower for the SS protocol. V[Combining Dot Above]O2max was significantly correlated with CADmax for the SS (r = 0.62) and LS protocols (r = 0.61). Strong correlations were found between CADmax and CADVT2 during the SS (r = 0.83) and LS protocols (r = 0.76). The results of the present study suggest that either SS or LS slide board incremental protocol can be used to evaluate skaters, since they elicited maximal physiological responses. Additionally, slide board incremental skating tests may be considered as a more specific and practical alternative than laboratory-based tests, especially when a large number of athletes need to be assessed.

  4. Cardio-pulmonary exercise testing: An objective approach to pre-operative assessment to define level of perioperative care.

    PubMed

    Bhagwat, Milind; Paramesh, Kaggere

    2010-07-01

    Cardiopulmonary exercise testing is a non-invasive, objective method of assessing integrated response of heart, lungs and musculoskeletal system to incremental exercise. Though it has been in use for a few decades, the recent rise in its use as a preoperative test modality is reviewed. A brief account of cardiopulmonary exercise test, as it is carried out in practice and its applications, is given. The physiological basis is explained and relationship of pathophysiology of poor exercise capacity with various test variables is discussed. Its use for prediction of postoperative morbidity in various noncardiopulmonary surgical procedures is reviewed.

  5. Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement.

    PubMed

    Puente-Maestu, Luis; Palange, Paolo; Casaburi, Richard; Laveneziana, Pierantonio; Maltais, François; Neder, J Alberto; O'Donnell, Denis E; Onorati, Paolo; Porszasz, Janos; Rabinovich, Roberto; Rossiter, Harry B; Singh, Sally; Troosters, Thierry; Ward, Susan

    2016-02-01

    This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others.

  6. Incremental test design, peak 'aerobic' running speed and endurance performance in runners.

    PubMed

    Machado, Fabiana A; Kravchychyn, Ana Claudia P; Peserico, Cecilia S; da Silva, Danilo F; Mezzaroba, Paulo V

    2013-11-01

    Peak running speed obtained during an incremental treadmill test (Vpeak) is a good predictor of endurance run performance. However, the best-designed protocol for Vpeak determination and the best Vpeak definition remain unknown. Therefore, this study examined the influence of stage duration and Vpeak definition on the relationship between Vpeak and endurance run performance. Relationship. Twenty-seven male, recreational, endurance-trained runners (10-km running pace: 10-17 k mh(-1)) performed, in counterbalanced order, three continuous incremental treadmill tests of different stage durations (1-, 2-, or 3-min) to determine Vpeak, and two 5-km and two 10-km time trials on a 400-m track to obtain their 5-km and 10-km run performances. Vpeak was defined as either (a) the highest speed that could be maintained for a complete minute (Vpeak-60 s), (b) the speed of the last complete stage (Vpeak-C), or (c) the speed of the last complete stage added to the multiplication of the speed increment by the completed fraction of the incomplete stage (Vpeak-P). The Vpeak determined during the 3-min stage duration protocol was the most highly correlated with both the 5-km (r=0.95) and 10-km (r=0.92) running performances and these relationships were minimally influenced by the Vpeak definition. However, independent of the stage duration, the Vpeak-P provided the highest correlation with both running performances. Incremental treadmill tests comprising 3-min stage duration is preferred to 1-min and 2-min stage duration protocols in order to determine Vpeak to accurately predict 5-km and 10-km running performances. Further, Vpeak-P should be used as standard for the determination of Vpeak. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  7. A Bayesian framework for estimating the incremental value of a diagnostic test in the absence of a gold standard.

    PubMed

    Ling, Daphne I; Pai, Madhukar; Schiller, Ian; Dendukuri, Nandini

    2014-05-15

    The absence of a gold standard, i.e., a diagnostic reference standard having perfect sensitivity and specificity, is a common problem in clinical practice and in diagnostic research studies. There is a need for methods to estimate the incremental value of a new, imperfect test in this context. We use a Bayesian approach to estimate the probability of the unknown disease status via a latent class model and extend two commonly-used measures of incremental value based on predictive values [difference in the area under the ROC curve (AUC) and integrated discrimination improvement (IDI)] to the context where no gold standard exists. The methods are illustrated using simulated data and applied to the problem of estimating the incremental value of a novel interferon-gamma release assay (IGRA) over the tuberculin skin test (TST) for latent tuberculosis (TB) screening. We also show how to estimate the incremental value of IGRAs when decisions are based on observed test results rather than predictive values. We showed that the incremental value is greatest when both sensitivity and specificity of the new test are better and that conditional dependence between the tests reduces the incremental value. The incremental value of the IGRA depends on the sensitivity and specificity of the TST, as well as the prevalence of latent TB, and may thus vary in different populations. Even in the absence of a gold standard, incremental value statistics may be estimated and can aid decisions about the practical value of a new diagnostic test.

  8. An integrated view on the oxygenation responses to incremental exercise at the brain, the locomotor and respiratory muscles.

    PubMed

    Boone, Jan; Vandekerckhove, Kristof; Coomans, Ilse; Prieur, Fabrice; Bourgois, Jan G

    2016-12-01

    In the past two decades oxygenation responses to incremental ramp exercise, measured non-invasively by means of near-infrared spectroscopy at different locations in the body, have advanced the insights on the underpinning mechanisms of the whole-body pulmonary oxygen uptake ([Formula: see text]) response. In healthy subjects the complex oxygenation responses at the level of locomotor and respiratory muscles, and brain were simplified and quantified by the detection of breakpoints as a deviation in the ongoing response pattern as work rate increases. These breakpoints were located in a narrow intensity range between 75 and 90 % of the maximal [Formula: see text] and were closely related to traditionally determined thresholds in pulmonary gas exchange (respiratory compensation point), blood lactate measurements (maximal lactate steady state), and critical power. Therefore, it has been assumed that these breakpoints in the oxygenation patterns at different sites in the body might be equivalent and could, therefore, be used interchangeably. In the present review the typical oxygenation responses (at locomotor and respiratory muscle level, and cerebral level) are described and a possible framework is provided showing the physiological events that might link the breakpoints at different body sites with the thresholds determined from pulmonary gas exchange and blood lactate measurements. However, despite a possible physiological association, several arguments prevent the current practical application of these breakpoints measured at a single site as markers of exercise intensity making it highly questionable whether measurements of the oxygenation response at one single site can be used as a reflection of whole-body responses to different exercise intensities.

  9. Exercise testing in suspected coronary artery disease.

    PubMed

    Sox, H C

    1985-12-01

    The interpretation and selection of exercise tests depends on the pretest probability of CAD. Imperfect tests (like exercise tests) provide probability estimates, not definite statements (such as "the patient has CAD" or "the patient does not have CAD"). In patients with a low pretest probability of CAD (asymptomatic persons or men and women with nonanginal chest pain), abnormal exercise test results provide probability estimates that are much too low to conclude that the patient has CAD. In patients with anginal pain and normal exercise tests, the probability of CAD is too high to conclude that the patient has a normal coronary circulation. Exercise tests are not useful for trying to rule out CAD in patients with anginal pain. In patients with an intermediate pretest probability of CAD (men and women with atypical angina and women with typical angina), abnormal exercise tests (particularly the myocardial scintiscan) provide probability estimates that are high enough to justify starting treatment for CAD. Exercise tests are most useful in this group, a conclusion that has been reached by other methods of analysis. The myocardial scintiscan is much more useful than the exercise ECG in women. When CAD is strongly suspected, exercise tests have relatively little diagnostic value but may be useful for prognosis. However, clinical evidence of poor ventricular function may alone suffice to select patients with angina pectoris for coronary arteriography. Conversely, when clinical indicators of congestive heart failure are absent, the prognosis in chronic stable angina is so favorable that any further testing may be unnecessary. Screening asymptomatic persons for CAD is a very low yield practice. Patients who have no cardiac risk factors (hypercholesterolemia, family history of CAD, cigarette smoking, and hypertension) are at especially low risk of a primary cardiac event. Older men with stable typical angina are particularly likely to have left main coronary artery

  10. Comparison of incremental and constant load tests of inspiratory muscle endurance in COPD.

    PubMed

    Hill, K; Jenkins, S C; Philippe, D L; Shepherd, K L; Hillman, D R; Eastwood, P R

    2007-09-01

    The aim of the present study was to determine the relative value of incremental and constant load tests in detecting changes in inspiratory muscle endurance following high-intensity inspiratory muscle training (H-IMT) in chronic obstructive pulmonary disease. In total, 16 subjects (11 males; forced expiratory volume in one second (FEV(1)) 37.4+/-12.5%) underwent H-IMT. In addition, 17 subjects (11 males; FEV(1) 36.5+/-11.5%) underwent sham inspiratory muscle training (S-IMT). Training took place three times a week for 8 weeks. Baseline and post-training measurements were obtained of maximum threshold pressure sustained during an incremental load test (P(th,max)) and time breathing against a constant load (t(lim)). Breathing pattern was unconstrained. H-IMT increased P(th,max) and t(lim) relative to baseline and to any change seen following S-IMT. The effect size for P(th,max) was greater than for t(lim). Post-training tests were accompanied by changes in breathing pattern, including decreased duty cycle, which may have served to decrease inspiratory work and thereby contribute to the increase in P(th,max) and t(lim) in both groups. When assessing inspiratory muscle function in chronic obstructive pulmonary disease via tests in which the pattern of breathing is unconstrained, the current authors recommend incremental load tests be used in preference to constant load tests. However, to attribute changes in these tests to improvements in inspiratory muscle endurance, breathing pattern should be controlled.

  11. Exercise limitation, exercise testing and exercise recommendations in sickle cell anemia.

    PubMed

    Connes, Philippe; Machado, Roberto; Hue, Olivier; Reid, Harvey

    2011-01-01

    Sickle cell anemia (SCA or SS homozygous sickle cell disease) is an inherited blood disorder caused by single nucleotide substitution in the β-globin gene that renders their hemoglobin (HbS) much less soluble than normal hemoglobin (HbA) when deoxygenated. The polymerization of HbS upon deoxygenation is the basic pathophysiologic event leading to RBC sickling, hemolysis, vasoocclusion and ultimately to chronic organ damage. The metabolic changes imposed by exercise may initiate sickling and vaso-occlusive episodes. Further, in patients with SCA, exercise limitation may be related to anemia or chronic complications such as pulmonary vascular disease, congestive heart failure and chronic parenchymal lung disease. Few studies have investigated the cardiorespiratory responses of patients with SCA during either symptom-limited maximal exercise test on cyclo-ergometer or during a six minute walk test. Therefore, patients are advised to start exercise slowly and progressively, to maintain adequate hydration during and after exercise, to avoid cold exposure or sudden change in temperature, and to avoid sports associated with mechanical trauma. There are, however, lack of evidence to allow practitioners to prescribe an exercise program for patients with SCA, and individuals are usually encouraged to exercise on a symptom-limited basis. Finally, this review will also highlight the basic principles that are often used for exercise practice and could be used for exercise prescription and rehabilitation in patients with sickle cell anemia.

  12. Cardiopulmonary Exercise Testing: What Is its Value?

    PubMed

    Guazzi, Marco; Bandera, Francesco; Ozemek, Cemal; Systrom, David; Arena, Ross

    2017-09-26

    Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension. The most impactful advance has recently come from the introduction of CPET combined with echocardiography or CPET imaging, which provides basic information regarding cardiac and valve morphology and function. This review highlights modern CPET use as a single or combined test that allows the pathophysiological bases of exercise limitation to be translated, quite easily, into clinical practice. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Exercise thallium testing in ventricular preexcitation

    SciTech Connect

    Archer, S.; Gornick, C.; Grund, F.; Shafer, R.; Weir, E.K.

    1987-05-01

    Ventricular preexcitation, as seen in Wolff-Parkinson-White syndrome, results in a high frequency of positive exercise electrocardiographic responses. Why this occurs is unknown but is not believed to reflect myocardial ischemia. Exercise thallium testing is often used for noninvasive assessment of coronary artery disease in patients with conditions known to result in false-positive electrocardiographic responses. To assess the effects of ventricular preexcitation on exercise thallium testing, 8 men (aged 42 +/- 4 years) with this finding were studied. No subject had signs or symptoms of coronary artery disease. Subjects exercised on a bicycle ergometer to a double product of 26,000 +/- 2,000 (+/- standard error of mean). All but one of the subjects had at least 1 mm of ST-segment depression. Tests were terminated because of fatigue or dyspnea and no patient had chest pain. Thallium test results were abnormal in 5 patients, 2 of whom had stress defects as well as abnormally delayed thallium washout. One of these subjects had normal coronary arteries on angiography with a negative ergonovine challenge, and both had normal exercise radionuclide ventriculographic studies. Delayed thallium washout was noted in 3 of the subjects with ventricular preexcitation and normal stress images. This study suggests that exercise thallium testing is frequently abnormal in subjects with ventricular preexcitation. Ventricular preexcitation may cause dyssynergy of ventricular activation, which could alter myocardial thallium handling, much as occurs with left bundle branch block. Exercise radionuclide ventriculography may be a better test for noninvasive assessment of coronary artery disease in patients with ventricular preexcitation.

  14. Exercise testing and stress imaging in valvular heart disease.

    PubMed

    Henri, Christine; Piérard, Luc A; Lancellotti, Patrizio; Mongeon, François-Pierre; Pibarot, Philippe; Basmadjian, Arsène J

    2014-09-01

    The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial dysfunction that could be missed at rest. Recent studies have demonstrated the incremental prognostic value of exercise echocardiography for asymptomatic patients with severe aortic stenosis, moderate-severe mitral stenosis, and severe primary mitral regurgitation. In patients with low-flow, low-gradient aortic stenosis, dobutamine stress echocardiography is recommended to differentiate true severe from pseudosevere aortic stenosis. Data on the prognostic value of stress echocardiography in aortic regurgitation and functional mitral regurgitation are less robust. Data are sparse on the use of stress imaging in right-sided VHD, however recent studies using stress cardiovascular magnetic resonance imaging offer some prognostic information. Although the strongest recommendations for surgical treatment continue to be based on symptom status and resting left ventricular repercussions, stress imaging can be useful to optimize risk stratification and timing of surgery in VHD. Randomized clinical trials are required to confirm that clinical decision-making based on stress imaging can lead to improved outcomes.

  15. Comparison between continuous and discontinuous incremental treadmill test to assess velocity at V̇O2max.

    PubMed

    Riboli, Andrea; Cè, Emiliano; Rampichini, Susanna; Venturelli, Massimo; Alberti, Giampietro; Limonta, Eloisa; Veicsteinas, Arsenio; Esposito, Fabio

    2017-09-01

    The velocity associated with maximum aerobic power (vV̇O2max) is an important physiological parameter, which is utilized to determine relative workloads on the field. The testing modality adopted to evaluate it, though, may cause differences in vV̇O2max assessment and, in turn, in training intensity. The aim of the study was to compare two different testing modalities (continuous incremental ramp and discontinuous square wave (SW) protocols) for vV̇O2max assessment on the treadmill. Seventeen physically active participants performed three maximum incremental tests on a treadmill: two continuous ramp protocols, with different ramp slopes (R1, 1 km/h every minute; and R2, 1 km/h every 2 minutes), and one discontinuous SW protocol, in random order, for maximum oxygen uptake (V̇O2max) and vV̇O2max determination. Cardiorespiratory and metabolic parameters were collected breath-by-breath at rest and during exercise. vV̇O2max was significantly higher in R1 and R2 compared to SW (20.7±0.5, 18.6±0.4, 16.8±0.6 km/h for R1, R2, and SW, respectively; P<0.001). No significant differences were found among protocols for V̇O2max (56.7±1.1, 57.0±1.2, and 56.6±1.2 mL/min/kg for SW, R1, R2, respectively) as well as for expiratory ventilation, carbon dioxide production, blood lactate concentration, and heart rate. In spite of similar V̇O2max values, vV̇O2max was higher during continuous incremental ramp tests compared to SW possibly due to the longer time for cardiorespiratory and metabolic adjustments, suggesting different aerobic and anaerobic metabolism involvement. The differences among protocols should be considered when vV̇O2max is used for training purposes.

  16. Effects of short-term training on plasma acid–base balance during incremental exercise in man

    PubMed Central

    Putman, Charles T; Jones, Norman L; Heigenhauser, George J F

    2003-01-01

    The present study examined the effect of short-term submaximal training on plasma acid–base balance during exercise. The influence of water and ion exchange between plasma, active muscles and erythrocytes in the response to training were also studied. The contributions of independent physicochemical variables (i.e. strong ion difference ([SID]), total concentration of weak acids ([Atot]) and PO2) to changes in arterial (a) and femoral venous (v) plasma [H+] were examined in six subjects (age 24 ± 1.5 years; maximum oxygen consumption rate (), 3.67 ± 0.24 l min−1) during steady-state cycling for 15 min at each of 30, 65 and 75 % of before (pre) and after (post) training for 7 days on a cycle ergometer (2 h daily at 60 % ). The rise in [H+]a during exercise was attenuated post-training by 3 and 5 nequiv l−1 (P < 0.05) at 65 and 75 % , respectively, due first to less decrease in [SID]a, secondary to lower [Cl−]a and [Lac−]a; and second, to a reduction in [Atot]a, due to greater plasma volume and less plasma water flux (Jv) into leg muscle (P < 0.05). The rise in [H+]v was also less in post-training by 4.5 and 6 nequiv l−1 (P < 0.05) at 65 and 75 % , respectively, and attributed solely to lower [Atot]v (P < 0.05). Attenuation of exercise induced decreases in plasma [SID]a and [SID]v from rest to 75 % was accompanied by reductions in erythrocyte Lac− and Cl− uptake (P < 0.05), and smaller increases in erythrocyte K+ release (P < 0.05). We conclude that the training-induced attenuation of the rise in plasma [H+]a and [H+]v during incremental exercise resulted from adaptive changes within muscles (less Lac− production and less water uptake) and erythrocytes (less uptake of Lac−, Cl− and K+), leading to greater [SID] and lower [Atot] in both arterial and femoral venous plasma. PMID:12766247

  17. Cardiopulmonary Exercise Test in Hypertrophic Cardiomyopathy.

    PubMed

    Magri, Damiano; Santolamazza, Caterina

    2017-04-04

    Understanding the functional limitation in hypertrophic cardiomyopathy, the most common inherited heart disease, is challenging. Beside the occurrence of disease-related complications, several factors are potential determinants of exercise limitation, including left ventricular hypertrophy, myocardial fiber disarray, left ventricular outflow tract obstruction, microvascular ischemia, and interstitial fibrosis. Furthermore, drugs commonly used in the daily management of these patients may interfere with exercise capacity, especially those with a negative chronotropic effect. Cardiopulmonary exercise testing can safely and objectively evaluate the functional capacity of these patients and help the physician in understanding the mechanisms that underlie this limitation. Features that reduce exercise capacity may predict progression to heart failure in these patients and even the risk of sudden cardiac death.

  18. Reproducibility of an incremental treadmill VO(2)max test with gas exchange analysis for runners.

    PubMed

    Lourenço, Thiago Fernando; Martins, Luiz Eduardo Barreto; Tessutti, Lucas Samuel; Brenzikofer, Rene; Macedo, Denise Vaz

    2011-07-01

    The evaluation of performance through the application of adequate physical tests during a sportive season may be a useful tool to evaluate training adaptations and determine training intensities. For runners, treadmill incremental VO(2)max tests with gas exchange analysis have been widely used to determine maximal and submaximal parameters such as the ventilatory threshold (VT) and respiratory compensation point (RCP) running speed. However, these tests often differ in methodological characteristics (e.g., stage duration, grade, and speed increment size), and few studies have examined the reproducibility of their protocol. Therefore, the aim of this study was to verify the reproducibility and determine the running speeds related to maximal and submaximal parameters of a specific incremental maximum effort treadmill protocol for amateur runners. Eleven amateur male runners underwent 4 repetitions of the protocol (25-second stages, each increasing by 0.3 km·h in running speed while the treadmill grade remained fixed at 1%) after 3 minutes of warm-up at 8-8.5 km·h. We found no significant differences in any of the analyzed parameters, including VT, RCP, and VO(2)max during the 4 repetitions (p > 0.05). Further, the results related to running speed showed high within-subject reproducibility (coefficient of variation < 5.2%). The typical error (TE) values for running speed related to VT (TE = 0.62 km·h), RCP (TE = 0.35 km·h), and VO(2)max (TE = 0.43 km·h) indicated high sensitivity and reproducibility of this protocol. We conclude that this VO(2)max protocol facilitates a clear determination of the running speeds related to VT, RCP, and VO(2)max and has the potential to enable the evaluation of small training effects on maximal and submaximal parameters.

  19. Reliability and minimal detectable change of a new treadmill-based progressive workload incremental test to measure cardiorespiratory fitness in manual wheelchair users.

    PubMed

    Gauthier, Cindy; Arel, Jasmine; Brosseau, Rachel; Hicks, Audrey L; Gagnon, Dany H

    2017-09-13

    Background Cardiorespiratory fitness training is commonly provided to manual wheelchair users (MWUs) in rehabilitation and physical activity programs, emphasizing the need for a reliable task-specific incremental wheelchair propulsion test. Objective Quantifying test-retest reliability and minimal detectable change (MDC) of key cardiorespiratory fitness measures following performance of a newly developed continuous treadmill-based wheelchair propulsion test (WPTTreadmill). Methods Twenty-five MWUs completed the WPTTreadmill on two separate occasions within one week. During these tests, participants continuously propelled their wheelchair on a motorized treadmill while the exercise intensity was gradually increased every minute until exhaustion by changing the slope and/or speed according to a standardized protocol. Peak oxygen consumption (VO2peak), carbon dioxide production (VCO2peak), respiratory exchange ratio (RERpeak), minute ventilation (VEpeak) and heart rate (HRpeak) were computed. Time to exhaustion (TTE) and number of increments completed were also measured. Intra-class correlation coefficients (ICC) were calculated to determine test-retest reliability. Standard error of measurement (SEM) and MDC90% values were calculated. Results Excellent test-retest reliability was reached for almost all outcome measures (ICC=0.91-0.76), except for RERpeak (ICC=0.58), which reached good reliability. TTE (ICC=0.89) and number of increments (ICC=0.91) also reached excellent test-retest reliability. For the main outcome measures (VO2peak and TTE), absolute SEM was 2.27 mL/kg/min and 0.76 minutes, respectively and absolute MDC90% was 5.30 mL/kg/min and 1.77 minutes, respectively. Conclusion The WPTTreadmill is a reliable test to assess cardiorespiratory fitness among MWUs. TTE and number of increments could be used as reliable outcome measures when VO2 measurement is not possible.

  20. The ISS Increments 3 and 4 Test Report: For the Active Rack Isolation System ISS Characterization Experiment (ARIS-ICE)

    NASA Technical Reports Server (NTRS)

    Quraishi, Naveed; Allen, Jim; Bushnell, Glenn; Fialho, Ian

    2003-01-01

    The purpose of ARIS-ICE is to improve, optimize then operationally test and document the performance of the ARIS system on the International Space Station. The ICE program required testing across a full 3 increments (2 through 4). This paper represents the operational report summarizing our accomplishments through the third and fourth increment of testing. The main objectives and results of the increment two testing are discussed in The Increment two Operational Report. This report can be obtained from the ISS Payloads Office or from (http://iss-www.isc.nasa.gov/sslissapt/payofc/OZ3/ARIS.html). In summary these were to ensure the smooth and successful activation of the system and correct operational issues related to long term testing. Then the follow on increment 3 & 4 testing encompassed the majority of the on orbit performance assessments and improvements made to the ARIS system. The intent here is to report these preliminary results of the increment 3 & 4 ARIS-ICE testing as well as the ARIS system improvements made for our users and customers.

  1. Muscle synergies during incremental rowing VO2max test of collegiate rowers and untrained subjects.

    PubMed

    Shaharudin, Shazlin; Agrawal, Sunil

    2016-09-01

    The purpose of this study was to evaluate the muscle synergies during incremental rowing VO2 max Test of collegiate rowers and untrained subjects. As a power endurance sport, high aerobic capacity was one of the determinants of rowing performance. The modulation of muscle recruitment patterns following specific physiological demands was an indication of the robustness of muscle synergies composition which was overlooked in previous studies. Ten male collegiate rowers and physically active untrained subjects were recruited. Muscle synergies were extracted from 16 rowing-specific muscles using Principal Component Analysis with varimax rotation. Incremental rowing VO2 max Test was performed on slides ergometer (SE). Rowing performance and physiological variables were analyzed. Rowers exerted greater power output, more energy expenditure and better rowing economy compared to untrained subjects. Rowers preferred to row slower with longer strokes compared to the untrained subjects. Three muscle synergies with high indices of similarity of waveform patterns were extracted in both groups. Significant association was found between muscle synergies and rowing economy. The findings of this study showed that muscle synergies were robust during aerobic-dominant activity for collegiate rowers and untrained subjects. Rowers and coaches could utilize the findings by emphasizing on muscle coordination training, which may enhance the rowing economy.

  2. Fat oxidation, hormonal and plasma metabolite kinetics during a submaximal incremental test in lean and obese adults.

    PubMed

    Lanzi, Stefano; Codecasa, Franco; Cornacchia, Mauro; Maestrini, Sabrina; Salvadori, Alberto; Brunani, Amelia; Malatesta, Davide

    2014-01-01

    This study aimed to compare fat oxidation, hormonal and plasma metabolite kinetics during exercise in lean (L) and obese (O) men. Sixteen L and 16 O men [Body Mass Index (BMI): 22.9 ± 0.3 and 39.0 ± 1.4 kg · m(-2)] performed a submaximal incremental test (Incr) on a cycle-ergometer. Fat oxidation rates (FORs) were determined using indirect calorimetry. A sinusoidal model, including 3 independent variables (dilatation, symmetry, translation), was used to describe fat oxidation kinetics and determine the intensity (Fat(max)) eliciting maximal fat oxidation. Blood samples were drawn for the hormonal and plasma metabolite determination at each step of Incr. FORs (mg · FFM(-1) · min(-1)) were significantly higher from 20 to 30% of peak oxygen uptake (VO2peak) in O than in L and from 65 to 85% VO2peak in L than in O (p ≤ 0.05). FORs were similar in O and in L from 35 to 60% VO2peak. Fat max was 17% significantly lower in O than in L (p<0.01). Fat oxidation kinetics were characterized by similar translation, significantly lower dilatation and left-shift symmetry in O compared with L (p<0.05). During whole exercise, a blunted lipolysis was found in O [lower glycerol/fat mass (FM) in O than in L (p ≤ 0.001)], likely associated with higher insulin concentrations in O than in L (p<0.01). Non-esterified fatty acids (NEFA) were significantly higher in O compared with L (p<0.05). Despite the blunted lipolysis, O presented higher NEFA availability, likely due to larger amounts of FM. Therefore, a lower Fat(max), a left-shifted and less dilated curve and a lower reliance on fat oxidation at high exercise intensities suggest that the difference in the fat oxidation kinetics is likely linked to impaired muscular capacity to oxidize NEFA in O. These results may have important implications for the appropriate exercise intensity prescription in training programs designed to optimize fat oxidation in O.

  3. Exercise-induced Myocardial Ischemia Detected by Cardiopulmonary Exercise Testing

    PubMed Central

    Chaudhry, Sundeep; Arena, Ross; Wasserman, Karlman; Hansen, James E.; Lewis, Gregory D.; Myers, Jonathan; Chronos, Nicolas; Boden, William E.

    2010-01-01

    Cardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation technique in patients diagnosed with heart failure and in individuals presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consumption relative to heart rate (VO2/HR or O2-pulse) and work rate (VO2/Watt) provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by myocardial ischemia. This concept paper describes both the methodology and clinical application of CPET associated with myocardial ischemia. Initial evidence indicates left ventricular dysfunction induced by myocardial ischemia may be accurately detected by an abnormal CPET response. CPET testing may complement current non-invasive testing modalities that elicit inducible ischemia. It provides a physiologic quantification of the work rate, heart rate and O2 uptake at which myocardial ischemia develops. In conclusion, the potential value of adding CPET with gas exchange measurements is likely to be of great value in diagnosing and quantifying both overt and occult myocardial ischemia and its reversibility with treatment. PMID:19231322

  4. Characteristics of inline speedskating--incremental tests and effect of drafting.

    PubMed

    Krieg, A; Meyer, T; Clas, S; Kindermann, W

    2006-10-01

    Competitive inline speedskating combines a movement pattern similar to speedskating on ice with pack-oriented competition modes known from cycling. The deep-seated body position leads to high static load and, thus, restricted blood flow within propulsive muscles. This condition may affect lactate kinetics and limit V.O (2peak). The present study compares physiologic reactions to graded cycling and skating exercise among top-level inline speedskaters and quantifies the effect of drafting. Eight male inline speedskaters of the top national level were examined. The study consisted of two graded exhaustive exercise tests (cycling and speedskating) and a pairwise drafting test. All tests were carried out with simultaneous gas exchange (MetaMax 2, Cortex, Germany) and heart rate measurements as well as determination of blood lactate concentrations. Maximal values of oxygen consumption (cycling: 4.91 +/- 0.60; skating: 4.85 +/- 0.50 l . min (-1); p = 0.78), lactate concentration, or heart rate were similar for cycling and skating. At workloads corresponding to blood lactate concentrations of 4 mmol . l (-1) oxygen uptake (cycling: 3.24 +/- 0.65; skating: 3.97 +/- 0.40 l . min (-1); p < 0.05) and heart rate (cycling: 162 +/- 9; skating: 173 +/- 6 min (-1); p < 0.05) were significantly higher during skating. The differences in heart rate ranged between - 2 and 23 min (-1). The drafting effect was 15 +/- 6 % at 30 km . h (-1) (3.34 +/- 0.19 vs. 2.83 +/- 0.29 l . min (-1)) and 14 +/- 5 % at 33 km . h (-1) (3.87 +/- 0.26 vs. 3.32 +/- 0.27 l . min (-1)). During inline speedskating the attainment of VO2peak is not impaired when compared to cycling exercise. However, the derivation of exercise prescriptions from a stepwise cycling test does not seem appropriate. The drafting effect of inline speedskating is within the range known from cycling.

  5. Exercise-induced muscle vasodilatation and treadmill exercise test responses in individuals without overt heart disease.

    PubMed

    Nunes, Rafael Amorim Belo; Giampaoli, Viviana; de Freitas, Humberto Felício Gonçalves; da Costa Pereira, Alexandre; Araújo, Fernando; Correia, Gustavo Ferreira; Rondon, Maria Urbana Pinto Brandão; Negrão, Carlos Eduardo; Mansur, Alfredo José

    2014-01-01

    The beneficial effects of exercise on cardiovascular health may be related to the improvement in several physiologic pathways, including peripheral vascular function. The aim of this study was to evaluate the relationship between cardiovascular responses during the treadmill exercise test and exercise-induced muscle vasodilatation in individuals without overt heart disease. The study included 796 asymptomatic subjects (431 females and 365 males) without overt heart disease. We evaluated the heart rate (chronotropic reserve and heart rate recovery), blood pressure (maximum systolic and diastolic blood pressure as well as systolic blood pressure recovery) and exercise capacity during symptom-limited treadmill exercise testing. Exercise-induced muscle vasodilatation was studied with venous occlusion plethysmography and estimated by forearm blood flow and vascular conductance responses during a 3-min handgrip maneuver. Forearm blood flow increase during the handgrip exercise was positively associated with heart rate recovery during treadmill exercise testing (p < 0.001). Forearm vascular conductance increase during the handgrip exercise was inversely associated with exercise diastolic blood pressure during exercise treadmill testing (p = 0.038). No significant association was found between exercise capacity and exercise-induced muscle vasodilation. In a sample of individuals without overt heart disease, exercise-induced muscle vasodilatation was associated with heart rate and blood pressure responses during treadmill exercise testing, but was not associated with exercise capacity. These findings suggest that favorable hemodynamic and chronotropic responses are associated with better vasodilator capacity, but exercise capacity does not predict muscle vasodilatation.

  6. Cardiopulmonary Exercise Test: Background, Applicability and Interpretation

    PubMed Central

    Herdy, Artur Haddad; Ritt, Luiz Eduardo Fonteles; Stein, Ricardo; de Araújo, Claudio Gil Soares; Milani, Mauricio; Meneghelo, Romeu Sérgio; Ferraz, Almir Sérgio; Hossri, Carlos; de Almeida, Antonio Eduardo Monteiro; Fernandes-Silva, Miguel Morita; Serra, Salvador Manoel

    2016-01-01

    Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: ventilation; oxygen consumption (VO2); carbon dioxide production (VCO2); and the other variables of conventional exercise testing. In addition, in specific situations, pulse oximetry and flow-volume loops during and after exertion are measured. The CPET provides joint data analysis that allows complete assessment of the cardiovascular, respiratory, muscular and metabolic systems during exertion, being considered gold standard for cardiorespiratory functional assessment.1-6 The CPET allows defining mechanisms related to low functional capacity that can cause symptoms, such as dyspnea, and correlate them with changes in the cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be used to provide the prognostic assessment of patients with heart or lung diseases, and in the preoperative period, in addition to aiding in a more careful exercise prescription to healthy subjects, athletes and patients with heart or lung diseases. Similarly to CPET clinical use, its research also increases, with the publication of several scientific contributions from Brazilian researchers in high-impact journals. Therefore, this study aimed at providing a comprehensive review on the applicability of CPET to different clinical situations, in addition to serving as a practical guide for the interpretation of that test. PMID:27982272

  7. A Bayesian framework for estimating the incremental value of a diagnostic test in the absence of a gold standard

    PubMed Central

    2014-01-01

    Background The absence of a gold standard, i.e., a diagnostic reference standard having perfect sensitivity and specificity, is a common problem in clinical practice and in diagnostic research studies. There is a need for methods to estimate the incremental value of a new, imperfect test in this context. Methods We use a Bayesian approach to estimate the probability of the unknown disease status via a latent class model and extend two commonly-used measures of incremental value based on predictive values [difference in the area under the ROC curve (AUC) and integrated discrimination improvement (IDI)] to the context where no gold standard exists. The methods are illustrated using simulated data and applied to the problem of estimating the incremental value of a novel interferon-gamma release assay (IGRA) over the tuberculin skin test (TST) for latent tuberculosis (TB) screening. We also show how to estimate the incremental value of IGRAs when decisions are based on observed test results rather than predictive values. Results We showed that the incremental value is greatest when both sensitivity and specificity of the new test are better and that conditional dependence between the tests reduces the incremental value. The incremental value of the IGRA depends on the sensitivity and specificity of the TST, as well as the prevalence of latent TB, and may thus vary in different populations. Conclusions Even in the absence of a gold standard, incremental value statistics may be estimated and can aid decisions about the practical value of a new diagnostic test. PMID:24886359

  8. One-year temporal stability and predictive and incremental validity of the body, eating, and exercise comparison orientation measure (BEECOM) among college women.

    PubMed

    Fitzsimmons-Craft, Ellen E; Bardone-Cone, Anna M

    2014-01-01

    This study examined the one-year temporal stability and the predictive and incremental validity of the Body, Eating, and Exercise Comparison Measure (BEECOM) in a sample of 237 college women who completed study measures at two time points about one year apart. One-year temporal stability was high for the BEECOM total and subscale (i.e., Body, Eating, and Exercise Comparison Orientation) scores. Additionally, the BEECOM exhibited predictive validity in that it accounted for variance in body dissatisfaction and eating disorder symptomatology one year later. These findings held even after controlling for body mass index and existing measures of social comparison orientation. However, results regarding the incremental validity of the BEECOM, or its ability to predict change in these constructs over time, were more mixed. Overall, this study demonstrated additional psychometric properties of the BEECOM among college women, further establishing the usefulness of this measure for more comprehensively assessing eating disorder-related social comparison.

  9. Yo-Yo IR1 vs. incremental continuous running test for prediction of 3000-m performance.

    PubMed

    Schmitz, Boris; Klose, Andreas; Schelleckes, Katrin; Jekat, Charlotte M; Krüger, Michael; Brand, Stefan-Martin

    2017-11-01

    This study aimed to compare physiological responses during the Yo-Yo intermittent recovery level 1 (Yo-Yo IR1) Test and an incremental continuous running field Test (ICRT) and to analyze their predictive value on 3000-m running performance. Forty moderately trained individuals (18 females) performed the ICRT and Yo-Yo IR1 Test to exhaustion. The ICRT was performed as graded running test with an increase of 2.0 km·h-1 after each 3 min interval for lactate diagnostic. In both tests, blood lactate levels were determined after the test and at 2 and 5 min of recovery. Heart rate (HR) was recorded to monitor differences in HR slopes and HR recovery. Comparison revealed a correlation between ICRT and Yo-Yo IR1 Test performance (R2=0.83, P<0.001), while significant differences in HRmax existed (Yo-Yo IR1, 189±10 bpm; ICRT, 195±16 bpm; P<0.005; ES=0.5). Maximum lactate levels were also different between test (Yo-Yo IR1, 10.1±2.1 mmol∙L-1; ICRT, 11.7±2.4 mmol∙L-1; P<0.01; ES=0.7). Significant inverse correlations were found between the Yo-Yo IR1 Test performance and 3000 m running time (R2=0.77, P<0.0001) as well as the ICRT and 3000 m time (R2=0.90, P<0.0001). Our data suggest that ICRT and Yo-Yo IR1 test are useful field test methods for the prediction of competitive running performances such as 3000-m runs but maximum HR and blood lactate values differ significantly. The ICRT may have higher predictive power for middle- to long- distance running performance such as 3000-m runs offering a reliable test for coaches in the recruitment of athletes or supervision of training concepts.

  10. Reproducibility of the incremental shuttle walk test for women with morbid obesity.

    PubMed

    Peixoto-Souza, Fabiana Sobral; Sampaio, Luciana Maria Malosa; de Campos, Elaine Cristina; Cangussu Barbalho-Moulim, Marcela; Nascimento de Araujo, Poliane; Laurino Neto, Rafael Melillo; Arena, Ross; Costa, Dirceu

    2015-01-01

    The incremental shuttle walk test (ISWT) is a valuable tool for the assessment of functional capacity. However, few studies have used the ISWT in individuals with obesity or have determined its reproducibility in this population. The aim of the present study was to evaluate the reproducibility of the ISWT in women with morbid obesity. Twenty-three women with a body mass index >40 kg/m(2) (mean age: 39.1 ± 7.7) performed the ISWT twice on the same day. The mean distance traveled was 313.3 ± 100.2 m on the first test and 322.5 ± 98.9 on the second test, with no significant difference between tests. The intraclass correlation coefficient (0.91) indicated excellent reproducibility. Reliability determined through Bland-Altman analysis revealed a small mean difference between tests (-9.2 m). The practice of repeating the ISWT appears to be unnecessary for women with morbid obesity, as demonstrated by the excellent reproducibility of the test.

  11. Broth microdilution testing of Pseudomonas aeruginosa and aminoglycosides: need for employing dilutions differing by small arithmetic increments.

    PubMed Central

    Woolfrey, B F; Fox, J M; Lally, R T; Quall, C O

    1982-01-01

    The use of dilutions differing by small arithmetic increments was studied as a means for improving the definition and measurement of minimum inhibitory concentrations and precision parameters for testing Pseudomonas aeruginosa versus the aminoglycosides by the broth microdilution test. For five strains of P. aeruginosa versus gentamicin, tobramycin, and amikacin, comparisons were made of minimum inhibitory concentrations which were replicated in parallel by using three microdilution systems: small increment panels prepared by us, modified twofold dilution panels prepared by us, and similar modified twofold dilution panels obtained commercially. The small increment dilutions were prepared to differ by concentrations of 1.0 microgram/ml for gentamicin and tobramycin and by 2.0 micrograms/ml for amikacin. Use of the small increment dilutions resulted in the ability to measure minimum inhibitory concentrations at more closely spaced intervals than those dictated by modified twofold dilution schemes, and confidence limits were significantly improved. The average coefficient of variation for the small increment microdilution test results was 9.5%, with 99.5% of minimum inhibitory concentrations falling within +/- 2 small increment dilutions from their modal values. PMID:6818244

  12. Autonomic control of heart rate during non-linear incremental upper-limb resistance exercise with elastic bands in young healthy female subjects.

    PubMed

    Ramos Batalha, Priscila; Borghi-Silva, Audrey; Campos Freire, Renato; Zanela DA Silva Arêas, Fernando; Peixoto Tinoco Arêas, Guilherme

    2016-11-01

    Elastic bands are therapeutic tools widely used in rehabilitation. However, knowledge regarding autonomic cardiovascular overload during this type of resistance exercise is limited. This study assessed the autonomic control of heart rate during an incremental exercise protocol with elastic bands in sedentary healthy young individuals. Ten young women were subjected to an exercise protocol involving bilateral shoulder flexion to 90° with various thicknesses of elastic bands; the exercise was performed for 36 uninterrupted repetitions with a 15-minute rest interval between sets. During the exercise, the RR intervals (R-Ri) were collected and determined, the heart rate variability was analyzed. All subjects completed the exercise protocol. Heart rate increased, and RR intervals decreased from the yellow elastic band onward. However, the square root of the sum of the square of the difference of RR intervals divided by the number of RR interval, standard deviation of the arithmetic mean of all normal RR intervals, and standard deviation of the RR interval instantaneous intervals of type I decreased significantly when performed with the green band onward (P<0.05). Exercise with progressive elastic load increases heart rate. However, the green elastic band induces less total and parasympathetic modulation heart rate variability.

  13. Is it possible to individualize intensity of eccentric cycling exercise from perceived exertion on concentric test?

    PubMed

    Laroche, Davy; Joussain, Charles; Espagnac, Claire; Morisset, Claire; Tordi, Nicolas; Gremeaux, Vincent; Casillas, Jean-Marie

    2013-08-01

    To assess the safety and acute effects of a procedure using perceived exertion during a prior submaximal concentric (CON) test to individualize eccentric (ECC) cycling exercise intensity. Prospective, monocentric open study. Technological investigation platform at a physical medicine and rehabilitation department in a university hospital. Healthy subjects (N=18; 15 men, 3 women) aged between 22 and 37 years. The subjects performed 3 cycling exercises: (1) incremental CON test to determine the comfortable pedaling power (CPP) corresponding to a Borg scale rating of 12 (rate of perceived exertion); (2) steady-state CON exercise at the CPP workload to determine the corresponding plantar pressure; and (3) steady-state ECC exercise with an imposed resistance corresponding to the CPP plantar pressure. Rate of perceived exertion on Borg scale, oxygen uptake (V˙o2), heart rate, cardiac output, and stroke volume using inert gas rebreathing techniques were measured during steady-state CON and ECC exercises. Muscle soreness was rated on a visual analog scale immediately, 24, and 48 hours after the tests. No adverse effects were reported. V˙o2 was about 5 times the resting value during CON exercise, while it was twice that during ECC exercise. Cardiac output was lower during ECC exercise (P<.05). This moderate increase of cardiac output was exclusively linked to a greater increase in stroke volume during ECC exercise than during CON exercise (P<.05). Moderate-intensity ECC cycling exercise tailored according to perceived exertion during a prior CON test is well tolerated. It corresponds to a limited muscular use of oxygen and to an isolated increase in stroke volume. It appears to be a feasible procedure for preconditioning before ECC training. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. The role of exercise testing in pediatric cardiology.

    PubMed

    Massin, Martial M

    2014-05-01

    Exercise testing for cardiac disease in children differs in many aspects from the tests performed in adults; their cardiovascular response to exercise presents different characteristics, which are essential for the interpretation of hemodynamic data. Moreover, diseases that are associated with myocardial ischemia are very rare in young patients, and the main indications for exercise testing are evaluation of exercise capacity and identification of exercise-induced arrhythmias. This article describes the specificity of exercise testing in pediatric cardiology, in terms of techniques, indications and interpretation of data.

  15. Does the Incremental Shuttle Walking Test require maximal effort in healthy subjects of different ages?

    PubMed

    Gonçalves, Cristiane Golias; Mesquita, Rafael; Hayashi, Daniela; Merli, Myriam Fernanda; Vidotto, Laís Silva; Fernandes, Karen Barros Parron; Probst, Vanessa S

    2015-06-01

    To evaluate if the Incremental Shuttle Walking Test (ISWT) requires maximal effort in healthy subjects of different ages. Cross-sectional. University-based research laboratory. 331 healthy subjects separated into six groups according to age: G1, 18 to 28 years; G2, 29 to 39 years; G3, 40 to 50 years; G4, 51 to 61 years; G5, 62 to 72 years and; G6, 73 to 83 years. Two ISWTs were performed and participants were permitted to run and to exceed 12 levels during the test, if necessary. Heart rate (HR) and symptoms of dyspnoea and fatigue were recorded before and after the test, and the percentage of age-predicted maximal HR (HRmax) was calculated. Maximal effort was defined as HRmax >90% of age-predicted HRmax. Almost 31% of the subjects exceeded 12 levels in the ISWT. At the end of the test, all groups presented a median [interquartile range] HR greater than 90% of HRmax (G1: 100 [95 to 104]; G2: 100 [96 to 105]; G3: 103 [97 to 108]; G4: 99 [91 to 106]; G5: 96 [87 to 106] and G6: 96 [91 to 109]% HRmax). Regarding symptoms, all groups showed higher values after the test (P<0.05). A multiple logistic regression analysis identified female gender, older age and a lower HR before the test as determinants of not achieving 90% of HRmax at the end of the test. The ISWT requires maximal effort in healthy individuals, but for that it is necessary to extend the test beyond twelve levels. Female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  16. Oxygen desaturation in healthy subjects undergoing the incremental shuttle walk test*

    PubMed Central

    Seixas, Daniel Machado; Seixas, Daniela Miti Tsukumo; Pereira, Monica Corso; Moreira, Marcos Mello; Paschoal, Ilma Aparecida

    2013-01-01

    OBJECTIVE: To determine the probability of oxygen desaturation in healthy individuals undergoing the incremental shuttle walk test (ISWT). METHODS: We enrolled 83 healthy subjects: 55 males (including 1 smoker) and 28 females. We determined pre-ISWT FEV1, FEV6, HR and SpO2, as well as post-ISWT HR and SpO2. RESULTS: Mean values overall were as follows: age, 35.05 ± 12.53 years; body mass index, 24.30 ± 3.47 kg/m2; resting HR, 75.12 ± 12.48 bpm; resting SpO2, 97.96 ± 1.02%; FEV1, 3.75 ± 0.81 L; FEV6, 4.45 ± 0.87 L; FEV1/FEV6 ratio, 0.83 ± 0.08 (no restriction or obstruction); incremental shuttle walk distance, 958.30 ± 146.32 m; post-ISWT HR, 162.41 ± 18.24 bpm; and post-ISWT SpO2, 96.27 ± 2.21%. In 11 subjects, post-ISWT SpO2 was higher than was pre-ISWT SpO2. In 17 subjects, there was a 4% decrease in SpO2 after the ISWT. There were no statistically significant differences between the groups with and without post-ISWT oxygen desaturation in terms of age, gender, FEV1, FEV6, FEV1/FEV6, pre-ISWT SpO2, incremental shuttle walk distance, HR, or percentage of maximal HR. In the individuals with post-ISWT oxygen desaturation, the body mass index was higher (p = 0.01) and post-ISWT SpO2 was lower (p = 0.0001). CONCLUSIONS: Healthy individuals can present oxygen desaturation after the ISWT. Using the ISWT to predict subtle respiratory abnormalities can be misleading. In healthy subjects, oxygen desaturation is common after the ISWT, as it is during any intense physical activity. PMID:24068265

  17. Validation of a Maximal Incremental Skating Test Performed on a Slide Board: Comparison With Treadmill Skating.

    PubMed

    Piucco, Tatiane; Diefenthaeler, Fernando; Soares, Rogério; Murias, Juan M; Millet, Guillaume Y

    2017-03-24

    the aim of this study was to investigate the criterion validity of a maximal incremental skating test performed on a slide board (SB). Twelve sub-elite speed skaters performed a maximal skating test on a treadmill and on a SB. Gas exchange threshold (GET), respiratory compensation point (RCP) and maximal variables were determined. oxygen uptake (V̇O2) (31.0 ± 3.2 and 31.4 ± 4.1 mL∙min(-1)∙kg(-1)), percentage of maximal oxygen uptake (V̇O2max) (66.3 ± 4 and 67.7 ± 7.1%), HR (153 ± 14 and 150 ± 12 bpm), and ventilation (59.8 ± 11.8 and 57.0 ± 10.7 L∙min(-1)) at GET, and V̇O2 (42.5 ± 4.4 and 42.9 ± 4.8 mL∙min(-1)∙kg(-1)), percentage of V̇O2max (91.1 ± 3.3 and 92.4 ± 2.1%), heart rate (HR) (178 ± 9 and 178 ± 6 bpm), and ventilation (96.5 ± 19.2 and 92.1 ± 12.7 L∙min(-1)) at RCP were not different between skating on a treadmill and on a SB. V̇O2max (46.7 ± 4.4 vs 46.4 ± 6.1 mL∙min(-1)∙kg(-1)) and maximal HR (195 ± 6 vs 196 ± 10 bpm) were not significantly different and correlated (r = 0.80 and r = 0.87, respectively; p < 0.05) between the treadmill and SB. V̇O2 at GET, RCP and V̇O2max obtained on a SB were correlated (r > 0.8) with athletes' best time on 1500 m. the incremental skating test on a SB was capable to distinguish maximal (V̇O2 and HR) and submaximal (V̇O2, % V̇O2max, HR and ventilation) parameters known to determine endurance performance. Therefore, the SB test can be considered as a specific and practical alternative to evaluate speed skaters.

  18. Validation of a New Portable Metabolic System During an Incremental Running Test

    PubMed Central

    Díaz, Víctor; Benito, Pedro José; Peinado, Ana Belén; Álvarez, María; Martín, Carlos; Salvo, Valter Di; Pigozzi, Fabio; Maffulli, Nicola; Calderón, Fracisco Javier

    2008-01-01

    We tested a new portable metabolic system, the Jaeger Oxycon Mobile (OM) at a range of running speeds. Six subjects carried out, in random order, two incremental tests on a treadmill, one of them using the OM, and the other using the Jaeger Oxycon Pro (OP). There are systematic errors in the measurements of oxygen consumption (VO2) and respiratory exchange ratio (RER) with the OM. Production of CO2 (VCO2) tends to be overestimated by the OM, although the differences are not significant. Ventilation (VE) showed very similar values in both analyzers. Data of VO2 and RER were corrected with a regression equation which minimised the differences among the devices. The portable metabolic system OM makes systematic errors in measurements of VO2 and RER which can be adjusted with a regression analysis to obtain data comparable to those obtained by fixed systems. Key pointsPortable metabolic systems are frequently used to explore various physiological ventilatory variables in field tests.There are systematic errors in the measurements of oxygen consumption (VO2) and respiratory exchange ratio (RER) with the Jaeger Oxycon Mobile (OM) portable metabolic systemProduction of CO2 (VCO2) tends to be overestimated by the OMData of VO2 and RER can be corrected with a regression equationThe portable metabolic system OM makes systematic errors in measurements of VO2 and RER which can be adjusted with a regression analysis to obtain data comparable to those obtained by fixed systems PMID:24149962

  19. Maximal Oxygen Uptake cannot be Determined in the Incremental Phase of The Lactate Minimum Test on a Cycle Ergometer.

    PubMed

    Miyagi, Willian Eiji; Malta, Elvis de Souza; Zagatto, Alessandro Moura

    2015-06-01

    The aim of this study was to investigate the maximal oxygen uptake (VO2MAX) determined using the incremental phase of the lactate minimum test (LM) on a cycle ergometer. Fifteen trained men were submitted to a graded exercise test (GXT) to evaluate the VO2MAX and LM. The total durations of the GXT and LM were 11.2±1.8 minutes (CI95%:10.2-12.3 minutes) and 25.3±3.2 minutes (CI95%:23.5-27.0), respectively. For the variables measured at exhaustion in both the GXT and LM, the oxygen uptake (54.6 ± 8.1 ml·kg(-1)·min(-1) vs 50.0 ± 7.7 ml·kg(-1)·min(-1)), carbon dioxide production (66.1 ± 7.5 ml·kg(-1)·min(-1) vs 50.4 ± 8.0 ml·kg(-1)·min(-1)), ventilation (153.9 ± 19.0 L·min(-1) vs 129.9 ± 22.9 L·min(-1)), respiratory exchange ratio (1.22 ± 0.10 vs1.01 ± 0.05), maximal power output achieved (331.6 ± 45.8 W vs 242.4 ± 41.0 W), heart rate (183.1 ± 6.9 bpm vs175.9 ± 10.6 bpm) and lactate (10.5 ± 2.3 mmol·L(-1) vs 6.6 ± 2.2 mmol·L(-1)) were statistically lower in the LM (p < 0.05). However, the values of rating of perceived exertion (17.6 ± 2.5 for GXT and 17.2 ± 2.3 for LM) did not differ (ES = 0.12 and CV = 7.8%). There was no good agreement between the values of the VO2MAX from the GXT and VO2PEAK from the LM, as evidenced in the Bland-Altman plot (4.7 ml·kg(-1)·min(-1) and 0.34 L·min(-1) of mean differences, respectively), as well as the high values of the upper and lower limits of agreement. We conclude that the VO2PEAK values obtained in the incremental phase of the LM underestimate the VO2MAX. Key pointsThe VO2MAX is not attained during the incremental phase of the lactate minimum test;The physiological responses at exhaustion during LM are not similar to physiological responses measured during GXT;There is a weak agreement between the peak VO2 measured at exhaustion during LM and the VO2MAX measured during GXT.

  20. Developing a cardiopulmonary exercise testing laboratory.

    PubMed

    Diamond, Edward

    2007-12-01

    Cardiopulmonary exercise testing is a noninvasive and cost-effective technique that adds significant value to the assessment and management of a variety of symptoms and diseases. The penetration of this testing in medical practice may be limited by perceived operational and financial barriers. This article reviews coding and supervision requirements related to both simple and complex pulmonary stress testing. A program evaluation and review technique diagram is used to describe the work flow process. Data from our laboratory are used to generate an income statement that separates fixed and variable costs and calculates the contribution margin. A cost-volume-profit (break-even) analysis is then performed. Using data from our laboratory including fixed and variable costs, payer mix, reimbursements by payer, and the assumption that the studies are divided evenly between simple and complex pulmonary stress tests, the break-even number is calculated to be 300 tests per year. A calculator with embedded formulas has been designed by the author and is available on request. Developing a cardiopulmonary exercise laboratory is challenging but achievable and potentially profitable. It should be considered by a practice that seeks to distinguish itself as a quality leader. Providing this clinically valuable service may yield indirect benefits such as increased patient volume and increased utilization of other services provided by the practice. The decision for a medical practice to commit resources to managerial accounting support requires a cost-benefit analysis, but may be a worthwhile investment in our challenging economic environment.

  1. Incremental Validity of Test Session and Classroom Observations in a Multimethod Assessment of Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    McConaughy, Stephanie H.; Harder, Valerie S.; Antshel, Kevin M.; Gordon, Michael; Eiraldi, Ricardo; Dumenci, Levent

    2010-01-01

    This study tested the incremental validity of behavioral observations, over and above parent and teacher reports, for assessing symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children ages 6 to 12, using the Test Observation Form (TOF) and Direct Observation Form (DOF) from the Achenbach System of Empirically Based Assessment. The…

  2. Incremental Validity of Test Session and Classroom Observations in a Multimethod Assessment of Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    McConaughy, Stephanie H.; Harder, Valerie S.; Antshel, Kevin M.; Gordon, Michael; Eiraldi, Ricardo; Dumenci, Levent

    2010-01-01

    This study tested the incremental validity of behavioral observations, over and above parent and teacher reports, for assessing symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children ages 6 to 12, using the Test Observation Form (TOF) and Direct Observation Form (DOF) from the Achenbach System of Empirically Based Assessment. The…

  3. Proposal of a New Specific Cardiopulmonary Exercise Test for Taekwondo Athletes.

    PubMed

    Araujo, Marcus P; Nóbrega, Antônio C L; Espinosa, Gabriel; Hausen, Matheus R; Castro, Renata R T; Soares, Pedro P; Gurgel, Jonas L

    2017-06-01

    The objective of this study is to evaluate the cardiorespiratory variables of Taekwondo athletes while performing incremental exercise test on an ergometer using a ramp protocol and to propose a specific protocol for assessing these physiological variables during Taekwondo practice. Fourteen athletes participated in 2 incremental exercise tests: a treadmill exercise test (TREADtest) and a Taekwondo-specific exercise test (TKDtest). The TKDtest consists in 1-minute stages of kicks with an incremental load between then. The subjects perform kicks each time a sound signal was heard. Heart rate (HR), oxygen uptake (V[Combining Dot Above]O2), and their reserve correspondents (V[Combining Dot Above]O2R and reserve heart rate [HRR]) were divided into quartiles to verify their kinetics along the tests. Significant difference between 2 tests was found only for V[Combining Dot Above]O2R (p = 0.03). Regarding the quartiles, significant differences were found for HR in the first (p = 0.030) and second (p = 0.003). Analyzing the regression curves, significant differences were found for HR for intercept (p = 0.01) and slope (p = 0.05) and HRR for slope (p = 0.02). Analysis showed that significant reliability, with intraclass correlation coefficient (ICC), was found for the V[Combining Dot Above]O2peak (ICC = 0.855, p = 0.003), V[Combining Dot Above]O2 in ventilatory thresholds 1 (ICC = 0.709, p = 0.03) and 2 (ICC = 0.848, p = 0.003). Bland-Altman analyses reported a mean difference ± the 95% limits of agreement of 2.2 ± 8.4 ml·kg·min to V[Combining Dot Above]O2peak. The TKDtest is reliable for measurement of cardiorespiratory variables, and the behavior of these variables differs mainly from TREADtest, probably because of the motor task performed.

  4. Proposal of a New Specific Cardiopulmonary Exercise Test for Taekwondo Athletes.

    PubMed

    Araujo, Marcus P; Nóbrega, Antônio C L; Espinosa, Gabriel; Hausen, Matheus; Castro, Renata R T; Soares, Pedro P; Gurgel, Jonas L

    2015-12-18

    The objective of this study is to evaluate the cardiorespiratory variables of Taekwondo athletes while performing incremental exercise test on ergometer using a ramp protocol and to propose a specific protocol for assessing these physiological variables during Taekwondo practice. Fourteen athletes participated in two incremental exercise tests: a treadmill exercise test (TREADtest) and a Taekwondo-specific exercise test (TKDtest). The TKDtest consists in one-minute stages of kicks with an incremental load between then. The subjects perform kicks each time a sound signal was heard. Heart rate (HR), oxygen uptake (V[Combining Dot Above]O2), and their reserve correspondents (V[Combining Dot Above]O2R and HRR) were divided into quartiles to verify their kinetics along the tests. Significant difference between two tests was found only for V[Combining Dot Above]O2R (p = 0.03). Regarding the quartiles, significant differences were found for HR in the 1 (p = 0.030) and 2 (p = 0.003). Analyzing the regression curves, significant differences were found for HR for intercept (p = 0.01) and slope (p = 0.05) and HRR for slope (p = 0.02). Analysis showed significant reliability, with intraclass correlation coefficient (ICC), was found for the V[Combining Dot Above]O2PEAK (ICC = 0.855, p = 0.003), V[Combining Dot Above]O2 in ventilatory thresholds 1 (ICC = 0.709, p = 0.03) and 2 (ICC = 0.848, p = 0.003). Bland-Altman analyses reported a mean difference ± the 95% limits of agreement of 2.2 ± 8.4 ml.kg.min to V[Combining Dot Above]O2PEAK. TKDtest is reliable for measurement of cardiorespiratory variables, and the behavior of these variables differs mainly from TREADtest, probably due to the motor task performed.

  5. Evidence that the talk test can be used to regulate exercise intensity.

    PubMed

    Woltmann, Michaela L; Foster, Carl; Porcari, John P; Camic, Clayton L; Dodge, Christopher; Haible, Stephanie; Mikat, Richard P

    2015-05-01

    The Talk Test (TT) has been shown to be a surrogate of the ventilatory threshold and to be a viable alternative to standard methods of prescribing exercise training intensity. The TT has also been shown to be responsive to manipulations known to change physiologic function including blood donation and training. Whether the TT can be used independently to regulated training intensity is not known. Physically active volunteers (N = 16) performed an incremental exercise test to identify stages of the TT (Last Positive [LP], Equivocal [EQ], and Negative [NEG]). In subsequent, randomly ordered, 30-minute steady-state runs, the running velocity was regulated solely by "clamping" the TT response desired and then monitoring the response of conventional markers of exercise intensity (heart rate, blood lactate, rating of perceived exertion). All subjects were able to complete the LP stage, but only 13 of 16 and 2 of 16 subjects were able to complete the EQ and NEG stages, respectively. Physiologic responses were broadly within those predicted from the incremental exercise test and within the appropriate range of physiologic responses for exercise training. Thus, in addition to correlating with convenient physiological markers, the TT can be used proactively to guide exercise training intensity. The LP stage produced training intensities compatible with appropriate training intensity in healthy adults and with recovery sessions or long duration training sessions in athletes. The EQ and NEG stages produced intensities compatible with higher intensity training in athletes. The results demonstrate that the TT can be used as a primary method to control exercise training intensity.

  6. Predictive Accuracy of Exercise Stress Testing the Healthy Adult.

    ERIC Educational Resources Information Center

    Lamont, Linda S.

    1981-01-01

    Exercise stress testing provides information on the aerobic capacity, heart rate, and blood pressure responses to graded exercises of a healthy adult. The reliability of exercise tests as a diagnostic procedure is discussed in relation to sensitivity and specificity and predictive accuracy. (JN)

  7. Predictive Accuracy of Exercise Stress Testing the Healthy Adult.

    ERIC Educational Resources Information Center

    Lamont, Linda S.

    1981-01-01

    Exercise stress testing provides information on the aerobic capacity, heart rate, and blood pressure responses to graded exercises of a healthy adult. The reliability of exercise tests as a diagnostic procedure is discussed in relation to sensitivity and specificity and predictive accuracy. (JN)

  8. Diagnostic value of exercise testing in asbestosis

    SciTech Connect

    Zejda, J. )

    1989-01-01

    The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease.

  9. Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention.

    PubMed

    Cournot, Maxime; Taraszkiewicz, Dorota; Cambou, Jean-Pierre; Galinier, Michel; Boccalon, Henri; Hanaire-Broutin, Hélène; Chamontin, Bernard; Carrié, Didier; Ferrières, Jean

    2009-11-01

    The choice of noninvasive tests used in primary prevention of cardiovascular diseases must be based on medical evidence. The aim of this study was to assess the additional prognostic value, over conventional risk factors, of physical examination, exercise testing, and arterial ultrasonography, in predicting a first coronary event. A prospective cohort study was conducted between 1996 and 2004 (n = 2,709), with follow-up in 2006 (response rate 96.6%). Participants had no history or symptoms of cardiovascular disease and had a standardized physical examination, a cardiac exercise testing, and carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during follow-up. Over the Framingham risk score, femoral bruit, positive exercise test, intima-media thickness >0.63 mm, and a femoral plaque provided significant additional information to the prediction model. The addition of the exercise test to the traditional risk factors, then the intima-media thickness and lastly the presence of femoral plaques, produces incremental increases in the area under the receiver operating characteristic curve (0.73-0.78, P = .02) and about a 50% increase in the positive predictive value (15.8%-31.4%), with no effect on the negative predictive value (96.4%-96.9%). Physical examination, exercise testing, and arterial ultrasonography provide incremental information on the risk of coronary event in asymptomatic adults. Exercise testing and femoral ultrasonography also improve the accuracy of the risk stratification.

  10. Agreement between adherences to four physical activity recommendations in patients with COPD: does the incremental shuttle walk test predict adherence?

    PubMed

    Mitchell, Katy E; Johnson, Vicki; Houchen-Wolloff, Linzy; Sewell, Louise; Morgan, Mike D; Steiner, Michael C; Singh, Sally J

    2016-09-22

    There are various recommendations for physical activity (PA). However agreement between all of these measures has not been established. Furthermore, given the challenges of measuring PA there is interest in evaluating whether a measure of exercise performance can be used as a surrogate measure to identify who is likely to achieve the recommendations. A total of 184 people with COPD were recruited, 128 of which had complete data for these analyses. Participants wore the SenseWear Armband for 7 consecutive days and all performed an incremental shuttle walk test (ISWT). We extracted moderate to vigorous physical activity (MVPA) in bouts of ≥10 min using a 3 metabolic equivalent (MET) threshold and an individually prescribed MET threshold (based on performance on the ISWT). Average daily step count and the physical activity level were also calculated. There was poor agreement between the four PA recommendations, with agreement on all four achieved in only 30 participants. People were least likely to be active using MVPA in ≥10 min bouts using 3 MET threshold (21.1% active), and most likely to be active using MVPA in ≥10 min bouts using an individually prescribed threshold (64.9% active). It was not possible to identify a threshold on the ISWT that would reliably predict those that achieved any of the four recommendations. Agreement between various physical activity recommendations is poor. This should be considered when measuring and describing physical activity adherence. The ISWT cannot be used to reliably predict adherence to physical activity guidelines. © 2016 John Wiley & Sons Ltd.

  11. Marginal increment analysis: a new statistical approach of testing for temporal periodicity in fish age verification.

    PubMed

    Okamura, H; Punt, A E; Semba, Y; Ichinokawa, M

    2013-04-01

    This paper proposes a new and flexible statistical method for marginal increment analysis that directly accounts for periodicity in circular data using a circular-linear regression model with random effects. The method is applied to vertebral marginal increment data for Alaska skate Bathyraja parmifera. The best fit model selected using the AIC indicates that growth bands are formed annually. Simulation, where the underlying characteristics of the data are known, shows that the method performs satisfactorily when uncertainty is not extremely high.

  12. Incremental Change or Initial Differences? Testing Two Models of Marital Deterioration

    PubMed Central

    Lavner, Justin A.; Bradbury, Thomas N.; Karney, Benjamin R.

    2012-01-01

    Most couples begin marriage intent on maintaining a fulfilling relationship, but some newlyweds soon struggle while others continue to experience high levels of satisfaction. Do these diverse outcomes result from an incremental process that unfolds over time, as prevailing models suggest, or are they a manifestation of initial differences that are largely evident at the start of the marriage? Using eight waves of data collected over the first 4 years of marriage (N = 502 spouses, or 251 newlywed marriages), we tested these competing perspectives first by identifying three qualitatively distinct relationship satisfaction trajectory groups and then by determining the extent to which spouses in these groups were differentiated on the basis of (a) initial scores and (b) 4-year changes in a set of established predictor variables, including relationship problems, aggression, attributions, stress, and self-esteem. The majority of spouses exhibited high, stable satisfaction over the first four years of marriage, whereas declining satisfaction was isolating among couples with relatively low initial satisfaction. Across all predictor variables, initial values afforded stronger discrimination of outcome groups than did rates of change in these variables. Thus, readily-measured initial differences are potent antecedents of relationship deterioration, and studies are now needed to clarify the specific ways in which initial indices of risk come to influence changes in spouses’ judgments of relationship satisfaction. PMID:22709260

  13. The geometric curvature of the spine of runners during maximal incremental effort test.

    PubMed

    Campos, Mário Hebling; de Paula, Marcelo Costa; Deprá, Pedro Paulo; Brenzikofer, René

    2015-04-13

    This study sought to analyse the behaviour of the average spinal posture using a novel investigative procedure in a maximal incremental effort test performed on a treadmill. Spine motion was collected via stereo-photogrammetric analysis in thirteen amateur athletes. At each time percentage of the gait cycle, the reconstructed spine points were projected onto the sagittal and frontal planes of the trunk. On each plane, a polynomial was fitted to the data, and the two-dimensional geometric curvature along the longitudinal axis of the trunk was calculated to quantify the geometric shape of the spine. The average posture presented at the gait cycle defined the spine Neutral Curve. This method enabled the lateral deviations, lordosis, and kyphosis of the spine to be quantified noninvasively and in detail. The similarity between each two volunteers was a maximum of 19% on the sagittal plane and 13% on the frontal (p<0.01). The data collected in this study can be considered preliminary evidence that there are subject-specific characteristics in spinal curvatures during running. Changes induced by increases in speed were not sufficient for the Neutral Curve to lose its individual characteristics, instead behaving like a postural signature. The data showed the descriptive capability of a new method to analyse spinal postures during locomotion; however, additional studies, and with larger sample sizes, are necessary for extracting more general information from this novel methodology.

  14. Swimming performance in juvenile shortnose sturgeon (Acipenser brevirostrum): the influence of time interval and velocity increments on critical swimming tests.

    PubMed

    Downie, Adam T; Kieffer, James D

    2017-01-01

    The most utilized method to measure swimming performance of fishes has been the critical swimming speed (UCrit) test. In this test, the fish is forced to swim against an incrementally increasing flow of water until fatigue. Before the water velocity is increased, the fish swims at the water velocity for a specific, pre-arranged time interval. The magnitude of the velocity increments and the time interval for each swimming period can vary across studies making the comparison between and within species difficult. This issue has been acknowledged in the literature, however, little empirical evidence exists that tests the importance of velocity and time increments on swimming performance in fish. A practical application for fish performance is through the design of fishways that enable fish to bypass anthropogenic structures (e.g. dams) that block migration routes, which is one of the causes of world-wide decline in sturgeon populations. While fishways will improve sturgeon conservation, they need to be specifically designed to accommodate the swimming capabilities specific for sturgeons, and it is possible that current swimming methodologies have under-estimated the swimming performance of sturgeons. The present study assessed the UCrit of shortnose sturgeon using modified UCrit to determine the importance of velocity increment (5 and 10 cm s(-1)) and time (5, 15 and 30 min) intervals on swimming performance. UCrit was found to be influenced by both time interval and water velocity. UCrit was generally lower in sturgeon when they were swum using 5cm s(-1) compared with 10 cm s(-1) increments. Velocity increment influences the UCrit more than time interval. Overall, researchers must consider the impacts of using particular swimming criteria when designing their experiments.

  15. Swimming performance in juvenile shortnose sturgeon (Acipenser brevirostrum): the influence of time interval and velocity increments on critical swimming tests

    PubMed Central

    Kieffer, James D.

    2017-01-01

    Abstract The most utilized method to measure swimming performance of fishes has been the critical swimming speed (UCrit) test. In this test, the fish is forced to swim against an incrementally increasing flow of water until fatigue. Before the water velocity is increased, the fish swims at the water velocity for a specific, pre-arranged time interval. The magnitude of the velocity increments and the time interval for each swimming period can vary across studies making the comparison between and within species difficult. This issue has been acknowledged in the literature, however, little empirical evidence exists that tests the importance of velocity and time increments on swimming performance in fish. A practical application for fish performance is through the design of fishways that enable fish to bypass anthropogenic structures (e.g. dams) that block migration routes, which is one of the causes of world-wide decline in sturgeon populations. While fishways will improve sturgeon conservation, they need to be specifically designed to accommodate the swimming capabilities specific for sturgeons, and it is possible that current swimming methodologies have under-estimated the swimming performance of sturgeons. The present study assessed the UCrit of shortnose sturgeon using modified UCrit to determine the importance of velocity increment (5 and 10 cm s−1) and time (5, 15 and 30 min) intervals on swimming performance. UCrit was found to be influenced by both time interval and water velocity. UCrit was generally lower in sturgeon when they were swum using 5cm s−1 compared with 10 cm s−1 increments. Velocity increment influences the UCrit more than time interval. Overall, researchers must consider the impacts of using particular swimming criteria when designing their experiments. PMID:28835841

  16. Optimal mode for maximal aerobic exercise testing in breast cancer survivors.

    PubMed

    Dolan, Lianne B; Lane, Kirstin; McKenzie, Donald C

    2012-12-01

    To determine which mode of exercise is preferred by breast cancer survivors and to evaluate this response between graded exercise testing on a treadmill and on a cycle ergometer. Twelve breast cancer survivors completed 2 maximal aerobic stress tests on separate days. The women completed a ramp protocol on an electronically braked cycle ergometer and an incremental step protocol on a treadmill to volitional fatigue. Test order was randomized. Expired gases were collected for the determination of peak aerobic capacity (Vo (2peak)). Exercise mode had a significant effect on the graded exercise response in breast cancer survivors, P = .003. Treadmill Vo (2peak) was significantly greater than bike Vo (2peak) (28.7 ± 4.7 vs 23.9 ± 4.7 mL/min/kg, respectively, P = .003) and VE(max) was equivalent between exercise modes (P = .731). Maximal heart rate was significantly higher by 11 bpm during the treadmill protocol (P = .004), and Ve/VCo (2) exhibited possible mode dependency (P = .018). This patient population felt more comfortable and produced significantly greater Vo2(peak) values using the treadmill protocol. These results discuss the potential implications concerning the design and interpretation of exercise interventions for breast cancer survivors.

  17. Performance of Fixed Heart Rate Increment Targets of 20 vs 30 Beats per Minute for Exercise Rehabilitation Prescription in Outpatients With Heart Failure.

    PubMed

    Reed, Jennifer L; Blais, Angelica Z; Keast, Marja-Leena; Pipe, Andrew L; Reid, Robert D

    2017-06-01

    Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated. We examined the appropriateness of RHR + 20/30 for prescribing exercise intensity and improving functional capacity for 55 patients with HF in an outpatient CR program. RHR + 20/30 values were compared to % HRR derived from peak exercise testing in patients with HF. Changes in functional capacity as measured by 6-minute walk test (6MWT) distance, and differences in ratings of perceived exertion (RPE), were examined between patients exercising at RHR + 20-29 and those exercising at RHR + ≥ 30. During weeks 1-3 and exercise at RHR + 20, 26% of participants would exercise at 40%-60% HRR. At RHR + 30, 38% would exercise at 40%-60% HRR. During weeks 4-12 and exercise at RHR + 20, 20% of participants would exercise at 50%-80% HRR. At RHR + 30, 41% would exercise at 50%-80% HRR. A smaller change in 6MWT distance was observed in participants exercising at RHR + 20-29 than in those exercising at RHR + ≥ 30 (Δ86.6 ± 70.3 vs Δ135.8 ± 73.7 m; P = 0.005). No differences in RPE were observed between participants exercising at RHR + 20-29 and those exercising at RHR + ≥ 30 (P > 0.05). RHR + 30 was more effective than RHR + 20 in assisting outpatients with HF achieve recommended exercise intensities and improve functional capacity. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. Role of Breathing Conditions During Exercise Testing on Training Prescription in Chronic Obstructive Pulmonary Disease.

    PubMed

    Neunhäuserer, Daniel; Steidle-Kloc, Eva; Bergamin, Marco; Weiss, Gertraud; Ermolao, Andrea; Lamprecht, Bernd; Studnicka, Michael; Niebauer, Josef

    2017-06-21

    This study investigated whether different breathing conditions during exercise testing will influence measures of exercise capacity commonly used for training prescription in chronic obstructive pulmonary disease. Twenty-seven patients with chronic obstructive pulmonary disease (forced expiratory volume in 1 sec = 45.6 [9.4]%) performed three maximal exercise tests within 8 days, but at least 48 hrs apart. Subjects were thereby breathing either room air through a tightly fitting face mask like during any cardiopulmonary exercise test (MASK), room air without mask (No-MASK), or 10 l/min of oxygen via nasal cannula (No-MASK + O2). Cycling protocols were identical for all tests (start = 20 watts, increment = 10 males/5 females watts/min). Maximal work rate (90.4 [33.8], 100.3 [34.8], 107.4 [35.9] watts, P < 0.001) and blood lactate at exhaustion (4.3 [1.5], 5.2 [1.6], 5.0 [1.4] mmol/l, P < 0.001) were lowest for MASK when compared with No-MASK and No-MASK + O2, respectively, whereas maximal heart rate did not differ significantly. Submaximal exertion (Borg rating of perceived exertion = 12-14) was perceived at lower intensity (P = 0.008), but higher heart rate (P = 0.005) when MASK was compared with No-MASK and No-MASK + O2. Different breathing conditions during exercise testing resulted in an 18.8% difference in maximal work rate, likely causing underdosing or overdosing of exercise in chronic obstructive pulmonary disease. Face masks reduced whereas supplemental oxygen increased patients' exercise capacity. For accurate prescription of exercise in chronic obstructive pulmonary disease, breathing conditions during testing should closely match training conditions.

  19. Predicting DMS-IV cluster B personality disorder criteria from MMPI-2 and Rorschach data: a test of incremental validity.

    PubMed

    Blais, M A; Hilsenroth, M J; Castlebury, F; Fowler, J C; Baity, M R

    2001-02-01

    Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed alimited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p <.05). Hierarchical regression analyses showed that both the MMPI and Rorschach data add incrementally in the prediction of DSM-IV borderline and narcissistic PD total criteria scores. The findings were less clear for the incremental value of Rorschach and MMPI-2 data in predicting the total number of DSM-IV histrionic PD criteria, which were best predicted by Rorschach data, and antisocial PD criteria, which were best predicted by MMPI-2 data. In addition to providing evidence of the incremental validity of Rorschach data, these findings also shed light on the psychological characteristics of the DSM-IV Cluster B PDs.

  20. Cardiopulmonary exercise testing in evaluation of patients of chronic obstructive pulmonary disease.

    PubMed

    Ganju, A A; Fuladi, A B; Tayade, B O; Ganju, N A

    2011-01-01

    Objective assessment of severity in patients with chronic obstructive pulmonary disease (COPD) is mainly limited to pulmonary function testing performed at rest. But, accurate assessment of exercise capacity in patients with COPD may be possible with cardiopulmonary exercise testing (CPET). Forty-three patients with stable COPD were included and were divided into three groups based upon the spirometry data as per the Global Initiative for Obstructive Lung Disease (GOLD) guidelines as follows: Group A: mild COPD, Group B: moderately severe COPD and Group C: severe COPD. Symptom-limited CPET was performed using treadmill on incremental continuous ramp protocol in all of them. Five patients (11.6%) had mild COPD; 16 (37.2%) had moderately severe COPD and the remaining 22 (51.6%) patients had severe COPD. Anaerobic threshold was attained in all the 43 patients. The dominant symptom at peak exercise were dyspnoea (n = 19) and both dyspnoea and leg fatigue (n = 7). The other causes of exercise limitation included dyspnoea with significant oxygen desaturation (n = 6); and dyspnoea with severe oxygen desaturation (n = 2). Six patients complained only of leg fatigue at peak exercise. A significant correlation between forced expiratory volume in the first second (FEV1) percent predicted and the predicted maximum oxygen uptake (VO2 max % predicted) was observed in all the three groups (r = 0.39, p = 0.011) but with marked variability of peak VO2 for a given degree of airflow obstruction. Twenty-three (53.5%) patients with low anaerobic threshold (< 30%) were identified as potential group likely to benefit from exercise training for pulmonary rehabilitation. Cardiopulmonary exercise testing is useful to determine the causes of exercise limitation and to assess the maximal exercise capacity of patients with COPD.

  1. Predicting functional capacity during treadmill testing independent of exercise protocol.

    PubMed

    Foster, C; Crowe, A J; Daines, E; Dumit, M; Green, M A; Lettau, S; Thompson, N N; Weymier, J

    1996-06-01

    Clinically useful estimates of VO2max from treadmill tests (GXT) may be made using protocol-specific equations. In many cases, GXT may proceed more effectively if the clinician is free to adjust speed and grade independent of a specific protocol. We sought to determine whether VO2max could be predicted from the estimated steady-state VO2 of the terminal exercise stage. Seventy clinically stable individuals performed GXT with direct measurement of VO2. Exercise was incremented each minute to optimize clinical examination. Measured VO2max was compared to the estimated steady-state VO2 of the terminal stage based on ACSM equations. Equations for walking or running were used based on the patient's observed method of ambulation. The measured VO2max was always less than the ACSM estimate, with a regular relationship between measured and estimated VO2max. No handrail support: VO2max = 0.869.ACSM -0.07; R2 = 0.955, SEE = 4.8 ml.min-1.kg-1 (N = 30). With handrail support: VO2max = 0.694.ACSM + 3.33; R2 = 0.833, SEE = 4.4 ml.min-1.kg-1 (N = 40). The equations were cross-validated with 20 patients. The correlation between predicted and observed values was r = 0.98 and 0.97 without and with handrail support, respectively. The mean absolute prediction error (3.1 and 4.1 ml.min-1.kg-1) were similar to protocol-specific equations. We conclude that VO2max can be predicted independent of treadmill protocol with approximately the same error as protocol-specific equations.

  2. [Relation of pulmonary vascular response to pressure-flow relationship during incremental exercise in patients with chronic obstructive pulmonary disease (COPD)].

    PubMed

    Yamamoto, T; Okada, O; Tanabe, N; Yasuda, J; Satou, K; Saitou, M; Yoshida, Y; Katou, K; Kuriyama, T

    1994-03-01

    Twenty-eight COPD patients underwent right heart catheterization while in clinically stable condition. Pulmonary vascular response to oxygen was evaluated by the percent change in pulmonary arteriolar resistance after 100% oxygen inhalation (% delta PAR), and its relation to the pressure-flow relationship during incremental exercise was assessed. Mean pulmonary arterial pressure (PPA) during exercise was plotted against the cardiac index (C.I.) from rest to maximal exercise in each patient. In most of the patients, the changes in PPA were nearly linear to the C.I. Therefore, a slope could be obtained from the regression equation in each patient. Patients were divided into two groups according to whether their % delta PAR was greater than 20 defined as a responder (RES), or less than five defined as a non-responder (N-RES). Seven out of 28 patients were RES, nine were N-RES, RES showed a higher %FEV1.0 level, C.I. and stroke volume index (S.I.) at maximal exercise, and a lower level of RV/TLC as well as slope. The slope correlated significantly with %DLCO (r = -0.724, p < 0.01), baseline PAR (r = 0.562, p < 0.01) and % delta PAR (r = -0.522, p < 0.01). These results suggest that the diminished pulmonary vascular bed, and the distensibility of pulmonary vessels, appear to contribute to the steepness of the slope and reduced % delta PAR in patients with COPD.

  3. The Incremental Effects of Manual Therapy or Booster Sessions in Addition to Exercise Therapy for Knee Osteoarthritis: A Randomized Clinical Trial.

    PubMed

    Abbott, J Haxby; Chapple, Catherine M; Fitzgerald, G Kelley; Fritz, Julie M; Childs, John D; Harcombe, Helen; Stout, Kirsten

    2015-12-01

    A factorial randomized controlled trial. To investigate the addition of manual therapy to exercise therapy for the reduction of pain and increase of physical function in people with knee osteoarthritis (OA), and whether "booster sessions" compared to consecutive sessions may improve outcomes. The benefits of providing manual therapy in addition to exercise therapy, or of distributing treatment sessions over time using periodic booster sessions, in people with knee OA are not well established. All participants had knee OA and were provided 12 sessions of multimodal exercise therapy supervised by a physical therapist. Participants were randomly allocated to 1 of 4 groups: exercise therapy in consecutive sessions, exercise therapy distributed over a year using booster sessions, exercise therapy plus manual therapy without booster sessions, and exercise therapy plus manual therapy with booster sessions. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score; 0-240 scale) at 1-year follow-up. Secondary outcome measures were the numeric pain-rating scale and physical performance tests. Of 75 participants recruited, 66 (88%) were retained at 1-year follow-up. Factorial analysis of covariance of the main effects showed significant benefit from booster sessions (P = .009) and manual therapy (P = .023) over exercise therapy alone. Group analysis showed that exercise therapy with booster sessions (WOMAC score, -46.0 points; 95% confidence interval [CI]: -80.0, -12.0) and exercise therapy plus manual therapy (WOMAC score, -37.5 points; 95% CI: -69.7, -5.5) had superior effects compared with exercise therapy alone. The combined strategy of exercise therapy plus manual therapy with booster sessions was not superior to exercise therapy alone. Distributing 12 sessions of exercise therapy over a year in the form of booster sessions was more effective than providing 12 consecutive exercise therapy sessions. Providing manual

  4. Decreased oxygen extraction during cardiopulmonary exercise test in patients with chronic fatigue syndrome

    PubMed Central

    2014-01-01

    Background The insufficient metabolic adaptation to exercise in Chronic Fatigue Syndrome (CFS) is still being debated and poorly understood. Methods We analysed the cardiopulmonary exercise tests of CFS patients, idiopathic chronic fatigue (CFI) patients and healthy visitors. Continuous non-invasive measurement of the cardiac output by Nexfin® (BMEYE B.V. Amsterdam, the Netherlands) was added to the cardiopulmonary exercise tests. The peak oxygen extraction by muscle cells and the increase of cardiac output relative to the increase of oxygen uptake (ΔQ’/ΔV’O2) were measured, calculated from the cardiac output and the oxygen uptake during incremental exercise. Results The peak oxygen extraction by muscle cells was 10.83 ± 2.80 ml/100ml in 178 CFS women, 11.62 ± 2.90 ml/100 ml in 172 CFI, and 13.45 ± 2.72 ml/100 ml in 11 healthy women (ANOVA: P=0.001), 13.66 ± 3.31 ml/100 ml in 25 CFS men, 14.63 ± 4.38 ml/100 ml in 51 CFI, and 19.52 ± 6.53 ml/100 ml in 7 healthy men (ANOVA: P=0.008). The ΔQ’/ΔV’O2 was > 6 L/L (normal ΔQ’/ΔV’O2 ≈ 5 L/L) in 70% of the patients and in 22% of the healthy group. Conclusion Low oxygen uptake by muscle cells causes exercise intolerance in a majority of CFS patients, indicating insufficient metabolic adaptation to incremental exercise. The high increase of the cardiac output relative to the increase of oxygen uptake argues against deconditioning as a cause for physical impairment in these patients. PMID:24456560

  5. A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.

    PubMed

    Rector, Neil A; Richter, Margaret A; Lerman, Bethany; Regev, Rotem

    2015-01-01

    The majority of "responders" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD.

  6. HR, V[Combining Dot Above]O2, and RPE Relationships in an Aquatic Incremental Maximum Test Performed by Young Women.

    PubMed

    David, Gabriela B; Andrade, Luana S; Schaun, Gustavo Z; Alberton, Cristine L

    2017-10-01

    David, GB, Andrade, LS, Schaun, GZ, and Alberton, CL. HR, V[Combining Dot Above]O2, and RPE relationships in an aquatic incremental maximum test performed by young women. J Strength Cond Res 31(10): 2852-2858, 2017-The purpose of the study was to verify the relationship between oxygen uptake (V[Combining Dot Above]O2), heart rate (HR), rate of perceived exertion (RPE), and cadence (CAD) in an aquatic incremental maximum test performed during a water-based stationary running exercise. The study also verified the best adjustments for these relationships (linear or polynomial). Thirteen young college women (mean ± SD: 23.15 ± 1.72 years, 21.43 ± 2.09 body mass index) participated in the study. They performed an aquatic incremental maximum test during a water-based stationary running exercise. The experimental protocol started at an initial CAD of 80 b·min, and it was followed by increases of 10 b·min every minute until exhaustion. V[Combining Dot Above]O2, HR, and RPE were measured along the test. Linear and polynomial regression analysis were performed to determine the relationship among the percentage of peak V[Combining Dot Above]O2 (%V[Combining Dot Above]O2peak), percentage of maximal HR (%HRmax), RPE, and CAD to determine the best adjustment for each analysis (α = 0.05). The polynomial regression showed the best adjustments for all analysis. Data revealed a significant relationship (p < 0.001) between %V[Combining Dot Above]O2peak and %HRmax (r = 0.858), %HRmax and RPE (r = 0.823), and %V[Combining Dot Above]O2peak and RPE (r = 0.871). Regarding the relationship between these above-mentioned variables and CAD, all of them were significant (p < 0.001), with r = 0.848 for CAD and %HRmax, r = 0.877 for CAD and %V[Combining Dot Above]O2peak and r = 0.878 for CAD and RPE. It was concluded that all analyzed variables are associated and their relationships are in a polynomial quadratic form. Based on the findings, instructors may use the positive relationships

  7. 'Incremental thermocouple probe' for testing insulation erosion on a rocket motor

    NASA Technical Reports Server (NTRS)

    Gould, Reginald J.

    1993-01-01

    An incremental thermocouple probe was developed to measure insulation erosion during a solid rocket motor firing. The probe's new and unique design is described along with its theory of operation. Data from an actual firing are reported which show that the probe's performance greatly exceeded predictions and present technology as a temperature measurement device and as an event gage.

  8. Impact of an incremental running test on jumping kinematics in endurance runners: can jumping kinematic explain the post-activation potentiation phenomenon?

    PubMed

    García-Pinillos, Felipe; Molina-Molina, Alejandro; Latorre-Román, Pedro Á

    2016-06-01

    This study aimed to determine whether kinematic data during countermovement jump (CMJ) might explain post-activation potentiation (PAP) phenomenon after an exhausting running test. Thirty-three trained endurance runners performed the Léger Test; an incremental test which consists of continuous running between two lines 20 m apart. CMJ performance was determined before (pre-test) and immediately after the protocol (post-test). Sagittal plane, video of CMJs was recorded and kinematic data were obtained throughout 2-Dimensional analysis. In addition to the duration of eccentric and concentric phases of CMJ, hip, knee and ankle angles were measured at four key points during CMJ: the lowest position of the squat, take-off, landing, and at the lowest position after landing. Additionally, heart rate was monitored, and rate of perceived exertion was recorded at post-test. Analysis of variance revealed a significant improvement in CMJ (p = 0.002) at post-test. Cluster analysis grouped according to whether PAP was experienced (responders group: RG, n = 25) or not (non-responders group: NRG, n = 8) relative to CMJ change from rest to post-test. RG significantly improved (p < 0.001) the performance in CMJ, whereas NRG remained unchanged. Kinematic data did not show significant differences between RG and NRG. Thus, the data suggest that jumping kinematic does not provide the necessary information to explain PAP phenomenon after intensive running exercises in endurance athletes.

  9. Cardiopulmonary exercise testing (CPET) as preoperative test before lung resection.

    PubMed

    Kallianos, Anastasios; Rapti, Aggeliki; Tsimpoukis, Sotirios; Charpidou, Andriani; Dannos, Ioannis; Kainis, Elias; Syrigos, Konstantinos

    2014-01-01

    Lung resection is still the only potentially curative therapy for patients with localized non-small lung cancer (NSCLC). However, the presence of cardiovascular comorbidities and underlying lung disease increases the risk of postoperative complications. Various studies have evaluated the use of different preoperative tests in order to identify patients with an increased risk for postoperative complications, associated with prolonged hospital stay and increased morbidity and mortality. In this topic review, we discuss the role of cardiopulmonary exercise testing (CPET) as one of the preoperative tests suggested for lung cancer patients scheduled for lung resection. We describe different types of exercise testing techniques and present algorithms of preoperative evaluation in lung cancer patients. Overall, patients with maximal oxygen consumption (VO2max) <10 mL/kg/min or those with VO2max <15 mL/kg/min and both postoperative FEV1 and DLCO<40% predicted, are at high risk for perioperative death and postoperative cardiopulmonary complications, and thus should be offered an alternative medical treatment option. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  10. Maximal power output during incremental cycling test is dependent on the curvature constant of the power-time relationship.

    PubMed

    Souza, Kristopher Mendes; de Lucas, Ricardo Dantas; do Nascimento Salvador, Paulo Cesar; Guglielmo, Luiz Guilherme Antonacci; Caritá, Renato Aparecido Corrêa; Greco, Camila Coelho; Denadai, Benedito Sérgio

    2015-09-01

    The aim of this study was to investigate whether the maximal power output (Pmax) during an incremental test was dependent on the curvature constant (W') of the power-time relationship. Thirty healthy male subjects (maximal oxygen uptake = 3.58 ± 0.40 L·min(-1)) performed a ramp incremental cycling test to determine the maximal oxygen uptake and Pmax, and 4 constant work rate tests to exhaustion to estimate 2 parameters from the modeling of the power-time relationship (i.e., critical power (CP) and W'). Afterwards, the participants were ranked according to their magnitude of W'. The median third was excluded to form a high W' group (HIGH, n = 10), and a low W' group (LOW, n = 10). Maximal oxygen uptake (3.84 ± 0.50 vs. 3.49 ± 0.37 L·min(-1)) and CP (213 ± 22 vs. 200 ± 29 W) were not significantly different between HIGH and LOW, respectively. However, Pmax was significantly greater for the HIGH (337 ± 23 W) than for the LOW (299 ± 40 W). Thus, in physically active individuals with similar aerobic parameters, W' influences the Pmax during incremental testing.

  11. Exercise Testing and Stress Imaging in Aortic Valve Disease.

    PubMed

    Pierard, Luc A; Dulgheru, Raluca

    2017-07-01

    Aortic valve disease and especially aortic stenosis (AS) is a growing cardiac pathology. Aortic valve replacement (AVR) is still the only treatment with proven benefit on survival in symptomatic patients and in patients with a left ventricular ejection fraction (LVEF) <50%. The benefit of prophylactic AVR in asymptomatic patients is still unproven. Once symptoms develop, the prognosis worsens. Exercise testing has emerged as a tool to unmask the "pseudo-asymptomatic" patients with AS (those without self-reporting symptoms), to link "exercise induced dyspnea" more confidently and more objectively to aortic valve disease and to allow for a safe "watchful waiting strategy" in "pseudo-symptomatic" patients (those with dyspnea unrelated to aortic valve disease). In cases in which exercise testing is unable to link dyspnea to aortic valve disease, exercise stress echocardiography and cardiopulmonary exercise testing may be helpful. Whatever the results of exercise testing with regard to symptom development, an increase in mean aortic valve pressure gradient >18-20 mmHg was associated with an increased risk of cardiac related events in severe AS patients (class IIb indication for AVR in the ESC guidelines). The decrease in LVEF during exercise as well as the development of exercise induced pulmonary hypertension, as revealed by exercise stress echocardiography, may be also useful in the risk stratification of these asymptomatic patients with severe AS. Data on the role of exercise echocardiography in asymptomatic severe aortic regurgitation patients is still scarce and further studies are needed. It seems that an exercise induced decrease in LVEF by 5% may be a better predictor of LV systolic dysfunction after AVR in asymptomatic patients or in patients with minimal symptoms. Exercise testing and exercise echocardiography are safe in the asymptomatic patients with aortic disease, provide useful clinical information that may help in risk assessment of these complicated

  12. Cardiopulmonary Exercise Test: Background, Applicability and Interpretation.

    PubMed

    Herdy, Artur Haddad; Ritt, Luiz Eduardo Fonteles; Stein, Ricardo; Araújo, Claudio Gil Soares de; Milani, Mauricio; Meneghelo, Romeu Sérgio; Ferraz, Almir Sérgio; Hossri, Carlos; Almeida, Antonio Eduardo Monteiro de; Fernandes-Silva, Miguel Morita; Serra, Salvador Manoel

    2016-11-01

    Cardiopulmonary exercise test (CPET) has been gaining importance as a method of functional assessment in Brazil and worldwide. In its most frequent applications, CPET consists in applying a gradually increasing intensity exercise until exhaustion or until the appearance of limiting symptoms and/or signs. The following parameters are measured: ventilation; oxygen consumption (VO2); carbon dioxide production (VCO2); and the other variables of conventional exercise testing. In addition, in specific situations, pulse oximetry and flow-volume loops during and after exertion are measured. The CPET provides joint data analysis that allows complete assessment of the cardiovascular, respiratory, muscular and metabolic systems during exertion, being considered gold standard for cardiorespiratory functional assessment.1-6 The CPET allows defining mechanisms related to low functional capacity that can cause symptoms, such as dyspnea, and correlate them with changes in the cardiovascular, pulmonary and skeletal muscle systems. Furthermore, it can be used to provide the prognostic assessment of patients with heart or lung diseases, and in the preoperative period, in addition to aiding in a more careful exercise prescription to healthy subjects, athletes and patients with heart or lung diseases. Similarly to CPET clinical use, its research also increases, with the publication of several scientific contributions from Brazilian researchers in high-impact journals. Therefore, this study aimed at providing a comprehensive review on the applicability of CPET to different clinical situations, in addition to serving as a practical guide for the interpretation of that test. Resumo O teste cardiopulmonar de exercício (TCPE) vem ganhando importância crescente como método de avaliação funcional tanto no Brasil quanto no Mundo. Nas suas aplicações mais frequentes, o teste consiste em submeter o indivíduo a um exercício de intensidade gradativamente crescente até a exaustão ou o

  13. Results of the International Space Station Interim Resistance Exercise Device Man-in-the-Loop Test

    NASA Technical Reports Server (NTRS)

    Moore, A. D., Jr.; Amonette, W. E.; Bentley, J. R.; Rapley, M. G.; Blazine, K. L.; Loehr, J. A.; Collier, K. R.; Boettcher, C. R.; Skrocki, J. S.; Hohrnann, R. J.

    2004-01-01

    The Interim Resistance Exercise Device (iRED), developed for the International Space Station (ISS), was evaluated using human subjects for a Man-In-The-Loop Test (MILT). Thirty-two human subjects exercised using the iRED in a test that was conducted over a 63-working-day period. The subjects performed the same exercises will be used on board ISS, and the iRED operating constraints that are to be used on ISS were followed. In addition, eight of the subjects were astronauts who volunteered to be in the evaluation in order to become familiar with the iRED and provide a critique of the device. The MILT was scheduled to last for 57,000 exercise repetitions on the iRED. This number of repetitions was agreed to as a number typical of that expected during a 3-person, 17-week ISS Increment. One of the canisters of the iRED failed at the 49,683- repetition mark (87.1% of targeted goal). The remaining canister was operated using the plan for operations if one canister fails during flight (contingency operations). This canister remained functional past the 57,000-repetition mark. This report details the results of the iRED MILT, and lists specific recommendations regarding both operation of the iRED and future resistance exercise device development.

  14. [Clinical exercise testing and the Fick equation: strategic thinking for optimizing diagnosis].

    PubMed

    Perrault, H; Richard, R

    2012-04-01

    This article examines the expected exercise-induced changes in the components of the oxygen transport system as described by the Fick equation with a view to enable a critical analysis of a standard incremental exercise test to identify normal and abnormal patterns of responses and generate hypotheses as to potential physiological and/or pathophysiological causes. The text reviews basic physiological principals and provides useful reminders of standard equations that serve to integrate circulatory, respiratory and skeletal muscle functions. More specifically, the article provides a conceptual and quantitative framework linking the exercise-induced increase in whole body oxygen uptake to central circulatory and peripheral circulatory factors with the view to establish the normalcy of response. Thus, the article reviews the exercise response to cardiac output determinants and provides qualitative and quantitative perspective bases for making assumptions on the peripheral circulatory factors and oxygen use. Finally, the article demonstrates the usefulness of exercise testing as an effective integrative physiological approach to develop clinical reasoning or verify pathophysiological outcomes. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  15. Consistency of the counting talk test for exercise prescription.

    PubMed

    Loose, Brant D; Christiansen, Ann M; Smolczyk, Jill E; Roberts, Kelsey L; Budziszewska, Anna; Hollatz, Crystal G; Norman, Joseph F

    2012-06-01

    The purpose of this study was to assess the consistency of the counting talk test (CTT) method for estimating exercise intensity across various modes of exercise in healthy young adults. Thirty-six individuals completed the study, which required participation in 3 separate sessions within a 2-week time period. During the first session, the individuals completed a maximal effort treadmill test from which each individual's heart rate reserve (HRR) was calculated. During the second and third sessions, the subjects participated in 2 modes of exercise in each session for a total of 4 different modes of exercise. The individuals exercised at 40% HRR, 50% HRR, 60% HRR, 75% HRR, and 85% HRR. The heart rate (HR), CTT, and rating of perceived exertion (RPE) were recorded at each workload. Based on the individual's resting CTT (CTT(rest)), the %CTT for each exercise stage was then calculated. Pearson correlations demonstrated moderate to good correlations between the CTT and HRR methods and the CTT and RPE methods for estimating exercise intensity. This study found that for the individuals with CTT(rest) <25, moderate to vigorous intensity exercise as recommended by the American College of Sports Medicine HRR guidelines could be achieved by exercising at a level of 40-50% CTT(rest). Individuals with a CTT(rest) ≥25, exercising at a level of 30-40% CTT(rest) would place them in the moderate to vigorous exercise intensity range. A high degree of reliability was demonstrated using the CTT method across the various modes of aerobic exercise. As such, independent of the exercise mode, the CTT was found to be an easy and consistent method for prescribing moderate to vigorous aerobic exercise intensity.

  16. The Utility of Exercise Testing in Patients with Lung Cancer.

    PubMed

    Ha, Duc; Mazzone, Peter J; Ries, Andrew L; Malhotra, Atul; Fuster, Mark

    2016-09-01

    The harm associated with lung cancer treatment include perioperative morbidity and mortality and therapy-induced toxicities in various organs, including the heart and lungs. Optimal treatment therefore entails a need for risk assessment to weigh the probabilities of benefits versus harm. Exercise testing offers an opportunity to evaluate a patient's physical fitness/exercise capacity objectively. In lung cancer, it is most often used to risk-stratify patients undergoing evaluation for lung cancer resection. In recent years, its use outside this context has been described, including in nonsurgical candidates and lung cancer survivors. In this article we review the physiology of exercise testing and lung cancer. Then, we assess the utility of exercise testing in patients with lung cancer in four contexts (preoperative evaluation for lung cancer resection, after lung cancer resection, lung cancer prognosis, and assessment of efficiency of exercise training programs) after systematically identifying original studies involving the most common forms of exercise tests in this patient population: laboratory cardiopulmonary exercise testing and simple field testing with the 6-minute walk test, shuttle walk test, and/or stair-climbing test. Lastly, we propose a conceptual framework for risk assessment of patients with lung cancer who are being considered for therapy and identify areas for further studies in this patient population.

  17. Cardiopulmonary exercise testing early after stroke using feedback-controlled robotics-assisted treadmill exercise: test-retest reliability and repeatability.

    PubMed

    Stoller, Oliver; de Bruin, Eling D; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A; Hunt, Kenneth J

    2014-10-11

    Exercise capacity is seriously reduced after stroke. While cardiopulmonary assessment and intervention strategies have been validated for the mildly and moderately impaired populations post-stroke, there is a lack of effective concepts for stroke survivors suffering from severe motor limitations. This study investigated the test-retest reliability and repeatability of cardiopulmonary exercise testing (CPET) using feedback-controlled robotics-assisted treadmill exercise (FC-RATE) in severely motor impaired individuals early after stroke. 20 subjects (age 44-84 years, <6 month post-stroke) with severe motor limitations (Functional Ambulatory Classification 0-2) were selected for consecutive constant load testing (CLT) and incremental exercise testing (IET) within a powered exoskeleton, synchronised with a treadmill and a body weight support system. A manual human-in-the-loop feedback system was used to guide individual work rate levels. Outcome variables focussed on standard cardiopulmonary performance parameters. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean difference, limits of agreement, and coefficient of variation (CoV) were estimated to assess repeatability. Peak performance parameters during IET yielded good to excellent relative reliability: absolute peak oxygen uptake (ICC =0.82), relative peak oxygen uptake (ICC =0.72), peak work rate (ICC =0.91), peak heart rate (ICC =0.80), absolute gas exchange threshold (ICC =0.91), relative gas exchange threshold (ICC =0.88), oxygen cost of work (ICC =0.87), oxygen pulse at peak oxygen uptake (ICC =0.92), ventilation rate versus carbon dioxide output slope (ICC =0.78). For these variables, SEM was 4-13%, MDC 12-36%, and CoV 0.10-0.36. CLT revealed high mean differences and insufficient test-retest reliability for all variables studied. This study presents

  18. Cardiopulmonary exercise testing following bilateral thoracoscopic sympathicolysis in patients with essential hyperhidrosis.

    PubMed Central

    Noppen, M.; Herregodts, P.; Dendale, P.; D'Haens, J.; Vincken, W.

    1995-01-01

    BACKGROUND--Essential hyperhidrosis is characterised by an overactivity of the sympathetic fibres passing through the upper dorsal sympathetic ganglia D2-D3. Anatomical interruption at the D2-D3 level is a highly effective treatment for essential hyperhidrosis but also causes (partial) cardiac denervation and, after surgical sympathicolysis, important impairment of cardiopulmonary exercise function has been observed. The purpose of this study was to compare the results of cardiopulmonary exercise testing between patients with essential hyperhidrosis and a normal control population, and to examine the effects of thoracoscopic D2-D3 sympathicolysis on cardiopulmonary exercise capacity in patients with essential hyperhidrosis. METHODS--maximal, symptom limited incremental exercise tests were performed in 26 patients with severe essential hyperhidrosis one week before and one month after D2-D3 thoracoscopic sympathicolysis, and in 14 age and sex matched healthy volunteers. D2-D3 thoracoscopic sympathicolysis was performed using a simplified one stage bilateral procedure. RESULTS--Palmar hyperhidrosis was relieved in every patient, confirming the D2-D3 denervation. A higher peak heart rate (7%) was seen in the patient group than in the normal subjects, but ll other cardiovascular, metabolic, and respiratory parameters were similar. After D2-D3 thoracoscopic sympathicolysis, heart rate at rest (13%) and at peak exercise (7%) were reduced, together with an increase in oxygen pulse. All other parameters remained unchanged. CONCLUSIONS--Sympathetic overactivity relevant to cardiovascular function in essential hyperhidrosis is evident only during sympathetic stimulation. D2-D3 thoracoscopic sympathicolysis causes a small and asymptomatic reduction in maximal and resting heart rate and is not associated with a decrease in exercise capacity, in contrast with the detrimental effects on exercise capacity of open surgical sympathectomy. PMID:7491560

  19. Clinical experience of a new reference material for exercise capacity in exercise stress testing in Sweden.

    PubMed

    Lindow, Thomas; Mosén, Henrik; Engblom, Henrik

    2017-09-21

    In 2014, the Swedish Association of Clinical Physiology recommended the use of a new reference material for exercise capacity in bicycle exercise stress testing, 'the Kalmar material'. Compared to the formerly used reference material, 'the Kristianstad material', an increase in the amount of patients being classified as having decreased exercise capacity was expected, but the extent of this in clinical practice is not known. Results of exercise capacity from 1449 bicycle exercise tests, in patients aged ≥20 years (656 women, 793 men) performed at two departments of Clinical Physiology before and after change of reference materials, were collected. Maximal workload was related to the predicted values of both reference materials. If made, recommendations for supplemental nuclear myocardial perfusion imaging study by the attending physician were noted. Using the new reference material, 31% of all patients were classified as having a decreased exercise capacity, compared to 17% using the formerly used reference material. The difference between the two reference materials was largest in the older age groups. In one of the departments, an increase in recommendations of supplemental myocardial perfusion studies was seen after introduction of the new reference material, whereas the opposite was seen at the other department. A large amount of patients are being classified as having decreased exercise capacity and very few as having good exercise capacity using the new reference material for exercise capacity. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  20. Utility of a Non-Exercise VO2max Prediction Model for Designing Ramp Test Protocols.

    PubMed

    Cunha, F A; Midgley, A; Montenegro, R; Vasconcellos, F; Farinatti, P

    2015-10-01

    This study investigated the validity of determining the final work rates of cycling and walking ramp-incremented maximal cardiopulmonary exercise tests (CPETs) using a non-exercise model to predict maximal oxygen uptake VO2max and the American College of Sports Medicine ACSM's metabolic equations. The validity of using this methodology to elicit the recommended test duration of between 8 and 12 min was then evaluated. First, 83 subjects visited the laboratory once to perform a cycling (n=49) or walking (n=34) CPET to investigate the validity of the methodology. Second, 25 subjects (cycling group: n=13; walking group: n=12) performed a CPET on 2 separate days to test the reliability of CPET outcomes. Observed VO2max was 1.0 ml·kg(-1)·min(-1) lower than predicted in the cycling CPET (P=0.001) and 1.4 ml·kg(-1)·min(-1) lower in the walking CPET (P=0.001). Only one of the 133 conducted CPETs was outside the test duration range of 8-12 min. Test-retest reliability was high for all CPET outcomes, with intraclass correlation coefficients of 0.90 to 0.99. In conclusion, the non-exercise model is a valid and reliable method for establishing the final work rate of cycling and walking CPETs for eliciting test durations of between 8 and 12 min.

  1. The cardiokymography exercise test compared to the thallium-201 perfusion exercise test in the diagnosis of coronary artery disease

    SciTech Connect

    Burke, J.F.; Morganroth, J.; Soffer, J.; Panidis, I.; Chen, C.C.; David, D.

    1984-04-01

    To determine the usefulness of exercise cardiokymography (CKG) compared to thallium-201 perfusion scanning in the diagnosis of coronary artery disease (CAD), 179 patients with a mean age of 54 +/- 10 years (73% men) were studied. Previously documented CAD was present in 73 patients (41%); 13 (7%) were asymptomatic and 93 (53%) had chest pain syndrome. Exercise stress testing, CKG, and thallium-201 perfusion scanning were independently correlated with coronary angiographic data. Treadmill exercise stress test alone without CKG had a sensitivity of 68% and specificity of 62%. CKG showed a sensitivity of 76% and a specificity of 90%, and easily interpreted cardiokymograms were obtained in 78% of patients studied. Thallium-201 scans had a sensitivity of 79% and a specificity of 88%. However, when the CKG and treadmill exercise test results were concordant (both positive or both negative), the CKG exercise test had a sensitivity of 87% and specificity of 100%. Thus, when the CKG and exercise test results are concordant, the sensitivity and specificity are equal to or better than thallium-201 perfusion scanning for the prediction of CAD. Since CKG is an inexpensive and noninvasive test, its adjunctive use with routine exercise stress testing may be of great value.

  2. Prognostic value of exercise capacity in patients with coronary artery disease: the FIT (Henry Ford ExercIse Testing) project.

    PubMed

    Hung, Rupert K; Al-Mallah, Mouaz H; McEvoy, John W; Whelton, Seamus P; Blumenthal, Roger S; Nasir, Khurram; Schairer, John R; Brawner, Clinton; Alam, Mohsen; Keteyian, Steven J; Blaha, Michael J

    2014-12-01

    To examine the prognostic value of exercise capacity in patients with nonrevascularized and revascularized coronary artery disease (CAD) seen in routine clinical practice. We analyzed 9852 adults with known CAD (mean ± SD age, 61±12 years; 69% men [n=6836], 31% black race [n=3005]) from The Henry Ford ExercIse Testing (FIT) Project, a retrospective cohort study of patients who underwent physician-referred stress testing at a single health care system between January 1, 1991, and May 31, 2009. Patients were categorized by revascularization status (nonrevascularized, percutaneous coronary intervention [PCI], or coronary artery bypass graft [CABG] surgery) and by metabolic equivalents (METs) achieved on stress testing. Using Cox regression models, hazard ratios for mortality, myocardial infarction (MI), and downstream revascularizations were calculated after adjusting for potential confounders, including cardiac risk factors, pertinent medications, and stress testing indication. There were 3824 all-cause deaths during median follow-up of 11.5 years. In addition, 1880 MIs, and 1930 revascularizations were ascertained. Each 1-MET increment in exercise capacity was associated with a hazard ratio (95% CI) of 0.87 (0.85-0.89), 0.87 (0.85-0.90), and 0.86 (0.84-0.89) for mortality; 0.98 (0.96-1.01), 0.88 (0.84-0.92), and 0.93 (0.90-0.97) for MI; and 0.94 (0.92-0.96), 0.91 (0.88-0.95), and 0.96 (0.92-0.99) for downstream revascularizations in the nonrevascularized, PCI, and CABG groups, respectively. In each MET category, the nonrevascularized group had similar mortality risk as and higher MI and downstream revascularization risk than the PCI and CABG surgery groups (P<.05). Exercise capacity was a strong predictor of mortality, MI, and downstream revascularizations in this cohort. Furthermore, patients with similar exercise capacities had an equivalent mortality risk, irrespective of baseline revascularization status. Copyright © 2014 Mayo Foundation for Medical Education

  3. Cardiopulmonary exercise testing (CPET) in pulmonary emphysema.

    PubMed

    Paoletti, Patrizia; De Filippis, Francesca; Fraioli, Francesco; Cinquanta, Alessandra; Valli, Gabriele; Laveneziana, Pierantonio; Vaccaro, Francesco; Martolini, Dario; Palange, Paolo

    2011-12-15

    In patients affected by chronic obstructive pulmonary disease (COPD), cardiopulmonary response to exercise was never related to the severity of emphysema (E) measured by high resolution computed tomography (HRCT). Sixteen patients (age=65±8 yrs; FEV(1)=54±18%pred; RV=160±28%pred) with moderate to severe E (quantified by lung HRCT as % voxels <-910 HU) were exercised on a cycle-ergometer to exhaustion. Oxygen uptake (V˙(O2)), carbon dioxide output (V˙(CO2)), ventilation (V˙(E)), tidal volume (V(T)), and end-tidal P(CO2) (PET(CO2)) derived variables were measured breath-by-breath. The % of E correlated with: (1) the ratio V(Tpeak) (r=0.74; p=0.001); (2) the V˙(E)/V˙(CO2) slope (r=-0.77; p=0.0004); (3) PET(CO2) values at peak exercise (r=0.80; p=0.0001). Also, the %E was strongly predicted by the following exercise equation: %E(EST) = 58.1 + 11.9 × ΔV˙(E)/V˙(CO2) (r=0.94; p<0.0001). A V(Tpeak)/FEV1 ratio>1 is typically observed in severe E patients; furthermore, the V˙(E)/V˙(CO2) slope and the PET(CO2peak) values decrease and increase respectively as more as the emphysema is severe.

  4. Exercise Test Performance Reveals Evidence of the Cardiorespiratory Fitness Hypothesis.

    PubMed

    Billinger, Sandra A; Vidoni, Eric D; Morris, Jill K; Thyfault, John P; Burns, Jeffrey M

    2017-04-01

    Positive physiologic and cognitive responses to aerobic exercise have resulted in a proposed cardiorespiratory (CR) fitness hypothesis in which fitness gains drive changes leading to cognitive benefit. The purpose of this study was to directly assess the CR fitness hypothesis. Using data from an aerobic exercise trial, we examined individuals who completed cardiopulmonary and cognitive testing at baseline and 26 weeks. Change in cognitive test performance was not related to CR fitness change (r(2) = .06, p = .06). However, in the subset of individuals who gave excellent effort during exercise testing, change in cognitive test performance was related to CR fitness change (r(2) = .33, p < .01). This was largely due to change in the cognitive domain of attention (r(2) = .36, p < .01). The magnitude of change was not explained by duration of exercise. Our findings support further investigation of the CR fitness hypothesis and mechanisms by which physiologic adaptation may drive cognitive change.

  5. Pediatric Exercise Testing: Value and Implications of Peak Oxygen Uptake

    PubMed Central

    Pianosi, Paolo T.; Liem, Robert I.; McMurray, Robert G.; Cerny, Frank J.; Falk, Bareket; Kemper, Han C. G.

    2017-01-01

    Peak oxygen uptake (peakV˙O2) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. PeakV˙O2 was shown to predict longevity in patients aged 7–35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peakV˙O2 as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peakV˙O2, and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics. PMID:28125022

  6. Pediatric Exercise Testing: Value and Implications of Peak Oxygen Uptake.

    PubMed

    Pianosi, Paolo T; Liem, Robert I; McMurray, Robert G; Cerny, Frank J; Falk, Bareket; Kemper, Han C G

    2017-01-24

    Peak oxygen uptake (peak V ˙ O 2 ) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak V ˙ O 2 was shown to predict longevity in patients aged 7-35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak V ˙ O 2 as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peak V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.

  7. The talk test as a marker of exercise training intensity.

    PubMed

    Foster, Carl; Porcari, John P; Anderson, Jennifer; Paulson, Melissa; Smaczny, Denise; Webber, Holly; Doberstein, Scott T; Udermann, Brian

    2008-01-01

    Correlative data have suggested that the Talk Test (TT) may be a surrogate of the ventilatory threshold (VT). This study examined manipulations of either the VT or exercise protocol to test the hypothesis that the TT and VT are related in a robust way, adequate for exercise prescription. Healthy young adults participated in 4 independent series of experiments designed to decrease (blood donation) or increase (training) VT, or to systematically vary the exercise intensity above and below VT. These interventions were matched to responses of the TT. The changes in the exercise intensity at VT and at the last positive stage of the TT matched each other following both blood donation and training. When exercise intensity was varied above and below VT, the predicted ability to speak was well matched to observations of the TT. Predictive errors biased toward passing the TT when exercise intensity was greater than VT. The time required for the result of TT to become negative when exercise intensity was more than VT, decreased with increasing intensity but averaged more than the 2 minutes that has been used in previous studies. This study confirms the robust relationship between VT and the TT during various interventions and suggests that the TT is suitable for exercise prescription.

  8. [Chronic obstructive pulmonary disease: evaluation of exercise tolerance using three different exercise tests].

    PubMed

    Montes de Oca, M; Ortega Balza, M; Lezama, J; López, J M

    2001-02-01

    The clinical usefulness of simple exercise tests in patients with chronic obstructive pulmonary disease (COPD) continues to give rise to debate. Questions remain about whether these tests assess maximum effort or only exercise tolerance (submaximal effort). To determine the levels of stress reached during the six-minute walking (6MW) test and stair climbing (SC) test and their relation to maximum aerobic capacity, 50 patients with COPD (FEV1 49 +/- 19%) were studied. Data collected included spirometric variables and VO2, heart rate (HR), ventilatory response and dyspnea during the progressive effort ergometric cycle (PEEC) test. Two 6MW and SC tests were completed on two separate days, with distance, number of steps, HR and dyspnea recorded. HR was higher during the PEEC test. Among the simple tests, SC caused a faster HR than did the 6MW test. Likewise, a significant linear relation was observed between VO2/kgpeak during the 6MW test (r2 = 0.27; p < 0.05) and the SC test (r2 = 0.33; p < 0.01). We therefore conclude that exercise tolerance in patients with COPD can be evaluated using simple stress tests. The SC test is probably the best simple way to determine maximum functional capacity, whereas the 6MW test can be reserved for measurement of exercise tolerance.

  9. Improved reclassification of mortality risk by assessment of physical activity in patients referred for exercise testing.

    PubMed

    Myers, Jonathan; Nead, Kevin T; Chang, Peter; Abella, Joshua; Kokkinos, Peter; Leeper, Nicholas J

    2015-04-01

    Inability to meet minimal guidelines on physical activity is associated with poor health outcomes, but quantifying activity can be complex. We studied whether a simple question regarding participation in regular activity improves risk classification for all-cause mortality. Maximal exercise testing was performed in 6962 patients (mean age, 58.9 ± 11 years) for clinical reasons. Subjects also were assessed for participation in regular activity using a simple yes/no response to meeting minimal recommendations on activity. The incremental value of adding a simple physical activity assessment to clinical, demographic, and exercise test information to predict mortality was determined using Cox proportional hazards models, net reclassification improvement, and integrated discrimination index during a mean follow-up of 9.7 ± 4 years. Subjects who did not meet the minimal guidelines on activity had a lower exercise capacity (7.4 ± 4.3 vs 9.1 ± 3.6 metabolic equivalents, P < .0001) and a higher annual mortality rate (2.42% vs 1.71%, P < .001). Not meeting activity guidelines was associated with an age-adjusted 36% higher risk of mortality (hazard ratio, 1.36; 95% confidence interval, 1.22-1.51, P < .0001). Among clinical and exercise test variables, fitness had the highest C-index for predicting mortality (0.72, P < .001). The addition of physical activity classification to a model including traditional risk factors resulted in a net reclassification improvement of 22.8% (P < .001); adding fitness to the traditional risk factor model resulted in a net reclassification improvement of 43.5% (P < .001). The addition of a simple assessment of physical activity status significantly improves reclassification of risk for all-cause mortality among patients who are referred for exercise testing. Published by Elsevier Inc.

  10. Blood Pressure Response to Submaximal Exercise Test in Adults

    PubMed Central

    Szmigielska, Katarzyna; Leszczynska, Joanna; Jegier, Anna

    2016-01-01

    Background. The assessment of blood pressure (BP) response during exercise test is an important diagnostic instrument in cardiovascular system evaluation. The study aim was to determine normal values of BP response to submaximal, multistage exercise test in healthy adults with regard to their age, gender, and workload. Materials and Methods. The study was conducted in randomly selected normotensive subjects (n = 1015), 512 females and 498 males, aged 18–64 years (mean age 42.1 ± 12.7 years) divided into five age groups. All subjects were clinically healthy with no chronic diseases diagnosed. Exercise stress tests were performed using Monark bicycle ergometer until a minimum of 85% of physical capacity was reached. BP was measured at rest and at peak of each exercise test stage. Results. The relations between BP, age, and workload during exercise test were determined by linear regression analysis and can be illustrated by the equations: systolic BP (mmHg) = 0.346 × load (W) + 135.76 for males and systolic BP (mmHg) = 0.103 × load (W) + 155.72 for females. Conclusions. Systolic BP increases significantly and proportionally to workload increase during exercise test in healthy adults. The relation can be described by linear equation which can be useful in diagnostics of cardiovascular diseases. PMID:27703976

  11. Ventilatory and Metabolic Response in the Incremental Shuttle and 6-Min Walking Tests Measured by Telemetry in Obese Patients Prior to Bariatric Surgery.

    PubMed

    Oliver, Nicole; Onofre, Tatiana; Carlos, Renata; Barbosa, Juliana; Godoy, Eudes; Pereira, Eliane; Guerra, Ricardo O; Bruno, Selma

    2015-09-01

    Low cardiopulmonary fitness, measured by oxygen uptake peak (VO 2pk), is associated with postoperative complications and mortality. Obese people have difficulty in performing the cardiopulmonary exercise test, which requires maximal exertion. The incremental shuttle walking test (ISWT) and 6-min walking test (6MWT) have been used to assess cardiorespiratory capacity, mortality, and complications in the postoperative phase. However, the physiological response elicited by these tests in obese people is unknown. This study analyzed and compared cardiopulmonary fitness (oxygen uptake [VO2] and CO2 output [VCO2]) in the ISWT and 6MWT in obese adults using a telemetry system. Fifteen obese patients (10 women; mean age 39.4 ± 10.1 years; mean body mass index 43.5 ± 6.8 kg/m(2)) with normal forced vital capacity (% FVC 93.7) performed the 6MWT and ISWT in the field in this cross-sectional study. Metabolic (VO 2pk, VCO2) and respiratory (minute ventilation; VE) variables were recorded using telemetry. Obese patients performed the ISWT with an incremental and exponential cardiopulmonary response, with higher VO 2pk (15.4 ± 2.9 ml/kg/min), VCO2 (1.7 ± 0.7 l/min), and VE (51.4 ± 21.3 l/min) than the 6MWT (VO 2pk = 13.2 ± 2.59 ml/kg/min, VCO2 = 1.4 ± 0.6 l/min; VE = 41.2 ± 16.6 l/min (all p < 0.01). They also demonstrated more effort intensity, assessed by VO2, (p = 0.006) and heart rate (p = 0.04) in the ISWT than the 6MWT. In the 6MWT, patients showed a fast rise in ventilatory and metabolic response, reaching a plateau. The ISWT test generated superior metabolic and ventilatory stress than the 6MWT and may be more suitable for assessing cardiopulmonary fitness than self-paced tests.

  12. Patterning of affective responses during a graded exercise test in children and adolescents.

    PubMed

    Benjamin, Charlotte C; Rowlands, Alex; Parfitt, Gaynor

    2012-05-01

    Past studies have shown the patterning of affective responses during a graded exercise test (GXT) in adult and male adolescent populations, but none have explored the patterns in adolescent girls or younger children. This study explored the patterning of affective responses during a GXT in adolescents and younger children. Forty-nine children (21 male and 28 female) aged between 8-14 years (10.8 ± 1.8 years) completed a GXT. Ventilatory threshold (VT) was identified. At the end of each incremental step, participants reported affective valence. Results revealed that affective valence assessed by the Feeling Scale (FS) significantly declined from the onset of exercise until the point of VT in the younger children, but remained relatively stable in the adolescents. Exercise above the VT brought about significant declines in affective valence regardless of age or sex, but the decrease was significantly greater in adolescents. Results suggest it may be preferable to prescribe lower exercise intensities (below VT) for children, compared with adolescents, to ensure a positive affective response.

  13. An MR-compatible bicycle ergometer for in-magnet whole-body human exercise testing.

    PubMed

    Jeneson, Jeroen A L; Schmitz, Joep P J; Hilbers, Peter A J; Nicolay, Klaas

    2010-01-01

    An MR-compatible ergometer was developed for in-magnet whole-body human exercise testing. Designed on the basis of conventional mechanically braked bicycle ergometers and constructed from nonferrous materials, the ergometer was implemented on a 1.5-T whole-body MR scanner. A spectrometer interface was constructed using standard scanner hardware, complemented with custom-built parts and software to enable gated data acquisition during exercise. High-quality 31P NMR spectra were reproducibly obtained from the medial head of the quadriceps muscle of the right leg of eight healthy subjects during two-legged high-frequency pedaling (80 revolutions per minute) at three incremental workloads, including maximal. Muscle phosphocreatine content dropped 82%, from 32.2+/-1.0 mM at rest to 5.7+/-1.1 mM at maximal workload (mean+/-standard error; n=8), indicating that the majority of quadriceps motor units were recruited. The cardiovascular load of the exercise was likewise significant, as evidenced by heart rates of 150 (+/-10%) beats per minute, measured immediately afterward. As such, the newly developed MR bicycling exercise equipment offers a powerful new tool for clinical musculoskeletal and cardiovascular MR investigation. The basic design of the ergometer is highly generic and adaptable for application on a wide selection of whole-body MR scanners.

  14. Reference values for cardiopulmonary exercise testing in healthy volunteers: the SHIP study.

    PubMed

    Koch, B; Schäper, C; Ittermann, T; Spielhagen, T; Dörr, M; Völzke, H; Opitz, C F; Ewert, R; Gläser, S

    2009-02-01

    Cardiopulmonary exercise testing (CPET) is a widely applied clinical procedure. The aim of the present study was to acquire a comprehensive set of reference values for cardiopulmonary responses to exercise and to evaluate possible associations with sex, age and body mass index (BMI). A standardised progressive incremental exercise protocol on a cycle ergometer was applied to 1,708 volunteers of a cross-sectional epidemiologic survey, called "Study of Health in Pomerania". Individuals with cardiopulmonary disorders, or echocardiographic or lung function pathologies, were excluded. The influence of potential confounding factors, such as smoking, taking beta-blockers, hypertension, diastolic dysfunction, BMI and physical activity, were analysed for their influencing power. Reference values of CPET parameters were determined by regression analyses. Of the volunteers, 542 current smokers and obese individuals were excluded for not being representative of a healthy population. The final sample size was 534 (253 males), with age 25-80 yrs. The current study provides a representative set of reference values for CPET parameters based on age and weight. Sex and age have a significant influence on exercise parameters. While addressing the problem of a selection bias, the current study provides the first comprehensive set of reference values obtained in a large number of healthy volunteers within a population-based survey.

  15. A prognostic scoring system for arm exercise stress testing

    PubMed Central

    Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, Wade H

    2016-01-01

    Objective Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. Methods In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI). Results Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all p<0.01). A score based on the relation HRR (bpm)+7.3×METs−10.5×ST depression (0=no; 1=yes) prognosticated 5-year cardiovascular mortality with a C-statistic of 0.81 before and 0.88 after adjustment for significant demographic and clinical covariates. Arm exercise scores for the other outcome end points yielded C-statistic values of 0.77–0.79 before and 0.82–0.86 after adjustment for significant covariates versus 0.64–0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period. Conclusions Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise. PMID:26835142

  16. Effects of light deprivation in physical performance and psychophysiological responses to a time-to-exhaustion exercise test.

    PubMed

    Pinheiro, Fabiano A; Santos, Tony M; Ugrinowitsch, Carlos; Noakes, Timothy D; Pires, Flávio O

    2015-11-01

    Studies have shown that there is no effect of light deprivation in closed-loop exercise performance, however less is known about the open-loop exercise performance. Thus, we verified if light deprivation may affect performance and psychophysiological responses to a time-to-exhaustion (TE), constant intensity exercise test. Twelve men performed TE tests (at 80% WPEAK of maximal incremental test) in control and light-deprived condition. Gaseous exchange (VE and VO2), heart rate (HR) and vastus lateralis electromyography (EMG) were continuously assessed, ratings of perceived exertion (RPE) and associative thoughts to exercise (ATE) were obtained every 60s. Responses at absolute time of exercise matched by the shortest time to exhaustion, and responses at exhaustion were compared between conditions (P<0.05). Exhaustion was shortened (5.0 ± 1.6 min vs 6.4 ± 2.4 min) and RPE slope was elevated in light deprivation, when compared to control (P<0.05). Responses of VE, VO2 and RPE were greater at exhaustion in light deprivation TE test than at the equivalent, paired time in control test. However, responses were similar at exhaustion of both TE tests; the exception was the lower EMG when the light was deprived. The light deprivation shortened the exhaustion and increased RPE in TE test, until the attainment of similar maximal psychophysiological responses.

  17. Use of transcutaneous oxygen and carbon dioxide tensions for assessing indices of gas exchange during exercise testing.

    PubMed

    Carter, R; Banham, S W

    2000-04-01

    The slow response characteristics of the combined transcutaneous electrode have been viewed as a major disadvantage when compared with other types of non-invasive assessment of gas exchange during exercise testing. We have previously shown that by using the highest recommended temperature of 45 degrees C to reduce response times, and combining this with an exercise protocol of gradual work load increments, that this allows changes in arterial blood gases to be closely followed by transcutaneous values. In the present study we have validated the use of a transcutaneous electrode for estimation of alveolar-arterial oxygen gradient (AaO2) and dead space to tidal volume ratio (V(D)/V(T)) during exercise, against values calculated from direct arterial blood gas analysis. One hundred measurements were made in 20 patients with various cardiopulmonary disorders who underwent exercise testing. Exercise testing was performed by bicycle ergometry with a specific protocol involving gradual work load increments at 2 min intervals. Transcutaneous gas tensions were measured by a heated combined O2 and CO2 electrode. Arterial blood was sampled at the midpoint of each stage of exercise and transcutaneous tensions noted at the end of each stage. The mean difference of the AaO2 gradient calculated from blood gas tensions obtained by the two methods was 0.14 kPa. The limits of agreement were -0.26 and 0.63 kPa. The same values for V(D)/V(T) calculated from gas tensions measured by the two methods were: mean difference 0001; limits of agreement -0.0242 and 0.0252. For both these parameters there was an even scatter around the mean value on Bland and Altman analysis. The findings of this study suggest that estimation of parameters of gas exchange using transcutaneous values during exercise testing is reliable, provided the electrode is heated to a slightly higher temperature than usual and the work load increments are gradual, allowing for the latency in the response time of the system

  18. Effects of air ventilation during stationary exercise testing.

    PubMed

    Van Schuylenbergh, R; Vanden Eynde, B; Hespel, P

    2004-07-01

    The impact of air ventilation on performance and physiological responses during stationary exercise in the laboratory was studied. Fourteen well-trained cyclists performed three exercise tests on a cycle ergometer, each separated by a 1-week interval. The first test was a graded test to determine the power output corresponding with the 4-mmol l(-1) lactate level. Tests 2 and 3 were 30-min constant-load tests at a power output corresponding with this 4-mmol l(-1) lactate threshold. One constant-load test was performed in the absence (NAV), whilst the other was performed in the presence (AV) of air ventilation (3 m s(-1)). During the constant-load tests, heart rate, tympanic temperature, blood lactate concentration and oxygen uptake (VO2) were measured at 10-min intervals and at the end of the test. Differences between the two test conditions were evaluated using paired t-tests. During NAV, 12 subjects interrupted the test due to premature exhaustion (exercise duration <30 min), versus only seven in AV ( P<0.05). At the end of the test tympanic temperature was 35.9 (0.2) degrees C in AV and was higher in NAV [36.7 (0.2) degrees C, P<0.05]. Exercise heart rate increased at a faster rate during NAV [+2.2 (0.3) beats min(-1)] than during AV [+1.5 (0.2) beats min(-1), P<0.05]. Blood lactate concentration and VO2 were similar between conditions. Air ventilation is essential to prevent an upward shift in the lactate:heart rate as well as the power output:heart rate relationship during laboratory exercise testing and indoor exercise training.

  19. Feasibility of cardiopulmonary exercise testing and training using a robotics-assisted tilt table in dependent-ambulatory stroke patients.

    PubMed

    Saengsuwan, Jittima; Huber, Celine; Schreiber, Jonathan; Schuster-Amft, Corina; Nef, Tobias; Hunt, Kenneth J

    2015-09-26

    We evaluated the feasibility of an augmented robotics-assisted tilt table (RATT) for incremental cardiopulmonary exercise testing (CPET) and exercise training in dependent-ambulatory stroke patients. Stroke patients (Functional Ambulation Category ≤ 3) underwent familiarization, an incremental exercise test (IET) and a constant load test (CLT) on separate days. A RATT equipped with force sensors in the thigh cuffs, a work rate estimation algorithm and real-time visual feedback to guide the exercise work rate was used. Feasibility assessment considered technical feasibility, patient tolerability, and cardiopulmonary responsiveness. Eight patients (4 female) aged 58.3 ± 9.2 years (mean ± SD) were recruited and all completed the study. For IETs, peak oxygen uptake (V'O2peak), peak heart rate (HRpeak) and peak work rate (WRpeak) were 11.9 ± 4.0 ml/kg/min (45 % of predicted V'O2max), 117 ± 32 beats/min (72 % of predicted HRmax) and 22.5 ± 13.0 W, respectively. Peak ratings of perceived exertion (RPE) were on the range "hard" to "very hard". All 8 patients reached their limit of functional capacity in terms of either their cardiopulmonary or neuromuscular performance. A ventilatory threshold (VT) was identified in 7 patients and a respiratory compensation point (RCP) in 6 patients: mean V'O2 at VT and RCP was 8.9 and 10.7 ml/kg/min, respectively, which represent 75 % (VT) and 85 % (RCP) of mean V'O2peak. Incremental CPET provided sufficient information to satisfy the responsiveness criteria and identification of key outcomes in all 8 patients. For CLTs, mean steady-state V'O2 was 6.9 ml/kg/min (49 % of V'O2 reserve), mean HR was 90 beats/min (56 % of HRmax), RPEs were > 2, and all patients maintained the active work rate for 10 min: these values meet recommended intensity levels for bouts of training. The augmented RATT is deemed feasible for incremental cardiopulmonary exercise testing and exercise training in dependent

  20. Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice

    PubMed Central

    Berry, Natalia C.; Manyoo, Agarwal; Oldham, William M.; Stephens, Thomas E.; Goldstein, Ronald H.; Waxman, Aaron B.; Tracy, Julie A.; Leary, Peter J.; Leopold, Jane A.; Kinlay, Scott; Opotowsky, Alexander R.; Systrom, David M.

    2015-01-01

    Abstract Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support the use of iCPET as a key methodology for diagnosing heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension as occult causes of exercise limitation, but there is little information available outlining the methodology to use this diagnostic test in clinical practice. To bridge this knowledge gap, the operational protocol for iCPET at our institution is discussed in detail. In turn, a standardized iCPET protocol may provide a common framework to describe the evolving understanding of mechanism(s) that limit exercise capacity and to facilitate research efforts to define novel treatments in these patients. PMID:26697168

  1. Protocol for exercise hemodynamic assessment: performing an invasive cardiopulmonary exercise test in clinical practice.

    PubMed

    Berry, Natalia C; Manyoo, Agarwal; Oldham, William M; Stephens, Thomas E; Goldstein, Ronald H; Waxman, Aaron B; Tracy, Julie A; Leary, Peter J; Leopold, Jane A; Kinlay, Scott; Opotowsky, Alexander R; Systrom, David M; Maron, Bradley A

    2015-12-01

    Invasive cardiopulmonary exercise testing (iCPET) combines full central hemodynamic assessment with continuous measurements of pulmonary gas exchange and ventilation to help in understanding the pathophysiology underpinning unexplained exertional intolerance. There is increasing evidence to support the use of iCPET as a key methodology for diagnosing heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension as occult causes of exercise limitation, but there is little information available outlining the methodology to use this diagnostic test in clinical practice. To bridge this knowledge gap, the operational protocol for iCPET at our institution is discussed in detail. In turn, a standardized iCPET protocol may provide a common framework to describe the evolving understanding of mechanism(s) that limit exercise capacity and to facilitate research efforts to define novel treatments in these patients.

  2. Parallel changes in the onset of blood lactate accumulation (OBLA) and threshold of psychomotor performance deterioration during incremental exercise after training in athletes.

    PubMed

    Chmura, Jan; Nazar, Krystyna

    2010-03-01

    During aerobic exercise with increasing intensities choice reaction time (CRT) progressively shortens up to 60-80% of maximal workload, and then it rapidly increases. The aim of this study was to determine whether workload associated with the shortest CRT operationally called "the psychomotor fatigue threshold" is related to the metabolic response to exercise. Thirteen male soccer players (aged 23.3 + or - 1.0 yrs) participated in this study. Before and after 6 weeks of training in the pre-competition period they underwent treadmill test at 0 grade with running speed increasing every 3 min by 2 km/h starting from 6 km/h until exhaustion. At each stage of exercise CRT, heart rate, respiratory gas exchange and blood lactate [LA] were measured and the workload corresponding to [LA] of 4 mmol/l (OBLA) was recorded. After training, CRT was significantly shortened at rest (from m + or - SEM = 345 + or - 12 to 317 + or - 12 ms) and during exercise (from 304 + or - 10 to 285 + or - 11 ms at the psychomotor fatigue threshold and from 359 + or - 13 to 331 + or - 13 ms, p<0.001 at the last stage). Both OBLA and the psychomotor fatigue threshold were shifted towards greater running velocities (by 0.92 + or - 0.26 and 0.85 + or - 0.22 km/h, respectively). The psychomotor fatigue threshold exceeded OBLA both before and after training. Significant correlations were ascertained between OBLA and psychomotor fatigue threshold (r = 0.97) and between the changes in OBLA occurring during training and those in psychomotor fatigue threshold (r = 0.88). It is concluded that endurance training not only increases exercise tolerance due to its influence on metabolism but also facilitates psychomotor performance during heavy exercise.

  3. Exercise testing and hemodynamic performance in healthy elderly persons

    SciTech Connect

    Hitzhusen, J.C.; Hickler, R.B.; Alpert, J.S.; Doherty, P.W.

    1984-11-01

    To determine the effect of age on cardiovascular performance, 39 healthy elderly men and women, 70 to 83 years old, underwent treadmill thallium-201 exercise perfusion imaging and radionuclide equilibrium angiography at rest and during supine bicycle exercise. Five volunteers who had a positive exercise thallium test response were excluded from the study. Radionuclide left ventricular ejection fraction, regional wall abnormalities, relative cardiac output, stroke volume, end-diastolic volume and end-systolic volume were measured. Seventy-four percent of the subjects maintained or increased their ejection fraction with exercise. With peak exercise, mean end-diastolic volume did not change, end-systolic volume decreased and cardiac output and stroke volume increased. Moreover, in 35% of the subjects, minor regional wall motion abnormalities developed during exercise. There was no significant difference in the response of men and women with regard to these variables. However, more women than men had difficulty performing bicycle ergometry because they had never bicycled before. Subjects who walked daily performed the exercise tests with less anxiety and with a smaller increase in heart rate and systolic blood pressure.

  4. Incremental Validity of Test Session and Classroom Observations in a Multimethod Assessment of Attention Deficit/Hyperactivity Disorder

    PubMed Central

    McConaughy, Stephanie H.; Harder, Valerie S.; Antshel, Kevin M.; Gordon, Michael; Eiraldi, Ricardo; Dumenci, Levent

    2010-01-01

    This study tested the incremental validity of behavioral observations, over and above parent and teacher reports, for assessing symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children ages 6 to 12, using the Test Observation Form (TOF) and Direct Observation Form (DOF) from the Achenbach System of Empirically Based Assessment (ASEBA). The TOF Attention Problems and DOF Intrusive scales contributed significant unique variance, over and above parent and teacher ratings, to predicting parent and teacher ratings of hyperactivity and impulsivity and predicting categorical diagnoses of ADHD-Combined type versus Non-ADHD and ADHD-Combined type versus ADHD-Predominantly Inattentive type. The TOF Oppositional and Attention Deficit/Hyperactivity Problems scales contributed unique variance to predicting parent ratings of hyperactivity and impulsivity and the DOF Oppositional and Attention Deficit/Hyperactivity Problems scales contributed unique variance to predicting teacher ratings of hyperactivity and impulsivity. PMID:20706918

  5. Are 30 minutes of rest between two incremental shuttle walking tests enough for cardiovascular variables and perceived exertion to return to baseline values?

    PubMed Central

    Ribeiro, Laís R. G.; Mesquita, Rafael B.; Vidotto, Laís S.; Merli, Myriam F.; Carvalho, Débora R.; de Castro, Larissa A.; Probst, Vanessa S.

    2015-01-01

    Objective: To verify whether 30 minutes of rest between two incremental shuttle walking tests (ISWT) are enough for cardiovascular variables and perceived exertion to return to baseline values in healthy subjects in a broad age range. Method: The maximal exercise capacity of 334 apparently healthy subjects (age ≥18) was evaluated using the ISWT. The test was performed twice with 30 minutes of rest in between. Heart rate (HR), arterial blood pressure (ABP), dyspnea, and leg fatigue were evaluated before and after each test. Subjects were allocated to 6 groups according to their age: G1: 18-29 years; G2: 30-39 years; G3: 40-49 years; G4: 50-59 years; G5: 60-69 years and G6: ≥70 years. Results: All groups had a good performance in the ISWT (median >90% of the predicted distance). The initial HR (HRi) of the second ISWT was higher than the first ISWT in the total sample (p<0.0001), as well as in all groups (p<0.0001). No difference was observed in the behavior of ABP (systolic and diastolic) and dyspnea between the two tests, but this difference occurred for leg fatigue (greater before the second ISWT) in G1 (p<0.05). Most subjects (58%) performed better in the second test. Conclusion: 30 minutes of rest between two ISWTs are not enough for all cardiovascular variables and perceived exertion to return to baseline values. However, this period appears to be sufficient for blood pressure and performance to recover in most subjects. PMID:25789556

  6. Field exercise testing for assessing fitness in French standardbred trotters.

    PubMed

    Couroucé, A

    1999-03-01

    This review considers standardized exercise testing which is, routinely used for French Trotters in the field. Track testing provides a more limited range of measurements than treadmill testing, but has the advantage of being performed in the horse's natural environment. Various measurements such as heart rate during exercise and blood lactate concentration after exercise may be measured on the track and lead to the calculation of physiological variables such as V200 (velocity corresponding to a 200 bpm heart rate) and V4 (velocity corresponding to a 4 mmol/L blood lactate concentration). V4 is related to the onset of blood lactate accumulation and relates to the aerobic capacity of the horse, as horses with high values for V4 have higher aerobic capacities. Although V4 is calculated during submaximal intensity exercise, it is related to racing performance and seems to be the most important measurement to assess changes in fitness. V200 represents the cardiac capacity of the horse during exercise and is close to V4 in mature horses. To explain further the clinical usefulness of track testing, and to help interpret both V4 and V200 variables, examples of exercise tests in 3-year-old French Trotters are presented here. These results show that changes may occur in V4 and V200 according to different factors such as the horse's physical ability and either training or disease states. It underlines the importance of exercise tests for both trainers and veterinarians and how they may help in the evaluation of a horse's performance ability; in defining the intensity of a training program, and also in the early detection of underlying diseases.

  7. [Value of the exercise test in asymptomatic myocardial ischemia].

    PubMed

    Iturralde, P; Hernández, D; de Micheli, A; Colín, L; Romero, L; Villarreal, A; Férez, S; Miguel Casanova, J; Barrera, M; González-Hermosillo, J A

    1990-01-01

    To evaluate the predictive value of ischemic ST segment depression without associated chest pain during exercise testing, data were analyzed from 7305 studies. Two hundred thirty six patients were included in this study and were separated in 2 groups. Group A consisted of 169 patients without chest pain who, during exercise testing, showed a positive ST segment response (at least 1.5 mm of horizontal or downward ST segment depression for at least 0.08 second, compared with the resting baseline value), and Group B consisted of 67 patients who had both chest pain and a positive ST segment response. Selective coronary angiogram was performed on all patients. Each Group was separated into 3 sub-group according to the Cohn criteria: sub-group I (asymptomatic persons 8.3 vs 19.4%); sub-group II (patients with history of Myocardial Infarction 36.7% vs 19.4%); sub-group III (patients with chronic angina 55% vs 61.2%). The clinical characteristics, coronary risk factors, distribution of coronary artery disease, and exercise test response were similar in both groups. During treadmill exercise, the mean heart rate was 140.6 +/- 22 in group A versus 127.1 +/- 23 in the group B. The pressure-rate product was 2.4 +/- 0.8 versus 1.9 +/- 0.5, respectively (P less than or equal to 0.05). The predictive value for severe coronary artery disease of an exercise test in patients with asymptomatic ischemia was 77.5% as compared with 89.6% in the group with angina. This study confirms the high frequency of asymptomatic myocardial ischemia during exercise testing, compared with patients who had angina during exercise testing, with high percentage of prediction (77.5%) for coronary artery disease.

  8. Methodologic problems in exercise testing research. Are we solving them

    SciTech Connect

    Detrano, R.; Lyons, K.P.; Marcondes, G.; Abbassi, N.; Froelicher, V.F.; Janosi, A.

    1988-06-01

    To evaluate the comparative effects of methodologic factors on the reported accuracies of two standard exercise tests, 56 publications comparing the exercise thallium scintigram with the coronary angiogram were analyzed for conformation to five methodologic standards. Analyzed were adequate definition of study group, avoidance of a limited challenge group, avoidance of workup bias, and blinded analysis of the coronary angiogram and myocardial scintigram. Study group characteristics and technical factors were also reviewed. Better conformation with methodologic standards was found than has been reported previously for treadmill exercise testing. Furthermore, study group characteristics and technical factors were better predictors of sensitivity and specificity than were methodologic deficiencies. Only workup bias and test blinding were significantly associated with test accuracy. The percentage of patients with previous myocardial infarction had the highest correlation and was independently and directly related to sensitivity and inversely related to specificity. 77 references.

  9. Evaluation of Exercise Response in a Young, High Risk Population: Submaximal Invasive Cardiopulmonary Exercise Testing (ICPET) in Active Duty Soldiers

    DTIC Science & Technology

    2017-03-17

    Submaximal Invasive Cardiopulmonary Exercise Testing iCPET in AD Soldiers presented at/published to American College of Cardiology’s 661h Annual...Eval of Exercise Response in a Young, High Risk Population: Submaximal Invasive Cardiopulmonary Exercise Testing (iCPET) in AD Sol<ldi 7. FUNDING

  10. Comparison of dobutamine infusion and supine bicycle exercise for radionuclide cardiac stress testing

    SciTech Connect

    Freeman, M.L.; Palac, R.; Mason, J.; Barnes, W.E.; Eastman, G.; Virupannavar, S.; Loeb, H.S.; Kaplan, E.

    1984-05-01

    A comparison is made of the inotropic drug dobutamine to supine bicycle exercise as a means of inducing stress in radionuclide ventriculography studies. Dobutamine has the following properties, making it favorable for widespread usage: 1) ability to be given safely in a peripheral vein, 2) rapid onset, and 3) short duration of action. Each patient underwent supine bicycle progressive resistance testing of 2 minutes per stage followed 30 minutes later by dobutamine administration. Accuracy of diagnosis was 0.93 and sensitivity was 0.89 with dobutamine, while with bicycle the accuracy was 0.93 and sensitivity was 0.94. While not designed to replace supine bicycle testing, incremental infusions of dobutamine appear to be nearly equal in accuracy and sensitivity, providing a satisfactory technique for cardiac evaluation of previously excluded patients.

  11. Comparative analysis on thermal non-destructive testing imagery applying Candid Covariance-Free Incremental Principal Component Thermography (CCIPCT)

    NASA Astrophysics Data System (ADS)

    Yousefi, Bardia; Sfarra, Stefano; Ibarra Castanedo, Clemente; Maldague, Xavier P. V.

    2017-09-01

    Thermal and infrared imagery creates considerable developments in Non-Destructive Testing (NDT) area. Here, a thermography method for NDT specimens inspection is addressed by applying a technique for computation of eigen-decomposition which refers as Candid Covariance-Free Incremental Principal Component Thermography (CCIPCT). The proposed approach uses a shorter computational alternative to estimate covariance matrix and Singular Value Decomposition (SVD) to obtain the result of Principal Component Thermography (PCT) and ultimately segments the defects in the specimens applying color based K-medoids clustering approach. The problem of computational expenses for high-dimensional thermal image acquisition is also investigated. Three types of specimens (CFRP, Plexiglas and Aluminium) have been used for comparative benchmarking. The results conclusively indicate the promising performance and demonstrate a confirmation for the outlined properties.

  12. Exercise tolerance in panic disorder patients.

    PubMed

    Stein, J M; Papp, L A; Klein, D F; Cohen, S; Simon, J; Ross, D; Martinez, J; Gorman, J M

    1992-08-01

    Sixteen panic patients and fifteen normal controls performed submaximal exercise testing on a bicycle ergometer. Only one patient subject panicked. Biochemical, physiological, and psychological data showed similar exercise tolerance in both patients and controls. Exercise-induced distress and lactate increment do not appear to cause panic attacks.

  13. The Language Policy of State Drivers' License Testing: Expediency, Symbolism, or Creeping Incrementalism?

    ERIC Educational Resources Information Center

    Schiffman, Harold F.; Weiner, Richard E.

    2012-01-01

    Until recently, educational language policy in the US has been the chief site of contention about language, as seen in recent initiatives, referenda, and state constitutional amendments. Provision for drivers' licensing testing in languages other than English (LotE), on the other hand, has often exemplified what we call expedient language policy,…

  14. The Language Policy of State Drivers' License Testing: Expediency, Symbolism, or Creeping Incrementalism?

    ERIC Educational Resources Information Center

    Schiffman, Harold F.; Weiner, Richard E.

    2012-01-01

    Until recently, educational language policy in the US has been the chief site of contention about language, as seen in recent initiatives, referenda, and state constitutional amendments. Provision for drivers' licensing testing in languages other than English (LotE), on the other hand, has often exemplified what we call expedient language policy,…

  15. An Exercise for Illustrating the Logic of Hypothesis Testing

    ERIC Educational Resources Information Center

    Lawton, Leigh

    2009-01-01

    Hypothesis testing is one of the more difficult concepts for students to master in a basic, undergraduate statistics course. Students often are puzzled as to why statisticians simply don't calculate the probability that a hypothesis is true. This article presents an exercise that forces students to lay out on their own a procedure for testing a…

  16. [VO2 max, a true exercise test].

    PubMed

    Saunier, Carole

    2013-01-01

    VO2 max is nowadays an essential examination performed in the monitoring of heart failure. The nurse has a role to play during the test and in supporting the patient, although this test remains highly technical and complex.

  17. The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases.

    PubMed

    Klemz, Bárbara Nascimento de Carvalho; Reis-Neto, Edgard Torres Dos; Jennings, Fábio; Siqueira, Usmary Sardinha; Klemz, Fábio Kadratz; Pinheiro, Helder Henrique Costa; Sato, Emília Inoue; Natour, Jamil; Szejnfeld, Vera Lúcia; Pinheiro, Marcelo de Medeiros

    2016-11-01

    To evaluate the impact and risk factors associated with an abnormal exercise test (ET) in systemic inflammatory rheumatic disease (SIRD) patients before commencing supervised physical exercise. A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P < 0.001). The disease itself was involved with higher likelihood of having an abnormal ET [Odds ratio (OR) = 12.0, 95% CI: 2.5, 56.7; P = 0.002 for SLE; OR = 13.56, 95% CI: 6.16, 29.8; P < 0.001 for RA; and OR = 4.31, 95% CI: 1.17, 15.8; P = 0.028, for AS]. Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6; P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99; P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0; P = 0.067). Our results showed a higher prevalence of abnormal ETs in asymptomatic cardiovascular SIRD patients, and the disease itself was associated with a higher likelihood of having an abnormal test, emphasizing the relevance and need of performing it before starting supervised physical exercise. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email

  18. Usefulness of stroke volume monitoring during upright ramp incremental cycle exercise in young patients with Fontan circulation.

    PubMed

    Legendre, Antoine; Guillot, Aurore; Ladouceur, Magalie; Bonnet, Damien

    2017-01-15

    Aerobic capacity (VO2 max) of patients with Fontan circulation (FC) is lowest within patients with congenital heart disease. The reasons have not been completely elucidated. Twenty five young patients with non-failing FC underwent a cardiopulmonary test during an upright ramp cycling. By using a signal morphology impedance cardiography device (physioflow®), stroke volume (SV) was evaluated along with effort. The results were compared with paired healthy controls. FC patients had lower VO2 max (24 vs 32ml/Kg/min) and maximal cardiac index (CI) (6.4 vs 9.9l/min/m(2)) than controls, due to impaired maximal SV (42 vs 54ml/m(2)) and maximal Heart Rate (HR) (154 vs 184/min) (p<0.001). No correlation between SV and HR at peak was found. At ventilatory threshold, SV continued to rise in a part of FC patients. Other FC patients showed an almost a "plateau" as in controls. The more maximal CI was impaired, the more was maximal arterio-venous difference (r=-0.6, p=0.001). Compared to controls, stroke work was lower in FC patients (p<0.01) even though maximal vascular resistance was higher in them (p<0.001). Impaired SV and chronotropic incompetence are both independently responsible for impaired CI at peak. The increase in arteriovenous difference appeared to be an adaptive response. As the stroke work was low among FC patients, high systemic vascular resistance does not appear to be the cause of SV impairment but rather a consequence. SV monitoring at effort evidences heterogeneous SV profiles among FC patients that could be considered for the management of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. The Submaximal Clinical Exercise Tolerance Test (SXTT) to Establish Safe Exercise Prescription Parameters for Patients with Chronic Disease and Disability

    PubMed Central

    Gappmaier, Eduard

    2012-01-01

    Purpose To describe how to perform a Submaximal Clinical Exercise Tolerance Test (SXTT) as part of an exercise evaluation in the physical therapy clinic to determine an appropriate exercise prescription and to establish safety of exercise for physical therapy clients. Summary of Key Points Physical activity is crucial for general health maintenance. An exercise evaluation includes a comprehensive patient history, physical examination, exercise testing, and exercise prescription. The SXTT provides important clinical data that form the foundation for an effective and safe exercise prescription. Observations obtained during the exercise evaluation will identify at-risk patients who should undergo further medical evaluation before starting an exercise program. Two case examples of SXTTs administered to individuals with multiple sclerosis are presented to demonstrate the application of these principles. Statement of Recommendations Due to their unique qualifications, physical therapists shall assume responsibility to design and monitor safe and effective physical activity programs for all clients and especially for individuals with chronic disease and disability. To ensure safety and efficacy of prescribed exercise interventions, physical therapists need to perform an appropriate exercise evaluation including exercise testing before starting their clients on an exercise program. PMID:22833706

  20. Screening for childhood asthma using an exercise test.

    PubMed Central

    Jones, A; Bowen, M

    1994-01-01

    BACKGROUND. Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM. The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD. In 1985 a cross-sectional research study was undertaken in 10 primary schools in West Glamorgan; the children were followed up over six years until 1991. The exercise test involved measuring peak expiratory flow rate before and after the children ran as fast as they could for six minutes. A control group of children with a negative exercise test result were compared with those not known to have asthma who had a positive result (fall in peak expiratory flow rate of 15% or greater), using clinical data. Similar clinical comparisons were undertaken between the children known to have asthma and a control group. RESULTS. Of 864 children not known to have asthma, 60 had a positive exercise result. Of 92 children known to have asthma, 33 had a positive test result and seven were unable to finish the test because of bronchospasm, a sensitivity of 43% and a specificity of 93%. Follow up of 55 of the 60 children not known to have asthma but who had an abnormal response to the test showed that 32 had developed clinically recognizable asthma six years later. There was a significantly higher prevalence of atopic and respiratory illnesses (otitis media, hay fever and eczema) in the group of children with bronchial hyperreactivity demonstrated on exercise than in those without bronchial hyperreactivity. CONCLUSION. This research shows that bronchial hyperreactivity demonstrated by an exercise test can be a marker for childhood asthma. The study has also identified other respiratory tract illnesses which appear to belong to the same spectrum as asthma. PMID:8204321

  1. Walking tests during the exercise training: specific use for the cardiac rehabilitation.

    PubMed

    Casillas, J-M; Hannequin, A; Besson, D; Benaïm, S; Krawcow, C; Laurent, Y; Gremeaux, V

    2013-10-01

    Walk tests, principally the six-minute walk test (6mWT), constitute a safe, useful submaximal tool for exercise tolerance testing in cardiac rehabilitation (CR). The 6mWT result reflects functional status, walking autonomy and efficacy of CR on walking endurance, which is more pronounced in patients with low functional capacity (heart failure - cardiac surgery). The 6mWT result is a strong predictor of mortality. However, clinically significant changes and reliability are still subject to debate - probably because of the ambiguity in terms of the target speed (either comfortable or brisk walking). Of the other time-based walk tests, the 2-minute-walk test is the only one applicable during CR, reserved for patients with severe disabilities by its psychometric properties. Fixed-distance tests (principally the 200m fast walk test) and incremental shuttle walking, tests explore higher levels of effort and may represent a safe and inexpensive alternative to laboratory-based tests during CR. These walking tests may be useful for personalizing prescription of training programs. However, the minimum clinically significant difference has not yet been determined. Lastly, walking tests appear to be potential useful tools in promoting physical activity and behavioural changes at home. Thus, validation of other walk tests with better psychometric properties will be necessary.

  2. A single electromyographic testing point is valid to monitor neuromuscular fatigue during continuous exercise.

    PubMed

    Galen, Sujay S; Malek, Moh H

    2014-10-01

    Two different protocols for estimating the electromyographic fatigue threshold (EMGFT) have been proposed in the literature. These protocols are distinguished by the number of visits required to determine the EMGFT. The purpose of this study, therefore, was to statistically compare the estimated EMGFT from the single-visit incremental test and the multiple-visit constant workload tests for single-leg knee-extensor exercise. Seven healthy college-aged men [mean ± SEM; age = 25.0 ± 0.7 years] performed the incremental test and on separate occasions also performed 4 constant workload tests to voluntary exhaustion. The EMG amplitude was recorded from the rectus femoris muscle during all the testing sessions. For the single-visit test, the EMG amplitude vs. time relationship for each power output was examined using linear regression. For the multiple-visit tests, the EMG amplitude vs. time relationship was calculated for each constant power output. Thereafter, the power outputs were plotted as a function of the slope coefficient for the EMG amplitude vs. time relationships, and linear regression was performed. The EMGFT was defined as the intersection of the regression line with the y-intercept of the power output vs. slope coefficient plot. The results indicated that the estimated EMGFT from the single-visit test was significantly (p = 0.012) lower than the estimate from the multiple-visit tests. Because this test is performed during a single visit and concludes within 20 minutes, it may also have application in clinical rehabilitation settings and not merely for an athletic population.

  3. Exercise testing and training in people with Huntington's disease.

    PubMed

    Dawes, H; Collett, J; Debono, K; Quinn, L; Jones, K; Kelson, M J; Simpson, S A; Playle, R; Backx, K; Wasley, D; Nemeth, A H; Rosser, A; Izardi, H; Busse, M

    2015-02-01

    To explore exercise response in people with Huntington's disease (HD). Experimental observational study with a randomly allocated subgroup before/after interventional study. Community. People with HD (n=30) and a healthy comparator group (n=20). Thirteen people from the HD group were randomly allocated to an exercise training program. Heart rate (HR) and perceived exertion on the Borg-CR10 scale (RPE) during a submaximal cycle ergometer exercise test (three minute unloaded and nine minute 65%-75%HRmaximum phase). Expired air and lactate measures were available for 8 people with HD during the exercise. A 12 week gym and home walking exercise programme (n=13). People with HD achieved a lower work rate at nine minutes (82±42(0-195) v 107±35(50 -185) Watts (p<0.05)), but higher RPE at both three (3±2(0-7) v 1±1(0-4)) and nine minutes (7±3(1-10) v 5± 2(2-9)) both p<0.01, compared to the healthy group and did not achieve a steady state HR during unloaded cycling. People with HD also demonstrated higher than expected lactate at three 2.5±2.5(1.1-8)mmo.L-1 and nine 3.8±1.9(1.2-6.6)mmo.L-1 minutes and respiratory exchange ratio at three 0.78±0.03 (0.74-0.81) and nine minutes 0.94±0.11(0.81-1.15). After exercise training there were no changes observed in HR or RPE responses during the exercise test. There was a large variability in the observed metabolic and physiological responses to exercise in people with HD. The observed exercise responses suggest that altered exercise prescription parameters may be required for people with HD and that exercise response and factors' affecting this requires further investigation. © The Author(s) 2014.

  4. Comparison of Oxygen Consumption in Rats During Uphill (Concentric) and Downhill (Eccentric) Treadmill Exercise Tests

    PubMed Central

    Chavanelle, Vivien; Sirvent, Pascal; Ennequin, Gaël; Caillaud, Kévin; Montaurier, Christophe; Morio, Béatrice; Boisseau, Nathalie; Richard, Ruddy

    2014-01-01

    The study of the physiological adaptations of skeletal muscle in response to eccentric (ECC) contraction is based on protocols in which exercise intensities are determined relative to the concentric (CON) reference exercise (as percentage of the CON maximal oxygen consumption, or VO2max). In order to use similar exercise protocols in rats, we compared the VO2 values during uphill (CON) and downhill (ECC) running tests. VO2 was measured in 15 Wistar rats during incremental treadmill running exercises with different slopes: level (0%), positive (+15% incline: CON+15%) and negative (i15% incline: ECC-15%; and 130% incline: ECC-30%). Similar VO2 values were obtained in the ECC-30% and CON+15% running conditions at the three target speeds (15, 25 and 35 cm/sec). Conversely, VO2 values were lower (p < 0.05) in the ECC-15% than in the CON+15% condition (CON+15% VO2/ECC-15% VO2 ratios ranging from 1.86 to 2.05 at the three target speeds). Thus, doubling the downhill slope gradient in ECC condition leads to an oxygen consumption level that is not significantly different as in CON condition. These findings can be useful for designing animal research protocols to study the effects of ECC and CON exercise in ageing population or subjects suffering from cardiovascular diseases. Key Points VO2 in rats during treadmill race in eccentric and concentric conditions were measured. A novel breath-by-breath device allowing direct access to the animal was used. Three different slopes: +15%, -15% and -30% were used. VO2 values obtained in the -30% eccentric and the +15% concentric conditions were not significantly different. PMID:25177200

  5. Reference values for the incremental shuttle walk test in healthy subjects: from the walk distance to physiological responses *,**

    PubMed Central

    Dourado, Victor Zuniga; Guerra, Ricardo Luís Fernandes; Tanni, Suzana Erico; Antunes, Letícia Cláudia de Oliveira; Godoy, Irma

    2013-01-01

    OBJECTIVE: To determine reference values for incremental shuttle walk distance (ISWD) and peak physiological responses during the incremental shuttle walk test (ISWT), as well as to develop a series of predictive equations for those variables in healthy adults. METHODS: We evaluated 103 healthy participants ≥ 40 years of age (54 women and 49 men). We fitted each participant with a gas analysis system for use during the ISWT. Oxygen consumption (VO2), carbon dioxide production, minute ventilation, heart rate (HR), ISWD, and maximal walking velocity (MWV) were obtained as primary outcomes. We also assessed hand grip strength (HGS) and lean body mass (LBM). RESULTS: The regression analysis models, including physiological variables, ISWD, and MWV (adjusted for age, body mass, height, and sex), produced R2 values ranging from 0.40 to 0.65 (for HR and peak VO2, respectively). Using the models including LBM or HGS, we obtained no significant increase in the R2 values for predicting peak VO2, although the use of those models did result in slight increases in the R2 values for ISWD and MWV (of 8% and 12%, respectively). The variables ISWD, MWV, and ISWD × body mass, respectively, explained 76.7%, 73.3%, and 81.2% of peak VO2 variability. CONCLUSIONS: Our results provide reference values for ISWD and physiological responses to the ISWT, which can be properly estimated by determining simple demographic and anthropometric characteristics in healthy adults ≥ 40 years of age. The ISWT could be used in assessing physical fitness in the general adult population and in designing individualized walking programs. PMID:23670504

  6. Validity of the Eating Attitude Test among Exercisers.

    PubMed

    Lane, Helen J; Lane, Andrew M; Matheson, Hilary

    2004-12-01

    Theory testing and construct measurement are inextricably linked. To date, no published research has looked at the factorial validity of an existing eating attitude inventory for use with exercisers. The Eating Attitude Test (EAT) is a 26-item measure that yields a single index of disordered eating attitudes. The original factor analysis showed three interrelated factors: Dieting behavior (13-items), oral control (7-items), and bulimia nervosa-food preoccupation (6-items). The primary purpose of the study was to examine the factorial validity of the EAT among a sample of exercisers. The second purpose was to investigate relationships between eating attitudes scores and selected psychological constructs. In stage one, 598 regular exercisers completed the EAT. Confirmatory factor analysis (CFA) was used to test the single-factor, a three-factor model, and a four-factor model, which distinguished bulimia from food pre-occupation. CFA of the single-factor model (RCFI = 0.66, RMSEA = 0.10), the three-factor-model (RCFI = 0.74; RMSEA = 0.09) showed poor model fit. There was marginal fit for the 4-factor model (RCFI = 0.91, RMSEA = 0.06). Results indicated five-items showed poor factor loadings. After these 5-items were discarded, the three models were re-analyzed. CFA results indicated that the single-factor model (RCFI = 0.76, RMSEA = 0.10) and three-factor model (RCFI = 0.82, RMSEA = 0.08) showed poor fit. CFA results for the four-factor model showed acceptable fit indices (RCFI = 0.98, RMSEA = 0.06). Stage two explored relationships between EAT scores, mood, self-esteem, and motivational indices toward exercise in terms of self-determination, enjoyment and competence. Correlation results indicated that depressed mood scores positively correlated with bulimia and dieting scores. Further, dieting was inversely related with self-determination toward exercising. Collectively, findings suggest that a 21-item four-factor model shows promising validity coefficients among

  7. Exercise-induced ischemic preconditioning detected by sequential exercise stress tests: a meta-analysis.

    PubMed

    Lalonde, François; Poirier, Paul; Sylvestre, Marie-Pierre; Arvisais, Denis; Curnier, Daniel

    2015-01-01

    Exercise-induced ischemic preconditioning (IPC) can be assessed with the second exercise stress test during sequential testing. Exercise-induced IPC is defined as the time to 1 mm ST segment depression (STD), the rate-pressure product (RPP) at 1 mm STD, the maximal ST depression and the rate-pressure product at peak exercise. The purpose of this meta-analysis is to validate the parameters used to assess exercise-induced IPC in the scientific community. A literature search was performed using electronic database. The main key words were limited to human studies, which were (a) ischemic preconditioning, (b) warm-up phenomenon, and (c) exercise. Meta-analyses were performed on the study-specific mean difference between the clinical measures obtained in the two consecutive stress tests (second minus first test score). Random effect models were fitted with inverse variance weighting to provide greater weight to studies with larger sample size and more precise estimates. The search resulted in 309 articles of which 34 were included after revision (1053 patients). Results are: (a) time to 1 mm ST segment depression increased by 91 s (95% confidence interval (CI): 75-108), p < 0.001; (b) peak ST depression decreased by -0.38 mm (95% CI: -0.66 to -0.10), p < 0.01; and (c) rate-pressure product at 1 mm STD increased by 1.80 × 10(3)mmHg (95% CI: 1.0-2.0), p < 0.001. This is the first meta-analysis to set clinical parameters to assess the benefit of exercise-induced ischemic preconditioning in sequential stress testing. The results of this first meta-analysis on the sequential stress test confirm what is presented in the literature by independent studies on exercise-induced ischemic preconditioning. From now on, the results could be used in further research to set standardized parameters to assess the phenomenon. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Reliability and validity of heart rate variability threshold assessment during an incremental shuttle-walk test in middle-aged and older adults

    PubMed Central

    Dourado, V.Z.; Guerra, R.L.F.

    2013-01-01

    Studies on the assessment of heart rate variability threshold (HRVT) during walking are scarce. We determined the reliability and validity of HRVT assessment during the incremental shuttle walk test (ISWT) in healthy subjects. Thirty-one participants aged 57 ± 9 years (17 females) performed 3 ISWTs. During the 1st and 2nd ISWTs, instantaneous heart rate variability was calculated every 30 s and HRVT was measured. Walking velocity at HRVT in these tests (WV-HRVT1 and WV-HRVT2) was registered. During the 3rd ISWT, physiological responses were assessed. The ventilatory equivalents were used to determine ventilatory threshold (VT) and the WV at VT (WV-VT) was recorded. The difference between WV-HRVT1 and WV-HRVT2 was not statistically significant (median and interquartile range = 4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h); the correlation between WV-HRVT1 and WV-HRVT2 was significant (r = 0.84); the intraclass correlation coefficient was high (0.92; 0.82 to 0.96), and the agreement was acceptable (-0.08 km/h; -0.92 to 0.87). The difference between WV-VT and WV-HRVT2 was not statistically significant (4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h) and the agreement was acceptable (0.04 km/h; -1.28 to 1.36). HRVT assessment during walking is a reliable measure and permits the estimation of VT in adults. We suggest the use of the ISWT for the assessment of exercise capacity in middle-aged and older adults. PMID:23369974

  9. Jogging in place. Evaluation of a simplified exercise test

    SciTech Connect

    Papazoglou, N.; Kolokouri-Dervou, E.; Fanourakis, I.; Natsis, P.; Koutsiouba, P. )

    1989-10-01

    The purpose of this study was to evaluate jogging in place as an electrocardiographic exercise test. Jogging in place continuously recorded via an ordinary single-channel electrocardiograph was compared with the Bruce treadmill protocol with a three-channel monitor and recorder in 141 cases with a wide spectrum of chest complaints. Agreement for the presence or absence of electrocardiographic ischemia (ST-segment displacement greater than or equal to 1 mm at 80 ms from the J point, or U-wave inversion) for the two tests was observed in 91 percent of the cases (95 percent confidence intervals: 86 percent to 95.5 percent). One hundred of the previous cases with paired electrocardiographic exercise tests were compared with the presence of reversible defects on exercise myocardial thallium-201 scintigraphy. The electrocardiographic ischemia had a similar correct classification rate in both methods (83 percent with jogging in place and 85 percent with Bruce treadmill protocol; not significant) against the finding of scintigraphic ischemia. This was also true for 52 cases having selective coronary arteriography. The correct classification rate was 54 percent (28/52) with jogging in place and 48 percent (25/52) with Bruce treadmill protocol (not significant). Given the safety and the easy applicability, even in older persons, this simplified test can be recommended as a valid alternative to the established multistage exercise tests.

  10. Incremental Validity of the Test for Auditory Comprehension of Language and the Developmental Test of Visual Motor Integration.

    ERIC Educational Resources Information Center

    Reynolds, Cecil R.; And Others

    1980-01-01

    Predictive validity of the Test for Auditory Comprehension of Language and the Developmental Test of Visual Motor Integration was investigated singly and in combination for a group of preschool children. The results indicated little practical significance in using both instruments as opposed to either test singly. (Author/CP)

  11. Hospital generator sizing, testing, and exercising.

    PubMed

    Nash, H O

    1994-02-01

    With the NFPA 99 and JCAHO requirements for minimum loads on generators during testing, hospital engineers are finding that oversized standby generators can mean operational problems. This document explains the oversized generator problem, including the code changes that gave birth to the problem. Some practical suggestions for sizing generators are then provided.

  12. Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.

    ERIC Educational Resources Information Center

    Minorsky, Peter V.; Willing, R. Paul

    1999-01-01

    Presents a fun, inexpensive, and pedagogically useful laboratory exercise that involves indoor studies of the dispersal properties of the winged fruits (samaras) of boxelder trees. Engages students in the process of hypothesis testing, experimental design, and data analysis as well as introducing students to important concepts related to…

  13. Samara Dispersal in Boxelder: An Exercise in Hypothesis Testing.

    ERIC Educational Resources Information Center

    Minorsky, Peter V.; Willing, R. Paul

    1999-01-01

    Presents a fun, inexpensive, and pedagogically useful laboratory exercise that involves indoor studies of the dispersal properties of the winged fruits (samaras) of boxelder trees. Engages students in the process of hypothesis testing, experimental design, and data analysis as well as introducing students to important concepts related to…

  14. The Hoff circuit test is more specific than an incremental treadmill test to assess endurance with the ball in youth soccer players.

    PubMed

    Zagatto, A M; Papoti, M; Da Silva, Asr; Barbieri, R A; Campos, E Z; Ferreira, E C; Loures, J P; Chamari, K

    2016-09-01

    The assessment of aerobic endurance is important for training prescription in soccer, and is usually measured by straight running without the ball on a track or treadmill. Due to the ball control and technical demands during a specific soccer test, the running speeds are likely to be lower compared to a continuous incremental test. The aim of the present study was to compare the heart rate (HR), rating of perceived exertion (RPE) and speeds corresponding to 2.0 mmol∙L(-1), 3.5 mmol∙L(-1), lactate threshold (Dmax method) and peak lactate determined in the laboratory and in the Hoff circuit soccer-specific test. Sixteen soccer players (16±1 years) underwent two incremental tests (laboratory and Hoff circuit tests). The speeds were significantly higher in the treadmill test than on the Hoff circuit (2.0 mmol∙L(-1): 9.5±1.2 and 8.1±1.0 km∙h(-1); 3.5 mmol∙L(-1): 12.0±1.2 and 10.2±1.1 km∙h(-1); Dmax: 11.4±1.4 and 9.3±0.4 km∙h(-1); peak lactate: 14.9±1.6 and 10.9±0.8 km∙h(-1)). The HR corresponding to 3.5 mmol∙L-1 was significantly higher on the Hoff circuit compared to the laboratory test (187.5±18.0 and 178.2±17.6 bpm, respectively; P <0.001), while the RPE at the last incremental stage was lower on the Hoff circuit (P < 0.01). The speeds during the Hoff specific soccer test and the HR corresponding to 2.0 mmol∙L(-1), 3.5 mmol∙L(-1) and Dmax/threshold were different compared with the laboratory test. The present study shows that it is possible to assess submaximal endurance related variables specifically in soccer players.

  15. Inflight exercise affects stand test responses after space flight

    NASA Technical Reports Server (NTRS)

    Lee, S. M.; Moore, A. D. Jr; Fritsch-Yelle, J. M.; Greenisen, M. C.; Schneider, S. M.

    1999-01-01

    PURPOSE: The purpose of this study was to determine whether exercise performed by Space Shuttle crew members during short-duration space flights (9-16 d) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 h of landing. METHODS: Thirty crew members performed self-selected inflight exercise and maintained exercise logs to monitor their exercise intensity and duration. Two subjects participated in this investigation during two different flights. A 10-min stand test, preceded by at least 6 min of quiet supine rest, was completed 10-15 d before launch (PRE) and within 4 h of landing (POST). Based upon their inflight exercise records, subjects were grouped as either high (HIex: > or = 3 times/week, HR > or = 70% HRmax, > or = 20 min/session, N = 11), medium (MEDex: > or = 3 times/week, HR < 70% HRmax, > or = 20 min/session, N = 10), or low (LOex: < or = 3 times/week, HR and duration variable, N = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, P < or = 0.05). RESULTS: There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared with PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36 +/- 5 bpm) compared with HIex or MEDex groups (25 +/- 1 bpm; 22 +/- 2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after space flight in the MEDex and HIex groups but was significantly greater in the LOex group (PRE: -9 +/- 3; POST: -19 +/- 4 mm Hg). CONCLUSIONS: Thus, moderate to high levels of inflight exercise attenuated HR and PP responses to standing after space flight.

  16. Inflight exercise affects stand test responses after space flight

    NASA Technical Reports Server (NTRS)

    Lee, S. M.; Moore, A. D. Jr; Fritsch-Yelle, J. M.; Greenisen, M. C.; Schneider, S. M.

    1999-01-01

    PURPOSE: The purpose of this study was to determine whether exercise performed by Space Shuttle crew members during short-duration space flights (9-16 d) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 h of landing. METHODS: Thirty crew members performed self-selected inflight exercise and maintained exercise logs to monitor their exercise intensity and duration. Two subjects participated in this investigation during two different flights. A 10-min stand test, preceded by at least 6 min of quiet supine rest, was completed 10-15 d before launch (PRE) and within 4 h of landing (POST). Based upon their inflight exercise records, subjects were grouped as either high (HIex: > or = 3 times/week, HR > or = 70% HRmax, > or = 20 min/session, N = 11), medium (MEDex: > or = 3 times/week, HR < 70% HRmax, > or = 20 min/session, N = 10), or low (LOex: < or = 3 times/week, HR and duration variable, N = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, P < or = 0.05). RESULTS: There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared with PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36 +/- 5 bpm) compared with HIex or MEDex groups (25 +/- 1 bpm; 22 +/- 2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after space flight in the MEDex and HIex groups but was significantly greater in the LOex group (PRE: -9 +/- 3; POST: -19 +/- 4 mm Hg). CONCLUSIONS: Thus, moderate to high levels of inflight exercise attenuated HR and PP responses to standing after space flight.

  17. The Contribution of Exercise Testing in the Prescription and Outcome Evaluation of Exercise Training in Pulmonary Rehabilitation

    PubMed Central

    STROESCU, Carmen; IONITA, Diana; CROITORU, Alina; TOMA, Claudia; PARASCHIV, Bianca

    2012-01-01

    ABSTRACT Pulmonary rehabilitation is a comprehensive therapeutic intervention with proven efficacy in relieving symptoms and increasing exercise tolerance in patients with chronic respiratory diseases. One of the main components of a pulmonary rehabilitation program is lower limbs exercise training. There are several ways of establishing the optimal intensity of the exercise training, using the target heart rate, symptom scores, walking tests and laboratory exercise tests with or without ventilation or gas exchange measurements. Each of these methods has advantages and disadvantages. The gold standard in exercise capacity evaluation is cardiopulmonary exercise testing (CPET) which brings a high level of objectivity in exercise tolerance evaluation and provides information on mechanisms responsible for its decline; this allows a better training prescription and a correct evaluation of rehabilitation outcomes. PMID:23118826

  18. Simple exercise test for the prediction of relative heat tolerance

    SciTech Connect

    Kenney, W.L.; Lewis, D.A.; Anderson, R.K.; Kamon, E.

    1986-04-01

    A medical screening exercise test is presented which accurately predicts relative heat tolerance during work in very hot environments. The test consisted of 15-20 min of exercise at a standard absolute intensity of about 600 kcal/hr (140W) with the subject wearing a vapor-barrier suit. Five minutes after the subject exercised, recovery heart rate was measured. When this heart rate is used, a physiological limit (+/- approximately 5 min) can be predicted with 95% confidence for the most intense work-heat conditions found in nuclear power stations. In addition, site health and safety personnel can establish qualification criteria for work on hot jobs, based on the test results. The test as developed can be performed in an office environment with the use of a minimum of equipment by personnel with minimal expertise and training. Total maximal test duration is about 20-25 min per person and only heart rate need be monitored (simple pulse palpation will suffice). Test modality is adaptable to any ergometer, the most readily available and least expensive of which is bench-stepping. It is recommended that this test be available for use for those persons who, based upon routine medical examination or past history, are suspected of being relatively heat intolerant.

  19. [Exercise test in patients with permanent pacemakers].

    PubMed

    Esturau, R; Iturralde, P; Férez, S; Galván, O; Rosado, J; Pérez, G; González Hermosillo, J A

    1991-01-01

    From June 1988 to June 1990 we studied fifty patients who had implantation of a pacemaker. (31 females and 19 males). All of them underwent stress test with Bruce's protocol. Patients were divided in two groups; pacemaker-independent (PI) and pacemaker-dependent (PD). Over 50% of the patients inhibited the pacemaker with their own rhythm, most of them had sinus dysfunction. Complete A-V block was predominant in PD. The group of PI achieved more mets and had more oxygen consumption. Blood pressure response was similar in both groups.

  20. Incremental Validity of the Subscales of the Emotional Regulation Related to Testing Scale for Predicting Test Anxiety

    ERIC Educational Resources Information Center

    Feldt, Ronald; Lindley, Kyla; Louison, Rebecca; Roe, Allison; Timm, Megan; Utinkova, Nikola

    2015-01-01

    The Emotional Regulation Related to Testing Scale (ERT Scale) assesses strategies students use to regulate emotion related to academic testing. It has four dimensions: Cognitive Appraising Processes (CAP), Emotion-Focusing Processes (EFP), Task-Focusing Processes (TFP), and Regaining Task-Focusing Processes (RTFP). The study examined the factor…

  1. Incremental Validity of the Subscales of the Emotional Regulation Related to Testing Scale for Predicting Test Anxiety

    ERIC Educational Resources Information Center

    Feldt, Ronald; Lindley, Kyla; Louison, Rebecca; Roe, Allison; Timm, Megan; Utinkova, Nikola

    2015-01-01

    The Emotional Regulation Related to Testing Scale (ERT Scale) assesses strategies students use to regulate emotion related to academic testing. It has four dimensions: Cognitive Appraising Processes (CAP), Emotion-Focusing Processes (EFP), Task-Focusing Processes (TFP), and Regaining Task-Focusing Processes (RTFP). The study examined the factor…

  2. A modified incremental shuttle run test for the determination of peak shuttle running speed and the prediction of maximal oxygen uptake.

    PubMed

    Wilkinson, D M; Fallowfield, J L; Myers, S D

    1999-05-01

    The aim of this study was to determine the incidence of subject drop-out on a multi-stage shuttle run test and a modified incremental shuttle run test in which speed was increased by 0.014 m x s(-1) every 20-m shuttle to avoid the need for verbal speed cues. Analysis of the multi-stage shuttle run test with 208 elite female netball players and 381 elite male lacrosse players found that 13 (+/-3) players stopped after the first shuttle of each new level, in comparison with 5 (+/-2) players on any other shuttle. No obvious drop-out pattern was observed on the incremental shuttle run test with 273 male and 79 female undergraduate students. The mean difference between a test-retest condition (n = 20) for peak shuttle running speed (-0.03+/-0.01 m x s(-1)) and maximal heart rate (0.4+/-0.1 beats x min(-1)) on the incremental test showed no bias (P > 0.05). The 95% absolute confidence limits of agreement were+/-0.11 m x s(-1) for peak shuttle running speed and+/-5 beats min(-1) for maximal heart rate. The relationship (n = 27) between peak shuttle running speed on the incremental shuttle run test (4.22+/-0.14 m x s(-1)) and VO2max (59.0+/-1.7 ml kg(-1) x min(-1)) was r= 0.91 (P< 0.01), with a standard error of prediction of +/-2.6 ml x kg(-1) x min(-1). These results suggest verbal cues during the multi-stage shuttle run test may influence subject drop-out. The incremental shuttle run test shows no obvious drop-out patten and provides a valid estimate of VO2max.

  3. Effect of exercise test on pulmonary function of obese adolescents.

    PubMed

    Faria, Alethéa Guimarães; Ribeiro, Maria Angela G O; Marson, Fernando Augusto Lima; Schivinski, Camila Isabel S; Severino, Silvana Dalge; Ribeiro, José Dirceu; Barros Filho, Antônio A

    2014-01-01

    to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender. a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic), divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2]), heart rate (HR), blood pressure (BP), respiratory rate (RR), and respiratory muscle strength were measured. Pulmonary function parameters were measured before, during, and after the exercise test. BP and HR were higher in obese individuals during the exercise test (p = 0.0001). SatO2 values decreased during exercise in obese adolescents (p = 0.0001). Obese males had higher levels of maximum inspiratory and expiratory pressures (p = 0.0002) when compared to obese and eutrophic females. Obese males showed lower values of maximum voluntary ventilation, forced vital capacity, and forced expiratory volume in the first second when compared to eutrophic males, before and after exercise (p = 0.0005). Obese females had greater inspiratory capacity compared to eutrophic females (p = 0.0001). Expiratory reserve volume was lower in obese subjects when compared to controls (p ≤ 0,05). obese adolescents presented changes in pulmonary function at rest and these changes remained present during exercise. The spirometric and cardiorespiratory values were different in the four study groups. The present data demonstrated that, in spite of differences in lung growth, the model of fat distribution alters pulmonary function differently in obese female and male adolescents. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Testing the Relations Between Impulsivity-Related Traits, Suicidality, and Nonsuicidal Self-Injury: A Test of the Incremental Validity of the UPPS Model

    PubMed Central

    Lynam, Donald R.; Miller, Joshua D.; Miller, Drew J.; Bornovalova, Marina A.; Lejuez, C. W.

    2011-01-01

    Borderline personality disorder (BPD) has received significant attention as a predictor of suicidal behavior (SB) and nonsuicidal self-injury (NSSI). Despite significant promise, trait impulsivity has received less attention. Understanding the relations between impulsivity and SB and NSSI is confounded, unfortunately, by the heterogeneous nature of impulsivity. This study examined the relations among 4 personality pathways to impulsive behavior studied via the UPPS model of impulsivity and SB and NSSI in a residential sample of drug abusers (N = 76). In this study, we tested whether these 4 impulsivity-related traits (i.e., Negative Urgency, Sensation Seeking, Lack of Premeditation, and Lack of Perseverance) provide incremental validity in the statistical prediction of SB and NSSI above and beyond BPD; they do. We also tested whether BPD symptoms provide incremental validity in the prediction of SB and NSSI above and beyond these impulsivity-related traits; they do not. In addition to the main effects of Lack of Premeditation and Negative Urgency, we found evidence of a robust interaction between these 2 personality traits. The current results argue strongly for the consideration of these 2 impulsivity-related domains—alone and in interaction—when attempting to understand and predict SB and NSSI. PMID:21833346

  5. Testing the relations between impulsivity-related traits, suicidality, and nonsuicidal self-injury: a test of the incremental validity of the UPPS model.

    PubMed

    Lynam, Donald R; Miller, Joshua D; Miller, Drew J; Bornovalova, Marina A; Lejuez, C W

    2011-04-01

    Borderline personality disorder (BPD) has received significant attention as a predictor of suicidal behavior (SB) and nonsuicidal self-injury (NSSI). Despite significant promise, trait impulsivity has received less attention. Understanding the relations between impulsivity and SB and NSSI is confounded, unfortunately, by the heterogeneous nature of impulsivity. This study examined the relations among 4 personality pathways to impulsive behavior studied via the UPPS model of impulsivity and SB and NSSI in a residential sample of drug abusers (N = 76). In this study, we tested whether these 4 impulsivity-related traits (i.e., Negative Urgency, Sensation Seeking, Lack of Premeditation, and Lack of Perseverance) provide incremental validity in the statistical prediction of SB and NSSI above and beyond BPD; they do. We also tested whether BPD symptoms provide incremental validity in the prediction of SB and NSSI above and beyond these impulsivity-related traits; they do not. In addition to the main effects of Lack of Premeditation and Negative Urgency, we found evidence of a robust interaction between these 2 personality traits. The current results argue strongly for the consideration of these 2 impulsivity-related domains--alone and in interaction--when attempting to understand and predict SB and NSSI.

  6. Determination of Aerobic Capacity via Cycle Ergometer Exercise Testing in Alzheimer's Disease.

    PubMed

    Bronas, Ulf G; Salisbury, Dereck; Kelly, Kaitlin; Leon, Arthur; Chow, Lisa; Yu, Fang

    2017-01-01

    Older adults with Alzheimer's disease (AD) may be unable to perform treadmill testing due to balance issues. We investigated whether older adults with AD could successfully complete a peak cycle ergometer test. Peak oxygen consumption (peak [Formula: see text]) assessed via a cycle ergometer test in 44 participants with AD (age 78.4 ± 6.8). Physical function was assessed via the incremental shuttle walk, 6-minute walk, and the Short Physical Performance Battery (SPPB). All participants completed the cycle ergometer test successfully. Peak [Formula: see text] was correlated with SPPB ( r = .35, P = .023), shuttle walk ( r = .35, P = .024), 6-minute walk ( r = .31, P = .05), and inversely with age ( r = -.4, P = .009). There was no correlation between peak [Formula: see text] and cognition. Older adults with AD are able to safely complete a peak cycle ergometer exercise testing protocol. We provide an individualized cycle ergometer test for determining aerobic capacity in older adults with AD who may be unable to perform treadmill testing due to balance or gait issues.

  7. Effects of the rotor pedalling system on the performance of trained cyclists during incremental and constant-load cycle-ergometer tests.

    PubMed

    Lucía, A; Balmer, J; Davison, R C R; Pérez, M; Santalla, A; Smith, P M

    2004-10-01

    The aim of this study was to determine the effects of Rotor, a new cycle crank configuration that effectively allows the pedals to move independently throughout the duty cycle, on indices of endurance cycling performance in trained cyclists. Ten cyclists (5 Rotor users and 5 non-users; age (mean +/- SD): 22 +/- 5 y; VO(2)max: 69.5 +/- 5.1 mL. kg(-1).min(-1)) volunteered to participate in the study. On four separate days, the subjects performed four cycle-ergometer tests, i.e. two incremental tests and two 20-min tests. An imposed crank rate of 75 rev.min(-1) was used during all tests. The incremental protocol started at 112.5 W, and the power output was increased by 37.5 W every 3 min until volitional exhaustion. The 20-min tests were performed at a fixed power output equivalent to 80 % of the highest power output that the cyclists maintained for a complete 3-min period during incremental tests. Both types of tests were performed with the conventional crank system and the Rotor following a counter-balanced, cross-over design. Gas exchange parameters were measured in all the tests and blood lactate was determined at the end of each 3-min period (incremental tests) and at the end of the 20-min tests. A three factor (pedalling system used during the tests x habitual pedalling system x power output [incremental tests] or time [20-min tests]) ANOVA with repeated measures on power output (incremental tests) or time (20-min tests) was used to analyse several indices of performance, e.g. peak power output, VO(2)max, lactate threshold, onset of blood lactate accumulation, economy, delta, and gross efficiency. No differences (p > 0.05) were found between the Rotor and conventional systems for any of the aforementioned variables. It seems that the theoretical advantage brought about by the Rotor system, i.e. improved contra-lateral cooperation of both legs, would be minimized in trained cyclists. Although field studies are needed to assess the possible implications, in terms

  8. Predicted Values of Cardiopulmonary Exercise Testing in Healthy Individuals (A Pilot Study)

    PubMed Central

    Mohammad, Majid Malek; Dadashpour, Shahdak

    2012-01-01

    Background Cardiopulmonary exercise testing evaluates the ability of one's cardiovascular and respiratory system in maximal exercise. This was a descriptive cross-sectional pilot study conducted at Masih Daneshvari Hospital in order to determine predicted values of cardiopulmonary exercise testing in individuals with normal physical activity patterns. Materials and Methods Thirty four individuals (14 women, 20 men) between 18-57 years of age were chosen using simple sampling method and evaluated with an incremental progressive cycle-ergometer test to a symptom-limited maximal tolerable work load. Subjects with a history of ischemic heart disease, pulmonary disease or neuromuscular disease were excluded from the study. Smokers were included but we made sure that all subjects had normal FEV1 and FEV1/FVC. This study aimed to compare measured values of VO2, VCO2, VO2/Kg, RER, O2pulse, HRR, HR, Load, Ant, BF, BR, VE, EQCO2, and EQO2 with previously published predicted values. Results We found that our obtained values for VO2 max, HRR max and HR max were different from standard tables but such difference was not observed for other understudy variables. Multiple linear regression analysis was done for height, weight and age (due to the small number of samples, no difference was detected between males and females). VO2 max and load max had reverse correlation with age and direct correlation with weight and height (P < 0.05) but the greatest correlation was observed for height. Conclusion Due to the small number of samples and poor correlations it was not possible to do regression analysis for other variables. In the next study with a larger sample size predicted values for all variables will be calculated. If the future study also indicates a significant difference between the predicted values and the reference values, we will need standard tables made specifically for our own country, Iran. PMID:25191396

  9. Predicted values of cardiopulmonary exercise testing in healthy individuals (a pilot study).

    PubMed

    Mohammad, Majid Malek; Dadashpour, Shahdak; Adimi, Parisa

    2012-01-01

    Cardiopulmonary exercise testing evaluates the ability of one's cardiovascular and respiratory system in maximal exercise. This was a descriptive cross-sectional pilot study conducted at Masih Daneshvari Hospital in order to determine predicted values of cardiopulmonary exercise testing in individuals with normal physical activity patterns. Thirty four individuals (14 women, 20 men) between 18-57 years of age were chosen using simple sampling method and evaluated with an incremental progressive cycle-ergometer test to a symptom-limited maximal tolerable work load. Subjects with a history of ischemic heart disease, pulmonary disease or neuromuscular disease were excluded from the study. Smokers were included but we made sure that all subjects had normal FEV1 and FEV1/FVC. This study aimed to compare measured values of VO2, VCO2, VO2/Kg, RER, O2pulse, HRR, HR, Load, Ant, BF, BR, VE, EQCO2, and EQO2 with previously published predicted values. We found that our obtained values for VO2 max, HRR max and HR max were different from standard tables but such difference was not observed for other understudy variables. Multiple linear regression analysis was done for height, weight and age (due to the small number of samples, no difference was detected between males and females). VO2 max and load max had reverse correlation with age and direct correlation with weight and height (P < 0.05) but the greatest correlation was observed for height. Due to the small number of samples and poor correlations it was not possible to do regression analysis for other variables. In the next study with a larger sample size predicted values for all variables will be calculated. If the future study also indicates a significant difference between the predicted values and the reference values, we will need standard tables made specifically for our own country, Iran.

  10. More about hospital generator sizing, testing and exercising.

    PubMed

    Nash, H O

    1996-08-01

    The National Fire Protection Agency (NFPA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirements for testing and exercising on-site standby generators are intended to prevent testing with insufficient load. However, engineers grapple with local and state enforcement agencies who require needlessly oversized standby generators, putting the engineer in the difficult position of using supplementary load banks because of insufficient building load for testing. This document examines the latest changes in NFPA codes and the JCAHO policy that aim to resolve testing issues.

  11. Reliability of peak treadmill exercise tests in mild Alzheimer disease.

    PubMed

    Anderson, Heather S; Kluding, Patricia M; Gajewski, Byron J; Donnelly, Joseph E; Burns, Jeffrey M

    2011-08-01

    The purpose of this study was to determine the reliability of treadmill peak exercise testing in people with very mild-to-mild Alzheimer disease (AD). Sixteen subjects with very mild-to-mild AD performed graded peak treadmill exercise tests twice within a 14-day period. Heart rate, oxygen consumption, and respiratory exchange ratio (RER) were continuously monitored. Peak values were analyzed for absolute level of agreement. Fourteen participants (87.5%) completed testing. Reliability was excellent with total peak oxygen consumption (VO2peak) (ml/kg/min) highly correlated across the two tests (r = 0.94, p < .001) with an intraclass correlation coefficient (ICC[3,1]) of 0.92 (95% confidence interval (CI) = 0.78, 0.97). The standard error of measurement (SEM) for VO2peak was 1.29 (95% CI = 0.88, 1.89). These results indicate that peak exercise testing on a treadmill is reliable in the early stages of AD.

  12. [Cardiovascular response to the treadmill exercise test in young women in Sarajevo during chronic stress due to the war].

    PubMed

    Nakas-Ićindić, E; Kulenović, H; Knezević, Z; Frljak, N; Mujić, M

    1997-01-01

    This study is unique in its approach because it was carried out under extremely hard conditions during intensive war activities. Specific characteristic of this aggressive war was that civilian population was forced to live in war zone for a very long period without enough food, water and energy supplies. It was really stressful to live with cognitiori that anyone at any moment and place could become victim of sudden shelling and shooting of civil targets. The aim of this study was to assess how the war caused stress influenced the function of cardiovascular system and its response on stress exercise in young women. The subjects were selected among the students of Sarajevo University. All of them lived in Sarajevo during whole war period. Nine young women (age 18-21) performed multistage incremental exercise treadmill testing under Bruce protocol. It was planned for each subject to complete two exercise sessions in three months interval, but only five persons completed second session. It was a period of intensive attack on the city so that some of our subjects left Sarajevo and some were wounded. The results of two exercise sessions showed that resting values of cardiovascular variables, were within physiological range but with great individual variations. The mean maximal exercise capacity expressed as metabolic units (METS) was 13.67 +/- 1.00 for the first exercise session and 13.40 +/- 0.89 for the second. Heart rate in response to exercise increased rapidly. It was achieved about 95% of predicted max. There were no significant differences in the results of two exercise sessions. Hyperreactive physiological responses as consequences of war caused stress could not be changed in so short period and under unchanged war conditions.

  13. Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women

    PubMed Central

    Diercks, Deborah B.; Mumma, Bryn E.; Peacock, W. Frank; Hollander, Judd E.; Safdar, Basmah; Mahler, Simon A.; Miller, Chadwick D.; Counselman, Francis L.; Birkhahn, Robert; Schrock, Jon; Singer, Adam J.; Nagurney, John T.

    2013-01-01

    Objectives Guidelines recommend that patients presenting to the emergency department (ED) with chest pain who are at low risk for acute coronary syndrome (ACS) receive an objective cardiac evaluation with a stress test or coronary imaging. It is uncertain whether all women derive benefit from this process. The study aim was to determine the incremental value of objective cardiac testing after serial cardiac markers and physician risk assessment. Methods Women enrolled in the 18-site Myeloperoxidase in the Diagnosis of Acute Coronary Syndrome (MIDAS) study had serial troponin I measured at time 0 and 90 minutes, and physician risk assessment for the presence of ACS. Risk estimates obtained at the time of ED evaluation were dichotomized as high or non-high risk. The primary outcome was the composite of acute myocardial infarction (AMI) or revascularization at 30 days. Logistic regression with receiver operator characteristic (ROC) curves and net reclassification index were used to determine the diagnostic accuracy for the composite outcome of 30-day MI or revascularization for two models: 1) troponin I results and physician risk assessment alone; and 2) troponin I results, physician risk assessment, and objective cardiac testing. Results Four hundred sixty women with a median age 58 years (IQR 48.5 to 68 years) were included, and 32 (6.9%) experienced AMI or revascularization by 30 days. Comparison of the area under the ROC curves (AUC) showed that the addition of objective cardiac testing to the combination of troponin I results and physician risk assessment did not significantly improve prediction of 30-day AMI or revascularization (AUC 0.85 vs. 0.89; p = 0.053). Using a threshold of 1%, net reclassification index showed that the addition of objective cardiac testing to troponin I results and physician risk assessment worsened the prediction for 30-day AMI and revascularization. All of the reclassified patients were false positives, with nine (2.1%) patients

  14. Incremental haemodialysis.

    PubMed

    Wong, Jonathan; Vilar, Enric; Davenport, Andrew; Farrington, Ken

    2015-10-01

    Thrice-weekly haemodialysis schedules have become the standard default haemodialysis prescription worldwide. Whereas the measurement of residual renal function is accepted practice for peritoneal dialysis patients and the importance of residual renal function in determining technique success is well established, few centres routinely assess residual renal function in haemodialysis patients. Although intradialytic hypotension and episodes of acute kidney injury may predispose to an earlier loss of residual renal function, a significant proportion of haemodialysis patients maintain some residual function long after dialysis initiation. As such, an incremental approach to the initiation of dialysis with careful monitoring of residual renal function may potentially provide some haemodialysis patients with an improved quality of life and greater preservation of residual renal function whilst fewer dialysis sessions may reduce health care costs. Prospective trials are required to determine the optimum approach to the initiation of haemodialysis for the oliguric patient. Once residual renal function has been lost, then dialysis prescriptions should be re-examined to consider the use of longer or more frequent treatment sessions and switching from low-flux to high-flux dialysis or haemodiafiltration to offset retention of middle sized molecules and protein-bound azotaemic solutes.

  15. Prognostic significance of cardiopulmonary exercise testing for 10-year survival in patients with mild to moderate heart failure.

    PubMed

    Koike, A; Koyama, Y; Itoh, H; Adachi, H; Marumo, F; Hiroe, M

    2000-12-01

    Although a number of studies have investigated the prognostic significance of exercise variables, they have focused only on short-term prognosis in relatively severe heart failure. This study was carried out to determine whether the indices obtained during cardiopulmonary exercise testing have prognostic significance during a 10-year follow-up in mild to moderate heart failure. Three hundred and sixty-four consecutive patients with cardiac disease performed 4 min of 20-W warm-up, followed by a symptom-limited incremental exercise test on a cycle ergometer. In addition to the measurements of peak oxygen uptake (VO2) and gas exchange (anaerobic) threshold, the time constant of VO2 kinetics during the onset of warm-up exercise was calculated using a single exponential equation. Data on mortality were available for follow-up in 260 patients. After 3,331+/-610 days of follow-up, 29 cardiovascular-related deaths occurred. The time constant of VO2 in the nonsurvivors was 76.7+/-43.3 s and was significantly prolonged compared with that of survivors (55.3+/-30.6 s, p=0.001). Peak VO2 and gas exchange threshold were both significantly lower in nonsurvivors than in survivors. Kaplan-Meier survival curves for 10 years of follow-up demonstrated a survival rate of 89.0% for patients with a normal VO2 time constant (< 80 s) and 71.7% for those with a longer time constant (> or = 80 s), showing a significant difference in survival (p=0.0028). Respiratory gas parameters obtained during exercise testing, particularly the time constant of VO2 kinetics, were found to be useful for predicting long-term prognosis in patients with chronic heart failure. These results suggest that cardiopulmonary exercise testing could be more applicable in ambulatory patients with minimal symptoms or minimal functional impairment.

  16. A comparative study of two protocols for treadmill walking exercise testing in ambulating subjects with incomplete spinal cord injury.

    PubMed

    Lundgaard, E; Wouda, M F; Strøm, V

    2017-05-23

    This is a comparative study of two exercise testing protocols. The objective of this study was to compare maximal oxygen uptake (VO2 max) and achieved criteria for maximal exercise testing between the Sunnaas Protocol-a newly designed treadmill exercise test protocol-and the Modified Bruce Protocol in persons with incomplete spinal cord injury (SCI). This study was conducted in Sunnaas Rehabilitation Hospital, Norway. Twenty persons (19 men) with incomplete SCI (AIS D) capable of ambulating without assistive devices performed two treadmill walking exercise tests (Sunnaas Protocol and Modified Bruce Protocol) until exhaustion 1-3 days apart. The key differences between the protocols are the smaller increments in speed and shorter duration on each workload in the Sunnaas Protocol. Cardiovascular responses were measured continuously throughout both tests. The subjects exhibited statistically significantly higher VO2 max when using the Sunnaas Protocol (37.1±9.9 vs 35.4±9.8 ml kg(-1) min(-1), P=0.01), with a mean between-test difference of 1.8 ml kg(-1) min(-1) (95% confidence interval: 0.49-3.16). There was no significant difference in mean maximal heart rate (HR max). Nineteen (95%) subjects achieved at least three of the four criteria for maximal oxygen uptake using the Sunnaas Protocol. Thirteen (65%) subjects achieved at least three of the criteria using a Modified Bruce protocol. The small differences in both VO2 max and achieved criteria in favor of the Sunnaas Protocol suggest that it could be a useful alternative treadmill exercise test protocol for ambulating persons with incomplete SCI.Spinal Cord advance online publication, 23 May 2017; doi:10.1038/sc.2017.34.

  17. How many electrocardiographic leads are required for exercise treadmill tests

    SciTech Connect

    Miller, T.D.; Desser, K.B.; Lawson, M.

    1987-04-01

    Forty-four consecutive patients who had perfusion defects on thallium-201 scanning and positive exercise treadmill tests were prospectively studied. Thirty-eight (86%) subjects had diagnostic ST segment changes in lead V5, 37 (84%) in lead V4, and 44 (100%) in either lead V4, V5 or both. Thirty patients had ST segment changes in the inferior leads, 20 in lead aVR, and only four in lead I and/or aVL. All of these latter subjects had diagnostic ST segments in lead V4 and/or V5. It is concluded that: combined electrocardiographic leads V4 and V5 detect the vast majority of ischemic changes during exercise treadmill testing, regardless of the site of perfusion defects detected by thallium-201 scanning; and monitoring the inferior and lateral leads rarely provides more diagnostic information.

  18. [Positive exercise test in hypertensive patients correlated with coronary angiography].

    PubMed

    Rosado, J; de los Santos, C; Iturralde, P; Pérez, G; Romero, L; Colín, L; González Hermosillo, A; Casanova, J M

    1991-01-01

    With the purpose of evaluate the state of the coronary arteries in hypertensive patients with positive exercise test, 82 patients were selected, 50 male and 32 female with mean age of 56.9 +/- 13.2 years. Angiography was normal in 25 patients thirteen patients had a single coronary arteries narrow of less than 50% and 44 cases with significant coronary arteries lesions of more than 50%. The parameters obtained in the exercise test are not significant for statistic purposes. Systolic hypertension or flat response was more frequent in the group with advanced coronary lesions with a predicted positive value in coronary obstructions of 66 and 75%. We conclude that 70% of hypertensive patients have obstructive coronary lesions of some degree.

  19. Ischemic preconditioning accelerates muscle deoxygenation dynamics and enhances exercise endurance during the work-to-work test.

    PubMed

    Kido, Kohei; Suga, Tadashi; Tanaka, Daichi; Honjo, Toyoyuki; Homma, Toshiyuki; Fujita, Satoshi; Hamaoka, Takafumi; Isaka, Tadao

    2015-05-01

    Ischemic preconditioning (IPC) improves maximal exercise performance. However, the potential mechanism(s) underlying the beneficial effects of IPC remain unknown. The dynamics of pulmonary oxygen uptake (VO2) and muscle deoxygenation during exercise is frequently used for assessing O2 supply and extraction. Thus, this study examined the effects of IPC on systemic and local O2 dynamics during the incremental step transitions from low- to moderate- and from moderate- to severe-intensity exercise. Fifteen healthy, male subjects were instructed to perform the work-to-work cycling exercise test, which was preceded by the control (no occlusion) or IPC (3 × 5 min, bilateral leg occlusion at >300 mmHg) treatments. The work-to-work test was performed by gradually increasing the exercise intensity as follows: low intensity at 30 W for 3 min, moderate intensity at 90% of the gas exchange threshold (GET) for 4 min, and severe intensity at 70% of the difference between the GET and VO2 peak until exhaustion. During the exercise test, the breath-by-breath pulmonary VO2 and near-infrared spectroscopy-derived muscle deoxygenation were continuously recorded. Exercise endurance during severe-intensity exercise was significantly enhanced by IPC. There were no significant differences in pulmonary VO2 dynamics between treatments. In contrast, muscle deoxygenation dynamics in the step transition from low- to moderate-intensity was significantly faster in IPC than in CON (27.2 ± 2.9 vs. 19.8 ± 0.9 sec, P < 0.05). The present findings showed that IPC accelerated muscle deoxygenation dynamics in moderate-intensity exercise and enhanced severe-intensity exercise endurance during work-to-work test. The IPC-induced effects may result from mitochondrial activation in skeletal muscle, as indicated by the accelerated O2 extraction. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological

  20. Prevention of sudden death in adolescent athletes: Incremental diagnostic value and cost-effectiveness of diagnostic tests.

    PubMed

    Grazioli, Gonzalo; Sanz de la Garza, Maria; Vidal, Barbara; Montserrat, Silvia; Sarquella-Brugada, Georgia; Pi, Ramon; Til, Lluis; Gutierrez, Josep; Brugada, Josep; Sitges, Marta

    2017-09-01

    Introduction Pre-participation screening in athletes attempts to reduce the incidence of sudden death during sports by identifying susceptible individuals. The objective of this study was to evaluate the diagnostic capacity of the different pre-participation screening points in adolescent athletes and the cost effectiveness of the programme. Methods Athletes were studied between 12-18 years old. Pre-participation screening included the American Heart Association questionnaire, electrocardiogram, echocardiogram, and stress test. The cost of test was established by the Catalan public health system. Results Of 1650 athletes included, 57% were men and mean age was 15.09 ± 1.82 years. Positive findings were identified as follows: in American Heart Association questionnaire 5.09% of subjects, in electrocardiogram 3.78%, in echocardiogram 4.96%, and in exercise test 1.75%. Six athletes (0.36%) were disqualified from participation and 10 (0.60%) were referred for interventional treatment. Diagnostic capacity was assessed by the area under the curve for detection of diseases that motivated disqualification for sport practice (American Heart Association questionnaire, 0.55; electrocardiogram, 0.72; echocardiogram, 0.88; stress test, 0.57). The cost for each athlete disqualified from the sport for a disease causing sudden death was €45,578. Conclusion The electrocardiogram and echocardiogram were the most useful studies to detect athletes susceptible to sudden death, and the stress test best diagnosed arrhythmias with specific treatment. In our country, pre-participatory screening was cost effective to detect athletes who might experience sudden death in sports.

  1. The prognostic value of a QRS score during exercise testing.

    PubMed

    Michaelides, Andreas P; Aigyprladou, Maria-Niki K; Andrikopoulos, George K; Richter, Dimitris J; Kartalis, Athanasios; Tapanlis, Evstratios; Fourlas, Christros A; Stefanadis, Christodoulos I

    2005-08-01

    Values of a QRS score have been positively related to the number of narrowed coronary arteries and to the extent of myocardial ischemia in radionuclide imaging techniques. This study was conducted to evaluate the potential prognostic information of abnormal values of this QRS score during treadmill exercise testing in patients with established coronary artery disease (CAD). In all, 309 patients (258 men, 51 women, mean age 56.1 +/- 10.0 years) with documented CAD, underwent a treadmill exercise test and coronary arteriography at baseline. Subsequently, they were prospectively followed to a maximum of 36 months (mean follow-up 23 +/- 13 months, median 25 months). During the follow-up period, 20 patients (6.5%) died from acute myocardial infarction. Abnormal QRS score values were found to be significantly and independently associated with cardiac mortality (QRS < or = -4: relative risk 11.7; 95% confidence interval = 2.5-55.4; p = 0.002). Taking into consideration the importance of exercise testing in the management of ischemic heart disease, the use of this QRS score could be of clinical value in predicting the outcome of patients with documented CAD.

  2. Assessing utility of exercise test in determining exercise prescription in adolescent and adult patients with repaired tetralogy of fallot.

    PubMed

    Yang, Ming-Chun; Chen, Chun-An; Chiu, Hsin-Hui; Wang, Jou-Kou; Lin, Ming-Tai; Chiu, Shuenn-Nan; Lu, Chun-Wei; Huang, Shu-Chien; Wu, Mei-Hwan

    2017-02-01

    Parameters from cardiopulmonary exercise test (CPET) are useful prognostic factors for patients with repaired tetralogy of fallot (TOF). Its application in exercise prescription remains unclear. This study sought to define its role. We made current exercise recommendations in repaired TOF patients according to European Society of Cardiology (ESC) guideline, which were based on ventricular function, pressure/volume load, pulmonary artery pressure, hypoxemia and arrhythmic burden both at rest and during exercise. CPET parameters (peak oxygen consumption, oxygen uptake efficiency plateau, and E/CO2 slope), along with cardiothoracic ratio, ventricular arrhythmia, QRS duration and NYHA functional status, were used to calculate "score to exercise". 112 repaired TOF adolescent and adult aged 32.6 ± 10.8 (14.05- to 56.99-year-old, median 30.1) years received exercise recommendations by ESC guideline, which suggested high, moderate and low intensity sports for 45 (40.2 %), 45 (40.2 %), and 22 (19.6 %) patients, respectively. The optimal cut-off values were 67 and 77 % for peak VO2, 86 and 100 % for OUEP, 22 and 28 for E/CO2 slope to correlate to the exercise intensity recommendation. But, individual CPET parameter had low consistency (41-46 %) in making decisions of exercise intensity compared to ESC recommendations. Using the "score to exercise", the consistency rate could be increased to 74.1 %. With "score to exercise" recommended exercise intensity, follow-up result revealed no adverse event related to sports. Individual CPET parameter did not correlate well to the exercise recommendation from ESC. We proposed a scoring system, "score to exercise", which incorporates three CPET parameters with cardiothoracic ratio, ventricular arrhythmia, QRS duration and NYHA functional status. Score to exercise is easy to be assessed and provides useful information for exercise recommendation in patients with repaired TOF.

  3. Heart rate recovery after exercise: an important prognostic criterion.

    PubMed

    Cay, Serkan

    2009-11-12

    Exercise stress testing gives important data about autonomic nervous system activity. It has been demonstrated that heart rate profile parameters such as resting heart rate before exercise, maximum heart rate at peak exercise, heart rate increment during exercise, and heart rate decrement after exercise (heart rate recovery) are important prognostic factors in a variety of patient population. These simply measured parameters give significant and valuable data about prognosis.

  4. EKGs and Exercise Stress Tests: When You Need Them for Heart Disease - and When You Don't

    MedlinePlus

    ... Resources EKGs and Exercise Stress Tests EKGs and Exercise Stress Tests When you need them—and when ... or electrocardiogram, measures your heart’s activity. In an exercise stress test, you have an EKG while you ...

  5. [Myocardial infarct immediately after a normal exercise test].

    PubMed

    Gómez-Jaume, A; González-Hermosillo, J A; Iturralde, P; Romero, L; Colín, L; Villarreal, A

    1990-01-01

    Two cases of myocardial infarction immediately following a normal stress testing, are described. The incidence and possible pathophysiological mechanisms are discussed. In one of the patients it was difficult to establish the pathophysiological mechanism which was the cause of the ischemic event. In the other, the coronary arteriography revealed only minimal obstructive disease. Therefore, coronary vasospasm with thrombus formation as a cause of the infarction ia an interesting speculative possibility in view of the angiographic findings. Acute myocardial infarction after a normal electrocardiographic response to maximal exercise testing is extremely rare, and the precise pathophysiologic mechanism that leads to his complication is not clear.

  6. [EXERCISE CAPACITY AND AEROBIC PHYSICAL FITNESS ASSESSMENT AMONG ADOLESCENTS AND ADULTS WITH CYSTIC FIBROSIS BY A QUESTIONNAIRE AND EXERCISE TESTS].

    PubMed

    Eisenstadt, Iris; Nice, Shachar; Constantini, Naama; Kerem, Eitan; Calderon-Margalit, Ronit

    2016-06-01

    Physical exercise has been shown to improve lung condition or to slow deterioration in patients with cystic fibrosis (CF) and improves their quality of life. This study analyzes the physical exercise capacity and the level of aerobic fitness of adolescents and adults with CF who are patients at the CF Center at Hadassah Medical Center Mount Scopus in Jerusalem, Israel. To assess physical exercise capacity and aerobic capacity levels among CF patients by a physical activity questionnaire in comparison to assessment by exercise tests. The participants completed a physical activity questionnaire, performed the "6 minute walk test" and a cardio-pulmonary test on a treadmill. The study group included 36 patients, ages 12-43 years, who completed a physical activity questionnaire. Most patients (92%) reported engaging in physical exercise. Most of those who exercised (61%) did so at a low intensity, as described in CF research literature. The average weekly exercise time was 177 minutes; 35 patients completed a cardio-pulmonary exercise test and a "6 minute walk test". The cardio-pulmonary exercise tests showed that 34% of the participants had 'good to excellent' aerobic fitness, 26% had 'moderate' aerobic fitness and 40% had "poor to very poor" fitness. Males achieved significantly higher maximal oxygen uptake than females, even when there were no differences in the severity of disease. Similar to the differences in the general population, these differences showed that male patients had higher aerobic fitness and exercise capacities than female CF patients. A significant correlation was found between self-reported exercise time and exercise intensity in the questionnaire and maximal oxygen uptake in the cardio-pulmonary test (r = 0.5, P < 0.01). The physical activity questionnaire had 85% sensitivity for the identification of patients with low aerobic exercise capacity and specificity of only 50%. The physical activity questionnaire showed a good correlation with the

  7. Incremental cost per newly diagnosed HIV infection (NDHI): routine (RTS), targeted (TTS), and current clinical practice testing strategies (CPTS).

    PubMed

    Gomez-Ayerbe, Cristina; Elías, María Jesús Pérez; Muriel, Alfonso; Elías, Pilar Pérez; Cano, Agustina; Diaz, Alberto; Moreno, Ana; Casado, Jose Luis; Santos, Cristina; Martinez-Colubi, María; Uranga, Almudena; Dronda, Fernando; Moreno, Santiago

    2014-01-01

    Although RTS as HIV Diagnosis was considered cost effectiveness [1], overall budget may be unaffordable for some countries. We explore Incremental cost per NDHI associated with different TS. From a health care perspective, using direct costs and Euros currency, we calculated budget and cost per NDHI of RTS (all patients were tested), TTS (Universal risk practices and clinical conditions-RP&CC - only positive were tested), and CPTS (Only patients physicians considered were tested). We considered DRIVE (Spanish acronym of HIV infection Rapid Diagnosis) study and clinical Practice outcomes. Population between 18-60 years, attending to a Hospital Emergency Room or to a Primary Care Center performed an HIV RP&CC questionnaire (Q) and an HIV rapid test (HIV RT). Unitary costs considered were: HIV RT, nurse, registry, transport and HIV confirmation when necessary, imputed to all population in RTS and CPTS and only in HIV RP&CC-Q positive in TTS analysis, while HIV RP&CC-Q costs were added to all population in TTS. Sensitivity analyses were performed with varying rates of NDHI and of positive HIV RP&CC-Q population, and different RP&CC Q sensitivity (SE) to predict HIV infection. 5,329 HIV RP&CC-Q and HIV RT were performed to 49.64% women, median age 37 years old, 74.9% Spaniards. In DRIVE and CP, NDHI were 4.1‰, and 1.6‰, while HIV RP&CC-Q was positive in 51.2%. HIV RP&CC-Q SE was 100%. Overall budget employed in HIV testing was in RTS 43,503€, in TTS 24,472€ and in CPTS 5,032€. Cost per 1 NDHI was 1,977€, 1,112€ and 5,032€, respectively. A reduction in cost of 865€, favouring TTS vs. RTS, while an increased cost of 824€ in CPTS vs. RTS was obtained. Considering NDHI rate of 2.6‰ saving costs increased to 1379€ in TTS, while were reduced to 576€ if NDHI rate increases 6.2‰. Effect of RP&CC-Q positivity rate was similar, if 25% saving costs were 1368€, while if 75% were reduced to 399€. Varying SE of RP&CC-Q to 95%, 91% and 50% cost saving

  8. Incremental cost per newly diagnosed HIV infection (NDHI): routine (RTS), targeted (TTS), and current clinical practice testing strategies (CPTS)

    PubMed Central

    Gomez-Ayerbe, Cristina; Jesús Pérez Elías, María; Muriel, Alfonso; Pérez Elías, Pilar; Cano, Agustina; Diaz, Alberto; Moreno, Ana; Luis Casado, Jose; Santos, Cristina; Martinez-Colubi, María; Uranga, Almudena; Dronda, Fernando; Moreno, Santiago

    2014-01-01

    Introduction Although RTS as HIV Diagnosis was considered cost effectiveness [1], overall budget may be unaffordable for some countries. We explore Incremental cost per NDHI associated with different TS. Materials and Methods From a health care perspective, using direct costs and Euros currency, we calculated budget and cost per NDHI of RTS (all patients were tested), TTS (Universal risk practices and clinical conditions-RP&CC - only positive were tested), and CPTS (Only patients physicians considered were tested). We considered DRIVE (Spanish acronym of HIV infection Rapid Diagnosis) study and clinical Practice outcomes. Population between 18–60 years, attending to a Hospital Emergency Room or to a Primary Care Center performed an HIV RP&CC questionnaire (Q) and an HIV rapid test (HIV RT). Unitary costs considered were: HIV RT, nurse, registry, transport and HIV confirmation when necessary, imputed to all population in RTS and CPTS and only in HIV RP&CC-Q positive in TTS analysis, while HIV RP&CC-Q costs were added to all population in TTS. Sensitivity analyses were performed with varying rates of NDHI and of positive HIV RP&CC-Q population, and different RP&CC Q sensitivity (SE) to predict HIV infection. Results 5,329 HIV RP&CC-Q and HIV RT were performed to 49.64% women, median age 37 years old, 74.9% Spaniards. In DRIVE and CP, NDHI were 4.1‰, and 1.6‰, while HIV RP&CC-Q was positive in 51.2%. HIV RP&CC-Q SE was 100%. Overall budget employed in HIV testing was in RTS 43,503€, in TTS 24,472€ and in CPTS 5,032€. Cost per 1 NDHI was 1,977€, 1,112€ and 5,032€, respectively. A reduction in cost of 865€, favouring TTS vs. RTS, while an increased cost of 824€ in CPTS vs. RTS was obtained. Considering NDHI rate of 2.6‰ saving costs increased to 1379€ in TTS, while were reduced to 576€ if NDHI rate increases 6.2‰. Effect of RP&CC-Q positivity rate was similar, if 25% saving costs were 1368€, while if 75% were reduced to 399€. Varying SE

  9. What to expect when you're exercising: An experimental test of the anticipated affect-exercise relationship.

    PubMed

    Kwan, Bethany M; Stevens, Courtney J; Bryan, Angela D

    2017-04-01

    Anticipated affect may influence exercise behavior via experienced affective responses and intentions. Cognitive manipulations of anticipated affect may inform exercise intervention design. The purpose of this study was to experimentally test the effects of an expectation-based manipulation of affective responses to exercise on anticipated, experienced, and remembered affect and adherence to a 7-day exercise prescription. Participants (N = 98) were randomly assigned to a positive anticipated affect manipulation, a negative anticipated affect manipulation, or a no affect manipulation control. They reported anticipated, experienced, and remembered affect during and after a standardized 30-min bout of treadmill exercise at an intensity just below ventilatory threshold. Participants were asked to try to complete the prescribed exercise daily for 1 week. Differences in affect and exercise behavior were examined across conditions, as were relationships between affect measures, intentions and behavior. The manipulation influenced anticipated and experienced affective responses, but not behavior. Participants generally expected exercise to be less pleasant and more fatiguing that it actually was. Anticipated, experienced, and remembered affect were associated with intentions to exercise. Intentions and remembered affect were both directly associated with exercise behavior. Moderate-to-vigorous exercise can be more pleasant than people expect it to be. Additionally, encouraging exercisers to focus on the positive affective outcomes of exercise can yield a more positive affective experience than those who focus on negative affective outcomes or do not focus on affective outcomes at all. The role of affect in both reflective and automatic motivation to exercise is discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Beyond the Bruce Protocol: Advanced Exercise Testing for the Sports Cardiologist.

    PubMed

    Sarma, Satyam; Levine, Benjamin D

    2016-11-01

    Exercise testing is an important tool for determining baseline fitness as well as to diagnose limitations in performance. The Bruce protocol has become the standard for exercise testing protocol in many exercise physiology laboratories, but is rarely a suitable test for athletes who often have complex hemodynamic and metabolic demands during exercise required for practice and competition. We describe the approach for exercise testing beyond the Bruce protocol and focus on strategies to individualize the testing protocol to the metabolic demands of an athlete's sport. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Higher incremental insulin area under the curve during oral glucose tolerance test predicts less food intake and weight gain.

    PubMed

    He, J; Votruba, S; Venti, C; Krakoff, J

    2011-12-01

    To investigate the correlation of peripheral insulin concentrations with food intake and body weight. Cross sectional and longitudinal clinical study: we investigated the association of peripheral insulin concentrations in response to an oral glucose tolerance test (OGTT) with subsequent measures of ad libitum food intake and body weight change. Food intake analysis: Pima Indians (n=67, 63% male; body mass index (mean ± s.d.) 34.2 ± 9.4 kg m(-2)) with normal glucose regulation (NGR; fasting glucose <5.6 mmol l(-1) and 2-h glucose <7.8 mmol l(-1)) participated in a study of ad libitum food intake measured over 3 days by an automated vending machine system. Weight change analysis: Pima Indians with NGR (n=339) who also participated in a longitudinal study of risks for type 2 diabetes and had follow-up weights. Food intake analysis: incremental area under the curve (iAUC) for insulin during the OGTT was negatively associated with mean daily ad libitum energy intake (DEI) (r=-0.26, P=0.04), calories consumed as percent weight-maintenance energy needs (%WMEN) (r=-0.38, P=0.002) and carbohydrate intake (gram per day) (r=-0.35, P=0.005). Adjustment for age and sex attenuated the association of iAUC with DEI (P=0.06) not with %WMEN and carbohydrate intake (P=0.005, P=0.008). Weight change analysis: after adjustment for age, sex, follow-up time and initial body weight, higher insulin iAUC predicted less absolute and percent weight change (β=-6.9, P=0.02; β=-0.08, P=0.008, respectively). In healthy Pima Indians with NGR, higher plasma iAUC during an OGTT predicted lower food intake and carbohydrate consumption and less weight gain. These data indicated a role for peripheral insulin as a negative feedback signal in the regulation of energy intake and body weight.

  12. Evaluation of automated blood pressure measurements during exercise testing.

    PubMed

    Hossack, K F; Gross, B W; Ritterman, J B; Kusumi, F; Bruce, R A

    1982-11-01

    Measurements of systolic (SBP) and diastolic (DBP) blood pressure were made at rest and during symptom-limited exercise with an automated blood pressure measuring device (EBPM). Comparisons were made between the EBPM readings and those made with mercury manometer. Correlations were high (SBP r = 0.92, DBP r = 0.80) when readings were made in the same arm, but were less satisfactory when the cuffs were on different arms (SBP r = 0.80, DBP r = 0.46). The correlation between two mercury manometer readings was SBP r = 0.90, and DBP r = 0.75. Comparison between EBPM and intra-arterial measurements were similar (SBP r = 0.74, DBP r = 0.79) to comparison between mercury manometer and intra-arterial measurements (SBP r = 0.81, DBP r = 0.61). The EBPM detected SBP at consistently higher levels than did physicians, which may be an advantage in the noisy environment of an exercise test. There was a definite tendency for physicians to record blood pressure to the nearest 10 mm Hg, whereas the frequency distribution curve for EBPM measurements was smoother. The EBPM operated satisfactorily at rest and during maximal exercise and gave as reliable measurements as a physician using a mercury manometer and, in the small number of available cases, detected exertional hypotension more often than the physician.

  13. Exercises

    MedlinePlus

    ... COPD: Overview COPD: Lifestyle Management COPD: Exercises COPD: Exercises Make an Appointment Refer a Patient Ask a ... lifelong activity you enjoy. Medication to Help You Exercise People with COPD often use inhaled short acting ...

  14. Exercises

    MedlinePlus

    ... Disease (COPD) COPD: Overview COPD: Lifestyle Management Exercises Exercises Make an Appointment Refer a Patient Ask a ... lifelong activity you enjoy. Medication to Help You Exercise People with COPD often use inhaled short acting ...

  15. Reliability and Validity of a Self-paced Cardiopulmonary Exercise Test in Post-MI Patients.

    PubMed

    Jenkins, Lauren Ann; Mauger, Alexis; Fisher, Jane; Hopker, James

    2017-04-01

    A self-paced peak oxygen uptake (V̇O2peak) test (SPV) has been shown to produce higher V̇O2peak values compared to standard cardiopulmonary exercise tests (sCPET), but has not been tested on any clinical population. This study aimed to assess the reliability of the SPV in a healthy population (study 1), and the validity and reliability of the SPV in post-myocardial infarction (post-MI) patients (study 2). For study 1, 25 healthy participants completed 3 SPV's. For study 2, 28 post-MI patients completed one sCPET and 2 SPV's. The SPV consisted of 5×2-min stages where participants were able to self-regulate their effort by using incremental 'clamps' in ratings of perceived exertion. The sCPET consisted of a 20 W/min ramp. Results demonstrated the SPV to have a coefficient of variation for V̇O2peak of 4.7% for the healthy population, and 8.2% for the post-MI patients. Limits of agreement ranged between±4.22-5.86 ml·kg(-1)·min(-1), with the intraclass correlation coefficient ranging between 0.89-0.95. In study 2, there was a significantly higher V̇O2peak achieved in the SPV (23.07±4.90 ml·kg(-1)·min(-1)) against the sCPET (21.29±4.93 ml·kg(-1)·min(-1)). It is concluded that these results provide initial evidence that the SPV may be a safe, valid and reliable method for determining exercise capacity in post-MI patients.

  16. Comparison of dipyridamole-handgrip test and bicycle exercise test for thallium tomographic imaging

    SciTech Connect

    Huikuri, H.V.; Korhonen, U.R.; Airaksinen, J.; Ikaeheimo, M.J.H.; Heikkilae, J.T.; Takkunen, J.T.

    1988-02-01

    Seventy-three patients with angina pectoris and 20 with atypical chest pain, who underwent coronary angiography, were examined by single-photon emission computed thallium tomography (TI-SPECT) using a combined dipyridamole-handgrip stress test. Perfusion defects were detected in 78 of 81 patients with angiographically significant coronary artery disease (CAD) (sensitivity 96%). In 9 of 12 patients without CAD, the thallium images were normal (specificity 75%). Thirty-five patients with CAD were reexamined by TI-SPECT using a dynamic bicycle exercise stress test. The sensitivity of the dipyridamole-handgrip test did not differ from the bicycle exercise test in diagnosing the CAD (97% vs 94%). Multiple thallium defects were seen in 19 of 22 (86%) patients with multivessel CAD by the dipyridamole-handgrip test but only in 14 of 22 (64%) by the bicycle exercise test. Noncardiac side-effects occurred in 17 of 93 (18%) patients after dipyridamole infusion. Cardiac symptoms were less common during the dipyridamole-handgrip test than during the bicycle exercise (15% vs 76%, p less than 0.01). These data suggest that the dipyridamole-handgrip test is a useful alternative stress method for thallium perfusion imaging, particularly in detecting multivessel CAD.

  17. Criminal recidivism among juvenile offenders: testing the incremental and predictive validity of three measures of psychopathic features.

    PubMed

    Douglas, Kevin S; Epstein, Monica E; Poythress, Norman G

    2008-10-01

    We studied the predictive, comparative, and incremental validity of three measures of psychopathic features (Psychopathy Checklist: Youth Version [PCL:YV]; Antisocial Process Screening Device [APSD]; Childhood Psychopathy Scale [CPS]) vis-à-vis criminal recidivism among 83 delinquent youth within a truly prospective design. Bivariate and multivariate analyses (Cox proportional hazard analyses) showed that of the three measures, the CPS was most consistently related to most types of recidivism in comparison to the other measures. However, incremental validity analyses demonstrated that all of the predictive effects for the measures of psychopathic features disappeared after conceptually relevant covariates (i.e., substance use, conduct disorder, young age, past property crime) were included in multivariate predictive models. Implications for the limits of these measures in applied juvenile justice assessment are discussed.

  18. Effects of exercise on alterations in redox homeostasis in elite male and female endurance athletes using a clinical point-of-care test.

    PubMed

    Lewis, Nathan A; Towey, Colin; Bruinvels, Georgie; Howatson, Glyn; Pedlar, Charles R

    2016-10-01

    Exercise causes alterations in redox homeostasis (ARH). Measuring ARH in elite athletes may aid in the identification of training tolerance, fatigued states, and underperformance. To the best of our knowledge, no studies have examined ARH in elite male and female distance runners at sea level. The monitoring of ARH in athletes is hindered by a lack of reliable and repeatable in-the-field testing tools and by the rapid turnaround of results. We examined the effects of various exercise intensities on ARH in healthy (non-over-reached) elite male and female endurance athletes using clinical point-of-care (POC) redox tests, referred to as the free oxygen radical test (FORT) (pro-oxidant) and the free oxygen radical defence (FORD) (antioxidant). Elite male and female endurance athletes (n = 22) completed a discontinuous incremental treadmill protocol at submaximal running speeds and a test to exhaustion. Redox measures were analyzed via blood sampling at rest, warm-up, submaximal exercise, exhaustion, and recovery. FORD was elevated above rest after submaximal and maximal exercise, and recovery (p < 0.05, d = 0.87-1.55), with only maximal exercise and recovery increasing FORT (p < 0.05, d = 0.23-0.32). Overall, a decrease in oxidative stress in response to submaximal and maximal exercise was evident (p < 0.05, d = 0.46). There were no gender differences for ARH (p > 0.05). The velocity at lactate threshold (vLT) correlated with the FORD response at rest, maximal exercise, and recovery (p < 0.05). Using the clinical POC redox test, an absence of oxidative stress after exhaustive exercise is evident in the nonfatigued elite endurance athlete. The blood antioxidant response (FORD) to exercise appears to be related to a key marker of aerobic fitness: vLT.

  19. Non-physician-led exercise stress testing is a safe and effective practice.

    PubMed

    Sanford, Kate L; Williams, Katie M; Archbald, Joel A; Parsonage, William A; Scott, Adam C

    2013-12-01

    Exercise stress testing is a non-invasive procedure that provides diagnostic and prognostic information for the evaluation of several pathologies, including arrhythmia provocation, assessment of exercise capacity, and coronary heart disease. Historically, exercise tests were directly supervised by physicians; however, cost-containment issues and time constraints on physicians have encouraged the use of health professionals with specific training and experience to supervise selected exercise stress tests. Evidence suggests that non-physician-led exercise stress testing is a safe and effective practice with similar morbidity and mortality rates as those performed or supervised by a physician.

  20. Predicting utility of exercise tests based on history/holter in patients with premature ventricular contractions.

    PubMed

    Robinson, Brad; Xie, Li; Temple, Joel; Octavio, Jenna; Srayyih, Maytham; Thacker, Deepika; Kharouf, Rami; Davies, Ryan; Gidding, Samuel S

    2015-01-01

    Premature ventricular contractions (PVCs) are considered benign in patients with structurally normal hearts, particularly if they suppress with exercise. Catecholaminergic polymorphic ventricular tachycardia (CPVT) requires exercise testing to unmask the malignant phenotype. We studied risk factors and Holter monitor variables to help predict the necessity of exercise testing in patients with PVCs. We retrospectively reviewed 81 patients with PVCs that suppressed at peak exercise and structurally normal hearts referred to the exercise laboratory in 2011. We reviewed 11 patients from 2003 to 2012 whose PVCs were augmented at peak exercise (mean age 13 ± 4 years; 52 % male, 180 exercise studies). We recorded clinical risk factors and comorbidities (family history of arrhythmia or sudden unexpected death [SUD], presence of syncope) and Holter testing parameters. Family history of VT or SUD (P = 0.011) and presence of VT on Holter (P = 0.011) were significant in predicting failure of PVCs to suppress at peak heart rate on exercise testing. Syncope was not statistically significant in predicting suppression (P = 0.18); however, CPVT was diagnosed in four patients with syncope during exercise. Quantity of PVCs, Lown grade, couplets on Holter, monomorphism, and PVC elimination at peak heart rate on Holter were not predictors of PVC suppression on exercise testing. Patients with syncope during exercise, family history of arrhythmia or SUD, or a Holter monitor showing VT warrant exercise testing to assess for CPVT.

  1. Systolic Blood Pressure Response During Exercise Stress Testing: The Henry Ford ExercIse Testing (FIT) Project.

    PubMed

    O'Neal, Wesley T; Qureshi, Waqas T; Blaha, Michael J; Keteyian, Steven J; Brawner, Clinton A; Al-Mallah, Mouaz H

    2015-05-07

    The prognostic significance of modest elevations in exercise systolic blood pressure response has not been extensively examined. We examined the association between systolic blood pressure response and all-cause death and incident myocardial infarction (MI) in 44 089 (mean age 53±13 years, 45% female, 26% black) patients who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project (1991-2010). Exercise systolic blood pressure response was examined as a categorical variable (>20 mm Hg: referent; 1 to 20 mm Hg, and ≤0 mm Hg) and per 1 SD decrease. Cox regression was used to compute hazard ratios (HR) and 95% CI for the association between systolic blood pressure response and all-cause death and incident MI. Over a median follow-up of 10 years, a total of 4782 (11%) deaths occurred and over 5.2 years, a total of 1188 (2.7%) MIs occurred. In a Cox regression analysis adjusted for demographics, physical fitness, and cardiovascular risk factors, an increased risk of death was observed with decreasing systolic blood pressure response (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.13, 95% CI=1.05, 1.22; ≤0 mm Hg: HR=1.21, 95% CI=1.09, 1.34). A trend for increased MI risk was observed (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.09, 95% CI=0.93, 1.27; ≤0 mm Hg: HR=1.19, 95% CI=0.95, 1.50). Decreases in systolic blood pressure response per 1 SD were associated with an increased risk for all-cause death (HR=1.08, 95% CI=1.05, 1.11) and incident MI (HR=1.09, 95% CI=1.03, 1.16). Our results suggest that modest increases in exercise systolic blood pressure response are associated with adverse outcomes. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Systolic Blood Pressure Response During Exercise Stress Testing: The Henry Ford ExercIse Testing (FIT) Project

    PubMed Central

    O’Neal, Wesley T; Qureshi, Waqas T; Blaha, Michael J; Keteyian, Steven J; Brawner, Clinton A; Al-Mallah, Mouaz H

    2015-01-01

    Background The prognostic significance of modest elevations in exercise systolic blood pressure response has not been extensively examined. Methods and Results We examined the association between systolic blood pressure response and all-cause death and incident myocardial infarction (MI) in 44 089 (mean age 53±13 years, 45% female, 26% black) patients who underwent exercise treadmill stress testing from the Henry Ford ExercIse Testing (FIT) Project (1991–2010). Exercise systolic blood pressure response was examined as a categorical variable (>20 mm Hg: referent; 1 to 20 mm Hg, and ≤0 mm Hg) and per 1 SD decrease. Cox regression was used to compute hazard ratios (HR) and 95% CI for the association between systolic blood pressure response and all-cause death and incident MI. Over a median follow-up of 10 years, a total of 4782 (11%) deaths occurred and over 5.2 years, a total of 1188 (2.7%) MIs occurred. In a Cox regression analysis adjusted for demographics, physical fitness, and cardiovascular risk factors, an increased risk of death was observed with decreasing systolic blood pressure response (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.13, 95% CI=1.05, 1.22; ≤0 mm Hg: HR=1.21, 95% CI=1.09, 1.34). A trend for increased MI risk was observed (>20 mm Hg: HR=1.0, referent; 1 to 20 mm Hg: HR=1.09, 95% CI=0.93, 1.27; ≤0 mm Hg: HR=1.19, 95% CI=0.95, 1.50). Decreases in systolic blood pressure response per 1 SD were associated with an increased risk for all-cause death (HR=1.08, 95% CI=1.05, 1.11) and incident MI (HR=1.09, 95% CI=1.03, 1.16). Conclusions Our results suggest that modest increases in exercise systolic blood pressure response are associated with adverse outcomes. PMID:25953655

  3. Reproducibility of maximal cardiopulmonary exercise testing for young cystic fibrosis patients.

    PubMed

    Saynor, Zoe L; Barker, Alan R; Oades, Patrick J; Williams, Craig A

    2013-12-01

    The reproducibility of cardiopulmonary exercise testing (CPET) has not been established in young cystic fibrosis (CF) patients using a valid protocol. Thirteen 7-18 year olds completed three CPETs, separated by 48 h and 4-6 weeks. CPET involved a ramp-incremental cycling test with supramaximal verification. Maximal oxygen uptake was repeatedly determined with no learning effect and typical errors expressed as a coefficient of variation (TE(CV%)) of 9.3% (48 h) and 13.3% (4-6 weeks). The reproducibility of additional parameters of aerobic function [gas exchange threshold (TE(CV%): 11.2%, 16.8%); VO2 mean response time (TE(CV%): 37.8%, 89.4%); VO2 gain (TE(CV%): 17.4%, 24.5%)] and clinical utility [e.g. SaO2% (TE(CV%): 2.2%, 3.1%); ventilatory drive (V(E)/VCO2-slope) (TE(CV%): 7.8%, 17.7%)] was also established over the short- and the medium-term, respectively. These results establish limits of variability to determine meaningful changes over the short- and the medium-term for CPET outcomes in young CF patients. Copyright © 2013 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  4. Exercise testing and training in patients with peripheral vascular disease and lower extremity amputation.

    PubMed

    Priebe, M; Davidoff, G; Lampman, R M

    1991-05-01

    Patients with peripheral vascular disease have a high risk of coronary artery disease. The risk is even greater when the peripheral vascular disease leads to lower extremity amputation. Exercise testing using lower extremity exercise has been the "gold standard" for screening for coronary artery disease, but many patients with peripheral vascular disease and those with amputations have difficulty doing this type of exercise. Arm exercise ergometry has been shown to be a safe and effective alternative for the detection of coronary artery disease in patients who cannot do leg exercise. This test has also been used to determine safe exercise levels and may be able to predict the ultimate level of prosthetic use in amputees. Exercise training with arm ergometry also improves cardiovascular efficiency and upper body strength in poorly conditioned patients. Studies are needed to appreciate fully the role of exercise testing and training in the recovery of these patients after amputation.

  5. Comparison of bioenergetics of walking during a multistage incremental shuttle walk test and a 6-min walk test in active older adults.

    PubMed

    Leone, Mario; Duvergé, Sébastien; Kalinova, Émilia; Bui, Hung Tien; Comtois, Alain S

    2017-04-01

    The goal of the present research was to compare the bioenergetics variability of walking, during the 6-min walk test (6-MWT) and a multistage incremental shuttle walk test (MISWT) in an active older population. Twenty-two healthy physically active older adults with a group mean age of 70.4 ± 5.8 years completed the 6-MWT and the MISWT. Heart rate (HR), walking speed and walking [Formula: see text]O2 were measured throughout each test with a portable metabolic cart. Strong correlations were found for the [Formula: see text]O2 peak and the walking speed (r = 0.91 and r = 0.89 respectively for 6-MWT and MISWT). Differences in [Formula: see text]O2 peak values were analysed with a paired Student's t test. Repeated measures ANOVA were conducted to detect differences between tests. The Bland and Altman plot indicates that the average difference between both tests was 2.5 ml kg(-1) min(-1). MISWT [Formula: see text]O2 peak means were significantly greater than the 6-MWT [Formula: see text]O2 peak mean values (21.6 ± 5.3 vs. 18.9 ± 4.5 ml kg(-1) min(-1)) which indicate bioenergetics differences between the two walking tests. Thus, the MISWT and 6-MWT elicited different walking [Formula: see text]O2 peak and HR suggesting that the MISWT field test challenge the participants to a higher level of cardiovascular and respiratory stress. The walking [Formula: see text]O2 peak recorded for the MISWT was significantly greater than the 6-MWT. Consequently, both tests seem to measure different facets of the aerobic capacity. MISWT seems to be a better indicator of maximal aerobic power whereas the 6-MWT provides more relevant information regarding aerobic endurance in aging population.

  6. [Application of cardiopulmonary exercise testing in patients with chronic thromboembolic pulmonary hypertension].

    PubMed

    Zhao, Zhi-hui; Liu, Zhi-hong; Gu, Qing; Luo, Qin; Zhao, Qing; Xiong, Chang-ming; Ni, Xin-hai

    2013-06-11

    To evaluate the application value of cardiopulmonary exercise testing in patients with chronic thromboembolic pulmonary hypertension (CTEPH). A total of 116 consecutive patients admitted into the Cardiology Department of Fuwai Hospital.They were divided into 3 groups of CTEPH (n = 44), CPE (without pulmonary hypertension in chronic pulmonary embolism) (n = 24) and control (without pulmonary embolism or pulmonary hypertension) (n = 48) respectively. Their levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. Incremental cardiopulmonary exercise testing was performed to compare its differential results among 3 groups and evaluate the correlation between NT-proBNP and its parameters. The body mass index (BMI) in the CTEPH group was lower than those in the CPE and control groups ((23.8 ± 3.9) vs (26.1 ± 3.6) and (26.7 ± 3.2) kg/m(2) ), both P < 0.05); the medical history in the CTEPH group was longer than those in the CPE and control groups ((58 ± 48) vs (12 ± 10) and (29 ± 25) months, both P < 0.05). The plasma concentrations of NT-proBNP in the CTEPH group were higher than those in the CPE and control groups ((1678 ± 1255) vs (577 ± 167) and (608 ± 247) pmol/L, both P < 0.05). All of them completed the test and there were no severe complications such as syncope or exacerbation of disease. Maximum oxygen consumption (VO2max), percentage of predicted maximum oxygen consumption (VO2 %), oxygen consumption in relation to body weight (VO2/kg), anaerobic threshold and O2 pulse in the CTEPH group were significantly lower than those in the CPE and control groups (P < 0.05). The ratios of dead space volume (VD) to tidal volume (VT) in the CTEPH and CPE groups were higher than those in the control group (P < 0.05). The plasma concentrations of NT-proBNP were inversely correlated with right ventricular internal diameter (r = -0.690, P = 0.000) and VO2/kg (r = -0.496, P = 0.000). The right ventricular internal diameter (β = 0.583, P = 0.000) and

  7. Running economy assessment within cardiopulmonary exercise testing for recreational runners.

    PubMed

    Engeroff, Tobias; Bernardi, Andreas; Vogt, Lutz; Banzer, Winfried

    2016-03-01

    The aim of this study was to evaluate the influence of running economy (RE) on running performance within recreational runners of different maximal aerobic capacity, and the feasibility of RE assessment within routine cardiopulmonary exercise testing (CPET). Sixty-eight recreational runners (m: 49, f: 19; age: 21-54) completed a graded exercise test (GXT) until exhaustion. Maximal oxygen uptake and respiratory compensation point were obtained via CPET. RE was calculated as relative oxygen uptake per covered distance (mL/kg/km) one step below respiratory compensation point (RCP). Subjects were grouped for RE via median split and categorized into one of six fitness levels (Very Poor, Poor, Fair, Good, Excellent, Superior) (ACSM 2010). Irrespective of fitness levels, recreational runners with a more energy efficient movement (RE<215.28 mL/kg/km) reached a significant (P<0.05) higher velocity at RCP (12.2 vs. 10.8 km/h). The measured VO2max values ranged between 35.2 and 66.0 ml/min/kg. Running velocity at RCP of runners within VO2max categories Good and Superior differed significantly (P<0.05) between RE groups. This study provides evidence that RE influences submaximal running performance in recreational distance runners within a broad range of maximal aerobic capacity. Complementing routine CPET with RE assessment at physiological threshold intensities and ACSM based categorization seems feasible to delineate the impact of movement efficiency and aerobic fitness on performance in recreational runners.

  8. Cardiopulmonary exercise testing is a better outcome predictor than exercise echocardiography in asymptomatic aortic stenosis.

    PubMed

    Domanski, Olivia; Richardson, Marjorie; Coisne, Augustin; Polge, Anne-Sophie; Mouton, Stephanie; Godart, François; Edmé, Jean Louis; Matran, Regis; Lancellotti, Patrizio; Montaigne, David

    2017-01-15

    Objective assessment of maximal aerobic capacity using peak oxygen consumption (peak VO2) can be helpful in the management of patients with asymptomatic aortic stenosis (AS). The relationship between peak VO2 and AS severity criteria derived from rest and supine exercise echocardiography (SEE) has never been explored. We aimed to determine whether low peak VO2 (<85% of predicted value) is associated with severity parameters in SEE, and poor clinical outcome. Fifty one asymptomatic patients (mean age of 54±21years) with moderate to severe aortic stenosis (Vmax>3m/s) and left ventricle ejection fraction>50% prospectively underwent resting and SEE and cardiopulmonary exercise testing (CPX). Peak VO2 was lower than expected (21.9±7.4mL/kg/min), i.e. <85% of predicted value in 57% patients, secondary to cardiac limitation in most of them (69%). In multiple regression analysis, age, BMI and female gender were the only independent determinants of peak VO2. Interestingly no parameter derived from SEE was associated with peak VO2. After 21±7month follow-up, no patient died, 20 underwent cardiac surgery. Peak VO2<85% of predicted value was associated with lower event free survival compared to normal peak VO2 (57%±11% vs 93±6%, p=0.036) whereas no exercise echocardiographic parameter could predict such events. Peak VO2≥85% had a negative predictive value of 97%. CPX detects a high proportion of false asymptomatic AS patients with poorer outcome that cannot be predicted by SEE markers of AS severity. Assessment of aerobic capacity should be part of current approach within a "watchful waiting" strategy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Exercise Testing, Training, and Beta-Adrenergic Blockade.

    ERIC Educational Resources Information Center

    Wilmore, Jack H.

    1988-01-01

    This article summarizes the current knowledge on the effects of beta-adrenergic blocking drugs, used widely for treatment of cardiovascular diseases, on exercise performance, training benefits, and exercise prescription. (IAH)

  10. Exercise Testing, Training, and Beta-Adrenergic Blockade.

    ERIC Educational Resources Information Center

    Wilmore, Jack H.

    1988-01-01

    This article summarizes the current knowledge on the effects of beta-adrenergic blocking drugs, used widely for treatment of cardiovascular diseases, on exercise performance, training benefits, and exercise prescription. (IAH)

  11. Regular Exercise Participation Mediates the Affective Response to Acute Bouts of Vigorous Exercise

    PubMed Central

    Hallgren, Mats Å.; Moss, Nathan D.; Gastin, Paul

    2010-01-01

    Physical inactivity is a leading factor associated with cardiovascular disease and a major contributor to the global burden of disease in developed countries. Subjective mood states associated with acute exercise are likely to influence future exercise adherence and warrant further investigation. The present study examined the effects of a single bout of vigorous exercise on mood and anxiety between individuals with substantially different exercise participation histories. Mood and anxiety were assessed one day before an exercise test (baseline), 5 minutes before (pre-test) and again 10 and 25 minutes post-exercise. Participants were 31 university students (16 males, 15 females; Age M = 20), with 16 participants reporting a history of regular exercise with the remaining 15 reporting to not exercise regularly. Each participant completed an incremental exercise test on a Monark cycle ergometer to volitional exhaustion. Regular exercisers reported significant post-exercise improvements in mood and reductions in state anxiety. By contrast, non-regular exercisers reported an initial decline in post-exercise mood and increased anxiety, followed by an improvement in mood and reduction in anxiety back to pre-exercise levels. Our findings suggest that previous exercise participation mediates affective responses to acute bouts of vigorous exercise. We suggest that to maximise positive mood changes following exercise, practitioners should carefully consider the individual's exercise participation history before prescribing new regimes. Key points Previous exercise participation mediates the affective response to acute bouts of vigorous exercise. Regular exercisers respond positively to acute bouts of vigorous physical activity, reporting less state anxiety and fatigue, and more vigour. Non-regular exercisers respond with an initial reduction in positive mood states, followed by a rebound to baseline levels 25 minutes post-exercise. To maximise positive post-exercise mood

  12. [Cardiopulmonary exercise testing before and after blood donation].

    PubMed

    Dellweg, D; Siemon, K; Mahler, F; Appelhans, P; Klauke, M; Köhler, D

    2008-06-01

    The link between haemoglobin and physical performance was established a long time ago and is the underlying principle of blood doping. Blood loss on the other hand decreases physical capacity. The aim of this study is to evaluate physical performance loss and underlying mechanisms following voluntary blood donation. Eleven voluntary subjects (four female) completed a symptom-limiting cardio-pulmonary exercise test before and after blood donation (500 mL blood). The haemoglobin value decreased by 1.2 mg/dL (9%, p < 0.001), maximal oxygen uptake by 9% (p = 0.006), maximal work rate by 13% (p = 0.001) and duration of exercise fell from 663 down to 607 seconds (p = 0.005). Anaerobic transition occurred at 81.2% and 71.5% of maximal oxygen uptake before and after blood donation, respectively (p = 0.001). Subjects who practise recreational endurance sports appear to be more effected by endurance loss. The haemoglobin value was the only significant predictor of maximal oxygen uptake in regression analysis (p < 0.001). Maximal physical performance is impaired after blood donation. Haemoglobin decline accounts for the decreased oxygen uptake. As a consequence thereof the anaerobic transition occurs earlier. Subjects not engaged in regular sports activity did not experience a decline in their capacity. Inclusion of the haemoglobin value into equations predicting maximal oxygen uptake could improve prediction precision.

  13. Influence of repeated maximal exercise testing on biomarkers and fatigue in sarcoidosis.

    PubMed

    Braam, A W E; de Haan, S N; Vorselaars, A D M; Rijkers, G T; Grutters, J C; van den Elshout, F J J; Korenromp, I H E

    2013-10-01

    Fatigue in the immune mediated inflammatory disease sarcoidosis is thought to be associated with impaired exercise tolerance. This prospective study assessed fatigue and recuperative capacity after repeated exercise, and examined whether changing concentrations in biomarkers upon exercise are associated with fatigue. Twenty sarcoidosis patients and 10 healthy volunteers performed maximal cardiopulmonary exercise tests on two successive days. Concentrations of cytokines, stress hormones, ACE and CK were assessed before and after the two exercise tests, and 3 days thereafter. All participants completed a sleep diary. Severely fatigued patients showed significant lower VO2 max (p=0.038, p=0.022) and maximal workload (p=0.034, p=0.028) on both exercise tests compared to healthy controls. No impairment of maximal exercise testing was demonstrated during the second cycling test in any group. Fatigue was not correlated with changes in concentrations of biomarkers upon exercise. Severely fatigued patients rated both tests as significantly more fatiguing, and reported significant lower mean subjective night sleeping time during the testing period. Fatigue in sarcoidosis patients cannot be objectified by reduction of exercise capacity after repeated maximal exercise testing, and is not correlated with significant changes in biomarkers. Severe fatigue is only and consistently featured by patient reported outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Incremental full configuration interaction

    NASA Astrophysics Data System (ADS)

    Zimmerman, Paul M.

    2017-03-01

    The incremental expansion provides a polynomial scaling method for computing electronic correlation energies. This article details a new algorithm and implementation for the incremental expansion of full configuration interaction (FCI), called iFCI. By dividing the problem into n-body interaction terms, accurate correlation energies can be recovered at low n in a highly parallel computation. Additionally, relatively low-cost approximations are possible in iFCI by solving for each incremental energy to within a specified threshold. Herein, systematic tests show that FCI-quality energies can be asymptotically reached for cases where dynamic correlation is dominant as well as where static correlation is vital. To further reduce computational costs and allow iFCI to reach larger systems, a select-CI approach (heat-bath CI) requiring two parameters is incorporated. Finally, iFCI provides the first estimate of FCI energies for hexatriene with a polarized double zeta basis set, which has 32 electrons correlated in 118 orbitals, corresponding to a FCI dimension of over 1038.

  15. Usefulness of myocardial perfusion imaging with exercise testing in children.

    PubMed

    Robinson, Brad; Goudie, Brett; Remmert, Jenna; Gidding, Samuel S

    2012-10-01

    Myocardial perfusion imaging (MPI) provides additional clinical information on children with cardiac disease but will not benefit children with chest pain and normal cardiac studies. This study reviewed all technetium-99 m ((99m)Tc) sestamibi stress MPI studies between 2004 and 2010 performed in association with graded exercise testing (86% with bicycle ergometer, 14% with treadmill). A positive test was defined as a perfusion defect or abnormal ventricular function response. Clinical records were reviewed, including follow-up assessment to determine accuracy of MPI interpretation. False-positive and false-negative rates were recorded. A total of 197 patients (mean age, 13.4 ± 3.6 years, 70% male) underwent 218 MPI studies. Group A had 42 patients (43 studies) with isolated chest pain and normal studies. Of the 43 studies, 39 had negative results, and 4 had false-positive results. Group B had 155 patients (175 studies) with known or suspected cardiac disease, and 39 tests (33 patients) had positive results. Whereas 32 studies were considered true-positive, 7 were false-positive. There was one false-negative test. According to the findings, (99m)Tc sestamibi MPI studies are clinically useful but not perfect tests in the setting of known or suspected cardiac disease based on clinical evaluation, electrocardiography (ECG), or echocardiography. Children who had isolated chest pain with a normal ECG and echocardiogram often have false-positive studies.

  16. Greater V˙O2peak is correlated with greater skeletal muscle deoxygenation amplitude and hemoglobin concentration within individual muscles during ramp-incremental cycle exercise.

    PubMed

    Okushima, Dai; Poole, David C; Barstow, Thomas J; Rossiter, Harry B; Kondo, Narihiko; Bowen, T Scott; Amano, Tatsuro; Koga, Shunsaku

    2016-12-01

    It is axiomatic that greater aerobic fitness (V˙O2peak) derives from enhanced perfusive and diffusive O2 conductances across active muscles. However, it remains unknown how these conductances might be reflected by regional differences in fractional O2 extraction (i.e., deoxy [Hb+Mb] and tissue O2 saturation [StO2]) and diffusive O2 potential (i.e., total[Hb+Mb]) among muscles spatially heterogeneous in blood flow, fiber type, and recruitment (vastus lateralis, VL; rectus femoris, RF). Using quantitative time-resolved near-infrared spectroscopy during ramp cycling in 24 young participants (V˙O2peak range: ~37.4-66.4 mL kg(-1) min(-1)), we tested the hypotheses that (1) deoxy[Hb+Mb] and total[Hb+Mb] at V˙O2peak would be positively correlated with V˙O2peak in both VL and RF muscles; (2) the pattern of deoxygenation (the deoxy[Hb+Mb] slopes) during submaximal exercise would not differ among subjects differing in V˙O2peak Peak deoxy [Hb+Mb] and StO2 correlated with V˙O2peak for both VL (r = 0.44 and -0.51) and RF (r = 0.49 and -0.49), whereas for total[Hb+Mb] this was true only for RF (r = 0.45). Baseline deoxy[Hb+Mb] and StO2 correlated with V˙O2peak only for RF (r = -0.50 and 0.54). In addition, the deoxy[Hb+Mb] slopes were not affected by aerobic fitness. In conclusion, while the pattern of deoxygenation (the deoxy[Hb+Mb] slopes) did not differ between fitness groups the capacity to deoxygenate [Hb+Mb] (index of maximal fractional O2 extraction) correlated significantly with V˙O2peak in both RF and VL muscles. However, only in the RF did total[Hb+Mb] (index of diffusive O2 potential) relate to fitness.

  17. Heart Rate Variability Measurements During Exercise Test May Improve the Diagnosis of Ischemic Heart Disease

    DTIC Science & Technology

    2001-10-25

    Abstract – In this work we have analyzed changes in the heart rate variability (HRV) during exercise test comparing them with the ST deviation...exactness up to 84%. The very high frequency (0.4 to 1 Hz) at the stress peak has shown to have diagnostic value. Adding the age and the maximum heart ...Keywords – Heart rate variability, exercise test, ischemia. I. INTRODUCTION Heart rate variability (HRV) measurements during exercise test have not

  18. Physiological responses to a tap dance choreography: comparisons with graded exercise test and prescription recommendations.

    PubMed

    Oliveira, Samantha M L; Simões, Herbert G; Moreira, Sergio R; Lima, Ricardo M; Almeida, Jeeser A; Ribeiro, Fabiana M R; Puga, Guilherme M; Campbell, Carmen S G

    2010-07-01

    The aim of this study was to analyze the physiological responses to a tap dance choreography and to compare with those observed during a maximal treadmill exercise test, in tap dancers. Eight women (19.6 +/- 2.4 years; 162.3 +/- 4.4 cm; 54.0 +/- 2.3 kg; 20.5 +/- 1.4 kg.m; and 5.1 +/- 2.6 years of tap dance training) were submitted to the following procedures: (a) graded exercise test (GXT) on a treadmill until volitional exhaustion with 0.8 km.h of increment at each 3 and 1 minute of interval between stages and (b) tap dance choreography (TAP)-"The Shim Sham Shimmy"-consisting of 9 stages of 3 minutes with 1-minute rest between stages. Expired gas analyses were performed in all experimental sessions, providing breath-by-breath values for respiratory exchange rate (RER), oxygen uptake (VO(2)), and carbon dioxide production (CO2). Heart rate (HR) and rate of perceived exertion (RPE) were also measured. During the rest period between stages, blood samples (25 microl) were collected from the ear lobe for lactate threshold (LT) determination. It was observed that at the end of the TAP, subjects achieved an average of 83.8 +/- 6.2% of the HRmax and 68.9 +/- 11.3% of the VO(2)max, both previously identified in the GXT. The choreography demanded 204.7 +/- 31.3 kcal, an average RER of 0.88 +/- 0.05 and mean RPE of 13 +/- 2. The VO(2), HR, and RPE values did not significantly differ from those at the LT intensity identified during the GTX. Based on the present results, it was concluded that the TAP performance in the "The Shim Sham Shimmy" choreography elicited acute physiologic responses similar to those observed at the LT intensity, thus suggesting that Tap Dance constitutes a useful exercise modality for aerobic fitness and cardiovascular health improvements.

  19. Nonsustained wide QRS tachycardia during an exercise ECG stress test.

    PubMed

    MacKenzie, Ross

    2007-01-01

    The evaluation of a nonsustained wide QRS tachycardia in a life insurance applicant's exercise test presents a special challenge to the medical director because of the unpredictable and potentially lethal nature of these arrhythmias. Ventricular tachycardia accounts for up to 80% of wide QRS tachycardias in unselected populations and more than 95% of cases with a prior myocardial infarction. Malignant ventricular arrhythmias usually occur in the presence of significant structural heart disease. In this setting, ventricular arrhythmias carry a high risk of sudden cardiac death. Less commonly, ventricular tachycardia occurs in hearts that appear normal. In many such cases, however, the heart is in fact not normal, but rather has less visible abnormalities including derangements of cardiac ion channels or structural proteins. In these individuals, ventricular arrhythmias also carry a high risk of sudden cardiac death. There are, however, some ventricular tachycardia syndromes which occur in normal hearts that have a more benign prognosis.

  20. [Irregular breathing during the cardiopulmonary exercise test - from mildly irregular breathing pattern to periodic breathing of oscillatory ventilation type].

    PubMed

    Várnay, František; Mífková, Leona; Homolka, Pavel; Dobšák, Petr

    2017-01-01

    The fluctuating course of tidal volume (VT), breathing frequency (DF) and minute ventilation (VE) during the cardio-pulmonary exercise test using a ramp incremental protocol occurs not only in patients, but relatively frequently also in healthy individuals. It can account for a number of irregularities in the course of the curves VO2, VCO2 and in particular of those of ventilatory equivalents for O2 and CO2 (EQO2, EQCO2) as well as curves of partial pressure of end-tidal oxygen and partial pressure of end-tidal carbon dioxide (PETO2, PETCO2), which are also used, inter alia, to establish ventilatory thresholds. The presence of exercise oscillatory ventilation (EOV) reflects the severity of heart failure and it is an independent predictor of the increased morbidity, cardiac and total mortality and sudden death caused by heart failure. However there is not a generally accepted universal definition of EOV available at present, as different criteria are used. We have not found a comparison which would indicate whether and how the "strength" of the prognostic criteria for EOV - established according to different methods - differs. Therefore it is very important to specify what method, or what criteria were used in the establishment of EOV.Key words: breathing pattern - EOV - exercise oscillatory ventilation - periodic breathing.

  1. Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients

    PubMed Central

    Grosbois, JM; Riquier, C; Chehere, B; Coquart, J; Béhal, H; Bart, F; Wallaert, B; Chenivesse, C

    2016-01-01

    Introduction Exercise tolerance testing is an integral part of the pulmonary rehabilitation (PR) management of patients with chronic obstructive pulmonary disease (COPD). The 6-minute stepper test (6MST) is a new, well-tolerated, reproducible exercise test, which can be performed without any spatial constraints. Objective The aim of this study was to compare the results of the 6MST to those obtained during a 6-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) in a cohort of COPD patients. Methods Ninety-one COPD patients managed by outpatient PR and assessed by 6MST, 6MWT, and CPET were retrospectively included in this study. Correlations between the number of steps on the 6MST, the distance covered on the 6MWT, oxygen consumption, and power at the ventilatory threshold and at maximum effort during CPET were analyzed before starting PR, and the improvement on the 6MST and 6MWT was compared after PR. Results The number of steps on the 6MST was significantly correlated with the distance covered on the 6MWT (r=0.56; P<0.0001), the power at maximum effort (r=0.46; P<0.0001), and oxygen consumption at maximum effort (r=0.39; P<0.005). Performances on the 6MST and 6MWT were significantly improved after PR (570 vs 488 steps, P=0.001 and 448 vs 406 m, respectively; P<0.0001). Improvements of the 6MST and 6MWT after PR were significantly correlated (r=0.34; P=0.03). Conclusion The results of this study show that the 6MST is a valid test to evaluate exercise tolerance in COPD patients. The use of this test in clinical practice appears to be particularly relevant for the assessment of patients managed by home PR. PMID:27099483

  2. Impact of choice of imaging modality accompanying outpatient exercise stress testing on outcomes and resource use after revascularization for acute coronary syndromes.

    PubMed

    Federspiel, Jerome J; Shah, Bimal R; Shaw, Leslee J; Masoudi, Frederick A; Chang, Patricia P; Stearns, Sally C; Mudrick, Daniel W; Cowper, Patricia A; Green, Cynthia L; Douglas, Pamela S

    2013-10-01

    Exercise stress testing is commonly obtained after percutaneous coronary intervention (PCI) performed for acute coronary syndromes (ACS). We compared the relationships between exercise echocardiography and nuclear testing after ACS-related PCI on outcomes and resource use. Longitudinal observational study using fee-for-service Medicare claims to identify patients undergoing outpatient exercise stress testing with imaging within 15 months after PCI performed for ACS between 2003 and 2004. Of 63,100 patients undergoing stress testing 3 to 15 months post-PCI, 31,731 (50.3%) underwent an exercise stress test with imaging. Among 29,279 patients undergoing exercise stress testing with imaging, 15.5% received echocardiography. Echocardiography recipients had higher rates of repeat stress testing (adjusted hazard ratio [HR] 2.60, CI 2.19-3.10) compared with those undergoing nuclear imaging in the 90 days after testing, but lower rates of revascularization (adjusted HR 0.87, CI 0.76-0.98) and coronary angiography (adjusted HR 0.88, CI 0.80-0.97). None of these differences persisted subsequent to 90 days after stress testing. Rates of death and readmission for myocardial infarction rates were similar. Total Medicare payments were lower initially after echocardiography (incremental difference $498, CI 488-507), an effect attributed primarily to lower reimbursement for the stress test itself, but not significantly different after 14 months after testing. In this study using administrative data, echocardiography recipients initially had fewer invasive procedures but higher rates of repeat testing than nuclear testing recipients. However, these differences between echo and nuclear testing did not persist over longer time frames. © 2013.

  3. Impact of choice of imaging modality accompanying outpatient exercise stress testing on outcomes and resource use after revascularization for acute coronary syndromes

    PubMed Central

    Federspiel, Jerome J.; Shah, Bimal R.; Shaw, Leslee J.; Masoudi, Frederick A.; Chang, Patricia P.; Stearns, Sally C.; Mudrick, Daniel W.; Cowper, Patricia A.; Green, Cynthia L.; Douglas, Pamela S.

    2013-01-01

    Background Exercise stress testing is commonly obtained after percutaneous coronary intervention (PCI) performed for acute coronary syndromes (ACS). We compared the relationships between exercise echocardiography and nuclear testing after ACS-related PCI on outcomes and resource use. Methods Longitudinal observational study using fee-for-service Medicare claims to identify patients undergoing outpatient exercise stress testing with imaging within 15 months after PCI performed for ACS between 2003 and 2004. Results Of 63,100 patients undergoing stress testing 3 to 15 months post-PCI, 31,731 (50.3%) underwent an exercise stress test with imaging. Among 29,279 patients undergoing exercise stress testing with imaging, 15.5% received echocardiography. Echocardiography recipients had higher rates of repeat stress testing (adjusted hazard ratio [HR] 2.60, CI 2.19–3.10) compared with those undergoing nuclear imaging in the 90 days after testing, but lower rates of revascularization (adjusted HR 0.87, CI 0.76–0.98) and coronary angiography (adjusted HR 0.88, CI 0.80–0.97). None of these differences persisted subsequent to 90 days after stress testing. Rates of death and readmission for myocardial infarction rates were similar. Total Medicare payments were lower initially after echocardiography (incremental difference $498, CI 488–507), an effect attributed primarily to lower reimbursement for the stress test itself, but not significantly different after 14 months after testing. Conclusions In this study using administrative data, echocardiography recipients initially had fewer invasive procedures but higher rates of repeat testing than nuclear testing recipients. However, these differences between echo and nuclear testing did not persist over longer time frames. PMID:24093861

  4. In search of the false-negative exercise treadmill testing evidence-based use of exercise echocardiography.

    PubMed

    Southard, Jeffrey; Baker, Larry; Schaefer, Saul

    2008-01-01

    Controversy exists regarding the role of exercise treadmill testing (ETT) versus exercise stress echocardiography (ESE) as the appropriate initial noninvasive test to risk-stratify patients with chest pain. The majority of studies to date that evaluated these methodologies included patients with poor functional status and baseline electrocardiogram (ECG) abnormalities, potentially limiting the sensitivity of ETT. We examined the hypothesis that given stringent standards of exercise duration and ECG interpretability, the ETT would have a high diagnostic sensitivity for the presence of significant coronary artery disease (CAD). Results of concurrent ETT and ESE in 3,098 patients were examined, and the subset of patients with a negative ETT and positive ESE (-ETT/ + ESE) were reviewed for the presence of CAD as a function of exercise duration (< or > or = 6 min) and baseline ECG normality. In those patients with a - ETT/ + ESE who exercised > or = 6 min, 54 had a normal baseline ECG, 22 underwent angiography and 6 had CAD (all of whom had either small, grafted or collateralized vessels). Patients with a - ETT/ + ESE who were incapable of exercising 6 min were more frequently older and female. Mortality was significantly greater in the < 6 min exercise duration group (31.4 versus 3.1%). These findings support the use of the ETT without imaging as the initial test in patients with chest pain who have a normal baseline ECG and are able to exercise 6 min. Using these criteria, false negative findings are generally seen in patients without critical large vessel epicardial disease. The ESE should be reserved as the initial test for patients with an abnormal baseline ECG or reduced functional capacity. 2007 Wiley Periodicals, Inc

  5. Cardiopulmonary exercise testing is more accurate than ECG-stress testing in diagnosing myocardial ischemia in subjects with chest pain.

    PubMed

    Belardinelli, Romualdo; Lacalaprice, Francesca; Tiano, Luca; Muçai, Andi; Perna, Gian Piero

    2014-06-15

    Cardiopulmonary exercise stress testing (CPET) is used to grade the severity of heart failure and to assess its prognosis. However it is unknown whether CPET may improve diagnostic accuracy of standard ECG stress testing to identify or exclude obstructive coronary artery disease (O-CAD) in patients with chest pain. We prospectively studied 1265 consecutive subjects (55 ± 8 years, 156 women) who were evaluated with ECG stress testing (ET) for chest pain. No one had a documented O-CAD. All patients performed an incremental CPET with ECG recordings on an electronically braked cycle ergometer. Of 1265 patients, 73 had a positive CPET and 1192 had a negative CPET. Seventy-three patients with a positive CPET and 71 patients with a negative CPET agreed to undergo nuclear SPECT imaging and coronary angiography. Follow-up lasted 48 ± 7 months. As compared with ET, sensitivity, specificity, PPV and NPV were all improved significantly (ET: 48%, 55%, 33%, 95%; CPET: 88%, 98%, 73%, 99%, respectively, P<0.001). Patients with both peak VO2>91% of predicted VO2 max and absence of VO2-related signs of myocardial ischemia had no evidence of O-CAD in 100% of cases. Cardiac events occurred in 32 patients with a positive CPET and 8 patients with a negative CPET (log rank 18.2, P<0.0001). In patients with chest pain, CPET showed a better diagnostic and predictive accuracy than traditional ET to detect/exclude myocardial ischemia. Its use should be encouraged among physicians as a first line diagnostic tool in clinical practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing.

    PubMed

    Gaspard, Dany; Kass, Jonathan; Akers, Stephen; Hunter, Krystal; Pratter, Melvin

    2017-08-08

    Patient-reported dyspnea plays a central role in assessing cardiopulmonary disease. There is little evidence, however, that dyspnea correlates with objective exercise capacity measurements. If the correlation is poor, dyspnea as a proxy for objective assessment may be misleading. To compare patient's perception of dyspnea with maximum oxygen uptake (MaxVO2) during cardiopulmonary exercise testing (CPET). Fifty patients undergoing CPET for dyspnea evaluation were studied prospectively. Dyspnea assessment was measured by a metabolic equivalent of task (METs) table, Mahler Dyspnea Index, Borg Index, number of blocks walked, and flights of stairs climbed before stopping due to dyspnea. These descriptors were compared to MaxVO2. MaxVO2 showed low correlation with METs table (r = 0.388, p = 0.005) and no correlation with Mahler Index (r = 0.24, p = 0.093), Borg Index (r = -0.017, p = 0.905), number of blocks walked (r = 0.266, p = 0.077) or flights of stairs climbed (r = 0.188, p = 0.217). When adjusted for weight (maxVO2/kg), there was significant correlation between MaxVO2 and METs table (r = 0.711, p < 0.001), moderate correlation with blocks walked (r = 0.614, p < 0.001), and low correlation with Mahler Index (r = 0.488 p = 0.001), Borg Index (r = -0.333 p = 0.036), and flights of stairs (r = 0.457 p = 0.004). Subgroup analysis showed worse correlation when patients with normal CPET were excluded (12/50 excluded). Patients with BMI < 30 had no correlation between Max VO2 and the assessment methods, while patients with BMI > 30 had moderate correlation between MaxVO2 and METs table (r = 0.568, p = 0.002). Patient-reported dyspnea correlates poorly with MaxVO2 and fails to predict exercise capacity. Reliance on reported dyspnea may result in suboptimal categorization of cardiopulmonary disease severity.

  7. [Evaluation of the appropriateness of prescribing exercise tests].

    PubMed

    Orsini, Enrico; Mazzuoli, Francesco; Odoguardi, Leonardo; Magnani, Mirco; Lorenzoni, Roberto

    2002-06-01

    We evaluated the appropriateness of the indications to exercise testing for ambulatory patients performed during 4 weeks in 21 laboratories in Tuscany and Umbria, Italy. We collected the following data: the appropriateness of the prescription (according to the guidelines of the Italian Federation of Cardiology), the prescribing physician (cardiologist vs non-cardiologist), the synthetic result (normal vs abnormal) and the clinical utility (useful vs useless) of each exam. We evaluated 1158 prescriptions (population: 822 males, 336 females; mean age 60 years, range 16-82 years). Prescriptions were of class I (appropriate) in 38.9%, of class II (of doubtful appropriateness) in 52.5% and of class III (inappropriate) in 8.6% of the cases. In 14.2% of the cases the exam was abnormal: it was abnormal in 35.5% of class I, in 26.6% of class II and in 23% of class III exams (p < 0.05). The exam was useful in 51.6% of the cases; it was useful in 62.4% of class I, in 50.2% of class II and in 13% of class III exams (p < 0.05). Cardiologists required 596/1158 tests (51.5%). Their indications were included in class I in 45.6%, in class II in 49.7% and in class III in 4.7% of the cases vs 31.7, 55.5 e 12.8% of non-cardiologists' prescriptions (p < 0.05). The test was abnormal in 35.7% of cardiologist vs 23.5% of non-cardiologist-prescribed examinations (odds ratio 1.81, 95% confidence interval 1.4-2.34; p < 0.05); the test was useful in 64.4% of cardiologist vs 38.2% of non-cardiologist-prescribed exams (odds ratio 2.92, 95% confidence interval 2.3-3.71; p < 0.05). In Tuscany and Umbria, Italy, less than half of exercise testing procedures are appropriate; appropriately-prescribed exams are more often abnormal and useful; cardiologist-prescribed exams are significantly more appropriate, abnormal and useful.

  8. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    PubMed Central

    Cortinas, Inés Vidal; Beretta, Mario; Alonso, Omar; Mut, Fernando

    2015-01-01

    Background Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. Objectives In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. Methods In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Results Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). Conclusions The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP. PMID:26039661

  9. Effects of physical activity on exercise tests and respiratory function

    PubMed Central

    Cheng, Y; Macera, C; Addy, C; Sy, F; Wieland, D; Blair, S

    2003-01-01

    Background: Exercise is an important component of pulmonary rehabilitation for patients with chronic lung disease. Objective: To explore the role of physical activity in maintaining cardiac and respiratory function in healthy people. Methods: Cardiorespiratory fitness was measured by a maximal treadmill test (MTT), and respiratory function was tested by spirometry. The cross sectional study included data from 24 536 healthy persons who were examined at the Cooper Clinic between 1971 and 1995; the longitudinal study included data from 5707 healthy persons who had an initial visit between 1971 and 1995 and a subsequent visit during the next five years. All participants were aged 25–55 years and completed a cardiorespiratory test and a medical questionnaire. Results: In the cross sectional study, after controlling for covariates, being active and not being a recent smoker were associated with better cardiorespiratory fitness and respiratory function in both men and women. In the follow up study, persons who remained or became active had better MTT than persons who remained or became sedentary. Men who remained active had higher forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) than the other groups. Smoking was related to lower cardiorespiratory fitness and respiratory function. Conclusions: Physical activity and non-smoking or smoking cessation is associated with maintenance of cardiorespiratory fitness. Change in physical activity habits is associated with change in cardiorespiratory fitness, but respiratory function contributed little to this association during a five year follow up. PMID:14665592

  10. How does heart rate recovery after sub-maximal exercise correlate with maximal exercise testing in children with CF?

    PubMed

    Cohen, Sarah P; Orenstein, David M

    2014-12-01

    Disease progression in cystic fibrosis (CF) is marked by worsening exercise tolerance. Further, maximal exercise capacity (VO2 peak) correlates with survival in CF, but maximal tests are uncomfortable and resource-intensive. A three-minute step test (STEP) has been validated in CF. Heart rate (HR) recovery after exercise correlates with all-cause mortality in adult non-CF populations. We compared HR recovery after the three-minute step test with VO2 peak in children with CF. Twenty-four children with CF performed STEP and a maximal exercise test. Correlation between the tests was assessed. Maximum HR on STEP was lower than on the maximal test (140 vs. 190, p<0.01). Peak HR during STEP correlated inversely with VO2 peak. In subjects with mild lung disease, faster HR recovery after STEP correlated with higher VO2 peak. The three-minute step test is a feasible submaximal test in this patient population. HR during and after a three-minute step test may reflect VO2 peak in children with CF. Copyright © 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  11. Prediction of functional aerobic capacity without exercise testing

    NASA Technical Reports Server (NTRS)

    Jackson, A. S.; Blair, S. N.; Mahar, M. T.; Wier, L. T.; Ross, R. M.; Stuteville, J. E.

    1990-01-01

    The purpose of this study was to develop functional aerobic capacity prediction models without using exercise tests (N-Ex) and to compare the accuracy with Astrand single-stage submaximal prediction methods. The data of 2,009 subjects (9.7% female) were randomly divided into validation (N = 1,543) and cross-validation (N = 466) samples. The validation sample was used to develop two N-Ex models to estimate VO2peak. Gender, age, body composition, and self-report activity were used to develop two N-Ex prediction models. One model estimated percent fat from skinfolds (N-Ex %fat) and the other used body mass index (N-Ex BMI) to represent body composition. The multiple correlations for the developed models were R = 0.81 (SE = 5.3 ml.kg-1.min-1) and R = 0.78 (SE = 5.6 ml.kg-1.min-1). This accuracy was confirmed when applied to the cross-validation sample. The N-Ex models were more accurate than what was obtained from VO2peak estimated from the Astrand prediction models. The SEs of the Astrand models ranged from 5.5-9.7 ml.kg-1.min-1. The N-Ex models were cross-validated on 59 men on hypertensive medication and 71 men who were found to have a positive exercise ECG. The SEs of the N-Ex models ranged from 4.6-5.4 ml.kg-1.min-1 with these subjects.(ABSTRACT TRUNCATED AT 250 WORDS).

  12. The minimal important difference of exercise tests in severe COPD.

    PubMed

    Puhan, M A; Chandra, D; Mosenifar, Z; Ries, A; Make, B; Hansel, N N; Wise, R A; Sciurba, F

    2011-04-01

    Our aim was to determine the minimal important difference (MID) for 6-min walk distance (6MWD) and maximal cycle exercise capacity (MCEC) in patients with severe chronic obstructive pulmonary disease (COPD). 1,218 patients enrolled in the National Emphysema Treatment Trial completed exercise tests before and after 4-6 weeks of pre-trial rehabilitation, and 6 months after randomisation to surgery or medical care. The St George's Respiratory Questionnaire (domain and total scores) and University of California San Diego Shortness of Breath Questionnaire (total score) served as anchors for anchor-based MID estimates. In order to calculate distribution-based estimates, we used the standard error of measurement, Cohen's effect size and the empirical rule effect size. Anchor-based estimates for the 6MWD were 18.9 m (95% CI 18.1-20.1 m), 24.2 m (95% CI 23.4-25.4 m), 24.6 m (95% CI 23.4-25.7 m) and 26.4 m (95% CI 25.4-27.4 m), which were similar to distribution-based MID estimates of 25.7, 26.8 and 30.6 m. For MCEC, anchor-based estimates for the MID were 2.2 W (95% CI 2.0-2.4 W), 3.2 W (95% CI 3.0-3.4 W), 3.2 W (95% CI 3.0-3.4 W) and 3.3 W (95% CI 3.0-3.5 W), while distribution-based estimates were 5.3 and 5.5 W. We suggest a MID of 26 ± 2 m for 6MWD and 4 ± 1 W for MCEC for patients with severe COPD.

  13. Prediction of functional aerobic capacity without exercise testing

    NASA Technical Reports Server (NTRS)

    Jackson, A. S.; Blair, S. N.; Mahar, M. T.; Wier, L. T.; Ross, R. M.; Stuteville, J. E.

    1990-01-01

    The purpose of this study was to develop functional aerobic capacity prediction models without using exercise tests (N-Ex) and to compare the accuracy with Astrand single-stage submaximal prediction methods. The data of 2,009 subjects (9.7% female) were randomly divided into validation (N = 1,543) and cross-validation (N = 466) samples. The validation sample was used to develop two N-Ex models to estimate VO2peak. Gender, age, body composition, and self-report activity were used to develop two N-Ex prediction models. One model estimated percent fat from skinfolds (N-Ex %fat) and the other used body mass index (N-Ex BMI) to represent body composition. The multiple correlations for the developed models were R = 0.81 (SE = 5.3 ml.kg-1.min-1) and R = 0.78 (SE = 5.6 ml.kg-1.min-1). This accuracy was confirmed when applied to the cross-validation sample. The N-Ex models were more accurate than what was obtained from VO2peak estimated from the Astrand prediction models. The SEs of the Astrand models ranged from 5.5-9.7 ml.kg-1.min-1. The N-Ex models were cross-validated on 59 men on hypertensive medication and 71 men who were found to have a positive exercise ECG. The SEs of the N-Ex models ranged from 4.6-5.4 ml.kg-1.min-1 with these subjects.(ABSTRACT TRUNCATED AT 250 WORDS).

  14. Noninvasive measurement of cardiac output during exercise by inert gas rebreathing technique.

    PubMed

    Cattadori, Gaia; Schmid, Jean-Paul; Agostoni, Piergiuseppe

    2009-04-01

    Reduced exercise tolerance and dyspnea during exercise are hallmarks of heart failure syndrome. Exercise capacity and various parameters of cardiopulmonary response to exercise are of important prognostic value. All the available parameters only indirectly reflect left ventricular dysfunction and hemodynamic adaptation to an increased demand. Noninvasive assessment of cardiac output, especially during an incremental exercise stress test, would allow the direct measure of cardiac reserve and may become the gold standard for prognostic evaluation in the future.

  15. Is ventilatory efficiency dependent on the speed of the exercise test protocol in healthy men and women?

    PubMed

    Davis, James A; Sorrentino, Kristin M; Soriano, April C; Pham, Patrick H; Dorado, Silvia

    2006-03-01

    Indices of ventilatory efficiency have proven useful in assessing patients with heart and lung disease. One of these indices is the slope of the ventilation (V(E)) versus carbon dioxide output (VCO(2)) relationship during cardiopulmonary exercise testing (CPET) for work rates where the relationship is linear. However, this relationship is defined not only by the slope but also by the y-intercept. To examine whether this relationship is dependent on the speed of the CPET protocol, 30 healthy subjects (16 males) were administered a rapid CPET with 1-min increment duration (1-min CPET) to the limit of tolerance and a slow CPET with 4-min increment duration (4-min CPET) to the lactate threshold. Ventilation and the gas fractions for oxygen and CO(2) were measured with a Vacumed metabolic cart. The average increment size of both protocols for both sexes was not significantly different (P>0.05). For the males, the mean (SD) slope for the 1- and 4-min CPET was 20.12 (2.61) and 20.37 (2.41), respectively. The corresponding values for the y-intercept were 4..89 (2.08) and 5..10 (2.00) l min(-1). For the females, the mean (SD) slope for the 1- and 4-min CPET was 23.90 (2.38) and 24.16 (2.55), respectively. The corresponding values for the y-intercept were 3.93 (0.39) and 3.77 (0.71) l min(-1). Paired t-test analysis demonstrated for both sexes that the slopes and y-intercepts were not different for the two protocols (P>0.05). The results of this study demonstrate that the V(E) versus VCO(2) relationship is not dependent on the speed of the CPET protocol.

  16. Minimal important difference in field walking tests in non-cystic fibrosis bronchiectasis following exercise training.

    PubMed

    Lee, A L; Hill, C J; Cecins, N; Jenkins, S; McDonald, C F; Burge, A T; Rautela, L; Stirling, R G; Thompson, P J; Holland, A E

    2014-09-01

    The 6-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) are clinically meaningful measures of exercise capacity in people with non-cystic fibrosis (CF) bronchiectasis, but the change in walking distance which constitutes clinical benefit is undefined. This study aimed to determine the minimal important difference for the 6MWD and ISWD in non-CF bronchiectasis. Thirty-seven participants with mean FEV1 70% predicted completed both field walking tests before and after an 8-week exercise program. The minimal important difference was calculated using a distribution-based and anchor-based method, with the global rating of change scale used. The mean change in 6MWD in participants who reported themselves to be unchanged was 10 m, compared to 36 m (small change) and 45 m (substantial change) (p = 0.01). For the ISWD, the mean change in participants who reported themselves to be unchanged was 33 m, compared to 54 m (small change) and 73 m (substantial change) (p = 0.04). The anchor-based method defined the minimal important difference for 6MWD as 24.5 m (AUC 0.76, 95% CI 0.61-0.91) and for ISWD as 35 m (AUC 0.88, 95% CI 0.73-0.99), based on participant's global rating of change. The distribution-based method indicated a value of 22.3 m for the 6MWD and 37 m for the ISWD. There was excellent agreement between the two methods for the 6MWD (kappa = 0.91) and the ISWD (kappa = 0.92). Small changes in 6MWD and ISWD may represent clinically important benefits in people with non-CF bronchiectasis. These data are likely to assist in the interpretation of change in exercise capacity following intervention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The talk test: a useful tool for prescribing and monitoring exercise intensity.

    PubMed

    Reed, Jennifer L; Pipe, Andrew L

    2014-09-01

    This review focuses on recent literature examining the validity and reliability of the talk test for prescribing and monitoring exercise intensity. The utility of the talk test for high-intensity interval training and recently proposed exercise training guidelines for patients with atrial fibrillation is also examined. In healthy adults and patients with cardiovascular disease, comfortable speech is likely possible (equivocal or last positive talk test stage) when exercise intensity is below the ventilatory or lactate threshold, and not likely possible (negative talk test stage) when exercise intensity exceeds the ventilatory or lactate threshold. The talk test can be used to produce exercise intensities (moderate-to-vigorous intensity, 40-80% (Equation is included in full-text article.)) within accepted Canadian Association of Cardiovascular Prevention and Rehabilitation and American College of Sports Medicine guidelines for exercise training, to monitor exercise training for patients with atrial fibrillation, and help avoid exertional ischemia. The talk test has been shown to be consistent across various modes of exercise (i.e., walking, jogging, cycling, elliptical trainer and stair stepper). It may not be practical for high-intensity interval training. The talk test is a valid, reliable, practical and inexpensive tool for prescribing and monitoring exercise intensity in competitive athletes, healthy active adults and patients with cardiovascular disease. Healthcare professionals should feel comfortable in advocating its use in a variety of clinical and health-promotion settings.

  18. Relation of Exercise Capacity to Risk of Development of Diabetes in Patients on Statin Therapy (the Henry Ford Exercise Testing Project).

    PubMed

    Shaya, Gabriel E; Juraschek, Stephen P; Feldman, David I; Brawner, Clinton A; Ehrman, Jonathan K; Keteyian, Steven J; Al-Mallah, Mouaz H; Blaha, Michael J

    2017-09-01

    High exercise capacity (EC) has been associated with a lower risk of incident diabetes, whereas statin therapy has been associated with a higher risk. We sought to investigate whether the association between EC and diabetes risk is modified by statin therapy. This retrospective cohort study included 47,337 patients without diabetes or coronary artery disease at baseline (age 53 ± 13 years, 48% women, 66% white) who underwent clinical treadmill stress testing within the Henry Ford Health System from January 1, 1991, to May 31, 2009. The patients were stratified by baseline statin use and estimated peak METs achieved during exercise testing. Hazard ratios for incident diabetes were calculated using Cox proportional hazards models adjusted for demographic characteristics, co-morbidities, pertinent medications, and stress test indication. We observed 6,921 new diabetes cases (14.6%) over a median follow-up period of 5.1 years (interquartile interval of 2.6 to 8.2 years). Compared with the statin group, the no-statin group achieved higher mean METs (8.9 ± 2.7 vs 9.6 ± 3.0, respectively; p <0.001). After adjustment for covariates, a higher EC was associated with a lower risk of incident diabetes, irrespective of statin use (p-interaction = 0.15). Each 1-MET increment was associated with an 8%, 8%, and 6% relative risk reduction in the total cohort, the no-statin, and the statin groups, respectively (95% confidence interval, 0.91 to 0.93, 0.91 to 0.93, and 0.91 to 0.96, respectively; p <0.001 for all). We conclude that a higher EC is associated with a lower risk of incident diabetes regardless of statin use. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Discordance of exercise thallium testing with coronary arteriography in patients with atypical presentations

    SciTech Connect

    Bungo, M.W.; Leland, O.S. Jr.

    1983-01-01

    Eighty-one patients with diagnostically difficult clinical presentations suggesting coronary disease underwent symptom-limited maximal-exercise treadmill testing (ETT) and exercise radionuclide scanning with /sup 201/Tl. Results of these tests were in agreement in only 47 percent of the cases. Either exercise thallium or ETT was positive in 94 percent of patients with disease. Among a population with a disease prevalence of 67 percent, agreement between exercise thallium an ETT predicted disease in 92 percent of instances or excluded disease in 82 percent of instances. Frequent discordance between these two tests in 53 percent of the cases unfortunately limits this usefulness.

  20. Refined exercise testing can aid DNA-based diagnosis in muscle channelopathies.

    PubMed

    Tan, S Veronica; Matthews, Emma; Barber, Melissa; Burge, James A; Rajakulendran, Sanjeev; Fialho, Doreen; Sud, Richa; Haworth, Andrea; Koltzenburg, Martin; Hanna, Michael G

    2011-02-01

    To improve the accuracy of genotype prediction and guide genetic testing in patients with muscle channelopathies we applied and refined specialized electrophysiological exercise test parameters. We studied 56 genetically confirmed patients and 65 controls using needle electromyography, the long exercise test, and short exercise tests at room temperature, after cooling, and rewarming. Concordant amplitude-and-area decrements were more reliable than amplitude-only measurements when interpreting patterns of change during the short exercise tests. Concordant amplitude-and-area pattern I and pattern II decrements of >20% were 100% specific for paramyotonia congenita and myotonia congenita, respectively. When decrements at room temperature and after cooling were <20%, a repeat short exercise test after rewarming was useful in patients with myotonia congenita. Area measurements and rewarming distinguished true temperature sensitivity from amplitude reduction due to cold-induced slowing of muscle fiber conduction. In patients with negative short exercise tests, symptomatic eye closure myotonia predicted sodium channel myotonia over myotonia congenita. Distinctive "tornado-shaped" neuromyotonia-like discharges may be seen in patients with paramyotonia congenita. In the long exercise test, area decrements from pre-exercise baseline were more sensitive than amplitude decrements-from-maximum-compound muscle action potential (CMAP) in patients with Andersen-Tawil syndrome. Possible ethnic differences in the normative data of the long exercise test argue for the use of appropriate ethnically-matched controls. Concordant CMAP amplitude-and-area decrements of >20% allow more reliable interpretation of the short exercise tests and aid accurate DNA-based diagnosis. In patients with negative exercise tests, specific clinical features are helpful in differentiating sodium from chloride channel myotonia. A modified algorithm is suggested. Copyright © 2011 American Neurological

  1. Refined Exercise testing can aid DNA-based Diagnosis in Muscle Channelopathies

    PubMed Central

    Tan, S. Veronica; Matthews, Emma; Barber, Melissa; Burge, James A; Rajakulendran, Sanjeev; Fialho, Doreen; Sud, Richa; Haworth, Andrea; Koltzenburg, Martin; Hanna, Michael G

    2010-01-01

    Objective To improve the accuracy of genotype prediction and guide genetic testing in patients with muscle channelopathies we applied and refined specialised electrophysiological exercise test parameters. Methods We studied 56 genetically confirmed patients and 65 controls using needle electromyography, the long exercise test, and short exercise tests at room temperature, after cooling, and rewarming. Results Concordant amplitude-and-area decrements were more reliable than amplitude-only measurements when interpreting patterns of change during the short exercise tests. Concordant amplitude-and-area pattern I and pattern II decrements of >20% were 100% specific for PMC and MC respectively. When decrements at room temperature and after cooling were <20%, a repeat short exercise test after rewarming was useful in patients with myotonia congenita. Area measurements and rewarming distinguished true temperature sensitivity from amplitude reduction due to cold-induced slowing of muscle fibre conduction. In patients with negative short exercise tests, symptomatic eye closure myotonia predicted sodium channel myotonia over myotonia congenita. Distinctive ‘tornado-shaped’ neuromyotonia-like discharges may be seen in patients with paramyotonia congenita. In the long exercise test, area decrements from pre-exercise baseline were more sensitive than amplitude decrements-from-maximum-CMAP in patients with Andersen-Tawil syndrome. Possible ethnic differences in the normative data of the long exercise test argue for the use of appropriate ethnically-matched controls. Interpretation Concordant CMAP amplitude-and-area decrements of >20% allow more reliable interpretation of the short exercise tests and aid accurate DNA-based diagnosis. In patients with negative exercise tests, specific clinical features are helpful in differentiating sodium from chloride channel myotonia. A modified algorithm is suggested.. PMID:21387378

  2. Low Cost Magnetic Resonance Imaging-Compatible Stepper Exercise Device for Use in Cardiac Stress Tests.

    PubMed

    Forouzan, Omid; Flink, Evan; Warczytowa, Jared; Thate, Nick; Hanske, Andrew; Lee, Tongkeun; Roldan-Alzate, Alejandro; François, Chris; Wieben, Oliver; Chesler, Naomi C

    2014-12-01

    Cardiovascular disease is the leading cause of death worldwide. Many cardiovascular diseases are better diagnosed during a cardiac stress test. Current approaches include either exercise or pharmacological stress echocardiography and pharmacological stress magnetic resonance imaging (MRI). MRI is the most accurate noninvasive method of assessing cardiac function. Currently there are very few exercise devices that allow collection of cardiovascular MRI data during exercise. We developed a low-cost exercise device that utilizes adjustable weight resistance and is compatible with magnetic resonance (MR) imaging. It is equipped with electronics that measure power output. Our device allows subjects to exercise with a leg-stepping motion while their torso is in the MR imager. The device is easy to mount on the MRI table and can be adjusted for different body sizes. Pilot tests were conducted with 5 healthy subjects (3 male and 2 female, 29.2 ± 3.9 yr old) showing significant exercise-induced changes in heart rate (+42%), cardiac output (+40%) and mean pulmonary artery (PA) flow (+%49) post exercise. These data demonstrate that our MR compatible stepper exercise device successfully generated a hemodynamically stressed state while allowing for high quality imaging. The adjustable weight resistance allows exercise stress testing of subjects with variable exercise capacities. This low-cost device has the potential to be used in a variety of pathologies that require a cardiac stress test for diagnosis and assessment of disease progression.

  3. Acute Hematological and Inflammatory Responses to High-intensity Exercise Tests: Impact of Duration and Mode of Exercise.

    PubMed

    Minuzzi, Luciele G; Carvalho, Humberto M; Brunelli, Diego T; Rosado, Fatima; Cavaglieri, Cláudia R; Gonçalves, Carlos E; Gaspar, Joana M; Rama, Luís M; Teixeira, Ana M

    2017-07-01

    The purpose of this study was to investigate the hematological and inflammatory responses to 4 maximal high-intensity protocols, considering energy expenditure in each test. 9 healthy volunteers performed 4 high-intensity exercise tests of short [Wingate (WANT); Repeated-sprints (RSA)] and long durations [Continuous VO2 test (VCONT); intermittent VO2 test (VINT)] in a cycle-ergometer, until exhaustion. Hematological parameters and IL-6, IL-10 and creatine kinase (CK) levels were determined before (PRE), POST, 30 min, 1, 2, 12 and 24 h after the end of the protocols. Additionally, energy expenditure was determined. Leucocytes, erythrocytes and lymphocytes increased at POST and returned to PRE values at 30 min for all protocols. Lymphocytes had a second decreased at 2 h and granulocytes increased at 2 h when compared to PRE. Both variables returned to PRE values between 12-24 h into recovery. The magnitude of response for IL-6 was greater in VINT and for IL-10 in VCONT. There was no association of energy expenditure within each exercise protocol with the pattern of IL-6, IL-10 and CK responses to the exercise protocols. The present finding support that similar responses after continuous or intermittent acute protocols are observed when exercises are performed to volitional failure, regardless of the duration and mode of exercise. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Testing causality in the association between regular exercise and symptoms of anxiety and depression.

    PubMed

    De Moor, Marleen H M; Boomsma, Dorret I; Stubbe, Janine H; Willemsen, Gonneke; de Geus, Eco J C

    2008-08-01

    In the population at large, regular exercise is associated with reduced anxious and depressive symptoms. Results of experimental studies in clinical populations suggest a causal effect of exercise on anxiety and depression, but it is unclear whether such a causal effect also drives the population association. We cannot exclude the major contribution of a third underlying factor influencing exercise behavior and symptoms of anxiety and depression. To test causal effects of exercise on anxious and depressive symptoms in a population-based sample. Population-based longitudinal study (1991-2002) in a genetically informative sample of twin families. Causal effects of exercise were tested by bivariate genetic modeling of the association between exercise and symptoms of anxiety and depression, correlation of intrapair differences in these traits among genetically identical twins, and longitudinal modeling of changes in exercise behavior and anxious and depressive symptoms. A total of 5952 twins from the Netherlands Twin Register, 1357 additional siblings, and 1249 parents. All participants were aged 18 to 50 years. Survey data about leisure-time exercise (metabolic equivalent task hours per week based on type, frequency, and duration of exercise) and 4 scales of anxious and depressive symptoms (depression, anxiety, somatic anxiety, and neuroticism, plus a composite score). Cross-sectional and longitudinal associations were small and were best explained by common genetic factors with opposite effects on exercise behavior and symptoms of anxiety and depression. In genetically identical twin pairs, the twin who exercised more did not display fewer anxious and depressive symptoms than the co-twin who exercised less. Longitudinal analyses showed that increases in exercise participation did not predict decreases in anxious and depressive symptoms. Regular exercise is associated with reduced anxious and depressive symptoms in the population at large, but the association is not

  5. Correlation between the degree of air trapping in chest HRCT and cardiopulmonary exercise test parameters: could HRCT be a predictor of disease severity?

    PubMed

    Ghanei, Mostafa; Sheyacy, Mohsen; Abbasi, Mohammad Amin; Ani, Alireza; Aslani, Jafar

    2011-03-01

    The purpose of this study was to examine whether the degree of air trapping in high resolution computed tomography (HRCT) of patients with histories of sulfur mustard gas exposure during suspended full expiration correlated with various parameters of the cardiopulmonary exercise test as the gold standard for assessment of pulmonary function. In this analytic study 75 male patients, each with a history of sulfur mustard gas exposure, were investigated. Each participant underwent an incremental cardiopulmonary exercise test, pulmonary function test and arterial oxygen saturation for hemoglobin measurement. For HRCT examination, both lungs were divided into three parts (upper, middle, and lower) and in each part images were separately observed from the involved area point of view (<25% ≤6/24; >25% ≥6/24). A total of 49.3% of the patients (37/75) had evidence of air trapping in over 25% of their lung segments. The mean age±SD in the patients with air trapping of =25% or <25% were 41.1±6.8 and 39.7±4.0 years, respectively (P=0.281). In our study there was no significant difference in pulmonary function test findings (FEV1, FVC and FEV1/FVC) between the two groups. There was no significant correlation with air trapping of =25% and any of the exercise test parameters. Also, no correlation was found between significant air trapping and exercise test findings in maximum exercise and anaerobic situations. No correlation was found between HRCT and cardiopulmonary exercise test findings. HRCT is neither pathognomic of the disease nor a good predictor of disease severity but it might be suggestive of mustard lung injuries.

  6. Psychopathy and crime: testing the incremental validity of PCL-R-measured psychopathy as a predictor of general and violent recidivism.

    PubMed

    Walters, Glenn D

    2012-10-01

    It has been argued that psychopathy plays a vital role in the criminal justice system. To test this assumption, the incremental validity of the psychopathy construct was examined in 198 male Canadian prison inmates serving time for nonsexual offenses and 122 male U. S. inmates undergoing forensic evaluations. When these two samples--which had been used previously to test the incremental validity of the four Psychopathy Checklist-Revised (PCL-R: Hare, 2003) facet scores (Walters, Wilson, & Glover, 2011)--were treated as a single group, second-order confirmatory factor analysis and item response theory principles indicated that a three-factor hierarchical model of the PCL-R facets (interpersonal, affective, lifestyle) fit the data better than a four-factor hierarchical model (interpersonal, affective, lifestyle, antisocial). When the two samples were examined separately, a composite of the first three PCL-R facets (interpersonal, affective, lifestyle) failed to predict general and violent recidivism above and beyond the contributions of age and criminal history. These results bring into question the utility of the psychopathy construct, as measured by Facets 1, 2, and 3 of the PCL-R, to predict important criminal justice outcomes like recidivism. Additional research using alternative measures of psychopathy and a wider array of outcome measures is required to determine the extent to which the psychopathy construct contributes to our understanding of criminal behavior.

  7. Treadmill exercise tests in persons with Parkinson's disease: responses and disease severity.

    PubMed

    Bryant, Mon S; Jackson, George R; Hou, Jyhgong Gabriel; Protas, Elizabeth J

    2016-10-01

    There is a paucity of information on cardiovascular responses with regard to the disease stage of Parkinson's disease (PD) when using an exercise test. Our purpose was to examine whether cardiovascular responses to the treadmill exercise test differed among persons with PD who have different disease severity. Forty-five subjects with PD were studied (34 men and 11 women). The subjects underwent a treadmill exercise test using a modified Bruce protocol. Resting heart rate (HR), resting blood pressure (BP), maximal HR, maximal BP, exercise duration, maximum percentage HR and METs achieved after the treadmill exercise test were studied. Seventeen subjects were in Hoehn and Yahr Staging Scale (HY) 2, 16 were in HY 2.5, and 12 were in HY 3. HR increased significantly in all three stages. Systolic BP increased significantly in the HY 2 and 2.5, but not the HY 3. Diastolic BP did not change in any stage. Resting HR was lower in the HY 2 compared to the HY 3 and resting systolic BP was higher in HY 2 compared to the HY 2.5. The three HY stages were not different in exercise duration, HR and BP responses, maximum percentage HR achieved, and METs achieved. Fatigue was a primary reason to discontinue the test. There were no fall incidents in any of the tests. Cardiovascular responses to the treadmill exercise test did not vary with disease severity. Treadmill exercise tests were safe to perform in persons with PD.

  8. Exercise thallium stress testing compared with coronary angiography in patients without exclusions for suboptimal exercise or cardioactive medications

    SciTech Connect

    Vincent, N.R.; Denis, L.

    1986-10-01

    From 1293 patients who underwent thallium stress testing and 1099 patients who had coronary angiography, a consecutive series of 122 who had both studies is evaluated. This group includes suboptimally exercised patients and those receiving one or several cardiovascular drugs that were not discontinued prior to exercise. When compared with the EKG stress test, thallium stress imaging was superior in sensitivity (80% vs 68%), specificity (84% vs 49%), accuracy (81% vs 62%), positive predictive value, (92% vs 75%), and negative predictive value (65% vs 45%) in this group, with 71% prevalence of angiographically significant coronary artery disease.

  9. Qualified Fitness and Exercise as Professionals and Exercise Prescription: Evolution of the PAR-Q and Canadian Aerobic Fitness Test.

    PubMed

    Shephard, Roy J

    2015-04-01

    Traditional approaches to exercise prescription have included a preliminary medical screening followed by exercise tests of varying sophistication. To maximize population involvement, qualified fitness and exercise professionals (QFEPs) have used a self-administered screening questionnaire (the Physical Activity Readiness Questionnaire, PAR-Q) and a simple measure of aerobic performance (the Canadian Aerobic Fitness Test, CAFT). However, problems have arisen in applying the original protocol to those with chronic disease. Recent developments have addressed these issues. Evolution of the PAR-Q and CAFT protocol is reviewed from their origins in 1974 to the current electronic decision tree model of exercise screening and prescription. About a fifth of apparently healthy adults responded positively to the original PAR-Q instrument, thus requiring an often unwarranted referral to a physician. Minor changes of wording did not overcome this problem. However, a consensus process has now developed an electronic decision tree for stratification of exercise risk not only for healthy individuals, but also for those with various types of chronic disease. The new approach to clearance greatly reduces physician referrals and extends the role of QFEPs. The availability of effective screening and simple fitness testing should contribute to the goal of maximizing physical activity in the entire population.

  10. Cost-effectiveness of exercise stress testing performed as part of executive health examinations.

    PubMed

    Shah, S J; Rehman, A; Shaukat, M H S; Awais, M

    2017-05-01

    An executive health examination is offered at many hospitals for "busy executives" that comprises of a typical history and examination along with screening tests for major cardiovascular and respiratory illnesses. Exercise stress tests are also frequently included in such packages, though the appropriateness of such stress testing remains uncertain. To assess the appropriateness and cost-effectiveness of exercise stress tests performed as part of executive health examinations. Records of all individuals who underwent an executive health examination at our institution between January, 2007 and December, 2012 were retrospectively reviewed. Data were collected pertaining to demographics, cardiovascular risk factors, indication of stress testing and results of exercise stress tests. Of a total of 1650 subjects who underwent exercise stress tests as part of executive health examinations, indication for exercise stress testing was class IIb or III (as per American College of Cardiology's appropriateness criteria) in 96.1 % of subjects. The cumulative cost and time burden of testing for these subjects were Rs. 11,419,200/- PKR (≈$114,192 USD) and 2 weeks and 4 days, respectively. Exercise stress tests were not positive for ischemia in any such cases. Based on the results of this study, exercise stress tests should not be routinely offered as part of executive health examinations.

  11. The Digit Naming Speed Test: Its Power and Incremental Validity in Identifying Children with Specific Reading Disabilities.

    ERIC Educational Resources Information Center

    Davis, John M.; Spring, Carl

    1990-01-01

    Conducted two studies to examine usefulness of Digit Naming Speed Test in diagnostic battery to assess reading disabilities. In first study, Digit Naming Speed Test significantly differentiated male elementary school disabled readers from age-matched boys reading at appropriate grade levels. In second study, Digit Naming Speed Test accounted for…

  12. A maximal incremental effort alters tear osmolarity depending on the fitness level in military helicopter pilots.

    PubMed

    Vera Vilchez, Jesús; Jimenez, Raimundo; Madinabeitia, Iker; Masiulis, Nerijus; Cárdenas, David

    2017-08-04

    Fitness level modulates the physiological responses to exercise for a variety of indices. While intense bouts of exercise have been demonstrated to increase tear osmolarity (Tosm), it is not known if fitness level can affect the Tosm response to acute exercise. This study aims to compare the effect of a maximal incremental test on Tosm between trained and untrained military helicopter pilots. Nineteen military helicopter pilots (ten trained and nine untrained) performed a maximal incremental test on a treadmill. A tear sample was collected before and after physical effort to determine the exercise-induced changes on Tosm. The Bayesian statistical analysis demonstrated that Tosm significantly increased from 303.72 ± 6.76 to 310.56 ± 8.80 mmol/L after performance of a maximal incremental test. However, while the untrained group showed an acute Tosm rise (12.33 mmol/L of increment), the trained group experienced a stable Tosm physical effort (1.45 mmol/L). There was a significant positive linear association between fat indices and Tosm changes (correlation coefficients [r] range: 0.77-0.89), whereas the Tosm changes displayed a negative relationship with the cardiorespiratory capacity (VO2 max; r = -0.75) and performance parameters (r = -0.75 for velocity, and r = -0.67 for time to exhaustion). The findings from this study provide evidence that fitness level is a major determinant of Tosm response to maximal incremental physical effort, showing a fairly linear association with several indices related to fitness level. High fitness level seems to be beneficial to avoid Tosm changes as consequence of intense exercise. Copyright © 2017. Published by Elsevier Inc.

  13. Exercise test using dry air in random adolescents: Temporal profile and predictors of bronchoconstriction.

    PubMed

    Johansson, Henrik; Norlander, Katarina; Alving, Kjell; Hedenström, Hans; Janson, Christer; Malinovschi, Andrei; Nordang, Leif; Emtner, Margareta

    2016-02-01

    Guidelines recommend exercise tests using dry air to diagnose exercise-induced bronchoconstriction (EIB). Lung function changes subsequent to these tests have not been investigated in a general adolescent population, and it remains unknown whether signs of airway inflammation, measured using exhaled nitric oxide (FeNO), can predict a positive response. The aim of this study was to investigate the temporal aspect of decline in forced expiratory volume in 1 s (FEV1 ) after an exercise test using dry air, and to investigate predictors of EIB. From a cross-sectional study on adolescents aged 13-15 years (n = 3838), a random subsample of 146 adolescents (99 with and 47 without self-reported exercise-induced dyspnoea) underwent standardized treadmill exercise tests for EIB while breathing dry air. Of the adolescents, 34% had a positive EIB test (decline of ≥10% in FEV1 from baseline) within 30 min. Of the subjects with EIB, 53% showed the greatest decline in FEV1 at 5 to 10 min (mean decline 18.5%), and the remaining 47% of the subjects showed the greatest decline at 15 to 30 min (mean decline 18.9%) after exercise. Increased FeNO (>20 ppb), female gender and self-reported exercise-induced dyspnoea were independently associated with a positive EIB test. When assessing general adolescents for EIB with exercise test using dry air, there is a temporal variation in the greatest FEV1 decline after exercise. Therefore, lung function should be measured for at least 30 min after the exercise. Increased FeNO, female gender and self-reported exercise-induced dyspnoea can be predictors of a positive EIB test. © 2015 Asian Pacific Society of Respirology.

  14. The relationship between blood potassium, blood lactate, and electromyography signals related to fatigue in a progressive cycling exercise test.

    PubMed

    Tenan, Matthew S; McMurray, Robert G; Blackburn, B Troy; McGrath, Melanie; Leppert, Kyle

    2011-02-01

    Local muscle fatigue may be related to potassium efflux from the muscle cell and/or lactate accumulation within the muscle. Local fatigue causes a decrease in median frequency (MPF) of the electromyogram's power spectrum during isometric contractions but its relationship to changes in potassium and lactate during dynamic exercise is equivocal. Thus, this investigation evaluated relationships between changes in the MPF from the vastus lateralis and blood levels of lactate and potassium during an incremental cycling test and recovery. Trained cyclists (n=8) completed a discontinuous, graded cycle test to exhaustion under normal and glycogen-reduced conditions. The glycogen reduced condition promoted an environment of lower lactate production while permitting a consistent potassium response. Blood samples and maximal isometric EMG data were collected at the end of each stage and during recovery. Maximal lactate levels were ∼ 60% lower in the glycogen reduced condition; potassium was similar between trials. MPF did not change significantly at volitional fatigue. Further, MPF was not significantly related to lactate (p>0.27) or potassium (p>0.16) in either condition. Though both lactate and potassium have been implicated as factors relating to local muscle fatigue, neither is significantly related to changes in MPF during or after progressive exercise on a cycle ergometer.

  15. Cardiopulmonary exercise test in chronic heart failure: beyond peak oxygen consumption.

    PubMed

    Franco, Veronica

    2011-03-01

    Patients with cardiovascular diseases commonly present with exercise intolerance, clinically manifest as shortness of breath and fatigue, and these symptoms have important prognostic implications. Cardiopulmonary exercise testing is a well-established method for evaluation of cardiopulmonary diseases. It provides an objective assessment of maximal aerobic capacity (peak VO(2)), estimates prognosis, and allows the physician to discriminate among many subtle and often overlapping etiologies. This review focuses on the evaluation of important exercise parameters, in addition to the peak VO(2), during cardiopulmonary exercise testing.

  16. Limitations of Spectral Electromyogramic Analysis to Determine the Onset of Neuromuscular Fatigue Threshold during Incremental Ergometer Cycling

    PubMed Central

    Latasa, Iban; Cordova, Alfredo; Malanda, Armando; Navallas, Javier; Lavilla-Oiz, Ana; Rodriguez-Falces, Javier

    2016-01-01

    Recently, a new method has been proposed to detect the onset of neuromuscular fatigue during an incremental cycling test by assessing the changes in spectral electromyographic (sEMG) frequencies within individual exercise periods of the test. The method consists on determining the highest power output that can be sustained without a significant decrease in spectral frequencies. This study evaluated the validity of the new approach by assessing the changes in spectral indicators both throughout the whole test and within individual exercise periods of the test. Fourteen cyclists performed incremental cycle ergometer rides to exhaustion with bipolar surface EMG signals recorded from the vastus lateralis. The mean and median frequencies (Fmean and Fmedian, respectively) of the sEMG power spectrum were calculated. The main findings were: (1) Examination of spectral indicators within individual exercise periods of the test showed that neither Fmean nor Fmedian decreased significantly during the last (most fatiguing) exercise periods. (2) Examination of the whole incremental test showed that the behaviour of Fmean and Fmedian with increasing power output was highly inconsistent and varied greatly among subjects. (3) Over the whole incremental test, half of the participants exhibited a positive relation between spectral indicators and workload, whereas the other half demonstrated the opposite behavior. Collectively, these findings indicate that spectral sEMG indexes do not provide a reliable measure of the fatigue state of the muscle during an incremental cycling test. Moreover, it is concluded that it is not possible to determine the onset of neuromuscular fatigue during an incremental cycling test by examining spectral indicators within individual exercise periods of the test. Key points The behaviour of spectral EMG indicators during the incremental test exhibited a high heterogeneity among individuals, with approximately half of the participants showing a positive

  17. Limitations of Spectral Electromyogramic Analysis to Determine the Onset of Neuromuscular Fatigue Threshold during Incremental Ergometer Cycling.

    PubMed

    Latasa, Iban; Cordova, Alfredo; Malanda, Armando; Navallas, Javier; Lavilla-Oiz, Ana; Rodriguez-Falces, Javier

    2016-03-01

    Recently, a new method has been proposed to detect the onset of neuromuscular fatigue during an incremental cycling test by assessing the changes in spectral electromyographic (sEMG) frequencies within individual exercise periods of the test. The method consists on determining the highest power output that can be sustained without a significant decrease in spectral frequencies. This study evaluated the validity of the new approach by assessing the changes in spectral indicators both throughout the whole test and within individual exercise periods of the test. Fourteen cyclists performed incremental cycle ergometer rides to exhaustion with bipolar surface EMG signals recorded from the vastus lateralis. The mean and median frequencies (Fmean and Fmedian, respectively) of the sEMG power spectrum were calculated. The main findings were: (1) Examination of spectral indicators within individual exercise periods of the test showed that neither Fmean nor Fmedian decreased significantly during the last (most fatiguing) exercise periods. (2) Examination of the whole incremental test showed that the behaviour of Fmean and Fmedian with increasing power output was highly inconsistent and varied greatly among subjects. (3) Over the whole incremental test, half of the participants exhibited a positive relation between spectral indicators and workload, whereas the other half demonstrated the opposite behavior. Collectively, these findings indicate that spectral sEMG indexes do not provide a reliable measure of the fatigue state of the muscle during an incremental cycling test. Moreover, it is concluded that it is not possible to determine the onset of neuromuscular fatigue during an incremental cycling test by examining spectral indicators within individual exercise periods of the test. Key pointsThe behaviour of spectral EMG indicators during the incremental test exhibited a high heterogeneity among individuals, with approximately half of the participants showing a positive

  18. Relationship Between Habitual Exercise and Performance on Cardiopulmonary Exercise Testing Differs Between Children With Single and Biventricular Circulations.

    PubMed

    O'Byrne, Michael L; Desai, Sanyukta; Lane, Megan; McBride, Michael; Paridon, Stephen; Goldmuntz, Elizabeth

    2017-03-01

    Increasing habitual exercise has been associated with improved cardiopulmonary exercise testing (CPET) performance, specifically maximal oxygen consumption in children with operatively corrected congenital heart disease. This has not been studied in children following Fontan palliation, a population in whom CPET performance is dramatically diminished. A single-center cross-sectional study with prospective and retrospective data collection was performed that assessed habitual exercise preceding a clinically indicated CPET in children and adolescents with Fontan palliation, transposition of the great arteries following arterial switch operation (TGA), and normal cardiac anatomy without prior operation. Data from contemporaneous clinical reports and imaging studies were collected. The association between percent predicted VO2max and habitual exercise duration adjusted for known covariates was tested. A total of 175 subjects (75 post-Fontan, 20 with TGA, and 80 with normal cardiac anatomy) were enrolled. VO2max was lower in the Fontan group than patients with normal cardiac anatomy (p < 0.0001) or TGA (p < 0.0001). In Fontan subjects, both univariate and multivariate analysis failed to demonstrate a significant association between habitual exercise and VO2max (p = 0.6), in sharp contrast to cardiac normal subjects. In multivariate analysis, increasing age was the only independent risk factor associated with decreasing VO2max in the Fontan group (p = 0.003). Habitual exercise was not associated with VO2max in subjects with a Fontan as compared to biventricular circulation. Further research is necessary to understand why their habitual exercise is ineffective and/or what aspects of the Fontan circulation disrupt this association.

  19. A simple semipaced 3-minute chair rise test for routine exercise tolerance testing in COPD

    PubMed Central

    Aguilaniu, Bernard; Roth, Hubert; Gonzalez-Bermejo, Jesus; Jondot, Marie; Maitre, Jocelyne; Denis, François; Similowski, Thomas

    2014-01-01

    The functional work capacity of chronic obstructive pulmonary disease (COPD) patients is usually assessed with walk tests such as the 6-minute walk test (6MWT) or the shuttle test. Because these exercise modalities require a controlled environment which limits their use by pulmonologists and severely restricts their use among general practitioners, different modalities of a short (1 minute or less) sit-to-stand test were recently proposed. In this study, we evaluated a new modality of a semipaced 3-minute chair rise test (3CRT) in 40 patients with COPD, and compared the reproducibility of physiological responses and symptoms during the 3CRT and their interchangeability with the 6MWT. The results demonstrate that physiological variables, heart rate, pulse oxygen saturation, work done, and symptoms (Borg dyspnea and fatigue scores), during the 3CRT were highly reproducible, and that the physiological responses and symptoms obtained during the 3CRT and the 6MWT were interchangeable for most patients. Moreover, these preliminary data suggest that patients able to perform more than 50 rises during 3 minutes had no significant disability. The simplicity and ease of execution of the 3CRT will facilitate the assessment of exercise symptoms and disability in COPD patients during routine consultations with pulmonologists and general practitioners, and will thus contribute to the improved management of COPD patients. PMID:25285001

  20. The effect of estrogen usage on eccentric exercise-induced damage in rat testes.

    PubMed

    Can, Serpil; Selli, Jale; Buyuk, Basak; Aydin, Sergulen; Kocaaslan, Ramazan; Guvendi, Gulname Findik

    2015-04-01

    Recent years, lots of scientific studies are focused on the possible mechanism of inflammatory response and oxidative stress which are the mechanism related with tissue damage and exercise fatigue. It is well-known that free oxygen radicals may be induced under invitro conditions as well as oxidative stress by exhaustive physical exercise. The aim of this study was to investigate the effects of anabolic steroids in conjunction with exercise in the process of spermatogenesis in the testes, using histological and stereological methods. Thirty-six male Sprague Dawley rats were divided to six groups, including the control group, the eccentric exercise administered group, the estrogen applied group, the estrogen applied and dissected one hour after eccentric exercise group, the no estrogen applied and dissected 48 hours after eccentric exercise group and the estrogen applied and dissected 48 hours after eccentric exercise group. Eccentric exercise was performed on a motorized rodent treadmill and the estrogen applied groups received daily physiological doses by subcutaneous injections. Testicular tissues were examined using specific histopathological, immunohistochemical and stereological methods. Sections of the testes tissue were stained using the TUNEL method to identify apoptotic cells. Apoptosis was calculated as the percentage of positive cells, using stereological analysis. A statistical analysis of the data was carried out with one-way analysis of variance (ANOVA) for the data obtained from stereological analysis. Conventional light microscopic results revealed that testes tissues of the eccentric exercise administered group and the estrogen supplemented group exhibited slight impairment. In groups that were both eccentrically exercised and estrogen supplemented, more deterioration was detected in testes tissues. Likewise, immunohistochemistry findings were also more prominent in the eccentrically exercised and estrogen supplemented groups. The findings suggest

  1. Reliability of the Shuttle Walk Test With Controlled Incremental Velocity in Patients With Difficult-to-Control Asthma.

    PubMed

    Costa, Ivan Peres; Dal Corso, Simone; Borghi-Silva, Audrey; Peixoto, Fabiana; Stirbulov, Roberto; Arena, Ross; Cahalin, Lawrence P; Malosá Sampaio, Luciana Maria

    2017-09-06

    Asthma is a chronic inflammatory condition characterized by bronchial hypersensitivity to endogenous or exogenous agents and variable airflow limitation, which is reversible either spontaneously or with the use of medication. The evaluation of functional capacity in these patients is commonly performed using field tests to gauge activity of daily living. However, the reliability of the symptom-controlled shuttle walk test has not yet been determined for individuals with difficult-to-control asthma. The aim of the present study was to determine the reliability of the shuttle walk test in patients with severe, difficult-to-control asthma. Forty-five patients were evaluated including lung function tests, the International Physical Activity Questionnaire (IPAQ), and the Asthma Control Questionnaire. The participants performed a shuttle walk test twice, with a 20-min rest period between tests. The mean distance walked for this cohort was 330.5 m (range, 50-570 m) on the first walk test and 336.3 m (range, 60-571 m) on the second test. There was no statistical difference between the mean distances walked. The Bland-Altman plots of the 2 tests revealed a mean difference of -12.7 m, with a 95% CI of 37.9 to -63.2 m. Significant correlations were found between the distance walked in meters and the IPAQ (r = 0.36, P < .01) and distance in meters and muscle mass (r = 0.39, P < .009). The shuttle walk test is reliable for individuals with difficult-to-control asthma and can be used in the evaluation of functional capacity.

  2. Sudden cardiac death in the young: the value of exercise testing.

    PubMed

    Stephens, Paul

    2017-01-01

    Paediatric exercise stress testing has historically been used to assess the functional status of patients after repair of CHDs and to assess the efficacy of medical or device therapy in patients with arrhythmias. Exercise stress testing is one of very few hospital- or clinic-based tests that can assess the response of the cardiopulmonary system in an environment that simulates the body's response to vigorous play and competitive sport. Exercise stress testing is therefore a useful modality in the assessment of child and athletes at risk for sudden cardiac death. The author discusses some cardiovascular maladies that can cause sudden cardiac death by utilising case illustrations as a learning tool.

  3. Systematic review of cardiopulmonary exercise testing post stroke: Are we adhering to practice recommendations?

    PubMed

    van de Port, Ingrid G L; Kwakkel, Gert; Wittink, Harriet

    2015-11-01

    To systematically review the use of cardiopulmonary exercise testing in people who have survived a stroke. The following questions are addressed: (i) What are the testing procedures used? (ii) What are the patient, safety and outcomes characteristics in the cardiopulmonary exercise testing procedures? (iii) Which criteria are used to determine maximum oxygen uptake (VO2peak/max) in the cardiopulmonary exercise testing procedures? Systematic review of studies of cardiopulmonary exercise testing in stroke survivors. PubMed, EMBASE, and CINAHL were searched from inception until January 2014. MeSH headings and keywords used were: oxygen capacity, oxygen consumption, oxygen uptake, peak VO2, max VO2, aerobic fitness, physical fitness, aerobic capacity, physical endurance and stroke. Search and selection were performed independently by 2 reviewers. Sixty studies were scrutinized, including 2,104 stroke survivors. Protocols included treadmill (n = 21), bicycle (n = 33), stepper (n = 3) and arm (n = 1) ergometry. Five studies reported 11 adverse events (1%). Secondary outcomes were reported in few studies, which hampered interpretation of the patient's effort, and hence the value of the VO2peak. Most studies did not adhere, or insufficiently adhered, to the existing cardiopulmonary exercise testing guidelines for exercise testing. Thus, the results of cardiopulmonary exercise testing protocols in stroke patients cannot be compared.

  4. Exercise testing and exercise rehabilitation for patients with peripheral arterial disease: status in 1997.

    PubMed

    Regensteiner, J G; Gardner, A; Hiatt, W R

    1997-01-01

    Intermittent claudication is a common manifestation of peripheral arterial occlusive disease (PAOD). Patients with claudication are limited in terms of work, housework and leisure activities so that functional status is very impaired. Therefore, the goals for treatment should focus on improving the functional impairment as well as on modifying risk factors. Evaluation of the functional status is of critical importance before beginning any therapy so that any resultant changes can be assessed. A validated graded treadmill protocol and validated questionnaires are used for this purpose. Three questionnaires that are currently used include the Walking Impairment Questionnaire, the PAOD Physical Activity Recall and the Medical Outcomes Study SF-36. Exercise rehabilitation is a method that has been particularly efficacious for treating the functional impairment associated with intermittent claudication. Exercise rehabilitation has been shown to improve pain-free treadmill walking distance by 44% to 300% and absolute walking distance by 25% to 442%. In addition, improvements have also been reported (using questionnaire data) in the ability to walk distances and speeds, in amount of habitual physical activity and in physical functioning. Thus, exercise rehabilitation has caused improvements not only in exercise capacity but also in community-based functional status. Because of the benefits of this treatment, in addition to the low associated morbidity, exercise therapy is recommended as an important treatment option for people with intermittent claudication due to PAOD.

  5. Realistic Exercises for Assessing Learning. I. Conceptual Design and Testing. Report 04-93.

    ERIC Educational Resources Information Center

    Gronlund, Wayne R.; And Others

    Researchers at the Coast Guard Academy have designed and tested a series of exercises for assessing the development of intellectual skills in an interdisciplinary context and providing career-related motivation for continued learning. These exercises are based on realistic situations that cadets might encounter as commissioned officers in the…

  6. Flow for Exercise Adherence: Testing an Intrinsic Model of Health Behavior

    ERIC Educational Resources Information Center

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

    Background: Health behavior theory generally does not include intrinsic motivation as a determinate of health practices. Purpose: The purpose of this study was to test the flow theory of exercise adherence. Flow theory posits that exercise can be intrinsically rewarding if the experiences of self/time transcendence and control/mastery are achieved…

  7. Flow for Exercise Adherence: Testing an Intrinsic Model of Health Behavior

    ERIC Educational Resources Information Center

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

    Background: Health behavior theory generally does not include intrinsic motivation as a determinate of health practices. Purpose: The purpose of this study was to test the flow theory of exercise adherence. Flow theory posits that exercise can be intrinsically rewarding if the experiences of self/time transcendence and control/mastery are achieved…

  8. Influence of Pedaling Cadence and Incremental Protocol on the Estimation of EMGFT.

    PubMed

    Duff, Timothy M; Fournier, Hallie; Hopp, Orie B; Ochshorn, Eli; Sanders, Eric S; Stevens, Rachel E; Malek, Moh H

    2016-08-01

    Duff, TM, Fournier, H, Hopp, OB, Ochshorn, E, Sanders, ES, Stevens, RE, and Malek, MH. Influence of pedaling cadence and incremental protocol on the estimation of EMGFT. J Strength Cond Res 30(8): 2206-2211, 2016-Theoretically, the electromyographic fatigue threshold (EMGFT) is the highest exercise intensity that an individual can exercise at indefinitely without an increase in electromyography (EMG) amplitude. This index is estimated from a single incremental test. There are, however, factors that may influence EMG amplitude such as pedaling cadence or the incremental protocol used. The purposes of this study were to determine whether different pedaling cadences and/or incremental protocols influence the estimation of the EMGFT. Eight healthy college-aged men performed incremental cycle ergometry on three separate visits. The participants exercised using the following combinations of pedaling cadences and incremental protocols in random order: 25 W at 70 RPM; 13 W at 70 RPM; and 25 W at 100 RPM. The EMGFT value was determined from the vastus lateralis muscle of each participant for each of the three conditions. Separate 1-way repeated measures analysis of variances were performed to determine mean differences for various outcome indices. The mean maximal power output for the 13 W at 70 RPM condition was significantly lower than the two other conditions. There were, however, no significant mean differences (F (2,14) = 2.03; p = 0.169) for EMGFT between the three conditions. The findings of this study indicated that different pedaling cadences and incremental protocols did not influence the estimation of the EMGFT.

  9. Provocation of Migraine after Maximal Exercise: A Test-Retest Study.

    PubMed

    Varkey, Emma; Grüner Sveälv, Bente; Edin, Fredrik; Ravn-Fischer, Annica; Cider, Åsa

    2017-01-01

    Exercise is often recommended in migraine treatment, but strenuous physical activity is also reported as a migraine trigger. The main aim of this study was to evaluate whether migraine can be triggered by a maximal exercise test, using a prospective test-retest method. A secondary aim was to compare the participants who responded to the maximal exercise test with a migraine attack with those who did not suffer a migraine attack after the test. A total of 19 patients reporting exercise as a potential trigger for their migraines were included in the study. After a baseline period of 1 month with measurements of migraine frequency, a cycle ergometer test until exhaustion was used twice on each patient. A total of 14 patients were test-retested, and of these, 3 reported migraine following both tests, 5 after one of the tests, and 6 did not report migraine after either test. We observed a higher risk of migraine after 1 or 2 tests in patients with a higher baseline migraine frequency (p = 0.036). In conclusion, the study showed that although maximal aerobic exercise can trigger migraine attacks, it does not always provoke an attack even in those who report exercise as a migraine trigger. © 2017 S. Karger AG, Basel.

  10. The Relation of Arm Exercise Peak Heart Rate to Stress Test Results and Outcome.

    PubMed

    Xian, Hong; Liu, Weijian; Marshall, Cynthia; Chandiramani, Pooja; Bainter, Emily; Martin, Wade H

    2016-09-01

    Arm exercise is an alternative to pharmacologic stress testing for >50% of patients unable to perform treadmill exercise, but no data exist regarding the effect of attained peak arm exercise heart rate on test sensitivity. Thus, the purpose of this investigation was to characterize the relationship of peak arm exercise heart rate responses to abnormal stress test findings, coronary revascularization, and mortality in patients unable to perform leg exercise. From 1997 until 2002, arm cycle ergometer stress tests were performed in 443 consecutive veterans age 64.1 yr (11.0 yr) (mean (SD)), of whom 253 also underwent myocardial perfusion imaging (MPI). Patients were categorized by frequency distributions of quartiles of percentage age-predicted peak heart rate (APPHR), heart rate reserve (HRR), and peak heart rate-systolic blood pressure product (PRPP). Exercise-induced ST-segment depression, abnormal MPI findings, coronary revascularization, and 12.0-yr (1.3 yr) Kaplan-Meier all-cause and cardiovascular mortality plots were then characterized by quartiles of APPHR, HRR, and PRPP. A reduced frequency of abnormal arm exercise ECG results was associated only with the lowest quartile of APPHR (≤69%) and HRR (≤43%), whereas higher frequency of abnormal MPI findings exhibited an inverse relationship trend with lower APPHR (P = 0.10) and HRR (P = 0.12). There was a strong inverse association of APPHR, HRR, and PRPP with all-cause (all P ≤ 0.01) and cardiovascular (P < 0.05) mortality. The frequency of coronary revascularization was unrelated to APPHR or HRR. Arm exercise ECG stress test sensitivity is only reduced at ≤69% APPHR or ≤43% HRR, whereas arm exercise MPI sensitivity and referral for coronary revascularization after arm exercise stress testing are not adversely affected by even a severely blunted peak heart rate. However, both all-cause mortality and cardiovascular mortality are strongly and inversely related to APPHR and HRR.

  11. Withholding Increments. Focus on School Law Series.

    ERIC Educational Resources Information Center

    Weger, Christine D.; Galante, Susan

    Local boards of education in New Jersey are authorized by law to withhold increments of staff members in certain circumstances. The purpose of this publication is to provide an analysis and summary of decisions involving a board's exercise of this authority, and it is intended to serve as a guide and a reference tool to be used in determining when…

  12. Comparison of physiological responses to an incremental running test on treadmill, natural grass, and synthetic turf in young soccer players.

    PubMed

    Di Michele, Rocco; Di Renzo, Anastasio M; Ammazzalorso, Sandro; Merni, Franco

    2009-05-01

    This study aimed to compare the physiological responses to a running test often used to assess lactate thresholds in soccer players when performed with an identical protocol on treadmill (Tr), natural grass (Nat), and synthetic turf (Synt). Eighteen young soccer players (mean +/- SD: age, 17.4 +/- 0.8 years; body mass, 66.2 +/- 6.7 kg; height, 175.8 +/- 5.7 cm) performed on each surface a multistage running test, including 4-minutes stages separated by a 1-minute rest, with initial speed set at 8 kmxh and increased of 2 km.h after each stage. Blood lactate concentration (La) and heart rate (HR) were assessed. The test ended when La exceeded 4 mmolxL. At each of the stages completed in the three conditions by all the subjects (8, 10, 12, and 14 kmxh), La was higher in Synt vs. both Nat and Tr with differences of at least 0.6 mmolxL (p < 0.05), whereas HR was higher (p < 0.05) in Synt vs. Nat with differences from 4.3 bxmin (at 10 kmxh) to 6.4 bxmin (at 8 kmxh). Running speed at the 4 mmolxL La threshold was lower (p < 0.05) in Synt (13.1 +/- 1.1 kmxh) than in Nat (13.9 +/- 1.2 kmxh) and Tr (14.4 +/- 1.3 kmxh). The La/HR curve obtained in Synt was shifted upward compared with the Nat and Tr curves, indicating higher La values at given HRs. These results could be mostly explained by adaptations of running mechanical patterns to surface properties that affect the energy requirements of running. This study emphasized the importance of testing soccer players on the specific surface used for training activities when assessing lactate threshold indices to prescribe and monitor field training.

  13. Defense Enterprise Accounting and Management System (DEAMS) Increment 1 Release 3 Initial Operational Test and Evaluation Report

    DTIC Science & Technology

    2015-08-01

    of Experiments (DOE) to provide a statistical confidence level of 80 percent. The IOT&E test plan was informed by two previous operational...The most significant of these was Oracle Business Intelligence Enterprise Edition (OBIEE) software that was purchased to replace Discoverer, the...availability (Ao) of 98.1 percent, which exceeded the 98 percent threshold for Ao (the 80 percent confidence interval ranged from 96.0 to 98.8 percent). DEAMS

  14. Usefulness of blood pressure rise prior to exercise stress testing to predict the risk of future hypertension in normotensive Korean men.

    PubMed

    Jae, Sae Young; Kurl, Sudhir; Laukkanen, Jari A; Choi, Yoon-Ho; Park, Won Hah; Bunsawat, Kanokwan; Heffernan, Kevin S; Fernhall, Bo; Kang, Seok-Min; Park, Jeong Bae

    2014-10-15

    The aim of this study was to test the hypothesis that blood pressure (BP) increase before exercise stress testing is associated with the incidence of hypertension in a prospective study of 3,805 normotensive men without hypertension at baseline. Changes in BP were defined as the difference between seated BP at rest and BP measured immediately before exercise stress testing. Hypertension was defined as systolic and diastolic BP ≥ 140/90 mm Hg or hypertension diagnosed by a physician at the second examination. During 18,923 patient-years of follow-up, 371 new cases of hypertension developed (incidence rate 19.6 per 1,000 patient-years). Men with systolic BP changes >0 mm Hg and diastolic BP changes >7 mm Hg had 1.70 times (95% confidence interval [CI] 1.37 to 2.12) and 2.23 times (95% CI 1.76 to 2.82) increased relative risk for incident hypertension compared with men whose systolic BP changes were <0 mm Hg and diastolic BP changes were <7 mm Hg after adjustment for confounders. Men in the highest quartile of mean BP change (>10 mm Hg) had a higher incidence of hypertension (relative risk 2.98, 95% CI 2.19 to 4.06) compared with those in the lowest quartile (<0 mm Hg), and each 1 mm Hg increment in mean BP was associated with a 6% (95% CI 1.05 to 1.09) higher incidence of hypertension after adjustment for risk factors. In conclusion, BP increase before exercise stress testing is associated with incident hypertension, independent of risk factors in normotensive men. The assessment of BP immediately before exercise testing may be a useful addition to the standard exercise stress testing procedures. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Narrative and framing: a test of an integrated message strategy in the exercise context.

    PubMed

    Gray, Jennifer B; Harrington, Nancy G

    2011-03-01

    Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research.

  16. Pulmonary thallium-201 uptake following dipyridamole-exercise combination compared with single modality stress testing.

    PubMed

    Hurwitz, G A; O'Donoghue, J P; Powe, J E; Gravelle, D R; MacDonald, A C; Finnie, K J

    1992-02-01

    Angiographic and clinical determinants of pulmonary uptake of thallium-201 were assessed in a laboratory setting where supine bicycle exercise is used for stress testing in the absence of limiting pharmacologic or physical factors, and where symptom-limited exercise is added to intravenous dipyridamole infusion in other cases. Angiographic correlation was available in 400 patients, including 130 tested with exercise, 94 in whom only handgrip or abbreviated bicycle exercise could be used after dipyridamole, and 176 in whom intravenous dipyridamole was combined with a significant level of exercise. For each test mode, lung/myocardial ratios on the immediate image were highly correlated (p less than or equal to 0.001) with a score based on the number of critical coronary artery stenoses, with grading by contrast ventriculography, and with the number of stenosed (greater than or equal to 50%) arteries; relationships (p less than 0.05) to history of myocardial infarction and to gender were also present. Multiple regression analysis showed the critical stenosis score and ventricular dysfunction to be the only significant determinants. When dipyridamole based tests were compared with exercise, curves of receiver-operating characteristics showed a tendency to better diagnostic performance. When dipyridamole is incorporated in stress testing, the value of increased lung uptake as an ancillary diagnostic sign is similar to that established for exercise.

  17. Early exercise stress testing is safe after primary percutaneous coronary intervention.

    PubMed

    Kanthan, Ajita; Tan, Timothy C; Zecchin, Robert P; Denniss, Alan Robert

    2012-06-01

    The optimal timing of exercise stress testing post primary percutaneous coronary intervention is uncertain with anecdotal evidence suggesting an increased risk of acute myocardial infarction and/or death if performed too early. This has translated into a delayed return to normal life activities following an acute myocardial infarction resulting in an increase in socio-economic burden. We hypothesize that early (within 7 days of primary percutaneous coronary intervention) exercise stress testing is safe. A prospective study of consecutive patients enrolled into the Cardiac Rehabilitation Program at a tertiary referral centre that underwent primary percutaneous coronary intervention, and who were able to perform a treadmill stress test were recruited. Timing of exercise stress testing was within 7 days post primary percutaneous coronary intervention and outcomes of death, acute myocardial infarction and other major adverse cardiac event were assessed 24 hours post exercise stress testing. Recruited patients (n=230) aged between 29 and 78 (mean age 56 ± 10 years) with 191 being males (83%) and 39 being females (17%). While 28 patients had a positive stress test (12.2%), there were no deaths, acute myocardial infarction or any other major adverse cardiac event within 24 hours of performing the exercise stress testing. Mean METS achieved were 8.1 ± 2.3. Early exercise stress testing after primary percutaneous coronary intervention appears safe.

  18. The validity and incremental validity of knowledge tests, low-fidelity simulations, and high-fidelity simulations for predicting job performance in advanced-level high-stakes selection.

    PubMed

    Lievens, Filip; Patterson, Fiona

    2011-09-01

    In high-stakes selection among candidates with considerable domain-specific knowledge and experience, investigations of whether high-fidelity simulations (assessment centers; ACs) have incremental validity over low-fidelity simulations (situational judgment tests; SJTs) are lacking. Therefore, this article integrates research on the validity of knowledge tests, low-fidelity simulations, and high-fidelity simulations in advanced-level high-stakes settings. A model and hypotheses of how these 3 predictors work in combination to predict job performance were developed. In a sample of 196 applicants, all 3 predictors were significantly related to job performance. Both the SJT and the AC had incremental validity over the knowledge test. Moreover, the AC had incremental validity over the SJT. Model tests showed that the SJT fully mediated the effects of declarative knowledge on job performance, whereas the AC partially mediated the effects of the SJT.

  19. Prognostic value of radionuclide exercise testing after myocardial infarction

    SciTech Connect

    Schocken, D.D.

    1984-08-01

    Abnormal systolic ventricular function and persistent ischemia are sensitive indicators of poor prognosis following myocardial infarction. Th