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.

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 O 2 extraction) during incremental exercise is altered in MetS and associated with reduced oxygen consumption ( V˙O 2peak ). 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˙O 2peak normalized to total lean mass, similar V˙O 2 response to exercise, and earlier break point (BP) in muscle deoxygenation. Consequently, deoxygenation slope from BP to peak exercise was greater. Furthermore, absolute V˙O 2peak 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 O 2 within skeletal muscle is impaired early in MetS natural history, which may contribute to the reduction in aerobic power. © 2017 The Obesity Society.

Influence on muscle oxygenation to EMG parameters at different skeletal muscle contraction

NASA Astrophysics Data System (ADS)

Zhang, Li; Song, Gaoqing

2010-02-01

The purpose of this study is to investigate the influence of muscle oxygenation on EMG parameters during isometric and incremental exercises and to observe the relationship between EMG parameters and muscle oxygenation. Twelve rowers took part in the tests. Near infrared spectrometer was utilized for measurements of muscle oxygenation on lateral quadriceps. sEMG measurement is performed for EMG parameters during isometric and incremental exercises. Results indicated that Oxy-Hb decrease significantly correlated with IEMG, E/T ratio and frequency of impulse signal during 1/3 MVC and 2/3 MVC isometric exercise, and it is also correlated with IEMG, E/T ratio and frequency of impulse signal. Increase of IEMG occurred at the time after Oxy-Hb decrease during incremental exercise and highly correlated with BLa. It is concluded that no matter how heavy the intensity is, Oxy-Hb dissociation may play an important role in affecting EMG parameters of muscle fatigue during isometric exercise. 2) EMG parameters may be influenced by Oxy-Hb dissociation and blood lactate concentration during dynamic exercise.

Influence on muscle oxygenation to EMG parameters at different skeletal muscle contraction

NASA Astrophysics Data System (ADS)

Zhang, Li; Song, Gaoqing

2009-10-01

The purpose of this study is to investigate the influence of muscle oxygenation on EMG parameters during isometric and incremental exercises and to observe the relationship between EMG parameters and muscle oxygenation. Twelve rowers took part in the tests. Near infrared spectrometer was utilized for measurements of muscle oxygenation on lateral quadriceps. sEMG measurement is performed for EMG parameters during isometric and incremental exercises. Results indicated that Oxy-Hb decrease significantly correlated with IEMG, E/T ratio and frequency of impulse signal during 1/3 MVC and 2/3 MVC isometric exercise, and it is also correlated with IEMG, E/T ratio and frequency of impulse signal. Increase of IEMG occurred at the time after Oxy-Hb decrease during incremental exercise and highly correlated with BLa. It is concluded that no matter how heavy the intensity is, Oxy-Hb dissociation may play an important role in affecting EMG parameters of muscle fatigue during isometric exercise. 2) EMG parameters may be influenced by Oxy-Hb dissociation and blood lactate concentration during dynamic exercise.

A maximal incremental effort alters tear osmolarity depending on the fitness level in military helicopter pilots.

PubMed

Vera, Jesús; Jiménez, Raimundo; Madinabeitia, Iker; Masiulis, Nerijus; Cárdenas, David

2017-10-01

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 Elsevier Inc. All rights reserved.

Blood temperature and perfusion to exercising and non-exercising human limbs.

PubMed

González-Alonso, José; Calbet, José A L; Boushel, Robert; Helge, Jørn W; Søndergaard, Hans; Munch-Andersen, Thor; van Hall, Gerrit; Mortensen, Stefan P; Secher, Niels H

2015-10-01

What is the central question of this study? Temperature-sensitive mechanisms are thought to contribute to blood-flow regulation, but the relationship between exercising and non-exercising limb perfusion and blood temperature is not established. What is the main finding and its importance? The close coupling among perfusion, blood temperature and aerobic metabolism in exercising and non-exercising extremities across different exercise modalities and activity levels and the tight association between limb vasodilatation and increases in plasma ATP suggest that both temperature- and metabolism-sensitive mechanisms are important for the control of human limb perfusion, possibly by activating ATP release from the erythrocytes. Temperature-sensitive mechanisms may contribute to blood-flow regulation, but the influence of temperature on perfusion to exercising and non-exercising human limbs is not established. Blood temperature (TB ), blood flow and oxygen uptake (V̇O2) in the legs and arms were measured in 16 healthy humans during 90 min of leg and arm exercise and during exhaustive incremental leg or arm exercise. During prolonged exercise, leg blood flow (LBF) was fourfold higher than arm blood flow (ABF) in association with higher TB and limb V̇O2. Leg and arm vascular conductance during exercise compared with rest was related closely to TB (r(2) = 0.91; P < 0.05), plasma ATP (r(2) = 0.94; P < 0.05) and limb V̇O2 (r(2) = 0.99; P < 0.05). During incremental leg exercise, LBF increased in association with elevations in TB and limb V̇O2, whereas ABF, arm TB and V̇O2 remained largely unchanged. During incremental arm exercise, both ABF and LBF increased in relationship to similar increases in V̇O2. In 12 trained males, increases in femoral TB and LBF during incremental leg exercise were mirrored by similar pulmonary artery TB and cardiac output dynamics, suggesting that processes in active limbs dominate central temperature and perfusion responses. The present data reveal a close coupling among perfusion, TB and aerobic metabolism in exercising and non-exercising extremities and a tight association between limb vasodilatation and increases in plasma ATP. These findings suggest that temperature and V̇O2 contribute to the regulation of limb perfusion through control of intravascular ATP. © 2015 The Authors Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.

Blood temperature and perfusion to exercising and non‐exercising human limbs

PubMed Central

Calbet, José A. L.; Boushel, Robert; Helge, Jørn W.; Søndergaard, Hans; Munch‐Andersen, Thor; van Hall, Gerrit; Mortensen, Stefan P.; Secher, Niels H.

2015-01-01

New Findings What is the central question of this study? Temperature‐sensitive mechanisms are thought to contribute to blood‐flow regulation, but the relationship between exercising and non‐exercising limb perfusion and blood temperature is not established. What is the main finding and its importance? The close coupling among perfusion, blood temperature and aerobic metabolism in exercising and non‐exercising extremities across different exercise modalities and activity levels and the tight association between limb vasodilatation and increases in plasma ATP suggest that both temperature‐ and metabolism‐sensitive mechanisms are important for the control of human limb perfusion, possibly by activating ATP release from the erythrocytes. Temperature‐sensitive mechanisms may contribute to blood‐flow regulation, but the influence of temperature on perfusion to exercising and non‐exercising human limbs is not established. Blood temperature (T B), blood flow and oxygen uptake (V˙O2) in the legs and arms were measured in 16 healthy humans during 90 min of leg and arm exercise and during exhaustive incremental leg or arm exercise. During prolonged exercise, leg blood flow (LBF) was fourfold higher than arm blood flow (ABF) in association with higher T B and limb V˙O2. Leg and arm vascular conductance during exercise compared with rest was related closely to T B (r 2 = 0.91; P < 0.05), plasma ATP (r 2 = 0.94; P < 0.05) and limb V˙O2 (r 2 = 0.99; P < 0.05). During incremental leg exercise, LBF increased in association with elevations in T B and limb V˙O2, whereas ABF, arm T B and V˙O2 remained largely unchanged. During incremental arm exercise, both ABF and LBF increased in relationship to similar increases in V˙O2. In 12 trained males, increases in femoral T B and LBF during incremental leg exercise were mirrored by similar pulmonary artery T B and cardiac output dynamics, suggesting that processes in active limbs dominate central temperature and perfusion responses. The present data reveal a close coupling among perfusion, T B and aerobic metabolism in exercising and non‐exercising extremities and a tight association between limb vasodilatation and increases in plasma ATP. These findings suggest that temperature and V˙O2 contribute to the regulation of limb perfusion through control of intravascular ATP. PMID:26268717

Heart rate profile during exercise in patients with early repolarization.

PubMed

Cay, Serkan; Cagirci, Goksel; Atak, Ramazan; Balbay, Yucel; Demir, Ahmet Duran; Aydogdu, Sinan

2010-09-01

Both early repolarization and altered heart rate profile are associated with sudden death. In this study, we aimed to demonstrate an association between early repolarization and heart rate profile during exercise. A total of 84 subjects were included in the study. Comparable 44 subjects with early repolarization and 40 subjects with normal electrocardiogram underwent exercise stress testing. Resting heart rate, maximum heart rate, heart rate increment and decrement were analyzed. Both groups were comparable for baseline characteristics including resting heart rate. Maximum heart rate, heart rate increment and heart rate decrement of the subjects in early repolarization group had significantly decreased maximum heart rate, heart rate increment and heart rate decrement compared to control group (all P < 0.05). The lower heart rate increment (< 106 beats/min) and heart rate decrement (< 95 beats/min) were significantly associated with the presence of early repolarization. After adjustment for age and sex, the multiple-adjusted OR of the risk of presence of early repolarization was 2.98 (95%CI 1.21-7.34) (P = 0.018) and 7.73 (95%CI 2.84-21.03) (P < 0.001) for the lower heart rate increment and heart rate decrement compared to higher levels, respectively. Subjects with early repolarization have altered heart rate profile during exercise compared to control subjects. This can be related to sudden death.

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

PubMed

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

2002-01-01

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

40 CFR 60.1615 - How do I comply with the increment of progress for awarding contracts?

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission..., 1999 Model Rule-Increments of Progress § 60.1615 How do I comply with the increment of progress for...

Association of heart rate profile during exercise with the severity of coronary artery disease.

PubMed

Cay, Serkan; Ozturk, Sezgin; Biyikoglu, Funda; Yildiz, Abdulkadir; Cimen, Tolga; Uygur, Belma; Tuna, Funda

2009-05-01

Coronary artery disease is the leading cause of morbidity and mortality around the world. Autonomic nervous system abnormalities are associated with coronary artery disease and its complications. Exercise stress tests are routinely used for the detection of the presence of coronary artery disease. In this study, we observed the association between heart rate profile during exercise and the severity of coronary artery disease. One hundred and sixty patients with abnormal exercise treadmill test (> or =1 mm horizontal or downsloping ST-segment depression; 119 men, 41 women; mean age = 57 +/- 9 years) were included in the study. Use of any drug affecting heart rate was not permitted. Resting heart rate before exercise, maximum heart rate during exercise, and resting heart rate after exercise (5 min later) were measured and two parameters were calculated: heart rate increment (maximum heart rate - resting heart rate before exercise) and heart rate decrement (maximum heart rate - resting heart rate after exercise). All patients underwent selective coronary angiography and subclassified into two groups according to stenotic lesion severity. Group 1 had at least 50% of stenotic lesion and group 2 had less than 50%. Patients in the first group had increased resting heart rate, decreased maximum heart rate, decreased heart rate increment, and decreased heart rate decrement compared with second group. All patients were classified into tertiles of resting heart rate, heart rate increment, and heart rate decrement level to evaluate whether these parameters were associated with severity of coronary artery stenosis in the study. The multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 21.888 (95% confidence interval 6.983-68.606) for the highest tertile of resting heart rate level compared with the lowest tertile. In addition, the multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 20.987 (95% confidence interval 6.635-66.387) for the lowest tertile of heart rate increment level compared with the highest tertile and 2.360 (95% confidence interval 1.004-5.544) for the lowest tertile of heart rate decrement level compared with the highest tertile. Altered autonomic nervous system regulation affects heart rate profile, increased resting heart rate, decreased heart rate increment, and decreased heart rate decrement, during exercise and this effect is strongly and independently associated with the severity of coronary artery disease.

Influence of low versus moderate glycemic index of diet on substrate oxidation and energy expenditure during incremental exercise in endurance athletes: a randomized counterbalanced cross-over trial.

PubMed

Durkalec-Michalski, Krzysztof; Zawieja, Emilia Ewa; Zawieja, Bogna Ewa; Podgórski, Tomasz; Jurkowska, Dominika; Jeszka, Jan

2017-12-18

The study was aimed at assessing the influence of 3-week low glycemic index (LGI) versus moderate glycemic index (MGI) diet on substrate oxidation during incremental exercise. 17 runners completed two 3-week trials of either LGI or MGI diet in a randomised counterbalanced manner. Before and after each trial the incremental cycling test was performed. Metabolic alternations were observed only within tested diets and no significant differences in fat and carbohydrate (CHO) oxidation were found between MGI and LGI diets. Following MGI diet CHO oxidation rate increased. The AUC of fat oxidation decreased after both diets. Percent contribution of fat to energy yield declined, whereas contribution of CHO was augmented following MGI diet. This study indicates that the 3-week MGI diet increased the rate of carbohydrate oxidation during incremental cycling test and improved performance in acute intense exercise test, while both high-carbohydrate diets downregulated fat oxidation rate.

40 CFR 60.2590 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commenced Construction On or Before November 30, 1999 Model Rule-Increments of Progress § 60.2590 When must... increments of progress must be postmarked no later than 10 business days after the compliance date for the...

40 CFR 60.2595 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... or Before November 30, 1999 Model Rule-Increments of Progress § 60.2595 What if I do not meet an... Administrator postmarked within 10 business days after the date for that increment of progress in table 1 of...

Pulmonary Vascular Response Patterns During Exercise in Left Ventricular Systolic Dysfunction Predict Exercise Capacity and Outcomes

PubMed Central

Lewis, Gregory D.; Murphy, Ryan M.; Shah, Ravi V.; Pappagianopoulos, Paul P.; Malhotra, Rajeev; Bloch, Kenneth D.; Systrom, David M.; Semigran, Marc J.

2012-01-01

Background Elevated resting pulmonary arterial pressure (PAP) in patients with left ventricular systolic dysfunction (LVSD) purports a poor prognosis. However, PAP response patterns to exercise in LVSD and their relationship to functional capacity and outcomes have not been characterized. Methods and Results Sixty consecutive patients with LVSD (age 60±12 years, LV ejection fraction 0.31±0.07, mean±SD) and 19 controls underwent maximum incremental cardiopulmonary exercise testing with simultaneous hemodynamic monitoring. During low-level exercise (30 Watts), LVSD subjects compared to controls, had greater augmentation in mean PAPs (15±1 vs. 5±1 mmHg), transpulmonary gradients (5±1 vs. 1±1 mmHg), and effective PA elastance (0.05±0.02 vs. −0.03±0.01 mmHg/ml, p<0.0001 for all). A linear increment in PAP relative to work (0.28±0.12 mmHg/watt) was observed in 65% of LVSD patients, which exceeded that observed in controls (0.07±0.02 mmHg/watt, P<0.0001). Exercise capacity and survival was worse in patients with a PAP/watt slope above the median than in patients with a lower slope. In the remaining 35% of LVSD patients, exercise induced a steep initial increment in PAP (0.41±0.16 mmHg/watt) followed by a plateau. The plateau pattern, compared to a linear pattern, was associated with reduced peak VO2 (10.6±2.6 vs. 13.1±4.0 ml/kg/min, P=0.005), lower right ventricular stroke work index augmentation with exercise (5.7±3.8 vs. 9.7±5.0 g/m2, P=0.002), and increased mortality (HR 8.1, 95% CI 2.7-23.8, P<0.001). Conclusions A steep increment in PAP during exercise and failure to augment PAP throughout exercise are associated with decreased exercise capacity and survival in patients with LVSD, and may therefore represent therapeutic targets. Clinical Trial Information URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00309790) PMID:21292991

Energy cost of wearing chemical protective clothing during progressive treadmill walking

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

Patton, J.F.; Bidwell, T.E.; Murphy, M.M.

1995-03-01

While chemical protective (CP) clothing is known to adversely affect physical performance, few data exist regarding the physiological response of wearing US military cp clothing during incremental, dynamic exercise. To quantify the effects of CP clothing on energy cost and to test the hypothesis that the mask contributes little to this effect, oxygen uptake (vo2) and ventilation (VE) were determined in 14 male soldiers who walked on a treadmill at 1.56 m -5(-1) for 20 min each at 0, 5, and 10% grades in three clothing conditions: BDU (battledress uniform only).

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.

Activity restriction in mild COPD: a challenging clinical problem

PubMed Central

O’Donnell, Denis E; Gebke, Kevin B

2014-01-01

Dyspnea, exercise intolerance, and activity restriction are already apparent in mild chronic obstructive pulmonary disease (COPD). However, patients may not seek medical help until their symptoms become troublesome and persistent and significant respiratory impairment is already present; as a consequence, further sustained physical inactivity may contribute to disease progression. Ventilatory and gas exchange impairment, cardiac dysfunction, and skeletal muscle dysfunction are present to a variable degree in patients with mild COPD, and collectively may contribute to exercise intolerance. As such, there is increasing interest in evaluating exercise tolerance and physical activity in symptomatic patients with COPD who have mild airway obstruction, as defined by spirometry. Simple questionnaires, eg, the modified British Medical Research Council dyspnea scale and the COPD Assessment Test, or exercise tests, eg, the 6-minute or incremental and endurance exercise tests can be used to assess exercise performance and functional status. Pedometers and accelerometers are used to evaluate physical activity, and endurance tests (cycle or treadmill) using constant work rate protocols are used to assess the effects of interventions such as pulmonary rehabilitation. In addition, alternative outcome measurements, such as tests of small airway dysfunction and laboratory-based exercise tests, are used to measure the extent of physiological impairment in individuals with persistent dyspnea. This review describes the mechanisms of exercise limitation in patients with mild COPD and the interventions that can potentially improve exercise tolerance. Also discussed are the benefits of pulmonary rehabilitation and the potential role of pharmacologic treatment in symptomatic patients with mild COPD. PMID:24940054

Anaerobic Threshold and Salivary α-amylase during Incremental Exercise.

PubMed

Akizuki, Kazunori; Yazaki, Syouichirou; Echizenya, Yuki; Ohashi, Yukari

2014-07-01

[Purpose] The purpose of this study was to clarify the validity of salivary α-amylase as a method of quickly estimating anaerobic threshold and to establish the relationship between salivary α-amylase and double-product breakpoint in order to create a way to adjust exercise intensity to a safe and effective range. [Subjects and Methods] Eleven healthy young adults performed an incremental exercise test using a cycle ergometer. During the incremental exercise test, oxygen consumption, carbon dioxide production, and ventilatory equivalent were measured using a breath-by-breath gas analyzer. Systolic blood pressure and heart rate were measured to calculate the double product, from which double-product breakpoint was determined. Salivary α-amylase was measured to calculate the salivary threshold. [Results] One-way ANOVA revealed no significant differences among workloads at the anaerobic threshold, double-product breakpoint, and salivary threshold. Significant correlations were found between anaerobic threshold and salivary threshold and between anaerobic threshold and double-product breakpoint. [Conclusion] As a method for estimating anaerobic threshold, salivary threshold was as good as or better than determination of double-product breakpoint because the correlation between anaerobic threshold and salivary threshold was higher than the correlation between anaerobic threshold and double-product breakpoint. Therefore, salivary threshold is a useful index of anaerobic threshold during an incremental workload.

Effects of lumbopelvic sling and abdominal drawing-in exercises on lung capacity in healthy adults.

PubMed

Kim, Myoung-Kwon; Cha, Hyun-Gyu; Shin, Young-Jun

2016-08-01

[Purpose] To examine the effects of lumbopelvic sling and abdominal drawing-in exercises on the lung capacities of healthy subjects. [Subjects and Methods] Twenty-nine healthy subjects with no orthopedic history of the back were recruited. Subjects were randomly assigned to a experimental group and control group. Subjects were allocated to one of two groups; an experimental group that underwent lumbopelvic sling and abdominal drawing-in exercises and a control group that underwent treadmill and abdominal drawing-in exercises. Lung capacities were evaluated 4 weeks after exercises. [Results] The experimental group showed significant increments in EV, ERV, IRV, VT vs. pre-intervention results, and the control group showed significant increments in the EVC and IRV. Significant intergroup differences were observed in terms of post-training gains in EVC, IRV, and VT. [Conclusion] Combined application of lumbopelvic sling and abdominal drawing-in exercises were found to have a positive effect on lung capacity.

Dehydration accelerates reductions in cerebral blood flow during prolonged exercise in the heat without compromising brain metabolism

PubMed Central

Trangmar, Steven J.; Chiesa, Scott T.; Llodio, Iñaki; Garcia, Benjamin; Kalsi, Kameljit K.; Secher, Niels H.

2015-01-01

Dehydration hastens the decline in cerebral blood flow (CBF) during incremental exercise, whereas the cerebral metabolic rate for O2 (CMRO2) is preserved. It remains unknown whether CMRO2 is also maintained during prolonged exercise in the heat and whether an eventual decline in CBF is coupled to fatigue. Two studies were undertaken. In study 1, 10 male cyclists cycled in the heat for ∼2 h with (control) and without fluid replacement (dehydration) while internal and external carotid artery blood flow and core and blood temperature were obtained. Arterial and internal jugular venous blood samples were assessed with dehydration to evaluate CMRO2. In study 2, in 8 male subjects, middle cerebral artery blood velocity was measured during prolonged exercise to exhaustion in both dehydrated and euhydrated states. After a rise at the onset of exercise, internal carotid artery flow declined to baseline with progressive dehydration (P < 0.05). However, cerebral metabolism remained stable through enhanced O2 and glucose extraction (P < 0.05). External carotid artery flow increased for 1 h but declined before exhaustion. Fluid ingestion maintained cerebral and extracranial perfusion throughout nonfatiguing exercise. During exhaustive exercise, however, euhydration delayed but did not prevent the decline in cerebral perfusion. In conclusion, during prolonged exercise in the heat, dehydration accelerates the decline in CBF without affecting CMRO2 and also restricts extracranial perfusion. Thus, fatigue is related to a reduction in CBF and extracranial perfusion rather than CMRO2. PMID:26371170

Evidence of cardiac functional reserve upon exhaustion during incremental exercise to determine VO2max.

PubMed

Elliott, Adrian D; Skowno, Justin; Prabhu, Mahesh; Noakes, Timothy David; Ansley, Les

2015-01-01

There remains considerable debate regarding the limiting factor(s) for maximal oxygen uptake (VO2max). Previous studies have shown that the central circulation may be the primary limiting factor for VO2max and that cardiac work increases beyond VO2max. We sought to evaluate whether the work of the heart limits VO2max during upright incremental cycle exercise to exhaustion. Eight trained men completed two incremental exercise trials, each terminating with exercise at two different rates of work eliciting VO2max (MAX and SUPRAMAX). During each exercise trial we continuously recorded cardiac output using pulse-contour analysis calibrated with a lithium dilution method. Intra-arterial pressure was recorded from the radial artery while pulmonary gas exchange was measured continuously for an assessment of oxygen uptake. The workload during SUPRAMAX (mean±SD: 346.5±43.2 W) was 10% greater than that achieved during MAX (315±39.3 W). There was no significant difference between MAX and SUPRAMAX for Q (28.7 vs 29.4 L/min) or VO2 (4.3 vs 4.3 L/min). Mean arterial pressure was significantly higher during SUPRAMAX, corresponding to a higher cardiac power output (8.1 vs 8.5 W; p<0.06). Despite similar VO2 and Q, the greater cardiac work during SUPRAMAX supports the view that the heart is working submaximally at exhaustion during an incremental exercise test (MAX). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

40 CFR 60.2575 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2575 What are my requirements for meeting increments of...

40 CFR 60.2575 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2575 What are my requirements for meeting increments of...

40 CFR 60.2575 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2575 What are my requirements for meeting increments of...

Sinusoidal high-intensity exercise does not elicit ventilatory limitation in chronic obstructive pulmonary disease.

PubMed

Porszasz, Janos; Rambod, Mehdi; van der Vaart, Hester; Rossiter, Harry B; Ma, Shuyi; Kiledjian, Rafi; Casaburi, Richard

2013-06-01

During exercise at critical power (CP) in chronic obstructive pulmonary disease (COPD) patients, ventilation approaches its maximum. As a result of the slow ventilatory dynamics in COPD, ventilatory limitation during supramaximal exercise might be escaped using rapid sinusoidal forcing. Nine COPD patients [age, 60.2 ± 6.9 years; forced expiratory volume in the first second (FEV(1)), 42 ± 17% of predicted; and FEV(1)/FVC, 39 ± 12%] underwent an incremental cycle ergometer test and then four constant work rate cycle ergometer tests; tolerable duration (t(lim)) was recorded. Critical power was determined from constant work rate testing by linear regression of work rate versus 1/t(lim). Patients then completed fast (FS; 60 s period) and slow (SS; 360 s period) sinusoidally fluctuating exercise tests with mean work rate at CP and peak at 120% of peak incremental test work rate, and one additional test at CP; each for a 20 min target. The value of t(lim) did not differ between CP (19.8 ± 0.6 min) and FS (19.0 ± 2.5 min), but was shorter in SS (13.2 ± 4.2 min; P < 0.05). The sinusoidal ventilatory amplitude was minimal (37.4 ± 34.9 ml min(-1) W(-1)) during FS but much larger during SS (189.6 ± 120.4 ml min(-1) W(-1)). The total ventilatory response in SS reached 110 ± 8.0% of the incremental test peak, suggesting ventilatory limitation. Slow components in ventilation during constant work rate and FS exercises were detected in most subjects and contributed appreciably to the total response asymptote. The SS exercise was associated with higher mid-exercise lactate concentrations (5.2 ± 1.7, 7.6 ± 1.7 and 4.5 ± 1.3 mmol l(-1) in FS, SS and CP). Large-amplitude, rapid sinusoidal fluctuation in work rate yields little fluctuation in ventilation despite reaching 120% of the incremental test peak work rate. This high-intensity exercise strategy might be suitable for programmes of rehabilitative exercise training in COPD.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

PubMed

Henchoz, Yves; Pinget, Christophe; Wasserfallen, Jean-Blaise; Paillex, Roland; de Goumoëns, Pierre; Norberg, Michael; Kai-Lik So, Alexander

2010-10-01

To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. Cost-utility analysis alongside a randomized controlled trial. A total of 105 patients with chronic low back pain. Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise

NASA Technical Reports Server (NTRS)

Gallagher, K. M.; Fadel, P. J.; Smith, S. A.; Norton, K. H.; Querry, R. G.; Olivencia-Yurvati, A.; Raven, P. B.

2001-01-01

This investigation was designed to determine the role of intramuscular pressure-sensitive mechanoreceptors and chemically sensitive metaboreceptors in affecting the blood pressure response to dynamic exercise in humans. Sixteen subjects performed incremental (20 W/min) cycle exercise to fatigue under four conditions: control, exercise with thigh cuff occlusion of 90 Torr (Cuff occlusion), exercise with lower body positive pressure (LBPP) of 45 Torr, and a combination of thigh cuff occlusion and LBPP (combination). Indexes of central command (heart rate, oxygen uptake, ratings of perceived exertion, and electromyographic activity), cardiac output, stroke volume, and total peripheral resistance were not significantly different between the four conditions. Mechanical stimulation during LBPP and combination conditions resulted in significant elevations in intramuscular pressure and mean arterial pressure from control at rest and throughout the incremental exercise protocol (P < 0.05). Conversely, there existed no significant changes in mean arterial pressure when the metaboreflex was stimulated by cuff occlusion. These findings suggest that under normal conditions the mechanoreflex is tonically active and is the primary mediator of exercise pressor reflex-induced alterations in arterial blood pressure during submaximal dynamic exercise in humans.

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 (FEV 1 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 (FEV 1 /FVC) and peak exercise (V̇ E /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.

Physiological Effects of Early Incremental Mobilization of a Patient with Acute Intracerebral and Intraventricular Hemorrhage Requiring Dual External Ventricular Drainage.

PubMed

Kumble, Sowmya; Zink, Elizabeth K; Burch, Mackenzie; Deluzio, Sandra; Stevens, Robert D; Bahouth, Mona N

2017-08-01

Recent trials have challenged the notion that very early mobility benefits patients with acute stroke. It is unclear how cerebral autoregulatory impairments, prevalent in this population, could be affected by mobilization. The safety of mobilizing patients who have external ventricular drainage (EVD) devices for cerebrospinal fluid diversion and intracranial pressure (ICP) monitoring is another concern due to risk of device dislodgment and potential elevation in ICP. We report hemodynamic and ICP responses during progressive, device-assisted mobility interventions performed in a critically ill patient with intracerebral hemorrhage (ICH) requiring two EVDs. A 55-year-old man was admitted to the Neuroscience Critical Care Unit with an acute thalamic ICH and complex intraventricular hemorrhage requiring placement of two EVDs. Progressive mobilization was achieved using mobility technology devices. Range of motion exercises were performed initially, progressing to supine cycle ergometry followed by incremental verticalization using a tilt table. Physiological parameters were recorded before and after the interventions. All mobility interventions were completed without any adverse event or clinically detectable change in the patient's neurological state. Physiological parameters including hemodynamic variables and ICP remained within prescribed goals throughout. Progressive, device-assisted early mobilization was feasible and safe in this critically ill patient with hemorrhagic stroke when titrated by an interdisciplinary team of skilled healthcare professionals. Studies are needed to gain insight into the hemodynamic and neurophysiological responses associated with early mobility in acute stroke to identify subsets of patients who are most likely to benefit from this intervention.

40 CFR 60.1630 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... Before August 30, 1999 Model Rule-Increments of Progress § 60.1630 How do I comply with the increment of...

Conventional testing methods produce submaximal values of maximum oxygen consumption.

PubMed

Beltrami, Fernando G; Froyd, Christian; Mauger, Alexis R; Metcalfe, Alan J; Marino, Frank; Noakes, Timothy D

2012-01-01

This study used a novel protocol to test the hypothesis that a plateau in oxygen consumption (VO(2 max)) during incremental exercise testing to exhaustion represents the maximal capacity of the cardiovascular system to transport oxygen. Twenty-six subjects were randomly divided into two groups matched by their initial VO(2 max). On separate days, the reverse group performed (i) an incremental uphill running test on a treadmill (INC(1)) plus verification test (VER) at a constant workload 1 km h(-1) higher than the last completed stage in INC(1); (ii) a decremental test (DEC) in which speed started as same as the VER but was reduced progressively and (iii) a final incremental test (INC(F)). The control group performed only INC on the same days that the reverse group was tested. VO(2 max) remained within 0.6 ml kg(-1) min(-1) across the three trials for the control group (p=0.93) but was 4.4% higher during DEC compared with INC(1) (63.9 ± 3.8 vs 61.2 ± 4.8 ml kg(-1) min(-1), respectively, p=0.004) in the reverse group, even though speed at VO(2 max) was lower (14.3 ± 1.1 vs 16.2 ± 0.7 km h(-1) for DEC and INC(1), respectively, p=0.0001). VO(2 max) remained significantly higher during INC(F) (63.6 ± 3.68 ml kg(-1) min(-1), p=0.01), despite an unchanged exercise time between INC(1) and INC(F). These findings go against the concept that a plateau in oxygen consumption measured during the classically described INC and VER represents a systemic limitation to oxygen use. The reasons for a higher VO(2) during INC(F) following the DEC test are unclear.

High intensity interval training in the heat enhances exercise-induced lipid peroxidation, but prevents protein oxidation in physically active men

PubMed Central

Souza-Silva, Ana Angélica; Moreira, Eduardo; de Melo-Marins, Denise; Schöler, Cinthia M.; de Bittencourt, Paulo Ivo Homem; Laitano, Orlando

2016-01-01

ABSTRACT Aim. The purpose of this study was to determine the response of circulating markers of lipid and protein oxidation following an incremental test to exhaustion before and after 4 weeks of high-intensity interval training performed in the heat. Methods. To address this question, 16 physically active men (age = 23 ± 2 years; body mass = 73 ± 12 kg; height = 173 ± 6 cm; % body fat = 12.5 ± 6 %; body mass index = 24 ± 4 kg/m2) were allocated into 2 groups: control group (n = 8) performing high-intensity interval training at 22°C, 55% relative humidity and heat group (n = 8) training under 35°C, 55% relative humidity. Both groups performed high-intensity interval training 3 times per week for 4 consecutive weeks, accumulating a total of 12 training sessions. Before and after the completion of 4 weeks of high-intensity interval training, participants performed an incremental cycling test until exhaustion under temperate environment (22°C, 55% relative humidity) where blood samples were collected after the test for determination of exercise-induced changes in oxidative damage biomarkers (thiobarbituric acid reactive species and protein carbonyls). Results. When high-intensity interval training was performed under control conditions, there was an increase in protein carbonyls (p < 0.05) following the incremental test to exhaustion with no changes in thiobarbituric acid reactive species. Conversely, high-intensity interval training performed in high environmental temperature enhanced the incremental exercise-induced increases in thiobarbituric acid reactive species (p < 0.05) with no changes in protein carbonyls. Conclusion. In conclusion, 4 weeks of high-intensity interval training performed in the heat enhances exercise-induced lipid peroxidation, but prevents protein oxidation following a maximal incremental exercise in healthy active men. PMID:27227083

40 CFR 60.1610 - How do I comply with the increment of progress for submittal of a control plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... Before August 30, 1999 Model Rule-Increments of Progress § 60.1610 How do I comply with the increment of...

Dehydration accelerates reductions in cerebral blood flow during prolonged exercise in the heat without compromising brain metabolism.

PubMed

Trangmar, Steven J; Chiesa, Scott T; Llodio, Iñaki; Garcia, Benjamin; Kalsi, Kameljit K; Secher, Niels H; González-Alonso, José

2015-11-01

Dehydration hastens the decline in cerebral blood flow (CBF) during incremental exercise, whereas the cerebral metabolic rate for O2 (CMRO2 ) is preserved. It remains unknown whether CMRO2 is also maintained during prolonged exercise in the heat and whether an eventual decline in CBF is coupled to fatigue. Two studies were undertaken. In study 1, 10 male cyclists cycled in the heat for ∼2 h with (control) and without fluid replacement (dehydration) while internal and external carotid artery blood flow and core and blood temperature were obtained. Arterial and internal jugular venous blood samples were assessed with dehydration to evaluate CMRO2 . In study 2, in 8 male subjects, middle cerebral artery blood velocity was measured during prolonged exercise to exhaustion in both dehydrated and euhydrated states. After a rise at the onset of exercise, internal carotid artery flow declined to baseline with progressive dehydration (P < 0.05). However, cerebral metabolism remained stable through enhanced O2 and glucose extraction (P < 0.05). External carotid artery flow increased for 1 h but declined before exhaustion. Fluid ingestion maintained cerebral and extracranial perfusion throughout nonfatiguing exercise. During exhaustive exercise, however, euhydration delayed but did not prevent the decline in cerebral perfusion. In conclusion, during prolonged exercise in the heat, dehydration accelerates the decline in CBF without affecting CMRO2 and also restricts extracranial perfusion. Thus, fatigue is related to a reduction in CBF and extracranial perfusion rather than CMRO2 . Copyright © 2015 the American Physiological Society.

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

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.

Criterion-related validity of perceived exertion scales in healthy children: a systematic review and meta-analysis.

PubMed

Rodríguez, Iván; Zambrano, Lysien; Manterola, Carlos

2016-04-01

Physiological parameters used to measure exercise intensity are oxygen uptake and heart rate. However, perceived exertion (PE) is a scale that has also been frequently applied. The objective of this study is to establish the criterion-related validity of PE scales in children during an incremental exercise test. Seven electronic databases were used. Studies aimed at assessing criterion-related validity of PE scales in healthy children during an incremental exercise test were included. Correlation coefficients were transformed into z-values and assessed in a meta-analysis by means of a fixed effects model if I2 was below 50% or a random effects model, if it was above 50%. wenty-five articles that studied 1418 children (boys: 49.2%) met the inclusion criteria. Children's average age was 10.5 years old. Exercise modalities included bike, running and stepping exercises. The weighted correlation coefficient was 0.835 (95% confidence interval: 0.762-0.887) and 0.874 (95% confidence interval: 0.794-0.924) for heart rate and oxygen uptake as reference criteria. The production paradigm and scales that had not been adapted to children showed the lowest measurement performance (p < 0.05). Measuring PE could be valid in healthy children during an incremental exercise test. Child-specific rating scales showed a better performance than those that had not been adapted to this population. Further studies with better methodological quality should be conducted in order to confirm these results. Sociedad Argentina de Pediatría.

Assessment of Intralaminar Progressive Damage and Failure Analysis Using an Efficient Evaluation Framework

NASA Technical Reports Server (NTRS)

Hyder, Imran; Schaefer, Joseph; Justusson, Brian; Wanthal, Steve; Leone, Frank; Rose, Cheryl

2017-01-01

Reducing the timeline for development and certification for composite structures has been a long standing objective of the aerospace industry. This timeline can be further exacerbated when attempting to integrate new fiber-reinforced composite materials due to the large number of testing required at every level of design. computational progressive damage and failure analysis (PDFA) attempts to mitigate this effect; however, new PDFA methods have been slow to be adopted in industry since material model evaluation techniques have not been fully defined. This study presents an efficient evaluation framework which uses a piecewise verification and validation (V&V) approach for PDFA methods. Specifically, the framework is applied to evaluate PDFA research codes within the context of intralaminar damage. Methods are incrementally taken through various V&V exercises specifically tailored to study PDFA intralaminar damage modeling capability. Finally, methods are evaluated against a defined set of success criteria to highlight successes and limitations.

Cost-effectiveness analysis of an 18-week exercise programme for patients with breast and colon cancer undergoing adjuvant chemotherapy: the randomised PACT study.

PubMed

May, Anne M; Bosch, Marcel J C; Velthuis, Miranda J; van der Wall, Elsken; Steins Bisschop, Charlotte N; Los, Maartje; Erdkamp, Frans; Bloemendal, Haiko J; de Roos, Marnix A J; Verhaar, Marlies; Ten Bokkel Huinink, Daan; Peeters, Petra H M; de Wit, G Ardine

2017-03-06

Meta-analyses show that exercise interventions during cancer treatment reduce cancer-related fatigue. However, little is known about the cost-effectiveness of such interventions. Here we aim to assess the cost-effectiveness of the 18-week physical activity during cancer treatment (PACT) intervention for patients with breast and colon cancer. The PACT trial showed beneficial effects for fatigue and physical fitness. Cost-effectiveness analyses with a 9-month time horizon (18 weeks of intervention and 18 weeks of follow-up) within the randomised controlled multicentre PACT study. Outpatient clinics of 7 hospitals in the Netherlands (1 academic and 6 general hospitals) PARTICIPANTS: 204 patients with breast cancer and 33 with colon cancer undergoing adjuvant treatment including chemotherapy. Supervised 1-hour aerobic and resistance exercise (twice per week for 18 weeks) or usual care. Costs, quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio. For colon cancer, the cost-effectiveness analysis showed beneficial effects of the exercise intervention with incremental costs savings of €4321 and QALY improvements of 0.03. 100% of bootstrap simulations indicated that the intervention is dominant (ie, cheaper and more effective). For breast cancer, the results did not indicate that the exercise intervention was cost-effective. Incremental costs were €2912, and the incremental effect was 0.01 QALY. At a Dutch threshold value of €20 000 per QALY, the probability that the intervention is cost-effective was 2%. Our results suggest that the 18-week exercise programme was cost-effective for colon cancer, but not for breast cancer. ISRCTN43801571. 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/.

Onset of Hyperventilation during Incremental Exercise: A Brief Review.

ERIC Educational Resources Information Center

Powers, Scott K.; Beadle, Ralph E.

1985-01-01

This review discussed the various mechanisms that have been proposed to be causative of the hyperventilation that occurs during heavy exercise. The humoral hypothesis and nonhumoral hypothesis and secondary factors are reviewed. (MT)

Exercise testing in asymptomatic severe aortic stenosis.

PubMed

Magne, Julien; Lancellotti, Patrizio; Piérard, Luc A

2014-02-01

The management and the clinical decision making in asymptomatic patients with aortic stenosis are challenging. An "aggressive" management, including early aortic valve replacement, is debated in these patients. However, the optimal timing for surgery remains controversial due to the lack of prospective data on the determinants of aortic stenosis progression, multicenter studies on risk stratification, and randomized studies on patient management. Exercise stress testing with or without imaging is strictly contraindicated in symptomatic patients with severe aortic stenosis. Exercise stress test is now recommended by current guidelines in asymptomatic patients and may provide incremental prognostic value. Indeed, the development of symptoms during exercise or an abnormal blood pressure response are associated with poor outcome and should be considered as an indication for surgery, as suggested by the most recently updated European Society of Cardiology 2012 guidelines. Exercise stress echocardiography may also improve the risk stratification and identify asymptomatic patients at higher risk of a cardiac event. When the test is combined with imaging, echocardiography during exercise should be recommended rather than post-exercise echocardiography. During exercise, an increase >18 to 20 mm Hg in mean pressure gradient, absence of improvement in left ventricular ejection fraction (i.e., absence of contractile reserve), and/or a systolic pulmonary arterial pressure >60 mm Hg (i.e., exercise pulmonary hypertension) are suggestive signs of advanced stages of the disease and impaired prognosis. Hence, exercise stress test may identify resting asymptomatic patients who develop exercise abnormalities and in whom surgery is recommended according to current guidelines. Exercise stress echocardiography may further unmask a subset of asymptomatic patients (i.e., without exercise stress test abnormalities) who are at high risk of reduced cardiac event free survival. In these patients, early surgery could be beneficial, whereas regular follow-up seems more appropriate in patients without echocardiographic abnormalities during exercise. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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.

Heterogeneity of muscle recruitment pattern during pedaling in professional road cyclists: a magnetic resonance imaging and electromyography study.

PubMed

Hug, François; Bendahan, David; Le Fur, Yann; Cozzone, Patrick J; Grélot, Laurent

2004-07-01

Although a number of studies have been devoted to the analysis of the activity pattern of the muscles involved in pedaling in sedentary subjects and/or amateur cyclists, data on professional cyclists are scarce and the issue of inter-individual differences has never been addressed in detail. In the present series of experiments, we performed a non-invasive investigation using functional magnetic resonance imaging and surface electromyography to determine the pattern of activity of lower limb muscles during two different exhausting pedaling exercises in eight French professional cyclists. Each subject performed an incremental exercise during which electromyographic activity of eight lower limb muscles and respiratory variables were recorded. After a 3-h recovery period, transverse relaxation times (T2) were measured before and just after a standardized constant-load maximal exercise in order to quantify exercise-related T2 changes. The global EMG activity illustrated by the root mean square clearly showed a large inter-individual difference during the incremental exercise regardless of the investigated muscle (variation coefficient up to 81%). In addition, for most of the muscles investigated, the constant-load exercise induced T2 increases, which varied noticeably among the subjects. This high level of variation in the recruitment of lower limb muscles in professional cyclists during both incremental and constant-load exercises is surprising given the homogeneity related to maximal oxygen consumption and training volume. The high degree of expertise of these professional cyclists was not linked to the production of a common pattern of pedaling and our results provide an additional evidence that the nervous system has multiple ways of accomplishing a given motor task, as has been suggested previously by neural control theorists and experimentalists.

Effect of aerobic exercise and fish oil supplements on plasma levels of inflammatory indexes in mice.

PubMed

Alizadeh, Hamid; Bazgir, Behzad; Daryanoosh, Farhad; Koushki, Maryam; Sobhani, Vahid

2014-01-01

Exercise has positive and negative effects on immune system. Herein, we would like to investigate the effects of incremental aerobic training and fish oil supplementation on the plasma levels of CRP, CPK and IL-17 in trained mice. One of the major roles of immune system is to produce soluble or cellular components that provide the immunity against inflammatory agent. The purpose of this study is to investigate distinct and combine effects of incremental aerobic training and fish oil supplement on plasma levels of IL-17, CPK and CRP in trained male mice. Totally, 54 healthy male mice (2 months old, weight= 34±1 grams) were selected. At first 10 mice were killed to determine base line values, the rest of them were randomly divided into four groups, control group (C, n=11), supplement group (S, n=11), training group (T, n=11) and supplement-training group (ST, n=11).The supplement and supplement-training groups were fed with 0.2cc/day fish oil for 8 weeks. Training and supplement-training groups underwent exercise for 5 sessions per week for a period of 8 weeks on animal treadmill. SPSS 16.0 software and multivariate analysis of variance were used for statistical analysis of data Exercise and fish oil supplement lead to a decrease in CRP levels and subsequently causing a reduction in plasma levels of IL-17 and CK in mice (p<0.05). Combination of exercise and fish oil can reduce regulate inflammatory response caused by incremental exercise.

Physiological Responses during Cycling With Oval Chainrings (Q-Ring) and Circular Chainrings.

PubMed

Cordova, Alfredo; Latasa, Iban; Seco, Jesus; Villa, Gerardo; Rodriguez-Falces, Javier

2014-05-01

The aim of this study was to compare the physiological responses of cyclists using round (C-ring) or oval (Q-ring) chainrings during an incremental test until exhaustion. Following a randomized design, twelve male elite cyclists [age (mean ± SD): 21.1 ± 2.1 yr; VO2max: 78.1 ± 5.3 mL·kg(-1)min(-1)] performed two incremental maximal tests separated by 48 h (one with C-rings, the other with Q-rings). Starting at 100 W, the workload was increased by 25 W every 3 min until volitional exhaustion. Maximal heart rate, power output and oxygen consumption were compared. Blood lactate was monitored throughout the test. After the incremental test, 4 intermittent 20-s maximal sprints with a 60-s recovery period in between were performed. Maximal isometric voluntary contractions were performed at rest and immediately after each 20-s maximal sprint, and the force and EMG RMS amplitude were recorded from the vastus medialis and vastus lateralis muscles. For the incremental exercise test, no significant differences were found in the maximal power output (P=0.12), oxygen consumption (P=0.39), and heart rate (P=0.32) between Q-rings and C-rings. Throughout the incremental test, lactate levels were comparable when using both the C-rings and Q-rings (P=0.47). During the short sprints, power output was 2.5-6.5% greater for Q-rings than for C-rings (P=0.22). The decline in EMG RMS amplitude observed during the incremental tests was comparable for Q-rings and C-rings (0.42). These findings indicate that the oval chainring design, presented here as "Q-rings", did not significantly influence the physiological response to an incremental exercise test as compared to a conventional chainring. Key pointsDuring the incremental exercise test, no significant differences were found in power output, oxygen consumption or heart rate between oval "Q-rings" and conventional chainrings.Over the course of the incremental test, blood lactate levels were comparable for the oval "Q-rings" and conventional chainrings.During the short sprints performed after the incremental test, there were no statistical differences in power production between oval "Q-rings" and conventional chainrings.

40 CFR 60.5090 - When must I complete each increment of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule-Increments of Progress § 60.5090 When...

40 CFR 62.14540 - When must I complete each increment of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and Increments of Progress § 62...

40 CFR 62.14540 - When must I complete each increment of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and Increments of Progress § 62...

Effects of Pressure Support Ventilation May Be Lost at High Exercise Intensities in People with COPD.

PubMed

Anekwe, David; de Marchie, Michel; Spahija, Jadranka

2017-06-01

Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H 2 O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H 2 O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator. Tests were performed in randomized order and at least 48 hours apart. The WLmax, breathing pattern, metabolic parameters, and mouth pressure (Pmo) were compared using repeated measures analysis of variance. Mean PSV during titration was 8.2 ± 4.5 cm H 2 O. There was no difference in the WLmax achieved during the three tests. At rest, PSV increased the tidal volume, minute ventilation, and mean inspiratory flow with a lower end-tidal CO 2 ; this was not sustained at peak exercise. Pmo decreased progressively (decreased unloading) with PSV at workloads close to peak, suggesting the ventilator was unable to keep up with the increased ventilatory demand at high workloads. In conclusion, with a Servo-i ventilator, 10 cm H 2 O of PSV and a fixed level of PSV established by titration to comfort at rest, is ineffective for the purpose of achieving higher exercise workloads as the acute physiological effects may not be sustained at peak exercise.

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

40 CFR 62.14555 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and Increments of Progress § 62...

40 CFR 62.14555 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and Increments of Progress § 62...

Bilateral asymmetry of skin temperature is not related to bilateral asymmetry of crank torque during an incremental cycling exercise to exhaustion

PubMed Central

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

2018-01-01

Although moderate relationships (|r| ∼ 0.5) were reported between skin temperature and performance-related variables (e.g., kinetic), it remains unclear whether skin temperature asymmetry reflects muscle force imbalance in cycling. Therefore, the aim of this study was to assess whether a relationship exists between kinetic and thermal asymmetry during a fatiguing exercise. Ten elite cyclists were enrolled and tested on a maximal incremental cycling test. Peak crank torques of both legs were obtained at the initial and final workload. Likewise, bilateral skin temperatures were recorded before and after exercise. Asymmetric indexes were also calculated for kinetic (AIK) and skin temperature (AIT) outcomes. The bilateral peak crank torques showed a larger difference at the final compared to the initial workload (p < 0.05) of the incremental exercise. Conversely, the bilateral skin temperature did not show any differences at both initial and final workload (p > 0.05). Additionally, trivial relationships were reported between AIK and AIT (−0.3 < r < 0.2) at the initial and final workload. The obtained results showed that changes in bilateral kinetic values did not reflect concurrent changes in bilateral skin temperatures. This finding emphasizes the difficulty of associating the asymmetry of skin temperature with those of muscle effort in elite cyclists. Lastly, our study also provided further insights on thermal skin responses during exhaustive cycling exercise in very highly-trained athletes. PMID:29507831

40 CFR 60.5105 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule-Increments of Progress § 60.5105 What if...

40 CFR 60.1605 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Times for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Model Rule... increment of progress, you must submit a notification to the Administrator postmarked within 10 business...

Temporal characteristics of exercise-induced diaphragmatic fatigue.

PubMed

Archiza, Bruno; Welch, Joseph F; Geary, Caitlin M; Allen, Grayson P; Borghi-Silva, Audrey; Sheel, A William

2018-04-01

There is evidence suggesting diaphragmatic fatigue (DF) occurs relatively early during high-intensity exercise; however, studies investigating the temporal characteristics of exercise-induced DF are limited by incongruent methodology. Eight healthy adult males (25 ± 5 yr) performed a maximal incremental exercise test on a cycle ergometer on day 1. A constant-load time-to-exhaustion (TTE) exercise test was conducted on day 2 at 60% delta between the calculated gas exchange threshold and peak work rate. Two additional constant-load exercise tests were performed at the same intensity on days 3 and 4 in a random order to either 50 or 75% TTE. DF was assessed on days 2, 3, and 4 by measuring transdiaphragmatic twitch pressure (P di,tw ) in response to cervical magnetic stimulation. DF was present after 75 and 100% TTE (≥20% decrease in P di,tw ). The magnitude of fatigue was 15.5 ± 5.7%, 23.6 ± 6.4%, and 35.0 ± 12.1% at 50, 75, and 100% TTE, respectively. Significant differences were found between 100 to 75 and 50% TTE (both P < 0.01), and 75 to 50% TTE ( P < 0.01). There was a significant relationship between the magnitude of fatigue and cumulative diaphragm force output ( r = 0.785; P < 0.001). Ventilation, the mechanical work of breathing (WOB), and pressure-time products were not different between trials ( P > 0.05). Our data indicate that exercise-induced DF presents a relatively late onset and is proportional to the cumulative WOB; thus the ability of the diaphragm to generate pressure progressively declines throughout exercise. NEW & NOTEWORTHY The notion that diaphragmatic fatigue (DF) occurs relatively early during exercise is equivocal. Our results indicate that DF occurs during high-intensity endurance exercise in healthy men and its magnitude is strongly related to the amount of pressure and work generated by respiratory muscles. Thus we conclude that the work of breathing is the major determinant of exercise-induced DF.

Association between progression-free survival and health-related quality of life in oncology: a systematic review protocol

PubMed Central

Kovic, Bruno; Guyatt, Gordon; Brundage, Michael; Thabane, Lehana; Bhatnagar, Neera; Xie, Feng

2016-01-01

Introduction There is an increasing number of new oncology drugs being studied, approved and put into clinical practice based on improvement in progression-free survival, when no overall survival benefits exist. In oncology, the association between progression-free survival and health-related quality of life is currently unknown, despite its importance for patients with cancer, and the unverified assumption that longer progression-free survival indicates improved health-related quality of life. Thus far, only 1 study has investigated this association, providing insufficient evidence and inconclusive results. The objective of this study protocol is to provide increased transparency in supporting a systematic summary of the evidence bearing on this association in oncology. Methods and analysis Using the OVID platform in MEDLINE, Embase and Cochrane databases, we will conduct a systematic review of randomised controlled human trials addressing oncology issues published starting in 2000. A team of reviewers will, in pairs, independently screen and abstract data using standardised, pilot-tested forms. We will employ numerical integration to calculate mean incremental area under the curve between treatment groups in studies for health-related quality of life, along with total related error estimates, and a 95% CI around incremental area. To describe the progression-free survival to health-related quality of life association, we will construct a scatterplot for incremental health-related quality of life versus incremental progression-free survival. To estimate the association, we will use a weighted simple regression approach, comparing mean incremental health-related quality of life with either median incremental progression-free survival time or the progression-free survival HR, in the absence of overall survival benefit. Discussion Identifying direction and magnitude of association between progression-free survival and health-related quality of life is critically important in interpreting results of oncology trials. Systematic evidence produced from our study will contribute to improvement of patient care and practice of evidence-based medicine in oncology. PMID:27591026

Exercise intensities during a ballet lesson in female adolescents with different technical ability.

PubMed

Guidetti, L; Gallotta, M C; Emerenziani, G P; Baldari, C

2007-09-01

To investigate the exercise intensity during a typical grade five ballet lesson, thirty-nine dancers (13 - 16 yrs) were divided into three different technical proficiency groups: low level (n = 13), intermediate level (n = 14), and high level (n = 12). A progressively incremented treadmill test was administered to determine VO(2max), individual ventilatory threshold (IVT), and the individual anaerobic threshold (IAT). Oxygen uptake (VO(2)), heart rate (HR) and blood lactate (La) were then evaluated during a grade five ballet lesson. Oxygen uptake at IVT, IAT and maximal oxygen uptake were greater (p < 0.05) in the high-level dancers indicating a higher level of fitness. HR and %VO(2max) obtained during the various exercises of the ballet lesson were similar among groups. During the ballet lesson, low technical level dancers had more V.O (2) and La values above (p < 0.05) the IAT than the other groups. Correlation analysis revealed that the number of exercises performed above IAT was positively related to anthropometric characteristics (BMI, %FM; r = 0.36, p < 0.05; r = 0.46, p < 0.01), negatively related to fitness parameters (VO(2IVT), VO(2IAT), VO(2max); r between - 0.43 and - 0.69; p < 0.001) and to technical level (r = - 0.70; p < 0.001). The subjects classified as having low technical abilities had lower fitness levels and performed more exercises above IAT than the more skilled dancers.

Repeated bouts of exhaustive exercise increase circulating cell free nuclear and mitochondrial DNA without development of tolerance in healthy men

PubMed Central

Stawski, Robert; Walczak, Konrad; Kosielski, Piotr; Meissner, Pawel; Budlewski, Tomasz; Padula, Gianluca; Nowak, Dariusz

2017-01-01

Objective Acute single strenuous exercise increases circulating cell free DNA (cf DNA). We tested whether three repeated bouts of exhaustive exercise induced the cf DNA response without development of tolerance in healthy men. Methods Eleven average-trained men (age 34.0±5.2 years, body mass index 26.2±3.1 kg/m2, maximal oxygen consumption—VO2max 49.6±4.5 ml/kg*min) performed three treadmill exercise tests to exhaustion at speed corresponding to 70% VO2max separated by 72 hours of resting. Blood was collected before and after each bout of exercise for determination of cell free nuclear and mitochondrial DNA (cf n-DNA, cf mt-DNA) by real-time PCR, selected markers of muscle damage, and blood cell count. Results Each bout induced the increase (p<0.05) in plasma cf n-DNA: from 3.4±1.4 to 38.5±27.5, from 4.1±3.3 to 48.5±26.2, and 3.1±1.6 to 53.8±39.9 ng/mL after the first, second, and third exercise, respectively. In a congruent way, cf mt-DNA rose significantly after the second (from 229±216 to 450±228*103 GE/mL) and third bout of exercise (from 173±120 to 462±314*103 GE/mL). Pre-exercise cf mt-DNA decreased (p<0.05) by 2-times (from 355±219 before the first bout to 173±120*103 GE/mL before the third bout) over the study period and were accompanied by significant increase in white blood cells, platelets, creatine kinase, creatinine and lactate after each bout. However, the exercise induced percentage increment of cf n-DNA was always many times higher than corresponding increments of the afore-mentioned markers at any occasion. Conclusions Repeated bouts of exhaustive exercise induced remarkable increase in circulating cf n-DNA without signs of tolerance development. Baseline cf mt-DNA decreased in response to series of strenuous exercise. Since percentage increments of cf n-DNA in response to exercise were many times higher than those observed for other markers, measurement of circulating cf n-DNA could be a sensitive tool for monitoring acute exercise effects in human body. PMID:28542490

Effects of chronic nitric oxide synthase inhibition on V'O2max and exercise capacity in mice.

PubMed

Wojewoda, M; Przyborowski, K; Sitek, B; Zakrzewska, A; Mateuszuk, L; Zoladz, J A; Chlopicki, S

2017-03-01

Acute inhibition of NOS by L-NAME (N ω -nitro-L-arginine methyl ester) is known to decrease maximal oxygen consumption (V'O 2max ) and impair maximal exercise capacity, whereas the effects of chronic L-NAME treatment on V'O 2max and exercise performance have not been studied so far. In this study, we analysed the effect of L-NAME treatment, (LN2 and LN12, respectively) on V'O 2max and exercise capacity (in maximal incremental running and prolonged sub-maximal incremental running tests), systemic NO bioavailability (plasma nitrite (NO 2 - ) and nitrate (NO 3 - )) and prostacyclin (PGI 2 ) production in C57BL6/J mice. Mice treated with L-NAME for 2 weeks (LN2) displayed higher V'O 2max and better running capacity than age-matched control mice. In LN2 mice, NO bioavailability was preserved, as evidenced by maintained NO 2 - plasma concentration. PGI 2 production was activated (increased 6-keto-PGF 1α plasma concentration) and the number of circulating erythrocytes (RBC) and haemoglobin concentration were increased. In mice treated with L-NAME for 12 weeks (LN12), NO bioavailability was decreased (lower NO 2 - plasma concentration), and 6-keto-PGF 1α plasma concentration and RBC number were not elevated compared to age-matched control mice. However, LN12 mice still performed better during the maximal incremental running test despite having lower V'O 2max . Interestingly, the LN12 mice showed poorer running capacity during the prolonged sub-maximal incremental running test. To conclude, short-term (2 weeks) but not long-term (12 weeks) treatment with L-NAME activated robust compensatory mechanisms involving preservation of NO2- plasma concentration, overproduction of PGI 2 and increased number of RBCs, which might explain the fully preserved exercise capacity despite the inhibition of NOS.

Rhesus monkey heart rate during exercise

NASA Technical Reports Server (NTRS)

Delorge, J.; Thach, J. S., Jr.

1972-01-01

Various schedules of reinforcement and their relation to heart rates of rhesus monkeys during exercise are described. All the reinforcement schedules produced 100 per cent or higher increments in the heart rates of the monkeys during exercise. Resting heart rates were generally much lower than those previously reported, which was attributed to the lack of physical restraint of the monkeys during recording.

Muscle-damaging exercise 48 h prior to a maximal incremental exercise treadmill test reduces time to exhaustion: is it time to reconsider our pretest procedures?

PubMed

Rose Chrismas, Bryna Catherine; Taylor, Lee; Siegler, Jason Charles; Midgley, Adrian Wayne

2017-01-01

Pretest guidelines typically stipulate that no exercise should be performed 48 h prior to a maximal incremental exercise [Formula: see text] test. However, no study has specifically investigated if this timescale alters key outcome variables associated with [Formula: see text]. Twenty apparently healthy males split into two equal groups performed [Formula: see text] during three visits (visits 1 - [Formula: see text] EXP1 , 2 - [Formula: see text] EXP2 and 4 - [Formula: see text] EXP3 ). The experimental group only, performed muscle-damaging exercise during visit 3. From [Formula: see text] EXP2 to [Formula: see text] EXP3 average time to exhaustion (TTE) decreased by 45 s (9%) (p < 0.01), maximum blood lactate decreased by 1.2 mmol/L (11%) (p = 0.03), and perceived readiness decreased by 8 mm (18%) (p = 0.01). There were no changes in any [Formula: see text] variables in the control group (p ≥ 0.37). Performing [Formula: see text] 48 h following muscle-damaging exercise impairs specific, but not all, physiological outcome variables.

Ergometric and psychological findings during overtraining: a long-term follow-up study in endurance athletes.

PubMed

Urhausen, A; Gabriel, H H; Weiler, B; Kindermann, W

1998-02-01

In the present prospective longitudinal study 17 male endurance trained athletes (cyclists and triathletes; age 23.4+/-6.7 years, VO2max 61.2+/-7.5 ml x min(-1) x kg(-1); means+/-SD) were investigated both during a state of overtraining syndrome (OT: N=15), mainly induced by an increase of exercise intensity, as well as several times in a state of regular physical ability (NS: N=62). Cycle-ergometric and psychological data were compared for a period of approximately 19 months. On 2 separate days, each subject performed a maximum incremental graded exercise, two anaerobic tests (10 s and 30 s) as well as a short-endurance "stress test" with the intensity of 110% of the individual anaerobic threshold until volitional exhaustion. The mood state was recorded by a psychological questionnaire including 40 basic items. During OT the submaximal lactate concentrations were slightly decreased. The performance of the 10 s- and 30 s-tests was unaffected. In contrast, the duration of the "stress test" decreased significantly by approximately 27% during OT compared to the individual NS. The submaximal oxygen uptake measured during the incremental graded exercise was slightly higher during OT as compared to NS, whereas the submaximal and maximal respiratory exchange ratio, maximal heart rate and maximal lactate concentrations were decreased. At the 10th minute of the "stress test", ammonia tended to be increased during OT (P=0.048). The parameters of mood state at rest as well as the subjective rating of perceived exertion during exercise were significantly impaired during OT. In conclusion, the results indicate a decreased intramuscular utilization of carbohydrates with diminished maximal anaerobic lactacid energy supply during OT. Neither the lactate-performance relationship during incremental graded exercise nor the anaerobic alactacid performance showed alterations. The duration of the short-endurance "stress test", the maximal lactate concentration of the incremental graded exercise as well as the altered mood profile turned out to be the most sensitive parameters for the diagnosis of OT.

40 CFR 60.1600 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES... Before August 30, 1999 Model Rule-Increments of Progress § 60.1600 When must I submit the notifications...

40 CFR 60.2585 - What must I include in the notifications of achievement of increments of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2585 What must I include in the notifications of...

40 CFR 60.2585 - What must I include in the notifications of achievement of increments of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2585 What must I include in the notifications of...

40 CFR 60.2585 - What must I include in the notifications of achievement of increments of progress?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Increments of Progress § 60.2585 What must I include in the notifications of...

Central and peripheral hemodynamics in exercising humans: leg vs arm exercise.

PubMed

Calbet, J A L; González-Alonso, J; Helge, J W; Søndergaard, H; Munch-Andersen, T; Saltin, B; Boushel, R

2015-12-01

In humans, arm exercise is known to elicit larger increases in arterial blood pressure (BP) than leg exercise. However, the precise regulation of regional vascular conductances (VC) for the distribution of cardiac output with exercise intensity remains unknown. Hemodynamic responses were assessed during incremental upright arm cranking (AC) and leg pedalling (LP) to exhaustion (Wmax) in nine males. Systemic VC, peak cardiac output (Qpeak) (indocyanine green) and stroke volume (SV) were 18%, 23%, and 20% lower during AC than LP. The mean BP, the rate-pressure product and the associated myocardial oxygen demand were 22%, 12%, and 14% higher, respectively, during maximal AC than LP. Trunk VC was reduced to similar values at Wmax. At Wmax, muscle mass-normalized VC and fractional O2 extraction were lower in the arm than the leg muscles. However, this was compensated for during AC by raising perfusion pressure to increase O2 delivery, allowing a similar peak VO2 per kg of muscle mass in both extremities. In summary, despite a lower Qpeak during arm cranking the cardiovascular strain is much higher than during leg pedalling. The adjustments of regional conductances during incremental exercise to exhaustion depend mostly on the relative intensity of exercise and are limb-specific. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prefrontal cortex haemodynamics and affective responses during exercise: a multi-channel near infrared spectroscopy study.

PubMed

Tempest, Gavin D; Eston, Roger G; Parfitt, Gaynor

2014-01-01

The dose-response effects of the intensity of exercise upon the potential regulation (through top-down processes) of affective (pleasure-displeasure) responses in the prefrontal cortex during an incremental exercise protocol have not been explored. This study examined the functional capacity of the prefrontal cortex (reflected by haemodynamics using near infrared spectroscopy) and affective responses during exercise at different intensities. Participants completed an incremental cycling exercise test to exhaustion. Changes (Δ) in oxygenation (O2Hb), deoxygenation (HHb), blood volume (tHb) and haemoglobin difference (HbDiff) were measured from bilateral dorsal and ventral prefrontal areas. Affective responses were measured every minute during exercise. Data were extracted at intensities standardised to: below ventilatory threshold, at ventilatory threshold, respiratory compensation point and the end of exercise. During exercise at intensities from ventilatory threshold to respiratory compensation point, ΔO2Hb, ΔHbDiff and ΔtHb were greater in mostly ventral than dorsal regions. From the respiratory compensation point to the end of exercise, ΔO2Hb remained stable and ΔHbDiff declined in dorsal regions. As the intensity increased above the ventilatory threshold, inverse associations between affective responses and oxygenation in (a) all regions of the left hemisphere and (b) lateral (dorsal and ventral) regions followed by the midline (ventral) region in the right hemisphere were observed. Differential activation patterns occur within the prefrontal cortex and are associated with affective responses during cycling exercise.

Prefrontal Cortex Haemodynamics and Affective Responses during Exercise: A Multi-Channel Near Infrared Spectroscopy Study

PubMed Central

Tempest, Gavin D.; Eston, Roger G.; Parfitt, Gaynor

2014-01-01

The dose-response effects of the intensity of exercise upon the potential regulation (through top-down processes) of affective (pleasure-displeasure) responses in the prefrontal cortex during an incremental exercise protocol have not been explored. This study examined the functional capacity of the prefrontal cortex (reflected by haemodynamics using near infrared spectroscopy) and affective responses during exercise at different intensities. Participants completed an incremental cycling exercise test to exhaustion. Changes (Δ) in oxygenation (O2Hb), deoxygenation (HHb), blood volume (tHb) and haemoglobin difference (HbDiff) were measured from bilateral dorsal and ventral prefrontal areas. Affective responses were measured every minute during exercise. Data were extracted at intensities standardised to: below ventilatory threshold, at ventilatory threshold, respiratory compensation point and the end of exercise. During exercise at intensities from ventilatory threshold to respiratory compensation point, ΔO2Hb, ΔHbDiff and ΔtHb were greater in mostly ventral than dorsal regions. From the respiratory compensation point to the end of exercise, ΔO2Hb remained stable and ΔHbDiff declined in dorsal regions. As the intensity increased above the ventilatory threshold, inverse associations between affective responses and oxygenation in (a) all regions of the left hemisphere and (b) lateral (dorsal and ventral) regions followed by the midline (ventral) region in the right hemisphere were observed. Differential activation patterns occur within the prefrontal cortex and are associated with affective responses during cycling exercise. PMID:24788166

Innovative technology for optical and infrared astronomy

NASA Astrophysics Data System (ADS)

Cunningham, Colin R.; Evans, Christopher J.; Molster, Frank; Kendrew, Sarah; Kenworthy, Matthew A.; Snik, Frans

2012-09-01

Advances in astronomy are often enabled by adoption of new technology. In some instances this is where the technology has been invented specifically for astronomy, but more usually it is adopted from another scientific or industrial area of application. The adoption of new technology typically occurs via one of two processes. The more usual is incremental progress by a series of small improvements, but occasionally this process is disruptive, where a new technology completely replaces an older one. One of the activities of the OPTICON Key Technology Network over the past few years has been a technology forecasting exercise. Here we report on a recent event which focused on the more radical, potentially disruptive technologies for ground-based, optical and infrared astronomy.

40 CFR 60.1620 - How do I comply with the increment of progress for initiating onsite construction?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... or Before August 30, 1999 Model Rule-Increments of Progress § 60.1620 How do I comply with the...

40 CFR 60.1585 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... or Before August 30, 1999 Model Rule-Increments of Progress § 60.1585 What are my requirements for...

40 CFR 60.1625 - How do I comply with the increment of progress for completing onsite construction?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... or Before August 30, 1999 Model Rule-Increments of Progress § 60.1625 How do I comply with the...

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

Reliability of an incremental exercise test to evaluate acute blood lactate, heart rate and body temperature responses in Labrador retrievers.

PubMed

Ferasin, Luca; Marcora, Samuele

2009-10-01

Thirteen healthy Labrador retrievers underwent a 5-stage incremental treadmill exercise test to assess its reliability. Blood lactate (BL), heart rate (HR), and body temperature (BT) were measured at rest, after each stage of exercise, and after a 20-min recovery. Reproducibility was assessed by repeating the test after 7 days. Two-way MANOVAs revealed significant differences between consecutive stages, and between values at rest and after recovery. There was also a significant reduction in physiological strain between the first and second trial (learning effect). Test reliability expressed as typical error (BL = 0.22 mmol/l, HR = 9.81 bpm, BT = 0.22 degrees C), coefficient of variation (BL = 19.3%, HR = 7.9% and BT = 0.6%) and test-retest correlation (BL = 0.89, HR = 0.96, BT = 0.95) was good. Results support test reproducibility although the learning effect needs to be controlled when investigating the exercise-related problems commonly observed in this breed.

40 CFR 60.1595 - What must I include in the notifications of achievement of my increments of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... or Before August 30, 1999 Model Rule-Increments of Progress § 60.1595 What must I include in the...

40 CFR 60.2830 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commenced Construction On or Before November 30, 1999 Model Rule-Air Curtain Incinerators § 60.2830 When... increments of progress must be postmarked no later than 10 business days after the compliance date for the...

Maximal lactate steady state determination with a single incremental test exercise.

PubMed

Laplaud, David; Guinot, Michel; Favre-Juvin, Anne; Flore, Patrice

2006-03-01

The aim of this study was to determine whether the power output associated with a maximal lactate steady state (MLSS) (.W(MLSS)) can be assessed using a single incremental cycling test. Eleven recreational sportsmen (age: 22+/-1 years, height: 175+/-6 cm, weight: 71+/-5 kg) volunteered to participate in the study. For each subject the first and second ventilatory thresholds (VT(1) and VT(2), respectively) and the power output corresponding to (respiratory exchange ratio) RER=1.00 were determined during an incremental test to exhaustion. Thereafter, each subject performed several 30-min constant load tests to determine MLSS. The workload used in the first constant test was set to the .W(RER=1.00) determined during the incremental test. .W(VT1) (175+/-24 W) and .W(VT2) (265+/-31 W) were significantly different from .W(MLSS )(220+/-36 W). Whereas, .W(RER=1.00) (224+/-33 W) was similar to .W(MLSS). HR, RER and .VE were significantly different between the 10th and the 30th minutes when exercising at .W(RER=1.00) and at .W(MLSS). In contrast, .VO(2) and .VCO(2) were stable over those 30-min constant tests. Power output at VT(1), RER=1.00 and VT(2) were all correlated to .W(MLSS) but the relationship was stronger between RER=1.00 and MLSS (R (2)=0.95). The present study shows that the power output associated with a RER value equal to 1.00 during an incremental test does not differ from that determined for MLSS. Hence, the MLSS can be estimated with a single exercise test.

Physical exercise-induced changes in the core body temperature of mice depend more on ambient temperature than on exercise protocol or intensity

NASA Astrophysics Data System (ADS)

Wanner, Samuel Penna; Costa, Kátia Anunciação; Soares, Anne Danieli Nascimento; Cardoso, Valbert Nascimento; Coimbra, Cândido Celso

2014-08-01

The mechanisms underlying physical exercise-induced hyperthermia may be species specific. Therefore, the present study aimed to investigate the effects of exercise intensity and ambient temperature on the core body temperature ( T core) of running mice, which provide an important experimental model for advancing the understanding of thermal physiology. We evaluated the influence of different protocols (constant- or incremental-speed exercises), treadmill speeds and ambient temperatures ( T a) on the magnitude of exercise-induced hyperthermia. To measure T core, a telemetric sensor was implanted in the abdominal cavity of male adult Swiss mice under anesthesia. After recovering from the surgery, the animals were familiarized to running on a treadmill and then subjected to the different running protocols and speeds at two T a: 24 °C or 34 °C. All of the experimental trials resulted in marked increases in T core. As expected, the higher-temperature environment increased the magnitude of running-induced hyperthermia. For example, during incremental exercise at 34 °C, the maximal T core achieved was increased by 1.2 °C relative to the value reached at 24 °C. However, at the same T a, neither treadmill speed nor exercise protocol altered the magnitude of exercise-induced hyperthermia. We conclude that T core of running mice is influenced greatly by T a, but not by the exercise protocols or intensities examined in the present report. These findings suggest that the magnitude of hyperthermia in running mice may be regulated centrally, independently of exercise intensity.

Physical exercise-induced changes in the core body temperature of mice depend more on ambient temperature than on exercise protocol or intensity.

PubMed

Wanner, Samuel Penna; Costa, Kátia Anunciação; Soares, Anne Danieli Nascimento; Cardoso, Valbert Nascimento; Coimbra, Cândido Celso

2014-08-01

The mechanisms underlying physical exercise-induced hyperthermia may be species specific. Therefore, the present study aimed to investigate the effects of exercise intensity and ambient temperature on the core body temperature (T core) of running mice, which provide an important experimental model for advancing the understanding of thermal physiology. We evaluated the influence of different protocols (constant- or incremental-speed exercises), treadmill speeds and ambient temperatures (T a) on the magnitude of exercise-induced hyperthermia. To measure T core, a telemetric sensor was implanted in the abdominal cavity of male adult Swiss mice under anesthesia. After recovering from the surgery, the animals were familiarized to running on a treadmill and then subjected to the different running protocols and speeds at two T a: 24 °C or 34 °C. All of the experimental trials resulted in marked increases in T core. As expected, the higher-temperature environment increased the magnitude of running-induced hyperthermia. For example, during incremental exercise at 34 °C, the maximal T core achieved was increased by 1.2 °C relative to the value reached at 24 °C. However, at the same T a, neither treadmill speed nor exercise protocol altered the magnitude of exercise-induced hyperthermia. We conclude that T core of running mice is influenced greatly by T a, but not by the exercise protocols or intensities examined in the present report. These findings suggest that the magnitude of hyperthermia in running mice may be regulated centrally, independently of exercise intensity.

Reproducibility of the exponential rise technique of CO(2) rebreathing for measuring P(v)CO(2) and C(v)CO(2 )to non-invasively estimate cardiac output during incremental, maximal treadmill exercise.

PubMed

Cade, W Todd; Nabar, Sharmila R; Keyser, Randall E

2004-05-01

The purpose of this study was to determine the reproducibility of the indirect Fick method for the measurement of mixed venous carbon dioxide partial pressure (P(v)CO(2)) and venous carbon dioxide content (C(v)CO(2)) for estimation of cardiac output (Q(c)), using the exponential rise method of carbon dioxide rebreathing, during non-steady-state treadmill exercise. Ten healthy participants (eight female and two male) performed three incremental, maximal exercise treadmill tests to exhaustion within 1 week. Non-invasive Q(c) measurements were evaluated at rest, during each 3-min stage, and at peak exercise, across three identical treadmill tests, using the exponential rise technique for measuring mixed venous PCO(2) and CCO(2) and estimating venous-arterio carbon dioxide content difference (C(v-a)CO(2)). Measurements were divided into measured or estimated variables [heart rate (HR), oxygen consumption (VO(2)), volume of expired carbon dioxide (VCO(2)), end-tidal carbon dioxide (P(ET)CO(2)), arterial carbon dioxide partial pressure (P(a)CO(2)), venous carbon dioxide partial pressure ( P(v)CO(2)), and C(v-a)CO(2)] and cardiorespiratory variables derived from the measured variables [Q(c), stroke volume (V(s)), and arteriovenous oxygen difference ( C(a-v)O(2))]. In general, the derived cardiorespiratory variables demonstrated acceptable (R=0.61) to high (R>0.80) reproducibility, especially at higher intensities and peak exercise. Measured variables, excluding P(a)CO(2) and C(v-a)CO(2), also demonstrated acceptable (R=0.6 to 0.79) to high reliability. The current study demonstrated acceptable to high reproducibility of the exponential rise indirect Fick method in measurement of mixed venous PCO(2) and CCO(2) for estimation of Q(c) during incremental treadmill exercise testing, especially at high-intensity and peak exercise.

Effects of increasing and decreasing physiological arousal on anticipation timing performance during competition and practice.

PubMed

Duncan, Michael J; Smith, Mike; Bryant, Elizabeth; Eyre, Emma; Cook, Kathryn; Hankey, Joanne; Tallis, Jason; Clarke, Neil; Jones, Marc V

2016-01-01

The aim of this study was to investigate if the effects of changes in physiological arousal on timing performance can be accurately predicted by the catastrophe model. Eighteen young adults (8 males, 10 females) volunteered to participate in the study following ethical approval. After familiarisation, coincidence anticipation was measured using the Bassin Anticipation Timer under four incremental exercise conditions: Increasing exercise intensity and low cognitive anxiety, increasing exercise intensity and high cognitive anxiety, decreasing exercise intensity and low cognitive anxiety and decreasing exercise intensity and high cognitive anxiety. Incremental exercise was performed on a treadmill at intensities of 30%, 50%, 70% and 90% heart rate reserve (HRR) respectively. Ratings of cognitive anxiety were taken at each intensity using the Mental Readiness Form 3 (MRF3) followed by performance of coincidence anticipation trials at speeds of 3 and 8 mph. Results indicated significant condition × intensity interactions for absolute error (AE; p = .0001) and MRF cognitive anxiety intensity scores (p = .05). Post hoc analysis indicated that there were no statistically significant differences in AE across exercise intensities in low-cognitive anxiety conditions. In high-cognitive anxiety conditions, timing performance AE was significantly poorer and cognitive anxiety higher at 90% HRR, compared to the other exercise intensities. There was no difference in timing responses at 90% HRR during competitive trials, irrespective of whether exercise intensity was increasing or decreasing. This study suggests that anticipation timing performance is negatively affected when physiological arousal and cognitive anxiety are high.

40 CFR 60.2835 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... or Before November 30, 1999 Model Rule-Air Curtain Incinerators § 60.2835 What if I do not meet an... Administrator postmarked within 10 business days after the date for that increment of progress in table 1 of...

Total Protein of Whole Saliva as a Biomarker of Anaerobic Threshold

ERIC Educational Resources Information Center

Bortolini, Miguel Junior Sordi; De Agostini, Guilherme Gularte; Reis, Ismair Teodoro; Lamounier, Romeu Paulo Martins Silva; Blumberg, Jeffrey B.; Espindola, Foued Salmen

2009-01-01

Saliva provides a convenient and noninvasive matrix for assessing specific physiological parameters, including some biomarkers of exercise. We investigated whether the total protein concentration of whole saliva (TPWS) would reflect the anaerobic threshold during an incremental exercise test. After a warm-up period, 13 nonsmoking men performed a…

Association between progression-free survival and health-related quality of life in oncology: a systematic review protocol.

PubMed

Kovic, Bruno; Guyatt, Gordon; Brundage, Michael; Thabane, Lehana; Bhatnagar, Neera; Xie, Feng

2016-09-02

There is an increasing number of new oncology drugs being studied, approved and put into clinical practice based on improvement in progression-free survival, when no overall survival benefits exist. In oncology, the association between progression-free survival and health-related quality of life is currently unknown, despite its importance for patients with cancer, and the unverified assumption that longer progression-free survival indicates improved health-related quality of life. Thus far, only 1 study has investigated this association, providing insufficient evidence and inconclusive results. The objective of this study protocol is to provide increased transparency in supporting a systematic summary of the evidence bearing on this association in oncology. Using the OVID platform in MEDLINE, Embase and Cochrane databases, we will conduct a systematic review of randomised controlled human trials addressing oncology issues published starting in 2000. A team of reviewers will, in pairs, independently screen and abstract data using standardised, pilot-tested forms. We will employ numerical integration to calculate mean incremental area under the curve between treatment groups in studies for health-related quality of life, along with total related error estimates, and a 95% CI around incremental area. To describe the progression-free survival to health-related quality of life association, we will construct a scatterplot for incremental health-related quality of life versus incremental progression-free survival. To estimate the association, we will use a weighted simple regression approach, comparing mean incremental health-related quality of life with either median incremental progression-free survival time or the progression-free survival HR, in the absence of overall survival benefit. Identifying direction and magnitude of association between progression-free survival and health-related quality of life is critically important in interpreting results of oncology trials. Systematic evidence produced from our study will contribute to improvement of patient care and practice of evidence-based medicine in oncology. 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/

Effects of dietary antioxidants on training and performance in female runners.

PubMed

Braakhuis, Andrea J; Hopkins, Will G; Lowe, Tim E

2014-01-01

Exercise-induced oxidative stress is implicated in muscle damage and fatigue which has led athletes to embark on antioxidant supplementation regimes to negate these effects. This study investigated the intake of vitamin C (VC) (1 g), blackcurrant (BC) juice (15 mg VC, 300 mg anthocyanins) and placebo in isocaloric drink form on training progression, incremental running test and 5-km time-trial performance. Twenty-three trained female runners (age, 31 ± 8 y; mean ± SD) completed three blocks of high-intensity training for 3 wks and 3 days, separated by a washout (~3.7 wks). Changes in training and performance with each treatment were analysed with a mixed linear model, adjusting for performance at the beginning of each training block. Markers of oxidative status included protein carbonyl, malondialdehyde (in plasma and in vitro erythrocytes), ascorbic acid, uric acid and erythrocyte enzyme activity of superoxide dismutase, catalase and glutathione peroxidase were analysed. There was a likely harmful effect on mean running speed during training when taking VC (1.3%; 90% confidence limits ±1.3%). Effects of the two treatments relative to placebo on mean performance in the incremental test and time trial were unclear, but runners faster by 1 SD of peak speed demonstrated a possible improvement on peak running speed with BC juice (1.9%; ±2.5%). Following VC, certain oxidative markers were elevated: catalase at rest (23%; ±21%), protein carbonyls at rest (27%; ±38%) and superoxide dismutase post-exercise (8.3%; ±9.3%). In conclusion, athletes should be cautioned about taking VC chronically, however, BC may improve performance in the elite.

Effects of postmeal exercise on postprandial glucose excursions in people with type 2 diabetes treated with add-on hypoglycemic agents.

PubMed

Erickson, Melissa L; Little, Jonathan P; Gay, Jennifer L; McCully, Kevin K; Jenkins, Nathan T

2017-04-01

Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents. Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA 1C : 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake. Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047). Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of ageing on hypoxic exercise cardiorespiratory, muscle and cerebral oxygenation responses in healthy humans.

PubMed

Puthon, Lara; Bouzat, Pierre; Robach, Paul; Favre-Juvin, Anne; Doutreleau, Stéphane; Verges, Samuel

2017-04-01

What is the central question of this study? This study aimed to determine the effect of ageing on cardiorespiratory and tissue oxygenation responses to hypoxia during maximal incremental exercise. What is the main finding and its importance? Older healthy subjects had preserved hypoxic cardiorespiratory and tissue oxygenation responses at rest and during moderate exercise. At maximal exercise, they had a reduced hypoxic ventilatory response but similar maximal power output reduction compared with young individuals. This study suggests that until moderate exercise, hypoxic responses are preserved until the age of 70 years and therefore that ageing is not a contraindication for high-altitude sojourn. This study assessed the effects of ageing on cardiorespiratory and tissue oxygenation responses to hypoxia both at rest and during incremental maximal exercise. Sixteen young (20-30 years old) and 15 older healthy subjects (60-70 years old) performed two maximal incremental cycling tests in normoxia and hypoxia (inspiratory oxygen fraction 12%). Cardiorespiratory responses, prefrontal cortex and quadriceps tissue oxygenation (near-infrared spectroscopy) were measured during exercise as well as during hypercapnia at rest. The hypoxic ventilatory response was similar in young compared with older individuals at rest and during moderate-intensity exercise (50% maximal power output: young 0.9 ± 0.2 versus older 1.1 ± 0.8 l min -1  % -1 ; P > 0.05) but larger in young subjects during high-intensity exercise (maximal power output: 2.2 ± 0.8 versus 1.8 ± 1.1 l min -1  % -1 ; P < 0.05). The hypoxic cardiac response did not differ between groups both at rest and during exercise. During exercise in hypoxia, young subjects showed greater deoxygenation than older subjects, at both the prefrontal cortex and quadriceps levels. The hypoxia-induced reduction in maximal power output (young -32 ± 5% versus older -30 ± 6%; P > 0.05) and the hypercapnic responses did not differ between groups. Older healthy and active individuals below the age of 70 years have cardiorespiratory and tissue oxygenation responses to hypoxia similar to young individuals both at rest and during moderate-intensity exercise. Despite a lower hypoxic ventilatory response at maximal exercise, older individuals have similar oxygen desaturation and maximal power output reduction compared with young subjects. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

Understanding the meaning of lactate threshold in resistance exercises.

PubMed

Garnacho-Castaño, M V; Dominguez, R; Maté-Muñoz, J L

2015-05-01

This study compares acute cardiorespiratory, metabolic, mechanical and rating of perceived effort (RPE) responses to 2 different prolonged constant-load exercises, half-squat (HS) and cycle ergometry, performed at a workload corresponding to the lactate threshold (LT). A total of 18 healthy subjects completed 5 exercise tests separated by 48 h rest periods: an incremental cycle ergometer test, a constant-load cycle ergometer test at LT intensity, a one-repetition maximum (1RM) HS test, an incremental HS test and a constant-load HS test at LT intensity. In both constant-load tests, cardiorespiratory, metabolic and RPE data were recorded. Mechanical responses before and after each test were assessed in terms of jump height and mean power measured in a counter movement jump (CMJ) test. In both exercises, cardiorespiratory and metabolic responses stabilized, though cardiorespiratory responses were significantly greater for cycle ergometry (P<0.001), with the exception of respiratory exchange ratio (RER), which was higher for HS (P=0.028). Mechanical fatigue was observed in only HS (P<0.001). In conclusion, different exercise modalities induced different yet stable acute cardiorespiratory and metabolic responses. Although such responses were significantly reduced in HS, greater mechanical fatigue was produced, most likely because of the particular muscle actions involved in this form of exercise. © Georg Thieme Verlag KG Stuttgart · New York.

Predictors of treatment response to strengthening and stretching exercises for patellofemoral pain: An examination of patellar alignment.

PubMed

Peng, Hsien-Te; Song, Chen-Yi

2015-12-01

Closed kinetic chain and quadriceps strengthening, combined with flexibility exercises of the lower limb musculature, is a common treatment for patellofemoral pain syndrome (PFPS). The effectiveness has been well documented; however, very little is known about which factors predict treatment success. A total of 43 female subjects with PFPS participated in an eight-week progressive leg press (LP) strengthening and stretching exercise program. A decrease of 1.5 cm on a 10 cm visual analog scale (VAS) score was used as an indicator for treatment success. The baseline patellar tilt angle difference (PTA-d) due to quadriceps contraction prior to treatment was evaluated as a predictor of treatment success. The logistic regression and receiver operating characteristics (ROC) curve analysis were performed to investigate the predictive value of PTA-d. PTA-d could significantly predict the treatment success of LP strengthening and stretching exercises. The odds ratio (OR) for having an unsuccessful outcome was 1.19 (95% confidence interval (CI), 1.03-1.39, P<0.021) per degree increment of PTA-d. The most optimal cut-off value for the clinical discrimination of treatment success after LP strengthening and stretching exercise was -1.5° of PTA-d (sensitivity=0.74, specificity=0.71). The area under the ROC curve was 0.73 (standard error=0.08). Female patients with PFPS whose quadriceps contraction reduced the lateral patellar tilt prior to LP strengthening and stretching exercise treatment are more likely to experience pain relief. It seems clinically important to check dynamic patellar tilt characteristics before treatment to aid in clinical decision making. Copyright © 2014 Elsevier B.V. All rights reserved.

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

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

2016-06-01

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. 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. 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). 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). The increase in free radicals during incremental exercises challenges gene expression and activity of antioxidant enzymes. However, despite the negative effects of free radicals, in women, activity and gene expression of antioxidant enzymes respond appropriately to free radicals.

The effects of taurine on repeat sprint cycling after low or high cadence exhaustive exercise in females.

PubMed

Waldron, Mark; Knight, Francesca; Tallent, Jamie; Patterson, Stephen; Jeffries, Owen

2018-06-01

This study investigated the effects of taurine on repeated sprint exercise, performed after fixed incremental ramp exercise to exhaustion at isokinetic high (90 r/min) or low (50 r/min) cadences. In a double-blind, repeated measures design, nine females completed an incremental ramp test to volitional exhaustion, followed by 2 min active recovery and 6 × 10 s sprints on a cycle ergometer, in one of four conditions: high cadence (90 r/min) + taurine (50 mg/kg body mass); high cadence + placebo (3 mg/kg body mass maltodextrin); low cadence (50 r/min) + taurine; low cadence + placebo. Heart rate (HR) and blood lactate concentration B[La] were measured before and after the ramp test and after the sprints. Taurine lowered HR vs. placebo prior to the ramp test (P = 0.004; d = 2.1). There was an effect of condition on ramp performance (P < 0.001), with higher end-test power (d = 3.7) in taurine conditions. During repeated sprints, there was a condition × time interaction (P = 0.002), with higher peak sprint power in the placebo conditions compared to taurine (sprint 2-6; P < 0.05). B[La] was higher in taurine compared to placebo post-ramp (P = 0.004; d = 4.7). Taurine-lowered pre-exercise HR and improved incremental end-test power output, with subsequent detrimental effects on sprint performance, independent of cadence. Short endurance performance can be acutely enhanced after taurine ingestion but this effect might not be maintained across longer periods of exercise or induce the need for longer recovery periods.

Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee. 2: economic evaluation alongside a randomized controlled trial.

PubMed

Pinto, D; Robertson, M C; Abbott, J H; Hansen, P; Campbell, A J

2013-10-01

To evaluate the cost effectiveness of manual physiotherapy, exercise physiotherapy, and a combination of these therapies for patients with osteoarthritis of the hip or knee. 206 Adults who met the American College of Rheumatology criteria for hip or knee osteoarthritis were included in an economic evaluation from the perspectives of the New Zealand health system and society alongside a randomized controlled trial. Resource use was collected using the Osteoarthritis Costs and Consequences Questionnaire. Quality-adjusted life years (QALYs) were calculated using the Short Form 6D. Willingness-to-pay threshold values were based on one to three times New Zealand's gross domestic product (GDP) per capita of NZ$ 29,149 (in 2009). All three treatment programmes resulted in incremental QALY gains relative to usual care. From the perspective of the New Zealand health system, exercise therapy was the only treatment to result in an incremental cost utility ratio under one time GDP per capita at NZ$ 26,400 (-$34,081 to $103,899). From the societal perspective manual therapy was cost saving relative to usual care for most scenarios studied. Exercise therapy resulted in incremental cost utility ratios regarded as cost effective but was not cost saving. For most scenarios combined therapy was not as cost effective as the two therapies alone. In this study, exercise therapy and manual therapy were more cost effective than usual care at policy relevant values of willingness-to-pay from both the perspective of the health system and society. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12608000130369. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Does cerebral oxygen delivery limit incremental exercise performance?

PubMed Central

Olin, J. Tod; Dimmen, Andrew C.; Polaner, David M.; Kayser, Bengt; Roach, Robert C.

2011-01-01

Previous studies have suggested that a reduction in cerebral oxygen delivery may limit motor drive, particularly in hypoxic conditions, where oxygen transport is impaired. We hypothesized that raising end-tidal Pco2 (PetCO2) during incremental exercise would increase cerebral blood flow (CBF) and oxygen delivery, thereby improving peak power output (Wpeak). Amateur cyclists performed two ramped exercise tests (25 W/min) in a counterbalanced order to compare the normal, poikilocapnic response against a clamped condition, in which PetCO2 was held at 50 Torr throughout exercise. Tests were performed in normoxia (barometric pressure = 630 mmHg, 1,650 m) and hypoxia (barometric pressure = 425 mmHg, 4,875 m) in a hypobaric chamber. An additional trial in hypoxia investigated effects of clamping at a lower PetCO2 (40 Torr) from ∼75 to 100% Wpeak to reduce potential influences of respiratory acidosis and muscle fatigue imposed by clamping PetCO2 at 50 Torr. Metabolic gases, ventilation, middle cerebral artery CBF velocity (transcranial Doppler), forehead pulse oximetry, and cerebral (prefrontal) and muscle (vastus lateralis) hemoglobin oxygenation (near infrared spectroscopy) were monitored across trials. Clamping PetCO2 at 50 Torr in both normoxia (n = 9) and hypoxia (n = 11) elevated CBF velocity (∼40%) and improved cerebral hemoglobin oxygenation (∼15%), but decreased Wpeak (6%) and peak oxygen consumption (11%). Clamping at 40 Torr near maximal effort in hypoxia (n = 6) also improved cerebral oxygenation (∼15%), but again limited Wpeak (5%). These findings demonstrate that increasing mass cerebral oxygen delivery via CO2-mediated vasodilation does not improve incremental exercise performance, at least when accompanied by respiratory acidosis. PMID:21921244

Cost-effectiveness of supervised exercise therapy in heart failure patients.

PubMed

Kühr, Eduardo M; Ribeiro, Rodrigo A; Rohde, Luis Eduardo P; Polanczyk, Carisi A

2011-01-01

Exercise therapy in heart failure (HF) patients is considered safe and has demonstrated modest reduction in hospitalization rates and death in recent trials. Previous cost-effectiveness analysis described favorable results considering long-term supervised exercise intervention and significant effectiveness of exercise therapy; however, these evidences are now no longer supported. To evaluate the cost-effectiveness of supervised exercise therapy in HF patients under the perspective of the Brazilian Public Healthcare System. We developed a Markov model to evaluate the incremental cost-effectiveness ratio of supervised exercise therapy compared to standard treatment in patients with New York Heart Association HF class II and III. Effectiveness was evaluated in quality-adjusted life years in a 10-year time horizon. We searched PUBMED for published clinical trials to estimate effectiveness, mortality, hospitalization, and utilities data. Treatment costs were obtained from published cohort updated to 2008 values. Exercise therapy intervention costs were obtained from a rehabilitation center. Model robustness was assessed through Monte Carlo simulation and sensitivity analysis. Cost were expressed as international dollars, applying the purchasing-power-parity conversion rate. Exercise therapy showed small reduction in hospitalization and mortality at a low cost, an incremental cost-effectiveness ratio of Int$26,462/quality-adjusted life year. Results were more sensitive to exercise therapy costs, standard treatment total costs, exercise therapy effectiveness, and medications costs. Considering a willingness-to-pay of Int$27,500, 55% of the trials fell below this value in the Monte Carlo simulation. In a Brazilian scenario, exercise therapy shows reasonable cost-effectiveness ratio, despite current evidence of limited benefit of this intervention. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Intense Exercise and Aerobic Conditioning Associated with Chromium or L-Carnitine Supplementation Modified the Fecal Microbiota of Fillies

PubMed Central

Feringer, Walter Heinz; Carvalho, Júlia Ribeiro Garcia; Rodrigues, Isadora Mestriner; Jordão, Lilian Rezende; Fonseca, Mayara Gonçalves; Carneiro de Rezende, Adalgiza Souza; de Queiroz Neto, Antonio; Weese, J. Scott; da Costa, Márcio Carvalho

2016-01-01

Recent studies performed in humans and rats have reported that exercise can alter the intestinal microbiota. Athletic horses perform intense exercise regularly, but studies characterizing horse microbiome during aerobic conditioning programs are still limited. Evidence has indicated that this microbial community is involved in the metabolic homeostasis of the host. Research on ergogenic substances using new sequencing technologies have been limited to the intestinal microbiota and there is a considerable demand for scientific studies that verify the effectiveness of these supplements in horses. L-carnitine and chromium are potentially ergogenic substances for athletic humans and horses since they are possibly able to modify the metabolism of carbohydrates and lipids. This study aimed to assess the impact of acute exercise and aerobic conditioning, associated either with L-carnitine or chromium supplementation, on the intestinal microbiota of fillies. Twelve “Mangalarga Marchador” fillies in the incipient fitness stage were distributed into four groups: control (no exercise), exercise, L-carnitine (10g/day) and chelated chromium (10mg/day). In order to investigate the impact of acute exercise or aerobic conditioning on fecal microbiota all fillies undergoing the conditioning program were analyzed as a separate treatment. The fillies underwent two incremental exercise tests before and after training on a treadmill for 42 days at 70–80% of the lactate threshold intensity. Fecal samples were obtained before and 48 h after acute exercise (incremental exercise test). Bacterial populations were characterized by sequencing the V4 region of the 16S rRNA gene using the MiSeq Illumina platform, and 5,224,389 sequences were obtained from 48 samples. The results showed that, overall, the two most abundant phyla were Firmicutes (50.22%) followed by Verrucomicrobia (15.13%). The taxa with the highest relative abundances were unclassified Clostridiales (17.06%) and "5 genus incertae sedis" from the phylum Verrucomicrobia (12.98%). There was a decrease in the phylum Chlamydiae and in the genus Mycobacterium after the second incremental exercise test. Intense exercise changed the community’s structure and aerobic conditioning was associated with changes in the composition and structure of the intestinal bacterial population of fillies. The intra-group comparison showed that chromium or L-carnitine induced moderate changes in the fecal microbiota of fillies, but the microbiota did not differ from the control group, which was exercised with no supplementation. Fecal pH correlated positively with Simpson’s index, while plasma pH correlated negatively. Our results show that exercise and aerobic conditioning can change in the microbiota and provide a basis for further studies enrolling a larger number of horses at different fitness levels to better understand the effects of exercise and training on the intestinal microbiota of horses. PMID:27935992

Intense Exercise and Aerobic Conditioning Associated with Chromium or L-Carnitine Supplementation Modified the Fecal Microbiota of Fillies.

PubMed

Almeida, Maria Luiza Mendes de; Feringer, Walter Heinz; Carvalho, Júlia Ribeiro Garcia; Rodrigues, Isadora Mestriner; Jordão, Lilian Rezende; Fonseca, Mayara Gonçalves; Carneiro de Rezende, Adalgiza Souza; de Queiroz Neto, Antonio; Weese, J Scott; Costa, Márcio Carvalho da; Lemos, Eliana Gertrudes de Macedo; Ferraz, Guilherme de Camargo

2016-01-01

Recent studies performed in humans and rats have reported that exercise can alter the intestinal microbiota. Athletic horses perform intense exercise regularly, but studies characterizing horse microbiome during aerobic conditioning programs are still limited. Evidence has indicated that this microbial community is involved in the metabolic homeostasis of the host. Research on ergogenic substances using new sequencing technologies have been limited to the intestinal microbiota and there is a considerable demand for scientific studies that verify the effectiveness of these supplements in horses. L-carnitine and chromium are potentially ergogenic substances for athletic humans and horses since they are possibly able to modify the metabolism of carbohydrates and lipids. This study aimed to assess the impact of acute exercise and aerobic conditioning, associated either with L-carnitine or chromium supplementation, on the intestinal microbiota of fillies. Twelve "Mangalarga Marchador" fillies in the incipient fitness stage were distributed into four groups: control (no exercise), exercise, L-carnitine (10g/day) and chelated chromium (10mg/day). In order to investigate the impact of acute exercise or aerobic conditioning on fecal microbiota all fillies undergoing the conditioning program were analyzed as a separate treatment. The fillies underwent two incremental exercise tests before and after training on a treadmill for 42 days at 70-80% of the lactate threshold intensity. Fecal samples were obtained before and 48 h after acute exercise (incremental exercise test). Bacterial populations were characterized by sequencing the V4 region of the 16S rRNA gene using the MiSeq Illumina platform, and 5,224,389 sequences were obtained from 48 samples. The results showed that, overall, the two most abundant phyla were Firmicutes (50.22%) followed by Verrucomicrobia (15.13%). The taxa with the highest relative abundances were unclassified Clostridiales (17.06%) and "5 genus incertae sedis" from the phylum Verrucomicrobia (12.98%). There was a decrease in the phylum Chlamydiae and in the genus Mycobacterium after the second incremental exercise test. Intense exercise changed the community's structure and aerobic conditioning was associated with changes in the composition and structure of the intestinal bacterial population of fillies. The intra-group comparison showed that chromium or L-carnitine induced moderate changes in the fecal microbiota of fillies, but the microbiota did not differ from the control group, which was exercised with no supplementation. Fecal pH correlated positively with Simpson's index, while plasma pH correlated negatively. Our results show that exercise and aerobic conditioning can change in the microbiota and provide a basis for further studies enrolling a larger number of horses at different fitness levels to better understand the effects of exercise and training on the intestinal microbiota of horses.

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.…

Cost-effectiveness Evaluation of the Inclusion of Dry Needling into an Exercise Program for Subacromial Pain Syndrome: Evidence from a Randomized Clinical Trial.

PubMed

Arias-Buría, José L; Martín-Saborido, Carlos; Cleland, Joshua; Koppenhaver, Shane L; Plaza-Manzano, Gustavo; Fernández-de-Las-Peñas, César

2018-02-22

To evaluate the cost-effectiveness of the inclusion of trigger point-dry needling (TrP-DN) into an exercise program for the management of subacromial pain syndrome. Fifty patients with unilateral subacromial pain syndrome were randomized with concealed allocation to exercise alone or exercise plus TrP-DN. Both groups were asked to perform an exercise program targeting the rotator cuff musculature twice daily for five weeks. Patients allocated to the exercise plus TrP-DN group also received dry needling during the second and fourth sessions. Societal costs and health-related quality of life (estimated by EuroQol-5D-5L) over a one-year follow-up were used to generate incremental cost per quality-adjusted life-year (QALY) ratios for each intervention.  Intention-to-treat analysis was possible for 48 (96%) of the participants. Those in the exercise group made more visits to medical doctors and received a greater number of other treatments (P < 0.001). The major contributor to societal costs (77%) was the absenteeism paid labor in favor of the exercise plus TrP-DN group (P = 0.03). The combination of exercise plus TrP-DN was less costly (mean difference cost/patient = €517.34, P = 0.003) than exercise alone. Incremental QALYs showed greater benefit for exercise plus TrP-DN (difference = 2.87, 95% confidence interval = 2.85-2.89). Therefore, the inclusion of TrP-DN into an exercise program was more likely to be cost-effective than an exercise program alone, with 99.5% of the iterations falling in the dominant area. The inclusion of TrP-DN into an exercise program was more cost-effective for individuals with subacromial pain syndrome than exercise alone. From a cost-benefit perspective, the inclusion of TrP-DN into multimodal management of patients with subacromial pain syndrome should be considered.

Effects of non-fatiguing respiratory muscle loading induced by expiratory flow limitation during strenuous incremental cycle exercise on metabolic stress and circulating natural killer cells.

PubMed

Rolland-Debord, Camille; Morelot-Panzini, Capucine; Similowski, Thomas; Duranti, Roberto; Laveneziana, Pierantonio

2017-12-01

Exercise induces release of cytokines and increase of circulating natural killers (NK) lymphocyte during strong activation of respiratory muscles. We hypothesised that non-fatiguing respiratory muscle loading during exercise causes an increase in NK cells and in metabolic stress indices. Heart rate (HR), ventilation (VE), oesophageal pressure (Pes), oxygen consumption (VO 2 ), dyspnoea and leg effort were measured in eight healthy humans (five men and three women, average age of 31 ± 4 years and body weight of 68 ± 10 kg), performing an incremental exercise testing on a cycle ergometer under control condition and expiratory flow limitation (FL) achieved by putting a Starling resistor. Blood samples were obtained at baseline, at peak of exercise and at iso-workload corresponding to that reached at the peak of FL exercise during control exercise. Diaphragmatic fatigue was evaluated by measuring the tension time index of the diaphragm. Respiratory muscle overloading caused an earlier interruption of exercise. Diaphragmatic fatigue did not occur in the two conditions. At peak of flow-limited exercise compared to iso-workload, HR, peak inspiratory and expiratory Pes, NK cells and norepinephrine were significantly higher. The number of NK cells was significantly related to ΔPes (i.e. difference between the most and the less negative Pes) and plasmatic catecholamines. Loading of respiratory muscles is able to cause an increase of NK cells provided that activation of respiratory muscles is intense enough to induce a significant metabolic stress.

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-ambulatory stroke patients: the approach was found to be technically implementable, acceptable to the patients, and it showed substantial cardiopulmonary responsiveness. This work has clinical implications for patients with severe disability who otherwise are not able to be tested.

Reduced Exercise Tolerance and Pulmonary Capillary Recruitment with Remote Secondhand Smoke Exposure

PubMed Central

Arjomandi, Mehrdad; Haight, Thaddeus; Sadeghi, Nasrat; Redberg, Rita; Gold, Warren M.

2012-01-01

Rationale Flight attendants who worked on commercial aircraft before the smoking ban in flights (pre-ban FAs) were exposed to high levels of secondhand smoke (SHS). We previously showed never-smoking pre-ban FAs to have reduced diffusing capacity (Dco) at rest. Methods To determine whether pre-ban FAs increase their Dco and pulmonary blood flow () during exercise, we administered a symptom-limited supine-posture progressively increasing cycle exercise test to determine the maximum work (watts) and oxygen uptake () achieved by FAs. After 30 min rest, we then measured Dco and at 20, 40, 60, and 80 percent of maximum observed work. Results The FAs with abnormal resting Dco achieved a lower level of maximum predicted work and compared to those with normal resting Dco (mean±SEM; 88.7±2.9 vs. 102.5±3.1%predicted ; p = 0.001). Exercise limitation was associated with the FAs' FEV1 (r = 0.33; p = 0.003). The Dco increased less with exercise in those with abnormal resting Dco (mean±SEM: 1.36±0.16 vs. 1.90±0.16 ml/min/mmHg per 20% increase in predicted watts; p = 0.020), and amongst all FAs, the increase with exercise seemed to be incrementally lower in those with lower resting Dco. Exercise-induced increase in was not different in the two groups. However, the FAs with abnormal resting Dco had less augmentation of their Dco with increase in during exercise (mean±SEM: 0.93±0.06 vs. 1.47±0.09 ml/min/mmHg per L/min; p<0.0001). The Dco during exercise was inversely associated with years of exposure to SHS in those FAs with ≥10 years of pre-ban experience (r = −0.32; p = 0.032). Conclusions This cohort of never-smoking FAs with SHS exposure showed exercise limitation based on their resting Dco. Those with lower resting Dco had reduced pulmonary capillary recruitment. Exposure to SHS in the aircraft cabin seemed to be a predictor for lower Dco during exercise. PMID:22493689

Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis.

PubMed

Illi, Sabine K; Held, Ulrike; Frank, Irène; Spengler, Christina M

2012-08-01

Two distinct types of specific respiratory muscle training (RMT), i.e. respiratory muscle strength (resistive/threshold) and endurance (hyperpnoea) training, have been established to improve the endurance performance of healthy individuals. We performed a systematic review and meta-analysis in order to determine the factors that affect the change in endurance performance after RMT in healthy subjects. A computerized search was performed without language restriction in MEDLINE, EMBASE and CINAHL and references of original studies and reviews were searched for further relevant studies. RMT studies with healthy individuals assessing changes in endurance exercise performance by maximal tests (constant load, time trial, intermittent incremental, conventional [non-intermittent] incremental) were screened and abstracted by two independent investigators. A multiple linear regression model was used to identify effects of subjects' fitness, type of RMT (inspiratory or combined inspiratory/expiratory muscle strength training, respiratory muscle endurance training), type of exercise test, test duration and type of sport (rowing, running, swimming, cycling) on changes in performance after RMT. In addition, a meta-analysis was performed to determine the effect of RMT on endurance performance in those studies providing the necessary data. The multiple linear regression analysis including 46 original studies revealed that less fit subjects benefit more from RMT than highly trained athletes (6.0% per 10 mL · kg⁻¹ · min⁻¹ decrease in maximal oxygen uptake, 95% confidence interval [CI] 1.8, 10.2%; p = 0.005) and that improvements do not differ significantly between inspiratory muscle strength and respiratory muscle endurance training (p = 0.208), while combined inspiratory and expiratory muscle strength training seems to be superior in improving performance, although based on only 6 studies (+12.8% compared with inspiratory muscle strength training, 95% CI 3.6, 22.0%; p = 0.006). Furthermore, constant load tests (+16%, 95% CI 10.2, 22.9%) and intermittent incremental tests (+18.5%, 95% CI 10.8, 26.3%) detect changes in endurance performance better than conventional incremental tests (both p < 0.001) with no difference between time trials and conventional incremental tests (p = 0.286). With increasing test duration, improvements in performance are greater (+0.4% per minute test duration, 95% CI 0.1, 0.6%; p = 0.011) and the type of sport does not influence the magnitude of improvements (all p > 0.05). The meta-analysis, performed on eight controlled trials revealed a significant improvement in performance after RMT, which was detected by constant load tests, time trials and intermittent incremental tests, but not by conventional incremental tests. RMT improves endurance exercise performance in healthy individuals with greater improvements in less fit individuals and in sports of longer durations. The two most common types of RMT (inspiratory muscle strength and respiratory muscle endurance training) do not differ significantly in their effect, while combined inspiratory/expiratory strength training might be superior. Improvements are similar between different types of sports. Changes in performance can be detected by constant load tests, time trials and intermittent incremental tests only. Thus, all types of RMT can be used to improve exercise performance in healthy subjects but care must be taken regarding the test used to investigate the improvements.

An equation to predict the maximal lactate steady state from ramp-incremental exercise test data in cycling.

PubMed

Iannetta, Danilo; Fontana, Federico Y; Maturana, Felipe Mattioni; Inglis, Erin Calaine; Pogliaghi, Silvia; Keir, Daniel A; Murias, Juan M

2018-05-23

The maximal lactate steady state (MLSS) represents the highest exercise intensity at which an elevated blood lactate concentration ([Lac] b ) is stabilized above resting values. MLSS quantifies the boundary between the heavy-to-very-heavy intensity domains but its determination is not widely performed due to the number of trials required. This study aimed to: (i) develop a mathematical equation capable of predicting MLSS using variables measured during a single ramp-incremental cycling test and (ii) test the accuracy of the optimized mathematical equation. The predictive MLSS equation was determined by stepwise backward regression analysis of twelve independent variables measured in sixty individuals who had previously performed ramp-incremental exercise and in whom MLSS was known (MLSS obs ). Next, twenty-nine different individuals were prospectively recruited to test the accuracy of the equation. These participants performed ramp-incremental exercise to exhaustion and two-to-three 30-min constant-power output cycling bouts with [Lac] b sampled at regular intervals for determination of MLSS obs . Predicted MLSS (MLSS pred ) and MLSS obs in both phases of the study were compared by paired t-test, major-axis regression and Bland-Altman analysis. The predictor variables of MLSS were: respiratory compensation point (Wkg -1 ), peak oxygen uptake (V˙O 2peak ) (mlkg -1 min -1 ) and body mass (kg). MLSS pred was highly correlated with MLSS obs (r=0.93; p<0.01). When this equation was tested on the independent group, MLSS pred was not different from MLSS obs (234±43 vs. 234±44W; SEE 4.8W; r=0.99; p<0.01). These data support the validity of the predictive MLSS equation. We advocate its use as a time-efficient alternative to traditional MLSS testing in cycling. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders

PubMed Central

Klatt, BN; Carender, WJ; Lin, CC; Alsubaie, SF; Kinnaird, CR; Sienko, KH; Whitney, SL

2016-01-01

There is little information in peer-reviewed literature to specifically guide the choice of exercise for persons with balance and vestibular disorders. The purpose of this study is to provide a rationale for the establishment of a progression framework and propose a logical sequence in progressing balance exercises for persons with vestibular disorders. Our preliminary conceptual framework was developed by a multidisciplinary team of physical therapists and engineers with extensive experience with people with vestibular disorders. Balance exercises are grouped into six different categories: static standing, compliant surface, weight shifting, modified center of gravity, gait, and vestibulo-ocular reflex (VOR). Through a systematized literature review, interviews and focus group discussions with physical therapists and postural control experts, and pilot studies involving repeated trials of each exercise, exercise progressions for each category were developed and ranked in order of degree of difficulty. Clinical expertise and experience guided decision making for the exercise progressions. Hundreds of exercise combinations were discussed and research is ongoing to validate the hypothesized rankings. The six exercise categories can be incorporated into a balance training program and the framework for exercise progression can be used to guide less experienced practitioners in the development of a balance program. It may also assist clinicians and researchers to design, develop, and progress interventions within a treatment plan of care, or within clinical trials. A structured exercise framework has the potential to maximize postural control, decrease symptoms of dizziness/visual vertigo, and provide “rules” for exercise progression for persons with vestibular disorders. The conceptual framework may also be applicable to persons with other balance-related issues. PMID:27489886

Evidence for β-adrenergic modulation of sweating during incremental exercise in habitually trained males.

PubMed

Amano, Tatsuro; Shitara, Yosuke; Fujii, Naoto; Inoue, Yoshimitsu; Kondo, Narihiko

2017-07-01

The aim of the present study was to determine the β-adrenergic contribution to sweating during incremental exercise in habitually trained males. Nine habitually trained and 11 untrained males performed incremental cycling until exhaustion (20 W/min). Bilateral forearm sweat rates (ventilated capsule) were measured at two skin sites that were transdermally administered via iontophoresis with either 1% propranolol (Propranolol, a nonselective β-adrenergic receptor antagonist) or saline (Control). The sweat rate was evaluated as a function of both relative (percentage of maximum workload) and absolute exercise intensities. The sweat rate at the Propranolol site was lower than the control during exercise at 80 (0.57 ± 0.21 and 0.45 ± 0.19 mg·cm -2 ·min -1 for Control and Propranolol, respectively) and 90% (0.74 ± 0.22 and 0.65 ± 0.17 mg·cm -2 ·min -1 , respectively) of maximum workload in trained males (all P < 0.05). By contrast, no between-site differences in sweat rates were observed in untrained counterparts (all P > 0.05). At the same absolute intensity, higher sweat rates on the control site were observed in trained males relative to the untrained during exercise at 160 (0.23 ± 0.20 and 0.04 ± 0.05 mg·cm -2 ·min -1 for trained and untrained, respectively) and 180 W (0.40 ± 0.20 and 0.13 ± 0.13 mg·cm -2 ·min -1 , respectively) (all P < 0.05), whereas this between-group difference was not observed at the Propranolol site (all P > 0.05). We show that the β-adrenergic mechanism does modulate sweating during exercise at a submaximal high relative intensity in habitually trained males. The β-adrenergic mechanism may in part contribute to the greater sweat production in habitually trained males than in untrained counterparts during exercise. NEW & NOTEWORTHY We demonstrated for the first time that the β-adrenergic mechanism does modulate sweating (i.e., β-adrenergic sweating) during exercise using a localized β-adrenoceptor blockade in humans in vivo. β-Adrenergic sweating was evident in habitually trained individuals during exercise at a submaximal high relative intensity (80-90% maximal work). This observation advances our understanding of human thermoregulation during exercise and of the mechanism that underlies sweat gland adaptation to habitual exercise training. Copyright © 2017 the American Physiological Society.

Progressive pigmentary purpura.

PubMed

Brauer, Jeremy A; Mundi, Jyoti; Chu, Julie; Patel, Rishi; Meehan, Shane; Greenspan, Alan H; Stein, Jennifer

2011-10-15

A 58-year-old man presented for evaluation and treatment of non-tender, non-pruritic, annular patches on the right temple and frontal aspect of the scalp that reddened with exercise. A biopsy specimen showed a purpuric dermatitis with features of lymphocytic vasculitis; a diagnosis of exercise-induced progressive pigmentary purpura was made. Whereas progressive pigmentary purpura is purported to be caused by exercise, other similar appearing entities are associated with exercise, namely exercise-induced vasculitis (EIV). EIV may be considered as an acute microcirculatory deficiency and thermoregulation decompensation that occurs after episodes of exhaustive major muscular activity or after unusual or excessive exercise. The combination of age greater than 50 years, heat, and prolonged exercise are the most potent contributing factors. This is the first report of exercise-induced progressive pigmentary purpura.

Cortisol levels during prolonged exercise: the influence of menstrual phase and menstrual status.

PubMed

Kanaley, J A; Boileau, R A; Bahr, J M; Misner, J E; Nelson, R A

1992-05-01

The purpose of this study was to determine the influence of menstrual phase and menstrual status on the cortisol response during 90 minutes of treadmill running at 60% VO2max. Eight eumenhorrheic athletes were tested in the early follicular (EF) (day 3-5), late follicular (LF) (day 13-15) and mid-luteal (ML) (day 22-24) phases. Six amenorrheic athletes were tested on two separate occasions. The resting cortisol levels were similar in each menstrual phase and overall a decreasing pattern of cortisol response to exercise was observed in all menstrual phases (P greater than .05). The amenorrheic athletes had a significantly greater (P less than .01) pattern of cortisol response than was observed in eumenorrheic athletes. The net increment in cortisol levels during exercise were distinctly greater (P less than .01) in amenorrheic than eumenorrheic athletes (amenorrheic: 413.8 +/- 113.1, eumenorrheic: EF: -482.8 +/- 88.3, LF: -311.8 +/- 102.1, ML: -386.3 +/- 146.2 nmol.l-1). In conclusion the cortisol levels are independent of menstrual phase. Also a larger cortisol increment is observed in amenorrheic athletes in response to prolonged submaximal exercise. The elevated cortisol levels in amenorrheics at rest and throughout exercise provides further evidence that disturbances in the hypothalamic-pituitary-adrenal function are associated with exercise-induced amenorrhea, although the site(s) of physiological disturbance have not been identified.

Cost effectiveness of a pragmatic exercise intervention (EXIMS) for people with multiple sclerosis: economic evaluation of a randomised controlled trial.

PubMed

Tosh, J; Dixon, S; Carter, A; Daley, A; Petty, J; Roalfe, A; Sharrack, B; Saxton, J M

2014-07-01

Exercise is a safe, non-pharmacological adjunctive treatment for people with multiple sclerosis but cost-effective approaches to implementing exercise within health care settings are needed. The objective of this paper is to assess the cost effectiveness of a pragmatic exercise intervention in conjunction with usual care compared to usual care only in people with mild to moderate multiple sclerosis. A cost-utility analysis of a pragmatic randomised controlled trial over nine months of follow-up was conducted. A total of 120 people with multiple sclerosis were randomised (1:1) to the intervention or usual care. Exercising participants received 18 supervised and 18 home exercise sessions over 12 weeks. The primary outcome for the cost utility analysis was the incremental cost per quality-adjusted life year (QALY) gained, calculated using utilities measured by the EQ-5D questionnaire. The incremental cost per QALY of the intervention was £10,137 per QALY gained compared to usual care. The probability of being cost effective at a £20,000 per QALY threshold was 0.75, rising to 0.78 at a £30,000 per QALY threshold. The pragmatic exercise intervention is highly likely to be cost effective at current established thresholds, and there is scope for it to be tailored to particular sub-groups of patients or services to reduce its cost impact. © The Author(s) 2013.

40 CFR Table 5 to Subpart Fff of... - Generic Compliance Schedules and Increments of Progress

Code of Federal Regulations, 2010 CFR

2010-07-01

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40 CFR Table 5 to Subpart Fff of... - Generic Compliance Schedules and Increments of Progress

Code of Federal Regulations, 2011 CFR

2011-07-01

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40 CFR Table 5 to Subpart Fff of... - Generic Compliance Schedules and Increments of Progress

Code of Federal Regulations, 2012 CFR

2012-07-01

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40 CFR Table 5 to Subpart Fff of... - Generic Compliance Schedules and Increments of Progress

Code of Federal Regulations, 2014 CFR

2014-07-01

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40 CFR Table 5 to Subpart Fff of... - Generic Compliance Schedules and Increments of Progress

Code of Federal Regulations, 2013 CFR

2013-07-01

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Pre-exercise blood glucose affects glycemic variation of aerobic exercise in patients with type 2 diabetes treated with continuous subcutaneous insulin infusion.

PubMed

Hu, Yun; Zhang, Dan-Feng; Dai, Lu; Li, Zheng; Li, Hui-Qin; Li, Feng-Fei; Liu, Bing-Li; Sun, Xiao-Juan; Ye, Lei; He, Ke; Ma, Jian-Hua

2018-05-03

Considering the insulin sensitivity may increase by exercise particularly in patients with type 2 diabetes (T2D), glycemic variation during exercise needs to be studied when the patients are treated with insulin. This study aimed to explore the influence factors of the efficacy and safety of aerobic exercise in patients with T2D treated with Continuous Subcutaneous Insulin Infusion (CSII). A total of 267 patients with T2D, treated with CSII, were included. Glycemic variations were assessed by continuous glucose monitoring (CGM). Patients were asked to complete 30 min aerobic exercise for at least one time during CGM. The patients were divided into effective and ineffective group by incremental glucose area under curve from 0 to 60 min after exercise (AUC 0-60 min ). The patients completed a total of 776 times of aerobic exercises. Blood glucose decreased fastest in the first 60 min of exercise. Pre-exercise blood glucose (PEBG) was negatively correlated with AUC 0-60 min (standardized β = -0.386, P < 0.001) and incremental AUC of blood glucose ≤ 4.4 mmol/L (standardized β = -0.078, P = 0.034), and was significantly higher in effective group than in ineffective group (P < 0.001). The Δglucose AUC 0-60 min during post-dinner was significantly higher than that during pre-lunch, post-lunch and pre-dinner (P < 0.05 for all). PEBG is positively correlated with efficacy of aerobic exercise. Aerobic exercise will not worsen hyperglycemia when the PEBG > 16.7 mmol/L. Post-dinner exercise decreases the blood glucose better than other periods of the day. ChiCTR-ONC-17010400, www.chictr.org.cn. Copyright © 2018 Elsevier B.V. All rights reserved.

Advances in the Evaluation of Respiratory Pathophysiology during Exercise in Chronic Lung Diseases

PubMed Central

O'Donnell, Denis E.; Elbehairy, Amany F.; Berton, Danilo C.; Domnik, Nicolle J.; Neder, J. Alberto

2017-01-01

Dyspnea and exercise limitation are among the most common symptoms experienced by patients with various chronic lung diseases and are linked to poor quality of life. Our understanding of the source and nature of perceived respiratory discomfort and exercise intolerance in chronic lung diseases has increased substantially in recent years. These new mechanistic insights are the primary focus of the current review. Cardiopulmonary exercise testing (CPET) provides a unique opportunity to objectively evaluate the ability of the respiratory system to respond to imposed incremental physiological stress. In addition to measuring aerobic capacity and quantifying an individual's cardiac and ventilatory reserves, we have expanded the role of CPET to include evaluation of symptom intensity, together with a simple “non-invasive” assessment of relevant ventilatory control parameters and dynamic respiratory mechanics during standardized incremental tests to tolerance. This review explores the application of the new advances in the clinical evaluation of the pathophysiology of exercise intolerance in chronic obstructive pulmonary disease (COPD), chronic asthma, interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). We hope to demonstrate how this novel approach to CPET interpretation, which includes a quantification of activity-related dyspnea and evaluation of its underlying mechanisms, enhances our ability to meaningfully intervene to improve quality of life in these pathologically-distinct conditions. PMID:28275353

Progressive simplification and transmission of building polygons based on triangle meshes

NASA Astrophysics Data System (ADS)

Li, Hongsheng; Wang, Yingjie; Guo, Qingsheng; Han, Jiafu

2010-11-01

Digital earth is a virtual representation of our planet and a data integration platform which aims at harnessing multisource, multi-resolution, multi-format spatial data. This paper introduces a research framework integrating progressive cartographic generalization and transmission of vector data. The progressive cartographic generalization provides multiple resolution data from coarse to fine as key scales and increments between them which is not available in traditional generalization framework. Based on the progressive simplification algorithm, the building polygons are triangulated into meshes and encoded according to the simplification sequence of two basic operations, edge collapse and vertex split. The map data at key scales and encoded increments between them are stored in a multi-resolution file. As the client submits requests to the server, the coarsest map is transmitted first and then the increments. After data decoding and mesh refinement the building polygons with more details will be visualized. Progressive generalization and transmission of building polygons is demonstrated in the paper.

Comparison of Multifrequency Bioelectrical Impedance vs. Dual-Energy X-ray Absorptiometry for Assessing Body Composition Changes After Participation in a 10-Week Resistance Training Program.

PubMed

Schoenfeld, Brad J; Nickerson, Brett S; Wilborn, Colin D; Urbina, Stacie L; Hayward, Sara B; Krieger, James; Aragon, Alan A; Tinsley, Grant M

2018-06-20

Schoenfeld, BJ, Nickerson, BS, Wilborn, CD, Urbina, SL, Hayward, SB, Krieger, J, Aragon, AA, and Tinsley, G. Comparison of multifrequency bioelectrical impedance vs. dual-energy x-ray absorptiometry for assessing body composition changes after participation in a 10-week resistance training program. J Strength Cond Res XX(X): 000-000, 2018-The purpose of this study was to assess the ability of multifrequency bioelectrical impedance analysis (MF-BIA) to determine alterations in total and segmental body composition across a 10-week resistance training (RT) program in comparison with the criterion reference dual-energy X-ray absorptiometry (DXA). Twenty-one young male volunteers (mean ± SD; age = 22.9 ± 3.0 years; height = 175.5 ± 5.9 cm; body mass = 82.9 ± 13.6 kg; body mass index = 26.9 ± 3.6) performed an RT program that included exercises for all major muscle groups. Body composition was assessed using both methods before and after the intervention; change scores were determined by subtracting pre-test values from post-test values for percent body fat ([INCREMENT]%BF), fat mass ([INCREMENT]FM), and fat-free mass ([INCREMENT]FFM). Mean changes were not significantly different when comparing MF-BIA with DXA for [INCREMENT]%BF (-1.05 vs. -1.28%), [INCREMENT]FM (-1.13 vs. -1.19 kg), and FFM (0.10 vs. 0.37 kg, respectively). Both methods showed strong agreement for [INCREMENT]%BF (r = 0.75; standard error of the estimate [SEE] = 1.15%), [INCREMENT]FM (r = 0.84; SEE 1.0 kg), and [INCREMENT]FFM (r = 0.71; SEE of 1.5 kg). The 2 methods were poor predictors of each other in regards to changes in segmental measurements. Our data indicate that MF-BIA is an acceptable alternative for tracking changes in FM and FFM during a combined diet and exercise program in young, athletic men, but segmental lean mass measurements must be interpreted with circumspection.

Influence of high altitude on cerebral blood flow and fuel utilization during exercise and recovery.

PubMed

Smith, K J; MacLeod, D; Willie, C K; Lewis, N C S; Hoiland, R L; Ikeda, K; Tymko, M M; Donnelly, J; Day, T A; MacLeod, N; Lucas, S J E; Ainslie, P N

2014-12-15

We examined the hypotheses that: (1) during incremental exercise and recovery following 4-6 days at high altitude (HA) global cerebral blood flow (gCBF) increases to preserve cerebral oxygen delivery (CDO2) in excess of that required by an increasing cerebral metabolic rate of oxygen ( CM RO2); (2) the trans-cerebral exchange of oxygen vs. carbohydrates (OCI; carbohydrates = glucose + ½lactate) would be similar during exercise and recovery at HA and sea level (SL). Global CBF, intra-cranial arterial blood velocities, extra-cranial blood flows, and arterial-jugular venous substrate differences were measured during progressive steady-state exercise (20, 40, 60, 80, 100% maximum workload (Wmax)) and through 30 min of recovery. Measurements (n = 8) were made at SL and following partial acclimatization to 5050 m. At HA, absolute Wmax was reduced by ∼50%. During submaximal exercise workloads (20-60% Wmax), despite an elevated absolute gCBF (∼20%, P < 0.05) the relative increases in gCBF were not different at HA and SL. In contrast, gCBF was elevated at HA compared with SL during 80 and 100% Wmax and recovery. Notwithstanding a maintained CDO2 and elevated absolute CM RO2 at HA compared with SL, the relative increase in CM RO2 was similar during 20-80% Wmax but half that of the SL response (i.e. 17 vs. 27%; P < 0.05 vs. SL) at 100% Wmax. The OCI was reduced at HA compared with SL during 20, 40, and 60% Wmax but comparable at 80 and 100% Wmax. At HA, OCI returned almost immediately to baseline values during recovery, whereas at SL it remained below baseline. In conclusion, the elevations in gCBF during exercise and recovery at HA serve to maintain CDO2. Despite adequate CDO2 at HA the brain appears to increase non-oxidative metabolism during exercise and recovery. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

Influence of high altitude on cerebral blood flow and fuel utilization during exercise and recovery

PubMed Central

Smith, K J; MacLeod, D; Willie, C K; Lewis, N C S; Hoiland, R L; Ikeda, K; Tymko, M M; Donnelly, J; Day, T A; MacLeod, N; Lucas, S J E; Ainslie, P N

2014-01-01

We examined the hypotheses that: (1) during incremental exercise and recovery following 4–6 days at high altitude (HA) global cerebral blood flow (gCBF) increases to preserve cerebral oxygen delivery () in excess of that required by an increasing cerebral metabolic rate of oxygen (); (2) the trans-cerebral exchange of oxygen vs. carbohydrates (OCI; carbohydrates = glucose + ½lactate) would be similar during exercise and recovery at HA and sea level (SL). Global CBF, intra-cranial arterial blood velocities, extra-cranial blood flows, and arterial–jugular venous substrate differences were measured during progressive steady-state exercise (20, 40, 60, 80, 100% maximum workload (Wmax)) and through 30 min of recovery. Measurements (n = 8) were made at SL and following partial acclimatization to 5050 m. At HA, absolute Wmax was reduced by ∼50%. During submaximal exercise workloads (20–60% Wmax), despite an elevated absolute gCBF (∼20%, P < 0.05) the relative increases in gCBF were not different at HA and SL. In contrast, gCBF was elevated at HA compared with SL during 80 and 100% Wmax and recovery. Notwithstanding a maintained and elevated absolute at HA compared with SL, the relative increase in was similar during 20–80% Wmax but half that of the SL response (i.e. 17 vs. 27%; P < 0.05 vs. SL) at 100% Wmax. The OCI was reduced at HA compared with SL during 20, 40, and 60% Wmax but comparable at 80 and 100% Wmax. At HA, OCI returned almost immediately to baseline values during recovery, whereas at SL it remained below baseline. In conclusion, the elevations in gCBF during exercise and recovery at HA serve to maintain . Despite adequate at HA the brain appears to increase non-oxidative metabolism during exercise and recovery. PMID:25362150

The impact of duration on effectiveness of exercise, the implication for periodization of training and goal setting for individuals who are overfat, a meta-analysis

PubMed Central

2016-01-01

Given the assumption that all methods of exercise, e.g., endurance (ET), resistance (RT), or combination of both (E+R), can induce a beneficial effect size (ES) for changes in body composition and health status of individuals who are overfat. Thus the aim and purpose of this study is to evaluate the current body of knowledge to address the question as to the impact that the duration of exercise has on its relative effectiveness for inducing health and body compositional changes in individuals who are overfat to assist with developing periodized exercise protocols and establishing short and long term goals. A tiered meta-analysis of 92-studies and 200-exercise groupings were used for establishing pooled ES within and between groupings based on the increments of 4-week of duration and study designs of ≤8, 9-16, 17-23, 24-36, and ≥36 weeks. Analysis based on random-effect of response indicates a continuum of effectiveness within and between ET, RT and E+R based on duration. Where beneficial effectiveness is not indicated for any measures until after 8-weeks of continuous training with progressive effectiveness being noted in changes to cardiorespiratory fitness, inflammatory cytokines, and alteration of metabolic status from 12-weeks through 32-weeks of continuous training. Results indicate a greater ES for RT and E+R versus ET early in intervention that equalizes with longer durations. Supporting the use of RT and E+R within a periodized program. And secondarily, goals should be established first on performance gains and second body composition or health status modifications for the individual who is overfat. PMID:28090136

Cardiorespiratory Fitness and Cognitive Function are Positively Related Among Participants with Mild and Subjective Cognitive Impairment.

PubMed

Stuckenschneider, Tim; Askew, Christopher David; Rüdiger, Stefanie; Cristina Polidori, Maria; Abeln, Vera; Vogt, Tobias; Krome, Andreas; Olde Rikkert, Marcel; Lawlor, Brian; Schneider, Stefan

2018-01-01

By 2030, about 74 million people will be diagnosed with dementia, and many more will experience subjective (SCI) or mild cognitive impairment (MCI). As physical inactivity has been identified to be a strong modifiable risk factor for dementia, exercise and physical activity (PA) may be important parameters to predict the progression from MCI to dementia, but might also represent disease trajectory modifying strategies for SCI and MCI. A better understanding of the relationship between activity, fitness, and cognitive function across the spectrum of MCI and SCI would provide an insight into the potential utility of PA and fitness as early markers, and treatment targets to prevent cognitive decline. 121 participants were stratified into three groups, late MCI (LMCI), early MCI (EMCI), and SCI based on the Montreal Cognitive Assessment (MoCA). Cognitive function assessments also included the Trail Making Test A+B, and a verbal fluency test. PA levels were evaluated with an interviewer-administered questionnaire (LAPAQ) and an activity monitor. An incremental exercise test was performed to estimate cardiorespiratory fitness and to determine exercise capacity relative to population normative data. ANCOVA revealed that LMCI subjects had the lowest PA levels (LAPAQ, p = 0.018; activity monitor, p = 0.041), and the lowest exercise capacity in relation to normative values (p = 0.041). Moreover, a modest correlation between MoCA and cardiorespiratory fitness (r = 0.25; p < 0.05) was found. These findings suggest that during the earliest stages of cognitive impairment PA and exercise capacity might present a marker for the risk of further cognitive decline. This finding warrants further investigation using longitudinal cohort studies.

The impact of duration on effectiveness of exercise, the implication for periodization of training and goal setting for individuals who are overfat, a meta-analysis.

PubMed

Clark, J E

2016-12-01

Given the assumption that all methods of exercise, e.g., endurance (ET), resistance (RT), or combination of both (E+R), can induce a beneficial effect size (ES) for changes in body composition and health status of individuals who are overfat. Thus the aim and purpose of this study is to evaluate the current body of knowledge to address the question as to the impact that the duration of exercise has on its relative effectiveness for inducing health and body compositional changes in individuals who are overfat to assist with developing periodized exercise protocols and establishing short and long term goals. A tiered meta-analysis of 92-studies and 200-exercise groupings were used for establishing pooled ES within and between groupings based on the increments of 4-week of duration and study designs of ≤8, 9-16, 17-23, 24-36, and ≥36 weeks. Analysis based on random-effect of response indicates a continuum of effectiveness within and between ET, RT and E+R based on duration. Where beneficial effectiveness is not indicated for any measures until after 8-weeks of continuous training with progressive effectiveness being noted in changes to cardiorespiratory fitness, inflammatory cytokines, and alteration of metabolic status from 12-weeks through 32-weeks of continuous training. Results indicate a greater ES for RT and E+R versus ET early in intervention that equalizes with longer durations. Supporting the use of RT and E+R within a periodized program. And secondarily, goals should be established first on performance gains and second body composition or health status modifications for the individual who is overfat.

Reduced haemodynamic coupling and exercise are associated with vascular stiffening in pulmonary arterial hypertension.

PubMed

Bellofiore, Alessandro; Dinges, Eric; Naeije, Robert; Mkrdichian, Hamorabi; Beussink-Nelson, Lauren; Bailey, Melissa; Cuttica, Michael J; Sweis, Ranya; Runo, James R; Keevil, Jon G; Francois, Christopher J; Shah, Sanjiv J; Chesler, Naomi C

2017-03-01

Inadequate right ventricular (RV) and pulmonary arterial (PA) functional responses to exercise are important yet poorly understood features of pulmonary arterial hypertension (PAH). This study combined invasive catheterisation with echocardiography to assess RV afterload, RV function and ventricular-vascular coupling in subjects with PAH. Twenty-six subjects with PAH were prospectively recruited to undergo right heart catheterisation and Doppler echocardiography at rest and during incremental exercise, and cardiac MRI at rest. Measurements at rest included basic haemodynamics, RV function and coupling efficiency (η). Measurements during incremental exercise included pulmonary vascular resistance (Z 0 ), characteristic impedance (Z C , a measure of proximal PA stiffness) and proximal and distal PA compliance (C PA ). In patients with PAH, the proximal PAs were significantly stiffer at maximum exercise (Z C =2.31±0.38 vs 1.33±0.15 WU×m 2 at rest; p=0.003) and PA compliance was decreased (C PA =0.88±0.10 vs 1.32±0.17 mL/mm Hg/m 2 at rest; p=0.0002). Z 0 did not change with exercise. As a result, the resistance-compliance (RC) time decreased with exercise (0.67±0.05 vs 1.00±0.07 s at rest; p<10 -6 ). When patients were grouped according to resting coupling efficiency, those with poorer η exhibited stiffer proximal PAs at rest, a lower maximum exercise level, and more limited C PA reduction at maximum exercise. In PAH, exercise causes proximal and distal PA stiffening, which combined with preserved Z 0 results in decreased RC time with exercise. Stiff PAs at rest may also contribute to poor haemodynamic coupling, reflecting reduced pulmonary vascular reserve that contributes to limit the maximum exercise level tolerated. 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/.

The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty: a single-blinded randomized controlled trial.

PubMed

Jørgensen, Peter B; Bogh, Søren B; Kierkegaard, Signe; Sørensen, Henrik; Odgaard, Anders; Søballe, Kjeld; Mechlenburg, Inger

2017-01-01

To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. Single blinded, randomized clinical trial. Surgery, progressive resistance training and testing was carried out at Aarhus University Hospital and home-based exercise was carried out in the home of the patient. Fifty five patients were randomized to either progressive resistance training or home-based exercise. Patients were randomized to either progressive resistance training (home based exercise five days/week and progressive resistance training two days/week) or control group (home based exercise seven days/week). Preoperative assessment, 10-week (primary endpoint) and one-year follow-up were performed for leg extension power, spatiotemporal gait parameters and knee injury and osteoarthritis outcome score (KOOS). Forty patients (73%) completed 1-year follow-up. Patients in the progressive resistance training group participated in average 11 of 16 training sessions. Leg extension power increased from baseline to 10-week follow-up in progressive resistance training group (progressive resistance training: 0.28 W/kg, P= 0.01, control group: 0.01 W/kg, P=0.93) with no between-group difference. Walking speed and KOOS scores increased from baseline to 10-week follow-up in both groups with no between-group difference (six minutes walk test P=0.63, KOOS P>0.29). Progressive resistance training two days/week combined with home based exercise five days/week was not superior to home based exercise seven days/week in improving leg extension power of the operated leg.

The effects of intensity on V̇O2 kinetics during incremental free swimming.

PubMed

de Jesus, Kelly; Sousa, Ana; de Jesus, Karla; Ribeiro, João; Machado, Leandro; Rodríguez, Ferran; Keskinen, Kari; Vilas-Boas, João Paulo; Fernandes, Ricardo J

2015-09-01

Swimming and training are carried out with wide variability in distances and intensities. However, oxygen uptake kinetics for the intensities seen in swimming has not been reported. The purpose of this study was to assess and compare the oxygen uptake kinetics throughout low-moderate to severe intensities during incremental swimming exercise. We hypothesized that the oxygen uptake kinetic parameters would be affected by swimming intensity. Twenty male trained swimmers completed an incremental protocol of seven 200-m crawl swims to exhaustion (0.05 m·s(-1) increments and 30-s intervals). Oxygen uptake was continuously measured by a portable gas analyzer connected to a respiratory snorkel and valve system. Oxygen uptake kinetics was assessed using a double exponential regression model that yielded both fast and slow components of the response of oxygen uptake to exercise. From low-moderate to severe swimming intensities changes occurred for the first and second oxygen uptake amplitudes (P ≤ 0.04), time constants (P = 0.01), and time delays (P ≤ 0.02). At the heavy and severe intensities, a notable oxygen uptake slow component (>255 mL·min(-1)) occurred in all swimmers. Oxygen uptake kinetics whilst swimming at different intensities offers relevant information regarding cardiorespiratory and metabolic stress that might be useful for appropriate performance diagnosis and training prescription.

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.

Artifical Pancreas

NASA Astrophysics Data System (ADS)

Fei, Jiangfeng

2013-03-01

In 2006, JDRF launched the Artificial Pancreas Project (APP) to accelerate the development of a commercially-viable artificial pancreas system to closely mimic the biological function of the pancreas individuals with insulin-dependent diabetes, particularly type 1 diabetes. By automating detection of blood sugar levels and delivery of insulin in response to those levels, an artificial pancreas has the potential to transform the lives of people with type 1 diabetes. The 6-step APP development pathway serves as JDRF's APP strategic funding plan and defines the priorities of product research and development. Each step in the plan represents incremental advances in automation beginning with devices that shut off insulin delivery to prevent episodes of low blood sugar and progressing ultimately to a fully automated ``closed loop'' system that maintains blood glucose at a target level without the need to bolus for meals or adjust for exercise.

Does a Rehabilitation Program of Aerobic and Progressive Resisted Exercises Influence HIV-Induced Distal Neuropathic Pain?

PubMed

Maharaj, Sonill S; Yakasai, Abdulsalam M

2018-05-01

Distal symmetrical polyneuropathy is a common neurological sequela after HIV, which leads to neuropathic pain and functional limitations. Rehabilitation programs with exercises are used to augment pharmacological therapy to relieve pain but appropriate and effective exercises are unknown. This study explored the safety and effect of moderate-intensity aerobic exercises and progressive resisted exercises for HIV-induced distal symmetrical polyneuropathy neuropathic pain. A randomized pretest, posttest of 12 wks of aerobic exercise or progressive resisted exercise compared with a control. Outcome measures were assessed using the subjective periphery neuropathy, brief peripheral neuropathy screening, and numeric pain rating scale. Pain was assessed at baseline, 6 and 12 wks. Data between groups were compared using Kruskal-Wallis, Mann-Whitney U test, and within-groups Friedman and Wilcoxon signed rank tests. There were 136 participants (mean [SD] age = 36.79 [8.23] yrs) and the exercise groups completed the protocols without any adverse effects. Pain scores within and between aerobic exercise and progressive resisted exercise groups showed significant improvement (P < 0.05) from baseline to 6 and 12 wks compared with the control (P > 0.05). This study supports a rehabilitation program of moderate-intensity aerobic exercise and progressive resisted exercise being safe and effective for reducing neuropathic pain and is beneficial with analgesics for HIV-induced distal symmetrical polyneuropathy.

Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation.

PubMed

Hollinghurst, Sandra; Sharp, Debbie; Ballard, Kathleen; Barnett, Jane; Beattie, Angela; Evans, Maggie; Lewith, George; Middleton, Karen; Oxford, Frances; Webley, Fran; Little, Paul

2008-12-11

An economic evaluation of therapeutic massage, exercise, and lessons in the Alexander technique for treating persistent back pain. Cost consequences study and cost effectiveness analysis at 12 month follow-up of a factorial randomised controlled trial. 579 patients with chronic or recurrent low back pain recruited from primary care. Normal care (control), massage, and six or 24 lessons in the Alexander technique. Half of each group were randomised to a prescription for exercise from a doctor plus behavioural counselling from a nurse. Costs to the NHS and to participants. Comparison of costs with Roland-Morris disability score (number of activities impaired by pain), days in pain, and quality adjusted life years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost effectiveness ratios and cost effectiveness acceptability curves. Intervention costs ranged from pound30 for exercise prescription to pound596 for 24 lessons in Alexander technique plus exercise. Cost of health services ranged from pound50 for 24 lessons in Alexander technique to pound124 for exercise. Incremental cost effectiveness analysis of single therapies showed that exercise offered best value ( pound61 per point on disability score, pound9 per additional pain-free day, pound2847 per QALY gain). For two-stage therapy, six lessons in Alexander technique combined with exercise was the best value (additional pound64 per point on disability score, pound43 per additional pain-free day, pound5332 per QALY gain). An exercise prescription and six lessons in Alexander technique alone were both more than 85% likely to be cost effective at values above pound20 000 per QALY, but the Alexander technique performed better than exercise on the full range of outcomes. A combination of six lessons in Alexander technique lessons followed by exercise was the most effective and cost effective option.

SAMS Acceleration Measurements on MIR

NASA Technical Reports Server (NTRS)

Moskowitz, Milton E.; Hrovat, Kenneth; Finkelstein, Robert; Reckart, Timothy

1997-01-01

During NASA Increment 3 (September 1996 to January 1997), about 5 gigabytes of acceleration data were collected by the Space Acceleration Measurement System (SAMS) onboard the Russian Space Station, Mir. The data were recorded on 11 optical disks and were returned to Earth on STS-81. During this time, SAMS data were collected in the Priroda module to support the following experiments: the Mir Structural Dynamics Experiment (MiSDE) and Binary Colloidal Alloy Tests (BCAT). This report points out some of the salient features of the microgravity environment to which these experiments were exposed. Also documented are mission events of interest such as the docked phase of STS-81 operations, a Progress engine burn, attitude control thruster operation, and crew exercise. Also included are a description of the Mir module orientations, and the panel notations within the modules. This report presents an overview of the SAMS acceleration measurements recorded by 10 Hz and 100 Hz sensor heads. Variations in the acceleration environment caused by unique activities such as crew exercise and life-support fans are presented. The analyses included herein complement those presented in previous mission summary reports published by the Principal Investigator Microgravity Services (PIMS) group.

Brain Temperature in Spontaneously Hypertensive Rats during Physical Exercise in Temperate and Warm Environments.

PubMed

Drummond, Lucas Rios; Kunstetter, Ana Cançado; Vaz, Filipe Ferreira; Campos, Helton Oliveira; Andrade, André Gustavo Pereira de; Coimbra, Cândido Celso; Natali, Antônio José; Wanner, Samuel Penna; Prímola-Gomes, Thales Nicolau

2016-01-01

This study aimed to evaluate brain temperature (Tbrain) changes in spontaneously hypertensive rats (SHRs) subjected to two different physical exercise protocols in temperate or warm environments. We also investigated whether hypertension affects the kinetics of exercise-induced increases in Tbrain relative to the kinetics of abdominal temperature (Tabd) increases. Male 16-week-old normotensive Wistar rats (NWRs) and SHRs were implanted with an abdominal temperature sensor and a guide cannula in the frontal cortex to enable the insertion of a thermistor to measure Tbrain. Next, the animals were subjected to incremental-speed (initial speed of 10 m/min; speed was increased by 1 m/min every 3 min) or constant-speed (60% of the maximum speed) treadmill running until they were fatigued in a temperate (25°C) or warm (32°C) environment. Tbrain, Tabd and tail skin temperature were measured every min throughout the exercise trials. During incremental and constant exercise at 25°C and 32°C, the SHR group exhibited greater increases in Tbrain and Tabd relative to the NWR group. Irrespective of the environment, the heat loss threshold was attained at higher temperatures (either Tbrain or Tabd) in the SHRs. Moreover, the brain-abdominal temperature differential was lower at 32°C in the SHRs than in the NWRs during treadmill running. Overall, we conclude that SHRs exhibit enhanced brain hyperthermia during exercise and that hypertension influences the kinetics of the Tbrain relative to the Tabd increases, particularly during exercise in a warm environment.

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

PubMed

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

2003-06-01

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

Brain Temperature in Spontaneously Hypertensive Rats during Physical Exercise in Temperate and Warm Environments

PubMed Central

Drummond, Lucas Rios; Kunstetter, Ana Cançado; Vaz, Filipe Ferreira; Campos, Helton Oliveira; de Andrade, André Gustavo Pereira; Coimbra, Cândido Celso; Natali, Antônio José

2016-01-01

This study aimed to evaluate brain temperature (Tbrain) changes in spontaneously hypertensive rats (SHRs) subjected to two different physical exercise protocols in temperate or warm environments. We also investigated whether hypertension affects the kinetics of exercise-induced increases in Tbrain relative to the kinetics of abdominal temperature (Tabd) increases. Male 16-week-old normotensive Wistar rats (NWRs) and SHRs were implanted with an abdominal temperature sensor and a guide cannula in the frontal cortex to enable the insertion of a thermistor to measure Tbrain. Next, the animals were subjected to incremental-speed (initial speed of 10 m/min; speed was increased by 1 m/min every 3 min) or constant-speed (60% of the maximum speed) treadmill running until they were fatigued in a temperate (25°C) or warm (32°C) environment. Tbrain, Tabd and tail skin temperature were measured every min throughout the exercise trials. During incremental and constant exercise at 25°C and 32°C, the SHR group exhibited greater increases in Tbrain and Tabd relative to the NWR group. Irrespective of the environment, the heat loss threshold was attained at higher temperatures (either Tbrain or Tabd) in the SHRs. Moreover, the brain-abdominal temperature differential was lower at 32°C in the SHRs than in the NWRs during treadmill running. Overall, we conclude that SHRs exhibit enhanced brain hyperthermia during exercise and that hypertension influences the kinetics of the Tbrain relative to the Tabd increases, particularly during exercise in a warm environment. PMID:27214497

40 CFR Table 6 to Subpart Fff of... - Site-Specific Compliance Schedules and Increments of Progress a

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Site-Specific Compliance Schedules and... Constructed on or Before September 20, 1994 Pt. 62, Subpt. FFF, Table 6 Table 6 to Subpart FFF of Part 62—Site-Specific Compliance Schedules and Increments of Progress a Affected facilities at the following MWC sites...

40 CFR Table 6 to Subpart Fff of... - Site-Specific Compliance Schedules and Increments of Progress a

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Site-Specific Compliance Schedules and... Constructed on or Before September 20, 1994 Pt. 62, Subpt. FFF, Table 6 Table 6 to Subpart FFF of Part 62—Site-Specific Compliance Schedules and Increments of Progress a Affected facilities at the following MWC sites...

Identification of anaerobic threshold by analysis of heart rate variability during discontinuous dynamic and resistance exercise protocols in healthy older men.

PubMed

Simões, Rodrigo Polaquini; Castello-Simões, Viviane; Mendes, Renata Gonçalves; Archiza, Bruno; Dos Santos, Daniel Augusto; Bonjorno, José Carlos; de Oliveira, Claudio Ricardo; Catai, Aparecida Maria; Arena, Ross; Borghi-Silva, Audrey

2014-03-01

The purposes of this study were to determine anaerobic threshold (AT) during discontinuous dynamic and resistive exercise protocols by analysing of heart rate variability (HRV) and blood lactate (BL) in healthy elderly subjects and compare the cardiovascular, metabolic and autonomic variables obtained from these two forms of exercise. Fourteen elderly (70 ± 4 years) apparently healthy males underwent the following tests: (i) incremental ramp test on cycle ergometer, (ii) one repetition maximum (1RM) leg press at 45°, (iii) a discontinuous exercise test on a cycle ergometer (DET-C) protocol and (iv) a resistance exercise leg press (DET-L) protocol. Heart rate, blood pressure and BL were obtained during each increment of exercise intensity. No significant differences (P>0·05) were found between methods of AT determination (BL and HRV) nor the relative intensity corresponding to AT (30% of maximum intensity) between the types of exercise (DET-C and DET-L). Furthermore, no significant differences (P>0·05) were found between the DET-C and DET-L in relation to HRV, however, the DET-L provided higher values of systolic blood pressure and BL (P<0·05) from the intensity corresponding to AT. We conclude that HRV was effective in determination of AT, and the parasympathetic modulation responses obtained during dynamic and resistive exercise protocols were similar when compared at the same relative intensity. However, DET-L resulted in higher values of blood pressure and BL at workloads beyond AT. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Changes in technique and efficiency after high-intensity exercise in cross-country skiers.

PubMed

Åsan Grasaas, Christina; Ettema, Gertjan; Hegge, Ann Magdalen; Skovereng, Knut; Sandbakk, Øyvind

2014-01-01

This study investigated changes in technique and efficiency after high-intensity exercise to exhaustion in elite cross-country skiers. Twelve elite male skiers completed 4 min submaximal exercise before and after a high-intensity incremental test to exhaustion with the G3 skating technique on a 5% inclined roller-ski treadmill. Kinematics and kinetics were monitored by instrumented roller skis, work rate was calculated as power against roller friction and gravity, aerobic metabolic cost was determined from gas exchange, and blood lactate values indicated the anaerobic contribution. Gross efficiency was the work rate divided by aerobic metabolic rate. A recovery period of 10 min between the incremental test and the posttest was included to allow the metabolic values to return to baseline. Changes in neuromuscular fatigue in upper and lower limbs before and after the incremental test were indicated by peak power in concentric bench press and squat-jump height. From pretest to posttest, cycle length decreased and cycle rate increased by approximately 5% (P < 0.001), whereas the amount of ski forces did not change significantly. Oxygen uptake increased by 4%, and gross efficiency decreased from 15.5% ± 0.7% to 15.2% ± 0.5% from pretest to posttest (both P < .02). Correspondingly, blood lactate concentration increased from 2.4 ± 1.0 to 6.2 ± 2.5 mmol/L (P < .001). Bench-press and squat-jump performance remained unaltered. Elite cross-country skiers demonstrated a less efficient technique and shorter cycle length during submaximal roller-ski skating after high-intensity exercise. However, there were no changes in ski forces or peak power in the upper and lower limbs that could explain these differences.

Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial.

PubMed

Goranitis, Ilias; Bellanca, Leana; Daley, Amanda J; Thomas, Adele; Stokes-Lampard, Helen; Roalfe, Andrea K; Jowett, Sue

2017-01-01

To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. Primary care. Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. Cost per quality-adjusted life-year (QALY). Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms.

Aerobic exercise for vasomotor menopausal symptoms: A cost-utility analysis based on the Active Women trial

PubMed Central

Goranitis, Ilias; Bellanca, Leana; Daley, Amanda J.; Thomas, Adele; Stokes-Lampard, Helen; Roalfe, Andrea K.

2017-01-01

Objective To compare the cost-utility of two exercise interventions relative to a control group for vasomotor menopausal symptoms. Design Economic evaluation taking a UK National Health Service and Personal Social Services perspective and a societal perspective. Setting Primary care. Population Peri- and postmenopausal women who have not used hormone therapy in the past 3 months and experience ≥ 5 episodes of vasomotor symptoms daily. Methods An individual and a social support-based exercise intervention were evaluated. The former (Exercise-DVD), aimed to prompt exercise with purpose-designed DVD and written materials, whereas the latter (Exercise-Social support) with community exercise social support groups. Costs and outcomes associated with these interventions were compared to those of a control group, who could only have an exercise consultation. An incremental cost-utility analysis was undertaken using bootstrapping to account for the uncertainty around cost-effectiveness point-estimates. Main outcome measure Cost per quality-adjusted life-year (QALY). Results Data for 261 women were available for analysis. Exercise-DVD was the most expensive and least effective intervention. Exercise-Social support was £52 (CIs: £18 to £86) and £18 (CIs: -£68 to £105) more expensive per woman than the control group at 6 and 12 months post-randomisation and led to 0.006 (CIs: -0.002 to 0.014) and 0.013 (CIs: -0.01 to 0.036) more QALYs, resulting in an incremental cost-effectiveness ratio of £8,940 and £1,413 per QALY gained respectively. Exercise-Social support had 80%-90% probability of being cost-effective in the UK context. A societal perspective of analysis and a complete-case analysis led to similar findings. Conclusions Exercise-Social support resulted in a small gain in health-related quality of life at a marginal additional cost in a context where broader wellbeing and long-term gains associated with exercise and social participation were not captured. Community exercise social support groups are very likely to be cost-effective in the management of vasomotor menopausal symptoms. PMID:28949974

40 CFR 60.2580 - When must I complete each increment of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

40 CFR 60.2580 - When must I complete each increment of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

40 CFR 60.2580 - When must I complete each increment of progress?

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

Low Cardiorespiratory Fitness is Partially Linked to Ventilatory Factors in Obese Adolescents.

PubMed

Mendelson, Monique; Michallet, Anne-Sophie; Tonini, Julia; Favre-Juvin, Anne; Guinot, Michel; Wuyam, Bernard; Flore, Patrice

2016-02-01

To examine the role of ventilatory constraint on cardiorespiratory fitness in obese adolescents. Thirty obese adolescents performed a maximal incremental cycling exercise and were divided into 2 groups based on maximal oxygen uptake (VO2peak): those presenting low (L; n = 15; VO2peak: 72.9 ± 8.6% predicted) or normal (N; n = 15; VO2peak: 113.6 ± 19.2% predicted) cardiorespiratory fitness. Both were compared with a group of healthy controls (C; n = 20; VO2peak: 103.1 ± 11.2% predicted). Ventilatory responses were explored using the flow volume loop method. Cardiorespiratory fitness (VO2peak, in % predicted) was lower in L compared with C and N and was moderately associated with the percent predicted forced vital capacity (FVC) (r = .52; p < .05) in L. At peak exercise, end inspiratory point was lower in L compared with N and C (77.4 ± 8.1, 86.4 ± 7.7, and 89.9 ± 7.6% FVC in L, N, and C, respectively; p < .05), suggesting an increased risk of ventilatory constraint in L, although at peak exercise this difference could be attributed to the lower maximal ventilation in L. Forced vital capacity and ventilatory strategy to incremental exercise slightly differed between N and L. These results suggest a modest participation of ventilatory factors to exercise intolerance.

Physiologic responses during indoor cycling.

PubMed

Battista, Rebecca A; Foster, Carl; Andrew, Jessica; Wright, Glenn; Lucia, Alejandro; Porcari, John P

2008-07-01

During the last decade, there has been active interest in indoor cycling (e.g., spinning) as a method of choreographed group exercise. Recent studies have suggested that exercise intensity during indoor cycling may be quite high and may transiently exceed Vo2max. This study sought to confirm these findings, as the apparent high intensity of indoor cycling has implications for both the efficacy and the risk of indoor cycling as an exercise method. Twenty healthy female students performed an incremental exercise test to define Vo2max and performed 2 videotaped indoor exercise classes lasting 45 minutes and 35 minutes. Vo2, heart rate (HR), and rating of perceived exertion (RPE) were measured during the indoor cycling classes, with Vo2 data integrated in 30-second intervals. The mean %Vo2max during the indoor cycling classes was modest (74 +/- 14% Vo2max and 66 +/- 14%Vo2max, respectively). However, 52% and 35% of the time during the 45- and 35-minute classes was spent at intensities greater than the ventilatory threshold (VT). The HR response indicated that 35% and 38% of the session time was above the HR associated with VT. In 10 of the 40 exercise sessions, there were segments in which the momentary Vo2 exceeded Vo2max observed during incremental testing, and the cumulative time with exercise intensity greater than Vo2max ranged from 0.5 to 14.0 minutes. It can be concluded that although the intensity of indoor cycling in healthy, physically active women is moderate, there are frequent observations of transient values of Vo2 exceeding Vo2max, and a substantial portion of the exercise bouts at intensities greater than VT. As such, the data suggest that indoor cycling must be considered a high-intensity exercise mode of exercise training, which has implications for both efficacy and risk.

Prescribing physical activity for older patients.

PubMed

Kligman, E W; Pepin, E

1992-08-01

Regular exercise is an effective nonpharmacologic therapy for stress, sleep disorders, depression, and anxiety, as well as such chronic conditions of aging as hypertension, obesity, diabetes mellitus, coronary artery disease, hyperlipidemia, and constipation. Pre-exercise office assessment of cardiac risk, possible limitations, and contraindications is advised. A balanced fitness training program includes activities to increase flexibility, strength, and cardiovascular endurance. The most effective exercise prescription begins with a type of aerobic activity the patient enjoys. A prescribed schedule of stepwise increments in frequency, duration, and intensity gradually leads to a maintenance level of fitness.

40 CFR 60.2595 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

40 CFR 60.2595 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

40 CFR 60.2595 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Increments of...

Effects of posture on exercise performance - Measurement by systolic time intervals.

NASA Technical Reports Server (NTRS)

Spodick, D. H.; Quarry-Pigott, V. M.

1973-01-01

Because posture significantly influences cardiac performance, the effects of moderate supine and upright ergometer exercise were compared on the basis of proportional (+37%) rate increments over resting control. Supine exercise produced significant decreases in left ventricular ejection time (LVET), pre-ejection period (PEP), and isovolumic contraction time (IVCT). Ejection time index (ETI) and corrected ejection time (LVETc) did not change significantly. Upright exercise produced greater decreases in PEP and LVET, but despite the rate increase there was no change in LVET, which resulted in sharp increases in ETI and LVETc. The discordant directional effects on LVET and its rate-correcting indices between the two postures were consistent with hemodynamic studies demonstrating lack of stroke volume change during supine exercise and increased stroke volume over control during light to moderate upright exercise.

Accurate prediction of cardiorespiratory fitness using cycle ergometry in minimally disabled persons with relapsing-remitting multiple sclerosis.

PubMed

Motl, Robert W; Fernhall, Bo

2012-03-01

To examine the accuracy of predicting peak oxygen consumption (VO(2peak)) primarily from peak work rate (WR(peak)) recorded during a maximal, incremental exercise test on a cycle ergometer among persons with relapsing-remitting multiple sclerosis (RRMS) who had minimal disability. Cross-sectional study. Clinical research laboratory. Women with RRMS (n=32) and sex-, age-, height-, and weight-matched healthy controls (n=16) completed an incremental exercise test on a cycle ergometer to volitional termination. Not applicable. Measured and predicted VO(2peak) and WR(peak). There were strong, statistically significant associations between measured and predicted VO(2peak) in the overall sample (R(2)=.89, standard error of the estimate=127.4 mL/min) and subsamples with (R(2)=.89, standard error of the estimate=131.3 mL/min) and without (R(2)=.85, standard error of the estimate=126.8 mL/min) multiple sclerosis (MS) based on the linear regression analyses. Based on the 95% confidence limits for worst-case errors, the equation predicted VO(2peak) within 10% of its true value in 95 of every 100 subjects with MS. Peak VO(2) can be accurately predicted in persons with RRMS who have minimal disability as it is in controls by using established equations and WR(peak) recorded from a maximal, incremental exercise test on a cycle ergometer. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Nighttime feeding likely alters morning metabolism but not exercise performance in female athletes.

PubMed

Ormsbee, Michael J; Gorman, Katherine A; Miller, Elizabeth A; Baur, Daniel A; Eckel, Lisa A; Contreras, Robert J; Panton, Lynn B; Spicer, Maria T

2016-07-01

The timing of morning endurance competition may limit proper pre-race fueling and resulting performance. A nighttime, pre-sleep nutritional strategy could be an alternative method to target the metabolic and hydrating needs of the early morning athlete without compromising sleep or gastrointestinal comfort during exercise. Therefore, the purpose of this investigation was to examine the acute effects of pre-sleep chocolate milk (CM) ingestion on next-morning running performance, metabolism, and hydration status. Twelve competitive female runners and triathletes (age, 30 ± 7 years; peak oxygen consumption, 53 ± 4 mL·kg(-1)·min(-1)) randomly ingested either pre-sleep CM or non-nutritive placebo (PL) ∼30 min before sleep and 7-9 h before a morning exercise trial. Resting metabolic rate (RMR) was assessed prior to exercise. The exercise trial included a warm-up, three 5-min incremental workloads at 55%, 65%, and 75% peak oxygen consumption, and a 10-km treadmill time trial (TT). Physiological responses were assessed prior, during (incremental and TT), and postexercise. Paired t tests and magnitude-based inferences were used to determine treatment differences. TT performances were not different ("most likely trivial" improvement with CM) between conditions (PL: 52.8 ± 8.4 min vs CM: 52.8 ± 8.0 min). RMR was "likely" increased (4.8%) and total carbohydrate oxidation (g·min(-1)) during exercise was "possibly" or likely increased (18.8%, 10.1%, 9.1% for stage 1-3, respectively) with CM versus PL. There were no consistent changes to hydration indices. In conclusion, pre-sleep CM may alter next-morning resting and exercise metabolism to favor carbohydrate oxidation, but effects did not translate to 10-km running performance improvements.

Dehydration affects cerebral blood flow but not its metabolic rate for oxygen during maximal exercise in trained humans.

PubMed

Trangmar, Steven J; Chiesa, Scott T; Stock, Christopher G; Kalsi, Kameljit K; Secher, Niels H; González-Alonso, José

2014-07-15

Intense exercise is associated with a reduction in cerebral blood flow (CBF), but regulation of CBF during strenuous exercise in the heat with dehydration is unclear. We assessed internal (ICA) and common carotid artery (CCA) haemodynamics (indicative of CBF and extra-cranial blood flow), middle cerebral artery velocity (MCA Vmean), arterial-venous differences and blood temperature in 10 trained males during incremental cycling to exhaustion in the heat (35°C) in control, dehydrated and rehydrated states. Dehydration reduced body mass (75.8 ± 3 vs. 78.2 ± 3 kg), increased internal temperature (38.3 ± 0.1 vs. 36.8 ± 0.1°C), impaired exercise capacity (269 ± 11 vs. 336 ± 14 W), and lowered ICA and MCA Vmean by 12-23% without compromising CCA blood flow. During euhydrated incremental exercise on a separate day, however, exercise capacity and ICA, MCA Vmean and CCA dynamics were preserved. The fast decline in cerebral perfusion with dehydration was accompanied by increased O2 extraction (P < 0.05), resulting in a maintained cerebral metabolic rate for oxygen (CMRO2). In all conditions, reductions in ICA and MCA Vmean were associated with declining cerebral vascular conductance, increasing jugular venous noradrenaline, and falling arterial carbon dioxide tension (P aCO 2) (R(2) ≥ 0.41, P ≤ 0.01) whereas CCA flow and conductance were related to elevated blood temperature. In conclusion, dehydration accelerated the decline in CBF by decreasing P aCO 2 and enhancing vasoconstrictor activity. However, the circulatory strain on the human brain during maximal exercise does not compromise CMRO2 because of compensatory increases in O2 extraction. © 2014 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.

Dehydration affects cerebral blood flow but not its metabolic rate for oxygen during maximal exercise in trained humans

PubMed Central

Trangmar, Steven J; Chiesa, Scott T; Stock, Christopher G; Kalsi, Kameljit K; Secher, Niels H; González-Alonso, José

2014-01-01

Intense exercise is associated with a reduction in cerebral blood flow (CBF), but regulation of CBF during strenuous exercise in the heat with dehydration is unclear. We assessed internal (ICA) and common carotid artery (CCA) haemodynamics (indicative of CBF and extra-cranial blood flow), middle cerebral artery velocity (MCA Vmean), arterial–venous differences and blood temperature in 10 trained males during incremental cycling to exhaustion in the heat (35°C) in control, dehydrated and rehydrated states. Dehydration reduced body mass (75.8 ± 3 vs. 78.2 ± 3 kg), increased internal temperature (38.3 ± 0.1 vs. 36.8 ± 0.1°C), impaired exercise capacity (269 ± 11 vs. 336 ± 14 W), and lowered ICA and MCA Vmean by 12–23% without compromising CCA blood flow. During euhydrated incremental exercise on a separate day, however, exercise capacity and ICA, MCA Vmean and CCA dynamics were preserved. The fast decline in cerebral perfusion with dehydration was accompanied by increased O2 extraction (P < 0.05), resulting in a maintained cerebral metabolic rate for oxygen (CMRO2). In all conditions, reductions in ICA and MCA Vmean were associated with declining cerebral vascular conductance, increasing jugular venous noradrenaline, and falling arterial carbon dioxide tension () (R2 ≥ 0.41, P ≤ 0.01) whereas CCA flow and conductance were related to elevated blood temperature. In conclusion, dehydration accelerated the decline in CBF by decreasing and enhancing vasoconstrictor activity. However, the circulatory strain on the human brain during maximal exercise does not compromise CMRO2 because of compensatory increases in O2 extraction. PMID:24835170

Use of a combined oxygen and carbon dioxide transcutaneous electrode in the estimation of gas exchange during exercise.

PubMed Central

Sridhar, M K; Carter, R; Moran, F; Banham, S W

1993-01-01

BACKGROUND--Accurate and reliable measurement of gas exchange during exercise has traditionally involved arterial cannulation. Non-invasive devices to estimate arterial oxygen (O2) and carbon dioxide (CO2) tensions are now available. A method has been devised and evaluated for measuring gas exchange during exercise with a combined transcutaneous O2 and CO2 electrode. METHODS--Symptom limited exercise tests were carried out in 24 patients reporting effort intolerance and breathlessness. Exercise testing was performed by bicycle ergometry with a specifically designed protocol involving gradual two minute workload increments. Arterial O2 and CO2 tensions were measured at rest and during exercise by direct blood sampling from an indwelling arterial cannula and a combined transcutaneous electrode heated to 45 degrees C. The transcutaneous system was calibrated against values obtained by direct arterial sampling before each test. RESULTS--In all tests the trend of gas exchange measured by the transcutaneous system was true to the trend measured from direct arterial sampling. In the 140 measurements the mean difference between the O2 tensions estimated by direct sampling and the transcutaneous method was 0.08 kPa (0.62 mm Hg, limits of agreement 4.42 and -3.38 mm Hg). The mean difference between the methods for CO2 was 0.02 kPa (0.22 mm Hg, limits of agreement 2.20 and -1.70 mm Hg). There was no morbidity associated with the use of the transcutaneous electrode heated to 45 degrees C. CONCLUSIONS--A combined transcutaneous O2 and CO2 electrode heated to 45 degrees C can be used to provide a reliable estimate of gas exchange during gradual incremental exercise in adults. PMID:8346496

The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population.

PubMed

Navsaria, Rishi; Ryder, Dionne M; Lewis, Jeremy S; Alexander, Caroline M

2015-03-01

Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p<0.001). A select progression of exercises combining the two protocols increased EMG activity in a linear fashion (p<0.001). The ICC values indicated good reliability (ICC>0.7) between the first and second tests for five participants. Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Validity and reliability of the Hexoskin® wearable biometric vest during maximal aerobic power testing in elite cyclists.

PubMed

Elliot, Catherine A; Hamlin, Michael J; Lizamore, Catherine A

2017-07-28

The purpose of this study was to investigate the validity and reliability of the Hexoskin® vest for measuring respiration and heart rate (HR) in elite cyclists during a progressive test to exhaustion. Ten male elite cyclists (age 28.8 ± 12.5 yr, height 179.3 ± 6.0 cm, weight 73.2 ± 9.1 kg, V˙ O2max 60.7 ± 7.8 ml.kg.min mean ± SD) conducted a maximal aerobic cycle ergometer test using a ramped protocol (starting at 100W with 25W increments each min to failure) during two separate occasions over a 3-4 day period. Compared to the criterion measure (Metamax 3B) the Hexoskin® vest showed mainly small typical errors (1.3-6.2%) for HR and breathing frequency (f), but larger typical errors (9.5-19.6%) for minute ventilation (V˙E) during the progressive test to exhaustion. The typical error indicating the reliability of the Hexoskin® vest at moderate intensity exercise between tests was small for HR (2.6-2.9%) and f (2.5-3.2%) but slightly larger for V˙E (5.3-7.9%). We conclude that the Hexoskin® vest is sufficiently valid and reliable for measurements of HR and f in elite athletes during high intensity cycling but the calculated V˙E value the Hexoskin® vest produces during such exercise should be used with caution due to the lower validity and reliability of this variable.

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.

Motivational and evolutionary aspects of a physical exercise training program: a longitudinal study

PubMed Central

Rosa, João P. P.; de Souza, Altay A. L.; de Lima, Giscard H. O.; Rodrigues, Dayane F.; de Aquino Lemos, Valdir; da Silva Alves, Eduardo; Tufik, Sergio; de Mello, Marco T.

2015-01-01

Several studies have indicated that motivational level and prior expectations influence one’s commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (SDT, Self Determination Theory) and distal (evolutionary) explanations in the literature. This paper aims to verify if level of motivation (BREQ-2, Behavioral Regulation in Exercise Questionnaire-2) and expectations regarding regular physical exercise (IMPRAF-54) before starting a 1-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women) included a completed protocol group (CPG; n = 21) and drop-out group (n = 73). The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation). Both questionnaires were assessed before starting a regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression analysis showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability – 18.5 points – 81% sensibility/50% specificity) and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity) of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness), physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, as occurs in hunter-gathering groups, can engage people to be physically active and can provide better results in adherence exercise programs for the general population. PMID:26042076

Progression-free survival/time to progression as a potential surrogate for overall survival in HR+, HER2- metastatic breast cancer.

PubMed

Forsythe, Anna; Chandiwana, David; Barth, Janina; Thabane, Marroon; Baeck, Johan; Tremblay, Gabriel

2018-01-01

Several recent randomized controlled trials (RCTs) in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC) have demonstrated significant improvements in progression-free survival (PFS); however, few have reported improvement in overall survival (OS). The surrogacy of PFS or time to progression (TTP) for OS has not been formally investigated in HR+, HER2- MBC. A systematic literature review of RCTs in HR+, HER2- MBC was conducted to identify studies that reported both median PFS/TTP and OS. The correlation between PFS/TTP and OS was evaluated using Pearson's product-moment correlation and Spearman's rank correlation. Subgroup analyses were performed to explore possible reasons for heterogeneity. Errors-in-variables weighted least squares regression (LSR) was used to model incremental OS months as a function of incremental PFS/TTP months. An exploratory analysis investigated the impact of three covariates (chemotherapy vs hormonal/targeted therapy, PFS vs TTP, and first-line therapy vs second-line therapy or greater) on OS prediction. The lower 95% prediction band was used to determine the minimum incremental PFS/TTP months required to predict OS benefit (surrogate threshold effect [STE]). Forty studies were identified. There was a statistically significant correlation between median PFS/TTP and OS (Pearson =0.741, P =0.000; Spearman =0.650, P =0.000). These results proved consistent for chemotherapy and hormonal/targeted therapy. Univariate LSR analysis yielded an R 2 of 0.354 with 1 incremental PFS/TTP month corresponding to 1.13 incremental OS months. Controlling the type of treatment (chemotherapy vs hormonal/targeted therapy), line of therapy (first vs subsequent), and progression measure (PFS vs TTP) led to an improved R 2 of 0.569 with 1 PFS/TTP month corresponding to 0.78 OS months. The STE for OS benefit was 5-6 months of incremental PFS/TTP. We demonstrated a significant association between PFS/TTP and OS, which may justify the use of PFS/TTP as a surrogate for OS benefit in HR+, HER2- MBC.

Regulating recognition decisions through incremental reinforcement learning.

PubMed

Han, Sanghoon; Dobbins, Ian G

2009-06-01

Does incremental reinforcement learning influence recognition memory judgments? We examined this question by subtly altering the relative validity or availability of feedback in order to differentially reinforce old or new recognition judgments. Experiment 1 probabilistically and incorrectly indicated that either misses or false alarms were correct in the context of feedback that was otherwise accurate. Experiment 2 selectively withheld feedback for either misses or false alarms in the context of feedback that was otherwise present. Both manipulations caused prominent shifts of recognition memory decision criteria that remained for considerable periods even after feedback had been altogether removed. Overall, these data demonstrate that incremental reinforcement-learning mechanisms influence the degree of caution subjects exercise when evaluating explicit memories.

Exercise Training in Progressive Multiple Sclerosis: A Comparison of Recumbent Stepping and Body Weight-Supported Treadmill Training.

PubMed

Pilutti, Lara A; Paulseth, John E; Dove, Carin; Jiang, Shucui; Rathbone, Michel P; Hicks, Audrey L

2016-01-01

Background: There is evidence of the benefits of exercise training in multiple sclerosis (MS); however, few studies have been conducted in individuals with progressive MS and severe mobility impairment. A potential exercise rehabilitation approach is total-body recumbent stepper training (TBRST). We evaluated the safety and participant-reported experience of TBRST in people with progressive MS and compared the efficacy of TBRST with that of body weight-supported treadmill training (BWSTT) on outcomes of function, fatigue, and health-related quality of life (HRQOL). Methods: Twelve participants with progressive MS (Expanded Disability Status Scale scores, 6.0-8.0) were randomized to receive TBRST or BWSTT. Participants completed three weekly sessions (30 minutes) of exercise training for 12 weeks. Primary outcomes included safety assessed as adverse events and patient-reported exercise experience assessed as postexercise response and evaluation of exercise equipment. Secondary outcomes included the Multiple Sclerosis Functional Composite, the Modified Fatigue Impact Scale, and the Multiple Sclerosis Quality of Life-54 questionnaire scores. Assessments were conducted at baseline and after 12 weeks. Results: Safety was confirmed in both exercise groups. Participants reported enjoying both exercise modalities; however, TBRST was reviewed more favorably. Both interventions reduced fatigue and improved HRQOL (P ≤ .05); there were no changes in function. Conclusions: Both TBRST and BWSTT seem to be safe, well tolerated, and enjoyable for participants with progressive MS with severe disability. Both interventions may also be efficacious for reducing fatigue and improving HRQOL. TBRST should be further explored as an exercise rehabilitation tool for patients with progressive MS.

Creatine kinase response to high-intensity aerobic exercise in adult-onset muscular dystrophy.

PubMed

Andersen, Søren P; Sveen, Marie-Louise; Hansen, Regitze S; Madsen, Karen L; Hansen, Jonas B; Madsen, Mads; Vissing, John

2013-12-01

We investigated the effect of high-intensity exercise on plasma creatine kinase (CK) in patients with muscular dystrophies. Fourteen patients with Becker (BMD), facioscapulohumeral (FSHD), or limb-girdle type 2 (LGMD2) muscular dystrophy, and 8 healthy subjects performed 5 cycling tests: an incremental max test, and tests at 65%, 75%, 85%, and 95% of maximal oxygen uptake (VO2max ). Heart rate and oxygen consumption were measured during the tests, and plasma CK was measured before, immediately after, and 24 hours after exercise. All subjects were able to perform high-intensity exercise at the different levels. In patients with LGMD2 and FSHD, CK normalized 24 hours after exercise compared with the pre-exercise value, whereas those with BMD and healthy controls had elevated CK values 24 hours after exercise. The findings suggest that high-intensity exercise is generally well tolerated in patients with LGMD2 and FSHD, whereas those with BMD may be more prone to exercise-induced damage. Copyright © 2013 Wiley Periodicals, Inc.

40 CFR 60.2815 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... Units Model Rule-Air Curtain Incinerators § 60.2815 What are my requirements for meeting increments of...

Effect of Aerobic Exercise Training on Ventilatory Efficiency and Respiratory Drive in Obese Subjects.

PubMed

Chlif, Mehdi; Chaouachi, Anis; Ahmaidi, Said

2017-07-01

Obese patients show a decline in exercise capacity and diverse degrees of dyspnea in association with mechanical abnormalities, increased ventilatory requirements secondary to the increased metabolic load, and a greater work of breathing. Consequently, obese patients may be particularly predisposed to the development of respiratory muscle fatigue during exercise. The aim of this study was to assess inspiratory muscle performance during incremental exercise in 19 obese male subjects (body mass index 41 ± 6 kg/m 2 ) after aerobic exercise training using the noninvasive, inspiratory muscle tension-time index (T T0.1 ). Measurements performed included anthropometric parameters, lung function assessed by spirometry, rate of perceived breathlessness with the modified Borg dyspnea scale (0-10), breathing pattern, maximal exercise capacity, and inspiratory muscle performance with a breath-by-breath automated exercise metabolic system during an incremental exercise test. T T0.1 was calculated using the equation, T T0.1 = P 0.1 /P Imax × T I /T tot (where P 0.1 represents mouth occlusion pressure, P Imax is maximal inspiratory pressure, and T I /T tot is the duty cycle). At rest, there was no statistically significant difference for spirometric parameters and cardiorespiratory parameters between pre- and post-training. At maximal exercise, the minute ventilation, the rate of exchange ratio, the rate of perceived breathlessness, and the respiratory muscle performance parameters were not significantly different pre- and post-training; in contrast, tidal volume ( P = .037, effect size = 1.51), breathing frequency ( P = .049, effect size = 0.97), power output ( P = .048, effect size = 0.79), peak oxygen uptake ( P = .02, effect size = 0.92) were significantly higher after training. At comparable work load, training induces lower minute ventilation, mouth occlusion pressure, ratio of occlusion pressure to maximal inspiratory pressure, T T0.1 , and rate of perceived breathlessness. Aerobic exercise at ventilatory threshold can induce significant improvement in respiratory muscle strength, maximal exercise capacity, and inspiratory muscle performance and decreased dyspnea perception in obese subjects. Copyright © 2017 by Daedalus Enterprises.

Exercise response in Parkinson’s disease: insights from a cross-sectional comparison with sedentary controls and a per-protocol analysis of a randomised controlled trial

PubMed Central

Collett, Johnny; Franssen, Marloes; Meaney, Andy; Sexton, Claire; Dennis-West, Andrea; Betts, Jill F; Izadi, Hooshang; Bogdanovic, Marko; Tims, Martin; Farmer, Andrew; Dawes, Helen

2017-01-01

Objectives To investigate the acute and adaptation cardiovascular and metabolic training responses in people with Parkinson’s disease (pwP). Design (1) A cross-sectional study of exercise response of pwP compared with sedentary controls and (2) an interventional study of exercise training in pwP. Setting Community leisure facilities. Participants pwP (n=83) and sedentary controls (n=55). Interventions Study 1 included participants from a two-arm-parallel single-blind phase II randomised controlled trial (RCT), that undertook a baseline maximal incremental exercise test and study 2 included those randomised to the exercise group in the RCT, who completed a 6-month weekly exercise programme (n=37). The intervention study 2 was a prescribed exercise program consisting of sessions lasting 60 min, two times a week over a 6-month period. The control group followed the same protocol which derived the same cardiorespiratory parameters, except that they were instructed to aim for a cadence of ~60 revolutions per minute and the unloaded phase lasted 3 min with an initial step of 25 W. Primary and secondary outcome measures Stepwise incremental exercise test to volitional exhaustion was the primary outcome measure. Results Study 1 showed higher maximum values for heart rate (HR), VO2 L/min, VCO2 L/min and ventilation L/min for the control group; respiratory exchange ratio (RER), perceived exertion and O2 pulse (VO2 L/min/HR) did not differ between groups. In study 2, for pwP who adhered to training (n=37), RER increased significantly and although there was no significant change in aerobic capacity or HR response, reduced blood pressure was found. Conclusions An abnormal cardiovascular response to exercise was observed in pwP compared to controls. After the exercise programme, metabolic deficiencies remained for pwP. These observations add to the pathogenic understanding of PD, acknowledge an underling metabolic contribution and support that certain cardiovascular symptoms may improve as a result of this type of exercise. PMID:29282259

Countermeasures (iRED, ARED CEVIS, MEC, TVIS, T2, Periodic Fitness Evaluation, BP-ECG, HRM). Critical Readiness Review Increment 23 and 24

NASA Technical Reports Server (NTRS)

Toder, Carly; Gipson, Iona; Conly, Danielle; Nieschwitz, Linda; Perk, Austin

2010-01-01

This slide presentation reviews attempts to counteract the effects of being in space. It includes information on the Resistive Exercise Device (RED), the Advanced Resistive Exercise Device (ARED), Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS), Treadmill with Vibration Isolation and Stabilization (TVIS) and periodic fitness evaluation with specific information on BP/ECG, heart rate monitor 2 and data distribution.

An Examination of the Counting Talk Test's Ability to Discern Individual Variability in Exercise-Induced Metabolic Stress

ERIC Educational Resources Information Center

Bonafiglia, Jacob T.; Sawula, Laura J.; Gurd, Brendon J.

2018-01-01

The purpose of this study was to determine if the counting talk test can be used to discern whether an individual is exercising above or at/below maximal lactate steady state. Twenty-two participants completed VO[subscript 2]peak and counting talk test incremental step tests followed by an endurance test at 65% of work rate at VO[subscript 2]peak…

Power reserve following ramp-incremental cycling to exhaustion: implications for muscle fatigue and function.

PubMed

Hodgson, Michael D; Keir, Daniel A; Copithorne, David B; Rice, Charles L; Kowalchuk, John M

2018-04-26

In ramp-incremental cycling exercise, some individuals are capable of producing power output (PO) in excess of that produced at their limit of tolerance (LoT) while others cannot. This study sought to describe the: 1) prevalence of a "power reserve" within a group of young men (n=21; mean {plus minus} SD: age 25{plus minus}4 years; V̇O 2max 45{plus minus}8 ml•kg -1 •min -1 ); and 2) muscle fatigue characteristics of those with and without a power reserve. Power reserve was determined as the difference between peak PO achieved during a ramp-incremental test to exhaustion and maximal, single-leg isokinetic dynamometer power. Pre- versus post-exercise changes in voluntary and electrically-stimulated single-leg muscle force production measures (maximal voluntary contraction, voluntary activation, maximal isotonic velocity and isokinetic power; 1-, 10-, 50-Hz torque and 10/50-Hz ratio), V̇O 2max and constant-PO cycling time-to-exhaustion also were assessed. A dichotomy in power reserve was prevalent within the sample resulting in two groups: 1) "No Reserve" (NRES: <5% reserve; n=10) and 2) "Reserve" (RES: >15% reserve; n=11). At the LoT, all participants had achieved V̇O 2max . Muscle fatigue was evident in both groups, although the NRES group had greater reductions (p<0.05) in 10-Hz peak torque (PT), 10/50 Hz ratio, and maximal velocity. Time-to-exhaustion during the constant-PO test was 22{plus minus}16% greater (p<0.05) in RES (116{plus minus}19 s; PO = 317{plus minus}52 W) than in NRES (90{plus minus}23 s; PO = 337{plus minus}71 W), despite similar ramp-incremental exercise durations and V̇O 2max between groups. The differences in muscle fatigue and function between groups suggest that the mechanisms contributing to the LoT are not uniform.

Controversies in the physiological basis of the 'anaerobic threshold' and their implications for clinical cardiopulmonary exercise testing.

PubMed

Hopker, J G; Jobson, S A; Pandit, J J

2011-02-01

This article reviews the notion of the 'anaerobic threshold' in the context of cardiopulmonary exercise testing. Primarily, this is a review of the proposed mechanisms underlying the ventilatory and lactate response to incremental exercise, which is important to the clinical interpretation of an exercise test. Since such tests are often conducted for risk stratification before major surgery, a failure to locate or justify the existence of an anaerobic threshold will have some implications for clinical practice. We also consider alternative endpoints within the exercise response that might be better used to indicate a patient's capacity to cope with the metabolic demands encountered both during and following major surgery. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

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. HR max 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 W max , VO 2max and lower values of HR max when compared to participants with altered sleep. Regarding sleep duration, only W max was influenced by the amount of sleeping hours per night and this association remained significant even after adjustment by VO 2max . Sleep duration and quality are associated, at least in part, with performance during maximal incremental test among healthy men, with losses in W max and HR max . In addition, our results suggest that the relationship between sleep patterns and performance, mainly in W max , is independent of fitness condition. Copyright © 2017 Elsevier Inc. All rights reserved.

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 (V̇O 2peak ) attained in a sprint interval testing protocol correlates with cycling performance, and whether it corresponds to maximal oxygen uptake (V̇O 2max ) 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.

Progressive resistive exercise interventions for adults living with HIV/AIDS.

PubMed

O'Brien, K; Nixon, S; Glazier, R H; Tynan, A M

2004-10-18

Due to medical advancements, many people living with HIV infection in developed countries are living longer (Palella 1998). HIV infection can now present as a chronic illness with an uncertain natural disease history. The changing course of HIV infection has lead to a potential increase in the prevalence and impact of disability in people living with HIV infection. Exercise is one key management strategy used by health care professionals to address impairments (problems with body function or structure as a significant deviation or loss such as pain or weakness), activity limitations (difficulties an individual may have in executing activities such as inability to walk) and participation restrictions (problems an individual may experience in life situations such as inability to work) in this population (World Health Organization 2001). Exercise may also be used to address unwanted changes in weight and body composition in people living with HIV infection. Aerobic exercise has been associated with improvements in strength, cardiovascular function, and psychological status in general populations (Bouchard 1993). Results of a systematic review suggested that aerobic exercise interventions appeared to be safe and may lead to improvements in cardiopulmonary fitness for adults living with HIV/AIDS (Nixon 2002). But what are the effects of progressive resistive exercise (PRE) for adults living with HIV infection?A better understanding of the effectiveness and safety of progressive resistive exercise will enable people living with HIV and their health care workers to practice effective and appropriate exercise prescription, thus contributing to improved overall outcomes for adults living with HIV infection. To examine the safety and effectiveness of progressive resistive exercise interventions on weight, body composition, strength, immunological/virological, cardiopulmonary and psychological parameters in adults living with HIV infection. To identify studies to be included in this review, we searched the following databases: MEDLINE, EMBASE, CINAHL, COCHRANE, SCIENCE CITATION INDEX, PSYCHINFO, SOCIOLOGICAL ABSTRACTS, SSCI, ERIC, DAI and HEALTHSTAR. We also reviewed both published and unpublished abstracts and proceedings from major international and national HIV/AIDS conferences such as the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), the Conference on Retroviruses and Opportunistic Infections (CROI), the Infectious Diseases Society of America Conference (IDSA), and the International AIDS Conference (IAC). Reference lists from pertinent articles and books were reviewed, as well as Collaborative Review Group databases. Targeted journals were also hand searched for relevant articles. No language restriction was applied. The search strategy covered literature from 1980-August 2003. We included studies that were randomized controlled trials (RCTs) comparing progressive resistive exercise interventions with no progressive resistive exercise or another exercise or treatment modality, performed at least three times per week, and lasting at least four weeks among adults (18 years of age or older) living with HIV/AIDS. Data collection forms were used by reviewers to abstract data pertaining to study design, participants, interventions, outcomes and methodological quality from the studies that met inclusion criteria. Whenever possible, meta-analyses were conducted on outcomes using RevMan 4.2.2 computer software. Seven studies met the inclusion criteria for this systematic review. Meta-analysis was limited due to the following differences among the studies: types of exercise interventions, inclusion of co-intervention groups, level of exercise supervision, baseline body composition and testosterone levels of participants, types of outcomes assessed, and methodological quality of the individual studies.Main results indicated that performing progressive resistive exercise or a combination of progressive resistive exercise and aerobic exercise at least three times a week for at least four weeks appears to be safe and may lead to statistically and possibly clinically important increases in body weight and composition. Results also indicate exercise interventions may lead to clinically important improvements in cardiopulmonary fitness. Individual studies included in this review suggest that progressive resistive exercise interventions with or without aerobic exercise also contribute to improvements in strength and psychological status for adults living with HIV/AIDS. Individual studies indicate that progressive resistive exercise or a combination of progressive resistive and aerobic exercise appears to be safe for adults living with HIV/AIDS who are medically stable as a result of no change seen in immunological/virological status. These results are limited to those who continued to exercise and for whom there were adequate follow-up data. Progressive resistive exercise or a combination of progressive resistive exercise and aerobic exercise appear to be safe and may be beneficial for adults living with HIV/AIDS. These findings are limited by the small number of studies that could be included in meta-analyses, small sample sizes and variable participant withdrawal rates among included studies. Future research would benefit from including participants at various stages of HIV infection, a greater proportion of female participants, and participants in a variety of age groups to increase the generalizability of results. Furthermore, future research would benefit from studies with larger sample sizes that conduct an "intention-to-treat" analysis (analysis of participants based on the groups to which they were originally allocated) to better understand outcomes of participants that withdraw from exercise interventions.

Are normal decision-makers sensitive to changes in value contrast under uncertainty? Evidence from the Iowa Gambling Task.

PubMed

Lee, We-Kang; Su, Yi-An; Song, Tzu-Jiun; Chiu, Yao-Chu; Lin, Ching-Hung

2014-01-01

The Iowa Gambling Task (IGT) developed by Bechara et al. in 1994 is used to diagnose patients with Ventromedial Medial Prefrontal Cortex (VMPFC) lesions, and it has become a landmark in research on decision making. According to Bechara et al., the manipulation of progressive increments of monetary value can normalize the performance of patients with VMPFC lesions; thus, they developed a computerized version of the IGT. However, the empirical results showed that patients' performances did not improve as a result of this manipulation, which suggested that patients with VMPFC lesions performed myopically for future consequences. Using the original version of the IGT, some IGT studies have demonstrated that increments of monetary value significantly influence the performance of normal subjects in the IGT. However, other research has resulted in inconsistent findings. In this study, we used the computerized IGT (1X-IGT) and manipulated the value contrast of progressive increments (i.e., by designing the 10X-IGT, which contained 10 times of progressive increment) to investigate the influence of value contrast on the performance of normal subjects. The resulting empirical observations indicated that the value contrast (1X- vs. 10X-IGT) of the progressive increment had no effect on the performance of normal subjects. This study also provides a discussion of the issue of value in IGT-related studies. Moreover, we found the "prominent deck B phenomenon" in both versions of the IGT, which indicated that the normal subjects were guided mostly by the gain-loss frequency, rather than by the monetary value contrast. In sum, the behavioral performance of normal subjects demonstrated a low correlation with changes in monetary value, even in the 10X-IGT.

Exercise Intervention: Attrition, Compliance, Adherence, and Progression Following Hematopoietic Stem Cell Transplantation
.

PubMed

Peters, Tara; Erdmann, Ruby; Hacker, Eileen Danaher

2018-02-01

Exercise is widely touted as an effective intervention to optimize health and well-being after high-dose chemotherapy and hematopoietic stem cell transplantation. 
. This article reports attrition, compliance, adherence, and progression from the strength training arm of the single-blind randomized, controlled trial Strength Training to Enhance Early Recovery (STEER). 
. 37 patients were randomized to the intervention and participated in a structured strength training program introduced during hospitalization and continued for six weeks after release. Research staff and patients maintained exercise logs to document compliance, adherence, and progression. 
. No patients left the study because of burden. Patients were compliant with completion of exercise sessions, and their adherence was high; they also progressed on their exercise prescription. Because STEER balances intervention effectiveness with patient burden, the findings support the likelihood of successful translation into clinical practice.

Feedback-controlled robotics-assisted treadmill exercise to assess and influence aerobic capacity early after stroke: a proof-of-concept study.

PubMed

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

2014-07-01

The majority of post-stroke individuals suffer from low exercise capacity as a secondary reaction to immobility. The aim of this study was to prove the concept of feedback-controlled robotics-assisted treadmill exercise (RATE) to assess aerobic capacity and guide cardiovascular exercise in severely impaired individuals early after stroke. Subjects underwent constant load and incremental exercise testing using a human-in-the-loop feedback system within a robotics-assisted exoskeleton (Lokomat, Hocoma AG, CH). Inclusion criteria were: stroke onset ≤8 weeks, stable medical condition, non-ambulatory status, moderate motor control of the lower limbs and appropriate cognitive function. Outcome measures included oxygen uptake kinetics, peak oxygen uptake (VO2peak), gas exchange threshold (GET), peak heart rate (HRpeak), peak work rate (Ppeak) and accuracy of reaching target work rate (P-RMSE). Three subjects (18-42 d post-stroke) were included. Oxygen uptake kinetics during constant load ranged from 42.0 to 60.2 s. Incremental exercise testing showed: VO2peak range 19.7-28.8 ml/min/kg, GET range 11.6-12.7 ml/min/kg, and HRpeak range 115-161 bpm. Ppeak range was 55.2-110.9 W and P-RMSE range was 3.8-7.5 W. The concept of feedback-controlled RATE for assessment of aerobic capacity and guidance of cardiovascular exercise is feasible. Further research is warranted to validate the method on a larger scale. Aerobic capacity is seriously reduced in post-stroke individuals as a secondary reaction to immobility. Robotics-assisted walking devices may have substantial clinical relevance regarding assessment and improvement of aerobic capacity early after stroke. Feedback-controlled robotics-assisted treadmill exercise represents a new concept for cardiovascular assessment and intervention protocols for severely impaired individuals.

Sustained economic benefits of resistance training in community-dwelling senior women.

PubMed

Davis, Jennifer C; Marra, Carlo A; Robertson, M Clare; Najafzadeh, Mehdi; Liu-Ambrose, Teresa

2011-07-01

To determine whether the health and cost benefits of resistance training were sustained 12 months after formal cessation of the intervention. Cost-utility analysis conducted alongside a randomized controlled trial. Community-dwelling women aged 65 to 75 living in Vancouver, British Columbia. One hundred twenty-three of the 155 community-dwelling women aged 65 to 75 years who originally were randomly allocated to once-weekly resistance training (n=54), twice-weekly resistance training (n=52), or twice-weekly balance and tone exercises (control group; n=49) participated in the 12-month follow-up study. Of these, 98 took part in the economic evaluation (twice-weekly balance and tone exercises, n=28; once-weekly resistance training, n=35; twice-weekly resistance training, n=35). The primary outcome measure was incremental cost per quality-adjusted life year (QALY) gained. Healthcare resource utilization was assessed over 21 months (2009 prices); health status was assessed using the EuroQol-5D to calculate QALYs using a 21-month time horizon. Once- and twice-weekly resistance training were less costly than balance and tone classes, with incremental mean healthcare costs of Canadian dollars (CAD$)1,857 and CAD$1,077, respectively. The incremental QALYs for once- and twice-weekly resistance training were -0.051 and -0.081, respectively, compared with balance and tone exercises. The cost benefits of participating in a 12-month resistance training intervention were sustained for the once- and twice-weekly resistance training group, whereas the health benefits were not. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care

PubMed Central

2004-01-01

Objective To assess the cost effectiveness of adding spinal manipulation, exercise classes, or manipulation followed by exercise (“combined treatment”) to “best care” in general practice for patients consulting with low back pain. Design Stochastic cost utility analysis alongside pragmatic randomised trial with factorial design. Setting 181 general practices and 63 community settings for physical treatments around 14 centres across the United Kingdom. Participants 1287 (96%) of 1334 trial participants. Main outcome measures Healthcare costs, quality adjusted life years (QALYs), and cost per QALY over 12 months. Results Over one year, mean treatment costs relative to “best care” were £195 ($360; €279; 95% credibility interval £85 to £308) for manipulation, £140 (£3 to £278) for exercise, and £125 (£21 to £228) for combined treatment. All three active treatments increased participants' average QALYs compared with best care alone. Each extra QALY that combined treatment yielded relative to best care cost £3800; in economic terms it had an “incremental cost effectiveness ratio” of £3800. Manipulation alone had a ratio of £8700 relative to combined treatment. If the NHS was prepared to pay at least £10 000 for each extra QALY (lower than previous recommendations in the United Kingdom), manipulation alone would probably be the best strategy. If manipulation was not available, exercise would have an incremental cost effectiveness ratio of £8300 relative to best care. Conclusions Spinal manipulation is a cost effective addition to “best care” for back pain in general practice. Manipulation alone probably gives better value for money than manipulation followed by exercise. PMID:15556954

Cost-effectiveness of supervised exercise, stenting, and optimal medical care for claudication: results from the Claudication: Exercise Versus Endoluminal Revascularization (CLEVER) trial.

PubMed

Reynolds, Matthew R; Apruzzese, Patricia; Galper, Benjamin Z; Murphy, Timothy P; Hirsch, Alan T; Cutlip, Donald E; Mohler, Emile R; Regensteiner, Judith G; Cohen, David J

2014-11-11

Both supervised exercise (SE) and stenting (ST) improve functional status, symptoms, and quality of life compared with optimal medical care (OMC) in patients with claudication. The relative cost-effectiveness of these strategies is not well defined. The Claudication: Exercise Versus Endoluminal Revascularization (CLEVER) study randomized patients with claudication due to aortoiliac stenosis to a 6-month SE program, to ST, or to OMC. Participants who completed 6-month follow-up (n=98) were included in a health economic analysis through 18 months. Costs were assessed using resource-based methods and hospital billing data. Quality-adjusted life-years were estimated using the EQ-5D. Markov modeling based on the in-trial results was used to explore the impact of assumptions about the longer term durability of observed differences in quality of life. Through 18 months, mean healthcare costs were $5178, $9804, and $14 590 per patient for OMC, SE, and ST, respectively. Measured quality-adjusted life-years through 18 months were 1.04, 1.16, and 1.20. In our base case analysis, which assumed that observed differences in quality of life would dissipate after 5 years, the incremental cost-effectiveness ratios were $24 070 per quality-adjusted life-year gained for SE versus OMC, $41 376 for ST versus OMC, and $122 600 for ST versus SE. If the treatment effect of ST was assumed to be more durable than that of SE, the incremental cost-effectiveness ratio for ST versus SE became more favorable. Both SE and ST are economically attractive by US standards relative to OMC for the treatment of claudication in patients with aortoiliac disease. ST is more expensive than SE, with uncertain incremental benefit. www.clinicaltrials.gov, Unique identifier: NCT00132743. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Relationship between blood oxygenation and lactate in human skeletal muscle revealed by near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Xu, Guodong; Luo, Qingming; Ge, Xinfa; Gong, Hui; Zeng, Shaoqun

2002-04-01

Near-infrared spectroscopy (NIRS) is a focus of attention in the research field of biomedical photonics. The concentration of HbO2 in human skeletal muscle has been measured noninvasive NIRS using a portable tissue oximeter continuously when the subjects did incremental exercises on a power bicycle. Blood lactate is one of traditional physical research subjects which is applied most widely. We study blood volume in the tissue of sportsmen when they are subjected by the incremental physical load, simultaneously detecting some parameters such as the heart rate, maximal oxygen absorption and the concentration of blood lactate. As the intensity of exercises was heightened, the concentration of blood lactate and blood volume in tissue increased, while the concentration of HbO2 decreased. Thus the rudimental characteristics of energy consumption and supply during hypoxia and aerobic exercises are investigated. By discovering the relationship between blood lactate in human skeletal muscle and blood oxygenation, a novel approach for measuring blood lactate noninvasively and assessing the sports ability could be provided. Furthermore, it is possible to assess the fatigue state with tissue oximeter to monitor the human sports intensity noninvasively and dynamically.

The effect of chronic progressive-dose sodium bicarbonate ingestion on CrossFit-like performance: A double-blind, randomized cross-over trial.

PubMed

Durkalec-Michalski, Krzysztof; Zawieja, Emilia E; Podgórski, Tomasz; Łoniewski, Igor; Zawieja, Bogna E; Warzybok, Marta; Jeszka, Jan

2018-01-01

Sodium bicarbonate (SB) has been proposed as an ergogenic aid, as it improves high-intensity and resistance exercise performance. However, no studies have yet investigated SB application in CrossFit. This study examined the effects of chronic, progressive-dose SB ingestion on CrossFit-like performance and aerobic capacity. In a randomized, double-blind, cross-over trial, 21 CrossFit-trained participants were randomly allocated to 2 groups and underwent 2 trials separated by a 14-day washout period. Participants ingested either up to 150 mg∙kg-1 of SB in a progressive-dose regimen or placebo for 10 days. Before and after each trial, Fight Gone Bad (FGB) and incremental cycling (ICT) tests were performed. In order to examine biochemical responses, blood samples were obtained prior to and 3 min after completing each exercise test. No gastrointestinal (GI) side effects were reported during the entire protocol. The overall FGB performance improved under SB by ~6.1% (p<0.001) and it was ~3.1% higher compared to post placebo (PLApost) (p = 0.040). The number of repetitions completed in each round also improved under SB (mean from baseline: +5.8% to +6.4%). Moreover, in ICT, the time to ventilatory threshold (VT) (~8:25 min SBpost vs. ~8:00 min PLApost, p = 0.020), workload at VT (~218 W SBpost vs. ~208 W PLApost, p = 0.037) and heart rate at VT (~165 bpm SBpost vs. ~161 bpm PLApost, p = 0.030) showed higher SBpost than PLApost. Furthermore, the maximum carbon dioxide production increased under SB by ~4.8% (from ~3604 mL∙min-1 to ~3776 mL∙min-1, p = 0.049). Pyruvate concentration and creatine kinase activity before ICT showed higher SBpost than PLApost (~0.32 mmol∙L-1 vs. ~0.26 mmol∙L-1, p = 0.001; ~275 U∙L-1 vs. ~250 U∙L-1, p = 0.010, respectively). However, the small sample size limits the wide-application of our results. Progressive-dose SB ingestion regimen eliminated GI side effects and improved CrossFit-like performance, as well as delayed ventilatory threshold occurrence.

Facial feature tracking: a psychophysiological measure to assess exercise intensity?

PubMed

Miles, Kathleen H; Clark, Bradley; Périard, Julien D; Goecke, Roland; Thompson, Kevin G

2018-04-01

The primary aim of this study was to determine whether facial feature tracking reliably measures changes in facial movement across varying exercise intensities. Fifteen cyclists completed three, incremental intensity, cycling trials to exhaustion while their faces were recorded with video cameras. Facial feature tracking was found to be a moderately reliable measure of facial movement during incremental intensity cycling (intra-class correlation coefficient = 0.65-0.68). Facial movement (whole face (WF), upper face (UF), lower face (LF) and head movement (HM)) increased with exercise intensity, from lactate threshold one (LT1) until attainment of maximal aerobic power (MAP) (WF 3464 ± 3364mm, P < 0.005; UF 1961 ± 1779mm, P = 0.002; LF 1608 ± 1404mm, P = 0.002; HM 849 ± 642mm, P < 0.001). UF movement was greater than LF movement at all exercise intensities (UF minus LF at: LT1, 1048 ± 383mm; LT2, 1208 ± 611mm; MAP, 1401 ± 712mm; P < 0.001). Significant medium to large non-linear relationships were found between facial movement and power output (r 2  = 0.24-0.31), HR (r 2  = 0.26-0.33), [La - ] (r 2  = 0.33-0.44) and RPE (r 2  = 0.38-0.45). The findings demonstrate the potential utility of facial feature tracking as a non-invasive, psychophysiological measure to potentially assess exercise intensity.

Is physical exercise a multiple sclerosis disease modifying treatment?

PubMed

Motl, Robert W; Pilutti, Lara A

2016-08-01

There is consensus that exercise represents a behavioral approach for the restoration of function and management of symptoms among persons with multiple sclerosis (MS). The current paper provides a review on the topic of exercise and physical activity as MS-disease modifying treatments. Firstly, metrics for evaluating disease modification and progression in MS are described. Secondly, evidence for exercise as a MS-disease modifying therapy based on individual studies, literature reviews, and meta-analyses is summarized. Finally, the paper focuses on major limitations of the existing body of research. Expert commentary: Exercise and physical activity have been associated with reduced relapse rate, mobility disability and its progression, and lesion volume, and improved neuroperformance, particularly walking outcomes. This evidence provides a positive, yet preliminary, picture for exercise having possible effects on markers of disease modification and progression in MS.

Design and conduct of Caudwell Xtreme Everest: an observational cohort study of variation in human adaptation to progressive environmental hypoxia

PubMed Central

2010-01-01

Background The physiological responses to hypoxaemia and cellular hypoxia are poorly understood, and inter-individual differences in performance at altitude and outcome in critical illness remain unexplained. We propose a model for exploring adaptation to hypoxia in the critically ill: the study of healthy humans, progressively exposed to environmental hypobaric hypoxia (EHH). The aim of this study was to describe the spectrum of adaptive responses in humans exposed to graded EHH and identify factors (physiological and genetic) associated with inter-individual variation in these responses. Methods Design Observational cohort study of progressive incremental exposure to EHH. Setting University human physiology laboratory in London, UK (75 m) and 7 field laboratories in Nepal at 1300 m, 3500 m, 4250 m, 5300 m, 6400 m, 7950 m and 8400 m. Participants 198 healthy volunteers and 24 investigators trekking to Everest Base Camp (EBC) (5300 m). A subgroup of 14 investigators studied at altitudes up to 8400 m on Everest. Main outcome measures Exercise capacity, exercise efficiency and economy, brain and muscle Near Infrared Spectroscopy, plasma biomarkers (including markers of inflammation), allele frequencies of known or suspected hypoxia responsive genes, spirometry, neurocognitive testing, retinal imaging, pupilometry. In nested subgroups: microcirculatory imaging, muscle biopsies with proteomic and transcriptomic tissue analysis, continuous cardiac output measurement, arterial blood gas measurement, trans-cranial Doppler, gastrointestinal tonometry, thromboelastography and ocular saccadometry. Results Of 198 healthy volunteers leaving Kathmandu, 190 reached EBC (5300 m). All 24 investigators reached EBC. The completion rate for planned testing was more than 99% in the investigator group and more than 95% in the trekkers. Unique measurements were safely performed at extreme altitude, including the highest (altitude) field measurements of exercise capacity, cerebral blood flow velocity and microvascular blood flow at 7950 m and arterial blood gas measurement at 8400 m. Conclusions This study demonstrates the feasibility and safety of conducting a large healthy volunteer cohort study of human adaptation to hypoxia in this difficult environment. Systematic measurements of a large set of variables were achieved in 222 subjects and at altitudes up to 8400 m. The resulting dataset is a unique resource for the study of genotype:phenotype interactions in relation to hypoxic adaptation. PMID:20964858

Exercise Improves Cognition in Parkinson’s Disease: the PRET-PD Randomized Clinical Trial

PubMed Central

David, Fabian J.; Robichaud, Julie A.; Leurgans, Sue E.; Poon, Cynthia; Kohrt, Wendy M.; Goldman, Jennifer G.; Comella, Cynthia L.; Vaillancourt, David E.; Corcos, Daniel M.

2015-01-01

Background This paper reports on the findings of the effect of two structured exercise interventions on secondary cognitive outcomes which were gathered as part of the Progressive Resistance Exercise Training in Parkinson’s disease randomized controlled trial. Methods This study was a prospective, parallel-group, single-center trial. Fifty-one non-demented patients with mild-to-moderate Parkinson’s disease were randomly assigned either to modified Fitness Counts or to Progressive Resistance Exercise, and were followed for 24 months. Cognitive outcomes were the Digit Span, Stroop, and Brief Test of Attention. Results Eighteen patients in modified Fitness Counts and 20 patients in Progressive Resistance Exercise completed the trial. At 12 and at 24 months no differences between groups were observed. At 12 months, relative to baseline, modified Fitness Counts improved on the Digit Span (estimated change, 0.3; Inter-Quartile Range, 0, 0.7; p=0.04) and Stroop (0.3; 0, 0.6; p=0.04), and Progressive Resistance Exercise improved only on the Digit Span (0.7; 0.3, 1; p<0.01). At 24 months, relative to baseline, modified Fitness Counts improved on the Digit Span (0.7; 0.3, 1.7; p<0.01) and Stroop (0.3; 0.1, 0.5; p=0.03), while Progressive Resistance Exercise improved on the Digit Span (0.5; 0.2, 0.8; p<0.01), Stroop (0.2; −0.1, 0.6; p=0.048), and Brief Test of Attention (0.3; 0, 0.8; p=0.048). No neurologic or cognitive adverse events were seen. Conclusions This study provides Class IV level of evidence that 24 months of Progressive Resistance Exercise or modified Fitness Counts may improve attention and working memory in non-demented patients with mild-to-moderate Parkinson’s disease. PMID:26148003

12-year Temporal Trend in Referral Pattern and Test Results of Stress Echocardiography in a Tertiary Care Referral Center with Moderate Volume Activities and Cath-lab Facility.

PubMed

Barbieri, Andrea; Mantovani, Francesca; Bursi, Francesca; Bartolacelli, Ylenia; Manicardi, Marcella; Lauria, Maria Giulia; Boriani, Giuseppe

2018-01-01

Data on stress echocardiography (SE) time-related changes in referral patterns and diagnostic yield for detection of inducible ischemia could enhance Echo Lab quality benchmarks and performance measures. This study aims to evaluate temporal trends in SE test results among ambulatory patients with suspected or known coronary artery disease (CAD) in a tertiary care referral center with moderate (>100/year) volume SE activities and Cath-Lab facility. From January 2004 to December 2015, 1954 patients (mean age 62 ± 12 years, 42% women, 27% with known CAD) underwent SE (1673 exercise SE, 86%, 246 pharmacological SE, 12%, 35 pacing SE, 2%). Time was grouped into three 4 year periods, where clinical data and test results were evaluated. Our series comprised low-to-intermediate pretest probability of CAD throughout the observation period (overall pretest probability of CAD 19% ± 15%). A progressive decline over time in the rate of pharmacological SE instead of a dramatic increment of exercise SE (79%-96%, P < 0.0001) was noted. The use of beta-blockers increased (from 43% to 66%, P < 0.0001), while the use of nitrates decreased (from 11% to 4%, P < 0.0001) over time. We noted a very uncommon occurrence of abnormal test results with a further decrease in the last period (from 11% to 3%, P < 0.0001). We observed, over a 12-year period, a progressive decrease in the frequency of inducible myocardial ischemia among patients with known or suspected CADe referred to our Echo Lab for SE with Cath-Lab facility, and this trend was parallel to changes in SE referral practice. These findings are particularly relevant if we consider the practical implications on diagnostic SE accuracy and risk assessment.

The effect of acute exercise on pulsatile release of luteinizing hormone in women runners.

PubMed

Cumming, D C; Vickovic, M M; Wall, S R; Fluker, M R; Belcastro, A N

1985-11-01

Endurance exercise has been associated with reproductive dysfunction. We have previously suggested that pulsatile release of luteinizing hormone is impaired at rest in normal menstruating runners compared with sedentary women. To determine whether acute exercise had any effect on pulsatile release of luteinizing hormone we investigated serum luteinizing hormone levels in six normal menstruating runners at rest and after 60 minutes of running exercise. Exercise induced an increment in circulating luteinizing hormone levels greater than the change in hematocrit. The luteinizing hormone pulse frequency, calculated as the number of luteinizing hormone pulses per 6 hours, was reduced after exercise compared with values obtained at rest. There was no significant difference in pulse amplitude or area under the 6-hour curve between resting and postexercise situations. These data suggest that acute exercise has an inhibitory effect on luteinizing hormone pulsatile release at the hypothalamic level in eumenorrheic runners that is in addition to the previously described effect of training.

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. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of increasing pump speed during exercise on peak oxygen uptake in heart failure patients supported with a continuous-flow left ventricular assist device. A double-blind randomized study.

PubMed

Jung, Mette Holme; Hansen, Peter Bo; Sander, Kaare; Olsen, Peter Skov; Rossing, Kasper; Boesgaard, Soeren; Russell, Stuart D; Gustafsson, Finn

2014-04-01

Continuous-flow left ventricular assist device (CF-LVAD) implantation is associated with improved quality of life, but the effect on exercise capacity is less well documented. It is uncertain whether a fixed CF-LVAD pump speed, which allows for sufficient circulatory support at rest, remains adequate during exercise. The aim of this study was to evaluate the effects of fixed versus incremental pump speed on peak oxygen uptake (peak VO2) during a maximal exercise test. In CF-LVAD (HeartMate II) patients exercise testing measuring peak oxygen uptake (VO2) was performed on an ergometer bike twice in one day: once with fixed pump speed (testfix) and once with incremental pump speed (testinc). The order of testfix and testinc in each patient was determined by randomization. During testinc pump speed was increased from the baseline value by 400 rpm/2 min. Fourteen patients (aged 23–69 years) were included with a mean support duration of 465±483 days. Baseline CF-LVAD speed was 9357±238 rpm and during testinc speed was increased by a mean of 1486±775 rpm. Mean peak VO2 was significantly higher in testinc compared with testfix (15.4±5.9 mL/kg/min vs. 14.1±6.3 mL/kg/min; P=0.012), corresponding to a 9.2% increase. All exercise tests (n=28) were adequately performed with RER>1. Increasing pump speed during exercise augments peak VO2 in patients supported with CF-LVADs. An automatic speed-change function in future generations of CF-LVADs might improve functional capacity. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

PubMed Central

Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

2014-01-01

Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral perfusion capacities that could elicit higher levels of peripheral cardiorepiratory stimulus during exercise. PMID:24838811

Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial.

PubMed

Bove, Allyn M; Smith, Kenneth J; Bise, Christopher G; Fritz, Julie M; Childs, John; Brennan, Gerard P; Abbott, J Haxby; Fitzgerald, G Kelley

2018-01-01

Limited information exists regarding the cost-effectiveness of rehabilitation strategies for individuals with knee osteoarthritis (OA). The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee OA. This economic evaluation involved a cost-effectiveness analysis performed alongside a multicenter randomized controlled trial. The study took place in Pittsburgh, Pennsylvania; Salt Lake City, Utah; and San Antonio, Texas. The study participants were 300 individuals taking part in a randomized controlled trial investigating various physical therapy strategies for knee OA. Participants were randomized into 4 treatment groups: exercise only (EX), exercise plus booster sessions (EX+B), exercise plus manual therapy (EX+MT), and exercise plus manual therapy and booster sessions (EX+MT+B). For the 2-year base case scenario, a Markov model was constructed using the United States societal perspective and a 3% discount rate for costs and quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were calculated to compare differences in cost per QALY gained among the 4 treatment strategies. In the 2-year analysis, booster strategies (EX+MT+B and EX+B) dominated no-booster strategies, with both lower health care costs and greater effectiveness. EX+MT+B had the lowest total health care costs. EX+B cost ${\\$}$1061 more and gained 0.082 more QALYs than EX+MT+B, for an incremental cost-effectiveness ratio of ${\\$}$12,900/QALY gained. The small number of total knee arthroplasty surgeries received by individuals in this study made the assessment of whether any particular strategy was more successful at delaying or preventing surgery in individuals with knee OA difficult. Spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA. © 2017 American Physical Therapy Association

A theoretical model to describe progressions and regressions for exercise rehabilitation.

PubMed

Blanchard, Sam; Glasgow, Phil

2014-08-01

This article aims to describe a new theoretical model to simplify and aid visualisation of the clinical reasoning process involved in progressing a single exercise. Exercise prescription is a core skill for physiotherapists but is an area that is lacking in theoretical models to assist clinicians when designing exercise programs to aid rehabilitation from injury. Historical models of periodization and motor learning theories lack any visual aids to assist clinicians. The concept of the proposed model is that new stimuli can be added or exchanged with other stimuli, either intrinsic or extrinsic to the participant, in order to gradually progress an exercise whilst remaining safe and effective. The proposed model maintains the core skills of physiotherapists by assisting clinical reasoning skills, exercise prescription and goal setting. It is not limited to any one pathology or rehabilitation setting and can adapted by any level of skilled clinician. Copyright © 2014 Elsevier Ltd. All rights reserved.

Contracting for Agile Software Development in the Department of Defense: An Introduction

DTIC Science & Technology

2015-08-01

Requirements are fixed at a more granular level; reviews of the work product happen more frequently and assess each individual increment rather than a “ big bang ...boundaries than “ big - bang ” development. The implementation of incremental or progressive reviews enables just that—any issues identified at the time of the...the contract needs to support the delivery of deployable software at defined increments/intervals, rather than incentivizing “ big - bang ” efforts or

Beetroot juice does not enhance altitude running performance in well-trained athletes.

PubMed

Arnold, Josh Timothy; Oliver, Samuel James; Lewis-Jones, Tammy Maria; Wylie, Lee John; Macdonald, Jamie Hugo

2015-06-01

We hypothesized that acute dietary nitrate (NO3(-)) provided as concentrated beetroot juice supplement would improve endurance running performance of well-trained runners in normobaric hypoxia. Ten male runners (mean (SD): sea level maximal oxygen uptake, 66 (7) mL·kg(-1)·min(-1); 10 km personal best, 36 (2) min) completed incremental exercise to exhaustion at 4000 m and a 10-km treadmill time-trial at 2500 m simulated altitude on separate days after supplementation with ∼7 mmol NO3(-) and a placebo at 2.5 h before exercise. Oxygen cost, arterial oxygen saturation, heart rate, and ratings of perceived exertion (RPE) were determined during the incremental exercise test. Differences between treatments were determined using means [95% confidence intervals], paired sample t tests, and a probability of individual response analysis. NO3(-) supplementation increased plasma nitrite concentration (NO3(-), 473 (226) nmol·L(-1) vs. placebo, 61 (37) nmol·L(-1), P < 0.001) but did not alter time to exhaustion during the incremental test (NO3(-), 402 (80) s vs. placebo 393 (62) s, P = 0.5) or time to complete the 10-km time-trial (NO3(-), 2862 (233) s vs. placebo, 2874 (265) s, P = 0.6). Further, no practically meaningful beneficial effect on time-trial performance was observed as the 11 [-60 to 38] s improvement was less than the a priori determined minimum important difference (51 s), and only 3 runners experienced a "likely, probable" performance improvement. NO3(-) also did not alter oxygen cost, arterial oxygen saturation, heart rate, or RPE. Acute dietary NO3(-) supplementation did not consistently enhance running performance of well-trained athletes in normobaric hypoxia.

Cost-effectiveness of supervised exercise therapy compared with endovascular revascularization for intermittent claudication.

PubMed

van den Houten, M M L; Lauret, G J; Fakhry, F; Fokkenrood, H J P; van Asselt, A D I; Hunink, M G M; Teijink, J A W

2016-11-01

Current guidelines recommend supervised exercise therapy (SET) as the preferred initial treatment for patients with intermittent claudication. The availability of SET programmes is, however, limited and such programmes are often not reimbursed. Evidence for the long-term cost-effectiveness of SET compared with endovascular revascularization (ER) as primary treatment for intermittent claudication might aid widespread adoption in clinical practice. A Markov model was constructed to determine the incremental costs, incremental quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio of SET versus ER for a hypothetical cohort of patients with newly diagnosed intermittent claudication, from the Dutch healthcare payer's perspective. In the event of primary treatment failure, possible secondary interventions were repeat ER, open revascularization or major amputation. Data sources for model parameters included original data from two RCTs, as well as evidence from the medical literature. The robustness of the results was tested with probabilistic and one-way sensitivity analysis. Considering a 5-year time horizon, probabilistic sensitivity analysis revealed that SET was associated with cost savings compared with ER (-€6412, 95 per cent credibility interval (CrI) -€11 874 to -€1939). The mean difference in effectiveness was -0·07 (95 per cent CrI -0·27 to 0·16) QALYs. ER was associated with an additional €91 600 per QALY gained compared with SET. One-way sensitivity analysis indicated more favourable cost-effectiveness for ER in subsets of patients with low quality-of-life scores at baseline. SET is a more cost-effective primary treatment for intermittent claudication than ER. These results support implementation of supervised exercise programmes in clinical practice. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Validation of a novel wearable, wireless technology to estimate oxygen levels and lactate threshold power in the exercising muscle.

PubMed

Farzam, Parisa; Starkweather, Zack; Franceschini, Maria A

2018-04-01

There is a growing interest in monitoring muscle oxygen saturation (SmO 2 ), which is a localized measure of muscle oxidative metabolism and can be acquired continuously and noninvasively using near-infrared spectroscopy (NIRS) methods. Most NIRS systems are cumbersome, expensive, fiber coupled devices, with use limited to lab settings. A novel, low cost, wireless, wearable has been developed for use in athletic training. In this study, we evaluate the advantages and limitations of this new simple continuous-wave (CW) NIRS device with respect to a benchtop, frequency-domain near-infrared spectroscopy (FDNIRS) system. Oxygen saturation and hemoglobin/myoglobin concentration in the exercising muscles of 17 athletic individuals were measured simultaneously with the two systems, while subjects performed an incremental test on a stationary cycle ergometer. In addition, blood lactate concentration was measured at the end of each increment with a lactate analyzer. During exercise, the correlation coefficients of the SmO 2 and hemoglobin/myoglobin concentrations between the two systems were over 0.70. We also found both systems were insensitive to the presence of thin layers of varying absorption, mimicking different skin colors. Neither system was able to predict the athletes' lactate threshold power accurately by simply using SmO 2 thresholds. Instead, the proprietary software of the wearable device was able to predict the athletes' lactate threshold power within half of one power increment of the cycling test. These results indicate this novel wearable device may provide a physiological indicator of athlete's exertion. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Effect of hyperventilation on rate corrected QT interval of children.

PubMed

Kannivelu, Arivalagan; Kudumula, Vikram; Bhole, Vinay

2013-02-01

Hyperventilation is known to cause ST segment changes and QT variability in adults, but this has not been systematically studied in children. To investigate the effect of hyperventilation on rate corrected QT interval (QTc) in children. 25 children (male=10) with a median age of 14 (range 8.3-17.6) years were asked to hyperventilate for 1 min before exercise testing using the modified Bruce protocol. Mean QTc at rest, after hyperventilation, at peak exercise and at 1 min of recovery was 425(±31), 460(±30), 446(±38) and 420(±32) ms, respectively. Mean increase (95% CI) in QTc after hyperventilation was 35(19 to 51) ms (p<0.001), while there was minimal difference between QT interval at rest and after hyperventilation (mean QT 352(±41) vs 357(±44) ms). In six children, there were abnormalities in T wave morphology following hyperventilation. The QTc increment following hyperventilation was more pronounced in children with resting QTc <440 ms (n=14, mean increment (95% CI): 55 (33 to 78) ms) compared to children with QTc ≥440 ms (n=11, mean increment (95% CI): 9 (-4 to 22) ms) (p=0.001). QTc prolongation following hyperventilation was seen in children with both low and intermediate probability of long QT syndrome (LQTS). Peak exercise and early recovery did not cause a statistically significant change in QTc in either of these groups. Hyperventilation produces repolarisation abnormalities, including prolongation of QTc and T wave abnormalities in children with low probability of LQTS. The likely mechanism is delayed adaptation of QT interval with increased heart rate. Thus, a hyperventilation episode can be misdiagnosed as LQTS, especially in an emergency department.

Exercise capacity and progression from prehypertension to hypertension.

PubMed

Faselis, Charles; Doumas, Michael; Kokkinos, John Peter; Panagiotakos, Demosthenes; Kheirbek, Raya; Sheriff, Helen M; Hare, Katherine; Papademetriou, Vasilios; Fletcher, Ross; Kokkinos, Peter

2012-08-01

Prehypertension is likely to progress to hypertension. The rate of progression is determined mostly by age and resting blood pressure but may also be attenuated by increased fitness. A graded exercise test was performed in 2303 men with prehypertension at the Veterans Affairs Medical Centers in Washington, DC. Four fitness categories were defined, based on peak metabolic equivalents (METs) achieved. We assessed the association between exercise capacity and rate of progression to hypertension (HTN). The median follow-up period was 7.8 years (mean (± SD) 9.2±6.1 years). The incidence rate of progression from prehypertension to hypertension was 34.4 per 1000 person-years. Exercise capacity was a strong and independent predictor of the rate of progression. Compared to the High-Fit individuals (>10.0 METs), the adjusted risk for developing HTN was 66% higher (hazard ratio, 1.66; 95% CI, 1.2 to 2.2; P=0.001) for the Low-Fit and, similarly, 72% higher (hazard ratio, 1.72; 95% CI, 1.2 to 2.3; P=0.001) for the Least-Fit individuals, whereas it was only 36% for the Moderate-Fit (hazard ratio, 1.36; 95% CI, 0.99 to 1.80; P=0.056). Significant predictors for the progression to HTN were also age (19% per 10 years), resting systolic blood pressure (16% per 10 mm Hg), body mass index (15.3% per 5 U), and type 2 diabetes mellitus (2-fold). In conclusion, an inverse, S-shaped association was shown between exercise capacity and the rate of progression from prehypertension to hypertension in middle-aged and older male veterans. The protective effects of fitness were evident when exercise capacity exceeded 8.5 METs. These findings emphasize the importance of fitness in the prevention of hypertension.

Low intensity aerobic exercise and oxidative stress markers in older adults.

PubMed

Bouzid, Mohamed A; Hammouda, Omar; Matran, Régis; Robin, Sophie; Fabre, Claudine

2014-10-01

This comparative study examined the effects of regular low intensity aerobic exercise on oxidative stress markers in older adults. The study was carried out on 15 sedentary subjects (age: 65.1 ± 3.5 years) versus 18 subjects performing fitness exercises (age: 65.8 ± 3.3 years). Before and after an incremental exercise test, oxidative stress markers were assessed. Superoxide dismutase was higher at rest and at the recovery for the physically active subjects compared with sedentary subjects (p < .05). At recovery, glutathione peroxidase and α -Tocopherol increased significantly above the resting values only in the active group (p < .05). Malondialdehyde had increased in both groups (p < .01), associated with a higher level in the sedentary group (p < .05) at the recovery. These data suggest that low intensity aerobic exercise may be useful to prevent the decline of antioxidants linked with aging.

[Exercise-related risk at anaerobic threshold in patients with chronic obstructive pulmonary disease].

PubMed

Xu, Q F; Yuan, W; Zhao, X J; Li, B; Wang, H Y

2016-02-01

To investigate the exercise-related risk at anaerobic threshold(AT) in patients with chronic obstructive pulmonary disease(COPD). Sixty two patients [men 56, women 6, aged (66±8) yr] with stable COPD in Beijing Friendship Hospital during 2013-2014, participated in this study. Incremental symptom-limited cardiopulmonary exercise test was performed on cycle ergometer. The AT was determined using the V-Slope technique and ventilatory equivalents for carbon dioxide and oxygen. Symptoms, 10-lead electrocardiogram, oxygen saturation by pulse oximetry(SpO(2)) were monitored during exercise. The AT, detectable in 53 patients, occurred at (68±10)% of peak oxygen uptake(peak VO(2)). The SpO(2) was in the safe range (94±2) % and the respiratory reserve was relatively high at AT (i.e. 48%). High-intensity exercise training can be performed in patients with moderate-to- severe COPD without resting oxygen desaturation.

[Application of the 6-Minute Walking Test and Shuttle Walking Test in the Exercise Tests of Patients With COPD].

PubMed

Ho, Chiung-Fang; Maa, Suh-Hwa

2016-08-01

Exercise training improves the management of stable chronic obstructive pulmonary disease (COPD). COPD patients benefit from exercise training programs in terms of improved VO2 peak values and decreased dyspnea, fatigue, hospital admissions, and rates of mortality, increasing exercise capacity and health-related quality of life (HRQOL). COPD is often associated with impairment in exercise tolerance. About 51% of patients have a limited capacity for normal activity, which often further degrades exercise capacity, creating a vicious circle. Exercise testing is highly recommended to assess a patient's individualized functions and limitations in order to determine the optimal level of training intensity prior to initiating an exercise-training regimen. The outcomes of exercise testing provide a powerful indicator of prognosis in COPD patients. The six-minute walking test (6MWT) and the incremental shuttle-walking test (ISWT) are widely used in exercise testing to measure a patient's exercise ability by walking distances. While nursing-related articles published in Taiwan frequently cite and use the 6MWT to assess exercise capacity in COPD patients, the ISWT is rarely used. This paper introduces the testing method, strengths and weaknesses, and application of the two tests in order to provide clinical guidelines for assessing the current exercise capacity of COPD patients.

Correlation of gas exchange threshold and first muscle oxyhemoglobin inflection point with time-to-exhaustion during heavy-intensity exercise.

PubMed

Coquart, Jérémy B; Mucci, Patrick; L'hermette, Maxime; Chamari, Karim; Tourny, Claire; Garcin, Murielle

2017-03-01

The twofold aim of the study was to: 1) compare the gas exchange threshold (GET), the first oxyhemoglobin inflection point ([O2Hb]-T), and perceptual threshold as determined during an incremental exercise test, and 2) investigate the link between each threshold and time-to-exhaustion during heavy intensity exercise. Fourteen competitive cyclists performed an incremental exercise test to exhaustion on a cycloergometer to determine the different thresholds and peak workload (Wpeak). The participants then performed a sub-maximal constant workload test (90% Wpeak) to exhaustion to determine time-to-exhaustion. The thresholds were identified from: 1) the first breakpoint in the oxygen uptake vs. carbon dioxide output curve (GET), 2) the [O2Hb]-T, and 3) a rating of 13 in perceived exertion (perceptual threshold: RPE13-T). Oxygen uptake at the different thresholds was not significantly different (P>0.05). Moreover, GET and [O2Hb]-T were significantly correlated: 1) to each other (r≥0.79; P≤0.001), and 2) to time-to-exhaustion (r=0.81 and r=0.72, respectively; P<0.01). RPE13-T, however, was not significantly correlated with the time-to-exhaustion (P=0.148). The anaerobic threshold as identified from GET was concomitant to [O2Hb]-T. Both thresholds were correlated to time-to-exhaustion, and could therefore be used as a performance index in middle-duration events.

Effects of exercise on fitness and cognition in progressive MS: a randomized, controlled pilot trial.

PubMed

Briken, S; Gold, S M; Patra, S; Vettorazzi, E; Harbs, D; Tallner, A; Ketels, G; Schulz, K H; Heesen, C

2014-03-01

Exercise may have beneficial effects on both well-being and walking ability in multiple sclerosis (MS). Exercise is shown to be neuroprotective in rodents and may also enhance cognitive function in humans. It may, therefore, be particularly useful for MS patients with pronounced neurodegeneration. To investigate the potential of standardized exercise as a therapeutic intervention for progressive MS, in a randomized-controlled pilot trial. Patients with progressive MS and moderate disability (Expanded Disability Status Scale (EDSS) of 4-6) were randomized to one of three exercise interventions (arm ergometry, rowing, bicycle ergometry) for 8-10 weeks or a waitlist control group. We analyzed the drop-out rate as a measure of feasibility. The primary endpoint of the study was aerobic fitness. Secondary endpoints were walking ability, cognitive function as measured by a neuropsychological test battery, depression and fatigue. A total of 42 patients completed the trial (10.6% drop-out rate). Significant improvements were seen in aerobic fitness. In addition, exercise improved walking ability, depressive symptoms, fatigue and several domains of cognitive function. This study indicated that aerobic training is feasible and could be beneficial for patients with progressive MS. Larger exercise studies are needed to confirm the effect on cognition. ISRCTN (trial number 76467492) http://isrctn.org.

Anaerobic threshold: review of the concept and directions for future research.

PubMed

Davis, J A

1985-02-01

Although the term anaerobic threshold was introduced 20 years ago, the concept that an exercise-induced lactic acidosis occurs at a particular oxygen uptake which varies among subjects is over 50 years old. The surge of new interest in the parameter relates to its strong relationship to prolonged exercise performance. The average marathon running speed has been shown to be closely related to the running speed at the anaerobic threshold. Numerous studies have shown that the parameter can be validly measured during incremental exercise from the gas exchange consequences of the increased carbon dioxide and hydrogen ion levels in blood resulting from bicarbonate buffering of lactic acid. Refinement of the noninvasive detection scheme has made the parameter attractive to investigators in preventative, rehabilitative, and occupational medicine and to researchers in the exercise sciences. Controversy exists regarding the specific cause for the onset of exercise-induced metabolic acidosis. As experimentation continues to unravel the mechanisms of lactate production and ventilatory control during exercise, the anaerobic threshold concept can be further evaluated.

Economic evaluation of an exercise-counselling intervention to enhance smoking cessation outcomes: The Fit2Quit trial.

PubMed

Leung, William; Roberts, Vaughan; Gordon, Louisa G; Bullen, Christopher; McRobbie, Hayden; Prapavessis, Harry; Jiang, Yannan; Maddison, Ralph

2017-01-01

In the Fit2Quit randomised controlled trial, insufficiently-active adult cigarette smokers who contacted Quitline for support to quit smoking were randomised to usual Quitline support or to also receive ≤10 face-to-face and telephone exercise-support sessions delivered by trained exercise facilitators over the 24-week trial. This paper aims to determine the cost-effectiveness of an exercise-counselling intervention added to Quitline compared to Quitline alone in the Fit2Quit trial. Within-trial and lifetime cost-effectiveness were assessed. A published Markov model was adapted, with smokers facing increased risks of lung cancer and cardiovascular disease. Over 24 weeks, the incremental programme cost per participant in the intervention was NZ$428 (US$289 or €226; purchasing power parity-adjusted [PPP]). The incremental cost-effectiveness ratio (ICER) for seven-day point prevalence measured at 24-week follow-up was NZ$31,733 (US$21,432 or €16,737 PPP-adjusted) per smoker abstaining. However, for the 52% who adhered to the intervention (≥7 contacts), the ICER for point prevalence was NZ$3,991 (US$2,695 or €2,105 PPP-adjusted). In this adherent subgroup, the Markov model estimated 0.057 and 0.068 discounted quality-adjusted life-year gains over the lifetime of 40-year-old males (ICER: NZ$4,431; US$2,993 or €2,337 PPP-adjusted) and females (ICER: NZ$2,909; US$1,965 or €1,534 PPP-adjusted). The exercise-counselling intervention will only be cost-effective if adherence is a minimum of ≥7 intervention calls, which in turn leads to a sufficient number of quitters for health gains. Australasian Clinical Trials Registry Number ACTRN12609000637246.

Emergency department triage strategies for acute chest pain using creatine kinase-MB and troponin I assays: a cost-effectiveness analysis.

PubMed

Polanczyk, C A; Kuntz, K M; Sacks, D B; Johnson, P A; Lee, T H

1999-12-21

Evaluation of acute chest pain is highly variable. To evaluate the cost-effectiveness of strategies using cardiac markers and noninvasive tests for myocardial ischemia. Cost-effectiveness analysis. Prospective data from 1066 patients with chest pain and from the published literature. Patients admitted with acute chest pain. Lifetime. Societal. Creatine kinase (CK)-MB mass assay alone; CK-MB mass assay followed by cardiac troponin I assay if the CK-MB value is normal; CK-MB mass assay followed by troponin I assay if the CK-MB value is normal and electrocardiography shows ischemic changes; both CK-MB mass and troponin I assays; and troponin I assay alone. These strategies were evaluated alone or in combination with early exercise testing. Lifetime cost, life expectancy (in years), and incremental cost-effectiveness. For patients 55 to 64 years of age, measurement of CK-MB mass followed by exercise testing in appropriate patients was the most competitive strategy ($43000 per year of life saved). Measurement of CK-MB mass followed by troponin I measurement had an incremental cost-effectiveness ratio of $47400 per year of life saved for patients 65 to 74 years of age; it was also the most cost-effective strategy when early exercise testing could not be performed, CK-MB values were normal, and ischemic changes were seen on electrocardiography. Results were influenced by age, probability of myocardial infarction, and medical costs. Measurement of CK-MB mass plus early exercise testing is a cost-effective initial strategy for younger patients and those with a low to moderate probability of myocardial infarction. Troponin I measurement can be a cost-effective second test in higher-risk subsets of patients if the CK-MB level is normal and early exercise testing is not an option.

Cost-effectiveness of coronary artery disease screening in asymptomatic patients with type 2 diabetes and other atherogenic risk factors in Japan: factors influencing on international application of evidence-based guidelines.

PubMed

Hayashino, Yasuaki; Shimbo, Takuro; Tsujii, Satoru; Ishii, Hitoshi; Kondo, Hirokazu; Nakamura, Tsukasa; Nagata-Kobayashi, Shizuko; Fukui, Tsuguya

2007-05-16

Screening for coronary artery disease (CAD) in asymptomatic diabetic patients with atherogenic risk factors is recommended by the American College of Cardiology/American Diabetes Association. It is not clear whether these guidelines apply to the Japanese population with a different epidemiology of CAD. This study evaluates the applicability of the U.S. guidelines to Japan, taking account of cost-effectiveness. A cost-effectiveness analysis using a Markov model was performed to measure the clinical benefit and cost of CAD screening in asymptomatic patients with diabetes and additional atherogenic risk factors. We evaluated cohorts of patients stratified by age, gender, and atherogenic risks. The incremental cost-effectiveness of not screening, exercise electrocardiography, exercise echocardiography, and exercise single-photon emission-tomography (SPECT) was calculated. The data used were obtained from the literature. Outcomes are expressed as US dollars per quality-adjusted life year (QALY). Compared with not screening, the incremental cost-effectiveness ratio (ICER) of exercise electrocardiography was $31,400/QALY for 60-year-old asymptomatic diabetic men, and 46,600 for 65-year-old women with hypertension and smoking. The ICER of exercise echocardiography was $31,500/QALY and of SPECT was $326,000/QALY, compared with the next dominant strategy. Sensitivity analyses found that these results varied according to age, gender, the combination of additional atherogenic risk factors, and the frequency of screening. From a societal perspective the U.S. guidelines on screening for CAD in high risk diabetic patients are applicable to the Japanese population. However, the population subjected to screening should be carefully selected to obtain greatest benefit from screening.

Incremental value of Veterans Specific Activity Questionnaire and the YMCA-step test for the assessment of cardiorespiratory fitness in population-based studies.

PubMed

Teren, Andrej; Zachariae, Silke; Beutner, Frank; Ubrich, Romy; Sandri, Marcus; Engel, Christoph; Löffler, Markus; Gielen, Stephan

2016-07-01

Cardiorespiratory fitness is a well-established independent predictor of cardiovascular health. However, the relevance of alternative exercise and non-exercise tests for cardiorespiratory fitness assessment in large cohorts has not been studied in detail. We aimed to evaluate the YMCA-step test and the Veterans Specific Activity Questionnaire (VSAQ) for the estimation of cardiorespiratory fitness in the general population. One hundred and five subjects answered the VSAQ, performed the YMCA-step test and a maximal cardiopulmonary exercise test (CPX) and gave BORG ratings for both exercise tests (BORGSTEP, BORGCPX). Correlations of peak oxygen uptake on a treadmill (VO2_PEAK) with VSAQ, BORGSTEP, one-minute, post-exercise heartbeat count, and peak oxygen uptake during the step test (VO2_STEP) were determined. Moreover, the incremental values of the questionnaire and the step test in addition to other fitness-related parameters were evaluated using block-wise hierarchical regression analysis. Eighty-six subjects completed the step test according to the protocol. For completers, correlations of VO2_PEAK with the age- and gender-adjusted VSAQ, heartbeat count and VO2_STEP were 0.67, 0.63 and 0.49, respectively. However, using hierarchical regression analysis, age, gender and body mass index already explained 68.8% of the variance of VO2_PEAK, while the additional benefit of VSAQ was rather low (3.4%). The inclusion of BORGSTEP, heartbeat count and VO2_STEP increased R(2) by a further 2.2%, 3.3% and 5.6%, respectively, yielding a total R(2) of 83.3%. Neither VSAQ nor the YMCA-step test contributes sufficiently to the assessment of cardiorespiratory fitness in population-based studies. © The European Society of Cardiology 2015.

Influence of dietary nitrate supplementation on physiological and muscle metabolic adaptations to sprint interval training

PubMed Central

Thompson, Christopher; Wylie, Lee J.; Blackwell, Jamie R.; Fulford, Jonathan; Black, Matthew I.; Kelly, James; McDonagh, Sinead T. J.; Carter, James; Bailey, Stephen J.; Vanhatalo, Anni

2017-01-01

We hypothesized that 4 wk of dietary nitrate supplementation would enhance exercise performance and muscle metabolic adaptations to sprint interval training (SIT). Thirty-six recreationally active subjects, matched on key variables at baseline, completed a series of exercise tests before and following a 4-wk period in which they were allocated to one of the following groups: 1) SIT and NO3−-depleted beetroot juice as a placebo (SIT+PL); 2) SIT and NO3−-rich beetroot juice (~13 mmol NO3−/day; SIT+BR); or 3) no training and NO3−-rich beetroot juice (NT+BR). During moderate-intensity exercise, pulmonary oxygen uptake was reduced by 4% following 4 wk of SIT+BR and NT+BR (P < 0.05) but not SIT+PL. The peak work rate attained during incremental exercise increased more in SIT+BR than in SIT+PL (P < 0.05) or NT+BR (P < 0.001). The reduction in muscle and blood [lactate] and the increase in muscle pH from preintervention to postintervention were greater at 3 min of severe-intensity exercise in SIT+BR compared with SIT+PL and NT+BR (P < 0.05). However, the change in severe-intensity exercise performance was not different between SIT+BR and SIT+PL (P > 0.05). The relative proportion of type IIx muscle fibers in the vastus lateralis muscle was reduced in SIT+BR only (P < 0.05). These findings suggest that BR supplementation may enhance some aspects of the physiological adaptations to SIT. NEW & NOTEWORTHY We investigated the influence of nitrate-rich and nitrate-depleted beetroot juice on the muscle metabolic and physiological adaptations to 4 wk of sprint interval training. Compared with placebo, dietary nitrate supplementation reduced the O2 cost of submaximal exercise, resulted in greater improvement in incremental (but not severe-intensity) exercise performance, and augmented some muscle metabolic adaptations to training. Nitrate supplementation may facilitate some of the physiological responses to sprint interval training. PMID:27909231

Objectivity and validity of EMG method in estimating anaerobic threshold.

PubMed

Kang, S-K; Kim, J; Kwon, M; Eom, H

2014-08-01

The purposes of this study were to verify and compare the performances of anaerobic threshold (AT) point estimates among different filtering intervals (9, 15, 20, 25, 30 s) and to investigate the interrelationships of AT point estimates obtained by ventilatory threshold (VT) and muscle fatigue thresholds using electromyographic (EMG) activity during incremental exercise on a cycle ergometer. 69 untrained male university students, yet pursuing regular exercise voluntarily participated in this study. The incremental exercise protocol was applied with a consistent stepwise increase in power output of 20 watts per minute until exhaustion. AT point was also estimated in the same manner using V-slope program with gas exchange parameters. In general, the estimated values of AT point-time computed by EMG method were more consistent across 5 filtering intervals and demonstrated higher correlations among themselves when compared with those values obtained by VT method. The results found in the present study suggest that the EMG signals could be used as an alternative or a new option in estimating AT point. Also the proposed computing procedure implemented in Matlab for the analysis of EMG signals appeared to be valid and reliable as it produced nearly identical values and high correlations with VT estimates. © Georg Thieme Verlag KG Stuttgart · New York.

Are there sex differences in the capillary blood volume and diffusing capacity response to exercise?

PubMed

Bouwsema, Melissa M; Tedjasaputra, Vincent; Stickland, Michael K

2017-03-01

Previous work suggests that women may exhibit a greater respiratory limitation in exercise compared with height-matched men. Diffusion capacity (Dl CO ) increases with incremental exercise, and the smaller lungs of women may limit membrane diffusing capacity (Dm) and pulmonary capillary blood volume (Vc) in response to the increased oxygen demand. We hypothesized that women would have lower Dl CO , Dl CO relative to cardiac output (Dl CO /Q̇), Dm, Vc, and pulmonary transit time, secondary to lower Vc at peak exercise. Sixteen women (112 ± 12% predicted relative V̇o 2peak ) and sixteen men (118 ± 22% predicted relative V̇o 2peak ) were matched for height and weight. Hemoglobin-corrected diffusing capacity (Dl CO ), Vc, and Dm were determined via the multiple-[Formula: see text] Dl CO technique at rest and during incremental exercise up to 90% of V̇o 2peak Both groups increased Dl CO , Vc, and Dm with exercise intensity, but women had 20% lower Dl CO ( P < 0.001), 18% lower Vc ( P = 0.002), and 22% lower Dm ( P < 0.001) compared with men across all workloads, and neither group exhibited a plateau in Vc. When expressed relative to alveolar volume (Va), the between-sex difference was eliminated. The drop in Dl CO /Q̇ was proportionally less in women than men, and mean pulmonary transit time did not drop below 0.3 s in either group. Women demonstrate consistently lower Dl CO , Vc, and Dm compared with height-matched men during exercise; however, these differences disappear with correction for lung size. These results suggest that after differences in lung volume are accounted for there is no intrinsic sex difference in the Dl CO , Vc, or Dm response to exercise. NEW & NOTEWORTHY Women demonstrate lower diffusing capacity-to-cardiac output ratio (Dl CO /Q̇), pulmonary capillary blood volume (Vc), and membrane diffusing capacity (Dm) compared with height-matched men during exercise. However, these differences disappear after correction for lung size. The drop in Dl CO /Q̇ was proportionally less in women, and pulmonary transit time did not drop below 0.3 s in either group. After differences in lung volume are accounted for, there is no intrinsic sex difference in Dl CO , Vc, or Dm response to exercise. Copyright © 2017 the American Physiological Society.

Elastic band prediction equations for combined free-weight and elastic band bench presses and squats.

PubMed

Shoepe, Todd C; Ramirez, David A; Almstedt, Hawley C

2010-01-01

Elastic bands added to traditional free-weight techniques have become a part of suggested training routines in recent years. Because of the variable loading patterns of elastic bands (i.e., greater stretch produces greater resistance), it is necessary to quantify the exact loading patterns of bands to identify the volume and intensity of training. The purpose of this study was to determine the length vs. tension properties of multiple sizes of a set of commonly used elastic bands to quantify the resistance that would be applied to free-weight plus elastic bench presses (BP) and squats (SQ). Five elastic bands of varying thickness were affixed to an overhead support beam. Dumbbells of varying weights were progressively added to the free end while the linear deformation was recorded with each subsequent weight increment. The resistance was plotted as a factor of linear deformation, and best-fit nonlinear logarithmic regression equations were then matched to the data. For both the BP and SQ loading conditions and all band thicknesses tested, R values were greater than 0.9623. These data suggest that differences in load exist as a result of the thickness of the elastic band, attachment technique, and type of exercise being performed. Facilities should adopt their own form of loading quantification to match their unique set of circumstances when acquiring, researching, and implementing elastic band and free-weight exercises into the training programs.

Thermoregulatory, cardiovascular, and perceptual responses to intermittent cooling during exercise in a hot, humid outdoor environment.

PubMed

Cleary, Michelle A; Toy, Michelle G; Lopez, Rebecca M

2014-03-01

Decreasing core body temperature during exercise may improve exercise tolerance, facilitate acclimatization, and prevent heat illness during summer training. We sought to evaluate the effectiveness of intermittent superficial cooling on thermoregulatory, cardiovascular, and perceptual responses during exercise in a hot humid environment. We used a randomized, counterbalanced, repeated measures investigation with 2 conditions (control and cooling) during exercise and recovery outdoors on artificial turf in a hot, humid tropical climate in the sun (wet bulb globe temperature outdoors [WBGTo], 27.0 ± 0.8° C; range, 25.8-28.1° C) and in the shade (WBGTo, 25.4 ± 0.9° C; range, 24.3-26.8° C). Participants were 10 healthy males (age, 22.6 ± 1.6 years; height, 176.0 ± 6.9 cm; mass, 76.5 ± 7.8 kg; body fat, 15.6 ± 5.4%) who wore shorts and T-shirt (control) or "phase change cooling" vest (cooling) during 5-minute rest breaks during 60 minutes of intense American football training and conditioning exercises in the heat and 30 minutes of recovery in the shade. Throughout, we measured core (Tgi) and skin (Tchest) temperature, heart rate (HR), thermal and thirst sensations, and rating of perceived exertion. We found significant (p ≤ 0.001) hypohydration (-2.1%); for Tgi, we found no significant differences between conditions (p = 0.674) during exercise and progressive decreases during recovery (p < 0.001). For [INCREMENT]Tg,i we found no significant (p = 0.090) differences. For Tchest, we found significantly (p < 0.001) decreased skin temperature in the cooling condition (Tchest, 31.85 ± 0.43° C) compared with the control condition (Tchest, 34.38 ± 0.43° C) during exercise and significantly (p < 0.001) lower skin temperature in the cooling condition (Tchest, 31.24 ± 0.47° C) compared with the control condition (Tchest, 33.48 ± 0.47° C) during recovery. For HR, we found no significant difference (p = 0.586) between the conditions during exercise; however, we did find significantly (p < 0.001) lower HR during recovery. Thermal sensations were significantly (p = 0.026) decreased in the cooling (4.4 ± 0.2 points) compared with the control (5.0 ± 0.2 points) condition but not for other perceptual responses. The cooling effects of "phase change cooling" material were effective in reducing skin temperature but did not sufficiently reduce core body temperature or cardiovascular strain.

Progressive exercise preconditioning protects against circulatory shock during experimental heatstroke.

PubMed

Hung, Ching-Hsia; Chang, Nen-Chung; Cheng, Bor-Chih; Lin, Mao-Tsun

2005-05-01

Heat shock protein (HSP) 72 expression protects against arterial hypotension in rat heatstroke. HSP72 can also be induced in multiple organs, including hearts from rats with endurance exercise. We validated the hypothesis that progressive exercise preconditioning may confer cardiovascular protection during heatstroke by inducing the overexpression of HSP72 in multiple organs. To deal with the matter, we assessed the effects of heatstroke on mean arterial pressure, heart rate, cardiac output, stroke volume, total peripheral vascular resistance, colonic temperature, blood gases, and serum or tissue levels of tumor necrosis factor-alpha (TNF-alpha) in urethane-anesthetized rats pretreated without or with progressive exercise training for 1, 2, or 3 weeks. In addition, HSP72 expression in multiple organs was determined in different groups of animals. Heatstroke was induced by exposing the rats to a high blanket temperature (43 degrees C); the moment at which mean arterial pressure decreased from the peak value was taken as the time of heatstroke onset. Previous exercise training for 3 weeks, but not 1 or 2 weeks, conferred significant protection against hyperthermia, arterial hypotension, decreased cardiac output, decreased stroke volume, decreased peripheral vascular resistance, and increased levels of serum or tissue TNF-alpha during heatstroke and correlated with overexpression of HSP72 in multiple organs, including heart, liver, and adrenal gland. However, 10 days after 3 weeks of progressive exercise training, when HSP72 expression in multiple organs returned to basal values, the beneficial effects exerted by 3 weeks of exercise training were no longer observed. These results strongly suggest that HSP72 preconditioning with progressive exercise training protects against hyperthermia, circulatory shock, and TNF-alpha overproduction during heatstroke.

The higher exercise intensity and the presence of allele I of ACE gene elicit a higher post-exercise blood pressure reduction and nitric oxide release in elderly women: an experimental study.

PubMed

Santana, Hugo A P; Moreira, Sérgio R; Neto, Willson B; Silva, Carla B; Sales, Marcelo M; Oliveira, Vanessa N; Asano, Ricardo Y; Espíndola, Foued S; Nóbrega, Otávio T; Campbell, Carmen S G; Simões, Herbert G

2011-12-02

The absence of the I allele of the angiotensin converting enzyme (ACE) gene has been associated with higher levels of circulating ACE, lower nitric oxide (NO) release and hypertension. The purposes of this study were to analyze the post-exercise salivary nitrite (NO2-) and blood pressure (BP) responses to different exercise intensities in elderly women divided according to their ACE genotype. Participants (n = 30; II/ID = 20 and DD = 10) underwent three experimental sessions: incremental test - IT (15 watts workload increase/3 min) until exhaustion; 20 min exercise 90% anaerobic threshold (90% AT); and 20 min control session without exercise. Volunteers had their BP and NO2- measured before and after experimental sessions. Despite both intensities showed protective effect on preventing the increase of BP during post-exercise recovery compared to control, post-exercise hypotension and increased NO2- release was observed only for carriers of the I allele (p < 0.05). Genotypes of the ACE gene may exert a role in post-exercise NO release and BP response.

Flight Rules Critical Readiness Review

NASA Technical Reports Server (NTRS)

Kim, E.; Knudsen, F.; Rice, S.

2010-01-01

The increment 23/24 Critical Readiness Review (CRR) flight rules are presented. The topics include: 1) B13-152 Acoustic Constraints; 2) B13-113 IFM/Corrective Action Prioritization Due to Loss of Exercise Capability; 3) B13-116 Constraints on Treadmill VIS Failure; 4) B13-201 Medical Management of ISS Fire/Smoke Response; 5) ARED and T2 Exercise constraints Flight rules (flight and stage specific); 6) FYI: B14 FR to be updated with requirement to sample crew sleep locations prior to receiving a "recommendation" from SRAG on where to sleep.

Physiological exercise loading suppresses post-traumatic osteoarthritis progression via an increase in bone morphogenetic proteins expression in an experimental rat knee model.

PubMed

Iijima, H; Ito, A; Nagai, M; Tajino, J; Yamaguchi, S; Kiyan, W; Nakahata, A; Zhang, J; Wang, T; Aoyama, T; Nishitani, K; Kuroki, H

2017-06-01

To evaluate the dose-response relationship of exercise loading in the cartilage-subchondral bone (SB) unit in surgically-induced post-traumatic osteoarthritis (PTOA) of the knee. Destabilized medial meniscus (DMM) surgery was performed on the right knee of 12-week-old male Wistar rats, and sham surgery was performed on the contralateral knee. Four weeks after the surgery, the animals were subjected to moderate (12 m/min) or intense (21 m/min) treadmill exercises for 30 min/day, 5 days/week for 4 weeks. PTOA development in articular cartilage and SB was examined using histological and immunohistochemical analyses, micro-computed tomography (micro-CT) analysis, and biomechanical testing at 8 weeks after surgery. Gremlin-1 was injected to determine the role of bone morphogenetic protein (BMP) signaling on PTOA development following moderate exercise. Moderate exercise increased BMP-2, BMP-4, BMP-6, BMP receptor 2, pSmad-5, and inhibitor of DNA binding protein-1 expression in the superficial zone chondrocytes and suppressed cartilage degeneration, osteophyte growth, SB damage, and osteoclast-mediated SB resorption. However, intense exercise had little effect on BMP expression and even caused progression of these osteoarthritis (OA) changes. Gremlin-1 injection following moderate exercise caused progression of the PTOA development down to the level of the non-exercise DMM-operated knee. Exercise regulated cartilage-SB PTOA development in DMM-operated knees in a dose-dependent manner. Our findings shed light on the important role of BMP expression in superficial zone chondrocytes in attenuation of PTOA development following physiological exercise loading. Further studies to support a mechanism by which BMPs would be beneficial in preventing PTOA progression are warranted. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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

PubMed

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

2015-11-01

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˙O2max and 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.

First- and Second-Line Bevacizumab in Addition to Chemotherapy for Metastatic Colorectal Cancer: A United States–Based Cost-Effectiveness Analysis

PubMed Central

Goldstein, Daniel A.; Chen, Qiushi; Ayer, Turgay; Howard, David H.; Lipscomb, Joseph; El-Rayes, Bassel F.; Flowers, Christopher R.

2015-01-01

Purpose The addition of bevacizumab to fluorouracil-based chemotherapy is a standard of care for previously untreated metastatic colorectal cancer. Continuation of bevacizumab beyond progression is an accepted standard of care based on a 1.4-month increase in median overall survival observed in a randomized trial. No United States–based cost-effectiveness modeling analyses are currently available addressing the use of bevacizumab in metastatic colorectal cancer. Our objective was to determine the cost effectiveness of bevacizumab in the first-line setting and when continued beyond progression from the perspective of US payers. Methods We developed two Markov models to compare the cost and effectiveness of fluorouracil, leucovorin, and oxaliplatin with or without bevacizumab in the first-line treatment and subsequent fluorouracil, leucovorin, and irinotecan with or without bevacizumab in the second-line treatment of metastatic colorectal cancer. Model robustness was addressed by univariable and probabilistic sensitivity analyses. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Results Using bevacizumab in first-line therapy provided an additional 0.10 QALYs (0.14 life-years) at a cost of $59,361. The incremental cost-effectiveness ratio was $571,240 per QALY. Continuing bevacizumab beyond progression provided an additional 0.11 QALYs (0.16 life-years) at a cost of $39,209. The incremental cost-effectiveness ratio was $364,083 per QALY. In univariable sensitivity analyses, the variables with the greatest influence on the incremental cost-effectiveness ratio were bevacizumab cost, overall survival, and utility. Conclusion Bevacizumab provides minimal incremental benefit at high incremental cost per QALY in both the first- and second-line settings of metastatic colorectal cancer treatment. PMID:25691669

The Spectrum of Intermediate Syndrome Following Acute Organophosphate Poisoning: A Prospective Cohort Study from Sri Lanka

PubMed Central

Jayawardane, Pradeepa; Dawson, Andrew H; Weerasinghe, Vajira; Karalliedde, Lakshman; Buckley, Nicholas A; Senanayake, Nimal

2008-01-01

Background Intermediate syndrome (IMS) is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS) predictors of IMS that would assist in patient management and clinical research. Methods and Findings Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively with daily physical examination and RNS. RNS was done on the right and left median and ulnar nerves at 1, 3, 10, 15, 20, and 30 Hz. The study was conducted as a prospective observational cohort study in the Central Province, Sri Lanka. IMS was diagnosed in ten out of 78 patients using a priori clinical diagnostic criteria, and five of them developed respiratory failure. All ten patients showed progressive RNS changes correlating with the severity of IMS. A decrement-increment was observed at intermediate and high frequencies preceding the onset of clinical signs of IMS. As the patient developed clinical signs of IMS, decrement-increment was progressively noted at low and intermediate frequencies and a combination of decrement-increment and repetitive fade or severe decrement was noted at high frequencies. Severe decrement preceded respiratory failure in four patients. Thirty patients developed forme fruste IMS with less severe weakness not progressing to respiratory failure whose RNS was characterized by decrement-increment or a combination of decrement-increment and repetitive fade but never severe decrements. Conclusions Characteristic changes in RNS, preceding the development of IMS, help to identify a subgroup of patients at high risk of developing respiratory failure. The forme fruste IMS with the characteristic early changes on RNS indicates that IMS is a spectrum disorder. RNS changes are objective and precede the diagnosis and complications of IMS. Thus they may be useful in clinical management and research. PMID:18630983

Exercise-induced changes in enzymatic O-methylation of catecholestrogens by erythrocytes of eumenorrheic women.

PubMed

De Crée, C; Van Kranenburg, G; Geurten, P; Fujimura, Y; Keizer, H A

1997-12-01

The present study was designed to assess the effects of acute exercise and short-term intensive training on catechol-O-methyltransferase (COMT) activity. COMT inactivates catecholamines and converts primary catecholestrogens (CE) into their O-methylated form yielding the 2- (2-MeOE) and 4-methoxyestrogens (4-MeOE). Blood samples were obtained from 15 previously untrained eumenorrheic women (mean +/- SE, VO2max: 43.8 mL x kg-1 x min-1 +/- 0.6) before and after a 5-d intensive training period, at rest and during incremental exercise. COMT activity was determined in the erythrocytes (RBC-COMT) after incubation of blood lysate with primary CE. The formation of both 2- and 4-MeOE was significantly higher (P < 0.05) during the luteal (LPh) than during the follicular phase (FPh). The amount of 2-MeOE formed (FPh: 4.2 +/- 0.2%; LPh: 4.9 +/- 0.2%) was significantly greater than the produced amount of 4-MeOE (FPh: 1.4 +/- 0.1%; LPh: 1.5 +/- 0.1%) (P < 0.05). Both before and after training, incremental exercise did not significantly alter RBC-COMT activity although we observed a trend for RBC-COMT activity increasing proportionally with the exercise intensity. After a brief period of exhaustive training, during rest the formation of 2-MeOE (FPh: +16.7%, LPh: +15.7%) and 4-MeOE (FPh: +28.6%; LPh: +40%) was significantly (P < 0.05) increased. The results of the present study are consistent with earlier findings reporting increased plasma concentrations of O-methylated CE following training. It is concluded that RBC-COMT activity is increased by brief intensive training, but not by acute exercise. We speculate that an increase in COMT-catalyzed O-methylation of CE may indicate that less COMT is available to deactivate norepinephrine.

Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults.

PubMed

Little, Jonathan P; Jung, Mary E; Wright, Amy E; Wright, Wendi; Manders, Ralph J F

2014-07-01

The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m(2)) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day's breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = Δ2.1 ± 0.9, CMI = Δ3.0 ± 0.9, control = Δ3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI.

Exercise Thresholds on Trial: Are They Really Equivalent?

PubMed

Caen, Kevin; Vermeire, Kobe; Bourgois, Jan G; Boone, Jan

2018-06-01

The interchangeable use of whole-body exercise thresholds and breakpoints (BP) in the local oxygenation response, as measured via near-infrared spectroscopy, has recently been questioned in scientific literature. Therefore, the present study aimed to longitudinally investigate the interrelationship of four commonly used exercise thresholds: critical power (CP), the respiratory compensation point (RCP), and BP in muscle (m[HHb]BP) and brain (c[O2Hb]BP) oxygenation. Nine male participants (21.8 ± 1.2 yr) completed 6 wk of cycling interval training. Before and after this intervention period, subjects performed a ramp incremental exercise protocol to determine RCP, m[HHb]BP, and c[O2Hb]BP and four constant work rate (WR) tests to calculate CP. WR associated with CP, RCP, m[HHB]BP, and c[O2Hb]BP increased by 7.7% ± 4.2%, 13.6% ± 9.0%, 9.8% ± 5.7%, and 11.3% ± 11.1%, respectively. CP was lower (pre: 260 ± 32 W, post: 280 ± 41 W; P < 0.05) than the WR associated with RCP (pre: 281 ± 28 W, post: 318 ± 36 W) and c[O2Hb]BP (pre: 283 ± 36 W, post: 313 ± 32 W) which occurred concomitantly (P = 0.683). M[HHb]BP occurred at the highest WR and differed from all others (pre: 313 ± 23 W, post: 344 ± 32 W; P < 0.05). Training-induced WR differences (ΔWR) did not contrast between thresholds, and initial parameter differences were not affected by the intervention (P = 0.253). Thresholds were partly correlated before (R = 0.67-0.85, P < 0.05) and after (R = 0.83-0.96, P < 0.05) training, but ΔWR values were not associated (P > 0.05). Results of the present study strongly question true equivalence of CP, RCP, m[HHb]BP, and c[O2Hb]BP during ramp incremental exercise. Therefore, these exercise thresholds should not be used interchangeably.

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

Computer-assisted upper extremity training using interactive biking exercise (iBikE) platform.

PubMed

Jeong, In Cheol; Finkelstein, Joseph

2012-01-01

Upper extremity exercise training has been shown to improve clinical outcomes in different chronic health conditions. Arm-operated bicycles are frequently used to facilitate upper extremity training however effective use of these devices at patient homes is hampered by lack of remote connectivity with clinical rehabilitation team, inability to monitor exercise progress in real time using simple graphical representation, and absence of an alert system which would prevent exertion levels exceeding those approved by the clinical rehabilitation team. We developed an interactive biking exercise (iBikE) platform aimed at addressing these limitations. The platform uses a miniature wireless 3-axis accelerometer mounted on a patient wrist that transmits the cycling acceleration data to a laptop. The laptop screen presents an exercise dashboard to the patient in real time allowing easy graphical visualization of exercise progress and presentation of exercise parameters in relation to prescribed targets. The iBikE platform is programmed to alert the patient when exercise intensity exceeds the levels recommended by the patient care provider. The iBikE platform has been tested in 7 healthy volunteers (age range: 26-50 years) and shown to reliably reflect exercise progress and to generate alerts at pre-setup levels. Implementation of remote connectivity with patient rehabilitation team is warranted for future extension and evaluation efforts.

Blood flow occlusion-related O2 extraction "reserve" is present in different muscles of the quadriceps but greater in deeper regions after ramp-incremental test.

PubMed

Iannetta, Danilo; Okushima, Dai; Inglis, Erin Calaine; Kondo, Narihiko; Murias, Juan M; Koga, Shunsaku

2018-05-03

It was recently demonstrated that an O 2 extraction reserve, as assessed by the near-infrared spectroscopy (NIRS)-derived deoxygenation signal ([HHb]), exists in the superficial region of vastus lateralis (VL) muscle during an occlusion performed at the end of a ramp-incremental test. However, it is unknown whether this reserve is present and/or different in magnitude in other portions and depths of the quadriceps muscles. We tested the hypothesis that O 2 extraction would exist in other regions of this muscle but greater in deep compared to more superficial portions. Superficial and deep VL (VL-s and VL-d, respectively) as well as superficial rectus femoris (RF-s) were monitored by a combination of low- and high- power time resolved (TRS) NIRS. During the occlusion immediately post ramp-incremental test there was a significant overshoot in the [HHb] signal (P<0.05). However, the magnitude of this increase was greater in VL-d (93.2{plus minus}42.9%) compared to VL-s (55.0{plus minus}19.6%) and RF-s (47.8{plus minus}14.0%) (P<0.05). The present study demonstrated that an O2 extraction reserve exists in different pools of active muscle fibers of the quadriceps at the end of a ramp exercise to exhaustion. The greater magnitude in the reserve observed in the deeper portion of VL, however, suggests that this portion of muscle may present a greater surplus of oxygenated blood, likely due to a greater population of slow-twitch fibers. These findings add to the notion that the plateau in the [HHb] signal towards the end of a ramp-incremental exercise does not indicate the upper limit of O 2 extraction.

Can more than one incremental cycling test be performed within one day?

PubMed

Scharhag-Rosenberger, Friederike; Carlsohn, Anja; Lundby, Carsten; Schüler, Stefan; Mayer, Frank; Scharhag, Jürgen

2014-01-01

Changes in performance parameters over four consecutive maximal incremental cycling tests were investigated to determine how many tests can be performed within one single day without negatively affecting performance. Sixteen male and female subjects (eight trained (T): 25 ± 3 yr, BMI 22.6 ± 2.5 kg·m(-2), maximal power output (P(max)) 4.6 ± 0.5 W·kg(-1); eight untrained (UT): 27 ± 3 yr, BMI 22.3 ± 1.2 kg·m(-2), P(max) 2.9 ± 0.3 W·kg(-1)) performed four successive maximal incremental cycling tests separated by 1.5 h of passive rest. Individual energy requirements were covered by standardised meals between trials. Maximal oxygen uptake (VO(2max)) remained unchanged over the four tests in both groups (P = 0.20 and P = 0.33, respectively). P(max) did not change in the T group (P = 0.32), but decreased from the third test in the UT group (P < 0.01). Heart rate responses to submaximal exercise were elevated from the third test in the T group and from the second test in the UT group (P < 0.05). The increase in blood lactate shifted rightward over the four tests in both groups (P < 0.001 and P < 0.01, respectively). Exercise-induced net increases in epinephrine and norepinephrine were not different between the tests in either group (P ≥ 0.15). If VO(2max) is the main parameter of interest, trained and untrained individuals can perform at least four maximal incremental cycling tests per day. However, because other parameters changed after the first and second test, respectively, no more than one test per day should be performed if parameters other than VO(2max) are the prime focus.

Making Acquisition Measurable

DTIC Science & Technology

2011-04-30

Corporation. All rights reserved End Users Administrator/ Maintainer (A/M) Subject Matter Expert ( SME ) Trainer/ Instructor Manager, Evaluator, Supervisor... CMMI ) - Acquisition (AQ) © 2011 The MITRE Corporation. All rights reserved 13 CMMI -Development Incremental iterative development (planning & execution...objectives Constructing games highlighting particular aspects of proposed CCOD® acquisition, and conducting exercises with Subject Matter Experts ( SMEs

40 CFR Table 3 to Subpart Ggg of... - Generic Compliance Schedule and Increments of Progress a

Code of Federal Regulations, 2013 CFR

2013-07-01

... DESIGNATED FACILITIES AND POLLUTANTS Federal Plan Requirements for Municipal Solid Waste Landfills That Commenced Construction Prior to May 30, 1991 and Have Not Been Modified or Reconstructed Since May 30, 1991... rate report showing NMOC emissions ≥ 50 Mg/yr.b Increment 3—Begin on-site construction 24 months after...

40 CFR Table 3 to Subpart Ggg of... - Generic Compliance Schedule and Increments of Progress a

Code of Federal Regulations, 2011 CFR

2011-07-01

... DESIGNATED FACILITIES AND POLLUTANTS Federal Plan Requirements for Municipal Solid Waste Landfills That Commenced Construction Prior to May 30, 1991 and Have Not Been Modified or Reconstructed Since May 30, 1991... rate report showing NMOC emissions ≥ 50 Mg/yr.b Increment 3—Begin on-site construction 24 months after...

Economic Analysis of Primary Care-Based Physical Activity Counseling in Older Men: The VA-LIFE Trial

PubMed Central

Cowper, Patricia A; Peterson, Matthew J; Pieper, Carl F; Sloane, Richard J; Hall, Katherine S; McConnell, Eleanor S; Bosworth, Hayden B; Ekelund, Carola C; Pearson, Megan P; Morey, Miriam C

2016-01-01

BACKGROUND/OBJECTIVES To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. DESIGN Secondary objective of randomized trial that assessed the effect of exercise counseling (relative to usual care) on physical performance, physical activity, function, disability and medical resource use and cost. SETTING Veterans Affairs Medical Center, Durham, North Carolina. PARTICIPANTS Male veterans aged ≥ 70 years (n=398). INTERVENTION An experienced health counselor provided baseline in-person exercise counseling, followed by telephone counseling at 2, 4, and 6 weeks, and monthly thereafter through one year. Each participant’s primary care physician provided initial endorsement of the intervention, followed by monthly automated telephone messages tailored to the patient. Individualized progress reports were mailed quarterly. MEASUREMENTS Intervention costs were assessed. Health care resource use and costs were estimated from enrollment through one year follow-up. The incremental cost of achieving clinically significant changes in major trial endpoints was calculated. RESULTS The total direct cost of the intervention per participant was $459, 85% of which was counselor effort. With overhead, program cost totaled $696 per participant. Medical costs during follow-up reached $10,418 with the intervention, versus $12,052 with usual care (difference = −$1,634 (95% confidence interval=−$4,683 to $1,416; p=0.29)). Expressed in terms of short-term clinical outcomes, the intervention cost $4,971 per additional patient reaching target exercise levels, or $4,640 per patient achieving a clinically significant change in rapid gait speed. CONCLUSION Improvements in physical activity and rapid gait speed in the physical activity counseling group were obtained at a cost that represents a small fraction of patients’ annual health care costs. PMID:28152170

Economic Analysis of Primary Care-Based Physical Activity Counseling in Older Men: The VA-LIFE Trial.

PubMed

Cowper, Patricia A; Peterson, Matthew J; Pieper, Carl F; Sloane, Richard J; Hall, Katherine S; McConnell, Eleanor S; Bosworth, Hayden B; Ekelund, Carola C; Pearson, Megan P; Morey, Miriam C

2017-03-01

To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. Secondary objective of randomized trial that assessed the effect of exercise counseling (relative to usual care) on physical performance, physical activity, function, disability, and medical resource use and cost. Veterans Affairs Medical Center, Durham, North Carolina. Male veterans aged ≥70 years (n = 398). An experienced health counselor provided baseline in-person exercise counseling, followed by telephone counseling at 2, 4, and 6 weeks, and monthly thereafter through one year. Each participant's primary care physician provided initial endorsement of the intervention, followed by monthly automated telephone messages tailored to the patient. Individualized progress reports were mailed quarterly. Intervention costs were assessed. Health care resource use and costs were estimated from enrollment through one year follow-up. The incremental cost of achieving clinically significant changes in major trial endpoints was calculated. The total direct cost of the intervention per participant was $459, 85% of which was counselor effort. With overhead, program cost totaled $696 per participant. Medical costs during follow-up reached $10,418 with the intervention, versus $12,052 with usual care (difference = -$1,634 (95% confidence interval = -$4,683 to $1,416; P = .29)). Expressed in terms of short-term clinical outcomes, the intervention cost $4,971 per additional patient reaching target exercise levels, or $4,640 per patient achieving a clinically significant change in rapid gait speed. Improvements in physical activity and rapid gait speed in the physical activity counseling group were obtained at a cost that represents a small fraction of patients' annual health care costs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Wheel running exercise attenuates vulnerability to self-administer nicotine in rats.

PubMed

Sanchez, Victoria; Lycas, Matthew D; Lynch, Wendy J; Brunzell, Darlene H

2015-11-01

Preventing or postponing tobacco use initiation could greatly reduce the number of tobacco-related deaths. While evidence suggests that exercise is a promising treatment for tobacco addiction, it is not clear whether exercise could prevent initial vulnerability to tobacco use. Thus, using an animal model, we examined whether exercise attenuates vulnerability to the use and reinforcing effects of nicotine, the primary addictive chemical in tobacco. Initial vulnerability was assessed using an acquisition procedure wherein exercising (unlocked running wheel, n=10) and sedentary (locked or no wheel, n=12) male adolescent rats had access to nicotine infusions (0.01-mg/kg) during daily 21.5-h sessions beginning on postnatal day 30. Exercise/sedentary sessions (2-h/day) were conducted prior to each of the acquisition sessions. The effects of exercise on nicotine's reinforcing effects were further assessed in separate groups of exercising (unlocked wheel, n=7) and sedentary (no wheel, n=5) rats responding for nicotine under a progressive-ratio schedule with exercise/sedentary sessions (2-h/day) conducted before the daily progressive-ratio sessions. While high rates of acquisition of nicotine self-administration were observed among both groups of sedentary controls, acquisition was robustly attenuated in the exercise group with only 20% of exercising rats meeting the acquisition criterion within the 16-day testing period as compared to 67% of the sedentary controls. Exercise also decreased progressive-ratio responding for nicotine as compared to baseline and to sedentary controls. Exercise may effectively prevent the initiation of nicotine use in adolescents by reducing the reinforcing effects of nicotine. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of inhaled ipratropium bromide on breathing mechanics and gas exchange in exercising horses with chronic obstructive pulmonary disease.

PubMed

Bayly, W M; Duvivier, D H; Votion, D; Vandenput, S; Art, T; Lekeux, P

2002-01-01

Six Warmblood horses suffering an acute exacerbation of COPD were tested to investigate whether inhalation of ipratropium bromide (IB) dry powder (2,400 microg) 30 min preexercise would improve their exercise capacity. A cross-over protocol with an inert powder placebo (P) was used. Mechanics of breathing and arterial blood gases were determined before treatment, after treatment but pre-exercise, and during an incremental exercise test. Oxygen consumption (VO2) was also measured before and during exercise, and the time to fatigue recorded. Inhalation of IB reduced total pulmonary resistance (RL) and maximum intrapleural pressure changes (deltaPpl(max)) and increased dynamic compliance before exercise. The onset of exercise was associated with a marked decrease in RL in P-treated horses but not those receiving IB, so that RL during exercise was not affected by treatment. Although deltaPpl(max) was lower at 8,9 and 10 m/s with IB, there were no treatment-related changes in VO2, blood gases, time to fatigue or any other measurement of breathing mechanics. Therefore, although inhalation of IB prior to exercise may have improved deltaPpl(max), it had no apparent impact on the horses' capacity for exercise.

The effect of resistance exercise on the thermic effect of food.

PubMed

Denzer, Charlene M; Young, John C

2003-09-01

The thermic effect of food (TEF) is the increment in energy expenditure above resting metabolic rate associated with the cost of absorption and processing of food for storage. Previous studies have shown that TEF is enhanced by aerobic endurance exercise of sufficient duration and intensity. The purpose of this study was to determine if a similar effect occurs with a single bout of resistance exercise (weightlifting). VO2 was measured in 9 healthy volunteers (3 males and 6 females) for 2 hours after ingestion of a 2760 kJ (660 kcal) carbohydrate meal with and without prior completion of a resistance training regimen (2 sets of 10 repetitions of 10 different exercises). The meal caused an immediate and persistent thermic effect in both the control and the exercise trial. Mean oxygen consumption over baseline increased 20% in the control trial and 34% in the exercise trial. TEF calculated from VO2 and RER (total area under the response curve above baseline) was 73% greater in the exercise trial compared with the control trial (159 +/- 18 vs. 92 +/- 14 KJ/2 hrs, p < .02). These results indicate that TEF in response to a carbohydrate meal is enhanced following a single bout of resistance exercise.

Influence of dietary nitrate supplementation on physiological and cognitive responses to incremental cycle exercise.

PubMed

Thompson, Kevin G; Turner, Louise; Prichard, Jonathon; Dodd, Fiona; Kennedy, David O; Haskell, Crystal; Blackwell, James R; Jones, Andrew M

2014-03-01

Dietary inorganic nitrate supplementation causes physiological effects which may enhance exercise tolerance. However it is not known whether nitrate might alter cognitive function during exercise. In a double-blind, cross-over study, sixteen subjects ingested either nitrate-rich beetroot juice or a placebo and completed a continuous cycle exercise test involving 20min stages at 50% and 70% V˙O2peak and a final stage at 90% V˙O2peak until volitional exhaustion. Cognitive tasks were completed before, during and after exercise. In the dietary nitrate condition: plasma [nitrite] increased (p<0.01), systolic blood pressure decreased (p<0.05) and there was a trend for a reduced oxygen uptake at 50% V˙O2peak. Tissue oxygenation improved across exercise intensities and exercise tolerance was greater at 90% V˙O2peak (p<0.05). Rating of perceived exertion, energy levels and cognitive performance were similar between conditions with mental fatigue being evident from 70% V˙O2peak onwards (p<0.05). Dietary nitrate supplementation enhanced short-term endurance exercise performance with concomitant mental fatigue but did not improve cognitive performance post-fatigue. Copyright © 2014 Elsevier B.V. All rights reserved.

Self-efficacy and enjoyment of middle school children performing the progressive aerobic cardiovascular endurance run (PACER).

PubMed

Kane, Irene; Robertson, Robert J; Fertman, Carl I; Nagle, Elizabeth F; McConnaha, Wendell R; Rabin, Bruce S

2013-10-01

Self-efficacy and enjoyment were examined among 34 middle school children (M age = 12.5 yr.) performing the Progressive Aerobic Cardiovascular Endurance Run (PACER). Exercise self-efficacy (running) and physical activity enjoyment were measured after viewing a video illustrating the PACER, and subsequently following a PACER test. Significantly greater pre- than post-exercise self-efficacy was reported; enjoyment scores did not differ. Ratings of self-efficacy were higher before exercise than after, but enjoyment scores were not significantly different. A significant correlation was found between post-exercise self-efficacy and enjoyment, but not between pre-exercise self-efficacy and enjoyment. Although positive correlations were found between PACER laps and pre-/post-exercise self-efficacy, correlations with ratings of enjoyment were not significant. Exercise self-efficacy was associated with children's beliefs about the task-specific PACER aerobic exercise; however, exercise enjoyment was stable. Children's self-efficacy and enjoyment beliefs should be considered when developing interventional strategies to promote aerobic exercise participation.

Rehabilitation of the Ankle After Acute Sprain or Chronic Instability.

PubMed

Mattacola, Carl G; Dwyer, Maureen K

2002-12-01

OBJECTIVE: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. BACKGROUND: Important considerations in the rehabilitation of ankle injuries include controlling the acute inflammatory process, regaining full ankle range of motion, increasing muscle strength and power, and improving proprioceptive abilities. These goals can be achieved through various modalities, flexibility exercises, and progressive strength- and balance-training exercises. In this article, we discuss the deleterious effects of ankle injury on ankle-joint proprioception and muscular strength and how these variables can be quantifiably measured to follow progress through a rehabilitation program. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provided, along with recommendations for functional rehabilitation of ankle injuries, including a structured progression of exercises. RECOMMENDATIONS: Early functional rehabilitation of the ankle should include range-of-motion exercises and isometric and isotonic strength-training exercises. In the intermediate stage of rehabilitation, a progression of proprioception-training exercises should be incorporated. Advanced rehabilitation should focus on sport-specific activities to prepare the athlete for return to competition. Although it is important to individualize each rehabilitation program, this well-structured template for ankle rehabilitation can be adapted as needed.

Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

PubMed Central

Mattacola, Carl G.; Dwyer, Maureen K.

2002-01-01

Objective: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. Background: Important considerations in the rehabilitation of ankle injuries include controlling the acute inflammatory process, regaining full ankle range of motion, increasing muscle strength and power, and improving proprioceptive abilities. These goals can be achieved through various modalities, flexibility exercises, and progressive strength- and balance-training exercises. In this article, we discuss the deleterious effects of ankle injury on ankle-joint proprioception and muscular strength and how these variables can be quantifiably measured to follow progress through a rehabilitation program. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provided, along with recommendations for functional rehabilitation of ankle injuries, including a structured progression of exercises. Recommendations: Early functional rehabilitation of the ankle should include range-of-motion exercises and isometric and isotonic strength-training exercises. In the intermediate stage of rehabilitation, a progression of proprioception-training exercises should be incorporated. Advanced rehabilitation should focus on sport-specific activities to prepare the athlete for return to competition. Although it is important to individualize each rehabilitation program, this well-structured template for ankle rehabilitation can be adapted as needed. PMID:12937563

A practical guide to exercise training for heart failure patients.

PubMed

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

2003-02-01

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

Predictive factors for progression through the difficulty levels of Pilates exercises in patients with low back pain: a secondary analysis of a randomized controlled trial.

PubMed

Franco, Katherinne Ferro Moura; Franco, Yuri Rafael Dos Santos; Oliveira, Naiane Teixeira Bastos de; Padula, Rosimeire Simprini; Cabral, Cristina Maria Nunes

2018-04-17

The progression through the difficulty levels of Pilates exercises is a subjective criterion, that depends on the therapist's experience and ability to identify the best moment to progress to the next level. To identify the factors that interfere in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain. Data from 139 patients with chronic nonspecific low back pain from a randomized controlled trial were used for statistical analysis using binary logistic regression. The dependent variable was the progression through the difficulty levels, and the independent variables were age, gender, educational level, low back pain duration, pain intensity, general disability, kinesiophobia, previous physical activity, and number of absences. The factors that interfered in the progression through the difficulty levels were previous physical inactivity (odds ratio [OR]=5.14, 95% confidence interval [CI]: 1.53-17.31), low educational level (OR=2.62, 95% CI: 1.12-6.10), more advanced age (OR=0.95, 95% CI: 0.92-0.98) and more absences (OR=0.63, 95% CI: 0.50-0.79). These variables explain 41% of the non-progression through the difficulty level of the exercises. Physical inactivity, low educational level, more advanced age and greater number of absences can be interfering factors in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Therapeutic Exercise Training to Reduce Chronic Headache in Working Women: Design of a Randomized Controlled Trial.

PubMed

Rinne, Marjo; Garam, Sanna; Häkkinen, Arja; Ylinen, Jari; Kukkonen-Harjula, Katriina; Nikander, Riku

2016-05-01

Cervicogenic headache and migraine are common causes of visits to physicians and physical therapists. Few randomized trials utilizing active physical therapy and progressive therapeutic exercise have been previously published. The existing evidence on active treatment methods supports a moderate effect on cervicogenic headache. The aim of this study is to investigate whether a progressive, group-based therapeutic exercise program decreases the intensity and frequency of chronic headache among women compared with a control group receiving a sham dose of transcutaneous electrical nerve stimulation (TENS) and stretching exercises. A randomized controlled trial with 6-month intervention and follow-up was developed. The participants were randomly assigned to either a treatment group or a control group. The study is being conducted at 2 study centers. The participants are women aged 18 to 60 years with chronic cervicogenic headache or migraine. The treatment group's exercise program consisted of 6 progressive therapeutic exercise modules, including proprioceptive low-load progressive craniocervical and cervical exercises and high-load exercises for the neck muscles. The participants in the control group received 6 individually performed sham TENS treatment sessions. The primary outcome is the intensity of headache. The secondary outcomes are changes in frequency and duration of headache, neck muscle strength, neck and shoulder flexibility, impact of headache on daily life, neck disability, fear-avoidance beliefs, work ability, and quality of life. Between-group differences will be analyzed separately at 6, 12, and 24 months with generalized linear mixed models. In the case of count data (eg, frequency of headache), Poisson or negative binomial regression will be used. The therapists are not blinded. The effects of specific therapeutic exercises on frequency, intensity, and duration of chronic headache and migraine will be reported. © 2016 American Physical Therapy Association.

Comparing peak and submaximal cardiorespiratory responses during field walking tests with incremental cycle ergometry in COPD.

PubMed

Hill, Kylie; Dolmage, Thomas E; Woon, Lynda; Coutts, Debbie; Goldstein, Roger; Brooks, Dina

2012-02-01

Field and laboratory-based tests are used to measure exercise capacity in people with COPD. A comparison of the cardiorespiratory responses to field tests, referenced to a laboratory test, is needed to appreciate the relative physiological demands. We sought to compare peak and submaximal cardiorespiratory responses to the 6-min walk test, incremental shuttle walk test and endurance shuttle walk test with a ramp cycle ergometer test (CET) in patients with COPD. Twenty-four participants (FEV(1) 50 ± 14%; 66.5 ± 7.7 years; 15 men) completed four sessions, separated by ≥24 h. During an individual session, participants completed either two 6-min walk tests, incremental shuttle walk tests, endurance shuttle walk tests using standardized protocols, or a single CET, wearing a portable gas analysis unit (Cosmed K4b(2)) which included measures of heart rate and arterial oxygen saturation (SpO(2)). Between tests, no difference was observed in the peak rate of oxygen uptake (F(3,69) = 1.2; P = 0.31), end-test heart rate (F(2,50) = 0.6; P = 0.58) or tidal volume (F(3,69) = 1.5; P = 0.21). Compared with all walking tests, the CET elicited a higher peak rate of carbon dioxide output (1173 ± 350 mL/min; F(3,62) = 4.8; P = 0.006), minute ventilation (48 ± 17 L/min; F(3,69) = 10.2; P < 0.001) and a higher end-test SpO(2) (95 ± 4%; F(3,63) = 24.9; P < 0.001). In patients with moderate COPD, field walking tests elicited a similar peak rate of oxygen uptake and heart rate as a CET, demonstrating that both self- and externally paced walking tests progress to high intensities. © 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.

[Effect of techniques of composite resin insertion and polymerization on microleakage and microhardness].

PubMed

Amaral, Cristiane Mariote; Castro, Ana Karina Barbieri Bedran de; Pimenta, Luiz André Freire; Ambrosano, Glaucia Maria Boni

2002-01-01

The aim of this study was to evaluate the influence of techniques of composite resin polymerization and insertion on microleakage and microhardness. One hundred and eighty class II cavities were prepared in bovine teeth and assigned to six groups: G1 - bulk filling + conventional polymerization; G2 - bucco-lingual increments + conventional polymerization; G3 - bulk filling + soft-start polymerization; G4 - bucco-lingual increments + soft-start polymerization; G5 - bulk filling + progressive polymerization; G6 - bucco-lingual increments + progressive polymerization. All cavities were restored with the Z100/Single Bond system (3M). After thermocycling, the samples were immersed in 2% methylene blue dye solution for 4 hours. Half of the samples were embedded in polystyrene resin, and Knoop microhardness was measured. The Kruskal-Wallis test did not reveal statistical differences (p > 0.05) between the polymerization and insertion techniques as to microleakage. Regarding microhardness, the two-way ANOVA and the Tukey test did not reveal statistical differences between the restorative techniques (p > 0.05), but progressive polymerization (G5 and G6) was associated with smaller Knoop microhardness values (p < 0.05): G = 144.11; G2 = 143.89; G3 = 141.14; G4 = 142.79; G5 = 132.15; G6 = 131.67. It was concluded that the evaluated polymerization and insertion techniques did not affect marginal microleakage, but a decrease in microhardness occurred when progressive polymerization was carried out.

Geography Assessment and Exercise Specifications for the 1994 National Assessment of Educational Progress.

ERIC Educational Resources Information Center

American Inst. for Research, Washington, DC. Washington Research Center.

This document lists and outlines the specific educational objectives of the content of the 1994 National Assessment of Educational Progress's Geography Assessment. The document is divided into two sections: "Assessment Specifications" and "Exercise Specifications." The "Assessment Specifications" provide an overall…

The effect of chronic progressive-dose sodium bicarbonate ingestion on CrossFit-like performance: A double-blind, randomized cross-over trial

PubMed Central

Zawieja, Emilia E.; Podgórski, Tomasz; Łoniewski, Igor; Zawieja, Bogna E.

2018-01-01

Background Sodium bicarbonate (SB) has been proposed as an ergogenic aid, as it improves high-intensity and resistance exercise performance. However, no studies have yet investigated SB application in CrossFit. This study examined the effects of chronic, progressive-dose SB ingestion on CrossFit-like performance and aerobic capacity. Methods In a randomized, double-blind, cross-over trial, 21 CrossFit-trained participants were randomly allocated to 2 groups and underwent 2 trials separated by a 14-day washout period. Participants ingested either up to 150 mg∙kg-1 of SB in a progressive-dose regimen or placebo for 10 days. Before and after each trial, Fight Gone Bad (FGB) and incremental cycling (ICT) tests were performed. In order to examine biochemical responses, blood samples were obtained prior to and 3 min after completing each exercise test. Results No gastrointestinal (GI) side effects were reported during the entire protocol. The overall FGB performance improved under SB by ~6.1% (p<0.001) and it was ~3.1% higher compared to post placebo (PLApost) (p = 0.040). The number of repetitions completed in each round also improved under SB (mean from baseline: +5.8% to +6.4%). Moreover, in ICT, the time to ventilatory threshold (VT) (~8:25 min SBpost vs. ~8:00 min PLApost, p = 0.020), workload at VT (~218 W SBpost vs. ~208 W PLApost, p = 0.037) and heart rate at VT (~165 bpm SBpost vs. ~161 bpm PLApost, p = 0.030) showed higher SBpost than PLApost. Furthermore, the maximum carbon dioxide production increased under SB by ~4.8% (from ~3604 mL∙min-1 to ~3776 mL∙min-1, p = 0.049). Pyruvate concentration and creatine kinase activity before ICT showed higher SBpost than PLApost (~0.32 mmol∙L-1 vs. ~0.26 mmol∙L-1, p = 0.001; ~275 U∙L-1 vs. ~250 U∙L-1, p = 0.010, respectively). However, the small sample size limits the wide-application of our results. Conclusions Progressive-dose SB ingestion regimen eliminated GI side effects and improved CrossFit-like performance, as well as delayed ventilatory threshold occurrence. PMID:29771966

Consumption of açai (Euterpe oleracea Mart.) functional beverage reduces muscle stress and improves effort tolerance in elite athletes: a randomized controlled intervention study.

PubMed

Carvalho-Peixoto, Jacqueline; Moura, Mirian Ribeiro Leite; Cunha, Felipe Amorim; Lollo, Pablo Christiano B; Monteiro, Walace David; Carvalho, Lucia Maria Jaeger de; Farinatti, Paulo de Tarso Veras

2015-07-01

The study analyzed the effect of an açai (Euterpe oleracea Mart.) functional beverage (AB) on muscle and oxidative stress markers, cardiorespiratory responses, perceived exertion, and time-to-exhaustion during maximal treadmill running. The beverage was developed as an ergogenic aid for athletes and contained 27.6 mg of anthocyanins per dose. Fourteen athletes performed 3 exercise tests: a ramp-incremental maximal exercise test and 2 maximal exercise bouts performed in 2 conditions (AB and without AB (control)) at 90% maximal oxygen uptake. Blood was collected at baseline and after maximal exercise in both conditions to determine biomarkers. AB increased time to exhaustion during short-term high-intensity exercise (mean difference: 69 s, 95% confidence interval = -296 s to 159 s, t = 2.2, p = 0.045), attenuating the metabolic stress induced by exercise (p < 0.05). AB also reduced perceived exertion and enhanced cardiorespiratory responses (p < 0.05). The AB may be a useful and practical ergogenic aid to enhance performance during high-intensity training.

Acute changes in arterial stiffness following exercise in people with metabolic syndrome.

PubMed

Radhakrishnan, Jeyasundar; Swaminathan, Narasimman; Pereira, Natasha M; Henderson, Keiran; Brodie, David A

This study aims to examine the changes in arterial stiffness immediately following sub-maximal exercise in people with metabolic syndrome. Ninety-four adult participants (19-80 years) with metabolic syndrome gave written consent and were measured for arterial stiffness using a SphygmoCor (SCOR-PVx, Version 8.0, Atcor Medical Private Ltd, USA) immediately before and within 5-10min after an incremental shuttle walk test. The arterial stiffness measures used were pulse wave velocity (PWV), aortic pulse pressure (PP), augmentation pressure, augmentation index (AI), subendocardial viability ratio (SEVR) and ejection duration (ED). There was a significant increase (p<0.05) in most of the arterial stiffness variables following exercise. Exercise capacity had a strong inverse correlation with arterial stiffness and age (p<0.01). Age influences arterial stiffness. Exercise capacity is inversely related to arterial stiffness and age in people with metabolic syndrome. Exercise induced changes in arterial stiffness measured using pulse wave analysis is an important tool that provides further evidence in studying cardiovascular risk in metabolic syndrome. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

[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.

Physical inactivity, neurological disability, and cardiorespiratory fitness in multiple sclerosis.

PubMed

Motl, R W; Goldman, M

2011-02-01

We examined the associations among physical activity, neurological disability, and cardiorespiratory fitness in two studies of individuals with multiple sclerosis (MS). Study 1 included 25 women with relapsing-remitting MS (RRMS) who undertook an incremental exercise test for measuring peak oxygen (VO₂(peak) ) consumption, wore an accelerometer during a 7-day period, and completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ). Study 2 was a follow-up of Study 1 and included 24 women with RRMS who completed the self-reported Expanded Disability Status Scale (EDSS), undertook an incremental exercise test, wore an accelerometer during a 7-day period, and completed the GLTEQ. Study 1 indicated that VO₂(peak) was significantly correlated with accelerometer counts (pr = 0.69) and GLTEQ scores (pr = 0.63) even after controlling for age and MS duration. Study 2 indicated that VO₂(peak) was significantly correlated with accelerometer counts (pr = 0.50), GLTEQ scores (pr = 0.59), and EDSS scores (pr = -0.43) even after controlling for age and MS duration; there was a moderate partial correlation between accelerometer counts and EDSS scores (pr = -0.43). Multiple linear regression analysis indicated that both accelerometer counts (β = 0.32) and EDSS scores (β = -0.40) had statistically significant associations with VO₂(peak). The findings indicate that physical inactivity and neurological disability might represent independent risk factors for reduced levels of cardiorespiratory fitness in this population. © 2010 John Wiley & Sons A/S.

Male Body Satisfaction: Factorial and Construct Validity of the Body Parts Satisfaction Scale for Men

ERIC Educational Resources Information Center

McFarland, Michael B.; Petrie, Trent A.

2012-01-01

Given the centrality of body dissatisfaction in the manifestation of eating, exercise, and affective disturbances in men, measurement of this construct becomes essential. Across 2 studies with male undergraduates (Ns = 189 and 188), the psychometric properties, including incremental validity and factor structure, of the 25-item Body Parts…

Effects of furosemide on hemorheologic alterations induced by incremental treadmill exercise in thoroughbreds.

PubMed

Weiss, D J; Geor, R J; Burger, K

1996-06-01

To determine whether furosemide treatment altered the blood flow properties and serum and RBC electrolyte concentrations of Thoroughbreds during submaximal treadmill exercise. Thoroughbreds were subjected to submaximal treadmill exercise with and without treatment with furosemide (1 mg/kg of body weight, IV). 5 healthy Throughbreds that had raced within the past year and had no history of exercise-induced pulmonary hemorrhage. Venous blood samples were obtained before exercise, at treadmill speeds of 9 and 13 m/s, and 10 minutes after exercise, and hemorheologic and electrolyte test results were determined. Hemorheologic changes 60 minutes after furosemide administration included increased PCV, plasma total protein concentration, whole blood viscosity, mean RBC volume, and RBC potassium concentration, and decreased serum potassium concentration, serum chloride concentration, and RBC chloride concentration. Furosemide treatment attenuated the exercise-associated changes in RBC size, serum sodium concentration, serum potassium concentration, RBC potassium and chloride concentrations, and RBC density; exacerbated exercise-associated increases in whole blood viscosity; and had no effect on RBC filterability. The hemorheologic effects of furosemide probably occurred secondary to total body and transmembrane fluid and electrolyte fluxes and would not improve blood flow properties. The beneficial effects of furosemide treatment in reducing the severity of bleeding in horses with exercise-induced pulmonary hemorrhage cannot be explained by improved blood flow properties.

Evaluation of exercise capacity after severe stroke using robotics-assisted treadmill exercise: a proof-of-concept study.

PubMed

Stoller, O; de Bruin, E D; Schindelholz, M; Schuster, C; de Bie, R A; Hunt, K J

2013-01-01

Robotics-assisted treadmill exercise (RATE) with focus on motor recovery has become popular in early post-stroke rehabilitation but low endurance for exercise is highly prevalent in these individuals. This study aimed to develop an exercise testing method using robotics-assisted treadmill exercise to evaluate aerobic capacity after severe stroke. Constant load testing (CLT) based on body weight support (BWS) control, and incremental exercise testing (IET) based on guidance force (GF) control were implemented during RATE. Analyses focussed on step change, step response kinetics, and peak performance parameters of oxygen uptake. Three subjects with severe motor impairment 16-23 days post-stroke were included. CLT yielded reasonable step change values in oxygen uptake, whereas response kinetics of oxygen uptake showed low goodness of fit. Peak performance parameters were not obtained during IET. Exercise testing in post-stroke individuals with severe motor impairments using a BWS control strategy for CLT is deemed feasible and safe. Our approach yielded reasonable results regarding cardiovascular performance parameters. IET based on GF control does not provoke peak cardiovascular performance due to uncoordinated walking patterns. GF control needs further development to optimally demand active participation during RATE. The findings warrant further research regarding the evaluation of exercise capacity after severe stroke.

Effects of continuous low-carbohydrate diet after long-term exercise on GLUT-4 protein content in rat skeletal muscle.

PubMed

Kubota, M; Koshinaka, K; Kawata, Y; Koike, T; Oshida, Y

2008-01-01

Stimulation of AMPK and decreased glycogen levels in skeletal muscle have a deep involvement in enhanced insulin action and GLUT-4 protein content after exercise training. The present study examined the chronic effects of a continuous low-carbohydrate diet after long-term exercise on GLUT-4 protein content, glycogen content, AMPK, and insulin signaling in skeletal muscle. Rats were divided randomly into four groups: normal chow diet sedentary (N-Sed), low carbohydrate diet sedentary (L-Sed), normal chow diet exercise (N-Ex), and low carbohydrate diet exercise (L-Ex) groups. Rats in the exercise groups (N-Ex and L-Ex) were exercised by swimming for 6 hours/day in two 3-hour bouts separated by 45 minutes of rest. The 10-day exercise training resulted in a significant increase in the GLUT-4 protein content (p<0.01). Additionally, the GLUT-4 protein content in L-Ex rats was increased by 29% above that in N-Ex rats (p<0.01). Finally, the glycogen content in skeletal muscle of L-Ex rats was decreased compared with that of N-Ex rats. Taken together, we suggest that the maintenance of glycogen depletion after exercise by continuous low carbohydrate diet results in the increment of the GLUT-4 protein content in skeletal muscle.

Changes in retinal venular oxygen saturation predict activity of proliferative diabetic retinopathy 3 months after panretinal photocoagulation.

PubMed

Torp, Thomas Lee; Kawasaki, Ryo; Wong, Tien Yin; Peto, Tunde; Grauslund, Jakob

2018-03-01

Proliferative diabetic retinopathy (PDR) is a severe blinding condition. We investigated whether retinal metabolism, measured by retinal oximetry, may predict PDR activity after panretinal laser photocoagulation (PRP). We performed a prospective, interventional, clinical study of patients with treatment-naive PDR. Wide-field fluorescein angiography (OPTOS, Optomap) and global and focal retinal oximetry (Oxymap T1) were performed at baseline (BL), and 3 months (3M) after PRP. Angiographic findings were used to divide patients according to progression or non-progression of PDR after PRP. We evaluated differences in global and focal retinal oxygen saturation between patients with and without progression of PDR after PRP treatment. We included 45 eyes of 37 patients (median age and duration of diabetes were 51.6 and 20 years). Eyes with progression of PDR developed a higher retinal venous oxygen saturation than eyes with non-progression at 3M (global: +5.9% (95% CI -1.5 to 12.9), focal: +5.4%, (95% CI -4.1 to 14.8)). Likewise, progression of PDR was associated with a lower arteriovenular (AV) oxygen difference between BL and 3M (global: -6.1%, (95% CI -13.4 to -1.4), focal: -4.5% (95% CI -12.1 to 3.2)). In a multiple logistic regression model, increment in global retinal venular oxygen saturation (OR 1.30 per 1%-point increment, p=0.017) and decrement in AV oxygen saturation difference (OR 0.72 per 1%-point increment, p=0.016) at 3M independently predicted progression of PDR. Development of higher retinal venular and lower AV global oxygen saturation independently predicts progression of PDR despite standard PRP and might be a potential non-invasive marker of angiogenic disease activity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The effects of breathing a helium-oxygen gas mixture on maximal pulmonary ventilation and maximal oxygen consumption during exercise in acute moderate hypobaric hypoxia.

PubMed

Ogawa, Takeshi; Calbet, Jose A L; Honda, Yasushi; Fujii, Naoto; Nishiyasu, Takeshi

2010-11-01

To test the hypothesis that maximal exercise pulmonary ventilation (VE max) is a limiting factor affecting maximal oxygen uptake (VO2 max) in moderate hypobaric hypoxia (H), we examined the effect of breathing a helium-oxygen gas mixture (He-O(2); 20.9% O(2)), which would reduce air density and would be expected to increase VE max. Fourteen healthy young male subjects performed incremental treadmill running tests to exhaustion in normobaric normoxia (N; sea level) and in H (atmospheric pressure equivalent to 2,500 m above sea level). These exercise tests were carried out under three conditions [H with He-O(2), H with normal air and N] in random order. VO2 max and arterial oxy-hemoglobin saturation (SaO(2)) were, respectively, 15.2, 7.5 and 4.0% higher (all p < 0.05) with He-O(2) than with normal air (VE max, 171.9 ± 16.1 vs. 150.1 ± 16.9 L/min; VO2 max, 52.50 ± 9.13 vs. 48.72 ± 5.35 mL/kg/min; arterial oxyhemoglobin saturation (SaO(2)), 79 ± 3 vs. 76 ± 3%). There was a linear relationship between the increment in VE max and the increment in VO2 max in H (r = 0.77; p < 0.05). When subjects were divided into two groups based on their VO2 max, both groups showed increased VE max and SaO(2) in H with He-O(2), but VO2 max was increased only in the high VO2 max group. These findings suggest that in acute moderate hypobaric hypoxia, air-flow resistance can be a limiting factor affecting VE max; consequently, VO2 max is limited in part by VE max especially in subjects with high VO2 max.

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.

Cost-effectiveness of exercise therapy versus general practitioner care for osteoarthritis of the hip: design of a randomised clinical trial.

PubMed

van Es, Pauline P; Luijsterburg, Pim A J; Dekker, Joost; Koopmanschap, Marc A; Bohnen, Arthur M; Verhaar, Jan A N; Koes, Bart W; Bierma-Zeinstra, Sita M A

2011-10-12

Osteoarthritis (OA) is the most common joint disease, causing pain and functional impairments. According to international guidelines, exercise therapy has a short-term effect in reducing pain/functional impairments in knee OA and is therefore also generally recommended for hip OA. Because of its high prevalence and clinical implications, OA is associated with considerable (healthcare) costs. However, studies evaluating cost-effectiveness of common exercise therapy in hip OA are lacking. Therefore, this randomised controlled trial is designed to investigate the cost-effectiveness of exercise therapy in conjunction with the general practitioner's (GP) care, compared to GP care alone, for patients with hip OA. Patients aged ≥ 45 years with OA of the hip, who consulted the GP during the past year for hip complaints and who comply with the American College of Rheumatology criteria, are included. Patients are randomly assigned to either exercise therapy in addition to GP care, or to GP care alone. Exercise therapy consists of (maximally) 12 treatment sessions with a physiotherapist, and home exercises. These are followed by three additional treatment sessions in the 5th, 7th and 9th month after the first treatment session. GP care consists of usual care for hip OA, such as general advice or prescribing pain medication. Primary outcomes are hip pain and hip-related activity limitations (measured with the Hip disability Osteoarthritis Outcome Score [HOOS]), direct costs, and productivity costs (measured with the PROductivity and DISease Questionnaire). These parameters are measured at baseline, at 6 weeks, and at 3, 6, 9 and 12 months follow-up. To detect a 25% clinical difference in the HOOS pain score, with a power of 80% and an alpha 5%, 210 patients are required. Data are analysed according to the intention-to-treat principle. Effectiveness is evaluated using linear regression models with repeated measurements. An incremental cost-effectiveness analysis and an incremental cost-utility analysis will also be performed. The results of this trial will provide insight into the cost-effectiveness of adding exercise therapy to GPs' care in the treatment of OA of the hip. This trial is registered in the Dutch trial registry http://www.trialregister.nl: trial number NTR1462.

Changes in circulating angiogenic factors after an acute training bout before and after resistance training with or without whole-body-vibration training

NASA Astrophysics Data System (ADS)

Beijer, Åsa; Degens, Hans; May, Francisca; Bloch, Wilhelm; Rittweger, Joern; Rosenberger, Andre

2012-07-01

Both Resistance Exercise and Whole-Body-Vibration training are currently considered as countermeasures against microgravity-induced physiological deconditioning. Here we investigated the effects of whole-body vibration superimposed upon resistance exercise. Within this context, the present study focuses on changes in circulating angiogenic factors as indicators of skeletal muscle adaption. Methods: Twenty-six healthy male subjects (25.2 ± 4.2 yr) were included in this two-group parallel-designed study and randomly assigned to one of the training interventions: either resistance exercise (RE) or resistance vibration exercise (RVE). Participants trained 2-3 times per week for 6 weeks (completing 16 training sessions), where one session took 9 ± 1 min. Participants trained with weights on a guided barbell. The individual training load was set at 80% of their 1-Repetition-Maximum. Each training session consisted of three sets with 8 squats and 12 heel raises, following an incremental training design with regards to weight (RE and RVE) and vibration frequency (RVE only). The vibration frequency was increased from 20 Hz in the first week till 40 Hz during the last two weeks with 5-Hz weekly increments. At the first and 16 ^{th} training session, six blood samples (pre training and 2 min, 5 min, 15 min, 35 min and 75 min post training) were taken. Circulating levels of vascular endothelial growth factor (VEGF), Endostatin and Matrix Metalloproteinases -2 and -9 (MMPs) were determined in serum using Enzyme-linked Immunosorbent Assays. Results: MMP-2 levels increased by 7.0% (SE = 2.7%, P < 0.001) within two minutes after the exercise bout and then decreased to 5.7% below baseline (SE = 2.4%, P < 0.001) between 15 and 75 minutes post exercise. This response was comparable before and after the training programs (P = 0.70) and also between the two intervention groups (P = 0.42). Preliminary analyses indicate that a similar pattern applies to circulating MMP-9, VEGF and Endostatin levels. Conclusion: The present findings suggest 1) that resistance exercise, both with and without superimposed vibration, leads to a transient rise in circulating angiogenic factors, 2) which is not altered after a period of resistance exercise with or without vibration.

Leptin, gastrointestinal and stress hormones in response to exercise in fasted or fed subjects and before or after blood donation.

PubMed

Sliwowski, Z; Lorens, K; Konturek, S J; Bielanski, W; Zoładź, J A

2001-03-01

Leptin, an ob gene product of adipocytes, plays a key role in the control of food intake and energy expenditure but little is known about leptin response to strenuous exercise in fasted and fed subjects or before and after blood donation. This study was designed to determine the immediate effects of strenuous exercise in healthy volunteers under fasting or fed conditions and before and one day after blood donation (450 ml) on plasma levels of leptin and gut hormones [gastrin, cholecystokinin (CCK), pancreatic polypeptide (PP) and insulin], as well as on "stress" hormones (cortisol, catecholamines and growth hormone. Two groups (A and B) of healthy non-smoking male volunteers were studied. All subjects performed incremental exercise tests until exhaustion (up to maximal oxygen uptake--VO2max), followed by 2 h of rest session. Group A perfomed the tests on a treadmill, while group B on a cycloergometer. In group A, one exercise was performed under fasting conditions and the second following ingestion of a standard liquid meal. In group B, one exercise test was performed as a control test and the second 24 h after blood donation (450 ml). Blood samples were withdrawn 5 min before the start of the test, at the VO2max, and 2 h after finishing the exercise. No significant change in plasma teptin were observed both immediately and 2 h after the exercise in fasted subjects, but after the meal the plasma leptin at VO2max and 2 h after the test was significantly higher, while after blood donation was significantly reduced. The postprandial rise in plasma leptin was accompanied by a marked increment in gut hormones; gastrin, CCK and PP and stress hormones such as norepinephrine, cortisol and GH. These hormonal changes could contribute to the postprandial rise in plasma leptin concentrations, while the fall of leptin after blood donation could be attributed to the inadequate response of stress hormones and autonomic nervous system to exhausting exercise. We conclude that strenuous physical exercise; 1) fails to affect plasma leptin level but when performed after meal but not after blood withdrawal it results in an increase and fall in plasma leptin, and 2) the release of gut hormones (gastrin, CCK and PP) and stress hormones (norepinephrine, cortisol, GH) increase immediately after exercise independently of feeding or blood donation and 3) following blood donation the strenuous exercise resulted in a marked reduction in the plasma leptin, cortisol and GH concentrations, possibly due to the impairment in the autonomic nervous control of these hormones.

Detection of the change point in oxygen uptake during an incremental exercise test using recursive residuals: relationship to the plasma lactate accumulation and blood acid base balance.

PubMed

Zoladz, J A; Szkutnik, Z; Majerczak, J; Duda, K

1998-09-01

The purpose of this study was to develop a method to determine the power output at which oxygen uptake (VO2) during an incremental exercise test begins to rise non-linearly. A group of 26 healthy non-smoking men [mean age 22.1 (SD 1.4) years, body mass 73.6 (SD 7.4) kg, height 179.4 (SD 7.5) cm, maximal oxygen uptake (VO2max) 3.726 (SD 0.363) l x min(-1)], experienced in laboratory tests, were the subjects in this study. They performed an incremental exercise test on a cycle ergometer at a pedalling rate of 70 rev x min(-1). The test started at a power output of 30 W, followed by increases amounting to 30 W every 3 min. At 5 min prior to the first exercise intensity, at the end of each stage of exercise protocol, blood samples (1 ml each) were taken from an antecubital vein. The samples were analysed for plasma lactate concentration [La]pl, partial pressure of O2 and CO2 and hydrogen ion concentration [H+]b. The lactate threshold (LT) in this study was defined as the highest power output above which [La-]pl showed a sustained increase of more than 0.5 mmol x l(-1) x step(-1). The VO2 was measured breath-by-breath. In the analysis of the change point (CP) of VO2 during the incremental exercise test, a two-phase model was assumed for the 3rd-min-data of each step of the test: Xi = at(i) + b + epsilon(i) for i = 1,2, ..., T, and E(Xi) > at(i) + b for i = T + 1, ..., n, where X1, ..., Xn are independent and epsilon(i) approximately N(0, sigma2). In the first phase, a linear relationship between VO2 and power output was assumed, whereas in the second phase an additional increase in VO2 above the values expected from the linear model was allowed. The power output at which the first phase ended was called the change point in oxygen uptake (CP-VO2). The identification of the model consisted of two steps: testing for the existence of CP and estimating its location. Both procedures were based on suitably normalised recursive residuals. We showed that in 25 out of 26 subjects it was possible to determine the CP-VO2 as described in our model. The power output at CP-VO2 amounted to 136.8 (SD 31.3) W. It was only 11 W -- non significantly -- higher than the power output corresponding to LT. The VO2 at CP-VO2 amounted to 1.828 (SD 0.356) l x min(-1) was [48.9 (SD 7.9)% VO2max]. The [La-]pl at CP-VO2, amounting to 2.57 (SD 0.69) mmol x l(-1) was significantly elevated (P < 0.01) above the resting level [1.85 (SD 0.46) mmol x l(-1)], however the [H+]b at CP-VO2 amounting to 45.1 (SD 3.0) nmol x l(-1), was not significantly different from the values at rest which amounted to 44.14 (SD 2.79) nmol x l(-1). An increase of power output of 30 W above CP-VO2 was accompanied by a significant increase in [H+]b above the resting level (P = 0.03).

Effect of exercise intensity on postprandial lipemia, markers of oxidative stress, and endothelial function after a high-fat meal.

PubMed

Lopes Krüger, Renata; Costa Teixeira, Bruno; Boufleur Farinha, Juliano; Cauduro Oliveira Macedo, Rodrigo; Pinto Boeno, Francesco; Rech, Anderson; Lopez, Pedro; Silveira Pinto, Ronei; Reischak-Oliveira, Alvaro

2016-12-01

The aim of this study was to compare the effects of 2 different exercise intensities on postprandial lipemia, oxidative stress markers, and endothelial function after a high-fat meal (HFM). Eleven young men completed 2-day trials in 3 conditions: rest, moderate-intensity exercise (MI-Exercise) and heavy-intensity exercise (HI-Exercise). Subjects performed an exercise bout or no exercise (Rest) on the evening of day 1. On the morning of day 2, an HFM was provided. Blood was sampled at fasting (0 h) and every hour from 1 to 5 h during the postprandial period for triacylglycerol (TAG), thiobarbituric acid reactive substance (TBARS), and nitrite/nitrate (NOx) concentrations. Flow-mediated dilatation (FMD) was also analyzed. TAG concentrations were reduced in exercise conditions compared with Rest during the postprandial period (P < 0.004). TAG incremental area under the curve (iAUC) was smaller after HI-Exercise compared with Rest (P = 0.012). TBARS concentrations were reduced in MI-Exercise compared with Rest (P < 0.041). FMD was higher in exercise conditions than Rest at 0 h (P < 0.02) and NOx concentrations were enhanced in MI-Exercise compared with Rest at 0 h (P < 0.01). These results suggest that acute exercise can reduce lipemia after an HFM. However, HI-Exercise showed to be more effective in reducing iAUC TAG, which might suggest higher protection against postprandial TAG enhancement. Conversely, MI-Exercise can be beneficial to attenuate the susceptibility of oxidative damage induced by an HFM and to increase endothelial function in the fasted state compared with Rest.

Effect of salbutamol on neuromuscular function in endurance athletes.

PubMed

Decorte, Nicolas; Bachasson, Damien; Guinot, Michel; Flore, Patrice; Levy, Patrick; Verges, Samuel; Wuyam, Bernard

2013-10-01

The potential ergogenic effects of therapeutic inhaled salbutamol doses in endurance athletes have been controversially discussed for decades. We hypothesized that salbutamol inhalation may increase peripheral muscle contractility, reduce fatigability, and improve force recovery after a localized exercise in endurance athletes. Eleven healthy, nonasthmatic male athletes with high aerobic capacities were recruited to be compared in a double-blinded, randomized crossover study of two dose levels of salbutamol (200 and 800 μg) and a placebo administered by inhalation before a quadriceps fatigue test. Subjects performed an incremental exercise protocol consisting in sets of 10 intermittent isometric contractions starting at 20% of maximum voluntary contraction (MVC) with 10% MVC increment until exhaustion. Femoral nerve magnetic stimulation was used during and after MVC to evaluate neuromuscular fatigue after each set, at task failure, and after 10 and 30 min of recovery. Initial MVC and evoked muscular responses were not modified with salbutamol (P > 0.05). The total number of submaximal contractions until task failure significantly differed between treatments (placebo, 72 ± 7; 200 µg, 78 ± 8; and 800 µg, 82 ± 7; P < 0.01). MVC and evoked muscular responses were similarly reduced with all treatments during the fatiguing task (all P > 0.05). Voluntary activation was unaffected by the fatiguing task and treatments (P > 0.05). Supratherapeutic inhaled doses of β2-agonists increased quadriceps endurance during an incremental and localized fatiguing task in healthy endurance-trained athletes without significant effect on neuromuscular fatigue. Further studies are needed to clarify the underlying mechanisms.

Economic evaluation of exercise-based cardiac rehabilitation in patients with a recent acute coronary syndrome.

PubMed

Hautala, A J; Kiviniemi, A M; Mäkikallio, T; Koistinen, P; Ryynänen, O-P; Martikainen, J A; Seppänen, T; Huikuri, H V; Tulppo, M P

2017-11-01

Health care decision-making requires evidence of the cost-effectiveness of medical therapies. We evaluated the cost-effectiveness of exercise-based cardiac rehabilitation (ECR) implemented according to guidelines. All the patients (n = 204) had experienced a recent acute coronary syndrome and were randomized to a 1-year ECR (n = 109) or usual care (UC) group (n = 95). The patients' health-related quality of life was followed using the 15D instrument and health care costs were collected from electronic health registries. The cost-effectiveness of ECR was estimated based on intervention and health care costs and quality-adjusted life years (QALYs) gained. The total average cost per patient was lower in ECR than in UC. The incremental cost was divided by the baseline-adjusted incremental QALYs (0.045), yielding an incremental cost-effectiveness ratio of -€24511/QALYs. A combined endpoint of mortality, recurrent coronary event, or hospitalization for a heart failure occurred for five patients in ECR and 16 patients in UC (HR 3.9, 95% CI 1.4-10.6, P = 0.004, relative risk reduction 73%, number needed to treat eight). ECR is a dominant treatment option and decreases the occurrence of adverse cardiac events. These results are useful for decision-making when planning optimal utilization of resources in Finnish health care. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial.

PubMed

Baker, Michael K; Kennedy, David J; Bohle, Philip L; Campbell, Deena S; Knapman, Leona; Grady, Jodie; Wiltshire, James; McNamara, Maria; Evans, William J; Atlantis, Evan; Fiatarone Singh, Maria A

2007-01-01

To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults. Randomized, controlled trial. Retirement village. Thirty-eight subjects (14 men and 24 women) aged 76.6 +/- 6.1. A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week. Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level. Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39+/-31% in exercise, versus 21+/-24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3+/-15%, P=.002) and chair stand time (-7.1+/-15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=-0.568, P=.009, PRT progression in loading r=-0.587, P=.02, and total volume of aerobic training r=-0.541, P=.01), as well as improvements in muscle strength (r=-0.498, P=.002). Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults.

Beneficial effects of training at the anaerobic threshold in addition to pharmacotherapy on weight loss, body composition, and exercise performance in women with obesity.

PubMed

Ozcelik, Oguz; Ozkan, Yusuf; Algul, Sermin; Colak, Ramis

2015-01-01

The aim of this study was to determine and compare the effects of weight loss achieved through orlistat therapy alone or a combination of orlistat and an aerobic exercise training program on aerobic fitness and body composition in obese females. Twenty-eight obese patients were randomly assigned to receive 12-week treatment with hypocaloric diet-orlistat or diet-orlistat-exercise. Each participant performed an incremental ramp exercise test every 4 weeks to measure aerobic fitness. Fourteen participants performed continuous exercise (approximately 45 minutes per session) at a work rate corresponding to the anaerobic threshold three times per week. A decrease in the fat mass to body weight ratio of 3.8% (P=0.006) was observed at the end of the 12 weeks in the orlistat group, while a decrease of 9.5% (P=0.001) was seen in the orlistat-exercise group. Maximal exercise capacity increased by 46.5% in the orlistat-exercise group and by 19.5% in the orlistat group. While orlistat therapy resulted in an improvement in body composition and aerobic fitness at the end of the 12-week period, its combination with exercise training provided improvements in the same parameters within the first 4 weeks of the study. These additional beneficial effects of combining aerobic exercise with orlistat therapy are important with regards to obesity-associated risk factors.

Exercise capacity in diabetes mellitus is predicted by activity status and cardiac size rather than cardiac function: a case control study.

PubMed

Roberts, Timothy J; Burns, Andrew T; MacIsaac, Richard J; MacIsaac, Andrew I; Prior, David L; La Gerche, André

2018-03-23

The reasons for reduced exercise capacity in diabetes mellitus (DM) remains incompletely understood, although diastolic dysfunction and diabetic cardiomyopathy are often favored explanations. However, there is a paucity of literature detailing cardiac function and reserve during incremental exercise to evaluate its significance and contribution. We sought to determine associations between comprehensive measures of cardiac function during exercise and maximal oxygen consumption ([Formula: see text]peak), with the hypothesis that the reduction in exercise capacity and cardiac function would be associated with co-morbidities and sedentary behavior rather than diabetes itself. This case-control study involved 60 subjects [20 with type 1 DM (T1DM), 20 T2DM, and 10 healthy controls age/sex-matched to each diabetes subtype] performing cardiopulmonary exercise testing and bicycle ergometer echocardiography studies. Measures of biventricular function were assessed during incremental exercise to maximal intensity. T2DM subjects were middle-aged (52 ± 11 years) with a mean T2DM diagnosis of 12 ± 7 years and modest glycemic control (HbA 1c 57 ± 12 mmol/mol). T1DM participants were younger (35 ± 8 years), with a 19 ± 10 year history of T1DM and suboptimal glycemic control (HbA 1c 65 ± 16 mmol/mol). Participants with T2DM were heavier than their controls (body mass index 29.3 ± 3.4 kg/m 2 vs. 24.7 ± 2.9, P = 0.001), performed less exercise (10 ± 12 vs. 28 ± 30 MET hours/week, P = 0.031) and had lower exercise capacity ([Formula: see text]peak = 26 ± 6 vs. 38 ± 8 ml/min/kg, P < 0.0001). These differences were not associated with biventricular systolic or left ventricular (LV) diastolic dysfunction at rest or during exercise. There was no difference in weight, exercise participation or [Formula: see text]peak in T1DM subjects as compared to their controls. After accounting for age, sex and body surface area in a multivariate analysis, significant positive predictors of [Formula: see text]peak were cardiac size (LV end-diastolic volume, LVEDV) and estimated MET-hours, while T2DM was a negative predictor. These combined factors accounted for 80% of the variance in [Formula: see text]peak (P < 0.0001). Exercise capacity is reduced in T2DM subjects relative to matched controls, whereas exercise capacity is preserved in T1DM. There was no evidence of sub-clinical cardiac dysfunction but, rather, there was an association between impaired exercise capacity, small LV volumes and sedentary behavior.

Gender-related difference in arterial elastance during exercise in patients with hypertension.

PubMed

Park, Sungha; Ha, Jong-Won; Shim, Chi Young; Choi, Eui-Young; Kim, Jin-Mi; Ahn, Jeong-Ah; Lee, Se-Wha; Rim, Se-Joong; Chung, Namsik

2008-04-01

Exercise intolerance and heart failure with preserved ejection fraction are common in females. Recently, arterial stiffness has been suggested to be a significant contributor in the development of heart failure. How gender difference affects arterial stiffening and its response to exercise is not well known. We hypothesized that arterial elastance index during exercise would be more abnormal in females with hypertension than males. Arterial elastance index was estimated as arterial end systolic pressure/stroke volume controlled for body surface area and was measured at rest and during graded supine bicycle exercise (25 watts, 3-minute increments) in 298 patients with hypertension (149 males; 149 females; mean age, 59). The subjects were divided into 2 groups by gender. Exercise duration was significantly shorter in females compared to males (692+/-222 versus 483+/-128 seconds, P<0.001). Although arterial elastance index at baseline was significantly higher in males, the magnitude of increase was steeper in females with the magnitude of change at 75 W of exercise being significantly higher in females compared to males (0.69+/-0.83 versus 0.43+/-0.69, P=0.018). Arterial elastance index at each stage of exercise up to 75 W was independently associated with decreased exercise duration. In conclusion, despite lower arterial elastance index at rest, the increase during exercise was steeper in women with hypertension, suggesting a gender-related difference in dynamic arterial stiffness. The arterial elastance index during exercise was significantly associated with exercise duration in patients with hypertension.

Departmental of Clinical Investigation: Annual Research Progress Report for Fiscal Year 1992. Volume 1

DTIC Science & Technology

1993-01-01

effect of cisapride on the symptoms of unexplained upper abdominal pain, nausea, vomiting, anorexia, early satiety, bloating/ distension in patients with...for 30 minutes following eccentric exercise will less the 3 indices of delayed-onset muscle soreness (DOMS): perceived muscular soreness, reduced...post-exercise and the Talag Pain Rating Scale will be used to assess muscular soreness. Progress: No progress report was furnished by the principal

Stochastic-Strength-Based Damage Simulation of Ceramic Matrix Composite Laminates

NASA Technical Reports Server (NTRS)

Nemeth, Noel N.; Mital, Subodh K.; Murthy, Pappu L. N.; Bednarcyk, Brett A.; Pineda, Evan J.; Bhatt, Ramakrishna T.; Arnold, Steven M.

2016-01-01

The Finite Element Analysis-Micromechanics Analysis Code/Ceramics Analysis and Reliability Evaluation of Structures (FEAMAC/CARES) program was used to characterize and predict the progressive damage response of silicon-carbide-fiber-reinforced reaction-bonded silicon nitride matrix (SiC/RBSN) composite laminate tensile specimens. Studied were unidirectional laminates [0] (sub 8), [10] (sub 8), [45] (sub 8), and [90] (sub 8); cross-ply laminates [0 (sub 2) divided by 90 (sub 2),]s; angled-ply laminates [plus 45 (sub 2) divided by -45 (sub 2), ]s; doubled-edge-notched [0] (sub 8), laminates; and central-hole laminates. Results correlated well with the experimental data. This work was performed as a validation and benchmarking exercise of the FEAMAC/CARES program. FEAMAC/CARES simulates stochastic-based discrete-event progressive damage of ceramic matrix composite and polymer matrix composite material structures. It couples three software programs: (1) the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC), (2) the Ceramics Analysis and Reliability Evaluation of Structures Life Prediction Program (CARES/Life), and (3) the Abaqus finite element analysis program. MAC/GMC contributes multiscale modeling capabilities and micromechanics relations to determine stresses and deformations at the microscale of the composite material repeating-unit-cell (RUC). CARES/Life contributes statistical multiaxial failure criteria that can be applied to the individual brittle-material constituents of the RUC, and Abaqus is used to model the overall composite structure. For each FEAMAC/CARES simulation trial, the stochastic nature of brittle material strength results in random, discrete damage events that incrementally progress until ultimate structural failure.

The effect of breathing an ambient low‐density, hyperoxic gas on the perceived effort of breathing and maximal performance of exercise in well‐trained athletes

PubMed Central

Ansley, L; Petersen, D; Thomas, A; Gibson, A St Clair; Robson‐Ansley, P; Noakes, T D

2007-01-01

Background The role of the perception of breathing effort in the regulation of performance of maximal exercise remains unclear. Aims To determine whether the perceived effort of ventilation is altered through substituting a less dense gas for normal ambient air and whether this substitution affects performance of maximal incremental exercise in trained athletes. Methods Eight highly trained cyclists (mean SD) maximal oxygen consumption (VO2max) = 69.9 (7.9) (mlO2/kg/min) performed two randomised maximal tests in a hyperbaric chamber breathing ambient air composed of either 35% O2/65% N2 (nitrox) or 35% O2/65% He (heliox). A ramp protocol was used in which power output was incremented at 0.5 W/s. The trials were separated by at least 48 h. The perceived effort of breathing was obtained via Borg Category Ratio Scales at 3‐min intervals and at fatigue. Oxygen consumption (VO2) and minute ventilation (VE) were monitored continuously. Results Breathing heliox did not change the sensation of dyspnoea: there were no differences between trials for the Borg scales at any time point. Exercise performance was not different between the nitrox and heliox trials (peak power output = 451 (58) and 453 (56) W), nor was VO2max (4.96 (0.61) and 4.88 (0.65) l/min) or maximal VE (157 (24) and 163 (22) l/min). Between‐trial variability in peak power output was less than either VO2max or maximal VE. Conclusion Breathing a less dense gas does not improve maximal performance of exercise or reduce the perception of breathing effort in highly trained athletes, although an attenuated submaximal tidal volume and VE with a concomitant reduction in VO2 suggests an improved gas exchange and reduced O2 cost of ventilation when breathing heliox. PMID:17062658

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.

High-intensity exercise training does not influence body weight but improves lipid oxidation in obese adults: a 6-week RCT.

PubMed

Jabbour, Georges; Iancu, Horia-Daniel

2017-01-01

This study examined the effects of 6 weeks of high-intensity training (HIT) on lipid oxidation (LO) rates during incremental exercises in obese adults. Twenty-four obese adults were randomised into a no-exercise control group (n=12; body mass index=33.3 (4.8) kg.m -2 ) and a HIT group (18 sessions of 6×6 s of supramaximal cycling and 2 min passive intervals; n=12; body mass index=33.2 (2.8)kg.m -2 ). The percentage of LO contribution was computed at rest and for all workloads (25, 50, 75, 100 and 125 W) in both groups before and after training via a graded maximal cycling test. After training, the HIT group showed significantly higher LO at rest and at 25, 50 and 75 W compared with baseline (p<0.01) and the control group (p<0.01). Moreover, for the training group, the homoeostasis model assessment of insulin resistance (HOMA-IR) index decreased significantly from the baseline value (p<0.01) and the control group value (p<0.01). The increases in LO observed at rest and stages 25, 50 and 75 W were positively correlated with the declines in the HOMA-IR index (r=0.87, r=0.83, r=0.91 and r=0.88; p<0.01). In obese adults, HIT increased lipid contributions to energy release at rest and in response to incremental exercise, while there were no changes in participants' aerobic capacity. This supports the hypothesis that metabolic changes rather than improved aerobic capacity are important to improve LO. ISRCTN66508384. Stage: post-results.

Cycling Power Outputs Predict Functional Threshold Power And Maximum Oxygen Uptake.

PubMed

Denham, Joshua; Scott-Hamilton, John; Hagstrom, Amanda D; Gray, Adrian J

2017-09-11

Functional threshold power (FTP) has emerged as a correlate of lactate threshold and is commonly assessed by recreational and professional cyclists for tailored exercise programing. To identify whether results from traditional aerobic and anaerobic cycling tests could predict FTP and V˙ O2max, we analysed the association between estimated FTP, maximum oxygen uptake (V˙ O2max [mlkgmin]) and power outputs obtained from a maximal cycle ergometry cardiopulmonary exercise test (CPET) and a 30-s Wingate test in a heterogeneous cohort of cycle-trained and untrained individuals (N=40, mean±SD; age: 32.6±10.6 y; relative V˙ O2max: 46.8±9.1 mlkgmin). The accuracy and sensitivity of the prediction equations was also assessed in young men (N=11) before and after a 6-wk sprint interval training intervention.Moderate to strong positive correlations were observed between FTP, relative V˙ O2max and power outputs achieved during incremental and 30-s Wingate cycling tests (r=.39-.965, all P<.05). While maximum power achieved during incremental cycle testing (Pmax) and relative V˙ O2max were predictors of FTP (r =.93), age and FTP (Wkg) estimated relative V˙ O2max (r=.80). Our findings confirm that FTP predominantly relies on aerobic metabolism and indicate both prediction models are sensitive enough to detect meaningful exercise-induced changes in FTP and V˙ O2max. Thus, coaches should consider limiting the time and load demands placed on athletes by conducting a maximal cycle ergometry CPET to estimate FTP. Additionally, a 20-min FTP test is a convenient method to assess V˙ O2max and is particularly relevant for exercise professionals without access to expensive CPET equipment.

Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients.

PubMed

do Nascimento, Eloisa Sanches Pereira; Sampaio, Luciana Maria Malosá; Peixoto-Souza, Fabiana Sobral; Dias, Fernanda Dultra; Gomes, Evelim Leal Freitas Dantas; Greiffo, Flavia Regina; Ligeiro de Oliveira, Ana Paula; Stirbulov, Roberto; Vieira, Rodolfo Paula; Costa, Dirceu

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.

Economic evaluation within a factorial-design randomised controlled trial of exercise, manual therapy, or both interventions for osteoarthritis of the hip or knee: study protocol.

PubMed

Pinto, Daniel; Robertson, M Clare; Hansen, Paul; Abbott, J Haxby

2011-06-17

Clinical guidelines for the treatment of hip and knee osteoarthritis recommend non-pharmacological and non-surgical treatments. Exercise treatments are recommended as primary strategies, but specific exercise programme components have not been specified. Early evidence indicates that manual physiotherapy is effective for hip and knee osteoarthritis. The Management of Osteoarthritis (MOA) Trial was designed to evaluate the effectiveness and cost-effectiveness of physiotherapist-led, individualised exercise, manual physiotherapy and a combination of these two interventions in the treatment of adults with hip or knee osteoarthrits. This paper describes the methods that will be used to conduct the economic evaluation of these interventions within the MOA Trial. This comprehensive economic evaluation will assess the incremental cost-effectiveness of physiotherapy plus usual care versus usual care alone from a societal perspective. The authors will conduct a cost-consequences analysis using end-points such as Outcomes Measures in Rheumatology Clinical Trials-Osteoarthritis Research Society International responder criteria and quality-adjusted life years. The evaluation will have a time horizon of 1 year (and so discounting will not be necessary). All costs will be reported in 2009 New Zealand dollars. The authors will address uncertainty via bootstrapping to calculate CIs for the mean incremental cost-effectiveness ratios and by performing sensitivity analyses. Ethical approval was granted by the Lower South Regional Ethics Committee of the New Zealand Ministry of Health (ethics reference: LRS/07/11/044). All participants of the MOA Trial provided written informed consent for the capture of their healthcare costs. We will submit the results of the study for publication irrespective of outcome. Clinical trials registration number ACTRN12608000130369.

The role of exercise in amyotrophic lateral sclerosis.

PubMed

Chen, Amy; Montes, Jacqueline; Mitsumoto, Hiroshi

2008-08-01

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting the motor nervous system. It causes progressive and cumulative physical disabilities in patients, and leads to eventual death due to respiratory muscle failure. The disease is diverse in its presentation, course, and progression. We do not yet fully understand the cause or causes of the disease, nor the mechanisms for its progression; thus, we lack effective means for treating this disease. Currently, we rely on a multidisciplinary approach to symptomatically manage and care for patients who have ALS. In this article, the authors review the literature on the role of exercise in patients who have ALS, and briefly compare what is known about exercise in other neuromuscular diseases.

[Russian treadmill BD-1 as a backup of the NASA TVIS].

PubMed

Iarmanova, E N; Kozlovskaia, I B; Bogomolov, V V; Rumiantseva, O N; Sukhachev, V I; Mel'nik, K A

2006-01-01

Already during the early ISS increments malfunctioning of NASA TVIS (treadmill with vibration isolation system) posed major problems for regular crew training and particularly scamper, one of the key exercises on the Russian physical training program. During ISS increment-3, TVIS unscheduled repairs took virtually all the training time. In search for TVIS backup, Russian and NASA engineers considered jointly Russian treadmill BD-1, originally designed for Russian "shuttle" Buran and accepted it as a suitable backup in case of complete TVIS failure. To enter into the "dialogue" with BD-1, i.e., to record and downlink training data, the treadmill speed indicator, a part of the treadmill stand, was replaced by PC.

Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: secondary exploratory analyses from a randomized controlled trial.

PubMed

Palstam, Annie; Larsson, Anette; Löfgren, Monika; Ernberg, Malin; Bjersing, Jan; Bileviciute-Ljungar, Indre; Gerdle, Björn; Kosek, Eva; Mannerkorpi, Kaisa

2016-05-21

Fibromyalgia (FM) is characterized by persistent widespread pain, increased pain sensitivity and tenderness. Women with FM also report disability, in terms of negative consequences on activities of daily living. Our recent randomized controlled trial (RCT) is the first study of resistance exercise to show positive effects on pain disability. The resistance exercise program of our RCT emphasized active involvement of participants in planning and progression of the exercise, using the principles of person-centeredness, to support each participant's ability to manage the exercise and the progress of it. The aim of this sub-study was to investigate explanatory factors for reduced pain disability in women with FM participating in a 15-week person-centered progressive resistance exercise program. A total of 67 women with FM were included in this sub-study of an RCT examining the effects of person-centered progressive resistance exercise performed twice a week for 15 weeks. Tests of physical capacity and health-related questionnaires were assessed at baseline and after the intervention period. Multivariable stepwise regression was used to analyze explanatory factors for improvements in pain disability. Reduced pain disability was explained by higher pain disability at baseline together with decreased fear avoidance beliefs about physical activity (R (2) = 28, p = 0.005). The improvements in the disability domains of recreation and social activity were explained by decreased fear avoidance beliefs about physical activity together with higher baseline values of each disability domain respectively (R (2) = 32, p = 0.025 and R (2) = 30, p = 0.017). The improvement in occupational disability was explained by higher baseline values of occupational disability (R (2) = 19, p = 0.001). The person-centered resistance exercise intervention, based on principles of self-efficacy, had a positive effect on recreational, social and occupational disability. The reduced pain disability seemed to be mediated by decreased fear avoidance beliefs. Age, symptom duration, pain intensity, and muscle strength at baseline had no explanatory value for reduced pain disability, indicating that the person-centered resistance exercise program has the potential to work for anyone with FM who has interest in physical exercise. The trial was registered on October 21, 2010 with ClinicalTrials.gov identification number: NCT01226784 .

Nineteenth century exercise clinics for the treatment of scoliosis.

PubMed

Elsaesser, S; Butler, A R

2014-01-01

Scoliosis is the abnormal lateral curvature and rotation of the spine. In the past this deformity has been linked with moral depravity, as in the case of Richard III. Treatment for scoliosis began with Hippocrates's use of boards and axial distortion. Today, bracing and surgery are used either to correct the deformity or to prevent further progression. In the past, however, exercise regimens have been used in the belief that strengthening back muscles would reduce curvature progression. This approach was pioneered by Per Henrik Ling in the early nineteenth century and was continued by his followers Mathius Roth and Franz Berwald and, most notably, by Gustav Zander. Even today a few clinics, particularly in Eastern Europe, still use exercise in the treatment of scoliosis. Whether it is effective remains debatable, but even if progression is not prevented the patient's general health will benefit from an exercise regimen.

Improving rice models for more reliable prediction of responses of rice yield to CO2 and temperature elevaton

USDA-ARS?s Scientific Manuscript database

Materials and Methods The simulation exercise and model improvement were implemented in phase-wise. In the first modelling activities, the model sensitivities were evaluated to given CO2 concentrations varying from 360 to 720 'mol mol-1 at an interval of 90 'mol mol-1 and air temperature increments...

Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise?

PubMed Central

Eijsvogels, Thijs M. H.; Fernandez, Antonio B.; Thompson, Paul D.

2015-01-01

Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including “myocardial” creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination. PMID:26607287

Exercise Prescription Using a Group-Normalized Rating of Perceived Exertion in Adolescents and Adults With Spina Bifida.

PubMed

Crytzer, Theresa M; Keramati, Mariam; Anthony, Steven J; Cheng, Yu-Ting; Robertson, Robert J; Dicianno, Brad E

2018-02-03

People with spina bifida (SB) face personal and environmental barriers to exercise that contribute to physical inactivity, obesity, risk of cardiovascular disease, and poor aerobic fitness. The WHEEL rating of perceived exertion (RPE) Scale was validated in people with SB to monitor exercise intensity. However, the psycho-physiological link between RPE and ventilatory breakpoint (Vpt), the group-normalized perceptual response, has not been determined and would provide a starting point for aerobic exercise in this cohort. The primary objectives were to determine the group-normalized RPE equivalent to Vpt based on WHEEL and Borg Scale ratings and to develop a regression model to predict Borg Scale (conditional metric) from WHEEL Scale (criterion metric). The secondary objective was to create a table of interchangeable values between WHEEL and Borg Scale RPE for people with SB performing a load incremental stress test. Cross-sectional observational. University laboratory. Twenty-nine participants with SB. Participants completed a load incremented arm ergometer exercise stress test. WHEEL and Borg Scale ratings were recorded the last 15 seconds of each 1-minute test phase. WHEEL and Borg Scale ratings, metabolic measures (eg, oxygen consumption, carbon dioxide production). Determined Vpt via plots of oxygen consumption and carbon dioxide production against time. Nineteen of 29 participants achieved Vpt (Group A). The mean ± standard deviation peak oxygen consumption at Vpt for Group A was 61.76 ± 16.26. The WHEEL and Borg Scale RPE at Vpt were 5.74 ± 2.58 (range 0-10) and 13.95 ± 3.50 (range 6-19), respectively. A significant linear regression model was developed (Borg Scale rating = 1.22 × WHEEL Scale rating + 7.14) and used to create a WHEEL-to-Borg Scale RPE conversion table. A significant linear regression model and table of interchangeable values was developed for participants with SB. The group-normalized RPE (WHEEL, 5.74; Borg, 13.95) can be used to prescribe and self-regulate arm ergometer exercise intensity approximating the Vpt. II. Copyright © 2018. Published by Elsevier Inc.

Utilizing Tornado Data for Classroom Exercises.

ERIC Educational Resources Information Center

Kohler, Fred

Exercises were developed using tornado statistics to provide students with a better understanding of the spatial and temporal characteristics of these phenomena in the United States. Four categories of exercises were considered beginning with the simplest and progressing to the more complex. The first set of exercises required students to…

Lactate kinetics in handcycling under various exercise modalities and their relationship to performance measures in able-bodied participants.

PubMed

Quittmann, Oliver J; Abel, Thomas; Zeller, Sebastian; Foitschik, Tina; Strüder, Heiko K

2018-05-03

The aim of this study was to expand exercise testing in handcycling by (1) examining different approaches to determine lactate kinetics in handcycling under various exercise modalities and (2) identifying relationships between parameters of lactate kinetics and selected performance measures. Twelve able-bodied nationally competitive triathletes performed a familiarisation, a sprint test, an incremental step test, and a continuous load trial at a power output corresponding to a lactate concentration (La) of 4 mmol l -1 (PO 4 ) in a racing handcycle that was mounted on an ergometer. During the tests, La and heart rate (HR) were determined. As performance measures, maximal power output during the 15-s All-Out sprint test (PO max,AO15 ) and maximal power output during the incremental test (PO max,ST ) were determined. As physiological parameters, coefficients of lactate kinetics, maximal lactate accumulation rate ([Formula: see text]La max ), maximal La following the sprint test and incremental test (La max,AO15 , La max,ST ) and the increase in La within the last 20 min of the continuous trial (La Crit,CT ) were determined. Mean values of PO max,AO15 (545.6 ± 69.9 W), PO max,ST (131.3 ± 14.9 W), PO 4 (86.73 ± 12.32 W), [Formula: see text]La max (0.45 ± 0.11 mmol l -1  s -1 ), La max,AO15 (6.64 ± 1.32 mmol l -1 ), La max,ST (9.64 ± 2.24 mmol l -1 ) and La Crit,CT (0.74 ± 0.74 mmol l -1 ) were in accordance to literature. [Formula: see text]La max was positively correlated with La max,AO15 and PO max,AO15 and negatively correlated with PO max,ST . PO max,ST was negatively correlated with La max,AO15 . PO 4 was negatively correlated with La max,ST . [Formula: see text]La max was identified as a promising parameter for exercise testing in handcycling that can be supplemented by other parameters describing lactate kinetics following a sprint test.

Effects of exercise-induced fatigue on postural balance: a comparison of treadmill versus cycle fatiguing protocols.

PubMed

Wright, Katherine E; Lyons, Thomas S; Navalta, James W

2013-05-01

The authors of this study examined the effects of muscle fatigue on balance indices and recovery time in recreationally trained individuals after incremental tests on a treadmill and a cycle ergometer. Sixteen participants (male N = 11, female N = 5) (mean age = 21.2 ± 2 years) completed this study. Balance measures were performed on a Biodex Balance System via the Dynamic Balance Test. Balance was measured pre-exercise, immediately post-exercise, and at 3-, 6-, 9-, 12-, 15-, 18-, and 21-min post-exercise. Immediately following the fatiguing treadmill test, balance increased significantly in the overall stability index (SI) (from 4.38 ± 2.48 to 6.09 ± 1.80) and the anterior/posterior index (API) (from 3.49 ± 2.18 to 5.28 ± 1.81) (p < 0.01). Immediately following the fatiguing cycle test, balance was not altered significantly in SI or API. Balance was not altered significantly for the medial/lateral index for either exercise test at any time point. Additionally, there were no significant differences in time to recovery. At 12-min post-exercise, all indices were below pre-exercise values, indicating that fatiguing exercise has a positive effect on balance over time. These results are consistent with previous research, suggesting that any effects of fatigue on balance are seen immediately and are diminished as time after exercise increases.

Physiologic abnormalities of cardiac function in progressive systemic sclerosis with diffuse scleroderma

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

Follansbee, W.P.; Curtiss, E.I.; Medsger, T.A. Jr.

1984-01-19

To investigate cardiopulmonary function in progressive systemic sclerosis with diffuse scleroderma, we studied 26 patients with maximal exercise and redistribution thallium scans, rest and exercise radionuclide ventriculography, pulmonary-function testing, and chest roentgenography. Although only 6 patients had clinical evidence of cardiac involvement, 20 had abnormal thallium scans, including 10 with reversible exercise-induced defects and 18 with fixed defects (8 had both). Seven of the 10 patients who had exercise-induced defects and underwent cardiac catheterization had normal coronary angiograms. Mean resting left ventricular ejection fraction and mean resting right ventricular ejection fraction were lower in patients with post-exercise left ventricular thalliummore » defect scores above the median (59 +/- 13 per cent vs. 69 +/- 6 per cent, and 36 +/- 12 per cent vs. 47 +/- 7 per cent, respectively). The authors conclude that in progressive systemic sclerosis with diffuse scleroderma, abnormalities of myocardial perfusion are common and appear to be due to a disturbance of the myocardial microcirculation. Both right and left ventricular dysfunction appear to be related to this circulatory disturbance, suggesting ischemically mediated injury.« less

Expiratory muscle loading increases intercostal muscle blood flow during leg exercise in healthy humans

PubMed Central

Athanasopoulos, Dimitris; Louvaris, Zafeiris; Cherouveim, Evgenia; Andrianopoulos, Vasilis; Roussos, Charis; Zakynthinos, Spyros

2010-01-01

We investigated whether expiratory muscle loading induced by the application of expiratory flow limitation (EFL) during exercise in healthy subjects causes a reduction in quadriceps muscle blood flow in favor of the blood flow to the intercostal muscles. We hypothesized that, during exercise with EFL quadriceps muscle blood flow would be reduced, whereas intercostal muscle blood flow would be increased compared with exercise without EFL. We initially performed an incremental exercise test on eight healthy male subjects with a Starling resistor in the expiratory line limiting expiratory flow to ∼ 1 l/s to determine peak EFL exercise workload. On a different day, two constant-load exercise trials were performed in a balanced ordering sequence, during which subjects exercised with or without EFL at peak EFL exercise workload for 6 min. Intercostal (probe over the 7th intercostal space) and vastus lateralis muscle blood flow index (BFI) was calculated by near-infrared spectroscopy using indocyanine green, whereas cardiac output (CO) was measured by an impedance cardiography technique. At exercise termination, CO and stroke volume were not significantly different during exercise, with or without EFL (CO: 16.5 vs. 15.2 l/min, stroke volume: 104 vs. 107 ml/beat). Quadriceps muscle BFI during exercise with EFL (5.4 nM/s) was significantly (P = 0.043) lower compared with exercise without EFL (7.6 nM/s), whereas intercostal muscle BFI during exercise with EFL (3.5 nM/s) was significantly (P = 0.021) greater compared with that recorded during control exercise (0.4 nM/s). In conclusion, increased respiratory muscle loading during exercise in healthy humans causes an increase in blood flow to the intercostal muscles and a concomitant decrease in quadriceps muscle blood flow. PMID:20507965

Daily Supine LBNP Treadmill Exercise Maintains Upright Exercise Capacity During 14 Days of Bed Rest

NASA Technical Reports Server (NTRS)

Ertl, Andy C.; Watenpaugh, D. E.; Hargens, Alan R.; Fortney, S. M.; Lee, S. M. C.; Ballard, R. E.; William, J. M.

1996-01-01

Exposure to microgravity or bed rest reduces upright exercise capacity. Exercise modes, durations, and intensities which will effectively and efficiently counteract such deconditioning are presently unresolved. We that daily supine treadmill interval training with lower body negative pressure (LBNP) would prevent reduction in upright exercise capacity during 14 days of 6 deg. head-down bed rest (BR). Eight healthy male subjects underwent two 14 day BR protocols separated by 3 months. In a crossover design, subjects either remained at strict BR or performed 40 min of daily exercise consisting of supine walking and running at intensities varying from 40-80% of pre-BR upright peak oxygen uptake (VO2). LBNP during supine exercise was used to provide 1.0 to 1.2 times body weight of footward force. An incremental upright treadmill test to measure submaximal and peak exercise responses was given pre- and post-BR. In the non-exercise condition, peak VO2 and time to exhaustion were reduced 16 +/- 4% and 10 +/- 1% (p less than 0.05), respectively, from pre-BR. With LBNP exercise these variables were not significantly different (NS) from pre-BR. During submaximal treadmill speeds after BR, heart rate was higher (11 +/- 11 bpm, p less than 0.05) and respiratory exchange ratio was elevated (p less than 0.05) in the no exercise condition. Both were maintained at pre-BR levels in the LBNP exercise condition (NS from pre-BR). Since this supine treadmill interval training with addition of LBNP maintained upright exercise responses and capacity during BR, this countermeasure may also be effective during space flight.

Disruption of BCAA metabolism in mice impairs exercise metabolism and endurance.

PubMed

She, Pengxiang; Zhou, Yingsheng; Zhang, Zhiyou; Griffin, Kathleen; Gowda, Kavitha; Lynch, Christopher J

2010-04-01

Exercise enhances branched-chain amino acid (BCAA) catabolism, and BCAA supplementation influences exercise metabolism. However, it remains controversial whether BCAA supplementation improves exercise endurance, and unknown whether the exercise endurance effect of BCAA supplementation requires catabolism of these amino acids. Therefore, we examined exercise capacity and intermediary metabolism in skeletal muscle of knockout (KO) mice of mitochondrial branched-chain aminotransferase (BCATm), which catalyzes the first step of BCAA catabolism. We found that BCATm KO mice were exercise intolerant with markedly decreased endurance to exhaustion. Their plasma lactate and lactate-to-pyruvate ratio in skeletal muscle during exercise and lactate release from hindlimb perfused with high concentrations of insulin and glucose were significantly higher in KO than wild-type (WT) mice. Plasma and muscle ammonia concentrations were also markedly higher in KO than WT mice during a brief bout of exercise. BCATm KO mice exhibited 43-79% declines in the muscle concentration of alanine, glutamine, aspartate, and glutamate at rest and during exercise. In response to exercise, the increments in muscle malate and alpha-ketoglutarate were greater in KO than WT mice. While muscle ATP concentration tended to be lower, muscle IMP concentration was sevenfold higher in KO compared with WT mice after a brief bout of exercise, suggesting elevated ammonia in KO is derived from the purine nucleotide cycle. These data suggest that disruption of BCAA transamination causes impaired malate/aspartate shuttle, thereby resulting in decreased alanine and glutamine formation, as well as increases in lactate-to-pyruvate ratio and ammonia in skeletal muscle. Thus BCAA metabolism may regulate exercise capacity in mice.

Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain.

PubMed

Lin, I-Hsien; Chang, Kwang-Hwa; Liou, Tsan-Hon; Tsou, Chih-Min; Huang, Yi-Ching

2018-02-01

Although neck pain is a common musculoskeletal disorder, there is no consensus on suitable exercise methods for middle-aged and senior patients with chronic neck pain. Therefore, this study investigated the effectiveness of a 6-week shoulder-neck exercise intervention program on cervical muscle function improvement in patients aged 45 years or older with chronic neck pain. The aim of the present study was to evaluate the effects of progressive shoulder-neck exercise on cervical muscle functions of middle-aged and senior patients with chronic neck pain. A randomized controlled single-blind trial. Rehabilitation department of a hospital. A total of 72 subjects aged ≥45 years with chronic neck pain were randomly allocated to either an experimental group (N.=36; age 57.3±8.74 years) or a control group (N.=36; age 58.15±8.17 years). The control group received only traditional physiotherapy, whereas the experimental group participated in a 6-week shoulder-neck exercise program consisting of cranio-cervical flexion and progressive resistance exercises in addition to receiving traditional physiotherapy. The muscle functions of subjects in both groups were tested before the experiment and also after the intervention program. The pretest and posttest measured the cranio-cervical flexion test (CCFT) and the superficial cervical muscle strength. After the intervention, the experimental group had a 56.48 point improvement in the performance index of the CCFT (P<0.001), a 1.71-kg improvement in superficial neck flexor strength (P<0.001), and a 2.52-kg improvement in superficial neck extensor strength (P<0.001), indicating that in 6-week intervention significantly influenced the improvement of cervical muscle functions. This study confirmed that the 6-week progressive shoulder-neck exercise program can effectively improve cervical muscle function in middle-aged and senior patients with chronic neck pain. Progressive shoulder-neck exercise might provide positive effect on deep and superficial neck muscle strength in patients with chronic neck pain. Therefore, this study may serve as a reference for the clinical rehabilitation of patients with chronic neck pain.

Accuracy of pulse oximeters in estimating heart rate at rest and during exercise.

PubMed Central

Iyriboz, Y; Powers, S; Morrow, J; Ayers, D; Landry, G

1991-01-01

Pulse oximeters are being widely used for non-invasive, simultaneous assessment of haemoglobin oxygen saturation. They are reliable, accurate, relatively inexpensive and portable. Pulse oximeters are often used for estimating heart rate at rest and during exercise. However, at present the data available to validate their use as heart rate monitors are not sufficient. We evaluated the accuracy of two oximeters (Radiometer, ear and finger probe; Ohmeda 3700, ear probe) in monitoring heart rate during incremental exercise by comparing the pulse oximeters with simultaneous ECG readings. Data were collected on eight men (713 heart rate readings) during graded cycle ergometer and treadmill exercise to volitional fatigue. Analysis by linear regression revealed that general oximeter readings significantly correlated with those of ECG (r = 0.91, P less than 0.0001). However, comparison of heart rate at each level of work showed that oximeter readings significantly (P less than 0.05) under-estimated rates above 155 beats/min. These results indicate that the use of pulse oximeters as heart rate monitors during strenuous exercise is questionable. This inaccuracy may well originate from the instability of the probes, sweating, other artefacts during exercise, and measurement of different components in the cardiovascular cycle. PMID:1777787

Cardiorespiratory response to exercise testing in individuals with Alzheimer's disease.

PubMed

Billinger, Sandra A; Vidoni, Eric D; Honea, Robyn A; Burns, Jeffrey M

2011-12-01

To examine exercise testing response in Alzheimer's disease (AD) and possible disease-related change over time. Retrospective assessment of a 2-year observational study. University medical center. Individuals without dementia (n=50) and with AD (n=31). Not applicable. Participants underwent a clinical dementia evaluation and performed an incremental exercise test using a treadmill and the modified Bruce protocol at baseline and at a 2-year follow-up. We examined oxygen consumption, minute ventilation, heart rate, and ventilatory equivalents for oxygen and carbon dioxide at submaximal and peak exercise intensities to determine whether the measures were different between groups or over time. Participants with AD and those without dementia performed similarly at submaximal effort, and both groups showed similar changes in exercise response over 2 years. However, nondemented individuals had consistently higher values of oxygen consumption (P≤.02) and minute ventilation at peak effort at baseline (P=.003). Individuals with AD demonstrate physiologic responses to submaximal exercise effort that are not significantly different than individuals without dementia. However, differences are apparent at the extreme of effort. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Expiratory flow limitation and operating lung volumes during exercise in older and younger adults.

PubMed

Smith, Joshua R; Kurti, Stephanie P; Meskimen, Kayla; Harms, Craig A

2017-06-01

We determined the effect of aging on expiratory flow limitation (EFL) and operating lung volumes when matched for lung size. We hypothesized that older adults will exhibit greater EFL and increases in EELV during exercise compared to younger controls. Ten older (5M/5W; >60years old) and nineteen height-matched young adults (10M/9W) were recruited. Young adults were matched for%predicted forced vital capacity (FVC) (Y-matched%Pred FVC; n=10) and absolute FVC (Y-matched FVC; n=10). Tidal flow-volume loops were recorded during the incremental exercise test with maximal flow-volume loops measured pre- and post-exercise. Compared to younger controls, older adults exhibited more EFL at ventilations of 26, 35, 51, and 80L/min. The older group had higher end-inspiratory lung volume compared to Y-matched%Pred FVC group during submaximal ventilations. The older group increased EELV during exercise, while EELV stayed below resting in the Y-matched%Pred FVC group. These data suggest older adults exhibit more EFL and increase EELV earlier during exercise compared to younger adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Changes in Ventilatory Response to Exercise in Trained Athletes: Respiratory Physiological Benefits Beyond Cardiovascular Performance.

PubMed

di Paco, Adriano; Dubé, Bruno-Pierre; Laveneziana, Pierantonio

2017-05-01

The beneficial impact of an 8-month competitive season on the ventilatory profile response to exercise in soccer players has never been evaluated. Ventilatory profile (evaluated by determining individual tidal volume [V T ] relative to minute ventilation [V E ] inflection points during exercise) and metabolic responses to incremental exercise were evaluated in 2 professional soccer teams before and after an 8-month competitive season. No differences between teams in anthropometric characteristics or in resting cardiopulmonary variables, included oxygen uptake (VO 2 ) and heart rate (HR), before and during the competitive season were found. At iso-speed, there were overall improvements in carbon dioxide output (VCO 2 ), V E /VO 2 , V E /VCO 2 , V E and respiratory frequency (fR) during the season. The V T /V E inflection points 1 and 2 occurred with greater exercise time, HR, VO 2 , VCO 2 , V E and V T during the competitive season. Despite very high baseline performance and a negligible improvement in VO 2 , an 8-month competitive season improved ventilatory profile response to exercise in elite athletes. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Scoliosis-Specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study.

PubMed

Negrini, Alessandra; Negrini, Maria Gabriella; Donzelli, Sabrina; Romano, Michele; Zaina, Fabio; Negrini, Stefano

2015-01-01

Scoliosis fusion surgery is generally considered the only means to stop the progression of adult idiopathic scoliosis (ADIS), but for patients refusing surgery there is lack of evidence in favour of conservative treatment. The aim of the present study was to verify the possible effectiveness of scoliosis-specific exercises when facing ADIS progression. We designed a retrospective cohort study. We included 34 ADIS patients in treatment at our Institute (5 males and 29 females, mean age was 38.0 ± 11.0), exclusively treated with specific Scoliosis Specific SEAS exercises. SEAS exercises are scoliosis-specific exercises. In adult patients they are aimed to recover postural collapse, postural control and vertebral stability through an active self-correction. Postural integration is a key element, including the neuromotor integration of correct postures and an ergonomic education program. Therapy includes at least two weekly exercise sessions each lasting 45 min. Radiographic progression was the main outcome and it was analysed as a continuous variable. One way ANOVA and paired t-test were applied for continuous data, while chi-square test was applied for categorical data. Alpha was set at 0.05. The mean Cobb angle of the patients included into the present study, was 55.8 ± 13.2 °. Fifteen patients had previous x-rays testifying scoliosis progression: the average curve progression (worsening) was 9.8 ± 6.6 ° at a median of 25 (range 17-48) years. The remaining were characterized by more severe curves, exceeding 40 ° Cobb (mean curvature 50.9 ± 13.6) but it was not possible to prove that the curves had progressed in these cases. After an average period of 2 years of treatment (range 1-18y), 68 % of the patients experienced an improvement in their scoliosis. However in one patient (3 %) the scoliosis worsened by 5 ° in 18 years (progression rate reduced from 0.5 ° to 0.27 ° per year). Patients improved 4.6 ± 5.0 ° Cobb (P < 0.05), with no differences based on the localization of the curve, gender, age, length of treatment, Cobb degrees at the start of observation or treatment. Scoliosis Specific SEAS Exercises proved to be superior to natural history in ADIS, at least in individual cases and should be considered as a first line treatment especially in patients refusing scoliosis surgery.

Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions.

PubMed

Stevens, John W; Khunti, Kamlesh; Harvey, Rebecca; Johnson, Maxine; Preston, Louise; Woods, Helen Buckley; Davies, Melanie; Goyder, Elizabeth

2015-03-01

Individuals with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) have an increased risk of progression to Type 2 diabetes mellitus. The objective of this review was to quantify the effectiveness of lifestyle, pharmacological and surgical interventions in reducing the progression to Type 2 diabetes mellitus in people with IFG or IGT. A systematic review was carried out. A network meta-analysis (NMA) of log-hazard ratios was performed. Results are presented as hazard ratios and the probabilities of treatment rankings. 30 studies were included in the NMA. There was a reduced hazard of progression to Type 2 diabetes mellitus associated with all interventions versus standard lifestyle advice; glipizide, diet plus pioglitazone, diet plus exercise plus metformin plus rosiglitazone, diet plus exercise plus orlistat, diet plus exercise plus pedometer, rosiglitazone, orlistat and diet plus exercise plus voglibose produced the greatest effects. Lifestyle and some pharmacological interventions are beneficial in reducing the risk of progression to Type 2 diabetes mellitus. Lifestyle interventions require significant behaviour changes that may be achieved through incentives such as the use of pedometers. Adverse events and cost of pharmacological interventions should be taken into account when considering potential risks and benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Domain Definition and Exercise Generation as Functions of the National Assessment of Educational Progress.

ERIC Educational Resources Information Center

Haertel, Edward H.

It has been recommended that the National Assessment of Educational Progress (NAEP) specify comprehensive exercise domains to measure academic achievement, and provide a national item pool to measure the objectives in these domains. These domain specifications and item pools would serve to satisfy the increasing demand for valid, accurate, and…

Non-invasive estimation of hydration status changes through tear fluid osmolarity during exercise and post-exercise rehydration.

PubMed

Ungaro, Corey T; Reimel, Adam J; Nuccio, Ryan P; Barnes, Kelly A; Pahnke, Matthew D; Baker, Lindsay B

2015-05-01

To determine if tear fluid osmolarity (Tosm) can track changes in hydration status during exercise and post-exercise rehydration. Nineteen male athletes (18-37 years, 74.6 ± 7.9 kg) completed two randomized, counterbalanced trials; cycling (~95 min) with water intake to replace fluid losses or water restriction to progressively dehydrate to 3 % body mass loss (BML). After exercise, subjects drank water to maintain body mass (water intake trials) or progressively rehydrate to pre-exercise body mass (water restriction trials) over a 90-min recovery period. Plasma osmolality (Posm) and Tosm measurements (mean of right and left eyes) were taken pre-exercise, during rest periods between exercise bouts corresponding to 1, 2, and 3 % BML, and rehydration at 2, 1, and 0 % BML. During exercise mean (± SD) Tosm was significantly higher in water restriction vs. water intake trials at 1 % BML (299 ± 9 vs. 293 ± 9 mmol/L), 2 % BML (301 ± 9 vs. 294 ± 9 mmol/L), and 3 % BML (302 ± 9 vs. 292 ± 8 mmol/L). Mean Tosm progressively decreased during post-exercise rehydration and was not different between trials at 1 % BML (291 ± 8 vs. 290 ± 7 mmol/L) and 0 % BML (288 ± 7 vs. 289 ± 8 mmol/L). Mean Tosm tracked changes in hydration status similar to that of mean Posm; however, the individual responses in Tosm to water restriction and water intake was considerably more variable than that of Posm. Tosm is a valid indicator of changes in hydration status when looking at the group mean; however, large differences among subjects in the Tosm response to hydration changes limit its validity for individual recommendations.

Exercises reduce the progression rate of adolescent idiopathic scoliosis: results of a comprehensive systematic review of the literature.

PubMed

Negrini, S; Fusco, C; Minozzi, S; Atanasio, S; Zaina, F; Romano, M

2008-01-01

A previously published systematic review (Ped.Rehab.2003 - DARE 2004) documented the existence of the evidence of level 2a (Oxford EBM Centre) on the efficacy of specific exercises to reduce the progression of AIS (Adolescent Idiopathic Scoliosis). To confirm whether the indication for treatment with specific exercises for AIS has changed in recent years. Systematic review. A bibliographic search with strict inclusion criteria (patients treated exclusively with exercises, outcome Cobb degrees, all study designs) was performed on the main electronic databases and through extensive manual searching. We retrieved 19 studies, including one RCT and eight controlled studies; 12 studies were prospective. A methodological and clinical evaluation was performed. The 19 papers considered included 1654 treated patients and 688 controls. The highest-quality study (RCT) compared two groups of 40 patients, showing an improvement of curvature in all treated patients after six months. We found three papers on Scoliosis Intensive Rehabilitation (Schroth), five on extrinsic autocorrection-based methods (Schroth, side-shift), four on intrinsic autocorrection-based approaches (Lyon and SEAS) and five with no autocorrection (three asymmetric, two symmetric exercises). Apart from one (no autocorrection, symmetric exercises, very low methodological quality), all studies confirmed the efficacy of exercises in reducing the progression rate (mainly in early puberty) and/or improving the Cobb angles (around the end of growth). Exercises were also shown to be effective in reducing brace prescription. In five years, eight more papers have been published to the indexed literature coming from throughout the world (Asia, the US, Eastern Europe) and proving that interest in exercises is not exclusive to Western Europe. This systematic review confirms and strengthens the previous ones. The actual evidence on exercises for AIS is of level 1b.

Core muscle activity in a series of balance exercises with different stability conditions.

PubMed

Calatayud, Joaquin; Borreani, Sebastien; Martin, Julio; Martin, Fernando; Flandez, Jorge; Colado, Juan C

2015-07-01

Literature that provides progression models based on core muscle activity and postural manipulations is scarce. The purpose of this study was to investigate the core muscle activity in a series of balance exercises with different stability levels and additional elastic resistance. A descriptive study of electromyography (EMG) was performed with forty-four healthy subjects that completed 12 exercises in a random order. Exercises were performed unipedally or bipedally with or without elastic tubing as resistance on various unstable (uncontrolled multiaxial and uniaxial movement) and stable surfaces. Surface EMG on the lumbar multífidus spinae (LM), thoracic multífidus spinae (TM), lumbar erector spinae (LE), thoracic erector spinae (TE) and gluteus maximus (GM), on the dominant side of the body were collected to quantify the amount of muscle activity and were expressed as a % of the maximum voluntary isometric contraction (MVIC). Significant differences (p<.001) were found between exercises. The three unipedal standing exercises with additional elastic resistance generated the greatest EMG values, ranging from 19% MVIC to 30% MVIC. Postural manipulations with additional elastic resistance and/or unstable devices increase core muscle activity. An adequate exercise progression based on global core EMG could start with seated positions, progressing to bipedal standing stance (i.e., from either multiaxial or stable surface to uniaxial surface). Following this, unipedal standing positions may be performed (i.e., from either multiaxial or stable surface to uniaxial surface) and finally, elastic resistance must be added in order to increase EMG levels (i.e., from stable surface progressing to any of the used unstable surfaces). Copyright © 2015 Elsevier B.V. All rights reserved.

Ineffectiveness of intravenous beta 2-agonists on improving exercise tolerance in patients with reversible chronic airway obstruction.

PubMed

Malerba, M; Boni, E; Tantucci, C; Filippi, B; Romagnoni, G; Grassi, V

1996-01-01

The effects on exercise tolerance after acute administration of beta 2-agonists were investigated in 11 patients with partly reversible chronic airway obstruction after 400 micrograms of salbutamol (S) given intravenously (i.v.) and after 400 micrograms i.v. of a new selective beta 2-agonist, broxaterol (B), by a cardiopulmonary incremental exercise test. At rest, while VE increased in respect to basal conditions (C) after S (from 13.3 +/- 2.2 to 14.4 +/- 2.8 l/min; p < 0.05) and after B (from 13.6 +/- 3.1 to 15.5 +/- 3.6 l/min; p < 0.05), VO2, VCO2 and VO2/HR showed no substantial variations. A small, not significant reduction of PaO2 was observed both after S (from 82.7 +/- 11.7 to 79.1 +/- 16.7 mm Hg) and B (from 81.6 +/- 10.5 to 78.0 +/- 11.0 mm Hg). The maximum workload increased neither after S (from 67.5 +/- 39.1 to 66.6 +/- 37.0 W) nor after B (from 65.7 +/- 39.3 to 60.0 +/- 35.8 W). At peak of exercise, VO2, VCO2 and VO2/HR did not change after S and B as compared with C, whereas VE remained higher after both beta 2-agonists throughout the effort. VO2 at ventilatory anaerobic threshold (AT) was significantly greater either after S (from 744 +/- 378 to 815 +/- 302 ml/min; p < 0.05) and after B (from 756 +/- 290 to 842 +/- 292 ml/min; p < 0.05). The PaO2 increase shown by these patients during effort was greater after beta 2-agonists administration, delta PaO2 from rest to peak of exercise amounting to 14.9 +/- 14.3 vs. 7.8 +/- 8.2 mm Hg after S and to 17.8 +/- 15.1 vs. 8.8 +/- 10.9 mm Hg after B, in respect to relative baseline (p < 0.05). We conclude that beta 2-agonists, when given acutely, do not improve exercise tolerance in patients with reversible chronic airflow obstruction, although these drugs can induce a small increment of ventilatory AT. In addition, arterial blood gases do not deteriorate at rest and are better preserved during exercise after beta 2-agonists.

Relationship between exercise pressure gradient and haemodynamic progression of aortic stenosis.

PubMed

Ringle, Anne; Levy, Franck; Ennezat, Pierre-Vladimir; Le Goffic, Caroline; Castel, Anne-Laure; Delelis, François; Menet, Aymeric; Malaquin, Dorothée; Graux, Pierre; Vincentelli, André; Tribouilloy, Christophe; Maréchaux, Sylvestre

We hypothesized that large exercise-induced increases in aortic mean pressure gradient can predict haemodynamic progression during follow-up in asymptomatic patients with aortic stenosis. We retrospectively identified patients with asymptomatic moderate or severe aortic stenosis (aortic valve area<1.5cm 2 or<1cm 2 ) and normal ejection fraction, who underwent an exercise stress echocardiography at baseline with a normal exercise test and a resting echocardiography during follow-up. The relationship between exercise-induced increase in aortic mean pressure gradient and annualised changes in resting mean pressure gradient during follow-up was investigated. Fifty-five patients (mean age 66±15 years; 45% severe aortic stenosis) were included. Aortic mean pressure gradient significantly increased from rest to peak exercise (P<0.001). During a median follow-up of 1.6 [1.1-3.2] years, resting mean pressure gradient increased from 35±13mmHg to 48±16mmHg, P<0.0001. Median annualised change in resting mean pressure gradient during follow-up was 5 [2-11] mmHg. Exercise-induced increase in aortic mean pressure gradient did correlate with annualised changes in mean pressure gradient during follow-up (r=0.35, P=0.01). Hemodynamic progression of aortic stenosis was faster in patients with large exercise-induced increase in aortic mean pressure gradient (≥20mmHg) as compared to those with exercise-induced increase in aortic mean pressure gradient<20mmHg (median annualised increase in mean pressure gradient 19 [6-28] vs. 4 [2-10] mmHg/y respectively, P=0.002). Similar results were found in the subgroup of 30 patients with moderate aortic stenosis. Large exercise-induced increases in aortic mean pressure gradient correlate with haemodynamic progression of stenosis during follow-up in patients with asymptomatic aortic stenosis. Further studies are needed to fully establish the role of ESE in the decision-making process in comparison to other prognostic markers in asymptomatic patients with aortic stenosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Modelling decremental ramps using 2- and 3-parameter "critical power" models.

PubMed

Morton, R Hugh; Billat, Veronique

2013-01-01

The "Critical Power" (CP) model of human bioenergetics provides a valuable way to identify both limits of tolerance to exercise and mechanisms that underpin that tolerance. It applies principally to cycling-based exercise, but with suitable adjustments for analogous units it can be applied to other exercise modalities; in particular to incremental ramp exercise. It has not yet been applied to decremental ramps which put heavy early demand on the anaerobic energy supply system. This paper details cycling-based bioenergetics of decremental ramps using 2- and 3-parameter CP models. It derives equations that, for an individual of known CP model parameters, define those combinations of starting intensity and decremental gradient which will or will not lead to exhaustion before ramping to zero; and equations that predict time to exhaustion on those decremental ramps that will. These are further detailed with suitably chosen numerical and graphical illustrations. These equations can be used for parameter estimation from collected data, or to make predictions when parameters are known.

Cardiorespiratory response to exercise testing in individuals with Alzheimer’s disease

PubMed Central

Billinger, Sandra A.; Vidoni, Eric D.; Honea, Robyn A.; Burns, Jeffrey M.

2011-01-01

Objective To exercise testing in AD and possible disease-related change over time. Though physical activity and fitness are receiving increased attention as a possible adjunct treatment for Alzheimer’s disease (AD), relatively little work has been done characterizing their physiologic response to exercise Design Retrospective assessment of a 2-year, observational study Setting University medical center Participants 50 nondemented individuals and 31 with AD Interventions None Main Outcome Measures Participants underwent a clinical dementia evaluation and performed an incremental exercise test using a treadmill and the modified Bruce protocol at baseline and at a two year follow-up. We examined oxygen consumption, minute ventilation, heart rate and ventilatory equivalents for oxygen and carbon dioxide at submaximal and peak exercise intensities to determine if the measures were different between groups or over time. Results AD and nondemented participants performed similarly at submaximal effort and both groups showed similar change in exercise response over 2 years. However, nondemented individuals had consistently higher values of oxygen consumption (p≤0.02) and minute ventilation at peak effort at baseline (p=0.003). Conclusions Individuals with AD demonstrate physiologic responses to submaximal exercise effort that are not significantly different than individuals without dementia. However, differences are apparent at the extreme of effort. PMID:22133248

Comparison of standardbred trotters exercising on a treadmill and a race track with identical draught resistances.

PubMed

Gottlieb-Vedi, M; Lindholm, A

1997-05-17

The responses in heart rate, plasma lactate and rectal temperature of standardbred trotters to draught loaded interval exercise on a treadmill and a race track were studied. The horses were exercised with incrementally increasing trotting speeds for two-minute intervals with draught loads of 10, 20 and 30 kilopond (kp) in three different tests. Each trotting interval was followed by two-minute periods at a walk without a draught load. Measurements of heart rate and plasma lactate were made at the end of each interval and the rectal temperature was taken at the end of the exercise. The heart rate and plasma lactate levels were significantly lower on the treadmill than on the track in the tests with 10 kp, but no significant differences were found between the treadmill and track exercise tests with the heavier draught resistances. No differences were observed in rectal temperature between treadmill and track conditions. From these findings it was concluded that the workload was significantly greater on the race track compared to the treadmill when the draught resistance was low (10 kp). Although the workload increased on both the race track and the treadmill as draught resistance increased, at the heavier draught resistances track exercise was no longer more demanding than exercise on the treadmill.

Energy expenditure and physiological responses during walking on a treadmill and moving on the Torqway vehicle.

PubMed

Maciejczyk, Marcin; Wiecek, Magdalena; Szymura, Jadwiga; Szygula, Zbigniew

2016-01-01

One of the new products which can be used to increase physical activity and energy expenditure is the Torqway vehicle, powered by the upper limbs. The aim of this study was to (1) assess the usefulness and repeatability of the Torqway vehicle for physical exercise, (2) compare energy expenditure and physiological responses during walking on a treadmill and during physical effort while moving on the Torqway at a constant speed. The participants (11 men, aged 20.2 ± 1.3) performed the incremental test and submaximal exercises (walking on the treadmill and moving on the Torqway vehicle at the same speed). Energy expenditure during the exercise on the Torqway was significantly higher (p = 0.001) than during the walking performed at the same speed. The intensity of the exercise performed on the Torqway expressed as %VO2max and %HRmax was significantly ( p < 0.001) higher than during walking (respectively: 35.0 ± 6.0 vs. 29.4 ± 7.4 %VO2max and 65.1 ± 7.3 vs. 47.2 ± 7.4 %HRmax). Exercise on the Torqway vehicle allows for the intensification of the exercise at a low movement speed, comparable to walking. Moving on the Torqway vehicle could be an effective alternative activity for physical fitness and exercise rehabilitation programs.

Influence of exercise induced hyperlactatemia on retinal blood flow during normo- and hyperglycemia.

PubMed

Garhöfer, Gerhard; Kopf, Andreas; Polska, Elzbieta; Malec, Magdalena; Dorner, Guido T; Wolzt, Michael; Schmetterer, Leopold

2004-05-01

Short term hyperglycemia has previously been shown to induce a blood flow increase in the retina. The mechanism behind this effect is poorly understood. We set out to investigate whether exercise-induced hyperlactatemia may alter the response of retinal blood flow to hyperglycemia. We performed a randomized, controlled two-way cross over study comprising 12 healthy subjects, performed a 6-minutes period of dynamic exercise during an euglcaemic or hyperglycaemic insulin clamp. Retinal blood flow was assessed by combined vessel size measurement with the Zeiss retinal vessel analyzer and measurement of red blood cell velocities using bi-directional laser Doppler velocimetry. Retinal and systemic hemodynamic parameters were measured before, immediately after and 10 and 20 minutes after isometric exercise. On the euglycemic study day retinal blood flow increased after dynamic exercise. The maximum increase in retinal blood flow was observed 10 minutes after the end of exercise when lactate plasma concentration peaked. Hyperglycemia increased retinal blood flow under basal conditions, but had no incremental effect during exercise induced hyperlactatemia. Our results indicate that both lactate and glucose induce an increase in retinal blood flow in healthy humans. This may indicate a common pathway between glucose and lactate induced blood flow changes in the human retina.

The Effects of Nandrolone Decanoate Along with Prolonged Low-Intensity Exercise on Susceptibility to Ventricular Arrhythmias.

PubMed

Binayi, Fateme; Joukar, Siyavash; Najafipour, Hamid; Karimi, Abdolah; Karimi, Ali; Abdollahi, Farzane; Masumi, Yaser

2016-01-01

We examined the influence of chronic administration of nandrolone decanoate with low-intensity endurance swimming exercise on susceptibility to lethal ventricular arrhythmias in rat. The animal groups included the control group, exercise group (EX), nandrolone group (Nan), vehicle group (Arach), trained vehicle group (Arach + Ex) and trained nandrolone group (Nan + Ex) that treated for 8 weeks. Then, arrhythmia induction was performed by intravenous infusion of aconitine and electrocardiogram recorded. Then, malondialdehyde (MDA), hydroxyproline (HYP) and glutathione peroxidase of heart tissue were measured. Chronic administration of nandrolone with low-intensity endurance swimming exercise had no significant effect on blood pressure, heart rate and basal ECG parameters except RR interval that showed increase (P < 0.05). Low-intensity exercise could prevent the incremental effect of nandrolone on MDA and HYP significantly. It also increased the heart hypertrophy index (P < 0.05) and reduced the abating effect of nandrolone on animal weighting. Nandrolone along with exercise significantly increased the duration of VF (P < 0.05) and reduced the VF latency (P < 0.05). The findings suggest that chronic co-administration of nandrolone with low-intensity endurance swimming exercise to some extent facilitates the occurrence of ventricular fibrillation in rat. Complementary studies are needed to elucidate the involved mechanisms of this abnormality.

Lack of age-specific influence on leg blood flow during incremental calf plantar-flexion exercise in men and women.

PubMed

Reilly, Heather; Lane, Louise M; Egaña, Mikel

2018-05-01

Age-related exercising leg blood flow (LBF) responses during dynamic knee-extension exercise and forearm blood flow responses during handgrip exercise are preserved in normally active men but attenuated in activity-matched women. We explored whether these age- and sex-specific effects are also apparent during isometric calf plantar-flexion incremental exercise. Normally active young men (YM, n = 15, 24 ± 2 years), young women (YW, n = 8, 22 ± 1 years), older men (OM, n = 13, 70 ± 7 years) and older women (OW, n = 10, 64 ± 7 years) were tested. LBF was measured between contractions using venous occlusion plethysmography. Peak force obtained was higher (P < 0.05) in men compared with women and in young compared with older individuals. However, peak LBF (YM; 971 ± 328 ml min -1 , OM; 985 ± 504 ml min -1 , YW; 844 ± 366 ml min -1 , OW; 960 ± 244 ml min -1 ) and peak leg vascular conductance [LVC = LBF/(MAP + hydrostatic pressure)] responses (YM; 6.0 ± 1.8 ml min -1  mmHg -1 , OM; 5.5 ± 2.8 ml min -1  mmHg -1 , YW; 5.3 ± 2.1 ml min -1  mmHg -1 , OW; 5.5 ± 1.6 ml min -1 mmHg -1 ) were similar among the four groups. Furthermore, the hyperaemic (YM; 8.8 ± 3.7 ml min -1  %F peak -1 OM; 8.3 ± 5.4 ml min -1  %F peak -1 , YW; 8.2 ± 3.5 ml min -1  %F peak -1 , OW; 9.6 ± 2.2 ml min -1  %F peak -1 ) and vasodilatory responses (YM; 0.053 ± 0.020 ml min -1  mmHg -1  %F peak -1 , OM; 0.048 ± 0.028 ml min -1  mmHg -1  %F peak -1 , YW; 0.051 ± 0.019 ml min -1  mmHg -1  %F peak -1 , OW; 0.055 ± 0.014 ml min -1  mmHg -1  %F peak -1 ) were not different among the four groups. These results were accompanied by similar resting LBF responses among groups and were not affected when data were normalised to estimated leg muscle mass. Our results demonstrate that exercising LBF responses during isometric incremental calf muscle exercise are preserved in older men and women, suggesting that the previously observed age-related attenuations in leg and forearm hyperaemia among women may be muscle-group specific.

Nandrolone Plus Moderate Exercise Increases the Susceptibility to Lethal Arrhythmias

PubMed Central

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

2015-01-01

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

Walking impairment in patients with multiple sclerosis: exercise training as a treatment option.

PubMed

Motl, Robert W; Goldman, Myla D; Benedict, Ralph H B

2010-11-16

Multiple sclerosis (MS) is a chronic disease of the central nervous system that culminates in the progression of physical and cognitive disability over time. Walking impairment is a ubiquitous feature of MS and a sentinel characteristic of the later or advanced stages of the disease. This paper presents a conceptual rationale along with empirical evidence for exercise training as a rehabilitation approach for managing walking impairment and improving walking function in persons with MS. Conceptually, MS is associated with a decrease in physical activity, which, in turn, can result in deconditioning across multiple domains of physiological functioning. The resulting deconditioning feeds back and further drives physical inactivity until a threshold is reached that likely initiates the progression of walking impairment in MS. Empirically, physical activity and exercise training have been associated with beneficial effects on walking function in persons with MS. This is based on cross-sectional, longitudinal, and experimental research that included diversity in the breadth of measures of walking, persons with MS, and exercise/physical activity characteristics. Of particular importance, future researchers might consider examining the combinatory effects of exercise training plus pharmacological agents on walking mobility in MS. Collectively, exercise training and physical activity might hold significant potential for the management of progressive mobility disability in MS.

Exercise training and immune crosstalk in breast cancer microenvironment: exploring the paradigms of exercise-induced immune modulation and exercise-induced myokines.

PubMed

Goh, Jorming; Niksirat, Negin; Campbell, Kristin L

2014-01-01

Observational research suggests that exercise may reduce the risk of breast cancer and improve survival. One proposed mechanism for the protective effect of aerobic exercise related to cancer risk and outcomes, but has not been examined definitively, is the immune response to aerobic exercise. Two prevailing paradigms are proposed. The first considers the host immune response as modifiable by aerobic exercise training. This exercise-modulated immune-tumor crosstalk in the mammary microenvironment may alter the balance between tumor initiation and progression versus tumor suppression. The second paradigm considers the beneficial role of exercise-induced, skeletal muscle-derived cytokines, termed "myokines". These myokines exert endocrine-like effects on multiple organs, including the mammary glands. In this systematic review, we i) define the role of macrophages and T-cells in breast cancer initiation and progression; ii) address the two paradigms that support exercise-induced immunomodulation; iii) systematically assessed the literature for exercise intervention that assessed biomarkers relevant to both paradigms in human intervention trials of aerobic exercise training, in healthy women and women with breast cancer; iv) incorporated pre-clinical animal studies and non-RCTs for background discussion of putative mechanisms, through which aerobic exercise training modulates the immunological crosstalk, or the myokine-tumor interaction in the tumor microenvironment; and v) speculated on the potential biomarkers and mechanisms that define an exercise-induced, anti-tumor "signature", with a view toward developing relevant biomarkers for future aerobic exercise intervention trials.

Exploring Wellness Interventions in Progressive Multiple Sclerosis: an Evidence-Based Review.

PubMed

Venasse, Myriam; Edwards, Thomas; Pilutti, Lara A

2018-04-10

There has been recent interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for patients with progressive MS, considering limited therapeutic options currently available. The purpose of this review is to examine the role of wellness-based interventions including exercise training, emotional well-being therapies, and dietary modification in patients with progressive MS. We conducted a literature search on the efficacy of wellness-based interventions in patients with progressive MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention. There is level C evidence (possibly effective; one class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in patients with progressive MS. There is level B evidence (probably effective; one class I study) for the efficacy of mindfulness training on psychological distress, depression, anxiety, pain, and quality of life in patients with progressive MS. There is inadequate evidence (level U) for efficacy of dietary modification (one class III study and one class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one class IV study). High-quality research is needed to provide evidence-based recommendations for wellness behaviors and lifestyle change in patients with progressive MS.

Bridging the gap between content and context: establishing expert consensus on the content of an exercise training program to prevent lower-limb injuries.

PubMed

Donaldson, Alex; Cook, Jill; Gabbe, Belinda; Lloyd, David G; Young, Warren; Finch, Caroline F

2015-05-01

To achieve expert consensus on the content of an exercise training program (known as FootyFirst) to prevent lower-limb injuries. Three-round online Delphi consultation process. Community Australian Football (AF). Members of the Australian Football Leagues' Medical Officers (n = 94), physiotherapists (n = 50), and Sports Science (n = 19) Associations were invited to participate through e-mail. Five people with more general expertise in sports-related lower-limb injury prevention were also invited to participate. The primary outcome measure was the level of agreement on the appropriateness of the proposed exercises and progressions for inclusion in FootyFirst. Consensus was reached when ≥75% of experts who responded to each item agreed and strongly agreed, or disagreed and strongly disagreed, that an exercise or its progressions were appropriate to include in FootyFirst. Fifty-five experts participated in at least 1 Delphi round. In round 1, consensus was achieved that the proposed warm-up (run through and dynamic stretches) and the exercises and progressions for hamstring strength and for balance, landing, and changing direction were appropriate to include in FootyFirst. There was also consensus in round 1 that progressions for hip/core strength should be included in FootyFirst. Consensus was reached in round 2 that the revised groin strength and hip strength exercises should be included in FootyFirst. Consensus was reached for the progression of the groin strength exercises in round 3. The formal consensus development process has resulted in an evidence-informed, researcher-developed, exercise-based sports injury prevention program that is expert endorsed and specific to the context of AF. Lower-limb injuries are common in running, kicking, and contact sports like AF. These injuries are often costly to treat, and many have high rates of recurrence, making them challenging to treat clinically. Reducing these injuries is a high priority for players, teams, and medical staff. Exercise programs provide a method for primary prevention of lower-limb injuries, but they have to be evidence based, have currency with sports practitioners/clinicians, and utility for the context in which they are to be used. However, the comprehensive methods and clinical engagement processes used to develop injury prevention exercise programs have not previously been described in detail. This study describes the results of engaging clinicians and sport scientists in the development of a lower-limb sports injury prevention program for community AF, enabling the development of a program that is both evidence informed and considerate of expert clinical opinion.

The effect of the hypohydration on the lactate threshold in a hot and humid environment.

PubMed

Papadopoulos, C; Doyle, J; Rupp, J; Brandon, L; Benardot, D; Thompson, W

2008-09-01

The purpose of this study was to investigate the effect of hypohydration (HH) on the lactate threshold (LT) in a hot and humid environment. Ten apparently healthy males (age 25+/-3 yrs; height 1.8+/-0.04 m; mass 78+/-12 kg; VO2peak 3.7+/-0.4 L/min) underwent four randomly assigned maximal treadmill tests. Two trials were at room temperature (22+/-1 degrees C; RH = 50%) under two different hydration conditions: euhydrated (EH-RM) and hypohydrated (HH-RM), and two trials were performed in a warm chamber (37+/-0.5 degrees C; RH = 70%) under two different hydration conditions: euhydrated (EH-HT) and hypohydrated (HH-HT). The desired HH level (2-4%) was accomplished in the 24+ hours before testing by fluid restriction. Mean HH was 2.6+/-1.0% body weight. Capillary blood samples were collected at the end of each stage and analyzed for lactic acid (LA). LA concentrations were plotted for each exercise stage, and the LT was determined by visual inspection as the highest exercise stage at which blood LA concentration began to increase above each individual's resting levels. LT and body temperature were analyzed with a two-way repeated measures ANOVA (P < 0.05). During the trials in the warm chamber, the LT occurred at a significantly earlier stage compared to the thermoneutral environment (4.4+/-0.09 vs 5.8+/-0.10) and with a significantly lower oxygen consumption (2.38+/-0.09 L.min(-1) vs 2.86+/-0.13 L.min(-1)). Body temperature at the LT was significantly higher in the heat trials compared to room temperature (38.7+/-0.12 degrees C vs 37.6+/-0.14 degrees C). LT determination was not significantly altered by hydration. These results suggest that during progressive incremental maximal treadmill exercise, moderate HH does not affect the LT, whereas exercise in a hot and humid environment induces a downward shift in the LT. The elevated body temperature during the heat trials suggests that body temperature may affect running performance associated with the LT.

Promotion Considerations for Exercise and Physical Activity in Mentally Impaired, Diseased, and Disabled Older Adults.

ERIC Educational Resources Information Center

Frizzell, Linda Bane

This paper reports evidence indicating that adapted exercise has a preventive effect on the incidence and progression of chronic diseases which are often related to the aging process. Exercise is known to preserve many physiological responses in the healthy elderly, yet those with physical impairments are often discouraged from exercising because…

Brain, Behavior, and Immunity: Effects and potential mechanisms of exercise training on cancer progression: A translational perspective

Cancer.gov

Review of the extant epidemiological evidence examining the association between exercise behavior, function capacity/exercise capacity, and cancer-specific recurrence and mortality as well as all-cause mortality individuals following a cancer diagnosis.

Warm-up strategy and high-intensity endurance performance in trained cyclists.

PubMed

Christensen, Peter M; Bangsbo, Jens

2015-04-01

To evaluate the influence of warm-up exercise intensity and subsequent recovery on intense endurance performance, selected blood variables, and the oxygen-uptake (VO2) response. Twelve highly trained male cyclists (VO2max 72.4 ± 8.0 mL · min-1 · kg-1, incremental-test peak power output (iPPO) 432 ± 31 W; mean ± SD) performed 3 warm-up strategies lasting 20 min before a 4-min maximal-performance test (PT). Strategies consisted of moderate-intensity exercise (50%iPPO) followed by 6 min of recovery (MOD6) or progressive high-intensity exercise (10-100%iPPO and 2 × 20-s sprints) followed by recovery for 6 min (HI6) or 20 min (HI20). Before PT venous pH was lower (P < .001) in HI6 (7.27 ± 0.05) than in HI20 (7.34 ± 0.04) and MOD6 (7.35 ± 0.03). At the same time, differences (P < .001) existed for venous lactate in HI6 (8.2 ± 2.0 mmol/L), HI20 (5.1 ± 1.7 mmol/L), and MOD6 (1.4 ± 0.4 mmol/L), as well as for venous bicarbonate in HI6 (19.3 ± 2.6 mmol/L), HI20 (22.6 ± 2.3 mmol/L), and MOD6 (26.0 ± 1.4 mmol/L). Mean power in PT in HI6 (402 ± 38 W) tended to be lower (P = .11) than in HI20 (409 ± 34 W) and was lower (P = .007) than in MOD6 (416 ± 32 W). Total VO2 (15-120 s in PT) was higher in HI6 (8.18 ± 0.86 L) than in HI20 (7.85 ± 0.82 L, P = .008) and MOD6 (7.90 ± 0.74 L, P = .012). Warm-up exercise including race-pace and sprint intervals combined with short recovery can reduce subsequent performance in a 4-min maximal test in highly trained cyclists. Thus, a reduced time at high exercise intensity, a reduced intensity in the warm-up, or an extension of the recovery period after an intense warm-up is advocated.

Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol.

PubMed

O'Brien, Kelly K; Tynan, Anne-Marie; Nixon, Stephanie A; Glazier, Richard H

2017-04-12

HIV is increasingly considered a chronic illness. More individuals are living longer and aging with the health-related consequences associated with HIV and multi-morbidity. Exercise is a self-management approach that can promote health for people aging with HIV. We examined the safety and effectiveness of progressive resistive exercise (PRE) interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV. We conducted a systematic review using the Cochrane Collaboration protocol. Searching databases up to April 2013, we included randomized controlled trials that compared PRE with no exercise or another intervention performed at least three times per week for at least four weeks with adults living with HIV. Two reviewers independently determined study eligibility. We extracted data from included studies and assessed risk of bias using the Cochrane Collaboration risk of bias tool. Meta-analyses were conducted using random effects models with Review Manager (RevMan) computer software. Twenty studies met inclusion criteria (n = 764 participants at study completion); the majority of participants were men (77%) taking antiretroviral therapy (14/20 included studies). Exercise interventions included PRE alone (8 studies) or a combination of resistive and aerobic exercise (12 studies) ranging from 6 to 52 weeks in duration. Thirty-four meta-analyses were performed. Results demonstrated statistically significant improvements in cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), weight, and body composition (arm and thigh girth, leg muscle area) among exercisers versus non-exercisers. We found no significant differences in change in CD4 count and viral load. We were unable to perform meta-analyses for psychological outcomes however results from individual studies demonstrated improvements in health-related quality of life with exercisers compared with non-exercisers. Performing progressive resistive exercise (PRE) or a combination of resistive and aerobic exercise at least three times per week for at least six weeks is safe and can lead to improvements in cardiorespiratory fitness, strength, weight, and body composition for adults with HIV. Exercise may be considered a safe and beneficial for enhancing the health of medically stable adults aging with HIV.

Exercise attenuates neuropathology and has greater benefit on cognitive than motor deficits in the R6/1 Huntington's disease mouse model.

PubMed

Harrison, David J; Busse, Monica; Openshaw, Rebecca; Rosser, Anne E; Dunnett, Stephen B; Brooks, Simon P

2013-10-01

Huntington's disease (HD) is a neurodegenerative disease caused by a mutation within the huntingtin gene that induces degeneration within the striatal nuclei, progressing to widespread brain atrophy and death. The neurodegeneration produces symptoms that reflect a corticostriatal disconnection syndrome involving motor, cognitive and psychiatric disturbance. Environmental enrichment has been demonstrated to be beneficial to patients with neurological disorders, with exercise being central to this effect. Rodent studies have confirmed exercise-induced neurogenesis and increased growth factor levels in the brain and improved behavioural function. The present study sought to determine whether an extended regime of exercise could retard disease progression in the R6/1 mouse model of HD. The study was designed specifically with a translational focus, selecting behavioural assessments with high clinical predictive validity. We found that exercise improved gait function in both control and HD mice and selectively improved performance in the R6/1 mice on a motor coordination aspect of the balance beam task. Exercise also retarded the progression of cognitive dysfunction on water T-maze procedural and reversal learning probes presented serially to probe cognitive flexibility. In addition, exercise reduced striatal neuron loss in the R6/1 mice but increased striatal neuronal intra-nuclear inclusion size and number relative to non-exercised R6/1 mice which demonstrated increased numbers of extra-neuronal inclusions, suggesting that the functional effects were striatally mediated. These results confirm and extend those from previous studies that demonstrate that HD may be amenable to exercise-mediated therapeutics, but suggest that the impact of such interventions may be primarily cognitive. © 2013.

Drug abusers have impaired cerebral oxygenation and cognition during exercise

PubMed Central

Soares Rachetti, Vanessa; Quirino Alves da Silva, Weslley; Aranha Rego Cabral, Daniel; Gomes da Silva Machado, Daniel; Caldas Costa, Eduardo; Forti, Rodrigo Menezes; Mesquita, Rickson Coelho; Elsangedy, Hassan Mohamed; Hideki Okano, Alexandre; Bodnariuc Fontes, Eduardo

2017-01-01

Background Individuals with Substance Use Disorder (SUD) have lower baseline metabolic activity of the prefrontal cortex (PFC) associated with impairment of cognitive functions in decision-making and inhibitory control. Aerobic exercise has shown to improve PFC function and cognitive performance, however, its effects on SUD individuals remain unclear. Purpose To verify the cognitive performance and oxygenation of the PFC during an incremental exercise in SUD individuals. Methods Fourteen individuals under SUD treatment performed a maximum graded exercise test on a cycle ergometer with continuous measurements of oxygen consumption, PFC oxygenation, and inhibitory control (Stroop test) every two minutes of exercise at different intensities. Fifteen non-SUD individuals performed the same protocol and were used as control group. Results Exercise increased oxyhemoglobin (O2Hb) and total hemoglobin (tHb) by 9% and 7%, respectively. However, when compared to a non-SUD group, this increase was lower at high intensities (p<0.001), and the inhibitory cognitive control was lower at rest and during exercise (p<0.007). In addition, PFC hemodynamics during exercise was inversely correlated with inhibitory cognitive performance (reaction time) (r = -0.62, p = 0.001), and a lower craving perception for the specific abused substance (p = 0.0189) was reported immediately after exercise. Conclusion Despite SUD individuals having their PFC cerebral oxygenation increased during exercise, they presented lower cognition and oxygenation when compared to controls, especially at elevated intensities. These results may reinforce the role of exercise as an adjuvant treatment to improve PFC function and cognitive control in individuals with SUD. PMID:29125875

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise.

PubMed

Tedjasaputra, Vincent; van Diepen, Sean; Collins, Sophie É; Michaelchuk, Wade M; Stickland, Michael K

2017-02-20

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure. We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment. Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment. The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease.

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

PubMed Central

Tedjasaputra, Vincent; van Diepen, Sean; Collins, Sophie É; Michaelchuk, Wade M.; Stickland, Michael K.

2017-01-01

Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure. At the same time, the recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) during exercise may contribute to gas exchange impairment and/or prevent large increases in pulmonary artery pressure. We describe two techniques to evaluate pulmonary diffusion and circulation at rest and during exercise. The first technique uses multiple-fraction of inspired oxygen (FIO2) DLCO breath holds to determine Vc and Dm at rest and during exercise. Additionally, echocardiography with intravenous agitated saline contrast is used to assess IPAVAs recruitment. Representative data showed that the DLCO, Vc, and Dm increased with exercise intensity. Echocardiographic data showed no IPAVA recruitment at rest, while contrast bubbles were seen in the left ventricle with exercise, suggesting exercise-induced IPAVA recruitment. The evaluation of pulmonary capillary blood volume, membrane diffusing capacity, and IPAVA recruitment using echocardiographic methods is useful to characterize the ability of the lung vasculature to adapt to the stress of exercise in health as well as in diseased groups, such as those with pulmonary arterial hypertension and chronic obstructive pulmonary disease. PMID:28287506

Effects of exercise continued until anaerobic threshold on balance performance in male basketball players.

PubMed

Erkmen, Nurtekin; Suveren, Sibel; Göktepe, Ahmet Salim

2012-06-01

The objective of the present study was to determine the effects of exercise continued until the anaerobic threshold on balance performance in basketball players. Twelve male basketball players (age = 20.92 ± 2.81 years, body height = 192.72 ± 7.61 cm, body mass = 88.09 ± 8.41 kg, training experience = 7.17 ± 3.10 years) volunteered to participate in this study. A Kinesthetic Ability Trainer (KAT 2000 stabilometer) was used to measure the balance performance. Balance tests consisted of static tests on dominant, nondominant and double leg stance. The Bruce Protocol was performed by means of a treadmill. The exercise protocol was terminated when the subject passed the anaerobic threshold. After the exercise protocol, balance measurements were immediately repeated. Statistical differences between pre and post-exercise for dominant, nondominant and double leg stance were determined by the paired samples t-test according to the results of the test of normality. The post-exercise balance score on the dominant leg was significantly higher than pre-exercise (t = -2.758, p < 0.05). No differences existed between pre- and post-exercise in the balance scores of the nondominant leg after the exercise protocol (t = 0.428, p > 0.05). A significant difference was found between pre and post-exercise balance scores in the double leg stance (t = -2.354, p < 0.05). The main finding of this study was that an incremental exercise continued until the anaerobic threshold decreased balance performance on the dominant leg in basketball players, but did not alter it in the nondominant leg.

The effects of sex, metabolic syndrome and exercise on postprandial lipemia.

PubMed

Cox-York, Kimberly A; Sharp, Teresa A; Stotz, Sarah A; Bessesen, Daniel H; Pagliassotti, Michael J; Horton, Tracy J

2013-02-01

Exercise has been suggested to have cardioprotective benefits due to a lowering of postprandial triglycerides (PPTG). We hypothesized that a morning exercise bout would significantly lower PPTG measured over a full day, in response to moderate fat meals (35% energy) in men more so than women, and in metabolic syndrome (MetS) relative to normal weight (NW) individuals. Participants completed two randomized study days; one control and one exercise day (60 min of morning exercise, 60% VO(2peak)). Meals were consumed at breakfast, lunch and dinner with the energy expended during exercise replaced on the active day. The areas (AUC) and incremental areas (IAUC) under the curve were calculated for total triglycerides, total cholesterol and other metabolites. Exercise did not significantly change the PPTG AUC & IAUC overall, or within, or between, each sex or group (NW and MetS). Exercise induced a 30% decrease in total cholesterol IAUC (p=0.003) in NW subjects. Overall, women had a lower IAUC for PPTG compared to men (p=0.037), with the greatest difference between MetS women and MetS men, due to a sustained drop in TG after lunch in the women. This suggests that PP, rather than fasting, lipid analyses may be particularly important when evaluating sex differences in metabolic risk. With energy replacement, moderate morning exercise did not result in a significant decrease in PPTG excursions. Exercise did elicit a significant decrease in PP cholesterol levels in NW subjects, suggesting a potential mechanism for the cardioprotective effects of exercise. Copyright © 2013 Elsevier Inc. All rights reserved.

An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel) + gemcitabine vs gemcitabine alone for metastatic pancreatic cancer patients: the APICE study.

PubMed

Lazzaro, Carlo; Barone, Carlo; Caprioni, Francesco; Cascinu, Stefano; Falcone, Alfredo; Maiello, Evaristo; Milella, Michele; Pinto, Carmine; Reni, Michele; Tortora, Giampaolo

2018-04-20

the APICE study evaluates the cost-effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel - Nab-P) + gemcitabine (G) vs G alone in metastatic pancreatic cancer (MPC) from the Italian National Health Service (INHS) standpoint. A 4-year, 4 health states (progression-free; progressed; end of life; death) Markov model based on the MPACT trial was developed to estimate costs (Euro [€], 2017 values), and quality-adjusted life years (QALYs). Patients were assumed to receive intravenously Nab-P 125 mg/m 2  + G 1000 mg/m 2 on days 1, 8, and 15 every 4 weeks or G alone 1000 mg/m 2 weekly for 7 out of 8 weeks (cycle 1) and then on days 1, 8, and 15 every 4 weeks (cycle 2 and subsequent cycles) until progression. One-way and probabilistic sensitivity analyses explored the uncertainty surrounding the baseline incremental cost-utility ratio (ICUR). Nab-P + G totals 0.154 incremental QALYs and €7082.68 incremental costs vs G alone. ICUR (€46,021.58) is lower than the informal threshold value of €87,330 adopted by the Italian Medicines Agency during 2010-2013 for reimbursing oncological drugs. Sensitivity analyses confirmed the robustness of the baseline findings. Nab-P + G in MPC patients can be considered cost-effective for the INHS.

Exercise performance and peripheral vascular insufficiency improve with AMPK activation in high-fat diet-fed mice.

PubMed

Baltgalvis, Kristen A; White, Kathy; Li, Wei; Claypool, Mark D; Lang, Wayne; Alcantara, Raniel; Singh, Baljit K; Friera, Annabelle M; McLaughlin, John; Hansen, Derek; McCaughey, Kelly; Nguyen, Henry; Smith, Ira J; Godinez, Guillermo; Shaw, Simon J; Goff, Dane; Singh, Rajinder; Markovtsov, Vadim; Sun, Tian-Qiang; Jenkins, Yonchu; Uy, Gerald; Li, Yingwu; Pan, Alison; Gururaja, Tarikere; Lau, David; Park, Gary; Hitoshi, Yasumichi; Payan, Donald G; Kinsella, Todd M

2014-04-15

Intermittent claudication is a form of exercise intolerance characterized by muscle pain during walking in patients with peripheral artery disease (PAD). Endothelial cell and muscle dysfunction are thought to be important contributors to the etiology of this disease, but a lack of preclinical models that incorporate these elements and measure exercise performance as a primary end point has slowed progress in finding new treatment options for these patients. We sought to develop an animal model of peripheral vascular insufficiency in which microvascular dysfunction and exercise intolerance were defining features. We further set out to determine if pharmacological activation of 5'-AMP-activated protein kinase (AMPK) might counteract any of these functional deficits. Mice aged on a high-fat diet demonstrate many functional and molecular characteristics of PAD, including the sequential development of peripheral vascular insufficiency, increased muscle fatigability, and progressive exercise intolerance. These changes occur gradually and are associated with alterations in nitric oxide bioavailability. Treatment of animals with an AMPK activator, R118, increased voluntary wheel running activity, decreased muscle fatigability, and prevented the progressive decrease in treadmill exercise capacity. These functional performance benefits were accompanied by improved mitochondrial function, the normalization of perfusion in exercising muscle, increased nitric oxide bioavailability, and decreased circulating levels of the endogenous endothelial nitric oxide synthase inhibitor asymmetric dimethylarginine. These data suggest that aged, obese mice represent a novel model for studying exercise intolerance associated with peripheral vascular insufficiency, and pharmacological activation of AMPK may be a suitable treatment for intermittent claudication associated with PAD.

Physical activity and cancer prevention : pathways and targets for intervention.

PubMed

Rogers, Connie J; Colbert, Lisa H; Greiner, John W; Perkins, Susan N; Hursting, Stephen D

2008-01-01

The prevalence of obesity, an established epidemiological risk factor for many cancers, has risen steadily for the past several decades in the US and many other countries. Particularly alarming are the increasing rates of obesity among children, portending continuing increases in the rates of obesity and obesity-related cancers for many years to come. Modulation of energy balance, via increased physical activity, has been shown in numerous comprehensive epidemiological reviews to reduce cancer risk. Unfortunately, the effects and mechanistic targets of physical activity interventions on the carcinogenesis process have not been thoroughly characterized. Studies to date suggest that exercise can exert its cancer-preventive effects at many stages during the process of carcinogenesis, including both tumour initiation and progression. As discussed in this review, exercise may be altering tumour initiation events by modifying carcinogen activation, specifically by enhancing the cytochrome P450 system and by enhancing selective enzymes in the carcinogen detoxification pathway, including, but not limited to, glutathione-S-transferases. Furthermore, exercise may reduce oxidative damage by increasing a variety of anti-oxidant enzymes, enhancing DNA repair systems and improving intracellular protein repair systems. In addition to altering processes related to tumour initiation, exercise may also exert a cancer-preventive effect by dampening the processes involved in the promotion and progression stages of carcinogenesis, including scavenging reactive oxygen species (ROS); altering cell proliferation, apoptosis and differentiation; decreasing inflammation; enhancing immune function; and suppressing angiogenesis. A paucity of data exists as to whether exercise may be working as an anti-promotion strategy via altering ROS in initiated or preneoplastic models; therefore, no conclusions can be made about this possible mechanism. The studies directly examining cell proliferation and apoptosis have shown that exercise can enhance both processes, which is difficult to interpret in the context of carcinogenesis. Studies examining the relationship between exercise and chronic inflammation suggest that exercise may reduce pro-inflammatory mediators and reduce the state of low-grade, chronic inflammation. Additionally, exercise has been shown to enhance components of the innate immune response (i.e. macrophage and natural killer cell function). Finally, only a limited number of studies have explored the relationship between exercise and angiogenesis; therefore, no conclusions can be made currently about the role of exercise in the angiogenesis process as it relates to tumour progression. In summary, exercise can alter biological processes that contribute to both anti-initiation and anti-progression events in the carcinogenesis process. However, more sophisticated, detailed studies are needed to examine each of the potential mechanisms contributing to an exercise-induced decrease in carcinogenesis in order to determine the minimum dose, duration and frequency of exercise needed to yield significant cancer-preventive effects, and whether exercise can be used prescriptively to reverse the obesity-induced physiological changes that increase cancer risk.

The effects of arm crank ergometry, cycle ergometry and treadmill walking on postural sway in healthy older females.

PubMed

Hill, M W; Oxford, S W; Duncan, M J; Price, M J

2015-01-01

Older adults are increasingly being encouraged to exercise but this may lead to muscle fatigue, which can adversely affect postural stability. Few studies have investigated the effects of upper body exercise on postural sway in groups at risk of falling, such as the elderly. The purpose of this study was to compare the effects arm crank ergometry (ACE), cycle ergometry (CE) and treadmill walking (TM) on postural sway in healthy older females. In addition, this study sought to determine the time necessary to recover postural control after exercise. A total of nine healthy older females participated in this study. Participants stood on a force platform to assess postural sway which was measured by displacement of the centre of pressure before and after six separate exercise trials. Each participant completed three incremental exercise tests to 85% of individual's theoretical maximal heart rate (HRMAX) for ACE, CE and TM. Subsequent tests involved 20-min of ACE, CE and TM exercise at a relative workload corresponding to 50% of each individual's predetermined heart rate reserve (HRE). Post fatigue effects and postural control recovery were measured at different times after exercise (1, 3, 5, 10, 15 and 30-min). None of the participants exhibited impaired postural stability after ACE. In contrast, CE and TM elicited significant post exercise balance impairments, which lasted for ∼ 10 min post exercise. We provide evidence of an exercise mode which does not elicit post exercise balance impairments. Older adults should exercise caution immediately following exercise engaging the lower limbs to avoid fall risk. Copyright © 2014 Elsevier B.V. All rights reserved.

Structuralized box-trainer laparoscopic training significantly improves performance in complex virtual reality laparoscopic tasks.

PubMed

Laski, Dariusz; Stefaniak, Tomasz J; Makarewicz, Wojciech; Proczko, Monika; Gruca, Zbigniew; Sledziński, Zbigniew

2012-03-01

In the era of flowering minimally invasive surgical techniques there is a need for new methods of teaching surgery and supervision of progress in skills and expertise. Virtual and physical box-trainers seem especially fit for this purpose, and allow for improvement of proficiency required in laparoscopic surgery. The study included 34 students who completed the authors' laparoscopic training on physical train-boxes. Progress was monitored by accomplishment of 3 exercises: moving pellets from one place to another, excising and clipping. Analysed parameters included time needed to complete the exercise and right and left hand movement tracks. Students were asked to do assigned tasks prior to, in the middle and after the training. The duration of the course was 28 h in total. Significant shortening of the time to perform each exercise and reduction of the left hand track were achieved. The right hand track was shortened only in exercise number 1. Exercises in the laboratory setting should be regarded as an important element of the process of skills acquisition by a young surgeon. Virtual reality laparoscopic training seems to be a new, interesting educational tool, and at the same time allows for reliable control and assessment of progress.

Simple sugar supplementation abrogates exercise-induced increase in hepcidin in young men.

PubMed

Tomczyk, Maja; Kortas, Jakub; Flis, Damian; Skrobot, Wojciech; Camilleri, Rafal; Antosiewicz, Jedrzej

2017-01-01

At present many young people experience too much body iron accumulation. The reason of this phenomenon is not clear. There is accumulating evidences that not proper diet and lack of exercise could be a main contributing factors. This investigation assessed the effects of a diet rich in simple sugars (glucose or fructose) on exercise-induced hepcidin which is hormone regulating iron metabolism. A group of physically active young men completed an incremental exercise test before and after a 3-day diet supplemented with fructose (4 g/kg BM) or glucose (4 g/kg BM). After a 1-week break, they crossed over to the alternate mode for the subsequent 3-days period. Venous blood samples were collected before and after 1 h exercise and were analysed for serum hepcidin, IL-6, CRP, iron, and ferritin. The physiological response to exercise was also determined. The concentration of hepcidin increased 1 h after exercise for the baseline test ( p  < 0.05), whereas no changes in hepcidin were observed in men whose diet was supplemented with fructose or glucose. Blood IL-6 increased significantly after exercise only in subjects supplemented with fructose. Changes in hepcidin did not correlate with shifts in serum IL-6. These data suggest that protective effects of exercise on excess iron accumulation in human body which is mediated by hepcidin can be abrogated by high sugar consumption which is typical for contemporary people.

Exercises for adolescent idiopathic scoliosis.

PubMed

Romano, Michele; Minozzi, Silvia; Bettany-Saltikov, Josette; Zaina, Fabio; Chockalingam, Nachiappan; Kotwicki, Tomasz; Maier-Hennes, Axel; Negrini, Stefano

2012-08-15

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine . While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of scoliosis-specific exercises (SSE) to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial. To evaluate the efficacy of SSE in adolescent patients with AIS. The following databases (up to 30 March 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SportDiscus (from January 1975), PsycInfo (from January 1887), PEDro (from January 1929). We screened reference lists of articles and also conducted an extensive handsearch of grey literature. Randomised controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises. Two review authors independently selected studies, assessed risk of bias and extracted data. Two studies (154 participants) were included. There is low quality evidence from one randomised controlled study that exercises as an adjunctive to other conservative treatments increase the efficacy of these treatments (thoracic curve reduced: mean difference (MD) 9.00, (95% confidence interval (CI) 5.47 to 12.53); lumbar curve reduced:MD 8.00, (95% CI 5.08 to 10.92)). There is very low quality evidence from a prospective controlled cohort study that scoliosis-specific exercises structured within an exercise programme can reduce brace prescription (risk ratio (RR) 0.24, (95% CI 0.06 to1.04) as compared to usual physiotherapy (many different kinds of general exercises according to the preferences of the single therapists within different facilities). There is a lack of high quality evidence to recommend the use of SSE for AIS. One very low quality study suggested that these exercises may be more effective than electrostimulation, traction and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice.

Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors.

PubMed

Kraaijenga, Sophie A C; Molen, Lisette van der; Stuiver, Martijn M; Takes, Robert P; Al-Mamgani, Abrahim; Brekel, Michiel W M van den; Hilgers, Frans J M

2017-10-01

The efficacy of rehabilitative exercises for chronic dysphagia treatment in head and neck cancer survivors has not been studied extensively and is ambiguous. A prospective clinical phase II study using an intensive strength training program was carried out in 17 head and neck cancer survivors with chronic dysphagia. Both swallow and nonswallow exercises were performed for 6-8 weeks with a newly developed tool allowing for progressive muscle overload, including chin tuck, jaw opening, and effortful swallow exercises. Outcome parameters were feasibility, compliance, and parameters for effect. Feasibility in terms of the program completion rate was 88%. Compliance with the exercises was 97%. After the training period, chin tuck, jaw opening, and anterior tongue strength had substantially improved. All but 1 patient reported to benefit from the exercises. Feasibility and compliance were high. Some objective and subjective effects of progressive load on muscle strength and swallowing function could be demonstrated. © 2017 Wiley Periodicals, Inc.

Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

PubMed

Arjomandi, Mehrdad; Zeng, Siyang; Geerts, Jeroen; Stiner, Rachel K; Bos, Bruce; van Koeverden, Ian; Keene, Jason; Elicker, Brett; Blanc, Paul D; Gold, Warren M

2018-01-01

Exposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV 1 /FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear. To investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO 2max ) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)). RV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV 1 /FVC and FEV 1 , respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r 2 =0.03; p=0.011) and lower VO 2max (n=179; r 2 =0.47; p=0.013), and %EFL was negatively associated with VO 2max (n=32; r 2 =0.40; p=0.017). In those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity.

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

PubMed Central

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 (V·O2) corresponding to the RCP, [HHb]BP, and the EMGt was determined. Results: Peak power output (POpeak) was 359 ± 48 W. Maximal oxygen consumption (V·O2max) was 3.87 ± 0.46 L·min−1. The V·O2 at the RCP was 3.39 ± 0.41 L·min−1. The V·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 V·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 V·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. PMID:28970805

Characterizing cerebral and locomotor muscle oxygenation to incremental ramp exercise in healthy children: relationship with pulmonary gas exchange.

PubMed

Vandekerckhove, Kristof; Coomans, Ilse; Moerman, Annelies; De Wolf, Daniel; Boone, Jan

2016-12-01

To characterize the oxygenation responses at cerebral and locomotor muscle level to incremental exercise in children and to assess the interrelationship with the pulmonary gas exchange responses. Eighteen children (9 boys, 9 girls) (mean age 10.9 ± 1.0 years) performed incremental cycle ramp exercise to exhaustion. The concentration of cerebral and muscle oxygenated (O 2 Hb) and deoxygenated (HHb) hemoglobin (by means of near-infrared spectroscopy) and pulmonary gas exchange was recorded. Cerebral and muscle O 2 Hb and HHb values were expressed as functions of oxygen uptake (VO 2 ) and breakpoints were detected by means of double linear model analysis. The respiratory compensation point (RCP) was determined. The breakpoints in cerebral and muscle O 2 Hb and HHb were compared and correlated to RCP. The subjects reached peak power output of 105 ± 18 W and VO 2peak of 43.5 ± 7.0 ml min -1  kg -1 . Cerebral O 2 Hb increased to an intensity of 89.4 ± 5.5 %VO 2peak , where a breakpoint occurred at which cerebral O 2 Hb started to decrease. Cerebral HHb increased slightly to 88.1 ± 4.8 %VO 2peak , at which the increase was accelerated. Muscle HHb increased to 90.5 ± 4.8 %VO 2peak where a leveling-off occurred. RCP occurred at 89.3 ± 4.3 %VO 2peak . The breakpoints and RCP did not differ significantly (P = 0.13) and were strongly correlated (r > 0.70, P < 0.05). There were no differences between boys and girls (P = 0.43) and there was no significant correlation with VO 2peak (P > 0.05). It was shown that cerebral and muscle oxygenation responses undergo significant changes as work rate increases and show breakpoints in the ongoing response at high intensity (85-95 %VO 2peak ). These breakpoints are strongly interrelated and associated with changes in pulmonary gas exchange.

Noninvasive method to estimate anaerobic threshold in individuals with type 2 diabetes.

PubMed

Sales, Marcelo M; Campbell, Carmen Sílvia G; Morais, Pâmella K; Ernesto, Carlos; Soares-Caldeira, Lúcio F; Russo, Paulo; Motta, Daisy F; Moreira, Sérgio R; Nakamura, Fábio Y; Simões, Herbert G

2011-01-12

While several studies have identified the anaerobic threshold (AT) through the responses of blood lactate, ventilation and blood glucose others have suggested the response of the heart rate variability (HRV) as a method to identify the AT in young healthy individuals. However, the validity of HRV in estimating the lactate threshold (LT) and ventilatory threshold (VT) for individuals with type 2 diabetes (T2D) has not been investigated yet. To analyze the possibility of identifying the heart rate variability threshold (HRVT) by considering the responses of parasympathetic indicators during incremental exercise test in type 2 diabetics subjects (T2D) and non diabetics individuals (ND). Nine T2D (55.6 ± 5.7 years, 83.4 ± 26.6 kg, 30.9 ± 5.2 kg.m2(-1)) and ten ND (50.8 ± 5.1 years, 76.2 ± 14.3 kg, 26.5 ± 3.8 kg.m2(-1)) underwent to an incremental exercise test (IT) on a cycle ergometer. Heart rate (HR), rate of perceived exertion (RPE), blood lactate and expired gas concentrations were measured at the end of each stage. HRVT was identified through the responses of root mean square successive difference between adjacent R-R intervals (RMSSD) and standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) by considering the last 60 s of each incremental stage, and were known as HRVT by RMSSD and SD1 (HRVT-RMSSD and HRVT-SD1), respectively. No differences were observed within groups for the exercise intensities corresponding to LT, VT, HRVT-RMSSD and HHVT-SD1. Furthermore, a strong relationship were verified among the studied parameters both for T2D (r = 0.68 to 0.87) and ND (r = 0.91 to 0.98) and the Bland & Altman technique confirmed the agreement among them. The HRVT identification by the proposed autonomic indicators (SD1 and RMSSD) were demonstrated to be valid to estimate the LT and VT for both T2D and ND.

Metabolic and Cardiovascular Responses during Aquatic Exercise in Water at Different Temperatures in Older Adults

ERIC Educational Resources Information Center

Bergamin, Marco; Ermolao, Andrea; Matten, Sonia; Sieverdes, John C.; Zaccaria, Marco

2015-01-01

Purpose: The aim of this study was to investigate the physiological responses during upper-body aquatic exercises in older adults with different pool temperatures. Method: Eleven older men (aged 65 years and older) underwent 2 identical aquatic exercise sessions that consisted of 3 upper-body exercises using progressive intensities (30, 35, and 40…

Mucosal immunity and upper respiratory tract symptoms in recreational endurance runners.

PubMed

Ihalainen, Johanna K; Schumann, Moritz; Häkkinen, Keijo; Mero, Antti A

2016-01-01

The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m(-2), peak aerobic capacity = 47.2 mL·kg(-1)·min(-1)) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days (R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly (p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners.

Methods for determining deformation history for chocolate tablet boudinage with fibrous crystals

NASA Astrophysics Data System (ADS)

Casey, M.; Dietrich, D.; Ramsay, J. G.

1983-02-01

Chocolate tablet boudinage with fibrous crystal growths between the boudinaged plates from two localities were studied. In one, from Leytron, Valais, Switzerland, the deformation history was found to be a succession of plane strain increments with the shortening direction perpendicular to the boudinaged sheet and the extension direction showing a progressive change in orientation within the sheet. The incremental and finite strains were evaluated. The other specimen, from Parys Mountain, Anglesey Great Britain, was found to have a more complex history with diachronous break up of the competent layer and flattening strain increments. It was found that under these circumstances the direct graphical methods of determining finite and incremental strains gave inconsistent results. A numerical model was developed which allowed the simulation of chocolate tablet structure with a complex deformation history. The model was applied to the Anglesey specimen and three possible strain histories for this structure were tried.

The safety of isometric exercise: Rethinking the exercise prescription paradigm for those with stage 1 hypertension.

PubMed

Wiles, Jonathan D; Taylor, Katrina; Coleman, Damian; Sharma, Rajan; O'Driscoll, Jamie M

2018-03-01

Few studies have investigated the relative safety of prescribing isometric exercise (IE) to reduce resting blood pressure (BP). This study aimed to ascertain the safety of the hemodynamic response during an IE wall squat protocol.Twenty-six hypertensive (BP of 120-139 mm Hg systolic and/or 80-90 mm Hg diastolic) males (45 ± 8 years; 1.78 ± 0.07 m; 89.7 ± 12.3 kg; mean ± SD), visited the laboratory on 2 separate occasions. Heart rate (HR) and BP were measured at rest and continuously throughout exercise. In visit 1, participants completed a continuous incremental isometric wall squat exercise test, starting at 135° of knee flexion, decreasing by 10° every 2 minutes until 95° (final stage). Exercise was terminated upon completion of the test or volitional fatigue. The relationship between knee joint angle and mean HR was used to calculate the participant-specific knee joint angle required to elicit a target HR of 95% HRpeak. This angle was used to determine exercise intensity for a wall squat training session consisting of 4 × 2 minute bouts (visit 2).Systolic BPs during the exercise test and training were 173 ± 21 mm Hg and 171 ± 19 mm Hg, respectively, (P > .05) and were positively related (r = 0.73, P < .05) with ratio limits of agreement (LoA) of 0.995 ×/÷ 1.077. Diastolic BPs were 116 ± 14 mm Hg and 113 ± 11 mm Hg, respectively, (P > .05) and were positively related (r = 0.42, P < .05) with ratio LoA of 0.99 ×/÷ 1.107. No participant recorded a systolic BP > 250 mm Hg. Diastolic BP values > 115 mm Hg were recorded in 12 participants during the incremental test and 6 participants during the training session. Peak rate pressure product was 20681 ± 3911 mm Hg bpm during the IE test and was lower (18074 ± 3209 mm Hg bpm) during the IE session (P = .002). No adverse effects were reported.Based on the current ACSM guidelines for aerobic exercise termination, systolic BP does not reach the upper limit during IE in this population. Diastolic BP exceeds 115 mm Hg in some during the IE protocol, which may suggest the need to individualise IE training prescription in some with suboptimal BP control. Future research is required to ascertain if IE requires modified BP termination guidelines.

Effect of exercise intensity and mode on acute appetite control in men and women.

PubMed

Panissa, Valéria Leme Gonçalves; Julio, Ursula Ferreira; Hardt, Felipe; Kurashima, Carolina; Lira, Fábio Santos; Takito, Monica Yuri; Franchini, Emerson

2016-07-07

The aim of this study was to compare the effects of exercise intensity on appetite control: relative energy intake (energy intake minus the energy expenditure of exercise; REI), hunger scores, and appetite-regulating hormones in men and women. Eleven men and 9 women were submitted to 4 experimental sessions: high-intensity intermittent all-out exercise (HIIE-A) for 60 × 8 s interspersed by 12 s of passive recovery; high-intensity intermittent exercise (HIIE) at 100% of maximal load attained in incremental test; steady-state exercise at 60% of maximal load, matched by work done; and a control session. Exercise was performed 1.5 h after a standardized breakfast, and an ad libitum lunch was offered 4 h after breakfast. Blood concentration of insulin, cortisol, acylated ghrelin, peptideYY 3-36 , glucose, and hunger scores were measured when fasting, and at 1.5, 2, 3.25, and 4 h of experiment. REI was lower in all exercises than in the control, without differences between exercises and sex showing no compensation in energy intake because of any exercise; the hunger scores were lower only in the exercises performed at higher intensity (HIIE and HIIE-A) compared with the control. The area under the curve of acylated ghrelin was lower in the HIIE-A when compared with the control. PeptideYY 3-36 was higher in men than women and cortisol higher in women than men independently of the condition. Although high-intensity exercises promoted a little more pronounced effects in the direction of suppressing the appetite, no differences were observed in REI, demonstrating that these modifications were not sufficient to affect energy intake.

Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial.

PubMed

Vasconcelos, Karina S S; Dias, João M D; Araújo, Marília C; Pinheiro, Ana C; Moreira, Bruno S; Dias, Rosângela C

2016-07-11

Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity.

Cost-effectiveness in fall prevention for older women.

PubMed

Hektoen, Liv F; Aas, Eline; Lurås, Hilde

2009-08-01

The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

Physiologic assessment before video thoracoscopic resection for lung cancer in patients with abnormal pulmonary function.

PubMed

Benattia, Amira; Debeaumont, David; Guyader, Vincent; Tardif, Catherine; Peillon, Christophe; Cuvelier, Antoine; Baste, Jean-Marc

2016-06-01

Impaired respiratory function may prevent curative surgery for patients with non-small cell lung cancer (NSCLC). Video-assisted thoracoscopic surgery (VATS) reduces postoperative morbility-mortality and could change preoperative assessment practices and therapeutic decisions. We evaluated the relation between preoperative pulmonary function tests and the occurrence of postoperative complications after VATS pulmonary resection in patients with abnormal pulmonary function. We included 106 consecutive patients with ≤80% predicted value of presurgical expiratory volume in one second (FEV1) and/or diffusing capacity of carbon monoxide (DLCO) and who underwent VATS pulmonary resection for NSCLC from a prospective surgical database. Patients (64±9.5 years) had lobectomy (n=91), segmentectomy (n=7), bilobectomy (n=4), or pneumonectomy (n=4). FEV1 and DLCO preoperative averages were 68%±21% and 60%±18%. Operative mortality was 1.89%. Only FEV1 was predictive of postoperative complications [odds ratio (OR), 0.96; 95% confidence interval (CI), 0.926-0.991, P=0.016], but there was no determinable threshold. Twenty-five patients underwent incremental exercise testing. Desaturations during exercise (OR, 0.462; 95% CI, 0.191-0.878, P=0.039) and heart rate (HR) response (OR, 0.953; 95% CI, 0.895-0.993, P=0.05) were associated with postoperative complications. FEV1 but not DLCO was a significant predictor of pulmonary complications after VATS pulmonary resection despite a low rate of severe morbidity. Incremental exercise testing seems more discriminating. Further investigation is required in a larger patient population to change current pre-operative threshold in a new era of minimally invasive surgery.

Body composition and metabolic changes during a 520-day mission simulation to Mars.

PubMed

Strollo, F; Macchi, C; Eberini, I; Masini, M A; Botta, M; Vassilieva, G; Nichiporuk, I; Monici, M; Santucci, D; Celotti, F; Magni, P; Ruscica, M

2018-03-12

The "Mars-500 project" allowed to evaluate the changes in psychological/physiological adaptation over a prolonged confinement, in order to gather information for future missions. Here, we evaluated the impact of confinement and isolation on body composition, glucose metabolism/insulin resistance and adipokine levels. The "Mars-500 project" consisted of 520 consecutive days of confinement from June 3, 2010 to Nov 4, 2011. The crew was composed of six male subjects (three Russians, two Europeans, and one Chinese) with a median age of 31 years (range 27-38 years). During the 520-day confinement, total body mass and BMI progressively decreased, reaching a significant difference at the end (417 days) of the observation period (- 9.2 and - 5.5%, respectively). Fat mass remained unchanged. A progressive and significant increase of fasting plasma glucose was observed between 249 and 417 days (+ 10/+ 17% vs baseline), with a further increase at the end of confinement (up to + 30%). Median plasma insulin showed a non-significant early increment (60 days; + 86%). Total adiponectin halved (- 47%) 60 days after hatch closure, remaining at this nadir (- 51%) level for a further 60 days. High molecular weight adiponectin remained significantly lower from 60 to 168 days. Based on these data, countermeasures may be envisioned to balance the potentially harmful effects of prolonged confinement, including a better exercise program, with accurate monitoring of (1) the individual activity and (2) the relationship between body composition and metabolic derangement.

Exhaustive submaximal endurance and resistance exercises induce temporary immunosuppression via physical and oxidative stress

PubMed Central

Jin, Chan-Ho; Paik, Il-Young; Kwak, Yi-Sub; Jee, Yong-Seok; Kim, Joo-Young

2015-01-01

Regular running and strength training are the best ways to improve aerobic capacity and develop the size of skeletal muscles. However, uncontrolled physical activities can often lead to an undertraining or over-training syndrome. In particular, overtraining causes persistent fatigue and reduces physical performance due to changes in the various physiological and immunological factors. In this study, we gave an exhaustive submaximal endurance or resistance exercise to participants and investigated the relationship between physical stress (cortisol level in blood), oxidative stress (intracellular ROS accumulation), and adaptive immune response (CD4:CD8 ratio). Materials and Methods Ten male volunteers were recruited, and performed a submaximal endurance or resistance exercise with 85% of VO2max or 1-repetition maximum until exhaustion. Blood samples were collected at rest, and at 0 and 30 min after the exercise. Cortisol levels, oxidative stress, and immune cell phenotypes in peripheral blood were evaluated. Cortisol levels in the sera increased after the exhaustive endurance and resistance exercises and such increments were maintained through the recovery. Intra-cellular ROS levels also increased after the exhaustive endurance and resistance exercises. The ratio of CD4+ T cells to CD8+ T cells after each type of submaximal exercise decreased compared with that at the resting stage, and returned to the resting level at 30 min after the exercise. In this study, an exhaustive endurance or a resistance exercise with submaximal intensity caused excessive physical stress, intra-cellular oxidative stress, and post-exercise immunosuppression. This result suggests that excessive physical stress induced temporary immune dysfunction via physical and oxidative stress. PMID:26331134

Perfusion dynamics assessment with Power Doppler ultrasound in skeletal muscle during maximal and submaximal cycling exercise.

PubMed

Heres, H M; Schoots, T; Tchang, B C Y; Rutten, M C M; Kemps, H M C; van de Vosse, F N; Lopata, R G P

2018-06-01

Assessment of limitations in the perfusion dynamics of skeletal muscle may provide insight in the pathophysiology of exercise intolerance in, e.g., heart failure patients. Power doppler ultrasound (PDUS) has been recognized as a sensitive tool for the detection of muscle blood flow. In this volunteer study (N = 30), a method is demonstrated for perfusion measurements in the vastus lateralis muscle, with PDUS, during standardized cycling exercise protocols, and the test-retest reliability has been investigated. Fixation of the ultrasound probe on the upper leg allowed for continuous PDUS measurements. Cycling exercise protocols included a submaximal and an incremental exercise to maximal power. The relative perfused area (RPA) was determined as a measure of perfusion. Absolute and relative reliability of RPA amplitude and kinetic parameters during exercise (onset, slope, maximum value) and recovery (overshoot, decay time constants) were investigated. A RPA increase during exercise followed by a signal recovery was measured in all volunteers. Amplitudes and kinetic parameters during exercise and recovery showed poor to good relative reliability (ICC ranging from 0.2-0.8), and poor to moderate absolute reliability (coefficient of variation (CV) range 18-60%). A method has been demonstrated which allows for continuous (Power Doppler) ultrasonography and assessment of perfusion dynamics in skeletal muscle during exercise. The reliability of the RPA amplitudes and kinetics ranges from poor to good, while the reliability of the RPA increase in submaximal cycling (ICC = 0.8, CV = 18%) is promising for non-invasive clinical assessment of the muscle perfusion response to daily exercise.

Acute exercise performed close to the anaerobic threshold improves cognitive performance in elderly females.

PubMed

Córdova, C; Silva, V C; Moraes, C F; Simões, H G; Nóbrega, O T

2009-05-01

The objective of the present study was to compare the effect of acute exercise performed at different intensities in relation to the anaerobic threshold (AT) on abilities requiring control of executive functions or alertness in physically active elderly females. Forty-eight physically active elderly females (63.8 +/- 4.6 years old) were assigned to one of four groups by drawing lots: control group without exercise or trial groups with exercise performed at 60, 90, or 110% of AT (watts) and submitted to 5 cognitive tests before and after exercise. Following cognitive pretesting, an incremental cycle ergometer test was conducted to determine AT using a fixed blood lactate concentration of 3.5 mmol/L as cutoff. Acute exercise executed at 90% of AT resulted in significant (P < 0.05, ANOVA) improvement in the performance of executive functions when compared to control in 3 of 5 tests (verbal fluency, Tower of Hanoi test (number of movements), and Trail Making test B). Exercising at 60% of AT did not improve results of any tests for executive functions, whereas exercise executed at 110% of AT only improved the performance in one of these tests (verbal fluency) compared to control. Women from all trial groups exhibited a remarkable reduction in the Simple Response Time (alertness) test (P = 0.001). Thus, physical exercise performed close to AT is more effective to improve cognitive processing of older women even if conducted acutely, and using a customized exercise prescription based on the anaerobic threshold should optimize the beneficial effects.

Exercise Tolerance Testing in a Prospective Cohort of Adolescents with Chronic Fatigue Syndrome and Recovered Controls Following Infectious Mononucleosis

PubMed Central

Katz, Ben Z.; Boas, Steven; Shiraishi, Yukiko; Mears, Cynthia J.; Taylor, Renee

2010-01-01

Objective Six months following acute infectious mononucleosis (IM), 13%, of adolescents meet criteria for chronic fatigue syndrome (CFS). We measured exercise tolerance in adolescents with CFS and controls 6 months following IM. Study design 21 adolescents with CFS 6 months following IM and 21 recovered controls performed a maximal incremental exercise tolerance test with breath-by-breath gas analysis. Values expressed are mean ± standard deviation. Results The adolescents diagnosed with CFS and controls did not differ in age, weight, body-mass index or peak work capacity. Lower VO2 (oxygen consumption) peak percent of predicted was seen in adolescents with CFS compared with controls (CFS 99.3 ± 16.6 vs control 110.7 ± 19.9, p = 0.05). Peak oxygen pulse also was lower in adolescents with CFS compared with recovered controls (CFS 12.4 ± 2.9 vs controls 14.9 ± 4.3, p = 0.03). Conclusions Adolescents with CFS 6 months following IM have a lower degree of fitness and efficiency of exercise than recovered adolescents. Whether these abnormal exercise findings are a cause or effect of CFS is unknown. IM can lead to both fatigue and measurable changes in exercise testing in a subset of adolescents. PMID:20447647

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia

PubMed Central

Bryan-Jones, Katherine; Chapman, Simon

2006-01-01

Background The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. Methods In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. Results SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. Conclusion Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option. PMID:16859560

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia.

PubMed

Bryan-Jones, Katherine; Chapman, Simon

2006-07-21

The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS) presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW), including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to finish the job. Publicity to the growing number of state and national governments that have successfully implemented total bans over the past decade is likely to make incrementalism an increasingly unattractive political option.

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

PubMed

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

2009-07-07

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

Effects of inspiratory muscle training on resistance to fatigue of respiratory muscles during exhaustive exercise.

PubMed

Segizbaeva, M O; Timofeev, N N; Donina, Zh A; Kur'yanovich, E N; Aleksandrova, N P

2015-01-01

The aim of this study was to assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm (D), parasternal (PS), sternocleidomastoid (SCM) and scalene (SC) muscles in healthy humans during exhaustive exercise. Daily inspiratory muscle strength training was performed for 3 weeks in 10 male subjects (at a pressure threshold load of 60% of maximal inspiratory pressure (MIP) for the first week, 70% of MIP for the second week, and 80% of MIP for the third week). Before and after training, subjects performed an incremental cycle test to exhaustion. Maximal inspiratory pressure and EMG-analysis served as indices of inspiratory muscle fatigue assessment. The before-to-after exercise decreases in MIP and centroid frequency (fc) of the EMG (D, PS, SCM, and SC) power spectrum (P<0.05) were observed in all subjects before the IMT intervention. Such changes were absent after the IMT. The study found that in healthy subjects, IMT results in significant increase in MIP (+18%), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.

Erythrocyte membrane fluidity and indices of plasmatic oxidative damage after acute physical exercise in humans.

PubMed

Berzosa, C; Gómez-Trullén, E M; Piedrafita, E; Cebrián, I; Martínez-Ballarín, E; Miana-Mena, F J; Fuentes-Broto, L; García, J J

2011-06-01

Optimal levels of membrane fluidity are essential for numerous cell functions including cell growth, solute transport and signal transduction. Since exercise enhances free radical production, our aim was to evaluate in healthy male subjects the effects of an acute bout of maximal and submaximal exercise on the erythrocyte membrane fluidity and its possible relation to the oxidative damage overproduction due to exercise. Subjects (n = 34) performed three cycloergometric tests: a continuous progressive exercise, a strenuous exercise until exhaustion and an acute bout of exercise at an intensity corresponding to 70% of maximal work capacity for 30 min. Venous blood samples were collected before and immediately after these exercises. Erythrocyte membrane fluidity was assessed by fluorescence spectroscopy. Plasma malondialdehyde (MDA) and 4-hydroxyalkenals (4-HDA) concentrations and carbonyl content of plasmatic proteins were used as an index of lipid and protein oxidation, respectively. Exercise produced a dramatic drop in the erythrocyte membrane fluidity as compared to resting time, but this was not accompanied by significant changes in the plasmatic MDA and 4-HDA concentrations. The highest erythrocyte membrane rigidity was detected immediately after strenuous exercise until exhaustion was performed. Protein carbonyl levels were higher after exhaustive exercises than at rest. Continuous progressive and strenuous exercises until exhaustion, but not submaximal workload, resulted in a significant enhanced accumulation of carbonylated proteins in the plasma. These findings are consistent with the idea that exercise exaggerates oxidative damage, which may contribute, at least partially, to explain the rigidity in the membrane of the erythrocytes due to acute exercise.

Kinetic Analysis of Horizontal Plyometric Exercise Intensity.

PubMed

Kossow, Andrew J; Ebben, William P

2018-05-01

Kossow, AJ, DeChiara, TG, Neahous, SM, and Ebben, WP. Kinetic analysis of horizontal plyometric exercise intensity. J Strength Cond Res 32(5): 1222-1229, 2018-Plyometric exercises are frequently performed as part of a strength and conditioning program. Most studies assessed the kinetics of plyometric exercises primarily performed in the vertical plane. The purpose of this study was to evaluate the multiplanar kinetic characteristics of a variety of plyometric exercises, which have a significant horizontal component. This study also sought to assess sex differences in the intensity progression of these exercises. Ten men and 10 women served as subjects. The subjects performed a variety of plyometric exercises including the double-leg hop, standing long jump, single-leg standing long jump, bounding, skipping, power skipping, cone hops, and 45.72-cm hurdle hops. Subjects also performed the countermovement jump for comparison. All plyometric exercises were evaluated using a force platform. Dependent variables included the landing rate of force development and landing ground reaction forces for each exercise in the vertical, frontal, and sagittal planes. A 2-way mixed analysis of variance with repeated-measures for plyometric exercise type demonstrated main effects for exercise type for all dependent variables (p ≤ 0.001). There was no significant interaction between plyometric exercise type and sex for any of the variable assessed. Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the dependent variables assessed (p ≤ 0.05). These findings should be used to guide practitioners in the progression of plyometric exercise intensity, and thus program design, for those who require significant horizontal power in their sport.

Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise.

PubMed

Lee, Yong Ki; Kim, Bo Ryun; Han, Eun Young

2017-05-01

The aim of this work was to investigate the cardiorespiratory responses of patients with subacute stroke to exercise stress tests with aquatic and land treadmills. Twenty-one consecutive patients who presented with first-ever subacute stroke in 2013-2015. All subjects underwent symptom-limited incremental exercise testing with aquatic and land treadmills. Land treadmill speed started at 1.5 km/h and increased 0.5 km/h every 1 to 2 minutes until maximal tolerable speed was achieved. Thereafter, the grade was elevated by 2% every 2 minutes. In the aquatic treadmill test, subjects were submerged to the xiphoid in 28°C water. Treadmill speed started at 1.5 km/h and was increased 0.5 km/h every 2 minutes thereafter. Cardiorespiratory responses were recorded with aquatic and land treadmills. Compared to land treadmill exercise, aquatic treadmill exercise achieved significantly better peak VO2 (22.0 vs 20.0; P = 0.02), peak metabolic equivalents (6.3 vs 5.8; P = 0.02), and peak rating of perceived exertion (17.6 vs 18.4, P = 0.01). Heart rate and VO2 correlated significantly during both tests (land treadmill: r = 0.96, P < 0.001; aquatic treadmill: r = 0.99, P < 0.001). Aquatic treadmill exercise elicited significantly better peak cardiorespiratory responses than land treadmill exercise and may be as effective for early intensive aerobic training in subacute stroke patients.

Training effects on ROS production determined by electron paramagnetic resonance in master swimmers.

PubMed

Mrakic-Sposta, Simona; Gussoni, Maristella; Porcelli, Simone; Pugliese, Lorenzo; Pavei, Gaspare; Bellistri, Giuseppe; Montorsi, Michela; Tacchini, Philippe; Vezzoli, Alessandra

2015-01-01

Acute exercise induces an increase in Reactive Oxygen Species (ROS) production dependent on exercise intensity with highest ROS amount generated by strenuous exercise. However, chronic repetition of exercise, that is, exercise training, may reduce exercise-induced oxidative stress. Aim of this study was to evaluate the effects of 6-weeks high-intensity discontinuous training (HIDT), characterized by repeated variations of intensity and changes of redox potential, on ROS production and antioxidant capacity in sixteen master swimmers. Time course changes of ROS generation were assessed by Electron Paramagnetic Resonance in capillary blood by a microinvasive approach. An incremental arm-ergometer exercise (IE) until exhaustion was carried out at both before (PRE) and after (POST) training (Trg) period. A significant (P < 0.01) increase of ROS production from REST to the END of IE in PRE Trg (2.82 ± 0.66 versus 3.28 ± 0.66 µmol·min(-1)) was observed. HIDT increased peak oxygen consumption (36.1 ± 4.3 versus 40.6 ± 5.7 mL·kg(-1)·min(-1) PRE and POST Trg, resp.) and the antioxidant capacity (+13%) while it significantly decreased the ROS production both at REST (-20%) and after IE (-25%). The observed link between ROS production, adaptive antioxidant defense mechanisms, and peak oxygen consumption provides new insight into the correlation between ROS response pathways and muscle metabolic function.

Mobile-phone-based home exercise training program decreases systemic inflammation in COPD: a pilot study.

PubMed

Wang, Chun-Hua; Chou, Pai-Chien; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Ho, Shu-Chuan; Lin, Horng-Chyuan; Huang, Chien-Da; Chung, Fu-Tsai; Chung, Kian Fan; Kuo, Han-Pin

2014-08-30

Moderate-intensity exercise training improves skeletal muscle aerobic capacity and increased oxidative enzyme activity, as well as exercise tolerance in COPD patients. To investigate whether the home-based exercise training program can reduce inflammatory biomarkers in patients with COPD, twelve patients using mobile phone assistance and 14 with free walk were assessed by incremental shuttle walk test (ISWT), spirometry, strength of limb muscles, and serum C-reactive protein (CRP) and inflammatory cytokines. Patients in the mobile phone group improved their ISWT walking distance, with decrease in serum CRP after 2 months, and sustained at 6 months. Patients in the control group had no improvement. Serum IL-8 in the mobile phone group was significantly reduced at 2, 3 and 6 months after doing home exercise training compared to baseline. IL-6 and TNF-α were significantly elevated at 3 and 6 months in control group, while there were no changes in mobile phone group. The strength of limb muscles was significantly greater compared to baseline at 3 and 6 months in the mobile phone group. A mobile-phone-based system can provide an efficient home endurance exercise training program with improved exercise capacity, strength of limb muscles and a decrease in serum CRP and IL-8 in COPD patients. Decreased systemic inflammation may contribute to these clinical benefits. (Clinical trial registration No.: NCT01631019).

Ability to work in anaerobic condition is associated with physical performance on the six-minute walk test in older patients receiving cardiac rehabilitation.

PubMed

Pasquini, Guido; Vannetti, Federica; Molino-Lova, Raffaele

2015-05-01

During maximal incremental exercise, the ability to work in the anaerobic condition, expressed by the respiratory exchange ratio, is associated with physical performance. Further, peak respiratory exchange ratio is regarded as the best non-invasive measure of a patient's actual exercise effort. This study examined whether ability to work in the anaerobic condition is also associated with physical performance in submaximal constant work rate exercise. A total of 75 older patients (51 men, 24 women), mean age 71.1 years (standard deviation 6.7 years), who had recently undergone cardiac surgery, performed cardiopulmonary exercise testing in a 6-min walk test before and after rehabilitation. The distance walked, steady-state oxygen uptake, carbon dioxide output and respiratory exchange ratio increased significantly after rehabilitation (p < 0.001 for all). In multivariable models predicting the distance walked before and after rehabilitation, higher steady-state respiratory exchange ratio was independently associated with longer distance (p < 0.001 for both). In older patients receiving post-acute cardiac rehabilitation the ability to work in the anaerobic condition is associated with physical performance in submaximal constant work rate exercises. Thus the steady-state respiratory exchange ratio might be regarded as a measure of the patient's actual exercise effort. This information may prove useful in customizing exercise prescription and assessing the effects of rehabilitation.

Inefficient skeletal muscle oxidative function flanks impaired motor neuron recruitment in Amyotrophic Lateral Sclerosis during exercise.

PubMed

Lanfranconi, F; Ferri, A; Corna, G; Bonazzi, R; Lunetta, C; Silani, V; Riva, N; Rigamonti, A; Maggiani, A; Ferrarese, C; Tremolizzo, L

2017-06-07

This study aimed to evaluate muscle oxidative function during exercise in amyotrophic lateral sclerosis patients (pALS) with non-invasive methods in order to assess if determinants of reduced exercise tolerance might match ALS clinical heterogeneity. 17 pALS, who were followed for 4 months, were compared with 13 healthy controls (CTRL). Exercise tolerance was assessed by an incremental exercise test on cycle ergometer measuring peak O 2 uptake ([Formula: see text]O 2peak ), vastus lateralis oxidative function by near infrared spectroscopy (NIRS) and breathing pattern ([Formula: see text]E peak ). pALS displayed: (1) 44% lower [Formula: see text]O 2peak vs. CTRL (p < 0.0001), paralleled by a 43% decreased peak skeletal muscle oxidative function (p < 0.01), with a linear regression between these two variables (r 2  = 0.64, p < 0.0001); (2) 46% reduced [Formula: see text]E peak vs. CTRL (p < 0.0001), achieved by using an inefficient breathing pattern (increasing respiratory frequency) from the onset until the end of exercise. Inefficient skeletal muscle O 2 function, when flanking the impaired motor units recruitment, is a major determinant of pALS clinical heterogeneity and working capacity exercise tolerance. CPET and NIRS are useful tools for detecting early stages of oxidative deficiency in skeletal muscles, disclosing individual impairments in the O 2 transport and utilization chain.

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 and increased bronchodilatation, accommodated the increased VT while preserving effort–displacement and breathlessness–V̇E relationships; and (3) dynamic mechanical ventilatory constraints contributed to respiratory discomfort near the limits of tolerance in late gestation. PMID:18687714

40 CFR 60.2820 - When must I complete each increment of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Air Curtain...

Effectiveness of Functional Progressive Resistance Exercise Training on Walking Ability in Children with Cerebral Palsy: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Scholtes, Vanessa A.; Becher, Jules G.; Janssen-Potten, Yvonne J.; Dekkers, Hurnet; Smallenbroek, Linda; Dallmeijer, Annet J.

2012-01-01

The objective of the study was to evaluate the effectiveness of functional progressive resistance exercise (PRE) training on walking ability in children with cerebral palsy (CP). Fifty-one ambulant children with spastic CP (mean age 10 years 5 months, 29 boys) were randomized to an intervention (n=26) or control group (n=25, receiving usual care).…

Early alterations in blood and brain RANTES and MCP-1 expression and the effect of exercise frequency in the 3xTg-AD mouse model of Alzheimer's disease.

PubMed

Haskins, Morgan; Jones, Terry E; Lu, Qun; Bareiss, Sonja K

2016-01-01

Exercise has been shown to protect against cognitive decline and Alzheimer's disease (AD) progression, however the dose of exercise required to protect against AD is unknown. Recent studies show that the pathological processes leading to AD cause characteristic alterations in blood and brain inflammatory proteins that are associated with the progression of AD, suggesting that these markers could be used to diagnosis and monitor disease progression. The purpose of this study was to determine the impact of exercise frequency on AD blood chemokine profiles, and correlate these findings with chemokine brain expression changes in the triple transgenic AD (3xTg-AD) mouse model. Three month old 3xTg-AD mice were subjected to 12 weeks of moderate intensity wheel running at a frequency of either 1×/week or 3×/week. Blood and cortical tissue were analyzed for expression of monocyte chemotactic protein-1 (MCP-1) and regulated and normal T cell expressed and secreted (RANTES). Alterations in blood RANTES and MCP-1 expression were evident at 3 and 6 month old animals compared to WT animals. Three times per week exercise but not 1×/week exercise was effective at reversing serum and brain RANTES and MCP-1 expression to the levels of WT controls, revealing a dose dependent response to exercise. Analysis of these chemokines showed a strong negative correlation between blood and brain expression of RANTES. The results indicate that alterations in serum and brain inflammatory chemokines are evident as early signs of Alzheimer's disease pathology and that higher frequency exercise was necessary to restore blood and brain inflammatory expression levels in this AD mouse model. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Low-level laser therapy (LLLT) in human progressive-intensity running: effects on exercise performance, skeletal muscle status, and oxidative stress.

PubMed

De Marchi, Thiago; Leal Junior, Ernesto Cesar Pinto; Bortoli, Celiana; Tomazoni, Shaiane Silva; Lopes-Martins, Rodrigo Alvaro Brandão; Salvador, Mirian

2012-01-01

The aim of this work was to evaluate the effects of low-level laser therapy (LLLT) on exercise performance, oxidative stress, and muscle status in humans. A randomized double-blind placebo-controlled crossover trial was performed with 22 untrained male volunteers. LLLT (810 nm, 200 mW, 30 J in each site, 30 s of irradiation in each site) using a multi-diode cluster (with five spots - 6 J from each spot) at 12 sites of each lower limb (six in quadriceps, four in hamstrings, and two in gastrocnemius) was performed 5 min before a standardized progressive-intensity running protocol on a motor-drive treadmill until exhaustion. We analyzed exercise performance (VO(2 max), time to exhaustion, aerobic threshold and anaerobic threshold), levels of oxidative damage to lipids and proteins, the activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and the markers of muscle damage creatine kinase (CK) and lactate dehydrogenase (LDH). Compared to placebo, active LLLT significantly increased exercise performance (VO(2 max) p = 0.01; time to exhaustion, p = 0.04) without changing the aerobic and anaerobic thresholds. LLLT also decreased post-exercise lipid (p = 0.0001) and protein (p = 0.0230) damages, as well as the activities of SOD (p = 0.0034), CK (p = 0.0001) and LDH (p = 0.0001) enzymes. LLLT application was not able to modulate CAT activity. The use of LLLT before progressive-intensity running exercise increases exercise performance, decreases exercise-induced oxidative stress and muscle damage, suggesting that the modulation of the redox system by LLLT could be related to the delay in skeletal muscle fatigue observed after the use of LLLT.

Peak Velocity as an Alternative Method for Training Prescription in Mice

PubMed Central

Picoli, Caroline de Carvalho; Romero, Paulo Vitor da Silva; Gilio, Gustavo R.; Guariglia, Débora A.; Tófolo, Laize P.; de Moraes, Solange M. F.; Machado, Fabiana A.; Peres, Sidney B.

2018-01-01

Purpose: To compare the efficiency of an aerobic physical training program prescribed according to either velocity associated with maximum oxygen uptake (vVO2max) or peak running speed obtained during an incremental treadmill test (Vpeak_K) in mice. Methods: Twenty male Swiss mice, 60 days old, were randomly divided into two groups with 10 animals each: 1. group trained by vVO2max (GVO2), 2. group trained by Vpeak_K (GVP). After the adaptation training period, an incremental test was performed at the beginning of each week to adjust training load and to determine the amount of VO2 and VCO2 fluxes consumed, energy expenditure (EE) and run distance during the incremental test. Mice were submitted to 4 weeks of aerobic exercise training of moderate intensity (velocity referring to 70% of vVO2max and Vpeak_K) in a programmable treadmill. The sessions lasted from 30 to 40 min in the first week, to reach 60 min in the fourth week, in order to provide the mice with a moderate intensity exercise, totaling 20 training sessions. Results: Mice demonstrated increases in VO2max (ml·kg−1·min−1) (GVO2 = 49.1% and GVP = 56.2%), Vpeak_K (cm·s−1) (GVO2 = 50.9% and GVP = 22.3%), EE (ml·kg−0,75·min−1) (GVO2 = 39.9% and GVP = 51.5%), and run distance (cm) (GVO2 = 43.5% and GVP = 33.4%), after 4 weeks of aerobic training (time effect, P < 0.05); there were no differences between the groups. Conclusions: Vpeak_K, as well as vVO2max, can be adopted as an alternative test to determine the performance and correct prescription of systemized aerobic protocol training to mice. PMID:29467664

Dynamic and Static Exercises Differentially Affect Plasma Cytokine Content in Elite Endurance- and Strength-Trained Athletes and Untrained Volunteers

PubMed Central

Kapilevich, Leonid V.; Zakharova, Anna N.; Kabachkova, Anastasia V.; Kironenko, Tatyana A.; Orlov, Sergei N.

2017-01-01

Extensive exercise increases the plasma content of IL-6, IL-8, IL-15, leukemia inhibitory factor (LIF), and several other cytokines via their augmented transcription in skeletal muscle cells. However, the relative impact of aerobic and resistant training interventions on cytokine production remains poorly defined. In this study, we compared effects of dynamic and static load on cytokine plasma content in elite strength- and endurance-trained athletes vs. healthy untrained volunteers. The plasma cytokine content was measured before, immediately after, and 30 min post-exercise using enzyme-linked immunosorbent assay. Pedaling on a bicycle ergometer increased IL-6 and IL-8 content in the plasma of trained athletes by about 4- and 2-fold, respectively. In contrast to dynamic load, weightlifting had negligible impact on these parameters in strength exercise-trained athletes. Unlike IL-6 and IL-8, dynamic exercise had no impact on IL-15 and LIF, whereas static load increases the content of these cytokines by ~50%. Two-fold increment of IL-8 content seen in athletes subjected to dynamic exercise was absent in untrained individuals, whereas the ~50% increase in IL-15 triggered by static load in the plasma of weightlifting athletes was not registered in the control group. Thus, our results show the distinct impact of static and dynamic exercises on cytokine content in the plasma of trained athletes. They also demonstrate that both types of exercises differentially affect cytokine content in plasma of athletes and untrained persons. PMID:28194116

The ventilatory anaerobic threshold is related to, but is lower than, the critical power, but does not explain exercise tolerance at this workrate.

PubMed

Okudan, N; Gökbel, H

2006-03-01

The aim of the present study was to investigate the relationships between critical power (CP), maximal aerobic power and the anaerobic threshold and whether exercise time to exhaustion and work at the CP can be used as an index in the determination of endurance. An incremental maximal cycle exercise test was performed on 30 untrained males aged 18-22 years. Lactate analysis was carried out on capillary blood samples at every 2 minutes. From gas exchange parameters and heart rate and lactate values, ventilatory anaerobic thresholds, heart rate deflection point and the onset of blood lactate accumulation were calculated. CP was determined with linear work-time method using 3 loads. The subjects exercised until they could no longer maintain a cadence above 24 rpm at their CP and exercise time to exhaustion was determined. CP was lower than the power output corresponding to VO2max, higher than the power outputs corresponding to anaerobic threshold. CP was correlated with VO2max and anaerobic threshold. Exercise time to exhaustion and work at CP were not correlated with VO2max and anaerobic threshold. Because of the correlations of the CP with VO2max and anaerobic threshold and no correlation of exercise time to exhaustion and work at the CP with these parameters, we conclude that exercise time to exhaustion and work at the CP cannot be used as an index in the determination of endurance.

Exercise after SCUBA diving increases the incidence of arterial gas embolism.

PubMed

Madden, Dennis; Lozo, Mislav; Dujic, Zeljko; Ljubkovic, Marko

2013-09-01

Arterialization of gas bubbles after decompression from scuba diving has traditionally been associated with pulmonary barotraumas or cardiac defects, such as the patent foramen ovale. Recent studies have demonstrated the right-to-left passage of bubbles through intrapulmonary arterial-venous anastamoses (IPAVA) that allow blood to bypass the pulmonary microcirculation. These passages open up during exercise, and the aim of this study is to see if exercise in a postdiving period increases the incidence of arterialization. After completing a dive to 18 m for 47 min, patent foramen ovale-negative subjects were monitored via transthoracic echocardiography, within 10 min after surfacing, for bubble score at rest. Subjects then completed an incremental cycle ergometry test to exhaustion under continuous transthoracic echocardiography observation. Exercise was suspended if arterialization was observed and resumed when the arterialization cleared. If arterialization was observed a second time, exercise was terminated, and oxygen was administered. Out of 23 subjects, 3 arterialized at rest, 12 arterialized with exercise, and 8 did not arterialize at all even during maximal exercise. The time for arterialization to clear with oxygen was significantly shorter than without. Exercise after diving increased the incidence of arterialization from 13% at rest to 52%. This study shows that individuals are capable of arterializing through IPAVA, and that the intensity at which these open varies by individual. Basic activities associated with SCUBA diving, such as surface swimming or walking with heavy equipment, may be enough to allow the passage of venous gas emboli through IPAVA.

Toward Ubiquitous BCIs

NASA Astrophysics Data System (ADS)

Allison, Brendan Z.

The preceding chapters in this book described modern BCI systems. This concluding chapter instead discusses future directions. While there are some specific predictions, I mainly analyze key factors and trends relating to practical mainstream BCI development. While I note some disruptive technologies that could dramatically change BCIs, this chapter focuses mainly on realistic, incremental progress and how progress could affect user groups and ethical issues.

Influence of work-interval intensity and duration on time spent at a high percentage of VO2max during intermittent supramaximal exercise.

PubMed

Wakefield, Benjamin R; Glaister, Mark

2009-12-01

The purpose of this study was to examine the effect of work-interval duration (WID) and intensity on the time spent at, or above, 95% VO2max (T95 VO2max) during intermittent bouts of supramaximal exercise. Over a 5-week period, 7 physically active men with a mean (+/-SD) age, height, body mass, and VO2max of 22 +/- 5 years, 181.5 +/- 5.6 cm, 86.4 +/- 11.4 kg, and 51.5 +/- 1.5 ml.kg-1.min-1, respectively, attended 7 testing sessions. After completing a submaximal incremental test on a treadmill to identify individual oxygen uptake/running velocity relationships, subjects completed a maximal incremental test to exhaustion to VO2max and subsequently (from the aforementioned relationship) the minimum velocity required to elicit VO2max (vVO2max). In a random order, subjects then carried out 3 intermittent runs to exhaustion at both 105% and 115% vVO2max. Each test used a different WID (20 s, 25 s, or 30 s) interspersed with 20-second passive recovery periods. Results revealed no significant difference in T95 vVO2max for intermittent runs at 105% versus 115% vVO2max (p = 0.142). There was, however, a significant effect (p < 0.001) of WID on T95 VO2max, with WIDs of 30 seconds enabling more time relative to WIDs of 20 seconds (p = 0.018) and 25 seconds (p = 0.009). Moreover, there was an interaction between intensity and duration such that the effect of WID was magnified at the lower exercise intensity (p = 0.046). In conclusion, despite a number of limitations, the results of this investigation suggest that exercise intensities of approximately 105% vVO2max combined with WIDs greater than 25 seconds provide the best way of optimizing T95 VO2max when using fixed 20-second stationary rest periods.

Functional impairment of skeletal muscle oxidative metabolism during knee extension exercise after bed rest.

PubMed

Salvadego, Desy; Lazzer, Stefano; Marzorati, Mauro; Porcelli, Simone; Rejc, Enrico; Simunic, Bostjan; Pisot, Rado; di Prampero, Pietro Enrico; Grassi, Bruno

2011-12-01

A functional evaluation of skeletal muscle oxidative metabolism during dynamic knee extension (KE) incremental exercises was carried out following a 35-day bed rest (BR) (Valdoltra 2008 BR campaign). Nine young male volunteers (age: 23.5 ± 2.2 yr; mean ± SD) were evaluated. Pulmonary gas exchange, heart rate and cardiac output (by impedance cardiography), skeletal muscle (vastus lateralis) fractional O(2) extraction, and brain (frontal cortex) oxygenation (by near-infrared spectroscopy) were determined during incremental KE. Values at exhaustion were considered "peak". Peak heart rate (147 ± 18 beats/min before vs. 146 ± 17 beats/min after BR) and peak cardiac output (17.8 ± 3.3 l/min before vs. 16.1 ± 1.8 l/min after BR) were unaffected by BR. As expected, brain oxygenation did not decrease during KE. Peak O(2) uptake was lower after vs. before BR, both when expressed as liters per minute (0.99 ± 0.17 vs. 1.26 ± 0.27) and when normalized per unit of quadriceps muscle mass (46.5 ± 6.4 vs. 56.9 ± 11.0 ml·min(-1)·100 g(-1)). Skeletal muscle peak fractional O(2) extraction, expressed as a percentage of the maximal values obtained during a transient limb ischemia, was lower after (46.3 ± 12.1%) vs. before BR (66.5 ± 11.2%). After elimination, by the adopted exercise protocol, of constraints related to cardiovascular O(2) delivery, a decrease in peak O(2) uptake and muscle peak capacity of fractional O(2) extraction was found after 35 days of BR. These findings suggest a substantial impairment of oxidative function at the muscle level, "downstream" with respect to bulk blood flow to the exercising muscles, that is possibly at the level of blood flow distribution/O(2) utilization inside the muscle, peripheral O(2) diffusion, and intracellular oxidative metabolism.

The impact of age on cerebral perfusion, oxygenation and metabolism during exercise in humans

PubMed Central

Braz, Igor D.

2015-01-01

Abstract Age is one of the most important risk factors for dementia and stroke. Examination of the cerebral circulatory responses to acute exercise in the elderly may help to pinpoint the mechanisms by which exercise training can reduce the risk of brain diseases, inform the optimization of exercise training programmes and assist with the identification of age‐related alterations in cerebral vascular function. During low‐to‐moderate intensity dynamic exercise, enhanced neuronal activity is accompanied by cerebral perfusion increases of ∼10–30%. Beyond ∼60–70% maximal oxygen uptake, cerebral metabolism remains elevated but perfusion in the anterior portion of the circulation returns towards baseline, substantively because of a hyperventilation‐mediated reduction in the partial pressure of arterial carbon dioxide (P aC O2) and cerebral vasoconstriction. Cerebral perfusion is lower in older individuals, both at rest and during incremental dynamic exercise. Nevertheless, the increase in the estimated cerebral metabolic rate for oxygen and the arterial–internal jugular venous differences for glucose and lactate are similar in young and older individuals exercising at the same relative exercise intensities. Correction for the age‐related reduction in P aC O2 during exercise by the provision of supplementary CO2 is suggested to remove ∼50% of the difference in cerebral perfusion between young and older individuals. A multitude of candidates could account for the remaining difference, including cerebral atrophy, and enhanced vasoconstrictor and blunted vasodilatory pathways. In summary, age‐related reductions in cerebral perfusion during exercise are partly associated with a lower P aC O2 in exercising older individuals; nevertheless the cerebral extraction of glucose, lactate and oxygen appear to be preserved. PMID:26435295

Cost-effectiveness of exercise therapy after corticosteroid injection for moderate to severe shoulder pain due to subacromial impingement syndrome: a trial-based analysis.

PubMed

Jowett, Sue; Crawshaw, Dickon P; Helliwell, Philip S; Hensor, Elizabeth M A; Hay, Elaine M; Conaghan, Philip G

2013-08-01

To perform a cost-effectiveness analysis of subacromial corticosteroid injection combined with exercise compared with exercise alone in patients with moderate to severe shoulder pain from subacromial impingement syndrome. A within-trial cost-effectiveness analysis with 232 patients randomized to physiotherapy-led injection combined with exercise (n = 115) or exercise alone (n = 117). The analysis was from a health care perspective with 24-week follow-up. Resource use information was collected from all patients on interventions, medication, primary and secondary care contacts, private health care use and over-the-counter purchases. The measure of outcome was quality-adjusted life years (QALYs), calculated from EQ-5D responses at baseline and three further time points. An incremental cost-effectiveness analysis was conducted. Mean per patient NHS costs (£255 vs £297) and overall health care costs (£261 vs £318) were lower in the injection plus exercise arm, but this difference was not statistically significant. Total QALYs gained were very similar in the two trial arms (0.3514 vs 0.3494 QALYs), although slightly higher in the injection plus exercise arm, indicating that injection plus exercise may be the dominant treatment option. At a willingness to pay of £20,000 per additional QALY gained, there was a 61% probability that injection plus exercise was the most cost-effective option. Injection plus exercise delivered by therapists may be a cost-effective use of resources compared with exercise alone and lead to lower health care costs and less time off work. International Standard Randomised Controlled Trial Number Register, http://www.controlled-trials.com/isrctn/, ISRCT 25817033.

Effects of low-level laser therapy applied before or after plyometric exercise on muscle damage markers: randomized, double-blind, placebo-controlled trial.

PubMed

Fritsch, Carolina Gassen; Dornelles, Maurício Pinto; Severo-Silveira, Lucas; Marques, Vanessa Bernardes; Rosso, Isabele de Albuquerque; Baroni, Bruno Manfredini

2016-12-01

Promising effects of phototherapy on markers of exercise-induced muscle damage has been already demonstrated in constant load or isokinetic protocols. However, its effects on more functional situations, such as plyometric exercises, and when is the best moment to apply this treatment (pre- or post-exercise) remain unclear. Therefore, the purpose of this study was to investigate the effect of low-level laser therapy (LLLT) before or after plyometric exercise on quadriceps muscle damage markers. A randomized, double-blinded, placebo-controlled trial was conducted with 24 healthy men, 12 at pre-exercise treatment group and 12 at post-exercise treatment group. Placebo and LLLT (810 nm, 200 mW per diode, 6 J per diode, 240 J per leg) were randomly applied on right/left knee extensor muscles of each volunteer before/after a plyometric exercise protocol. Muscular echo intensity (ultrasonography images), soreness (visual analogue scale - VAS), and strength impairment (maximal voluntary contraction - MVC) were assessed at baseline, 24, 48, and 72 h post-exercise. Legs treated with LLLT before or after exercise presented significantly smaller increments of echo intensity (values up to 1 %) compared to placebo treatments (increased up to ∼7 %). No significant treatment effect was found for VAS and MVC, although a trend toward better results on LLLT legs have been found for VAS (mean values up to 30 % lesser than placebo leg). In conclusion, LLLT applied before or after plyometric exercise reduces the muscle echo intensity response and possibly attenuates the muscle soreness. However, these positive results were not observed on strength impairment.

The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men.

PubMed

Littlefield, Laurel A; Papadakis, Zacharias; Rogers, Katie M; Moncada-Jiménez, José; Taylor, J Kyle; Grandjean, Peter W

2017-09-01

Reductions in postprandial lipemia have been observed following aerobic exercise of sufficient energy expenditure. Increased excess postexercise oxygen consumption (EPOC) has been documented when comparing high- versus low-intensity exercise. The contribution of EPOC energy expenditure to alterations in postprandial lipemia has not been determined. The purpose of this study was to evaluate the effects of low- and high-intensity exercise on postprandial lipemia in healthy, sedentary, overweight and obese men (age, 43 ± 10 years; peak oxygen consumption, 31.1 ± 7.5 mL·kg -1 ·min -1 ; body mass index, 31.8 ± 4.5 kg/m 2 ) and to determine the contribution of EPOC to reductions in postprandial lipemia. Participants completed 4 conditions: nonexercise control, low-intensity exercise at 40%-50% oxygen uptake reserve (LI), high-intensity exercise at 70%-80% oxygen uptake reserve (HI), and HI plus EPOC re-feeding (HI+EERM), where the difference in EPOC energy expenditure between LI and HI was re-fed in the form of a sports nutrition bar (Premier Nutrition Corp., Emeryville, Calif., USA). Two hours following exercise participants ingested a high-fat (1010 kcals, 99 g sat fat) test meal. Blood samples were obtained before exercise, before the test meal, and at 2, 4, and 6 h postprandially. Triglyceride incremental area under the curve was significantly reduced following LI, HI, and HI+EERM when compared with nonexercise control (p < 0.05) with no differences between the exercise conditions (p > 0.05). In conclusions, prior LI and HI exercise equally attenuated postprandial triglyceride responses to the test meal. The extra energy expended during EPOC does not contribute significantly to exercise energy expenditure or to reductions in postprandial lipemia in overweight men.

Back to the basics: regular exercise matters in parkinson's disease: results from the National Parkinson Foundation QII registry study.

PubMed

Oguh, O; Eisenstein, A; Kwasny, M; Simuni, T

2014-11-01

There is a substantial interest in the impact of exercise on reduction of disability and rate of progression of Parkinson's disease (PD). The primary aim was to describe exercise habits of PD patients and factors associated with greater levels of exercise. The secondary aim was to explore whether regular exercise is associated with a slower decline of function, disease-related quality of life, and caregiver burden. The National Parkinson's Foundation (NPF) QII Registry data was used to analyze variables that correlate with levels of exercise in PD patients across disease severity. Subjects were categorized into three groups: non-exercisers (0 min/week), low exercisers (1-150 min/week), and regular exercisers (>150 min/week). Health related outcomes, disease metrics, and demographic factors associated with exercise were examined using bivariate analyses. Multiple regression models controlled for disease duration, severity, and cognitive function. An exploratory analysis was completed on the association of baseline level of exercise with health outcomes at one year follow up. 4866 subjects were included in the baseline analysis and 2252 subjects who had second visits were included in the longitudinal data. Regular exercisers at baseline were associated with better QOL, mobility, and physical function, less progression of disease, less caregiver burden and less cognitive decline one year later, after controlling for demographic and disease severity variables. This study provides important preliminary evidence of the beneficial effects of regular exercise in a large PD cohort. Longitudinal studies will be essential to confirm findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does vigorous exercise have a neuroprotective effect in Parkinson disease?

PubMed Central

2011-01-01

Parkinson disease (PD) is progressive, with dementia and medication-refractory motor problems common reasons for late-stage nursing-home placement. Increasing evidence suggests that ongoing vigorous exercise/physical fitness may favorably influence this progression. Parkinsonian animal models reveal exercise-related protection from dopaminergic neurotoxins, apparently mediated by brain neurotrophic factors and neuroplasticity (predicted from in vitro studies). Similarly, exercise consistently improves cognition in animals, also linked to enhanced neuroplasticity and increased neurotrophic factor expression. In these animal models, immobilization has the opposite effect. Brain-derived neurotrophic factor (BDNF) may mediate at least some of this exercise benefit. In humans, exercise increases serum BDNF, and this is known to cross the blood–brain barrier. PD risk in humans is significantly reduced by midlife exercise, documented in large prospective studies. No studies have addressed whether exercise influences dementia risk in PD, but exercised patients with PD improve cognitive scores. Among seniors in general, exercise or physical fitness has not only been associated with better cognitive scores, but midlife exercise significantly reduces the later risk of both dementia and mild cognitive impairment. Finally, numerous studies in seniors with and without dementia have reported increased cerebral gray matter volumes associated with physical fitness or exercise. These findings have several implications for PD clinicians. 1) Ongoing vigorous exercise and physical fitness should be highly encouraged. 2) PD physical therapy programs should include structured, graduated fitness instruction and guidance for deconditioned patients with PD. 3) Levodopa and other forms of dopamine replenishment therapy should be utilized to achieve the maximum capability and motivation for patients to maintain fitness. PMID:21768599

The respiration pattern as an indicator of the anaerobic threshold.

PubMed

Mirmohamadsadeghi, Leila; Vesin, Jean-Marc; Lemay, Mathieu; Deriaz, Olivier

2015-08-01

The anaerobic threshold (AT) is a good index of personal endurance but needs a laboratory setting to be determined. It is important to develop easy AT field measurements techniques in order to rapidly adapt training programs. In the present study, it is postulated that the variability of the respiratory parameters decreases with exercise intensity (especially at the AT level). The aim of this work was to assess, on healthy trained subjects, the putative relationships between the variability of some respiration parameters and the AT. The heart rate and respiratory variables (volume, rate) were measured during an incremental exercise performed on a treadmill by healthy moderately trained subjects. Results show a decrease in the variance of 1/tidal volume with the intensity of exercise. Consequently, the cumulated variance (sum of the variance measured at each level of the exercise) follows an exponential relationship with respect to the intensity to reach eventually a plateau. The amplitude of this plateau is closely related to the AT (r=-0.8). It is concluded that the AT is related to the variability of the respiration.

An Improved Dynamic Model for the Respiratory Response to Exercise

PubMed Central

Serna, Leidy Y.; Mañanas, Miguel A.; Hernández, Alher M.; Rabinovich, Roberto A.

2018-01-01

Respiratory system modeling has been extensively studied in steady-state conditions to simulate sleep disorders, to predict its behavior under ventilatory diseases or stimuli and to simulate its interaction with mechanical ventilation. Nevertheless, the studies focused on the instantaneous response are limited, which restricts its application in clinical practice. The aim of this study is double: firstly, to analyze both dynamic and static responses of two known respiratory models under exercise stimuli by using an incremental exercise stimulus sequence (to analyze the model responses when step inputs are applied) and experimental data (to assess prediction capability of each model). Secondly, to propose changes in the models' structures to improve their transient and stationary responses. The versatility of the resulting model vs. the other two is shown according to the ability to simulate ventilatory stimuli, like exercise, with a proper regulation of the arterial blood gases, suitable constant times and a better adjustment to experimental data. The proposed model adjusts the breathing pattern every respiratory cycle using an optimization criterion based on minimization of work of breathing through regulation of respiratory frequency. PMID:29467674

Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods A minimum of 80 volunteers who meet the inclusion criteria will be recruited from the local population through newspaper advertisements. Following initial assessment volunteers will be randomised into two groups. The intervention group will participate in a progressive aquatic resistance exercise program of 1-hour duration 3 times a week for four months. The control group will be asked to maintain normal care during this period. Primary outcome measure for this study is the biochemical composition of knee cartilage measured using quantitative magnetic resonance imaging; T2 relaxation time and delayed gadolinium-enhanced magnetic resonance imaging techniques. In addition, knee cartilage morphology as regional cartilage thickness will be studied. Secondary outcomes include measures of body composition and bone traits using dual energy x-ray absorptiometry and peripheral quantitative computed tomography, pain, function using questionnaires and physical performance tests and quality of life. Measurements will be performed at baseline, after the 4-month intervention period and at one year follow up. Discussion This randomised controlled trial will investigate the effect a progressive aquatic resistance exercise program has on the biochemical composition of cartilage in post-menopausal women with mild knee osteoarthritis. This is the first study to investigate what impact aquatic exercise has on human articular cartilage. In addition it will investigate the effect aquatic exercise has on physical function, pain, bone and body composition and quality of life. The results of this study will help optimise the prescription of aquatic exercise to persons with mild knee osteoarthritis. Trial Registration ISRCTN65346593 PMID:23497162

Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial.

PubMed

Waller, Benjamin; Munukka, Matti; Multanen, Juhani; Rantalainen, Timo; Pöyhönen, Tapani; Nieminen, Miika T; Kiviranta, Ilkka; Kautiainen, Hannu; Selänne, Harri; Dekker, Joost; Sipilä, Sarianna; Kujala, Urho M; Häkkinen, Arja; Heinonen, Ari

2013-03-07

Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. A minimum of 80 volunteers who meet the inclusion criteria will be recruited from the local population through newspaper advertisements. Following initial assessment volunteers will be randomised into two groups. The intervention group will participate in a progressive aquatic resistance exercise program of 1-hour duration 3 times a week for four months. The control group will be asked to maintain normal care during this period. Primary outcome measure for this study is the biochemical composition of knee cartilage measured using quantitative magnetic resonance imaging; T2 relaxation time and delayed gadolinium-enhanced magnetic resonance imaging techniques. In addition, knee cartilage morphology as regional cartilage thickness will be studied. Secondary outcomes include measures of body composition and bone traits using dual energy x-ray absorptiometry and peripheral quantitative computed tomography, pain, function using questionnaires and physical performance tests and quality of life. Measurements will be performed at baseline, after the 4-month intervention period and at one year follow up. This randomised controlled trial will investigate the effect a progressive aquatic resistance exercise program has on the biochemical composition of cartilage in post-menopausal women with mild knee osteoarthritis. This is the first study to investigate what impact aquatic exercise has on human articular cartilage. In addition it will investigate the effect aquatic exercise has on physical function, pain, bone and body composition and quality of life. The results of this study will help optimise the prescription of aquatic exercise to persons with mild knee osteoarthritis. ISRCTN65346593.

Exercises for adolescent idiopathic scoliosis: a Cochrane systematic review.

PubMed

Romano, Michele; Minozzi, Silvia; Zaina, Fabio; Saltikov, Josette Bettany; Chockalingam, Nachiappan; Kotwicki, Tomasz; Hennes, Axel Maier; Negrini, Stefano

2013-06-15

Systematic review of interventions. To evaluate the efficacy of scoliosis-specific exercise (SSE) in adolescent patients with adolescent idiopathic scoliosis (AIS). AIS is a 3-dimensional deformity of the spine. Although AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of SSEs to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial. The following databases (up to March 30, 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SPORTDiscus (from January 1975), PsycINFO (from January 1887), and PEDro (from January 1929). We screened reference lists of articles and conducted an extensive hand search of gray literature. randomized controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises. Two review authors independently selected studies, assessed risk of bias and extracted data. Two studies (154 participants) were included. There is low-quality evidence from 1 randomized controlled study that exercises as an adjunctive to other conservative treatments to increase the efficacy of these treatments (thoracic curve reduced: mean difference 9.00, [95% confidence interval, 5.47-12.53]; lumbar curve reduced: mean difference 8.00, [95% confidence interval, 5.08-10.92]). There is very low-quality evidence from a prospective controlled cohort study that SSEs structured within an exercise program can reduce brace prescription (risk ratio, 0.24; [95% confidence interval, 0.06-1.04]) as compared with "usual physiotherapy" [many different kinds of general exercises according to the preferences of the single therapists within different facilities]). There is a lack of high-quality evidence to recommend the use of SSE for AIS. One very low-quality study suggested that these exercises may be more effective than electrostimulation, traction, and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice. 2.

Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome.

PubMed

Costa, Eduardo Caldas; de Sá, Joceline Cássia Ferezini; Stepto, Nigel Keith; Costa, Ingrid Bezerra Barbosa; Farias-Junior, Luiz Fernando; da Nóbrega Tomaz Moreira, Simone; Soares, Elvira Maria Mafaldo; Lemos, Telma Maria Araújo Moura; Browne, Rodrigo Alberto Vieira; Azevedo, George Dantas

2018-02-13

To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). Twenty-seven overweight/obese inactive women with PCOS (body mass index, BMI ≥ 25 kg/m; aged from 18 to 34 years) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min/week) over 16 weeks. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. The exercise group improved 21 ± 12% of cardiorespiratory fitness (p < 0.001) and HRQL in the following domains: physical-functioning, general health, and mental health (p < 0.05). Moreover, the exercise group decreased BMI, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (p < 0.05). The affective response varied from "good" to "fairly good" (i.e., positive affective response) in an exercise intensity dependent manner during the exercise training sessions. Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.

Establishment of peak bone mass.

PubMed

Mora, Stefano; Gilsanz, Vicente

2003-03-01

Among the main areas of progress in osteoporosis research during the last decade or so are the general recognition that this condition, which is the cause of so much pain in the elderly population, has its antecedents in childhood and the identification of the structural basis accounting for much of the differences in bone strength among humans. Nevertheless, current understanding of the bone mineral accrual process is far from complete. The search for genes that regulate bone mass acquisition is ongoing, and current results are not sufficient to identify subjects at risk. However, there is solid evidence that BMD measurements can be helpful for the selection of subjects that presumably would benefit from preventive interventions. The questions regarding the type of preventive interventions, their magnitude, and duration remain unanswered. Carefully designed controlled trials are needed. Nevertheless, previous experience indicates that weight-bearing activity and possibly calcium supplements are beneficial if they are begun during childhood and preferably before the onset of puberty. Modification of unhealthy lifestyles and increments in exercise or calcium assumption are logical interventions that should be implemented to improve bone mass gains in all children and adolescents who are at risk of failing to achieve an optimal peak bone mass.

Effects of acute hypoxia on the determination of anaerobic threshold using the heart rate-work rate relationships during incremental exercise tests.

PubMed

Ozcelik, O; Kelestimur, H

2004-01-01

Anaerobic threshold which describes the onset of systematic increase in blood lactate concentration is a widely used concept in clinical and sports medicine. A deflection point between heart rate-work rate has been introduced to determine the anaerobic threshold non-invasively. However, some researchers have consistently reported a heart rate deflection at higher work rates, while others have not. The present study was designed to investigate whether the heart rate deflection point accurately predicts the anaerobic threshold under the condition of acute hypoxia. Eight untrained males performed two incremental exercise tests using an electromagnetically braked cycle ergometer: one breathing room air and one breathing 12 % O2. The anaerobic threshold was estimated using the V-slope method and determined from the increase in blood lactate and the decrease in standard bicarbonate concentration. This threshold was also estimated by in the heart rate-work rate relationship. Not all subjects exhibited a heart rate deflection. Only two subjects in the control and four subjects in the hypoxia groups showed a heart rate deflection. Additionally, the heart rate deflection point overestimated the anaerobic threshold. In conclusion, the heart rate deflection point was not an accurate predictor of anaerobic threshold and acute hypoxia did not systematically affect the heart rate-work rate relationships.

Cost-effectiveness of everolimus vs sunitinib in treating patients with advanced, progressive pancreatic neuroendocrine tumors in the United States.

PubMed

Casciano, Roman; Chulikavit, Maruit; Perrin, Allison; Liu, Zhimei; Wang, Xufang; Garrison, Louis P

2012-01-01

Everolimus (Afinitor) and sunitinib (Sutent) were recently approved to treat patients with advanced, progressive pancreatic neuroendocrine tumors (pNETs). (Afinitor is a registered trademark of Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; Sutent is a registered trademark of Pfizer Inc., New York, NY, USA.) This analysis examined the projected cost-effectiveness of everolimus vs sunitinib in this setting from a US payer perspective. A semi-Markov model was developed to simulate a cohort of patients with advanced, progressive pNET and to estimate the cost per life-year gained (LYG) and per quality-adjusted life-year (QALY) gained when treating with everolimus vs sunitinib. Efficacy data were based on a weight-adjusted indirect comparison of the agents using phase 3 trial data. Model health states included: stable disease with no adverse events, stable disease with adverse events, disease progression, and death. Therapy costs were based on wholesale acquisition cost. Other costs such as physician visits, tests, hospitalizations, and adverse event costs were obtained from literature and/or primary research. Utility inputs were based on primary research. Sensitivity analyses were conducted to test the model's robustness. In the base-case analysis, everolimus was associated with an incremental 0.448 LYG (0.304 QALYs) at an incremental cost of $12,673, resulting in an incremental cost-effectiveness ratio (ICER) of $28,281/LYG ($41,702/QALY gained). The ICER fell within the cost per QALY range for many widely used oncology drugs. Sensitivity analyses demonstrated that, overall, there is a trend that everolimus is cost-effective compared to sunitinib in this setting. Results of the indirect analysis were not statistically significant (p > 0.05). Assumptions that treatment patterns are the same across therapies may not represent real-world practice. While the analysis is limited by its reliance on an indirect comparison of two phase 3 studies, everolimus is expected to be cost-effective relative to sunitinib in advanced, progressive pNET.

SAMS Acceleration Measurements on Mir (NASA Increment 4)

NASA Technical Reports Server (NTRS)

DeLombard, Richard

1998-01-01

During NASA Increment 4 (January to May 1997), about 5 gigabytes of acceleration data were collected by the Space Acceleration Measurements System (SAMS) onboard the Russian Space Station, Mir. The data were recorded on 28 optical disks which were returned to Earth on STS-84. During this increment, SAMS data were collected in the Priroda module to support the Mir Structural Dynamics Experiment (MiSDE), the Binary Colloidal Alloy Tests (BCAT), Angular Liquid Bridge (ALB), Candle Flames in Microgravity (CFM), Diffusion Controlled Apparatus Module (DCAM), Enhanced Dynamic Load Sensors (EDLS), Forced Flow Flame Spreading Test (FFFr), Liquid Metal Diffusion (LMD), Protein Crystal Growth in Dewar (PCG/Dewar), Queen's University Experiments in Liquid Diffusion (QUELD), and Technical Evaluation of MIM (TEM). This report points out some of the salient features of the microgravity environment to which these experiments were exposed. Also documented are mission events of interest such as the docked phase of STS-84 operations, a Progress engine bum, Soyuz vehicle docking and undocking, and Progress vehicle docking. This report presents an overview of the SAMS acceleration measurements recorded by 10 Hz and 100 Hz sensor heads. The analyses included herein complement those presented in previous summary reports prepared by the Principal Investigator Microgravity Services (PIMS) group.

40 CFR 60.2835 - What if I do not meet an increment of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Air Curtain...

40 CFR 60.1590 - When must I complete each increment of progress?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Small Municipal Waste Combustion Units Constructed on or Before August 30, 1999 Model Rule...

40 CFR 62.14505 - What are the principal components of this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That...) through (k) of this section. (a) Increments of progress toward compliance. (b) Waste management plan. (c...

Prior Exercise Does Not Reduce Postprandial Lipemia Following a Mixed Glucose Meal When Compared with a Mixed Fructose Meal.

PubMed

Rowe, James R; Biggerstaff, Kyle D; Ben-Ezra, Vic; Nichols, David L; DiMarco, Nancy

2016-10-01

This study examined the effect of prior exercise on postprandial lipemia (PPL) concentration following a mixed meal (MM) made with either glucose or fructose. Sedentary women completed four trials in random order: 1) Rest-Fructose: RF, 2) Rest-Glucose: RG, 3) Exercise-Fructose: EF, 4) Exercise-Glucose: EG. Exercise expended 500 kcal while walking at 70%VO 2max . Rest was 60 min of sitting. The morning after each trial, a fasting (12 hr) blood sample was collected followed by consumption of the MM. The MM was blended with whole milk and ice cream plus a glucose or fructose powder. Glucose and fructose powder accounted for 30% of the total kcal within the MM. Blood was collected periodically for 6 hr post-MM and analyzed for PPL. Magnitude of PPL over the 6 hr postmeal was quantified using the triglyceride incremental area under the curve (TG AUC I ). Significant differences (p < .05) between trials were determined using repeated-measures ANOVA and Bonferroni post hoc test. There was no significant difference in the TG AUC I between the four trials (p > .05). A significant trial by time interaction for TG concentration was reported (p < .05). Despite lack of change in the AUC I with prior exercise, the lower TG concentration at multiple time points in the EG trial does indicate that prior exercise has some desirable effect on PPL. This study suggests that replacing fructose with glucose sugars and incorporating exercise may minimize PPL following a mixed meal but exercise will need to elicit greater energy expenditure.

Exercise capacity in the Bidirectional Glenn physiology: Coupling cardiac index, ventricular function and oxygen extraction ratio.

PubMed

Vallecilla, Carolina; Khiabani, Reza H; Trusty, Phillip; Sandoval, Néstor; Fogel, Mark; Briceño, Juan Carlos; Yoganathan, Ajit P

2015-07-16

In Bi-directional Glenn (BDG) physiology, the superior systemic circulation and pulmonary circulation are in series. Consequently, only blood from the superior vena cava is oxygenated in the lungs. Oxygenated blood then travels to the ventricle where it is mixed with blood returning from the lower body. Therefore, incremental changes in oxygen extraction ratio (OER) could compromise exercise tolerance. In this study, the effect of exercise on the hemodynamic and ventricular performance of BDG physiology was investigated using clinical patient data as inputs for a lumped parameter model coupled with oxygenation equations. Changes in cardiac index, Qp/Qs, systemic pressure, oxygen extraction ratio and ventricular/vascular coupling ratio were calculated for three different exercise levels. The patient cohort (n=29) was sub-grouped by age and pulmonary vascular resistance (PVR) at rest. It was observed that the changes in exercise tolerance are significant in both comparisons, but most significant when sub-grouped by PVR at rest. Results showed that patients over 2 years old with high PVR are above or close to the upper tolerable limit of OER (0.32) at baseline. Patients with high PVR at rest had very poor exercise tolerance while patients with low PVR at rest could tolerate low exercise conditions. In general, ventricular function of SV patients is too poor to increase CI and fulfill exercise requirements. The presented mathematical model provides a framework to estimate the hemodynamic performance of BDG patients at different exercise levels according to patient specific data. Published by Elsevier Ltd.

Water-based exercise training for chronic obstructive pulmonary disease.

PubMed

McNamara, Renae J; McKeough, Zoe J; McKenzie, David K; Alison, Jennifer A

2013-12-18

Land-based exercise training improves exercise capacity and quality of life in people with chronic obstructive pulmonary disease (COPD). Water-based exercise training is an alternative mode of physical exercise training that may appeal to the older population attending pulmonary rehabilitation programmes, those who are unable to complete land-based exercise programmes and people with COPD with comorbid physical and medical conditions. To assess the effects of water-based exercise training in people with COPD. A search of the Cochrane Airways Group Specialised Register of trials, which is derived from systematic searches of bibliographic databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED and PsycINFO, was conducted (from inception to August 2013). Handsearching was done to identify further qualifying studies from reference lists of relevant studies. Review authors included randomised or quasi-randomised controlled trials in which water-based exercise training of at least four weeks' duration was compared with no exercise training or any other form of exercise training in people with COPD. Swimming was excluded. We used standard methodological procedures expected by The Cochrane Collaboration. Five studies were included with a total of 176 participants (71 people participated in water-based exercise training and 54 in land-based exercise training; 51 completed no exercise training). All studies compared supervised water-based exercise training versus land-based exercise training and/or no exercise training in people with COPD (with average forced expiratory volume in one second (FEV1) %predicted ranging from 39% to 62%). Sample sizes ranged from 11 to 53 participants. The exercise training programmes lasted from four to 12 weeks, and the mean age of participants ranged from 57 to 73 years. A moderate risk of bias was due to lack of reporting of randomisation, allocation and blinding procedures in some studies, as well as small sample sizes.Compared with no exercise, water-based exercise training improved the six-minute walk distance (mean difference (MD) 62 metres; 95% confidence interval (CI) 44 to 80 metres; three studies; 99 participants; moderate quality evidence), the incremental shuttle walk distance (MD 50 metres; 95% CI 20 to 80 metres; one study; 30 participants; high quality evidence) and the endurance shuttle walk distance (MD 371 metres; 95% CI 121 to 621 metres; one study; 30 participants; high quality evidence). Quality of life was also improved after water-based exercise training compared with no exercise (standardised mean difference (SMD) -0.97, 95% CI -0.37 to -1.57; two studies; 49 participants; low quality evidence). Compared with land-based exercise training, water-based exercise training did not significantly change the six-minute walk distance (MD 11 metres; 95% CI -11 to 33 metres; three studies; 62 participants; moderate quality evidence) or the incremental shuttle walk distance (MD 9 metres; 95% CI -15 to 34 metres; two studies; 59 participants; low quality evidence). However, the endurance shuttle walk distance improved following water-based exercise training compared with land-based exercise training (MD 313 metres; 95% CI 232 to 394 metres; two studies; 59 participants; moderate quality evidence). No significant differences were found between water-based exercise training and land-based exercise training for quality of life, as measured by the St George's Respiratory Questionnaire or by three of four domains of the Chronic Respiratory Disease Questionnaire (CRDQ); however, the fatigue domain of the CRDQ showed a statistically significant difference in favour of water-based exercise (MD -3.00; 95% CI -5.26 to -0.74; one study; 30 participants). Only one study reported long-term outcomes after water-based exercise training for quality of life and body composition, and no significant change was observed between baseline results and six-month follow-up results. One minor adverse event was reported for water-based exercise training (based on reporting from two studies; 20 participants). Impact of disease severity could not be examined because data were insufficient. There is limited quality evidence that water-based exercise training is safe and improves exercise capacity and quality of life in people with COPD immediately after training. There is limited quality evidence that water-based exercise training offers advantages over land-based exercise training in improving endurance exercise capacity, but we remain uncertain as to whether it leads to better quality of life. Little evidence exists examining the long-term effect of water-based exercise training.

Application of Science and Medicine to Sport.

ERIC Educational Resources Information Center

Taylor, Albert W., Ed.

Great progress has been made in recent years in the scientific study of exercise and application to sport. This book provides an analysis of the state of physiological and clinical knowledge related to exercise and sports. The three sections--medicine and physical activity, science and exercise, and practical application to sport--cover a variety…

Mathematics Technical Report: Exercise Volume. National Assessment of Educational Progress. Report No. 04-MA-20.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

Included in Chapter 1 of this report are background information on the 1972-73 mathematics assessment; details of the computational formulas used in reporting results; and explanations of the technical documentation, exercise presentation, documentation pages, scoring guides, and data tables for released and unreleased exercises. The remainder of…

Elaborer un exercice de grammaire (Working Out a Grammar Exercise)

ERIC Educational Resources Information Center

Principaud, Jeanne-Marie

1977-01-01

An elaboration of the official instruction on teaching French to native speakers in elementary school. The topics covered are: Methodological development of exercises; the linguistic ability and milieu of the students; operative criteria; and the question of a logical progression or spontaneous use of grammar exercises. (Text is in French.) (AMH)

Patterns of changes in wheelchair exercise capacity after spinal cord injury.

PubMed

van Koppenhagen, Casper F; de Groot, Sonja; Post, Marcel W; Hoekstra, Trynke; van Asbeck, Floris W; Bongers, Helma; Lindeman, Eline; van der Woude, Luc H

2013-07-01

(1) To identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge; (2) to examine the pattern determinants of the change in wheelchair exercise capacity. Prospective cohort study. Measurements were recorded at the start of active inpatient rehabilitation, 3 months after the start, at discharge of inpatient rehabilitation, 1 year after discharge, and 5 years after discharge. Eight rehabilitation centers. Persons with SCI (N=130; age range, 18-65y), who were wheelchair-dependent, at least for long distances. Not applicable. Wheelchair exercise capacity: peak power output (W). We found 4 different patterns of the change of peak power output (mean ± SD): (1) a pattern with high and progressive scores (33% of total study group): high progressive scores (start of rehabilitation: 49±15W to 5 years after discharge: 77±17.2W); (2) a pattern of improvement during inpatient rehabilitation and deterioration after inpatient rehabilitation (12%): progressive scores during inpatient rehabilitation with deteriorating scores after discharge (start of rehabilitation: 29±8.7W, to discharge: 60±8.4W, to 5 years after discharge: 39±13.1W); (3) a pattern with low and only slightly progressive scores (52%): low progressive scores (start of rehabilitation: 20±10.1W to 5 years after discharge: 31±15.9W); and (4) a pattern with low scores during inpatient rehabilitation and a sharp rise after discharge (3%): low inpatient scores with strong progressive scores after discharge (start of rehabilitation: 29±15.5W to 5 years after discharge: 82±10.6W). A logistic regression of factors that may distinguish between patterns with high and progressive scores and patterns with low and only slightly progressive scores revealed that older age, being a woman, having a tetraplegic lesion, and low functional status were associated with patterns with low and only slightly progressive scores. The pattern of improvement during inpatient rehabilitation and deterioration after inpatient rehabilitation showed more neuropathic pain and lower sports participation than patterns with high and progressive scores. For the vast majority of patients, wheelchair exercise capacity after SCI shows a positive trend and can be described in distinct patterns that are dependent on personal, lesion, and functional characteristics. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Early ICU Standardized Rehabilitation Therapy for the Critically Injured Burn Patient

DTIC Science & Technology

2016-10-01

physical therapy , respiratory therapy and related disciplines. Accordingly, the investigators feel that the proposed continuation plan will both fall... physical therapy , and progressive resistance exercise. The usual care group received weekday physical therapy when ordered by the clinical team. For the... physical therapy , and 3.0 (1.0-5.0) for progressive resistance exercise. Themedian days of delivery of physical therapy for the usual care group was 1.0

Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial

PubMed Central

Vasconcelos, Karina S. S.; Dias, João M. D.; Araújo, Marília C.; Pinheiro, Ana C.; Moreira, Bruno S.; Dias, Rosângela C.

2016-01-01

ABSTRACT Background Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. Objective To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Method Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. Results The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. Conclusion In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity. PMID:27410162

Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy: study protocol for a randomised controlled trial.

PubMed

Ingwersen, Kim G; Christensen, Robin; Sørensen, Lilli; Jørgensen, Hans Ri; Jensen, Steen Lund; Rasmussen, Sten; Søgaard, Karen; Juul-Kristensen, Birgit

2015-01-27

Shoulder pain is the third most common musculoskeletal disorder, often affecting people's daily living and work capacity. The most common shoulder disorder is the subacromial impingement syndrome (SIS) which, among other pathophysiological changes, is often characterised by rotator cuff tendinopathy. Exercise is often considered the primary treatment option for rotator cuff tendinopathy, but there is no consensus on which exercise strategy is the most effective. As eccentric and high-load strength training have been shown to have a positive effect on patella and Achilles tendinopathy, the aim of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy. The current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with rotator cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and perform home-based exercises three times a week. The primary outcome measure will be change from baseline to 12 weeks in the patient-reported outcome Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Previous studies of exercise treatment for SIS have not differentiated between subgroups of SIS and have often had methodological flaws, making it difficult to specifically design target treatment for patients diagnosed with SIS. Therefore, it was considered important to focus on a subgroup such as tendinopathy, with a specific tailored intervention strategy based on evidence from other regions of the body, and to clearly describe the intervention in a methodologically strong study. The trial was registered with Clinicaltrials.gov ( NCT01984203 ) on 31 October 2013.

Carotid Baroreflex Function During Prolonged Exercise

NASA Technical Reports Server (NTRS)

Raven, P. B.

1999-01-01

Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative pressure (-10 torr) to mimic spaceflight- related decreases in cardiac filling volumes.

Exercise training in patients with heart disease: review of beneficial effects and clinical recommendations.

PubMed

Gielen, Stephan; Laughlin, M Harold; O'Conner, Christopher; Duncker, Dirk J

2015-01-01

Over the last decades exercise training has evolved into an established evidence-based therapeutic strategy with prognostic benefits in many cardiovascular diseases (CVDs): In stable coronary artery disease (CAD) exercise training attenuates disease progression by beneficially influencing CVD risk factors (i.e., hyperlipidemia, hypertension) and coronary endothelial function. In heart failure (HF) with reduced ejection fraction (HFrEF) training prevents the progressive loss of exercise capacity by antagonizing peripheral skeletal muscle wasting and by promoting left ventricular reverse remodeling with reduction in cardiomegaly and improvement of ejection fraction. Novel areas for exercise training interventions include HF with preserved ejection fraction (HFpEF), pulmonary hypertension, and valvular heart disease. In HFpEF, randomized studies indicate a lusitropic effect of training on left ventricular diastolic function associated with symptomatic improvement of exercise capacity. In pulmonary hypertension, reductions in pulmonary artery pressure were observed following endurance exercise training. Recently, innovative training methods such as high-intensity interval training, resistance training and others have been introduced. Although their prognostic value still needs to be determined, these approaches may achieve superior improvements in aerobic exercise capacity and gain in muscle mass, respectively. In this review, we give an overview of the prognostic and symptomatic benefits of exercise training in the most common cardiac disease entities. Additionally, key guideline recommendations for the initiation of training programs are summarized. Copyright © 2014 Elsevier Inc. All rights reserved.

Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis.

PubMed

Negrini, Stefano; Zaina, Fabio; Romano, Michele; Negrini, Alessandra; Parzini, Silvana

2008-06-01

To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis. Prospective controlled cohort observational study. Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously. Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation. There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened. These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.

The safety of isometric exercise

PubMed Central

Wiles, Jonathan D.; Taylor, Katrina; Coleman, Damian; Sharma, Rajan; O’Driscoll, Jamie M.

2018-01-01

Abstract Few studies have investigated the relative safety of prescribing isometric exercise (IE) to reduce resting blood pressure (BP). This study aimed to ascertain the safety of the hemodynamic response during an IE wall squat protocol. Twenty-six hypertensive (BP of 120–139 mm Hg systolic and/or 80–90 mm Hg diastolic) males (45 ± 8 years; 1.78 ± 0.07 m; 89.7 ± 12.3 kg; mean ± SD), visited the laboratory on 2 separate occasions. Heart rate (HR) and BP were measured at rest and continuously throughout exercise. In visit 1, participants completed a continuous incremental isometric wall squat exercise test, starting at 135° of knee flexion, decreasing by 10° every 2 minutes until 95° (final stage). Exercise was terminated upon completion of the test or volitional fatigue. The relationship between knee joint angle and mean HR was used to calculate the participant-specific knee joint angle required to elicit a target HR of 95% HRpeak. This angle was used to determine exercise intensity for a wall squat training session consisting of 4 × 2 minute bouts (visit 2). Systolic BPs during the exercise test and training were 173 ± 21 mm Hg and 171 ± 19 mm Hg, respectively, (P > .05) and were positively related (r = 0.73, P < .05) with ratio limits of agreement (LoA) of 0.995 ×/÷ 1.077. Diastolic BPs were 116 ± 14 mm Hg and 113 ± 11 mm Hg, respectively, (P > .05) and were positively related (r = 0.42, P < .05) with ratio LoA of 0.99 ×/÷ 1.107. No participant recorded a systolic BP > 250 mm Hg. Diastolic BP values > 115 mm Hg were recorded in 12 participants during the incremental test and 6 participants during the training session. Peak rate pressure product was 20681 ± 3911 mm Hg bpm during the IE test and was lower (18074 ± 3209 mm Hg bpm) during the IE session (P = .002). No adverse effects were reported. Based on the current ACSM guidelines for aerobic exercise termination, systolic BP does not reach the upper limit during IE in this population. Diastolic BP exceeds 115 mm Hg in some during the IE protocol, which may suggest the need to individualise IE training prescription in some with suboptimal BP control. Future research is required to ascertain if IE requires modified BP termination guidelines. PMID:29517686

Reliability of muscle blood flow and oxygen consumption response from exercise using near-infrared spectroscopy.

PubMed

Lucero, Adam A; Addae, Gifty; Lawrence, Wayne; Neway, Beemnet; Credeur, Daniel P; Faulkner, James; Rowlands, David; Stoner, Lee

2018-01-01

What is the central question of this study? Continuous-wave near-infrared spectroscopy, coupled with venous and arterial occlusions, offers an economical, non-invasive alternative to measuring skeletal muscle blood flow and oxygen consumption, but its reliability during exercise has not been established. What is the main finding and its importance? Continuous-wave near-infrared spectroscopy devices can reliably assess local skeletal muscle blood flow and oxygen consumption from the vastus lateralis in healthy, physically active adults. The patterns of response exhibited during exercise of varying intensity agree with other published results using similar methodologies, meriting potential applications in clinical diagnosis and therapeutic assessment. Near-infrared spectroscopy (NIRS), coupled with rapid venous and arterial occlusions, can be used for the non-invasive estimation of resting local skeletal muscle blood flow (mBF) and oxygen consumption (mV̇O2), respectively. However, the day-to-day reliability of mBF and mV̇O2 responses to stressors such as incremental dynamic exercise has not been established. The aim of this study was to determine the reliability of NIRS-derived mBF and mV̇O2 responses from incremental dynamic exercise. Measurements of mBF and mV̇O2 were collected in the vastus lateralis of 12 healthy, physically active adults [seven men and five women; 25 (SD 6) years old] during three non-consecutive visits within 10 days. After 10 min rest, participants performed 3 min of rhythmic isotonic knee extension (one extension every 4 s) at 5, 10, 15, 20, 25 and 30% of maximal voluntary contraction (MVC), before four venous occlusions and then two arterial occlusions. The mBF and mV̇O2 increased proportionally with intensity [from 0.55 to 7.68 ml min -1  (100 ml) -1 and from 0.05 to 1.86 ml O 2  min -1  (100 g) -1 , respectively] up to 25% MVC, where they began to plateau at 30% MVC. Moreover, an mBF/mV̇O2 muscle oxygen consumption ratio of ∼5 was consistent for all exercise stages. The intraclass correlation coefficient for mBF indicated high to very high reliability for 10-30% MVC (0.82-0.9). There was very high reliability for mV̇O2 across all exercise stages (intraclass correlation coefficient 0.91-0.96). In conclusion, NIRS can reliably assess muscle blood flow and oxygen consumption responses to low- to moderate-intensity exercise, meriting potential applications in clinical diagnosis and therapeutic assessment. © 2017 The Authors. Experimental Physiology © 2017 The Physiological Society.

The measurement conundrum in exercise adherence research.

PubMed

Dishman, R K

1994-11-01

This paper has two purposes. It first prefaces a symposium titled "Exercise adherence and behavior change: prospects, problems, and future directions." The symposium describes the progress made during the past 5 years toward understanding the adoption and maintenance of physical activity and exercise. Specifically, research is discussed that has tested the applicability to physical activity of four psychological models of behavior: Reasoned Action, Planned Behavior, Social-Cognitive Theory, and the Transtheoretical Model of stages of change. Recent exercise interventions in clinical/community settings also are discussed to illustrate how theoretical models can be implemented to increase and maintain exercise. The second purpose of this paper is to provide a brief summary of the contemporary literatures on the determinants of physical activity and interventions designed to increase and maintain physical activity. The summary focuses on the measurement problems that have limited the advances made in theory and application in these areas of research. Progress toward resolving the measurement problems during the past 5 years is contrasted with earlier scientific consensus.

Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study.

PubMed

McCullagh, Ruth; Fitzgerald, Anthony P; Murphy, Raymond P; Cooke, Grace

2008-03-01

To determine if exercise benefits patients with multiple sclerosis. Randomized controlled trial. Participants exercised at home and also attended exercise classes held in a hospital physiotherapy gym. Thirty patients, diagnosed and independently mobile, were recruited in the Dublin area. For three months, classes were held twice-weekly and participants exercised independently once-weekly. The control group was monitored monthly and management remained unchanged. Measurements were taken at baseline, three and six months. The Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Impact Scale-29 (MSIS-29) and Functional Assessment of Multiple Sclerosis (FAMS) were used to measure fatigue and quality of life (QOL). Heart rate (HR) and the Borg's Rating of Perceived Exertion (RPE) were recorded during an incremental exercise test. The change from baseline scores between groups was compared using the Mann-Whitney U-test. Twenty-four participants completed the programme (n = 12 in each group). Based on the change in scores at three months, the exercise group had significantly greater improvements in exercise capacity (HR: -14 [-18.5, -2.5] versus 0.5 [-4, 5.5], P= 0.009), QOL (FAMS: 23 [9.5, 42.5] versus -3.5 [-16, 5], P=0.006) and fatigue (MFIS: -13 [-20, -3] versus 1 [-4, 4.5], P=0.02). At six months, the difference in change scores remained significant for FAMS (19 [14, 31] versus -4.5 [-25, 8], P=0.002) and MFIS (-8.5 [-19.5, -1] versus 0.5 [-2.5, 6.5], P=0.02) only. A three-month exercise programme improved participants' exercise capacity, QOL and fatigue, with the improvements in QOL and fatigue lasting beyond the programme.

Effects of the different frequencies of whole-body vibration during the recovery phase after exhaustive exercise.

PubMed

Cheng, C F; Hsu, W C; Lee, C L; Chung, P K

2010-12-01

This study was to investigate the effects of vibration exercise on the oxygen consumption (VO2) and heart rate variability (HRV) during the recovery phase after exhaustive exercise. Twenty male college students volunteered as subjects to participate in the study. The subjects were randomly crossover assigned to perform three 10 min vibration exercises, namely non-vibration (CON, 0 Hz, 0 mm), low-frequency (LFT, 20 Hz, 0.4 mm) and high-frequency (HFT, 36 Hz, 0.4 mm) treatments immediately after an incremental exhaustive cycling exercise in separated days. The beat-to-beat HRV, blood lactate concentration and VO2 were measured during the 1-hour recovery phase. The time- and frequency-domain indices of HRV were analyzed to confirm the effects of vibration exercises on the cardiac autonomic modulation. There were no significant differences on the VO2, HRV and blood lactate concentrations at 30th minute (post-30 min) or 60th minute (post-60 min) during the recovery phase among the three treatments. There were also no significant differences on the excess post-exercise oxygen consumption (EPOC) during the recovery phase among the treatments. However, the VO2 at post-30 min in CON and LFT were significantly higher than the baseline values, whereas the VO2 in HFT returned to resting condition at the post-30 min. The results indicate that both low and high frequency vibration exercises could not improve the physiological recovery after exhaustive cycling exercise. However, the high frequency vibration exercise probably has a potential to facilitate the VO2 to return to the resting level during the recovery phase.

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.

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

Examining the Technical Adequacy of Progress Monitoring Using Early Writing Curriculum-Based Measures

ERIC Educational Resources Information Center

Hampton, David D.; Lembke, Erica S.

2016-01-01

The purpose of this study was to examine 4 early writing measures used to monitor the early writing progress of 1st-grade students. We administered the measures to 23 1st-grade students biweekly for a total of 16 weeks. We obtained 3-min samples and conducted analyses for each 1-min increment. We scored samples using 2 different methods: correct…

EPIRUS-NET: A Wireless Health Telematics Network in Greece

DTIC Science & Technology

2001-10-25

has also to be made. The system is represented of three basic layers: the database layer, the middleware and the Hospital Daily Progress Anamnesis ... Anamnesis . The Encounter entry is uniquely identified by the incremental ID, IID, attribute. Each encounter entry is associated with a clinical...the main entities of the system (Hospital, Patient, Anamnesis , Encounter, Clinical Examination, Daily Progress, Examination, Release Ticket), along

40 CFR 60.5115 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule...

40 CFR 60.2590 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.2590 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.2830 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.2590 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.5100 - When must I submit the notifications of achievement of increments of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule...

Longitudinal changes in reproductive hormones and menstrual cyclicity in cynomolgus monkeys during strenuous exercise training: abrupt transition to exercise-induced amenorrhea.

PubMed

Williams, N I; Caston-Balderrama, A L; Helmreich, D L; Parfitt, D B; Nosbisch, C; Cameron, J L

2001-06-01

Cross-sectional studies of exercise-induced reproductive dysfunction have documented a high proportion of menstrual cycle disturbances in women involved in strenuous exercise training. However, longitudinal studies have been needed to examine individual susceptibility to exercise-induced reproductive dysfunction and to elucidate the progression of changes in reproductive function that occur with strenuous exercise training. Using the female cynomolgus monkey (Macaca fascicularis), we documented changes in menstrual cyclicity and patterns of LH, FSH, estradiol, and progesterone secretion as the animals developed exercise-induced amenorrhea. As monkeys gradually increased running to 12.3 +/- 0.9 km/day, body weight did not change significantly although food intake remained constant. The time spent training until amenorrhea developed varied widely among animals (7-24 months; mean = 14.3 +/- 2.2 months) and was not correlated with initial body weight, training distance, or food intake. Consistent changes in function of the reproductive axis occurred abruptly, one to two menstrual cycles before the development of amenorrhea. These included significant declines in plasma reproductive hormone concentrations, an increase in follicular phase length, and a decrease in luteal phase progesterone secretion. These data document a high level of interindividual variability in the development of exercise-induced reproductive dysfunction, delineate the progression of changes in reproductive hormone secretion that occur with exercise training, and illustrate an abrupt transition from normal cyclicity to an amenorrheic state in exercising individuals, that is not necessarily associated with weight loss.

Kinetic quantification of plyometric exercise intensity.

PubMed

Ebben, William P; Fauth, McKenzie L; Garceau, Luke R; Petushek, Erich J

2011-12-01

Ebben, WP, Fauth, ML, Garceau, LR, and Petushek, EJ. Kinetic quantification of plyometric exercise intensity. J Strength Cond Res 25(12): 3288-3298, 2011-Quantification of plyometric exercise intensity is necessary to understand the characteristics of these exercises and the proper progression of this mode of exercise. The purpose of this study was to assess the kinetic characteristics of a variety of plyometric exercises. This study also sought to assess gender differences in these variables. Twenty-six men and 23 women with previous experience in performing plyometric training served as subjects. The subjects performed a variety of plyometric exercises including line hops, 15.24-cm cone hops, squat jumps, tuck jumps, countermovement jumps (CMJs), loaded CMJs equal to 30% of 1 repetition maximum squat, depth jumps normalized to the subject's jump height (JH), and single leg jumps. All plyometric exercises were assessed with a force platform. Outcome variables associated with the takeoff, airborne, and landing phase of each plyometric exercise were evaluated. These variables included the peak vertical ground reaction force (GRF) during takeoff, the time to takeoff, flight time, JH, peak power, landing rate of force development, and peak vertical GRF during landing. A 2-way mixed analysis of variance with repeated measures for plyometric exercise type demonstrated main effects for exercise type and all outcome variables (p ≤ 0.05) and for the interaction between gender and peak vertical GRF during takeoff (p ≤ 0.05). Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the outcome variables assessed (p ≤ 0.05). These findings can be used to guide the progression of plyometric training by incorporating exercises of increasing intensity over the course of a program.

A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury.

PubMed

Eitzen, Ingrid; Moksnes, Håvard; Snyder-Mackler, Lynn; Risberg, May Arna

2010-11-01

Prospective cohort study without a control group. Firstly, to present our 5-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. Secondly, to evaluate changes in knee function after completion of the program for patients with ACL injury in general and also when classified as potential copers or noncopers, and, finally, to examine potential adverse events. Few studies concerning early-stage ACL rehabilitation protocols exist. Consequently, little is known about the tolerance for, and outcomes from, short-term exercise therapy programs in the early stage after injury. One-hundred patients were included in a 5-week progressive exercise therapy program, within 3 months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, 4 single-leg hop tests, 2 different self-assessment questionnaires, and a global rating of knee function. A 2-way mixed-model analysis of variance was conducted to evaluate changes from pretest to posttest for the limb symmetry index for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean for muscle strength and single-leg hop tests were calculated at pretest and posttest for the injured and uninjured limb. Adverse events during the 5-week period were recorded. The progressive 5-week exercise therapy program led to significant improvements (P<.05) in knee function from pretest to posttest both for patients classified as potential copers and noncopers. Standardized response mean values for changes in muscle strength and single-leg hop performance from pretest to posttest for the injured limb were moderate to strong (0.49-0.84), indicating the observed improvements to be clinically relevant. Adverse events occurred in 3.9% of the patients. Short-term progressive exercise therapy programs are well tolerated and should be incorporated in early-stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further nonoperative management. Therapy, level 2b.

Accounting Clerk Guide, Exercise and Worksheet Packet--Part I.

ERIC Educational Resources Information Center

Foster, Brian; And Others

The exercise and worksheet packet is part of an eight volume unit for grades 10, 11, and 12, designed for individualized progression in preparing students for entry into the occupation of accounting clerk. The exercise and worksheet packet contains a copy of every worksheet in the learner packet for lessons 1 through 11 so that the instructor can…

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 therapy in addition to exercise therapy improved treatment effectiveness compared to providing 12 consecutive exercise therapy sessions alone. Trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000460808).

Protein and exercise in the prevention of sarcopenia and aging.

PubMed

Naseeb, Manal A; Volpe, Stella L

2017-04-01

Aging is associated with a progressive decline in skeletal muscle mass and strength. The decline, known as sarcopenia, could lead to physical disability, poor quality of life, and death. In addition, the older population usually experiences age-related muscle changes that affect muscle mass, muscular strength, and functional abilities. The purpose of this review is to describe the role of protein and exercise in slowing the progression of sarcopenia. It will also discuss whether age-related changes can be attenuated by dietary protein and exercise in the older population. This review will also cover one of the possible mechanisms of how dietary protein and exercise are involved in sarcopenia prevention, as well as the available measurement tools. Based on the findings of this review, the adequate amount of protein required for older men and women needs to be revised and likely be higher. Moreover, studies are required to explore some inconclusive findings concerning sarcopenia in the older population. Further research is required to investigate the following: (1) the safety and effectiveness concerning the consumption of 1.4 g of protein/kg of body weight (or more) in this vulnerable population; (2) the effectiveness of amino acid supplementation in reducing progression of sarcopenia over time through longitudinal studies; (3) the preferred source and timing of protein for the older population to maintain muscular strength and attenuate sarcopenia; (4) exercise interventions, especially those of longer duration, in the attenuation of sarcopenia; (5) other types of exercise and their effects on age-related muscle changes; (6) the mechanism of how protein and exercise prevent muscle loss with aging; and (7) determine the best method to diagnose sarcopenia. Copyright © 2017 Elsevier Inc. All rights reserved.

Lack of Association Between ACE Indel Polymorphism and Cardiorespiratory Fitness in Physically Active and Sedentary Young Women.

PubMed

Verlengia, Rozangela; Rebelo, Ana C; Crisp, Alex H; Kunz, Vandeni C; Dos Santos Carneiro Cordeiro, Marco A; Hirata, Mario H; Crespo Hirata, Rosario D; Silva, Ester

2014-09-01

Polymorphisms at the angiotensin-converting enzyme gene (ACE), such as the indel [rs1799752] variant in intron 16, have been shown to be associated with aerobic performance of athletes and non-athletes. However, the relationship between ACE indel polymorphism and cardiorespiratory fitness has not been always demonstrated. The relationship between ACE indel polymorphism and cardiorespiratory fitness was investigated in a sample of young Caucasian Brazilian women. This study investigated 117 healthy women (aged 18 to 30 years) who were grouped as physically active (n = 59) or sedentary (n = 58). All subjects performed an incremental exercise test (ramp protocol) on a cycle-ergometer with 20-25 W/min increments. Blood samples were obtained for DNA extraction and to analyze metabolic and hormonal profiles. ACE indel polymorphism was determined by polymerase chain reaction (PCR) and fragment size analysis. The physically active group had higher values of peak oxygen uptake (VO2 peak), carbon dioxide output (VCO2), ventilation (VE) and power output than the sedentary group (P < 0.05) at the peak of the exercise test. However, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) did not differ between groups. There was no relationship between ACE indel polymorphism and cardiorespiratory variables during the test in both the physically active and sedentary groups, even when the dominant (DD vs. D1 + 2) and recessive (2 vs. DI + DD) models of inheritance were tested. These results do not support the concept that the genetic variation at the ACE locus contributes to the cardiorespiratory responses at the peak of exercise test in physically active or sedentary healthy women. This indicates that other factors might mediate these responses, including the physical training level of the women.

Lack of Association Between ACE Indel Polymorphism and Cardiorespiratory Fitness in Physically Active and Sedentary Young Women

PubMed Central

Verlengia, Rozangela; Rebelo, Ana C.; Crisp, Alex H.; Kunz, Vandeni C.; dos Santos Carneiro Cordeiro, Marco A.; Hirata, Mario H.; Crespo Hirata, Rosario D.; Silva, Ester

2014-01-01

Background: Polymorphisms at the angiotensin-converting enzyme gene (ACE), such as the indel [rs1799752] variant in intron 16, have been shown to be associated with aerobic performance of athletes and non-athletes. However, the relationship between ACE indel polymorphism and cardiorespiratory fitness has not been always demonstrated. Objectives: The relationship between ACE indel polymorphism and cardiorespiratory fitness was investigated in a sample of young Caucasian Brazilian women. Patients and Methods: This study investigated 117 healthy women (aged 18 to 30 years) who were grouped as physically active (n = 59) or sedentary (n = 58). All subjects performed an incremental exercise test (ramp protocol) on a cycle-ergometer with 20-25 W/min increments. Blood samples were obtained for DNA extraction and to analyze metabolic and hormonal profiles. ACE indel polymorphism was determined by polymerase chain reaction (PCR) and fragment size analysis. Results: The physically active group had higher values of peak oxygen uptake (VO2 peak), carbon dioxide output (VCO2), ventilation (VE) and power output than the sedentary group (P < 0.05) at the peak of the exercise test. However, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) did not differ between groups. There was no relationship between ACE indel polymorphism and cardiorespiratory variables during the test in both the physically active and sedentary groups, even when the dominant (DD vs. D1 + 2) and recessive (2 vs. DI + DD) models of inheritance were tested. Conclusions: These results do not support the concept that the genetic variation at the ACE locus contributes to the cardiorespiratory responses at the peak of exercise test in physically active or sedentary healthy women. This indicates that other factors might mediate these responses, including the physical training level of the women. PMID:25520764

The influence of musical cadence into aquatic jumping jacks kinematics.

PubMed

Costa, Mário J; Oliveira, Cristiana; Teixeira, Genoveva; Marinho, Daniel A; Silva, António J; Barbosa, Tiago M

2011-01-01

The aim of this study was to analyze the relationships between the head-out aquatic exercise "Jumping jacks" kinematics and the musical cadence in healthy and fit subjects. Five young women, with at least one year of experience conducting head- out aquatic programs were videotaped in the frontal plane, with a pair of cameras providing a double projection (above and below the water surface). Subjects performed an incremental protocol of five bouts (120 b·min(-1), 135 b·min(-1), 150 b·min(-1), 165 b·min(-1) and 180 b·min(-1)) with 16 full cycles of the "Jumping jacks" exercise. Data processing and calculation of upper limbs' (i.e. hands), lower limbs' (i.e. feet) and center of mass' 2D linear velocity and displacement were computed with the software Ariel Performance Analysis System and applying the 2D-DLT algorithm. Subjects decreased the cycle period during the incremental protocol. Significant and negative relationships with the musical cadence were verified for the center of mass and upper limbs vertical displacement. On the other hand, for the lower limbs lateral velocity, a significant and positive relationship was observed. It is concluded that expert and fit subjects increase the lower limb's velocity to maintain the range of motion, while the upper limb's displacement is reduced to coupe the music cadence. Key pointsWhile performing the Jumping Jacks, expert and fit subjects increase their lower limbs segmental velocity to maintain the range of motion.The upper limbs displacement is reduced to maintain the music cadence.Expert and fit subjects present similar response for alternating or simultaneously head-out aquatic exercises when increasing the music cadence.

A Lactate Kinetics Method for Assessing the Maximal Lactate Steady State Workload

PubMed Central

Hering, Gernot O.; Hennig, Ewald M.; Riehle, Hartmut J.; Stepan, Jens

2018-01-01

During a continuously increasing exercise workload (WL) a point will be reached at which arterial lactate accumulates rapidly. This so-called lactate threshold (LT) is associated with the maximal lactate steady state workload (MLSSW), the highest WL, at which arterial lactate concentration [LA] does not change. However, the physiological range in which the LT and the MLSSW occur has not been demonstrated directly. We used minor WL variations in the MLSSW range to assess arterial lactate kinetics in 278 treadmill and 148 bicycle ergometer exercise tests. At a certain workload, minimal further increment of running speed (0.1–0.15 m/s) or cycling power (7–10 W) caused a steep elevation of [LA] (0.9 ± 0.43 mM, maximum increase 2.4 mM), indicating LT achievement. This sharp [LA] increase was more pronounced when higher WL increments were used (0.1 vs. 0.30 m/s, P = 0.02; 0.15 vs. 0.30 m/s, P < 0.001; 7 vs. 15 W, P = 0.002; 10 vs. 15 W, P = 0.001). A subsequent workload reduction (0.1 m/s/7 W) stopped the [LA] increase indicating MLSSW realization. LT based determination of running speed (MLSSW) was highly reproducible on a day-to-day basis (r = 0.996, P < 0.001), valid in a 10 km constant velocity setting (r = 0.981, P < 0.001) and a half marathon race (r = 0.969, P < 0.001). These results demonstrate a fine-tuned regulation of exercise-related lactate metabolism, which can be reliably captured by assessing lactate kinetics at the MLSSW. PMID:29651253

Physical activity, sedentary behavior, and aerobic capacity in persons with multiple sclerosis.

PubMed

Motl, Robert W; Sandroff, Brian M; Pilutti, Lara A; Klaren, Rachel E; Baynard, Tracy; Fernhall, Bo

2017-01-15

There is substantial evidence that exercise training improves aerobic capacity among people with multiple sclerosis (MS), but less is known about the associations between physical activity and sedentary behaviors with aerobic capacity. This study examined if objectively-measured moderate-to-vigorous (MVPA) and light (LPA) physical activity and sedentary behavior were associated with peak aerobic capacity (VO 2 peak) measured using an established protocol for conducting a maximal, incremental exercise test in persons with MS. The study involved a cross-sectional, observational study design and included 49 persons with MS. Participants wore an accelerometer around the waist during the waking hours for a 7-day period as a measure of physical activity and sedentary behaviors, and completed a maximal, incremental exercise test on an electronically-braked, computer-controlled cycle ergometer with open-circuit spirometry for measuring VO 2 peak. VO 2 peak was significantly correlated with MVPA (r=0.53, p<0.001) and LPA (r=0.39, p<0.01), but not sedentary behavior (r=-0.12, p=0.44). Linear regression analysis indicated that MVPA (B=0.19, SE B=0.04, β=0.51, p<0.001) and LPA (B=0.02, SE B=0.01, β=0.30, p<0.05), but not sedentary behavior (B=-0.01, SE B=0.01, β=-0.14, p=0.26), explained significant variance in VO 2 peak (R 2 =0.40). We provide the first evidence that MVPA and LPA represent concurrent correlates of VO 2 peak and both could be targeted for improving aerobic capacity in persons with MS. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical Determinants of Incremental Shuttle Walk Test in Adults with Bronchiectasis.

PubMed

Yildiz, Sulenur; Inal-Ince, Deniz; Calik-Kutukcu, Ebru; Vardar-Yagli, Naciye; Saglam, Melda; Arikan, Hulya; Coplu, Lutfi

2018-06-01

Exercise capacity is impaired in patients with bronchiectasis. Incremental shuttle walk test (ISWT) stresses cardiorespiratory system physiologically to symptom-limited maximal exercise capacity. The purpose of this study was to investigate the clinical determinants of ISWT in adults with non-cystic fibrosis (CF) bronchiectasis. Forty-one clinically stable bronchiectasis patients aged 18-72 years (27 females, 14 males) participated in the study. Subjects' demographics and physical characteristics were recorded. Bronchiectasis Severity Index was used to identify disease severity. Pulmonary function test was performed. Dyspnea perception was assessed using the modified Medical Research Council Dyspnea Scale. Maximum inspiratory and expiratory pressures were measured. Peripheral muscle strength using a hand held dynamometer was measured. ISWT was performed to determine exercise capacity. Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Leicester Cough Questionnaire were used to determine fatigue, psychosocial status, and quality of life. Patients' mean ISWT distance was 469.5 m. The ISWT distance was significantly related with age (r = - 0.472), height (r = 0.469), gender (r = 0.520), FEV 1 (r = 0.651), and FVC (r = 0.545, p < 0.05). Quadriceps muscle strength was higher in males (p = 0.001) as compared to females. Age and gender were identified as independent predictors of the ISWT, explaining 42% of variance in ISWT distance (r = 0.649, r 2  = 0.421, F (2,38)  = 13.794, p < 0.001). The clinical determinants of ISWT in clinically stable patients with non-CF bronchiectasis are age and gender. Pulmonary function, dyspnea perception, muscle strength, disease severity, fatigue, psychosocial factors, and health-related quality of life seems to have an independent effect on ISWT in this group of patients with bronchiectasis.

Facilitation of corticospinal excitability according to motor imagery and mirror therapy in healthy subjects and stroke patients.

PubMed

Kang, Youn Joo; Ku, Jeonghun; Kim, Hyun Jung; Park, Hae Kyung

2011-12-01

To delineate the changes in corticospinal excitability when individuals are asked to exercise their hand using observation, motor imagery, voluntary exercise, and exercise with a mirror. The participants consisted of 30 healthy subjects and 30 stroke patients. In healthy subjects, the amplitudes and latencies of motor evoked potential (MEP) were obtained using seven conditions: (A) rest; (B) imagery; (C) observation and imagery of the hand activity of other individuals; (D) observation and imagery of own ipsilateral hand activity; (E) observation and imagery of the hand activity of another individual with a mirror; (F) observation and imagery of own symmetric ipsilateral hand activity (thumb abduction) with a mirror; and (G) observation and imagery of own asymmetric ipsilateral hand activity (little finger abduction) with a mirror. In stroke patients, MEPs were obtained in the A, C, D, E, F conditions. In both groups, increment of the percentage MEP amplitude (at rest) and latency decrement of MEPs were significantly higher during the observation of the activity of the hand of another individual with a mirror and during symmetric ipsilateral hand activity on their own hand with a mirror than they were without a mirror. In healthy subjects, the increment of percentage MEP amplitude and latency decrement were significantly higher during the observation of the symmetric ipsilateral hand activity with a mirror compared to the observation of the activity of the asymmetric ipsilateral hand with a mirror of their own hand. In both groups, corticospinal excitability was facilitated by viewing the mirror image of the activity of the ipsilateral hand. These findings provide neurophysiological evidence supporting the application of various mirror imagery programs during stroke rehabilitation.

Facilitation of Corticospinal Excitability According to Motor Imagery and Mirror Therapy in Healthy Subjects and Stroke Patients

PubMed Central

Kang, Youn Joo; Ku, Jeonghun; Kim, Hyun Jung

2011-01-01

Objective To delineate the changes in corticospinal excitability when individuals are asked to exercise their hand using observation, motor imagery, voluntary exercise, and exercise with a mirror. Method The participants consisted of 30 healthy subjects and 30 stroke patients. In healthy subjects, the amplitudes and latencies of motor evoked potential (MEP) were obtained using seven conditions: (A) rest; (B) imagery; (C) observation and imagery of the hand activity of other individuals; (D) observation and imagery of own ipsilateral hand activity; (E) observation and imagery of the hand activity of another individual with a mirror; (F) observation and imagery of own symmetric ipsilateral hand activity (thumb abduction) with a mirror; and (G) observation and imagery of own asymmetric ipsilateral hand activity (little finger abduction) with a mirror. In stroke patients, MEPs were obtained in the A, C, D, E, F conditions. Results In both groups, increment of the percentage MEP amplitude (at rest) and latency decrement of MEPs were significantly higher during the observation of the activity of the hand of another individual with a mirror and during symmetric ipsilateral hand activity on their own hand with a mirror than they were without a mirror. In healthy subjects, the increment of percentage MEP amplitude and latency decrement were significantly higher during the observation of the symmetric ipsilateral hand activity with a mirror compared to the observation of the activity of the asymmetric ipsilateral hand with a mirror of their own hand. Conclusion In both groups, corticospinal excitability was facilitated by viewing the mirror image of the activity of the ipsilateral hand. These findings provide neurophysiological evidence supporting the application of various mirror imagery programs during stroke rehabilitation. PMID:22506202

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.

Abnormal heart rate recovery and chronotropic incompetence on exercise in chronic obstructive pulmonary disease.

PubMed

Gupta, Mansi; Bansal, Vishal; Chhabra, Sunil K

2013-08-01

Chronotropic incompetence (CI; failure to reach the targeted heart rate (HR) on exercise) and a delayed HR recovery (HRR; ≤12 beats decline within the first minute after cessation) reflect autonomic dysfunction (AD) and predict adverse cardiac prognosis. As chronic obstructive pulmonary disease (COPD) is known to be associated with AD, we hypothesized that these patients may manifest these responses on exercise. The prevalence and predictors of these responses in COPD and their association with its severity have not been evaluated. Normoxemic, stable male patients with COPD (n = 39) and 11 healthy controls underwent lung function testing and incremental leg ergometry. HR responses were monitored during exercise and recovery to compute the HRR and CI. Of all the patients, 33 (84.6%) had at least one of the two exercise responses as abnormal, with the majority (23, 58.9%) having both an abnormal HRR and CI. The frequency of abnormal responses increased with increasing Global Initiative for Chronic Obstructive Lung Disease stage and body mass index, airflow obstruction, dyspnoea and exercise capacity index. After adjusting for smoking history and post-bronchodilator forced expiratory volume in 1 second, only a reduced diffusion capacity for carbon monoxide predicted abnormal HRR, though weakly. We concluded that abnormal HRR and CI are common in patients with COPD. These responses are observed with increasing frequency as the severity of disease increases.

Physiological Correlates of Endurance Time Variability during Constant-Workrate Cycling Exercise in Patients with COPD

PubMed Central

Vivodtzev, Isabelle; Gagnon, Philippe; Pepin, Véronique; Saey, Didier; Laviolette, Louis; Brouillard, Cynthia; Maltais, François

2011-01-01

Rationale The endurance time (Tend) during constant-workrate cycling exercise (CET) is highly variable in COPD. We investigated pulmonary and physiological variables that may contribute to these variations in Tend. Methods Ninety-two patients with COPD completed a CET performed at 80% of peak workrate capacity (Wpeak). Patients were divided into tertiles of Tend [Group 1: <4 min; Group 2: 4–6 min; Group 3: >6 min]. Disease severity (FEV1), aerobic fitness (Wpeak, peak oxygen consumption [ peak], ventilatory threshold [ VT]), quadriceps strength (MVC), symptom scores at the end of CET and exercise intensity during CET (heart rate at the end of CET to heart rate at peak incremental exercise ratio [HRCET/HRpeak]) were analyzed as potential variables influencing Tend. Results Wpeak, peak, VT, MVC, leg fatigue at end of CET, and HRCET/HRpeak were lower in group 1 than in group 2 or 3 (p≤0.05). VT and leg fatigue at end of CET independently predicted Tend in multiple regression analysis (r = 0.50, p = 0.001). Conclusion Tend was independently related to the aerobic fitness and to tolerance to leg fatigue at the end of exercise. A large fraction of the variability in Tend was not explained by the physiological parameters assessed in the present study. Individualization of exercise intensity during CET should help in reducing variations in Tend among patients with COPD. PMID:21386991

Does wearing clothing made of a synthetic “cooling” fabric improve indoor cycle exercise endurance in trained athletes?

PubMed Central

Abdallah, Sara J; Krug, Robin; Jensen, Dennis

2015-01-01

This randomized, double-blind, crossover study examined the effects of a clothing ensemble made of a synthetic fabric promoted as having superior cooling properties (COOL) on exercise performance and its physiological and perceptual determinants during cycle exercise in ambient laboratory conditions that mimic environmental conditions of indoor training/sporting facilities. Twenty athletes (15 men:5 women) aged 25.8 ± 1.2 years (mean ± SEM) with a maximal rate of O2 consumption of 63.7 ± 1.5 mL·kg−1·min−1 completed cycle exercise testing at 85% of their maximal incremental power output to exhaustion while wearing an ensemble consisting of a fitted long-sleeved shirt and full trousers made of either COOL or a synthetic control fabric (CTRL). Exercise endurance time was not different under COOL versus CTRL conditions: 12.38 ± 0.98 versus 11.75 ± 1.10 min, respectively (P > 0.05). Similarly, COOL had no effect on detailed thermoregulatory (skin and esophageal temperatures), cardiometabolic, ventilatory, and perceptual responses to exercise (all P > 0.05). In conclusion, clothing made of a synthetic fabric with purported “cooling” properties did not improve high-intensity cycle exercise endurance in trained athletes under ambient laboratory conditions that mimic the environmental conditions of indoor training/sporting facilities. PMID:26290527

Phosphocreatine resynthesis during recovery in different muscles of the exercising leg by 31P-MRS.

PubMed

Yoshida, T; Abe, D; Fukuoka, Y

2013-10-01

To investigate the high-energy phosphate metabolism by (31) P-nuclear magnetic resonance spectroscopy during off-transition of exercise in different muscle groups, such as calf muscles and biceps femoris muscles, seven male long-distance runners (LDR) and nine untrained males (UT) performed both submaximal constant and incremental exercises. The relative exercise intensity was set at 60% of the maximal work rate (60%W max) during both knee flexion and plantar flexion submaximal constant load exercises. The relative areas under the inorganic phosphate (Pi ) and phosphocreatine (PCr) peaks were determined. During the 5-min recovery following the 60%W max, the time constant for the PCr off-kinetics was significantly faster in the plantar flexion (LDR: 17.3 ± 3.6 s, UT: 26.7 ± 6.7 s) than in the knee flexion (LDR: 29.7 ± 4.7 s, UT: 42.7 ± 2.8 s, P < 0.05). In addition, a significantly faster PCr off-kinetics was observed in LDR than in UT for both exercises. The ratio of Pi to PCr (Pi /PCr) during exercise was significantly lower during the plantar flexion than during the knee flexion (P < 0.01). These findings indicated that the calf muscles had relatively higher potential for oxidative capacity than that of biceps femoris muscles with an association of training status. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bilateral changes in forearm oxygen consumption at rest and after exercise in patients with unilateral repetitive strain injury: a case-control study.

PubMed

Brunnekreef, Jaap J J; Thijssen, Dick H J; Oosterhof, Jan; Hopman, Maria T E

2012-04-01

Case-control study. To investigate whether oxygen consumption and blood flow at rest and after exercise are lower in the affected arm of patients with repetitive strain injury (RSI) compared to controls, and lower in the healthy nonaffected forearm within patients with unilateral RSI. RSI is considered an upper extremity overuse injury. Despite the local presentation of complaints, RSI may be represented by systemic adaptations. Insight into the pathophysiology of RSI is important to better understand the development of RSI complaints and to develop effective treatment and prevention strategies. Twenty patients with unilateral RSI and 20 gender-matched control subjects participated in this study. Forearm muscle blood flow and oxygen consumption were measured using near-infrared spectroscopy at baseline and immediately after isometric handgrip exercises at 10%, 20%, and 40% of the individual maximal voluntary contraction. Unilateral RSI resulted in a lower oxygen consumption and blood flow in the affected forearm at baseline and lower oxygen consumption after incremental handgrip exercises compared to controls (P<.05). In addition, exercise-induced blood flow and oxygen consumption in the nonaffected forearm in patients with RSI were similarly reduced. Blood flow and oxygen consumption after exercise are similarly attenuated in the affected and nonaffected arms of patients with unilateral RSI. Our findings suggest that, despite the unilateral character in clinical symptoms, RSI demonstrates systemic adaptations in forearm blood flow and oxygen consumption at rest and after exercise.

A new technique for the characterization of chaff elements

NASA Astrophysics Data System (ADS)

Scholfield, David; Myat, Maung; Dauby, Jason; Fesler, Jonathon; Bright, Jonathan

2011-07-01

A new technique for the experimental characterization of electromagnetic chaff based on Inverse Synthetic Aperture Radar is presented. This technique allows for the characterization of as few as one filament of chaff in a controlled anechoic environment allowing for stability and repeatability of experimental results. This approach allows for a deeper understanding of the fundamental phenomena of electromagnetic scattering from chaff through an incremental analysis approach. Chaff analysis can now begin with a single element and progress through the build-up of particles into pseudo-cloud structures. This controlled incremental approach is supported by an identical incremental modeling and validation process. Additionally, this technique has the potential to produce considerable savings in financial and schedule cost and provides a stable and repeatable experiment to aid model valuation.

On the statistics of increments in strong Alfvenic turbulence

NASA Astrophysics Data System (ADS)

Palacios, J. C.; Perez, J. C.

2017-12-01

In-situ measurements have shown that the solar wind is dominated by non-compressive Alfvén-like fluctuations of plasma velocity and magnetic field over a broad range of scales. In this work, we present recent progress in understanding intermittency in Alfvenic turbulence by investigating the statistics of Elsasser increments from simulations of steadily driven Reduced MHD with numerical resolutions up to 2048^3. The nature of these statistics guards a close relation to the fundamental properties of small-scale structures in which the turbulence is ultimately dissipated and therefore has profound implications in the possible contribution of turbulence to the heating of the solar wind. We extensively investigate the properties and three-dimensional structure of probability density functions (PDFs) of increments and compare with recent phenomenological models of intermittency in MHD turbulence.

Effects of Three-Day Bed Rest on Physiological Responses to Graded Exercise in Endurance Athletes, Body Builders and Sedentary Men

NASA Technical Reports Server (NTRS)

Smorawinski, J.; Nazar, K.; Kaciuza-Uscilko; Kaminska, E.; Kodrzycka, A.; Bicz, B.; Greenleaf, J. E.

2001-01-01

To test the hypotheses that short-term bed rest (BR) deconditioning influences metabolic, cardiorespiratory and neurohormonal responses to exercise and that these effects depend on the subjects' training status, 12 sedentary men, and 10 endurance- and 10 strength-trained athletes were submitted to three-day BR. Before and after BR they performed incremental exercise tests until volitional exhaustion. Respiratory gas exchange and HR were recorded continuously and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate [LA], adrenaline [A], noradrenaline [NA], renin activity (PRA), growth hormone [hGH], testosterone and cortisol determination. Reduction of peak oxygen uptake (V02peak) after BR was greater in the endurance athletes than in the remaining groups (17 % vs. 10%). Decrements in VO2peak correlated positively with the initial values (r = 0.73, p is less than 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased the in endurance athletes from 71 to 60% V02 peak (p is less than0.001), they also had an earlier increase in [NA], an attenuated increase in [hGH], and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion: reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Effects of Three-Day Bed Rest on Physiological Responses to Graded Exercise in Endurance Athletes, Body Builders and Sedentary Men

NASA Technical Reports Server (NTRS)

Smorawinski, J.; Nazar, K.; Kaciuza-Uscilko, H.; Kaminska, E.; Cybulski, G.; Kodrzycka, A.; Bice, B.; Greenleaf, J. E.; Sun, Sid (Technical Monitor)

2001-01-01

To test the hypotheses that short-term bed rest (BR) deconditioning influences metabolic, cardiorespiratory and neurohormonal responses to exercise and that these effects depend on the subjects' training status 12 sedentary men, and 10 endurance- and 10 strength-trained athletes were submitted to three-day BR. Before and after BR they performed incremental exercise test until volitional exhaustion. Respiratory gas exchange and HR were recorded continuously and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate [LA], adrenaline [A], noradrenaline, [NA], renting activity (PRA), growth hormone [hGH], testosterone and cortisol determination. Reduction of peak oxygen uptake (VO2peak) after BR was greater in the endurance athletes (than in the remaining groups (17 % vs. 100%). Decrements in VO2peak correlated positively with the initial values (r = 0.73, p less than 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased the in endurance athletes from 71 to 60 %VO2 peak (p less than 0.001); they also had an earlier increase in [NA], and an attenuated increase in [hGH), and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion: reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Effects of 3-day bed rest on physiological responses to graded exercise in athletes and sedentary men

NASA Technical Reports Server (NTRS)

Smorawinski, J.; Nazar, K.; Kaciuba-Uscilko, H.; Kaminska, E.; Cybulski, G.; Kodrzycka, A.; Bicz, B.; Greenleaf, J. E.

2001-01-01

To test the hypotheses that short-term bed-rest (BR) deconditioning influences metabolic, cardiorespiratory, and neurohormonal responses to exercise and that these effects depend on the subjects' training status, 12 sedentary men and 10 endurance- and 10 strength-trained athletes were submitted to 3-day BR. Before and after BR they performed incremental exercise test until volitional exhaustion. Respiratory gas exchange and heart rate (HR) were recorded continuously, and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate concentration ([LA]), epinephrine concentration ([Epi]), norepinephrine concentration ([NE]), plasma renin activity (PRA), human growth hormone concentration ([hGH]), testosterone, and cortisol determination. Reduction of peak oxygen uptake (VO(2 peak)) after BR was greater in the endurance athletes than in the remaining groups (17 vs. 10%). Decrements in VO(2 peak) correlated positively with the initial values (r = 0.73, P < 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased in the endurance athletes from 71 to 60% VO(2 peak) (P < 0.001); they also had an earlier increase in [NE], an attenuated increase in [hGH], and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion, reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Effects of 3-day bed rest on physiological responses to graded exercise in athletes and sedentary men.

PubMed

Smorawiński, J; Nazar, K; Kaciuba-Uscilko, H; Kamińska, E; Cybulski, G; Kodrzycka, A; Bicz, B; Greenleaf, J E

2001-07-01

To test the hypotheses that short-term bed-rest (BR) deconditioning influences metabolic, cardiorespiratory, and neurohormonal responses to exercise and that these effects depend on the subjects' training status, 12 sedentary men and 10 endurance- and 10 strength-trained athletes were submitted to 3-day BR. Before and after BR they performed incremental exercise test until volitional exhaustion. Respiratory gas exchange and heart rate (HR) were recorded continuously, and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate concentration ([LA]), epinephrine concentration ([Epi]), norepinephrine concentration ([NE]), plasma renin activity (PRA), human growth hormone concentration ([hGH]), testosterone, and cortisol determination. Reduction of peak oxygen uptake (VO(2 peak)) after BR was greater in the endurance athletes than in the remaining groups (17 vs. 10%). Decrements in VO(2 peak) correlated positively with the initial values (r = 0.73, P < 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased in the endurance athletes from 71 to 60% VO(2 peak) (P < 0.001); they also had an earlier increase in [NE], an attenuated increase in [hGH], and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion, reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Burrowing as a novel voluntary strength training method for mice: A comparison of various voluntary strength or resistance exercise methods.

PubMed

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-04-15

Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. The current study tested functional and muscular effects of two novel voluntary strength training methods, burrowing (digging a substrate out of a tube) and unloaded tower climbing, in male C57Bl6 mice. To compare these two novel methods with existing exercise methods, resistance running and (non-resistance) running were included. Motor coordination, grip strength and muscle fatigue were measured at baseline, halfway through and near the end of a fourteen week exercise intervention. Endurance was measured by an incremental treadmill test after twelve weeks. Both burrowing and resistance running improved forelimb grip strength as compared to controls. Running and resistance running increased endurance in the treadmill test and improved motor skills as measured by the balance beam test. Post-mortem tissue analyses revealed that running and resistance running induced Soleus muscle hypertrophy and reduced epididymal fat mass. Tower climbing elicited no functional or muscular changes. As a voluntary strength exercise method, burrowing avoids the confounding effects of stress and positive reinforcers elicited in forced strength exercise methods. Compared to voluntary resistance running, burrowing likely reduces the contribution of aerobic exercise components. Burrowing qualifies as a suitable voluntary strength training method in mice. Furthermore, resistance running shares features of strength training and endurance (aerobic) exercise and should be considered a multi-modal aerobic-strength exercise method in mice. Copyright © 2017 Elsevier B.V. All rights reserved.

Is exercise effective in promoting mental well-being in older age? A systematic review.

PubMed

Windle, Gill; Hughes, Dyfrig; Linck, Pat; Russell, Ian; Woods, Bob

2010-08-01

Promoting the mental well-being of older people has been neglected. To examine the clinical and cost-effectiveness of exercise and physical activity interventions on mental well-being in people aged 65+. Systematic review, meta-analysis, economic model. Reports published in English, identified by searching 25 databases, 11 websites and references lists of systematic reviews. Eligible studies were those with a comparison or control group or offering qualitative evidence; exercise and physical activity interventions for people aged 65 and above living at home, in the community, in supported housing or in residential care homes; including outcome measures of mental well-being, not simply measures of depression or anxiety. Low-quality studies were excluded from the data synthesis. An overall effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14-0.40). The included interventions were designed for older people, targeted those who are sedentary and delivered in a community setting, primarily through a group-based approach led by trained leaders. As a minimum, the evidence would suggest two exercise sessions per week, each of 45 min duration. There is some indication that exercise can also improve the mental well-being of frail elders. Economic evidence indicated incremental cost-effectiveness ratios (compared with minimal intervention) of pound 7300 and pound 12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively. Mental well-being in later life is modifiable through exercise and physical activity. To generalise the findings, there is a need for more evidence of effectiveness from older people in the UK.

40 CFR 60.2845 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.5085 - What are my requirements for meeting increments of progress and achieving final compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule...

40 CFR 60.5095 - What must I include in the notifications of achievement of increments of progress?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance Times for Existing Sewage Sludge Incineration Units Model Rule...

40 CFR 60.2605 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 60.2605 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model...

40 CFR 62.14565 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... DESIGNATED FACILITIES AND POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and...

40 CFR 62.14565 - How do I comply with the increment of progress for achieving final compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... DESIGNATED FACILITIES AND POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Compliance Schedule and...

An index for breathlessness and leg fatigue.

PubMed

Borg, E; Borg, G; Larsson, K; Letzter, M; Sundblad, B-M

2010-08-01

The features of perceived symptoms causing discontinuation of strenuous exercise have been scarcely studied. The aim was to characterize the two main symptoms causing the discontinuation of heavy work in healthy persons as well as describe the growth of symptoms during exercise. Breathlessness (b) and leg fatigue (l) were assessed using the Borg CR10 Scale and the Borg CR100 (centiMax) Scale, during a standardized exercise test in 38 healthy subjects (24-71 years). The b/l-relationships were calculated for terminal perceptions (ERI(b/l)), and the growth of symptoms determined by power functions for the whole test, as well as by growth response indexes (GRI). This latter index was constructed as a ratio between power levels corresponding to a very strong and a moderate perception. In the majority (71%) of the test subjects, leg fatigue was the dominant symptom at the conclusion of exercise (P<0.001) and the b/l ratio was 0.77 (CR10) and 0.75 (CR100), respectively. The GRI for breathlessness and leg fatigue was similar, with good correlations between GRI and the power function exponent (P<0.005). In healthy subjects, leg fatigue is the most common cause for discontinuing an incremental exercise test. The growth functions for breathlessness and leg fatigue during work are, however, almost parallel.

A comparison of head motion and prefrontal haemodynamics during upright and recumbent cycling exercise.

PubMed

Tempest, Gavin D; Eston, Roger G; Parfitt, Gaynor

2017-11-01

The aim of this observational study was to compare head motion and prefrontal haemodynamics during exercise using three commercial cycling ergometers. Participants (n = 12) completed an incremental exercise test to exhaustion during upright, recumbent and semi-recumbent cycling. Head motion (using accelerometry), physiological data (oxygen uptake, end-tidal carbon dioxide [P ET CO 2 ] and heart rate) and changes in prefrontal haemodynamics (oxygenation, deoxygenation and blood volume using near infrared spectroscopy [NIRS]) were recorded. Despite no difference in oxygen uptake and heart rate, head motion was higher and P ET CO 2 was lower during upright cycling at maximal exercise (P<0·05). Analyses of covariance (covariates: head motion P>0·05; P ET CO 2 , P<0·01) revealed that prefrontal oxygenation was higher during semi-recumbent than recumbent cycling and deoxygenation and blood volume were higher during upright than recumbent and semi-recumbent cycling (respectively; P<0·05). This work highlights the robustness of the utility of NIRS to head motion and describes the potential postural effects upon the prefrontal haemodynamic response during upright and recumbent cycling exercise. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

The Nonproliferation Review

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

RAJEN,GAURAV; BIRINGER,KENT L.

2000-07-28

The aim of this paper is to understand the numerous nuclear-related agreements that involve India and Pakistan, and in so doing identify starting points for future confidence-creating and confidence-building projects. Existing nuclear-related agreements provide a framework under which various projects can be proposed that foster greater nuclear transparency and cooperation in South Asia. The basic assumptions and arguments underlying this paper can be summarized as follows: (1) Increased nuclear transparency between India and Pakistan is a worthwhile objective, as it will lead to the irreversibility of extant nuclear agreements, the prospects of future agreements; and the balance of opacity andmore » transparency required for stability in times of crises; (2) Given the current state of Indian and Pakistani relations, incremental progress in increased nuclear transparency is the most likely future outcome; and (3) Incremental progress can be achieved by enhancing the information exchange required by existing nuclear-related agreements.« less

[Effects of aerobic exercise program and relaxation techniques on anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia: a randomized controlled trial].

PubMed

Arcos-Carmona, Isabel María; Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo Adolfo; Gutiérrez-Rubio, Ana Belén; Ramos-González, Elena; Moreno-Lorenzo, Carmen

2011-10-08

Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The purpose of the present study was to determine the benefits of aerobic exercise program and progressive relaxation techniques on anxiety, quality of sleep, depression and quality of life in patients with fibromyalgia. An experimental study was performed with a placebo control group. Fifty-six fibromyalgia patients were randomly assigned to intervention (aerobic exercises+progressive relaxation techniques) and placebo (sham treatment with disconnected magnet therapy device) groups. Outcome measures were anxiety (STAI- State Trait Anxiety Inventory), quality of sleep (Pittsburgh sleep quality index), depression (Beck depression inventory) and quality of life (questionnaire SF-36). Measures were performed at baseline and after 10-weeks treatment. After 10 weeks of treatment, the intervention group showed significant reduction (p<0.05) in sleep duration, trait anxiety and quality of life. The combination of aerobic exercise program and progressive relaxation techniques contribute to improve night rest, trait anxiety and quality of life in patients with fibromyalgia. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Aerobic exercise decreases the positive-reinforcing effects of cocaine.

PubMed

Smith, Mark A; Schmidt, Karl T; Iordanou, Jordan C; Mustroph, Martina L

2008-11-01

Aerobic exercise can serve as an alternative, non-drug reinforcer in laboratory animals and has been recommended as a potential intervention for substance abusing populations. Unfortunately, relatively little empirical data have been collected that specifically address the possible protective effects of voluntary, long-term exercise on measures of drug self-administration. The purpose of the present study was to examine the effects of chronic exercise on sensitivity to the positive-reinforcing effects of cocaine in the drug self-administration procedure. Female rats were obtained at weaning and immediately divided into two groups. Sedentary rats were housed individually in standard laboratory cages that permitted no exercise beyond normal cage ambulation; exercising rats were housed individually in modified cages equipped with a running wheel. After 6 weeks under these conditions, rats were surgically implanted with venous catheters and trained to self-administer cocaine on a fixed-ratio schedule of reinforcement. Once self-administration was acquired, cocaine was made available on a progressive ratio schedule and breakpoints were obtained for various doses of cocaine. Sedentary and exercising rats did not differ in the time to acquire cocaine self-administration or responding on the fixed-ratio schedule of reinforcement. However, on the progressive ratio schedule, breakpoints were significantly lower in exercising rats than sedentary rats when responding was maintained by both low (0.3mg/kg/infusion) and high (1.0mg/kg/infusion) doses of cocaine. In exercising rats, greater exercise output prior to catheter implantation was associated with lower breakpoints at the high dose of cocaine. These data indicate that chronic exercise decreases the positive-reinforcing effects of cocaine and support the possibility that exercise may be an effective intervention in drug abuse prevention and treatment programs.

Heart rate variability and aerobic fitness.

PubMed

De Meersman, R E

1993-03-01

Heart rate variability, a noninvasive marker of parasympathetic activity, diminishes with aging and is augmented after exercise training. Whether habitual exercise over time can attenuate this loss is unknown. This cross-sectional investigation compared 72 male runners, aged 15 to 83 to 72 age- and weight-matched sedentary control subjects for the amplitude of their heart rate variability. Heart rate variability was assessed during rest while subjects were breathing at a rate of 6 breaths per minute and at an augmented tidal volume (tidal volume = 30% of vital capacity). Fitness levels were assessed with on-line, open-circuit spirometry while subjects were performing an incremental stress test. Overall results between the two groups showed that the physically active group had significantly higher fitness levels (p < 0.001), which were associated with significantly higher levels of heart rate variability, when compared with their sedentary counterparts (p < 0.001). These findings provide suggestive evidence for habitual aerobic exercise as a beneficial modulator of heart rate variability in an aging population.

Noninvasive monitoring local variations of fever and edema on human: potential for point-of-care inflammation assessment

NASA Astrophysics Data System (ADS)

Li, Zebin; Li, Xianglin; Li, Ting

2018-02-01

Tissue inflammation is often accompanied by fever and edema, which are common and troublesome problems that probably trigger disability, lymphangitis, cosmetic deformity and cellulitis. Here we developed a device, which can measure concentration and temperature variations of water in local human body by extended near infrared spectroscopy in 900 1000 nm wavelength range. An experiment of four steps incremental cycling exercise was designed to change tissue water concentration and temperature of subjects. Body temperature was also estimated by tympanic thermometer and surface thermometer as comparisons during the experiment. In the stage of recovery after exercise, the signal detected by custom device is similar to tympanic thermometer at the beginning, but it is closer to the temperature of surface later. In particular, this signal shows a better linearity, and a significant change when the exercise was suspended. This study demonstrated the potential of optical touch-sensing for inflammation severity monitoring by measuring water concentration and temperature variations in local lesions.

Software designs of image processing tasks with incremental refinement of computation.

PubMed

Anastasia, Davide; Andreopoulos, Yiannis

2010-08-01

Software realizations of computationally-demanding image processing tasks (e.g., image transforms and convolution) do not currently provide graceful degradation when their clock-cycles budgets are reduced, e.g., when delay deadlines are imposed in a multitasking environment to meet throughput requirements. This is an important obstacle in the quest for full utilization of modern programmable platforms' capabilities since worst-case considerations must be in place for reasonable quality of results. In this paper, we propose (and make available online) platform-independent software designs performing bitplane-based computation combined with an incremental packing framework in order to realize block transforms, 2-D convolution and frame-by-frame block matching. The proposed framework realizes incremental computation: progressive processing of input-source increments improves the output quality monotonically. Comparisons with the equivalent nonincremental software realization of each algorithm reveal that, for the same precision of the result, the proposed approach can lead to comparable or faster execution, while it can be arbitrarily terminated and provide the result up to the computed precision. Application examples with region-of-interest based incremental computation, task scheduling per frame, and energy-distortion scalability verify that our proposal provides significant performance scalability with graceful degradation.

Amphetamine enhances endurance by increasing heat dissipation.

PubMed

Morozova, Ekaterina; Yoo, Yeonjoo; Behrouzvaziri, Abolhassan; Zaretskaia, Maria; Rusyniak, Daniel; Zaretsky, Dmitry; Molkov, Yaroslav

2016-09-01

Athletes use amphetamines to improve their performance through largely unknown mechanisms. Considering that body temperature is one of the major determinants of exhaustion during exercise, we investigated the influence of amphetamine on the thermoregulation. To explore this, we measured core body temperature and oxygen consumption of control and amphetamine-trea ted rats running on a treadmill with an incrementally increasing load (both speed and incline). Experimental results showed that rats treated with amphetamine (2 mg/kg) were able to run significantly longer than control rats. Due to a progressively increasing workload, which was matched by oxygen consumption, the control group exhibited a steady increase in the body temperature. The administration of amphetamine slowed down the temperature rise (thus decreasing core body temperature) in the beginning of the run without affecting oxygen consumption. In contrast, a lower dose of amphetamine (1 mg/kg) had no effect on measured parameters. Using a mathematical model describing temperature dynamics in two compartments (the core and the muscles), we were able to infer what physiological parameters were affected by amphetamine. Modeling revealed that amphetamine administration increases heat dissipation in the core. Furthermore, the model predicted that the muscle temperature at the end of the run in the amphetamine-treated group was significantly higher than in the control group. Therefore, we conclude that amphetamine may mask or delay fatigue by slowing down exercise-induced core body temperature growth by increasing heat dissipation. However, this affects the integrity of thermoregulatory system and may result in potentially dangerous overheating of the muscles. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Role of maximal heart rate and arterial O2 saturation on the decrement of VO2max in moderate acute hypoxia in trained and untrained men.

PubMed

Mollard, P; Woorons, X; Letournel, M; Cornolo, J; Lamberto, C; Beaudry, M; Richalet, J-P

2007-03-01

We aimed to evaluate 1) the altitude where maximal heart rate (HR (max)) decreases significantly in both trained and untrained subjects in moderate acute hypoxia, and 2) if the HR (max) decrease could partly explain the drop of V.O (2max). Seventeen healthy males, nine trained endurance athletes (TS) and eight untrained individuals (US) were studied. Subjects performed incremental exercise tests at sea level and at 5 simulated altitudes (1000, 1500, 2500, 3500, 4500 meters). Power output (PO), heart rate (HR), arterial oxygen saturation (SaO (2)), oxygen uptake (V.O (2)), arterialized blood pH and lactate were measured. Both groups showed a progressive reduction in V.O (2max). The decrement in HR (max) (DeltaHR (max)) was significant from 1000 m for TS and 2500 m for US and more important in TS than US (at 1500 m and 3500 m). At maximal exercise, TS had a greater reduction in SaO (2) (DeltaSaO (2)) at each altitude. DeltaHR (max) observed in TS was correlated with DeltaSaO (2). When the two groups were pooled, simple regressions showed that DeltaV.O (2max) was correlated with both DeltaSaO (2) and DeltaHR (max). However, a multiple regression analysis demonstrated that DeltaSaO (2) alone may account for DeltaV.O (2max). Furthermore, in spite of a greater reduction in SaO (2) and HR (max) in TS, no difference was evidenced in relative DeltaV.O (2max) between groups. Thus, in moderate acute hypoxia, the reduction in SaO (2) is the primary factor to explain the drop of V.O (2max) in trained and untrained subjects.

Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol.

PubMed

Newton, Robert U; Kenfield, Stacey A; Hart, Nicolas H; Chan, June M; Courneya, Kerry S; Catto, James; Finn, Stephen P; Greenwood, Rosemary; Hughes, Daniel C; Mucci, Lorelei; Plymate, Stephen R; Praet, Stephan F E; Guinan, Emer M; Van Blarigan, Erin L; Casey, Orla; Buzza, Mark; Gledhill, Sam; Zhang, Li; Galvão, Daniel A; Ryan, Charles J; Saad, Fred

2018-05-14

Preliminary evidence supports the beneficial role of physical activity on prostate cancer outcomes. This phase III randomised controlled trial (RCT) is designed to determine if supervised high-intensity aerobic and resistance exercise increases overall survival (OS) in patients with metastatic castrate-resistant prostate cancer (mCRPC). Participants (n=866) must have histologically documented metastatic prostate cancer with evidence of progressive disease on androgen deprivation therapy (defined as mCRPC). Patients can be treatment-naïve for mCRPC or on first-line androgen receptor-targeted therapy for mCRPC (ie, abiraterone or enzalutamide) without evidence of progression at enrolment, and with no prior chemotherapy for mCRPC. Patients will receive psychosocial support and will be randomly assigned (1:1) to either supervised exercise (high-intensity aerobic and resistance training) or self-directed exercise (provision of guidelines), stratified by treatment status and site. Exercise prescriptions will be tailored to each participant's fitness and morbidities. The primary endpoint is OS. Secondary endpoints include time to disease progression, occurrence of a skeletal-related event or progression of pain, and degree of pain, opiate use, physical and emotional quality of life, and changes in metabolic biomarkers. An assessment of whether immune function, inflammation, dysregulation of insulin and energy metabolism, and androgen biomarkers are associated with OS will be performed, and whether they mediate the primary association between exercise and OS will also be investigated. This study will also establish a biobank for future biomarker discovery or validation. Validation of exercise as medicine and its mechanisms of action will create evidence to change clinical practice. Accordingly, outcomes of this RCT will be published in international, peer-reviewed journals, and presented at national and international conferences. Ethics approval was first obtained at Edith Cowan University (ID: 13236 NEWTON), with a further 10 investigator sites since receiving ethics approval, prior to activation. NCT02730338. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Robotic Surgery Simulator: Elements to Build a Training Program.

PubMed

Tillou, Xavier; Collon, Sylvie; Martin-Francois, Sandrine; Doerfler, Arnaud

2016-01-01

Face, content, and construct validity of robotic surgery simulators were confirmed in the literature by several studies, but elements to build a training program are still lacking. The aim of our study was to validate a progressive training program and to assess according to prior surgical experience the amount of training needed with a robotic simulator to complete the program. Exercises using the Da Vinci Skill Simulator were chosen to ensure progressive learning. A new exercise could only be started if a minimal score of 80% was achieved in the prior one. The number of repetitions to achieve an exercise was not limited. We devised a "performance index" by calculating the ratio of the sum of scores for each exercise over the number of repetitions needed to complete the exercise with at least an 80% score. The study took place at the François Baclesse Cancer Center. Participants all work at the primary care university Hospital located next to the cancer center. A total of 32 surgeons participated in the study- 2 experienced surgeons, 8 junior and 8 senior residents in surgery, 6 registrars, and 6 attending surgeons. There was no difference between junior and senior residents, whereas the registrars had better results (p < 0.0001). The registrars performed less exercise repetitions compared to the junior or senior residents (p = 0.012). Attending surgeons performed significantly more repetitions than registrars (p = 0.024), but they performed fewer repetitions than junior or senior residents with no statistical difference (p = 0.09). The registrars had a performance index of 50, which is the best result among all novice groups. Attending surgeons were between senior and junior residents with an index at 33.85. Choice of basic exercises to manipulate different elements of the robotic surgery console in a specific and progressive order enables rapid progress. The level of prior experience in laparoscopic surgery affects outcomes. More advanced laparoscopic expertise seems to slow down learning, surgeons having to "unlearn" to acquire a new technique. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Sarcopenia intervention with progressive resistance training and protein nutritional supplements].

PubMed

Palop Montoro, M Victoria; Párraga Montilla, Juan Antonio; Lozano Aguilera, Emilio; Arteaga Checa, Milagros

2015-04-01

Aging is accompanied by changes in body composition among which is a progressive reduction in muscle mass, which may contribute to the development of functional limitations in older people, and where the lifestyle plays a particularly important role. To test the effectiveness of progressive resistance training, protein nutritional supplements and both interventions combined in the treatment of sarcopenia. Review of literature in Medline, ScienceDirect, CINAHL, ISI WOK and PEDro data by combining the descriptors of Medical Subject Headings (MeSH) concerning sarcopenia, progressive resistance training, protein supplements and seniors. A total of 147 studies were found which resistance exercise performed by sessions 45-60 minutes, 2-3 times a week, and 3-4 sets of 8 repetitions, to an increasing intensity. This exercise resulted in increased muscle mass and strength, and increased skeletal muscle protein synthesis and muscle fiber size. Nutritional supplements such as beta-hydroxy-beta-methylbutyrate, leucine and essential amino acids produced gains in muscle mass. All supplements increased strength, especially when combined with resistance exercise. The combination of progressive resistance training and protein included in the diet, either in the form of nutritional supplements, strengthens the impact that each of these interventions can have on the treatment of sarcopenia in the elderly. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The role of resistance and aerobic exercise training on insulin sensitivity measures in STZ-induced Type 1 diabetic rodents.

PubMed

Hall, Katharine E; McDonald, Matthew W; Grisé, Kenneth N; Campos, Oscar A; Noble, Earl G; Melling, C W James

2013-10-01

Individuals with Type 1 Diabetes Mellitus (T1DM) can develop insulin resistance. Regular exercise may improve insulin resistance partially through increased expression of skeletal muscle GLUT4 content. To examine if different exercise training modalities can alter glucose tolerance through changes in skeletal muscle GLUT4 content in T1DM rats. Fifty rats were divided into 5 groups; control, diabetic control, diabetic resistance exercised, and diabetic high and low intensity treadmill exercised. Diabetes was induced using multiple low dose Streptozotocin (20 mg/kg/day) injections and blood glucose concentrations were maintained moderately hyperglycemic through subcutaneous insulin pellets. Resistance trained rats climbed a ladder with incremental loads, while treadmill trained rats ran on a treadmill at 27 or 15 m/min, respectively, all for 6 weeks. At weeks 3 and 6, area under the curve measurements following an intravenous glucose tolerance test (AUC-IVGTT) in all diabetic groups were higher than control rats (p<0.05). At 6 weeks, all exercise groups had significantly lower AUC-IVGTT values than diabetic control animals (p<0.05). Treadmill trained rats had the lowest insulin dose requirement of the T1DM rats and the greatest reduction in insulin dosage was evident in high intensity treadmill exercise. Concomitant with improvements in glucose handling improvements, tissue-specific elevations in GLUT4 content were demonstrated in both red and white portions of vastus lateralis and gastrocnemius muscles, suggesting that glucose handling capacity was altered in the skeletal muscle of exercised T1DM rats. These results suggest that, while all exercise modalities can improve glucose tolerance, each mode leads to differential improvements in insulin requirements and protein content alterations. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of a pre-exercise hydrocortisone dose on short-term physical performance in female patients with primary adrenal failure.

PubMed

Simunkova, Katerina; Jovanovic, Nevena; Rostrup, Espen; Methlie, Paal; Øksnes, Marianne; Nilsen, Roy Miodini; Hennø, Hanne; Tilseth, Mira; Godang, Kristin; Kovac, Ana; Løvås, Kristian; Husebye, Eystein S

2016-01-01

Many patients with primary adrenal insufficiency (Addison's disease) take extra doses of glucocorticoids during stressful events, but a benefit has not been demonstrated in controlled trials. Here, we investigated the effects of a pre-exercise hydrocortisone dose on cardiorespiratory, hormonal and metabolic parameters in response to short-term strenuous physical activity. This was a randomized placebo-controlled, two-week cross-over clinical trial. Ten women with Addison's disease and 10 age-matched healthy females participated in the study. All women in the study underwent maximal incremental exercise testing. A stress dose of 10 mg hydrocortisone or placebo was given 1 h prior to exercise on two occasions. Blood samples were drawn before, and 0, 15 and 30 min post exercise. Oxygen uptake, maximal aerobic capacity, endocrine and metabolic responses to physical activity, as well as health status by questionnaires were evaluated. Maximal aerobic capacity and duration of exercise were significantly lower in patients than in healthy subjects and did not improve with the treatment. After an extra hydrocortisone dose serum cortisol was significantly higher than in the healthy subjects (P<0.001). Post-exercise glucose and adrenaline levels were significantly lower and free fatty acids insignificantly higher in patients irrespective of stress dose. Stress dosing did not alter other metabolic or hormonal parameters or quality of life after the exercise. The patients did not benefit from an extra dose of hydrocortisone in short strenuous exercise. Stress dosing may not be justified in this setting. Whether stress dosing is beneficial in other types of physical activity will have to be examined further. © 2016 European Society of Endocrinology.

The Positive Effects of Priming Exercise on Oxygen Uptake Kinetics and High-Intensity Exercise Performance Are Not Magnified by a Fast-Start Pacing Strategy in Trained Cyclists

PubMed Central

Caritá, Renato Aparecido Corrêa; Greco, Camila Coelho; Denadai, Benedito Sérgio

2014-01-01

The purpose of this study was to determine both the independent and additive effects of prior heavy-intensity exercise and pacing strategies on the VO2 kinetics and performance during high-intensity exercise. Fourteen endurance cyclists (VO2max  = 62.8±8.5 mL.kg−1.min−1) volunteered to participate in the present study with the following protocols: 1) incremental test to determine lactate threshold and VO2max; 2) four maximal constant-load tests to estimate critical power; 3) six bouts of exercise, using a fast-start (FS), even-start (ES) or slow-start (SS) pacing strategy, with and without a preceding heavy-intensity exercise session (i.e., 90% critical power). In all conditions, the subjects completed an all-out sprint during the final 60 s of the test as a measure of the performance. For the control condition, the mean response time was significantly shorter (p<0.001) for FS (27±4 s) than for ES (32±5 s) and SS (32±6 s). After the prior exercise, the mean response time was not significantly different among the paced conditions (FS = 24±5 s; ES = 25±5 s; SS = 26±5 s). The end-sprint performance (i.e., mean power output) was only improved (∼3.2%, p<0.01) by prior exercise. Thus, in trained endurance cyclists, an FS pacing strategy does not magnify the positive effects of priming exercise on the overall VO2 kinetics and short-term high-intensity performance. PMID:24740278

The Effect of Krill Oil Supplementation on Exercise Performance and Markers of Immune Function

PubMed Central

Da Boit, Mariasole; Mastalurova, Ina; Brazaite, Goda; McGovern, Niall; Thompson, Keith; Gray, Stuart Robert

2015-01-01

Background Krill oil is a rich source of the long-chain n-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which may alter immune function after exercise. The aim of the study was to determine the effects of krill oil supplementation on post exercise immune function and performance. Methods Nineteen males and 18 females (age: 25.8 ± 5.3 years; mean ± S.D.) were randomly assigned to 2 g/day of krill oil (n = 18) or placebo (n = 19) supplementation for 6 weeks. A maximal incremental exercise test and cycling time trial (time to complete set amount of work) were performed pre-supplementation with the time trial repeated post-supplementation. Blood samples collected pre- and post- supplementation at rest, and immediately, 1 and 3h post-exercise. Plasma IL-6 and thiobarbituric acid reactive substances (TBARS) concentrations and, erythrocyte fatty acid composition were measured. Natural killer (NK) cell cytotoxic activity and peripheral blood mononuclear cell (PBMC) IL-2, IL-4, IL-10, IL-17 and IFNγ production were also measured. Results No effects of gender were noted for any variable. PBMC IL-2 and NK cell cytotoxic activity were greater (P < 0.05) 3h post exercise in the krill oil compared to the control group. Plasma IL-6 and TBARS, PBMC IL-4, IL-10, IL-17 and IFNγ production, along with performance and physiological measures during exercise, were not different between groups. Conclusion Six weeks of krill oil supplementation can increase PBMC IL-2 production and NK cell cytotoxic activity 3h post-exercise in both healthy young males and females. Krill oil does not modify exercise performance. PMID:26407095

Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition.

PubMed

Simões, Herbert Gustavo; Asano, Ricardo Yukio; Sales, Marcelo Magalhães; Browne, Rodrigo Alberto Vieira; Arsa, Gisela; Motta-Santos, Daisy; Puga, Guilherme Morais; Lima, Laila Cândida de Jesus; Campbell, Carmen Sílvia Grubert; Franco, Octavio Luiz

2013-01-01

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

Type 2 Diabetes Elicits Lower Nitric Oxide, Bradykinin Concentration and Kallikrein Activity Together with Higher DesArg9-BK and Reduced Post-Exercise Hypotension Compared to Non-Diabetic Condition

PubMed Central

Browne, Rodrigo Alberto Vieira; Arsa, Gisela; Motta-Santos, Daisy; Puga, Guilherme Morais; Lima, Laila Cândida de Jesus; Campbell, Carmen Sílvia Grubert; Franco, Octavio Luiz

2013-01-01

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg9-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg9-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg9-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg9-BK production and reduced PEH in relation to ND participants after a single exercise session. PMID:24265812

Association between exercise intensity and renal blood flow evaluated using ultrasound echo.

PubMed

Kawakami, Shotaro; Yasuno, Tetsuhiko; Matsuda, Takuro; Fujimi, Kanta; Ito, Ai; Yoshimura, Saki; Uehara, Yoshinari; Tanaka, Hiroaki; Saito, Takao; Higaki, Yasuki

2018-03-10

High-intensity exercise reduces renal blood flow (RBF) and may transiently exacerbate renal dysfunction. RBF has previously been measured invasively by administration of an indicator material; however, non-invasive measurement is now possible with technological innovations. This study examined variations in RBF at different exercise intensities using ultrasound echo. Eight healthy men with normal renal function (eGFR cys 114 ± 19 mL/min/1.73 m 2 ) participated in this study. Using a bicycle ergometer, participants underwent an incremental exercise test using a ramp protocol (20 W/min) until exhaustion in Study 1 and the lactate acid breaking point (LaBP) was calculated. Participants underwent a multi-stage test at exercise intensities of 60, 80, 100, 120, and 140% LaBP in Study 2. RBF was measured by ultrasound echo at rest and 5 min after exercise in Study 1 and at rest and immediately after each exercise in Study 2. To determine the mechanisms behind RBF decline, a catheter was placed into the antecubital vein to study vasoconstriction dynamics. RBF after maximum exercise decreased by 51% in Study 1. In Study 2, RBF showed no significant decrease until 80% LaBP, and showed a significant decrease (31%) at 100% LaBP compared with at rest (p < 0.01). The sympathetic nervous system may be involved in this reduction in RBF. RBF showed no significant decrease until 80% LaBP, and decreased with an increase in blood lactate. Reduction in RBF with exercise above the intensity at LaBP was due to decreased cross-sectional area rather than time-averaged flow velocity.

Resistance Exercise in Already-Active Diabetic Individuals (READI): study rationale, design and methods for a randomized controlled trial of resistance and aerobic exercise in type 1 diabetes.

PubMed

Yardley, Jane E; Kenny, Glen P; Perkins, Bruce A; Riddell, Michael C; Goldfield, Gary S; Donovan, Lois; Hadjiyannakis, Stasia; Wells, George A; Phillips, Penny; Sigal, Ronald J

2015-03-01

The Resistance Exercise in Already Active Diabetic Individuals (READI) trial aimed to examine whether adding a 6-month resistance training program would improve glycemic control (as reflected in reduced HbA₁c) in individuals with type 1 diabetes who were already engaged in aerobic exercise compared to aerobic training alone. After a 5-week run-in period including optimization of diabetes care and low-intensity exercise, 131 physically active adults with type 1 diabetes were randomized to two groups for 22weeks: resistance training three times weekly, or waiting-list control. Both groups maintained the same volume, duration and intensity of aerobic exercise throughout the study as they did at baseline. HbA₁c, body composition, frequency of hypoglycemia, lipids, blood pressure, apolipoproteins B and A-1 (ApoB and ApoA1), the ApoB-ApoA1 ratio, urinary albumin excretion, serum C-reactive protein, free fatty acids, total daily insulin dose, health-related quality of life, cardiorespiratory fitness and musculoskeletal fitness were recorded at baseline, 3 (for some variables), and 6 months. To our knowledge, READI is the only trial to date assessing the incremental health-related impact of adding resistance training for individuals with type 1 diabetes who are already aerobically active. Few exercise trials have been completed in this population, and even fewer have assessed resistance exercise. With recent improvements in the quality of diabetes care, the READI study will provide conclusive evidence to support or refute a major clinically relevant effect of exercise type in the recommendations for physical activity in patients with type 1 diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.